Developing Twenty-First Century Competencies through the Arts: A Case Study of A High Performing Secondary School Band in Singapore

ERIC Educational Resources Information Center

Tan, Leonard

2017-01-01

The purpose of this study was to examine the development of "21st Century Competencies" (21CC) through the secondary school band programme. The researcher used ethnographic research methods to document the lived musical experiences of students from a high performing secondary school band in Singapore, captured the voices of the…

Gender Differences in Mathematics Achievement and Retention Scores: A Case of Problem-Based Learning Method

ERIC Educational Resources Information Center

Ajai, John T.; Imoko, Benjamin I.

2015-01-01

This study was undertaken to assess gender differences in mathematics achievement and retention by using Problem-Based Learning (PBL). The design of the study was pre-posttest quasi-experimental. Four hundred and twenty eight senior secondary one (SS I) students using multistage sampling from ten grant-aided and government schools were involved in…

Social and Emotional Components of Book Reading between Caregivers and Their Toddlers in a High-Risk Sample

ERIC Educational Resources Information Center

Cross, Jennifer Riedl; Fletcher, Kathryn L.; Speirs Neumeister, Kristie L.

2011-01-01

In this collective case study of caregiver behaviors with their toddlers, two-minute videotaped reading interactions were analyzed using a constant comparative method. Twenty-four caregiver-toddler dyads from a high-risk sample of children prenatally exposed to cocaine were selected from a larger sample because they represented the extremes of…

Active case finding of tuberculosis: historical perspective and future prospects

PubMed Central

Golub, J. E.; Mohan, C. I.; Comstock, G. W.; Chaisson, R. E.

2015-01-01

SUMMARY Despite a history of remarkable scientific achievements in microbiology and therapeutics, tuberculosis (TB) continues to pose an extraordinary threat to human health. Case finding and treatment of TB disease are the principal means of controlling transmission and reducing incidence. This review presents a historical perspective of active case finding (ACF) of TB, detailing case detection strategies that have been used over the last century. This review is divided into the following sections: mass radiography, house-to-house surveys, out-patient case detection, enhanced case finding, high-risk populations and cost-effectiveness. The report concludes with a discussion and recommendations for future case finding strategies. Understanding the strengths and weaknesses of these methods will help inform and shape ACF as a TB control policy in the twenty-first century. PMID:16333924

Twenty Years On!: Updating the IEA BESTEST Building Thermal Fabric Test Cases for ASHRAE Standard 140

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

Judkoff, R.; Neymark, J.

2013-07-01

ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs applies the IEA BESTEST building thermal fabric test cases and example simulation results originally published in 1995. These software accuracy test cases and their example simulation results, which comprise the first test suite adapted for the initial 2001 version of Standard 140, are approaching their 20th anniversary. In response to the evolution of the state of the art in building thermal fabric modeling since the test cases and example simulation results were developed, work is commencing to update the normative test specification and themore » informative example results.« less

Twenty Years On!: Updating the IEA BESTEST Building Thermal Fabric Test Cases for ASHRAE Standard 140: Preprint

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

Judkoff, R.; Neymark, J.

2013-07-01

ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs applies the IEA BESTEST building thermal fabric test cases and example simulation results originally published in 1995. These software accuracy test cases and their example simulation results, which comprise the first test suite adapted for the initial 2001 version of Standard 140, are approaching their 20th anniversary. In response to the evolution of the state of the art in building thermal fabric modeling since the test cases and example simulation results were developed, work is commencing to update the normative test specification and themore » informative example results.« less

Long-term outcomes in primary spinal osteochondroma: a multicenter study of 27 patients

PubMed Central

Sciubba, Daniel M.; Macki, Mohamed; Bydon, Mohamad; Germscheid, Niccole M.; Wolinsky, Jean-Paul; Boriani, Stefano; Bettegowda, Chetan; Chou, Dean; Luzzati, Alessandro; Reynolds, Jeremy J.; Szövérfi, Zsolt; Zadnik, Patti; Rhines, Laurence D.; Gokaslan, Ziya L.; Fisher, Charles G.; Varga, Peter Paul

2016-01-01

OBJECT Clinical outcomes in patients with primary spinal osteochondromas are limited to small series and sporadic case reports. The authors present data on the first long-term investigation of spinal osteochondroma cases. METHODS An international, multicenter ambispective study on primary spinal osteochondroma was performed. Patients were included if they were diagnosed with an osteochondroma of the spine and received surgical treatment between October 1996 and June 2012 with at least 1 follow-up. Perioperative prognostic variables, including patient age, tumor size, spinal level, and resection, were analyzed in reference to long-term local recurrence and survival. Tumor resections were compared using Enneking appropriate (EA) or Enneking inappropriate surgical margins. RESULTS Osteochondromas were diagnosed in 27 patients at an average age of 37 years. Twenty-two lesions were found in the mobile spine (cervical, thoracic, or lumbar) and 5 in the fixed spine (sacrum). Twenty-three cases (88%) were benign tumors (Enneking tumor Stages 1–3), whereas 3 (12%) exhibited malignant changes (Enneking tumor Stages IA–IIB). Sixteen patients (62%) underwent en bloc treatment—that is, wide or marginal resection—and 10 (38%) underwent intralesional resection. Twenty-four operations (92%) followed EA margins. No one received adjuvant therapy. Two patients (8%) experienced recurrences: one in the fixed spine and one in the mobile spine. Both recurrences occurred in latent Stage 1 tumors following en bloc resection. No osteochondroma-related deaths were observed. CONCLUSIONS In the present study, most patients underwent en bloc resection and were treated as EA cases. Both recurrences occurred in the Stage 1 tumor cohort. Therefore, although benign in character, osteochondromas still require careful management and thorough follow-up. PMID:25793467

[Treatment of complex scapular body fractures by locking reconstructive plates].

PubMed

Zhang, Jun-wei; Hou, Jin-yong; Yang, Mao-qing

2011-03-01

To investigate the method and effect of treatment of complex scapular body fractures by locking reconstructive plate through modified posterior approach. From August 2005 to November 2009, 27 patients with complex scapula body fractures were treated by locking reconstruction bone plate fixation,including 19 males and 8 females with an average age of 36 years old ranging from 16 to 64 years. The time after injury was 0.5 hours to 11 days (averaged 3 days). Of all the patients, 9 cases were associated with ipsilateral clavicle fracture, 2 cases were associated with acromioclavicular joint dislocation,16 cases were associated with multiple rib fractures, 1 case were associated with humeral shaft fractures, 5 cases were associated with pleural effusion, atelectasis, lung contusion etc. After operating,shoulder functional recovery were followed up. Twenty-four patients were followed up from 2 to 35 months with an average of 19 months. According to Hardegger shoulder function,the results were excellent in 15 cases, good in 7 cases, general in 2 cases. This method had the advantage of less trauma and clear exposure, firm and reliable fixation, and early activities.

Acute Effects of a Therapeutic Mobility Device on Physical Activity and Heart Rate in Children with Down Syndrome

ERIC Educational Resources Information Center

Hauck, Janet L.; Ulrich, Dale A.

2015-01-01

Purpose: The purpose of this feasibility study was to provide an opportunity to increase physical activity (PA) and heart rate (HR) for children with Down syndrome (DS) during unstructured group exercise utilizing a riding device called the Power Pumper®. Method: Twenty-four children aged 5 to 7 years old participated in this case-control study,…

Dedifferentiated chondrosarcoma: Radiological features, prognostic factors and survival statistics in 23 patients

PubMed Central

Liu, Chenglei; Xi, Yan; Li, Mei; Jiao, Qiong; Zhang, Huizhen; Yang, Qingcheng; Yao, Weiwu

2017-01-01

Background Dedifferentiated chondrosarcoma is a rare, highly malignant tumor with a poor survival. There are many confusing issues concerning the imaging feature that can facilitate early diagnosis and the factors that might be related to outcomes. Methods Twenty-three patients with dedifferentiated chondrosarcoma confirmed by pathology were retrospectively reviewed from 2008 to 2015. The patients’ clinical information, images from radiographs (n = 17), CT (n = 19), and MRI (n = 17), histological features, treatment and prognosis were analyzed. Results There were 12 males and 11 females, and the mean age was 50.39 years old. Fourteen cases affected the axial bone (pelvis, spine), and 9 cases involved the appendicular bone. Seven (41.17%), 9 (47.36), and 12 (66.66%) lesions showed a biphasic nature on radiograph, CT and MRI, respectively. Of the lesions, 17.39% (4/23) were accompanied by pathological fractures. Histologically, the cartilage component was considered histological Grade1 in 12 patients and Grade 2 in 11 patients. The dedifferentiated component showed features of osteosarcoma in 8 cases, malignant fibrous histiocytoma in3 cases, myofibroblastic sarcoma in 1 case and spindle cell sarcoma in 11cases. Twenty-two cases were treated with surgical resection, and 17 cases achieved adequate (wide or radical) surgical margin. In 8 cases, surgery was combined with adjuvant chemotherapy. The overall median survival time was nine months; 17.4% of patients survived to five years. Conclusion Axial bone location, lung metastasis at diagnosis, inadequate surgical margin, incorrect diagnosis before surgery and pathological fractures was related to poorer outcome. Pre- or postoperative chemotherapy had no definitively effect on improved survival. PMID:28301537

Leadership for Twenty-First-Century Schools and Student Achievement: Lessons Learned from Three Exemplary Cases

ERIC Educational Resources Information Center

Schrum, Lynne; Levin, Barbara B.

2013-01-01

The purpose of this research was to understand ways exemplary award winning secondary school leaders have transformed their schools for twenty-first-century education and student achievement. This article presents three diverse case studies and identifies ways that each school's leader and leadership team reconfigured its culture and expectations,…

Diffusion via space discretization method to study the concentration dependence of self-diffusivity under confinement

NASA Astrophysics Data System (ADS)

Sant, Marco; Papadopoulos, George K.; Theodorou, Doros N.

2010-04-01

The concentration dependence of self-diffusivity is investigated by means of a novel method, extending our previously developed second-order Markov process model to periodic media. Introducing the concept of minimum-crossing surface, we obtain a unique decomposition of the self-diffusion coefficient into two parameters with specific physical meanings. Two case studies showing a maximum in self-diffusivity as a function of concentration are investigated, along with two cases where such a maximum cannot be present. Subsequently, the method is applied to the large cavity pore network of the ITQ-1 (Mobil tWenty tWo, MWW) zeolite for methane (displaying a maximum in self-diffusivity) and carbon dioxide (no maximum), explaining the diffusivity trend on the basis of the evolution of the model parameters as a function of concentration.

A prospective clinical study to evaluate the safety and performance of wireless localization of nonpalpable breast lesions using radiofrequency identification technology.

PubMed

Dauphine, Christine; Reicher, Joshua J; Reicher, Murray A; Gondusky, Christina; Khalkhali, Iraj; Kim, Michelle

2015-06-01

The purpose of this study was to evaluate the safety and performance of localizing nonpalpable breast lesions using radiofrequency identification technology. Twenty consecutive women requiring preoperative localization of a breast lesion were recruited. Subjects underwent placement of both a hook wire and a radiofrequency identification tag immediately before surgery. The radiofrequency identification tag was the primary method used by the operating surgeon to localize each lesion during excision, with the hook wire serving as backup in case of tag migration or failed localization. Successful localization with removal of the intended lesion was the primary outcome measured. Tag migration and postoperative infection were also noted to assess safety. Twenty patients underwent placement of a radiofrequency identification tag, 12 under ultrasound guidance and eight with stereotactic guidance. In all cases, the radiofrequency identification tag was successfully localized by the reader at the level of the skin before incision, and the intended lesion was removed along with the radiofrequency identification tag. There were no localization failures and no postoperative infections. Tag migration did not occur before incision, but in three cases, occurred as the lesion was being retracted with fingers to make the final cut along the deep surface of the specimen. In this initial clinical study, radiofrequency tags were safe and able to successfully localize nonpalpable breast lesions. Radiofrequency identification technology may represent an alternative method to hook wire localization.

Psoriasis and Diabetes Millitus.

PubMed

Sundharam, J A; Singh, Ratan; Agarwal, P S

1980-01-01

Twenty uncomplicated cases of psoriasis and an equal number of matched controls were evaluated using the oral and steroid primed glucose tolerance test. Six of the twenty psoriatics (30%) studied showed an abnormal glucose tolerancewhereas only one of the twenty control subjects (5 %) showed abnormality (p < 0.05). A relationship was found between abnormal glucose tolerance and surface area involved by psoriasis.

Post legalisation challenge: minimizing complications of abortion.

PubMed

Ojha, N; Sharma, S; Paudel, J

2004-01-01

Abortion has been legalized in Nepal since September 2002 by 11th amendment to the Muluki Ain. The present study was conducted in Paropakar Shree Panch Indra Rajya Laxmi Devi Maternity Hospital to assess the magnitude of induced abortion, its causes and the types of complications, in the post legalization phase. Prospective descriptive analyses of the patients who were admitted with history of induced abortion from 16th Dec 2003 to 13th March 2004 was carried out. A total of 305 cases of abortion complications were admitted during the three-month study period, which is 39.7% of the total gynaecological admissions (768). Of these 31 (10.25%) patients had history of induced abortion. Half of the induced abortion cases (52%) were of age group 21-29 yrs and 42% had three or more children. 39% of the cases had history of induced abortion at more than 12 weeks and almost half of the cases (48%) had history of family planning. The most common reason for seeking abortion was too many children (59%) followed by illegitimate pregnancy (16%). Twenty-one patients gave history of abortion being performed by doctors and the most common method used was D and C (75%). 77% of cases presented as incomplete abortion and one case presented with uterine perforation, bowel injury and peritonitis. Twenty patients had evacuation under sedation while five had manual vacuum aspiration (MVA); one patient required laparatomy. In two third of the patients intravenous fluid and antibiotics were used. Four patients required blood transfusion. Abortion complications constitute almost 40% of the total gynaecological admissions. Ten percent of the abortion cases had history of induced abortion. Medical persons, mainly doctors, performed most of the cases of induced abortion and D and C was the most commonly used method. However the patients had faced various types of complications. Untrained provider, resulting in serious life threatening injuries, performed more than a third of the cases of induced abortion at more than twelve weeks gestation. This points to the need for improved monitoring of the quality of services provided, and adherence to the criteria set by the procedural order.

Usability Testing and Redesign of Library Web Pages at Lund University, Faculty of Engineering: A Case Study Applying a Two-Phase, Systematic Quality Approach

ERIC Educational Resources Information Center

Persson, Ann-Christin; Langh, Maria; Nilsson, Jessica

2010-01-01

Introduction: The Lund University Faculty of Engineering's LibQual+[R] survey 2007 showed that students and faculty had difficulties finding the information they needed at the libraries' Websites. To be able to improve the Websites, we needed to find out how the users navigated the Websites, as well as what content they needed. Method: Twenty-four…

[Long-term experience with multidisciplinary therapy of twenty-six patients with dermatofibrosarcoma protuberans].

PubMed

Mátrai, Zoltán; Liszkay, Gabriella; Plotár, Vanda; Orosz, Zsolt; Székely, Judit; Hitre, Erika; Bartal, Alexandra; Langmár, Zoltán; Bocs, Katalin; Rényi Vámos, Ferenc; Sávolt, Akos; Tóth, László

2009-10-11

Dermatofibrosarcoma protuberans is a low or moderate grade malignant, uncommon soft tissue tumor. The tumor is characterized by slow, but locally aggressive growth, low metastatic potential and high recurrence rate. Initial treatment is the radical surgical excision, using traditional wide excision or Mohs surgery. In case of positive surgical margin or local recurrence, radio-chemotherapy and recently imatinib mesylate is used as adjuvant therapy. Twenty-six patients treated multidisciplinary for dermatofibrosarcoma protuberans were followed up. Mean age of the patients was 44.7 years; mean follow-up time was 60.57 months. In fifteen cases (57.7%) R0 resection was performed, while eleven patients (42,3%) received only R1 resection. An average of 1.87 resections was necessary in order to achieve R0 resection. Six patients (23%) received adjuvant radiotherapy and two patients (7.6%) adjuvant chemotherapy following the removal of the primary tumor. Sixteen patients had no local recurrence. Ongoing treatments were needed in the case of ten patients (38.4%) who developed local recurrence. One patient has deceased due to distant metastases. Using statistical methods we examined the effects indicated as prognostic factors in the literature on local recurrence, precisely, the effect of age above 50 years and surgical radicalism. Dermatofibrosarcoma protuberans can be successfully treated with multidisciplinary therapy. A larger number of cases and randomized multicenter investigations are needed in order to reach more accurate conclusion.

Statistical physics of hard combinatorial optimization: Vertex cover problem

NASA Astrophysics Data System (ADS)

Zhao, Jin-Hua; Zhou, Hai-Jun

2014-07-01

Typical-case computation complexity is a research topic at the boundary of computer science, applied mathematics, and statistical physics. In the last twenty years, the replica-symmetry-breaking mean field theory of spin glasses and the associated message-passing algorithms have greatly deepened our understanding of typical-case computation complexity. In this paper, we use the vertex cover problem, a basic nondeterministic-polynomial (NP)-complete combinatorial optimization problem of wide application, as an example to introduce the statistical physical methods and algorithms. We do not go into the technical details but emphasize mainly the intuitive physical meanings of the message-passing equations. A nonfamiliar reader shall be able to understand to a large extent the physics behind the mean field approaches and to adjust the mean field methods in solving other optimization problems.

A new multiplex real-time polymerase chain reaction assay for the diagnosis of periprosthetic joint infection.

PubMed

Kawamura, Masaki; Kobayashi, Naomi; Inaba, Yutaka; Choe, Hyonmin; Tezuka, Taro; Kubota, So; Saito, Tomoyuki

2017-11-01

A new multiplex real-time polymerase chain reaction (PCR) assay was developed to detect methicillin-resistant Staphylococcus (MRS) and to distinguish between gram-positive and gram-negative bacteria. In this study, we validated the sensitivity and specificity of this assay with periprosthetic joint infections (PJIs) and evaluated the utility of PCR for culture-negative PJI. Forty-five samples from 23 infectious PJI cases and 106 samples from 64 non-infectious control cases were analyzed by real-time PCR using a LightCycler Nano ® system. Twenty-eight clinical samples, comprising bacteria of known species isolated consecutively in the microbiological laboratory of our hospital, were used to determine the spectrum of bacterial species that could be detected using the new multiplex primers and probes. The sensitivity and specificity of the MRS- and universal-PCR assays were 92% and 99%, and 91% and 88%, respectively. Twenty-eight species of clinically isolated bacteria were detected using this method and the concordance rate for the identification of gram-positive or gram-negative organisms was 96%. Eight samples were identified as PCR-positive despite a culture-negative result. This novel multiplex real-time PCR system has acceptable sensitivity and specificity and several advantages; therefore, it has potential use for the diagnosis of PJIs, particularly in culture-negative cases.

Results of miconazole therapy in twenty-eight patients with paracoccidioidomycosis (South American blastomycosis).

PubMed Central

Negroni, R; Rubinstein, P; Herrmann, A; Gimenez, A

1977-01-01

Results are presented of treatment with miconazole, orally and intravenously, in patients with paracoccidioidomycosis. Twenty-eight male patients aged from 34 to 66 years and exhibiting various clinical forms of the disease were studied. Twenty-five came from endemic areas in north east Argentina (Chaco, Formosa, Misiones, Corrientes and northern Santa Fe) and the remaining three from Paraguay. Twenty patients were engaged in agricultural work or at woodmills. single or multiple lesions were observed in 24 cases. Thirteen were suffering from infection of the larynx and in two of them a tracheotomy was necessary. Twenty-three showed pulmonary lesions on X-rays. Twelve had ganglionic lesions, eight had cutaneous lesions and one patient had osteoarthritis of the knee. One patient had hepatomegaly which was unrelated to chronic alcoholism. Fourteen patients had received previous treatments such as sulphonamides and amphotericin B (7 cases); sulphonamides (3), sulphonamides and the combination sulfamethoxazole + trimethoprim (3), and one patient had received all three medications. All patients had relapsed before starting miconazole therapy. Diagnosis was established by the presence of P. brasiliensis in all cases, recovered either from cutaneous or mucosal biopsy samples or from the sputum. Complement fixation tests were positive in all patients at the onset of the treatment and the immunodiffusion reactions showed precipitation bands in 27/28 patients. Skin tests with P. brasiliensis antigens proved to be positive in 18 cases and negative in 10. The erythrocyte sedimentation rate was markedly accelerated in 22 patients (greater than 20 mm in the first hour).(ABSTRACT TRUNCATED AT 250 WORDS) Images p24-a Fig 1 Fig 2 PMID:122643

House Dust Mite Prevalence in the House of Patients with Atopic Dermatitis in Mashhad, Iran

PubMed Central

Ziyaei, Toktam; Berenji, Fariba; Jabbari-Azad, Farahzad; Fata, Abdolmajid; Jarahi, Lida; Fereidouni, Mohammad

2017-01-01

Background: Being exposed to house dust mites intensifies atopic dermatitis. This study has investigated the contamination rate with Dermatophagoides mites in patient’s residential home with atopic dermatitis. Methods: In this cross-sectional study, 40 patients took part with atopic dermatitis (positive or negative for mites by prick Dermal Test). Samples were collected from 3 locations (living room, bedroom and bed) by vacuum cleaner. Dust samples (transferred to freezer −20 °C) were examined by direct method and flotation. The data were analyzed using statistical SPSS vr.20 software. Results: Twenty patients of positive prick test included 8 (40%) male and 12 (60%) female. The results of direct observation of mites: 7 cases (35%) in bedding sheets, 6 cases (30%) bedrooms’ carpet, 3 cases (15%) living room’s carpet. Twenty patients of negative prick test included 8 (40%) male and 12 (60%) female. Only mites were found (5%) in living room’s carpets of negative prick test patients. Dermatophagoides pteronyssinus was more frequent than Dermatophagoides farinae. (98% vs 83%). Conclusion: Fifty-five percent of residential homes of prick test positive patients and only 5% of residential homes of prick test negative patients were positive for mite. Sunshine provided home had fewer mites than home where sunshine is not provided. Prick test positive patients used handmade carpets more than machine made ones. In positive prick test patients, mites were found in bed sheet and bedroom’s carpet more than negative prick test patient’s sheets and carpets. PMID:29062855

Long-term follow-up of corticosteroid injection for traumatic olecranon bursitis.

PubMed Central

Weinstein, P S; Canoso, J J; Wohlgethan, J R

1984-01-01

Forty-seven patients with traumatic olecranon bursitis were evaluated after a mean follow-up of 31 months (range 6 to 62 months). Twenty-two patients treated with bursal aspiration had delayed recovery and no complications of therapy. Twenty-five patients treated with intrabursal injection of 20 mg of triamcinolone hexacetonide had rapid recovery, usually within one week, but suffered complications such as infection (3 cases), skin atrophy (5 cases), and chronic local pain (7 cases). Since spontaneous resolution can be expected, a conservative approach is suggested in the treatment of traumatic olecranon bursitis. Images PMID:6696516

The Kepler Mission: Search for Habitable Planets

NASA Technical Reports Server (NTRS)

Borucki, William; Likins, B.; DeVincenzi, Donald L. (Technical Monitor)

1998-01-01

Detecting extrasolar terrestrial planets orbiting main-sequence stars is of great interest and importance. Current ground-based methods are only capable of detecting objects about the size or mass of Jupiter or larger. The difficulties encountered with direct imaging of Earth-size planets from space are expected to be resolved in the next twenty years. Spacebased photometry of planetary transits is currently the only viable method for detection of terrestrial planets (30-600 times less massive than Jupiter). This method searches the extended solar neighborhood, providing a statistically large sample and the detailed characteristics of each individual case. A robust concept has been developed and proposed as a Discovery-class mission. Its capabilities and strengths are presented.

Evaluation of three different methods of distance learning for postgraduate diagnostic imaging education: A pilot study.

PubMed

Poirier, Jean-Nicolas; Cooley, Jeffrey R; Wessely, Michelle; Guebert, Gary M; Petrocco-Napuli, Kristina

2014-10-01

Objective : The purpose of this study was to evaluate the perceived effectiveness and learning potential of 3 Web-based educational methods in a postgraduate radiology setting. Methods : Three chiropractic radiology faculty from diverse geographic locations led mini-courses using asynchronous discussion boards, synchronous Web conferencing, and asynchronous voice-over case presentations formatted for Web viewing. At the conclusion of each course, participants filled out a 14-question survey (using a 5-point Likert scale) designed to evaluate the effectiveness of each method in achieving specified course objectives and goals and their satisfaction when considering the learning potential of each method. The mean, standard deviation, and percentage agreements were tabulated. Results : Twenty, 15, and 10 participants completed the discussion board, Web conferencing, and case presentation surveys, respectively. All educational methods demonstrated a high level of agreement regarding the course objective (total mean rating >4.1). The case presentations had the highest overall rating for achieving the course goals; however, all but one method still had total mean ratings >4.0 and overall agreement levels of 70%-100%. The strongest potential for interactive learning was found with Web conferencing and discussion boards, while case presentations rated very low in this regard. Conclusions : The perceived effectiveness in achieving the course objective and goals was high for each method. Residency-based distance education may be a beneficial adjunct to current methods of training, allowing for international collaboration. When considering all aspects tested, there does not appear to be a clear advantage to any one method. Utilizing various methods may be most appropriate.

Arthrodesis for failed knee arthroplasty. A report of 20 cases.

PubMed

Knutson, K; Lindstrand, A; Lidgren, L

1985-01-01

Twenty consecutive patients treated by arthrodesis for failed knee arthroplasty are reviewed. Eight hinged, five stabilised and seven compartmental prostheses were removed, for infection (15 cases), loosening (4) and instability (1). One patient refused a second-stage operation but the remainder gained sound fusion. Infected knees had a two-stage procedure with temporary insertion of gentamicin-loaded beads after removal of the prosthesis; all infections healed. Six arthrodeses using a Hoffmann-Vidal external fixator resulted in two temporary failures. One Ace-Fischer external fixation was successful. Of 10 primary attempts at arthrodesis with an intramedullary Küntscher nail, nine were successful; the tenth fused after two more attempts by the same method. The two failures of external fixation and two failures after Charnley single-frame compression done elsewhere were successfully fused with intramedullary nails. Delayed union in three cases fused after prolonged fixation and repeated bone grafts. The indications for and methods of arthrodesis after failed knee arthroplasty are discussed.

The role of digital tomosynthesis in reducing the number of equivocal breast reportings

NASA Astrophysics Data System (ADS)

Alakhras, Maram; Mello-Thoms, Claudia; Rickard, Mary; Bourne, Roger; Brennan, Patrick C.

2015-03-01

Purpose To compare radiologists' confidence in assessing breast cancer using combined digital mammography (DM) and digital breast tomosynthesis (DBT) compared with DM alone as a function of previous experience with DBT. Materials and Methods Institutional ethics approval was obtained. Twenty-three experienced breast radiologists reviewed 50 cases in two modes, DM alone and DM+DBT. Twenty-seven cases presented with breast cancer. Each radiologist was asked to detect breast lesions and give a confidence score of 1-5 (1- Normal, 2- Benign, 3- Equivocal, 4- Suspicious, 5- Malignant). Radiologists were divided into three sub-groups according to their prior experience with DBT (none, workshop experience, and clinical experience). Confidence scores using DM+DBT were compared with DM alone for all readers combined and for each DBT experience subgroup. Statistical analyses, using GraphPad Prism 5, were carried out using the Wilcoxon signed-rank test with statistical significance set at p< 0.05. Results Confidence scores were higher for true positive cancer cases using DM+DBT compared with DM alone for all readers (p < 0.0001). Confidence scores for normal cases were lower (indicating greater confidence in the non-cancer diagnosis) with DM+DBT compared with DM alone for all readers (p= 0.018) and readers with no prior DBT experience (p= 0.035). Conclusion Addition of DBT to DM increases the confidence level of radiologists in scoring cancer and normal/benign cases. This finding appears to apply across radiologists with varying levels of DBT experience, however further work involving greater numbers of radiologists is required.

Virtual Reality Therapy: case study of fear of public speaking.

PubMed

North, Max M; Schoeneman, Curt M; Mathis, James R

2002-01-01

The major goal of this research case study was to investigate the effectiveness of Virtual Reality Therapy (VRT) in the treatment of the fear of public speaking. A twenty-eight-year-old Caucasian male was selected from questionnaires distributed to a class of undergraduate students enrolled at Kennesaw State University. Two assessment measures were used in this study. The first measure used was the Attitude Towards Public Speaking (ATPS) Questionnaire. The second measure used was the eleven-point Subjective Units of Disturbance (SUD) scale. These measurements assessed the anxiety, avoidance, attitudes and disturbance associated with the subject's fear of public speaking before and after each VRT treatment session. This case study of public speaking fear indicates that VRT may be used as an effective treatment method for reducing self-reported anxiety.

[Duodenal and pancreatic injuries].

PubMed

De Angelis, P; Bergaminelli, C; Pastore, S; Giardiello, C; Salzano, A; Vecchio, G

2000-04-01

Pancreatic and duodenal injuries occur rather infrequently and the incidence ranges between 1% and 12% of all abdominal injuries. The high rate of mortality and morbidity (10-40%) depends on associated complication rate of all intra-abdominal organs (90%). Twenty-five cases of pancreatic and duodenal injuries observed between 1987 and 1997, with an incidence of 0.7% of all abdominal injuries, are reported. In 16 cases the cause was penetrating injury (gunshot) and in 9 cases it was blunt abdominal trauma. Only two patients presented an isolated pancreatic lesion, all the others had at least an associated lesion. In all the cases the patients were male and they were submitted to emergency laparotomy. The mortality rate was 20%, the morbidity was 24%. The relatively low incidence of these injuries and the high rate of associated lesions cause a difficult diagnostic and therapeutic approach, the absence of a unified method to follow and the unsatisfactory results observed.

Young Creative Producers: Twenty-Five Years Later

ERIC Educational Resources Information Center

Westberg, Karen L.

2010-01-01

This retrospective study examines the lives of students twenty-five years after they participated in an elementary gifted program based on The Revolving Door Identification Model (Renzulli, Reis, and Smith, 1981). The purpose of the multiple case-study research was to investigate the relationship between students' early interests and their…

Indiana's Twenty-First Century Scholars Program

ERIC Educational Resources Information Center

Wandel, Tamara L.

2004-01-01

This case study analyzes the impact of Indiana's Twenty-First Century Scholars college tuition discount program on the academic self-efficacy of high-risk, low-income students. The program is designed to increase the number of high-risk individuals attending college. The self-efficacy "training" of the program helps instill and reinforce the…

Transportation planning effectiveness: twenty case studies

DOT National Transportation Integrated Search

1977-12-31

This document consists of 20 site-specific case studies of urban area experience with the Technical Study Grant Program of the Urban Mass Transportation Administration (UMTA). The objective of the case studies is to determine how the Technical Study ...

A Kepler Mission, A Search for Habitable Planets: Concept, Capabilities and Strengths

NASA Technical Reports Server (NTRS)

Koch, David; Borucki, William; Lissauer, Jack; Dunham, Edward; Jenkins, Jon; DeVincenzi, D. (Technical Monitor)

1998-01-01

The detection of extrasolar terrestrial planets orbiting main-sequence stars is of great interest and importance. Current ground-based methods are only capable of detecting objects about the size or mass of Jupiter or larger. The technological challenges of direct imaging of Earth-size planets from space are expected to be resolved over the next twenty years. Spacebased photometry of planetary transits is currently the only viable method for detection of terrestrial planets (30-600 times less massive than Jupiter). The method searches the extended solar neighborhood, providing a statistically large sample and the detailed characteristics of each individual case. A robust concept has been developed and proposed as a Discovery-class mission. The concept, its capabilities and strengths are presented.

Hepatosplenic T-cell lymphoma in patients receiving TNF-α inhibitor therapy: expanding the groups at risk.

PubMed

Parakkal, Deepak; Sifuentes, Humberto; Semer, Rumi; Ehrenpreis, Eli Daniel

2011-11-01

Hepatosplenic T-cell lymphoma (HSTCL) is a rare, lethal disease generally seen in young male patients with inflammatory bowel disease. The study of biologic and immunomodulator naive patients in Crohn's disease (SONIC), advocates combining infliximab with an immunomodulator in moderate-to-severe Crohn's disease. Unfortunately, combined immunosuppression increases risk for HSTCL. We herein review all cases of HSTCL reported to the Food and Drug Administration (FDA) in patients receiving TNF-α inhibitors. Individual reports from the FDA Adverse Event Reporting System database for lymphomas from the biological agents - infliximab, adalimumab, certolizumab, natalizumab, and etanercept were downloaded and analyzed with Microsoft Access. Full reports for all identified HSTCL cases were obtained from the FDA. Twenty-five cases of HSTCL were identified. Twenty-two (88%) patients had inflammatory bowel disease and three had rheumatoid arthritis. Four cases (16%) were in women and four patients were above 65 years of age. Twenty-four cases (96%) also received an immunomodulator (azathioprine, 6-mercaptopurine, or methotrexate). Two patients received adalimumab alone. HSTCL is no longer restricted to the previously identified risk group of young male patients, but can also occur in patients with rheumatoid arthritis, females and older adults receiving TNF-α inhibitors and immunomodulators. Improved disease outcomes using combination therapy should be tempered by the risk of developing HSTCL.

OPTIMIZING USABILITY OF AN ECONOMIC DECISION SUPPORT TOOL: PROTOTYPE OF THE EQUIPT TOOL.

PubMed

Cheung, Kei Long; Hiligsmann, Mickaël; Präger, Maximilian; Jones, Teresa; Józwiak-Hagymásy, Judit; Muñoz, Celia; Lester-George, Adam; Pokhrel, Subhash; López-Nicolás, Ángel; Trapero-Bertran, Marta; Evers, Silvia M A A; de Vries, Hein

2018-01-01

Economic decision-support tools can provide valuable information for tobacco control stakeholders, but their usability may impact the adoption of such tools. This study aims to illustrate a mixed-method usability evaluation of an economic decision-support tool for tobacco control, using the EQUIPT ROI tool prototype as a case study. A cross-sectional mixed methods design was used, including a heuristic evaluation, a thinking aloud approach, and a questionnaire testing and exploring the usability of the Return of Investment tool. A total of sixty-six users evaluated the tool (thinking aloud) and completed the questionnaire. For the heuristic evaluation, four experts evaluated the interface. In total twenty-one percent of the respondents perceived good usability. A total of 118 usability problems were identified, from which twenty-six problems were categorized as most severe, indicating high priority to fix them before implementation. Combining user-based and expert-based evaluation methods is recommended as these were shown to identify unique usability problems. The evaluation provides input to optimize usability of a decision-support tool, and may serve as a vantage point for other developers to conduct usability evaluations to refine similar tools before wide-scale implementation. Such studies could reduce implementation gaps by optimizing usability, enhancing in turn the research impact of such interventions.

Paratrooper's Ankle Fracture: Posterior Malleolar Fracture

PubMed Central

Young, Ki Won; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai

2015-01-01

Background We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Methods Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. Results The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Conclusions Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to undergo surgical repairs. PMID:25729514

Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes.

PubMed

Zheng, Yingying; Zhou, Yiyi; Lai, Qiujia

2015-06-01

The aim of the current study was to observe the effects of Twenty-four Move Shadow Boxing combined with psychosomatic relaxation on depression and anxiety in patients with Type-2 Diabetes. One hundred and twenty (120) patients with Type-2 Diabetes and depressive/anxious symptoms were divided into intervention group (60 cases) and control group (60 cases) according to the minimum distribution principle of unbalanced indicators. Twenty-four Move Shadow Boxing group used this intervention combined with psychosomatic relaxation. Control group underwent conventional treatment. All the patients in the two groups completed the Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment. Among the 52 people included in the statistical analysis, the recovery rate was 13.3%. The differences between depression and anxiety scores in the intervention group before and after treatment were statistically significant (P<0.001), whereas these differences were non-significant in the control group (P=0.123). After the treatment, the glycated hemoglobin reduction in the intervention group was greater than that of the control group (t=2.438, P=0.016). The combination of Twenty-four Move Shadow Boxing and psychosomatic relaxation has a beneficial auxiliary therapeutic effect on depression and anxiety accompanying Type-2 Diabetes.

The Effect of Aquatic Exercise Therapy on Muscle Strength and Joint's Range of Motion in Hemophilia Patients.

PubMed

Kargarfard, Mehdi; Dehghadani, Mehdi; Ghias, Reza

2013-01-01

This study was to evaluate the effect of a period of aquatic exercise therapy on muscle strength and joints range of motion in hemophilia patients. This was a semiexperimental, pretest, post-test study with a control group. This semi-experimental study comprised twenty men suffering moderate hemophilia were selected by convenience sampling method from patients of a referral hospital. They were randomly assigned to intervention and control groups of equal number. The hemophilia patients who were referred to Sayedo-Shohada Hospital enrolled in this study. Twenty men suffering moderate hemophilia were selected using convenience sampling method and then divided randomly into intervention and control groups (10 patients in each group). Subjects of aquatic exercise therapy group underwent activity in water in three sessions (45-60 minutes) per week for 8 weeks, while the control group was only under follow-up and during this period did not experience any effective physical activity. The patients' muscle strength and joint range of motion were evaluated through standard laboratory tools, using an isokinetic dynamometer (Biodex, Systems III) and a standard goniometer in the beginning and at end of the study. Finally, data was analyzed using analysis of covariance (ANCOVA). The strength of the muscles around the knee joint (to perform extension and flexion movements) increased significantly in the case group while the control group experienced a significant reduction of strength in left leg, but in right leg remarkable change was observed. Range of motion in all joints was improved in the case group, while the control group did not improve significantly. The results showed that aquatic exercise therapy can be a useful method to improve joints' strength and range of motion in hemophilia patients in order to improve their daily functioning and quality of life.

Online Learning Community: A Case Study of Teacher Professional Development in Indonesia

ERIC Educational Resources Information Center

Sari, Eunice Ratna

2012-01-01

This paper investigates the concept of online learning community (OLC) to address the issues of teacher professional development practice in twenty-first-century Indonesia. Teachers in Indonesia are trained in a "conventional way", hence, not ready to prepare the younger generations for entrance into the twenty-first-century complex life…

Esophageal dilatation using the Eder Puestow dilators.

PubMed

Royston, C M; Dowling, B L; Gear, M W

1976-06-01

We have performed fifty-one dilatations in twenty-six patients using an end-viewing fiberoptic endoscope and Eder Puestow dilators. All (except two) were performed using intravenous diazepam, the majority on an outpatient basis. The only complication has been a single case of aspiration pneumonia. We have found this method of esophageal dilatation particularly useful in the preoperative dilatation of benign strictures, and in those elderly frail patients who are unsuitable for surgery. Transthoracic resection of the stricture is avoided and thus transabdominal repair of the hiatus hernia may be undertaken.

Serum homocysteine levels in cerebrovascular accidents.

PubMed

Zongte, Zolianthanga; Shaini, L; Debbarma, Asis; Singh, Th Bhimo; Devi, S Bilasini; Singh, W Gyaneshwar

2008-04-01

Hyperhomocysteinemia has been considered an independent risk factor in the development of stroke. The present study was undertaken to evaluate serum homocysteine levels in patients with cerebrovascular accidents among the Manipuri population and to compare with the normal cases. Ninety-three cerebrovascular accident cases admitted in the hospital were enrolled for the study and twenty-seven age and sex matched individuals free from cerebrovascular diseases were taken as control group. Serum homocysteine levels were estimated by ELISA method using Axis homocysteine EIA kit manufactured by Ranbaxy Diagnostic Ltd. India. The finding suggests that hyperhomocysteinemia is associated with cerebrovascular accident with male preponderance, which increases with advancing age. However, whether hyperhomocysteinemia is the cause or the result of cerebrovascular accidents needs further investigations.

Introduction to “Global tsunami science: Past and future, Volume I”

USGS Publications Warehouse

Geist, Eric L.; Fritz, Hermann; Rabinovich, Alexander B.; Tanioka, Yuichiro

2016-01-01

Twenty-five papers on the study of tsunamis are included in Volume I of the PAGEOPH topical issue “Global Tsunami Science: Past and Future”. Six papers examine various aspects of tsunami probability and uncertainty analysis related to hazard assessment. Three papers relate to deterministic hazard and risk assessment. Five more papers present new methods for tsunami warning and detection. Six papers describe new methods for modeling tsunami hydrodynamics. Two papers investigate tsunamis generated by non-seismic sources: landslides and meteorological disturbances. The final three papers describe important case studies of recent and historical events. Collectively, this volume highlights contemporary trends in global tsunami research, both fundamental and applied toward hazard assessment and mitigation.

Introduction to "Global Tsunami Science: Past and Future, Volume I"

NASA Astrophysics Data System (ADS)

Geist, Eric L.; Fritz, Hermann M.; Rabinovich, Alexander B.; Tanioka, Yuichiro

2016-12-01

Twenty-five papers on the study of tsunamis are included in Volume I of the PAGEOPH topical issue "Global Tsunami Science: Past and Future". Six papers examine various aspects of tsunami probability and uncertainty analysis related to hazard assessment. Three papers relate to deterministic hazard and risk assessment. Five more papers present new methods for tsunami warning and detection. Six papers describe new methods for modeling tsunami hydrodynamics. Two papers investigate tsunamis generated by non-seismic sources: landslides and meteorological disturbances. The final three papers describe important case studies of recent and historical events. Collectively, this volume highlights contemporary trends in global tsunami research, both fundamental and applied toward hazard assessment and mitigation.

Genetic analysis and antigenic characterization of swine origin influenza viruses isolated from humans in the United States, 1990-2010.

PubMed

Shu, Bo; Garten, Rebecca; Emery, Shannon; Balish, Amanda; Cooper, Lynn; Sessions, Wendy; Deyde, Varough; Smith, Catherine; Berman, LaShondra; Klimov, Alexander; Lindstrom, Stephen; Xu, Xiyan

2012-01-05

Swine influenza viruses (SIV) have been recognized as important pathogens for pigs and occasional human infections with swine origin influenza viruses (SOIV) have been reported. Between 1990 and 2010, a total of twenty seven human cases of SOIV infections have been identified in the United States. Six viruses isolated from 1990 to 1995 were recognized as classical SOIV (cSOIV) A(H1N1). After 1998, twenty-one SOIV recovered from human cases were characterized as triple reassortant (tr_SOIV) inheriting genes from classical swine, avian and human influenza viruses. Of those twenty-one tr_SOIV, thirteen were of A(H1N1), one of A(H1N2), and seven of A(H3N2) subtype. SOIV characterized were antigenically and genetically closely related to the subtypes of influenza viruses circulating in pigs but distinct from contemporary influenza viruses circulating in humans. The diversity of subtypes and genetic lineages in SOIV cases highlights the importance of continued surveillance at the animal-human interface. Copyright © 2011. Published by Elsevier Inc.

First sternocostal degenerative arthritis with intrarticular fluid collection. A case report.

PubMed

Chalazonitis, Athanasios N; Condilis, Nicolas; Tilentzoglou, Anastasia C; Pontikis, John; Tzovara, Joannie

2006-01-01

A rare case with clinical condition of first sternocostal degenerative arthritis with intra-articular fluid collection that developed after long-lasting intense exercise (weight-lifting) for twenty years is reported. Imaging findings and differential diagnoses of the case are presented.

Candida endophthalmitis after heroin abuse.

PubMed

Malecaze, F; Arne, J L; Bec, P; Séguéla, J P; Linas, M D; Recco, P; Béssières, M H

1985-11-01

Three cases of ocular candidosis involving heroin abusers have been observed in 1983 in Toulouse department of ophthalmology. These three patients had used iranian brown heroin. Twenty similar cases have been published in these last years. This new pathology can be explained on two reasons. The first is that the drug abusers have some immunity pertubation; however, immunity exploration in these patients does not reveal any immunodeficiency. The second reason, certainly more important, is the method of using heroin. The diagnosis of Candida endophthalmitis of course based on clinical context must be proved by biological tests. Candida albicans is never identified in aqueous humor. For this reason, it seems very interesting to detect anti-candida antibodies in aqueous humor. It has been used as methods of dosage laser Nephelemetry for IgG and immunofluorescence for candidosis antibodies. The criterion used is similar to the toxoplasmosis coefficient established by Desmonts (3). In two cases, this test was the only way that permits us to have certitude of candidosis ocular diagnosis. Otherwise the observations show that anterior chamber punction is more significant when there is an anterior uveitis.

A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis.

PubMed

Taylor, Graeme B; Paviour, Sue D; Musaad, Sahar; Jones, Wayne O; Holland, David J

2003-04-01

Granulomatous mastitis is a rare condition of unknown aetiology. The great majority of cases has not been associated with bacterial pathogens if women with mammary tuberculosis are excluded. We noted that some women in Auckland with a histological diagnosis of granulomatous mastitis had both microbiological and histological evidence of corynebacteria infection and aimed to study this further. Thirty-four women were reviewed who presented with inflammatory breast disease and had microbiological specimens from which corynebacteria were isolated and/or histological specimens containing coryneform bacteria. These 34 cases were compared with 28 controls with similar histology but no evidence of corynebacteria infection. Twenty-seven (79%) of the cases and 21 (75%) of the controls had histological and/or cytological evidence of suppurative granulomas. Fourteen of the 34 cases also had Gram-positive bacilli (GPB), recognisable as coryneform bacteria, in histological sections. In all cases the bacilli were confined to empty spaces, consistent with dissolved lipid, and were surrounded by neutrophils and, frequently, suppurative granulomas. Corynebacterium species were isolated from 52 of 116 microbiological specimens taken from the 34 cases. Forty of these 52 cultures were pure. Twenty-four of the cultures were further classified biochemically and using 16S rRNA gene sequencing. Twenty of the 24 were lipophilic Corynebacterium species and 14 were identified as Corynebacterium kroppenstedtii. The cases were more likely to present with fever or neutrophilia and more often formed sinuses than the controls but other clinical features were similar. Maori and Pacific Islanders accounted for 77% of the women across both groups. We suggest granulomatous mastitis can be associated with corynebacteria infection, particularly infection by C. kroppenstedtii. The significance of this finding, which has previously been described in only a single case report, is discussed.

A Singapore Case Study of Curriculum Innovation in the Twenty-First Century: Demands, Tensions and Deliberations

ERIC Educational Resources Information Center

Koh, Elizabeth; Ponnusamy, Letchmi Devi; Tan, Liang See; Lee, Shu-Shing; Ramos, Maria Eloisa

2014-01-01

With the ever-pressing twenty-first century demands, such as the need for new knowledge generation and application, schools today are aware of the necessity to change their structures, processes and practices to be relevant. In Singapore's centralized education system, the Ministry has introduced several decentralization initiatives in the hope of…

Mobile Experiences of an Adolescent Learning Spanish Online in a Twenty-First Century High School

ERIC Educational Resources Information Center

Tochon, Francois Victor

2015-01-01

This article focuses on a case analysis based on the experience of an adolescent having to further Spanish learning through the Spanish 3 (third year) distance course of a twenty-first century high school program. Autoethnographic reflections mediate the storyline of the experiential report, as conversations and observations are internalized by…

Faculty Perceptions about the Implementation of e-Learning in Thailand: An Analysis of Cultural Factors

ERIC Educational Resources Information Center

Trangratapit, Peerapat

2010-01-01

The purpose of this case study was to qualitatively examine how culture influenced faculty members' perception toward the implementation of e-learning in a university in Thailand. There were twenty-five faculty participants in this study who were purposefully selected from different disciplines. Four of twenty-five participants occupy the role of…

Wound infection after median sternotomy during the war in Croatia.

PubMed

Jelić, I; Anić, D; Alfirević, I; Kalinić, S; Ugljen, R; Letica, D; Ante Korda, Z; Vucemilo, I; Bulat, C; Predrijevac, M; Corić, V; Husar, J; Jelic, M; Hulina, D; Depina, I; Dadić, D

1996-12-01

From 1990 to 1994 at Clinical Hospital Center, Zagreb, 1904 median sternotomies were performed for cardiac operations. Patients shared the same intensive care unit (ICU) with the wounded persons, admitted to the hospital from battlefield. Infection developed in 124 patients, an incidence of 6.51%. Methicillin resistant Staphylococcus aureus (MRSA) was isolated from 90, methicillin resistant Staphylococcus epidermidis (MRSE) from 19, and gram negative bacilli (GNB) from 56 patients, Pseudomonas aeruginosa in 2, and Clostridium pneumoniae in 1 case. Ninety-six patients (5.04%) developed superficial localized infection of subcutaneous tissues and they were treated with frequent dressing changes with antibiotic-soaked gauze in combination with systemic antibiotics. Twenty-eight patients (1.47%) developed mediastinitis and sternal dehiscence. They were treated by operative debridement followed by reclosure of the sternum with continuous antibiotic irrigation. We obtained satisfactory results with our method of closure of sternum which is a modification of Robicsek's technique. Nine of them required further operation. In seven cases we performed muscle flaps and in two omentoplasty. One hundred and twenty patients were discharged in satisfactory condition. The uncontrolled mediastinal sepsis caused death in 4 patients. Higher infection rate after median sternotomy during 1991 and 1992 could be possibly explained with the war circumstances in Croatia, and especially with MRSA strain becoming endemic in surgical ICU.

Tuning up mind's pattern to nature's own idea: Eddington's early twenties case for variational derivatives

NASA Astrophysics Data System (ADS)

Smadja, Ivahn

This paper sets out to show how Eddington's early twenties case for variational derivatives significantly bears witness to a steady and consistent shift in focus from a resolute striving for objectivity towards "selective subjectivism" and structuralism. While framing his so-called "Hamiltonian derivatives" along the lines of previously available variational methods allowing to derive gravitational field equations from an action principle, Eddington assigned them a theoretical function of his own devising in The Mathematical Theory of Relativity (1923). I make clear that two stages should be marked out in Eddington's train of thought if the meaning of such variational derivatives is to be adequately assessed. As far as they were originally intended to embody the mind's collusion with nature by linking atomicity of matter with atomicity of action, variational derivatives were at first assigned a dual role requiring of them not only to express mind's craving for permanence but also to tune up mind's privileged pattern to "Nature's own idea". Whereas at a later stage, as affine field theory would provide a framework for world-building, such "Hamiltonian differentiation" would grow out of tune through gauge-invariance and, by disregarding how mathematical theory might precisely come into contact with actual world, would be turned into a mere heuristic device for structural knowledge.

PROMETHEE II: A knowledge-driven method for copper exploration

NASA Astrophysics Data System (ADS)

Abedi, Maysam; Ali Torabi, S.; Norouzi, Gholam-Hossain; Hamzeh, Mohammad; Elyasi, Gholam-Reza

2012-09-01

This paper describes the application of a well-known Multi Criteria Decision Making (MCDM) technique called Preference Ranking Organization METHod for Enrichment Evaluation (PROMETHEE II) to explore porphyry copper deposits. Various raster-based evidential layers involving geological, geophysical, and geochemical geo-datasets are integrated to prepare a mineral prospectivity mapping (MPM). In a case study, thirteen layers of the Now Chun copper deposit located in the Kerman province of Iran are used to explore the region of interest. The PROMETHEE II technique is applied to produce the desired MPM, and the outputs are validated using twenty-one boreholes that have been classified into five classes. This proposed method shows a high performance when providing the MPM while reducing the cost of exploratory drilling in the study area.

Medical student case presentation performance and perception when using mobile learning technology in the emergency department

PubMed Central

Tews, Matthew; Brennan, Kimberly; Begaz, Tomer; Treat, Robert

2011-01-01

Background Hand-held mobile learning technology provides opportunities for clinically relevant self-instructional modules to augment traditional bedside teaching. Using this technology as a teaching tool has not been well studied. We sought to evaluate medical students’ case presentation performance and perception when viewing short, just-in-time mobile learning videos using the iPod touch prior to patient encounters. Methods Twenty-two fourth-year medical students were randomized to receive or not to receive instruction by video, using the iPod Touch, prior to patient encounters. After seeing a patient, they presented the case to their faculty, who completed a standard data collection sheet. Students were surveyed on their perceived confidence and effectiveness after using these videos. Results Twenty-two students completed a total of 67 patient encounters. There was a statistically significant improvement in presentations when the videos were viewed for the first time (p=0.032). There was no difference when the presentations were summed for the entire rotation (p=0.671). The reliable (alpha=0.97) survey indicated that the videos were a useful teaching tool and gave students more confidence in their presentations. Conclusions Medical student patient presentations were improved with the use of mobile instructional videos following first time use, suggesting mobile learning videos may be useful in medical student education. If direct bedside teaching is unavailable, just-in-time iPod touch videos can be an alternative instructional strategy to improve first-time patient presentations by medical students. PMID:22013378

House Dust Mite Prevalence in the House of Patients with Atopic Dermatitis in Mashhad, Iran.

PubMed

Ziyaei, Toktam; Berenji, Fariba; Jabbari-Azad, Farahzad; Fata, Abdolmajid; Jarahi, Lida; Fereidouni, Mohammad

2017-06-01

Being exposed to house dust mites intensifies atopic dermatitis. This study has investigated the contamination rate with Dermatophagoides mites in patient's residential home with atopic dermatitis. In this cross-sectional study, 40 patients took part with atopic dermatitis (positive or negative for mites by prick Dermal Test). Samples were collected from 3 locations (living room, bedroom and bed) by vacuum cleaner. Dust samples (transferred to freezer -20 °C) were examined by direct method and flotation. The data were analyzed using statistical SPSS vr.20 software. Twenty patients of positive prick test included 8 (40%) male and 12 (60%) female. The results of direct observation of mites: 7 cases (35%) in bedding sheets, 6 cases (30%) bedrooms' carpet, 3 cases (15%) living room's carpet. Twenty patients of negative prick test included 8 (40%) male and 12 (60%) female. Only mites were found (5%) in living room's carpets of negative prick test patients. Dermatophagoides pteronyssinus was more frequent than Dermatophagoides farina e. (98% vs 83%). Fifty-five percent of residential homes of prick test positive patients and only 5% of residential homes of prick test negative patients were positive for mite. Sunshine provided home had fewer mites than home where sunshine is not provided. Prick test positive patients used handmade carpets more than machine made ones. In positive prick test patients, mites were found in bed sheet and bedroom's carpet more than negative prick test patient's sheets and carpets.

COMPARISON BETWEEN COMPUTED TOMOGRAPHIC ARTHROGRAPHY, RADIOGRAPHY, ULTRASONOGRAPHY, AND ARTHROSCOPY FOR THE DIAGNOSIS OF FEMOROTIBIAL JOINT DISEASE IN WESTERN PERFORMANCE HORSES.

PubMed

Nelson, Brad B; Kawcak, Chris E; Goodrich, Laurie R; Werpy, Natasha M; Valdés-Martínez, Alejandro; McIlwraith, C Wayne

2016-07-01

The femorotibial joints are a common source of lameness in Western performance horses. The objective of this prospective study was to compare the radiography, ultrasonography, computed tomographic arthrography (CTA), and arthroscopy findings in horses with lameness localized to the femorotibial joints. Twenty-five stifles in 24 horses were included and were evaluated with all four of these diagnostic methods. Defects detected in femorotibial joint structures were compared between diagnostic methods using a McNemar's test to evaluate for disagreement. Cranial medial meniscotibial desmopathy was most detected on arthroscopy (in 14/25 cases) and was only detected on ultrasonography in three out of 11 (27.3%) arthroscopically observed cases, but was detected on CTA in nine out of 12 (75%) arthroscopically observed cases. Medial meniscal injury located on the craniolateral border was most detected on arthroscopy (n = 9) and was detected on CTA in five cases, but on ultrasonography in 0 cases. Detection of articular cartilage defects on the medial femoral condyle was most detected with arthroscopy (24/25, 96% cases) and was also detected on CTA in 12/20 (60%) cases with a significant disagreement identified between modalities (P = 0.02). Cranial and caudal cruciate ligament defects were detected on CTA in 6/22 (27.3%) and 7/19 (36.8%) cases, respectively, and with arthroscopy in 3/25 (12%) and 2/25 (8%) cases, respectively. The use of CTA detected more defects in the cruciate ligaments, proximal tibia, and ligament entheses than the other diagnostic methods, but was not reliable for detection of articular cartilage damage on the medial femoral condyle. © 2016 American College of Veterinary Radiology.

Angiomyolipoma of the Liver: A Rare Benign Tumor Treated with a Laparoscopic Approach for the First Time.

PubMed Central

DAMASKOS, CHRISTOS; GARMPIS, NIKOLAOS; ANNA, GARMPI; NONNI, AFRODITI; SAKELLARIOU, STRATIGOULA; MARGONIS, GEORGIOS-ANTONIOS; SPARTALIS, ELEFTHERIOS; SCHIZAS, DIMITRIOS; ANDREATOS, NIKOLAOS; MAGKOUTI, ELENI; GRIVAS, ALEXANDROS; KONTZOGLOU, KONSTANTINOS; ANTONIOU, A. EFSTATHIOS

2017-01-01

Background/Aim: Epithelioid angiomyolipoma of the liver is a rare benign mesenchymal tumor that usually presents in adult female patients. It most frequently occurs in the kidney, with the liver being the second most common site of involvement. Angiomyolipoma belongs to a family of tumors arising from perivascular epithelioid cells but in rare cases may also have cystic features. We report our experience via the first case of hepatic angiomyolipoma treated by laparoscopic approach. Patients and Methods: We present the case of a 50-year old female patient complaining of abdominal pain. Abdominal ultrasound (US) and Magnetic Resonance Imaging (MRI) revealed a 5x3cm mass located in the left liver lobe. The tumor was resected with a laparoscopic approach. Microscopic examination of the tumor revealed hepatic angiomyolipoma. Results: Twenty-seven months postoperatively, the patient remains fit and healthy. Conclusion: Angiomyolipoma can be removed by laparoscopy. PMID:29102941

In-office microwave disinfection of soft contact lenses

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

Harris, M.G.; Rechberger, J.; Grant, T.

1990-02-01

We evaluated the effectiveness of an in-office microwave disinfection procedure which allowed for the disinfection of up to 40 soft contact lenses at one time. Ciba AOSept cases filled with sterile unpreserved saline were contaminated with one of six FDA test challenge microorganisms at a concentration of approximately 10(3) colony forming units per milliliter (CFU/ml). Twenty cases were placed on the rotating plate of a standard 2450 MHz 650 W microwave oven in a 10-cm diameter circle. The cases were exposed to high intensity microwave irradiation for periods of 0 to 15 min. None of the 6 microorganisms evaluated survivedmore » 2 min or longer of microwave exposure. Our findings indicated that microwave irradiation can be a convenient, rapid, and effective method of disinfecting a number of soft contact lenses at one time and thus adaptable as an in-office soft contact lens disinfection procedure.« less

The Effect of Aquatic Exercise Therapy on Muscle Strength and Joint's Range of Motion in Hemophilia Patients

PubMed Central

Kargarfard, Mehdi; Dehghadani, Mehdi; Ghias, Reza

2013-01-01

Background: This study was to evaluate the effect of a period of aquatic exercise therapy on muscle strength and joints range of motion in hemophilia patients. Methods: This was a semiexperimental, pretest, post-test study with a control group. This semi-experimental study comprised twenty men suffering moderate hemophilia were selected by convenience sampling method from patients of a referral hospital. They were randomly assigned to intervention and control groups of equal number. The hemophilia patients who were referred to Sayedo-Shohada Hospital enrolled in this study. Twenty men suffering moderate hemophilia were selected using convenience sampling method and then divided randomly into intervention and control groups (10 patients in each group). Subjects of aquatic exercise therapy group underwent activity in water in three sessions (45-60 minutes) per week for 8 weeks, while the control group was only under follow-up and during this period did not experience any effective physical activity. The patients’ muscle strength and joint range of motion were evaluated through standard laboratory tools, using an isokinetic dynamometer (Biodex, Systems III) and a standard goniometer in the beginning and at end of the study. Finally, data was analyzed using analysis of covariance (ANCOVA). Results: The strength of the muscles around the knee joint (to perform extension and flexion movements) increased significantly in the case group while the control group experienced a significant reduction of strength in left leg, but in right leg remarkable change was observed. Range of motion in all joints was improved in the case group, while the control group did not improve significantly. Conclusion: The results showed that aquatic exercise therapy can be a useful method to improve joints’ strength and range of motion in hemophilia patients in order to improve their daily functioning and quality of life. PMID:23412736

Twenty-year experience with laparoscopic inguinal hernia repair in infants and children: considerations and results on 1833 hernia repairs.

PubMed

Esposito, Ciro; Escolino, Maria; Cortese, Giuseppe; Aprea, Gianfranco; Turrà, Francesco; Farina, Alessandra; Roberti, Agnese; Cerulo, Mariapina; Settimi, Alessandro

2017-03-01

The role of laparoscopy in pediatric inguinal hernia (IH) is still controversial. The authors reported their twenty-year experience in laparoscopic IH repair in children. In a twenty-year period (1995-2015), we operated 1300 infants and children (935 boys-365 girls) with IH using laparoscopy. The average age at surgery was 18 months (range 7 days-14 years). Body weight ranged between 1.9 and 50 kg (average 9.3). Preoperatively all patients presented a monolateral IH, right-sided in 781 cases (60.1 %) and left-sided in 519 (39.9 %). We excluded patients with bilateral IH and unstable patients in which laparoscopy was contraindicated. If the inguinal orifice diameter was ≥10 mm, we performed a modified purse string suture on peri-orificial peritoneum, in orifices ≤5 mm, we performed a N-shaped suture. No conversion to open surgery was reported. In 533 cases (41 %), we found a contralateral patency of internal inguinal ring that was always closed in laparoscopy. In 1273 cases (97.9 %), we found an oblique external hernia; in 21 cases (1.6 %), a direct hernia; and in 6 cases (0.5 %), a double hernia on the same side (hernia en pantaloon). We found an incarcerated hernia in 27 patients (2 %). Average operative time was 18 min (range 7-65). We recorded 5/1300 recurrences (0.3 %), but in the last 950 patients, we had no recurrence (0 %). We recorded 20 complications (1.5 %): 18 umbilical granulomas and two trocars scar infections, treated in outpatient setting. On the basis of our twenty-year experience, we prefer to perform IH repair in children using laparoscopy rather than inguinal approach. Laparoscopy is as fast as inguinal approach, and it has the advantage to treat during the same anesthesia a contralateral patency occured in about 40 % of our cases and to treat also rare hernias in about 3 % of cases.

Twenty-First Century Literacy: A Matter of Scale from Micro to Mega

ERIC Educational Resources Information Center

Brown, Abbie; Slagter van Tryon, Patricia J.

2010-01-01

Twenty-first century technologies require educators to look for new ways to teach literacy skills. Current communication methods are combinations of traditional and newer, network-driven forms. This article describes the changes twenty-first century technologies cause in the perception of time, size, distance, audience, and available data, and…

Case report: Atrial fibrillation following exposure to ambient air pollution particles

EPA Science Inventory

CONTEXT: Exposure to air pollution can result in the onset of atrial fibrillation. CASE PRESENTATION: We present a case of a 58 year old woman who volunteered to participate in a controlled exposure to concentrated ambient particles (CAPs). Twenty minutes into the exposure, there...

Prevalence of ulnar-to-median nerve motor fiber anastomosis (Riché-Cannieu communicating branch) in hand: An electrophysiological study

PubMed Central

Ahadi, Tannaz; Raissi, Gholam Reza; Yavari, Masood; Majidi, Lobat

2016-01-01

Background: Two main muscles studied in the hand for evaluation of median nerve injuries are opponens pollicis (OP) and abductor pollicis brevis (APB). However, Riché-Cannieu communicating branch (RCCB) may limit the use of these muscles in electrodiagnosis. This condition is confusing in the case of median nerve injuries. This study was conducted to evaluate the prevalence of RCCB. Methods: Twenty-three consecutive cases of complete median nerve injury were studied. Evoked responses via stimulation of median and ulnar nerves in the wrist and recording with needle in the thenar area were studied. Results: Of the patients, 82.6% exhibited RCCB. In 14 (60.8%) cases the OP and in 19(82.6%) cases APB was supplied by the ulnar nerve. Conclusion: RCCB was detected to be 60.8% in OP and 82.6% in APB, so OP is preferable to APB in the study of median nerve. PMID:27390694

Transformative Pedagogy, Leadership and School Organisation for the Twenty-First-Century Knowledge-Based Economy: The Case of Singapore

ERIC Educational Resources Information Center

Dimmock, Clive; Goh, Jonathan W. P.

2011-01-01

Singapore has a high performing school system; its students top international tests in maths and science. Yet while the Singapore government cherishes its world class "brand", it realises that in a globally competitive world, its schools need to prepare students for the twenty-first-century knowledge-based economy (KBE). Accordingly,…

Noise Management in Twenty-First Century Libraries: Case Studies of Four U.S. Academic Institutions

ERIC Educational Resources Information Center

Franks, Janet E.; Asher, Darla C.

2014-01-01

University libraries have had to provide acceptable noise levels for many years and this pressure has not diminished in the twenty-first century. Library space has to be utilized to ensure noise levels are best managed. A study was undertaken across four university libraries in South Florida to determine how universities utilized their limited…

"Créolization" and the New Cosmopolitanism: Examining Twenty-First-Century Student Identities and Literacy Practices for Transcultural Understanding

ERIC Educational Resources Information Center

Lemrow, Erin Moira

2017-01-01

This paper considers the rapid demographic shifts in contemporary American society as they manifest themselves in today's classrooms in the United States. An effort to articulate these twenty-first-century student identities is highlighted in data from an ethnographic case study examining the literacy practices of one student of Filipino and…

Notification and management of congenital syphilis in the Northern Territory 2009 to 2014.

PubMed

McLeod, Charlie; Su, Jiunn-Yih; Francis, Joshua R; Ishwar, Alice; Ryder, Nathan

2015-09-30

To determine whether cases of congenital syphilis in the Northern Territory between 2009 and 2014 were correctly notified based on probable or confirmed case criteria stipulated by the Communicable Diseases Network Australia (CDNA). Pregnant women with positive syphilis serology defined as reactive treponemal test and rapid plasma reagin titre ≥1:8 were identified from the Northern Territory Syphilis Register Information System. Risk classification was performed based on local guidelines, and CDNA criteria for probable/confirmed cases of congenital syphilis were applied to determine whether cases were appropriately notified. Thirty-four cases of positive maternal syphilis serology in pregnancy were identified from 31 women; all were Indigenous. Twenty-one cases fulfilled criteria for probable congenital syphilis; 1 case was formally notified to the Centre for Disease Control. Twenty cases (95%) fulfilling CDNA criteria for probable congenital syphilis were not notified over the study period. Application of standard case definitions significantly increases the rate of congenital syphilis cases in the Northern Territory. Improved education regarding CDNA criteria for notification of congenital syphilis is necessary for clinicians and public health staff. Emerging evidence has supported the recent simplification of CDNA criteria for notification of congenital syphilis, effective 1 July 2015.

A Case Study of "Empathetic Teaching Artistry"

ERIC Educational Resources Information Center

Risner, Doug

2014-01-01

This case study is one of twenty cases derived from Anderson and Risner's international study of teaching artists in dance, and theatre, which investigated participants' (n=172) artistic and academic preparation in dance, and theatre, initial entry into the teaching artist field, rewards, challenges, and obstacles in participants' work, artists'…

Modeling Heterogeneity in Momentary Interpersonal and Affective Dynamic Processes in Borderline Personality Disorder

PubMed Central

Wright, Aidan G. C.; Hallquist, Michael N.; Stepp, Stephanie D.; Scott, Lori N.; Beeney, Joseph E.; Lazarus, Sophie A.; Pilkonis, Paul A.

