Learning & Growing: Integrating Technology Undergraduates into the Development of an Industrial Case Study

ERIC Educational Resources Information Center

Newton, Kathryne; Schmidt, Edie

2004-01-01

A national industrial distribution association approached the authors to develop a case study for its association members. The national association assumed responsibility for identifying educational needs of upper level, mid level, and lower level personnel in the industry. In the previous year, a case study had been developed to educate upper…

Mobile phone use and the risk for malignant brain tumors: a case-control study on deceased cases and controls.

PubMed

Hardell, Lennart; Carlberg, Michael; Hansson Mild, Kjell

2010-08-01

We investigated the use of mobile or cordless phones and the risk for malignant brain tumors in a group of deceased cases. Most previous studies have either left out deceased cases of brain tumors or matched them to living controls and therefore a study matching deceased cases to deceased controls is warranted. Recall error is one issue since it has been claimed that increased risks reported in some studies could be due to cases blaming mobile phones as a cause of the disease. This should be of less importance for deceased cases and if cancer controls are used. In this study brain tumor cases aged 20-80 years diagnosed during 1997-2003 that had died before inclusion in our previous studies on the same topic were included. Two control groups were used: one with controls that had died from another type of cancer than brain tumor and one with controls that had died from other diseases. Exposure was assessed by a questionnaire sent to the next-of-kin for both cases and controls. Replies were obtained for 346 (75%) cases, 343 (74%) cancer controls and 276 (60%) controls with other diseases. Use of mobile phones gave an increased risk, highest in the >10 years' latency group yielding odds ratio (OR) = 2.4, and 95% confidence interval (CI) = 1.4-4.1. The risk increased with cumulative number of lifetime hours for use, and was highest in the >2,000 h group (OR = 3.4, 95% CI = 1.6-7.1). No clear association was found for use of cordless phones, although OR = 1.7, 95% CI = 0.8-3.4 was found in the group with >2,000 h of cumulative use. This investigation confirmed our previous results of an association between mobile phone use and malignant brain tumors. Copyright 2010 S. Karger AG, Basel.

Segmental stiff skin syndrome (SSS): A distinct clinical entity.

PubMed

Myers, Kathryn L; Mir, Adnan; Schaffer, Julie V; Meehan, Shane A; Orlow, Seth J; Brinster, Nooshin K

2016-07-01

Stiff skin syndrome (SSS) is a noninflammatory, fibrosing condition of the skin, often affecting the limb girdles. We present 4 new patients with SSS with largely unilateral, segmental distribution. To date, reported cases of SSS have been grouped based on generally accepted clinical and histopathologic findings. The purpose of this study was to analyze differences in clinical and histopathologic findings between previously reported SSS cases. This is a retrospective review of 4 new cases and 48 previously published cases of SSS obtained from PubMed search. Of 52 total cases, 18 (35%) were segmentally distributed and 34 (65%) were widespread. The average age of onset was 4.1 years versus 1.6 years for segmental versus widespread SSS, respectively. Limitation in joint mobility affected 44% of patients with segmental SSS and 97% of patients with widespread SSS. Histopathologic findings were common between the 2 groups. This was a retrospective study of previously published cases limited by the completeness and accuracy of the reviewed cases. We propose a distinct clinical entity, segmental SSS, characterized by a segmental distribution, later age of onset, and less severe functional limitation. Both segmental SSS and widespread SSS share common diagnostic histopathologic features. Copyright © 2016 American Academy of Dermatology, Inc. All rights reserved.

Students' self-explanations while solving unfamiliar cases: the role of biomedical knowledge.

PubMed

Chamberland, Martine; Mamede, Sílvia; St-Onge, Christina; Rivard, Marc-Antoine; Setrakian, Jean; Lévesque, Annie; Lanthier, Luc; Schmidt, Henk G; Rikers, Remy M J P

2013-11-01

General guidelines for teaching clinical reasoning have received much attention, despite a paucity of instructional approaches with demonstrated effectiveness. As suggested in a recent experimental study, self-explanation while solving clinical cases may be an effective strategy to foster reasoning in clinical clerks dealing with less familiar cases. However, the mechanisms that mediate this benefit have not been specifically investigated. The aim of this study was to explore the types of knowledge used by students when solving familiar and less familiar clinical cases with self-explanation. In a previous study, 36 third-year medical students diagnosed familiar and less familiar clinical cases either by engaging in self-explanation or not. Based on an analysis of previously collected data, the present study compared the content of self-explanation protocols generated by seven randomly selected students while solving four familiar and four less familiar cases. In total, 56 verbal protocols (28 familiar and 28 less familiar) were segmented and coded using the following categories: paraphrases, biomedical inferences, clinical inferences, monitoring statements and errors. Students provided more self-explanation segments from less familiar cases (M = 275.29) than from familiar cases (M = 248.71, p = 0.046). They provided significantly more paraphrases (p = 0.001) and made more errors (p = 0.008). A significant interaction was found between familiarity and the type of inferences (biomedical versus clinical, p = 0.016). When self-explaining less familiar cases, students provided significantly more biomedical inferences than familiar cases. Lack of familiarity with a case seems to stimulate medical students to engage in more extensive thinking during self-explanation. Less familiar cases seem to activate students' biomedical knowledge, which in turn helps them to create new links between biomedical and clinical knowledge, and eventually construct a more coherent mental representation of diseases. This may clarify the previously found positive effect that self-explanation has on the diagnosis of unfamiliar cases. © 2013 John Wiley & Sons Ltd.

Associative visual agnosia: a case study.

PubMed

Charnallet, A; Carbonnel, S; David, D; Moreaud, O

2008-01-01

We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

High Prevalence of Multidrug-Resistant Tuberculosis, Swaziland, 2009–2010

PubMed Central

Dlamini, Themba; Ascorra, Alexandra; Rüsch-Gerdes, Sabine; Tefera, Zerihun Demissie; Calain, Philippe; de la Tour, Roberto; Jochims, Frauke; Richter, Elvira; Bonnet, Maryline

2012-01-01

In Africa, although emergence of multidrug-resistant (MDR) tuberculosis (TB) represents a serious threat in countries severely affected by the HIV epidemic, most countries lack drug-resistant TB data. This finding was particularly true in the Kingdom of Swaziland, which has the world’s highest HIV and TB prevalences. Therefore, we conducted a national survey in 2009–2010 to measure prevalence of drug-resistant TB. Of 988 patients screened, 420 new case-patients and 420 previously treated case-patients met the study criteria. Among culture-positive patients, 15.3% new case-patients and 49.5% previously treated case-patients harbored drug-resistant strains. MDR TB prevalence was 7.7% and 33.8% among new case-patients and previously treated case-patients, respectively. HIV infection and past TB treatment were independently associated with MDR TB. The findings assert the need for wide-scale intervention in resource-limited contexts such as Swaziland, where diagnostic and treatment facilities and health personnel are lacking. PMID:22260950

Surgical Management of Complex Lower-Extremity Trauma With a Long Hindfoot Fusion Nail: A Case Report.

PubMed

Jain, Nickul S; Lopez, Gregory D; Bederman, S Samuel; Wirth, Garrett A; Scolaro, John A

2016-08-01

High-energy injuries can result in complete or partial loss of the talus. Ipsilateral fractures to the lower limb increase the complexity of surgical management, and treatment is guided by previous case reports of similar injuries. A case of complex lower-extremity trauma with extruded and missing talar body and ipsilateral type IIIB open tibia fracture is presented. Surgical limb reconstruction and salvage was performed successfully with a single orthopaedic implant in a manner not described previously in the literature. The purpose of this case report is to present the novel use of a single orthopaedic implant for treatment of a complex, open traumatic injury. Previous case reports in the literature have described the management of complete or partial talar loss. We describe the novel use of a long hindfoot fusion nail and staged bone grafting to achieve tibiocalcaneal arthrodesis for the treatment of complex lower-extremity trauma. Therapeutic, Level IV: Case study. © 2015 The Author(s).

Understanding Service Utilization in Cases of Elder Abuse to Inform Best Practices.

PubMed

Burnes, David; Rizzo, Victoria M; Gorroochurn, Prakash; Pollack, Martha H; Lachs, Mark S

2016-10-01

Elder abuse (EA) case resolution is contingent upon victims accepting and pursuing protective service interventions. Refusal/underutilization of services is a major problem. This study explored factors associated with extent of EA victim service utilization (SU). Data were collected from a random sample of EA cases (n = 250) at a protective service program in New York City. In cases involving financial abuse, higher SU was associated with females, poor health, perceived danger, previous help-seeking, and self or family referral. In physical abuse cases, higher SU was associated with family referral and previous help-seeking; lower SU was related to Hispanic race/ethnicity, being married, and child/grandchild perpetrator. In emotional abuse cases, higher SU was associated with self or family referral, victim-perpetrator gender differential, perceived danger, and previous help-seeking; lower SU was related to child/grandchild perpetrator. Findings carry implications for best practices to retain and promote service use among elder victims of abuse. © The Author(s) 2014.

Real-time Raman spectroscopy for automatic in vivo skin cancer detection: an independent validation.

PubMed

Zhao, Jianhua; Lui, Harvey; Kalia, Sunil; Zeng, Haishan

2015-11-01

In a recent study, we have demonstrated that real-time Raman spectroscopy could be used for skin cancer diagnosis. As a translational study, the objective of this study is to validate previous findings through a completely independent clinical test. In total, 645 confirmed cases were included in the analysis, including a cohort of 518 cases from a previous study, and an independent cohort of 127 new cases. Multi-variant statistical data analyses including principal component with general discriminant analysis (PC-GDA) and partial least squares (PLS) were used separately for lesion classification, which generated similar results. When the previous cohort (n = 518) was used as training and the new cohort (n = 127) was used as testing, the area under the receiver operating characteristic curve (ROC AUC) was found to be 0.889 (95 % CI 0.834-0.944; PLS); when the two cohorts were combined, the ROC AUC was 0.894 (95 % CI 0.870-0.918; PLS) with the narrowest confidence intervals. Both analyses were comparable to the previous findings, where the ROC AUC was 0.896 (95 % CI 0.846-0.946; PLS). The independent study validates that real-time Raman spectroscopy could be used for automatic in vivo skin cancer diagnosis with good accuracy.

The efficacy of hydroxychloroquine for obstetrical outcome in anti-phospholipid syndrome: Data from a European multicenter retrospective study.

PubMed

Mekinian, Arsène; Lazzaroni, Maria Grazia; Kuzenko, Anna; Alijotas-Reig, Jaume; Ruffatti, Amelia; Levy, Pierre; Canti, Valentina; Bremme, Katarina; Bezanahary, Holy; Bertero, Tiziana; Dhote, Robin; Maurier, Francois; Andreoli, Laura; Benbara, Amélie; Tigazin, Ahmed; Carbillon, Lionel; Nicaise-Roland, Pascale; Tincani, Angela; Fain, Olivier

2015-06-01

In European multicenter study, we aimed to describe the real-life hydroxychloroquine use in APS patients during pregnancy and determine its benefit in refractory obstetrical APS. We analyzed the outcome of pregnancies treated by hydroxychloroquine in patients with APS or asymptomatic antiphospholipid (aPL) antibodies carriers. Thirty patients with APS with 35 pregnancies treated by hydroxychloroquine were analyzed. Comparing the outcome of pregnancies treated by the addition of hydroxychloroquine to previous pregnancies under the conventional treatment, pregnancy losses decreased from 81% to 19% (p<0.05), without differences in the associated treatments. The univariate analysis showed that the previous intrauterine deaths and higher hydroxychloroquine amount (400mg per day) were the factors associated with pregnancy outcome. Considering 14 patients with previous refractory obstetrical APS (n=5 with obstetrical and thrombotic primary APS and n=9 with purely obstetrical APS), all with previous pregnancy losses under treatment (aspirin with LMWH in 11 cases and LMWH in 3 cases), the addition of hydroxychloroquine resulted in live born babies in 11/14 (78%) cases (p<0.05). Our study shows the benefit of hydroxychloroquine addition in patients with refractory obstetrical APS and raises the need of prospective studies to confirm our preliminary study. Copyright © 2015 Elsevier B.V. All rights reserved.

Context Matters: Increasing Understanding with Interactive Clicker Case Studies

ERIC Educational Resources Information Center

Lundeberg, Mary A.; Kang, Hosun; Wolter, Bjorn; delMas, Robert; Armstrong, Norris; Borsari, Bruno; Boury, Nancy; Brickman, Peggy; Hannam, Kristi; Heinz, Cheryl; Horvath, Thomas; Knabb, Maureen; Platt, Terry; Rice, Nancy; Rogers, Bill; Sharp, Joan; Ribbens, Eric; Maier, Kimberly S.; Deschryver, Mike; Hagley, Rodney; Goulet, Tamar; Herreid, Clyde F.

2011-01-01

Although interactive technology is presumed to increase student understanding in large classes, no previous research studies have empirically explored the effects of Clicker Cases on students' performance. A Clicker Case is a story (e.g., a problem someone is facing) that uses clickers (student response systems) to engage students in understanding…

Mode Deactivation Therapy (MDT): A Theoretical Case Analysis on a Suicidal Adolescent

ERIC Educational Resources Information Center

Apsche, Jack A.; Siv, Alexander M.

2005-01-01

This case study presents a case study of the effectiveness of Mode deactivation therapy (MDT) (Apsche, Bass, Jennings, Murphy, Hunter, and Siv, 2005) with an adolescent male, with reactive conduct disorder, PTSD and 8 lethal suicide attempts. The youngster was hospitalized four times for suicide attempts, three previous placements in residential…

A case-crossover study of transient risk factors influence on occupational injuries: a study protocol based on a review of previous studies.

PubMed

Oesterlund, Anna H; Lander, Flemming; Lauritsen, Jens

2016-10-01

The occupational injury incident rate remains relatively high in the European Union. The case-crossover study gives a unique opportunity to study transient risk factors that normally would be very difficult to approach. Studies like this have been carried out in both America and Asia, but so far no relevant research has been conducted in Europe. Case-crossover studies of occupational injuries were collected from PubMed and Embase and read through. Previous experiences concerning method, exposure and outcome, time-related measurements and construction of the questionnaire were taken into account in the preparation of a pilot study. Consequently, experiences from the pilot study were used to design the study protocol. Approximately 2000 patients with an occupational injury will be recruited from the emergency departments in Herning and Odense, Denmark. A standardised questionnaire will be used to collect basic demographic data and information on eight transient risk factors. Based on previous studies and knowledge on occupational injuries the transient risk factors we chose to examine were: time pressure, performing a task with a different method/using unaccustomed technique, change in working surroundings, using a phone, disagreement, feeling ill, being distracted and using malfunctioning machinery/tools or work material. Exposure time 'just before the injury' will be compared with two control periods, 'previous day at the same time of the injury' (pair match) and the previous work week (usual frequency). This study protocol describes a unique opportunity to calculate the effect of transient risk factors on occupational injuries in a European setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

MBA: Is the Traditional Model Doomed?

ERIC Educational Resources Information Center

Lataif, Louis E.; And Others

1992-01-01

Presents 13 commentaries on a previously published case study about the value of a Master's of Business Administration to employers today. Critiques center on the case study method, theory-practice gap, and value of practical experience and include international perspectives. (SK)

A comparison of 'cough and cold' and pneumonia: risk factors for pneumonia in children under 5 years revisited.

PubMed

Fatmi, Zafar; White, Franklin

2002-12-01

The aim of this study was to identify and measure the risk factors differentiating upper respiratory infection from pneumonia. The World Health Organization's acute respiratory infection case management criteria were used. We studied 259 cases of pneumonia (cases) and 187 cases of 'cough and cold' (controls) among children under 5 years of age at a large tertiary-care hospital in Gilgit, Pakistan. While previous studies used healthy controls, in this study we used controls who had mild infection ('cough and cold'). In the multivariate logistic regression analysis, lack of immunization (adjusted odds ratio (AOR)=1.54, 95% CI 1.0, 2.3), previous history of pneumonia (AOR=1.77, 95% CI 1.16, 2.7), younger age (AOR for each preceding month in children aged up to 59 months=1.01, 95% CI 0.99, 1.03) and malnutrition (wasting) (AOR=2.2, 95% CI 1.0, 5.23) were revealed as important risk factors for pneumonia. Some of the factors reported in previous studies that used healthy controls were not found to be significant when 'cough and cold' children were used as controls. Nonetheless, malnutrition, younger age, low coverage of immunization and also early childhood mismanagement and respiratory damage were found to be significant factors for development of pneumonia.

Associative Visual Agnosia: A Case Study

PubMed Central

Charnallet, A.; Carbonnel, S.; David, D.; Moreaud, O.

2008-01-01

We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive) episodic models of memory [4]. PMID:18413915

Imperfect information facilitates the evolution of reciprocity.

PubMed

Kurokawa, Shun

2016-06-01

The existence of cooperation demands explanation since cooperation is costly to the actor. Reciprocity has long been regarded as a potential explanatory mechanism for the existence of cooperation. Reciprocity is a mechanism wherein a cooperator responds to an opponent's behavior by switching his/her own behavior. Hence, a possible problematic case relevant to the theory of reciprocity evolution arises when the mechanism is such that the information regarding an opponent's behavior is imperfect. Although it has been confirmed also by previous theoretical studies that imperfect information interferes with the evolution of reciprocity, this argument is based on the assumption that there are no mistakes in behavior. And, a previous study presumed that it might be expected that when such mistakes occur, reciprocity can more readily evolve in the case of imperfect information than in the case of perfect information. The reason why the previous study considers so is that in the former case, reciprocators can miss defections incurred by other reciprocators' mistakes due to imperfect information, allowing cooperation to persist when such reciprocators meet. However, contrary to this expectation, the previous study has shown that even when mistakes occur, imperfect information interferes with the evolution of reciprocity. Nevertheless, the previous study assumed that payoffs are linear (i.e., that the effect of behavior is additive and there are no synergetic effects). In this study, we revisited the same problem but removed the assumption that payoffs are linear. We used evolutionarily stable strategy analysis to compare the condition for reciprocity to evolve when mistakes occur and information is imperfect with the condition for reciprocity to evolve when mistakes occur and information is perfect. Our study revealed that when payoffs are not linear, imperfect information can facilitate the evolution of reciprocity when mistakes occur; while when payoffs are linear, imperfect information disturbs the evolution of reciprocity even when mistakes occur. Imperfect information can encourage the evolution of cooperation. Copyright © 2016 Elsevier Inc. All rights reserved.

Previous Mental Health Service Utilization and Change in Clients' Depressive Symptoms

ERIC Educational Resources Information Center

Boswell, James F.; McAleavey, Andrew A.; Castonguay, Louis G.; Hayes, Jeffrey A.; Locke, Benjamin D.

2012-01-01

Although a potentially important factor in case conceptualization and treatment planning, the impact of previous treatment on subsequent counseling response has received little empirical attention. Using archival data, this study aimed to (a) report the prevalence of previous treatment utilization in a counseling population, (b) examine potential…

Meteorological factors affecting scrub typhus occurrence: a retrospective study of Yamagata Prefecture, Japan, 1984-2014.

PubMed

Seto, J; Suzuki, Y; Nakao, R; Otani, K; Yahagi, K; Mizuta, K

2017-02-01

Climate change, by its influence on the ecology of vectors might affect the occurrence of vector-borne diseases. This study examines the effects of meteorological factors in Japan on the occurrence of scrub typhus, a mite-borne zoonosis caused by Orientia tsutsugamushi. Using negative binomial regression, we analysed the relationships between meteorological factors (including temperature, rainfall, snowfall) and spring-early summer cases of scrub typhus in Yamagata Prefecture, Japan, during 1984-2014. The average temperature in July and August of the previous year, cumulative rainfall in September of the previous year, snowfall throughout the winter, and maximum depth of snow cover in January and February were positively correlated with the number of scrub typhus cases. By contrast, cumulative rainfall in July of the previous year showed a negative relationship to the number of cases. These associations can be explained by the life-cycle of Leptotrombidium pallidum, a predominant vector of spring-early summer cases of scrub typhus in northern Japan. Our findings show that several meteorological factors are useful to estimate the number of scrub typhus cases before the endemic period. They are applicable to establish an early warning system for scrub typhus in northern Japan.

Cervical cytology of atypical squamous cells, cannot exclude high-grade squamous intra-epithelial lesion: significance of age, human papillomavirus DNA detection and previous abnormal cytology on follow-up outcomes.

PubMed

Sung, Chang Ohk; Oh, Young Lyun; Song, Sang Yong

2011-11-01

Despite the usefulness of Pap tests for cancer screening, outcomes can be difficult to predict when atypical squamous cells (ASCs) are identified. According to the 2001 Bethesda system, ASCs can be subdivided into two groups: ASCs of undetermined significance (ASC-US); and ASCs, cannot exclude high-grade squamous intra-epithelial lesion (ASC-H). ASC-H interpretations are uncommon, and studies involving this type of lesion are based on small numbers of cases. Cross-sectional, retrospective study of 392 ASC-H cases. The follow-up outcomes of ASC-H cases that were diagnosed during routine primary screening between 2002 and 2008 were investigated, and relationships between clinicopathological parameters were assessed, particularly positive test for high-risk HPV (HPV) DNA, patient age at diagnosis and previous abnormal cytology. Of the 392 cases, high-grade squamous intra-epithelial lesion (HSIL) was detected in 111 (28.3%) cases, squamous cell carcinoma was detected in 15 (3.8%) cases, low-grade squamous intra-epithelial lesion was detected in 37 (9.4%) cases, reactive change was detected in 178 (45.4%) cases, atrophy was detected in 47 (12.0%) cases, and adenocarcinoma was detected in four (1.0%) cases. The prevalence of HSIL or greater was 27.8% for women aged ≥ 40 years, and 52.3% for women aged <40 years (p<0.001). HPV positivity in ASC-H smears was significantly associated with HSIL or greater, irrespective of age (<40 years, p=0.003; ≥ 40 years, p<0.001). ASC-H with previous abnormal cytology greater than ASC-US showed a significantly higher detection rate for HSIL or greater at follow-up (p<0.001). Patient age, positive HPV DNA test and previous abnormal cytology are useful predictors of underlying HSIL or greater in women with ASC-H. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Treatment of Chronic Breath-Holding in an Adult with Severe Mental Retardation: A Clinical Case Study

ERIC Educational Resources Information Center

Reed, Derek D.; Martens, Brian K.

2008-01-01

We describe a clinical case study surrounding the behavioral assessment and operant treatment of, an adult with severe mental retardation who engaged in chronic breath-holding. In this clinical case, previous neurological and medical testing had ruled out biological bases for the individual's breath-holding. A functional behavioral assessment…

Two case studies of highly insoluble plutonium inhalation with implications for bioassay.

PubMed

Carbaugh, E H; La Bone, T R

2003-01-01

Two well characterised Pu inhalation cases show some remarkable similarities between substantially different types of Pu oxide. The circumstances of exposure, therapy, bioassay data, chemical solubility studies and dosimetry associated with these cases suggest that highly insoluble Pu may be more common than previously thought, and can pose significant challenges to bioassay programmes.

Two Case Studies of Highly Insoluble Plutonium Inhalation with Implications for Bioassay

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

Carbaugh, Eugene H.; La Bone, Thomas R.

2003-01-01

Two well-characterized Pu inhalation cases show some remarkable similarities between substantially different types of Pu oxide. The circumstances of exposure, therapy, bioassay data, chemical solubility studies, and dosimetry associated with these cases suggests taht highly insoluble Pu may be more common than previously thought, and can pose significant challenges to bioassay programs.

A 27-year experience with infective endocarditis in Lebanon.

PubMed

El-Chakhtoura, Nadim; Yasmin, Mohamad; Kanj, Souha S; Baban, Tania; Sfeir, Jad; Kanafani, Zeina A

Although rare, infective endocarditis (IE) continues to cause significant morbidity and mortality. Previous data from the American University of Beirut Medical Center (AUBMC) had shown predominance of streptococcal infection. As worldwide studies in developed countries show increasing trends in Staphylococcus aureus endocarditis, it becomes vital to continually inspect local data for epidemiological variations. We reviewed all IE cases between 2001 and 2014, and we performed a comparison to a historical cohort of 86 IE cases from 1987 to 2001. A total of 80 patients were diagnosed with IE between 2001 and 2014. The mean age was 61 years. The most commonly isolated organisms were streptococci (37%), compared to 51% in the previous cohort. S. aureus accounted for 11%. Only one S. aureus isolate was methicillin-resistant. In the historical cohort, 26% of cases were caused by S. aureus. Enterococci ranked behind staphylococci with 22% of total cases, while in the previous cohort, enterococcal IE was only 4%. Compared to previous data from AUBMC, the rates of streptococcal and staphylococcal endocarditis have decreased while enterococcal endocarditis has increased. This study reconfirms that in Lebanon, a developing country, we continue to have a low predominance of staphylococci as etiologic agents in IE. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Associated factors and outcomes for OXA-232 Carbapenem-resistant Enterobacteriaceae infections in a tertiary care centre in Mexico City: A case-control-control study.

PubMed

Torres-González, Pedro; Ortiz-Brizuela, Edgar; Cervera-Hernandez, Miguel Enrique; Bobadilla-Del Valle, Miriam; Martínez-Gamboa, Areli; Sifuentes-Osornio, José; Ponce-de-Leon, Alfredo

2016-10-01

We describe the outcomes and factors associated with OXA-232 producing carbapenem-resistant Enterobacteriaceae infections. A case-control-control study was performed; each case of infection by a carbapenem-resistant/OXA-232 (OXA-232-cases, n=27) was matched by isolation site, species, and date, with 2 cases of infection by carbapenem-susceptible/third-generation cephalosporin-susceptible (TGCS-controls, n=54) and 2 cases by carbapenem-susceptible/ESBL producing Enterobacteriaceae (ESBL-controls, n=54); 66% were urinary tract and 18.5% intra-abdominal infections. In the multivariable analysis with ESBL-controls, previous use β-lactam/β-lactamase antibiotics (OR 6.2; 95% CI 1.6-23.8) and, third-generation cephalosporins (OR 0.2; 95% CI 0.05-0.8) were associated with OXA-232 infection; with TGSC-controls previous use of β-lactam/β-lactamase antibiotics (OR 3.7; 95% 1.1-12.0) was associated. Among the OXA-232-cases, 29% received imipenem/cilastatin or meropenem, 11.1% ceftriaxone, 22.2% a carbapenem-based combination and 33.3% other antimicrobials as treatment. Previous β-lactam/β-lactamase antibiotics are associated with OXA-232 infections, and some may be treated with other active carbapenems or, in the absence of ESBL, third-generation cephalosporins. Copyright © 2016 Elsevier Inc. All rights reserved.

Genetic Relatedness among Nontypeable Pneumococci Implicated in Sporadic Cases of Conjunctivitis

PubMed Central

Barker, Jason H.; Musher, Daniel M.; Silberman, Ronald; Phan, Hoang M.; Watson, David A.

1999-01-01

Nontypeable Streptococcus pneumoniae is a common cause of epidemic conjunctivitis. A previous molecular fingerprinting study identified a clone of nontypeable pneumococcus that was responsible for a recent outbreak of conjunctivitis. In the present study, we examined the extent to which pneumococci that cause sporadic cases of conjunctivitis are related to this epidemic strain. Using arbitrarily primed BOX-PCR, we have determined that, of 10 nontypeable pneumococci causing sporadic conjunctivitis, 5 were clonal and closely related to a previous outbreak strain, whereas 5 others were genetically diverse. PMID:10565927

An Ethnographic Case Study on the Phenomena of Blended Learning Teachers

ERIC Educational Resources Information Center

Tiell, Lauren Renae

2017-01-01

This study determined the teacher-perceived experiences within the blended learning environment to fill a void in previous data. The three research questions defined blended learning, explained strengths and challenges, and provided feedback on teaching programs. This qualitative case study used an ethnographic framework through interviews,…

Smoking during Pregnancy and Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: A Case-Control Study

ERIC Educational Resources Information Center

Schmitz, Marcelo; Denardin, Daniel; Silva, Tatiana Laufer; Pianca, Thiago; Hutz, Mara Helena; Faraone, Stephen; Rohde, Luis Augusto

2006-01-01

Objective: Few previous studies assessed specifically attention-deficit/hyperactivity disorder, predominantly inattentive subtype (ADHD-I) in nonreferred samples. This study investigated the association between ADHD-I and prenatal exposure to nicotine. Method: In a case-control study performed between September 2002 and April 2005, we assessed a…

Identification of seven new prostate cancer susceptibility loci through a genome-wide association study.

PubMed

Eeles, Rosalind A; Kote-Jarai, Zsofia; Al Olama, Ali Amin; Giles, Graham G; Guy, Michelle; Severi, Gianluca; Muir, Kenneth; Hopper, John L; Henderson, Brian E; Haiman, Christopher A; Schleutker, Johanna; Hamdy, Freddie C; Neal, David E; Donovan, Jenny L; Stanford, Janet L; Ostrander, Elaine A; Ingles, Sue A; John, Esther M; Thibodeau, Stephen N; Schaid, Daniel; Park, Jong Y; Spurdle, Amanda; Clements, Judith; Dickinson, Joanne L; Maier, Christiane; Vogel, Walther; Dörk, Thilo; Rebbeck, Timothy R; Cooney, Kathleen A; Cannon-Albright, Lisa; Chappuis, Pierre O; Hutter, Pierre; Zeegers, Maurice; Kaneva, Radka; Zhang, Hong-Wei; Lu, Yong-Jie; Foulkes, William D; English, Dallas R; Leongamornlert, Daniel A; Tymrakiewicz, Malgorzata; Morrison, Jonathan; Ardern-Jones, Audrey T; Hall, Amanda L; O'Brien, Lynne T; Wilkinson, Rosemary A; Saunders, Edward J; Page, Elizabeth C; Sawyer, Emma J; Edwards, Stephen M; Dearnaley, David P; Horwich, Alan; Huddart, Robert A; Khoo, Vincent S; Parker, Christopher C; Van As, Nicholas; Woodhouse, Christopher J; Thompson, Alan; Christmas, Tim; Ogden, Chris; Cooper, Colin S; Southey, Melissa C; Lophatananon, Artitaya; Liu, Jo-Fen; Kolonel, Laurence N; Le Marchand, Loic; Wahlfors, Tiina; Tammela, Teuvo L; Auvinen, Anssi; Lewis, Sarah J; Cox, Angela; FitzGerald, Liesel M; Koopmeiners, Joseph S; Karyadi, Danielle M; Kwon, Erika M; Stern, Mariana C; Corral, Roman; Joshi, Amit D; Shahabi, Ahva; McDonnell, Shannon K; Sellers, Thomas A; Pow-Sang, Julio; Chambers, Suzanne; Aitken, Joanne; Gardiner, R A Frank; Batra, Jyotsna; Kedda, Mary Anne; Lose, Felicity; Polanowski, Andrea; Patterson, Briony; Serth, Jürgen; Meyer, Andreas; Luedeke, Manuel; Stefflova, Klara; Ray, Anna M; Lange, Ethan M; Farnham, Jim; Khan, Humera; Slavov, Chavdar; Mitkova, Atanaska; Cao, Guangwen; Easton, Douglas F

2009-10-01

Prostate cancer (PrCa) is the most frequently diagnosed cancer in males in developed countries. To identify common PrCa susceptibility alleles, we previously conducted a genome-wide association study in which 541,129 SNPs were genotyped in 1,854 PrCa cases with clinically detected disease and in 1,894 controls. We have now extended the study to evaluate promising associations in a second stage in which we genotyped 43,671 SNPs in 3,650 PrCa cases and 3,940 controls and in a third stage involving an additional 16,229 cases and 14,821 controls from 21 studies. In addition to replicating previous associations, we identified seven new prostate cancer susceptibility loci on chromosomes 2, 4, 8, 11 and 22 (with P = 1.6 x 10(-8) to P = 2.7 x 10(-33)).

Does the presence of placental basal plate myometrial fibres increase the risk of subsequent morbidly adherent placenta: a case-control study.

PubMed

Miller, E S; Linn, R L; Ernst, L M

2016-12-01

Antenatal diagnosis of morbidly adherent placenta has been shown to improve outcomes, but existing predictors lack sensitivity. Our objective was to determine whether the presence of myometrial fibres attached to the placental basal plate (BPMYO) in an antecedent pregnancy is associated with subsequent morbidly adherent placenta. A case-control study. Departments of Obstetrics and Gynecology and Pathology, Northwestern University, Chicago, IL, USA. Women who had at least two pregnancies with placental pathological evaluation. Cases were defined as women with evidence of morbidly adherent placenta (both clinically and pathologically) in their most recent pregnancy whereas women without evidence of morbidly adherent placenta served as controls. Pathological specimens of placentas from previous pregnancies were evaluated for BPMYO. The presence of BPMYO on a previous placenta was evaluated to determine whether it could be used to improve the antenatal diagnosis of morbidly adherent placenta. Of the 25 cases of morbidly adherent placenta, 19 (76%) had BPMYO present on their previous placenta compared with 41 (41%) of controls (odds ratio 4.8, 95% CI 1.8-13.0). Adding BPMYO to a regression including other risk factors for morbidly adherent placenta (i.e. maternal age, number of previous caesarean sections, placenta praevia, previous multiple gestation, any previous curettage, and ultrasonographic suspicion of placenta accreta) significantly improved the sensitivity of antenatal diagnosis of morbidly adherent placenta (61% versus 39%, P < 0.001) without a change in specificity (97% versus 97%, P = 1.00). BPMYO on previous placental pathology is associated with an increased risk of morbidly adherent placenta in a subsequent pregnancy. These findings may shed light on the pathophysiology of accreta and inform future research on predictors of accreta. Previous basal plate myometrium improves the ability to detect subsequent morbidly adherent placenta. © 2015 Royal College of Obstetricians and Gynaecologists.

Human Health Risk Assessment: A case study application of principles in dose response assessment

EPA Science Inventory

This case study application workshop will build on fundamental concepts and techniques in risk assessment presented and archived at previous TRAC meeting workshops. Practical examples from publicly available, peer reviewed risk assessments will be used as teaching aids. Course ...

Possibilities of tourist use of natural and cultural resources in the Lublin Region - case study

NASA Astrophysics Data System (ADS)

Świeca, Andrzej; Krukowska, Renata; Tucki, Andrzej; Skowronek, Ewa; Brzezińska-Wójcik, Teresa; Kociuba, Waldemar; Jóźwik, Marta

2012-01-01

The paper presents an overview of previous studies, the possibilities for tourist use of natural and cultural resources of the Lublin Region and presents case studies in this area. The case studies focused on assessing the tourism potential of spatial units of an administrative nature: the Lublin voivodeship, Lublin city and the municipality of Krasnobród, as well as physical-geographical units - the Giełczew Elevation.

Assessment of "Teenage Diaries" for Teaching Concepts in Adolescent Psychology

ERIC Educational Resources Information Center

McKee, Meredith L.; MacDonald, Pamelyn M.

2009-01-01

Student self-report measures have been reported in numerous studies to assert that the use of case studies in college psychology courses can help students to better understand the relevance of course topics; however, few studies have directly measured the impact of case studies on students' learning. The present study differs from previous studies…

A Case Study of Learning, Motivation, and Performance Strategies for Teaching and Coaching CDE Teams

ERIC Educational Resources Information Center

Ball, Anna; Bowling, Amanda; Bird, Will

2016-01-01

This intrinsic case study examined the case of students on CDE (Career Development Event) teams preparing for state competitive events and the teacher preparing them in a school with a previous exemplary track record of winning multiple state and national career development events. The students were interviewed multiple times during the 16-week…

Brief Report: Maternal Smoking during Pregnancy and Autism Spectrum Disorders

ERIC Educational Resources Information Center

Lee, Brian K.; Gardner, Renee M.; Dal, Henrik; Svensson, Anna; Galanti, Maria Rosaria; Rai, Dheeraj; Dalman, Christina; Magnusson, Cecilia

2012-01-01

Prenatal exposure to tobacco smoke is suggested as a potential risk factor for autism spectrum disorders (ASD). Previous epidemiological studies of this topic have yielded mixed findings. We performed a case-control study of 3,958 ASD cases and 38,983 controls nested in a large register-based cohort in Sweden. ASD case status was measured using a…

An Investigation of Agility Issues in Scrum Teams Using Agility Indicators

NASA Astrophysics Data System (ADS)

Pikkarainen, Minna; Wang, Xiaofeng

Agile software development methods have emerged and become increasingly popular in recent years; yet the issues encountered by software development teams that strive to achieve agility using agile methods are yet to be explored systematically. Built upon a previous study that has established a set of indicators of agility, this study investigates what issues are manifested in software development teams using agile methods. It is focussed on Scrum teams particularly. In other words, the goal of the chapter is to evaluate Scrum teams using agility indicators and therefore to further validate previously presented agility indicators within the additional cases. A multiple case study research method is employed. The findings of the study reveal that the teams using Scrum do not necessarily achieve agility in terms of team autonomy, sharing, stability and embraced uncertainty. The possible reasons include previous organizational plan-driven culture, resistance towards the Scrum roles and changing resources.

EGFR, KRAS, and BRAF mutational profiles of female patients with micropapillary predominant invasive lung adenocarcinoma

PubMed

Demirağ, Funda; Yılmaz, Aydın; Yılmaz Demirci, Nilgün; Yılmaz, Ülkü; Erdoğan, Yurdanur

2017-11-13

Background/aim: This study aimed to analyze EGFR, KRAS, and BRAF mutations in females with micropapillary predominant invasive lung adenocarcinoma and their relationships with immunohistochemical and clinicopathological patterns.Materials and methods: A total of 15 females with micropapillary lung adenocarcinoma were selected. Mutational analysis of the EGFR, KRAS, and BRAF genes was carried out. Information regarding the demographic data, tumor size, treatment, and survival time for each patient was collated, and the predominant cell type, secondary architectural growth patterns, psammoma bodies, necrosis, and visceral pleural and angiolymphatic invasions were evaluated.Results: We identified EGFR mutation in six cases, KRAS mutation in three cases, and BRAF mutation in one case. EGFR, c-kit, VEGFR, and bcl-2 positivity was observed in ten, seven, four, and six cases, respectively. All cases were positive for VEGF (strong positivity in 11 cases and weak positivity in four cases) and bcl-2 (strong positivity in nine cases and weak positivity in six cases). Seven (46.6%) cases were positive for c-kit and 10 (66.6%) cases were positive for EGFR. Conclusion: EGFR mutation occurred at a higher incidence rate in micropapillary predominant invasive adenocarcinoma than has previously been found in conventional lung adenocarcinomas. KRAS mutation was observed as having a similar frequency to what was previously observed, but the frequency of BRAF mutation was lower than previously reported.

Improving prediction of conditions that modulate dengue fever risks in Yucatán, México.

NASA Astrophysics Data System (ADS)

Laureano-Rosario, A. E.; Garcia-Rejon, J. E.; Gomez-Carro, S.; Farfan-Ale, J.; Muller-Karger, F. E.

2015-12-01

Accurately predicting vector-borne diseases is essential for communities everywhere around the world. Yet this is a difficult task, even in areas where annual epidemics occur. The primary vector for dengue virus disease (DENV) is Aedes aegypti. This is a tropical-subtropical mosquito that proliferates in urban areas. Precipitation and increased temperatures are known to promote growth, reproduction and transmission of DENV. This study assesses potential health risks on coastal communities in the northwest Yucatan Peninsula, Mexico. We studied the relation between DENV incidences and environmental data. We hypothesized that environmental parameters such as rainfall, sea surface temperature (SST), air temperature, humidity, and past DENV cases are the primary drivers of DENV incidences. We collected DENV data from the National Health Information System and demographic data from the National Institute of Statistics and Geography. Precipitation and air temperature were obtained from the National Water Commission. SST was derived from the NOAA Advanced Very High Resolution Radiometer (AVHRR) satellite sensor. In addition, incidence of DENV cases per year was calculated. Multiple regression analyses show that previous DENV cases, minimum air temperature, humidity, and precipitation are positively related to DENV cases and explain 82% of the variation, with 77% explained by previous DENV cases (cases that took place 2-weeks before the target). A second regression model without the previous DENV cases showed 30% of the variation explained by humidity and precipitation (p<0.05). Satellite-derived SST was also included to test whether the percent variation of DENV explained increased. These results imply that if these environmental variables continue to increase with time, the trend of DENV cases will also increase. This study suggests that it is possible to significantly improve DENV prevention and prediction of potential outcomes in Yucatan using remote sensing data.

Tuberculosis retreatment 'others' in comparison with classical retreatment cases; a retrospective cohort review.

PubMed

Nabukenya-Mudiope, Mary G; Kawuma, Herman Joseph; Brouwer, Miranda; Mudiope, Peter; Vassall, Anna

2015-09-02

Many of the countries in sub-Saharan Africa are still largely dependent on microscopy as the mainstay for diagnosis of tuberculosis (TB) including patients with previous history of TB treatment. The available guidance in management of TB retreatment cases is focused on bacteriologically confirmed TB retreatment cases leaving out those classified as retreatment 'others'. Retreatment 'others' refer to all TB cases who were previously treated but with unknown outcome of that previous treatment or who have returned to treatment with bacteriologically negative pulmonary or extra-pulmonary TB. This study was conducted in 11 regional referral hospitals (RRHs) serving high burden TB districts in Uganda to determine the profile and treatment success of TB retreatment 'others' in comparison with the classical retreatment cases. A retrospective cohort review of routinely collected National TB and Leprosy Program (NTLP) facility data from 1 January to 31 December 2010. This study uses the term classical retreatment cases to refer to a combined group of bacteriologically confirmed relapse, return after failure and return after loss to follow-up cases as a distinct group from retreatment 'others'. Distribution of categorical characteristics were compared using Chi-squared test for difference between proportions. The log likelihood ratio test was used to assess the independent contribution of type of retreatment, human immunodeficiency virus (HIV) status, age group and sex to the models. Of the 6244 TB cases registered at the study sites, 733 (11.7%) were retreatment cases. Retreatment 'others' constituted 45.5% of retreatment cases. Co-infection with HIV was higher among retreatment 'others' (70.9%) than classical retreatment cases (53.5%). Treatment was successful in 410 (56.2%) retreatment cases. Retreatment 'others' were associated with reduced odds of success (AOR = 0.44, 95% CI 0.22,0.88) compared to classical cases. Lost to follow up was the commonest adverse outcome (38% of adverse outcomes) in all retreatment cases. Type of retreatment case, HIV status, and age were independently associated with treatment success. TB retreatment 'others' constitute a significant proportion of retreatment cases, with higher HIV prevalence and worse treatment success. There is need to review the diagnosis and management of retreatment 'others'.

Talk, Decisions, and Action in Curriculum-Making: Reflections on the "ILS" and "L97" Case Studies

ERIC Educational Resources Information Center

Westbury, Ian

2016-01-01

Previous papers in this issue of "JCS" have presented case studies of the state-based curriculum commissions that developed the "Illinois Learning Standards" of 1997 and Norway's "Laereplanverket 1997" ("L97") (1997). The studies were developed using as a framework a body of German research that sees…

Student Engagement with Computer-Generated Feedback: A Case Study

ERIC Educational Resources Information Center

Zhang, Zhe

2017-01-01

In order to benefit from feedback on their writing, students need to engage effectively with it. This article reports a case study on student engagement with computer-generated feedback, known as automated writing evaluation (AWE) feedback, in an EFL context. Differing from previous studies that explored commercially available AWE programs, this…

Are You an Online Team Player? A Pilot Study

ERIC Educational Resources Information Center

Rawlings, Melody

2014-01-01

The purpose of this pilot case study was to answer the following research questions: How do previous experiences affect students' attitudes toward online teamwork? When do students' attitudes toward online teamwork first develop and why? Using a social constructivist framework, a qualitative case study design was utilized to conduct an online…

Unexplained Cases of Allergic Reactions Linked to Red Meat

MedlinePlus

... that starts after being bitten by a lone star tick may cause unexplained cases of recurrent anaphylaxis. ... after eating meat. Previous studies have linked lone star tick bites to this unusual food allergy. The ...

Is Social Media Too Social for Class? A Case Study of Twitter Use

ERIC Educational Resources Information Center

Lin, Meng-Fen Grace; Hoffman, Ellen S.; Borengasser, Claire

2013-01-01

This qualitative case study examined Twitter use by undergraduate and graduate students in three classes. Previous studies have shown that while some faculty use Twitter, few are incorporating it into classes despite many recommendations for such use. This study examined how students perceived Twitter as a classroom tool. As an optional activity,…

Reverse case study: to think like a nurse.

PubMed

Beyer, Deborah A

2011-01-01

Reverse case study is a collaborative, innovative, active learning strategy that nurse educators can use in the classroom. Groups of students develop a case study and a care plan from a list of medications and a short two- to three-sentence scenario. The students apply the nursing process to thoroughly develop a complete case study written as a concept map. The strategy builds on previous learned information and applies the information to new content, thus promoting critical thinking and problem solving. Reverse case study has been used in both associate and baccalaureate nursing degree theory courses to generate discussion and assist students in thinking like a nurse. 2011, SLACK Incorporated.

Case-study experiments in the introductory physics curriculum

NASA Astrophysics Data System (ADS)

Arion, D. N.; Crosby, K. M.; Murphy, E. A.

2000-09-01

Carthage College added inquiry-based case study activities to the traditional introductory physics laboratory. Student teams designed, constructed, and executed their own experiments to study real-world phenomena, through which they gained understanding both of physic principles and methods of physics research. Assessment results and student feedback through teacher evaluations indicate that these activities improved student attitudes about physics as well as their ability to solve physics problems relative to previous course offerings that did not include case study.

Caught between Cultures: Case Study of an "Out of School" Ethnic Minority Student in Hong Kong

ERIC Educational Resources Information Center

Bhowmik, Miron Kumar; Kennedy, Kerry J.

2017-01-01

This paper reports a case study on Maneesha Rai, a Nepalese girl living in Hong Kong and an "out of school" student. Based on in-depth interviews, a case was constructed of her previous school days and current "out of school" days. These provided a vivid picture of her life and several themes were created using schema analysis…

Bayesian approach to the assessment of the population-specific risk of inhibitors in hemophilia A patients: a case study

PubMed Central

Cheng, Ji; Iorio, Alfonso; Marcucci, Maura; Romanov, Vadim; Pullenayegum, Eleanor M; Marshall, John K; Thabane, Lehana

2016-01-01

Background Developing inhibitors is a rare event during the treatment of hemophilia A. The multifacets and uncertainty surrounding the development of inhibitors further complicate the process of estimating inhibitor rate from the limited data. Bayesian statistical modeling provides a useful tool in generating, enhancing, and exploring the evidence through incorporating all the available information. Methods We built our Bayesian analysis using three study cases to estimate the inhibitor rates of patients with hemophilia A in three different scenarios: Case 1, a single cohort of previously treated patients (PTPs) or previously untreated patients; Case 2, a meta-analysis of PTP cohorts; and Case 3, a previously unexplored patient population – patients with baseline low-titer inhibitor or history of inhibitor development. The data used in this study were extracted from three published ADVATE (antihemophilic factor [recombinant] is a product of Baxter for treating hemophilia A) post-authorization surveillance studies. Noninformative and informative priors were applied to Bayesian standard (Case 1) or random-effects (Case 2 and Case 3) logistic models. Bayesian probabilities of satisfying three meaningful thresholds of the risk of developing a clinical significant inhibitor (10/100, 5/100 [high rates], and 1/86 [the Food and Drug Administration mandated cutoff rate in PTPs]) were calculated. The effect of discounting prior information or scaling up the study data was evaluated. Results Results based on noninformative priors were similar to the classical approach. Using priors from PTPs lowered the point estimate and narrowed the 95% credible intervals (Case 1: from 1.3 [0.5, 2.7] to 0.8 [0.5, 1.1]; Case 2: from 1.9 [0.6, 6.0] to 0.8 [0.5, 1.1]; Case 3: 2.3 [0.5, 6.8] to 0.7 [0.5, 1.1]). All probabilities of satisfying a threshold of 1/86 were above 0.65. Increasing the number of patients by two and ten times substantially narrowed the credible intervals for the single cohort study (1.4 [0.7, 2.3] and 1.4 [1.1, 1.8], respectively). Increasing the number of studies by two and ten times for the multiple study scenarios (Case 2: 1.9 [0.6, 4.0] and 1.9 [1.5, 2.6]; Case 3: 2.4 [0.9, 5.0] and 2.6 [1.9, 3.5], respectively) had a similar effect. Conclusion Bayesian approach as a robust, transparent, and reproducible analytic method can be efficiently used to estimate the inhibitor rate of hemophilia A in complex clinical settings. PMID:27822129

Bayesian approach to the assessment of the population-specific risk of inhibitors in hemophilia A patients: a case study.

PubMed

Cheng, Ji; Iorio, Alfonso; Marcucci, Maura; Romanov, Vadim; Pullenayegum, Eleanor M; Marshall, John K; Thabane, Lehana

2016-01-01

Developing inhibitors is a rare event during the treatment of hemophilia A. The multifacets and uncertainty surrounding the development of inhibitors further complicate the process of estimating inhibitor rate from the limited data. Bayesian statistical modeling provides a useful tool in generating, enhancing, and exploring the evidence through incorporating all the available information. We built our Bayesian analysis using three study cases to estimate the inhibitor rates of patients with hemophilia A in three different scenarios: Case 1, a single cohort of previously treated patients (PTPs) or previously untreated patients; Case 2, a meta-analysis of PTP cohorts; and Case 3, a previously unexplored patient population - patients with baseline low-titer inhibitor or history of inhibitor development. The data used in this study were extracted from three published ADVATE (antihemophilic factor [recombinant] is a product of Baxter for treating hemophilia A) post-authorization surveillance studies. Noninformative and informative priors were applied to Bayesian standard (Case 1) or random-effects (Case 2 and Case 3) logistic models. Bayesian probabilities of satisfying three meaningful thresholds of the risk of developing a clinical significant inhibitor (10/100, 5/100 [high rates], and 1/86 [the Food and Drug Administration mandated cutoff rate in PTPs]) were calculated. The effect of discounting prior information or scaling up the study data was evaluated. Results based on noninformative priors were similar to the classical approach. Using priors from PTPs lowered the point estimate and narrowed the 95% credible intervals (Case 1: from 1.3 [0.5, 2.7] to 0.8 [0.5, 1.1]; Case 2: from 1.9 [0.6, 6.0] to 0.8 [0.5, 1.1]; Case 3: 2.3 [0.5, 6.8] to 0.7 [0.5, 1.1]). All probabilities of satisfying a threshold of 1/86 were above 0.65. Increasing the number of patients by two and ten times substantially narrowed the credible intervals for the single cohort study (1.4 [0.7, 2.3] and 1.4 [1.1, 1.8], respectively). Increasing the number of studies by two and ten times for the multiple study scenarios (Case 2: 1.9 [0.6, 4.0] and 1.9 [1.5, 2.6]; Case 3: 2.4 [0.9, 5.0] and 2.6 [1.9, 3.5], respectively) had a similar effect. Bayesian approach as a robust, transparent, and reproducible analytic method can be efficiently used to estimate the inhibitor rate of hemophilia A in complex clinical settings.

Rebel Integration in Conflict Settlements: Past Lessons and the Prospects of MILF Reintegration

DTIC Science & Technology

2017-12-01

ethnicity, religion, or language among a nation’s citizens.33 A series of investigations on case studies conducted by Matthew Hoddie and Caroline Hartzell...rebel reintegration from previous peace agreements was consulted. The selected case studies center on the peace agreements in Zimbabwe, Rwanda...Dayton.” 85 Akyol. 86 David Wage and Lois Haigh, “A Case Study on the Arusha Peace Agreement” (Florida State University, July 19, 2004), http

Identification of seven new prostate cancer susceptibility loci through a genome-wide association study

PubMed Central

Eeles, Rosalind A.; Kote-Jarai, Zsofia; Olama, Ali Amin Al; Giles, Graham G.; Guy, Michelle; Severi, Gianluca; Muir, Kenneth; Hopper, John L.; Henderson, Brian E.; Haiman, Christopher A.; Schleutker, Johanna; Hamdy, Freddie C.; Neal, David E.; Donovan, Jenny L.; Stanford, Janet L.; Ostrander, Elaine A.; Ingles, Sue A.; John, Esther M.; Thibodeau, Stephen N.; Schaid, Daniel; Park, Jong Y.; Spurdle, Amanda; Clements, Judith; Dickinson, Joanne L.; Maier, Christiane; Vogel, Walther; Dörk, Thilo; Rebbeck, Timothy R.; Cooney, Kathleen A.; Cannon-Albright, Lisa; Chappuis, Pierre O.; Hutter, Pierre; Zeegers, Maurice; Kaneva, Radka; Zhang, Hong-Wei; Lu, Yong-Jie; Foulkes, William D.; English, Dallas R.; Leongamornlert, Daniel A.; Tymrakiewicz, Malgorzata; Morrison, Jonathan; Ardern-Jones, Audrey T.; Hall, Amanda L.; O’Brien, Lynne T.; Wilkinson, Rosemary A.; Saunders, Edward J.; Page, Elizabeth C.; Sawyer, Emma J.; Edwards, Stephen M.; Dearnaley, David P.; Horwich, Alan; Huddart, Robert A.; Khoo, Vincent S.; Parker, Christopher C.; Van As, Nicholas; Woodhouse, Christopher J.; Thompson, Alan; Christmas, Tim; Ogden, Chris; Cooper, Colin S.; Southey, Melissa C.; Lophatananon, Artitaya; Liu, Jo-Fen; Kolonel, Laurence N.; Le Marchand, Loic; Wahlfors, Tiina; Tammela, Teuvo L.; Auvinen, Anssi; Lewis, Sarah J.; Cox, Angela; FitzGerald, Liesel M.; Koopmeiners, Joseph S.; Karyadi, Danielle M.; Kwon, Erika M.; Stern, Mariana C.; Corral, Roman; Joshi, Amit D.; Shahabi, Ahva; McDonnell, Shannon K.; Sellers, Thomas A; Pow-Sang, Julio; Chambers, Suzanne; Aitken, Joanne; Gardiner, R.A. (Frank); Batra, Jyotsna; Kedda, Mary Anne; Lose, Felicity; Polanowski, Andrea; Patterson, Briony; Serth, Jürgen; Meyer, Andreas; Luedeke, Manuel; Stefflova, Klara; Ray, Anna M.; Lange, Ethan M.; Farnham, Jim; Khan, Humera; Slavov, Chavdar; Mitkova, Atanaska; Cao, Guangwen; Easton, Douglas F.

2010-01-01

Prostate cancer (PrCa) is the most frequently diagnosed male cancer in developed countries. To identify common PrCa susceptibility alleles, we have previously conducted a genome-wide association study in which 541, 129 SNPs were genotyped in 1,854 PrCa cases with clinically detected disease and 1,894 controls. We have now evaluated promising associations in a second stage, in which we genotyped 43,671 SNPs in 3,650 PrCa cases and 3,940 controls, and a third stage, involving an additional 16,229 cases and 14,821 controls from 21 studies. In addition to previously identified loci, we identified a further seven new prostate cancer susceptibility loci on chromosomes 2, 4, 8, 11, and 22 (P=1.6×10−8 to P=2.7×10−33). PMID:19767753

Clinicopathological Findings of Suicide in the Elderly: Three Cases

ERIC Educational Resources Information Center

Peisah, Carmelle; Snowdon, John; Kril, Jillian; Rodriguez, Michael

2007-01-01

The neuropathological correlates of suicide in older persons have received little research attention. Our recent study of elderly suicide victims from an Australian forensic medicine department (n = 143), unlike a previous case-control study, did not find an increased prevalence of Alzheimer's disease (AD) in older persons who committed suicide…

A Case Study of International Students' Social Adjustment, Friendship Development, and Physical Activity

ERIC Educational Resources Information Center

Li, Shuang; Zizzi, Sam

2018-01-01

Previous literature has focused on international student's social transition and monocultural and bicultural ties. Little research has explored international students' multicultural friendship development and the role that physical activity plays in their social interaction. The current case study explored a group of international students'…

The Role of Simulation Case Studies in Enterprise Education

ERIC Educational Resources Information Center

Tunstall, Richard; Lynch, Martin

2010-01-01

Purpose: This paper aims to explore the role of electronic simulation case studies in enterprise education, their effectiveness, and their relationship to traditional forms of classroom-based approaches to experiential learning. The paper seeks to build on previous work within the field of enterprise and management education, specifically in…

NCI International EBV-Gastric Cancer Consortium

Cancer.gov

A collaboration among NCI and extramural investigators, established by DCEG in 2006, that utilizes data and biospecimens from completed and ongoing case series and observational studies of gastric cancer to replicate and extend findings from previous studies hindered by small numbers of EBV-positive cases, and to stimulate multidisciplinary research in this area.

Minimizing pathogen growth and quality deterioration of packaged leafy greens by maintaining optimum temperature in refrigerated display cases with doors

USDA-ARS?s Scientific Manuscript database

Retail display of packaged fresh-cut leafy greens is a critical stage of cold chain management and is prone to temperature abuse when produce is displayed in open cases, due to infiltration of ambient air into the case. Previous studies demonstrated that retrofitting open display cases with doors is...

[Immunohistochemistry diagnosis of fungal infections].

PubMed

Rocha, D C; Duarte, M I; Pagliari, C; de Oliveira, M S

1998-01-01

Because the mycosis incidence has increased a lot with the appearing of AIDS, the Immunohistochemistry study among fungus shows the importance of fast methods for their identification that have advantage of been a durable method in comparison with immunofluorescence and the possibility of making retrospective studies in material embedded in paraffin. The Immunohistochemistry reaction with Histoplasma capsulatum, Pneumocystis carinii; and Criptococcus neoformans antibodies were sensitive, specifics, and intensely positive in all the cases previously diagnosed as Histoplasmosis, Pneumocystosis and Cryptococcosis, without cross-reaction with other fungus; while the anti-Candida albicans antibody showed weak positiveness in four Histoplasmosis cases, in one of Paracoccidioidomycosis cases and Sporotrichosis case; and the reactions with the antibody anti-P. brasiliensis were intensely positive in all the Paracoccidioidomycosis cases and weakly positive in two Histoplasmosis and two of the four Candidiasis cases. The previous identification of each fungi on tissue sample was made by Grocott method. This preliminary study showed that it is necessary to use other kinds of antibody and fungus, in order to get more details about the possible occurrence of cross-reactions. We suggest the use of new antibodies, with new standardizations in order to find the best titles for each reaction and eliminate the cross-reactions.

Multiple Case Study on Cyberbullying's Impacts on Adolescent Technology Use

ERIC Educational Resources Information Center

Thompson, Kent W.

2013-01-01

This multiple case study focused on whether and how cyberbullying had an impact on students' use of technology. Analysis of the lived experiences of the participants in this study added depth to the quantitative research previously conducted by others in this area. The conceptual framework was based on social learning theory, which suggested that…

Code-Switching and Gender: A Longitudinal Study of Spanish/English Speaking Fraternal Boy-Girl Twins

ERIC Educational Resources Information Center

Robinson, Colin

2015-01-01

Researchers from Jean Piaget (1932) to Sehlauoi (2008) have utilized small case studies to intensively examine naturally occurring child language production in the home environment. This qualitative, 5-year longitudinal, five-year case study continues the focus of previous research on child bilingualism and code-switching; however, it aims to…

The Effect of English Language Learning on Creative Thinking Skills: A Mixed Methods Case Study

ERIC Educational Resources Information Center

Sehic, Sandro

2017-01-01

The purpose of this sequential explanatory mixed-methods case study was to investigate the effects of English language learning on creative thinking skills in the domains of fluency, flexibility, originality, and elaboration as measured with the Alternate Uses Test. Unlike the previous research studies that investigated the links between English…

Academic Staff's Perspectives upon Student Plagiarism: A Case Study at a University in Hong Kong

ERIC Educational Resources Information Center

Li, Yongyan

2015-01-01

Much of the previous research concerning student plagiarism has been conducted in Anglo-American settings. The present paper reports a case study of academic staff's perspectives upon student plagiarism at a university in Hong Kong. Based on interviews with 16 instructors, the study focused on the teachers' views and pedagogical practices,…

The Effect of Tomatis Therapy on Children with Autism: Eleven Case Studies

ERIC Educational Resources Information Center

Gerritsen, Jan

2010-01-01

This article presents a reanalysis of a previously reported study on the impact of the Tomatis Method of auditory stimulation on subjects with autism. When analyzed as individual case studies, the data showed that six of the 11 subjects with autism demonstrated significant improvement from 90 hours of Tomatis Therapy. Five subjects did not benefit…

How to Integrate Student Internships into Legal Studies Research and Curriculum: A Case Study

ERIC Educational Resources Information Center

Jasperson, Jill O.

2017-01-01

The aim of this article is to answer the "how" and "why" of a Legal Studies internship experience at a public university. Internship is an integral part of student learning. Although the Faculty/Organizers conducted a free legal clinic for five years previous, this case study discusses a first time internship attempt by faculty…

Integrating ICT in Kenyan Secondary Schools: An Exploratory Case Study of a Professional Development Programme

ERIC Educational Resources Information Center

Tondeur, Jo; Krug, Don; Bill, Mike; Smulders, Maaike; Zhu, Chang

2015-01-01

This study explores the introduction of Information and Communication Technology (ICT) in Kenyan secondary schools. Specifically, it is a case study of four schools with no previous access to ICT. The professional development programme from which data for this study were drawn was designed to support teachers learning to integrate ICT in the…

The incubation period distribution of tuberculosis estimated with a molecular epidemiological approach.

PubMed

Borgdorff, Martien W; Sebek, Maruschka; Geskus, Ronald B; Kremer, Kristin; Kalisvaart, Nico; van Soolingen, Dick

2011-08-01

There is limited information on the distribution of incubation periods of tuberculosis (TB). In The Netherlands, patients whose Mycobacterium tuberculosis isolates have identical DNA fingerprints in the period 1993-2007 were interviewed to identify epidemiological links between cases. We determined the incubation period distribution in secondary cases. Survival analysis techniques were used to include secondary cases not yet symptomatic at diagnosis with weighting to adjust for lower capture probabilities of couples with longer time intervals between their diagnoses. In order to deal with missing data, we used multiple imputations. We identified 1095 epidemiologically linked secondary cases, attributed to 688 source cases with pulmonary TB. Of those developing disease within 15 years, the Kaplan-Meier probability to fall ill within 1 year was 45%, within 2 years 62% and within 5 years 83%. The incubation time was shorter in secondary cases who were men, young, those with extra-pulmonary TB and those not reporting previous TB or previous preventive therapy. Molecular epidemiological analysis has allowed a more precise description of the incubation period of TB than was possible in previous studies, including the identification of risk factors for shorter incubation periods.

Microphthalmia and anophthalmia in Chuuk State, Federated States of Micronesia.

PubMed

Yomai, A A; Pavlin, B I

2010-04-01

Microphthalmia ('small eye') and anophthalmia ('no eye') are rare congenital defects of eye development. Previous studies utilizing a variety of methodologies have estimated their combined incidence at anywhere from 4 to 30 cases per 100,000 live births. In Chuuk, Federated States of Micronesia, there have been 42 cases detected since 1988, yielding an estimated incidence of 140 cases per 100,000. A number of putative genetic and environmental causes have previously been associated with microphthalmia and anophthalmia, including vitamin A deficiency. To date, it is unclear which of these factors may play a role in the alarmingly high rates observed in Chuuk. The Chuuk Division of Public Health has proposed a study to explore these potential causes, which will hopefully shed light on the prevention of these rare but debilitating conditions.

Nanomaterial Case Study: A Comparison of Multiwalled ...

EPA Pesticide Factsheets

The draft document is intended to be used as part of a process to identify what is known and, more importantly, what is not yet known that could be of value in assessing the broad implications of specific nanomaterials. Like previous case studies (see History/ Chronology below), this draft case study on multiwalled carbon nanotubes (MWCNTs) is based on the comprehensive environmental assessment (CEA) approach, which consists of both a framework and a process. Unlike previous case studies this case study incorporates information about a traditional (i.e., “non-nano-enabled”) product, against which the MWCNT flame-retardant coating applied to upholstery textiles (i.e., the “nano-enabled” product) can be compared. The comparative element serves dual-purposes: 1) to provide a more robust database that facilitates identification of data gaps related to the nano-enabled product and 2) to provide a context for identifying key factors and data gaps for future efforts to evaluate risk-related trade-offs between a nano-enabled and non-nano-enabled product. This draft case study does not represent a completed or even a preliminary assessment of MWCNTs; rather, it uses the CEA framework to structure information from available literature and other resources (e.g., government reports) on the product life cycle, fate and transport processes in various environmental media, exposure-dose characterization, and impacts in human, ecological, and environmental receptors.

Tuberculosis in Auckland autopsies, revisited.

PubMed

Lum, Dennis; Koelmeyer, Timothy

2005-03-11

To review the cases of tuberculosis found at autopsy in the Auckland Coronial Autopsy Service in the previous 10 years, and compare the results with that of a similar study for the period 1975 to 1992. Cases which were not diagnosed prior to autopsy are scrutinised as to why the diagnosis may have been missed. A computerised search of the Forensic Pathology Department database at Auckland Hospital for cases of tuberculosis or atypical mycobacterial infection found at autopsy was done. Basic demographic data, past medical history, and police reports were analysed. The cases were placed into five groups for analysis. A total of 30 cases of tuberculosis (including 3 cases of atypical mycobacterial infection) were found. A large proportion (70%) was undiagnosed before death, and each case was potentially infective. Two cases had respiratory symptoms suggestive of tuberculosis, and a further 5 cases had generalised symptoms which were unexplained yet tuberculosis was not considered. In those cases that were missed, the autopsy played a vital role by identifying the previously undiagnosed cases of tuberculosis and ensuring contact screening. Awareness of tuberculosis and its increasing prevalence in New Zealand is essential for minimising missed diagnoses.

Gestational diabetes insipidus: a morphological study of the placenta.

PubMed

Castiglione, F; Buccoliero, A M; Garbini, F; Gheri, C F; Moncini, D; Poggi, G; Saladino, V; Rossi Degl'Innocenti, D; Gheri, R G; Taddei, G L

2009-12-01

Gestational diabetes insipidus (GDI) refers to the state of excessive water intake and hypotonic polyuria. Those cases manifesting in pregnancy and referred to as GDI may persist thereafter or may be a transient latent form that resolves after delivery. Microscopic examination of affected subjects has not been previously reported. In the literature, there are various case reports and case series on diabetes insipidus in pregnancy. In this study, we present a case that had transient diabetes insipidus during pregnancy in which the placenta was examined.

Appendectomy, smoking habits and the risk of developing ulcerative colitis: a case control study in private practice setting.

PubMed

de Saussure, Philippe; Clerson, Pierre; Prost, Pierre-Louis; Truong Tan, Nghiep; Bouhnik, Yoram; Gil-Rch

2007-05-01

The strongest environmental factors identified for ulcerative colitis (UC) are cigarette smoking and appendectomy. However, most studies have been performed using case-controls from hospital-based populations. The purpose of this study was to compare the history of previous appendectomy and smoking habits in a group of patients with UC and a control group, followed by gastroenterologists in private practice. We performed a case control study in which 100 physicians recruited UC-patients and age and sex matched controls. Data were collected during a single visit. Based on a standardized questionnaire, UC patients and controls were divided into never, former or current smokers, and into subjects with or without a previous history of appendectomy. One hundred and ninety eight age- and sex-matched pairs of UC patients and controls were included. The prevalence of appendectomy in the UC-patients and control group was 12% and 46%, respectively. The pairwise-matched OR of ulcerative colitis for previous appendectomy was 0.10 (95% CI, 0.05-0.21) (P<0.0001). The OR for former and never smokers versus current smokers was 2.40 (95% CI 1.31-4.38) (P=0.004). In UC-patients, the OR of family history of UC compared with controls was 2.80 (95% CI, 1.01-7.77) (P=0.048). This case-control study confirmed a strong negative correlation between both appendectomy and tobacco smoking, and ulcerative colitis in patients followed-up by gastroenterological practitioners.

Risk factors for hospital acquisition of trimethoprim-sulfamethoxazole resistant Stenotrophomonas maltophilia in adults: A matched case-control study.

PubMed

Wang, Ching-Hsun; Lin, Jung-Chung; Chang, Feng-Yee; Yu, Ching-Mei; Lin, Wei-San; Yeh, Kuo-Ming

2017-10-01

The emergence of trimethoprim-sulfamethoxazole resistant Stenotrophomonas maltophilia (TSRSM) represents a serious threat to patients. The aim of current study was to identify risk factors associated with hospital-acquired TSRSM occurrence in adult inpatients. We conducted a matched case-control study in Tri-Service General Hospital, Taipei, Taiwan. From January 2014 through June 2015, case patients with TSRSM and control patients with trimethoprim-sulfamethoxazole susceptible S. maltophilia (TSSSM) during hospitalization were identified. Control patients were matched with TSRSM cases for age (within five years), sex, and site of isolation at a ratio of 1:1. A total of 266 patients were included in our study (133 cases and 133 matched controls). Bivariable analysis showed that previous exposure to fluoroquinolone [odds ratio (OR), 2.693; 95% confidence interval (CI, 1.492-5.884; p = 0.002)], length of intensive care unit stay (OR, 1.015 per day; 95% CI, 1.001-1.030; p = 0.041), and length of hospital stay (OR, 1.012 per day; 95% CI, 1.002-1.023; p = 0.018) prior to S. maltophilia isolation were associated with TSRSM occurrence. A multivariable analysis showed that previous exposure to fluoroquinolone (OR, 3.158; 95% CI, 1.551-6.430; p = 0.002) was an independent risk factor for TSRSM occurrence after adjustment. Previous fluoroquinolone use was an independent risk factor for hospital-acquired TSRSM occurrence in adult inpatients, suggesting that judicious administration of fluoroquinolone may be important for limiting TSRSM occurrence. Copyright © 2017. Published by Elsevier B.V.

