Sample records for painless gross hematuria

  1. Gross intermittent hematuria after laparoscopic donor nephrectomy

    PubMed Central

    Gaurav, G; Santosh, K; Samiran, A; Ganesh, G

    2008-01-01

    Laparoscopic donor nephrectomy is a routine practice but still requires an intense level of attention to prevent complications. We report a rare case of gross hematuria in postoperative period after an uneventful laparoscopic donor nephrectomy. PMID:19547672

  2. Balloon-Occluded Percutaneous Transhepatic Obliteration of Isolated Vesical Varices Causing Gross Hematuria

    PubMed Central

    Lim, Dong Hoon; Kim, Min Seok; Kim, Chul Sung

    2013-01-01

    Gross hematuria secondary to vesical varices is an unusual presentation. We report such a case recurrent gross hematuria in a male patient who had a history of bladder substitution with ileal segments that had been treated by balloon-occluded percutaneous transhepatic obliteration of vesical varices. PMID:23323037

  3. Gross Hematuria: Assessment and Management at the End of Life

    PubMed Central

    Groninger, Hunter; Phillips, Jayne M.

    2013-01-01

    A distressing complication for patients and families, gross hematuria at the end of life challenges hospice and palliative care clinicians to utilize skills in medical and nursing management, communication and clarification of patient goals, and relief of symptom burden. Massive hemorrhage in the genitourinary tract can radically alter the terminal trajectory for patients and necessitate intensive interventions aimed at promoting comfort. Here, a case of gross hematuria in an adult hospice patient serves to broaching decision-making challenges and management strategies. PMID:24826082

  4. Gross hematuria and urinary retention among men from a nationally representative survey in Sierra Leone.

    PubMed

    Patel, Hiten D; Kamara, Thaim B; Kushner, Adam L; Groen, Reinou S; Allaf, Mohamad E

    2014-06-01

    To estimate the prevalence of gross hematuria and urinary retention among men in Sierra Leone and report on barriers to care and associated disability. Gross hematuria and urinary retention are classic urologic complaints that require medical attention for significant underlying pathology, but their burden has not been quantified in a developing country. A cluster randomized, cross-sectional household survey was administered in Sierra Leone using the Surgeons OverSeas Assessment of Surgical need tool as a verbal head-to-toe examination. A total of 2 respondents in each of 25 households in 75 clusters were surveyed to assess surgical needs. Data on questions related to blood from the penis and the inability to urinate for men>12 years were included in the present analysis to determine the period and point prevalence of hematuria and urinary retention. From 3645 total respondents, 1054 (28.9%) were men>12 years included in the analysis. Period and point prevalence of gross hematuria were 21.8 per 1000 (95% confidence interval [CI] 13.0-30.7) and 12.3 per 1000 (95% CI 5.7-19.0), respectively, and for urinary retention, they were 19.9 per 1000 (95% CI 11.5-28.4) and 4.7 per 1000 (95% CI 0.5-8.9), respectively. Lack of financial resources was the major barrier to care. Disability assessment showed 19.1% were not able to work as a result of urinary retention, and 34.8% felt ashamed of their gross hematuria. The results provide a prevalence estimate of gross hematuria and urinary retention for men in Sierra Leone. Accessible medical and surgical care will be critical for early intervention and management. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Effect of tranexamic acid on gross hematuria: A pilot randomized clinical trial study.

    PubMed

    Moharamzadeh, Payman; Ojaghihaghighi, Seyedhossein; Amjadi, Mohsen; Rahmani, Farzad; Farjamnia, Arezoo

    2017-12-01

    Local forms of the tranexamic acid have been effective in treating many haemorrhagic cases. So that the aim of the current study is to assess the effectiveness of local tranexamic acid in controlling painless hematuria in patients referred to the emergency department. This is a randomized, double-blind clinical trial study, which was conducted on 50 patients with complaints of painless lower urinary tract bleeding during June 2014 and August 2015. The patients were randomly divided into two groups of 25 people each, one group receiving tranexamic acid and the other given a placebo. During bladder irrigation, local tranexamic acid and the placebo were injected into the bladder via Foley catheter. Patients were examined over 24h in terms of the amount of normal saline serum used for irrigation, level of hemoglobin, and blood in urine. In this study it was observed that consumption of tranexamic acid significantly decreased the volume of used serum for bladder irrigation (P=0.041) and the microscopic status of urine decreased significantly in terms of the hematuria after 24h (P=0.026). However, the rate of packed cell transfusion and drop in hemoglobin levels showed no significant difference in both groups of patients (P˃0.05). The results of this study showed that tranexamic acid could significantly reduce the volume of required serum for bladder irrigation to clear urine, but it had no significant effect on the drop in serum hemoglobin levels. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Xp11.2 translocation tumor: a rare cause of gross hematuria.

    PubMed

    Asaki, Howard E; Moshero, Gianni; Stanton, Melissa L; Humphreys, Mitchell R

    2014-02-01

    Xp11.2 translocation tumor is a rare but aggressive form of renal cell carcinoma that predominantly occurs in children but also may be found in young adults. Because this type of cancer is diagnosed via histologic and chromosomal analysis, clinicians should consider translocation tumor in the differential diagnosis of patients with renal lesions and gross hematuria.

  7. A Cough Deteriorating Gross Hematuria: A Clinical Sign of a Forthcoming Life-Threatening Rupture of an Intraparenchymal Aneurysm of Renal Artery (Wunderlich's Syndrome)

    PubMed Central

    Anastasiou, Ioannis; Pournaras, Christos; Mitropoulos, Dionysios; Constantinides, Constantinos A.

    2013-01-01

    Macroscopic hematuria regards the 4% to 20% of all urological visits. Renal artery aneurysms (RAAs) are detected in approximately 0.01%–1% of the general population, while intraparenchymal renal artery aneurysms (IPRAAs) are even more rarely detected in less than 10% of patients with RAAs. We present a case of a 58-year-old woman that came into the emergency room (ER) complaining of a gross hematuria during the last four days. Although in the ER room the first urine sample was clear after a cough episode, a severe gross hematuria began which led to a hemodynamically unstable patient. Finally, a radical nephrectomy was performed, and an IPRAA was the final diagnosis. A cough deteriorating hematuria could be attributed to a ruptured intraparenchymal renal artery aneurysm, which even though constitutes a rare entity, it is a life-threatening medical emergency. PMID:23864981

  8. Emphysematous cystitis: a rare cause of gross hematuria.

    PubMed

    Chang, Chirn-Bin; Chang, Chia-Chu

    2011-05-01

    Emphysematous cystitis is a relatively rare infectious condition of the urinary bladder. The mortality rate is high if the diagnosis is delayed or if the treatment is inadequate. We present an uncommon case of emphysematous cystitis and highlight the risk factors for this disease. An 81-year-old man with a past medical history of type 2 diabetes and a central pontine infarction presented to the Emergency Department due to gross hematuria. Computed tomography (CT) and plain radiography revealed localized gas within the bladder that was compatible with the diagnosis of emphysematous cystitis. A Foley catheter was inserted. Urine culture grew Klebsiella pneumoniae; 2 g cefotaxime daily was initiated. Subsequent plain radiography and CT scan showed regression of intraluminal gas. We recommend CT for the definitive diagnosis of emphysematous cystitis. Adequate antibiotic therapy, strict blood glucose control, adequate drainage of urine, and early goal-directed therapy for suspected sepsis are suggested to prevent the complications of emphysematous cystitis. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Loin pain hematuria syndrome.

    PubMed

    Taba Taba Vakili, Sahar; Alam, Tausif; Sollinger, Hans

    2014-09-01

    Loin pain hematuria syndrome is a rare disease with a prevalence of ∼0.012%. The most prominent clinical features include periods of severe intermittent or persistent unilateral or bilateral loin pain accompanied by either microscopic or gross hematuria. Patients with loin pain hematuria syndrome initially present with hematuria, flank pain, or most often both hematuria and flank pain. Kidney biopsies from patients with loin pain hematuria typically reveal only minor pathologic abnormalities. Further, loin pain hematuria syndrome is not associated with loss of kidney function or urinary tract infections. Loin pain hematuria syndrome-associated hematuria and pain are postulated to be linked to vascular disease of the kidney, coagulopathy, renal vasospasm with microinfarction, hypersensitivity, complement activation on arterioles, venocalyceal fistula, abnormal ureteral peristalsis, and intratubular deposition of calcium or uric acid microcrystals. Many patients with loin pain hematuria syndrome also meet criteria for a somatoform disorder, and analgesic medications, including narcotics, commonly are used to treat loin pain hematuria syndrome-associated pain. Interventional treatments include renal denervation, kidney autotransplantation, and nephrectomy; however, these methods should be used only as a last resort when less invasive measures have been tried unsuccessfully. In this review article, we discuss and critique current clinical practices related to loin pain hematuria syndrome pathophysiology, diagnosis, treatment, and prognosis. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  10. Giant prostatic hyperplasia: report of a previously asymptomatic man presenting with gross hematuria and hypovolemic shock

    PubMed Central

    Wroclawski, Marcelo Langer; Carneiro, Ariê; Tristão, Rodrigo Alves; Sakuramoto, Paulo Kouiti; Youssef, Jorg Daoud Merched; Lopes, Antonio Correa; Santiago, Lucila Heloísa Simardi; Pompeo, Antonio Carlos Lima

    2015-01-01

    Giant prostatic hyperplasia is a rare condition characterized by very high volume benign prostatic enlargement (>500g). Few cases have been reported so far and most of them are associated with severe lower urinary symptoms. We report the first case of asymptomatic giant prostatic hyperplasia in an elderly man who had a 720g prostate adenoma, sudden gross hematuria and hypovolemic shock. The patient was successfully treated with open transvesical prostatectomy and had an uneventful postoperative recovery. PMID:26132361

  11. Massive gross hematuria in a sickle cell trait patient with renal papillary necrosis. Conservative approach using a balloon ureteral catheter to tamponade the papilla bleeding.

    PubMed

    Herard, A; Colin, J; Youinou, Y; Drancourt, E; Brandt, B

    1998-08-01

    We report the case of a patient with heterozygous sickle cell trait presenting with massive gross hematuria. Ureteroscopy revealed bleeding from the tip of papilla of the inferior calica and allowed us to tamponade the bleeding with a balloon ureteral dilator set (Cook(R) Urology). We show the value of the endourological approach in the conservative management of these patients at high risk of recurrent hematuria.

  12. Recurrent urethral obstruction secondary to idiopathic renal hematuria in a puppy.

    PubMed

    Hawthorne, J C; deHaan, J J; Goring, R L; Randall, S R; Kennedy, F S; Stone, E; Zimmerman, K M; McAbee, S W

    1998-01-01

    A seven-month-old, neutered male Catahoula leopard dog cross was presented for recurrent urethral obstruction and intermittent hematuria. After exploratory laparotomy and ventral cystotomy, unilateral idiopathic renal hematuria was diagnosed based on gross observation of hematuria from the left ureteral catheter. The hematuria resolved after nephrectomy of the left kidney. The histopathological diagnosis was multifocal, acute congestion and intratubular hemorrhage. Although idiopathic renal hematuria has been described previously, this puppy was unique because the hematuria caused recurrent, complete urethral obstruction.

  13. Development of Endoscopic Diagnosis and Treatment for Chronic Unilateral Hematuria: 35 Years Experience.

    PubMed

    Tanimoto, Ryuta; Kumon, Hiromi; Bagley, Demetrius H

    2017-04-01

    Chronic unilateral hematuria (CUH) is also called lateralizing essential hematuria, benign essential hematuria, and benign lateralizing hematuria, which was defined as intermittent or continuous gross hematuria that cannot be diagnosed with standard radiology and hematology studies, together with unilateral bloody efflux by cystoscopy. CUH is rare, but sometimes confused with malignancy or life-threatening hemorrhage. Therefore, it can cause considerable anxiety to not only patients but also urologists. For this study, we summarized articles about endoscopic diagnosis and treatment of CUH, and discussed the development of endourology for CUH. We searched articles related to CUH that were indexed in the PubMed database and published in English. Key terms used were "unilateral," "lateralizing," "chronic," "benign," and "idiopathic" hematuria. We found 15 pertinent articles reporting CUH. Endoscopically, CUH can be classified into three categories: discrete lesion, diffuse lesion, or no (unidentified) lesion. Currently, endoscopic techniques for CUH are similar to the techniques for upper tract urothelial carcinoma, using semi-rigid and flexible ureteroscopes with diathermy fulguration or laser ablation for treatment. The overall success rate of endoscopic treatment for CUH, defined as resolution of gross hematuria after treatment, was 93% (190/205). The recurrence rate, defined as recurrent gross hematuria after treatment, was 10% (19/189). Advancements in endoscopic devices and techniques have enabled more accurate and less invasive diagnosis and treatment of CUH. Once CUH is defined, flexible ureteroscopy is the diagnostic and therapeutic technique of choice.

  14. Painless Urethral Bleeding During Penile Erection in an Adult Man With Klippel-Trenaunay Syndrome: A Case Report.

    PubMed

    Lei, Hongen; Guan, Xing; Han, Hu; Qian, Xiaosong; Zhou, Xiaoguang; Zhang, Xiaodong; Tian, Long

    2018-06-01

    Klippel-Trenaunay syndrome (KTS) is a rare congenital vascular disorder characterized by a triad of cutaneous port wine capillary malformations, varicose veins, and hemihypertrophy of bone and soft tissues. To report on a rare case of KTS in an adult man manifested by painless urethral bleeding during penile erection briefly review the clinical presentation and management of the genitourinary forms of this syndrome. On presentation, the clinical features of this patient, including medical history, signs and symptoms, and imaging examinations, were recorded. After diagnosis and initial treatment, a literature review of the urethral features of KTS was performed and is discussed in this report. A 35-year-old man with KTS presented with painless urethral bleeding during penile erection that was associated with posterior urethral vascular malformations. The coagulation method was used to treat the malformation, and no urethral bleeding or gross hematuria occurred during a postoperative follow-up period of 6 months. This case demonstrates that coagulation therapy and careful follow-up can be adequate treatment approaches for urethral features of KTS. However, the long-term efficacy of coagulation for this disorder should be investigated further. Lei H, Guan X, Han H, et al. Painless Urethral Bleeding During Penile Erection in an Adult Man With Klippel-Trenaunay Syndrome: A Case Report. Sex Med 2018;6:180-183. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Radiofrequency Ablation for Tumor-Related Massive Hematuria

    PubMed Central

    Neeman, Ziv; Sarin, Shawn; Coleman, Jonathan; Fojo, Tito; Wood, Bradford J.

    2008-01-01

    To determine whether radiofrequency (RF) ablation targeting the tumor-collecting system interface has a durable effect in patients with transfusion-dependent kidney tumor-related hematuria, four patients aged 61-71 years were successfully treated with RF ablation, with a mean follow up of 12 months. Baseline creatinine levels varied from 2.0 mg/dL to 3.7 mg/dL. All patients had received red blood cell transfusions in the days and hours before RF ablation. No subsequent surgical or interventional procedures were required for management of hematuria. Gross hematuria resolved in 24-48 hours in all four patients. Two of the patients are alive with stable renal function and two died of causes unrelated to treatment. RF ablation may be an effective therapeutic option for transfusion-dependent cancer-related hematuria in patients with renal insufficiency, solitary kidney, or comorbidities, or after failed conventional therapies in patients who are not candidates for surgery. PMID:15758142

  16. Radiofrequency ablation for tumor-related massive hematuria.

    PubMed

    Neeman, Ziv; Sarin, Shawn; Coleman, Jonathan; Fojo, Tito; Wood, Bradford J

    2005-03-01

    To determine whether radiofrequency (RF) ablation targeting the tumor-collecting system interface has a durable effect in patients with transfusion-dependent kidney tumor-related hematuria, four patients aged 61-71 years were successfully treated with RF ablation, with a mean follow up of 12 months. Baseline creatinine levels varied from 2.0 mg/dL to 3.7 mg/dL. All patients had received red blood cell transfusions in the days and hours before RF ablation. No subsequent surgical or interventional procedures were required for management of hematuria. Gross hematuria resolved in 24-48 hours in all four patients. Two of the patients are alive with stable renal function and two died of causes unrelated to treatment. RF ablation may be an effective therapeutic option for transfusion-dependent cancer-related hematuria in patients with renal insufficiency, solitary kidney, or comorbidities, or after failed conventional therapies in patients who are not candidates for surgery.

  17. Castleman's Disease: An Interesting Cause of Hematuria.

    PubMed

    Tolofari, Sotonye Karl; Chow, Wai-Man; Hussain, Basharat

    2015-03-01

    Castleman's disease is a rare benign lymphoproliferative disorder, characterized by benign growths of the lymph node tissue. It is associated with a number of malignancies, including Kaposi sarcoma, non-Hodgkin's and Hodgkins lymphoma, and POEMS syndrome. This report describes the case of a 38 year old gentleman, presenting with painless hematuria. Initial investigations, including flexible cystoscopy were unremarkable. However, subsequent imaging including CT Urogram and MR pelvis revealed multiple prevesical lesions. Histology obtained from excision biopsy revealed histological features consistent with Castleman's disease. In this report we discuss the nature, presentation and treatment modalities of this rare condition.

  18. Familial microscopic hematuria caused by hypercalciuria and hyperuricosuria.

    PubMed

    Praga, M; Alegre, R; Hernández, E; Morales, E; Domínguez-Gil, B; Carreño, A; Andrés, A

    2000-01-01

    We report 12 patients belonging to five different families in whom persistent isolated microhematuria was associated with hypercalciuria and/or hyperuricosuria. Four patients had episodes of gross hematuria, three patients had passed renal stones, and a history of nephrolithiasis was obtained in four of the families (80%). Calcium oxalate and uric acid crystals were commonly observed in the urine sediments. Urinary erythrocytes had a normal appearance on phase-microscopic examination. Reduction of calciuria and uricosuria by thiazide diuretics, allopurinol, forced fluid intake, and dietetic measures led to a persistent normalization of urine sediment with complete disappearance of hematuria. Determination of calcium and uric acid urinary excretions should be included in the study of familial hematuria.

  19. Povidone iodine sclerotherapy for treatment of idiopathic renal hematuria in two dogs.

    PubMed

    Adelman, Lauren B; Bartges, Joseph; Whittemore, Jacqueline C

    2017-01-15

    CASE DESCRIPTION A 6-year-old spayed female Great Pyrenees (dog 1) and a 2-year-old spayed female German Shepherd Dog (dog 2) were evaluated because of gross hematuria of 5 and 2 months' duration, respectively. CLINICAL FINDINGS In both dogs, coagulation times were within reference limits, results of aerobic bacterial culture of urine samples were negative, echogenic debris could be seen within the urinary bladder ultrasonographically, and hematuric urine could be seen exiting the right ureterovesicular junction, with grossly normal urine exiting the left ureterovesicular junction, during cystoscopy. A diagnosis of idiopathic renal hematuria was made in both dogs. TREATMENT AND OUTCOME Both dogs underwent retrograde ureteropyelography, unilateral povidone iodine sclerotherapy, and ureteral stent placement. The right ureter was occluded with a ureteropelvic junction balloon catheter, and a 5% povidone iodine solution was infused into the renal pelvis 3 times. A double-pigtail ureteral stent was then placed. Both dogs recovered without complications, with cessation of gross hematuria within 12 hours. Cystoscopic removal of the ureteral stent was performed in dog 1 after 4 months; at that time, the urine sediment contained 5 to 10 RBCs/hpf. In dog 2, urine sediment contained 50 to 75 RBCs/hpf 2 weeks after sclerotherapy, with continued resolution of gross hematuria 8 weeks after sclerotherapy. The owners declined removal of the stent in dog 2. CLINICAL RELEVANCE Findings suggested that povidone iodine sclerotherapy may be an effective renal-sparing treatment for idiopathic renal hematuria in dogs. Further evaluation with longer follow-up times is warranted.

  20. The development of reversible hematuria and oliguria following elevation of renal venous pressure.

    DOT National Transportation Integrated Search

    1963-01-01

    An investigation was completed to study the acute effects of elevated renal venous pressure in the development of reversible gross hematuria and oliguria. Both isolated and intact dog kidney preparations were utilized. Results demonstrate that gross ...

  1. A Prospective Blinded Evaluation of Urine-DNA Testing for Detection of Urothelial Bladder Carcinoma in Patients with Gross Hematuria.

    PubMed

    Dahmcke, Christina M; Steven, Kenneth E; Larsen, Louise K; Poulsen, Asger L; Abdul-Al, Ahmad; Dahl, Christina; Guldberg, Per

    2016-12-01

    Retrospective studies have provided proof of principle that bladder cancer can be detected by testing for the presence of tumor DNA in urine. We have conducted a prospective blinded study to determine whether a urine-based DNA test can replace flexible cystoscopy in the initial assessment of gross hematuria. A total of 475 consecutive patients underwent standard urological examination including flexible cystoscopy and computed tomography urography, and provided urine samples immediately before (n=461) and after (n=444) cystoscopy. Urine cells were collected using a filtration device and tested for eight DNA mutation and methylation biomarkers. Clinical evaluation identified 99 (20.8%) patients with urothelial bladder tumors. With this result as a reference and based on the analysis of all urine samples, the DNA test had a sensitivity of 97.0%, a specificity of 76.9%, a positive predictive value of 52.5%, and a negative predictive value of 99.0%. In three patients with a positive urine-DNA test without clinical evidence of cancer, a tumor was detected at repeat cystoscopy within 16 mo. Our results suggest that urine-DNA testing can be used to identify a large subgroup of patients with gross hematuria in whom cystoscopy is not required. We tested the possibility of using a urine-based DNA test to check for bladder cancer in patients with visible blood in the urine. Our results show that the test efficiently detects bladder cancer and therefore may be used to greatly reduce the number of patients who would need to undergo cystoscopy. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  2. Loin pain hematuria syndrome

    PubMed Central

    Zubair, Adeel S.; Salameh, Hassan; Erickson, Stephen B.; Prieto, Mikel

    2016-01-01

    Loin pain hematuria syndrome (LPHS), first described in 1967, is a rare pain syndrome, which is not well understood. The syndrome is characterized by severe intermittent or persistent flank pain, either unilateral or bilateral, associated with gross or microscopic hematuria. LPHS is a diagnosis of exclusion as there still is not a consensus of validated diagnostic criteria, though several criteria have been proposed. The wide differential diagnosis would suggest a meticulous yet specific diagnostic work-up depending on the individual clinical features and natural history. Several mechanisms regarding the pathophysiology of LPHS have been proposed but without pinpointing the actual causative etiology, the treatment remains symptomatic. Treatment modalities for LPHS are diverse including simple analgesia, opioid analgesic and kidney autotransplantation. This review article summarizes the current understanding regarding the pathophysiology of LPHS along with the steps required for proper diagnosis and a discussion of the different therapeutic approaches for LPHS. PMID:26798473

  3. Preliminary experience with epsilon aminocaproic acid for treatment of intractable upper tract hematuria in children with hematological disorders.

    PubMed

    Kaye, Jonathan D; Smith, Edwin A; Kirsch, Andrew J; Cerwinka, Wolfgang H; Elmore, James M

    2010-09-01

    Gross, intractable hematuria is rare in children. Although the role of epsilon aminocaproic acid in the management of refractory hematuria is well established in the adult population, few data exist about its use in children for this indication. We present our initial experience with epsilon aminocaproic acid for the treatment of intractable hematuria after more conservative measures failed, and propose an algorithm for administration of epsilon aminocaproic acid in children. We reviewed the charts of all patients treated with epsilon aminocaproic acid for intractable gross hematuria at our institution during a period of 36 months. All patients underwent hematological evaluation and any underlying bleeding dyscrasias were addressed. All patients also underwent renal and bladder ultrasound, retrograde pyelogram and ureteroscopy. Demographic information, medical and surgical histories, and epsilon aminocaproic acid dosing and outcomes were recorded. Three boys and 1 girl 11 to 17 years old were treated with epsilon aminocaproic acid. Three patients had sickle trait (1 with nutcracker phenomenon) and 1 had hemophilia A. Three patients required packed red blood cell transfusions to maintain hematocrit. Three renal angiograms were performed, all of which were nondiagnostic. Duration of hematuria ranged from 1 to 52 weeks before administration of epsilon aminocaproic acid. Endoscopic evaluation demonstrated hematuria localized to 1 ureteral orifice in all 4 patients. All patients received 100 mg/kg epsilon aminocaproic acid orally every 6 hours, which uniformly led to cessation of hematuria. Epsilon aminocaproic acid is useful for the management of gross refractory hematuria when more conservative measures fail. Because of its potential side effects, it should be used cautiously. 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. Nephrolithiasis and hematuria--sometimes a stony road to diagnosis.

    PubMed

    Sellin, L; Quack, I; Weiner, S M; Waldherr, R; Henning, B; Hofebauer, S; Rump, L C

    2005-08-01

    We report a case of a young man with a history of kidney stones. Occurrence of gross hematuria several months after the extracorporeal shock wave, lithotripsy (ESWL) treatment lead to hospitalization. By ultrasound and abdominal CT scan, the urologist could exclude post-renal causes of the gross hematuria and acute renal failure. After transfer to a department of nephrology hemodialysis was started, an immediate kidney biopsy was performed and prednisolone was administered on the same day. The kidney biopsy revealed an anti-glomerular basement membrane (GBM) disease. The renal function did not recover and the patient remained on hemodialysis. In the literature it has been hypothesized that ESWL-treated patients are prone to develop anti-GBM disease by liberation of glomerular basement antigen through the ESWL high energy shock waves. An additional hypothesis considering the higher susceptibility for anti-GBM disease among certain HLA-tissue types is discussed with regard to our case. Unfortunately, the prolonged track to diagnosis and delayed immunosuppressive treatment could not prevent poor clinical outcome. Although anti-GBM disease is a rather rare disease, it should be included as a differential diagnosis for hematuria--especially months after ESWL treatment. Otherwise early diagnosis may be missed and as in our patient immunosuppressive treatment will remain unsuccessful to recover renal function.

  5. Pancreatic Anastomosis Leak 15 Years after Simultaneous Pancreas-Kidney Transplantation from Late-Onset Allograft Cytomegalovirus Duodenal Ulcers Presenting with Gross Hematuria

    PubMed Central

    Tantisattamo, Ekamol; Chung, Heath; Okado, Manami

    2013-01-01

    Cytomegalovirus (CMV) infection is one of the most important causes of morbidity and mortality in solid organ transplantation. It can present with hematuria, the most common urological complication in the early post-simultaneous pancreas-kidney (SPK) transplant period. In SPK transplantation, CMV infection usually occurs 1 month after transplantation. We report an instance of bladder-drained SPK transplant presenting with recurrent gross hematuria from CMV infected duodenal graft ulcers 15 years after preserved well-functioning grafts. Serum quantitative Polymerase Chain Reaction (qPCR) for CMV was negative. Postmortem duodenal graft staining for CMV was positive, and revealed the cause of the inciting ulcer. To our knowledge, our patient is the first reported case of very late onset invasive CMV disease causing duodenal graft ulcers 15 years after transplantation, as previously reported cases of posttransplant CMV disease occurred only as late as 18 months. In addition, the absence of correlation between CMV viremia and CMV-infected duodenal allograft in SPK transplant has not been reported. Our case demonstrates that CMV viral load is -unreliable to diagnose invasive CMV disease, and tissue biopsy should be obtained to avoid missed diagnosis causing high morbidity and mortality. PMID:24349888

  6. Chronic hematuria and localized bladder damage following combined cyclophosphamide and local radiotherapy

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

    Kende, G.; Wajsman, Z.; Thomas, P.R.M.

    1979-01-01

    A 13-year-old white male had Ewing sarcoma of the right pubic and ischial bones. Initial therapy consisted of 5400 rads in seven weeks to the right side of the pelvis and 14 intravenous injections of cyclophosphamide (Cytoxan, CTX) at 500 mg/m/sup 2/; BCNU and Adriamycin maintenance therapy continued for a total of two years. He has now been disease-free for five years. Three months following the completion of the right pelvic radiotherapy (RT), while on intravenous CTX, severe hematuria appeared, which subsided, but at present he has continuous microscopic hematuria, as well as periodic episodes of gross hematuria. Serial cystocopiesmore » initially revealed thickening and hemorrhagic and edematous changes on the right (irradiated) side of the bladder, and recent multiple telangiectatic patches have been demonstrated as a late healing phase. This case demonstrates the additive toxicity to the bladder of CTX and RT, illustrating that the hemorrhagic cystitis can be extremely protracted lasting five years.« less

  7. Association Between Use of Antithrombotic Medication and Hematuria-Related Complications

    PubMed Central

    Wallis, Christopher J. D.; Juvet, Tristan; Lee, Yuna; Matta, Rano; Herschorn, Sender; Kodama, Ronald; Kulkarni, Girish S.; Satkunasivam, Raj; Geerts, William; McLeod, Anne; Narod, Steven A.

    2017-01-01

    Importance Antithrombotic medications are among the most commonly prescribed medications. Objective To characterize rates of hematuria-related complications among patients taking antithrombotic medications. Design, Setting, and Participants Population-based, retrospective cohort study including all citizens in Ontario, Canada, aged 66 years and older between 2002 and 2014. The final follow-up date was December 31, 2014. Exposures Receipt of an oral anticoagulant or antiplatelet medication. Main Outcomes and Measures Hematuria-related complications, defined as emergency department visit, hospitalization, or a urologic procedure to investigate or manage gross hematuria. Results Among 2 518 064 patients, 808 897 (mean [SD] age, 72.1 [6.8] years; 428 531 [53%] women) received at least 1 prescription for an antithrombotic agent over the study period. Over a median follow-up of 7.3 years, the rates of hematuria-related complications were 123.95 events per 1000 person-years among patients actively exposed to antithrombotic agents vs 80.17 events per 1000 person-years among patients not exposed to these drugs (difference, 43.8; 95% CI, 43.0-44.6; P < .001, and incidence rate ratio [IRR], 1.44; 95% CI, 1.42-1.46). The rates of complications among exposed vs unexposed patients (80.17 events/1000 person-years) were 105.78 for urologic procedures (difference, 33.5; 95% CI, 32.8-34.3; P < .001, and IRR, 1.37; 95% CI, 1.36-1.39), 11.12 for hospitalizations (difference, 5.7; 95% CI, 5.5-5.9; P < .001, and IRR, 2.03; 95% CI, 2.00-2.06), and 7.05 for emergency department visits (difference, 4.5; 95% CI, 4.3-4.7; P < .001, and IRR, 2.80; 95% CI, 2.74-2.86). Compared with patients who were unexposed to thrombotic agents, the rates of hematuria-related complications were 191.61 events per 1000 person-years (difference, 117.3; 95% CI, 112.8-121.8) for those exposed to both an anticoagulant and antiplatelet agent (IRR, 10.48; 95% CI, 8.16-13.45), 140

  8. [Painless thyroiditis].

    PubMed

    Okamura, Ken; Fujikawa, Megumi; Bandai, Sachiko

    2006-12-01

    Painless thyroiditis is characterized by painless low-uptake thyrotoxicosis (thyrotoxicosis without hyperthyroidism). Destructive damage of the thyroid has been thought to be the mechanism for self-limited thyrotoxicosis. However, hydrolysis of thyroglobulin must be responsible for the release of excessive thyroid hormone. Low-uptake of iodine and excessive release of thyroid hormone suggest the uncoupling of hormone synthesis and hormone secretion in the thyroid gland. Suppressed serum TSH level, various cytokines or growth factors including TGFbeta1, and thyroglobulin itself may be responsible for the suppressed hormone synthesis. The mechanism for persistent hormone release despite suppressed hormone synthesis should be clarified. Quantitative TSH binding inhibitor immunoglobulin assay is helpful for the differential diagnosis of painless thyroiditis and Graves' hyperthyroidism.

  9. Creation and validation of a visual macroscopic hematuria scale for optimal communication and an objective hematuria index.

    PubMed

    Wong, Lih-Ming; Chum, Jia-Min; Maddy, Peter; Chan, Steven T F; Travis, Douglas; Lawrentschuk, Nathan

    2010-07-01

    Macroscopic hematuria is a common symptom and sign that is challenging to quantify and describe. The degree of hematuria communicated is variable due to health worker experience combined with lack of a reliable grading tool. We produced a reliable, standardized visual scale to describe hematuria severity. Our secondary aim was to validate a new laboratory test to quantify hemoglobin in hematuria specimens. Nurses were surveyed to ascertain current hematuria descriptions. Blood and urine were titrated at varying concentrations and digitally photographed in catheter bag tubing. Photos were processed and printed on transparency paper to create a prototype swatch or card showing light, medium, heavy and old hematuria. Using the swatch 60 samples were rated by nurses and laymen. Interobserver variability was reported using the generalized kappa coefficient of agreement. Specimens were analyzed for hemolysis by measuring optical density at oxyhemoglobin absorption peaks. Interobserver agreement between nurses and laymen was good (kappa = 0.51, p <0.001). Subgroup analysis showed substantial agreement for light hematuria (kappa = 0.71). Overall agreement improved when the moderate (kappa = 0.28) and heavy (kappa = 0.53) hematuria categories were combined (kappa = 0.70). Compared to known blood concentrations the assay of optical density at oxyhemoglobin absorption peaks showed a linear trend. A simple visual scale to grade and communicate hematuria with adequate interobserver agreement is feasible. The test for optical density at oxyhemoglobin absorption peaks is a new method, validated in our study, to quantify hemoglobin in a hematuria specimen. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. Proteinuria and Hematuria in the Neonate

    PubMed Central

    Joseph, Catherine; Gattineni, Jyothsna

    2016-01-01

    Purpose of Review Neonatal proteinuria and hematuria while not common can have potentially devastating consequences if left undiagnosed and untreated. It is important to distinguish between inherited and acquired causes of proteinuria to initiate appropriate and timely treatment. In regards to hematuria, it is critical to identify true hematuria from pseudo-hematuria in order to balance between thorough investigation and unnecessary laboratory work up. This review provides an overview of the common causes of hematuria and proteinuria in a neonate. Recent Findings Identification of genetic mutations in nephrotic syndrome has improved our understanding of the role of various proteins that play an important role in maintaining the glomerular filtration barrier. With the advancement in our ability to provide care for extreme premature neonates, the incidence of acute kidney injury has increased in these neonates along with proteinuria and hematuria. Summary Persistent proteinuria after neonatal acute kidney injury would be of interest in regards to the risk of developing future chronic kidney disease and hypertension. PMID:26845146

  11. Cadmium exposure induces hematuria in Korean adults

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

    Han, Seung Seok; Kim, Myounghee, E-mail: dkkim73@gmail.com; Lee, Su Mi

    2013-07-15

    Introduction: Toxic heavy metals have adverse effects on human health. However, the risk of hematuria caused by heavy metal exposure has not been evaluated. Methods: Data from 4701 Korean adults were obtained in the Korean National Health and Nutritional Examination Survey (2008–2010). Blood levels of the toxic heavy metals cadmium, lead, and mercury were measured. Hematuria was defined as a result of ≥+1 on a urine dipstick test. The odds ratios (ORs) for hematuria were measured according to the blood heavy metal levels after adjusting for multiple variables. Results: Individuals with blood cadmium levels in the 3rd and 4th quartilesmore » had a greater OR for hematuria than those in the 1st quartile group: 3rd quartile, 1.35 (1.019–1.777; P=0.037); 4th quartile, 1.52 (1.140–2.017; P=0.004). When blood cadmium was considered as a log-transformed continuous variable, the correlation between blood cadmium and hematuria was significant: OR, 1.97 (1.224–3.160; P{sub trend}=0.005). In contrast, no significant correlations between hematuria and blood lead or mercury were found in the multivariate analyses. Discussion: The present study shows that high cadmium exposure is associated with a risk of hematuria. -- Highlights: • A high level of blood cadmium is associated with a high risk of hematuria. • This correlation is independent of several confounding factors. • Blood levels of lead and mercury are not associated with risk of hematuria. • This is the first study on the correlation between cadmium exposure and hematuria risk.« less

  12. Blood in the Urine (Hematuria)

    MedlinePlus

    ... 2 weeks later to make sure the urine is free of red blood cells. If hematuria only happens once, there's usually ... follow-up tests to make sure your urine is free of red blood cells. If the hematuria goes away, your doctor ...

  13. Leech in urinary bladder causing hematuria.

    PubMed

    Alam, Shadrul; Das Choudhary, Mrigen Kumar; Islam, Kabirul

    2008-02-01

    To estimate efficacy of normal saline in the management of hematuria caused by accidental entry of a leech per urethra into the urinary bladder. An intervention study was carried out in the Department of Pediatric Surgery of Sylhet MAG Osmani Medical College between January 1998 and December 2003. A total of 43 boys (mean age 8 years, SD+/-2.6) were enrolled. In all cases, a leech had entered the urinary bladder through the urethra causing hematuria. All patients were equipped with a self-retaining Foley catheter. They were managed by infusing 50ml of normal saline into the urinary bladder through the catheter that was then clamped for 3h. After removing the catheter, in all cases the whole leech was spontaneously expelled intact, dead or alive, within 2-24h during the subsequent act of micturition. Hematuria gradually diminished to a clear flow within the next 6h in 27 cases, 12h in 14 cases and 24h in two cases. All patients were followed up for 2 weeks, and none developed recurrent hematuria. Catheterization and irrigation of the urinary bladder with normal saline is a relatively simple, safe and inexpensive method of removing the leech and controlling hematuria.

  14. Ureteropyeloscopy in the diagnosis of patients with upper tract hematuria: an initial clinical study.

    PubMed

    Yazaki, T; Kamiyama, Y; Tomomasa, H; Shimizu, H; Okano, Y; Iiyama, T; Iizumi, T; Umeda, T

    1999-05-01

    To study the usefulness and safety of ureteropyeloscopy in the diagnosis of upper tract hematuria of unknown etiology by standard diagnostic methods. Fifteen patients with upper tract hematuria of unknown etiology were the subjects of the present study. Prior to ureteropyeloscopy, they underwent standard diagnostic methods, including cystourethroscopy, excretory urography and computed tomography scan. The upper tract (ureter, renal pelvis and calyces) was inspected systematically with a flexible ureteropyeloscope under epidural anesthesia. A biopsy specimen was obtained when neoplasm of a suspicious lesion was seen. Bleeding and hemangiomatous lesions were fulgurated at the time of ureteropyeloscopy. Unilateral gross hematuria was seen in 12 patients. Imaging studies revealed a filling defect in four patients, ureteral stenosis in one patient and nutcracker phenomenon in one patient. Urine cytology was positive in three patients and suspicious in four patients. Results of ureteropyeloscopy were papillary tumor in three patients, whitish encrustation in one patient, redness of the renal pelvis in one patient, bleeding from the renal calyx in two patients, hemangiomatous lesion in one patient, ureteral stenosis in two patients and no abnormalities in five patients. Biopsies were performed in five patients. The pathology results were transitional cell carcinoma in four patients and no abnormality in one patient. Although a ureteral stent catheter was placed in one patient, no serious complications were encountered during or after the procedures. Ureteropyeloscopy was useful and relatively safe. This endoscopic examination can differentiate insignificant lesions from significant lesions by visual inspection of the lesions, in addition, pathological diagnosis by biopsy specimen can also be performed if deemed necessary. Ureteropyeloscopy is recommended in the diagnosis of upper tract hematuria of unknown etiology.

  15. WhatsApp Use In The Evaluation of Hematuria.

    PubMed

    Sener, Tarik Emre; Butticè, Salvatore; Sahin, Bahadir; Netsch, Christopher; Dragos, Laurian; Pappalardo, Rosa; Magno, Carlo

    2018-03-01

    The advancements in telemedicine provide the possibility to send photos of hematuria cases to professionals for further evaluation. We aimed to evaluate the inter-rater reliability of WhatsApp use in the evaluation of hematuria. Between December 2014 and April 2016, 212 patients were evaluated prospectively for hematuria by 2 groups of urologists; Group A: in direct contact with patients for evaluation; Group B: "blind" urologist who had no access to the patients' data but received pictures via WhatsApp. Two photos of voided urine in a sterile container were taken and sent using WhatsApp. The opinions of Group A and B about the grade of hematuria were evaluated. Shapiro-Wilk test and Fleiss' kappa statistics were used for statistical analyses. The median age of patients was 71 (min 22, max 96). The Group A urologists were in accordance in 96.22% of cases. Group B urologists had common opinions in 99.5% (n = 203) and there was almost perfect agreement between 2 groups (λ = 0.992). The number of common opinions among "blind" urologists is more than the number of common opinions among the consultants. When further classification is performed as serious and non-serious hematuria, the rate of misdiagnosing serious cases is approximately 6.5-7%. However, using WhatsApp, the urologists can differentiate normal urine and any form of hematuria with 100% accuracy. It is possible to evaluate hematuria remotely and also reduce unnecessary costs of services for hematuria of mild clinical significance by using telemedicine. WhatsApp can provide valuable aid to tertiary hospitals where the urologist is not always present as well as in rural areas. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Gastrocystoplasty and Hematuria-dysuria Syndrome. What Role Plays Helicobacter Pylori? Case Report and Literature Review

    PubMed Central

    Aponte, Hernán A.; Clavijo, Rafael A.; Quiroz, Yesica J.; Dallos, Diego F.; Ruiz, William N.; Ramirez-Troche, Nelson E.; Martin, Oscar Dario

    2015-01-01

    49 years male, who comes to the urology department, complaining of 8 months of lower abdominal pain, burning and oppressive type, of variable intensity reaching 9/10, which is occasionally exacerbated by urination, associated with intermittent gross hematuria, dysuria, refers no fever at any time. Patient with past medical history of bladder and right kidney Tuberculosis (TBC) 25 years ago, treated with a simple right nephrectomy and bladder augmentation with antrum segment of stomach, for low bladder capacity. Never showed any symptom during those 25 years lapsing time PMID:26793505

  17. Bladder Tumor in Women with Microscopic Hematuria: An Iranian Experience and a Review of the Literature

    PubMed Central

    Abbaszadeh, Shahin; Taheri, Saeed; Nourbala, Mohammad Hossein

    2009-01-01

    Aim. In this study we report our experience with microhematuria and its relation with bladder tumors in Iranian women. Materials and Methods. Overall 249 women were evaluated. Microscopic hematuria was defined as three or more red blood cells per high-power field on at least two different occasions. Patients with a history of gross hematuria or coagulation disorders, having organic diseases, urinary stones, urinary tract infections, nephrological diseases, and local lesions such as urethral caruncle were excluded from the study population. Final diagnosis of malignant tumors was done with cystoscopy and biopsy specimen pathological assessment in all cases. Results. Age for the study population was 49.7 ± 11.8 years. 95 (38%) of patients were identified during routine check up and presenting symptoms in other patients were frequency, dysuria, stress urge incontinence, urge incontinence, feeling of incomplete urine emptying, and flunk pain, respectively. Finally, 7 (2.8%) of study subjects were confirmed as having bladder tumors. One of tumor cases was diagnosed 24 months after initial assessments. Patients with bladder tumor were significantly older; more frequently had diverticulum in their bladder wall (P < .05). Conclusion. Female microscopic hematuria is relevant and deserves evaluations, especially in elderly patients. Patients whose reason for microhematuria would not be diagnosed at the initial evaluations should be followed. PMID:19639044

  18. The frequency of hematuria in acne vulgaris patients during isotretinoin treatment.

    PubMed

    Yesilkaya, Burcu; Alli, Nuran; Artuz, R Ferda; Ulu, Ezgi; Kartal, Demet; Cinar, S Levent

    2017-03-01

    Systemic isotretinoin (13-cis-retinoic acid) is effective in the treatment of acne vulgaris. The most common side effects are mucocutaneous ones. Hematuria seen secondary to isotretinoin treatment is thought to be due to mucosal dryness in the urinary system. This study aims to determine the frequency of hematuria in acne vulgaris patients during isotretinoin treatment. Eighty-eight subjects aged 16-32 years were included in the study group and 52 subjects were in the control group. The subjects were treated for 6 months and were monitored monthly by complete urine analyzes. They were also examined each month in terms of cheilitis, xerosis, epistaxis, rectal bleeding, fatigue, myalgia, weight loss, dry eye, conjunctivitis, headache, dysuria and pollakiuria. In the study group, 15 subjects (17%) had hematuria at least once during the study, and in the control group, four subjects (7.7%) had hematuria. The difference was not statistically significant (p = 0.118). Among the subjects who had hematuria, 11 of them (73.3%) were female and four of them (33.3%) were male in the study group while all the subjects with hematuria in the control group were female. Hematuria and gender did not show a statistically significant correlation. Hematuria was observed in 17% of the study group; this frequency rate was not different from that of the normal population. In subjects having isotretinoin treatment, if all the other reasons or disorders are excluded, one must keep in mind that hematuria may be due to isotretinoin use.

  19. Primary non-Hodgkin’s lymphoma of the prostate with intractable hematuria: A case report and review of the literature

    PubMed Central

    HU, SHANBIAO; WANG, YINHUAI; YANG, LUOYAN; YI, LU; NIAN, YEQI

    2015-01-01

    Cases of primary non-Hodgkin’s lymphoma of the prostate are globally rare. The present study reports a case of prostatic diffuse large B-cell lymphoma (DLBCL) with intractable hematuria in a 75-year-old male. The patient presented with difficulties in urination and gross hematuria. A prostate biopsy was performed immediately, followed by conservative treatment for bleeding. A bilateral iliac arteriography and chemoembolization were then performed as emergency procedures under local anesthesia due to significant bleeding and a sharply decreased blood pressure, indicating the failure of the conservative treatment. Consequently, the bleeding was effectively controlled. Pathological examination of the prostate biopsy confirmed the presence of a DLBCL of non-germinal center B-cell origin. Immunohistochemical examination demonstrated cluster of differentiation (CD)20(++), CD3(+), leukocyte common antigen(+++), B-cell lymphoma-2(+) and prostate-specific antigen(−) results. Due to the poor general condition and low hemoglobin levels of the patient, a low-dose Rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) chemotherapy regimen was administered. Subsequent to three courses of chemotherapy, the patient achieved complete remission. In conclusion, combining R-CHOP and bilateral selective iliac arterial chemoembolization could be a safe and effective way to treat patients with non-Hodgkin’s lymphoma of the prostate and intractable hematuria. PMID:25663879

  20. Increased hematuria following hypergravic exposure in middle-aged women

    NASA Technical Reports Server (NTRS)

    Goldwater, D. J.; Ohara, D. B.; Sandler, H.

    1982-01-01

    The effects of simulated weightlessness on orthostatic tolerance were studied in 9 women (55 to 65 years old) who underwent acceleration and lower body negative pressure before and after 10 days of horizontal bed rest. The results of this study show the first known association of microscopic hematuria with hypergravic and orthostatic stress which suggests similarities to the 'stress hematuria syndrome' previously seen with heavy exercise (Boileau et al., 1980). In addition, the sporadic occurrence of this phenomenon indicates a multifactorial etiology in predisposed individuals. Bedrest or weightlessness simulation per se does not seem to significantly alter renal function, but may decrease microscopic hematuria with an orthostatic component.

  1. HYPNOTHERAPY INTERVENTION FOR LOIN PAIN HEMATURIA: A CASE STUDY1

    PubMed Central

    Elkins, Gary R.; Koep, Lauren L.; Kendrick, Cassie E.

    2012-01-01

    Loin pain hematuria is characterized by chronic loin pain, hematuria, and dysuria. There are no known effective treatments for loin pain hematuria and longer-term use of analgesics and surgical options are often ineffective or associated with negative side effects. This article reports on a 17-year-old female patient diagnosed with loin pain hematuria who presented with unilateral, uncontrolled loin pain following numerous unsuccessful attempts at controlling her symptoms with traditional medical interventions—including antibiotics, opioids, and renal denervation. The patient received 8 sessions of hypnotherapy. Baseline, end-point, and follow-up measures administered included the General Health Questionnaire, Hospital Anxiety and Depression Scale, McGill Pain Questionnaire, Pain Discomfort Scale, and visual analogue measures of pain, academic interference, and social interference. At follow-up, results indicated clinically significant decreases in pain, anxiety, and depression with nearly complete remission of presenting symptoms. PMID:22098573

  2. [Secondary amyloidosis of the bladder and massive hematuria].

    PubMed

    García-Escudero López, A; Arruza Echevarría, A; Leunda Saizar, J; Infante Riaño, R; Padilla Nieva, J; Ortiz Barredo, E

    2010-01-01

    To report four additional cases of secondary amyloidosis of the bladder, an extremely rare condition, as shown by the cases reported in the literature. Four clinical cases are reported, all of them occurring as hematuria, which was massive and fulminant and resulted in death in three patients. Secondary amyloidosis of the bladder is of the AA type, which is more common in females and mainly secondary to rheumatoid arthritis, but also to ankylosing spondylitis and long-standing chronic inflammatory conditions. Hematuria is the main and virtually only symptom. A pathological and immunohistochemical study confirmed diagnosis. All three patients who experienced massive, fatal hematuria had an intercurrent condition requiring urethral catheterization, which was the triggering factor. Despite its rarity, as shown by the few cases reported, secondary amyloidosis of the bladder should be considered in patients already diagnosed with systemic amyloidosis and/or the conditions reported who require simple urethral catheterization.

  3. Evaluation of an Epigenetic Profile for the Detection of Bladder Cancer in Patients with Hematuria.

    PubMed

    van Kessel, Kim E M; Van Neste, Leander; Lurkin, Irene; Zwarthoff, Ellen C; Van Criekinge, Wim

    2016-03-01

    Many patients enter the care cycle with gross or microscopic hematuria and undergo cystoscopy to rule out bladder cancer. Sensitivity of this invasive examination is limited, leaving many patients at risk for undetected cancer. To improve current clinical practice more sensitive and noninvasive screening methods should be applied. A total of 154 urine samples were collected from patients with hematuria, including 80 without and 74 with bladder cancer. DNA from cells in the urine was epigenetically profiled using 2 independent assays. Methylation specific polymerase chain reaction was performed on TWIST1. SNaPshot™ methylation analysis was done for different loci of OTX1 and ONECUT2. Additionally all samples were analyzed for mutation status of TERT (telomerase reverse transcriptase), PIK3CA, FGFR3 (fibroblast growth factor receptor 3), HRAS, KRAS and NRAS. The combination of TWIST1, ONECUT2 (2 loci) and OTX1 resulted in the best overall performing panel. Logistic regression analysis on these methylation markers, mutation status of FGFR3, TERT and HRAS, and patient age resulted in an accurate model with 97% sensitivity, 83% specificity and an AUC of 0.93 (95% CI 0.88-0.98). Internal validation led to an optimism corrected AUC of 0.92. With an estimated bladder cancer prevalence of 5% to 10% in a hematuria cohort the assay resulted in a 99.6% to 99.9% negative predictive value. Epigenetic profiling using TWIST1, ONECUT2 and OTX1 results in a high sensitivity and specificity. Accurate risk prediction might result in less extensive and invasive examination of patients at low risk, thereby reducing unnecessary patient burden and health care costs. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. Perineal Pseudoaneurysm from Traumatic Foley Removal Leads to Recurrent Life-Threatening Hematuria.

    PubMed

    Liang, Lorraine Min-Shan; Xue, Jingbing; Erturk, Erdal

    2015-01-01

    Hematuria resulting from urethral traumatic catheter insertion and removal is often encountered. Usually, hematuria resolves with conservative measures. We report a case of traumatic Foley removal leading to intermittent life-threatening hematuria resulting in blood loss anemia requiring multiple transfusions and multiple episodes of hypotension requiring pressors. A pelvic angiogram revealed a pseudoaneurysm of the left pudendal artery, which was treated with microcoil embolization leading to resolution of bleeding.

  5. Delayed diagnosis of Alport syndrome without hematuria.

    PubMed

    Yin-Yin, Chen; You-Ming, Peng; Yu-Mei, Liang

    2014-05-01

    Alport syndrome is a progressive hereditary disease caused by mutations in the genes encoding type IV collagen. Persistent microscopic hematuria is the hallmark of Alport syndrome, occurring in almost all boys according to previous reports. We report the case of a 20-year-old man presented with proteinuria but no hematuria that was initially misdiagnosed with refractory nephrotic syndrome and was eventually diagnosed with Alport syndrome following kidney and skin biopsy. During the follow-up period, he experienced a rapid progression to end-stage renal disease. Timely diagnosis of Alport syndrome is important, because patients may benefit from early intervention and avoid suffering from unnecessary nephrotoxic drug use.

  6. Perineal Pseudoaneurysm from Traumatic Foley Removal Leads to Recurrent Life-Threatening Hematuria

    PubMed Central

    Xue, Jingbing; Erturk, Erdal

    2015-01-01

    Abstract Hematuria resulting from urethral traumatic catheter insertion and removal is often encountered. Usually, hematuria resolves with conservative measures. We report a case of traumatic Foley removal leading to intermittent life-threatening hematuria resulting in blood loss anemia requiring multiple transfusions and multiple episodes of hypotension requiring pressors. A pelvic angiogram revealed a pseudoaneurysm of the left pudendal artery, which was treated with microcoil embolization leading to resolution of bleeding. PMID:27579388

  7. Lessons from mosquitoes' painless piercing.

    PubMed

    Gurera, Dev; Bhushan, Bharat; Kumar, Navin

    2018-05-18

    Arthropods are the largest group of the living organisms. They attack other organisms by biting, stinging, or piercing and sucking. Among various medically important arthropods, which feed on living hosts, mosquitoes' piercing spread viruses which have been reported to cause the highest number of deaths annually. The primary cause of the deaths is malaria, which is spread by infected mosquitoes' piercing. This study aims at elucidating lessons from mosquitoes' painless piercing. Mosquitoes pierce using their fascicle, which is a bundle of coherently functioning six stylets. Based on experiments and available literature, it is presented that mosquitoes painlessly pierce using a combination of the numbing, the fascicle's serrated design, the vibratory actuation, and the graded and frequency-dependent mechanical properties of the labrum. Based on this understanding, a mosquito-inspired microneedle design has also been proposed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Wilms tumor in a child with trisomy 13.

    PubMed

    Sweeney, H; Pelegano, J

    2000-01-01

    A 4-year-old black boy with trisomy 13, a history of frequent urinary tract infections, and a horseshoe kidney with painless gross hematuria was examined. An abdominal mass was detected and surgically resected. Examination of the surgical specimen revealed a Wilms tumor. Given the concurrence of trisomy 13 and Wilms tumor and the presence of another such case in the literature, there may be just cause to suspect a locus on chromosome 13 that affects the probability of developing Wilms tumor. Given the increasingly longer survival of patients with trisomy 13, clinicians may need to be aware of the possibility of renal malignant disease in this population of patients.

  9. An evidence-based approach to the management of hematuria in children in the emergency department.

    PubMed

    Pade, Kathryn H; Liu, Deborah R

    2014-09-01

    Hematuria is defined as an abnormal number of red blood cells in urine. Even a tiny amount of blood (1 mL in 1000 mL of urine) is sufficient to make urine appear pink or red. In the pediatric population, the majority of etiologies are benign and often asymptomatic. However, hematuria may also be a sign of renal pathology, local infection, or systemic disease. Hematuria can be differentiated into 2 categories: macroscopic hematuria (visible to the naked eye) and microscopic hematuria (> 5 red blood cells/high-powered field on urinalysis). This review will outline the current literature regarding evaluation and management of pediatric patients who present to the emergency department with hematuria. Obtaining a thorough history and the appropriate diagnostic tests will be discussed in depth.

  10. Painless thyroiditis complicating with hypercalcemic encephalopathy.

    PubMed

    Thewjitcharoen, Yotsapon; Lumlertgul, Nuttha

    2012-01-01

    Severe hypercalcemia has rarely been reported in patients with hyperthyroidism. Although the pathogenesis is not clear; it is believed to be due to activation of osteoclasts resulting in excessive bone resorption. To recognize the unusual cause of hypercalcemia from painless thyroiditis, which could manifest with transient hyperthyroidism in the early stage. A 70-year-old woman presented with watery diarrhea, nausea and vomiting and significant weight loss for two months. Initially, she was misdiagnosed as having Graves'disease from her clinical presentation and thyroid function tests. Oral propylthiouracil was given to treat hyperthyroidism. However two weeks after discharge, she developed altered consciousness due to severe hypercalcemia. After combined treatment of hypercalcemia and severe hyperthyroidism, her symptoms resolved quickly. Later on, her thyroid function tests switched to subclinical hypothyroid at two months after initial presentation. No concurrent pathological conditions could be found to explain the other causes of hypercalcemia. Therefore, painless thyroiditis complicated with severe hypercalcemia was subsequently diagnosed based on her clinical course. Hypercalcemic encephalopathy is an uncommon manifestation of hyperthyroidism that should be kept in mind in patients who demonstrated clinical pictures of hyperthyroidism and alteration of consciousness. Moreover the present case emphasizes the consideration of painless thyroiditis as a differential diagnosis of hyperthyroidism because anti-thyroid medications were not indicated in this condition.