2016-01-01

Borderline personality disorder (BPD) is a diagnosis defined by impairments in several dynamic processes (e.g., interpersonal relating, affect regulation, behavioral control). Theories of BPD emphasize that these impairments appear in specific contexts, and emerging results confirm this view. At the same time, BPD is a complex construct that encompasses individuals with heterogeneous pathology. These features—dynamic processes, situational specificity, and individual heterogeneity—pose significant assessment challenges. In the current study, we demonstrate assessment and analytic methods that capture both between-person differences and within-person changes over time. Twenty-five participants diagnosed with BPD completed event-contingent, ambulatory assessment protocols over 21 days. We used p-technique factor analyses to identify person-specific psychological structures consistent with clinical theories of personality. Five exemplar cases are selected and presented in detail to showcase the potential utility of these methods. The presented cases' factor structures reflect not only heterogeneity but also suggest points of convergence. The factors also demonstrated significant associations with important clinical targets (self-harm, interpersonal violence). PMID:27317561

Occupational health crossing borders - part 1: concept, teaching methods, and user evaluation of the first international summer school in Munich, Germany.

PubMed

Radon, Katja; Ehrenstein, Vera; Bigaignon-Cantineau, Janine; Vellore, Arun Dev; Fingerhut, Marilyn; Nowak, Dennis

2009-10-01

Occupational health and safety (OHS) is relevant for occupational health professionals (OHP) throughout the world. However, training opportunities are often limited and exchange between OHP from industrialized and developing countries is sparse. We aimed to contribute to the international exchange of OHP through a 2-week summer school program. Twenty-three OHP from 11 countries participated. Teaching methods included interactive lectures, participants' presentations, case-based e-learning, enterprise visits, and hands-on sessions. After completion, participants evaluated the course. OHS systems of 18 different countries were presented using the same set of clinical cases as a starting point. Opportunities and challenges in the different OHS systems were considered. On median, participants rated the course as excellent and totally agreed that it will help them in their daily work. An international summer school teaching basic aspects of different OHS systems is a useful tool for training and exchange at the global level. Copyright 2009 Wiley-Liss, Inc.

Comparing lagged linear correlation, lagged regression, Granger causality, and vector autoregression for uncovering associations in EHR data.

PubMed

Levine, Matthew E; Albers, David J; Hripcsak, George

2016-01-01

Time series analysis methods have been shown to reveal clinical and biological associations in data collected in the electronic health record. We wish to develop reliable high-throughput methods for identifying adverse drug effects that are easy to implement and produce readily interpretable results. To move toward this goal, we used univariate and multivariate lagged regression models to investigate associations between twenty pairs of drug orders and laboratory measurements. Multivariate lagged regression models exhibited higher sensitivity and specificity than univariate lagged regression in the 20 examples, and incorporating autoregressive terms for labs and drugs produced more robust signals in cases of known associations among the 20 example pairings. Moreover, including inpatient admission terms in the model attenuated the signals for some cases of unlikely associations, demonstrating how multivariate lagged regression models' explicit handling of context-based variables can provide a simple way to probe for health-care processes that confound analyses of EHR data.

Power and control in the legal system: from marriage/relationship to divorce and custody.

PubMed

Watson, Laurel B; Ancis, Julie R

2013-02-01

The purpose of this study was to examine the ways in which abuse that occurred during marriage/relationship continued within divorce and custody-related legal proceedings. Twenty-seven women participated in semistructured interviews. Interviews were analyzed utilizing a grounded theory approach in order to inductively arrive at a theory explaining how abuse dynamics may continue during legal proceedings. Participants identified child support litigation, custody and visitation battles, intimidation/harassment, deliberately prolonging the case, manipulating finances, and distortions of information as methods by which their exes sought to maintain power and control. Counseling implications are described.

Preparing the Twenty-First Century Workforce: The Case of Curriculum Change in Radiation Protection Education in the United States

ERIC Educational Resources Information Center

Schmidt, Matthew; Easter, Matthew; Jonassen, David; Miller, William; Ionas, Gelu

2008-01-01

The advent of the global information society and a myriad of other rapidly changing variables are presenting many new and unique challenges for the twenty-first century workforce, and perhaps the most pressing of these challenges is actually meeting the needs for qualified workers to fill the positions in emerging and growing fields. One such…

Engagement and Resistance at Last Chance High: A Case Study of Twenty-First-Century Literacies and Identities in One English Classroom

ERIC Educational Resources Information Center

Hines, Mary Beth; Kersulov, Michael

2015-01-01

This article investigates the nature of student resistance to and engagement with digital media and twenty-first-century literacies in the English classroom at Last Chance High, an alternative high school. It traces the dynamic interplay of literacy practices and identity performances with and around digital media, exploring one student's…

How common are cognitive errors in cases presented at emergency medicine resident morbidity and mortality conferences?

PubMed

Chu, David; Xiao, Jane; Shah, Payal; Todd, Brett

2018-06-20

Cognitive errors are a major contributor to medical error. Traditionally, medical errors at teaching hospitals are analyzed in morbidity and mortality (M&M) conferences. We aimed to describe the frequency of cognitive errors in relation to the occurrence of diagnostic and other error types, in cases presented at an emergency medicine (EM) resident M&M conference. We conducted a retrospective study of all cases presented at a suburban US EM residency monthly M&M conference from September 2011 to August 2016. Each case was reviewed using the electronic medical record (EMR) and notes from the M&M case by two EM physicians. Each case was categorized by type of primary medical error that occurred as described by Okafor et al. When a diagnostic error occurred, the case was reviewed for contributing cognitive and non-cognitive factors. Finally, when a cognitive error occurred, the case was classified into faulty knowledge, faulty data gathering or faulty synthesis, as described by Graber et al. Disagreements in error type were mediated by a third EM physician. A total of 87 M&M cases were reviewed; the two reviewers agreed on 73 cases, and 14 cases required mediation by a third reviewer. Forty-eight cases involved diagnostic errors, 47 of which were cognitive errors. Of these 47 cases, 38 involved faulty synthesis, 22 involved faulty data gathering and only 11 involved faulty knowledge. Twenty cases contained more than one type of cognitive error. Twenty-nine cases involved both a resident and an attending physician, while 17 cases involved only an attending physician. Twenty-one percent of the resident cases involved all three cognitive errors, while none of the attending cases involved all three. Forty-one percent of the resident cases and only 6% of the attending cases involved faulty knowledge. One hundred percent of the resident cases and 94% of the attending cases involved faulty synthesis. Our review of 87 EM M&M cases revealed that cognitive errors are commonly involved in cases presented, and that these errors are less likely due to deficient knowledge and more likely due to faulty synthesis. M&M conferences may therefore provide an excellent forum to discuss cognitive errors and how to reduce their occurrence.

Development of quantitative analysis method for stereotactic brain image: assessment of reduced accumulation in extent and severity using anatomical segmentation.

PubMed

Mizumura, Sunao; Kumita, Shin-ichiro; Cho, Keiichi; Ishihara, Makiko; Nakajo, Hidenobu; Toba, Masahiro; Kumazaki, Tatsuo

2003-06-01

Through visual assessment by three-dimensional (3D) brain image analysis methods using stereotactic brain coordinates system, such as three-dimensional stereotactic surface projections and statistical parametric mapping, it is difficult to quantitatively assess anatomical information and the range of extent of an abnormal region. In this study, we devised a method to quantitatively assess local abnormal findings by segmenting a brain map according to anatomical structure. Through quantitative local abnormality assessment using this method, we studied the characteristics of distribution of reduced blood flow in cases with dementia of the Alzheimer type (DAT). Using twenty-five cases with DAT (mean age, 68.9 years old), all of whom were diagnosed as probable Alzheimer's disease based on NINCDS-ADRDA, we collected I-123 iodoamphetamine SPECT data. A 3D brain map using the 3D-SSP program was compared with the data of 20 cases in the control group, who age-matched the subject cases. To study local abnormalities on the 3D images, we divided the whole brain into 24 segments based on anatomical classification. We assessed the extent of an abnormal region in each segment (rate of the coordinates with a Z-value that exceeds the threshold value, in all coordinates within a segment), and severity (average Z-value of the coordinates with a Z-value that exceeds the threshold value). This method clarified orientation and expansion of reduced accumulation, through classifying stereotactic brain coordinates according to the anatomical structure. This method was considered useful for quantitatively grasping distribution abnormalities in the brain and changes in abnormality distribution.

Autologous blood transfusion in dogs with thoracic or abdominal hemorrhage: 25 cases (2007-2012).

PubMed

Higgs, Veronica A; Rudloff, Elke; Kirby, Rebecca; Linklater, Andrew K J

2015-01-01

To describe the use and outcome following autologous blood transfusion (ABT) in dogs. Retrospective study (January 2007-July 2012). Private veterinary referral center. Twenty-five dogs that underwent ABT secondary to thoracic or abdominal hemorrhage. None. The hospital transaction database was searched using the keyword "autotransfusion" from January 2007 to July 2012. Data collected included signalment, body weight, etiology of hemorrhage, source and method of collection, volumes and method of ABT administration, use of anticoagulant, reported complications, and outcome. Twenty-five dogs were included for a total of 27 ABTs. Causes of hemorrhage included vascular trauma (14/25 dogs, 56%), ruptured tumor (8/25, 32%), and coagulopathy attributed to brodifacoum toxicosis (3/25, 12%). Autologous blood was collected from the abdominal (19/25, 76%), thoracic (5/25, 20%), or abdominal and thoracic cavities (1/25, 4%). Anticoagulant was added to the ABT blood in 13 of 25 (52%) cases. A median ABT volume of 29.3 mL/kg (range 2.9-406.9 mL/kg) was infused through either a 210 μm blood administration filter (21/27, 78%) or an 18 μm hemonate filter (6/27, 22%). Reported complications that may have been associated with ABT included hypocalcemia (4/17, 24%), hemolyzed serum (5/19, 26%), and prolonged coagulation times (4/5, 80%). These complications were considered of minimal clinical significance. Additional blood products were administered in 17 of 25 (68%) dogs. Seventeen (68%) dogs survived to discharge. Cause of death in the remaining cases was euthanasia or cardiac arrest secondary to uncontrollable hemorrhage. ABT is an adjunct to volume replacement in dogs with thoracic or abdominal hemorrhage secondary to vascular trauma, ruptured tumor, or anticoagulant rodenticide toxicosis. ABT may be used as bridge to definitive hemorrhage control, particularly when other blood products are not available or affordable. Complications may include hypocalcemia, prolonged coagulation times, and hemolysis. © Veterinary Emergency and Critical Care Society 2015.

Prediction of Gut Wall Integrity Loss in Viral Gastroenteritis by Non-Invasive Marker

PubMed Central

Elnady, Hala G.; Sherif, Lobna S.; Saleh, Maysa T.; El-Alameey, Inas R.; Youssef, Mai M.; El Shafie, Amal I.; Helwa, Iman; Raouf, Haiam Abdel; EL-Taweel, Ahmed N.

2015-01-01

BACKGROUND: Intestinal fatty acid binding proteins (I-FABPs) are mainly expressed in the intestinal villi, which are the initial site of destruction in viral gastroenteritis. AIM: This study was designed to assess serum I-FABPs as a predictor of gut wall integrity loss in viral gastroenteritis. PATIENTS AND METHODS: This case-control cross-sectional study was conducted on 93 cases of acute viral gastroenteritis. Twenty-eight healthy children matching in age were recruited as control group. Serum I-FABPs were measured using ELISA technique. Viral detection and typing were done by PCR for adenovirus, and by Reverse transcriptase PCR for rotavirus, astrovirus and norovirus. RESULTS: Serum I-FABPs level was significantly higher in the cases compared to the controls and was also higher in the 46 rotavirus gastroenteritis cases compared to other viral gastroenteritis cases. Serum I- FABPs level was significantly higher in severely dehydrated cases as compared to mildly dehydrated ones (P=0.037). CONCLUSION: Serum I-FABPs could be used as an early and sensitive predictor marker of gut wall integrity loss in children with viral gastroenteritis and its level can indicate case severity. PMID:27275194

Science Teacher Education in the Twenty-First Century: A Pedagogical Framework for Technology-Integrated Social Constructivism

ERIC Educational Resources Information Center

Barak, Miri

2017-01-01

Changes in our global world have shifted the skill demands from acquisition of structured knowledge to mastery of skills, often referred to as twenty-first century competencies. Given these changes, a sequential explanatory mixed methods study was undertaken to (a) examine predominant instructional methods and technologies used by teacher…

The Effectiveness of Simulated Robots for Supporting the Learning of Introductory Programming: A Multi-Case Case Study

ERIC Educational Resources Information Center

Major, Louis; Kyriacou, Theocharis; Brereton, Pearl

2014-01-01

This work investigates the effectiveness of simulated robots as tools to support the learning of programming. After the completion of a systematic review and exploratory research, a multi-case case study was undertaken. A simulator, named Kebot, was developed and used to run four 10-hour programming workshops. Twenty-three student participants…

Early prognostic markers for fatal fulminant hepatic failure cases with viral hepatitis: proton nuclear magnetic resonance spectroscopic studies of serum.

PubMed

Bala, Lakshmi; Mehrotra, Mayank; Mohindra, Samir; Saxena, Rajan; Khetrapal, Chunni Lal

2013-02-01

Fulminant hepatic failure is associated with liver metabolic derangements which could have fatal consequences. The aim of the present study is to identify serum markers for early prediction of the outcome. Proton nuclear magnetic resonance spectroscopic studies of serum of fulminant hepatic failure patients due to viral hepatitis with grade II/III of encephalopathy (twenty-four: ten prospective and fourteen retrospective) and twenty-five controls were undertaken. Of the twenty-four patients, fifteen survived with medical management alone while nine had fatal outcome. The results demonstrated significantly elevated indices of amino acids (alanine, lysine, glutamine, histidine, tyrosine, phenylalanine and 1,2-propanediol) in fatal cases compared to survivors and controls. Principal component analysis showed clear separation of fatal and surviving cases. Liver function parameters were significantly deranged in patients but they failed to provide early significant differences between surviving and fatal cases. Compared to model for end-stage liver disease scores, principal component analysis appear to be better as an early prognostic indicator. Biochemical mapping of pathways suggested interruptions in amino acid metabolism and urea cycle. Proton nuclear magnetic resonance studies of serum have the potential of rapidly identifying patients with irreversible fulminant hepatic failure requiring liver transplantation as life saving option. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Legionella spp. in UK composts--a potential public health issue?

PubMed

Currie, S L; Beattie, T K; Knapp, C W; Lindsay, D S J

2014-04-01

Over the past 5 years, a number of cases of legionellosis in Scotland have been associated with compost use; however, studies investigating sources of infection other than water systems remain limited. This study delivers the first comprehensive survey of composts commonly available in the UK for the presence of Legionella species. Twenty-two store-bought composts, one green-waste compost and one home-made compost were tested for Legionella by culture methods on BCYE-α medium, and the findings were confirmed by macrophage infectivity potentiator (mip) speciation. Twenty-two of the samples were retested after an enrichment period of 8 weeks. In total, 15 of 24 composts tested positive for Legionella species, a higher level of contamination than previously seen in Europe. Two isolates of Legionella pneumophila were identified, and Legionella longbeachae serogroup 1 was found to be one of the most commonly isolated species. L. longbeachae infection would not be detected by routine Legionella urinary antigen assay, so such testing should not be used as the sole diagnostic technique in atypical pneumonia cases, particularly where there is an association with compost use. The occurrence of Legionella in over half of the samples tested indicates that compost could pose a public health risk. The addition of general hygiene warnings to compost packages may be beneficial in protecting public health. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Safety and efficacy of percutaneous nephrolithotomy for the treatment of paediatric urolithiasis

PubMed Central

Veeratterapillay, R; Shaw, MBK; Williams, R; Haslam, P; Lall, A; De la Hunt, M; Hasan, ST; Thomas, DJ

2012-01-01

INTRODUCTION Paediatric percutaneous nephrolithotomy (PCNL) has revolutionised the treatment of paediatric nephrolithiasis. Paediatric PCNL has been performed using both adult and paediatric instruments. Stone clearance rates and complications vary according to the technique used and surgeon experience. We present our experience with PCNL using adult instruments and a 28Fr access tract for large renal calculi in children under 18 years. METHODS All patients undergoing PCNL at our institution between 2000 and 2009 were reviewed. Demographics, surgical details and post-operative follow-up information were obtained to identify stone clearance rates and complications. RESULTS PCNL was performed in 32 renal units in 31 patients (mean age: 10.8 years). The mean stone diameter was 19mm (range: 5–40mm). Twenty-six cases required single puncture and six required multiple tracts. Overall, 11 staghorn stones, 10 multiple calyceal stones and 11 single stones were treated. Twenty-seven patients (84%) were completely stone free following initial PCNL. Two cases had extracorporeal shock wave lithotripsy for residual fragments, giving an overall stone free rate of 91% following treatment. There was no significant bleeding or sepsis encountered either during the operation or in the post-operative setting. No patient required or received a blood transfusion. CONCLUSIONS Paediatric PCNL can be performed safely with minimal morbidity using adult instruments for large stone burden, enabling rapid and complete stone clearance. PMID:23131231

[Robotic assisted laparoscopy: comparison of segmentary colorectal resection and shaving for colorectal endometriosis].

PubMed

Diguisto, C; Hébert, T; Paternotte, J; Kellal, I; Marret, H; Ouldamer, L; Body, G

2015-04-01

To compare perioperative complications of two surgical methods for digestive endometriosis management: "shaving" and colorectal resection in robotic-assisted laparoscopy. Twenty-eight women underwent robotic-assisted laparoscopy for digestive endometriosis, confirmed histologically. Six women had a digestive resection and twenty-one women had a shaving procedure. Short-term and long-term results and complications were compared between the two groups. Operative time was significantly shorter (P=0.0002) and estimated blood loss was significantly lower (200 ml vs 560 ml, P=0.04) in the shaving procedure group in comparison with the resection group. We observed one conversion to laparotomy in the resection group and one case of bladder injury in the shaving group. Length of hospital stay was longer (P=0.0001) in the resection group than in the shaving group. At the two-month re-evaluation, there was no significant difference between the two groups for the number of women in full remission for pelvic pain, urinary or gastrointestinal symptoms or dyspareunia. Two women of the resection group reported functional gastrointestinal signs that persisted 24 months after the intervention. Both immediate and delayed operative morbidity are more frequent in case of resection. Surgery for deep infiltrating endometriosis, even if operated with robotic assisted laparoscopy, is associated with significant morbidity. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

A correction factor for estimating statewide agricultural injuries from ambulance reports.

PubMed

Scott, Erika E; Earle-Richardson, Giulia; Krupa, Nicole; Jenkins, Paul

2011-10-01

Agriculture ranks as one of the most hazardous industries in the nation. Agricultural injury surveillance is critical to identifying and reducing major injury hazards. Currently, there is no comprehensive system of identifying and characterizing fatal and serious non-fatal agricultural injuries. Researchers sought to calculate a multiplier for estimating the number of agricultural injury cases based on the number of times the farm box indicator was checked on the ambulance report. Farm injuries from 2007 that used ambulance transport were ascertained for 10 New York counties using two methods: (1) ambulance reports including hand-entered free text; and (2) community surveillance. The resulting multiplier that was developed from contrasting these two methods was then applied to the statewide Emergency Medical Services database to estimate the total number of agricultural injuries for New York state. There were 25,735 unique ambulance runs due to injuries in the 10 counties in 2007. Among these, the farm box was checked a total of 90 times. Of these 90, 63 (70%) were determined to be agricultural. Among injury runs where the farm box was not checked, an additional 59 cases were identified from the free text. Among these 122 cases (63 + 59), four were duplicates. Twenty-four additional unique cases were identified from the community surveillance for a total of 142. This yielded a multiplier of 142/90 = 1.578 for estimating all agricultural injuries from the farm box indicator. Sensitivity and specificity of the ambulance report method were 53.4% and 99.9%, respectively. This method provides a cost-effective way to estimate the total number of agricultural injuries for the state. However, it would not eliminate the more labor intensive methods that are required to identify of the actual individual case records. Incorporating an independent source of case ascertainment (community surveillance) increased the multiplier by 17%. Copyright © 2011 Elsevier Inc. All rights reserved.

[Verifying the function of hepaticojejunostomies by scintigraphy of the bile ducts].

PubMed

Champetier, J; Busquet, G; Letoublon, C; Vigneau, B; Yver, R; Rambeaud, J J

1984-01-01

Thirty six hepatobiliary scintigraphies with 99mTc-Dimethyl IDA were performed in thirty patients with an hepaticojejunostomy one month to ten years after surgery. Twenty patients underwent surgery for biliary disease and ten for duodenal or pancreatic disease. In most cases (twenty three), the radionuclide study has been systematically performed to assess the scintigraphic pattern of a normal hepaticojejunostomy. In seven cases this pattern was abnormal. Four times the biliary enteric anastomosis was involved. Three times it showed an abnormal liver morphology. After an hepaticojejunostomy, hepatobiliary scintigraphy seems to be the only examination providing dynamic information for the biliary enteric anastomosis and the intestinal loop. But it sometimes is difficult to analyse in all cases, it must be the screening test in patients when symptoms occur after hepaticojejunostomy; but a percutaneous transhepatic cholangiogram cannot always be avoided.

Philosophy and Methods for China's Vocational Education Curriculum Reforms in the Early Twenty-First Century

ERIC Educational Resources Information Center

Xu, Guoqing

2014-01-01

Curriculum reform is an important aspect of progress in China's vocational education in the twenty-first century. The past decade's round of reforms were unprecedented in China in terms of both the scope and depth of their impact. They have and will continue to dramatically alter the nation's vocational education curriculum and teaching methods.…

Takayasu Arteritis in the pediatric population: a contemporary United States-Based Single Center Cohort

PubMed Central

2014-01-01

Background Takayasu Arteritis is an idiopathic, chronic, large vessel vasculitis involving the aorta and its primary branches. Few studies have been done in pediatric patients to date with the largest case series of US patients published in 2003 consisting of only 6 patients. Methods A retrospective chart review was performed on all patients seen at Cleveland Clinic Children’s up until 2012 who met EULAR/PRINTO/PRES classification criteria for childhood Takayasu Arteritis. Results Twenty-one patients with a mean follow up of 2.3 years were studied. Weight loss, fatigue, and anorexia were the most common presenting complaints. 57.1% of patients were hypertensive at first visit. The most common examintation finding was diminished pulses (61.9%), followed by bruits, and then murmurs. Thoracic aorta stenosis was the most common vascular abnormality. Seven of twenty-one patients responded well to methotrexate and prednisone alone. Ten of twenty-one patients required an additional medication for symptom and disease control (infliximab most commonly). About two-thirds of patients required at least one anti-hypertensive medication. Eight of the twenty-one patients required surgical intervention for severe disease refractory to medications (renal artery stenosis being the most common indication). Almost all patients reported symptomatic improvement after surgical intervention. Two of the eight patients required a second surgery for return of symptoms. Disease sequelae included arterial aneurysms, resolved heart failure, and hypertensive emergencies. Conclusion Our study emphasizes that constitutional symptoms coupled with objective findings of diminished pulses, bruits, and hypertension should raise clinical suspicion for Takayasu Arteritis in pediatric patients. Pharmacologic therapy alone can be successful in controlling disease progression, however surgery was successful in minimizing symptoms when medical therapies failed. PMID:24955077

Pilot surveillance for childhood encephalitis in Australia using the Paediatric Active Enhanced Disease Surveillance (PAEDS) network.

PubMed

Britton, P N; Dale, R C; Elliott, E; Festa, M; Macartney, K; Booy, R; Jones, C A

2016-07-01

We aimed to assess the performance of active surveillance for hospitalized childhood encephalitis in New South Wales (NSW) using the Paediatric Active Enhanced Disease Surveillance (PAEDS) network to inform methodology for the nationwide Australian childhood encephalitis (ACE) study. We piloted active surveillance for suspected encephalitis from May to December 2013 at the Children's Hospital at Westmead, Sydney, NSW. Cases were ascertained using four screening methods: weekday nurse screening of admission records (PAEDS), cerebrospinal fluid (CSF) microscopy records, magnetic resonance imaging (MRI) reports, and pharmacy dispensing records. Comprehensive clinical data were prospectively collected on consented participants and subsequently reviewed by an expert panel. Cases were categorized as confirmed encephalitis or 'not encephalitis'; encephalitis cases were sub-categorized as infectious, immune-mediated or unknown. We performed an ICD-10 diagnostic code audit of hospitalizations for the pilot period. We compared case ascertainment in the four screening methods and with the ICD code audit. Forty-eight cases of suspected encephalitis were identified by one or more methods. PAEDS was the most efficient mechanism (yield 34%), followed by MRI, CSF, and pharmacy audits (yield 14%, 12%, and 7% respectively). Twenty-five cases met the criteria for confirmed encephalitis. PAEDS was the most sensitive of the mechanisms for confirmed encephalitis (92%) with a positive predictive value (PPV) of 72%. The ICD audit was moderately sensitive (64%) but poorly specific (Sp 9%, PPV 14%). Of the 25 confirmed encephalitis cases, 19 (76%) were sub-categorized as infectious, three (12%) were immune-mediated, and three (12%) were 'unknown'. We identified encephalitis cases associated with two infectious disease outbreaks (enterovirus 71, parechovirus 3). PAEDS is an efficient, sensitive and accurate surveillance mechanism for detecting cases of childhood encephalitis including those associated with emerging infectious diseases. Active surveillance significantly increases the ascertainment of encephalitis cases compared with passive approaches.

Coexistence of nail lichen planus and lichen planus pigmentosus.

PubMed

Lemes, Luciana Rodino; Verde, Renata Brandão Villa; Durães, Sandra Maria Barbosa; Araripe, Adolpho de Alencar; Pantaleão, Luciana

2016-01-01

We describe a fifty-six-year old, Afro-descendent female patient showing dystrophy of her twenty nails and hyperchromic, asymptomatic macule on her face. Histopathological examination of the macule showed vacuolization of the basal layer, melanophages in the superficial dermis and lymphoplasmocytic inflammatory infiltrate. Nail biopsy revealed orthokeratotic hyperkeratosis and lichenoid inflammatory infiltrate. Lichen planus pigmentosus is an uncommon variety of lichen planus. It is characterized by typical hyperpigmented macules on the face and neck. Nail changes might be present in 10% of lichen planus cases, but no associations with lichen planus pigmentosus have been described. We report a case of lichen planus in twenty nails associated with lichen planus pigmentosus on the patient's face.

[Use of high frequency cinematography in diagnosis of globus sensation].

PubMed

Alberty, J; Oelerich, M

1996-09-01

Globus pharyngis is a frequent symptom in patients who consult an otolaryngologist. In many cases, routine diagnostic work-up including history, clinical examination, and barium swallow fail to revealing the underlying pathogenesis. In a retrospective study, we present 51 selected patients suffering from globus pharyngis of unknown origin who were investigated by high-speed cineradiography in a standardized manner. Twenty-four of the patients enrolled in the study (47.1%) showed functional and/or structural swallowing disorders. In 13 cases (25.5%) dyskinesias of the superior esophagus sphincter muscle were found. Five of these patients (9.8%) also had an inconstant hypopharyngeal diverticulum. Six cases (11.8%) showed laryngeal penetration or tracheal aspiration. In four cases (7.8%) functional disorders of pharyngeal, and in three cases (5.9%) functional disorders of oral bolus transport were found. Furthermore one hypopharyngeal web (1.9%) and two benign tumors (3.9%) were detected. In many cases, varying combinations of these findings occurred. Using high-speed cineradiography for evaluation of globus pharyngis results in an increased incidence of pathologic findings, and thus is an important method for interdisciplinary diagnostic work up of patients suffering from this symptom.

Computer-aided detection of bladder masses in CT urography (CTU)

NASA Astrophysics Data System (ADS)

Cha, Kenny H.; Hadjiiski, Lubomir M.; Chan, Heang-Ping; Caoili, Elaine M.; Cohan, Richard H.; Weizer, Alon; Samala, Ravi K.

2017-03-01

We are developing a computer-aided detection system for bladder cancer in CT urography (CTU). We have previously developed methods for detection of bladder masses within the contrast-enhanced and the non-contrastenhanced regions of the bladder individually. In this study, we investigated methods for detection of bladder masses within the entire bladder. The bladder was segmented using our method that combined deep-learning convolutional neural network with level sets. The non-contrast-enhanced region was separated from the contrast-enhanced region with a maximum-intensity-projection-based method. The non-contrast region was smoothed and gray level threshold was applied to the contrast and non-contrast regions separately to extract the bladder wall and potential masses. The bladder wall was transformed into a straightened thickness profile, which was analyzed to identify lesion candidates in a prescreening step. The candidates were mapped back to the 3D CT volume and segmented using our auto-initialized cascaded level set (AI-CALS) segmentation method. Twenty-seven morphological features were extracted for each candidate. A data set of 57 patients with 71 biopsy-proven bladder lesions was used, which was split into independent training and test sets: 42 training cases with 52 lesions, and 15 test cases with 19 lesions. Using the training set, feature selection was performed and a linear discriminant (LDA) classifier was designed to merge the selected features for classification of bladder lesions and false positives. The trained classifier was evaluated with the test set. FROC analysis showed that the system achieved a sensitivity of 86.5% at 3.3 FPs/case for the training set, and 84.2% at 3.7 FPs/case for the test set.

Automated processing of fluorescence in-situ hybridization slides for HER2 testing in breast and gastro-esophageal carcinomas.

PubMed

Tafe, Laura J; Allen, Samantha F; Steinmetz, Heather B; Dokus, Betty A; Cook, Leanne J; Marotti, Jonathan D; Tsongalis, Gregory J

2014-08-01

HER2 fluorescence in-situ hybridization (FISH) is used in breast and gastro-esophageal carcinoma for determining HER2 gene amplification and patients' eligibility for HER2 targeted therapeutics. Traditional manual processing of the FISH slides is labor intensive because of multiple steps that require hands on manipulation of the slides and specifically timed intervals between steps. This highly manual processing also introduces inter-run and inter-operator variability that may affect the quality of the FISH result. Therefore, we sought to incorporate an automated processing instrument into our FISH workflow. Twenty-six cases including breast (20) and gastro-esophageal (6) cancer comprising 23 biopsies and three excision specimens were tested for HER2 FISH (Pathvysion, Abbott) using the Thermobrite Elite (TBE) system (Leica). Up to 12 slides can be run simultaneously. All cases were previously tested by the Pathvysion HER2 FISH assay with manual preparation. Twenty cells were counted by two observers for each case; five cases were tested on three separate runs by different operators to evaluate the precision and inter-operator variability. There was 100% concordance in the scoring between the manual and TBE methods as well as among the five cases that were tested on three runs. Only one case failed due to poor probe hybridization. In total, seven cases were positive for HER2 amplification (HER2:CEP17 ratio >2.2) and the remaining 19 were negative (HER2:CEP17 ratio <1.8) utilizing the 2007 ASCO/CAP scoring criteria. Due to the automated denaturation and hybridization, for each run, there was a reduction in labor of 3.5h which could then be dedicated to other lab functions. The TBE is a walk away pre- and post-hybridization system that automates FISH slide processing, improves work flow and consistency and saves approximately 3.5h of technologist time. The instrument has a small footprint thus occupying minimal counter space. TBE processed slides performed exceptionally well in comparison to the manual technique with no disagreement in HER2 amplification status. Copyright © 2014 Elsevier Inc. All rights reserved.

Pyrosequencing analysis of the gyrB gene to differentiate bacteria responsible for diarrheal diseases.

PubMed

Hou, X-L; Cao, Q-Y; Jia, H-Y; Chen, Z

2008-07-01

Pathogens causing acute diarrhea include a large variety of species from Enterobacteriaceae and Vibrionaceae. A method based on pyrosequencing was used here to differentiate bacteria commonly associated with diarrhea in China; the method is targeted to a partial amplicon of the gyrB gene, which encodes the B subunit of DNA gyrase. Twenty-eight specific polymorphic positions were identified from sequence alignment of a large sequence dataset and targeted using 17 sequencing primers. Of 95 isolates tested, belonging to 13 species within 7 genera, most could be identified to the species level; O157 type could be differentiated from other E. coli types; Salmonella enterica subsp. enterica could be identified at the serotype level; the genus Shigella, except for S. boydii and S. dysenteriae, could also be identified. All these isolates were also subjected to conventional sequencing of a relatively long ( approximately1.2 kb) region of gyrB DNA; these results confirmed those with pyrosequencing. Twenty-two fecal samples were surveyed, the results of which were concordant with culture-based bacterial identification, and the pathogen detection limit with simulated stool specimens was 10(4) CFU/ml. DNA from different pathogens was also mixed to simulate a case of multibacterial infection, and the generated signals correlated well with the mix ratio. In summary, the gyrB-based pyrosequencing approach proved to have significant reliability and discriminatory power for enteropathogenic bacterial identification and provided a fast and effective method for clinical diagnosis.

Increase of cases of legionellosis in Latvia, 2011.

PubMed

Rozentale, B; Bormane, A; Perevosčikovs, J; Lucenko, I; Brila, A

2011-11-10

An increased number of legionellosis cases in 2011 has been reported in Latvia, compared to the ten previous years. A total of 30 legionellosis cases (1.35 per 100,000 inhabitants), including 19 females, have been confirmed until the end of September 2011. The majority of cases (n=23) were inhabitants of the capital city Riga. The reason for the increase in legionellosis is unclear. Twenty-six of the 30 cases are not travel-related.

Landslide hazard mapping with selected dominant factors: A study case of Penang Island, Malaysia

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

Tay, Lea Tien; Alkhasawneh, Mutasem Sh.; Ngah, Umi Kalthum

Landslide is one of the destructive natural geohazards in Malaysia. In addition to rainfall as triggering factos for landslide in Malaysia, topographical and geological factors play important role in the landslide susceptibility analysis. Conventional topographic factors such as elevation, slope angle, slope aspect, plan curvature and profile curvature have been considered as landslide causative factors in many research works. However, other topographic factors such as diagonal length, surface area, surface roughness and rugosity have not been considered, especially for the research work in landslide hazard analysis in Malaysia. This paper presents landslide hazard mapping using Frequency Ratio (FR) and themore » study area is Penang Island of Malaysia. Frequency ratio approach is a variant of probabilistic method that is based on the observed relationships between the distribution of landslides and each landslide-causative factor. Landslide hazard map of Penang Island is produced by considering twenty-two (22) landslide causative factors. Among these twenty-two (22) factors, fourteen (14) factors are topographic factors. They are elevation, slope gradient, slope aspect, plan curvature, profile curvature, general curvature, tangential curvature, longitudinal curvature, cross section curvature, total curvature, diagonal length, surface area, surface roughness and rugosity. These topographic factors are extracted from the digital elevation model of Penang Island. The other eight (8) non-topographic factors considered are land cover, vegetation cover, distance from road, distance from stream, distance from fault line, geology, soil texture and rainfall precipitation. After considering all twenty-two factors for landslide hazard mapping, the analysis is repeated with fourteen dominant factors which are selected from the twenty-two factors. Landslide hazard map was segregated into four categories of risks, i.e. Highly hazardous area, Hazardous area, Moderately hazardous area and Not hazardous area. The maps was assessed using ROC (Rate of Curve) based on the area under the curve method (AUC). The result indicates an increase of accuracy from 77.76% (with all 22 factors) to 79.00% (with 14 dominant factors) in the prediction of landslide occurrence.« less

The association between Chance fractures and intra-abdominal injuries revisited: a multicenter review.

PubMed

Tyroch, Alan H; McGuire, Emmett L; McLean, Susan F; Kozar, Rosemary A; Gates, Keith A; Kaups, Krista L; Cook, Charles; Cowgill, Sarah M; Griswold, John A; Sue, Larry A; Craun, Michael L; Price, Jan

2005-05-01

The association between Chance fractures and intra-abdominal injuries is reported to be as high as 89 per cent. Because prior studies were small series or case reports, we conducted a multicenter review to learn the true association between Chance fractures and intra-abdominal injuries as well as diagnostic trends. Trauma registry data, medical records, and radiology reports from 7 trauma centers were used to characterize 79 trauma patients with Chance fractures. Initial methods of abdominal assessment were computed tomography (CT) scan (79%), clinical examination (16%), and diagnostic peritoneal lavage (DPL) (5%). Twenty-six (33%) patients had intraabdominal injuries of which hollow viscus injuries predominated (22%). Twenty patients (25%) underwent laparotomy. The presence of an abdominal wall contusion and automobile restraint use were highly predictive of intra-abdominal injury and the need for laparotomy. The association between a Chance fracture and intra-abdominal injury is not as high as previously reported. CT scan has become the primary modality to assess the abdominal cavity of patients with Chance fractures, whereas the role of DPL has diminished.

Amniotic membrane transplantation with conjunctival autograft for recurrent pterygium.

PubMed

Shimazaki, Jun; Kosaka, Koichi; Shimmura, Shigeto; Tsubota, Kazuo

2003-01-01

To study the effect of amniotic membrane transplantation (AMT) combined with either limbal autograft transplantation (LAT) or conjunctival autograft transplantation (CAT) in recurrent pterygium. Retrospective, noncomparative, interventional case series. Twenty-seven eyes of 27 patients with recurrent pterygium. The mean number of prior surgeries was 3.1 (range, 1-10). Fifteen eyes each had restriction of ocular movement and symblepharon before surgery. Patients were treated by AMT with either LAT (n = 15) or CAT (n = 12). Recurrence of pterygium, improvement in ocular movement, and symblepharon formation. Twenty-three (85.2%) of 27 eyes showed no recurrence with a mean observation period of 67.0 weeks. Fourteen eyes (93.3%) each showed improvement in ocular movement restriction and symblepharon after AMT. In four eyes that developed recurrence, three had LAT and one had CAT combined with AMT, suggesting that there was no difference in surgical outcome between LAT and CAT. AMT with CAT is a safe and effective method for recurrent pterygium, especially that associated with ocular movement restriction and symblepharon. Considering the potential adverse effects associated with limbal excision, AMT plus CAT may be preferred over AMT plus LAT.

Neural differences in processing of case particles in Japanese: an fMRI study

PubMed Central

Hashimoto, Yosuke; Yokoyama, Satoru; Kawashima, Ryuta

2014-01-01

Introduction In subject–object–verb (SOV) languages, such as Japanese, sentence processing proceeds incrementally to the late presentation of the head (verb). Japanese case particles play a crucial role in sentence processing; however, little is known about how these particles are processed. In particular, it is still unclear how the functional difference between case particles is represented in the human brain. Methods In this study, we conducted an fMRI experiment using an event-related design to directly compare brain activity during Japanese case particle processing among the nominative case ga, accusative case o, and dative case ni. Twenty five native Japanese speakers were asked to judge whether the presented character was a particle in a particle judgment task and whether the character ended with a specific vowel in a phonological judgment task, which was used as a control condition. Results A particle comparison demonstrated that the processing of ni was associated with significantly weaker brain activity than that of ga and o in the left middle frontal gyrus (MFG) and the inferior frontal gyrus (IFG). Significantly greater brain activity associated with ni relative to ga in the right IFG was also observed. Conclusion These results suggest that the Japanese case particles ga, ni, and o are represented differently in the brain. PMID:24683511

Major Depressive Disorder Among Preadolescent Canadian Children: Rare Disorder or Rarely Detected?

PubMed

Korczak, Daphne J; Ofner, Marianna; LeBlanc, John; Wong, Sam; Feldman, Mark; Parkin, Patricia C

2017-03-01

Despite agreement that preadult onset of depression is associated with greater illness severity, and that children can meet the diagnostic criteria for major depressive disorder (MDD), few studies have examined the presentation of MDD among young children. This is the first nationwide study of MDD among preadolescent children in Canada. Pediatrician members (2500) of a Canadian pediatric surveillance network were surveyed monthly over 3 years to report new cases of MDD among 5- to 12-year-olds. Survey response and questionnaire completion rates were 80% and 85%, respectively. Symptom presentation and duration, impairment, medical and psychiatric history, and management were reported. Twenty-nine new cases of MDD were identified by pediatricians. Of these, 23 (79%) experienced symptoms for >6 months before presentation with global functional impairment. Parental depression or anxiety, commonly maternal, was present in 21 cases (72%). Twenty-two children (76%) reported suicidal ideation; 6 (21%) had attempted suicide. Twenty-three children (79%) were treated with medication. Thirteen children (45%) were treated with 2 or more medications. Children with MDD frequently had a parental history of mood disorders, experienced long-standing symptom presence, high symptom burden and functional impairment prior to presentation; and commonly treatment with polypharmacy. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Prevalence of Wernicke-Korsakoff syndrome in Australia: has thiamine fortification made a difference?

PubMed Central

Harper, Clive G; Sheedy, Donna L; Lara, Ana I; Garrick, Therese M; Hilton, John M; Raisanen, Jack

2012-01-01

Objective To determine the prevalence of the Wernicke-Korsakoff syndrome (WKS) in Australia and compare this with previous studies. Design and setting Prospective autopsy study at the New South Wales Institute of Forensic Medicine, 1996-1997. Methods Brains of deceased people (aged over 15 years) derived from 2212 sequential autopsies performed between 1 January 1996 and 31 December 1997 were studied macroscopically and microscopically to identify cases of WKS. Main outcome measures Standard histological criteria for WKS and any available clinical data. Results Twenty-five cases of WKS were identified (prevalence, 1.1%), mostly among the 5.9% of the 2212 people who had a history suggestive of alcohol abuse. Only four cases (16%) had been diagnosed during life. Conclusions There has been a significant reduction in the prevalence of WKS in Australia since the introduction of thiamine enrichment of bread flour. While the prevalence is still higher than in most other Western countries, further research is needed before adding thiamine to alcoholic beverages can be recommended. PMID:9640303

APC gene expression in gastric carcinoma: an immunohistochemical study.

PubMed

Grace, A; Butler, D; Gallagher, M; Al-Agha, R; Xin, Y; Leader, M; Kay, E

2002-09-01

Gastric carcinoma is one of the most common malignancies worldwide, particularly in Japan and China. Inactivation of the adenomatous polyposis coli ( ) gene, a tumor suppressor gene, has been shown to play a significant role in the development of colorectal carcinoma, and it has been suggested that it may play a role throughout the digestive tract, including the stomach. This study assesses gene expression in normal gastric mucosa and gastric adenocarcinoma using an antibody to the C-terminal region. One hundred twenty cases of gastric adenocarcinoma were examined from the files of Beaumont Hospital, Dublin, Ireland, and China Medical University, Shenyang, China. Ninety-one cases were informative. Of these, 78% revealed loss of staining. Loss of staining in adenocarcinoma showed no association with tumor type, tumor, stage or patient nationality. Loss of staining was also found in nine of 35 cases (26%) of intestinal metaplasia. In conclusion, loss of the gene, as determined by immunohistochemical staining, appears to be an early event in gastric carcinogenesis. Immunohistochemistry is a sensitive method for detection of this loss.

Comparison of shade matching by visual observation and an intraoral dental colorimeter.

PubMed

Li, Q; Wang, Y N

2007-11-01

The purpose of this study was to compare the applicability of two shade-matching approaches: Vintage Halo shade guide (visual method) and Shofu ShadeEye NCC colorimeter (instrumental method). Twenty participants' maxillary left central incisors were evaluated. Corresponding metal ceramic crowns were fabricated with each shade-matching approach. The colour distributions (L*, a* and b*) of the middle third region of each tooth and corresponding metal ceramic crowns were spectrophotometrically assessed. The colour difference (DeltaE) and colour distributions (DeltaL*, Deltaa* and Deltab*) between the tooth and the corresponding crowns were calculated. We found that the colour differences of both groups fell within the clinical unacceptable range (DeltaE > 2.75). Regarding DeltaE and the three colour distributions, no significant difference was found, expect for a* (P < 0.01). The shade matching difficulty degree was analysed through the agreements of visual shade selection. Within easy matching cases, the instrumental method achieved better results (P = 0.041). In conclusion, it is suggested that the reliability of shade matching can be ensured by neither the colorimeter nor the visual approach. However, the colorimeter can achieve better results within easy matching cases.

Comparison of Radiography and Ultrasonography for Diagnosis of Diaphragmatic Hernia in Bovines

PubMed Central

Athar, Hakim; Mohindroo, Jitender; Singh, Kiranjeet; Kumar, Ashwani; Raghunath, Mulinti

2010-01-01

The present study was conducted on 101 animals suffering from thoracoabdominal disorders; out of which twenty seven animals (twenty six buffaloes and one cow) were diagnosed with diaphragmatic hernia based on clinical signs, radiography, ultrasonography, and left flank laparorumenotomy. Radiography alone confirmed diaphragmatic hernia in 18 cases (66.67%) with a sac-like structure cranial to the diaphragm. In 15 animals the sac contained metallic densities while in three cases a sac-like structure with no metallic densities was present. Ultrasonography was helpful in confirming diaphragmatic hernia in 23 cases (85.18%) and ultrasonographically reticular motility was evident at the level of 4th/5th intercostal space in all the animals. B+M mode ultrasonography was used for the first time for diagnosis of diaphragmatic hernia in bovines and the results suggested that ultrasonography was a reliable diagnostic modality for diaphragmatic hernia in bovines. PMID:20445795

Taming the Technology.

ERIC Educational Resources Information Center

Clinton, Janeen S.

This document reports on efforts to find technology-based solutions for the diverse challenges faced by students with disabling conditions. Twenty-three case studies describe actual scenarios experienced in the school district of Palm Beach County, Florida. For each case study, a situation is described, a challenge is identified, solutions are…

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

PubMed

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

2014-10-01

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

Fatty acid ethyl esters (FAEEs) as markers for alcohol in meconium: method validation and implementation of a screening program for prenatal drug exposure.

PubMed

Hastedt, Martin; Krumbiegel, Franziska; Gapert, René; Tsokos, Michael; Hartwig, Sven

2013-09-01

Alcohol consumption during pregnancy is a widespread problem and can cause severe fetal damage. As the diagnosis of fetal alcohol syndrome is difficult, the implementation of a reliable marker for alcohol consumption during pregnancy into meconium drug screening programs would be invaluable. A previously published gas chromatography mass spectrometry method for the detection of fatty acid ethyl esters (FAEEs) as alcohol markers in meconium was optimized and newly validated for a sample size of 50 mg. This method was applied to 122 cases from a drug-using population. The meconium samples were also tested for common drugs of abuse. In 73 % of the cases, one or more drugs were found. Twenty percent of the samples tested positive for FAEEs at levels indicating significant alcohol exposure. Consequently, alcohol was found to be the third most frequently abused substance within the study group. This re-validated method provides an increase in testing sensitivity, is reliable and easily applicable as part of a drug screening program. It can be used as a non-invasive tool to detect high alcohol consumption in the last trimester of pregnancy. The introduction of FAEEs testing in meconium screening was found to be of particular use in a drug-using population.

Learner perception of oral and written examinations in an international medical training program

PubMed Central

Weiner, Scott G.; Anderson, Philip D.; Irish, Julie; Ciottone, Greg; Pini, Riccardo; Grifoni, Stefano; Rosen, Peter; Ban, Kevin M.

2010-01-01

Background There are an increasing number of training programs in emergency medicine involving different countries or cultures. Many examination types, both oral and written, have been validated as useful assessment tools around the world; but learner perception of their use in the setting of cross-cultural training programs has not been described. Aims The goal of this study was to evaluate learner perception of four common examination methods in an international educational curriculum in emergency medicine. Methods Twenty-four physicians in a cross-cultural training program were surveyed to determine learner perception of four different examination methods: structured oral case simulations, multiple-choice tests, semi-structured oral examinations, and essay tests. We also describe techniques used and barriers faced. Results There was a 100% response rate. Learners reported that all testing methods were useful in measuring knowledge and clinical ability and should be used for accreditation and future training programs. They rated oral examinations as significantly more useful than written in measuring clinical abilities (p < 0.01). Compared to the other three types of examinations, learners ranked oral case simulations as the most useful examination method for assessing learners’ fund of knowledge and clinical ability (p < 0.01). Conclusions Physician learners in a cross-cultural, international training program perceive all four written and oral examination methods as useful, but rate structured oral case simulations as the most useful method for assessing fund of knowledge and clinical ability. Electronic supplementary material The online version of this article (doi:10.1007/s12245-009-0147-2) contains supplementary material, which is available to authorized users. PMID:20414377

Section 17. Laparoscopic and minimal incisional donor hepatectomy.

PubMed

Choi, YoungRok; Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk

2014-04-27

Living donor hepatectomy is now a well-established surgical procedure. However, a large abdominal incision is still required, which results in a large permanent scar, especially for a right liver graft. This report reviews our techniques of minimally invasive or minimal incisional donor hepatectomy using a transverse incision.Twenty-five living donors underwent right hepatectomy with a transverse incision and 484 donors with a conventional incision between April 2007 and December 2012. Among the donors with a transverse incision, two cases were totally laparoscopic procedures using a hand-port device; 11 cases were laparoscopic-assisted hepatectomy (hybrid technique), and 14 cases were open procedures using a transverse incision without the aid of the laparoscopic technique. Currently, a hybrid method has been exclusively used because of the long operation time and surgical difficulty in totally laparoscopic hepatectomy and the exposure problems for the liver cephalic portion during the open technique using a transverse incision.All donors with a transverse incision were women except for one. Twenty-four of the grafts were right livers without middle hepatic vein (MHV) and one with MHV. The donors' mean BMI was 21.1 kg/m. The median operation time was 355 minutes, and the mean estimated blood loss was 346.1±247.3 mL (range, 70-1200). There was no intraoperative transfusion. These donors had 29 cases of grade I [14 pleural effusions (56%), 11 abdominal fluid collections (44%), 3 atelectasis (12%), 1bile leak (4%)], 1 case of grade II (1 pneumothorax) and two cases of grade III complications; two interventions were needed because of abdominal fluid collections by Clavien-Dindo classification. Meanwhile, donors with a conventional big incision, which included the Mercedes-Benz incision or an inverted L-shaped incision, had 433 cases of grade I, 19 cases of grade II and 18 cases of grade III complications. However, the liver enzymes and total bilirubin of all donors were normalized within 1 month, and they recovered fully. Additionally, in a survey inquiring about cosmetic outcomes with a numeric scale of 1 through 10 (1, Not confident; 10, Very confident), the transverse incision had more satisfactory scores compared to the conventional big incision (9.80 vs. 6.17, P=0.001). In conclusion, the hybrid technique can be safely performed in donor right hepatectomy, with a minimal transverse skin incision, resulting in a good cosmetic outcome.

Cutaneous anthrax: evaluation of 28 cases in the Eastern Anatolian region of Turkey.

PubMed

Denk, Affan; Tartar, Ayse Sagmak; Ozden, Mehmet; Demir, Betul; Akbulut, Ayhan

2016-09-01

Anthrax is an endemic disease in developing countries. Human cases are usually associated with animal products. About 95% of naturally acquired cases are cutaneous anthrax. In this study, cutaneous anthrax cases from the Elazig province (the Eastern Anatolian region) of Turkey seen in our hospital within a 6-year period were evaluated with respect to epidemiological and clinical features, diagnosis, treatment and outcome. Twenty-eight patients with cutaneous anthrax observed between January 2009 and December 2014 were investigated retrospectively. The diagnosis of cutaneous anthrax was based on detailed history, dermatologic findings, including painless, ulcers covered by a characteristic black eschar and/or microbiological procedures, including Gram stain and culture of materials obtained from the lesions. Of the 28 patients followed up with cutaneous anthrax diagnosis, 14 (50%) were female and 14 (50%) were male. The mean age of the cases was 39.6 years (age range 17-65 years). The patients have an incubation period in the range of 1-9 days (mean 4.6 ± 0.5 days). The cases were seen between April and November of each year during the study period. Twenty-three cases (82%) had a history of contact with animals or animal products. Twenty patients (71.4%) showed malignant pustules and eight (28.6%) malignant edema. Bacillus anthracis was isolated in three cases (10.7%) and Gram stain smear were positive in five cases (17.8%). All patients were treated successfully with penicillin or ciprofloxacin. Systemic corticosteroids were added to the antibiotic treatment in six patients with malignant edema. Sepsis no developed in patients, all the cases recovered. Anthrax is still a serious public health problem in Turkey. Cutaneous anthrax must always be kept in mind when characteristic lesions such as a painless ulcer with vesicles, edema, and a history of contact with animals or animal products are observed in an individual. Early and correct diagnosis significantly affects course of the disease. Protective precautions such as vaccination of animals against anthrax and education of the population would reduce the incidence of the disease.

Ultrasonography and magnetic resonance imaging in the diagnosis of Morton's neuroma.

PubMed

Fazal, Muhammad Ali; Khan, Ishrat; Thomas, Cherian

2012-01-01

Magnetic resonance imaging (MRI) and ultrasonography are used widely for the diagnosis of Morton's neuroma. The aim of this study was to assess the accuracy of these two modalities as diagnostic tools in Morton's neuroma. Fifty feet of 47 consecutive patients (39 women and 8 men; mean age, 46 years; age range, 36-64 years) who presented between January 1, 2005, and June 30, 2008, were included in the study. Twenty-five feet were investigated with ultrasonography and 25 with MRI. Morton's neuroma was confirmed surgically and histologically in all of the patients. A Student unpaired t test was applied. Twenty-two MRIs were diagnostic (sensitivity, 88%). Three patients with negative MRI findings underwent ultrasonography and were found to have a neuroma smaller than 5 mm. Twenty-four ultrasound scans demonstrated the neuroma (sensitivity, 96%), with five neuromas being smaller than 5 mm. Ultrasonography has a slightly higher sensitivity in the diagnosis of Morton's neuroma, particularly of neuromas smaller than 5 mm, and should be the preferred imaging modality in suspected cases, and MRI should be reserved for cases with equivocal diagnosis.

Multimodal neurophysiological and psychometric evaluation among patients with systemic lupus erythematosus

PubMed Central

Shehata, Ghaydaa A; Elserogy, Yasser MB; Ahmad, Hossam Eddin K; Abdel-Kareem, Mohamed I; Al-kabeer, Ashraf M; Rayan, Mohamed M; El-Baky, Mohamed ES Abd

2011-01-01

Objective: To determine some of the neuropsychiatric manifestations of systemic lupus erythematosus (SLE) by applying multimodal neurophysiological and psychometric studies. Patients and methods: Twenty-six SLE patients were evaluated for neurological and psychiatric disorders and compared with 26 healthy controls matched for age, sex, education, and social class. The severity of SLE disease was assessed. Each subject was subjected to the following examinations: laboratory, neurophysiology, magnetic resonance imaging of the brain, transcranial duplex, Modified Mini-mental State Examination, Cognitive Assessment Scale Inventory, Hamilton Depression Scale, and Hamilton Anxiety Scale. Results: The mean age of subjects was 25.9 ± 8.9 years. The most prevalent neurological manifestations were (in order of frequency) anxiety in 17 cases (65.4%), depression in 15 cases (57.7%), headache in 10 cases (38.5%), peripheral neuropathy in 7 cases (26.9%), seizures in 6 cases (23.1%), psychosis in 5 cases (19.2%), dementia in 4 cases (15.4%), radiculopathy in 4 cases (15.4%), myositis in 3 cases (11.5%), and stroke in 2 cases (7.7%). There was a significant affection in amplitude of the ulnar nerve, cognitive function impairment, and electroencephalography changes. There was a significant increased mean velocity and decreased Pulsatility Index of the most studied intracranial vessels in the patients. Conclusion: The use of multimodal neurophysiological, transcranial duplex, and psychometric scales increases the sensitivity for detecting nervous system involvement. PMID:21674025

Single-Incision Laparoscopic Total Colectomy

PubMed Central

Ojo, Oluwatosin J.; Carne, David; Guyton, Daniel

2012-01-01

Background and Objectives: To present our experience with a single-incision laparoscopic total colectomy, along with a literature review of all published cases on single-incision laparoscopic total colectomy. Methods: A total of 22 cases were published between 2010 and 2011, with our patient being case 23. These procedures were performed in the United States and United Kingdom. Surgical procedures included total colectomy with end ileostomy, proctocolectomy with ileorectal anastomosis, and total proctocolectomy with ileopouch-anal anastomosis. Intraoperative and postoperative data are analyzed. Results: Twenty-two of the 23 cases were performed for benign cases including Crohns, ulcerative colitis, and familial adenomatous polyposis. One case was performed for adenocarcinoma of the cecum. The mean age was 35.3 years (range, 13 to 64), the mean body mass index was 20.1 (range, 19 to 25), mean operative time was 175.9 minutes (range, 139 to 216), mean blood loss was 95.3mL (range, 59 to 200), mean incision length was 2.61cm (range, 2 to 3). Average follow-up was 4.6 months with 2 reported complications. Conclusions: Single-incision laparoscopic total colectomy is feasible and safe in the hands of an experienced surgeon. It has been performed for both benign and malignant cases. It is comparable to the conventional multi-port laparoscopic total colectomy. PMID:22906326

[Diagnosis and treatment of pediatric anismus].

PubMed

Ding, Shu-qing; Ding, Yi-jiang; Chen, Yong-tian; Ye, Hui

2006-11-01

To explore the diagnosis and treatment methods of pediatric anismus. Twenty-nine patients with idiopathic chronic constipation, diagnosed with anismus by colon barium contrast and anorectal manometry from Nov. 2001 to Nov. 2004 in our hospital, were investigated retrospectively. This group consisted of 13 men and 16 women whose mean age was (6.7+/-4.0) years. Hirschsprung diseases were excluded from the patients by colon barium contrast and rectoanal inhibitory reflex (RAIR) examination. Normal RAIR (5-10 ml elicited) was showed on 21 cases while weakened RAIR (15-30 ml elicited) was showed on 8 cases. After the diagnosis, the patients were treated by toilet training, diet regulation and laxative for 1-2 months. 4 cases were recovered, 5 cases were improved and 20 cases were relied on glycerin suppository. Four cases, relied on glycerin suppository, underwent Lynn procedure and had good results after 5-24 months follow-up. Two cases were re-examined by anorectal manometry 3 and 6 months after surgery, the resting pressure and the high pressure zone (HPZ) decreased, but the simulation defecation reflex was still abnormal. The diagnosis of pediatric anismus relies on history of constipation, combined with anorectal manometry and colon barium contrast. Lynn procedure could be chosen for the patients unsatisfied in toilet training and other non-operative treatment.

Use of LANDSAT imagery for wildlife habitat mapping in northeast and east central Alaska

NASA Technical Reports Server (NTRS)

Lent, P. C. (Principal Investigator)

1975-01-01

The author has identified the following significant results. Two scenes were analyzed by applying an iterative cluster analysis to a 2% random data sample and then using the resulting clusters as a training set basis for maximum likelihood classification. Twenty-six and twenty-seven categorical classes, respectively resulted from this process. The majority of classes in each case were quite specific vegetation types; each of these types has specific value as moose habitat.

Case Studies in Library Computer Systems.

ERIC Educational Resources Information Center

Palmer, Richard Phillips

Twenty descriptive case studies of computer applications in a variety of libraries are presented in this book. Computerized circulation, serial and acquisition systems in public, high school, college, university and business libraries are included. Each of the studies discusses: 1) the environment in which the system operates, 2) the objectives of…

Managing School Districts for High Performance: Cases in Public Education Leadership

ERIC Educational Resources Information Center

Childress, Stacey, Ed.; Elmore, Richard F., Ed.; Grossman, Allen, Ed.; Johnson, Susan Moore, Ed.

2007-01-01

"Managing School Districts for High Performance" brings together more than twenty case studies and other readings that offer a powerful and transformative approach to advancing and sustaining the work of school improvement. At the center of this work is the concept of organizational coherence: aligning organizational design, human…

A Constructivist Case Study Examining the Leadership Development of Undergraduate Students in Campus Recreational Sports

ERIC Educational Resources Information Center

Hall, Stacey L.; Forrester, Scott; Borsz, Melissa

2008-01-01

This constructivist case study examined undergraduate student leadership development. Twenty-one student leaders, 13 females and 8 males, in a campus recreational sports department were interviewed using a semi-structured interview protocol. Seven broad themes: organizing, planning, and delegating; balancing academic, personal and professional…

Mood perception of interior colors in a gym

NASA Astrophysics Data System (ADS)

Ohno, Haruyo; Koizumi, Naoko

2002-06-01

When people enter a gym, they feel more like exercising in some cases than other cases. The interior color of the space may be a contributing factor. This paper discusses how the interior color of a gym affects female subjects in their twenties and forties to fifties both physiologically and psychologically.

Accuracy of patient specific organ-dose estimates obtained using an automated image segmentation algorithm

NASA Astrophysics Data System (ADS)

Gilat-Schmidt, Taly; Wang, Adam; Coradi, Thomas; Haas, Benjamin; Star-Lack, Josh

2016-03-01

The overall goal of this work is to develop a rapid, accurate and fully automated software tool to estimate patient-specific organ doses from computed tomography (CT) scans using a deterministic Boltzmann Transport Equation solver and automated CT segmentation algorithms. This work quantified the accuracy of organ dose estimates obtained by an automated segmentation algorithm. The investigated algorithm uses a combination of feature-based and atlas-based methods. A multiatlas approach was also investigated. We hypothesize that the auto-segmentation algorithm is sufficiently accurate to provide organ dose estimates since random errors at the organ boundaries will average out when computing the total organ dose. To test this hypothesis, twenty head-neck CT scans were expertly segmented into nine regions. A leave-one-out validation study was performed, where every case was automatically segmented with each of the remaining cases used as the expert atlas, resulting in nineteen automated segmentations for each of the twenty datasets. The segmented regions were applied to gold-standard Monte Carlo dose maps to estimate mean and peak organ doses. The results demonstrated that the fully automated segmentation algorithm estimated the mean organ dose to within 10% of the expert segmentation for regions other than the spinal canal, with median error for each organ region below 2%. In the spinal canal region, the median error was 7% across all data sets and atlases, with a maximum error of 20%. The error in peak organ dose was below 10% for all regions, with a median error below 4% for all organ regions. The multiple-case atlas reduced the variation in the dose estimates and additional improvements may be possible with more robust multi-atlas approaches. Overall, the results support potential feasibility of an automated segmentation algorithm to provide accurate organ dose estimates.

Computed-tomography modeled polyether ether ketone (PEEK) implants in revision cranioplasty.

PubMed

O'Reilly, Eamon B; Barnett, Sam; Madden, Christopher; Welch, Babu; Mickey, Bruce; Rozen, Shai

2015-03-01

Traditional cranioplasty methods focus on pre-operative or intraoperative hand molding. Recently, CT-guided polyether ether ketone (PEEK) plate reconstruction enables precise, time-saving reconstruction. This case series aims to show a single institution experience with use of PEEK cranioplasty as an effective, safe, precise, reusable, and time-saving cranioplasty technique in large, complex cranial defects. We performed a 6-year retrospective review of cranioplasty procedures performed at our affiliated hospitals using PEEK implants. A total of nineteen patients underwent twenty-two cranioplasty procedures. Pre-operative, intra-operative, and post-operative data was collected. Nineteen patients underwent twenty-two procedures. Time interval from injury to loss of primary cranioplasty averaged 57.7 months (0-336 mo); 4.0 months (n=10, range 0-19) in cases of trauma. Time interval from primary cranioplasty loss to PEEK cranioplasty was 11.8 months for infection (n=11, range 6-25 mo), 12.2 months for trauma (n=5, range 2-27 mo), and 0.3 months for cosmetic or functional reconstructions (n=3, range 0-1). Similar surgical techniques were used in all patients. Drains were placed in 11/22 procedures. Varying techniques were used in skin closure, including adjacent tissue transfer (4/22) and free tissue transfer (1/22). The PEEK plate required modification in four procedures. Three patients had reoperation following PEEK plate reconstruction. Cranioplasty utilizing CT-guided PEEK plate allows easy inset, anatomic accuracy, mirror image aesthetics, simplification of complex 3D defects, and potential time savings. Additionally, it's easily manipulated in the operating room, and can be easily re-utilized in cases of intraoperative course changes or infection. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test, stress radiography, magnetic resonance imaging, and arthroscopy.

PubMed

Cho, Jae Ho; Lee, Doo Hyung; Song, Hyung Keun; Bang, Joon Young; Lee, Kyung Tai; Park, Young Uk

2016-04-01

Clinicians frequently diagnose chronic ankle instability using the manual anterior drawer test and stress radiography. However, both examinations can yield incorrect results and do not reveal the extent of ankle instability. Stress ultrasound has been reported to be a new diagnostic tool for the diagnosis of chronic ankle instability. The purpose of this study was to assess the diagnostic value of stress ultrasound for chronic ankle instability compared to the manual anterior drawer test, stress radiography, magnetic resonance imaging (MRI), and arthroscopy. Twenty-eight consecutive patients who underwent ankle arthroscopy and subsequent modified Broström repair for treatment of chronic ankle instability were included. The arthroscopic findings were used as the reference standard. A standardized physical examination (manual anterior drawer test), stress radiography, MRI, and stress ultrasound were performed to assess the anterior talofibular ligament (ATFL) prior to operation. Ultrasound images were taken in the resting position and the maximal anterior drawer position. Grade 3 lateral instability was verified arthroscopically in all 28 cases with a clinical diagnosis (100%). Twenty-two cases showed grade III instability on the manual anterior drawer test (78.6%). Twenty-four cases displayed anterior translation exceeding 5 mm on stress radiography (86%), and talar tilt angle exceeded 15° in three cases (11 %). Nineteen cases displayed a partial chronic tear (change in thickness or signal intensity), and nine cases displayed complete tear on MRI (100%). Lax and wavy ATFL was evident on stress ultrasound in all cases (100 %). The mean value of the ATFL length was 2.8 ± 0.3 cm for the stressed condition and 2.1 ± 0.2 cm for the resting condition (p < 0.001). Stress ultrasound may be useful for the diagnosis of chronic ankle instability in addition to the manual anterior drawer test and stress radiography. III.

Association between oral lichen planus and Epstein–Barr virus in Iranian patients

PubMed Central

Shariati, Matin; Mokhtari, Mojgan; Masoudifar, Aria

2018-01-01

Background: Oral lichen planus (OLP) is a common mucocutaneous disease with malignant transformation potential. Several etiologies such as humoral, autoimmunity, and viral infections might play a role, but still there is no definite etiology for this disease. The aim of this study was to investigate the presence of Epstein–Barr virus (EBV) genome in Iranian patients with OLP as compared to people with normal mucosa. Materials and Methods: The study was carried out on a case group including 38 tissue specimens of patients with histopathological confirmation of OLP and a control group including 38 samples of healthy mucosa. All samples were examined by nested polymerase chain reaction (PCR) method to determine the DNA of EBV. Results: Twenty-two (57.9%) female samples and 16 (42.1%) male samples with OLP were randomly selected as the case group, and 20 (52.6%) female samples and 18 (47.4%) male samples with healthy mucosa as the control group. There was a statistically significant difference in the percentage of EBV positivity between the case (15.8%) and the control groups (P < 0.05); in the case group, three female samples (13.6%) and three male samples (18.8%) were infected with EBV; the difference between the genders was not statistically significant (P = 0.50). Conclusion: Results emphasized that EBV genome was significantly higher among Iranian patients with OLP so antiviral therapy might be helpful. PMID:29692821

[Diagnosis and surgical treatment results of angio-Behçet syndrome: an analysis of 26 patients].

PubMed

Shen, Chen-yang; He, Chang-shun; Pan, Hao; Zhang, Xiao-ming

2012-03-01

To analyze the diagnosis and surgical treatment results of angio-Behçet syndrome. The clinical data of pre-operation diagnosis, surgical treatment methods and prospective efficacy of 26 patients who were diagnosed as Behçet syndrome between January 2003 and April 2011 was analyzed retrospectively. There were 23 male and 3 female patients, aging from 20 to 76 years with a mean of (37 ± 6) years. Among them, 3 patients showed the clinical symptoms as arterial stenosis or occlusion, 9 patients had aneurysm, 13 patients had phlebitis or phlebothrombosis. One patient had both aneurysm and venous thrombosis. Totally 11 patients had experienced 22 cases surgical treatment including interventional therapy for 8 cases, open operation for 13 cases and hybrid operation for 1 case. Twenty-two patients (84.6%) were followed up from 3 months to 96 months after various surgical treatment methods. The average follow-up periond was 39.3 months. Totally, perioperative mortality was 1/11 after surgical treatment. Healing rates were 7/8 and 8/13, recurrence rates were 5/8 and 7/8 in patients with interventional therapy compared with that of experiencing open surgery respectively. Behçet syndrome patients combined with various vascular lesions should be thought of angio-Behçet syndrome. Choosing correct surgical treatment according to patient's condition and timing of pathological changes are the keys of gaining satisfactory results.

