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Sample records for official american thoracic

  1. An official American Thoracic Society/European Respiratory Society statement: research questions in COPD.

    PubMed

    Celli, Bartolome R; Decramer, Marc; Wedzicha, Jadwiga A; Wilson, Kevin C; Agustí, Alvar A; Criner, Gerard J; MacNee, William; Make, Barry J; Rennard, Stephen I; Stockley, Robert A; Vogelmeier, Claus; Anzueto, Antonio; Au, David H; Barnes, Peter J; Burgel, Pierre-Regis; Calverley, Peter M; Casanova, Ciro; Clini, Enrico M; Cooper, Christopher B; Coxson, Harvey O; Dusser, Daniel J; Fabbri, Leonardo M; Fahy, Bonnie; Ferguson, Gary T; Fisher, Andrew; Fletcher, Monica J; Hayot, Maurice; Hurst, John R; Jones, Paul W; Mahler, Donald A; Maltais, François; Mannino, David M; Martinez, Fernando J; Miravitlles, Marc; Meek, Paula M; Papi, Alberto; Rabe, Klaus F; Roche, Nicolas; Sciurba, Frank C; Sethi, Sanjay; Siafakas, Nikos; Sin, Don D; Soriano, Joan B; Stoller, James K; Tashkin, Donald P; Troosters, Thierry; Verleden, Geert M; Verschakelen, Johny; Vestbo, Jorgen; Walsh, John W; Washko, George R; Wise, Robert A; Wouters, Emiel F M; ZuWallack, Richard L

    2015-06-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) Research Statement is to describe evidence related to diagnosis, assessment, and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. Clinicians, researchers and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified. Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers and patient advocates believe will have the greatest impact on patient-centred outcomes.

  2. An official American Thoracic Society/European Respiratory Society statement: research questions in COPD.

    PubMed

    Celli, Bartolome R; Decramer, Marc; Wedzicha, Jadwiga A; Wilson, Kevin C; Agustí, Alvar; Criner, Gerard J; MacNee, William; Make, Barry J; Rennard, Stephen I; Stockley, Robert A; Vogelmeier, Claus; Anzueto, Antonio; Au, David H; Barnes, Peter J; Burgel, Pierre-Regis; Calverley, Peter M; Casanova, Ciro; Clini, Enrico M; Cooper, Christopher B; Coxson, Harvey O; Dusser, Daniel J; Fabbri, Leonardo M; Fahy, Bonnie; Ferguson, Gary T; Fisher, Andrew; Fletcher, Monica J; Hayot, Maurice; Hurst, John R; Jones, Paul W; Mahler, Donald A; Maltais, François; Mannino, David M; Martinez, Fernando J; Miravitlles, Marc; Meek, Paula M; Papi, Alberto; Rabe, Klaus F; Roche, Nicolas; Sciurba, Frank C; Sethi, Sanjay; Siafakas, Nikos; Sin, Don D; Soriano, Joan B; Stoller, James K; Tashkin, Donald P; Troosters, Thierry; Verleden, Geert M; Verschakelen, Johny; Vestbo, Jorgen; Walsh, John W; Washko, George R; Wise, Robert A; Wouters, Emiel F M; ZuWallack, Richard L

    2015-04-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) research statement is to describe evidence related to diagnosis, assessment and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. Clinicians, researchers, and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified. Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers, and patient advocates believe will have the greatest impact on patient-centred outcomes.

  3. An official American Thoracic Society workshop report: assessment and palliative management of dyspnea crisis.

    PubMed

    Mularski, Richard A; Reinke, Lynn F; Carrieri-Kohlman, Virginia; Fischer, Mark D; Campbell, Margaret L; Rocker, Graeme; Schneidman, Ann; Jacobs, Susan S; Arnold, Robert; Benditt, Joshua O; Booth, Sara; Byock, Ira; Chan, Garrett K; Curtis, J Randall; Donesky, Doranne; Hansen-Flaschen, John; Heffner, John; Klein, Russell; Limberg, Trina M; Manning, Harold L; Morrison, R Sean; Ries, Andrew L; Schmidt, Gregory A; Selecky, Paul A; Truog, Robert D; Wang, Angela C C; White, Douglas B

    2013-10-01

    In 2009, the American Thoracic Society (ATS) funded an assembly project, Palliative Management of Dyspnea Crisis, to focus on identification, management, and optimal resource utilization for effective palliation of acute episodes of dyspnea. We conducted a comprehensive search of the medical literature and evaluated available evidence from systematic evidence-based reviews (SEBRs) using a modified AMSTAR approach and then summarized the palliative management knowledge base for participants to use in discourse at a 2009 ATS workshop. We used an informal consensus process to develop a working definition of this novel entity and established an Ad Hoc Committee on Palliative Management of Dyspnea Crisis to further develop an official ATS document on the topic. The Ad Hoc Committee members defined dyspnea crisis as "sustained and severe resting breathing discomfort that occurs in patients with advanced, often life-limiting illness and overwhelms the patient and caregivers' ability to achieve symptom relief." Dyspnea crisis can occur suddenly and is characteristically without a reversible etiology. The workshop participants focused on dyspnea crisis management for patients in whom the goals of care are focused on palliation and for whom endotracheal intubation and mechanical ventilation are not consistent with articulated preferences. However, approaches to dyspnea crisis may also be appropriate for patients electing life-sustaining treatment. The Ad Hoc Committee developed a Workshop Report concerning assessment of dyspnea crisis; ethical and professional considerations; efficient utilization, communication, and care coordination; clinical management of dyspnea crisis; development of patient education and provider aid products; and enhancing implementation with audit and quality improvement.

  4. An official European Respiratory Society/American Thoracic Society research statement: interstitial pneumonia with autoimmune features.

    PubMed

    Fischer, Aryeh; Antoniou, Katerina M; Brown, Kevin K; Cadranel, Jacques; Corte, Tamera J; du Bois, Roland M; Lee, Joyce S; Leslie, Kevin O; Lynch, David A; Matteson, Eric L; Mosca, Marta; Noth, Imre; Richeldi, Luca; Strek, Mary E; Swigris, Jeffrey J; Wells, Athol U; West, Sterling G; Collard, Harold R; Cottin, Vincent

    2015-10-01

    Many patients with an idiopathic interstitial pneumonia (IIP) have clinical features that suggest an underlying autoimmune process but do not meet established criteria for a connective tissue disease (CTD). Researchers have proposed differing criteria and terms to describe these patients, and lack of consensus over nomenclature and classification limits the ability to conduct prospective studies of a uniform cohort.The "European Respiratory Society/American Thoracic Society Task Force on Undifferentiated Forms of Connective Tissue Disease-associated Interstitial Lung Disease" was formed to create consensus regarding the nomenclature and classification criteria for patients with IIP and features of autoimmunity.The task force proposes the term "interstitial pneumonia with autoimmune features" (IPAF) and offers classification criteria organised around the presence of a combination of features from three domains: a clinical domain consisting of specific extra-thoracic features, a serologic domain consisting of specific autoantibodies, and a morphologic domain consisting of specific chest imaging, histopathologic or pulmonary physiologic features.A designation of IPAF should be used to identify individuals with IIP and features suggestive of, but not definitive for, a CTD. With IPAF, a sound platform has been provided from which to launch the requisite future research investigations of a more uniform cohort.

  5. An Official American Thoracic Society Workshop Report 2015. Stem Cells and Cell Therapies in Lung Biology and Diseases.

    PubMed

    Wagner, Darcy E; Cardoso, Wellington V; Gilpin, Sarah E; Majka, Susan; Ott, Harald; Randell, Scott H; Thébaud, Bernard; Waddell, Thomas; Weiss, Daniel J

    2016-08-01

    The University of Vermont College of Medicine, in collaboration with the NHLBI, Alpha-1 Foundation, American Thoracic Society, Cystic Fibrosis Foundation, European Respiratory Society, International Society for Cellular Therapy, and the Pulmonary Fibrosis Foundation, convened a workshop, "Stem Cells and Cell Therapies in Lung Biology and Lung Diseases," held July 27 to 30, 2015, at the University of Vermont. The conference objectives were to review the current understanding of the role of stem and progenitor cells in lung repair after injury and to review the current status of cell therapy and ex vivo bioengineering approaches for lung diseases. These are all rapidly expanding areas of study that both provide further insight into and challenge traditional views of mechanisms of lung repair after injury and pathogenesis of several lung diseases. The goals of the conference were to summarize the current state of the field, discuss and debate current controversies, and identify future research directions and opportunities for both basic and translational research in cell-based therapies for lung diseases. This 10th anniversary conference was a follow up to five previous biennial conferences held at the University of Vermont in 2005, 2007, 2009, 2011, and 2013. Each of those conferences, also sponsored by the National Institutes of Health, American Thoracic Society, and respiratory disease foundations, has been important in helping guide research and funding priorities. The major conference recommendations are summarized at the end of the report and highlight both the significant progress and major challenges in these rapidly progressing fields. PMID:27509163

  6. An official American Thoracic Society workshop report: stem cells and cell therapies in lung biology and diseases.

    PubMed

    Weiss, Daniel J; Chambers, Daniel; Giangreco, Adam; Keating, Armand; Kotton, Darrell; Lelkes, Peter I; Wagner, Darcy E; Prockop, Darwin J

    2015-04-01

    The University of Vermont College of Medicine and the Vermont Lung Center, in collaboration with the NHLBI, Alpha-1 Foundation, American Thoracic Society, European Respiratory Society, International Society for Cell Therapy, and the Pulmonary Fibrosis Foundation, convened a workshop, "Stem Cells and Cell Therapies in Lung Biology and Lung Diseases," held July 29 to August 1, 2013 at the University of Vermont. The conference objectives were to review the current understanding of the role of stem and progenitor cells in lung repair after injury and to review the current status of cell therapy and ex vivo bioengineering approaches for lung diseases. These are all rapidly expanding areas of study that both provide further insight into and challenge traditional views of mechanisms of lung repair after injury and pathogenesis of several lung diseases. The goals of the conference were to summarize the current state of the field, discuss and debate current controversies, and identify future research directions and opportunities for both basic and translational research in cell-based therapies for lung diseases. This conference was a follow-up to four previous biennial conferences held at the University of Vermont in 2005, 2007, 2009, and 2011. Each of those conferences, also sponsored by the National Institutes of Health, American Thoracic Society, and Respiratory Disease Foundations, has been important in helping guide research and funding priorities. The major conference recommendations are summarized at the end of the report and highlight both the significant progress and major challenges in these rapidly progressing fields.

  7. An Official American Thoracic Society Workshop Report 2015. Stem Cells and Cell Therapies in Lung Biology and Diseases.

    PubMed

    Wagner, Darcy E; Cardoso, Wellington V; Gilpin, Sarah E; Majka, Susan; Ott, Harald; Randell, Scott H; Thébaud, Bernard; Waddell, Thomas; Weiss, Daniel J

    2016-08-01

    The University of Vermont College of Medicine, in collaboration with the NHLBI, Alpha-1 Foundation, American Thoracic Society, Cystic Fibrosis Foundation, European Respiratory Society, International Society for Cellular Therapy, and the Pulmonary Fibrosis Foundation, convened a workshop, "Stem Cells and Cell Therapies in Lung Biology and Lung Diseases," held July 27 to 30, 2015, at the University of Vermont. The conference objectives were to review the current understanding of the role of stem and progenitor cells in lung repair after injury and to review the current status of cell therapy and ex vivo bioengineering approaches for lung diseases. These are all rapidly expanding areas of study that both provide further insight into and challenge traditional views of mechanisms of lung repair after injury and pathogenesis of several lung diseases. The goals of the conference were to summarize the current state of the field, discuss and debate current controversies, and identify future research directions and opportunities for both basic and translational research in cell-based therapies for lung diseases. This 10th anniversary conference was a follow up to five previous biennial conferences held at the University of Vermont in 2005, 2007, 2009, 2011, and 2013. Each of those conferences, also sponsored by the National Institutes of Health, American Thoracic Society, and respiratory disease foundations, has been important in helping guide research and funding priorities. The major conference recommendations are summarized at the end of the report and highlight both the significant progress and major challenges in these rapidly progressing fields.

  8. An official American Thoracic Society workshop report: optimal lung function tests for monitoring cystic fibrosis, bronchopulmonary dysplasia, and recurrent wheezing in children less than 6 years of age.

    PubMed

    Rosenfeld, Margaret; Allen, Julian; Arets, Bert H G M; Aurora, Paul; Beydon, Nicole; Calogero, Claudia; Castile, Robert G; Davis, Stephanie D; Fuchs, Susanne; Gappa, Monika; Gustaffson, Per M; Hall, Graham L; Jones, Marcus H; Kirkby, Jane C; Kraemer, Richard; Lombardi, Enrico; Lum, Sooky; Mayer, Oscar H; Merkus, Peter; Nielsen, Kim G; Oliver, Cara; Oostveen, Ellie; Ranganathan, Sarath; Ren, Clement L; Robinson, Paul D; Seddon, Paul C; Sly, Peter D; Sockrider, Marianna M; Sonnappa, Samatha; Stocks, Janet; Subbarao, Padmaja; Tepper, Robert S; Vilozni, Daphna

    2013-04-01

    Although pulmonary function testing plays a key role in the diagnosis and management of chronic pulmonary conditions in children under 6 years of age, objective physiologic assessment is limited in the clinical care of infants and children less than 6 years old, due to the challenges of measuring lung function in this age range. Ongoing research in lung function testing in infants, toddlers, and preschoolers has resulted in techniques that show promise as safe, feasible, and potentially clinically useful tests. Official American Thoracic Society workshops were convened in 2009 and 2010 to review six lung function tests based on a comprehensive review of the literature (infant raised-volume rapid thoracic compression and plethysmography, preschool spirometry, specific airway resistance, forced oscillation, the interrupter technique, and multiple-breath washout). In these proceedings, the current state of the art for each of these tests is reviewed as it applies to the clinical management of infants and children under 6 years of age with cystic fibrosis, bronchopulmonary dysplasia, and recurrent wheeze, using a standardized format that allows easy comparison between the measures. Although insufficient evidence exists to recommend incorporation of these tests into the routine diagnostic evaluation and clinical monitoring of infants and young children with cystic fibrosis, bronchopulmonary dysplasia, or recurrent wheeze, they may be valuable tools with which to address specific concerns, such as ongoing symptoms or monitoring response to treatment, and as outcome measures in clinical research studies.

  9. An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

    PubMed Central

    Maltais, François; Decramer, Marc; Casaburi, Richard; Barreiro, Esther; Burelle, Yan; Debigaré, Richard; Dekhuijzen, P. N. Richard; Franssen, Frits; Gayan-Ramirez, Ghislaine; Gea, Joaquim; Gosker, Harry R.; Gosselink, Rik; Hayot, Maurice; Hussain, Sabah N. A.; Janssens, Wim; Polkey, Micheal I.; Roca, Josep; Saey, Didier; Schols, Annemie M. W. J.; Spruit, Martijn A.; Steiner, Michael; Taivassalo, Tanja; Troosters, Thierry; Vogiatzis, Ioannis; Wagner, Peter D.

    2014-01-01

    Background: Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. Purpose: The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. Methods: An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. Results: We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. Conclusions: Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem

  10. An Official American Thoracic Society/American College of Chest Physicians Policy Statement: Implementation of Low-Dose Computed Tomography Lung Cancer Screening Programs in Clinical Practice

    PubMed Central

    Wiener, Renda Soylemez; Gould, Michael K.; Arenberg, Douglas A.; Au, David H.; Fennig, Kathleen; Lamb, Carla R.; Mazzone, Peter J.; Midthun, David E.; Napoli, Maryann; Ost, David E.; Powell, Charles A.; Rivera, M. Patricia; Slatore, Christopher G.; Tanner, Nichole T.; Vachani, Anil; Wisnivesky, Juan P.; Yoon, Sue H.

    2015-01-01

    Rationale: Annual low-radiation-dose computed tomography (LDCT) screening for lung cancer has been shown to reduce lung cancer mortality among high-risk individuals and is now recommended by multiple organizations. However, LDCT screening is complex, and implementation requires careful planning to ensure benefits outweigh harms. Little guidance has been provided for sites wishing to develop and implement lung cancer screening programs. Objectives: To promote successful implementation of comprehensive LDCT screening programs that are safe, effective, and sustainable. Methods: The American Thoracic Society (ATS) and American College of Chest Physicians (CHEST) convened a committee with expertise in lung cancer screening, pulmonary nodule evaluation, and implementation science. The committee reviewed the evidence from systematic reviews, clinical practice guidelines, surveys, and the experience of early-adopting LDCT screening programs and summarized potential strategies to implement LDCT screening programs successfully. Measurements and Main Results: We address steps that sites should consider during the main three phases of developing an LDCT screening program: planning, implementation, and maintenance. We present multiple strategies to implement the nine core elements of comprehensive lung cancer screening programs enumerated in a recent CHEST/ATS statement, which will allow sites to select the strategy that best fits with their local context and workflow patterns. Although we do not comment on cost-effectiveness of LDCT screening, we outline the necessary costs associated with starting and sustaining a high-quality LDCT screening program. Conclusions: Following the strategies delineated in this policy statement may help sites to develop comprehensive LDCT screening programs that are safe and effective. PMID:26426785

  11. An Official American Thoracic Society Workshop Report. A Framework for Addressing Multimorbidity in Clinical Practice Guidelines for Pulmonary Disease, Critical Illness, and Sleep Disorders.

    PubMed

    Wilson, Kevin C; Gould, Michael K; Krishnan, Jerry A; Boyd, Cynthia M; Brozek, Jan L; Cooke, Colin R; Douglas, Ivor S; Goodman, Richard A; Joo, Min J; Lareau, Suzanne; Mularski, Richard A; Patel, Minal R; Rosenfeld, Richard M; Shanawani, Hasan; Slatore, Christopher; Sockrider, Marianna; Sufian, Beth; Thomson, Carey C; Wiener, Renda Soylemez

    2016-03-01

    Coexistence of multiple chronic conditions (i.e., multimorbidity) is the most common chronic health problem in adults. However, clinical practice guidelines have primarily focused on patients with a single disease, resulting in uncertainty about the care of patients with multimorbidity. The American Thoracic Society convened a workshop with the goal of establishing a strategy to address multimorbidity within clinical practice guidelines. In this Workshop Report, we describe a framework that addresses multimorbidity in each of the key steps of guideline development: topic selection, panel composition, identifying clinical questions, searching for and synthesizing evidence, rating the quality of that evidence, summarizing benefits and harms, formulating recommendations, and rating the strength of the recommendations. For the consideration of multimorbidity in guidelines to be successful and sustainable, the process must be both feasible and pragmatic. It is likely that this will be achieved best by the step-wise addition and refinement of the various components of the framework.

  12. Executive Summary: Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.

    PubMed

    Nahid, Payam; Dorman, Susan E; Alipanah, Narges; Barry, Pennan M; Brozek, Jan L; Cattamanchi, Adithya; Chaisson, Lelia H; Chaisson, Richard E; Daley, Charles L; Grzemska, Malgosia; Higashi, Julie M; Ho, Christine S; Hopewell, Philip C; Keshavjee, Salmaan A; Lienhardt, Christian; Menzies, Richard; Merrifield, Cynthia; Narita, Masahiro; O'Brien, Rick; Peloquin, Charles A; Raftery, Ann; Saukkonen, Jussi; Schaaf, H Simon; Sotgiu, Giovanni; Starke, Jeffrey R; Migliori, Giovanni Battista; Vernon, Andrew

    2016-10-01

    The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline. This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis. For all recommendations, literature reviews were performed, followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology. Given the public health implications of prompt diagnosis and effective management of tuberculosis, empiric multidrug treatment is initiated in almost all situations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities, severity of disease, and response to treatment influence management decisions. Specific recommendations on the use of case management strategies (including directly observed therapy), regimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tuberculosis treatment and timing of initiation of antiretroviral therapy), as well as treatment of extrapulmonary disease (central nervous system, pericardial among other sites) are provided. The development of more potent and better-tolerated drug regimens, optimization of drug exposure for the

  13. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.

    PubMed

    Nahid, Payam; Dorman, Susan E; Alipanah, Narges; Barry, Pennan M; Brozek, Jan L; Cattamanchi, Adithya; Chaisson, Lelia H; Chaisson, Richard E; Daley, Charles L; Grzemska, Malgosia; Higashi, Julie M; Ho, Christine S; Hopewell, Philip C; Keshavjee, Salmaan A; Lienhardt, Christian; Menzies, Richard; Merrifield, Cynthia; Narita, Masahiro; O'Brien, Rick; Peloquin, Charles A; Raftery, Ann; Saukkonen, Jussi; Schaaf, H Simon; Sotgiu, Giovanni; Starke, Jeffrey R; Migliori, Giovanni Battista; Vernon, Andrew

    2016-10-01

    The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline. This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis. For all recommendations, literature reviews were performed, followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology. Given the public health implications of prompt diagnosis and effective management of tuberculosis, empiric multidrug treatment is initiated in almost all situations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities, severity of disease, and response to treatment influence management decisions. Specific recommendations on the use of case management strategies (including directly observed therapy), regimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tuberculosis treatment and timing of initiation of antiretroviral therapy), as well as treatment of extrapulmonary disease (central nervous system, pericardial among other sites) are provided. The development of more potent and better-tolerated drug regimens, optimization of drug exposure for the

  14. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.

    PubMed

    Nahid, Payam; Dorman, Susan E; Alipanah, Narges; Barry, Pennan M; Brozek, Jan L; Cattamanchi, Adithya; Chaisson, Lelia H; Chaisson, Richard E; Daley, Charles L; Grzemska, Malgosia; Higashi, Julie M; Ho, Christine S; Hopewell, Philip C; Keshavjee, Salmaan A; Lienhardt, Christian; Menzies, Richard; Merrifield, Cynthia; Narita, Masahiro; O'Brien, Rick; Peloquin, Charles A; Raftery, Ann; Saukkonen, Jussi; Schaaf, H Simon; Sotgiu, Giovanni; Starke, Jeffrey R; Migliori, Giovanni Battista; Vernon, Andrew

    2016-10-01

    The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline. This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis. For all recommendations, literature reviews were performed, followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology. Given the public health implications of prompt diagnosis and effective management of tuberculosis, empiric multidrug treatment is initiated in almost all situations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities, severity of disease, and response to treatment influence management decisions. Specific recommendations on the use of case management strategies (including directly observed therapy), regimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tuberculosis treatment and timing of initiation of antiretroviral therapy), as well as treatment of extrapulmonary disease (central nervous system, pericardial among other sites) are provided. The development of more potent and better-tolerated drug regimens, optimization of drug exposure for the

  15. Executive Summary: Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.

    PubMed

    Nahid, Payam; Dorman, Susan E; Alipanah, Narges; Barry, Pennan M; Brozek, Jan L; Cattamanchi, Adithya; Chaisson, Lelia H; Chaisson, Richard E; Daley, Charles L; Grzemska, Malgosia; Higashi, Julie M; Ho, Christine S; Hopewell, Philip C; Keshavjee, Salmaan A; Lienhardt, Christian; Menzies, Richard; Merrifield, Cynthia; Narita, Masahiro; O'Brien, Rick; Peloquin, Charles A; Raftery, Ann; Saukkonen, Jussi; Schaaf, H Simon; Sotgiu, Giovanni; Starke, Jeffrey R; Migliori, Giovanni Battista; Vernon, Andrew

    2016-10-01

    The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline. This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis. For all recommendations, literature reviews were performed, followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology. Given the public health implications of prompt diagnosis and effective management of tuberculosis, empiric multidrug treatment is initiated in almost all situations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities, severity of disease, and response to treatment influence management decisions. Specific recommendations on the use of case management strategies (including directly observed therapy), regimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tuberculosis treatment and timing of initiation of antiretroviral therapy), as well as treatment of extrapulmonary disease (central nervous system, pericardial among other sites) are provided. The development of more potent and better-tolerated drug regimens, optimization of drug exposure for the

  16. An Official American Thoracic Society/European Respiratory Society Workshop Report: Evaluation of Respiratory Mechanics and Function in the Pediatric and Neonatal Intensive Care Units.

    PubMed

    Peterson-Carmichael, Stacey; Seddon, Paul C; Cheifetz, Ira M; Frerichs, Inéz; Hall, Graham L; Hammer, Jürg; Hantos, Zoltán; van Kaam, Anton H; McEvoy, Cindy T; Newth, Christopher J L; Pillow, J Jane; Rafferty, Gerrard F; Rosenfeld, Margaret; Stocks, Janet; Ranganathan, Sarath C

    2016-02-01

    Ready access to physiologic measures, including respiratory mechanics, lung volumes, and ventilation/perfusion inhomogeneity, could optimize the clinical management of the critically ill pediatric or neonatal patient and minimize lung injury. There are many techniques for measuring respiratory function in infants and children but very limited information on the technical ease and applicability of these tests in the pediatric and neonatal intensive care unit (PICU, NICU) environments. This report summarizes the proceedings of a 2011 American Thoracic Society Workshop critically reviewing techniques available for ventilated and spontaneously breathing infants and children in the ICU. It outlines for each test how readily it is performed at the bedside and how it may impact patient management as well as indicating future areas of potential research collaboration. From expert panel discussions and literature reviews, we conclude that many of the techniques can aid in optimizing respiratory support in the PICU and NICU, quantifying the effect of therapeutic interventions, and guiding ventilator weaning and extubation. Most techniques now have commercially available equipment for the PICU and NICU, and many can generate continuous data points to help with ventilator weaning and other interventions. Technical and validation studies in the PICU and NICU are published for the majority of techniques; some have been used as outcome measures in clinical trials, but few have been assessed specifically for their ability to improve clinical outcomes. Although they show considerable promise, these techniques still require further study in the PICU and NICU together with increased availability of commercial equipment before wider incorporation into daily clinical practice.

  17. The American Association for Thoracic Surgery Consensus Guidelines: Reasons and purpose.

    PubMed

    Svensson, Lars G; Gillinov, A Marc; Weisel, Richard D; Keshavjee, Shaf; Bacha, Emile A; Moon, Marc R; Cameron, Duke E; Sugarbaker, David J; Adams, David H; Gaynor, J William; Coselli, Joseph S; Del Nido, Pedro J; Jones, David; Sundt, Thoralf M; Cohn, Lawrence H; Pomar, Jose L; Lytle, Bruce W; Schaff, Hartzell V

    2016-04-01

    The time interval for the doubling of medical knowledge continues to decline. Physicians, patients, administrators, government officials, and payors are struggling to keep up to date with the waves of new information and to integrate the knowledge into new patient treatment protocols, processes, and metrics. Guidelines, Consensus Guidelines, and Consensus Statements, moderated by seasoned content experts, offer one method to rapidly distribute new information in a timely manner and also guide minimal standards of treatment of clinical care pathways as they are developed as part of bundled care programs. These proposed Consensus Guidelines advance The American Association for Thoracic Surgery's mission of leading in cardiothoracic health care, education, innovation, and modeling excellence.

  18. 1. Historic American Buildings Survey From The Blue Book, Official ...

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

    1. Historic American Buildings Survey From The Blue Book, Official Souvenir View Book Panama Pacific International Exposition - 1915 VIEW FROM THE EAST - Palace of Fine Arts, Baker Street, San Francisco, San Francisco County, CA

  19. The Official Ideology of American Law Schools

    ERIC Educational Resources Information Center

    Dent, George W., Jr.

    2011-01-01

    In this article, the author describes the seemingly all-powerful Association of American Law Schools (AALS) and the negative effects of its single-minded obsession with "diversity." He suggests ways in which true diversity of viewpoint might be injected into law school education. The key is to raise awareness and apply the same standards to all…

  20. American Thoracic Society member survey on climate change and health.

    PubMed

    Sarfaty, Mona; Bloodhart, Brittany; Ewart, Gary; Thurston, George D; Balmes, John R; Guidotti, Tee L; Maibach, Edward W

    2015-02-01

    The American Thoracic Society (ATS), in collaboration with George Mason University, surveyed a random sample of ATS members to assess their perceptions of, clinical experiences with, and preferred policy responses to climate change. An e-mail containing an invitation from the ATS President and a link to an online survey was sent to 5,500 randomly selected U.S. members; up to four reminder e-mails were sent to nonrespondents. Responses were received from members in 49 states and the District of Columbia (n = 915); the response rate was 17%. Geographic distribution of respondents mirrored that of the sample. Survey estimates' confidence intervals were ±3.5% or smaller. Results indicate that a large majority of ATS members have concluded that climate change is happening (89%), that it is driven by human activity (68%), and that it is relevant to patient care ("a great deal"/"a moderate amount") (65%). A majority of respondents indicated they were already observing health impacts of climate change among their patients, most commonly as increases in chronic disease severity from air pollution (77%), allergic symptoms from exposure to plants or mold (58%), and severe weather injuries (57%). A larger majority anticipated seeing these climate-related health impacts in the next 2 decades. Respondents indicated that physicians and physician organizations should play an active role in educating patients, the public, and policy makers on the human health effects of climate change. Overall, ATS members are observing that human health is already adversely affected by climate change and support responses to address this situation. PMID:25535822

  1. American Thoracic Society member survey on climate change and health.

    PubMed

    Sarfaty, Mona; Bloodhart, Brittany; Ewart, Gary; Thurston, George D; Balmes, John R; Guidotti, Tee L; Maibach, Edward W

    2015-02-01

    The American Thoracic Society (ATS), in collaboration with George Mason University, surveyed a random sample of ATS members to assess their perceptions of, clinical experiences with, and preferred policy responses to climate change. An e-mail containing an invitation from the ATS President and a link to an online survey was sent to 5,500 randomly selected U.S. members; up to four reminder e-mails were sent to nonrespondents. Responses were received from members in 49 states and the District of Columbia (n = 915); the response rate was 17%. Geographic distribution of respondents mirrored that of the sample. Survey estimates' confidence intervals were ±3.5% or smaller. Results indicate that a large majority of ATS members have concluded that climate change is happening (89%), that it is driven by human activity (68%), and that it is relevant to patient care ("a great deal"/"a moderate amount") (65%). A majority of respondents indicated they were already observing health impacts of climate change among their patients, most commonly as increases in chronic disease severity from air pollution (77%), allergic symptoms from exposure to plants or mold (58%), and severe weather injuries (57%). A larger majority anticipated seeing these climate-related health impacts in the next 2 decades. Respondents indicated that physicians and physician organizations should play an active role in educating patients, the public, and policy makers on the human health effects of climate change. Overall, ATS members are observing that human health is already adversely affected by climate change and support responses to address this situation.

  2. The Official Records of the American Civil War: A Researcher's Guide. 2nd Edition.

    ERIC Educational Resources Information Center

    Aimone, Alan Conrad

    Official reports and correspondence of the American Civil War were printed by the United States Government Printing Office as the "Official Records, Army" (O.R.) in 129 volumes and the "Official Records, Navy" (N.O.R.) in 31 volumes. This corrected and expanded edition of the guide provides a brief historical sketch of the O.R. and N.O.R. and…

  3. 78 FR 36571 - North American Datum of 1983 (NAD 83) Outer Continental Shelf (OCS) Provisional Official...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... Bureau of Ocean Energy Management North American Datum of 1983 (NAD 83) Outer Continental Shelf (OCS) Provisional Official Protraction Diagram (OPDs) AGENCY: Bureau of Ocean Energy Management (BOEM), Interior... Ocean Energy Management. BILLING CODE 4310-MR-P...

  4. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  5. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  6. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  7. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  8. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  9. American Thoracic Society and Marron Institute Report. Estimated Excess Morbidity and Mortality Caused by Air Pollution above American Thoracic Society-Recommended Standards, 2011-2013.

    PubMed

    Cromar, Kevin R; Gladson, Laura A; Perlmutt, Lars D; Ghazipura, Marya; Ewart, Gary W

    2016-08-01

    Estimates of the health impacts of air pollution are needed to make informed air quality management decisions at both the national and local levels. Using design values of ambient pollution concentrations from 2011-2013 as a baseline, the American Thoracic Society (ATS) and the Marron Institute of Urban Management estimated excess morbidity and mortality in the United States attributable to exposure to ambient ozone (O3) and fine particulate matter (PM2.5) at levels above the American Thoracic Society-recommended standards. Within the subset of counties with valid design values for each pollutant, 14% had PM2.5 concentrations greater than the ATS recommendation, whereas 91% had O3 concentrations greater than the ATS recommendation. Approximately 9,320 excess deaths (69% from O3; 31% from PM2.5), 21,400 excess morbidities (74% from O3; 26% from PM2.5), and 19,300,000 adversely impacted days (88% from O3; 12% from PM2.5) in the United States each year are attributable to pollution exceeding the ATS-recommended standards. California alone is responsible for 37% of the total estimated health impacts, and the next three states (Pennsylvania, Texas, and Ohio) together contributed to 20% of the total estimates. City-specific health estimates are provided in this report and through an accompanying online tool to help inform air quality management decisions made at the local level. Riverside and Los Angeles, California have the most to gain by attaining the ATS recommendations for O3 and PM2.5. This report will be revised and updated regularly to help cities track their progress. PMID:27509145

  10. American Thoracic Society and Marron Institute Report. Estimated Excess Morbidity and Mortality Caused by Air Pollution above American Thoracic Society-Recommended Standards, 2011-2013.

    PubMed

    Cromar, Kevin R; Gladson, Laura A; Perlmutt, Lars D; Ghazipura, Marya; Ewart, Gary W

    2016-08-01

    Estimates of the health impacts of air pollution are needed to make informed air quality management decisions at both the national and local levels. Using design values of ambient pollution concentrations from 2011-2013 as a baseline, the American Thoracic Society (ATS) and the Marron Institute of Urban Management estimated excess morbidity and mortality in the United States attributable to exposure to ambient ozone (O3) and fine particulate matter (PM2.5) at levels above the American Thoracic Society-recommended standards. Within the subset of counties with valid design values for each pollutant, 14% had PM2.5 concentrations greater than the ATS recommendation, whereas 91% had O3 concentrations greater than the ATS recommendation. Approximately 9,320 excess deaths (69% from O3; 31% from PM2.5), 21,400 excess morbidities (74% from O3; 26% from PM2.5), and 19,300,000 adversely impacted days (88% from O3; 12% from PM2.5) in the United States each year are attributable to pollution exceeding the ATS-recommended standards. California alone is responsible for 37% of the total estimated health impacts, and the next three states (Pennsylvania, Texas, and Ohio) together contributed to 20% of the total estimates. City-specific health estimates are provided in this report and through an accompanying online tool to help inform air quality management decisions made at the local level. Riverside and Los Angeles, California have the most to gain by attaining the ATS recommendations for O3 and PM2.5. This report will be revised and updated regularly to help cities track their progress.