  11. A Case of Severe and Recurrent Painless Thyroiditis Requiring Thyroidectomy

    PubMed Central

    Ishii, Hiroaki; Takei, Masahiro; Sato, Yoshihiko; Ito, Tokiko; Ito, Ken-ichi; Sakai, Yasuhiro; Yumita, Wataru; Suzuki, Satoru; Komatsu, Mitsuhisa

    2013-01-01

    Objective To report a case of severe and recurrent painless thyroiditis requiring thyroidectomy. Clinical Presentation and Intervention A 47-year-old man who presented with severe thyrotoxicosis was found to have extremely low radioactive iodine uptake, negative TSH receptor antibodies, and normal C-reactive protein; these findings suggested a diagnosis of painless thyroiditis. Due to the severity and recurrence of thyrotoxicosis, surgical resection of the thyroid gland was performed to prevent a thyrotoxic storm. Histological examination revealed typical lymphoid infiltration of the thyroid gland. Conclusion This case illustrates that a patient with painless thyroiditis was successfully treated with surgery. PMID:23182952

  12. Microscopic hematuria and calculus-related ureteral obstruction.

    PubMed

    Stewart, D P; Kowalski, R; Wong, P; Krome, R

    1990-01-01

    The evaluation of patients with ureteral calculi in the emergency department has historically included urinalysis (UA) and intravenous pyelograms (IVP). This retrospective study was done to determine if a statistically significant relationship existed between the degree of calculus-related ureteral obstruction, proven by IVP, and the presence or absence of microscopic hematuria. Urine red blood cells were recorded as less than 3 rbc/hpf (negative) or greater than or equal to 3 rbc/hpf (positive). IVPs were recorded as nonsevere or severe. IVP criteria were based on the presence or absence of extravasation, greater than 2-hour ureteral filling times, and a numerical scoring system of 1 to 4 for ureteral or calyceal dilatation and nephrogenic effect. Eighty-nine men (72%) had non-severe obstructions and 34 (28%) had severe obstructions. Twenty-five women (68%) had nonsevere obstructions and 12 (32%) had severe obstructions. Of the 28 patients with normal UAs, 11 had severe ureteral obstructions and 17 had nonsevere ureteral obstructions. There were no statistically significant differences between the presence or absence of significant microscopic hematuria and the presence or absence of severe ureteral obstruction. Microscopic hematuria is neither sensitive nor specific in determining the degree of calculus-related ureteral obstruction.

  13. Therapeutic options for intractable hematuria in advanced bladder cancer.

    PubMed

    Abt, Dominik; Bywater, Mirjam; Engeler, Daniel Stephan; Schmid, Hans-Peter

    2013-07-01

    Intractable hematuria is a common and severe complication in patients with inoperable bladder carcinoma. The aim was to provide an overview of therapeutic options for such cases, and analyze their effectiveness and risk profile, so a systematic literature search of peer-reviewed papers published up to September 2012 was carried out. Various options are available to treat hematuria in patients with inoperable bladder cancer; these include orally administered epsilon-aminocaproic acid, intravesical formalin, alum or prostaglandin irrigation, hydrostatic pressure, urinary diversion, radiotherapy, embolization and intraarterial mitoxantrone perfusion. These treatment options are associated with different prospects of success, risks and side-effects. Well-designed and large studies comparing options are completely lacking. Despite various treatment options, management of intractable hematuria in patients with inoperable bladder cancer remains a challenge, and most of the reported methods should be seen as experimental. Interventional radiology and alum instillation seem to be suitable alternative options for patients who, after critical consideration, cannot be treated by irrigation, transurethral resection or palliative cystectomy. © 2013 The Japanese Urological Association.

  14. Vesical schistosomiasis with terminal hematuria in sub-Saharan patients.

    PubMed

    Pereira, J; Calleja, E; Marne, C; Borque, A

    2014-03-01

    To know the characteristics of vesical schistosomiasis caused by schistosoma hematobium in immigrant patients. The retrospective study of 41 cases microbiologically diagnosed in our hospital over the last 16 years is presented. Data was collected on origin, age, presentation form, diagnostic tests and treatment. All were African patients whose ages ranged from 4 to 32 years and who had terminal macroscopic hematuria. Most of the patients (85%) were men. In all of the cases, diagnosis was by a urinary microbiological study and in one case, cystoscopy with a biopsy of a typical vesical lesion. Terminal hematuria is the most representative clinical sign. They were treated with praziquantel. The epidemiology and intermittent terminal hematuria in African patients should lead to the suspicion of vesical schistosomiasis as the first diagnostic option. Urinary microbiological study is a rapid, non-invasive, test with high diagnostic yield that would avoid performing invasive studies. Its simple treatment assures high level of compliance and consequent efficacy. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  15. Computerized tomography tailored for the assessment of microscopic hematuria.

    PubMed

    Lang, Erich K; Macchia, Richard J; Thomas, Raju; Ruiz-Deya, Gilberto; Watson, Richard A; Richter, Frank; Irwin R, Robert; Marberger, Michael; Mydlo, Jack; Lechner, Gerhard; Cho, Kyunghee C; Gayle, Brian

    2002-02-01

    We report the results of a multicenter study of arterial, corticomedullary, nephrographic and excretory phase helical computerized tomography (CT) for detecting and characterizing abnormalities causing asymptomatic microscopic hematuria. We evaluated 350 consecutive patients, including 216 men and 134 women 23 to 88 years old, with asymptomatic microscopic hematuria of undetermined cause at 4 medical centers. Patients with known urological pathology were excluded from study. We performed 4 helical CT sequences, including pre-enhancement phase imaging from kidney to symphysis pubis, arterial phase imaging of the kidney and lower pelvis, corticomedullary nephrographic phase imaging of the kidney and lower pelvis, and excretory phase imaging from kidney to symphysis pubis with 2 to 5 mm. collimation and 1 to 1.5 pitch. Of 171 proved lesions 158 were correctly diagnosed. There were 10 false-positive and 13 false-negative diagnoses, indicating 0.9239 sensitivity, 0.9441 specificity, 0.9404 positive and 0.9285 negative predictive values, (p <0.001). All cases of congenital renal lesions, calculous disease, ureteral lesion and neoplastic lesion of the bladder were correctly diagnosed, as were 40 of 41 inflammatory renal, 21 of 23 renal masses and 13 of 16 inflammatory bladder lesions. In 27 patients with renal calculi the study was limited to pre-enhancement spiral CT. A positive diagnosis rate of 45.1% (158 of 350 cases) for the causes of heretofore refractory cases of hematuria with high sensitivity and specificity attest to the effectiveness of our hematuria CT protocol and support its use.

  16. Management of bilateral idiopathic renal hematuria in a dog with silver nitrate

    PubMed Central

    Di Cicco, Michael F.; Fetzer, Tara; Secoura, Patricia L.; Jermyn, Kieri; Hill, Tracy; Chaloub, Serge; Vaden, Shelly

    2013-01-01

    Renal hematuria has limited treatment options. This report describes management of bilateral idiopathic renal hematuria in a dog with surgically assisted installation of 0.5% silver nitrate solution. Initial treatment resulted in freedom from clinical signs or recurrent anemia for 10 months; however, recurrence of bleeding following a nephrectomy resulted in euthanasia. PMID:24155476

  17. [Development of a new technique to detect the laterality of microscopic hematuria by means of gas cystoscopy].

    PubMed

    Kamoi, K; Teraski, T; Kojima, M; Uchida, M; Watanabe, H

    1996-04-01

    We developed a new technique to determine the laterality of microscopic hematuria by means of gas cystoscopy. An originally designed catheter system consisted of two catheters. On the tip of an inner catheter, a urine dipstick for blood was attached, with a cap on the tip of an outer catheter to keep the dipstick dry. In order to react a dipstick with the urine coming out from a ureteral orifice in the bladder, CO2 was insufflated into the bladder through a cystoscope (gas cystoscopy). The laterality of microscopic hematuria was determined in the bladder, based on the color reaction on the dipstick. This technique was performed successfully in 14 (88%) of 16 cases with microscopic hematuria. The laterality of microscopic hematuria was determined to be ipsilateral in 6 patients, which coincided with the side of a urological upper urinary tract disorder. In contract, bilateral microscopic hematuria was confirmed in 8 patients with glomerular disorders. The diagnostic process in patients with microscopic hematuria remains unsolved for urologists and nephrologists. This technique may provide a new approach in diagnosing microscopic hematuria.

  18. Hematuria as a sign of aorto-caval fistula.

    PubMed Central

    Brewster, D C; Ottinger, L W; Darling, R C

    1977-01-01

    An aorto-caval fistula is a rare complication of an abdominal aortic aneurysm (AAA). Typical features, including congestive heart failure and a loud abdominal bruit, may be present and allow prompt diagnosis, but not infrequently they are absent or overlooked and the diagnosis not made preoperatively. Four patients with an AAA and an aorto-caval fistula are described, each of whom presented with hematuria. We believe the presence of hematuria in a patient with a symptomatic AAA should suggest the diagnosis of an aorto-caval fistula. A correct preoperative diagnosis may contribute to better planning of the operative procedure, reduced blood loss, and avoidance of possible pulmonary embolization. Images Fig. 1a. Fig. 1b. Fig. 2a. Fig. 2b. Fig. 3. Fig. 4. PMID:603281

  19. Blood in the Urine (Hematuria) (For Parents)

    MedlinePlus

    ... weeks later, just to make sure the urine is free of red blood cells. Hematuria that only happens once won't ... up tests to make sure your child's urine is free of red blood cells. Reviewed by: Robert S. Mathias, MD Date reviewed: ...

  20. [Hemangioma of the renal calyx].

    PubMed

    Jlidi, R; Jemni, M; Zakhama, A; Mokni, M; Kraim, C; Bouzakoura, C

    1991-01-01

    A case of renal hemangioma in a child is reported. The patient presented with severe painless hematuria. Intravenous pyelography showed a filling defect in the middle calyx of the right kidney. Ultrasonography showed a hypoechoic zone in the renal sinus. Hematuria was unilateral on right side at cystoscopy. Total nephrectomy was performed. The diagnosis was confirmed by histology.

  1. Urothelial papilloma: a rare cause of gross haematuria in childhood.

    PubMed

    Ribeiro, Andreia; Pereira, Maria; Reis, Armando; Ferreira, Graça

    2017-05-13

    Bladder urothelial papilloma is extremely rare in the paediatric population. It usually presents as painless gross haematuria and its diagnosis implies a high index of suspicion as other causes of haematuria predominate in this age range. We describe a 9-year-old boy with two episodes of gross haematuria occurring 1 year apart with spontaneous resolution after 2 days. Bladder ultrasound revealed an endovesical papillary lesion of 24×24 mm suggestive of bladder tumour. The diagnosis was confirmed by histopathological examination of the specimen obtained by cystoscopy with transurethral resection. After 3 years of follow-up with ultrasound and cystoscopy, there are no signs of recurrence. Due to the low prevalence of urothelial papilloma, paediatric guidelines for appropriate management and follow-up are unavailable, making this a challenging entity. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. [Renal cirsoid aneurysm (congenital arteriovenous fistula): a rare cause of severe hematuria].

    PubMed

    Pereira Arias, José Gregorio; Ullate Jaime, Vicente; Pereda Martínez, Esther; Gutiérrez Díez, José María; Ateca Díaz-Obregón, Ricardo; Ramírez Rodríguez, Maria Mar; Berreteaga Gallastegui, José Ramón

    2007-06-01

    Congenital arteriovenous fistulas are an exceptional clinical feature. Although they are frequently asymptomatic, their presentation as severe hematuria pose an excellent diagnostic exercise and often immediate therapeutic action. We report the case of a 75-year-old female patient presenting with severe hematuria producing anaemia, high blood pressure and congestive heart failure. Image tests revealed right ureteral-hydronephrosis with bladder blockage by blood clots. The endoscopic study (cystoscopy and ureterorenoscopy) alerted about the origin of the hematuria from the right kidney, finally requiring nephrectomy as definitive treatment. Pathology revealed the presence of a round formation with multiple vascular channels, arterial and venous, in the pyelocalicial submucosa, with focal epithelial erosion, compatible with congenital arteriovenous fistula. We review the diagnostic and therapeutic features in the literature. Renal congenital arteriovenous fistulas represent a diagnostic dilemma. They may present asymptomatic or condition clinical features derived from the shunt and high cardiac output (hypertensive cardiopathy and congestive heart failure) or from the erosion and acute hemorrhage into the urinary tract (severe renal hematuria). Treatment should be conservative with embolization or supraselective sclerosis. Nevertheless, in cases of big fistulas, post embolization revascularization, or hemodynamic instability nephrectomy is an excellent option.

  3. Macroscopic hematuria caused by congenital portosystemic shunt and concomitant nutcracker syndrome.

    PubMed

    Lee, Sang Hyub; Lee, Dong-Gi

    2015-06-01

    Nutcracker syndrome (NCS) is an uncommon vascular abnormality that causes a variety of symptoms that range from asymptomatic microscopic hematuria to severe pelvic congestion. Congenital portosystemic shunt (CPSS) is an extremely rare anomaly that causes serious complications. Many cases of NCS and CPSS that have presented separately have been reported, but no cases of concomitant NCS and CPSS have been reported. We present a case of intermittent macroscopic hematuria in a patient with both NCS and CPSS. We diagnosed NCS on pressure gradient between the left renal vein (LRV) and the inferior vena cava. The presence of CPSS, which emerged from the LRV and connected to the extrahepatic portal vein, was confirmed on computed tomography. The interaction between NCS and CPSS resulted in mild intermittent macroscopic hematuria only, rather than the more common symptoms that occur when NCS or CPSS present separately. © 2015 Japan Pediatric Society.

  4. Idiopathic renal hematuria in a dog; the usefulness of a method of partial occlusion of the renal artery.

    PubMed

    Mishina, M; Watanabe, T; Yugeta, N; Maeda, H; Fujii, K; Wakao, Y; Takahashi, M; Yamamura, H

    1997-04-01

    Exploratory laparotomy was performed on a dog suspected of having idiopathic renal hematuria. Two catheters were inserted into the bilateral ureters, and hematuria from the left kidney was confirmed. The blood flow was occluded in the ventral and dorsal rami of the left renal artery in order to localize the site of hemorrhage. As hematuria disappeared when the dorsal ramus was occluded, the site of renal hematuria was localized to the area dominated by the dorsal ramus of the renal artery. As a result of ligating the dorsal ramus of the left renal artery in this dog, renal hematuria subsided, and the dog has shown a favorable course, to date, one year after surgery.

  5. Macroscopic Hematuria After Conventional or Hypofractionated Radiation Therapy: Results From a Prospective Phase 3 Study

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

    Sanguineti, Giuseppe, E-mail: sanguineti@ifo.it; Arcidiacono, Fabio; Landoni, Valeria

    2016-10-01

    Purpose: To assess the macroscopic hematuria rates within a single-institution randomized phase 3 trial comparing dose-escalated, conventionally fractionated radiation therapy (CFRT) and moderately hypofractionated radiation therapy (MHRT) for localized prostate cancer. Methods and Materials: Patients with intermediate- to high-risk localized prostate cancer were treated with conformal RT and short-course androgen deprivation. Both the prostate and the entire seminal vesicles were treated to 80 Gy in 40 fractions over 8 weeks (CFRT) or 62 Gy in 20 fractions over 5 weeks (MHRT). The endpoint of the present study was the development of any episode or grade of macroscopic hematuria. The median follow-up period was 93 monthsmore » (range 6-143). Results: Macroscopic hematuria was reported by 25 of 168 patients (14.9%). The actuarial estimate of hematuria at 8 years was 17.0% (95% confidence interval [CI] 10.7%-23.3%). The number of patients with hematuria was 6 and 19 in the CFRT and MHRT arms, respectively, for an actuarial 8-year estimate of 9.7% and 24.3%, respectively (hazard ratio 3.468, 95% CI 1.385-8.684; P=.008). Overall, 8 of 25 patients were found to have biopsy-proven urothelial carcinoma (3 in the CFRT arm and 5 in the MHRT arm; P=.27). Thus, the 8-year actuarial incidence of macroscopic hematuria (after censoring urothelial cancer–related episodes) was 4.1% and 18.2% after CFRT and MHRT, respectively (hazard ratio 4.961, 95% CI 1.426-17.263; P=.012). The results were confirmed by multivariate analysis after accounting for several patient-, treatment-, and tumor-related covariates. Conclusions: MHRT was associated with a statistically significant increased risk of macroscopic hematuria compared with CFRT.« less

  6. An Inexpensive, Point-of-Care Urine Test for Bladder Cancer in Patients Undergoing Hematuria Evaluation.

    PubMed

    Acharya, Abhinav P; Theisen, Kathryn M; Correa, Andres; Meyyappan, Thiagarajan; Apfel, Abraham; Sun, Tao; Tarin, Tatum V; Little, Steven R

    2017-11-01

    Although hematuria (blood in urine) is the most common symptom of bladder cancer, 70-98% of hematuria cases are benign. These hematuria patients unnecessarily undergo costly, invasive, and expensive evaluation for bladder cancer. Therefore, there remains a need for noninvasive office-based tests that can rapidly and reliably rule out bladder cancer in patients undergoing hematuria evaluation. Herein, a clinical assay for matrix metalloproteinases ("Ammps") is presented, which generates a visual signal based on the collagenase activity (in urine of patients) on the Ammps substrates. Ammps substrates are generated by crosslinking gelatin with Fe(II) chelated alginate nanoparticles, which precipitate in urine samples. The cleavage of gelatin-conjugated alginate (Fe(II)) nanoparticles by collagenases generates free-floating alginate (Fe(II)) nanoparticles that participate in Fenton's reaction to generate a visual signal. In a pilot study of 88 patients, Ammps had 100% sensitivity, 85% specificity, and a negative predictive value (NPV) of 100% for diagnosing bladder cancer. This high NPV can be useful in ruling out bladder cancer in patients referred for hematuria evaluation. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Painless thyroiditis associated to thyroid carcinoma: role of initial ultrasonography evaluation.

    PubMed

    Valentini, Raisa Bressan; Macedo, Bruno Mussoi de; Izquierdo, Rogério Friedrich; Meyer, Erika Laurini Souza

    2016-04-01

    Even though it is a rare event, most associations of thyroid carcinoma with subacute thyroiditis described in the literature are related to its granulomatous form (Quervain's thyroiditis). We present a patient with subacute lymphocytic thyroiditis (painless thyroiditis) and papillary thyroid cancer that was first suspected in an initial ultrasound evaluation. A 30-year old female patient who was referred to the emergency room due to hyperthyroidism symptoms was diagnosed with painless thyroiditis established by physical examination and laboratory findings. With the presence of a palpable painless thyroid nodule an ultrasound was prescribed and the images revealed a suspicious thyroid nodule, microcalcification focus in the heterogeneous thyroid parenquima and cervical lymphadenopathy. Fine needle aspiration biopsy was taken from this nodule; cytology was assessed for compatibility with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a multicentric papillary carcinoma and lymphocytic infiltration. Subacute thyroiditis, regardless of type, may produce transitory ultrasound changes that obscure the coexistence of papillary carcinoma. Due to this, initial thyroid ultrasound evaluation should be delayed until clinical recovery. We recommended a thyroid ultrasound exam for initial evaluation of painless thyroiditis, particularly in patients with palpable thyroid nodule. Further cytological examination is recommended in cases presenting with suspect thyroid nodule and/or non-nodular hypoechoic (> 1 cm) or heterogeneous areas with microcalcification focus.

  8. Nutcracker Syndrome and Sickle Cell Trait: A Perfect Storm for Hematuria.

    PubMed

    Ahmad, Amier; McElwee, Samuel K; Kraemer, Ryan R

    2017-05-01

    We describe the case of a 27-year-old woman with a history of sickle cell trait (SCT) who presented with several months of hematuria and was found to have nutcracker syndrome (NCS). While SCT is a common cause of hematuria resulting from renal papillary necrosis, our patient had concomitant abdominal pain and anemia, prompting further evaluation and the subsequent diagnosis of NCS. Interestingly, the anoxia in the left renal vein from NCS predisposes patients with SCT to sickling. Our case highlights key clinical features of both NCS and SCT and the relationship between the two disease processes.

  9. Characteristics of patients with graves disease and intrathyroid hypovascularity compared to painless thyroiditis.

    PubMed

    Uchida, Toyoyoshi; Shigihara, Nayumi; Takeno, Kageumi; Komiya, Koji; Goto, Hiromasa; Abe, Hiroko; Sato, Junko; Honda, Akira; Fujitani, Yoshio; Watada, Hirotaka

    2014-10-01

    The purpose of this study was to assess the frequency and sonographic and laboratory characteristics of Graves disease with intrathyroid hypovascularity in Japanese patients and to compare these characteristics in patients with painless thyroiditis. A total of 194 consecutive patients with Graves disease and 21 patients with painless thyroiditis were enrolled. The patients underwent thyroid volume measurement, mean superior thyroid artery peak systolic velocity (PSV) measurement, power Doppler sonography, and proper blood testing to discriminate between Graves disease and painless thyroiditis. Based on the power Doppler sonographic findings, they were divided into 4 groups: from pattern 0 (most hypovascular thyroid) to pattern III (most hypervascular thyroid). Comparisons of multiple thyroid parameters were made among the groups. The prevalence of Graves disease with pattern 0 (n = 27) was 13.9% among the patients with Graves disease. The sonographic and laboratory data for patients with Graves disease and pattern 0 were compared to those of the 21 patients with painless thyroiditis, which typically shows intrathyroid hypovascularity. Free triiodothyronine and thyroxine levels and the superior thyroid artery PSV were significantly lower in patients with Graves disease and pattern 0 than those with patterns I, II, and III (P < .05). The thyroid volume and thyrotropin receptor antibody level were significantly lower in patients with Graves disease and pattern 0 than those with pattern III. In the comparison between patients with Graves disease and pattern 0 and those with painless thyroiditis and pattern 0, apart from thyrotropin receptor antibody, only the superior thyroid artery PSV was different. Although the clinical features of patients with Graves disease and intrathyroid hypovascularity were similar to those patients with painless thyroiditis, the superior thyroid artery PSV showed a moderate ability to discriminate these patients. © 2014 by the American

  10. Association between arsenic exposure from drinking water and hematuria: Results from the Health Effects of Arsenic Longitudinal Study

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

    McClintock, Tyler R.; Department of Environmental Medicine, New York University School of Medicine, New York, NY; Department of Urology, New York University School of Medicine, New York, NY

    2014-04-01

    Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly relatedmore » to prevalence of hematuria (P-trend < 0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04–1.59), 1.41 (95% CI: 1.15–1.74), 1.46 (95% CI: 1.19–1.79), and 1.56 (95% CI: 1.27–1.91). Compared to those with relatively little absolute urinary As change during follow-up (− 10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80–1.22) and 0.80 (95% CI: 0.65–0.99) for those whose urinary As decreased by > 47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94–1.45) and 1.36 (95% CI: 1.10–1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and > 41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by relatively short-term changes in drinking water As. - Highlights: • Hematuria is the most common symptom of urinary tract disease. • Arsenic exposure is associated with renal dysfunction and urologic malignancy. • Water arsenic was positively associated with prevalence and incidence of hematuria. • Reduction in exposure lowered hematuria risk especially in low

  11. Sex disparities in diagnosis of bladder cancer after initial presentation with hematuria: a nationwide claims-based investigation.

    PubMed

    Cohn, Joshua A; Vekhter, Benjamin; Lyttle, Christopher; Steinberg, Gary D; Large, Michael C

    2014-02-15

    Women have disproportionately higher mortality rates relative to incidence for bladder cancer. Multiple etiologies have been proposed, including delayed diagnosis and treatment. Guidelines recommend ruling out malignancy in men and women presenting with hematuria. This study sought to determine the difference in timing from presentation with hematuria to diagnosis of bladder cancer in women versus men. This is a retrospective population-based study examining the timing from presentation with hematuria to diagnosis of bladder cancer, based on data from the MarketScan databases, which include enrollees of more than 100 health insurance plans of approximately 40 large US employers from 2004 through 2010. All study patients presented with hematuria and were subsequently diagnosed with bladder cancer. The primary outcome measure was number of days between initial presentation with hematuria and diagnosis of bladder cancer by sex. A total of 5416 men and 2233 women met inclusion criteria. Mean days from initial hematuria claim to bladder cancer claim was significantly longer in women (85.4 versus 73.6 days, P < .001), and the proportion of women with >6 month delay in bladder cancer diagnosis was significantly higher (17.3% versus 14.1%, P < .001). Women were more likely to be diagnosed with urinary tract infection (odds ratio = 2.32, 95% confidence interval = 2.07-2.59) and less likely to undergo abdominal or pelvic imaging (odds ratio = 0.80, 95% confidence interval = 0.71-0.89). Both men and women experience significant delays between presentation with hematuria and diagnosis of bladder cancer, with longer delays for women. This may be partly responsible for the sex-based discrepancy in outcomes associated with bladder cancer. © 2013 American Cancer Society.

  12. Urinary Schistosomiasis in an Adolescent Refugee from Africa: An Uncommon Cause of Hematuria and an Emerging Infectious Disease in Europe.

    PubMed

    Poddighe, Dimitri; Castelli, Lucia; Pulcrano, Giovanna; Grosini, Alessia; Balzaretti, Michela; Spadaro, Salvatore; Bruni, Paola

    2016-10-01

    We report a case of urinary schistosomiasis in an adolescent refugee from Gambia (arrived to Italy illegally), who was brought to the Emergency Department of our hospital. The patient complained of gross hematuria and, in the absence of clinical evidence of bacterial urinary infection, was admitted to the pediatric ward, considering his provenience and social setting. An appropriate collection and microscopic analysis of urine samples led to the detection of bilharzia. Much attention should be paid to this emerging disease in Europe by physicians in order to recognize and treat it timely, which could prevent future and higher costs for public health systems and could reduce the potential risk of environmental spreading. In fact, there are some areas in Italy where the parasite can find its intermediate host to complete its lifecycle.

  13. Thyrotoxicosis-induced acute myocardial infarction due to painless thyroiditis.

    PubMed

    Kim, Hee Jin; Jung, Tae Sik; Hahm, Jong Ryeal; Hwang, Seok-Jae; Lee, Sang Min; Jung, Jung Hwa; Kim, Soo Kyoung; Chung, Soon Il

    2011-10-01

    Thyrotoxicosis influences cardiovascular hemodynamics and can induce coronary vasospasm. Patients with thyrotoxicosis-induced acute myocardial infarction (AMI) are unusual and almost all reported cases have been associated with Graves' disease. Patients with painless thyroiditis show a thyrotoxic phase during the early stages. Here we describe a very rare case of thyrotoxicosis with painless thyroiditis-induced AMI. A 35-year-old Korean man visited the emergency room for a 2-hour duration of typical AMI chest pain. The patient did not have any coronary artery disease (CAD) risk factors. The electrocardiogram showed 3 mm of ST-segment elevation in leads II, III, and aVF, which is consistent with inferior AMI. We immediately treated the patient with aspirin, clopidogrel, and nitroglycerine and performed emergent coronary angiography. Coronary angiography showed normal coronary arteries without any stenotic lesions. Consistent with AMI, cardiac enzyme levels of serum creatine kinase (CK), CK-MB, and troponin-I were also elevated. Laboratory findings showed thyrotoxicosis without any thyroid autoantibodies. A 99m-technetium scintigraphy showed markedly decreased thyroid uptake compatible with thyroiditis. We treated the patient with calcium channel blockers and nitrates. The patient spontaneously recovered normal thyroid function after 6 weeks of observation and did not complain of chest pain. Thyrotoxicosis due to painless thyroiditis provoked AMI in a young man who had no atherosclerotic coronary lesions and no CAD risk factors.

  14. Radio-frequency ablation: new technology for palliative treatment of hematuria in disseminated renal cell carcinoma.

    PubMed

    Matuszewski, Margin; Krajka, Kazimierz

    2007-01-01

    Hematuria is often a significant symptom in patients with disseminated renal cell carcinoma. We present a case in which the minimally invasive procedure of radio-frequency ablation was used in a patient with serious hematuria. The procedure was completely successful and there were no complications. In our opinion it may be recommended in such a situation.

  15. Should the presence of a culture positive urinary tract infection exclude patients from rapid evaluation hematuria protocols?

    PubMed

    Vasdev, Nikhil; Thorpe, Andrew C

    2013-08-01

    Current rapid evaluation protocols for patients with hematuria tend to exclude those with urinary tract infection since this is assumed to be evidence of a benign treatable cause. The likelihood of a urinary tract cancer in such patients is, however, uncertain, and we have therefore analyzed a prospective hematuria clinic database to determine risk. A total of 1,740 patients were enrolled prospectively in this study at our unit's one stop fast track hematuria clinic between April 2003 and March 2006. Evaluation of patients consisted of basic demographics, history and examination, urinalysis, urine culture, urine cytology, and serum creatinine. All patients then underwent a renal ultrasound, intravenous urogram, and cystoscopy. A total of 1,067 males and 673 females with a mean (range) age of 60.8 (16-96) years were included in the study. One hundred sixty-one patients had a positive mid-stream urine (MSU) on a specimen collected at the hematuria clinic. Amongst this group 20% (32) patients had a urologic malignancy diagnosed, of whom 12% (4) had metastatic disease at presentation. Only 1% (3) of patients had a urologic malignancy with a previous history of a treated urinary tract infection (UTI) and negative MSU at the clinic. The risk of urologic malignancy was 24% (303) in the remaining 1,249 patients with no history of a UTI prior to presentation and a negative MSU on a specimen collected at the one stop fast track hematuria clinic. Despite selection bias inherent in this analysis, it appears that the presence of UTI does not decrease the likelihood of having a urologic malignancy diagnosed. Hence, there is no indication to delay prompt evaluation in patients with hematuria and a positive urine culture collected at the hematuria clinic. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Can renal and bladder ultrasound replace CT urogram in patients investigated for microscopic hematuria?

    PubMed

    Tan, Wei Shen; Sarpong, Rachael; Khetrapal, Pramit; Rodney, Simon; Mostafid, Hugh; Cresswell, Joanne; Hicks, James; Rane, Abhay; Henderson, Alastair; Watson, Dawn; Cherian, Jacob; Williams, Norman; Brew-Graves, Chris; Feber, Andrew; Kelly, John D

    2018-04-24

    Computed tomography urogram (CTU) is recommended when investigating patients with hematuria. We determine the incidence of urinary tract cancer and compare the diagnostic accuracy of CTU and renal and bladder ultrasound (RBUS) at identifying urinary tract cancer. The DETECT I study (clinicaltrials.gov NCT02676180) is a prospective observational study recruiting patients ≥18 years following a presentation of macroscopic or microscopic haematuria at 40 hospitals. All patients had cystoscopy and upper tract imaging (CTU, RBUS or both). 3,556 patients with a median age of 68 years were recruited, of which 2166 had RBUS and 1692 had CTU in addition to cystoscopy. The incidence of bladder, renal and upper tract urothelial cancer (UTUC) were 11.0%, 1.4% and 0.8% respectively in macroscopic hematuria patients. Patients with microscopic hematuria had a 2.7%, 0.4% and 0% incidence of bladder, renal and UTUC respectively. The sensitivity and negative predictive value (NPV) of RBUS for the detection of renal cancer was 85.7% and 99.9% respectively but 14.3% and 99.7% for the detection of UTUC. RBUS was poor at identifying renal calculi. Sensitivity of RBUS was lower than CTU for the detection of bladder cancer (both <85%). Cystoscopy has a specificity and PPV of 98.3% and 83.9% respectively. CTU can be safely replaced with RBUS in patients with microscopic hematuria. The incidence of UTUC is 0.8% in patients with macroscopic hematuria and CTU is recommended. Patients with suspected renal calculi will require non-contrast renal tract CT. Imaging cannot replace cystoscopy to diagnose bladder cancer. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Endovascular Management of Ureteroarterial Fistula: A Rare Potentially Life Threatening Cause of Hematuria

    PubMed Central

    Copelan, Alexander; Chehab, Monzer; Cash, Charles; Korman, Howard; Dixit, Purushottam

    2014-01-01

    Ureteroarterial fistula is a rare, potentially life-threatening cause of hematuria characterized by an abnormal channel between a ureter and artery. The rarity of this condition, complexity of predisposing risk factors and intermittence of symptoms may delay or obscure its diagnosis. With a high index of suspicion and careful angiographic evaluation, embarking on this condition is not only possible but sets the stage for curative intervention. We report a case of a ureteroarterial fistula presenting with intermittent hematuria, successfully diagnosed at angiography and managed with endovascular stent graft placement. PMID:25426238

  18. Severe hematuria after transurethral electrocoagulation in a patient with an arteriovesical fistula.

    PubMed

    Zheng, Xiangyi; Lin, Yiwei; Chen, Bin; Zhou, Xianyong; Zhou, Xiaofeng; Shen, Yuehong; Xie, Liping

    2013-12-01

    Arteriovesical fistulas are extremely rare. Only eleven cases were previously reported in the literature. They can occur iatrogenically, traumatically or spontaneously. We report an unusual case of a 62-year-old woman with arteriovesical fistula that developed fatal hematuria after transurethral electrocoagulation. Computed tomography (CT) and selective angiography revealed a pseudoaneurysm of the right superior vesical artery with arteriovesical fistula formation, which was managed by transarterial embolization. Contrast enhanced CT or CT angiography should be performed when a pulsatile hemorrhage is revealed during cystoscopy. Therapeutic vesical arterial embolization should be considered as a safe and effective procedure for arteriovesical fistulas. Transurethral electrocoagulation may cause severe hematuria for pulsatile bladder bleeding in patients with pelvic vascular malformation.

  19. Acute bilateral painless radiculitis with abnormal Borrelia burgdorferi immunoblot.

    PubMed

    Almodovar, Jorge L; Hehir, Michael K; Nicholson, Katharine A; Stommel, Elijah W

    2012-12-01

    A 57-year-old woman with a history of hypertension and hypothyroidism presented with painless left arm weakness and numbness 2 weeks before evaluation. Nerve conduction studies of the left arm revealed normal motor and sensory responses. Needle examination revealed acute denervation changes in all myotomes of the affected extremity, including cervical paraspinals on the left, and several myotomes on the contralateral side. The laboratory evaluation revealed normal anti-GM1 antibodies and 3 IgM/5 IgG bands on Lyme Western Blot. The patient began treatment with 28 days of intravenous ceftriaxone. On follow-up, patient had regained full strength of her extremities with no sensory deficits. Inflammatory borrelia radiculitis usually presents with pain in the distribution of the affected nerves and nerve roots. The novelty of this case report rests on (1) the absence of primary borreliosis symptomatology preceding the radiculitis and (2) the painless and bilateral clinical presentation in a patient with suspected Lyme radiculitis.

  20. Hematuria and clot retention after transvaginal oocyte aspiration: a case report.

    PubMed

    Modder, Joshua; Kettel, L Michael; Sakamoto, Kyoko

    2006-09-01

    To report a case of bladder injury with hematuria and urinary retention after transvaginal oocyte aspiration. Case report. Emergency room in a university medical center. A 28-year-old woman presented with urinary retention and suprapubic pain 8 hours after oocyte aspiration. Foley catheter, intravenous fluid bolus, bladder irrigation, and computed tomography with postvoid films that showed a blood clot in the bladder. Patient was discharged home with antibiotics and catheter in place. Clinical follow-up. Patient passed voiding trial 4 days later and was artificially inseminated. No further hematuria or voiding problems were reported, and she had a successful pregnancy. Patients who elect to undergo oocyte aspiration should be warned about the possibility of bladder injury because of the close proximity of the ovaries to the bladder, and physicians should have an appropriate treatment plan.

  1. Severe hematuria after transurethral electrocoagulation in a patient with an arteriovesical fistula

    PubMed Central

    2013-01-01

    Background Arteriovesical fistulas are extremely rare. Only eleven cases were previously reported in the literature. They can occur iatrogenically, traumatically or spontaneously. Case presentation We report an unusual case of a 62-year-old woman with arteriovesical fistula that developed fatal hematuria after transurethral electrocoagulation. Computed tomography (CT) and selective angiography revealed a pseudoaneurysm of the right superior vesical artery with arteriovesical fistula formation, which was managed by transarterial embolization. Conclusions Contrast enhanced CT or CT angiography should be performed when a pulsatile hemorrhage is revealed during cystoscopy. Therapeutic vesical arterial embolization should be considered as a safe and effective procedure for arteriovesical fistulas. Transurethral electrocoagulation may cause severe hematuria for pulsatile bladder bleeding in patients with pelvic vascular malformation. PMID:24289138

  2. Association between arsenic exposure from drinking water and hematuria: results from the Health Effects of Arsenic Longitudinal Study.

    PubMed

    McClintock, Tyler R; Chen, Yu; Parvez, Faruque; Makarov, Danil V; Ge, Wenzhen; Islam, Tariqul; Ahmed, Alauddin; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Sarwar, Golam; Slavkovich, Vesna; Bjurlin, Marc A; Graziano, Joseph H; Ahsan, Habibul

    2014-04-01

    Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly related to prevalence of hematuria (P-trend<0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04-1.59), 1.41 (95% CI: 1.15-1.74), 1.46 (95% CI: 1.19-1.79), and 1.56 (95% CI: 1.27-1.91). Compared to those with relatively little absolute urinary As change during follow-up (-10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80-1.22) and 0.80 (95% CI: 0.65-0.99) for those whose urinary As decreased by >47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94-1.45) and 1.36 (95% CI: 1.10-1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and >41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by relatively short-term changes in drinking water As. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Association between arsenic exposure from drinking water and hematuria: results from the Health Effects of Arsenic Longitudinal Study

    PubMed Central

    McClintock, Tyler R.; Chen, Yu; Parvez, Faruque; Makarov, Danil V.; Ge, Wenzhen; Islam, Tariqul; Ahmed, Alauddin; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Sarwar, Golam; Slavkovich, Vesna; Bjurlin, Marc A.; Graziano, Joseph H.; Ahsan, Habibul

    2014-01-01

    Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7,843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly related to prevalence of hematuria (P-trend < 0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04–1.59), 1.41 (95% CI: 1.15–1.74), 1.46 (95% CI: 1.19–1.79), and 1.56 (95% CI: 1.27–1.91). Compared to those with relatively little absolute urinary As change during follow-up (−10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80–1.22) and 0.80 (95% CI: 0.65–0.99) for those whose urinary As decreased by >47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94–1.45) and 1.36 (95% CI: 1.10–1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and >41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by short-term changes in drinking water As. PMID:24486435

  4. Response of Drosophila to wasabi is mediated by painless, the fly homolog of mammalian TRPA1/ANKTM1.

    PubMed

    Al-Anzi, Bader; Tracey, W Daniel; Benzer, Seymour

    2006-05-23

    A number of repellent compounds produced by plants elicit a spicy or pungent sensation in mammals . In several cases, this has been found to occur through activation of ion channels in the transient receptor potential (TRP) family . We report that isothiocyanate (ITC), the pungent ingredient of wasabi, is a repellent to the insect Drosophila melanogaster, and that the painless gene, previously known to be required for larval nociception, is required for this avoidance behavior. A painless reporter gene is expressed in gustatory receptor neurons of the labial palpus, tarsus, and wing anterior margin, but not in olfactory receptor neurons, suggesting a gustatory role. Indeed, painless expression overlaps with a variety of gustatory-receptor gene reporters. Some, such as Gr66a, are known to be expressed in neurons that mediate gustatory repulsion . painless mutants are not taste blind; they show normal aversive gustatory behavior with salt and quinine and attractive responses to sugars and capsaicin. The painless gene is an evolutionary homolog of the mammalian "wasabi receptor" TRPA1/ANKTM1 , also thought to be involved in nociception. Our results suggest that the stinging sensation of isothiocyanate is caused by activation of an evolutionarily conserved molecular pathway that is also used for nociception.

  5. Survey of parental willingness to pay and willingness to stay for "painless" intravenous catheter placement.

    PubMed

    Walsh, Brooks Myrick; Bartfield, Joel Michael

    2006-11-01

    This study examined how much parents are willing to pay and/or willing to stay to make their child's intravenous (IV) catheter placement painless. A prospective survey was conducted using a questionnaire administered to a consecutive sample of parents presenting to an emergency department (ED). Eligible subjects were parents accompanying a child 8 years of age or younger. A hypothetical visit to the ED, requiring an IV for their child, was described. Parents were asked if they would prefer to make the IV catheter placement painless and if so, how much of an increase in out-of-pocket cost (none, 15 dollars, and 100 dollars) and/or length of stay they would be willing to incur (no time, 15 minutes, 1 hour). Statistics were chiefly descriptive. Associations of demographic elements with willingness to pay and willingness to stay were analyzed using chi and t tests, where appropriate. One hundred eight subjects were available for analysis. Most parents were mothers (71%), white (53%), and with previous IVs (70%). Most children were boys (55%) with no previous IV placements (55%). The choice of a painless IV placement was independent of demographics and IV experience. Most parents (89%) chose a painless IV placement. Of these parents, 65% chose a willingness to stay of 1 extra hour, and 77% a willingness to pay at least 15 dollars; 37% of parents would pay 100 dollars. Willingness to pay was dependent on both income (P = 0.014) and ethnicity (P = 0.0013). Willingness to stay was independent of both income (P = 0.24) and ethnicity (P = 0.07). Parents are willing to spend both time and money to make their child's IV placement painless. This information should be considered when choosing therapies to reduce the pain of IV placement.

  6. Thyrotoxic periodic paralysis associated with transient thyrotoxicosis due to painless thyroiditis.

    PubMed

    Oh, Sang Bo; Ahn, Jinhee; Oh, Min Young; Choi, Bo Gwang; Kang, Ji Hyun; Jeon, Yun Kyung; Kim, Sang Soo; Kim, Bo Hyun; Kim, Yong Ki; Kim, In Joo

    2012-07-01

    Thyrotoxic periodic paralysis (TPP) is a rare manifestation of hyperthyroidism characterized by muscle weakness and hypokalemia. All ethnicities can be affected, but TPP typically presents in men of Asian descent. The most common cause of TPP in thyrotoxicosis is Graves' disease. However, TPP can occur with any form of thyrotoxicosis. Up to our knowledge, very few cases ever reported the relationship between TPP and painless thyroiditis. We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. The paralytic attack did not recur after improving the thyroid function. Therefore, it is necessary that early diagnosis of TPP due to transient thyrotoxicosis is made to administer definite treatment and prevent recurrent paralysis.

  7. Thyrotoxic Periodic Paralysis Associated with Transient Thyrotoxicosis Due to Painless Thyroiditis

    PubMed Central

    Oh, Sang Bo; Ahn, Jinhee; Oh, Min Young; Choi, Bo Gwang; Kang, Ji Hyun; Jeon, Yun Kyung; Kim, Sang Soo; Kim, Yong Ki; Kim, In Joo

    2012-01-01

    Thyrotoxic periodic paralysis (TPP) is a rare manifestation of hyperthyroidism characterized by muscle weakness and hypokalemia. All ethnicities can be affected, but TPP typically presents in men of Asian descent. The most common cause of TPP in thyrotoxicosis is Graves' disease. However, TPP can occur with any form of thyrotoxicosis. Up to our knowledge, very few cases ever reported the relationship between TPP and painless thyroiditis. We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. The paralytic attack did not recur after improving the thyroid function. Therefore, it is necessary that early diagnosis of TPP due to transient thyrotoxicosis is made to administer definite treatment and prevent recurrent paralysis. PMID:22787383

  8. The role of molecular genetics in diagnosing familial hematuria(s).

    PubMed

    Deltas, Constantinos; Pierides, Alkis; Voskarides, Konstantinos

    2012-08-01

    Familial microscopic hematuria (MH) of glomerular origin represents a heterogeneous group of monogenic conditions involving several genes, some of which remain unknown. Recent advances have increased our understanding and our ability to use molecular genetics for diagnosing such patients, enabling us to study their clinical characteristics over time. Three collagen IV genes, COL4A3, COL4A4, and COL4A5 explain the autosomal and X-linked forms of Alport syndrome (AS), and a subset of thin basement membrane nephropathy (TBMN). A number of X-linked AS patients follow a milder course reminiscent of that of patients with heterozygous COL4A3/COL4A4 mutations and TBMN, while at the same time a significant subset of patients with TBMN and familial MH progress to chronic kidney disease (CKD) or end-stage kidney disease (ESKD). A mutation in CFHR5, a member of the complement factor H family of genes that regulate complement activation, was recently shown to cause isolated C3 glomerulopathy, presenting with MH in childhood and demonstrating a significant risk for CKD/ESKD after 40 years old. Through these results molecular genetics emerges as a powerful tool for a definite diagnosis when all the above conditions enter the differential diagnosis, while in many at-risk related family members, a molecular diagnosis may obviate the need for another renal biopsy.

  9. Prevalence of hypertension, obesity, hematuria and proteinuria amongst healthy adolescents living in Western Saudi Arabia

    PubMed Central

    Hothan, Kholoud A.; Alasmari, Bashaer A.; Alkhelaiwi, Omniya K.; Althagafi, Khalid M.; Alkhaldi, Abdulaziz A.; Alfityani, Ahmed K.; Aladawi, Mohannad M.; Sharief, Sara N.; Desoky, Sherif El; Kari, Jameela A.

    2016-01-01

    Objectives: To determine the prevalence of hypertension, obesity, hematuria, and proteinuria among healthy adolescents and to determine the associated risk factors. Methods: This is a cross-sectional study of 8 intermediate schools in Jeddah, Saudi Arabia between March 2015 and June 2015. Samples were selected randomly and equal proportions from each school for both genders were ensured. Both blood pressure and body mass index were measured and a brief questionnaire was filled out for the specified studied group. Urine dipstick analysis was carried out for 294 children. A second questionnaire was completed for hypertensive and obese subjects in addition to those with hematuria and proteinuria. Results: A total of 401 children (200 males) with a mean (SD) age of 13.87 (1.27) were included. Hypertension was found in 17.2% with a male to female ratio of 1.4:1. Pre-hypertension was found in 4.2% of our sample with a male to female ratio of 2.1:1. Obesity was found in 19.2% with a male to female ratio of 1.5:1. Obesity was found to be the most significant risk factor for hypertension with a related risk: 2.87, 95% and confidence interval: 1.9-4.3. For urine abnormalities, 10.2% of samples were positive for proteinuria, 17% for hematuria, and 3.1% for both. Conclusion: It was found that there is a positive correlation between the incidence of obesity and hypertension in adolescents. Hematuria and proteinuria were also found to be high. Screening and prevention programs are therefore recommended. PMID:27652364

  10. Ratio of serum free triiodothyronine to free thyroxine in Graves' hyperthyroidism and thyrotoxicosis caused by painless thyroiditis.

    PubMed

    Yoshimura Noh, Jaeduk; Momotani, Naoko; Fukada, Shuji; Ito, Koichi; Miyauchi, Akira; Amino, Nobuyuki

    2005-10-01

    The serum T3 to T4 ratio is a useful indicator for differentiating destruction-induced thyrotoxicosis from Graves' thyrotoxicosis. However, the usefulness of the serum free T3 (FT3) to free T4 (FT4) ratio is controversial. We therefore systematically evaluated the usefulness of this ratio, based on measurements made using two widely available commercial kits in two hospitals. Eighty-two untreated patients with thyrotoxicosis (48 patients with Graves' disease and 34 patients with painless thyroiditis) were examined in Kuma Hospital, and 218 patients (126 with Graves' disease and 92 with painless thyroiditis) and 66 normal controls were examined in Ito Hospital. The FT3 and FT4 values, as well as the FT3/FT4 ratios, were significantly higher in the patients with Graves' disease than in those with painless thyroiditis in both hospitals, but considerable overlap between the two disorders was observed. Receiver operating characteristic (ROC) curves for the FT3 and FT4 values and the FT3/FT4 ratios of patients with Graves' disease and those with painless thyroiditis seen in both hospitals were prepared, and the area under the curves (AUC), the cut-off points for discriminating Graves' disease from painless thyroiditis, the sensitivity, and the specificity were calculated. AUC and sensitivity of the FT(3)/FT(4) ratio were smaller than those of FT(3) and FT(4) in both hospitals. The patients treated at Ito hospital were then divided into 4 groups according to their FT4 levels (A: < or =2.3, B: >2.3 approximately < or =3.9, C: 3.9 approximately < or =5.4, D: >5.4 ng/dl), and the AUC, cut-off points, sensitivity, and specificity of the FT(3)/FT(4) ratios were calculated. The AUC and sensitivity of each group increased with the FT4 levels (AUC: 57.8%, 72.1%, 91.1%, and 93.4%, respectively; sensitivity: 62.6%, 50.0%, 77.8%, and 97.0%, respectively). The means +/- SE of the FT3/FT4 ratio in the Graves' disease groups were 3.1 +/- 0.22, 3.1 +/- 0.09, 3.2 +/- 0.06, and 3.1 +/- 0

  11. Role of Diffusion-Weighted Magnetic Resonance (MR) Imaging in Differentiation Between Graves' Disease and Painless Thyroiditis.

    PubMed

    Abdel Razek, Ahmed Abdel Khalek; Abd Allah, Sieza Samir; El-Said, Amr Abd El-Hamid

    2017-01-01

    To assess the role of diffusion-weighted MR imaging in differentiation between Graves' disease and painless thyroiditis. A prospective study was conducted among 37 consecutive patients with untreated thyrotoxicosis (25 female and 12 male; mean age of 44 years) and 15 ageand sex-matched controls. Diffusion-weighted MR imaging of the thyroid gland was performed in patients and controls. The apparent diffusion coefficient (ADC) value of the thyroid gland was calculated and correlated with Tc-99m uptake and thyroid function tests of the patients. There was a significant difference in the ADC value of the thyroid gland between patients and the control group ( P =0.001). The mean ADC value of the thyroid gland in Graves' disease was 2.03±0.28×10 -3 mm 2 /sec, and in patients with painless thyroiditis 1.46±0.22×10 -3 mm 2 /sec, respectively. There was a significant difference in the ADC values between Graves' disease and painless thyroiditis ( P =0.001). When the ADC value of 1.45×10 -3 mm 2 /sec was used as a threshold value for differentiating Graves' disease from painless thyroiditis, the best result was obtained with area under the curve of 0.934, accuracy of 83.8%, sensitivity of 95.8%, and specificity of 61.5%. The mean ADC value of the thyroid gland in patients positively correlated with serum TRAb and Tc-99m uptake ( r =0.57, P =0.001 and r =0.74, P =0.001, respectively). We concluded that ADC values of the thyroid gland can be used to differentiate Graves' disease from painless thyroiditis in patients with untreated thyrotoxicosis.

  12. Association of dipstick hematuria with all-cause mortality in the general population: results from the specific health check and guidance program in Japan.

    PubMed

    Iseki, Kunitoshi; Konta, Tsuneo; Asahi, Koichi; Yamagata, Kunihiro; Fujimoto, Shouichi; Tsuruya, Kazuhiko; Narita, Ichiei; Kasahara, Masato; Shibagaki, Yugo; Moriyama, Toshiki; Kondo, Masahide; Iseki, Chiho; Watanabe, Tsuyoshi

    2018-05-01

    Dipstick urine tests are used for general health screening in Japan. The effects of this screening on mortality have not been examined, especially with regard to hematuria. Subjects were those who participated in the 2008 Tokutei-Kenshin (nationwide specific health check and guidance program) in six districts in Japan. Using the national database of death certificates from 2008 to 2012, we identified subjects who might have died. We verified the candidates in collaboration with the regional National Health Insurance agency and public health nurses. Data were released to the research team supported by the Ministry of Health, Labor, and Welfare of Japan. Dipstick results of 1+ and higher were defined as hematuria (+). Hazard ratio (HR) [95% confidence interval (CI)] was calculated using the Cox proportional hazard analysis. Among 112 115 subjects, we identified that 1290 had died by the end of 2012. In hematuria (-) subjects, the crude mortality rates were 1.2% (1.8% in men, 0.7% in women), whereas in hematuria (+) subjects, they were 1.1% (2.9% in men, 0.7% in women). After adjusting for age, body mass index, estimated glomerular filtration rate, proteinuria, comorbid condition (diabetes mellitus, hypertension and dyslipidemia), past history (stroke, heart disease and kidney disease) and lifestyle (smoking, drinking, walking and exercise), the HR (95% CI) for dipstick hematuria (+) in men was 1.464 (1.147-1.846; P = 0.003), whereas that for hematuria (-) was 0.820 (0.617-1.073; P = 0.151). Dipstick hematuria is significantly associated with mortality in men among Japanese community-based screening participants.

  13. Thyroid profiles in a patient with resistance to thyroid hormone and episodes of thyrotoxicosis, including repeated painless thyroiditis.

    PubMed

    Taniyama, Matsuo; Otsuka, Fumiko; Tozaki, Teruaki; Ban, Yoshiyuki

    2013-07-01

    Thyrotoxic disease can be difficult to recognize in patients with resistance to thyroid hormone (RTH) because the clinical symptoms of thyrotoxicosis cannot be observed, and thyrotropin (TSH) may not be suppressed because of hormone resistance. Painless thyroiditis is a relatively common cause of thyrotoxicosis, but its occurrence in RTH has not been reported. We assessed the thyroid profile in a patient with RTH and episodes of thyrotoxicosis who experienced repeated painless thyroiditis. A 44-year-old Japanese woman with RTH, which was confirmed by the presence of a P453A mutation in the thyroid hormone receptor β (TRβ) gene, showed a slight elevation of the basal levels of thyroid hormones, which indicated that her pituitary RTH was mild. She experienced a slight exacerbation of hyperthyroxinemia concomitant with TSH suppression. A diagnosis of painless thyroiditis was made because of the absence of TSH receptor antibodies, low Tc-99m pertechnetate uptake by the thyroid gland, and transient suppression followed by a slight elevation of TSH following the elevation of thyroid hormones. The patient's complaints of general malaise and occasional palpitations did not change throughout the course of painless thyroiditis. Three years later, painless thyroiditis occurred again without any deterioration of the clinical manifestations. Mild pituitary RTH can be overcome by slight exacerbation of hyperthyroxinemia during mild thyrotoxicosis. When pituitary resistance is severe and TSH is not suppressed, thyrotoxicosis may be overlooked.

  14. [Clinical study on painless labor under drugs combined with acupuncture analgesia].

    PubMed

    Jin, Y; Wu, L; Xia, Y

    1996-01-01

    To study the analgesia efficacy of drugs combined with acupuncture analgesia for painless labor, 462 normal pregnancy women were observed. During the latent phase in labor, several analgesia methods: acupuncture analgesia, analgesics, magnetotherapy and auricular acupressure, TENS combined with dihydroetorphine were used respectively. While the intrauterine pressure and the peripheral content of beta-EP were measured during labor, the experiments of SEPS were also performed on healthy adults to demonstrate the analgesia efficacy of those analgesia methods. The combination of drugs with acupuncture is an excellent method for painless labor without any complications and all the mothers and babies are safety. The effectiveness is 97.5%. The results demonstrate that the mechanism of analgesia efficacy should be regulated the incoordinate uterine action and improve the hypertonic status of uterus, but also can decrease the pain threshold and elevate the tolerance of uterine contractions during labor.

  15. Role of Diffusion-Weighted Magnetic Resonance (MR) Imaging in Differentiation Between Graves’ Disease and Painless Thyroiditis

    PubMed Central

    Abdel Razek, Ahmed Abdel Khalek; El-Said, Amr Abd El-hamid

    2017-01-01

    Summary Background To assess the role of diffusion-weighted MR imaging in differentiation between Graves’ disease and painless thyroiditis. Material/Methods A prospective study was conducted among 37 consecutive patients with untreated thyrotoxicosis (25 female and 12 male; mean age of 44 years) and 15 ageand sex-matched controls. Diffusion-weighted MR imaging of the thyroid gland was performed in patients and controls. The apparent diffusion coefficient (ADC) value of the thyroid gland was calculated and correlated with Tc-99m uptake and thyroid function tests of the patients. Results There was a significant difference in the ADC value of the thyroid gland between patients and the control group (P=0.001). The mean ADC value of the thyroid gland in Graves’ disease was 2.03±0.28×10–3 mm2/sec, and in patients with painless thyroiditis 1.46±0.22×10–3 mm2/sec, respectively. There was a significant difference in the ADC values between Graves’ disease and painless thyroiditis (P=0.001). When the ADC value of 1.45×10–3 mm2/sec was used as a threshold value for differentiating Graves’ disease from painless thyroiditis, the best result was obtained with area under the curve of 0.934, accuracy of 83.8%, sensitivity of 95.8%, and specificity of 61.5%. The mean ADC value of the thyroid gland in patients positively correlated with serum TRAb and Tc-99m uptake (r=0.57, P=0.001 and r=0.74, P=0.001, respectively). Conclusions We concluded that ADC values of the thyroid gland can be used to differentiate Graves’ disease from painless thyroiditis in patients with untreated thyrotoxicosis. PMID:29662585

  16. Awareness that early cancer lump is painless could decrease breast cancer mortality in developing countries.

    PubMed

    Garg, Pankaj

    2016-06-10

    There are several factors which contribute to patients' reporting late to healthcare facility even after detecting the breast lump (patient delay). Amongst these, one of the important factors in low- and middle-income countries is lack of awareness that early cancer lump is painless (ECLIPs). Pain is often taken as a danger sign and absence of pain is often not taken seriously. The studies have shown that up to 98% of women in low-income countries are unaware that a painless lump could be a warning sign of early breast cancer. This fact is significant because this could be one of the prime reasons for the women having discovered a painless lump in the breast, accidentally or by breast self-examination, presume it to be harmless and don't report early to health care facility. Therefore, creating awareness about ECLIPs could be an effective strategy to reduce mortality due to breast cancer in low- and middle-income countries. Moreover, unlike modifying risk factors which requires long term behavior modification, creating awareness about ECLIPs is easy and cost effective.