Hepatoblastoma Biology Using Isotope Ratio Mass Spectrometry: Utility of a Unique Technique for the Analysis of Oncological Specimens.

PubMed

Taran, Katarzyna; Frączek, Tomasz; Sitkiewicz, Anna; Sikora-Szubert, Anita; Kobos, Józef; Paneth, Piotr

2016-07-07

Hepatoblastoma is the most common primary liver tumor in children. However, it occurs rarely, with an incidence of 0.5-1.5 cases per million children. There is no clear explanation of the relationship between clinicopathologic features, therapy, and outcome in hepatoblastoma cases, so far. One of the most widely accepted prognostic factors in hepatoblastoma is histology of the tumor. The aim of the study was to determine the potential differences in biology of hepatoblastoma histological subtypes at the atomic level using the unique method of isotope ratio mass spectrometry, which is especially valuable in examination of small groups of biological samples. Twenty-four measurements of nitrogen stable isotope ratio, carbon stable isotope ratio and total carbon to nitrogen mass ratio in fetal and embryonal hepatoblastoma tissue were performed using a Sercon 20-22 Continuous Flow Isotope Ratio Mass Spectrometer (CF-IRMS) coupled with a Sercon SL elemental analyzer for simultaneous carbon-nitrogen-sulfur (NCS) analysis. A difference of about 1.781‰ in stable nitrogen isotope 15N/14N ratio was found between examined hepatoblastoma histological subtypes. The prognosis in liver tumors cases in children may be challenging particularly because of the lack of versatile methods of its evaluation. Isotope ratio mass spectrometry allows one to determine the difference between hepatoblastoma histological subtypes and clearly indicates the cases with the best outcome.

Arthroscopically assisted percutaneous repair of fresh closed achilles tendon rupture by Kessler's suture.

PubMed

Tang, Kang-lai; Thermann, Hajo; Dai, Gang; Chen, Guang-xing; Guo, Lin; Yang, Liu

2007-04-01

Achilles tendon ruptures are difficult to repair, and the healing rate is low due to this structure's anatomic and physiological characteristics. It is essential to develop new techniques to increase the healing rate and decrease the rate of complications. To propose and evaluate a new percutaneous method of repairing fresh closed Achilles tendon ruptures by Kessler's suture under arthroscopy. Case series; Level of evidence, 4. Twenty patients were followed at least 12 months in this study. First, the torn ends of the Achilles tendon were debrided during arthroscopy. Then percutaneous repair of the Achilles tendon was performed using Kessler's suture by an inside-out technique. All cases were followed up for an average range of 21 months (range, 12-36 months). All patients were evaluated by clinical examination, magnetic resonance imaging, and the Lindholm scale. The torn ends were well aligned and sutured after the debridement under arthroscopy. According to the Lindholm scale, excellent results were seen in 15 cases and good in 5 cases. No patients had complications such as nerve injury, infection, or re-rupture at follow-up. Magnetic resonance imaging results showed that the ruptured Achilles tendons were repaired and remodeled very well in all patients. The present method is an effective surgical technique for repair of a closed rupture of the Achilles tendon. The short-term follow-up results were good, and recovery time was short. Few complications were found in our study cases.

Bone metastasis from ovarian cancer. Clinical analysis of 26 cases.

PubMed

Zhang, Min; Sun, Jimei

2013-12-01

To study the clinical characteristics of bone metastasis from ovarian cancer, and facilitate physicians to develop treatment strategies. This retrospective study was carried out in the Provincial Hospital Affiliated to Shandong University, Shandong, China. Twenty-six cases of bone metastasis from ovarian cancer treated between January 2002 and May 2008 were reviewed, and the clinical data were collected. In the current study, the incidence of bone metastasis is 0.82%. Twelve cases of bone metastasis occurred in the cervical vertebra, 10 in the lumbar vertebra, 8 in the pelvis, 7 in the thoracic vertebra, 5 in the limbs, one in the ribs, and 2 in the sternum. Lung metastasis occurred concomitantly in 9 cases, liver metastasis in 5 cases, brain metastasis in 4 cases, splenic metastasis in 3 cases, adrenal metastasis in 2 cases, and lymphatic metastasis in 12 cases. Twenty-three cases (88.5%) of bone metastasis were detected in stage III-IV, and 3 (11.5%) in stage II (p=0.000). The survival time in cases treated using comprehensive therapy was longer than those using radiotherapy or chemotherapy alone (p=0.047). Bone metastasis from ovarian cancer is rare, however, the increasing pathological stage of ovarian cancer may add to the risk of bone metastasis, especially in the cases with lung or lymphatic metastasis. The pelvis and vertebral bone are the most common location of bone metastasis, and comprehensive treatment may improve the survival time of patients.

Twenty-first century learning after school: the case of 4-H.

PubMed

Kress, Cathann

2006-01-01

Founded in the early 1900s, the 4-H Youth Development program can serve as a model for out-of-school programs of the twenty-first century. The 4-H pledge, repeated by its members--over 7 million, ranging in age from five to twenty--articulates its core values: "I pledge: My head to clearer thinking, My heart to greater loyalty, My hands to larger service, and My health to better living for my club, my community, my country, and my world." The 4-H Development movement was created to provide opportunities for rural children, to help them become constructive adults. Through an emphasis on "learning by doing," 4-H teaches children the habits of lifelong learning. Historically, 4-H has tapped into university-level advancements, extending such knowledge to youth and thereby giving them early access to scientific discoveries and technological progress. Members apply this learning in their communities through hands-on projects crossing a wide-range of pertinent topics. Research shows that 4-H members are more successful in school than other children and develop a wide range of skills essential in the twenty-first century. Thus, the author makes the case that the foundation of 4-H is exceptionally relevant in today's complex world, perhaps even more so than a century ago. 4-H is a leader in youth development, making it a natural model for twenty-first century after-school programs. Expanding on the 4-H pledge, the author outlines the principles a successful youth development program would have: an emphasis on leadership skills, a feeling of connection and belonging, a forum for exploring career opportunities, and a component of meaningful community service.

Preoperative computed tomography diagnosis of non-recurrent laryngeal nerve in patients with esophageal carcinoma.

PubMed

Niu, Zhong-Xi; Zhang, Hang; Chen, Long-Qi; Shi, Hui; Peng, Jun; Su, Li-Wei; Li, Wei; Xiao, Bo; He, Shu; Yue, Hong-Xu

2017-01-01

The non-recurrent laryngeal nerve (NRLN) is a rare but potentially serious anomaly that is commonly associated with the aberrant right subclavian artery (ARSA). It is easy to damage during surgical resection of esophageal cancer, leading to severe complications. Preoperative enhanced thoracic computed tomography (CT) scans of 2697 patients with esophageal carcinoma treated in our hospital between January 2010 and December 2013 were examined. We classified the positional relationship between the right subclavian artery and the membranous wall of the trachea into two types and used this method to predicate NRLN by identifying ARSA. Twenty-six patients (0.96%) were identified with ARSA, all of which were cases of NRLN by CT. NRLN was identified during surgery in the 26 patients, and a normal right recurrent laryngeal nerve was observed in 2671 patients. The ARSA was detected on the dorsal side of the membranous wall of the trachea in all 26 NRLN cases, while it was detected on the ventral side in all 2671 recurrent laryngeal nerve cases. Enhanced CT scanning is a reliable method for predicting NRLN by identifying ARSA. Preoperative recognition of this nerve anomaly allows surgeons to avoid damaging the nerve and abnormal vessels during esophagectomy. © 2016 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Cognitive problem solving patterns of medical students correlate with success in diagnostic case solutions.

PubMed

Kiesewetter, Jan; Ebersbach, René; Görlitz, Anja; Holzer, Matthias; Fischer, Martin R; Schmidmaier, Ralf

2013-01-01

Problem-solving in terms of clinical reasoning is regarded as a key competence of medical doctors. Little is known about the general cognitive actions underlying the strategies of problem-solving among medical students. In this study, a theory-based model was used and adapted in order to investigate the cognitive actions in which medical students are engaged when dealing with a case and how patterns of these actions are related to the correct solution. Twenty-three medical students worked on three cases on clinical nephrology using the think-aloud method. The transcribed recordings were coded using a theory-based model consisting of eight different cognitive actions. The coded data was analysed using time sequences in a graphical representation software. Furthermore the relationship between the coded data and accuracy of diagnosis was investigated with inferential statistical methods. The observation of all main actions in a case elaboration, including evaluation, representation and integration, was considered a complete model and was found in the majority of cases (56%). This pattern significantly related to the accuracy of the case solution (φ = 0.55; p<.001). Extent of prior knowledge was neither related to the complete model nor to the correct solution. The proposed model is suitable to empirically verify the cognitive actions of problem-solving of medical students. The cognitive actions evaluation, representation and integration are crucial for the complete model and therefore for the accuracy of the solution. The educational implication which may be drawn from this study is to foster students reasoning by focusing on higher level reasoning.

Exploring Situational Awareness in Diagnostic Errors in Primary Care

PubMed Central

Singh, Hardeep; Giardina, Traber Davis; Petersen, Laura A.; Smith, Michael; Wilson, Lindsey; Dismukes, Key; Bhagwath, Gayathri; Thomas, Eric J.

2013-01-01

Objective Diagnostic errors in primary care are harmful but poorly studied. To facilitate understanding of diagnostic errors in real-world primary care settings using electronic health records (EHRs), this study explored the use of the Situational Awareness (SA) framework from aviation human factors research. Methods A mixed-methods study was conducted involving reviews of EHR data followed by semi-structured interviews of selected providers from two institutions in the US. The study population included 380 consecutive patients with colorectal and lung cancers diagnosed between February 2008 and January 2009. Using a pre-tested data collection instrument, trained physicians identified diagnostic errors, defined as lack of timely action on one or more established indications for diagnostic work-up for lung and colorectal cancers. Twenty-six providers involved in cases with and without errors were interviewed. Interviews probed for providers' lack of SA and how this may have influenced the diagnostic process. Results Of 254 cases meeting inclusion criteria, errors were found in 30 (32.6%) of 92 lung cancer cases and 56 (33.5%) of 167 colorectal cancer cases. Analysis of interviews related to error cases revealed evidence of lack of one of four levels of SA applicable to primary care practice: information perception, information comprehension, forecasting future events, and choosing appropriate action based on the first three levels. In cases without error, the application of the SA framework provided insight into processes involved in attention management. Conclusions A framework of SA can help analyze and understand diagnostic errors in primary care settings that use EHRs. PMID:21890757

Giant cell tumour of tendon sheath and synovial membrane: A review of 26 cases.

PubMed

Kant, Kumar Shashi; Manav, Ajoy Kumar; Kumar, Rakesh; Abhinav; Sinha, Vishvendra Kumar; Sharma, Akshat

2017-11-01

Aim of our study is to highlight the incidence and benign nature of Giant cell tumour of tendon sheath and need for complete removal, thus minimizing the chances of recurrence. A total of 26 cases of Giant cell tumour of tendon sheath operated in the department of Orthopaedics, Patna Medical College & Hospital, Patna from 2003 to 2010 were included in this study. The surgery was performed after clinical evaluation of the lesion and Fine Needle Aspiration Cytology (FNAC). The tumour underwent en bloc marginal excision. The patients were followed up for minimum two year. Our study population consisted of 18 females and 8 males. The mean age at the time of surgery was 38.3 years (range, 18-62 years). Twenty three cases were found in the 3rd and 4th decade. Twenty two cases involved upper extremity and only 4 cases in lower extremity. MRI was done in 2 cases where diagnosis was in doubt. Bony indentation on X-ray film was found in 7 cases and thorough curettage of cortical shell was done. All the cases were treated by marginal excision. Three cases developed post-operative stiffness but regained full range of movement with physiotherapy. Sensory impairment was seen in 3 cases. Recurrence occurred in 2 case and they were treated by repeat marginal excision. Meticulous en-masse marginal excision of the giant cell tumour of tendon sheath in blood less field using magnification is the treatment of choice.

Semantic divergence in clinical education: Student-centered or student democracy

PubMed Central

Khademolhosseini, Seyyed Mohammad; Vanaki, Zohreh; Memarian, Robabeh; Ebadi, Abass

2012-01-01

Aims: Although several studies have confirmed the validity and the strength of the student-centered approach and most training centeres have put it as the heading of their agenda, there are still problems in the method of implementation, increasing the need for further research to review the mode of implementation. In this regard, the present study has been conducted to investigate students’ and educators’ perception in terms of interaction manner in clinical education process. Settings and Design: This study was performed in a qualitative approach and by the conventional content analysis method. Materials and Methods: Data were collected until saturation through use of individual semi-structured interviews. Twenty-one subjects including undergraduate nursing students (8 cases), faculty member educators (9 cases), head nurses (3 cases), and educational supervisor (1 case) participated in the study, and the data were analyzed using MAXQDA3 software. Results: “tudent democrac” was extracted through data analysis as the main theme of the study. Participants’ experience in terms of the five sub-themes included instructor’s loss of dignity, negligence in the evaluation of the students, poor discipline, lack of compliance with the educator, and lack of motivation. Conclusions: Instructor’s weaknesses in planning, guiding, and evaluating the students led to student’s interference in these affairs and a challenge in effective student-centered approach. Although excessive emphasis on students’ opinion for educational evaluation is apparently a sign of tribute to the students, it ultimately contributes to ignoring the process of learning to attract students’ interest, occupational devaluation, and a decrease in students’ motivation. PMID:23922594

Novice Teachers' Case Dilemmas: Surprising Perspectives Related to Diversity.

ERIC Educational Resources Information Center

Mastrilli, Thomas; Sardo-Brown, Deborah; Hinson, Stephanie

This study described novice teachers' case dilemmas, analyzing them for assumptions made by teachers about teaching and learning as well as for solutions to the dilemmas. Twenty-one of the thirty-six dilemmas emphasized either minority students, students of low socioeconomic status, or students from single-parent households. Among the issues…

Action Research Localization in China: Three Cases

ERIC Educational Resources Information Center

Bai, Yimin

2009-01-01

Since the introduction of the action research into China in the 1980s, especially since the start of the twenty-first century, Chinese education researchers have been trying to localize it in relation to the backdrop of the national curriculum reform in basic education. This article presents three cases in which educators aimed for a conscious…

Integrating Curriculum: A Case Study of Teaching Global Education

ERIC Educational Resources Information Center

Ferguson-Patrick, Kate; Reynolds, Ruth; Macqueen, Suzanne

2018-01-01

Despite widespread support for integrated approaches to teaching, classroom practice reveals a lack of implementation. This paper explores challenges and opportunities in teaching an integrated curriculum, and connects this with the contemporary notion of a twenty-first century curriculum and pedagogy. A case study of Global Education (GE) is used…

Miliaria rubra of the lower limbs in underground miners.

PubMed

Donoghue, A M; Sinclair, M J

2000-08-01

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.

Cutaneous myeloid sarcoma: natural history and biology of an uncommon manifestation of acute myeloid leukemia.

PubMed

Hurley, M Yadira; Ghahramani, Grant K; Frisch, Stephanie; Armbrecht, Eric S; Lind, Anne C; Nguyen, Tudung T; Hassan, Anjum; Kreisel, Friederike H; Frater, John L

2013-05-01

We conducted a retrospective study of patients with cutaneous myeloid sarcoma, from 2 tertiary care institutions. Eighty-three patients presented, with a mean age of 52 years. Diagnosis of myeloid sarcoma in the skin was difficult due to the low frequency of myeloperoxidase and/or CD34+ cases (56% and 19% of tested cases, respectively). Seventy-one of the 83 patients (86%) had ≥ 1 bone marrow biopsy. Twenty-eight (39%) had acute myeloid leukemia with monocytic differentiation. Twenty-three had other de novo acute myeloid leukemia subtypes. Thirteen patients had other myeloid neoplasms, of which 4 ultimately progressed to an acute myeloid leukemia. Seven had no bone marrow malignancy. Ninety-eight percent of the patients received chemotherapy, and approximately 89% died of causes related to their disease. Cutaneous myeloid sarcoma in most cases represents an aggressive manifestation of acute myeloid leukemia. Diagnosis can be challenging due to lack of myeloblast-associated antigen expression in many cases, and difficulty in distinguishing monocyte-lineage blasts from neoplastic and non-neoplastic mature monocytes.

Endoscopic photodynamic therapy with hematoporphyrin derivative in the treatment of malignant tumors: report of 120 cases

NASA Astrophysics Data System (ADS)

Tian, Mao-en; Liu, Fa-wen; Qian, Jia-ping; Ji, Qing; Feng, Yun-qiu

1993-03-01

One-hundred-twenty cases of malignant tumors treated by endoscopic photodynamic therapy with hematoporphyrin derivative from August 1982 - July 1990 are reported. Of the 120 cases, including 97 males and 23 females ages varying from 39 to 77 years old, 40 cases were primary tumors and 80 cases were local residual or recurrent after surgery or radiotherapy or chemotherapy. All cases were confirmed in pathological biopsy, including 58 squamous cell carcinoma, 28 various adenocarcinoma, and 34 transitional cell carcinoma. Twenty-four, 48 and/or 72 hours after intravenous injection of HpD 2.0 - 3.0 mg/kg, or DHE 1.5 - 2.0 mg/kg, or Y-HpD 5.0 mg/kg, the tumor was irradiated with 630 nm wavelength of argon dye laser via a quartz light fiber inserted through the forceps channel of the endoscope. Of the 120 cases treated, CR was obtained in 38 cases, PR in 25 cases, MR in 52 cases, and NR in 5 cases. Total response rate was 95.8%; significant response rate 52.5%; and tumor eradicated rate 31.7%. The 38 cases included: 14 cases of early esophageal carcinoma, 3 cases of early cardiac carcinoma, 1 case of early lung cancer, 1 case of early gastric carcinoma, 15 cases of superficial bladder carcinoma, 3 cases of local residual recurrent micro lung cancer, and 1 case of cardiac carcinoma. The longest cancer-free survival was over eight years. Endoscopic photodynamic therapy is, therefore, curative effective in the treatment of early and superficial carcinoma, and palliative effective in the treatment of advanced carcinoma. Standardized and controlled trials are required to assess its place in combined treatment of malignant tumors.

[Pulmonary and systemic fat embolism as a cause of death in forensic autopsy practice].

PubMed

Akçay Turan, Arzu; Celik, Safa; Karayel, Ferah; Pakiş, Işil; Arican, Nadir

2006-04-01

The aim of this study was to evaluate the possible correlations between the grade of fat embolism and age, gender, severity of trauma and post-traumatic survival time. Thirty-one cases with pulmonary and/or systemic fat embolism, auotopsied at the Morgue Department of Council of Forensic Medicine were evaluated retrospectively. Twenty-eight cases (90%) died due to trauma and its complications. Nineteen cases (61%) were injured in motor vehicle-related accidents. Post-traumatic survival time varied between 0-384 hours (61.6+/-86.2 hours). Abbreviated injury scale (AIS) was 8.1+/-3.9 and injury severity score (ISS) was 26.5+/-19.7 SD. Twenty-four (77%) cases were determined as isolated pulmonary fat embolism and 7 (23%) cases as systemic fat embolism on histopathological examination. Possible correlations between the grade of fat embolism and age, gender, severity of trauma and post-traumatic survival time were evaluated statistically with using Chi-square and Spearman's correlation tests. There were no correlations between the grade of fat embolism and age, gender, the severity of trauma. Post-traumatic survival time and the severity of trauma had a very weak negative correlation without any statistical significance.

Surveillance of congenital rubella and rubella infections in pregnancy in EU/EEA countries, 2012: Current status and future perspective to monitor elimination.

PubMed

Giambi, C; Montaño-Remacha, C; Celentano, L Pastore; Derrough, T

2015-09-11

Rubella elimination and congenital rubella syndrome (CRS) prevention are targets for achievement by 2015 in the WHO-EURO Region. This paper describes the existing surveillance systems for CRS and rubella in pregnancy in order to critically interpret the findings in relation to the 2012 WHO-EURO surveillance guidelines. In 2012 we conducted a survey to collect information on surveillance of CRS and rubella in pregnancy in 29 EU/EEA countries. Questionnaires explored the characteristics of the surveillance systems, case definition, epidemiological investigation and follow-up of cases, reference laboratories and types of tests performed. Twenty-eight countries had surveillance systems for CRS, mostly nationwide, mandatory, passive and case-based; 23 collected information on the origin of the infection; 11 reported asymptomatic infections; 6 required zero-reporting. Case definitions varied among countries, although 24 used the EU definition. Laboratories reported cases in 18 countries. Twenty countries collected information on pregnancy within the rubella surveillance system and 5 had specific surveillance for rubella in pregnancy. Two countries did not monitor outcomes of suspected infections in pregnancy; infants with CRS were monitored in all the remaining countries; asymptomatic infected infants in 15; stillbirths and fetal deaths in 13; therapeutic and spontaneous abortions in 8 and 7. Twenty-seven countries had a national reference laboratory for CRS and rubella in pregnancy; genotyping was performed in 15. The current surveillance systems allow adequate CRS monitoring in EU. Further efforts are needed to improve their quality, including uniform case definitions, collection of information on the origin of infection, and promotion of reporting from laboratories. Follow-up of pregnant women with suspected infection should be strengthened because it is an entry point for CRS, including detection of fetal deaths, stillbirths and abortions. Laboratory capacity for confirming congenital rubella infections and infections in pregnancy is good in EU, however the use of genotyping should be encouraged. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Use of Continuous Electrocardiographic Holter Monitoring in Pediatric Cardiology

PubMed Central

Begic, Zijo; Begic, Edin; Mesihovic-Dinarevic, Senka; Masic, Izet; Pesto, Senad; Halimic, Mirza; Kadic, Almira; Dobraca, Amra

2016-01-01

Objective: To show the place and role of continuous electrocardiographic twenty-four-hour ECG monitoring in daily clinical practice of pediatric cardiologists. Methods: According to protocol, 2753 patients underwent dynamic continuous ECG Holter monitoring (data collected from the “Register of ECG Holter monitoring” of Pediatric Clinic, UCC Sarajevo in period April 2003- April 2015). Results: There were 50,5% boys and 49,5% girls, aged from birth to 19 years (1,63% - neonates and infants, 2,6% - toddlers, 9,95% - preschool children, 35,5% - gradeschoolers and 50,3% children in puberty and adolescence). In 68,1% of patients Holter was performed for the first time. Indications for conducting Holter were: arrhythmias in 42,2% cases, precordial pain in 23,5%, suspicion of pre-excitation and/or pre-excitation in 10%, crisis of consciousness in 8%, uncorrected congenital/acquired heart defects in 4,2%, operated heart defects in 3,7%, hypertension in 3,1% cases, control of the pacemaker in 1,63% and other causes in 3,5% cases. Discharge diagnosis after ECG Holter monitoring were: insignificant arrhythmias in 47,1% cases, wandering pacemaker in 21,3%, pre-excitation in 16,2%, benign ventricular premature beats in 6,3%, atrioventricular block in 3%, sinus pause in 2.2% cases and other arrhythmias in 3,5%. In mentioned period 57 cases of Wolf Parkinson White syndrome were registered, in 4,5% of patients antiarrhythmic therapy was administered. Radiofrequent ablation was performed in 23 cases. Conclusion: The development of pediatric cardiac surgery has initiated development of pediatric arrhythmology as imperative segment of pediatric cardiology. Continuous ECG Holter monitoring has become irreplaceable method in everyday diagnostics and therapy of arrhythmias in children. PMID:27708487

[Study of tuberculosis outbreaks reported in Catalonia, 1998-2002].

PubMed

Bran, Carlos M; Caylá, Joan A; Domínguez, Angela; Camps, Neus; Godoy, Pere; Orcau, Angels; Barrabeig, Irene; Alcaide, José; Altet, Neus; Alvarez, Pep

2006-06-01

To analyze the characteristics of tuberculosis outbreaks declared under vigilance programs in Catalonia. Descriptive study of outbreaks from 1998 through 2002 for which reports were available. An outbreak was defined as 3 or more associated cases appearing within a year. For 2 health care regions, outbreaks for which there were full surveillance reports with contact tracing were compared to outbreaks identified but which had not been fully reported. Twenty-seven outbreaks were analyzed. Nineteen (70%) occurred within families. A total of 22 outbreaks were declared upon identification of the true index case and 5 upon detection of secondary cases. The mean annual incidence of outbreaks was 0.40/100,100 inhabitants. Most cases were in males 16 to 40 years of age and involved cavitary lesions and a clinically significant diagnostic delay. Twenty-seven outbreaks caused 69 secondary cases. A longer diagnostic delay was seen to correspond to a larger number of secondary cases (P=.08). In the 2 health care regions analyzed, full surveillance reports with contact tracing were issued for 2 of the 14 outbreaks detected (14.4%). Tuberculosis outbreaks are common but investigative follow-up is scarce. The size of the outbreak is related to the length of diagnostic delay. Rapid diagnosis, contact tracing, and the issuance of a public health report should be priorities in all outbreaks detected.

[Molecular diagnosis of two Chinese cystic fibrosis children and literature review].

PubMed

Xu, B P; Wang, H; Zhao, Y H; Liu, J; Yao, Y; Feng, X L; Shen, K L

2016-05-01

To investigate the clinical manifestations and molecular features of cystic fibrosis in Chinese children. A retrospective analysis of two pediatric cystic fibrosis cases diagnosed by gene test in Beijing Children's Hospital, Capital Medical University from 2010 to 2015, and Chinese cystic fibrosis reported patients searched of"cystic fibrosis, Chinese"on Chinese databases (CNKI, Wanfang Data) and PubMed from 1975 to 2015.The clinical manifestations and molecular features were analyzed. One of the two newly diagnosed cystic fibrosis cases was a 10-year old girl who suffered from reccurent cough with expectoration and associated with cirrhosis.Sweat tests showed increased chloride twice with the lower level of 306.82 mmol/L.The other was an 8-month old boy with reccurent pneumonia from neonate, failure to thrive and fatty diarrhea.Two children had various degrees of bronchiectasis and massive sticky secretion on the bronchoscopy.They had no family history and their parents had no consanguineous marriage.CFTR mutations of c. 595C>T and c. 2290C>T were found in gene tests.On the database, twenty-one reports involving thirty-six Chinese patients (16 males and 20 females) were retrieved.Together with this group of 2 cases, a total of 38 cases were involved.The age at diagnosis was 4 months to 28 years with a median age of 10 years.All patients had reccurent respiratory infections, twenty-seven cases (71%) had malnutrition, fifteen (39%)had chronic diarrhea, and 16 cases (42%) had other digestive manifestations, including jaundice (4 cases), hepatomegaly (11 cases), ascites (2 cases) and pancreatic atrophy (3 cases). Five cases had a positive family history and six cases had a suspicious family history.Consanguineous marriage was found in three families.Sweat test revealed elevated chloride (52-327 mmol/L) in 28 cases.Eight of the 16 patients who performed pancreatic exocrine function examination showed pancreatic insufficiency.Eighteen of the 20 patients described the image manifestation of bronchiectasis.The age at death of 13 patients(34%) was 4 months to 25 years with a median of 11 years.Twenty-nine rare CFTR mutations were found in 25 tested patients, and c. 1766+ 5G>T(5 cases), c.2083dupG and c. 2684G>A (3 cases) held the top three mutation patterns. Respiratory symptoms and bronchiectasis are the main manifestations of Chinese cystic fibrosis patients, although some of them may be associated with malnutrition, digestive symptoms and pancreatic insufficiency. CFTR mutations are various and rare in Caucasians.

What’s Causing Toxicity in Sediments? Results of Twenty Years of Toxicity Identification and Evaluations (TIEs)

EPA Science Inventory

Sediment Toxicity Identification and Evaluation (TIEs) methods have been used for twenty years to identify the causes of toxicity in sediments around the world. We summarized and categorized results of more than 80 peer-reviewed TIE studies into non-ionic organic, cationic, ammo...

Exploring nursing expertise in residential care for older people: a mixed method study.

PubMed

Phelan, Amanda; McCormack, Brendan

2016-10-01

To explore the expertise of Registered Nurses in residential care for older people. As older people in residential care have many complex dependencies, nursing expertise is an essential component of care excellence. However, the work of these nurses can be invisible and, therefore, unrecognized. Thus, additional attention is required to illuminate such nursing expertise. A mixed method design was used in this study. The research took place in 2012 in the Republic of Ireland. Twenty-three case study nurses were recruited from nursing homes. Each case study nurse involved five data collection methods: shadowing, interview with a colleague, interview with a resident, a demographic profile and a director of nursing survey. The study was also informed by a modified focus group. Qualitative data were analysed using directed content analysis using a conceptual framework generated from the literature on nursing expertise. Quantitative data were analysed using SPSS and presented in descriptive statistics. The findings from the case studies and the modified focus group are presented in seven themes, which represent nursing expertise in residential care of older people: transitions, context of the nursing home, saliency, holistic practice knowledge, knowing the resident, moral agency and skilled know how. Nursing expertise in residential care of older people is a complex phenomenon which encompasses many aspects of care delivery in a person-centred framework. By rendering this expertise visible, the need for appropriate and adequate skill mix for a growing residential care population is presented. © 2016 John Wiley & Sons Ltd.

Science Teacher Education in the Twenty-First Century: a Pedagogical Framework for Technology-Integrated Social Constructivism

NASA Astrophysics Data System (ADS)

Barak, Miri

2017-04-01

Changes in our global world have shifted the skill demands from acquisition of structured knowledge to mastery of skills, often referred to as twenty-first century competencies. Given these changes, a sequential explanatory mixed methods study was undertaken to (a) examine predominant instructional methods and technologies used by teacher educators, (b) identify attributes for learning and teaching in the twenty-first century, and (c) develop a pedagogical framework for promoting meaningful usage of advanced technologies. Quantitative and qualitative data were collected via an online survey, personal interviews, and written reflections with science teacher educators and student teachers. Findings indicated that teacher educators do not provide sufficient models for the promotion of reform-based practice via web 2.0 environments, such as Wikis, blogs, social networks, or other cloud technologies. Findings also indicated four attributes for teaching and learning in the twenty-first century: (a) adapting to frequent changes and uncertain situations, (b) collaborating and communicating in decentralized environments, (c) generating data and managing information, and (d) releasing control by encouraging exploration. Guided by social constructivist paradigms and twenty-first century teaching attributes, this study suggests a pedagogical framework for fostering meaningful usage of advanced technologies in science teacher education courses.

Nano-material and method of fabrication

DOEpatents

Menchhofer, Paul A; Seals, Roland D; Howe, Jane Y; Wang, Wei

2015-02-03

A fluffy nano-material and method of manufacture are described. At 2000.times. magnification the fluffy nanomaterial has the appearance of raw, uncarded wool, with individual fiber lengths ranging from approximately four microns to twenty microns. Powder-based nanocatalysts are dispersed in the fluffy nanomaterial. The production of fluffy nanomaterial typically involves flowing about 125 cc/min of organic vapor at a pressure of about 400 torr over powder-based nano-catalysts for a period of time that may range from approximately thirty minutes to twenty-four hours.

[Revision of Schatzker type Ⅵ tibial plateau fracture failure focus on the recovery of lower limb alignment].

PubMed

Cong, R J; Liu, J F; Jiang, Y; Dilixiati, Duolikun; Hou, X D; Zheng, L P

2018-03-01

Objective: To explore the influence of the lower extremity abnormal alignment and the joint surface, and to explore the surgical skills. Methods: Twenty-two cases of tibial plateau Schatzker Ⅵ fracture internal fixation failure revision from January 2012 to January 2017 in Department of Orthopedics, Shanghai 10(th) Hospital.One year follow-up after initial surgery to make sure of failure.Three-dimensional CT scan, radiography, infection index, gait analysis, knee joint ROM, femur tibia angle, tibial plateau tibial shaft angle and posterior slope if tibial plateau were observed. The medial approach and bi-planer osteotoma were used.Autogenous iliac bone graft, postoperative fast recovery channel were used.Follow-up point included preoperative and postoperative 7 days, 6 weeks, 3 months, and 6 months.Obvervational index included double lower limbs radiography, knee society score(KSS), complications such as infection, skin necrosis, joint main passive activity, double lower limbs alignment the last follow-up SF-36 scale.Rate was compared by χ(2) test, measurement data using paired sample t test.Correlation was analyzed by Pearson correlation regression testing. Results: Twenty-two patients received follow-up.KSS, more than 21 cases were benign, with good gait.One case was poor, with claudication gait.Not skin necrosis, no deep infection cases, 1 case get blisters 2 days postoperatively, and disappear after 5 days with detumescence and cold therapy.Whether restoring force line affect the KSS significantly(χ(2)=22.000, P =0.000). Knee joint ROM, SF-36 score, KSS and lower limb alignment were improved significantly. In different individual the articular surface and anatomical angle recovered greatly but the posterior slope angle was quite difference which has no correlation with KSS and SF-36 scale( P >0.01). Conclusions: Revision of Schatzker type Ⅵ tibial plateau fracture failure should focus on the recovery of lower limb alignment.moderate overcorrect bone cutting and joint surface height can bring benefits to the postoperative knee function.Revision surgery patients have greater psychological pressure, more early psychological intervention is necessary.

Repetitive deliberate fires: Development and validation of a methodology to detect series.

PubMed

Bruenisholz, Eva; Delémont, Olivier; Ribaux, Olivier; Wilson-Wilde, Linzi

2017-08-01

The detection of repetitive deliberate fire events is challenging and still often ineffective due to a case-by-case approach. A previous study provided a critical review of the situation and analysis of the main challenges. This study suggested that the intelligence process, integrating forensic data, could be a valid framework to provide a follow-up and systematic analysis provided it is adapted to the specificities of repetitive deliberate fires. In this current manuscript, a specific methodology to detect deliberate fires series, i.e. set by the same perpetrators, is presented and validated. It is based on case profiles relying on specific elements previously identified. The method was validated using a dataset of approximately 8000 deliberate fire events collected over 12 years in a Swiss state. Twenty possible series were detected, including 6 of 9 known series. These results are very promising and lead the way to a systematic implementation of this methodology in an intelligence framework, whilst demonstrating the need and benefit of increasing the collection of forensic specific information to strengthen the value of links between cases. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Multislice CT Angiography in Renal Artery Stent Evaluation: Prospective Comparison with Intra-Arterial Digital Subtraction Angiography

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

Raza, Syed A.; Chughtai, Aamer R.; Wahba, Mona

2004-01-15

Purpose: To assess the role of multislice computed tomography angiography (MCTA) in the evaluation of renal artery stents, using intra-arterial digital subtraction angiography (DSA) as the gold standard. Methods: Twenty consecutive patients (15 men, 5 women) with 23 renal artery stents prospectively underwent both MCTA and DSA. Axial images, multiplanar reconstructions and maximum intensity projection images were used for diagnosis. The MCTA and DSA images were each interpreted without reference to the result of the other investigation. Results:The three cases of restenosis on DSA were detected correctly by MCTA; in 19 cases where MCTA showed a fully patent stent, themore » DSA was also negative. Sensitivity and negative predictive value (NPV) of MCTA were therefore 100%. In four cases, MCTA showed apparently minimal disease which was not shown on DSA. These cases are taken as false positive giving a specificity of 80% and a positive predictive value of 43%. Conclusion: The high sensitivity and NPV suggest MCTA may be useful as a noninvasive screen for renal artery stentrestenosis. MCTA detected mild disease in a few patients which was not confirmed on angiography.« less

Nasopharyngeal carcinoma heterogeneity of DNA content identified on cytologic preparations.

PubMed

Maohuai, C; Chang, A R; Lo, D

2001-06-01

To evaluate tumor heterogeneity of DNA content in nasopharyngeal carcinoma (NPC) performed on cytologic specimens. Image cytometric analysis of DNA ploidy status of 40 NPCs was performed on nasopharyngeal brushing smears stained with the Feulgen method after hematoxylin eosin staining. If the DNA distribution pattern from the same tumor exhibited diploid, aneuploid or/and tetraploid peaks or some combination of these patterns, the presence of tumor heterogeneity of DNA content was identified. Thirty-four cases (85%) had a nondiploid DNA pattern among the 40 NPCs. Twenty-eight cases exhibited tumor heterogeneity of DNA content (70%). Of the 28 tumors, 13 (46%) had a combination of diploid and tetraploid patterns, 10 (37%) had a combination of diploid and aneuploid patterns, 3 cases (11%) had a combination of tetraploid and aneuploid patterns, and 2 cases had two aneuploid stem lines. The relationship between DNA ploidy pattern and tumor histologic and cytologic morphology was also examined. There is a high incidence of DNA content heterogeneity in NPC. The relevance of tumor heterogeneity to the biologic behavior of NPC awaits further study. DNA quantification with image cytometry on destained cytologic preparations is feasible and reliable.

Twenty-first century learning in schools: A case study of New Technology High School in Napa, California.

PubMed

Pearlman, Bob

2006-01-01

The most pertinent question concerning teaching and learning in the twenty-first century is not what knowledge and skills students need--that laundry list was identified over a decade ago--but rather how to foster twenty-first century learning. What curricula, experiences, assessments, environments, and technology best support twenty-first century learning? New Technology High School (NTHS) in Napa, California, is one example of a successful twenty-first century school. In this chapter, the author describes the components of this exemplary high school, illustrating an environment that will cultivate twenty-first century student learning. New Technology High School began by defining eight learning outcomes, aligned with the standards of the Partnership for 21st Century Skills; to graduate, students demonstrate mastery of these outcomes through an online portfolio. To help students achieve the outcomes, NTHS employs project- and problem-based learning. Whereas in traditional classrooms students work alone on short-term assignments that do not lend themselves to deep understanding, the project-based learning approach has students working in teams on long-term, in-depth, rigorous projects. Students' work is supported by the school's workplace-like environment and effectiv use of technology. Meaningful assessment is essential to project-based learning; students receive continuous feedback, helping them become self-directed learners. In fact, NTHS uses outcome-based grading through which students constantly know how they are performing on the twenty-first century outcomes. Research has shown that NTHS graduates are better prepared for postsecondary education, careers, and citizenship than their peers from other schools. To facilitate twenty-first century learning, all schools need to rethink their approach to teaching and learning. New Technology High School is one way to do so.

Chemistry Teachers' Views on Teaching "Climate Change"--An Interview Case Study from Research-Oriented Learning in Teacher Education

ERIC Educational Resources Information Center

Feierabend, Timo; Jokmin, Sebastian; Eilks, Ingo

2011-01-01

This paper presents a case study from research-oriented learning in chemistry teacher education. The study evaluates the views of twenty experienced German chemistry teachers about the teaching of climate change in chemistry education. Data was collected using semi-structured interviews about the teachers' experiences and their views about…

Using Problem-Based Learning Software with At-Risk Students: A Case Study

ERIC Educational Resources Information Center

Samsonov, Pavel; Pedersen, Susan; Hill, Christine L.

2006-01-01

In an extension of research examining student-centered pedagogy, the present case study examined how at-risk students used Alien Rescue, a problem-based learning (PBL) software program for middle school science. Twenty-nine participants were observed and interviewed over the twelve class days in which they were engaged in Alien Rescue. Students'…

Complications of oral exposure to fentanyl transdermal delivery system patches.

PubMed

Prosser, Jane M; Jones, Brent E; Nelson, Lewis

2010-12-01

Fentanyl is a synthetic opioid available therapeutically as an intravenous, transbucal, or transdermal preparation. It is also used as a drug of abuse through a variety of different methods, including the oral abuse of transdermal fentanyl patches. This is a series of patients with oral fentanyl patch exposure reported to our center and represents the first series of oral fentanyl patch exposures collected outside of the postmortem setting. In this series, we examined the New York Poison Control Center database for all cases of oral abuse of fentanyl reported between January 2000 and April 2008. Twenty cases were reported, nine were asymptomatic or had symptoms of opioid withdrawal; 11 had symptoms of opioid intoxication. Eight patients were administered naloxone and all showed improvement in clinical status. Only one case resulted in a confirmed fatality-this patient had an orally adherent patch discovered at intubation. Oral exposure may result in life-threatening toxicity. Patients should be closely assessed and monitored for the opioid toxidrome, and if symptomatic, should be managed with opioid antagonists and ventilatory support.

Ebola outbreak in rural West Africa: epidemiology, clinical features and outcomes

PubMed Central

Dallatomasina, Silvia; Crestani, Rosa; Sylvester Squire, James; Declerk, Hilde; Caleo, Grazia Marta; Wolz, Anja; Stinson, Kathryn; Patten, Gabriela; Brechard, Raphael; Gbabai, Osman Bamba-Moi; Spreicher, Armand; Van Herp, Michel; Zachariah, Rony

2015-01-01

Objective To describe Ebola cases in the district Ebola management centre of in Kailahun, a remote rural district of Sierra Leone, in terms of geographic origin, patient and hospitalisation characteristics, treatment outcomes and time from symptom onset to admission. Methods Data of all Ebola cases from June 23rd to October 5th 2014 were reviewed. Ebola was confirmed by reverse-transcriptase-polymerase-chain-reaction assay. Results Of 489 confirmed cases (51% male, median age 28 years), 166 (34%) originated outside Kailahun district. Twenty-eight (6%) were health workers: 2 doctors, 11 nurses, 2 laboratory technicians, 7 community health workers and 6 other cadres. More than 50% of patients had fever, headache, abdominal pain, diarrhoea/vomiting. An unusual feature was cough in 40%. Unexplained bleeding was reported in 5%. Outcomes for the 489 confirmed cases were 227 (47%) discharges, 259 (53%) deaths and 3 transfers. Case fatality in health workers (68%) was higher than other occupations (52%, P = 0.05). The median community infectivity time was 6.5 days for both general population and health workers (P = 0.4). Conclusions One in three admitted cases originated outside Kailahun district due to limited national access to Ebola management centres – complicating contact tracing, safe burial and disinfection measures. The comparatively high case fatality among health workers requires attention. The community infectivity time needs to be reduced to prevent continued transmission. PMID:25565430

[Epidemiological situation of the selected infectious diseases in Poland in 1918-1939].

PubMed

Sztuka-Polińska, Urszula

2002-01-01

In Poland, during twenty years between the first and the second world war modern methods and remedies were created and applied to save the society from biological extermination caused by the epidemics of acute infectious diseases that existed in the larger areas of the country and other diseases that could threaten the society when brought from abroad. Poland regained its independence in 1918 as a country completely destroyed by war and encompassed three partitioned sectors that differed in wealth, class consciousness, various infrastructure, legislation, epidemiological situation of infectious diseases and threats spreading from abroad. Infectious diseases such as typhus fever, typhoid fever, cholera, smallpox, dysentery and other diseases spreading by alimentary tracts caused the greatest epidemiological problem. The considerable number of smallpox cases was noted in 1920-1922. In the thirties only individual cases occurred. Since 1934 no fatal cases of smallpox were registered. In 1919, in Poland 219,688 cases and 18,641 typhus fever deaths were registered. Between 1930 and 1939 the annual number of cases ranged from 2000 to 4000. In Poland each year between the first and the second world war typhoid fever was a serious sanitary problem. The largest outbreak of dysentery occurred in Poland in 1920-1921 and comprised 64,000 cases, among them 10,000 deaths. Acute childhood diseases such as scarlet fever and diphtheria were in Poland endemic. Number of registered cases was variable.

Fast Fragmentation of Networks Using Module-Based Attacks

PubMed Central

Requião da Cunha, Bruno; González-Avella, Juan Carlos; Gonçalves, Sebastián

2015-01-01

In the multidisciplinary field of Network Science, optimization of procedures for efficiently breaking complex networks is attracting much attention from a practical point of view. In this contribution, we present a module-based method to efficiently fragment complex networks. The procedure firstly identifies topological communities through which the network can be represented using a well established heuristic algorithm of community finding. Then only the nodes that participate of inter-community links are removed in descending order of their betweenness centrality. We illustrate the method by applying it to a variety of examples in the social, infrastructure, and biological fields. It is shown that the module-based approach always outperforms targeted attacks to vertices based on node degree or betweenness centrality rankings, with gains in efficiency strongly related to the modularity of the network. Remarkably, in the US power grid case, by deleting 3% of the nodes, the proposed method breaks the original network in fragments which are twenty times smaller in size than the fragments left by betweenness-based attack. PMID:26569610

Haplotype diversity of the myostatin gene among beef cattle breeds

PubMed Central

Dunner, Susana; Miranda, M Eugenia; Amigues, Yves; Cañón, Javier; Georges, Michel; Hanset, Roger; Williams, John; Ménissier, François

2003-01-01

A total of 678 individuals from 28 European bovine breeds were both phenotyped and analysed at the myostatin locus by the Single Strand Conformation Polymorphism (SSCP) method. Seven new mutations were identified which contribute to the high polymorphism (1 SNP every 100 bp) present in this small gene; twenty haplotypes were described and a genotyping method was set up using the Oligonucleotide Ligation Assay (OLA) method. Some haplotypes appeared to be exclusive to a particular breed; this was the case for 5 in the Charolaise (involving mutation Q204X) and 7 in the Maine-Anjou (involving mutation E226X). The relationships between the different haplotypes were studied, thus allowing to test the earlier hypothesis on the origin of muscular hypertrophy in Europe: muscular hypertrophy (namely nt821(del11)) was mainly spread in different waves from northern Europe milk purpose populations in most breeds; however, other mutations (mostly disruptive) arose in a single breed, were highly selected and have since scarcely evolved to other populations. PMID:12605853

Views of Cameroonian sex workers on a woman-controlled method of contraception and disease protection.

PubMed

Visness, C M; Ulin, P; Pfannenschmidt, S; Zekeng, L

1998-11-01

Five hundred and twenty female Cameroonian sex workers participating in a clinical trial of the effectiveness of nonoxynol-9 (N-9) contraceptive film to prevent HIV infection were interviewed to determine their experience with this woman-controlled method. The sex workers liked the film, with over 80% stating they would continue to use it if it were shown to be effective against HIV and were to become widely available. However, they were much more likely to use condoms and films simultaneously with their clients (40%) than with their regular partners (16%). The advantages ascribed to the film were that its use was under the woman's control; it could be used without the partner's knowledge; it allowed direct contact between partners; and it provided back-up protection in case of condom breakage. Data from this small study suggest that development of an effective, woman-controlled method of pregnancy and disease protection would be welcomed by these women.

Percutaneous sonographically assisted endoscopic gastrostomy for difficult cases with interposed organs.

PubMed

Moriwaki, Yoshihiro; Otani, Jun; Okuda, Junzo; Zotani, Hitomi; Kasuga, So

2018-03-27

The aim of this retrospective observational study was to clarify the usefulness and safety of percutaneous sonographically assisted endoscopic gastrostomy or duodenostomy (PSEGD) using the introduction method. The information for the sequential 22 patients who could not undergo standard percutaneous endoscopic gastrostomy (PEG) and underwent PSEGD for 3 y was extracted and was reviewed. In standard PEG, we performed pushing out of the stomach from the mediastinum and full distention to adhere the gastric wall to the peritoneal wall without interposing of the intraperitoneal tissues by air inflation and a turning-over procedure of the endoscope, four-point square fixation of the stomach to the peritoneal wall by using a Funada-style gastric wall fixation kit under diaphanoscopy, extracorporeal thumb pushing, and in difficult cases extracorporeal ultrasound guidance, and if necessary confirmation of fixation of the gastric wall to the peritoneal wall and placement of the PEG tube without any interposed tissues by using ultrasound. Twenty-one patients (95.5%) successfully underwent PSEGD. Early complications (more than grade 2 in Clavien-Dindo classification) just after the procedure occurred in one case (active oozing). We did not encounter a case with mispuncture of the intraperitoneal organs and tissues. Delayed complications occurring within 1 mo were pneumonia in five patients, including death in three cases; bleeding from puncture site in two patients; and atrial fibrilation in one patient. PSEGD using the introduction method is a useful procedure for difficult patients in whom intraperitoneal organ or tissue is suspected to be interposed between the abdominal wall and stomach. Copyright © 2018 Elsevier Inc. All rights reserved.

Mathematical model for the Bridgman-Stockbarger crystal growing system

NASA Technical Reports Server (NTRS)

Roberts, G. O.

1986-01-01

In a major technical breakthrough, a computer model for Bridgman-Stockbarger crystal growth was developed. The model includes melt convection, solute effects, thermal conduction in the ampule, melt, and crystal, and the determination of the curved moving crystal-melt interface. The key to the numerical method is the use of a nonuniform computational mesh which moves with the interface, so that the interface is a mesh surface. In addition, implicit methods are used for advection and diffusion of heat, concentration, and vorticity, for interface movement, and for internal gracity waves. This allows large time-steps without loss of stability or accuracy. Numerical results are presented for the interface shape, temperature distribution, and concentration distribution, in steady-state crystl growth. Solutions are presented for two test cases using water, with two different salts in solution. The two diffusivities differ by a factor of ten, and the concentrations differ by a factor of twenty.

Twenty Golden Opportunities To Enhance Student Learning: Use Them or Lose Them.

ERIC Educational Resources Information Center

Sponder, Barry

In an average classroom period, a teacher has twenty or more opportunities to interact with students and thereby influence learning outcomes. As such, teachers should use these opportunities to reinforce instruction or give positive corrective feedback. Typical methods used in schools emphasize error correction at the expense of calling attention…

The Twenty-First NASTRAN (R) Users' Colloquium

NASA Technical Reports Server (NTRS)

1993-01-01

This publication contains the proceedings of the Twenty-First NASTRAN Users' Colloquium held in Tampa, FL, April 26 through April 30, 1993. It provides some comprehensive general papers on the application of finite elements in engineering, comparisons with other approaches, unique applications, pre-and postprocessing with other auxiliary programs and new methods of analysis with NASTRAN.

Twenty-first-century science.

PubMed Central

Greenwood, M R

1995-01-01

Scientific life is changing in fundamental ways as the twenty-first century approaches. Advances in technology are changing methods of scientific communications and dissemination of information, while diminishing resources lead to stabilization, politicization, increased public oversight, and the potential for significant downsizing. Libraries can foster the crucial interdisciplinary connections necessary to forge a new vision of scholarship. PMID:7703945

Visual Literacy: Does It Enhance Leadership Abilities Required for the Twenty-First Century?

ERIC Educational Resources Information Center

Bintz, Carol

2016-01-01

The twenty-first century hosts a well-established global economy, where leaders are required to have increasingly complex skills that include creativity, innovation, vision, relatability, critical thinking and well-honed communications methods. The experience gained by learning to be visually literate includes the ability to see, observe, analyze,…

The second-generation eCLIPs Endovascular Clip System: initial experience.

PubMed

Chiu, Albert H; De Vries, Joost; O'Kelly, Cian J; Riina, Howard; McDougall, Ian; Tippett, Jonathan; Wan, Martina; de Oliveira Manoel, Airton Leonardo; Marotta, Thomas R

2018-02-01

OBJECTIVE Treatment of wide-necked intracranial aneurysms is associated with higher recanalization and complication rates; however, the most commonly used methods are not specifically designed to work in bifurcation lesions. To address these issues, the authors describe the evolution in the design and use of the eCLIPs (Endovascular Clip System) device, a novel hybrid stent-like assist device with flow diverter properties that was first described in 2008. METHODS A registry was established covering 13 international centers at which patients were treated with the second-generation eCLIPs device. Aneurysm morphology and rupture status, device neck coverage, coil retention, and procedural and late morbidity and mortality were recorded. For those patients who had undergone successful implantation more than 6 months earlier, the final imaging and clinical follow-up results and need for re-treatment were recorded. RESULTS Thirty-three patients were treated between June 2013 and September 2015. Twenty-five (76%) patients had successful placement of an eCLIPs device; 23 (92%) of these 25 patients had complete data. Eight cases of nondeployment occurred during the 1st year of use, consistent with a learning curve; no failures of deployment occurred thereafter. Two periprocedural transient ischemic attacks and 2 asymptomatic thrombotic events occurred. Twenty-one (91%) of 23 patients underwent follow-up at an average of 8 months (range 3-18 months); 9 (42.9%) of these 21 patients demonstrated an improvement in Raymond grade at follow-up; no cases of worsening Raymond grade were recorded, and 17 (81.0%) patients sustained a modified Raymond-Roy Classification class of I or II angiographic result at follow-up. Two delayed ruptures were recorded, both in previously coiled, symptomatic giant aneurysms where the device was used as a part of a salvage strategy. CONCLUSIONS The second-generation eCLIPs device is a viable treatment option for bifurcation aneurysms. The aneurysm occlusion rates in this initial clinical series are comparable to the initial experience with other bifurcation support devices.

An updated review of case-control studies of lung cancer and indoor radon-Is indoor radon the risk factor for lung cancer?

PubMed

Sheen, Seungsoo; Lee, Keu Sung; Chung, Wou Young; Nam, Saeil; Kang, Dae Ryong

2016-01-01

Lung cancer is a leading cause of cancer-related death in the world. Smoking is definitely the most important risk factor for lung cancer. Radon ((222)Rn) is a natural gas produced from radium ((226)Ra) in the decay series of uranium ((238)U). Radon exposure is the second most common cause of lung cancer and the first risk factor for lung cancer in never-smokers. Case-control studies have provided epidemiological evidence of the causative relationship between indoor radon exposure and lung cancer. Twenty-four case-control study papers were found by our search strategy from the PubMed database. Among them, seven studies showed that indoor radon has a statistically significant association with lung cancer. The studies performed in radon-prone areas showed a more positive association between radon and lung cancer. Reviewed papers had inconsistent results on the dose-response relationship between indoor radon and lung cancer risk. Further refined case-control studies will be required to evaluate the relationship between radon and lung cancer. Sufficient study sample size, proper interview methods, valid and precise indoor radon measurement, wide range of indoor radon, and appropriate control of confounders such as smoking status should be considered in further case-control studies.

Tale of the Tails, the Missing Postpartum IUCD Strings.

PubMed

Mishra, Sujnanendra

2017-06-01

Using an intrauterine device (IUD) is many times safer than pregnancy and more effective in preventing pregnancy than oral contraceptives, condoms, spermicidal, any barrier method, or natural family planning. Benefits of healthy timing and spacing of pregnancy are many. Postpartum contraception is becoming popular after introduction of PPIUCD services. To study the incidence, management, clinical outcome of missing strings cases in post-placental and intra-cesarean IUCD. This study was a retrospective observational study, carried out in the district of Balangir, Odisha, India. Status of women who had post-placental and intra-cesarean IUCD insertion in various institutions between January 2010 and December 2012 having follow-up as per the protocol was taken for the study. All the complications were recorded and studied. Incidence, clinical outcome, and management of missing strings were analyzed. Records of 1343 clients were studied. Six hundred and seventeen cases had failed to report for follow-up as per the study design. Seven hundred and twenty-six cases had follow-up as per the protocol. Of them, 36 had expulsion, and rest 690 cases were taken for the study. There were 209 missing strings at 3 months. At the end of the study, there was spontaneous descend in 138 cases. More than 50 % cases were asymptomatic. Ultrasonography was the method of diagnosis, and simple sounding of the uterus alone could also establish IUD in uterine cavity. Removal rate was higher in missing strings group, Continuation rate is higher in String visible group. Post-placental intra-cesarean Copper T 380A insertion is a safe and effective method of reversible contraception; missing string is emerging as a potential distracter of its use. It is important that every user must be followed up and the providers must be competent in managing complication. Better after care in form of effective follow-up and complication management is needed to maintain popularity. Introduction of compensation scheme will also help improving the acceptance.

PRCC-TFE3 dual-fusion FISH assay: A new method for identifying PRCC-TFE3 renal cell carcinoma in paraffin-embedded tissue

PubMed Central

Liu, Ning; Wang, Zhen; Miao, Baolei; Li, Dongmei; Guo, Hongqian

2017-01-01

PRCC-TFE3 renal cell carcinoma (RCC) is one of the most common types of Xp11.2 translocation renal cell carcinoma (tRCC), of which the diagnosis mainly relies on reverse transcription-polymerase chain reaction (RT-PCR) or chromosomal analysis in fresh frozen samples. Herein, we developed a new dual-fusion fluorescence in situ hybridization (FISH) probe to succinctly identify PRCC-TFE3 RCC in paraffin-embedded tissue. We immunohistochemically analyzed TFE3 and cathepsin K expression in 23 cases of Xp11.2 tRCC which had been confirmed by break-apart TFE3 FISH probe. Next, the dual-fusion FISH assay was performed on these selected cases. Twenty typical cases of clear renal cell carcinoma and 20 cases of papillary renal cell carcinoma were collected as control groups. Seven cases were finally confirmed as PRCC-TFE3 RCC by FISH detection, emerging dual-fusion signals, of which 2 cases were identified as PRCC-TFE3 RCC by RT-PCR previously. All remaining cases were negative for the PRCC-TFE3 rearrangement by FISH. The TFE3 immunohistochemistry was positive in 22/23 cases and the cathepsin K was positive in 16/23 cases. All 7 PRCC-TFE3 RCCs showed positive cathepsin K immunoreactivity. Our results reveal that PRCC-TFE3 dual-fusion FISH probe is an efficient and concise technique for diagnosing PRCC-TFE3 RCC in paraffin-embedded tissue. PMID:28949976

[Effect of neurolysis on intractable greater occipital nerve neuralgia].

PubMed

Tian, Yunhu; Liu, Ya; Liu, Huancai

2007-09-01

To investigate the effect of neurolysis on intractable greater occipital nerve neuralgia. From March 1998 to August 2005, twenty-six patients suffering from intractable greater occipital nerve neuralgia were treated. There were 12 males and 14 females with an average age of 52 years (ranged 38-63 years). The disease course was 3-7 years. Sixteen cases had a long duration of work with bowing head, 5 cases symptoms appeared after trauma, and others had no identified causes. The visual analogue scales (VAS) scoring was 6.0 to 9.5, averaged 8. 6. Seven cases were treated by apocope of obliquus capitis inferior under general anaesthesia and 19 cases were treated by neurolysis of greater occipital nerve under local anaesthesia. The compression mass were examined. Symptoms ameliorated or disappeared in 26 cases immediately after operation. The wounds healed by first intention. The pathological results of the removal mass included lymph node (3 cases), neurilemmoma (2 cases) and scar (5 cases). The VAS scoring of 26 cases was 0 to 5 (average, 2) 3 days after operation. Twenty-three cases were followed up for 1 to 3 years. The VAS scoring of 23 cases was 0 to 4.5 ( average, 1.9) 1 months after operation. Only two cases recurred and the symptoms were ameliorated. Pain aggavated after tiredness and reliveed after oral anti-inflammatory analgesics in 6 cases. No relapse occurred in the others. The complete neurolysis of greater occipital nerve (including apocope of obliquus capitis inferior, release between the cucullaris and semispinalis) which make the greater occipital nerve goes without any compression is the key point to treat intractable greater occipital nerve neuralgia.

An international survey of cerebral palsy registers and surveillance systems

PubMed Central

Goldsmith, Shona; McIntyre, Sarah; Smithers-Sheedy, Hayley; Blair, Eve; Cans, Christine; Watson, Linda; Yeargin-Allsopp, Marshalyn

2016-01-01

AIM To describe cerebral palsy (CP) surveillance programmes and identify similarities and differences in governance and funding, aims and scope, definition, inclusion/exclusion criteria, ascertainment and data collection, to enhance the potential for research collaboration. METHOD Representatives from 38 CP surveillance programmes were invited to participate in an online survey and submit their data collection forms. Descriptive statistics were used to summarize information submitted. RESULTS Twenty-seven surveillance programmes participated (25 functioning registers, two closed owing to lack of funding). Their aims spanned five domains: resource for CP research, surveillance, aetiology/prevention, service planning, and information provision (in descending order of frequency). Published definitions guided decision making for the definition of CP and case eligibility for most programmes. Consent, case identification, and data collection methods varied widely. Ten key data items were collected by all programmes and a further seven by at least 80% of programmes. All programmes reported an interest in research collaboration. INTERPRETATION Despite variability in methodologies, similarities exist across programmes in terms of their aims, definitions, and data collected. These findings will facilitate harmonization of data and collaborative research efforts, which are so necessary on account of the heterogeneity and relatively low prevalence of CP. PMID:26781543

[Small-diameter portosystemic shunts: indications and limitations].

PubMed

Angel Mercado, M; Granados-García, J; Barradas, F; Chan, C; Contreras, J L; Orozco, H; Angel-Mercado, M

1998-01-01

Low diameter porto-systemic shunts for the treatment of portal hypertension bleeding have emerged as a consequence of the technical development of vascular grafts (PTFE) that allow the use of a narrow lumen. The experience with this kind of operation at the Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City during a 6-year period is reported. There were twenty-seven patients with good liver function (Child-Pugh A-B) were operated or electively, average Age 47.5 years (range 17-71), twenty three patients with liver cirrhosis, one with portal fibrosis and three with idiopathic portal hypertension. Operative mortality: 4%. Rebleeding: 14%. Postoperative encephalopathy was observed in 14 of 27, three of them being grade III-IV (11%). In the remaining 11 cases, it was mild and easily controlled. Postoperative angiography showed shunt patency in 81% of the cases; in 33% of the cases, portal vein diameter reduction was shown, as well as two cases with portal vein thrombosis. In 77% of the cases, adequate postoperative quality of life was observed. Survival (Kaplan-Meier): 86% at 12 months and 56% at 60 months. These kinds of shunts are a good alternate choice for patients considered for surgery, in which other portal blood flow preserving procedures (selective shunts, devascularization with transection) are not feasible.

An outbreak of sand impaction in postpartum dairy cows

PubMed Central

Melendez, Pedro; Krueger, Traci; Benzaquen, Mauricio; Risco, Carlos

2007-01-01

Twenty-two cases of indigestion occurred in a 650-cow herd. Five cows had severe sand abomasal impaction, diagnosed by laparotomy. The pH of prepartum cows’ urine was < 6.0 and of sand 8.0. Feed showed a dietary cation-anion difference ≤ −110 mEq/kg. After feeding management corrections, no more cases were diagnosed. PMID:17987969

Rethinking Instructional Technology to Improve Pedagogy for Digital Literacy: A Design Case in a Graduate Early Childhood Education Course

ERIC Educational Resources Information Center

Langub, Lee Woodham; Lokey-Vega, Anissa

2017-01-01

Digital literacy is an important aspect to consider within teacher education as a way to address twenty-first century learner needs, particularly in early childhood contexts where developmental concerns should be paramount in making instructional design decisions. This article is a design case of a graduate level early childhood education…

A Case Study in Teacher-Centered Curriculum Development: The Process in Walpole Public Schools.

ERIC Educational Resources Information Center

Kline, Jane

In this case study illustrating teacher-centered curriculum development, teachers in the Walpole (Massachusetts) public school system were asked to select a reading program for use in grades K-8. Twenty-five teachers served on two teams over a two-year period. They used developmental learning kits at the kindergarten level, basal reading series…

Twenty-First Asilomar Conference on Polymeric Materials

DTIC Science & Technology

1998-03-10

Silver Spring, MD a ’Micro- and Nano- Layered Polymer Composites" Professor Eric Baer Case Western Reserve University Cleveland, OH "Theoretical...Corporation Roswell, GA 30076 Dr. Zhong-he Shen Nalge Nunc International Naperville, IL 60563 Dr. Mark Sinsky Goodyear Tire & Rubber Company...on Polymers February 22-25, 1998 Micro-arid Nano- Layered Polymer Composites Eric Baer Department of Macromolecular Science Case Western

76 FR 52969 - In the Matter of Certain Protective Cases and Components Thereof Notice of Commission...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

.... International Trade Commission has determined not to review the presiding administrative law judge's (``ALJ... named twenty nine respondents, including Cellaris Franchise, Inc. of Alpharetta, Georgia (``Cellaris...

Early diagnosis of thoracolumbar spine fractures in children. A prospective study.

PubMed

Leroux, J; Vivier, P-H; Ould Slimane, M; Foulongne, E; Abu-Amara, S; Lechevallier, J; Griffet, J

2013-02-01

Early detection of spine fractures in children is difficult because the clinical examination does not always raise worrisome symptoms and the vertebrae are still cartilaginous, and consequently incompletely visualized on routine X-rays. Therefore, diagnosis is often delayed or missed. The search for a "breath arrest" sensation at the moment of the trauma improves early detection of thoracolumbar spine fractures in children. This was a prospective monocentric study including all children consulting at the paediatric emergency unit of a single university hospital with a thoracolumbar spine trauma between January 2008 and March 2009. All children had the same care. Pain was quantified when they arrived using the visual analog scale. Clinical examination searched for a "breath arrest" sensation at the moment of the trauma and noted the circumstances of the accident. X-rays and MRI were done in all cases. Fifty children were included with a mean age of 11.4 years. Trauma occurred during games or sports in 94% of the cases. They fell on the back in 72% cases. Twenty-three children (46%) had fractures on the MRI, with a mean number of four fractured vertebrae (range, 1-10). Twenty-one of them (91%) had a "breath arrest" sensation. Fractures were not visualized on X-rays in five cases (22%). Twenty-seven children had no fracture; 19 of them (70%) did not feel a "breath arrest". Fractures were suspected on X-rays in 15 cases (56%). The search for a "breath arrest" sensation at the moment of injury improves early detection of thoracolumbar spine fractures in children (Se=87%, Sp=67%, PPV=69%, NPV=86%). When no fracture is apparent on X-rays and no "breath arrest" sensation is expressed by the child, the clinician can be sure there is no fracture (Se=26%, Sp=100%, PPV=100%, NPV=53%). Level III. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

The ANKLe Score: An Audit of Otolaryngology Emergency Clinic Record Keeping

PubMed Central

Dexter, Sara C; Hayashi, Daichi; Tysome, James R

2008-01-01

INTRODUCTION Accurate and legible medical records are essential to good quality patient care. Guidelines from The Royal College of Surgeons of England (RCSE) state the content required to form a complete medical record, but do not address legibility. An audit of otolaryngology emergency clinic record keeping was performed using a new scoring system. PATIENTS AND METHODS The Adjusted Note Keeping and Legibility (ANKLe) score was developed as an objective and quantitative method to assess both the content and legibility of case notes, incorporating the RCSE guidelines. Twenty consecutive otolaryngology emergency clinic case notes from each of 7 senior house officers were audited against standards for legibility and content using the ANKLe score. A proforma was introduced to improve documentation and handwriting advice was given. A further set of 140 notes (20 notes for each of the 7 doctors) was audited in the same way to provide feedback. RESULTS The introduction of a proforma and advice on handwriting significantly increased the quality of case note entries in terms of content, legibility and overall ANKLe score. CONCLUSIONS Accurate note keeping can be improved by the use of a proforma. The legibility of handwriting can be improved using simple advice. The ANKLe score is an objective assessment tool of the overall quality of medical note documentation which can be adapted for use in other specialties. PMID:18430339

[Placenta accreta: can prenatal diagnosis be performed? Ultrasound and MRI interests. About 27 cases].