  11. A snapshot of pulmonary medicine at the turn of the century: the American Thoracic Society membership.

    PubMed

    Schnapp, Lynn M; Matosian, Melissa; Weisman, Idelle; Welsh, Carolyn H

    2003-05-01

    To describe the characteristics of the American Thoracic Society, the Membership Committee developed a survey to assess demographics, training, professional activities, and needs of a diverse membership with a growing international segment. It also provided an opportunity to determine how the Society reflects the current state of pulmonary medicine in the United States. A self-administered survey was mailed to active members. Of responding members, 80% reside in the United States or Canada; the remainder come from 90 different countries. The majority of North American respondents (79%) were white, non-Hispanic. Seventeen percent of respondents were female. Female respondents were younger, with a mean age of 42 years, compared with 47 years for males. Sixty-five percent of respondents identified clinical practice, 20% research, and 5% teaching as their major activity. More women (33%) than men (22%) identified themselves as researchers. The majority of respondents (69%) have a medical school faculty affiliation. The American Thoracic Society represents a global organization with diverse clinical expertise and scientific interests. The majority of respondents are clinicians; however, the membership has a strong academic bent with most reporting academic affiliation, and describing teaching as a secondary activity. PMID:12522026

  12. Evolution and revolution: the formation of today's American Thoracic Society, part 1.

    PubMed

    Murray, John F; Du Melle, Fran; Hopewell, Philip C

    2012-11-15

    The American Thoracic Society (ATS), the preeminent professional organization in the field of respiratory, critical care, and sleep medicine, is now 107 years old. For the most part, the Society's administrative and medical-scientific interests evolved in an orderly fashion, but two "revolutions" took place that should be remembered. What ultimately metamorphosed into the ATS in 1960 began in 1905 as the 34-member American Sanatorium Association, which in 1915 became the medical section of the National Association for the Study and Prevention of Tuberculosis (NASPT). In 1918, the NASPT became the National Tuberculosis Association and in 1939, the ASA became the American Trudeau Society, cosmetic revisions having no effect on either the medical section-parent relationship or the one-disease orientation of both organizations. After World War II, the narrow focus of the ATS on tuberculosis was progressively enlarged through coalescence of several factors that transformed the practice of pulmonary medicine: the growth of intensive care units and pulmonary function laboratories and the advent of fiberoptic bronchoscopy; the rise of asthma, chronic obstructive pulmonary disease, and lung cancer coincident with the withering of tuberculosis; and the arrival of pulmonary physician-scientists who sought enrichment through a professional society. The newcomers found a home in the ATS, but it was slow to fulfill their needs for scientific communication and administrative responsibility. The first revolution, the formation of Scientific Assemblies, got the job done quickly and well, as described in Part 1 of this perspective. The second revolution, separation from the American Lung Association, is described in Part 2.

  13. Evolution and revolution: the formation of Today's American Thoracic Society, Part 2.

    PubMed

    Hopewell, Philip C; Du Melle, Fran; Murray, John F

    2012-12-01

    The major event in the recent history of the American Thoracic Society (ATS) is its separation from the American Lung Association (ALA), resulting in the Society's independence. The seeds of the separation were sown over the course of many years. The fundamental reason driving the separation was the organizational structure of the ALA, with the ATS being a division within the larger organization and having neither the standing to make independent decisions nor the ability to respond effectively to the expectations of a growing and diverse membership. Additional important factors included continual organizational conflicts; ongoing struggles over finances; reluctance by the ALA to provide what the ATS considered to be appropriate support for research; divergence of areas of interest as the Society became more broad based to include critical care and sleep medicine, as well as concerns with medical practice issues; and internationalization of the Society, with an increasing proportion of members residing outside the United States. Once it was decided that the ATS could only exist as an independent organization, the separation agreement was negotiated in less than 3 years. Although there were substantial unknowns immediately after the separation, a unified leadership, a strongly supportive membership, and a skilled and dedicated staff guided the organization through this difficult period, from which the Society emerged as a strong independent professional organization that remains true to the public-minded spirit that guided its formation 107 years ago.

  14. American Thoracic Society and National Heart, Lung, and Blood Institute Implementation Research Workshop Report.

    PubMed

    Bender, Bruce G; Krishnan, Jerry A; Chambers, David A; Cloutier, Michelle M; Riekert, Kristin A; Rand, Cynthia S; Schatz, Michael; Thomson, Carey C; Wilson, Sandra R; Apter, Andrea; Carson, Shannon S; George, Maureen; Gerald, Joe K; Gerald, Lynn; Goss, Christopher H; Okelo, Sande O; Mularski, Richard A; Nguyen, Huong Q; Patel, Minal R; Szefler, Stanley J; Weiss, Curtis H; Wilson, Kevin C; Freemer, Michelle

    2015-12-01

    To advance implementation research (IR) in respiratory, sleep, and critical care medicine, the American Thoracic Society and the Division of Lung Diseases from the NHLBI cosponsored an Implementation Research Workshop on May 17, 2014. The goals of IR are to understand the barriers and facilitators of integrating new evidence into healthcare practices and to develop and test strategies that systematically target these factors to accelerate the adoption of evidence-based care. Throughout the workshop, presenters provided examples of IR that focused on the rate of adoption of evidence-based practices, the feasibility and acceptability of interventions to patients and other stakeholders who make healthcare decisions, the fidelity with which practitioners use specific interventions, the effects of specific barriers on the sustainability of an intervention, and the implications of their research to inform policies to improve patients' access to high-quality care. During the discussions that ensued, investigators' experience led to recommendations underscoring the importance of identifying and involving key stakeholders throughout the research process, ensuring that those who serve as reviewers understand the tenets of IR, managing staff motivation and turnover, and tackling the challenges of scaling up interventions across multiple settings.

  15. Political conservatism, rigidity, and dogmatism in American foreign policy officials: the 1966 Mennis data.

    PubMed

    Kemmelmeier, Markus

    2007-01-01

    Researchers have established a relationship between political orientation and cognitive styles (A. Chirumbolo, 2002; J. T. Jost, J. Glaser, A. W. Kruglanski, & F. Sulloway, 2003a, 2003b; M. Kemmelmeier, 1997). In this article, the author examined whether this finding is true in the political elite, whether the relationship is linear or curvilinear, and whether interest in politics moderates the relationship between political orientation and cognitive styles. He used a 1966 sample of American foreign policy officials (N = 95) to examine the relationship between self-described conservatism and party identification and individual differences in rigidity and dogmatism. Rigidity was related to self-described conservatism, but this relationship was only significant among participants high in political interest, whereas dogmatism was unconditionally related to party identification. All relationships were linear and did not contain a curvilinear component.

  16. Differential aspects of ascending thoracic aortic dissection and its treatment: the North American experience

    PubMed Central

    Coselli, Joseph S.

    2016-01-01

    Acute type A aortic dissection is a deadly disease with significant morbidity and mortality. We describe the differential aspects of the disease and the North American experience with its treatment. PMID:27563548

  17. Audit, quality control, and performance in thoracic surgery: a North American perspective.

    PubMed

    Tong, Betty C; Harpole, David H

    2007-08-01

    Although difficult to precisely define, health care quality is often measured by components of structure, outcomes, and process. One way for thoracic surgeons to evaluate their practices is to compare themselves with evidence-based national guidelines. Outcomes data are often generated from entries into large patient databases. The largest examples of these databases include the STS National Databases and the VA/ACS NSQIP programs. Each of these has unique features, but there is the common goal of enabling participants to examine their surgical outcomes and results relative to others. The data integrity of these databases is high. The new STS composite quality score for CABG combines providers' outcome and practice data into a calculated index for comparison with national averages. In addition to providing meaningful information regarding surgical outcomes and quality, these databases are used as the basis for risk-adjusted models to accurately predict surgical morbidity and mortality. These models can be used as auditing tools against which surgeon- and site-specific morbidity and mortality can be compared with predicted values. As practices and methods continue to evolve, measures of quality--and therefore quality itself--will continue to improve, resulting in better patient care.

  18. Thoracic radiculopathy.

    PubMed

    O'Connor, Ryan C; Andary, Michael T; Russo, Randolph B; DeLano, Mark

    2002-08-01

    Thoracic radiculopathy represents an uncommon spinal disorder that is frequently overlooked in the evaluation of spinal pain syndromes. Degenerative disc disease and diabetes mellitus may frequently cause radiculopathy at the thoracic level. Electromyography and magnetic resonance imaging are useful in the evaluation of radiculopathy and thoracic spinal pain syndromes. Percutaneous vertebroplasty is a procedure that may be used in the treatment of thoracic spinal pain syndromes. Surgical intervention for thoracic radiculopathy usually is reserved for patients with progressive myelopathy and neurologic compromise.

  19. Insights from the early experience of the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

    PubMed

    Rumsfeld, John S; Holmes, David R; Stough, Wendy Gattis; Edwards, Fred H; Jacques, Louis B; Mack, Michael J

    2015-03-01

    The current system for postmarket surveillance of medical devices in the United States is limited. To help change this paradigm for transcatheter valve therapies (TVTs), starting with transcatheter aortic valve replacement, the Society of Thoracic Surgeons and the American College of Cardiology partnered to form the TVT Registry program in close collaboration with the U.S. Food and Drug Administration and the Center for Medicare and Medicaid Services. The goal of the TVT Registry is to measure and improve quality of care and patient outcomes in clinical practice and to have a pivotal role in the scientific evidence and surveillance for medical devices. Challenges were faced in the early experience of the registry included developing multistakeholder partnerships, data collection requirements, and the use of the registry for pre- and post-market device evaluations. In addressing these challenges, the TVT Registry demonstrates that it is feasible for professional societies to assume a pivotal role in pre- and/or post-market studies, leveraging a clinical registry infrastructure. Sharing the TVT Registry experience may help other professional societies and stakeholders better anticipate and plan for these challenges. PMID:25703888

  20. American Thoracic Society-European Respiratory Society Classification of the Idiopathic Interstitial Pneumonias: Advances in Knowledge since 2002.

    PubMed

    Sverzellati, Nicola; Lynch, David A; Hansell, David M; Johkoh, Takeshi; King, Talmadge E; Travis, William D

    2015-01-01

    In the updated American Thoracic Society-European Respiratory Society classification of the idiopathic interstitial pneumonias (IIPs), the major entities have been preserved and grouped into (a) "chronic fibrosing IIPs" (idiopathic pulmonary fibrosis and idiopathic nonspecific interstitial pneumonia), (b) "smoking-related IIPs" (respiratory bronchiolitis-associated interstitial lung disease and desquamative interstitial pneumonia), (c) "acute or subacute IIPs" (cryptogenic organizing pneumonia and acute interstitial pneumonia), and (d) "rare IIPs" (lymphoid interstitial pneumonia and idiopathic pleuroparenchymal fibroelastosis). Furthermore, it has been acknowledged that a final diagnosis is not always achievable, and the category "unclassifiable IIP" has been proposed. The diagnostic interpretation of the IIPs is often challenging because other diseases with a known etiology (most notably, connective tissue disease and hypersensitivity pneumonitis) may show similar morphologic patterns. Indeed, more emphasis has been given to the integration of clinical, computed tomographic (CT), and pathologic findings for multidisciplinary diagnosis. Typical CT-based morphologic patterns are associated with the IIPs, and radiologists play an important role in diagnosis and characterization. Optimal CT quality and a systematic approach are both pivotal for evaluation of IIP. Interobserver variation for the various patterns encountered in the IIPs is an issue. It is important for radiologists to understand the longitudinal behavior of IIPs at serial CT examinations, especially for providing a framework for cases that are unclassifiable or in which a histologic diagnosis cannot be obtained.

  1. Official Policy Positions of the National Congress of American Indians for Convention Year 1977-1978.

    ERIC Educational Resources Information Center

    National Congress of American Indians, Washington, DC.

    During its convention year of 1977-78, the National Congress of American Indians held an annual convention in Dallas in September, 1977, an executive council meeting in Washington in January, 1978, a special conference on federal recognition and the impact of the Oliphant decision in Nashville, Tennessee in March, 1978, and a mid-year conference…

  2. The electronic cigarette. Official statement of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) on the efficacy, safety and regulation of electronic cigarettes.

    PubMed

    Jimenez Ruiz, Carlos A; Solano Reina, Segismundo; de Granda Orive, Jose Ignacio; Signes-Costa Minaya, Jaime; de Higes Martinez, Eva; Riesco Miranda, Juan Antonio; Altet Gómez, Neus; Lorza Blasco, Jose Javier; Barrueco Ferrero, Miguel; de Lucas Ramos, Pilar

    2014-08-01

    The electronic cigarette (EC) is a device formed by three basic elements: battery, atomizer and cartridge. When assembled, it looks like a cigarette. The cartridge contains different substances: propylene glycol, glycerine and, sometimes, nicotine. When the user "vapes", the battery is activated, the atomizer is heated and the liquid is drawn in and vaporized. The smoker inhales the mist produced. Various substances have been detected in this mist: formaldehyde, acetaldehyde and acrolein and some heavy metals. Although these are found in lower concentrations than in cigarettes, they may still be harmful for the human body. Several surveys show that 3-10% of smokers regularly use e-cigarettes. A randomized study has shown that the efficacy of e-cigarettes for helping smokers to quit is similar to nicotine patches. Nevertheless, the study has relevant methodological limitations and reliable conclusions cannot be deduced. This report sets down the Position Statement of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) on the efficacy and safety of e-cigarettes. This statement declares that e-cigarettes should be regulated as medicinal products.

  3. The electronic cigarette. Official statement of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) on the efficacy, safety and regulation of electronic cigarettes.

    PubMed

    Jimenez Ruiz, Carlos A; Solano Reina, Segismundo; de Granda Orive, Jose Ignacio; Signes-Costa Minaya, Jaime; de Higes Martinez, Eva; Riesco Miranda, Juan Antonio; Altet Gómez, Neus; Lorza Blasco, Jose Javier; Barrueco Ferrero, Miguel; de Lucas Ramos, Pilar

    2014-08-01

    The electronic cigarette (EC) is a device formed by three basic elements: battery, atomizer and cartridge. When assembled, it looks like a cigarette. The cartridge contains different substances: propylene glycol, glycerine and, sometimes, nicotine. When the user "vapes", the battery is activated, the atomizer is heated and the liquid is drawn in and vaporized. The smoker inhales the mist produced. Various substances have been detected in this mist: formaldehyde, acetaldehyde and acrolein and some heavy metals. Although these are found in lower concentrations than in cigarettes, they may still be harmful for the human body. Several surveys show that 3-10% of smokers regularly use e-cigarettes. A randomized study has shown that the efficacy of e-cigarettes for helping smokers to quit is similar to nicotine patches. Nevertheless, the study has relevant methodological limitations and reliable conclusions cannot be deduced. This report sets down the Position Statement of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) on the efficacy and safety of e-cigarettes. This statement declares that e-cigarettes should be regulated as medicinal products. PMID:24684764

  4. Resisting Official Knowledge: The Incorporation and Abjection of Race and Poverty in High School American History Textbooks, 1960s-2000s

    ERIC Educational Resources Information Center

    Kearl, Benjamin Kelsey

    2014-01-01

    Through an interpretive analysis of how high school American history textbooks depict the urban-riots of the late-1960s, in this article the author discusses how textbooks incorporate and abject official knowledge related to the intersections of race and poverty. Incorporation is related with Raymond Williams' theory of the selective tradition and…

  5. 7 CFR 58.337 - Official test methods.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... of Analysis of the Association of Official Analytical Chemists, published by the Association of Official Analytical Chemists, the Official and Tentative Methods of the American Oil Chemists Society...

  6. American Thoracic Society

    MedlinePlus

    ... Immunology & Inflammation Behavioral Science and Health Services Research Clinical Problems Critical Care Environmental, Occupational & Population Health Microbiology, Tuberculosis & Pulmonary Infections Nursing Pediatrics Pulmonary Circulation Pulmonary ...

  7. Pulmonary Rehabilitation Exercise Prescription in Chronic Obstructive Pulmonary Disease: Review of Selected Guidelines: AN OFFICIAL STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION.

    PubMed

    Garvey, Chris; Bayles, Madeline Paternostro; Hamm, Larry F; Hill, Kylie; Holland, Anne; Limberg, Trina M; Spruit, Martijn A

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is associated with disabling dyspnea, skeletal muscle dysfunction, and significant morbidity and mortality. Current guidelines recommend pulmonary rehabilitation (PR) to improve dyspnea, functional capacity, and quality of life. Translating exercise science into safe and effective exercise training requires interpretation and use of multiple guidelines and recommendations. The purpose of this statement is to summarize for clinicians 3 current chronic obstructive pulmonary disease guidelines for exercise that may be used to develop exercise prescriptions in the PR setting. The 3 guidelines have been published by the American College of Sports Medicine, the American Thoracic Society/European Respiratory Society, and the American Association of Cardiovascular and Pulmonary Rehabilitation. In addition to summarizing these 3 guidelines, this statement describes clinical applications, explores areas of uncertainty, and suggests strategies for providing effective exercise training, given the diversity of guidelines and patient complexity. PMID:26906147

  8. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A; Masoudi, Frederick A; Dehmer, Gregory J; Patel, Manesh R; Smith, Peter K; Chambers, Charles E; Ferguson, T Bruce; Garcia, Mario J; Grover, Frederick L; Holmes, David R; Klein, Lloyd W; Limacher, Marian C; Mack, Michael J; Malenka, David J; Park, Myung H; Ragosta, Michael; Ritchie, James L; Rose, Geoffrey A; Rosenberg, Alan B; Russo, Andrea M; Shemin, Richard J; Weintraub, William S; Wolk, Michael J; Bailey, Steven R; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Shaw, Leslee; Stainback, Raymond F; Allen, Joseph M

    2012-04-01

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD

  9. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2012-02-28

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD

  10. Establishing pulmonary and critical care medicine as a subspecialty in China: joint statement of the Chinese thoracic society and the American college of chest physicians.

    PubMed

    Qiao, Renli; Rosen, Mark J; Chen, Rongchang; Wu, Sinan; Marciniuk, Darcy; Wang, Chen

    2014-01-01

    This commentary heralds the recognition in China of a new subspecialty, Pulmonary and Critical Care Medicine, and the first national fellowship training pathway in any medical specialty. Because of striking environmental health-care similarities that existed in the United States, the Chinese medical community decided to model the specialty after that in the United States. Because of its expertise in educating pulmonary and critical care physicians in the United States, the American College of Chest Physicians was chosen by the Chinese Thoracic Society, with the approval of the Chinese government, to help with the transformation of this new specialty. A work group representing the two societies is collaborating to reorganize ICUs within a select group of large teaching hospitals in China and to introduce standardized and rigorous training in pulmonary and critical care medicine as a national program.

  11. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2009-03-10

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is

  12. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization : a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology. Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A; Masoudi, Frederick A; Brindis, Ralph G; Beckman, Karen J; Chambers, Charles E; Ferguson, T Bruce; Garcia, Mario J; Grover, Frederick L; Holmes, David R; Klein, Lloyd W; Limacher, Marian; Mack, Michael J; Malenka, David J; Park, Myung H; Ragosta, Michael; Ritchie, James L; Rose, Geoffrey A; Rosenberg, Alan B; Shemin, Richard J; Weintraub, William S; Wolk, Michael J; Allen, Joseph M; Douglas, Pamela S; Hendel, Robert C; Peterson, Eric D

    2009-02-15

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is

  13. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: a report by the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2009-02-10

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is

  14. Creating Official Language Policy from Local Practice: The Example of the Native American Languages Act 1990/1992

    ERIC Educational Resources Information Center

    Warhol, Larisa

    2012-01-01

    This research explores the development of landmark federal language policy in the United States: the Native American Languages Act of 1990/1992 (NALA). Overturning more than two centuries of United States American Indian policy, NALA established the federal role in preserving and protecting Native American languages. Indigenous languages in the…

  15. Official Encouragement, Institutional Discouragement: Minorities in Academe--The Native American Experience. Interpretive Perspectives on Education and Policy [Series].

    ERIC Educational Resources Information Center

    Tierney, William G.

    American Indian students are among the most underrepresented groups in academe, and few of those who enter college finish. This book attempts to provide greater understanding of Native American experiences in higher education through analysis based on critical theory, focusing particularly on the recruitment and retention of Native Americans by…

  16. The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass—Temperature Management during Cardiopulmonary Bypass

    PubMed Central

    Engelman, Richard; Baker, Robert A.; Likosky, Donald S.; Grigore, Alina; Dickinson, Timothy A.; Shore-Lesserson, Linda; Hammon, John W.

    2015-01-01

    Abstract: To improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate. Authors adopted the American College of Cardiology/American Heart Association method for development clinical practice guidelines, and arrived at the following recommendation. PMID:26543248

  17. The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass--Temperature Management during Cardiopulmonary Bypass.

    PubMed

    Engelman, Richard; Baker, Robert A; Likosky, Donald S; Grigore, Alina; Dickinson, Timothy A; Shore-Lesserson, Linda; Hammon, John W

    2015-09-01

    To improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate. Authors adopted the American College of Cardiology/American Heart Association method for development clinical practice guidelines, and arrived at the following recommendation.

  18. Thoracic actinomycosis

    PubMed Central

    Slade, P. R.; Slesser, B. V.; Southgate, J.

    1973-01-01

    Six cases of pulmonary infection with Actinomyces Israeli and one case of infection with Nocardia asteroides are described. The incidence of thoracic actinomycosis has declined recently and the classical presentation with chronic discharging sinuses is now uncommon. The cases described illustrate some of the forms which the disease may take. Actinomycotic infection has been noted, not infrequently, to co-exist with bronchial carcinoma and a case illustrating this association is described. Sputum cytology as practised for the diagnosis of bronchial carcinoma has helped to identify the fungi in the sputum. Treatment is discussed, particularly the possible use of oral antibiotics rather than penicillin by injection. Images PMID:4568119

  19. Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: American Speech-Language-Hearing Association

    ERIC Educational Resources Information Center

    US Department of Education, 2010

    2010-01-01

    The American Speech-Language-Hearing Association, Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) is a national accrediting agency of graduate education programs in audiology or speech-language pathology. The CAA currently accredits or or preaccredits 319 programs (247 in speech-language pathology and 72 in…

  20. Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: American Board of Funeral Service Education

    ERIC Educational Resources Information Center

    US Department of Education, 2010

    2010-01-01

    The American Board of Funeral Service Education (ABFSE), Committee on Accreditation (COA), is a national specialized accrediting agency. Its current scope of recognition is the accreditation of institutions and programs awarding diplomas, associate degrees and bachelor's degrees in funeral service or mortuary science. ABFSE is, therefore, both an…

  1. The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass--Temperature Management During Cardiopulmonary Bypass.

    PubMed

    Engelman, Richard; Baker, Robert A; Likosky, Donald S; Grigore, Alina; Dickinson, Timothy A; Shore-Lesserson, Linda; Hammon, John W

    2015-08-01

    In order to improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including: 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate. Authors adopted the American College of Cardiology/American Heart Association method for development clinical practice guidelines, and arrived at the following recommendations: No Recommendation No recommendation for a guideline is provided concerning optimal temperature for weaning from CPB due to insufficient published evidence.

  2. Thoracic amebiasis.

    PubMed

    Shamsuzzaman, S M; Hashiguchi, Y

    2002-06-01

    Pleuropulmonary amebiasis is the common and pericardial amebiasis the rare form of thoracic amebiasis. Low socioeconomic conditions, malnutrition, chronic alcoholism, and ASD with left to right shunt are contributing factors to the development of pulmonary amebiasis. Although no age is exempt, it commonly occurs in patients aged 20 to 40 years, with an adult male to female ratio of 10:1. Children rarely develop thoracic amebiasis: when it does occur there is an equal sex distribution. The infection usually spreads to the lungs by extension of an amebic liver abscess. Infection may pass to the thorax directly from the primary intestinal lesion through hematogenous spread, however. Lymphatic spread is one possible route. Inhalation of dust containing cysts and aspiration of cysts or trophozoites of E histolytica in the lungs are some other hypothetical routes. The lung is the second most common extraintestinal site of amebic involvement after the liver. Usually the lower lobe, and sometimes the middle lobe of the right lung, are affected, but it may affect any lobe of the lungs. The patient develops fever and right upper quadrant pain that is referred to the tip of the right shoulder or in between the scapula. Hemophtysis is common. The diagnosis of thoracic amebiasis is suggested by the combination of an elevated hemidiaphragm (usually right), hepatomegaly, pleural effusion, and involvement of the right lung base in the form of haziness and obliteration of costophrenic and costodiaphragmatic angles. Infection is usually extended to the thorax by perforation of a hepatic abscess through the diaphragm and across an obliterated pleural space, producing pulmonary consolidation, abscesses, or broncho-hepatic fistula. Empyema develops when a liver abscess ruptures into the pleural space. Rarely, a posterior amebic liver abscess can burst into the inferior vena cava and develop an embolism of the inferior vena cava and thromboembolic disease of the lungs with congestive

  3. Thoracic amebiasis.

    PubMed

    Shamsuzzaman, S M; Hashiguchi, Y

    2002-06-01

    Pleuropulmonary amebiasis is the common and pericardial amebiasis the rare form of thoracic amebiasis. Low socioeconomic conditions, malnutrition, chronic alcoholism, and ASD with left to right shunt are contributing factors to the development of pulmonary amebiasis. Although no age is exempt, it commonly occurs in patients aged 20 to 40 years, with an adult male to female ratio of 10:1. Children rarely develop thoracic amebiasis: when it does occur there is an equal sex distribution. The infection usually spreads to the lungs by extension of an amebic liver abscess. Infection may pass to the thorax directly from the primary intestinal lesion through hematogenous spread, however. Lymphatic spread is one possible route. Inhalation of dust containing cysts and aspiration of cysts or trophozoites of E histolytica in the lungs are some other hypothetical routes. The lung is the second most common extraintestinal site of amebic involvement after the liver. Usually the lower lobe, and sometimes the middle lobe of the right lung, are affected, but it may affect any lobe of the lungs. The patient develops fever and right upper quadrant pain that is referred to the tip of the right shoulder or in between the scapula. Hemophtysis is common. The diagnosis of thoracic amebiasis is suggested by the combination of an elevated hemidiaphragm (usually right), hepatomegaly, pleural effusion, and involvement of the right lung base in the form of haziness and obliteration of costophrenic and costodiaphragmatic angles. Infection is usually extended to the thorax by perforation of a hepatic abscess through the diaphragm and across an obliterated pleural space, producing pulmonary consolidation, abscesses, or broncho-hepatic fistula. Empyema develops when a liver abscess ruptures into the pleural space. Rarely, a posterior amebic liver abscess can burst into the inferior vena cava and develop an embolism of the inferior vena cava and thromboembolic disease of the lungs with congestive

  4. Society of Thoracic Surgeons

    MedlinePlus

    ... With Its Intense Demands New Website from The Society of Thoracic Surgeons Puts the Power of Information ... Hotel Discount for STS Members Copyright © 2016 The Society of Thoracic Surgeons. All rights reserved. Expanded Proprietary ...

  5. Thoracic outlet syndrome.

    PubMed

    Kuhn, John E; Lebus V, George F; Bible, Jesse E

    2015-04-01

    Thoracic outlet syndrome is a well-described disorder caused by thoracic outlet compression of the brachial plexus and/or the subclavian vessels. Neurogenic thoracic outlet syndrome is the most common manifestation, presenting with pain, numbness, tingling, weakness, and vasomotor changes of the upper extremity. Vascular complications of thoracic outlet syndrome are uncommon and include thromboembolic phenomena and swelling. The clinical presentation is highly variable, and no reproducible study exists to confirm the diagnosis; instead, the diagnosis is based on a physician's judgment after a meticulous history and physical examination. Both nonsurgical and surgical treatment methods are available for thoracic outlet syndrome. Whereas nonsurgical management appears to be effective in some persons, surgical treatment has been shown to provide predictable long-term cure rates for carefully selected patients. In addition, physicians who do not regularly treat patients with thoracic outlet syndrome may not have an accurate view of this disorder, its treatment, or the possible success rate of treatment. PMID:25808686

  6. Thoracic outlet syndrome.

    PubMed

    Kuhn, John E; Lebus V, George F; Bible, Jesse E

    2015-04-01

    Thoracic outlet syndrome is a well-described disorder caused by thoracic outlet compression of the brachial plexus and/or the subclavian vessels. Neurogenic thoracic outlet syndrome is the most common manifestation, presenting with pain, numbness, tingling, weakness, and vasomotor changes of the upper extremity. Vascular complications of thoracic outlet syndrome are uncommon and include thromboembolic phenomena and swelling. The clinical presentation is highly variable, and no reproducible study exists to confirm the diagnosis; instead, the diagnosis is based on a physician's judgment after a meticulous history and physical examination. Both nonsurgical and surgical treatment methods are available for thoracic outlet syndrome. Whereas nonsurgical management appears to be effective in some persons, surgical treatment has been shown to provide predictable long-term cure rates for carefully selected patients. In addition, physicians who do not regularly treat patients with thoracic outlet syndrome may not have an accurate view of this disorder, its treatment, or the possible success rate of treatment.

  7. The Incorporation and Abjection of Official Knowledge

    ERIC Educational Resources Information Center

    Kearl, Benjamin Kelsey

    2012-01-01

    In this essay, the author analyzes two theoretical perspectives--incorporation and abjection--that inform official knowledge generally and high school American history textbooks specifically. While contemporary textbooks increasingly depict the experiences of historically marginalized groups such as women, African Americans, Latinos, American…

  8. Endoscopic thoracic sympathectomy

    MedlinePlus

    Endoscopic thoracic sympathectomy (ETS) is surgery to treat sweating that is much heavier than normal. This condition ... hyperhidrosis . Usually the surgery is used to treat sweating in the palms or face. The sympathetic nerves ...

  9. Thoracic intrathymic thyroid.

    PubMed Central

    Spinner, R J; Moore, K L; Gottfried, M R; Lowe, J E; Sabiston, D C

    1994-01-01

    OBJECTIVE: The authors introduce thoracic intrathymic thyroid as a clinical entity. SUMMARY BACKGROUND DATA: Although accessory aberrant thyroid has not been found in other tissues in the mediastinum, a thoracic intrathymic location has not been described previously. It is believed that mediastinal thyroid tissue represents accessory ectopic tissue from the median thyroid anlage. Moreover, the close association of the thymus and thyroid supports the theory that mediastinal ectopic thyroid tissue develops from abnormal descent of these structures during embryogenesis. METHODS: Benign thoracic intrathymic thyroid lesions are described in patients with mediastinal masses. CONCLUSION: Thoracic intrathymic thyroid is a distinct entity. Its occurrence is supported both clinically and embryologically. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. PMID:8024364

  10. Thoracic Outlet Syndrome

    MedlinePlus

    Thoracic outlet syndrome (TOS) causes pain in the shoulder, arm, and neck. It happens when the nerves or blood vessels just below your ... vein is compressed, your hand might be sensitive to cold, or turn pale or bluish. Your arm ...

  11. Fast track endoscopic thoracic sympathicotomy.

    PubMed

    Duarte, João Bosco Vieira; Kux, Peter; Castro, Carlos H V; Cruvinel, Marcos G C; Costa, José R R

    2003-12-01

    The length of hospital stay is an important factor of cost and psychological discomfort in the treatment of hyperhidrosis by endoscopic thoracic sympathicotomy (ETS). Our experience enrolls 1587 patients operated on an outpatient basis in the last 10 years and seven months. This study aimed to confirm that ETS can be performed on an outpatient basis. Fifty-two consecutive patients (30 males and 22 females) were submitted to ETS under general anesthesia using a single lumen endotracheal tube, with lung collapse by intrapleural injection of CO(2). The sympathetic chain and the communicating rami were severed at different levels according to hyperhidrosis location. Patients were physical state American Society of Anesthesiologists 1 and 2. Age varied between 13 and 55 years (27.3 +/- 10.2 years). They were monitored with ECG, SPO2, NIBP, expired CO(2), sevoflurane analyzer, and airway pressure. Normal saline (40.0 +/- 2.7 ml/kg) was infused intravenously. The drugs used were propofol, alfentanil, rocuronium, ondansetron, dexamethasone, dipyrone, cetoprofene and sevoflurane. Anesthesia and post-operative data were analyzed. Post-operative thoracic X-rays were taken in 20 patients before discharge. Anesthesia lasted 67.2 +/- 20.8 minutes, and the surgical procedure took 46.3 +/- 20.9 minutes. The patients stayed 18.0 +/- 11.0 minutes in the post-anaesthetic care unit and were discharged from hospital after 150.3 +/- 43.1 minutes. The only abnormal post-operative event observed was insignificant residual carbothorax, found in 2 (10%) of the thoracic X-rays taken. In conclusion, this study confirmed that ETS can be performed safely on an outpatient basis. PMID:14673677

  12. [Thoracic outlet syndrome].