Intercultural Blended Design Considerations: A Case Study of a Nordic-Baltic Course in Autism Intervention

ERIC Educational Resources Information Center

Kack, Annika; Roll-Pettersson, Lise; Alai-Rosales, Shahla S.; Hoium, Kari; Mannikko-Barbutiu, Sirkku; Fors, Uno G. H.

2014-01-01

Specialized educational programs previously unavailable to many students are now accessible to students spread throughout the world. In particular, this globalization presents new opportunities and challenges for universities educating professionals in the field of autism treatment. The aim of the present case study is to analyse the experiences…

C++ and operating systems performance - A case study

NASA Technical Reports Server (NTRS)

Russo, Vincent F.; Madany, Peter W.; Campbell, Roy H.

1990-01-01

Object-oriented design and programming has many software engineering advantages. Its application to large systems, however, has previously been constrained by performance concerns. The Choices operating system, which has over 75,000 lines of code, is object-oriented and programmed in C++. This paper is a case study of the performance of Choices.

Follow-Up Study on Parenting with Intellectual Disability in Germany.

ERIC Educational Resources Information Center

Pixa-Kettner, Ursula

1999-01-01

Five cases of parenthood of persons with intellectual disability were reinvestigated about two years after a previous German study. Problem-centered interviews were conducted with mothers or fathers with an intellectual disability and with the caretakers. Results show developmental disability in two of six children and, in some cases,…

Analogical Encoding with and without Instructions for Case Comparison of Scientific Phenomena

ERIC Educational Resources Information Center

Mason, Lucia; Tornatora, Maria Caterina

2016-01-01

The study aimed to extend current research on conditions that better support analogical encoding through mutual alignment. We focused on two variables that have not been examined independently in previous studies: the joint presentations of two cases of a scientific phenomenon and the explicit instructions for comparison. One hundred and…

An Approach to Meeting the Needs of Medical Students with Learning Disabilities.

ERIC Educational Resources Information Center

Walters, Janice A.; Croen, Lila G.

1993-01-01

A study at the Albert Einstein College of Medicine (Yeshiva University, New York) has identified students from each medical class with previously unidentified learning disabilities. In three case studies, the importance of early identification and support is illustrated. In each case, dramatic improvement occurred with student awareness and…

Personalised Virtual Learning Spaces to Support Undergraduates in Producing Research Reports: Two Case Studies

ERIC Educational Resources Information Center

Kallkvist, Marie; Gomez, Stephen; Andersson, Holger; Lush, David

2009-01-01

The purpose of this study was to create and evaluate personalised virtual learning spaces (PVLSs) in a course that was previously delivered face-to-face only. The study addressed three related questions: (1) Can a PVLS successfully be introduced into a course where IT has not previously featured? (2) Can the PVLSs be used to enhance the assessment…

Training "Rule-of-(E)": Further Investigation of a Previously Successful Intervention for a Spelling Rule in Developmental Mixed Dysgraphia

ERIC Educational Resources Information Center

Kohnen, Saskia; Nickels, Lyndsey; Coltheart, Max

2010-01-01

This paper reports a single case treatment study conducted with R.F.L., a young man with developmental mixed dysgraphia. The intervention focused on teaching spelling rules and was a replication of a previous successful study. The results of the present study provided further insights into the mechanism that operates to update faulty lexical…

Acute myeloid and chronic lymphoid leukaemias and exposure to low-level benzene among petroleum workers

PubMed Central

Rushton, L; Schnatter, A R; Tang, G; Glass, D C

2014-01-01

Background: High benzene exposure causes acute myeloid leukaemia (AML). Three petroleum case–control studies identified 60 cases (241 matched controls) for AML and 80 cases (345 matched controls) for chronic lymphoid leukaemia (CLL). Methods: Cases were classified and scored regarding uncertainty by two haematologists using available diagnostic information. Blinded quantitative benzene exposure assessment used work histories and exposure measurements adjusted for era-specific circumstances. Statistical analyses included conditional logistic regression and penalised smoothing splines. Results: Benzene exposures were much lower than previous studies. Categorical analyses showed increased ORs for AML with several exposure metrics, although patterns were unclear; neither continuous exposure metrics nor spline analyses gave increased risks. ORs were highest in terminal workers, particularly for Tanker Drivers. No relationship was found between benzene exposure and risk of CLL, although the Australian study showed increased risks in refinery workers. Conclusion: Overall, this study does not persuasively demonstrate a risk between benzene and AML. A previously reported strong relationship between myelodysplastic syndrome (MDS) (potentially previously reported as AML) at our study's low benzene levels suggests that MDS may be the more relevant health risk for lower exposure. Higher CLL risks in refinery workers may be due to more diverse exposures than benzene alone. PMID:24357793

Pathology analysis for mesothelioma study in the United Kingdom: Current practice and historical development.

PubMed

Case, B W

2016-01-01

Following up on the largest case-control study of malignant mesothelioma yet performed, investigators at the London School of Hygiene and Tropical Medicine assessed 1732 male and 670 female cases as of May 2013. Epidemiological findings of a subset of these were published previously, excluding patients who died or who refused to be interviewed. Pathology reports were collected for subjects, including those both eligible and ineligible for epidemiology study based on vital status. The current investigation examined 860 cases having pathology reports available. Sixty-one cases were diagnosed using cytology only, often with equivocal diagnoses, while 799 reported at least a biopsy of the tumor. Of these, 748 had pathology sufficiently detailed for evaluation. These reports were examined for basis of diagnosis, differences between study cases and ineligible cases, pathology characteristics, and immunohistochemical and other tests used. The most prominent subtype was epithelioid (64% of study cases but only 49% of ineligible cases). Biphasic subtype was present in 10% of study cases and 16% of those ineligible. Sarcomatoid subtype was present in 7% of study cases and 19% of ineligible cases, most of whom died. Twelve percent of study cases displayed no specified subtype, versus 7% of ineligible cases. Of recorded immunohistochemical stains specific for mesothelial cell origin, calretinin (95%) and CK 5/6 or CK5 alone (84%) were by far the most common. Calretinin and CK 5/6 or CK 5 alone were also most sensitive and positive in 92% of cases presenting with surgical pathology report. Ninety percent of cases had at least one immunohistochemical marker for possible lung carcinoma applied, with BER-Ep4 and TTF-1 the most frequent at 68% and CEA at 58%. TTF-1 and CEA were positive in 1% or less of cases. Patterns of use and positive and negative results for each of these as well as other immunohistochemical stains are presented and discussed, along with a brief historical description of their development and use. Possible effects of the pathologic analysis on the results of previously published and future epidemiological studies are discussed.

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

Mills, Evan; Jones, Richard B.

Large yet infrequent disruptions of electrical power can impact tens of millions of people in a single event, triggering significant economic damages, portions of which are insured. Small and frequent events are also significant in the aggregate. This article explores the role that insurance claims data can play in better defining the broader economic impacts of grid disruptions in the U.S. context. We developed four case studies, using previously unpublished data for specific actual grid disruptions. The cases include the 1977 New York City blackout, the 2003 Northeast blackout, multi-year national annual lightning-related electrical damage and multi-year national line-disturbance events.more » Insured losses represent between 3 and 64 per cent of total loss costs across the case studies. Here, the household sector emerges as a larger locus of costs than indicated in previous studies, and short-lived events emerge as important sources of loss costs.« less

An insurance perspective on U.S. electric grid disruption costs

DOE PAGES

Mills, Evan; Jones, Richard B.

2016-10-12

Large yet infrequent disruptions of electrical power can impact tens of millions of people in a single event, triggering significant economic damages, portions of which are insured. Small and frequent events are also significant in the aggregate. This article explores the role that insurance claims data can play in better defining the broader economic impacts of grid disruptions in the U.S. context. We developed four case studies, using previously unpublished data for specific actual grid disruptions. The cases include the 1977 New York City blackout, the 2003 Northeast blackout, multi-year national annual lightning-related electrical damage and multi-year national line-disturbance events.more » Insured losses represent between 3 and 64 per cent of total loss costs across the case studies. Here, the household sector emerges as a larger locus of costs than indicated in previous studies, and short-lived events emerge as important sources of loss costs.« less

Munchausen Syndrome by Proxy: Unusual Manifestations and Disturbing Sequelae.

ERIC Educational Resources Information Center

Porter, Gerald E.; And Others

1994-01-01

This study documents previously unreported findings in cases of Munchausen Syndrome by Proxy (in which a mother fabricates an illness in her child). In the reported case, esophageal perforation, retrograde intussusception, tooth loss, and bradycardia were found. (Author/DB)

Adjustment Following Disability: Representative Case Studies.

ERIC Educational Resources Information Center

Heinemann, Allen W.; Shontz, Franklin C.

1984-01-01

Examined adjustment following physical disability using the representative case method with two persons with quadriplegia. Results highlighted the importance of previously established coping styles as well as the role of the environment in adjustment. Willingness to mourn aided in later growth. (JAC)

An alternative experimental case-control design for genetic association studies on bovine mastitis.

PubMed

Biffani, S; Del Corvo, M; Capoferri, R; Pedretti, A; Luini, M; Williams, J L; Pagnacco, G; Minvielle, F; Minozzi, G

2017-04-01

The possibility of using genetic control strategies to increase disease resistance to infectious diseases relies on the identification of markers to include in the breeding plans. Possible incomplete exposure of mastitis-free (control) animals, however, is a major issue to find relevant markers in genetic association studies for infectious diseases. Usually, designs based on elite dairy sires are used in association studies, but an epidemiological case-control strategy, based on cows repeatedly field-tested could be an alternative for disease traits. To test this hypothesis, genetic association results obtained in the present work from a cohort of Italian Holstein cows tested for mastitis over time were compared with those from a previous genome-wide scan on Italian Holstein sires genotyped with 50k single nucleotide polymorphisms for de-regressed estimated breeding values for somatic cell counts (SCCs) on Bos taurus autosome (BTA6) and BTA14. A total of 1121 cows were selected for the case-control approach (cases=550, controls=571), on a combination of herd level of SCC incidence and of within herd individual level of SCC. The association study was conducted on nine previously identified markers, six on BTA6 and four on BTA14, using the R statistical environment with the 'qtscore' function of the GenABEL package, on high/low adjusted linear score as a binomial trait. The results obtained in the cow cohort selected on epidemiological information were in agreement with those obtained from the previous sire genome-wide association study (GWAS). Six out of the nine markers showed significant association, four on BTA14 (rs109146371, rs109234250, rs109421300, rs109162116) and two on BTA6 (rs110527224 and rs42766480). Most importantly, using mastitis as a case study, the current work further validated the alternative use of historical field disease data in case-control designs for genetic analysis of infectious diseases in livestock.

Implant failure and history of failed endodontic treatment: A retrospective case-control study.

PubMed

Chatzopoulos, Georgios S; Wolff, Larry F

2017-11-01

Residual bacterial biofilm and/or bacteria in planktonic form may be survived in the bone following an extraction of an infected tooth that was endodontically treated unsuccessfully Failed endodontic treatment may be associated with failure of implants to osseointegrate in the same sites. Therefore, the aim of this retrospective case-control study is to examine the risk of implant failure in previous failed endodontic sites. This retrospective case-control study is based on 94 dental records of implants placed at the University of Minnesota School of Dentistry. Dental records of patients who received an implant in sites with previously failed endodontic therapy in the dental school were identified from the electronic database, while control subjects were obtained from the same pool of patients with the requirement to have received an implant in a site that was not endodontically treated. The mean age of the population was 62.89±14.17 years with 57.4% of the sample being females and 42.6% of them being males. In regards to the socio-economic status and dental insurance, 84.0% of this population was classified as low socio-economic status and 68.1% had dental insurance. Tobacco use was self-reported by 9.6% and hypercholesterolemia was the most prevalent systemic medical condition. Dental implant failure was identified in two of the included records (2.1%), both of which were placed in sites with a history of failed endodontic treatment. Within the limitations of this retrospective case-control study, further investigation with a larger population group into implant failure of sites that previously had unsuccessful endodontic treatment would be warranted. Implant failure may be associated with a history of failed endodontic treatment. Key words: Implantology, endodontics, osseointegration, treatment outcome, case-control study.

A Collaborative Approach to Experiential Learning in University Newswriting and Editing Classes: A Case Study

ERIC Educational Resources Information Center

Parks, Perry

2015-01-01

This case study examines a creative approach by two journalism professors to enhance experiential learning in separate skills-based newswriting and editing courses by collaborating to produce a live online news report from campus each week on a four-hour deadline. The study builds on previous research into how innovative classroom structures that…

Social Factors for Code-Switching in Tunisian Business Companies: A Case Study

ERIC Educational Resources Information Center

Baoueb, Lamia Bach

2009-01-01

Although the literature on CS between Arabic and French in different bilingual speech communities is wide, few studies have dealt with the Tunisian context and no previous work has ever been done on the Tunisian business sector as a specific group using more than one pair of languages to communicate. This case study investigates the variety of…

A Case Study on the Experiences of University-Based Muslim Women in Physical Activity during Their Studies at One UK Higher Education Institution

ERIC Educational Resources Information Center

Miles, Claire; Benn, Tansin

2016-01-01

The case study explores the experiences of Muslim women in the area of physical activity participation conducted whilst they were studying at one UK University. Previous research in the field indicated that Muslim women can be denied opportunities to participate in areas of sport-related physical activity through multiple factors such as…

Clinical characteristics of canine fibrocartilaginous embolic myelopathy (FCE): a systematic review of 393 cases (1973-2013).

PubMed

Bartholomew, K A; Stover, K E; Olby, N J; Moore, S A

2016-12-24

Fibrocartilaginous embolic myelopathy (FCE) is common in dogs; however, there is conflicting information in the veterinary literature regarding clinical characteristics and data on recovery in severe cases is sparse. A systematic review of canine FCE was performed to delineate the natural history of this disease. 322 previously reported cases and 71 previously unreported cases were identified for inclusion. Source publications were identified via PubMed central search and by references from review articles. Previously unreported cases were identified via computerised medical records search at two veterinary institutions. FCE was most common in middle-aged large breed dogs (30 per cent); however, the miniature schnauzer was the most frequently reported individual breed and small breeds comprised 24 per cent of all reported cases. The most common neuroanatomical localisation was a T3-L3 myelopathy (33.1 per cent). Prognosis for recovery of ambulation was good to excellent with 85 per cent of cases regaining the ability to walk unassisted, most within 3 weeks. Persistent neurological deficits were common in patients that recovered ambulation (49.1 per cent). When nociception was absent in the affected limbs at initial presentation, rate of recovery was lower (10 per cent); however, this data is likely biased by limited follow-up in more severe cases. Future prospective studies should evaluate prognosis for more severely affected patients. British Veterinary Association.

Toward instructional design principles: Inducing Faraday's law with contrasting cases

NASA Astrophysics Data System (ADS)

Kuo, Eric; Wieman, Carl E.

2016-06-01

Although physics education research (PER) has improved instructional practices, there are not agreed upon principles for designing effective instructional materials. Here, we illustrate how close comparison of instructional materials could support the development of such principles. Specifically, in discussion sections of a large, introductory physics course, a pair of studies compare two instructional strategies for teaching a physics concept: having students (i) explain a set of contrasting cases or (ii) apply and build on previously learned concepts. We compare these strategies for the teaching of Faraday's law, showing that explaining a set of related contrasting cases not only improves student performance on Faraday's law questions over building on a previously learned concept (i.e., Lorentz force), but also prepares students to better learn subsequent topics, such as Lenz's law. These differences persist to the final exam. We argue that early exposure to contrasting cases better focuses student attention on a key feature related to both concepts: change in magnetic flux. Importantly, the benefits of contrasting cases for both learning and enjoyment are enhanced for students who did not first attend a Faraday's law lecture, consistent with previous research suggesting that being told a solution can circumvent the benefits of its discovery. These studies illustrate an experimental approach for understanding how the structure of activities affects learning and performance outcomes, a first step toward design principles for effective instructional materials.

Acute fatal hemorrhage from previously undiagnosed cerebral arteriovenous malformations in children: a single-center experience.

PubMed

Riordan, Coleman P; Orbach, Darren B; Smith, Edward R; Scott, R Michael

2018-06-01

OBJECTIVE The most significant adverse outcome of intracranial hemorrhage from an arteriovenous malformation (AVM) is death. This study reviews a single-center experience with pediatric AVMs to quantify the incidence and characterize clinical and radiographic factors associated with sudden death from the hemorrhage of previously undiagnosed AVMs in children. METHODS A single-center database review of the period from 2006 to 2017 identified all patients with a first-time intracranial hemorrhage from a previously undiagnosed AVM. Clinical and radiographic data were collected and compared between patients who survived to hospital discharge and those who died at presentation. RESULTS A total of 57 patients (average age 10.8 years, range 0.1-19 years) presented with first-time intracranial hemorrhage from a previously undiagnosed AVM during the study period. Of this group, 7/57 (12%) patients (average age 11.5 years, range 6-16 years) suffered hemorrhages that led directly to their deaths. Compared to the cohort of patients who survived their hemorrhage, patients who died were 4 times more likely to have an AVM in the posterior fossa. No clear pattern of antecedent triggering activity (sports, trauma, etc.) was identified, and 3/7 (43%) experienced cardiac arrest in the prehospital setting. Surviving patients were ultimately treated with resection of the AVM in 42/50 (84%) of cases. CONCLUSIONS Children who present with hemorrhage from a previously undiagnosed intracranial AVM had a 12% chance of sudden death in our single-institution series of pediatric cerebrovascular cases. Clinical triggers of hemorrhage are unpredictable, but subsequent radiographic evidence of a posterior fossa AVM was present in 57% of fatal cases, and all fatal cases were in locations with high risk of potential herniation. These data support a proactive, aggressive approach toward definitive treatment of AVMs in children.

Effect of previous and current vaccination against influenza A(H1N1)pdm09, A(H3N2), and B during the post-pandemic period 2010-2016 in Spain

PubMed Central

Castilla, Jesús; Pozo, Francisco

2017-01-01

Background Recent studies suggest that the protective effect of the current influenza vaccine could be influenced by vaccination in previous seasons. We estimated the combined effect of the previous and current influenza vaccines from the 2010–2011 season to the 2015–2016 season in Spain. Methods We performed a test-negative case-control study in patients ≥9 years old. We estimated the influenza vaccine effectiveness (IVE) against influenza A(H1N1)pdm09, A(H3N2), and B virus. Results We included 1206 influenza A(H1N1)pdm09 cases, 1358 A(H3N2) cases and 1079 B cases. IVE against A(H1N1)pdm09 virus in the pooled-season analysis was 53% (95% Confidence Interval (CI): 21% to 72%) for those vaccinated only in the current season and 50% (95%CI: 23% to 68%) for those vaccinated in the both current and previous seasons. Against the influenza A(H3N2) virus, IVE was 17% (95%CI: -43% to 52%) for those vaccinated only in the current season and 3% (95%CI: -33% to 28%) for those vaccinated in both seasons. Regarding influenza B, we obtained similar IVEs for those vaccinated only in the current and those vaccinated in both seasons: 57% (95%CI: 12% to 79%) and 56% (95%CI: 36% to 70%), respectively. Conclusion Our results suggested no interference between the previous and current influenza vaccines against A(H1N1)pdm09 and B viruses, but a possible negative interference against A(H3N2) virus. PMID:28614376

Surgical cannulation of the superior ophthalmic vein for the treatment of previously embolized cavernous sinus dural arteriovenous fistulas: serial studies and angiographic follow-up.

PubMed

Luo, Bin; Zhang, Xin; Duan, Chuan-Zhi; He, Xu-Ying; Li, Xi-Feng; Karuna, Tamrakar; Gu, Da-Qun; Long, Xiao-Ao; Li, Tie-Lin; Zhang, Shi-Zhong; Ke, Yi-Quan; Jiang, Xiao-Dan

2013-04-01

The purpose of this study was to evaluate the safety and efficacy of transorbital puncture for the retreatment of previously embolized cavernous sinus dural arteriovenous fistulas (DAVFs) via a superior ophthalmic vein (SOV) approach. During a 12-year period, 9 consecutive patients with previously embolized cavernous sinus DAVFs underwent retreatment via the transorbital SOV approach. All of the nine cases of previously embolized cavernous sinus DAVFs were successfully embolized. Clinical follow-ups were conducted in all nine cases at the duration of 17-141 months (61.22 ± 39.13 months). No recanalization occurred during the follow-up period. A subtle ptosis appeared in two patients and disappeared in one of the two cases after a 4-year follow-up. One patient suffered from paroxysmal positional vertigo and bruit for nearly 2 years after the treatment, but the follow-up angiography demonstrated no recurrence. One patient had persistent visual impairment caused by the initial venous stasis retinopathy. One patient with a history of a procedure-related transient decrease in visual acuity had it return to the normal level. The remaining four cases had clear improvement in the ocular symptoms and became completely asymptomatic during the follow-up period. No patient worsened or developed new symptoms. The approach of surgical cannulation of the SOV for the retreatment of previously embolized cavernous sinus DAVFs was proved feasible and efficient, especially when the transarterial and transfemoral venous approaches were inaccessible. However, if the SOV is not dilated enough or is located deeply in the orbit, transorbital venous puncture access may not be possible.

Effect of previous and current vaccination against influenza A(H1N1)pdm09, A(H3N2), and B during the post-pandemic period 2010-2016 in Spain.

PubMed

Gherasim, Alin; Martínez-Baz, Iván; Castilla, Jesús; Pozo, Francisco; Larrauri, Amparo

2017-01-01

Recent studies suggest that the protective effect of the current influenza vaccine could be influenced by vaccination in previous seasons. We estimated the combined effect of the previous and current influenza vaccines from the 2010-2011 season to the 2015-2016 season in Spain. We performed a test-negative case-control study in patients ≥9 years old. We estimated the influenza vaccine effectiveness (IVE) against influenza A(H1N1)pdm09, A(H3N2), and B virus. We included 1206 influenza A(H1N1)pdm09 cases, 1358 A(H3N2) cases and 1079 B cases. IVE against A(H1N1)pdm09 virus in the pooled-season analysis was 53% (95% Confidence Interval (CI): 21% to 72%) for those vaccinated only in the current season and 50% (95%CI: 23% to 68%) for those vaccinated in the both current and previous seasons. Against the influenza A(H3N2) virus, IVE was 17% (95%CI: -43% to 52%) for those vaccinated only in the current season and 3% (95%CI: -33% to 28%) for those vaccinated in both seasons. Regarding influenza B, we obtained similar IVEs for those vaccinated only in the current and those vaccinated in both seasons: 57% (95%CI: 12% to 79%) and 56% (95%CI: 36% to 70%), respectively. Our results suggested no interference between the previous and current influenza vaccines against A(H1N1)pdm09 and B viruses, but a possible negative interference against A(H3N2) virus.

Investigating Time Lags and Attribution in the Translation of Cancer Research: A Case Study Approach.

PubMed

Guthrie, Susan; Pollitt, Alexandra; Hanney, Stephen; Grant, Jonathan

2014-01-01

In 2012, RAND Europe and the Health Economics Research Group (Brunel University) were commissioned by the Wellcome Trust, Cancer Research UK, the National Institute for Health Research and the Academy of Medical Science to conduct a study of the returns to the public/charitable investment in cancer-related research. This study built on previous work published in the 2008 "What's it worth?" report that estimated the economic returns to medical research in terms of spillover benefits and health gain. The 2008 study was extensively quoted and cited as a clear justification for the economic importance of medical research and appears to have played a role in achieving the protection of the medical science budget in the recent public expenditure cuts. This cancer study used a similar approach to that used in the previous study, but with some methodological developments. One of the methodological developments was the inclusion of case studies to examine the validity and variability of the estimates on elapsed time between funding and health gains, and the amount of health gains that can be attributed to UK research. This study provides the full text of the five case studies conducted as well as some discussion of observations emerging across the case study set.

Assessing Discriminative Performance at External Validation of Clinical Prediction Models

PubMed Central

Nieboer, Daan; van der Ploeg, Tjeerd; Steyerberg, Ewout W.

2016-01-01

Introduction External validation studies are essential to study the generalizability of prediction models. Recently a permutation test, focusing on discrimination as quantified by the c-statistic, was proposed to judge whether a prediction model is transportable to a new setting. We aimed to evaluate this test and compare it to previously proposed procedures to judge any changes in c-statistic from development to external validation setting. Methods We compared the use of the permutation test to the use of benchmark values of the c-statistic following from a previously proposed framework to judge transportability of a prediction model. In a simulation study we developed a prediction model with logistic regression on a development set and validated them in the validation set. We concentrated on two scenarios: 1) the case-mix was more heterogeneous and predictor effects were weaker in the validation set compared to the development set, and 2) the case-mix was less heterogeneous in the validation set and predictor effects were identical in the validation and development set. Furthermore we illustrated the methods in a case study using 15 datasets of patients suffering from traumatic brain injury. Results The permutation test indicated that the validation and development set were homogenous in scenario 1 (in almost all simulated samples) and heterogeneous in scenario 2 (in 17%-39% of simulated samples). Previously proposed benchmark values of the c-statistic and the standard deviation of the linear predictors correctly pointed at the more heterogeneous case-mix in scenario 1 and the less heterogeneous case-mix in scenario 2. Conclusion The recently proposed permutation test may provide misleading results when externally validating prediction models in the presence of case-mix differences between the development and validation population. To correctly interpret the c-statistic found at external validation it is crucial to disentangle case-mix differences from incorrect regression coefficients. PMID:26881753

Assessing Discriminative Performance at External Validation of Clinical Prediction Models.

PubMed

Nieboer, Daan; van der Ploeg, Tjeerd; Steyerberg, Ewout W

2016-01-01

External validation studies are essential to study the generalizability of prediction models. Recently a permutation test, focusing on discrimination as quantified by the c-statistic, was proposed to judge whether a prediction model is transportable to a new setting. We aimed to evaluate this test and compare it to previously proposed procedures to judge any changes in c-statistic from development to external validation setting. We compared the use of the permutation test to the use of benchmark values of the c-statistic following from a previously proposed framework to judge transportability of a prediction model. In a simulation study we developed a prediction model with logistic regression on a development set and validated them in the validation set. We concentrated on two scenarios: 1) the case-mix was more heterogeneous and predictor effects were weaker in the validation set compared to the development set, and 2) the case-mix was less heterogeneous in the validation set and predictor effects were identical in the validation and development set. Furthermore we illustrated the methods in a case study using 15 datasets of patients suffering from traumatic brain injury. The permutation test indicated that the validation and development set were homogenous in scenario 1 (in almost all simulated samples) and heterogeneous in scenario 2 (in 17%-39% of simulated samples). Previously proposed benchmark values of the c-statistic and the standard deviation of the linear predictors correctly pointed at the more heterogeneous case-mix in scenario 1 and the less heterogeneous case-mix in scenario 2. The recently proposed permutation test may provide misleading results when externally validating prediction models in the presence of case-mix differences between the development and validation population. To correctly interpret the c-statistic found at external validation it is crucial to disentangle case-mix differences from incorrect regression coefficients.

Genome-wide association study identifies two new susceptibility loci for atopic dermatitis in the Chinese Han population.

PubMed

Sun, Liang-Dan; Xiao, Feng-Li; Li, Yang; Zhou, Wen-Ming; Tang, Hua-Yang; Tang, Xian-Fa; Zhang, Hui; Schaarschmidt, Heidi; Zuo, Xian-Bo; Foelster-Holst, Regina; He, Su-Min; Shi, Mei; Liu, Qiang; Lv, Yong-Mei; Chen, Xi-Lan; Zhu, Kun-Ju; Guo, Yi-Feng; Hu, Da-Yan; Li, Ming; Li, Min; Zhang, Yan-Hong; Zhang, Xin; Tang, Jian-Ping; Guo, Bi-Rong; Wang, Hua; Liu, Yuan; Zou, Xiao-Yan; Zhou, Fu-Sheng; Liu, Xiao-Yan; Chen, Gang; Ma, Lin; Zhang, Shu-Mei; Jiang, Ai-Ping; Zheng, Xiao-Dong; Gao, Xing-Hua; Li, Pan; Tu, Cai-Xia; Yin, Xian-Yong; Han, Xiu-Ping; Ren, Yun-Qing; Song, Shun-Peng; Lu, Zhi-Yong; Zhang, Xing-Lian; Cui, Yong; Chang, Jing; Gao, Min; Luo, Xiao-Yan; Wang, Pei-Guang; Dai, Xing; Su, Wei; Li, Hui; Shen, Chun-Pin; Liu, Sheng-Xiu; Feng, Xiao-Bo; Yang, Chun-Jun; Lin, Guo-Shu; Wang, Zai-Xing; Huang, Jian-Qing; Fan, Xing; Wang, Yan; Bao, Yi-Xiao; Yang, Sen; Liu, Jian-Jun; Franke, Andre; Weidinger, Stephan; Yao, Zhi-Rong; Zhang, Xue-Jun

2011-06-12

Atopic dermatitis is a chronic, relapsing form of inflammatory skin disorder that is affected by genetic and environmental factors. We performed a genome-wide association study of atopic dermatitis in a Chinese Han population using 1,012 affected individuals (cases) and 1,362 controls followed by a replication study in an additional 3,624 cases and 12,197 controls of Chinese Han ethnicity, as well as 1,806 cases and 3,256 controls from Germany. We identified previously undescribed susceptibility loci at 5q22.1 (TMEM232 and SLC25A46, rs7701890, P(combined) = 3.15 × 10(-9), odds ratio (OR) = 1.24) and 20q13.33 (TNFRSF6B and ZGPAT, rs6010620, P(combined) = 3.0 × 10(-8), OR = 1.17) and replicated another previously reported locus at 1q21.3 (FLG, rs3126085, P(combined) = 5.90 × 10(-12), OR = 0.82) in the Chinese sample. The 20q13.33 locus also showed evidence for association in the German sample (rs6010620, P = 2.87 × 10(-5), OR = 1.25). Our study identifies new genetic susceptibility factors and suggests previously unidentified biological pathways in atopic dermatitis.

Composing in a Second Language: A Case Study of a Russian College Student.

ERIC Educational Resources Information Center

Kim, Anna Charr

The case study examined the development of English writing skills in a native Russian-speaking college student with no previous instruction in English as a Second Language. It drew on writing samples from 2 years of English language instruction. Theories of first and second language acquisition, especially in written expression, are analyzed in…

Teachers' Implicit Meaning Systems and Their Implications for Pedagogical Thinking and Practice: A Case Study from Finland

ERIC Educational Resources Information Center

Rissanen, Inkeri; Kuusisto, Elina; Hanhimäki, Eija; Tirri, Kirsi

2018-01-01

This qualitative case study examines teachers' implicit meaning systems built around their core beliefs on the malleability of human qualities. Previous research has demonstrated the influence of students' implicit theories on motivation and achievement and has presented successful interventions for students. However, research on teachers'…

Innovation and Integration: Case Studies of Effective Teacher Practices in the Use of Handheld Computers

ERIC Educational Resources Information Center

Chavez, Raymond Anthony

2010-01-01

Previous research conducted on the use of handheld computers in K-12 education has focused on how handheld computer use affects student motivation, engagement, and productivity. These four case studies sought to identify effective teacher practices in the integration of handhelds into the curriculum and the factors that affect those practices. The…

Leadership Development for Organizational Change in a "New" UK University

ERIC Educational Resources Information Center

Turnbull, Sharon; Edwards, Gareth

2005-01-01

This paper reports on the findings of a case study of an Organizational Development (OD) intervention within a new university in the UK. Previous research into the leadership of higher education has highlighted a number of apparently inevitable tensions. The findings of the case study uncovered a number of complex and interrelated tensions. The…

Teachers' Perceptions about their Own and their Schools' Readiness for Computer Implementation: A South African Case Study

ERIC Educational Resources Information Center

du Plessis, Andre; Webb, Paul

2012-01-01

This case study, involving 30 participating teachers from six previously disadvantaged South African schools, provides data on teacher perceptions of the challenges related to implementing Information and Communication Technology (ICT). The schools had minimal resources as a residual result of the South African apartheid policy prior to 1994 and…

More than "Getting Us through": A Case Study in Cultural Capital Enrichment of Underrepresented Minority Undergraduates

ERIC Educational Resources Information Center

Ovink, Sarah M.; Veazey, Brian D.

2011-01-01

Minority students continue to be underrepresented among those who seek graduate and professional degrees in the sciences. Much previous research has focused on academic preparation. Equally important, however, are the psychological-social barriers and lack of institutional support encountered by many minority students. We present a case study of a…

Cognitive-Behavioral Treatment for Specific Phobias with a Child Demonstrating Severe Problem Behavior and Developmental Delays

ERIC Educational Resources Information Center

Davis, Thompson E., III; Kurtz, Patricia F.; Gardner, Andrew W.; Carman, Nicole B.

2007-01-01

Cognitive-behavioral treatments (CBTs) are widely used for anxiety disorders in typically developing children; however, there has been no previous attempt to administer CBT for specific phobia (in this case study, one-session treatment) to developmentally or intellectually disabled children. This case study integrates both cognitive-behavioral and…

Association analysis of 9,560 prostate cancer cases from the International Consortium of Prostate Cancer Genetics confirms the role of reported prostate-cancer associated SNPs for familial disease

PubMed Central

Teerlink, Craig C.; Thibodeau, Stephen N.; McDonnell, Shannon K.; Schaid, Daniel J.; Rinckleb, Antje; Maier, Christiane; Vogel, Walther; Cancel-Tassin, Geraldine; Egrot, Christophe; Cussenot, Olivier; Foulkes, William D.; Giles, Graham G.; Hopper, John L.; Severi, Gianluca; Eeles, Ros; Easton, Douglas; Kote-Jarai, Zsofia; Guy, Michelle; Cooney, Kathleen A.; Ray, Anna M.; Zuhlke, Kimberly A.; Lange, Ethan M.; FitzGerald, Liesel M.; Stanford, Janet L.; Ostrander, Elaine A.; Wiley, Kathleen E.; Isaacs, Sarah D.; Walsh, Patrick C.; Isaacs, William B.; Wahlfors, Tiina; Tammela, Teuvo; Schleutker, Johanna; Wiklund, Fredrik; Grönberg, Henrik; Emanuelsson, Monica; Carpten, John; Bailey-Wilson, Joan; Whittemore, Alice S.; Oakley-Girvan, Ingrid; Hsieh, Chih-Lin; Catalona, William J.; Zheng, S. Lilly; Jin, Guangfu; Lu, Lingyi; Xu, Jianfeng; Camp, Nicola J.; Cannon-Albright, Lisa A.

2013-01-01

Previous GWAS studies have reported significant associations between various common SNPs and prostate cancer risk using cases unselected for family history. How these variants influence risk in familial prostate cancer is not well studied. Here, we analyzed 25 previously reported SNPs across 14 loci from prior prostate cancer GWAS. The International Consortium for Prostate Cancer Genetics (ICPCG) previously validated some of these using a family-based association method (FBAT). However, this approach suffered reduced power due to the conditional statistics implemented in FBAT. Here, we use a case-control design with an empirical analysis strategy to analyze the ICPCG resource for association between these 25 SNPs and familial prostate cancer risk. Fourteen sites contributed 12,506 samples (9,560 prostate cancer cases, 3,368 with aggressive disease, and 2,946 controls from 2,283 pedigrees). We performed association analysis with Genie software which accounts for relationships. We analyzed all familial prostate cancer cases and the subset of aggressive cases. For the familial prostate cancer phenotype, 20 of the 25 SNPs were at least nominally associated with prostate cancer and 16 remained significant after multiple testing correction (p≤1E−3) occurring on chromosomal bands 6q25, 7p15, 8q24, 10q11, 11q13, 17q12, 17q24, and Xp11. For aggressive disease, 16 of the SNPs had at least nominal evidence and 8 were statistically significant including 2p15. The results indicate that the majority of common, low-risk alleles identified in GWAS studies for all prostate cancer also contribute risk for familial prostate cancer, and that some may be contribute risk to aggressive disease. PMID:24162621

Teenage cardiac arrest following abuse of synthetic cannabis.

PubMed

Davis, C; Boddington, D

2015-10-01

The cardiac effects of many illegal substances (cocaine, methadone) have previously been well described [1,2]. However the association between synthetic cannabis and cardiac arrest is less well documented. Here we describe an out-of-hospital cardiac arrest in a previously healthy 16-year-old female associated with the use of inhaled synthetic cannabis. An electronic systematic search of online databases PubMed and Embase was performed using keywords, "synthetic cannabis death" and "cardiac arrest". In this case study a previously healthy 16-year-old had a cardiac arrest after synthetic cannabis use. Despite extensive investigations no other cause for her arrest was found. To the best of our knowledge there has been one previous case report of cardiac arrest following synthetic cannabis use in a 56-year-old man [3]. This case report augments the relationship between synthetic cannabis and cardiac arrest in the medical community. More awareness surrounding the risk of synthetic cannabinoids is warranted. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Known glioma risk loci are associated with glioma with a family history of brain tumours -- a case-control gene association study.

PubMed

Melin, Beatrice; Dahlin, Anna M; Andersson, Ulrika; Wang, Zhaoming; Henriksson, Roger; Hallmans, Göran; Bondy, Melissa L; Johansen, Christoffer; Feychting, Maria; Ahlbom, Anders; Kitahara, Cari M; Wang, Sophia S; Ruder, Avima M; Carreón, Tania; Butler, Mary Ann; Inskip, Peter D; Purdue, Mark; Hsing, Ann W; Mechanic, Leah; Gillanders, Elizabeth; Yeager, Meredith; Linet, Martha; Chanock, Stephen J; Hartge, Patricia; Rajaraman, Preetha

2013-05-15

Familial cancer can be used to leverage genetic association studies. Recent genome-wide association studies have reported independent associations between seven single nucleotide polymorphisms (SNPs) and risk of glioma. The aim of this study was to investigate whether glioma cases with a positive family history of brain tumours, defined as having at least one first- or second-degree relative with a history of brain tumour, are associated with known glioma risk loci. One thousand four hundred and thirty-one glioma cases and 2,868 cancer-free controls were identified from four case-control studies and two prospective cohorts from USA, Sweden and Denmark and genotyped for seven SNPs previously reported to be associated with glioma risk in case-control designed studies. Odds ratios were calculated by unconditional logistic regression. In analyses including glioma cases with a family history of brain tumours (n = 104) and control subjects free of glioma at baseline, three of seven SNPs were associated with glioma risk: rs2736100 (5p15.33, TERT), rs4977756 (9p21.3, CDKN2A-CDKN2B) and rs6010620 (20q13.33, RTEL1). After Bonferroni correction for multiple comparisons, only one marker was statistically significantly associated with glioma risk, rs6010620 (ORtrend for the minor (A) allele, 0.39; 95% CI: 0.25-0.61; Bonferroni adjusted ptrend , 1.7 × 10(-4) ). In conclusion, as previously shown for glioma regardless of family history of brain tumours, rs6010620 (RTEL1) was associated with an increased risk of glioma when restricting to cases with family history of brain tumours. These findings require confirmation in further studies with a larger number of glioma cases with a family history of brain tumours. Copyright © 2012 UICC.

Prevalence and Risk factors for Drug Resistance among Hospitalized TB Patients in Georgia

PubMed Central

Vashakidze, L; Salakaia, A.; Shubladze, N.; Cynamon, M.; Barbakadze, K.; Kikvidze, M.; Papitashvili, L.; Nonikashvili, M.; Solomonia, N.; Bejanishvili, N.; Khurtsilava, I.

2010-01-01

SUMMARY Background Tuberculosis control in Georgia follows the WHO recommended DOTS strategy and has reached Global TB Control targets in treatment of sensitive TB, but the management of drug resistant forms of TB still represents a serious problem. A country-wide Drug Resistance Survey (DRS) found that the prevalence of MDR-TB was 6.8% in new and 27.4% in previously treated TB cases. Objective To determine prevalence and risk factors for drug resistance among TB patients in order to improve DR-TB case management and control. Methods Extensive social, clinical and bacteriological data were collected from hospitalized patients (National Centre for Tuberculosis and Lung Diseases, Georgia, 2005–2007). Results Out of 605 patients DR-TB was found in 491 (81.2%) cases, MDR-TB was observed in 261(43.1%) [51 (23%) out of 222 New cases and 210 (55%) out of 383 Previously treated cases], mono-DR-TB in 130 (21.5%), poly-DR-TB in 67 (11.1%) and XDR-TB in 33 (5.5%) cases. Study showed that female gender, living in densely populated capital, family TB contact and previous TB treatment are associated with risk for having MDR-TB. Conclusions Findings confirm the necessity of improvement of infection control measures and availability of standardized treatment for DR-TB patients. PMID:19723406

Deaths certified as asthma and use of medical services: a national case-control study

PubMed Central

Sturdy, P; Butland, B; Anderson, H; Ayres, J; Bland, J; Harrison, B; Peckitt, C; Victor, C; on, b

2005-01-01

Background: Studies have linked asthma death to either increased or decreased use of medical services. Methods: A population based case-control study of asthma deaths in 1994–8 was performed in 22 English, six Scottish, and five Welsh health authorities/boards. All 681 subjects who died were under the age of 65 years with asthma in Part I on the death certificates. After exclusions, 532 hospital controls were matched to 532 cases for age, district, and date of asthma admission/death. Data were extracted blind from primary care records. Results: The median age of the subjects who died was 53 years; 60% of cases and 64% of controls were female. There was little difference in outpatient attendance (55% and 55%), hospital admission for asthma (51% and 54%), and median inpatient days (20 days and 15 days) in the previous 5 years. After mutual adjustment and adjustment for sex, using conditional logistic regression, three variables were independently associated with asthma death: fewer general practice contacts (odds ratio 0.82 (95% confidence interval (CI) 0.74 to 0.91) per 5 contacts) in the previous year, more home visits (1.14 (95% CI 1.08 to 1.21) per visit) in the previous year, and fewer peak expiratory flow recordings (0.83 (95% CI 0.74 to 0.92) per occasion) in the previous 3 months. These associations were similar after adjustment for markers of severity, psychosocial factors, systemic steroids, short acting bronchodilators and antibiotics, although the association with peak flow was weakened and just lost significance. Conclusion: Asthma death is associated with less use of primary care services. Both practice and patient factors may be involved and a better understanding of these may offer possibilities for reducing asthma death. PMID:16055628

It Takes a Toll on Pre-Service Teachers and Programs: Case Studies of Teacher Candidates Who Withdrew from a Teacher Education Program

ERIC Educational Resources Information Center

Lin, Pei-Ying; Childs, Ruth A.; Zhang, Jingshun

2016-01-01

Previous studies have examined patterns of withdrawal from initial teacher education (ITE) programs and have found that pre-service teachers are more likely to withdraw if they are male or older than the typical pre-service teacher. This study presents case studies based on semi-structured interviews with older male pre-service teachers who…

Complexity in Design-Driven Innovation: A Case Study of Knowledge Transfer Flow in Subsea Seismic Sensor Technology and Design Education

ERIC Educational Resources Information Center

Pavel, Nenad; Berg, Arild

2015-01-01

To the extent previously claimed, concept exploration is not the key to product innovation. However, companies that are design-focused are twice as innovative as those that are not. To study design-driven innovation and its occurrence in design education, two case studies are conducted. The first is an example of design practice which includes…

Validation of a computer case definition for sudden cardiac death in opioid users.

PubMed

Kawai, Vivian K; Murray, Katherine T; Stein, C Michael; Cooper, William O; Graham, David J; Hall, Kathi; Ray, Wayne A

2012-08-31

To facilitate the use of automated databases for studies of sudden cardiac death, we previously developed a computerized case definition that had a positive predictive value between 86% and 88%. However, the definition has not been specifically validated for prescription opioid users, for whom out-of-hospital overdose deaths may be difficult to distinguish from sudden cardiac death. We assembled a cohort of persons 30-74 years of age prescribed propoxyphene or hydrocodone who had no life-threatening non-cardiovascular illness, diagnosed drug abuse, residence in a nursing home in the past year, or hospital stay within the past 30 days. Medical records were sought for a sample of 140 cohort deaths within 30 days of a prescription fill meeting the computer case definition. Of the 140 sampled deaths, 81 were adjudicated; 73 (90%) were sudden cardiac deaths. Two deaths had possible opioid overdose; after removing these two the positive predictive value was 88%. These findings are consistent with our previous validation studies and suggest the computer case definition of sudden cardiac death is a useful tool for pharmacoepidemiologic studies of opioid analgesics.

The challenge of Parkinson's disease management in Africa.

PubMed

Dotchin, C L; Msuya, O; Walker, R W

2007-03-01

Parkinson's disease (PD) is said to be less common in Africa than elsewhere in the world, but previous studies have been based on small numbers. Also, the differences may be due to the diagnostic criteria used, case finding methods and different population age structures. Developing countries have few facilities for chronic disease management and non-communicable diseases, although on the increase, tend to play second fiddle to malaria and HIV/AIDS. Previous reports suggest that, at least from anecdotal information, under-diagnosis of PD is common and long-term availability of medication, follow-up, patient education and multidisciplinary input is lacking. Published literature is scarce and there is a lack of recent information. We are currently conducting a door-to-door prevalence study in northern Tanzania in a population of 161,162. We have reviewed previous literature on PD in Africa and illustrate our personal experience of PD and its management in Africa with three cases.

The association of genome-wide significant spirometric loci with chronic obstructive pulmonary disease susceptibility.

PubMed

Castaldi, Peter J; Cho, Michael H; Litonjua, Augusto A; Bakke, Per; Gulsvik, Amund; Lomas, David A; Anderson, Wayne; Beaty, Terri H; Hokanson, John E; Crapo, James D; Laird, Nan; Silverman, Edwin K

2011-12-01

Two recent metaanalyses of genome-wide association studies conducted by the CHARGE and SpiroMeta consortia identified novel loci yielding evidence of association at or near genome-wide significance (GWS) with FEV(1) and FEV(1)/FVC. We hypothesized that a subset of these markers would also be associated with chronic obstructive pulmonary disease (COPD) susceptibility. Thirty-two single-nucleotide polymorphisms (SNPs) in or near 17 genes in 11 previously identified GWS spirometric genomic regions were tested for association with COPD status in four COPD case-control study samples (NETT/NAS, the Norway case-control study, ECLIPSE, and the first 1,000 subjects in COPDGene; total sample size, 3,456 cases and 1,906 controls). In addition to testing the 32 spirometric GWS SNPs, we tested a dense panel of imputed HapMap2 SNP markers from the 17 genes located near the 32 GWS SNPs and in a set of 21 well studied COPD candidate genes. Of the previously identified GWS spirometric genomic regions, three loci harbored SNPs associated with COPD susceptibility at a 5% false discovery rate: the 4q24 locus including FLJ20184/INTS12/GSTCD/NPNT, the 6p21 locus including AGER and PPT2, and the 5q33 locus including ADAM19. In conclusion, markers previously associated at or near GWS with spirometric measures were tested for association with COPD status in data from four COPD case-control studies, and three loci showed evidence of association with COPD susceptibility at a 5% false discovery rate.

Association between previous splenectomy and gastric dilatation-volvulus in dogs: 453 cases (2004-2009).

PubMed

Sartor, Angela J; Bentley, Adrienne M; Brown, Dorothy C

2013-05-15

To evaluate the association between previous splenectomy and gastric dilatation-volvulus (GDV) in dogs. Multi-institutional retrospective case-control study. Animals-151 dogs treated surgically for GDV and 302 control dogs with no history of GDV. Computerized records of dogs evaluated via exploratory laparotomy or abdominal ultrasonography were searched, and dogs with GDV and dogs without GDV (control dogs) were identified. Two control dogs were matched with respect to age, body weight, sex, neuter status, and breed to each dog with GDV. Data were collected on the presence or absence of the spleen for both dogs with GDV and control dogs. Conditional logistic regression analysis was used to investigate the association of previous splenectomy with GDV. 6 (4%) dogs in the GDV group and 3 (1%) dogs in the control group had a history of previous splenectomy. The odds of GDV in dogs with a history of previous splenectomy in this population of dogs were 5.3 times those of dogs without a history of previous splenectomy (95% confidence interval, 1.1 to 26.8). For the patients in the present study, there was an increased odds of GDV in dogs with a history of splenectomy. Prophylactic gastropexy may be considered in dogs undergoing a splenectomy, particularly if other risk factors for GDV are present.

Has universal screening with Xpert® MTB/RIF increased the proportion of multidrug-resistant tuberculosis cases diagnosed in a routine operational setting?

PubMed Central

Dunbar, Rory; Caldwell, Judy; Lombard, Carl; Beyers, Nulda

2017-01-01

Setting Primary health services in Cape Town, South Africa where the introduction of Xpert® MTB/RIF (Xpert) enabled simultaneous screening for tuberculosis (TB) and drug susceptibility in all presumptive cases. Study aim To compare the proportion of TB cases with drug susceptibility tests undertaken and multidrug-resistant tuberculosis (MDR-TB) diagnosed pre-treatment and during the course of 1st line treatment in the previous smear/culture and the newly introduced Xpert-based algorithms. Methods TB cases identified in a previous stepped-wedge study of TB yield in five sub-districts over seven one-month time-points prior to, during and after the introduction of the Xpert-based algorithm were analysed. We used a combination of patient identifiers to identify all drug susceptibility tests undertaken from electronic laboratory records. Differences in the proportions of DST undertaken and MDR-TB cases diagnosed between algorithms were estimated using a binomial regression model. Results Pre-treatment, the probability of having a DST undertaken (RR = 1.82)(p<0.001) and being diagnosed with MDR-TB (RR = 1.42)(p<0.001) was higher in the Xpert-based algorithm than in the smear/culture-based algorithm. For cases evaluated during the course of 1st-line TB treatment, there was no significant difference in the proportion with DST undertaken (RR = 1.02)(p = 0.848) or MDR-TB diagnosed (RR = 1.12)(p = 0.678) between algorithms. Conclusion Universal screening for drug susceptibility in all presumptive TB cases in the Xpert-based algorithm resulted in a higher overall proportion of MDR-TB cases being diagnosed and is an important strategy in reducing transmission. The previous strategy of only screening new TB cases when 1st line treatment failed did not compensate for cases missed pre-treatment. PMID:28199375

Student Perceptions of Peer versus Instructor Facilitation of Asynchronous Online Discussions: Further Findings from Three Cases

ERIC Educational Resources Information Center

Hew, Khe Foon

2015-01-01

This study aims to extend a previous work on the role of peer facilitation of asynchronous online discussions. Specifically, in this paper I report three cases that examine students' preference for peer or instructor facilitation of online discussion forums, as well as their respective reasons for it. These three cases involved the following…

The Performance of the Japanese Case Particles in Children's Speech: With Special Reference to "Ga" and "O."

ERIC Educational Resources Information Center

Miyata, Hiroko

1993-01-01

The purpose of this paper is to demonstrate that children's use of Japanese case particles obeys the grammatical principles introduced at the earlier stage of language development. In previous studies concerning the acquisition of Japanese case examined through the experimental method, it has been suggested that children acquire the functional use…

"Give Me a Name for What's Wrong with Him": A Case Study of a Rare Chromosome Disorder

ERIC Educational Resources Information Center

Gilmore, Linda; Campbell, Marilyn

2006-01-01

The case is presented of a young boy with a rare chromosome disorder involving an interstitial deletion on chromosome 16 (16q11.2q13). Background information on chromosome disorders is presented along with a review of previous findings about the developmental consequences of chromosome 16q deletions. The case description illustrates the…

Psychiatric comorbidity may not predict suicide during and after hospitalization. A nested case-control study with blinded raters.

PubMed

Walby, Fredrik A; Odegaard, Erik; Mehlum, Lars

2006-06-01

To investigate the differential impact of DSM-IV axis-I and axis-II disorders on completed suicide and to study if psychiatric comorbidity increases the risk of suicide in currently and previously hospitalized psychiatric patients. A nested case-control design based on case notes from 136 suicides and 166 matched controls. All cases and controls were rediagnosed using the SCID-CV for axis-I and the DSM-IV criteria for axis-II disorders and the inter-rater reliability was satisfactory. Raters were blind to the case and control status and the original hospital diagnoses. Depressive disorders and bipolar disorders were associated with an increased risk of suicide. No such effect was found for comorbidity between axis-I disorders and for comorbidity between axis-I and axis-II disorders. Psychiatric diagnoses, although made using a structured and criteria-based approach, was based on information recorded in case notes. Axis-II comorbidity could only be investigated at an aggregated level. Psychiatric comorbidity did not predict suicide in this sample. Mood disorders did, however, increase the risk significantly independent of history of previous suicide attempts. Both findings can inform identification and treatment of patients at high risk for completed suicide.

Factors determining case fatality in myocardial infarction "who dies in a heart attack"?

PubMed

Wannamethee, G; Whincup, P H; Shaper, A G; Walker, M; MacFarlane, P W

1995-09-01

To examine the determinants of case fatality in the first major ischaemic heart disease event (heart attack) after screening. Prospective study of 7735 middle aged men drawn from general practices in 24 British towns. During 11.5 years follow up there were 743 major ischaemic heart disease events of which 302 (40.6%) were fatal within 28 days of onset. Previous definite myocardial infarction or stroke and age at time of event were most strongly associated with case fatality. In men with no previous myocardial infarction or stroke, after adjustment for a range of risk factors, antihypertensive treatment (odds ratio (OR) = 1.97, P < 0.05), arrhythmia (OR = 1.93, P = 0.06), increased heart rate (OR = 2.03, P = 0.06), and diabetes (OR = 2.61, P = 0.07) were associated with increased case fatality. High levels of physical activity (OR = 0.53, P < 0.05) and moderate drinking (16-42 units/week) (OR = 0.61, P < 0.05) were associated with lower case fatality, although moderate drinking was not associated with a lower incidence of major ischaemic heart disease events. Current smoking, serum total cholesterol, and systolic blood pressure were not significantly associated with case fatality. In men with previous myocardial infarction or stroke, arrhythmia and to a lesser degree antihypertensive treatment, moderate or heavy drinking, and diabetes were associated with higher case fatality. These findings suggest that physical activity may be an important modifiable factor influencing the incidence of ischaemic heart disease and the chance of survival in men without a previous heart attack or stroke. Arrhythmia, increased heart rate, diabetes, and treatment for hypertension are also areas of concern.

Pre-emptive therapy for severe nausea and vomiting of pregnancy and hyperemesis gravidarum.

PubMed

Koren, G; Maltepe, Caroline

2004-08-01

Nausea and vomiting of pregnancy (NVP) affects 80% of pregnancies. Its severe form, hyperemesis gravidarum (HG), results in dehydration, electrolyte imbalance, the need for hospitalisation and can, rarely, be fatal. This was a prospective, open-labelled, controlled, interventional study to evaluate the effectiveness of pre-emptive treatment of NVP symptoms in women who experienced severe NVP or HG in their previous pregnancy. Twenty-five women who reported severe symptoms of NVP with or without HG in their previous pregnancy were recruited and counselled to commence the use of antiemetics as soon as they became aware of the present pregnancy, and no later than the beginning of symptoms. They were followed-up prospectively through the index pregnancy for symptoms of NVP, and were counselled continuously as to how to modify antiemetic doses based on symptoms. A comparison group consisted of randomly selected women also counselled by us for NVP, who had also had severe NVP in the previous pregnancy, but who did not call before a planned pregnancy and thus could not be offered pre-emptive therapy. The recruited women commenced pre-emptive drug therapy for NVP before conception or up to 7 weeks' gestation, before the appearance of NVP symptoms in all cases. In comparison to the previous pregnancy, only eight of these 18 women experienced a HG again in the index pregnancy (P = 0.01). The majority of study the women had an improvement in severity of NVP symptoms compared to the previous pregnancy. In the comparison group (n = 35), symptoms in the index pregnancy remained severe in 28 cases (80%), decreased to moderate in six (16.6%) and decreased to mild in five cases (13.9%). There were five cases of HG in the previous pregnancy and three in the index pregnancy. The pre-emptive group was improved significantly compared to the control group (P = 0.01). Pre-emptive symptom management appears to be effective in preventing severe NVP in general, and HG in particular. Women who have experienced severe NVP in a previous pregnancy may benefit from taking antiemetics before, or immediately at the start of symptoms in a subsequent pregnancy.

Assessment of the incidence of GDV following splenectomy in dogs.

PubMed

Goldhammer, M A; Haining, H; Milne, E M; Shaw, D J; Yool, D A

2010-01-01

To establish if splenectomy increases the incidence of gastric dilatation and volvulus (GDV) in dogs. Two case-series studies of cases and controls were performed. Records of dogs that had undergone splenectomy (37 cases) were compared with records of dogs that had undergone other abdominal surgery (43 cases). Records of dogs that presented for non-elective gastropexy (33 cases) were compared with records of dogs presented to the hospital for unrelated reasons (39 cases). Survival following splenectomy and development of GDV in the first 12 months following surgery were retrieved from the clinical records and by questionnaire-based canvassing of the referring clinician. The incidence of GDV following splenectomy was established and the association between a current episode of GDV and previous splenectomy was assessed. There was no evidence that splenectomy was associated with an increased incidence of subsequent GDV (P=0.469). No association between a current episode of GDV and previous splenectomy was found. Splenectomy is not associated with an increase in the incidence of GDV.

Acinetobacter bacteraemia in Thailand: evidence for infections outside the hospital setting

PubMed Central

PORTER, K. A.; RHODES, J.; DEJSIRILERT, S.; HENCHAICHON, S.; SILUDJAI, D.; THAMTHITIWAT, S.; PRAPASIRI, P.; JORAKATE, P.; KAEWPAN, A.; PERUSKI, L. F.; KERDSIN, A.; PRASERT, K.; YUENPRAKONE, S.; MALONEY, S. A.; BAGGETT, H. C.

2015-01-01

SUMMARY Acinetobacter is a well-recognized nosocomial pathogen. Previous reports of community-associated Acinetobacter infections have lacked clear case definitions and assessment of healthcare-associated (HCA) risk factors. We identified Acinetobacter bacteraemia cases from blood cultures obtained <3 days after hospitalization in rural Thailand and performed medical record reviews to assess HCA risk factors in the previous year and compare clinical and microbiological characteristics between cases with and without HCA risk factors. Of 72 Acinetobacter cases, 32 (44%) had no HCA risk factors. Compared to HCA infections, non-HCA infections were more often caused by Acinetobacter species other than calcoaceticus–baumannii complex species and by antibiotic-susceptible organisms. Despite similar symptoms, the case-fatality proportion was lower in non-HCA than HCA cases (9% vs. 45%, P < 0·01). Clinicians should be aware of Acinetobacter as a potential cause of community-associated infections in Thailand; prospective studies are needed to improve understanding of associated risk factors and disease burden. PMID:24001479

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

PubMed Central

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

2011-01-01

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

Achieving Affective and Behavioral Outcomes in Culture Learning: The Case for Ethnographic Interviews

ERIC Educational Resources Information Center

Bateman, Blair E.

2004-01-01

This study sought to extend previous research on ethnographic interviews as a method of culture learning in foreign language classes by employing a qualitative case study methodology. Fifty-four university students in a first-year Spanish course worked in pairs to conduct a series of three ethnographic interviews with a native speaker of Spanish.…

Another Look at the Fizz Keeper: A Case-Study Laboratory Exercise for High School Students

ERIC Educational Resources Information Center

Mekelburg, Christopher R.; Szczepankiewicz, Steven H.; Hellerer, Matthew

2010-01-01

This case study places the high school student as a researcher for Carbonation Creators (fictional entity), a company responsible for making the Fizzy Forcer (a device to improve carbonation in previously opened bottles of soft drinks). The company faces a class-action lawsuit claiming that the Fizzy Forcer does not retain carbonation levels in…

Application of a Reference Framework for Integration of Web Resources in Dotlrn--Case Study of Physics--Topic: Waves

ERIC Educational Resources Information Center

Gomez, Fabinton Sotelo; Ordóñez, Armando

2016-01-01

Previously a framework for integrating web resources providing educational services in dotLRN was presented. The present paper describes the application of this framework in a rural school in Cauca--Colombia. The case study includes two web resources about the topic of waves (physics) which is oriented in secondary education. Web classes and…

Implications of Information Technology for Employment, Skills, and Wages: Findings from Sectoral and Case Study Research. Final Report

ERIC Educational Resources Information Center

Handel, Michael J.

2004-01-01

This paper reviews evidence from industry-specific and case studies that shed light on the extent to which computers and automation eliminate jobs, raise job skill requirements, and, consequently, contribute to increased wage inequality between less- and more skilled workers. This paper complements a previous review of large-scale econometric…

Internationalisation of the Chemistry Curriculum: Two Problem-Based Learning Activities for Undergraduate Chemists

ERIC Educational Resources Information Center

Overton, Tina L.; Bradley, John S.

2010-01-01

In this paper we describe the development and evaluation of two activities for delivery in first year B.Sc. and M.Chem. degree courses, in which we introduced an international context representing either a linguistic or a cultural modification to the previously developed case studies. The case studies focus on an industrial and an environmental…

Integrating Quality Matters into Hybrid Course Design: A Principles of Marketing Case Study

ERIC Educational Resources Information Center

Young, Mark R.

2014-01-01

Previous research supports the idea that the success of hybrid or online delivery modes is more a function of course design than delivery media. This article describes a case study of a hybrid Principles of Marketing course that implemented a comprehensive redesign based on design principles espoused by the Quality Matters Program, a center for…

Implications of Student and Lecturer Qualitative Views on Reading Lists: A Case Study at Loughborough University, UK

ERIC Educational Resources Information Center

Brewerton, Gary

2014-01-01

This case study explores student and lecturer views of reading lists at Loughborough University. Taking the qualitative data from two surveys previously undertaken at the institution, it uses the grounded theory approach to identify key issues regarding the purpose, importance, visibility, content, currency, and length of reading lists, as well as…

Nanomaterial Case Study: A Comparison of Multiwalled Carbon Nanotube and Decabromodiphenyl Ether Flame-Retardant Coatings Applied to Upholstery Textiles (External Review Draft)

EPA Science Inventory

The draft document is intended to be used as part of a process to identify what is known and, more importantly, what is not yet known that could be of value in assessing the broad implications of specific nanomaterials. Like previous case studies (see History/ Chronology below), ...

Baldness and testicular cancer: the EPSAM case-control study.

PubMed

Moirano, G; Zugna, D; Grasso, C; Lista, P; Ciuffreda, L; Segnan, N; Merletti, F; Richiardi, L

2016-03-01

The etiology of testicular cancer is largely unexplained. Research has mainly focused on prenatal exposures, especially to sex hormones, while less attention has been paid to exposures that may act also postnatally. As baldness has been previously associated with testicular cancer risk we focused on baldness and body hairiness, which are both associated with androgen activity. We used data of the Postnatal Exposures and Male Health (EPSAM) study, a case-control study on testicular cancer conducted in the Province of Turin, Italy, involving cases diagnosed between 1997 and 2008. Information was collected using mailed questionnaires. Analyses included 255 cases and 459 controls. We calculated ORs and 95% CIs to estimate testicular cancer risk among those who developed baldness and among those with body hairiness. We found an inverse association between testicular cancer and baldness (OR: 0.67, 95% CI: 0.46-0.98) and body hairiness (OR: 0.78, 95% CI: 0.53-1.16), although the latter had wider CIs. The inverse association between baldness and testicular cancer is consistent with the results from previous studies. These results suggest that androgens activity may influence testicular cancer risk. © 2016 American Society of Andrology and European Academy of Andrology.

Myeloid leukaemia in systemic lupus erythematosus--a nested case-control study based on Swedish registers.

PubMed

Löfström, Björn; Backlin, Carin; Sundström, Christer; Hellström-Lindberg, Eva; Ekbom, Anders; Lundberg, Ingrid E

2009-10-01

To assess the risk factors for leukaemic transformation and myeloid leukaemia in patients with SLE. A national SLE cohort identified through SLE discharge diagnoses in the Swedish hospital discharge register during 1964 to 1995 (n = 6438) was linked to the national cancer register. A nested case-control study in SLE patients who developed acute or chronic myeloid leukaemia was performed with SLE patients without malignancy as controls. Medical records from cases and controls were reviewed and bone marrow specimens were re-evaluated. A Medline search of previously published cases of SLE and myeloid leukaemia was performed. After confirmation of SLE diagnosis according to the ACR criteria, eight patients with SLE and myeloid leukaemia and 18 SLE controls were included in the study. Preceding leucopenia was significantly associated with leukaemia development, whereas other SLE manifestations were not. Two cases had a preceding bone marrow confirming myelodysplastic syndrome (MDS). Only two cases were significantly treated with cyclophosphamide or AZA. A Medline search resulted in only 15 previously published cases of coincident SLE and myeloid leukaemia. Preceding MDS was reported in five of these, whereas only eight had been treated with cytotoxic drugs. Low-dose chemotherapy was not a major cause of myeloid malignancy in our population-based cohort of SLE patients nor in the reported cases from literature. Leucopenia was a risk factor for myeloid leukaemia development and an MDS was frequently seen. Therefore bone marrow investigation should be considered in SLE patients with long-standing leucopenia and anaemia.

[Complicated jejunoileal diverticular disease: a 12 cases' serie and literature review].

PubMed

López Marcano, Aylhin Joana; Ramia, José Manuel; De la Plaza Llamas, Roberto; Alonso, Soledad; Gonzales Aguilar, Johnny David; Kühnhardt Barrantes, Andree Wolfgang

2017-01-01

To perform a retrospective analysis of a series of complicated JID (jejunoileal diverticulitis) cases surgically treated in our service during the period from 2002 to 2015. We treated 12 cases of jejunoileal complicated diverticulosis. 7 women and 5 men. The mean age was 76 years. The clinical presentation in all cases was acute abdominal pain, one with gastrointestinal bleeding. All cases had leukocytosis, neutrophilia and increased acute phase reactants. All patients underwent emergency abdominal CT. In 11 cases, there was consistency between imaging studies and surgical findings. Diverticula were located: jejunum (9) and ileum (3). Urgent exploratory laparotomy was always done and findings were: diverticular perforation with peritonitis (7 cases), diverticular perforation with abscess (4 cases) and in one case an ischemic area with diverticular perforation after embolization. Intestinal resection and anastomosis was performed in all cases. There were no patients, in which the diagnosis of diverticulosis jejunoileal was previously known. Complications were: Clavien I (2), Clavien IIIa (1), Clavien IVb (1), Clavien V (1). Jejunoileal diverticulitis is a rare entity, usually the first sign of onset of diverticular disease not previously known. Abdominal CT is of great diagnostic value. Resection of the affected segment is the treatment of choice.

Mitochondrial DNA G10398A variant is not associated with breast cancer in African-American women

PubMed Central

Setiawan, Veronica Wendy; Chu, Li-Hao; John, Esther M.; Ding, Yuan Chun; Ingles, Sue A.; Bernstein, Leslie; Press, Michael F.; Ursin, Giske; Haiman, Christopher A.; Neuhausen, Susan L

2009-01-01

Mitochondria play important roles in cellular energy production, free radical generation and apoptosis. In a previous report in Cancer Research, the mitochondrial DNA (mtDNA) G10398A (Thr → Ala) polymorphism was associated with breast cancer risk in African-American women. Here, we seek to replicate the association by genotyping the G10398A polymorphism in three established population-based case-control studies of breast cancer in African-American women. The 10398A allele was not significantly associated with risk in any of the studies [San Francisco study (542 cases, 282 controls, odds ratio (OR) = 1.73; 95% confidence interval (CI): 0.87, 3.47, P = 0.12); Multiethnic Cohort (391 cases, 460 controls, OR = 1.08; 95% CI: 0.62, 1.86, P = 0.79); CARE/LIFE study (524 cases, 236 controls, OR = 0.81; 95% CI: 0.43, 1.52, P = 0.50)]. When pooling the data across the three studies (1456 cases and 978 controls), no significant association was observed with the 10398A allele (OR = 1.14; 95% CI: 0.80, 1.62, P = 0.47, P heterogeneity=0.30). In analysis of advanced breast cancer cases (n=674), there also was no significant association (OR = 1.18; 95% CI: 0.76, 1.82, P = 0.46). Our results do not support the hypothesis that the mtDNA G10398A polymorphism is a marker of breast cancer risk in African Americans as previously reported. PMID:18262047

The Development of Technical and Vocational Education in Indonesia--A Case Study in Quality Improvement. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Bakri, Mohamad

After its independence in 1969, Indonesia studied and analyzed its previous colonial system of technical and vocational education (TVE) and took steps to overcome the shortcomings. TVE was required to provide expansion of work opportunities and industrial development to promote national development. Until 1989, attention was given to further…

A Strategic Culture Assessment of the Transatlantic Divide

DTIC Science & Technology

2008-03-01

security divide through the strategic culture lens, taking a comparative case study approach . It analyzes the emergent EU strategic culture by looking...utilize the strategic culture approach in the ensuing case study comparisons. B. WHY THE USE OF STRATEGIC CULTURE? In a study published in 2004...analysis use a comparative cultural approach when a previous comparison of U.S. and EU behavior found these actors’ behavior most aligned with realism’s

Incidence of epilepsy in Ferrara, Italy.

PubMed

Cesnik, Edward; Pedelini, Francesco; Faggioli, Raffaella; Monetti, Vincenza Cinzia; Granieri, Enrico; Casetta, Ilaria

2013-12-01

Few studies have been carried out in the same area at different times, allowing an assessment of the incidence of epilepsy (E.), including all ages, over time. The available data on temporal trend show a decrease in E. incidence in childhood and an increase in the elderly. We sought to update the incidence of E. in the province of Ferrara, where a previous study estimated an incidence rate of 33.1 per 100,000, 35.8, if standardized to the European population. Newly diagnosed patients aged up to 14 years were drawn from a community-based prospective multi-source registry, and adult onset E. cases were collected through multiple overlapping sources of case collection. Cases were included and classified according to ILAE recommendations. During the study period (2007-2008), 141 newly diagnosed cases (66 men and 75 women) living in the study area were identified. The crude incidence rate was 46.1 per 100,000 person-years (95 % CI 39.0-54.5), 35.5 (95 % CI 28.0-43.0) if adjusted to the European population. The incidence of childhood and adolescence epilepsy was 57.0 per 100,000 person-years (95 % CI 33.8-90.0), lower than that reported in our previous study, and it was 44.8 (95 % CI 37.4-53.6) for adult onset E., which is significantly higher as compared to our previous study. The overall incidence of E. in northern Italy is stable over time. We detected a significant decrease in incidence of childhood and adolescence E. and an increase in adult-onset E. The burden of epilepsy will increase as the population continues to age.