PubMed

Bauwens, J; Coulon, C; Azaïs, H; Bigot, J; Houfflin-Debarge, V

2014-05-01

To list ultrasonography signs identified when a placenta accreta is suspected. Secondary objectives are to analyze the relevance of diagnosis with ultrasonography and magnetic resonance imaging, and to know diagnosis circumstances in order to identify main risk factors. We present a monocentric retrospective study. All the cases of placentas accreta, observed from 2005 to 2010 at Lille University Hospital (France), have been included. Twenty-seven patients had a placenta accreta during this period. There was an antenatal suspicion for 22 cases and 21 were confirmed after delivery. Six cases were discovered per-partum. Diagnosis was suspected after metrorrhagia for 41% of women. In case of antenatal diagnosis, 100% of the patients had an anterior placenta praevia and an uterine scare. Fifty percent of the placentas accreta diagnosed per-partum were posterior. The most frequently ultrasonography signs are "intra-placental lacuna" (85.7%), "abnormal vascularization" (71.4%), "loss of normal hypoechoic retroplacental myometrial zone" (66.7%), "irregularity of the vesical wall" (66.7%). Sensibility of ultrasonography screening is 78%. Twenty-one magnetic resonance imaging examinations executed secondarily confirmed the diagnosis in 66.7% of the cases. Ultrasonography is a relevant exam for the diagnosis of placenta accreta. Posterior placenta should not be forsaken. Anterior placenta praevia in multiparous patients with a uterine scare should be a warning. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Matrix interference evaluation employing GC and LC coupled to triple quadrupole tandem mass spectrometry.

PubMed

Uclés, S; Lozano, A; Sosa, A; Parrilla Vázquez, P; Valverde, A; Fernández-Alba, A R

2017-11-01

Gas and liquid chromatography coupled to triple quadrupole tandem mass spectrometry are currently the most powerful tools employed for the routine analysis of pesticide residues in food control laboratories. However, whatever the multiresidue extraction method, there will be a residual matrix effect making it difficult to identify/quantify some specific compounds in certain cases. Two main effects stand out: (i) co-elution with isobaric matrix interferents, which can be a major drawback for unequivocal identification, and therefore false negative detections, and (ii) signal suppression/enhancement, commonly called the "matrix effect", which may cause serious problems including inaccurate quantitation, low analyte detectability and increased method uncertainty. The aim of this analytical study is to provide a framework for evaluating the maximum expected errors associated with the matrix effects. The worst-case study contrived to give an estimation of the extreme errors caused by matrix effects when extraction/determination protocols are applied in routine multiresidue analysis. Twenty-five different blank matrices extracted with the four most common extraction methods used in routine analysis (citrate QuEChERS with/without PSA clean-up, ethyl acetate and the Dutch mini-Luke "NL" methods) were evaluated by both GC-QqQ-MS/MS and LC-QqQ-MS/MS. The results showed that the presence of matrix compounds with isobaric transitions to target pesticides was higher in GC than under LC in the experimental conditions tested. In a second study, the number of "potential" false negatives was evaluated. For that, ten matrices with higher percentages of natural interfering components were checked. Additionally, the results showed that for more than 90% of the cases, pesticide quantification was not affected by matrix-matched standard calibration when an interferent was kept constant along the calibration curve. The error in quantification depended on the concentration level. In a third study, the "matrix effect" was evaluated for each commodity/extraction method. Results showed 44% of cases with suppression/enhancement for LC and 93% of cases with enhancement for GC. Copyright © 2017 Elsevier B.V. All rights reserved.

A Proposal for a Compilation of Requirements and Teaching Methods of Courses at Gaston College.

ERIC Educational Resources Information Center

Jones, Dean H.

The purpose of this practicum was to determine the response of faculty members and students to the possibility of producing a pamphlet listing instructional methodologies and course requirements for classes at Gaston College (North Carolina). A questionnaire was completed by twenty-five instructors and twenty-five students, and additional…

Boar Semen Studies

PubMed Central

King, G. J.; Macpherson, J. W.

1967-01-01

A successful method for low temperature preservation of bull semen was modified for use with boar semen and resulted in recovery of twenty to fifty per cent motile cells immediately after thawing. Recovered cells did not survive five hours incubation at 37° C. and no pregnancies resulted following insemination of twenty-four sows and gilts with frozen semen. PMID:4226659

Single-session Gamma Knife radiosurgery for optic pathway/hypothalamic gliomas.

PubMed

El-Shehaby, Amr M N; Reda, Wael A; Abdel Karim, Khaled M; Emad Eldin, Reem M; Nabeel, Ahmed M

2016-12-01

OBJECTIVE Because of their critical and central location, it is deemed necessary to fractionate when considering irradiating optic pathway/hypothalamic gliomas. Stereotactic fractionated radiotherapy is considered safer when dealing with gliomas in this location. In this study, the safety and efficacy of single-session stereotactic radiosurgery for optic pathway/hypothalamic gliomas were reviewed. METHODS Between December 2004 and June 2014, 22 patients with optic pathway/hypothalamic gliomas were treated by single-session Gamma Knife radiosurgery. Twenty patients were available for follow-up for a minimum of 1 year after treatment. The patients were 5 to 43 years (median 16 years) of age. The tumor volume was 0.15 to 18.2 cm 3 (median 3.1 cm 3 ). The prescription dose ranged from 8 to 14 Gy (median 11.5 Gy). RESULTS The mean follow-up period was 43 months. Five tumors involved the optic nerve only, and 15 tumors involved the chiasm/hypothalamus. Two patients died during the follow-up period. The tumors shrank in 12 cases, remained stable in 6 cases, and progressed in 2 cases, thereby making the tumor control rate 90%. Vision remained stable in 12 cases, improved in 6 cases, and worsened in 2 cases in which there was tumor progression. Progression-free survival was 83% at 3 years. CONCLUSIONS The initial results indicate that single-session Gamma Knife radiosurgery is a safe and effective treatment option for optic pathway/hypothalamic gliomas.

Radiofrequency ablation of osteoid osteomas: five years experience.

PubMed

Papathanassiou, Zafiria G; Petsas, Theodore; Papachristou, Dionysios; Megas, Panagiotis

2011-12-01

The purpose of this study is to retrospectively evaluate the efficacy of radiofrequency ablation as a curative treatment method for benign bone tumours. Twenty-nine osteoid osteomas were treated with radiofrequency ablation. Primary success rate was 89.6% and total secondary success rate was 93.1%. Mean clinical follow-up period was 26.7 months (range: 6-63 months). Statistical analysis of 25 cases of osteoid osteomas with CT follow-up revealed that post-treatment re-ossification does not correlate with clinical outcome (p = 0.14) but is strongly correlated with long-term (> or = 12 months) CT follow-up (p = 0.014). Percutaneous radiofrequency ablation was found to be an effective and safe treatment for osteoid osteomas. CT findings cannot solely differentiate between treatment successes and failures.

Diagnostic Value of Leukocyte Esterase Test Strip Reagents for Rapid Clinical Diagnosis of Spontaneous Bacterial Peritonitis in Patients Admitted to Hospital Emergency Departments in Iran.

PubMed

Hashemian, Amir Masoud; Ahmadi, Koorosh; Zamani Moghaddam, Hamid; Zakeri, Hosein; Davoodi Navakh, Seyed Akbar; Sharifi, Mohammad Davood; Bahrami, Abdollah

2015-10-01

Spontaneous bacterial peritonitis (SBP) is a common and important clinical problem and is life-threatening in decompensated liver disease. Ascites fluid test by leukocyte esterase test strip has been recently proposed as an effective and rapid method to diagnose SBP in patients with cirrhosis. This study aimed to evaluate sensitivity and specificity of leukocyte esterase test strip in the diagnosis of SBP. The population of this research was all patients with cirrhosis and ascites admitted to the emergency room at Imam Reza (AS) hospital, Mashhad. A written consent was taken for inclusion in the study. 50 mL ascites sample was taken from all patients for use in a urine test strip (LER) (Urine Test Strips Convergys®Urine Matrix 11). The patient's ascites samples were evaluated for cell counting. Positive dipstick test for LER in this study considered as grade 3 +. The values of WBC > 500 cell/mm(3) or PMN > 250 cell/mm(3) considered as positive result of the gold standard method for the diagnosis of SBP. In this study, 100 patients with ascites due to cirrhosis, with an average age of 38.9 ± 6.54 years were evaluated. Twenty cases had positive results, of whom 17 cases were also detected based on the standard diagnostic criteria and other three cases were healthy individuals. Thus, sensitivity, specificity, positive and negative predictive values, and accuracy of the method were 95%, 96.3%, 85%, 97.5% and 95%, respectively. The use of leukocyte esterase urine dipstick test can be a quick and easy method in early diagnosis of SBP to start the treatment until preparation of SBP-cell count results.

War stories: a qualitative analysis of narrative teaching strategies in the operating room

PubMed Central

Hu, Yue-Yung; Peyre, Sarah E.; Arriaga, Alexander F.; Roth, Emilie M.; Corso, Katherine A.; Greenberg, Caprice C.

2015-01-01

BACKGROUND “War stories” are commonplace in surgical education, yet little is known about their purpose, construct, or use in the education of trainees. METHODS Ten complex operations were videotaped and audiotaped. Narrative stories were analyzed using grounded theory to identify emergent themes in both the types of stories being told and the teaching objectives they illustrated. RESULTS Twenty-four stories were identified in 9 of the 10 cases (mean, 2.4/case). They were brief (mean, 58 seconds), illustrative of multiple teaching points (mean, 1.5/story), and appeared throughout the operations. Anchored in personal experience, these stories taught both clinical (eg, operative technique, decision making, error identification) and programmatic (eg, resource management, professionalism) topics. CONCLUSIONS Narrative stories are used frequently and intuitively by physicians to emphasize a variety of intraoperative teaching points. They socialize trainees in the culture of surgery and may represent an underrecognized approach to teaching the core competencies. More understanding is needed to maximize their potential. PMID:22088266

Suicide and the Publicly Exposed Pedophile

PubMed Central

Walter, Garry; Pridmore, Saxby

2012-01-01

Background: Current clinical wisdom is that the vast majority of those who complete suicide suffer from a mental disorder. Uncritical adherence to this belief may limit our understanding and restrict the full range of prevention activities. We aimed to examine the public record for accounts of suicide by men who had been, or were about to be, investigated or apprehended for “sex only” child sex offences, with a view to presenting a collection of case histories, and identifying examples of suicide in the apparent absence of mental disorder other than pedophilia. Methods: The public record (hard and electronic copy) was examined. Results: Twenty case histories were identified of men with no apparent mental disorder (other than pedophilia) who completed suicide shortly after exposure or threatened public exposure and/or early or potential legal punishment. Conclusion: This evidence strongly suggests that exposure or threatened public exposure of pedophilia and/or early or potential legal punishment creates a predicament, which may lead to completed suicide. PMID:23613648

Differences in MYB expression and gene abnormalities further confirm that salivary cribriform basal cell tumors and adenoid cystic carcinoma are two distinct tumor entities.

PubMed

Tian, Zhen; Li, Lei; Zhang, Chun-Ye; Gu, Ting; Li, Jiang

2016-10-01

In practices, some cases of salivary basal cell tumors that consist mainly of cribriform growth pattern are difficult to differentiate from adenoid cystic carcinoma (AdCC). Identification of reliable molecular biomarkers for the differential diagnosis between them is required. Twenty-two cases of cribriform salivary basal cell tumors (at least 10% cribriform pattern present in each tumor) comprising 18 cases of basal cell adenoma (BCA) and four cases of basal cell adenocarcinoma (BcAC) were collected between 1985 and 2008. Twenty cases of cribriform AdCC were retrieved from our archives. MYB protein expression and gene abnormalities were detected in all cases by immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH) analyses, respectively. Neither MYB protein nor split genes were detected in any of the cases of cribriform basal cell tumors, while 55% (11/20) of cases of cribriform AdCC had MYB protein expression. High MYB expression was detected in 81.8% (9/11) cases, while low expression was found in the remaining cases. FISH analysis indicated that nine AdCC tumors with high MYB protein expression were split gene-positive, while MYB gene splitting was not detected in the 11 cases with low or absent MYB protein expression. The molecular changes in AdCC differ from those associated with cribriform basal cell tumors, which further confirms that cribriform basal cell tumors and AdCC are two distinct tumor entities. Simultaneous detection of MYB protein expression and the associated molecular changes could be beneficial in differentiating salivary cribriform basal cell tumors from AdCC. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Development of a group contribution method for estimating free energy of peptides in a dodecane-water system via molecular dynamic simulations.

PubMed

Mora Osorio, Camilo Andrés; González Barrios, Andrés Fernando

2016-12-07

Calculation of the Gibbs free energy changes of biological molecules at the oil-water interface is commonly performed with Molecular Dynamics simulations (MD). It is a process that could be performed repeatedly in order to find some molecules of high stability in this medium. Here, an alternative method of calculation has been proposed: a group contribution method (GCM) for peptides based on MD of the twenty classic amino acids to obtain free energy change during the insertion of any peptide chain in water-dodecane interfaces. Multiple MD of the twenty classic amino acids located at the interface of rectangular simulation boxes with a dodecane-water medium were performed. A GCM to calculate the free energy of entire peptides is then proposed. The method uses the summation of the Gibbs free energy of each amino acid adjusted in function of its presence or absence in the chain as well as its hydrophobic characteristics. Validation of the equation was performed with twenty-one peptides all simulated using MD in dodecane-water rectangular boxes in previous work, obtaining an average relative error of 16%.

The cementless anatomic medullary locking femoral component: an independent clinical and radiographic assessment

PubMed Central

Chess, David G.; Grainger, R. Wayne; Phillips, Tom; Zarzour, Zane D.; Sheppard, Bruce R.

1996-01-01

Objective To review the clinical performance of the anatomic medullary locking (AML) femoral stem in total hip arthroplasty. Design A clinical and radiographic review. Setting A tertiary lower limb joint replacement centre. Patients Two hundred and twenty-one patients with noninflammatory gonarthrosis. Interventions Two hundred and twenty-seven primary total hip arthroplasties with the noncemented AML component completed by two surgeons. Main Outcome Measures Independent review by two experienced reviewers of the postoperative Harris hip score, radiographs of component fixation, size and degree of diaphyseal fill. Results Harris hip score was 84 (range from 43 to 98); component fixation showed bone ingrowth in 41%, stable fixation with fibrous ingrowth in 56% and unstable fixation in 3%; severe thigh pain in 4% of cases correlated with unstable fixation, and there was mild thigh pain in 20% of cases. Conclusion The AML femoral stem performs well in replacement arthroplasty compared with other noncemented stems. PMID:8857987

Cell-mediated immunity to homologous spermatozoa following vasectomy in the human male.

PubMed Central

Nagarkatti, P S; Rao, S S

1976-01-01

Cell-mediated immunity (CMI) to homologous spermatozoal antigens was studied in sixty-two males following vasectomy of a duration of 1-10 years. A group of twenty-two normal, fertile non-vasectomized males was also included in the study. The inhibition in the leucocyte migration test (LMT), in the presence of spermatozoal antigen, was taken as an index of CMI. Twenty of the sixty-two vasectomized males (32.2 percent) showed a positive LMT reaction. When the results were analysed with reference to the duration of vasectomy, it was noted that four cases each (22.2 percent), showed a positive LMT reaction in the groups 0-2 years, and 3.5 years. On the other hand twelve cases gave a positive reaction in the group 6-10 years (46.1 percent). It appears that the incidence of CMI to spermatozoa increases with the duration in vasectomy. PMID:991454

History and evolution of dorsal onlay urethroplasty for bulbar urethral stricture repair using skin or buccal mucosal grafts.

PubMed

Barbagli, G; Lazzeri, M

2007-01-01

OBJECTIVES. To illustrate the history and the evolution over time of bulbar dorsal onlay urethroplasty, comparing outcomes when using buccal mucosa or skin grafts. MATERIALS AND METHODS. Ninety-four patients underwent bulbar urethral reconstruction using two dorsal onlay techniques, namely augmented anastomotic urethroplasty and dorsal onlay graft urethroplasty. Preoperative evaluation included clinical history, physical examination, urine culture, residual urine measurement, uroflowmetry and urethrography. Thirty-four patients underwent augmented anastomotic urethroplasty using penile skin (10 cases) or buccal mucosa (24 cases) grafts. Sixty patients underwent dorsal onlay graft urethroplasty using penile skin (38 cases) or buccal mucosa (22 cases) grafts. Forty-eight out of 94 patients received skin grafts and 46 buccal mucosal grafts. RESULTS. Sixty-four (68%) out of 94 cases were successful, whereas 30 (32%) failed. The 34 augmented anastomotic urethroplasties provided successful outcomes in 24 cases (70.6%), but poor outcomes in 10 (29.4%) cases. The 60 dorsal onlay graft urethroplasty proved to be successful in 42 cases (70%), failing in 18 (30%) cases. Twenty-eight (58.3%) out of 48 penile skin grafts were successful and 20 (41.7%) failed. Thirty-six (78.3%) out of 46 buccal mucosa grafts were successful and 10 (21.7%) failed. The 30 failed cases were then treated with internal urethrotomy in 14 cases (46.7%), perineal urethrostomy in 8 cases (26.7%), two-stage repair in 4 cases (13.3%), and one-stage repair in 4 cases (13.3%). CONCLUSIONS. The dorsal onlay technique used for bulbar urethral stricture repair has changed over time. In our experience, the buccal mucosa seems to be the best substitute graft material for bulbar urethroplasty using dorsal approach.

Hemi-wedge osteotomy in the management of large angular deformities around the knee joint.

PubMed

El-Alfy, Barakat Sayed

2016-08-01

Angular deformity around the knee joint is a common orthopedic problem. Many options are available for the management of such problem with varying degrees of success and failure. The aim of the present study was to assess the results of hemi-wedge osteotomy in the management of big angular deformities about the knee joint. Twenty-eight limbs in 21 patients with large angular deformities around the knee joint were treated by the hemi-wedge osteotomy technique. The ages ranged from 12 to 43 years with an average of 19.8 years. The deformity ranged from 20° to 40° with a mean of 30.39° ± 5.99°. The deformities were genu varum in 12 cases and genu valgum in 9 cases. Seven cases had bilateral deformities. Small wedge was removed from the convex side of the bone and put in the gap created in the other side after correction of the deformity. At the final follow-up, the deformity was corrected in all cases except two. Full range of knee movement was regained in all cases. The complications included superficial wound infection in two cases, overcorrection in one case, pain along the lateral aspect of the knee in one case and recurrence of the deformity in one case. No cases were complicated by nerve injury or vascular injury. Hemi-wedge osteotomy is a good method for treatment of deformities around the knee joint. It can correct large angular deformities without major complications.

Abstract principles and concrete cases in intuitive lawmaking.

PubMed

Ellman, Ira Mark; Braver, Sanford L; MacCoun, Robert J

2012-04-01

Citizens awaiting jury service were asked a series of items, in Likert format, to determine their endorsement of various statements about principles to use in setting child support amounts. These twenty items were derived from extant child support systems, from past literature and from Ellman and Ellman's (2008) Theory of Child Support. The twenty items were found to coalesce into four factors (principles). There were pervasive gender differences in respondent's endorsement of the principles. More importantly, three of these four principles were systematically reflected, in very rational (if complex) ways, in the respondents' resolution of the individual child support cases they were asked to decide. Differences among respondents in their endorsement of these three principles accounted for differences in their patterns of child support judgments. It is suggested that the pattern of coherent arbitrariness (Ariely et al., Q J Econ 118(1):73-105, 2003) in those support judgments, noted in an earlier study (Ellman, Braver, & MacCoun, 2009) is thus partially explained, in that the seeming arbitrariness of respondents' initial support judgments reflect in part their differing views about the basic principles that should decide the cases.

Death by 'ice': fatal methamphetamine intoxication of a body packer case detected by postmortem computed tomography (PMCT) and validated by autopsy.

PubMed

Bin Abdul Rashid, Saiful Nizam; Rahim, Amir Saad Abdul; Thali, Michael J; Flach, Patricia M

2013-03-01

Fatal acute methamphetamine (MA) poisoning in cases of internal drug trafficking is rarely described in the literature. This case study reports an MA 'body packer' who died from fatal methamphetamine intoxication due to leaking drug packages in the alimentary tract. The deceased was examined by postmortem computed tomography (PMCT), and the results were correlated to subsequent autopsy and toxicological findings. The deceased was arrested by the police when he was found disoriented in the city of Kuala Lumpur. He was transferred to the emergency department on suspicion of drug abuse. The initial drug screening was reactive for amphetamines. Shortly after admission to the hospital, he died despite rigorous resuscitation attempts. The postmortem plain chest and abdominal radiographs revealed multiple suspicious opacities in the gastrointestinal tract attributable to body packages. An unenhanced whole body PMCT revealed twenty-five drug packages, twenty-four in the stomach and one in the transverse colon. At least two were disintegrating, and therefore leaking. The autopsy findings were consistent with the PMCT results. Toxicology confirmed the diagnosis of fatal methamphetamine intoxication.

Comparison of methods for identifying causative bacterial microorganisms in presumed acute endophthalmitis: conventional culture, blood culture, and PCR.

PubMed

Pongsachareonnont, Pear; Honglertnapakul, Worawalun; Chatsuwan, Tanittha

2017-02-21

Identification of bacterial pathogens in endophthalmitis is important to inform antibiotic selection and treatment decisions. Hemoculture bottles and polymerase chain reaction (PCR) analysis have been proposed to offer good detection sensitivity. This study compared the sensitivity and accuracy of a blood culture system, a PCR approach, and conventional culture methods for identification of causative bacteria in cases of acute endophthalmitis. Twenty-nine patients with a diagnosis of presumed acute bacterial endophthalmitis who underwent vitreous specimen collection at King Chulalongkorn Memorial Hospital were enrolled in this study. Forty-one specimens were collected. Each specimen was divided into three parts, and each part was analyzed using one of three microbial identification techniques: conventional plate culture, blood culture, and polymerase chain reaction and sequencing. The results of the three methods were then compared. Bacteria were identified in 15 of the 41 specimens (36.5%). Five (12.2%) specimens were positive by conventional culture methods, 11 (26.8%) were positive by hemoculture, and 11 (26.8%) were positive by PCR. Cohen's kappa analysis revealed p-values for conventional methods vs. hemoculture, conventional methods vs. PCR, and hemoculture vs. PCR of 0.057, 0.33, and 0.009, respectively. Higher detection rates of Enterococcus faecalis were observed for hemoculture and PCR than for conventional methods. Blood culture bottles and PCR detection may facilitate bacterial identification in cases of presumed acute endophthalmitis. These techniques should be used in addition to conventional plate culture methods because they provide a greater degree of sensitivity than conventional plate culture alone for the detection of specific microorganisms such as E. faecalis. Thai Clinical Trial Register No. TCTR20110000024 .

Research Trends in Evidence-Based Medicine: A Joinpoint Regression Analysis of More than 50 Years of Publication Data

PubMed Central

Hung, Bui The; Long, Nguyen Phuoc; Hung, Le Phi; Luan, Nguyen Thien; Anh, Nguyen Hoang; Nghi, Tran Diem; Van Hieu, Mai; Trang, Nguyen Thi Huyen; Rafidinarivo, Herizo Fabien; Anh, Nguyen Ky; Hawkes, David; Huy, Nguyen Tien; Hirayama, Kenji

2015-01-01

Background Evidence-based medicine (EBM) has developed as the dominant paradigm of assessment of evidence that is used in clinical practice. Since its development, EBM has been applied to integrate the best available research into diagnosis and treatment with the purpose of improving patient care. In the EBM era, a hierarchy of evidence has been proposed, including various types of research methods, such as meta-analysis (MA), systematic review (SRV), randomized controlled trial (RCT), case report (CR), practice guideline (PGL), and so on. Although there are numerous studies examining the impact and importance of specific cases of EBM in clinical practice, there is a lack of research quantitatively measuring publication trends in the growth and development of EBM. Therefore, a bibliometric analysis was constructed to determine the scientific productivity of EBM research over decades. Methods NCBI PubMed database was used to search, retrieve and classify publications according to research method and year of publication. Joinpoint regression analysis was undertaken to analyze trends in research productivity and the prevalence of individual research methods. Findings Analysis indicates that MA and SRV, which are classified as the highest ranking of evidence in the EBM, accounted for a relatively small but auspicious number of publications. For most research methods, the annual percent change (APC) indicates a consistent increase in publication frequency. MA, SRV and RCT show the highest rate of publication growth in the past twenty years. Only controlled clinical trials (CCT) shows a non-significant reduction in publications over the past ten years. Conclusions Higher quality research methods, such as MA, SRV and RCT, are showing continuous publication growth, which suggests an acknowledgement of the value of these methods. This study provides the first quantitative assessment of research method publication trends in EBM. PMID:25849641

Twenty-Nail Transverse Melanonychia Induced by Hydroxyurea: Case Report and Review of the Literature.

PubMed

Osemwota, Osamuede; Uhlemann, John; Rubin, Adam

2017-08-01

Twenty-nail transverse melanonychia from hydroxyurea is a rare phenomenon, only reported four times previously. Here we describe a 51-year-old female who presented with 20-nail transverse melanonychia 3 months after initiating hydroxyurea therapy. Transverse melanonychia is a benign process but can cause patients significant distress, and thus is an entity with which dermatologists should recognize. We then review the cutaneous manifestations, differential diagnosis, and clinical considerations when evaluating patients with transverse melanonychia from hydroxyurea or other causes.

J Drugs Dermatol. 2017;16(8):814-815.

Non-surgical Management of Congenital Auricular Deformities

PubMed Central

Mohammadi, Ali Akbar; Imani, Mohammad Taghi; Kardeh, Sina; Karami, Mehrab Mohammad; Kherad, Masoomeh

2016-01-01

BACKGROUND Unlike congenital auricular malformations which are identified by underdevelopment of dermal and cartilaginous tissues, deformed ears are less sever congenital anomalies characterized only by a misshaped pinna structure and can be improved with acceptable cosmetic results and minimal cost through ear molding if treated in early neonatal period. In this study, authors present the first report of using splinting techniques for treatment of deformational auricular anomalies in Iranian children. METHODS Our case load consisted of a series of 29 patients (Male=16, Female=13) who were referred to Plastic Surgery Unit of Shiraz University of Medical Sciences from September 2011 to December 2014. Children aged more than 6 moths were excluded. Twenty-nine children affected by various deformities including prominent ears (n=11), lop ears (n=8) and constricted ears (n=10) were treated by splintage as a nonsurgical technique. The mean time of treatment was 13.33±2 weeks. RESULTS Eight (27.6%) patients did not complete the treatment. Splinting resulted in excellent or satisfactory results in 12 (57.14%) of treated cases. No improvement was observed at the end of the molding treatment in 9 patients. No complication was observed during the treatment in any of the patients. CONCLUSION The nonsurgical molding can be used as an effective approach for achieving natural outcomes and correcting cosmetic abnormalities. Rate of satisfaction is dependent on type of deformity, the neonatal age in which treatment started and also parents’ adherence to treatment methods and principals. Concerning the low rate of complications and high satisfactory results the method can be used instead of surgery in appropriate cases. PMID:27579269

Sexual and functional results after creation of a neovagina in women with Mayer-Rokitansky-Küster-Hauser syndrome: a comparison of nonsurgical and surgical procedures.

PubMed

Morcel, Karine; Lavoué, Vincent; Jaffre, Frédérique; Paniel, Bernard-Jean; Rouzier, Roman

2013-07-01

To compare nonsurgical and surgical procedures for creation of a neovagina in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome in terms of sexual satisfaction. We report a cross-sectional study of 91 women with MRKH syndrome undergoing a neovagina creation procedure. They were members of the French National Association of Women with MRKH syndrome. We analyzed all answers to a questionnaire mailed to each woman. The questionnaire solicited short answers concerning the diagnosis and the neovagina procedure, and included the standardized FSFI (Female Sexual Function Index) questionnaire. All analyses were performed using the chi-squared test and Student's t-test. A p-value of <0.05 was considered statistically significant. Forty women answered the questionnaire. Twenty had been treated by Frank's method (non-surgical group) and 20 had undergone a surgical procedure, sigmoid vaginoplasty (12 cases) or Davidov's technique (8 cases) (surgical group). The mean time after neovagina creation was 7 years (range 1-44 years). The population characteristics did not differ significantly between the nonsurgical and surgical groups. The total FSFI score indicated good and similar functional results in the two groups (25.3±7.5 versus 25.3±8.0). Functional sexual outcomes after nonsurgical and surgical methods were similar. Therefore, the Frank's method should be proposed as first line therapy because it is less invasive than surgical procedures. In the case of failure of this technique or of refusal by the patient, surgical reconstruction may then be offered. Copyright © 2013. Published by Elsevier Ireland Ltd.

A Case Study Examining the Influence of Dual Enrollment and High School Advising on Student Persistence in College

ERIC Educational Resources Information Center

Raia-Taylor, Maureen

2012-01-01

This qualitative,descriptive single case study describes the problem of student persistence in college through the theoretical lens of Alexander Astin's Theory of Student Involvement, and Vincent Tinto's Theory of Student Departure. The decline in the college retention rate in the United States over the last twenty years and the high…

Theorizing the Racial and Gendered Educational Experiences of Chicanas and Native American Women at the Ph.D. Level in Higher Education: "Testimonios" of Resistance, Defiance, Survival, and Hope

ERIC Educational Resources Information Center

Cueva, Bert Maria

2013-01-01

This national case study examines the educational experiences of twenty-one women that self-identified as low-income or working-class Chicanas or Native American women pursuing professoriate degrees in the Humanities, Social Sciences, Forestry, and Education. The case study includes forty-two qualitative "testimonio" interviews that…

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

Versino, Daniele; Brock, Jerry Steven

In this manuscript we describe test cases for the dynamic sphere problem in presence of finite deformations. The spherical shell in exam is made of a homogeneous, isotropic or transverse isotropic material and elastic and elastic-plastic material behaviors are considered. Twenty cases, (a) to (t), are thus defined combining material types and boundary conditions. The inner surface radius, the outer surface radius and the material's density are kept constant for all the considered test cases and their values are r i = 10mm, r o = 20mm and p = 1000Kg/m 3 respectively.

Case studies for GSHP demonstration projects in the US

DOE PAGES

Liu, Xiaobing; Malhotra, Mini; Im, Piljae

2015-07-01

Under the American Recovery and Reinvestment Act , twenty-six ground source heat pump (GSHP) projects were competitively selected and carried out to demonstrate the benefits of GSHP systems and innovative technologies for cost reduction and/or performance improvement. This article gives an overview of the case studies for six of the systems. These case studies evaluated efficiencies, energy savings, and costs of the demonstrated systems. In addition, it was found that more energy savings could be achieved if controls of GSHP system are improved.

How Trust in Wikipedia Evolves: A Survey of Students Aged 11 to 25

ERIC Educational Resources Information Center

Mothe, Josiane; Sahut, Gilles

2018-01-01

Introduction: Whether Wikipedia is to be considered a trusted source is frequently questioned in France. This paper reports the results of a survey examining the levels of trust shown by young people aged eleven to twenty-five. Method: We analyse the answers given by 841 young people, aged eleven to twenty-five, to a questionnaire. To our…

Social Vulnerability in Congenital Syphilis Case Mothers: Qualitative Assessment of Cases in Indiana, 2014-2016.

PubMed

DiOrio, Dawne; Kroeger, Karen; Ross, Amara

2018-01-04

Congenital syphilis occurs when a pregnant woman with syphilis is not diagnosed or treated and the infection is passed in utero, causing severe infant morbidity and mortality. Congenital syphilis is easily prevented if women receive timely and adequate prenatal care. Cases of congenital syphilis are considered indicators of problems in the safety net. However, maternal social and behavioral factors can impede women's care, even when providers follow guidelines. We reviewed case interviews and maternal records for 23 congenital syphilis cases reported to CDC from Indiana between 2014 and 2016. We used qualitative methods to analyze narrative notes from maternal interviews to learn more about factors that potentially contributed to CS cases. All providers followed CDC and state recommendations for screening and treatment of pregnant women with syphilis. Twenty-one of 23 women had health insurance. The number of prenatal care visits women had was suboptimal; more than one third of women had no prenatal care. Nearly one third of women's only risk factor was sex with a primary male sex partner. The majority of women suffered social vulnerabilities, including homelessness, substance abuse, and incarceration. Despite provider adherence to guidelines and health insurance availability, some pregnant women with syphilis are unlikely to receive timely diagnosis and treatment. Pregnant women at high risk for syphilis may need additional social and material support to prevent a CS case. Additional efforts are needed to reach the male partners of vulnerable females with syphilis.

Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis.

PubMed

Wills, John; Schwend, Richard M; Paterson, Andrew; Albin, Maurice S

2005-10-15

Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. To report 2 cases where visible bubbling at the operative site was the first clinical indication of VAE-induced cardiovascular collapse and to raise the level of consciousness that VAE in the prone position can occur, often with serious consequences. Twenty-two cases of VAE during surgery for scoliosis in the prone position have been reported. Ten were fatal and ten were in children. Visible bubbling at the operative site was noted in two published cases. Retrospective study of 2 cases of VAE at one institution. Clinical, anesthetic, and radiographic features are presented. Details of previously published cases are reviewed and discussed. Both patients were girls with adolescent scoliosis who underwent prone positioned posterior spinal fusion with instrumentation. Visible bubbling of air at the thoracic aspect of the surgical site was noted near the completion of instrumentation and was the first indication of VAE. In both cases, this was clinically recognized and promptly treated. One patient survived normally and the other died. Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.

Clinical Features and Molecular Epidemiology of CMY-Type β-Lactamase-Producing Escherichia coli

PubMed Central

Sidjabat, Hanna E.; Paterson, David L.; Qureshi, Zubair A.; Adams-Haduch, Jennifer M.; O’Keefe, Alexandra; Pascual, Alvaro; Rodríguez-Baño, Jesús; Doi, Yohei

2009-01-01

Background Knowledge on the clinical features of infections caused by Escherichia coli producing plasmid-mediated AmpC β-lactamase is limited. Of the several groups of plasmid-mediated AmpC β-lactamase, CMY-type β-lactamase is the most common in the United States. Methods We prospectively identified E. coli producing CMY-type β-lactamase and collected clinical data over a seven-month period. A retrospective cohort study was performed to identify features associated with these cases, using cases due to extended-spectrum β-lactamase (ESBL)-producing E. coli as controls. Pulsed-field gel electrophoresis (PFGE), plasmid analysis and phylogenetic typing were performed. Results Twenty-two cases with CMY-producing E. coli and 25 cases with ESBL-producing E. coli were identified. The demographics of the patients were similar between the CMY and ESBL cohorts. CMY cases were significantly more likely to represent symptomatic infection compared with ESBL cases (P=0.028). The CMY-type β-lactamase was identified as CMY-2 or its variants. Ninety-four percent of the CMY-producing isolates belonged to E. coli phylogenetic groups B2 and D, which are associated with virulence. Many of them shared similar plasmid profiles, whereas the PFGE profiles were diverse. Co-resistance to non-β-lactam antimicrobials was common. Conclusion In Pittsburgh, CMY-producing E. coli is almost as common as ESBL-producing E. coli and causes symptomatic infection in the majority of cases. PMID:19187027

An analysis of transportation planning effectiveness

DOT National Transportation Integrated Search

1977-07-01

The report documents a novel methodology and analysis procedure for measuring a program's effect, and it is based on data from case studies of a representative group of twenty urban areas, conducted during 1976, which are reported in a companion repo...

37. ISLAND PLANT: Nos. 1 AND 2 TWENTYSIX INCH SPECIAL ...

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

37. ISLAND PLANT: Nos. 1 AND 2 TWENTY-SIX INCH SPECIAL HORIZONTAL SAMSON TURBINE (RIVITED CASE) - American Falls Water, Power & Light Company, Island Power Plant, Snake River, below American Falls Dam, American Falls, Power County, ID

Narrowing of the Diagnostic Gap of Acute Gastroenteritis in Children 0-6 Years of Age Using a Combination of Classical and Molecular Techniques, Delivers Challenges in Syndromic Approach Diagnostics.

PubMed

Steyer, Andrej; Jevšnik, Monika; Petrovec, Miroslav; Pokorn, Marko; Grosek, Štefan; Fratnik Steyer, Adela; Šoba, Barbara; Uršič, Tina; Cerar Kišek, Tjaša; Kolenc, Marko; Trkov, Marija; Šparl, Petra; Duraisamy, Raja; Lipkin, W Ian; Terzić, Sara; Kolnik, Mojca; Mrvič, Tatjana; Kapoor, Amit; Strle, Franc

2016-09-01

Twenty-five percent to 50% of acute gastroenteritis (AGE) cases remain etiologically undiagnosed. Our main aim was to determine the most appropriate list of enteric pathogens to be included in the daily diagnostics scheme of AGE, ensuring the lowest possible diagnostic gap. Two hundred ninety seven children ≤6 years of age, admitted to hospital in Slovenia, October 2011 to October 2012, with AGE, and 88 ≤6 years old healthy children were included in the study. A broad spectrum of enteric pathogens was targeted with molecular methods, including 8 viruses, 6 bacteria and 2 parasites. At least one enteric pathogen was detected in 91.2% of cases with AGE and 27.3% of controls. Viruses were the most prevalent (82.5% and 15.9%), followed by bacteria (27.3% and 10.2%) and parasites (3.0% and 1.1%) in cases and controls, respectively. A high proportion (41.8%) of mixed infections was observed in the cases. For cases with undetermined etiology (8.8%), stool samples were analyzed with next generation sequencing, and a potential viral pathogen was detected in 17 additional samples (5.8%). Our study suggests that tests for rotaviruses, noroviruses genogroup II, adenoviruses 40/41, astroviruses, Campylobacter spp. and Salmonella sp. should be included in the initial diagnostic algorithm, which revealed the etiology in 83.5% of children tested. The use of molecular methods in diagnostics of gastroenteritis is preferable because of their high sensitivity, specificity, fast performance and the possibility of establishing the concentration of the target. The latter may be valuable for assessing the clinical significance of the detected enteric, particularly viral pathogens.

FLOATING ELBOW IN CHILDREN: A DESCRIPTIVE STUDY OF 31 CASES ATTENDED IN A REFERENCE CENTER FOR PEDIATRIC TRAUMA

PubMed Central

Malheiros, Dorotea Starling; Bárbara, Gustavo Henrique Silva; Mafalda, Leandro Gonçalves; Madureira, João Lopo; Braga, Gilberto Ferreira; Terra, Dalton Lopes

2015-01-01

Objective: To conduct a descriptive analysis on 31 cases of children with floating elbow who were attended at our clinic between 1994 and 2009, and to review the literature relating to this topic. Methods: Data were obtained through examining the medical records. The following variables were used: age, gender, side, mechanism, type of fracture, classification, treatment and complications. Results: Twenty-four patients (77.4%) were male and seven (22.6%) were female. The mean age was 8.5 (± 3.2) years, ranging from one to 14 years. The left side was predominantly affected (67.7%). The commonest injury mechanism was a fall from a height (74.2%). All the supracondylar fractures were Gartland type III. Distal radius fractures alone, of Salter-Harris type II, were diagnosed in 22 patients (71%). Open fractures occurred in 22 cases (71%). Closed reduction and application of a plaster cast for a closed fracture of the distal radius was performed in two patients (6.45%). Simultaneous conservative treatment for two fractures was not used. Sixteen supracondylar fractures (54.8%) were fixed using crossed wires, at 90° to each other, and in 14 cases (45.16%), an intramedullary wire was used together with another wire introduced through the lateral epicondyle at 45°. The following complications were observed: deformed consolidation (10%), nerve injuries (6%), compartment syndrome (3%) and pin path infection (16%). Conclusions: This is an uncommon injury that in most cases results from high-energy trauma. Surgical treatment for both fractures is recommended by most authors. Ulnar nerve injuries were correlated with the fixation method, but no neurological injuries were triggered by the initial trauma. PMID:27027045

In silico methods for design of biological therapeutics.

PubMed

Roy, Ankit; Nair, Sanjana; Sen, Neeladri; Soni, Neelesh; Madhusudhan, M S

2017-12-01

It has been twenty years since the first rationally designed small molecule drug was introduced into the market. Since then, we have progressed from designing small molecules to designing biotherapeutics. This class of therapeutics includes designed proteins, peptides and nucleic acids that could more effectively combat drug resistance and even act in cases where the disease is caused because of a molecular deficiency. Computational methods are crucial in this design exercise and this review discusses the various elements of designing biotherapeutic proteins and peptides. Many of the techniques discussed here, such as the deterministic and stochastic design methods, are generally used in protein design. We have devoted special attention to the design of antibodies and vaccines. In addition to the methods for designing these molecules, we have included a comprehensive list of all biotherapeutics approved for clinical use. Also included is an overview of methods that predict the binding affinity, cell penetration ability, half-life, solubility, immunogenicity and toxicity of the designed therapeutics. Biotherapeutics are only going to grow in clinical importance and are set to herald a new generation of disease management and cure. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

[Effectiveness of thalidomide for erythema nodosum leprosum (ENL): retrospective study of 20 Japanese cases in National Sanatrium Oku-Komyoen].

PubMed

Matsuki, Takanobu; Okano, Yoshiko; Aoki, Yoshinori; Ishida, Yutaka; Hatano, Kentaro; Kumano, Kimiko

2014-12-01

Thalidomide is a TNF-alpha inhibitor and has been administrated for erythema nodosum leprosum (ENL, Type II leprosy reaction) which is one of leprosy reactions and can cause serious illness to patients oflepromatous pole among the immune spectrum. Twenty live cases (at May, 2011) were identified to whom thalidomide had been administrated since 1978 for their ENL reactions. Data were collected from their clinical records in order to evaluate the usage and effectiveness of thalidomide in National Sanatorium Oku-Komyoen, Okayama, Setouchi-city, Japan. Individual data includes bacillary index (BI), total dose, average daily dose, maximum daily dose, minimum daily dose, methods of thalidomide administration and change of symptoms of ENL. Results: No adverse effect was found among 20 cases. Average daily dose of 20 cases was 19 mg. Regarding to the maximum daily dose, in 3 cases (15%) more than 100 mg, in 3 cases (15%) 50 mg, and in 14 cases (70%) less than 40 mg was administrated. Dose was gradually tapered in most cases. From clinical records, thalidomide was found effective for ENL in 19 cases and clinicians concerned were trying to adjust the proper dose of the drug carefully depending on the current symptoms, because there was no guideline of thalidomide administration for ENL. This data suggests that even less than 50-100 mg as the initial daily dose was still effective, though 50-100 mg daily dose is recommended in the current guideline of Japan (2011) and more dose had been administrated in USA and India.

A novel response to an outbreak of infectious syphilis in Christchurch, New Zealand.

PubMed

Coughlan, Edward; Young, Heather; Parkes, Catherine; Coshall, Maureen; Dickson, Nigel; Psutka, Rebecca; Saxton, Peter; Pink, Ramon; Adams, Katharine

2015-04-01

During 2012, Christchurch experienced a dramatic increase in cases of infectious syphilis among men who have sex with men. This was accompanied by some novel trends; notably, the acquisition of infection in a younger age group, with local sexual contacts, commonly via the use of social media. This study is a report on an approach to case identification and public health communication as a component of a multifaceted outbreak response. Enhanced syphilis surveillance data on public health responses to outbreaks of sexually transmissible infections was collated and reviewed, alongside clinical records and literature. Reported outbreak response methods were adapted for the Christchurch cohort. A Facebook page was created to raise awareness of infectious syphilis, the importance of screening and where to get tested. Twenty-six males were diagnosed with infectious syphilis in 2012, an increase from previous years, of which 22 reported only male sexual contact. High use of social media used to find potential sexual contacts was reported. Enhanced syphilis surveillance characterised in detail an infectious syphilis outbreak in Christchurch. Index cases were identified, contact tracing mapping was used to identify transmission networks and social media was also used to educate the risk group. There was a decrease in infectious syphilis presentations, with no cases in the last 3 months of 2012.

Therapeutic plasma exchange in poisoning: 8 years' experience of a university hospital.

PubMed

Dişel, Nezihat Rana; Akpınar, Ayça Açıkalın; Sebe, Ahmet; Karakoç, Emre; Sürer, Selen; Turhan, Ferda Tekin; Matyar, Selçuk

2015-10-01

This study examined the extracorporeal methods for the elimination of toxic substances in poisoned patients that are used by clinicians taking care of such patients. Here we present our experience in the use of therapeutic plasma exchange (TPE). To the best of our knowledge, this is the largest number of poisoning cases ever reported in a study. This is a retrospective study conducted at the Çukurova University Faculty of Medicine, Department of Emergency Medicine, with the permission of the ethical committee of the medical faculty. The study includes patients who had undergone TPE because of poisoning between January 2007 and May 2015. We summarize the clinical data and outcomes of the patients with available files. A total of 36 cases among the 42 patients who underwent TPE in this 8-year period were included in the study. More than 20 identified toxic substances, most of which were pesticides, were found to be the causes of poisoning. Twenty-three healthy discharges and 12 deaths are discussed in the study. We believe that our study reports the largest ever number of poisoning cases treated with TPE in the literature. When applicable, TPE may be a promising extracorporeal elimination and treatment technique in poisoned patients when performed in selected cases. Copyright © 2015 Elsevier Inc. All rights reserved.

Litigation in nontraumatic aortic diseases--a tempest in the malpractice maelstrom.

PubMed

Elefteriades, John A; Barrett, Peter W; Kopf, Gary S

2008-01-01

Physicians are vulnerable to highly litigated thoracic aortic diseases. On the basis of a review of litigated cases, we aim to determine legally protective strategies for physicians and methods to improve treatment. Thirty-three nontraumatic, thoracic aorta-related legal cases were analyzed. Twenty-three patients (69.7%) had dissections (21 ascending, 2 descending), 8 (24.2%) had aneurysms and 2 had miscellaneous other phenomena (1 coarctation and 1 iatrogenic descending aortic rupture). The adverse event was death in 30 (90.9%) patients and paraplegia or stroke in 3 (9.1%). Allegations included: failure/delay in diagnosis (19), delay in surgery (4), error in surgical technique (5), failure to prevent paraplegia (2) and miscellaneous (3). Medical treatment was retrospectively judged suboptimal in 22 cases (66.6%) for reasons consonant with allegations. Aortic disease can be diagnostically elusive, as 'the great masquerader'. Emergency physicians must maintain a high index of suspicion for aneurysm and dissection. The D-dimer test can effectively rule out aortic dissection. 'Triple rule-out' CT scans should be performed liberally. CT scan readers must remember to evaluate the aorta. Operating room administrators must be aware that postponing a scheduled thoracic aortic case may result in interim rupture and consequent litigation. With virulent thoracic aortic diseases, adverse outcome itself does not imply substandard care. 2007 S. Karger AG, Basel

Horizontal alveolar ridge augmentation using autologous press fit bone cylinders and micro-lag-screw fixation: technical note and initial experience.

PubMed

Streckbein, Philipp; Kähling, Christopher; Wilbrand, Jan-Falco; Malik, Christoph-Yves; Schaaf, Heidrun; Howaldt, Hans-Peter; Streckbein, Roland

2014-07-01

The use of autologous block bone grafts for horizontal alveolar ridge augmentation in dental implantology is a common surgical procedure. Typically, bone grafts are individually moulded. The aim of this paper is to introduce an innovative procedure in lateral bone augmentation, where the recipient side is adjusted to the graft, not vice versa as in common procedures. Our initial clinical experience of twenty-five consecutive cases is presented. Adjusted trephine drills were used to harvest partly cylindrical grafts from the retromolar region of the mandible. After preparing the recipient site with accurately fitting grinding drills, the bone grafts were transplanted. The horizontally compromised alveolar ridges were successfully augmented and treated with dental implants. No major complication occurred during transplantation, the healing period, and subsequent implant therapy in our experimental setting with 25 patients and 38 augmentation procedures. One out of twenty-five patients presented with temporary dysaesthesia of the inferior alveolar nerve. The new method presented is an effective treatment option for horizontal alveolar ridge augmentation prior to single implant installation. Further studies should evaluate the donor site morbidity and long-term outcome on a larger population. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Higher Expression of Toll-like Receptors 3, 7, 8, and 9 in Pityriasis Rosea

PubMed Central

El-Ela, Mostafa Abou; El-Komy, Mohamed; Hay, Rania Abdel; Hegazy, Rehab; Sharobim, Amin; Rashed, Laila; Amr, Khalda

2017-01-01

Background Pityriasis rosea (PR) is a common papulosquamous skin disease in which an infective agent may be implicated. Toll-like receptors (TLRs) play an important role in immune responses and in the pathophysiology of inflammatory skin diseases. Our aim was to determine the possible roles of TLRs 3, 7, 8, and 9 in the pathogenesis of PR. Methods Twenty-four PR patients and 24 healthy individuals (as controls) were included in this case control study. All recruits were subjected to routine laboratory investigations. Biopsies were obtained from one active PR lesion and from healthy skin of controls for the detection of TLR 3, 7, 8, and 9 gene expression using real-time polymerase chain reaction. Results This study included 24 patients (8 females and 16 males) with active PR lesions, with a mean age of 28.62 years. Twenty four healthy age- and sex-matched individuals were included as controls (8 females and 16 males, with a mean age of 30.83 years). The results of the routine laboratory tests revealed no significant differences between both groups. Significantly elevated expression of all studied TLRs were detected in PR patients relative to healthy controls (p < .001). Conclusions TLRs 3, 7, 8, and 9 might be involved in the pathogenesis of PR. PMID:28192646

Acute juvenile Paracoccidioidomycosis: A 9-year cohort study in the endemic area of Rio de Janeiro, Brazil

PubMed Central

Almeida-Paes, Rodrigo; Freitas, Dayvison Francis Saraiva; Varon, Andréa Gina; Paixão, Ariane Gomes; Romão, Anselmo Rocha; Coutinho, Ziadir Francisco; Pizzini, Claudia Vera; Zancopé-Oliveira, Rosely Maria; Francesconi do Valle, Antonio Carlos

2017-01-01

Background Paracoccidioidomycosis (PCM) is a systemic mycosis caused by pathogenic dimorphic fungi of the genus Paracoccidioides. It is the most important systemic mycosis in Latin America and the leading cause of hospitalizations and death among them in Brazil. Acute PCM is less frequent but relevant because vulnerable young patients are affected and the severity is usually higher than that of the chronic type. Methods The authors performed a retrospective cohort study from 2001 to 2009 including acute juvenile PCM patients from a reference center in Rio de Janeiro, Brazil. Clinical, epidemiological, diagnostic, therapeutic, and prognostic data were reported. Results Twenty-nine patients were included. The average age was 23 years old and the male to female ratio was 1:1.07. All cases were referred from 3 of 9 existing health areas in the state of Rio de Janeiro, predominantly from urban areas (96.5%). Lymph nodes were the most affected organs (100%), followed by the skin and the spleen (31% each). Twenty-eight patients completed treatment (median 25 months) and progressed to clinical and serological cure; 1 death occurred. Twenty-four patients completed 48-month median follow-up. Four patients abandoned follow-up after the end of treatment. The most frequent sequela was low adrenal reserve. Paracoccidioides brasiliensis S1 was identified by partial sequencing of the arf and gp43 genes from 4 patients who presented a viable fungal culture. Conclusion Acute juvenile PCM is a severe disease with a high rate of complications. There are few cohort clinical studies of acute PCM in the literature. More studies should be developed to promote improvement in patients’ healthcare. PMID:28355221

[Pituitary apoplexy. Report of 25 patients].

PubMed

Khaldi, M; Ben Hamouda, K; Jemel, H; Kallel, J; Zemmel, I

2006-09-01

A series of 25 patients with a clinical diagnosis of pituitary apoplexy (PA) is reviewed. It included 14 men and 11 women aged between 20 to 79 years (mean age: 54 years). Twenty-two patients did not know that they had a pituitary tumor when the apoplexy occurred. A precipitating event was found in 3 cases. Symptoms and signs ranged from isolated ocular paresis to a deep coma. Seventeen patients experienced a decrease in their visual acuity. CTscan and MRI showed a pituitary adenoma in all cases, a hemorrhage was also present in 10 out of the 24 CTscans, and in all the 8 MRI performed. Twenty patients underwent surgery; 18 of them by a transsphenoidal approach. A complete recovery of visual acuity was observed in 75% of patients operated within the week following the onset of symptoms, and in 56% of patients operated later on. There was no case of complete visual recovery among the blind patients. Pituitary apoplexy is a clinical concept. It applies only to symptomatic cases. It is generally a complication of a pituitary adenoma which is in most cases unknown. There are different degrees of severity; PA can even be life-threatening. The principal aim of surgery in the acute phase is the improvement of visual prognosis. In our series, blind patients or those with a history of visual loss for more than a week or with a blindness had a poorer prognosis.

Endoscope-assisted approach to excision of branchial cleft cysts.

PubMed

Teng, Stephanie E; Paul, Benjamin C; Brumm, John D; Fritz, Mark; Fang, Yixin; Myssiorek, David

2016-06-01

The purpose of this study is to describe an endoscope-assisted surgical technique for the excision of branchial cleft cysts and compare it to the standard approach. Retrospective case series review. Twenty-seven cases described as branchial cleft excisions performed by a single surgeon at one academic medical center were identified between 2007 and 2014. Twenty-five cases (8 endoscopic, 17 standard approach) were included in the study. Cases were excluded if final pathology was malignant. Patient charts were reviewed, and two techniques were compared through analysis of incision size, operative time, and surgical outcomes. This study showed that the length of incision required for the endoscopic approach (mean = 2.13 ± 0.23) was significantly less than that of the standard approach (mean = 4.10 ± 1.46, P = 0.008) despite the fact that there was no significant difference in cyst size between the two groups (P = 0.09). The other variables examined, including operative time and surgical outcomes, were not significantly different between the two groups. This transcervical endoscope-assisted approach to branchial cleft cyst excision is a viable option for uncomplicated cases. It provides better cosmetic results than the standard approach and does not negatively affect outcomes, increase operative time, or result in recurrence. 4. Laryngoscope, 126:1339-1342, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Loss of heterozygosity at 11p13 and 11p15 in Wilms tumor: a study of 22 cases from India.

PubMed

Sigamani, Elanthenral; Wari, Mohammad Nahidul; Iyer, Venkateswaran K; Agarwala, Sandeep; Sharma, Arundhati; Bakhshi, Sameer; Dinda, Amit

2013-03-01

11p13 and 11p15 loss of heterozygosity (LOH) in Wilms tumor (WT), the commonest molecular pathogenetic event in WT, shows variation in different parts of the world. The present study looked for the presence of 11p13 and 11p15 LOH as well as nephrogenic rests in WT occurring in India. Twenty-two cases of WT were subjected to thorough pathological examination for presence of nephrogenic rests. Fresh frozen tissue was evaluated for LOH at 11p13 and 11p15, using PCR for microsatellite markers. Among twenty-two consecutive cases of WT, 20 were unilateral and 2 were bilateral. 6/22 showed LOH at 11p13 (27.7 %) and 1/22 showed LOH at 11p15 (4.54 %). 2/22 cases showed presence of nephrogenic rests. One of the cases with LOH at 11p13 had intralobar nephrogenic rest in the adjacent kidney. One specimen had perilobar nephrogenic rest in the adjacent kidney but did not show LOH for either 11p13 or 11p15 in the tumor. LOH at 11p13 is seen in 27.27 % of WT in India, which is similar to reports in the English language literature. LOH at 11p15 was seen in 4.54 % of WT, which is lower than that reported from Western subjects.

Comparative evaluation of immunochromatographic dipstick test (ICT) rk39, soluble antigen ELISA and IFAT for the sero-diagnosis of visceral leishmaniasis in Morocco.

PubMed

Mniouil, Meryem; Fellah, Hajiba; Amarir, Fatima; Sadak, Abderrahim; Et-Touys, Abdeslam; Bakri, Youssef; Moustachi, Aziza; Tassou, Fatima Zahraa; Hida, Mostapha; Lyagoubi, Mohamed; Adlaoui, El Bachir; Rhajaoui, Mohamed; Sebti, Faiza

2018-06-01

A rapid, sensitive and specific tool for detection of Leishmania infantum infection in Humans would be highly desirable, because it would allow control interventions in endemic areas of visceral leishmaniasis. This study was carried out at the Reference National Laboratory of Leishmaniasis (RNLL) in National Institute of Hygiene (NIH) Morocco, in order to evaluate the diagnostic potential of immunochromatographic dipstick test (ICT) rk39 in Moroccan suspected VL patients. A total of 49 admitted patients with strong clinical suspicion of VL and 40 healthy controls were investigated for the performance of the ICT rk39. Bone marrow smears were examined for microscopic detection of Leishmania amastigotes obtained from the admitted patients. Only PCR and smear positive cases were considered as gold standard as well as confirmed cases of VL. Out of 49 suspected patients, twenty four (48.9%) were found PCR and smear-positive and twenty three (46.9%) were positive for ICT rk39. Voluntary healthy controls, which included twenty persons from the endemic zone and twenty from non-endemic zone of VL, were found all negative for the strip test. The sensitivity in sera was 75% by ELISA and 87.5% by IFAT, compared with 95.8% for ICT rk39. Specificity was 95.8%, with both tests ELISA and IFAT, and 100% by ICT rk39 respectively. Present study findings again reinforce that the ICT rk39 is a simple, reliable and easy-to-perform non-invasive diagnostic tool for visceral leishmaniasis in the endemic area of Morocco. Copyright © 2018 Elsevier B.V. All rights reserved.

EDITORIAL: Probing the nanoworld Probing the nanoworld

NASA Astrophysics Data System (ADS)

Miles, Mervyn

2009-10-01

In nanotechnology, it is the unique properties arising from nanometre-scale structures that lead not only to their technological importance but also to a better understanding of the underlying science. Over the last twenty years, material properties at the nanoscale have been dominated by the properties of carbon in the form of the C60 molecule, single- and multi-wall carbon nanotubes, nanodiamonds, and recently graphene. During this period, research published in the journal Nanotechnology has revealed the amazing mechanical properties of such materials as well as their remarkable electronic properties with the promise of new devices. Furthermore, nanoparticles, nanotubes, nanorods, and nanowires from metals and dielectrics have been characterized for their electronic, mechanical, optical, chemical and catalytic properties. Scanning probe microscopy (SPM) has become the main characterization technique and atomic force microscopy (AFM) the most frequently used SPM. Over the past twenty years, SPM techniques that were previously experimental in nature have become routine. At the same time, investigations using AFM continue to yield impressive results that demonstrate the great potential of this powerful imaging tool, particularly in close to physiological conditions. In this special issue a collaboration of researchers in Europe report the use of AFM to provide high-resolution topographical images of individual carbon nanotubes immobilized on various biological membranes, including a nuclear membrane for the first time (Lamprecht C et al 2009 Nanotechnology 20 434001). Other SPM developments such as high-speed AFM appear to be making a transition from specialist laboratories to the mainstream, and perhaps the same may be said for non-contact AFM. Looking to the future, characterisation techniques involving SPM and spectroscopy, such as tip-enhanced Raman spectroscopy, could emerge as everyday methods. In all these advanced techniques, routinely available probes will be needed to make them mainstream methods, as was indeed the case for establishing AFM. At the same time, both transmission electron microscopy and scanning electron microscopy have undergone major developments in resolution, spectroscopic techniques, and new techniques such as tomography. It is exciting to speculate in which areas new properties of materials at the nanoscale will be discovered over the next twenty years, and how characterization methods will evolve, but it is the unimaginable and unpredictable that will bring the most dramatic changes to nanotechnology.

The preparedness level of final year medical students for an adequate medical approach to emergency cases: computer-based medical education in emergency medicine

PubMed Central

2014-01-01

Background We aimed to observe the preparedness level of final year medical students in approaching emergencies by computer-based simulation training and evaluate the efficacy of the program. Methods A computer-based prototype simulation program (Lsim), designed by researchers from the medical education and computer science departments, was used to present virtual cases for medical learning. Fifty-four final year medical students from Ondokuz Mayis University School of Medicine attended an education program on June 20, 2012 and were trained with Lsim. Volunteer attendants completed a pre-test and post-test exam at the beginning and end of the course, respectively, on the same day. Results Twenty-nine of the 54 students who attended the course accepted to take the pre-test and post-test exams; 58.6% (n = 17) were female. In 10 emergency medical cases, an average of 3.9 correct medical approaches were performed in the pre-test and an average of 9.6 correct medical approaches were performed in the post-test (t = 17.18, P = 0.006). Conclusions This study’s results showed that the readiness level of students for an adequate medical approach to emergency cases was very low. Computer-based training could help in the adequate approach of students to various emergency cases. PMID:24386919

Lipoprotein lipase activity and mass, apolipoprotein C-II mass and polymorphisms of apolipoproteins E and A5 in subjects with prior acute hypertriglyceridaemic pancreatitis

PubMed Central

2009-01-01

Background Severe hypertriglyceridaemia due to chylomicronemia may trigger an acute pancreatitis. However, the basic underlying mechanism is usually not well understood. We decided to analyze some proteins involved in the catabolism of triglyceride-rich lipoproteins in patients with severe hypertriglyceridaemia. Methods Twenty-four survivors of acute hypertriglyceridaemic pancreatitis (cases) and 31 patients with severe hypertriglyceridaemia (controls) were included. Clinical and anthropometrical data, chylomicronaemia, lipoprotein profile, postheparin lipoprotein lipase mass and activity, hepatic lipase activity, apolipoprotein C II and CIII mass, apo E and A5 polymorphisms were assessed. Results Only five cases were found to have LPL mass and activity deficiency, all of them thin and having the first episode in childhood. No cases had apolipoprotein CII deficiency. No significant differences were found between the non-deficient LPL cases and the controls in terms of obesity, diabetes, alcohol consumption, drug therapy, gender distribution, evidence of fasting chylomicronaemia, lipid levels, LPL activity and mass, hepatic lipase activity, CII and CIII mass or apo E polymorphisms. However, the SNP S19W of apo A5 tended to be more prevalent in cases than controls (40% vs. 23%, NS). Conclusion Primary defects in LPL and C-II are rare in survivors of acute hypertriglyceridaemic pancreatitis; lipase activity measurements should be restricted to those having their first episode during chilhood. PMID:19534808

Ocular Injury in Cosmetic Laser Treatments of the Face.

PubMed

Huang, Amy; Phillips, Arianna; Adar, Tony; Hui, Andrea

2018-02-01

BACKGROUND: The eye is a vulnerable and commonly injured organ in cosmetic laser procedures of the face. Treatment of the eyelids and periorbital areas increases this risk, especially when ocular protection devices are not used or are removed during the procedure. A study has shown that injury from laser epilation of the periocular areas is one of the most common causes of litigation in cutaneous laser surgery. OBJECTIVE: The goal of this review is to determine the causes of ocular injury in cosmetic laser procedures and derive lessons on critical safety elements to prevent future injury. METHODS: We conducted a review of the current literature through a PubMed search on case reports of ocular injury in cosmetic laser treatments of the face. Twenty-one cases are examined. RESULTS: In more than 62 percent of cases, ocular protection was not used or protection was used but removed during the procedure to treat areas close to the eye. However, despite the proper use of intraocular corneal shields and wavelength-specific goggles, accidents occurred in 33 percent of cases. CONCLUSION: Ocular protection devices are essential to prevent most cases of laser-induced eye injury. Use of high fluence and long wavelength lasers increases the risk of ocular injury due to deeper penetration of the organ by radiation. Inadequate cooling between pulses also predisposes to injury by cosmetic lasers.

Laparoscopic radical cystectomy with intracorporeal orthotopic ileal neobladder: technique and clinical outcomes.

PubMed

Shao, Pengfei; Li, Pu; Ju, Xiaobing; Qin, Chao; Li, Jie; Lv, Qiang; Meng, Xiaoxin; Yin, Changjun

2015-02-01

To study the feasibility and safety of laparoscopic radical cystectomy with intracorporeal orthotopic ileal neobladder and to evaluate the role of endoscopic stapling in neobladder construction. Fifty-five patients with bladder cancer who underwent laparoscopic radical cystectomy were retrospectively examined. Extended pelvic lymph node dissection was performed before cystectomy. An ileal segment of 50 cm was harvested to construct a U-shaped reservoir. The bottom of the reservoir was anastomosed with the posterior urethra. Twenty-five patients underwent neobladder construction by manual suturing and 30 patients by endoscopic stapler suturing. The mean operative time was 346 minutes, and mean neobladder construction time was 230 minutes. The median estimated blood loss was 500 mL, and 17 patients received intraoperative transfusion. Postoperative complications included 2 cases of urine leakage, 7 cases of pyelonephritis, 4 cases of incomplete bowel obstruction, 1 case of anastomotic stricture, and 1 case of death. Endoscopic stapler suturing for neobladder construction took significantly less time than manual suturing. However, neobladder stones were found in 2 patients who underwent operation using endoscopic suturing, and the stones were removed cystoscopically. The functional outcomes of the 2 constructive methods were comparable. Laparoscopic radical cystectomy with intracorporeal orthotopic neobladder is safe and feasible for experienced laparoscopic surgeons. Application of endoscopic stapler simplifies the surgical procedure while increasing the risk of neobladder stone formation. Copyright © 2015 Elsevier Inc. All rights reserved.

Beyond the specific child. What is 'a child's case' in general practice?

PubMed

Hølge-Hazelton, Bibi; Tulinius, Charlotte

2010-01-01

Too many abused and neglected children are being overlooked by GPs and other professionals who are in contact with the families. Some suggestions for a definition of 'a child in need' have been given, but the functionality of these definitions has not been tested in general practice. To describe the problems presented by GPs as cases with children in need during supervision, and from here to suggest an empirically-based definition of a child in need in general practice. A mixed-method evaluation design was used. Twenty-one GPs, in Denmark, participated in supervision groups concerning cases with children in need in general practice. The data were analysed via field notes and video recordings; case categorisation into sex, ethnicity, and developmental stages; thematically using the GPs' own descriptions; and a theoretically supported style. Analysis of the data led to the suggested definition of a case concerning 'a child in need' in general practice as one that directly or indirectly involves problems with a specific child, an as-yet unborn child, or one or both parents of a family currently or potentially threatening the wellbeing of the family or the child. Based on this analysis, one suggestion as to why some abused and neglected children are overlooked in general practice is that GPs often have to navigate in difficult indirect consultations, where there is a high risk of losing the overview.

Ocular Injury in Cosmetic Laser Treatments of the Face

PubMed Central

Huang, Amy; Phillips, Arianna; Adar, Tony

2018-01-01

BACKGROUND: The eye is a vulnerable and commonly injured organ in cosmetic laser procedures of the face. Treatment of the eyelids and periorbital areas increases this risk, especially when ocular protection devices are not used or are removed during the procedure. A study has shown that injury from laser epilation of the periocular areas is one of the most common causes of litigation in cutaneous laser surgery. OBJECTIVE: The goal of this review is to determine the causes of ocular injury in cosmetic laser procedures and derive lessons on critical safety elements to prevent future injury. METHODS: We conducted a review of the current literature through a PubMed search on case reports of ocular injury in cosmetic laser treatments of the face. Twenty-one cases are examined. RESULTS: In more than 62 percent of cases, ocular protection was not used or protection was used but removed during the procedure to treat areas close to the eye. However, despite the proper use of intraocular corneal shields and wavelength-specific goggles, accidents occurred in 33 percent of cases. CONCLUSION: Ocular protection devices are essential to prevent most cases of laser-induced eye injury. Use of high fluence and long wavelength lasers increases the risk of ocular injury due to deeper penetration of the organ by radiation. Inadequate cooling between pulses also predisposes to injury by cosmetic lasers. PMID:29552271

A district confidential enquiry into deaths due to asthma.

PubMed Central

Wareham, N. J.; Harrison, B. D.; Jenkins, P. F.; Nicholls, J.; Stableforth, D. E.