  17. Simultaneous uterine and urinary bladder rupture in an otherwise successful vaginal birth after cesarean delivery.

    PubMed

    Ho, Szu-Ying; Chang, Shuenn-Dhy; Liang, Ching-Chung

    2010-12-01

    Uterine rupture is the primary concern when a patient chooses a trial of labor after a cesarean section. Bladder rupture accompanied by uterine rupture should be taken into consideration if gross hematuria occurs. We report the case of a patient with uterine rupture during a trial of labor after cesarean delivery. She had a normal course of labor and no classic signs of uterine rupture. However, gross hematuria was noted after repair of the episiotomy. The patient began to complain of progressive abdominal pain, gross hematuria and oliguria. Cystoscopy revealed a direct communication between the bladder and the uterus. When opening the bladder peritoneum, rupture sites over the anterior uterus and posterior wall of the bladder were noted. Following primary repair of both wounds, a Foley catheter was left in place for 12 days. The patient had achieved a full recovery by the 2-year follow-up examination. Bladder injury and uterine rupture can occur at any time during labor. Gross hematuria immediately after delivery is the most common presentation. Cystoscopy is a good tool to identify the severity of bladder injury. Copyright © 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

  18. Urogenital schistosomiasis and urological assessment of hematuria in preschool-aged children in rural communities of Nigeria.

    PubMed

    Salawu, Oyetunde T; Odaibo, Alexander B

    2014-02-01

    The study evaluates the prevalence of urogenital schistosomiasis and diagnostic performance of chemical reagent strips used for disease diagnosis in preschool-aged children (≤ 5 years) in Nigeria rural communities. Urine samples from 419 children were observed microscopically for Schistosoma haematobium and screened for hematuria using standard urine chemical reagent strips. Prevalence and intensity of infection were 9.8% and 14.4 eggs/10 ml of urine, respectively. Prevalence of infection was similar in girls (10%) and boys (9.6%) (p > 0.05). The intensity of infection was higher in boys (17.1 eggs/10 ml of urine) than in girls (12.8 eggs/10 ml of urine); however, this was not gender dependent (p > 0.05). The occurrence of hematuria was not associated with gender (p > 0.05), but was associated with prevalence of infection (p < 0.05). Infection with S. haematobium occurs early in life in the communities and although intensity of infection is low, it could have serious implications in disease transmission. Hematuria, although moderately sensitive to infection, is an important morbidity indicator of urogenital schistosomiasis in the study population. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  19. Variation in the Diagnostic Evaluation among Persons with Hematuria: Influence of Gender, Race and Risk Factors for Bladder Cancer.

    PubMed

    Ark, Jacob T; Alvarez, JoAnn R; Koyama, Tatsuki; Bassett, Jeffrey C; Blot, William J; Mumma, Michael T; Resnick, Matthew J; You, Chaochen; Penson, David F; Barocas, Daniel A

    2017-11-01

    We sought to determine whether race, gender and number of bladder cancer risk factors are significant predictors of hematuria evaluation. We used self-reported data from SCCS (Southern Community Cohort Study) linked to Medicare claims data. Evaluation of subjects diagnosed with incident hematuria was considered complete if imaging and cystoscopy were performed within 180 days of diagnosis. Exposures of interest were race, gender and risk factors for bladder cancer. Of the 1,412 patients evaluation was complete in 261 (18%). On our adjusted analyses African American patients were less likely than Caucasian patients to undergo any aspect of evaluation, including urology referral (OR 0.72, 95% CI 0.56-0.93), cystoscopy (OR 0.67, 95% CI 0.50-0.89) and imaging (OR 0.75, 95% CI 0.59-0.95). Women were less likely than men to be referred to a urologist (OR 0.59, 95% CI 0.46-0.76). Also, although all patients with 2 or 3 risk factors had 31% higher odds of urology referral (OR 1.31, 95% CI 1.02-1.69), adjusted analyses indicated that this effect was only apparent among men. Only 18% of patients with an incident hematuria diagnosis underwent complete hematuria evaluation. Gender had a substantial effect on referral to urology when controlling for socioeconomic factors but otherwise it had an unclear role on the quality of evaluation. African American patients had markedly lower rates of thorough evaluation than Caucasian patients. Number of risk factors predicted referral to urology among men but it was otherwise a poor predictor of evaluation. There is opportunity for improvement by increasing the completion of hematuria evaluations, particularly in patients at high risk and those who are vulnerable. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. The influence of renal manifestations to the progression of autosomal dominant polycystic kidney disease

    PubMed Central

    Idrizi, A; Barbullushi, M; Petrela, E; Kodra, S; Koroshi, A; Thereska, N

    2009-01-01

    Background: Renal stones, urinary tract infections (UTI) and gross hematuria (GH) are the most important renal manifestations of autosomal dominant polycystic kidney disease (ADPKD). They are not only common, but are also frequent cause of morbidity, influencing renal dysfunction. The aim of this study was to evaluate the frequency of these manifestations in our patients with ADPKD and their impact on renal function. Methods: One hundred eighty ADPKD patients were included in the study. Subjects were studied for the presence of UTI, gross hematuria frequency and responsible factors of nephrolithiasis. Survival times were calculated as the time to renal replacement therapy or time of serum creatinine value up to 10 mg/dl. Kaplan-Meier product-limit survival curves were constructed, and log rank test was used to compare the survival curves. Results: Kidney stones were present in 76/180 (42% of pts). The stones were composed of urate (47%) calcium oxalate (39%), and other compounds 14%. UTI was observed in 60% (108 patients). Patients treated with urinary disinfectants had a significant lower frequency of urinary infection (p<0.001) and hematuria (p<0.001) after one year than untreated patients. Gross hematuria was present in 113 patients (63%). In 43 patients hematuria was diagnosed before age 30 (38%), while in 70 patients it was diagnosed after age 30 (62%). Conclusions: UTI is frequent in our ADPKD patients. The correct treatment of UTI decreases its frequency and has beneficial role in the rate of progression to renal failure in ADPKD patients. Patients with recurrent episodes of gross hematuria may be at risk for more severe renal disease. PMID:19918304

  1. Leishmania infection: painful or painless?

    PubMed

    Borghi, Sergio M; Fattori, Victor; Conchon-Costa, Ivete; Pinge-Filho, Phileno; Pavanelli, Wander R; Verri, Waldiceu A

    2017-02-01

    The complex life cycle and immunopathological features underpinning the interaction of Leishmania parasites and their mammalian hosts poses frequent poorly explored and inconclusively resolved questions. The altered nociceptive signals over the course of leishmaniasis remain an intriguing issue for nociceptive and parasitology researchers. Experimental investigations have utilized behavioral, morphological, and neuro-immune approaches in the study of experimental cutaneous leishmaniasis (CL). The data generated indicates new venues for the study of the pathological characteristics of nociceptive processing in this parasitic disease. Leishmania-induced pain may be easily observed in mice and rats. However, nociceptive data is more complex in human investigations, including the occurrence of painless lesions in mucocutaneous and cutaneous leishmaniasis. Data from recent decades indicate that humans can also be affected by pain-related symptoms, often distinct from the region of body infection. The molecular and cellular mechanisms underlying such variable nociceptive states in humans during the course of leishmaniasis are an active area of research. The present article reviews nociception in leishmaniasis, including in experimental models of CL and clinical reports.

  2. Noninvasive and Painless Urine Glucose Detection by Using Computer-based Polarimeter

    NASA Astrophysics Data System (ADS)

    Sutrisno; Laksono, Y. A.; Hidayat, N.

    2017-05-01

    Diabetes kills millions of people worldwide each year. It challenges us as researchers to give contribution in early diagnosis to ensure a healthy life. As a matter of fact, common glucose testing devices that have been widely used so far are, at least, glucose meter and urine glucose test strip. The glucose meter ordinarily requires blood taken from patient’s finger. The glucose test strip uses patient’s urine but records unspecific urine glucose level, since the strip only provides the glucose level in some particular ranges. Instead of detecting the glucose level in blood and using the non-specific technique, a noninvasive and painless technique that can detect glucose level accurately will provide a more feasible approach for diabetes diagnosis. The noninvasive and painless urine glucose level monitoring by means of computer-based polarimeter is presented in this paper. The instrument consisted of a power source, a sample box, a light sensor, a polarizer, an analyzer, an analog to digital converter (ADC), and a computer. The concentration of urine glucose concentration was evaluated from the curve of the change in detected optical rotation angle and output potential by the computer-based polarimeter. Statistical analyses by means of Gaussian fitting and linear regression were applied to investigate the rotation angle and urine glucose concentration, respectively. From our experiment, the urine glucose level, measured by glucose test strips, of the normal patient was 100 mg/dl, and the diabetic patient was 500 mg/dl. Our polarimeter even read more precise values for the urine glucose concentrations of those normal and diabetic of the same patients, i.e. 50.61 mg/dl and 502.41 mg/dl, respectively. In other words, the results showed that our polarimeter was able to quantitatively measure the urine glucose level more accurate than urine glucose test strips. Hence, this computer-based polarimeter could be used as an alternative for early detection of urine

  3. Renal Trauma from Recreational Accidents Manifests Different Injury Patterns than Urban Renal Trauma

    PubMed Central

    Lloyd, Granville L.; Slack, Sean; McWilliams, Kelly L.; Black, Aaron; Nicholson, Tristan M.

    2013-01-01

    Purpose The majority of blunt renal trauma is a consequence of motor vehicle collisions and falls. Prior publications based on urban series have shown that significant renal injuries are almost always accompanied by gross hematuria alone or microscopic hematuria with concomitant hypotension. We present a series of blunt renal trauma sustained during recreational pursuits, and describe the mechanisms, injury patterns and management. Materials and Methods Database review from 1996 to 2009 identified 145 renal injuries. Children younger than age 16 years, and trauma involving licensable motor vehicles, penetrating injuries and work related injuries were excluded from analysis. Grade, hematuria, hypotension, age, gender, laterality, mechanism, management, injury severity score and associated injuries were recorded. Results We identified 106 patients meeting the criteria and 85% of the injuries were snow sport related. Age range was 16 to 76 years and 92.5% of patients were male. There were 39 grade 1 injuries, 30 grade 2, 22 grade 3, 12 grade 4 and 3 grade 5 injuries. Gross hematuria was present in 56.7%, 77.2% and 83.3% of grade 2, grade 3 and grade 4 injuries, respectively. None of the patients with grade 2 or greater injuries and microscopic hematuria had hypotension except 1 grade 5 pedicle injury. The nephrectomy and renorrhaphy rate for grade 1 to grade 4 injuries was 0%. Conclusions Compared to urban series of blunt renal trauma, recreationally acquired injuries appear to follow different patterns, including a paucity of associated injuries or hypotension. If imaging were limited to the presence of gross hematuria, or microscopic hematuria with hypotension, 23% of grade 2 to grade 4 injuries would be missed. Men are at higher risk than women. However, operative intervention is rarely helpful. PMID:22591969

  4. [Ascites and hematuria after falling in an alcoholic patient].

    PubMed

    Bürkner, A; Neuhaus, V; Schöb, O

    2010-02-03

    Isolated ruptures of the urinary bladder following minor traumas are a rare abdominal lesion. Diagnosis and treatment are a challenge to emergency physicians and surgeons. This case shows a 46-year-old patient admitted for a minor brain injury after falling during an episode of alcoholic intoxication. Ultrasound and CT scan of the abdomen showed intraabdominal fluid without a parenchymatous lesion. Also a hematuria was significant. The retrograde cystography showed intraabdominal contrast agent. The rupture of the urinary bladder was confirmed by laparoscopy and was intracorporal sutured in double layer technique. Without any postoperative complications the patient was discharged after 4 days. The retrograde cystography after 10 days showed no leckage and the urinary catheter could be removed.

  5. [Psychogenic purpura with hematuria and sexual pain disorder: a case report].

    PubMed

    Ozyildirim, Ilker; Yücel, Başak; Aktan, Melih

    2010-01-01

    Psychogenic purpura (Gardner-Diamond syndrome) is the occurrence and spontaneous recurrence of painful ecchymosis following emotional stress and minor trauma. Although the exact mechanism of this syndrome remains unknown, apart from skin lesions, different types of hemorrhaging have been reported, such as epistaxis, gastrointestinal bleeding, and bleeding from the ear canals and eyes. We report a psychogenic purpura case that presented with hematuria in addition to skin lesions. Based on the psychiatric evaluation she was diagnosed with major depressive disorder, generalized anxiety disorder, and obsessive-compulsive disorder. Additionally, sexual pain disorder accompanied these disorders. With the help of antidepressant and supportive psychotherapy, the patient's ecchymosis and bleeding disappeared. During 8 months of follow-up the symptoms did not return. Vaginismus has not been reported in patients with psychogenic purpura. The presence of vaginismus, which is seen more frequently in eastern cultures and is thought to be related to sociocultural determinants, suggests that some cultural factors may be common to both psychogenic purpura and vaginismus. The aim of this case report was to call attention to a syndrome that is rarely seen and diagnosed, and to discuss its relationship to psychosocial factors. This syndrome should be considered in the differential diagnosis of not only ecchymotic lesions, but also various types of bleeding, including hematuria. Despite the fact that its etiology and treatment are not clearly understood, it should be noted that psychological factors play a role in this disease and therefore, psychopharmacological and psychotherapeutic approaches can be effective.

  6. Effect of painless diabetic neuropathy on pressure pain hypersensitivity (hyperalgesia) after acute foot trauma

    PubMed Central

    Wienemann, Tobias; Chantelau, Ernst A.; Koller, Armin

    2014-01-01

    Introduction and objective Acute injury transiently lowers local mechanical pain thresholds at a limb. To elucidate the impact of painless (diabetic) neuropathy on this post-traumatic hyperalgesia, pressure pain perception thresholds after a skeletal foot trauma were studied in consecutive persons without and with neuropathy (i.e. history of foot ulcer or Charcot arthropathy). Design and methods A case–control study was done on 25 unselected clinical routine patients with acute unilateral foot trauma (cases: elective bone surgery; controls: sprain, toe fracture). Cases were 12 patients (11 diabetic subjects) with severe painless neuropathy and chronic foot pathology. Controls were 13 non-neuropathic persons. Over 1 week after the trauma, cutaneous pressure pain perception threshold (CPPPT) and deep pressure pain perception threshold (DPPPT) were measured repeatedly, adjacent to the injury and at the opposite foot (pinprick stimulators, Algometer II®). Results In the control group, post-traumatic DPPPT (but not CPPPT) at the injured foot was reduced by about 15–25%. In the case group, pre- and post-operative CPPPT and DPPPT were supranormal. Although DPPPT fell post-operatively by about 15–20%, it remained always higher than the post-traumatic DPPPT in the control group: over musculus abductor hallucis 615 kPa (kilopascal) versus 422 kPa, and over metatarsophalangeal joint 518 kPa versus 375 kPa (medians; case vs. control group); CPPPT did not decrease post-operatively. Conclusion Physiological nociception and post-traumatic hyperalgesia to pressure are diminished at the foot with severe painless (diabetic) neuropathy. A degree of post-traumatic hypersensitivity required to ‘pull away’ from any one, even innocuous, mechanical impact in order to avoid additional damage is, therefore, lacking. PMID:25397867

  7. Hemoglobinuria Misidentified as Hematuria: Review of Discolored Urine and Paroxysmal Nocturnal Hemoglobinuria

    PubMed Central

    Veerreddy, Prashant

    2013-01-01

    Discolored urine is a common reason for office visits to a primary care physician and urology referral. Early differentiation of the type or cause of discolored urine is necessary for accurate diagnosis and prompt management. Paroxysmal nocturnal hemoglobinuria is a clonal disorder caused by acquired somatic mutations in the PIG-A gene on the X- chromosome of hemopoietic stem cells and leads to deficiency of surface membrane anchor proteins. The deficiency of these proteins leads to an increased risk of hemolysis of erythrocytes and structural damage of platelets, resulting in a clinical syndrome characterized by complement-mediated intravascular hemolytic anemia, bone marrow failure, and venous thrombosis. Patients with this clinical syndrome present with paroxysms of hemolysis, causing hemoglobinuria manifesting as discolored urine. This can be easily confused with other common causes of discolored urine and result in extensive urologic work-up. Three commonly confused entities of discolored urine include hematuria, hemoglobinuria, and myoglobinuria. Specific characteristics in a dipstick test or urinalysis can guide differentiation of these three causes of discolored urine. This article begins with a case summary of a woman presenting with cranberry-colored urine and a final delayed diagnosis of paryxysmal nocturnal hemoglobinuria. Her hemoglobinuria was misdiagnosed as hematuria, leading to extensive urologic work-up. The article also gives an overview of the approach to diagnosing and treating discolored urine. PMID:25512715

  8. Simultaneous occurrence of transient resolving thyrotoxicosis due to painless thyroiditis, hypopituitarism and diabetes insipidus following pituitary apoplexy

    PubMed Central

    Sasaki, Haruka; Ohnishi, Osamu; Okudera, Toshio; Okumura, Makoto

    1991-01-01

    A rare case of concomitant association of transient thyrotoxicosis due to painless thyroiditis, hypopituitarism and central diabetes insipidus following spontaneous pituitary apoplexy is presented. ImagesFigure 1 PMID:2057436

  9. Painless acute myocardial infarction on Mount Kilimanjaro

    PubMed Central

    Jamal, Nasiruddin; Rajhy, Mubina; Bapumia, Mustaafa

    2016-01-01

    An individual experiencing dyspnoea or syncope at high altitude is commonly diagnosed to have high-altitude pulmonary edema or cerebral edema. Acute myocardial infarction (AMI) is generally not considered in the differential diagnosis. There have been very rare cases of AMI reported only from Mount Everest. We report a case of painless ST segment elevation myocardial infarction (STEMI) that occurred while climbing Mount Kilimanjaro. A 51-year-old man suffered dyspnoea and loss of consciousness near the mountain peak, at about 5600 m. At a nearby hospital, he was treated as a case of high-altitude pulmonary edema. ECG was not obtained. Two days after the incident, he presented to our institution with continued symptoms of dyspnoea, light-headedness and weakness, but no pain. He was found to have inferior wall and right ventricular STEMI complicated by complete heart block. He was successfully managed with coronary angioplasty, with good recovery. PMID:26989121

  10. Arteriovenous fistula and prolonged hematuria after renal biopsy: treatment with epsilon aminocaproic acid

    PubMed Central

    Silverberg, D. S.; Dossetor, J. B.; Eid, T. C.; Mant, M. J.; Miller, J. D. R.

    1974-01-01

    A patient with membranoproliferative glomerulonephritis and mild hypertension is described who, after a renal biopsy, developed an arteriovenous fistula and then severe continuous hematuria from the seventh to the 38th postbiopsy day. Treatment with epsilon aminocaproic acid was associated with rapid and permanent cessation of bleeding, gradual improvement in renal function, and disappearance of the renal artery bruit. No complications were encountered. ImagesFIG. 2FIG. 3FIG. 4FIG. 5FIG. 6 PMID:4817213

  11. Gross Motor Development.

    ERIC Educational Resources Information Center

    Florida Learning Resources System/CROWN, Jacksonville.

    The document is designed to help teachers identify and remediate gross motor development deficits in elementary school students. A definition of gross motor development and a checklist of gross motor skills are provided. Sections cover the following topics: successful teaching techniques; activities for perceptual-motor training; activities for…

  12. Nivolumab causing painless thyroiditis in a patient with adenocarcinoma of the lung.

    PubMed

    Verma, Isha; Modi, Anar; Tripathi, Hemantkumar; Agrawal, Abhinav

    2016-01-05

    Thyroiditis is characterised by transient hyperthyroidism, followed sometimes by hypothyroidism, and then recovery. We report a case of painless drug-induced thyroiditis-in a patient with no history of any thyroid disorder-treated with Nivolumab (an IgG4 monoclonal antibody against Programmed Death Receptor 1). The purpose of this case report is to increase awareness among clinicians regarding this possible adverse effect from Nivolumab, and discuss the possible pathophysiology and management strategies in such patients. 2016 BMJ Publishing Group Ltd.

  13. What Is New in Evaluation of Asymptomatic Microscopic Hematuria in Women?: Best Articles From the Past Year.

    PubMed

    Kenton, Kimberly

    2017-09-01

    This month we focus on current research in asymptomatic microscopic hematuria. Dr. Kenton discusses four recent publications, which are concluded with a "bottom line" that is a take-home message. A complete reference for each can be found on on this page along with direct links to abstracts.

  14. Arterioureteral Fistula: Treatment of a Hemorrhagic Shock with Massive Hematuria by Placing a Balloon Catheter.

    PubMed

    Merzeau, Nicolas; Riquet, Hervé; Nicolacopoulos, Ioannis; Alame, Abbas; Larré, Stéphane

    2017-01-01

    Arterioureteral fistulas (AUF) are serious diseases with increasing incidence. This case report relates the management of AUF in a patient with a history of abdominal oncological surgery, pelvic radiotherapy, and a double J stent in place. The fistula was discovered during a hemorrhagic shock with massive hematuria. The bleeding was controlled by a balloon catheter which led to endovascular treatment consisting of a covered stent.

  15. Arterioureteral Fistula: Treatment of a Hemorrhagic Shock with Massive Hematuria by Placing a Balloon Catheter

    PubMed Central

    Riquet, Hervé; Nicolacopoulos, Ioannis; Alame, Abbas

    2017-01-01

    Arterioureteral fistulas (AUF) are serious diseases with increasing incidence. This case report relates the management of AUF in a patient with a history of abdominal oncological surgery, pelvic radiotherapy, and a double J stent in place. The fistula was discovered during a hemorrhagic shock with massive hematuria. The bleeding was controlled by a balloon catheter which led to endovascular treatment consisting of a covered stent. PMID:28465857

  16. Painless motor radiculopathy of the cervical spine: clinical and radiological characteristics and long-term outcomes after operative decompression.

    PubMed

    Siller, Sebastian; Kasem, Rami; Witt, Thomas-Nikolaus; Tonn, Joerg-Christian; Zausinger, Stefan

    2018-03-23

    OBJECTIVE Various neurological diseases are known to cause progressive painless paresis of the upper limbs. In this study the authors describe the previously unspecified syndrome of compression-induced painless cervical radiculopathy with predominant motor deficit and muscular atrophy, and highlight the clinical and radiological characteristics and outcomes after surgery for this rare syndrome, along with its neurological differential diagnoses. METHODS Medical records of 788 patients undergoing surgical decompression due to degenerative cervical spine diseases between 2005 and 2014 were assessed. Among those patients, 31 (3.9%, male to female ratio 4.8 to 1, mean age 60 years) presented with painless compressive cervical motor radiculopathy due to neuroforaminal stenosis without signs of myelopathy; long-term evaluation was available in 23 patients with 49 symptomatic foraminal stenoses. Clinical, imaging, and operative findings as well as the long-term course of paresis and quality of life were analyzed. RESULTS Presenting symptoms (mean duration 13.3 months) included a defining progressive flaccid radicular paresis (median grade 3/5) without any history of radiating pain (100%) and a concomitant muscular atrophy (78%); 83% of the patients were smokers and 17% patients had diabetes. Imaging revealed a predominantly anterior nerve root compression at the neuroforaminal entrance in 98% of stenoses. Thirty stenoses (11 patients) were initially decompressed via an anterior surgical approach and 19 stenoses (12 patients) via a posterior surgical approach. Overall reoperation rate due to new or recurrent stenoses was 22%, with time to reoperation shorter in smokers (p = 0.033). Independently of the surgical procedure chosen, long-term follow-up (mean 3.9 years) revealed a stable or improved paresis in 87% of the patients (median grade 4/5) and an excellent general performance and quality of life. CONCLUSIONS Painless cervical motor radiculopathy predominantly occurs

  17. [Anesthetic effect of preemptive analgesia of frequency acupoint electrical stimulation on painless-induced abortion].

    PubMed

    Wang, Li-Hong; Zhu, Hong-Xia; Su, Xin-Jing; Hao, Wen-Bin

    2014-07-01

    To explore the anesthetic effect of preemptive analgesia of frequency acupoint electrical stimulation on painless-induced abortion as well as its effect on anesthetics dosage. Ninety cases of early pregnancy who selected painless-induced abortion were randomly divided into two groups, 45 cases in each group. Frequency acupoint electrical stimulation at Ciliao (BL 32) and Shenshu (BL 23), disperse-densewave, 2 Hz/100 Hz in frequency for 15 to 20 min, was applied in the group A, which was followed by intravenous anesthesia of propofol. The intravenous anesthesia of propofol was applied in the group B. The blood pressure (BP), heart rate (HR) and SpO2 before, during and after surgery, anesthetic effect and dosage, waking time and adverse events were observed in the two groups. The BP and HR during and after the surgery in the group A were not statistically different from those before the surgery (all P > 0.05). The BP was reduced and HR was slowed down during the surgery in the group B, which was significantly different from those before the surgery as well as those in the group A (all P < 0.05). The dosage of propofol was (114. 3-+6. 1) mg in the group A. obviously less than (193.2 +/- 8.9) mg in the group B (P < 0.05). The waking time was (5.6 +/- 1.2) min in the group A, obviously less than (10.1 +/- 3.9) min in the group B (P < 0.05). As for anesthetic effect, the incidence of Grade I in the group A was more than the group B (P < 0.05). The adverse events, including nausea, vomiting and contractions pain in the group A were evidently less than those in the group B (all P < 0.05). The preemptive analgesia of frequency acupoint electrical stimulation could significantly improve anesthetic effect of painless-induced abortion, reduce dosage of anesthetics, shorten waking time of surgery and guarantee the safety of surgery.

  18. Pheochromocytoma of urinary bladder - a case report.

    PubMed

    Sharma, Shaleen; Gokhro, Sunil; Sharma, K K; Sadasukhi, T C

    2007-08-01

    Pheochromocytomas are catecholamine producing neuroendocrine tumours. Bladder involvement with pheochromocytoma is rare that usually presents with hypertension, hematuria and syncope often related to voiding. Clinical manifestation may be inconsistent and high index of suspicion is required for accurate diagnosis. We report a case, who presented with gross intermittent hematuria and mild elevation of pulserate and bloodpressure. Patient was adequately treated with partial cystectomy.

  19. Life-threatening hematuria requiring transcatheter embolization following radiofrequency ablation of renal cell carcinoma.

    PubMed

    Roach, H; Whittlestone, T; Callaway, M P

    2006-01-01

    Radiofrequency ablation is increasingly being acknowledged as a valid treatment for renal cell carcinoma in patients in whom definitive curative resection is deemed either undesirable or unsafe. A number of published series have shown the technique to have encouraging results and relatively low complication rates. In this article, we report a case of delayed life-threatening hematuria requiring transcatheter embolization of a bleeding intrarenal artery in a patient who had undergone imaging-guided radiofrequency ablation of a 3 cm renal cell carcinoma. To our knowledge, such a complication has not been reported previously.

  20. Painless Parker's legacy: ethics, commerce, and advertising in the professions.

    PubMed

    Peltier, Bruce

    2007-01-01

    This presentation will review the life and contributions of Dr. Edgar Parker, the infamous and controversial pioneer who specialized in a precarious straddling of the ethics of the commercial marketplace and the ethics of care. Something of a Rorschach test, he was alternatively referred to as a charlatan, the first people's dentist, a renegade, a crusader, a quack, the Henry Ford of dentistry, and "a menace to the dignity of the profession". He eventually owned and managed thirty dental offices, several in San Francisco, as well as the Parker Dental Circus. Because many young, twenty-first century practitioners have little problem with slick advertising, it seems appropriate to revisit Painless Parker's career and contribution to the current state of affairs.

  1. Macroscopic Hematuria due to Placenta Percreta: Report of Two Cases and Short Review

    PubMed Central

    Garas, Antonios; Sveronis, George; Nidimos, Asterios; Gkorezi, Irondiana; Alevra, Zoi; Oeconomou, Athanasios; Zachos, Ioannis

    2017-01-01

    Herein we present two cases of pregnant women with placenta percreta and severe hematuria during the 24th and 35th weeks of pregnancy, respectively. A timely sonographic diagnosis was feasible in the first case and cesarean section was performed during the 29th week. During the operation, the placenta was invading the bladder wall and concomitant hysterectomy with cystotomy and bladder wall reconstruction was performed. The second case presented in our emergency department with vaginal bleeding during the 35th weeks of pregnancy. She underwent an emergency cesarean section with uterine preservation, cystotomy, and bladder reconstruction. PMID:28698813

  2. Noninvasive metabolic profiling for painless diagnosis of human diseases and disorders.

    PubMed

    Mal, Mainak

    2016-06-01

    Metabolic profiling provides a powerful diagnostic tool complementary to genomics and proteomics. The pain, discomfort and probable iatrogenic injury associated with invasive or minimally invasive diagnostic methods, render them unsuitable in terms of patient compliance and participation. Metabolic profiling of biomatrices like urine, breath, saliva, sweat and feces, which can be collected in a painless manner, could be used for noninvasive diagnosis. This review article covers the noninvasive metabolic profiling studies that have exhibited diagnostic potential for diseases and disorders. Their potential applications are evident in different forms of cancer, metabolic disorders, infectious diseases, neurodegenerative disorders, rheumatic diseases and pulmonary diseases. Large scale clinical validation of such diagnostic methods is necessary in future.

  3. Noninvasive metabolic profiling for painless diagnosis of human diseases and disorders

    PubMed Central

    Mal, Mainak

    2016-01-01

    Metabolic profiling provides a powerful diagnostic tool complementary to genomics and proteomics. The pain, discomfort and probable iatrogenic injury associated with invasive or minimally invasive diagnostic methods, render them unsuitable in terms of patient compliance and participation. Metabolic profiling of biomatrices like urine, breath, saliva, sweat and feces, which can be collected in a painless manner, could be used for noninvasive diagnosis. This review article covers the noninvasive metabolic profiling studies that have exhibited diagnostic potential for diseases and disorders. Their potential applications are evident in different forms of cancer, metabolic disorders, infectious diseases, neurodegenerative disorders, rheumatic diseases and pulmonary diseases. Large scale clinical validation of such diagnostic methods is necessary in future. PMID:28031956

  4. Cutoff value of thyroid uptake of (99m)Tc-pertechnetate to discriminate between Graves' disease and painless thyroiditis: a single center retrospective study.

    PubMed

    Uchida, Toyoyoshi; Suzuki, Ruriko; Kasai, Takatoshi; Onose, Hiroyuki; Komiya, Koji; Goto, Hiromasa; Takeno, Kageumi; Ishii, Shinya; Sato, Junko; Honda, Akira; Kawano, Yui; Himuro, Miwa; Yamada, Emiko; Yamada, Tetsu; Watada, Hirotaka

    2016-01-01

    Thyroid uptake of (99m)Tc-pertechnetate is a useful way to determine the cause of thyrotoxicosis. In daily clinical practice, (99m)Tc-pertechnetate uptake is used to discriminate between Graves' disease and painless thyroiditis when clinical information is not enough to make the distinction. However, since the optimal cutoff value of (99m)Tc-pertechnetate uptake has not yet been elucidated, our aim was to determine this value. We recruited patients with thyrotoxicosis in whom (99m)Tc-pertechnetate uptake was measured in clinical settings between 2009 and 2013. Three experienced endocrinologists (who were blinded to the value of (99m)Tc-pertechnetate uptake and initial treatment) diagnosed the cause of thyrotoxicosis based on thyrotropin, free triiodothyronine, free thyroxine, and thyrotropin receptor antibody levels, and by ultrasound findings and using images of thyroid uptake of (99m)Tc-pertechnetate without the actual values. Ninety-four patients diagnosed as having Graves' disease or painless thyroiditis were finally included. According to the diagnosis, the optimal cutoff value of (99m)Tc-pertechnetate uptake was determined by receiver operating characteristics analysis. A cutoff value of 1.0% provided optimal sensitivity and specificity of 96.6% and 97.1%, respectively. Then, its validity was confirmed in 78 patients with confirmed Graves' disease or painless thyroiditis diagnosed at another institute. Applying this cutoff value to the patients with thyrotoxicosis revealed positive and negative predictive values for Graves' disease of 100% and 88.9%, respectively. In conclusion, a cutoff value for (99m)Tc-pertechnetate uptake of 1.0% was useful to discriminate between Graves' disease and painless thyroiditis.

  5. Gross-alpha and gross-beta activities in airborne particulate samples. Analysis and prediction models.

    PubMed

    Dueñas, C; Fernández, M C; Carretero, J; Liger, E; Cañete, S

    2001-04-01

    Measurements of gross-alpha and gross-beta activities were made every week during the years 1992-1997 for airborne particulate samples collected using air filters at a clear site. The data are sufficiently numerous to allow the examination of variations in time and by these measurements to establish several features that should be important in understanding any trends of atmospheric radioactivity. Two models were used to predict the gross-alpha and gross-beta activities. A good agreement between the results of these models and the measurements was highlighted.

  6. Longitudinal (4 year) change of thigh muscle and adipose tissue distribution in chronically painful vs. painless knees – data from the Osteoarthritis Initiative

    PubMed Central

    Ruhdorfer, Anja; Wirth, Wolfgang; Dannhauer, Torben; Eckstein, Felix

    2015-01-01

    Objective To evaluate 4-year longitudinal change in thigh muscle and adipose tissue content in chronically painful versus painless knees. Methods Knees from Osteoarthritis Initiative participants with non-acceptable symptom status (numerical rating scale ≥4) and frequent pain (≥6 months at baseline, year 2 and year 4 follow-up) were studied. These were matched with painless controls (bilateral NRS pain intensity≤1 and ≤infrequent pain at all 3 timepoints). 4-year longitudinal changes in thigh muscle anatomical cross-sectional areas (CSAs), isometric muscle strength, and in subcutaneous (SCF) and intermuscular fat (IMF) CSAs were obtained from magnetic resonance images (MRI) and were compared between groups (paired t-tests). Results 43 participants fulfilled the inclusion criteria of chronic pain, had complete thigh muscle MRI acquisitions and strength measurements, and a matched control. Quadriceps CSAs, but not extensor strength, showed a significant longitudinal decrease in chronically painful knees (-3.9%; 95%confidence interval [95 CI] -6.3%,-1.5%) and in painless controls (-2.4%; 95% CI -4.1%, -0.7%); the difference in change was not statistically significant (p=0.33). There was a significant 4-year gain in SCF in painful knees (8.1%; 95% CI 3.1%, 13%) but not in controls (0.0%; 95%CI -4.4%, +4.4%) with the difference in change being significant (p=0.03). The gain in IMF (∼5.2%) was similar between painful and painless knees. Conclusion This is the first paper to show a significant impact of (chronic) knee pain on longitudinal change in local subcutaneous adipose tissue. The effect of pain on subcutaneous fat appeared stronger than that on intermuscular adipose tissue and on muscle status. PMID:25887367

  7. [Meta analysis for the anesthesia effect and adverse reactions of etomidate and propofol on 
the painless abortion surgery].

    PubMed

    Wang, Li; Li, Wen; Xu, Rui; Long, Lihui

    2016-04-01

    To evaluate the anesthesia effect of etomidate and propofol on painless abortion surgery. 
 After screening the Cochrane Library, Pubmed, China National Knowledge Infrastructure (CNKI), WANFANG, VIP database, the literatures regarding the anesthesia effect of etomidate and propofol on painless abortion surgery were collected from 1995 to 2014. The randomized controlled trials (RCTs) were selected, the quality evaluation was performed and the data was analyzed by using RevMan5.3 software.
 A total of 1 130 patients were included in 9 RCTs. The results of Meta analysis were as follows: the anesthesia induction time in the etomidate group was less than that in propofol group (MD=-0.14, 95% CI -0.24 to -0.04, P=0.004); there were more adverse reactions, such as myoclonus, nausea and vomiting, in the etomidate group compared with the propofol group (P<0.001); the incidence of pain in the etomidate group was less than that in the propofol group (P<0.001); there was no significant difference in the incidence of respiratory depression between the 2 groups (P>0.05); the surgery time, analgesia and duration from withdrawal to the wake-up was not significantly different between the 2 groups (P>0.05). 
 Etomidate had a shorter anesthesia induction time than propofol in the painless abortion surgery. The incidence of reverse reactions such as myoclonus, nausea and vomiting, was more common in application of etomidate, whereas the incidence of injection pain was more common in the use of propofol group. There was no significant difference in respiratory depression between the 2 drugs. The comprehensive efficacy of propofol is better than etomidate.

  8. Nephron-sparing surgery in the treatment of pediatric renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions.

    PubMed

    Liu, Chao; Zhang, Weiping; Song, Hongcheng

    2017-09-01

    To investigate the safety and efficacy of nephron-sparing surgery (NSS) in the treatment of pediatric Xp11.2 translocation renal cell carcinoma (RCC). Clinical characteristics of 9 RCC children (7 males and 2 females) with Xp11.2 translocation who received NSS between January 1973 and December 2015 were retrospectively analyzed. The mean age was 7.8years (range: 4.5-13.5years). Xp11.2 translocation RCC was found in the left side in 4 patients and right in 5. 3 tumors were located in the upper pole of the kidney, 1 in the middle dorsal, 1 in the middle ventral and 4 in the lower pole. RCC presented with painless gross hematuria in 4 patients, abdominal mass in 1, and as an incidental finding by ultrasound examination in 4 patients. The mean course of hematuria was 3months (range: 1-7months). The mean tumor diameters were 3.7cm (range: 2.2-6.9cm). All the patients received NSS with open transperitoneal approach. The mean operative time and estimated blood loss were 115min and 40ml, respectively. The time of renal pedicle clamping was 19-25min (mean: 21.5min). No complications (such as leakage of urine, prolonged drainage or secondary bleeding) were noted. No patients experienced local recurrence during the mean of 50.1-month follow-up (range: 13-117months). Intravenous urography (IVU) or contrast-enhanced CT was conducted at 6months after surgery which showed favorable kidney function in all patients. Xp11.2 translocation RCC is a predominant pathological but biologically inert type of pediatric RCC. For Xp11.2 translocation RCC sized <4-7cm in diameter and located in one pole, NSS is safe and feasible. Treatment Studies, LEVEL IV. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. 26 CFR 1.832-1 - Gross income.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... deposit premiums received, but not assessments, shall be excluded from gross income. Gross income does not... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Gross income. 1.832-1 Section 1.832-1 Internal... TAXES Other Insurance Companies § 1.832-1 Gross income. (a) Gross income as defined in section 832(b)(1...

  10. Hemorrhagic cystitis in a patient receiving conventional doses of dacarbazine for metastatic malignant melanoma: case report and review of the literature.

    PubMed

    Mohammadianpanah, Mohammad; Shirazi, Mehdi; Mosalaei, Ahmad; Omidvari, Shapour; Ahmadloo, Niloofar

    2007-06-01

    Hemorrhagic cystitis is a potentially life-threatening complication in patients receiving cancer therapy. This urologic emergency is commonly associated with the chemotherapeutic use of oxazaphosphorine alkylating agents. This report describes a case of hemorrhagic cystitis associated with dacarbazine treatment. A 63-year-old man with asymptomatic metastatic malignant melanoma received 3 cycles of dacarbazine (600-850 mg/m2) monochemotherapy, each 3 weeks apart. Two weeks after the third cycle, he presented with gross hematuria and mild dysuria. Physical examination revealed no significant finding. Hematuria was confirmed by urinalysis, and urinary infection was excluded by repeated urine cultures. Ultrasonography revealed diffuse bladder wall thickening with no discrete mass or ulceration. Cystoscopy findings revealed generalized inflammation and edema of the mucosa of the bladder, confirming the diagnosis of hemorrhagic cystitis. The patient's gross hematuria continued for 2 weeks and then completely resolved with supportive care. Two weeks after complete resolution, the patient experienced 2 transient episodes of gross hematuria that lasted a few hours and subsided spontaneously. Dacarbazine is currently considered the standard first-line treatment in patients with advanced malignant melanoma. At standard prescribed doses (a single dose of 850-1000 mg/m2 or 250 mg/m2 for 5 days per cycle), dacarbazine is a reasonably well tolerated chemotherapeutic drug; nausea, vomiting, and myelosuppression are the most common adverse effects. Association of dacarbazine with hemorrhagic cystitis has not been reported previously (in a PubMed literature search from 1950-2006), and only 1 case report associates temozolomide (an analog of dacarbazine) with hemorrhagic cystitis. Based on the Naranjo adverse drug reactions probability scale, an objective assessment revealed dacarbazine to be a probable cause of hemorrhagic cystitis in this case. This case report suggests that

  11. An optimal painless treatment for early hemorrhoids; our experience in Government Medical College and Hospital

    PubMed Central

    Singal, R; Gupta, S; Dalal, AK; Dalal, U; Attri, AK

    2013-01-01

    Objective - To evaluate the efficacy of Infrared Coagulation Therapy (IRC) for hemorrhoids. IRC is a painless, safe and successful procedure. Place and duration of study - Department of Surgery, Government Medical College and Hospital, Sector-32, Chandigarh, India, from August 2006 to October 2008. The choice of procedure depends on the patient's symptoms, the extent of the hemorrhoidal disease, and the experience of the surgeon along with the availability of the techniques/instruments. Materials and methods - This is a prospective study done from August 2006 to October 2008. Total number of 155 patients was included in the study. Infrared Coagulation Therapy (IRC) was performed through a special designed proctoscope. Patients excluded were with coagulopathy disorders, fissure in ano, and anal ulcers. Results - It is an outpatient Department (OPD), non-surgical, ambulatory, painless and bloodless procedure, without any hospital stay. Early recovery and minimal recurrence of hemorrhoids were noted without any morbidity or mortality. We have studied 155 patients, treated with IRC on OPD basis. Surgery was required in few patients in whom IRC failed or was contraindicated. Out of the total 155 patients, 127 came for follow up. After the 1st sitting of IRC therapy: out of 127; 43 patients got a total relief, mass shrinkage was of > 75% in 57 cases and < 50% in 14 cases. Twenty-eight cases did not come for follow-up. In the 2nd sitting, out of 84/127; 58 patients got a total relief, >75% relief in 15 cases and >50 % relief in 11 patients. In the 3rd sitting out of 26/84 cases: 13 cases got a total relief and 13 cases refused to take the third sitting; however, in 7 cases the hemorrhoidal mass shrank up to 50% after the two sittings. These 14 were operated as there was no relief from bleeding after giving two sittings of IRC. Our opinion is that, in the above 14 cases, the patient might have not followed the instructions properly for dietary habits. Conclusion - IRC is a

  12. An optimal painless treatment for early hemorrhoids; our experience in Government Medical College and Hospital.

    PubMed

    Singal, R; Gupta, S; Dalal, A K; Dalal, U; Attri, A K

    2013-09-15

    To evaluate the efficacy of Infrared Coagulation Therapy (IRC) for hemorrhoids. IRC is a painless, safe and successful procedure. Department of Surgery, Government Medical College and Hospital, Sector-32, Chandigarh, India, from August 2006 to October 2008. The choice of procedure depends on the patient's symptoms, the extent of the hemorrhoidal disease, and the experience of the surgeon along with the availability of the techniques/instruments. This is a prospective study done from August 2006 to October 2008. Total number of 155 patients was included in the study. Infrared Coagulation Therapy (IRC) was performed through a special designed proctoscope. Patients excluded were with coagulopathy disorders, fissure in ano, and anal ulcers. Results - It is an outpatient Department (OPD), non-surgical, ambulatory, painless and bloodless procedure, without any hospital stay. Early recovery and minimal recurrence of hemorrhoids were noted without any morbidity or mortality. We have studied 155 patients, treated with IRC on OPD basis. Surgery was required in few patients in whom IRC failed or was contraindicated. Out of the total 155 patients, 127 came for follow up. After the 1st sitting of IRC therapy: out of 127; 43 patients got a total relief, mass shrinkage was of > 75% in 57 cases and < 50% in 14 cases. Twenty-eight cases did not come for follow-up. In the 2nd sitting, out of 84/127; 58 patients got a total relief, >75% relief in 15 cases and >50 % relief in 11 patients. In the 3rd sitting out of 26/84 cases: 13 cases got a total relief and 13 cases refused to take the third sitting; however, in 7 cases the hemorrhoidal mass shrank up to 50% after the two sittings. These 14 were operated as there was no relief from bleeding after giving two sittings of IRC. Our opinion is that, in the above 14 cases, the patient might have not followed the instructions properly for dietary habits. IRC is a safe, simple and effective procedure for early hemorrhoids without any

  13. A patient with a painless neck tumour revealed as a carotid paraganglioma: a case report.

    PubMed

    Peric, Barbara; Marinsek, Ziva Pohar; Skrbinc, Breda; Music, Maja; Zagar, Ivana; Hocevar, Marko

    2014-08-20

    Carotid paragangliomas are usually slowly enlarging and painless lateral neck masses. These mostly benign lesions are recognized due to their typical location, vessel displacement and specific blood supply, features that are usually seen on different imaging modalities. Surgery for carotid paraganglioma can be associated with immediate cerebrovascular complications or delayed neurological impairment.We are reporting the case of a 36-year-old man who presented with a painless mass on the right side of his neck 11 months after being treated for testicular cancer. After a fine-needle aspiration biopsy, he was diagnosed with a testicular cancer lymph node metastasis. Neck US and fluorine [F-18]-fluorodeoxy-D-glucose (FDG) PET-CT showed no signs of hypervascularity or vessel displacement. The patient underwent a level II to V functional neck dissection. During the procedure, suspicion of a carotid paraganglioma was raised and the tumour was carefully dissected from the walls of the carotid arteries with minimal blood loss and no cranial nerve dysfunction.The histology report revealed carotid paraganglioma with no metastasis in the rest of the lymph nodes. The patient's history of testicular germ cell tumour led to a functional neck dissection during which a previously unrecognized carotid paraganglioma was removed.Surgery for carotid PG can be associated with complications that have major impact on quality of life. A thorough assessment of the patient and neck mass must therefore be performed preoperatively in order to perform the surgical procedure under optimal conditions.

  14. 26 CFR 1.61-1 - Gross income.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Gross income. 1.61-1 Section 1.61-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Definition of Gross Income, Adjusted Gross Income, and Taxable Income § 1.61-1 Gross...

  15. What factors are associated with unplanned return following transurethral resection of bladder tumor? An analysis of a large single institution's experience.

    PubMed

    Ghali, Fady; Moses, Rachel A; Raffin, Eric; Hyams, Elias S

    2016-10-01

    This study sought to evaluate factors associated with unplanned hospital return (UR) following transurethral resection of bladder tumor (TURBT), the largest source of readmission among ambulatory urological procedures. A retrospective review of TURBTs at a single academic institution between April 2011 and August 2014 was performed. Demographics, comorbidities, length of stay, tumor size and multiple other factors were recorded. UR was recorded within 30 days of surgery. Bivariate and multivariable analyses were performed to determine factors associated with UR. Among 708 patients undergoing TURBT, 23.9% were female with a mean age of 70 years. The rate of UR was 10.9%. The most common cause of UR was gross hematuria, accounting for 70%. On bivariate analysis, Foley catheter placement in the operating room, non-aspirin anticoagulation and index length of stay longer than 24 h were associated with hematuria-related UR (p < 0.05). Preoperative antibiotics, female gender and aspirin therapy were associated with lower rates of hematuria-related UR (p < 0.05), while tumor size, distance of residence to the hospital, and Foley on hospital discharge (rather than from the operating room) had no association (p > 0.05). On multivariable analysis, only Foley placement in the operating room remained associated with higher rates of hematuria-related UR, while preoperative antibiotics, female gender and aspirin therapy remained associated with a lower likelihood of this event. UR following TURBT is common and typically results from gross hematuria. Patients with postoperative Foley catheterization in the operating room may require additional counseling or supervision before discharge, and should be considered for discharge with a Foley rather than having a prompt voiding trial.

  16. Renal Denervation in Patients With Loin Pain Hematuria Syndrome.

    PubMed

    Prasad, Bhanu; Giebel, Shelley; Garcia, Francisco; Goyal, Kunal; St Onge, Jennifer Rose

    2017-01-01

    Loin pain hematuria syndrome (LPHS) is a painful and incapacitating condition that typically affects young women. Treatment options, including opiates and/or surgical denervation of the renal nerves by autotransplantation, have variable success. In this report, we describe the successful use of endovascular renal nerve ablation in this population. Four women with LPHS and intractable pain unresponsive to conservative measures underwent endovascular ablation of the renal nerves between July and November 2015 using the Vessix renal denervation system. The number and frequency of pain medications and responses to the EQ-5D, McGill Pain Questionnaire, Geriatric Depression Score, 36-Item Short-Form Health Survey, and Oswestry Disability Index were measured at baseline and 3 and 6 months postprocedure to evaluate changes in pain, disability, quality of life, and mood. There were improvements in pain, disability, and quality of life from baseline to 6 months postprocedure. By 6 months, 2 of 4 patients had discontinued all pain medications, whereas the other 2 had reduced their doses of these medications by 75%. These results suggest that percutaneous catheter-based renal nerve ablation with radiofrequency energy may be a treatment option for some patients with LPHS. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  17. Microscopic or occult hematuria, when reflex testing is not good laboratory practice.

    PubMed

    Froom, Paul; Barak, Mira

    2010-01-01

    Consensus opinion suggests that hematuria found by dipstick and not confirmed on microscopic examination (<2 erythrocytes per high power field) signifies a false-positive reagent strip test result. Standard practice is to repeat the dipstick test several days later and if still positive to confirm by microscopic examination. If discordant results are obtained, experts recommend reflex testing for urinary myoglobin and hemoglobin concentrations. The question is whether or not this approach represents good laboratory practice. These recommendations are not evidence based. We conclude that the reference range for red blood cells on the reagent strip should be increased to 25x10(6) cells/L for young men, and 50x10(6) cells/L for the rest of the adult population, ranges consistent with flow cytometry reports. Confirmation reflex testing using tests that have inferior sensitivity, precision and probably accuracy is not recommended.

  18. Painless giant cell thyroiditis diagnosed by fine needle aspiration and associated with intense thyroidal uptake of gallium

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

    Sanders, L.R.; Moreno, A.J.; Pittman, D.L.

    1986-05-01

    A 52-year-old woman presented with fever, goiter, and no evidence of pain or tenderness in the thyroid. A diagnosis of silent thyroiditis was made after obtaining evidence of biochemical thyrotoxicosis, intense gallium-67 citrate thyroidal localization, and cytologic thyroiditis. Fine needle aspiration biopsy of the thyroid revealed numerous giant cells in all areas of the thyroid, typical of subacute thyroiditis. This is believed to be the first time painless thyroiditis is reported with the classic cytologic feature of painful subacute thyroiditis.

  19. Innovative procedure for the determination of gross-alpha/gross-beta activities in drinking water.

    PubMed

    Wisser, S; Frenzel, E; Dittmer, M

    2006-03-01

    An alternative sample preparation method for the determination of gross-alpha/beta activity concentrations in drinking water is introduced in this paper. After the freeze-drying of tap water samples, determination by liquid scintillation counting can be applied utilizing alpha/beta separation. It has been shown that there is no adsorption or loss of solid radionuclides during the freeze-drying procedure. However, the samples have to be measured quickly after the preparation since the ingrowth of daughter isotopes negatively effects the measurement. The limits of detection for gross-alpha and gross-beta activity are in the range 25-210 mBq/l, respectively, for a measurement time of only 8-9 h.

  20. Emerging role of multi-detector computed tomography in the diagnosis of hematuria following percutaneous nephrolithotomy: A case scenario.

    PubMed

    Sivanandam, S E; Mathew, Georgie; Bhat, Sanjay H

    2009-07-01

    Persistent hematuria is one of the most dreaded complications following percutanous nephrolithotomy (PCNL). Although invasive, a catheter-based angiogram is usually used to localize the bleeding vessel and subsequently embolize it. Advances in imaging technology have now made it possible to use a non invasive multi-detector computed tomography (MDCT) angiogram with 3-D reconstruction to establish the diagnosis. We report a case of post-PCNL hemorrhage due to a pseudo aneurysm that was missed by a conventional angiogram and subsequently detected on MDCT angiogram.

  1. Detection of Ptaquilosides in different phenologic stages of Bracken fern (Pteridium aquilinum) and analysis of milk samples in farms with hematuria in Tolima, Colombia

    USDA-ARS?s Scientific Manuscript database

    Bracken fern or “Helecho Macho” (Pteridium aquilinum) is one of the most common weeds in the meadows of the mountain ranges of Colombia. Consumption of this palatable plant by bovines causes a disease known as bovine enzootic hematuria and esophageal neoplasia. The toxic effect of the plant in bovin...

  2. Bellini's duct carcinoma: A report of two cases and a review of the literature

    PubMed Central

    LI, YIFAN; JIN, LU; LIU, JIAJU; CHEN, DUQUN; SU, ZHENGMING; ZHOU, LIQUN; SHI, BENTAO; LAI, YONGQING

    2016-01-01

    Bellini's duct carcinoma (BDC) is a rare and aggressive variant of renal cell carcinoma that possesses an extremely poor prognosis. The greater the grade or stage of disease, the poorer the prognosis tends to be. This study presents two cases of BDC; one case of low grade BDC and one case of high grade BDC in a 47-year-old male and 74-year-old female, respectively. The 47-year-old male patient presented with painless gross hematuria, which had lasted for 3 weeks and subsequently underwent purely laparoscopic nephroureterectomy. After 4-years of follow-up, the patient remained disease-free. By contrast, a right renal tumor was identified in the 74-year-old female patient during a routine examination. Radical right nephrectomy and lymph node dissection were performed, however, 10 months after surgery the patient succumbed due to wide-spread metastasis. The two cases reported in the present study not only represent excellent examples of the disease spectrum, but also act as a reminder of the possibility of detecting BDC in an early stage of disease. Therefore, the epidemiology of BDC has been discussed, and the aggressive growth pattern of BDC has been presented in terms of signs, symptoms and imaging examinations, including ultrasonography, computed tomography (CT), angiography and single photon emission CT, in the early stage of disease. PMID:27313704

  3. Bellini's duct carcinoma: A report of two cases and a review of the literature.

    PubMed

    Li, Yifan; Jin, L U; Liu, Jiaju; Chen, Duqun; Su, Zhengming; Zhou, Liqun; Shi, Bentao; Lai, Yongqing

    2016-06-01

    Bellini's duct carcinoma (BDC) is a rare and aggressive variant of renal cell carcinoma that possesses an extremely poor prognosis. The greater the grade or stage of disease, the poorer the prognosis tends to be. This study presents two cases of BDC; one case of low grade BDC and one case of high grade BDC in a 47-year-old male and 74-year-old female, respectively. The 47-year-old male patient presented with painless gross hematuria, which had lasted for 3 weeks and subsequently underwent purely laparoscopic nephroureterectomy. After 4-years of follow-up, the patient remained disease-free. By contrast, a right renal tumor was identified in the 74-year-old female patient during a routine examination. Radical right nephrectomy and lymph node dissection were performed, however, 10 months after surgery the patient succumbed due to wide-spread metastasis. The two cases reported in the present study not only represent excellent examples of the disease spectrum, but also act as a reminder of the possibility of detecting BDC in an early stage of disease. Therefore, the epidemiology of BDC has been discussed, and the aggressive growth pattern of BDC has been presented in terms of signs, symptoms and imaging examinations, including ultrasonography, computed tomography (CT), angiography and single photon emission CT, in the early stage of disease.

  4. Simultaneous determination of gross alpha, gross beta and ²²⁶Ra in natural water by liquid scintillation counting.

    PubMed

    Fons, J; Zapata-García, D; Tent, J; Llauradó, M

    2013-11-01

    The determination of gross alpha, gross beta and (226)Ra activity in natural waters is useful in a wide range of environmental studies. Furthermore, gross alpha and gross beta parameters are included in international legislation on the quality of drinking water [Council Directive 98/83/EC]. In this work, a low-background liquid scintillation counter (Wallac, Quantulus 1220) was used to simultaneously determine gross alpha, gross beta and (226)Ra activity in natural water samples. Sample preparation involved evaporation to remove (222)Rn and its short-lived decay daughters. The evaporation process concentrated the sample ten-fold. Afterwards, a sample aliquot of 8 mL was mixed with 12 mL of Ultima Gold AB scintillation cocktail in low-diffusion vials. In this study, a theoretical mathematical model based on secular equilibrium conditions between (226)Ra and its short-lived decay daughters is presented. The proposed model makes it possible to determine (226)Ra activity from two measurements. These measurements also allow determining gross alpha and gross beta simultaneously. To validate the proposed model, spiked samples with different activity levels for each parameter were analysed. Additionally, to evaluate the model's applicability in natural water, eight natural water samples from different parts of Spain were analysed. The eight natural water samples were also characterised by alpha spectrometry for the naturally occurring isotopes of uranium ((234)U, (235)U and (238)U), radium ((224)Ra and (226)Ra), (210)Po and (232)Th. The results for gross alpha and (226)Ra activity were compared with alpha spectrometry characterization, and an acceptable concordance was obtained. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Intravesical instillation of Formalin for hemorrhagic cystitis secondary to radiation for gynecologic malignancies

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

    Behnam, K.; Patil, U.B.; Mariano, E.