Default Mode Network Connectivity in Children with a History of Preschool Onset Depression

ERIC Educational Resources Information Center

Gaffrey, Michael S.; Luby, Joan L.; Botteron, Kelly; Repovs, Grega; Barch, Deanna M.

2012-01-01

Background: Atypical Default Mode Network (DMN) functional connectivity has been previously reported in depressed adults. However, there is relatively little data informing the developmental nature of this phenomenon. The current case-control study examined the DMN in a unique prospective sample of school-age children with a previous history of…

Multicenter outbreak of infections by Saprochaete clavata, an unrecognized opportunistic fungal pathogen.

PubMed

Vaux, Sophie; Criscuolo, Alexis; Desnos-Ollivier, Marie; Diancourt, Laure; Tarnaud, Chloé; Vandenbogaert, Matthias; Brisse, Sylvain; Coignard, Bruno; Dromer, Françoise

2014-12-16

Rapidly fatal cases of invasive fungal infections due to a fungus later identified as Saprochaete clavata were reported in France in May 2012. The objectives of this study were to determine the clonal relatedness of the isolates and to investigate possible sources of contamination. A nationwide alert was launched to collect cases. Molecular identification methods, whole-genome sequencing (WGS), and clone-specific genotyping were used to analyze recent and historical isolates, and a case-case study was performed. Isolates from thirty cases (26 fungemias, 22 associated deaths at day 30) were collected between September 2011 and October 2012. Eighteen cases occurred within 8 weeks (outbreak) in 10 health care facilities, suggesting a common source of contamination, with potential secondary cases. Phylogenetic analysis identified one clade (clade A), which accounted for 16/18 outbreak cases. Results of microbiological investigations of environmental, drug, or food sources were negative. Analysis of exposures pointed to a medical device used for storage and infusion of blood products, but no fungal contamination was detected in the unused devices. Molecular identification of isolates from previous studies demonstrated that S. clavata can be found in dairy products and has already been involved in monocentric outbreaks in hematology wards. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen. This report also underlines further the potential of WGS for investigation of outbreaks due to uncommon fungal pathogens. Several cases of rapidly fatal infections due to the fungus Saprochaete clavata were reported in France within a short period of time in three health care facilities, suggesting a common source of contamination. A nationwide alert collected 30 cases over 1 year, including an outbreak of 18 cases over 8 weeks. Whole-genome sequencing (WGS) was used to analyze recent and historical isolates and to design a clade-specific genotyping method that uncovered a clone associated with the outbreak, thus allowing a case-case study to analyze the risk factors associated with infection by the clone. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen. Copyright © 2014 Vaux et al.

A plague on five of your houses--statistical re-assessment of three pneumonic plague outbreaks that occurred in Suffolk, England, between 1906 and 1918.

PubMed

Egan, Joseph R

2010-10-25

Plague is a re-emerging disease and its pneumonic form is a high priority bio-terrorist threat. Epidemiologists have previously analysed historical outbreaks of pneumonic plague to better understand the dynamics of infection, transmission and control. This study examines 3 relatively unknown outbreaks of pneumonic plague that occurred in Suffolk, England, during the first 2 decades of the twentieth century. The Kolmogorov-Smirnov statistical test is used to compare the symptomatic period and the length of time between successive cases (i.e. the serial interval) with previously reported values. Consideration is also given to the case fatality ratio, the average number of secondary cases resulting from each primary case in the observed minor outbreaks (termed R(minor)), and the proportion of individuals living within an affected household that succumb to pneumonic plague via the index case (i.e. the household secondary attack rate (SAR)). 2 of the 14 cases survived giving a case fatality ratio of 86% (95% confidence interval (CI) = {57%, 98%}). For the 12 fatal cases, the average symptomatic period was 3.3 days (standard deviation (SD) = 1.2 days) and, for the 11 non index cases, the average serial interval was 5.8 days (SD = 2.0 days). R(minor) was calculated to be 0.9 (SD = 1.0) and, in 2 households, the SAR was approximately 14% (95% CI = {0%, 58%}) and 20% (95% CI = {1%, 72%}), respectively. The symptomatic period was approximately 1 day longer on average than in an earlier study but the serial interval was in close agreement with 2 previously reported values. 2 of the 3 outbreaks ended without explicit public health interventions; however, non-professional caregivers were particularly vulnerable - an important public health consideration for any future outbreak of pneumonic plague.

A plague on five of your houses - statistical re-assessment of three pneumonic plague outbreaks that occurred in Suffolk, England, between 1906 and 1918

PubMed Central

2010-01-01

Background Plague is a re-emerging disease and its pneumonic form is a high priority bio-terrorist threat. Epidemiologists have previously analysed historical outbreaks of pneumonic plague to better understand the dynamics of infection, transmission and control. This study examines 3 relatively unknown outbreaks of pneumonic plague that occurred in Suffolk, England, during the first 2 decades of the twentieth century. Methods The Kolmogorov-Smirnov statistical test is used to compare the symptomatic period and the length of time between successive cases (i.e. the serial interval) with previously reported values. Consideration is also given to the case fatality ratio, the average number of secondary cases resulting from each primary case in the observed minor outbreaks (termed Rminor), and the proportion of individuals living within an affected household that succumb to pneumonic plague via the index case (i.e. the household secondary attack rate (SAR)). Results 2 of the 14 cases survived giving a case fatality ratio of 86% (95% confidence interval (CI) = {57%, 98%}). For the 12 fatal cases, the average symptomatic period was 3.3 days (standard deviation (SD) = 1.2 days) and, for the 11 non index cases, the average serial interval was 5.8 days (SD = 2.0 days). Rminor was calculated to be 0.9 (SD = 1.0) and, in 2 households, the SAR was approximately 14% (95% CI = {0%, 58%}) and 20% (95% CI = {1%, 72%}), respectively. Conclusions The symptomatic period was approximately 1 day longer on average than in an earlier study but the serial interval was in close agreement with 2 previously reported values. 2 of the 3 outbreaks ended without explicit public health interventions; however, non-professional caregivers were particularly vulnerable - an important public health consideration for any future outbreak of pneumonic plague. PMID:20973955

Halo naevi, vitiligo and diffuse alopecia areata associated with tocilizumab therapy

PubMed Central

Nadesalingam, Kavitha; Goodfield, Mark; Emery, Paul

2016-01-01

We present a follow-up case report of a 33-year-old lady with juvenile onset arthritis who developed halo naevi while on treatment with tocilizumab. This case report describes the development of halo naevi, vitiligo and diffuse alopecia areata associated with tocilizumab therapy following infection with Methicillin-resistant Staphylococcus aureus (MRSA) and Panton–Valentine leukocidin positivity. This is the first case that describes these events and supports previous theories on cellular and humoral immunity as causative factors. The regression of melanocytes during treatment with tocilizumab could also implicate IL-6 and sIL-6R as future targets in the treatment of melanoma through its direct effect of melanocytic cytotoxicity, which supports previous studies. PMID:27516894

Prevalent fragility fractures as risk factor for skeletal muscle function deficit and dysmobility syndrome in post-menopausal women.

PubMed

Iolascon, Giovanni; Moretti, Antimo; Giamattei, Maria Teresa; Migliaccio, Silvia; Gimigliano, Francesca

2015-10-01

Fragility fractures are a major burden for health and social care in elderly people. In order to identify earlier the "frail elders", new concepts of "dysmobility syndrome" and skeletal muscle function deficit (SMFD), including sarcopenia, osteoporosis, obesity, and mobility limitation, leading to a higher risk of fractures, have been recently introduced. There are very few studies investigating the association between fragility fractures and both the dysmobility syndrome and the SMFD. The objective of our study is to investigate the role of previous fragility fractures as a risk factor in determining the dysmobility syndrome and/or the SMFD in post-menopausal women. In this case-control study, we retrospectively examined data from the medical records of post-menopausal women aged 50 or older. We divided the study population in two groups. The first group includes women with a previous fragility fracture (cases) and the other group includes women without any previous osteoporotic fracture (controls). We identified the subjects with "dysmobility syndrome", "dynapenic SMFD", "sarcopenic SMFD", and "mixed SMFD" in both groups. Data collected refer to a 6-month period. We retrieved data of 121 post-menopausal women, 77 (63.64%) had already sustained a fragility fracture at any site (cases). The risk for dysmobility syndrome was significantly higher (adjusted OR for age and serum 25-OH vitamin D3 of 2.46) in the cases compared with the controls. An early diagnosis of conditions limiting mobility, including dysmobility syndrome, might be useful to identify, among patients with osteoporotic fractures, those who might have a higher risk of a new fragility fracture.

An open randomized controlled study comparing an online text-based scenario and a serious game by Belgian and Swiss pharmacy students.

PubMed

Berger, Jérôme; Bawab, Noura; De Mooij, Jeremy; Sutter Widmer, Denise; Szilas, Nicolas; De Vriese, Carine; Bugnon, Olivier

2018-03-01

To compare online learning tools, looped, branch serious game (SG) and linear text-based scenario (TBS), among a sample of Belgian and Swiss pharmacy students. Open randomized controlled study. The lesson was based on the case of a benign cough in a healthy child. A randomized sample of 117 students: only the Swiss students had attended a previous lecture on coughs. Participation rate, pre- and post-experience Likert scales and students' clinical knowledge were measured. Our primary hypothesis was demonstrated: students favored the SG even if navigation was rated as more complex, and students who performed the SG better understood the aim of pharmacist triage in case of cough. The influence of the SG appeared to be linked to the presence of a previous lecture in the curriculum. SG and TBS are effective to teach pharmacist triage. Higher SG complexity should be used to teach the aim of pharmacist triage in the case of a specific disease and could be an alternative to simulated patients. A simpler TBS does not require a previous lecture and a debriefing to be fully effective. Copyright © 2017 Elsevier Inc. All rights reserved.

Translocation 4p;21q identified by FISH in a case previously described as {open_quotes}presumptive monosomy 21{close_quotes}

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

Yao, Xiu-Lan; Jenkins, E.C.

1994-10-01

Recently, Lopez-Pajares et al. (1993) reported identification of a translocation between the short arm of a chromosome 5 and the long arm of a chromosome 21 in a patient who was thought to be monosomy 21. This study is the first application of a chromosome 21 painting probe, pBS-21, and fluorescent in situ chromosome hybridization (FISH) to revise an earlier diagnosis of monosomy 21. We have now restudied skin fibroblast cultures, GM00137B, that are still available from another patient previously described as {open_quotes}presumptive monosomy 21{close_quotes} and have found that this case also has a translocation involving chromosomes 21 and 4.more » The authors urge that all previous cases of what appeared to be monosomy 21 should be re-examined with FISH to confirm or revise the original diagnosis so that genetic counseling of the family may be updated. 3 refs., 3 figs.« less

Score distributions of gapped multiple sequence alignments down to the low-probability tail

NASA Astrophysics Data System (ADS)

Fieth, Pascal; Hartmann, Alexander K.

2016-08-01

Assessing the significance of alignment scores of optimally aligned DNA or amino acid sequences can be achieved via the knowledge of the score distribution of random sequences. But this requires obtaining the distribution in the biologically relevant high-scoring region, where the probabilities are exponentially small. For gapless local alignments of infinitely long sequences this distribution is known analytically to follow a Gumbel distribution. Distributions for gapped local alignments and global alignments of finite lengths can only be obtained numerically. To obtain result for the small-probability region, specific statistical mechanics-based rare-event algorithms can be applied. In previous studies, this was achieved for pairwise alignments. They showed that, contrary to results from previous simple sampling studies, strong deviations from the Gumbel distribution occur in case of finite sequence lengths. Here we extend the studies to multiple sequence alignments with gaps, which are much more relevant for practical applications in molecular biology. We study the distributions of scores over a large range of the support, reaching probabilities as small as 10-160, for global and local (sum-of-pair scores) multiple alignments. We find that even after suitable rescaling, eliminating the sequence-length dependence, the distributions for multiple alignment differ from the pairwise alignment case. Furthermore, we also show that the previously discussed Gaussian correction to the Gumbel distribution needs to be refined, also for the case of pairwise alignments.

[Renal oncocytoma in the single kidney after previous surgery of renal carcinoma. Apropos of 2 cases].

PubMed

Veneroni, L; Canclini, L; Berti, G L; Giola, V; Leidi, G L; Maccaroni, A; Raimoldi, A; Sironi, M; Assi, A; Bacchioni, A M

1997-12-01

Renal oncocytoma is a neoplasm which rarely occurs in patients with solitary kidney, the other being absent because of a previous nephrectomy performed for renal cancer. We present two case reports and a literature review. We have studied some important problems such as the histogenesis, the potential for malignancy, the diagnosis, the treatment and the follow up. The high incidence of coexistence of renal oncocytoma and renal cell carcinoma has important clinical implications. We would like to emphasize the importance of preoperatory FNAB, nephron sparing surgery and very careful follow up.

A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta

PubMed Central

Matsuzaki, Satoko; Matsuzaki, Shinya; Ueda, Yutaka; Tanaka, Yusuke; Kakuda, Mamoru; Kanagawa, Takeshi; Kimura, Tadashi

2014-01-01

Objective Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM). Study Design Case report and review of the literature. Results A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options. PMID:26199801

A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta.

PubMed

Matsuzaki, Satoko; Matsuzaki, Shinya; Ueda, Yutaka; Tanaka, Yusuke; Kakuda, Mamoru; Kanagawa, Takeshi; Kimura, Tadashi

2015-04-01

Objective Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM). Study Design Case report and review of the literature. Results A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

A Case Study of the Impact of a Reformed Science Curriculum on Student Attitudes and Learning in a Secondary Physics Classroom

ERIC Educational Resources Information Center

Molotsky, Gregg Jeremy

2011-01-01

This case study examined the impact of the application of an inquiry-based concept related physics curriculum on student attitudes and learning in a secondary physics classroom in southern New Jersey. Students who had previously used a traditional physics curriculum were presented with a 10 week inquiry-based concept related physics curriculum on…

Pushing and Pulling Sara: A Case Study of the Contrasting Influences of High School and University Experiences on Engineering Agency, Identity, and Participation

ERIC Educational Resources Information Center

Godwin, Allison; Potvin, Geoff

2017-01-01

This manuscript reports a longitudinal case study of how one woman, Sara, who had previously considered dropping out of high school, authored strong mathematics and science identities and purposefully exhibited agency through her experiences in high school science. These experiences empowered her to choose an engineering major in college; however,…

Perceptions of Parents of Students with Autism towards the IEP Meeting: A Case Study of One Family Support Group Chapter

ERIC Educational Resources Information Center

Fish, Wade W.

2006-01-01

This case study investigated parental perceptions of students with autism towards the IEP meeting from one family support group chapter in the north Texas area. Participants were asked to share their experiences of previous IEP meetings and to provide input regarding not only measures that school districts may take towards improving IEP meetings,…

A Model of Human Orientation and Self Motion Perception during Body Acceleration: The Orientation Modeling System

DTIC Science & Technology

2016-09-28

previous research and modeling results. The OMS and Perception Toolbox were used to perform a case study of an F18 mishap. Model results imply that...request documents from DTIC. Change of Address Organizations receiving reports from the U.S. Army Aeromedical Research Laboratory on automatic...54  Coriolis head movement during a coordinated turn. .............................................55  Case Study

Expanded Awareness of Student Performance: A Case Study in Applied Ethnographic Monitoring in a Bilingual Classroom. Sociolinguistic Working Paper Number 60.

ERIC Educational Resources Information Center

Carrasco, Robert L.

The case study of the use of a classroom observation technique to evaluate the abilities and performance of a bilingual kindergarten student previously assessed as a low achiever is described. There are three objectives: to show the validity of the ethnographic monitoring technique, to show the value of teachers as collaborating researchers, and…

Review of fuel treatment effectiveness in forests and rangelands and a case study from the 2007 megafires in central, Idaho, USA

Treesearch

Andrew T. Hudak; Ian Rickert; Penelope Morgan; Eva Strand; Sarah A. Lewis; Peter R. Robichaud; Chad Hoffman; Zachary A. Holden

2011-01-01

This report provides managers with the current state of knowledge regarding the effectiveness of fuel treatments for mitigating severe wildfire effects. A literature review examines the effectiveness of fuel treatments that had been previously applied and were subsequently burned through by wildfire in forests and rangelands. A case study focuses on WUI fuel treatments...

Piscine mycobacteriosis - Involvement of bacterial species and reflection in pathology.

PubMed

Keller, C; Wenker, C; Jermann, T; Hirschi, R; Schildger, B; Meier, R; Schmidt-Posthaus, H

2018-06-01

Piscine mycobacteriosis is a lethal disease with zoonotic potential, found worldwide in both fresh and marine fish. More than 20 strains of Mycobacterium spp. are known to persist in fish so far, but the pathogenicity is currently unknown for most of them. However, M. marinum is reported as one of the most pathogenic agents for fish and is involved in zoonotic cases. We examined 47 different cases from two zoological gardens, where fish tuberculosis was identified or previously suspected during the last ten years. We collected PCR and sequencing data, which were then compared to previously collected clinical data and pathology. The clinical signs caused by Mycobacterium spp. were similar in all the cases, except for cases infected by M. marinum, which lacked the presence of skin lesions. Lesions seen in histology caused by M. marinum tended to be more acute and severe compared lesions caused by other Mycobacterium spp. The majority of M. marinum cases have been reported within marine fish. In contrast to previous studies we detected this species to be the predominant bacteria present within freshwater fish. Interestingly, we detected M. holsaticum in one of the seawater systems used in this project, being the first report of this Mycobacterium species shown to be present in a fish.

Association of Placenta Previa with a History of Previous Cesarian Deliveries and Indications for a Possible Role of a Genetic Component

PubMed Central

M, Matalliotakis; A, Velegrakis; GN, Goulielmos; E, Niraki; AE, Patelarou; I, Matalliotakis

2017-01-01

Abstract A prior Cesaria section (C-section) is an important risk factor that leads to endometrial damage and abnormal implantation of the placenta. Our retrospective study aims to correlate the frequency of placenta previa to previous C-sections, to determine the effect of male gender in this condition and to evaluate further the maternal outcome. Seventy-six cases with placenta previa were selected out of 5200 live births. Diagnosis was confirmed by ultrasound and in the operating theater. In the 76 women examined, we found 50 cases with a history of a previous C-section (66.0%) and 49 male offspring (65.0%) (p <0.001), with a mean birth weight of 2635 ± 740 g. Of all these patients, six (8.0%) cases developed placenta percreta, seven (9.0%) were transferred to the intensive care unit (ICU), 14 (18.0%) women needed blood transfusion and eight (11.0%) underwent hysterectomy. The results of our series show a strong correlation of placenta previa to a history of previous C-sections and a predominance of male fetuses. Early recognition and proper monitoring could minimize the possibility of a poor outcome. PMID:29876227

Association of Placenta Previa with a History of Previous Cesarian Deliveries and Indications for a Possible Role of a Genetic Component.

PubMed

M, Matalliotakis; A, Velegrakis; Gn, Goulielmos; E, Niraki; Ae, Patelarou; I, Matalliotakis

2017-12-01

A prior Cesaria section (C-section) is an important risk factor that leads to endometrial damage and abnormal implantation of the placenta. Our retrospective study aims to correlate the frequency of placenta previa to previous C-sections, to determine the effect of male gender in this condition and to evaluate further the maternal outcome. Seventy-six cases with placenta previa were selected out of 5200 live births. Diagnosis was confirmed by ultrasound and in the operating theater. In the 76 women examined, we found 50 cases with a history of a previous C-section (66.0%) and 49 male offspring (65.0%) ( p <0.001), with a mean birth weight of 2635 ± 740 g. Of all these patients, six (8.0%) cases developed placenta percreta, seven (9.0%) were transferred to the intensive care unit (ICU), 14 (18.0%) women needed blood transfusion and eight (11.0%) underwent hysterectomy. The results of our series show a strong correlation of placenta previa to a history of previous C-sections and a predominance of male fetuses. Early recognition and proper monitoring could minimize the possibility of a poor outcome.

Case-Mix Variables and Predictors for Outcomes of Laparoscopic Hysterectomy: A Systematic Review.

PubMed

Driessen, Sara R C; Sandberg, Evelien M; la Chapelle, Claire F; Twijnstra, Andries R H; Rhemrev, Johann P T; Jansen, Frank Willem

2016-01-01

The assessment of surgical quality is complex, and an adequate case-mix correction is missing in currently applied quality indicators. The purpose of this study is to give an overview of all studies mentioning statistically significant associations between patient characteristics and surgical outcomes for laparoscopic hysterectomy (LH). Additionally, we identified a set of potential case-mix characteristics for LH. This systematic review was conducted according to the Meta-Analysis of Observational Studies in Epidemiology guidelines. We searched PubMed and EMBASE from January 1, 2000 to August 1, 2015. All articles describing statistically significant associations between patient characteristics and adverse outcomes of LH for benign indications were included. Primary outcomes were blood loss, operative time, conversion, and complications. The methodologic quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. The included articles were summed per predictor and surgical outcome. Three sets of case-mix characteristics were determined, stratified by different levels of evidence. Eighty-five of 1549 identified studies were considered eligible. Uterine weight and body mass index (BMI) were the most mentioned predictors (described, respectively, 83 and 45 times) in high quality studies. For longer operative time and higher blood loss, uterine weight ≥ 250 to 300 g and ≥500 g and BMI ≥ 30 kg/m(2) dominated as predictors. Previous operations, adhesions, and higher age were also considered as predictors for longer operative time. For complications and conversions, the patient characteristics varied widely, and uterine weight, BMI, previous operations, adhesions, and age predominated. Studies of high methodologic quality indicated uterine weight and BMI as relevant case-mix characteristics for all surgical outcomes. For future development of quality indicators of LH and to compare surgical outcomes adequately, a case-mix correction is suggested for at least uterine weight and BMI. A potential case-mix correction for adhesions and previous operations can be considered. For both surgeons and patients it is valuable to be aware of potential factors predicting adverse outcomes and to anticipate this. Finally, to benchmark clinical outcomes at an international level, it is of the utmost importance to introduce uniform outcome definitions. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Risk factors for first trimester miscarriage--results from a UK-population-based case-control study.

PubMed

Maconochie, N; Doyle, P; Prior, S; Simmons, R

2007-02-01

The aim of this study was to examine the association between biological, behavioural and lifestyle risk factors and risk of miscarriage. Population-based case-control study. Case-control study nested within a population-based, two-stage postal survey of reproductive histories of women randomly sampled from the UK electoral register. Six hundred and three women aged 18-55 years whose most recent pregnancy had ended in first trimester miscarriage (<13 weeks of gestation; cases) and 6116 women aged 18-55 years whose most recent pregnancy had progressed beyond 12 weeks (controls). Women were questioned about socio-demographic, behavioural and other factors in their most recent pregnancy. First trimester miscarriage. After adjustment for confounding, the following were independently associated with increased risk: high maternal age; previous miscarriage, termination and infertility; assisted conception; low pre-pregnancy body mass index; regular or high alcohol consumption; feeling stressed (including trend with number of stressful or traumatic events); high paternal age and changing partner. Previous live birth, nausea, vitamin supplementation and eating fresh fruits and vegetables daily were associated with reduced risk, as were feeling well enough to fly or to have sex. After adjustment for nausea, we did not confirm an association with caffeine consumption, smoking or moderate or occasional alcohol consumption; nor did we find an association with educational level, socio-economic circumstances or working during pregnancy. The results confirm that advice to encourage a healthy diet, reduce stress and promote emotional wellbeing might help women in early pregnancy (or planning a pregnancy) reduce their risk of miscarriage. Findings of increased risk associated with previous termination, stress, change of partner and low pre-pregnancy weight are noteworthy, and we recommend further work to confirm these findings in other study populations.

Effects of exercise and dietary habits on the occurrence of polycystic ovary syndrome over 5 years of follow-up.

PubMed

Zhang, Jing; Zhou, Kunyan; Luo, Li; Liu, Ying; Liu, Xiaofang; Xu, Liangzhi

2018-06-07

To evaluate the effects of recent and previous exercise and dietary habits on the occurrence of polycystic ovary syndrome (PCOS). The present study had a population-based case-control phase and a nested case-control phase. Women aged 12-44 years with and without PCOS were surveyed using the Semiquantitative Food Frequency Questionnaire and the International Physical Activity Questionnaire to evaluate the correlation of PCOS with recent (last 7 days) or previous (5 years ago) exercise and dietary habits. No difference in recent physical activity was found between the PCOS and control groups (case-control phase, n=1854). However, patients with PCOS had previously (5 years ago; nested case-control phase, n=1149) spent less time physical active in relation to transportation (P=0.003), housekeeping (P=0.023), walking (P<0.001), and activities of moderate intensity (P=0.008), and had spent more time sitting (P<0.001). Dietary nutrients and energy intake did not differ between the two groups (P>0.05 for all comparisons). A previous exercise habit was associated with subsequent PCOS whereas a recently acquired exercise routine was not. Women should avoid long-term sedentary lifestyle habits and focus on adding to the duration of, or enhancing the intensity of, physical activity. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Examining the Impact of a Video Case-Based Mathematics Methods Course on Secondary Pre-Service Teachers' Skills at Analysing Students' Strategies

ERIC Educational Resources Information Center

Martinez, Mara Vanina; Superfine, Alison Castro; Carlton, Theresa; Dasgupta, Chandan

2015-01-01

This paper focuses on results from a study conducted with two cohorts of pre-service teachers (PSTs) in a video case-based mathematics methods course at a large Midwestern university in the US. The motivation for this study was to look beyond whether or not PSTs pay attention to mathematical thinking of students, as shown by previous studies when…

Development of Procedures for Assessing the Impact of Vocational Education Research and Development on Vocational Education (Project IMPACT). Volume 4--A Case Study of Illinois Projects in Horticulture.

ERIC Educational Resources Information Center

Hook, Colin; Ethridge, James

As part of Project IMPACT's efforts to identify and develop procedures for complying with the impact requirements of Public Law 94-482, a case study was made of Illinois Projects in Horticulture. Fourteen horticulture projects in high schools and junior colleges were discovered through a previous study, personal interviews with two University of…

Mixed Methods Survey of Zoonotic Disease Awareness and Practice among Animal and Human Healthcare Providers in Moshi, Tanzania

PubMed Central

Zhang, Helen L.; Mnzava, Kunda W.; Mitchell, Sarah T.; Melubo, Matayo L.; Kibona, Tito J.; Cleaveland, Sarah; Kazwala, Rudovick R.; Crump, John A.; Sharp, Joanne P.; Halliday, Jo E. B.

2016-01-01

Background Zoonoses are common causes of human and livestock illness in Tanzania. Previous studies have shown that brucellosis, leptospirosis, and Q fever account for a large proportion of human febrile illness in northern Tanzania, yet they are infrequently diagnosed. We conducted this study to assess awareness and knowledge regarding selected zoonoses among healthcare providers in Moshi, Tanzania; to determine what diagnostic and treatment protocols are utilized; and obtain insights into contextual factors contributing to the apparent under-diagnosis of zoonoses. Methodology/Results We conducted a questionnaire about zoonoses knowledge, case reporting, and testing with 52 human health practitioners and 10 livestock health providers. Immediately following questionnaire administration, we conducted semi-structured interviews with 60 of these respondents, using the findings of a previous fever etiology study to prompt conversation. Sixty respondents (97%) had heard of brucellosis, 26 (42%) leptospirosis, and 20 (32%) Q fever. Animal sector respondents reported seeing cases of animal brucellosis (4), rabies (4), and anthrax (3) in the previous 12 months. Human sector respondents reported cases of human brucellosis (15, 29%), rabies (9, 18%) and anthrax (6, 12%). None reported leptospirosis or Q fever cases. Nineteen respondents were aware of a local diagnostic test for human brucellosis. Reports of tests for human leptospirosis or Q fever, or for any of the study pathogens in animals, were rare. Many respondents expressed awareness of malaria over-diagnosis and zoonoses under-diagnosis, and many identified low knowledge and testing capacity as reasons for zoonoses under-diagnosis. Conclusions This study revealed differences in knowledge of different zoonoses and low case report frequencies of brucellosis, leptospirosis, and Q fever. There was a lack of known diagnostic services for leptospirosis and Q fever. These findings emphasize a need for improved diagnostic capacity alongside healthcare provider education and improved clinical guidelines for syndrome-based disease management to provoke diagnostic consideration of locally relevant zoonoses in the absence of laboratory confirmation. PMID:26943334

Common germline polymorphisms associated with breast cancer-specific survival.

PubMed

Pirie, Ailith; Guo, Qi; Kraft, Peter; Canisius, Sander; Eccles, Diana M; Rahman, Nazneen; Nevanlinna, Heli; Chen, Constance; Khan, Sofia; Tyrer, Jonathan; Bolla, Manjeet K; Wang, Qin; Dennis, Joe; Michailidou, Kyriaki; Lush, Michael; Dunning, Alison M; Shah, Mitul; Czene, Kamila; Darabi, Hatef; Eriksson, Mikael; Lambrechts, Dieter; Weltens, Caroline; Leunen, Karin; van Ongeval, Chantal; Nordestgaard, Børge G; Nielsen, Sune F; Flyger, Henrik; Rudolph, Anja; Seibold, Petra; Flesch-Janys, Dieter; Blomqvist, Carl; Aittomäki, Kristiina; Fagerholm, Rainer; Muranen, Taru A; Olsen, Janet E; Hallberg, Emily; Vachon, Celine; Knight, Julia A; Glendon, Gord; Mulligan, Anna Marie; Broeks, Annegien; Cornelissen, Sten; Haiman, Christopher A; Henderson, Brian E; Schumacher, Frederick; Le Marchand, Loic; Hopper, John L; Tsimiklis, Helen; Apicella, Carmel; Southey, Melissa C; Cross, Simon S; Reed, Malcolm Wr; Giles, Graham G; Milne, Roger L; McLean, Catriona; Winqvist, Robert; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Grip, Mervi; Hooning, Maartje J; Hollestelle, Antoinette; Martens, John Wm; van den Ouweland, Ans Mw; Marme, Federick; Schneeweiss, Andreas; Yang, Rongxi; Burwinkel, Barbara; Figueroa, Jonine; Chanock, Stephen J; Lissowska, Jolanta; Sawyer, Elinor J; Tomlinson, Ian; Kerin, Michael J; Miller, Nicola; Brenner, Hermann; Butterbach, Katja; Holleczek, Bernd; Kataja, Vesa; Kosma, Veli-Matti; Hartikainen, Jaana M; Li, Jingmei; Brand, Judith S; Humphreys, Keith; Devilee, Peter; Tollenaar, Robert Aem; Seynaeve, Caroline; Radice, Paolo; Peterlongo, Paolo; Manoukian, Siranoush; Ficarazzi, Filomena; Beckmann, Matthias W; Hein, Alexander; Ekici, Arif B; Balleine, Rosemary; Phillips, Kelly-Anne; Benitez, Javier; Zamora, M Pilar; Perez, Jose Ignacio Arias; Menéndez, Primitiva; Jakubowska, Anna; Lubinski, Jan; Gronwald, Jacek; Durda, Katarzyna; Hamann, Ute; Kabisch, Maria; Ulmer, Hans Ulrich; Rüdiger, Thomas; Margolin, Sara; Kristensen, Vessela; Nord, Siljie; Evans, D Gareth; Abraham, Jean; Earl, Helena; Poole, Christopher J; Hiller, Louise; Dunn, Janet A; Bowden, Sarah; Yang, Rose; Campa, Daniele; Diver, W Ryan; Gapstur, Susan M; Gaudet, Mia M; Hankinson, Susan; Hoover, Robert N; Hüsing, Anika; Kaaks, Rudolf; Machiela, Mitchell J; Willett, Walter; Barrdahl, Myrto; Canzian, Federico; Chin, Suet-Feung; Caldas, Carlos; Hunter, David J; Lindstrom, Sara; Garcia-Closas, Montserrat; Couch, Fergus J; Chenevix-Trench, Georgia; Mannermaa, Arto; Andrulis, Irene L; Hall, Per; Chang-Claude, Jenny; Easton, Douglas F; Bojesen, Stig E; Cox, Angela; Fasching, Peter A; Pharoah, Paul Dp; Schmidt, Marjanka K

2015-04-22

Previous studies have identified common germline variants nominally associated with breast cancer survival. These associations have not been widely replicated in further studies. The purpose of this study was to evaluate the association of previously reported SNPs with breast cancer-specific survival using data from a pooled analysis of eight breast cancer survival genome-wide association studies (GWAS) from the Breast Cancer Association Consortium. A literature review was conducted of all previously published associations between common germline variants and three survival outcomes: breast cancer-specific survival, overall survival and disease-free survival. All associations that reached the nominal significance level of P value <0.05 were included. Single nucleotide polymorphisms that had been previously reported as nominally associated with at least one survival outcome were evaluated in the pooled analysis of over 37,000 breast cancer cases for association with breast cancer-specific survival. Previous associations were evaluated using a one-sided test based on the reported direction of effect. Fifty-six variants from 45 previous publications were evaluated in the meta-analysis. Fifty-four of these were evaluated in the full set of 37,954 breast cancer cases with 2,900 events and the two additional variants were evaluated in a reduced sample size of 30,000 samples in order to ensure independence from the previously published studies. Five variants reached nominal significance (P <0.05) in the pooled GWAS data compared to 2.8 expected under the null hypothesis. Seven additional variants were associated (P <0.05) with ER-positive disease. Although no variants reached genome-wide significance (P <5 x 10(-8)), these results suggest that there is some evidence of association between candidate common germline variants and breast cancer prognosis. Larger studies from multinational collaborations are necessary to increase the power to detect associations, between common variants and prognosis, at more stringent significance levels.

Is screening of TORCH worthwhile in women with bad obstetric history: an observation from eastern Nepal.

PubMed

Kumari, Namrata; Morris, Norman; Dutta, Renu

2011-02-01

This pilot case-control study at a tertiary-care hospital over a four-month period was aimed at evaluating the possible usefulness of screening of TORCH (Toxoplasma gondii, rubella virus, cytomegalovirus, and Herpes simplex virus) in females with bad obstetric history. The study included 12 women with bad obstetric history and a similar number of matched controls with previous normal pregnancies. A serological evaluation of TORCH infections was carried out by detecting IgG and IgM antibodies against these infections by ELISA test-kit. Statistical analysis was not done to compare the results relating to the two groups due to a small number of cases and controls included in the study. Ten (83.3%) of the 12 cases with bad obstetric history and two (16.7%) of the 12 healthy controls were serologically positive at least for one of the TORCH agents. The seropositivity rate in women with bad obstetric history was quite high compared to that in the normal healthy controls. The results suggest that a previous history of pregnancy wastage and the serological evaluation of TORCH infections during current pregnancy must be considered while managing cases with bad obstetric history.

Landscape and Residential Variables Associated with Plague-Endemic Villages in the West Nile Region of Uganda

PubMed Central

MacMillan, Katherine; Enscore, Russell E.; Ogen-Odoi, Asaph; Borchert, Jeff N.; Babi, Nackson; Amatre, Gerald; Atiku, Linda A.; Mead, Paul S.; Gage, Kenneth L.; Eisen, Rebecca J.

2011-01-01

Plague, caused by the bacteria Yersinia pestis, is a severe, often fatal disease. This study focuses on the plague-endemic West Nile region of Uganda, where limited information is available regarding environmental and behavioral risk factors associated with plague infection. We conducted observational surveys of 10 randomly selected huts within historically classified case and control villages (four each) two times during the dry season of 2006 (N = 78 case huts and N = 80 control huts), which immediately preceded a large plague outbreak. By coupling a previously published landscape-level statistical model of plague risk with this observational survey, we were able to identify potential residence-based risk factors for plague associated with huts within historic case or control villages (e.g., distance to neighboring homestead and presence of pigs near the home) and huts within areas previously predicted as elevated risk or low risk (e.g., corn and other annual crops grown near the home, water storage in the home, and processed commercial foods stored in the home). The identified variables are consistent with current ecologic theories on plague transmission dynamics. This preliminary study serves as a foundation for future case control studies in the area. PMID:21363983

Validation of a computer case definition for sudden cardiac death in opioid users

PubMed Central

2012-01-01

Background To facilitate the use of automated databases for studies of sudden cardiac death, we previously developed a computerized case definition that had a positive predictive value between 86% and 88%. However, the definition has not been specifically validated for prescription opioid users, for whom out-of-hospital overdose deaths may be difficult to distinguish from sudden cardiac death. Findings We assembled a cohort of persons 30-74 years of age prescribed propoxyphene or hydrocodone who had no life-threatening non-cardiovascular illness, diagnosed drug abuse, residence in a nursing home in the past year, or hospital stay within the past 30 days. Medical records were sought for a sample of 140 cohort deaths within 30 days of a prescription fill meeting the computer case definition. Of the 140 sampled deaths, 81 were adjudicated; 73 (90%) were sudden cardiac deaths. Two deaths had possible opioid overdose; after removing these two the positive predictive value was 88%. Conclusions These findings are consistent with our previous validation studies and suggest the computer case definition of sudden cardiac death is a useful tool for pharmacoepidemiologic studies of opioid analgesics. PMID:22938531

A case of misdiagnosis of mild cognitive impairment: The utility of symptom validity testing in an outpatient memory clinic.

PubMed

Roor, Jeroen J; Dandachi-FitzGerald, Brechje; Ponds, Rudolf W H M

2016-01-01

Noncredible symptom reports hinder the diagnostic process. This fact is especially the case for medical conditions that rely on subjective report of symptoms instead of objective measures. Mild cognitive impairment (MCI) primarily relies on subjective report, which makes it potentially susceptible to erroneous diagnosis. In this case report, we describe a 59-year-old female patient diagnosed with MCI 10 years previously. The patient was referred to the neurology department for reexamination by her general practitioner because of cognitive complaints and persistent fatigue. This case study used information from the medical file, a new magnetic resonance imaging brain scan, and neuropsychological assessment. Current neuropsychological assessment, including symptom validity tests, clearly indicated noncredible test performance, thereby invalidating the obtained neuropsychological test data. We conclude that a blind spot for noncredible symptom reports existed in the previous diagnostic assessments. This case highlights the usefulness of formal symptom validity testing in the diagnostic assessment of MCI.

Rickettsia sp. Strain Atlantic Rainforest Infection in a Patient from a Spotted Fever-Endemic Area in Southern Brazil

PubMed Central

Krawczak, Felipe S.; Muñoz-Leal, Sebastián; Guztzazky, Ana Carolina; Oliveira, Stefan V.; Santos, Fabiana C. P.; Angerami, Rodrigo N.; Moraes-Filho, Jonas; de Souza, Julio C.; Labruna, Marcelo B.

2016-01-01

Santa Catarina State in southern Brazil is the state with the second highest number of laboratory-confirmed cases of spotted fever illness in Brazil. However, all these cases were confirmed solely by serological analysis (seroconversion to spotted fever group rickettsiae), which has not allowed identification of the rickettsial agent. Here, a clinical case of spotted fever illness from Santa Catarina is shown by seroconversion and molecular analysis to be caused by Rickettsia sp. strain Atlantic rainforest. This is the third confirmed clinical case due to this emerging rickettsial agent in Brazil. Like the previous two cases, the patient presented an inoculation eschar at the tick bite site. Our molecular diagnosis was performed on DNA extracted from the crust removed from the eschar. These results are supported by previous epidemiological studies in Santa Catarina, which showed that nearly 10% of the most common human-biting ticks were infected by Rickettsia sp. strain Atlantic rainforest. PMID:27325804

Rickettsia sp. Strain Atlantic Rainforest Infection in a Patient from a Spotted Fever-Endemic Area in Southern Brazil.

PubMed

Krawczak, Felipe S; Muñoz-Leal, Sebastián; Guztzazky, Ana Carolina; Oliveira, Stefan V; Santos, Fabiana C P; Angerami, Rodrigo N; Moraes-Filho, Jonas; de Souza, Julio C; Labruna, Marcelo B

2016-09-07

Santa Catarina State in southern Brazil is the state with the second highest number of laboratory-confirmed cases of spotted fever illness in Brazil. However, all these cases were confirmed solely by serological analysis (seroconversion to spotted fever group rickettsiae), which has not allowed identification of the rickettsial agent. Here, a clinical case of spotted fever illness from Santa Catarina is shown by seroconversion and molecular analysis to be caused by Rickettsia sp. strain Atlantic rainforest. This is the third confirmed clinical case due to this emerging rickettsial agent in Brazil. Like the previous two cases, the patient presented an inoculation eschar at the tick bite site. Our molecular diagnosis was performed on DNA extracted from the crust removed from the eschar. These results are supported by previous epidemiological studies in Santa Catarina, which showed that nearly 10% of the most common human-biting ticks were infected by Rickettsia sp. strain Atlantic rainforest. © The American Society of Tropical Medicine and Hygiene.

Active case finding for carbapenemase-producing Enterobacteriaceae in a teaching hospital: prevalence and risk factors for colonization.

PubMed

Poole, K; George, R; Decraene, V; Shankar, K; Cawthorne, J; Savage, N; Welfare, W; Dodgson, A

2016-10-01

Over the past decade, the prevalence of carbapenemase-producing Enterobacteriaceae (CPE) has increased. Whilst basic infection prevention and control practices reduce the risk of transmission, cases of unrecognized carriage pose a potential risk of transmission. To estimate the prevalence of CPE and explore risk factors associated with colonization within a large teaching hospital with an established CPE outbreak. All inpatients that had not previously tested positive for CPE were offered testing. Demographic and hospital episode data were also collected, together with antibiotic and proton pump inhibitor (PPI) use in the preceding 24h. This study identified 70 CPE-positive cases (26 newly identified and 44 previously known) and 592 CPE-negative cases, giving a combined prevalence of 11% [95% confidence interval (CI) 8-13]. Medication (antibiotic and PPI use), previous admission, ethnicity and length of stay were assessed as risk factors for colonization, and none were found to be independently associated with CPE colonization. Using logistic regression, age [odds ratio (OR) 1.03, 95% CI 1.01-1.07] and antibiotic use (OR 2.55, 95% CI 1.08-6.03) were the only risk factors significantly associated with CPE colonization. This study has added to the evidence base by estimating the prevalence of CPE among inpatients in an acute hospital with an established CPE outbreak. A case-finding exercise was feasible and identified a number of new cases. Despite a small sample size, increasing age and prescription of an antibiotic on the day of testing were significantly associated with CPE colonization. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Shear-wave velocity-based probabilistic and deterministic assessment of seismic soil liquefaction potential

USGS Publications Warehouse

Kayen, R.; Moss, R.E.S.; Thompson, E.M.; Seed, R.B.; Cetin, K.O.; Der Kiureghian, A.; Tanaka, Y.; Tokimatsu, K.

2013-01-01

Shear-wave velocity (Vs) offers a means to determine the seismic resistance of soil to liquefaction by a fundamental soil property. This paper presents the results of an 11-year international project to gather new Vs site data and develop probabilistic correlations for seismic soil liquefaction occurrence. Toward that objective, shear-wave velocity test sites were identified, and measurements made for 301 new liquefaction field case histories in China, Japan, Taiwan, Greece, and the United States over a decade. The majority of these new case histories reoccupy those previously investigated by penetration testing. These new data are combined with previously published case histories to build a global catalog of 422 case histories of Vs liquefaction performance. Bayesian regression and structural reliability methods facilitate a probabilistic treatment of the Vs catalog for performance-based engineering applications. Where possible, uncertainties of the variables comprising both the seismic demand and the soil capacity were estimated and included in the analysis, resulting in greatly reduced overall model uncertainty relative to previous studies. The presented data set and probabilistic analysis also help resolve the ancillary issues of adjustment for soil fines content and magnitude scaling factors.

A Case Analysis of a Suburban North Carolina Public School System's Elementary School Level Redistricting Outcomes

ERIC Educational Resources Information Center

LoFrese, Christopher Todd

2014-01-01

This case study explored the socioeconomic integration outcomes of a central North Carolina Public School District's recent elementary level redistricting process. The district's student assignment policy seeks to balance schools in part by the socioeconomic status of students. Previous redistricting efforts used free and reduced price lunch…

Haemophilus haemolyticus Isolates Causing Clinical Disease

PubMed Central

Wang, Xin; Briere, Elizabeth C.; Katz, Lee S.; Cohn, Amanda C.; Clark, Thomas A.; Messonnier, Nancy E.; Mayer, Leonard W.

2012-01-01

We report seven cases of Haemophilus haemolyticus invasive disease detected in the United States, which were previously misidentified as nontypeable Haemophilus influenzae. All cases had different symptoms and presentations. Our study suggests that a testing scheme that includes reliable PCR assays and standard microbiological methods should be used in order to improve H. haemolyticus identification. PMID:22573587

Haemophilus haemolyticus isolates causing clinical disease.

PubMed

Anderson, Raydel; Wang, Xin; Briere, Elizabeth C; Katz, Lee S; Cohn, Amanda C; Clark, Thomas A; Messonnier, Nancy E; Mayer, Leonard W

2012-07-01

We report seven cases of Haemophilus haemolyticus invasive disease detected in the United States, which were previously misidentified as nontypeable Haemophilus influenzae. All cases had different symptoms and presentations. Our study suggests that a testing scheme that includes reliable PCR assays and standard microbiological methods should be used in order to improve H. haemolyticus identification.

Radiofrequency denervation of the hip joint for pain management: case report and literature review.

PubMed

Gupta, Gaurav; Radhakrishna, Mohan; Etheridge, Paul; Besemann, Markus; Finlayson, Robert J

2014-01-01

A 55-year-old male presented with severe pain and functional limitations as a result of left hip osteoarthritis. He had failed multiple treatments while waiting for a hip arthroplasty, including physical therapy, medications, and various intra-articular injections. Thermal radiofrequency lesioning of the obturator and femoral articular branches to the hip joint was offered in the interim. To our knowledge, this is the first report to describe an inferior-lateral approach for lesioning the obturator branch, the clinical application of successive lesions to increase denervation area, and outcomes in a patient receiving a second treatment with previously good results. To discuss relevant and technical factors for this specific case, we reviewed previous literature on hip joint radiofrequency and critically evaluated previous anatomic studies in the context of radiofrequency. The first treatment provided significant benefit for a period of 6 months. A second treatment was employed providing only mild to moderate benefit until his joint replacement surgery 4 months later. Literature review revealed studies of low quality secondary to small sample sizes, patient selection methodology, inclusion of patients with heterogenous etiologies for pain, variable needle placement techniques, and lack of measurement of functional outcomes. Case report and low quality studies in existing literature. Hip joint radiofrequency denervation is a promising avenue for adjunctive treatment of hip pain. Further cadaveric studies are required to clarify a multitude of technical parameters. Once these are well defined, future clinical studies should consider pain, functional, and economic outcomes in their design.

Multicenter Outbreak of Infections by Saprochaete clavata, an Unrecognized Opportunistic Fungal Pathogen

PubMed Central

Vaux, Sophie; Criscuolo, Alexis; Desnos-Ollivier, Marie; Diancourt, Laure; Tarnaud, Chloé; Vandenbogaert, Matthias; Brisse, Sylvain; Coignard, Bruno; Garcia-Hermoso, Dea; Blanc, Catherine; Hoinard, Damien; Lortholary, Olivier; Bretagne, Stéphane; Thiolet, Jean-Michel; de Valk, Henriette; Courbil, Rémi; Chabanel, Anne; Simonet, Marion; Maire, Francoise; Jbilou, Saadia; Tiberghien, Pierre; Blanchard, Hervé; Venier, Anne-Gaëlle; Bernet, Claude; Simon, Loïc; Sénéchal, Hélène; Pouchol, Elodie; Angot, Christiane; Ribaud, Patricia; Socié, G.; Flèche, M.; Brieu, Nathalie; Lagier, Evelyne; Chartier, Vanessa; Allegre, Thierry; Maulin, Laurence; Lanic, Hélène; Tilly, Hervé; Bouchara, Jean-Philippe; Pihet, Marc; Schmidt, Aline; Kouatchet, Achille; Vandamme, Yves-Marie; Ifrah, Norbert; Mercat, Alain; Accoceberry, Isabelle; Albert, Olivier; Leguay, Thibaut; Rogues, Anne-Marie; Bonhomme, Julie; Reman, Oumédaly; Lesteven, Claire; Poirier, Philippe; Chabrot, Cécile Molucon; Calvet, Laure; Baud, Olivier; Cambon, Monique; Farkas, Jean Chistophe; Lafon, Bruno; Dalle, Frédéric; Caillot, Denis; Lazzarotti, Aline; Aho, Serge; Combret, Sandrine; Facon, Thierry; Sendid, Boualem; Loridant, Séverine; Louis, Terriou; Cazin, Bruno; Grandbastien, Bruno; Bourgeois, Nathalie; Lotthé, Anne; Cartron, Guillaume; Ravel, Christophe; Colson, Pascal; Gaudard, Philippe; Bonmati, Caroline; Simon, Loic; Rabaud, Christian; Machouart, Marie; Poisson, Didier; Carp, Diana; Meunier, Jérôme; Gaschet, Anne; Miquel, Chantal; Sanhes, Laurence; Ferreyra, Milagros; Leibinger, Franck; Geudet, Philippe; Toubas, Dominique; Himberlin, Chantal; Bureau-Chalot, Florence; Delmer, Alain; Favennec, Loïc; Gargala, Gilles; Michot, Jean-Baptiste; Girault, Christophe; David, Marion; Leprêtre, Stéphane; Jardin, Fabrice; Honderlick, Pierre; Caille, Vincent; Cerf, Charles; Cassaing, Sophie; Recher, Christian; Picard, Muriel; Protin, Caroline; Huguet, Françoise; Huynh, Anne; Ruiz, Jean; Riu-Poulenc, Béatrice; Letocart, Philippe; Marchou, Bruno; Verdeil, Xavier; Cavalié, Laurent; Chauvin, Pamela; Iriart, Xavier; Valentin, Alexis; Bouvet, Emmanuelle; Delmas-Marsalet, Béatrice; Jeblaoui, Asma; Kassis-Chikhani, Najiby; Mühlethaler, Konrad; Zimmerli, Stefan; Zalar, Polona; Sánchez-Reus, Ferran; Gurgui, Merce

2014-01-01

ABSTRACT Rapidly fatal cases of invasive fungal infections due to a fungus later identified as Saprochaete clavata were reported in France in May 2012. The objectives of this study were to determine the clonal relatedness of the isolates and to investigate possible sources of contamination. A nationwide alert was launched to collect cases. Molecular identification methods, whole-genome sequencing (WGS), and clone-specific genotyping were used to analyze recent and historical isolates, and a case-case study was performed. Isolates from thirty cases (26 fungemias, 22 associated deaths at day 30) were collected between September 2011 and October 2012. Eighteen cases occurred within 8 weeks (outbreak) in 10 health care facilities, suggesting a common source of contamination, with potential secondary cases. Phylogenetic analysis identified one clade (clade A), which accounted for 16/18 outbreak cases. Results of microbiological investigations of environmental, drug, or food sources were negative. Analysis of exposures pointed to a medical device used for storage and infusion of blood products, but no fungal contamination was detected in the unused devices. Molecular identification of isolates from previous studies demonstrated that S. clavata can be found in dairy products and has already been involved in monocentric outbreaks in hematology wards. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen. This report also underlines further the potential of WGS for investigation of outbreaks due to uncommon fungal pathogens. PMID:25516620

Proton-pump inhibitors can decrease gastrointestinal bleeding after percutaneous coronary intervention.

PubMed

Jiang, Zongdan; Wu, Hailu; Duan, Zhaotao; Wang, Zhibing; Hu, Kewei; Ye, Fei; Zhang, Zhenyu

2013-12-01

Current medical therapies for patients who have an acute coronary syndrome (ACS) focus on the coagulation cascade and platelet inhibition. These, coupled with early use of cardiac catheterization and revascularization, have decreased morbidity and mortality rates in patients who have acute ischemic heart disease with risk of bleeding. The study aimed to determine the incidence of gastrointestinal bleeding after percutaneous coronary intervention (PCI). The effect of proton-pump inhibitor (PPI) treatment was also analyzed. This case-control study evaluated gastrointestinal bleeding within a year of PCI for stable angina and acute coronary syndromes at Nanjing First Hospital between 2008 and 2011. Cases were identified and outcomes assessed using linkage analysis of data from cardiology and gastroenterology department databases. Analysis of the case and control groups for both risk and protective factors was performed using independent two-sample Student's t-test with Fisher's exact P value and logistic regression. The incidence of gastrointestinal bleeding following PCI was 1.3% (35/2680 patients). The risk factors for gastrointestinal bleeding were advanced age, female gender, smoking, drinking, previous peptic ulcer and previous gastrointestinal bleeding. PPI use after PCI (P=0.000) was accompanied by a lower risk of gastrointestinal bleeding, with only a few cases of gastrointestinal bleeding events reported. The incidence of gastrointestinal bleeding associated with the combination of aspirin and clopidogrel therapy was estimated to be 1.3%. Advanced age, being female, smokers, drinkers, previous peptic ulcer and previous gastrointestinal bleeding were significant independent risk factors. PPI for the prevention and treatment of gastrointestinal bleeding induced by the combination of aspirin and clopidogrel in patients after PCI was safe and effective. Published by Elsevier Masson SAS.

The relationship between the Southern Oscillation Index, rainfall and the occurrence of canine tick paralysis, feline tick paralysis and canine parvovirus in Australia.

PubMed

Rika-Heke, Tamara; Kelman, Mark; Ward, Michael P

2015-07-01

The aim of this study was to describe the association between climate, weather and the occurrence of canine tick paralysis, feline tick paralysis and canine parvovirus in Australia. The Southern Oscillation Index (SOI) and monthly average rainfall (mm) data were used as indices for climate and weather, respectively. Case data were extracted from a voluntary national companion animal disease surveillance resource. Climate and weather data were obtained from the Australian Government Bureau of Meteorology. During the 4-year study period (January 2010-December 2013), a total of 4742 canine parvovirus cases and 8417 tick paralysis cases were reported. No significant (P ≥ 0.05) correlations were found between the SOI and parvovirus, canine tick paralysis or feline tick paralysis. A significant (P < 0.05) positive cross-correlation was found between parvovirus occurrence and rainfall in the same month (0.28), and significant negative cross-correlations (-0.26 to -0.36) between parvovirus occurrence and rainfall 4-6 months previously. Significant (P < 0.05) negative cross-correlations (-0.34 to -0.39) were found between canine tick paralysis occurrence and rainfall 1-3 months previously, and significant positive cross-correlations (0.29-0.47) between canine tick paralysis occurrence and rainfall 7-10 months previously. Significant positive cross-correlations (0.37-0.68) were found between cases of feline tick paralysis and rainfall 6-10 months previously. These findings may offer a useful tool for the management and prevention of tick paralysis and canine parvovirus, by providing an evidence base supporting the recommendations of veterinarians to clients thus reducing the impact of these diseases. Copyright © 2015 Elsevier Ltd. All rights reserved.

A cholera outbreak in Alborz Province, Iran: a matched case-control study.

PubMed

Moradi, Ghobad; Rasouli, Mohammad Aziz; Mohammadi, Parvin; Elahi, Elham; Barati, Hojatollah

2016-01-01

A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks. An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method. In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72). Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

The relationship between prior antimicrobial prescription and meningitis: a case-control study.

PubMed

Armstrong, David; Ashworth, Mark; Dregan, Alex; White, Patrick

2016-04-01

Recent research into the role of the human microbiome in maintaining health has identified the potentially harmful impact of antimicrobials. The association with bacterial and viral meningitis following antimicrobial prescription during the previous year was investigated to determine whether antimicrobials have a deleterious effect on the nasopharyngeal microbiome. A case-control study (1:4 cases to controls) was conducted examining the rate of previous antimicrobial exposure in cases of meningitis and in a matched control group. Data from a UK primary care clinical database were analysed using conditional logistic regression. A total of 7346 cases of meningitis were identified, 3307 (45%) viral, 1812 (25%) bacterial, and 2227 (30%) unspecified. The risks of viral (adjusted odds ratio [AOR] 2.45; 95% confidence interval [CI] = 2.24 to 2.68) or bacterial (AOR 1.98; 95% CI = 1.71 to 2.30) meningitis were both increased following antimicrobial prescription in the preceding year. Patients who received ≥4 antimicrobial prescriptions in the preceding year were at significantly increased risk of all types of meningitis (AOR 2.85; 95% CI = 2.44 to 3.34), bacterial meningitis (AOR 3.06; 95% CI = 2.26 to 4.15) and viral meningitis (AOR 3.23; 95% CI = 2.55 to 4.08) compared to their matched controls. There was an increased risk of meningitis following antimicrobial prescription in the previous year. It is possible that this increase was due to an effect of antimicrobials on the microbiome or reflected an increased general susceptibility to infections in these patients. © British Journal of General Practice 2016.

Preliminary Clinical Experience with a Combined Automated Breast Ultrasound and Digital Breast Tomosynthesis System.

PubMed

Larson, Eric D; Lee, Won-Mean; Roubidoux, Marilyn A; Goodsitt, Mitchell M; Lashbrook, Chris; Davis, Cynthia E; Kripfgans, Oliver D; Carson, Paul L

2018-03-01

We analyzed the performance of a mammographically configured, automated breast ultrasound (McABUS) scanner combined with a digital breast tomosynthesis (DBT) system. The GE Invenia ultrasound system was modified for integration with GE DBT systems. Ultrasound and DBT imaging were performed in the same mammographic compression. Our small preliminary study included 13 cases, six of whom had contained invasive cancers. From analysis of these cases, current limitations and corresponding potential improvements of the system were determined. A registration analysis was performed to compare the ease of McABUS to DBT registration for this system with that of two systems designed previously. It was observed that in comparison to data from an earlier study, the McABUS-to-DBT registration alignment errors for both this system and a previously built combined system were smaller than those for a previously built standalone McABUS system. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

Maternal asthma and idiopathic preterm labor.

PubMed

Kramer, M S; Coates, A L; Michoud, M C; Dagenais, S; Moshonas, D; Davis, G M; Hamilton, E F; Nuwayhid, B; Joshi, A K; Papageorgiou, A

1995-11-15

Previous studies suggest that women with asthma are at increased risk of preterm birth. Moreover, drugs (especially beta-agonists) used to treat asthma are also used to treat preterm labor. The authors carried out a case-control study of 555 women from three hospital centers with idiopathic preterm labor (< 37 weeks), including two overlapping (i.e., non-mutually exclusive) subsamples: cases with early idiopathic preterm labor (< 34 weeks) and cases with idiopathic recurrent preterm labor (< 37 weeks plus a previous history of preterm delivery or second-trimester miscarriage). Controls were matched to cases according to race and smoking history prior to and during pregnancy. All subjects responded in person to questions about atopic, respiratory, obstetric, and sociodemographic histories. Subjects in the early and recurrent preterm labor subsamples were also asked to undergo spirometric testing with methacholine challenge 6-12 weeks after delivery. Cases were significantly more likely to report histories of asthma symptoms and physician-diagnosed asthma (matched odds ratios of 2-3) than controls, particularly those cases with recurrent preterm labor. No significant associations were observed, however, with methacholine responsiveness. These results could not be explained by residual confounding by smoking or other variables, nor by selective recall of asthma symptoms and histories by cases. Women with asthma are at increased risk of idiopathic preterm labor. The fact that no such association was seen with methacholine responsiveness suggests that nonatopic, noncholinergic mechanisms may link bronchial and uterine smooth muscle lability.

Using the Web as a Higher Order Thinking Partner: Case Study of an Advanced Learner Creatively Synthesizing Knowledge on the Web

ERIC Educational Resources Information Center

DeSchryver, Michael

2017-01-01

Previous work provided foundations for the theory of web-mediated knowledge synthesis, a framework for using the web in more creative and generative ways. This article explores specific instances of the various elements of that theory in a single case from the initial study. That is, a thorough exploration of think-aloud, screen capture, and…

Do I Belong? Factors Contributing to the Development of Social Belonging of Children Who Are Homeless in Southeastern United States Shelters: A Multi-Case Study

ERIC Educational Resources Information Center

Ott, Corilyn Mae

2012-01-01

This qualitative multiple case study explored the factors that contribute to the development of social belonging in the classroom for children who are homeless age's five to seven. Previous empirical research has shown the importance of children who are homeless developing belonging in the classroom and other research has shown the negative…

Brain cancer and nonoccupational risk factors: a case-control study among workers at two nuclear facilities

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

Carpenter, A.V.; Flanders, W.D.; Frome, E.L.

1987-09-01

In a nested case-control study of nuclear workers, 82 brain cancer cases were compared with 328 matched controls to investigate the possible association with nonoccupational risk factors such as histories of epilepsy or head injury. We observed a moderately strong association between brain cancer occurrence and history of epilepsy (OR = 5.7, 95 per cent CI: 1.0, 32.1), but did not find a positive association with previous head injury (OR = 0.9, 95 per cent CI: 0.2, 4.2).

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

PubMed

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

2015-06-01

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

Title: Studies on drug switchability showed heterogeneity in methodological approaches: a scoping review.

PubMed

Belleudi, Valeria; Trotta, Francesco; Vecchi, Simona; Amato, Laura; Addis, Antonio; Davoli, Marina

2018-05-16

Several drugs share the same therapeutic indication, including those undergoing patent expiration. Concerns on the interchangeability are frequent in clinical practice, challenging the evaluation of switchability through observational research. To conduct a scoping review of observational studies on drug switchability to identify methodological strategies adopted to deal with bias and confounding. We searched PubMed, EMBASE, and Web of Science (updated 1/31/2017) to identify studies evaluating switchability in terms of effectiveness/safety outcomes or compliance. Three reviewers independently screened studies extracting all characteristics. Strategies to address confounding, particularly, previous drug use and switching reasons were considered. All findings were summarized in descriptive analyses. Thirty-two studies, published in the last 10 years, met the inclusion criteria. Epilepsy, cardiovascular and rheumatology were the most frequently represented clinical areas. 75% of the studies reported data on effectiveness/safety outcomes. The most frequent study design was cohort (65.6%) followed by case-control (21.9%) and self-controlled (12.5%). Case-control and case-crossover studies showed homogeneous methodological strategies to deal with bias and confounding. Among cohort studies, the confounding associated with previous drug use was addressed introducing variables in multivariate model (47.3%) or selecting only adherent patients (14.3%). Around 30% of cohort studies did not report reasons for switching. In the remaining 70%, clinical parameters or previous occurrence of outcomes were measured to identify switching connected with lack of effectiveness or adverse events. This study represents a starting point for researchers and administrators who are approaching the investigation and assessment of issues related to interchangeability of drugs. Copyright © 2018. Published by Elsevier Inc.

Diesel Exhaust Exposure and the Risk of Lung Cancer—A Review of the Epidemiological Evidence

PubMed Central

Sun, Yi; Bochmann, Frank; Nold, Annette; Mattenklott, Markus

2014-01-01

To critically evaluate the association between diesel exhaust (DE) exposure and the risk of lung cancer, we conducted a systematic review of published epidemiological evidences. To comprehensively identify original studies on the association between DE exposure and the risk of lung cancer, literature searches were performed in literature databases for the period between 1970 and 2013, including bibliographies and cross-referencing. In total, 42 cohort studies and 32 case-control studies were identified in which the association between DE exposures and lung cancer was examined. In general, previous studies suffer from a series of methodological limitations, including design, exposure assessment methods and statistical analysis used. A lack of objective exposure information appears to be the main problem in interpreting epidemiological evidence. To facilitate the interpretation and comparison of previous studies, a job-exposure matrix (JEM) of DE exposures was created based on around 4,000 historical industrial measurements. The values from the JEM were considered during interpretation and comparison of previous studies. Overall, neither cohort nor case-control studies indicate a clear exposure-response relationship between DE exposure and lung cancer. Epidemiological studies published to date do not allow a valid quantification of the association between DE and lung cancer. PMID:24473109

Natural course of undescended testes after inguinoscrotal surgery.

PubMed

Meij-deVries, Annebeth; van der Voort, Laszla M; Sijstermans, Karlijn; Meijer, Robert W; van der Plas, Evelyn M; Hack, Wilfried W M

2013-12-01

The purpose of the study is to study the natural course of undescended testes after inguinoscrotal surgery. From 2003-2010, 24 boys were observed with 26 undescended testes after inguinoscrotal surgery; 12 had previously undergone inguinal hernia repair and 12 orchidopexy. Spontaneous descent was awaited and (re-)orchidopexy would only be performed in case of non-descent at puberty. The boys were assessed annually for testis position and for testis volume as measured by ultrasound. At the end of the study period, 19 testes had reached scrotal position; of these, 13 (68%) had descended spontaneously and 6 (32%) had been (re-)orchidopexied. No difference was found in the rate of spontaneous descent after previous orchidopexy or inguinal hernia repair (P=0.419). Spontaneous descent of undescended testes after inguinoscrotal surgery occurs regularly. In this study, it was observed in two out of every three cases. © 2013.

Intelligence, previous convictions and interrogative suggestibility: a path analysis of alleged false-confession cases.

PubMed

Sharrock, R; Gudjonsson, G H

1993-05-01

The main purpose of this study was to investigate the relationship between interrogative suggestibility and previous convictions among 108 defendants in criminal trials, using a path analysis technique. It was hypothesized that previous convictions, which may provide defendants with interrogative experiences, would correlate negatively with 'shift' as measured by the Gudjonsson Suggestibility Scale (Gudjonsson, 1984a), after intelligence and memory had been controlled for. The hypothesis was partially confirmed and the theoretical and practical implications of the findings are discussed.

Characterizing the genetic risk for Type 2 diabetes in a Malaysian multi-ethnic cohort.

PubMed

Abdullah, N; Abdul Murad, N A; Attia, J; Oldmeadow, C; Mohd Haniff, E A; Syafruddin, S E; Abd Jalal, N; Ismail, N; Ishak, M; Jamal, R; Scott, R J; Holliday, E G

2015-10-01

To characterize the association with Type 2 diabetes of known Type 2 diabetes risk variants in people in Malaysia of Malay, Chinese and Indian ancestry who participated in the Malaysian Cohort project. We genotyped 1604 people of Malay ancestry (722 cases, 882 controls), 1654 of Chinese ancestry (819 cases, 835 controls) and 1728 of Indian ancestry (851 cases, 877 controls). First, 62 candidate single-nucleotide polymorphisms previously associated with Type 2 diabetes were assessed for association via logistic regression within ancestral groups and then across ancestral groups using a meta-analysis. Second, estimated odds ratios were assessed for excess directional concordance with previously studied populations. Third, a genetic risk score aggregating allele dosage across the candidate single-nucleotide polymorphisms was tested for association within and across ancestral groups. After Bonferroni correction, seven individual single-nucleotide polymorphisms were associated with Type 2 diabetes in the combined Malaysian sample. We observed a highly significant excess in concordance of effect directions between Malaysian and previously studied populations. The genetic risk score was strongly associated with Type 2 diabetes in all Malaysian groups, explaining from 1.0 to 1.7% of total Type 2 diabetes risk variance. This study suggests there is substantial overlap of the genetic risk alleles underlying Type 2 diabetes in Malaysian and other populations. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

A Case Study to Improve Emergency Room Patient Flow at Womack Army Medical Center

DTIC Science & Technology

2009-06-01

use just the previous month, moving average 2-month period ( MA2 ) uses the average from the previous two months, moving average 3-month period (MA3...ED prior to discharge by provider) MA2 /MA3/MA4 - moving averages of 2-4 months in length MAD - mean absolute deviation (measure of accuracy for

The Effects of Fading a Strategic Self-Monitoring Intervention on Students' Academic Engagement, Accuracy, and Productivity

ERIC Educational Resources Information Center

Rock, Marcia L.; Thead, Beth K.

2007-01-01

In this study, using a single-case multiple-treatment reversal (A-B-A-B-C) research design, we replicated and extended previous strategic self-monitoring research by teaching five students, with and without disabilities, to use ACT-REACT to increase their academic engagement, productivity, and accuracy across new and previously learned math…

[Tetanus after cat scratch and bites in a previously immunized patient].

PubMed

Fica, Alberto; Gaínza, Daniela; Ortigosa, Pablo

2017-04-01

Tetanus is declining due to vaccination, professional labor management and appropriate wound care. Tetanus cases have been reported despite immunization. We report the case of a previously healthy 21 years old female patient that presented a mild generalized tetanus requiring admission after mild and recurrent cat scratch and bites. She had received six vaccine shots during childhood, and a booster dose five years earlier after a rabbit bite. Symptoms appeared seven weeks after the last contact, and included headache, muscle spasms and mild opisthotonus. Laboratory evaluation, including CSF analysis and microbiological investigation, as well as imaging studies were all normal. The patient received 6,000 IU of human antitoxin immunoglobulin. No autonomic manifestations or respiratory compromise were registered. Symptoms resolved rapidly and she was discharge after seven days with an order to complete a tetanus toxoid immunization schedule with three doses. Tetanus is possible in urban settings with a declining epidemiologic curve of disease in previously immunized patients. Severity of disease is modulated by previous vaccination.

[Incidence and surgical wound infection risk factors in breast cancer surgery].

PubMed

Lefebvre, D; Penel, N; Deberles, M F; Fournier, C

2000-11-18

In order to evaluate occurrence and risk factors for wound infection (WI) in breast cancer surgery, we carried out a prospective study. From September 1996 through April 1997, an infection control physician prospectively evaluated 542 wounds of all patients having breast cancer surgery at the Oscar Lambret Cancer Center. WI was defined as a wound with pus. Antibiotic prophylaxis was given in case of immediate breast reconstruction. Statistical evaluation was performed using the c < or = test for categorial data and non-parametric Mann-Whitney test for continuous data. In univariate analysis, differences were considered significant at p < 0.01. The overall WI rate was 3.51% (19/352). In univariate analysis, risk factors for WI were: total preoperative hospital stay (p = 0.01), previous chemotherapy (p = 0.01), previous oncologic surgery (p = 0.03) and immediate breast reconstruction (p = 0.002). In mutivariate analysis, we observed two independent predictive factors for WI: previous chemotherapy (p = 0.05) and immediate breast reconstruction (p = 0.02). Previous anticancer chemotherapy was a major risk factor. In these cases, a phase III trial could confirm efficacy of standard antibiotic prophylaxis. Breast reconstruction was the second major risk factor. Standard antibiotic prophylaxis (used in our study) was insufficient.