1993-01-01

BACKGROUND--The aim was to establish a continuing district based confidential enquiry into deaths from asthma. METHODS--A confidential enquiry was conducted in an English health district. Subjects comprised 24 residents of the Norwich health district aged between 16 and 65 years who had died between 1988 and 1991 with asthma as the principal cause of death. RESULTS--Twenty one of the patients (88%) died away from hospital. Overall the routine asthma management was appropriate in all respects in only four patients. In five cases the drug treatment was considered inappropriate, in 10 cases (42%) there was no written evidence that the patient had received advice and education, and only six cases had a written management plan. In 17 patients (71%) the fatal attack of asthma developed rapidly (in under three hours). The medical care during the final attack was found to have been inappropriate in six cases. Seventeen cases (71%) had psychological or social factors that were considered to have been of potential importance. CONCLUSIONS--This study has shown the feasibility of organising a confidential enquiry into asthma deaths within a health district. The distinguishing features of such an enquiry are that it is continuing, that the quality of care given to those patients who died is compared against a recognised standard, and that there is a structured system for feeding back the conclusions of the enquiry to the local medical community. PMID:8296254

Fast Foods, Sweets and Beverage Consumption and Risk of Colorectal Cancer: A Case-Control Study in Jordan

PubMed Central

Tayyem, Reema F; Bawadi, Hiba A; Shehadah, Ihab; Bani-Hani, Kamal E; Takruri, Hamed; Al-Jaberi, Tareq; Heath, Dennis D

2018-01-01

Background: The effects of consuming fast foods, sweets and beverages on the development of colorectal cancer (CRC) are unclear. The aim of this case-control study was to assess possible associations between the consumption of different fast foods, sweets and beverages and CRC risk in a Jordanian population. Methods: Two hundred and twenty diagnosed CRC cases and 281 controls were enrolled. Diet history was obtained using a validated quantitative questionnaire. Results: Consumption of some types of fast food, and particularly falafel, was associated with an increased risk of developing CRC. Elevated risk was found for potato and corn chips with an AOR of 4.36 (95%CI: 1.24-15.28) for daily consumption and 3.33 (95%CI: 1.00-11.11) for ≥5 servings/week. Consuming 1-2 or >5 servings per week of fried potatoes or 2-3 servings per week of chicken in sandwiches also increased the risk while exposure to fresh tomato juice and hot pepper sauce on a monthly basis appeared to exert a protective effect. Conclusions: Consumption of fried fast food items was significantly linked with an increased risk of developing CRC in Jordan. PMID:29374411

Use of Multiple Metabolic and Genetic Markers to Improve the Prediction of Type 2 Diabetes: the EPIC-Potsdam Study

PubMed Central

Schulze, Matthias B.; Weikert, Cornelia; Pischon, Tobias; Bergmann, Manuela M.; Al-Hasani, Hadi; Schleicher, Erwin; Fritsche, Andreas; Häring, Hans-Ulrich; Boeing, Heiner; Joost, Hans-Georg

2009-01-01

OBJECTIVE We investigated whether metabolic biomarkers and single nucleotide polymorphisms (SNPs) improve diabetes prediction beyond age, anthropometry, and lifestyle risk factors. RESEARCH DESIGN AND METHODS A case-cohort study within a prospective study was designed. We randomly selected a subcohort (n = 2,500) from 26,444 participants, of whom 1,962 were diabetes free at baseline. Of the 801 incident type 2 diabetes cases identified in the cohort during 7 years of follow-up, 579 remained for analyses after exclusions. Prediction models were compared by receiver operatoring characteristic (ROC) curve and integrated discrimination improvement. RESULTS Case-control discrimination by the lifestyle characteristics (ROC-AUC: 0.8465) improved with plasma glucose (ROC-AUC: 0.8672, P < 0.001) and A1C (ROC-AUC: 0.8859, P < 0.001). ROC-AUC further improved with HDL cholesterol, triglycerides, γ-glutamyltransferase, and alanine aminotransferase (0.9000, P = 0.002). Twenty SNPs did not improve discrimination beyond these characteristics (P = 0.69). CONCLUSIONS Metabolic markers, but not genotyping for 20 diabetogenic SNPs, improve discrimination of incident type 2 diabetes beyond lifestyle risk factors. PMID:19720844

Naratriptan in the Prophylactic Treatment of Cluster Headache.

PubMed

Ito, Yasuo; Mitsufuji, Takashi; Asano, Yoshio; Shimazu, Tomokazu; Kato, Yuji; Tanahashi, Norio; Maruki, Yuichi; Sakai, Fumihiko; Yamamoto, Toshimasa; Araki, Nobuo

2017-10-01

Objective Naratriptan has been reported to reduce the frequency of cluster headache. The purpose of this study was to determine whether naratriptan is effective as a prophylactic treatment for cluster headache in Japan. Methods We retrospectively reviewed all 43 patients with cluster headache who received preventive treatment with naratriptan from April 2009 to April 2015. The International Classification of Headache Disorders, 3rd Edition (beta version) (ICHD-3 beta) was used to diagnose cluster headache. This study was conducted at 3 centers (Department of Neurology, Saitama Medical University; Saitama Neuropsychiatric Institute; Saitama Medical University International Medical Center). Patients were recruited from these specialized headache outpatient centers. Naratriptan was taken before the patient went to bed. Results The study population included 30 men (69.8%) and 13 women (30.2%). Twenty-two cases received other preventive treatments (51.2%), while 21 cases only received naratriptan (48.8%). Among the 43 cases, 37 patients (86.0%) achieved an improvement of cluster headache on naratriptan. Conclusion Naratriptan has been suggested as a preventive medicine for cluster headache because of the longer the biological half-life in comparison to other triptans. The internal use of naratriptan 2 hours before attacks appears to achieve a good response in patients with cluster headache.

Low-Grade Myxofibrosarcoma of the Rectus Abdominus Muscle Infiltrating into Abdominal Cavity: A Case Report.

PubMed

Nomura, Tadashi; Sakakibara, Shunsuke; Moriwaki, Aya; Kawamoto, Teruya; Suzuki, Satoshi; Ishimura, Takeshi; Hashikawa, Kazunobu; Terashi, Hiroto

2017-01-01

Objective: Myxofibrosarcoma (MFS) is a relatively rare tumor that is histologically characterized by myxoid stroma and spindle cell proliferation. This tumor most commonly arises as a slow growing, enlarging painless mass in the extremities of elderly patients. Methods: We report a case of a primary, low-grade MFS in the rectus abdominis muscle infiltrating the abdominal cavity of a 75-year-old man. Results: The patient underwent a wide excision of the right abdominal wall mass with a 3-cm surgical margin from the scar due to a biopsy. The tumor infiltrated the urinary bladder, peritoneum, and external iliac vessels. Twenty-six months after the initial operation, he had recurrences in his abdominal wall, urinary bladder, and right iliac vessels. Conclusions: To our knowledge, primary MFS of the muscle in the abdomen has not been documented previously. Although this case was histopathologically classified as a low-grade tumor, it infiltrated the abdominal cavity. The tumor is suspected to have penetrated the abdominal cavity below the linea arcuata, which lacks the posterior sheath of the rectus abdominis muscle; from there, it could easily spread without being blocked by any biological barriers.

[Clinical experience in facial nerve tumors: a review of 27 cases].

PubMed

Zhang, Fan; Wang, Yucheng; Dai, Chunfu; Chi, Fanglu; Zhou, Liang; Chen, Bing; Li, Huawei

2010-01-01

To analyze the clinical manifestations and the diagnosis of the facial nerve tumor according to the clinical information, and evaluate the different surgical approaches depending on tumor location. Twenty-seven cases of facial nerve tumors with general clinical informations available from 1999.9 to 2006.12 in the Shanghai EENT Hospital were reviewed retrospectively. Twenty (74.1%) schwannomas, 4 (14.8%) neurofibromas ,and 3 (11.1%) hemangiomas were identified with histopathology postoperatively. During the course of the disease, 23 patients (85.2%) suffered facial paralysis, both hearing loss and tinnitus affected 11 (40.7%) cases, 5 (18.5%) manifested infra-auricular mass and the others showed some of otalgia or vertigo or ear fullness or facial numbness/twitches. CT or/and MRI results in 24 cases indicated that the tumors originated from the facial nerve. Intra-operative findings showed that 24 (88.9%) cases involved no less than 2 segments of the facial nerve, of these 24 cases 87.5% (21/24) involved the mastoid portion, 70.8% (17/24) involved the tympanic portion, 62.5% (15/24) involved the geniculate ganglion, only 4.2% (1/24) involved the internal acoustic canal (IAC), and 3 cases (11.1%) had only one segments involved. In all of these 27 cases, the tumors were completely excised, of which 13 were resected followed by an immediate facial nerve reconstruction, including 11 sural nerve cable graft, 1 facial nerve end-to-end anastomosis and 1 hypoglossal-facial nerve end-to-end anastomosis. Tumors were removed with preservation of facial nerve continuity in 2 cases. Facial nerve tumor is a rare and benign lesion, and has numerous clinical manifestations. CT and MRI can help surgeons to make a right diagnosis preoperatively. When and how to give the patients an operation depends on the patients individually.

Treatment of unicameral bone cysts by curettage and packing with plaster-of-Paris pellets. 1978.

PubMed

Peltier, Leonard F; Jones, Richard H

2004-05-01

Long-term follow-up of twenty-six patients with unicameral bone cysts treated by curettage and packing with plaster-of-Paris pellets showed a recurrence in only two cases and no serious complications.

The Impact of ICT as Another Route to Overcome Learning Barriers for Students with SEN: A Case Study in an Egyptian Context

ERIC Educational Resources Information Center

Al-Gawhary, Wedad; Kambouri, Maria

2012-01-01

The purpose of this case study was to measure the impact of using ICT in Individual Learning Programmes of students with learning disabilities. Twenty five students and thirteen teachers took part in the research which was based on classroom observations. The Kappa coefficient was employed as a measure to statistically quantify the students'…

Circumferential suture technique for esophageal transection to treat esophageal variceal bleeding.

PubMed

Jeng, L B; Chen, M F

1993-01-01

The EEA stapler has been used routinely for esophageal transection to treat esophageal variceal bleeding for some time. It carries the risk of postoperative leakage and is not suitable in those cases receiving recent sclerotherapy. The circumferential suture technique presented in this paper can be used in any situation requiring esophageal transection. It has been utilized by us in twenty-two emergent cases with good results.

Economic Education Experiences of Enterprising Teachers, Volume 15. A Report Developed from the 1976-77 Entries in the International Paper Company Foundation Awards Program for the Teaching of Economics.

ERIC Educational Resources Information Center

Dawson, George G., Ed.

Twenty award winning, teacher-developed programs, projects, courses, and materials in economic education are presented. These case study projects are designed to be used with kindergarten through college students. The case studies are organized by grade level into five chapters. Chapter I suggests ways to teach economic concepts to educable…

Primary Langerhans Cell Histiocytosis of the Vulva: Case Report and Review of the Literature.

PubMed

Zudaire, Tamara; Guarch, Rosa; Valcayo, Ana; García, Kelly; Resano, Miguel Ángel; Requena, Diego; Rodríguez, Mercedes

2017-03-01

Langerhans cell histiocytosis (LCH) of the vulva is rare and even moreso in postmenopausal women. Twenty-six cases of primary vulvar LCH have been described in the current literature, and only 8 cases are in postmenopausal women. We report an additional case of primary vulvar LCH in a 59-yr-old woman with subsequent multiorgan involvement. In this article, we briefly describe the clinical presentation, histopathological findings, and immunohistochemistry results of vulvar LCH. We want to emphasize the importance of recognizing this entity in a woman with vulvar lesions both for the clinician and the pathologist.

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

[Primary colonic intussusception protruding from the anus in adults. Two cases].

PubMed

Bail, J P; Holderbach, L J; Robaszkiewicz, M; Dartoy, C; Noundou, P M; Charles, J F

1992-01-01

The authors report two cases of colonic intussusception in the adult protruding from the anus--or colon-anal intussusception--, not due to a tumor. The first case was a chronic ileo-caeco-colique intussusception, the second case was an acute colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than twenty cases have been described since 1925 in adults. The absence of a tumor origin in our cases represents a special feature, as only three other similar cases have been described. The surgical treatment in both cases was primary colonic resection without colostomy. The surgical treatment of the first case was subtotal colectomy with ileo-rectal anastomosis. The second case was primarily reduced by barium enema which allowed optimal secondary surgical resection of a prepared colon.

Lymphomas or leukemia presenting as ovarian tumors. An analysis of 42 cases.

PubMed

Osborne, B M; Robboy, S J

1983-11-15

Forty cases of ovarian lymphoma and two of extramedullary leukemia were examined with emphasis on histologic types correlated with age, modes of presentation, operative findings, including frequency of bilaterality and omental spread, clinical course following therapy, and problems in differential diagnosis. Although most cases were referred with diagnoses other than lymphoma (granulosa cell tumor or dysgerminoma, occasionally anaplastic tumor, Krukenberg tumor, or metastatic breast carcinoma), utilization of sections cut at 4 mu and stained with hematoxylin and eosin, or sections stained by the methyl green pyronine (MGP), naphthol-ASD esterase (NASD) or periodic acid-Schiff (PAS) methods helped bring out the lymphoid or hematopoietic nature of the cells. Sixteen patients were under 20 years of age. They had small noncleaved cell lymphoma (undifferentiated Burkitt's and non-Burkitt's, 10 cases), diffuse immunoblastic large cell lymphoma (4 cases), or acute granulocytic leukemia (2 cases). Twenty-six patients were 29 to 74 years of age and had diffuse large cell lymphoma (10 cases), diffuse immunoblastic large cell lymphoma (9 cases), follicular (nodular) lymphoma (6 cases) or small noncleaved cell lymphoma (1 case). Pain with an abdominal or pelvic mass was the most common presentation. Nine tumors were discovered during investigation of other gynecologic complaints. At laparotomy, the tumors in 55% of cases involved both ovaries, and in 64% also involved extragonadal sites (usually omentum, fallopian tubes, or lymph nodes). Seventeen patients had tumor affecting one ovary, seven of these without any evidence of extragonadal spread. Forty-two percent (15) of 37 patients with follow-up were alive after 2 years. Only nine patients survived more than 5 years; two subsequently died of lymphoma. Favorable prognostic features included: (1) FIGO stage IA; (2) unilateral ovarian involvement; (3) focal involvement of one ovary; and (4) follicular (nodular) lymphoma.

Ostomy or intestinal anastomosis in cases of peritonitis.

PubMed

Rasslan, S; Margutti Fonoff, A; Soldá, S C; Angelo Casaroli, A

1995-01-01

Twenty-six patients showing peritonitis due to nontraumatic acute abdomen were submitted to ostomy. Mean age was 51 years (range 25-83), being 13 males and 13 females. Bowel obstruction (BO) was the most frequent cause of peritonitis (11 cases), followed by intestinal perforation (IP) (8 cases), acute mesenteric infarction (AMI) (5 cases), and acute abdomen of inflammatory/infectious origin (AAIO) (2 cases). Brook's ileostomy was performed on 65% of the patients. Jejunostomy was performed only in 4 patients, leading to a bad evolution. Overall mortality was 54%. Primary ostomy or anastomosis in cases of peritonitis constitute a highly controversial theme. Indications and problems involving the intestinal exteriorization in emergency surgery urgency are herein discussed.

Epidemiology and prophylaxis of rabies in humans in France: evaluation and perspectives of a twenty-five year surveillance programme.

PubMed

Rotivel, Y; Goudal, M; De Fanti, A Simons; Van Der Vliet, D

2008-01-01

The National Reference Centre for Rabies (NRC) was created at the Pasteur Institute after the fox epizootic reached the French territory. The missions of the NRC include, among others, the surveillance of rabies cases in humans and rabies post-exposure prophylaxis (PEP) treatments. The surveillance has been effective since 1982. A Bulletin on the Epidemiology and the Prophylaxis of Rabies in Humans in France is published every year. This Bulletin is now available on the Internet for Human Health and Veterinary national and local Authorities. Since 2005, data is collected with new software, Voozanoo, directly via the Internet. Twenty cases of rabies in humans have been reported since 1970. There were no indigenously acquired cases. The number of PEP treatments peaked in 1990, when the number of cases in the wild fauna was at its acme. Following the decrease of rabies cases in the wild fauna, PEP decreased by 60%. Nevertheless, about4,000 PEP treatments are still carried out. These patients have been exposed to bats or to rabid animals illegally introduced onto the French territory, or during a stay in rabies enzootic countries, or to unobservable animals. The study of this database leads to a number of conclusions: canine variants acquired directly in canine enzootic areas, that are translocated, or acquired through iatrogenic exposure, are responsible for the majority of cases; bats appear to be an increasing source of exposure; PEP surveillance is of utmost importance to monitor and to improve the quality of case management.

Update on the management of pineal cysts: Case series and a review of the literature.

PubMed

Berhouma, M; Ni, H; Delabar, V; Tahhan, N; Memou Salem, S; Mottolese, C; Vallee, B

2015-01-01

The natural history of pineal cysts still remains unclear. Incidental pineal cysts have become more common which raises the question of their management. Symptomatic pineal cysts may require a surgical solution but therapeutic indications have not yet been clearly established. From 1986 to 2012, 26 patients with pineal cysts were identified. Their medical records were retrospectively assessed focusing on the initial symptoms, imaging characteristics of the cyst, management strategy, operative technique and their complications, as well as the latest follow-up. A systematic review of the literature is also presented. Twenty-six patients with pineal cysts were identified. The mean age was 23.5 years ranging from 7 to 49 years. Symptoms included intracranial hypertension with obstructive hydrocephalus in 18 cases and oculomotor anomalies in 12 cases. Two adult cases presented with non-specific headaches and did not require surgery. Twenty patients were operated via a suboccipital transtentorial approach with total removal of the cyst in 70% of the cases, while the remaining 4 cases were treated with an intraventricular endoscopic marsupialization associating a third ventriculostomy. Four patients required a preoperative ventriculo-peritoneal shunt due to life-threatening obstructive hydrocephalus. Overall, peri-operative mortality was nil. In the two non-operated patients, the cyst remained stable and no recurrences were observed in all operated patients with a mean follow-up of 144 months. In the majority of incidental pineal cysts, a clinical and imaging follow-up is sufficient but occasionally not required especially in adults as very rare cases of increase in size have been reported. Copyright © 2014. Published by Elsevier Masson SAS.

Pattern and profile of electric burn injury cases at a Burn centre.

PubMed

Cheema, Saeed Ashraf

2016-01-01

Electrical burns are quite different from thermal and chemical burns. This study is from a centre which deals with job related electric burn injuries alone and thus can give a pure account of the electric burns and discuss the related peculiarities. Study aims to highlight the differences in the mechanism of electric burn injury, its mode of presentation, morbidity, complications and thus the treatment strategies as compared to rest of the burn injuries. This is a descriptive case series study of first consecutive 61 electric burn victims treated at a Burn Unit and Plastic Surgery centre. Cases were admitted and resuscitated at the emergency, and further treated at burn unit. Thorough history, examination findings and operative procedures were recorded. Patients were photographed for record as well. Emergency operative procedures, wound management, soft tissue coverage procedures and complications during the hospital stay were recorded and studied. Twenty cases (33%) were in the fifth decade of life. High voltage electric burn injury was seen in 42 (69%) of the cases. Whereas only 9 cases were treated conservatively, other 52 cases had 24 fasciotomies and 71 debridements. Series witnessed 10 expiries, and 22 amputations and all these were result of high voltage electric burns. Twenty eight soft tissue coverage procedures were carried out. Electric burn injuries are altogether different from rest of the burn injuries and must be treated accordingly. These injuries are peculiar for ongoing damage, extensive trauma, complications and prolonged morbidity. Treatment requires a high degree of suspicion, more aggressive management to unfold and minimize the deep seated insult.

Supercritical wing sections 2, volume 108

NASA Technical Reports Server (NTRS)

Bauer, F.; Garabedian, P.; Korn, D.; Jameson, A.; Beckmann, M. (Editor); Kuenzi, H. P. (Editor)

1975-01-01

A mathematical theory for the design and analysis of supercritical wing sections was previously presented. Examples and computer programs showing how this method works were included. The work on transonics is presented in a more definitive form. For design, a better model of the trailing edge is introduced which should eliminate a loss of fifteen or twenty percent in lift experienced with previous heavily aft loaded models, which is attributed to boundary layer separation. How drag creep can be reduced at off-design conditions is indicated. A rotated finite difference scheme is presented that enables the application of Murman's method of analysis in more or less arbitrary curvilinear coordinate systems. This allows the use of supersonic as well as subsonic free stream Mach numbers and to capture shock waves as far back on an airfoil as desired. Moreover, it leads to an effective three dimensional program for the computation of transonic flow past an oblique wing. In the case of two dimensional flow, the method is extended to take into account the displacement thickness computed by a semi-empirical turbulent boundary layer correction.

Assessing pre-service science teachers' technological pedagogical content knowledge (TPACK) through observations and lesson plans

NASA Astrophysics Data System (ADS)

Canbazoglu Bilici, Sedef; Selcen Guzey, S.; Yamak, Havva

2016-05-01

Background: Technological pedagogical content knowledge (TPACK) is critical for effective teaching with technology. However, generally science teacher education programs do not help pre-service teachers develop TPACK. Purpose: The purpose of this study was to assess pre-service science teachers' TPACK over a semester-long Science Methods. Sample: Twenty-seven pre-service science teachers took the course toward the end of their four-year teacher education program. Design and method: The study employed the case study methodology. Lesson plans and microteaching observations were used as data collection tools. Technological Pedagogical Content Knowledge-based lesson plan assessment instrument (TPACK-LpAI) and Technological Pedagogical Content Knowledge Observation Protocol (TPACK-OP) were used to analyze data obtained from observations and lesson plans. Results: The results showed that the TPACK-focused Science Methods course had an impact on pre-service teachers' TPACK to varying degrees. Most importantly, the course helped teachers gain knowledge of effective usage of educational technology tools. Conclusion: Teacher education programs should provide opportunities to pre-service teachers to develop their TPACK so that they can effectively integrate technology into their teaching.

[Learning strategies of autonomous medical students].

PubMed

Márquez U, Carolina; Fasce H, Eduardo; Ortega B, Javiera; Bustamante D, Carolina; Pérez V, Cristhian; Ibáñez G, Pilar; Ortiz M, Liliana; Espinoza P, Camila; Bastías V, Nancy

2015-12-01

Understanding how autonomous students are capable of regulating their own learning process is essential to develop self-directed teaching methods. To understand how self-directed medical students approach learning in medical schools at University of Concepción, Chile. A qualitative and descriptive study, performed according to Grounded Theory guidelines, following Strauss & Corbin was performed. Twenty medical students were selected by the maximum variation sampling method. The data collection technique was carried out by a semi-structured thematic interview. Students were interviewed by researchers after an informed consent procedure. Data were analyzed by the open coding method using Atlas-ti 7.5.2 software. Self-directed learners were characterized by being good planners and managing their time correctly. Students performed a diligent selection of contents to study based on reliable literature sources, theoretical relevance and type of evaluation. They also emphasized the discussion of clinical cases, where theoretical contents can be applied. This modality allows them to gain a global view of theoretical contents, to verbalize knowledge and to obtain a learning feedback. The learning process of autonomous students is intentional and planned.

Rheumatic and musculoskeletal features of Whipple disease: a report of 29 cases.

PubMed

Meunier, Marine; Puechal, Xavier; Hoppé, Emmanuel; Soubrier, Martin; Dieudé, Philippe; Berthelot, Jean Marie; Caramaschi, Paola; Gottenberg, Jacques-Eric; Gossec, Laure; Morel, Jacques; Maury, Emilie; Wipff, Julien; Kahan, André; Allanore, Yannick

2013-12-01

Whipple disease is a rare infection caused by Tropheryma whipplei. Although patients commonly complain of osteoarticular involvement, musculoskeletal manifestations have been poorly described. We report cases of Whipple disease with rheumatic symptoms and describe their clinical presentation, modes of diagnosis, and outcomes. This retrospective multicenter study included patients with Whipple disease diagnosed and referenced between 1977 and 2011 in 10 rheumatology centers in France and Italy. Twenty-nine patients were included. The median age was 55 years. The median time to diagnosis from first symptoms was 5 years. Polyarthritis was the most frequent presentation (20/29), and was most often chronic, intermittent (19/29), seronegative (22/23), and nonerosive (22/29). In all cases, the symptoms had led to incorrect diagnosis of inflammatory rheumatic disease and immunosuppressants, including biotherapy, were prescribed in most cases (24/29) without success. The diagnosis of Whipple disease was made by histological analysis, molecular biology tests, or both in 21%, 36%, and 43% of the cases, respectively. Duodenal biopsies were performed in most cases (86%). Synovial biopsies were performed in 18% of cases, but all contributed to diagnosis. The clinical outcomes after antibiotic therapy were good for all patients. Polyarthritis is the main feature observed in cases of Whipple disease; it is seronegative and associated with general and gastrointestinal symptoms. The molecular analysis of duodenal tissue and/or other tissues remains the method of choice to confirm the diagnosis. Reducing the time to diagnosis is important because severe late systemic and fatal forms of the disease may occur.

Investigation of a measles outbreak in Cordillera, Northern Philippines, 2013

PubMed Central

Zapanta, Ma Justina; de los Reyes, Vikki Carr; Tayag, Enrique; Magpantay, Rio

2016-01-01

Introduction Measles is a highly infectious viral illness that remains one of the leading causes of death among children worldwide. In the Philippines, decreasing routine vaccination coverage from 2007 to 2011 led to local measles outbreaks. A team investigated a measles outbreak reported in Cordillera of the Philippines in May 2013. Methods Measles case data with symptom onset from 2 February to 27 May 2013 were obtained from official sources and verified on site. Data included age, sex, residential address, signs and symptoms and vaccination status. Active case-findings were also conducted for contacts of these cases. The living environments of the cases were investigated. A survey was conducted with the cases and caregivers to understand their knowledge and attitudes about measles. Results There were 50 measles cases identified with an age range from six months to 32 years (median: 16 years). Thirty-two were male (64%). Twenty (40%) were hospitalized with one death. Thirty-two (64%) cases were laboratory confirmed, and 36 (72%) received a single dose of measles vaccine. Overcrowded living environments were observed among many cases. The majority of respondents (46/48, 96%) knew about measles, but there were misconceptions about the cause of measles and how it can be prevented and managed. Conclusion This measles outbreak occurred in an area with low immunization coverage. Achieving 95% measles immunization coverage and strengthening routine immunization strategies to address high-risk populations are recommended. Also, we recommend health education campaigns to include components that address misconceptions about measles. PMID:27766180

Practical dose point-based methods to characterize dose distribution in a stationary elliptical body phantom for a cone-beam C-arm CT system

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

Choi, Jang-Hwan, E-mail: jhchoi21@stanford.edu; Constantin, Dragos; Ganguly, Arundhuti

2015-08-15

Purpose: To propose new dose point measurement-based metrics to characterize the dose distributions and the mean dose from a single partial rotation of an automatic exposure control-enabled, C-arm-based, wide cone angle computed tomography system over a stationary, large, body-shaped phantom. Methods: A small 0.6 cm{sup 3} ion chamber (IC) was used to measure the radiation dose in an elliptical body-shaped phantom made of tissue-equivalent material. The IC was placed at 23 well-distributed holes in the central and peripheral regions of the phantom and dose was recorded for six acquisition protocols with different combinations of minimum kVp (109 and 125 kVp)more » and z-collimator aperture (full: 22.2 cm; medium: 14.0 cm; small: 8.4 cm). Monte Carlo (MC) simulations were carried out to generate complete 2D dose distributions in the central plane (z = 0). The MC model was validated at the 23 dose points against IC experimental data. The planar dose distributions were then estimated using subsets of the point dose measurements using two proposed methods: (1) the proximity-based weighting method (method 1) and (2) the dose point surface fitting method (method 2). Twenty-eight different dose point distributions with six different point number cases (4, 5, 6, 7, 14, and 23 dose points) were evaluated to determine the optimal number of dose points and their placement in the phantom. The performances of the methods were determined by comparing their results with those of the validated MC simulations. The performances of the methods in the presence of measurement uncertainties were evaluated. Results: The 5-, 6-, and 7-point cases had differences below 2%, ranging from 1.0% to 1.7% for both methods, which is a performance comparable to that of the methods with a relatively large number of points, i.e., the 14- and 23-point cases. However, with the 4-point case, the performances of the two methods decreased sharply. Among the 4-, 5-, 6-, and 7-point cases, the 7-point case (1.0% [±0.6%] difference) and the 6-point case (0.7% [±0.6%] difference) performed best for method 1 and method 2, respectively. Moreover, method 2 demonstrated high-fidelity surface reconstruction with as few as 5 points, showing pixelwise absolute differences of 3.80 mGy (±0.32 mGy). Although the performance was shown to be sensitive to the phantom displacement from the isocenter, the performance changed by less than 2% for shifts up to 2 cm in the x- and y-axes in the central phantom plane. Conclusions: With as few as five points, method 1 and method 2 were able to compute the mean dose with reasonable accuracy, demonstrating differences of 1.7% (±1.2%) and 1.3% (±1.0%), respectively. A larger number of points do not necessarily guarantee better performance of the methods; optimal choice of point placement is necessary. The performance of the methods is sensitive to the alignment of the center of the body phantom relative to the isocenter. In body applications where dose distributions are important, method 2 is a better choice than method 1, as it reconstructs the dose surface with high fidelity, using as few as five points.« less

Serotyping and esterase typing for analysis of Listeria monocytogenes populations recovered from foodstuffs and from human patients with listeriosis in Belgium.

PubMed Central

Gilot, P; Genicot, A; André, P

1996-01-01

Listeria monocytogenes strains isolated in Belgium from different foodstuffs and in sporadic cases of human listeriosis were analyzed. The distribution of serovars differed in each of these populations. The bacteria isolated from cheeses and from human patients with listeriosis were further studied by esterase typing. The twenty esterase patterns defined were not equally distributed in these two populations. The secretion of the virulence determinant phosphatidylinositol-specific phospholipase C and the pathogenicity level of strains in immunocompromised mice could not explain the unequal distribution of esterase types. The discrimination index of esterase typing (DI = 0.868) was compared with that of serotyping (DI = 0.666) and with that of the two combined methods (DI = 0.899). PMID:8815071

Pediatric glioblastoma multiforme: A single-institution experience

PubMed Central

Ansari, Mansour; Nasrolahi, Hamid; Kani, Amir-Abbas; Mohammadianpanah, Mohammad; Ahmadloo, Niloofar; Omidvari, Shapour; Mosalaei, Ahmad

2012-01-01

Background: Glioblastoma multiforme (GBM) is the most common astrocytoma in adults and has a poor prognosis, with a median survival of about 12 months. But, it is rare in children. We report our experience on the pediatric population (20 years or younger) with GBM. Patients and Methods: Twenty-three patients with GBM who were treated at our hospital during 1990–2008 were evaluated. Results: The mean age was 15.2 years, and the majority of them (14/23) were male. All had received radiotherapy and some had also received chemotherapy. The mean survival was 16.0 months. Two cases survived more than 5 years. Age, radiation dose and performance status were significantly related to survival. Conclusion: GBM in pediatric patients were not very common in our center, and prognosis was unfavorable. PMID:23248421

Genotype distribution of cervical human papillomavirus DNA in women with cervical lesions in Bioko, Equatorial Guinea

PubMed Central

García-Espinosa, Benjamín; Nieto-Bona, Ma Paz; Rueda, Sonsoles; Silva-Sánchez, Luís Fernando; Piernas-Morales, Ma Concepción; Carro-Campos, Patricia; Cortés-Lambea, Luís; Moro-Rodríguez, Ernesto

2009-01-01

Background The HVP vaccine is a useful tool for preventing cervical cancer. The purpose of this study is to determine the most frequent HPV genotypes in Equatorial Guinea in order to develop future vaccination strategies to apply in this country. Methods A campaign against cervical cancer was carried out in the area on a total of 1,680 women. 26 of the women, following cytological screening, were treated surgically with a loop electrosurgical excision procedure (LEEP). Cases were studied histologically and were genotyped from paraffin blocks by applying a commercial kit that recognized 35 HPV types. Results Cytological diagnoses included 17 HSIL, 1 LSIL, 5 ASC-H and 3 AGUS. Histological diagnosis resulted in 3 cases of microinvasive squamous cell carcinoma stage IA of FIGO, 9 CIN-3, 8 CIN-2, 2 CIN-1, 3 flat condylomas and mild dysplasia of the endocervical epithelium. Fifteen of twenty-five cases genotyped were positive for HPV (60%). HPV 16 and 33 were identified in four cases each, HPV 58 in two other cases, and HPV 18, 31, 52, and 82 in one case, with one HPV 16 and 58 coinfection. Conclusion The frequency of HPV types in the African area varies in comparison to other regions, particularly in Europe and USA. Vaccination against the five most common HPV types (16, 33, 58, 18, and 31) should be considered in the geographic region of West Africa and specifically in Equatorial Guinea. PMID:19740435

Investigations into distribution of lidocaine in human autopsy material.

PubMed

Oertel, Reinhard; Arenz, Norman; Zeitz, Sten Gunnar; Pietsch, Jörg

2015-08-01

With screening methods in the legal medicine drugs were often detected in autopsy material. In this study the antiarrhythmic and the local anesthetic drug lidocaine could be proved in fifty-one cases and determined in different autopsy materials. For the first time the comparison of so many distribution patterns of lidocaine in human compartments was possible. A liquid-liquid extraction procedure, a standard addition method and LC/MS/MS were used for analytics. The measured concentrations in blood were in the therapeutic range or lower. The time between lidocaine application and death was given in twenty-nine cases. These data were very helpful to estimate and interpret the distribution process of lidocaine between application and death. This time exerted a crucial influence on the distribution of lidocaine in the compartments. Most of the intravenous applicated lidocaine was found in heart blood after a very short time of distribution. Afterwards the highest concentrations were measured in brain. Later the highest concentration was found in the kidney samples or in urine. If the time between lidocaine application and death is known, the results of this study can be used to deepen the knowledge of its pharmacokinetics. If this time is unknown, the circumstances and the causes of death can be better explained. Copyright © 2015 John Wiley & Sons, Ltd.

Histoplasmosis After Solid Organ Transplant

PubMed Central

Assi, Maha; Martin, Stanley; Wheat, L. Joseph; Hage, Chadi; Freifeld, Alison; Avery, Robin; Baddley, John W.; Vergidis, Paschalis; Miller, Rachel; Andes, David; Young, Jo-Anne H.; Hammoud, Kassem; Huprikar, Shirish; McKinsey, David; Myint, Thein; Garcia-Diaz, Julia; Esguerra, Eden; Kwak, E. J.; Morris, Michele; Mullane, Kathleen M.; Prakash, Vidhya; Burdette, Steven D.; Sandid, Mohammad; Dickter, Jana; Ostrander, Darin; Antoun, Smyrna Abou; Kaul, Daniel R.

2013-01-01

Background. To improve our understanding of risk factors, management, diagnosis, and outcomes associated with histoplasmosis after solid organ transplant (SOT), we report a large series of histoplasmosis occurring after SOT. Methods. All cases of histoplasmosis in SOT recipients diagnosed between 1 January 2003 and 31 December 2010 at 24 institutions were identified. Demographic, clinical, and laboratory data were collected. Results. One hundred fifty-two cases were identified: kidney (51%), liver (16%), kidney/pancreas (14%), heart (9%), lung (5%), pancreas (2%), and other (2%). The median time from transplant to diagnosis was 27 months, but 34% were diagnosed in the first year after transplant. Twenty-eight percent of patients had severe disease (requiring intensive care unit admission); 81% had disseminated disease. Urine Histoplasma antigen detection was the most sensitive diagnostic method, positive in 132 of 142 patients (93%). An amphotericin formulation was administered initially to 73% of patients for a median duration of 2 weeks; step-down therapy with an azole was continued for a median duration of 12 months. Ten percent of patients died due to histoplasmosis with 72% of deaths occurring in the first month after diagnosis; older age and severe disease were risk factors for death from histoplasmosis. Relapse occurred in 6% of patients. Conclusions. Although late cases occur, the first year after SOT is the period of highest risk for histoplasmosis. In patients who survive the first month after diagnosis, treatment with an amphotericin formulation followed by an azole for 12 months is usually successful, with only rare relapse. PMID:24046304

Analysis of Short Ramps for Dual-Mode and PRT Stations

DOT National Transportation Integrated Search

1977-07-01

The report documents a novel methodology and analysis procedure for measuring a program's effect, and it is based on data from case studies of a representative group of twenty urban areas, conducted during 1976, which are reported in a companion repo...

A longitudinal study of adult-onset asthma incidence among HMO members

PubMed Central

Sama, Susan R; Hunt, Phillip R; Cirillo, CIH Priscilla; Marx, Arminda; Rosiello, Richard A; Henneberger, Paul K; Milton, Donald K

2003-01-01

Background HMO databases offer an opportunity for community based epidemiologic studies of asthma incidence, etiology and treatment. The incidence of asthma in HMO populations and the utility of HMO data, including use of computerized algorithms and manual review of medical charts for determining etiologic factors has not been fully explored. Methods We identified adult-onset asthma, using computerized record searches in a New England HMO. Monthly, our software applied exclusion and inclusion criteria to identify an "at-risk" population and "potential cases". Electronic and paper medical records from the past year were then reviewed for each potential case. Persons with other respiratory diseases or insignificant treatment for asthma were excluded. Confirmed adult-onset asthma (AOA) cases were defined as those potential cases with either new-onset asthma or reactivated mild intermittent asthma that had been quiescent for at least one year. We validated the methods by reviewing charts of selected subjects rejected by the algorithm. Results The algorithm was 93 to 99.3% sensitive and 99.6% specific. Sixty-three percent (n = 469) of potential cases were confirmed as AOA. Two thirds of confirmed cases were women with an average age of 34.8 (SD 11.8), and 45% had no evidence of previous asthma diagnosis. The annualized monthly rate of AOA ranged from 4.1 to 11.4 per 1000 at-risk members. Physicians most commonly attribute asthma to infection (59%) and allergy (14%). New-onset cases were more likely attributed to infection, while reactivated cases were more associated with allergies. Medical charts included a discussion of work exposures in relation to asthma in only 32 (7%) cases. Twenty-three of these (72%) indicated there was an association between asthma and workplace exposures for an overall rate of work-related asthma of 4.9%. Conclusion Computerized HMO records can be successfully used to identify AOA. Manual review of these records is important to confirm case status and is useful in evaluation of provider consideration of etiologies. We demonstrated that clinicians attribute most AOA to infection and tend to ignore the contribution of environmental and occupational exposures. PMID:12952547

Allegations of children's involvement in ritual sexual abuse: clinical experience of 20 cases.

PubMed

Weir, I K; Wheatcroft, M S

1995-04-01

Twenty cases were evaluated in which allegations had been made of children being involved in ritual sexual abuse (RSA). A selection of case histories are presented together with a summary of the salient points in the other cases. Using a standard format developed for assessing the validity of allegations in sexual abuse cases, it was concluded that false allegations of ritual sexual abuse occurred in three-quarters of the cases and true allegations only in one-quarter. This high rate of false allegations is unlike the author's clinical experience in other cases of child sexual abuse where the rate of false allegations is much lower and similar to other published series. Reasons for the high rate of false allegations are discussed.

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

PubMed Central

Chakravarthy, Murali; Mitra, Sona; Nonis, Latha

2012-01-01

Objective Cardiac arrest in the hospital wards may not receive as much attention as it does in the operation theatre and intensive care unit (ICU). The experience and the qualifications of personnel in the ward may not be comparable to those in the other vital areas of the hospital. The outcome of cardiac arrest from the ward areas is a reasonable surrogate of training of the ward nurses and technicians in cardiopulmonary resuscitation. We conducted an audit to assess the issues surrounding the resuscitation of cardiac arrest in areas other than operation theatre and ICU in a tertiary referral hospital. Aims of the audit To assess the outcomes of cardiac arrest in a tertiary referral hospital. Areas such as wards, dialysis room and emergency room were considered for the audit. Methods This is a retrospective observational audit of the case records of all the adult patients who were resuscitated from ‘code blue’. Data for 2 years from 2007 was analysed by a research fellow unconnected with the resuscitations. Results Twenty-two thousand three hundred and forty-four patients were admitted as in-patients to the hospital during the 2 years, starting May 2007 through May 2009. One hundred code blue calls were received during this time. Twenty-two of the total calls received were false. Among the 78 confirmed cardiac arrests 69 occurred in the wards, 2 in emergency room, 1 in cardiac catheterisation laboratory and 3 in dialysis room. Twenty-eight patients were declared dead after unsuccessful cardiopulmonary resuscitation. Among the 50 who were resuscitated with a return of spontaneous rhythm 26 died. Twenty-four patients were discharged (survival rate of 30%). The survival decreased significantly as the age progressed beyond 60. The resuscitation rates were better in day shifts in contrast to the night. Higher survival was noted in patients who received resuscitation in less than a minute. Conclusion A overall survival to discharge rate of 30% was noted in this audit. Higher survival rates might be attributable to high rate and degree of training at the time of their employment, which was repeated at yearly interval. PMID:22572417

Medicolegal aspects of atypical firearm injuries: a case report.

PubMed

Gürses, Murat Serdar; Akan, Okan; Eren, Bülent; Durak, Dilek; Türkmen, Nursel; Cetin, Selçuk

2014-01-01

Our case was a twenty year-old man, who was injured during the military duty with G3 infantry rifle in the training area. An atypical firearm entry wound on the left side of sternum which was 4.5 cm in diameter, and was surrounded by six irregular skin burn wounds by a flash-suppressor and a 0.7 cm diameter firearm exit wound at space on the left midscapular line. Our case emphasizes that the interpretation of properties of these atypical firearm entry wounds need to be carefully assessed by physicians.

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.

Hyperactivity of the default-mode network in first-episode, drug-naive schizophrenia at rest revealed by family-based case-control and traditional case-control designs.

PubMed

Guo, Wenbin; Liu, Feng; Chen, Jindong; Wu, Renrong; Li, Lehua; Zhang, Zhikun; Chen, Huafu; Zhao, Jingping

2017-03-01

Abnormal regional activity and functional connectivity of the default-mode network (DMN) have been reported in schizophrenia. However, previous studies may have been biased by unmatched case-control design. To limit such bias, the present study used both the family-based case-control design and the traditional case-control design to investigate abnormal regional activity of the DMN in patients with schizophrenia at rest.Twenty-eight first-episode, drug-naive patients with schizophrenia, 28 age-, sex-matched unaffected siblings of the patients (family-based controls, FBC), and 40 healthy controls (HC) underwent resting-state functional magnetic resonance imaging (fMRI) scans. The group-independent component analysis and fractional amplitude of low-frequency fluctuation (fALFF) methods were used to analyze the data.Patients with schizophrenia show increased fALFF in an overlapped region of the right superior medial prefrontal cortex (MPFC) relative to the FBC and the HC. Compared with the HC, the patients and the FBC exhibit increased fALFF in an overlapped region of the left posterior cingulate cortex/precuneus (PCC/PCu). Furthermore, the z values of the 2 overlapped regions can separate the patients from the FBC/HC, and separate the patients/FBC from the HC with relatively high sensitivity and specificity.Both the family-based case-control and traditional case-control designs reveal hyperactivity of the DMN in first-episode, drug-naive patients with paranoid schizophrenia, which highlights the importance of the DMN in the neurobiology of schizophrenia. Family-based case-control design can limit the confounding effects of environmental factors in schizophrenia. Combination of the family-based case-control and traditional case-control designs may be a viable option for the neuroimaging studies.

EGFR immunoexpression, RAS immunoexpression and their effects on survival in lung adenocarcinoma cases

PubMed Central

Onder, Sevgen; Firat, Pinar; Dogan, Riza

2014-01-01

Background The impacts of epidermal growth factor receptor (EGFR) immunoexpression and RAS immunoexpression on the survival and prognosis of lung adenocarcinoma patients are debated in the literature. Methods Twenty-six patients, who underwent pulmonary resections between 2002 and 2007 in our clinic, and whose pathologic examinations yielded adenocarcinoma, were included in the study. EGFR and RAS expression levels were examined by immunohistochemical methods. The results were compared with the survival, stage of the disease, nodal involvement, lymphovascular invasion, and pleural invasion. Nonparametric bivariate analyses were used for statistical analyses. Results A significant link between EGFR immunoexpression and survival has been identified while RAS immunoexpression and survival have been proven to be irrelevant. Neither EGFR, nor RAS has displayed a significant link with the stage of the disease, nodal involvement, lymphovascular invasion, or pleural invasion. Conclusions Positive EGFR immunoexpression affects survival negatively, while RAS immunoexpression has no effect on survival in lung adenocarcinoma patients. PMID:24977003

[Stereotactic biopsy in the accurate diagnosis of lesions in the brain stem and deep brain].

PubMed

Qin, F; Huang, Z C; Cai, M Q; Xu, X F; Lu, T T; Dong, Q; Wu, A M; Lu, Z Z; Zhao, C; Guo, Y

2018-06-12

Objective: To investigate the value of stereotactic biopsy in the accurate diagnosis of lesions in the brain stem and deep brain. Methods: A total of 29 consecutive patients who underwent stereotactic biopsy of brainstem and deep brain lesions between May 2012 and January 2018 were retrospectively reviewed. The Cosman-Roberts-Wells (CRW) stereotactic frame was installed under local anesthesia. Thin-layer CT and MRI scanning were performed. Target coordinates were calculated by inputting CT-MRI data into the radionics surgical planning system. The individualized puncture path was designed according to the location of the lesions and the characteristics of the image. Target distributions were as follows: 12 cases of midbrain or pons, 2 cases of internal capsule, 3 cases of thalamus, 12 cases of basal ganglia. The biopsy samples were used for further pathological and/or genetic diagnosis. Results: Twenty-eight of the 29 cases (96.6%) were diagnosed accurately by histopathology and genomic examination following stereotactic biopsy. Pathological results were as follows: 8 cases of lymphoma, 7 cases of glioma, 4 cases of demyelination, 2 cases of germ cell tumor, 2 cases of metastatic tumor, 1 cases of cerebral sparganosis, 1 case of tuberculous granuloma, 1 case of hereditary prion disease, 1 case of glial hyperplasia, 1 case of leukemia. The accurate diagnosis of one case required a combination of histopathology and genomic examination. Undefined diagnosis was still made in 1 cases (3.45%) after biopsy. After biopsy, there were 2 cases (6.9%) with symptomatic slight hemorrhage, 1 case (3.45%) with symptomatic severe hemorrhage, and 1 cass (3.45%) with permanent neurological dysfunction. No one died because of surgery or surgical complications. Conclusions: Stereotactic biopsy is fast, safe and minimally invasive. It is an ideal strategy for accurate diagnosis of lesions in brain stem and deep brain.

Aortic aneurysm surgery: long-term patency of the reimplanted intercostal arteries.

PubMed

David, Nathalie; Roux, Nicolas; Douvrin, Françoise; Clavier, Erick; Bessou, Jean Paul; Plissonnier, Didier

2012-08-01

During aortic surgery, the long-term patency of reimplanted intercostal arteries is unknown, limiting the relevance to preserve spinal cord vascularization. Between January 2001 and January 2007, 40 patients were operated for either thoracic aortic aneurysm (TAA) or thoracoabdominal aortic aneurysm (TAAA). Twenty cases of aneurysms limited to the proximal descending thoracic aorta were treated using endovascular repair, without preoperative spinal cord artery identification. Twenty patients--seven with extensive TAA, seven with type I TAAA, two with type II TAAA, and four with type III TAAA--underwent open surgery. Before open surgery, preoperative angiography was performed to identify spinal cord vascularization; in one case, the angiography failed to identify it. The segmental artery destined to the spinal cord artery was identified as originating from outside the aneurysm in 7 patients and inside the aneurysm in 12 patients: T6 R (1), T8 L (2), T9 L (3), T10 L (3), T11 L (3), L1 L (1). During the surgery, normothermic and femorofemoral bypass was used for visceral protection. All segmental arteries identified as critical before surgery were reattached in the graft. Twenty-four months later, computed tomography scans were performed to assess the patency of the reattached segmental arteries. Three patients died, including one with paraplegia (T9 L). No other cases of paraplegia were reported. Computed tomography scans were performed in 10 patients. Segmental artery reattachment was patent in nine patients. Our experience indicates the long-term patency of reimplanted segmental artery, without any convincing evidence of its utility in preventing neurologic events during TAA and TAAA direct repair. Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

Contemporary Statewide Practice Pattern Assessment of the Palliative Treatment of Bone Metastasis.

PubMed

Spratt, Daniel E; Mancini, Brandon R; Hayman, James A; Boike, Thomas; Pierce, Lori J; Moran, Jean M; Dominello, Michael M; Fireman, Mark; Griffith, Kent; Jolly, Shruti

2018-06-01

Palliative radiation therapy for bone metastases is often viewed as a single entity, despite national guidelines providing input principally only for painful uncomplicated bone metastases. Data surrounding the treatment of bone metastases are often gleaned from questionnaires of what providers would theoretically do in practice or from population-based data lacking critical granular information. We investigated the real-world treatment of bone metastases with radiation therapy. Twenty diverse institutions across the state of Michigan had data extracted for their 10 most recent cases of radiation therapy delivered for the treatment of bone metastases at their institution between January and February 2017. Uni- and multivariable binary logistic regression was used to assess the use of single fraction (8 Gy × 1) radiation therapy. A total of 196 cases were eligible for inclusion. Twenty-eight different fractionation schedules were identified. The most common schedule was 3 Gy × 10 fractions (n = 100; 51.0%), 4 Gy × 5 fractions (n = 32; 16.3%), and 8 Gy × 1 (n = 15; 7.7%). The significant predictors for the use of single fraction radiation therapy were the presence of oligometastatic disease (P = .008), previous overlapping radiation therapy (P = .050), and academic practice type (P = .039). Twenty-nine cases (14.8%) received >10 fractions (median 15, range 11-20). Intensity modulated radiation therapy was used in 14 cases (7.1%), stereotactic body radiation therapy in 11 (5.6%), and image guidance with cone beam computed tomography in 11 (5.6%). Of the cases of simple painful bone metastases (no previous surgery, spinal cord compression, fracture, soft tissue extension, or overlapping previous radiation therapy; n = 70), only 12.9% were treated with 8 Gy × 1. Bone metastases represent a heterogeneous disease, and radiation therapy for bone metastases is similarly diverse. Future work is needed to understand the barriers to single fraction use, and clinical trials are necessary to establish appropriate guidelines for the breadth of this complex disease. Copyright © 2018 Elsevier Inc. All rights reserved.

Dofetilide in Overdose: A Case Series from Poison Center Data.

PubMed

Hieger, M A; Maskell, K F; Moss, M J; Powell, S W; Cumpston, K L

2017-07-01

Dofetilide is a class III antiarrhythmic used for treating atrial dysrhythmias. Though its adverse effects are well described in routine use, very little is known about dofetilide toxicity in overdose. This is a retrospective case series of consecutive patients reported to our poison center after dofetilide overdose. Twenty-seven cases were included. Seventeen patients were treated at a healthcare facility, and of these, eight were admitted. Twenty-one patients took one extra capsule, four took someone else's medication, one took three extra capsules, and one had a large intentional overdose. Ten patients had co-ingestants reported, including three QT-prolonging agents. No one required cardioversion, defibrillation, CPR, or overdrive pacing. The patient who reported taking 90 times his usual dose in suicide attempt was the only patient to have significant clinical effects. He experienced an 8-beat run of non-sustained ventricular tachycardia, frequent multifocal PVCs, and ventricular bigeminy. He received magnesium sulfate and potassium chloride supplementation. In this series, unintentional small overdoses did not result in significant clinical effects and were often managed successfully at home, despite the fact that information showing a single capsule can cause torsades. This study is limited by its small sample size, retrospective design, and reliance on incomplete information.

Efficacy of octreotide in the management of chronic diarrhoea in AIDS.

PubMed

Romeu, J; Miró, J M; Sirera, G; Mallolas, J; Arnal, J; Valls, M E; Tortosa, F; Clotet, B; Foz, M

1991-12-01

Patients with HIV infection were studied to assess the efficacy of octreotide, a somatostatin analogue, in the long-term management of refractory diarrhoea. Dosage of subcutaneous octreotide was increased progressively at 48 h intervals from 150 to 300, 750 and 1500 micrograms/day according to response. Twenty-nine patients, 21 with Cryptosporidium enteritis, one with Isospora belli enteritis and seven with no identifiable pathogen were selected for the study; four of these were excluded from the study because of death during the first month (two cases), abdominal pain and acute pancreatitis (one case each). Twenty-five patients were evaluable for response. Ten patients (four with Cryptosporidium enteritis, five without an identifiable pathogen and one with I. belli enteritis) achieved a complete response (40%) and nine cases (all with cryptosporidial enteritis) had a partial response (36%). Patients with higher weight and Karnofsky performance status and non-cryptosporidial enteritis had a better response to treatment. Mean durations of treatment and response were 4.2 +/- 4.2 and 4.4 +/- 4.5 months, respectively. In the absence of specific agents for cryptosporidial enteritis and HIV enteropathy, octreotide was found to be useful in the management of chronic diarrhoea in AIDS patients.

A fast liquid chromatography-tandem mass spectrometry method for determining benzodiazepines and analogues in urine. Validation and application to real cases of forensic interest.

PubMed

Salomone, Alberto; Gerace, Enrico; Brizio, Paola; Gennaro, M Carla; Vincenti, Marco

2011-11-01

A fast liquid chromatographic/tandem mass spectrometric method was developed for the simultaneous determination in human urine of seventeen benzodiazepines, four relevant metabolites together plus zolpidem and zopiclone. The sample preparation, optimized to take into account the matrix effect, was based on enzymatic hydrolysis and liquid-liquid extraction. The separation of the twenty-three analytes was achieved in less than eight minutes. The whole methodology was fully validated according to UNI EN ISO/IEC 17025:2005 rules and 2006 SOFT/AAFS guidelines. Selectivity, linearity range, identification (LOD) and quantitation (LOQ) limits, precision, accuracy and recovery were evaluated. For all the species the signal/concentration linearity was satisfactory in the 50-1000 ng/mL concentration range. The limits of detection ranged from 0.5 to 30 ng/mL and LOQs from 1.7 to 100.0 ng/mL. Precisions were in the ranges 5.0-11.8%, 1.5-11.0% and 1.1-4.4% for low (100 ng/mL), medium (300 ng/mL) and high (1000 ng/mL) concentration, respectively. The accuracy, expressed as bias% was within ± 25 % for all the analytes. The recovery values, evaluated at 300 ng/mL concentration, ranged from 56.2% to 98.8%. The present method for the determination of several benzodiazepines, zolpidem and zopiclone in human urine proved to be simple, fast, specific and sensitive. The quantification by LC-MS/MS was successfully applied to 329 forensic cases among driving re-licensing, car accidents and alleged sexual violence cases. Copyright © 2011 Elsevier B.V. All rights reserved.

Teaching Idiomatic Expressions: A Comparison of Two Instructional Methods.

ERIC Educational Resources Information Center

Rittenhouse, Robert K.; Kenyon, Patricia L.

1990-01-01

Twenty hearing-impaired adolescents were taught idiomatic expressions using captioned videotape presentations followed by classroom discussion, or by extended classroom discussions. Improvement in understanding idioms was significantly greater under the videotape method. (Author/JDD)

Trends Developments.

ERIC Educational Resources Information Center

ASPBAE Courier Service, 1981

1981-01-01

This issue contains extracts from twenty-one country reports and case studies presented to the Unesco Regional Seminar on Adult Education and Development in Bangkok, November 24-December 4, 1980. The excerpts have an emphasis on innovations in adult education in the region. Countries and programs discussed include (1) community…

[Sclerosing therapy of testicular hydrocele with tetracycline].

PubMed

Losada Guerra, J L; Hernández Navarro, E

1992-12-01

Twenty-six patients, aged 38 to 78 years, with testicular hydrocele were treated by aspiration, punction and tetracycline instillation. The cure rate was 79%. Inflammation of the scrotum was observed in all of the cases. Due to recurrence two patients underwent surgery, which revealed a hematocele.

75 FR 32642 - Defense Federal Acquisition Regulation Supplement; Ground and Flight Risk Clause (DFARS Case 2007...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... relating to wear and tear or deterioration, or to the extent the loss or damage is caused by negligence of... negligence of Government personnel; or (ii) Twenty percent of the price or estimated cost of this contract...

A multi-site evaluation of innovative approaches to increase tuberculosis case notification: summary results.

PubMed

Creswell, Jacob; Sahu, Suvanand; Blok, Lucie; Bakker, Mirjam I; Stevens, Robert; Ditiu, Lucica

2014-01-01

Globally, TB notifications have stagnated since 2007, and sputum smear positive notifications have been declining despite policies to improve case detection. We evaluate results of 28 interventions focused on improving TB case detection. We measured additional sputum smear positive cases treated, defined as the intervention area's increase in case notification during the project compared to the previous year. Projects were encouraged to select control areas and collect historical notification data. We used time series negative binomial regression for over-dispersed cross-sectional data accounting for fixed and random effects to test the individual projects' effects on TB notification while controlling for trend and control populations. Twenty-eight projects, 19 with control populations, completed at least four quarters of case finding activities, covering a population of 89.2 million. Among all projects sputum smear positive (SS+) TB notifications increased 24.9% and annualized notification rates increased from 69.1 to 86.2/100,000 (p = 0.0209) during interventions. Among the 19 projects with control populations, SS+TB case notifications increased 36.9% increase while in the control populations a 3.6% decrease was observed. Fourteen (74%) of the 19 projects' SS+TB notification rates in intervention areas increased from the baseline to intervention period when controlling for historical trends and notifications in control areas. Interventions were associated with large increases in TB notifications across many settings, using an array of interventions. Many people with TB are not reached using current approaches. Different methods and interventions tailored to local realities are urgently needed.

First branchial cleft anomalies in children: Experience with 30 cases.

PubMed

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

2017-07-01

First branchial cleft anomalies (FBCA) are rare in the clinical setting, as they account for 1 to 8% of all branchial abnormalities. The purpose of this study is to explore the relationship between the fistula tract and facial nerve and the surgical method of FBCA. This retrospective study included 30 cases of FBCA in children managed from 2009 to 2016. All patients underwent surgery to remove the tract of the FBCA. We reviewed the clinical data of the patients to obtain their demographics and management. Thirty patients (11 male and 19 female) with anomalies of FBCA were diagnosed. The ages ranged from 1 to 13 years (median, 3 years). Twenty cases had a close relationship with the parotid gland. The facial nerve was identified in 20 of the 30 patients. The tract ran deep to the facial nerve in 3 cases, superficial to it in 21 cases, and passed between the branches of the nerve in 6 cases. The facial nerve was not identified in ten patients, as the tract was superficial to it. There were 2 cases of postoperative temporary facial paralysis (2/30, 6.7%). The symptoms gradually improved after one month, 1 case had permanent facial paralysis (1/30, 3.3%), and 1 case had postoperative recurrence. Complete excision of the tract is the only way to manage FBCA, and the course of the tracts vary and have different relationships with the facial nerve. There are 3 types: Superficial, deep to the facial nerve, and between the branches of the nerve. Therefore, surgical approaches differ among the various types, and careful preoperative planning and protecting the facial nerve during resection of the tract are essential.

First branchial cleft anomalies in children: Experience with 30 cases

PubMed Central

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

2017-01-01

First branchial cleft anomalies (FBCA) are rare in the clinical setting, as they account for 1 to 8% of all branchial abnormalities. The purpose of this study is to explore the relationship between the fistula tract and facial nerve and the surgical method of FBCA. This retrospective study included 30 cases of FBCA in children managed from 2009 to 2016. All patients underwent surgery to remove the tract of the FBCA. We reviewed the clinical data of the patients to obtain their demographics and management. Thirty patients (11 male and 19 female) with anomalies of FBCA were diagnosed. The ages ranged from 1 to 13 years (median, 3 years). Twenty cases had a close relationship with the parotid gland. The facial nerve was identified in 20 of the 30 patients. The tract ran deep to the facial nerve in 3 cases, superficial to it in 21 cases, and passed between the branches of the nerve in 6 cases. The facial nerve was not identified in ten patients, as the tract was superficial to it. There were 2 cases of postoperative temporary facial paralysis (2/30, 6.7%). The symptoms gradually improved after one month, 1 case had permanent facial paralysis (1/30, 3.3%), and 1 case had postoperative recurrence. Complete excision of the tract is the only way to manage FBCA, and the course of the tracts vary and have different relationships with the facial nerve. There are 3 types: Superficial, deep to the facial nerve, and between the branches of the nerve. Therefore, surgical approaches differ among the various types, and careful preoperative planning and protecting the facial nerve during resection of the tract are essential. PMID:28672934

[Treatment of thoracolumbar burst fracture with lateral anterior decompression, internal fixation with Ventrofix and bone graft with titanic mesh].

PubMed

Zhang, Shi-min; Zhang, Zhao-jie; Liu, Yu-zhang; Zhang, Lu-tang; Li, Xing

2011-11-01

To discuss the efficacy of lateral anterior decompression, internal fixation with Ventrofix and bone graft with titanic mesh in the treatment of severe thoracolumbar burst fracture. From January 2008 to January 2010, 21 patients with severe thoracolumbar burst fracture were treated with lateral anterior decompression, internal fixation with Ventrofix, bone graft with titanic mesh. There were 15 males and 6 females, ranging in age from 21 to 46 years with an average of 32.2 years. Segment of fracture: 3 cases were in T11, 6 cases in T12, 7 cases in L1, 5 cases in L2. The mean kyphosis angle was 20.1 degrees and loading of fracture was 7.8 scores. Twenty-one cases accompany with incomplete paralysis. Nerves functions were observed according to Frankel grade; correction and maintain of kyphosis angle were observed by X-rays and CT. All the patients were followed up from 12 to 34 months with an average of 18.5 years. Postoperative complication including injury of pleura in 1 case, dynamic ileus in 2 cases, ilioinguinal nerve injury in 1 case, faulty union of wound in 1 case. All the above complications got recovery after symptomatic treatment. The mean kyphosis angle in fusional segment were 4.2 degrees and the rate of correction was 79%. Nerves functions of all patients got improvement and no internal fixation fail, kyphosis angle obviously lost, titanium mesh shifting, loosening and breakage of screw were found at final follow-up. Lateral anterior decompression, bone graft with titanic mesh, internal fixation with Ventrofix is an idea technique for severe thoracolumber burst fracture, but the method can not be used for patient with severity osteoporosis.

Cochineal dye-induced immediate allergy: Review of Japanese cases and proposed new diagnostic chart.

PubMed

Takeo, Naoko; Nakamura, Masashi; Nakayama, Satoshi; Okamoto, Osamu; Sugimoto, Naoki; Sugiura, Shinichi; Sato, Nayu; Harada, Susumu; Yamaguchi, Masao; Mitsui, Naoya; Kubota, Yumiko; Suzuki, Kayoko; Terada, Makoto; Nagai, Akiyo; Sowa-Osako, Junko; Hatano, Yutaka; Akiyama, Hiroshi; Yagami, Akiko; Fujiwara, Sakuhei; Matsunaga, Kayoko

2018-04-25

Cochineal dye is used worldwide as a red coloring in foods, drinks, cosmetics, quasi-drugs, and drugs. The main component of the red color is carminic acid (CA). Carmine is an aluminum- or calcium-chelated product of CA. CA and carmine usually contain contaminating proteins, including a 38-kDa protein thought to be the primary allergen. Severe allergic reactions manifest as anaphylaxis. The aim of this study was to review all Japanese reported cases and propose useful diagnostic chart. All reported Japanese cases of cochineal dye-induced immediate allergy were reviewed, and newly registered cases were examined by skin prick test (SPT) with cochineal extract (CE) and measurement of CE and carmine-specific serum IgE test. Two-dimensional (2D) western blotting using patient serum was conducted to identify the antigen. Twenty-two Japanese cases have been reported. SPT and the level of specific IgE test indicated that six cases should be newly registered as cochineal dye allergy. All cases were adult females, and all cases except three involved anaphylaxis; 13 cases involved past history of local symptoms associated with cosmetics use. Japanese strawberry juice and fish-meat sausage, and European processed foods (especially macarons made in France) and drinks were recent major sources of allergen. 2D western blotting showed that patient IgE reacted to the 38-kDa protein and other proteins. Serum from healthy controls also weakly reacted with these proteins. SPT with CE and determination of the level of CE and carmine-specific IgE test are useful methods for the diagnosis of cochineal dye allergy. Copyright © 2018 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

A Clinico-Mycological Study on Suspected Cases of Chromoblastomycosis: Challenges in Diagnosis and Management

PubMed Central

Majumdar, Banashree; Jain, Atul; Maiti, Prasanta Kumar; Chatterjee, Gobinda

2015-01-01

Introduction Verrucous plaques mimicking chromoblastomycosis are frequently seen in dermatology outpatient departments (OPD). However, no scientific evaluation has been carried out till date from eastern India. So this present endeavour is aimed at a thorough study of those cases to readdress the challenges in diagnosis and management in chromoblastomycosis from this part of the country. Aim The study is to observe the incidence of proved chromoblastomycosis cases from clinically mimicking conditions and to note therapeutic prospects by use of different antifungal agents. Materials and Methods Twenty clinically suspected cases attending dermatology OPD were included in this study. Relevant histories were taken. Apart from routine hematological and biochemical investigations, scrapings from lesions were examined by direct microscopy with KOH wet mount, calcoflour white mount and fungal culture. Histopatholgical examination was also done. Any fungal growth was identified by growth characteristics and morphological features. Results Sclerotic bodies were detected in five samples. Of them three were found to be culture positive. Two growths were identified as Fonsecaea pedrosoi and one as Cladosporium carrionii. Rest 12 cases were diagnosed as either lupus vulgaris (3 cases; 15%), atypical mycobacterial infections (3 cases, 15%), Hypertrophic lichen planus (2, 10%), Hypertrophic DLE plaque (2; 10%), Wart (1, 5%) or fixed cutaneous sporothricosis (1, 5%), zygomycosis (1, 5%). Three cases (15%) were lost in follow up. Cases of chromoblastomycosis were managed with prolonged use of antifungal alone or in combination with saturated solution of potassium iodide and/or debridement. They were followed up for at least six months post treatment. Conclusion A database comprising diagnostic clues and effective therapeutic intervention have been proposed for these rare subcutaneous mycoses. PMID:26816977

Allograft for maxillary sinus floor augmentation: a retrospective study of 90 cases.

PubMed

Guerrero, Jaime S; Al-Jandan, Badr A

2012-04-01

The aim of this study is to demonstrate the clinical applicability and efficacy of an allograft for maxillary sinus augmentations in patients requiring placement of dental implants. Sixty consecutive patients underwent a total of 90 sinus augmentations. Twenty-nine were women and 31 men, with a mean age of 54 years. Twenty-six patients received a bilateral procedure and 34 unilateral. All cases were treated with the lateral wall technique. Allograft consisted of demineralized freeze-dried blocks in 6 cases, particulate in 82 cases, and a combination of both in 2 cases. In 30 patients, it was combined with platelet-rich plasma. A total of 84 implants were inserted. Bone samples of grafted areas were obtained in two patients for histological examination. Seventy-three implants were clinically successful at the reentry time. Eleven implants in seven patients were removed between 15 days and 6 months after their placement. Seven of these implants were replaced and received prostheses as well, for an overall postloading success rate of 95.2%. Follow-up for all patients after final restoration was between 12 and 96 months. Specimen's histological evaluation revealed bone formation and evidence of inflammatory infiltrate. Based on the findings of this study, it can be suggested that the use of the demineralized freeze-dried bone allograft from the Banco de Huesos y Tejidos Fundación Cosme y Damian for sinus augmentation is effective and constitutes a feasible therapeutic alternative for implant placement.

Twenty-First Century Educational Theory and the Challenges of Modern Education: Appealing to the Heritage of the General Teaching Theory of the Secondary Educational Curriculum and the Learning Process

ERIC Educational Resources Information Center

Klarin, Mikhail V.