    PubMed

    Rodriguez, José Maria

    2005-01-01

    The thoracic outlet syndrome is a polymorphic clinical entity, whose nature is essentially anatomic, caused by the chronic compression of the neurovascular structures that are originated in the chest or neck and course to the upper extremity. According to the most affected structure, they can be classified as neurologic, arterial or venous syndromes, that may cause discomfort, pain and disability, sometimes definite and irreparable. Thoracic outlet syndrome are often difficult to recognize in clinical practice and it is important to emphasize some peculiar symptoms or signs that each syndrome may present, through specific maneuvers or adequate complementary studies. The great majority of patients may improve with physical therapy or postural correction, and a minority is indicated for surgical therapy. The main features of the diverse thoracic outlet syndromes, their clinical presentation, diagnosis, conventional and surgical management, surgical access, complications and prognosis are described and discussed in this paper dedicated to a complete review of the entity. PMID:16234911

  13. Thoracic spine x-ray

    MedlinePlus

    Vertebral radiography; X-ray - spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films ... care provider's office. You will lie on the x-ray table in different positions. If the x-ray ...

  14. Thoracic outlet syndrome: anatomy.

    PubMed

    Atasoy, Erdoğan

    2004-02-01

    The thoracic outlet region contains three important structures: the brachial plexus, the subclavian artery, and the subclavian vein. As they travel from the upper mediastinum to the upper extremity, these structures run through three important spaces: the interscalene triangle, the costoclavicular space, and the subpectoral space. Compression can occur in any of these three spaces because of structural anomalies or trauma.

  15. Official Basketball Rules for Girls and Women. July 1972 - July 1973. Reprint.

    ERIC Educational Resources Information Center

    American Association for Health, Physical Education, and Recreation, Washington, DC. Div. for Girls and Women's Sports.

    The official American Association for Health, Physical Education, and Recreation (AAHPER) rules for girls and women's basketball, July 1972 - July 1973 are listed. Exact court measurements are given as are official scoring rules, timing procedures, duties of officials, definition of playing terms, violations and penalties, and officials' signals.…

  16. Thoracic textilomas: CT findings*

    PubMed Central

    Machado, Dianne Melo; Zanetti, Gláucia; Araujo, Cesar Augusto; Nobre, Luiz Felipe; Meirelles, Gustavo de Souza Portes; Pereira e Silva, Jorge Luiz; Guimarães, Marcos Duarte; Escuissato, Dante Luiz; Souza, Arthur Soares; Hochhegger, Bruno; Marchiori, Edson

    2014-01-01

    OBJECTIVE: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. METHODS: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. RESULTS: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). CONCLUSIONS: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication. PMID:25410842

  17. Mediastinal thoracic duct cyst.

    PubMed Central

    Gowar, F J

    1978-01-01

    A case of mediastinal thoracic duct cyst is described; it is believed to be the first to be reported in Britain. Five surgically treated cases have been reported but in none was the diagnosis made before operation. Symptoms are caused by pressure of the cyst on the trachea and oesophagus and my be aggravted by eating a fatty meal. Differential diagnosis from other mediastinal tumours, especially bronchogenic cyst and neurofibroma, could perhaps be established before operation by lymphangiography. Images PMID:746509

  18. [Surgery for thoracic tuberculosis].

    PubMed

    Kilani, T; Boudaya, M S; Zribi, H; Ouerghi, S; Marghli, A; Mestiri, T; Mezni, F

    2015-01-01

    Tuberculosis is mainly a medical disease. Surgery has been the unique therapeutic tool for a long time before the advent of specific antituberculous drugs, and the role of surgery was then confined to the treatment of the sequelae of tuberculosis and their complications. The resurgence of tuberculosis and the emergence of multidrug-resistant TB combined to immunosuppressed patients represent a new challenge for tuberculosis surgery. Surgery may be indicated for a diagnostic purpose in patients with pulmonary, pleural, mediastinal or thoracic wall involvement, or with a therapeutic purpose (drainage, resection, residual cavity obliteration). Modern imaging techniques and the advent of video-assisted thoracic surgery allowed a new approach of this pathology; the majority of diagnostic interventions and selected cases requiring lung resection can be performed through a mini-invasive approach. Patients proposed for aggressive surgery may be treated with the best results thanks to a good evaluation of the thoracic lesions, of the patients' nutritional, infectious and general status combined with a good coordination between the specialized medical team for an optimal preparation to surgery.

  19. [Thoracic actinomycosis: three cases].

    PubMed

    Herrak, L; Msougar, Y; Ouadnouni, Y; Bouchikh, M; Benosmane, A

    2007-09-01

    Actinomycosis is a rare condition which, in the thoracic localisation, can mimic cancer or tuberculosis. We report a series of three case of thoracic actinomycosis treated in the Ibn Sina University Thoracic Surgery Unit in Rabat, Morocco. CASE N degrees 1: This 45-year-old patient presented a tumefaction on the left anterior aspect of the chest. Physical examination identified a parietal mass with fistulisation to the skin. Radiography demonstrated a left pulmonary mass. Transparietal puncture led to the pathological diagnosis of actinomycosis. The patient was given medical treatment and improved clinically and radiographically. CASE N degrees 2: This 68-year-old patient presented repeated episodes of hemoptysis. The chest x-ray revealed atelectasia of the middle lobe and bronchial fibroscopy demonstrated the presence of a bud in the middle lobar bronchus. Biopsies were negative. The patient underwent surgery and the histology examination of the operative specimen revealed pulmonary actinomycosis. The patient recovered well clinically and radiographically with antibiotic therapy. CASE N degrees 3: This 56-year-old patient presented cough and hemoptysis. Physical examination revealed a left condensation and destruction of the left lung was noted on the chest x-ray. Left pleuropulmonectomy was performed. Histological analysis of the surgical specimen identified associated Aspergillus and Actinomyces. The outcome was favorable with medical treatment. The purpose of this work was to recall the radiological, clinical, histological, therapeutic, outcome aspects of this condition and to relate the problems of differential diagnosis when can suggest other diseases. PMID:17978739

  20. Official portrait of Astronaut Vance D. Brand

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Official portrait of Astronaut Vance D. Brand. Brand is in the dark blue shuttle flight suit with his helmet under his arm and an American flag behind him. Above and to the right of his head is a view of the shuttle flying.

  1. The State's Official Measures of School Performance

    ERIC Educational Resources Information Center

    EdSource, 2005

    2005-01-01

    This guide describes the measures California state officials use to evaluate schools and school districts, explaining what they are and what they indicate. Results of standard tests and the Academic Performance Index (API) indicate substantial gaps between the achievement of various groups of students in California. African American, Latino, and…

  2. 35th Annual Official Education Construction Report

    ERIC Educational Resources Information Center

    Agron, Joe

    2009-01-01

    Spending on construction by the nation's education institutions increased in 2008, reversing four years of declines in total annual expenditures, according to "American School & University"'s 35th annual Official Education Construction Report. One of the reasons for the increase in spending was the fact that the majority of the construction…

  3. 34th Annual Official Education Construction Report

    ERIC Educational Resources Information Center

    Agron, Joe

    2008-01-01

    According to American School & University's 34th annual Official Education Construction Report, spending on construction by the nation's school districts and colleges slowed in 2007, representing the fourth consecutive year total expenditures dropped from the year before and setting a low point in spending so far this decade. A difficult economy…

  4. [Paravertebral analgesia in thoracic surgery].

    PubMed

    Arnal, D; Garutti, I; Olmedilla, L

    2004-10-01

    Managing postoperative pain from thoracotomy is one of the greatest challenges anesthesiologists face in daily practice. Proper management is assumed to improve the patient's prognosis. The thoracic paravertebral block, following its rediscovery, is being used with increasing frequency and success for both surgery and recovery from thoracotomy, challenging the supremacy of thoracic epidural analgesia, which to date has been considered the gold standard. We describe the history, anatomy, techniques and complications of the thoracic paravertebral block and review published randomized controlled trials comparing the thoracic paravertebral block to placebo and to epidural analgesia. In view of published evidence, it seems that the thoracic paravertebral block may replace the thoracic epidural technique as the gold standard for providing analgesia for patients undergoing thoracotomy.

  5. Nonmalignant Adult Thoracic Lymphatic Disorders.

    PubMed

    Itkin, Maxim; McCormack, Francis X

    2016-09-01

    The thoracic lymphatic disorders are a heterogeneous group of uncommon conditions that are associated with thoracic masses, interstitial pulmonary infiltrates, and chylous complications. Accurate diagnosis of the thoracic lymphatic disorders has important implications for the newest approaches to management, including embolization and treatment with antilymphangiogenic drugs. New imaging techniques to characterize lymphatic flow, such as dynamic contrast-enhanced magnetic resonance lymphangiogram, are redefining approaches to disease classification and therapy. PMID:27514588

  6. Nonintubated anesthesia for thoracic surgery

    PubMed Central

    Wang, Bei

    2014-01-01

    Nonintubated thoracic surgery has been used in procedures including pleura, lungs and mediastinum. Appropriate anesthesia techniques with or without sedation allow thoracic surgery patients to avoid the potential risks of intubated general anesthesia, particularly for the high-risk patients. However, nonintubated anesthesia for thoracic surgery has some benefits as well as problems. In this review, the background, indication, perioperative anesthetic consideration and management, and advantages and disadvantages are discussed and summarized. PMID:25589994

  7. Aneurysms: thoracic aortic aneurysms.

    PubMed

    Chun, Kevin C; Lee, Eugene S

    2015-04-01

    Thoracic aortic aneurysms (TAAs) have many possible etiologies, including congenital heart defects (eg, bicuspid aortic valves, coarctation of the aorta), inherited connective tissue disorders (eg, Marfan, Ehlers-Danlos, Loeys-Dietz syndromes), and degenerative conditions (eg, medial necrosis, atherosclerosis of the aortic wall). Symptoms of rupture include a severe tearing pain in the chest, back, or neck, sometimes associated with cardiovascular collapse. Before rupture, TAAs may exert pressure on other thoracic structures, leading to a variety of symptoms. However, most TAAs are asymptomatic and are found incidentally during imaging for other conditions. Diagnosis is confirmed with computed tomography scan or echocardiography. Asymptomatic TAAs should be monitored with imaging at specified intervals and patients referred for repair if the TAAs are enlarging rapidly (greater than 0.5 cm in diameter over 6 months for heritable etiologies; greater than 0.5 cm over 1 year for degenerative etiologies) or reach a critical aortic diameter threshold for elective surgery (5.5 cm for TAAs due to degenerative etiologies, 5.0 cm when associated with inherited syndromes). Open surgery is used most often to treat asymptomatic TAAs in the ascending aorta and aortic arch. Asymptomatic TAAs in the descending aorta often are treated medically with aggressive blood pressure control, though recent data suggest that endovascular procedures may result in better long-term survival rates. PMID:25860136

  8. American Society of Nuclear Cardiology

    MedlinePlus

    ... much more! class="box-li"> Journal of Nuclear Cardiology Official publication of the American Society of Nuclear Cardiology Clinical Guidelines Procedures, Appropriate Use Criteria, Information Statements ...

  9. Chondroblastoma of the thoracic vertebra.

    PubMed

    Attar, A; Ugur, H C; Caglar, Y S; Erdogan, A; Ozdemir, N

    2001-01-01

    A 48-year-old patient with interscapular pain was admitted to our clinic. MRI revealed a mass infiltrating the second thoracic vertebra and adjacent structures. No other clinical manifestations were observed in general examination. The patient underwent surgery and subtotal removal was achieved while anterior and posterior stabilisations were performed. Diagnosis was pathologically confirmed. As thoracic chondroblastoma cases are not frequent, we decided to present this case. PMID:11148083

  10. [Thoracic outlet syndrome].

    PubMed

    Sonoo, Masahiro

    2014-12-01

    Thoracic outlet syndrome (TOS) is a well-known disorder, but its definition has been disputed. TOS is differentiated into five distinct disorders: arterial vascular, venous vascular, traumatic neurovascular, true neurologic (TN-TOS), and nonspecific TOS. TN-TOS is caused by compression of the lower plexus (T1>C8 roots and/or lower trunk) by a fibrous band. The most frequent presenting symptoms are insidious-onset atrophy and weakness of the intrinsic hand muscles, predominantly in the thenar eminence and radial digital flexors. Numbness and sensory loss are usually present, mainly in the ulnar forearm, although severe pain or pain/paresthesia proximal to the elbow can occur; however, sensory symptoms or signs can be absent in some patients. Nerve conduction studies are pathognomonic and show the loss or severe attenuation of the sensory nerve action potential (SNAP) of the medial antebrachial cutaneous nerve. Additionally, they show a severely depressed median compound muscle action potential (CMAP) and, subsequently, a depressed ulnar CMAP and SNAP. TN-TOS is a rare disorder, although its incidence may be higher than previously believed. Hirayama disease is an important differential diagnosis. Nonspecific TOS, which is mainly diagnosed by provocative maneuvers, corresponds to the classical concept of TOS. However, this concept is now challenged and the existence of nonspecific TOS is doubted. PMID:25475030

  11. NAGWS Volleyball Guide, 1989. Official Rules & Interpretations/Officiating.

    ERIC Educational Resources Information Center

    American Alliance for Health, Physical Education, Recreation and Dance, Reston, VA. National Association for Girls and Women in Sport.

    This booklet contains the official rules and interpretations for officiating in volleyball competitions. Section 1 states the National Association for Girls and Women in Sport (NAGWS) interscholastic and collegiate volleyball rules for 1989-90. Section 2 presents a summary and descriptions of officiating techniques and mechanics. Study questions…

  12. Thoracic Radiculopathy due to Rare Causes

    PubMed Central

    2016-01-01

    Thoracic radiculopathy represents an uncommon spinal disorder that is frequently overlooked in the evaluation of thoracic, or abdominal pain syndrome. The clinical representation of this uncommon disorder is often atypical. With many differential diagnoses to consider, it is not surprising that the cause of thoracic radiculopathy is often not discovered for months, or years, after the symptoms arise. We report two rare cases of thoracic radiculopathy; one case was caused by extraskeletal Ewing sarcoma (EES) along the thoracic paraspinal area, and the other by foraminal stenosis, due to a bony spur of the thoracic vertebra. As such, thoracic radiculopathy should be considered in the diagnosis of patients with thoracic and abdominal pain, especially if initial diagnostic studies are inconclusive. PMID:27446792

  13. [A case of thoracic actinomycosis].

    PubMed

    Denisova, O A; Cherniavskaia, G M; Beloborodova, É I; Topol'nitskiĭ, E B; Iakimenko, Iu V; Chernogoriuk, G É; Beloborodova, E V; Strezh, Iu A; Vil'danova, L R

    2014-01-01

    A case of thoracic actinomycosis manifest as round shadow in the lung is described. Diagnosis was based on the presence of actinomycetes in a transthoracic lung biopsy sample. Treatment for 3 months resulted in recovery. No relapse was documented during 1 year follow-up period. PMID:25265662

  14. Endovascular Repair of Thoracic Aortic Aneurysms

    PubMed Central

    Findeiss, Laura K.; Cody, Michael E.

    2011-01-01

    Degenerative aneurysms of the thoracic aorta are increasing in prevalence; open repair of descending thoracic aortic aneurysms is associated with high rates of morbidity and mortality. Repair of isolated descending thoracic aortic aneurysms using stent grafts was introduced in 1995, and in an anatomically suitable subgroup of patients with thoracic aortic aneurysm, repair with endovascular stent graft provides favorable outcomes, with decreased perioperative morbidity and mortality relative to open repair. The cornerstones of successful thoracic endovascular aneurysm repair are appropriate patient selection, thorough preprocedural planning, and cautious procedural execution, the elements of which are discussed here. PMID:22379281

  15. Officials of the Army Ballistic Missile Agency

    NASA Technical Reports Server (NTRS)

    1956-01-01

    Hermann Oberth (forefront) with officials of the Army Ballistic Missile Agency at Huntsville, Alabama in 1956. Left to right: Dr. Ernst Stuhlinger (seated); Major General H.N. Toftoy, Commanding Officer and person responsible for 'Project Paperclip,' which took scientists and engineers out of Germany after World War II to design rockets for American military use. Many of the scientists later helped to design the Saturn V rocket that took the Apollo 11 astronauts to the Moon. Dr. Eberhard Rees, Deputy Director, Development Operations Division Wernher von Braun, Director, Development Operations Division.

  16. NAGWS Volleyball Guide 1990: Official Rules & Interpretations/Officiating.

    ERIC Educational Resources Information Center

    American Alliance for Health, Physical Education, Recreation and Dance, Reston, VA. National Association for Girls and Women in Sport.

    This guide presents the 1990 update of the National Association for Girls & Women in Sport (NAGWS) interscholastic and collegiate volleyball rules. It includes the official U.S. volleyball rules and a summary of rule changes, definitions of skills and fouls, and a summary of penalties. Officiating techniques and mechanics are covered with a…

  17. Official portrait of astronaut Robert D.Cabana

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Official portrait of astronaut Robert D.Cabana, a colonel in the United States Marine Corps (USMC) and a member of the 1985 Astronaut Class 11. Cabana is wearing a blue flight suit and poses with an American flag and asmall model of the space shuttle orbiter.

  18. Official portrait Payload specialists Robert Cenker and Gerard Magilton

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Official portrait Robert J. Cenker (right) and Gerard Magilton, RCA Payload Specialists for STS 61-C. They are wearing the blue shuttle flight suit. They are sitting in front of a table with their helmets and an American flag behind them.

  19. Robotic Surgery for Thoracic Disease

    PubMed Central

    Yoshida, Yasuhiro; Iwasaki, Akinori

    2016-01-01

    Robotic surgeries have developed in the general thoracic field over the past decade, and publications on robotic surgery outcomes have accumulated. However, controversy remains about the application of robotic surgery, with a lack of well-established evidence. Robotic surgery has several advantages such as natural movement of the surgeon’s hands when manipulating the robotic arms and instruments controlled by computer-assisted systems. Most studies have reported the feasibility and safety of robotic surgery based on acceptable morbidity and mortality compared to open or video-assisted thoracic surgery (VATS). Furthermore, there are accumulated data to indicate longer operation times and shorter hospital stay in robotic surgery. However, randomized controlled trials between robotic and open or VATS procedures are needed to clarify the advantage of robotic surgery. In this review, we focused the literature about robotic surgery used to treat lung cancer and mediastinal tumor. PMID:26822625

  20. Nanotechnology applications in thoracic surgery.

    PubMed

    Hofferberth, Sophie C; Grinstaff, Mark W; Colson, Yolonda L

    2016-07-01

    Nanotechnology is an emerging, rapidly evolving field with the potential to significantly impact care across the full spectrum of cancer therapy. Of note, several recent nanotechnological advances show particular promise to improve outcomes for thoracic surgical patients. A variety of nanotechnologies are described that offer possible solutions to existing challenges encountered in the detection, diagnosis and treatment of lung cancer. Nanotechnology-based imaging platforms have the ability to improve the surgical care of patients with thoracic malignancies through technological advances in intraoperative tumour localization, lymph node mapping and accuracy of tumour resection. Moreover, nanotechnology is poised to revolutionize adjuvant lung cancer therapy. Common chemotherapeutic drugs, such as paclitaxel, docetaxel and doxorubicin, are being formulated using various nanotechnologies to improve drug delivery, whereas nanoparticle (NP)-based imaging technologies can monitor the tumour microenvironment and facilitate molecularly targeted lung cancer therapy. Although early nanotechnology-based delivery systems show promise, the next frontier in lung cancer therapy is the development of 'theranostic' multifunctional NPs capable of integrating diagnosis, drug monitoring, tumour targeting and controlled drug release into various unifying platforms. This article provides an overview of key existing and emerging nanotechnology platforms that may find clinical application in thoracic surgery in the near future. PMID:26843431

  1. Thoracic spine sports-related injuries.

    PubMed

    Menzer, Heather; Gill, G Keith; Paterson, Andrew

    2015-01-01

    Although sports-related injuries to the thoracic spine are relatively uncommon, they are among the most feared due to the potential for catastrophic neurologic injury. The increased biomechanical support of the thoracic spine makes injuries in this region particularly rare compared with the cervical and lumbar spine. As a result, thoracic spine injuries can be missed easily, difficult to diagnose, and problematic to treat. Recognition of mechanism and awareness of injury patterns help physicians determine a diagnosis and create an index of suspicion for unstable thoracic spine injuries. Aggressive full-contact sports receive the most attention for spinal injury; however several sports with repetitive loading of the spine can cause severe injuries, including rowing, gymnastics, and golf. The goal of this article was to provide an overview of the unique anatomic and biomechanical features of the thoracic spine and to discuss some of the more common thoracic injuries that can affect athletes. PMID:25574880

  2. 22 CFR 1006.860 - What factors may influence the debarring official's decision?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... not necessarily determinative of your present responsibility. In making a debarment decision, the... official's decision? 1006.860 Section 1006.860 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE... official's decision? This section lists the mitigating and aggravating factors that the debarring...

  3. Official portrait Robert J. Cenker, Payload specialist for STS 61-C

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Official portrait Robert J. Cenker, RCA Payload specialist for STS 61-C. He is wearing the blue shuttle flight suit. He is sitting in front of a table with a model of the shuttle and an American flag behind him.

  4. TEVAR: Endovascular Repair of the Thoracic Aorta

    PubMed Central

    Nation, David A.; Wang, Grace J.

    2015-01-01

    The development of thoracic endovascular aortic repair (TEVAR) has allowed a minimally invasive approach for management of an array of thoracic aortic pathologies. Initially developed specifically for exclusion of thoracic aortic aneurysms, TEVAR is now used as an alternative to open surgery for a variety of disease pathologies due to the lower morbidity of this approach. Advances in endograft technology continue to broaden the applications of this technique. PMID:26327745

  5. Billing, coding, and credentialing in the thoracic surgery practice.

    PubMed

    Cooke, David T; Gelfand, Gary A J; Broghammer, Joshua A

    2011-08-01

    New graduates entering thoracic surgery often face bureaucratic barriers to beginning practice. It is important to understand the credentialing and privileging process to navigate these obstacles successfully. In addition, the implementation of cutting-edge technology by recent trainees can pose problems in institutions not familiar with newer surgical techniques. Efficient coding and billing are a requirement for maintaining profitability and delivering the best care possible. This article explores theses nuances in both the American and the Canadian medical systems in building a successful practice. PMID:21762858

  6. Calibration of high flow rate thoracic-size selective samplers

    PubMed Central

    Lee, Taekhee; Thorpe, Andrew; Cauda, Emanuele; Harper, Martin

    2016-01-01

    High flow rate respirable size selective samplers, GK4.126 and FSP10 cyclones, were calibrated for thoracic-size selective sampling in two different laboratories. The National Institute for Occupational Safety and Health (NIOSH) utilized monodisperse ammonium fluorescein particles and scanning electron microscopy to determine the aerodynamic particle size of the monodisperse aerosol. Fluorescein intensity was measured to determine sampling efficiencies of the cyclones. The Health Safety and Laboratory (HSL) utilized a real time particle sizing instrument (Aerodynamic Particle Sizer) and poly-disperse glass sphere particles and particle size distributions between the cyclone and reference sampler were compared. Sampling efficiency of the cyclones were compared to the thoracic convention defined by the American Conference of Governmental Industrial Hygienists (ACGIH)/Comité Européen de Normalisation (CEN)/International Standards Organization (ISO). The GK4.126 cyclone showed minimum bias compared to the thoracic convention at flow rates of 3.5 l min−1 (NIOSH) and 2.7–3.3 l min−1 (HSL) and the difference may be from the use of different test systems. In order to collect the most dust and reduce the limit of detection, HSL suggested using the upper end in range (3.3 l min−1). A flow rate of 3.4 l min−1 would be a reasonable compromise, pending confirmation in other laboratories. The FSP10 cyclone showed minimum bias at the flow rate of 4.0 l min−1 in the NIOSH laboratory test. The high flow rate thoracic-size selective samplers might be used for higher sample mass collection in order to meet analytical limits of quantification. PMID:26891196

  7. Calibration of high flow rate thoracic-size selective samplers.

    PubMed

    Lee, Taekhee; Thorpe, Andrew; Cauda, Emanuele; Harper, Martin

    2016-01-01

    High flow rate respirable size selective samplers, GK4.126 and FSP10 cyclones, were calibrated for thoracic-size selective sampling in two different laboratories. The National Institute for Occupational Safety and Health (NIOSH) utilized monodisperse ammonium fluorescein particles and scanning electron microscopy to determine the aerodynamic particle size of the monodisperse aerosol. Fluorescein intensity was measured to determine sampling efficiencies of the cyclones. The Health Safety and Laboratory (HSL) utilized a real time particle sizing instrument (Aerodynamic Particle Sizer) and polydisperse glass sphere particles and particle size distributions between the cyclone and reference sampler were compared. Sampling efficiency of the cyclones were compared to the thoracic convention defined by the American Conference of Governmental Industrial Hygienists (ACGIH)/Comité Européen de Normalisation (CEN)/International Standards Organization (ISO). The GK4.126 cyclone showed minimum bias compared to the thoracic convention at flow rates of 3.5 l min(-1) (NIOSH) and 2.7-3.3 l min(-1) (HSL) and the difference may be from the use of different test systems. In order to collect the most dust and reduce the limit of detection, HSL suggested using the upper end in range (3.3 l min(-1)). A flow rate of 3.4 l min(-1) would be a reasonable compromise, pending confirmation in other laboratories. The FSP10 cyclone showed minimum bias at the flow rate of 4.0 l min(-1) in the NIOSH laboratory test. The high flow rate thoracic-size selective samplers might be used for higher sample mass collection in order to meet analytical limits of quantification. PMID:26891196

  8. Analgesia in thoracic surgery: review.

    PubMed

    De Cosmo, G; Aceto, P; Gualtieri, E; Congedo, E

    2009-06-01

    Post-thoracotomy pain is one of the most severe types of postoperative pain. It can last up to 2 months and can become chronic in 30% of patients. Pain relief after thoracic surgery is of particular significance, not only for ethical considerations but also for reduction of postoperative pulmonary and cardiac complications. Because of the difficulty in pain control, many approaches have been suggested, but a multimodal therapeutic strategy that provides a central or peripheral block associated with nonsteroidal anti-inflammatory (NSAID) and adjuvant drugs is now the cornerstone of treatment, offering the possibility of reducing opioid requirements and side effects. Thoracic epidural analgesia with local anesthetics and opioids is regarded as the gold standard treatment for post-thoracotomy pain management because it results in early extubation, better ventilatory mechanisms and gas exchange, decreased incidence of atelectasis, pneumonia and chronic postoperative pain. When epidural analgesia is contraindicated or cannot be performed, other regional techniques of analgesia can be used. An alternative method of providing adequate pain relief is a thoracic paravertebral block: continuous paravertebral infusion of local anesthetic via a catheter placed percutaneously or under direct vision during thoracotomy. This is effective in controlling postoperative pain and in preserving pulmonary function. Other techniques, such as intercostal and interpleural blocks, are rarely utilized, whereas a single shot of intrathecal injection of a hydrophilic opioid, such as morphine, appears to be effective. Cryoanalgesia, which is successful in the immediate postoperative period, has been abandoned for its brief duration and increased incidence of chronic pain. PMID:18953284

  9. ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker

    2012-05-29

    The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research.

  10. [A review on thoracic ultrasound].

    PubMed

    Fernández-Bussy, Sebastián; Labarca, Gonzalo; Lanza, Mario; Folch, Erik; Majid, Adnan

    2016-07-01

    The use of thoracic ultrasound as a diagnostic tool in the emergency department, intensive care unit or in patients with pulmonary diseases is increasing steadily. It is used to guide percutaneous tracheostomies, to assess pleural effusions, to rule out pneumothorax, and to guide the placement of endovascular and pleural catheters. It is also useful in the assessment of patients with dyspnea. The aim of this review is to provide the practical and technical basics for the use of this diagnostic tool among internists and specialists in pulmonary diseases. PMID:27661554

  11. Official Apollo 11 Crew Photo

    NASA Technical Reports Server (NTRS)

    1971-01-01

    The Official Crew Photo of the Apollo 11 Prime Crew. From left to right are Astronauts Neil A. Armstrong, Commander; Michael Collins, Command Module Pilot; and Edwin E. Aldrin Jr., Lunar Module Pilot.

  12. ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker

    2012-05-29

    The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. PMID:22578925

  13. Evolution of thoracic surgery in Canada

    PubMed Central

    Deslauriers, Jean; Griffith Pearson, F; Nelems, Bill

    2015-01-01

    BACKGROUND: Canada’s contributions toward the 21st century’s practice of thoracic surgery have been both unique and multilayered. Scattered throughout are tales of pioneers where none had gone before, where opportunities were greeted by creativity and where iconic figures followed one another. OBJECTIVE: To describe the numerous and important achievements of Canadian thoracic surgeons in the areas of surgery for pulmonary tuberculosis, thoracic oncology, airway surgery and lung transplantation. METHOD: Information was collected through reading of the numerous publications written by Canadian thoracic surgeons over the past 100 years, interviews with interested people from all thoracic surgery divisions across Canada and review of pertinent material form the archives of several Canadian hospitals and universities. RESULTS: Many of the developments occurred by chance. It was the early and specific focus on thoracic surgery, to the exclusion of cardiac and general surgery, that distinguishes the Canadian experience, a model that is now emerging everywhere. From lung transplantation in chimera twin calves to ex vivo organ preservation, from the removal of airways to tissue regeneration, and from intensive care research to complex science, Canadians have excelled in their commitment to research. Over the years, the influence of Canadian thoracic surgery on international practice has been significant. CONCLUSIONS: Canada spearheaded the development of thoracic surgery over the past 100 years to a greater degree than any other country. From research to education, from national infrastructures to the regionalization of local practices, it happened in Canada.

  14. Thoracic organ transplantation: laboratory methods.

    PubMed

    Patel, Jignesh K; Kobashigawa, Jon A

    2013-01-01

    Although great progress has been achieved in thoracic organ transplantation through the development of effective immunosuppression, there is still significant risk of rejection during the early post-transplant period, creating a need for routine monitoring for both acute antibody and cellular mediated rejection. The currently available multiplexed, microbead assays utilizing solubilized HLA antigens afford the capability of sensitive detection and identification of HLA and non-HLA specific antibodies. These assays are being used to assess the relative strength of donor specific antibodies; to permit performance of virtual crossmatches which can reduce the waiting time to transplantation; to monitor antibody levels during desensitization; and for heart transplants to monitor antibodies post-transplant. For cell mediated immune responses, the recent development of gene expression profiling has allowed noninvasive monitoring of heart transplant recipients yielding predictive values for acute cellular rejection. T cell immune monitoring in heart and lung transplant recipients has allowed individual tailoring of immunosuppression, particularly to minimize risk of infection. While the current antibody and cellular laboratory techniques have enhanced the ability to manage thoracic organ transplant recipients, future developments from improved understanding of microchimerism and graft tolerance may allow more refined allograft monitoring techniques. PMID:23775735

  15. Bilateral internal thoracic artery grafting

    PubMed Central

    2013-01-01

    The effectiveness of the left internal mammary artery graft to the anterior descending coronary artery as a surgical strategy has been shown to improve the survival rate and decrease the risk of adverse cardiac events in patients undergoing coronary bypass surgery. These clinical benefits appear to be related to the superior short and long-term patency rates of the internal thoracic artery graft. Although the advantages of using of both internal thoracic arteries (ITA) for bypass grafting have taken longer to prove, recent results from multiple data sets now support these findings. The major advantage of bilateral ITA grafting appears to be improved survival rate, while the disadvantages of complex ITA grafting include the increased complexity of operation, and an increased risk of wound complications. While these short-term disadvantages have been mitigated in contemporary surgical practice, they have not eliminated. Bilateral ITA grafting should be considered the procedure of choice for patients undergoing coronary bypass surgery that have a predicted survival rate of longer than ten years. PMID:23977627

  16. American Association for Geriatric Psychiatry

    MedlinePlus

    ... in your area. Read more » AAGP Journal Official Journal of the American Association for Geriatric Psychiatry. Read more ... RESEARCHERS GMHF Scholars Since my program is so small and there is not much interest among my ...

  17. Ossification of thoracic ligamenta flava

    SciTech Connect

    Kudo, S.; Minoru, O.; Russell, W.J.

    1983-07-01

    Although ligamentum flavum ossification (LFO) often occurs in normal persons, there are no reports of its detection on lateral chest radiographs made during screening examinations. Review of 1,744 consecutive lateral chest radiographs identified LFO in 6.2% of males and 4.8% of females. LFO occurred mainly at the intervertebral segments from T9-T10 through T12-L1. Most prevalent was the hook-shaped LFO, protruding inferoirly from the inferior facets into the projections of the intervertabral foramina. Though LFO can cause severe neurologic symptoms, none of the affected persons in this study reported such symptoms. LFO was first visualized radiographically when the subjects were 20-40 years old, and it may be a physiologic condition. The LFO in these cases existed independent of thoracic posterior longitudinal ligament ossification, diffuse idiopathic skeletal hyperostosis, and degenerative osteoarthritis.

  18. [Thoracic nocardiosis - a clinical report].

    PubMed

    Vale, Artur; Guerra, Miguel; Martins, Daniel; Lameiras, Angelina; Miranda, José; Vouga, Luís

    2014-01-01

    Nocardia genus microorganisms are ubiquitous, Gram positive aerobic bacterias, responsible for disease mainly in immunocompromised hosts, with cellular immune response commitment. Inhalation is the main form of transmition and pulmonary disease is the most frequent presentation. Dissemination may occur by contiguity and also via hematogenous. The clinical and imaging presentation is not specific, and diagnosis is obtained after identification of Nocardia bacteria in biological samples. Since there are no reliable studies that indicate the best therapeutic option, treatment should be individualized and based on antimicrobial susceptibility testing. Surgical drainage should also be considered in all patients. The authors present a clinical case of a patient with thoracic nocardiosis, and make a short literature review on the theme.

  19. Thoracic Extraosseous Epidural Cavernous Hemangioma

    PubMed Central

    Asil, Kiyasettin; Ceylan, Davut; Erdem, Sahin

    2015-01-01

    Cavernous hemangiomas were first reported in 1929 by Globus and Doshay, and are defined as benign vascular structures developed between the neural tissues occurring in the central nervous system, consisting of a dilated vascular bed. Cavernous hemangiomas comprise nearly 5-12% of all spinal vascular malformations; however, existence in the epidural space without bone involvement is rare. Only 4% of all cavernous hemangiomas (0.22/1.000.000) are purely epidural cavernous hemangiomas. In this case report, we removed a hemorrhagic thoracic mass presenting with progressive neurological deficits in a 55-year-old male patient. We found this case to be appropriate for presentation due to the rare occurrence of this type of cavernous hemangioma. PMID:25674348

  20. [Thoracic actinomycosis versus bronchial cancer].