The influence of flexible management practices on the sharing of experiential knowledge in the workplace: a case study of food service helpers.

PubMed

Ledoux, Elise; Cloutier, Esther; Fournier, Pierre-Sébastien

2012-01-01

Previous studies have shown that the job knowledge and prudent knowledge of experienced workers constitute a wealth that needs to be shared in workplaces to promote worker integration, job retention and occupational health and safety. It appears, however, that certain management practices undermine this knowledge sharing process. This case study of food service helpers in institutional food service departments is part of a research project aimed at comparing the impact of different work organization methods on knowledge sharing in the workplace on the basis of case studies carried out in several organizations. The results of this case study reveal that by destabilizing and weakening the work teams, flexible management practices create an environment that is not conducive to experiential knowledge sharing.

Effect of Space Flight on Adrenal Medullary Function

NASA Technical Reports Server (NTRS)

Lelkes, Peter I.

1999-01-01

We hypothesize that microgravity conditions during space flight alter the expression and specific activities of the adrenal medullary CA synthesizing enzymes (CASE). Previously, we examined adrenals from six rats flown for six days aboard STS 54 and reported that microgravity induced a decrease in the expression and specific activity of rat adrenal medullary tyrosine hydroxylase, the rate limiting enzyme of CA synthesis, without affecting the expression of other CASE. In the past, we analyzed some of the > 300 adrenals from two previous Space Shuttle missions (PARE 03 and SLS 2). The preliminary results (a) attest to the good state of tissue preservation, thus proving the feasibility of subsequent large-scale evaluation, and (b) confirm and extend our previous findings. With this grant we will be able to expeditiously analyze all our specimens and to complete our studies in a timely fashion.

Electroencephalography Spectral Power Density in First-Episode Mania: A Comparative Study with Subsequent Remission Period.

PubMed

Güven, Sertaç; Kesebir, Sermin; Demirer, R Murat; Bilici, Mustafa

2015-06-01

Our aim in this study was to investigate spectral power density (PSD) in first-episode mania and subsequent remission period and to evaluate their difference. Sixty-nine consecutive cases referring to our hospital within the previous 1 year, who were evaluated as bipolar disorder manic episode according to The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) at the first episode and had the informed consent form signed by first degree relatives, were included in this study. Exclusion criteria included having previous depressive episode, using drugs which could influence electroencephalographic activity before electroencephalography (EEG), and having previous neurological disease, particularly epilepsy, head trauma, and/or loss of consciousness. EEG records were obtained using a digital device in 16 channels; 23 surface electrodes were placed according to the International 10-20 system. Spectral power density (dbμV/Hz) of EEG signal provided information on the power carried out by EEG waves in defined frequancy range per unit frequency in the present study. A peak power value detected on the right with FP2P4 and on the left with F7T3 electrodes were found to be higher in the manic episode than in the remission period (p=0.018 and 0.025). In the remission period, in cases with psychotic symptoms during the manic period, F4C4 peak power value was found to be lower than that in cases with no psychotic findings during the manic period (p=0.027). There was no relation was found between YMRS scores and peak power scores. Electrophysiological corollary of mood episode is present from the onset of the disease, and it differs between the manic and remission periods of bipolar disorder. In the remission period, peak power values of PSD distinguish cases with psychotic findings from cases without psychotic findings when they were manic.

Using the genome aggregation database, computational pathogenicity prediction tools, and patch clamp heterologous expression studies to demote previously published long QT syndrome type 1 mutations from pathogenic to benign.

PubMed

Clemens, Daniel J; Lentino, Anne R; Kapplinger, Jamie D; Ye, Dan; Zhou, Wei; Tester, David J; Ackerman, Michael J

2018-04-01

Mutations in the KCNQ1-encoded Kv7.1 potassium channel cause long QT syndrome (LQTS) type 1 (LQT1). It has been suggested that ∼10%-20% of rare LQTS case-derived variants in the literature may have been published erroneously as LQT1-causative mutations and may be "false positives." The purpose of this study was to determine which previously published KCNQ1 case variants are likely false positives. A list of all published, case-derived KCNQ1 missense variants (MVs) was compiled. The occurrence of each MV within the Genome Aggregation Database (gnomAD) was assessed. Eight in silico tools were used to predict each variant's pathogenicity. Case-derived variants that were either (1) too frequently found in gnomAD or (2) absent in gnomAD but predicted to be pathogenic by ≤2 tools were considered potential false positives. Three of these variants were characterized functionally using whole-cell patch clamp technique. Overall, there were 244 KCNQ1 case-derived MVs. Of these, 29 (12%) were seen in ≥10 individuals in gnomAD and are demotable. However, 157 of 244 MVs (64%) were absent in gnomAD. Of these, 7 (4%) were predicted to be pathogenic by ≤2 tools, 3 of which we characterized functionally. There was no significant difference in current density between heterozygous KCNQ1-F127L, -P477L, or -L619M variant-containing channels compared to KCNQ1-WT. This study offers preliminary evidence for the demotion of 32 (13%) previously published LQT1 MVs. Of these, 29 were demoted because of their frequent sighting in gnomAD. Additionally, in silico analysis and in vitro functional studies have facilitated the demotion of 3 ultra-rare MVs (F127L, P477L, L619M). Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Ectopic pregnancy in southern Iran: a statistical review of 96 cases.

PubMed

Javey, H

1976-01-01

A review is presented of 96 cases of ectopic pregnacy over a 7-year period. It is noted that in recent years the incidence of this problem has increased. Inadequately diagnosed and treated pelvic inflammatory disease has been found to be the main predisposing factor (40%). The rate of extra-uterine gestation was 1:336 deliveries. In this study, previous fertility was high, and primigravidae constituted only 10.4% of the total. The effect of previous pelvic operations and pelvic infection is discussed; a statistical review of signs and symptoms is tabulated, and the management of the patient and of concomitant problems is presented.

[Course and treatment of infantile asthma in our milieu].

PubMed

Scrigni, A; Grenoville, M; de Sarasqueta, P; Verna, R; Breiter, P; Jimenez, C

1993-01-01

We studied the clinical evolution and therapeutic approach of 50 children who were treated at the Emergency Room for an asthmatic crisis. We observed a high frequency of early onset of asthma before one year of age (n:16), constant symptoms between the crisis (n:34) and previous admissions before the present crisis (n:34) and previous admissions before the present crisis (n:16). Most cases did not have a family doctor. In 16 cases, the present crisis had four or more days of duration. We observed a frequent administration of suboptimal doses of bronchodilator and antiinflammatory drugs. These results show a non satisfactory treatment of infantile asthma.

Supplement use and other characteristics among pregnant women with a previous pregnancy affected by a neural tube defect - United States, 1997-2009.

PubMed

Arth, Annelise; Tinker, Sarah; Moore, Cynthia; Canfield, Mark; Agopian, Aj; Reefhuis, Jennita

2015-01-16

Neural tube defects (NTDs) include anomalies of the brain (anencephaly and encephalocele) and spine (spina bifida). Even with ongoing mandatory folic acid fortification of enriched cereal grain products, the U.S. Preventive Services Task Force recommends that women of childbearing potential consume a daily supplement containing 400 µg-800 µg of folic acid. Women with a prior NTD-affected pregnancy have an increased risk for having another NTD-affected pregnancy, and if they are planning another pregnancy, the recommendation is that they consume high-dosage folic acid supplements (4.0 mg/day) beginning ≥4 weeks before conception and continuing through the first 12 weeks of pregnancy. To learn whether folic acid supplementation (from multivitamins or single- ingredient supplements) was commonly used during pregnancy by women with a previous NTD-affected pregnancy, supplement use was assessed among a convenience sample of women with a previous NTD-affected pregnancy who participated in the National Birth Defects Prevention Study (NBDPS), a case-control study of major birth defects in the United States. Characteristics of women who previously had an NTD-affected pregnancy and whose index pregnancy (pregnancy included in NBDPS) was either affected by an NTD (N = 17) (i.e., recurrence-cases) or resulted in a live-born infant without a major birth defect (N = 10) (i.e., recurrence-controls) were assessed. Taking a supplement that included folic acid was more common among recurrence-control mothers (80%) than recurrence-case mothers (35%). The recommendation that women should take folic acid supplements just before and during early pregnancy is not being followed by many women and offers an opportunity for NTD prevention, especially among women who are at a higher risk because they have had a previous pregnancy affected by an NTD.

Double balloon catheter for induction of labour in Chinese women with previous caesarean section: one-year experience and literature review.

PubMed

Cheuk, Queenie K Y; Lo, T K; Lee, C P; Yeung, Anita P C

2015-06-01

To evaluate the efficacy and safety of double balloon catheter for induction of labour in Chinese women with one previous caesarean section and unfavourable cervix at term. Retrospective cohort study. A regional hospital in Hong Kong. Women with previous caesarean delivery requiring induction of labour at term and with an unfavourable cervix from May 2013 to April 2014. Primary outcome was to assess rate of successful vaginal delivery (spontaneous or instrument-assisted) using double balloon catheter. Secondary outcomes were double balloon catheter induction-to-delivery and removal-to-delivery interval; cervical score improvement; oxytocin augmentation; maternal or fetal complications during cervical ripening, intrapartum and postpartum period; and risk factors associated with unsuccessful induction. All 24 Chinese women tolerated double balloon catheter well. After double balloon catheter expulsion or removal, the cervix successfully ripened in 18 (75%) cases. The improvement in Bishop score 3 (interquartile range, 2-4) was statistically significant (P<0.001). Overall, 18 (75%) cases were delivered vaginally. The median insertion-to-delivery and removal-to-delivery intervals were 19 (interquartile range, 13.4-23.0) hours and 6.9 (interquartile range, 4.1-10.8) hours, respectively. Compared with cases without, the interval to delivery was statistically significantly shorter in those with spontaneous balloon expulsion or spontaneous membrane rupture during ripening (7.8 vs 3.0 hours; P=0.025). There were no major maternal or neonatal complications. The only factor significantly associated with failed vaginal birth after caesarean was previous caesarean section for failure to progress (P<0.001). This is the first study using double balloon catheter for induction of labour in Asian Chinese women with previous caesarean section. Using double balloon catheter, we achieved a vaginal birth after caesarean rate of 75% without major complications.

Pathophysiology and management of intracranial arterial stenosis around the circle of Willis associated with hyperthyroidism: case reports and literature review.

PubMed

Matano, Fumihiro; Murai, Yasuo; Adachi, Koji; Kitamura, Takayuki; Teramoto, Akira

2014-04-01

Cases of moyamoya disease or intracranial arterial stenosis around the circle of Willis (M/IAS) associated with hyperthyroidism have been reported. However, most of these previous reports were of the ischemic form of M/IAS and primary hyperthyroidism. To the best of our knowledge, no studies have documented therapy for M/IAS associated with hyperthyroidism. We discuss four previously unreported cases, including those involving the intracerebral hemorrhage form and thyroid-stimulating hormone (TSH) secretion from a pituitary adenoma (secondary hyperthyroidism). We analyzed data from 52 previously reported cases, including the 4 cases presented here, and discuss M/IAS associated with hyperthyroidism, treatment options, pathophysiology, the ischemic and hemorrhagic forms, secondary hyperthyroidism, and the relevant literature. Hyperthyroidism results in thyrotoxicosis and the stimulation of the superior cervical ganglion by TSH antibodies and f-T3/f-T4. Consequently, hypercoagulability and stenosis of the cerebral artery can occur. There are many reports of ischemic M/IAS associated with hyperthyroidism. A conservative approach to treatment is important in such cases; for example, antithyroid therapy should be the first choice to treat ischemic M/IAS. There have been only a limited number of reports on hemorrhagic M/IAS. We presume that hemorrhagic M/IAS tears the weakened vasculature in a manner similar to that of normal M/IAS (with no complicating hyperthyroidism). The authors also reported M/IAS associated with secondary hyperthyroidism due to pituitary thyroid secreting hormone secreting adenoma.

Proposed epidemiological case definition for serious skin infection in children.

PubMed

O'Sullivan, Cathryn E; Baker, Michael G

2010-04-01

Researching the rising incidence of serious skin infections in children is limited by the lack of a consistent and valid case definition. We aimed to develop and evaluate a good quality case definition, for use in future research and surveillance of these infections. We tested the validity of the existing case definition, and then of 11 proposed alternative definitions, by assessing their screening performance when applied to a population of paediatric skin infection cases identified by a chart review of 4 years of admissions to a New Zealand hospital. Previous studies have largely used definitions based on the International Classification of Diseases skin infection subchapter. This definition is highly specific (100%) but poorly sensitive (61%); it fails to capture skin infections of atypical anatomical sites, those secondary to primary skin disease and trauma, and those recorded as additional diagnoses. Including these groups produced a new case definition with 98.9% sensitivity and 98.8% specificity. Previous analyses of serious skin infection in children have underestimated the true burden of disease. Using this proposed broader case definition should allow future researchers to produce more valid and comparable estimates of the true burden of these important and increasing infections.

The Case against the Case against Recasts

ERIC Educational Resources Information Center

Goo, Jaemyung; Mackey, Alison

2013-01-01

In the previous 20 years, more than 60 studies have been carried out within the input and interaction approach to SLA (Long, 2007; Mackey 2012), many of which have found positive associations between different types of recasts and the learning of a range of linguistic forms for a number of different second languages (L2s), in different learning…

Model-Based Weighting and Comparisons: Research Report. ETS RR-08-17

ERIC Educational Resources Information Center

Qian, Jiahe

2008-01-01

In survey research, sometimes the formation of groupings, or aggregations of cases on which to make an inference, are of importance. Of particular interest are the situations where the cases aggregated carry useful information that has been transferred from a sample employed in a previous study. For example, a school to be included in the sample…

The Urban Superintendency and the Depression: The Case of Thomas Warrington Gosling, Akron, Ohio: 1928-34.

ERIC Educational Resources Information Center

Hinson, Gregory L.; Dye, Charles M.

The case study of an Ohio school superintendent's experiences during the depression illustrates how political, social, and economic events can affect an educational system. Dr. Thomas Warrington Gosling was named superintendent of Akron schools in 1928, following resignation of the previous superintendent as a consequence of turmoil on the Board…

Applying Corpus-Based Findings to Form-Focused Instruction: The Case of Reported Speech

ERIC Educational Resources Information Center

Barbieri, Federica; Eckhardt, Suzanne E. B.

2007-01-01

Arguing that the introduction of corpus linguistics in teaching materials and the language classroom should be informed by theories and principles of SLA, this paper presents a case study illustrating how corpus-based findings on reported speech can be integrated into a form-focused model of instruction. After overviewing previous work which…

The Effect of Self-Explanation of Pathophysiological Mechanisms of Diseases on Medical Students' Diagnostic Performance

ERIC Educational Resources Information Center

Peixoto, José Maria; Mamede, Sílvia; de Faria, Rosa Malena Delbone; Moura, Alexandre Sampaio; Santos, Silvana Maria Elói; Schmidt, Henk G.

2017-01-01

Self-explanation while diagnosing clinical cases fosters medical students' diagnostic performance. In previous studies on self-explanation, students were free to self-explain any aspect of the case, and mostly clinical knowledge was used. Elaboration on knowledge of pathophysiological mechanisms of diseases has been largely unexplored in studies…

Hepatobiliary fascioliasis: a case with unusual radiological features.

PubMed

Yeşildağ, Ahmet; Senol, Altuğ; Köroğlu, Mert; Koçkar, Cem; Oyar, Orhan; Işler, Mehmet

2010-12-01

We report a case of hepatobiliary fascioliasis presenting with unusual radiological findings that have not been reported previously. Imaging studies revealed hepatic cystic pouches communicating with intrahepatic bile ducts. Snail-like, oval shaped and conglomerated echogenic particles with no acoustic shadowing, suggesting F. hepatica, were detected in these cystic pouches. In addition, secondary sclerosing cholangitis developed after fascioliasis.

Data Gap Analysis and Damage Case Studies: Risk Analyses from Construction and Demolition Debris Landfills and Recycling Facilities

EPA Science Inventory

The report presents an evaluation of construction and demolition (C&D) debris management in the US to update and expand upon the previous set of data to include information on more recent cases of damage and potential impacts and expand the breadth of damages beyond groundwater a...

Interactive Land-Use Optimization Using Laguerre Voronoi Diagram with Dynamic Generating Point Allocation

NASA Astrophysics Data System (ADS)

Chaidee, S.; Pakawanwong, P.; Suppakitpaisarn, V.; Teerasawat, P.

2017-09-01

In this work, we devise an efficient method for the land-use optimization problem based on Laguerre Voronoi diagram. Previous Voronoi diagram-based methods are more efficient and more suitable for interactive design than discrete optimization-based method, but, in many cases, their outputs do not satisfy area constraints. To cope with the problem, we propose a force-directed graph drawing algorithm, which automatically allocates generating points of Voronoi diagram to appropriate positions. Then, we construct a Laguerre Voronoi diagram based on these generating points, use linear programs to adjust each cell, and reconstruct the diagram based on the adjustment. We adopt the proposed method to the practical case study of Chiang Mai University's allocated land for a mixed-use complex. For this case study, compared to other Voronoi diagram-based method, we decrease the land allocation error by 62.557 %. Although our computation time is larger than the previous Voronoi-diagram-based method, it is still suitable for interactive design.

The incidence of Crohn's disease in Cardiff over the last 75 years: an update for 1996-2005.

PubMed

Gunesh, S; Thomas, G A O; Williams, G T; Roberts, A; Hawthorne, A B

2008-02-01

The incidence of Crohn's disease rose rapidly in industralized countries over the past 50 years, but it is unclear whether the incidence is still rising or has reached a plateau. To update the long-term incidence study of Crohn's disease in Cardiff for 1996-2005, to investigate whether incidence is still rising and to study changes in disease characteristics over time. Crohn's cases identified by retrospective analysis of hospital records as in previous studies in Cardiff. Two hundred and twelve cases were identified. Corrected incidence for this decade was 66 x 10(6) per year (95% confidence interval: 58-76), showing a continuing rise compared to previous decades. The proportion with colonic disease at presentation continues to rise (43%) with a corresponding fall in those with terminal ileal disease. There remains a strong female preponderance (F:M 1.6:1) as in previous studies. The incidence in children under age 16 continues to rise, and the median age at diagnosis has fallen slightly. Crohn's disease incidence continues to rise slowly in Cardiff with a continuing increase in those presenting with colonic disease, which is now the commonest disease pattern.

Lexical and Indexical Conversational Components That Mediate Professional Noticing during Lesson Study

ERIC Educational Resources Information Center

Weiland Carter, Ingrid S.; Amador, Julie M.

2015-01-01

Previous research indicates that lesson study can support preservice teachers' abilities to professionally notice. This qualitative case study examined specific lexical and indexical conversational components of lesson study analysis meetings that afford or constrain elementary preservice teachers' incidences of professionally noticing students'…

Adverse obstetric outcomes in women with previous cesarean for dystocia in second stage of labor.

PubMed

Jastrow, Nicole; Demers, Suzanne; Gauthier, Robert J; Chaillet, Nils; Brassard, Normand; Bujold, Emmanuel

2013-03-01

To evaluate obstetric outcomes in women undergoing a trial of labor (TOL) after a previous cesarean for dystocia in second stage of labor. A retrospective cohort study of women with one previous low transverse cesarean undergoing a first TOL was performed. Women with previous cesarean for dystocia in first stage and those with previous dystocia in second stage were compared with those with previous cesarean for nonrecurrent reasons (controls). Multivariable regressions analyses were performed. Of 1655 women, those with previous dystocia in second stage of labor (n = 204) had greater risks than controls (n = 880) to have an operative delivery [odds ratio (OR): 1.5; 95% confidence intervals (CI) 1.1 to 2.2], shoulder dystocia (OR: 2.9; 95% CI 1.1 to 8.0), and uterine rupture in the second stage of labor (OR: 4.9; 95% CI 1.1 to 23), and especially in case of fetal macrosomia (OR: 29.6; 95% CI 4.4 to 202). The median second stage of labor duration before uterine rupture was 2.5 hours (interquartile range: 1.5 to 3.2 hours) in these women. Previous cesarean for dystocia in the second stage of labor is associated with second-stage uterine rupture at next delivery, especially in cases of suspected fetal macrosomia and prolonged second stage of labor. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Case Report of Myeloid Sarcoma Masquerading as In-Transit Metastasis at a Previous Melanoma Site: Avoiding a Diagnostic Pitfall.

PubMed

Curry, Jonathan L; Tetzlaff, Michael T; Wang, Sa A; Landon, Gene; Alouch, Nail; Patel, Sapna P; Nagarajan, Priyadharsini; Gupta, Shiva; Aung, Phyu P; Devine, Catherine E; Khoury, Joseph D; Loghavi, Sanam; Prieto, Victor G; DiNardo, Courtney D; Gershenwald, Jeffrey E

2018-06-01

Myeloid sarcoma is a rare extramedullary hematologic malignancy. Accurate and timely diagnosis may be challenging because myeloid sarcoma is known to mimic solid tumors, including hepatobiliary, nasopharyngeal, and breast carcinomas. We report a case of myeloid sarcoma that developed in the primary tumor lymphatic drainage field of a previously treated intermediate-thickness cutaneous melanoma, clinically and radiographically mimicking an in-transit metastasis, in a patient with myelodysplastic syndrome. The diagnosis of myeloid sarcoma was achieved after surgical excision of the mass and pathological examination that included extensive immunohistochemical studies. Awareness of such an unusual clinical presentation can help reduce diagnostic delay and ensure that adequate tissue is obtained for pathological examination and ancillary studies that are critical for accurate diagnosis and appropriate patient management.

Three dimensional modeling and dynamic analysis of four-wheel-steering vehicles

NASA Astrophysics Data System (ADS)

Hu, Haiyan; Han, Qiang

2003-02-01

The paper presents a nonlinear dynamic model of 9 degrees of freedom for four-wheel-steering vehicles. Compared with those in previous studies, this model includes the pitch and roll of the vehicle body, the motion of 4 wheels in the accelerating or braking process, the nonlinear coupling of vehicle body and unsprung part, as well as the air drag and wind effect. As a result, the model can be used for the analysis of various maneuvers of the four-wheel-steering vehicles. In addition, the previous models can be considered as a special case of this model. The paper gives some case studies for the dynamic performance of a four-wheel-steering vehicle under step input and saw-tooth input of steering angle applied on the front wheels, respectively.

Event Networks and the Identification of Crime Pattern Motifs

PubMed Central

2015-01-01

In this paper we demonstrate the use of network analysis to characterise patterns of clustering in spatio-temporal events. Such clustering is of both theoretical and practical importance in the study of crime, and forms the basis for a number of preventative strategies. However, existing analytical methods show only that clustering is present in data, while offering little insight into the nature of the patterns present. Here, we show how the classification of pairs of events as close in space and time can be used to define a network, thereby generalising previous approaches. The application of graph-theoretic techniques to these networks can then offer significantly deeper insight into the structure of the data than previously possible. In particular, we focus on the identification of network motifs, which have clear interpretation in terms of spatio-temporal behaviour. Statistical analysis is complicated by the nature of the underlying data, and we provide a method by which appropriate randomised graphs can be generated. Two datasets are used as case studies: maritime piracy at the global scale, and residential burglary in an urban area. In both cases, the same significant 3-vertex motif is found; this result suggests that incidents tend to occur not just in pairs, but in fact in larger groups within a restricted spatio-temporal domain. In the 4-vertex case, different motifs are found to be significant in each case, suggesting that this technique is capable of discriminating between clustering patterns at a finer granularity than previously possible. PMID:26605544

Is surgical case order associated with increased infection rate after spine surgery?

PubMed

Gruskay, Jordan; Kepler, Christopher; Smith, Jeremy; Radcliff, Kristen; Vaccaro, Alexander

2012-06-01

Retrospective database review. To determine whether surgical site infections are associated with case order in spinal surgery. Postoperative wound infection is the most common complication after spinal surgery, with incidence varying from 0.5% to 20%. The addition of instrumentation, use of preoperative prophylactic antibiotics, length of procedure, and intraoperative blood loss have all been found to influence infection rate. No previous study has attempted to correlate case order with infection risk after surgery. A total of 6666 spine surgery cases occurring between January 2005 and December 2009 were studied. Subjects were classified into 2 categories: fusion and decompression. Case order was determined, with each procedure labeled 1 to 5 depending on the number of previous cases in the room. Variables such as the American Society of Anesthesiologists score, number of operative levels, wound class, age, sex, and length of surgery were also tracked. A step-down binary regression was used to analyze each variable as a potential risk factor for infection. Decompression cases had a 2.4% incidence of infection. Longer surgical time and higher case order were found to be significant risk factors for lumbar decompressions. Fusion cases had a 3.5% incidence of infection. Posterior approach and revision cases were significant risk factors for infection in cervical cases. For lumbar fusion cases, longer surgical time, higher American Society of Anesthesiologists score, and older age were all significant risk factors for infection. Decompressive procedures performed later in the day carry a higher risk for postoperative infection. No similar trend was shown for fusion procedures. Our results identify potential modifiable risk factors contributing to infection rates in spinal procedures. Specific risk factors, although not defined in this study, might be related to contamination of the operating room, cross-contamination between health care providers during the course of the day, use of flash sterilization, and mid-day shift changes.

Histological analysis on the medieval mummy in Korea.

PubMed

Shin, Dong Hoon; Youn, Minyoung; Chang, Byung Soo

2003-11-26

Recently, there have been some reports on the mummies from the medieval tombs in Korea, which were not made on purpose. Although these mummies could be an invaluable source for the studies on the physical state of medieval Koreans, there were not any reports on this subject until now. In this study, we first tried to investigate the various tissues using light- and electron-microscopic techniques. In the organs we have examined, even though the collagen fibers were profusely found within all of them, some types of cells, such as red blood cells, chondrocytes, hepatocyte and muscle cells, were also visible in various tissues. The histological characteristics of the current case seemed to be well matched with the previous study in general even though there were also somewhat different findings from the previous reports on the mummies. Although the cause of the mummification in Korea was not completely explained, we think that the cause in this case could be correlated with cultural aspects--not with natural conditions--because the mummies were only found in cases where the lime-soil barrier was maintained until their discovery, and which separated the inner space of the coffins from the outer space. As similar cases are frequently reported nowadays, invaluable data on the physical status of the medieval Koreans could be attainable if systemic investigation could be performed on similar cases which are found in the future.

Validation of key indicators in cattle farms at high risk of animal welfare problems: a qualitative case-control study.

PubMed

Kelly, P C; More, S J; Blake, M; Higgins, I; Clegg, T; Hanlon, A

2013-03-23

The objective of this study was to validate four key farmer performance indicators (KFPI), identified in a previous study, as indicators of on-farm cattle welfare incidents in Ireland, through comparison of the distribution of these KPFIs in the national herd (n=109,925) and in case herds (n=18), where welfare incidents were previously studied. The KFPIs identified were late registrations, and exits from the herd by on-farm burial, by moves to knackeries and by moves to 'herd unknown'. Data were extracted from two Department of Agriculture, Food and the Marine databases for the national herd and the case herds. All four KFPIs differed significantly between the case herds and the national herd, and one further KFPI was identified, namely moves to factories. The data for these KFPIs are routinely stored on national databases, which were established in order to comply with Regulation (EC) 1760/2000. Based on the results obtained in this study, it may be possible in the future to use routine data capture to improve strategy towards on-farm animal welfare. At this point, however, based on calculated specificities and sensitivities, none of these five KFPIs, at the cut-offs investigated and using several combinations, are able to distinguish herds with and without on-farm animal welfare problems at an accuracy suitable for routine national use in Ireland.

Human papillomavirus infection and spontaneous abortion: a case-control study performed in Mexico.

PubMed

Conde-Ferráez, Laura; Chan May, Alberto de A; Carrillo-Martínez, Jorge R; Ayora-Talavera, Guadalupe; González-Losa, María del Refugio

2013-10-01

To investigate if HPV cervical infection is associated with spontaneous abortion in a Mexican population. Case control study including 281 women from two Social Security Hospitals in Merida, Mexico. Cases were women with spontaneous abortion attending for curettage, and controls were pregnant women at term who attended for delivery. HPV molecular detection and typing of HPV 16, 18, 58 and 6/11 was performed on cervical samples, and TORCH serology IgM tests (against T. gondii, CMV, HSV) were performed on cases. Data were analyzed using Chi square, odds ratio and linear regression tests. HPV global prevalence was 19.8% (24.4% in cases and 15.2% in controls). HPV types 16 and 58 were the most frequently detected in both groups. Multiple HPV types concurrent infection were found in 31.4% of typified samples. Amongst cases 27.3% of HPV positive women reported at least one previous pregnancy loss; compared to 17.43% amongst HPV negative women. Nevertheless, HPV was not significantly associated with spontaneous or to repetitive abortion. Cases were 60.2% positive to any TORCH agent, although it was not significantly associated to referred miscarriage history. Spontaneous abortion was associated to a previous pregnancy loss and to women's age older than 35 years old. HPV infection was significantly associated to alcohol intake before pregnancy and to multiple sexual partners. HPV cervical infection was not associated with spontaneous abortion. HPV in spontaneous abortion and other adverse pregnancy outcomes merits further study. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

[Changes in the diagnosis and therapeutic management of hepatic trauma. A retrospective study comparing 2 series of cases in different (1997-1984 vs. 2001-2008)].

PubMed

Sánchez-Bueno, Francisco; Fernández-Carrión, Jezabel; Torres Salmerón, Gloria; García Pérez, Rocío; Ramírez Romero, Pablo; Fuster Quiñonero, Matilde; Parrilla, Pascual

2011-01-01

We present a series of 146 cases of hepatic trauma (HT) treated in our hospital over a period of 8 yearsm (2001-2008), and comparing it with a previous series of 92 cases (1977-1984). The mean age in the current series was 28.6 years and the majority were male. The closed traumas were mainly penetrating, with the most frequent cause being road traffic accidents. The American Association for the Surgery of Trauma (AAST) classification was used to evaluate the grade of the hepatic injury. Associated abdominal and /or extra-abdominal injuries were seen in 79.5% of the patients, with the most frequent being chest trauma, compared to bone fractures in the previous series. The most common associated intra-abdominal injury was the spleen in both series. The most used diagnostic technique in the current series was abdominal CT. Simple peritoneal puncture and lavage (PLP) were the most used examinations used in the previous series. Non-surgical treatment (NST) was given in 98 cases and the surgery was indicated in the remaining 48. In the previous series, 97.8% of patients were operated on. In the current series, on the 15 patients with severe liver injuries, 5 right hepatectomies, 2 segmentectomies and 6 packing compressions were performed, with the remaining two dying during surgery due to hepatic avulsion. The overall mortality was 3.4%, being 1% in the NST group and 8.3% in the surgical patients. In the previous series, the overall mortality was 29.3%. The key factor for using NST is to control haemodynamic stability, leaving surgical treatment for haemodynamically unstable patients. Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.

Idiosyncratic Gesture Use in Atypical Language Development, and Its Interaction with Speech Rhythm, Word Juncture, Syntax, Pragmatics and Discourse: A Case Study

ERIC Educational Resources Information Center

Howard, Sara J.; Perkins, Michael R.; Sowden, Hannah

2012-01-01

Very little is known about the use of gesture by children with developmental language disorders (DLDs). This case study of "Lucy", a child aged 4;10 with a DLD, expands on what is known and in particular focuses on a type of idiosyncratic "rhythmic gesture" (RG) not previously reported. A fine-grained qualitative analysis was carried out of video…

Radionuclide demonstration of urinary extravasation with ureteral obstruction

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

Yeh, V.A.; Chiang, L.C.; Meade, R.C.

Two cases of urinary extravasation with ureteral obstruction demonstrated by the radionuclide studies are reported. The value of radionuclide studies in patients with renal transplantation has been reported previously, but studies in patients without transplantation have rarely been described in the literature. Ureteral obstruction may cause urinary extravasation, which may be demonstrated by radionuclide studies even when radiologic studies are inconclusive. In one case, urinary extravasation was detected in the sitting position but not in the supine position. Renal imaging should probably be performed not only with multiple projections but also in different positions.

Post-traumatic stress disorder and head injury as a dual diagnosis: "islands" of memory as a mechanism.

PubMed Central

King, N S

1997-01-01

This case study describes post-traumatic stress disorder (PTSD) and head injury after a road traffic accident involving a pedestrian. Previous studies have proposed two mechanisms by which this dual diagnosis may occur: (1) when post-traumatic amnesia and retrograde amnesia are small or non-existent and (2) when non-declarative memory systems for the traumatic event are in operation. This case study demonstrates a third mechanism--"islands" of memory within post-traumatic amnesia. PMID:9010405

Post-traumatic stress disorder and head injury as a dual diagnosis: "islands" of memory as a mechanism.

PubMed

King, N S

1997-01-01

This case study describes post-traumatic stress disorder (PTSD) and head injury after a road traffic accident involving a pedestrian. Previous studies have proposed two mechanisms by which this dual diagnosis may occur: (1) when post-traumatic amnesia and retrograde amnesia are small or non-existent and (2) when non-declarative memory systems for the traumatic event are in operation. This case study demonstrates a third mechanism--"islands" of memory within post-traumatic amnesia.

Lung Transplantation From Donors After Previous Cardiac Surgery: Ideal Graft in Marginal Donor?

PubMed

Palleschi, A; Mendogni, P; Tosi, D; Montoli, M; Carrinola, R; Mariolo, A V; Briganti, F; Nosotti, M

2017-05-01

Lung transplantation is a limited by donor pool shortage. Despite the efforts to extend the graft acceptability with recurrent donor criteria reformulations, previous cardiothoracic surgery is still considered a contraindication. A donor who underwent cardiac surgery could potentially provide an ideal lung but high intraoperative risks and intrinsic technical challenges are expected during the graft harvesting. The purpose of this study is to present our dedicated protocol and four clinical cases of successful lung procurements from donors who had a previous major cardiac surgery. One donor had ascending aortic root (AAR) substitution, another had mitral valve substitution, and two had coronary artery bypass surgery. The others' eligibility criteria for organ allocation, such as ABO compatibility, PaO 2 /FiO 2 ratio, absence of aspiration, or sepsis were respected. In one of the cases with previous coronary bypass grafting, the donor had a veno-arterial extracorporeal membrane oxygenation support. Consequently, the grafts required an ex vivo lung perfusion evaluation. We report the technical details of procurement and postoperative courses of recipients. All procurements were uneventful, without lung damage or waste of abdominal organs related to catastrophic intraoperative events. All recipients had a successful clinical outcome. We believe that successful transplantation is achievable even in a complicated setting, such as cases involving donors with previous cardiac surgery frequently are. Facing lung donor shortage, we strongly support any effort to avoid the loss of possible acceptable lungs. In particular, previous major cardiac surgery does not strictly imply a poor quality of lungs as well as unsustainable graft procurement. Copyright © 2017 Elsevier Inc. All rights reserved.

Experiences Using Formal Methods for Requirements Modeling

NASA Technical Reports Server (NTRS)

Easterbrook, Steve; Lutz, Robyn; Covington, Rick; Kelly, John; Ampo, Yoko; Hamilton, David

1996-01-01

This paper describes three cases studies in the lightweight application of formal methods to requirements modeling for spacecraft fault protection systems. The case studies differ from previously reported applications of formal methods in that formal methods were applied very early in the requirements engineering process, to validate the evolving requirements. The results were fed back into the projects, to improve the informal specifications. For each case study, we describe what methods were applied, how they were applied, how much effort was involved, and what the findings were. In all three cases, the formal modeling provided a cost effective enhancement of the existing verification and validation processes. We conclude that the benefits gained from early modeling of unstable requirements more than outweigh the effort needed to maintain multiple representations.

Is pain suffering? A case study.

PubMed

Black, Helen K

2007-01-01

In this article, the case study of an elderly woman shows how bodily pain and suffering meld in her narrative, not as the subjective and objective sides of the same event, but as distinct experiences in which both constructs emerge separately or come together based on the meaning she imputes to the event. The case study shows the clear methodological fit of qualitative narrative research with the lived experiences of pain and suffering. The narrator recalled the "tremendous" pain she experienced almost 60 years previously as both suffering and not-suffering, depending on the outcome of the circumstances that surrounded her pain. This case shows how a significant aspect of the aging experience-suffering-is medicalized, yet remains resistant to both categorization and medicine.

Automated detection of nerve fiber layer defects on retinal fundus images using fully convolutional network for early diagnosis of glaucoma

NASA Astrophysics Data System (ADS)

Watanabe, Ryusuke; Muramatsu, Chisako; Ishida, Kyoko; Sawada, Akira; Hatanaka, Yuji; Yamamoto, Tetsuya; Fujita, Hiroshi

2017-03-01

Early detection of glaucoma is important to slow down progression of the disease and to prevent total vision loss. We have been studying an automated scheme for detection of a retinal nerve fiber layer defect (NFLD), which is one of the earliest signs of glaucoma on retinal fundus images. In our previous study, we proposed a multi-step detection scheme which consists of Gabor filtering, clustering and adaptive thresholding. The problems of the previous method were that the number of false positives (FPs) was still large and that the method included too many rules. In attempt to solve these problems, we investigated the end-to-end learning system without pre-specified features. A deep convolutional neural network (DCNN) with deconvolutional layers was trained to detect NFLD regions. In this preliminary investigation, we investigated effective ways of preparing the input images and compared the detection results. The optimal result was then compared with the result obtained by the previous method. DCNN training was carried out using original images of abnormal cases, original images of both normal and abnormal cases, ellipse-based polar transformed images, and transformed half images. The result showed that use of both normal and abnormal cases increased the sensitivity as well as the number of FPs. Although NFLDs are visualized with the highest contrast in green plane, the use of color images provided higher sensitivity than the use of green image only. The free response receiver operating characteristic curve using the transformed color images, which was the best among seven different sets studied, was comparable to that of the previous method. Use of DCNN has a potential to improve the generalizability of automated detection method of NFLDs and may be useful in assisting glaucoma diagnosis on retinal fundus images.

Summary of Data from the Sixth AIAA CFD Drag Prediction Workshop: CRM Cases 2 to 5

NASA Technical Reports Server (NTRS)

Tinoco, Edward N.; Brodersen, Olaf P.; Keye, Stefan; Laflin, Kelly R.; Feltrop, Edward; Vassberg, John C.; Mani, Mori; Rider, Ben; Wahls, Richard A.; Morrison, Joseph H.;

Ocular adnexal and orbital amyloidosis: a case series and literature review.

PubMed

Mora-Horna, Eduardo R; Rojas-Padilla, Rubí; López, Vianhi G; Guzmán, Martín J; Ceriotto, Ariel; Salcedo, Guillermo

2016-04-01

The purpose of the study was to describe the main clinical and epidemiologic characteristics, treatment options, and outcome in a large series of patients with periocular and orbital amyloidosis. This is a retrospective, descriptive, observational study of a case series of 14 patients with periocular and orbital amyloidosis and is a review of previously published cases with this diagnosis between September 2004 and January 2015. In this study, we analyzed our 14 patients in conjunction with 69 well-documented cases of orbital and/or periocular amyloidosis previously reported, with a total of 83. Of these, 54 were female (65.1 %), 28 male (33.7 %), and one with unspecified gender. The mean age at diagnosis was 54.9 years (range, 18-87). The localization of the amyloidosis was classified as superficial, deep and combined, with involvement of 53 (63.9 %), 26 (31.3 %), and four cases (4.8 %) in each group, respectively. The main findings in superficial amyloidosis were mass or tissue infiltration (84.9 %) and ptosis (30.2 %) and, in the cases with deep involvement, mass (65.4 %), proptosis (57.7 %), limited ocular movements (34.6 %), ocular displacement (30.8 %), and ptosis (26.9 %). The cases with combined involvement presented with signs and symptoms of the two groups. Regarding the outcome, 43 patients were reported stable after the diagnosis and 21 had recurrence or required new surgical procedures. Periocular and orbital amyloidosis is a rare disease that can present with a variety of symptoms and signs depending on the localization and extension of involvement. Its prompt recognition is important in order to investigate systemic disease, which will affect the prognosis of each case.

Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013.

PubMed

Samayoa-Peláez, Maritza; Ayala, Nancy; Yadon, Zaida E; Heldal, Einar

2016-01-01

Objective To assess whether the National Tuberculosis Program (NTP) guidelines for culture and drug sensitivity testing (DST) in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB) or previously treated TB, by documenting notification rates by department (geographic area), disease type and category, and culture and DST results. Methods This was a cross-sectional, operational research study that merged and linked all patients registered by the NTP and the National Reference Laboratory in 2013, eliminating duplicates. The proportions with culture (for new smear negative pulmonary cases) and culture combined with DST (for previously treated patients) were estimated and analyzed by department. Data were analyzed using EpiData Analysis version 2.2. Results There were 3 074 patients registered with TB (all forms), for a case notification rate of 20/100 000 population. Of these, 2 842 had new TB, of which 2 167 (76%) were smear-positive pulmonary TB (PTB), 385 (14%) were smear-negative PTB, and 290 (10%) were extrapulmonary TB. There were 232 (8%) previously treated cases. Case notification rates (all forms) varied by department from 2-68 per 100 000 population, with the highest rates seen in the southwest and northeast part of Guatemala. Of new TB patients, 136 had a culture performed and 55 had DST of which the results were 33 fully sensitive, 9 monoresistant, 3 polyresistant, and 10 multidrug resistant TB (MDR-TB). Only 21 (5%) of new smear-negative PTB patients had cultures. Of 232 previously treated patients, 54 (23%) had a culture and 47 (20%) had DST, of which 29 were fully sensitive, 7 monoresistant, 2 polyresistant, and 9 MDR-TB. Of 22 departments (including the capital), culture and DST was performed in new smear-negative PTB in 7 departments (32%) and in previously treated TB in 13 departments (59%). Conclusions Despite national guidelines, only 5% of smear-negative PTB cases had a culture and only 20% of previously treated TB had a culture and DST. Several departments did not perform culture or DST. These short comings must be improved if Guatemala is to curtail the spread of drug resistant forms of TB, while striving to eliminate all TB.

Case-control study: soft-tissue sarcomas and exposure to phenoxyacetic acids or chlorophenols.

PubMed Central

Hardell, L.; Sandström, A.

1979-01-01

In 1977 a number of patients with soft-tissue sarcomas and previous exposure to phenoxyacetic acids were described. Following from these observations a matched case-control study was made. Exposure to chlorophenols was also included in this study. The results showed that exposure to phenoxyacetic acids or chlorophenols gave an approximately 6-fold increase in the risk for this type of tumour. It was not possible to determine, however, whether the carcinogenic effect was exerted by these compounds or by impurities such as chlorinated dibenzodioxins and dibenzofurans that in almost all cases were part of the commercial preparations. PMID:444410

Another look at roles and functions: has hospital case management lost its way?

PubMed

Reynolds, John J

2013-01-01

The purpose of this study was to identify the roles, functions, and types of activities that hospital case managers engage in on a day-to-day basis and that leverage the most amounts of time. Previous studies superimpose a priori categories on research tools. Hospital case management. This study analyzes 4,064 spontaneous, unstructured list serve postings from the American Case Management Association Learning Link list serve from August 15, 2011, to August 18, 2012. The study group was a cross section of 415 case management professionals. The data suggest that hospital case managers' time is inordinately leveraged by issues related to observation status/leveling of patients and the Centers for Medicare and Medicaid Services compliance. The data also suggest that hospital case management has taken a conceptual trajectory that has deviated significantly from what was initially conceived (quality, advocacy, and care coordination) and what is publicly purported. Case management education and practical orientation will need to be commensurate with this emerging emphasis. Case management leadership will need to be adept at mitigating the stresses of role confusion, role conflict, and role ambiguity.

Does the average cost of home health care vary with case mix?

PubMed

Nyman, J A; Svetlik, M A

1989-01-01

The relationship between the average cost of home health care and the case mix of patients served by the home health agency is investigated using 1983 data from Wisconsin's home health care agencies. In contrast to previous work, case mix is shown to have a significant effect on the home health agency's average costs. The methods used in the previous work are evaluated, and differences between the earlier study and the present study are discussed to explain the divergent results. Also, average costs are shown to decrease with output, to increase with the proportion of private patients served by the agency, and to be higher if the home health agency is located in an urban area or if it has a proprietary charter. The implications of this research for the design of an appropriate home health reimbursement policy are discussed. Primarily, it is argued that, although future research might confirm the relationship between average costs and case mix for home health agencies, we cannot necessarily conclude that reimbursement rates must be adjusted to account for differences in case mix as many States are now doing for nursing home reimbursement. Policies must take into account the fundamental differences between home health agencies and nursing homes, and their respective markets, in order to be effective.

Does the average cost of home health care vary with case mix?

PubMed Central

Nyman, J A; Svetlik, M A

1989-01-01

The relationship between the average cost of home health care and the case mix of patients served by the home health agency is investigated using 1983 data from Wisconsin's home health care agencies. In contrast to previous work, case mix is shown to have a significant effect on the home health agency's average costs. The methods used in the previous work are evaluated, and differences between the earlier study and the present study are discussed to explain the divergent results. Also, average costs are shown to decrease with output, to increase with the proportion of private patients served by the agency, and to be higher if the home health agency is located in an urban area or if it has a proprietary charter. The implications of this research for the design of an appropriate home health reimbursement policy are discussed. Primarily, it is argued that, although future research might confirm the relationship between average costs and case mix for home health agencies, we cannot necessarily conclude that reimbursement rates must be adjusted to account for differences in case mix as many States are now doing for nursing home reimbursement. Policies must take into account the fundamental differences between home health agencies and nursing homes, and their respective markets, in order to be effective. PMID:2502804

Higher risk of orofacial clefts in children born to mothers with angina pectoris: a population-based case-control study.

PubMed

Czeizel, Andrew E; Vereczkey, Attila; Bánhidy, Ferenc

2015-02-01

Previously an unexpected association of maternal angina pectoris (MAP) during pregnancy with a higher risk of orofacial clefts in their children was found. There were three objectives of this study: (i) to evaluate the validity of MAP-diagnoses in the previous study and the recent history of mothers with MAP in a follow-up study; (ii) to estimate the prevalence of other congenital abnormalities in the offspring of mothers with MAP; and (iii) to analyze the possible effect of confounders for the risk of orofacial clefts. The large dataset of population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996 was evaluated including 22 843 cases with congenital abnormalities and 38 151 controls without any defect. Twenty-two cases (0.10%) and 12 controls (0.03%) were born to mothers with medically recorded MAP (odds ratio [OR] with 95% confidence interval [CI]: 3.7, 1.8-7.3). Of 22 cases, six had isolated cleft lip ± palate (OR with 95% CI: 13.3, 4.9-35.9) and two were affected with isolated cleft palate (OR with 95% CI: 10.5, 2.3-47.6). The diagnosis of MAP was confirmed in seven women visited at home in 2009-2010, two had recent myocardial infarction and five were smokers. There was no higher risk for other congenital abnormalities. In conclusion the higher risk of orofacial clefts was confirmed in the children of mothers with MAP and smoking may trigger the genetic predisposition of both MAP and orofacial clefts. However, the number of cases was limited and therefore further studies are needed to confirm or reject this theoretically and practically important observation. © 2014 Japanese Teratology Society.

Acquired immunodeficiency syndrome in a patient with no known risk factors: a pathological study.

PubMed

Burt, A D; Scott, G; Shiach, C R; Isles, C G

1984-04-01

We present the pathological findings in a case of acquired immunodeficiency syndrome (AIDS) in a patient with no known risk factor. Postmortem examination showed klebsiella lung abscess, generalised cytomegalovirus infection, cerebral toxoplasmosis, and a primary cerebral lymphoma. An additional feature was the presence of dilatation of the intrahepatic large bile ducts in association with an atypical distribution of cytomegalovirus. The relation between this case and previously reported cases of AIDS is discussed.

What Are the Perceptions of Administrators and Clinicians on an Effective Anti-Bully Prevention Program?

ERIC Educational Resources Information Center

Bringas, Mary Elizabeth

2017-01-01

This qualitative case study examined the effective elements of a successful anti-bullying program through clinician and administrator perceptions. Previous studies have examined resources and interventions as curricular strategies, with some studies reflecting interventions as comprehensive programs; however, most studies do not provide…

Simulation model calibration and validation : phase II : development of implementation handbook and short course.

DOT National Transportation Integrated Search

2006-01-01

A previous study developed a procedure for microscopic simulation model calibration and validation and evaluated the procedure via two relatively simple case studies using three microscopic simulation models. Results showed that default parameters we...

Global Characteristics of Childhood Acute Promyelocytic Leukemia

PubMed Central

Zhang, L; Samad, A; Pombo-de-Oliveira, MS; Scelo, G; Smith, MT; Feusner, J; Wiemels, JL; Metayer, C

2014-01-01

Acute promyelocytic leukemia (APL) comprises approximately 5–10% of childhood acute myeloid leukemia (AML) cases in the US. While variation in this percentage among other populations was noted previously, global patterns of childhood APL have not been thoroughly characterized. In this comprehensive review of childhood APL, we examined its geographic pattern and the potential contribution of environmental factors to observed variation. In 142 studies (spanning >60 countries) identified, variation was apparent—de novo APL represented from 2% (Switzerland) to >50% (Nicaragua) of childhood AML in different geographic regions. Because a limited number of previous studies addressed specific environmental exposures that potentially underlie childhood APL development, we gathered 28 childhood cases of therapy-related APL, which exemplified associations between prior exposures to chemotherapeutic drugs/radiation and APL diagnosis. Future population-based studies examining childhood APL patterns and the potential association with specific environmental exposures and other risk factors are needed. PMID:25445717

Model systems in heterogeneous catalysis: towards the design and understanding of structure and electronic properties.

PubMed

Pan, Q; Li, L; Shaikhutdinov, S; Fujimori, Y; Hollerer, M; Sterrer, M; Freund, H-J

2018-05-29

We discuss in this paper two case studies related to nano-particle catalyst systems. One concerns a model system for the Cr/SiO2 Phillips catalyst for ethylene polymerization and here we present XPS data to complement the previously published TPD, IRAS and reactivity studies to elucidate the electronic structure of the system in some detail. The second case study provides additional information on Au nano-particles supported on ultrathin MgO(100)/Ag(100) films where we had observed a specific activity of the particle's rim at the metal-oxide interface with respect to CO2 activation and oxalate formation, obviously connected to electron transfer through the MgO film from the metal substrate underneath. Here we present XPS and Auger data, which allows detailed analysis of the observed chemical shifts. This analysis corroborates previous findings deduced via STM.

Craniospinal Irradiation for Trilateral Retinoblastoma Following Ocular Irradiation

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

Marks, Lawrence B.; Bentel, Gunilla; Sherouse, George W.

A case study is presented. Craniospinal radiotherapy and a three-field pineal boost for trilateral retinoblastoma were delivered to a patient previously irradiated for ocular retinoblastoma. The availability of CT-based three-dimensional treatment planning provided the capability of identifying the previously irradiated volume as a three-dimensional anatomic structure and of designing a highly customized set of treatment beams that minimized reirradiation of that volume.

Mosaicism for the FMR1 gene influences adaptive skills development in fragile X-affected males

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

Cohen, I.L.; Sudhalter, V.; Nolin, S.L.

Fragile X syndrome is one of the most common forms of inherited mental retardation, and the first of a new class of genetic disorders associated with expanded trinucleotide repeats. Previously, we found that about 41% of affected males are mosaic for this mutation in that some of their blood cells have an active fragile X gene and others do not. It has been hypothesized that these mosaic cases should show higher levels of functioning than those who have only the inactive full mutation gene, but previous studies have provided negative or equivocal results. In the present study, the cross-sectional developmentmore » of communication, self-care, socialization, and motor skills was studied in 46 males with fragile X syndrome under age 20 years as a function of two variables: age and the presence or absence of mosaicism. The rate of adaptive skills development was 2-4 times as great in mosaic cases as in full mutation cases. There was also a trend for cases with autism to be more prevalent in the full-mutation group. These results have implications for prognosis, for the utility of gene or protein replacement therapies for this disorder, and for understanding the association between mental retardation, developmental disorders, and fragile X syndrome. 21 refs., 3 figs.« less

[Effect of drug interaction between clopidogrel and omeprazole in hospital readmision of patients by a recurrent acute coronary syndrome: a case-control study].

PubMed

Amariles, Pedro; Holguín, Héctor; Angulo, Nancy Yaneth; Betancourth, Piedad Maria; Ceballos, Mauricio

2014-10-01

To evaluate the effect of drug interaction between omeprazol and clopidogrel in hospital readmission of patients with acute coronary syndrome (ACS). Case-control study. University Clinic LeonXIII, Medellin, Colombia. We selected from a prevalent population, between 2009-2010, use of clopidogrel patients on an outpatient basis (less than one year and more than 30days), and hospital stay for ACS or the presence of a previous ACS. A case-patient was defined as one who had a recurrence of ACS and a patient-control is defined as one that no recurrence of ACS. Both groups used ambulatory prior clopidogrel due to ACS. As defined risk factor the joint use of omeprazole and clopidogrel outpatients. During the study, 1680patients clopidogrel formulated. This group identified 50cases readmitted with ACS and 76controls. No statistically significant association was found between use of clopidogrel-omeprazole and increased risk of hospital readmission for ACS (OR: 1.05; 95%CI: 0.516-2.152; P=.8851). In this small group of patients with previous SCA, the simultaneous use of clopidogrel with omeprazole does not increase the risk of a readmission by recurrence of this type of coronary event. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Tinea faciei in a central Portuguese hospital: A 9-year survey.

PubMed

Borges, Ana; Brasileiro, Ana; Galhardas, Célia; Apetato, Margarida

2018-04-01

Tinea faciei is a relatively uncommon dermatophytosis that affects the glabrous skin of the face. The aim of this study was to analyse the epidemiologic, clinical and mycological features of tinea faciei cases diagnosed at the Dermatology and Venereology Department of Hospital Santo António dos Capuchos (Lisbon, Portugal). Consecutive cases diagnosed between 2008 and 2016 were studied retrospectively. A total of 72 tinea faciei cases have been diagnosed, involving 37 male and 35 female, aged between 8 months and 86 years. The majority were observed in patients younger than 12 years of age (59.72%). Anthropophilic isolates (mainly Microsporum audouinii, Trichophyton soudanense and Trichophyton rubrum) accounted for 75.7% of the identified dermatophytes. One quarter of the patients were also affected by dermatophytosis in other areas, such as the scalp. Only 10 cases were previously treated with topical steroids due to misdiagnosis. Most patients were treated with topical and systemic antifungal therapy with total resolution of skin lesions, without relapse or side effects. In contrast to other European studies, anthropophilic dermatophytes were the main causative agents of tinea faciei. As previously described to tinea capitis, this result is probably due to changes in the epidemiology of dermatophytes worldwide. © 2017 Blackwell Verlag GmbH.

RICKETS IN RURAL KENYAN PRESCHOOL CHILDREN: CASE REPORT.

PubMed

Bwibo, N O; Nyawade, S; Neumann, C G

2013-03-01

Clinical rickets has not been reported previously in Embu district, Kenya. Baseline clinical assessments performed for a nutrition intervention study in preschool children (n=324) identified 28 cases of rickets (8.6% of study sample). Clinical characteristics included: delays of sitting, walking, and teething; bone and chest deformities; widened wrists and ankles; and bowed lower extremities. Risk factors identified were short duration of breastfeeding with feeding of cereal-based supplements with little or no milk, low calcium intake, limited sunlight exposure. Vitamin D and calcium deficiencies likely contributed to these cases. Treatment with Vitamin D3 and milk resulted in clinical improvement.

Neoplastic disease in a medicolegal autopsy material. A retrospective study in northern Sweden.

PubMed

Gezelius, C; Eriksson, A

1988-01-01

Only a small fraction of sudden unexpected deaths are caused by neoplastic disease and thus subject ot medicolegal autopsy. The medicolegal autopsy forms an opportunity to study not only medically diagnosed and treated neoplasms, but also the natural evolution of untreated disease. In a series of 7,020 consecutive medicolegal autopsies in northern Sweden, we found 171 cases with malignant and/or intracranial neoplasms. In 41 cases, sudden death was caused by previously unknown tumors. The most common mechanisms of death in this group were disseminated cancer, intracranial tumors, pulmonary thromboembolism, hemoptysis, and aspiration of blood, and the most common locations were the bronchi and the lung. In some of these cases, the mechanism was sometimes dramatic, raising a question of violent death or intoxication. In 30 cases, sudden unexpected death was caused by previously known tumors, and also in this group disseminated cancer was the most common cause of death, and the most common locations were the bronchi and the lung. In 22 cases, tumors were found suicidal cases; in 14 of these, the tumor was considered to be a major causative factor to the suicide, while in eight cases the tumor was considered to be an incidental finding. The expected number of cancers in the 1,060 suicides investigated in this series was 27, according to the official cancer prevalence data. Thus, a possible over-representation of suicides among persons with cancer seems doubtful and needs further exploration.

First national survey of anti-tuberculosis drug resistance in Azerbaijan and risk factors analysis

PubMed Central

Akhundova, I.; Seyfaddinova, M.; Mammadbayov, E.; Mirtskulava, V.; Rüsch-Gerdes, S.; Bayramov, R.; Suleymanova, J.; Kremer, K.; Dadu, A.; Acosta, C. D.; Harries, A. D.; Dara, M.

2014-01-01

Setting: Civilian population of the Republic of Azerbaijan. Objectives: To determine patterns of anti-tuberculosis drug resistance among new and previously treated pulmonary tuberculosis (TB) cases, and explore their association with socio-demographic and clinical characteristics. Design: National cross-sectional survey conducted in 2012–2013. Results: Of 789 patients (549 new and 240 previously treated) who met the enrolment criteria, 231 (42%) new and 146 (61%) previously treated patients were resistant to any anti-tuberculosis drug; 72 (13%) new and 66 (28%) previously treated patients had multidrug-resistant TB (MDR-TB). Among MDR-TB cases, 38% of new and 46% of previously treated cases had pre-extensively drug-resistant TB (pre-XDR-TB) or XDR-TB. In previously treated cases, 51% of those who had failed treatment had MDR-TB, which was 15 times higher than in relapse cases (OR 15.2, 95%CI 6–39). The only characteristic significantly associated with MDR-TB was a history of previous treatment (OR 3.1, 95%CI 2.1–4.7); for this group, history of incarceration was an additional risk factor for MDR-TB (OR 2.8, 95%CI 1.1–7.4). Conclusion: Azerbaijan remains a high MDR-TB burden country. There is a need to implement countrywide control and innovative measures to accelerate early diagnosis of drug resistance in individual patients, improve treatment adherence and strengthen routine surveillance of drug resistance. PMID:26393092

Pertussis-associated persistent cough in previously vaccinated children.

PubMed

Principi, Nicola; Litt, David; Terranova, Leonardo; Picca, Marina; Malvaso, Concetta; Vitale, Cettina; Fry, Norman K; Esposito, Susanna

2017-11-01

To evaluate the role of Bordetella pertussis infection, 96 otherwise healthy 7- to 17-year-old subjects who were suffering from a cough lasting from 2 to 8 weeks were prospectively recruited. At enrolment, a nasopharyngeal swab and an oral fluid sample were obtained to search for pertussis infection by the detection of B. pertussis DNA and/or an elevated titre of anti-pertussis toxin IgG. Evidence of pertussis infection was found in 18 (18.7 %; 95 % confidence interval, 11.5-28.0) cases. In 15 cases, the disease occurred despite booster administration. In two cases, pertussis was diagnosed less than 2 years after the booster injection, whereas in the other cases it was diagnosed between 2 and 9 years after the booster dose. This study used non-invasive testing to show that pertussis is one of the most important causes of long-lasting cough in school-age subjects. Moreover, the protection offered by acellular pertussis vaccines currently wanes more rapidly than previously thought.

Drug Resistance in Newly Presenting and Previously Treated Tuberculosis Patients in Guangxi Province, People's Republic of China.

PubMed

Luo, Dan; Zhao, Jinming; Lin, Mei; Liu, Feiying; Huang, Shuhai; Zhang, Yingkun; Huang, Minying; Li, Juan; Zhou, Yang; Lan, Rushu; Zhao, Yanlin

2017-05-01

Drug-resistant Mycobacterium tuberculosis strains are a major threat to the control of tuberculosis (TB), but the prevalence of drug-resistant TB is still unknown in the southern ethnic region of China. A cluster-randomized sampling method was used to include the study population. Isolates were tested for resistance to 6 antituberculosis drugs, and genotyped to identify Beijing strains. Overall, 11.3% (139/1229) of new cases and 33.0% (126/382) of retreated cases had drug-resistant tuberculosis. Multiple previous TB treatment episodes and multiple treatment interruptions were risk factors for both drug-resistant and multidrug-resistant TB among retreated cases. A total of 53.2% of the patients were infected with a Beijing strain of M tuberculosis. Infection with a Beijing strain was significantly associated with drug resistance among new cases (odds ratio, 1.44; 95% CI, 1.01-2.07). Novel strategies to rapid diagnosis and effective treatment are urgently needed to prevent the development of drug resistance.

Cultural specificity in food choice - The case of ethnography in Japan.

PubMed

Freedman, Irith

2016-01-01

Previous studies examining food choice from a cross-cultural perspective were based primarily on quantitative research using the Food Choice Questionnaire (FCQ). This study suggests ethnography as a complementary research method in cross-cultural food choice studies. While use of the FCQ resulted in findings of cultural differences in food choice processes, within a preliminary motive list, ethnography allows the exploration of new, possibly culture-specific motives for food choice. Moreover, ethnography allows a deeper understanding of the cultural background of food choice processes in a studied culture. Using Japan as a case study, this research demonstrates the use of ethnography to argue that variety is a primary motive for food choice in contemporary Japanese culture. Variety is hence regarded here as a part of a larger food culture attribute, an "adventurous palate," which can also provide a background for previous FCQ findings (Prescott, Young, O'neill, Yau, & Stevens, 2002). Copyright © 2015 Elsevier Ltd. All rights reserved.

Bladder Pain Syndrome/Interstitial Cystitis Is Associated with Hyperthyroidism

PubMed Central

Liu, Shih-Ping; Lin, Ching-Chun; Lin, Herng-Ching

2013-01-01

Background Although the etiology of bladder pain syndrome/interstitial cystitis (BPS/IC) is still unclear, a common theme with BPS/IC patients is comorbid disorders which are related to the autonomic nervous system that connects the nervous system to end-organs. Nevertheless, no study to date has reported the association between hyperthyroidism and BPS/IC. In this study, we examined the association of IC/BPS with having previously been diagnosed with hyperthyroidism in Taiwan. Design Data in this study were retrieved from the Longitudinal Health Insurance Database. Our study consisted of 736 female cases with BPS/IC and 2208 randomly selected female controls. We performed a conditional logistic regression to calculate the odds ratio (OR) for having previously been diagnosed with hyperthyroidism between cases and controls. Results Of the 2944 sampled subjects, there was a significant difference in the prevalence of prior hyperthyroidism between cases and controls (3.3% vs. 1.5%, p<0.001). The conditional logistic regression analysis revealed that compared to controls, the OR for prior hyperthyroidism among cases was 2.16 (95% confidence interval (CI): 1.27∼3.66). Furthermore, the OR for prior hyperthyroidism among cases was 2.01 (95% CI: 1.15∼3.53) compared to controls after adjusting for diabetes, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraines, sicca syndrome, allergies, endometriosis, and asthma. Conclusions Our study results indicated an association between hyperthyroidism and BPS/IC. We suggest that clinicians treating female subjects with hyperthyroidism be alert to urinary complaints in this population. PMID:23991081

Bladder pain syndrome/interstitial cystitis is associated with hyperthyroidism.

PubMed

Chung, Shiu-Dong; Liu, Shih-Ping; Lin, Ching-Chun; Li, Hsien-Chang; Lin, Herng-Ching

2013-01-01

Although the etiology of bladder pain syndrome/interstitial cystitis (BPS/IC) is still unclear, a common theme with BPS/IC patients is comorbid disorders which are related to the autonomic nervous system that connects the nervous system to end-organs. Nevertheless, no study to date has reported the association between hyperthyroidism and BPS/IC. In this study, we examined the association of IC/BPS with having previously been diagnosed with hyperthyroidism in Taiwan. Data in this study were retrieved from the Longitudinal Health Insurance Database. Our study consisted of 736 female cases with BPS/IC and 2208 randomly selected female controls. We performed a conditional logistic regression to calculate the odds ratio (OR) for having previously been diagnosed with hyperthyroidism between cases and controls. Of the 2944 sampled subjects, there was a significant difference in the prevalence of prior hyperthyroidism between cases and controls (3.3% vs. 1.5%, p<0.001). The conditional logistic regression analysis revealed that compared to controls, the OR for prior hyperthyroidism among cases was 2.16 (95% confidence interval (CI): 1.27∼3.66). Furthermore, the OR for prior hyperthyroidism among cases was 2.01 (95% CI: 1.15∼3.53) compared to controls after adjusting for diabetes, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraines, sicca syndrome, allergies, endometriosis, and asthma. Our study results indicated an association between hyperthyroidism and BPS/IC. We suggest that clinicians treating female subjects with hyperthyroidism be alert to urinary complaints in this population.

Symmetry considerations in the scattering of identical composite bodies

NASA Technical Reports Server (NTRS)

Norbury, J. W.; Townsend, L. W.; Deutchman, P. A.

1986-01-01

Previous studies of the interactions between composite particles were extended to the case in which the composites are identical. The form of the total interaction potential matrix elements was obtained, and guidelines for their explicit evaluation were given. For the case of elastic scattering of identical composites, the matrix element approach was shown to be equivalent to the scattering amplitude method.

"Another Link in the Chain" Update: State Policies and Practices for Case Management and Environmental Investigation for Lead-Poisoned Children.

ERIC Educational Resources Information Center

McLaine, Pat; Gaitens, Joanna

This report details a national survey, conducted in 2000, to document changes since 1998 in policies and practices for case management and environmental investigation for lead poisoned children; the study also investigated the impact of the previous national survey in precipitating change. Participating in the survey were program directors or…

Toward an Interdisciplinary Understanding of Educational Equity and Difference: The Case of the Racialization of Ability

ERIC Educational Resources Information Center

Artiles, Alfredo J.

2011-01-01

The author argues for an interdisciplinary perspective to study the complexities of educational equity and transcend the limits of previous research. He focuses on the racialization of disability as a case in point; specifically, he reviews the visions of justice that inform the scholarship on racial and ability differences and situates their…

Aspiration cytology of extramammary tumors metastatic to the breast.

PubMed

Deshpande, A H; Munshi, M M; Lele, V R; Bobhate, S K

1999-11-01

This study was carried out to examine the cytomorphologic features of metastatic breast tumors and to assess the utility of fine-needle aspiration cytology (FNAC) in diagnosing these tumors. The study group comprised five females and one male, all presenting with a breast mass. Their ages ranged between 35 and 65 years. FNAC of the breast mass was done in all cases. Three of the cases were previously diagnosed as squamous cell carcinoma (SCC) of the cervix, mucinous cystadenocarcinoma (MCA) of the ovary, and melanoma. Three cases presented initially with a breast mass. These included melanoma, non-Hodgkin's lymphoma (NHL), and plasmacytoma. The diagnosis of NHL was confirmed on histology. The patient with plasmacytoma presented primarily with a breast lump but subsequently developed multiple myeloma, and in one case of melanoma the primary tumor was detected after breast metastases. Preoperative FNAC of extramammary tumors metastatic to the breast is invaluable because the management of the patient differs entirely from that of a primary neoplasm. An accurate diagnosis can be made with the help of clinical and radiological correlation. If available, a perusal of previous history and biopsy material may prove useful. Copyright 1999 Wiley-Liss, Inc.

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

PubMed

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

2017-08-01

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

Novel deletions involving the USH2A gene in patients with Usher syndrome and retinitis pigmentosa.

PubMed

García-García, Gema; Aller, Elena; Jaijo, Teresa; Aparisi, Maria J; Larrieu, Lise; Faugère, Valérie; Blanco-Kelly, Fiona; Ayuso, Carmen; Roux, Anne-Francoise; Millán, José M

2014-01-01

The aim of the present work was to identify and characterize large rearrangements involving the USH2A gene in patients with Usher syndrome and nonsyndromic retinitis pigmentosa. The multiplex ligation-dependent probe amplification (MLPA) technique combined with a customized array-based comparative genomic hybridization (aCGH) analysis was applied to 40 unrelated patients previously screened for point mutations in the USH2A gene in which none or only one pathologic mutation was identified. We detected six large deletions involving USH2A in six out of the 40 cases studied. Three of the patients were homozygous for the deletion, and the remaining three were compound heterozygous with a previously identified USH2A point mutation. In five of these cases, the patients displayed Usher type 2, and the remaining case displayed nonsyndromic retinitis pigmentosa. The exact breakpoint junctions of the deletions found in USH2A in four of these cases were characterized. Our study highlights the need to develop improved efficient strategies of mutation screening based upon next generation sequencing (NGS) that reduce cost, time, and complexity and allow simultaneous identification of all types of disease-causing mutations in diagnostic procedures.

Study of EEG during Sternberg Tasks with Different Direction of Arrangement for Letters

NASA Astrophysics Data System (ADS)

Kamihoriuchi, Kenji; Nuruki, Atsuo; Matae, Tadashi; Kurono, Asutsugu; Yunokuchi, Kazutomo

In previous study, we recorded electroencephalogram (EEG) of patients with dementia and healthy subjects during Sternberg task. But, only one presentation method of Sternberg task was considered in previous study. Therefore, we examined whether the EEG was different in two different presentation methods wrote letters horizontally and wrote letters vertically in this study. We recorded EEG of six healthy subjects during Sternberg task using two different presentation methods. The result was not different in EEG topography of all subjects. In all subjects, correct rate increased in case of vertically arranged letters.