2016-01-01

The article presents an analysis of educational theory in light of the challenges confronting education in the twenty-first century. The author examines how our ideas about the methods for managing the transmission of culture, the subject of education, and the consequences of these changes for the theory of education have changed. The author…

Hashimoto thyroiditis: Part 1, sonographic analysis of the nodular form of Hashimoto thyroiditis.

PubMed

Anderson, Lauren; Middleton, William D; Teefey, Sharlene A; Reading, Carl C; Langer, Jill E; Desser, Terry; Szabunio, Margaret M; Hildebolt, Charles F; Mandel, Susan J; Cronan, John J

2010-07-01

The purpose of this article is to analyze the sonographic appearance of nodular Hashimoto thyroiditis. As part of an ongoing multiinstitutional study, patients who underwent ultrasound examination and fine-needle aspiration of one or more thyroid nodules were analyzed for multiple predetermined sonographic features. Patients completed a questionnaire, including information about thyroid function and thyroid medication. Patients (n = 61) with fine-needle aspiration cytologic results consistent with nodular Hashimoto thyroiditis (n = 64) were included in the study. The mean (+/- SD) diameter of nodular Hashimoto thyroiditis was 15 +/- 7.33 mm. Nodular Hashimoto thyroiditis occurred as a solitary nodule in 36% (23/64) of cases and in the setting of five or more nodules in 23% (15/64) of cases. Fifty-five percent (35/64) of the cases of nodular Hashimoto thyroiditis occurred within a sonographic background of diffuse Hashimoto thyroiditis, and 45% (29/64) of cases occurred within normal thyroid parenchyma. The sonographic appearance was extremely variable. It was most commonly solid (69% [42/61] of cases) and hypoechoic (47% [27/58] of cases). Twenty percent (13/64) of nodules had calcifications (seven with nonspecific bright reflectors, four with macrocalcifications, and three eggshell), and 5% (3/64) of nodules had colloid. Twenty-seven percent (17/64) of nodules had a hypoechoic halo. The margins were well defined in 60% (36/60) and ill defined in 40% (24/60) of nodules. On Doppler analysis, 35% (22/62) of nodules were hypervascular, 42% (26/62) were isovascular or hypovascular, and 23% (14/62) were avascular. The sonographic features and vascularity of nodular Hashimoto thyroiditis were extremely variable.

Evaluation of an internet-based e-learning module to introduce nuclear medicine to medical students: a feasibility study.

PubMed

Diessl, Stefanie; Verburg, Frederik A; Hoernlein, Alexander; Schumann, Martin; Luster, Markus; Reiners, Christoph

2010-12-01

The advent of electronic learning, the so-called e-learning, offers new possibilities for instruction in addition to the traditional face-to-face teaching in the education of medical students. To evaluate the additional educational value of a voluntary e-learning module in a nuclear medicine course for third-year medical students. Twenty exemplary nuclear medicine patient cases from our department were developed for e-learning purposes and presented on the internet using the web-based training program ‘CaseTrain’. Subsequently, three selected test cases were handled and evaluated by an unselected population of third-year medical students. One hundred and twenty-eight students studied the three patient cases and filled out the evaluation questionnaire completely. The most important result is that both the interest in and the subjective feeling of the knowledge level regarding the specialized field of nuclear medicine had increased significantly after working through the three e-learning cases. Ninety-seven percent of the evaluating students considered the use of computer-based learning useful. The subjective grading of the content of the cases and the handling of the software were graded with high marks by the participants, 1.9 and 2.0, respectively, on a linear scale with 1 being the best and 6 being the worst. The addition of e-learning to face-to-face teaching as a form of ‘blended learning’ is highly appreciated by medical students, and will provide an effective medium for bringing better understanding of nuclear medicine to future colleagues.

Patient satisfaction and aesthetic outcomes after ear reconstruction with a Branemark-type, bone-anchored, ear prosthesis: a 16 year review.

PubMed

Younis, Ibby; Gault, David; Sabbagh, Walid; Kang, Norbert V

2010-10-01

Reconstruction of the human ear with a bone-anchored prosthesis is a widely accepted alternative when autologous reconstruction is technically impossible or declined by the individual. However, there are relatively few data in the literature documenting patient satisfaction with this form of reconstruction. This study examines different aspects of patient satisfaction using an eighteen-point postal questionnaire to measure patient outcomes against a Likert rating scale. The questionnaire was sent to 33 patients who completed prosthetic ear reconstruction over a 16 year period at a specialist plastic surgery unit in the United Kingdom. Medical case notes for these cases were also reviewed. Twenty completed questionnaires were returned. The response rate was 61%. The majority of patients were satisfied with the aesthetics, ease of handling and comfort of the bone-anchored implant and prosthesis. However, the majority of patients was only moderately satisfied or was dissatisfied with this method of reconstruction. Specifically, 15 of the respondents reported skin problems around the abutments of the bone-anchored implant with 10 patients reporting ongoing skin complications. Granulation tissue was the most common skin problem (12 cases) followed by local infection (10 cases). Interestingly, despite the chronic skin problems, most patients indicated that they would undergo the same procedure again or would recommend it to others. Our survey shows that patients fitted with a Branemark-type bone-anchored implant for ear reconstruction are pleased with the aesthetic appearance but experience multiple, chronic, skin complications and other implant related problems. These affect their satisfaction with this method of reconstruction. Our findings may have significant implications for patients and surgeons considering this form of reconstruction and for the institutions making decisions about funding this treatment. Copyright 2009. Published by Elsevier Ltd.

Aneurysmal and haemangiopericytoma-like fibrous histiocytoma.

PubMed Central

Zelger, B W; Zelger, B G; Steiner, H; Ofner, D

1996-01-01

AIM: To describe the clinicopathological features of 33 aneurysmal fibrous histiocytomas (AFH), including five cases with a haemangiopericytoma-like pattern. METHODS: Thirty three cases of AFH were studied by using routine histology and immunohistochemistry for factor XIIIa, the "cell activity marker" E9 (anti-metallothionein), NK1C3 (CD57), smooth muscle actin (SMA), factor VIII, ulex europaeus agglutinin, JC70A (CD31), and QBEND10 (CD34). The time dependent variation in histopathological features was evaluated by statistical methods (Pearson chi 2, likelihood ratio chi 2). RESULTS: Of the AFHs, 29 of 33 occurred on the extremities of adults (age range 30 to 50 years), six of which were associated with rapid growth, probably caused by trauma, and pain. Twenty one lesions were thought to be vascular and/or melanocytic lesions, including two melanomas, because of a bluish-black and/or cystic appearance. Histologically, large areas of haemorrhage, up to 50% of the tumour bulk, lacking an endothelial lining were seen in otherwise typical fibrous histiocytomas. Five cases resembled nodular stages of Kaposi's sarcoma. Variable haemosiderin deposition in histiocytes (18/33) and giant cells (11/33) was suggestive of haemosiderotic histiocytoma. A haemangiopericytoma-like pattern was seen in five otherwise indistinguishable cases. On immunohistochemistry, variable reactivity was seen for factor XIIIa (18/30), with E9 (18/30), NK1C3 (19/30), and for SMA (14/30), but labelling for vascular markers was not detected. Early lesions without iron deposition were factor XIIIa positive; late lesions with iron deposition were factor XIIIa negative. Labelling for SMA correlated with prominent sclerosis. CONCLUSION: AFHs, including a haemangiopericytoma-like variant, have a characteristic time dependent histological and immunophenotypic profile, clearly different from nodular type Kaposi's sarcoma. Images PMID:8655708

Delayed surgical repair of penile fracture under local anesthesia.

PubMed

Nasser, Taha Abdel; Mostafa, Taymour

2008-10-01

Penile fracture is a traumatic rupture of the tunica albuginea because of blunt injury of an erect penis. To assess the efficacy of a simple delayed surgical repair of penile fracture after a conservative treatment under local anesthesia in patients presented after 24 hours. Twenty-four patients with penile fracture presented after 24 hours were subjected to history taking, clinical examination, urine analysis, and penile ultrasound. They underwent conservative treatment for 7-12 days, and then a surgical repair under local anesthesia was carried out. A follow-up for 6 months for sexual activity and any associated complaints in addition to local examination. All cases were presented with unilateral single tear, and the main cause of penile fracture was sexual intercourse. No intraoperative or postoperative complications were encountered. They regained their sexual activity 4-6 weeks after the repair. One case developed a mild penile deviation that did not interfere with sexual relation after the 6-month follow-up. Surgical repair of penile fracture after a conservative treatment is an effective method for patients with delayed presentation devoid of urethral involvement.

Neural cell adhesion molecule-180 expression as a prognostic criterion in colorectal carcinoma: Feasible or not?

PubMed Central

Tascilar, Oge; Cakmak, Güldeniz Karadeniz; Tekin, Ishak Ozel; Emre, Ali Ugur; Ucan, Bulent Hamdi; Irkorucu, Oktay; Karakaya, Kemal; Gül, Mesut; Engin, Hüseyin Bülent; Comert, Mustafa

2007-01-01

AIM: To evaluate the frequency of neural cell adhesion molecule (NCAM)-180 expression in fresh tumor tissue samples and to discuss the prognostic value of NCAM-180 in routine clinical practice. METHODS: Twenty-six patients (16 men, 10 women) with colorectal cancer were included in the study. Fresh tumor tissue samples and macroscopically healthy proximal margins of each specimen were subjected to flow-cytometric analysis for NCAM-180 expression. RESULTS: Flow-cytometric analysis determined NCAM-180 expression in whole tissue samples of macroscopically healthy colorectal tissues. However, NCAM-180 expression was positive in only one case (3.84%) with well-differentiated Stage II disease who experienced no active disease at 30 mon follow-up. CONCLUSION: As a consequence of the limited number of cases in our series, it might not be possible to make a generalisation, nevertheless the routine use of NCAM-180 expression as a prognostic marker for colorectal carcinoma seems to be unfeasible and not cost-effective in clinical practice due to its very low incidence. PMID:17907291

Hippocampal sclerosis dementia: an amnesic variant of frontotemporal degeneration

PubMed Central

Onyike, Chiadi U.; Pletnikova, Olga; Sloane, Kelly L.; Sullivan, Campbell; Troncoso, Juan C.; Rabins, Peter V.

2013-01-01

OBJECTIVE To describe characteristics of hippocampal sclerosis dementia. METHODS Convenience sample of Hippocampal sclerosis dementia (HSD) recruited from the Johns Hopkins University Brain Resource Center. Twenty-four cases with post-mortem pathological diagnosis of hippocampal sclerosis dementia were reviewed for clinical characterization. RESULTS The cases showed atrophy and neuronal loss localized to the hippocampus, amygdala and entorrhinal cortex. The majority (79.2%) had amnesia at illness onset, and many (54.2%) showed abnormal conduct and psychiatric disorder. Nearly 42% presented with an amnesic state, and 37.5% presented with amnesia plus abnormal conduct and psychiatric disorder. All eventually developed a behavioral or psychiatric disorder. Disorientation, executive dysfunction, aphasia, agnosia and apraxia were uncommon at onset. Alzheimer disease (AD) was the initial clinical diagnosis in 89% and the final clinical diagnosis in 75%. Diagnosis of frontotemporal dementia (FTD) was uncommon (seen in 8%). CONCLUSION HSD shows pathological characteristics of FTD and clinical features that mimic AD and overlap with FTD. The findings, placed in the context of earlier work, support the proposition that HSD belongs to the FTD family, where it may be identified as an amnesic variant. PMID:24363834

Comparison of standard radiography and computed tomography in 21 dogs with maxillary masses.

PubMed

Ghirelli, Carolina O; Villamizar, Lenin A; Pinto, Ana Carolina B C Fonseca

2013-01-01

Imaging of patients with oral cancer is required to determine tumor extension in order to assist in prognosis and surgical planning. Conventional screen-film radiography (SFR) used to be the most common method for oral assessment, but computed tomography (CT) has become more available and is being used for obtaining complementary information. CT examinations eliminate superimposition by acquiring cross-sectional images of the region of interest. The objective of this study was to determine the diagnostic value of SFR compared with CT examinations for evaluation of oral masses in dogs. Twenty-one dogs received head and thorax SFR, and pre- and post-contrast head CT. Bony changes were observed in 80.9% and 95.2% of the cases in SFR and CT studies, respectively. Invasion of adjacent structures (i.e. nasal cavity, frontal and sphenoidal sinuses, orbit, maxillary recess, nasopharynx) was observed in only 30% of cases with SFR while CT showed 90.4% involvement. CT is an important preoperative examination modality and is more effective in identifying bone changes and tumor invasion of adjacent structures compared with SFR.

Structure-based CoMFA as a predictive model - CYP2C9 inhibitors as a test case.

PubMed

Yasuo, Kazuya; Yamaotsu, Noriyuki; Gouda, Hiroaki; Tsujishita, Hideki; Hirono, Shuichi

2009-04-01

In this study, we tried to establish a general scheme to create a model that could predict the affinity of small compounds to their target proteins. This scheme consists of a search for ligand-binding sites on a protein, a generation of bound conformations (poses) of ligands in each of the sites by docking, identifications of the correct poses of each ligand by consensus scoring and MM-PBSA analysis, and a construction of a CoMFA model with the obtained poses to predict the affinity of the ligands. By using a crystal structure of CYP 2C9 and the twenty known CYP inhibitors as a test case, we obtained a CoMFA model with a good statistics, which suggested that the classification of the binding sites as well as the predicted bound poses of the ligands should be reasonable enough. The scheme described here would give a method to predict the affinity of small compounds with a reasonable accuracy, which is expected to heighten the value of computational chemistry in the drug design process.

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

Huang, P; Gang, Y; Qin, S

Purpose: Many patients with hepatocellular carcinoma (HCC) had hepatic anatomy variations as a result of inter-fraction deformation during fractionated radiotherapy, which may result in difference from the planned dose. This study aimed to investigate the relationship between adjusted dose and radiation induced liver disease (RILD) in HCC patients receiving three dimensional conformal radiotherapy (3DCRT). Methods: Twenty-three HCC patients received conventional fractionated 3DCRT were enrolled in this retrospective investigation. Among them, seven patients had been diagnosed of RILD post-radiotherapy, including 4 cases of grade 2, 3 cases of grade 3 according to the CTCAE Version 3.0. Daily cone-beam CT (CBCT) scansmore » were acquired throughout the whole treatment course for each patient. To reconstruct the daily dose to a patient considering the interfraction anatomy variations, the planned beams from each patient’s treatment plan were firstly applied to each daily modified CBCT (mCBCT). The daily doses were then summed together with the help of deformable image registration (DIR) to obtain the adjusted dose (Dadjusted) of the patient. Finally, the dose changes in normal liver between planned dose (Dplan) and Dadjusted were evaluated by V20, V30, V40 and the mean dose to normal liver (MDTNL). Univariate analysis was performed to identify the significant dose changes. Results: Among the twenty-three patients, the adjusted liver V20, V30, V40 and MDTNL showed significant changes from the planned ones (p<0.05) and averagely increased by 4.1%, 4.7%, 4.5% and 3.9Gy, respectively. And the adjusted liver dose in twenty-one patients (91%) were higher than planned value, the adjusted dose of patients with RILD (6/7) exceeds to the hepatic radiation tolerance. Conclusion: The adjusted dose of all the studied patients significantly differs from planned dose, and mCBCT-based dose reconstruction can aid in evaluating the robustness of the planning solutions, and adjusted dose has the potential to reduce the risk of RILD. The author would like to express great thanks to Lei Xing, Daniel S Kapp and Yong Yang in the Stanford University School of Medicine for their valuable suggestions to this work.This work is supported by NSFC(61471226),China Postdoctoral Science Foundation (2015T80739, 2014M551949) and research funding from Shandong Province(JQ201516).« less

Metabolic impact of partial volume correction of [18F]FDG PET-CT oncological studies on the assessment of tumor response to treatment.

PubMed

Stefano, A; Gallivanone, F; Messa, C; Gilardi, M C; Gastiglioni, I

2014-12-01

The aim of this work is to evaluate the metabolic impact of Partial Volume Correction (PVC) on the measurement of the Standard Uptake Value (SUV) from [18F]FDG PET-CT oncological studies for treatment monitoring purpose. Twenty-nine breast cancer patients with bone lesions (42 lesions in total) underwent [18F]FDG PET-CT studies after surgical resection of breast cancer primitives, and before (PET-II) chemotherapy and hormone treatment. PVC of bone lesion uptake was performed on the two [18F]FDG PET-CT studies, using a method based on Recovery Coefficients (RC) and on an automatic measurement of lesion metabolic volume. Body-weight average SUV was calculated for each lesion, with and without PVC. The accuracy, reproducibility, clinical feasibility and the metabolic impact on treatment response of the considered PVC method was evaluated. The PVC method was found clinically feasible in bone lesions, with an accuracy of 93% for lesion sphere-equivalent diameter >1 cm. Applying PVC, average SUV values increased, from 7% up to 154% considering both PET-I and PET-II studies, proving the need of the correction. As main finding, PVC modified the therapy response classification in 6 cases according to EORTC 1999 classification and in 5 cases according to PERCIST 1.0 classification. PVC has an important metabolic impact on the assessment of tumor response to treatment by [18F]FDG PET-CT oncological studies.

A Case Study of Job-Embedded Learning

ERIC Educational Resources Information Center

Hess, Amanda Nichols

2016-01-01

Librarians recognize the importance of professional learning as their roles and responsibilities evolve in the shifting teaching and learning environments of the twenty-first century. However, the literature on meaningful, job-embedded learning opportunities for academic librarians is scant, and opportunities are especially scarce in the fields of…

A DRIED BLOOD SPOT METHOD TO EVALUATE CHOLINESTERASE ACTIVITY IN YOUNG CHILDREN

EPA Science Inventory

Field methods are needed to detect and monitor anticholinesterase pesticide exposure of young children. Twenty children, aged 11-18 months, living in an agricultural community along the US/Mexico border were enrolled in a pilot study investigating methods to detect pesticide expo...

Clinical and mycological analysis of twenty-one cases of tinea incognita in the Aegean region of Turkey: a retrospective study.

PubMed

Turk, Bengu Gerceker; Taskin, Banu; Karaca, Nezih; Sezgin, Aycan Ozden; Aytimur, Derya

2013-01-01

Tinea incognita is a dermatophyte infection with atypical clinical features modified by the improper use of corticosteroids or calcineurin inhibitors. The aim of this study was to analyze clinical and microbiological features of patients with tinea incognita. A total of 6326 patients referred to mycology laboratory between January 2008 and January 2011 for mycological examination with a diagnosis of tinea incognita were reviewed retrospectively. Twenty-one patients, 13 (61.9%) women and 8 (38.1%) men, mean age 42.2±36.8, were included in the study. Of them, lesions were localized in 15 (71.4%) patients and widespread in six (28.6%) patients. The mean duration of the disease was 9.5 (range 1-120) months. All patients had a history of treatment with steroids. Before admission, most of them had been misdiagnosed as eczema or psoriasis. Microscopic examination revealed hyphae and spores in most of the cases (n=17, 80.95%). Mycological cultures were positive in 19 (90.5%) patients. The most frequently isolated dermatophyte was Trichophyton rubrum (n=14, 66.7%). This case series revealed Trichophyton rubrum as the most frequent agent of tinea incognita. To the best of our knowledge, this is the largest case series from Turkey describing clinical features and mycological agents of tinea incognita.

Prairie rattlesnake envenomation in 27 New World camelids.

PubMed

Sonis, J M; Hackett, E S; Callan, R J; Holt, T N; Hackett, T B

2013-01-01

Morbidity and case fatality from rattlesnake envenomation is regionally specific because of variability in relative toxicity of the species of snake encountered. A previous report of rattlesnake envenomation in New World camelids (NWC) from the western coastal United States documented high case fatality rates and guarded prognosis for survival. To describe clinical findings, treatments, and outcome of NWC with prairie rattlesnake (Crotalus viridis viridis) envenomation in the Rocky Mountain region of the United States. Twenty-seven NWC admitted to the Colorado State University Veterinary Teaching Hospital for evaluation of acute rattlesnake envenomation between 1992 and 2012. Medical records of NWC evaluated for rattlesnake envenomation as coded by the attending clinician and identified by a database search were reviewed retrospectively. Month of admission, signalment, area of bite, clinical and clinicopathologic data, treatments, and outcome were recorded. Twenty-five llamas and 2 alpacas were admitted for envenomation. Llamas were overrepresented compared to hospital caseload. The face was the most common site of envenomation, observed in 96% of recorded cases. Presenting clinical signs included fever, tachypnea, tachycardia, and respiratory distress. Nine animals required a tracheotomy. Median hospitalization time was 3 days and overall survival rate was 69%. Case fatality rate for prairie rattlesnake envenomation in NWC was lower than that reported in the Western coastal region of the United States and similar to that reported for prairie rattlesnake envenomation in horses. Copyright © 2013 by the American College of Veterinary Internal Medicine.

The identification of incident cancers in UK primary care databases: a systematic review.

PubMed

Rañopa, Michael; Douglas, Ian; van Staa, Tjeerd; Smeeth, Liam; Klungel, Olaf; Reynolds, Robert; Bhaskaran, Krishnan

2015-01-01

UK primary care databases are frequently used in observational studies with cancer outcomes. We aimed to systematically review methods used by such studies to identify and validate incident cancers of the breast, colorectum, and prostate. Medline and Embase (1980-2013) were searched for UK primary care database studies with incident breast, colorectal, or prostate cancer outcomes. Data on the methods used for case ascertainment were extracted and summarised. Questionnaires were sent to corresponding authors to obtain details about case ascertainment. Eighty-four studies of breast (n = 51), colorectal (n = 54), and prostate cancer (n = 31) were identified; 30 examined >1 cancer type. Among the 84 studies, 57 defined cancers using only diagnosis codes, while 27 required further evidence such as chemotherapy. Few studies described methods used to create cancer code lists (n = 5); or made lists available directly (n = 5). Twenty-eight code lists were received on request from study authors. All included malignant neoplasm diagnosis codes, but there was considerable variation in the specific codes included which was not explained by coding dictionary changes. Code lists also varied in terms of other types of codes included, such as in-situ, cancer morphology, history of cancer, and secondary/suspected/borderline cancer codes. In UK primary care database studies, methods for identifying breast, colorectal, and prostate cancers were often unclear. Code lists were often unavailable, and where provided, we observed variation in the individual codes and types of codes included. Clearer reporting of methods and publication of code lists would improve transparency and reproducibility of studies. Copyright © 2014 John Wiley & Sons, Ltd.

Association between oral lichen planus and Epstein-Barr virus in Iranian patients.

PubMed

Shariati, Matin; Mokhtari, Mojgan; Masoudifar, Aria

2018-01-01

Oral lichen planus (OLP) is a common mucocutaneous disease with malignant transformation potential. Several etiologies such as humoral, autoimmunity, and viral infections might play a role, but still there is no definite etiology for this disease. The aim of this study was to investigate the presence of Epstein-Barr virus (EBV) genome in Iranian patients with OLP as compared to people with normal mucosa. The study was carried out on a case group including 38 tissue specimens of patients with histopathological confirmation of OLP and a control group including 38 samples of healthy mucosa. All samples were examined by nested polymerase chain reaction (PCR) method to determine the DNA of EBV. Twenty-two (57.9%) female samples and 16 (42.1%) male samples with OLP were randomly selected as the case group, and 20 (52.6%) female samples and 18 (47.4%) male samples with healthy mucosa as the control group. There was a statistically significant difference in the percentage of EBV positivity between the case (15.8%) and the control groups ( P < 0.05); in the case group, three female samples (13.6%) and three male samples (18.8%) were infected with EBV; the difference between the genders was not statistically significant ( P = 0.50). Results emphasized that EBV genome was significantly higher among Iranian patients with OLP so antiviral therapy might be helpful.

Interrelationship between TP53 gene deletion, protein expression and chromosome 17 aneusomy in gastric adenocarcinoma

PubMed Central

2009-01-01

Background This study evaluates the existence of numerical alterations of chromosome 17 and TP53 gene deletion in gastric adenocarcinoma. The p53 protein expression was also evaluated, as well as, possible associations with clinicopathological characteristics. Methods Dual-color fluorescence in situ hybridization and immunostaining were performed in twenty gastric cancer samples of individuals from Northern Brazil. Results Deletion of TP53 was found in all samples. TP53 was inactivated mainly by single allelic deletion, varying to 7–39% of cells/case. Aneusomy of chromosome 17 was observed in 85% of cases. Chromosome 17 monosomy and gain were both observed in about half of cases. Cells with gain of chromosome 17 frequently presented TP53 deletion. The frequency of cells with two chr17 and one TP53 signals observed was higher in diffuse than in intestinal-type GC. Immunoreactivity of p53 was found only in intestinal-type samples. The frequency of cells with two chr17 and two TP53 signals found was higher in samples with positive p53 expression than in negative cases in intestinal-type GC. Conclusion We suggest that TP53 deletion and chromosome 17 aneusomy is a common event in GC and other TP53 alterations, as mutation, may be implicated in the distinct carcinogenesis process of diffuse and intestinal types. PMID:19619279

Three different clinical faces of the same histopathological entity: hair follicle nevus, trichofolliculoma and accessory tragus*

PubMed Central

Karabulut, Yasemin Yuyucu; Şenel, Engin; Karabulut, Hacı Halil; Dölek, Yasemin

2015-01-01

BACKGROUND Hair follicle nevus is a rare, congenital hamartoma with follicular differentiation characterized histologically by numerous, tiny, mature hair follicles. Trichofolliculoma, the histopathological features of which are quite similar to those of hair follicle nevus, is also a hamartoma that differs from hair follicle. Accessory tragus is a relatively common, benign congenital abnormality of the external ear with an incidence rate of 1 to 10 per 1,000 live births. OBJECTIVE This study seeks to assess the discriminatory value of currently available, histological criteria in the differential diagnosis of hair follicle nevus, accessory tragi and trichofolliculoma. METHODS Twenty-one patients comprising 9 cases of hair follicle nevus, 8 accessory tragi patients and 4 trichofolliculoma cases, were recruited to perform the study. RESULTS There were 10 males and 11 females in the study group. No significant difference was observed between the three study groups in terms of age, gender or histopathological parameters such as density of hair follicles, subcutaneous fat score and presence of connective tissue framework. Cartilaginous component was seen in 8 cases that were diagnosed as accessory tragi, while central cyst and radiating hair follicles were seen in 4 cases which were diagnosed as trichofolliculoma. CONCLUSION The results of our study showed that diagnostic discrimination of these diseases could be made only with the clinicopathologic correlation because of their clinical and histopathological similarities. PMID:26375221

Relationship between C-Reactive Protein Level and Diabetic Retinopathy: A Systematic Review and Meta-Analysis

PubMed Central

Chen, Song; Duan, Hongtao; Kong, Jiahui; Li, Zedong

2015-01-01

Objectives To date, the relationship between C-reactive protein (CRP) level and diabetic retinopathy (DR) remains controversial. Therefore, a systematic review and meta-analysis was used to reveal the potential relationship between CRP level and DR. Methods A systematic search of PubMed, Embase.com, and Web of Science was performed to identify all comparative studies that compared the CRP level of two groups (case group and control group). We defined that diabetic patients without retinopathy and /or matched healthy persons constituted the control group, and patients with DR were the case group. Results Two cross sectional studies and twenty case control studies including a total of 3679 participants were identified. After pooling the data from all 22 studies, obvious heterogeneity existed between the studies, so a subgroup analysis and sensitivity analysis were performed. Removing the sensitivity studies, the blood CRP levels in the case group were observed to be higher than those in the control group [SMD = 0.22, 95% confidence interval (CI), 0.11–0.34], and the blood CRP levels in the proliferative diabetic retinopathy (PDR) group were also higher than those in the non-proliferative diabetic retinopathy (NPDR) group [SMD = 0.50, 95% CI, 0.30–0.70]. Conclusions The results from this current meta-analysis indicate that the CRP level might be used as a biomarker to determine the severity of DR. PMID:26636823

Videothoracoscopy in the treatment of benign neurogenic tumours of the posterior mediastinum

PubMed Central

Brzeziński, Daniel; Kozak, Józef

2014-01-01

Introduction The indications for videothoracoscopy are very broad and include the treatment of mediastinal tumours. Aim To present our experience of using the minimally invasive technique in treating benign neurogenic tumours. Material and methods Twenty-two patients were treated due to tumours of the posterior mediastinum from 2003 to 2012. The size of the tumours ranged from 2 cm to 25 cm. Tumours up to the size of 6 cm were treated using videothoracoscopy (VT), bigger ones through thoracotomy. Results The videothoracoscopy technique was used in 17 patients, thoracotomy in 5. In 2 cases conversion was required due to adhesions in the pleural cavity preventing VT treatment. Complications related to the procedure were not observed. The average time of hospital stay after VT treatment was 4 days, while after thoracotomy it was 6 days. Histologically, tumours of benign nature were found in all cases. Schwannoma was diagnosed in 15 patients, ganglioneuroma in 3 patients, neurofibroma in 3 patients, and chemodectoma in 1 patient. None of the 3 cases of neurofibroma was associated with Recklinghausen's disease. At a mean follow-up of 60 months no recurrence of the tumour was found. Conclusions In the case of tumours up to 6 cm the best surgical technique is videothoracoscopy. In the case of large tumours the best access is the open technique. The minimally invasive technique allows one to shorten the patient's treatment time, reduce postoperative pain and obtain a good cosmetic effect of the treatment. PMID:25337152

Flexible ureterorenoscopy and laser lithotripsy in children

PubMed Central

Yeow, When-Chan; Pemberton, Richard; Barker, Andrew

2009-01-01

Background: Flexible ureterorenoscopy (FUR) and laser lithotripsy (LL) are techniques used in the management of upper urinary tract disorders. These techniques, so far established in adults, are now being used in children as well. We report our experience with 26 cases of pediatric upper urinary tract disorders treated using these techniques. Methods: In the period from 1997 to 2006, FUR was performed in 26 children (14 males and 12 females) in the age group of three months to 15 years with a mean age of 8.2 years. Twenty five were stented prior to undergoing FUR and 24 presented with suspected upper tract stones (17 pelvicalyceal and seven midureteric). Two cases showed JJ stent migration post-pyeloplasty. Results: Eight cases involved diagnostic procedures. Six excluded the presence of renal calculi, one had focal medullary sponge kidney, and one had calcified papillae. There were 15 cases of therapeutic FUR. Of these, 12 had LL with only one had incomplete stone fragmentation which subsequently passed spontaneously. Other therapeutic procedures included removal of migrated JJ stents and FUR with the basket removal of a midureteric calculus. Three cases failed ureterorenoscopy due to technical difficulties. The overall success rate was 88.5% for FUR. Conclusion: FUR and LL are valuable minimally invasive techniques for the examination and treatment of pediatric upper urinary tract conditions. Preoperative stenting improves passage of the ureteroscope and with progressive miniaturization of instruments, the lower weight limit will decrease. PMID:20671848

Integrative Therapies for Low Back Pain That Include Complementary and Alternative Medicine Care: A Systematic Review

PubMed Central

Rose, Kevin; Kadar, Gena E.

2014-01-01

Study Design: Systematic review of the literature. Objective: To evaluate whether an integrated approach that includes different Complementary and Alternative Medicine (CAM) therapies combined or CAM therapies combined with conventional medical care is more effective for the management of low back pain (LBP) than single modalities alone. Summary of Background Data: LBP is one of the leading causes of disability worldwide, yet its optimal management is still unresolved. Methods: The PRISMA Statement guidelines were followed. The Cochrane Back Review Group scale was used to rate the quality of the studies found. Results: Twenty-one studies were found that met the inclusion criteria. The CAM modalities used in the studies included spinal manipulative therapy, acupuncture, exercise therapy, physiotherapy, massage therapy, and a topical ointment. Twenty studies included acupuncture and/or spinal manipulative therapy. Nine high quality studies showed that integrative care was clinically effective for the management of LBP. Spinal manipulative therapy combined with exercise therapy and acupuncture combined with conventional medical care or with exercise therapy appears to be promising approaches to the management of chronic cases of LBP. Conclusions: There is support in the literature for integrated CAM and conventional medical therapy for the management of chronic LBP. Further research into the integrated management of LBP is clearly needed to provide better guidance for patients and clinicians. PMID:25568825

Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study

PubMed Central

Nada, Waled Mahdy; Al Aswad, Mahmoud A; El-Haig, Wael M

2017-01-01

Purpose To evaluate the efficacy of combination therapy of a single intrastromal injection of amphotericin B and topical fluconazole in resistant cases of fungal keratitis, and also topical amphotericin B as monotherapy in terms of the duration of the recovery period and toxic drug effects. Methods This retrospective 2-year study reviewed 68 cases of unilateral fungal keratitis diagnosed by clinical features and positive laboratory culture results. Forty-one cases were resistant and did not respond to monotherapy with an antifungal agent. Thus, they were treated with a single intrastromal injection of amphotericin B in addition to topical fluconazole as combined antifungal therapy, representing group A. Twenty-seven cases were treated with topical amphotericin B as antifungal monotherapy, representing group B. Topical atropine 1% and different antibiotic eye drops were added to the antifungal agents in both groups. Follow-up of patient records was performed monitoring cure rate, duration of recovery period, and toxic drug effects such as pain, burning sensation, and corneal melting. Results The results revealed that group A, treated with combination therapy, showed recovery of 34 cases (82.9%) with a mean duration of 24±6.42 days, significantly different from group B which showed recovery of 16 cases (59.3%) with a mean duration of 39.66±13.6 days. Group A also showed less manifestation of drug toxicity than group B. Conclusion Combined intrastromal injection of amphotericin B and topical fluconazole can provide a good modality in the treatment of resistant cases of fungal keratitis, exhibiting highly potent antifungal effects, shorter recovery period, and reduced corneal toxicity. PMID:28503064

Mother, melancholia, and humor in Erik H. Erikson's earliest writings.

PubMed

Capps, Donald

2008-09-01

Erik H. Erikson wrote three articles when he was in his late-twenties and an up-and-coming member of the psychoanalytic community in Vienna. At the time he wrote these articles, he was in a training psychoanalysis with Anna Freud, teaching at the Heitzing School in Vienna, and learning the Montessori method of teaching. These articles focus on the loss of primary narcissism and the development of the superego (or punitive conscience) in early childhood, especially through the child's conflict with maternal authority. They support the idea that melancholia, with its internalized rage against the mother, is the inevitable outcome of the loss of primary narcissism. I note, however, that the third of these articles makes a case for the restorative role of humor, especially when Freud's view that humor is a function of the superego is taken into account.

Adapting School-Based Substance Use Prevention Curriculum Through Cultural Grounding: A Review and Exemplar of Adaptation Processes for Rural Schools

PubMed Central

Colby, Margaret; Hecht, Michael L.; Miller-Day, Michelle; Krieger, Janice L.; Syvertsen, Amy K.; Graham, John W.; Pettigrew, Jonathan

2014-01-01

A central challenge facing twenty-first century community-based researchers and prevention scientists is curriculum adaptation processes. While early prevention efforts sought to develop effective programs, taking programs to scale implies that they will be adapted, especially as programs are implemented with populations other than those with whom they were developed or tested. The principle of cultural grounding, which argues that health message adaptation should be informed by knowledge of the target population and by cultural insiders, provides a theoretical rational for cultural regrounding and presents an illustrative case of methods used to reground the keepin’ it REAL substance use prevention curriculum for a rural adolescent population. We argue that adaptation processes like those presented should be incorporated into the design and dissemination of prevention interventions. PMID:22961604

Adapting school-based substance use prevention curriculum through cultural grounding: a review and exemplar of adaptation processes for rural schools.

PubMed

Colby, Margaret; Hecht, Michael L; Miller-Day, Michelle; Krieger, Janice L; Syvertsen, Amy K; Graham, John W; Pettigrew, Jonathan

2013-03-01

A central challenge facing twenty-first century community-based researchers and prevention scientists is curriculum adaptation processes. While early prevention efforts sought to develop effective programs, taking programs to scale implies that they will be adapted, especially as programs are implemented with populations other than those with whom they were developed or tested. The principle of cultural grounding, which argues that health message adaptation should be informed by knowledge of the target population and by cultural insiders, provides a theoretical rational for cultural regrounding and presents an illustrative case of methods used to reground the keepin' it REAL substance use prevention curriculum for a rural adolescent population. We argue that adaptation processes like those presented should be incorporated into the design and dissemination of prevention interventions.

Design and application of nickel-titanium olecranon memory connector in treatment of olecranon fractures: a prospective randomized controlled trial.

PubMed

Chen, Xiao; Liu, Peng; Zhu, Xiaofei; Cao, Liehu; Zhang, Chuncai; Su, Jiacan

2013-06-01

We carried out this study to test the efficacy of the olecranon memory connector (OMC) in olecranon fractures. We designed a prospective randomised controlled trial involving 40 cases of olecranon fractures. From May 2004 to December 2009, 40 patients with olecranon fractures were randomly assigned into two groups. Twenty patients were treated with OMC, while another 20 patients were fixed with locking plates in our hospital. The DASH score, MEP score, range of motion and radiographs were used to evaluate the postoperative elbow function and complications. For MEP score, OMC was better than the locking plate; for DASH score, complication rate, and range of elbow motion, the two methods presented no significant difference. The study showed that OMC could be an effective alternative to treat olecranon fractures.

Gender & Education Association: A Case Study in Feminist Education?

ERIC Educational Resources Information Center

David, Miriam E.

2015-01-01

This article focuses on feminist activist academics who were instrumental in creating the UK Gender & Education Association at the turn of the twenty-first century. Drawing on my own intellectual biography (David, M. E. 2003. "Personal and Political: Feminisms, Sociology and Family Lives" Stoke-on-Trent. Trentham Books.) linked to…

The Roles of Assessment in Language Teaching

ERIC Educational Resources Information Center

Frank, Jerrold

2012-01-01

This piece makes a case for using assessment to understand and identify the needs of learners and introduces the three reprints that follow: "Twenty Common Testing Mistakes for EFL Teachers to Avoid," "Coming to Grips with Progress Testing: Some Guidelines for Its Design," and "Purposeful Language Assessment: Selecting the Right Alternative Test."

Determining Student Competency in Field Placements: An Emerging Theoretical Model

ERIC Educational Resources Information Center

Salm, Twyla L.; Johner, Randy; Luhanga, Florence

2016-01-01

This paper describes a qualitative case study that explores how twenty-three field advisors, representing three human service professions including education, nursing, and social work, experience the process of assessment with students who are struggling to meet minimum competencies in field placements. Five themes emerged from the analysis of…

Vietnam's Half-Hearted Welcome Home

ERIC Educational Resources Information Center

Overland, Martha Ann

2008-01-01

Twenty years ago, Vietnam's closed-door policy meant its students were restricted to the former Soviet-bloc countries. Today they study all over the world--about 6,000 are in the United States alone. In many cases, their tuition and living expenses are paid by foreign governments and private charitable organizations. Fulbright, the Ford…

Uncovering "Unwelcome Truths" through Student Voice: Teacher Inquiry into Agency and Student Assessment Literacy

ERIC Educational Resources Information Center

Charteris, Jennifer; Thomas, Eryn

2017-01-01

Learner agency is often seen unproblematically as an integral aspect of "twenty-first century lifelong learning". Agency and instrumentalist forms of teacher professional development are problematised through this qualitative case study that explores a teacher's inquiry into assessment for learning practices. This article illustrates how…

A Library Communication Audit for the Twenty-First Century

ERIC Educational Resources Information Center

Chalmers, Mardi; Liedtka, Theresa; Bednar, Carol

2006-01-01

This article describes a case study relating to an internal communication audit conducted in a large academic library that assessed existing information channels during a period of organizational change in order to recommend improvements. A communications task force developed and administered a survey instrument and then analyzed data and reported…

Student Workers: Essential Partners in the Twenty-First Century Academic Library

ERIC Educational Resources Information Center

Logan, Firouzeh

2012-01-01

This article describes a case study that best illustrates the value of student workers in university libraries, focusing particularly on how this kind of creative endeavor benefits everyone involved--the library, the students, the faculty, and at the end of the project: the university community. (Contains 1 table.)

Quality Assurance Strategies in Higher Education: The Case of Ghanaian Polytechnics

ERIC Educational Resources Information Center

Swanzy, Patrick; Potts, Anthony

2017-01-01

This study investigated the internal quality assurance strategies Ghanaian polytechnics enacted in order to improve graduate outcomes. A qualitative methodological approach via in-depth interviewing of twenty key informants and document analysis was used to establish how polytechnics in Ghana addressed problematic situations in quality assurance.…

Investigating Students' Mathematical Difficulties with Quadratic Equations

ERIC Educational Resources Information Center

O'Connor, Bronwyn Reid; Norton, Stephen

2016-01-01

This paper examines the factors that hinder students' success in working with and understanding the mathematics of quadratic equations using a case study analysis of student error patterns. Twenty-five Year 11 students were administered a written test to examine their understanding of concepts and procedures associated with this topic. The…

Illustrative Case Using the RISK21 Roadmap and Matrix: Prioritization for Evaluation of Chemicals Found in Drinking Water

EPA Science Inventory

The HESI-led RISK21 effort has developed a framework supporting the use of twenty first century technology in obtaining and using information for chemical risk assessment. This framework represents a problem formulation-based, exposure-driven, tiered data acquisition approach tha...

Social Support for Online Learning: Perspectives of Nursing Students

ERIC Educational Resources Information Center

Munich, Kim

2014-01-01

The purpose of this study was to identify supports beyond the educator that contributed to undergraduate and graduate nursing students' ability and motivation to learn online. Case study methodology similar to Stake (2000) was bounded or contained by undergraduate and graduate online courses. Twenty-nine undergraduate and graduate nursing…

454 next generation-sequencing outperforms allele-specific PCR, Sanger sequencing, and pyrosequencing for routine KRAS mutation analysis of formalin-fixed, paraffin-embedded samples

PubMed Central

Altimari, Annalisa; de Biase, Dario; De Maglio, Giovanna; Gruppioni, Elisa; Capizzi, Elisa; Degiovanni, Alessio; D’Errico, Antonia; Pession, Annalisa; Pizzolitto, Stefano; Fiorentino, Michelangelo; Tallini, Giovanni

2013-01-01

Detection of KRAS mutations in archival pathology samples is critical for therapeutic appropriateness of anti-EGFR monoclonal antibodies in colorectal cancer. We compared the sensitivity, specificity, and accuracy of Sanger sequencing, ARMS-Scorpion (TheraScreen®) real-time polymerase chain reaction (PCR), pyrosequencing, chip array hybridization, and 454 next-generation sequencing to assess KRAS codon 12 and 13 mutations in 60 nonconsecutive selected cases of colorectal cancer. Twenty of the 60 cases were detected as wild-type KRAS by all methods with 100% specificity. Among the 40 mutated cases, 13 were discrepant with at least one method. The sensitivity was 85%, 90%, 93%, and 92%, and the accuracy was 90%, 93%, 95%, and 95% for Sanger sequencing, TheraScreen real-time PCR, pyrosequencing, and chip array hybridization, respectively. The main limitation of Sanger sequencing was its low analytical sensitivity, whereas TheraScreen real-time PCR, pyrosequencing, and chip array hybridization showed higher sensitivity but suffered from the limitations of predesigned assays. Concordance between the methods was k = 0.79 for Sanger sequencing and k > 0.85 for the other techniques. Tumor cell enrichment correlated significantly with the abundance of KRAS-mutated deoxyribonucleic acid (DNA), evaluated as ΔCt for TheraScreen real-time PCR (P = 0.03), percentage of mutation for pyrosequencing (P = 0.001), ratio for chip array hybridization (P = 0.003), and percentage of mutation for 454 next-generation sequencing (P = 0.004). Also, 454 next-generation sequencing showed the best cross correlation for quantification of mutation abundance compared with all the other methods (P < 0.001). Our comparison showed the superiority of next-generation sequencing over the other techniques in terms of sensitivity and specificity. Next-generation sequencing will replace Sanger sequencing as the reference technique for diagnostic detection of KRAS mutation in archival tumor tissues. PMID:23950653

Periprosthetic supracondylar femoral fractures following total knee arthroplasty: clinical comparison and related complications of the femur plate system and retrograde-inserted supracondylar nail.

PubMed

Gondalia, Viral; Choi, Duck Hyun; Lee, Su Chan; Nam, Chang Hyun; Hwang, Bo Hyun; Ahn, Hye Sun; Ong, Alvin C; Park, Ha Young; Jung, Kwang Am

2014-09-01

The purpose of this study is to analyze the clinical results and related complications of the femur plate system (FP) and the retrograde-inserted supracondylar nail (RISN). The study included 42 cases of periprosthetic supracondylar femoral fractures (PSF) proximal to posterior stabilized total knee arthroplasty between 2005 and 2009. Twenty-four cases of PSF were treated with the FP, and the other 18 cases were treated with the RISN. This study cohort was divided into subgroups according to the AO classification. We retrospectively compared the clinical results between the FP and RISN group. There were no significant differences between the two groups in terms of time of clinical union (p = 0.649). In the subgroup analysis, the mean operation time was significantly different only in subgroup A1 (p = 0.03). Complications were seen in 29.2 % (7/24) of patients in the FP group and 27.8 % (5/18) in the RISN group. The age during the index TKA and fracture fixation was a significant risk (p = 0.008) factor for complications between the two groups. No significant differences were found in the other factors between the two groups. The p value for operative time (p = 0.223), immobilization period (p = 0.129), ROM (p = 0.573), KSS (p = 0.379), KSS functional scores (p = 0.310) and time to union (p = 0.649). Clinical results did not differ according to the treatment methods used. Fixation method and fracture type did not cause an increase in the complication rate, but there was a trend toward higher non-union rates with the FP method and higher re-fracture rate with the RISN method. Noting the fact that only increasing age correlated with an increased complication rate, more careful attention should be paid to elderly patients in terms of both prevention and surgical care. Level III, therapeutic study.

Flexible intramedullary nailing for unicameral cysts in children's long bones : Level of evidence: lV, case series.

PubMed

Glanzmann, Michael C; Campos, Lautaro

2007-07-01

The purpose of this study was to evaluate the outcome of flexible intramedullary nailing for unicameral bone cysts in terms of function and osseous consolidation. Twenty-two unicameral bone cysts in children's long bones were treated by flexible intramedullary nailing. In 13 cases the bone cyst was diagnosed in a traumatic event leading to a pathologic fracture. Fifteen patients were referred to our clinic after failed conservative treatment. In 16 patients the cyst was located in the humerus, and in 6 patients in the femur. Mean duration of follow-up after surgery was 24 months. According to Capanna's criteria healing was obtained in 20 cases with a mean time of 16 months. Sixteen cysts healed completely. Four lesions were classified as grade 2, meaning that residual radiolucencies were radiographically visible at the latest follow-up. Two recurrences of humeral cysts were seen at 16 and 18 months postoperatively. The complication rate was minimal. Due to the immediate stabilization of the lesion aftercare becomes facile. This method allows prompt mobilization and early weight bearing without the necessity of a plaster cast. Further it prevents effectively the most common complication, a re-fracture or a pathologic fracture. Therefore we propose this surgical procedure as the treatment of choice for unicameral bone cysts in children's long bones.

CD56 Expression in Odontogenic Cysts and Tumors.

PubMed

Jaafari-Ashkavandi, Zohreh; Dehghani-Nazhvani, Ali; Razmjouyi, Faranak

2014-01-01

Background and aims. Odontogenic cysts and tumors have a wide spectrum of clinical characteristics that lead to the different management strategies. Since definite diagnosis is difficult in some cases, it has been suggested that CD56 may be a candidate marker for definitive diagnosis of some odontogenic tumors. The present study was designed to examine CD56 expression in lesions with histopathological similarities. Materials and methods. In this cross-sectional, analytical study the subjects were 22 ameloblastomas, 13 dentigerous cysts, 10 keratocystic odontogenic tumors (KCOT), 4 adenomatoid odontogenic tumors (AOT), 3 orthokeratinized odonto-genic cysts, 3 calcifying odontogenic cysts (COC) and one glandular odontogenic cyst (GOC). All the samples were examined for CD56 immunoreactivity. Data were analyzed using chi-square test. Results. Twenty cases (91%) of ameloblastomas, 3 (75%) AOT, 4 (40%) KCOT and one case of GOC were positive for CD56. None of the dentigerous cysts, COC and orthokeratinized odontogenic cysts was CD56-positive. There was a significant difference in the CD56 expression between ameloblastoma and dentigerous cyst, as well as COC. Also, KCOT showed significantly higher expression than orthokeratinized odontogenic cyst. Conclusion. In this study CD56 expression was limited to the odontogenic tumors and more aggressive cystic lesions. This marker can be a useful aid for distinguishing cysts and tumors from similar lesions.

Laser treatment of cutaneous angiokeratomas: A systematic review.

PubMed

Nguyen, Jannett; Chapman, Lance W; Korta, Dorota Z; Zachary, Christopher B

2017-11-01

Angiokeratomas can present therapeutic challenges, especially in cases of extensive lesions, where traditional surgical methods carry high risks of scarring and hemorrhage. Argon, pulsed dye (PDL), neodymium-doped yttrium aluminum garnet (Nd:YAG), copper vapor, potassium titanyl phosphate, carbon dioxide, and erbium-doped yttrium aluminum garnet (Er:YAG) lasers have emerged as alternative options. To review the use and efficacy of lasers in treating angiokeratomas. A PubMed search identified randomized clinical trials, cohort studies, case series, and case reports involving laser treatment of cutaneous angiokeratomas. Twenty-five studies were included. Quality ratings were assigned using the Oxford Centre for Evidence-Based Medicine scheme. Several laser modalities are effective in treating multiple variants of angiokeratomas. Vascular lasers like PDL, Nd:YAG, and argon are the most studied and of these, PDL offers the safest side effect profile. Nd:YAG may be more effective for hyperkeratotic angiokeratomas. Combination treatment with multiple laser modalities has also demonstrated some success. Lasers are a promising treatment option for angiokeratomas, but current use is limited by the lack of treatment guidelines. There are limited high quality studies comparing laser treatments to each other and to non-laser options. Additional studies are needed to establish guidelines and to optimize laser parameters. © 2017 Wiley Periodicals, Inc.

Anatomical study of the accessory axillary vein in cadavers: a contribution to the axillary surgical approach

PubMed Central

Felix, Valtuir Barbosa; dos Santos, José André Bernardino; Fernandes, Katharina Jucá de Moraes; Cabral, Dhayanna Rolemberg Gama; dos Santos, Carlos Adriano Silva; Rodrigues, Célio Fernando de Sousa; Lima, Jacqueline Silva Brito; Ramalho, Antônio José Casado

2016-01-01

Abstract Background The axillary vein is an important blood vessel that participates in drainage of the upper limb. Some individuals present a second axillary vein (accessory axillary vein), which is an important collateral drainage path. Objectives The goal of this study was to determine the incidence of the accessory axillary vein and to describe this vessel’s topography. Methods In this study, axillary dissections were carried out on twenty-four (24) human cadavers of both sexes that had been fixed with 10% formaldehyde. The upper limbs of the cadavers were still attached to the bodies and the axillary structures were preserved. Data collection was carried out and the axillary structures of the cadavers were compared. Results The incidence of accessory axillary veins was 58.3%, with no significant preference for sex or for side of the body. The accessory axillary vein originated from the lateral brachial vein in 39.28% of cases, from the common brachial vein in 35.71% of cases, and from the deep brachial vein in 25% of cases. Conclusions Its high incidence and clinical relevance make the accessory axillary vein important for provision of collateral circulation in the event of traumatic injury to the axillary vein.

A survey of current practices for genomic sequencing test interpretation and reporting processes in US laboratories.

PubMed

O'Daniel, Julianne M; McLaughlin, Heather M; Amendola, Laura M; Bale, Sherri J; Berg, Jonathan S; Bick, David; Bowling, Kevin M; Chao, Elizabeth C; Chung, Wendy K; Conlin, Laura K; Cooper, Gregory M; Das, Soma; Deignan, Joshua L; Dorschner, Michael O; Evans, James P; Ghazani, Arezou A; Goddard, Katrina A; Gornick, Michele; Farwell Hagman, Kelly D; Hambuch, Tina; Hegde, Madhuri; Hindorff, Lucia A; Holm, Ingrid A; Jarvik, Gail P; Knight Johnson, Amy; Mighion, Lindsey; Morra, Massimo; Plon, Sharon E; Punj, Sumit; Richards, C Sue; Santani, Avni; Shirts, Brian H; Spinner, Nancy B; Tang, Sha; Weck, Karen E; Wolf, Susan M; Yang, Yaping; Rehm, Heidi L

2017-05-01

While the diagnostic success of genomic sequencing expands, the complexity of this testing should not be overlooked. Numerous laboratory processes are required to support the identification, interpretation, and reporting of clinically significant variants. This study aimed to examine the workflow and reporting procedures among US laboratories to highlight shared practices and identify areas in need of standardization. Surveys and follow-up interviews were conducted with laboratories offering exome and/or genome sequencing to support a research program or for routine clinical services. The 73-item survey elicited multiple choice and free-text responses that were later clarified with phone interviews. Twenty-one laboratories participated. Practices highly concordant across all groups included consent documentation, multiperson case review, and enabling patient opt-out of incidental or secondary findings analysis. Noted divergence included use of phenotypic data to inform case analysis and interpretation and reporting of case-specific quality metrics and methods. Few laboratory policies detailed procedures for data reanalysis, data sharing, or patient access to data. This study provides an overview of practices and policies of experienced exome and genome sequencing laboratories. The results enable broader consideration of which practices are becoming standard approaches, where divergence remains, and areas of development in best practice guidelines that may be helpful.Genet Med advance online publication 03 Novemeber 2016.

Contribution of GLC3A locus to Primary Congenital Glaucoma in Pakistani population

PubMed Central

Bashir, Rasheeda; Sanai, Mahrukh; Azeem, Adnan; Altaf, Imran; Saleem, Faiza; Naz, Sadaf

2014-01-01

Objectives: To check the contribution of GLC3A locus to primary congenital glaucoma in the Pakistani population. Methods: We enrolled twenty-nine sporadic cases and three families with multiple individuals affected with recessive primary congenital glaucoma in the year 2013. It was a genetic linkage study accomplished jointly in Department of Biotechnology of Lahore College for Women University and School of Biological Sciences, University of the Punjab, Lahore. Samples from all affected individuals were checked for homozygosity for alleles of microsatellite markers spanning CYP1B1 at GLC3A locus. Genotyping was performed with fluorescently labeled primers by capillary electrophoresis. For familial cases, linkage was evaluated by checking the co-segregation of the phenotype with the genotypes. Two-point LOD score was calculated for each microsatellite marker with MLINK. Results: Our study revealed that GLCA3 may contribute to glaucoma in 17% of the sporadic cases and patients in 2 of the 3 families. Conclusions: This data suggests that the GLC3A may make an important contribution to autosomal recessive primary congenital glaucoma in the Pakistani population. Genotyping and Sequencing of more families will be helpful to identify the common mutations in CYP1B1 in future. PMID:25674135

Factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation: a retrospective case study in Southeast China

PubMed Central

Guo, Wan-liang; Zhan, Yang; Fang, Fang; Deng, Yan-bing; Zhao, Jun-gang

2018-01-01

Objective The aim of this study was to evaluate factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of congenital choledochal malformation (CCM). Design A 3-year retrospective study was undertaken between January 2013 and December 2015 in four centres in China. Setting This involved a retrospective chart review of paediatric patients with CCM in four large hospitals in Southeast China. Participants Sixty-five paediatric patients with CCM were included in this study. We derived all available information on patient demographics, clinical characteristics, preoperative complications and surgical methods from the charts of all these patients. Interventions Univariate and multivariate logistic regression analyses were used to evaluate factors significantly affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM. Results Twenty-three of the 65 case surgeries were performed using laparoscopic technique, and 42 surgeries were performed by conventional open surgery. The median operating time was 215 min (range 120–430 min). The morphological subtype of CCM and the presence of cholecystitis or cholangitis were the only factors found to affect the operating time (p<0.05). Logistic regression analysis confirmed cholangitis as an independent risk factor. Conclusions The morphological subtype of CMM and the presence of cholecystitis or cholangitis are factors affecting the operating time for complete cyst excision and Roux-en-Y hepaticojejunostomy in paediatric cases of CCM, whereas cholangitis is an independent risk factor. PMID:29804066

The epidemiology of conjoined twins in Latin America.

PubMed

Castilla, E E; Lopez-Camelo, J S; Orioli, I M; Sánchez, O; Paz, J E

1988-01-01

Twenty-three cases of symmetrical conjoined twins were registered by the Latin-American Collaborative Study of Congenital Malformations (ECLAMC) in 1,714,952 births, which were observed during the 1967-1986 period in 95 maternity hospitals distributed in eleven Latin-American countries. This results in a birth prevalence rate of about 1/75,000 births. The secular and geographic distribution of this material do not depart from random in spite of one hospital with three cases, and two hospitals with two cases each, within a short time period. These 23 cases include one diprosopus, 3 dicephalus, one ischiopagus, 5 pygopagus, none dipygus, 3 syncephalus, none craniopagus, 9 thoracopagus, one omphalopagus, and one rachipagus. Sex distribution is even, with 12 male and 11 female cases.

Fireworks related injuries during Hari Raya festival in Hospital Universiti Sains Malaysia--1986 to 1990.

PubMed

Isa, A R; Moe, H

1991-12-01

A total of 38 cases of fireworks related injuries from Hospital USM over a 5-year period from 1986 to 1990 during Hari Raya festival were analysed. The majority (68.5%) of the patients were teenagers, between 10 to 19 years of age. All the cases were Malays and most of the accidents occurred before the Hari Raya Idilfitri festive seasons. Fourteen cases were caused by self-made fireworks and another 16 cases were due to modified fire-works. Twenty-four cases suffered permanent disabilities mostly finger amputations. Such injuries could be prevented by law enforcement coupled with public health education to modify social behaviour especially when the ban against the use of fireworks is lifted on religious grounds.

[Long term result of arytenoidectomy with CO₂ laser for dyspnoea in iatrogenic bilateral vocal fold paralysis patients].

PubMed

Cheng, Q H; Ge, P J; Sheng, X L; Jiang, J; Zhang, S Y; Chen, S H

2016-03-20

Objective: To investigate the optimal time of tracheotomy/arytenoidectomy and the improvement of dyspnoea, dysphonia and dysphagia after arytenoidectomy with CO₂ laser in iatrogenic bilateral vocal folds paralysis patients. Method: Thirty patients [29 females, 56 (49-60) years, one male, 49 years] with bilateral vocal cords paralysis resulted from neck surgery were retrospectively analyzed by case archived information and following-up questionnaire. The data included patients' dysponea time, degree and duration from tracheotomy/arytenoidectomy to neck surgery. Twenty sixty patients required unilateral partial/total arytenoidectomy. The results of treatment were evaluated by questionnaire including dyspnoea, dysphonia and dysphagia. Result: All patients whose bilateral vocal paralysis were resulted from thyroid gland surgery. Dysponea occurred immediately after thyroidectomy surgery in 14 cases (46.7%), and 2 years later after thyroidectomy in 13 cases (43.3%), 8 years later in 3 cases (10.0%). There was one (3.3%) patient without tracheotomy. The duration of tracheotomy/arytenoidectomy to neck surgery was significantly correlated with duration of tracheotomy/arytenoidectomy to dyspnoea appearance ( r =0.879, P <0.05), not correlated with duration of thyroid surgery to dyspnoea appearance. There is significantly negative correlation between degree of dyspnoea and duration of tracheotomy/arytenoidectomy to neck surgery ( r =0.452, P <0.05). Twenty six patients appeared dyspnoea and underwent CO₂ laser arytenoidectomy after thyoidectomy 0.5-23 years. Five patients did unilateral total arytenoidectomy and 21 patients did unilateral partial arytenoidectomy. After 12-96 months following up, dyspnoea improved in 24 patients, no improved in 2 patients. Dysphonia improved and remained in 17 patients, being worse mildly in 8 patients and obviously in one patient. Dysphagia improved and remained in 24 patients, being worse in 2 patients. There was no difference between total and partial arytenoidectomy in dyspnoea, dysphonia and dysphagia. Conclusion: The morbidity of dyspnoea was correlated with time after neck surgery. It was rarely necessary to take tracheotomy immediately in bilateral vocal fords paralysis patients after neck surgery. The severer degree of dyspnoea led to shorter duration between neck surgery and tracheotomy/arytenoidectomy. There was obvious improvement after arytenoidectomy in dyspnoea, no significant change in dysphonia and dysphagia. The effect of total arytenoidectomy on bilateral vocal paralysis was similar to partial arytenoidectomy. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Automatic segmentation of male pelvic anatomy on computed tomography images: a comparison with multiple observers in the context of a multicentre clinical trial.

PubMed

Geraghty, John P; Grogan, Garry; Ebert, Martin A

2013-04-30

This study investigates the variation in segmentation of several pelvic anatomical structures on computed tomography (CT) between multiple observers and a commercial automatic segmentation method, in the context of quality assurance and evaluation during a multicentre clinical trial. CT scans of two prostate cancer patients ('benchmarking cases'), one high risk (HR) and one intermediate risk (IR), were sent to multiple radiotherapy centres for segmentation of prostate, rectum and bladder structures according to the TROG 03.04 "RADAR" trial protocol definitions. The same structures were automatically segmented using iPlan software for the same two patients, allowing structures defined by automatic segmentation to be quantitatively compared with those defined by multiple observers. A sample of twenty trial patient datasets were also used to automatically generate anatomical structures for quantitative comparison with structures defined by individual observers for the same datasets. There was considerable agreement amongst all observers and automatic segmentation of the benchmarking cases for bladder (mean spatial variations < 0.4 cm across the majority of image slices). Although there was some variation in interpretation of the superior-inferior (cranio-caudal) extent of rectum, human-observer contours were typically within a mean 0.6 cm of automatically-defined contours. Prostate structures were more consistent for the HR case than the IR case with all human observers segmenting a prostate with considerably more volume (mean +113.3%) than that automatically segmented. Similar results were seen across the twenty sample datasets, with disagreement between iPlan and observers dominant at the prostatic apex and superior part of the rectum, which is consistent with observations made during quality assurance reviews during the trial. This study has demonstrated quantitative analysis for comparison of multi-observer segmentation studies. For automatic segmentation algorithms based on image-registration as in iPlan, it is apparent that agreement between observer and automatic segmentation will be a function of patient-specific image characteristics, particularly for anatomy with poor contrast definition. For this reason, it is suggested that automatic registration based on transformation of a single reference dataset adds a significant systematic bias to the resulting volumes and their use in the context of a multicentre trial should be carefully considered.

[Prevalence of extrinsic allergic alveolitis in cattle breeders from the province of Reggio Emilia].

PubMed

Ferri, F; Ruggieri, Maria Paola; Guidetti, G; Azzarone, G; Giammartini, Pasquina; Capanni, S; Mantovani, P; Bertani, Marisa

2003-01-01

Several new cases of Extrinsic Allergic Alveolitis or Farmer's Lung (FL) in farm workers were reported to Occupational Health Services in the province of Reggio Emilia (Italy). This prompted the Public Health Department to study the prevalence of the disease among milk-cow breeders involved in Parmigiano-Reggiano cheese production: who are the biggest hay users. A suitable questionnaire was sent to 1875 farmers in three of the six districts of the province. Half of them (935: 841 males, 94 females) answered; further contacts and medical history research revealed 33 case of "likely FL". Twenty-three (2 females) (10 "missing"), underwent pulmonary function tests, chest X-rays, precipitins tests against Saccharopolyspora Rectivirgula and other fungal antigens and (22 farmers) bronchoalveolar lavage (BAL). According to the "Società Italiana di Medicina del Lavoro e di Igiene Industriale" diagnostic standards, we found 20 subjects suffering from FL among farmers collecting hay in large cylindrical (round) bales, dried on field (2.6%) and among others still using small (traditional), prismatic bales (0.5%). The prevalence on the whole exposed population (6000-9000 people) was estimated between 1.5% and 3.0% (90-270 people); no difference was found in FL prevalence between flat and hilly or mountain areas; the method of collecting hay in big "round" bales, dried on field, seems to produce higher frequencies of FL cases if compared with the traditional ones (more frequent in mountain areas). The new hay packing methods, using forced air driers, are suggested as a possible solution.

Non-surgical Management of Congenital Auricular Deformities.

PubMed

Mohammadi, Ali Akbar; Imani, Mohammad Taghi; Kardeh, Sina; Karami, Mehrab Mohammad; Kherad, Masoomeh

2016-05-01

Unlike congenital auricular malformations which are identified by underdevelopment of dermal and cartilaginous tissues, deformed ears are less sever congenital anomalies characterized only by a misshaped pinna structure and can be improved with acceptable cosmetic results and minimal cost through ear molding if treated in early neonatal period. In this study, authors present the first report of using splinting techniques for treatment of deformational auricular anomalies in Iranian children. Our case load consisted of a series of 29 patients (Male=16, Female=13) who were referred to Plastic Surgery Unit of Shiraz University of Medical Sciences from September 2011 to December 2014. Children aged more than 6 moths were excluded. Twenty-nine children affected by various deformities including prominent ears (n=11), lop ears (n=8) and constricted ears (n=10) were treated by splintage as a nonsurgical technique. The mean time of treatment was 13.33±2 weeks. Eight (27.6%) patients did not complete the treatment. Splinting resulted in excellent or satisfactory results in 12 (57.14%) of treated cases. No improvement was observed at the end of the molding treatment in 9 patients. No complication was observed during the treatment in any of the patients. The nonsurgical molding can be used as an effective approach for achieving natural outcomes and correcting cosmetic abnormalities. Rate of satisfaction is dependent on type of deformity, the neonatal age in which treatment started and also parents' adherence to treatment methods and principals. Concerning the low rate of complications and high satisfactory results the method can be used instead of surgery in appropriate cases.

Transcranial Magnetic Stimulation as an Additional Diagnostic Tool in Children with Acute Inflammatory Demyelinating Polyneuropathy

PubMed Central

Voitenkov, Voitenkov Vladislav; Andrey, Klimkin; Natalia, Skripchenko; Anastasia, Aksenova

2017-01-01

Context: The diagnosis of polyneuropathy may be challenging at the early stages of the disease. Despite electromyography (EMG) efficacy in the establishment of polyneuropathy diagnosis, in some cases, results are dubious and neurophysiologists may implement additional techniques to ensure that conduction is affected. Aims: The aim of the study was to evaluate motor-evoked potential (MEP) characteristics in children with acute inflammatory demyelinating polyneuropathy (AIDP). Settings and Design: The study was conducted at a pediatric research and clinical center for infectious diseases. Subjects and Methods: Twenty healthy children (7–14 years old) without signs of neurological disorders were enrolled as controls. Thirty-seven patients (8–13 years old) with AIDP were enrolled as the main group. EMG and transcranial magnetic stimulation (TMS) were performed on the 3rd–7th days from the onset of the first symptoms. Statistical Analysis Used: Descriptive statistics and Student's t-test were used. Bonferroni method was applied to implement appropriate corrections for multiple comparisons. Results: Significant differences between children with AIDP and controls on latencies of both cortical and lumbar MEPs were registered. Cortical MEP shapes were disperse in 100% of the cases and lumbar MEPs were disperse in 57% of the cases. Conclusions: Diagnostic TMS on the early stage of the AIDP in children may be implemented as the additional tool. The main finding in this population is lengthening of the latency of cortical and lumbar MEPs. Disperse shape of the lumbar MEPs may be used as the early sign of the acute demyelization. PMID:28904571

Comparative study of single lateral locked plating versus double plating in type C bicondylar tibial plateau fractures

PubMed Central

Neogi, Devdatta Suhas; Trikha, Vivek; Mishra, Kaushal Kant; Bandekar, Shivanand M.; Yadav, Chandra Shekhar

2015-01-01

Background: Bicondylar tibial plateau fractures are complex injuries and treatment is challenging. Ideal method is still controversial with risk of unsatisfactory results if not treated properly. Many different techniques of internal and external fixation are used. This study compares the clinical results in single locked plating versus dual plating (DP) using two incision approaches. Our hypothesis was that DP leads to less collapse and change in alignment at final followup compared with single plating. Materials and Methods: 61 cases of Type C tibial plateau fractures operated between January 2007 and June 2011 were included in this prospective study. All cases were operated either by single lateral locked plate by anterolateral approach or double plating through double incision. All cases were followed for a minimum of 24 months radiologically and clinically. The statistical analysis was performed using software SPSS 10.0 to analyze the data. Results: Twenty nine patients in a single lateral locked plate and 32 patients in a double plating group were followed for minimum 2 years. All fractures healed, however there was a significant incidence of malalignment in the single lateral plating group. Though there was a significant increase in soft tissue issues with the double plating group; however, there was only 3.12% incidence of deep infection. There was no significant difference in Hospital for special surgery score at 2 years followup. Conclusion: Double plating through two incisions resulted in a better limb alignment and joint reduction with an acceptable soft tissue complication rate. PMID:26015609

Twenty-year summary of surveillance for human hantavirus infections, United States.