    PubMed

    Brombacher-Frey, I; Wöckel, W; Kreusser, T

    1992-01-01

    We report on 4 thoracic actinomycoses; in three of these four cases a bronchial carcinoma was suspected, and in case No. 2 this carcinoma had been considered to be in a very advanced and inoperable stage. A man of 51 years of age was in a generally run-down condition. He also noticed that his sputum was tinged with blood. The x-ray film showed a large space-occupying growth at the right lung hilus. Repeated perbronchial biopsies of the focus did not yield any diagnosis. Actinomycosis was identified histologically only in the tissue samples obtained via thoracotomy. After a three-month penicillin course the hilar shadow receded. A 61-year old male patient was transferred to our Pneumological Hospital, being strongly suspected of suffering from an extensive bronchial carcinoma, and having multiple intrathoracic space-occupying growths as well as pleural effusions, a pericardial effusion, and an infiltration of the left thoracic wall with fistula formation; however, histological examination of skin biopsies revealed that he was suffering from actinomycosis. Antibiotic therapy cured him completely in a six-month course. In a man of 32 years of age who had been indulging for many years in a severe abuse of nicotin, we suspected a central bronchial carcinoma on the basis of his x-ray, but histology of the tissue taken from the space-occupying growth via diagnostic thoracotomy revealed that this patient, too, suffered from actinomycosis. Complete recession occurred after several months of antibiotic treatment. A woman of 82 years had been an inpatient for several months in another hospital because of relapsing pleuropneumonias on the right side. She was transferred to us as an outpatient after a renewed relapse. We conducted a transcutaneous fine-needle biopsy of the right indurating pleural effusion. A few actinomyces filaments were seen on histological examination of the purulent exudate. Hence, actinomycosis was confirmed. After antibiotic therapy the finding receded

  1. 34 CFR 85.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Debarring official. 85.935 Section 85.935 Education Office of the Secretary, Department of Education GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 85.935 Debarring official. (a) Debarring official means an agency official who is authorized...

  2. 22 CFR 41.27 - Official visas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Official visas. 41.27 Section 41.27 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.27 Official visas. (a) Definition. Official...

  3. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Ethics officials. 20.201 Section...

  4. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Ethics officials. 20.201 Section...

  5. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Ethics officials. 20.201 Section...

  6. 29 CFR 98.1010 - Suspending official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Suspending official. 98.1010 Section 98.1010 Labor Office of the Secretary of Labor GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 98.1010 Suspending official. (a) Suspending official means an agency official who is authorized to impose...

  7. 34 CFR 85.1010 - Suspending official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... designated by the agency head. (b) Authority: E.O. 12549 (3 CFR, 1986 Comp., p. 189); E.O 12689 (3 CFR, 1989... 34 Education 1 2010-07-01 2010-07-01 false Suspending official. 85.1010 Section 85.1010 Education...) Definitions § 85.1010 Suspending official. (a) Suspending official means an agency official who is...

  8. 22 CFR 208.1010 - Suspending official.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Suspending official. 208.1010 Section 208.1010 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 208.1010 Suspending official. (a) Suspending official means an agency official...

  9. 21 CFR 1404.1010 - Suspending official.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Suspending official. 1404.1010 Section 1404.1010 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 1404.1010 Suspending official. (a) Suspending official means an agency official...

  10. 2 CFR 180.1010 - Suspending official.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Suspending official. 180.1010 Section 180.1010 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND...) Definitions § 180.1010 Suspending official. (a) Suspending official means an agency official who is...

  11. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Ethics officials. 20.201 Section...

  12. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Ethics officials. 20.201 Section...

  13. 7 CFR 62.207 - Official assessment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Official assessment. 62.207 Section 62.207 Agriculture... Definitions Service § 62.207 Official assessment. Official assessment of an applicant's program shall include: (a) Documentation assessment. Auditors and other USDA officials shall review the applicant's...

  14. 7 CFR 62.207 - Official assessment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Official assessment. 62.207 Section 62.207 Agriculture... Definitions Service § 62.207 Official assessment. Official assessment of an applicant's program shall include: (a) Documentation assessment. Auditors and other USDA officials shall review the applicant's...

  15. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  16. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  17. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  18. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  19. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  20. NAGWS Volleyball Guide 1988. Official Rules & Interpretations/Officiating.

    ERIC Educational Resources Information Center

    American Alliance for Health, Physical Education, Recreation and Dance, Reston, VA. National Association for Girls and Women in Sport.

    This National Association for Girls and Women in Sport (NAGWS) handbook sets forth the official rules and interpretations for women's interscholastic and collegiate volleyball for 1988-89. No major changes have been made in this issue. A check or underlining is used to denote clarifications, and/or the addition of experimental rules and some minor…

  1. PET-Based Thoracic Radiation Oncology.

    PubMed

    Simone, Charles B; Houshmand, Sina; Kalbasi, Anusha; Salavati, Ali; Alavi, Abass

    2016-07-01

    Fluorodeoxyglucose-PET is increasingly being integrated into multiple aspects of oncology. PET/computed tomography (PET/CT) has become especially important in radiation oncology. With the increasing use of advanced techniques like intensity-modulated radiation therapy and proton therapy, PET/CT scans have played critical roles in the target delineation of tumors for radiation oncologists delivering conformal treatment techniques. Use of PET/CT is well established in lung cancer and several other thoracic malignancies. This article details the current uses of PET/CT in thoracic radiation oncology with a focus on lung cancer and describes expected future roles of PET/CT for thoracic tumors.

  2. Thoracic ranula: an extremely rare case.

    PubMed

    Pang, Claudine Elizabeth; Lee, Tee Sin; Pang, Kenny Peter; Pang, Yoke Teen

    2005-03-01

    We present the first case of a thoracic ranula which originated from the left submandibular area extending into the subcutaneous tissue planes of the anterior chest wall. The patient had a history of surgery for a previous benign left salivary gland cyst, and presented with an enlarging mass in the anterior chest wall. This was a recurrence of a ranula, with an extension into the anterior thoracic wall. The thoracic ranula was excised, together with ipsilateral sublingual and submandibular glands, via a transcervical approach. No recurrence was detected over a 3-year post-operative follow up.

  3. Thoracic Duct Embolization with Lipiodol for Chylothorax due to Thoracic Endovascular Aortic Repair with Debranching Procedure

    PubMed Central

    Lee, Kwang Hyoung; Jung, Jae Seung; Cho, Sung Bum; Lee, Seung Hun; Kim, Hee Jung; Son, Ho Sung

    2015-01-01

    Chylothorax is a rare postoperative complication of a thoracic surgical procedure. Here, we report a case of chylothorax after thoracic endovascular aortic repair with debranching for the distal arch aneurysm of the aorta. First, the patient was treated by a medical method (nil per os, fat-free diet, and octreotide), but this method failed. The patient strongly refused surgical treatment. Therefore, we tried to occlude the thoracic duct by lymphangiography Lipiodol, and this line of treatment was successful. PMID:25705604

  4. 9 CFR 325.5 - Unmarked inspected product transported under official seal between official establishments for...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... under official seal between official establishments for further processing; certificate. 325.5 Section... CERTIFICATION TRANSPORTATION § 325.5 Unmarked inspected product transported under official seal between official... other means of conveyance which is sealed by a Program employee with an official seal of the...

  5. 9 CFR 325.5 - Unmarked inspected product transported under official seal between official establishments for...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... under official seal between official establishments for further processing; certificate. 325.5 Section... CERTIFICATION TRANSPORTATION § 325.5 Unmarked inspected product transported under official seal between official... other means of conveyance which is sealed by a Program employee with an official seal of the...

  6. 9 CFR 325.5 - Unmarked inspected product transported under official seal between official establishments for...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... under official seal between official establishments for further processing; certificate. 325.5 Section... CERTIFICATION TRANSPORTATION § 325.5 Unmarked inspected product transported under official seal between official... other means of conveyance which is sealed by a Program employee with an official seal of the...

  7. [Big data in official statistics].

    PubMed

    Zwick, Markus

    2015-08-01

    The concept of "big data" stands to change the face of official statistics over the coming years, having an impact on almost all aspects of data production. The tasks of future statisticians will not necessarily be to produce new data, but rather to identify and make use of existing data to adequately describe social and economic phenomena. Until big data can be used correctly in official statistics, a lot of questions need to be answered and problems solved: the quality of data, data protection, privacy, and the sustainable availability are some of the more pressing issues to be addressed. The essential skills of official statisticians will undoubtedly change, and this implies a number of challenges to be faced by statistical education systems, in universities, and inside the statistical offices. The national statistical offices of the European Union have concluded a concrete strategy for exploring the possibilities of big data for official statistics, by means of the Big Data Roadmap and Action Plan 1.0. This is an important first step and will have a significant influence on implementing the concept of big data inside the statistical offices of Germany.

  8. [Big data in official statistics].

    PubMed

    Zwick, Markus

    2015-08-01

    The concept of "big data" stands to change the face of official statistics over the coming years, having an impact on almost all aspects of data production. The tasks of future statisticians will not necessarily be to produce new data, but rather to identify and make use of existing data to adequately describe social and economic phenomena. Until big data can be used correctly in official statistics, a lot of questions need to be answered and problems solved: the quality of data, data protection, privacy, and the sustainable availability are some of the more pressing issues to be addressed. The essential skills of official statisticians will undoubtedly change, and this implies a number of challenges to be faced by statistical education systems, in universities, and inside the statistical offices. The national statistical offices of the European Union have concluded a concrete strategy for exploring the possibilities of big data for official statistics, by means of the Big Data Roadmap and Action Plan 1.0. This is an important first step and will have a significant influence on implementing the concept of big data inside the statistical offices of Germany. PMID:26077871

  9. Thoracic and abdominal blastomycosis in a horse.

    PubMed

    Toribio, R E; Kohn, C W; Lawrence, A E; Hardy, J; Hutt, J A

    1999-05-01

    A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy. PMID:10319179

  10. Clinical innovations in Philippine thoracic surgery

    PubMed Central

    2016-01-01

    Thoracic surgery in the Philippines followed the development of thoracic surgery in the United States and Europe. With better understanding of the physiology of the open chest and refinements in thoracic anesthetic and surgical approaches, Filipino surgeons began performing thoracoplasties, then lung resections for pulmonary tuberculosis and later for lung cancer in specialty hospitals dealing with pulmonary diseases—first at the Quezon Institute (QI) and presently at the Lung Center of the Philippines although some university and private hospitals made occasional forays into the chest. Esophageal surgery began its early attempts during the post-World War II era at the Philippine General Hospital (PGH), a university hospital affiliated with the University of the Philippines. With the introduction of minimally invasive thoracic surgical approaches, Filipino thoracic surgeons have managed to keep up with their Asian counterparts although the problems of financial reimbursement typical of a developing country remain. The need for creative innovative approaches of a focused multidisciplinary team will advance the boundaries of thoracic surgery in the Philippines.

  11. Clinical innovations in Philippine thoracic surgery.

    PubMed

    Danguilan, Jose Luis J

    2016-08-01

    Thoracic surgery in the Philippines followed the development of thoracic surgery in the United States and Europe. With better understanding of the physiology of the open chest and refinements in thoracic anesthetic and surgical approaches, Filipino surgeons began performing thoracoplasties, then lung resections for pulmonary tuberculosis and later for lung cancer in specialty hospitals dealing with pulmonary diseases-first at the Quezon Institute (QI) and presently at the Lung Center of the Philippines although some university and private hospitals made occasional forays into the chest. Esophageal surgery began its early attempts during the post-World War II era at the Philippine General Hospital (PGH), a university hospital affiliated with the University of the Philippines. With the introduction of minimally invasive thoracic surgical approaches, Filipino thoracic surgeons have managed to keep up with their Asian counterparts although the problems of financial reimbursement typical of a developing country remain. The need for creative innovative approaches of a focused multidisciplinary team will advance the boundaries of thoracic surgery in the Philippines. PMID:27651936

  12. Clinical innovations in Philippine thoracic surgery.

    PubMed

    Danguilan, Jose Luis J

    2016-08-01

    Thoracic surgery in the Philippines followed the development of thoracic surgery in the United States and Europe. With better understanding of the physiology of the open chest and refinements in thoracic anesthetic and surgical approaches, Filipino surgeons began performing thoracoplasties, then lung resections for pulmonary tuberculosis and later for lung cancer in specialty hospitals dealing with pulmonary diseases-first at the Quezon Institute (QI) and presently at the Lung Center of the Philippines although some university and private hospitals made occasional forays into the chest. Esophageal surgery began its early attempts during the post-World War II era at the Philippine General Hospital (PGH), a university hospital affiliated with the University of the Philippines. With the introduction of minimally invasive thoracic surgical approaches, Filipino thoracic surgeons have managed to keep up with their Asian counterparts although the problems of financial reimbursement typical of a developing country remain. The need for creative innovative approaches of a focused multidisciplinary team will advance the boundaries of thoracic surgery in the Philippines.

  13. Clinical innovations in Philippine thoracic surgery

    PubMed Central

    2016-01-01

    Thoracic surgery in the Philippines followed the development of thoracic surgery in the United States and Europe. With better understanding of the physiology of the open chest and refinements in thoracic anesthetic and surgical approaches, Filipino surgeons began performing thoracoplasties, then lung resections for pulmonary tuberculosis and later for lung cancer in specialty hospitals dealing with pulmonary diseases—first at the Quezon Institute (QI) and presently at the Lung Center of the Philippines although some university and private hospitals made occasional forays into the chest. Esophageal surgery began its early attempts during the post-World War II era at the Philippine General Hospital (PGH), a university hospital affiliated with the University of the Philippines. With the introduction of minimally invasive thoracic surgical approaches, Filipino thoracic surgeons have managed to keep up with their Asian counterparts although the problems of financial reimbursement typical of a developing country remain. The need for creative innovative approaches of a focused multidisciplinary team will advance the boundaries of thoracic surgery in the Philippines. PMID:27651936

  14. Cytomegalovirus Immunoglobulin After Thoracic Transplantation

    PubMed Central

    Grossi, Paolo; Mohacsi, Paul; Szabolcs, Zoltán; Potena, Luciano

    2016-01-01

    Abstract Cytomegalovirus (CMV) is a highly complex pathogen which, despite modern prophylactic regimens, continues to affect a high proportion of thoracic organ transplant recipients. The symptomatic manifestations of CMV infection are compounded by adverse indirect effects induced by the multiple immunomodulatory actions of CMV. These include a higher risk of acute rejection, cardiac allograft vasculopathy after heart transplantation, and potentially bronchiolitis obliterans syndrome in lung transplant recipients, with a greater propensity for opportunistic secondary infections. Prophylaxis for CMV using antiviral agents (typically oral valganciclovir or intravenous ganciclovir) is now almost universal, at least in high-risk transplants (D+/R−). Even with extended prophylactic regimens, however, challenges remain. The CMV events can still occur despite antiviral prophylaxis, including late-onset infection or recurrent disease, and patients with ganciclovir-resistant CMV infection or who are intolerant to antiviral therapy require alternative strategies. The CMV immunoglobulin (CMVIG) and antiviral agents have complementary modes of action. High-titer CMVIG preparations provide passive CMV-specific immunity but also exert complex immunomodulatory properties which augment the antiviral effect of antiviral agents and offer the potential to suppress the indirect effects of CMV infection. This supplement discusses the available data concerning the immunological and clinical effects of CMVIG after heart or lung transplantation. PMID:26900989

  15. Assessing Crime as a Problem: The Relationship between Residents' Perception of Crime and Official Crime Rates over 25 Years

    ERIC Educational Resources Information Center

    Hipp, John R.

    2013-01-01

    This study compares the relationship between official crime rates in census tracts and resident perceptions of crime. Using a unique data set that links household-level data from the American Housing Survey metro samples over 25 years (1976-1999) with official crime rate data for census tracts in selected cities during selected years, this study…

  16. Teaching Japanese-American Incarceration

    ERIC Educational Resources Information Center

    Miksch, Karen L.; Ghere, David

    2004-01-01

    Few events in American history are so universally deplored as the incarceration of Japanese Americans during World War II. The United States government has acknowledged the error and the injustice that resulted with an official Presidential apology and a Congressional disbursement of reparations to the victims of the incarceration policy. The…

  17. [Video-assisted thoracic surgery, lung transplantation and mediastinitis: major issues in thoracic surgery in 2010].

    PubMed

    Borro, José M; Moreno, Ramón; Gómez, Ana; Duque, José Luis

    2011-01-01

    We reviewed the major issues in thoracic surgery relating to the advances made in our specialty in 2010. To do this, the 43(rd) Congress of the Spanish Society of Pneumology and Thoracic Surgery held in La Coruña and the articles published in the Society's journal, Archivos de Bronconeumología, were reviewed. The main areas of interest were related to the development of video-assisted thoracic surgery, lung transplantation and descending mediastinitis. The new tumor-node-metastasis (TNM) classification (7(th) edition), presented last year, was still a topical issue this year. The First Forum of Thoracic Surgeons and the Update in Thoracic Surgery together with the Nurses' Area have constituted an excellent teaching program. PMID:21300211

  18. 7 CFR 58.646 - Official identification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Products Bearing Usda Official Identification § 58.646 Official identification. (a) Only ice cream and.... grades established (nonfat dry milk, whole milk, buttermilk and whey) shall be U.S. Extra Grade or...

  19. 7 CFR 58.646 - Official identification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Products Bearing Usda Official Identification § 58.646 Official identification. (a) Only ice cream and.... grades established (nonfat dry milk, whole milk, buttermilk and whey) shall be U.S. Extra Grade or...

  20. 7 CFR 58.646 - Official identification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Products Bearing Usda Official Identification § 58.646 Official identification. (a) Only ice cream and.... grades established (nonfat dry milk, whole milk, buttermilk and whey) shall be U.S. Extra Grade or...

  1. Asian perspective in surgery: thoracic surgery in Turkey

    PubMed Central

    2016-01-01

    Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surgeons. There are a number of reasons to predict that the number of thoracic surgical cases will be increased and new generation of thoracic surgeons will be operating more minimally invasive resectional surgeries for most lung cancer in future.

  2. Asian perspective in surgery: thoracic surgery in Turkey.

    PubMed

    Turna, Akif

    2016-08-01

    Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surgeons. There are a number of reasons to predict that the number of thoracic surgical cases will be increased and new generation of thoracic surgeons will be operating more minimally invasive resectional surgeries for most lung cancer in future.

  3. 12 CFR 328.1 - Official sign.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Official sign. 328.1 Section 328.1 Banks and... OF MEMBERSHIP § 328.1 Official sign. (a) The official sign referred to in this part shall be 7″ by 3... “symbol” of the Corporation, as used in this part, shall be that portion of the official sign...

  4. 12 CFR 328.1 - Official sign.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Official sign. 328.1 Section 328.1 Banks and... OF MEMBERSHIP § 328.1 Official sign. (a) The official sign referred to in this part shall be 7″ by 3... “symbol” of the Corporation, as used in this part, shall be that portion of the official sign...

  5. 12 CFR 328.1 - Official sign.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Official sign. 328.1 Section 328.1 Banks and... OF MEMBERSHIP § 328.1 Official sign. (a) The official sign referred to in this part shall be 7″ by 3... “symbol” of the Corporation, as used in this part, shall be that portion of the official sign...

  6. 12 CFR 328.1 - Official sign.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Official sign. 328.1 Section 328.1 Banks and... OF MEMBERSHIP § 328.1 Official sign. (a) The official sign referred to in this part shall be 7″ by 3... “symbol” of the Corporation, as used in this part, shall be that portion of the official sign...

  7. Thoracic manifestations of collagen vascular diseases.

    PubMed

    Capobianco, Julia; Grimberg, Alexandre; Thompson, Bruna M; Antunes, Viviane B; Jasinowodolinski, Dany; Meirelles, Gustavo S P

    2012-01-01

    Collagen vascular diseases are a diverse group of immunologically mediated systemic disorders that often lead to thoracic changes. The collagen vascular diseases that most commonly involve the lung are rheumatoid arthritis, progressive systemic sclerosis, systemic lupus erythematosus, polymyositis and dermatomyositis, mixed connective tissue disease, and Sjögren syndrome. Interstitial lung disease and pulmonary arterial hypertension are the main causes of mortality and morbidity among patients with collagen vascular diseases. Given the broad spectrum of possible thoracic manifestations and the varying frequency with which different interstitial lung diseases occur, the interpretation of thoracic images obtained in patients with collagen vascular diseases can be challenging. The task may be more difficult in the presence of treatment-related complications such as drug toxicity and infections, which are common in this group of patients. Although chest radiography is most often used for screening and monitoring of thoracic alterations, high-resolution computed tomography can provide additional information about lung involvement in collagen vascular diseases and may be especially helpful for differentiating specific disease patterns in the lung. General knowledge about the manifestations of thoracic involvement in collagen vascular diseases allows radiologists to provide better guidance for treatment and follow-up of these patients.

  8. 7 CFR 51.17 - Official sampling.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Official sampling. 51.17 Section 51.17 Agriculture... Inspection Service § 51.17 Official sampling. Samples may be officially drawn by any duly authorized... time and place of the sampling and the brands or other identifying marks of the containers from...

  9. 7 CFR 51.17 - Official sampling.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Official sampling. 51.17 Section 51.17 Agriculture... Inspection Service § 51.17 Official sampling. Samples may be officially drawn by any duly authorized... time and place of the sampling and the brands or other identifying marks of the containers from...

  10. 7 CFR 51.17 - Official sampling.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Official sampling. 51.17 Section 51.17 Agriculture... Inspection Service § 51.17 Official sampling. Samples may be officially drawn by any duly authorized... time and place of the sampling and the brands or other identifying marks of the containers from...

  11. 9 CFR 86.4 - Official identification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... interstate movement unless they are exempt from official identification requirements under 9 CFR part 79 or are officially identified after the interstate movement, as provided in 9 CFR part 79. (3) Swine... more National Uniform Eartagging System tags and/or an official vaccination eartag used for...

  12. 22 CFR 1429.13 - Official time.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Official time. 1429.13 Section 1429.13 Foreign... REQUIREMENTS Miscellaneous § 1429.13 Official time. If the participation of any employee in any phase of any... of the Board designated by the Board, such employee shall be granted official time for...

  13. 22 CFR 1429.13 - Official time.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Official time. 1429.13 Section 1429.13 Foreign... REQUIREMENTS Miscellaneous § 1429.13 Official time. If the participation of any employee in any phase of any... of the Board designated by the Board, such employee shall be granted official time for...

  14. 5 CFR 9701.523 - Official time.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Official time. 9701.523 Section 9701.523... MANAGEMENT SYSTEM Labor-Management Relations § 9701.523 Official time. (a) Any employee representing an... authorized official time for such purposes, including attendance at impasse proceedings, during the time...

  15. 5 CFR 9701.523 - Official time.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Official time. 9701.523 Section 9701.523... MANAGEMENT SYSTEM Labor-Management Relations § 9701.523 Official time. (a) Any employee representing an... authorized official time for such purposes, including attendance at impasse proceedings, during the time...

  16. 22 CFR 1429.13 - Official time.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Official time. 1429.13 Section 1429.13 Foreign... REQUIREMENTS Miscellaneous § 1429.13 Official time. If the participation of any employee in any phase of any... of the Board designated by the Board, such employee shall be granted official time for...

  17. 5 CFR 9701.523 - Official time.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Official time. 9701.523 Section 9701.523... MANAGEMENT SYSTEM Labor-Management Relations § 9701.523 Official time. (a) Any employee representing an... authorized official time for such purposes, including attendance at impasse proceedings, during the time...

  18. 5 CFR 9701.523 - Official time.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Official time. 9701.523 Section 9701.523... MANAGEMENT SYSTEM Labor-Management Relations § 9701.523 Official time. (a) Any employee representing an... authorized official time for such purposes, including attendance at impasse proceedings, during the time...

  19. 22 CFR 1429.13 - Official time.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Official time. 1429.13 Section 1429.13 Foreign... REQUIREMENTS Miscellaneous § 1429.13 Official time. If the participation of any employee in any phase of any... of the Board designated by the Board, such employee shall be granted official time for...

  20. 12 CFR 328.1 - Official sign.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Official sign. 328.1 Section 328.1 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY ADVERTISEMENT OF MEMBERSHIP § 328.1 Official sign. (a) The official sign referred to in this part shall be 7″ by...

  1. 7 CFR 37.10 - Official assessment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Official assessment. 37.10 Section 37.10 Agriculture... ASSESS ORGANIC CERTIFYING AGENCIES § 37.10 Official assessment. Official assessment of an applicant's... completion of an adequacy audit by the auditors. (b) Program assessment. Assessment of a...

  2. 7 CFR 37.10 - Official assessment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Official assessment. 37.10 Section 37.10 Agriculture... ASSESS ORGANIC CERTIFYING AGENCIES § 37.10 Official assessment. Official assessment of an applicant's... completion of an adequacy audit by the auditors. (b) Program assessment. Assessment of a...

  3. 7 CFR 58.526 - Official identification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Requirements for Cottage Cheese Bearing Usda Official Identification § 58.526 Official identification. (a) Only cottage cheese... compliance with these requirements may be identified with the official USDA Quality Approved...

  4. 5 CFR 9701.523 - Official time.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Official time. 9701.523 Section 9701.523... MANAGEMENT SYSTEM Labor-Management Relations § 9701.523 Official time. (a) Any employee representing an... authorized official time for such purposes, including attendance at impasse proceedings, during the time...

  5. 9 CFR 381.98 - Official seal.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Official seal. 381.98 Section 381.98... Certificates; Certification Procedures § 381.98 Official seal. The official mark for use in sealing means of... and a serial number as shown below, and any seals approved by the Administrator for applying such...

  6. 9 CFR 381.98 - Official seal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Official seal. 381.98 Section 381.98... Certificates; Certification Procedures § 381.98 Official seal. The official mark for use in sealing means of... and a serial number as shown below, and any seals approved by the Administrator for applying such...

  7. 9 CFR 381.98 - Official seal.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Official seal. 381.98 Section 381.98... Certificates; Certification Procedures § 381.98 Official seal. The official mark for use in sealing means of... and a serial number as shown below, and any seals approved by the Administrator for applying such...

  8. 46 CFR 501.11 - Official seal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 9 2012-10-01 2012-10-01 false Official seal. 501.11 Section 501.11 Shipping FEDERAL... Seal § 501.11 Official seal. (a) Description. Pursuant to section 201(c) of the Merchant Marine Act, 1936, as amended (46 U.S.C. 301(d)), the Commission prescribes its official seal, as adopted by...

  9. 9 CFR 381.98 - Official seal.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Official seal. 381.98 Section 381.98... Certificates; Certification Procedures § 381.98 Official seal. The official mark for use in sealing means of... and a serial number as shown below, and any seals approved by the Administrator for applying such...

  10. 46 CFR 501.11 - Official seal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Official seal. 501.11 Section 501.11 Shipping FEDERAL... Seal § 501.11 Official seal. (a) Description. Pursuant to section 201(c) of the Merchant Marine Act, 1936, as amended (46 U.S.C. 301(d)), the Commission prescribes its official seal, as adopted by...

  11. 46 CFR 501.11 - Official seal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 9 2014-10-01 2014-10-01 false Official seal. 501.11 Section 501.11 Shipping FEDERAL... Seal § 501.11 Official seal. (a) Description. Pursuant to section 201(c) of the Merchant Marine Act, 1936, as amended (46 U.S.C. 301(d)), the Commission prescribes its official seal, as adopted by...

  12. 46 CFR 501.11 - Official seal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 9 2011-10-01 2011-10-01 false Official seal. 501.11 Section 501.11 Shipping FEDERAL... Seal § 501.11 Official seal. (a) Description. Pursuant to section 201(c) of the Merchant Marine Act, 1936, as amended (46 U.S.C. 301(d)), the Commission prescribes its official seal, as adopted by...

  13. 9 CFR 381.98 - Official seal.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Official seal. 381.98 Section 381.98... Certificates; Certification Procedures § 381.98 Official seal. The official mark for use in sealing means of... and a serial number as shown below, and any seals approved by the Administrator for applying such...

  14. 46 CFR 501.11 - Official seal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 9 2013-10-01 2013-10-01 false Official seal. 501.11 Section 501.11 Shipping FEDERAL... Seal § 501.11 Official seal. (a) Description. Pursuant to section 201(c) of the Merchant Marine Act, 1936, as amended (46 U.S.C. 301(d)), the Commission prescribes its official seal, as adopted by...

  15. Acute Shingles after Resection of Thoracic Schwannoma

    PubMed Central

    Muesse, Jason L.; Blackmon, Shanda H.; Harris, Richard L.; Kim, Min P.

    2012-01-01

    Herpes zoster is relatively uncommon after surgery in immunocompetent patients. To our knowledge, there have been no reports of herpes zoster after the resection of a thoracic schwannoma. We report the case of a 48-year-old woman in whom acute shingles developed after the video-assisted thoracic surgical resection of a posterior mediastinal schwannoma adjacent to the 4th thoracic vertebral body. The patient recovered after receiving timely antiviral therapy. Rash and pain are common in patients who have wound infections and contact dermatitis after surgery, so the possible reactivation of varicella virus might not be prominent in the surgeon's mind. This case serves as a reminder that viral infections such as shingles should be considered in the differential diagnosis of postoperative erythema and pain. PMID:22740749

  16. 29 CFR 2703.2 - Designated agency ethics official and alternate designated agency ethics official.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Designated agency ethics official and alternate designated agency ethics official. 2703.2 Section 2703.2 Labor Regulations Relating to Labor (Continued) FEDERAL... agency ethics official and alternate designated agency ethics official. The Chairman shall appoint...

  17. 29 CFR 2703.2 - Designated agency ethics official and alternate designated agency ethics official.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Designated agency ethics official and alternate designated agency ethics official. 2703.2 Section 2703.2 Labor Regulations Relating to Labor (Continued) FEDERAL... agency ethics official and alternate designated agency ethics official. The Chairman shall appoint...

  18. 29 CFR 2703.2 - Designated agency ethics official and alternate designated agency ethics official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Designated agency ethics official and alternate designated agency ethics official. 2703.2 Section 2703.2 Labor Regulations Relating to Labor (Continued) FEDERAL... agency ethics official and alternate designated agency ethics official. The Chairman shall appoint...

  19. 9 CFR 325.7 - Shipment of products requiring special supervision between official establishments under official...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... supervision between official establishments under official seal; certificate. 325.7 Section 325.7 Animals and... official seal; certificate. (a) Products passed for cooking, pork that has been refrigerated to destroy... subchapter, in railroad cars, trucks, or other means of conveyance sealed with the official seal of...

  20. 29 CFR 2703.2 - Designated agency ethics official and alternate designated agency ethics official.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Designated agency ethics official and alternate designated agency ethics official. 2703.2 Section 2703.2 Labor Regulations Relating to Labor (Continued) FEDERAL... agency ethics official and alternate designated agency ethics official. The Chairman shall appoint...

  1. 29 CFR 2703.2 - Designated agency ethics official and alternate designated agency ethics official.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Designated agency ethics official and alternate designated agency ethics official. 2703.2 Section 2703.2 Labor Regulations Relating to Labor (Continued) FEDERAL... agency ethics official and alternate designated agency ethics official. The Chairman shall appoint...

  2. 9 CFR 381.123 - Official inspection mark; official establishment number.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... establishment number. 381.123 Section 381.123 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... Containers § 381.123 Official inspection mark; official establishment number. The immediate container of... official establishment number of the official establishment in which the product was processed...

  3. 49 CFR 604.6 - Government officials on official government business.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Government officials on official government...) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Exceptions § 604.6 Government officials on official government business. (a) A recipient may provide charter service to...

  4. 49 CFR 604.6 - Government officials on official government business.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Government officials on official government...) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Exceptions § 604.6 Government officials on official government business. (a) A recipient may provide charter service to...

  5. 49 CFR 604.6 - Government officials on official government business.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Government officials on official government...) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Exceptions § 604.6 Government officials on official government business. (a) A recipient may provide charter service to...

  6. 49 CFR 604.6 - Government officials on official government business.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Government officials on official government...) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Exceptions § 604.6 Government officials on official government business. (a) A recipient may provide charter service to...

  7. 49 CFR 604.6 - Government officials on official government business.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Government officials on official government...) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Exceptions § 604.6 Government officials on official government business. (a) A recipient may provide charter service to...

  8. 9 CFR 325.7 - Shipment of products requiring special supervision between official establishments under official...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... supervision between official establishments under official seal; certificate. 325.7 Section 325.7 Animals and... official seal; certificate. (a) Products passed for cooking, pork that has been refrigerated to destroy... subchapter, in railroad cars, trucks, or other means of conveyance sealed with the official seal of...

  9. 9 CFR 325.7 - Shipment of products requiring special supervision between official establishments under official...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... supervision between official establishments under official seal; certificate. 325.7 Section 325.7 Animals and... official seal; certificate. (a) Products passed for cooking, pork that has been refrigerated to destroy... subchapter, in railroad cars, trucks, or other means of conveyance sealed with the official seal of...

  10. Genetics Home Reference: familial thoracic aortic aneurysm and dissection

    MedlinePlus

    ... Home Health Conditions familial TAAD familial thoracic aortic aneurysm and dissection Enable Javascript to view the expand/ ... Open All Close All Description Familial thoracic aortic aneurysm and dissection ( familial TAAD ) involves problems with the ...

  11. Key Obama officials leave administration

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2013-01-01

    Secretary of the Interior Ken Salazar is one of the latest members of the Obama administration to announce that he is leaving his position near the start of President Obama's second term in office. Salazar, who has served as interior secretary since January 2009, intends to leave the department by the end of March, the department noted on 16 January. Salazar joins a number of other key officials who are planning to leave the administration. They include Environmental Protection Agency administrator Lisa Jackson, National Oceanic and Atmospheric Administration administrator Jane Lubchenco, and U.S. Geological Survey director Marcia McNutt.