Case control study of neuroblastoma in west-Germany after the Chernobyl accident.

PubMed

Michaelis, J; Haaf, H G; Zöllner, J; Kaatsch, P; Krummenauer, F; Berthold, F

1996-01-01

To explore possible causes of a 1988 incidence peak of infant neuroblastoma in west German regions which were contaminated with more than 6000 Bq/m2 Cs137 from the Chernobyl accident. The primary working hypothesis was that parents of the diseased children had been contaminated by an excessive intake of locally produced food, especially mushrooms or deer. Case control study with 1:2 (cases:controls) matching. Data were collected from the children's parents by questionnaires and telephone interviews. Nation-wide study (former FRG) based on the German Childhood Cancer Registry. Cases born in 1988 and reported with a neuroblastoma to the registry until March 1992. Population-based healthy controls, matched for age, sex and residence at time of diagnosis. The working hypothesis could not be confirmed by the study, because the parents of cases tended to eat less locally grown food than the parents of controls (RR = 0.63, 95% CI:0.20-1.97). Possible influence factors which previously have been described to be associated with neuroblastoma incidence could not be confirmed by the study. Parental exposure to herbicides and pesticides was associated with the occurrence of neuroblastoma (RR = 4.2, 95% CI:1.4-12.9). Neuroblastoma stage distribution in the contaminated regions was shifted towards lower stages as compared to the less contaminated regions and previous age cohorts. The study does not show additional evidence that the observed increase in neuroblastoma incidence might have been caused by exposure to fallout from the Chernobyl accident. The observed shift towards lower clinical stages may rather indicate increased diagnostic awareness. The association between neuroblastoma and parental exposure with herbicides and pesticides resulted from an extensive exploratory data analysis and needs to be confirmed in further studies.

Effect of the new standards for case logging on resident operative volume: doing better cases or better numbers?

PubMed

Murthy, Raghav; Shepard, Alex; Swartz, Andrew; Woodward, Ann; Reickert, Craig; Horst, Mathilda; Rubinfeld, Ilan

2012-01-01

The Accreditation Council for Graduate Medical Education (ACGME) modified the designation of major (index) operative cases to include those previously considered "minor." This study assessed the potential effect of these changes on resident operative experience. With Institutional Review Board approval, we analyzed National Surgical Quality Improvement Program participant use files for 2005-2008 for general and vascular surgery cases. Primary CPT case coding was mapped to the ACGME major case category using both the old and new classification schemes. The variables were analyzed using χ(2) analysis in SPSS IBM 19 (IBM, Armonk, New York). A total of 576,019 cases were reviewed. Major cases as defined by the new classification represented an increasing proportion of the cases each year, rising from 88.3% in 2005 to 95% by 2008 (p < 0.001). Major cases as defined by the old scheme decreased from 71% in 2005 to 62% by 2008 (p < 0.001). The cases covered by a resident dropped from 82% in 2005 to 61% in 2008 (p < 0.001). When comparing the new to the old scheme, 364,366 (63.3%) cases were considered major and 30,587 (5.3%) were minor by both standards; 7089 (1.2%) cases previously classified as major were changed to minor, whereas 173,977 (30.2%) (p < 0.001) previously classified as minor were now major. This latter group showed top procedures to include excision of breast lesion (22,175 [12.7%]), laparoscopic gastric bypass (18,825 [10.8%]), ventral hernia repair (14,732 [8.5%]), and appendectomy (10,190 [5.9%]). Of these newly designated major cases, the proportion not covered by residents increased from 22% in 2005 to 44% in 2007 and 2008 (p < 0.001). Although some operative cases newly classified as major are technically advanced procedures (eg, Roux-en-Y gastric bypass), other cases are not (eg, breast lesion excision), which raises the issue as to whether the major case category has been diluted by less demanding case types. The implications of these findings may suggest preservation of case volumes at the expense of case quality. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Proposal for a new classification of variations in the iliac venous system based on internal iliac veins: a case series and a review of double and left inferior vena cava.

PubMed

Hayashi, Shogo; Naito, Munekazu; Hirai, Shuichi; Terayama, Hayato; Miyaki, Takayoshi; Itoh, Masahiro; Fukuzawa, Yoshitaka; Nakano, Takashi

2013-09-01

There are many reports on variations in the inferior vena cava (IVC), particularly double IVC (DIVC) and left IVC (LIVC). However, no systematic report has recorded iliac vein (IV) flow patterns in the DIVC and LIVC. In this study, we examined IV flow patterns in both DIVC and LIVC observed during gross anatomy courses conducted for medical students and in previously reported cases. During the gross anatomy courses, three cases of DIVC and one case of LIVC were found in 618 cadavers. The IV flow pattern from these four cases and all other previously reported cases can be classified into one of the following three types according to the vein into which the internal iliac vein drained: the ipsilateral external IV; confluence of the ipsilateral external IV and IVC; and the communicating vein, which connects the IVC and the contralateral IVC or its iliac branch. This classification, which is based on the internal IV course, is considered to be useful because IV variations have the potential to cause clinical problems during related retroperitoneal surgery, venous interventional radiology, and diagnostic procedures for pelvic cancer.

Non-malignant respiratory diseases and lung cancer among Chinese workers exposed to silica.

PubMed

Cocco, P; Rice, C H; Chen, J Q; McCawley, M; McLaughlin, J K; Dosemeci, M

2000-06-01

The objective of this study was to explore whether a medical history for non-malignant respiratory disease contributes to an increased lung cancer risk among workers exposed to silica. We analyzed data from a nested case-control study in 29 dusty workplaces in China. The study population consisted of 316 lung cancer cases and 1356 controls matched to cases by facility type and decade of birth who were alive at the time of diagnosis of the index case and who were identified in a follow-up study of about 68,000 workers. Age at first exposure and cigarette smoking were accounted for in the analysis. Smoking was the main risk factor for both lung cancer and chronic bronchitis. Lung cancer risk showed a modest association with silicosis and with cumulative silica exposure, which did not vary by history of previous pulmonary tuberculosis. Among subjects without a medical history for chronic bronchitis or asthma, lung cancer risk was associated with silicosis (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1 to 2.2), and it was increased in each quartile of cumulative silica exposure. However, risk was not elevated in the highest quartile (OR, 1.3, 1.6, 1.8, 1.4). Among subjects with a medical history for chronic bronchitis or asthma, lung cancer risk was associated with neither silicosis (subjects with chronic bronchitis: OR, 0.6; subjects with asthma: OR, 0.4) nor with silica exposure. In this study population, we observed a modest association of both silicosis and cumulative exposure to silica with lung cancer among subjects who were not previously diagnosed with chronic bronchitis or asthma, but not among subjects who had a medical history for either disease. Risk of lung cancer associated with silicosis or cumulative exposure to silica did not vary by previous medical history of pulmonary tuberculosis.

Treatment seeking for problematic pornography use among women.

PubMed

Lewczuk, Karol; Szmyd, Joanna; Skorko, Maciej; Gola, Mateusz

2017-12-01

Background and aims Previous studies examined psychological factors related to treatment seeking for problematic pornography use (PU) among males. In this study, we focused on females who seek treatment for problematic PU and compared them with non-problematic pornography users with regard to variables related to problematic PU. Second, we investigated the relationships between critical constructs related to problematic PU with the path analysis method, emphasizing the predictors for treatment seeking among women. We also compared our results with previous studies on males. Methods A survey study was conducted on 719 Polish-speaking Caucasian females, 14-63 years old, including 39 treatment seekers for problematic PU. Results The positive relationship between the mere amount of PU and treatment seeking loses its significance after introducing two other predictors of treatment-seeking: religiosity and negative symptoms associated with PU. This pattern is different from the results obtained in previous studies on males. Discussion Different from previous studies on male samples, our analysis showed that in the case of women, mere amount of PU may be related to treatment-seeking behavior even after accounting for negative symptoms associated with PU. Moreover, religiousness is a significant predictor of treatment seeking among women, which may indicate that in the case of women, treatment seeking for problematic PU is motivated not only by experienced negative symptoms of PU but also by personal beliefs about PU and social norms. Conclusion For females, negative symptoms associated with PU, the amount of PU and religiosity is associated with treatment seeking. Those factors should be considered in treatment.

Primary care-led commissioning: applying lessons from the past to the early development of clinical commissioning groups in England.

PubMed

Checkland, Kath; Coleman, Anna; McDermott, Imelda; Segar, Julia; Miller, Rosalind; Petsoulas, Christina; Wallace, Andrew; Harrison, Stephen; Peckham, Stephen

2013-09-01

The current reorganisation of the English NHS is one of the most comprehensive ever seen. This study reports early evidence from the development of clinical commissioning groups (CCGs), a key element in the new structures. To explore the development of CCGs in the context of what is known from previous studies of GP involvement in commissioning. Case study analysis from sites chosen to provide maximum variety across a number of dimensions, from September 2011 to June 2012. A case study analysis was conducted using eight detailed qualitative case studies supplemented by descriptive information from web surveys at two points in time. Data collection involved observation of a variety of meetings, and interviews with key participants. Previous research shows that clinical involvement in commissioning is most effective when GPs feel able to act autonomously. Complicated internal structures, alongside developing external accountability relationships mean that CCGs' freedom to act may be subject to considerable constraint. Effective GP engagement is also important in determining outcomes of clinical commissioning, and there are a number of outstanding issues for CCGs, including: who feels 'ownership' of the CCG; how internal communication is conceptualised and realised; and the role and remit of locality groups. Previous incarnations of GP-led commissioning have tended to focus on local and primary care services. CCGs are keen to act to improve quality in their constituent practices, using approaches that many developed under practice-based commissioning. Constrained managerial support and the need to maintain GP engagement may have an impact. CCGs are new organisations, faced with significant new responsibilities. This study provides early evidence of issues that CCGs and those responsible for CCG development may wish to address.

Primary care-led commissioning: applying lessons from the past to the early development of clinical commissioning groups in England

PubMed Central

Checkland, Kath; Coleman, Anna; McDermott, Imelda; Segar, Julia; Miller, Rosalind; Petsoulas, Christina; Wallace, Andrew; Harrison, Stephen; Peckham, Stephen

2013-01-01

Background The current reorganisation of the English NHS is one of the most comprehensive ever seen. This study reports early evidence from the development of clinical commissioning groups (CCGs), a key element in the new structures. Aim To explore the development of CCGs in the context of what is known from previous studies of GP involvement in commissioning. Design and setting Case study analysis from sites chosen to provide maximum variety across a number of dimensions, from September 2011 to June 2012. Method A case study analysis was conducted using eight detailed qualitative case studies supplemented by descriptive information from web surveys at two points in time. Data collection involved observation of a variety of meetings, and interviews with key participants. Results Previous research shows that clinical involvement in commissioning is most effective when GPs feel able to act autonomously. Complicated internal structures, alongside developing external accountability relationships mean that CCGs’ freedom to act may be subject to considerable constraint. Effective GP engagement is also important in determining outcomes of clinical commissioning, and there are a number of outstanding issues for CCGs, including: who feels ‘ownership’ of the CCG; how internal communication is conceptualised and realised; and the role and remit of locality groups. Previous incarnations of GP-led commissioning have tended to focus on local and primary care services. CCGs are keen to act to improve quality in their constituent practices, using approaches that many developed under practice-based commissioning. Constrained managerial support and the need to maintain GP engagement may have an impact. Conclusion CCGs are new organisations, faced with significant new responsibilities. This study provides early evidence of issues that CCGs and those responsible for CCG development may wish to address. PMID:23998841

Urothelial melanosis of the bladder.

PubMed

Valente, Sara L; Bieniek, Jared M; Kesler, Stuart S

2017-10-01

Urothelial melanosis is a rare finding characterized by abnormal pigmentation noted on cystoscopic evaluation and histologically defined by melanin deposition in the urothelium. Although generally considered benign, few cases of urothelial melanosis have been reported in the literature and the risk of recurrence or progression remains largely unknown. Four cases associated with urothelial cell carcinoma have been previously described. Here, we report a case of urothelial melanosis and review previously published cases in the literature.

Type 1 neurofibromatosis and pulmonary hypertension: a report of two cases and a review

PubMed Central

Malviya, Amit; Mishra, Sundeep; Kothari, Shyam S

2012-01-01

Pulmonary hypertension in type 1 neurofibromatosis is not well known and was previously attributed to diffuse fibrosing alveolitis and parenchymal tumours. More recently, cases of severe pulmonary hypertension due to pulmonary vasculopathy have been described. Involvement of vascular beds, both large and medium calibre vessels, but not pulmonary vasculature, in type 1 neurofibromatosis is well known. The authors describe two such cases and briefly review the literature. Pulmonary arterial hypertension in neurofibromatosis warrants further studies. PMID:27326022

An Exploration of Lesbian Maternal Bereavement

ERIC Educational Resources Information Center

Cacciatore, Joanne; Raffo, Zulma

2011-01-01

Research on parental bereavement has focused historically on single or partnered cross-gendered (heterosexual) bereaved parents. No previous studies have examined the unique experiences of same-gendered bereaved parents. This multiple-case study focused on child death in same-gendered-parent families. The goal of this study was to yield…

Foodborne botulism in Poland in 2014

PubMed

Czerwiński, Michał; Czarkowski, Mirosław P; Kondej, Barbara

The aim of the study is to assess the epidemiology of foodborne botulism in Poland in 2014 compared to previous years. We reviewed (1) surveillance data published in the annual bulletin “Infectious diseases and poisonings in Poland in 2014” and in previous publications, and (2) unpublished data retrieved from botulism case reports for 2014 sent to the Department of Epidemiology NIPH-NIH by Sanitary-Epidemiological Stations. In 2014, a total of 29 foodborne botulism cases (including 17 laboratory confirmed) was reported; the annual incidence rate (0.08 per 100,000 population) increased slightly in comparison to previous year, but was similar to the median incidence for years 2008 to 2012. The highest incidence in the country was reported in Lubelskie province (0.33). Incidence in rural areas (0.09) was only slightly higher than the incidence in urban areas (0.06). Men, had more than 4 times higher incidence than women; the highest incidence rate (0.31) was observed among men in the age group of 20-24 years. Most cases were associated with consumption of different types of commercially canned meat. Home-made vegetable meat preserves were also a common vehicle. All cases were hospitalized. Two deaths related to the disease were reported. Since 2008, the epidemiological situation of foodborne botulism in the country remains stable with an average 30 cases per year and corresponding incidence rate of 0.08 per 100,000 population. However, in 2014 draws attention a significant number of cases with undetermined food vehicle and relatively high percentage of cases with no laboratory confirmation. Therefore, it is important to enhance epidemiological investigation as well as laboratory capacity for surveillance.

A retrospective analysis of episodes of single tooth extraction under general anaesthesia for adults.

PubMed

Hong, B; Birnie, A

2016-01-15

To investigate the provision of adult dental extraction under general anaesthesia (DGA) at the Royal Cornwall Hospitals NHS Trust (RCHT)-- specifically adult single tooth DGA episodes in regards to numbers, demographics, justifications, and appropriateness regarding the use of resources. Data were collected retrospectively from the patient case notes and electronic records for the complete study cohort. This study included all episodes of adult single tooth DGA in all RCHT sites during 2014, except for mandibular third molar and impacted teeth. Each case was tested against the DGA case selection criteria empirically devised for this study. In 2014, 106 episodes of adult single tooth DGA were carried out in RCHT that met the inclusion criteria. Younger females from more socio-economically deprived areas of Cornwall were increasingly likely to have this procedure. Mental disorders were the most prevalent co-morbidity (21.7%) in this cohort. The vast majority of patients (93.4%) had previously tolerated dental treatment without the need for general anaesthesia (GA). Many referrals (46.2%) and listings (30.2%) specifically stated patient demand-driven reasons. None of the cohort had DGA due to failure of sedation. There were potentially 11 episodes that met the DGA case selection criteria. Patients waited for 126 days (median) from the referral date for an operation which took seven minutes (median) to complete. The majority (83%) of the cases were simple exodontia. Twenty patients (18.9%) had previous DGA. Potentially a considerable proportion of GA prescription appeared to be driven by patient demand rather than clinical need. This study poses a fundamental question--what drives the demand for DGA? National data collection and specific DGA case selection criteria are recommended.

Sexually transmitted diseases in Poland in 2011.

PubMed

Majewski, Sławomir; Rudnicka, Iwona

2013-01-01

Was to assess epidemiological situation of sexually transmitted diseases in Poland in 2011. Analysis of the data on prevalence of syphilis, gonorrhoea, non-gonococcal urethritis, genital herpes and genital warts was gathered from yearly reports MZ-14 from several didtricts. In 2011 there were 841 reported cases of all types of syphilis, which was higher by 24 than in 2010. Within the reported cases, 554 cases were of early syphilis, 274 cases of late syphilis, and 11 cases of congenital syphilis. Syphilis during pregnancy and childbirth was reported in 13 women. The highest incidence of syphilis in 2011, similarly to previous years was in Mazowieckie district (4.7/100,000) and the lowest in Swietokrzyskie district (0.2/100,000), the average in a whole country accounted to 2.2/100,000. In 2011 there were 351 cases of gonorrhoea reported, which was higher by 77 cases than reported in the previous year. The highest incidence was reported in Mazowieckie voivodeship. Non-gonococcal urethritis -NGU was identified in 484 persons; this was less by 294 cases than reported in the previous year. The highest incidence rate was reported in Dolnoślaskie voivodeship 9.6/100,000. There were 428 cases of genital warts reported which was less by 174 cases than reported in 2010. The highest incidence rate was reported in Mazowieckie voivodeship, Warminsko- Mazurskie voivodeship and Kujawsko-Pomorskie voivodeship. As in previous years the most unfavourable epidemiological situation in terms of all registered sexually transmitted diseases was in Mazowieckie voivodeship. In 2011 among sexually transmitted diseases NGU and genital warts were reported in lower numbers then in previous year. In the same time numbers of reported cases of gonorrhoea and syphilis increased. There is a continued decrease in the number of serological tests done for syphilis. Epidemiological indicators of treatment for gonorrhoea and syphilis are very low for number of years. The epidemiological data is probably incomplete due to the low sensitivity of reporting.

Iodine-131 induced hepatotoxicity in previously healthy patients with Grave’s disease

PubMed Central

2013-01-01

Objective To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave’s disease (GD) patients after the treatment with radioactive iodine 131I (RAI). Case presentation We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. Conclusion To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine 131I. PMID:23497434

Mutational spectrum in breast cancer associated BRCA1 and BRCA2 genes in Colombia

PubMed Central

Gómez-Gutiérrez, Alberto; Díaz-Dussán, Natalia Andrea; Noguera-Santamaría, María Claudia; Díaz-Rincón, Diego; Casas-Gómez, María Consuelo

2017-01-01

Abstract Introduction: The risk of developing breast and ovarian cancer is higher in families that carry mutations in BRCA1 or BRCA2 genes, and timely mutation detection is critical. Objective: To identify the presence of mutations in the Colombian population and evaluate two testing strategies. Methods: From a total universe of 853 individual blood samples referred for BRCA1 and BRCA2 typing, 256 cases were analyzed by complete direct sequencing of both genes in Myriad Genetics, and the remaining 597 cases were studied by partial sequencing based on founder mutations in a PCR test designed by ourselves ("Profile Colombia"). Results: We found 107 patients carrying deleterious mutations in this group of patients, 69 (64.5%) located in BRCA1, and 38 (35.5%) in BRCA2. Overall, we detected 39 previously unreported mutations in Colombia (22 in BRCA1 and 17 in BRCA2) and only 4 out of the 6 previously reported founder mutations. Sixty four out of 597 patients (10.7%) studied by "Profile Colombia" showed mutations in BRCA1 or BRCA2, and 41/256 patients (16%) showed mutations by complete BRCA1-BRCA2 sequencing. Conclusions: The spectrum of 44 different mutations in Colombia as detected in our study is broader than the one previously reported for this country. "Profile Colombia" is a useful screening test to establish both founder and new mutations (detection rate of 10.7%) in cases with family history of breast cancer. Complete sequencing shows a detection rate of 16.0%, and should complement the study of the genetic basis of this disease. PMID:29021639

Determinants of Chronic Respiratory Symptoms among Pharmaceutical Factory Workers

PubMed Central

Enquselassie, Fikre; Tefera, Yifokire; Gizaw, Muluken; Wakuma, Samson; Woldemariam, Messay

2018-01-01

Background Chronic respiratory symptoms including chronic cough, chronic phlegm, wheezing, shortness of breath, and chest pain are manifestations of respiratory problems which are mainly evolved as a result of occupational exposures. This study aims to assess determinants of chronic respiratory symptoms among pharmaceutical factory workers. Methods A case control study was carried out among 453 pharmaceutical factory workers with 151 cases and 302 controls. Data was collected using pretested and structured questionnaire. The data was analyzed using descriptive statistics and bivariate and multivariate analysis. Result Previous history of chronic respiratory diseases (AOR = 3.36, 95% CI = 1.85–6.12), family history of chronic respiratory diseases (AOR = 2.55, 95% CI = 1.51–4.32), previous dusty working environment (AOR = 2.26, 95% CI = 1.07–4.78), ever smoking (AOR = 3.66, 95% CI = 1.05–12.72), and service years (AOR = 1.86, 95% CI = 1.16–2.99) showed statistically significant association with chronic respiratory symptoms. Conclusion Previous history of respiratory diseases, family history of chronic respiratory diseases, previous dusty working environment, smoking, and service years were determinants of chronic respiratory symptoms. Public health endeavors to prevent the burden of chronic respiratory symptoms among pharmaceutical factory workers should target the reduction of adverse workplace exposures and discouragement of smoking. PMID:29666655

Diagnosis of primary antibody and complement deficiencies in young adults after a first invasive bacterial infection.

PubMed

Sanges, S; Wallet, F; Blondiaux, N; Theis, D; Vérin, I; Vachée, A; Dessein, R; Faure, K; Viget, N; Senneville, E; Leroy, O; Maury, F; Just, N; Poissy, J; Mathieu, D; Prévotat, A; Chenivesse, C; Scherpereel, A; Smith, G; Lopez, B; Rosain, J; Frémeaux-Bacchi, V; Hachulla, E; Hatron, P-Y; Bahuaud, M; Batteux, F; Launay, D; Labalette, M; Lefèvre, G

2017-08-01

Screening for primary immunodeficiencies (PIDs) in adults is recommended after two severe bacterial infections. We aimed to evaluate if screening should be performed after the first invasive infection in young adults. Eligible patients were retrospectively identified using hospital discharge and bacteriology databases in three centres during a 3-year period. Eighteen to 40-year-old patients were included if they had experienced an invasive infection with encapsulated bacteria commonly encountered in PIDs (Streptococcus pneumoniae (SP), Neisseria meningitidis (NM), Neisseria gonorrhoeae (NG), Haemophilus influenzae (HI), or group A Streptococcus (GAS)). They were excluded in case of general or local predisposing factors. Immunological explorations and PIDs diagnoses were retrieved from medical records. Serum complement and IgG/A/M testings were systematically proposed at the time of study to patients with previously incomplete PID screening. The study population comprised 38 patients. Thirty-six had experienced a first invasive episode and a PID was diagnosed in seven (19%): two cases of common variable immunodeficiency revealed by SP bacteraemia, one case of idiopathic primary hypogammaglobulinaemia, and two cases of complement (C6 and C7) deficiency revealed by NM meningitis, one case of IgG2/IgG4 subclasses deficiency revealed by GAS bacteraemia, and one case of specific polysaccharide antibody deficiency revealed by HI meningitis. Two patients had previously experienced an invasive infection before the study period: in both cases, a complement deficiency was diagnosed after a second NM meningitis and a second NG bacteraemia, respectively. PID screening should be considered after a first unexplained invasive encapsulated-bacterial infection in young adults. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Experiences Using Lightweight Formal Methods for Requirements Modeling

NASA Technical Reports Server (NTRS)

Easterbrook, Steve; Lutz, Robyn; Covington, Rick; Kelly, John; Ampo, Yoko; Hamilton, David

1997-01-01

This paper describes three case studies in the lightweight application of formal methods to requirements modeling for spacecraft fault protection systems. The case studies differ from previously reported applications of formal methods in that formal methods were applied very early in the requirements engineering process, to validate the evolving requirements. The results were fed back into the projects, to improve the informal specifications. For each case study, we describe what methods were applied, how they were applied, how much effort was involved, and what the findings were. In all three cases, formal methods enhanced the existing verification and validation processes, by testing key properties of the evolving requirements, and helping to identify weaknesses. We conclude that the benefits gained from early modeling of unstable requirements more than outweigh the effort needed to maintain multiple representations.

Navigating Undiagnosed Dissociative Identity Disorder in the Inpatient Setting: A Case Report.

PubMed

Urbina, Theresa M; May, Tania; Hastings, Michelle

2017-05-01

This case illustrates previously undiagnosed dissociative identity disorder (DID) in a middle-aged female with extensive childhood trauma, who was high functioning prior to a trigger that caused a reemergence of her symptoms. The trigger sparked a dissociative state, attempted suicide, and subsequent inpatient psychiatric hospitalization. Practitioners should include in their differential and screen for undiagnosed DID in patients with episodic psychiatric hospitalizations refractory to the standard treatments for previously diagnosed mental illnesses. Case study. During hospitalization, the diagnosis of DID became apparent and treatment included low-dose risperidone, mirtazapine, sertraline, unconditional positive regard, normalization of her dissociative states in an attempt to decrease her anxiety during treatment, and documentation for the patient via written notes following interviews. These methods helped her come to terms with the diagnosis and allowed the treatment team to teach her coping skills to lessen the impact of dissociative states following discharge.

Active Surveillance of Hansen's Disease (Leprosy): Importance for Case Finding among Extra-domiciliary Contacts

PubMed Central

Moura, Maria L. N.; Dupnik, Kathryn M.; Sampaio, Gabriel A. A.; Nóbrega, Priscilla F. C.; Jeronimo, Ana K.; do Nascimento-Filho, Jose M.; Miranda Dantas, Roberta L.; Queiroz, Jose W.; Barbosa, James D.; Dias, Gutemberg; Jeronimo, Selma M. B.; Souza, Marcia C. F.; Nobre, Maurício L.

2013-01-01

Hansen's disease (leprosy) remains an important health problem in Brazil, where 34,894 new cases were diagnosed in 2010, corresponding to 15.3% of the world's new cases detected in that year. The purpose of this study was to use home visits as a tool for surveillance of Hansen's disease in a hyperendemic area in Brazil. A total of 258 residences were visited with 719 individuals examined. Of these, 82 individuals had had a previous history of Hansen's disease, 209 were their household contacts and 428 lived in neighboring residences. Fifteen new Hansen's disease cases were confirmed, yielding a detection rate of 2.0% of people examined. There was no difference in the detection rate between household and neighbor contacts (p = 0.615). The two groups had the same background in relation to education (p = 0.510), household income (p = 0.582), and the number of people living in the residence (p = 0.188). Spatial analysis showed clustering of newly diagnosed cases and association with residential coordinates of previously diagnosed multibacillary cases. Active case finding is an important tool for Hansen's disease control in hyperendemic areas, enabling earlier diagnosis, treatment, decrease in disability from Hansen's disease and potentially less spread of Mycobacterium leprae. PMID:23516645

A New Lagrangian Relaxation Method Considering Previous Hour Scheduling for Unit Commitment Problem

NASA Astrophysics Data System (ADS)

Khorasani, H.; Rashidinejad, M.; Purakbari-Kasmaie, M.; Abdollahi, A.

2009-08-01

Generation scheduling is a crucial challenge in power systems especially under new environment of liberalization of electricity industry. A new Lagrangian relaxation method for unit commitment (UC) has been presented for solving generation scheduling problem. This paper focuses on the economical aspect of UC problem, while the previous hour scheduling as a very important issue is studied. In this paper generation scheduling of present hour has been conducted by considering the previous hour scheduling. The impacts of hot/cold start-up cost have been taken in to account in this paper. Case studies and numerical analysis presents significant outcomes while it demonstrates the effectiveness of the proposed method.

Some experiments on Yaw stability of wind turbines with various coning angles

NASA Technical Reports Server (NTRS)

Bundas, D.; Dugundji, J.

1981-01-01

A horizontal axis wind turbine was constructed to study the effect of coning angle on the yawing moments produced. Coning angles of 0 deg, +10 deg and -10 deg were studied in the upwind and downwind cases. Moment and rotational frequency of the blades at each yaw angle setting were taken. It was found that as the coning angle increased from -10 deg to +10 deg in either the upwind or downwind case the stability decreased. The downwind case was slightly more stable for all coning angles than was the upwind case. It is found that all the previous cases were stable for high rotation speeds, but at lower rotation speeds, they were all unstable and could not self start unless held in the wind.

Investigation of established genetic risk variants for glioma in prediagnostic samples from a population-based nested case-control study.

PubMed

Wibom, Carl; Späth, Florentin; Dahlin, Anna M; Langseth, Hilde; Hovig, Eivind; Rajaraman, Preetha; Johannesen, Tom Børge; Andersson, Ulrika; Melin, Beatrice

2015-05-01

Although glioma etiology is poorly understood in general, growing evidence indicates a genetic component. Four large genome-wide association studies (GWAS) have linked common genetic variants with an increased glioma risk. However, to date, these studies are based largely on a case-control design, where cases have been recruited at the time of or after diagnosis. They may therefore suffer from a degree of survival bias, introduced when rapidly fatal cases are not included. To confirm glioma risk variants in a prospective setting, we have analyzed 11 previously identified risk variants in a set of prediagnostic serum samples with 598 cases and 595 matched controls. Serum samples were acquired from The Janus Serum Bank, a Norwegian population-based biobank reserved for cancer research. We confirmed the association with glioma risk for variants within five genomic regions: 8q24.21 (CCDC26), 9p21.3 (CDKN2B-AS1), 11q23.3 (PHLDB1), 17p13.1 (TP53), and 20q13.33 (RTEL1). However, previously identified risk variants within the 7p11.2 (EGFR) region were not confirmed by this study. Our results indicate that the risk variants that were confirmed by this study are truly associated with glioma risk and may, consequently, affect gliomagenesis. Though the lack of positive confirmation of EGFR risk variants may be attributable to relatively limited statistical power, it nevertheless raises the question whether they truly are risk variants or markers for glioma prognosis. Our findings indicate the need for further studies to clarify the role of glioma risk loci with respect to prolonged survival versus etiology. ©2015 American Association for Cancer Research.

Analysis of 60 reported glioma risk SNPs replicates published GWAS findings but fails to replicate associations from published candidate-gene studies.

PubMed

Walsh, Kyle M; Anderson, Erik; Hansen, Helen M; Decker, Paul A; Kosel, Matt L; Kollmeyer, Thomas; Rice, Terri; Zheng, Shichun; Xiao, Yuanyuan; Chang, Jeffrey S; McCoy, Lucie S; Bracci, Paige M; Wiemels, Joe L; Pico, Alexander R; Smirnov, Ivan; Lachance, Daniel H; Sicotte, Hugues; Eckel-Passow, Jeanette E; Wiencke, John K; Jenkins, Robert B; Wrensch, Margaret R

2013-02-01

Genomewide association studies (GWAS) and candidate-gene studies have implicated single-nucleotide polymorphisms (SNPs) in at least 45 different genes as putative glioma risk factors. Attempts to validate these associations have yielded variable results and few genetic risk factors have been consistently replicated. We conducted a case-control study of Caucasian glioma cases and controls from the University of California San Francisco (810 cases, 512 controls) and the Mayo Clinic (852 cases, 789 controls) in an attempt to replicate previously reported genetic risk factors for glioma. Sixty SNPs selected from the literature (eight from GWAS and 52 from candidate-gene studies) were successfully genotyped on an Illumina custom genotyping panel. Eight SNPs in/near seven different genes (TERT, EGFR, CCDC26, CDKN2A, PHLDB1, RTEL1, TP53) were significantly associated with glioma risk in the combined dataset (P < 0.05), with all associations in the same direction as in previous reports. Several SNP associations showed considerable differences across histologic subtype. All eight successfully replicated associations were first identified by GWAS, although none of the putative risk SNPs from candidate-gene studies was associated in the full case-control sample (all P values > 0.05). Although several confirmed associations are located near genes long known to be involved in gliomagenesis (e.g., EGFR, CDKN2A, TP53), these associations were first discovered by the GWAS approach and are in noncoding regions. These results highlight that the deficiencies of the candidate-gene approach lay in selecting both appropriate genes and relevant SNPs within these genes. © 2012 WILEY PERIODICALS, INC.

A 10% liquid immunoglobulin preparation for intravenous use (Privigen®) in paediatric patients with primary immunodeficiencies and hypersensitivity to IVIG.

PubMed

Lozano-Blasco, J; Martín-Mateos, M A; Alsina, L; Domínguez, O; Giner, M T; Piquer, M; Alvaro, M; Plaza, A M

2014-01-01

The objective of this study was to evaluate safety and efficacy of Privigen®, a 10% intravenous immunoglobulin (IVIG), in a particular group of paediatric patients (highly sensitive to previous IVIG infusion) affected with Primary Immunodeficiencies (PID). Patients (n=8) from 3 to 17 years old diagnosed of PID who often suffered from adverse events related to the infusion to previous IVIG were switched to Privigen® in an open protocol. Data were prospectively collected regarding Privigen® administration: infusion, safety and efficacy. In parallel, data on safety and tolerance were retrospectively collected from medical charts regarding the previous 10% IVIG product used. 50% of the patients required premedication with previous IVIG. At the end of the study none required premedication with Privigen®. The infusion rate was lower than that recommended by the manufacturer. All patients had suffered through adverse events during previous IVIG infusion being severe in three patients and recurrent in the rest. With Privigen® only three patients suffered from an adverse event (all cases were milder than previous related). Trough levels of IgG remained stable. None suffer from any episode of bacterial infection. The present work shows that Privigen® was safe in a group of hypersensitive paediatric patients who did not tolerate the administration of a previous 10% liquid IVIG by using a particular infusion protocol slower than recommended. The number of adverse effects was smaller than published, and all cases were mild. No premedication was needed. Privigen® was also effective in this small group. Copyright © 2012 SEICAP. Published by Elsevier Espana. All rights reserved.

Maternal hypertension and risk for hypospadias in offspring.

PubMed

Agopian, A J; Hoang, Thanh T; Mitchell, Laura E; Morrison, Alanna C; Tu, Duong; Nassar, Natasha; Canfield, Mark A

2016-12-01

Hypospadias is one of the most common birth defects in male infants. Maternal hypertension is a suspected risk factor; however, few previous studies have addressed the possibility of reporting bias, and several previous studies have not accounted for hypospadias severity. We analyzed data from the Texas Birth Defects Registry for 10,924 nonsyndromic cases and statewide vital records for deliveries during 1999-2009, using Poisson regression. After adjustment for potential confounders, hypospadias was associated with maternal hypertension (adjusted prevalence ratio: 1.5, 95% confidence interval: 1.4-1.7). Similar associations were observed with gestational and pregestational hypertension, including separate analyses restricted to the subset of cases with severe (second- or third-degree) hypospadias. All of these associations were also similar among the subset of cases with isolated hypospadias (without additional birth defects). To evaluate the potential for bias due to potential hypertension misclassification, we repeated our analyses using logistic regression, comparing the cases to controls with other birth defects. In these analyses, the associations with gestational hypertension were similar, but adjusted associations with pregestational hypertension were no longer observed. Our findings support an association between gestational hypertension and hypospadias in offspring, but also suggest that previously observed associations with pregestational hypertension may have been inflated due to differential misclassification of hypertension (e.g., reporting bias). As gestational hypertension is recognized after hypospadias development, more research is needed to determine if this association reflects an increase in gestational hypertension risk secondary to hypospadias or if both conditions have shared risk factors (e.g., precursors of gestational hypertension). © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

[The present situation, treatment and prognosis of drug-resistant pulmonary tuberculosis. Cooperative Study Unit of Chemotherapy of Tuberculosis of the National Sanitoria in Japan].

PubMed

Sato, K; Nagai, H; Kurashima, A; Mori, M; Katayama, T

1995-10-01

We studied 266 patients with drug-resistant pulmonary tuberculosis at national sanatoria in Japan. The patients included 218 men (mean age, 58 years) and 48 women (mean age, 62 years). The levels of isoniazid and rifampicin resistance were determined at 1 mcg/mL and 50 mcg/mL, respectively. The results were as follows. (1) Most patients with drug-resistant pulmonary tuberculosis were middle-aged or past middle-aged. (2) There were many cases of drug-resistant pulmonary tuberculosis in previously treated tuberculosis patients with active disease and several cases in previously untreated pulmonary tuberculosis patients. However, in some previously untreated patients active tuberculosis was convert relatively easily to inactive tuberculosis. (3) Concerning life style, bachelors who drank heavily were more likely to develop drug-resistant pulmonary tuberculosis. (4) Most cases of drug-resistant pulmonary tuberculosis had at least one cavity on chest radiographs. (5) Several patients with drug-resistant tuberculosis left the hospital against the advice of their attending doctors; therefore, it was difficult to treat their illnesses. (6) In more than half the cases in which Mycobacterium tuberculosis was resistant to isoniazid and rifampicin, tolerance to streptomycin and ethanbutol was also seen. (7) When patients with drug-resistant pulmonary tuberculosis continued to have tuberculous bacilli in their sputum after 3 months of chemotherapy, there was a tendency for them to expectorate tuberculous bacilli in their sputum. For these drug-resistant tuberculosis patients, we must pay attention not only to the medical aspects but also to the social aspects of their disease.

The relationship between prior antimicrobial prescription and meningitis: a case–control study

PubMed Central

Armstrong, David; Ashworth, Mark; Dregan, Alex; White, Patrick

2016-01-01

Background Recent research into the role of the human microbiome in maintaining health has identified the potentially harmful impact of antimicrobials. Aim The association with bacterial and viral meningitis following antimicrobial prescription during the previous year was investigated to determine whether antimicrobials have a deleterious effect on the nasopharyngeal microbiome. Design and setting A case-control study (1:4 cases to controls) was conducted examining the rate of previous antimicrobial exposure in cases of meningitis and in a matched control group. Data from a UK primary care clinical database were analysed using conditional logistic regression. Results A total of 7346 cases of meningitis were identified, 3307 (45%) viral, 1812 (25%) bacterial, and 2227 (30%) unspecified. The risks of viral (adjusted odds ratio [AOR] 2.45; 95% confidence interval [CI] = 2.24 to 2.68) or bacterial (AOR 1.98; 95% CI = 1.71 to 2.30) meningitis were both increased following antimicrobial prescription in the preceding year. Patients who received ≥4 antimicrobial prescriptions in the preceding year were at significantly increased risk of all types of meningitis (AOR 2.85; 95% CI = 2.44 to 3.34), bacterial meningitis (AOR 3.06; 95% CI = 2.26 to 4.15) and viral meningitis (AOR 3.23; 95% CI = 2.55 to 4.08) compared to their matched controls. Conclusion There was an increased risk of meningitis following antimicrobial prescription in the previous year. It is possible that this increase was due to an effect of antimicrobials on the microbiome or reflected an increased general susceptibility to infections in these patients. PMID:26965030

Filicide in Austria and Finland--a register-based study on all filicide cases in Austria and Finland 1995-2005.

PubMed

Putkonen, Hanna; Amon, Sabine; Almiron, Maria P; Cederwall, Jenny Yourstone; Eronen, Markku; Klier, Claudia; Kjelsberg, Ellen; Weizmann-Henelius, Ghitta

2009-11-21

Filicide is the tragic crime of murdering one's own child. Previous research has found that the offending parents are commonly depressed and that suicide is often associated as an actual act or an intention. Yet, filicide is an underreported crime and previous studies have been strained with methodological problems. No comprehensive international studies on filicide have been presented in the literature until now. This was a descriptive, comprehensive, register-based study of all filicides in Austria and Finland during 1995-2005. Filicide-suicide cases were also included. Most of the perpetrators were the biological mothers; in Austria 72%, in Finland 52%. Suicide followed filicide either as an attempt or a fulfilled act in 32% and 54% of the cases in Austria and Finland, respectively. Psychotic mood disorders were diagnosed for 10% of the living perpetrators in Austria, and 12% in Finland. Non-psychotic depression was diagnosed in 9% of surviving perpetrators in Austria, 35% in Finland. The data from the two countries demonstrated that filicide is such a multifaceted and rare phenomenon that national data from individual countries seldom offer sufficient scope for its thorough study. Further analyses are needed to produce a complete picture of filicide.

Filicide in Austria and Finland - A register-based study on all filicide cases in Austria and Finland 1995-2005

PubMed Central

2009-01-01

Background Filicide is the tragic crime of murdering one's own child. Previous research has found that the offending parents are commonly depressed and that suicide is often associated as an actual act or an intention. Yet, filicide is an underreported crime and previous studies have been strained with methodological problems. No comprehensive international studies on filicide have been presented in the literature until now. Methods This was a descriptive, comprehensive, register-based study of all filicides in Austria and Finland during 1995-2005. Filicide-suicide cases were also included. Results Most of the perpetrators were the biological mothers; in Austria 72%, in Finland 52%. Suicide followed filicide either as an attempt or a fulfilled act in 32% and 54% of the cases in Austria and Finland, respectively. Psychotic mood disorders were diagnosed for 10% of the living perpetrators in Austria, and 12% in Finland. Non-psychotic depression was diagnosed in 9% of surviving perpetrators in Austria, 35% in Finland. Conclusion The data from the two countries demonstrated that filicide is such a multifaceted and rare phenomenon that national data from individual countries seldom offer sufficient scope for its thorough study. Further analyses are needed to produce a complete picture of filicide. PMID:19930581

Discovery of previously undetected intellectual disability by psychological assessment: a study of consecutively referred child and adolescent psychiatric inpatients.

PubMed

Pogge, David L; Stokes, John; Buccolo, Martin L; Pappalardo, Stephen; Harvey, Philip D

2014-07-01

Intellectual disability is associated with an increased risk of behavioral disturbances and also complicates their treatment. Despite increases in the sophistication of medical detection of early risk for intellectual disability, there is remarkably little data about the detection of intellectual disability in cases referred for psychiatric treatment. In this study, we used a 10-year sample of 23,629 consecutive child and adolescent admissions (ages between 6 and 17) to inpatient psychiatric treatment. Eleven percent (n=2621) of these cases were referred for psychological assessment and were examined with a general measure of intellectual functioning (i.e., WISC-IV). Of these cases, 16% had Full Scale IQs below 70. Of the cases whose therapists then referred them for formal assessment of their adaptive functioning (i.e., ABAS-II) 81% were found to have composite scores below 70 as well. Only one of the cases whose Full Scale IQ was less than 70 had a referral diagnosis of intellectual disability. Cases with previously undetected intellectual disability were found to be significantly more likely to have a diagnosis of a psychotic disorder and less likely to have a diagnosis of mood disorder than cases with IQs over 70. Disruptive behavior disorder diagnoses did not differ as a function of intellectual performance. These data suggest a high rate of undetected intellectual disability in cases with a psychiatric condition serious enough to require hospitalization and this raises the possibility that many such cases may be misdiagnosed, the basis of their problems may be misconceptualized, and they may be receiving treatments that do not take into account their intellectual level. Copyright © 2014 Elsevier Ltd. All rights reserved.

Whole exome sequencing identifies genetic variants in inherited thrombocytopenia with secondary qualitative function defects

PubMed Central

Johnson, Ben; Lowe, Gillian C.; Futterer, Jane; Lordkipanidzé, Marie; MacDonald, David; Simpson, Michael A.; Sanchez-Guiú, Isabel; Drake, Sian; Bem, Danai; Leo, Vincenzo; Fletcher, Sarah J.; Dawood, Ban; Rivera, José; Allsup, David; Biss, Tina; Bolton-Maggs, Paula HB; Collins, Peter; Curry, Nicola; Grimley, Charlotte; James, Beki; Makris, Mike; Motwani, Jayashree; Pavord, Sue; Talks, Katherine; Thachil, Jecko; Wilde, Jonathan; Williams, Mike; Harrison, Paul; Gissen, Paul; Mundell, Stuart; Mumford, Andrew; Daly, Martina E.; Watson, Steve P.; Morgan, Neil V.

2016-01-01

Inherited thrombocytopenias are a heterogeneous group of disorders characterized by abnormally low platelet counts which can be associated with abnormal bleeding. Next-generation sequencing has previously been employed in these disorders for the confirmation of suspected genetic abnormalities, and more recently in the discovery of novel disease-causing genes. However its full potential has not yet been exploited. Over the past 6 years we have sequenced the exomes from 55 patients, including 37 index cases and 18 additional family members, all of whom were recruited to the UK Genotyping and Phenotyping of Platelets study. All patients had inherited or sustained thrombocytopenia of unknown etiology with platelet counts varying from 11×109/L to 186×109/L. Of the 51 patients phenotypically tested, 37 (73%), had an additional secondary qualitative platelet defect. Using whole exome sequencing analysis we have identified “pathogenic” or “likely pathogenic” variants in 46% (17/37) of our index patients with thrombocytopenia. In addition, we report variants of uncertain significance in 12 index cases, including novel candidate genetic variants in previously unreported genes in four index cases. These results demonstrate that whole exome sequencing is an efficient method for elucidating potential pathogenic genetic variants in inherited thrombocytopenia. Whole exome sequencing also has the added benefit of discovering potentially pathogenic genetic variants for further study in novel genes not previously implicated in inherited thrombocytopenia. PMID:27479822

Agreement between the results of meta-analyses from case reports and from clinical studies regarding the efficacy of laronidase therapy in patients with mucopolysaccharidosis type I who initiated enzyme replacement therapy in adult age: An example of case reports meta-analyses as an useful tool for evidence-based medicine in rare diseases.

PubMed

Sampayo-Cordero, Miguel; Miguel-Huguet, Bernat; Pardo-Mateos, Almudena; Moltó-Abad, Marc; Muñoz-Delgado, Cecilia; Pérez-López, Jordi

2018-02-01

Case reports might have a prominent role in the rare diseases field, due to the small number of patients affected by one such disease. A previous systematic review regarding the efficacy of laronidase therapy in patients with mucopolysaccharidosis type I (MPS-I) who initiated enzyme replacement therapy (ERT) in adult age has been published. The review included a meta-analysis of 19 clinical studies and the description of eleven case reports. It was of interest to perform a meta-analysis of those case reports to explore the role of such meta-analyses as a tool for evidence-based medicine in rare diseases. The study included all case reports with standard treatment regimen. Primary analysis was the percentage of case reports showing an improvement in a specific outcome. Only when that percentage was statistically higher than 5%, the improvement was confirmed as such. The outcomes that accomplished this criterion were ranked and compared to the GRADE criteria obtained by those same outcomes in the previous meta-analysis of clinical studies. There were three outcomes that had a significant improvement: Urine glycosaminoglycans, liver volume and 6-minute walking test. Positive and negative predictive values, sensitivity and specificity for the results of the meta-analysis of case reports as compared to that of clinical studies were 100%, 88.9%, 75% and 100%, respectively. Accordingly, absolute (Rho=0.82, 95%CI: 0.47 to 0.95) and relative agreement (Kappa=0.79, 95%CI: 0.593 to 0.99) between the number of case reports with improvement in a specific outcome and the GRADE evidence score for that outcome were good. Sensitivity analysis showed that agreement between the meta-analysis of case reports and that of the clinical studies were good only when using a strong confirmatory strategy for outcome improvement in case reports. We found an agreement between the results of meta-analyses from case reports and from clinical studies in the efficacy of laronidase therapy in patients with MPS-I who initiated ERT in adult age. This agreement suggests that combining case reports quantitatively, rather than analyzing them separately or qualitatively, may improve conclusions in the field of rare diseases. Copyright © 2018 Elsevier Inc. All rights reserved.

A Study of the Effectiveness of the Case Method in Teaching Interpersonal Relations to Psychiatric Aides. League Exchange No. 69.

ERIC Educational Resources Information Center

Swatsley, Dolores E.

In a 950-bed state psychiatric hospital, primarily an admission-and-treatment center, the case method was compared with the lecture-discussion method in teaching a unit on interpersonal relations with psychiatric patients to nurse aides. Two groups of 10 aides each were equated for age, sex, formal education, previous inservice training, and…

Possible risk factors for Down syndrome and sex chromosomal aneuploidy in Mysore, South India

PubMed Central

Malini, Suttur S.; Ramachandra, Nallur B.

2007-01-01

BACKGROUND: Down syndrome (DS) and sex chromosomal aneuploidy (SA) are common chromosomal anomalies causing congenital malformations and mental retardation in humans. The well-established risk factor, advanced maternal age, was not found in many of the DS and SA cases in India, while the other possible risk factors have not been well studied. In view of this, the present study has been made. MATERIALS AND METHODS: During the last 5 years, 150 clinically suspected DS and 25 SA cases were referred to our laboratory for chromosome investigation from major hospitals of Mysore city. Chromosome preparations were made from these patients after informed consent was obtained. Well-spread G-banded metaphase plates were analyzed by automated LEICA KARYO software. Two hundred and 100 randomly selected families belonging to different religions were used as controls for the DS and SA cases, respectively. Statistical analysis was carried out using logistic regression RESULTS: Out of the 150 cases of DS, 122 had free trisomy 21, two were mosaic trisomy 21, and one had translocation. Logistic regression of case-control study of DS children revealed that the odds ratio of uncle-niece marriages, or second cousin marriages, or parents lived in rural region, or exposure of the parents to chemicals, or parents education status, or habits (tobacco/ alcohol used) of father, or mother not undergone prenatal scanning, or mothers with previous abortions were significant when all the variables of that category were used one at a time. Exposure of the parents to chemicals, parents’ educational status, habits (tobacco/alcohol use) of the father, mother not undergone prenatal scanning, and history of previous abortions were significant when all the variables of that category were used one at a time. Similarly, except for consanguinity, history of previous abortions, and mother not undergone prenatal scanning, all other factors showed significant odds ratios in SA cases. CONCLUSION: Besides the known risk factors, consanguinity, region (rural/urban) of residence of parents, exposure of parents to chemicals, educational status of parents, habits of father, prenatal scanning, and reproductive performance of mother are possible risk factors for chromosomal aneuploidy. PMID:21957357

Writing for professional publication. Part 9: using client case studies.

PubMed

Fowler, John

The previous articles in this series of writing for professional publication focused on the preparation you need to do before starting to write an article, the practicalities of writing the abstract, creating interest in the reader's mind, and how an article for publication differs from an academic essay. Recently we considered the importance of selecting the correct journal for submission. In this article, John Fowler, an experienced nursing lecturer and author, discusses how client case studies can be used within your article.

Serum progesterone in pregnant bitches supplemented with progestin because of expected or suspected luteal insufficiency.

PubMed

Günzel-Apel, A; Urhausen, C; Wolf, K; Einspanier, A; Oei, C; Piechotta, M

2012-12-01

Progesterone profiles of individual bitches may vary considerably both between and within individuals during pregnancy and non-pregnancy. Suspected luteal deficiency is commonly purported but is difficult to evaluate in clinical cases when progesterone is supplemented because this masks the underlying hormone changes. Therefore, in this study, suspected cases of luteal deficiency (six pregnancies from five bitches) were supplemented with oral medroxyprogesterone acetate (MPA), allowing measurement of endogenous progesterone using conventional assay. MPA (0.1 mg/kg) treatment commenced between days 30 and 36 after estimated ovulation and was continued for 18-28 days. Endogenous progesterone was measured throughout treatment, and blood was additionally analysed for prolactin (PRL) and relaxin (RLN) as well as MPA. The latter revealed delayed MPA clearance in two bitches, in which Caesarean operation had to be performed because of a low foetal heart rate. In two cases with confirmed basal concentrations of both P(4) and MPA at term, spontaneous parturition occurred. Low endogenous progesterone during pregnancy was not apparent in three bitches that had previously had a short inter-oestrous interval of which two had previously had confirmed short luteal phase. However, in the remaining two cases, there had been previous pregnancy failure, but in only one of these, a premature decrease in endogenous progesterone to <2 ng/ml was detected. The latter had also low concentrations of PRL and RLN. The results of this preliminary clinical study suggest that abnormal progesterone profiles in pregnancy may be uncommon in bitches even when there has been previously documented short inter-oestrous interval. However, luteal deficiency may be suspected in bitches with a history of repeated pregnancy failure or abortion. MPA supplementation appears to be efficacious for management of suspected luteal deficiency and verification of the ovarian dysfunction, but care should be taken regarding the timing of MPA withdrawal and prolongation of pregnancy because of delayed elimination of MPA from blood circulation. © 2012 Blackwell Verlag GmbH.

CHEK2, MGMT, SULT1E1 and SULT1A1 polymorphisms and endometrial cancer risk.

PubMed

O'Mara, Tracy A; Ferguson, Kaltin; Fahey, Paul; Marquart, Louise; Yang, Hannah P; Lissowska, Jolanta; Chanock, Stephen; Garcia-Closas, Montserrat; Thompson, Deborah J; Healey, Catherine S; Dunning, Alison M; Easton, Douglas F; Webb, Penelope M; Spurdle, Amanda B

2011-08-01

Several single nucleotide polymorphisms (SNPs) in candidate genes of DNA repair and hormone pathways have been reported to be associated with endometrial cancer risk. We sought to confirm these associations in two endometrial cancer case-control sample sets and used additional data from an existing genome-wide association study to prioritize an additional SNP for further study. Five SNPs from the CHEK2, MGMT, SULT1E1 and SULT1A1 genes, genotyped in a total of 1597 cases and 1507 controls from two case-control studies, the Australian National Endometrial Cancer Study and the Polish Endometrial Cancer Study, were assessed for association with endometrial cancer risk using logistic regression analysis. Imputed data was drawn for CHEK2 rs8135424 for 666 cases from the Study of Epidemiology and Risk factors in Cancer Heredity study and 5190 controls from the Wellcome Trust Case Control Consortium. We observed no association between SNPs in the MGMT, SULT1E1 and SULT1A1 genes and endometrial cancer risk. The A allele of the rs8135424 CHEK2 SNP was associated with decreased risk of endometrial cancer (adjusted per-allele OR 0.83; 95%CI 0.70-0.98; p = .03) however this finding was opposite to that previously published. Imputed data for CHEK2 rs8135424 supported the direction of effect reported in this study (OR 0.85; 95% CI 0.65-1.10). Previously reported endometrial cancer risk associations with SNPs from in genes involved in estrogen metabolism and DNA repair were not replicated in our larger study population. This study highlights the need for replication of candidate gene SNP studies using large sample groups, to confirm risk associations and better prioritize downstream studies to assess the causal relationship between genetic variants and cancer risk. Our findings suggest that the CHEK2 SNP rs8135424 be prioritized for further study as a genetic factor associated with risk of endometrial cancer.

Evaluation of paradoxical TB–associated IRIS with the use of standardized case definitions for resource limited settings

PubMed Central

Eshun-Wilson, Ingrid; Havers, Fiona; Nachega, Jean B; Prozesky, Hans W; Taljaard, Jantjie J; Zeier, Michele D; Cotton, Mark; Simon, Gary; Soentjens, Patrick

2011-01-01

Objective Standardized case definitions have recently been proposed by the International Network for the Study of HIV-associated IRIS (INSHI) for use in resource-limited settings. We evaluated paradoxical TB-associated IRIS in a large cohort from a TB endemic setting with the use of these case definitions. Design A retrospective cohort analysis. Methods We reviewed records from 1250 South African patients who initiated anti-retroviral therapy (ART) over a five-year period. Results 333 (27%) of the patients in the cohort had prevalent TB at the initiation of ART. Of 54 possible paradoxical TB-associated IRIS cases, 35 fulfilled the INSHI case definitions (11% of TB cases). Conclusions INSHI standardised case definitions were used successfully in identifying paradoxical TB-associated IRIS in this cohort and resulted in a similar proportion of TB IRIS cases (11%) as that reported in previous studies from resource-limited settings (8-13%). This case definition should be evaluated prospectively. PMID:20160249

An alternative approach for socio-hydrology: case study research

NASA Astrophysics Data System (ADS)

Mostert, Erik

2018-01-01

Currently the most popular approach in socio hydrology is to develop coupled human-water models. This article proposes an alternative approach, qualitative case study research, involving a systematic review of (1) the human activities affecting the hydrology in the case, (2) the main human actors, and (3) the main factors influencing the actors and their activities. Moreover, this article presents a case study of the Dommel Basin in Belgium and the Netherlands, and compares this with a coupled model of the Kissimmee Basin in Florida. In both basins a pendulum swing from water resources development and control to protection and restoration can be observed. The Dommel case study moreover points to the importance of institutional and financial arrangements, community values, and broader social, economic, and technical developments. These factors are missing from the Kissimmee model. Generally, case studies can result in a more complete understanding of individual cases than coupled models, and if the cases are selected carefully and compared with previous studies, it is possible to generalize on the basis of them. Case studies also offer more levers for management and facilitate interdisciplinary cooperation. Coupled models, on the other hand, can be used to generate possible explanations of past developments and quantitative scenarios for future developments. The article concludes that, given the limited attention they currently get and their potential benefits, case studies deserve more attention in socio-hydrology.

Genome-wide association analysis identifies 13 new risk loci for schizophrenia.

PubMed

Ripke, Stephan; O'Dushlaine, Colm; Chambert, Kimberly; Moran, Jennifer L; Kähler, Anna K; Akterin, Susanne; Bergen, Sarah E; Collins, Ann L; Crowley, James J; Fromer, Menachem; Kim, Yunjung; Lee, Sang Hong; Magnusson, Patrik K E; Sanchez, Nick; Stahl, Eli A; Williams, Stephanie; Wray, Naomi R; Xia, Kai; Bettella, Francesco; Borglum, Anders D; Bulik-Sullivan, Brendan K; Cormican, Paul; Craddock, Nick; de Leeuw, Christiaan; Durmishi, Naser; Gill, Michael; Golimbet, Vera; Hamshere, Marian L; Holmans, Peter; Hougaard, David M; Kendler, Kenneth S; Lin, Kuang; Morris, Derek W; Mors, Ole; Mortensen, Preben B; Neale, Benjamin M; O'Neill, Francis A; Owen, Michael J; Milovancevic, Milica Pejovic; Posthuma, Danielle; Powell, John; Richards, Alexander L; Riley, Brien P; Ruderfer, Douglas; Rujescu, Dan; Sigurdsson, Engilbert; Silagadze, Teimuraz; Smit, August B; Stefansson, Hreinn; Steinberg, Stacy; Suvisaari, Jaana; Tosato, Sarah; Verhage, Matthijs; Walters, James T; Levinson, Douglas F; Gejman, Pablo V; Kendler, Kenneth S; Laurent, Claudine; Mowry, Bryan J; O'Donovan, Michael C; Owen, Michael J; Pulver, Ann E; Riley, Brien P; Schwab, Sibylle G; Wildenauer, Dieter B; Dudbridge, Frank; Holmans, Peter; Shi, Jianxin; Albus, Margot; Alexander, Madeline; Campion, Dominique; Cohen, David; Dikeos, Dimitris; Duan, Jubao; Eichhammer, Peter; Godard, Stephanie; Hansen, Mark; Lerer, F Bernard; Liang, Kung-Yee; Maier, Wolfgang; Mallet, Jacques; Nertney, Deborah A; Nestadt, Gerald; Norton, Nadine; O'Neill, Francis A; Papadimitriou, George N; Ribble, Robert; Sanders, Alan R; Silverman, Jeremy M; Walsh, Dermot; Williams, Nigel M; Wormley, Brandon; Arranz, Maria J; Bakker, Steven; Bender, Stephan; Bramon, Elvira; Collier, David; Crespo-Facorro, Benedicto; Hall, Jeremy; Iyegbe, Conrad; Jablensky, Assen; Kahn, Rene S; Kalaydjieva, Luba; Lawrie, Stephen; Lewis, Cathryn M; Lin, Kuang; Linszen, Don H; Mata, Ignacio; McIntosh, Andrew; Murray, Robin M; Ophoff, Roel A; Powell, John; Rujescu, Dan; Van Os, Jim; Walshe, Muriel; Weisbrod, Matthias; Wiersma, Durk; Donnelly, Peter; Barroso, Ines; Blackwell, Jenefer M; Bramon, Elvira; Brown, Matthew A; Casas, Juan P; Corvin, Aiden P; Deloukas, Panos; Duncanson, Audrey; Jankowski, Janusz; Markus, Hugh S; Mathew, Christopher G; Palmer, Colin N A; Plomin, Robert; Rautanen, Anna; Sawcer, Stephen J; Trembath, Richard C; Viswanathan, Ananth C; Wood, Nicholas W; Spencer, Chris C A; Band, Gavin; Bellenguez, Céline; Freeman, Colin; Hellenthal, Garrett; Giannoulatou, Eleni; Pirinen, Matti; Pearson, Richard D; Strange, Amy; Su, Zhan; Vukcevic, Damjan; Donnelly, Peter; Langford, Cordelia; Hunt, Sarah E; Edkins, Sarah; Gwilliam, Rhian; Blackburn, Hannah; Bumpstead, Suzannah J; Dronov, Serge; Gillman, Matthew; Gray, Emma; Hammond, Naomi; Jayakumar, Alagurevathi; McCann, Owen T; Liddle, Jennifer; Potter, Simon C; Ravindrarajah, Radhi; Ricketts, Michelle; Tashakkori-Ghanbaria, Avazeh; Waller, Matthew J; Weston, Paul; Widaa, Sara; Whittaker, Pamela; Barroso, Ines; Deloukas, Panos; Mathew, Christopher G; Blackwell, Jenefer M; Brown, Matthew A; Corvin, Aiden P; McCarthy, Mark I; Spencer, Chris C A; Bramon, Elvira; Corvin, Aiden P; O'Donovan, Michael C; Stefansson, Kari; Scolnick, Edward; Purcell, Shaun; McCarroll, Steven A; Sklar, Pamela; Hultman, Christina M; Sullivan, Patrick F

2013-10-01

Schizophrenia is an idiopathic mental disorder with a heritable component and a substantial public health impact. We conducted a multi-stage genome-wide association study (GWAS) for schizophrenia beginning with a Swedish national sample (5,001 cases and 6,243 controls) followed by meta-analysis with previous schizophrenia GWAS (8,832 cases and 12,067 controls) and finally by replication of SNPs in 168 genomic regions in independent samples (7,413 cases, 19,762 controls and 581 parent-offspring trios). We identified 22 loci associated at genome-wide significance; 13 of these are new, and 1 was previously implicated in bipolar disorder. Examination of candidate genes at these loci suggests the involvement of neuronal calcium signaling. We estimate that 8,300 independent, mostly common SNPs (95% credible interval of 6,300-10,200 SNPs) contribute to risk for schizophrenia and that these collectively account for at least 32% of the variance in liability. Common genetic variation has an important role in the etiology of schizophrenia, and larger studies will allow more detailed understanding of this disorder.

Iodine-131 induced hepatotoxicity in previously healthy patients with Grave's disease.

PubMed

Jhummon, Navina Priya; Tohooloo, Bhavna; Qu, Shen

2013-01-01

To describe the association of the rare and serious complication of liver toxicity in previously healthy Grave's disease (GD) patients after the treatment with radioactive iodine (131)I (RAI). We report the clinical, laboratory and pathologic findings of 2 cases of severe liver toxicity associated with the treatment with RAI in previously healthy patients with GD. Clinical examination and laboratory investigations excluded viral hepatitis, autoimmune hepatitis, granulomatous disease, primary biliary disease, extrahepatic biliary obstruction, and heart failure. Case 1: A previously healthy 52-years old man reportedly having a typical GD but following RAI treatment, concomitantly developed severe liver toxicity that required 1 week of treatment in hospital. Case 2: A previously healthy 34-years old woman is reported as having a typical GD but developed jaundice following RAI treatment that required several weeks of in hospital treatment in the hepato-biliary department. In both cases, the liver dysfunction resolved after intensive treatment with hepato-protective agents. In this report the therapeutic considerations as well as the pathogenetic possibilities are reviewed. To the best of our knowledge, this is the first description of the association observed, which is rare but may be severe and should be considered in any case of thyrotoxicosis where a liver dysfunction develops after the treatment with radioactive iodine (131)I.

Incidence of status epilepticus in southern Europe: a population study in the health district of Ferrara, Italy.

PubMed

Govoni, Vittorio; Fallica, Elisa; Monetti, Vincenza Cinzia; Guerzoni, Franco; Faggioli, Raffaella; Casetta, Ilaria; Granieri, Enrico

2008-01-01

The epidemiologic features of status epilepticus (SE) are still in the course of definition. We carried out an intensive survey of multiple sources of case material in the resident population of the health district of Ferrara, Italy, in 2003. Information was collected on age, gender, duration, seizure type and etiology of SE. The age- adjusted annual incidence rate of SE was 27.2/100,000 (95% CI = 19.4-36.9) and it was higher in men (41.7/100,000, 95% CI = 26.9-61.7) than in women (12.3/100,000, 95% CI = 6.9-20.4). The incidence was higher in the elderly (older than 60 years, 39.2/100,000) than in younger adults in the age group 20-59 years (14.7/100,000). The age-specific incidence showed a bimodal distribution peaking in the youngest (0-4 years) and in the oldest age group (75+ years). Cerebrovascular disease was the most frequent etiologic factor (45%). Epilepsy had previously been diagnosed in 40% of the patients. The case fatality was 5%. The study found a higher incidence of SE than that expected on the basis of the previous European studies suggesting that the risk of SE in southern Europe is higher and more similar to that estimated in population studies in the United States. The case fatality was lower than that reported in previous South-European population studies despite the similar clinical features of the patients. Indirect evidence suggests that several factors related to the SE management could have positively influenced the outcome. Copyright 2007 S. Karger AG, Basel.

Risk factors for death from canine parvoviral-related disease in Australia.

PubMed

Ling, Monika; Norris, Jacqueline M; Kelman, Mark; Ward, Michael P

2012-08-17

Canine parvovirus (CPV) is a highly contagious cause of serious and often fatal disease in dogs worldwide despite the availability of safe and efficacious vaccines. Although a number of studies have focussed on identifying risk factors in disease development, risk factors associated with death from CPV are largely unknown. In this study we analysed a total of 1451 CPV cases reported from an Australian surveillance system - using univariate and multivariate techniques - to determine significant risk factors associated with death and euthanasia. A crude case fatality rate of 42.3% was estimated - higher than has been reported previously. We found that 3.3% of CPV cases had a history of vaccination in the previous 12 months, despite having completed the primary puppy vaccination course. The majority (89.5%) of these cases occurred in dogs <12 months of age, indicating failure of the primary vaccination course to provide protective immunity (most likely due to interference of the vaccine antigen with maternal antibodies but other reasons are discussed). Extending the age at which the final puppy vaccination is administered might be one of several strategies to consider. The final multivariate model showed that in non-litter CPV cases, risk of death was significantly associated with season of diagnosis (summer) and pedigree type (hounds and non-sporting dogs). Euthanasia in non-litter CPV cases was significantly associated with season of diagnosis (summer), state of residence (Northern Territory/South Australia/Tasmania combined), age (

Can anaerobes be acid fast? A novel, clinically relevant acid fast anaerobe.

PubMed

Navas, Maria E; Jump, Robin; Canaday, David H; Wnek, Maria D; SenGupta, Dhruba J; McQuiston, John R; Bell, Melissa

2016-08-01

Anaerobic acid fast bacilli (AFB) have not been previously reported in clinical microbiology. This is the second case report of a novel anaerobic AFB causing disease in humans. An anaerobic AFB was isolated from an abdominal wall abscess in a 64-year-old Caucasian diabetic male, who underwent distal pancreatectomy and splenectomy for resection of a pancreatic neuroendocrine tumour. The isolated bacteria were gram-variable and acid-fast, consisting of small irregular rods. The 16S rRNA gene sequence analysis showed that the isolate is a novel organism described in the literature only once before. The organism was studied at the CDC (Centers for Disease Control and Prevention) by the same group that worked with the isolates from the previous report; their findings suggest that the strain belongs to the suborder Corynebacterineae. This is the fifth reported case of an anaerobic AFB involved in clinical disease; its microbiological features and 16S RNA sequence are identical to previously reported cases. Clinical disease with this organism seems to be associated with recent history of surgery and abscess formation in deep soft tissues. Acquisition from surgical material is uncertain but seems unlikely.

Patent nasopalatine ducts: an update of the literature and a series of new cases.

PubMed

von Arx, Th; Schaffner, M; Bornstein, M M

2018-02-01

The objective of this review is to present an update and summary of clinical findings of cases with a patent nasopalatine duct (NPD) reported in the literature from 1881 to 2016. Previous articles and reviews about patent NPDs were studied and copies of all original publications were obtained for data verification. Furthermore, a literature search was conducted. In addition, the study sample was complemented with four cases recently seen in our institution. Ten out of 67 published cases were to be excluded for this analysis due to misinterpretation or misreporting in previous articles. Overall, 57 cases with NPD patency could be analyzed. Males outnumbered females in a ratio of 2:1. The mean age (when this information was available) was 34.1 ± 17.6 years (range 6-69 years). NPDs were located bilaterally (60%), unilaterally (20%) or centrally (20%). Complete or partial patency was reported in 73.9 and 26.1%, respectively. 74.1% of patients presented a variety of clinical signs and symptoms. The ability of the patient to produce a squeaky or whistling sound was the most frequent clinical finding (23.8%). Caution must be exercised when reading review articles about NPD patency since wrong data have been copied in several subsequent publications. Since epidemiological data are missing with regard to patent NPDs, age and gender predilections are not warranted. Bilateral occurrence and full patency were prevailing features in the evaluated case reports of patent NPDs.

Large-scale gene-centric analysis identifies novel variants for coronary artery disease.