PubMed

Knust, Barbara; Rollin, Pierre E

2013-12-01

In the past 20 years of surveillance for hantavirus in humans in the United States, 624 cases of hantavirus pulmonary syndrome (HPS) have been reported, 96% of which occurred in states west of the Mississippi River. Most hantavirus infections are caused by Sin Nombre virus, but cases of HPS caused by Bayou, Black Creek Canal, Monongahela, and New York viruses have been reported, and cases of domestically acquired hemorrhagic fever and renal syndrome caused by Seoul virus have also occurred. Rarely, hantavirus infections result in mild illness that does not progress to HPS. Continued testing and surveillance of clinical cases in humans will improve our understanding of the etiologic agents involved and the spectrum of diseases.

[Rhinitis and asthma related to cotton dust exposure in apprentices in the clothing industry].

PubMed

Chaari, N; Amri, C; Khalfallah, T; Alaya, A; Abdallah, B; Harzallah, L; Henchi, M-A; Bchir, N; Kamel, A; Akrout, M

2009-01-01

Respiratory allergies are the most common occupational diseases in the world. The aim of this study was to determine the prevalence of rhinitis and asthma among apprentices exposed to cotton dust in the clothing industry and to describe their epidemiologic and clinical profiles. We carried out a descriptive study of 600 apprentices in a textile and clothing vocational training centre in the Monastir area. The investigation comprised a questionnaire exploring risk factors and symptoms appearing during their training. Subjects who developed allergic respiratory symptoms at the work-place underwent a clinical examination, rhinomanometry and investigation of their allergic status and respiratory function. One hundred twenty apprentices (20%) developed allergic respiratory reactions due to exposure to textile dust (exclusively cotton) during their training, with a positive withdrawal-re-exposure test. Conjunctivitis (14.3%) and rhinitis (8.5%) were the most frequent allergic symptoms. Twenty eight apprentices (4.6%) presented symptoms of asthma. Rhinitis was associated with asthma in 45% of cases. Two cases of asthma were diagnosed clinically at the work-place following their exposure to textile dust. The prick test performed in 120 symptomatic apprentices was positive in 41.6% of cases. There was sensitization to pollens in 29 cases and to dermatophagoides in 13 cases. Cotton and wool allergy was noted in two cases. Allergic symptoms developing during the training were significantly more frequent in the atopic group, and they varied according to the intensity of textile dust exposure. In the textile and clothing industry the frequency of respiratory disorders caused by allergens remains high, especially in atopic apprentices who constitute a population at high risk.

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

Martin, Olga A.; Molecular Radiation Biology Laboratory, Peter MacCallum Cancer Centre, East Melbourne, VIC; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC

Purpose: To determine whether radiation therapy (RT) could mobilize viable tumor cells into the circulation of non-small cell lung cancer (NSCLC) patients. Methods and Materials: We enumerated circulating tumor cells (CTCs) by fluorescence microscopy of blood samples immunostained with conventional CTC markers. We measured their DNA damage levels using γ-H2AX, a biomarker for radiation-induced DNA double-strand breaks, either by fluorescence-activated cell sorting or by immunofluorescence microscopy. Results: Twenty-seven RT-treated NSCLC patients had blood samples analyzed by 1 or more methods. We identified increased CTC numbers after commencement of RT in 7 of 9 patients treated with palliative RT, and inmore » 4 of 8 patients treated with curative-intent RT. Circulating tumor cells were also identified, singly and in clumps in large numbers, during RT by cytopathologic examination (in all 5 cases studied). Elevated γ-H2AX signal in post-RT blood samples signified the presence of CTCs derived from irradiated tumors. Blood taken after the commencement of RT contained tumor cells that proliferated extensively in vitro (in all 6 cases studied). Circulating tumor cells formed γ-H2AX foci in response to ex vivo irradiation, providing further evidence of their viability. Conclusions: Our findings provide a rationale for the development of strategies to reduce the concentration of viable CTCs by modulating RT fractionation or by coadministering systemic therapies.« less

Carbon Monoxide Poisoning After an Ice Storm in Kentucky, 2009

PubMed Central

Lutterloh, Emily C.; Iqbal, Shahed; Clower, Jacquelyn H.; Spillerr, Henry A.; Riggs, Margaret A.; Sugg, Tennis J.; Humbaugh, Kraig E.; Cadwell, Betsy L.; Thoroughman, Douglas A.

2011-01-01

Objectives. Carbon monoxide (CO) poisoning is a leading cause of morbidity and mortality during natural disasters. On January 26–27, 2009, a severe ice storm occurred in Kentucky, causing widespread, extended power outages and disrupting transportation and communications. After the storm, CO poisonings were reported throughout the state. The objectives of this investigation were to determine the extent of the problem, identify sources of CO poisoning, characterize cases, make recommendations to reduce morbidity and mortality, and develop prevention strategies. Methods. We obtained data from the Kentucky Regional Poison Center (KRPC), hyperbaric oxygen treatment (HBOT) facilities, and coroners. Additionally, the Kentucky Department for Public Health provided statewide emergency department (ED) and hospitalization data. Results. During the two weeks after the storm, KRPC identified 144 cases of CO poisoning; exposure sources included kerosene heaters, generators, and propane heaters. Hospitals reported 202 ED visits and 26 admissions. Twenty-eight people received HBOT. Ten deaths were attributed to CO poisoning, eight of which were related to inappropriate generator location. Higher rates of CO poisoning were reported in areas with the most ice accumulation. Conclusions. Although CO poisonings are preventable, they continue to occur in postdisaster situations. Recommendations include encouraging use of CO alarms, exploring use of engineering controls on generators to decrease CO exposure, providing specific information regarding safe use and placement of CO-producing devices, and using multiple communication methods to reach people without electricity. PMID:21563718

Esophageal lesions following button-battery ingestion in children: Analysis of causes and proposals for preventive measures.

PubMed

Lahmar, J; Célérier, C; Garabédian, E N; Couloigner, V; Leboulanger, N; Denoyelle, F

2018-04-01

To study recent cases of esophageal injury due to button-battery ingestion in children presenting in pediatric ENT emergency departments of the Paris area of France (Île-de-France region), in order to propose appropriate preventive measures. A retrospective descriptive single-center study included all children under 15 years of age, presenting in pediatric ENT emergency departments between January 2008 and April 2014 for button-battery ingestion with esophageal impaction requiring emergency removal. Twenty-two boys and 4 girls, with a median age of 25 months, were included. Twenty-five of the 26 batteries had diameters of 20mm or more. Median esophageal impaction time was 7 hours 30 minutes (range, 2 to 72 hours). The complications rate was 23%. Mean hospital stay cost was €38,751 (range, €5130-119,737). The origin of the battery was known in 23 of the 26 cases: remote control without screw-secured compartment (42.3%), open battery pack (15.4%), children's toy (15.3%), camera (7.7%), watch (1 case) and hearing aid without screw-secured compartment (1 case). Esophageal lesions due to ingestion of button-batteries in children are almost always due to batteries larger than 20mm in diameter, mostly from devices with a poorly protected compartment, or batteries that are not individually packaged. These lesions cause serious complications in a quarter of cases and their management entails high health costs. Legislation requiring screw-secured compartments and individual blisters for batteries could have prevented 69.2% of the ingestions. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Usability evaluation techniques in mobile commerce applications: A systematic review

NASA Astrophysics Data System (ADS)

Hussain, Azham; Mkpojiogu, Emmanuel O. C.

2016-08-01

Obviously, there are a number of literatures concerning the usability of mobile commerce (m-commerce) applications and related areas, but they do not adequately provide knowledge about usability techniques used in most of the empirical usability evaluation for m-commerce application. Therefore, this paper is aimed at producing the usability techniques frequently used in the aspect of usability evaluation for m-commerce applications. To achieve the stated objective, systematic literature review was employed. Sixty seven papers were downloaded in usability evaluation for m-commerce and related areas; twenty one most relevant studies were selected for review in order to extract the appropriate information. The results from the review shows that heuristic evaluation, formal test and think aloud methods are the most commonly used methods in m-commerce application in comparison to cognitive walkthrough and the informal test methods. Moreover, most of the studies applied control experiment (33.3% of the total studies); other studies that applied case study for usability evaluation are 14.28%. The results from this paper provide additional knowledge to the usability practitioners and research community for the current state and use of usability techniques in m-commerce application.

Finding the Right Mix: Teaching Methods as Predictors for Student Progress on Learning Objectives

ERIC Educational Resources Information Center

Glover, Jacob I.

2012-01-01

This study extends existing student ratings research by exploring how teaching methods, individually and collectively, influence a minimum standard of student achievement on learning objectives and how class size impacts this influence. Twenty teaching methods were used to predict substantial or exceptional progress on each of 12 learning…

Ultra-deep sequencing confirms immunohistochemistry as a highly sensitive and specific method for detecting BRAF V600E mutations in colorectal carcinoma.

PubMed

Rössle, Matthias; Sigg, Michèle; Rüschoff, Jan H; Wild, Peter J; Moch, Holger; Weber, Achim; Rechsteiner, Markus P

2013-11-01

The activating BRAF (V600) mutation is a well-established negative prognostic biomarker in metastatic colorectal carcinoma (CRC). A recently developed monoclonal mouse antibody (clone VE1) has been shown to detect reliably BRAF (V600E) mutated protein by immunohistochemistry (IHC). In this study, we aimed to compare the detection of BRAF (V600E) mutations by IHC, Sanger sequencing (SaS), and ultra-deep sequencing (UDS) in CRC. VE1-IHC was established in a cohort of 68 KRAS wild-type CRCs. The VE1-IHC was only positive in the three patients with a known BRAF (V600E) mutation as assessed by SaS and UDS. The test cohort consisted of 265 non-selected, consecutive CRC samples. Thirty-nine out of 265 cases (14.7%) were positive by VE1-IHC. SaS of 20 randomly selected IHC negative tumors showed BRAF wild-type (20/20). Twenty-four IHC-positive cases were confirmed by SaS (24/39; 61.5%) and 15 IHC-positive cases (15/39; 38.5%) showed a BRAF wild-type by SaS. UDS detected a BRAF (V600E) mutation in 13 of these 15 discordant cases. In one tumor, the mutation frequency was below our threshold for UDS positivity, while in another case, UDS could not be performed due to low DNA amount. Statistical analysis showed sensitivities of 100% and 63% and specificities of 95 and 100% for VE1-IHC and SaS, respectively, compared to combined results of SaS and UDS. Our data suggests that there is high concordance between UDS and IHC using the anti-BRAF(V600E) (VE1) antibody. Thus, VE1 immunohistochemistry is a highly sensitive and specific method in detecting BRAF (V600E) mutations in colorectal carcinoma.

The role of human papillomavirus in p16-positive oral cancers.

PubMed

Belobrov, Simone; Cornall, Alyssa M; Young, Richard J; Koo, Kendrick; Angel, Christopher; Wiesenfeld, David; Rischin, Danny; Garland, Suzanne M; McCullough, Michael

2018-01-01

The aim of this study was to identify the presence and frequency of human papillomavirus (HPV) nucleic acid in p16-positive oral squamous cell carcinomas (OSCCs), to assess whether the virus was transcriptionally active and to assess the utility of p16 overexpression as a surrogate marker for HPV in OSCC. Forty-six OSCC patients treated between 2007 and 2011 with available formalin-fixed paraffin-embedded (FFPE) specimens were included. Twenty-three patients were positive for p16 by immunohistochemistry (IHC) and these were matched with 23 patients with p16-negative tumours. Laser capture microdissection of the FFPE OSCC tissues was undertaken to isolate invasive tumour tissue. DNA was extracted and tested for high-risk HPV types using a PCR-ELISA method based on the L1 SPF10 consensus primers, and a real-time PCR method targeting HPV-16 and HPV-18 E6 region. Genotyping of HPV-positive cases was performed using a reverse line blot hybridization assay (Inno-LiPA). RNAScope ® (a chromogenic RNA in situ hybridization assay) was utilized to detect E6/E7 mRNA of known high-risk HPV types for detection of transcriptionally active virus. HPV DNA was found in 3 OSCC cases, all of which were p16 IHC-positive. Two cases were genotyped as HPV-16 and one as HPV-33. Only one of the HPV-16 cases was confirmed to harbour transcriptionally active virus via HPV RNA ISH. We have shown that the presence of transcriptionally active HPV rarely occurs in OSCC and that p16 is not an appropriate surrogate marker for HPV in OSCC cases. We propose that non-viral mechanisms are responsible for the majority of IHC p16 overexpression in OSCC. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Microbiological Characteristics of Acute Prostatitis After Transrectal Prostate Biopsy

PubMed Central

Bang, Jun-Ho; Choe, Hyun-Sop; Lee, Dong-Sup; Lee, Seung-Ju

2013-01-01

Purpose We aimed to identify microbiological characteristics in patients with acute prostatitis after transrectal prostate biopsy to provide guidance in the review of prevention and treatment protocols. Materials and Methods A retrospective analysis of medical records was performed in 1,814 cases who underwent prostate biopsy at Seoul St. Mary's Hospital and St. Vincent's Hospital over a 5 year period from 2006 to 2011. Cases in which acute prostatitis occurred within 7 days after the biopsy were investigated. Before starting treatment with antibiotics, sample collections were done for culture of urine and blood. Culture and drug susceptibility was identified by use of a method established by the Clinical and Laboratory Standards Institute. Results A total of 1,814 biopsy procedures were performed in 1,541 patients. For 1,246 patients, the procedure was the first biopsy, whereas for 295 patients it was a repeat biopsy. Twenty-one patients (1.36%) were identified as having acute bacterial prostatitis after the biopsy. Fifteen patients (1.2%) had acute prostatitis after the first biopsy, and 6 patients (2.03%) experienced acute prostatitis after a repeat biopsy. Even though the incidence of acute bacterial prostatitis was higher after repeat biopsy than that after the first biopsy, there was no statistically significant intergroup difference in terms of incidence (χ2=1.223, p=0.269). When the collected urine and blood samples were cultured, Escherichia coli was found in samples from 15 patients (71.4%), Klebsiella pneumoniae in 3 patients (14.3%), Enterobacter intermedius in 1 patient (4.8%), E. aerogenes in 1 patient (4.8%), and Pseudomonas aeruginosa in 1 patient (4.8%). A fluoroquinolone-resistant strain was confirmed in 5 cases (23.8%) in total. Three cases of E. coli and 1 case of Klebsiella had extended-spectrum β-lactamase activity. Conclusions Empirical treatment of acute prostatitis should be done with consideration of geographical prevalence and drug resistance. This study will provide meaningful information for the management of acute prostatitis after transrectal prostate biopsy. PMID:23550205

Arthroscopy in the early diagnosis of injuries to the knee joint.

PubMed

Lysholm, J; Gillquist, J; Liljedahl, S O

1981-02-01

In a series of 192 patients with acute knee injuries the diagnosis at arthroscopy was compared with the clinical diagnosis with or without confirmation at arthrotomy. Arthroscopy was used in 117 cases, clinical examination in 72 cases, and arthrography in 3 cases. All patients presented for diagnosis and treatment within 4 weeks of injury, and most within 1 week. The anterior cruciate ligament (ACL) was torn in 100 cases, and in 92 this was the main injury. The incidence of complete, isolated ACL tear was 1.5 per cent. ACL tear occurred in a higher proportion of cases in the arthroscopy group compared with diagnosis by other methods. An ACL tear was usually combined with injury to the medial ligament complex. Twenty-five patients showed tear of the posterior cruciate ligament (PCL), and in one-third of these there was also injury to the ACL. The medial ligaments were injured in 77 per cent of the whole series and this was the predominant lesion in 57 cases. Tear of the postero-medial capsular ligament (PMCL) was found in more than half of our patients. The ratio lateral/medial meniscus tear was 1:1.6 in the arthroscopy group and 1:27 in the group where arthroscopy was not undertaken. Arthroscopy resulted in an increase in the number of components of injury identified owing to improved diagnosis of tears of the ACL, the PMCL, the lateral meniscus, and possibly also of the PCL. There were no complication or side-effects of arthroscopy. In 93 per cent of cases primary suture was done. Reconstruction was rarely necessary if operation was undertaken within 2 weeks of injury.

Human infections due to Staphylococcus pseudintermedius, an emerging zoonosis of canine origin: report of 24 cases.

PubMed

Somayaji, R; Priyantha, M A R; Rubin, J E; Church, D

2016-08-01

Staphylococcus pseudintermedius has been recently identified as a novel species within the genus Staphylococcus, and is commonly associated with infections in dogs. Currently, there are few reports of human infections due to this bacterium. To use a population-based approach to describe the characteristics of human S. pseudintermedius infections in a large Canadian healthcare region. All adult cases aged ≥18 years identified at a large regional laboratory from April 1, 2013 to April 1, 2015 who had at least one positive culture for S. pseudintermedius were retrospectively reviewed. A combination of phenotypic methods, mass spectrometry (i.e., MALDI-TOF), and cpn60 sequencing were used to identify S. pseudintermedius. Chart review was conducted, and cases were analysed descriptively. Twenty-seven isolates of S. pseudintermedius from 24 human cases were included for analysis. 58.3% were male with median age of 61 years (IQR 55-70.5). Most patients [22 (92.1%)] had confirmed contact with dogs at time of infection. S. pseudintermedius was isolated in 18 cases (75.0%) of skin and soft tissue infections (SSTI), and 2 invasive cases (8.3%) including a prosthetic joint and bloodstream infection. The other 4 patients were considered to be colonized (skin - 3; lung - 1). Methicillin resistance was identified in 3 cases with 6 total isolates (22.2%); multi-drug resistance was also demonstrated commonly. S. pseudintermedius is most commonly associated with SSTIs in humans. Transmission probably occurs from a pet dog. Species-level identification of S. pseudintermedius is important due to the high prevalence of antibiotic resistance, particularly to methicillin. Copyright © 2016 Elsevier Inc. All rights reserved.

Spatial and Temporal Patterns of Locally-Acquired Dengue Transmission in Northern Queensland, Australia, 1993–2012

PubMed Central

Naish, Suchithra; Dale, Pat; Mackenzie, John S.; McBride, John; Mengersen, Kerrie; Tong, Shilu

2014-01-01

Background Dengue has been a major public health concern in Australia since it re-emerged in Queensland in 1992–1993. We explored spatio-temporal characteristics of locally-acquired dengue cases in northern tropical Queensland, Australia during the period 1993–2012. Methods Locally-acquired notified cases of dengue were collected for northern tropical Queensland from 1993 to 2012. Descriptive spatial and temporal analyses were conducted using geographic information system tools and geostatistical techniques. Results 2,398 locally-acquired dengue cases were recorded in northern tropical Queensland during the study period. The areas affected by the dengue cases exhibited spatial and temporal variation over the study period. Notified cases of dengue occurred more frequently in autumn. Mapping of dengue by statistical local areas (census units) reveals the presence of substantial spatio-temporal variation over time and place. Statistically significant differences in dengue incidence rates among males and females (with more cases in females) (χ2 = 15.17, d.f. = 1, p<0.01). Differences were observed among age groups, but these were not statistically significant. There was a significant positive spatial autocorrelation of dengue incidence for the four sub-periods, with the Moran's I statistic ranging from 0.011 to 0.463 (p<0.01). Semi-variogram analysis and smoothed maps created from interpolation techniques indicate that the pattern of spatial autocorrelation was not homogeneous across the northern Queensland. Conclusions Tropical areas are potential high-risk areas for mosquito-borne diseases such as dengue. This study demonstrated that the locally-acquired dengue cases have exhibited a spatial and temporal variation over the past twenty years in northern tropical Queensland, Australia. Therefore, this study provides an impetus for further investigation of clusters and risk factors in these high-risk areas. PMID:24691549

Clinical and epidemiological features of patients with clonorchiasis.

PubMed

Wang, Ke-Xia; Zhang, Rong-Bo; Cui, Yu-Bao; Tian, Ye; Cai, Ru; Li, Chao-Pin

2004-02-01

To study the clinical and epidemiological features of patients with clonorchiasis so as to provide scientific evidences for the diagnosis and prevention of clonorchiasis. Stools from 282 subjects suspected of having clonorchiasis were examined for helminth eggs with modified Kato's thick smear and sedimentation methods, and their sera were tested for HAV-DNA, HBV-DNA, HCV-RNA, HDV-RNA and HEV-RNA with polymerase chain reaction (PCR). Clinical symptoms of patients with clonorchiasis only were analyzed, and their blood samples were tested for circulating antigen (CAg) with Dot-ELISA, eosinophilic granulocyte count, and alanine aminotransferase (ALT). Meanwhile, they were asked to provide data of occupation, eating habit, hygienic habit and knowledge of clonorchiasis. In addition, the ecosystem of the environment in epidemic areas was surveyed. Among the 282 patients, 61 (21.43%) were infected with clonorchis sinensis only, 97 (34.64%) were co-infected with clonorchis sinensis and other pathogens, 92 (32.86%) were infected with hepatitis virus only and 31 (11.07%) neither with clonorchis sinensis nor hepatitis virus. Among the 61 patients with clonorchiasis only, there were 14 (22.95%) subjects with discomfort over hepatic region or epigasfrium, 12 (19.67%) with general malaise or discomfort and inertia in total body, 6 (9.84%) with anorexia, indigestion and nausea, 4 (6.56%) with fever, dizziness and headache (6.56%), and 25 (40.98%) without any symptoms; sixty one (100%) with CAg (+), 98.33% (59/60) with eosinophilic granulocytes increased and 65.00% (39/60) with ALT increased. B-mode ultrasonography revealed 61 cases with dilated and thickened walls of intrahepatic bile duct, and blurred patchy echo acoustic image in liver. Twenty-six cases had stones in the bile duct, 39 cases had slightly enlarged liver with diffuse coarse spots in liver parenchyma. Twenty cases had enlarged gallbladder with thickened coarse wall and image of floating plagues, 9 cases had slightly enlarged spleen. By analysis of epidemiological data, we found that the ecologic environment was favorable for the epidemiology of clonorchiasis. Most patients with clonorchiasis were lack of knowledge about the disease. Their living environment, hygienic habits, eating habits and their occupations were the related factors that caused the prevalence of the disease. The clinical symptoms of clonorchiasis are non-specific, and the main evidences for diagnosis of clonorchiasis should be provided by etiologic examination, B-mode ultrasonography and clinical history. The infection of clonorchis sinensis is related to occupations, bad eating habits and lack of knowledge about prevention of the disease.

Clinical features and management of facial nerve paralysis in children: analysis of 24 cases.

PubMed

Cha, H E; Baek, M K; Yoon, J H; Yoon, B K; Kim, M J; Lee, J H

2010-04-01

To evaluate the causes, treatment modalities and recovery rate of paediatric facial nerve paralysis. We analysed 24 cases of paediatric facial nerve paralysis diagnosed in the otolaryngology department of Gachon University Gil Medical Center between January 2001 and June 2006. The most common cause was idiopathic palsy (16 cases, 66.7 per cent). The most common degree of facial nerve paralysis on first presentation was House-Brackmann grade IV (15 of 24 cases). All cases were treated with steroids. One of the 24 cases was also treated surgically with facial nerve decompression. Twenty-two cases (91.6 per cent) recovered to House-Brackmann grade I or II over the six-month follow-up period. Facial nerve paralysis in children can generally be successfully treated with conservative measures. However, in cases associated with trauma, radiological investigation is required for further evaluation and treatment.

What Second Generation Deaf Students Bring to the Reading Task: Another Case for Metalinguistics and Reading.

ERIC Educational Resources Information Center

Hirsh-Pasek, Kathy

Twenty-five second generation deaf signers (6-16 years old) participated in three experiments measuring their ability to classify fingerspelled and signed words and attend to the individual handshapes within fingerspelled words. Results revealed that Ss could discriminate fingerspelled words and decompose fingerspelling into the handshapes that…

The Case for the Relevant University

ERIC Educational Resources Information Center

Botman, H. R.

2011-01-01

Stellenbosch University has gone through a serious engagement with the topic of a pedagogy of hope. The engagement included the initial proposal of Paulo Friere, the South American educationist, bearing the imprints of the twentieth century and the new ways in which intellectuals are revisiting the critical pedagogy of hope for the twenty first…

Regionalizing Postsecondary Education for the Twenty-First Century: Promising Innovations and Capacity Challenges

ERIC Educational Resources Information Center

Phelps, L. Allen

2012-01-01

In this article, separate sections examine the anchoring ingredients of the regional strategies through which two-year colleges are responding to local, regional, and in some cases broader needs deemed critical to generating and sustaining economic productivity and other forms of social and civic capital. First, drawing on recent European…

Innovations in Learning and Development: A Case from the Arab World

ERIC Educational Resources Information Center

Al-Khatib, Hyat

2014-01-01

The twenty-first century is witnessing innovative practices in the advancement of learning in the developed world as a consequence of the technological revolution of the period and the increased demand for higher education (Bax, 2011; Barab, King and Gray, 2004; Roman, 2001). Education is perceived as the cornerstone for development,…

Design under Constraints: The Case of Large-Scale Assessment Systems

ERIC Educational Resources Information Center

Mislevy, Robert J.

2010-01-01

In "Updating the Duplex Design for Test-Based Accountability in the Twenty-First Century," Bejar and Graf (2010) propose extensions to the duplex design for large-scale assessment presented in Bock and Mislevy (1988). Examining the range of people who use assessment results--from students, teachers, administrators, curriculum designers,…

Strategic Organizational Engagement in Social Media to Motivate Directed Action

ERIC Educational Resources Information Center

Heath, Donald Ray, Jr.

2014-01-01

Little is known regarding organizations' high-level strategies toward social media. This research develops an empirically informed understanding of how organizations can engage in social media to accomplish their strategic goals. To develop an in formed understanding, I conduct interpretive case research over a twenty-four month period on a single…

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

ERIC Educational Resources Information Center

Contreras, Frances

2009-01-01

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

Outcomes of Synergetic Peer Assessment: First-Year Experience

ERIC Educational Resources Information Center

Hodgson, Paula; Chan, Kitty; Liu, Justina

2014-01-01

Active participation in learning activities and reviewing assessment activity can facilitate learners engaged in these processes. This case study reports student experiences of the process of peer assessment with teacher guidance in a group project for a first-year nursing course with 153 students. Twenty groups of students were assigned roles in…

Towards Student-Centred Conceptions of Teaching: The Case of Four Ethiopian Universities

ERIC Educational Resources Information Center

Degago, Adinew Tadesse; Kaino, Luckson Muganyizi

2015-01-01

This study explored instructors' conceptions of teaching in view of the existing calls for improving the quality of teaching at higher education in Ethiopia. Twenty university instructors were interviewed using a phenomenographic approach, a popular research procedure to explore variation in the ways instructors experience and understand teaching.…

Case Study Research: Training Interdisciplinary Engineers with Context-Dependent Knowledge

ERIC Educational Resources Information Center

Chanan, Amit; Vigneswaran, Saravanamuth; Kandasamy, Jaya

2012-01-01

It is now widely acknowledged that water management discipline is transforming, from being a public health and flood prevention challenge of the nineteenth century to a multi-dimensional challenge of water security for the twenty-first century. In order to train water engineers to be capable of working with this holistic multi-dimensional…

Methodologies for Teaching English to Adult Students in Spanish Vocational Education Programs

ERIC Educational Resources Information Center

Castañeda, Sergio Bernal

2016-01-01

This paper explores strategies used by teachers of English in Spain to compensate for learning limitations associated with student age. As part of a qualitative study of multiple cases, twenty teachers from different vocational programs volunteered to participate in semi-structured interviews. The interviews revealed the difficulties that older…

From Teachers to Teacher-Leaders: A Case Study

ERIC Educational Resources Information Center

Riveros, Augusto; Newton, Paul; da Costa, José

2013-01-01

This paper reports on a study of teacher leadership conducted in Alberta, Canada. Twenty-one school teachers and administrators were interviewed about their experiences with a provincial teacher-leader program in which they participated from 1997 to 2007. The participants were asked questions related to their experience in the program and how…

Assessing English Teachers as a Foreign Language (EFL) Telecollaborative Competence: A Case Study from Saudi Arabia

ERIC Educational Resources Information Center

Al Khateeb, Ahmed Abdulateef

2018-01-01

The role of telecollaborative competence has become vital among twenty-first century English language teachers. Yet, the reinforcement of this competence with its establishment within educational systems is not always straightforward; particularly in traditional educational settings. Looking at telecollaborative competence amongst English as a…

Youth Organizing: From Youth Development to School Reform

ERIC Educational Resources Information Center

Warren, Mark R.; Mira, Meredith; Nikundiwe, Thomas

2008-01-01

Over the past twenty years, youth organizing has grown across the country. Through organizing, young people identify issues of concern and mobilize their peers to build action campaigns to achieve their objectives. Youth organizing has been appreciated for its contributions to youth and community development. The authors use two case studies to…

Factors Influencing Enrolment: A Case Study from Birth to Twenty, the 1990 Birth Cohort in Soweto-Johannesburg

ERIC Educational Resources Information Center

Richter, Linda M.; Panday, Saadhna; Norris, Shane A.

2009-01-01

Longitudinal studies offer significant advantages in rendering data commensurate with the complexity of human development. However, incomplete enrolment and attrition over time can introduce bias. Furthermore, there is a scarcity of evaluative information on cohorts in developing countries. This paper documents various strategies adopted to…

Investigating Lebanese Grade Seven Biology Teachers Mathematical Knowledge and Skills: A Case Study

ERIC Educational Resources Information Center

Raad, Nawal Abou; Chatila, Hanadi

2016-01-01

This paper investigates Lebanese grade 7 biology teachers' mathematical knowledge and skills, by exploring how they explain a visual representation in an activity depending on the mathematical concept "Function". Twenty Lebanese in-service biology teachers participated in the study, and were interviewed about their explanation for the…

NMR-Metabolic Methodology in the Study of GM Foods

USDA-ARS?s Scientific Manuscript database

The 1H NMR methodology used in the study of genetically modified (GM) foodstuff is discussed. The study of transgenic lettuce (Lactuca sativa cv "Luxor") over-expressing the KNAT1 gene from Arabidopsis is presented as a novel study-case. The 1H NMR metabolic profiling was carried out. Twenty-two wat...

Education in the New Millennium: The Case for Design-Based Learning

ERIC Educational Resources Information Center

Lee, Hyun-Kyung; Breitenberg, Mark

2010-01-01

This article focuses on current examples of project or design-based learning at the secondary school level in the context of the increasing importance of creativity and innovative thinking in the twenty-first century. The authors argue that students today learn more effectively in pedagogical practices that emphasise holistic thinking, active…

Analysing Students' Engagement and Learning Presence in an Educational Blog Community

ERIC Educational Resources Information Center

Angelaina, Sophia; Jimoyiannis, Athanassios

2012-01-01

This paper reports on a case study investigating students' participation and learning presence in an educational blog implemented as a cross-thematic inquiry activity exploring and debating on the acid rain problem. Twenty-one secondary education students (14-15 years aged), coming from two separate classes, were involved. The content and…

Twenty-First Century Learning after School: The Case of 4-H

ERIC Educational Resources Information Center

Kress, Cathann

2006-01-01

4-H Youth Development is an educational movement founded to create opportunities for youth to understand their dependence on nature's resources and to value the fullest development of hand, head, and heart. It originated in the 1900s as "four-square education": educational development, fellowship development, physical development, and moral…

Collaboration, Intragroup Conflict, and Social Skills in Project-Based Learning

ERIC Educational Resources Information Center

Lee, Dabae; Huh, Yeol; Reigeluth, Charles M.

2015-01-01

This case study was conducted in two high school classrooms that utilized collaborative project-based learning (PBL). Collaboration is an important instructional strategy, especially used in conjunction with PBL, and is an essential learning outcome for the twenty-first century. This study examined how collaboration can be achieved as a learning…

The Twenty-First Century Multiple Generation Workforce: Overlaps and Differences but Also Challenges and Benefits

ERIC Educational Resources Information Center

Helyer, Ruth; Lee, Dionne

2012-01-01

Purpose: The purpose of this paper is to explore the issues around a multiple generational workforce and more specifically, the challenges and benefits for education providers and employers. Design/methodology/approach: Reviewing research papers, analysing academic texts, interrogating market intelligence and contextualising case studies, the…

Influence of Voluntary Coffee Certifications on Cooperatives' Advisory Services and Agricultural Practices of Smallholder Farmers in Costa Rica

ERIC Educational Resources Information Center

Snider, Anna; Kraus, Eva; Sibelet, Nicole; Bosselmann, Aske Skovmand; Faure, Guy

2016-01-01

Purpose: This article explores how voluntary certifications influence the way cooperatives provide advisory services to their members and the influence of these services on agricultural practices. Design/Methodology/Approach: Case studies were conducted in four representative Costa Rican cooperatives interviewing twenty interviewed cooperative…

Keeping "Community" in a Community Land Trust

ERIC Educational Resources Information Center

Gray, Karen A.; Galande, Mugdha

2011-01-01

This instrumental case study examined the role of grassroots community organizing in a community land trust (CLT) in a southern U.S. city. Twenty-nine homeowners, renters, board members, community members, and current and former CLT employees were interviewed. In addition, two focus groups of 11 and six participants composed of CLT residents and…

16 CFR 2.7 - Compulsory process in investigations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... demand, or, if the return date is less than twenty (20) days after service, prior to the return date..., issue a subpoena or a civil investigative demand directing the person named therein to appear before a... both, or, in the case of a civil investigative demand, to provide a written report or answers to...

16 CFR 2.7 - Compulsory process in investigations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... demand, or, if the return date is less than twenty (20) days after service, prior to the return date..., issue a subpoena or a civil investigative demand directing the person named therein to appear before a... both, or, in the case of a civil investigative demand, to provide a written report or answers to...

Application Development Methodology Appropriateness: An Exploratory Case Study Bridging the Gap between Framework Characteristics and Selection

ERIC Educational Resources Information Center

Williams, Lawrence H., Jr.

2013-01-01

This qualitative study analyzed experiences of twenty software developers. The research showed that all software development methodologies are distinct from each other. While some, such as waterfall, focus on traditional, plan-driven approaches that allow software requirements and design to evolve; others facilitate ambiguity and uncertainty by…

University Lecturers' and Students' Views on Mass Education: A Case Study of Great Zimbabwe University

ERIC Educational Resources Information Center

Mapako, Felix; Mareva, Rugare; Gonye, Jairos; Gamira, Daniel

2012-01-01

The study focused on university lecturers' and students' views on mass education at university level. The inquiry employed both a qualitative and quantitative research design in which twenty lecturers were purposively sampled and interviewed using semi-structured interview guides.A semi-structured questionnaire was also administered to fifty…

Identifying Threshold Concepts in the Careers of Educational Developers

ERIC Educational Resources Information Center

Timmermans, Julie A.

2014-01-01

The purpose of this multiple case study was to identify threshold concepts in the careers of educational developers. Twenty-one common threshold concepts emerged, with one threshold concept common among all participants: Facilitating a change process. The remaining 20 threshold concepts were captured in the following three categories: (1) Ways of…

Microbial diversity on commercial eggs as affected by the production system. A first approach using PGM.

PubMed

Neira, Carmen; Laca, Amanda; Laca, Adriana; Díaz, Mario

2017-12-04

A novel DNA-based technique (PGM) has been employed for first time to analyse commercial eggs with the advantage of allowing an exhaustive identification of the microbiota present. Eggs from two different production systems, i.e. a free range system and a cage system, were analysed. Twenty-one and twenty-two phyla were identified on the surface of cage system and free range system eggs, respectively. In both cases, Firmicutes was the dominant phylum (representing around 50% of total phyla), being found families frequently reported to be present in the intestinal microbiota of chickens or hens, such as Clostridiaceae, Ruminococcaceae and Lachnospiraceae. Additionally, other phyla and families not previously described in association with eggshells could also be identified in this work. Most of the potential pathogenic genera associated with eggs (Salmonella, Clostridium, Helicobacter, Pseudomonas and Staphylococcus) showed higher incidence in eggs coming from cage systems than in eggs coming from free range systems, although the abundance of these genera were very low in both cases (<5% of total bacteria). Copyright © 2017 Elsevier B.V. All rights reserved.

Botulinum toxin in the treatment of refractory vaginismus.

PubMed

Ghazizadeh, Shirin; Nikzad, Masoomeh

2004-11-01

To investigate the efficacy of botulinum toxin injection to treat women with moderate and severe vaginismus. Twenty-four women referred to our clinic from February 2002 to February 2004 (mean age 25 years; range 19-34 years) with third- to fourth-degree vaginismus were recruited for this study. These women had previous unsuccessful treatments. Botulinum toxin (150-400 mIU) was injected into the puborectalis muscles in 3 sites on each side of the vagina. Twenty-three patients (95.8%) had vaginal examinations 1 week postoperatively that showed little or no vaginismus, 18 (75%) achieved satisfactory intercourse after the first injection, 4 (16.7%) had mild pain, 1 was cured after a second injection, 1 patient refused vaginal examination and did not attempt to have coitus, and another had no coitus as a result of her husband's secondary impotence. The women were followed up for a mean of 12.3 months (range 2-24 months), and there were no cases of recurrence. In refractory cases of vaginismus when conventional therapies have failed, local injection of botulinum toxin can be considered. III.

IRMS detection of testosterone manipulated with 13C labeled standards in human urine by removing the labeled 13C.

PubMed

Wang, Jingzhu; Yang, Rui; Yang, Wenning; Liu, Xin; Xing, Yanyi; Xu, Youxuan

2014-12-10

Isotope ratio mass spectrometry (IRMS) is applied to confirm testosterone (T) abuse by determining the carbon isotope ratios (δ(13)C value). However, (13)C labeled standards can be used to control the δ(13)C value and produce manipulated T which cannot be detected by the current method. A method was explored to remove the (13)C labeled atom at C-3 from the molecule of androsterone (Andro), the metabolite of T in urine, to produce the resultant (A-nor-5α-androstane-2,17-dione, ANAD). The difference in δ(13)C values between Andro and ANAD (Δδ(13)CAndro-ANAD, ‰) would change significantly in case manipulated T is abused. Twenty-one volunteers administered T manipulated with different (13)C labeled standards. The collected urine samples were analyzed with the established method, and the maximum value of Δδ(13)CAndro-ANAD post ingestion ranged from 3.0‰ to 8.8‰. Based on the population reference, the cut-off value of Δδ(13)CAndro-ANAD for positive result was suggested as 1.2‰. The developed method could be used to detect T manipulated with 3-(13)C labeled standards. Copyright © 2014 Elsevier B.V. All rights reserved.

Arthrodesis of the knee following failed arthroplasty.

PubMed

Van Rensch, P J H; Van de Pol, G J; Goosen, J H M; Wymenga, A B; De Man, F H R

2014-08-01

Primary stability in arthrodesis of the knee can be achieved by external fixation, intramedullary nailing or plate fixation. Each method has different features and results. We present a practical algorithm for arthrodesis of the knee following a failed (infected) arthroplasty, based on our own results and a literature review. Between 2004 and 2010, patients were included with an indication for arthrodesis after failed (revision) arthroplasty of the knee. Patients were analyzed with respect to indication, fusion method and bone contact. End-point was solid fusion. Twenty-six arthrodeses were performed. Eighteen patients were treated because of an infected arthroplasty. In total, ten external fixators, ten intramedullary nails and six plate fixations were applied; solid fusion was achieved in 3/10, 8/10 and 3/6, respectively. There is no definite answer as to which method is superior in performing an arthrodesis of the knee. Intramedullary nailing achieved the best fusion rates, but was used most in cases without--or cured--infection. Our data and the contemporary literature suggest that external fixation can be abandoned as standard fusion method, but can be of use following persisting infection. The Ilizarov circular external fixator, however, seems to render high fusion rates. Good patient selection and appropriate individual treatment are the key to a successful arthrodesis. Based upon these findings, a practical algorithm was developed.

Paratrooper's ankle fracture: posterior malleolar fracture.

PubMed

Young, Ki Won; Kim, Jin-su; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai

2015-03-01

We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to undergo surgical repairs.

Listeria monocytogenes endophthalmitis - case report and review of risk factors and treatment outcomes.

PubMed

Bajor, Anna; Luhr, Anke; Brockmann, Dorothee; Suerbaum, Sebastian; Framme, Carsten; Sedlacek, Ludwig

2016-07-16

The majority of cases of endophthalmitis are caused by exogenous pathogens; only 5-10 % are of endogenous origin. One cause of these rare cases of endogenous endophthalmitis is Listeria monocytogenes. Twenty-six cases of endophthalmitis due to this pathogen have been published over the last twenty years. The aim of this review is to summarize the main risk factors and common clinical findings of endogenous endophthalmitis due to Listeria monocytogenes. We report on a 62-year-old female presenting with a sterile hypopyon iritis with secondary glaucoma and an underlying rheumatoid disease. In microbiological analysis we identified Listeria monocytogenes. Further we searched through all published cases for typical signs, risk factors, details of medical and surgical treatment and outcome of endogenous endophthalmitis due to this rare pathogen. Ocular symptoms in almost all of these published cases included pain, redness of the eye, and decreased vision. Main clinical features included elevated intraocular pressure and fibrinous anterior chamber reaction, as well as a dark hypopyon. While the infection is typically spread endogenously, neither an exogenous nor endogenous source of infection could be identified in most cases. Immunocompromised patients are at higher risk of being infected than immunocompetent patients. The clinical course of endophthalmitis caused by Listeria monocytogenes had different visual outcomes. In some cases, the infection led to enucleation, blindness, or strong visual loss, whereas most patients showed a tendency of visual improvement during therapy. Early diagnosis and treatment initiation are crucial factors in the outcome of endogenous endophthalmitis caused by Listeria monocytogenes. This possible differential diagnosis should be kept in mind while treating patients with presumable sterile hypopyon and anterior uveitis having a high intraocular pressure. A bacterial source should be considered with a prompt initiation of systemic antibiotic treatment, mainly in immunocompromised patients, who develop endogenous anterior uveitis. An appropriate microbiological sampling is essential to detect atypical microorganisms and to choose an effective antibiotic treatment.

Analytical Performance of a Multiplex Real-Time PCR Assay Using TaqMan Probes for Quantification of Trypanosoma cruzi Satellite DNA in Blood Samples

PubMed Central

Abate, Teresa; Cayo, Nelly M.; Parrado, Rudy; Bello, Zoraida Diaz; Velazquez, Elsa; Muñoz-Calderon, Arturo; Juiz, Natalia A.; Basile, Joaquín; Garcia, Lineth; Riarte, Adelina; Nasser, Julio R.; Ocampo, Susana B.; Yadon, Zaida E.; Torrico, Faustino; de Noya, Belkisyole Alarcón; Ribeiro, Isabela; Schijman, Alejandro G.

2013-01-01

Background The analytical validation of sensitive, accurate and standardized Real-Time PCR methods for Trypanosoma cruzi quantification is crucial to provide a reliable laboratory tool for diagnosis of recent infections as well as for monitoring treatment efficacy. Methods/Principal Findings We have standardized and validated a multiplex Real-Time quantitative PCR assay (qPCR) based on TaqMan technology, aiming to quantify T. cruzi satellite DNA as well as an internal amplification control (IAC) in a single-tube reaction. IAC amplification allows rule out false negative PCR results due to inhibitory substances or loss of DNA during sample processing. The assay has a limit of detection (LOD) of 0.70 parasite equivalents/mL and a limit of quantification (LOQ) of 1.53 parasite equivalents/mL starting from non-boiled Guanidine EDTA blood spiked with T. cruzi CL-Brener stock. The method was evaluated with blood samples collected from Chagas disease patients experiencing different clinical stages and epidemiological scenarios: 1- Sixteen Venezuelan patients from an outbreak of oral transmission, 2- Sixty three Bolivian patients suffering chronic Chagas disease, 3- Thirty four Argentinean cases with chronic Chagas disease, 4- Twenty seven newborns to seropositive mothers, 5- A seronegative receptor who got infected after transplantation with a cadaveric kidney explanted from an infected subject. Conclusions/Significance The performing parameters of this assay encourage its application to early assessment of T. cruzi infection in cases in which serological methods are not informative, such as recent infections by oral contamination or congenital transmission or after transplantation with organs from seropositive donors, as well as for monitoring Chagas disease patients under etiological treatment. PMID:23350002

50 Years of the Macedonian Academy of Sciences and Arts 1967-2017 and 48 Years of Publishing the Journal Prilozi (Contributions) of MASA.

PubMed

Polenakovic, Momir; Pop-Jordanova, Nada; Gucev, Zoran

2017-12-01

Papers on medical subjects have been published since the first issue of the journal Prilozi in 1969, totalling a number of of 957 (nine hundred and fifty seven) papers have been published in Prilozi. Two hundred and twenty nine cover subjects on natural sciences and mathematics, and 728 (seven hundred and twenty eight) subjects on medical sciences. So far, 2017 No. XXXVIII-2, 622 (six hundred and twenty two) papers published in Prilozi are in Pubmed. Prilozi is published three times a year and it is covered by the following services: Baidu Scholar, Case, Celdes, CNKI Scholar (China National Knowledge Infrastructure), CNPIEC, DOAJ (Directory of Open Access Journals), EBSCO (relevant databases), EBSCO Discovery Service, Elsevier - SCOPUS, Google Scholar, J-Gate, JournalTOCs, KESLI-NDSL (Korean National Discovery for Science Leaders), Naviga (Softweco), Primo Central (ExLibris), Publons, PubMed, ReadCube, ResearchGate, SCImago (SJR), Summon (Serials Solutions/ProQuest), TDNet, Ulrich's Periodicals Directory/ulrichsweb WanFang Data, WorldCat (OCLC).

Fourier plane filters

NASA Technical Reports Server (NTRS)

Oliver, D. S.; Aldrich, R. E.; Krol, F. T.

1972-01-01

An electrically addressed liquid crystal Fourier plane filter capable of real time optical image processing is described. The filter consists of two parts: a wedge filter having forty 9 deg segments and a ring filter having twenty concentric rings in a one inch diameter active area. Transmission of the filter in the off (transparent) state exceeds fifty percent. By using polarizing optics, contrast as high as 10,000:1 can be achieved at voltages compatible with FET switching technology. A phenomenological model for the dynamic scattering is presented for this special case. The filter is designed to be operated from a computer and is addressed by a seven bit binary word which includes an on or off command and selects any one of the twenty rings or twenty wedge pairs. The overall system uses addressable latches so that once an element is in a specified state, it will remain there until a change of state command is received. The drive for the liquid crystal filter is ? 30 V peak at 30 Hz to 70 Hz. These parameters give a rise time for the scattering of 20 msec and a decay time of 80 to 100 msec.

Case Method in COPD education for primary care physicians: study protocol for a cluster randomised controlled trial.

PubMed

Sandelowsky, Hanna; Krakau, Ingvar; Modin, Sonja; Ställberg, Björn; Nager, Anna

2017-04-27

Chronic obstructive pulmonary disease (COPD) is a common cause of morbidity and mortality worldwide. It is often undiagnosed and insufficiently managed. Effective forms of continuing medical education (CME) for primary care physicians (PCPs) are necessary to ensure the implementation of guidelines in clinical practice and, thus, improve patients' health. In this study, we will measure the effects of CME by Case Method and compare them against those of traditional lectures and no CME at all through an unblinded, cluster randomised controlled trial (CRCT). Thirty-three primary health care centres (PHCCs) in Stockholm, Sweden, with a total of 180 PCPs will be involved. Twenty-two primary PHCCs, will be cluster-randomised into: an intervention group who will receive CME by Case Method (n = 11) and a control group who will receive traditional lectures (n = 11). The remaining PHCCs (n = 11) will be a reference group and will receive no CME. From the intervention and control groups, 460 randomly selected patients with COPD in GOLD stages 2 and 3 will participate, while no patients will be recruited from the reference group. For the patients, smoking status, actual treatment and urgent visits to a health provider due to airway problems will be registered. For the PCPs, professional competence (i.e. knowledge and management skills) in COPD, will be measured using a questionnaire based on current guidelines and guideline implementation problems in clinical practice which has previously been described by the authors. Data will be collected at baseline and at follow-up, which will be after 1.5 years for the patients, and 1 year for the PCPs. Statistical methods for individual-level and cluster-level analyses will be used. COPD is considered a particularly complex clinical challenge involving managing multimorbidity, symptom adaptation, and lifestyle problematisation. Case Method in CME for PCPs may contribute to a better understanding of the impact of COPD on patients' lives and, thus, improve their management of it. The present study is expected to contribute scientific knowledge about indicators for an effective CME in COPD that is tailor-made to primary care physicians. ClinicalTrials.gov, identifier: NCT02213809 . Registered on 10 August 2014. Protocol version: Issue date: May 2014.

Giant condyloma acuminata: Incidence among cases diagnosed as carcinoma of the penis

PubMed Central

Davies, Sylvia W.

1965-01-01

Twenty-four cases of giant condyloma acuminata were found among 100 cases diagnosed as carcinoma of the penis. One of the 24 tumours showed early malignant change. The characteristic histological pattern of giant condyloma consists of broad processes composed of prickle cells associated with little keratinization. The malignant condylomas show, in comparison, a loss of prickle cell preponderance, increased basal cell activity and frequent keratinization, or may present as a solid papillary epithelioma forming broad sheets of uniform cells with many mitoses. The incidence of malignant change in the giant condyloma and the relationship between the benign and malignant tumours are discussed. Images PMID:14276146

Linear lichen planus in children - Case report*

PubMed Central

Horowitz, Marcia Raquel; Vidal, Marcela de Lima; Resende, Manuela Oliveira; Teixeira, Márcia Almeida Galvão; Cavalcanti, Silvana Maria de Morais; de Alencar, Eliane Ruth Barbosa

2013-01-01

Lichen planus is an uncommon disease in children, and only 2 to 3% of affected patients are under twenty years of age. This dermatosis may appear in several clinical forms, which vary according to the morphology and distribution of lesions. In less than 0.2% of all lichen planus cases, the lesions are distributed along the lines of Blaschko, and is a variant called linear lichen planus. This is a case report of a patient aged two years and eight months, who presented keratotic violaceous papules, affecting the abdomen, buttocks and right thigh, distributed along the lines of Blaschko. Histopathological examination confirmed a diagnosis of linear lichen planus. PMID:24346902

The aetiology of mirror writing: a new hypothesis.

PubMed Central

Tashiro, K; Matsumoto, A; Hamada, T; Moriwaka, F

1987-01-01

Twenty-eight cases of mirror writing were seen during a period of three and a half years. These consisted of 12 patients with essential tremor, nine with Parkinson's disease, three with spino-cerebellar degeneration and four other cases. There were no cases of hemiparesis, aphasia, apraxia, agnosia or confusion. Fragmentary reversals were excluded from this study. Since essential tremor, Parkinsonian tremor and cerebellar tremor can be abolished by a stereotaxic produce applied to the thalamus, a common neural pathway via the thalamic nuclei may exist in these disorders. The existence is therefore proposed of some neural mechanism that controls the higher cerebral function of writing via the thalamus. PMID:3437291

Retrobulbar tumors in dogs and cats: 25 cases.

PubMed

Attali-Soussay, K; Jegou, J P; Clerc, B

2001-03-01

Twenty-five cases of retrobulbar tumors are presented and discussed. Affected animals were dogs and cats (average 10.7 years). No breed or sex predisposition was noted. The most common clinical signs were exophthalmos (84%), conjunctival hyperemia (40%), protrusion of the nictitating membrane (28%), exposure keratitis (20%) and fundus abnormalities (20%). Diagnostic tools included fine needle aspiration, radiography, ultrasonography, computed tomography and histology. Surgical treatment by orbitotomy or exenteration was combined with chemotherapy and radiotherapy in some cases. The prognosis was poor with low survival times: 1 month in cats, and 10 months in dogs, with a high rate of euthanasia (35%) at the time of diagnosis.

A systematic method of interconnection optimization for dense-array concentrator photovoltaic system.

PubMed

Siaw, Fei-Lu; Chong, Kok-Keong

2013-01-01

This paper presents a new systematic approach to analyze all possible array configurations in order to determine the most optimal dense-array configuration for concentrator photovoltaic (CPV) systems. The proposed method is fast, simple, reasonably accurate, and very useful as a preliminary study before constructing a dense-array CPV panel. Using measured flux distribution data, each CPV cells' voltage and current values at three critical points which are at short-circuit, open-circuit, and maximum power point are determined. From there, an algorithm groups the cells into basic modules. The next step is I-V curve prediction, to find the maximum output power of each array configuration. As a case study, twenty different I-V predictions are made for a prototype of nonimaging planar concentrator, and the array configuration that yields the highest output power is determined. The result is then verified by assembling and testing of an actual dense-array on the prototype. It was found that the I-V curve closely resembles simulated I-V prediction, and measured maximum output power varies by only 1.34%.

Attitudes toward Physical Activity of White Midlife Women

PubMed Central

Im, Eun-Ok; Lee, Bokim; Chee, Wonshik; Stuifbergen, Alexa

2011-01-01

Objective To explore attitudes toward physical activity of White midlife women in the United States using a feminist perspective. Design A cross-sectional qualitative study using a thematic analysis. Setting Internet communities for midlife women. Participants Twenty-nine White midlife women in the United States recruited using a convenience sampling method. Methods We used 17 topics on attitudes toward physical activity and ethnic-specific contexts to administer an online forum. We analyzed the data using thematic analysis. Results We found three themes: “thinking without action”; “gendered and sedentary culture”; and “motivating myself.” The women knew and understood the necessity of physical activity for their physical and mental health but in most cases had not been able to take action to increase their physical activities. Although the culture that circumscribed the women's physical activity was sedentary in nature, the women tried to motivate themselves to increase their physical activities through several creative strategies. Conclusion The findings strongly suggest that although women were doing their best, American culture itself needs to be changed to help women increase physical activity in their daily lives. PMID:21585528

A case for the use of Q-methodology in disability research: lessons learned from a training workshop.

PubMed

McKenzie, Judith; Braswell, Bob; Jelsma, Jennifer; Naidoo, Nirmala

2011-01-01

Q-methodology was developed to analyse subjective responses to a range of items dealing with specific topics. This article describes the use of Q-methodology and presents the results of a Q-study on perspectives on disability carried out in a training workshop as evidence for its usefulness in disability research. A Q-sort was administered in the context of a training workshop on Q-method. The Q-sort consisted of statements related to the topic of disability. The responses were analysed using specifically developed software to identify factors that represent patterns of responses. Twenty-two of the 23 respondents loaded on four factors. These factors appeared to represent different paradigms relating to the social, medical and disability rights models of disability. The fourth factor appeared to be that of a family perspective. These are all models evident in the disability research literature and provide evidence for the validity of Q-method in disability research. Based on this opportunistic study, it would appear that Q-methodology is a useful tool for identifying different view points related to disability.

Highlight report: Launch of a large integrated European in vitro toxicology project: EU-ToxRisk.

PubMed

Daneshian, Mardas; Kamp, Hennicke; Hengstler, Jan; Leist, Marcel; van de Water, Bob

2016-05-01

The integrated European project, EU-ToxRisk, proudly sees itself as "flagship" exploring new alternative-to-animal approaches to chemical safety evaluation. It promotes mechanism-based toxicity testing and risk assessment according to the principles laid down for toxicology for the twenty-first century. The project was officially launched in January 2016 with a kickoff meeting in Egmond aan Zee, the Netherlands. Over 100 scientists representing academia and industry as well as regulatory authorities attended the inaugural meeting. The project will integrate advances in in vitro and in silico toxicology, read-across methods, and adverse outcome pathways. EU-ToxRisk will continue to make use of the case study strategy deployed in SEURAT-1, a FP7 initiative ended in December 2015. Even though the development of new non-animal methods is one target of EU-ToxRisk, the project puts special emphasis on their acceptance and implementation in regulatory contexts. This €30 million Horizon 2020 project involves 38 European partners and one from the USA. EU-ToxRisk aims at the "development of a new way of risk assessment."

A Systematic Method of Interconnection Optimization for Dense-Array Concentrator Photovoltaic System

PubMed Central

Siaw, Fei-Lu

2013-01-01

This paper presents a new systematic approach to analyze all possible array configurations in order to determine the most optimal dense-array configuration for concentrator photovoltaic (CPV) systems. The proposed method is fast, simple, reasonably accurate, and very useful as a preliminary study before constructing a dense-array CPV panel. Using measured flux distribution data, each CPV cells' voltage and current values at three critical points which are at short-circuit, open-circuit, and maximum power point are determined. From there, an algorithm groups the cells into basic modules. The next step is I-V curve prediction, to find the maximum output power of each array configuration. As a case study, twenty different I-V predictions are made for a prototype of nonimaging planar concentrator, and the array configuration that yields the highest output power is determined. The result is then verified by assembling and testing of an actual dense-array on the prototype. It was found that the I-V curve closely resembles simulated I-V prediction, and measured maximum output power varies by only 1.34%. PMID:24453823

Sex assessment using measurements of the first lumbar vertebra.

PubMed

Zheng, Wen Xu; Cheng, Fu Bo; Cheng, Kai Liang; Tian, Yong; Lai, Ying; Zhang, Wen Song; Zheng, Ya Juan; Li, You Qiong

2012-06-10

Sex determination is a vital part of the medico-legal system but can be difficult in cases where the integrity of the body has been compromised. The purpose of this study was to develop a technique for sex assessment from measurements of the first lumber vertebrate. Twenty-nine linear measurements and five ratios were collected from 113 Chinese adult males and 97 Chinese adult females using digital three-dimensional anthropometry methods. By using discriminant analysis, we found that 23 linear measurements and two ratios identified sexual dimorphism (P<0.01), with predictive accuracy ranging from 57.1% to 86.6%. Using a stepwise method of discriminant function analysis, we found three dimensions predicted sex with 88.6% accuracy: (a) upper end-plate width (EPWu), (b) left pedicle height (PHl), and (c) middle end-plate depth (EPDm). This study shows that a single first lumber vertebra can be used for this purpose, and that the discriminant equation will help forensic determination of sex in the Chinese population. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Effect of various binning methods and ROI sizes on the accuracy of the automatic classification system for differentiation between diffuse infiltrative lung diseases on the basis of texture features at HRCT

NASA Astrophysics Data System (ADS)

Kim, Namkug; Seo, Joon Beom; Sung, Yu Sub; Park, Bum-Woo; Lee, Youngjoo; Park, Seong Hoon; Lee, Young Kyung; Kang, Suk-Ho

2008-03-01

To find optimal binning, variable binning size linear binning (LB) and non-linear binning (NLB) methods were tested. In case of small binning size (Q <= 10), NLB shows significant better accuracy than the LB. K-means NLB (Q = 26) is statistically significant better than every LB. To find optimal binning method and ROI size of the automatic classification system for differentiation between diffuse infiltrative lung diseases on the basis of textural analysis at HRCT Six-hundred circular regions of interest (ROI) with 10, 20, and 30 pixel diameter, comprising of each 100 ROIs representing six regional disease patterns (normal, NL; ground-glass opacity, GGO; reticular opacity, RO; honeycombing, HC; emphysema, EMPH; and consolidation, CONS) were marked by an experienced radiologist from HRCT images. Histogram (mean) and co-occurrence matrix (mean and SD of angular second moment, contrast, correlation, entropy, and inverse difference momentum) features were employed to test binning and ROI effects. To find optimal binning, variable binning size LB (bin size Q: 4~30, 32, 64, 128, 144, 196, 256, 384) and NLB (Q: 4~30) methods (K-means, and Fuzzy C-means clustering) were tested. For automated classification, a SVM classifier was implemented. To assess cross-validation of the system, a five-folding method was used. Each test was repeatedly performed twenty times. Overall accuracies with every combination of variable ROIs, and binning sizes were statistically compared. In case of small binning size (Q <= 10), NLB shows significant better accuracy than the LB. K-means NLB (Q = 26) is statistically significant better than every LB. In case of 30x30 ROI size and most of binning size, the K-means method showed better than other NLB and LB methods. When optimal binning and other parameters were set, overall sensitivity of the classifier was 92.85%. The sensitivity and specificity of the system for each class were as follows: NL, 95%, 97.9%; GGO, 80%, 98.9%; RO 85%, 96.9%; HC, 94.7%, 97%; EMPH, 100%, 100%; and CONS, 100%, 100%, respectively. We determined the optimal binning method and ROI size of the automatic classification system for differentiation between diffuse infiltrative lung diseases on the basis of texture features at HRCT.

Guidelines for Reporting Case Studies on Extracorporeal Treatments in Poisonings: Methodology

PubMed Central

Lavergne, Valéry; Ouellet, Georges; Bouchard, Josée; Galvao, Tais; Kielstein, Jan T; Roberts, Darren M; Kanji, Salmaan; Mowry, James B; Calello, Diane P; Hoffman, Robert S; Gosselin, Sophie; Nolin, Thomas D; Goldfarb, David S; Burdmann, Emmanuel A; Dargan, Paul I; Decker, Brian Scott; Hoegberg, Lotte C; Maclaren, Robert; Megarbane, Bruno; Sowinski, Kevin M; Yates, Christopher; Mactier, Robert; Wiegand, Timothy; Ghannoum, Marc

2014-01-01

A literature review performed by the EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup highlighted deficiencies in the existing literature, especially the reporting of case studies. Although general reporting guidelines exist for case studies, there are none in the specific field of extracorporeal treatments in toxicology. Our goal was to construct and propose a checklist that systematically outlines the minimum essential items to be reported in a case study of poisoned patients undergoing extracorporeal treatments. Through a modified two-round Delphi technique, panelists (mostly chosen from the EXTRIP workgroup) were asked to vote on the pertinence of a set of items to identify those considered minimally essential for reporting complete and accurate case reports. Furthermore, independent raters validated the clarity of each selected items between each round of voting. All case reports containing data on extracorporeal treatments in poisoning published in Medline in 2011 were reviewed during the external validation rounds. Twenty-one panelists (20 from the EXTRIP workgroup and an invited expert on pharmacology reporting guidelines) participated in the modified Delphi technique. This group included journal editors and experts in nephrology, clinical toxicology, critical care medicine, emergency medicine, and clinical pharmacology. Three independent raters participated in the validation rounds. Panelists voted on a total of 144 items in the first round and 137 items in the second round, with response rates of 96.3% and 98.3%, respectively. Twenty case reports were evaluated at each validation round and the independent raters' response rate was 99.6% and 98.8% per validation round. The final checklist consists of 114 items considered essential for case study reporting. This methodology of alternate voting and external validation rounds was useful in developing the first reporting guideline for case studies in the field of extracorporeal treatments in poisoning. We believe that this guideline will improve the completeness and transparency of published case reports and that the systematic aggregation of information from case reports may provide early signals of effectiveness and/or harm, thereby improving healthcare decision-making. PMID:24890576

Chemodectomas: review and report of nine cases.

PubMed

Poster, D S; Schapiro, H; Woronoff, R

1979-01-01

We have reviewed the broad spectrum of disease caused by chemodectomas. This spectrum extends from the benign to the aggressively malignant with many graduations in-between. Our analyses included cases from the literature and nine new cases seen over the past twenty-five years. Surgery as the primary and most definitive form of therapy, is recommended if feasible, with total excision as the goal, in both benign and malignant histologies. An excellent outcome is to be expected in benign cases. At present, no predictor exists to foretell the behavior of malignant lesions, which can range from the aggressive to the slowly progressive. Both radiotherapy and chemotherapy have been tried in malignant cases. No consistent good result has occurred from the use of either. The future will hopefully bring us more effective therapy.

Orbit-associated tumors: navigation and control of resection using intraoperative computed tomography.

PubMed

Terpolilli, Nicole A; Rachinger, Walter; Kunz, Mathias; Thon, Niklas; Flatz, Wilhelm H; Tonn, Jörg-Christian; Schichor, Christian

2016-05-01

OBJECT Treatment of skull base lesions is complex and usually requires a multidisciplinary approach. In meningioma, which is the most common tumor entity in this region, resection is considered to be the most important therapeutic step to avoid tumor recurrence. However, resection of skull base lesions with orbital or optic nerve involvement poses a challenge due to their anatomical structure and their proximity to eloquent areas. Therefore the main goal of surgery should be to achieve the maximum extent of resection while preserving neurological function. In the postoperative course, medical and radiotherapeutic strategies may then be successfully used to treat possible tumor residues. Methods to safely improve the extent of resection in skull base lesions therefore are desirable. The current study reports the authors' experience with the use of intraoperative CT (iCT) combined with neuronavigation with regard to feasibility and possible benefits of the method. METHODS Those patients with tumorous lesions in relationship to the orbit, sphenoid wing, or cavernous sinus who were surgically treated between October 2008 and December 2013 using iCT-based neuronavigation and in whom an intraoperative scan was obtained for control of resection were included. In all cases a second iCT scan was performed under sterile conditions after completion of navigation-guided microsurgical tumor resection. The surgical strategy was adapted accordingly; if necessary, resection was continued. RESULTS Twenty-three patients (19 with WHO Grade I meningioma and 4 with other lesions) were included. The most common clinical symptoms were loss of visual acuity and exophthalmus. Intraoperative control of resection by iCT was successfully obtained in all cases. Intraoperative imaging changed the surgical approach in more than half (52.2%) of these patients, either because iCT demonstrated unexpected residual tumor masses or because the second scan revealed additional tumor tissue that was not detected in the first scan due to overlay by osseous tumor parts; in these cases resection was continued. In the remaining cases resection was concluded as planned because iCT verified the surgeon's microscopic estimation of tumor resection status. Postoperative visual outcome was favorable in more than 80% of patients. CONCLUSIONS Intraoperative CT allows control of resection in case of uncertainty and can help to improve the extent of maximal safe resection, especially in case of osseous tumor parts and masses within the orbit.

Board Level Proton Testing Book of Knowledge for NASA Electronic Parts and Packaging Program

NASA Technical Reports Server (NTRS)

Guertin, Steven M.