    Our experience with the use of Formalin instillation in intractable gross hematuria secondary to radiation cystitis in patients with gynecological malignancies is reported. This study indicates coagulative effect of low concentration of Formalin with minimal side effects as a method to control hemorrhage.

  6. [Painless skin nodules and ecchymosis in a school-aged girl].

    PubMed

    Liu, Ying-Ting; Yang, Ming-Hua; Cao, Li-Zhi; Huang, Ye-Hong; Xie, Min; Yang, Liang-Chun; Yang, Hui; Tang, Xing

    2015-10-01

    A 7-year-old girl was admitted to Xiangya Hospital due to systemic lymphadenectasis for 2 months and skin ecchymosis for 3 days. Nine months ago, the girl experienced painless nodules in the left lower extremity with no apparent causes. Three months later, dermatorrhagia and ecchymosis occurred in many regions such as the periocular areas, conjunctiva, oral mucosa, perineal area, and groin, with a "raccoon sign" in both eyes; superficial lymphadenectasis and hepatosplenomegaly were also observed in many regions. The pathological sections for the skin nodules showed malignant tumors in lymphohematopoietic cells, and in combination with clinical manifestations, immunohistochemistry, and positive results for CD4, CD56, and CD123 by bone marrow flow cytometry, the girl was diagnosed with blastic plasmacytoid dendritic cell neoplasm. Then high-risk ALL regimen was applied as the chemotherapy for this girl. At present, the girl has been followed up for 3 months; ecchymosis has disappeared, and the enlarged lymph nodes have shrunk. No abnormal cells have been found in bone marrow morphological examination, and bone marrow flow cytometry has shown that primitive precursor cells account for 1.5% and express CD33, CD34, CD123, and CD117.

  7. 26 CFR 1.809-4 - Gross amount.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... categories of items taken into account are: (1) Premiums. (i) The gross amount of all premiums and other... premiums and premiums and other consideration arising out of reinsurance ceded. The term gross amount of... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Gross amount. 1.809-4 Section 1.809-4 Internal...

  8. Pelvic fracture and injury to the lower urinary tract.

    PubMed

    Spirnak, J P

    1988-10-01

    The presence of a urologic injury must be considered in all patients with pelvic fracture. Uroradiographic evaluation starting with retrograde urethrography is indicated in all male patients with concomitant gross hematuria, bloody urethral discharge, scrotal or perineal ecchymosis, a nonpalpable prostate on rectal examination, or an inability to urinate. If the urethra is normal, a catheter may be passed, and in the presence of gross hematuria, a cystogram must be performed. Female patients rarely suffer urethral lacerations. The urethra is examined, and a Foley catheter may be passed without a urethrogram. The immediate management of associated urologic injuries continues to evolve and evoke controversy. Selected cases of extraperitoneal bladder perforation may be safely managed solely by catheter drainage. Intraperitoneal perforations require surgical exploration and repair. Urethral disruption (partial or complete) may be safely managed by primary cystostomy drainage with management of potential complications (stricture, impotence, incontinence) in 4 to 6 months.

  9. 26 CFR 1.832-4 - Gross income.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

  10. 26 CFR 1.832-4 - Gross income.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

  11. 26 CFR 1.832-4 - Gross income.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

  12. 26 CFR 1.832-4 - Gross income.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

  13. Concurrent Validity of Preschooler Gross Motor Quality Scale with Test of Gross Motor Development-2

    ERIC Educational Resources Information Center

    Sun, Shih-Heng; Sun, Hsiao-Ling; Zhu, Yi-Ching; Huang, Li-chi; Hsieh, Yueh-Ling

    2011-01-01

    Preschooler Gross Motor Quality Scale (PGMQ) was recently developed to evaluate motor skill quality of preschoolers. The purpose of this study was to establish the concurrent validity of PGMQ using Test of Gross Motor Development-2 (TGMD-2) as the gold standard. One hundred and thirty five preschool children aged from three to six years were…

  14. Ludwik Gross, Sarah Stewart, and the 1950s discoveries of Gross murine leukemia virus and polyoma virus.

    PubMed

    Morgan, Gregory J

    2014-12-01

    The Polish-American scientist Ludwik Gross made two important discoveries in the early 1950s. He showed that two viruses - murine leukemia virus and parotid tumor virus - could cause cancer when they were injected into susceptible animals. At first, Gross's discoveries were greeted with skepticism: it seemed implausible that viruses could cause a disease as complex as cancer. Inspired by Gross's initial experiments, similar results were obtained by Sarah Stewart and Bernice Eddy who later renamed the parotid tumor virus SE polyoma virus after finding it could cause many different types of tumors in mice, hamsters, and rats. Eventually the "SE" was dropped and virologists adopted the name "polyoma virus." After Gross's work was published, additional viruses capable of causing solid tumors or blood-borne tumors in mice were described by Arnold Graffi, Charlotte Friend, John Moloney and others. By 1961, sufficient data had been accumulated for Gross to confidently publish an extensive monograph--Oncogenic Viruses--the first history of tumor virology, which became a standard reference work and marked the emergence of tumor virology as a distinct, legitimate field of study. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Dissolution of infection-induced struvite bladder stones by using a noncalculolytic diet and antibiotic therapy

    PubMed Central

    2004-01-01

    Abstract An 8-year-old, female spayed miniature schnauzer was presented for pollakiuria and gross hematuria. Infection-induced struvite urolithiasis with concurrent bacterial urinary tract infection was diagnosed. The treatment is described, followed by a brief discussion of struvite stones and their medical management. PMID:15532883

  16. 20 CFR 209.13 - Employers' gross earnings reports.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... RAILROAD EMPLOYERS' REPORTS AND RESPONSIBILITIES § 209.13 Employers' gross earnings reports. (a) Each employer is required to report the gross earnings of a one-percent sample group of railroad employees. The... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Employers' gross earnings reports. 209.13...

  17. High cumulative incidence of urinary tract transitional cell carcinoma after kidney transplantation in Taiwan.

    PubMed

    Wu, Ming-Ju; Lian, Jong-Da; Yang, Chi-Rei; Cheng, Chi-Hung; Chen, Cheng-Hsu; Lee, Wen-Chin; Shu, Kuo-Hsiung; Tang, Ming-Jer

    2004-06-01

    Cancer is a well-documented complication after kidney transplantation. Increased incidence of bladder cancer had been reported in long-term hemodialysis patients in Taiwan. Herein, the authors report a very high cumulative incidence of transitional cell carcinoma (TCC) of the urinary tract after kidney transplantation in Taiwan. The authors retrospectively reviewed the clinical data, medical records, and outcome of 730 kidney transplant (KT) recipients. The cumulative incidence of TCC was computed. The Cox regression method was used to analysis the role of potential risk factors. After a mean follow-up duration of 72.2 +/- 54.4 months, 69 cancers were diagnosed in 63 (8.6%) KT recipients. Of them, 30 cases (4.1%) were TCC. The cumulative incidence for TCC was 3.0% after 3 years of graft survival, increasing to 7.2% at 6 years and 17.5% at 10 years. Compared with the general population in Taiwan, the standardized mortality ratio was 398.4 (male, 192.6; female, 875.6). Painless gross hematuria was the cardinal initial symptom in 22 (73.3%) of the 30 KT recipients with TCC. Another 4 (13.3%) KT recipients with TCC presented with chronic urinary tract infection (UTI). Bilateral nephroureterectomy with removal of bladder cuffs was performed in 18 (60%) patients. Synchronous TCC in bilateral upper urinary tracts was confirmed in 11 (36.7%) of KT recipients with TCC. The age at the time of KT, female sex, compound analgesics usage, Chinese herb usage, and underground water intake had statistical significance as risk factors (P < 0.05). The KT recipients are at extremely high risk for TCC in Taiwan, with an incidence of 4.1%. This study indicates that hematuria and chronic UTI are the initial presentation of TCC in KT recipients. Carefully urologic screening is indicated for patients with high risk for TCC, including those with older age, compound analgesics usage, Chinese herbs usage, and underground water intake as well as women.

  18. 32 CFR 644.43 - Gross appraisals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... HANDBOOK Appraisal § 644.43 Gross appraisals. (a) Preparation. (1) The gross appraisal sections of real...-type or brief real estate design memoranda on civil works projects are submitted, comparable sales data... issued on the same project and if values have changed in the interim, additional sales data submitted to...

  19. 32 CFR 644.43 - Gross appraisals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... HANDBOOK Appraisal § 644.43 Gross appraisals. (a) Preparation. (1) The gross appraisal sections of real...-type or brief real estate design memoranda on civil works projects are submitted, comparable sales data... issued on the same project and if values have changed in the interim, additional sales data submitted to...

  20. 7 CFR 1410.44 - Average adjusted gross income.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Average adjusted gross income. 1410.44 Section 1410... Average adjusted gross income. (a) Benefits under this part will not be available to persons or legal entities whose average adjusted gross income exceeds $1,000,000 or as further specified in part 1400...

  1. 7 CFR 1410.44 - Average adjusted gross income.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Average adjusted gross income. 1410.44 Section 1410... Average adjusted gross income. (a) Benefits under this part will not be available to persons or legal entities whose average adjusted gross income exceeds $1,000,000 or as further specified in part 1400...

  2. Determination of gross alpha and gross beta in soil around repository facility at Bukit Kledang, Perak, Malaysia

    NASA Astrophysics Data System (ADS)

    Adziz, Mohd Izwan Abdul; Siong, Khoo Kok

    2018-04-01

    Recently, the Long Term Storage Facility (LTSF) in Bukit Kledang, Perak, Malaysia, has been upgraded to repository facility upon the completion of decontamination and decommissioning (D&D) process. Thorium waste and contaminated material that may contain some minor amounts of thorium hydroxide were disposed in this facility. This study is conducted to determine the concentrations of gross alpha and gross beta radioactivities in soil samples collected around the repository facility. A total of 12 soil samples were collected consisting 10 samples from around the facility and 2 samples from selected residential area near the facility. In addition, the respective dose rates were measured 5 cm and 1 m above the ground by using survey meter with Geiger Muller (GM) detector and Sodium Iodide (NaI) detector. Soil samples were collected using hand auger and then were taken back to the laboratory for further analysis. Samples were cleaned, dried, pulverized and sieved prior to analysis. Gross alpha and gross beta activity measurements were carried out using gas flow proportional counter, Canberra Series 5 XLB - Automatic Low Background Alpha and Beta Counting System. The obtained results show that, the gross alpha and gross beta activity concentration ranged from 1.55 to 5.34 Bq/g with a mean value of 3.47 ± 0.09 Bq/g and 1.64 to 5.78 Bq/g with a mean value of 3.49 ± 0.09 Bq/g, respectively. These results can be used as an additional data to represent terrestrial radioactivity baseline data for Malaysia environment. This estimation will also serve as baseline for detection of any future related activities of contamination especially around the repository facility area.

  3. Visually guided male urinary catheterization: a feasibility study.

    PubMed

    Willette, Paul A; Banks, Kevin; Shaffer, Lynn

    2013-01-01

    Ten percent to 15% of urinary catheterizations involve complications. New techniques to reduce risks and pain are indicated. This study examines the feasibility and safety of male urinary catheterization by nursing personnel using a visually guided device in a clinical setting. The device, a 0.6-mm fiber-optic bundle inside a 14F triple-lumen flexible urinary catheter with a lubricious coating, irrigation port, and angled tip, connects to a camera, allowing real-time viewing of progress on a color monitor. Two emergency nurses were trained to use the device. Male patients 18 years or older presenting to the emergency department with an indication for urinary catheterization using a standard Foley or Coudé catheter were eligible to participate in the study. Exclusion criteria were a current suprapubic tube or gross hematuria prior to the procedure. Twenty-five patients were enrolled. Data collected included success of placement, total procedure time, pre-procedure pain and maximum pain during the procedure, gross hematuria, abnormalities or injuries identified if catheterization failed, occurrence of and reason for equipment failures, and number of passes required for placement. All catheters were successfully placed. The median number of passes required was 1. For all but one patient, procedure time was ≤ 17 minutes. A median increase in pain scores of 1 point from baseline to the maximum was reported. Gross hematuria was observed in 2 patients. The success rate for placement of a Foley catheter with the visually guided device was 100%, indicating its safety, accuracy, and feasibility in a clinical setting. Minimal pain was associated with the procedure. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  4. Validating the Rett Syndrome Gross Motor Scale.

    PubMed

    Downs, Jenny; Stahlhut, Michelle; Wong, Kingsley; Syhler, Birgit; Bisgaard, Anne-Marie; Jacoby, Peter; Leonard, Helen

    2016-01-01

    Rett syndrome is a pervasive neurodevelopmental disorder associated with a pathogenic mutation on the MECP2 gene. Impaired movement is a fundamental component and the Rett Syndrome Gross Motor Scale was developed to measure gross motor abilities in this population. The current study investigated the validity and reliability of the Rett Syndrome Gross Motor Scale. Video data showing gross motor abilities supplemented with parent report data was collected for 255 girls and women registered with the Australian Rett Syndrome Database, and the factor structure and relationships between motor scores, age and genotype were investigated. Clinical assessment scores for 38 girls and women with Rett syndrome who attended the Danish Center for Rett Syndrome were used to assess consistency of measurement. Principal components analysis enabled the calculation of three factor scores: Sitting, Standing and Walking, and Challenge. Motor scores were poorer with increasing age and those with the p.Arg133Cys, p.Arg294* or p.Arg306Cys mutation achieved higher scores than those with a large deletion. The repeatability of clinical assessment was excellent (intraclass correlation coefficient for total score 0.99, 95% CI 0.93-0.98). The standard error of measurement for the total score was 2 points and we would be 95% confident that a change 4 points in the 45-point scale would be greater than within-subject measurement error. The Rett Syndrome Gross Motor Scale could be an appropriate measure of gross motor skills in clinical practice and clinical trials.

  5. Gross motor skill development of kindergarten children in Japan.

    PubMed

    Aye, Thanda; Kuramoto-Ahuja, Tsugumi; Sato, Tamae; Sadakiyo, Kaori; Watanabe, Miyoko; Maruyama, Hitoshi

    2018-05-01

    [Purpose] The purposes of this study were to assess and explore the gender-based differences in gross motor skill development of 5-year-old Japanese children. [Subjects and Methods] This cross-sectional study recruited 60 healthy 5-year-old (third-year kindergarten, i.e., nencho ) children (34 boys, 26 girls) from one local private kindergarten school in Otawara city, Tochigi Prefecture, Japan. Gross motor skills, including six locomotor and six object control skills, were assessed using the test of gross motor development, second edition (TGMD-2). All subjects performed two trials of each gross motor skill, and the performances were video-recorded and scored. Assessment procedures were performed according to the standardized guidelines of the TGMD-2. [Results] The majority of subjects had an average level of overall gross motor skills. Girls had significantly better locomotor skills. Boys had significantly better object control skills. [Conclusion] The gross motor skill development of 5-year-old Japanese children involves gender-based differences in locomotor and object control skills. This study provided valuable information that can be used to establish normative references for the gross motor skills of 5-year-old Japanese children.

  6. Gross motor skill development of kindergarten children in Japan

    PubMed Central

    Aye, Thanda; Kuramoto-Ahuja, Tsugumi; Sato, Tamae; Sadakiyo, Kaori; Watanabe, Miyoko; Maruyama, Hitoshi

    2018-01-01

    [Purpose] The purposes of this study were to assess and explore the gender-based differences in gross motor skill development of 5-year-old Japanese children. [Subjects and Methods] This cross-sectional study recruited 60 healthy 5-year-old (third-year kindergarten, i.e., nencho) children (34 boys, 26 girls) from one local private kindergarten school in Otawara city, Tochigi Prefecture, Japan. Gross motor skills, including six locomotor and six object control skills, were assessed using the test of gross motor development, second edition (TGMD-2). All subjects performed two trials of each gross motor skill, and the performances were video-recorded and scored. Assessment procedures were performed according to the standardized guidelines of the TGMD-2. [Results] The majority of subjects had an average level of overall gross motor skills. Girls had significantly better locomotor skills. Boys had significantly better object control skills. [Conclusion] The gross motor skill development of 5-year-old Japanese children involves gender-based differences in locomotor and object control skills. This study provided valuable information that can be used to establish normative references for the gross motor skills of 5-year-old Japanese children. PMID:29765187

  7. 75 FR 78897 - Definition of Omission From Gross Income

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ... Definition of Omission From Gross Income AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations. SUMMARY: This document contains final regulations defining an omission from gross income for... overstatement of basis in a sold asset results in an omission from gross income. The regulations will affect any...

  8. 29 CFR 779.259 - What is included in annual gross volume.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... whole. The computation of the annual gross volume of sales or business of the enterprise is made... Coverage Annual Gross Volume of Sales Made Or Business Done § 779.259 What is included in annual gross volume. (a) The annual gross volume of sales made or business done of an enterprise consists of its gross...

  9. 29 CFR 779.259 - What is included in annual gross volume.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... whole. The computation of the annual gross volume of sales or business of the enterprise is made... Coverage Annual Gross Volume of Sales Made Or Business Done § 779.259 What is included in annual gross volume. (a) The annual gross volume of sales made or business done of an enterprise consists of its gross...

  10. 7 CFR 701.17 - Average adjusted gross income limitation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Average adjusted gross income limitation. 701.17... RELATED PROGRAMS PREVIOUSLY ADMINISTERED UNDER THIS PART § 701.17 Average adjusted gross income limitation... 9003), each applicant must meet the provisions of the Adjusted Gross Income Limitations at 7 CFR part...

  11. 7 CFR 701.117 - Average adjusted gross income limitation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Average adjusted gross income limitation. 701.117... Conservation Program § 701.117 Average adjusted gross income limitation. To be eligible for payments issued... the provisions of the Adjusted Gross Income Limitations at 7 CFR part 1400 subpart G. [72 FR 45880...

  12. Gross motor development is delayed following early cardiac surgery.

    PubMed

    Long, Suzanne H; Harris, Susan R; Eldridge, Beverley J; Galea, Mary P

    2012-10-01

    To describe the gross motor development of infants who had undergone cardiac surgery in the neonatal or early infant period. Gross motor performance was assessed when infants were 4, 8, 12, and 16 months of age with the Alberta Infant Motor Scale. This scale is a discriminative gross motor outcome measure that may be used to assess infants from birth to independent walking. Infants were videotaped during the assessment and were later evaluated by a senior paediatric physiotherapist who was blinded to each infant's medical history, including previous clinical assessments. Demographic, diagnostic, surgical, critical care, and medical variables were considered with respect to gross motor outcomes. A total of 50 infants who underwent elective or emergency cardiac surgery at less than or up to 8 weeks of age, between July 2006 and January 2008, were recruited to this study and were assessed at 4 months of age. Approximately, 92%, 84%, and 94% of study participants returned for assessment at 8, 12, and 16 months of age, respectively. Study participants had delayed gross motor development across all study time points; 62% of study participants did not have typical gross motor development during the first year of life. Hospital length of stay was associated with gross motor outcome across infancy. Active gross motor surveillance of all infants undergoing early cardiac surgery is recommended. Further studies of larger congenital heart disease samples are required, as are longitudinal studies that determine the significance of these findings at school age and beyond.

  13. 7 CFR 1424.7 - Gross payable units.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...) Biodiesel producers will be eligible for payments on gross payable units for all biodiesel production from... rates. Unless otherwise determined by CCC, gross payable units for biodiesel production from eligible inputs will be calculated as follows: (1) For APP, by dividing the gallons of increased biodiesel by the...

  14. 7 CFR 1424.7 - Gross payable units.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) Biodiesel producers will be eligible for payments on gross payable units for all biodiesel production from... rates. Unless otherwise determined by CCC, gross payable units for biodiesel production from eligible inputs will be calculated as follows: (1) For APP, by dividing the gallons of increased biodiesel by the...

  15. 7 CFR 1424.7 - Gross payable units.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) Biodiesel producers will be eligible for payments on gross payable units for all biodiesel production from... rates. Unless otherwise determined by CCC, gross payable units for biodiesel production from eligible inputs will be calculated as follows: (1) For APP, by dividing the gallons of increased biodiesel by the...

  16. 7 CFR 1424.7 - Gross payable units.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) Biodiesel producers will be eligible for payments on gross payable units for all biodiesel production from... rates. Unless otherwise determined by CCC, gross payable units for biodiesel production from eligible inputs will be calculated as follows: (1) For APP, by dividing the gallons of increased biodiesel by the...

  17. 7 CFR 1424.7 - Gross payable units.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) Biodiesel producers will be eligible for payments on gross payable units for all biodiesel production from... rates. Unless otherwise determined by CCC, gross payable units for biodiesel production from eligible inputs will be calculated as follows: (1) For APP, by dividing the gallons of increased biodiesel by the...

  18. 26 CFR 1.832-4 - Gross income.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TAXES Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in section 832(b... the exhibit, however, do not reflect an insurance company's income as defined in the Code. By reason... amounts payable to customers under the applicable portion of such arrangements as losses incurred...

  19. Samuel D. Gross, the Writing of American Surgical History.

    PubMed

    Rutkow, Ira

    2015-12-01

    To explore the details of Samuel D. Gross's achievements as America's foremost historian of medicine in the mid-nineteenth century. The life of Samuel D. Gross, the most renowned of the nation's surgeons in the nineteenth century, has been extensively researched and celebrated. Despite the long-standing interest in Gross's accomplishments, there is an important and influential aspect of his career that has been forgotten. Gross was the country's first surgical historian and his boosting of the popular image of the knife bearer was crucial to shaping the future of the craft, in particular surgery's rise as a respected specialty within the whole of medicine. An analysis of the published medical literature and unpublished documents relating to Samuel D. Gross and his status as the country's earliest historian of surgery. At a time when surgery was not considered a separate branch of medicine but a mere technical mode of treatment, Gross's efforts in medical and surgical history provided a much needed boost to surgeons in their pursuit of self-confidence and self-respect. Although Gross's accomplishments as a medical historian have been overlooked, it is undeniable that he was America's pioneer surgical historian and, as such, afforded surgeons their earliest measure of self-esteem, a critical attribute that was indispensable for the rise of surgery as a distinguished profession.

  20. 26 CFR 1.832-1 - Gross income.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-1 Gross income. (a) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in § 1.831-1 the..., remittances from the home office of a foreign insurance company to the United States branch, borrowed money...

  1. 26 CFR 1.832-1 - Gross income.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-1 Gross income. (a) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in § 1.831-1 the..., remittances from the home office of a foreign insurance company to the United States branch, borrowed money...

  2. 26 CFR 1.832-1 - Gross income.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-1 Gross income. (a) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in § 1.831-1 the..., remittances from the home office of a foreign insurance company to the United States branch, borrowed money...

  3. 26 CFR 1.832-1 - Gross income.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-1 Gross income. (a) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in § 1.831-1 the..., remittances from the home office of a foreign insurance company to the United States branch, borrowed money...

  4. Calcium-creatinine ratio in a morning urine sample for the estimation of hypercalciuria associated with non-glomerular hematuria observed in children and adolescents.

    PubMed

    Quiñones-Vázquez, Susana; Liriano-Ricabal, María Del Rosario; Santana-Porbén, Sergio; Salabarría-González, José Reinaldo

    2018-01-01

    Hypercalciuria might be revealed during the differential diagnosis of hematuria accompanying renal lithiasis (RL). In spite of this, diagnostic accuracy of calcium urinary excretion might be affected by incomplete 24-hour urine collections. In the present study, the diagnostic utility of calcium/creatinine (ICaCre) index for determining hypercalciuria associated with non-glomerular hematuria (NGH) and RL was assessed. ICaCre (mg/mg) index was calculated from calcium (mmol/l) and creatinine (µmol/l) concentrations in an aliquot from a 24-hour urine collection in 169 children and adolescents with NGH or RL. Calciuria values > 4.0 mg/kg in 24 hours were distributed according to the presence of NGH or RL. Mean ICaCre index was 0.2 ± 0.1 mg/mg. Calciuria values estimated from ICaCre were statistically higher to those from 24-hour urine collection (p < 0.05). The frequency of hypercalciuria was independent from the measurement method (estimated from ICaCre 39.5% vs. 24 h collection 32.1%; p > 0.05). Hypercalciuria distribution was as follows: no NGH + no RL: 59.0%; no NGH + RL: 60.0% (∆ = +1.0%); NGH + no RL: 68.2% (∆ = +9.2%); NGH + RL: 73.3% (∆ = +14.4%). The use of ICaCre index for determining calcium urine excretion might be effective in the study of hypercalciuria associated with NGH and RL. Copyright: © 2018 Permanyer.

  5. BOREAS HYD-8 Gross Precipitation Data

    NASA Technical Reports Server (NTRS)

    Fernandes, Richard; Hall, Forrest G. (Editor); Knapp, David E. (Editor); Smith, David E. (Technical Monitor)

    2000-01-01

    The Boreal Ecosystem-Atmosphere Study (BOREAS) Hydrology (HYD)-08 team made measurements of surface hydrological processes at the Southern Study Area-Old Black Spruce (SSA-OBS) Tower Flux site to support its research into point hydrological processes and the spatial variation of these processes. Data collected may be useful in characterizing canopy interception, drip, throughfall, moss interception, drainage, evaporation, and capacity during the growing season at daily temporal resolution. This particular data set contains the gross precipitation measurements for July to August 1996. Gross precipitation is the precipitation that falls that is not intercepted by tree canopies. These data are stored in ASCII text files. The HYD-08 gross precipitation data are available from the Earth Observing System Data and Information System (EOSDIS) Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC). The data files are available on a CD-ROM (see document number 20010000884).

  6. 29 CFR 794.122 - Ascertainment of “annual” gross sales volume.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Ascertainment of âannualâ gross sales volume. 794.122... Annual Gross Volume of Sales § 794.122 Ascertainment of “annual” gross sales volume. The annual gross volume of sales of an enterprise engaged in the wholesale or bulk distribution of petroleum products...

  7. 7 CFR 1400.501 - Determination of average adjusted gross income.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Determination of average adjusted gross income. 1400... PAYMENT ELIGIBILITY FOR 2009 AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Average Adjusted Gross Income Limitation § 1400.501 Determination of average adjusted gross income. (a) Except as otherwise provided in...

  8. Psychiatric Symptoms in Children with Gross Motor Problems

    ERIC Educational Resources Information Center

    Emck, Claudia; Bosscher, Ruud J.; van Wieringen, Piet C. W.; Doreleijers, Theo; Beek, Peter J.

    2012-01-01

    Children with psychiatric disorders often demonstrate gross motor problems. This study investigates if the reverse also holds true by assessing psychiatric symptoms present in children with gross motor problems. Emotional, behavioral, and autism spectrum disorders (ASD), as well as psychosocial problems, were assessed in a sample of 40 children…

  9. The Gross Motor Skills of Children with Mild Learning Disabilities

    ERIC Educational Resources Information Center

    Nonis, Karen P.; Jernice, Tan Sing Yee

    2014-01-01

    Many international studies have examined the gross motor skills of children studying in special schools while local studies of such nature are limited. This study investigated the gross motor skills of children with Mild Learning Disabilities (MLD; n = 14, M age = 8.93 years, SD = 0.33) with the Test of Gross Motor Development-2 (TGMD-2, Ulrich,…

  10. Development of Rapid Radiochemical Method for Gross Alpha and Gross Beta Activity Concentration in Flowback and Produced Waters from Hydraulic Fracturing Operations

    EPA Science Inventory

    This report summarizes the development and validation of an improved method for the Determination of Gross Alpha and Gross Beta Activity in Flowback and Produced Waters from Hydraulic Fracturing Operations (FPWHFO). Flowback and produced waters are characterized by high concentra...

  11. Ruptured renal arteriovenous malformation successfully treated by catheter embolization: a case report.

    PubMed

    Takeuchi, Nobuhiro; Nomura, Yusuke

    2014-01-09

    Renal arteriovenous fistula (RAVF) is a comparatively rare malformation. Here, we report a case of ruptured RAVF that was successfully treated by catheter embolization. An 89-year-old female was transferred to our institution with massive gross hematuria in March 2011. Plain abdominal computed tomography (CT) revealed dilated left renal pelvis with high-density contents. Hematoma was suspected. Subsequent plain abdominal magnetic resonance imaging revealed left hydronephrosis and blood retention in the dilated left renal pelvis. No renal or ureteral cancer was evident. Hematuria was conservatively treated using hemostatic agents but hematuria persisted. Repeated urinary cytology revealed no malignant cells. On day 9, the patient went into septic and/or hemorrhagic shock. Fluid and catecholamine infusion, blood transfusion, and antibacterial drugs were rapidly initiated, and the patient's general condition gradually improved. Contrast-enhanced abdominal CT revealed marked expansion of the hematoma in the renal pelvis and microaneurysms in the segmental arteries of the left kidney. Inflammation improved, and a left double-J stent was inserted. Selective renal angiography revealed RAVF with microaneurysms in the left segmental arteries; therefore, catheter embolization using metallic coils was performed, which resolved hematuria. We report a case of ruptured renal arteriovenous malformation, which was successfully treated by catheter embolization.

  12. Histopathologic Findings of Potential Kidney Donors With Asymptomatic Microscopic Hematuria: Impact on Donation.

    PubMed

    Hassan, E A; Ali, T Z; Abdulbaki, A; Ibrahim, I A; Almanae, H M; Aleid, H A

    2017-10-01

    Isolated microscopic hematuria (IMH) is not uncommon in potential kidney donors. The aim was to study the kidney biopsy findings of potential kidney donors with IMH and the impact of the histopathologic diagnoses on the decision to accept or decline such donors from kidney donation. In this retrospective study, all the potential kidney donors with IMH were identified from the medical records of patients who underwent kidney biopsies between January 2010 and December 2016. Forty-five such individuals were identified. The mean age of these potential donors was 32.6 years and 76% were male. All of them had normal blood pressure and no significant proteinuria. Seventeen (38%) biopsies showed histopathologic abnormalities; thin basement membrane disease (n = 13; 28%) was the most common cause followed by immunoglobulin (Ig)A nephropathy (n = 4; 9%). Donors with abnormal biopsy findings were excluded from donation. However, 62% of the potential donors had normal kidney biopsy findings and were accepted for kidney donation. IMH justifies extensive work-up including kidney biopsy to identify donors who may have underlying significant glomerular pathology excluding them from kidney donation. On the other hand, kidney biopsy also helps in accepting the donors if it does not show significant abnormality. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Renal arteriovenous malformation: an unusual cause of recurrent haematuria

    PubMed Central

    Ali, Mazhar; Aziz, Wajahat; Abbas, Farhat

    2013-01-01

    A 54-year-old woman presented with gross painless haematuria. Initial workup showed no abnormality except mild hydronephrosis on CT scan. Cystoscopy and retrograde pyelography did not find any gross lesion and her urine cytology was also negative. She had recurrent haematuria so her CT was reviewed with the radiologist with clinical suspicion of arteriovenous malformation (AVM) which was suggested by relatively increased contrast density in the hemiazygous vein and renal vein in the arterial phase. She underwent angioembiolisation of left renal AVM after which her haematuria settled. PMID:23867881

  14. [The physical therapy undergraduate students' responses to the gross human anatomy subjects].

    PubMed

    Anahara, Reiko; Kawashiro, Yukiko; Matsuno, Yoshiharu; Mori, Chisato; Kohno, Toshihiko

    2008-09-01

    Instruction in gross human anatomy is one of the important items in the subject for co-medical students of the physical therapist course. The physical therapy undergraduate students are required to have a solid understanding of the structure and formation of the human body. Therefore, their good-understanding of the course on the gross human anatomy and their experience of the gross human anatomy laboratory (observation practice) are acquired to improve their knowledge of the human body. To clarify the student responses to the gross human anatomy course including the gross human anatomy laboratory, several questionnaires were administered to the freshman physical therapy undergraduate student for two years. We found that more than 80% of the students, who felt a negative attitude for gross human anatomy before the course started, had a positive attitude about the gross human anatomy after going through the course. The experience of the gross human anatomy laboratory increased the students' activity of learning and they thought more about the dignity of being human after the course than before viewing. In addition, the results suggested that the multiple experiences of the gross human anatomy course are useful for the physical therapy undergraduate students to improve the quality of their understanding of the human body.

  15. [Kidney traumatism in general surgery (65 cases)].

    PubMed

    Brunet, C; Sielezneff, I; Voinchet, V; Rosset, E; Grégoire, R; Thirion, X; Ugarte, S; Farisse, J

    1995-01-01

    From September 1989 to September 1994, 65 patients, 15 females and 50 males, with a mean age of 32 +/- 14 years were admitted in the emergency unit for renal trauma. In 38.5% of cases multiple trauma was present. Lesional mechanism was most frequently contusions (49.2%) and deceleration injuries (43.1%). Gross hematuria or microscopic hematuria were presents in 72.3% of cases. The sensibility of systematic abdominal echography was 100% in case of perirenal hematoma and 65% in case of parenchymatous lesions. Only 23 patients were operated (35.3%) because of low blood pressure. None secondary operation was necessary in abstention group. Global mortality was 7.7%. Postoperative morbidity was 20% and specific morbidity in abstention group was 10.7%.

  16. Acute painless monocular visual loss due to central retinal artery occlusion in a patient with Churg-Strauss vasculitis.

    PubMed

    Skrapari, Ioanna; Kagkelari, Eleftheria; Charitatos, Evangelos; Pantelidaki, Catherine; Gounaris, Theodoros; Sioula, Evagelia

    2008-01-01

    Ocular involvement in Churg-Strauss syndrome (CSS) is infrequent. We describe a case of a 50-year-old woman, with blood eosinophilia, involvement of the respiratory tract, skin, and peripheral nervous system, fulfilling the American College of Rheumatology criteria for CSS, who presented with left foot drop followed by left acute painless visual loss. Central retinal artery occlusion was diagnosed by fundoscopic findings (retinal whitening with a cherry-red spot). CSS was confirmed by sural nerve biopsy. Despite treatment with high-dose corticosteroids, cyclophosphamide, and anticoagulant therapy, visual acuity was not substantially improved. Acute blindness in CSS has been rarely described. Even more rarely, central retinal artery occlusion has been found to be the underlying cause of this infrequent clinical manifestation in CSS.

  17. The Drosophila TRPA channel, Painless, regulates sexual receptivity in virgin females

    PubMed Central

    Sakai, Takaomi; Kasuya, Junko; Kitamoto, Toshihiro; Aigaki, Toshiro

    2009-01-01

    Transient receptor potential (TRP) channels play crucial roles in sensory perception. Expression of the Drosophila painless (pain) gene, a homolog of the mammalian TRPA1/ANKTM1 gene, in the peripheral nervous system is required for avoidance behavior of noxious heat or wasabi. Here we report a novel role of the Pain TRP channel expressed in the nervous system in the sexual receptivity in Drosophila virgin females. Compared with wild-type females, pain mutant females copulated with wild-type males significantly earlier. Wild-type males showed comparable courtship latency and courtship index toward wild-type and pain mutant females. Therefore, the early copulation observed in wild-type male and pain mutant female pairs is the result of enhanced sexual receptivity in pain mutant females. Involvement of pain in enhanced female sexual receptivity was confirmed by rescue experiments in which expression of a pain transgene in a pain mutant background restored the female sexual receptivity to the wild-type level. Targeted expression of pain RNAi in putative cholinergic or GABAergic neurons phenocopied the mutant phenotype of pain females. On the other hand, target expression of pain RNAi in dopaminergic neurons did not affect female sexual receptivity. In addition, conditional suppression of neurotransmission in putative GABAergic neurons resulted in a similar enhanced sexual receptivity. Our results suggest that Pain TRP channels expressed in cholinergic and/or GABAergic neurons are involved in female sexual receptivity. PMID:19531155

  18. The Drosophila TRPA channel, Painless, regulates sexual receptivity in virgin females.

    PubMed

    Sakai, T; Kasuya, J; Kitamoto, T; Aigaki, T

    2009-07-01

    Transient receptor potential (TRP) channels play crucial roles in sensory perception. Expression of the Drosophila painless (pain) gene, a homolog of the mammalian TRPA1/ANKTM1 gene, in the peripheral nervous system is required for avoidance behavior of noxious heat or wasabi. In this study, we report a novel role of the Pain TRP channel expressed in the nervous system in the sexual receptivity in Drosophila virgin females. Compared with wild-type females, pain mutant females copulated with wild-type males significantly earlier. Wild-type males showed comparable courtship latency and courtship index toward wild-type and pain mutant females. Therefore, the early copulation observed in wild-type male and pain mutant female pairs is the result of enhanced sexual receptivity in pain mutant females. Involvement of pain in enhanced female sexual receptivity was confirmed by rescue experiments in which expression of a pain transgene in a pain mutant background restored the female sexual receptivity to the wild-type level. Targeted expression of pain RNA interference (RNAi) in putative cholinergic or GABAergic neurons phenocopied the mutant phenotype of pain females. However, target expression of pain RNAi in dopaminergic neurons did not affect female sexual receptivity. In addition, conditional suppression of neurotransmission in putative GABAergic neurons resulted in a similar enhanced sexual receptivity. Our results suggest that Pain TRP channels expressed in cholinergic and/or GABAergic neurons are involved in female sexual receptivity.

  19. 46 CFR 69.117 - Spaces exempt from inclusion in gross tonnage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Spaces exempt from inclusion in gross tonnage. 69.117 Section 69.117 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DOCUMENTATION AND... inclusion in gross tonnage. (a) Purpose. This section lists spaces which are exempt from inclusion in gross...

  20. 46 CFR 69.117 - Spaces exempt from inclusion in gross tonnage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Spaces exempt from inclusion in gross tonnage. 69.117 Section 69.117 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DOCUMENTATION AND... inclusion in gross tonnage. (a) Purpose. This section lists spaces which are exempt from inclusion in gross...

  1. 46 CFR 69.117 - Spaces exempt from inclusion in gross tonnage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Spaces exempt from inclusion in gross tonnage. 69.117 Section 69.117 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) DOCUMENTATION AND... inclusion in gross tonnage. (a) Purpose. This section lists spaces which are exempt from inclusion in gross...

  2. 26 CFR 1.872-1 - Gross income of nonresident alien individuals.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 9 2011-04-01 2011-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a...

  3. 26 CFR 1.872-1 - Gross income of nonresident alien individuals.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 9 2012-04-01 2012-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a...

  4. 26 CFR 1.872-1 - Gross income of nonresident alien individuals.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 9 2013-04-01 2013-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a...

  5. 26 CFR 1.872-1 - Gross income of nonresident alien individuals.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 9 2014-04-01 2014-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a...

  6. The nociception genes painless and Piezo are required for the cellular immune response of Drosophila larvae to wasp parasitization.

    PubMed

    Tokusumi, Yumiko; Tokusumi, Tsuyoshi; Schulz, Robert A

    2017-05-13

    In vertebrates, interaction between the nervous system and immune system is important to protect a challenged host from stress inputs from external sources. In this study, we demonstrate that sensory neurons are involved in the cellular immune response elicited by wasp infestation of Drosophila larvae. Multidendritic class IV neurons sense contacts from external stimuli and induce avoidance behaviors for host defense. Our findings show that inactivation of these sensory neurons impairs the cellular response against wasp parasitization. We also demonstrate that the nociception genes encoding the mechanosensory receptors Painless and Piezo, both expressed in class IV neurons, are essential for the normal cellular immune response to parasite challenge. Copyright © 2017. Published by Elsevier Inc.

  7. 77 FR 51706 - Gross Combination Weight Rating (GCWR); Definition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-27

    .... SUMMARY: The Federal Motor Carrier Safety Administration (FMCSA) amends the definition of ``gross... DEPARTMENT OF TRANSPORTATION Federal Motor Carrier Safety Administration 49 CFR Parts 383 and 390 [Docket No. FMCSA-2012-0156] RIN 2126-AB53 Gross Combination Weight Rating (GCWR); Definition AGENCY...

  8. Curricular Guidelines in Gross Anatomy.

    ERIC Educational Resources Information Center

    Horn, Stanton D.; And Others

    1981-01-01

    An outline of AADS curricular guidelines for gross anatomy in dental education includes primary educational goals, prerequisites, core content, specific course objectives for each section of content, sequencing, faculty requirements, and facility and equipment needs. (MSE)

  9. 26 CFR 1.872-1 - Gross income of nonresident alien individuals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a nonresident alien...

  10. Current usage and future trends in gross digital photography in Canada.

    PubMed

    Horn, Christopher L; DeKoning, Lawrence; Klonowski, Paul; Naugler, Christopher

    2014-01-14

    The purpose of this study was to assess the current usage, utilization and future direction of digital photography of gross surgical specimens in pathology laboratories across Canada. An online survey consisting of 23 multiple choice and free-text questions regarding gross digital photography was sent out to via email to laboratory staff across Canada involved in gross dissection of surgical specimens. Sixty surveys were returned with representation from most of the provinces. Results showed that gross digital photography is utilized at most institutions (90.0%) and the primary users of the technology are Pathologists (88.0%), Pathologists' Assistants (54.0%) and Pathology residents (50.0%). Most respondents felt that there is a definite need for routine digital imaging of gross surgical specimens in their practice (80.0%). The top two applications for gross digital photography are for documentation of interesting/ complex cases (98.0%) and for teaching purposes (84.0%). The main limitations identified by the survey group are storage space (42.5%) and security issues (40.0%). Respondents indicated that future applications of gross digital photography mostly include teaching (96.6%), presentation at tumour boards/ clinical rounds (89.8%), medico-legal documentation (72.9%) and usage for consultation purposes (69.5%). The results of this survey indicate that pathology staff across Canada currently utilizes gross digital images for regular documentation and educational reasons. They also show that the technology will be needed for future applications in teaching, consultation and medico-legal purposes.

  11. Associations between gross motor skills and physical activity in Australian toddlers.

    PubMed

    Veldman, Sanne L C; Jones, Rachel A; Santos, Rute; Sousa-Sá, Eduarda; Pereira, João R; Zhang, Zhiguang; Okely, Anthony D

    2018-08-01

    Physical activity can be promoted by high levels of gross motor skills. A systematic review found a positive relationship in children (3-18 years) but only few studies examined this in younger children. The aim of this study was to examine the association between gross motor skills and physical activity in children aged 11-29 months. Cross-sectional study. This study involved 284 children from 30 childcare services in NSW, Australia (Mean age=19.77±4.18months, 53.2% boys). Physical activity was measured using accelerometers (Actigraph GT3X+). Gross motor skills were assessed using the Peabody Developmental Motor Scales Second Edition (PDMS-2). Multilevel linear regression analyses were computed to assess associations between gross motor skills and physical activity, adjusting for sex, age and BMI. Children spent 53.08% of their time in physical activity and 10.39% in moderate to vigorous physical activity (MVPA). Boys had higher total physical activity (p<0.01) and MVPA (p<0.01) than girls. The average gross motor skills score was 96.16. Boys scored higher than girls in object manipulation (p<0.001). There was no association between gross motor skills and total physical activity or MVPA. Although gross motor skills were not associated with physical activity in this sample, stronger associations are apparent in older children. This study therefore highlights a potential important age to promote gross motor skills. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  12. 26 CFR 1.882-3 - Gross income of a foreign corporation.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 9 2014-04-01 2014-04-01 false Gross income of a foreign corporation. 1.882-3... TAX (CONTINUED) INCOME TAXES (CONTINUED) Foreign Corporations § 1.882-3 Gross income of a foreign corporation. (a) In general—(1) Inclusions. The gross income of a foreign corporation for any taxable year...

  13. 46 CFR 69.169 - Spaces exempt from inclusion in gross tonnage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Spaces exempt from inclusion in gross tonnage. 69.169... MEASUREMENT OF VESSELS MEASUREMENT OF VESSELS Dual Measurement System § 69.169 Spaces exempt from inclusion in gross tonnage. The tonnage of the following spaces is exempt from inclusion in gross tonnage: (a) Spaces...

  14. 46 CFR 69.169 - Spaces exempt from inclusion in gross tonnage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Spaces exempt from inclusion in gross tonnage. 69.169... MEASUREMENT OF VESSELS MEASUREMENT OF VESSELS Dual Measurement System § 69.169 Spaces exempt from inclusion in gross tonnage. The tonnage of the following spaces is exempt from inclusion in gross tonnage: (a) Spaces...

  15. 46 CFR 69.169 - Spaces exempt from inclusion in gross tonnage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Spaces exempt from inclusion in gross tonnage. 69.169... MEASUREMENT OF VESSELS MEASUREMENT OF VESSELS Dual Measurement System § 69.169 Spaces exempt from inclusion in gross tonnage. The tonnage of the following spaces is exempt from inclusion in gross tonnage: (a) Spaces...

  16. 46 CFR 69.169 - Spaces exempt from inclusion in gross tonnage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Spaces exempt from inclusion in gross tonnage. 69.169... MEASUREMENT OF VESSELS MEASUREMENT OF VESSELS Dual Measurement System § 69.169 Spaces exempt from inclusion in gross tonnage. The tonnage of the following spaces is exempt from inclusion in gross tonnage: (a) Spaces...

  17. 46 CFR 69.169 - Spaces exempt from inclusion in gross tonnage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Spaces exempt from inclusion in gross tonnage. 69.169... MEASUREMENT OF VESSELS MEASUREMENT OF VESSELS Dual Measurement System § 69.169 Spaces exempt from inclusion in gross tonnage. The tonnage of the following spaces is exempt from inclusion in gross tonnage: (a) Spaces...

  18. Tensorial Gross-Neveu models

    NASA Astrophysics Data System (ADS)

    Benedetti, Dario; Carrozza, Sylvain; Gurau, Razvan; Sfondrini, Alessandro

    2018-01-01

    We define and study various tensorial generalizations of the Gross-Neveu model in two dimensions, that is, models with four-fermion interactions and G 3 symmetry, where we take either G = U( N) or G = O( N). Such models can also be viewed as two-dimensional generalizations of the Sachdev-Ye-Kitaev model, or more precisely of its tensorial counterpart introduced by Klebanov and Tarnopolsky, which is in part our motivation for studying them. Using the Schwinger-Dyson equations at large- N, we discuss the phenomenon of dynamical mass generation and possible combinations of couplings to avoid it. For the case G = U( N),we introduce an intermediate field representation and perform a stability analysis of the vacua. It turns out that the only apparently viable combination of couplings that avoids mass generation corresponds to an unstable vacuum. The stable vacuum breaks U( N)3 invariance, in contradiction with the Coleman-Mermin-Wagner theorem, but this is an artifact of the large- N expansion, similar to the breaking of continuous chiral symmetry in the chiral Gross-Neveu model.

  19. Prostate Artery Embolization (PAE) in the Management of Refractory Hematuria of Prostatic Origin Secondary to Iatrogenic Urological Trauma: A Safe and Effective Technique.

    PubMed

    Kably, Isaam; Pereira, Keith; Chong, William; Bhatia, Shivank

    2016-02-01

    Incidence of refractory hematuria of prostatic origin (RHPO) is extremely rare, with an iatrogenic etiology even rarer. When conservative methods fail to control bleeding, more invasive surgical methods are needed. In this article we describe our experience with prostatic artery embolization (PAE) as a minimally invasive alternative treatment option in patients with RHPO secondary to iatrogenic urologic trauma. Three patients presented with RHPO. The etiologies were transurethral resection of prostate surgery, Foley catheter removal with a supratherapeutic international normalized ratio and self-traumatic Foley catheter removal respectively. Stepwise management with conservative and medical methods failed to control bleeding. Under local anesthesia and moderate sedation, bilateral PAE was performed via a right common femoral artery access and using cone beam computed tomography. An embolic mixture containing 300-500 um Embosphere® Microspheres (Biosphere Medical, Rockland, MA) was injected under fluoroscopic guidance until stasis was achieved. PAE using the described technique was a technical and clinical success in all three patients. Hematuria resolved within a period of 24 hours. There were no intra- or periprocedural complications. PAE offers a reasonable option in treatment of RHPO, regardless of the cause and may be attempted prior to surgical techniques or sometimes in conjunction. Being minimally invasive and performed under local anesthesia, PAE is especially useful when excessive bleeding prevents adequate visualization of a bleeding source during cystoscopy and in the elderly age group with several comorbidities. An added advantage is the prostatic parenchymal ischemia leading to significant prostate volume reduction and alleviation of the obstructive symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Complications of acucise endopyelotomy.

    PubMed

    Kim, F J; Herrell, S D; Jahoda, A E; Albala, D M

    1998-10-01

    Endoscopic management of ureteropelvic junction (UPJ) obstruction has a success rate of 80% to 86%. We have been performing a ureteral cutting balloon procedure under fluoroscopic control (Acucise endopyelotomy) for UPJ obstruction at Loyola University Medical Center since 1991. The overall success rate in 77 patients was 78%. All patients had a preoperative intravenous urogram or a retrograde pyelogram, but none had vascular imaging studies. Acucise endopyelotomy consisted of a posterolateral incision of the UPJ and placement of an endopyelotomy or double-J stent. Foley catheter placement at the end of the procedure demonstrated significant gross hematuria in three patients (4%). All three remained hemodynamically stable but with significant drops in postprocedure hemoglobin levels, which necessitated blood transfusion. Aggressive management included angiographic studies and embolization of lower-pole branching arteries in two patients (3%). One patient stopped bleeding after being given two units of blood. None of the patients required an open exploratory procedure. Although the risk of vascular injury is low with Acucise endopyelotomy, prolonged postoperative gross hematuria does mandate investigation and observation. Angiographic embolization appears to be the therapeutic modality of choice for patients with hemorrhagic complications after an Acucise endopyelotomy.

  1. 77 FR 65497 - Gross Combination Weight Rating (GCWR); Definition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-29

    ... [Docket No. FMCSA-2012-0156] RIN 2126-AB53 Gross Combination Weight Rating (GCWR); Definition AGENCY...: FMCSA withdraws its August 27, 2012, direct final rule (DFR) amending the definition of ``gross... definition. DATES: The direct final rule published August 27, 2012 (77 FR 51706) is withdrawn effective...

  2. The Gross Anatomy Course: An Analysis of Its Importance

    ERIC Educational Resources Information Center

    Bockers, Anja; Jerg-Bretzke, Lucia; Lamp, Christoph; Brinkmann, Anke; Traue, Harald C.; Bockers, Tobias M.

    2010-01-01

    The gross anatomy dissection course is a cost-intensive piece of undergraduate medical education that students and professionals alike describe as very important within the overall medical curriculum. We sought to understand more explicitly students' valuation of gross anatomy as an "important" course and so developed a quantitative…

  3. Cerebral palsy in Victoria: motor types, topography and gross motor function.

    PubMed

    Howard, Jason; Soo, Brendan; Graham, H Kerr; Boyd, Roslyn N; Reid, Sue; Lanigan, Anna; Wolfe, Rory; Reddihough, Dinah S

    2005-01-01

    To study the relationships between motor type, topographical distribution and gross motor function in a large, population-based cohort of children with cerebral palsy (CP), from the State of Victoria, and compare this cohort to similar cohorts from other countries. An inception cohort was generated from the Victorian Cerebral Palsy Register (VCPR) for the birth years 1990-1992. Demographic information, motor types and topographical distribution were obtained from the register and supplemented by grading gross motor function according to the Gross Motor Function Classification System (GMFCS). Complete data were obtained on 323 (86%) of 374 children in the cohort. Gross motor function varied from GMFCS level I (35%) to GMFCS level V (18%) and was similar in distribution to a contemporaneous Swedish cohort. There was a fairly even distribution across the topographical distributions of hemiplegia (35%), diplegia (28%) and quadriplegia (37%) with a large majority of young people having the spastic motor type (86%). The VCPR is ideal for population-based studies of gross motor function in children with CP. Gross motor function is similar in populations of children with CP in developed countries but the comparison of motor types and topographical distribution is difficult because of lack of consensus with classification systems. Use of the GMFCS provides a valid and reproducible method for clinicians to describe gross motor function in children with CP using a universal language.

  4. Guidelines for Standard Photography in Gross and Clinical Anatomy

    ERIC Educational Resources Information Center

    Barut, Cagatay; Ertilav, Hakan

    2011-01-01

    Photography has a widespread usage in medicine and anatomy. In this review, authors focused on the usage of photography in gross and clinical anatomy. Photography in gross and clinical anatomy is not only essential for accurate documentation of morphological findings but also important in sharing knowledge and experience. Photographs of cadavers…

  5. 26 CFR 1.993-6 - Definition of gross receipts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Definition of gross receipts. 1.993-6 Section 1.993-6 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Domestic International Sales Corporations § 1.993-6 Definition of gross receipts. (a...

  6. 46 CFR 69.119 - Spaces deducted from gross tonnage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Spaces deducted from gross tonnage. 69.119 Section 69... VESSELS MEASUREMENT OF VESSELS Standard Measurement System § 69.119 Spaces deducted from gross tonnage. (a) Purpose. This section lists the requirements for spaces (other than propelling machinery spaces under § 69...

  7. 29 CFR 794.120 - Meaning of “annual gross volume of sales.”

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Meaning of âannual gross volume of sales.â 794.120 Section... of Sales § 794.120 Meaning of “annual gross volume of sales.” The annual gross volume of sales of an... gross volume derived from all sales transactions is included, and will embrace among other things...

  8. 26 CFR 1.199-3 - Domestic production gross receipts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 3 2011-04-01 2011-04-01 false Domestic production gross receipts. 1.199-3 Section 1.199-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations (continued) § 1.199-3 Domestic production gross...

  9. 26 CFR 1.199-3 - Domestic production gross receipts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 3 2014-04-01 2014-04-01 false Domestic production gross receipts. 1.199-3 Section 1.199-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations (continued) § 1.199-3 Domestic production gross...

  10. 26 CFR 1.199-3 - Domestic production gross receipts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 3 2013-04-01 2013-04-01 false Domestic production gross receipts. 1.199-3 Section 1.199-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations (continued) § 1.199-3 Domestic production gross...

  11. 26 CFR 1.199-3 - Domestic production gross receipts.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 3 2012-04-01 2012-04-01 false Domestic production gross receipts. 1.199-3 Section 1.199-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations (continued) § 1.199-3 Domestic production gross...

  12. 26 CFR 1.199-3 - Domestic production gross receipts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Domestic production gross receipts. 1.199-3 Section 1.199-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Itemized Deductions for Individuals and Corporations (continued) § 1.199-3 Domestic production gross receipts. (a) In...

  13. Oropharyngeal dysphagia and gross motor skills in children with cerebral palsy.

    PubMed

    Benfer, Katherine A; Weir, Kelly A; Bell, Kristie L; Ware, Robert S; Davies, Peter S W; Boyd, Roslyn N

    2013-05-01

    To determine the prevalence of oropharyngeal dysphagia (OPD) and its subtypes (oral phase, pharyngeal phase, saliva control), and their relationship to gross motor functional skills in preschool children with cerebral palsy (CP). It was hypothesized that OPD would be present across all gross motor severity levels, and children with more severe gross motor function would have increased prevalence and severity of OPD. Children with a confirmed diagnosis of CP, 18 to 36 months corrected age, born in Queensland between 2006 and 2009, participated. Children with neurodegenerative conditions were excluded. This was a cross-sectional population-based study. Children were assessed by using 2 direct OPD measures (Schedule for Oral Motor Assessment; Dysphagia Disorders Survey), and observations of signs suggestive of pharyngeal phase impairment and impaired saliva control. Gross motor skills were described by using the Gross Motor Function Measure, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System, and motor type/ distribution. OPD was prevalent in 85% of children with CP, and there was a stepwise relationship between OPD and GMFCS level. There was a significant increase in odds of having OPD, or a subtype, for children who were nonambulant (GMFCS V) compared with those who were ambulant (GMFCS I) (odds ratio = 17.9, P = .036). OPD was present across all levels of gross motor severity using direct assessments. This highlights the need for proactive screening of all young children with CP, even those with mild impairments, to improve growth and nutritional outcomes and respiratory health.

  14. Anselm's Discovery of the Gross-Neveu Model in 1958

    NASA Astrophysics Data System (ADS)

    Shifman, M.