PubMed

2011-09-01

Coronary artery disease (CAD) has a significant genetic contribution that is incompletely characterized. To complement genome-wide association (GWA) studies, we conducted a large and systematic candidate gene study of CAD susceptibility, including analysis of many uncommon and functional variants. We examined 49,094 genetic variants in ∼2,100 genes of cardiovascular relevance, using a customised gene array in 15,596 CAD cases and 34,992 controls (11,202 cases and 30,733 controls of European descent; 4,394 cases and 4,259 controls of South Asian origin). We attempted to replicate putative novel associations in an additional 17,121 CAD cases and 40,473 controls. Potential mechanisms through which the novel variants could affect CAD risk were explored through association tests with vascular risk factors and gene expression. We confirmed associations of several previously known CAD susceptibility loci (eg, 9p21.3:p<10(-33); LPA:p<10(-19); 1p13.3:p<10(-17)) as well as three recently discovered loci (COL4A1/COL4A2, ZC3HC1, CYP17A1:p<5×10(-7)). However, we found essentially null results for most previously suggested CAD candidate genes. In our replication study of 24 promising common variants, we identified novel associations of variants in or near LIPA, IL5, TRIB1, and ABCG5/ABCG8, with per-allele odds ratios for CAD risk with each of the novel variants ranging from 1.06-1.09. Associations with variants at LIPA, TRIB1, and ABCG5/ABCG8 were supported by gene expression data or effects on lipid levels. Apart from the previously reported variants in LPA, none of the other ∼4,500 low frequency and functional variants showed a strong effect. Associations in South Asians did not differ appreciably from those in Europeans, except for 9p21.3 (per-allele odds ratio: 1.14 versus 1.27 respectively; P for heterogeneity = 0.003). This large-scale gene-centric analysis has identified several novel genes for CAD that relate to diverse biochemical and cellular functions and clarified the literature with regard to many previously suggested genes.

Roles and Educational Effects of Clinical Case Studies in Home Medical Care.

PubMed

Ohsawa, Tomoji; Shimazoe, Takao

2017-01-01

Due to the progression of aging in Japan, pharmacists need to participate in home medical care. To enable pharmacists with no previous experience to participate in home medical care of patients with various diseases in the home environment, it is necessary to adopt an approach of training them in advance. It is thought useful for such clinical training to include patient case studies, which may facilitate the training of pharmacists for home medical care through simulated experience. "The working group to create home clinical cases for education" was launched by a group of university faculty, who have educational knowledge, and trained pharmacists who work with the patients at home. The home care cases were compiled by the university faculty members and the home care practice pharmacists. Working pharmacists and students at pharmaceutical college studied the same case studies of home medical care, and their self-evaluations were compared. They showed that the students rated themselves higher than the pharmacists. One of the reasons was the systematic education of the case studies. The clinical case studies are a good educational tool to promote home care medicine in pharmacies and university pharmaceutical colleges.

The clinical evaluation of Pterocarpus santalinus Linn. Ointment on lower extremity wounds--a preliminary report.

PubMed

Biswas, Tuhin Kanti; Maity, Lakshmi Narayan; Mukherjee, Biswapati

2004-12-01

Pterocarpus santalinus is described in the Ayurveda for its wide spectrum of medicinal properties including wound healing. Previously the authors reported animal studies that demonstrated that an ointment made from the bark of this tree was effective without any toxic effects. They used the same ointment in 6 cases of lower extremity wounds. Healing was observed in all wounds. The study was not controlled, the findings are presented here as case studies. Further studies are planned to develop a wound healing ointment from a locally available and inexpensive plant.

Association between prostate cancer and urinary calculi: a population-based study.

PubMed

Chung, Shiu-Dong; Liu, Shih-Ping; Lin, Herng-Ching

2013-01-01

Understanding the reasons underlying the emerging trend and the changing demographics of Asian prostate cancer (PC) has become an important field of study. This study set out to explore the possibility that urinary calculi (UC) and PC may share an association by conducting a case-control study on a population-based database in Taiwan. The cases of this study included 2,900 subjects ≥ 40 years-old who had received their first-time diagnosis of PC and 14,500 randomly selected controls without PC. Conditional logistic regressions were employed to explore the association between PC and having been previously diagnosed with UC. We found that prior UC was found among 608 (21.0%) cases and 2,037 (14.1%) controls (p<0.001). Conditional logistic regression analysis revealed that compared to controls, the odds ratio (OR) of prior UC for cases was 1.63 (95% CI = 1.47-1.80). Furthermore, we found that cases were more likely to have been previously diagnosed with kidney calculus (OR = 1.71; 95% CI = 1.42-2.05), bladder calculus (OR = 2.06; 95% CI = 1.32-3.23), unspecified calculus (OR = 1.66; 95% CI = 1.37-2.00), and ≥2 locations of UC (OR = 1.73; 1.47-2.02) than controls. However, there was no significant relationship between PC and prior ureter calculus. We also found that of the patients with UC, there was no significant difference between PC and treatment method. This investigation detected an association between PC and prior UC. These results highlight a potential target population for PC screening.

Exploring Techniques of Developing Writing Skill in IELTS Preparatory Courses: A Data-Driven Study

ERIC Educational Resources Information Center

Ostovar-Namaghi, Seyyed Ali; Safaee, Seyyed Esmail

2017-01-01

Being driven by the hypothetico-deductive mode of inquiry, previous studies have tested the effectiveness of theory-driven interventions under controlled experimental conditions to come up with universally applicable generalizations. To make a case in the opposite direction, this data-driven study aims at uncovering techniques and strategies…

Obesity in Adults with Down Syndrome: A Case-Control Study

ERIC Educational Resources Information Center

Melville, C. A.; Cooper, S.-A.; McGrother, C. W.; Thorp, C. F.; Collacott, R.

2005-01-01

Obesity has a negative impact upon mortality and morbidity. Studies report that obesity is more prevalent in individuals with Down syndrome than individuals with intellectual disabilities (ID) not associated with Down syndrome. However, there have been no studies using a methodology of matched comparison groups and findings from previous studies…

Ecological periodic tables for benthic macrofaunal usage of estuarine habitats : Insights from a case study in Tillamook bay, Oregon, USA

EPA Science Inventory

This study validates the ecological relevance of estuarine habitat types to the benthic macrofaunal community and, together with previous similar studies, suggests they can serve as elements in ecological periodic tables of benthic macrofaunal usage in the bioregion. We compared...

Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

ERIC Educational Resources Information Center

Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

2013-01-01

Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

Pharyngocutaneous fistulae following total laryngectomy comparison between manual and mechanical sutures.

PubMed

Gonçalves, Antonio José; de Souza, J A L; Menezes, M B; Kavabata, N K; Suehara, A B; Lehn, C N

2009-11-01

The extension of the surgery and closure type of the pharynx can be the determinants in the pharyngocutaneous fistula development. The objective of the study is to evaluate the incidence of pharingocutaneous salivary fistulae after total laryngectomies comparing manual and mechanical sutures. The study is designed as non-randomized, prospective clinical study. Sixty patients with squamous cell carcinoma were submitted to total laryngectomies. In 30 cases, the linear stapler (75 mm) closure (surgical technique described in details) and in other 30 cases manual suture was used. The cases of mechanical suture were prospective and consecutive and the cases of manual suture were a review series of patients who underwent a manual suture of pharynx, in the same period of time. The statistical analysis between the two groups concluded that both were comparable. Fistulae incidence was 6.7% (2/30) in the group with the mechanical suture and 36.7% (11/30) in the group with manual suture closure, presenting a significant difference (p = 0.0047). The total laryngectomy with mechanical closure is an easy and fast learning technique, allowing watertight closure of the pharynx with a low risk of contamination of the surgical field. It is an assured method, even in previously irradiated patients, since we respect the limits of its indication regarding the extension of primary tumor that must be confirmed by previous suspension laryngectomy performed in the operating room.

MANAGEMENT OF ENDOMETRIOSIS IN TWO CAPTIVE MANDRILLS (MANDRILLUS SPHINX).

PubMed

Okeson, Danelle M; Higbie, Christine T; Mylniczenko, Natalie D; Haynes, April; Bennett, Suzanne; Klocke, Emily; Carpenter, James W

2016-06-01

Endometriosis has been reported in humans, great apes, and Old World monkeys. Although cases are noted anecdotally in Mandrillus spp., and a previously reported case was noted on postmortem examination, to the authors' knowledge, no previous reports of case management have been published in the peer-reviewed literature. This paper describes the medical and surgical management of endometriosis in two mandrills (Mandrillus sphinx).

Calculation of flexoelectric deformations of finite-size bodies

NASA Astrophysics Data System (ADS)

Yurkov, A. S.

2015-03-01

The previously developed approximate theory of flexoelectric deformations of finite-size bodies has been considered as applied to three special cases: a uniformly polarized ball, a uniformly polarized circular rod, and a uniformly polarized thin circular plate of an isotropic material. For these cases simple algebraic formulas have been derived. In the case of the ball, the solution is compared with the previously obtained exact solution.

Pertussis Prevalence in Korean Adolescents and Adults with Persistent Cough.

PubMed

Lee, Soo Young; Han, Seung Beom; Kang, Jin Han; Kim, Ju Sang

2015-07-01

We investigated the prevalence of pertussis in Korean adolescents and adults with persistent cough. Study population was adolescents (aged 11-20 yr) and adults (≥ 21 yr old) who showed persistent cough of 1-8 weeks' duration. Pertussis was diagnosed by culture, polymerase chain reaction (PCR), and serology. A total of 310 subjects participated in this study, and 76 cases (24.5%) met the criteria for laboratory-confirmed pertussis. The majority of the pertussis cases (66/76) were confirmed by serology, while 3 cases (1.0%) were diagnosed with culture, and 10 cases (3.2%) were detected with PCR. Of the 76 subjects diagnosed with pertussis, 20/86 cases were adolescents and 56/224 cases were adults. Neither adolescents nor adults received adolescent-adult booster against pertussis within the previous 5 yr. Pertussis can be a primary cause of persistent cough in Korean adolescents and adults.

Diff-invariant kinetic terms in arbitrary dimensions

NASA Astrophysics Data System (ADS)

Barbero G., J. Fernando; Villaseñor, Eduardo J.

2002-06-01

We study the physical content of quadratic diff-invariant Lagrangians in arbitrary dimensions by using covariant symplectic techniques. This paper extends previous results in dimension four. We discuss the difference between the even and odd dimensional cases.

Private Sector Involvement in Urban Transportation: Case Studies

DOT National Transportation Integrated Search

1984-07-01

This report describes the development of formulas which predict the severity of accidents at public rail-highway crossings. They employ the previously developed DOT accident prediction formula, U.S. DOT-AAR National Rail-Highway Crossing Inventory, a...

Meta-analysis of 74,046 individuals identifies 11 new susceptibility loci for Alzheimer’s disease

PubMed Central

Lambert, Jean-Charles; Ibrahim-Verbaas, Carla A; Harold, Denise; Naj, Adam C; Sims, Rebecca; Bellenguez, Céline; Jun, Gyungah; DeStefano, Anita L; Bis, Joshua C; Beecham, Gary W; Grenier-Boley, Benjamin; Russo, Giancarlo; Thornton-Wells, Tricia A; Jones, Nicola; Smith, Albert V; Chouraki, Vincent; Thomas, Charlene; Ikram, M Arfan; Zelenika, Diana; Vardarajan, Badri N; Kamatani, Yoichiro; Lin, Chiao-Feng; Gerrish, Amy; Schmidt, Helena; Kunkle, Brian; Dunstan, Melanie L; Ruiz, Agustin; Bihoreau, Marie-Thérèse; Choi, Seung-Hoan; Reitz, Christiane; Pasquier, Florence; Hollingworth, Paul; Ramirez, Alfredo; Hanon, Olivier; Fitzpatrick, Annette L; Buxbaum, Joseph D; Campion, Dominique; Crane, Paul K; Baldwin, Clinton; Becker, Tim; Gudnason, Vilmundur; Cruchaga, Carlos; Craig, David; Amin, Najaf; Berr, Claudine; Lopez, Oscar L; De Jager, Philip L; Deramecourt, Vincent; Johnston, Janet A; Evans, Denis; Lovestone, Simon; Letenneur, Luc; Morón, Francisco J; Rubinsztein, David C; Eiriksdottir, Gudny; Sleegers, Kristel; Goate, Alison M; Fiévet, Nathalie; Huentelman, Matthew J; Gill, Michael; Brown, Kristelle; Kamboh, M Ilyas; Keller, Lina; Barberger-Gateau, Pascale; McGuinness, Bernadette; Larson, Eric B; Green, Robert; Myers, Amanda J; Dufouil, Carole; Todd, Stephen; Wallon, David; Love, Seth; Rogaeva, Ekaterina; Gallacher, John; St George-Hyslop, Peter; Clarimon, Jordi; Lleo, Alberto; Bayer, Anthony; Tsuang, Debby W; Yu, Lei; Tsolaki, Magda; Bossù, Paola; Spalletta, Gianfranco; Proitsi, Petroula; Collinge, John; Sorbi, Sandro; Sanchez-Garcia, Florentino; Fox, Nick C; Hardy, John; Deniz Naranjo, Maria Candida; Bosco, Paolo; Clarke, Robert; Brayne, Carol; Galimberti, Daniela; Mancuso, Michelangelo; Matthews, Fiona; Moebus, Susanne; Mecocci, Patrizia; Zompo, Maria Del; Maier, Wolfgang; Hampel, Harald; Pilotto, Alberto; Bullido, Maria; Panza, Francesco; Caffarra, Paolo; Nacmias, Benedetta; Gilbert, John R; Mayhaus, Manuel; Lannfelt, Lars; Hakonarson, Hakon; Pichler, Sabrina; Carrasquillo, Minerva M; Ingelsson, Martin; Beekly, Duane; Alvarez, Victoria; Zou, Fanggeng; Valladares, Otto; Younkin, Steven G; Coto, Eliecer; Hamilton-Nelson, Kara L; Gu, Wei; Razquin, Cristina; Pastor, Pau; Mateo, Ignacio; Owen, Michael J; Faber, Kelley M; Jonsson, Palmi V; Combarros, Onofre; O’Donovan, Michael C; Cantwell, Laura B; Soininen, Hilkka; Blacker, Deborah; Mead, Simon; Mosley, Thomas H; Bennett, David A; Harris, Tamara B; Fratiglioni, Laura; Holmes, Clive; de Bruijn, Renee F A G; Passmore, Peter; Montine, Thomas J; Bettens, Karolien; Rotter, Jerome I; Brice, Alexis; Morgan, Kevin; Foroud, Tatiana M; Kukull, Walter A; Hannequin, Didier; Powell, John F; Nalls, Michael A; Ritchie, Karen; Lunetta, Kathryn L; Kauwe, John S K; Boerwinkle, Eric; Riemenschneider, Matthias; Boada, Mercè; Hiltunen, Mikko; Martin, Eden R; Schmidt, Reinhold; Rujescu, Dan; Wang, Li-san; Dartigues, Jean-François; Mayeux, Richard; Tzourio, Christophe; Hofman, Albert; Nöthen, Markus M; Graff, Caroline; Psaty, Bruce M; Jones, Lesley; Haines, Jonathan L; Holmans, Peter A; Lathrop, Mark; Pericak-Vance, Margaret A; Launer, Lenore J; Farrer, Lindsay A; van Duijn, Cornelia M; Van Broeckhoven, Christine; Moskvina, Valentina; Seshadri, Sudha; Williams, Julie; Schellenberg, Gerard D; Amouyel, Philippe

2013-01-01

Eleven susceptibility loci for late-onset Alzheimer’s disease (LOAD) were identified by previous studies; however, a large portion of the genetic risk for this disease remains unexplained. We conducted a large, two-stage meta-analysis of genome-wide association studies (GWAS) in individuals of European ancestry. In stage 1, we used genotyped and imputed data (7,055,881 SNPs) to perform meta-analysis on 4 previously published GWAS data sets consisting of 17,008 Alzheimer’s disease cases and 37,154 controls. In stage 2,11,632 SNPs were genotyped and tested for association in an independent set of 8,572 Alzheimer’s disease cases and 11,312 controls. In addition to the APOE locus (encoding apolipoprotein E), 19 loci reached genome-wide significance (P < 5 × 10−8) in the combined stage 1 and stage 2 analysis, of which 11 are newly associated with Alzheimer’s disease. PMID:24162737

Making transit-oriented development work in low-income Latino neighborhoods : a comparative case study of Boyle Heights, Los Angeles and Logan Heights, San Diego.

DOT National Transportation Integrated Search

2016-12-01

This research project is a continuation of a previous NITC-funded study. The first study compared the MacArthur Park TOD in Los Angeles to the : Fruitvale Village TOD in Oakland. The findings from this new study further validate the key findings from...

Criminal investigation of child sexual abuse: a comparison of cases referred to the prosecutor to those not referred.

PubMed

Stroud, D D; Martens, S L; Barker, J

2000-05-01

The present study sought to identify characteristics of child sexual abuse cases which differentiate cases referred for criminal prosecution ("criminal-action") from those not referred ("dropped") by investigators. The study sample consisted of 1043 children who completed a forensic interview for sexual abuse that allegedly occurred at the hands of an adult between January 1, 1993 and December 31, 1996 in Bernalillo County of New Mexico. Data was systematically obtained from forensic interview files and offender records at the local prosecutor's office. Differences between criminal-action and dropped cases were found in relation to the children (age, sex and ethnicity), the alleged offenders (age, sex and relationship to child), and the case characteristics (disclosure and injury to the child). The present study provided insight into the characteristics of a previously ignored population (reported child sexual abuse cases that are not referred for prosecution). Recommendations are made to address the needs of these children and their families.

Gender Differences in Hiccup Patients: Analysis of Published Case Reports and Case-Control Studies.

PubMed

Lee, Gyeong-Won; Kim, Rock Bum; Go, Se Il; Cho, Hyun Seop; Lee, Seung Jun; Hui, David; Bruera, Eduardo; Kang, Jung Hun

2016-02-01

Although sporadic male predominance in hiccup patients has been reported, the association between gender differences and triggering factors has rarely been evaluated in patients with hiccups. The aim of this study was to investigate whether gender differences exist in hiccup patients by analyzing all previously published hiccup literature containing gender and etiology information. Published literature on this topic was identified using a standardized search strategy in the PubMed, SCOPUS, and CINAHL electronic databases. The literature search included studies published from January 1990 to December 2013. Searches were limited to English-language publications. Of 476 identified studies, 318 studies were eligible including eight case-control studies that contained nonhiccup control groups. Triggering factors for hiccups were categorized into two types: central nervous system (CNS) and non-CNS causes. Odds ratios (ORs) were calculated for the eight case-control studies and event rates for the other studies by meta-analysis. In addition, gender differences and mean ages were analyzed for the case studies. Pooled OR was 2.42 (95% confidence interval [CI] 1.40-4.17) with inclination for male predominance. Subgroup analysis by cause showed clear male predominance in the non-CNS type with OR of 11.72 (95% CI 3.16-43.50), whereas indistinct in the CNS type with OR of 1.74 (95% CI 0.95-3.16). Of the remaining 310 studies with 864 patients, previous findings were consistent. Male predominance was consistent in non-CNS (85.1%, 95% CI 78.2-90.2) and unknown origin (82.2%, 95% CI 75.8-87.2) patients, whereas mitigating the sex discrepancy in those with CNS origin (65.8%, 95% CI 53.1-76.5). We demonstrated male predominance in hiccup patients. This gender difference for hiccups was more pronounced in patients with non-CNS causes, whereas indistinct in patients with CNS causes. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Lactobacillus as a rare cause of an infected total knee replacement: a case report

PubMed Central

2009-01-01

Introduction We report a rare case of an infected revision total knee replacement as a result of a Lactobacillus species infection. Lactobacillus infections have been associated with prolonged broad-spectrum antibiotic use. This can have implications in revision surgery, especially when patients have been on previous long-term suppressive antibiotic therapy. Case presentation An 81-year-old British man with a previous history of complex revision knee arthroplasty for infection presented with a hot, swollen knee joint. He had previously been on long-term suppressive antibiotic therapy. Aspiration of the knee joint yielded a culture of Lactobacillus species. Conclusion In patients undergoing revision joint arthroplasty, especially for previous infection, the presence of common and uncommon bacterial species must be excluded and eradicated before further surgical intervention. PMID:19830207

Application of multi-dimensional discrimination diagrams and probability calculations to Paleoproterozoic acid rocks from Brazilian cratons and provinces to infer tectonic settings

NASA Astrophysics Data System (ADS)

Verma, Sanjeet K.; Oliveira, Elson P.

2013-08-01

In present work, we applied two sets of new multi-dimensional geochemical diagrams (Verma et al., 2013) obtained from linear discriminant analysis (LDA) of natural logarithm-transformed ratios of major elements and immobile major and trace elements in acid magmas to decipher plate tectonic settings and corresponding probability estimates for Paleoproterozoic rocks from Amazonian craton, São Francisco craton, São Luís craton, and Borborema province of Brazil. The robustness of LDA minimizes the effects of petrogenetic processes and maximizes the separation among the different tectonic groups. The probability based boundaries further provide a better objective statistical method in comparison to the commonly used subjective method of determining the boundaries by eye judgment. The use of readjusted major element data to 100% on an anhydrous basis from SINCLAS computer program, also helps to minimize the effects of post-emplacement compositional changes and analytical errors on these tectonic discrimination diagrams. Fifteen case studies of acid suites highlighted the application of these diagrams and probability calculations. The first case study on Jamon and Musa granites, Carajás area (Central Amazonian Province, Amazonian craton) shows a collision setting (previously thought anorogenic). A collision setting was clearly inferred for Bom Jardim granite, Xingú area (Central Amazonian Province, Amazonian craton) The third case study on Older São Jorge, Younger São Jorge and Maloquinha granites Tapajós area (Ventuari-Tapajós Province, Amazonian craton) indicated a within-plate setting (previously transitional between volcanic arc and within-plate). We also recognized a within-plate setting for the next three case studies on Aripuanã and Teles Pires granites (SW Amazonian craton), and Pitinga area granites (Mapuera Suite, NW Amazonian craton), which were all previously suggested to have been emplaced in post-collision to within-plate settings. The seventh case studies on Cassiterita-Tabuões, Ritápolis, São Tiago-Rezende Costa (south of São Francisco craton, Minas Gerais) showed a collision setting, which agrees fairly reasonably with a syn-collision tectonic setting indicated in the literature. A within-plate setting is suggested for the Serrinha magmatic suite, Mineiro belt (south of São Francisco craton, Minas Gerais), contrasting markedly with the arc setting suggested in the literature. The ninth case study on Rio Itapicuru granites and Rio Capim dacites (north of São Francisco craton, Serrinha block, Bahia) showed a continental arc setting. The tenth case study indicated within-plate setting for Rio dos Remédios volcanic rocks (São Francisco craton, Bahia), which is compatible with these rocks being the initial, rift-related igneous activity associated with the Chapada Diamantina cratonic cover. The eleventh, twelfth and thirteenth case studies on Bom Jesus-Areal granites, Rio Diamante-Rosilha dacite-rhyolite and Timbozal-Cantão granites (São Luís craton) showed continental arc, within-plate and collision settings, respectively. Finally, the last two case studies, fourteenth and fifteenth showed a collision setting for Caicó Complex and continental arc setting for Algodões (Borborema province).

Bifurcation study of phase oscillator systems with attractive and repulsive interaction.

PubMed

Burylko, Oleksandr; Kazanovich, Yakov; Borisyuk, Roman

2014-08-01

We study a model of globally coupled phase oscillators that contains two groups of oscillators with positive (synchronizing) and negative (desynchronizing) incoming connections for the first and second groups, respectively. This model was previously studied by Hong and Strogatz (the Hong-Strogatz model) in the case of a large number of oscillators. We consider a generalized Hong-Strogatz model with a constant phase shift in coupling. Our approach is based on the study of invariant manifolds and bifurcation analysis of the system. In the case of zero phase shift, various invariant manifolds are analytically described and a new dynamical mode is found. In the case of a nonzero phase shift we obtained a set of bifurcation diagrams for various systems with three or four oscillators. It is shown that in these cases system dynamics can be complex enough and include multistability and chaotic oscillations.

Bifurcation study of phase oscillator systems with attractive and repulsive interaction

NASA Astrophysics Data System (ADS)

Burylko, Oleksandr; Kazanovich, Yakov; Borisyuk, Roman

2014-08-01

We study a model of globally coupled phase oscillators that contains two groups of oscillators with positive (synchronizing) and negative (desynchronizing) incoming connections for the first and second groups, respectively. This model was previously studied by Hong and Strogatz (the Hong-Strogatz model) in the case of a large number of oscillators. We consider a generalized Hong-Strogatz model with a constant phase shift in coupling. Our approach is based on the study of invariant manifolds and bifurcation analysis of the system. In the case of zero phase shift, various invariant manifolds are analytically described and a new dynamical mode is found. In the case of a nonzero phase shift we obtained a set of bifurcation diagrams for various systems with three or four oscillators. It is shown that in these cases system dynamics can be complex enough and include multistability and chaotic oscillations.

Childhood herpes zoster: a clustering of ten cases.

PubMed

Prabhu, Smitha; Sripathi, H; Gupta, Sanjeev; Prabhu, Mukyaprana

2009-01-01

Herpes zoster occurs due to reactivation of the latent varicella zoster virus and is usually a disease of the elderly. Childhood herpes zoster is believed to be rare, though recent studies suggest increasing incidence in children. Here we report ten cases of childhood herpes zoster, seven of which occurred within a short span of six months, at a tertiary care level hospital in Pokhara, Nepal. Only three of the ten children reported previous history of varicella infection and none was immunized against varicella. Though childhood herpes zoster accounted for less than 1% of the total zoster cases in the past, recent reports show an increase in the number of cases in apparently healthy children. So far, no studies have been done linking childhood herpes zoster with HIV, though there are many studies linking it with other immunocompromised conditions.

Oral hygiene, dentition, sexual habits and risk of oral cancer

PubMed Central

Talamini, R; Vaccarella, S; Barbone, F; Tavani, A; Vecchia, C La; Herrero, R; Muñoz, N; Franceschi, S

2000-01-01

In an Italian case-control study of oral cancer, number of missing teeth and other aspects of dental care were similar, but the general condition of the mouth, as indicated by gum bleeding, tartar deposits and mucosal irritation, was worse among oral cancer cases than controls. No differences were detected in sexual practices (including oral sex) and (previous) sexually transmitted infections. © 2000 Cancer Research Campaign PMID:11027440

Phenylpropanolamine and cerebral hemorrhage

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

McDowell, J.R.; LeBlanc, H.J.

1985-05-01

Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures.

UTSW Researchers Identify Potential Therapeutic Targets for High-grade Neuroendocrine Lung Cancers | Office of Cancer Genomics

Cancer.gov

Neuroendocrine specific lung cancers comprise about 10% of non-small cell lung cancer (NSCLC) cases and all small cell lung cancer (SCLC) cases. Studies have previously shown that the transcription factor achaete-scute homolog 1 (ASCL1) is a cancer “lineage” factor required for the development and survival of SCLC, and is highly expressed in neuroendocrine-specific NSCLC (NE-NSCLC).

[Pterygium surgery and fibrin glue: avoiding dehiscence].

PubMed

Pérez-Silguero, D; Díaz-Ginory, A; Santana-Rodríguez, C; Pérez-Silguero, M A

2014-01-01

The purpose of the study is to evaluate those cases of pterygium surgery with fibrin sealant that produced dehiscence of the graft, and then apply and evaluate the efficacy of a different surgical technique in an attempt eliminate this complication in previously identified cases of high risk. The first phase is a retrospective study of 42 cases of pterygium surgery. In the second phase, the variation in the surgical technique was prospectively used in 14 cases of pterygium surgery. Cases of recurrent pterygium, broad pterygium, and complicated surgery were identified as the groups with a risk of suffering dehiscence of the graft. With the variant applied surgery no dehiscence occurred when using the variation in surgical technique, with no added complications. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

A genome-wide association study identifies colorectal cancer susceptibility loci on chromosomes 10p14 and 8q23.3.

PubMed

Tomlinson, Ian P M; Webb, Emily; Carvajal-Carmona, Luis; Broderick, Peter; Howarth, Kimberley; Pittman, Alan M; Spain, Sarah; Lubbe, Steven; Walther, Axel; Sullivan, Kate; Jaeger, Emma; Fielding, Sarah; Rowan, Andrew; Vijayakrishnan, Jayaram; Domingo, Enric; Chandler, Ian; Kemp, Zoe; Qureshi, Mobshra; Farrington, Susan M; Tenesa, Albert; Prendergast, James G D; Barnetson, Rebecca A; Penegar, Steven; Barclay, Ella; Wood, Wendy; Martin, Lynn; Gorman, Maggie; Thomas, Huw; Peto, Julian; Bishop, D Timothy; Gray, Richard; Maher, Eamonn R; Lucassen, Anneke; Kerr, David; Evans, D Gareth R; Schafmayer, Clemens; Buch, Stephan; Völzke, Henry; Hampe, Jochen; Schreiber, Stefan; John, Ulrich; Koessler, Thibaud; Pharoah, Paul; van Wezel, Tom; Morreau, Hans; Wijnen, Juul T; Hopper, John L; Southey, Melissa C; Giles, Graham G; Severi, Gianluca; Castellví-Bel, Sergi; Ruiz-Ponte, Clara; Carracedo, Angel; Castells, Antoni; Försti, Asta; Hemminki, Kari; Vodicka, Pavel; Naccarati, Alessio; Lipton, Lara; Ho, Judy W C; Cheng, K K; Sham, Pak C; Luk, J; Agúndez, Jose A G; Ladero, Jose M; de la Hoya, Miguel; Caldés, Trinidad; Niittymäki, Iina; Tuupanen, Sari; Karhu, Auli; Aaltonen, Lauri; Cazier, Jean-Baptiste; Campbell, Harry; Dunlop, Malcolm G; Houlston, Richard S

2008-05-01

To identify colorectal cancer (CRC) susceptibility alleles, we conducted a genome-wide association study. In phase 1, we genotyped 550,163 tagSNPs in 940 familial colorectal tumor cases (627 CRC, 313 high-risk adenoma) and 965 controls. In phase 2, we genotyped 42,708 selected SNPs in 2,873 CRC cases and 2,871 controls. In phase 3, we evaluated 11 SNPs showing association at P < 10(-4) in a joint analysis of phases 1 and 2 in 4,287 CRC cases and 3,743 controls. Two SNPs were taken forward to phase 4 genotyping (10,731 CRC cases and 10,961 controls from eight centers). In addition to the previously reported 8q24, 15q13 and 18q21 CRC risk loci, we identified two previously unreported associations: rs10795668, located at 10p14 (P = 2.5 x 10(-13) overall; P = 6.9 x 10(-12) replication), and rs16892766, at 8q23.3 (P = 3.3 x 10(-18) overall; P = 9.6 x 10(-17) replication), which tags a plausible causative gene, EIF3H. These data provide further evidence for the 'common-disease common-variant' model of CRC predisposition.

Stressful life events and the risk of initial central nervous system demyelination.

PubMed

Saul, Alice; Ponsonby, Anne-Louise; Lucas, Robyn M; Taylor, Bruce V; Simpson, Steve; Valery, Patricia; Dwyer, Terence; Kilpatrick, Trevor J; Pender, Michael P; van der Mei, Ingrid Af

2017-06-01

There is substantial evidence that stress increases multiple sclerosis disease activity, but limited evidence on its association with the onset of multiple sclerosis. To examine the association between stressful life events and risk of first demyelinating event (FDE). This was a multicentre incident case-control study. Cases ( n = 282 with first diagnosis of central nervous system (CNS) demyelination, including n = 216 with 'classic FDE') were aged 18-59 years. Controls without CNS demyelination ( n = 558) were matched to cases on age, sex and study region. Stressful life events were assessed using a questionnaire based on the Social Readjustment Rating Scale. Those who suffered from a serious illness in the previous 12 months were more likely to have an FDE (odds ratio (OR) = 2.35 (1.36, 4.06), p = 0.002), and when we limited our reference group to those who had no stressful life events, the magnitude of effect became stronger (OR = 5.41 (1.80, 16.28)). The total stress number and stress load were not convincingly associated with the risk of an FDE. Cases were more likely to report a serious illness in the previous 12 months, which could suggest that a non-specific illness provides an additional strain to an already predisposed immune system.

Novel deletions involving the USH2A gene in patients with Usher syndrome and retinitis pigmentosa

PubMed Central

García-García, Gema; Jaijo, Teresa; Aparisi, Maria J.; Larrieu, Lise; Faugère, Valérie; Blanco-Kelly, Fiona; Ayuso, Carmen; Roux, Anne-Francoise; Millán, José M.

2014-01-01

Purpose The aim of the present work was to identify and characterize large rearrangements involving the USH2A gene in patients with Usher syndrome and nonsyndromic retinitis pigmentosa. Methods The multiplex ligation-dependent probe amplification (MLPA) technique combined with a customized array-based comparative genomic hybridization (aCGH) analysis was applied to 40 unrelated patients previously screened for point mutations in the USH2A gene in which none or only one pathologic mutation was identified. Results We detected six large deletions involving USH2A in six out of the 40 cases studied. Three of the patients were homozygous for the deletion, and the remaining three were compound heterozygous with a previously identified USH2A point mutation. In five of these cases, the patients displayed Usher type 2, and the remaining case displayed nonsyndromic retinitis pigmentosa. The exact breakpoint junctions of the deletions found in USH2A in four of these cases were characterized. Conclusions Our study highlights the need to develop improved efficient strategies of mutation screening based upon next generation sequencing (NGS) that reduce cost, time, and complexity and allow simultaneous identification of all types of disease-causing mutations in diagnostic procedures. PMID:25352746

Toward Self-Authoring a Civic Teacher Identity: Service-Learning in Teacher Education

ERIC Educational Resources Information Center

McLean, Lorna R.; Truong-White, Hoa H.

2016-01-01

Previous scholarship has examined how teachers' civic knowledge and conceptions of citizenship influence their goals, pedagogical practices, and confidence in teaching citizenship, but few studies have probed how teacher candidates develop identities as civic educators through community service-learning projects. This case study draws upon Baxter…

National Policy and the Development of Inclusive School Practices: A Case Study

ERIC Educational Resources Information Center

Dyson, Alan; Gallannaugh, Frances

2007-01-01

National education policy in England under New Labour Governments has encompassed both a "standards agenda" and an "inclusion agenda", with schools required to respond to both simultaneously. Some previous studies have seen these agendas as contradictory and have seen schools' efforts to develop inclusive practices as being…

Maintaining Momentum toward Graduation: OER and the Course Throughput Rate

ERIC Educational Resources Information Center

Hilton, John, III; Fischer, Lane; Wiley, David; Williams, Linda

2016-01-01

"Open Educational Resources" (OER) have the potential to replace traditional textbooks in higher education. Previous studies indicate that use of OER results in high student and faculty satisfaction, lower costs, and similar or better educational outcomes. In this case study, we compared students using traditional textbooks with those…

International Students' Networks: A Case Study in a UK University

ERIC Educational Resources Information Center

Taha, Nashrawan; Cox, Andrew

2016-01-01

The great influx of international students into UK universities has led to internationalisation becoming an important issue. Previous studies have focused on the integration of home and international students, illustrating a lack of intercultural interaction. Yet there has been a lack of research investigating international students' networks and…

Project-Based Learning and Student Knowledge Construction during Asynchronous Online Discussion

ERIC Educational Resources Information Center

Koh, Joyce Hwee Ling; Herring, Susan C.; Hew, Khe Foon

2010-01-01

Project-based learning engages students in problem solving through artefact design. However, previous studies of online project-based learning have focused primarily on the dynamics of online collaboration; students' knowledge construction throughout this process has not been examined thoroughly. This case study analyzed the relationship between…

Aphasia and Topic Initiation in Conversation: A Case Study

ERIC Educational Resources Information Center

Barnes, Scott E.; Candlin, Christopher N.; Ferguson, Alison

2013-01-01

Background: Aphasiologists often research, assess and treat linguistic impairment and its consequences for daily life separately. Studies that link the language used by people with aphasia to routine communicative activities may expand the linguistic forms treated as relevant for successful communication by people with aphasia. Previous research…

Three Reflections on Assessing Safety Training Needs: A Case Study

ERIC Educational Resources Information Center

Sleezer, Catherine M.; Kelsey, Kathleen D.; Wood, Thomas E.

2008-01-01

Needs assessment plays an important role in training and human performance improvement efforts, but the literature contains little research on this topic. This study extended previous research on the Performance Analysis for Training (PAT) model of needs assessment by examining its implementation to determine environmental and occupational health…

Entrepreneurship Education and Graduates Unemployment in Oyo State, Nigeria

ERIC Educational Resources Information Center

Emunemu, B. O.; Kasali, O. J.

2014-01-01

This study investigated entrepreneurship and graduates' unemployment in Nigeria.The problem of unemployment in Nigeria has become endemic. There have been reported cases of under-employment, seasonal, casual and full blown unemployment. Previous studies on unemployment and factors influencing it in Nigeria identify poor educational standards,…

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures

PubMed Central

Weidauer, Lee A.; Binkley, Teresa; Vukovich, Matt; Specker, Bonny

2014-01-01

Background: Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. Purpose: To determine factors associated with the development of stress fractures in female athletes. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. Results: No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). Conclusion: A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures. PMID:26535343

The relationship of SSRI and SNRI usage with interstitial lung disease and bronchiectasis in an elderly population: a case–control study

PubMed Central

Rosenberg, Ted; Lattimer, Rory; Montgomery, Patrick; Wiens, Christian; Levy, Liran

2017-01-01

Background The association between interstitial lung disease (ILD) and selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors (SSRI/SNRI) has been previously described in published case reports. However, its prevalence may be more common than expected. We examined the association between SSRI/SNRI usage and presence of ILD and or bronchiectasis (ILD/B) in an elderly population. Methods We conducted a retrospective case series and case–control study involving all 296 eligible elderly patients in one primary care geriatric practice in Victoria, BC, Canada. Cases required the presence of ILD/B on computed tomography (CT) or chest X-ray (CXR). Cases were excluded if they had other causes for ILD/B on CXR or CT such as exposure to known pneumotoxic drugs, metastatic cancer, rheumatoid lung disease, sarcoidosis, previous pulmonary tuberculosis, or pneumoconiosis. Data were abstracted from the patients’ medical record. The exposure variable was standardized cumulative person-month (p-m) dose of SSRI/SNRI. The study was approved by the Clinical Research Ethics Board of University of British Columbia with a waiver of informed consent. Results A total of 12 cases and 273 controls were identified. Their mean ages were 89.0 and 88.7 years, respectively (p=0.862). A total of 10/12 cases and 99/273 controls were exposed to SSRI/SNRI. The odds ratio was 8.79, 95% confidence interval 2.40–32.23 (p=0.001). The median p-m exposure to SSRI/SNRI was 110.0 months for cases and 29.5 for controls (p=0.003). Conclusion SSRIs and SNRIs were significantly associated with the risk of ILD/B in this elderly population. Because of their widespread usage, further studies should be done to validate these findings. Prescribers should cautiously monitor patients for development of insidious pulmonary symptoms when these drugs are used. PMID:29200837

Trace elements in early phase type 2 diabetes mellitus-A population-based study. The HUNT study in Norway.

PubMed

Hansen, Ailin Falkmo; Simić, Anica; Åsvold, Bjørn Olav; Romundstad, Pål Richard; Midthjell, Kristian; Syversen, Tore; Flaten, Trond Peder

2017-03-01

Differences in trace elements levels between individuals with type 2 diabetes and controls have been reported in several studies in various body fluids and tissues, but results have been inconsistent. In order to examine trace element levels in the early phase of type 2 diabetes, we investigated the association between whole blood levels of 26 trace elements and the prevalence of previously undiagnosed, screening-detected type 2 diabetes. The study was conducted as a case-control study nested within the third survey of the population-based Nord-Trøndelag Health Study (HUNT3 Survey). Among participants without previously known diabetes, 128 cases of type 2 diabetes were diagnosed in people with a high diabetes risk score (FINDRISC≥15), and frequency-matched for age and sex with 755 controls. Blood samples were analyzed by high resolution inductively coupled plasma mass spectrometry. Associations between trace element levels and the prevalence of previously undiagnosed type 2 diabetes were evaluated with multivariable conditional logistic regression controlling for age, sex, body mass index, waist-to-hip ratio, education, income, smoking and family history of diabetes. The prevalence of previously undiagnosed type 2 diabetes increased across tertiles/quartiles for cadmium, chromium, iron, nickel, silver and zinc, and decreased with increasing quartiles of bromine (P trend <0.05). After corrections for multiple testing, associations for chromium remained significant (Q trend <0.05), while associations for iron and silver were borderline significant. No associations were found for arsenic, boron, calcium, cesium, copper, gallium, gold, indium, lead, magnesium, manganese, mercury, molybdenum, rubidium, selenium, strontium, tantalum, thallium and tin. Our results suggest a possible role of bromine, cadmium, chromium, iron, nickel, silver and zinc in the development of type 2 diabetes. Copyright © 2016 Elsevier GmbH. All rights reserved.

Towards a conceptual framework demonstrating the effectiveness of audiovisual patient descriptions (patient video cases): a review of the current literature

PubMed Central

2012-01-01

Background Technological advances have enabled the widespread use of video cases via web-streaming and online download as an educational medium. The use of real subjects to demonstrate acute pathology should aid the education of health care professionals. However, the methodology by which this effect may be tested is not clear. Methods We undertook a literature review of major databases, found relevant articles relevant to using patient video cases as educational interventions, extracted the methodologies used and assessed these methods for internal and construct validity. Results A review of 2532 abstracts revealed 23 studies meeting the inclusion criteria and a final review of 18 of relevance. Medical students were the most commonly studied group (10 articles) with a spread of learner satisfaction, knowledge and behaviour tested. Only two of the studies fulfilled defined criteria on achieving internal and construct validity. The heterogeneity of articles meant it was not possible to perform any meta-analysis. Conclusions Previous studies have not well classified which facet of training or educational outcome the study is aiming to explore and had poor internal and construct validity. Future research should aim to validate a particular outcome measure, preferably by reproducing previous work rather than adopting new methods. In particular cognitive processing enhancement, demonstrated in a number of the medical student studies, should be tested at a postgraduate level. PMID:23256787

Tetanus - still a scourge in the 21st century: a paediatric hospital-based study in India.

PubMed

Mishra, Kirtisudha; Basu, Srikanta; Kumar, Dipti; Dutta, Ashok Kumar; Kumar, Praveen; Rath, Bimbadhar

2012-07-01

Tetanus remains endemic in India. A retrospective hospital-based study was conducted to review the profile of all children admitted with diagnosis of tetanus between January 2009 and December 2010. A total of 140 cases of tetanus were admitted; 45 cases of neonatal tetanus (NT) and 77 cases of post-neonatal tetanus (PNT) were studied. Age of presentation of NT was 9.4 ± 1.2 days. Home-delivered children accounted for 86.7% of cases, with 77.8% being attended by untrained birth attendants. Unimmunized mothers accounted for 93.4%. In PNT, otogenic route of infection and trauma were present in 58.4% and 23.3% of cases, respectively. The rate of hospital admission of tetanus remains high. Unlike previously published reports, otogenic route is the most common mode of PNT infection in this study. Improving immunization, increasing deliveries by skilled birth attendants and prompt treatment of suppurative otitis media are the main areas in which public health initiatives need to be focused.

Diagnosis of Placenta Accreta by Uterine Artery Doppler Velocimetry in Patients With Placenta Previa.

PubMed

Cho, Hee Young; Hwang, Han Sung; Jung, Inkyung; Park, Yong Won; Kwon, Ja-Young; Kim, Young Han

2015-09-01

To evaluate the potential value of uterine artery Doppler velocimetry in diagnosing placenta accreta. Clinical records of all deliveries between April 1991 and March 2013 were retrospectively analyzed. Cases of intrauterine growth restriction, pregnancy-induced hypertension, multiple pregnancies, fetal anomalies, chromosomal abnormalities, and maternal medical illnesses such as cardiovascular disease, renal disease, and diabetes mellitus were excluded. A total of 11,210 cases were evaluated, including 403 cases of placenta previa without accreta (placenta previa) and 39 cases of placenta previa with accreta (placenta accreta). All patients underwent uterine artery Doppler velocimetry to measure the mean resistive index and pulsatility index (PI) in the third trimester. The analysis included participant characteristics such as age, parity, abortion history, previous cesarean delivery, gestational age at delivery, neonatal sex, and birth weight. The mean uterine artery PI was significantly lower in the placenta accreta group compared to previa alone (0.51 versus 0.57; P = .002). The odds ratios for placenta accreta were 2.4 for 2 or more previous abortions (P = .011) and 5.3 and 7.0 for 1 and 2 or more previous cesarean deliveries (P = .001 and .005). With an increase in the mean PI by 0.01, the odds ratio for placenta accreta decreased by 0.94 (P < .001). The area under the receive operating characteristic curve was 0.72 for previous cesarean delivery alone, increasing to 0.77 with the combination of the mean PI and previous cesarean delivery (P = .047). This study suggests that the mean PI measured by uterine artery Doppler velocimetry is reduced in patients with placenta accreta compared to those without accreta. The diagnostic accuracy of placenta accreta can be potentially improved if uterine artery Doppler values and the history of cesarean delivery are combined. © 2015 by the American Institute of Ultrasound in Medicine.

A population-based study of first and second-line drug-resistant tuberculosis in a high-burden area of the Mexico/United States border.

PubMed

Becerril-Montes, Pola; Said-Fernández, Salvador; Luna-Herrera, Julieta; Caballero-Olín, Guillermo; Enciso-Moreno, José Antonio; Martínez-Rodríguez, Herminia Guadalupe; Padilla-Rivas, Gerardo; Nancy-Garza-Treviño, Elsa; Molina-Salinas, Gloria María

2013-04-01

The resistance of 139 Mycobacterium tuberculosis (MTB) isolates from the city of Monterrey, Northeast Mexico, to first and second-line anti-TB drugs was analysed. A total of 73 isolates were susceptible and 66 were resistant to anti-TB drugs. Monoresistance to streptomycin, isoniazid (INH) and ethambutol was observed in 29 cases. Resistance to INH was found in 52 cases and in 29 cases INH resistance was combined with resistance to two or three drugs. A total of 24 isolates were multidrug-resistant (MDR) resistant to at least INH and rifampicin and 11 MDR cases were resistant to five drugs. The proportion of MDR-TB among new TB cases in our target population was 0.72% (1/139 cases). The proportion of MDR-TB among previously treated cases was 25.18% (35/139 cases). The 13 polyresistant and 24 MDR isolates were assayed against the following seven second-line drugs: amikacin (AMK), kanamycin (KAN), capreomycin (CAP), clofazimine (CLF), ethionamide (ETH), ofloxacin (OFL) and cycloserine (CLS). Resistance to CLF, OFL or CLS was not observed. Resistance was detected to ETH (10.80%) and to AMK (2.70%), KAN (2.70%) and CAP (2.70%). One isolate of MDR with primary resistance was also resistant to three second-line drugs. Monterrey has a high prevalence of MDR-TB among previously treated cases and extensively drug-resistant-MTB strains may soon appear.

A population-based study of first and second-line drug-resistant tuberculosis in a high-burden area of the Mexico/United States border

PubMed Central

Becerril-Montes, Pola; Said-Fernández, Salvador; Luna-Herrera, Julieta; Caballero-Olín, Guillermo; Enciso-Moreno, José Antonio; Martínez-Rodríguez, Herminia Guadalupe; Padilla-Rivas, Gerardo; Nancy-Garza-Treviño, Elsa; Molina-Salinas, Gloria María

2013-01-01

The resistance of 139 Mycobacterium tuberculosis (MTB) isolates from the city of Monterrey, Northeast Mexico, to first and second-line anti-TB drugs was analysed. A total of 73 isolates were susceptible and 66 were resistant to anti-TB drugs. Monoresistance to streptomycin, isoniazid (INH) and ethambutol was observed in 29 cases. Resistance to INH was found in 52 cases and in 29 cases INH resistance was combined with resistance to two or three drugs. A total of 24 isolates were multidrug-resistant (MDR) resistant to at least INH and rifampicin and 11 MDR cases were resistant to five drugs. The proportion of MDR-TB among new TB cases in our target population was 0.72% (1/139 cases). The proportion of MDR-TB among previously treated cases was 25.18% (35/139 cases). The 13 polyresistant and 24 MDR isolates were assayed against the following seven second-line drugs: amikacin (AMK), kanamycin (KAN), capreomycin (CAP), clofazimine (CLF), ethionamide (ETH), ofloxacin (OFL) and cycloserine (CLS). Resistance to CLF, OFL or CLS was not observed. Resistance was detected to ETH (10.80%) and to AMK (2.70%), KAN (2.70%) and CAP (2.70%). One isolate of MDR with primary resistance was also resistant to three second-line drugs. Monterrey has a high prevalence of MDR-TB among previously treated cases and extensively drug-resistant-MTB strains may soon appear. PMID:23579794

Mesothelioma in the Quebec chrysotile mining region

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

Case, B.W.; Armstrong, B.; McDonald, J.C.

Previous studies of incidence of mesothelioma and lung tissue burden in workers and nonworkers in the Quebec chrysotile mining region showed that mesothelioma incidence is very slightly increased in the mining area, and that tremolite, or even commercial amphiboles, are responsible (and chrysotile is not). Recently, one of us (BC) noted an increase in the numbers of cases of mesothelioma coming to autopsy in the mining region. There were 19 cases, all confirmed histologically, since 1982, vs. 6 that we know of in the previous 10 y. Eighteen were occupationally exposed; one was the wife of chrysotile miner/miller. We examinedmore » lung tissue from 9 cases matched to controls of the same sex and age, dying in the same years in the same hospitals, without evidence of malignant disease. We found an excess in cases of typical asbestos bodies; tremolite fibers; and total amphiboles. In univariate linear relative risk analysis, both longer (>8 {mu}m) and shorter fibers are significant. Multivariate analysis indicates that while adjustment of chrysotile lung content for tremolite content eliminates any statistical effect of chrysotile, the reverse comparison retains significance.« less

Inadvertent Evisceration of Eyes Containing Uveal Melanoma

PubMed Central

Eagle, Ralph C.; Grossniklaus, Hans E.; Syed, Nasreen; Hogan, R. Nick; Lloyd, William C.; Folberg, Robert

2010-01-01

Objectives To report an important complication of ocular evisceration therapy for blind, painful eyes that has been unreported in the literature, and to stress the need for careful preoperative evaluation to exclude occult neoplasms prior to therapy. Design Multicenter, retrospective, nonrandomized clinicopathological case series of patients found to have previously unsuspected uveal malignant melanoma during histopathological examination of blind, painful eyes treated by evisceration. Results Histopathological examination of evisceration specimens disclosed previously unsuspected uveal melanoma in 7 patients who were treated for blind, painful eyes. Inflammation caused by necrosis of the tumor and other ocular tissues led to misdiagnosis as endophthalmitis, orbital cellulitis, or idiopathic orbital inflammation in several cases. Preoperative imaging was not performed in 3 cases and failed to detect tumors in the remaining 4 cases. Failure of necrotic tumors to enhance contributed to misdiagnosis. Conclusions The presence of a malignant intraocular neoplasm should be excluded prior to evisceration of any blind eye or blind, painful eye, particularly with opaque media. Necrosis-related inflammation can confound the clinical diagnosis of occult lesions, as can failure of necrotic tumors to enhance on imaging studies. PMID:19204229

Statin-Associated Polymyalgia Rheumatica. An Analysis Using WHO Global Individual Case Safety Database: A Case/Non-Case Approach

PubMed Central

de Jong, Hilda J. I.; Saldi, Siti R. F.; Klungel, Olaf H.; Vandebriel, Rob J.; Souverein, Patrick C.; Meyboom, Ronald H. B.; Passier, J. L. M. (Anneke); van Loveren, Henk; Tervaert, Jan Willem Cohen

2012-01-01

Objective To assess whether there is an association between statin use and the occurrence of polymyalgia rheumatic (PMR) in the spontaneous reporting database of the World Health Organisation (WHO). Methods We conducted a case/non-case study based on individual case safety reports (ICSR) in the WHO global ICSR database (VigiBase). Case reports containing the adverse event term polymyalgia rheumatica (WHOART or MedDRA Preferred Term) were defined as cases. Non-cases were all case reports containing other adverse event terms. Each case was matched to five non-cases by age, gender, and time of reporting. Case reports regarding a statin as suspected or concomitant drug were identified using the Anatomical Therapeutic Chemical (ATC) classification. Multivariate logistic regression was used to calculate reporting odds ratios (RORs) with 95% confidence intervals (CI). Results We identified 327 reports of PMR as cases and 1635 reports of other ADRs as non-cases. Among cases, statins were more frequently reported as suspected agent (29.4%) compared to non-cases (2.9%). After adjustment for several covariates, statins were significantly associated with reports of PMR (ROR 14.21; 95% CI 9.89–20.85). Conclusion The results of this study lends support to previous anecdotal case reports in the literature suggesting that the use of a statin may be associated with the occurrence of PMR. Further studies are needed to study the strength of the association in more detail and to elucidate the underlying mechanism. PMID:22844450

Vaginal birth after one previous caesarean section in a tertiary institution in Nigeria.

PubMed

Aisien, A O; Oronsaye, A U

2004-11-01

Vaginal birth after one previous lower segment caesarean section represents one of the most significant and challenging issues in obstetric practice. A 5-year retrospective study was carried out at the University of Benin Teaching Hospital between January 1999 and December 2003, to determine the incidence, the maternal and fetal outcome following vaginal delivery after one previous caesarean section with a view to evaluating its safety and efficacy. There were 5234 deliveries, with 395 cases of one previous caesarean section, giving an incidence of 7.5%. The incidences of emergency caesarean section, elective caesarean section and spontaneous vaginal delivery following trial of vaginal delivery were 34.7%, 9.4% and 48.1%, respectively. During the study period there were 1317 cases of caesarean section, giving an incidence of 25.2% caesarean section rate. The incidence of one previous section among all caesarean section births was 30%. The major morbidity following vaginal delivery was uterine rupture with an incidence of 1.5% and hysterectomy of 0.8%. Three of the uterine ruptures occurred before admission because the patients laboured at home. One maternal death occurred as a result of uterine rupture and postpartum haemorrhage, giving a maternal mortality ratio of 19/100,000 and a case fatality rate of 0.3%. The corrected perinatal mortality rate was 15.2/1000, mainly from obstructed labour, abruptio placenta and fetal distress. Both maternal and fetal mortalities from vaginal birth after one previous section were significantly less than the respective overall maternal and fetal mortality from the institution. The 1-minute apgar score of babies delivered by elective section was significantly (P < 0.001) higher than the apgar score of babies delivered by emergency section and vaginally. There was only one patient with wound dehiscence at elective section without associated perinatal death. Vaginal delivery following caesarean section is relatively safe. However, women in developing countries will continue to require counselling to counter the myths of aversion to operative delivery even at the expense of losing their lives. Our hospitals should have adequate monitoring equipment for high-risk pregnancies so that patients and their babies can be assured of survival.

Association between chronic kidney disease and urinary calculus by stone location: a population-based study.

PubMed

Keller, Joseph J; Chen, Yi-Kuang; Lin, Herng-Ching

2012-12-01

Study Type--Disease prevalence study (cohort design) Level of Evidence 2a. What's known on the subject? and What does the study add? Several studies have estimated the potential association of urinary calculus (UC) with chronic kidney disease (CKD). However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system. We found that patients with CKD were consistently more likely than comparison subjects to have been previously diagnosed with kidney calculus (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.95-2.27), ureter calculus (OR 1.68, 95% CI 1.51-1.85), bladder calculus (OR 1.49, 95% CI 1.13-1.98), and unspecified calculus (OR 1.89, 95% CI 1.74-2.06). We concluded that there was an association between CKD and UC regardless of stone location. • To explore the association of chronic kidney disease (CKD) with prior kidney calculus, ureter calculus, and bladder calculus using a population-based dataset in Taiwan. Several studies have estimated the potential association of urinary calculus (UC) with CKD. However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system. • We identified 21,474 patients who received their first-time diagnosis of CKD between 2001 and 2009. • The 21,474 controls were frequency-matched with cases for sex, age group, and index year. • We used conditional logistic regression analyses to compute the odds ratio (OR) and corresponding 95% confidence interval (CI) as an estimation of association between CKD and having been previously diagnosed with UC. • The results show that compared with controls, the OR of prior UC for cases was 1.91 (95% CI 1.81-2.01, P < 0.001) after adjusting for potential confounders. • Furthermore, cases were consistently more likely than controls to have been previously diagnosed with kidney calculus (OR 2.10, 95% CI 1.95-2.27), ureter calculus (OR 1.68, 95% CI 1.51-1.85), bladder calculus (OR 1.49, 95% CI 1.13-1.98), and unspecified UC (OR 1.89, 95% CI 1.74-2.06). • We concluded that there was an association between ckd and UC regardless of stone location. © 2012 BJU INTERNATIONAL.

[Left-sided endocarditis due to gram-negative bacilli: epidemiology and clinical characteristics].

PubMed

Noureddine, Mariam; de la Torre, Javier; Ivanova, Radka; Martínez, Francisco José; Lomas, Jose María; Plata, Antonio; Gálvez, Juan; Reguera, Jose María; Ruiz, Josefa; Hidalgo, Carmen; Luque, Rafael; García-López, María Victoria; de Alarcón, Arístides

2011-04-01

The aim of this study is to describe the epidemiological, clinical characteristics, and outcome of patients with left-side endocarditis caused by gram-negative bacteria. Prospective multicenter study of left-sided infective endocarditis reported in the Andalusian Cohort for the Study of Cardiovascular Infections between 1984 and 2008. Among the 961 endocarditis, 24 (2.5%) were caused by gram-negative bacilli. The most common pathogens were Escherichia coli, Pseudomonas aeruginosa and Salmonella enterica. Native valves (85.7%) were mainly affected, most of them with previous valve damage (57%). Comorbidity was greater (90% vs 39%; P=.05) than in endocarditis due to other microorganism, the most frequent being, diabetes, hepatic cirrhosis and neoplasm. A previous manipulation was found in 47.6% of the cases, and 37% were considered hospital-acquired. Renal failure (41%), central nervous system involvement (33%) and ventricular dysfunction (45%) were the most frequent complications. Five cases (21%) required cardiac surgery, mostly due to ventricular dysfunction. More than 50% of cases were treated with aminoglycosides, but this did not lead to a better outcome or prognosis. Mortality (10 patients) was higher than that reported with other microorganisms (41% vs 35%; P=.05). Left-sided endocarditis due to gram-negative bacilli is a rare disease, which affects patients with major morbidities and often with a previous history of hospital manipulations. Cardiac, neurological and renal complications are frequent and associated with a high mortality. The association of aminoglycosides in the antimicrobial treatment did not involve a better outcome or prognosis. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Pap-tests with non-hyperchromatic dyskariosis are often associated with squamous intraepithelial lesions of the cervix uteri with eosinophilic features.

PubMed

Bellisano, Giulia; Ambrosini-Spaltro, Andrea; Faa, Gavino; Ravarino, Alberto; Piccin, Andrea; Peer, Irmgard; Kasal, Armin; Vittadello, Fabio; Negri, Giovanni

2016-10-01

Squamous intraepithelial lesions of the cervix uteri with eosinophilic features (eosinophilic dysplasia, ED) are a peculiar type of dysplasia with metaplastic phenotype which was described in histological specimens. The cytological features of these lesions have not been studied yet. Histological samples from 66 women with features of ED and positive p16(INK4a) staining were included in the study. Within the previous year, all women had at least one pap-test, whose features were recorded and compared with 31 control samples with high-grade dysplasia of usual type. The previous pap-test showed high-grade dysplastic cells with non-hyperchromatic nuclei in 56/66 (84.8%) cases and metaplastic features in 60/66 (90.9%) cases. Conversely, the dysplastic cells of the usual lesions showed non-hyperchromatic nuclei in 6/31 (19.4%) and metaplastic features in 4/31 (12.9%) cases. Statistical analysis showed significant differences in distribution of the non-hyperchromatic nuclei (P < 0.001), metaplastic features (P < 0.001), presence of both non-hyperchromatic nuclei and metaplastic features (P < 0.001) and usual dysplastic features (P < 0.001) among the study and control groups. A high-grade squamous intraepithelial lesion with non-hyperchromatic nuclei or metaplastic features is often found in the pap-test previous to the histological diagnosis of ED and may represent the cytologic correlate of this particular type of dysplasia. Diagn. Cytopathol. 2016;44:783-786. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A case-control study on the association between bladder cancer and prior bladder calculus.

PubMed

Chung, Shiu-Dong; Tsai, Ming-Chieh; Lin, Ching-Chun; Lin, Herng-Ching

2013-03-15

Bladder calculus is associated with chronic irritation and inflammation. As there is substantial documentation that inflammation can play a direct role in carcinogenesis, to date the relationship between stone formation and bladder cancer (BC) remains unclear. This study aimed to examine the association between BC and prior bladder calculus using a population-based dataset. This case-control study included 2,086 cases who had received their first-time diagnosis of BC between 2001 and 2009 and 10,430 randomly selected controls without BC. Conditional logistic regressions were employed to explore the association between BC and having been previously diagnosed with bladder calculus. Of the sampled subjects, bladder calculus was found in 71 (3.4%) cases and 105 (1.1%) controls. Conditional logistic regression analysis revealed that the odds ratio (OR) of having been diagnosed with bladder calculus before the index date for cases was 3.42 (95% CI = 2.48-4.72) when compared with controls after adjusting for monthly income, geographic region, hypertension, diabetes, coronary heart disease, and renal disease, tobacco use disorder, obesity, alcohol abuse, and schistosomiasis, bladder outlet obstruction, and urinary tract infection. We further analyzed according to sex and found that among males, the OR of having been previously diagnosed with bladder calculus for cases was 3.45 (95% CI = 2.39-4.99) that of controls. Among females, the OR was 3.05 (95% CI = 1.53-6.08) that of controls. These results add to the evidence surrounding the conflicting reports regarding the association between BC and prior bladder calculus and highlight a potential target population for bladder cancer screening.

Cumulative exposure to biologics and risk of cancer in psoriasis patients: A meta-analysis of Psonet studies from Israel, Italy, Spain, United Kingdom and Republic of Ireland.

PubMed

Garcia-Doval, I; Descalzo, M A; Mason, K J; Cohen, A D; Ormerod, A D; Gómez-García, F J; Cazzaniga, S; Feldhamer, I; Ali, H; Herrera-Acosta, E; Griffiths, C E M; Stern, R; Naldi, L

2018-05-03

Cancer risk following long-term exposure to systemic immunomodulatory therapies in psoriasis patients is possible. To assess a dose-response relationship between cumulative length of exposure to biologic therapy and risk of cancer. Four national studies (a healthcare database from Israel, and prospective cohorts form Italy, Spain and UK/ROI) collaborating through Psonet (European Registry of Psoriasis) participated in these nested case-control studies, including nearly 60.000 person-years of observation. Cases were patients who developed an incident cancer. Patients with previous cancers and benign or in-situ tumours were excluded. Four cancer-free controls were matched to each case on year of birth, gender, geographic area, and registration year. Follow-up for controls was censored at the date of cancer diagnosis for the matched case. Conditional logistic regression was performed by each registry. Results were pooled using random effects meta-analysis. 728 cases and 2671 controls were identified. After matching, differences between cases and controls were present for the Charlson comorbidity index in all three registries, and in the prevalence of previous exposure to psoralen-ultraviolet-A (PUVA) and smoking (BADBIR only). The risk of first cancers was not significantly associated with cumulative exposure to biologics (adjusted odds ratio per year of exposure 1.02; 95%CI 0.92, 1.13). Results were similar if squamous and basal cell carcinomas were included in the outcome. Cumulative length of exposure to biologic therapies of psoriasis patients in real-world clinical practice does not appear to be linked to a higher risk of cancer after several years of use. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Driving behaviors and on-duty road accidents: a French case-control study.

PubMed

Fort, Emmanuel; Chiron, Mireille; Davezies, Philippe; Bergeret, Alain; Charbotel, Barbara

2013-01-01

A case-control study was carried out to identify driving behaviors associated with the risk of on-duty road accident and to compare driving behaviors according to the type of journey (on duty, commuting, and private) for on-duty road accident victims. Cases were recruited from the Rhône Road Trauma Registry between January 2004 and October 2005 and were on duty at the time of the accident. Control subjects were recruited from the electoral rolls of the case subjects' constituencies of residence. Cases' and controls' driving behavior data were collected by self-administered questionnaire. A logistic regression was performed to identify behavioral risk factors for on-duty road accidents, taking into account age, sex, place of residence, road accident risk exposure, socio-occupational category, and type of road user. A second analysis focused specifically on the case subjects, comparing their self-assessed usual behaviors according to the type of journey. Significant factors for multivariate analysis of on-duty road accidents were female gender, history of on-duty road accidents during the previous 10 years, severe time pressure at work, and driving a vehicle not belonging to the driver. On-duty road accident victims reported behavioral risk factors more frequently in relation to driving for work than driving for private reasons or commuting: nonsystematic seat belt use, cell phone use at least once daily while driving, and history of accidents with injury during the previous 10 years. This study provides knowledge on behavioral risk factors for on-duty road accidents and differences in behavior according to the type of journey for subjects who have been on-duty road accident victims. These results will be useful for the design of on-duty road risk prevention.

How Can Flood Affect the Real Estate Market?

NASA Astrophysics Data System (ADS)

Trejo Rangel, Miguel Angel; Sapač, Klaudija; Brilly, Mitja

2016-04-01

The purpose of this paper is to examine how actual flood events can affect the real estate for different case studies. Therefore, we have analysed the impact for two cases, the first is the flood event which occurred in 2013 in Boulder, Colorado, United States, city that is located in the eastern part of the Rocky Mountains, and the second event was the flood which occurred in 2010 the city of Ljubljana, capital and largest city of Slovenia, that is located between the Alpine and Balkan mountains.. The methodology that was used is comparison of mean prices of real estate, taking into account the flood events which have been chosen in accordance with the available data and previous studies, furthermore for the case study of Ljubljana, Slovenia questionnaires were sent through one civil organization which is actively working in the area (Civil Initiative for Flood Security SW part of Ljubljana). Analysed sales prices during the period 2009-2014 in the case study of Boulder, Colorado, United States showed that the flood event in 2013 did not significantly affect the mean price of real estate within the flooded area, besides prices inside the flood plain tended to stay above the prices outside the floodplain. Nevertheless, we have found that the flood event affected the real estate sector in terms of number of sales, being that after the flood event in 2013 sales decreased 52% regarding the previous years. For the case study of Ljubljana, Slovenia the results were unexpected somehow. In fact we expected that the prices of real estate located within the flooded areas, on average, would be lower than those located outside the flooded areas, and that was what shown in the results, which is actually opposite to what occurred for the case study of Boulder City. However the research showed that the flood event in 2010 did not affect the change in prices of real estate within the flooded areas and the trend was considerable similar to previous years the flood event in 2010, where property prices within the flooded area were during the whole period for approximately 10.6% lower than those outside the flooded area. This shows that there is a constant influence of the flood-prone area which is also confirm by the respondents of the questionnaires which were sent, however they tended to underestimate even more the actual value of the properties inside this area almost half the price of a similar property outside the flood-prone area.

Self-cannibalism (autosarcophagy) in psychosis: a case report.

PubMed

Libbon, Randi; Hamalian, Gareen; Yager, Joel

2015-02-01

Only nine previous cases of self- or auto-cannibalism (autosarcophagy) have previously been reported in the literature. Here, we report a 29-year-old man with psychosis and a history of polysubstance use who presented after his second attempt to self-cannibalize. This case raises questions about the underlying causes and dynamics of self-cannibalism in psychiatric illness and its relation to other types of self-harm behavior.

Undiagnosed pulmonary tuberculosis among prisoners in Malaysia: an overlooked risk for tuberculosis in the community.

PubMed

Al-Darraji, Haider Abdulrazzaq Abed; Altice, Frederick L; Kamarulzaman, Adeeba

2016-08-01

To investigate the prevalence of previously undiagnosed active tuberculosis (TB) cases among prisoners in Malaysia's largest prison using an intensified TB case-finding strategy. From October 2012 to May 2013, prisoners housed in two distinct units (HIV-negative and HIV-positive) were approached to participate in the TB screening study. Consenting prisoners submitted two sputum samples that were examined using GeneXpert MTB/RIF, smear microscopy and liquid culture. Socio-demographic and clinical information was collected and correlates of active TB, defined as having either a positive GeneXpert MTB/RIF or culture results, were assessed using regression analyses. Among the total of 559 prisoners, 442 (79.1%) had complete data; 28.7% were HIV-infected, 80.8% were men and the average age was 36.4 (SD 9.8) years. Overall, 34 (7.7%) had previously undiagnosed active TB, of whom 64.7% were unable to complete their TB treatment in prison due to insufficient time (<6 months) remaining in prison. Previously undiagnosed active TB was independently associated with older age groups (AOR 11.44 and 6.06 for age ≥ 50 and age 40-49 years, respectively) and with higher levels of immunosuppression (CD4 < 200 cells/ml) in HIV-infected prisoners (AOR 3.07, 95% CI 1.03-9.17). The high prevalence of previously undiagnosed active TB in this prison highlights the inadequate performance of internationally recommended case-finding strategies and suggests that passive case-finding policies should be abandoned, especially in prison settings where HIV infection is prevalent. Moreover, partnerships between criminal justice and public health treatment systems are crucial to continue TB treatment after release. © 2016 John Wiley & Sons Ltd.