2017-01-01

This book of knowledge (BoK) provides a critical review of the benefits and difficulties associated with using proton irradiation as a means of exploring the radiation hardness of commercial-off-the-shelf (COTS) systems. This work was developed for the NASA Electronic Parts and Packaging (NEPP) Board Level Testing for the COTS task. The fundamental findings of this BoK are the following. The board-level test method can reduce the worst case estimate for a board's single-event effect (SEE) sensitivity compared to the case of no test data, but only by a factor of ten. The estimated worst case rate of failure for untested boards is about 0.1 SEE/board-day. By employing the use of protons with energies near or above 200 MeV, this rate can be safely reduced to 0.01 SEE/board-day, with only those SEEs with deep charge collection mechanisms rising this high. For general SEEs, such as static random-access memory (SRAM) upsets, single-event transients (SETs), single-event gate ruptures (SEGRs), and similar cases where the relevant charge collection depth is less than 10 µm, the worst case rate for SEE is below 0.001 SEE/board-day. Note that these bounds assume that no SEEs are observed during testing. When SEEs are observed during testing, the board-level test method can establish a reliable event rate in some orbits, though all established rates will be at or above 0.001 SEE/board-day. The board-level test approach we explore has picked up support as a radiation hardness assurance technique over the last twenty years. The approach originally was used to provide a very limited verification of the suitability of low cost assemblies to be used in the very benign environment of the International Space Station (ISS), in limited reliability applications. Recently the method has been gaining popularity as a way to establish a minimum level of SEE performance of systems that require somewhat higher reliability performance than previous applications. This sort of application of the method suggests a critical analysis of the method is in order. This is also of current consideration because the primary facility used for this type of work, the Indiana University Cyclotron Facility (IUCF) (also known as the Integrated Science and Technology (ISAT) hall), has closed permanently, and the future selection of alternate test facilities is critically important. This document reviews the main theoretical work on proton testing of assemblies over the last twenty years. It augments this with review of reported data generated from the method and other data that applies to the limitations of the proton board-level test approach. When protons are incident on a system for test they can produce spallation reactions. From these reactions, secondary particles with linear energy transfers (LETs) significantly higher than the incident protons can be produced. These secondary particles, together with the protons, can simulate a subset of the space environment for particles capable of inducing single event effects (SEEs). The proton board-level test approach has been used to bound SEE rates, establishing a maximum possible SEE rate that a test article may exhibit in space. This bound is not particularly useful in many cases because the bound is quite loose. We discuss the established limit that the proton board-level test approach leaves us with. The remaining possible SEE rates may be as high as one per ten years for most devices. The situation is actually more problematic for many SEE types with deep charge collection. In cases with these SEEs, the limits set by the proton board-level test can be on the order of one per 100 days. Because of the limited nature of the bounds established by proton testing alone, it is possible that tested devices will have actual SEE sensitivity that is very low (e.g., fewer than one event in 1 × 10(exp 4) years), but the test method will only be able to establish the limits indicated above. This BoK further examines other benefits of proton board-level testing besides hardness assurance. The primary alternate use is the injection of errors. Error injection, or fault injection, is something that is often done in a simulation environment. But the proton beam has the benefit of injecting the majority of actual SEEs without risk of something being missed, and without the risk of simulation artifacts misleading the SEE investigation.

Modified tube gastropexy using a mushroom-tipped silicone catheter for management of gastric dilatation-volvulus in dogs.

PubMed

Belch, A; Rubinos, C; Barnes, D C; Nelissen, P

2017-02-01

To report the short- and long-term complications and clinical outcomes of a cohort of dogs managed for gastric dilatation-volvulus using a modified right-sided tube gastropexy technique. Retrospective case series. Of 31 dogs treated, 29 (93·5%) had an excellent short-term outcome, and gastric dilatation-volvulus did not recur in any dog. Twenty-six dogs (84%) were initially fed via the gastrostomy tube postoperatively; three (9·7%) suffered a major complication including septic peritonitis (n=1), and premature tube removal (n=2). Fourteen dogs (45·1%) had minor complications including mild, self-limiting discharge from the stoma site in 13. Modified tube gastropexy using a mushroom-tipped silicone catheter is an effective and safe surgical method for the management of gastric dilatation-volvulus. The gastrostomy tube allowed early enteral feeding and easy administration of medications, including gastroprotectants. © 2017 British Small Animal Veterinary Association.

Laparoscopic Common Bile Duct Exploration in Patients With Gallstones and Choledocholithiasis

PubMed Central

Rodriguez, Omaira; Bellorín, Omar; Sánchez, Renata; Benítez, Gustavo

2010-01-01

Objectives: To compare the effectiveness of laparoscopic common bile duct exploration in patients with failed endoscopic retrograde cholangiopancreatography (ERCP). Methods: This is a descriptive, comparative study. Patients with an indication of common bile duct exploration between February 2005 and October 2008 were included. We studied 2 groups: Group A: patients with failed ERCP who underwent LCBDE plus LC. Group B: patients with common bile duct stones managed with the 1-step approach (LCBDE + LC) with no prior ERCP. Results: Twenty-five patients were included. Group A: 9 patients, group B: 16 patients. Success rate, operative time, and hospital stay were as follows: group A 66% vs group B 87.5%; group A 187 minutes vs 106 minutes; group A 4.5 days vs 2.3 days; respectively. Conclusion: Patients with failed ERCP should be considered as high-complex cases in which the laparoscopic procedure success rate decreases, and the conversion rate increases considerably. PMID:20932377

Impact of novel energy sources: OTEC, wind, goethermal, biomass

NASA Technical Reports Server (NTRS)

Roberts, A. S., Jr.

1978-01-01

Alternate energy conversion methods such as ocean thermal energy conversion (OTEC), wind power, geothermal wells and biomass conversion are being explored, and re-examined in some cases, for commercial viability. At a time when United States fossil fuel and uranium resources are found to be insufficient to supply national needs into the twenty-first century, it is essential to broaden the base of feasible energy conversion technologies. The motivations for development of these four alternative energy forms are established. Primary technical aspects of OTEC, wind, geothermal and biomass energy conversion systems are described along with a discussion of relative advantages and disadvantages of the concepts. Finally, the sentiment is voiced that each of the four systems should be developed to the prototype stage and employed in the region of the country and in the sector of economy which is complimentary to the form of system output.

Limitations of the Patient Health Questionnaire in Identifying Anxiety and Depression: Many Cases Are Undetected

PubMed Central

Eack, Shaun M.; Greeno, Catherine G.; Lee, Bong-Jae

2013-01-01

Objective To determine the concordance between the Structured Clinical Interview for DSM-IV (SCID) and the Patient Health Questionnaire (PHQ) in diagnosing anxiety and depressive disorders. Method Fifty women seeking psychiatric services for their children at two mental health centers in Western Pennsylvania were assessed for anxiety and depressive disorders using the SCID and the PHQ. Results Twenty-five women met SCID criteria for at least one anxiety disorder, 11 (44%) of whom the PHQ failed to identify. The PHQ was particularly limited in identifying individuals with anxiety disorders other than panic disorder. Seventeen women met SCID criteria for at least one major depressive disorder, 6 (35%) of whom the PHQ failed to identify. The PHQ was particularly limited in identifying depressed individuals with dysthymia. Conclusions Caution should be used when screening for anxiety and depression with the PHQ. Implications for improving diagnostic accuracy in social work practice are discussed. PMID:24465121

Long-bone fractures in llamas and alpacas: 28 cases (1998–2008)

PubMed Central

Knafo, S. Emmanuelle; Getman, Liberty M.; Richardson, Dean W.; Fecteau, Marie-Eve

2012-01-01

Treatment and outcome of camelids with long-bone fractures are described. Medical records (1998–2008) of camelids (n = 28) with long-bone fractures were reviewed for signalment, time to presentation, fracture type, method of repair, duration of hospitalization, and post-operative complications. Follow-up information was obtained via telephone interviews with owners. Mean age and weight at presentation were 3.4 years and 56.3 kg, respectively. Twenty-six fractures were treated with internal fixation (n = 11), external fixation (n = 10), combination of internal and external fixation (n = 3), amputation (n = 1), and external fixation followed by amputation (n = 1). Long-term follow-up information was obtained for 19 of the 26 animals. The post-operative complication rate was 23% and owner satisfaction was high. Animals with open fractures were more likely to experience complications. Internal fixation was associated with superior alignment and outcome. Internal fixation techniques should be recommended for camelids. PMID:23277645

Knee arthrodesis as limb salvage for complex failures of total knee arthroplasty.

PubMed

Kuchinad, Raul; Fourman, Mitchell S; Fragomen, Austin T; Rozbruch, S Robert

2014-11-01

Patients with multiple failures of total knee arthroplasty (TKA) are challenging limb salvage cases. Twenty one patients over the last 10 years were referred to our service for knee fusion by arthroplasty surgeons who felt they were not candidates for revision TKA. Active infection was present in 76.2% and total bone loss averaged 6.6 cm. Lengthening was performed in 7/22 patients. Total time in Ilizarov frames was 9 months, with 93.3% union. Patients treated with IM fusion nails had 100% union. Average LLD increased from 3.6 to 4.5 cm following intervention, while those with concurrent lengthening improved to 1.6 cm. Findings suggest that bone loss and the soft-tissue envelope dictate knee fusion method, and multiple techniques may be needed. A treatment algorithm is presented. Copyright © 2014 Elsevier Inc. All rights reserved.

Long-bone fractures in llamas and alpacas: 28 cases (1998-2008).

PubMed

Knafo, S Emmanuelle; Getman, Liberty M; Richardson, Dean W; Fecteau, Marie-Eve

2012-07-01

Treatment and outcome of camelids with long-bone fractures are described. Medical records (1998-2008) of camelids (n = 28) with long-bone fractures were reviewed for signalment, time to presentation, fracture type, method of repair, duration of hospitalization, and post-operative complications. Follow-up information was obtained via telephone interviews with owners. Mean age and weight at presentation were 3.4 years and 56.3 kg, respectively. Twenty-six fractures were treated with internal fixation (n = 11), external fixation (n = 10), combination of internal and external fixation (n = 3), amputation (n = 1), and external fixation followed by amputation (n = 1). Long-term follow-up information was obtained for 19 of the 26 animals. The post-operative complication rate was 23% and owner satisfaction was high. Animals with open fractures were more likely to experience complications. Internal fixation was associated with superior alignment and outcome. Internal fixation techniques should be recommended for camelids.

Afebrile Benign Convulsion Associated With Mild Gastroenteritis

PubMed Central

Khosroshahi, Nahid; Rahbarimanesh, Aliakbar; Boroujeni, Farhad Asadi; Eskandarizadeh, Zahra; Zoham, Mojdeh Habibi

2018-01-01

Background: Benign convulsion with mild gastroenteritis is a new clinical entity that occurs in children who are otherwise healthy. Method: This cohort study held among patients with afebrile convulsion and accompanying gastroenteritis in a tertiary children hospital during a 2-year period. Demographic and clinical data were analyzed. Neurodevelopmental milestones were observed during a follow-up period of 12 to 24 months. Results: Twenty-five patients aged 3 to 48 months with female predominance were enrolled. Ninety-three percent of cases experienced generalized tonic-clonic seizures. One-third of seizures occurred in clusters. Primary laboratory findings and electroencephalography were normal except for 3 with few epileptic waves. During the follow-up period, no seizure recurrence happened. Long-term antiepileptic treatment was unnecessary. Conclusion: Afebrile convulsion accompanying mild gastroenteritis is a convulsive disorder with reassuring prognosis. Due to its benign course, comprehensive neurodiagnostic evaluation and long-term antiepileptic drugs are usually avoidable.

EGFR immunoexpression, RAS immunoexpression and their effects on survival in lung adenocarcinoma cases.

PubMed

Gundogdu, Ahmet Gokhan; Onder, Sevgen; Firat, Pinar; Dogan, Riza

2014-06-01

The impacts of epidermal growth factor receptor (EGFR) immunoexpression and RAS immunoexpression on the survival and prognosis of lung adenocarcinoma patients are debated in the literature. Twenty-six patients, who underwent pulmonary resections between 2002 and 2007 in our clinic, and whose pathologic examinations yielded adenocarcinoma, were included in the study. EGFR and RAS expression levels were examined by immunohistochemical methods. The results were compared with the survival, stage of the disease, nodal involvement, lymphovascular invasion, and pleural invasion. Nonparametric bivariate analyses were used for statistical analyses. A significant link between EGFR immunoexpression and survival has been identified while RAS immunoexpression and survival have been proven to be irrelevant. Neither EGFR, nor RAS has displayed a significant link with the stage of the disease, nodal involvement, lymphovascular invasion, or pleural invasion. Positive EGFR immunoexpression affects survival negatively, while RAS immunoexpression has no effect on survival in lung adenocarcinoma patients.

Computers and the orthopaedic office.

PubMed

Berumen, Edmundo; Barllow, Fidel Dobarganes; Fong, Fransisco Javier; Lopez, Jorge Arturo

2002-01-01

The advance of today's medicine could be linked very closely to the history of computers through the last twenty years. In the beginning the first attempt to build a computer was trying to help us with mathematical calculations. This has changed recently and computers are now linked to x-ray machines, CT scanners, and MRIs. Being able to share information is one of the goals of the future. Today's computer technology has helped a great deal to allow orthopaedic surgeons from around the world to consult on a difficult case or to become a part of a large database. Obtaining the results from a method of treatment using a multicentric information study can be done on a regular basis. In the future, computers will help us to retrieve information from patients' clinical history directly from a hospital database or by portable memory cards that will carry every radiograph or video from previous surgeries.

Incorporating Meaningful Gamification in a Blended Learning Research Methods Class: Examining Student Learning, Engagement, and Affective Outcomes

ERIC Educational Resources Information Center

Tan, Meng; Hew, Khe Foon

2016-01-01

In this study, we investigated how the use of meaningful gamification affects student learning, engagement, and affective outcomes in a short, 3-day blended learning research methods class using a combination of experimental and qualitative research methods. Twenty-two postgraduates were randomly split into two groups taught by the same…

Evaluation of ALK rearrangement in Chinese non-small cell lung cancer using FISH, immunohistochemistry, and real-time quantitative RT- PCR on paraffin-embedded tissues.

PubMed

Zhang, Yun-Gang; Jin, Mu-Lan; Li, Li; Zhao, Hong-Ying; Zeng, Xuan; Jiang, Lei; Wei, Ping; Diao, Xiao-Li; Li, Xue; Cao, Qing; Tian, Xin-Xia

2013-01-01

Patients with ALK gene rearrangements often manifest dramatic responses to crizotinib, an ALK inhibitor. Accurate identification of patients with ALK-positive non-small cell lung cancer (NSCLC) is essential for the clinical application of ALK-targeted therapy. However, assessing EML4-ALK rearrangement in NSCLC remains challenging in routine pathology practice. The aim of this study was to compare the diagnostic accuracy of FISH, immunohistochemistry (IHC), and real-time quantitative RT-PCR (QPCR) methodologies for detection of EML4-ALK rearrangement in NSCLC and to appraise immunohistochemistry as a pre-screening tool. In this study, a total of 473 paraffin-embedded NSCLC samples from surgical resections and biopsies were analyzed by IHC with ALK antibody. ALK rearrangement was further confirmed by FISH and QPCR. ALK protein expression was detected in twenty patients (20/473, 4.2%). Of the 20 ALK-positive cases by IHC, 15 cases were further confirmed as ALK rearrangement by FISH, and 5 cases were not interpretable. Also, we evaluated 13 out of the 20 IHC-positive tissues by QPCR in additional to FISH, and found that 9 cases were positive and 2 cases were equivocal, whereas 2 cases were negative although they were positive by both IHC and FISH. The ALK status was concordant in 5 out of 8 cases that were interpretable by three methods. Additionally, none of the 110 IHC-negative cases with adenocarcinoma histology showed ALK rearrangements by FISH. Histologically, almost all the ALK-rearranged cases were adenocarcinoma, except that one case was sarcomatoid carcinoma. A solid signet-ring cell pattern or mucinous cribriform pattern was presented at least focally in all ALK-positive tumors. In conclusion, our findings suggested that ALK rearrangement was associated with ALK protein expression. The conventional IHC assay is a valuable tool for the pre-screening of patients with ALK rearrangement in clinical practice and a combination of FISH and QPCR is required for further confirmation.

Mortality among PCR negative admitted Ebola suspects during the 2014/15 outbreak in Conakry, Guinea: A retrospective cohort study.

PubMed

Ingelbeen, Brecht; Bah, Elhadj Ibrahima; Decroo, Tom; Balde, Idrissa; Nordenstedt, Helena; van Griensven, Johan; De Weggheleire, Anja

2017-01-01

Non-cases are suspect Ebola Virus Disease (EVD) cases testing negative by EVD RT-PCR after admission to an Ebola Treatment Centre (ETC). Admitting non-cases to an ETC prompts concerns on case- and workload in the ETC, risk for nosocomial EVD infection, and delays in diagnosis and disease-specific treatment. We retrospectively analysed characteristics, outcomes and determinants of death of EVD cases and non-cases admitted to the Conakry ETC in Guinea between 03/2014 and 09/2015. Of the 2362 admitted suspects who underwent full confirmatory PCR testing, 1540 (65.2%) were non-cases; among them 727 needed repeated confirmatory PCR testing resulting in 2.5 days (average) in the ETC isolation ward. Twenty-one patients tested positive on the repeat test, most in a period of flawed sampling for the initial test and none after introduction of PCR confirmation with geneXpert. No readmissions following nosocomial EVD infection were recorded. No combination of symptoms yielded acceptable sensitivity and specificity to allow differentiating confirmed from non-cases. Symptoms as ocular bleeding/redness have high specificity, but limited usefulness as not common. Admission delay and age distribution were not different for both groups. In total, 98 (20.6%) of 475 deaths in the ETC were non-cases. Most died within 24 hours after admission. Living in Conakry (aOR 1.78 (1.08-2.96)) was the strongest risk factor for death. Weeks with higher admission load had lower case fatality among non-cases, probably because more acute (and treatable) illnesses of contacts of known cases were admitted. These findings show high numbers of potentially critically ill non-cases need to be considered when setting up triage and referral of EVD suspect cases. Symptoms and risk factors alone do not allow differentiating the non-cases. Integration of highly-sensitive EVD diagnostic methods with short turnaround time in the triage of peripheral hospitals and dropping the systematic 2nd PCR for symptomatic early presenters could limit delays in access to adapted care of cases and seriously ill non-cases. Whether feasible without compromising outbreak control, and under which conditions, should be further assessed.

Mortality among PCR negative admitted Ebola suspects during the 2014/15 outbreak in Conakry, Guinea: A retrospective cohort study

PubMed Central

Bah, Elhadj Ibrahima; Decroo, Tom; Balde, Idrissa; Nordenstedt, Helena; van Griensven, Johan; De Weggheleire, Anja

2017-01-01

Non-cases are suspect Ebola Virus Disease (EVD) cases testing negative by EVD RT-PCR after admission to an Ebola Treatment Centre (ETC). Admitting non-cases to an ETC prompts concerns on case- and workload in the ETC, risk for nosocomial EVD infection, and delays in diagnosis and disease-specific treatment. We retrospectively analysed characteristics, outcomes and determinants of death of EVD cases and non-cases admitted to the Conakry ETC in Guinea between 03/2014 and 09/2015. Of the 2362 admitted suspects who underwent full confirmatory PCR testing, 1540 (65.2%) were non-cases; among them 727 needed repeated confirmatory PCR testing resulting in 2.5 days (average) in the ETC isolation ward. Twenty-one patients tested positive on the repeat test, most in a period of flawed sampling for the initial test and none after introduction of PCR confirmation with geneXpert. No readmissions following nosocomial EVD infection were recorded. No combination of symptoms yielded acceptable sensitivity and specificity to allow differentiating confirmed from non-cases. Symptoms as ocular bleeding/redness have high specificity, but limited usefulness as not common. Admission delay and age distribution were not different for both groups. In total, 98 (20.6%) of 475 deaths in the ETC were non-cases. Most died within 24 hours after admission. Living in Conakry (aOR 1.78 (1.08–2.96)) was the strongest risk factor for death. Weeks with higher admission load had lower case fatality among non-cases, probably because more acute (and treatable) illnesses of contacts of known cases were admitted. These findings show high numbers of potentially critically ill non-cases need to be considered when setting up triage and referral of EVD suspect cases. Symptoms and risk factors alone do not allow differentiating the non-cases. Integration of highly-sensitive EVD diagnostic methods with short turnaround time in the triage of peripheral hospitals and dropping the systematic 2nd PCR for symptomatic early presenters could limit delays in access to adapted care of cases and seriously ill non-cases. Whether feasible without compromising outbreak control, and under which conditions, should be further assessed. PMID:28665950

Transient hypothyroidism in infants born to mothers with chronic thyroiditis--a nationwide study of twenty-three cases. The Transient Hypothyroidism Study Group.

PubMed

Matsuura, N; Konishi, J

1990-06-01

To define the difference in prognosis and the clinical features of transient neonatal hypothyroidism in infants born to mothers with chronic thyroiditis, we conducted a nationwide study of this condition. Sixteen mothers with chronic thyroiditis and twenty-three of their offspring with transient hypothyroidism were registered and reported in this paper. Five (group A) of twenty-two live infants showed physical, mental and/or psychomotor developmental delay (IQ below 80). No significant difference between TSH-binding inhibitor immunoglobulin (TBII) or thyroid-stimulation blocking antibody (TSBAb) activities in groups A and B (normal development) were noted. Moreover, there was no significant difference in thyroid function in the newborn period, ages at the start of thyroid medication or the dose and duration of treatment in the two groups. A striking difference observed between the two groups was the thyroid function of their mothers during pregnancy. In group A, four mothers were hypothyroid during pregnancy, and another mother discontinued thyroid medication in the last trimester and her baby was most delayed at the start thyroid medication. On the other hand, the mothers of only two of seventeen live cases in group B had mild hypothyroidism during pregnancy. There were two sets of siblings whose mother received inadequate treatment during the first pregnancy and adequate treatment during the second pregnancy. The psychomotor, physical and mental developmental delay were observed in their first babies. These findings suggested that maternal thyroid function during pregnancy might be an important factor in the prognosis of infants born to mothers with chronic thyroiditis.

Pediatric falls from windows and balconies: incidents and risk factors as reported by newspapers in the United Arab Emirates.

PubMed

Grivna, Michal; Al-Marzouqi, Hanan M; Al-Ali, Maryam R; Al-Saadi, Nada N; Abu-Zidan, Fikri M

2017-01-01

Falls of children from heights (balconies and windows) usually result in severe injuries and death. Details on child falls from heights in the United Arab Emirates (UAE) are not easily accessible. Our aim was to assess the incidents, personal, and environmental risk factors for pediatric falls from windows/balconies using newspaper clippings. We used a retrospective study design to electronically assess all major UAE national Arabic and English newspapers for reports of unintentional child falls from windows and balconies during 2005-2016. A structured data collection form was developed to collect information. Data were entered into an Excel sheet and descriptive analysis was performed. Newspaper clippings documented 96 fall incidents. After cleaning the data and excluding duplicate cases and intentional injuries, 81 cases were included into the final analysis. Fifty-three percent ( n  = 42) were boys. The mean (range) age was 4.9 years (1-15). Thirty-eight (47%) children fell from windows and 36 (44%) from balconies. Twenty-two (27%) children climbed on the furniture placed on a balcony or close to a window. Twenty-five (31%) children were not alone in the apartment when they fell. Twenty-nine children fell from less than 5 floors (37%), 33 from 5 to 10 floors (42%) and 16 from more than 10 floors (21%) . Fifteen children (19%) were hospitalized and survived the fall incident, while 66 died (81%). Newspapers proved to be useful to study pediatric falls from heights. It is necessary to improve window safety by installing window guards and raising awareness.

Open unstable metaphyseo-diaphyseal fractures of the tibia in adolescents: treatment by flexible intramedullary nails augmented by external fixator.

PubMed

Atef, Ashraf; El Tantawy, Ahmad

2015-05-01

The treatment of open and unstable metaphyseo-diaphyseal fractures of the tibia in adolescents is challenging. It is important to choose a fixation method that can maintain alignment, allow wound care and not violate the growth plate. The aim of this work was to evaluate the efficacy of using flexible intramedullary nails (FIN) augmented by external fixator (EF) in the management of such fractures. A total of 26 males, with a mean age of 14.08 years and average body weight of 49.8 kg, presented with open metaphyseo-diaphyseal tibial fractures. All cases were treated using FIN augmented by mono-lateral EF. The fractures were located at the upper third in 17 cases and at the lower third in nine cases. The fracture pattern was spiral in eight cases, oblique in seven and multi-fragmentary in 11. The results were evaluated according to the scoring system for femoral TENs. All fractures united primarily after an average eight to 12 weeks with no evident angular deformity or limb-length discrepancy. None of the cases required cast immobilization or revision procedure. Twenty patients had excellent results, six patients showed good results and none had poor results. Fracture characteristics as well as patients' characteristics had no statistically significant effect (p > 0.005) on the final end results. The use of FIN augmented by EF is a good alternative in the management of open metaphyseo-diaphyseal tibial fractures in adolescents. This fixation provides more stability, allows easy access to the wound and early patients' ambulation.

Door-to-door capture of incident and prevalent stroke cases in Durango, Mexico – the Brain Attack Surveillance in Durango (BASID) Study

PubMed Central

Cantu-Brito, Carlos; Majersik, Jennifer J; Sánchez, Brisa N; Ruano, Angel; Becerra-Mendoza, Daniela; Wing, Jeffrey J; Morgenstern, Lewis B

2011-01-01

Background and Purpose Stroke incidence and prevalence estimates in developing countries should include stroke cases not presenting to hospital. We performed door-to-door stroke case ascertainment in Durango Municipality, Mexico to estimate stroke incidence and prevalence, and to determine the error made by only ascertaining hospital cases. Methods Between September 2008 and March 2009, 1996 housing units were randomly sampled to screen for stroke in Durango Municipality residents ≥35 years of age. Field workers utilized a validated screening tool. Those screening positive were referred to a neurologist for history and examination and if confirmed, a head CT scan. Prevalence and cumulative incidence from the door-to-door surveillance were calculated and compared with previously reported hospitalization rates during the same defined time. Results Respondents included 2437 subjects from 1419 homes. The refusal rate was 3.8%. Twenty subjects had verified or probable stroke. The prevalence of probable or verified stroke was 7.7/1000 (95% CI: 4.3/1000, 11.2/1000). Five patients had a stroke during the time of the hospital surveillance, yielding a cumulative incidence of 232.3/100,000 (95% CI: 27.8, 436.9). Two of the 5 cases were captured by door-to-door surveillance but not by hospital surveillance. Conclusions This study provides the first community-based stroke prevalence and incidence estimates in Mexico. The wide confidence intervals, despite the large number of surveyed housing units, suggest the need for more advanced sampling strategies for stroke surveillance in the developing world. PMID:21212398

Rhabdomyolysis After Cooked Seafood Consumption (Haff Disease) in the United States vs China

PubMed Central

Diaz, James H.

2015-01-01

Background Haff disease is a syndrome of myalgia and rhabdomyolysis that occurs after eating cooked seafood. Methods For this descriptive analytical article, a literature search identified the scientific articles on Haff disease and/or rhabdomyolysis after eating cooked seafood in the United States and China. Analysis of those articles focused on identifying the seafood vectors of Haff disease, describing the most commonly recurring clinical and laboratory manifestations of Haff disease, and comparing the Haff disease toxidrome with other similar seafood-borne toxidromes. Statistically significant differences were determined using unpaired t tests and Fisher exact tests. Results Twenty-nine confirmed cases of Haff disease were identified in the United States, and 60 cases were identified in China during 1984-2014. Most of the US cases followed consumption of buffalo fish, and most of the Chinese cases followed consumption of freshwater pomfret. However, Haff disease also followed consumption of the same species of boiled crayfish (Procambarus clarkii) in the United States (n=9) and China (n=6). US patients with crayfish-transmitted Haff disease reported significantly more nausea with and without vomiting, chest pain, body and back pain, dyspnea, and diaphoresis than the Chinese patients and were more frequently misdiagnosed as having myocardial infarctions. Conclusion The bioaccumulation of a new, heat-stable freshwater and/or brackish/saltwater algal toxin, similar to palytoxin but primarily myotoxic and not neurotoxic, is suspected of causing Haff disease. At present, only the rapid identification of the seafood vectors of Haff disease will limit disease outbreaks and prevent further cases. PMID:26130980

The Salmonella Mutagenicity Assay: The Stethoscope of Genetic Toxicology for the 21 st Century

EPA Science Inventory

OBJECTIVES: According to the 2007 National Research Council report Toxicology for the Twenty-first Century, modem methods ("omics," in vitro assays, high-throughput testing, computational methods, etc.) will lead to the emergence of a new approach to toxicology. The Salmonella ma...

P14.06 Central nervous system symptoms as the first manifestation of malignant neoplasm

PubMed Central

Espírito Santo, V.; Almendra, R.; Mendes, M.; Veiga, A.; Velon, A.; Guimarães, P.

2017-01-01

Abstract Introduction: Neurological involvement is a frequent complication of systemic neoplasm, but not all secondary lesions have clinical manifestations, and there are fewer cases in which first symptom is neurological. Materials and Methods: Retrospective study between January 2006 through November 2016 of patients in whom neurological manifestations due to metastases were the inaugural manifestation of systemic neoplasm. Results: Twenty-six patients (19 male, 7 female) between the ages of 48 and 85 were identified. The main complaints were motor deficit (n = 10), headache (n = 7), behaviour change (n = 3), sensory deficit (n = 2), language disorder (n=1), visual disorder (n=1), syncope (n = 1) and dizziness (n = 1), with 11 patients presenting with symptoms other than the main complaint. Twenty-four patients had brain metastases, in 9 patients, it was solitary, in 5 patients, 2 lesions were found and in the remaining 9, 3 or more lesions were found. Two patients had multiple spinal metastases and 1 patient presented meningeal carcinomatosis. The primary neoplasm were of pulmonary origin (n = 17), gastric (n = 1), prostatic (n = 1), rectal (n = 1) and skin (n=1). In 5 patients the primary lesion remained hidden. Histology results were available in 19 patients: adenocarcinoma (n = 13), small cell carcinoma (n = 3), spinous cell carcinoma (n = 1), melanoma (n = 1) and linitis plastica (n=1). The treatment consisted in corticosteroid treatment (n = 23), chemotherapy (n = 11), radiotherapy (n = 11), surgery (n = 2) and hormonal treatment (n = 1). The mean survival was 225 days, ranging from 9 to 801 days. Conclusions: With this work we verified a broad spectrum of central nervous system symptoms as clinical presentation of malignant neoplasm. In these cases, a detailed investigation is essential for the treatment and prognosis of these patients.

Torsion of Abdominal Organs in Sows: A Report of 36 Cases

PubMed Central

Morin, M.; Sauvageau, R.; Phaneuf, J.-B.; Teuscher, E.; Beauregard, M.; Lagacé, A.

1984-01-01

Necropsy records of 36 sows with torsion of abdominal organs involving individually the stomach, the spleen, a liver lobe or the intestine were reviewed for the years 1970 to 1983, and the age, the clinical signs and the gross lesions were recorded. These acute abdominal accidents were characterized clinically by sudden death. Dry sows from large breeding units were affected. Twenty-six cases were diagnosed between January 1981 and December 1983 while only ten cases had been seen between 1970 and 1980. Gastric torsion was the most common condition (40% of the cases) and the other three conditions were equally represented (20% each). Management practises that could be responsible for the apparent increase in occurrence of this problem are discussed. PMID:17422483

Lymphoepithelioma-like carcinoma of the breast presenting as breast abscess.

PubMed

Suzuki, Ikumi; Chakkabat, Pimchandr; Goicochea, Lindsay; Campassi, Cristina; Chumsri, Saranya

2014-12-10

Lymphoepithelioma-like carcinoma (LELC) is a rare type of neoplasm in which only twenty cases have been reported in the breast. This type of tumor can be difficult to distinguish from other breast tumors particularly medullary carcinoma and lymphoma in the breast. We present a case of LELC of the breast presenting as an abscess along with a review of the literature. This is the 21(st) reported case of LELC of the breast and the first case to present as an abscess. Her clinical picture could have been mistaken for other infectious or inflammatory diseases. Given the potential for favorable outcome, early detection and general knowledge of this neoplasm are essential to expedite treatment for this rare tumor type.

Prenatal irradiation, possible etiological factor in epilepsy (in French)

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

Geets, W.

1972-01-01

Twenty four cases of epilepsy in a group of 28 children aged 1 month to 16 yrs, in whom antecedents were negative except that - the mother had undergone an abdominal radiography during pregnancy were observed. In seven cases a mild mental retardation was noted. Generalized seizures were first observed between the age of 1 month and 4.5 yrs, focal attacks between the age of 7 and 12.5 yrs. EEG recordings at rest show discharges of generalized or focal slow waves in eight cases and a reduced acceleration of the cerebral rhythm between 3 and 7 yrs, in seven cases.more » These clinical observations confirm some experimental data but a statistical analysis on a larger scale is necessary. (auth)« less

Viral Retinitis following Intraocular or Periocular Corticosteroid Administration: A Case Series and Comprehensive Review of the Literature

PubMed Central

Takakura, Ako; Tessler, Howard H.; Goldstein, Debra A.; Guex-Crosier, Yan; Chan, Chi-Chao; Brown, Diane M.; Thorne, Jennifer E.; Wang, Robert; Cunningham, Emmett T.

2014-01-01

Purpose To describe viral retinitis following intravitreal and periocular corticosteroid administration. Methods Retrospective case series and comprehensive literature review. Results We analyzed 5 unreported and 25 previously published cases of viral retinitis following local corticosteroid administration. Causes of retinitis included 23 CMV (76.7%), 5 HSV (16.7%), and 1 each VZV and unspecified (3.3%). Two of 22 tested patients (9.1%) were HIV positive. Twenty-one of 30 (70.0%) cases followed one or more intravitreal injections of triamcinolone acetonide (TA), 4 (13.3%) after one or more posterior sub-Tenon injections of TA, 3 (10.0%) after placement of a 0.59-mg fluocinolone acetonide implant (Retisert), and 1 (3.3%) each after an anterior subconjunctival injection of TA (together with IVTA), an anterior chamber injection, and an anterior sub-Tenon injection. Mean time from most recent corticosteroid administration to development of retinitis was 4.2 months (median 3.8; range 0.25–13.0). Twelve patients (40.0%) had type II diabetes mellitus. Treatments used included systemic antiviral agents (26/30, 86.7%), intravitreal antiviral injections (20/30, 66.7%), and ganciclovir intravitreal implants (4/30, 13.3%). Conclusions Viral retinitis may develop or reactivate following intraocular or periocular corticosteroid administration. Average time to development of retinitis was 4 months, and CMV was the most frequently observed agent. Diabetes was a frequent co-morbidity and several patients with uveitis who developed retinitis were also receiving systemic immunosuppressive therapy. PMID:24655372

New application of 18F-fluoride PET for the detection of bone remodeling in early-stage osteoarthritis of the hip.

PubMed

Kobayashi, Naomi; Inaba, Yutaka; Tateishi, Ukihide; Yukizawa, Yohei; Ike, Hiroyuki; Inoue, Tomio; Saito, Tomoyuki

2013-10-01

Recent studies have reported the acceleration of subchondral bone remodeling during the development of osteoarthritis (OA). However, it is not possible to evaluate such molecular abnormalities using conventional radiographic techniques. We have applied 18F-fluoride PET to the analysis of painful or dysplastic hips at various stages of OA and then compared this with radiographic findings and clinical findings. A consecutive series of 65 joints from 48 patients (average age, 40 years; range, 19-72 years) with a hip joint complaint or radiographic dysplastic hip were enrolled in this study. Twenty-five contralateral joints without any evidence of OA or clinical symptoms were assigned as a normal control group. Radiographic evaluations were performed on the basis of Kellgren and Lawrence grade and the minimum joint space. Clinical evaluations were performed using the grading scale for pain severity and the SUVmax was measured for each joint. The association between SUVmax and the radiographic or clinical findings was evaluated. 18F-fluoride PET shows a significantly higher uptake value for progressive-stage OA cases than for early-stage cases and also shows a significantly higher uptake value in cases with severe pain. Even in early-OA-stage patients who do not show joint space narrowing on a plain x-ray, cases with severe pain show a significantly higher uptake value. 18F-fluoride PET has great potential as an imaging method for diagnosing early-stage OA without any marked radiographic changes.

[Abnormality of TOP2A expression and its gene copy number variations in neuroblastic tumors].

PubMed

Chen, J M; Zhou, C J; Ma, X L; Guan, D D; Yang, L Y; Yue, P; Gong, L P

2016-11-08

Objective: To detect TOP2A protein expression and gene copy number alterations, and to analyze related clinical and pathological implications in pediatric neuroblastic tumors (NT). Methods: Immunohistochemistry was used to detect TOP2A protein expression. Fluorescence in situ hybridization (FISH) was used to detect numerical aberrations of TOP2A. Results: TOP2A protein was expressed in 59.1%(52/88) of cases, which was associated with differentiation ( P =0.006), Ki-67 index ( P <0.01) and MKI ( P =0.001). Twenty-eight cases (35.0%, 28/88) showed TOP2A gene amplification, which was correlated with the age ( P <0.01), clinical stage ( P =0.028), high risk group ( P =0.001), Ki-67 index ( P =0.040) and differentiation ( P =0.014). Survival analysis showed that TOP2A expression was related to survival rate. Multivariate analyses showed that TOP2A expression was an independent predictor for poor prognosis ( P =0.010). Conclusions: More than half of the cases show TOP2A expression, which is more likely associated with NB, high Ki-67 index and high MKI. Cases with TOP2A expression have shorter survivals and poorer prognosis. TOP2A amplification is seen in 35% and likely occurs in patients older than 18 months and at advanced INSS stages (Ⅲ and Ⅳ). As a target of the anthracycline-based adjuvant drugs, TOP2A test can be used to select patient with NT for the therapy.

Probabilistic Tractography of the Cranial Nerves in Vestibular Schwannoma.

PubMed

Zolal, Amir; Juratli, Tareq A; Podlesek, Dino; Rieger, Bernhard; Kitzler, Hagen H; Linn, Jennifer; Schackert, Gabriele; Sobottka, Stephan B

2017-11-01

Multiple recent studies have reported on diffusion tensor-based fiber tracking of cranial nerves in vestibular schwannoma, with conflicting results as to the accuracy of the method and the occurrence of cochlear nerve depiction. Probabilistic nontensor-based tractography might offer advantages in terms of better extraction of directional information from the underlying data in cranial nerves, which are of subvoxel size. Twenty-one patients with large vestibular schwannomas were recruited. The probabilistic tracking was run preoperatively and the position of the potential depictions of the facial and cochlear nerves was estimated postoperatively by 3 independent observers in a blinded fashion. The true position of the nerve was determined intraoperatively by the surgeon. Thereafter, the imaging-based estimated position was compared with the intraoperatively determined position. Tumor size, cystic appearance, and postoperative House-Brackmann score were analyzed with regard to the accuracy of the depiction of the nerves. The probabilistic tracking showed a connection that correlated to the position of the facial nerve in 81% of the cases and to the position of the cochlear nerve in 33% of the cases. Altogether, the resulting depiction did not correspond to the intraoperative position of any of the nerves in 3 cases. In a majority of cases, the position of the facial nerve, but not of the cochlear nerve, could be estimated by evaluation of the probabilistic tracking results. However, false depictions not corresponding to any nerve do occur and cannot be discerned as such from the image only. Copyright © 2017 Elsevier Inc. All rights reserved.

Influence of different types of pulp treatment during isolation in the obtention of human dental pulp stem cells

PubMed Central

Viña-Almunia, Jose; Borras, Consuelo; Gambini, Juan; El Alamy, Marya; Viña, Jose

2016-01-01

Background Different methods have been used in order to isolate dental pulp stem cells. The aim of this study was to study the effect of different types of pulp treatment during isolation, under 3% O2 conditions, in the time needed and the efficacy for obtaining dental pulp stem cells. Material and Methods One hundred and twenty dental pulps were used to isolate dental pulp stem cells treating the pulp tissue during isolation using 9 different methods, using digestive, disgregation, or mechanical agents, or combining them. The cells were positive for CD133, Oct4, Nestin, Stro-1, CD34 markers, and negative for the hematopoietic cell marker CD-45, thus confirming the presence of mesenchymal stem cells. The efficacy of dental pulp stem cells obtention and the minimum time needed to obtain such cells comparing the 9 different methods was analyzed. Results Dental pulp stem cells were obtained from 97 of the 120 pulps used in the study, i.e. 80.8% of the cases. They were obtained with all the methods used except with mechanical fragmentation of the pulp, where no enzymatic digestion was performed. The minimum time needed to isolate dental pulp stem cells was 8 hours, digesting with 2mg/ml EDTA for 10 minutes, 4mg/ml of type I collagenase, 4mg/ml of type II dispase for 40 minutes, 13ng/ml of thermolysine for 40 minutes and sonicating the culture for one minute. Conclusions Dental pulp stem cells were obtained in 97 cases from a series of 120 pulps. The time for obtaining dental pulp stem cells was reduced maximally, without compromising the obtention of the cells, by combining digestive, disgregation, and mechanical agents. Key words:Dental pulp stem cells, mesenchymal stem cells, isolation method. PMID:26946201

Twenty-first century learning in school systems: the case of the Metropolitan School District of Lawrence Township, Indianapolis, Indiana.

PubMed

Capuano, Marcia; Knoderer, Troy

2006-01-01

To empower students with skills such as information and technological literacy, global awareness and cultural competence, self-direction, and sound reasoning, teachers must master these skills themselves. This chapter examines how the Digital Age Literacy Initiative of the Metropolitan School District of Lawrence Township in Indianapolis, Indiana, which is funded by the Lilly Endowment, incorporated twenty-first century learning through a systemic approach involving teacher training and the use of data. The authors explain the district's content, process, and context goals toward accomplishing its mission of empowering students with the necessary twenty-first century skills to succeed in the digital age. The district places a strong emphasis on professional development for teachers. To support the necessary teacher learning and therefore sustain the work of the initiative, the district has adopted action research, self-assessment, and an online professional development network. To support teachers in implementing new strategies, master teachers serve as digital age literacy coaches. The chapter discusses the initiative's focus on evidence of progress. Through a partnership with the Metiri Group of California, the district has built a range of assessments including online inventories and twenty-first century skill rubrics. For example, the Mankato Survey collected teacher and student data around access, ability, and use of technology in the classroom in 2001 and then in 2004. This research showed significant gains in some technologies across all grade levels and consistent gains in nearly all technologies for middle and high school students. As it moves into the next phase of implementing the Digital Age Literacy Initiative, the district embraces the systemic shifts in school culture necessary to institutionalize twenty-first century learning.

Ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock: Case report.

PubMed

Corbacioglu, Kerem Seref; Aksel, Gokhan; Yildiz, Altan

2016-03-01

Pseudoaneurysm of the superior gluteal artery (SGA) is very rare and the most common causes are blunt or penetrating pelvic traumas. Although pseudoaneurysm can be asymptomatic at the time of initial trauma, it can be symptomatic weeks, months, even years after initial trauma. We present a case of a ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock twenty days after a bomb injury in the Syria civil war. In addition, we review the anatomy of the SGA, clinical presentation and pitfalls of pseudoaneurysm, and imaging and treatment options.

[Presentation of 2 cases of sudden deafness in patients with sickle-cell anemia and trait].

PubMed

García Callejo, F J; Sebastián Gil, E; Morant Ventura, A; Marco Algarra, J

2002-05-01

We report two cases of sudden deafness which appeared during vaso-occlusive crisis of a sickle cell anaemia (homozygous form of disease) and a sickle cell trait (heterozygous form) in two males aged sixteen and twenty-two, respectively. A high erythrocyte aggregability and low deformability were proved in both young men. Although hearing disorders have been reported in this disease, a sudden onset is not common. The treatment used was useful in the removal of painful crisis and infections, but deafness did not improve in either of then.

Advanced soft computing diagnosis method for tumour grading.

PubMed

Papageorgiou, E I; Spyridonos, P P; Stylios, C D; Ravazoula, P; Groumpos, P P; Nikiforidis, G N

2006-01-01

To develop an advanced diagnostic method for urinary bladder tumour grading. A novel soft computing modelling methodology based on the augmentation of fuzzy cognitive maps (FCMs) with the unsupervised active Hebbian learning (AHL) algorithm is applied. One hundred and twenty-eight cases of urinary bladder cancer were retrieved from the archives of the Department of Histopathology, University Hospital of Patras, Greece. All tumours had been characterized according to the classical World Health Organization (WHO) grading system. To design the FCM model for tumour grading, three experts histopathologists defined the main histopathological features (concepts) and their impact on grade characterization. The resulted FCM model consisted of nine concepts. Eight concepts represented the main histopathological features for tumour grading. The ninth concept represented the tumour grade. To increase the classification ability of the FCM model, the AHL algorithm was applied to adjust the weights of the FCM. The proposed FCM grading model achieved a classification accuracy of 72.5%, 74.42% and 95.55% for tumours of grades I, II and III, respectively. An advanced computerized method to support tumour grade diagnosis decision was proposed and developed. The novelty of the method is based on employing the soft computing method of FCMs to represent specialized knowledge on histopathology and on augmenting FCMs ability using an unsupervised learning algorithm, the AHL. The proposed method performs with reasonably high accuracy compared to other existing methods and at the same time meets the physicians' requirements for transparency and explicability.

[Legionnaires' disease in travellers].

PubMed

Jarraud, S; Reyrolle, M; Riffard, S; Lo Presti, F; Etienne, J

1998-01-01

The outbreak of pneumonia involving delegates to the 1976 American Legion convention at a Philadelphia hotel was the first example of travel-associated legionnaires' disease. Travel is now well known as a common risk factor for legionnaires' disease. This travel-associated disease is a preoccupation among European countries because of morbidity among citizens of the European Union. The definition of the case of legionellosis is a patient who presents an acute lower respiratory tract infection with focal signs of pneumonia and/or radiological features, and microbiological evidence of Legionella infection. A case is considered to be travel associated if the patient has spent one or more nights away from home during the ten days before becoming ill. An European Surveillance Scheme for Travel-Associated Legionnaires' Disease was established in 1987 to identify clusters and outbreaks of cases of the disease. This group centralizes the case reports of twenty-nine collaborating centres in twenty-five countries. Outbreaks of legionnaires' disease were described in hotels, camps or cruise ships. In 1996, the number of travel-associated cases of legionnaires' disease represented 16% of the total number cases. The increase of the number of reported cases may reflect improved surveillance and increased ascertainment. In Europe in 1996, the diagnosis of legionellosis was confirmed by detection of Legionella pneumophila sero-group 1 antigen in urine (36%), seroconversion (fourfold rise in antibody titre, 33%) and culture of the organism (16%). Fifteen per cent of legionellosis was diagnosed by the identification of a single high antibody titre. In France a coordination between Public Health Institutions (Réseau National de Santé Public and DDASS), clinicians, laboratories and National Reference Center was established to improve prevention and control of legionnaires' disease outbreaks. Legislation obliges to report each case. When more two cases in the same area are notified an epidemiological investigation must be done. The knowing of the source of the contamination and its eradication allows to prevent new cases and outbreaks. Outbreaks of Legionnaires' disease are even now mediatic and this fact leads to maintain attention for the quality of diagnosis and epidemiology investigation due to touristic and economic consequences for the implicated countries.

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

PubMed

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

2015-06-01

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

Newly Designed Break-Apart and ASPL-TFE3 Dual-Fusion FISH Assay Are Useful in Diagnosing Xp11.2 Translocation Renal Cell Carcinoma and ASPL-TFE3 Renal Cell Carcinoma

PubMed Central

Chen, Xiancheng; Yang, Yang; Gan, Weidong; Xu, Linfeng; Ye, Qing; Guo, Hongqian

2015-01-01

Abstract The diagnosis of Xp11.2 translocation renal cell carcinoma (tRCC), which relies on morphology and immunohistochemistry (IHC), is often either missed in the diagnosis or misdiagnosed. To improve the accuracy of diagnosis of Xp11.2 tRCC and ASPL-TFE3 renal cell carcinoma (RCC), we investigated newly designed fluorescence in situ hybridization (FISH) probes (diagnostic accuracy study). Based on the genetic characteristics of Xp11.2 tRCC and the ASPL-TFE3 RCC, a new break-apart TFE3 FISH probe and an ASPL-TFE3 dual-fusion FISH probe were designed and applied to 65 patients with RCC who were <45 years old or showed suspicious microscopic features of Xp11.2 tRCC in our hospital. To test the accuracy of the probes, we further performed reverse transcriptase–polymerase chain reaction (PCR) on 8 cases for which frozen tissues were available. Among the 65 cases diagnosed with RCC, TFE3 IHC was positive in 24 cases. Twenty-two cases were confirmed as Xp11.2 tRCC by break-apart TFE3 FISH, and 6 of these cases were further diagnosed as ASPL-TFE3 RCC by ASPL-TFE3 dual-fusion FISH detection. Importantly, reverse transcriptase–PCR showed concordant results with the results of FISH assay in the 8 available frozen cases. The break-apart and ASPL-TFE3 dual-fusion FISH assay can accurately detect the translocation of the TFE3 gene and ASPL-TFE3 fusion gene and can thus serve as a valid complementary method for diagnosing Xp11.2 tRCC and ASPL-TFE3 RCC. PMID:25984679

Newly designed break-apart and ASPL-TFE3 dual-fusion FISH assay are useful in diagnosing Xp11.2 translocation renal cell carcinoma and ASPL-TFE3 renal cell carcinoma: a STARD-compliant article.

PubMed

Chen, Xiancheng; Yang, Yang; Gan, Weidong; Xu, Linfeng; Ye, Qing; Guo, Hongqian

2015-05-01

The diagnosis of Xp11.2 translocation renal cell carcinoma (tRCC), which relies on morphology and immunohistochemistry (IHC), is often either missed in the diagnosis or misdiagnosed. To improve the accuracy of diagnosis of Xp11.2 tRCC and ASPL-TFE3 renal cell carcinoma (RCC), we investigated newly designed fluorescence in situ hybridization (FISH) probes (diagnostic accuracy study).Based on the genetic characteristics of Xp11.2 tRCC and the ASPL-TFE3 RCC, a new break-apart TFE3 FISH probe and an ASPL-TFE3 dual-fusion FISH probe were designed and applied to 65 patients with RCC who were <45 years old or showed suspicious microscopic features of Xp11.2 tRCC in our hospital. To test the accuracy of the probes, we further performed reverse transcriptase-polymerase chain reaction (PCR) on 8 cases for which frozen tissues were available.Among the 65 cases diagnosed with RCC, TFE3 IHC was positive in 24 cases. Twenty-two cases were confirmed as Xp11.2 tRCC by break-apart TFE3 FISH, and 6 of these cases were further diagnosed as ASPL-TFE3 RCC by ASPL-TFE3 dual-fusion FISH detection. Importantly, reverse transcriptase-PCR showed concordant results with the results of FISH assay in the 8 available frozen cases.The break-apart and ASPL-TFE3 dual-fusion FISH assay can accurately detect the translocation of the TFE3 gene and ASPL-TFE3 fusion gene and can thus serve as a valid complementary method for diagnosing Xp11.2 tRCC and ASPL-TFE3 RCC.

PROSPECTIVE ASSESSMENT OF THE CLINICAL, RADIOGRAPHIC AND FUNCTIONAL EVOLUTION OF TREATMENT FOR UNSTABLE TROCHANTERIC FRACTURES OF THE FEMUR USING A CEPHALOMEDULLARY NAIL

PubMed Central

Borger, Richard Armelin; Borger, Frederico Araújo; Pires de Araújo, Rodrigo; Pereira, Thiago Ferreira Nunes; Queiroz, Roberto Dantas

2015-01-01

To assess the clinical, radiological and functional evolution of osteosynthesis using a cephalomedullary nail, in unstable trochanteric fractures of the femur, over a one-year postoperative follow-up. Methods: Fourteen men and 23 women of mean age 77.7 years were evaluated. Twenty-seven of them had fractures classified as AO/ASIF 31A2 and ten as 31A3. The patients were evaluated clinically, radiologically and functionally one week, two weeks, one month, two months, six months and one year after the operation. Results: The clinical complications comprised five cases of death, one case of calcaneal ulcer, one case of acute arterial obstruction and two cases of deep vein thrombosis. The radiographic evaluation showed that the mean cervicodiaphyseal angle in the immediate postoperative period was 132.5°. The mean tip-apex index was 22.8 mm. After one year, the mean cervicodiaphyseal angle was 131.7°. Fracture consolidation was seen in all the patients six months after the operation, except in one case that presented cut-out. There were no cases of fracture below the implant. The functional evaluation using the Harris score after one year showed a mean of 69.3 points. The evaluation of walking progress showed that after one year, 40.6% of the patients had the same ability to walk that they had before the fracture. The visual analogue pain scale showed that a significant decrease in pain complaints occurred, going from 5.19 in the first week to 2.25 after 1 year. Conclusion: Osteosynthesis using a cephalomedullary nail resulted in low rates of clinical and mechanical complications and adequate functional outcomes. PMID:27027025

Measles outbreak prevention and control among adults: Lessons from an importation outbreak in Yunnan province, China, 2015.

PubMed

Zhao, Zhixian; Zhou, Rongrong; Yu, Wen; Li, Liqun; Li, Qiongfen; Hu, Pei

2018-04-03

The incidence of measles in Yunnan Province among vaccine target-age children has decreased markedly after attaining and sustaining high 2-dose coverage of measles containing vaccine (MCV) through routine immunization services and supplementary immunization activities (SIAs). Most cases of measles now occur among adults. In 2015, we investigated a measles outbreak among adults to determine transmission patterns and the potential role of nosocomial transmission. We enhanced measles surveillance using retrospective active case search. We conducted case investigations to determine sources of infection and routes of transmission; laboratory testing included serologic and molecular diagnostic methods. Twenty-two outbreak-associated cases of measles were identified; most (86.36%) were among individuals 20 to 39 years of age (range, 7 months to 43 years). We interviewed 19 individuals who had acquired measles. The first 3 cases were infected in Tibet; 12 (63%) were hospital-acquired infections; 2 (11%) were community-acquired; and 2 (11%) were family-contact cases. We conducted outbreak response immunization (ORI) that provided MCV without regard to vaccination status; 10,596 residents between 20 and 40 years of age were vaccinated. A serological survey conducted during the ORI showed that 84% of the 20-40 year-olds were immune to measles prior to vaccination. Post-vaccination serological testing showed 100% were immune. Despite high population immunity among children and adolescents, imported measles virus transmission occurred among adults in a provincial cross-border area. Nosocomial transmission and measles immunity gaps among adults poses a threat to measles elimination and highlights the strategy of targeting adults during ORI to outbreaks with adult-to-adult transmission.

Medical management of lead-exposed workers: results of physician interviews in New Jersey.

PubMed

Roché, L M; Gerwel, B; Ramaprasad, R; Udasin, I G

1995-02-01

Between July 1990 and April 1992, a questionnaire was administered to the physicians who saw 62 individuals with a blood lead (PbB) level equal to or higher than 2.40 mumol/liter with occupational inorganic lead exposure, to ascertain the medical management of workers with elevated PbB levels. Most of the 62 cases were seen by their personal physician (50%) or a private physician under contract with the company for which the patient worked (40%). Only eight (13%) patients were seen by a physician in a medical specialty assumed to include training relevant to occupational lead exposure. Fifteen percent of the patients' physicians reported taking no action for the elevated PbB level. Twenty-nine percent did not report retesting the patient (all should have been retested). Twenty-one percent of the 62 patients' physicians reported informing no one, including the patient, of the elevated PbB level. The majority of the physicians did not know the answer or declined to answer a question about what PbB level would prompt them to take six follow-up actions. The results of the physician interviews indicate that medical follow-up on workers with elevated PbB levels may not be adequate to prevent lead poisoning of the workers and their co-workers. Recommendations include methods to increase physician and employer knowledge of the medical management of workers with elevated PbB levels and to increase employer compliance with OSHA standards regarding medical surveillance of lead-exposed workers.

Prediction of load threshold of fibre-reinforced laminated composite panels subjected to low velocity drop-weight impact using efficient data filtering techniques

NASA Astrophysics Data System (ADS)

Farooq, Umar; Myler, Peter

This work is concerned with physical testing of carbon fibrous laminated composite panels with low velocity drop-weight impacts from flat and round nose impactors. Eight, sixteen, and twenty-four ply panels were considered. Non-destructive damage inspections of tested specimens were conducted to approximate impact-induced damage. Recorded data were correlated to load-time, load-deflection, and energy-time history plots to interpret impact induced damage. Data filtering techniques were also applied to the noisy data that unavoidably generate due to limitations of testing and logging systems. Built-in, statistical, and numerical filters effectively predicted load thresholds for eight and sixteen ply laminates. However, flat nose impact of twenty-four ply laminates produced clipped data that can only be de-noised involving oscillatory algorithms. Data filtering and extrapolation of such data have received rare attention in the literature that needs to be investigated. The present work demonstrated filtering and extrapolation of the clipped data using Fast Fourier Convolution algorithm to predict load thresholds. Selected results were compared to the damage zones identified with C-scan and acceptable agreements have been observed. Based on the results it is proposed that use of advanced data filtering and analysis methods to data collected by the available resources has effectively enhanced data interpretations without resorting to additional resources. The methodology could be useful for efficient and reliable data analysis and impact-induced damage prediction of similar cases' data.

The Case against Exit Exams. Policy Brief

ERIC Educational Resources Information Center

Hyslop, Anne

2014-01-01

In the 2013-14 school year, twenty-four states required students to be proficient on standardized tests in order to graduate from high school. But starting next year, and in the years to come, states will launch more rigorous, college- and career-ready assessments aligned to the Common Core. As they do so, they should revisit the stakes on these…

Teachers' Perceptions about Teaching Multimodal Composition: The Case Study of Korean English Teachers at Secondary Schools

ERIC Educational Resources Information Center

Ryu, Jung; Boggs, George

2016-01-01

Twenty-first-century literacy is not confined to communication based on reading and writing only traditional printed texts. New kinds of literacies extend to multimedia projects and multimodal texts, which include visual, audio, and technological elements to create meanings. The purpose of this study is to explore how Korean secondary English…

Orientation Programs and Student Retention in Distance Learning: The Case of University of Cape Coast

ERIC Educational Resources Information Center

Arhin, Vera; Wang'eri, Tabitha

2018-01-01

This study investigated how orientation programs predict student retention in distance learning at the University of Cape Coast. A correlational research design was employed for the study. The target population was level-200 students in the distance education program at the university. Seven hundred and twenty-seven participants were selected from…

How Twenty-Five People Shook the Archival World: The Case of Descriptive Standards

ERIC Educational Resources Information Center

Davis, Susan E.

2006-01-01

This study explores the development of the archival profession during the 1980s, a period that experienced rapid change and the adoption of the first descriptive standards. The research focuses on the leadership roles played by individuals acting independently and on behalf of their employing institutions and professional associations in the…

National Symposium on Information Technology: Proceedings (7th, Myrtle Beach, South Carolina, May 3-6, 1992). Volume 6.

ERIC Educational Resources Information Center

Lesser, Donna L., Ed.

Twenty-three papers address issues of access, case management, innovative computer applications, and information and referral in the use of information technology by individuals with disabilities and their families. The papers are: "Improving the Use of Information Technology by Individuals with Disabilities and Their Families" (William H.…

Good Intentions: Teaching and Specialist Support Staff Perspectives of Student Disclosure of Mental Health Issues in Post-Secondary Education

ERIC Educational Resources Information Center

Venville, Annie; Street, Annette F.; Fossey, Ellie

2014-01-01

This article reports findings from a qualitative case study, as part of which staff perspectives of student disclosure of mental health issues in an Australian post-secondary vocational education setting were explored. Twenty teaching and specialist support staff from four vocational education and training institutions participated in individual…

Child Sexual Abuse in the Anglican Church of Australia

ERIC Educational Resources Information Center

Parkinson, Patrick N.; Oates, R. Kim; Jayakody, Amanda A.

2012-01-01

This article reports on a retrospective study of cases of child sexual abuse complaints made against clergy, other employed pastoral staff, and volunteers in the Anglican Church of Australia between 1990 and 2008. There were 191 allegations of sexual abuse made by 180 complainants against 135 individuals. Twenty-seven of those 135 had more than…

Algorithmic Contexts and Learning Potentiality: A Case Study of Students' Understanding of Calculus

ERIC Educational Resources Information Center

Pettersson, Kerstin; Scheja, Max

2008-01-01

The study explores the nature of students' conceptual understanding of calculus. Twenty students of engineering were asked to reflect in writing on the meaning of the concepts of limit and integral. A sub-sample of four students was selected for subsequent interviews, which explored in detail the students' understandings of the two concepts.…

Renewal: Remaking America's Schools for the Twenty-First Century

ERIC Educational Resources Information Center

Kwalwasser, Harold

2012-01-01

Harold Kwalwasser has put together a call to action for education reform that makes a clear case for what has to be done in order to educate all children to their full potential. He visited forty high-performing and transforming school districts, charters, parochial, and private schools to understand why they have succeeded where others have…

Moebius Sequence and Autism Spectrum Disorders--Less Frequently Associated than Formerly Thought

ERIC Educational Resources Information Center

Briegel, Wolfgang; Schimek, Martina; Kamp-Becker, Inge

2010-01-01

Moebius sequence is a rare congenital disorder usually defined as a combination of facial weakness with impairment of ocular abduction. It is questionable, whether there is a strong association of the sequence with autism spectrum disorders (ASDs) as suggested in some earlier case reports and studies. Twenty-two participants with Moebius sequence…

Beer, Free Speech, and Barriers to Interstate Commerce: A Case of Imported Beer

ERIC Educational Resources Information Center

Monseau, Susanna

2008-01-01

In the twenty-first century, differences in the treatment of trade in alcoholic beverages in comparison to other commercial goods seem at odds with the federal regulation of interstate trade under the Commerce Clause of the United States Constitution, which prohibits "differential treatment of in-state and out-of-state economic interests that…

Twenty-Five Years after "Larry P.": The California Response to Overrepresentation of African Americans in Special Education

ERIC Educational Resources Information Center

Powers, Kristin M.; Hagans-Murillo, Kristi S.; Restori, Alberto F.

2004-01-01

In this article, major laws, regulations, court cases, policies and practices related to intelligence testing of African American students in California are reviewed. A California Department of Education (CDE) ban on intelligence testing of African American students for the purpose of determining special education eligibility is in effect and…

Reiteration Relations in EFL Student Writing: The Case of Moroccan University Students

ERIC Educational Resources Information Center

Hellalet, Nadia

2013-01-01

This study looks into the use of reiteration relations in EFL student writing. The aim is to determine the extent to which Moroccan college students rely on lexical cohesion to produce native-sounding texts. Twenty essays written by college students from two different levels were analyzed quantitatively using Halliday and Hasan's (1976) and Hoey's…

Examining of Model Eliciting Activities Developed by Mathematics Student Teachers

ERIC Educational Resources Information Center

Dede, Ayse Tekin; Hidiroglu, Çaglar Naci; Güzel, Esra Bukova

2017-01-01

The purpose of this study is to examine the model eliciting activities developed by the mathematics student teachers in the context of the principles of the model eliciting activities. The participants of the study conducted as a case study design were twenty one mathematics student teachers working on seven groups. The data collection tools were…

Directionality Effects in Simultaneous Language Interpreting: The Case of Sign Language Interpreters in the Netherlands

ERIC Educational Resources Information Center

van Dijk, Rick; Boers, Eveline; Christoffels, Ingrid; Hermans, Daan

2011-01-01

The quality of interpretations produced by sign language interpreters was investigated. Twenty-five experienced interpreters were instructed to interpret narratives from (a) spoken Dutch to Sign Language of the Netherlands (SLN), (b) spoken Dutch to Sign Supported Dutch (SSD), and (c) SLN to spoken Dutch. The quality of the interpreted narratives…

And Gladly Teche: Notes on Instructing the Natives in the Native Tongue.

ERIC Educational Resources Information Center

Laird, Charlton

Twenty-three lectures by Charlton Laird, read at institutes and conventions over the past 25 years, deal with such areas in language, literature, and composition as "Trouble in Linguistic Paradise;""A Simpleminded Look at Grammar and Language;""Goldilocks and the Three or More Rhetorics;""More About Creative Writing;""The Case for Casebooks: One…

Madera Unified School District, 2004-2009. District Case Study

ERIC Educational Resources Information Center

Pivot Learning Partners, 2012

2012-01-01

Situated in the heart of the fertile San Joaquin Valley twenty miles north of Fresno, the city of Madera has a population of 56,710 people. Agriculture is the driving force behind the local economy; the area produces more than 100 crops including raisin grapes, almonds, figs, pistachios, alfalfa, corn, milk, cattle and poultry. The total value of…

Whatever Happened to Learning?

ERIC Educational Resources Information Center

Moore, Honour H.

2009-01-01

Twenty-five years ago, when the author began her career in higher education, it seemed to her that adult students started or went back to college because they wanted to learn. Either they felt something missing in their lives, that they hoped an education would provide, or they had a hunger for something beyond the mundane. In either case, for the…

Institutional Factors That Positively Impact First-Year Students' Sense of Well-Being

ERIC Educational Resources Information Center

Harmening, Debra S.; Jacob, Stacy A.

2015-01-01

This qualitative case study conducted at a single institution in the Midwest examines how institutional context and environment impact college students' sense of well-being. Twenty-seven first-year students participated in one to two hour, in-depth interviews where they talked about their first-year experiences, their concepts of well-being, and…

Concept Mapping in Science Class: A Case Study of Fifth Grade Students

ERIC Educational Resources Information Center

Asan, Askin

2007-01-01

The purpose of this research project was to determine the effects of incorporating concept mapping on the achievement of fifth grade students in science class. The study was conducted with twenty-three students at Ata Elementary School, Trabzon, Turkey. The students were tested with teacher-constructed pre- and post tests containing 20…

"Get an Education in Case He Leaves You": "Consejos" for Mexican American Women PhDs

ERIC Educational Resources Information Center

Espino, Michelle M.

2016-01-01

In this study, Michelle M. Espino uncovers the ways in which twenty-five Mexican American women PhDs made meaning of conflicting messages about the purpose of higher education as they navigated within and through educational structures and shifting familial expectations. Participants received "consejos", or nurturing advice, from parents…

Economic Rationalism: Serving Tertiary Business Education Needs? The Australian Case

ERIC Educational Resources Information Center

Richter, Ewa Maria; Buttery, Ernest Alan

2004-01-01

Economic rationalism is a major driver of the education system in many parts of the world. In the scramble to facilitate economic rationalism, the education needs required at national level to keep nations, like Australia, competitive into the twenty-first century have not been fully considered. Such countries have ignored the needs of education…

Scientific Literacy and Purposes for Teaching Science: A Case Study of Lebanese Private School Teachers

ERIC Educational Resources Information Center

Dani, Danielle

2009-01-01

In the United States and around the world, calls for educational reform stress the need for a scientifically literate population, prepared for the twenty-first century workforce. These calls have translated into new curricula, which in isolation, are not enough? Teachers play an essential role in the development of scientifically literate…

Middle Years Students' Experiences in Nature: A Case Study on Nature-Play

ERIC Educational Resources Information Center

Francis, Marj; Paige, Kathy; Lloyd, David

2013-01-01

Increasingly, children today are becoming disconnected from the natural environments resulting in a diminished sense of self, place and community. In an attempt to find out their perceptions, attitudes and values about the natural world, twenty-five Year 6 and 7 students from a northern Adelaide primary school participated in a nature-play case…

Sequential Bimodal Bilingual Acquisition: Mediation Using a Cochlear Implant as a Tool

ERIC Educational Resources Information Center

Cramér-Wolrath, Emelie

2013-01-01

Most deaf children are born to hearing families. During the last twenty years deaf children, in increasing numbers and at an early age, receive a cochlear implant, a highly technological hearing device. The aim of this qualitative, longitudinal, single-case study was to explore and describe critical changes in naturalistic, video-observed…

The Role of Sensorimotor Impairments in Dyslexia: A Multiple Case Study of Dyslexic Children

ERIC Educational Resources Information Center

White, Sarah; Milne, Elizabeth; Rosen, Stuart; Hansen, Peter; Swettenham, John; Frith, Uta; Ramus, Franck

2006-01-01

This study attempts to investigate the role of sensorimotor impairments in the reading disability that characterizes dyslexia. Twenty-three children with dyslexia were compared to 22 control children, matched for age and non-verbal intelligence, on tasks assessing literacy as well as phonological, visual, auditory and motor abilities. The dyslexic…