  12. Long thoracic neuropathy from athletic activity.

    PubMed

    Schultz, J S; Leonard, J A

    1992-01-01

    Four cases of long thoracic mononeuropathy associated with sports participation are presented. Each patient developed shoulder pain or dysfunction after an acute event or vigorous activity, and demonstrated scapular winging consistent with serratus anterior weakness. The diagnosis was confirmed with electromyography in each case. It is suggested that the athletic activity caused a stretch injury to the long thoracic nerve. Conservative management, consisting of range of motion exercises for the shoulder and strengthening of the serratus anterior muscle, resulted in a favorable outcome in all patients.

  13. Official Portrait of Astronaut Frank Borman

    NASA Technical Reports Server (NTRS)

    1964-01-01

    This is the official portrait of astronaut Frank Borman. A career Air Force officer from 1950, his assignments included service as a fighter pilot, an operational pilot and instructor, an experimental test pilot and an assistant professor of thermodynamics and fluid mechanics at West Point. When selected by NASA, Frank Borman was an instructor at the Aerospace Research Pilot School at Edwards AFB, California. In 1967 he served as a member of the Apollo 204 Fire Investigation Board, investigating the causes of the fire which killed three astronauts aboard an Apollo spacecraft. Later he became the Apollo Program Resident Manager, heading the team that reengineered the Apollo spacecraft. He also served as Field Director of the NASA Space Station Task Force. Frank Borman retired from the air Force in 1970, but is well remembered as a part of American history as a pioneer in the exploration of space. He is a veteran of both the Gemini 7, 1965 Space Orbital Rendezvous with Gemini 6 and the first manned lunar orbital mission, Apollo 8, in 1968.

  14. Mayo Clinic: An Institutional History of General Thoracic Surgery.

    PubMed

    Gillaspie, Erin A; Nichols, Francis C; Allen, Mark S

    2015-01-01

    The Mayo Clinic was started in Rochester, MN after a 1883 tornado disaster. The Mayo brothers, William and Charles began thoracic surgical procedures early in their career. Dr. Samuel Robinson is recognized as the first thoracic surgeon at Mayo. He was followed by Drs. Harrington and Claret who became famous surgeons. Many other notable surgeons have help to build the thoracic surgical practice into what is today a world renown center of excellence in thoracic surgery. PMID:26811041

  15. Mayo Clinic: An Institutional History of General Thoracic Surgery.

    PubMed

    Gillaspie, Erin A; Nichols, Francis C; Allen, Mark S

    2015-01-01

    The Mayo Clinic was started in Rochester, MN after a 1883 tornado disaster. The Mayo brothers, William and Charles began thoracic surgical procedures early in their career. Dr. Samuel Robinson is recognized as the first thoracic surgeon at Mayo. He was followed by Drs. Harrington and Claret who became famous surgeons. Many other notable surgeons have help to build the thoracic surgical practice into what is today a world renown center of excellence in thoracic surgery.

  16. Percutaneous approach to the upper thoracic spine: optimal patient positioning.

    PubMed

    Bayley, Edward; Clamp, Jonathan; Boszczyk, Bronek M

    2009-12-01

    Percutaneous access to the upper thoracic vertebrae under fluoroscopic guidance is challenging. We describe our positioning technique facilitating optimal visualisation of the high thoracic vertebrae in the prone position. This allows safe practice of kyphoplasty, vertebroplasty and biopsy throughout the upper thoracic spine.

  17. Coil embolization of traumatic pseudoaneurysm of right internal thoracic artery.

    PubMed

    Tourmousoglou, Christos; Zambakis, Peter; Koletsis, Efstratios; Prokakis, Christos; Charoulis, Nikolaos; Dougenis, Dimitrios

    2015-10-01

    Traumatic injury to the chest and internal thoracic artery is a perplexing problem that is difficult to diagnose and open to different treatment options. Internal thoracic artery pseudoaneurysms are an extremely rare vascular abnormality. We report the case of a patient with a pseudoaneurysm of the musculophrenic artery, a branch of right internal thoracic artery, caused by a penetrating injury of the chest.

  18. Latin American Conference on Agricultural Education

    ERIC Educational Resources Information Center

    Agan, Ray

    1971-01-01

    Presents the subject matter of a UNESCO sponsored conference in Pamplona, Colombia, April 26- May 23, 1970 of school directors and Ministry officials in Agricultural Education from 12 Latin American Countries. (GB)

  19. Functional chiral asymmetry in descending thoracic aorta.

    PubMed

    Frazin, L J; Lanza, G; Vonesh, M; Khasho, F; Spitzzeri, C; McGee, S; Mehlman, D; Chandran, K B; Talano, J; McPherson, D

    1990-12-01

    To determine whether rotational blood flow or chiral asymmetry exists in the human descending thoracic aorta, we established the ability of color Doppler ultrasound to detect rotational flow in a tornado tube model of a vortex descending fluid column. In a model of the human aortic arch with a pulse duplicator, color Doppler was then used to demonstrate that rotational flow occurs first in the transverse arch and then in the proximal descending thoracic aorta. With the use of color Doppler esophageal echocardiography, 53 patients (age range, 25-78 years; mean age, 56.4 years) were prospectively examined for rotational flow in the descending thoracic aorta. At 10 cm superior to retro-left ventricular position, 22 of 38 patients (58%) revealed rotational flow with obvious diastolic counterclockwise rotation but less obvious systolic clockwise rotation. At 5 cm superior to retro-left ventricular position, 29 of 46 patients (63%) revealed rotational flow with a tendency toward systolic clockwise and diastolic counterclockwise rotation. At the retro-left ventricular position, 47 of 53 patients (89%) revealed rotational flow, usually of a clockwise direction, occurring in systole. Our data suggest that aortic flow is not purely pulsatile and axial but has a rotational component. Rotational flow begins in the aortic arch and is carried through to the descending thoracic aorta, where flow is chirally asymmetric with systolic clockwise and diastolic counterclockwise components. These data demonstrate an aortic rotational flow component that may have physiological implications for organ perfusion. PMID:2242523

  20. Retrograde replacement of the thoracic aorta.

    PubMed Central

    Cooley, D A

    1995-01-01

    A technique is described for replacement of the entire thoracic aorta. In this "pull-through" technique, which utilizes hypothermic circulatory arrest, the graft is implanted in a retrograde fashion, thus providing protection for the spinal cord and brain and avoiding injury to the vagus and phrenic nerves. PMID:7647599

  1. Thoracic BB injuries in pediatric patients.

    PubMed

    Fernandez, L G; Radhakrishnan, J; Gordon, R T; Shah, M R; Lain, K Y; Messersmith, R N; Roettger, R H; Norwood, S H

    1995-03-01

    Penetrating thoracic injury from BB shot remains an innocuous event in most patients, but factors including location, proximity, gun type, and patient weight may identify groups at risk. The following cases demonstrate morbidity and mortality in two patients, and this experience may suggest the need for reassessment of this injury.

  2. Cerebrospinal Fluid Leakage after Thoracic Decompression

    PubMed Central

    Hu, Pan-Pan; Liu, Xiao-Guang; Yu, Miao

    2016-01-01

    Objective: The objective of this study is to review cerebrospinal fluid leakage (CSFL) after thoracic decompression and describe its regular and special features. Data Sources: Literature cited in this review was retrieved from PubMed and Medline and was primarily published during the last 10 years. “Cerebrospinal fluid”, “leakage”, “dural tears”, and “thoracic decompression” were the indexed terms. Relevant citations in the retrieved articles were also screened to include more data. Study Selection: All retrieved literature was scrutinized, and four categories were recorded: incidence and risk factors, complications, treatment modalities, and prognosis. Results: CSFL is much more frequent after thoracic decompression than after cervical and lumbar spinal surgeries. Its occurrence is related to many clinical factors, especially the presence of ossified ligaments and the adhesion of the dural sac. While its impact on the late neurological recovery is currently controversial, CSFL increases the risk of other perioperative complications, such as low intracranial pressure symptoms, infection, and vascular events. The combined use of primary repairs during the operation and conservative treatment postoperatively is generally effective for most CSFL cases, whereas lumbar drains and reoperations should be implemented as rescue options for refractory cases only. Conclusions: CSFL after thoracic decompression has not been specifically investigated, so the present study provides a systematic and comprehensive review of the issue. CSFL is a multi-factor-related complication, and pathological factors play a decisive role. The importance of CSFL is in its impact on the increased risk of other complications during the postoperative period. Methods to prevent these complications are in need. In addition, though the required treatment resources are not special for CSFL after thoracic decompression, most CSFL cases are conservatively curable, and surgeons should be

  3. Chronic pain and the thoracic spine

    PubMed Central

    Louw, Adriaan; Schmidt, Stephen G.

    2015-01-01

    In recent years there has been an increased interest in pain neuroscience in physical therapy.1,2 Emerging pain neuroscience research has challenged prevailing models used to understand and treat pain, including the Cartesian model of pain and the pain gate.2–4 Focus has shifted to the brain's processing of a pain experience, the pain neuromatrix and more recently, cortical reorganisation of body maps.2,3,5,6 In turn, these emerging theories have catapulted new treatments, such as therapeutic neuroscience education (TNE)7–10 and graded motor imagery (GMI),11,12 to the forefront of treating people suffering from persistent spinal pain. In line with their increased use, both of these approaches have exponentially gathered increasing evidence to support their use.4,10 For example, various randomised controlled trials and systematic reviews have shown that teaching patients more about the biology and physiology of their pain experience leads to positive changes in pain, pain catastrophization, function, physical movement and healthcare utilisation.7–10 Graded motor imagery, in turn, has shown increasing evidence to help pain and disability in complex pain states such as complex regional pain syndrome (CRPS).11,12 Most research using TNE and GMI has focussed on chronic low back pain (CLBP) and CRPS and none of these advanced pain treatments have been trialled on the thoracic spine. This lack of research and writings in regards to the thoracic spine is not unique to pain science, but also in manual therapy. There are, however, very unique pain neuroscience issues that skilled manual therapists may find clinically meaningful when treating a patient struggling with persistent thoracic pain. Utilising the latest understanding of pain neuroscience, three key clinical chronic thoracic issues will be discussed – hypersensitisation of intercostal nerves, posterior primary rami nerves mimicking Cloward areas and mechanical and sensitisation issues of the spinal dura in

  4. Non-intubated anesthesia in thoracic surgery—technical issues

    PubMed Central

    2015-01-01

    Performing awake thoracic surgery (ATS) is technically more challenging than thoracic surgery under general anesthesia (GA), but it can result in a greater benefit for the patient. Local wound infiltration and lidocaine administration in the pleural space can be considered for ATS. More invasive techniques are local wound infiltration with wound catheter insertion, thoracic wall blocks, selective intercostal nerve blockade, thoracic paravertebral blockade and thoracic epidural analgesia, offering the advantage of a catheter placement which can also be continued for postoperative analgesia. PMID:26046050

  5. Dry needling for the management of thoracic spine pain

    PubMed Central

    Fernández-de-las-Peñas, César; Layton, Michelle; Dommerholt, Jan

    2015-01-01

    Thoracic spine pain is as disabling as neck and low back pain without receiving the same level of attention in the scientific literature. Among the different structures that can refer pain to the thoracic spine, muscles often play a relevant role. Trigger points (TrPs) from neck, shoulder and spinal muscles can induce pain in the region of the thoracic spine. There is a lack of evidence reporting the presence of TrPs in the region of the thoracic spine, but clinical evidence suggests that TrPs can be a potential source of thoracic spine pain. The current paper discusses the role of TrPs in the thoracic spine and dry needling (DN) for the management of TrPs in the thoracic multifidi and longissimus thoracis. This paper also includes a brief discussion of the application of DN in other tissues such as tendons, ligaments and scars. PMID:26309385

  6. Dry needling for the management of thoracic spine pain.

    PubMed

    Fernández-de-Las-Peñas, César; Layton, Michelle; Dommerholt, Jan

    2015-07-01

    Thoracic spine pain is as disabling as neck and low back pain without receiving the same level of attention in the scientific literature. Among the different structures that can refer pain to the thoracic spine, muscles often play a relevant role. Trigger points (TrPs) from neck, shoulder and spinal muscles can induce pain in the region of the thoracic spine. There is a lack of evidence reporting the presence of TrPs in the region of the thoracic spine, but clinical evidence suggests that TrPs can be a potential source of thoracic spine pain. The current paper discusses the role of TrPs in the thoracic spine and dry needling (DN) for the management of TrPs in the thoracic multifidi and longissimus thoracis. This paper also includes a brief discussion of the application of DN in other tissues such as tendons, ligaments and scars. PMID:26309385

  7. Dry needling for the management of thoracic spine pain.

    PubMed

    Fernández-de-Las-Peñas, César; Layton, Michelle; Dommerholt, Jan

    2015-07-01

    Thoracic spine pain is as disabling as neck and low back pain without receiving the same level of attention in the scientific literature. Among the different structures that can refer pain to the thoracic spine, muscles often play a relevant role. Trigger points (TrPs) from neck, shoulder and spinal muscles can induce pain in the region of the thoracic spine. There is a lack of evidence reporting the presence of TrPs in the region of the thoracic spine, but clinical evidence suggests that TrPs can be a potential source of thoracic spine pain. The current paper discusses the role of TrPs in the thoracic spine and dry needling (DN) for the management of TrPs in the thoracic multifidi and longissimus thoracis. This paper also includes a brief discussion of the application of DN in other tissues such as tendons, ligaments and scars.

  8. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M

    2014-02-01

    The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram

  9. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Ronan, Grace; Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M; Brindis, Ralph G; Kramer, Christopher M; Shaw, Leslee J; Cerqueira, Manuel D; Chen, Jersey; Dean, Larry S; Fazel, Reza; Hundley, W Gregory; Itchhaporia, Dipti; Kligfield, Paul; Lockwood, Richard; Marine, Joseph Edward; McCully, Robert Benjamin; Messer, Joseph V; O'Gara, Patrick T; Shemin, Richard J; Wann, L Samuel; Wong, John B; Patel, Manesh R; Kramer, Christopher M; Bailey, Steven R; Brown, Alan S; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Lindsay, Bruce D; Min, James K; Shaw, Leslee J; Stainback, Raymond F; Wann, L Samuel; Wolk, Michael J; Allen, Joseph M

    2014-02-01

    The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1-9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram (ECG

  10. The European educational platform on thoracic surgery.

    PubMed

    Massard, Gilbert; Rocco, Gaetano; Venuta, Federico

    2014-05-01

    As the largest scientific organisation world-wide exclusively dedicated to general thoracic surgery (GTS), the European Society of Thoracic Surgeons (ESTS) recognized that one of its priorities is education. The educational platform designed ESTS addresses not only trainees, but also confirmed thoracic surgeons. The two main aims are (I) to prepare trainees to graduation and to the certification by the European Board of Thoracic Surgery and (II) to offer opportunities for continuous medical education in the perspective of life-long learning and continuous professional development to certified thoracic surgeons. It is likely that recertification will become an obligation during the coming decade. At its inception, the platform differentiated two different events. A 6-day course emphasizing on theoretic knowledge was created in Antalya in 2007. The same year, a 2-day school oriented to practical issues with hands-on in the animal lab was launched in Antalya. These two teaching tracks need further development. In the knowledge track, we intend to organize highly specialized 2-day courses to deepen insight into theoretical questions. The skill track will be implemented by specialized courses for high technology such as tracheal surgery, ECMO, robotics or chest wall reconstruction. In order to promote tomorrows' leadership, we created an academic competence track giving an insight into medical communication, methodology and management. We also had to respond to an increasing demand from the Russian speaking countries, where colleagues may face problems to attend western meetings, and where the language bareer may be a major impediment. We initiated a Russian school with three events yearly in 2012. Contemporary teaching must be completed with an e-learning platform, which is currently under development. The school activities are organized by the educational committee, which is headed by the ESTS Director of Education, assisted by coordinators of the teaching tracks and

  11. Official portrait of Payload Specialist Sultan Salman Abdelazize Al-Saud

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Official portrait of Payload Specialist Sultan Salman Abdelazize Al-Saud. He is wearing the blue shuttle flight suit and holding his helmet under his arm. Behind him to the right is the Saudi Arabian flag. To his left is the American flag and a model of the Space Shuttle.

  12. 76 FR 63654 - Outer Continental Shelf Official Protraction Diagram, Lease Maps, and Supplemental Official Outer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Bureau of Ocean Energy Management Outer Continental Shelf Official Protraction Diagram, Lease Maps, and Supplemental Official Outer Continental Shelf Block Diagrams AGENCY: Bureau of Ocean Energy Management (BOEM... (SOBDs); Correction. SUMMARY: BOEM (formerly the Bureau of Ocean Energy Management, Regulation...

  13. [Digital thoracic radiology: devices, image processing, limits].

    PubMed

    Frija, J; de Géry, S; Lallouet, F; Guermazi, A; Zagdanski, A M; De Kerviler, E

    2001-09-01

    In a first part, the different techniques of digital thoracic radiography are described. Since computed radiography with phosphore plates are the most commercialized it is more emphasized. But the other detectors are also described, as the drum coated with selenium and the direct digital radiography with selenium detectors. The other detectors are also studied in particular indirect flat panels detectors and the system with four high resolution CCD cameras. In a second step the most important image processing are discussed: the gradation curves, the unsharp mask processing, the system MUSICA, the dynamic range compression or reduction, the soustraction with dual energy. In the last part the advantages and the drawbacks of computed thoracic radiography are emphasized. The most important are the almost constant good quality of the pictures and the possibilities of image processing.

  14. Thoracic Endometriosis Syndrome: A Veritable Pandora's Box.

    PubMed

    Nair, Sobha S; Nayar, Jayashree

    2016-04-01

    Thoracic endometriosis syndrome is a rare disorder characterised by the presence of functioning endometrial tissue in pleura, lung parenchyma, airways, and/or encompasses mainly four clinical entities-catamenial pneumothorax, catamenial haemothorax, catamenial haemoptysis and lung nodules. The cases were studied retrospectively by reviewing the records at Amrita Institute of Medical Sciences, for duration of five years i.e., form March 2010-2014 and analysed for the clinical presentation and management of thoracic endometriosis syndrome. Catamenial breathlessness was the main symptom. Pneumothorax and pleural effusion were the findings on investigations. Histopathology report of endometriosis was present in three cases (50%). Conditions with excess oestrogen like endometriosis, fibroid, adenomyosis were diagnosed in these patients by pelvic scan. After the initial supportive treatment with hormones, pleurodesis, hysterectomy and lung decortication were the treatment modalities. Two cases that had multiple recurrences were diagnosed as disseminated TES. They underwent combined treatment of surgery and hormones.

  15. [Digital thoracic radiology: devices, image processing, limits].

    PubMed

    Frija, J; de Géry, S; Lallouet, F; Guermazi, A; Zagdanski, A M; De Kerviler, E

    2001-09-01

    In a first part, the different techniques of digital thoracic radiography are described. Since computed radiography with phosphore plates are the most commercialized it is more emphasized. But the other detectors are also described, as the drum coated with selenium and the direct digital radiography with selenium detectors. The other detectors are also studied in particular indirect flat panels detectors and the system with four high resolution CCD cameras. In a second step the most important image processing are discussed: the gradation curves, the unsharp mask processing, the system MUSICA, the dynamic range compression or reduction, the soustraction with dual energy. In the last part the advantages and the drawbacks of computed thoracic radiography are emphasized. The most important are the almost constant good quality of the pictures and the possibilities of image processing. PMID:11567193

  16. Acute Aortic Syndromes and Thoracic Aortic Aneurysm

    PubMed Central

    Ramanath, Vijay S.; Oh, Jae K.; Sundt, Thoralf M.; Eagle, Kim A.

    2009-01-01

    Acute and chronic aortic diseases have been diagnosed and studied by physicians for centuries. Both the diagnosis and treatment of aortic diseases have been steadily improving over time, largely because of increased physician awareness and improvements in diagnostic modalities. This comprehensive review discusses the pathophysiology and risk factors, classification schemes, epidemiology, clinical presentations, diagnostic modalities, management options, and outcomes of various aortic conditions, including acute aortic dissection (and its variants intramural hematoma and penetrating aortic ulcers) and thoracic aortic aneurysms. Literature searches of the PubMed database were conducted using the following keywords: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies performed within the past 20 years were included in the review; however, most data are from the past 15 years. PMID:19411444

  17. Endovascular repair of thoracic aortic aneurysm

    PubMed Central

    Akin, Ibrahim; Kische, Stephan; Rehders, Tim C.; Nienaber, Christoph A.; Rauchhaus, Mathias

    2010-01-01

    A thoracic aortic aneurysm (TAA) is a potentially life-threatening condition with structural weakness of the aortic wall, which can progress to arterial dilatation and rupture. Today, both an increasing awareness of vascular disease and the access to tomographic imaging facilitate the diagnosis of TAA even in an asymptomatic stage. The risk of rupture for untreated aneurysms beyond a diameter of 5.6 cm ranges from 46% to 74% and the two-year mortality rate is greater than 70%, with most deaths resulting from rupture. Treatment options include surgical and non-surgical repair to prevent aneurysm enlargement and rupture. While most cases of ascending aortic involvement are subject to surgical repair (partially with valve-preserving techniques), aneurysm of the distal arch and descending thoracic aorta are amenable to emerging endovascular techniques as an alternative to classic open repair or to a hybrid approach (combining debranching surgery with stent grafting) in an attempt to improve outcomes. PMID:22419919

  18. Perspectives on Official English. The Campaign for English as the Official Language of the USA.

    ERIC Educational Resources Information Center

    Adams, Karen L., Ed.; Brink, Daniel T., Ed.

    Essays on the campaign to establish English as the United States' official language include: "Official Languages and Language Planning" (Richard Ruiz); "Una lingua, una patria?: Is Monolingualism Beneficial or Harmful to a Nation's Unity?" (David F. Marshall and Roseann D. Gonzalez); "Canadian Perspectives on Official English" (Joseph E. Magnet);…

  19. 9 CFR 325.6 - Shipment of paunches between official establishments under official seal; certificate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... establishments under official seal; certificate. 325.6 Section 325.6 Animals and Animal Products FOOD SAFETY AND... between official establishments under official seal; certificate. Cattle and sheep paunches which have... seal of the Department as prescribed in § 312.5(a) of this subchapter....

  20. 9 CFR 325.6 - Shipment of paunches between official establishments under official seal; certificate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... establishments under official seal; certificate. 325.6 Section 325.6 Animals and Animal Products FOOD SAFETY AND... between official establishments under official seal; certificate. Cattle and sheep paunches which have... seal of the Department as prescribed in § 312.5(a) of this subchapter....

  1. 9 CFR 325.6 - Shipment of paunches between official establishments under official seal; certificate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... establishments under official seal; certificate. 325.6 Section 325.6 Animals and Animal Products FOOD SAFETY AND... between official establishments under official seal; certificate. Cattle and sheep paunches which have... seal of the Department as prescribed in § 312.5(a) of this subchapter....

  2. 9 CFR 325.6 - Shipment of paunches between official establishments under official seal; certificate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... establishments under official seal; certificate. 325.6 Section 325.6 Animals and Animal Products FOOD SAFETY AND... between official establishments under official seal; certificate. Cattle and sheep paunches which have... seal of the Department as prescribed in § 312.5(a) of this subchapter....

  3. 9 CFR 325.6 - Shipment of paunches between official establishments under official seal; certificate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... establishments under official seal; certificate. 325.6 Section 325.6 Animals and Animal Products FOOD SAFETY AND... between official establishments under official seal; certificate. Cattle and sheep paunches which have... seal of the Department as prescribed in § 312.5(a) of this subchapter....

  4. 31 CFR 19.1010 - Suspending official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Suspending official. 19.1010 Section 19.1010 Money and Finance: Treasury Office of the Secretary of the Treasury GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 19.1010 Suspending official. (a) Suspending...

  5. 29 CFR 1471.1010 - Suspending official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Suspending official. 1471.1010 Section 1471.1010 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 1471.1010 Suspending official. (a) Suspending...

  6. 7 CFR 51.17 - Official sampling.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Official sampling. 51.17 Section 51.17 Agriculture..., CERTIFICATION, AND STANDARDS) Regulations 1 Inspection Service § 51.17 Official sampling. Samples may be... inspector who drew the samples, showing the time and place of the sampling and the brands or...

  7. 7 CFR 51.17 - Official sampling.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Official sampling. 51.17 Section 51.17 Agriculture..., CERTIFICATION, AND STANDARDS) Regulations 1 Inspection Service § 51.17 Official sampling. Samples may be... inspector who drew the samples, showing the time and place of the sampling and the brands or...

  8. 32 CFR 516.48 - Official information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false Official information. 516.48 Section 516.48... PUBLIC RELATIONS LITIGATION Release of Information and Appearance of Witnesses Scope Da Personnel As Witnesses in Private Litigation § 516.48 Official information. (a) In instances involving §...

  9. 7 CFR 29.33 - Official sample.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Official sample. 29.33 Section 29.33 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Regulations Definitions § 29.33 Official sample. A sample selected, tagged, and signed by...

  10. 7 CFR 29.24 - Official standards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Official standards. 29.24 Section 29.24 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Regulations Definitions § 29.24 Official standards. Standards for tobacco promulgated by...

  11. 39 CFR 963.21 - Official record.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Official record. 963.21 Section 963.21 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO VIOLATIONS OF THE PANDERING ADVERTISEMENTS STATUTE, 39 U.S.C. 3008 § 963.21 Official record. The transcript...

  12. 7 CFR 58.2827 - Official identification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Department of Agriculture Standard for Ice Cream § 58.2827 Official identification. (a) The official symbol to be used to identify product meeting the USDA standard for ice cream shall be as follows: EC25SE91.017 (b) Ice cream manufacturing plants using this symbol shall be USDA approved as set forth...

  13. 7 CFR 58.2827 - Official identification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Department of Agriculture Standard for Ice Cream § 58.2827 Official identification. (a) The official symbol to be used to identify product meeting the USDA standard for ice cream shall be as follows: EC25SE91.017 (b) Ice cream manufacturing plants using this symbol shall be USDA approved as set forth...

  14. 7 CFR 58.2827 - Official identification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Department of Agriculture Standard for Ice Cream § 58.2827 Official identification. (a) The official symbol to be used to identify product meeting the USDA standard for ice cream shall be as follows: EC25SE91.017 (b) Ice cream manufacturing plants using this symbol shall be USDA approved as set forth...

  15. 7 CFR 58.2827 - Official identification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Department of Agriculture Standard for Ice Cream § 58.2827 Official identification. (a) The official symbol to be used to identify product meeting the USDA standard for ice cream shall be as follows: EC25SE91.017 (b) Ice cream manufacturing plants using this symbol shall be USDA approved as set forth...

  16. 7 CFR 58.2827 - Official identification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Department of Agriculture Standard for Ice Cream § 58.2827 Official identification. (a) The official symbol to be used to identify product meeting the USDA standard for ice cream shall be as follows: EC25SE91.017 (b) Ice cream manufacturing plants using this symbol shall be USDA approved as set forth...

  17. 10 CFR 590.314 - Presiding officials.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Presiding officials. 590.314 Section 590.314 Energy DEPARTMENT OF ENERGY (CONTINUED) NATURAL GAS (ECONOMIC REGULATORY ADMINISTRATION) ADMINISTRATIVE PROCEDURES WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Procedures § 590.314 Presiding officials. (a)...

  18. 16 CFR 5.59 - Presiding official.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Presiding official. 5.59 Section 5.59 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE STANDARDS OF CONDUCT Disciplinary Actions Concerning Postemployment Conflict of Interest § 5.59 Presiding official....

  19. 7 CFR 58.734 - Official identification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Requirements for Processed Cheese Products Bearing Usda Official Identification § 58.734 Official identification. Only...

  20. 7 CFR 58.526 - Official identification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Requirements for Cottage Cheese Bearing Usda Official Identification § 58.526 Official identification. (a) Only cottage...

  1. 10 CFR 603.1310 - Program official.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Program official. 603.1310 Section 603.1310 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in this Part § 603.1310 Program official. A Federal Government program manager, project...

  2. 76 FR 42767 - Management Officials Interlocks

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-19

    ... Office of Thrift Supervision Management Officials Interlocks AGENCY: Office of Thrift Supervision (OTS... Management and Budget (OMB) for review, as required by the Paperwork Reduction Act. Today, OTS is soliciting...: Management Officials Interlocks. OMB Number: 1550-0051. Form Number: N/A. Description: OTS uses the...

  3. 22 CFR 1429.13 - Official time.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... participation, including necessary travel time, as occurs during the employee's regular work hours and when the... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Official time. 1429.13 Section 1429.13 Foreign... REQUIREMENTS Miscellaneous § 1429.13 Official time. If the participation of any employee in any phase of...

  4. 39 CFR 952.32 - Official record.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Official record. 952.32 Section 952.32 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS § 952.32 Official record. The transcript of testimony together with...

  5. 10 CFR 590.314 - Presiding officials.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Presiding officials. 590.314 Section 590.314 Energy DEPARTMENT OF ENERGY (CONTINUED) NATURAL GAS (ECONOMIC REGULATORY ADMINISTRATION) ADMINISTRATIVE PROCEDURES WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Procedures § 590.314 Presiding officials. (a)...

  6. 10 CFR 590.314 - Presiding officials.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Presiding officials. 590.314 Section 590.314 Energy DEPARTMENT OF ENERGY (CONTINUED) NATURAL GAS (ECONOMIC REGULATORY ADMINISTRATION) ADMINISTRATIVE PROCEDURES WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Procedures § 590.314 Presiding officials. (a)...

  7. 28 CFR 345.71 - Official commendations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Official commendations. 345.71 Section 345.71 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Awards Program § 345.71 Official commendations. An inmate worker...

  8. 28 CFR 345.71 - Official commendations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Official commendations. 345.71 Section 345.71 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Awards Program § 345.71 Official commendations. An inmate worker...

  9. 28 CFR 345.71 - Official commendations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Official commendations. 345.71 Section 345.71 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Awards Program § 345.71 Official commendations. An inmate worker...

  10. 28 CFR 345.71 - Official commendations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Official commendations. 345.71 Section 345.71 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Awards Program § 345.71 Official commendations. An inmate worker...

  11. 28 CFR 345.71 - Official commendations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Official commendations. 345.71 Section 345.71 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Awards Program § 345.71 Official commendations. An inmate worker...

  12. 7 CFR 37.10 - Official assessment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ASSESS ORGANIC CERTIFYING AGENCIES § 37.10 Official assessment. Official assessment of an applicant's... program will be issued by the Branch Chief by written memorandum or other approved method of assessment... provided by the Branch Chief with a written summary of observed program deficiencies. The applicant...

  13. Thoracic surgery in India: challenges and opportunities

    PubMed Central

    2016-01-01

    India has the dubitable honor of being ranked first in the world with regards to lung disease burden. A good proportion of this disease burden is amenable to surgical treatment. However, patients have limited access to quality thoracic surgical care due to a number of obstacles. This review article summarizes these obstacles and the implied opportunities that exist in this nascent surgical discipline in the world’s second most populous country.

  14. Chondromyxoid fibroma of two thoracic vertebrae.

    PubMed

    Bruder, E; Zanetti, M; Boos, N; von Hochstetter, A R

    1999-05-01

    We report on a case of chondromyxoid fibroma involving two adjacent thoracic vertebrae with features of aggressive behaviour on radiographs, CT and MRI. Histology revealed typical chondromyxoid fibroma with unusually coarse calcifications. Chondromyxoid fibroma of the spine is rare, and only 30 of these tumours have been reported so far. Involvement of two contiguous vertebral bodies by chondromyxoid fibroma, as reported here, appears exceptional. PMID:10424337

  15. [Septic arthritis of thoracic facet joint].

    PubMed

    Ben Abdelghani, K; Gérard-Dran, D; Combe, B

    2009-08-01

    Septic arthritis of the facet joint is a rare condition. We report a case of septic arthritis of both a thoracic facet joint and a wrist. Clinical manifestations were consistent with a spondylodiscitis. Magnetic resonance imaging of the spine demonstrated infection of facet joints of T1 and T2. A surgical biopsy of the wrist isolated a type B streptococcus. The same organism was found in urine culture. The patient had an uneventful recovery on antibiotics.

  16. Endovascular intervention in thoracic arterial trauma.

    PubMed

    Hoffer, Eric K

    2008-11-01

    The management of thoracic vascular injury has improved dramatically over the past two decades. The availability of multi-row detector CT has facilitated early diagnosis and incorporation of minimally invasive endograft repair for traumatic aortic injury has improved mortality and paraplegia rates. This review evaluates the available data on stent-graft repair of acute blunt traumatic aortic injury and traumatic great vessel injury with regard to safety and efficacy in comparison with conventional open surgical repair. PMID:18842261

  17. Rare thoracic cancers, including peritoneum mesothelioma.

    PubMed

    Siesling, Sabine; van der Zwan, Jan Maarten; Izarzugaza, Isabel; Jaal, Jana; Treasure, Tom; Foschi, Roberto; Ricardi, Umberto; Groen, Harry; Tavilla, Andrea; Ardanaz, Eva

    2012-05-01

    Rare thoracic cancers include those of the trachea, thymus and mesothelioma (including peritoneum mesothelioma). The aim of this study was to describe the incidence, prevalence and survival of rare thoracic tumours using a large database, which includes cancer patients diagnosed from 1978 to 2002, registered in 89 population-based cancer registries (CRs) and followed-up to 31st December 2003. Over 17,688 cases of rare thoracic cancers were selected based on the list of the RACECARE project. Mesothelioma was the most common tumour (19 per million per year) followed by epithelial tumours of the trachea and thymus (1.3 and 1.7, respectively). The age standardised incidence rates of epithelial tumours of the trachea was double in Eastern and Southern Europe versus the other European regions: 2 per million per year. Epithelial tumours of the thymus had the lowest incidence in Northern and Eastern Europe and UK and Ireland(1) and somewhat higher incidence in Central and Southern Europe.(2) Highest incidence in mesothelioma was seen in UK and Ireland(23) and lowest in Eastern Europe.(4) Patients with tumours of the thymus had the best prognosis (1-year survival 85%, 66% at 5 years). Five year survival was lowest for the mesothelioma 5% compared to 14% of patients with tumours of the trachea. Mesothelioma was the most prevalent rare cancer (12,000 cases), followed by thymus (7000) and trachea (1400). Cancer Registry (CR) data play an important role in revealing the burden of rare thoracic cancers and monitoring the effect of regulations on asbestos use and smoking related policies.

  18. Thoracic surgery in India: challenges and opportunities

    PubMed Central

    2016-01-01

    India has the dubitable honor of being ranked first in the world with regards to lung disease burden. A good proportion of this disease burden is amenable to surgical treatment. However, patients have limited access to quality thoracic surgical care due to a number of obstacles. This review article summarizes these obstacles and the implied opportunities that exist in this nascent surgical discipline in the world’s second most populous country. PMID:27651933

  19. Thoracic surgery in India: challenges and opportunities.

    PubMed

    Yendamuri, Sai

    2016-08-01

    India has the dubitable honor of being ranked first in the world with regards to lung disease burden. A good proportion of this disease burden is amenable to surgical treatment. However, patients have limited access to quality thoracic surgical care due to a number of obstacles. This review article summarizes these obstacles and the implied opportunities that exist in this nascent surgical discipline in the world's second most populous country.

  20. Thoracic surgery in India: challenges and opportunities.

    PubMed

    Yendamuri, Sai

    2016-08-01

    India has the dubitable honor of being ranked first in the world with regards to lung disease burden. A good proportion of this disease burden is amenable to surgical treatment. However, patients have limited access to quality thoracic surgical care due to a number of obstacles. This review article summarizes these obstacles and the implied opportunities that exist in this nascent surgical discipline in the world's second most populous country. PMID:27651933

  1. The European general thoracic surgery database project.

    PubMed

    Falcoz, Pierre Emmanuel; Brunelli, Alessandro

    2014-05-01

    The European Society of Thoracic Surgeons (ESTS) Database is a free registry created by ESTS in 2001. The current online version was launched in 2007. It runs currently on a Dendrite platform with extensive data security and frequent backups. The main features are a specialty-specific, procedure-specific, prospectively maintained, periodically audited and web-based electronic database, designed for quality control and performance monitoring, which allows for the collection of all general thoracic procedures. Data collection is the "backbone" of the ESTS database. It includes many risk factors, processes of care and outcomes, which are specially designed for quality control and performance audit. The user can download and export their own data and use them for internal analyses and quality control audits. The ESTS database represents the gold standard of clinical data collection for European General Thoracic Surgery. Over the past years, the ESTS database has achieved many accomplishments. In particular, the database hit two major milestones: it now includes more than 235 participating centers and 70,000 surgical procedures. The ESTS database is a snapshot of surgical practice that aims at improving patient care. In other words, data capture should become integral to routine patient care, with the final objective of improving quality of care within Europe.

  2. [Thoracic surgery for patients with bronchial asthma].

    PubMed

    Iyoda, A; Satoh, Y

    2012-07-01

    Thoracic surgery poses a risk for complications in the respiratory system. In particular, for patients with bronchial asthma, we need to care for perioperative complications because it is well known that these patients frequently have respiratory complications after surgery, and they may have bronchial spasms during surgery. If we can get good control of their bronchial asthma, we can usually perform surgery for these patients without limitations. For safe postoperative care, it is desirable that these patients have stable asthma conditions that are well-controlled before surgery, as thoracic surgery requires intrabronchial intubation for anesthesia and sometimes bronchial resection. These stimulations to the bronchus do not provide for good conditions because of the risk of bronchial spasm. Therefore, we should use the same agents that are used to control bronchial asthma if it is already well controlled. If it is not, we have to administer a β₂ stimulator, aminophylline, or steroidal agents for good control. Isoflurane or sevoflurane are effective for the safe control of anesthesia during surgery, and we should use a β₂ stimulator, with or without inhalation, or steroidal agents after surgery. It is important to understand that we can perform thoracic surgery for asthma patients if we can provide perioperative control of bronchial asthma, although these patients still have severe risks. PMID:22868432

  3. Association of race and socioeconomic status with the use of endovascular repair to treat thoracic aortic diseases

    PubMed Central

    Johnston, William F.; LaPar, Damien J.; Newhook, Timothy E.; Stone, Matthew L.; Upchurch, Gilbert R.; Ailawadi, Gorav

    2014-01-01

    Objective Descending thoracic aortic diseases may be treated with either open thoracic aortic repair or thoracic endovascular aortic repair (TEVAR). Previous studies have demonstrated that race and socioeconomic status (SES) affect access to care and treatment allocation in vascular surgery. We hypothesized that racial minorities and lower SES patients have decreased propensity to have their thoracic aortic disease treated with TEVAR. Methods Weighted discharge records for patients who underwent either open thoracic aortic repair or TEVAR between 2005 and 2008 were evaluated using the Nationwide Inpatient Sample. Patient records were stratified by therapeutic intervention (open repair vs TEVAR). Differences in baseline comorbidities, race, and SES were compared. To account for the effects of comorbidities and other factors, hierarchical logistic regression modeling was used to determine the likelihood for TEVAR performance based on differences in patients’ race and SES. Results A total of 60,784 thoracic repairs were analyzed, the majority (79.4%) of which were open repairs. The most common race was white (78.2%), followed by black (9.1%), Hispanic (5.7%), Asian or Pacific Islander (2.9%), and Native American (0.7%). Patients were divided into quartiles according to SES with 20.6% of patients in the lowest SES quartile, 24.3% in the second quartile, 26.4% in the third quartile, and 28.8% in the highest SES quartile. Indications for treatment were similar for both treatment groups. After adjusting for multiple patient and hospital factors, race and SES were significantly associated with treatment modality for thoracic aortic disease. Black, Hispanic, and Native American populations had increased adjusted odds ratios of TEVAR performance compared with white patients. Similarly, lower SES correlated with increased use of TEVAR. Conclusions Contrary to our initial hypothesis, racial minorities (Black, Hispanic, and Native American) and patients with lower median

  4. Canadian Cardiovascular Society position statement on the management of thoracic aortic disease.

    PubMed

    Boodhwani, Munir; Andelfinger, Gregor; Leipsic, Jonathon; Lindsay, Thomas; McMurtry, M Sean; Therrien, Judith; Siu, Samuel C

    2014-06-01

    This Canadian Cardiovascular Society position statement aims to provide succinct perspectives on key issues in the management of thoracic aortic disease (TAD). This document is not a comprehensive overview of TAD and important elements of the epidemiology, presentation, diagnosis, and management of acute aortic syndromes are deliberately not discussed; readers are referred to the 2010 guidelines published by the American Heart Association, American College of Cardiology, American Association for Thoracic Surgery, and other stakeholders. Rather, this document is a practical guide for clinicians managing adult patients with TAD. Topics covered include size thresholds for surgical intervention, emerging therapies, imaging modalities, medical and lifestyle management, and genetics of TAD. The primary panel consisted of experts from a variety of disciplines that are essential for comprehensive management of TAD patients. The methodology involved a focused literature review with an emphasis on updates since 2010 and the use of Grading of Recommendations Assessment, Development, and Evaluation methodology to arrive at specific recommendations. The final document then underwent review by a secondary panel. This document aims to provide recommendations for most patients and situations. However, the ultimate judgement regarding the management of any individual patients should be made by their health care team.

  5. Asian perspective in surgery: thoracic surgery in Turkey.

    PubMed

    Turna, Akif

    2016-08-01

    Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surgeons. There are a number of reasons to predict that the number of thoracic surgical cases will be increased and new generation of thoracic surgeons will be operating more minimally invasive resectional surgeries for most lung cancer in future. PMID:27651934

  6. Asian perspective in surgery: thoracic surgery in Turkey

    PubMed Central

    2016-01-01

    Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surgeons. There are a number of reasons to predict that the number of thoracic surgical cases will be increased and new generation of thoracic surgeons will be operating more minimally invasive resectional surgeries for most lung cancer in future. PMID:27651934

  7. Thoracic Endovascular Stent Graft Repair of Middle Aortic Syndrome.

    PubMed

    Kim, Joung Taek; Lee, Mina; Kim, Young Sam; Yoon, Yong Han; Baek, Wan Ki

    2016-09-01

    Middle aortic syndrome is a rare disease defined as a segmental narrowing of the distal descending thoracic or abdominal aorta. A thoracoabdominal bypass or endovascular treatment is the choice of treatment. Endovascular therapy consists of a balloon dilatation and stent implantation. Recently, thoracic endovascular aortic repair has been widely used in a variety of aortic diseases. We report a case of middle aortic syndrome treated with a thoracic endovascular stent graft. PMID:27549552

  8. Thoracic Kidney: Extremely Rare State of Aberrant Kidney

    PubMed Central

    Khoshchehreh, Mahdi; Paknejad, Omalbanin; Bakhshayesh-Karam, Mehrdad; Pazoki, Marzieh

    2015-01-01

    The thorax is the rarest place among all forms of renal ectopia. We report a rare case of an unacquired thoracic kidney. Only about 200 cases of the thoracic kidney have ever been reported in medical literature worldwide. In this paper we present the rarest form of nontraumatic nonhernia associated, truly ectopic thoracic kidney. The differential diagnosis and management options and classification of this rare form of aberrant kidney are discussed. PMID:26301113

  9. Staged treatment of thoracic and lumbar spinal tuberculosis with flow injection abscess.

    PubMed

    Zeng, Hao; Zhang, Yupeng; Shen, Xiongjie; Luo, Chengke; Xu, Zhengquan; Liu, Zheng; Liu, Xiangyang; Wang, Xiyang

    2015-01-01

    The study was to investigate the feasibility and effectiveness of posterior-only approach combining with puncture drainage under CT-guide in staged treatment of thoracic and lumbar spinal tuberculosis with flow injection abscess. We retrospectively analyzed 15 patients (came from 72 cases with thoracic and lumbar spinal tuberculosis) with flow injection abscesses underwent surgery from January 2007 to February 2009, and evaluated the American Spinal Injury Association (ASIA) scoring system of nerve function, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), abscess absorption time and the Oswestry Disability Index (ODI), preoperatively and postoperatively. 15 patients were followed up for 13-37 months, no recurrence of tuberculosis, no fixation loosening and neurologic symptoms aggravated. The flow injection abscesses are absorbed within 3-6 months postoperative operation. In final follow-up, ESR went down to 5.2±2.1 mm/h from preoperative 79.6±14.8 mm/h, CRP decreased from preoperative 49.3±7.5 mg/L to 1.8±0.7 mg/L, ODI changed from 75.13±20.15 to 16.72±8.62, all of them changed significantly (P<0.05). In conclusions, one-stage posterior debridement, interbody fusion, pedicle screw fixation and two-stage CT-guided interventional therapy were safe and effective in treatment of the thoracic and lumbar spinal tuberculosis with flow injection abscess. PMID:26770442

  10. Staged treatment of thoracic and lumbar spinal tuberculosis with flow injection abscess

    PubMed Central

    Zeng, Hao; Zhang, Yupeng; Shen, Xiongjie; Luo, Chengke; Xu, Zhengquan; Liu, Zheng; Liu, Xiangyang; Wang, Xiyang

    2015-01-01

    The study was to investigate the feasibility and effectiveness of posterior-only approach combining with puncture drainage under CT-guide in staged treatment of thoracic and lumbar spinal tuberculosis with flow injection abscess. We retrospectively analyzed 15 patients (came from 72 cases with thoracic and lumbar spinal tuberculosis) with flow injection abscesses underwent surgery from January 2007 to February 2009, and evaluated the American Spinal Injury Association (ASIA) scoring system of nerve function, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), abscess absorption time and the Oswestry Disability Index (ODI), preoperatively and postoperatively. 15 patients were followed up for 13-37 months, no recurrence of tuberculosis, no fixation loosening and neurologic symptoms aggravated. The flow injection abscesses are absorbed within 3-6 months postoperative operation. In final follow-up, ESR went down to 5.2±2.1 mm/h from preoperative 79.6±14.8 mm/h, CRP decreased from preoperative 49.3±7.5 mg/L to 1.8±0.7 mg/L, ODI changed from 75.13±20.15 to 16.72±8.62, all of them changed significantly (P<0.05). In conclusions, one-stage posterior debridement, interbody fusion, pedicle screw fixation and two-stage CT-guided interventional therapy were safe and effective in treatment of the thoracic and lumbar spinal tuberculosis with flow injection abscess. PMID:26770442

  11. American Indian Cultural Resources: A Preservation Handbook.

    ERIC Educational Resources Information Center

    Gorospe, Kathy

    Designed for use by American Indian tribes, archaeologists, law enforcement officials, local/state/federal administrators in charge of cultural resources management matters, and the general public, this handbook has been compiled to serve as a practical guide to protecting American Indian cultural resources in Oregon. The book brings together…

  12. Ending Discrimination Against Arab Americans.

    ERIC Educational Resources Information Center

    Abourezk, James G.; Revell, Oliver B.

    1983-01-01

    Abourezk holds that Arab Americans are victims of much racial hatred and stereotyping and that the Federal Bureau of Investigation (FBI) has been the primary governmental agency abusing the civil rights of this group. Revell, an official of the FBI, counters Abourezk's contentions. (GC)

  13. Almanac of American Education, 2011

    ERIC Educational Resources Information Center

    Bernan Press, 2011

    2011-01-01

    "The Almanac of American Education" is an easy-to-use, single-volume source designed to help users understand and compare the quality of education at the national, state, and county levels. Compiled from official U.S. government and reliable private sources, "The Almanac" contains historical and current data, insightful analysis, and useful graphs…

  14. Multidimensional Analysis of Magnetic Resonance Imaging Predicts Early Impairment in Thoracic and Thoracolumbar Spinal Cord Injury.

    PubMed

    Mabray, Marc C; Talbott, Jason F; Whetstone, William D; Dhall, Sanjay S; Phillips, David B; Pan, Jonathan Z; Manley, Geoffrey T; Bresnahan, Jacqueline C; Beattie, Michael S; Haefeli, Jenny; Ferguson, Adam R

    2016-05-15

    Literature examining magnetic resonance imaging (MRI) in acute spinal cord injury (SCI) has focused on cervical SCI. Reproducible systems have been developed for MRI-based grading; however, it is unclear how they apply to thoracic SCI. Our hypothesis is that MRI measures will group as coherent multivariate principal component (PC) ensembles, and that distinct PCs and individual variables will show discriminant validity for predicting early impairment in thoracic SCI. We undertook a retrospective cohort study of 25 patients with acute thoracic SCI who underwent MRI on admission and had American Spinal Injury Association Impairment Scale (AIS) assessment at hospital discharge. Imaging variables of axial grade, sagittal grade, length of injury, thoracolumbar injury classification system (TLICS), maximum canal compromise (MCC), and maximum spinal cord compression (MSCC) were collected. We performed an analytical workflow to detect multivariate PC patterns followed by explicit hypothesis testing to predict AIS at discharge. All imaging variables loaded positively on PC1 (64.3% of variance), which was highly related to AIS at discharge. MCC, MSCC, and TLICS also loaded positively on PC2 (22.7% of variance), while variables concerning cord signal abnormality loaded negatively on PC2. PC2 was highly related to the patient undergoing surgical decompression. Variables of signal abnormality were all negatively correlated with AIS at discharge with the highest level of correlation for axial grade as assessed with the Brain and Spinal Injury Center (BASIC) score. A multiple variable model identified BASIC as the only statistically significant predictor of AIS at discharge, signifying that BASIC best captured the variance in AIS within our study population. Our study provides evidence of convergent validity, construct validity, and clinical predictive validity for the sampled MRI measures of SCI when applied in acute thoracic and thoracolumbar SCI.

  15. 39 CFR 262.2 - Officials.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT... ensure that record management practices are in compliance with the Privacy Act and FOIA. The Manager... postal facilities. (d) Information System Executive. The Postal Service official who prescribes...

  16. 39 CFR 3002.3 - Official seal.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Commission. (b) Description. (1) On a gold color (yellow) pentagon device, the base-line formed as a “V... Commission” and the date “2006”, all in gold (yellow). (2) The official seal of the Postal...

  17. 7 CFR 62.213 - Official identification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURAL COMMODITIES (QUALITY SYSTEMS VERIFICATION PROGRAMS) Quality Systems Verification Programs Definitions Service § 62.213 Official identification. The following, as shown in figure 1, constitutes... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE...

  18. 5 CFR 1201.64 - Official notice.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., on his or her own motion or on the motion of a party, may take official notice of matters of common knowledge or matters that can be verified. The parties may be given an opportunity to object to the...

  19. 39 CFR 3002.3 - Official seal.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Commission. (b) Description. (1) On a gold color (yellow) pentagon device, the base-line formed as a “V... Commission” and the date “2006”, all in gold (yellow). (2) The official seal of the Postal...

  20. Official portrait of astronaut Robert C. Springer

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Official portrait of astronaut Robert C. Springer, United Stated Marine Corps (USMC) Colonel, member of Astronaut Class 9 (1980), and mission specialist. Springer wears launch and entry suit (LES) while holding helmet.

  1. A Better Handoff for Code Officials

    SciTech Connect

    Conover, David R.; Yerkes, Sara

    2010-09-24

    The U.S. Department of Energy's Building Energy Codes Program has partnered with ICC to release the new Building Energy Codes Resource Guide: Code Officials Edition. We created this binder of practical materials for a simple reason: code officials are busy learning and enforcing several codes at once for the diverse buildings across their jurisdictions. This doesn’t leave much time to search www.energycodes.gov, www.iccsafe.org, or the range of other helpful web-based resources for the latest energy codes tools, support, and information. So, we decided to bring the most relevant materials to code officials in a way that works best with their daily routine, and point to where they can find even more. Like a coach’s game plan, the Resource Guide is an "energy playbook" for code officials.

  2. 39 CFR 262.2 - Officials.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT... ensure that record management practices are in compliance with the Privacy Act and FOIA. The Manager... postal facilities. (d) Information System Executive. The Postal Service official who prescribes...

  3. 39 CFR 262.2 - Officials.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT... ensure that record management practices are in compliance with the Privacy Act and FOIA. The Manager... postal facilities. (d) Information System Executive. The Postal Service official who prescribes...

  4. 39 CFR 262.2 - Officials.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT... ensure that record management practices are in compliance with the Privacy Act and FOIA. The Manager... postal facilities. (d) Information System Executive. The Postal Service official who prescribes...

  5. Video-Assisted Thoracic Sympathectomy for Hyperhidrosis.

    PubMed

    Milanez de Campos, Jose Ribas; Kauffman, Paulo; Gomes, Oswaldo; Wolosker, Nelson

    2016-08-01

    By the 1980s, endoscopy was in use by some groups in sympathetic denervation of the upper limbs with vascular indications. Low morbidity, cosmetic results, reduction in the incidence of Horner syndrome, and the shortened time in hospital made video-assisted thoracic sympathectomy (VATS) better accepted by those undergoing treatment for hyperhidrosis. Over the last 25 years, this surgical procedure has become routine in the treatment of hyperhidrosis, leading to a significant increase in the number of papers on the subject in the literature. PMID:27427529

  6. Video-assisted thoracic surgery complications

    PubMed Central

    Kozak, Józef

    2014-01-01

    Video-assisted thoracic surgery (VATS) is a miniinvasive technique commonly applied worldwide. Indications for VATS are very broad and include the diagnosis of mediastinal, lung and pleural diseases, as well as large resection procedures such as pneumonectomy. The most frequent complication is prolonged postoperative air leak. The other significant complications are bleeding, infections, postoperative pain and recurrence at the port site. Different complications of VATS procedures can occur with variable frequency in various diseases. Despite the large number of their types, such complications are rare and can be avoided through the proper selection of patients and an appropriate surgical technique. PMID:25561984

  7. Idiopathic thoracic aortic aneurysm at pediatric age.

    PubMed

    Marín-Manzano, E; González-de-Olano, D; Haurie-Girelli, J; Herráiz-Sarachaga, J I; Bermúdez-Cañete, R; Tamariz-Martel, A; Cuesta-Gimeno, C; Pérez-de-León, J

    2009-03-01

    A 6-year-old-boy presented with epigastric pain and vomiting over 1 year. Chest X-ray and esophagogastric transit showed a mediastinal mass. A chest computerized tomography angiogram demonstrated a descending thoracic aortic aneurysm. Analytical determinations carried out were all negative. The aneurysm was surgically repaired using a Dacron patch. The anatomopathological study described atherosclerotic lesions with calcifications, compatible with an atherosclerotic aneurysm wall. Aneurysms are uncommon in the pediatric population. Usually, no pathogenesis can be determined, and thus, such cases are grouped as idiopathic. Direct repair with or without patch is a therapeutic alternative in pediatric aneurysms and can allow the growth of the aortic circumference.

  8. Thoracic outlet syndrome following breast implant rupture.

    PubMed

    Mistry, Raakhi; Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus

    2015-03-01

    We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient. PMID:25878942

  9. Thoracic Outlet Syndrome Following Breast Implant Rupture

    PubMed Central

    Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus

    2015-01-01

    Summary: We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient. PMID:25878942

  10. [Extra-thoracic solitary fibrous tumor. Report of 2 cases].

    PubMed

    Trabelsi, Amel; Mestiri, Sarra; Mokni, Moncef; Stita, Wided; Ikram, Bellara; Sriha, Badreddine; Korbi, Sadok

    2006-09-01

    The solitary fibrous tumor (SFT), is an unusual entity, first described in the pleura, but can involve other serosal surfaces and viscera. We report two cases of extra-thoracic SFT involving the retro-peritoneum and the upper arm. Extra-thoracic TFS is a rarily wide morphologic and evolutive spectrum.

  11. Thoracic-pelvic dysostosis: a 'new' autosomal dominant form.

    PubMed Central

    Bankier, A; Danks, D M

    1983-01-01

    A form of thoracic and pelvic dysostosis is reported in a mother and her son. The short ribs caused respiratory distress in the baby and raised the possibility of asphyxiating thoracic dystrophy (ATD). The radiological features, however, distinguish this benign condition from ATD and other described skeletal dysplasias. Images PMID:6620328

  12. Thoracic aortopathies in the military patient.

    PubMed

    O'Brien, David; White, S; Wilson, D; Haworth, K; Williams, A

    2015-09-01

    Thoracic aortic disease is an important contributor to arterial disease and therefore, mortality in the UK. It has close associations with hypertension, atherosclerosis and genetic conditions such as Marfan syndrome. The cardiovascular consequences of acute aortic dissection or the rupture of a thoracic aneurysm are life threatening with a 1% increase in mortality per hour with a type A aortic dissection and a high 30-day mortality rate. The clinical diagnosis can be difficult for the general physician as the symptoms can mimic more common conditions such as acute coronary syndrome, pulmonary embolism or acute abdomen. The investigations that carry the highest sensitivity and specificity, CT, transoesophageal echocardiography and MRI are not usually first-line investigations in most patients so a high index of clinical suspicion is key. The management of acute aortic syndromes involves good initial resuscitation and early discussion with the cardiothoracic surgeons. Given the serious consequences of acute aortic syndromes, it is important for all military doctors to be aware of these presentations and to appreciate the difficulties that can be encountered when trying to accurately diagnose them. Routine medicals, particularly entrance medicals, present a unique clinical opportunity to recognise the clinical features that would warrant further investigation and specialist advice. PMID:26243806

  13. Thoracic aortopathies in the military patient.

    PubMed

    O'Brien, David; White, S; Wilson, D; Haworth, K; Williams, A

    2015-09-01

    Thoracic aortic disease is an important contributor to arterial disease and therefore, mortality in the UK. It has close associations with hypertension, atherosclerosis and genetic conditions such as Marfan syndrome. The cardiovascular consequences of acute aortic dissection or the rupture of a thoracic aneurysm are life threatening with a 1% increase in mortality per hour with a type A aortic dissection and a high 30-day mortality rate. The clinical diagnosis can be difficult for the general physician as the symptoms can mimic more common conditions such as acute coronary syndrome, pulmonary embolism or acute abdomen. The investigations that carry the highest sensitivity and specificity, CT, transoesophageal echocardiography and MRI are not usually first-line investigations in most patients so a high index of clinical suspicion is key. The management of acute aortic syndromes involves good initial resuscitation and early discussion with the cardiothoracic surgeons. Given the serious consequences of acute aortic syndromes, it is important for all military doctors to be aware of these presentations and to appreciate the difficulties that can be encountered when trying to accurately diagnose them. Routine medicals, particularly entrance medicals, present a unique clinical opportunity to recognise the clinical features that would warrant further investigation and specialist advice.

  14. Basic thoracic ultrasound for the respiratory physician.

    PubMed

    Jimborean, Gabriela; Ianoşi, Edith Simona; Nemeş, Roxana Maria; Toma, Tudor P

    2015-01-01

    Thoracic ultrasound (TUS) evolved in the last ten years as the method of choice for evaluating pleural abnormalities and for guiding lung procedures. TUS can "see" almost all structures in the chest, including thoracic wall, pleura, pleural space, the heart, the great vessels and the peripheral layers of the lungs. However, there is still a great need to develop TUS services in respiratory departments in Romania. To facilitate this development we reviewed the literature and selected what we considered to be essential practical information for the beginner in TUS, including technique, normal findings, and common abnormalities. Moreover, we describe here a step-by-step scanning technique for chest physicians. Our aim is to raise awareness of TUS. Because TUS is rapid, accurate, noninvasive and can be applied in any ward, we recommend facilitating the training of all junior respiratory doctors in this technique, as it is likely to improve patient experience, clinical effectiveness and to reduce costs with chest radiographs or CT scans in the future. PMID:26738366

  15. The thoracic anterior spinal cord adhesion syndrome

    PubMed Central

    Taylor, T R; Dineen, R; White, B; Jaspan, T

    2012-01-01

    Objectives This study included a series of middle-aged male and female patients who presented with chronic anterior hemicord dysfunction progressing to paraplegia. Imaging of anterior thoracic cord displacement by either a dural adhesion or a dural defect with associated cord herniation is presented. Methods This is a retrospective review of cases referred to a tertiary neuroscience centre over a 19-year period. Imaging series were classified by two experienced neuroradiologists against several criteria and correlated with clinical examination and/or findings at surgery. Results 16 cases were available for full review. Nine were considered to represent adhesions (four confirmed surgically) and four to represent true herniation (three confirmed surgically). In the three remaining cases the diagnosis was radiologically uncertain. Conclusion The authors propose “thoracic anterior spinal cord adhesion syndrome” as a novel term to describe this patient cohort and suggest appropriate clinicoradiological features for diagnosis. Several possible aetiologies are also suggested, with disc rupture and inflammation followed by disc resorption and dural pocket formation being a possible mechanism predisposing to herniation at the extreme end of a clinicopathological spectrum. PMID:22665931

  16. Women in Thoracic Surgery: 30 Years of History.

    PubMed

    Antonoff, Mara B; David, Elizabeth A; Donington, Jessica S; Colson, Yolonda L; Litle, Virginia R; Lawton, Jennifer S; Burgess, Nora L

    2016-01-01

    Women in Thoracic Surgery was founded in 1986, with 2016 marking its 30th anniversary. Reflecting back on the last 3 decades of history, accomplishments, and enormous strides in our field, we review the past, present, and future of this organization. Although women still constitute a small minority of practicing surgeons in our field today, opportunities currently abound for women in thoracic surgery. Owing much to the early female pioneers in the field and to the support of male sponsors and our national societies, Women in Thoracic Surgery has grown and prospered, as have its members and the global community of female thoracic surgeons as a whole. In celebration of our 30th anniversary, we share with the readership the rich history of Women in Thoracic Surgery and its goals for the future.

  17. The Role of the Public Health Official in Communicating Public Health Information

    PubMed Central

    Regidor, Enrique; de la Fuente, Luis; Gutiérrez-Fisac, Juan L.; de Mateo, Salvador; Pascual, Cruz; Sánchez-Payá, José; Ronda, Elena

    2007-01-01

    The prevailing views on the role of public health professionals refer to professionals in the academic world, without taking into account the fact that many public health professionals are government employees. For example, the American Public Health Association states that public health professionals play an active role in communicating public health information to nonscientific audiences, such as the general population or the mass media. We propose that public health officials have an important responsibility to promote the practice of public health. However, they must do so within the bureaucracy. Any actions that public health officials wish to take as advocates of particular public health activities should be carried out independent of their role as government officials. PMID:17413063

  18. 31 CFR 0.104 - Designated Agency Ethics Official and Alternate Designated Agency Ethics Official.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Standards and Treasury Supplemental Standards and Rules. See 5 CFR 2638.203. The Senior Counsel for Ethics... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Designated Agency Ethics Official and Alternate Designated Agency Ethics Official. 0.104 Section 0.104 Money and Finance: Treasury Office of...

  19. 31 CFR 0.104 - Designated Agency Ethics Official and Alternate Designated Agency Ethics Official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Standards and Treasury Supplemental Standards and Rules. See 5 CFR 2638.203. The Senior Counsel for Ethics... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Designated Agency Ethics Official and Alternate Designated Agency Ethics Official. 0.104 Section 0.104 Money and Finance: Treasury Office of...

  20. 31 CFR 0.104 - Designated Agency Ethics Official and Alternate Designated Agency Ethics Official.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Standards and Treasury Supplemental Standards and Rules. See 5 CFR 2638.203. The Senior Counsel for Ethics... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Designated Agency Ethics Official and Alternate Designated Agency Ethics Official. 0.104 Section 0.104 Money and Finance: Treasury Office of...

  1. 31 CFR 0.104 - Designated Agency Ethics Official and Alternate Designated Agency Ethics Official.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Standards and Treasury Supplemental Standards and Rules. See 5 CFR 2638.203. The Senior Counsel for Ethics... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Designated Agency Ethics Official and Alternate Designated Agency Ethics Official. 0.104 Section 0.104 Money and Finance: Treasury Office of...

  2. 31 CFR 0.104 - Designated Agency Ethics Official and Alternate Designated Agency Ethics Official.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Standards and Treasury Supplemental Standards and Rules. See 5 CFR 2638.203. The Senior Counsel for Ethics... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Designated Agency Ethics Official and Alternate Designated Agency Ethics Official. 0.104 Section 0.104 Money and Finance: Treasury Office of...

  3. 9 CFR 318.4 - Preparation of products to be officially supervised; responsibilities of official establishments...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Logo. Owners and operators of official establishments having a total plant quality control system... responsibility of the operator of every official establishment to comply with the Act and the regulations in this subchapter. In order to carry out this responsibility effectively, the operator of the establishment...

  4. Thoracic endovascular aortic repair for blunt thoracic aortic injuries in complex aortic arch vessels anatomies.

    PubMed

    Piffaretti, Gabriele; Carrafiello, Gianpaolo; Ierardi, Anna Maria; Mariscalco, Giovanni; Macchi, Edoardo; Castelli, Patrizio; Tozzi, Matteo; Franchin, Marco

    2015-08-01

    The aim of this study is to report the use of thoracic endovascular aortic repair (TEVAR) in blunt thoracic aortic injuries (BTAIs) presenting with complex anatomies of the aortic arch vessels. Two patients were admitted to our hospital for the management of BTAI. Anomalies were as follow: aberrant right subclavian artery (n = 1) and right-sided aortic arch with 5 vessels anatomy variant (n = 1). TEVAR was accomplished using parallel graft with periscope configuration in the patient with the aberrant right subclavian artery. At 12-month follow-up, computed tomography angiographies confirmed the exclusion of the BTAI, the stability of the endograft, the resolution of the pseudoaneurysm, and the patency of the parallel endograft. Aortic arch vessels variants and anomalies are not rare, and should be recognized and studied precisely to plan the most appropriate operative treatment. TEVAR proved to be effective even in complex anatomies.

  5. 10 CFR 13.5 - Review by the reviewing official.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Review by the reviewing official. 13.5 Section 13.5 Energy NUCLEAR REGULATORY COMMISSION PROGRAM FRAUD CIVIL REMEDIES § 13.5 Review by the reviewing official. (a) If, based on the report of the investigating official under § 13.4(b), the reviewing official...

  6. 9 CFR 305.1 - Official numbers; subsidiaries and tenants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Official numbers; subsidiaries and... INSPECTION AND CERTIFICATION OFFICIAL NUMBERS; INAUGURATION OF INSPECTION; WITHDRAWAL OF INSPECTION; REPORTS OF VIOLATION § 305.1 Official numbers; subsidiaries and tenants. (a) An official number shall...

  7. 25 CFR 502.19 - Primary management official.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 2 2011-04-01 2011-04-01 false Primary management official. 502.19 Section 502.19... THIS CHAPTER § 502.19 Primary management official. Primary management official means: (a) The person... designated by the tribe as a primary management official....

  8. 25 CFR 502.19 - Primary management official.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Primary management official. 502.19 Section 502.19... THIS CHAPTER § 502.19 Primary management official. Primary management official means: (a) The person... designated by the tribe as a primary management official....

  9. 22 CFR 41.22 - Officials of foreign governments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Officials of foreign governments. 41.22 Section... IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.22 Officials of foreign governments. (a) Criteria for classification of foreign government officials. (1) An alien is classifiable...

  10. 22 CFR 41.22 - Officials of foreign governments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Officials of foreign governments. 41.22 Section... IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.22 Officials of foreign governments. (a) Criteria for classification of foreign government officials. (1) An alien is classifiable...

  11. 22 CFR 41.22 - Officials of foreign governments.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Officials of foreign governments. 41.22 Section... IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.22 Officials of foreign governments. (a) Criteria for classification of foreign government officials. (1) An alien is classifiable...

  12. 12 CFR 1200.3 - Official logo and seal.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Official logo and seal. 1200.3 Section 1200.3... § 1200.3 Official logo and seal. This section describes and displays the logo adopted by the Director as... signage. The logo serves as the official seal to certify and authenticate official documents of the...