    2013-06-01

    The Gross-Neveu model comprises quantum field theory of N Dirac fermions interacting via four-fermion interaction in one spatial and one time dimension. It was introduced in 1974 (shortly after quantum chromodynamics was discovered) by David Gross and André Neveu [1] as a toy model which mimics two crucial features of quantum chromodynamics: asymptotic freedom and spontaneous breaking of a chiral symmetry. The model is based on N Dirac (i.e. complex two-component) fermions, ψ1, ψ2, ..., ψN. The Lagrangian of the Gross-Neveau model is [ {L} = bar{psi}ipartial_{mu}gamma^{mu}psi + frac{g^{2}}{2}(sumlimits_{k = 1}^{N}bar{psi}_{k}psi^{k})^{2}.

  15. Phase III gross solids removal devices pilot study, 2002-2005.

    DOT National Transportation Integrated Search

    2005-12-01

    The objective of the Phase III Gross Solids Removal Devices (GSRDs) Pilot study was to : evaluate the performance of non-proprietary devices that can capture gross solids and that can be : incorporated into existing highway drainage systems or implem...

  16. Phase IV gross solids removal devices pilot study, 2004-2005.

    DOT National Transportation Integrated Search

    2005-12-01

    The objective of the Phase IV Gross Solids Removal Device (GSRD) Pilot study was to evaluate : the performance of one non-proprietary device that can capture gross solids and that can be : incorporated into existing highway drainage systems or implem...

  17. Curriculum Guidelines for Gross Anatomy.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1993

    1993-01-01

    The American Association of Dental Schools' revised guidelines on curricula for gross anatomy suggest percentages of effort and time devoted to curricular areas, offer a rationale for anatomy instruction, note primary educational goals and prerequisites, outline content, and make recommendations for sequencing. Appropriate faculty and facilities…

  18. 48 CFR 29.401-4 - New Mexico gross receipts and compensating tax.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false New Mexico gross receipts... ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS TAXES Contract Clauses 29.401-4 New Mexico gross... Gross Receipts and Compensating Tax Act of the State of New Mexico, Sec. 7-9-3(k) NM SA 1978, and means...

  19. 48 CFR 29.401-4 - New Mexico gross receipts and compensating tax.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false New Mexico gross receipts... ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS TAXES Contract Clauses 29.401-4 New Mexico gross... Gross Receipts and Compensating Tax Act of the State of New Mexico, Sec. 7-9-3(k) NM SA 1978, and means...

  20. 48 CFR 29.401-4 - New Mexico gross receipts and compensating tax.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false New Mexico gross receipts... ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS TAXES Contract Clauses 29.401-4 New Mexico gross... Gross Receipts and Compensating Tax Act of the State of New Mexico, Sec. 7-9-3(k) NM SA 1978, and means...

  1. 48 CFR 29.401-4 - New Mexico gross receipts and compensating tax.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false New Mexico gross receipts... ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS TAXES Contract Clauses 29.401-4 New Mexico gross... Gross Receipts and Compensating Tax Act of the State of New Mexico, Sec. 7-9-3(k) NM SA 1978, and means...

  2. 48 CFR 29.401-4 - New Mexico gross receipts and compensating tax.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false New Mexico gross receipts... ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS TAXES Contract Clauses 29.401-4 New Mexico gross... Gross Receipts and Compensating Tax Act of the State of New Mexico, Sec. 7-9-3(k) NM SA 1978, and means...

  3. Medullary Sponge Kidney and Urinary Calculi Aeromedical Concerns

    NASA Technical Reports Server (NTRS)

    Jones, Jeffrey A.; Cherian, Sebastian F.; Barr, Yael R.; Stocco, Amber

    2008-01-01

    Medullary Sponge Kidney (MSK) is a benign disorder associated with renal stones in 60% of patients. Patients frequently have episodic painless hematuria but are otherwise asymptomatic unless renal calculi or infections complicate the disease. Nephrolithiasis is a relative, but frequently enforced, contraindication to space or other high performance flight. Two case reports of asymptomatic NASA flight crew with MSK and three cases of military aviators diagnosed with MSK are reviewed, all cases resulted in waiver and return to flight status after treatment and a vigorous follow up and prophylaxis protocol. MSK in aviation and space flight necessitates a highly case-by-case dependent evaluation and treatment process to rule out other potential confounding factors that might also contribute to stone formation and in order to re-qualify the aviator for flight duties.

  4. Massive postpartum right renal hemorrhage.

    PubMed

    Kiracofe, H L; Peterson, N

    1975-06-01

    All reported cases of massive postpartum right renal hemorrhage have involved healthy young primigravidas and blacks have predominated (4 of 7 women). Coagulopathies and underlying renal disease have been absent. Hematuria was painless in 5 of 8 cases. Hemorrhage began within 24 hours in 1 case, within 48 hours in 4 cases and 4 days post partum in 3 cases. Our first case is the only report in which hemorrhage has occurred in a primipara. Failure of closure or reopening of pyelovenous channels is suggested as the pathogenesis. The hemorrhage has been self-limiting, requiring no more than 1,500 cc whole blood replacement. Bleeding should stop spontaneously, and rapid renal pelvic clot lysis should follow with maintenance of adequate urine output and Foley catheter bladder decompression. To date surgical intervention has not been necessary.

  5. Developmental and physical-fitness associations with gross motor coordination problems in Peruvian children.

    PubMed

    de Chaves, Raquel Nichele; Bustamante Valdívia, Alcibíades; Nevill, Alan; Freitas, Duarte; Tani, Go; Katzmarzyk, Peter T; Maia, José António Ribeiro

    2016-01-01

    The aims of this cross-sectional study were to examine the developmental characteristics (biological maturation and body size) associated with gross motor coordination problems in 5193 Peruvian children (2787 girls) aged 6-14 years from different geographical locations, and to investigate how the probability that children suffer with gross motor coordination problems varies with physical fitness. Children with gross motor coordination problems were more likely to have lower flexibility and explosive strength levels, having adjusted for age, sex, maturation and study site. Older children were more likely to suffer from gross motor coordination problems, as were those with greater body mass index. However, more mature children were less likely to have gross motor coordination problems, although children who live at sea level or at high altitude were more likely to suffer from gross motor coordination problems than children living in the jungle. Our results provide evidence that children and adolescents with lower physical fitness are more likely to have gross motor coordination difficulties. The identification of youths with gross motor coordination problems and providing them with effective intervention programs is an important priority in order to overcome such developmental problems, and help to improve their general health status. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Treatment of radiation-induced cystitis with hyperbaric oxygen

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

    Weiss, J.P.; Boland, F.P.; Mori, H.

    The effects of hyperbaric oxygen on radiation cystitis have been documented in 3 patients with radiation-induced hemorrhagic cystitis refractory to conventional therapy. Cessation of gross hematuria and reversal of cystoscopic bladder changes were seen in response to a series of hyperbaric oxygen treatments of 2 atmosphere absolute pressure for 2 hours. To our knowledge this is the first report of cystoscopically documented healing of radiation-induced bladder injury.

  7. A longitudinal study of painless and painful intercostobrachial neuropathy after breast cancer surgery.

    PubMed

    La Cesa, S; Sammartino, P; Mollica, C; Cascialli, G; Cruccu, G; Truini, A; Framarino-Dei-Malatesta, M

    2018-04-29

    Intercostobrachial neuropathy, often resulting in neuropathic pain, is a common complication of breast cancer surgery. In this 1-year longitudinal study, we aimed at seeking information on the frequency, clinical features, and course of painless and painful intercostobrachial neuropathy. We enrolled 40 women previously undergoing breast cancer surgery. In these patients, we collected, at 3, 6 and 12 months after surgery, clinical and quantitative sensory testing (QST) variables to diagnose intercostobrachial neuropathy, DN4 questionnaire to identify neuropathic pain, Neuropathic Pain Symptom Inventory to assess the different neuropathic pain symptoms, the Beck Depression Inventory to assess depressive symptoms, and SF36 to assess quality of life and Patient Global Impression of Change. Clinical and QST examination showed an intercostobrachial neuropathy in 23 patients (57.5%). Out of the 23 patients, five experienced neuropathic pain, as assessed with clinical examination and DN4. Axillary surgery clearance was associated with an increased risk of intercostobrachial neuropathy. Whereas sensory disturbances improved during the 1-year observation, neuropathic pain did not. Nevertheless, Beck Depression Inventory, SF36, and the Patient Global Impression of Change scores significantly improved over time. Our study shows that although intercostobrachial neuropathy is a common complication of breast cancer surgery, neuropathic pain affects only a minor proportion of patients. After 1 year, sensory disturbances partially improve and have only a mild impact on mood and quality of life.

  8. Samuel D. Gross: the nestor of American surgery.

    PubMed

    Toledo-Pereyra, Luis H

    2006-01-01

    Samuel David Gross (1805-1884) represented the most notable surgeon of his generation and was honored with the title of "The Nestor of American Surgeon" by surgeon biographer Isaac Minis Hays. Of Pennsylvania Dutch stock, he was born on the family farm near Easton, Pennsylvania. He attended Wilkebarré Academy and Lawrenceville High School, noted private institutions of the day. He apprenticed under Doctor Joseph K. Swift of Easton and later with Professor George McClellan while in Philadelphia. In 1828, he graduated from Jefferson Medical College and remained for a short time in Philadelphia. Professor Gross focused his professional pursuits in the cities of Easton (1830-1833), Cincinnati (1833-1840), Louisville (1840-1856), and Philadelphia (1856-1882). He retired from Jefferson Medical College two years before his death in 1884. Samuel D. Gross' contributions to surgery were numerous and diverse. He was recognized as a prolific author of classic texts of pathology, surgery, and history, an educator, a leader, a surgical researcher, and a pioneer surgeon practitioner. His influence in national affairs was immense, and his recognition as a respected surgeon was unmatched. He remains the most distinguished surgeon of his times. History values him as a hard working, honest, highly competent, and committed individual. His capacity for work and his dedication to a single cause were unrivaled. Doctor Gross integrated the best that surgery could give to future generations of surgical professionals.

  9. 26 CFR 1.613-3 - Gross income from the property.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 7 2011-04-01 2009-04-01 true Gross income from the property. 1.613-3 Section 1.613-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1.613-3 Gross income from the property. Oil and gas...

  10. Gross Motor Skills in Children With Idiopathic Clubfoot and the Association Between Gross Motor Skills, Foot Involvement, Gait, and Foot Motion.

    PubMed

    Lööf, Elin; Andriesse, Hanneke; André, Marie; Böhm, Stephanie; Iversen, Maura D; Broström, Eva W

    2017-02-24

    Little is known regarding gross motor skills (GMS) in children with idiopathic clubfoot (IC). This study describes GMS, specifically foot involvement and asymmetries, and analyses the association between GMS, gait, and foot status in children with IC. Gross motor tasks and gait were analyzed in children with IC and typically developed (TD) children. GMS were assessed using videotapes and the Clubfoot Assessment Protocol (CAP). The Gait Deviation Index (GDI) and GDI-Kinetic were calculated from gait analyses. Children were divided into bilateral, unilateral clubfoot, or TD groups. To analyze asymmetries, feet within each group were further classified into superior or inferior foot, depending on their CAP scores. Correlations identified associations between CAP and GDI, GDI-Kinetic, passive foot motion, and Dimeglio Classification Scores at birth in the clubfeet. In total, 75 children (mean age, 5 years) were enrolled (bilateral n=22, unilateral clubfoot n=25, TD=28). Children with clubfeet demonstrated significantly lower GMS, gait, and foot motion compared with TD children. One leg standing and hopping deviated in 84% and 91%, respectively, in at least one foot in children with clubfoot. Gross motor asymmetries were evident in both children with bilateral and unilateral involvement. In children with unilateral clubfoot, contralateral feet showed few deviations in GMS compared with TD; however, differences existed in gait and foot motion. The association between GMS and gait, foot motion, and initial foot status varied between poor and moderate. Gross motor deficits and asymmetries are present in children with both bilateral and unilateral IC. Development of GMS of the contralateral foot mirrors that of TD children, but modifies to the clubfoot in gait and foot motion. The weak association with gait, foot motion, and initial clubfoot severity indicates that gross motor measurements represent a different outcome entity in clubfoot treatment. We therefore, recommend

  11. Gross Motor Skills and Cardiometabolic Risk in Children: A Mediation Analysis.

    PubMed

    Burns, Ryan D; Brusseau, Timothy A; Fu, You; Hannon, James C

    2017-04-01

    The purpose of this study was to examine the linear relationship between gross motor skills and cardiometabolic risk, with aerobic fitness as a mediator variable, in low-income children from the United States. Participants were a convenience sample of 224 children (mean ± SD age = 9.1 ± 1.1 yr; 129 girls and 95 boys) recruited from five low-income elementary schools from the Mountain West Region of the United States. Gross motor skills were assessed using the Test for Gross Motor Development, 3rd Edition. Gross motor skills were analyzed using a locomotor skill, a ball skill, and a total gross motor skill score. Aerobic fitness was assessed using the Progressive Aerobic Cardiovascular Endurance Run that was administered during physical education class. A continuous and age- and sex-adjusted metabolic syndrome score (MetS) was calculated from health and blood marker measurements collected in a fasted state before school hours. Total effects, average direct effects, and indirect effects (average causal mediation effect) were calculated using a bootstrap mediation analysis method via a linear regression algorithm. The average causal mediation effect of gross locomotor skills on MetS scores, using aerobic fitness as the mediator variable, was statistically significant (β = -0.055, 95% confidence interval = -0.097 to -0.021, P = 0.003). The model explained approximately 17.5% of the total variance in MetS with approximately 43.7% of the relationship between locomotor skills and MetS mediated through aerobic fitness. Ball skills did not significantly relate with cardiometabolic risk. There is a significant relationship between gross locomotor skills and cardiometabolic risk that is partially mediated through aerobic fitness in a sample of low-income children from the United States.

  12. Gross Motor Profile and Its Association with Socialization Skills in Children with Autism Spectrum Disorders.

    PubMed

    Pusponegoro, Hardiono D; Efar, Pustika; Soedjatmiko; Soebadi, Amanda; Firmansyah, Agus; Chen, Hui-Ju; Hung, Kun-Long

    2016-12-01

    While social impairment is considered to be the core deficit in children with autism spectrum disorder (ASD), a large proportion of these children have poor gross motor ability, and gross motor deficits may influence socialization skills in children with ASD. The objectives of this study were to compare gross motor skills in children with ASD to typically developing children, to describe gross motor problems in children with ASD, and to investigate associations between gross motor and socialization skills in children with ASD. This was a cross-sectional study including 40 ASD children aged from 18 months to 6 years and 40 age-matched typically developing controls. Gross motor and socialization skills were scored using the Vineland Adaptive Behavior Scales, 2 nd edition (Vineland-II). Below average gross motor function was found in eight of 40 (20%) ASD children. The mean gross motor v-scale score in the ASD group was 15.1 [standard deviation (SD) 3.12], significantly lower than in the control group [18.7, SD 2.09, p = 0.0001; 95% confidence intervals (CI) from -4.725 to -2.525]. The differences were most prominent in ball throwing and catching, using stairs, jumping, and bicycling. The ASD children with gross motor impairments had a mean socialization domain score of 66.6 (SD 6.50) compared to 85.7 (SD 10.90) in those without gross motor impairments (p = 0.0001, 95% CI from -25.327 to -12.736). Children with ASD had lower gross motor skills compared to typically developing children. Gross motor impairments were found in 20% of the ASD children, and these children also had lower socialization skills than those without gross motor impairments. Copyright © 2016. Published by Elsevier B.V.

  13. Clubfoot Does Not Impair Gross Motor Development in 5-Year-Olds.

    PubMed

    Zapata, Karina A; Karol, Lori A; Jeans, Kelly A; Jo, Chan-Hee

    2018-04-01

    To evaluate the gross motor development of 5-year-olds using the Peabody Developmental Motor Scales, 2nd Edition (PDMS-2), test after initial nonoperative management of clubfoot as infants. The PDMS-2 Stationary, Locomotion, and Object Manipulation subtests were assessed on 128 children with idiopathic clubfeet at the age of 5 years. Children were categorized by their initial clubfoot severity as greater than 13, unilateral or bilateral involvement, and required surgery. Children with treated clubfeet had average gross motor scores (99 Gross Motor Quotient) compared with age-matched normative scores. Children with more severe clubfeet required surgery significantly more than children with less severe scores (P < .01). Peabody scores were not significantly different according to initial clubfoot severity, unilateral versus bilateral involvement, and surgical versus nonsurgical outcomes. Clubfoot does not significantly impair gross motor development in 5-year-olds.

  14. Gross motor skill development of 5-year-old Kindergarten children in Myanmar.

    PubMed

    Aye, Thanda; Oo, Khin Saw; Khin, Myo Thuzar; Kuramoto-Ahuja, Tsugumi; Maruyama, Hitoshi

    2017-10-01

    [Purpose] The purpose of this study was to examine the gross motor skill development of 5-year-old Kindergarten children in Myanmar. [Subjects and Methods] Total 472 healthy Kindergarten children (237 males, 235 females) of 2016-2017 academic year from four schools in urban area and four schools in rural area of Myanmar were recruited. The gross motor skill development of all subjects was assessed with the test of gross motor development second edition (TGMD-2). All subjects performed two trials for each gross motor skill and the performance was video recorded and scored. The assessment procedures were done according to the standardized guidelines of TGMD-2. [Results] The majority of subjects had average level of gross motor skill rank. The significant differences were found on the run and gallop of locomotor skills and the most of object control skills except the catch between males and females. The significant differences were also found between subjects from urban and rural areas. [Conclusion] Gross motor skill development of 5-year-old Kindergarten children in Myanmar had gender-based and region-based differences on both locomotor and object control skills. This study added a valuable information to the establishment of a normative reference of Kindergarten aged children for future studies.

  15. Gross motor skill development of 5-year-old Kindergarten children in Myanmar

    PubMed Central

    Aye, Thanda; Oo, Khin Saw; Khin, Myo Thuzar; Kuramoto-Ahuja, Tsugumi; Maruyama, Hitoshi

    2017-01-01

    [Purpose] The purpose of this study was to examine the gross motor skill development of 5-year-old Kindergarten children in Myanmar. [Subjects and Methods] Total 472 healthy Kindergarten children (237 males, 235 females) of 2016–2017 academic year from four schools in urban area and four schools in rural area of Myanmar were recruited. The gross motor skill development of all subjects was assessed with the test of gross motor development second edition (TGMD-2). All subjects performed two trials for each gross motor skill and the performance was video recorded and scored. The assessment procedures were done according to the standardized guidelines of TGMD-2. [Results] The majority of subjects had average level of gross motor skill rank. The significant differences were found on the run and gallop of locomotor skills and the most of object control skills except the catch between males and females. The significant differences were also found between subjects from urban and rural areas. [Conclusion] Gross motor skill development of 5-year-old Kindergarten children in Myanmar had gender-based and region-based differences on both locomotor and object control skills. This study added a valuable information to the establishment of a normative reference of Kindergarten aged children for future studies. PMID:29184287

  16. 26 CFR 1.61-3 - Gross income derived from business.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... section 162 (c), (f), or (g) in the case of a business expense. The cost of goods sold should be... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Gross income derived from business. 1.61-3... Taxable Income § 1.61-3 Gross income derived from business. (a) In general. In a manufacturing...

  17. Gross and Microscopic Lesions in Corals from Micronesia.

    PubMed

    Work, T M; Aeby, G S; Hughen, K A

    2016-01-01

    The authors documented gross and microscopic morphology of lesions in corals on 7 islands spanning western, southern, and eastern Micronesia, sampling 76 colonies comprising 30 species of corals among 18 genera, with Acropora, Porites, and Montipora dominating. Tissue loss comprised the majority of gross lesions sampled (41%), followed by discoloration (30%) and growth anomaly (29%). Of 31 cases of tissue loss, most lesions were subacute (48%), followed by acute and chronic (26% each). Of 23 samples with discoloration, most were dark discoloration (40%), with bleaching and other discoloration each constituting 30%. Of 22 growth anomalies, umbonate growth anomalies composed half, with exophytic, nodular, and rugose growth anomalies composing the remainder. On histopathology, for 9 cases of dark discoloration, fungal infections predominated (77%); for 7 bleached corals, depletion of zooxanthellae from the gastrodermis made up a majority of microscopic diagnoses (57%); and for growth anomalies other than umbonate, hyperplasia of the basal body wall was the most common microscopic finding (63%). For the remainder of the gross lesions, no single microscopic finding constituted >50% of the total. Host response varied with the agent present on histology. Fragmentation of tissues was most often associated with algae (60%), whereas necrosis dominated (53%) for fungi. Two newly documented potentially symbiotic tissue-associated metazoans were seen in Porites and Montipora. Findings of multiple potential etiologies for a given gross lesion highlight the importance of incorporating histopathology in coral disease surveys. This study also expands the range of corals infected with cell-associated microbial aggregates. © The Author(s) 2015.

  18. Gross and microscopic lesions in corals from Micronesia

    USGS Publications Warehouse

    Work, Thierry M.; Aeby, Greta S.; Hughen, Konrad A.

    2015-01-01

    The authors documented gross and microscopic morphology of lesions in corals on 7 islands spanning western, southern, and eastern Micronesia, sampling 76 colonies comprising 30 species of corals among 18 genera, with Acropora, Porites, and Montipora dominating. Tissue loss comprised the majority of gross lesions sampled (41%), followed by discoloration (30%) and growth anomaly (29%). Of 31 cases of tissue loss, most lesions were subacute (48%), followed by acute and chronic (26% each). Of 23 samples with discoloration, most were dark discoloration (40%), with bleaching and other discoloration each constituting 30%. Of 22 growth anomalies, umbonate growth anomalies composed half, with exophytic, nodular, and rugose growth anomalies composing the remainder. On histopathology, for 9 cases of dark discoloration, fungal infections predominated (77%); for 7 bleached corals, depletion of zooxanthellae from the gastrodermis made up a majority of microscopic diagnoses (57%); and for growth anomalies other than umbonate, hyperplasia of the basal body wall was the most common microscopic finding (63%). For the remainder of the gross lesions, no single microscopic finding constituted >50% of the total. Host response varied with the agent present on histology. Fragmentation of tissues was most often associated with algae (60%), whereas necrosis dominated (53%) for fungi. Two newly documented potentially symbiotic tissue-associated metazoans were seen in Porites and Montipora. Findings of multiple potential etiologies for a given gross lesion highlight the importance of incorporating histopathology in coral disease surveys. This study also expands the range of corals infected with cell-associated microbial aggregates.

  19. 26 CFR 1.1312-1 - Double inclusion of an item of gross income.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 11 2014-04-01 2014-04-01 false Double inclusion of an item of gross income. 1... Limitations § 1.1312-1 Double inclusion of an item of gross income. (a) Paragraph (1) of section 1312 applies if the determination requires the inclusion in a taxpayer's gross income of an item which was...

  20. 26 CFR 1.1312-1 - Double inclusion of an item of gross income.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 11 2013-04-01 2013-04-01 false Double inclusion of an item of gross income. 1... Limitations § 1.1312-1 Double inclusion of an item of gross income. (a) Paragraph (1) of section 1312 applies if the determination requires the inclusion in a taxpayer's gross income of an item which was...

  1. 26 CFR 1.1312-1 - Double inclusion of an item of gross income.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 11 2012-04-01 2012-04-01 false Double inclusion of an item of gross income. 1... Limitations § 1.1312-1 Double inclusion of an item of gross income. (a) Paragraph (1) of section 1312 applies if the determination requires the inclusion in a taxpayer's gross income of an item which was...

  2. 26 CFR 1.1312-1 - Double inclusion of an item of gross income.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 11 2011-04-01 2011-04-01 false Double inclusion of an item of gross income. 1... Limitations § 1.1312-1 Double inclusion of an item of gross income. (a) Paragraph (1) of section 1312 applies if the determination requires the inclusion in a taxpayer's gross income of an item which was...

  3. 26 CFR 1.1312-1 - Double inclusion of an item of gross income.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Double inclusion of an item of gross income. 1....1312-1 Double inclusion of an item of gross income. (a) Paragraph (1) of section 1312 applies if the determination requires the inclusion in a taxpayer's gross income of an item which was erroneously included in...

  4. Vast Portfolio Selection with Gross-exposure Constraints*

    PubMed Central

    Fan, Jianqing; Zhang, Jingjin; Yu, Ke

    2012-01-01

    We introduce the large portfolio selection using gross-exposure constraints. We show that with gross-exposure constraint the empirically selected optimal portfolios based on estimated covariance matrices have similar performance to the theoretical optimal ones and there is no error accumulation effect from estimation of vast covariance matrices. This gives theoretical justification to the empirical results in Jagannathan and Ma (2003). We also show that the no-short-sale portfolio can be improved by allowing some short positions. The applications to portfolio selection, tracking, and improvements are also addressed. The utility of our new approach is illustrated by simulation and empirical studies on the 100 Fama-French industrial portfolios and the 600 stocks randomly selected from Russell 3000. PMID:23293404

  5. 75 FR 63380 - Exclusions From Gross Income of Foreign Corporations; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ... Exclusions From Gross Income of Foreign Corporations; Correction AGENCY: Internal Revenue Service (IRS...) under section 883(a) and (c) of the Internal Revenue Code, concerning the exclusion from gross income of income derived by certain foreign corporations from the international operation of ships or aircraft...

  6. The prediction of gross calorific value using infrared (IR) spectroscopy and multivariate analysis

    Treesearch

    Chi-Leung So; Thomas L. Eberhardt

    2011-01-01

    The gross calorific value (GCV) of a fuel, also known as the higher heating value (HHV) or gross heat of combustion, is the amount of heat released by a specified quantity (initially at 25°C) once it is com-busted and the products returned to that temperature. Fuwape (1989) noted that extractive-free wood from Gmelina arborea (Roxb), a hardwood, had a lower gross heat...

  7. A global assessment of gross and net land change dynamics for current conditions and future scenarios

    NASA Astrophysics Data System (ADS)

    Fuchs, Richard; Prestele, Reinhard; Verburg, Peter H.

    2018-05-01

    The consideration of gross land changes, meaning all area gains and losses within a pixel or administrative unit (e.g. country), plays an essential role in the estimation of total land changes. Gross land changes affect the magnitude of total land changes, which feeds back to the attribution of biogeochemical and biophysical processes related to climate change in Earth system models. Global empirical studies on gross land changes are currently lacking. Whilst the relevance of gross changes for global change has been indicated in the literature, it is not accounted for in future land change scenarios. In this study, we extract gross and net land change dynamics from large-scale and high-resolution (30-100 m) remote sensing products to create a new global gross and net change dataset. Subsequently, we developed an approach to integrate our empirically derived gross and net changes with the results of future simulation models by accounting for the gross and net change addressed by the land use model and the gross and net change that is below the resolution of modelling. Based on our empirical data, we found that gross land change within 0.5° grid cells was substantially larger than net changes in all parts of the world. As 0.5° grid cells are a standard resolution of Earth system models, this leads to an underestimation of the amount of change. This finding contradicts earlier studies, which assumed gross land changes to appear in shifting cultivation areas only. Applied in a future scenario, the consideration of gross land changes led to approximately 50 % more land changes globally compared to a net land change representation. Gross land changes were most important in heterogeneous land systems with multiple land uses (e.g. shifting cultivation, smallholder farming, and agro-forestry systems). Moreover, the importance of gross changes decreased over time due to further polarization and intensification of land use. Our results serve as an empirical database for

  8. 49 CFR 179.13 - Tank car capacity and gross weight limitation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Tank car capacity and gross weight limitation. 179... FOR TANK CARS General Design Requirements § 179.13 Tank car capacity and gross weight limitation. Except as provided in this section, tank cars, built after November 30, 1970, or any existing tank cars...

  9. 49 CFR 179.13 - Tank car capacity and gross weight limitation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Tank car capacity and gross weight limitation. 179... FOR TANK CARS General Design Requirements § 179.13 Tank car capacity and gross weight limitation. Except as provided in this section, tank cars, built after November 30, 1970, or any existing tank cars...

  10. 49 CFR 179.13 - Tank car capacity and gross weight limitation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Tank car capacity and gross weight limitation. 179... FOR TANK CARS General Design Requirements § 179.13 Tank car capacity and gross weight limitation. Except as provided in this section, tank cars, built after November 30, 1970, or any existing tank cars...

  11. 49 CFR 179.13 - Tank car capacity and gross weight limitation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Tank car capacity and gross weight limitation. 179... FOR TANK CARS General Design Requirements § 179.13 Tank car capacity and gross weight limitation. Except as provided in this section, tank cars, built after November 30, 1970, or any existing tank cars...

  12. 49 CFR 179.13 - Tank car capacity and gross weight limitation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Tank car capacity and gross weight limitation. 179... FOR TANK CARS General Design Requirements § 179.13 Tank car capacity and gross weight limitation. Except as provided in this section, tank cars, built after November 30, 1970, or any existing tank cars...

  13. Laboratory testing of gross solids removal devices.

    DOT National Transportation Integrated Search

    2005-05-01

    This report details the outcome of tests carried out at the Hydraulics Laboratory : of the University of California, Davis to assess the performance of three : alternative Gross Solids Removal Devices (GSRDs) developed by Caltrans to : remove litter ...

  14. 48 CFR 52.229-10 - State of New Mexico Gross Receipts and Compensating Tax.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false State of New Mexico Gross... Provisions and Clauses 52.229-10 State of New Mexico Gross Receipts and Compensating Tax. As prescribed in 29.401-4(b), insert the following clause: State of New Mexico Gross Receipts and Compensating Tax (APR...

  15. 48 CFR 52.229-10 - State of New Mexico Gross Receipts and Compensating Tax.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 2 2013-10-01 2013-10-01 false State of New Mexico Gross... Provisions and Clauses 52.229-10 State of New Mexico Gross Receipts and Compensating Tax. As prescribed in 29.401-4(b), insert the following clause: State of New Mexico Gross Receipts and Compensating Tax (APR...

  16. 48 CFR 52.229-10 - State of New Mexico Gross Receipts and Compensating Tax.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false State of New Mexico Gross... Provisions and Clauses 52.229-10 State of New Mexico Gross Receipts and Compensating Tax. As prescribed in 29.401-4(b), insert the following clause: State of New Mexico Gross Receipts and Compensating Tax (APR...

  17. 48 CFR 52.229-10 - State of New Mexico Gross Receipts and Compensating Tax.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false State of New Mexico Gross... Provisions and Clauses 52.229-10 State of New Mexico Gross Receipts and Compensating Tax. As prescribed in 29.401-4(b), insert the following clause: State of New Mexico Gross Receipts and Compensating Tax (APR...

  18. 48 CFR 52.229-10 - State of New Mexico Gross Receipts and Compensating Tax.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 2 2012-10-01 2012-10-01 false State of New Mexico Gross... Provisions and Clauses 52.229-10 State of New Mexico Gross Receipts and Compensating Tax. As prescribed in 29.401-4(b), insert the following clause: State of New Mexico Gross Receipts and Compensating Tax (APR...

  19. The Relationship between Gross Motor Skills and Academic Achievement in Children with Learning Disabilities

    ERIC Educational Resources Information Center

    Westendorp, Marieke; Hartman, Esther; Houwen, Suzanne; Smith, Joanne; Visscher, Chris

    2011-01-01

    The present study compared the gross motor skills of 7- to 12-year-old children with learning disabilities (n = 104) with those of age-matched typically developing children (n = 104) using the Test of Gross Motor Development-2. Additionally, the specific relationships between subsets of gross motor skills and academic performance in reading,…

  20. School Physical Activity Programming and Gross Motor Skills in Children.

    PubMed

    Burns, Ryan D; Fu, You; Hannon, James C; Brusseau, Timothy A

    2017-09-01

    We examined the effect of a comprehensive school physical activity program (CSPAP) on gross motor skills in children. Participants were 959 children (1st-6th grade; Mean age = 9.1 ± 1.5 years; 406 girls, 553 boys) recruited from 5 low-income schools receiving a year-long CSPAP intervention. Data were collected at the beginning of the school year and at a 36-week follow-up. Gross motor skills were assessed using the Test for Gross Motor Development (3rd ed.) (TGMD-3) instrument. Multi-level mixed effects models were employed to examine the effect of CSPAP on TGMD-3 scores, testing age and sex as effect modifiers and adjusting for clustering of observations within the data structure. There were statistically significant coefficients for time (β = 8.1, 95% CI [3.9, 12.3], p < .001) and an age × time interaction (β = -1.7, 95% CI [-2.3, -1.1], p < .001) on TGMD-3 total scores. Significant improvements were also seen for locomotor skills and ball skills sub-test scores. Children showed improved gross motor skill scores at the end of the 36-week CSPAP that were modified by age, as younger children displayed greater improvements in TGMD-3 scores compared to older children.

  1. 40 CFR 403.15 - Net/Gross calculation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 403.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PRETREATMENT REGULATIONS FOR EXISTING AND NEW SOURCES OF POLLUTION § 403.15 Net/Gross... environmental degradation will result. [70 FR 60198, Oct. 14, 2005] ...

  2. Gross-beta activity in ground water: natural sources and artifacts of sampling and laboratory analysis

    USGS Publications Warehouse

    Welch, Alan H.

    1995-01-01

    Gross-beta activity has been used as an indicator of beta-emitting isotopes in water since at least the early 1950s. Originally designed for detection of radioactive releases from nuclear facilities and weapons tests, analysis of gross-beta activity is widely used in studies of naturally occurring radioactivity in ground water. Analyses of about 800 samples from 5 ground-water regions of the United States provide a basis for evaluating the utility of this measurement. The data suggest that measured gross-beta activities are due to (1) long-lived radionuclides in ground water, and (2) ingrowth of beta-emitting radionuclides during holding times between collection of samples and laboratory measurements.Although40K and228Ra appear to be the primary sources of beta activity in ground water, the sum of40K plus228Ra appears to be less than the measured gross-beta activity in most ground-water samples. The difference between the contribution from these radionuclides and gross-beta activity is most pronounced in ground water with gross-beta activities > 10 pCi/L, where these 2 radionuclides account for less than one-half the measured ross-beta activity. One exception is groundwater from the Coastal Plain of New Jersey, where40K plus228Ra generally contribute most of the gross-beta activity. In contrast,40K and228Ra generally contribute most of beta activity in ground water with gross-beta activities < 1 pCi/L.The gross-beta technique does not measure all beta activity in ground water. Although3H contributes beta activity to some ground water, it is driven from the sample before counting and therefore is not detected by gross-beta measurements. Beta-emitting radionuclides with half-lives shorter than a few days can decay to low values between sampling and counting. Although little is known about concentrations of most short-lived beta-emitting radionuclides in environmental ground water (water unaffected by direct releases from nuclear facilities and weapons tests), their

  3. Confirmatory Factor Analysis of the Test of Gross Motor Development-2

    ERIC Educational Resources Information Center

    Wong, Ka Yee Allison; Cheung, Siu Yin

    2010-01-01

    The purpose of this study was to examine the underlying structure of the second edition of the Test of Gross Motor Development-2 (Ulrich, 2000) as applied to Chinese children. The Test of Gross Motor Development-2 was administered to 626 Hong Kong Chinese children. The outlier test with standard scoring was utilized. After data screening, a total…

  4. Gross-Pitaevski map as a chaotic dynamical system.

    PubMed

    Guarneri, Italo

    2017-03-01

    The Gross-Pitaevski map is a discrete time, split-operator version of the Gross-Pitaevski dynamics in the circle, for which exponential instability has been recently reported. Here it is studied as a classical dynamical system in its own right. A systematic analysis of Lyapunov exponents exposes strongly chaotic behavior. Exponential growth of energy is then shown to be a direct consequence of rotational invariance and for stationary solutions the full spectrum of Lyapunov exponents is analytically computed. The present analysis includes the "resonant" case, when the free rotation period is commensurate to 2π, and the map has countably many constants of the motion. Except for lowest-order resonances, this case exhibits an integrable-chaotic transition.

  5. Development of a Computerized Adaptive Test of Children's Gross Motor Skills.

    PubMed

    Huang, Chien-Yu; Tung, Li-Chen; Chou, Yeh-Tai; Wu, Hing-Man; Chen, Kuan-Lin; Hsieh, Ching-Lin

    2018-03-01

    To (1) develop a computerized adaptive test for gross motor skills (GM-CAT) as a diagnostic test and an outcome measure, using the gross motor skills subscale of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT-GM) as the candidate item bank; and (2) examine the psychometric properties and the efficiency of the GM-CAT. Retrospective study. A developmental center of a medical center. Children with and without developmental delay (N=1738). Not applicable. The CDIIT-GM contains 56 universal items on gross motor skills assessing children's antigravity control, locomotion, and body movement coordination. The item bank of the GM-CAT had 44 items that met the dichotomous Rasch model's assumptions. High Rasch person reliabilities were found for each estimated gross motor skill for the GM-CAT (Rasch person reliabilities =.940-.995, SE=.68-2.43). For children aged 6 to 71 months, the GM-CAT had good concurrent validity (r values =.97-.98), adequate to excellent diagnostic accuracy (area under receiver operating characteristics curve =.80-.98), and moderate to large responsiveness (effect size =.65-5.82). The averages of items administered for the GM-CAT were 7 to 11, depending on the age group. The results of this study support the use of the GM-CAT as a diagnostic and outcome measure to estimate children's gross motor skills in both research and clinical settings. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Improvement of gross theory of beta-decay for application to nuclear data

    NASA Astrophysics Data System (ADS)

    Koura, Hiroyuki; Yoshida, Tadashi; Tachibana, Takahiro; Chiba, Satoshi

    2017-09-01

    A theoretical study of β decay and delayed neutron has been carried out with a global β-decay model, the gross theory. The gross theory is based on a consideration of the sum rule of the β-strength function, and gives reasonable results of β-decay rates and delayed neutron in the entire nuclear mass region. In a fissioning nucleus, neutrons are produced by β decay of neutron-rich fission fragments from actinides known as delayed neutrons. The average number of delayed neutrons is estimated based on the sum of the β-delayed neutron-emission probabilities multiplied by the cumulative fission yield for each nucleus. Such a behavior is important to manipulate nuclear reactors, and when we adopt some new high-burn-up reactors, properties of minor actinides will play an important roll in the system, but these data have not been sufficient. We re-analyze and improve the gross theory. For example, we considered the parity of neutrons and protons at the Fermi surface, and treat a suppression for the allowed transitions in the framework of the gross theory. By using the improved gross theory, underestimated half-lives in the neutron-rich indium isotopes and neighboring region increase, and consequently follow experimental trend. The ability of reproduction (and also prediction) of the β-decay rates, delayed-neutron emission probabilities is discussed. With this work, we have described the development of a programming code of the gross theory of β-decay including the improved parts. After preparation finished, this code can be released for the nuclear data community.

  7. Acute glomerulonephritis: a 7 years follow up of children in center of Iran.

    PubMed

    Sepahi, Mohsen Akhavan; Shajari, Ahmad; Shakiba, Mehrdad; Shooshtary, Fatemeh Khalife; Salimi, Mohammad Hossein

    2011-01-01

    Acute glomerulonephritis (AGN) is a type of renal disease which indicates the inflammation of glomerulus and nephrons. This study was carried on 94 children, <15 years old with the diagnosis of AGN who were admitted to Qom and Yazd's hospitals between 2000 and 2006. Data were collected using hospital records on admission, progression notes and outpatient follow up. Among 94 patients, 55.3% were male and 44.6% were female. Mean age of patients was 8.2±2.7 years old. Acute post streptococcal glomerulonephritis (APSGN) was reported in 92.5%, membranoproliferative glomerulonephritis in 4.2%, hemolytic uremic syndrome in 2.1% and IgA nephropathy in 1.06%. There was no significant differences between GN types and gender (P=0.54). Clinical manifestation included edema in 68.8%, oliguria in 36.3%, gross hematuria in 69.1%, HTN in 61.7% and anuria in 1.06%. Microscopic hematuria was detected in all patients. In the time of follow up none of patients had hypertension, 3.1% had proteinuria and 6.3% had microscopic hematuria. APSGN is the most common causes of AGN in Qom and Yazd's children. Early diagnosis and treatment of APSGN may protect children from long term morbidity and mortality and improve quality of life.

  8. Are gross motor skills and sports participation related in children with intellectual disabilities?

    PubMed

    Westendorp, Marieke; Houwen, Suzanne; Hartman, Esther; Visscher, Chris

    2011-01-01

    This study compared the specific gross motor skills of 156 children with intellectual disabilities (ID) (50 ≤ IQ ≥ 79) with that of 255 typically developing children, aged 7-12 years. Additionally, the relationship between the specific gross motor skills and organized sports participation was examined in both groups. The Test of Gross Motor Development-2 and a self-report measure were used to assess children's gross motor skills and sports participation, respectively. The children with ID scored significantly lower on almost all specific motor skill items than the typically developing children. Children with mild ID scored lower on the locomotor skills than children with borderline ID. Furthermore, we found in all groups that children with higher object-control scores participated more in organized sports than children with lower object-control scores. Our results support the importance of attention for well-developed gross motor skills in children with borderline and mild ID, especially to object-control skills, which might contribute positively to their sports participation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. 78 FR 75905 - Credit for Increasing Research Activities: Intra-Group Gross Receipts

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-13

    ... CFR Part 1 [REG-159420-04] RIN 1545-BE14 Credit for Increasing Research Activities: Intra-Group Gross... Internal Revenue Code (Code) relating to the treatment of qualified research expenditures (QREs) and gross... trades or businesses under common control (intra-group transactions) for purposes of determining the...

  10. Recurrent abdominal pain in childhood urolithiasis.

    PubMed

    Polito, Cesare; La Manna, Angela; Signoriello, Giuseppe; Marte, Antonio

    2009-12-01

    Our goal was to establish the clinical presentation and features of pain attacks in children with recurrent abdominal pain (RAP) and urolithiasis. We compared the rate of previous appendectomy among 100 consecutive patients with that of 270 control subjects. We also compared the frequency of pain attacks with that reported by children with functional or organic gastrointestinal RAP. Fifty-three patients had no history of dysuria or gross hematuria, and only 35 had hematuria at the first visit; 41 patients were evaluated for urolithiasis only because of a family history of kidney stones associated with RAP. Twenty-nine patients had been previously hospitalized for abdominal symptoms. Sixteen patients and 4 control subjects (1.5%) had undergone a previous appendectomy (P < .0001). Two to 28 months before the diagnosis of urolithiasis, 37 patients underwent abdominal ultrasonography, which did not show urinary stones. Sixty-nine percent of subjects younger than 8 years of age had central/diffuse abdominal pain. The mean frequency of pain attacks was 4 to 9 times lower than in patients with functional or organic gastrointestinal RAP. Because of the inconstant occurrence of dysuria and hematuria, the location of pain in areas other than the flank, and the lack of calculi shown on imaging studies performed after pain attacks, the urologic origin of pain may be overlooked and ineffective procedures performed. The possibility of urolithiasis should be considered in children with RAP who have a family history of urolithiasis and/or infrequent pain attacks, even when dysuria and hematuria are lacking, and in younger children even when pain is not lateral.

  11. Urethral polyp-like lesions on prostatic urethra caused by Chlamydia trachomatis infection: a case report.

    PubMed

    Muranaka, Takashi; Takahashi, Satoshi; Hirose, Takaoki; Hattori, Atsuo

    2014-11-01

    Urethral polyp is one of differential diagnoses for the male patients complain of gross-hematuria and/or hematospermia. However, there have been limited numbers of case reports including infectious etiology. Here we reported clinical course and pathological findings of one rare case who was diagnosed and treated as urethral polyp-like lesions on the prostatic urethra caused by Chlamydia trachomatis infection. A 25 year-old man who had a past history of frequent sexual intercourse with unspecified female sexual partner visited the clinic. His chief complaint was gross-hematuria and hematospermia. Endoscopic findings showed that non-specific hemorrhagic polyp-like lesions. To determine the pathological findings including malignant diseases and diagnosis, transurethral resection was performed. Because the pathological findings were similar to those of chlamydial proctitis, additional examination was done. As the results, nucleic acid amplification test of C. trachomatis in urine specimen was positive and immunohistochemical staining of specific chlamydia antigen in resected specimen was also positive. Treatment by orally minocyline 100 mg twice daily for 4 weeks was introduced. After the treatment, symptom was disappeared and nucleic acid amplification test of C. trachomatis in urine specimen turned to be negative. No recurrence was reported 2 years posttreatment. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  12. Associations Between Gross Motor and Communicative Development in At-Risk Infants

    PubMed Central

    LeBarton, Eve Sauer; Iverson, Jana M.

    2016-01-01

    Infants' advances in locomotion relate to advances in communicative development. However, little is known about these relations in infants at risk for delays in these domains and whether they may extend to earlier achievements in gross motor development in infancy. We examined whether advances in sitting and prone locomotion are related to communicative development in infants who have an older sibling with autism spectrum disorder (ASD) and are at risk for motor and communication delays (heightened-risk; HR). We conducted a longitudinal study with 37 HR infants who did not receive an ASD diagnosis at 36 months. Infants were observed monthly between the ages of 5 and 14 months. We assessed gross motor development using the Alberta Infant Motor Scales (AIMS) and recorded ages of onset of verbal and nonverbal communicative behaviors. Results indicated increased presence of early gross motor delay from 5 to 10 months. In addition, there were positive relations between sitting and gesture and babble onset and between prone development and gesture onset. Thus, links between gross motor development and communication extend to at-risk development and provide a starting point for future research on potential cascading consequences of motor advances on communication development. PMID:27314943

  13. Laser microporation of the skin: prospects for painless application of protective and therapeutic vaccines

    PubMed Central

    Scheiblhofer, Sandra; Thalhamer, Josef; Weiss, Richard

    2013-01-01

    Introduction: In contrast to muscle and subcutaneous tissue, the skin is easily accessible and provides unique immunological properties. Increasing knowledge about the complex interplay of skin-associated cell types in the development of cutaneous immune responses has fueled efforts to target the skin for vaccination as well as for immunotherapy. Areas covered: This review provides an overview on skin layers and their resident immunocompetent cell types. Advantages and shortcomings of standard methods and innovative technologies to circumvent the outermost skin barrier are addressed. Studies employing fractional skin ablation by infrared lasers for cutaneous delivery of drugs, as well as high molecular weight molecules such as protein antigens or antibodies, are reviewed, and laserporation is introduced as a versatile transcutaneous vaccination platform. Specific targeting of the epidermis or the dermis by different laser settings, the resulting kinetics of uptake and transport and the immune response types elicited are discussed, and the potential of this transcutaneous delivery platform for allergen-specific immunotherapy is demonstrated. Expert opinion: Needle-free and painless vaccination approaches have the potential to replace standard methods due to their improved safety and optimal patient compliance. The use of fractional laser devices for stepwise ablation of skin layers might be advantageous for both vaccination against microbial pathogens, as well as immunotherapeutic approaches, such as allergen-specific immunotherapy. Thorough investigation of the underlying immunological mechanisms will help to provide the knowledge for a rational design of transcutaneous protective/therapeutic vaccines. PMID:23425032

  14. Noninvasive and painless magnetic stimulation of nerves improved brain motor function and mobility in a cerebral palsy case.

    PubMed

    Flamand, Véronique H; Schneider, Cyril

    2014-10-01

    Motor deficits in cerebral palsy disturb functional independence. This study tested whether noninvasive and painless repetitive peripheral magnetic stimulation could improve motor function in a 7-year-old boy with spastic hemiparetic cerebral palsy. Stimulation was applied over different nerves of the lower limbs for 5 sessions. We measured the concurrent aftereffects of this intervention on ankle motor control, gait (walking velocity, stride length, cadence, cycle duration), and function of brain motor pathways. We observed a decrease of ankle plantar flexors resistance to stretch, an increase of active dorsiflexion range of movement, and improvements of corticospinal control of ankle dorsiflexors. Joint mobility changes were still present 15 days after the end of stimulation, when all gait parameters were also improved. Resistance to stretch was still lower than prestimulation values 45 days after the end of stimulation. This case illustrates the sustained effects of repetitive peripheral magnetic stimulation on brain plasticity, motor function, and gait. It suggests a potential impact for physical rehabilitation in cerebral palsy. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. 29 CFR 779.267 - Fluctuations in annual gross volume affecting enterprise coverage and establishment exemptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Act on the basis of previous sales analyses may fall below $1 million when the annual gross volume is... basis of previous sales analyses, may increase its annual gross volume to $1 million or more when... 29 Labor 3 2010-07-01 2010-07-01 false Fluctuations in annual gross volume affecting enterprise...

  16. Effects of land use change on soil gross nitrogen transformation rates in subtropical acid soils of Southwest China.

    PubMed

    Xu, Yongbo; Xu, Zhihong

    2015-07-01

    Land use change affects soil gross nitrogen (N) transformations, but such information is particularly lacking under subtropical conditions. A study was carried out to investigate the potential gross N transformation rates in forest and agricultural (converted from the forest) soils in subtropical China. The simultaneously occurring gross N transformations in soil were quantified by a (15)N tracing study under aerobic conditions. The results showed that change of land use types substantially altered most gross N transformation rates. The gross ammonification and nitrification rates were significantly higher in the agricultural soils than in the forest soils, while the reverse was true for the gross N immobilization rates. The higher total carbon (C) concentrations and C / N ratio in the forest soils relative to the agricultural soils were related to the greater gross N immobilization rates in the forest soils. The lower gross ammonification combined with negligible gross nitrification rates, but much higher gross N immobilization rates in the forest soils than in the agricultural soils suggest that this may be a mechanism to effectively conserve available mineral N in the forest soils through increasing microbial biomass N, the relatively labile organic N. The greater gross nitrification rates and lower gross N immobilization rates in the agricultural soils suggest that conversion of forests to agricultural soils may exert more negative effects on the environment by N loss through NO3 (-) leaching or denitrification (when conditions for denitrification exist).

  17. Induction of painless thyroiditis in patients receiving programmed death 1 receptor immunotherapy for metastatic malignancies.

    PubMed

    Orlov, Steven; Salari, Farnaz; Kashat, Lawrence; Walfish, Paul G

    2015-05-01

    Immunotherapies against immune checkpoints that inhibit T cell activation [cytotoxic T lymphocyte antigen 4 (CTLA-4) and programmed cell death 1 (PD-1)] are emerging and promising treatments for several metastatic malignancies. However, the precise adverse effects of these therapies on thyroid gland function have not been well described. We report on 10 cases of painless thyroiditis syndrome (PTS) from a novel etiology, following immunotherapy with anti-PD-1 monoclonal antibodies (mAb) during treatment for metastatic malignancies. Six patients presented with transient thyrotoxicosis in which thyrotropin binding inhibitory immunoglobulins (TBII) were absent for all, whereas four patients had evidence of positive antithyroid antibodies. All thyrotoxic patients required temporary beta-blocker therapy and had spontaneous resolution of thyrotoxicosis with subsequent hypothyroidism. Four patients presented with hypothyroidism without a detected preceding thyrotoxic phase, occurring 6-8 weeks after initial drug exposure. All of these patients had positive antithyroid antibodies and required thyroid hormone replacement therapy for a minimum of 6 months. Patients receiving anti-PD-1 mAb therapy should be monitored for signs and symptoms of PTS which may require supportive treatment with beta-blockers or thyroid hormone replacement. The anti-PD-1 mAb is a novel exogenous cause of PTS and provides new insight into the possible perturbations of the immune network that may modulate the development of endogenous PTS, including cases of sporadic and postpartum thyroiditis.

  18. Gross-Motor Skill Acquisition by Preschool Dance Students under Self-Instruction Procedures

    ERIC Educational Resources Information Center

    Vintere, Parsla; Hemmes, Nancy S.; Brown, Bruce L.; Poulson, Claire L.

    2004-01-01

    The effects of two training procedures -- (a) modeling and praise and (b) self-instruction, modeling, and praise -- on complex gross-motor chain acquisition for preschool dance class students were evaluated. Six girls participated in the study. A multiple baseline design across six gross-motor chains with a secondary group comparison for treatment…

  19. 46 CFR 15.901 - Inspected vessels of less than 100 gross tons.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Inspected vessels of less than 100 gross tons. 15.901 Section 15.901 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Equivalents § 15.901 Inspected vessels of less than 100 gross tons. (a) An individual...

  20. 46 CFR 15.901 - Inspected vessels of less than 100 gross tons.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Inspected vessels of less than 100 gross tons. 15.901 Section 15.901 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY MERCHANT MARINE OFFICERS AND SEAMEN MANNING REQUIREMENTS Equivalents § 15.901 Inspected vessels of less than 100 gross tons. (a) An individual...

  1. 76 FR 71491 - Gross Estate; Election to Value on Alternate Valuation Date

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ...'s estate may elect to exclude from the gross estate a portion of the fair market value of property includible in the decedent's gross estate by granting a qualified conservation easement on that property... the alternate valuation period, but only to the extent that the reduction in value is due to market...

  2. Watch Me Move: A Program For Parents of Young Children With Gross-Motor Delays.

    PubMed

    Natrasony, Candice; Teitelbaum, Debra

    2016-11-01

    Watch Me Move (WMM) is a 6-week parent education program for caregivers of children with gross-motor delays. The aims are to improve parent-child interaction in a gross-motor context, increase parents' knowledge of behavioral cues and gross-motor development, and decrease perceived parental stress. Forty mothers of children, 6 months to 3 years of age, with a gross-motor delay participated in a randomized control trial comparing parents who received the WMM program plus standard of care physiotherapy (n = 24) with parents whose children received standard of care physiotherapy (n = 16). Mothers who received the WMM program had significantly higher change scores on two subscales of the Nursing Child Assessment Teaching Scale (NCATS; i.e., cognitive growth fostering, and responsiveness to caregiver) and on the Parent Knowledge Questionnaire assessing knowledge of behavioral cues and gross-motor development. There were no significant group differences on the other four NCATS subscales (i.e., sensitivity to cues, response to child's distress, social emotional growth fostering, and clarity of cues) or the Parenting Stress Index. The addition of WMM to traditional physiotherapy improved aspects of mothers' ability to interact with their children and their knowledge of behavioral cues and gross-motor development.

  3. 36 CFR 910.60 - Gross floor area.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Gross floor area. 910.60 Section 910.60 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION GENERAL GUIDELINES AND UNIFORM STANDARDS FOR URBAN PLANNING AND DESIGN OF DEVELOPMENT WITHIN THE PENNSYLVANIA AVENUE...

  4. 36 CFR 910.60 - Gross floor area.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Gross floor area. 910.60 Section 910.60 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION GENERAL GUIDELINES AND UNIFORM STANDARDS FOR URBAN PLANNING AND DESIGN OF DEVELOPMENT WITHIN THE PENNSYLVANIA AVENUE...

  5. 46 CFR 130.240 - Anchors and chains for OSVs of 100 or more gross tons.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Anchors and chains for OSVs of 100 or more gross tons... SUPPLY VESSELS VESSEL CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Miscellaneous Equipment and Systems § 130.240 Anchors and chains for OSVs of 100 or more gross tons. (a) Each OSV of 100 or more gross...

  6. 46 CFR 130.240 - Anchors and chains for OSVs of 100 or more gross tons.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Anchors and chains for OSVs of 100 or more gross tons... SUPPLY VESSELS VESSEL CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Miscellaneous Equipment and Systems § 130.240 Anchors and chains for OSVs of 100 or more gross tons. (a) Each OSV of 100 or more gross...

  7. 46 CFR 130.240 - Anchors and chains for OSVs of 100 or more gross tons.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Anchors and chains for OSVs of 100 or more gross tons... SUPPLY VESSELS VESSEL CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Miscellaneous Equipment and Systems § 130.240 Anchors and chains for OSVs of 100 or more gross tons. (a) Each OSV of 100 or more gross...

  8. 46 CFR 130.240 - Anchors and chains for OSVs of 100 or more gross tons.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Anchors and chains for OSVs of 100 or more gross tons... SUPPLY VESSELS VESSEL CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Miscellaneous Equipment and Systems § 130.240 Anchors and chains for OSVs of 100 or more gross tons. (a) Each OSV of 100 or more gross...

  9. 46 CFR 130.240 - Anchors and chains for OSVs of 100 or more gross tons.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Anchors and chains for OSVs of 100 or more gross tons... SUPPLY VESSELS VESSEL CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Miscellaneous Equipment and Systems § 130.240 Anchors and chains for OSVs of 100 or more gross tons. (a) Each OSV of 100 or more gross...

  10. Modeling of the Gross Regional Product on the Basis of Production Functions

    ERIC Educational Resources Information Center

    Sadovin, Nikolay S.; Kokotkina, Tatiana N.; Barkalova, Tatiana G.; Tsaregorodsev, Evgeny I.

    2016-01-01

    The article is devoted to elaboration and construction of a static model of macroeconomics in which economics is considered as an unstructured holistic unit, the input of which receives the resources, and the output is the result of the functioning of economics in the form of gross domestic product or gross regional product. Resources are…

  11. Transitional cell carcinomas in four fishing cats (Prionailurus viverrinus).

    PubMed

    Sutherland-Smith, Meg; Harvey, Catherine; Campbell, Mark; McAloose, Denise; Rideout, Bruce; Morris, Patrick

    2004-09-01

    Transitional cell carcinomas (TCC) of the urinary bladder were diagnosed in four related fishing cats (Prionailurus viverrinus). The major clinical sign in each case was persistent hematuria unresponsive to medical therapy. Cystotomy and biopsy provided an antemortem diagnosis in three of the fishing cats before euthanasia because of progression of clinical signs. The diagnosis was made in the fourth cat after euthanasia because of renal failure. Hematuria improved temporarily in one of the cats diagnosed antemortem and treated with piroxicam and carboplatin. Attempts to isolate a herpesvirus in two of the cats failed. Histopathologic appearance of the TCC was similar to that described for other species. TCC metastasis to the lungs was noted at necropsy in one cat; metastatic disease was not noted in the other fishing cats on gross or histopathologic examination. TCC of the urinary bladder appears to be more prevalent in fishing cats than in other species of domestic or nondomestic felids.

  12. Longitudinal Association Between Gross Motor Capacity and Neuromusculoskeletal Function in Children and Youth With Cerebral Palsy.

    PubMed

    Vos, Rimke C; Becher, Jules G; Voorman, Jeanine M; Gorter, Jan Willem; van Eck, Mirjam; van Meeteren, Jetty; Smits, Dirk-Wouter; Twisk, Jos W; Dallmeijer, Annet J

    2016-08-01

    To examine associations over longitudinal measurements between neuromusculoskeletal function and gross motor capacity in children and youth with cerebral palsy (CP). A prospective cohort study. Rehabilitation departments of university medical centers and rehabilitations centers. A sample (N=327) consisting of 148 children (aged 5-9y) and 179 youth (aged 11-20y) with CP, Gross Motor Function Classification System level I (n=180), level II (n=44), level III (n=36), level IV (n=34), and level V (n=33). Not applicable. Gross motor capacity was assessed with the Gross Motor Function Measure-66 over a period of 2 to 4 years in different age cohorts. Neuromusculoskeletal function included selective motor control (SMC), muscle strength, spasticity, and range of motion (ROM) of the lower extremities. Multilevel analyses showed that SMC was significantly associated with gross motor capacity in children and youth with CP, showing higher values and a more favorable course of gross motor capacity in those with better SMC. Strength was only associated with gross motor capacity in youth. Reduced ROM of hip (children) and knee extension (youth) and spasticity of the hip adductors (youth) were additionally-but more weakly-associated with lower values and a less favorable course of gross motor capacity. Results indicate that children and youth with more severely impaired SMC and youth with reduced muscle strength have a less favorable course of gross motor capacity, while spasticity and reduced ROM are less determinative. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Gross Motor Activities: Movement for Fun and Learning.

    ERIC Educational Resources Information Center

    Lowenthal, Barbara

    1983-01-01

    Examples are provided of ways in which gross motor activities are integrated into mathematics, language arts, social studies, art, and music and creative movement concepts for preschool- and primary-age children with special needs. (CL)

  14. Associations between gross motor and communicative development in at-risk infants.

    PubMed

    LeBarton, Eve Sauer; Iverson, Jana M

    2016-08-01

    Infants' advances in locomotion relate to advances in communicative development. However, little is known about these relations in infants at risk for delays in these domains and whether they may extend to earlier achievements in gross motor development in infancy. We examined whether advances in sitting and prone locomotion are related to communicative development in infants who have an older sibling with autism spectrum disorder (ASD) and are at risk for motor and communication delays (heightened-risk; HR). We conducted a longitudinal study with 37 HR infants who did not receive an ASD diagnosis at 36 months. Infants were observed monthly between the ages of 5 and 14 months. We assessed gross motor development using the Alberta Infant Motor Scales (AIMS) and recorded ages of onset of verbal and nonverbal communicative behaviors. Results indicated increased presence of early gross motor delay from 5 to 10 months. In addition, there were positive relations between sitting and gesture and babble onset and between prone development and gesture onset. Thus, links between gross motor development and communication extend to at-risk development and provide a starting point for future research on potential cascading consequences of motor advances on communication development. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Factors Associated with Enhanced Gross Motor Progress in Children with Cerebral Palsy: A Register-Based Study.

    PubMed

    Størvold, Gunfrid V; Jahnsen, Reidun B; Evensen, Kari Anne I; Romild, Ulla K; Bratberg, Grete H

    2018-05-01

    To examine associations between interventions and child characteristics; and enhanced gross motor progress in children with cerebral palsy (CP). Prospective cohort study based on 2048 assessments of 442 children (256 boys, 186 girls) aged 2-12 years registered in the Cerebral Palsy Follow-up Program and the Cerebral Palsy Register of Norway. Gross motor progress estimates were based on repeated measures of reference percentiles for the Gross Motor Function Measure (GMFM-66) in a linear mixed model. Mean follow-up time: 2.9 years. Intensive training was the only intervention factor associated with enhanced gross motor progress (mean 3.3 percentiles, 95% CI: 1.0, 5.5 per period of ≥3 sessions per week and/or participation in an intensive program). Gross motor function was on average 24.2 percentiles (95% CI: 15.2, 33.2) lower in children with intellectual disability compared with others. Except for eating problems (-10.5 percentiles 95% CI: -18.5, -2.4) and ankle contractures by age (-1.9 percentiles 95% CI: -3.6, -0.2) no other factors examined were associated with long-term gross motor progress. Intensive training was associated with enhanced gross motor progress over an average of 2.9 years in children with CP. Intellectual disability was a strong negative prognostic factor. Preventing ankle contractures appears important for gross motor progress.

  16. Divergence of fine and gross motor skills in prelingually deaf children: implications for cochlear implantation.

    PubMed

    Horn, David L; Pisoni, David B; Miyamoto, Richard T

    2006-08-01

    The objective of this study was to assess relations between fine and gross motor development and spoken language processing skills in pediatric cochlear implant users. The authors conducted a retrospective analysis of longitudinal data. Prelingually deaf children who received a cochlear implant before age 5 and had no known developmental delay or cognitive impairment were included in the study. Fine and gross motor development were assessed before implantation using the Vineland Adaptive Behavioral Scales, a standardized parental report of adaptive behavior. Fine and gross motor scores reflected a given child's motor functioning with respect to a normative sample of typically developing, normal-hearing children. Relations between these preimplant scores and postimplant spoken language outcomes were assessed. In general, gross motor scores were found to be positively related to chronologic age, whereas the opposite trend was observed for fine motor scores. Fine motor scores were more strongly correlated with postimplant expressive and receptive language scores than gross motor scores. Our findings suggest a disassociation between fine and gross motor development in prelingually deaf children: fine motor skills, in contrast to gross motor skills, tend to be delayed as the prelingually deaf children get older. These findings provide new knowledge about the links between motor and spoken language development and suggest that auditory deprivation may lead to atypical development of certain motor and language skills that share common cortical processing resources.

  17. A simplified gross thrust computing technique for an afterburning turbofan engine

    NASA Technical Reports Server (NTRS)

    Hamer, M. J.; Kurtenbach, F. J.

    1978-01-01

    A simplified gross thrust computing technique extended to the F100-PW-100 afterburning turbofan engine is described. The technique uses measured total and static pressures in the engine tailpipe and ambient static pressure to compute gross thrust. Empirically evaluated calibration factors account for three-dimensional effects, the effects of friction and mass transfer, and the effects of simplifying assumptions for solving the equations. Instrumentation requirements and the sensitivity of computed thrust to transducer errors are presented. NASA altitude facility tests on F100 engines (computed thrust versus measured thrust) are presented, and calibration factors obtained on one engine are shown to be applicable to the second engine by comparing the computed gross thrust. It is concluded that this thrust method is potentially suitable for flight test application and engine maintenance on production engines with a minimum amount of instrumentation.

  18. Comparison of a gross anatomy laboratory to online anatomy software for teaching anatomy.

    PubMed

    Mathiowetz, Virgil; Yu, Chih-Huang; Quake-Rapp, Cindee

    2016-01-01

    This study was designed to assess the grades, self-perceived learning, and satisfaction between occupational therapy students who used a gross anatomy laboratory versus online anatomy software (AnatomyTV) as tools to learn anatomy at a large public university and a satellite campus in the mid-western United States. The goal was to determine if equivalent learning outcomes could be achieved regardless of learning tool used. In addition, it was important to determine why students chose the gross anatomy laboratory over online AnatomyTV. A two group, post-test only design was used with data gathered at the end of the course. Primary outcomes were students' grades, self-perceived learning, and satisfaction. In addition, a survey was used to collect descriptive data. One cadaver prosection was available for every four students in the gross anatomy laboratory. AnatomyTV was available online through the university library. At the conclusion of the course, the gross anatomy laboratory group had significantly higher grade percentage, self-perceived learning, and satisfaction than the AnatomyTV group. However, the practical significance of the difference is debatable. The significantly greater time spent in gross anatomy laboratory during the laboratory portion of the course may have affected the study outcomes. In addition, some students may find the difference in (B+) versus (A-) grade as not practically significant. Further research needs to be conducted to identify what specific anatomy teaching resources are most effective beyond prosection for students without access to a gross anatomy laboratory. © 2015 American Association of Anatomists.

  19. Characteristics of dysphagia in children with cerebral palsy, related to gross motor function.

    PubMed

    Kim, Joon-Sung; Han, Zee-A; Song, Dae Heon; Oh, Hyun-Mi; Chung, Myung Eun

    2013-10-01

    The aim of this study was to report the characteristics of dysphagia in children with cerebral palsy (CP), related to gross motor function. Videofluoroscopic swallow study was performed in 29 children with CP, according to the manual of Logemann. Five questions about oromotor dysfunction were answered. Gross motor function level was classified by the Gross Motor Function Classification System Expanded and Revised. The results of the videofluoroscopic swallowing studies showed that reduced lip closure, inadequate bolus formation, residue in the oral cavity, delayed triggering of pharyngeal swallow, reduced larynx elevation, coating on the pharyngeal wall, delayed pharyngeal transit time, multiple swallow, and aspiration were significantly more common in the severe group (Gross Motor Function Classification System Expanded and Revised IV or V). As for aspiration, 50% of the children with severe CP had problems, but only 14.3% of them with moderate (Gross Motor Function Classification System Expanded and Revised III) CP and none of them with mild CP had abnormalities. In addition, five of the seven aspiration cases occurred silently. This study shows that dysphagia is closely related to gross motor function in children with CP. Silent aspiration was observed in the moderate to severe CP groups. Aspiration is an important cause of medical problems such as acute and chronic lung disease, and associated respiratory complications contribute significantly in increasing morbidity and mortality in these patient groups. Therefore, the authors suggest that early dysphagia evaluation including videofluoroscopic swallow study is necessary in managing feeding problems and may prevent chronic aspiration, malnutrition, and infections.

  20. Acute radiotherapy toxicity in 57 dogs with gross and microscopic mast cell tumours.

    PubMed

    Blackwood, L; Tanis, J B; Harper, A; Amores-Fuster, I; Killick, D R; Finotello, R

    2018-05-15

    Mast cell tumours (MCTs) are commonly treated with radiation therapy, most often in a microscopic disease setting. Poorer outcomes are expected in patients with gross disease, and irradiation of gross disease may be associated with greater toxicity. The aim of this study was to compare acute radiation adverse events (AE) in dogs with gross and microscopic MCTs receiving radiotherapy. Fifty-seven dogs were included, 28 with gross disease and 29 with microscopic. In order to assess mucosal and skin toxicity, patients were assigned to 2 groups: head (29 patients, 14 patients with gross and 15 microscopic) and other sites (28 patients, 14 each). All were treated with external beam radiotherapy, and toxicity assessed at the end of treatment and 10 to 14 days later (first recheck). All patients developed some acute radiation toxicity by the end of the course. However, there was no difference in the severity of toxicity between gross and microscopic disease in either site group at either time point. The only variable associated with an increased frequency of grade 2 or 3 toxicity at the first recheck was the use of prednisolone prior to radiotherapy (P = .05). No other factors were identified which were associated with increased toxicity. For the head group, the site of highest grade toxicity was mucosa or, if included in the field, nasal planum, which was often more severely affected than the mucosa. No significant late toxicity was identified. Two dogs developed acute haematemesis during the radiotherapy course, but both completed the course without further events. © 2018 John Wiley & Sons Ltd.

  1. 5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

  2. 5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

  3. 5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

  4. 5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

  5. 5 CFR 890.1112 - Denial of continuation of coverage due to involuntary separation for gross misconduct.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... involuntary separation for gross misconduct. 890.1112 Section 890.1112 Administrative Personnel OFFICE OF... involuntary separation for gross misconduct. (a) Notice of denial. (1) When an employing office determines that the offense for which an employee is being removed constitutes gross misconduct for the purpose of...

  6. Fine and gross motor skills: The effects on skill-focused dual-tasks.

    PubMed

    Raisbeck, Louisa D; Diekfuss, Jed A

    2015-10-01

    Dual-task methodology often directs participants' attention towards a gross motor skill involved in the execution of a skill, but researchers have not investigated the comparative effects of attention on fine motor skill tasks. Furthermore, there is limited information about participants' subjective perception of workload with respect to task performance. To examine this, the current study administered the NASA-Task Load Index following a simulated shooting dual-task. The task required participants to stand 15 feet from a projector screen which depicted virtual targets and fire a modified Glock 17 handgun equipped with an infrared laser. Participants performed the primary shooting task alone (control), or were also instructed to focus their attention on a gross motor skill relevant to task execution (gross skill-focused) and a fine motor skill relevant to task execution (fine skill-focused). Results revealed that workload was significantly greater during the fine skill-focused task for both skill levels, but performance was only affected for the lesser-skilled participants. Shooting performance for the lesser-skilled participants was greater during the gross skill-focused condition compared to the fine skill-focused condition. Correlational analyses also demonstrated a significant negative relationship between shooting performance and workload during the gross skill-focused task for the higher-skilled participants. A discussion of the relationship between skill type, workload, skill level, and performance in dual-task paradigms is presented. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. 26 CFR 1.809-4 - Gross amount.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...), respectively, section 809(c) specifies three categories of items which shall be taken into account. Such items... three categories of items taken into account are: (1) Premiums. (i) The gross amount of all premiums and... definition of assumption reinsurance. (2) Decreases in certain reserves. Each net decrease in reserves which...

  8. 26 CFR 1.809-4 - Gross amount.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...), respectively, section 809(c) specifies three categories of items which shall be taken into account. Such items... three categories of items taken into account are: (1) Premiums. (i) The gross amount of all premiums and... definition of assumption reinsurance. (2) Decreases in certain reserves. Each net decrease in reserves which...

  9. 26 CFR 1.809-4 - Gross amount.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...), respectively, section 809(c) specifies three categories of items which shall be taken into account. Such items... three categories of items taken into account are: (1) Premiums. (i) The gross amount of all premiums and... definition of assumption reinsurance. (2) Decreases in certain reserves. Each net decrease in reserves which...

  10. Renal diagnosis of chronic hemodialysis patients with urinary tract transitional cell carcinoma in Taiwan.

    PubMed

    Chang, Chung-Hsin; Yang, Cheng-Ming; Yang, An-Hang

    2007-04-15

    Transitional cell carcinoma (TCC) is the most common malignancy in dialysis patients of Taiwan. The reason for such a high incidence of TCC is undetermined. The correlation between the underlying renal disease and the development of TCC was investigated. The authors retrospectively reviewed the clinical data and outcome of 1537 chronic hemodialysis (HD) patients from 1993 to 2002. The incidence of TCC was computed. The Cox regression method was used to analyze the role of potential risk factors. After a mean dialysis duration of 46.5 months, 26 (1.69%) patients with TCC were diagnosed. The standardized incidence ratio (SIR) of TCC was 48.2 as compared with the general population and the SIR of TCC seemed higher in women (65.1) and in the age group 50 to 54 years (173.6). Of them, most cases showed no definite etiology. All these cases showed bilateral contracted kidneys. Nonnephrotic proteinuria was found in all cases and trace glucosuria was found in 17 (65%). Painless gross hematuria was the cardinal symptom and distant metastasis was rare. Also, TCC in upper urinary tracts were common and found in 14 (54%) of patients. Age at the time of dialysis, female sex, compound analgesic use, and Chinese herb use had statistical significance as risk factors (P < .05). Chronic HD patients have a high risk of TCC in Taiwan, especially in female and middle-aged patients. The study indicated that chronic tubulointerstitial nephritis (CTIN) is the most likely underlying renal disease in HD patients with TCC, a high percentage of the CTIN related to the usage of Chinese herbs or compound analgesics may contribute to the development of TCC, whereas diabetes or chronic glomerulonephritis play only a minor role.

  11. The new energy management policy: Indonesian PSC-gross-split applied on steam flooding project

    NASA Astrophysics Data System (ADS)

    Irham, S.; Julyus, P.

    2018-01-01

    “SIPY” oil field has been producing oil using steam flooding technology since 1992 under the PSC-Cost-Recovery policy. In 2021, the contract will be finished, and a new agreement must be submitted to the Indonesian government. There are two applied fiscal policies on oil and gas management: PSC-Cost-Recovery and PSC-Gross-Split (introduced in 2017 as the new energy management plan). The contractor must choose between PSC-Cost-Recovery and PSC-Gross-split which makes more profit. The aim of this research is to determine the best oil and gas contract policy for the contractor. The methods are calculating contractor cash flow and comparing the Profitability Indexes. The results of this study are (1) Net Present Values for the PSC-Cost-Recovery and the PSC-Gross-Split are 15 MMUS and 61 MMUS, respectively; and (2) Internal Rate of Return values for the PSC-Cost-Recovery and PSC-Gross-Split are 10% and 11%, respectively. The conclusion is that the Net Present Value and Internal Rate of Return of PSC-Gross-Split are greater than those of PSC-Cost-Recovery, but in Pay Out Time of PSC-Gross-split is longer than Pay Out Time in PSC-Cost-Recovery. Thus, the new energy management policy will be more attractive than PSC-Cost-Recovery.

  12. The new management policy: Indonesian PSC-Gross split applied on CO2 flooding project

    NASA Astrophysics Data System (ADS)

    Irham, S.; Sibuea, S. N.; Danu, A.

    2018-01-01

    “SIAD” oil field will be developed by CO2 flooding. CO2, a famous pollutant gas, is injected into the oil reservoir to optimize the oil recovery. This technique should be conducted economically according to the energy management policy in Indonesia. In general, Indonesia has two policy contracts on oil and gas: the old one is PSC-Cost-Recovery, and the new one is PSC-Gross-Split (introduced in 2017 as the new energy management plan). The contractor must choose between PSC-Cost-Recovery and PSC-Gross-Split which makes more profit. The aim of this paper is to show the best oil and gas contract policy for the contractor. The methods are calculating and comparing the economic indicators. The result of this study are (1) NPV for the PSC-Cost-Recovery is -46 MUS, while for the PSC-Gross-Split is 73 MUS, and (2) IRR for the PSC-Cost-Recovery is 9%, whereas for the PSC-Gross-Split is 11%. The conclusion is that the NPV and IRR for PSC-Gross-Split are greater than the NPV and IRR of PSC-Cost-Recovery, but POT in PSC-Gross-split is longer than POT in PSC-Cost-Recovery. Thus, in this case, the new energy policy contract can be applied for CO2 flooding technology since it yields higher economic indicators than its antecendent.

  13. Gross efficiency and energy expenditure in kayak ergometer exercise.

    PubMed

    Gomes, B B; Mourão, L; Massart, A; Figueiredo, P; Vilas-Boas, J P; Santos, A M C; Fernandes, R J

    2012-08-01

    We purposed to study energy expenditure, power output and gross efficiency during kayak ergometer exercise in 12 elite sprint kayakers. 6 males (age 24.2±4.8 years, height 180.4±4.8 cm, body mass 79.7±8.5 kg) and 6 females (age 24.3±4.5 years, height 164.5±3.9 cm, body mass 65.4±3.5 kg), performed an incremental intermittent protocol on kayak ergometer with VO2 and blood lactate concentration assessment, a non-linear increase between power output and energy expenditure being observed. Paddling power output, energy expenditure and gross efficiency corresponding to VO2max averaged 199.92±50.41 W, 75.27±6.30 ml.kg - 1.min - 1, and 10.10±1.08%. Male kayakers presented higher VO2max, power output and gross efficiency at the VO2max, and lower heart rate and maximal lactate concentration than females, but no differences were found between genders regarding energy expenditure at VO2max. Aerobic and anaerobic components of energy expenditure evidenced a significant contribution of anaerobic energy sources in sprint kayak performance. Results also suggested the dependence of the gross efficiency on the changes in the amount of the aerobic and anaerobic contributions, at heavy and severe intensities. The inter-individual variance of the relationship between energy expenditure and the corresponding paddling power output revealed a relevant tracking for females (FDγ=0.73±0.06), conversely to the male group (FDγ=0.27±0.08), supporting that some male kayakers are more skilled in some paddling intensities than others. © Georg Thieme Verlag KG Stuttgart · New York.

  14. The Performance of Fundamental Gross Motor Skills by Children Enrolled in Head Start.

    ERIC Educational Resources Information Center

    Woodard, Rebecca J.; Yun, Joonkoo

    2001-01-01

    This study sought to descriptively evaluate the performance of fundamental gross motor skills among Head Start children. Levels of performance were compared and contrasted with performance profiles of the Test of Gross Motor Development. Findings suggest that Head Start curriculum should focus on the importance of developing fundamental gross…

  15. Landscape History of Grosses Moos, NW Swiss Alpine Foreland.

    NASA Astrophysics Data System (ADS)

    Joanna Heer, Aleksandra; Adamiec, Grzegorz; Veit, Heinz; May, Jan-Hendrik; Novenko, Elena; Hajdas, Irka

    2017-04-01

    The western Swiss Plateau with Lake Neuchâtel is part of the alpine foreland and among the key areas for the reconstruction of environmental changes since the last postglacial. This study was carried out in a landscape located NE of the lake and called Grosses Moos (The Large Fen) - currently designated the Swiss largest, continuous farming area, after the fen was drained in course of landscape engineering projects performed in Switzerland at the end of the 19th century. The study contributes new results from nine excavations of littoral ridges identified in Grosses Moos, and integrates sedimentology, paleo-environmental analysis and three independent chronological methods. Radiocarbon dating, pollen analysis and optically stimulated luminescence (OSL) were applied to the sediments. While pollen and radiocarbon follow the standard procedures, the evaluation of the luminescence age estimates demanded adjustment according to the physical and microdosimetric properties of the alpine quartz, and consideration of the peculiarities of the changing littoral environments of Grosses Moos. The Grosses Moos landscape developed on the temporary surface of the post-Last Glacial sedimentary infill of the over-deepened glacial Aare valley. In this study the landscape history has been fitted into the existing supraregional time scales of NGRIP, the Swiss bio-zones system and the human history based on archaeological and historic records and covers a time span of up to 15'000 yr b2k. The wide-ranging suite of geomorphic features and sedimentary sequences, including littoral lake sediments, beach ridges, dunes, palaeo-channels, peat and colluvial deposits, enable the extensive reconstruction of spatially and temporally variable natural shaping processes. In addition, our results indicate remobilization of soil, colluvium, and sediment due to human settlement activities since the Neolithic - with an important increase in sediment load and spatial variability since the Bronze Age

  16. David J. Gross and the Strong Force

    Science.gov Websites

    allows physicist to predict experimental results to within one part in 100 million. ... The new Nobelists available in electronic documents and on the Web. Documents: Ultraviolet Behavior of Non-Abelian Gauge Gross, Interview (video) Top Some links on this page may take you to non-federal websites. Their

  17. 26 CFR 1.804-3 - Gross investment income of a life insurance company.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... income of a life insurance company. (a) Gross investment income defined. For purposes of part I... insurance company as the sum of the following: (1) The gross amount of income from: (i) Interest (including... agreement from which the life insurance company may derive interest, rents, or royalties. (v) The alteration...

  18. 26 CFR 1.804-3 - Gross investment income of a life insurance company.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... income of a life insurance company. (a) Gross investment income defined. For purposes of part I... insurance company as the sum of the following: (1) The gross amount of income from: (i) Interest (including... agreement from which the life insurance company may derive interest, rents, or royalties. (v) The alteration...

  19. 26 CFR 1.804-3 - Gross investment income of a life insurance company.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... income of a life insurance company. (a) Gross investment income defined. For purposes of part I... insurance company as the sum of the following: (1) The gross amount of income from: (i) Interest (including... agreement from which the life insurance company may derive interest, rents, or royalties. (v) The alteration...

  20. 26 CFR 1.804-3 - Gross investment income of a life insurance company.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... income of a life insurance company. (a) Gross investment income defined. For purposes of part I... insurance company as the sum of the following: (1) The gross amount of income from: (i) Interest (including... agreement from which the life insurance company may derive interest, rents, or royalties. (v) The alteration...

  1. 26 CFR 1.804-3 - Gross investment income of a life insurance company.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... insurance company. (a) Gross investment income defined. For purposes of part I, subchapter L, chapter 1 of the Code, section 804(b) defines the term gross investment income of a life insurance company as the... which the life insurance company may derive interest, rents, or royalties. (v) The alteration or...

  2. Urologic Outcomes of Children With Hemorrhagic Cystitis After Bone Marrow Transplant at a Single Institution.

    PubMed

    Au, Jason K; Graziano, Christopher; Elizondo, Rodolfo A; Ryan, Sheila; Roth, David R; Koh, Chester J; Gonzales, Edmond T; Tu, Duong T; Janzen, Nicolette; Naik, Swati; Seth, Abhishek

    2017-03-01

    To analyze clinical outcomes and the risk factors associated with genitourinary (GU) morbidity and mortality in children who present with hemorrhagic cystitis (HC) after bone marrow transplant (BMT). A retrospective chart review of patients with HC who had undergone BMT at a single pediatric hospital from 2008 to 2015 was conducted. Demographic data, severity of hematuria, HC management, and mortality were analyzed. Bivariate analysis and binary logistic regression were performed to identify risk factors. Out of 43 patients who met inclusion criteria, 67.4% were male with a median age at BMT of 10.2 years (interquartile range 5.8-14.6). Percutaneous nephrostomy catheters were inserted in 5 patients for urinary diversion. All-cause mortality was 32.6% (N = 14). Intravesical retroviral therapy (P <.001), HC grade (P <.001), total Foley time (P <.001), total gross hematuria time (P <.001), total days hospitalized (P = .012), and days to most improved hematuria (P = .032) were associated with significant GU morbidity on bivariate analysis. On multivariable analysis, days to most improved hematuria was associated with significant GU morbidity odds ratio of 1.177 (1.006-1.376) (P = .042). Status of percutaneous nephrostomy was not associated with increased mortality (P = .472); however, in the multivariate model, BK viremia (P = .023), need for renal dialysis (P = .003), and presence of Foley catheter (P = .005) were associated with increased mortality. Children with HC after BMT fall in a very high-risk category with high mortality and significant GU morbidity. The presence of a Foley catheter, need for dialysis, and BK viremia are associated with increased mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Relation between hand function and gross motor function in full term infants aged 4 to 8 months.

    PubMed

    Nogueira, Solange F; Figueiredo, Elyonara M; Gonçalves, Rejane V; Mancini, Marisa C

    2015-01-01

    In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. RESULTS revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development.

  4. Relation between hand function and gross motor function in full term infants aged 4 to 8 months

    PubMed Central

    Nogueira, Solange F.; Figueiredo, Elyonara M.; Gonçalves, Rejane V.; Mancini, Marisa C.

    2015-01-01

    Background: In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. Objective: To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. Method: The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. Results: Results revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. Conclusion: The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development. PMID:25714437

  5. 26 CFR 1.1332-1 - Inclusion in gross income of war loss recoveries.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 11 2013-04-01 2013-04-01 false Inclusion in gross income of war loss recoveries. 1.1332-1 Section 1.1332-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) War Loss Recoveries § 1.1332-1 Inclusion in gross...

  6. 26 CFR 1.1332-1 - Inclusion in gross income of war loss recoveries.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 11 2012-04-01 2012-04-01 false Inclusion in gross income of war loss recoveries. 1.1332-1 Section 1.1332-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) War Loss Recoveries § 1.1332-1 Inclusion in gross...

  7. 26 CFR 1.1332-1 - Inclusion in gross income of war loss recoveries.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 11 2014-04-01 2014-04-01 false Inclusion in gross income of war loss recoveries. 1.1332-1 Section 1.1332-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) War Loss Recoveries § 1.1332-1 Inclusion in gross...

  8. 26 CFR 1.1332-1 - Inclusion in gross income of war loss recoveries.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 11 2011-04-01 2011-04-01 false Inclusion in gross income of war loss recoveries. 1.1332-1 Section 1.1332-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) War Loss Recoveries § 1.1332-1 Inclusion in gross...

  9. 26 CFR 1.1332-1 - Inclusion in gross income of war loss recoveries.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Inclusion in gross income of war loss recoveries. 1.1332-1 Section 1.1332-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES War Loss Recoveries § 1.1332-1 Inclusion in gross income of...

  10. Gross Motor Development of Malaysian Hearing Impaired Male Pre- and Early School Children

    ERIC Educational Resources Information Center

    Zawi, Khairi; Lian, Denise Koh Choon; Abdullah, Rozlina Tan

    2014-01-01

    Acquisition of gross motor skill is a natural developmental process for children. This aspect of human development increases with one's chronological age, irrespective of any developmental conditions. The purpose of this study was to assess the level of gross motor skill development among pre- and early school-aged children with motor disability.…

  11. Biological characteristics of pediatric renal cell carcinoma associated with Xp11.2 translocations/TFE3 gene fusions.

    PubMed

    Song, Hong Cheng; Sun, Ning; Zhang, Wei Ping; He, LeJian; Fu, Libing; Huang, ChengRu

    2014-04-01

    To investigate the clinical features of pediatric Xp11.2 translocation renal cell carcinoma (RCC). A retrospective review of 22 cases over 35 years. Xp11.2 translocation RCCs were identified in 13 boys and 9 girls with a median age of 10.5 years (range: 2.5-16 years). RCC presented with hematuria in 17, abdominal mass in 1, abdominal masses with hematuria in 2, abdominal pain with hematuria in 1, and as an incidental finding in 1 patient. Ten patients were classified stage I, 10 were stage III, and two were stage IV. Of the 10 patients with stage I RCCs, 3 patients with tumor measuring less than 7 cm had nephron-sparing surgery (NSS) and 17 patients underwent simple nephrectomy. A 15-cm tumor was incompletely removed in one patient and another patient with a 25-cm × 18-cm × 15-cm tumor had gross residual. Of the 15 patients followed up between 6 months and 35 years, 13 were still living and 2 had died after surgery. Xp11.2 translocation RCC is the predominant form of pediatric RCC, associated with advanced stage at presentation. Nephrectomy is the usual treatment for RCC but NSS is an option for patients with tumors measuring<7 cm. Patients with N+M0 maintained a favorable prognosis following surgery alone. © 2014.

  12. Modality-specific occult intrarenal pseudoaneurysm in a renal allograft and the legacy of catheter angiography.

    PubMed

    Rastogi, Neeraj; Williams, Gethin; Alencar, Herlen

    2013-11-01

    A 69-year-old man with history of end-stage-renal disease (ESRD) underwent successful kidney transplantation from a cadaveric donor in November 2011. However, posttransplant recovery was complicated by delayed graft function and recurrent gross hematuria. Serial Doppler ultrasound (US) of the renal allograft demonstrated a pseudoaneurysm with interval increase in size. However, it could not be visualized with other modalities, including an initial angiogram (postoperative day 49) and a second angiogram (postoperative day 68), followed by surgical exploration (postoperative day 71), which demonstrated complete intra-aneurysmal thrombosis on intraoperative Doppler US. Unfortunately, the patient's hematuria continued and a repeat Doppler US 48 hours later demonstrated a persistent pseudoaneurysm. Therefore, on postoperative day 75, we performed targeted percutaneous intra-aneurysmal thrombin injection under dual image guidance, which showed complete intra-aneurysmal thrombosis on intraprocedural Doppler US. Hematuria recurred the next day. A third angiogram (postoperative day 77) finally illuminated the hidden pseudoaneurysm occult on the first and second angiographic studies (sensitivity [index case] 33%) and surgery. This allowed for successful coil embolization of a subsegmental feeding branch with an excellent outcome. We support a more aggressive management with serial angiography and embolization of the intrarenal symptomatic pseudoaneurysm rather than surgery in renal allograft recipients, with the benefits outweighing the risks. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. The Psychoprophylactic Method of Painless Childbirth in Socialist Czechoslovakia: from State Propaganda to Activism of Enthusiasts.

    PubMed

    Hrešanová, Ema

    2016-10-01

    This paper explores the history of the 'psychoprophylactic method of painless childbirth' in socialist Czechoslovakia, in particular, in the Czech and Moravian regions of the country, showing that it substantially differs from the course that the method took in other countries. This non-pharmacological method of pain relief originated in the USSR and became well known as the Lamaze method in western English-speaking countries. Use of the method in Czechoslovakia, however, followed a very different path from both the West, where its use was refined mainly outside the biomedical frame, and the USSR, where it ceased to be pursued as a scientific method in the 1950s after Stalin's death. The method was imported to Czechoslovakia in the early 1950s and it was politically promoted as Soviet science's gift to women. In the 1960s the method became widespread in practice but research on it diminished and, in the 1970s, its use declined too. However, in the 1980s, in the last decade of the Communist regime, the method resurfaced in the pages of Czechoslovak medical journals and underwent an exciting renaissance, having been reintroduced by a few enthusiastic individuals, most of them women. This article explores the background to the renewed interest in the method while providing insight into the wider social and political context that shaped socialist maternity and birth care in different periods.

  14. Gross changes in forest area shape the future carbon balance of tropical forests

    NASA Astrophysics Data System (ADS)

    Li, Wei; Ciais, Philippe; Yue, Chao; Gasser, Thomas; Peng, Shushi; Bastos, Ana

    2018-01-01

    Bookkeeping models are used to estimate land-use and land-cover change (LULCC) carbon fluxes (ELULCC). The uncertainty of bookkeeping models partly arises from data used to define response curves (usually from local data) and their representativeness for application to large regions. Here, we compare biomass recovery curves derived from a recent synthesis of secondary forest plots in Latin America by Poorter et al. (2016) with the curves used previously in bookkeeping models from Houghton (1999) and Hansis et al. (2015). We find that the two latter models overestimate the long-term (100 years) vegetation carbon density of secondary forest by about 25 %. We also use idealized LULCC scenarios combined with these three different response curves to demonstrate the importance of considering gross forest area changes instead of net forest area changes for estimating regional ELULCC. In the illustrative case of a net gain in forest area composed of a large gross loss and a large gross gain occurring during a single year, the initial gross loss has an important legacy effect on ELULCC so that the system can be a net source of CO2 to the atmosphere long after the initial forest area change. We show the existence of critical values of the ratio of gross area change over net area change (γAnetAgross), above which cumulative ELULCC is a net CO2 source rather than a sink for a given time horizon after the initial perturbation. These theoretical critical ratio values derived from simulations of a bookkeeping model are compared with observations from the 30 m resolution Landsat Thematic Mapper data of gross and net forest area change in the Amazon. This allows us to diagnose areas in which current forest gains with a large land turnover will still result in LULCC carbon emissions in 20, 50 and 100 years.

  15. Are Gross Motor Skills and Sports Participation Related in Children with Intellectual Disabilities?

    ERIC Educational Resources Information Center

    Westendorp, Marieke; Houwen, Suzanne; Hartman, Esther; Visscher, Chris

    2011-01-01

    This study compared the specific gross motor skills of 156 children with intellectual disabilities (ID) (50 less than or equal to IQ greater than or equal to 79) with that of 255 typically developing children, aged 7-12 years. Additionally, the relationship between the specific gross motor skills and organized sports participation was examined in…

  16. Comparison of gross anatomy test scores using traditional specimens vs. QuickTime Virtual Reality animated specimens

    NASA Astrophysics Data System (ADS)

    Maza, Paul Sadiri

    In recent years, technological advances such as computers have been employed in teaching gross anatomy at all levels of education, even in professional schools such as medical and veterinary medical colleges. Benefits of computer based instructional tools for gross anatomy include the convenience of not having to physically view or dissect a cadaver. Anatomy educators debate over the advantages versus the disadvantages of computer based resources for gross anatomy instruction. Many studies, case reports, and editorials argue for the increased use of computer based anatomy educational tools, while others discuss the necessity of dissection for various reasons important in learning anatomy, such as a three-dimensional physical view of the specimen, physical handling of tissues, interactions with fellow students during dissection, and differences between specific specimens. While many articles deal with gross anatomy education using computers, there seems to be a lack of studies investigating the use of computer based resources as an assessment tool for gross anatomy, specifically using the Apple application QuickTime Virtual Reality (QTVR). This study investigated the use of QTVR movie modules to assess if using computer based QTVR movie module assessments were equal in quality to actual physical specimen examinations. A gross anatomy course in the College of Veterinary Medicine at Cornell University was used as a source of anatomy students and gross anatomy examinations. Two groups were compared, one group taking gross anatomy examinations in a traditional manner, by viewing actual physical specimens and answering questions based on those specimens. The other group took the same examinations using the same specimens, but the specimens were viewed as simulated three-dimensional objects in a QTVR movie module. Sample group means for the assessments were compared. A survey was also administered asking students' perceptions of quality and user-friendliness of the QTVR

  17. Promoting gross motor skills and physical activity in childcare: A translational randomized controlled trial.

    PubMed

    Jones, Rachel A; Okely, Anthony D; Hinkley, Trina; Batterham, Marijka; Burke, Claire

    2016-09-01

    Educator-led programs for physical activity and motor skill development show potential but few have been implemented and evaluated using a randomized controlled design. Furthermore, few educator-led programs have evaluated both gross motor skills and physical activity. Therefore, the aim of this study was to evaluate a gross motor skill and physical activity program for preschool children which was facilitated solely by childcare educators. A six-month 2-arm randomized controlled trial was implemented between April and September 2012 in four early childhood centers in Tasmania, Australia. Educators participated in ongoing professional development sessions and children participated in structured physical activity lessons and unstructured physical activity sessions. In total, 150 children were recruited from four centers which were randomized to intervention or wait-list control group. Six early childhood educators from the intervention centers were trained to deliver the intervention. Gross motor skills were assessed using the Test of Gross Motor Development (2nd edition) and physical activity was measured objectively using GT3X+ Actigraph accelerometers. No statistically significant differences were identified. However, small to medium effect sizes, in favor of the intervention group, were evident for four of the five gross motor skills and the total gross motor skill score and small to medium effect sizes were reported for all physical activity outcomes. This study highlights the potential of educator-led physical activity interventions and supports the need for further translational trials within the early childhood sector. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  18. Fine and gross motor skills differ between healthy-weight and obese children.

    PubMed

    Gentier, Ilse; D'Hondt, Eva; Shultz, Sarah; Deforche, Benedicte; Augustijn, Mireille; Hoorne, Sofie; Verlaecke, Katja; De Bourdeaudhuij, Ilse; Lenoir, Matthieu

    2013-11-01

    Within the obesity literature, focus is put on the link between weight status and gross motor skills. However, research on fine motor skills in the obese (OB) childhood population is limited. Therefore, the present study focused on possible weight related differences in gross as well as fine motor skill tasks. Thirty-four OB children (12 ♀ and 22 ♂, aged 7-13 years) were recruited prior to participating in a multidisciplinary treatment program at the Zeepreventorium (De Haan, Belgium). Additionally, a control group of 34 age and gender-matched healthy-weight (HW) children was included in the study. Anthropometric measures were recorded and gross and fine motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2). Results were analyzed by independent samples t-tests, multivariate analysis of variance, and a chi-squared test. Being OB was detrimental for all subtests evaluating gross motor skill performance (i.e., upper-limb coordination, bilateral coordination, balance, running speed and agility, and strength). Furthermore, OB children performed worse in fine motor precision and a manual dexterity task, when compared to their HW peers. No group differences existed for the fine motor integration task. Our study provides evidence that lower motor competence in OB children is not limited to gross motor skills alone; OB children are also affected by fine motor skill problems. Further investigation is warranted to provide possible explanations for these differences. It is tentatively suggested that OB children experience difficulties with the integration and processing of sensory information. Future research is needed to explore whether this assumption is correct and what the underlying mechanism(s) could be. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. 46 CFR 167.01-8 - Inspection of school ships using gross tonnage criterion.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Inspection of school ships using gross tonnage criterion. 167.01-8 Section 167.01-8 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS PUBLIC NAUTICAL SCHOOL SHIPS General Provisions § 167.01-8 Inspection of school ships using gross tonnage criterion. (a) One of the...

  20. 25 CFR 215.21 - Payment of gross production tax on lead and zinc.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Payment of gross production tax on lead and zinc. 215.21... ZINC MINING OPERATIONS AND LEASES, QUAPAW AGENCY § 215.21 Payment of gross production tax on lead and zinc. The superintendent of the Quapaw Indian Agency is hereby authorized and directed to pay at the...

  1. 25 CFR 215.21 - Payment of gross production tax on lead and zinc.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Payment of gross production tax on lead and zinc. 215.21... ZINC MINING OPERATIONS AND LEASES, QUAPAW AGENCY § 215.21 Payment of gross production tax on lead and zinc. The superintendent of the Quapaw Indian Agency is hereby authorized and directed to pay at the...

  2. 25 CFR 215.21 - Payment of gross production tax on lead and zinc.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Payment of gross production tax on lead and zinc. 215.21 Section 215.21 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEAD AND ZINC MINING OPERATIONS AND LEASES, QUAPAW AGENCY § 215.21 Payment of gross production tax on lead and...

  3. Clinical assessment, gross examination, frozen section of ovarian masses: do patients benefit?

    PubMed

    Ghaemmaghami, Fatemah; Fakour, Fereshteh; Karimi Zarchi, Mojgan; Behtash, Nadereh; Modares Gilani, Mitra; Mousavi, Azamsadat; Shariat, Mamak

    2008-09-01

    The overall risk of malignancy in ovarian neoplasm is 13% in premenopausal women and 45% in postmenopausal women. Differentiating benign and malignant disease with frozen section is possible during operation; however, information on patients' history, physical examination, paraclinical criteria (tumour markers, imaging) and gross examination of tumour can also be helpful in planing the surgery. This study was conducted on 150 women who underwent laparotomy due to adnexal mass between April 2003 and October 2005 at Vali-e-Asr Hospital, Tehran, Iran. Sensitivity and specificity of clinical assessment (history, tumour marker and imaging), gross examination and frozen section were calculated. Based on our findings frozen section had the highest sensitivity for diagnosing malignant tumour comparing with other methods of diagnosis (88.9%). Sensitivity was 71.3% for preoperative clinical examination, 83% for ultrasonography, 89.8% for CT scan, 70% for CA125 and 84.1% for gross examination, likewise the highest specificity was seen for frozen section (93.5%). This data confirm that frozen section diagnosis is a reliable method for the surgical management of patients with an ovarian mass, but history of disease, Para clinical criteria and gross examination can help to surgeon to perform on appropriate operation in the areas where frozen section is not possible.

  4. Gross and microscopic pathology of hard and soft corals in New Caledonia

    USGS Publications Warehouse

    Work, Thierry M.; Aeby, Greta S.; Lasne, Gregory; Tribollet, Aline

    2014-01-01

    We surveyed the reefs of Grande Terre, New Caledonia, for coral diseases in 2010 and 2013. Lesions encountered in hard and soft corals were systematically described at the gross and microscopic level. We sampled paired and normal tissues from 101 and 65 colonies in 2010 and 2013, respectively, comprising 51 species of corals from 27 genera. Tissue loss was the most common gross lesion sampled (40%) followed by discoloration (28%), growth anomalies (13%), bleaching (10%), and flatworm infestation (1%). When grouped by gross lesions, the diversity of microscopic lesions as measured by Shannon–Wiener index was highest for tissue loss, followed by discoloration, bleaching, and growth anomaly. Our findings document an extension of the range of certain diseases such as Porites trematodiasis and endolithic hypermycosis (dark spots) to the Western Pacific as well as the presence of a putative cnidarian endosymbiont. We also expand the range of species infected by cell-associated microbial aggregates, and confirm the trend that these aggregates predominate in dominant genera of corals in the Indo-Pacific. This study highlights the importance of including histopathology as an integral component of baseline coral disease surveys, because a given gross lesion might be associated with multiple potential causative agents.

  5. The relationship between spasticity and gross motor capability in nonambulatory children with spastic cerebral palsy.

    PubMed

    Katusic, Ana; Alimovic, Sonja

    2013-09-01

    Spasticity has been considered as a major impairment in cerebral palsy (CP), but the relationship between this impairment and motor functions is still unclear, especially in the same group of patients with CP. The aim of this investigation is to determine the relationship between spasticity and gross motor capability in nonambulatory children with spastic CP. Seventy-one children (30 boys, 41 girls) with bilateral spastic cerebral palsy and with Gross Motor Function Classification System (GMFCS) levels IV (n=34) and V (n=37) were included in the study. The spasticity level in lower limbs was evaluated using the Modified Modified Ashworth Scale and the gross motor function with the Gross Motor Function Measure (GMFM-88). Spearman's correlation analysis was used to determine the nature and the strength of the relationship. The results showed a moderate correlation between spasticity and gross motor skills (ρ=0.52 for the GMFCS level; ρ=0.57 for the GMFM-88), accounting for less than 30% of the explained variance. It seems that spasticity is just one factor among many others that could interfere with gross motor skills, even in children with severe forms of spastic CP. Knowledge of the impact of spasticity on motor skills may be useful in the setting of adequate rehabilitation strategies for nonambulatory children with spastic CP.

  6. Histopathological spectrum of childhood nephrotic syndrome in Indian children.

    PubMed

    Kumar, Jitendra; Gulati, Sanjeev; Sharma, Ajay Prakash; Sharma, Raj Kumar; Gupta, Ramesh Kumar

    2003-07-01

    Nephrotic syndrome in children is a clinical manifestation of different histopathological subtypes. There is a paucity of recent large studies dealing with the histopathological spectrum from developing countries. A prospective study was performed from January 1990 to December 2000 at our center, involving 600 children (with age of onset up to 16 years) with idiopathic nephrotic syndrome (INS). The objectives were: (1) to study the histopathological distribution of different subtypes of INS and (2) to compare the clinical and biochemical parameters at the time of diagnosis of minimal change disease (MCD) with non-MCD subtypes. For the purpose of this study we analyzed only those children with INS who underwent biopsies. The study group included 290 children in which adequate biopsy reports were available. There were 213 males and 77 females. Mean age at onset of INS was 7.9+5.1 years. Facial edema was found in 286 (98.6%), microhematuria in 120 (41.3%), gross hematuria in 7 (2.5%), and hypertension in 77(26.8%) patients. All patients of the study group were seronegative for HBsAg and HIV. Focal and segmental glomerulosclerosis (FSGS) was the most common histopathological subtype, occurring in 110 of 290 children (38%). Other subtypes included MCD in 95 children (32%), membranoproliferative glomerulonephritis (MPGN) in 44 children (15%), mesangioproliferative glomerulonephritis in 33 children (11%), membranous glomerulonephritis in 5 children (2%), and diffuse mesangial sclerosis in 3 children (1%). In children under 8 years of age, MCD was the most common entity, whereas FSGS predominated in children with age at onset greater than 8 years. The age at onset of nephrotic syndrome was significantly higher in the non-MCD group than the MCD group. The incidence of hypertension, microhematuria, and gross hematuria was significantly lower in the MCD group. MCD remains the most common histopathological subtype in Indian children with INS and onset under 8 years of age. The

  7. [Feasibility and safety evaluation of retrograde inserting of ureteric catheter via flexible cystoscope].

    PubMed

    Jin, Xiao-dong; Li, Zhong-yi; Luo, Xue-hong; Chen, Zhao-dian; Cai, Song-liang; Xie, Li-ping

    2008-06-24

    To introduce a method of retrograde ureteric catheter placement via flexible cystoscope , and to evaluate the feasibility and safety of this method. 112 patients, 62 males and 50 females undergoing retrograde ureteropyelography by 2 same physicians in cooperation were randomly divided into two equal groups with 31 males and 25 females each: one group via flexible cystoscope and the other group via rigid cystoscope. The catheterizing time, visual analogue scale (VAS) pain score, gross hematuria rate, and fever rate were compared between these 2 groups. Fifty-five patients underwent ureteric catheter placement successfully via flexible cystoscope (98%, 55/56), while 53 cases were technically successful by rigid cystoscope (95%, 53/56). The inserting time in women patients of the flexible cystoscopy group was (7.6 +/- 1.8) min, significantly shorter than that of the men [(8.0 +/- 1.8) min, P < 0.05]. The inserting time in women patients of the rigid cystoscopy group was (7.4 +/- 1.5) min, significantly shorter than that of the men [(8.2 +/- 1.2) min, P < 0.05]. However, there were not significant differences in the inserting times in both men and women between these 2 groups (both P > 0.05). The VAS pain scores in men and women of the flexible cystoscope group were 3. 5 and 2. 3 respectively, both significantly lower than those of the rigid cystoscopy group (7.2 and 3.3 respectively, both P < 0.05). The gross hematuria rate of the flexible cystoscope group was 8.6% (5/56), significantly lower than that of the rigid cystoscopy group (25.0%, 14/56, P < 0.05). Four patients had a fever after flexible cystoscopy while 6 cases did after rigid cystoscopy, however, without significant difference between these 2 groups (P > 0.05). Retrograde placement of ureteric catheter via flexible cystoscope is safe and reliable as rigid cystoscopy. Meanwhile, inserting ureteric catheter via flexible cystoscope causes the patients less pain and less chance of hematuria.

  8. The effect of height, weight and head circumference on gross motor development in achondroplasia.

    PubMed

    Ireland, Penelope Jane; Ware, Robert S; Donaghey, Samantha; McGill, James; Zankl, Andreas; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth; Townshend, Sharron; Johnston, Leanne M

    2013-02-01

    This study aimed to investigate whether height, weight, head circumference and/or relationships between these factors are associated with gross motor milestone acquisition in children with achondroplasia. Population-based data regarding timing of major gross motor milestones up to 5 years were correlated with height, weight and head circumference at birth and 12 months in 48 children with achondroplasia born in Australia and New Zealand between 2000 and 2009. Although as a group children with achondroplasia showed delayed gross motor skill acquisition, within group differences in height, weight or head circumference did not appear to influence timing of gross motor skills before 5 years. The exception was lie to sit transitioning, which appears likely to occur earlier if the child is taller and heavier at 12 months, and later if the child has significant head-to-body disproportion. This is the first study to investigate the relationship between common musculoskeletal impairments associated with achondroplasia and timing of gross motor achievement. Identification of the musculoskeletal factors that exacerbate delays in transitioning from lying to sitting will assist clinicians to provide more proactive assessment, advice and intervention regarding motor skill acquisition for this population. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  9. Iliac Artery-Uretero-Colonic Fistula Presenting as Gastrointestinal Hemorrhage and Hematuria: A Case Report.

    PubMed

    Kurata, Saya; Tobu, Shohei; Udo, Kazuma; Noguchi, Mitsuru

    2018-01-01

    Background: The experience with uretero-arterial fistulas has been limited. However, the aggressive treatment of pelvic tumors with surgical resection and radiotherapy, along with liberal use of ureteral catheters, has been attributed to an increase in their incidence. Unless they are promptly diagnosed and treated, uretero-arterial fistulas are associated with considerably high rates of morbidity and mortality. Urologists need maintain a high degree of suspicion for uretero-arterial fistula in high-risk patients. We herein present the clinical course of an iliac artery-uretero-colonic fistula. Case Presentation: A 67-year-old woman with a history of colon cancer who underwent laparoscopic high anterior resection in July 2010. A ureteral stent inserted to right ureteral stricture, which developed as a result of local recurrence of the tumor in September 2010. She had undergone chemoradiotherapy, but the lesion had slowly increased in size. During the replacement of the ureteral stent in April 2016, she immediately experienced bladder tamponade, bloody bowel discharge, and hypotension. Contrast CT revealed a complex fistula between the right distal ureter and the right internal iliac artery. Furthermore, contrast medium flowed into the intestinal tract through the tumor. The patient was therefore diagnosed with internal iliac artery-uretero-colonic fistula. Arteriography revealed a right uretero-internal iliac artery fistula, and the embolization of the right internal iliac artery was performed. The right ureteral stent was removed. Her hematuria and bloody bowel discharge disappeared, but right nephrostomy was performed because she presented with acute pyelonephritis to ureteral obstruction. Conclusion: In the present case, the uretero-arterial fistula was caused by the long use of an indwelling stent, chemoradiotherapy, infection, and an increase in the size of the lesion. When a suspected uretero-arterial fistula is accompanied by bloody bowel discharge, we

  10. Early gross motor development of preterm infants according to the Alberta Infant Motor Scale.

    PubMed

    van Haastert, I C; de Vries, L S; Helders, P J M; Jongmans, M J

    2006-11-01

    To systematically examine gross motor development in the first 18 months of life of preterm infants. A total of 800 preterm infants (356 boys), ages between 1 and 18 months and corrected for degree of prematurity, were assessed with the use of the Alberta Infant Motor Scale. Comparison of the mean Alberta Infant Motor Scale scores of the preterm infants with the norm-referenced values derived from term infants revealed that as a group, the preterm infants scored significantly lower at all age levels, even with full correction for degree of prematurity. In general, preterm infants exhibit different gross motor developmental trajectories compared with term infants in the first 18 months of life. The gross motor developmental profile of preterm infants may reflect a variant of typical gross motor development, which seems most likely to be specific for this population. As a consequence, adjusted norms should be used for proper evaluation and clinical decision-making in relation to preterm infants.

  11. Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis.

    PubMed

    Lucas, Barbara R; Elliott, Elizabeth J; Coggan, Sarah; Pinto, Rafael Z; Jirikowic, Tracy; McCoy, Sarah Westcott; Latimer, Jane

    2016-11-29

    Gross motor skills are fundamental to childhood development. The effectiveness of current physical therapy options for children with mild to moderate gross motor disorders is unknown. The aim of this study was to systematically review the literature to investigate the effectiveness of conservative interventions to improve gross motor performance in children with a range of neurodevelopmental disorders. A systematic review with meta-analysis was conducted. MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PEDro, Cochrane Collaboration, Google Scholar databases and clinical trial registries were searched. Published randomised controlled trials including children 3 to ≤18 years with (i) Developmental Coordination Disorder (DCD) or Cerebral Palsy (CP) (Gross Motor Function Classification System Level 1) or Developmental Delay or Minimal Acquired Brain Injury or Prematurity (<30 weeks gestational age) or Fetal Alcohol Spectrum Disorders; and (ii) receiving non-pharmacological or non-surgical interventions from a health professional and (iii) gross motor outcomes obtained using a standardised assessment tool. Meta-analysis was performed to determine the pooled effect of intervention on gross motor function. Methodological quality and strength of meta-analysis recommendations were evaluated using PEDro and the GRADE approach respectively. Of 2513 papers, 9 met inclusion criteria including children with CP (n = 2) or DCD (n = 7) receiving 11 different interventions. Only two of 9 trials showed an effect for treatment. Using the least conservative trial outcomes a large beneficial effect of intervention was shown (SMD:-0.8; 95% CI:-1.1 to -0.5) with "very low quality" GRADE ratings. Using the most conservative trial outcomes there is no treatment effect (SMD:-0.1; 95% CI:-0.3 to 0.2) with "low quality" GRADE ratings. Study limitations included the small number and poor quality of the available trials. Although we found that some interventions with a task

  12. 25 CFR 215.21 - Payment of gross production tax on lead and zinc.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Payment of gross production tax on lead and zinc. 215.21 Section 215.21 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEAD AND ZINC MINING OPERATIONS AND LEASES, QUAPAW AGENCY § 215.21 Payment of gross production tax on lead and zinc. The superintendent of the Quapaw...

  13. 25 CFR 215.21 - Payment of gross production tax on lead and zinc.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Payment of gross production tax on lead and zinc. 215.21 Section 215.21 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEAD AND ZINC MINING OPERATIONS AND LEASES, QUAPAW AGENCY § 215.21 Payment of gross production tax on lead and zinc. The superintendent of the Quapaw...

  14. a Gross Error Elimination Method for Point Cloud Data Based on Kd-Tree

    NASA Astrophysics Data System (ADS)

    Kang, Q.; Huang, G.; Yang, S.

    2018-04-01

    Point cloud data has been one type of widely used data sources in the field of remote sensing. Key steps of point cloud data's pro-processing focus on gross error elimination and quality control. Owing to the volume feature of point could data, existed gross error elimination methods need spend massive memory both in space and time. This paper employed a new method which based on Kd-tree algorithm to construct, k-nearest neighbor algorithm to search, settled appropriate threshold to determine with result turns out a judgement that whether target point is or not an outlier. Experimental results show that, our proposed algorithm will help to delete gross error in point cloud data and facilitate to decrease memory consumption, improve efficiency.