Effects of endoscopic sphincterotomy on biliary epithelium: A case-control study

PubMed Central

Kalaitzis, John; Vezakis, Antonios; Fragulidis, George; Anagnostopoulou, Irene; Rizos, Spyros; Papalambros, Efstathios; Polydorou, Andreas

2012-01-01

AIM: To study the long-term effects of endoscopic sphincterotomy on biliary epithelium. METHODS: This is a prospective case-control study. A total of 25 patients with a median age of 71 years (range 49-89 years) and prior endoscopic sphincterotomy (ES) for benign disease formed the first group. The median time from ES was 42 mo (range 8-144 mo). Another 25 patients with a median age of 76 years (range 44-94 mo) and similar characteristics who underwent current endoscopic retrograde cholangiopancreatography (ERCP) and ES for benign disease formed the second group (control group). Brush cytology of the biliary tree with p53 immunocytology was performed in all patients of both groups. ERCPs and recruitment were conducted at the Endoscopic Unit of Aretaieion University Hospital and Tzaneio Hospital, Athens, from October 2006 to June 2010. RESULTS: No cases were positive or suspicious for malignancy. Epithelial atypia was higher in the first group (32% vs 8% in the second group, P = 0.034). Acute cholangitis and previous biliary operation rates were also higher in the first group (acute cholangitis, 60% vs 24% in the second group, P = 0.01; previous biliary operation, 76% vs 24% in the second group, P = 0.001). Subgroup analysis showed that previous ES was the main causal factor for atypia, which was not related to the time interval from the ES (P = 0.407). Two patients (8%) with atypia in the first group were p53-positive. CONCLUSION: ES causes biliary epithelial atypia that represents mostly reactive/proliferative rather than premalignant changes. The role of p53 immunoreactivity in biliary atypia needs to be further studied. PMID:22371639

Factors associated with Clostridium difficile infection: A nested case-control study in a three year prospective cohort.

PubMed

Khanafer, Nagham; Vanhems, Philippe; Barbut, Frédéric; Luxemburger, Christine

2017-04-01

Clostridium difficile infection (CDI) is a serious medical condition that is associated with substantial morbidity and mortality. Identification of risk factors associated with CDI and prompt recognition of patients at risk is key to successfully preventing CDI. A 3-year prospective, observational, cohort study was conducted in a French university hospital and a nested case-control study was performed to identify risk factors for CDI. Inpatients aged 18 years or older, suffering from diarrhea suspected to be related to CDI, were asked to participate. A total of 945 patients were included, of which 233 cases had a confirmed CDI. CDI infection was more common in men (58.4%) (P = 0.04) compared with patients with diarrhea not related to C. difficile. Previous hospitalization (P < 0.001), prior treatment with antibiotics (P = 0.001) or antiperistaltics (P = 0.002), liver disease (P = 0.003), malnutrition (P < 0.001), and previous CDI (P < 0.001) were significantly more common in patients with CDI. Multivariate logistic regression analysis showed that exposure to antibiotics in the last 60 days (especially third generation cephalosporins and penicillins with β-lactamase inhibitor), chronic renal or liver disease, malnutrition or previous CDI, were associated with an independent high risk of CDI. Age was not related with CDI. This study showed that antibiotics and some comorbid conditions were predictors of CDI. Patients at high risk of acquiring CDI at the time of admission may benefit from careful monitoring of antibiotic prescriptions and early attention to infection control issues. In future, these "high-risk" patients may benefit from novel agents being developed to prevent CDI. Copyright © 2017 Elsevier Ltd. All rights reserved.

Validation of satellite-based CI detection of convective storms via backward trajectories

NASA Astrophysics Data System (ADS)

Dietzsch, Felix; Senf, Fabian; Deneke, Hartwig

2013-04-01

Within this study, the rapid development and evolution of several severe convective events is investigated based on geostationary satellite images, and is related to previous findings on suitable detection thresholds for convective initiation. Nine severe events have been selected that occurred over Central Europe in summer 2012, and have been classified into the categories supercell, mesoscale convective system, frontal system and orographic convection. The cases are traced backward starting from the fully developed convective systems to its very beginning initial state using ECMWF data with 0.5 degree spatial resolution and 3h temporal resolution. For every case the storm life cycle was quantified through the storm's infrared (IR) brightness temperatures obtained from Meteosat Second Generation SEVIRI with 5 min temporal resolution and 4.5 km spatial resolution. In addition, cloud products including cloud optical thickness, cloud phase and effective droplet radius have been taken into account. A semi-automatic adjustment of the tracks within a search box was necessary to improve the tracking accuracy and thus the quality of the derived life-cycles. The combination of IR brightness temperatures, IR temperature time trends and satellite-based cloud products revealed different stages of storm development such as updraft intensification and glaciation well in most casesconfirming previously developed CI criteria from other studies. The vertical temperature gradient between 850 and 500 hPa, the Total-Totals-Index and the storm-relative helicity have been derived from ECMWF data and were used to characterize the storm synoptic environment. The results suggest that the storm-relative helicity also influences the life time of convective storms over Central Europe confirming previous studies. Tracking accuracy has shown to be a crucial issue in our study and a fully automated approach is required to enlarge the number of cases for significant statistics.

Factors and Regional Differences Associated with Endometriosis: A Multi-Country, Case-Control Study.

PubMed

Chapron, Charles; Lang, Jing-He; Leng, Jin-Hua; Zhou, Yingfang; Zhang, Xinmei; Xue, Min; Popov, Alexander; Romanov, Vladimir; Maisonobe, Pascal; Cabri, Patrick

2016-08-01

The present study aimed to investigate clinical, lifestyle, and environmental factors associated with endometrioma (OMA) and/or deep infiltrating endometriosis (DIE) as determined by case-control comparison [women with superficial peritoneal endometriosis (SUP) or no endometriosis], and compare differences between factor associated with endometriosis at a national level. This was three countries (China, Russia, and France), case-control study in 1008 patients. Patients were identified and enrolled during their first routine appointment with their physician post-surgery for a benign gynecologic indication, excluding pregnancy. Retrospective information on symptoms and previous medical history was collected via face-to-face interviews; patients also completed a questionnaire to provide information on current habits. For every DIE patient recruited (n = 143), two women without endometriosis (n = 288), two SUP patients (n = 288), and two OMA patients (n = 288) were recruited. For the overall population, factors significantly associated (P ≤ 0.05) with DIE or OMA [Odds ratio (OR) >1] were: previous use of hormonal treatment for endometriosis [OR 6.66; 95% confidence interval (CI) 4.05-10.93]; previous surgery for endometriosis (OR 1.95; 95% CI 1.11-3.43); and living or working in a city or by a busy area (OR 1.66; 95% CI 1.09-2.52). Differences between regions with regard to the diagnosis, symptomatology, and treatment of endometriosis exist. The findings provide insight into potential risk factors for endometriosis and differences between regions in terms of endometriosis management and symptomatology. Further investigations are required to confirm the associations found in this study. ClinicalTrials.gov identifier, NCT01351051. Ipsen.

Risk factors for near-fatal asthma. A case-control study in hospitalized patients with asthma.

PubMed

Turner, M O; Noertjojo, K; Vedal, S; Bai, T; Crump, S; Fitzgerald, J M

1998-06-01

We prospectively recruited patients admitted to the hospital with severe asthma to comprehensively evaluate the association of historical and physiologic features with the risk of near-fatal asthma (NFA). A case-control study design was used. All patients admitted with NFA (cases) were identified prospectively and compared with asthma patients admitted during the same period without respiratory failure (controls). Nineteen cases (age: 40.2 +/- 12.0 yr) (mean +/- SD) and 80 controls (age: 36 +/- 13.5 yr) were enrolled. Duration of asthma, gender, smoking status, ethnicity, and prevalence of atopy were similar in the case and control groups. More than 80% of patients in both groups reported worsening symptoms for more than 48 h before admission, and more than 50% were worse for longer than 7 d. There was no difference in degree of airways obstruction or bronchial hyperresponsiveness (PC20). Perception of dyspnea was similar in the cases and controls, but among cases the males had greater impairment than the females (Borg score: 1.9 +/- 1. 4 versus 3.9 +/- 1.2: p = 0.05). Univariate analysis identified a history of previous mechanical ventilation (OR: 27.5; 95% CI: 6.60 to 113.7), admission to the intensive care unit (ICU) (OR: 9.9; 95% CI: 3.0 to 32.9), history of worse asthma during January and February (OR: 3.5; 95% CI: 1.0 to 11.8), and use of air-conditioning (OR: 15.0; 95% CI: 1.3 to 166) as risk factors for NFA. Of concern was the dependence of most patients (59.8%) on the emergency department (ED) for initial care, and the small number of cases (16%) in which patients visited a physician before admission to the hospital. We have confirmed risk factors identified previously in retrospective studies of fatal and NFA, and have also shown that hospitalized patients with asthma, irrespective of severity of their asthma, share several characteristics, especially in terms of their failure to respond to worsening asthma.

Primary pure choriocarcinoma of the liver.

PubMed

Fernández Alonso, J; Sáez, C; Pérez, P; Montaño, A; Japón, M A

1992-04-01

We report a pure choriocarcinoma of the liver studied at necropsy. The tumour was diagnosed ante-mortem and treated by chemotherapy with no satisfactory response. Previous cases of hepatic choriocarcinoma are reviewed and criteria to diagnose this extragonadal neoplasm are recommended.

Influence of previous breast surgery in sentinel lymph node biopsy in patients with breast cancer.

PubMed

López-Prior, V; Díaz-Expósito, R; Casáns Tormo, I

The aim of this study was to review the feasibility of selective sentinel lymph node biopsy in patients with previous surgery for breast cancer, as well as to examine the factors that may interfere with sentinel node detection. A retrospective review was performed on 91 patients with breast cancer and previous breast surgery, and who underwent sentinel lymph node biopsy. Patients were divided into two groups according to their previous treatment: aesthetic breast surgery in 30 patients (group I) and breast-conserving surgery in 61 (group II). Lymphoscintigraphy was performed after an intra-tumour injection in 21 cases and a peri-areolar injection in 70 cases. An analysis was made of lymphatic drainage patterns and overall sentinel node detection according to clinical, pathological and surgical variables. The overall detection of the sentinel lymph node in the lymphoscintigraphy was 92.3%, with 7.7% of extra-axillary drainages. The identification rate was similar after aesthetic breast surgery (93.3%) and breast-conserving surgery (91.8%). Sentinel lymph nodes were found in the contralateral axilla in two patients (2.2%), and they were included in the histopathology study. The non-identification rate in the lymphoscintigraphy was 7.7%. There was a significantly higher non-detection rate in the highest histological grade tumours (28.6% grade III, 4.5% grade I and 3.6% grade II). Sentinel lymph node biopsy in patients with previous breast surgery is feasible and deserves further studies to assess the influence of different aspects in sentinel node detection in this clinical scenario. A high histological grade was significantly associated with a lower detection. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Prevalence of drug-resistant tuberculosis in Nigeria: A systematic review and meta-analysis

PubMed Central

Onyedum, Cajetan C.; Alobu, Isaac

2017-01-01

Background Drug-resistant tuberculosis (TB) undermines control efforts and its burden is poorly understood in resource-limited settings. We performed a systematic review and meta-analysis to provide an up-to-date summary of the extent of drug-resistant TB in Nigeria. Methods We searched PubMed, Scopus, Embase, HINARI, AJOL, the Cochrane library, Web of Science, and Google Scholar for reports published before January 31 2017, that included any resistance, mono-resistance or multidrug resistance to anti-TB drugs in Nigeria. Summary estimates were calculated using random effects models. Results We identified 34 anti-TB drug resistance surveys with 8002 adult TB patients consisting of 2982 new and 5020 previously-treated cases. The prevalence rate of any drug resistance among new TB cases was 32.0% (95% CI 24.0–40.0%; 734/2892) and among previously-treated cases, the rate was 53.0% (95% CI 35.0–71.0%; 1467/5020). Furthermore, multidrug resistance among new and previously-treated cases was 6.0% (95% CI 4.0–8.0%;161/2502)and 32.0% (95%CI 20.0–44.0; 357/949), respectively. There was significant heterogeneity between the studies (p<0.001, I2 tests). The prevalence of drug-resistant TB varied according to methods of drug susceptibility testing and geographic region of Nigeria. Conclusion The burden of drug-resistant TB in Nigeria is high. We recommend that a national anti-TB drug resistance survey be carried out, and strategies for case detection and programmatic management of drug-resistant TB in Nigeria need to be strengthened. PMID:28704459

Prevalence of drug-resistant tuberculosis in Nigeria: A systematic review and meta-analysis.

PubMed

Onyedum, Cajetan C; Alobu, Isaac; Ukwaja, Kingsley Nnanna

2017-01-01

Drug-resistant tuberculosis (TB) undermines control efforts and its burden is poorly understood in resource-limited settings. We performed a systematic review and meta-analysis to provide an up-to-date summary of the extent of drug-resistant TB in Nigeria. We searched PubMed, Scopus, Embase, HINARI, AJOL, the Cochrane library, Web of Science, and Google Scholar for reports published before January 31 2017, that included any resistance, mono-resistance or multidrug resistance to anti-TB drugs in Nigeria. Summary estimates were calculated using random effects models. We identified 34 anti-TB drug resistance surveys with 8002 adult TB patients consisting of 2982 new and 5020 previously-treated cases. The prevalence rate of any drug resistance among new TB cases was 32.0% (95% CI 24.0-40.0%; 734/2892) and among previously-treated cases, the rate was 53.0% (95% CI 35.0-71.0%; 1467/5020). Furthermore, multidrug resistance among new and previously-treated cases was 6.0% (95% CI 4.0-8.0%;161/2502)and 32.0% (95%CI 20.0-44.0; 357/949), respectively. There was significant heterogeneity between the studies (p<0.001, I2 tests). The prevalence of drug-resistant TB varied according to methods of drug susceptibility testing and geographic region of Nigeria. The burden of drug-resistant TB in Nigeria is high. We recommend that a national anti-TB drug resistance survey be carried out, and strategies for case detection and programmatic management of drug-resistant TB in Nigeria need to be strengthened.

Acute porphyrias: clinical spectrum of hospitalized patients.

PubMed

Sheerani, Mughis; Urfy, Mian Zainulsajadeen; Hassan, Ali; Islam, Zunaira; Baig, Shahid

2007-11-01

To determine characteristics, clinical features and triggers of acute porphyria in hospitalized patients presenting to a tertiary care center in Pakistan. Case series. The Aga Khan University Hospital, Karachi, from 1988 to 2003. Case records of 26 patients hospitalized with diagnosis were identified through computerized hospital patients' data. The diagnosis of acute porphyria was based on pertinent clinical features and laboratory investigations after exclusion of other alternative diagnosis and patients previously diagnosed as porphyric. The data was analyzed through SPSS software version 11.0. Twelve patients (46.2%) were males. Mean age was 21 years. Most common manifestation were gastrointestinal (n=22; 88.5%) followed by neurological symptoms (n=14; 54%). Neurological manifestations included seizures (n=9; 34.6%) and neuropathy (n=6; 23%). One patient presented with depression and insomnia. Family history was positive in (n=8; 30.8%). Eighteen (69%) had history of previous attacks at their presentation to the hospital. Most common precipitating factor was 'eating outside' (n=18; 69%). Porphyrias are uncommon and cryptic group of diseases. This study shows a slightly different gender distribution, earlier onset of symptoms, higher number of neuropsychiatric symptoms (especially seizures), more distal neuropathies and different precipitant in the studied subset of patients than described previously in the western studies.

Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

PubMed Central

Moise, Imelda K.; Mulhall, Peter F.

2016-01-01

Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking clients to adequate services rather than reporting performance. Case managers favored measurable deliverables rather than operational work products. A proposed solution to current challenges emphasizes and encourages the iterative learning process and shared decision making between program targets, funders and providers. Case managers are aware of the challenging environment in which they operate for their clients and for themselves. However, future interventions will require clearly identified performance measures and increased systems support. PMID:27149061

The effect of previous traumatic injury on homicide risk.

PubMed

Griffin, Russell L; Davis, Gregory G; Levitan, Emily B; MacLennan, Paul A; Redden, David T; McGwin, Gerald

2014-07-01

Research has reported that a strong risk factor for traumatic injury is having a previous injury (i.e., recidivism). To date, the only study examining the relationship between recidivism and homicide reported strong associations, but was limited by possible selection bias. The current matched case-control study utilized coroner's data from 2004 to 2008. Subjects were linked to trauma registry data to determine whether the person had a previous traumatic injury. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between homicide and recidivism. Homicide risk was increased for those having a previous traumatic injury (OR 1.81, 95% CI 1.09-2.99) or a previous intentional injury (OR 2.53, 95% CI 1.24-5.17). These results suggest an association between homicide and injury recidivism, and that trauma centers may be an effective setting for screening individuals for secondary prevention efforts of homicide through violence prevention programs. © 2014 American Academy of Forensic Sciences.

Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia

PubMed Central

Hodges, John R.; Knopman, David; Mendez, Mario F.; Kramer, Joel H.; Neuhaus, John; van Swieten, John C.; Seelaar, Harro; Dopper, Elise G. P.; Onyike, Chiadi U.; Hillis, Argye E.; Josephs, Keith A.; Boeve, Bradley F.; Kertesz, Andrew; Seeley, William W.; Rankin, Katherine P.; Johnson, Julene K.; Gorno-Tempini, Maria-Luisa; Rosen, Howard; Prioleau-Latham, Caroline E.; Lee, Albert; Kipps, Christopher M.; Lillo, Patricia; Piguet, Olivier; Rohrer, Jonathan D.; Rossor, Martin N.; Warren, Jason D.; Fox, Nick C.; Galasko, Douglas; Salmon, David P.; Black, Sandra E.; Mesulam, Marsel; Weintraub, Sandra; Dickerson, Brad C.; Diehl-Schmid, Janine; Pasquier, Florence; Deramecourt, Vincent; Lebert, Florence; Pijnenburg, Yolande; Chow, Tiffany W.; Manes, Facundo; Grafman, Jordan; Cappa, Stefano F.; Freedman, Morris; Grossman, Murray; Miller, Bruce L.

2011-01-01

Based on the recent literature and collective experience, an international consortium developed revised guidelines for the diagnosis of behavioural variant frontotemporal dementia. The validation process retrospectively reviewed clinical records and compared the sensitivity of proposed and earlier criteria in a multi-site sample of patients with pathologically verified frontotemporal lobar degeneration. According to the revised criteria, ‘possible’ behavioural variant frontotemporal dementia requires three of six clinically discriminating features (disinhibition, apathy/inertia, loss of sympathy/empathy, perseverative/compulsive behaviours, hyperorality and dysexecutive neuropsychological profile). ‘Probable’ behavioural variant frontotemporal dementia adds functional disability and characteristic neuroimaging, while behavioural variant frontotemporal dementia ‘with definite frontotemporal lobar degeneration’ requires histopathological confirmation or a pathogenic mutation. Sixteen brain banks contributed cases meeting histopathological criteria for frontotemporal lobar degeneration and a clinical diagnosis of behavioural variant frontotemporal dementia, Alzheimer’s disease, dementia with Lewy bodies or vascular dementia at presentation. Cases with predominant primary progressive aphasia or extra-pyramidal syndromes were excluded. In these autopsy-confirmed cases, an experienced neurologist or psychiatrist ascertained clinical features necessary for making a diagnosis according to previous and proposed criteria at presentation. Of 137 cases where features were available for both proposed and previously established criteria, 118 (86%) met ‘possible’ criteria, and 104 (76%) met criteria for ‘probable’ behavioural variant frontotemporal dementia. In contrast, 72 cases (53%) met previously established criteria for the syndrome (P < 0.001 for comparison with ‘possible’ and ‘probable’ criteria). Patients who failed to meet revised criteria were significantly older and most had atypical presentations with marked memory impairment. In conclusion, the revised criteria for behavioural variant frontotemporal dementia improve diagnostic accuracy compared with previously established criteria in a sample with known frontotemporal lobar degeneration. Greater sensitivity of the proposed criteria may reflect the optimized diagnostic features, less restrictive exclusion features and a flexible structure that accommodates different initial clinical presentations. Future studies will be needed to establish the reliability and specificity of these revised diagnostic guidelines. PMID:21810890

Information about ADRs explored by pharmacovigilance approaches: a qualitative review of studies on antibiotics, SSRIs and NSAIDs

PubMed Central

Aagaard, Lise; Hansen, Ebba Holme

2009-01-01

Background Despite surveillance efforts, unexpected and serious adverse drug reactions (ADRs) repeatedly occur after marketing. The aim of this article is to analyse ADRs reported by available ADR signal detection approaches and to explore which information about new and unexpected ADRs these approaches have detected. Methods We selected three therapeutic cases for the review: antibiotics for systemic use, non-steroidal anti-inflammatory medicines (NSAID) and selective serotonin re-uptake inhibitors (SSRI). These groups are widely used and represent different therapeutic classes of medicines. The ADR studies were identified through literature search in Medline and Embase. The search was conducted in July 2007. For each therapeutic case, we analysed the time of publication, the strengths of the evidence of safety in the different approaches, reported ADRs and whether the studies have produced new information about ADRs compared to the information available at the time of marketing. Results 79 studies were eligible for inclusion in the analysis: 23 antibiotics studies, 35 NSAID studies, 20 SSRI studies. Studies were mainly published from the end of the 1990s and onwards. Although the drugs were launched in different decades, both analytical and observational approaches to ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. The studies primarily dealt with analyses of ADRs of the type A and B and to a lesser extent C and D, cf. Rawlins' classification system. The therapeutic cases provided similar results with regard to detecting information about new ADRs despite different time periods and organs attacked. Approaches ranging higher in the evidence hierarchy provided information about risks of already known or expected ADRs, while information about new and previously unknown ADRs was only detected by case reports, the lowest ranking approach in the evidence hierarchy. Conclusion Although the medicines were launched in different decades, approaches to the ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. Both descriptive and analytical designs were applied. Despite the fact that analytical studies rank higher in the evidence hierarchy, only the lower ranking descriptive case reports/spontaneous reports provided information about new and previously undetected ADRs. This review underscores the importance of systems for spontaneous reporting of ADRs. Therefore, spontaneous reporting should be encouraged further and the information in ADR databases should continuously be subjected to systematic analysis. PMID:19254390

Information about ADRs explored by pharmacovigilance approaches: a qualitative review of studies on antibiotics, SSRIs and NSAIDs.

PubMed

Aagaard, Lise; Hansen, Ebba Holme

2009-03-03

Despite surveillance efforts, unexpected and serious adverse drug reactions (ADRs) repeatedly occur after marketing. The aim of this article is to analyse ADRs reported by available ADR signal detection approaches and to explore which information about new and unexpected ADRs these approaches have detected. We selected three therapeutic cases for the review: antibiotics for systemic use, non-steroidal anti-inflammatory medicines (NSAID) and selective serotonin re-uptake inhibitors (SSRI). These groups are widely used and represent different therapeutic classes of medicines. The ADR studies were identified through literature search in Medline and Embase. The search was conducted in July 2007. For each therapeutic case, we analysed the time of publication, the strengths of the evidence of safety in the different approaches, reported ADRs and whether the studies have produced new information about ADRs compared to the information available at the time of marketing. 79 studies were eligible for inclusion in the analysis: 23 antibiotics studies, 35 NSAID studies, 20 SSRI studies. Studies were mainly published from the end of the 1990s and onwards. Although the drugs were launched in different decades, both analytical and observational approaches to ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. The studies primarily dealt with analyses of ADRs of the type A and B and to a lesser extent C and D, cf. Rawlins' classification system. The therapeutic cases provided similar results with regard to detecting information about new ADRs despite different time periods and organs attacked. Approaches ranging higher in the evidence hierarchy provided information about risks of already known or expected ADRs, while information about new and previously unknown ADRs was only detected by case reports, the lowest ranking approach in the evidence hierarchy. Although the medicines were launched in different decades, approaches to the ADR studies were similar for all three therapeutic cases: antibiotics, NSAIDs and SSRIs. Both descriptive and analytical designs were applied. Despite the fact that analytical studies rank higher in the evidence hierarchy, only the lower ranking descriptive case reports/spontaneous reports provided information about new and previously undetected ADRs. This review underscores the importance of systems for spontaneous reporting of ADRs. Therefore, spontaneous reporting should be encouraged further and the information in ADR databases should continuously be subjected to systematic analysis.

The costs of managing genital warts in the UK by devolved nation: England, Scotland, Wales and Northern Ireland.

PubMed

Coles, V A H; Chapman, R; Lanitis, T; Carroll, S M

2016-01-01

Genital warts, 90% of which are caused by human papillomavirus types 6 and 11, are a significant problem in the UK. The cost of managing genital warts was previously estimated at £52.4 million for 2010. The objective of this study was to estimate the cost of genital warts management up to 2012 in the UK and by jurisdiction. Population statistics and the number of reported genital warts cases in genito-urinary medicine clinics were obtained and extrapolated to 2012. Cases of genital warts treated in primary care were estimated from The Health Improvement Network database. The number of visits and therapy required were estimated by genito-urinary medicine experts. Costs were obtained from the appropriate national tariffs. The model estimated there were 220,875 genital warts cases in the UK in 2012, costing £58.44 million (£265/patient). It estimated 157,793 cases in England costing £41.74 million; 7468 cases in Scotland costing £1.90 million; 7095 cases in Wales costing £1.87 million; and 3621 cases in Northern Ireland costing £948,000. The full National Health Service costs for the management of genital warts have never previously been estimated separately for each jurisdiction. Findings reveal a significant economic burden, which is important to quantify when understanding the value of quadrivalent human papilloma virus vaccination. © The Author(s) 2015.

Intradiscal injection of triamcinolone hexacetonide for acute, subacute, and chronic sciatica. Results at 3 months an open-prospectus study of 30 cases and review of the literature.

PubMed

Bertin, P; Rochet, N; Arnaud, M; Treves, R; Desproges Gotteron, R; Charissoux, J L

1990-09-01

The authors report an open study of 30 cases of intradiscal injection of triamcinolone hexacetonide in the treatment of sciatica. The patients were monitored at months 1 and 3. The results were judged to be good in 36.6% of the cases, moderate in 36.6% and poor in 26.7% of the cases. Two adverse effects were reported: 1 case of reversible urinary retention and 1 case of deficiency of the dorsiflexor muscles of the foot. The good results reported in previous series were only found in this study when the indications were restricted to certain favourable prognostic factors: duration of sciatica less than 6 months and CAT-scan appearance of discal hernia. This technique has the advantage of being simple, economical and nonallergic. On the basis of the encouraging results of the initial series, this technique should be considered as an interesting therapeutic alternative in sciatica. Larger series and double-blind studies, however, are necessary to confirm the initial results.

Pitfalls and major issues in the histologic diagnosis of peripheral T-cell lymphomas: results of the central review of 573 cases from the T-Cell Project, an international, cooperative study.

PubMed

Bellei, Monica; Sabattini, Elena; Pesce, Emanuela Anna; Ko, Young-Hyeh; Kim, Won Seog; Cabrera, Maria Elena; Martinez, Virginia; Dlouhy, Ivan; Paes, Roberto Pinto; Barrese, Tomas; Vassallo, Josè; Tarantino, Vittoria; Vose, Julie; Weisenburger, Dennis; Rüdiger, Thomas; Federico, Massimo; Pileri, Stefano

2017-12-01

Peripheral T-cell lymphomas (PTCLs) comprise a heterogeneous group of neoplasms that are derived from post-thymic lymphoid cells at different stages of differentiation with different morphological patterns, phenotypes and clinical presentations. PTCLs are highly diverse, reflecting the diverse cells from which they can originate and are currently sub-classified using World Health Organization (WHO) 2008 criteria. In 2006 the International T-Cell Lymphoma Project launched the T-Cell Project, building on the retrospective study previously carried on by the network, with the aim to prospectively collect accurate data to improve knowledge on this group of lymphomas. Based on previously published reports from International Study Groups it emerged that rendering a correct classification of PTCLs is quite difficult because the relatively low prevalence of these diseases results in a lack of confidence by most pathologists. This is the reason why the T-Cell Project requested the availability of diagnostic material from the initial biopsy of each patient registered in the study in order to have the initial diagnosis centrally reviewed by expert hematopathologists. In the present report the results of the review process performed on 573 cases are presented. Overall, an incorrect diagnosis was centrally recorded in 13.1% cases, including 8.5% cases centrally reclassified with a subtype eligible for the project and 4.6% cases misclassified and found to be disorders other than T-cell lymphomas; 2.1% cases were centrally classified as T-Cell disorders not included in the study population. Thus, the T-Cell Project confirmed the difficulties in providing an accurate classification when a diagnosis of PTCLs is suspected, singled out the major pitfalls that can bias a correct histologic categorization and confirmed that a centralized expert review with the application of adequate diagnostic algorithms is mandatory when dealing with these tumours. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

A Prospective Study of Chronic Inflammation in Benign Prostate Tissue and Risk of Prostate Cancer: Linked PCPT and SELECT Cohorts

PubMed Central

Platz, Elizabeth A.; Kulac, Ibrahim; Barber, John R.; Drake, Charles G.; Joshu, Corinne E.; Nelson, William G.; Lucia, M. Scott; Klein, Eric A.; Lippman, Scott M.; Parnes, Howard L.; Thompson, Ian M.; Goodman, Phyllis J.; Tangen, Catherine M.; De Marzo, Angelo M.

2017-01-01

Background We leveraged two trials to test the hypothesis of an inflammation-prostate cancer link prospectively in men without indication for biopsy. Methods Prostate Cancer Prevention Trial (PCPT) participants who had an end-of-study biopsy performed per protocol that was negative for cancer and who subsequently enrolled in the Selenium and Vitamin E Cancer Prevention Trial (SELECT) were eligible. We selected all 100 cases and sampled 200 frequency-matched controls and used PCPT end-of-study biopsies as “baseline”. Five men with PSA >4 ng/mL at end-of-study biopsy were excluded. Tissue was located for 92 cases and 193 controls. We visually assessed inflammation in benign tissue. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression adjusting for age and race. Results Mean time between biopsy and diagnosis was 5.9 years. In men previously in the PCPT placebo arm, 78.1% of cases (N=41) and 68.2% of controls (N=85) had at least one baseline biopsy core (~5 evaluated per man) with inflammation. The odds of prostate cancer (N=41 cases) appeared to increase with increasing mean percentage of tissue area with inflammation, a trend that was statistically significant for Gleason sum <4+3 disease (N=31 cases; versus 0%, >0–<1.8% OR=1.70, 1.8%–<5.0% OR=2.39, ≥5% OR=3.31, p-trend=0.047). In men previously in the finasteride arm, prevalence of inflammation did not differ between cases (76.5%; N=51) and controls (75.0%; N=108). Conclusions Benign tissue inflammation was positively associated with prostate cancer. Impact This first prospective study of men without biopsy indication supports the hypothesis that inflammation influences prostate cancer development. PMID:28754796

Is drug-resistant Mycobacterium leprae a real cause for concern?: First approach to molecular monitoring of multibacillary Colombian patients with and without previous leprosy treatment.

PubMed

Guerrero, Martha Inírida; Colorado, Claudia Lucía; Torres, José Fernando; León, Clara Inés

2014-04-01

There is no information in Colombia on Mycobacterium leprae primary and secondary drug resistance in regards to the WHO-multidrug therapy regime. On the other hand, public health authorities around the world have issued various recommendations, one of which prompts for the immediate organization of resistance surveillance through simple molecular methods. To determine the prevalence of Mycobacterium leprae drug resistance to rifampicin, ofloxacin and dapsone in untreated and previously treated patients at the Centro Dermatológico Federico Lleras Acosta during the 1985-2004 period. We conducted a retrospective study which included multibacillary patient biopsies through elective sampling: 381 of them from new patients and 560 from previously treated patients. Using a microtome, we obtained six slides from each skin biopsy preserved in paraffin, and we extracted M. leprae DNA. We amplified three molecular targets through PCR and obtained the patterns of drug resistance to dapsone, rifampicin and ofloxacin by reverse hybridization. Finally, we collected epidemiological, clinical and demographical data for analyses. From 941 samples under study, 4.14% of them were resistant to one or more drugs, and 5.77 and 3.04% had resistant genotypes in new and previously treated patients, respectively. Total resistance for each drug was 0.43% for dapsone, 3.19% for rifampicin and 1.17% for ofloxacin. We found statistically significant differences for rifampicin and for the total population when comparing the results from untreated versus previously treated patients. Two thirds of the resistant samples were resistant to rifampicin alone or combined. The standard multidrug therapy schemes continue being effective for leprosy cases; however, it is necessary to guarantee adherence and regularity. Surveillance to drug resistance in new and previously treated leprosy cases should be established.

[Malaria in Poland in 2010].

PubMed

Stepień, Małgorzata

2012-01-01

The objective of this study was to describe the epidemiology of imported malaria in Poland in 2010 in comparison to previous years. The study included malaria cases that were collected and registered by the State Sanitary Inspection in 2010 in Poland. Data reported was verified, processed and published by National Institute of Public Health - National Institute of Hygiene. All cases were laboratory confirmed by blood film, polymerase chain reaction or rapid diagnostic tests outlined by the EU case definition. Differences in the distribution of demographic, parasitological and clinical characteristics, and incidence were analyzed. In 2010, a total of 35 confirmed malaria cases were notified in Poland, 13 more than 2009. All cases were imported, 49% from Africa, including 1 case with relapsing malaria caused by P. vivax and 2 cases of recrudescence falciparum malaria following failure of treatment. The number of cases acquired in Asia (37% of the total), mainly from India and Indonesia, was significantly higher than observed in previous years. Among cases with species-specific diagnosis 19 (63%) were caused by P. falciparum, 9 (30%) by P. vivax, one by P. ovale and one by P. malariae. The median age of all cases was 42 years (range 9 months to 71 years), males comprised 69% of patients, females 31%, three patients were Indian citizens temporarily in Poland. Common reasons for travel to endemic countries were tourism (57%), work-related visits (37%), one person visited family and in one case the reason for travel was unknown. Sixteen travelers took chemoprophylaxis, but only three of them appropriately (adherence to the recommended drug regimen, continuation upon return and use of appropriate medicines). In 2010, there were no deaths due to malaria and clinical course of disease was severe in 7 cases. When compared with 2009, there was a marked increase in the number of imported malaria cases in Poland, however the total number of notified cases remained low. Serious malaria (caused by P. falciparum), most frequently due to delayed diagnosis and treatment, is a continual problem. Such cases underline the need for adequate pre-travel information regarding the risk of malaria and preventive measures available.

Multidrug-resistant Pulmonary Tuberculosis Among Young Korean Soldiers in a Communal Setting

PubMed Central

Lee, Sei Won; Kim, Kwang Hyun; Min, Kyung Hoon

2009-01-01

The goal of this study was to evaluate the prevalence of first-line anti-tuberculosis drug resistance and risk factors associated with multidrug-resistant tuberculosis (MDR TB) among young soldiers in the Korean military, which has a strict tuberculosis control program. All patients with culture-confirmed pulmonary tuberculosis during their service at the Armed Forces Capital Hospital from January 2001 to December 2006 were enrolled in the study. Drug resistant Mycobacterium tuberculosis was isolated from 18 patients (12.2%) and multidrug-resistant M. tuberculosis was isolated from 12 patients (8.1%). Previous treatment of tuberculosis and the presence of a cavity on the patient's chest computed tomography scan were associated with MDR TB; military rank, smoking habits, and positive acid-fast bacilli smears were not associated with MDR TB. In a multiple logistic regression analysis, previous treatment of tuberculosis was a significant independent risk factor for MDR TB (odds ratio 6.12, 95% confidence interval 1.53-24.46). The prevalence of drug resistant tuberculosis among young soldiers in the Korean military was moderately high and the majority of resistant cases were found in patients who had undergone previous treatment of tuberculosis. Based on our results, we suggest that relapsed tuberculosis cases within communal settings should be cautiously managed until the drug susceptibility tests report is completed, even if previous treatment results were satisfactory. PMID:19654938

Is repetitive intraoperative splash basin use a source of bacterial contamination in total joint replacement?

PubMed

Glait, Sergio A; Schwarzkopf, Ran; Gould, Steven; Bosco, Joseph; Slover, James

2011-09-09

Splash basins are used in arthroplasty cases to wash instruments. Several studies in the literature have shown these basins being a potential source of bacterial infection. This study assesses the risk of contamination of intraoperative splash basins used to wash and store instruments. A total of 46 random clean primary arthroplasty cases (32 hips, 13 knees, and 1 unicondylar knee) were studied by taking cultures of sterile splash basins as soon as they are opened (controls) and again at wound closure after instruments and debris have come into contact with the sterile water. All cultures were taken with sterile culture swabs and sent to the laboratory for aerobic, anaerobic, and fungal culture. Outcome measured was any positive culture. A total of 92 cultures from 46 cases were tested. Only 1 (2.17%) control culture, which grew Streptococcus viridans, was positive for bacterial growth. One of 46 samples (2.17%) taken at wound closure was positive for coagulase-negative Staphylococcus. Mean time between basin opening and wound closure was 180±45 minutes. For the 1 infected sample taken at the conclusion of the case, it was 240 minutes. Previous studies show contamination rates as high as 74% for splash basins used intraoperatively. Our study contradicts the belief that splash basins are a high source of infection, with only 2.17% of basins showing contamination. Splash basins can be a potential source of contamination, but the risk is not as high as previously cited in the orthopedic literature. Copyright 2011, SLACK Incorporated.

Functional Assessment of the Vanderbilt Multigrasp Myoelectric Hand: A Continuing Case Study

PubMed Central

Dalley, Skyler A.; Bennett, Daniel A.; Goldfarb, Michael

2015-01-01

This paper presents a case study involving the functional assessment of the Vanderbilt Multigrasp (VMG) hand prosthesis on a single transradial amputee subject. In particular, a transradial amputee subject performed the Southampton Hand Assessment Procedure (SHAP) using the hand prosthesis and multigrasp myoelectric controller in a series of experimental sessions occurring over a multi-week time span. The subject’s index of function (IoF) improved with each session, although essentially plateaued after the fourth session, resulting in a IoF score of 87, which compares favorably to SHAP scores published in previous studies. PMID:25571412

Analysis of Over 10,000 Cases Finds No Association between Previously-Reported Candidate Polymorphisms and Ovarian Cancer Outcome

PubMed Central

White, Kristin L.; Vierkant, Robert A.; Fogarty, Zachary C.; Charbonneau, Bridget; Block, Matthew S.; Pharoah, Paul D.P.; Chenevix-Trench, Georgia; Rossing, Mary Anne; Cramer, Daniel W.; Pearce, C. Leigh; Schildkraut, Joellen M.; Menon, Usha; Kjaer, Susanne Kruger; Levine, Douglas A.; Gronwald, Jacek; Culver, Hoda Anton; Whittemore, Alice S.; Karlan, Beth Y.; Lambrechts, Diether; Wentzensen, Nicolas; Kupryjanczyk, Jolanta; Chang-Claude, Jenny; Bandera, Elisa V.; Hogdall, Estrid; Heitz, Florian; Kaye, Stanley B.; Fasching, Peter A.; Campbell, Ian; Goodman, Marc T.; Pejovic, Tanja; Bean, Yukie; Lurie, Galina; Eccles, Diana; Hein, Alexander; Beckmann, Matthias W.; Ekici, Arif B.; Paul, James; Brown, Robert; Flanagan, James; Harter, Philipp; du Bois, Andreas; Schwaab, Ira; Hogdall, Claus K.; Lundvall, Lene; Olson, Sara H.; Orlow, Irene; Paddock, Lisa E.; Rudolph, Anja; Eilber, Ursula; Dansonka-Mieszkowska, Agnieszka; Rzepecka, Iwona K.; Ziolkowska-Seta, Izabela; Brinton, Louise; Yang, Hannah; Garcia-Closas, Montserrat; Despierre, Evelyn; Lambrechts, Sandrina; Vergote, Ignace; Walsh, Christine; Lester, Jenny; Sieh, Weiva; McGuire, Valerie; Rothstein, Joseph H.; Ziogas, Argyrios; Lubiński, Jan; Cybulski, Cezary; Menkiszak, Janusz; Jensen, Allan; Gayther, Simon A.; Ramus, Susan J.; Gentry-Maharaj, Aleksandra; Berchuck, Andrew; Wu, Anna H.; Pike, Malcolm C.; Van Den Berg, David; Terry, Kathryn L.; Vitonis, Allison F.; Doherty, Jennifer A.; Johnatty, Sharon; deFazio, Anna; Song, Honglin; Tyrer, Jonathan; Sellers, Thomas A.; Phelan, Catherine M.; Kalli, Kimberly R.; Cunningham, Julie M.; Fridley, Brooke L.; Goode, Ellen L.

2013-01-01

Background Ovarian cancer is a leading cause of cancer-related death among women. In an effort to understand contributors to disease outcome, we evaluated single-nucleotide polymorphisms (SNPs) previously associated with ovarian cancer recurrence or survival, specifically in angiogenesis, inflammation, mitosis, and drug disposition genes. Methods Twenty-seven SNPs in VHL, HGF, IL18, PRKACB, ABCB1, CYP2C8, ERCC2, and ERCC1 previously associated with ovarian cancer outcome were genotyped in 10,084 invasive cases from 28 studies from the Ovarian Cancer Association Consortium with over 37,000 observed person-years and 4,478 deaths. Cox proportional hazards models were used to examine the association between candidate SNPs and ovarian cancer recurrence or survival with and without adjustment for key covariates. Results We observed no association between genotype and ovarian cancer recurrence or survival for any of the SNPs examined. Conclusions These results refute prior associations between these SNPs and ovarian cancer outcome and underscore the importance of maximally powered genetic association studies. Impact These variants should not be used in prognostic models. Alternate approaches to uncovering inherited prognostic factors, if they exist, are needed. PMID:23513043

Long-term mobile phone use and acoustic neuroma risk.

PubMed

Pettersson, David; Mathiesen, Tiit; Prochazka, Michaela; Bergenheim, Tommy; Florentzson, Rut; Harder, Henrik; Nyberg, Gunnar; Siesjö, Peter; Feychting, Maria

2014-03-01

There is concern about potential effects of radiofrequency fields generated by mobile phones on cancer risk. Most previous studies have found no association between mobile phone use and acoustic neuroma, although information about long-term use is limited. We conducted a population-based, nation-wide, case-control study of acoustic neuroma in Sweden. Eligible cases were persons aged 20 to 69 years, who were diagnosed between 2002 and 2007. Controls were randomly selected from the population registry, matched on age, sex, and residential area. Postal questionnaires were completed by 451 cases (83%) and 710 controls (65%). Ever having used mobile phones regularly (defined as weekly use for at least 6 months) was associated with an odds ratio (OR) of 1.18 (95% confidence interval = 0.88 to 1.59). The association was weaker for the longest induction time (≥10 years) (1.11 [0.76 to 1.61]) and for regular use on the tumor side (0.98 [0.68 to 1.43]). The OR for the highest quartile of cumulative calling time (≥680 hours) was 1.46 (0.98 to 2.17). Restricting analyses to histologically confirmed cases reduced all ORs; the OR for ≥680 hours was 1.14 (0.63 to 2.07). A similar pattern was seen for cordless land-line phones, although with slightly higher ORs. Analyses of the complete history of laterality of mobile phone revealed considerable bias in laterality analyses. The findings do not support the hypothesis that long-term mobile phone use increases the risk of acoustic neuroma. The study suggests that phone use might increase the likelihood that an acoustic neuroma case is detected and that there could be bias in the laterality analyses performed in previous studies.

Prescription of Zolpidem and the Risk of Fatal Motor Vehicle Collisions: A Population-Based, Case-Crossover Study from South Korea.

PubMed

Yang, Bo Ram; Kim, Ye-Jee; Kim, Mi-Sook; Jung, Sun-Young; Choi, Nam-Kyong; Hwang, Byungkwan; Park, Byung-Joo; Lee, Joongyub

2018-05-23

Zolpidem is one of the most frequently used hypnotics worldwide, but associations with serious adverse effects such as motor vehicle collisions have been reported. The objective of this study was to evaluate the association of fatal motor vehicle collisions with a prescription for zolpidem, considering the context of the motor vehicle collisions. We conducted a case-crossover study, where each case served as its own control, by linking data about fatal motor vehicle collisions from the Korean Road Traffic Authority between 2010 and 2014 with national health insurance data. The case period was defined as 1 day before the fatal motor vehicle collisions, and was matched to four control periods at 90-day intervals. Conditional logistic regression was performed to calculate the odds ratio for fatal motor vehicle collisions associated with zolpidem exposure, and odds ratios were adjusted for time-varying exposure to confounding medications. A stratified analysis was performed by age group (younger than 65 years or not), the Charlson Comorbidity Index, and whether patients were new zolpidem users. Among the 714 subjects, the adjusted odds ratio for a fatal motor vehicle collision associated with a prescription for zolpidem the previous day was 1.48 (95% confidence interval 1.06-2.07). After stratification, a significantly increased risk was observed in subjects with a high Charlson Comorbidity Index (odds ratio 1.81; 95% confidence interval 1.16-2.84), the younger age group (odds ratio: 1.62; 95% confidence interval 1.03-2.56), and new zolpidem users (odds ratio 2.37; 95% confidence interval 1.40-4.00). A prescription for zolpidem on the previous day was significantly related to an increased risk of fatal motor vehicle collisions in this population-based case-crossover study.

An Investigation of Factors Determining the Study Abroad Destination Choice: A Case Study of Taiwan

ERIC Educational Resources Information Center

Lee, Cheng-Fei

2014-01-01

Previous studies on the field of education abroad have mainly focused on the factors influencing the mobility of international students from developing to developed countries and very few have been conducted to investigate the factors influencing the flow of international students to the Asia Pacific region. As a piece of country-specific…

University Students' Perception of the Pedagogical Use of Podcasts: A Case Study of an Online Information System Course

ERIC Educational Resources Information Center

Khechine, Hager; Lakhal, Sawsen; Pascot, Daniel

2013-01-01

Previous studies on podcasting assessed the usage impact of this technology on some cognitive and affective variables such as learning, performance efficiency, satisfaction and anxiety. However, these studies assumed that students had adopted podcasting without questioning their opinions. In order to reach a deeper understanding of students'…

A Case Study on Learning Difficulties and Corresponding Supports for Learning in cMOOCs

ERIC Educational Resources Information Center

Li, Shuang; Tang, Qi; Zhang, Yanxia

2016-01-01

cMOOCs, which are based on connectivist learning theory, bring challenges for learners as well as opportunities for self-inquiry. Previous studies have shown that learners in cMOOCs may have difficulties learning, but these studies do not provide any in-depth, empirical explorations of student difficulties or support strategies. This paper…

A Case Study of College Level Second Language Teachers' Perceptions and Implementations of Communicative Language Teaching

ERIC Educational Resources Information Center

Wong, Chiu-Yin

2012-01-01

Previous research studies have indicated that some educators do not advocate Communicative Language Teaching (CLT) because of their misunderstanding of the methodology. This article explores the relationship between college-level second language (L2) educators' perceptions and their implementations of CLT. The results of this study show that the…

Mixed vascular nevus syndrome: a report of four new cases and a literature review.

PubMed

Ruggieri, Martino; Polizzi, Agata; Strano, Serena; Schepis, Carmelo; Morano, Massimiliano; Belfiore, Giuseppe; Palmucci, Stefano; Foti, Pietro Valerio; Pirrone, Concetta; Sofia, Vito; David, Emanuele; Salpietro, Vincenzo; Mankad, Kshitij; Milone, Pietro

2016-10-01

Mixed vascular nevus (or nevus vascularis mixtus) represents an admixture of cutaneous vascular malformations of the telangiectatic type and angiospastic spots of nevus anemicus. It can occur as an purely cutaneous trait or as a hallmark of a neurocutaneous phenotype (mixed vascular nevus syndrome) characterised by the combination of: (I) paired vascular (telangiectatic and anemic) twin nevi and brain abnormalities of the Dyke-Davidoff-Masson type (i.e., crossed cerebral/cerebellar hemiatrophy with hypoplasia of the ipsilateral cerebral vessels and homolateral hypertrophy of the skull and sinuses (hyperpneumatisation) with contralateral hemispheric hypertrophy); or (II) paired vascular twin nevi and brain malformations of the Dyke-Davidoff-Masson type in association with systemic abnormalities consisting in facial asymmetry, skeletal anomalies (i.e., Legg-Calvé-Perthes-like disease) and disorders of autoimmunity (i.e., diabetes, thyroiditis). In 2014, Happle proposed to name the syndrome with the eponym Ruggieri-Leech syndrome. Review of the existing literature on nevus vascularis mixtus and information on our personal experience on new cases and follow-up of previously reported cases by some of us. The existing literature revealed 4 previous studies including 33 cases with an inferred purely cutaneous trait and 3 cases with a combination of paired vascular twin nevi and brain malformation of the Dyke-Davidoff-Masson type. Our personal experience includes 4 unpublished patients (1 female and 3 males; currently aged 2 to 34 years) seen and followed-up at our Institutions in Italy who had: paired vascular nevi involving either the face (n=2) or the face and parts of the body (n=2); facial asymmetry (n=4); mild to moderate facial dysmorphic features (n=2); developmental delay (n=3); seizures/stroke-like episodes and associated hemiplegia (n=4); muscular hypotrophy (n=2); mild to moderate hemispheric atrophy (n=4); skull osseous hypertrophy (n=4); hyperpneumatisation of the sinuses (n=2); hypoplastic brain vessels (n=4); colpocephaly and malformation of cortical development (n=2). Follow-up data on our previous 2 cases revealed that the vascular abnormalities in the skin and nervous system were stable over years without neurological progression or deterioration. Pathogenically, this complex phenotype suggests that embryonic pairing and somatic recombination of recessive (didymotic) alleles controlling the balance between constriction (i.e., nevus anemicus) and dilatation (i.e., nevus telangiectaticus) of blood vessels could be the primary event causing the phenomena of cutaneous and brain vascular twin spotting and the paired phenomena of skull hyperpneumatisation vs . hypertrophy and brain megalencephaly/colpocephaly vs . cortical dysplasia. This association is likely more frequent than previously thought and should be investigated by means of: (I) brain and spinal cord imaging (combination of CT and MRI studies); (II) skeletal X-ray studies (when dictated by clinical findings); (III) systemic ultrasound studies; (IV) neurophysiologic studies (EEG); (V) psychomotor testing; (VI) and laboratory investigation (including immune-mediated dysfunction).

Mixed vascular nevus syndrome: a report of four new cases and a literature review

PubMed Central

Polizzi, Agata; Strano, Serena; Schepis, Carmelo; Morano, Massimiliano; Belfiore, Giuseppe; Palmucci, Stefano; Foti, Pietro Valerio; Pirrone, Concetta; Sofia, Vito; David, Emanuele; Salpietro, Vincenzo; Mankad, Kshitij; Milone, Pietro

2016-01-01

Background Mixed vascular nevus (or nevus vascularis mixtus) represents an admixture of cutaneous vascular malformations of the telangiectatic type and angiospastic spots of nevus anemicus. It can occur as an purely cutaneous trait or as a hallmark of a neurocutaneous phenotype (mixed vascular nevus syndrome) characterised by the combination of: (I) paired vascular (telangiectatic and anemic) twin nevi and brain abnormalities of the Dyke-Davidoff-Masson type (i.e., crossed cerebral/cerebellar hemiatrophy with hypoplasia of the ipsilateral cerebral vessels and homolateral hypertrophy of the skull and sinuses (hyperpneumatisation) with contralateral hemispheric hypertrophy); or (II) paired vascular twin nevi and brain malformations of the Dyke-Davidoff-Masson type in association with systemic abnormalities consisting in facial asymmetry, skeletal anomalies (i.e., Legg-Calvé-Perthes-like disease) and disorders of autoimmunity (i.e., diabetes, thyroiditis). In 2014, Happle proposed to name the syndrome with the eponym Ruggieri-Leech syndrome. Methods Review of the existing literature on nevus vascularis mixtus and information on our personal experience on new cases and follow-up of previously reported cases by some of us. Results The existing literature revealed 4 previous studies including 33 cases with an inferred purely cutaneous trait and 3 cases with a combination of paired vascular twin nevi and brain malformation of the Dyke-Davidoff-Masson type. Our personal experience includes 4 unpublished patients (1 female and 3 males; currently aged 2 to 34 years) seen and followed-up at our Institutions in Italy who had: paired vascular nevi involving either the face (n=2) or the face and parts of the body (n=2); facial asymmetry (n=4); mild to moderate facial dysmorphic features (n=2); developmental delay (n=3); seizures/stroke-like episodes and associated hemiplegia (n=4); muscular hypotrophy (n=2); mild to moderate hemispheric atrophy (n=4); skull osseous hypertrophy (n=4); hyperpneumatisation of the sinuses (n=2); hypoplastic brain vessels (n=4); colpocephaly and malformation of cortical development (n=2). Follow-up data on our previous 2 cases revealed that the vascular abnormalities in the skin and nervous system were stable over years without neurological progression or deterioration. Conclusions Pathogenically, this complex phenotype suggests that embryonic pairing and somatic recombination of recessive (didymotic) alleles controlling the balance between constriction (i.e., nevus anemicus) and dilatation (i.e., nevus telangiectaticus) of blood vessels could be the primary event causing the phenomena of cutaneous and brain vascular twin spotting and the paired phenomena of skull hyperpneumatisation vs. hypertrophy and brain megalencephaly/colpocephaly vs. cortical dysplasia. This association is likely more frequent than previously thought and should be investigated by means of: (I) brain and spinal cord imaging (combination of CT and MRI studies); (II) skeletal X-ray studies (when dictated by clinical findings); (III) systemic ultrasound studies; (IV) neurophysiologic studies (EEG); (V) psychomotor testing; (VI) and laboratory investigation (including immune-mediated dysfunction). PMID:27942471

Intramedullary spindle cell hemangioma: case report.

PubMed

Nasser, Rani; Ashayeri, Kimberly; Legatt, Alan D; Houten, John K

2016-09-01

The authors describe the case of a 48-year-old man found to have the first reported intramedullary spinal cord spindle cell hemangioma. Previous research indicates that spindle cell hemangiomas are rarely found in the spine. Only 3 previous cases exist, all in the intradural, extramedullary space. In the present case, gross-total resection of the tumor was possible with no loss of function from baseline. This report presents the successful resection of the first reported intramedullary spindle cell hemangioma and reports 4-month follow-up, demonstrating the biological behavior of this rare tumor.

Kindler syndrome in native Americans from Panama: report of 26 cases.

PubMed

Penagos, Homero; Jaen, Marta; Sancho, Mario T; Saborio, Manuel R; Fallas, Victor G; Siegel, Dawn H; Frieden, Ilona J

2004-08-01

To investigate the clinical, genetic, and laboratory features of 26 patients with Kindler syndrome. Case series of patients recruited when they were seen at outpatient consultations in the Department of Dermatology at the Changuinola Hospital in Bocas del Toro, Panama, between May 1986 and December 1990. Clinical history, physical examination, and laboratory studies were done at a community hospital in Panama. Twelve of the patients had further studies performed at a children's hospital in Costa Rica. A total of 26 patients were entered into the study. They were members of the Ngöbe-Buglé tribe and resided in isolated villages in rural Panama. The major findings were skin fragility with blistering (100%), poikiloderma (96%), photosensitivity (92%), severe cutaneous atrophy (89%), hyperkeratosis of the palms and soles (81%), congenital acral blisters (81%), severe periodontal disease (81%), and phimosis (80% of male subjects). In 1 large family with 10 patients, inheritance of Kindler syndrome followed that of an autosomal recessive disease. Karyotypes in 3 patients and 1 unaffected father were normal. Findings from ultrastructural studies showed replication of lamina densa in 10 patients. To our knowledge, this study represents the largest series to date of patients with Kindler syndrome. The clinical features confirm previously reported cases, and segregation analysis confirms its autosomal recessive inheritance. We also report severe phimosis as a complication, which has not been previously described in this syndrome.

Video-assisted parathyroidectomy via the lateral approach vs conventional surgery in the treatment of sporadic primary hyperparathyroidism: results of a case-control study.

PubMed

Henry, J F; Raffaelli, M; Iacobone, M; Volot, F

2001-10-01

We previously demonstrated that minimally invasive video-assisted parathyroidectomy (VAP) can be performed via a lateral approach on the line of the sternocleidomastoid muscle. The aim of this study was to compare the results of this technique with those of conventional parathyroidectomy (CP) in a case-control study. Over a 2-year period, 80 VAP were attempted. The selection criteria were as follows: sporadic primary hyperparathyroidism, no history of previous neck surgery, no thyroid disease, suggestion of a single adenoma on preoperative imaging. A rapid intraoperative parathyroid hormone (PTH) assay was performed. The procedure was completed successfully in 68 patients. A case-control study of 68 patients who underwent CP for a single adenoma was performed. The controls were matched for age and sex. All of the patients were normocalcemic at follow-up. No statistically significant differences between the VAP and the control groups were found for age, sex, pre- and postoperative calcemia and PTH, adenoma weight, operating time, complication rate, or postoperative stay. One VAP patient developed recurrent laryngeal nerve palsy. Patients who underwent VAP required less analgesics (p < 0.0001) and were more satisfied with the cosmetic results (p < 0.0001). This study suggests that VAP by the lateral approach has some advantages over CP in terms of postoperative pain and cosmetic results.

Efficacy and safety of aflibercept in metastatic colorectal cancer pretreated with bevacizumab: A report of five cases.

PubMed

Alcaide, Julia; Delgado, Mayte; Legerén, Marta; Jurado, José Miguel; Blancas, Isabel; Pereda, Teresa; López, Jorge; Garrido, Margarita; Sánchez, María J; García, José L; Rueda, Antonio

2016-11-01

Aflibercept is a recombinant fusion protein that acts by inhibiting tumoural angiogenesis. Efficacy data obtained in the VELOUR randomised study has contributed to the approval of aflibercept as a second-line metastatic colorectal cancer (mCRC) treatment following an oxaliplatin-based regimen. The present study reports a case series of five patients with mCRC, who were treated in two centres since 2011 in the Compassionate Use Program for aflibercept. All patients had a KRAS mutation and previously received palliative fluoropyrimidine-oxaliplatin-based chemotherapy with bevacizumab. A doublet with irinotecan combined with aflibercept was administered until progression of disease. The majority of patients received a greater number of aflibercept cycles than the median reported in the VELOUR study (12 vs. 7 cycles), with manageable and reversible toxicity. The most frequent adverse events observed were diarrhoea, neutropenia, fatigue, proteinuria and hypertension. Most cases obtained a progression-free survival greater than the median reported in the VELOUR study (11 vs. 6.9 months) and, in a subgroup of patients previously treated with bevacizumab, and a median survival time of ~47 months was reached from the initial treatment of the disease. The present study contrasts the efficacy and safety results obtained from the pivotal VELOUR trial, and confirms that aflibercept, used in routine clinical practice outside of the clinical trial environment, is active and well-tolerated following bevacizumab treatment.

43 CFR 11.64 - Injury determination phase-testing and sampling methods.

Code of Federal Regulations, 2012 CFR

2012-10-01

.... In developing these objectives, the availability of information from response actions relating to the...), test cases proving the code works, and any alteration of previously documented code made to adapt the... computer code (if any), test cases proving the code works, and any alteration of previously documented code...

43 CFR 11.64 - Injury determination phase-testing and sampling methods.

Code of Federal Regulations, 2014 CFR

2014-10-01

.... In developing these objectives, the availability of information from response actions relating to the...), test cases proving the code works, and any alteration of previously documented code made to adapt the... computer code (if any), test cases proving the code works, and any alteration of previously documented code...

43 CFR 11.64 - Injury determination phase-testing and sampling methods.

Code of Federal Regulations, 2013 CFR

2013-10-01

.... In developing these objectives, the availability of information from response actions relating to the...), test cases proving the code works, and any alteration of previously documented code made to adapt the... computer code (if any), test cases proving the code works, and any alteration of previously documented code...

Matched cohort study of external cephalic version in women with previous cesarean delivery.

PubMed

Keepanasseril, Anish; Anand, Keerthana; Soundara Raghavan, Subrahmanian

2017-07-01

To evaluate the efficacy and safety of external cephalic version (ECV) among women with previous cesarean delivery. A retrospective study was conducted using data for women with previous cesarean delivery and breech presentation who underwent ECV at or after 36 weeks of pregnancy during 2011-2016. For every case, two multiparous women without previous cesarean delivery who underwent ECV and were matched for age and pregnancy duration were included. Characteristics and outcomes were compared between groups. ECV was successful for 32 (84.2%) of 38 women with previous cesarean delivery and 62 (81.6%) in the control group (P=0.728). Multivariate regression analysis confirmed that previous cesarean was not associated with ECV success (odds ratio 1.89, 95% confidence interval 0.19-18.47; P=0.244). Successful vaginal delivery after successful ECV was reported for 19 (59.4%) women in the previous cesarean delivery group and 52 (83.9%) in the control group (P<0.001). No ECV-associated complications occurred in women with previous cesarean delivery. To avoid a repeat cesarean delivery, ECV can be offered to women with breech presentation and previous cesarean delivery who are otherwise eligible for a trial of labor. © 2017 International Federation of Gynecology and Obstetrics.

A country-wide study of spoligotype and drug resistance characteristics of Mycobacterium tuberculosis isolates from children in China.

PubMed

Jiao, Weiwei; Liu, Zhiguang; Han, Rui; Zhao, Xiuqin; Dong, Fang; Dong, Haiyan; Huang, Hairong; Tian, Jianling; Li, Qinjing; Lian, Lulu; Yin, Qingqin; Song, Wenqi; Wan, Kanglin; Shen, A-Dong

2013-01-01

Tuberculosis (TB) is still a big threat to human health, especially in children. However, an isolation of Mycobacterium tuberculosis culture from pediatric cases remains a challenge. In order to provide some scientific basis for children TB control, we investigated the genotyping and drug resistance characteristics of M. tuberculosis isolates from pediatric cases in China. In this study, a total of 440 strains including 90 from children (<15 years), 159 from adolescents (15-18 years) and 191 from adults (>18 years) isolated in 25 provinces across China were subjected to spoligotyping and drug susceptibility testing. As a result, Beijing family strains were shown to remain predominant in China (85.6%, 81.1% and 75.4% in three above groups, respectively), especially among new children cases (91.0% vs. 69.6% in previously treated cases, P=0.03). The prevalence of the Beijing genotype isolates was higher in northern and central China in the total collection (85.1% in northern and 83.9% in central vs. 61.6% in southern China, P<0.001) and a similar trend was seen in all three age groups (P=0.708, <0.001 and 0.025, respectively). In adolescents, the frequencies of isoniazid (INH)-resistant and ethambutol (EMB)-resistant isolates were significantly higher among Beijing strains compared to non-Beijing genotype strains (P=0.028 for INH and P=0.027 for EMB). Furthermore, strong association was observed between resistance to rifampicine (RIF), streptomycin (STR) and multidrug resistance (MDR) among Beijing compared to non-Beijing strains in previously treated cases of children (P=0.01, 0.01 and 0.025, respectively). Beijing family was more prevalent in northern and central China compared to southern China and these strains were predominant in all age groups. The genetic diversity of M. tuberculosis isolates from children was similar to that found in adolescents and adults. Beijing genotype was associated with RIF, STR and MDR resistance in previously treated children.

Need of tetraiodothyronine supplemental therapy in pregnant women

NASA Astrophysics Data System (ADS)

Stoian, Dana; Craciunescu, Mihalea; Timar, Romulus; Schiller, Adalbert; Pater, Liana; Craina, Marius

2013-10-01

Thyroid hormones are essential for fetal development. Normal thyroid function in pregnant women adjusts by itself in cases of pregnancy, phenomenon that is deficient in cases of previous maternal thyroid disease. The study group was represented by 120 females, with reproductive age, with known thyroid disease, that had a up to delivery pregnancy. Thyroid ultrasound parameters and functional parameters were follow-up during the 9-month of gestation. The study proposes a mathematical model of predicting the need and the amount of tetraiodothyronine treatment in pregnant women with prevalent thyroid disease.

The Power of Policy: A Case Study of Healthy Eating Among Children

PubMed Central

Cassady, Diana; Vogt, Rainbow; Oto-Kent, Debbie; Mosley, Ramona; Lincoln, Richard

2006-01-01

We used a case study approach to examine the nutritional effect of a policy to increase fruit and vegetable consumption in the Students Today Achieving Results for Tomorrow after-school program. The snack menu was changed in 44 after-school programs serving 8000 low-income and ethnically diverse elementary-school students. A comparison of previous and current snack menus identified a significant increase in fruit servings (83%) and no change in vegetable servings. We discuss the unintended consequences resulting from the menu changes. PMID:16873746

Phylogeny, character evolution, and biogeography of Cuscuta (dodders; Convolvulaceae) inferred from coding plastid and nuclear sequences.

PubMed

García, Miguel A; Costea, Mihai; Kuzmina, Maria; Stefanović, Saša

2014-04-01

The parasitic genus Cuscuta, containing some 200 species circumscribed traditionally in three subgenera, is nearly cosmopolitan, occurring in a wide range of habitats and hosts. Previous molecular studies, on subgenera Grammica and Cuscuta, delimited major clades within these groups. However, the sequences used were unalignable among subgenera, preventing the phylogenetic comparison across the genus. We conducted a broad phylogenetic study using rbcL and nrLSU sequences covering the morphological, physiological, and geographical diversity of Cuscuta. We used parsimony methods to reconstruct ancestral states for taxonomically important characters. Biogeographical inferences were obtained using statistical and Bayesian approaches. Four well-supported major clades are resolved. Two of them correspond to subgenera Monogynella and Grammica. Subgenus Cuscuta is paraphyletic, with section Pachystigma sister to subgenus Grammica. Previously described cases of strongly supported discordance between plastid and nuclear phylogenies, interpreted as reticulation events, are confirmed here and three new cases are detected. Dehiscent fruits and globose stigmas are inferred as ancestral character states, whereas the ancestral style number is ambiguous. Biogeographical reconstructions suggest an Old World origin for the genus and subsequent spread to the Americas as a consequence of one long-distance dispersal. Hybridization may play an important yet underestimated role in the evolution of Cuscuta. Our results disagree with scenarios of evolution (polarity) previously proposed for several taxonomically important morphological characters, and with their usage and significance. While several cases of long-distance dispersal are inferred, vicariance or dispersal to adjacent areas emerges as the dominant biogeographical pattern.

Whole exome sequencing identifies genetic variants in inherited thrombocytopenia with secondary qualitative function defects.

PubMed

Johnson, Ben; Lowe, Gillian C; Futterer, Jane; Lordkipanidzé, Marie; MacDonald, David; Simpson, Michael A; Sanchez-Guiú, Isabel; Drake, Sian; Bem, Danai; Leo, Vincenzo; Fletcher, Sarah J; Dawood, Ban; Rivera, José; Allsup, David; Biss, Tina; Bolton-Maggs, Paula Hb; Collins, Peter; Curry, Nicola; Grimley, Charlotte; James, Beki; Makris, Mike; Motwani, Jayashree; Pavord, Sue; Talks, Katherine; Thachil, Jecko; Wilde, Jonathan; Williams, Mike; Harrison, Paul; Gissen, Paul; Mundell, Stuart; Mumford, Andrew; Daly, Martina E; Watson, Steve P; Morgan, Neil V

2016-10-01

Inherited thrombocytopenias are a heterogeneous group of disorders characterized by abnormally low platelet counts which can be associated with abnormal bleeding. Next-generation sequencing has previously been employed in these disorders for the confirmation of suspected genetic abnormalities, and more recently in the discovery of novel disease-causing genes. However its full potential has not yet been exploited. Over the past 6 years we have sequenced the exomes from 55 patients, including 37 index cases and 18 additional family members, all of whom were recruited to the UK Genotyping and Phenotyping of Platelets study. All patients had inherited or sustained thrombocytopenia of unknown etiology with platelet counts varying from 11×10 9 /L to 186×10 9 /L. Of the 51 patients phenotypically tested, 37 (73%), had an additional secondary qualitative platelet defect. Using whole exome sequencing analysis we have identified "pathogenic" or "likely pathogenic" variants in 46% (17/37) of our index patients with thrombocytopenia. In addition, we report variants of uncertain significance in 12 index cases, including novel candidate genetic variants in previously unreported genes in four index cases. These results demonstrate that whole exome sequencing is an efficient method for elucidating potential pathogenic genetic variants in inherited thrombocytopenia. Whole exome sequencing also has the added benefit of discovering potentially pathogenic genetic variants for further study in novel genes not previously implicated in inherited thrombocytopenia. Copyright© Ferrata Storti Foundation.

Emergency department screening for syphilis in pregnant women without prenatal care.

PubMed

Ernst, A A; Romolo, R; Nick, T

1993-05-01

To determine if there is a high seroprevalence of syphilis in pregnant women without prenatal care presenting to an urban emergency department. Prospective, nonblinded sampling of pregnant women without prenatal care with a comparison group of pregnant women with prenatal care from the obstetrics clinic. Patients in the ED setting were asked about such associated risk factors as previous syphilis and drug use. Urban ED. Pregnant women without prenatal care. Patients were screened for syphilis using the automated reagin test. Reactive automated reagin tests were confirmed by the fluorescent treponemal antibody absorption. In addition, 44 patients with nonreactive automated reagin tests had confirmatory tests done. New cases were verified by the state health department. Seventy-two patients were included in the study. The average age was 25 years. Eight patients (11.1%) were diagnosed with previously undetected syphilis. Four patients (5.6%) had previously treated syphilis. The laboratory cost of screening was $248 per new case of syphilis detected. The study group was compared with 118 patients matched for age and race who presented to the obstetrics clinic for routine prenatal care. Two new cases of syphilis were discovered in the clinic population (1.7%). A high rate of syphilis infection was detected in this inner-city ED population presenting without prenatal care. This was higher than that found in the patients presenting for obstetrics care in the clinic. Patients can be screened effectively in the ED.

Exome Sequencing Reveals Primary Immunodeficiencies in Children with Community-Acquired Pseudomonas aeruginosa Sepsis.