  13. 12 CFR 905.26 - Official logo and seal.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Official logo and seal. 905.26 Section 905.26... OPERATIONS DESCRIPTION OF ORGANIZATION AND FUNCTIONS Miscellaneous § 905.26 Official logo and seal. This... as the official seal used to certify and authenticate official documents of the Board of...

  14. 12 CFR 905.26 - Official logo and seal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Official logo and seal. 905.26 Section 905.26... OPERATIONS DESCRIPTION OF ORGANIZATION AND FUNCTIONS Miscellaneous § 905.26 Official logo and seal. This... as the official seal used to certify and authenticate official documents of the Board of...

  15. 12 CFR 1700.3 - Official logo and seal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Official logo and seal. 1700.3 Section 1700.3... DEVELOPMENT OFHEO ORGANIZATION AND FUNCTIONS ORGANIZATION AND FUNCTIONS § 1700.3 Official logo and seal. The..., and signage. The logo serves as the official seal to authenticate official documents of the Agency....

  16. 12 CFR 1200.3 - Official logo and seal.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Official logo and seal. 1200.3 Section 1200.3... § 1200.3 Official logo and seal. This section describes and displays the logo adopted by the Director as... signage. The logo serves as the official seal to certify and authenticate official documents of the...

  17. 12 CFR 905.26 - Official logo and seal.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Official logo and seal. 905.26 Section 905.26... OPERATIONS DESCRIPTION OF ORGANIZATION AND FUNCTIONS Miscellaneous § 905.26 Official logo and seal. This... as the official seal used to certify and authenticate official documents of the Board of...

  18. 12 CFR 1700.3 - Official logo and seal.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Official logo and seal. 1700.3 Section 1700.3... DEVELOPMENT OFHEO ORGANIZATION AND FUNCTIONS ORGANIZATION AND FUNCTIONS § 1700.3 Official logo and seal. The..., and signage. The logo serves as the official seal to authenticate official documents of the Agency....

  19. 12 CFR 1700.3 - Official logo and seal.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Official logo and seal. 1700.3 Section 1700.3... DEVELOPMENT OFHEO ORGANIZATION AND FUNCTIONS ORGANIZATION AND FUNCTIONS § 1700.3 Official logo and seal. The..., and signage. The logo serves as the official seal to authenticate official documents of the Agency....

  20. A Personality Profile of Southeastern Conference Football Officials.

    ERIC Educational Resources Information Center

    Ittenbach, Richard F.; Eller, Ben F.

    Despite the importance of officiating, there is little information available on how major college football officials view their sport, themselves, and their role as officials. Southeastern Conference (SEC) football officials (N=39) responded to a survey packet consisting of the California Psychological Inventory (CPI) and a four-page profile of…

  1. Non-intubated thoracic surgery—A survey from the European Society of Thoracic Surgeons

    PubMed Central

    Sorge, Roberto; Akopov, Andrej; Congregado, Miguel; Grodzki, Tomasz

    2015-01-01

    Background A survey amongst the European Society of Thoracic Surgeons (ESTS) members has been performed to investigate the currents trends, rates of adoption as well as potential for future expansion of non-intubated thoracic surgery (NITS) performed under spontaneous ventilation. Methods A 14-question-based questionnaire has been e-mailed to ESTS members. To facilitate the completion of the questionnaire, questions entailed either quantitative or multiple-choice answers. Investigated issues included previous experience with NITS and number of procedures performed, preferred types of anesthesia protocols (i.e., thoracic epidural anesthesia, intercostal or paravertebral blocks, laryngeal mask, use of additional sedation), type of procedures, ideal candidates for NITS, main advantages and technical disadvantages. Non-univocal answer to multiple-choice questions was permitted. Results Out of 105 responders, 62 reported an experience with NITS. The preferred types of anesthesia were intercostal blocks with (59%) or without (50%) sedation, followed by laryngeal mask with sedation (43%) and thoracic epidural anesthesia with sedation (20%). The most frequently performed procedures included thoracoscopic management of recurrent pleural effusion (98%), pleural decortication for empyema thoracis and lung biopsy for interstitial lung disease (26% each); pericardial window and mediastinal biopsy (20% each). More complex procedures such as lobectomy, lung volume reduction surgery and thymectomy have been performed by a minority of responders (2% each). Poor-risk patients due to co-morbidities (70%) and patients with poor pulmonary function (43%) were considered the ideal candidates. Main advantages included faster, recovery (67%), reduced morbidity (59%) and shorter hospital stay with decreased costs (43% each). Reported technical disadvantages included coughing (59%) and poor maneuverability due to diaphragmatic and lung movements (56%). Overall, 69% of responders indicated

  2. Respiratory Displacement of the Thoracic Aorta: Physiological Phenomenon With Potential Implications for Thoracic Endovascular Repair

    SciTech Connect

    Weber, Tim Frederik; Tetzlaff, Ralf; Rengier, Fabian; Geisbuesch, Philipp; Kopp-Schneider, Annette; Boeckler, Dittmar; Eichinger, Monika; Kauczor, Hans-Ulrich; Tengg-Kobligk, Hendrik von

    2009-07-15

    The purpose of this study was to assess the magnitude and direction of respiratory displacement of the ascending and descending thoracic aorta during breathing maneuvers. In 11 healthy nonsmokers, dynamic magnetic resonance imaging was performed in transverse orientation at the tracheal bifurcation during maximum expiration and inspiration as well as tidal breathing. The magnitude and direction of aortic displacement was determined relatively to resting respiratory position for the ascending (AA) and descending (DA) aorta. To estimate a respiratory threshold for occurrence of distinct respiratory aortic motion, the latter was related to the underlying change in anterior-posterior thorax diameter. Compound displacement between maximum expiration and inspiration was 24.3 {+-} 6.0 mm for the AA in the left anterior direction and 18.2 {+-} 5.5 mm for the DA in the right anterior direction. The mean respiratory thorax excursion during tidal breathing was 8.9 {+-} 2.8 mm. The respiratory threshold, i.e., the increase in thorax diameter necessary to result in respiratory aortic displacement, was estimated to be 15.7 mm. The data suggest that after a threshold of respiratory thorax excursion is exceeded, respiration is accompanied by significant displacement of the thoracic aorta. Although this threshold may not be reached during tidal breathing in the majority of individuals, segmental differences during forced respiration impact on aortic geometry, may result in additional extrinsic forces on the aortic wall, and may be of significance for aortic prostheses designed for thoracic endovascular aortic repair.

  3. Multifocal thoracic chordoma mimicking a paraganglioma.

    PubMed

    Conzo, Giovanni; Gambardella, Claudio; Pasquali, Daniela; Ciancia, Giuseppe; Avenia, Nicola; Pietra, Cristina Della; Napolitano, Salvatore; Palazzo, Antonietta; Mauriello, Claudio; Parmeggiani, Domenico; Pettinato, Guido; Napolitano, Vincenzo; Santini, Luigi

    2013-01-01

    Chordoma of thoracic vertebras is a very rare locally invasive neoplasm with low grade malignancy arising from embryonic notochordal remnants. Radical surgery remains the cornerstone of the treatment. We describe a case of multifocal T1-T2 chordoma, without bone and disc involvement, incidentally misdiagnosed as a paraganglioma, occurring in a 47-year-old male asymptomatic patient. Neoplasm was radically removed by an endocrine surgeon through a right extended cervicotomy. A preoperative reliable diagnosis of chordoma, as in the reported case, is often difficult. Radical surgery can provide a favorable outcome but, given the high rates of local recurrence of this neoplasm, a strict and careful follow-up is recommended. Although very rare, chordoma should be suggested in the differential diagnosis of the paravertebral cervical masses of unknown origin. Spine surgeon consultation and a FNB should be routinely included in the multidisciplinary preoperative work-up of these neoplasms. PMID:24125991

  4. Thoracic spinal cord compression by a tophus.

    PubMed

    Ntsiba, Honoré; Makosso, Edouard; Moyikoua, Armand

    2010-03-01

    We report a case of thoracic (T10) spinal cord compression by a tophus in a patient with known chronic gout. Spastic paraplegia developed gradually over 6 months in this 43-year-old man with hypertension, alcohol abuse, and chronic gouty arthritis with tophi. Magnetic resonance imaging and computed tomography visualized an intradural nodule measuring 1.5cm in diameter at the level of T10, as well as geodes in the left T10 lamina and left T9-T10 articular processes. The nodule was removed surgically and shown by histological examination to be a tophus. The neurological impairments resolved rapidly and completely. We found about 60 similar cases in the literature. Spinal cord compression in a patient with chronic gout can be caused by a tophus.

  5. Tophaceous pseudogout of the thoracic spine.

    PubMed

    Srinivasan, Vasisht; Kesler, Henry; Johnson, Mahlon; Dorfman, Howard; Walter, Kevin

    2012-04-01

    Calcium pyrophosphate dihydrate deposition disease (CPDD, tophaceous pseudogout) is a rare crystal arthropathy characterized by pyrophosphate crystal deposition in joints, synovitis and chondrocalcinosis on imaging. We present the case of a 72-year-old man with 6 months of left chest pain; magnetic resonance imaging revealed a T9/T10 herniated disc. Intraoperatively, the material was sent for pathological analysis revealing pseudogout. Axial calcium pyrophosphate crystal deposition is rare but reported in the literature and found at the craniocervical junction and skull. Spinal calcium pyrophosphate crystal deposition is rare in the thoracic spine. It is often asymptompatic and can involve the disc or ligaments. This case demonstrates a unique presentation of CPDD.

  6. Caring for umpires, officials, and referees.

    PubMed

    Erickson, Steven M; Letendre, Mark A; Shaarawy, Kareem M; Overlin, Amy Jo F

    2012-01-01

    Umpires, referees, and sports officials have not been accorded the same attention as athletes by the sports medicine community. The physical and psychological demands of their jobs expose them to a unique constellation of medical, psychological, and orthopedic problems. Likewise their age, fitness level, and disease risk factors may warrant closer scrutiny for them and greater need for participation evaluation than the athletes with whom they share the field. Limited medical literature is published regarding the care of sports officials, even though they have a higher incidence of medical problems, cardiovascular risk, and orthopedic injuries than sports participants.

  7. Current status of thoracic dorsal sympathectomy.

    PubMed

    Welch, E; Geary, J

    1984-01-01

    This article summarizes over 20 years of experience (1962 to 1982) with cervical sympathectomy (thoracic dorsal sympathectomy) in 46 patients undergoing 68 sympathectomies. All operations were performed through an anterior supraclavicular approach. Indications for surgery were intractable Raynaud's disease (26 patients), atherosclerotic obliterative arterial disease (five), causalgia (five), posttraumatic sympathetic dystrophy (seven), collagen vascular disorders (eight), hyperhidrosis (12), occupational-related digital thrombosis (four), and thrombosis secondary to intra-arterial injection (one). The incidence of complications and side effects, both temporary and permanent, including Horner's syndrome, is reviewed in detail. Particular reference is made to the various surgical techniques of managing the stellate ganglion; four patients had two-third to three-fourth resection of the stellate ganglion down to and including the T-3 thoracic ganglion, two had preservation of the stellate ganglion and resection of the T-2 through T-4 ganglia, seven had excision of the entire stellate ganglion down to and including the T-4 ganglion, seven had resection of the lower third of the stellate ganglion down to and including the T-4 ganglion, and 48 had removal of the lower half of the stellate ganglion down to and including the T-3 ganglion. The study reviews the literature germane to anatomic considerations and suggests revisions in current texts and atlases. By retrospective analysis of the records and a follow-up questionnaire, which provided an 86% follow-up (average 8.4 years), the paper points to the distinctive clinical characteristics of the different groups within the population undergoing the operation and provides guidelines for patient selection and conclusions on the place for this operation in the management of vascular diseases involving the upper extremity. PMID:6481864

  8. 31 CFR 537.512 - Importation for official or personal use by foreign diplomatic and consular officials.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Importation for official or personal....512 Importation for official or personal use by foreign diplomatic and consular officials. All... is destined for official or personal use by personnel employed by a diplomatic mission or...

  9. 9 CFR 54.11 - Approval of laboratories to run official scrapie tests and official genotype tests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Approval of laboratories to run official scrapie tests and official genotype tests. 54.11 Section 54.11 Animals and Animal Products ANIMAL... laboratories to run official scrapie tests and official genotype tests. (a) State, Federal, and...

  10. 9 CFR 54.11 - Approval of laboratories to run official scrapie tests and official genotype tests.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Approval of laboratories to run official scrapie tests and official genotype tests. 54.11 Section 54.11 Animals and Animal Products ANIMAL... laboratories to run official scrapie tests and official genotype tests. (a) State, Federal, and...

  11. 9 CFR 54.11 - Approval of laboratories to run official scrapie tests and official genotype tests.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Approval of laboratories to run official scrapie tests and official genotype tests. 54.11 Section 54.11 Animals and Animal Products ANIMAL... laboratories to run official scrapie tests and official genotype tests. (a) State, Federal, and...

  12. 9 CFR 54.11 - Approval of laboratories to run official scrapie tests and official genotype tests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Approval of laboratories to run official scrapie tests and official genotype tests. 54.11 Section 54.11 Animals and Animal Products ANIMAL... laboratories to run official scrapie tests and official genotype tests. (a) State, Federal, and...

  13. 9 CFR 54.11 - Approval of laboratories to run official scrapie tests and official genotype tests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Approval of laboratories to run official scrapie tests and official genotype tests. 54.11 Section 54.11 Animals and Animal Products ANIMAL... laboratories to run official scrapie tests and official genotype tests. (a) State, Federal, and...

  14. Nearly Asymptomatic Eight-Month Thoracic Aortic Dissection

    PubMed Central

    Kumar, Arjun; Kumar, Krishan; Zeltser, Roman; Makaryus, Amgad N.

    2016-01-01

    Thoracic aortic dissection is a rare, but lethal, medical condition that is either misdiagnosed as a myocardial infarction or overlooked completely. Though thoracic aortic dissections are commonly diagnosed in patients exhibiting sharp chest pain, there are some notable cases where patients do not report the expected severity of pain. We report a unique case of a patient with a thoracic aortic dissection who was initially nearly asymptomatic for eight months, in order to heighten awareness, highlight diagnosis protocol, and improve prognosis for this commonly misdiagnosed, but fatal, condition. PMID:27257400

  15. Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs.

    PubMed

    Osarogiagbon, Raymond U; Freeman, Richard K; Krasna, Mark J

    2015-08-01

    Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed. PMID:26380186

  16. Rare case of thoracic kidney detected by renal scintigraphy

    PubMed Central

    Natarajan, Aravintho; Agrawal, Archi; Purandare, Nilendu; Shah, Sneha; Rangarajan, Venkatesh

    2016-01-01

    Intrathoracic kidney is a rare congenital abnormality with lowest frequency among all renal ectopias. Patients with thoracic kidneys are usually asymptomatic, and the condition is usually discovered incidentally during radiological evaluation for other conditions or during thoracic surgery. We report a case of a 62-year-old male who was referred to our department for renal scintigraphy for a nonvisualized left kidney on ultrasonography report. Both Tc-99m dimercaptosuccinic acid and diethylenetriaminepentaacetic acid scans revealed a left thoracic kidney which was confirmed by CT scan of the thorax and abdomen. PMID:27385896

  17. Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs

    PubMed Central

    Freeman, Richard K.; Krasna, Mark J.

    2015-01-01

    Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed. PMID:26380186

  18. Thoracic and lumbar extradural structure examined by extraduroscope.

    PubMed

    Igarashi, T; Hirabayashi, Y; Shimizu, R; Saitoh, K; Fukuda, H

    1998-08-01

    We examined the extradural space using a flexible extraduroscope in 113 patients undergoing extradural anaesthesia. Patients were classified into two groups to receive either thoracic or lumbar extradural anaesthesia as needed for perioperative analgesia. The extraduroscopy showed that the thoracic extradural space becomes widely patent after injecting a given amount of air and that the amount of fatty and fibrous connective tissue is less in the thoracic extradural space compared with the lumbar extradural space. We suggest that differences between the structure of these two vertebral regions may affect the spread of local anaesthetics in the extradural space. PMID:9813508

  19. Initial experience in the treatment of thoracic aortic aneurysmal disease with a thoracic aortic endograft at Baylor University Medical Center

    PubMed Central

    Apple, Jeffrey; McQuade, Karen L.; Hamman, Baron L.; Hebeler, Robert F.; Shutze, William P.

    2008-01-01

    A retrospective review of 27 patients who underwent endovascular repair of thoracic aneurysms and of other thoracic aortic pathology with the thoracic aortic endograft (Gore Medical, Flagstaff, AZ) from June 2005 to July 2007 was performed. The mean follow-up period was 13.5 months (range, 2–25 months). Indications for thoracic endografting included descending thoracic aneurysms (n = 18), thoracoabdominal aneurysms (n = 3), traumatic aortic injuries (n = 3), penetrating aortic ulcers (n = 2), and contained rupture of a type B dissection (n = 1). One patient died during the procedure, for an overall mortality rate of 3.7%. The average length of stay was 8.1 days, with an average stay in the intensive care unit of 4.2 days. If patients with traumatic aortic injuries were excluded, the average overall and intensive care unit length of stay were 5.6 and 1.8 days, respectively. There was one incident of spinal cord ischemia (3.7%). There were five type I or type III endoleaks, three of which required revision (11.1%). In conclusion, thoracic endografting is a safe and viable option for the repair of descending thoracic aneurysms and other aortic pathologies. We have found it to be less invasive, even in conjunction with preoperative debranching procedures, with a shorter recovery time, decreased perioperative morbidity and blood loss, and decreased peri-operative mortality compared with standard open repair. PMID:18382748

  20. 7 CFR 58.646 - Official identification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 3 2014-01-01 2014-01-01 false Official identification. 58.646 Section 58.646 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF...

  1. 5 CFR 919.1010 - Suspending official.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Suspending official. 919.1010 Section 919.1010 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 919.1010...

  2. 7 CFR 54.14 - Official certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... (a) Agricultural Products Certificate Form LS-5-3 (Figure 1) is the official certificate for products... Certificate Form LS-5-3 covering products for which that grader determined final specification compliance... Verified.” (b) Applicant Charges Certificate Form LS-5-5 (Figure 2) will be used to reduce paperwork...

  3. 76 FR 45174 - State Official Notification Rules

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-28

    ... PROTECTION 12 CFR Part 1082 RIN 3170-AA02 State Official Notification Rules AGENCY: Bureau of Consumer..., with several paragraphs, each of which is addressed below. Section 1082.1(a) Notice Requirement This... notice. Section 1082.1(b) Emergency Actions Section 1082.1(b) sets out the process for the provision...

  4. 7 CFR 62.213 - Official identification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Official identification. 62.213 Section 62.213 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER...

  5. DIAA Official Handbook, 2004-2005.

    ERIC Educational Resources Information Center

    Delaware State Department of Education, 2004

    2004-01-01

    This publication details all of the official rules and regulations of the Delaware Interscholastic Athletic Association. Some of the items discussed are: All-Star Contests; Appeal Procedure; Associate Member School; Awards; Conditioning Programs; Investigative Procedure; Non-School Competition; Postgraduates/Higher Institutions; Practice Sessions;…

  6. How Justice System Officials View Wrongful Convictions

    ERIC Educational Resources Information Center

    Smith, Brad; Zalman, Marvin; Kiger, Angie

    2011-01-01

    The wrongful conviction of factually innocent people is a growing concern within the United States. Reforms generated by this concern are predicated in part on the views of justice system participants. The authors surveyed judges, police officials, prosecutors, and defense lawyers in Michigan regarding their views of why wrongful convictions…

  7. 9 CFR 351.6 - Official number.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal fat... to identify all certified technical animal fat prepared or stored by the plant....

  8. 9 CFR 351.6 - Official number.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal fat... to identify all certified technical animal fat prepared or stored by the plant....

  9. 9 CFR 351.6 - Official number.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal fat... to identify all certified technical animal fat prepared or stored by the plant....

  10. 9 CFR 351.6 - Official number.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal fat... to identify all certified technical animal fat prepared or stored by the plant....

  11. FY 1993 Cohort Official Default Rate Guide.

    ERIC Educational Resources Information Center

    Office of Postsecondary Education (ED), Washington, DC.

    This document is intended to help institutions of postsecondary education understand their rights and responsibilities relating to school cohort default rates for the Federal Family Education Loan (FFEL)Program. Section 1 focuses on the calculation of FY 1993 official cohort default rates including how student loan activity is tracked and…

  12. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Debarring official. 93.206 Section 93.206 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  13. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Debarring official. 93.206 Section 93.206 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  14. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Debarring official. 93.206 Section 93.206 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  15. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Debarring official. 93.206 Section 93.206 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  16. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Debarring official. 93.206 Section 93.206 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  17. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  18. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  19. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  20. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  1. 16 CFR 0.2 - Official address.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2 Official address. The principal office of the Commission is at Washington, DC. All communications to the Commission should be addressed to the Federal Trade Commission, 600 Pennsylvania Avenue, NW, Washington,...

  2. 4 CFR 28.59 - Official record.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 4 Accounts 1 2010-01-01 2010-01-01 false Official record. 28.59 Section 28.59 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL APPEALS BOARD; PROCEDURES APPLICABLE TO CLAIMS CONCERNING EMPLOYMENT PRACTICES AT THE GOVERNMENT ACCOUNTABILITY OFFICE...

  3. 4 CFR 28.59 - Official record.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 4 Accounts 1 2011-01-01 2011-01-01 false Official record. 28.59 Section 28.59 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL APPEALS BOARD; PROCEDURES APPLICABLE TO CLAIMS CONCERNING EMPLOYMENT PRACTICES AT THE GOVERNMENT ACCOUNTABILITY OFFICE...

  4. 42 CFR 73.9 - Responsible Official.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SELECT AGENTS AND TOXINS § 73.9 Responsible Official. (a) An individual or entity required to register... onsite incidents involving select agents and toxins in accordance with the entity's incident response... toxins are stored or used in order to determine compliance with the requirements of this part....

  5. 9 CFR 121.9 - Responsible official.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS POSSESSION, USE, AND TRANSFER OF SELECT AGENTS AND TOXINS § 121.9 Responsible official. (a) An individual or entity required to... toxins are stored or used in order to determine compliance with the requirements of this part....

  6. 9 CFR 121.9 - Responsible official.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS POSSESSION, USE, AND TRANSFER OF SELECT AGENTS AND TOXINS § 121.9 Responsible official. (a) An individual or entity required to... respond in a timely manner to onsite incidents involving select agents and toxins in accordance with...

  7. 9 CFR 121.9 - Responsible official.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS POSSESSION, USE, AND TRANSFER OF SELECT AGENTS AND TOXINS § 121.9 Responsible official. (a) An individual or entity required to... toxins are stored or used in order to determine compliance with the requirements of this part....

  8. 42 CFR 73.9 - Responsible Official.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SELECT AGENTS AND TOXINS § 73.9 Responsible Official. (a) An individual or entity required to register... onsite incidents involving select agents and toxins in accordance with the entity's incident response... toxins are stored or used in order to determine compliance with the requirements of this part....

  9. 7 CFR 58.526 - Official identification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Official identification. 58.526 Section 58.526 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF...

  10. 15 CFR 700.6 - Official actions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Official actions. 700.6 Section 700.6 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE NATIONAL SECURITY INDUSTRIAL BASE REGULATIONS...

  11. 49 CFR 511.48 - Official docket.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 6 2011-10-01 2011-10-01 false Official docket. 511.48 Section 511.48 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY... Transportation's regulations on Public Availability of Information (49 CFR part 7)....

  12. 49 CFR 511.48 - Official docket.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false Official docket. 511.48 Section 511.48 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY... Transportation's regulations on Public Availability of Information (49 CFR part 7)....

  13. 49 CFR 1139.24 - Official notice.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Official notice. 1139.24 Section 1139.24 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE PROCEDURES IN MOTOR CARRIER REVENUE PROCEEDINGS Intercity...

  14. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Section 375.103 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The... outside border of which shall consist of two concentric circles enclosing the words “Department of...

  15. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Section 375.103 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The... outside border of which shall consist of two concentric circles enclosing the words “Department of...

  16. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Section 375.103 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The... outside border of which shall consist of two concentric circles enclosing the words “Department of...

  17. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Section 375.103 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The... outside border of which shall consist of two concentric circles enclosing the words “Department of...

  18. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Section 375.103 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The... outside border of which shall consist of two concentric circles enclosing the words “Department of...

  19. 28 CFR 68.41 - Official notice.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Official notice. 68.41 Section 68.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE HEARINGS BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT...

  20. 9 CFR 355.8 - Official number.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Official number. 355.8 Section 355.8 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER CARNIVORA; INSPECTION, CERTIFICATION,...

  1. 9 CFR 355.8 - Official number.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Official number. 355.8 Section 355.8 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER CARNIVORA; INSPECTION, CERTIFICATION,...

  2. 9 CFR 355.8 - Official number.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Official number. 355.8 Section 355.8 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER CARNIVORA; INSPECTION, CERTIFICATION,...

  3. 9 CFR 355.8 - Official number.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Official number. 355.8 Section 355.8 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER CARNIVORA; INSPECTION, CERTIFICATION,...

  4. 42 CFR 430.94 - Official transcript.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Official transcript. 430.94 Section 430.94 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS Hearings on Conformity...

  5. 9 CFR 351.6 - Official number.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR EXPORT Procedure for Obtaining Service: Administration of Program § 351.6 Official number. The Administrator will assign a certified technical animal...

  6. Savant officials in the Prussian mining administration.

    PubMed

    Klein, Ursula

    2012-07-01

    In the second half of the eighteenth century, the Prussian State supported savants who combined learned inquiry into nature with technical work. Members of the physical and mathematical classes of the Royal Prussian Academy of Sciences were involved in State projects such as surveying for the construction of canals, chemical analysis of Silesian iron, production of porcelain and of beet sugar. Some of these men were truly 'hybrid' experts living both in the worlds of State-directed manufacture and academic natural inquiry. Among these savant experts there was a particular sub-group that is at the centre of this paper: mining officials who were also recognized as mineralogists, geologists and chemists. The paper describes and analyses the training and the varied technical and scientific activities of these 'savant officials'. At the centre of attention are the travels of inspection of the mineralogist and mining official Carl Abraham Gerhard (1738-1821) in the late 1760s. I argue that Gerhard's travels of inspection were at the same time geological travels and that savant officials like Gerhard made a significant contribution to the fledgling science of geology.

  7. Official STS-59 preflight crew portrait

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This is the Official STS-59 preflight crew portrait. Sidney M. Gutierrez, mission commander is standing (right) along with Kevin P. Chilton, pilot. Others, left to right are Limda M. Godwin, payload commander; and Thomas D. Jones, Jerome (Jay) Apt and Michael R. (Rich) Clifford, all mission specialists. All are wearing orange launch and entry suits.

  8. 12 CFR 367.3 - Appropriate officials.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Appropriate officials. 367.3 Section 367.3 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY... (Ethics Section). This part does not modify the responsibility to report allegations of fraud, waste...

  9. The immediate effects of spinal thoracic manipulation on respiratory functions

    PubMed Central

    Shin, Doo Chul; Lee, Yong Woo

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of thoracic spinal manipulation therapy on respiratory function including forced vital capacity and forced expiratory volume in one second in young healthy individuals. [Subjects and Methods] Thirty young healthy subjects recruited from a local university participated in this study. Subjects were randomly allocated into an experimental group (n=15) and a control group (n=15). The experimental group received thoracic spinal manipulation and the control group received placebo thoracic spinal manipulation. Respiratory function tests, including forced vital capacity and forced expiratory volume in one second, were measured before and after intervention. [Results] The values for both tests were significantly higher in the experimental group. The control group showed no changes after the intervention. Differences in pre- and post-intervention values for both tests were significantly different between the 2 groups. [Conclusion] Spinal manipulation therapy applied to the thoracic region improved respiratory function test results of participants in this study. PMID:27799691

  10. An improved retractor for cardiac and thoracic operations.

    PubMed

    McEnany, M T

    1980-10-01

    Several standard abdominal wall retractors have been modified to improve exposure at the extremes of thoracic and groin incisions and to enhance the efficiency and comfort of the assistant in supplying adequate visibility in these areas.

  11. Thoracic and respirable particle definitions for human health risk assessment

    EPA Science Inventory

    Provides estimates of the thoracic and respirable fractions, for adults and children during typical activities during both nasal and oral inhalation, that may be used in the design of experimental studies and interpretation of evidence of health effects.

  12. Clinical pathway for thoracic surgery in the United States

    PubMed Central

    Wei, Benjamin

    2016-01-01

    The paradigm for postoperative care for thoracic surgical patients in the United States has shifted with efforts to reduce hospital length of stay and improve quality of life. The increasing usage of minimally invasive techniques in thoracic surgery has been an important part of this. In this review we will examine our standard practices as well as the evidence behind both general contemporary postoperative care principles and those specific to certain operations. PMID:26941967

  13. Unilateral anhidrosis: A rare complication of thoracic epidural analgesia.

    PubMed

    Gulbahar, Gultekin; Gundogdu, Ahmet Gokhan; Alkan, Güzide; Baysalman, Hatice Baran; Kaplan, Tevfik

    2016-02-01

    Management of pain following thoracotomy is an important issue for the control of early morbidity. We herein present the case of a patient who was referred to our hospital after a fall from a height. Right-sided multiple rib fractures, hemopneumothorax, and diaphragmatic rupture were detected. Thoracic epidural catheterization was performed for pain management just before thoracotomy. The patient developed unilateral anhidrosis postoperatively. We discuss this rare complication of thoracic epidural analgesia with a review of relevant literature.

  14. Critical decisions in trauma of the thoracic aorta.

    PubMed

    Degiannis, E; Boffard, K

    2002-05-01

    Trauma to the thoracic aorta is a significant injury with a high mortality. This mortality is partly due to the delayed recognition of the condition. The increase of motor vehicle accidents and the use of firearms worldwide has resulted in an increase of the incidence of trauma to the thoracic aorta. Certain new developments in diagnosis and management have resulted in traditional methods being questioned. This review analyses current literature and data which we attempt to evaluate.

  15. Single-stage posterior-only approach treating single-segment thoracic tubercular spondylitis

    PubMed Central

    Shen, Xiongjie; Liu, Hongzhe; Wang, Guoping; Liu, Xiangyang

    2015-01-01

    There are quite a few controversies on surgical management of single-segment thoracic spinal tuberculosis (STB) with neurological deficits. The present study was to compare single-stage posterior-only transpedicular debridement, interbody fusion and posterior instrumentation (posterior-only surgery) with a combined posterior-anterior surgical approach for treatment of single-segment thoracic STB with neurological deficits and to determinethe clinical feasibility and effectiveness of posterior-only surgical treatment. Sixty patients with single-segment thoracic STB with neurological deficits were treated with one of two surgical procedures in our center from January 2003 to January 2013. Thirty patients were treated with posterior-only surgery (Group A) andthirty were treated with combined posterior-anterior surgery (Group B). The American Spinal Injury Association (ASIA) score system to evaluate the neurological deficits, thevisual analogue scale (VAS) to assess the degree of pain, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) to judge the activity of tuberculosis (TB), surgery duration, intraoperative blood loss, length of hospitalization, bonyfusion rates, and kyphosis correction of the two groups were compared. The average follow-up period was 36.5 ± 9.2 months for Group A and 34.6 ± 10.2 months for Group B. Under the ASIA score system, all patients improved with treatment. STB was completely cured and grafted bones were fused within 5-11 months in allpatients. There were no persistent or recurrent infections orobvious differences in radiological results between thegroups. The kyphosis deformity was significantly corrected after surgical management. The average operative duration, blood loss, length of hospital stay, and postoperative complication rateof Group A were lower than those of Group B. In conclusions, posterior-only surgery is feasible and effective, resulting in better clinical outcomes than combined posterior-anterior surgeries

  16. Treatment of symptomatic thoracic disc herniations with lateral interbody fusion

    PubMed Central

    Parker, Rhiannon M.

    2015-01-01

    Background Symptomatic thoracic herniated discs have historically been treated using open exposures (i.e., thoracotomy), posing a clinical challenge given the approach related morbidity. Lateral interbody fusion (LIF) is one modern minimally disruptive alternative to thoracotomy. The direct lateral technique for lumbar pathologies has seen a sharp increase in procedural numbers; however application of this technique in thoracic pathologies has not been widely reported. Methods This study presents the results of three cases where LIF was used to treat symptomatic thoracic disc herniations. Indications for surgery included thoracic myelopathy, radiculopathy and discogenic pain. Patients were treated with LIF, without supplemental internal fixation, and followed for 24 months postoperatively. Results: Average length of hospital stay was 5 days. One patient experienced mild persistent neuropathic thoracic pain, which was managed medically. At 3 months postoperative all patients had returned to work and by 12 months all patients were fused. From preoperative to 24-month follow-up there were mean improvements of 83.3% in visual analogue scale (VAS), 75.3% in Oswestry Disability Index (ODI), and 79.2% and 17.4% in SF-36 physical (PCS) and mental component scores (MCS), respectively. Conclusions LIF is a viable minimally invasive alternative to conventional approaches in treating symptomatic thoracic pathology without an access surgeon, rib resection, or lung deflation.

  17. Normal and abnormal spine and thoracic cage development

    PubMed Central

    Canavese, Federico; Dimeglio, Alain

    2013-01-01

    Development of the spine and thoracic cage consists of a complex series of events involving multiple metabolic processes, genes and signaling pathways. During growth, complex phenomena occur in rapid succession. This succession of events, this establishment of elements, is programmed according to a hierarchy. These events are well synchronized to maintain harmonious limb, spine and thoracic cage relationships, as growth in the various body segments does not occur simultaneously at the same magnitude or rate. In most severe cases of untreated progressive early-onset spinal deformities, respiratory insufficiency and pulmonary and cardiac hypertension (cor pulmonale), which characterize thoracic insufficiency syndrome (TIS), can develop, sometimes leading to death. TIS is the inability of the thorax to ensure normal breathing. This clinical condition can be linked to costo-vertebral malformations (e.g., fused ribs, hemivertebrae, congenital bars), neuromuscular diseases (e.g., expiratory congenital hypotonia), Jeune or Jarcho-Levin syndromes or to 50% to 75% fusion of the thoracic spine before seven years of age. Complex spinal deformities alter normal growth plate development, and vertebral bodies become progressively distorted, perpetuating the disorder. Therefore, many scoliotic deformities can become growth plate disorders over time. This review aims to provide a comprehensive review of how spinal deformities can affect normal spine and thoracic cage growth. Previous conceptualizations are integrated with more recent scientific data to provide a better understanding of both normal and abnormal spine and thoracic cage growth. PMID:24147251

  18. Injury Profile of Northeastern Ohio High School Basketball Officials.

    PubMed

    Bandy, W D; Shaw, D K

    1986-01-01

    In brief: Little is known about the nature, location, and mechanism of injuries among basketball officials. The purpose of the present study was to develop an injury profile for this group. A total of 145 high school basketball officials were surveyed by means of a questionnaire. Sixty-one officials (42.1%) reported 71 injuries, 59 of which (83.1%) occurred in the lower extremity. Most injuries were related to change of direction or speed while running, a contrast to football, in which more injuries to officials are from collisions with players. Overall, basketball officials seem to have a lower injury rate than football officials.

  19. Comparison between Thoracic Epidural Block and Thoracic Paravertebral Block for Post Thoracotomy Pain Relief

    PubMed Central

    Biswas, Soniya; Bhatia, Vinod Kumar; Chaudhary, Ajay Kumar; Chandra, Girish; Prakash, Ravi

    2016-01-01

    Introduction Postoperative pain after thoracotomy is being considered one of the most severe pain and if not treated well, can result in various respiratory and other complications. Aim Present study was conducted with the aim to compare continuous thoracic epidural infusion with continuous paravertebral infusion for postoperative pain using Visual Analogue Scale (VAS) score and four point observer ranking. The secondary outcomes measured were pulmonary functions and any complication like hypotension, bradycardia, nausea, vomiting, urinary retention and neurological complications if any. Materials and Methods Sixty patients of age group 18-60 years posted for anterolateral thoracotomy surgery for lung resection were randomised either to epidural or paravertebral group in this randomised prospective double blind study. In Epidural group 7.5ml bolus of 0.125% Bupivacaine with 50μg Fentanyl and in Paravertebral group 15ml bolus of 0.125% Bupivacaine with 50μg Fentanyl was given 30 minutes before the anticipated end of surgery. Bolus dose was followed by infusion of 0.125% Bupivacaine with 2μg/ml Fentanyl at the rate of 5 ml/hr in both groups. Parameters noted were Mean Arterial Pressure (MAP), Heart Rate (HR), Oxygen Saturation (SpO2), Arterial Blood Gas (PaCO2, P/F ratio), Visual Analogue Scale (VAS) and Four Point Observer Ranking Scale (FPORS) for pain, number of sensory segments blocked (by checking for pinprick sensation), requirement of infusion top ups and rescue analgesia (Tramadol), pre and postoperative pulmonary function test {(Forced Expiratory Volume (FEV)1, Forced Vital Capacity (FVC), FEV1/FVC, Peak Expiratory Flow Rate (PEFR)} and complications from start of infusion till 24 hours in the postoperative period. Results Both the techniques were effective in relieving pain but pain relief was significantly better with epidural. Postoperatively, HR, SpO2, P/F ratio and PaCO2 were comparable between group E and P. There was significant decline in FeV1

  20. Acute lung injury after thoracic surgery.

    PubMed

    Eichenbaum, Kenneth D; Neustein, Steven M

    2010-08-01

    In this review, the authors discussed criteria for diagnosing ALI; incidence, etiology, preoperative risk factors, intraoperative management, risk-reduction strategies, treatment, and prognosis. The anesthesiologist needs to maintain an index of suspicion for ALI in the perioperative period of thoracic surgery, particularly after lung resection on the right side. Acute hypoxemia, imaging analysis for diffuse infiltrates, and detecting a noncardiogenic origin for pulmonary edema are important hallmarks of acute lung injury. Conservative intraoperative fluid administration of neutral to slightly negative fluid balance over the postoperative first week can reduce the number of ventilator days. Fluid management may be optimized with the assistance of new imaging techniques, and the anesthesiologist should monitor for transfusion-related lung injuries. Small tidal volumes of 6 mL/kg and low plateau pressures of < or =30 cmH2O may reduce organ and systemic failure. PEEP may improve oxygenation and increases organ failure-free days but has not shown a mortality benefit. The optimal mode of ventilation has not been shown in perioperative studies. Permissive hypercapnia may be needed in order to reduce lung injury from positive-pressure ventilation. NO is not recommended as a treatment. Strategies such as bronchodilation, smoking cessation, steroids, and recruitment maneuvers are unproven to benefit mortality although symptomatically they often have been shown to help ALI patients. Further studies to isolate biomarkers active in the acute setting of lung injury and pharmacologic agents to inhibit inflammatory intermediates may help improve management of this complex disease.

  1. Conduits for Coronary Bypass: Internal Thoracic Artery

    PubMed Central

    2012-01-01

    This second report in the series on coronary artery bypass presents the authors experience and personal views on the internal thoracic artery (ITA) which date to 1966. There has been a very gradual evolution in the acceptance of this conduit which was initially compared with the saphenous vein and viewed as an improbable alternative to it. As is common with concepts and techniques which are 'outside the box' there was skepticism and criticism of this new conduit which was more difficult and time consuming to harvest for the surgeon who had to do it all. It was viewed as small, fragile, spastic and its flow capacity was questioned. Only a few surgeons employed it because of these issues and some of them would frequently graft it to the diagonal artery as it was thought not to supply adequate flow for the left anterior descending unless it was small. After a decade, angiographic data revealed superior patency to vein grafts. Even this evidence and survival benefit reported a few years later did not convince many surgeons that their concerns about limitations justified its use. Thus widespread adaption of the ITA as the conduit of choice for the anterior descending required another decade and bilateral use is only now expanding to more than 5% of patients in the US and somewhat faster in other countries. PMID:23275918

  2. Computer modeling of thoracic response to blast.

    PubMed

    Stuhmiller, J H; Chuong, C J; Phillips, Y Y; Dodd, K T

    1988-01-01

    Primary blast injury affects the gas-containing structures of the body. Damage to the lungs with resultant respiratory insufficiency and arterial embolization of air from alveolar pulmonary venous fistulae is the predominant cause of morbidity and mortality following high-level blast exposure. In an effort to generate a widely applicable damage-risk criterion for thoracic injury from blast we are developing a complex computer finite element model (FEM) of the thorax. Taking an engineering approach, a horizontal cross-section of the thorax is divided into small discrete units (finite elements) of homogeneous structure. The necessary physical properties (density, bulk modulus, etc.) are then determined for each element. Specifying the material constants and geometry of the elements, the computer can load the surface of the structure with some force-time function (blast pressure-time history) and calculate the resultant physical events such as displacement, compression, stress, strain, etc. Computer predictions of pressure wave phenomena in the lung parenchyma are compared with trans-bronchially measured pressures in blast-exposed animals. The model should prove useful in assessing the risk of blast injury in diverse overpressure environments and may give insight into pathophysiologic mechanisms and strategies for protection.

  3. Endovascular Management of Thoracic Aortic Aneurysms

    SciTech Connect

    Fattori, Rossella Russo, Vincenzo; Lovato, Luigi; Buttazzi, Katia; Rinaldi, Giovanni

    2011-12-15

    The overall survival of patients with thoracic aortic aneurysm (TAA) has improved significantly in the past few years. Endovascular treatment, proposed as an alternative to surgery, has been considered a therapeutic innovation because of its low degree of invasiveness, which allows the treatment of even high-surgical risk patients with limited complications and mortality. A major limitation is the lack of adequate evidence regarding long-term benefit and durability because follow-up has been limited to just a few years even in the largest series. The combination of endovascular exclusion with visceral branch revascularization for the treatment of thoraco-abdominal aortic aneurysms involving the visceral aorta has also been attempted. As an alternative, endografts with branches represent a technological evolution that allows treatment of complex anatomy. Even if only small numbers of patients and short follow-up are available, this technical approach, which has with limited mortality (<10%) and paraplegia rates, to expand endovascular treatment to TAA seems feasible. With improved capability to recognize proper anatomy and select clinical candidates, the choice of endovascular stent-graft placement may offer a strategy to optimize management and improve prognosis.

  4. Cytomegalovirus Immunoglobulin After Thoracic Transplantation: An Overview.

    PubMed

    Grossi, Paolo; Mohacsi, Paul; Szabolcs, Zoltán; Potena, Luciano

    2016-03-01

    Cytomegalovirus (CMV) is a highly complex pathogen which, despite modern prophylactic regimens, continues to affect a high proportion of thoracic organ transplant recipients. The symptomatic manifestations of CMV infection are compounded by adverse indirect effects induced by the multiple immunomodulatory actions of CMV. These include a higher risk of acute rejection, cardiac allograft vasculopathy after heart transplantation, and potentially bronchiolitis obliterans syndrome in lung transplant recipients, with a greater propensity for opportunistic secondary infections. Prophylaxis for CMV using antiviral agents (typically oral valganciclovir or intravenous ganciclovir) is now almost universal, at least in high-risk transplants (D+/R-). Even with extended prophylactic regimens, however, challenges remain. The CMV events can still occur despite antiviral prophylaxis, including late-onset infection or recurrent disease, and patients with ganciclovir-resistant CMV infection or who are intolerant to antiviral therapy require alternative strategies. The CMV immunoglobulin (CMVIG) and antiviral agents have complementary modes of action. High-titer CMVIG preparations provide passive CMV-specific immunity but also exert complex immunomodulatory properties which augment the antiviral effect of antiviral agents and offer the potential to suppress the indirect effects of CMV infection. This supplement discusses the available data concerning the immunological and clinical effects of CMVIG after heart or lung transplantation.

  5. Molecular Mechanisms of Thoracic Aortic Dissection

    PubMed Central

    Wu, Darrell; Shen, Ying H.; Russell, Ludivine; Coselli, Joseph S.; LeMaire, Scott A.

    2013-01-01

    Thoracic aortic dissection (TAD) is a highly lethal vascular disease. In many patients with TAD, the aorta progressively dilates and ultimately ruptures. Dissection formation, progression, and rupture cannot be reliably prevented pharmacologically because the molecular mechanisms of aortic wall degeneration are poorly understood. The key histopathologic feature of TAD is medial degeneration, a process characterized by smooth muscle cell depletion and extracellular matrix degradation. These structural changes have a profound impact on the functional properties of the aortic wall and can result from excessive protease-mediated destruction of the extracellular matrix, altered signaling pathways, and altered gene expression. Review of the literature reveals differences in the processes that lead to ascending versus descending and sporadic versus hereditary TAD. These differences add to the complexity of this disease. Although tremendous progress has been made in diagnosing and treating TAD, a better understanding of the molecular, cellular, and genetic mechanisms that cause this disease is necessary to developing more effective preventative and therapeutic treatment strategies. PMID:23856125

  6. Selective lung intubation during paediatric thoracic surgeries.

    PubMed

    Mixa, V; Nedomova, B; Rygl, M

    2016-01-01

    Selective lung intubation is a necessary prerequisite for the completion of most interventions comprising thoracotomy and thoracoscopy. In paediatric care, our site uses Univent tubes for children up to the age of three years and double-lumen tubes (DLT) for children from 6-8 years of age. In younger children, we usually use regular endotracheal intubation, with the lung being held in the hemithorax position being operated on using a surgical retractor. The article presents the analysis of 860 thoracic surgeries, of which 491 comprised selective intubation (Univent 57 cases, DLT 434 cases). The use of the aforementioned devices is connected with certain complications. Univent tube can be connected with intraoperative dislocation of the obturating balloon (29.8%) and balloon perforation (5.2%). DLT insertion may be connected with failure of tube fitting. In 84 cases we had to repeat DLT insertion (20.6%). In 8 cases we were not able to insert DLT at all (1.8%). Standard use of selective intubation methods in paediatric patients from two years of age improved the conditions for surgical interventions (Tab. 2, Fig. 2, Ref. 19). PMID:27546541

  7. 7 CFR 56.41 - Check grading officially identified product.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (CONTINUED) VOLUNTARY GRADING OF SHELL EGGS Grading of Shell Eggs Prerequisites to Packaging Shell Eggs Identified with Grademarks § 56.41 Check grading officially identified product. Officially identified...

  8. 75 FR 61512 - Outer Continental Shelf Official Protraction Diagrams

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... Outer Continental Shelf Official Protraction Diagrams (OPDs) located within Atlantic Ocean areas, with... Bureau of Ocean Energy Management, Regulation and Enforcement Outer Continental Shelf Official Protraction Diagrams AGENCY: Bureau of Ocean Energy Management, Regulation and Enforcement, Interior....

  9. Developing the Governance Capacity of Local Elected Officials.

    ERIC Educational Resources Information Center

    Vogelsang-Coombs, Vera; Miller, Melissa

    1999-01-01

    Discusses a study of the necessity of leadership training for local elected officials (LEOs). Shows why local governments cannot exist without competent LEOs and suggests how public-administration educators can help prepare elected officials for municipal governance. (JOW)

  10. 5 CFR 2635.705 - Use of official time.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... performance of official duties. Example 1: An employee of the Social Security Administration may use official... the Department of Housing and Urban Development may not ask his secretary to type his...

  11. 7 CFR 62.212 - Official assessment reports.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURAL COMMODITIES (QUALITY SYSTEMS VERIFICATION PROGRAMS) Quality Systems Verification Programs Definitions Service § 62.212 Official assessment reports. Official QSVP assessment reports shall be generated... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE...

  12. 45 CFR 73.735-307 - Use of official information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... interests. Such a use of official information is clearly a violation of a public trust. Employees shall not... private interest, official information not made available to the general public. (b) The Privacy...

  13. 45 CFR 73.735-307 - Use of official information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... interests. Such a use of official information is clearly a violation of a public trust. Employees shall not... private interest, official information not made available to the general public. (b) The Privacy...

  14. 45 CFR 73.735-307 - Use of official information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... interests. Such a use of official information is clearly a violation of a public trust. Employees shall not... private interest, official information not made available to the general public. (b) The Privacy...

  15. 45 CFR 73.735-307 - Use of official information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... interests. Such a use of official information is clearly a violation of a public trust. Employees shall not... private interest, official information not made available to the general public. (b) The Privacy...

  16. 32 CFR 234.5 - Compliance with official signs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) MISCELLANEOUS CONDUCT ON THE PENTAGON RESERVATION § 234.5 Compliance with official signs. Persons on the Pentagon Reservation shall at all times comply with official signs of a prohibitory, regulatory,...

  17. 32 CFR 234.5 - Compliance with official signs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) MISCELLANEOUS CONDUCT ON THE PENTAGON RESERVATION § 234.5 Compliance with official signs. Persons on the Pentagon Reservation shall at all times comply with official signs of a prohibitory, regulatory,...

  18. 32 CFR 234.5 - Compliance with official signs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) MISCELLANEOUS CONDUCT ON THE PENTAGON RESERVATION § 234.5 Compliance with official signs. Persons on the Pentagon Reservation shall at all times comply with official signs of a prohibitory, regulatory,...

  19. 32 CFR 234.5 - Compliance with official signs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) MISCELLANEOUS CONDUCT ON THE PENTAGON RESERVATION § 234.5 Compliance with official signs. Persons on the Pentagon Reservation shall at all times comply with official signs of a prohibitory, regulatory,...

  20. 32 CFR 234.5 - Compliance with official signs.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) MISCELLANEOUS CONDUCT ON THE PENTAGON RESERVATION § 234.5 Compliance with official signs. Persons on the Pentagon Reservation shall at all times comply with official signs of a prohibitory, regulatory,...

  1. Effectiveness of a thoracic multidisciplinary clinic in the treatment of stage III non-small-cell lung cancer

    PubMed Central

    Friedman, Eliot L; Kruklitis, Robert J; Patson, Brian J; Sopka, Dennis M; Weiss, Michael J

    2016-01-01

    Introduction The Institute of Medicine, the American Society of Clinical Oncology, and the European Society of Medical Oncology promote a multidisciplinary approach for the treatment of cancer. Stage III non-small-cell lung cancer (NSCLC) represents a heterogeneous group of diseases necessitating coordination of care among medical, radiation, and surgical oncology. The optimal care of stage III NSCLC underscores the need for a multidisciplinary approach. Methods From tumor registry data, we identified all cases of stage III NSCLC seen at Lehigh Valley Health Network between March 2010 and March 2013. The care received by patients when seen in the thoracic multidisciplinary clinic (MDC) was compared with the care received when not seen in the thoracic MDC. Results All patients seen in the MDC, compared to <50% of patients seen outside the MDC, were evaluated by more than one physician prior to beginning the treatment. Time to initiate treatment was shorter in MDC patients than in non-MDC patients. Patients seen in the MDC had a greater concordance with clinical pathways. A greater percentage of patients seen in the thoracic MDC had pathologic staging of their mediastinum. Patients seen in the MDC were more likely to receive all of their care at Lehigh Valley Health Network. Conclusion Multidisciplinary care is essential in the treatment of patients with stage III NSCLC. Greater utilization of MDCs for this complex group of patients will result in more efficient coordination of care, pretreatment evaluation, and therapy, which in turn should translate to improve patients’ outcomes. PMID:27358568

  2. Investigation of pulsatile flowfield in healthy thoracic aorta models.

    PubMed

    Wen, Chih-Yung; Yang, An-Shik; Tseng, Li-Yu; Chai, Jyh-Wen

    2010-02-01

    Cardiovascular disease is the primary cause of morbidity and mortality in the western world. Complex hemodynamics plays a critical role in the development of aortic dissection and atherosclerosis, as well as many other diseases. Since fundamental fluid mechanics are important for the understanding of the blood flow in the cardiovascular circulatory system of the human body aspects, a joint experimental and numerical study was conducted in this study to determine the distributions of wall shear stress and pressure and oscillatory WSS index, and to examine their correlation with the aortic disorders, especially dissection. Experimentally, the Phase-Contrast Magnetic Resonance Imaging (PC-MRI) method was used to acquire the true geometry of a normal human thoracic aorta, which was readily converted into a transparent thoracic aorta model by the rapid prototyping (RP) technique. The thoracic aorta model was then used in the in vitro experiments and computations. Simulations were performed using the computational fluid dynamic (CFD) code ACE+((R)) to determine flow characteristics of the three-dimensional, pulsatile, incompressible, and Newtonian fluid in the thoracic aorta model. The unsteady boundary conditions at the inlet and the outlet of the aortic flow were specified from the measured flowrate and pressure results during in vitro experiments. For the code validation, the predicted axial velocity reasonably agrees with the PC-MRI experimental data in the oblique sagittal plane of the thoracic aorta model. The thorough analyses of the thoracic aorta flow, WSSs, WSS index (OSI), and wall pressures are presented. The predicted locations of the maxima of WSS and the wall pressure can be then correlated with that of the thoracic aorta dissection, and thereby may lead to a useful biological significance. The numerical results also suggest that the effects of low WSS and high OSI tend to cause wall thickening occurred along the inferior wall of the aortic arch and the

  3. "An Affirmation of the Abilities of Woman": Women's Contributions to the American Academy of Kinesiology and Physical Education

    ERIC Educational Resources Information Center

    Park, Roberta J.

    2006-01-01

    Women attained leadership roles within the American Physical Education Association much earlier than in organizations like the American Medical Association and the American Physiological Society. Women also were members of the American Academy of Physical Education before its official founding in 1930. Archival records and responses by current…

  4. 9 CFR 305.2 - Separation of official establishments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Separation of official establishments. 305.2 Section 305.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.2 Separation of official establishments. (a) Each official establishment shall...

  5. 9 CFR 305.2 - Separation of official establishments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Separation of official establishments. 305.2 Section 305.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.2 Separation of official establishments. (a) Each official establishment shall...

  6. 9 CFR 305.2 - Separation of official establishments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Separation of official establishments. 305.2 Section 305.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.2 Separation of official establishments. (a) Each official establishment shall...

  7. 9 CFR 305.2 - Separation of official establishments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Separation of official establishments. 305.2 Section 305.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.2 Separation of official establishments. (a) Each official establishment shall...

  8. 9 CFR 305.2 - Separation of official establishments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Separation of official establishments. 305.2 Section 305.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... OF VIOLATION § 305.2 Separation of official establishments. (a) Each official establishment shall...

  9. 34 CFR 85.942 - ED Deciding Official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false ED Deciding Official. 85.942 Section 85.942 Education Office of the Secretary, Department of Education GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 85.942 ED Deciding Official. The ED Deciding Official is an ED officer who has...

  10. 46 CFR 131.630 - Entries in official logbooks.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Entries in official logbooks. 131.630 Section 131.630 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS OPERATIONS Logs § 131.630 Entries in official logbooks. On each vessel required to have an Official Logbook, the...

  11. 22 CFR 41.23 - Accredited officials in transit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Accredited officials in transit. 41.23 Section 41.23 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.23 Accredited officials...

  12. 31 CFR 0.105 - Deputy Ethics Official.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Deputy Ethics Official. 0.105 Section... EMPLOYEE RULES OF CONDUCT General Provisions Responsibilities § 0.105 Deputy Ethics Official. The Chief Counsel or Legal Counsel for a bureau, or a designee, is the Deputy Ethics Official for that bureau....

  13. 31 CFR 0.105 - Deputy Ethics Official.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Deputy Ethics Official. 0.105 Section... EMPLOYEE RULES OF CONDUCT General Provisions Responsibilities § 0.105 Deputy Ethics Official. The Chief Counsel or Legal Counsel for a bureau, or a designee, is the Deputy Ethics Official for that bureau....

  14. 31 CFR 0.105 - Deputy Ethics Official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Deputy Ethics Official. 0.105 Section... EMPLOYEE RULES OF CONDUCT General Provisions Responsibilities § 0.105 Deputy Ethics Official. The Chief Counsel or Legal Counsel for a bureau, or a designee, is the Deputy Ethics Official for that bureau....

  15. 14 CFR § 1207.103 - Designations of responsible officials.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... delegated the authority to coordinate and manage NASA's ethics program as set forth in 5 CFR 2638.203. (b... Counsel at each NASA Center and Component Facility. (d) Agency Designee. As used in 5 CFR part 2635, the... Official, Alternate Designated Agency Ethics Official, and Deputy Ethics Officials, see 5 CFR part...

  16. 18 CFR 1301.63 - Senior agency official.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... agency official to direct and administer its information security program. TVA's senior agency official is the Director, Enterprise Information Security & Policy. (b) Questions with respect to the... Protection of National Security Classified Information § 1301.63 Senior agency official. (a) The...

  17. 18 CFR 1301.63 - Senior agency official.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... agency official to direct and administer its information security program. TVA's senior agency official is the Director, Enterprise Information Security & Policy. (b) Questions with respect to the... Protection of National Security Classified Information § 1301.63 Senior agency official. (a) The...

  18. 18 CFR 1301.63 - Senior agency official.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... agency official to direct and administer its information security program. TVA's senior agency official is the Director, Enterprise Information Security & Policy. (b) Questions with respect to the... Protection of National Security Classified Information § 1301.63 Senior agency official. (a) The...

  19. 9 CFR 354.71 - Affixing of official identification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INSPECTION AND CERTIFICATION VOLUNTARY INSPECTION OF RABBITS AND EDIBLE PRODUCTS THEREOF Supervision of... inspected and certified products to be shipped from one official plant to another official plant for further... manner as may be approved by the Administrator; and (5) The plant number of the official plant where...

  20. 9 CFR 354.71 - Affixing of official identification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INSPECTION AND CERTIFICATION VOLUNTARY INSPECTION OF RABBITS AND EDIBLE PRODUCTS THEREOF Supervision of... inspected and certified products to be shipped from one official plant to another official plant for further... manner as may be approved by the Administrator; and (5) The plant number of the official plant where...

  1. 9 CFR 2.51 - Form of official tag.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Form of official tag. 2.51 Section 2.51 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Identification of Animals § 2.51 Form of official tag. (a) The official...

  2. 13 CFR 105.403 - Designated Agency Ethics Officials.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Designated Agency Ethics Officials. 105.403 Section 105.403 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION STANDARDS OF... Agency Ethics Officials. The Designated Agency Ethics Official and Alternates administer the program...

  3. 13 CFR 105.403 - Designated Agency Ethics Officials.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Designated Agency Ethics Officials. 105.403 Section 105.403 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION STANDARDS OF... Agency Ethics Officials. The Designated Agency Ethics Official and Alternates administer the program...

  4. 13 CFR 105.403 - Designated Agency Ethics Officials.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Designated Agency Ethics Officials. 105.403 Section 105.403 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION STANDARDS OF... Agency Ethics Officials. The Designated Agency Ethics Official and Alternates administer the program...

  5. 13 CFR 105.403 - Designated Agency Ethics Officials.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Designated Agency Ethics Officials. 105.403 Section 105.403 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION STANDARDS OF... Agency Ethics Officials. The Designated Agency Ethics Official and Alternates administer the program...

  6. 22 CFR 41.22 - Officials of foreign governments.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.22 Officials of foreign... and acting courier on official business—(1) Courier of career. An alien regularly and professionally... professionally employed as a courier by the government of the country to which the alien owes allegiance...

  7. 22 CFR 41.22 - Officials of foreign governments.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.22 Officials of foreign...) Courier of career. An alien regularly and professionally employed as a courier by the government of the...) Official acting as courier. An alien not regularly and professionally employed as a courier by...

  8. 31 CFR 0.105 - Deputy Ethics Official.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Deputy Ethics Official. 0.105 Section... EMPLOYEE RULES OF CONDUCT General Provisions Responsibilities § 0.105 Deputy Ethics Official. The Chief Counsel or Legal Counsel for a bureau, or a designee, is the Deputy Ethics Official for that bureau....

  9. 31 CFR 0.105 - Deputy Ethics Official.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Deputy Ethics Official. 0.105 Section... EMPLOYEE RULES OF CONDUCT General Provisions Responsibilities § 0.105 Deputy Ethics Official. The Chief Counsel or Legal Counsel for a bureau, or a designee, is the Deputy Ethics Official for that bureau....

  10. 12 CFR 268.605 - Representation and official time.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Representation and official time. 268.605... Representation and official time. (a) At any stage in the processing of a complaint, including the counseling... or she shall have a reasonable amount of official time, if otherwise on duty, to prepare...

  11. 12 CFR 268.605 - Representation and official time.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 4 2013-01-01 2013-01-01 false Representation and official time. 268.605... Representation and official time. (a) At any stage in the processing of a complaint, including the counseling... or she shall have a reasonable amount of official time, if otherwise on duty, to prepare...

  12. 12 CFR 268.605 - Representation and official time.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Representation and official time. 268.605... and official time. (a) At any stage in the processing of a complaint, including the counseling stage... a reasonable amount of official time, if otherwise on duty, to prepare the complaint and to...

  13. 22 CFR 41.25 - NATO representatives, officials, and employees.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false NATO representatives, officials, and employees... UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.25 NATO representatives, officials, and employees. (a) Classification. An alien shall be classified under the symbol...

  14. 22 CFR 41.25 - NATO representatives, officials, and employees.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false NATO representatives, officials, and employees... UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.25 NATO representatives, officials, and employees. (a) Classification. An alien shall be classified under the symbol...

  15. 22 CFR 41.25 - NATO representatives, officials, and employees.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false NATO representatives, officials, and employees... UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.25 NATO representatives, officials, and employees. (a) Classification. An alien shall be classified under the symbol...

  16. 45 CFR 73.735-202 - Management officials.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Management officials. 73.735-202 Section 73.735... Responsibilities § 73.735-202 Management officials. (a) The Department has an obligation to enforce the... management official, or the Inspector General, as necessary, with his or her legal evaluation of the...

  17. 45 CFR 73.735-202 - Management officials.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Management officials. 73.735-202 Section 73.735... Responsibilities § 73.735-202 Management officials. (a) The Department has an obligation to enforce the... management official, or the Inspector General, as necessary, with his or her legal evaluation of the...

  18. 9 CFR 590.30 - At official plants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false At official plants. 590.30 Section 590... Authorities § 590.30 At official plants. (a) Requirements within the scope of the Act with respect to premises, facilities, and operations of any official plant which are in addition to or different than those made...

  19. 9 CFR 590.30 - At official plants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false At official plants. 590.30 Section 590... Authorities § 590.30 At official plants. (a) Requirements within the scope of the Act with respect to premises, facilities, and operations of any official plant which are in addition to or different than those made...

  20. 9 CFR 590.150 - Official plant numbers.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Official plant numbers. 590.150... of Service § 590.150 Official plant numbers. An official plant number shall be assigned to each plant granted inspection service. Such plant number shall be used to identify all containers of...

  1. 9 CFR 590.150 - Official plant numbers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Official plant numbers. 590.150... of Service § 590.150 Official plant numbers. An official plant number shall be assigned to each plant granted inspection service. Such plant number shall be used to identify all containers of...

  2. 9 CFR 590.30 - At official plants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false At official plants. 590.30 Section 590... Authorities § 590.30 At official plants. (a) Requirements within the scope of the Act with respect to premises, facilities, and operations of any official plant which are in addition to or different than those made...

  3. 9 CFR 590.150 - Official plant numbers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Official plant numbers. 590.150... of Service § 590.150 Official plant numbers. An official plant number shall be assigned to each plant granted inspection service. Such plant number shall be used to identify all containers of...

  4. 7 CFR 800.156 - Official inspection records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Official Records... official factor or an official criteria, an approved abbreviation may be used. (d) File samples—(1) General... in a sample shall include one or more file samples as prescribed in the instructions. (2) Size....

  5. 41 CFR 60-30.22 - Official transcript.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Official transcript. 60-30.22 Section 60-30.22 Public Contracts and Property Management Other Provisions Relating to Public... ORDER 11246 Hearings and Related Matters § 60-30.22 Official transcript. The official transcripts...

  6. 41 CFR 60-30.22 - Official transcript.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Official transcript. 60-30.22 Section 60-30.22 Public Contracts and Property Management Other Provisions Relating to Public... ORDER 11246 Hearings and Related Matters § 60-30.22 Official transcript. The official transcripts...

  7. 41 CFR 60-30.22 - Official transcript.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Official transcript. 60-30.22 Section 60-30.22 Public Contracts and Property Management Other Provisions Relating to Public... ORDER 11246 Hearings and Related Matters § 60-30.22 Official transcript. The official transcripts...

  8. 41 CFR 60-30.22 - Official transcript.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Official transcript. 60-30.22 Section 60-30.22 Public Contracts and Property Management Other Provisions Relating to Public... ORDER 11246 Hearings and Related Matters § 60-30.22 Official transcript. The official transcripts...

  9. 41 CFR 60-30.22 - Official transcript.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 1 2014-07-01 2014-07-01 false Official transcript. 60-30.22 Section 60-30.22 Public Contracts and Property Management Other Provisions Relating to Public... ORDER 11246 Hearings and Related Matters § 60-30.22 Official transcript. The official transcripts...

  10. 13 CFR 105.403 - Designated Agency Ethics Officials.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Designated Agency Ethics Officials. 105.403 Section 105.403 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION STANDARDS OF... Agency Ethics Officials. The Designated Agency Ethics Official and Alternates administer the program...

  11. 22 CFR 41.23 - Accredited officials in transit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 41.23 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.23 Accredited officials in... transit through the United States on official business for that government is entitled to the benefits...

  12. 9 CFR 590.30 - At official plants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false At official plants. 590.30 Section 590... Authorities § 590.30 At official plants. (a) Requirements within the scope of the Act with respect to premises, facilities, and operations of any official plant which are in addition to or different than those made...

  13. 9 CFR 590.150 - Official plant numbers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Official plant numbers. 590.150... of Service § 590.150 Official plant numbers. An official plant number shall be assigned to each plant granted inspection service. Such plant number shall be used to identify all containers of...

  14. 39 CFR 601.108 - SDR Official disagreement resolution.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false SDR Official disagreement resolution. 601.108...: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.108 SDR Official... not to accept or consider proposals under § 601.105 is contested, the SDR Official is available...

  15. 39 CFR 601.108 - SDR Official disagreement resolution.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false SDR Official disagreement resolution. 601.108...: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.108 SDR Official... not to accept or consider proposals under § 601.105 is contested, the SDR Official is available...

  16. 39 CFR 601.108 - SDR Official disagreement resolution.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false SDR Official disagreement resolution. 601.108...: INTELLECTUAL PROPERTY RIGHTS OTHER THAN PATENTS PURCHASING OF PROPERTY AND SERVICES § 601.108 SDR Official... not to accept or consider proposals under § 601.105 is contested, the SDR Official is available...

  17. 12 CFR 328.3 - Official advertising statement requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Official advertising statement requirements... OF GENERAL POLICY ADVERTISEMENT OF MEMBERSHIP § 328.3 Official advertising statement requirements. (a... advertising statement. The official advertising statement shall be in substance as follows: “Member of...

  18. 29 CFR 1960.54 - Training of top management officials.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Training of top management officials. 1960.54 Section 1960... PROGRAMS AND RELATED MATTERS Training § 1960.54 Training of top management officials. Each agency shall provide top management officials with orientation and other learning experiences which will enable them...

  19. 29 CFR 1960.54 - Training of top management officials.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Training of top management officials. 1960.54 Section 1960... PROGRAMS AND RELATED MATTERS Training § 1960.54 Training of top management officials. Each agency shall provide top management officials with orientation and other learning experiences which will enable them...

  20. 29 CFR 1960.54 - Training of top management officials.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Training of top management officials. 1960.54 Section 1960... PROGRAMS AND RELATED MATTERS Training § 1960.54 Training of top management officials. Each agency shall provide top management officials with orientation and other learning experiences which will enable them...