  15. Pure Small Cell Carcinoma of the Bladder: A Case Report.

    PubMed

    Trabelsi, Amel; Abdelkrim, Soumaya Ben; Tebra, Samah; Gharbi, Olfa; Jaidane, Lilia; Bouaouina, Noureddine; Abbassi, Dajla Bakir; Mokni, Moncef

    2010-06-01

    Small cell carcinoma of the urinary bladder is an uncommon tumor that has been described in case reports or small series. We report a new case in a 67-year-old male who presented with gross hematuria and irritative symptoms. Cystoscopy revealed an extensive mass of the bladder and computed tomography scan showed an important thickening of the bladder wall. Diagnosis of small cell carcinoma was established after radical cystectomy and microscopic examination. The patient received pelvic hemostatic radiotherapy and platinium-based chemotherapy. Three months after the diagnosis, he developed bone, renal and adrenal metastases.

  16. Health and Gross National Happiness: review of current status in Bhutan.

    PubMed

    Tobgay, Tashi; Dophu, Ugen; Torres, Cristina E; Na-Bangchang, Kesara

    2011-01-01

    Worldwide, contemporary measures of the success of health development programs have been mostly in terms of the reduction of mortality and morbidity as well as increasing longevity. While these goals have yielded much-needed health improvements, the subjective outcomes of these improvements, as experienced by individuals and the communities, have not been considered. Bhutan, under the overarching policy of Gross National Happiness, has provided due consideration to these subjective indicators. Here, we report on the current status of health and happiness in Bhutan as revealed by conventional objective indicators and subjective Gross National Happiness indicators. The current literature on health in Bhutan in relation to the Gross National Happiness Survey conducted by the Centre of Bhutan Studies has been reviewed. Bhutan has made great strides within a short period of modernization, as shown by both objective and subjective indicators. Tremendous challenges lie ahead to achieve the ultimate goal of health and happiness, and how Bhutan articulates its path to modernization may be a lesson for the rest of the world.

  17. Dynamics of Gross Methane Production and Oxidation in a Peatland Soil

    NASA Astrophysics Data System (ADS)

    McNicol, G.; Yang, W. H.; Teh, Y.; Silver, W. L.

    2012-12-01

    Globally, peatlands are major sources of the potent greenhouse gas methane (CH4) that is implicated in 20% of the post-industrial increase in radiative forcing. Many temperate peatlands have been drained for alternative land-use and are characterized by a layer of unsaturated soil overlying the remnant organic histosol. Drained soil layers may attenuate surface CH4 emissions from deeper, flooded peat layers via microbial CH4 consumption. We measured gross rates of CH4 production and oxidation seasonally across a range of topographic landforms in a partially drained peatland on Sherman Island, California. Net CH4 fluxes across the soil-atmosphere interface ranged from -7.4 to 1096 mg-C m-2 d-1 across all landforms. Fluxes were highest in May and in irrigation ditches (date, p < 0.001; landform, p < 0.001; n = 55). Gross CH4 production rates ranged from 0-1461 mg-C m-2 d-1 and oxidation rates ranged from 0-40 mg-C m-2 d-1. Excluding the irrigation ditches, gross fluxes did not vary seasonally. Gross CH4 fluxes were significantly higher in the hollow/hummock than in the slope. We subsequently selected the hollow/hummock based upon the observation of a strong redox gradient with depth and characterized gross fluxes of CH4 both in the field and in laboratory incubations of four soil depth increments (0-10 cm, 10-30 cm, 30-60 cm, 60-80 cm). The laboratory incubation consisted of 3 separate gross flux experiments: the first using fresh soil under ambient headspace, the second after incubation in an N2 headspace, and the third after incubation in an ambient headspace. Gross CH4 fluxes in the field varied from a slight sink (-0.11 mg-C m-2 d-1) to a large source (23.9 mg-C m-2 d-1). In 3 plots net fluxes were reduced by competing CH4 oxidation. In the depth profile experiment, production and consumption were observed in the fresh soil, but without a clear depth trend. In contrast, we found that consumption rates increased with depth following the aerobic incubation and

  18. The San Andreas fault experiment. [gross tectonic plates relative velocity

    NASA Technical Reports Server (NTRS)

    Smith, D. E.; Vonbun, F. O.

    1973-01-01

    A plan was developed during 1971 to determine gross tectonic plate motions along the San Andreas Fault System in California. Knowledge of the gross motion along the total fault system is an essential component in the construction of realistic deformation models of fault regions. Such mathematical models will be used in the future for studies which will eventually lead to prediction of major earthquakes. The main purpose of the experiment described is the determination of the relative velocity of the North American and the Pacific Plates. This motion being so extremely small, cannot be measured directly but can be deduced from distance measurements between points on opposite sites of the plate boundary taken over a number of years.

  19. Trained, Generalized, and Collateral Behavior Changes of Preschool Children Receiving Gross-Motor Skills Training.

    ERIC Educational Resources Information Center

    Kirby, Kimberly C.; Holborn, Stephen W.

    1986-01-01

    Three preschool children participated in a behavioral training program to improve their gross-motor skills. Results indicated that the program improved the 10 targeted gross-motor skills and that improvements sometimes generalized to other settings. The program did not produce changes in fine-motor skills or social behaviors. Implications are…

  20. GROSS- GAMMA RAY OBSERVATORY ATTITUDE DYNAMICS SIMULATOR

    NASA Technical Reports Server (NTRS)

    Garrick, J.

    1994-01-01

    The Gamma Ray Observatory (GRO) spacecraft will constitute a major advance in gamma ray astronomy by offering the first opportunity for comprehensive observations in the range of 0.1 to 30,000 megaelectronvolts (MeV). The Gamma Ray Observatory Attitude Dynamics Simulator, GROSS, is designed to simulate this mission. The GRO Dynamics Simulator consists of three separate programs: the Standalone Profile Program; the Simulator Program, which contains the Simulation Control Input/Output (SCIO) Subsystem, the Truth Model (TM) Subsystem, and the Onboard Computer (OBC) Subsystem; and the Postprocessor Program. The Standalone Profile Program models the environment of the spacecraft and generates a profile data set for use by the simulator. This data set contains items such as individual external torques; GRO spacecraft, Tracking and Data Relay Satellite (TDRS), and solar and lunar ephemerides; and star data. The Standalone Profile Program is run before a simulation. The SCIO subsystem is the executive driver for the simulator. It accepts user input, initializes parameters, controls simulation, and generates output data files and simulation status display. The TM subsystem models the spacecraft dynamics, sensors, and actuators. It accepts ephemerides, star data, and environmental torques from the Standalone Profile Program. With these and actuator commands from the OBC subsystem, the TM subsystem propagates the current state of the spacecraft and generates sensor data for use by the OBC and SCIO subsystems. The OBC subsystem uses sensor data from the TM subsystem, a Kalman filter (for attitude determination), and control laws to compute actuator commands to the TM subsystem. The OBC subsystem also provides output data to the SCIO subsystem for output to the analysts. The Postprocessor Program is run after simulation is completed. It generates printer and CRT plots and tabular reports of the simulated data at the direction of the user. GROSS is written in FORTRAN 77 and

  1. A preliminary investigation of the relationship between language and gross motor skills in preschool children.

    PubMed

    Merriman, W J; Barnett, B E

    1995-12-01

    This study was undertaken to explore the relationship between language skills and gross-motor skills of 28 preschool children from two private preschools in New York City. Pearson product-moment correlation coefficients were calculated for language (revised Preschool Language Scale) and gross motor (Test of Gross Motor Development) scores. Locomotor skills were significantly related to both auditory comprehension and verbal ability while object control scores did not correlate significantly with either language score. These results were discussed in terms of previous research and with reference to dynamical systems theory. Suggestions for research were made.

  2. Gross motor development in babies with treated idiopathic clubfoot.

    PubMed

    Garcia, Nancy L; McMulkin, Mark L; Tompkins, Bryan J; Caskey, Paul M; Mader, Shelley L; Baird, Glen O

    2011-01-01

    To investigate the effect of treated clubfoot disorder on gross motor skill level measured by the Alberta Infant Motor Scale (AIMS). Fifty-two babies participated: 26 were treated for idiopathic clubfoot (12 with the Ponseti treatment method, 9 with the French physical therapy technique, and 5 with a combination of both methods); 26 were babies who were typically developing and without medical diagnoses. The AIMS was administered at 3-month intervals. No significant differences in AIMS scores were found between the clubfoot and control groups at 3 and 6 months, but at 9 and 12 months the clubfoot group scored significantly lower. Babies who were typically developing were significantly more likely to be walking at 12 months than babies with clubfoot. Treated clubfoot was associated with a mild delay in attainment of gross motor skills at 9 and 12 months of age.

  3. The Psychoprophylactic Method of Painless Childbirth in Socialist Czechoslovakia: from State Propaganda to Activism of Enthusiasts

    PubMed Central

    Hrešanová, Ema

    2016-01-01

    This paper explores the history of the ‘psychoprophylactic method of painless childbirth’ in socialist Czechoslovakia, in particular, in the Czech and Moravian regions of the country, showing that it substantially differs from the course that the method took in other countries. This non-pharmacological method of pain relief originated in the USSR and became well known as the Lamaze method in western English-speaking countries. Use of the method in Czechoslovakia, however, followed a very different path from both the West, where its use was refined mainly outside the biomedical frame, and the USSR, where it ceased to be pursued as a scientific method in the 1950s after Stalin’s death. The method was imported to Czechoslovakia in the early 1950s and it was politically promoted as Soviet science’s gift to women. In the 1960s the method became widespread in practice but research on it diminished and, in the 1970s, its use declined too. However, in the 1980s, in the last decade of the Communist regime, the method resurfaced in the pages of Czechoslovak medical journals and underwent an exciting renaissance, having been reintroduced by a few enthusiastic individuals, most of them women. This article explores the background to the renewed interest in the method while providing insight into the wider social and political context that shaped socialist maternity and birth care in different periods. PMID:27628861

  4. 26 CFR 1.924(a)-1T - Temporary regulations; definition of foreign trading gross receipts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Engineering and architectural services—(1) In general. Foreign trading gross receipts of a FSC include gross receipts from engineering services (as described in paragraph (e)(5) of this section) or architectural... without the United States. (2) Services included. Engineering and architectural services include...

  5. 26 CFR 1.924(a)-1T - Temporary regulations; definition of foreign trading gross receipts.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Engineering and architectural services—(1) In general. Foreign trading gross receipts of a FSC include gross receipts from engineering services (as described in paragraph (e)(5) of this section) or architectural... without the United States. (2) Services included. Engineering and architectural services include...

  6. 26 CFR 1.924(a)-1T - Temporary regulations; definition of foreign trading gross receipts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Engineering and architectural services—(1) In general. Foreign trading gross receipts of a FSC include gross receipts from engineering services (as described in paragraph (e)(5) of this section) or architectural... without the United States. (2) Services included. Engineering and architectural services include...

  7. 26 CFR 1.924(a)-1T - Temporary regulations; definition of foreign trading gross receipts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Engineering and architectural services—(1) In general. Foreign trading gross receipts of a FSC include gross receipts from engineering services (as described in paragraph (e)(5) of this section) or architectural... without the United States. (2) Services included. Engineering and architectural services include...

  8. 76 FR 4250 - Operating Certain Railroad Tank Cars in Excess of 263,000 Pounds Gross Rail Load; Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ... Railroad Tank Cars in Excess of 263,000 Pounds Gross Rail Load; Approval AGENCY: Federal Railroad... certain railroad tank cars in excess of 263,000 pounds gross rail load. SUMMARY: On May 14, 2010, the... to allow certain rail tank cars, transporting hazardous materials, to exceed the gross weight on rail...

  9. [Analysis of diagnosis and treatment of Alport syndrome].

    PubMed

    An, X G; Zhang, Y Q; Ding, J; Wang, F; Xiao, H J; Yao, Y

    2016-09-01

    To investigate the clinical characteristics and the status of diagnosis and treatment of patients with Alport syndrome in China. Patients with affirmative diagnosis of Alport syndrome from Department of Pedatrics, Peking University First Hospital in the past 20 years (1995-2015) were analyzed retrospectively. The clinical data including initial symptoms, visit reasons, age at onset of disease, family history, hereditary mode, methods of diagnosis, misdiagnosis and mistreatment were collected. A total of 398 patients with Alport syndrome were included in this study, 48.2% of patients had the onset of symptoms before age of 3 years. The rate of onset of symptoms and diagnosis before age of 17 years were 95.7%. The initial symptoms included gross hematuria (37.2%), microscopic hematuria and proteinuria (25.1%), microscopic hematuria (14.8%), edema of eyelid and lower limbs (10.3%), increased foam in urine (4.3%), etc.; 39.5% of patients had no symptoms of urinary tract. Only 14.0% of the patients were diagnosed as Alport syndrome for the first time, and 86.0% of the patients were misdiagnosed. Hormones and immunosuppressive agents were used in 19.0% of patients diagnosed as Alport syndrome, and in 43.0% of patients there was misdiagnosis. Skin biopsy and immunofluorescence of type Ⅳ collagen ɑ5 chain in epithelial basement membrane had a detection rate of 77.8%. Electron microscopy of glomerular basement membrane had a detection rate of 92.6%, and genetic testing 96.6%. The time interval of diagnosis was 18.2 months and was gradually shortened in recent years. Alport syndrome developed at a very young age. Hematuria was the most frequent initial symptom. There was a high rate of misdiagnosis and mistreatment for Alport syndrome. Genetic testing for Alport syndrome had advantages of high detection rate, genetic consultation and prenatal diagnosis.

  10. Assessing Gross Motor Skills of Kosovar Preschool Children

    ERIC Educational Resources Information Center

    Shala, Merita

    2009-01-01

    In the light of the new developments in preschool education in Kosovo, this study attempts to carry out an assessment of the development of gross motor skills of preschool children attending institutional education. The emphasis is on creating a set of tests to measure the motor attainments of these children by conducting assessments of the…

  11. A Study on Postmortem Wound Dating by Gross and Histopathological Examination of Abrasions.

    PubMed

    Vinay, Javaregowda; Harish, Sathyanarayana; Mangala, Gouri S R; Hugar, Basappa S

    2017-06-01

    Abrasions are the most common blunt force injuries. The precise dating of injury is extremely important in forensic medicine practice. As we know, the wound healing occurs in well-orchestrated sequence, consisting of inflammation, proliferation, and maturation.A study of occurrence of such phases will help in understanding the sequence of events in wound healing. In this context, this study of wound dating from gross and microscopic level was taken. Postmortem study of wound dating by gross and histopathological examination of abrasions was carried out in the Department of Forensic Medicine, in M.S. Ramaiah Medical College. A total of 101 abrasions were correlated to time frame the occurrence of different gross changes and microscopic changes that follow the blunt trauma. Abrasions ranging from 0 hour to a maximum of 45 days were studied. The gross changes of abrasions were in correlation with the microscopic changes; however, the role of the comorbid conditions is significant because the results showed variations with respect to healing process. This study signifies that, if naked eye examination is studied along with histopathological examination, the reliability and accuracy of dating of wound increase. Whenever accurate determination of age is required, the autopsy surgeon can subject the samples for histopathological examination and correlate before opining the age of injury.

  12. Determination of natural radioactivity by gross alpha and beta measurements in ground water samples.

    PubMed

    Turhan, S; Ozçitak, E; Taşkin, H; Varinlioğlu, A

    2013-06-01

    In this study, the activity concentrations of the gross α and β in ground water samples collected from the different drilled wells in Nevşehir province were measured to assess annual effective dose due to the ingestion of the water samples. Nevşehir province is one of the major cities of Cappadocia Region which is a popular tourist destination as it has many areas with unique geological, historic, and cultural features. Sampling and measurements were carried out in the autumn of 2011 and the spring of 2012. The values of the activity concentrations of the gross α and β measured in the water samples ranged from 80 to 380 mBq L(-1) with a mean of 192 mBq L(-1) and 120-3470 mBq L(-1) with a mean of 579 mBq L(-1) respectively. All values of the gross α were lower than the limit value of 500 mBq L(-1) while two ground water samples were found to have gross β activity concentrations of greater than 1000 mBq L(-1). Therefore two water samples were the subject of further radioisotope-specific analysis. The obtained result indicated that the elevated activity concentrations of the gross β in these water samples are dominated by (40)K activity. Annual effective doses ranged from 0.04 to 0.20 mSv y(-1). Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Gross decontamination experiment report

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

    Mason, R.; Kinney, K.; Dettorre, J.

    1983-07-01

    A Gross Decontamination Experiment was conducted on various levels and surfaces of the TMI - Unit 2 reactor building in March 1982. The polar crane, D-rings, missile shields, refueling canals, refueling bridges, equipment, and elevations 305' and 347'-6'' were flushed with low pressure water. Additionally, floor surfaces on elevation 305' and floor surfaces and major pieces of equipment on elevation 347'-6'' were sprayed with high pressure water. Selective surfaces were decontaminated with a mechanical scrubber and chemicals. Strippable coating was tested and evaluated on equipment and floor surfaces. The effectiveness, efficiency, and safety of several decontamination techniques were established formore » the large, complex decontamination effort. Various decontamination equipment was evaluated and its effectiveness was documented. Decontamination training and procedures were documented and evaluated, as were the support system and organization for the experiment.« less

  14. Verbal priming and taste sensitivity make moral transgressions gross.

    PubMed

    Herz, Rachel S

    2014-02-01

    The aims of the present study were to assess whether: (a) visceral and moral disgust share a common oral origin (taste); (b) moral transgressions that are also viscerally involving are evaluated accordingly as a function of individual differences in taste sensitivity; (c) verbal priming interacts with taste sensitivity to alter how disgust is experienced in moral transgressions; and (d) whether gender moderates these effects. Standard tests of disgust sensitivity, a questionnaire developed for this research assessing different types of moral transgressions (nonvisceral, implied-visceral, visceral) with the terms "angry" and "grossed-out," and a taste sensitivity test of 6-n-propylthiouracil (PROP) were administered to 102 participants. Results confirmed past findings that the more sensitive to PROP a participant was the more disgusted they were by visceral, but not moral, disgust elicitors. Importantly, the findings newly revealed that taste sensitivity had no bearing on evaluations of moral transgressions, regardless of their visceral nature, when "angry" was the emotion primed. However, when "grossed-out" was primed for evaluating moral violations, the more intense PROP tasted to a participant the more "grossed-out" they were by all transgressions. Women were generally more disgust sensitive and morally condemning than men, but disgust test, transgression type, and priming scale modulated these effects. The present findings support the proposition that moral and visceral disgust do not share a common oral origin, but show that linguistic priming can transform a moral transgression into a viscerally repulsive event and that susceptibility to this priming varies as a function of an individual's sensitivity to the origins of visceral disgust-bitter taste.

  15. Interlimb Coordination: An Important Facet of Gross-Motor Ability

    ERIC Educational Resources Information Center

    Bobbio, Tatiana; Gabbard, Carl; Cacola, Priscila

    2009-01-01

    Motor development attains landmark significance during early childhood. Although early childhood educators may be familiar with the gross-motor skill category, the subcategory of interlimb coordination needs greater attention than it typically receives from teachers of young children. Interlimb coordination primarily involves movements requiring…

  16. Gross anatomy of network security

    NASA Technical Reports Server (NTRS)

    Siu, Thomas J.

    2002-01-01

    Information security involves many branches of effort, including information assurance, host level security, physical security, and network security. Computer network security methods and implementations are given a top-down description to permit a medically focused audience to anchor this information to their daily practice. The depth of detail of network functionality and security measures, like that of the study of human anatomy, can be highly involved. Presented at the level of major gross anatomical systems, this paper will focus on network backbone implementation and perimeter defenses, then diagnostic tools, and finally the user practices (the human element). Physical security measures, though significant, have been defined as beyond the scope of this presentation.

  17. Fortran programs for the time-dependent Gross-Pitaevskii equation in a fully anisotropic trap

    NASA Astrophysics Data System (ADS)

    Muruganandam, P.; Adhikari, S. K.

    2009-10-01

    Here we develop simple numerical algorithms for both stationary and non-stationary solutions of the time-dependent Gross-Pitaevskii (GP) equation describing the properties of Bose-Einstein condensates at ultra low temperatures. In particular, we consider algorithms involving real- and imaginary-time propagation based on a split-step Crank-Nicolson method. In a one-space-variable form of the GP equation we consider the one-dimensional, two-dimensional circularly-symmetric, and the three-dimensional spherically-symmetric harmonic-oscillator traps. In the two-space-variable form we consider the GP equation in two-dimensional anisotropic and three-dimensional axially-symmetric traps. The fully-anisotropic three-dimensional GP equation is also considered. Numerical results for the chemical potential and root-mean-square size of stationary states are reported using imaginary-time propagation programs for all the cases and compared with previously obtained results. Also presented are numerical results of non-stationary oscillation for different trap symmetries using real-time propagation programs. A set of convenient working codes developed in Fortran 77 are also provided for all these cases (twelve programs in all). In the case of two or three space variables, Fortran 90/95 versions provide some simplification over the Fortran 77 programs, and these programs are also included (six programs in all). Program summaryProgram title: (i) imagetime1d, (ii) imagetime2d, (iii) imagetime3d, (iv) imagetimecir, (v) imagetimesph, (vi) imagetimeaxial, (vii) realtime1d, (viii) realtime2d, (ix) realtime3d, (x) realtimecir, (xi) realtimesph, (xii) realtimeaxial Catalogue identifier: AEDU_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEDU_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data

  18. Schistosoma haematobium Infection That Mimics Bladder Cancer in a 66-Year-Old Ethnic Egyptian Man.

    PubMed

    Zepeda, Celenne Morfin; Coffey, Kristen H

    2015-01-01

    66-year-old ethnic Egyptian man. Hematuria. The patient had a history of multiple episodes of gross hematuria for the past 5 years. Because the hematuria usually resolved on its own, he did not seek medical attention during that time. Bladder cancer was suspected. The patient had a history of coronary artery disease, hypertension, nephrolithiasis, congestive heart failure, lifelong smoking, and ischemic cardiomyopathy. He has been taking the anticoagulants clopidogrel (Plavix) and warfarin (Coumadin). The patient is originally from Egypt and has been living in the United States for the past 10 years. A complete blood count showed a hemoglobin of 13.0 g per dL (reference range, 14.0 to 18.0 g per dL), hematocrit 40% (40% to 54%), red blood cell count (RBC) 4.65 × 10(9) per L (4.60 to 6.00), and platelet count 179 × 10(9) per L (150 to 450). The urinalysis results showed 3+ protein, 4+ blood, and urine RBC of greater than 100 per high power field (hpf). The urinalysis results did not indicate the presence of parasitic ova or adult parasites. Based on these results, the physician ordered cystoscopic testing, suspecting bladder cancer. Analysis of the bladder tissue showed inflammation (Image 1) and several ova that were consistent with developing Schistosoma (Image 2). Many of the ova were calcified and surrounded by severely inflamed tissue (Image 3). Copyright© by the American Society for Clinical Pathology (ASCP).

  19. 29 CFR 779.267 - Fluctuations in annual gross volume affecting enterprise coverage and establishment exemptions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... monetary provisions of the Act may reveal changes in the annual gross volume or other determinative factors... 29 Labor 3 2011-07-01 2011-07-01 false Fluctuations in annual gross volume affecting enterprise... Employment to Which the Act May Apply; Enterprise Coverage Computing the Annual Volume § 779.267 Fluctuations...

  20. Adaptive downhill skiing in children with cerebral palsy: effect on gross motor function.

    PubMed

    Sterba, John A

    2006-01-01

    The study was designed to examine the effect of adaptive downhill skiing (ADS) on gross motor function in children with spastic cerebral palsy. One girl and four boys participated (mean age = eight years, five months). All were ambulatory. Participants' Gross Motor Function Measure (GMFM) classifications were: Level I (n = 2); Level II (n = 2); Level III (n = 1). ADS was conducted for a 10-week period at one ski resort. Each participant had the same ski instructor. GMFM was obtained every five weeks: beginning five weeks before ADS instruction and continuing to 10 weeks after ADS instruction. After 10 weeks of ADS GMFM-D, and GMFM-Total Score increased 5.4% (p = 0.022) and 3.2% (p = 0.035), respectively, and remained increased 10 weeks after ADS. ADS could be recommended by clinicians as a recreational activity for the gross motor rehabilitation of ambulatory children with spastic cerebral palsy.

  1. Comparison of Gross Anatomy Test Scores Using Traditional Specimens vs. Quicktime Virtual Reality Animated Specimens

    ERIC Educational Resources Information Center

    Maza, Paul Sadiri

    2010-01-01

    In recent years, technological advances such as computers have been employed in teaching gross anatomy at all levels of education, even in professional schools such as medical and veterinary medical colleges. Benefits of computer based instructional tools for gross anatomy include the convenience of not having to physically view or dissect a…

  2. Application of the One-Minute Preceptor Technique by Novice Teachers in the Gross Anatomy Laboratory

    ERIC Educational Resources Information Center

    Chan, Lap Ki; Yang, Jian; Irby, David M.

    2015-01-01

    The one-minute preceptor (OMP) was originally developed in the ambulatory care setting as a time-efficient teaching technique for learner-centered clinical training. There are also possible advantages of using the OMP in the gross anatomy laboratory. However, in a previous study it was found that providing training to experienced gross anatomy…

  3. Chronological changes of radiofrequency ablation zone in rabbit liver: an in vivo correlation between gross pathology and histopathology

    PubMed Central

    Song, Kyoung D; Rhim, Hyunchul; Kang, Tae Wook; Cha, Dong Ik; Yang, Jehoon

    2017-01-01

    Objective: To examine the gross pathology and histopathology of ablation zones created from radiofrequency (RF) ablation and to correlate their chronological changes. Methods: A total of 48 in vivo ablation zones (16 rabbit livers) were obtained immediately after and also 30 min, 1 h and 2 h after RF ablation and were subjected to haematoxylin and eosin (H&E) staining, nicotinamide adenine dinucleotide (NADH) diaphorase staining, terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) staining. Chronological changes in gross pathology and histopathology were evaluated and correlated with each other. Results: Peripheral red zones on gross pathology correlated with peripheral zones on H&E staining, lightly stained peripheral zones on NADH staining and peripheral positive zones on TUNEL staining. Central white zones on gross pathology correlated with combined central and border zones on H&E staining, central negative zones on NADH staining and combined central-positive and middle-negative zones on TUNEL staining. Boundary visibility between central white and peripheral red zones on gross pathology was significantly higher at 1 and 2 h than immediately after RF ablation. As time increased after RF ablation, visibility of the border zone on H&E staining and the grade of positively stained hepatocytes in the peripheral zone on TUNEL staining increased. Conclusion: Chronological changes in gross pathology of RF ablation zones correlated well with histopathology. The boundary between the central white and peripheral red zones tended to become clear at 1 h after RF ablation. Advances in knowledge: (1) RF ablation zones show chronological changes on gross pathology and histopathology. (2) Gross pathology and histopathology correlate well with each other. PMID:28139942

  4. A Study on Postmortem Wound Dating by Gross and Histopathological Examination of Abrasions

    PubMed Central

    Vinay, Javaregowda; Harish, Sathyanarayana; Mangala, Gouri S.R.; Hugar, Basappa S.

    2017-01-01

    Introduction Abrasions are the most common blunt force injuries. The precise dating of injury is extremely important in forensic medicine practice. As we know, the wound healing occurs in well-orchestrated sequence, consisting of inflammation, proliferation, and maturation. A study of occurrence of such phases will help in understanding the sequence of events in wound healing. In this context, this study of wound dating from gross and microscopic level was taken. Materials and Methods Postmortem study of wound dating by gross and histopathological examination of abrasions was carried out in the Department of Forensic Medicine, in M.S. Ramaiah Medical College. A total of 101 abrasions were correlated to time frame the occurrence of different gross changes and microscopic changes that follow the blunt trauma. Abrasions ranging from 0 hour to a maximum of 45 days were studied. Results The gross changes of abrasions were in correlation with the microscopic changes; however, the role of the comorbid conditions is significant because the results showed variations with respect to healing process. Conclusions This study signifies that, if naked eye examination is studied along with histopathological examination, the reliability and accuracy of dating of wound increase. Whenever accurate determination of age is required, the autopsy surgeon can subject the samples for histopathological examination and correlate before opining the age of injury. PMID:28418938

  5. Investigating the use of quick response codes in the gross anatomy laboratory.

    PubMed

    Traser, Courtney J; Hoffman, Leslie A; Seifert, Mark F; Wilson, Adam B

    2015-01-01

    The use of quick response (QR) codes within undergraduate university courses is on the rise, yet literature concerning their use in medical education is scant. This study examined student perceptions on the usefulness of QR codes as learning aids in a medical gross anatomy course, statistically analyzed whether this learning aid impacted student performance, and evaluated whether performance could be explained by the frequency of QR code usage. Question prompts and QR codes tagged on cadaveric specimens and models were available for four weeks as learning aids to medical (n = 155) and doctor of physical therapy (n = 39) students. Each QR code provided answers to posed questions in the form of embedded text or hyperlinked web pages. Students' perceptions were gathered using a formative questionnaire and practical examination scores were used to assess potential gains in student achievement. Overall, students responded positively to the use of QR codes in the gross anatomy laboratory as 89% (57/64) agreed the codes augmented their learning of anatomy. The users' most noticeable objection to using QR codes was the reluctance to bring their smartphones into the gross anatomy laboratory. A comparison between the performance of QR code users and non-users was found to be nonsignificant (P = 0.113), and no significant gains in performance (P = 0.302) were observed after the intervention. Learners welcomed the implementation of QR code technology in the gross anatomy laboratory, yet this intervention had no apparent effect on practical examination performance. © 2014 American Association of Anatomists.

  6. Gross Motor Development in Children Aged 3-5 Years, United States 2012.

    PubMed

    Kit, Brian K; Akinbami, Lara J; Isfahani, Neda Sarafrazi; Ulrich, Dale A

    2017-07-01

    Objective Gross motor development in early childhood is important in fostering greater interaction with the environment. The purpose of this study is to describe gross motor skills among US children aged 3-5 years using the Test of Gross Motor Development (TGMD-2). Methods We used 2012 NHANES National Youth Fitness Survey (NNYFS) data, which included TGMD-2 scores obtained according to an established protocol. Outcome measures included locomotor and object control raw and age-standardized scores. Means and standard errors were calculated for demographic and weight status with SUDAAN using sample weights to calculate nationally representative estimates, and survey design variables to account for the complex sampling methods. Results The sample included 339 children aged 3-5 years. As expected, locomotor and object control raw scores increased with age. Overall mean standardized scores for locomotor and object control were similar to the mean value previously determined using a normative sample. Girls had a higher mean locomotor, but not mean object control, standardized score than boys (p < 0.05). However, the mean locomotor standardized scores for both boys and girls fell into the range categorized as "average." There were no other differences by age, race/Hispanic origin, weight status, or income in either of the subtest standardized scores (p > 0.05). Conclusions In a nationally representative sample of US children aged 3-5 years, TGMD-2 mean locomotor and object control standardized scores were similar to the established mean. These results suggest that standardized gross motor development among young children generally did not differ by demographic or weight status.

  7. The relationship between body mass index and gross motor development in children aged 3 to 5 years.

    PubMed

    Nervik, Deborah; Martin, Kathy; Rundquist, Peter; Cleland, Joshua

    2011-01-01

    To investigate the relationship between obesity and gross motor development in children who are developing typically and determine whether body mass index (BMI) predicts difficulty in gross motor skills. BMIs were calculated and gross motor skills examined in 50 children who were healthy aged 3 to 5 years using the Peabody Developmental Motor Scales, 2nd edition (PDMS-2). Pearson chi-square statistic and stepwise linear hierarchical regression were used for analysis. A total of 24% of the children were overweight/obese, whereas 76% were found not to be overweight/obese. Fifty-eight percent of the overweight/obese group scored below average on the PDMS-2 compared to 15% of the nonoverweight group. Association between BMI and gross motor quotients was identified with significance of less than 0.002. Regression results were nonsignificant with all 50 subjects, yet showed significance (P = 0.018) when an outlier was excluded. Children aged 3 to 5 years with high BMIs may have difficulty with their gross motor skills. Further research is needed.

  8. Bladder cancer in patients with spinal cord injury.

    PubMed

    Hess, Marika J; Zhan, Ellen H; Foo, Dominic K; Yalla, Subbarao V

    2003-01-01

    The incidence of bladder cancer in spinal cord injury (SCI) is 16 to 28 times higher than that in the general population. The objective of this study was to investigate the characteristics of bladder cancer that are unique to the SCI population. Retrospective review. The charts of 16 patients diagnosed with bladder cancer from 1982 to 2001 were reviewed for type of cancer, exposure to risk factors, presenting symptoms, and survival time. The presenting manifestations were gross hematuria in 14 patients, papillary urethral growth in 1 patient, and acute obstructive renal failure in 1 patient. The diagnosis was made on initial cystoscopic evaluation in 16 patients; 3 patients required further evaluation. Eight of the 11 screening cytologies were suspicious for a malignancy prior to the diagnosis. Seven patients had transitional cell carcinoma, 6 patients had squamous cell carcinoma (SCCA), and 3 patients had both. The bladder wasmanaged with chronic indwelling catheter in 12 patients. Nine patients died of bladder cancer metastases and the remaining 3 patients died of other causes. Six patients survived 5 years or more; 4 were still alive at the completion of this study. Gross hematuria in individuals with SCI warrants aggressive assessment for bladder cancer. Chronic indwelling catheter, smoking, and renal and bladder stones are important risk factors for cancer. The incidence of SCCA in the SCI popullation is much higher than in the general population. Cystoscopic and cytologic evaluation in patients with advanced disease may fail to confirm the diagnosis in a high proportion of patients.

  9. Attitudes of Healthcare Students on Gross Anatomy Laboratory Sessions

    ERIC Educational Resources Information Center

    Kawashiro, Yukiko; Anahara, Reiko; Kohno, Toshihiko; Mori, Chisato; Matsuno, Yoshiharu

    2009-01-01

    At Chiba University, gross anatomy laboratory sessions ("laboratories") are required for physical therapy students. Though most physical therapy schools require their students to participate in laboratories so that they will better understand the structure of the human body, few data exist on the value of these laboratories specifically…

  10. Gross motor skill performance in children with and without visual impairments--research to practice.

    PubMed

    Wagner, Matthias O; Haibach, Pamela S; Lieberman, Lauren J

    2013-10-01

    The aim of this study was to provide an empirical basis for teaching gross motor skills in children with visual impairments. For this purpose, gross motor skill performance of 23, 6-12 year old, boys and girls who are blind (ICD-10 H54.0) and 28 sighted controls with comparable age and gender characteristics was compared on six locomotor and six object control tasks using the Test of Gross Motor Development-Second Edition. Results indicate that children who are blind perform significantly (p<.05) worse in all assessed locomotor and object control skills, whereby running, leaping, kicking and catching are the most affected skills, and corresponding differences are related to most running, leaping, kicking and catching component. Practical implications are provided. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Effect of cerebrolysin on gross motor function of children with cerebral palsy: a clinical trial.

    PubMed

    Nasiri, Jafar; Safavifar, Faezeh

    2017-06-01

    Gross motor dysfunction is considered as the most challenging problem in cerebral palsy (CP). It is proven that improvement of gross motor function could reduce CP-related disabilities and provide better quality of life in this group of patients. Therefore, the aim of this trial is to evaluate the effectiveness of cerebrolysin (CBL) on gross motor function of children with CP who are undergoing treatment. In this clinical trial study, paediatric patients aged 18-75 months with spastic diplegic or quadriplegic cerebral palsy, who were under rehabilitation therapy, were selected and randomly allocated in control and CBL groups. Patients in CBL group underwent treatment with standard rehabilitation therapy plus CBL. The latter was administrated intramuscularly as a single daily dose of 0.1 cc/kg for 10 days and then continued weekly for 4 months. Gross motor function of participants in the two studied groups, before and after trial, was evaluated and compared using the validated Persian version of gross motor function classification system-expanded and revised (GMFCS-E&R). During this trial, 108 patients with CP were evaluated for eligibility. From these, 50 patients were enrolled and randomly allocated in the CBL and control groups. Four months after trial, the mean level of GMFCS decreased significantly in the two groups (P < 0.05). However, it was significantly lower in the CBL group than in the control group (2.1 vs. 3.16, P < 0.05). The results of this trial indicated that CBL could improve gross motor function in patients with CP. This finding is consistent with neurotrophic and neuroprotective effects of CBL, which have been reported in various clinical trials in other neurological disorders. Further studies are recommended to establish the value of continued neuroprotection and to determine the pharmacokinetics/dynamics of CBL in this group of patients.

  12. Relationship between communication skills and gross motor function in preschool-aged children with cerebral palsy.

    PubMed

    Coleman, Andrea; Weir, Kelly A; Ware, Robert S; Boyd, Roslyn N

    2013-11-01

    To explore the communication skills of children with cerebral palsy (CP) at 24 months' corrected age with reference to typically developing children, and to determine the relationship between communication ability, gross motor function, and other comorbidities associated with CP. Prospective, cross-sectional, population-based cohort study. General community. Children with CP (N=124; mean age, 24mo; functional severity on Gross Motor Function Classification System [GMFCS]: I=47, II=14, III=22, IV=19, V=22). Not applicable. Parents reported communication skills on the Communication and Symbolic Behavior Scales Developmental Profile (CSBS-DP) Infant-Toddler Checklist. Two independent physiotherapists classified motor type, distribution, and GMFCS. Data on comorbidities were obtained from parent interviews and medical records. Children with mild CP (GMFCS I/II) had mean CSBS-DP scores that were 0.5 to 0.6 SD below the mean for typically developing peers, while those with moderate-severe impairment (GMFCS III-V) were 1.4 to 2.6 SD below the mean. GMFCS was significantly associated with performance on the CSBS-DP (F=18.55, P<.001), with gross motor ability accounting for 38% of the variation in communication. Poorer communication was strongly associated with gross motor function and full-term birth. Preschool-aged children with CP, with more severe gross motor impairment, showed delayed communication, while children with mild motor impairment were less vulnerable. Term-born children had significantly poorer communication than those born prematurely. Because a portion of each gross motor functional severity level is at risk, this study reinforces the need for early monitoring of communication development for all children with CP. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Relationship between habitual physical activity and gross motor skills is multifaceted in 5- to 8-year-old children.

    PubMed

    Laukkanen, A; Pesola, A; Havu, M; Sääkslahti, A; Finni, T

    2014-04-01

    Adequate motor skills are essential for children participating in age-related physical activities, and gross motor skills may play an important role for maintaining sufficient level of physical activity (PA) during life course. The purpose of this study was to examine the relationship between gross motor skills and PA in children when PA was analyzed by both metabolic- and neuromuscular-based methods. Gross motor skills (KTK--Körperkoordinationstest für Kinder and APM inventory--manipulative skill test) of 84 children aged 5-8 years (53 preschoolers, 28 girls; 31 primary schoolers, 18 girls) were measured, and accelerometer-derived PA was analyzed using in parallel metabolic counts and neuromuscular impact methods. The gross motor skills were associated with moderate-to-high neuromuscular impacts, PA of vigorous metabolic intensity, and mean level of PA in primary school girls (0.5 < r < 0.7, P < 0.05), and with high impacts in preschool girls (0.3 < r < 0.5, P < 0.05). In preschool boys, moderate impacts, light-to-vigorous PA, and mean level of PA were associated with gross motor skills (0.4 < r < 0.7, P < 0.05). In conclusion, the result emphasizes an important relationship between gross motor skills and PA stressing both metabolic and neuromuscular systems in children. Furthermore, PA highly stressing neuromuscular system interacts with gross motor proficiency in girls especially. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Relationship Between Broiler Body Weights, Eimeria maxima Gross Lesion Scores, and Microscores in Three Anticoccidial Sensitivity Tests.

    PubMed

    Barrios, Miguel A; Da Costa, Manuel; Kimminau, Emily; Fuller, Lorraine; Clark, Steven; Pesti, Gene; Beckstead, Robert

    2017-06-01

    Anticoccidial sensitivity tests (ASTs) serve to determine the efficacy of anticoccidial drugs against Eimeria field isolates in a controlled laboratory setting. The most commonly measured parameters are body weight gain, feed conversion ratio, gross intestinal lesion scores, and mortality. Due to the difficulty in reliably scoring gross lesion scores of Eimeria maxima , microscopic analysis of intestinal scrapings (microscores) can be used in the field to indicate the presence of this particular Eimeria. The goal of this study was to determine the relationship between E. maxima microscores and broiler body weights and gross E. maxima lesion scores in three ASTs. Day-old broiler chicks were raised for 12 days on a standard corn-soy diet. On Day 12, chicks were placed in Petersime batteries and treatment diets were provided. There were six birds per pen, four pens per treatment, and 12 treatments, for a total of 288 chicks per AST. The treatments were as follows: 1) nonmedicated, noninfected; 2) nonmedicated, infected; 3) lasalocid, infected; 4) salinomycin, infected; 5) diclazuril, infected; 6) monensin, infected; 7) decoquinate, infected; 8) narasin + nicarbazin, infected; 9) narasin, infected; 10) nicarbazin, infected; 11) robenidine, infected; and 12) zoalene, infected. On Day 14, chicks were challenged with an Eimeria field isolate by oral gavage. On Day 20, broilers were weighed, and gross lesion scores and microscores were classified from 0 to 4 depending on the severity of the gross lesion scores and E. maxima microscores. Data from three trials using different field isolates were statistically analyzed using a logarithmic regression model. There was no relationship (P = 0.1224) between microscores and body weight gain. There was a positive relationship between microscores and gross lesion scores (P = 0.004). However, there was also an interaction between isolate and treatment (P < 0.0001). Lastly, the interaction between isolate and gross lesion scores (P

  15. Early postoperative physical therapy for improving short-term gross motor outcome in infants with cyanotic and acyanotic congenital heart disease.

    PubMed

    Haseba, Sumihito; Sakakima, Harutoshi; Nakao, Syuhei; Ohira, Misaki; Yanagi, Shigefumi; Imoto, Yutaka; Yoshida, Akira; Shimodozono, Megumi

    2018-07-01

    We analysed the gross motor recovery of infants and toddlers with cyanotic and acyanotic congenital heart disease (CHD) who received early postoperative physical therapy to see whether there was any difference in the duration to recovery. This study retrospectively evaluated the influence of early physical therapy on postoperative gross motor outcomes of patients with CHD. The gross motor ability of patients with cyanotic (n = 25, average age: 376.4 days) and acyanotic (n = 26, average age: 164.5 days) CHD was evaluated using our newly developed nine-grade mobility assessment scale. Physical therapy was started at an average of five days after surgery, during which each patient's gross motor ability was significantly decreased compared with the preoperative level. Patients (who received early postoperative physical therapy) with cyanotic (88.0%) and acyanotic CHD (96.2%) showed improved preoperative mobility grades by the time of hospital discharge. However, patients with cyanotic CHD had a significantly prolonged recovery period compared to those with acyanotic CHD (p < .01). The postoperative recovery period to preoperative mobility grade was significantly correlated with pre-, intra-, and postoperative factors. Our findings suggested that infants with cyanotic CHD are likely at a greater risk of gross motor delays, the recovery of which might differ between infants with cyanotic and acyanotic CHD after cardiac surgery. Early postoperative physical therapy promotes gross motor recovery. Implications of Rehabilitation Infants and toddlers with cyanotic congenital heart disease are likely at greater risk of gross motor delays and have a prolonged recovery period of gross motor ability compared to those with acyanotic congenital heart disease. Early postoperative physical therapy for patients with congenital heart disease after cardiac surgery promoted gross motor recovery. The postoperative recovery period to preoperative mobility grade was affected

  16. Evaluation of the contributions of four components of gross domestic product in various regions in China.

    PubMed

    Wu, Sanmang; Lei, Yalin; Li, Li

    2015-01-01

    Four major components influence the growth of the gross domestic product in Chinese provinces: consumption, investment, transnational exports, and inter-provincial exports. By splitting a competitive input-output table into a non-competitive input-output table, this study used an input-output model to measure the contributions of the four components of gross domestic product in various regions in China. We found that international exports drove the growth of the gross domestic product more strongly in the eastern region than in other regions. Investment and inter-provincial exports were the major impetus for gross domestic product growth in the central and western regions. We also found that consumption played a minimal role in driving the growth of the gross domestic product in all regions in China. According to these findings, although various regions can share much in terms of policies to transform the impetus for economic growth, there should be different foci for different regions. Their shared policy is to increase the role of final consumption in stimulating economic growth. Region-specific policies mandate that the eastern region should strengthen the driving force provided by international exports and that the central and western regions should strengthen indigenous growth capabilities by improving scientific innovation, industrial support, and institutional innovation.

  17. Evaluation of the Contributions of Four Components of Gross Domestic Product in Various Regions in China

    PubMed Central

    Wu, Sanmang; Lei, Yalin; Li, Li

    2015-01-01

    Four major components influence the growth of the gross domestic product in Chinese provinces: consumption, investment, transnational exports, and inter-provincial exports. By splitting a competitive input-output table into a non-competitive input-output table, this study used an input-output model to measure the contributions of the four components of gross domestic product in various regions in China. We found that international exports drove the growth of the gross domestic product more strongly in the eastern region than in other regions. Investment and inter-provincial exports were the major impetus for gross domestic product growth in the central and western regions. We also found that consumption played a minimal role in driving the growth of the gross domestic product in all regions in China. According to these findings, although various regions can share much in terms of policies to transform the impetus for economic growth, there should be different foci for different regions. Their shared policy is to increase the role of final consumption in stimulating economic growth. Region-specific policies mandate that the eastern region should strengthen the driving force provided by international exports and that the central and western regions should strengthen indigenous growth capabilities by improving scientific innovation, industrial support, and institutional innovation. PMID:25915927

  18. Effective Collaboration among the Gross Motor Assessment Team Members

    ERIC Educational Resources Information Center

    Menear, Kristi S.; Davis, Timothy D.

    2015-01-01

    This article describes the gross motor assessment team (GMAT) members' roles and collaborative approach to making appropriate decisions and modifications when addressing the needs of individuals with disabilities in physical education. Case studies of students are used to demonstrate effective uses of the GMAT. The primary outcome of the GMAT's…

  19. Neonatal stroke causes poor midline motor behaviors and poor fine and gross motor skills during early infancy.

    PubMed

    Chen, Chao-Ying; Lo, Warren D; Heathcock, Jill C

    2013-03-01

    Upper extremity movements, midline behaviors, fine, and gross motor skills are frequently impaired in hemiparesis and cerebral palsy. We investigated midline toy exploration and fine and gross motor skills in infants at risk for hemiplegic cerebral palsy. Eight infants with neonatal stroke (NS) and thirteen infants with typical development (TD) were assessed from 2 to 7 months of age. The following variables were analyzed: percentage of time in midline and fine and gross motor scores on the Bayley Scales of Infant Development (BSID-III). Infants with neonatal stroke demonstrated poor performance in midline behaviors and fine and gross motor scores on the BSID-III. These results suggest that infants with NS have poor midline behaviors and motor skill development early in infancy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. The Effects of Basketball Basic Skills Training on Gross Motor Skills Development of Female Children

    ERIC Educational Resources Information Center

    Bayazit, Betul

    2015-01-01

    The purpose of this study was to investigate the effects of basketball basic skills training on gross motor skills development of female children in Turkey. For that purpose, 40 female children took part in the study voluntarily. Basketball basic skills test was used to improve the gross motor skills of the female children in the study. Also,…

  1. Hyperbaric oxygen: Primary treatment of radiation-induced hemorrhagic cystitis

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

    Weiss, J.P.; Neville, E.C.

    Of 8 patients with symptoms of advanced cystitis due to pelvic radiation treated with hyperbaric oxygen 7 are persistently improved during followup. All 6 patients treated for gross hematuria requiring hospitalization have been free of symptoms for an average of 24 months (range 6 to 43 months). One patient treated for stress incontinence currently is dry despite little change in bladder capacity, implying salutary effect from hyperbaric oxygen on the sphincter mechanism. One patient with radiation-induced prostatitis failed to respond. This experience suggests that hyperbaric oxygen should be considered the primary treatment for patients with symptomatic radiation-induced hemorrhagic cystitis.

  2. Pure Small Cell Carcinoma of the Bladder: A Case Report

    PubMed Central

    Trabelsi, Amel; Abdelkrim, Soumaya Ben; Tebra, Samah; Gharbi, Olfa; Jaidane, Lilia; Bouaouina, Noureddine; Abbassi, Dajla Bakir; Mokni, Moncef

    2010-01-01

    Small cell carcinoma of the urinary bladder is an uncommon tumor that has been described in case reports or small series. We report a new case in a 67-year-old male who presented with gross hematuria and irritative symptoms. Cystoscopy revealed an extensive mass of the bladder and computed tomography scan showed an important thickening of the bladder wall. Diagnosis of small cell carcinoma was established after radical cystectomy and microscopic examination. The patient received pelvic hemostatic radiotherapy and platinium-based chemotherapy. Three months after the diagnosis, he developed bone, renal and adrenal metastases. PMID:29147197

  3. Gross Motor Skill Acquisition in Adolescents with Down Syndrome

    ERIC Educational Resources Information Center

    Meegan, Sarah; Maraj, Brian K. V.; Weeks, Daniel; Chua, Romeo

    2006-01-01

    The purpose of this study was to assess whether verbal-motor performances deficits exhibited by individuals with Down syndrome limited their ability to acquire gross motor skills when given visual and verbal instruction together and then transferred to either a visual or verbal instructional mode to reproduce the movement. Nine individuals with…

  4. Investigating the correlation between paediatric stride interval persistence and gross energy expenditure.

    PubMed

    Fairley, Jillian A; Sejdić, Ervin; Chau, Tom

    2010-02-26

    Stride interval persistence, a term used to describe the correlation structure of stride interval time series, is thought to provide insight into neuromotor control, though its exact clinical meaning has not yet been realized. Since human locomotion is shaped by energy efficient movements, it has been hypothesized that stride interval dynamics and energy expenditure may be inherently tied, both having demonstrated similar sensitivities to age, disease, and pace-constrained walking. This study tested for correlations between stride interval persistence and measures of energy expenditure including mass-specific gross oxygen consumption per minute (VO₂), mass-specific gross oxygen cost per meter (VO₂) and heart rate (HR). Metabolic and stride interval data were collected from 30 asymptomatic children who completed one 10-minute walking trial under each of the following conditions: (i) overground walking, (ii) hands-free treadmill walking, and (iii) handrail-supported treadmill walking. Stride interval persistence was not significantly correlated with (p > 0.32), VO₂ (p > 0.18) or HR (p > 0.56). No simple linear dependence exists between stride interval persistence and measures of gross energy expenditure in asymptomatic children when walking overground and on a treadmill.

  5. The chemokine CXCL12 mediates the anti-amyloidogenic action of painless human nerve growth factor.

    PubMed

    Capsoni, Simona; Malerba, Francesca; Carucci, Nicola Maria; Rizzi, Caterina; Criscuolo, Chiara; Origlia, Nicola; Calvello, Mariantonietta; Viegi, Alessandro; Meli, Giovanni; Cattaneo, Antonino

    2017-01-01

    Nerve growth factor is a therapeutic candidate for Alzheimer's disease. Due to its pain-inducing activity, in current clinical trials nerve growth factor is delivered locally into the brain by neurosurgery, but data on the efficacy of local nerve growth factor delivery in decreasing amyloid-β deposition are not available. To reduce the nerve growth factor pain-inducing side effects, thus avoiding the need for local brain injection, we developed human painless nerve growth factor (hNGFp), inspired by the human genetic disease hereditary sensory and autonomic neuropathy type V. hNGFp has identical neurotrophic potency as wild-type human nerve growth factor, but a 10-fold lower pain sensitizing activity. In this study we first mimicked, in the 5xFAD mouse model, the intraparenchymal delivery of hNGFp used in clinical trials and found it to be ineffective in decreasing amyloid-β plaque load. On the contrary, the same dose of hNGFp delivered intranasally, which was widely biodistributed in the brain and did not induce pain, showed a potent anti-amyloidogenic action and rescued synaptic plasticity and memory deficits. We found that hNGFp acts on glial cells, modulating inflammatory proteins such as the soluble TNFα receptor II and the chemokine CXCL12. We further established that the rescuing effect by hNGFp is mediated by CXCL12, as pharmacological inhibition of CXCL12 receptor CXCR4 occludes most of hNGFp effects. These findings have significant therapeutic implications: (i) we established that a widespread exposure of the brain is required for nerve growth factor to fully exert its neuroprotective actions; and (ii) we have identified a new anti-neurodegenerative pathway as a broad target for new therapeutic opportunities for neurodegenerative diseases. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain.

  6. Magnetic air capsule robotic system: proof of concept of a novel approach for painless colonoscopy.

    PubMed

    Valdastri, P; Ciuti, G; Verbeni, A; Menciassi, A; Dario, P; Arezzo, A; Morino, M

    2012-05-01

    Despite being considered the most effective method for colorectal cancer diagnosis, colonoscopy take-up as a mass-screening procedure is limited mainly due to invasiveness, patient discomfort, fear of pain, and the need for sedation. In an effort to mitigate some of the disadvantages associated with colonoscopy, this work provides a preliminary assessment of a novel endoscopic device consisting in a softly tethered capsule for painless colonoscopy under robotic magnetic steering. The proposed platform consists of the endoscopic device, a robotic unit, and a control box. In contrast to the traditional insertion method (i.e., pushing from behind), a "front-wheel" propulsion approach is proposed. A compliant tether connecting the device to an external box is used to provide insufflation, passing a flexible operative tool, enabling lens cleaning, and operating the vision module. To assess the diagnostic and treatment ability of the platform, 12 users were asked to find and remove artificially implanted beads as polyp surrogates in an ex vivo model. In vivo testing consisted of a qualitative study of the platform in pigs, focusing on active locomotion, diagnostic and therapeutic capabilities, safety, and usability. The mean percentage of beads identified by each user during ex vivo trials was 85 ± 11%. All the identified beads were removed successfully using the polypectomy loop. The mean completion time for accomplishing the entire procedure was 678 ± 179 s. No immediate mucosal damage, acute complications such as perforation, or delayed adverse consequences were observed following application of the proposed method in vivo. Use of the proposed platform in ex vivo and preliminary animal studies indicates that it is safe and operates effectively in a manner similar to a standard colonoscope. These studies served to demonstrate the platform's added advantages of reduced size, front-wheel drive strategy, and robotic control over locomotion and orientation.

  7. Gross anatomy education for South African undergraduate physiotherapy students.

    PubMed

    Shead, Dorothy A; Roos, Ronel; Olivier, Benita; Ihunwo, Amadi O

    2018-01-16

    Eight faculties in South Africa offer undergraduate physiotherapy training with gross anatomy included as a basis for clinical practice. Little information exists about anatomy education for this student body. A 42-question peer-reviewed survey was distributed to physiotherapy gross anatomy course coordinators in all the eight faculties. Seven coordinators from six (75%) of the universities responded. Two respondents' data from the same university were pooled. Collected data show that staff qualifications and experience varied widely and high to average staff to student ratios exist between faculties. Direct anatomy teaching duration was 12.3 (SD ±5.2) weeks per semester. Total number of weeks in courses per faculty was 27.6 (SD ±5.7) varying widely between institutions. Calculable direct contact anatomy hours ranged between 100 and 308 with a mean of 207.6 (SD ±78.1). Direct contact hours in lectures averaged 3.9 (SD ±1.6) per week and the average direct contact hours in practical sessions were 3.5 (SD ±1.8) per week. Dissection, prosection, plastinated models, surface anatomy, and e-learning were available across faculties. Ancillary modalities such as vertical integration and inter-professional learning were in use. All faculties had multiple-choice questions, spot tests, and short examination questions. Half had viva-voce examinations and one had additional long questions assessment. Students evaluated teaching performance in five faculties. Four faculties were reviewing anatomy programs to consider implementing changes to anatomy curriculum or pedagogy. The findings highlighted disparity between programs and also identified the need for specific guidelines to develop a unified South African gross anatomy course for physiotherapy students. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

  8. The Case History Method of Testing Students in Gross Anatomy.

    ERIC Educational Resources Information Center

    Cruise, Leon J.

    1980-01-01

    The use of case histories to test a student's knowledge of the previous weeks' dissection in gross anatomy class is discussed. The test is seen as a way to integrate other basic sciences. An example of this type of test is provided. (MLW)

  9. Multiscale analyses of solar-induced florescence and gross primary production

    USDA-ARS?s Scientific Manuscript database

    Remotely sensed solar induced fluorescence (SIF) has shown great promise for probing spatiotemporal variations in terrestrial gross primary production (GPP), the largest component flux of the global carbon cycle. However, scale mismatches between SIF and ground-based GPP have posed challenges toward...

  10. 26 CFR 1.61-4 - Gross income of farmers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... from the sale of livestock and produce which he raised, (2) The profits from the sale of any livestock... received which must be considered as income, and (5) Gross income from all other sources. The profit from... purchased animals held for draft, breeding, or dairy purposes, the profits shall be the amount of any excess...

  11. 26 CFR 1.61-4 - Gross income of farmers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... from the sale of livestock and produce which he raised, (2) The profits from the sale of any livestock... received which must be considered as income, and (5) Gross income from all other sources. The profit from... purchased animals held for draft, breeding, or dairy purposes, the profits shall be the amount of any excess...

  12. 26 CFR 1.61-4 - Gross income of farmers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... from the sale of livestock and produce which he raised, (2) The profits from the sale of any livestock... received which must be considered as income, and (5) Gross income from all other sources. The profit from... purchased animals held for draft, breeding, or dairy purposes, the profits shall be the amount of any excess...

  13. 26 CFR 1.61-4 - Gross income of farmers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... from the sale of livestock and produce which he raised, (2) The profits from the sale of any livestock... received which must be considered as income, and (5) Gross income from all other sources. The profit from... purchased animals held for draft, breeding, or dairy purposes, the profits shall be the amount of any excess...

  14. 26 CFR 1.61-4 - Gross income of farmers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... from the sale of livestock and produce which he raised, (2) The profits from the sale of any livestock... received which must be considered as income, and (5) Gross income from all other sources. The profit from... purchased animals held for draft, breeding, or dairy purposes, the profits shall be the amount of any excess...

  15. Outcomes of a Rotational Dissection System in Gross Anatomy

    ERIC Educational Resources Information Center

    Marshak, David W.; Oakes, Joanne; Hsieh, Pei-Hsuan; Chuang, Alice Z.; Cleary, Leonard J.

    2015-01-01

    At the University of Texas Houston Medical School, a rotational dissection system was introduced to improve coordination between the Gross Anatomy and the Introduction to Clinical Medicine (ICM) courses. Six students were assigned to each cadaver and divided into two teams. For each laboratory, one team was assigned to dissect and the other to…

  16. Resilience Does Not Predict Academic Performance in Gross Anatomy

    ERIC Educational Resources Information Center

    Elizondo-Omana, Rodrigo Enrique; Garcia-Rodriguez, Maria de los Angeles; Hinojosa-Amaya, Jose Miguel; Villarreal-Silva, Eliud Enrique; Avilan, Rosa Ivette Guzman; Cruz, Juan Jose Bazaldua; Guzman-Lopez, Santos

    2010-01-01

    Few studies have evaluated resilience in an academic environment as it relates to academic success or failure. This work sought to assess resilience in regular and remedial students of gross anatomy during the first and second semesters of medical school and to correlate this personal trait with academic performance. Two groups of students were…

  17. Development of the Gross Motor Function Classification System (1997)

    ERIC Educational Resources Information Center

    Morris, Christopher

    2008-01-01

    To address the need for a standardized system to classify the gross motor function of children with cerebral palsy, the authors developed a five-level classification system analogous to the staging and grading systems used in medicine. Nominal group process and Delphi survey consensus methods were used to examine content validity and revise the…

  18. Scattering for the 3D Gross-Pitaevskii Equation

    NASA Astrophysics Data System (ADS)

    Guo, Zihua; Hani, Zaher; Nakanishi, Kenji

    2017-11-01

    We study the Cauchy problem for the 3D Gross-Pitaevskii equation. The global well-posedness in the natural energy space was proved by Gérard (Ann. Inst. H. Poincaré Anal. Non Linéaire 23(5):765-779, 2006). In this paper we prove scattering for small data in the same space with some additional angular regularity, and in particular in the radial case we obtain small energy scattering.

  19. Preferred sleep position and gross motor achievement in early infancy.

    PubMed

    Carmeli, Eli; Marmur, Rachel; Cohen, Ayala; Tirosh, Emanuel

    2009-06-01

    The aim of this study was to assess the effect of an infant's favoured position on their motor development at the age of six months. Seventy-five full-term infants were prospectively observed at home for their preferred sleep, awake, play and uninterrupted positions. A parental log was completed daily and then weekly up to the age of six months, when the Alberta Infant Motor Scale (AIMS) was administered. No significant relationship between the preferred or sleep positions as well as the awake and mutual play positions and gross motor developmental attainment at six months of age was noted. A significant change in the preferred recumbent posture with increased prone positioning both during sleep and awake time over the first six months was noted. A balanced positioning policy while awake, regardless of the infant's preference while recumbent, is not associated with gross motor delay.

  20. The relationship between gross motor skills and academic achievement in children with learning disabilities.

    PubMed

    Westendorp, Marieke; Hartman, Esther; Houwen, Suzanne; Smith, Joanne; Visscher, Chris

    2011-01-01

    The present study compared the gross motor skills of 7- to 12-year-old children with learning disabilities (n = 104) with those of age-matched typically developing children (n = 104) using the Test of Gross Motor Development-2. Additionally, the specific relationships between subsets of gross motor skills and academic performance in reading, spelling, and mathematics were examined in children with learning disabilities. As expected, the children with learning disabilities scored poorer on both the locomotor and object-control subtests than their typically developing peers. Furthermore, in children with learning disabilities a specific relationship was observed between reading and locomotor skills and a trend was found for a relationship between mathematics and object-control skills: the larger children's learning lag, the poorer their motor skill scores. This study stresses the importance of specific interventions facilitating both motor and academic abilities. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Jung's twin brother. Otto Gross and Carl Gustav Jung. With an hitherto unpublished letter by C. G. Jung.

    PubMed

    Heuer, G

    2001-10-01

    This paper is a preliminary communication of several years of research into the life and work of the Austrian psychoanalyst and anarchist Otto Gross (1877-1920). Although he played a pivotal role in the birth of modernity, acting as a significant influence upon psychiatry, psychoanalysis, ethics, sociology and literature, he has remained virtually unknown to this day. Following a biographical sketch and an overview of his main theoretical contributions, the impact of Gross' life and work on the development of analytical theory and practice is described. His relationship with some of the key figures in psychoanalysis is presented, with particular emphasis on his connections to Jung. The paper concludes with an account of relevant contemporary interest in his work: the founding of the International Otto Gross Society, the first edition of The Collected Works of Otto Gross on the Internet, and the 1st and 2nd International Otto Gross Congresses which took place in Berlin in 1999 and at the Burghölzli Clinic, Zürich, in October 2000.

  2. Gross motor function change after multilevel soft tissue release in children with cerebral palsy.

    PubMed

    Chang, Chia-Hsieh; Chen, Yu-Ying; Yeh, Kuo-Kuang; Chen, Chia-Ling

    2017-06-01

    Improving motor function is a major goal of therapy for children with cerebral palsy (CP). However, changes in motor function after orthopedic surgery for gait disorders are seldom discussed. This study aimed to evaluate the postoperative changes in gross motor function and to investigate the prognostic factors for such changes. We prospectively studied 25 children with CP (4-12 years) who were gross motor function classification system (GMFCS) level II to IV and and underwent bilateral multilevel soft-tissue release for knee flexion gait. Patients were evaluated preoperatively and at 6 weeks and 3 and 6 months postoperatively for Gross Motor Function Measure (GMFM-66), range of motion, spasticity, and selective motor control. The associations between change in GMFM-66 score and possible factors were analyzed. 25 children with gross motor function level II to IV underwent surgery at a mean age of 8.6 years (range, 4-12 years). Mean GMFM-66 score decreased from 55.9 at baseline to 54.3 at 6-weeks postoperatively and increased to 57.5 at 6-months postoperatively (p < 0.05). Regression analysis revealed better gross motor function level and greater surgical reduction of spasticity were predictors for decreased GMFM-66 score at 6-weeks postoperatively. Younger age was a predictor for increased GMFM-66 score at 6-months postoperatively. Reduction of contracture and spasticity and improvement of selective motor control were noted after surgery in children with CP. However, a down-and-up course of GMFM-66 score was noted. It is emphasized that deterioration of motor function in children with ambulatory ability and the improvement in young children after orthopedic surgery for gait disorders. case series, therapeutic study, level 4. Copyright © 2017 Chang Gung University. Published by Elsevier B.V. All rights reserved.

  3. Brief Assessment of Motor Function: Content Validity and Reliability of the Upper Extremity Gross Motor Scale

    ERIC Educational Resources Information Center

    Cintas, Holly Lea; Parks, Rebecca; Don, Sarah; Gerber, Lynn

    2011-01-01

    Content validity and reliability of the Brief Assessment of Motor Function (BAMF) Upper Extremity Gross Motor Scale (UEGMS) were evaluated in this prospective, descriptive study. The UEGMS is one of five BAMF ordinal scales designed for quick documentation of gross, fine, and oral motor skill levels. Designed to be independent of age and…

  4. 76 FR 43896 - Safety Zone; Kathleen Whelan Wedding Fireworks, Lake St. Clair, Grosse Pointe Farms, MI

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ...-AA00 Safety Zone; Kathleen Whelan Wedding Fireworks, Lake St. Clair, Grosse Pointe Farms, MI AGENCY... safety zone on Lake St. Clair, Grosse Pointe Farms, MI. This zone is intended to restrict vessels from a portion of Lake St. Clair during the Kathleen Whelan Wedding Fireworks. DATES: This rule is effective from...

  5. 76 FR 21637 - Safety Zone; Ford Estate Wedding Fireworks, Lake St. Clair, Grosse Pointe Shores, MI

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-18

    ...-AA00 Safety Zone; Ford Estate Wedding Fireworks, Lake St. Clair, Grosse Pointe Shores, MI AGENCY: Coast... zone on Lake St. Clair, Grosse Pointe Shores, MI. This zone is intended to restrict vessels from a portion of Lake St. Clair River during the Ford Estate Wedding Fireworks. DATES: This rule is effective...

  6. A Study on Gross Motor Skills of Preschool Children

    ERIC Educational Resources Information Center

    Wang, Joanne Hui-Tzu

    2004-01-01

    The purpose of this study was to investigate the effects of a creative movement program on gross motor skills of preschool children. Sixty children between the ages of 3 to 5 were drawn from the population of a preschool in Taichung, Taiwan. An experimental pretest-posttest control-group design was utilized. The children enrolled in the…

  7. 26 CFR 1.993-6 - Definition of gross receipts.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... by it in a related foreign export corporation (as defined in § 1.993-5), interest on producer's loans... business, and (2) Gross income recognized from all other sources, such as, for example, from— (i) The... proceeds of a loan or of the repayment of a loan, or (2) A receipt of property in a transaction to which...

  8. 26 CFR 1.993-6 - Definition of gross receipts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... by it in a related foreign export corporation (as defined in § 1.993-5), interest on producer's loans... business, and (2) Gross income recognized from all other sources, such as, for example, from— (i) The... proceeds of a loan or of the repayment of a loan, or (2) A receipt of property in a transaction to which...

  9. 26 CFR 1.993-6 - Definition of gross receipts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... by it in a related foreign export corporation (as defined in § 1.993-5), interest on producer's loans... business, and (2) Gross income recognized from all other sources, such as, for example, from— (i) The... proceeds of a loan or of the repayment of a loan, or (2) A receipt of property in a transaction to which...

  10. 26 CFR 1.993-6 - Definition of gross receipts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... by it in a related foreign export corporation (as defined in § 1.993-5), interest on producer's loans... business, and (2) Gross income recognized from all other sources, such as, for example, from— (i) The... proceeds of a loan or of the repayment of a loan, or (2) A receipt of property in a transaction to which...

  11. Determinants of gross motor skill performance in children with visual impairments.

    PubMed

    Haibach, Pamela S; Wagner, Matthias O; Lieberman, Lauren J

    2014-10-01

    Children with visual impairments (CWVI) generally perform poorer in gross motor skills when compared with their sighted peers. This study examined the influence of age, sex, and severity of visual impairment upon locomotor and object control skills in CWVI. Participants included 100 CWVI from across the United States who completed the Test of Gross Motor Development II (TGMD-II). The TGMD-II consists of 12 gross motor skills including 6 object control skills (catching, kicking, striking, dribbling, throwing, and rolling) and 6 locomotor skills (running, sliding, galloping, leaping, jumping, and hopping). The full range of visual impairments according to United States Association for Blind Athletes (USABA; B3=20/200-20/599, legally blind; B2=20/600 and up, travel vision; B1=totally blind) were assessed. The B1 group performed significantly worse than the B2 (0.000 ≤ p ≤ 0.049) or B3 groups (0.000 ≤ p ≤ 0.005); however, there were no significant differences between B2 and B3 except for the run (p=0.006), catch (p=0.000), and throw (p=0.012). Age and sex did not play an important role in most of the skills, with the exception of boys outperforming girls striking (p=0.009), dribbling (p=0.013), and throwing (p=0.000), and older children outperforming younger children in dribbling (p=0.002). The significant impact of the severity of visual impairment is likely due to decreased experiences and opportunities for children with more severe visual impairments. In addition, it is likely that these reduced experiences explain the lack of age-related differences in the CWVI. The large disparities in performance between children who are blind and their partially sighted peers give direction for instruction and future research. In addition, there is a critical need for intentional and specific instruction on motor skills at a younger age to enable CWVI to develop their gross motor skills. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Gross Motor Function Measure Evolution Ratio: Use as a Control for Natural Progression in Cerebral Palsy.

    PubMed

    Marois, Pierre; Marois, Mikael; Pouliot-Laforte, Annie; Vanasse, Michel; Lambert, Jean; Ballaz, Laurent

    2016-05-01

    To develop a new way to interpret Gross Motor Function Measure (GMFM-66) score improvement in studies conducted without control groups in children with cerebral palsy (CP). The curves, which describe the pattern of motor development according to the children's Gross Motor Function Classification System level, were used as historical control to define the GMFM-66 expected natural evolution in children with CP. These curves have been modeled and generalized to fit the curve to particular children characteristics. Research center. Not applicable. Not applicable. Not applicable. Assuming that the GMFM-66 score evolution followed the shape of the Rosenbaum curves, by taking into account the age and GMFM-66 score of children, the expected natural evolution of the GMFM-66 score was predicted for any group of children with CP who were <8 years old. Because the expected natural evolution could be predicted for a specific group of children with CP, the efficacy of a treatment could be determined by comparing the GMFM-66 score evolution measured before and after treatment with the expected natural evolution for the same period. A new index, the Gross Motor Function Measure Evolution Ratio, was defined as follows: Gross Motor Function Measure Evolution Ratio=measured GMFM-66 score change/expected natural evolution. For practical or ethical reasons, it is almost impossible to use control groups in studies evaluating effectiveness of many therapeutic modalities. The Gross Motor Function Measure Evolution Ratio gives the opportunity to take into account the expected natural evolution of the gross motor function of children with CP, which is essential to accurately interpret the therapy effect on the GMFM-66. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. 46 CFR 171.135 - Weather deck drainage on a vessel of 100 gross tons or more.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Weather deck drainage on a vessel of 100 gross tons or...) SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO VESSELS CARRYING PASSENGERS Drainage of Weather Decks § 171.135 Weather deck drainage on a vessel of 100 gross tons or more. The weather deck must have...

  14. 46 CFR 171.135 - Weather deck drainage on a vessel of 100 gross tons or more.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Weather deck drainage on a vessel of 100 gross tons or...) SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO VESSELS CARRYING PASSENGERS Drainage of Weather Decks § 171.135 Weather deck drainage on a vessel of 100 gross tons or more. The weather deck must have...

  15. 46 CFR 171.135 - Weather deck drainage on a vessel of 100 gross tons or more.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Weather deck drainage on a vessel of 100 gross tons or...) SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO VESSELS CARRYING PASSENGERS Drainage of Weather Decks § 171.135 Weather deck drainage on a vessel of 100 gross tons or more. The weather deck must have...

  16. 46 CFR 171.135 - Weather deck drainage on a vessel of 100 gross tons or more.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Weather deck drainage on a vessel of 100 gross tons or...) SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO VESSELS CARRYING PASSENGERS Drainage of Weather Decks § 171.135 Weather deck drainage on a vessel of 100 gross tons or more. The weather deck must have...

  17. 46 CFR 171.135 - Weather deck drainage on a vessel of 100 gross tons or more.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Weather deck drainage on a vessel of 100 gross tons or...) SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO VESSELS CARRYING PASSENGERS Drainage of Weather Decks § 171.135 Weather deck drainage on a vessel of 100 gross tons or more. The weather deck must have...

  18. Evaluation of an Innovative Hands-On Anatomy-Centered Ultrasound Curriculum to Supplement Graduate Gross Anatomy Education

    ERIC Educational Resources Information Center

    Royer, Danielle F.; Kessler, Ross; Stowell, Jeffrey R.

    2017-01-01

    Ultrasound (US) can enhance anatomy education, yet is incorporated into few non-medical anatomy programs. This study is the first to evaluate the impact of US training in gross anatomy for non-medical students in the United States. All 32 master's students enrolled in gross anatomy with the anatomy-centered ultrasound (ACUS) curriculum were…

  19. Student performance on practical gross anatomy examinations is not affected by assessment modality.

    PubMed

    Meyer, Amanda J; Innes, Stanley I; Stomski, Norman J; Armson, Anthony J

    2016-01-01

    Anatomical education is becoming modernized, not only in its teaching and learning, but also in its assessment formats. Traditional "steeplechase" examinations are being replaced with online gross anatomy examinations. The aims of this study were to: (1) determine if online anatomy practical examinations are equivalent to traditional anatomy practical examinations; and (2) to examine if students' perceptions of the online or laboratory testing environments influenced their performance on the examinations. In phase one, 10 third-year students were interviewed to generate perception items to which five anatomy lecturers assigned content validity. In phase two, students' gross anatomical knowledge was assessed by examinations in two modes and their perceptions were examined using the devised survey instrument. Forty-five second-year chiropractic students voluntarily participated in Phase Two. The two randomly allocated groups completed the examinations in a sequential cross-over manner. Student performance on the gross anatomy examination was not different between traditional "steeplechase" (mean ± standard deviation (SD): 69 ± 11%) and online (68 ± 15%) modes. The majority of students (87%) agreed that they felt comfortable using computers for gross anatomy examinations. However, fewer students found it easy to orientate images of cadaver specimens online. The majority of students (85%) agreed that they felt comfortable working with cadavers but there was less agreement on the effect of moving around the laboratory during practical examinations. This data will allow anatomists to confidently implement online assessments without fear of jeopardizing academic rigor or student performance. © 2015 American Association of Anatomists.

  20. Does Parent Report Gross Motor Function Level of Cerebral Palsy Children Impact on the Quality of Life in these Children?

    PubMed

    Pashmdarfard, Marzieh; Amini, Malek; Badv, Reza Shervin; Ghaffarzade Namazi, Narges; Rassafiani, Mehdi

    2017-01-01

    The aim of this study was to assess the effect of parent report gross motor function level of cerebral palsy (CP) children on the parent report quality of life of CP children. Sampling of this cross-sectional study was done in occupational therapy clinics and CP children's schools in 2016 in Zanjan, Iran. Samples size was 60 CP children aged 6-12 yr and for sampling method, a non-probability convenience was used. For assessing the quality of life of CP children the cerebral palsy quality of life (CP QOL) questionnaire and for assessing the level of gross motor function of CP children the Gross Motor Function Classification System Family Report Questionnaire (GMFCSFRQ) were used. The average age of children (22 males and 30 females) was 8.92 yr old (minimum 6 yr and maximum 12 yr). The relationship between the level of gross motor function and participation and physical health was direct and significant (r=0.65). The relationship between functioning, access to services and family health with the level of gross motor function was direct but was not significant ( P >0.05) and the relationship between pain and impact of disability and emotional well-being with the level of gross motor function was significant ( P <0.05). There was no strong correlation between the level of gross motor function and quality of life of children with cerebral palsy. It means that the level of gross motor function cannot be used as a predictor of quality of life for children with cerebral palsy alone.

  1. Reliability of the test of gross motor development second edition (TGMD-2) for Kindergarten children in Myanmar

    PubMed Central

    Aye, Thanda; Oo, Khin Saw; Khin, Myo Thuzar; Kuramoto-Ahuja, Tsugumi; Maruyama, Hitoshi

    2017-01-01

    [Purpose] The purpose of this study was to investigate reliability of the test of gross motor development second edition (TGMD-2) for Kindergarten children in Myanmar. [Subjects and Methods] Fifty healthy Kindergarten children (23 males, 27 females) whose parents/guardians had given written consent were participated. The subjects were explained and demonstrated all 12 gross motor skills of TGMD-2 before the assessment. Each subject individually performed two trials for each gross motor skill and the performance was video recorded. Three raters separately watched the video recordings and rated for inter-rater reliability. The second assessment was done one month later with 25 out of 50 subjects for test-rest reliability. The video recordings of 12 subjects were randomly selected from the first 50 recordings for intra-rater reliability six weeks after the first assessment. The agreement on the locomotor and object control raw scores and the gross motor quotient (GMQ) were calculated. [Results] The findings of all the reliability coefficients for the locomotor and object control raw scores and the GMQ were interpreted as good and excellent reliability. [Conclusion] The results represented that TGMD-2 is a highly reliable and appropriate assessment tool for assessing gross motor skill development of Kindergarten children in Myanmar. PMID:29184278

  2. Reliability of the test of gross motor development second edition (TGMD-2) for Kindergarten children in Myanmar.

    PubMed

    Aye, Thanda; Oo, Khin Saw; Khin, Myo Thuzar; Kuramoto-Ahuja, Tsugumi; Maruyama, Hitoshi

    2017-10-01

    [Purpose] The purpose of this study was to investigate reliability of the test of gross motor development second edition (TGMD-2) for Kindergarten children in Myanmar. [Subjects and Methods] Fifty healthy Kindergarten children (23 males, 27 females) whose parents/guardians had given written consent were participated. The subjects were explained and demonstrated all 12 gross motor skills of TGMD-2 before the assessment. Each subject individually performed two trials for each gross motor skill and the performance was video recorded. Three raters separately watched the video recordings and rated for inter-rater reliability. The second assessment was done one month later with 25 out of 50 subjects for test-rest reliability. The video recordings of 12 subjects were randomly selected from the first 50 recordings for intra-rater reliability six weeks after the first assessment. The agreement on the locomotor and object control raw scores and the gross motor quotient (GMQ) were calculated. [Results] The findings of all the reliability coefficients for the locomotor and object control raw scores and the GMQ were interpreted as good and excellent reliability. [Conclusion] The results represented that TGMD-2 is a highly reliable and appropriate assessment tool for assessing gross motor skill development of Kindergarten children in Myanmar.

  3. Evaluation of a simplified gross thrust calculation method for a J85-21 afterburning turbojet engine in an altitude facility

    NASA Technical Reports Server (NTRS)

    Baer-Riedhart, J. L.

    1982-01-01

    A simplified gross thrust calculation method was evaluated on its ability to predict the gross thrust of a modified J85-21 engine. The method used tailpipe pressure data and ambient pressure data to predict the gross thrust. The method's algorithm is based on a one-dimensional analysis of the flow in the afterburner and nozzle. The test results showed that the method was notably accurate over the engine operating envelope using the altitude facility measured thrust for comparison. A summary of these results, the simplified gross thrust method and requirements, and the test techniques used are discussed in this paper.

  4. Balance, Proprioception, and Gross Motor Development of Chinese Children Aged 3 to 6 Years.

    PubMed

    Jiang, Gui-Ping; Jiao, Xi-Bian; Wu, Sheng-Kou; Ji, Zhong-Qiu; Liu, Wei-Tong; Chen, Xi; Wang, Hui-Hui

    2018-01-01

    The authors' aim was to find the features of balance, proprioception, and gross motor development of Chinese children 3-6 years old and their correlations, provide theoretical support for promoting children's motor development, and enrich the world theoretical system of motor development. This study used a Tekscan foot pressure measurement instrument (Tekscan, Inc., Boston, MA), walking on a balance beam, Xsens 3-dimensional positional measuring system (Xsens Technologies, Enschede, the Netherlands), and Test of Gross Motor Development-2 to assess static balance, dynamic balance, knee proprioception, and levels of gross motor development (GMD) of 3- to 6-year-old children (n = 60) in Beijing. The results are as follows: children had significant age differences in static balance, dynamic balance, proprioception, and levels of GMD; children had significant gender differences in static balance, proprioception, and levels of GMD; children's static balance, dynamic balance, and proprioception had a very significant positive correlation with GMD (p < .01), but no significant correlation with body mass index.

  5. Incidence rate of symptomatic painless thyroiditis presenting with thyrotoxicosis in Denmark as evaluated by consecutive thyroid scintigraphies.

    PubMed

    Schwartz, Frederik; Bergmann, Natasha; Zerahn, Bo; Faber, Jens

    2013-04-01

    Painless thyroiditis (PT) is a transient kind of thyrotoxicosis, with lack of uptake on a thyroid scintigraphy in a non-tender thyroid gland, elevated anti-TPO antibodies, no fever, no history of increased iodine intake, and a normal sedimentation rate. The prevalence of PT varies hugely in the literature. To establish the incidence rate of PT in Denmark as well as to describe the phenotype of PT in more detail. Tc-99m pertechnetate scintigraphies were performed over a period of 9.75 years on 6022 consecutive patients (2349 had a thyrotoxic episode), and were divided into high or normal (5528), reduced (300) or lack of uptake (194). Patient records were evaluated: 292 with reduced, and 186 with lack of uptake. As a control measure, 230 consecutive thyrotoxic patients were also analyzed. Based on scintigraphies, 12 patients had PT, 10 with lack of uptake and two with reduced, corresponding to an incidence rate of 0.49/100,000 person years. It was predicted, that only one patient among the newly diagnosed consecutive thyrotoxic cohort had PT. This patient was identified. The prevalence of PT among thyrotoxic patients was 0.51% as evaluated by scintigraphy, and 0.43% among the biochemically thyrotoxic patient cohort. Twenty-five percent had more than one thyrotoxic episode, 75% had at least one subsequent hypothyroid episode, and 33% developed permanent hypothyroidism. PT presenting with symptomatic thyrotoxicosis is an extremely rare disease in Denmark. Symptomatic PT presents most often with no uptake on a Tc-99m pertechnetate scintigraphy. Clinical follow-up is essential.

  6. 20 CFR 418.2245 - What will happen if you notify us that your modified adjusted gross income for the more recent...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... modified adjusted gross income for the more recent tax year changes? 418.2245 Section 418.2245 Employees... Prescription Drug Coverage Premiums Determinations Using A More Recent Tax Year's Modified Adjusted Gross... recent tax year changes? (a) If you notify us that your modified adjusted gross income for the more...

  7. 20 CFR 418.2245 - What will happen if you notify us that your modified adjusted gross income for the more recent...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... modified adjusted gross income for the more recent tax year changes? 418.2245 Section 418.2245 Employees... Prescription Drug Coverage Premiums Determinations Using A More Recent Tax Year's Modified Adjusted Gross... recent tax year changes? (a) If you notify us that your modified adjusted gross income for the more...

  8. 20 CFR 418.2245 - What will happen if you notify us that your modified adjusted gross income for the more recent...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... modified adjusted gross income for the more recent tax year changes? 418.2245 Section 418.2245 Employees... Prescription Drug Coverage Premiums Determinations Using A More Recent Tax Year's Modified Adjusted Gross... recent tax year changes? (a) If you notify us that your modified adjusted gross income for the more...

  9. 20 CFR 418.2245 - What will happen if you notify us that your modified adjusted gross income for the more recent...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... modified adjusted gross income for the more recent tax year changes? 418.2245 Section 418.2245 Employees... Prescription Drug Coverage Premiums Determinations Using A More Recent Tax Year's Modified Adjusted Gross... recent tax year changes? (a) If you notify us that your modified adjusted gross income for the more...

  10. Embracing the Black English Vernacular: Response to Koch and Gross.

    ERIC Educational Resources Information Center

    Burnett, Myra N.; Burlew, Randi; Hudson, Glenetta

    1997-01-01

    Reviews the findings of L. Koch and A. Gross (1997) and suggests that the positive perceptions of black children toward Black English reflect the dominant linguistic standard within their peer groups. Retention of the Black English vernacular is advocated because it is an expressively rich form of communication. (SLD)

  11. Relationships Between Gross Motor Skills and Social Function in Young Boys With Autism Spectrum Disorder.

    PubMed

    Holloway, Jamie M; Long, Toby M; Biasini, Fred

    2018-05-02

    The purpose of this study was to examine the relationship between gross motor skills and social function in young boys with autism spectrum disorder. Twenty-one children with autism spectrum disorder participated in the study. The Peabody Developmental Motor Scales Second Edition and the Miller Function and Participation Scales were used to assess gross motor skills. The Social Skills Improvement System Rating Scales was used to assess social function. Moderately high correlations were found between overall gross motor and social skills (r = 0.644) and between the core stability motor subtest and overall social skills (r = -0.672). Specific motor impairments in stability, motor accuracy, and object manipulation scores were predictive of social function. This study suggests that motor skills and social function are related in young boys with autism. Implications for physical therapy intervention are also discussed.

  12. Integration of digital gross pathology images for enterprise-wide access.

    PubMed

    Amin, Milon; Sharma, Gaurav; Parwani, Anil V; Anderson, Ralph; Kolowitz, Brian J; Piccoli, Anthony; Shrestha, Rasu B; Lauro, Gonzalo Romero; Pantanowitz, Liron

    2012-01-01

    Sharing digital pathology images for enterprise- wide use into a picture archiving and communication system (PACS) is not yet widely adopted. We share our solution and 3-year experience of transmitting such images to an enterprise image server (EIS). Gross pathology images acquired by prosectors were integrated with clinical cases into the laboratory information system's image management module, and stored in JPEG2000 format on a networked image server. Automated daily searches for cases with gross images were used to compile an ASCII text file that was forwarded to a separate institutional Enterprise Digital Imaging and Communications in Medicine (DICOM) Wrapper (EDW) server. Concurrently, an HL7-based image order for these cases was generated, containing the locations of images and patient data, and forwarded to the EDW, which combined data in these locations to generate images with patient data, as required by DICOM standards. The image and data were then "wrapped" according to DICOM standards, transferred to the PACS servers, and made accessible on an institution-wide basis. In total, 26,966 gross images from 9,733 cases were transmitted over the 3-year period from the laboratory information system to the EIS. The average process time for cases with successful automatic uploads (n=9,688) to the EIS was 98 seconds. Only 45 cases (0.5%) failed requiring manual intervention. Uploaded images were immediately available to institution- wide PACS users. Since inception, user feedback has been positive. Enterprise- wide PACS- based sharing of pathology images is feasible, provides useful services to clinical staff, and utilizes existing information system and telecommunications infrastructure. PACS-shared pathology images, however, require a "DICOM wrapper" for multisystem compatibility.

  13. Gross motor skills in toddlers: Prevalence and socio-demographic differences.

    PubMed

    Veldman, Sanne L C; Jones, Rachel A; Santos, Rute; Sousa-Sá, Eduarda; Okely, Anthony D

    2018-05-19

    Gross motor skills (GMS) are a vital component of a child's development. Monitoring levels and correlates of GMS is important to ensure appropriate strategies are put in place to promote these skills in young children. The aim of this study was to describe the current level of GMS development of children aged 11-29months and how these levels differ by age, sex, BMI and socio-economic status. Cross-sectional study. This study involved children from 30 childcare services in NSW, Australia. GMS were assessed using the Peabody Developmental Motor Scales Second Edition. Prevalence was reported using the gross motor quotient and both raw and standard scores for locomotor, object manipulation and stationary subtests. Socio-demographics were collected via parent questionnaires. Analyses included t-tests, chi-square tests, one-way ANOVA and linear regression models. This study included 335 children (mean age=19.80±4.08months, 53.9% boys). For the gross motor quotient, 23.3% of the children scored below average. For the GMS subtests, 34.3% of children scored below average for locomotion, 10.1% for object manipulation and 0.3% for stationary. Boys were more proficient in object manipulation than girls (p=0.001). GMS were negatively associated with age and a higher socio-economic status (all p<0.05). There were no associations for BMI. This is the first descriptive study to show the prevalence of below average at locomotor skills in toddlers is higher than reported in normative samples. Early commencement of GMS promotion is recommended with a focus on locomotor skills and girls' object manipulation skills. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. Eosinophilic cystitis with recurrent urinary retention: case report.

    PubMed

    Park, Hongzoo

    2017-01-01

    Eosinophilic cystitis is a rare inflammatory disease of the bladder whose origin, pathogenesis, and treatment are unknown. Frequency, dysuria, and hematuria are frequent symptoms. Here, we report a rare occurrence of recurrent urinary retention and repetitive catheterization. A 67-year-old male presented with acute urinary retention and intermittent gross hematuria of 2 weeks duration. Urethral catheterization followed by a trial without catheter, was successful. Complete blood count showed presence of eosinophils (eosinophilia) and computed tomography of kidneys, ureter and bladder with contrast showed thickened bladder wall and small prostate. Cystoscopy revealed an erythematous lesion over the anterior wall. The rest of the mucosa was normal. Transurethral biopsies of the lesion were performed and histologic examination showed features of eosinophilic cystitis. Despite multiple medication regimens containing corticosteroids and antihistamines, he presented with recurrent urinary retention, approximately once every month. After 6 months, he was started on bethanechol, which led to no catheterization for up to 2 years. To the best of our knowledge, this is the first report on the successful use of bethanechol as a treatment for eosinophilic cystitis with recurrent urinary retention.

  15. Associations of Gross Motor Delay, Behavior, and Quality of Life in Young Children With Autism Spectrum Disorder.

    PubMed

    Hedgecock, James B; Dannemiller, Lisa A; Shui, Amy M; Rapport, Mary Jane; Katz, Terry

    2018-04-01

    Young children with autism spectrum disorder (ASD) often have gross motor delays that may accentuate problem daytime behavior and health-related quality of life (QoL). The objective of this study was to describe the degree of gross motor delays in young children with ASD and associations of gross motor delays with problem daytime behavior and QoL. The primary hypothesis was that Gross motor delays significantly modifies the associations between internalizing or externalizing problem daytime behavior and QoL. This study used a cross-sectional, retrospective analysis. Data from 3253 children who were 2 to 6 years old and who had ASD were obtained from the Autism Speaks Autism Treatment Network and analyzed using unadjusted and adjusted linear regression. Measures included the Vineland Adaptive Behavior Scales, 2nd edition, gross motor v-scale score (VABS-GM) (for Gross motor delays), the Child Behavior Checklist (CBCL) (for Problem daytime behavior), and the Pediatric Quality of Life Inventory (PedsQL) (for QoL). The mean VABS-GM was 12.12 (SD = 2.2), representing performance at or below the 16th percentile. After adjustment for covariates, the internalizing CBCL t score decreased with increasing VABS-GM (β = - 0.64 SE = 0.12). Total and subscale PedsQL scores increased with increasing VABS-GM (for total score: β = 1.79 SE = 0.17; for subscale score: β = 0.9-2.66 SE = 0.17-0.25). CBCL internalizing and externalizing t scores decreased with increasing PedsQL total score (β = - 0.39 SE = 0.01; β = - 0.36 SE = 0.01). The associations between CBCL internalizing or externalizing t scores and PedsQL were significantly modified by VABSGM (β = - 0.026 SE = 0.005]; β = - 0.019 SE = 0.007). The study lacked ethnic and socioeconomic diversity. Measures were collected via parent report without accompanying clinical assessment. Cross motor delay was independently associated with Problem daytime behavior and QoL in children with ASD. Gross

  16. Effects of gross motor function and manual function levels on performance-based ADL motor skills of children with spastic cerebral palsy.

    PubMed

    Park, Myoung-Ok

    2017-02-01

    [Purpose] The purpose of this study was to determine effects of Gross Motor Function Classification System and Manual Ability Classification System levels on performance-based motor skills of children with spastic cerebral palsy. [Subjects and Methods] Twenty-three children with cerebral palsy were included. The Assessment of Motor and Process Skills was used to evaluate performance-based motor skills in daily life. Gross motor function was assessed using Gross Motor Function Classification Systems, and manual function was measured using the Manual Ability Classification System. [Results] Motor skills in daily activities were significantly different on Gross Motor Function Classification System level and Manual Ability Classification System level. According to the results of multiple regression analysis, children categorized as Gross Motor Function Classification System level III scored lower in terms of performance based motor skills than Gross Motor Function Classification System level I children. Also, when analyzed with respect to Manual Ability Classification System level, level II was lower than level I, and level III was lower than level II in terms of performance based motor skills. [Conclusion] The results of this study indicate that performance-based motor skills differ among children categorized based on Gross Motor Function Classification System and Manual Ability Classification System levels of cerebral palsy.

  17. 20 CFR 418.1245 - What will happen if you notify us that your modified adjusted gross income for the more recent...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... modified adjusted gross income for the more recent tax year changes? 418.1245 Section 418.1245 Employees... Adjustment Amount Determinations Using A More Recent Tax Year's Modified Adjusted Gross Income § 418.1245 What will happen if you notify us that your modified adjusted gross income for the more recent tax year...

  18. 20 CFR 418.1245 - What will happen if you notify us that your modified adjusted gross income for the more recent...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... modified adjusted gross income for the more recent tax year changes? 418.1245 Section 418.1245 Employees... Adjustment Amount Determinations Using A More Recent Tax Year's Modified Adjusted Gross Income § 418.1245 What will happen if you notify us that your modified adjusted gross income for the more recent tax year...

  19. 20 CFR 418.1245 - What will happen if you notify us that your modified adjusted gross income for the more recent...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... modified adjusted gross income for the more recent tax year changes? 418.1245 Section 418.1245 Employees... Adjustment Amount Determinations Using A More Recent Tax Year's Modified Adjusted Gross Income § 418.1245 What will happen if you notify us that your modified adjusted gross income for the more recent tax year...

  20. 20 CFR 418.1245 - What will happen if you notify us that your modified adjusted gross income for the more recent...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... modified adjusted gross income for the more recent tax year changes? 418.1245 Section 418.1245 Employees... Adjustment Amount Determinations Using A More Recent Tax Year's Modified Adjusted Gross Income § 418.1245 What will happen if you notify us that your modified adjusted gross income for the more recent tax year...

  1. Smoking in top-grossing movies --- United States, 1991-2009.

    PubMed

    2010-08-20

    Exposure to onscreen smoking in movies increases the probability that youths will start smoking. Youths who are heavily exposed to onscreen smoking are approximately two to three times more likely to begin smoking than youths who are lightly exposed; a similar, but smaller effect exists for young adults. To monitor the extent to which tobacco use is shown in popular movies, Thumbs Up! Thumbs Down! (TUTD), a project of Breathe California of Sacramento-Emigrant Trails, counted the occurrences of tobacco use (termed "incidents") shown in U.S. top-grossing movies during 1991-2009. This report summarizes the results of that study, which found that the number of tobacco incidents depicted in the movies during this period peaked in 2005 and then progressively declined. Top-grossing movies released in 2009 contained 49% of the number of onscreen smoking incidents as observed in 2005 (1,935 incidents in 2009 versus 3,967 incidents in 2005). Further reduction of tobacco use depicted in popular movies could lead to less initiation of smoking among adolescents. Effective methods to reduce the potential harmful influence of onscreen tobacco use should be implemented.

  2. 77 FR 40515 - Safety Zone; Detroit Symphony Orchestra at Ford House Fireworks, Lake St. Clair, Grosse Pointe...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-10

    ...-AA00 Safety Zone; Detroit Symphony Orchestra at Ford House Fireworks, Lake St. Clair, Grosse Pointe... Detroit Symphony Orchestra at the Ford House Fireworks. This zone will be effective and enforced from 10.... 165.T09-0600 Safety Zone; Detroit Symphony Orchestra at Ford House Fireworks, Lake St. Clair, Grosse...

  3. Neonatal Stroke Causes Poor Midline Motor Behaviors and Poor Fine and Gross Motor Skills during Early Infancy

    ERIC Educational Resources Information Center

    Chen, Chao-Ying; Lo, Warren D.; Heathcock, Jill C.

    2013-01-01

    Upper extremity movements, midline behaviors, fine, and gross motor skills are frequently impaired in hemiparesis and cerebral palsy. We investigated midline toy exploration and fine and gross motor skills in infants at risk for hemiplegic cerebral palsy. Eight infants with neonatal stroke (NS) and thirteen infants with typical development (TD)…

  4. Dietary lipid and gross energy affect protein utilization in the rare minnow Gobiocypris rarus

    NASA Astrophysics Data System (ADS)

    Wu, Benli; Xiong, Xiaoqin; Xie, Shouqi; Wang, Jianwei

    2016-07-01

    An 8-week feeding trial was conducted to detect the optimal dietary protein and energy, as well as the effects of protein to energy ratio on growth, for the rare minnow ( Gobiocypris rarus), which are critical to nutrition standardization for model fish. Twenty-four diets were formulated to contain three gross energy (10, 12.5, 15 kJ/g), four protein (20%, 25%, 30%, 35%), and two lipid levels (3%, 6%). The results showed that optimal dietary E/P was 41.7-50 kJ/g for maximum growth in juvenile rare minnows at 6% dietary crude lipid. At 3% dietary lipid, specific growth rate (SGR) increased markedly when E/P decreased from 62.5 kJ/g to 35.7 kJ/g and gross energy was 12.5 kJ/g, and from 75 kJ/g to 42.9 kJ/g when gross energy was 15.0 kJ/g. The optimal gross energy was estimated at 12.5 kJ/g and excess energy decreased food intake and growth. Dietary lipid exhibited an apparent protein-sparing effect. Optimal protein decreased from 35% to 25%-30% with an increase in dietary lipid from 3% to 6% without adversely effecting growth. Dietary lipid level affects the optimal dietary E/P ratio. In conclusion, recommended dietary protein and energy for rare minnow are 20%-35% and 10-12.5 kJ/g, respectively.

  5. Measuring Change in Professionalism Attitudes during the Gross Anatomy Course

    ERIC Educational Resources Information Center

    Pearson, William G., Jr.; Hoagland, Todd M.

    2010-01-01

    By design or default, anatomy educators are often responsible for introducing students to medical professionalism. Although much has been said about the role of anatomical education, there are no published reports suggesting how to measure change. This study investigated what professionalism attitudes, if any, change during a gross anatomy course.…

  6. Performance of a two-leaf light use efficiency model for mapping gross primary productivity against remotely sensed sun-induced chlorophyll fluorescence data.

    PubMed

    Zan, Mei; Zhou, Yanlian; Ju, Weimin; Zhang, Yongguang; Zhang, Leiming; Liu, Yibo

    2018-02-01

    Estimating terrestrial gross primary production is an important task when studying the carbon cycle. In this study, the ability of a two-leaf light use efficiency model to simulate regional gross primary production in China was validated using satellite Global Ozone Monitoring Instrument - 2 sun-induced chlorophyll fluorescence data. The two-leaf light use efficiency model was used to estimate daily gross primary production in China's terrestrial ecosystems with 500-m resolution for the period from 2007 to 2014. Gross primary production simulated with the two-leaf light use efficiency model was resampled to a spatial resolution of 0.5° and then compared with sun-induced chlorophyll fluorescence. During the study period, sun-induced chlorophyll fluorescence and gross primary production simulated by the two-leaf light use efficiency model exhibited similar spatial and temporal patterns in China. The correlation coefficient between sun-induced chlorophyll fluorescence and monthly gross primary production simulated by the two-leaf light use efficiency model was significant (p<0.05, n=96) in 88.9% of vegetated areas in China (average value 0.78) and varied among vegetation types. The interannual variations in monthly sun-induced chlorophyll fluorescence and gross primary production simulated by the two-leaf light use efficiency model were similar in spring and autumn in most vegetated regions, but dissimilar in winter and summer. The spatial variability of sun-induced chlorophyll fluorescence and gross primary production simulated by the two-leaf light use efficiency model was similar in spring, summer, and autumn. The proportion of spatial variations of sun-induced chlorophyll fluorescence and annual gross primary production simulated by the two-leaf light use efficiency model explained by ranged from 0.76 (2011) to 0.80 (2013) during the study period. Overall, the two-leaf light use efficiency model was capable of capturing spatial and temporal variations in gross

  7. Spontaneous movements of preterm infants is associated with outcome of gross motor development.

    PubMed

    Miyagishima, Saori; Asaka, Tadayoshi; Kamatsuka, Kaori; Kozuka, Naoki; Kobayashi, Masaki; Igarashi, Lisa; Hori, Tsukasa; Tsutsumi, Hiroyuki

    2018-04-30

    We conducted a longitudinal cohort study to analyze the relationship between outcome of gross motor development in preterm infants and factors that might affect their development. Preterm infants with a birth weight of <1500 g were recruited. We measured spontaneous antigravity limbs movements by 3D motion capture system at 3 months corrected age. Gross motor developmental outcomes at 6 and 12 months corrected age were evaluated using the Alberta Infant Motor Scale (AIMS). Statistical analysis was carried out by canonical correlation analysis. Eighteen preterm infants were included. In the 6 months corrected age analysis, spontaneous movement had a major effect on Prone and Sitting at 6 months corrected age of AIMS. In the 12 months corrected age analysis, spontaneous movement had a major effect on Sitting and Standing at 12 months corrected age of AIMS. In preterm infants, better antigravity spontaneous movements at 3 months corrected age were significantly correlated with better gross motor development at 6 or 12 months corrected age. Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  8. GPELab, a Matlab toolbox to solve Gross-Pitaevskii equations II: Dynamics and stochastic simulations

    NASA Astrophysics Data System (ADS)

    Antoine, Xavier; Duboscq, Romain

    2015-08-01

    GPELab is a free Matlab toolbox for modeling and numerically solving large classes of systems of Gross-Pitaevskii equations that arise in the physics of Bose-Einstein condensates. The aim of this second paper, which follows (Antoine and Duboscq, 2014), is to first present the various pseudospectral schemes available in GPELab for computing the deterministic and stochastic nonlinear dynamics of Gross-Pitaevskii equations (Antoine, et al., 2013). Next, the corresponding GPELab functions are explained in detail. Finally, some numerical examples are provided to show how the code works for the complex dynamics of BEC problems.

  9. 46 CFR 11.406 - Service requirements for second mate of ocean or near coastal steam or motor vessels of any gross...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... coastal steam or motor vessels of any gross tons. 11.406 Section 11.406 Shipping COAST GUARD, DEPARTMENT... coastal steam or motor vessels of any gross tons. The minimum service required to qualify an applicant for an endorsement as second mate of ocean or near coastal steam or motor vessels of any gross tons is...

  10. Clinical evaluation of double-pigtail stent in patients with upper urinary tract diseases: report of 2685 cases.

    PubMed

    Hao, Ping; Li, Weibing; Song, Caiping; Yan, Junan; Song, Bo; Li, Longkun

    2008-01-01

    To review the indications, procedures, complications, and related treatments of double pigtail stent (DPS) placement as an adjunct for some types of endoscopic and open urologic surgery. From July 1998 to December 2006, 2413 patients aged 8 to 81 years underwent stent placement (2685 total placements). The indications consisted of ureteroscopic lithotripsy (1984 cases), percutaneous nephrolithotomy (329 cases), ureteral incision to remove calculi (71 cases), extracorporeal shockwave lithotripsy for upper urinary tract calculi (145 cases), ureteropelvic junction obstruction (31 cases), ureterocystoneostomy (29 cases), benign ureteral stenosis (52 cases), extrinsic ureteral stenosis (16 cases), and iatrogenic ureteral trauma (28 cases). DPSs were inserted into the ureter by cystoscopy (115 stents), ureteroscopy (2052 stents), percutaneous nephrostomy (393 stents), or open surgery (125 stents), and were kept inside the body for 28 +/- 1.7 days (range 1-193 days). The mean follow-up period was 31 +/- 1.9 days (range 1-123 days). Three hundred sixty-five patients (19.6%) experienced one or more problems during the stenting procedure. The main complications were gross hematuria (385 cases), pain (101 cases), bladder irritation (105 cases), high fever (6 cases), encrustation (53 cases), stent migration (42 cases), and stenosis or restenosis (51 cases). Most of the complications were mild and tolerable, and all were immediately treated appropriately. However, 60 stents had to be removed: 29 for gross hematuria, 18 for pain, 7 for bladder irritation, and 6 for high fever. DPS is a safe and useful adjunct for both endoscopic and open procedures to treat upper urinary tract diseases. Most of the complications of DPS placement can be well managed.

  11. The Effects of Instrumentation on Urine Cytology and CK-20 Analysis for the Detection of Bladder Cancer.

    PubMed

    Wegelin, Olivier; Bartels, Diny W M; Tromp, Ellen; Kuypers, Karel C; van Melick, Harm H E

    2015-10-01

    To evaluate the effects of cystoscopy on urine cytology and additional cytokeratin-20 (CK-20) staining in patients presenting with gross hematuria. For 83 patients presenting with gross hematuria, spontaneous and instrumented paired urine samples were analyzed. Three patients were excluded. Spontaneous samples were collected within 1 hour before cystoscopy, and the instrumented samples were tapped through the cystoscope. Subsequently, patients underwent cystoscopic evaluation and imaging of the urinary tract. If tumor suspicious lesions were found on cystoscopy or imaging, subjects underwent transurethral resection or ureterorenoscopy. Two blinded uropathological reviewers (DB, KK) evaluated 160 urine samples. Reference standards were results of cystoscopy, imaging, or histopathology. Thirty-seven patients (46.3%) underwent transurethral resection or ureterorenoscopy procedures. In 30 patients (37.5%) tumor presence was confirmed by histopathology. The specificity of urine analysis was significantly higher for spontaneous samples than instrumented samples for both cytology alone (94% vs 72%, P = .01) and for cytology combined with CK-20 analysis (98% vs 84%, P = .02). The difference in sensitivity between spontaneous and instrumented samples was not significant for both cytology alone (40% vs 53%) and combined with CK-20 analysis (67% vs 67%). The addition of CK-20 analysis to cytology significantly increases test sensitivity in spontaneous urine cytology (67% vs 40%, P = .03). Instrumentation significantly decreases specificity of urine cytology. This may lead to unnecessary diagnostic procedures. Additional CK-20 staining in spontaneous urine cytology significantly increases sensitivity but did not improve the already high specificity. We suggest performing urine cytology and CK-20 analysis on spontaneously voided urine. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Urethral and bladder neck injury associated with pelvic fracture in 25 female patients.

    PubMed

    Black, Peter C; Miller, Elizabeth A; Porter, James R; Wessells, Hunter

    2006-06-01

    We describe the presentation, diagnostic evaluation, management and outcome of female urethral trauma. All female patients treated at Harborview Medical Center between 1985 and 2001 with urethral injury were identified by International Classification of Diseases 9th revision code. Approval of the Human Subject Division was obtained and patient charts were reviewed. The Urogenital Distress Inventory Short Form, the Incontinence Impact Questionnaire Short Form and the Female Sexual Function Index were sent to the patients. A total of 25 patients (13 adults, 12 children) with a mean age of 22 years (range 4 to 67) met inclusion criteria. All had pelvic fracture related to blunt trauma. They represented 6% of all female patients treated in the same review period with pelvic fracture. Blood was seen at the introitus in 15 patients and 19 had gross hematuria. Of the injuries 9 were avulsions, 15 were longitudinal lacerations and 1 was not further specified. Primary repair was performed in 21 patients and 4 were treated nonoperatively. There were 5 patients who required secondary procedures including fistula repair in 4 and continent urinary diversion in 1. At a mean followup of 7.3 years (range 1.6 to 14.4) 9 of 21 patients (43%) had moderate or severe lower urinary tract symptoms and 8 of 13 (38%) had sexual dysfunction (FSFI score less than 26.55). Female urethral and bladder neck injury occurs with pelvic fracture, presents with gross hematuria and/or blood at the introitus, and requires operative repair for avulsions and longitudinal lacerations. These patients are at risk for significant sexual and lower urinary tract dysfunction.

  13. 7 CFR 1400.501 - Determination of average adjusted gross income.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... renewable energy; (4) The sale, including the sale of easements and development rights, of farm, ranch... renewable energy; (7) The feeding, rearing, or finishing of livestock; (8) The sale of land that has been... year, as determined by CCC. A new legal entity will have its adjusted gross income averaged only for...

  14. 7 CFR 1400.501 - Determination of average adjusted gross income.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... renewable energy; (4) The sale, including the sale of easements and development rights, of farm, ranch... renewable energy; (7) The feeding, rearing, or finishing of livestock; (8) The sale of land that has been... year, as determined by CCC. A new legal entity will have its adjusted gross income averaged only for...

  15. 7 CFR 1400.501 - Determination of average adjusted gross income.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... renewable energy; (4) The sale, including the sale of easements and development rights, of farm, ranch... renewable energy; (7) The feeding, rearing, or finishing of livestock; (8) The sale of land that has been... year, as determined by CCC. A new legal entity will have its adjusted gross income averaged only for...

  16. 26 CFR 1.691(a)-3 - Character of gross income.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....691(a)-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Income in Respect of Decedents § 1.691(a)-3 Character of gross income. (a) The right..., or by the person entitled to receive such amount by bequest, devise, or inheritance from the decedent...

  17. 46 CFR 11.433 - Service requirements for master of Great Lakes and inland steam or motor vessels of any gross tons.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... inland steam or motor vessels of any gross tons. 11.433 Section 11.433 Shipping COAST GUARD, DEPARTMENT... steam or motor vessels of any gross tons. The minimum service required to qualify an applicant for an endorsement as master of Great Lakes and inland steam or motor vessels of any gross tons is: (a) One year of...

  18. 46 CFR 11.405 - Service requirements for chief mate of ocean or near coastal steam or motor vessels of any gross...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... coastal steam or motor vessels of any gross tons. 11.405 Section 11.405 Shipping COAST GUARD, DEPARTMENT... coastal steam or motor vessels of any gross tons. The minimum service required to qualify an applicant for an endorsement as chief mate of ocean or near coastal steam or motor vessels of any gross tons is one...

  19. Gross Instability After Hip Arthroscopy: An Analysis of Case Reports Evaluating Surgical and Patient Factors.

    PubMed

    Yeung, Marco; Memon, Muzammil; Simunovic, Nicole; Belzile, Etienne; Philippon, Marc J; Ayeni, Olufemi R

    2016-06-01

    Gross hip instability is a rare complication after hip arthroscopy, and there is limited literature surrounding this topic. This systematic review investigates cases of gross hip instability after arthroscopy and discusses the risk factors associated with this complication. A systematic search was performed in duplicate for studies investigating gross hip instability after hip arthroscopy up to October 2015. Study parameters including sample size, mechanism and type of dislocation, surgical procedure details, patient characteristics, postoperative rehabilitation protocol, and level of evidence were analyzed. The systematic review identified 9 case reports investigating gross hip instability after hip arthroscopy (10 patients). Anterior dislocation occurred in 66.7% of patients, and most injuries occurred with a low-energy mechanism. Common surgical factors cited included unrepaired capsulotomy (77.8%) and iliopsoas release (33.3%), whereas patient factors included female gender (77.8%), acetabular dysplasia (22.2%), and general ligamentous laxity (11.1%). Postoperative restrictions and protocols were variable and inconsistently reported, and their relation to post-arthroscopy instability was difficult to ascertain. This systematic review discussed various patient, surgical, and postoperative risk factors of gross hip instability after arthroscopy. Patient characteristics such as female gender, hip dysplasia, and ligamentous laxity may be risk factors for post-arthroscopy dislocation. Similarly, surgical risk factors for iatrogenic hip instability may include unrepaired capsulotomies and iliopsoas debridement, although the role of capsular closure in iatrogenic instability is not clear. The influences of postoperative restrictions and protocols on dislocation are also unclear in the current literature. Surgeons should be cognizant of these risk factors when performing hip arthroscopy and be mindful that these factors appear to occur in combination. Level IV

  20. Gross violation of human rights and inequality in city of São Paulo, Southeastern Brazil.

    PubMed

    Ruotti, Caren; Freitas, Taís Viudes de; Almeida, Juliana Feliciano de; Peres, Maria Fernanda Tourinho

    2009-06-01

    To analyze the profile of gross human rights violations, and the relationship between these violations and socioeconomic and demographic indicators. Cross-sectional ecological study of 96 census districts of the city of São Paulo (Southeastern Brazil) in the year 2000. The data used came from the gross human rights violations database maintained by the Núcleo de Estudos de Violência (Center for the Study of Violence) at the Universidade de São Paulo. This database contains information on all the cases of summary executions, lynching and police violence reported on the written press. Socioeconomic and demographic data were obtained from the 2000 Census carried out by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics). A descriptive analysis of the data was carried out, and the association between the dependent variable - gross human rights violations (number of police violence victims, lynching episodes and summary executions) -, and different socioeconomic and demographic variables was tested. In order to test this association the Spearman's correlation test was used. The correlations between gross human rights violations and the socioeconomic and demographic indicators were statistically significant, except for the urbanization rate and the hospital beds per 1000 inhabitants. The strongest correlations were found between the dependent variable and the following variables: size of the resident population (r=0,693), proportion of youths aged from 15 to 24 years (r=0,621), and proportion of household heads with no education or with up to three years of schooling (r=0,590). Gross human rights violations more markedly occur in the population with the worst living conditions. Therefore, in a scenario in which inequality in attaining social and economic rights is directly superposed to the violation of civil rights, the violence cycle is intensified and perpetuated.