PubMed

Asgari, Samira; McLaren, Paul J; Peake, Jane; Wong, Melanie; Wong, Richard; Bartha, Istvan; Francis, Joshua R; Abarca, Katia; Gelderman, Kyra A; Agyeman, Philipp; Aebi, Christoph; Berger, Christoph; Fellay, Jacques; Schlapbach, Luregn J

2016-01-01

One out of three pediatric sepsis deaths in high income countries occur in previously healthy children. Primary immunodeficiencies (PIDs) have been postulated to underlie fulminant sepsis, but this concept remains to be confirmed in clinical practice. Pseudomonas aeruginosa ( P. aeruginosa ) is a common bacterium mostly associated with health care-related infections in immunocompromised individuals. However, in rare cases, it can cause sepsis in previously healthy children. We used exome sequencing and bioinformatic analysis to systematically search for genetic factors underpinning severe P. aeruginosa infection in the pediatric population. We collected blood samples from 11 previously healthy children, with no family history of immunodeficiency, who presented with severe sepsis due to community-acquired P. aeruginosa bacteremia. Genomic DNA was extracted from blood or tissue samples obtained intravitam or postmortem. We obtained high-coverage exome sequencing data and searched for rare loss-of-function variants. After rigorous filtrations, 12 potentially causal variants were identified. Two out of eight (25%) fatal cases were found to carry novel pathogenic variants in PID genes, including BTK and DNMT3B . This study demonstrates that exome sequencing allows to identify rare, deleterious human genetic variants responsible for fulminant sepsis in apparently healthy children. Diagnosing PIDs in such patients is of high relevance to survivors and affected families. We propose that unusually severe and fatal sepsis cases in previously healthy children should be considered for exome/genome sequencing to search for underlying PIDs.

Exome Sequencing Reveals Primary Immunodeficiencies in Children with Community-Acquired Pseudomonas aeruginosa Sepsis

PubMed Central

Asgari, Samira; McLaren, Paul J.; Peake, Jane; Wong, Melanie; Wong, Richard; Bartha, Istvan; Francis, Joshua R.; Abarca, Katia; Gelderman, Kyra A.; Agyeman, Philipp; Aebi, Christoph; Berger, Christoph; Fellay, Jacques; Schlapbach, Luregn J.; Posfay-Barbe, Klara

2016-01-01

One out of three pediatric sepsis deaths in high income countries occur in previously healthy children. Primary immunodeficiencies (PIDs) have been postulated to underlie fulminant sepsis, but this concept remains to be confirmed in clinical practice. Pseudomonas aeruginosa (P. aeruginosa) is a common bacterium mostly associated with health care-related infections in immunocompromised individuals. However, in rare cases, it can cause sepsis in previously healthy children. We used exome sequencing and bioinformatic analysis to systematically search for genetic factors underpinning severe P. aeruginosa infection in the pediatric population. We collected blood samples from 11 previously healthy children, with no family history of immunodeficiency, who presented with severe sepsis due to community-acquired P. aeruginosa bacteremia. Genomic DNA was extracted from blood or tissue samples obtained intravitam or postmortem. We obtained high-coverage exome sequencing data and searched for rare loss-of-function variants. After rigorous filtrations, 12 potentially causal variants were identified. Two out of eight (25%) fatal cases were found to carry novel pathogenic variants in PID genes, including BTK and DNMT3B. This study demonstrates that exome sequencing allows to identify rare, deleterious human genetic variants responsible for fulminant sepsis in apparently healthy children. Diagnosing PIDs in such patients is of high relevance to survivors and affected families. We propose that unusually severe and fatal sepsis cases in previously healthy children should be considered for exome/genome sequencing to search for underlying PIDs. PMID:27703454

Subspine impingement: 2 case reports of a previously unreported cause of instability in total hip arthroplasty.

PubMed

Davidovitch, Roy I; DelSole, Edward M; Vigdorchik, Jonathan M

2016-03-23

Instability is a common cause of revision hip arthroplasty and is frequently due to improper component placement and subsequent component impingement. Impingement of the greater trochanter upon the anterior inferior iliac spine (AIIS) has been described as a cause of symptomatic femoroacetabular impingement (FAI), but has never been described as a cause of instability following total hip arthroplasty (THA). We present 2 cases of patients undergoing THA. Each patient was evaluated preoperatively and found to have a prominent AIIS, which was concerning due to it overhanging the anterolateral acetabular lip. Both patients had intraoperative posterior instability of their THA, the cause of which was determined to be impingement of the greater trochanter upon a prominent AIIS. Open resection of the AIIS was performed with subsequent resolution of impingement. AIIS impingement has been reported as a cause of symptomatic FAI. In these case reports, open or arthroscopic resection of the AIIS resulted in resolution of symptoms. Morphologically distinct subtypes of the AIIS have been previously described based upon computed tomography, and some subtypes are associated with a high risk of impingement in the native hip. No previous studies have described this phenomenon in the setting of THA. Instability is a common cause of revision THA. Impingement of the greater trochanter upon a prominent AIIS is a previously unreported cause of THA instability which can be addressed with intraoperative resection of the AIIS with good result.

A Three Year Clinicopathological Study of Cases of Rupture Uterus

PubMed Central

Rathod, Setu; Swain, Sujata

2015-01-01

Introduction Rupture uterus is a life threatening obstetric complication with serious maternal and fetal side-effects. We report a 3 year (2010-2013) retrospective clinical study of pregnancy with rupture uterus cases attending a tertiary care hospital. Aim The aim of the study was to evaluate the incidence of rupture uterus, incidence as per age, parity, clinical presentations, risk factors, complications and management. Materials and Methods Retrospective data of 74 cases of rupture uterus in SCB Medical college, Cuttack was collected from case records of 26,547 deliveries during a 3 year span (2010-2013). Parameters like cause of rupture, type, site of rupture and outcome were recorded. The collected data was analysed by SPSS software v19. Results Out of 26,547 deliveries during the three year period, there were 74 cases of rupture uterus with an incidence of rupture 1 in 359 (0.28%). The mean age of rupture uterus was 27.4 years. 95.8% were multigravida and majority were referred cases from low socioeconomic status. Only 40.5% had the required minimum of four antenatal visits as recommended by WHO (World Health Organisation). A total of 48.6% of cases with rupture uterus had history of previous Caesarean section. Prolonged labour was present in 75.6% of the cases. Only 12.2% of the cases had history of oxytocin use whereas 9.5% had undergone an operative vaginal delivery. Obstructed labour was the cause in 24.3% of cases, 85.1% had complete rupture. Majority had a rupture in the anterior wall (69%) and 81.1% had rupture in lower segment of uterus. Only 17.6% had broad ligament haematoma, 10.8% colporrhexis and 6.8% had associated bladder injury. Repair was possible in only 39.2% of cases, whereas majority landed up in hysterectomy. Internal iliac ligation was done in 2.7% of cases. Perinatal mortality was 90.5% whereas maternal death was seen in 13.5% cases. One patient developed VVF (vesicovaginal fistula). Duration of hospital stay was upto 14 days in 81.1% cases. Conclusion Education and proper care especially of high risk patients like previous caesarean by competent personnal, proper use of oxytocin and early referral may help to reduce the incidence of “rupture uterus”. PMID:26673858

A Mixed-Method Study of Princeville's Rebuilding from the Flood of 1999: Lessons on the Importance of Invisible Community Assets

ERIC Educational Resources Information Center

Yoon, Intae

2009-01-01

Guided by previous studies and the community assets perspective, a concurrent mixed-method case study was conducted five years after a devastating flood to investigate how invisible community assets played a role in Princeville's rebuilding process from the flood of 1999. The independent variables in this study included retrospectively assessed…

Approach to Mathematical Problem Solving and Students' Belief Systems: Two Case Studies

ERIC Educational Resources Information Center

Callejo, Maria Luz; Vila, Antoni

2009-01-01

The goal of the study reported here is to gain a better understanding of the role of belief systems in the approach phase to mathematical problem solving. Two students of high academic performance were selected based on a previous exploratory study of 61 students 12-13 years old. In this study we identified different types of approaches to…

Complete duplication of collecting system in a horseshoe kidney presenting with recurrent urinary tract infections: report of an exceedingly rare congenital anomaly and review of literature.

PubMed

Mirzazadeh, Majid; Richards, Kyle A

2011-01-01

We report the fifth case in the English literature of a horseshoe kidney with a complete ureteral duplication. Our case is unique in that the previous four cases occurred in the presence of a ureterocele, whereas our patient lacked this anomaly. Further, our patient was managed conservatively, whereas the previous four patients were managed with surgery.

[Epidemiological methods used in studies in the prevalence of Tourette syndrome].

PubMed

Stefanoff, Paweł; Mazurek, Jacek

2003-01-01

Tourette syndrome (TS) prevalence was studied since the early 80-ies. Its clinical course is characterised by co-occurrence of motor and vocal tics. Results of previous epidemiological studies were surprisingly divergent: the prevalence varied from 0.5 to 115 cases per 10,000 population. The disease previously recognised as extremely rare and severe is now considered as quite common, with often moderate course. Selected methods used in studies of TS prevalence and analysis of their possible impact on study results are presented. The studies were divided into 3 groups: studies of the hospitalised population, large-scale screenings and studies involving school population, basing on characteristic and size of population, methods of selection of subjects, diagnostic and screening methods used. Studies of the hospitalised population involved patients with most severe symptoms, in different age groups, different methods of final diagnosis confirmation were used. TS prevalence varied from 0.5 up to 15 cases per 10,000 population. Procedures used in large-scale screening studies made possible the elimination of potential selection bias. Large populations were studied using transparent and repetitive confirmation of diagnoses. Their validity was additionally checked in parallel validity studies. TS prevalence was in the range 4.3 to 10 cases per 10,000 population. The highest TS prevalence was obtained in studies involving schoolchildren. Data were gathered from multiple sources: from parents, teachers and children, as well as from classroom observation. Diagnoses were made by experienced clinicians. TS prevalence obtained in school population studies was between 36.2 up to 115 per 10,000 population.

Neurology cases evaluated by the U.S. Air Force School of Aerospace Medicine 2000-2012.

PubMed

Hesselbrock, Roger; Heaton, John

2014-05-01

Historically, neurologic conditions are a major cause for removing aviators from flying status. Early neuropsychiatry studies included psychiatric conditions along with neurologic disorders. Previously reported data specifically addressing neurologic conditions in aviators are limited. And there is little current neurology-specific data reported. A retrospective review was done on patients with diagnoses evaluated by Neurology at the U.S. Air Force School of Aerospace Medicine Aeromedical Consultation Service (ACS) between 2000 and 2012 using ACS records and databases to identify cases. Patient demographics, major diagnoses with associated International Classification of Diseases (9th rev.) codes, and aeromedical disposition recommendations were abstracted into a separate database for analysis. In total, 871 cases were identified. Patients were predominantly male (91%) with average age 34 and were predominantly pilots (69%). The top neurology-related diagnoses found in our series were headaches, head injuries, and radiculopathies. Of the cases evaluated, 570 aviators (65%) were recommended by ACS to return to flying status. Waiver authorities accepted 88% of ACS recommendations. Current patterns in neurologic conditions in the selected population of cases evaluated by the ACS were presented. Of the neurologic diagnoses seen, a novel finding was the prominence of head injuries in our series not seen in previous studies. This may be due to more stringent aeromedical standards with advances in medical practice and underscores that this issue is not just about disability but affects aircrew operational readiness. Most cases of neurologic disease evaluated by the ACS were recommended for return to flying status.

Considering a Merger?

ERIC Educational Resources Information Center

Thompson, Hugh L.

1985-01-01

A successful college merger is often conditioned by geography, previous cooperation, complementary instructional programs, academic excellence, and common political interest. Suggestions when considering a merger are offered. A case study of a failed merger between Detroit Institute of Technology and Wayne State University is presented. (MLW)

Prevalence of Novel MAGED2 Mutations in Antenatal Bartter Syndrome.

PubMed

Legrand, Anne; Treard, Cyrielle; Roncelin, Isabelle; Dreux, Sophie; Bertholet-Thomas, Aurélia; Broux, Françoise; Bruno, Daniele; Decramer, Stéphane; Deschenes, Georges; Djeddi, Djamal; Guigonis, Vincent; Jay, Nadine; Khalifeh, Tackwa; Llanas, Brigitte; Morin, Denis; Morin, Gilles; Nobili, François; Pietrement, Christine; Ryckewaert, Amélie; Salomon, Rémi; Vrillon, Isabelle; Blanchard, Anne; Vargas-Poussou, Rosa

2018-02-07

Mutations in the MAGED2 gene, located on the X chromosome, have been recently detected in males with a transient form of antenatal Bartter syndrome or with idiopathic polyhydramnios. The aim of this study is to analyze the proportion of the population with mutations in this gene in a French cohort of patients with antenatal Bartter syndrome. The French cohort of patients with antenatal Bartter syndrome encompasses 171 families. Mutations in genes responsible for types 1-4 have been detected in 75% of cases. In patients without identified genetic cause ( n =42), transient antenatal Bartter syndrome was reported in 12 cases. We analyzed the MAGED2 gene in the entire cohort of negative cases by Sanger sequencing and retrospectively collected clinical data regarding pregnancy as well as the postnatal outcome for positive cases. We detected mutations in MAGED2 in 17 patients, including the 12 with transient antenatal Bartter syndrome, from 16 families. Fifteen different mutations were detected (one whole deletion, three frameshift, three splicing, three nonsense, two inframe deletions, and three missense); 13 of these mutations had not been previously described. Interestingly, two patients are females; in one of these patients our data are consistent with selective inactivation of chromosome X explaining the severity. The phenotypic presentation in our patients was variable and less severe than that of the originally described cases. MAGED2 mutations explained 9% of cases of antenatal Bartter syndrome in a French cohort, and accounted for 38% of patients without other characterized mutations and for 44% of male probands of negative cases. Our study confirmed previously published data and showed that females can be affected. As a result, this gene must be included in the screening of the most severe clinical form of Bartter syndrome. Copyright © 2018 by the American Society of Nephrology.

[A case study on duty of care in professional nursing].

PubMed

Huang, Hui-Man; Liao, Chi-Chun

2013-08-01

Nurses are expected to discharge their duty of care effectively and professionally to prevent medical negligence. Only three articles have previously focused on medical negligence. Duty of care and medical negligence in nursing are topics that have been neglected in Taiwan. (1) Classify the duty of care of professional nurses; (2) Investigate the facts and disputes in the current case; (3) Clarify the legal issues involved with regard to duty-of-care violations in the current case; (4) Explore the causal relationships in a legal context between nurses' duty-of-care violations and patient harm / injury. Literature analysis and a case study are used to analyze Supreme Court Verdict No.5550 (2010). Duty of care for nursing professionals may be classified into seven broad categories. Each category has its distinct correlatives. In nursing practice, every nursing behavior has a corresponding duty. In this case, the case study nurse did not discharge her obstetric professional duty and failed to inform the doctor in a timely manner. Negligence resulted in prenatal death and the case study nurse was found guilty. In order to prevent committing a crime, nurses should gain a better understanding of their duty of care and adequately discharge these duties in daily practice.

The impact of protocol on nurses' role stress: a longitudinal perspective.

PubMed

Dodd-McCue, Diane; Tartaglia, Alexander; Veazey, Kenneth W; Streetman, Pamela S

2005-04-01

The study examined the impact of a protocol directed at increasing organ donation on the role stress and work attitudes of critical care nurses involved in potential organ donation cases. The research examined whether the protocol could positively affect nurses' perceptions of role stress, and if so, could the work environment improvements be sustained over time. The Family Communication Coordinator (FCC) protocol promotes effective communication during potential organ donation cases using a multidisciplinary team approach. Previous research found it associated with improved donation outcomes and with improved perceptions of role stress by critical care nurses. However, the previous study lacked methodological rigor necessary to determine causality and sustainability over time. The study used a quasi-experimental prospective longitudinal design. The sample included critical care nurses who had experience with potential organ donation cases with the protocol. Survey data were collected at 4 points over 2 years. Surveys used previously validated and reliable measures of role stress (role ambiguity, role conflict, role overload) and work attitudes (commitment, satisfaction). Interviews supplemented these data. The nurses' perceptions of role stress associated with potential organ donation cases dramatically dropped after the protocol was implemented. All measures of role stress, particularly role ambiguity and role conflict, showed statistically significant and sustained improvement. Nurses' professional, unit, and hospital commitment and satisfaction reflect an increasingly positive workplace. The results demonstrate that the FCC protocol positively influenced the workplace through its impact on role stress over the first 2 years following its implementation. The findings suggest that similar protocols may be appropriate in improving the critical care environment by reducing the stress and uncertainty of professionals involved in other end-of-life situations. However, the most striking implication relates to the reality of the workplace: meeting the goals of improved patient care outcomes and those of improving the healthcare work environment are not mutually exclusive and may be mutually essential.

Association between osteoporosis and urinary calculus: evidence from a population-based study.

PubMed

Keller, J J; Lin, C-C; Kang, J-H; Lin, H-C

2013-02-01

This population-based case-control analysis investigated the association between osteoporosis and prior urinary calculus (UC) in Taiwan. We succeeded in detecting an association between osteoporosis and prior UC (adjusted odds ratio = 1.66). This association was consistent and significant regardless of stone location. UC has been demonstrated to be a risk factor for osteoporotic fractures, but no studies to date have directly investigated the association between UC and osteoporosis. This case-control analysis aimed to investigate the association of osteoporosis with prior UC using a population-based dataset in Taiwan. We first identified 39,840 cases ≥40 years who received their first-time diagnosis of osteoporosis between 2002 and 2009 and then randomly selected 79,680 controls. We used conditional logistic regression analyses to compute the odds ratio (OR) and the corresponding 95 % confidence interval (CI) for having been previously diagnosed with UC between cases and controls. The OR of having been previously diagnosed with UC for patients with osteoporosis was 1.66 (95 % CI = 1.59-1.73) when compared to controls after adjusting for geographic location, urbanization level, type I diabetes mellitus, coronary heart disease, hyperlipidemia, rheumatoid arthritis, stroke, renal disease, Parkinson's disease, hyperthyroidism, chronic hepatopathy, Cushing's syndrome, malabsorption, gastrectomy, obesity, and alcohol abuse/alcohol dependence syndrome. The results consistently showed that osteoporosis was significantly associated with a previous diagnosis of UC regardless of stone location; the adjusted ORs of prior kidney calculus, ureter calculus, bladder calculus, and unspecified calculus when compared to controls were 1.71 (95 % CI = 1.61-1.81), 1.60 (95 % CI = 1.47-1.74), 1.59 (95 % CI = 1.23-2.04), and 1.69 (95 % CI = 1.59-1.80), respectively. This study succeeded in detecting an association between osteoporosis and prior UC. In addition, our findings were consistent and significant regardless of stone location.

Advanced Placement Academy: Case Study of a Program within a School

ERIC Educational Resources Information Center

Swanson, Julie Dingle; Nagy, Steven

2014-01-01

The focus of this study was the first year of implementation of the Advanced Placement Academy (APA), a program within a high school providing honors and Advanced Placement coursework for high-ability African American students with previously limited access to rigorous courses. The qualitative investigation explores practical solutions from…

Relative Category-Specific Preservation in Semantic Dementia? Evidence from 35 Cases

ERIC Educational Resources Information Center

Merck, Catherine; Jonin, Pierre-Yves; Vichard, Helene; Boursiquot, Sandrine Le Moal; Leblay, Virginie; Belliard, Serge

2013-01-01

Category-specific deficits have rarely been reported in semantic dementia (SD). To our knowledge, only four previous studies have documented category-specific deficits, and these have focused on the living versus non-living things contrast rather than on more fine-grained semantic categories. This study aimed to determine whether a…

Physical Education Teachers' Career-Long Professional Learning: Getting Personal

ERIC Educational Resources Information Center

Makopoulou, Kyriaki; Armour, Kathleen M.

2011-01-01

The aim of this study was to build upon previous PE-CPD (Physical Education Continuing Professional Development) research by exploring Greek case study physical education (PE) teachers' engagement in professional learning. It is argued that in the contemporary European context, where the teaching profession is viewed as central to achieving wider…

HUMAN SCALP HAIR: AN ENVIRONMENTAL EXPOSURE INDEX FOR TRACE ELEMENTS. I. FIFTEEN TRACE ELEMENTS IN NEW YORK, N.Y. (1971-72)

EPA Science Inventory

Previous studies have revealed that hair trace element concentrations can reflect exposure in cases of frank poisoning and deficiency. Correlations have been found also in some populations living in regions where metallurgic processes are conducted. This study reports significant...

A Mixed Method Case Study on Learner Engagement in e-Learning Professional Training

ERIC Educational Resources Information Center

Zhao, Jane Yanfeng

2014-01-01

Previous research showed that learners' reluctance in participating in e-Learning training is a major obstacle in achieving training objectives. This study focused on learners' e-Learning engagement in professional training in the chapter of the American Society for Training and Development (ASTD). The participants were 21 chapter members.…

Managing School-Based Curriculum Innovations: A Hong Kong Case Study

ERIC Educational Resources Information Center

Law, Edmond H. F.; Wan, Sally W. Y.; Galton, Maurice; Lee, John C. K.

2010-01-01

This study was originally designed to explore the impact of a distributed approach to developing curriculum leadership among schoolteachers. Previous papers have focused on reporting evidence of teacher learning in the process of engaging teachers in various types of curriculum decision-making in an innovation project based on interview data. This…

Matching Linguistic and Pedagogical Objectives in a Telecollaboration Project: A Case Study

ERIC Educational Resources Information Center

Bueno-Alastuey, M. C.; Kleban, M.

2016-01-01

This article attempts to analyse to what extent a distance collaboration project between two groups of university students sharing the same lingua franca (English), but with different course educational objectives can benefit its participants. We build on the knowledge gleaned from previous studies of second language telecollaboration which point…

Individual Differences in Adolescent Health Symptoms: The Effects of Gender and Coping

ERIC Educational Resources Information Center

Wilson, G.S.; Pritchard, M.E.; Revalee, B.

2005-01-01

Previous studies have suggested that adult men and women experience different types and severities of physical and psychological health symptoms. This study examined whether in the case of adolescents these reported gender differences in physical and psychological health symptoms could actually be the result of differences in coping styles. Five…

High plasma levels of vitamin C and E are associated with incident radiographic knee osteoarthritis

USDA-ARS?s Scientific Manuscript database

Previous studies suggest that the antioxidants vitamins C and E may protect against development of knee osteoarthritis (OA). We examined the association of circulating levels of vitamin C and E with incident whole knee radiographic OA (WKROA). We performed a nested case-control study of incident WKR...

Gender Divergence in Academics' Representation and Research Productivity: A Nigerian Case Study

ERIC Educational Resources Information Center

Opesade, Adeola Omobola; Famurewa, Kofoworola Folakemi; Igwe, Ebelechukwu Gloria

2017-01-01

Gender equity is increasingly seen as an indicator of development and global acceptance in networks of higher education. Despite this, gender divergence in research productivity of academics coupled with under-representation of women in science has been reported to beset female's scholarly activities. Previous studies provide differing results,…

Can Blogging Increase Extroverts' Satisfaction in the Classroom? Lessons from Multiple Case Studies

ERIC Educational Resources Information Center

Samuel-Azran, Tal; Ravid, Gilad

2016-01-01

In light of systematic evidence that extroverts are disadvantaged in the classroom, we examined whether an online environment assignment that builds on extroverts' character strengths can increase their overall course satisfaction. Based on previous studies demonstrating that extroverts are energized by feedback from outsiders, we asked 180…

Understanding Educational Policy Formation: The Case of School Violence Policies in Israel

ERIC Educational Resources Information Center

Fast, Idit

2016-01-01

This study explores mechanisms underlying processes of educational policy formation. Previous studies have given much attention to processes of diffusion when accounting for educational policy formation. Less account has been given to the day-to-day institutional dynamics through which educational policies develop and change. Building on extensive…

The College-Choice Process of High Achieving Freshmen: A Comparative Case Study

ERIC Educational Resources Information Center

Dale, Amanda

2010-01-01

The purpose of this study was to examine the college-choice process of high achieving students. Employing current literature and previous research, it combined current models of college choice and the influential factors identified throughout the literature while utilizing the concept of bounded rationality to create a conceptual framework to…

Malignant Mesothelioma in a Motor Vehicle Mechanic.

PubMed

Meisenkothen, Christopher

2017-02-01

Case reports remain an important source of data in the debate over the carcinogenic effect of asbestos-containing automotive friction products. This report documents a case of pleural mesothelioma accompanied by asbestos bodies in the lung tissue of a career auto mechanic with no other known sources of exposure. Previously unreported historical and contemporary exposure data are also discussed in the context of providing additional support for the proposition that work with asbestos-containing automotive products presents a risk of significant exposure. While there remains a body of negative epidemiology that fails to find an increased risk of disease among auto workers, those data must be approached with caution. Many of those studies have drawn technical criticisms, which are beyond the scope of this report, but they remain a key part of the legal defense mounted by defendant-companies who are involved in asbestos-related litigation. This ongoing debate provides the context for the continued relevance of case reports such as this one, as well as the presentation of new and previously unpublished exposure data.

Risk factors for extended-spectrum β-lactamase-producing Escherichia coli urinary tract infection in the community in Denmark: a case-control study.

PubMed

Søgaard, M; Heide-Jørgensen, U; Vandenbroucke, J P; Schønheyder, H C; Vandenbroucke-Grauls, C M J E

2017-12-01

To verify the role of proton pump inhibitors (PPI) and nitrofurantoin, which have appeared as novel risk factors for carriage of extended-spectrum β-lactamase (ESBL) -producing Escherichia coli, as risk factors for ESBL E. coli urinary tract infection (UTI). We included known risk factors to ascertain whether our findings are comparable with those of previous studies. Population-based case-control study including 339 cases with community-onset ESBL E. coli UTI in 2007-2012, 3390 non-ESBL E. coli UTI controls and 3390 population controls. We investigated potential risk factors by estimating ORs and 95% CIs adjusting for sex, age and co-morbidity. Comparing cases with non-ESBL E. coli UTI, PPI use yielded an OR of 1.6 (95% CI 1.2-2.0) and antibiotic exposure gave an OR of 1.4 (95% CI 1.1-1.8); these were driven by nitrofurantoin (OR 1.8; 95% CI 1.3-2.6) and macrolides (OR 1.7; 95% CI 1.2-2.3). Other risk factors included previous hospitalization with one or two and more than two hospitalizations versus none yielding ORs of 1.9 (95% CI 1.4-2.5) and 4.6 (95% CI 3.2-6.8), recent surgery (OR 2.0; 95% CI 1.5-2.8), renal disease (OR 2.2; 95% CI 1.4-3.4), chronic pulmonary disease (OR 1.4; 95% CI 1.0-2.0) and cancer (OR 1.5; 95% CI 1.1-2.1). Comparing cases with population controls, we found that most risk factors were also risk factors for non-ESBL UTI. ESBL E. coli UTI were associated with previous hospitalization and surgery. Nitrofurantoin and macrolides augmented the risk. PPIs had a moderate effect but may be important facilitators of ESBL carriage due to their widespread use. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

A case of pediatric B-Lymphoblastic leukemia presenting with a t(9;12)(p24;q11.2) involving JAK2 and concomitant MLL rearrangement with apparent insertion at 6q27

PubMed Central

2013-01-01

Background B-cell acute lymphoblastic leukemia (B-ALL) is the most common malignancy in pediatric patients and the leading cause of cancer-related death in children and young adults. Translocations of 9p24 involving JAK2 (9p24) and gain-of-function mutations of JAK2 with subsequent activation of the JAK2 kinase have been described in several hematological malignancies including B-ALL. However, rearrangements involving JAK2 are rare in B-ALL as only few cases have been described in the literature. Findings Herein, we present a case of pediatric B-ALL whose conventional cytogenetics revealed an abnormal karyotype with a reciprocal translocation involving 9p24 (JAK2) and 12p11.2. Fluorescence in situ hybridization (FISH) studies using the RP11-927H16 Spectrum Green JAK2 probe on previously G-banded metaphases confirmed the involvement of JAK2 in this rearrangement. Further FISH studies on the same previously G-banded metaphases using the LSI MLL probe helped to characterize an insertion of MLL into 6q27 as an additional abnormality in this karyotype. FISH studies performed on interphase nuclei also revealed an abnormal clone with MLL rearrangements in 23.6% of the nuclei examined as well as an abnormal clonal population with a deletion of the 5'IGH@ region in 88.3% of the nuclei examined. Conclusions Rearrangements of 9p24 can result in constitutive activation of JAK2, and have been observed in B-ALL. Rearrangements of the MLL gene have also been described extensively in B-ALL. However, rearrangements of MLL with a partner at 6q27 and in conjunction with a translocation involving JAK2 have not been previously described. This case pinpoints the importance of FISH and conventional cytogenetics to characterize complex rearrangements in which JAK2 and MLL are involved. The therapeutic targeting of JAK2 and MLL in cases like this may be prognostically beneficial. PMID:24274401

Grammatical gender in German: a case for linguistic relativity?

PubMed

Bender, Andrea; Beller, Sieghard; Klauer, Karl Christoph

2011-09-01

The "principle of linguistic relativity" holds that, by way of grammatical categorization, language affects the conceptual representations of its speakers. Formal gender systems are a case in point, albeit a particularly controversial one: Previous studies obtained broadly diverging data, thus giving rise to conflicting conclusions. To a large extent, this incoherence is related to task differences and methodological problems. Here, a priming design is presented that avoids previous problems, as it prevents participants from employing gender information in a strategic manner. Four experiments with German native speakers show priming effects of the prime's grammatical gender on animate and nonanimate targets, an effect for the prime's biological gender on animate targets, but no effect for the prime's biological gender on nonanimate targets, and thus speak against an effect of language on thought for German gender.

Unilateral occipital nerve stimulation for bilateral occipital neuralgia: a case report and literature review

PubMed Central

Liu, Aijun; Jiao, Yongcheng; Ji, Huijun; Zhang, Zhiwen

2017-01-01

Objectives The aim of this study is to present a case of successful relief of bilateral occipital neuralgia (ON) using unilateral occipital nerve stimulation (ONS) and to discuss the possible underlying mechanisms. Materials and methods We present the case of a 59-year-old female patient with severe bilateral ON treated with unilateral ONS. We systematically reviewed previous studies of ONS for ON, discussing the possible mechanisms of ONS in the relief of ON. Results The patient reported complete pain relief after consistent unilateral ONS during the follow-up period. The underlying mechanisms may be linked to the relationship between pain and several brain regions, including the pons, midbrain, and periaqueductal gray. Conclusion ONS is an effective and safe option for treating ON. Future studies will be required to clarify the mechanisms by which unilateral occipital stimulation provided relief for bilateral neuralgia in this case. PMID:28176938

Unilateral occipital nerve stimulation for bilateral occipital neuralgia: a case report and literature review.

PubMed

Liu, Aijun; Jiao, Yongcheng; Ji, Huijun; Zhang, Zhiwen

2017-01-01

The aim of this study is to present a case of successful relief of bilateral occipital neuralgia (ON) using unilateral occipital nerve stimulation (ONS) and to discuss the possible underlying mechanisms. We present the case of a 59-year-old female patient with severe bilateral ON treated with unilateral ONS. We systematically reviewed previous studies of ONS for ON, discussing the possible mechanisms of ONS in the relief of ON. The patient reported complete pain relief after consistent unilateral ONS during the follow-up period. The underlying mechanisms may be linked to the relationship between pain and several brain regions, including the pons, midbrain, and periaqueductal gray. ONS is an effective and safe option for treating ON. Future studies will be required to clarify the mechanisms by which unilateral occipital stimulation provided relief for bilateral neuralgia in this case.

Modelling dengue fever risk in the State of Yucatan, Mexico using regional-scale satellite-derived sea surface temperature.

PubMed

Laureano-Rosario, Abdiel E; Garcia-Rejon, Julian E; Gomez-Carro, Salvador; Farfan-Ale, Jose A; Muller-Karger, Frank E

2017-08-01

Accurately predicting vector-borne diseases, such as dengue fever, is essential for communities worldwide. Changes in environmental parameters such as precipitation, air temperature, and humidity are known to influence dengue fever dynamics. Furthermore, previous studies have shown how oceanographic variables, such as El Niño Southern Oscillation (ENSO)-related sea surface temperature from the Pacific Ocean, influences dengue fever in the Americas. However, literature is lacking on the use of regional-scale satellite-derived sea surface temperature (SST) to assess its relationship with dengue fever in coastal areas. Data on confirmed dengue cases, demographics, precipitation, and air temperature were collected. Incidence of weekly dengue cases was examined. Stepwise multiple regression analyses (AIC model selection) were used to assess which environmental variables best explained increased dengue incidence rates. SST, minimum air temperature, precipitation, and humidity substantially explained 42% of the observed variation (r 2 =0.42). Infectious diseases are characterized by the influence of past cases on current cases and results show that previous dengue cases alone explained 89% of the variation. Ordinary least-squares analyses showed a positive trend of 0.20±0.03°C in SST from 2006 to 2015. An important element of this study is to help develop strategic recommendations for public health officials in Mexico by providing a simple early warning capability for dengue incidence. Copyright © 2017 Elsevier B.V. All rights reserved.

Correlates of Incident Cognitive Impairment in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

PubMed Central

Gillett, Sarah R.; Thacker, Evan L.; Letter, Abraham J.; McClure, Leslie A.; Wadley, Virginia G.; Unverzagt, Frederick W.; Kissela, Brett M.; Kennedy, Richard E.; Glasser, Stephen P.; Levine, Deborah A.; Cushman, Mary

2015-01-01

Objective To identify approximately 500 cases of incident cognitive impairment (ICI) in a large, national sample adapting an existing cognitive test-based case definition and to examine relationships of vascular risk factors with ICI. Method Participants were from the REGARDS study, a national sample of 30,239 African-American and white Americans. Participants included in this analysis had normal cognitive screening and no history of stroke at baseline, and at least one follow-up cognitive assessment with a three test battery (TTB). Regression-based norms were applied to TTB scores to identify cases of ICI. Logistic regression was used to model associations with baseline vascular risk factors. Results We identified 495 participants with ICI out of 17,630 eligible participants. In multivariable modeling, income (OR 1.83 CI 1.27,2.62), stroke belt residence (OR 1.45 CI 1.18,1.78), history of transient ischemic attack (OR 1.90 CI 1.29,2.81), coronary artery disease(OR 1.32 CI 1.02,1.70), diabetes (OR 1.48 CI 1.17,1.87), obesity (OR 1.40 CI 1.05,1.86), and incident stroke (OR 2.73 CI 1.52,4.90) were associated with ICI. Conclusions We adapted a previously validated cognitive test-based case definition to identify cases of ICI. Many previously identified risk factors were associated with ICI, supporting the criterion-related validity of our definition. PMID:25978342

Insight into infection-mediated prostate damage: Contrasting patterns of C-reactive protein and prostate-specific antigen levels during infection.

PubMed

Milbrandt, Melissa; Winter, Anke C; Nevin, Remington L; Pakpahan, Ratna; Bradwin, Gary; De Marzo, Angelo M; Elliott, Debra J; Gaydos, Charlotte A; Isaacs, William B; Nelson, William G; Rifai, Nader; Sokoll, Lori J; Zenilman, Jonathan M; Platz, Elizabeth A; Sutcliffe, Siobhan

2017-05-01

To investigate mechanisms underlying our previous observation of a large rise in serum prostate-specific antigen, a marker of prostate pathology, during both sexually transmitted and systemic infections, we measured serum high-sensitivity C-reactive protein (hsCRP), a marker of systemic inflammation, in our previous case-control study of young, male US military members and compared our findings to those for PSA. We measured hsCRP before and during infection for 299 chlamydia, 112 gonorrhea, and 59 non-chlamydial, non-gonococcal urethritis (NCNGU) cases; before and after infection for 55 infectious mononucleosis (IM) and 90 other systemic/non-genitourinary cases; and for 220-256 controls. Only gonorrhea cases were significantly more likely to have a large hsCRP rise (≥1.40 mg/L or ≥239%) during infection than controls (P < 0.01). However, gonorrhea, IM, and other systemic/non-genitourinary cases were more likely to have a rise of any magnitude up to one year post-diagnosis than controls (p = 0.038-0.077). These findings, which differ from those for PSA, suggest distinct mechanisms of elevation for hsCRP and PSA, and support both direct (eg, prostate infection) and indirect (eg, systemic inflammation-mediated prostate cell damage) mechanisms for PSA elevation. Future studies should explore our PSA findings further for their relevance to both prostate cancer screening and risk. © 2017 Wiley Periodicals, Inc.

Indoor air pollution from secondhand tobacco smoke, solid fuels, and kerosene in homes with active tuberculosis disease in South Africa.

PubMed

Elf, Jessica L; Eke, Onyinyechi; Rakgokong, Modiehi; Variava, Ebrahim; Baliram, Yudesh; Motlhaoleng, Katlego; Lebina, Limakatso; Shapiro, Adrienne E; Breysse, Patrick N; Golub, Jonathan E; Martinson, Neil

2017-11-13

Secondhand tobacco smoke (SHS), use of solid fuels, and kerosene may play an important role in perpetuating the tuberculosis (TB) epidemic. The purpose of this study was to explore the prevalence of household air pollution (HAP) from these sources in homes of someone with TB in a high HIV-prevalence setting. A convenience sample of homes and household members participating in an ongoing active case-finding study in Matlosana district townships surrounding Klerksdorp, South Africa were included. We found a high prevalence of air pollution from SHS, solid fuels, and kerosene among individuals in homes with a case of prevalent active TB disease in Klerksdorp, South Africa. Adults in 40% of homes reported a daily smoker in the home, and 70% of homes had detectable air nicotine. In homes with a history of previous TB (prior to but not including the index case) as compared to those without previous TB, both SHS (83% vs. 65%, respectively) and solid/kerosene fuel use for more than 1 h/day (27% vs. 21%, respectively) were more prevalent. Larger studies are needed to estimate the risk of TB from these types of air pollution in HIV infected individuals and settings with high HIV prevalence.

Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

PubMed

Sørensen, Holger J; Larsen, Janne T; Mors, Ole; Nordentoft, Merete; Mortensen, Preben B; Petersen, Liselotte

2015-03-01

Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only. Copyright © 2015 Elsevier B.V. All rights reserved.

ALS syndrome in patients with HIV-1 infection.

PubMed

Verma, Ashok; Berger, Joseph R

2006-01-15

A viral etiology of amyotrophic lateral sclerosis (ALS) has been proposed because of the selective vulnerability of motor neurons to certain viruses. During the last 20 years, at least 19 cases of ALS or ALS-like disease have been reported in HIV-1 (HIV) seropositive individuals. To describe two cases of clinically definite ALS in patients with HIV infection and to review the previously reported cases of HIV-associated ALS syndrome. A multidisciplinary ALS center and Neuro-AIDS clinic at a tertiary care university hospital. We investigated and prospectively monitored two patients who had developed clinically definite ALS by El Escorial criteria several years after acquiring the HIV infection. The previously reported cases of ALS or ALS-like disease in patients with HIV infection were reviewed for comparison and contrast with the characteristics of sporadic ALS. The clinical course of ALS in our two HIV seropositive individuals mirrored that of classical sporadic ALS. A review of previously described 19 patients with ALS syndrome revealed clinically definite ALS in 4 cases and clinically probable or possible ALS in 15. ALS commenced at different stages of the HIV disease; in 7 patients, HIV infection was discovered contemporaneously with diagnosis of ALS. CD4+ T cell count ranged from 2 to 560 cells/mm3. Three (1 definite ALS) of the fatal cases were studied at autopsy and all exhibited pathology outside the motor neuron pool. Unlike our patients, 7 of 8 patients with HIV-associated ALS syndrome receiving HAART demonstrated at least partial recovery of their motor deficit. ALS-like syndrome can occur in association with HIV infection; however, the causal relationship remains uncertain. Patients with ALS syndrome related to HIV infection are generally younger in age and often demonstrate pathology outside the motor neuron system. Patients with HIV-associated ALS syndrome may improve following antiretroviral therapy. An aggressive HAART regimen to reduce viral load should be pursued in all such cases.

Molecular genetic study of the frequency of monosomy 22q11 in DiGeorge syndrome

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

Carey, A.H.; Kelly, D.; Halford, S.

1992-11-01

It is well established that DiGeorge syndrome (DGS) may be associated with monosomy of 22q11-pter. More recently, DNA probes have been used to detect hemizygosity for this region in patients with no visible karyotypic abnormality. However, DGS has also been described in cases where the cytogenetic abnormality does not involve 22q11; for instance, four cases of 10p- have been reported. In this study the authors have prospectively analyzed patients, but using DNA markers from 22q11, to assess the frequency of 22q11 rearrangements in DGS. Twenty-one of 22 cases had demonstrable hemizygosity for 22q11. Cytogenetic analysis had identified interstitial deletion inmore » 6 of 16 cases tested; in 6 other cases no karyotype was available. When these results are combined with those of previous studies, 33 of 35 DGS patients had chromosome 22q11 deletions detectable by DNA probes. 22 refs., 6 figs., 1 tab.« less

Convergence of methods for coupling of microscopic and mesoscopic reaction-diffusion simulations

NASA Astrophysics Data System (ADS)

Flegg, Mark B.; Hellander, Stefan; Erban, Radek

2015-05-01

In this paper, three multiscale methods for coupling of mesoscopic (compartment-based) and microscopic (molecular-based) stochastic reaction-diffusion simulations are investigated. Two of the three methods that will be discussed in detail have been previously reported in the literature; the two-regime method (TRM) and the compartment-placement method (CPM). The third method that is introduced and analysed in this paper is called the ghost cell method (GCM), since it works by constructing a "ghost cell" in which molecules can disappear and jump into the compartment-based simulation. Presented is a comparison of sources of error. The convergent properties of this error are studied as the time step Δt (for updating the molecular-based part of the model) approaches zero. It is found that the error behaviour depends on another fundamental computational parameter h, the compartment size in the mesoscopic part of the model. Two important limiting cases, which appear in applications, are considered: Δt → 0 and h is fixed; Δt → 0 and h → 0 such that √{ Δt } / h is fixed. The error for previously developed approaches (the TRM and CPM) converges to zero only in the limiting case (ii), but not in case (i). It is shown that the error of the GCM converges in the limiting case (i). Thus the GCM is superior to previous coupling techniques if the mesoscopic description is much coarser than the microscopic part of the model.

Usher syndrome associated with Fuchs' heterochromic uveitis.

PubMed

Lichtinger, Alejandro; Chowers, Itay; Amer, Radgonde

2010-10-01

The purpose of this study is to report two new cases of Usher syndrome associated with Fuchs' heterochromic uveitis (FHU), to confirm our previous observation of the association between FHU and retinitis pigmentosa (RP), and to evaluate if FHU is particularly associated with Usher syndrome. Retrospective medical record review of all new RP cases at Hadassah Medical Center between the years 2000 and 2007, review of our previously published data, and a meta-analysis of published relevant articles in peer reviewed journals. During the time frame of the study we diagnosed 58 new cases of RP, of whom one male and one female had the typical findings of FHU, and both had Usher syndrome type II. The difference in the occurrence of FHU between the 616 controls and the patients with RP was significant (p = 0.0073, Fisher's exact test). In our combined data, FHU occurred only in two types of RP; RP simplex with an incidence of 0.57%, and Usher syndrome with an incidence of 13.5%. This difference between the incidence of FHU in patients with Usher syndrome and other types of RP was significant (p < 0.0001, Fisher's exact test). Adding up these two cases with what is already published in the literature makes up a total of 17 RP patients with coexisting FHU. This study confirms the association between FHU and RP; and a particularly stronger association with Usher syndrome type II. Although infectious agents seem to play a role, the cause for this significant correlation is still unclear.

Weighing of risk factors for penetrating keratoplasty graft failure: application of Risk Score System.

PubMed

Tourkmani, Abdo Karim; Sánchez-Huerta, Valeria; De Wit, Guillermo; Martínez, Jaime D; Mingo, David; Mahillo-Fernández, Ignacio; Jiménez-Alfaro, Ignacio

2017-01-01

To analyze the relationship between the score obtained in the Risk Score System (RSS) proposed by Hicks et al with penetrating keratoplasty (PKP) graft failure at 1y postoperatively and among each factor in the RSS with the risk of PKP graft failure using univariate and multivariate analysis. The retrospective cohort study had 152 PKPs from 152 patients. Eighteen cases were excluded from our study due to primary failure (10 cases), incomplete medical notes (5 cases) and follow-up less than 1y (3 cases). We included 134 PKPs from 134 patients stratified by preoperative risk score. Spearman coefficient was calculated for the relationship between the score obtained and risk of failure at 1y. Univariate and multivariate analysis were calculated for the impact of every single risk factor included in the RSS over graft failure at 1y. Spearman coefficient showed statistically significant correlation between the score in the RSS and graft failure ( P <0.05). Multivariate logistic regression analysis showed no statistically significant relationship ( P >0.05) between diagnosis and lens status with graft failure. The relationship between the other risk factors studied and graft failure was significant ( P <0.05), although the results for previous grafts and graft failure was unreliable. None of our patients had previous blood transfusion, thus, it had no impact. After the application of multivariate analysis techniques, some risk factors do not show the expected impact over graft failure at 1y.

Weighing of risk factors for penetrating keratoplasty graft failure: application of Risk Score System

PubMed Central

Tourkmani, Abdo Karim; Sánchez-Huerta, Valeria; De Wit, Guillermo; Martínez, Jaime D.; Mingo, David; Mahillo-Fernández, Ignacio; Jiménez-Alfaro, Ignacio

2017-01-01

AIM To analyze the relationship between the score obtained in the Risk Score System (RSS) proposed by Hicks et al with penetrating keratoplasty (PKP) graft failure at 1y postoperatively and among each factor in the RSS with the risk of PKP graft failure using univariate and multivariate analysis. METHODS The retrospective cohort study had 152 PKPs from 152 patients. Eighteen cases were excluded from our study due to primary failure (10 cases), incomplete medical notes (5 cases) and follow-up less than 1y (3 cases). We included 134 PKPs from 134 patients stratified by preoperative risk score. Spearman coefficient was calculated for the relationship between the score obtained and risk of failure at 1y. Univariate and multivariate analysis were calculated for the impact of every single risk factor included in the RSS over graft failure at 1y. RESULTS Spearman coefficient showed statistically significant correlation between the score in the RSS and graft failure (P<0.05). Multivariate logistic regression analysis showed no statistically significant relationship (P>0.05) between diagnosis and lens status with graft failure. The relationship between the other risk factors studied and graft failure was significant (P<0.05), although the results for previous grafts and graft failure was unreliable. None of our patients had previous blood transfusion, thus, it had no impact. CONCLUSION After the application of multivariate analysis techniques, some risk factors do not show the expected impact over graft failure at 1y. PMID:28393027

Rare copy number variants in patients with congenital conotruncal heart defects.

PubMed

Xie, Hongbo M; Werner, Petra; Stambolian, Dwight; Bailey-Wilson, Joan E; Hakonarson, Hakon; White, Peter S; Taylor, Deanne M; Goldmuntz, Elizabeth

2017-03-01

Previous studies using different cardiac phenotypes, technologies and designs suggest a burden of large, rare or de novo copy number variants (CNVs) in subjects with congenital heart defects. We sought to identify disease-related CNVs, candidate genes, and functional pathways in a large number of cases with conotruncal and related defects that carried no known genetic syndrome. Cases and control samples were divided into two cohorts and genotyped to assess each subject's CNV content. Analyses were performed to ascertain differences in overall CNV prevalence and to identify enrichment of specific genes and functional pathways in conotruncal cases relative to healthy controls. Only findings present in both cohorts are presented. From 973 total conotruncal cases, a burden of rare CNVs was detected in both cohorts. Candidate genes from rare CNVs found in both cohorts were identified based on their association with cardiac development or disease, and/or their reported disruption in published studies. Functional and pathway analyses revealed significant enrichment of terms involved in either heart or early embryonic development. Our study tested one of the largest cohorts specifically with cardiac conotruncal and related defects. These results confirm and extend previous findings that CNVs contribute to disease risk for congenital heart defects in general and conotruncal defects in particular. As disease heterogeneity renders identification of single recurrent genes or loci difficult, functional pathway and gene regulation network analyses appear to be more informative. Birth Defects Research 109:271-295, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Risk factors for cardiomyopathy syndrome (CMS) in Norwegian salmon farming.

PubMed

Bang Jensen, Britt; Brun, Edgar; Fineid, Birgitte; Larssen, Rolf Bjerke; Kristoffersen, Anja B

2013-12-12

Cardiomyopathy syndrome (CMS) has been an economically important disease in Norwegian aquaculture since the 1990s. In this study, data on monthly production characteristics and case registrations were combined in a cohort study and supplemented with a questionnaire-based case-control survey on management factors in order to identify risk factors for CMS. The cohort study included cases and controls from 2005 to 2012. From this dataset differences between all cases and controls were analyzed by a mixed effect multivariate logistic regression. From this we found that the probability of CMS increased with increasing time in the sea, infection pressure, and cohort size, and that cohorts which had previously been diagnosed with heart and skeletal muscle inflammation or which were in farms with a history of CMS in previous cohorts had double the odds of developing CMS. The model was then used to calculate the predicted value for each cohort from which additional data were obtained via the questionnaire-based survey and used as offset for calculating the probability of CMS in a semi-univariate analysis of additional risk factors. Finally, the model was used to calculate the probability of developing CMS in 100 different scenarios in which the cohorts were subject to increasingly worse conditions with regards to the risk factors from the dataset. We believe that this exercise is a good way of communicating the findings to farmers, so they can make informed decisions when trying to avoid CMS in their fish cohorts.

Genetic association study of exfoliation syndrome identifies a protective rare variant at LOXL1 and five new susceptibility loci.

PubMed

Aung, Tin; Ozaki, Mineo; Lee, Mei Chin; Schlötzer-Schrehardt, Ursula; Thorleifsson, Gudmar; Mizoguchi, Takanori; Igo, Robert P; Haripriya, Aravind; Williams, Susan E; Astakhov, Yury S; Orr, Andrew C; Burdon, Kathryn P; Nakano, Satoko; Mori, Kazuhiko; Abu-Amero, Khaled; Hauser, Michael; Li, Zheng; Prakadeeswari, Gopalakrishnan; Bailey, Jessica N Cooke; Cherecheanu, Alina Popa; Kang, Jae H; Nelson, Sarah; Hayashi, Ken; Manabe, Shin-Ichi; Kazama, Shigeyasu; Zarnowski, Tomasz; Inoue, Kenji; Irkec, Murat; Coca-Prados, Miguel; Sugiyama, Kazuhisa; Järvelä, Irma; Schlottmann, Patricio; Lerner, S Fabian; Lamari, Hasnaa; Nilgün, Yildirim; Bikbov, Mukharram; Park, Ki Ho; Cha, Soon Cheol; Yamashiro, Kenji; Zenteno, Juan C; Jonas, Jost B; Kumar, Rajesh S; Perera, Shamira A; Chan, Anita S Y; Kobakhidze, Nino; George, Ronnie; Vijaya, Lingam; Do, Tan; Edward, Deepak P; de Juan Marcos, Lourdes; Pakravan, Mohammad; Moghimi, Sasan; Ideta, Ryuichi; Bach-Holm, Daniella; Kappelgaard, Per; Wirostko, Barbara; Thomas, Samuel; Gaston, Daniel; Bedard, Karen; Greer, Wenda L; Yang, Zhenglin; Chen, Xueyi; Huang, Lulin; Sang, Jinghong; Jia, Hongyan; Jia, Liyun; Qiao, Chunyan; Zhang, Hui; Liu, Xuyang; Zhao, Bowen; Wang, Ya-Xing; Xu, Liang; Leruez, Stéphanie; Reynier, Pascal; Chichua, George; Tabagari, Sergo; Uebe, Steffen; Zenkel, Matthias; Berner, Daniel; Mossböck, Georg; Weisschuh, Nicole; Hoja, Ursula; Welge-Luessen, Ulrich-Christoph; Mardin, Christian; Founti, Panayiota; Chatzikyriakidou, Anthi; Pappas, Theofanis; Anastasopoulos, Eleftherios; Lambropoulos, Alexandros; Ghosh, Arkasubhra; Shetty, Rohit; Porporato, Natalia; Saravanan, Vijayan; Venkatesh, Rengaraj; Shivkumar, Chandrashekaran; Kalpana, Narendran; Sarangapani, Sripriya; Kanavi, Mozhgan R; Beni, Afsaneh Naderi; Yazdani, Shahin; Lashay, Alireza; Naderifar, Homa; Khatibi, Nassim; Fea, Antonio; Lavia, Carlo; Dallorto, Laura; Rolle, Teresa; Frezzotti, Paolo; Paoli, Daniela; Salvi, Erika; Manunta, Paolo; Mori, Yosai; Miyata, Kazunori; Higashide, Tomomi; Chihara, Etsuo; Ishiko, Satoshi; Yoshida, Akitoshi; Yanagi, Masahide; Kiuchi, Yoshiaki; Ohashi, Tsutomu; Sakurai, Toshiya; Sugimoto, Takako; Chuman, Hideki; Aihara, Makoto; Inatani, Masaru; Miyake, Masahiro; Gotoh, Norimoto; Matsuda, Fumihiko; Yoshimura, Nagahisa; Ikeda, Yoko; Ueno, Morio; Sotozono, Chie; Jeoung, Jin Wook; Sagong, Min; Park, Kyu Hyung; Ahn, Jeeyun; Cruz-Aguilar, Marisa; Ezzouhairi, Sidi M; Rafei, Abderrahman; Chong, Yaan Fun; Ng, Xiao Yu; Goh, Shuang Ru; Chen, Yueming; Yong, Victor H K; Khan, Muhammad Imran; Olawoye, Olusola O; Ashaye, Adeyinka O; Ugbede, Idakwo; Onakoya, Adeola; Kizor-Akaraiwe, Nkiru; Teekhasaenee, Chaiwat; Suwan, Yanin; Supakontanasan, Wasu; Okeke, Suhanya; Uche, Nkechi J; Asimadu, Ifeoma; Ayub, Humaira; Akhtar, Farah; Kosior-Jarecka, Ewa; Lukasik, Urszula; Lischinsky, Ignacio; Castro, Vania; Grossmann, Rodolfo Perez; Sunaric Megevand, Gordana; Roy, Sylvain; Dervan, Edward; Silke, Eoin; Rao, Aparna; Sahay, Priti; Fornero, Pablo; Cuello, Osvaldo; Sivori, Delia; Zompa, Tamara; Mills, Richard A; Souzeau, Emmanuelle; Mitchell, Paul; Wang, Jie Jin; Hewitt, Alex W; Coote, Michael; Crowston, Jonathan G; Astakhov, Sergei Y; Akopov, Eugeny L; Emelyanov, Anton; Vysochinskaya, Vera; Kazakbaeva, Gyulli; Fayzrakhmanov, Rinat; Al-Obeidan, Saleh A; Owaidhah, Ohoud; Aljasim, Leyla Ali; Chowbay, Balram; Foo, Jia Nee; Soh, Raphael Q; Sim, Kar Seng; Xie, Zhicheng; Cheong, Augustine W O; Mok, Shi Qi; Soo, Hui Meng; Chen, Xiao Yin; Peh, Su Qin; Heng, Khai Koon; Husain, Rahat; Ho, Su-Ling; Hillmer, Axel M; Cheng, Ching-Yu; Escudero-Domínguez, Francisco A; González-Sarmiento, Rogelio; Martinon-Torres, Frederico; Salas, Antonio; Pathanapitoon, Kessara; Hansapinyo, Linda; Wanichwecharugruang, Boonsong; Kitnarong, Naris; Sakuntabhai, Anavaj; Nguyn, Hip X; Nguyn, Giang T T; Nguyn, Trình V; Zenz, Werner; Binder, Alexander; Klobassa, Daniela S; Hibberd, Martin L; Davila, Sonia; Herms, Stefan; Nöthen, Markus M; Moebus, Susanne; Rautenbach, Robyn M; Ziskind, Ari; Carmichael, Trevor R; Ramsay, Michele; Álvarez, Lydia; García, Montserrat; González-Iglesias, Héctor; Rodríguez-Calvo, Pedro P; Fernández-Vega Cueto, Luis; Oguz, Çilingir; Tamcelik, Nevbahar; Atalay, Eray; Batu, Bilge; Aktas, Dilek; Kasım, Burcu; Wilson, M Roy; Coleman, Anne L; Liu, Yutao; Challa, Pratap; Herndon, Leon; Kuchtey, Rachel W; Kuchtey, John; Curtin, Karen; Chaya, Craig J; Crandall, Alan; Zangwill, Linda M; Wong, Tien Yin; Nakano, Masakazu; Kinoshita, Shigeru; den Hollander, Anneke I; Vesti, Eija; Fingert, John H; Lee, Richard K; Sit, Arthur J; Shingleton, Bradford J; Wang, Ningli; Cusi, Daniele; Qamar, Raheel; Kraft, Peter; Pericak-Vance, Margaret A; Raychaudhuri, Soumya; Heegaard, Steffen; Kivelä, Tero; Reis, André; Kruse, Friedrich E; Weinreb, Robert N; Pasquale, Louis R; Haines, Jonathan L; Thorsteinsdottir, Unnur; Jonasson, Fridbert; Allingham, R Rand; Milea, Dan; Ritch, Robert; Kubota, Toshiaki; Tashiro, Kei; Vithana, Eranga N; Micheal, Shazia; Topouzis, Fotis; Craig, Jamie E; Dubina, Michael; Sundaresan, Periasamy; Stefansson, Kari; Wiggs, Janey L; Pasutto, Francesca; Khor, Chiea Chuen

2017-07-01

Exfoliation syndrome (XFS) is the most common known risk factor for secondary glaucoma and a major cause of blindness worldwide. Variants in two genes, LOXL1 and CACNA1A, have previously been associated with XFS. To further elucidate the genetic basis of XFS, we collected a global sample of XFS cases to refine the association at LOXL1, which previously showed inconsistent results across populations, and to identify new variants associated with XFS. We identified a rare protective allele at LOXL1 (p.Phe407, odds ratio (OR) = 25, P = 2.9 × 10 -14 ) through deep resequencing of XFS cases and controls from nine countries. A genome-wide association study (GWAS) of XFS cases and controls from 24 countries followed by replication in 18 countries identified seven genome-wide significant loci (P < 5 × 10 -8 ). We identified association signals at 13q12 (POMP), 11q23.3 (TMEM136), 6p21 (AGPAT1), 3p24 (RBMS3) and 5q23 (near SEMA6A). These findings provide biological insights into the pathology of XFS and highlight a potential role for naturally occurring rare LOXL1 variants in disease biology.

Lupus Anticoagulant-hypoprothrombinemia Syndrome (LAC-HPS) in Children With Systemic Lupus Erythematosus: Report of 3 Cases.

PubMed

Komvilaisak, Patcharee; Wisanuyotin, Suwannee; Jettrisuparb, Arunee; Wiangnon, Surapon

2017-11-01

Lupus anticoagulant, also known as lupus antibody, is generally associated with thrombosis rather than bleeding events. Lupus anticoagulant-hypoprothrombinemia syndrome in children is rather rare but can lead to mild to life-threatening bleeding. Here, we report 3 cases of lupus anticoagulant-hypoprothrombinemia syndrome associated with systemic lupus erythematosus. They initially presented with mucocutaneous bleedings, and subsequently developed other symptoms fulfilling the laboratory criteria for systemic lupus erythematosus. Case 2 and 3 had significant epistaxis and intracerebral hemorrhage responded to systemic corticosteroid along with fresh frozen plasma. Three cases demonstrated acquired hypoprothrombinemia with no correction of mixing studies. Case 1 had low factor X level, which has never been reported previously. In all 3 cases, their coagulogram returned to normal level after corticosteroid treatment.

Incidence of human T cell lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis in a long-term prospective cohort study of initially asymptomatic individuals in Brazil.

PubMed

Romanelli, Luiz Cláudio Ferreira; Caramelli, Paulo; Martins, Marina Lobato; Gonçalves, Denise Utsch; Proietti, Fernando Augusto; Ribas, João Gabriel Ramos; Araújo, Marcelo Grossi; Carneiro-Proietti, Anna Bárbara de Freitas

2013-09-01

The incidence of human T cell lymphotropic virus type 1 (HLTV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is not well defined in the literature. Several studies have reported different incidence rates, and recent publications suggest a higher incidence and prevalence of HAM/TSP. The interdisciplinary HTLV Research Group (GIPH) is a prospective open cohort study of individuals infected with HTLV-1/2. This study describes the demographic data and HAM/TSP incidence rate observed in 181 HTLV-1-seropositive individuals and compares the results with previous reports in the literature. HAM/TSP was diagnosed on the basis of the World Health Organization diagnostic criteria and De Castro-Costa et al. [Proposal for diagnostic criteria of tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM). AIDS Res Hum Retroviruses 2006;22:931-935]. Seven HAM/TSP incident cases were observed during the follow-up. The HAM/TSP incidence density was 5.3 cases per 1,000 HTLV-1-seropositive cases per year (95% confidence interval: 2.6-10.9), with a mean follow-up of 7±4 years (range: 1 month to 15 years). HAM/TSP was more frequent in women in their 40s and 50s with probable infection via the sexual route. The HAM/TSP incidence density among HTLV-1-seropositive cases observed in the present study is higher than that in previous studies. HAM/TSP may be underdiagnosed in countries like Brazil where HTLV infection is prevalent. Orientation and prevent transmission of HTLV programs are needed. Currently, preventing HTLV-1 transmission is the most effective way to reduce the impact of HAM/TSP on society.

Parental and comorbid epilepsy in persons with bipolar disorder.

PubMed

Sucksdorff, Dan; Brown, Alan S; Chudal, Roshan; Jokiranta-Olkoniemi, Elina; Leivonen, Susanna; Suominen, Auli; Heinimaa, Markus; Sourander, Andre

2015-12-01

Population-based studies have demonstrated an overrepresentation of bipolar disorder (BPD) in individuals with epilepsy. However, few studies have examined the reverse association, i.e. comorbid epilepsy in individuals selected based on BPD diagnosis. No previous population-based study having examined the co-occurrence of BPD and epilepsy has adjusted for parental psychopathology. Such an adjustment is motivated by population-based studies reporting an overrepresentation of various types of parental psychiatric disorders in both BPD and epilepsy. Furthermore, an association between epilepsy in first-degree relatives and BPD has previously only been examined and demonstrated in a small clinical sample. The objective of this study is to examine the associations between parental and comorbid epilepsy and BPD, adjusting for parental psychopathology. This nested case-control study identified 1861 cases with BPD, age up to 25 years, 3643 matched controls, and their parents from Finnish national registers. Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) and two-sided significance limits of p<0.05. BPD was associated with comorbid epilepsy (adjusted OR 2.53, 95% CI: 1.73-3.70) but not with parental epilepsy. Epilepsy was found in 3.33% of cases versus 1.29% of controls, 2.69% of cases' parents versus 2.53% of controls' parents. The diagnoses were register-based, not based on standardized procedures with direct ascertainment. An association between BPD and comorbid epilepsy persists even after adjusting for parental psychopathology. Lack of familial clustering of BPD and epilepsy would suggest that the elevated co-occurrence of these disorders is influenced by non-genetic factors. Copyright © 2015 Elsevier B.V. All rights reserved.

Current Fluctuations in Stochastic Lattice Gases

NASA Astrophysics Data System (ADS)

Bertini, L.; de Sole, A.; Gabrielli, D.; Jona-Lasinio, G.; Landim, C.

2005-01-01

We study current fluctuations in lattice gases in the macroscopic limit extending the dynamic approach for density fluctuations developed in previous articles. More precisely, we establish a large deviation theory for the space-time fluctuations of the empirical current which include the previous results. We then estimate the probability of a fluctuation of the average current over a large time interval. It turns out that recent results by Bodineau and Derrida [Phys. Rev. Lett.922004180601] in certain cases underestimate this probability due to the occurrence of dynamical phase transitions.

Complete Duplication of Collecting System in a Horseshoe Kidney Presenting with Recurrent Urinary Tract Infections: Report of an Exceedingly Rare Congenital Anomaly and Review of Literature

PubMed Central

Mirzazadeh, Majid; Richards, Kyle A.

2011-01-01

We report the fifth case in the English literature of a horseshoe kidney with a complete ureteral duplication. Our case is unique in that the previous four cases occurred in the presence of a ureterocele, whereas our patient lacked this anomaly. Further, our patient was managed conservatively, whereas the previous four patients were managed with surgery. PMID:22224073

Dermatoglyphs in congenital heart disease.

PubMed Central

David, T J

1981-01-01

The palmar dermatoglyphs of 800 patients with anatomically proven congenital heart disease were compared with prints from 1000 controls. A review of the previous studies revealed major technical deficiencies, and the present study failed to confirm most of the previously reported positive findings. An overall increase in the incidence of hypothenar patterns was found, probably explaining the previous suggestion of increased atd angle in congenital heart disease. A large number of statistical comparisons inevitably produced a few 'significant' results, most of which were inconsistent in various ways. Two percent of cases were found to have rare epidermal ridge malformation, ridge dissociation. The nature of the relationship between this and congenital heart disease is obscure. Claims that there are diagnostically useful dermatoglyphic changes in congenital heart disease can be disregarded. PMID:7328614

Thermal diffusion in partially ionized gases - The case of unequal temperatures. [in solar chromosphere

NASA Technical Reports Server (NTRS)

Geiss, J.; Burgi, A.

1987-01-01

Previous calculations of thermal diffusion coefficients in partially ionized gases are extended to the case of unequal neutral and ion temperatures and/or temperature gradients. Formulas are derived for the general case of a major gas as well as for minor atoms and ions. Strong enhancements of minor-ion thermal diffusion coefficients over their values in the fully ionized gas are found when the degree of ionization in the main gas is relatively low. However, compared to the case of equal temperatures, the enhancements are less strong when the neutrals are cooler than the ions. The specific case of the H-H(+) mixture, which is important in the study of solar and stellar atmospheres, is discussed as an application.

Lung cancer risk among bricklayers in a pooled analysis of case–control studies

PubMed Central

Consonni, Dario; Matteis, Sara De; Pesatori, Angela C; Bertazzi, Pier Alberto; Olsson, Ann C; Kromhout, Hans; Peters, Susan; Vermeulen, Roel CH; Pesch, Beate; Brüning, Thomas; Kendzia, Benjamin; Behrens, Thomas; Stücker, Isabelle; Guida, Florence; Wichmann, Heinz-Erich; Brüske, Irene; Landi, Maria Teresa; Caporaso, Neil E; Gustavsson, Per; Plato, Nils; Tse, Lap Ah; Yu, Ignatius Tak-sun; Jöckel, Karl-Heinz; Ahrens, Wolfgang; Pohlabeln, Hermann; Merletti, Franco; Richiardi, Lorenzo; Simonato, Lorenzo; Forastiere, Francesco; Siemiatycki, Jack; Parent, Marie-Élise; Tardón, Adonina; Boffetta, Paolo; Zaridze, David; Chen, Ying; Field, John K; 't Mannetje, Andrea; Pearce, Neil; McLaughlin, John; Demers, Paul; Lissowska, Jolanta; Szeszenia-Dabrowska, Neonila; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Rudnai, Peter; Fabiánová, Eleonóra; Stanescu Dumitru, Rodica; Bueno-de-Mesquita, H B(as); Schüz, Joachim; Straif, Kurt

2015-01-01

Bricklayers may be exposed to several lung carcinogens, including crystalline silica and asbestos. Previous studies that analyzed lung cancer risk among these workers had several study design limitations. We examined lung cancer risk among bricklayers within SYNERGY, a large international pooled analysis of case–control studies on lung cancer and the joint effects of occupational carcinogens. For men ever employed as bricklayers we estimated odds ratios (OR) and 95% confidence intervals (CI) adjusted for study center, age, lifetime smoking history and employment in occupations with exposures to known or suspected lung carcinogens. Among 15,608 cases and 18,531 controls, there were 695 cases and 469 controls who had ever worked as bricklayers (OR: 1.47; 95% CI: 1.28–1.68). In studies using population controls the OR was 1.55 (95% CI: 1.32–1.81, 540/349 cases/controls), while it was 1.24 (95% CI: 0.93–1.64, 155/120 cases/controls) in hospital-based studies. There was a clear positive trend with length of employment (p < 0.001). The relative risk was higher for squamous (OR: 1.68, 95% CI: 1.42–1.98, 309 cases) and small cell carcinomas (OR: 1.78, 95% CI: 1.44–2.20, 140 cases), than for adenocarcinoma (OR: 1.17, 95% CI: 0.95–1.43, 150 cases) (p-homogeneity: 0.0007). ORs were still elevated after additional adjustment for education and in analyses using blue collar workers as referents. This study provided robust evidence of increased lung cancer risk in bricklayers. Although non-causal explanations cannot be completely ruled out, the association is plausible in view of the potential for exposure to several carcinogens, notably crystalline silica and to a lesser extent asbestos. What's new? In their work, bricklayers can be exposed to various airborne carcinogens, including crystalline silica and asbestos. Previous studies of cancer risk have not accounted for full employment history or smoking status, and failed to establish a firm relationship between bricklaying and lung cancer. In this study, the authors used data from the largest collection of case-control studies on lung cancer with complete occupational and smoking history existing today, the SYNERGY project. They found clear evidence that lung cancer risk increases in proportion to the length of time spent working as a bricklayer, paving the way for better protection and compensation for those in this occupation. PMID:24861979

Egg cases of the genus Apristurus (Chondrichthyes: Scyliorhinidae): phylogenetic and ecological implications.

PubMed

Flammang, Brooke E; Ebert, David A; Cailliet, Gregor M

2007-01-01

The genus Apristurus has been divided formerly into three species subgroups based on morphological and molecular phylogenies. Previous studies have agreed on the separation into distinct species groups, the largest two of which have been described as the brunneus and spongiceps groups. An examination of the egg cases produced by these oviparous catsharks corroborates the distinction in species groups: egg cases of the brunneus group have long fibrous and curly tendrils at either end, whereas egg cases of the spongiceps group lack tendrils. The egg cases of A. kampae, A. manis, A. spongiceps and Apristurus sp. D are described for the first time, and the egg cases of A. brunneus and A. riveri are re-described to include comparable morphological characteristics. The ecological implications of egg case morphology on oviposition and ventilation are also discussed.

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures.

PubMed

Weidauer, Lee A; Binkley, Teresa; Vukovich, Matt; Specker, Bonny

2014-07-01

Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. To determine factors associated with the development of stress fractures in female athletes. Case-control study; Level of evidence, 3. A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures.