This book is a monograph on case studies using time series analysis, which includes the main research works applied to practical projects by the author in the past 15 years. The works cover different problems in broad fields, such as: engineering, labour protection, astronomy, physiology, endocrinology, oil development, etc. The first part of this book introduces some basic knowledge of time series analysis which is necessary for the reader to understand the methods and the theory used in the procedure for solving problems. The second part is the main part of this book - case studies in differ
Filho, Epitacio Leite Rolim; Lins, Otavio Gomes; Aragão, Maria de Fátima Viana Vasco; Brainer-Lima, Alessandra Mertens; Cruz, Danielle Di Cavalcanti Sousa; Rocha, Maria Angela Wanderley; Sobral da Silva, Paula Fabiana; Carvalho, Maria Durce Costa Gomes; do Amaral, Fernando José; Gomes, Joelma Arruda; Ribeiro de Medeiros, Igor Colaço; Ventura, Camila V; Ramos, Regina Coeli
Objective To describe the clinical, radiological, and electromyographic features in a series of children with joint contractures (arthrogryposis) associated with congenital infection presumably caused by Zika virus. Design Retrospective case series study. Setting Association for Assistance of Disabled Children, Pernambuco state, Brazil. Participants Seven children with arthrogryposis and a diagnosis of congenital infection presumably caused by Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Main clinical, radiological, and electromyographic findings, and likely correlation between clinical and primary neurological abnormalities. Results The brain images of all seven children were characteristic of congenital infection and arthrogryposis. Two children tested positive for IgM to Zika virus in the cerebrospinal fluid. Arthrogryposis was present in the arms and legs of six children (86%) and the legs of one child (14%). Hip radiographs showed bilateral dislocation in seven children, subluxation of the knee associated with genu valgus in three children (43%), which was bilateral in two (29%). All the children underwent high definition ultrasonography of the joints, and there was no evidence of abnormalities. Moderate signs of remodeling of the motor units and a reduced recruitment pattern were found on needle electromyography (monopolar). Five of the children underwent brain computed tomography (CT) and magnetic resonance imaging (MRI) and the remaining two CT only. All presented malformations of cortical development, calcifications predominantly in the cortex and subcortical white matter (especially in the junction between the cortex and white matter), reduction in brain volume, ventriculomegaly, and hypoplasia of the brainstem and cerebellum. MRI of the spine in four children showed apparent thinning of the cord and reduced ventral roots. Conclusions Congenital Zika syndrome should be added to the differential diagnosis of congenital
Setia, Maninder Singh
Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias. PMID:27057012
Maninder Singh Setia
Full Text Available Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases, whereas others do not have the outcome of interest (referred to as controls. The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective. It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias.
Watson, Michael; Benford, Penny; Coupland, Carol; Clacy, Rose; Hindmarch, Paul; Majsak-Newman, Gosia; Deave, Toity; Kendrick, Denise
Objective To measure the validity of safety behaviours, safety equipment use and hazards reported on a questionnaire by parents/carers with children aged under 5 years participating in a series of home safety case-control studies. Methods The questionnaire measured safety behaviours, safety equipment use and hazards being used as exposures in five case-control studies. Responses to questions were compared with observations made during a home visit. The researchers making observations were bli...
Anguera, A; Barreiro, J M; Lara, J A; Lizcano, D
One of the major challenges in the medical domain today is how to exploit the huge amount of data that this field generates. To do this, approaches are required that are capable of discovering knowledge that is useful for decision making in the medical field. Time series are data types that are common in the medical domain and require specialized analysis techniques and tools, especially if the information of interest to specialists is concentrated within particular time series regions, known as events. This research followed the steps specified by the so-called knowledge discovery in databases (KDD) process to discover knowledge from medical time series derived from stabilometric (396 series) and electroencephalographic (200) patient electronic health records (EHR). The view offered in the paper is based on the experience gathered as part of the VIIP project. Knowledge discovery in medical time series has a number of difficulties and implications that are highlighted by illustrating the application of several techniques that cover the entire KDD process through two case studies. This paper illustrates the application of different knowledge discovery techniques for the purposes of classification within the above domains. The accuracy of this application for the two classes considered in each case is 99.86% and 98.11% for epilepsy diagnosis in the electroencephalography (EEG) domain and 99.4% and 99.1% for early-age sports talent classification in the stabilometry domain. The KDD techniques achieve better results than other traditional neural network-based classification techniques. PMID:27293535
Khomand, Payam; Hassanzadeh, Kambiz
Background: We report a case series of cerebral vein thrombosis (CVT) in women who used oral contraceptive pill (OCP) in the Muslims Ramadan and fasting month. Methods: This study was a retrospective case series of 9 patients with diagnosis of CVT, who admitted in the neurology ward of Tohid Hospital of Sanandaj, Iran, in July-August 2014-2015. Results: Patients had no history of thrombosis before. They were treated with oral contraceptive more than 1 month to be able to fast during Ramadan. They did not have other possible risk factors for CVT. A headache was the most common in 9/9 patients (100%) followed by vomiting and vertigo. Conclusion: We found that high rate of CVT in female population during Ramadan indicates that it needs be considered as a specific risk factor and should be considered by healthcare system. PMID:27326364
Full Text Available To present three cases who presented with neonatal hiccups and who were later diagnosed with nonketotic hyperglycinemia (NKH. Case series. We present three babies who presented in neonatal life with hiccups who later were diagnosed with NKH. Two babies presented on the 2nd day of life with hypotonia, poor feeding, and abnormal movements including jitteriness, hiccups, and twitching. The third baby only had transient hiccups lasting for a couple of days in the 1st week of life but later presented at 3 months of age with poor feeding, drowsiness, and jerky movements. All three cases needed extensive investigations before reaching the diagnosis including metabolic screen, lumbar puncture, electroencephalography, and computed tomography/magnetic resonance imaging. The first two babies needed intubation on their 2nd day of life because of apneas in whom later, the care was withdrawn after reaching the diagnosis of NKH because of poor prognosis. The third baby was discharged home on oral dextromethorphan and ketogenic diet. We discuss the importance of early recognition of symptoms (frequent hiccups and investigation needed to reach the diagnosis early as it helps in making decision to either carry on treatment or withdraw care because of poor prognosis. It also helps in genetic counseling and prenatal diagnosis can be offered at the subsequent pregnancy.
Full Text Available Measles is a highly contagious viral disease that remains an important cause of mortality among children despite the availability of a safe and effective vaccine around the world. We aimed this study to show a measles out-break occurring.In early 2012, a report of measles outbreak was recorded on center for disease control (CDC of Fars province, south of Iran. With this case-series study, characteristics of cases and network transition model were described.The primary case was an Afghan refugee who is likely to carry the measles virus from its country or from anywhere in Iran to Koordeh, a small village in south of Iran. Followed by the Afghan case, 6 secondary and tertiary cases including rural health worker, were occurred. Except a case of 35 year old, in which her vaccination status was unknown, all cases has had adherence to vaccination protocol.More immunologic and vaccine quality investigations are needed to find the main cause of the outbreak. Nonetheless, due to the warm weather, probable bad temperature management of cold chain and technical problem in vaccination are the main suspicious reasons of the outbreak.
Full Text Available Shoulder dislocation is identified as displacement of humerus head from the glenoid cavity of scapula bone, which makes up about 50% of total joint dislocations. Taking into account the importance of the side effects and disabilities caused by this type of dislocation and that it can be prevented, the present study was designed aiming to evaluate the epidemiologic characteristics of the patients with shoulder dislocation. In this retrospective cross-sectional study, all the patients referred to the emergency department (ED with complaint of shoulder dislocation throughout one year were evaluated. Demographic data and characteristics regarding the type of dislocation, presence of accompanying fractures, mechanism of dislocation, history of dislocation and the method of reduction were extracted from the patients’ profiles and recorded in a checklist designed for this purpose. Data were then statistically analyzed using SPSS version 19. Statistics showed that 120 patients with the mean age of 39.3 ± 21.2 years had been admitted to ED of the studied center in one year (79.2% male. The most common type of dislocation was anterior dislocation (95.8% and in the right shoulder (52.5% and the most common cause was falling on open arm (34.2%. Reduction method was non-operative in 93.3% of the cases and surgery in 6.7%. Based on the results of this study, in the studied population, most patients with shoulder dislocation were young men who had an anterior dislocation in their right shoulder because of falling on out stretched hand and treated with close reduction.
Full Text Available Joseph Finkelstein,1 Carol Friedman,1 George Hripcsak,1 Manuel Cabrera2 1Department of Biomedical Informatics, 2Department of Medicine, Columbia University, New York, NY, USA Abstract: Pharmacogenomic (PGx testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as “CYP3A4/CYP3A5 poor metabolizer”, which affected metabolism of eleven prescribed drugs. The second case had “CYP2D6 rapid metabolizer” status affecting three prescribed medications, two of which were key drugs for managing this patient's chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug–drug interactions. Both patients with significant drug–gene interactions had a history of frequent hospitalizations (six and 23, respectively, whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to
Lopes, Rubia Garcia; de Santi, Maria Eugenia Simões Onofre; Franco, Bruno Edin; Deana, Alessandro Melo; Prates, Renato Araujo; França, Cristiane Miranda; Fernandes, Kristianne Porta Santos; Ferrari, Raquel Agnelli Mesquita; Bussadori, Sandra Kalil
Introduction: Halitosis is a common problem that affects a large portion of the population worldwide. The origin of this condition is oral in 90% of cases and systemic in 10% of cases. The foul odor is caused mainly by volatile sulfur compounds produced by Gram-negative bacteria. However, it has recently been found that anaerobic Gram-positive bacteria also produce hydrogen sulfide (H2S) in the presence of amino acids, such as cysteine. Light with and without the combination of chemical agents has been used to induce therapeutic and antimicrobial effects. In photodynamic therapy, the antimicrobial effect is confined to areas covered by the photosensitizing dye. The aim of the present case series study was to evaluate the antimicrobial effect of photodynamic therapy on halitosis in adolescents through the analysis of volatile sulfur compounds measured using a sulfide meter (Halimeter®). Methods: Five adolescents aged 14 to 16 years were evaluated using a sulfide meter before and one hour after photodynamic therapy, which involved the use of methylene blue 0.005% on the middle third and posterior thirds of the dorsum of the tongue and nine points of laser irradiation in the red band (660 nm) with an energy dose of 9 J, power output of 100 mW and 90-seconds exposure time. Results: A 31.8% reduction in the concentration of volatile sulfur compounds was found in the comparison of the initial and final readings. The statistically significant reduction (p = 0.0091) led to an absence of halitosis following treatment (mean: 58.2 ppb). Conclusion: Photodynamic therapy seems to be effective on reduction the concentration of volatile sulfur compounds.Considering the positive effects of photodynamic therapy in this case series, further studies involving microbiological analyses should be conducted to allow comparisons of the results. PMID:25653814
Cyril A. Ogbokor
Full Text Available The study addresses empirically the Export-led Growth Hypothesis (ELGH using Zimbabwe as a case study. This research work attempts to provide some evidence in this regard by examining the influence of trade on economic growth in the economy and ascertaining if the regressors utilised are good predictors of growth. Ordinary Least Squares (OLS method is resorted in order to estimate the specified equations used in the study. The time-series data utilized runs from 1991 to 2003. The results of the study confirm the existence of the export-led growth model in Zimbabwe. In the face of continual instability in its export receipts, we recommend that fundamental economic and political restructuring should be embarked upon in order to address and subsequently reverse the present situation.
McCluskey, Brian J; Haley, Charles; Rovira, Albert; Main, Rodger; Zhang, Yan; Barder, Sunny
Porcine deltacoronavirus (PDCoV) was first reported in the United States (US) in February 2014. This was the second novel swine enteric coronavirus detected in the US since May 2013. In this study, we conducted retrospective testing of samples submitted to three veterinary diagnostic laboratories where qualifying biological samples were derived from previously submitted diagnostic case submissions from US commercial swine farms with a clinical history of enteric disease or from cases that had been previously tested for transmissible gastroenteritis virus, PEDV, or rotavirus. Overall, 2286 banked samples were tested from 27 States. Samples were collected in 3 separate years and in 17 different months. Test results revealed 4 positive samples, 3 collected in August 2013 and 1 collected in October 2013. In addition, a case series including 42 operations in 10 States was conducted through administration of a survey. Survey data collected included information on characteristics of swine operations that had experienced PDCoV clinical signs. Special emphasis was placed on obtaining descriptive estimates of biosecurity practices and disease status over time of each operation. Clinical signs of PDCoV were reported to be similar to those of PEDV. The average number of animals on each operation exhibiting clinical signs (morbidity) and the average number of case fatalities was greatest for suckling and weaned pigs. Average operation-level weaned pig morbidity was greatest in the first week of the outbreak while average operation-level suckling pig case fatality was greatest in the second week of the outbreak. The survey included questions regarding biosecurity practices for visitors and operation employees; trucks, equipment and drivers; and feed sources. These questions attempted to identify a likely pathway of introduction of PDCoV onto the operations surveyed. PMID:26603048
Bhavana Venkata Nagabhushana Rao
Full Text Available Aortic dissection may not be attended by a physician in his lifetime, but he should possess all the clinical acumen to deal with as it is a catastrophic disease. Early and accurate diagnosis will save a life. Here we present three cases we faced in sequence over a period of two months. A case of extensive dissection arch to thoracic aorta, its display in detail. Second case eliciting ambiguity between coronary ischemia and aortic dissection. Management difficulties of such clinician situation are discussed. Third case, the fracture of a renal artery stent leading to severe hypertension, abdominal pain, and aortic dissection. Such case was not described in the literature to our knowledge. [Int J Res Med Sci 2016; 4(4.000: 1268-1271
Finkelstein, Joseph; Friedman, Carol; Hripcsak, George; Cabrera, Manuel
Pharmacogenomic (PGx) testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as “CYP3A4/CYP3A5 poor metabolizer”, which affected metabolism of eleven prescribed drugs. The second case had “CYP2D6 rapid metabolizer” status affecting three prescribed medications, two of which were key drugs for managing this patient’s chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug–drug interactions. Both patients with significant drug–gene interactions had a history of frequent hospitalizations (six and 23, respectively), whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to be established. Studies evaluating clinical impact of PGx testing in older adults with polypharmacy are warranted. For practical implementation of pharmacogenomics in routine clinical care, besides
Admário Silva Santos Filho
Full Text Available Objective: to describe the initial experience of a gynecology team, at a tertiary care center, when performing single-port laparoscopic surgery. Methods: this is a retrospective study reviewing the medical records of 50 patients treated at the outpatient gynecology clinic of our institution between June 2012 and July 2013 who underwent single-port laparoscopic surgery. This study was approved by the institution’s Ethics in Research Committee. Results: the mean age of patients is 37.8 years, ranging from 18 to 70 years, and the most frequent surgical indications were adnexal mass (72% and chronic pelvic pain (24%. The mean operative time was 94.4 minutes with a mean hospital stay of 25.8 hours. There were no perioperative complications. We recorded two conversions to laparotomy due to technical difficulties during the procedure. All cases of conversion had pelvic adhesions. All operative complications were successfully treated and none were considered severe. Conclusion: this is one of the largest case series in the literature regarding surgical treatment by single-port laparoscopy in gynecology and presents evidence on reduction of surgical morbidity and satisfactory cosmetic results. We conclude that single-port laparoscopy is a viable minimally invasive technique, and that it contributes to the construction of a new scenario in modern gynecological surgery.
Full Text Available Tinea incognito is a dermatophytic infection which has lost its typical clinical appearance because of inappropriate use of topical or systemic corticosteroids. The clinical manifestations of tinea incognito can mimic many dermatoses such as eczema, psoriasis, allergic contact dermatitis, rosacea, seborrheic dermatitis and atopic dermatitis. The diagnosis of tinea incognito is confirmed by direct KOH (potassium hydroxide examination ( native preparation, making the fungal cultures from the lesion and histopathological examination in some cases. Systemic antifungal therapy is recommended in the treatment of tinea incognito. Herein, 10 cases of tinea incognito which mimicking various dermatoses were diagnosed and treated in our clinic in 2014 is presented.
Full Text Available Abstract Background Home Based Management of fever (HBM was introduced as a national policy in Uganda to increase access to prompt presumptive treatment of malaria. Pre-packed Chloroquine/Fansidar combination is distributed free of charge to febrile children Methods A case-series study was performed during 20 weeks in a West-Ugandan sub-county with an under-five population of 3,600. Community drug distributors (DDs were visited fortnightly and recording forms collected. Referred children were located and primary caretaker interviewed in the household. Referral health facility records were studied for those stating having completed referral. Results Overall referral rate was 8% (117/1454. Fever was the main reason for mothers to seek DD care and for DDs to refer. Twenty-six of the 28 (93% "urgent referrals" accessed referral care but 8 (31% delayed >24 hours. Waiting for antimalarial drugs to finish caused most delays. Of 32 possible pneumonias only 16 (50% were urgently referred; most delayed ≥ 2 days before accessing referral care. Conclusion The HBM has high referral compliance and extends primary health care to the communities by maintaining linkages with formal health services. Referral non-completion was not a major issue but failure to recognise pneumonia symptoms and delays in referral care access for respiratory illnesses may pose hazards for children with acute respiratory infections. Extending HBM to also include pneumonia may increase prompt and effective care of the sick child in sub-Saharan Africa.
Full Text Available The aim of this work was to assess the feasibility of a treatment based on volitional cycling augmented by Functional Electrical Stimulation (FES on hemiparetic adolescents. Six chronic hemiparetic adolescents were included in a case series study. Patients underwent FES-cycling training combined with voluntary pedaling. The intervention consisted of 21 sessions lasting 30 minutes each. Patients were evaluated before, after training, and at a 3-month follow-up visit through clinical scales (Winter scale, observational gait scale, gross motor function measurement, Boyd test and Ashworth scale, a standard gait analysis and a voluntary pedaling test. Results were compared with an age-matched healthy control group (N=6. Two subjects withdrew the study before the completion of the intervention. Concerning the four remaining subjects, the clinical scales showed a slight level of disability already at baseline and no changes were observed after the intervention. In terms of walking ability, some significant improvements (Kruskal-Wallis test, p-value<0.05 were obtained after training in two out of four subjects: an increase of about 16% and 41% of the ankle range of motion and of about 18% and 33% of the ankle propelling power were achieved for two subjects, respectively. During pedaling, the work produced by the paretic leg while pulling the pedal significantly increased in 3 out of 4 subjects. In one subject a more symmetrical cycling movement was observed, whilst for another subject a significant improvement in terms of co-contraction between rectus femoris and biceps femoris was achieved. In conclusion, this study assessed the feasibility of FES-cycling training on hemiparetic adolescents, but did not provide evidences about the effectiveness of this intervention in improving motor recovery and walking ability. However, since only a small group of patients with a low level of disability was involved in the study, further investigations are needed to
Teresita Barrios; Arelis Duménico Soler; Raúl López Fernández; Enrique Pérez Abreus; Julio Romero Rodríguez; Yordany Boza Mejías
Background: the study of salivary gland neoplasms is one of the most complex issues of cancer of the head and neck. Objective: to determine the behavior of tumors of the major salivary glands. Method: an observational-descriptive-retrospective case series in the Maxillofacial Surgery Department of the Hospital General Universitario Dr. Gustavo Lima Aldereguía of Cienfuegos, in the period from January 2000 through December 2009. Results: tumors of the major salivary glands occurred in the stu...
Full Text Available Abstract Background It is thought that a good survival rate of patients with acute liver failure can be achieved by establishing an artificial liver support system that reliably compensates liver function until the liver regenerates or a patient undergoes transplantation. We introduced a new artificial liver support system, on-line hemodiafiltration, in patients with acute liver failure. Methods This case series study was conducted from May 2001 to October 2008 at the medical intensive care unit of a tertiary care academic medical center. Seventeen consecutive patients who admitted to our hospital presenting with acute liver failure were treated with artificial liver support including daily on-line hemodiafiltration and plasma exchange. Results After 4.9 ± 0.7 (mean ± SD on-line hemodiafiltration sessions, 16 of 17 (94.1% patients completely recovered from hepatic encephalopathy and maintained consciousness for 16.4 ± 3.4 (7-55 days until discontinuation of artificial liver support (a total of 14.4 ± 2.6 [6-47] on-line hemodiafiltration sessions. Significant correlation was observed between the degree of encephalopathy and number of sessions of on-line HDF required for recovery of consciousness. Of the 16 patients who recovered consciousness, 7 fully recovered and returned to society with no cognitive sequelae, 3 died of complications of acute liver failure except brain edema, and the remaining 6 were candidates for liver transplantation; 2 of them received living-related liver transplantation but 4 died without transplantation after discontinuation of therapy. Conclusions On-line hemodiafiltration was effective in patients with acute liver failure, and consciousness was maintained for the duration of artificial liver support, even in those in whom it was considered that hepatic function was completely abolished.
Towgood, Karren J.; Meuwese, Julia D. I.; Gilbert, Sam J.; Turner, Martha S.; Burgess, Paul W.
In the neuropsychological case series approach, tasks are administered that tap different cognitive domains, and differences within rather than across individuals are the basis for theorising; each individual is effectively their own control. This approach is a mainstay of cognitive neuropsychology, and is particularly suited to the study of…
Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D; Anagonou, Séverin
Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The "R" software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78% ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15-34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887
Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D.; Anagonou, Séverin
Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The “R” software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78% ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15–34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887
Schwartz, Myrna F.; Dell, Gary S.
Case series methodology involves the systematic assessment of a sample of related patients, with the goal of understanding how and why they differ from one another. This method has become increasingly important in cognitive neuropsychology, which has long been identified with single-subject research. We review case series studies dealing with impaired semantic memory, reading, and language production, and draw attention to the affinity of this methodology for testing theories that are express...
van Lent Wineke AM
Full Text Available Abstract Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC, three chemotherapy day units (CDU were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found
Sanjeev N Deshpande
Full Text Available Introduction: The chin (mentum is vital to the human facial morphology as it contributes to the facial aesthetics and harmony both on frontal and lateral views. Osseous genioplasty, the alteration of the chin through skeletal modification, can lead to significant enhancement of the overall facial profile. Aim and Study Design: A case series was designed to study the long-term results of osseous genioplasty in Indian patients with regard to patient satisfaction, complications, and long-term stability. Materials and Methods: All subjects who underwent osseous genioplasty either alone or as a component of orthognathic surgery between January 1992 and December 2010, with a minimum follow-up of 2 years, were included. The genioplasty was performed using standard protocols of assessment and execution. Post-operative evaluation included patient satisfaction, complications and radiological evidence of long-term stability. A comprehensive score was formulated for the purpose of the study. Results: Thirty-seven subjects underwent osseous genioplasty with at least 2 years of follow-up in the study period. This included 17 male and 20 female subjects, with a mean age of 22.8 years (15-52 years and a mean follow-up of 3 years 4 months (2 years to 4 years and 11 months. Nineteen subjects underwent isolated genioplasty while 18 underwent genioplasty as a part of orthognathic surgery. The procedures included advancement (22, pushback (9, side-to-side (4 and vertical reduction (2 genioplasty.Thirty-six subjects (97.3% were extremely pleased with the results with only one subject expressing reservations, without, however, demanding any further procedure. There were no significant complications. The osteotomised segment was well maintained in its new position with good bony union and minimal resorption. Overall, 35 (94.6% cases had excellent results and 2 (4.4% cases had good results, according to the comprehensive score. Conclusions: Osseous genioplasty is a safe
Vale, Edivânia Barbosa do; Ramos Perez, Flávia Maria de Moraes; Rodrigues, Gabryelle Linhares Correa; Carvalho, Elaine Judite de Amorim; Castro, Jurema Freire Lisboa de; Perez, Danyel Elias da Cruz
Objective: The aim of this study was to evaluate the clinicopathological features of oral lesions in children and adolescents diagnosed in an Oral Pathology Laboratory. Study design: Between 2000 and 2010, all oral lesions diagnosed in patients younger than 18 years old, from the Oral Pathology Laboratory, Federal University of Pernambuco, Brazil, were selected for the study. The clinical data were obtained from the patient charts filed in the Laboratory. All cases were microscopically review...
Yuan Ji; Wen-Hui Lou; Da-Yong Jin; Tian-Tao Kuang; Meng-Su Zeng; Yun-Shan Tan; Hai-Ying Zeng; Akesu Sujie; Xiong-Zeng Zhu
AIM: To recognize cystic neoplasia of the pancreas and thus to identify a panel of curable diseases. METHODS: Sixty-four cases of cystic neoplasia of the pancreas, including 28 cases of intraductal papillary mucinous neoplasia (IPMN), 12 Cases of serous cystic neoplasia (SCN), 11 cases of mucinous cystic neoplasia (MCN), 11 cases of solid pseudo-papillary neoplasia (SPN), and 2 cases of solid tumor with cystic degeneration were examined immunohistochemically for their expression of MUC1, MUC2, MUC4, MUC5AC, and MUC6, as well as other related antigens.RESULTS: Adenoma type of IPMN and borderline lesions exhibited high expressions of MUC2, and MUCSAC. Tn contrast, IPMN with invasive carcinoma component showed MUC1 immunoreactivity. SCN was mainly positive for MUC1 and MUC6, while negative for MUC2, MUC4 and MUC5AC. Noninvasive MCN, regardless of its cellular atypia degree, was positive for MUC5AC and negative for MUC1. MUC1 expression was only observed in patients with an invasive component. No mucin expression was found in SPN.CONCLUSION: Mucin profile may, in conjunction with histologic study, provide important information on tumor types and patient treatment of cystic neoplasia of the pancreas.
Greenspan, Stanley I., Ed.; And Others
Work conducted by the Clinical Infant Development Program (CIDP) of the National Institute of Mental Health, involving 47 multirisk families and their infants over a period of several years, is described. Part I contains four detailed case studies by Delise Williams, Euthymia Hibbs, Serena Wieder and others, providing data for comprehensive…
Grases, Fèlix; Costa-Bauzá, Antonia; Rafel M. Prieto; Conte, Antonio; Servera, Antonio
Background The objective of this study is to determine in a case series (four patients) how calcified deposits in renal papillae are associated with the development of calcium oxalate monohydrate (COM) papillary calculi. Methods From the recently collected papillary calculi, we evaluated retrospectively patients, subjected to retrograde ureteroscopy, with COM papillary lithiasis. Results The COM papillary calculi were found to result from subepithelial injury. Many of these lesions underwent ...
Pepe, Antonio; De Luca, Claudio; Di Martino, Gerardo; Iodice, Antonio; Manzo, Mariarosaria; Pepe, Susi; Riccio, Daniele; Ruello, Giuseppe; Sansosti, Eugenio; Zinno, Ivana
The fractal dimension is a significant geophysical parameter describing natural surfaces representing the distribution of the roughness over different spatial scale; in case of volcanic structures, it has been related to the specific nature of materials and to the effects of active geodynamic processes. In this work, we present the analysis of the temporal behavior of the fractal dimension estimates generated from multi-pass SAR images relevant to the Somma-Vesuvio volcanic complex (South Italy). To this aim, we consider a Cosmo-SkyMed data-set of 42 stripmap images acquired from ascending orbits between October 2009 and December 2012. Starting from these images, we generate a three-dimensional stack composed by the corresponding fractal maps (ordered according to the acquisition dates), after a proper co-registration. The time-series of the pixel-by-pixel estimated fractal dimension values show that, over invariant natural areas, the fractal dimension values do not reveal significant changes; on the contrary, over urban areas, it correctly assumes values outside the natural surfaces fractality range and show strong fluctuations. As a final result of our analysis, we generate a fractal map that includes only the areas where the fractal dimension is considered reliable and stable (i.e., whose standard deviation computed over the time series is reasonably small). The so-obtained fractal dimension map is then used to identify areas that are homogeneous from a fractal viewpoint. Indeed, the analysis of this map reveals the presence of two distinctive landscape units corresponding to the Mt. Vesuvio and Gran Cono. The comparison with the (simplified) geological map clearly shows the presence in these two areas of volcanic products of different age. The presented fractal dimension map analysis demonstrates the ability to get a figure about the evolution degree of the monitored volcanic edifice and can be profitably extended in the future to other volcanic systems with
Goudarzi, M. A.; Cocard, M.; Santerre, R.
We analyzed the noise characteristics of 112 continuously operating GPS stations in eastern North America using the Spectral Analysis and the Maximum Likelihood Estimation (MLE) methods. Results of both methods show that the combination ofwhite plus flicker noise is the best model for describing the stochastic part of the position time series. We explored this further using the MLE in the time domain by testing noise models of (a) powerlaw, (b)white, (c)white plus flicker, (d)white plus randomwalk, and (e) white plus flicker plus random-walk. The results show that amplitudes of all noise models are smallest in the north direction and largest in the vertical direction. While amplitudes of white noise model in (c-e) are almost equal across the study area, they are prevailed by the flicker and Random-walk noise for all directions. Assuming flicker noise model increases uncertainties of the estimated velocities by a factor of 5-38 compared to the white noise model.
Lee, Victoria E.; DePaolo, Donald J.; Christensen, John N.
Obtaining quantitative information about the timescales associated with sediment transport, storage, and deposition in continental settings is important but challenging. The uranium-series comminution age method potentially provides a universal approach for direct dating of Quaternary detrital sediments, and can also provide estimates of the sediment transport and storage timescales. (The word"comminution" means"to reduce to powder," reflecting the start of the comminution age clock as reduction of lithic parent material below a critical grain size threshold of ~;;50 mu m.) To test the comminution age method as a means to date continental sediments, we applied the method to drill-core samples of the glacially-derived Kings River Fan alluvial deposits in central California. Sediments from the 45 m core have independently-estimated depositional ages of up to ~;;800 ka, based on paleomagnetism and correlations to nearby dated sediments. We characterized sequentially-leached core samples (both bulk sediment and grain size separates) for U, Nd, and Sr isotopes, grain size, surface texture, and mineralogy. In accordance with the comminution age model, where 234U is partially lost from small sediment grains due to alpha recoil, we found that (234U/238U) activity ratios generally decrease with age, depth, and specific surface area, with depletions of up to 9percent relative to radioactive equilibrium. The resulting calculated comminution ages are reasonable, although they do not exactly match age estimates from previous studies and also depend on assumptions about 234U loss rates. The results indicate that the method may be a significant addition to the sparse set of available tools for dating detrital continental sediments, following further refinement. Improving the accuracy of the method requires more advanced models or measurements for both the recoil loss factor fa and weathering effects. We discuss several independent methods for obtaining fa on individual samples
Full Text Available Currently, the best practice to support land planning calls for the development of Spatial Data Infrastructures (SDI capable of integrating both geospatial datasets and time series information from multiple sources, e.g., multitemporal satellite data and Volunteered Geographic Information (VGI. This paper describes an original OGC standard interoperable SDI architecture and a geospatial data and metadata workflow for creating and managing multisource heterogeneous geospatial datasets and time series, and discusses it in the framework of the Space4Agri project study case developed to support the agricultural sector in Lombardy region, Northern Italy. The main novel contributions go beyond the application domain for which the SDI has been developed and are the following: the ingestion within an a-centric SDI, potentially distributed in several nodes on the Internet to support scalability, of products derived by processing remote sensing images, authoritative data, georeferenced in-situ measurements and voluntary information (VGI created by farmers and agronomists using an original Smart App; the workflow automation for publishing sets and time series of heterogeneous multisource geospatial data and relative web services; and, finally, the project geoportal, that can ease the analysis of the geospatial datasets and time series by providing complex intelligent spatio-temporal query and answering facilities.
Full Text Available Abstract Background Referral is a critical part of appropriate primary care and of the Integrated Management of Childhood Illness (IMCI strategy. We set out to study referrals from the aspect both of primary level facilities and the referral hospital in Kilombero District, southern Tanzania. Through record review and a separate prospective study we estimate referral rates, report on delays in reaching referral care and summarise the appropriateness of pediatric referral cases in terms of admission to the pediatric ward at a district hospital Methods A sample of patient records from primary level government health facilities throughout 1993 were summarised by age, diagnosis, whether a new case or a reattendance, and whether or not they were referred. From August 1994 to July 1995, mothers or carers of all sick children less than five years old attending the Maternal and Child Health (MCH clinic or outpatient department (OPD of SFDDH were interviewed using a standard questionnaire recording age, sex, diagnosis, place of residence, whether the child was admitted to the paediatric ward, and whether the child was referred. Results From record review, only 0.6% of children from primary level government facilities were referred to a higher level of care. At the referral hospital, 7.8 cases per thousand under five catchment population had been referred annually. The hospital MCH clinic and OPD were generally used by children who lived nearby: 91% (n = 7,166 of sick children and 75% (n = 607 of admissions came from within 10 km. Of 235 referred children, the majority (62% had come from dispensaries. Almost half of the referrals (48% took 2 or more days to arrive at the hospital. Severe malaria and anaemia were the leading diagnoses in referred children, together accounting for a total of 70% of all the referrals. Most referred children (167/235, 71% were admitted to the hospital paediatric ward. Conclusions The high admission rate among referrals
Burgher, Karl E.; Snyder, Michael
This is the third in a series of eight articles on project management (PM) in the academy. In this article, the authors describe the step-by-step implementation of a structural change to Indiana State University's (ISU's) Office of Registration and Records (ORR). The process described may vary as it is implemented elsewhere, but the authors…
The present article describes the series of incident primary ovarian tumors in the Life Span Study (LSS) cohort of the Radiation Effects Research Foundation, with particular emphasis on case ascertainment and characterization of histological features of the tumors. We identified 723 ovarian tumors (260 malignant, 463 benign) in 648 individuals of about 70,000 female LSS subjects; 71 cases had more than one ovarian tumor. We histologically confirmed 601 tumors (182 malignant, 419 benign tumors). The most frequent histological type was common epithelial tumor (90.7% for malignant and 59.7% for benign tumors). The distributions of ovarian tumors by histological type were similar to those from other studies. Among malignancies, the frequency of common epithelial types relative to other tumor types increased with radiation dose (p=0.02). Among benign tumors, the relative frequency of sex-cord stromal tumors increased with radiation dose (p=0.04). The women with mucinous cancer had better survival than those with serous cancers (p=0.03). Within tumor types, there was no consistent pattern of survival by radiation dose. Variations in histological types of ovarian tumors in response to radiation dose, suggested by the case series data need to be followed up by population-based incidence analysis. (author)
Montalto, Placido; Aliotta, Marco; Cassisi, Carmelo; Prestifilippo, Michele; Cannata, Andrea
The variables collected by a sensor network constitute a heterogeneous data source that needs to be properly organized in order to be used in research and geophysical monitoring. With the time series term we refer to a set of observations of a given phenomenon acquired sequentially in time. When the time intervals are equally spaced one speaks of period or sampling frequency. Our work describes in detail a possible methodology for storage and management of time series using a specific data structure. We designed a framework, hereinafter called TSDSystem (Time Series Database System), in order to acquire time series from different data sources and standardize them within a relational database. The operation of standardization provides the ability to perform operations, such as query and visualization, of many measures synchronizing them using a common time scale. The proposed architecture follows a multiple layer paradigm (Loaders layer, Database layer and Business Logic layer). Each layer is specialized in performing particular operations for the reorganization and archiving of data from different sources such as ASCII, Excel, ODBC (Open DataBase Connectivity), file accessible from the Internet (web pages, XML). In particular, the loader layer performs a security check of the working status of each running software through an heartbeat system, in order to automate the discovery of acquisition issues and other warning conditions. Although our system has to manage huge amounts of data, performance is guaranteed by using a smart partitioning table strategy, that keeps balanced the percentage of data stored in each database table. TSDSystem also contains modules for the visualization of acquired data, that provide the possibility to query different time series on a specified time range, or follow the realtime signal acquisition, according to a data access policy from the users.
Full Text Available Abstract Background Overactivity of anterior and/or posterior tibial tendon may be a causative factor of spastic varus foot deformity. The prevalence of their dysfunction has been reported with not well defined results. Although gait analysis and dynamic electromyography provide useful information for the assessment of the patients, they are not available in every hospital. The purpose of the current study is to identify the causative muscle producing the deformity and apply the most suitable technique for its correction. Methods We retrospectively evaluated 48 consecutive ambulant patients (52 feet with spastic paralysis due to cerebral palsy. The average age at the time of the operation was 12,4 yrs (9-18 and the mean follow-up 7,8 yrs (4-14. Eigtheen feet presented equinus hind foot deformity due to gastrocnemius and soleus shortening. According to the deformity, the feet were divided in two groups (Group I with forefoot and midfoot inversion and Group II with hindfoot varus. The deformities were flexible in all cases in both groups. Split anterior tibial tendon transfer (SPLATT was performed in Group I (11 feet, while split posterior tibial tendon transfer (SPOTT was performed in Group II (38 feet. In 3 feet both procedures were performed. Achilles tendon sliding lengthening (Hoke procedure was done in 18 feet either preoperatively or concomitantly with the index procedure. Results The results in Group I, were rated according to Hoffer's clinical criteria as excellent in 8 feet and satisfactory in 3, while in Group II according to Kling's clinical criteria were rated as excellent in 20 feet, good in 14 and poor in 4. The feet with poor results presented residual varus deformity due to intraoperative technical errors. Conclusion Overactivity of the anterior tibial tendon produces inversion most prominent in the forefoot and midfoot and similarly overactivity of the posterior tibial tendon produces hindfoot varus. The deformity can be
Marcello H. Nogueira-Barbosa
Full Text Available Abstract Objective: The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods: Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results: Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5% patients (mean age, 50.9 years; age range, 42-58 years; 42% female. Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion: Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.
Roghani-Dehkordi, Farshad; Hadizadeh, Mahmood; Hadizadeh, Fatemeh
BACKGROUND Coronary angiography is the gold standard method for diagnosis of coronary heart disease and usually performed by femoral approach that has several complications. To reduce these complications, upper extremity approach is increasingly used and is becoming preferred access site by many interventionists. Although radial approach is relatively well studied, safety, feasibility and risk of applying ulnar approach in not clearly known yet. METHODS We followed 97 patients (man = 56%, mean ± standard deviation of age = 57 ± 18) who had undergone coronary angiography or angioplasty via ulnar approach for 6-10 months and recorded their outcomes. RESULTS In 97 patients out of 105 ones (92.38%), procedure through ulnar access were successfully done. Unsuccessful puncture (3 patients), wiring (2 patients), passing of sheet (2 patients), and anatomically unsuitable ulnar artery (1 patient) were the reasons of failure. In 94 patients (89.52%), the angiography and angioplasty was done without any complications. Five patients (5.1%) hematoma and 11 patients (11%) experienced low-grade pain that resolved with painkiller. No infection, amputation or need for surgery was reported. CONCLUSION This study demonstrated that ulnar access in our patients was a safe and practical approach for coronary angiography or angioplasty, without any major complication. Bearing in mind its high success rate, it can be utilized when a radial artery is not useful for the catheterization and in cases such as prior harvesting of the radial artery (in prior coronary artery bypass grafting). PMID:26715936
Full Text Available Disaggregation of hourly rainfall data is very important to fulfil the input of continual rainfall-runoff model, when the availability of automatic rainfall records are limited. Continual rainfall-runoff modeling requires rainfall data in form of series of hourly. Such specification can be obtained by temporal disaggregation in single site. The paper attempts to generate single-site rainfall model based upon time series (AR1 model by adjusting and establishing dummy procedure. Estimated with Bayesian Markov Chain Monte Carlo (MCMC the objective variable is hourly rainfall depth. Performance of model has been evaluated by comparison of history data and model prediction. The result shows that the model has a good performance for dry interval periods. The performance of the model good represented by smaller number of MAE by 0.21 respectively.
Sheikh, A.; Nurmatov, U.; Venderbosch, I.; Bischoff, E.W.
BACKGROUND: Allergy to peanuts is associated with considerable morbidity and, in a minority of cases, mortality. Natural resolution to peanut allergy occurs in only a few cases, hence the need to find effective interventions. Peanut oral immunotherapy (OIT) is a potentially important new therapeutic
Ghaffari Razin, Mir Reza; Voosoghi, Behzad
Wavelet neural networks (WNNs) are important tools for analyzing time series especially when it is non-linear and non-stationary. It takes advantage of high resolution of wavelets and feed forward nature of neural networks (NNs). Therefore, in this paper, WNNs is used for modeling of ionosphere time series in Iran. To apply the method, observations collected at 22 GPS stations in 12 successive days of 2012 (DOY# 219-230) from Azerbaijan local GPS network are used. For training of WNN, back-propagation (BP) algorithm is used. The results of WNN compared with results of international reference ionosphere 2012 (IRI-2012) and international GNSS service (IGS) products. To assess the error of WNN, statistical indicators, relative and absolute errors are used. Minimum relative error for WNN compared with GPS TEC is 6.37% and maximum relative error is 12.94%. Also the maximum and minimum absolute error computed 6.32 and 0.13 TECU, respectively. Comparison of diurnal predicted TEC values from the WNN model and the IRI-2012 with GPS TEC revealed that the WNN provides more accurate predictions than the IRI-2012 model and IGS products in the test area.
Aracele Tenório de Almeida e Cavalcanti
Full Text Available HIV/AIDS-associated visceral leishmaniasis may display the characteristics of an aggressive disease or without specific symptoms at all, thus making diagnosis difficult. The present study describes the results of diagnostic tests applied to a series of suspected VL cases in HIV-infected/AIDS patients admitted in referral hospitals in Pernambuco, Brazil. From a total of 14 eligible patients with cytopenias and/or fever of an unknown etiology, and indication of bone marrow aspirate, 10 patients were selected for inclusion in the study. Diagnosis was confirmed by the following examinations: Leishmania detection in bone marrow aspirate, direct agglutination test, indirect immunofluorescence, rK39 dipstick test, polymerase chain reaction and latex agglutination test. Five out of the ten patients were diagnosed with co-infection. A positive direct agglutination test was recorded for all five co-infected patients, the Leishmania detection and latex agglutination tests were positive in four patients, the rK39 dipstick test in three, the indirect immunofluorescence in two and a positive polymerase chain reaction was recorded for one patient. This series of cases was the first to be conducted in Brazil using this set of tests in order to detect co-infection. However, no consensus has thus far been reached regarding the most appropriate examination for the screening and monitoring of this group of patients.
Lopes, Rubia Garcia; de Santi, Maria Eugenia Simões Onofre; Franco, Bruno Edin; Deana, Alessandro Melo; Prates, Renato Araujo; França, Cristiane Miranda; Fernandes, Kristianne Porta Santos; Ferrari, Raquel Agnelli Mesquita; Sandra Kalil BUSSADORI
Introduction: Halitosis is a common problem that affects a large portion of the population worldwide. The origin of this condition is oral in 90% of cases and systemic in 10% of cases. The foul odor is caused mainly by volatile sulfur compounds produced by Gram-negative bacteria. However, it has recently been found that anaerobic Gram-positive bacteria also produce hydrogen sulfide (H2S) in the presence of amino acids, such as cysteine. Light with and without the combination of chemical agent...
This paper focuses on the characterization of time series rainfall data to understand the behavior in the Malaysian rainfall data. An analysis of the rainfall behavior of different time periods is also conducted. The rainfall data is rounded. A bar with a width of 12 pixels is drawn for each day in the data. The length of the bars drawn is equal to the corresponding rainfall value. Each bar is separated by a space of 2 pixels. Bars for data from different year are stored in different rows. Morphological opening is performed on the barcode image obtained, using line kernels of increasing length. Connected component-labeling algorithm is implemented on the resulting images to identify the individual bar codes and to compute the number of bars remaining after the opening process. A daily rainfall record for the duration of 30 years, obtained from the Melaka Meteorological Station, is analyzed. The results provide characterization of behavior in daily rainfall data
Radhakrishnan, P. [Faculty of Information Science and Technology, Multimedia University, Melaka 75450 (Malaysia)] e-mail: firstname.lastname@example.org; Dinesh, S. [Faculty of Engineering and Technology, Multimedia University, Melaka 75450 (Malaysia)
This paper focuses on the characterization of time series rainfall data to understand the behavior in the Malaysian rainfall data. An analysis of the rainfall behavior of different time periods is also conducted. The rainfall data is rounded. A bar with a width of 12 pixels is drawn for each day in the data. The length of the bars drawn is equal to the corresponding rainfall value. Each bar is separated by a space of 2 pixels. Bars for data from different year are stored in different rows. Morphological opening is performed on the barcode image obtained, using line kernels of increasing length. Connected component-labeling algorithm is implemented on the resulting images to identify the individual bar codes and to compute the number of bars remaining after the opening process. A daily rainfall record for the duration of 30 years, obtained from the Melaka Meteorological Station, is analyzed. The results provide characterization of behavior in daily rainfall data.
Disequilibria in uranium series and their consequences on the annual dose determination in luminescence dating studies are now well-known, but only a few studies refer to the systematic research of this kind of phenomenon, and eventually to how the problem has been misguided. The present work aims at considering a new case study: anciently heated ferruginous sandstones from a Magdalenian archaeological site have been dated by thermoluminescence. In this work, uranium series disequilibrium has been detected both in samples and surrounding sediments, using high resolution low background gamma spectrometry measurements. Further investigations, in particular with alpha-spectrometry measurements and geochemical considerations, helped us to understand when and how the disequilibrium began, and it led us to propose a specific simple model, based on a continuous and regular enrichment in uranium, for the evaluation of the mean annual dose absorbed by the samples to be dated. This work deals with the results of gamma and alpha-spectrometry as well as the dose variation model proposed and the dating results obtained, in terms of annual dose determination and in terms of age obtained.
Full Text Available In patients with panfacial trauma where short-term intraoperative control of airway is required, submental intubation is an alternative to tracheostomy as it is associated with lesser morbidity. It is also an interesting alternative to oral and nasal intubation as intraoperatively the tube does not cause any hindrance to the surgeon and occlusion can also be assessed simultaneously. Out of 10 cases of maxillofacial trauma operated in our hospital using submental intubation, the cuff of the pilot tube was brought out in 5 of them through the midline incision, while in remaining 5 it was left inside the nasopharynx. It was observed subsequently that cuff inside the nasopharynx had some advantage, viz. there were lesser chances of accidental extubation, rupture of cuff and the incision size need not be extended to extract the cuff which resulted into a cosmetically better scar.
Alvira González, Joaquín; Díaz Campos, Erick; Sánchez Garcés, María Angeles; Gay Escoda, Cosme
Background To assess and compare survival rates of immediately and delayed loaded short implants (7 mm) in free ends of a partially edentulous jaw with moderate-severe alveolar bone resorption. Material and Methods 24 patients with atrophic edentulous free-ends were included in this prospective study. Four study groups were monitored monthly and their behavior was evaluated: bridges supported only by short implants and mixed short and long implant bridge groups, both with immediate and delaye...
van Lent Wineke AM; de Beer Relinde D; van Harten Wim H
Abstract Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations managem...
Alvira-González, Joaquin; Díaz-Campos, Erick; Sánchez-Garcés, Maria-Angeles
Background To assess and compare survival rates of immediately and delayed loaded short implants (7 mm) in free ends of a partially edentulous jaw with moderate-severe alveolar bone resorption. Material and Methods 24 patients with atrophic edentulous free-ends were included in this prospective study. Four study groups were monitored monthly and their behavior was evaluated: bridges supported only by short implants and mixed short and long implant bridge groups, both with immediate and delayed loading. Failures, bone loss, probing depth and bleeding on probing were evaluated. Results 54 Mk III Shorty TiU and 15 Brånemark System®MK III TiU implants with a length longer than 7mm were included in the study. Twenty-eight implants were inserted following the immediate loading protocol and 26 according a two-stage procedure, depending on the torque value. The cumulative survival rate of short implants was 87% (n=54) after a mean time of 47.72 months (range 33-62 months), showing statistically significant differences related to loading protocol (p=0.047). Short implants immediately loaded had a higher long-term survival rate (96.4%) compared to the other study group (76.9%). Besides, short implants splinted to longer immediately loaded implants presented the highest survival rate (100%). Twenty-five (53.19%) short implants showed a bone loss of less than one millimeter after the follow-up period. Statistically significant differences were found between bleeding on probing, presence of plaque or suppuration and a higher bone loss in both loading protocols (p=0.001). Conclusions Immediate loading of short implants placed on free ends can be considered an option in the treatment protocol of patients with severe bone resorption especially if implants are splinted to others of greater length. Key words: Dental implants, short implants, immediate loading, prospective study, TiUnite surface. PMID:26034926
Reimão, S.; Francioni, E.; Bories, E.; Caillol, F.; Pesenti, C.; Giovannini, M
Introduction: Biliary obstruction is preferentially managed by endoscopic retrograde cholangiopancreatography (ERCP). However, after ERCP failed, alternatives include percutaneous transhepatic drainage, surgery and more recently, endoscopic ultrasonography (EUS)-guided hepaticogastrostomy. The limitation of this technique is that the drainage is restricted to the left side. The aim of this study is to describe a new method of drainage of both hepatic ductal systems by hepaticogastrostomy in p...
Majerus Steve; Demertzi Athena; Gosseries Olivia; Boly Mélanie; Schnakers Caroline; Vanhaudenhuyse Audrey; Bruno Marie-Aurélie; Moonen Gustave; Hustinx Roland; Laureys Steven
Abstract Background Assessment of visual fixation is commonly used in the clinical examination of patients with disorders of consciousness. However, different international guidelines seem to disagree whether fixation is compatible with the diagnosis of the vegetative state (i.e., represents "automatic" subcortical processing) or is a sufficient sign of consciousness and higher order cortical processing. Methods We here studied cerebral metabolism in ten patients with chronic post-anoxic ence...
Seyed Ziaollah Haghi
Full Text Available Introduction: There are significant gender differences in the epidemiology and presentation of cardiovascular diseases (CVDs, physiological aspects of CVDs, response to diagnostic tests or interventions, and prevalence or incidence of the associated risk factors. Considering the independent influence of gender on early dire consequences of such diseases, this study was conducted to investigate gender differences in patients' beliefs about biological, environmental, behavioral, and psychological risk factors in a cardiac rehabilitation program. Materials and Methods: This study has cross sectional design. The sample was composed of 775 patients referred to cardiac rehabilitation unit in Imam Ali Hospital in Kermanshah, Iran. The data were collected using clinical interview and patients’ medical records. The data were analyzed using descriptive statistics such as mean, standard deviation, and chi-square test. To do the statistical analysis, SPSS version 20 was utilized. Results: As the results indicated, there was a significant difference between the beliefs of men and women about risk factors of heart disease (X2= 48.36; P
Full Text Available Background: Distal femur wedge osteotomies for varus or valgus alignment of the lower extremity could be done in either uniplanar or biplanar fashion.Union time and stability of the osteotomy site has been considered important in this anatomic region. In this study, clinical and radiographic findings of biplane distal femur osteotomy were reported. Methods: Clinical, functional, and radiological findings of eight patients (10 kneesunderwent biplane distal femur osteotomy were evaluated. Visual analogue score (VAS and Lysholm-Tegner knee score were used for the assessment of pain and function before and three months after surgery. Results: In this study, eight patients were included. All patients were female. The mean age was 28±6.3. The mean pre-operativemechanical anglewas 8.7±2.2˚and the post-operativeangle was 1.4±0.53˚ in patients with valgus alignment whileit was 7.0±1.0˚preoperatively and 0.66±1.2˚ postoperatively in patients with varus alignment. The mean lateral distal femoral angle (LDFAwas 85±8.0˚ before surgery and was 88±1.3˚ after surgery. According to Lysholm- Tegner knee score, in the post-operative visit, sixknees were good and four were excellent. The mean union time was 9.2±2.3 weeks. Conclusions: Biplane distal femur osteotomy is a reliable technique that creates larger surfaces and more stability at the osteotomy site with further rapid union.
Full Text Available Stochastic techniques are essential in planning and management of water resources systems especially in arid and semi-arid areas where water is scarce. The forecasting of future events requires identifying proper stochastic models to be used in this process. For this purpose, a Periodic ARMA (PARMA model and a temporal disaggregation models were used in this study to investigate weather they are appropriate for modeling the monthly rainfall data in Saudi Arabia. Results showed PARMA and temporal disaggregation models performed well in modeling the monthly rainfalls in Saudi Arabia. These models were able to preserve the basic seasonal statistics of the observed data well as preserving the seasonal correlation structure observed in the historical data. However, the PARMA model did not perform well at the annual level. In contrast, the disaggregation model performed well in preserving the correlation structure of the historical data at the annual level. Thus, these models can be used in modeling and forecasting of monthly rainfall in Arid and semi-arid areas.
Full Text Available Background: Increasing antimicrobial resistance is now a critical point of human being in the world. Especially wide spectrum antibiotics resistance germs like vancomycin-resistant enterococci (VRE should be dealt as soon as possible as an emergency conflict. Our study tries to reveal the amount of irrational use of vancomycin in a teaching hospital in Iran.Methods: We elected the whole inpatients that received vancomycin between February 2007 and May 2008.Results: Forty four out of those 45 patients had inappropriate indication and dosing regimen of vancomycin (97.7%. The most use of vancomycin was recorded in hematology – oncology ward and then Intensive Care Unit (ICU. Culture responses were negative despite great clinical evidence of infection.Conclusion: Vancomycin irrational use was high compared to other countries and it could be concerned as a major health problem by health policy makers and physicians to deal. However more detailed researches are needed to reveal the other aspects of this problem. Implementation of antibiotic protocols and standard treatment guidelines are recommended.
Objective: To evaluate the efficacy of acupuncture in treating chronic non-specific low back pain. Methods: Ten patients with chronic low back pain were selected to receive 9 acupuncture treatments over a three-week period with point selection based on syndrome differentiation in Chinese medicine. The BROM Instrument for assessment of back range of motion; subjective evaluation with Visual Analog Scale of Pain (VASP) ratings, Oswestry Disability ratings, objective measurements including Algometry, and Flexion and Extension ratings to investigate the range of motion were used for comparing the large, medium and small effect sizes of baseline, treatment and follow-up phases. Results: Clinical significance of pain relief was shown in all parameters assessed. A large effect size was detected in VASP, Oswestry and Algometry. A small effect size was demonstrated in Flexion/Extension. Needling over short period time (3 weeks) could relieve the pain, but the muscular-skeletal function measured by BROM persists. To treat patients exclusively by needling for statistical purposes can not be justified, because by merely relieving pain, permanent improvement in function may not be achieved. Conclusion: Acupuncture offers an effective alternative for the clinical management of chronic low back pain, significant improvement in most of the parameters evaluated, but the functional improvement was not as satisfactory as pain relieving. Further study with larger sample size focuses on long-term efficacy and functional improvement for chronic low back pain is recommended.
Arntz, Arnoud; Sofi, Dana; van Breukelen, Gerard
This study tested the effectiveness of Imagery Rescripting (ImRs) for complicated war-related PTSD in refugees. Ten adult patients in long-term supportive care with a primary diagnosis of war-related PTSD and Posttraumatic Symptom Scale (PSS) score > 20 participated. A concurrent multiple baseline design was used with baseline varying from 6 to 10weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase followed with weekly sessions during which traumas were explored, without trauma-focused treatment. Then 10 weekly ImRs sessions were given followed by 5-week follow-up without treatment. Participants were randomly assigned to baseline length, and filled out the PSS and the BDI on a weekly basis. Data were analyzed with mixed regression. Results revealed significant linear trends during ImRs (reductions of PSS and BDI scores), but not during the other conditions. The scores during follow-up were stable and significantly lower compared to baseline, with very high effect sizes (Cohen's d = 2.87 (PSS) and 1.29 (BDI)). One patient did clearly not respond positively, and revealed that his actual problem was his sexual identity that he couldn't accept. There were no dropouts. In conclusion, results indicate that ImRs is a highly acceptable and effective treatment for this difficult group of patients. PMID:23524061
Full Text Available Abstract Background Assessment of visual fixation is commonly used in the clinical examination of patients with disorders of consciousness. However, different international guidelines seem to disagree whether fixation is compatible with the diagnosis of the vegetative state (i.e., represents "automatic" subcortical processing or is a sufficient sign of consciousness and higher order cortical processing. Methods We here studied cerebral metabolism in ten patients with chronic post-anoxic encephalopathy and 39 age-matched healthy controls. Five patients were in a vegetative state (without fixation and five presented visual fixation but otherwise showed all criteria typical of the vegetative state. Patients were matched for age, etiology and time since insult and were followed by repeated Coma Recovery Scale-Revised (CRS-R assessments for at least 1 year. Sustained visual fixation was considered as present when the eyes refixated a moving target for more than 2 seconds as defined by CRS-R criteria. Results Patients without fixation showed metabolic dysfunction in a widespread fronto-parietal cortical network (with only sparing of the brainstem and cerebellum which was not different from the brain function seen in patients with visual fixation. Cortico-cortical functional connectivity with visual cortex showed no difference between both patient groups. Recovery rates did not differ between patients without or with fixation (none of the patients showed good outcome. Conclusions Our findings suggest that sustained visual fixation in (non-traumatic disorders of consciousness does not necessarily reflect consciousness and higher order cortical brain function.
Amaya, Daniel; Sánchez, Andrés; Sánchez, Jorge
Inducible urticaria is a heterogeneous group of skin disorders characterized by the appearance of wheals, pruritus and/or angioedema, sometimes accompanied by systemic symptoms caused by innocuous stimuli (cold, heat, pressure, etc.). This group of disorders compromises people's quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. The aim of this review is to show an up-to-date overview of the available literature for various types of inducible urticarias, always beginning with an illustrative case and then describing their pathophysiological mechanisms, clinical manifestations, and treatment. PMID:27622434
Purpose. Our aim was to study the results and the complications of this series of 207 patients treated from 1976 to 1992 and to compare them with the results of the literature. Material and methods. The treatment consisted of a combination of external beam irradiation (EBI) (to the tumor and the node areas) and complementary brachytherapy to the primary tumor in 105 cases. In 102 cases, brachytherapy only was delivered to the tumor with or without neck dissection of the node areas. The brachytherapy was performed mostly with the hairpin technique in the beginning (in 61 cases) and subsequently the plastic tube technique with iridium wires. The dosimetry followed the Paris system rules. There were 41% T1, 48% T2, 8% T3, 2% T4 and 1% Tx with 83% N0, 12% N1, 3% N2, 2% N3. Ninety-one percent of patients were male and 9% were female. Results. The local control at 5 years is 97, 72 and 51%, respectively, for T1, T2, T3. The specific survival (without the patients dead of intercurrent disease or second cancer) was 88, 47 and 36%, and the overall survival at 5 years was 71, 42 and 35%. Of note, approximately one third of patients died of intercurrent disease or second cancers (70 patients = 34%). Significant factors that can influence the results are: for local control, the size of the lesion T1/T2/T3 (p < 0.0001); for the locoregional control, the absence of node involvement. The following factors are not significant: age and sex (age significant for survival). The significant treatment factors are the safety margin (p < 0.0003), brachytherapy only on T for T2N0 (p = 0.01). A total duration of treatment of less than 50 days is also significant. The spacing and the total dose (higher dose for large tumors) were not found to be significant. The complications were classified into four grades: grade 1, 17% (median healing, 2 months for soft tissue complications and 5 months for bone complications); grade 2, 12%; grade 3, 6% (frequently requiring surgical resection); grade 4
Bhatia M S
Full Text Available A series 25 cases of delusional parasitosis is being reported. There were three cases below 45 years, 12 cases between 46-45 years and 11 cases above 55 years of age, 64% cases were females. A majority of cases (92% had insidious onset. The duration of symptoms in all the cases (except one was 6 months or more. 13 cases presented with infestation with insects over body and 10 cases with insects crawling over scalp. There were three cases each with diabetes mellitus and leprosy. Three cased had dementia, 2 cases had depression and one case presented with trichotillomania. Pimozide was used in22 cases, amitriptyline in 2 cases and fluoxetine in one. 14 cases (52% showed complete remission while receiving drug, 8 cases showed partial improvement and 3 cases did not respond.
Full Text Available In Taiwan, new H1N1 monovalent vaccines without adjuvant and with MF59® adjuvant were used in the nationwide vaccination campaign beginning on November 1, 2009. From November 2009 through February 2010, the authors identified recipients of H1N1 vaccines who were diagnosed with adverse events of special interest (AESIs in a large-linked safety database, and used the self-controlled case series (SCCS method to examine the risk of each AESI in the 0-42 days after H1N1 vaccination. Of the 3.5 million doses of H1N1 vaccines administered and captured in the linked database, the SCCS analysis of Guillain-Barré syndrome (GBS found an incidence rate ratio of 3.81 (95% confidence interval 0.43-33.85 within 0-42 days after nonadjuvanted H1N1 vaccination and no cases after MF59®-adjuvanted H1N1 vaccination. The risks of other AESIs were, in general, not increased in any of the predefined postvaccination risk periods and age groups. The databases and infrastructure created for H1N1 vaccine safety evaluation may serve as a model for safety, effectiveness and coverage studies of licensed vaccines in Taiwan.
Hatim A. Omar
Full Text Available The purpose was to illustrate the variability of hormonal contraception of patients that presented with membranous dysmenorrheal. A case analysis chart review was completed on six patients referred to a Pediatric Gynecologist in an academic setting. In each case the patient underwent a thorough pelvic and bimanual exam. Following the initial presentation, each patient continued to be followed on a regular visits. Cases: Two were using the transdermal contraceptive patch and oral contraceptive, but following the expulsion of decidual cast, they were both placed on depot medroxyprogesterone acetate (DMPA without further complications. Three of the six cases were on DMPA prior to the similar occurrence of membranous dysmenorrheal and following this incident, continued on DMPA without further problems. The final case was on the transdermal patch prior to decidual cast expulsion and remained on this form of hormonal contraception without further complications. These cases indicate that membranous dysmenorrheal is not limited to the use of DMPA.
Nucera, Eleonora; Aruanno, Arianna; Rizzi, Angela; Pecora, Valentina; Patriarca, Giampiero; Buonomo, Alessandro; Mezzacappa, Simona; Schiavino, Domenico
The role of profilin as an allergen has long been questioned. The capacity of profilin to induce respiratory symptoms has recently been demonstrated; moreover, over 50% of patients sensitized to profilin experienced symptoms after the ingestion of plant-derived foods, suggesting that profilin should be considered as a clinically relevant food allergen.We describe the cases of seven allergic patients with oral allergy syndrome and other adverse reactions after eating plant-derived food, that have been undergone to profilin desensitization treatment.The protocol started with a drop of profilin solution (50 µg/mL) diluted 1:10(18) in water until the highest dose of 10 drops of undiluted solution three times a week. At the end of the treatment we observed a decreased mean diameter of profilin wheal in skin prick test (SPT) in five of the seven participants and in profilin specific IgE values in six patients that repeated the test. Regarding basophil activation test (BAT) and the detection of IgG4, we do not have significant results because the tests have to be repeated in some patients. Regarding the double-blind placebo-controlled challenges, after about 10 months of induction phase all the patients showed tolerance to several foods that they previously did not tolerate.Moreover, the immunotherapy with profilin has proved to be safe because no serious adverse events have been reported in our patients.In summary, the results of this exploratory study of sublingual immunotherapy (SLIT) for profilin allergy show that it can be a promising therapeutic option that could modify the clinical reactivity of the patients to the intake of plant-derived food. PMID:26684620
Full Text Available Mucormycosis is a rare opportunistic fungal infection with a rapidly progressive and fulminantcourse with often fatal outcome. A less fulminant variety of this is the Rhino maxillary subtypewhich usually presents with palatal ulceration, facial swelling, turbinate necrosis and purulentsinusitis. We are reporting our experience of 4 such cases seen during the last 10 yrs. A strongsuspicion, prompt diagnosis with pathological confirmation and aggressive surgical treatmentgives a better outcome.
Meshkini, Ali; Vahedi, Amir; Meshkini, Mohammad; Alikhah, Hossein; Naghavi-behzad, Mohammad
Medulloblastoma is common in children as a tumor of midline posterior fossa, which arises from vermis and appears as a homogenously enhancing hyperdense mass on computed tomography scan and is associated with the clinical picture of posterior fossa syndrome. This unique clinic-radiological pattern in considered “typical” medulloblastoma, but medulloblastomas does not follow the typical clinic-radiological pattern in a significant number of children and adult cases. We review here the previous...
Full Text Available BACKGROUND: Results from epidemiologic studies on the relationship between vitamin D and breast cancer risk are inconclusive. It is possible that vitamin D may be effective in reducing risk only of specific subtypes due to disease heterogeneity. METHODS AND FINDINGS: In case-control and case-series analyses, we examined serum concentrations of 25-hydroxyvitamin D (25OHD in relation to breast cancer prognostic characteristics, including histologic grade, estrogen receptor (ER, and molecular subtypes defined by ER, progesterone receptor (PR and HER2, among 579 women with incident breast cancer and 574 controls matched on age and time of blood draw enrolled in the Roswell Park Cancer Institute from 2003 to 2008. We found that breast cancer cases had significantly lower 25OHD concentrations than controls (adjusted mean, 22.8 versus 26.2 ng/mL, p<0.001. Among premenopausal women, 25OHD concentrations were lower in those with high- versus low-grade tumors, and ER negative versus ER positive tumors (p≤0.03. Levels were lowest among women with triple-negative cancer (17.5 ng/mL, significantly different from those with luminal A cancer (24.5 ng/mL, p = 0.002. In case-control analyses, premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer (OR = 0.21, 95% CI = 0.08-0.53 than those with levels below the median; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64% lower odds of having triple-negative cancer (OR = 0.36, 95% CI = 0.22-0.56. The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses. CONCLUSION: In our analyses, higher serum levels of 25OHD were associated with reduced risk of breast cancer, with associations strongest for high grade, ER negative or triple negative cancers in premenopausal women. With further confirmation in large prospective studies, these findings
Yao, Song; Sucheston, Lara E.; Millen, Amy E.; Johnson, Candace S.; Trump, Donald L.; Nesline, Mary K.; Davis, Warren; Hong, Chi-Chen; McCann, Susan E.; Hwang, Helena; Kulkarni, Swati; Edge, Stephen B.; O'Connor, Tracey L.; Ambrosone, Christine B.
Background Results from epidemiologic studies on the relationship between vitamin D and breast cancer risk are inconclusive. It is possible that vitamin D may be effective in reducing risk only of specific subtypes due to disease heterogeneity. Methods and Findings In case-control and case-series analyses, we examined serum concentrations of 25-hydroxyvitamin D (25OHD) in relation to breast cancer prognostic characteristics, including histologic grade, estrogen receptor (ER), and molecular subtypes defined by ER, progesterone receptor (PR) and HER2, among 579 women with incident breast cancer and 574 controls matched on age and time of blood draw enrolled in the Roswell Park Cancer Institute from 2003 to 2008. We found that breast cancer cases had significantly lower 25OHD concentrations than controls (adjusted mean, 22.8 versus 26.2 ng/mL, p<0.001). Among premenopausal women, 25OHD concentrations were lower in those with high- versus low-grade tumors, and ER negative versus ER positive tumors (p≤0.03). Levels were lowest among women with triple-negative cancer (17.5 ng/mL), significantly different from those with luminal A cancer (24.5 ng/mL, p = 0.002). In case-control analyses, premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer (OR = 0.21, 95% CI = 0.08–0.53) than those with levels below the median; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64% lower odds of having triple-negative cancer (OR = 0.36, 95% CI = 0.22–0.56). The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses. Conclusion In our analyses, higher serum levels of 25OHD were associated with reduced risk of breast cancer, with associations strongest for high grade, ER negative or triple negative cancers in premenopausal women. With further confirmation in large prospective studies, these findings could warrant
Birca, Veronica; Tayah, Tania; Saint-Hilaire, Jean-Marc; Nguyen, Dang Khoa
Seizures can manifest with ictal swearing but few studies have investigated the localising value of this epileptic manifestation. In this case series and review of the literature, we attempted to determine whether ictal swearing could help localise the epileptic focus. We review two previously published cases and report eight additional epileptic patients with ictal swearing for whom the epileptic focus was determined based on clinical, structural, electrophysiological, and surgical outcome data. Results indicated that ictal swearing occurs more commonly in male subjects and lateralises to the non-dominant hemisphere, but has poor localisation value, arising either from the frontal, parietal, temporal or occipital lobes in different patients. We discuss the significance of these findings. [Published with video sequences]. PMID:24317202
Wan-Ting Huang; Hsu-Wen Yang; Tzu-Lin Liao; Wan-Jen Wu; Shu-Er Yang; Yi-Chien Chih; Jen-Hsiang Chuang
In Taiwan, new H1N1 monovalent vaccines without adjuvant and with MF59® adjuvant were used in the nationwide vaccination campaign beginning on November 1, 2009. From November 2009 through February 2010, the authors identified recipients of H1N1 vaccines who were diagnosed with adverse events of special interest (AESIs) in a large-linked safety database, and used the self-controlled case series (SCCS) method to examine the risk of each AESI in the 0-42 days after H1N1 vaccination. Of the 3.5 m...
Soydemir, Ersen Çağlar
ABSTRACT: Increase in the use of media in Turkey and in the world, led advertisers find new strategies to reach the target audience. Product placement can be counted as one of those strategies. Product placement is a type of advertisement in which a product can be seen in the TV series, movies, computer games, music videos and etc. This study took place in Eastern Mediterranean University in North Cyprus. Study occurred during the 2011 spring semester with the participation of the univers...
de Fatima Vasco Aragao, Maria; van der Linden, Vanessa; Brainer-Lima, Alessandra Mertens; Coeli, Regina Ramos; Rocha, Maria Angela; Sobral da Silva, Paula; Durce Costa Gomes de Carvalho, Maria; van der Linden, Ana; Cesario de Holanda, Arthur; Valenca, Marcelo Moraes
Objective To report radiological findings observed in computed tomography (CT) and magnetic resonance imaging (MRI) scans of the first cases of congenital infection and microcephaly presumably associated with the Zika virus in the current Brazilian epidemic. Design Retrospective study with a case series. Setting Association for Assistance of Disabled Children (AACD), Pernambuco state, Brazil. Participants 23 children with a diagnosis of congenital infection presumably associated with the Zika...
Full Text Available In the oro-facial region cystic lesions of different etiologies are encountered owing to the presence of the teeth in the jaw bones. A bewildering variety of developmental, odontogenic and non-odontogenic cysts are seen. Epidermoid cyst is a rare developmental cyst of the oro-facial region which results from entrapped epidermal elements without adnexal appendages. Dermoid and epidermoid cysts occur in oro-facial region with an incidence of 6.9-7% and represents less than 0.01% of all oral cavity cysts. Here we report two cases of epidermoid cysts occurring at unusual locations involving upper left maxillary region lateral to the nose and pinna of the ear.
Bonano, Manuela; Arangio, Stefania; Calò, Fabiana; Di Mauro, Maria; Marsella, Maria; Manunta, Michele
those situations where a quick analysis of a large number of buildings is needed. Finally, such an integrated method is valuable to carry out accurate back-analyses on the conditions of the investigated buildings over time and, in some cases, also predictive studies to estimate their future structural conditions. References Arangio, S., Calò, F., Di Mauro, M., Bonano, M., Marsella, M., Manunta, M, 2013, An application of the SBAS-DInSAR technique for the assessment of structural damage in the city of Rome (Italy), Structure and Infrastructure Engineering: Maintenance, Management, Life-Cycle Design and Performance, DOI: 10.1080/15732479.2013.833949 Bonano, M. Manunta, M. Marsella, and R. Lanari, 2012, Long-term ERS/ENVISAT deformation time-series generation at full spatial resolution via the extended SBAS technique, Int. J. Remote Sens., 33, 15, pp. 4756-4783, doi:10.1080/01431161.2011.638340. Finno R.J., Voss F.T., Rossow E., Blackburn J.T., 2005, Evaluating damage potential in building affected by excavations, Journal of Geotechnical and Geoenvironmental Engineering, 1199-1210. Lanari, R., Mora, O., Manunta, M., Mallorquí, J.J., Berardino, P., Sansosti E., 2004, A small baseline approach for investigating deformations on full resolution differential SAR interferograms, IEEE Transactions on Geoscience and Remote Sensing, 42, 1377-1386.
Dutrieux, Loïc P.; Jakovac, Catarina C.; Latifah, Siti H.; Kooistra, Lammert
We developed a method to reconstruct land use history from Landsat images time-series. The method uses a breakpoint detection framework derived from the econometrics field and applicable to time-series regression models. The Breaks For Additive Season and Trend (BFAST) framework is used for defining the time-series regression models which may contain trend and phenology, hence appropriately modelling vegetation intra and inter-annual dynamics. All available Landsat data are used for a selected study area, and the time-series are partitioned into segments delimited by breakpoints. Segments can be associated to land use regimes, while the breakpoints then correspond to shifts in land use regimes. In order to further characterize these shifts, we classified the unlabelled breakpoints returned by the algorithm into their corresponding processes. We used a Random Forest classifier, trained from a set of visually interpreted time-series profiles to infer the processes and assign labels to the breakpoints. The whole approach was applied to quantifying the number of cultivation cycles in a swidden agriculture system in Brazil (state of Amazonas). Number and frequency of cultivation cycles is of particular ecological relevance in these systems since they largely affect the capacity of the forest to regenerate after land abandonment. We applied the method to a Landsat time-series of Normalized Difference Moisture Index (NDMI) spanning the 1984-2015 period and derived from it the number of cultivation cycles during that period at the individual field scale level. Agricultural fields boundaries used to apply the method were derived using a multi-temporal segmentation approach. We validated the number of cultivation cycles predicted by the method against in-situ information collected from farmers interviews, resulting in a Normalized Residual Mean Squared Error (NRMSE) of 0.25. Overall the method performed well, producing maps with coherent spatial patterns. We identified
Full Text Available Abstract Background Clinical trials assessing efficacy and safety of Intramuscular (IM Olanzapine in acute schizophrenia and acute mania have previously been undertaken in studies required for drug registration in patients who were required to give informed consent. These patients may have less severe forms of psychosis than patients treated in routine practice. Data derived from naturalistic practice following the launch of IM olanzapine may be helpful for clinicians in assessing efficacy and safety of IM olanzapine. The PANSS-EC scale used in the clinical studies may represent a tool that could be used in routine clinical practice. Case presentation We report on an early unselected case series of 7 patients who received IM olanzapine in routine clinical practice settings in the UK. In this case series, olanzapine IM was generally effective, and no adverse events were reported. Adjunctive benzodiazepines were given concomitantly in 1 of the 7 subjects. This is relevant as concomitant benzodiazepines are not recommended for a minimum of 1 hour post IM olanzapine administration. PANSS-EC data was collected in 2 of the 7 subjects. Conclusion Although patients had greater severity of psychosis than clinical trial patients there were no unexpected findings. In addition the PANSS-EC scale is a scale that may be useful in assessing the efficacy of IM antipsychotics in routine clinical practice.
Sanderland J T Gurgel
Full Text Available OBJECTIVES: To evaluate the efficacy and safety of enhanced recovery after surgery (ERAS programs in elective open surgical repair (OSR of abdominal aortic aneurysm (AAA. BACKGROUND: Open surgical repair of AAA is associated with high morbidity and mortality, prolonged hospital stay and high costs. ERAS programs contribute to the optimization of treatment by reducing hospital stay and improving clinical outcomes. METHODS: A review of PubMed, EMBASE and LILACS databases was conducted. As only one randomized controlled trial was found, a pooled analysis of proportions from case series was conducted, considering it a complementary overview of the topic. Inclusion criteria were case series with more than five cases reported, adult patients who underwent an elective OSR of AAA and use of an ERAS program. ERAS was compared to conventional perioperative care. The pooled proportion and the confidence interval (CI are shown for each outcome. The overlap of the CI suggests similar effect of the interventions studied. RESULTS: Thirteen case series studies with ERAS involving 1,250 patients were compared to six case series with conventional care with a total of 1,429 patients. The pooled, respective proportions for ERAS and conventional care were: mortality, 1.51% [95% CI: 0.0091, 0.0226] and 3.0% [95% CI 0.0183, 0.0445]; and incidence of complications, 3.82% [95% CI 0.0259, 0.0528] and 4.0% [95% CI 0.03, 0.05]. CONCLUSION: This review shows that ERAS and conventional care therapies have similar mortality and complication rates in OSR of AAA.
Story-telling is important to child language development and plays a critical role within the English National Curriculum. Children who use Augmentative and Alternative Communication (AAC) have limited opportunities to develop narrative compared to their typically developing peers. The current study aimed to explore narrative construction in communicative dyads comprising an aided speaker (AS) and natural speaker (NS). A case series design was employed to investigate narrative interactions of...
Sprague, Brian L.; Gangnon, Ronald E.; Hampton, John M.; Egan, Kathleen M.; Titus, Linda J.; Kerlikowske, Karla; Remington, Patrick L; Newcomb, Polly A.; Trentham-Dietz, Amy
Concerns about breast cancer overdiagnosis have increased the need to understand how cancers detected through screening mammography differ from those first detected by a woman or her clinician. We investigated risk factor associations for invasive breast cancer by method of detection within a series of case-control studies (1992–2007) carried out in Wisconsin, Massachusetts, and New Hampshire (n = 15,648 invasive breast cancer patients and 17,602 controls aged 40–79 years). Approximately half...
Stein, Cynthia J; Kinney, Susan A; McCrystal, Tara; Carew, Elizabeth A; Bottino, Nicole M; Meehan Iii, William P; Micheli, Lyle J
Sport-related concussion is a topic of increasing public and media attention; the medical literature on this topic is growing rapidly. However, to our knowledge no published papers have described concussion specifically in the dancer. This case series involved a retrospective chart review at a large teaching hospital over a 5.5-year period. Eleven dancers (10 female, 1 male) were identified who experienced concussions while in dance class, rehearsal, or performance: 2 in classical ballet, 2 in modern dance, 2 in acro dance, 1 in hip hop, 1 in musical theater, and 3 were unspecified. Dancers were between 12 and 20 years old at the time of presentation. Three concussions occurred during stunting, diving, or flipping. Three resulted from unintentional drops while partnering. Two followed slips and falls. Two were due to direct blows to the head, and one dancer developed symptoms after repeatedly whipping her head and neck in a choreographed movement. Time to presentation in the sports medicine clinic ranged from the day of injury to 3 months. Duration of symptoms ranged from less than 3 weeks to greater than 2 years at last documented follow-up appointment. It is concluded that dancers do suffer dance-related concussions that can result in severe symptoms, limitations in dance participation, and difficulty with activities of daily living. Future studies are needed to evaluate dancers' recognition of concussion symptoms and care-seeking behaviors. Additional work is also necessary to tailor existing guidelines for gradual, progressive, safe return to dance. PMID:24844421
Xu, Guangyu; Bemis, Karen; Jackson, Darrell; Light, Russ
One intriguing feature of a mid-ocean ridge hydrothermal system is the intimate interconnections among hydrothermal, geological, oceanic, and biological processes. The advent of the NEPTUNE observatory operated by Ocean Networks Canada at the Endeavour Segment, Juan de Fuca Ridge enables scientists to study these interconnections through multidisciplinary, continuous, real-time observations. In this study, we present the time-series observations of a seafloor hydrothermal vent made using the Cabled Observatory Vent Imaging Sonar (COVIS). COVIS is currently connected to the NEPTUNE observatory to monitor the hydrothermal discharge from the Grotto mound on the Endeavour Segment. Since its deployment in 2010, COVIS has recorded a 3-year long dataset of the shape and outflow fluxes of the buoyant plumes above Grotto along with the areal coverage of its diffuse flow discharge. The interpretation of these data in light of contemporaneous observations of ocean currents, venting temperature, and seismicity made using other NEPTUNE observatory instruments reveals significant impacts of ocean currents and geological events on hydrothermal venting. In this study, we summarize these findings in the hope of forming a more complete understanding of the intricate interconnections among oceanic, geological, and hydrothermal processes.
Kurt A Wargo
Full Text Available Context There is only one previously published case report of acute pancreatitis secondary to the use of tetrahydrocannabinoid. While drugs, in general, account for 2% of all the causes of acute pancreatitis, we add to the literature three additional cases of cannabis-induced pancreatitis. Cases The first case occurred in a 22-year-old man who admitted to smoking tetrahydrocannabinoid heavily over the days prior to admission. The second case involved a 23-year-old man with multiple admissions for tetrahydrocannabinoid-induced pancreatitis. The third case involved a 20-year-old female who admitted to smoking tetrahydrocannabinoid heavily over a period of two weeks prior to admission. In all cases, other causes of pancreatitis were ruled out. Furthermore, the symptoms associated with the acute pancreatitis subsided upon discontinuation of the drug. Conclusion Cannabis is the world’s most popular illicit drug with over 4% of the world’s population using it each year. Despite this, acute pancreatitis is a rarely reported adverse effect of cannabis use. This case series adds to the literature that cannabis does in fact cause pancreatitis and it may be dose related, although the exact mechanism remains unknown.
Full Text Available This paper deals with an examination of the selected time series and an examination of price transmission in the selected agri-food chain. The analysis is connected with the working question of whether the selection of time series influences the results of price transmission. The analysis is focused on the pork agri-food chain in the Czech Republic; the time series of farm-gate price, wholesale price and consumer price is examined. First of all, the main properties of the selected time series are examined; subsequently, price transmissions based on time series of different frequency and in different periods are analyzed. The price transmission analysis is based on multivariate time series analysis; to be precise, the Vector error correction model and co-integration analysis are employed. The analysis shows that the choice of time series of different frequency should not significantly influence the results of price transmission, whereas the choice of time period might be crucial.The results presented in this paper are outputs of the research project “P402/11/P591 Modelling of price transmission and its asymmetry in agri-food chain – theoretical-empirical implications” supported by Czech Science Foundation.
van Manen, S. M.; Dehn, J.; Blake, S.
not change ahead of the large explosions that disrupt its usual strombolian and lava flow activity. This study highlights the use of long-term time series to characterise and understand volcanic activity and thermal precursors. It also shows that care must be taken when comparing analogous volcanoes, such as those that have experienced a lateral blast (e.g. Shiveluch, Bezymianny and Mt. St. Helens).
Bruni, S.; Zerbini, Susanna; Raicich, F.; Errico, M.; Santi, E.
Global navigation satellite systems (GNSS) data are a fundamental source of information for achieving a better understanding of geophysical and climate-related phenomena. However, discontinuities in the coordinate time series might be a severe limiting factor for the reliable estimate of long-term trends. A methodological approach has been adapted from Rodionov (Geophys Res Lett 31:L09204, 2004; Geophys Res Lett 31:L12707, 2006) and from Rodionov and Overland (J Marine Sci 62:328-332, 2005) to identify both the epoch of occurrence and the magnitude of jumps corrupting GNSS data sets without any a priori information on these quantities. The procedure is based on the Sequential t test Analysis of Regime Shifts (STARS) (Rodionov in Geophys Res Lett 31:L09204, 2004). The method has been tested against a synthetic data set characterized by typical features exhibited by real GNSS time series, such as linear trend, seasonal cycle, jumps, missing epochs and a combination of white and flicker noise. The results show that the offsets identified by the algorithm are split into 48 % of true-positive, 28 % of false-positive and 24 % of false-negative events. The procedure has then been applied to GPS coordinate time series of stations located in the southeastern Po Plain, in Italy. The series span more than 15 years and are affected by offsets of different nature. The methodology proves to be effective, as confirmed by the comparison between the corrected GPS time series and those obtained by other observation techniques.
Full Text Available We describe a case series of seven patients presenting to an emergency department with symptoms of paralytic shellfish poisoning. They developed varying degrees of nausea, vomiting, diarrhea, weakness, ataxia and paresthesias after eating mussels harvested from a beach near their resort. Four patients were admitted to the hospital, one due to increasing respiratory failure requiring endotracheal intubation and the remainder for respiratory monitoring. All patients made a full recovery, most within 24 hours. The ability to recognize and identify paralytic shellfish poisoning and manage its complications are important to providers of emergency medicine. [West J Emerg Med. 2014;15(4:378-381.
Yusop, Farrah Dina
This paper presents a curriculum and design analyses of an Emmy-award winning children educational television series, Cyberchase. Using Posner's (2004) four process of curriculum analysis framework, this paper addresses each of the components and relates it to the design principles undertaken by the Cyberchase production team. Media and document…
Notti, Davide; Calò, Fabiana; Cigna, Francesca; Manunta, Michele; Herrera, Gerardo; Berti, Matteo; Meisina, Claudia; Tapete, Deodato; Zucca, Francesco
Recent advances in multi-temporal Differential Synthetic Aperture Radar (SAR) Interferometry (DInSAR) have greatly improved our capability to monitor geological processes. Ground motion studies using DInSAR require both the availability of good quality input data and rigorous approaches to exploit the retrieved Time Series (TS) at their full potential. In this work we present a methodology for DInSAR TS analysis, with particular focus on landslides and subsidence phenomena. The proposed methodology consists of three main steps: (1) pre-processing, i.e., assessment of a SAR Dataset Quality Index (SDQI) (2) post-processing, i.e., application of empirical/stochastic methods to improve the TS quality, and (3) trend analysis, i.e., comparative implementation of methodologies for automatic TS analysis. Tests were carried out on TS datasets retrieved from processing of SAR imagery acquired by different radar sensors (i.e., ERS-1/2 SAR, RADARSAT-1, ENVISAT ASAR, ALOS PALSAR, TerraSAR-X, COSMO-SkyMed) using advanced DInSAR techniques (i.e., SqueeSAR™, PSInSAR™, SPN and SBAS). The obtained values of SDQI are discussed against the technical parameters of each data stack (e.g., radar band, number of SAR scenes, temporal coverage, revisiting time), the retrieved coverage of the DInSAR results, and the constraints related to the characterization of the investigated geological processes. Empirical and stochastic approaches were used to demonstrate how the quality of the TS can be improved after the SAR processing, and examples are discussed to mitigate phase unwrapping errors, and remove regional trends, noise and anomalies. Performance assessment of recently developed methods of trend analysis (i.e., PS-Time, Deviation Index and velocity TS) was conducted on two selected study areas in Northern Italy affected by land subsidence and landslides. Results show that the automatic detection of motion trends enhances the interpretation of DInSAR data, since it provides an objective
Full Text Available INTRODUCTION: The term "Spondylolisthesis" refers to a condition where one of the vertebrae (usually L5 becomes misaligned anteriorly (slips forward in relation to the vertebra below. This forward slippage is caused by a problem or defect within the pars interarticularis. Occasionally, facet joint and/or posterior neural arch defects may also cause this syndrome as well. We encountered 3 cases of two levels spondylolisthesis, a case series rarely documented. CASE REPORTS: Patient, Kanthaiah 5yrs male, presented with low backache radiating to left lower limb associated with tingling and numbness sensations. X-rays showed spondylolisthesis L4-L5-S1. MRI showed left sided nerve root compression and myelogram showed cut off at L4-L5, L5-S1. Patient had left sided deficits and so the patient was operated and post operatively improved clinically and was followed up regularly. Another patient Muniyamma, 68 yrs female, presented to our hospital 10 yrs back with two levels spondylolisthesis. In a outside hospital, posterior spinal decompression and interbody fusion was done without stabilization at only one level (L4-L5. On subsequent follow up the other level (L5-S1 worsened. Right now patient is not willing for any surgical intervention so we are managing with conservative treatment. Our third patient, Geetha 42yrs female, presented to our hospital with two levels spondylolisthesis, grade 2 at L3-L4 and L4-L5 levels. Patient was operated and has improved clinically. CONCLUSION: Incidence of spondylolisthesis is 3% to 6%. Multilevel spondylolisthesis is rarely documented in literature. This case series is being reported because of the rare documentation
Dyah R. Panuju
Full Text Available In addition to forest encroachment, forest fire is a serious problem in Indonesia. Attempts at managing its widespread and frequent occurrence has led to intensive use of remote sensing data. Coarse resolution images have been employed to derive hot spots as an indicator of forest fire. However, most efforts to verify the hot spot data and to verify fire accidents have been restricted to the use of medium or high resolution data. At present, it is difficult to verify solely upon those data due to severe cloud cover and low revisit time. In this paper, we present a method to validate forest fire using NDVI time series data. With the freely available NDVI data from SPOT VEGETATION, we successfully detected changes in time series data which were associated with fire accidents.
Chen, C; Zhang, X
Endoplasmic reticulum aminopeptidase 1 (ERAP1) has been confirmed to be associated with ankylosing spondylitis (AS) in Caucasian. However, whether they are associated with AS in East Asian population remains unidentified. We investigated this relationship by a new Chinese case-control study and a meta-analysis of published series. 368 cases and 460 controls were recruited in the Chinese case-control study. Genotyping was completed using the chip-based matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Allelic associations were analysed using contingency tables. In the meta-analysis, up to 2748 cases and 2774 controls from seven different studies and the new Chinese study were combined using Review Manager software version 5.1.1. Mantel-Haenszel or Inverse Variance test was used to calculate fixed or random-effects pooled ORs. In the new Chinese study, strong association with AS was observed for marker rs10050860, rs27434 and rs1065407 at P value of ERAP1 variants are associated with AS in East Asian population, indicating a common pathogenic mechanism for AS in East Asians and Caucasians. PMID:25817437
Nole, Gabriele; Lasaponara, Rosa
Up to nowadays, satellite data have become increasingly available, thus offering a low cost or even free of charge unique tool, with a great potential for operational monitoring of vegetation cover, quantitative assessment of urban expansion and urban sprawl, as well as for monitoring of land use changes and soil consumption. This growing observational capacity has also highlighted the need for research efforts aimed at exploring the potential offered by data processing methods and algorithms, in order to exploit as much as possible this invaluable space-based data source. The work herein presented concerns an application study on the monitoring of vegetation cover and urban sprawl conducted with the use of satellite Landsat TM data. The selected test site is the Iguazu park highly significant, being it one of the most threatened global conservation priorities (http://whc.unesco.org/en/list/303/). In order to produce synthetic maps of the investigated areas to monitor the status of vegetation and ongoing subtle changes, satellite Landsat TM data images were classified using two automatic classifiers, Maximum Likelihood (MLC) and Support Vector Machines (SVMs) applied by changing setting parameters, with the aim to compare their respective performances in terms of robustness, speed and accuracy. All process steps have been developed integrating Geographical Information System and Remote Sensing, and adopting free and open source software. Results pointed out that the SVM classifier with RBF kernel was generally the best choice (with accuracy higher than 90%) among all the configurations compared, and the use of multiple bands globally improves classification. One of the critical elements found in the case of monitoring of urban area expansion is given by the presence of urban garden mixed with urban fabric. The use of different configurations for the SVMs, i.e. different kernels and values of the setting parameters, allowed us to calibrate the classifier also to
Ye Jing; Han Jun; Shi Qi; Zhang Bao-Yun; Wang Gui-Rong; Tian Chan; Gao Chen; Chen Jian-Min; Li Cun-Jiang; Liu Zheng; Li Xian-Zhang; Zhang Lai-Zhong; Dong Xiao-Ping
Abstract Introduction Transmissible spongiform encephalopathies are a group of neurodegenerative diseases of humans and animals. Genetic Creutzfeldt-Jakob diseases, in which mutations in the PRNP gene predispose to disease by causing the expression of abnormal PrP protein, include familial Creutzfeldt-Jakob disease, Gerstmann-Straussler-Scheinker syndrome and fatal familial insomnia. Case presentation A 47-year-old Han-Chinese woman was hospitalized with a 2-year history of progressive dement...
Full Text Available Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced lymphedema. Saireito (SRT is a traditional Japanese herbal medicine that has been used for treating edema and inflammation in conditions such as nephritic disease. This study investigated the effect of SRT on lymphedema caused by radiotherapy. Four patients were treated with SRT at a dose of 9 g/day. The severity of lymphedema was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale before and after SRT treatment. After the treatment with SRT, 2 of 4 patients (50% showed apparent improvement in lymphedema. One of the cases had difficulty in wearing the custom-made thermoplastic cast, but after SRT administration, he could wear the mask easily. One case decided to stop taking SRT 3 days after initiation because cough and fever appeared. In conclusion, it is important to control the side effects of radiotherapy, which leads to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.
Full Text Available Abstract Introduction Transmissible spongiform encephalopathies are a group of neurodegenerative diseases of humans and animals. Genetic Creutzfeldt-Jakob diseases, in which mutations in the PRNP gene predispose to disease by causing the expression of abnormal PrP protein, include familial Creutzfeldt-Jakob disease, Gerstmann-Straussler-Scheinker syndrome and fatal familial insomnia. Case presentation A 47-year-old Han-Chinese woman was hospitalized with a 2-year history of progressive dementia, tiredness, lethargy and mild difficulty in falling asleep. On neurological examination, there was severe apathy, spontaneous myoclonus of the lower limbs, generalized hyperreflexia and bilateral Babinski signs. A missense mutation (T to G was identified at the position of nt 341 in one PRNP allele, leading to a change from glycine (Gly to valine (Val at codon 114. PK-resistant PrPSc was detected in brain tissues by Western blotting and immunohistochemical assays. Information on pedigree was collected notably by interviews with family members. A further four suspected patients in five consecutive generations of the family have been identified. One of them was hospitalized for progressive memory impairment at the age of 32. On examination, he had impairment of memory, calculation and comprehension, mild ataxia of the limbs, tremor and a left Babinski sign. He is still alive. Conclusion This family with G114V inherited prion disease is the first to be described in China and represents the second family worldwide in which this mutation has been identified. Three other suspected cases have been retrospectively identified in this family, and a further case with suggestive clinical manifestations has been shown by gene sequencing to have the causal mutation.
Full Text Available Fireworks are used to celebrate a variety of religious, patriotic, and cultural holidays and events around the world. Fireworks are common in the United States, with the most popular holiday for their use being national Independence Day, also known as July Fourth. The use of fireworks within the context of celebrations and holidays presents the ideal environment for accidents that lead to severe and dangerous injuries. Injuries to the face from explosions present a challenging problem in terms of restoring ideal ocular, oral, and facial function. Despite the well documented prevalence of firework use and injury, there is a relatively large deficit in the literature in terms of firework injury that involves the face. We present a unique case series that includes 4 adult male patients all with severe firework injuries to the face that presented at an urban level 1 trauma center. These four patients had an average age of 26.7 years old and presented within 5 hours of each other starting on July Fourth. Two patients died from their injuries and two patients underwent reconstructive surgical management, one of which had two follow up surgeries. We explore in detail their presentation, management, and subsequent outcomes as an attempt to add to the very limited data in the field of facial firework blast injury. In addition, the coincidence of their presentation within the same 5 hours brings into question the availability of the fireworks involved, and the possibility of similar injuries related to this type of firework in the future.
Conclusions: All surgical PG eyes in this study had satisfactory IOP control 8 years after the surgery with well-preserved visual function. The long-term efficacy and safety of trabeculectomy are promising in PG patients.
Heyen, H. [GKSS-Forschungszentrum Geesthacht GmbH (Germany). Inst. fuer Gewaesserphysik
A multivariate statistical approach is presented that allows a systematic search for relationships between the interannual variability in climate records and ecological time series. Statistical models are built between climatological predictor fields and the variables of interest. Relationships are sought on different temporal scales and for different seasons and time lags. The possibilities and limitations of this approach are discussed in four case studies dealing with salinity in the German Bight, abundance of zooplankton at Helgoland Roads, macrofauna communities off Norderney and the arrival of migratory birds on Helgoland. (orig.) [Deutsch] Ein statistisches, multivariates Modell wird vorgestellt, das eine systematische Suche nach potentiellen Zusammenhaengen zwischen Variabilitaet in Klima- und oekologischen Zeitserien erlaubt. Anhand von vier Anwendungsbeispielen wird der Klimaeinfluss auf den Salzgehalt in der Deutschen Bucht, Zooplankton vor Helgoland, Makrofauna vor Norderney, und die Ankunft von Zugvoegeln auf Helgoland untersucht. (orig.)
Village agroforestry systems in Sri Lanka have evolved through farmers' efforts to meet their survival needs. The paper examines farmers' land-use systems and their perceptions of the role of trees in the villages of Bambarabedda and Madugalla in central Sri Lanka. The benefits of village agroforestry are diverse food, fuelwood, fodder, timber, and mulch, but food products are of outstanding importance. The ability of Artocarpus heterophyllus (the jackfruit tree) and Cocos nucifera (coconut) to ensure food security during the dry season and provide traditional foods throughout the year, as well as to grow in limited space, make them popular crops in the two study villages. The study recommends that further research precede the formulation of agricultural interventions and that efforts to promote improved tree varieties recognize farmers' practices and expressed needs.
Broos, Siacia; Malisoux, Laurent; Theisen, Daniel; Francaux, Marc; Deldicque, Louise; Thomis, Martine
A common nonsense polymorphism in the ACTN3 gene results in the absence of α-actinin-3 in XX individuals. The wild type allele has been associated with power athlete status and an increased force output in numeral studies, though the mechanisms by which these effects occur are unclear. Recent findings in the Actn3(-/-) (KO) mouse suggest a shift towards 'slow' metabolic and contractile characteristics of fast muscle fibers lacking α-actinin-3. Skinned single fibers from the quadriceps muscle ...
Deilami, Mostafa; Jahandideh, Asghar; Kazemnejad, Yousef; Fakour, Yousef; Alipoor, Shiva; Rabiee, Fatemeh; Pournesaie, Ghazal Saadat; Heidari, Rosemarie Noot; Mosavi, Seyed Aliasghar
Introduction: This study aimed to evaluate the effectiveness of neurofeedback on attention deficit hyperactivity disorder. Methods: This is a quasi-experimental study without a control group. The study population included all children aged 5 to 12 years old affected with attention deficit hyperactivity disorders in Tehran, Iran who were referred to psychiatric clinics and given the diagnosis. The sample included 12 children with attention deficit hyperactivity disorder who were selected based on their availability (non-random sampling). They received 30 sessions of neurofeedback treatment, 2 times per week. Before and after neurofeedback training, the children were evaluated and compared with the use of cognitive assessment system test. Data were analyzed using dependent T-test. Results: The total mean score for pretest was 88.81 while the total mean score for the post test was 82.23. The mean in pretest for attention hyperactivity disorder was higher than the mean in the post test. Moreover, The difference of pretest and post test scores of children affected with learning disorder associated with ADHD was calculated that showed significant (P=0.003). Conclusion: Neurofeedback is effective in the improvement of attention deficit hyperactivity disorder. PMID:27303612
Welsh Brian J; Redmond Anthony C; Chockalingam Nachiappan; Keenan Anne-Maree
Abstract Background First metatarsophalangeal (MTP) joint pain is a common foot complaint which is often considered to be a consequence of altered mechanics. Foot orthoses are often prescribed to reduce 1st MTP joint pain with the aim of altering dorsiflexion at propulsion. This study explores changes in 1st MTP joint pain and kinematics following the use of foot orthoses. Methods The effect of modified, pre-fabricated foot orthoses (X-line®) were evaluated in thirty-two patients with 1st MTP...
Proven options available to Sri Lanka for large scale electricity generation in the future are coal-fired thermal, oil-fired thermal and Nuclear. Four case studies for groups participated are indicated. Case study for group 1 is comparison of the three options by taking into consideration the capital and recurrent expenditure involved. Environmental effects of the three options are also given. Case study for group 2 is economic comparison of three renewable energy based power generation system. Case study for group 3 is based on energy conservation, efficiency, improvement and demand management. Assuming that a continuous saving of 20 MW of demand from 1996 onwards is effective two projects are suggested to achieve this result. Case study for group 4 is a feasibility study for hydro power development of the Kukule Ganga (river) in Sri Lanka. Participants are required to evaluate one of the three optional development concepts which are technically feasible
Full Text Available The wafer-level packaging process is an important technology used in semiconductor manufacturing, and how to effectively control this manufacturing system is thus an important issue for packaging firms. One way to aid in this process is to use a forecasting tool. However, the number of observations collected in the early stages of this process is usually too few to use with traditional forecasting techniques, and thus inaccurate results are obtained. One potential solution to this problem is the use of grey system theory, with its feature of small dataset modeling. This study thus uses the AGM(1,1 grey model to solve the problem of forecasting in the pilot run stage of the packaging process. The experimental results show that the grey approach is an appropriate and effective forecasting tool for use with small datasets and that it can be applied to improve the wafer-level packaging process.
Welsh Brian J
Full Text Available Abstract Background First metatarsophalangeal (MTP joint pain is a common foot complaint which is often considered to be a consequence of altered mechanics. Foot orthoses are often prescribed to reduce 1st MTP joint pain with the aim of altering dorsiflexion at propulsion. This study explores changes in 1st MTP joint pain and kinematics following the use of foot orthoses. Methods The effect of modified, pre-fabricated foot orthoses (X-line® were evaluated in thirty-two patients with 1st MTP joint pain of mechanical origin. The primary outcome was pain measured at baseline and 24 weeks using the pain subscale of the foot function index (FFI. In a small sub-group of patients (n = 9, the relationship between pain and kinematic variables was explored with and without their orthoses, using an electromagnetic motion tracking (EMT system. Results A significant reduction in pain was observed between baseline (median = 48 mm and the 24 week endpoint (median = 14.50 mm, z = -4.88, p st MTP joint motion, and no significant differences were found between the 1st MTP joint maximum dorsiflexion or ankle/subtalar complex maximum eversion, with and without the orthoses. Conclusions This observational study demonstrated a significant decrease in 1st MTP joint pain associated with the use of foot orthoses. Change in pain was not shown to be associated with 1st MTP joint dorsiflexion nor with altered ankle/subtalar complex eversion. Further research into the effect of foot orthoses on foot function is indicated.
Nishimura, Katsuji; Omori, Masako; Sato, Eri; Katsumata, Yasuhiro; Gono, Takahisa; Kawaguchi, Yasushi; Harigai, Masayoshi; Yamanaka, Hisashi; Ishigooka, Jun
The objective of this study was to clarify the incidence, clinical characteristics, and courses of new-onset psychiatric manifestations after corticosteroid therapy in patients with systemic lupus erythematosus (SLE), including possible ways of differentiating between corticosteroid-induced psychiatric disorders (CIPDs) and central nervous system manifestations of SLE (CNS-SLE). We prospectively followed for 8 weeks 139 consecutive episodes in 135 in-patients who had a non-CNS-SLE flare treated with corticosteroids. Psychiatric events were evaluated once a week using DSM-IV criteria. We then conducted a post hoc etiological analysis of any newly developed psychiatric events during this follow-up period. In the 8 weeks of corticosteroid administration, new psychiatric events occurred in 20 (14.4 %) of the 139 episodes. The mean dosage of corticosteroids administered was prednisolone at 0.98 (range 0.24-1.39) mg/kg/day. Of the 20 psychiatric events, 14 (10.1 %) were suitable for the strict definition of CIPDs, accompanied by mood disorders in 13 (depressive in 2, manic in 9, and mixed in 2) and psychotic disorder in one. Two (1.4 %), both presenting delirium, were diagnosed as CNS-SLE on the basis of evidence of abnormal CNS findings even before psychiatric manifestations, all of which improved in parallel with these patients' recoveries through augmentation of immunosuppressive therapy. The other four events (2.9 %) could not be etiologically identified. This study suggests that corticosteroid therapy triggers CIPDs and CNS-SLE in patients with SLE. Delirium may be suggestive of CNS-SLE, while mood disorders may be more suggestive of CIPDs. Electroencephalographic abnormalities may possibly be predictive of CNS-SLE. PMID:25142268
Full Text Available A common nonsense polymorphism in the ACTN3 gene results in the absence of α-actinin-3 in XX individuals. The wild type allele has been associated with power athlete status and an increased force output in numeral studies, though the mechanisms by which these effects occur are unclear. Recent findings in the Actn3(-/- (KO mouse suggest a shift towards 'slow' metabolic and contractile characteristics of fast muscle fibers lacking α-actinin-3. Skinned single fibers from the quadriceps muscle of three men with spinal cord injury (SCI were tested regarding peak force, unloaded shortening velocity, force-velocity relationship, passive tension and calcium sensitivity. The SCI condition induces an 'equal environment condition' what makes these subjects ideal to study the role of α-actinin-3 on fiber type expression and single muscle fiber contractile properties. Genotyping for ACTN3 revealed that the three subjects were XX, RX and RR carriers, respectively. The XX carrier's biopsy was the only one that presented type I fibers with a complete lack of type II(x fibers. Properties of hybrid type II(a/II(x fibers were compared between the three subjects. Absence of α-actinin-3 resulted in less stiff type II(a/II(x fibers. The heterozygote (RX exhibited the highest fiber diameter (0.121±0.005 mm and CSA (0.012±0.001 mm(2 and, as a consequence, the highest peak force (2.11±0.14 mN. Normalized peak force was similar in all three subjects (P = 0.75. Unloaded shortening velocity was highest in R-allele carriers (P<0.001. No difference was found in calcium sensitivity. The preservation of type I fibers and the absence of type II(x fibers in the XX individual indicate a restricted transformation of the muscle fiber composition to type II fibers in response to long-term muscle disuse. Lack of α-actinin-3 may decrease unloaded shortening velocity and increase fiber elasticity.
Tang, Wei; Liao, Mingsheng; Yuan, Peng
The dominant error source of Synthetic Aperture Radar Interferometry (InSAR) is atmospheric phase screen (APS), resulting in phase delay of the radar signal propagating through the atmosphere. The APS in the atmosphere can be decomposed into stratified and turbulent components. In this paper, we introduced a method to compensate for stratified component in a radar interferogram using ERA-Interim reanalysis products obtained from European Centre for Medium-Range Weather Forecasts (ECMWF). Our comparative results with radiosonde data demonstrated that atmospheric condition from ERA-Interim could produce reasonable patterns of vertical profiles of atmospheric states. The stratified atmosphere shows seasonal changes which are correlated with time. It cannot be properly estimated by temporal high-pass filtering which assumes that atmospheric effects are random in time in conventional persistent scatterer InSAR (PSI). Thus, the estimated deformation velocity fields are biased. Therefore, we propose the atmosphere-corrected PSI method that the stratified delay are corrected on each interferogram by using ERA-Interim. The atmospheric residuals after correction of stratified delay were interpreted as random variations in space and time which are mitigated by using spatial-temporal filtering. We applied the proposed method to ENVISAT ASAR images covering Taiyuan basin, China, to study the ground deformation associated with groundwater withdrawal. Experimental results show that the proposed method significantly mitigate the topography-correlated APS and the estimated ground displacements agree more closely with GPS measurements than the conventional PSI.
Full Text Available The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56-80 years; interval between onset of stroke and treatment: 24-37 months with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS, Modified Mann Assessment of Swallowing Ability (MMASA, Functional Oral Intake Scale (FOIS, laryngeal elevation delay time (LEDT and Repetitive Saliva-Swallowing Test (RSST on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients.
Full Text Available Lake Urmia is one of the most important ecosystems of the country which is on the verge of elimination. Many factors contribute to this crisis among them is the precipitation, paly important roll. Precipitation has many forms one of them is in the form of snow. The snow on Sahand Mountain is one of the main and important sources of the Lake Urmia’s water. Snow Depth (SD is vital parameters for estimating water balance for future year. In this regards, this study is focused on SD parameter using Special Sensor Microwave/Imager (SSM/I instruments on board the Defence Meteorological Satellite Program (DMSP F16. The usual statistical methods for retrieving SD include linear and non-linear ones. These methods used least square procedure to estimate SD model. Recently, kernel base methods widely used for modelling statistical problem. From these methods, the support vector regression (SVR is achieved the high performance for modelling the statistical problem. Examination of the obtained data shows the existence of outlier in them. For omitting these outliers, wavelet denoising method is applied. After the omission of the outliers it is needed to select the optimum bands and parameters for SVR. To overcome these issues, feature selection methods have shown a direct effect on improving the regression performance. We used genetic algorithm (GA for selecting suitable features of the SSMI bands in order to estimate SD model. The results for the training and testing data in Sahand mountain is [R²_TEST=0.9049 and RMSE= 6.9654] that show the high SVR performance.
Zahir, N.; Mahdi, H.
Lake Urmia is one of the most important ecosystems of the country which is on the verge of elimination. Many factors contribute to this crisis among them is the precipitation, paly important roll. Precipitation has many forms one of them is in the form of snow. The snow on Sahand Mountain is one of the main and important sources of the Lake Urmia's water. Snow Depth (SD) is vital parameters for estimating water balance for future year. In this regards, this study is focused on SD parameter using Special Sensor Microwave/Imager (SSM/I) instruments on board the Defence Meteorological Satellite Program (DMSP) F16. The usual statistical methods for retrieving SD include linear and non-linear ones. These methods used least square procedure to estimate SD model. Recently, kernel base methods widely used for modelling statistical problem. From these methods, the support vector regression (SVR) is achieved the high performance for modelling the statistical problem. Examination of the obtained data shows the existence of outlier in them. For omitting these outliers, wavelet denoising method is applied. After the omission of the outliers it is needed to select the optimum bands and parameters for SVR. To overcome these issues, feature selection methods have shown a direct effect on improving the regression performance. We used genetic algorithm (GA) for selecting suitable features of the SSMI bands in order to estimate SD model. The results for the training and testing data in Sahand mountain is [R²_TEST=0.9049 and RMSE= 6.9654] that show the high SVR performance.
Minguez-Zuazo, Ana; Grande-Alonso, Mónica; Saiz, Beatriz Moral; La Touche, Roy; Lara, Sergio Lerma
The purpose of this study was to evaluate the effectiveness of a treatment for patients with cervicogenic dizziness that consisted of therapeutic education and exercises. The Dizziness Handicap Inventory and Neck Disability Index were used. Secondary outcomes included range of motion, postural control, and psychological variables. Seven patients (two males and five females) aged 38.43±14.10 with cervicogenic dizziness were included. All the participants received eight treatment sessions. The treatment was performed twice a week during a four weeks period. Outcome measures included a questionnaire (demographic data, body chart, and questions about pain) and self-reported disability, pain, and psychological variables. Subjects were examined for cervical range of motion and postural control. All of these variables were assessed pre- and postintervention. Participants received eight sessions of therapeutic education patient and therapeutic exercise. The majority of participants showed an improvement in catastrophism (mean change, 11.57±7.13; 95% confidence interval [CI], 4.96-18.17; d=1.60), neck disability (mean change, 5.14±2.27.28; 95% CI, 3.04-7.24; d=1.32), and dizziness disability (mean change, 9.71±6.96; 95% CI, 3.26-16.15; d=1.01). Patients also showed improved range of motion in the right and left side. Therapeutic patient education in combination with therapeutic exercise was an effective treatment. Future research should investigate the efficacy of therapeutic patient education and exercise with larger sample sizes of patients with cervicogenic dizziness. PMID:27419118
Asgary, Saeed; Alim Marvasti, Laleh; Kolahdouzan, Alireza
This case series aims to comprehensively introduce intentional replantation with a focus on its indications and case selection in endodontics. In all represented cases, calcium enriched mixture (CEM) cement is used for root-end filling. This case series demonstrates twenty cases of IR and extraoral root-end resection and filling with CEM cement. All the selected teeth had a failed endodontic treatment and required surgical/nonsurgical endodontic (re)treatment or extraction. Subsequent to gent...
van der Linden, Vanessa; Brainer-Lima, Alessandra Mertens; Coeli, Regina Ramos; Rocha, Maria Angela; Sobral da Silva, Paula; Durce Costa Gomes de Carvalho, Maria; van der Linden, Ana; Cesario de Holanda, Arthur; Valenca, Marcelo Moraes
Objective To report radiological findings observed in computed tomography (CT) and magnetic resonance imaging (MRI) scans of the first cases of congenital infection and microcephaly presumably associated with the Zika virus in the current Brazilian epidemic. Design Retrospective study with a case series. Setting Association for Assistance of Disabled Children (AACD), Pernambuco state, Brazil. Participants 23 children with a diagnosis of congenital infection presumably associated with the Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Types of abnormalities and the radiological pattern of lesions identified on CT and MRI brain scans. Results Six of the 23 children tested positive for IgM antibodies to Zika virus in cerebrospinal fluid. The other 17 children met the protocol criteria for congenital infection presumably associated with the Zika virus, even without being tested for IgM antibodies to the virus—the test was not yet available on a routine basis. Of the 23 children, 15 underwent CT, seven underwent both CT and MRI, and one underwent MRI. Of the 22 children who underwent CT, all had calcifications in the junction between cortical and subcortical white matter, 21 (95%) had malformations of cortical development, 20 (91%) had a decreased brain volume, 19 (86%) had ventriculomegaly, and 11 (50%) had hypoplasia of the cerebellum or brainstem. Of the eight children who underwent MRI, all had calcifications in the junction between cortical and subcortical white matter, malformations of cortical development occurring predominantly in the frontal lobes, and ventriculomegaly. Seven of the eight (88%) children had enlarged cisterna magna, seven (88%) delayed myelination, and six each (75%) a moderate to severe decrease in brain volume, simplified gyral pattern, and abnormalities of the corpus callosum (38% hypogenesis and 38% hypoplasia). Malformations were symmetrical in 75% of the cases. Conclusion Severe cerebral damage was
Full Text Available Currently, accurate information on crop area coverage is vital for food security and industry, and there is strong demand for timely crop mapping. In this study, we used MODIS time series data to investigate the effect of the time series length on crop mapping. Eight time series with different lengths (ranging from one month to eight months were tested. For each time series, we first used the Random Forest (RF algorithm to calculate the importance score for all features (including multi-spectral data, Normalized Difference Vegetation Index (NDVI, Normalized Difference Water Index (NDWI, and phenological metrics. Subsequently, an extension of the Jeffries–Matusita (JM distance was used to measure class separability for each time series. Finally, the RF algorithm was used to classify crop types, and the classification accuracy and certainty were used to analyze the influence of the time series length and the number of features on classification performance; the features were added one by one based on their importance scores. Results indicated that when the time series was longer than five months, the top ten features remained stable. These features were mainly in July and August. In addition, the NDVI features contributed the majority of the most significant features for crop mapping. The NDWI and data from multi-spectral bands also contributed to improving crop mapping. On the other hand, separability, classification accuracy, and certainty increased with the number of features used and the time series length, although these values quickly reached saturation. Five months was the optimal time series length, as longer time series provided no further improvement in the classification performance. This result shows that relatively short time series have the potential to identify crops accurately, which allows for early crop mapping over large areas.
Anish M Shah
Full Text Available Context Acute pancreatitis is diagnosed on the basis of clinical features, biochemical tests and imaging studies. Normal serum amylase level has been reported in the setting of acute pancreatitis but normal serum lipase level in acute pancreatitis is extremely rare. Case report Herein, we present a case series of acute pancreatitis with normal serum lipase levels along with a review of the topic. Conclusion In appropriate clinical setting, the diagnosis of acute pancreatitis should be entertained even with normal serum amylase and lipase levels.
Aparna R Pai
Full Text Available Background: Global aphasia without hemiparesis (GAWH is a rare stroke syndrome characterized by the unusual dissociation of motor and language functions. Issues regarding its etio-pathogenesis, lesion sites, and recovery patterns are extensively being debated in contemporary neuroscience literature. Materials and Methods: Four patients admitted in our hospital between 2005 and 2009 with GAWH caused by ischemic stroke were studied retrospectively with emphasis on number and site of lesions, etiology, and recovery patterns. Results: The clinical findings from our subjects showed that GAWH could result from either single/multiple lesions including subcortical lesions. The recovery was rapid, although not complete. One case evolved into Wernicke′s aphasia as seen in earlier studies. Two subjects revealed evolution to transcortical sensory aphasia and one to Broca′s aphasia which is distinct from previous proposals. Two cases showed lack of clinico-anatomic correlation during recovery. Conclusions: GAWH could result from both embolic and large vessel strokes and single or multiple lesions. The recovery pattern may be variable and may show lack of clinico-anatomical correlation indicating anomalous cerebral functional reorganization, questioning the conventional teaching of language representation in the brain.
Full Text Available Time series remote sensing products with both fine spatial and dense temporal resolutions are urgently needed for many earth system studies. The development of small satellite constellations with identical sensors affords novel opportunities to provide such kind of earth observations. In this paper, a new dense time series 30-m image product was proposed respectively based on an 8-day, 16-day and monthly composition. The products were composited by the Charge Coupled Device (CCD images from the 2-day revisit small satellite constellation for environmental monitoring and disaster mitigation of China (HJ-1A/B. Taking the Zoige plateau in China as a case area where it is covered by highly heterogeneous vegetation landscapes, a detailed methodology was introduced on how to use 183 scenes of CCD images in 2010 to create composite products. The quality of the HJ CCD composites was evaluated by inter-comparison with the monthly 30-m global Web-Enabled Landsat Data (WELD, 16-day 500-m MODIS NDVI, and 8-day 500-m MODIS surface reflectance products. Results showed that the radiometric consistency between HJ and WELD composited Top Of Atmosphere (TOA reflectance was in good agreement except for May, June, July and August when more clouds and invalid data gaps appeared in WELD. Visual assessment and temporal profile analysis also revealed that HJ possessed better visual effects and temporal coherence than that of WELD. The comparison between HJ and MODIS products indicated that HJ composites were radiometrically consistent with MODIS products over areas consisting of large patches of homogeneous surface types, but can better reflect the detailed spatial differences in regions with heterogeneous landscapes. This paper highlights the potential of compositing HJ-1A/B CCD images, allowing for providing a cloud free, time-space consistent, 30-m spatial resolution, and dense in time series image product. Meanwhile, the proposed products could also be treated as a
Generalized gingival enlargement is characterized by massive and exuberant gingival overgrowth that poses social, aesthetic, phonetic and functional problems for the patient. Therefore, it requires meticulous management. Objective: To describe the surgical management of generalized gingival enlargement by electrosurgical excision of patients presenting to a tertiary care centre. Study Design: Case series. Materials and Methods: The study was conducted at the Department of Oral and Maxillofacial Surgery, de'Montmorency College of Dentistry, Lahore, from January 2010 to December 2012. A total of sixteen patients were operated by using electrosurgical approach under general anaesthesia for surgical excision of generalized gingival enlargement. Results: All of the sixteen patients, 11 males and 5 females, showed excellent healing postoperatively without any recurrent gingival overgrowth. Discussion: To the best of our knowledge, the current study presents the largest case series of generalized gingival enlargement. Most of these cases were with massive disease due to lack of information of the study population about their disease, delay in referral by the general dental practitioners, painless and innocent nature of the problem. Early referral of such patients to tertiary care centers can prevent the patients from social and psychological embarrassment. Conclusion: Electrosurgical excision is an excellent surgical technique for management of generalized gingival enlargement. Moreover, cross comparative studies are required to establish some diagnostic and therapeutic standards for such patients. (author)
Full Text Available Abstract Background To determine the agents of poisoning and demographic distribution of children brought to Civil Hospital Karachi (CHK with a history of accidental poison intake and to examine the factors associated with it. Methods This hospital based descriptive study of first 100 patients from both sexes who presented to Pediatric department, CHK from 1st January 2006 till 31st December 2008 with exposure to a known poisonous agent and fulfilling other inclusion criteria were included in the study. Data regarding their demographic profile and potential risk factors was collected on a well structured proforma, cases were followed until discharge or expiry. Data was analyzed using frequencies, proportions, group means, median and standard deviations. Results The male to female ratio in our study was 1.2:1, with kerosene (50% being the most common household agent followed by medicines (38%, insecticides (7% and bathroom cleaners (5%. Factors such as mother's education level, number of siblings and storage place of poison correlated significantly with the cases of accidental poisoning. Most of the children (70% presented within 3 hours of ingestion. Dyspnea was the most common symptom observed. The mortality rate in our study was 3%. Conclusions Children belonging to age group 2-3 years are the most susceptible both in terms of morbidity and mortality. Preventive strategies need to be adopted at a national level to spread awareness among parents.
Full Text Available BACKGROUND: Granulomatous lobular mastitis (GLM is an inflammatory disease of the breast, which can mimic breast cancer in clinical and radiological findings. We conducted the present study in order to determine the diagnostic and other important aspects of this disease. METHODS: In this study, we reviewed the records of 38 patients with granulomatous lobular mastitis in order to describe the clinical, imaging, laboratory, pathologic, and treatment aspects of this disease. RESULTS: All of the patients’ ages were in the range of 22-62 years (mean age: 42 years. All of them had children, history of oral contraceptive pill (OCP usage, antibiotic therapy and mammoplasty. In physical examination, dimpling, edema, inflammation, ulcer, abscess, and firm mass were detected. Size of masses was in the range of 2 × 2 to 8 × 6 cm and their location, in most cases, was in the superior lateral quadrant or central region. In Ultrasonography, a hypoechoic fibroglandular mass and collection, and in pathologic findings, granulomatous reaction was reported. These patients were treated by antibiotics, corticosteroids, and surgery. CONCLUSIONS: GLM is a chronic inflammatory lesion of the breast which can mimic breast cancer. A history of child bearing, lactation, and OCP drug usage have suspicious roles in the formation of GLM. The most common clinical sign in these patients is a painful mass in the breast. We uncovered that clinical and radiological findings are not specific and sufficient for diagnosis of GLM. Therefore, for better diagnosis of this disease, usage of core, incisional, or excisional biopsy are recommended.
Full Text Available Pulmonary artery agenesis is a rare congenital abnormality in which atresia was encountered in the short segment of the right or left pulmonary arteries. It can be isolated or associated with cardiac abnormalities such as tetralogy of Fallot, septal defects or pulmonary stenosis.The majority of cases are diagnosed in childhood whereas some cases yield no symptoms until adulthood. We evaluated retrospectively 5 pulmonary artery agenesis cases diagnosed in our clinics between 1998-2010 with respect to the literature.
We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of ...
Full Text Available Three cases of rhinocerebral mucormycosis (RCM with different courses of illness following a common standardized treatment protocol are discussed. Seen predominantly in diabetics. Clinical picture is often blurred by overlapping features of chronic rhinosinusitis. CT picture is helpful in assessing extent. Histopathological evidence is diagnostic. We describe three cases of RCM with different presentations but followed same treatment protocol. RCM is not just a disease of chronic uncontrolled diabetics. Its indolent clinical course doesn′t correlate with its aggressive pathology for which strict treatment protocol to be followed. In suspected cases of RCM, improvement of predisposing diseases, radical surgical debridement and effective systemic antifungal therapy must be instituted immediately. Absence of intracranial or orbital extension are indicators of good prognosis. Ketoacidosis is the single most important detrimental factor.
Full Text Available We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of developing pneumothorax in otherwise healthy individuals. This aspect of pneumothorax development is worthy of further exploration, to better elucidate the mechanism and enhance our understanding of this common respiratory presentation.
Dejene, Shiferaw; Ahmed, Fahim; Jack, Kastelik; Anthony, Arnorld
We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of developing pneumothorax in otherwise healthy individuals. This aspect of pneumothorax development is worthy of further exploration, to better elucidate the mechanism and enhance our understanding of this common respiratory presentation. PMID:23922614
Zoltán Bajkó; Rodica Bălaşa; Anca Moţăţăianu; Smaranda Maier; Octavia Claudia Chebuţ; Szabolcs Szatmári
Subjects and Methods. We analysed 5000 cerebrovascular ultrasound records. A total of 0.4% of the patients had common carotid artery occlusion (CCAO). Results. The mean age was 59.8 ± 14.2 years, and the male/female ratio was 2.33. The most frequent risk factors were hypertension, ischaemic heart disease, dyslipidemia, diabetes mellitus, and smoking. Right-sided and left-sided CCAO occurred in 65% and 30% of the cases, respectively, and bilateral occlusion was detected in one case (5%). Paten...
Gilabert, M. A; Martinez, B.; Melia, J.
The objective of this work is to study the spatial patterns of vegetation activity over spain and its temporal variability throughout the period 1989-2002. A multi-resolution analysis (MRA) bases on the wavelet transform has been implemented on NDVI time series from the MEDOKADS database. The MRA decomposes the original signal as a sum of series associated with temporal scales. Specifically, the intra-annual series is processed to define several key features in relation with the vegetation penology. In contras, the inter-annual components of the signal is used to detect trends by means of a Mann-Kendall test and map the magnitude of the land-cover change. Finally, a comprehensive identification of the areas presenting a negative value of the magnitude of change is carried out to select those linked to land degradation processes. Results show a major presence of these areas the Southeast of Spain. (Author) 5 refs.
The objective of this work is to study the spatial patterns of vegetation activity over spain and its temporal variability throughout the period 1989-2002. A multi-resolution analysis (MRA) bases on the wavelet transform has been implemented on NDVI time series from the MEDOKADS database. The MRA decomposes the original signal as a sum of series associated with temporal scales. Specifically, the intra-annual series is processed to define several key features in relation with the vegetation penology. In contras, the inter-annual components of the signal is used to detect trends by means of a Mann-Kendall test and map the magnitude of the land-cover change. Finally, a comprehensive identification of the areas presenting a negative value of the magnitude of change is carried out to select those linked to land degradation processes. Results show a major presence of these areas the Southeast of Spain. (Author) 5 refs.
Machiwal, Deepesh; Kumar, Sanjay; Dayal, Devi
This study aimed at characterization of rainfall dynamics in a hot arid region of Gujarat, India by employing time-series modeling techniques and sustainability approach. Five characteristics, i.e., normality, stationarity, homogeneity, presence/absence of trend, and persistence of 34-year (1980-2013) period annual rainfall time series of ten stations were identified/detected by applying multiple parametric and non-parametric statistical tests. Furthermore, the study involves novelty of proposing sustainability concept for evaluating rainfall time series and demonstrated the concept, for the first time, by identifying the most sustainable rainfall series following reliability ( R y), resilience ( R e), and vulnerability ( V y) approach. Box-whisker plots, normal probability plots, and histograms indicated that the annual rainfall of Mandvi and Dayapar stations is relatively more positively skewed and non-normal compared with that of other stations, which is due to the presence of severe outlier and extreme. Results of Shapiro-Wilk test and Lilliefors test revealed that annual rainfall series of all stations significantly deviated from normal distribution. Two parametric t tests and the non-parametric Mann-Whitney test indicated significant non-stationarity in annual rainfall of Rapar station, where the rainfall was also found to be non-homogeneous based on the results of four parametric homogeneity tests. Four trend tests indicated significantly increasing rainfall trends at Rapar and Gandhidham stations. The autocorrelation analysis suggested the presence of persistence of statistically significant nature in rainfall series of Bhachau (3-year time lag), Mundra (1- and 9-year time lag), Nakhatrana (9-year time lag), and Rapar (3- and 4-year time lag). Results of sustainability approach indicated that annual rainfall of Mundra and Naliya stations ( R y = 0.50 and 0.44; R e = 0.47 and 0.47; V y = 0.49 and 0.46, respectively) are the most sustainable and dependable
Oyen Wim JG
Full Text Available Abstract Background Few studies have described patients with foregut dysmotility in inflammatory bowel disease. The aim of this case series was to evaluate clinical characteristics of 5 patients with inflammatory bowel disease and symptoms and signs of upper gut dysmotility. Case presentations We describe a series of four patients with Crohn's disease and one with indeterminate colitis who presented with severe symptoms and signs of gastroparesis. We reviewed medical records of all cases. Gastric emptying of a solid meal was assessed by scintigraphy. Small bowel enteroclysis, gastroduodenoscopy and colonoscopy with biopsies were performed to estimate the activity of the disease and to exclude organic obstruction. None of the patients had any signs of active inflammation or stricture. All of the patients had markedly delayed gastric emptying with a mean t 1/2 of 234 minutes (range 110–380 minutes; normal values 54–94 minutes. Conclusion Clinicians should consider impaired gastric emptying when evaluating patients with Crohn's disease and severe symptoms of upper gut dysmotility, which cannot be attributed to active inflammation or organic obstruction of the digestive tract. Symptoms in these patients are refractory to various therapeutic interventions including tube feeding and gastric surgery.
ÜNGÖR, Dr. Dt. Cem; KILIÇ, Dt. İbrahim
Odontomas are considered as developmental anomalies resulting from the growth of completely differentiated epithelial and mesenchymal cells that give rise to ameloblasts and odontoblasts. The exact etiology of odontomes is still not known. Most odontomes are asymptomatic and are discovered during routine radiographic investigations. Odontomas are the most common odontogenic tumours. In this report, 5 odontoma cases ( 2 complex, 3 compaund) and their treatments was presented.
Yu Jin Jung
Full Text Available Stiff-person syndrome (SPS is a rare disorder, characterized by progressive fluctuating muscular rigidity and spasms. Glutamic acid decarboxylase (GAD antibody is primarily involved in the pathogenesis of SPS and SPS is strongly associated with other autoimmune disease. Here we report three cases of patients with classical SPS finally confirmed by high serum level of GAD antibodies. All of our patients respond favorably to gamma amino butyric acid-enhancing drugs and immunotherapies.
Ferrier, Fran; Trood, Clifford; Whittingham, Karen
This document presents case studies of 10 cooperative research centers (CRCs) across Australia and their relationships with the vocational education and training (VET) sector. The CRCs profiled in the case studies are as follows: Co-operative Research Centre for Sustainable Rice Production; Cast Alloy and Solidification Technology Co-operative…
MANJU, Jyotir; Patil, Shruti; RAU, ATK
The prognosis of Herpes simplex encephalitis (HSE) depends on the early and appropriate administration of specific antiviral therapy. We retrospectively reviewed 42 children with acute CNS infection, over a period of 18 months, of which 4 were positive for HSV antibodies. All four showed CSF pleocytosis, with mildly elevated protein and rising titers of antibodies to HSV in the CSF. All the 4 cases were started on i.v. acyclovir on day 1 and continued for a total duration of 14 days. The pati...
Gyldenløve, Mette; Nepper-Christensen, Steen; Thyssen, Jacob P; Faurschou, Annesofie
Christmas tree hypersensitivity is a rare condition, which has so far obtained scarce attention in the medical literature. We present two clinical cases of hypersensitivity associated with Christmas tree exposure, a 51-year-old woman with allergic contact dermatitis and a 41-year-old man with all...... allergic rhinitis. The female patient had a positive patch test reaction to colophony, and the male patient had a positive skin prick test reaction to alternaria mould. Both were successfully advised to avoid prolonged exposure to Christmas trees and buy artificial trees for Christmas....
Full Text Available Abstract Background The restoration of walking ability is the main goal of post-stroke lower limb rehabilitation and different studies suggest that pedaling may have a positive effect on locomotion. The aim of this study was to explore the feasibility of a biofeedback pedaling treatment and its effects on cycling and walking ability in chronic stroke patients. A case series study was designed and participants were recruited based on a gait pattern classification of a population of 153 chronic stroke patients. Methods In order to optimize participants selection, a k-means cluster analysis was performed to subgroup homogenous gait patterns in terms of gait speed and symmetry. The training consisted of a 2-week treatment of 6 sessions. A visual biofeedback helped the subjects in maintaining a symmetrical contribution of the two legs during pedaling. Participants were assessed before, after training and at follow-up visits (one week after treatment. Outcome measures were the unbalance during a pedaling test, and the temporal, spatial, and symmetry parameters during gait analysis. Results and discussion Three clusters, mainly differing in terms of gait speed, were identified and participants, representative of each cluster, were selected. An intra-subject statistical analysis (ANOVA showed that all patients significantly decreased the pedaling unbalance after treatment and maintained significant improvements with respect to baseline at follow-up. The 2-week treatment induced some modifications in the gait pattern of two patients: one, the most impaired, significantly improved mean velocity and increased gait symmetry; the other one reduced significantly the over-compensation of the healthy limb. No benefits were produced in the gait of the last subject who maintained her slow but almost symmetrical pattern. Thus, this study might suggest that the treatment can be beneficial for patients having a very asymmetrical and inefficient gait and for those
Full Text Available Some drugs have been known to damage to esophagusfor a long time. Half of the cases reported are of tetracyclineand its derivatives. The damage caused by thesedrugs is depends on the drug itself and the patient.In this paper we present 5 patients having diagnosedesophageal damage endoscopically after due to doxycyclinuse. The mean age of the patients was 26 years.Three of them for acne and 2 for heir complaints gynecologicalinfection were taking these drugs. Lesions werelocated at the middle in 4 cases and lover part in 1 patient.The common complaint was retrosternal pain and heartburnafter taking the drug with insufficient water or withoutwater. All the patients were relieved by symtomatic teratment.Esophageal damage is to be remembered in patientscomplaning sudden pain and difficult swallowing on doxycyclintreatment and endoscopic procedure should beemployed for definition of diagnosis and evaluation of theseverity of the damage. After treatment, endoscopic controlis not necessary. Physicians must not forget to advicethe patients to take these drugs with splendid amount ofwater.Key words: Doxycycline, esophagus damage, endoscopy
Karabacak, Volkan; Tonguç Uysal, İ.; Ünal-İmer, Ezgi
Dating of late Quaternary volcanism is crucial to understanding of the recent mechanism of crustal deformation and future volcanic explosivity risk of the region. However, radiometric dating of volcanic products has been a major challenge because of high methodological error rate. In most cases, there are difficulties on discrimination of the volcanic lava flow relations in the field. Furthermore, there would be unrecorded and unpreserved volcanoclastic layers by depositional and erosional processes. We present a new method that allows precise dating of late Quaternary volcanic events (in the time range of 0-500,000 years before present) using the Uranium-series technique on travertine mass, which is thought to be controlled by the young volcanism. Since the high pressure CO2 in the spring waters are mobilized during crustal strain cycles and the carbonates are precipitated in the fissures act as conduit for hot springs, thus, travertine deposits provide important information about crustal deformation. In this study we studied Ihlara fissure ridge travertines in the Central Anatolia Volcanic Province. This region is surrounded by many eruption centers (i.e. Hasandaǧı, Acıgöl and Göllüdaǧı) known as the late Quaternary and their widespread volcanoclastic products. Recent studies have suggested at least 11 events at around Acıgöl Caldera for the last 180 ka and 2 events at Hasandaǧı Stratovolcano for the last 30 ka. Active travertine masses around Ihlara deposited from hotwaters, which rise up through deep-penetrated fissures in volcanoclastic products of surrounding volcanoes. Analyses of the joint systems indicate that these vein structures are controlled by the crustal deformation due to young volcanism in the vicinity. Thus, the geological history of Ihlara travertine mass is regarded as a record of surrounding young volcanism. We dated 9 samples from 5 ridge-type travertine masses around Ihlara region. The age distribution indicates that the crustal
Cramer, Holger; Krucoff, Carol; Dobos, Gustav
While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopeni...
Full text: Rhabdomyosarcoma (RMS) is the most common soft tissue tumour in children, with the head and neck region accounting for 35-40% of cases. Nasopharyngeal RMSs tend to grow rapidly and invade adjacent structures. Both the intergroup Rhabdomyosarcoma studies and the European Studies have established that the ideal management of this disease is multimodal, using a combination of surgery, chemotherapy and radiotherapy. This case series examines the role of radiotherapy in the management of paediatric nasopharyngeal RMSs, with particular reference to long-term morbidity and disease-free survival. The cases of five children with nasopharyngeal RMS were reviewed and a systematic review of the literature contained in the PubMed databases was conducted to establish 24 individually detailed cases. Management in all patients was multimodal, using a combination of chemotherapy, radiotherapy as well as surgery. External beam radiotherapy is an integral component of treatment for nasopharyngeal RMSs. With more patients surviving for longer periods, more long-term sequelae of radiotherapy have been reported. Complications include sensorineural deafness, endocrine manifestations following radiation of the pituitary gland, cranial nerve palsies, second malignancies within the radiation field, cataract formation, retinopathy and growth disturbance. Morbidity from radiotherapy may be considerable and depends on the field and dose of radiation. Current advances in radiotherapy are aimed at improving the rate of tumour control and reducing such complications. Recent improvements in imaging and conformal techniques have the potential to reduce the morbidity associated with radiotherapy in this cohort.
Full Text Available Purpose: Aspergillosis is uncommon in HIV patients and has been mostly reported in patients with CD4<50/µL. Data on risk factors and prognosis are scarce. We reviewed 19 cases of aspergillosis diagnosed in our HIV cohort. Methods: In the Brussels Saint-Pierre HIV cohort, 19 patients were diagnosed with aspergillosis between 1998 and 2012 (0.87/1000 patient/year of follow-up. We analyzed retrospectively and described localization and invasiveness of aspergillosis, risk factors, treatment and outcome of these patients. Results: Patients were mostly African (74% and mean age was 40 years (22–60. Clinical presentation were 10 invasive aspergillosis (IA (53%, 6 pulmonary aspergilloma (31% and 3 sinus fungal ball (16%. The global mortality was 42%. IA was proven for 3 patients, probable for 4 patients and possible for 3 patients according to IDSA definitions. Risk factors for IA included CD4<200/µL (70%; 40%<50 CD4/µL, corticotherapy (50%, neutropenia (20%, intravenous drug use (20%, cirrhosis (20%. IA arose in the time course of septic shock in 30% and opportunistic infections occurred concomitantly in 40%. Seven patients out of 10 with IA died including 3 patients before antifungal therapy. The 3 survivors recovered without relapse. Four patients were treated with voriconazole, 2 with itraconazole, 2 with liposomal amphotericine, 1 with caspofungine, and 2 with bitherapy. Among patients with aspergilloma (n=6, the major associated risk factor was tuberculosis sequelae (80%. Two patients were successfully treated with surgery and voriconazole, 1 died from massive hemoptysis, 2 were lost to follow-up, 1 is currently asymptomatic without treatment. Among patients with sinus fungal ball (n=3, all recovered without relapse with surgical treatment associated with voriconazole for one. Conclusion: Incidence of aspergillosis in HIV patients remains low but in accordance to previous reports, mortality of IA is high (70%. CD4<200 is the most common risk
Ergül, Dursun Fırat; Ekemen, Serdar; Yelken, Birgül Büyükkıdan
In the language of the streets, 'bonzai', known as '1-naphthalenyl of methanol', also known as JWH-18 group, is a drug belonging to the group of synthetic cannabinoids. At the beginning of 2004, it started to be sold on the internet and it is seen that private markets. It has structurally similar chemical characteristics as delta 9-tetrahydrocannabinol (THC), the active substance in marijuana. In 2013, in a study conducted by the European Monitoring Centre of Drugs and Drug Addiction (EMCDDA), 102 varieties of synthetic cannabinoids were identified; however, more than 200 substances have been reported since 1997. In this study, we report the difficulties in the clinical course, treatment and management of six patients that had a use history of bonzai although it was not detected in blood in a short period of time in the intensive care unit. PMID:27366526
OBJECTIVES: To establish a clinicopathological profile of malignant otitis externa (MOE) in an Australian tertiary referral institution. STUDY DESIGN: Retrospective cohort outcomes study. METHODS: 24 patients were identified with MOE between January 1998 and July 2007. Patients were classified into Radiological Grades I-IV. Laboratory investigations Including C-reactive protein (CRP), white cell count (WCC), glycosylated haemoglobin (HBA1c) and average glucose level over admission were recorded. RESULTS: Radiological Grade was significantly associated with duration of therapy (rank correlation 0.57, p = 0.004). CRP was a useful indicator confirming disease resolution. Diabetics with MOE had elevated average blood sugar levels during their Hospital admission (p < 0.001) and had poor overall glycaemic control represented by Elevated HBA1c scores (p < 0.001). CONCLUSIONS: Malignant otitis externa is a rare disease, which is best managed in a multidisciplinary team setting. This practical grading system can be used to predict the duration of therapy at time of diagnosis, which enables the efficient utilisation of Hospital resources. Poorly controlled diabetics are more susceptible to developing. MOE than diabetics with satisfactory glycaemic control and may represent a subgroup of more brittle diabetics. CRP combined with appropriate clinical and radiological investigations is useful in assessing disease resolution.
Full Text Available Objective: Neonatal pneumothoraces are associated with high mortality. Prompt recognition to minimize its complications is paramount for ultimate outcome of these babies.Methods: A retrospective case series study was carried out at Aga khan University Hospital, from January 2010 to December 2010 to determine the etiology and outcome of neonates with pneumothorax in a neonatal tertiary care unit.Results: Ten neonates diagnosed radiologically with pneumothoraces were included. M: F ratio was 1:2.3. Birth weight ranged from 1750-3600 grams with a mean of 2100 grams. The occurrence of pneumothoraces was 50% on the left side, 20% on right, and 30% were bilateral. Primary etiology included pneumonia and sepsis (30%, hyaline membrane disease (20%, meconium aspiration syndrome (20% and congenital diaphragmatic hernia (10%. Spontaneous pneumothoraces were present in 20% of cases. In our study, the incidence of neonatal pneumothoraces was 2.5/1000 births compared to 10-15/1000 in Denmark, 10-20/1000 in Turkey and 6.3/1000 from Vermont Oxford Group. Despite the small number of cases, one incidental finding was the occurrence of pneumothorax, which declined in elective cesarean section after 37 weeks gestation i.e., 1.3 of 1000 births. Mortality was 60% determined mainly by the primary etiology and other co-morbid conditions.Conclusion: The study showed a higher number of mortality cases (60%. Although, it was difficult to draw a conclusion from the limited number of cases, there may be a benefit on neonatal respiratory outcome to be obtained by better selection of mothers and by waiting until 37 weeks before performing elective cesarean section. Adequate clinician training in soft ventilation strategies will reduce the occurrence of pneumothoraces.
Full Text Available Accurate monitoring of land surface dynamics using remote sensing is essential for the synoptic assessment of environmental change. We assessed a Medium Resolution Imaging Spectrometer (MERIS full resolution dataset for vegetation monitoring as an alternative to the more commonly used Moderate-Resolution Imaging Spectroradiometer (MODIS data. Time series of vegetation indices calculated from 300 m resolution MERIS and 250 m resolution MODIS datasets were analyzed to monitor vegetation productivity trends in the irrigated lowlands in Northern Uzbekistan for the period 2003–2011. Mann-Kendall trend analysis was conducted using the time series of Normalized Differenced Vegetation Index (NDVI, Soil-Adjusted Vegetation Index (SAVI, and MERIS-based Terrestrial Chlorophyll Index (MTCI to detect trends and examine the capabilities of each sensor and index. The methodology consisted of (1 preprocessing of the original imagery; (2 processing and statistical analysis of the corresponding time series datasets; and (3 comparison of the resulting trends. Results confirmed the occurrence of widespread vegetation productivity decline, ranging from 5.5% (MERIS-MTCI to 21% (MODIS-NDVI of the total irrigated cropland in the study area. All indices identified the same spatial patterns of decreasing vegetation. Average vegetation index values of NDVI and SAVI were slightly higher when measured by MERIS than by MODIS. These differences merit further investigation to allow a fusion of these datasets for consistent monitoring of cropland productivity decline at scales suitable for guiding operational land management practices.
Hassan, Rashedul; Rahman, Md. Mujibur; Moniruzzaman, Md; RAHIM, Abdur; Barua, Satyajit; Biswas, Rajib; Biswas, Pijous; Mowla, Syed Ghulam Mogni; Chowdhury, MA Jalil
Introduction Chikungunya is an arthropod-borne virus endemic to Africa, Southeast Asia and India that causes acute febrile polyarthralgia and arthritis. In this short case series, we discuss six Bangladeshi patients with chikungunya fever. Though Bangladesh is in endemic zone, it is not common here, hence it demands attention for proper diagnosis and management. Case presentation The six cases of chikungunya we report occurred in native Bangladeshi women with ages ranging from 20 to 50 years ...
Eosinophilic meningoencephalitis (EM) is a rare type of meningoencephalitis. The objective of this report is to describe a series of EM identified in a specific geographic area over a short period of time. Materials and Methods: This series of cases are described from a neurological center in Central Kerala occuring in the period between February 2004 and June 2006. Results: During this period we had identified ten patients (eight males and two females) with EM. Their mean age was 37.1 ye...
Full Text Available Objective. To summarize the characteristics and analysis of relevant factors and to give references for prevention and further study of liver damage associated with Polygonum multiflorum Thunb. (HSW, we provide a systematic review of case reports and case series about liver damage associated with HSW. Methods. An extensive search of 6 medical databases was performed up to June 2014. Case reports and case series involving liver damage associated with HSW were included. Results. This review covers a total of 450 cases in 76 articles. HSW types included raw and processed HSW decoction pieces and many Chinese patent medicines that contain HSW. Symptoms of liver damage occur mostly a month or so after taking the medicine, mainly including jaundice, fatigue, anorexia, and yellow or tawny urine. Of the 450 patients, two cases who received liver transplantation and seven who died, the remaining 441 cases recovered or had liver function improvement after discontinuing HSW products and conservative care. Conclusion. HSW causes liver toxicity and may cause liver damage in different degrees and even lead to death; most of them are much related to long-term and overdose of drugs. Liver damage associated with HSW is reversible, and, after active treatment, the majority can be cured. People should be alert to liver damage when taking HSW preparations.
Maryam Alsadat Hashemipour
Full Text Available Snus (nass is a form of snuff used in a similar manner to American dipping tobacco, but it does not typically result in a need for spitting. Possible hazards associated with this material include malignant and premalignant lesions in the oral cavity and gastrointestinal tract. The use of smokeless tobacco has increased in the Middle East in recent decades, particularly among teenagers and young adults. Therefore, practitioners must be able to recognize malignant and premalignant lesions. Although, an estimated 10-25% of the world′s population uses smokeless tobacco, this practice is virtually unknown in Iran. The aim of this study is to report a series of cases of squamous cell carcinoma and verrucous carcinoma occurring in the users of snus, who referred to the Department of Oral Medicine in Kerman Dental School.
seyyed Ahmad Tabatabaei
Full Text Available Pulmonary Alveolar Proteinosis(PAP is a rare disease of unknown etiology, characterized by the accumulation of proteinoceous material in the alveoli that is rich in lipid and is positive on periodic acid-Schiff(PAS stain. PAP is rare in children. Two forms are encountered in pediatric practice: congenital alveolar proteinosis (CAP and a later–onset form that is generally less severe. Broncho-alveolar lavage is the key to diagnosis. Therapeutic lung lavages are the only effective treatment for severe cases. Other therapeutic trials have been proposed such as: lung transplantation, adminstration of GM- CSF and gene-therapy. This case series presents six cases of PAP which were diagnosed by open lung biopsy in Mofid children hospital in Tehran capital city over a three-year period (2003–2006 and one in 1998. The aim of the present study was to provide detailed data on the characteristics of these patients and the methods of diagnosis and treatment.
A multidisciplinary study of the Roc de Marsal Cave gave us the opportunity to re-examine the known problem posed by U-series disequilibria in sediments in the field of palaeodosimetric dating. Apart from burnt flints and heated limestones, the material being dated, THAT IS our principal concern here, is made of burnt sediment samples collected from a reddish layer that forms the very base of the Roc de Marsal Mousterian sequence (Couche B). U-series disequilibria of long life nuclides in sediments were observed: as a general trend, the activity of 238U is greater than that of 226Ra. Important discrepancies in age determination can occur according to the origin of the disequilibrium and its kinetics. To characterise these ancient modifications of radioactivity and constrain the range of possible variations of annual doses, a statistical study of 238U, 226Ra and 232Th activities, measured by gamma spectrometry, was carried out. It shows that the sediment was mainly enriched in mobile uranium. This conclusion is in accordance with the results of complementary measurements of 230Th and 234U performed by alpha spectrometry. On the kinetics side, two models of time-variation of U and daughter concentrations are compared, taking experimental data into account. A detailed presentation of the methodology and the method of calculation of dose rates, and particularly time-averaged dose rates in such a situation, is given.
Full Text Available A range of single classifiers have been proposed to classify crop types using time series vegetation indices, and hybrid classifiers are used to improve discriminatory power. Traditional fusion rules use the product of multi-single classifiers, but that strategy cannot integrate the classification output of machine learning classifiers. In this research, the performance of two hybrid strategies, multiple voting (M-voting and probabilistic fusion (P-fusion, for crop classification using NDVI time series were tested with different training sample sizes at both pixel and object levels, and two representative counties in north Xinjiang were selected as study area. The single classifiers employed in this research included Random Forest (RF, Support Vector Machine (SVM, and See 5 (C 5.0. The results indicated that classification performance improved (increased the mean overall accuracy by 5%~10%, and reduced standard deviation of overall accuracy by around 1% substantially with the training sample number, and when the training sample size was small (50 or 100 training samples, hybrid classifiers substantially outperformed single classifiers with higher mean overall accuracy (1%~2%. However, when abundant training samples (4,000 were employed, single classifiers could achieve good classification accuracy, and all classifiers obtained similar performances. Additionally, although object-based classification did not improve accuracy, it resulted in greater visual appeal, especially in study areas with a heterogeneous cropping pattern.
Ulahannan, Sansho Elavumkal; Kurien, John S; Joseph, Aneesh; Kurien, Annie Sandhya; Varghese, Sandeep Abraham; Thomas, Bindhya; Varghese, Fobin
Hernia is an abnormal protrusion of an organ or tissue through a defect in its surrounding walls. It can be divided into internal, external and diaphragmatic hernias. Most of them can be asymptomatic. If they become symptomatic they can present with features of intestinal obstruction, incarceration or strangulation. In this case series we compare the incidence of these rare presentations of hernias with world literature and to warn surgeons not to cut the obstructing band in cases of internal hernias. In this case series, we review the clinical details of 7 rare presentations of hernia, who presented with various types of hernias to a tertiary care centre in Kerala over a period of one year. Of these 7 cases 6 cases were internal hernias (3 left paraduodenal hernias, 2 transmesentric hernias, and 1 pericaecal hernia) and a case of spigelian hernia above the level of umbilicus. All of them presented as acute abdomen in the emergency department. Among these 7 cases, only one case was diagnosed preoperatively. Three patients had bowel gangrene and had to undergo resection- anastomosis of the bowel. The survival rate among these cases was 100% as compared to 50% in the world literature if they had been left untreated. Even though internal hernias are a rare entity, we need to have it as a differential diagnosis in case of intestinal obstruction, in a previously non-operated abdomen.
Full Text Available INTRODUCTION: Lipoma , the ubiquitous benign tumor , is not very common in the hand and that to involving the palmar space or finger is very rare. This series of case presentation lays emphasis on consideration of lipoma in the differential diagnosis of swellings/ soft tissue tumors of the hand and the use o f imaging studies in their diagnosis. We report a ser ies of six cases of lipoma in different parts and planes of hand , involving palm and fingers . An uncommon site , size , shape , plane and age of occurrence of this common tumor warrants it’s reporting and an effort had been made to highlight the management. CONCLUSION : Hand lipoma is rare entity for a surgeon in the differential diagnosis of soft tissue tumors with radiology being an invaluable tool. Though rare but frequently seen in this pa rt of country , Precise surgical techniques with a sound anatomic knowledge helps in complete excision without damaging the vital structures and abates recurrences Lipoma , subcutaneous , mid - palmar space.
National Endowment for the Arts, 2009
The Big Read evaluation included a series of 35 case studies designed to gather more in-depth information on the program's implementation and impact. The case studies gave readers a valuable first-hand look at The Big Read in context. Both formal and informal interviews, focus groups, attendance at a wide range of events--all showed how…
Koutsias, Nikos; Bajocco, Sofia
Vegetation phenology is an important element of vegetation characteristics that can be useful in vegetation monitoring especially when satellite remote sensing observations are used. In that sense temporal profiles extracted from spectral signal of time series satellite images can be used to characterize vegetation phenology and thus can be helpful for assessing, for example, phenology patterns between burned and non-burned areas. The aim of this study is to define phenological patterns for the fire ignition points in two Mediterranean study areas located in Italy (Sardinia) and Greece (Peloponnisos) and compare them with control points created after random sampling techniques restricted to certain buffer zones. Remotely sensed data from MODIS (2000-2015) and LANDSAT (1984-2015) satellites were acquired and processed to extract the temporal profiles of the spectral signal of fire ignition points and of control points. Apart of the use of the original spectral data, we used vegetation indices commonly found in vegetation studies as well as in burned area mapping studies. Different metrics linked to key phenological events have been derived and used to assess vegetation phenology in the fire-affected areas.
Full Text Available Melanoma of the oral cavity is a rare malignant disease. On account of the presence at relatively obscure areas in the oral cavity, most of oral malignant melanomas are diagnosed at a late stage. Early diagnosis is essential for successful treatment and perhaps is the key factor in improving the prognosis of oral malignant melanoma. However, no large clinical series exist, and in fact, clinical cases are the sole key source of information. We hereby present a series of four cases of primary oral malignant melanoma of South-East Asian ethnic origin, with long-term, regular follow-up. The age of the patients ranged between 40 and 70 years, with equal sex predilection, and the gingiva was found to be the most common site of its occurrence. Based on clinical and histological parameters, all the cases were diagnosed as primary malignant melanoma, which were further confirmed by using immunohistochemical markers.
Full Text Available Host modulation, includes inhibition of matrix metalloproteinases, blocking production of proinflammatory cytokines and inhibition of osteoclastic activity, has therapeutic value as adjunctive therapy in treating chronic periodontitis. This case series presented three patients with chief complaint of teeth mobility where endo perio involvement was diagnosed. The endo perio combined lesions generally shows the communication between pulp and periodontal tissues with the same origin of dental infection. Diagnosis in such cases is difficult and generally raising problem in the management. All of the cases were managed by non surgical endodontic therapy combined with host modulation. All local factors causing the lesion were removed. Clinical outcome after six and nine months were quite satisfactory. Combined endo perio cases are challenging to the dentists and involve multidisciplinary involvement. To manage such cases, dentists have to rely on the unconventional techniques.DOI: 10.14693/jdi.v22i1.378
Rita de Cássia Reis Cruz
Full Text Available Bacterial infections are important factors in decompensation, and they increase the mortality rate of patients with liver cirrhosis. The most common infections among these patients are spontaneous bacterial peritonitis, pneumonia, skin infections and urinary tract infections (UTI. This transversal study evaluated the frequency of UTI in non-hospitalized patients with cirrhosis followed in a hepatology outpatient unit. Patients with clinical, laboratorial, echographic and/or histological diagnosis of cirrhosis were evaluated from April 2002 to August 2004. Patients who accepted participating in this study were submitted to clinical evaluation and the following laboratorial examinations: urine analysis, urine culture, blood culture and hepatic function tests. Patients with symptoms of UTI, diabetis, prostatic disease were excluded. Eighty-two patients with cirrhosis were studied. Their mean age was 51 years (SD = 11; 73% were male. Hepatitis C virus was the main etiology in 45% of the cases. The Child-Pugh B functional class was observed in 52% of the cases. Urine cultures were positive in 4.9% of these patients. In this study of non-hospitalized cirrhotic patients, with no symptoms of UTI, the frequency of urinary tract infection was approximately 5%. The bacteria found were E. coli and Klebsiella pneumonia. We conclude that it is necessary to screen for UTI in such patients.
Full Text Available Osteoid osteoma is a unique benign primary bone tumor that may present in the metaphyseal diaphyseal areas of the short tubular bones and has also been reported in the carpal bones. It occurs in the first two decades of life. The classic history is bone pain, often relieved by aspirin. The clinical appearance is local swelling and tenderness. The typical radiographic appearance is very characteristic: an eccentric area of cortical sclerosis, frequently with a radiolucent nidus. The lesion does not exceed 1 cm in diameter. The use of a bone scan may be helpful diagnostically, as are the CAT scan and tomography. Doyle et al described seven cases of osteoid osteoma with a prolonged delay in diagnosis, but reported an excellent cure rate following excision. The carpus is not unusual as a site for this tumor, especially the scaphoid. Treatment is windowing with curettage of the tumor nidus. The use of a dental drill to window the phalanx and expose the nidus is very helpful. Removal of the entire nidus is permanently curative, but if a portion of the tumor is missed, prompt recurrence of the symptoms is the rule.
Full Text Available Time series data capture crop growth dynamics and are some of the most effective data sources for crop mapping. However, a drawback of precise crop classification at medium resolution (30 m using multi-temporal data is that some images at crucial time periods are absent from a single sensor. In this research, a medium-resolution, 15-day time series was obtained by merging Landsat-5 TM and HJ-1 CCD data (with similar radiometric performances in multi-spectral bands. Subsequently, optimal temporal windows for accurate crop mapping were evaluated using an extension of the Jeffries–Matusita (JM distance from the merged time series. A support vector machine (SVM was then used to compare the classification accuracy of the optimal temporal windows and the entire time series. In addition, different training sample sizes (10% to 90% of the entire training sample in 10% increments; five repetitions for each sample size were used to investigate the stability of optimal temporal windows. The results showed that time series in optimal temporal windows can achieve high classification accuracies. The optimal temporal windows were robust when the training sample size was sufficiently large. However, they were not stable when the sample size was too small (i.e., less than 300 and may shift in different agro-ecosystems, because of different classes. In addition, merged time series had higher temporal resolution and were more likely to comprise the optimal temporal periods than time series from single-sensor data. Therefore, the use of merged time series increased the possibility of precise crop classification.
Full Text Available According to the theory of human action, Skopostheorie assigns the translation into the category of human communication activity with specific purposes. Therefore, subtitle translation, as one type of translation, also has its own purposes. The subtitle translation is characterized by instantaneity and popularity. Furthermore, the language of the subtitle translation must fulfill the high requirement in terms of logicality and artistic appeal. The translation in this paper, a work by the author, is an extract from the series of CCTV documentary “The Japanese Repatriation from the Huludao”. Based on the principle that the purpose rules, the author did a careful analysis on the receivers’ expectations, education background, and translation commissioner’s requirements, etc.. The author also studied the language characteristics and the general translation strategies in the subtitle translation. In conclusion, the author comes up with the suitable translation strategies for this particular translation practice: naturalization, adding and omitting, logic combing and structure re-organizing, and choosing between styles.
WU Minna; ZHANG Huiwen; LI Xinyu; ZHANG Yan; SU Zhencheng; ZHANG Chenggang
Fungistasis is one of the important approaches to control soil-borne plant pathogens. Some hypotheses about the mechanisms for soil fungistasis had been established, which mainly focused on the soil bacterial community composition, structure, diversity as well as function. In this study, the bacterial community composition and diversity of a series of soils treated by autoclaving, which coming from the same original soil sample and showing gradient fungistasis to the target soil-borne pathogen fungi Fusarium graminearum, was investigated by soil bacterial 16S rDNA-PCR (polymerance chain reaction) Cloning, Restriction fragment length polymorphism (RFLP), and sequencing. The results showed that the soil fungistasis capacity was closely correlated with soil bacterial community composition and diversity, i.e., soil fungistasis declined with the decrease of soil bacterial diversity. Meanwhile, the bacterial community composition and structure were significantly different along the gradient of soil fungistasis tested. α-Proteobacteria, β-proteobacteria, Flexibacter and some uncultured soil bacteria were contributed to soil fungistasis in combination with some other special bacteria (Pseudomonas and Acidobacteria) which were know to be key species in suppression of fungal growth.
Full Text Available Background: High tibia osteotomy (HTO is a common surgical operation for correction of genu varum deformity. In some patients, there are concurrent tibia vara and genu varum (bow leg. This study aimed to consider the possibility of better correction of bow leg deformity after double level tibial osteotomy (DLTO. Materials and Methods: A case series of 10 patients of genu varum in addition to tibia vara (bow leg deformity who were referred to orthopedic ward of an academic hospital of Isfahan- Iran during 2009-2011 were included in the study. The mean age was 17.3 ± 3.1 years and all of them underwent DLTO. The results of treatment have been assessed based on clinical and radiological parameters before and after surgery. Results: The mean pre- and post operative values for Tibia-Femoral Angle, Medial Proximal of Tibia Angle (MPTA, and Lateral Distal of Tibia Angle (LDTA were 18.13 ± 3.05° vs. 3.93 ± 0.66°, 79.13 ± 3.4° vs. 89.7 ± 1.8° and 96.40 ± 1.8° vs. 88.73 ± 3.0° respectively (P < 0.05. Improvement of all radiological parameters was meaningful. Seventy three percent of patients had normal mechanical axis of limb after surgery. The remaining cases had varus deformity in distal femur that was corrected by valgus supracondylar osteotomy in an additional operation. Limited range of motion (ROM near knee and ankle was not observed. Conclusion : DLTO correct bow leg deformity in the point of alignment of limb and paralleling of knee and ankle joint more effectively. This method can be used in metabolic and congenital bow leg which deformities are present in throughout of the lower limb. We described this technique for the first time.
Brusger, E.C.; Farber, M.A.; Sharpe Hayes, M.M.
This series of three case studies illustrates the validity and usefulness of MIDAS, a microcomputer-based tool for integrated resource planning under uncertainty. The first, at Union Electric, serves to test and validate the model and to illustrate its use for demand/supply option evaluation. Focusing on nuclear plant life extension, the Virginia Power case demonstrates the model's extensive detail, particularly in the production cost and financial areas, as well as its flexibility in addressing approximately 70 uncertainty scenarios. Puget Sound Power Light, the third case, used MIDAS for the preparation of its integrated resource plan. A 108-endpoint decision tree illustrates the full power of the decision analysis capability.
LUCKY OBUKOWHO ONOTAI; ADAOBI ELIZABETH OSUJI
Foreign body (FB) ingestion is common in clinical practice especially in children. Its impaction in the esophagus constitutes an important cause of morbidity and mortality in our environment. Due to technological advancement and increase use of disk batteries to power children toys and remote control gadgets, ingestion of disk batteries is now commonplace. In our environment there is paucity of information on disk batteries hence we decided to present case series of disk batteries in the esop...
Peeran, Syed Wali; Ramalingam, Karthikeyan; Peeran, Syed Ali; Mugrabi, Marei Hamed; Abdulla, Khaled Awidat
Hereditary gingival fibromatosis (HGF) is a rare, benign disorder with slowly progressive enlargement of maxillary and mandibular gingiva. Herewith, we report the first case series of HGF presenting among mother and all of her 3 children. Their complaints included unaesthetic appearance due to gingival growth, malocclusion, and difficulty in mastication. Conventional gingivectomy with oral hygiene measures and regular followup is the treatment of choice for such presentation. PMID:24191204
Syed Wali Peeran; Karthikeyan Ramalingam; Syed Ali Peeran; Marei Hamed Mugrabi; Khaled Awidat Abdulla
Hereditary gingival fibromatosis (HGF) is a rare, benign disorder with slowly progressive enlargement of maxillary and mandibular gingiva. Herewith, we report the first case series of HGF presenting among mother and all of her 3 children. Their complaints included unaesthetic appearance due to gingival growth, malocclusion, and difficulty in mastication. Conventional gingivectomy with oral hygiene measures and regular followup is the treatment of choice for such presentation.
Taylor Mark; Bushe Chris J; Mathew Mathew
Abstract Background Clinical trials assessing efficacy and safety of Intramuscular (IM) Olanzapine in acute schizophrenia and acute mania have previously been undertaken in studies required for drug registration in patients who were required to give informed consent. These patients may have less severe forms of psychosis than patients treated in routine practice. Data derived from naturalistic practice following the launch of IM olanzapine may be helpful for clinicians in assessing efficacy a...
Although liver biopsy is an easy procedure for hospitalized patients and outpatients, some complications may occur. To evaluate the efficiency, complications, safety and clinicopathological utility of ultrasonographic-guided percutaneous liver biopsy in diffuse liver disease. In our retrospective study, we evaluated ultrasound-assisted needle biopsies that were performed in outpatients from October 2006 to July 2010. The liver biopsies were performed following one-night fasting using the tru-cut biopsy gun (18-20 gauge) after marking the best seen and hypovascular part of the liver, distant enough from the adjacent organs. A total of 1018 patients were referred to our radiology department. Most of the patients had hepatitis B (60.6%). The biopsy specimens were recorded and sent to our pathology department for histopathological examination. According to the results of our series, percutaneous liver biopsy using the tru-cut biopsy gun guided by ultrasonography can be performed safely. We resolve that routine ultrasound of the puncture site is a quick, effective and safe procedure. The complication rate is very low. The US-assisted percutaneous liver biopsy should be used for all cases
Full Text Available Abstract Introduction Branding refers to a process whereby third degree burns are inflicted on the skin with a hot iron rod or metallic object. Branding employs the phenomenon of "counter irritation," and is widely used by faith healers in developing countries for therapeutic purposes. Some methods, which are very crude and inhuman, carry a large risk of complications. The purpose of this study is to present a series of complications and to familiarize clinicians with this dangerous method of treatment. Case presentation Four Pakistani patients, three male and one female, ranging from 25 to 60 years of age "branded" with a red hot iron rod for various medical reasons presented with severe medical complications to our tertiary care hospital. The mean duration between the procedure and presentation to the hospital was 6 days. At the time of admission, two patients had septic shock, one patient had cavernous sinus thrombosis and one patient had multiple splenic abscesses. All patients received standard care for wound management and systemic infections. Two patients eventually died during the course of treatment. Conclusion Severe complications from branding are troublesome and the potential risks of this treatment outweigh its benefits. Globally, there is a great need for heightened awareness about the dangers of branding among patients and physicians, as this will have an important effect on patients who seek branding for various medical conditions.
Guru Dayal Singh Kalra
Full Text Available Background: The facial asymmetry correction in complex craniofacial malformations presents a challenging problem for reconstructive surgeons. Progressive hemifacial atrophy (HFA and hemifacial microsomia (HFM can manifest in different grades of severity. Most patients require only soft-tissue augmentation. Free flaps are the best option for correction of severe facial soft-tissue deficiency. Materials and Methods: Twenty-two patients of HFM and HFA were included in this study from January 2006 to March 2009 in the Department of Plastic and Reconstructive Surgery, SMS Medical College and Hospital. In all cases, atrophy correction was done using de-epithelialised parascapular free flap with the de-epithelialised surface was placed under the skin. A small skin paddle was taken for monitoring. Results: All cases were reconstructed with de-epithelialised parascapular free flap. There was no flap loss in this series. Hematoma was noted in five cases. Debulking and removal of skin paddle were done in all cases after 6 months. Atrophy recurrence was not observed in any of the cases on follow-up. Conclusion: Contouring of face in cases of HMF and HFA is satisfactorily done with the parascapular free flap. It gives better cosmetic results with minimal donor site morbidity. Facial vessels are better recipient vessels for anastomosis. Keeping de-epithelialised surface of flap under the skin helped in preventing sagging.
Bhaskaran, Krishnan; Gasparrini, Antonio; Hajat, Shakoor; Smeeth, Liam; Armstrong, Ben
Time series regression studies have been widely used in environmental epidemiology, notably in investigating the short-term associations between exposures such as air pollution, weather variables or pollen, and health outcomes such as mortality, myocardial infarction or disease-specific hospital admissions. Typically, for both exposure and outcome, data are available at regular time intervals (e.g. daily pollution levels and daily mortality counts) and the aim is to explore short-term associa...
Chris D Kalogeropoulos
Full Text Available Purpose: Dirofilaria repens is an endemic parasite in Mediterranean countries that mostly affects animals. Rarely, however, it can infect humans. This case series presents patients with ocular infections due to D. repens. Materials and Methods: A chart review was performed of patients with ocular dirofilariasis after the year 2000, treated at a tertiary referral centre in Greece. Data were collected on the ocular, microbiological, or/and histopathological aspects and treatment. Results: Eight cases of unilateral ocular dirofilariasis were identified, of which 5 were subconjunctival (1 masquerading as nodular scleritis and were removed through a conjunctival incision, 2 cases were intravitreal and were removed with vitrectomy, and 1 was intraorbital (adjacent to the roof of the orbit. The latter appeared as an encapsulated mass and subsequent histological examination revealed the presence of the parasite. Of the 8 cases recorded after the year 2000, 7 appeared within the last 6 years (4 cases within the last 3 years. The majority of cases involved residents of the Ionian Islands (7 of 8 cases. Conclusions: D. repens can affect various ocular and periocular tissues. A progressive increase in the incidence of dirofilariasis was observed, which is potentially associated with climate changes in warm and moist areas where this parasite is endemic.
Burdea, Grigore C; Cioi, Daniel; Kale, Angad; Janes, William E; Ross, Sandy A; Engsberg, Jack R
The objective of this study was to investigate the feasibility of game-based robotic training of the ankle in children with cerebral palsy (CP). The design was a case study, 12 weeks intervention, with no follow-up. The setting was a university research laboratory. The participants were a referred sample of three children with cerebral palsy, age 7-12, all male. All completed the intervention. Participants trained on the Rutgers Ankle CP system for 36 rehabilitation sessions (12 weeks, three times/week), playing two custom virtual reality games. The games were played while participants were seated, and trained one ankle at-a-time for strength, motor control, and coordination. The primary study outcome measures were for impairment (DF/PF torques, DF initial contact angle and gait speed), function (GMFM), and quality of life (Peds QL). Secondary outcome measures relate to game performance (game scores as reflective of ankle motor control and endurance). Gait function improved substantially in ankle kinematics, speed and endurance. Overall function (GMFM) indicated improvements that were typical of other ankle strength training programs. Quality of life increased beyond what would be considered a minimal clinical important difference. Game performance improved in both games during the intervention. This feasibility study supports the assumption that game-based robotic training of the ankle benefits gait in children with CP. Game technology is appropriate for the age group and was well accepted by the participants. Additional studies are needed however, to quantify the level of benefit and compare the approach presented here to traditional methods of therapy. PMID:22773059
Safal Khanal, BOptom
Full Text Available Background: Waardenburg syndrome is a rare autosomally-inherited developmental disorder characterized by sensorineural deafness in association with pigmentary anomalies comprising various ocular features including dystopia canthorum, iris heterochromia, eyebrow flare, and fundus alterations. It is a congenital non-progressive genetic disorder that has been found to result in hearing loss, reduced vision, reduced self esteem, problems related to appearance, and decreased intellectual functioning.Case Reports: We report two familial case series that presented with the characteristic ocular findings and the systemic features of Waardenburg syndrome. The first series comprised a 32-year-old father with his two sons aged nine and six years. Two female siblings, aged 10 and eight years, both with cochlear implants, were included in the second series.Conclusion: Waardenburg syndrome manifests differently with dissimilar genetic penetration even within the same family. Some individuals will require no treatment, while others may need treatment or surgery for other abnormalities. Appropriate measures can be undertaken to negotiate the disabilities resulting from the ocular conditions associated with this syndrome.
COME, Etienne; Oukhellou, Latifa
Today, more and more bicycle sharing systems (BSS) are being introduced in big cities. These transportation systems generate sizable transportation data, the mining of which can reveal the underlying urban phenomena linked to city dynamics. This paper presents a statistical model to automatically analyze the trips data of a bike sharing system. The proposed solution partitions (i.e. cluster) the stations according to their usage profiles. To do so, count series describing the stations' usage ...
Full Text Available New and multiple access devices and distribution channels to audiovisual content has led to the emergence of the phenomenon known as ‘second screen’ and the existence of more proactive and participatory consumption of audiovisual products by consumers. We make a bibliographic review on the concepts of social television and audience, transmedia storytelling and the new roles of audiovisual archivists on the generation of added value on audiovisual products, especially in social audiences deferred in time. To this end we have analized the television serie The Ministry of Time, premiered the public Spanish television La 1 - TVE. We collected and analyzed more than 30,000 tweets sent with some of the hashtags used by producers and consumers of the television serie. The results show a high dispersion in the number of authors, a concentration of a few authors that send many tweets and a vast majority who just send one or two tweets but represent over 90% of all the tweets sent. We also conducted an analysis of both, hashtags and content analysis of the messages showing some terms and words that show the degree of consumer satisfaction with the serie and the positive sentiment to some of the characters.
Full Text Available The characterization and evaluation of the recent status of biodiversity in Southern Africa’s Savannas is a major prerequisite for suitable and sustainable land management and conservation purposes. This paper presents an integrated concept for vegetation type mapping in a dry savanna ecosystem based on local scale in-situ botanical survey data with high resolution (Landsat and coarse resolution (MODIS satellite time series. In this context, a semi-automated training database generation procedure using object-oriented image segmentation techniques is introduced. A tree-based Random Forest classifier was used for mapping vegetation type associations in the Kalahari of NE Namibia based on inter-annual intensity- and phenology-related time series metrics. The utilization of long-term inter-annual temporal metrics delivered the best classification accuracies (Kappa = 0.93 compared with classifications based on seasonal feature sets. The relationship between annual classification accuracies and bi-annual precipitation sums was conducted using data from the Tropical Rainfall Measuring Mission (TRMM. Increased error rates occurred in years with high rainfall rates compared to dry rainy seasons. The variable importance was analyzed and showed high-rank positions for features of the Enhanced Vegetation Index (EVI and the blue and middle infrared bands, indicating that soil reflectance was crucial information for an accurate spectral discrimination of Kalahari vegetation types. Time series features related to reflectance intensity obtained increased rank-positions compared to phenology-related metrics.
PENG Guangxiong; DENG Lei; CUI Weihong; MING Tao; SHEN Wei
Using three-phase remote sensing images of China-Brazil Earth Resources Satellite 02B (CBERS02B) and Landsat-5 TM, tobacco field was extracted by the analysis of time series image based on the different phenological characteristics between tobacco and other crops. The spectral characteristics of tobacco and corn in luxuriant growth stage are very similar, which makes them difficult to be distinguished using a single-phase remote sensing image. Field film after tobacco seedlings transplanting can be used as significant sign to identify tobacco. Remote sensing interpretation map based on the fusion image of TM and CBERS02B's High-Resolution (HR) camera image was used as standard reference material to evaluate the classification accuracy of Spectral Angle Mapper (SAM) and Maximum Likelihood Classifier (MLC) for time series image based on full samples test method. SAM has higher classification accuracy and stability than MLC in dealing with time series image. The accuracy and Kappa of tobacco coverage extracted by SAM are 83.4% and 0.692 respectively, which can achieve the accuracy required by tobacco coverage measurement in a large area.
Full Text Available Introduction Hydrops Fetalis is a serious condition in fetal period, characterized by the presence of serous fluid accumulation in at least two potential spaces in fetus including pleural effusion, pericardial effusion, and ascites. The incidence of hydrops fetalis is one per 2500-3000 pregnancies. This condition is followed by different diseases. Fetal hemolytic anemia and its hypoxemia due to hydrops fetalis are potentially life or function threatening. Mortality rate is 50-90%; this poor prognosis is improving with advances in prenatal and medical treatment. Methods and Materials This study performed on patients’ records with hydrops fetalis diagnosis in one of the neonatal referral and academic center, Vali-e-Asr Hospital Tehran, the capital of Iran from 2003 to 2010. Etiology, prognosis, and frequency of Hydrops fetalis in newborns were evaluated. Results Out of 10878 cases, 0.35% was born with hydrops fetalis:18.42% immune [Rh incompatibility (%85.71, Kell antigen system(%14.29 ] and 81.58% non-immune. Conclusion The rate of hydrops due to Rh incompatibility is significant in our center (85.71%, however, it is unusual in most of medical centers all over the world.
This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes incorporating a journal article into the classroom by first converting it into a case study.
Bhaskaran, Krishnan; Gasparrini, Antonio; Hajat, Shakoor; Smeeth, Liam; Armstrong, Ben
Time series regression studies have been widely used in environmental epidemiology, notably in investigating the short-term associations between exposures such as air pollution, weather variables or pollen, and health outcomes such as mortality, myocardial infarction or disease-specific hospital admissions. Typically, for both exposure and outcome, data are available at regular time intervals (e.g. daily pollution levels and daily mortality counts) and the aim is to explore short-term associations between them. In this article, we describe the general features of time series data, and we outline the analysis process, beginning with descriptive analysis, then focusing on issues in time series regression that differ from other regression methods: modelling short-term fluctuations in the presence of seasonal and long-term patterns, dealing with time varying confounding factors and modelling delayed ('lagged') associations between exposure and outcome. We finish with advice on model checking and sensitivity analysis, and some common extensions to the basic model. PMID:23760528
Seyyed Ahmad Tabatabaei
Full Text Available Pulmonary alveolar proteinosis, (PAP is a rare disease of unknown etiology, characterized by accumulation of intraalveolar proteinaceous material which is rich in lipid and positive on periodic acid-Schiff stain. Two clinically different pediatric types have been defined as congenital PAP which is fulminant and fatal, and a late-onset PAP which is similar to the adult form and less severe. Eight children with late-onset PAP were hospitalized from 1998 to 2005 in Mofid Children Hospital. Characteristics of these patients and the methods of diagnosis and treatment are presented in this case series.
Kenneth D. Katz
Full Text Available Synthetic cannabinoid use has risen at alarming rates. This case series describes 11 patients exposed to the synthetic cannabinoid, MAB-CHMINACA who presented to an emergency department with life-threatening toxicity including obtundation, severe agitation, seizures and death. All patients required sedatives for agitation, nine required endotracheal intubation, three experienced seizures, and one developed hyperthermia. One developed anoxic brain injury, rhabdomyolysis and died. A significant number were pediatric patients. The mainstay of treatment was aggressive sedation and respiratory support. Synthetic cannabinoids pose a major public health risk. Emergency physicians must be aware of their clinical presentation, diagnosis and treatment.
This paper presents space-time kriging within a multi-Gaussian framework for time-series mapping of particulate matter less than 10 μm in aerodynamic diameter (PM10) concentration. To account for the spatiotemporal autocorrelation structures of monitoring data and to model the uncertainties attached to the prediction, conventional multi-Gaussian kriging is extended to the space-time domain. Multi-Gaussian space-time kriging presented in this paper is based on decomposition of the PM10 concent...
Full Text Available The data requirements for most quantitative fishery assessment models are extensive, and most of the fisheries in the world lack time series of the required biological and socioeconomic data. Many innovative approaches have been developed to improve data collection for fisheries. We explored the use of data from fishers' interviews to estimate time series of approximate "best" catch rates. A total of 472 standardized interviews were conducted with 423 fishers along the southern Red Sea coast recording the best catch recalled and the change in average catch rates throughout the fishing career of interviewees. The results showed a decline of best catch rates in all fisheries, ranging from 4% to 10% per year for more than 50 years. The estimated rates of decline of the typical catch were higher for fishers who started fishing in recent years, suggesting that the resource base is declining, in concordance with other indicators. It is suggested that analysis of approximate data, quickly acquired at low cost from fishers through interviews, can be used to supplement other data-recording systems or used independently to document the changes that have occurred in the resource base over a lifetime of fishing. The results can be used to guide the assessment and management of resources to conserve ecosystems and livelihoods.
Aneja, Jitender; Grover, Sandeep; Avasthi, Ajit; Mahajan, Sudhir; Pokhrel, Prabhakar; Triveni, Davuluri
Masturbation is common in all societies. Despite being common, it is admonished culturally and almost all religions prohibit masturbation and consider it an act of immorality. The prohibition for masturbation leads to a lot of cultural beliefs, including certain myths, which influence sexual behavior of the person. The impact of these common cultural myths associated with masturbation, are clinically understood as Dhat syndrome and masturbatory guilt. Although there is a reasonable literature on Dhat syndrome, there is limited literature with regard to masturbatory guilt especially linking the same with axis-I psychopathology. In this case series, three cases of masturbatory guilt are presented in whom masturbatory guilt was associated with manifestation of severe psychopathology. This report suggests that masturbatory guilt must be enquired for in patients presenting with severe mental disorder. PMID:25722518
If one has to attain high accuracy over long timescales during the numerical computation of the N-body problem, the method called Lie-integration is one of the most effective algorithms. In this paper we present a set of recurrence relations with which the coefficients needed by the Lie-integration of the orbital elements related to the spatial N-body problem can be derived up to arbitrary order. Similarly to the planar case, these formulae yields identically zero series in the case of no perturbations. In addition, the derivation of the formulae has two stages, analogously to the planar problem. Namely, the formulae are obtained to the first order, and then, higher order relations are expanded by involving directly the multilinear and fractional properties of the Lie-operator.
Full Text Available Masturbation is common in all societies. Despite being common, it is admonished culturally and almost all religions prohibit masturbation and consider it an act of immorality. The prohibition for masturbation leads to a lot of cultural beliefs, including certain myths, which influence sexual behavior of the person. The impact of these common cultural myths associated with masturbation, are clinically understood as Dhat syndrome and masturbatory guilt. Although there is a reasonable literature on Dhat syndrome, there is limited literature with regard to masturbatory guilt especially linking the same with axis-I psychopathology. In this case series, three cases of masturbatory guilt are presented in whom masturbatory guilt was associated with manifestation of severe psychopathology. This report suggests that masturbatory guilt must be enquired for in patients presenting with severe mental disorder.
Rudramurthy, Pradeep; Lokanatha, Hemalata
Chediak-Higashi syndrome (CHS) is a rare autosomal recessive disease, characterized by partial oculocutaneous albinism, frequent pyogenic infections, and the presence of abnormal large granules in leukocytes and other granulecontaining cells. The abnormal granules are readily seen in blood and marrow granulocytes. Other clinical features include silvery hair, photophobia, nystagmus and hepatosplenomegaly. However, the presence of abnormal giant intracytoplasmic granules in neutrophils and their precursors are diagnostic of CHS. Here, we present a series of five cases, out of which four presented in the accelerated phase. In all the five cases, the giant granules were noted predominantly in the cytoplasm of lymphocytes, which is a rare occurrence compared to those present in the granulocytes. PMID:26538743
Full Text Available Background: Peptide Receptor Radionuclide Therapy (PRRT is novel and efficacious treatment of neuroendocrine tumors (NETs. Methods: Twenty-seven patients (14 females, 13 males, mean age 54.37±11.14 years; range 30-74 years with progressive, metastatic neuroendocrine tumors, were treated at least once during the period of 31 months (from July the 6th 2009 to February the 6th 2012 with PRRT in Nuclear Medicine Center, Clinical Center Kragujevac. There were carcinoids in 8 cases (6pts had intestinal and 2pts had lung carcinoid, medullary thyroid carcinoma in 5 cases, pancreatic carcinoma in 3 cases, paraganlioma in 2 cases, pheochromocytoma in 2 cases and in 7 cases primary tumors were not detected. We used 56 doses of different kinds of radiopharmaceuticals: 32 doses of 90Y-DOTATOC, 12 doses of 177Lu-DOTATATE, and 12 doses combining the 90Y-DODTATOC and 177Lu-DOTATATE. The PRRT was given in cycles: 12 pts received one cycle, 9 pts two cycles, 4 pts three cycles, 1 patient 4cycles and 2 pts five cycles of PRRT. The radioactivity was 3.2-7.40 GBq per cycle, and intervals between cycles ranged from 6 to 8 weeks. Results: The response to PRRT was assessed by morphological imaging (MSCT and MRI as well as by tumor marker follow up (CgA, 5-HIAA, catecholamines, CT and CEA. Seven pts (25.9% had partial response (PR, 17 pts (63.0% had stable disease (SD, and 3 pts (11.1% had progressive disease (PD. None of our patients had complete response (CR. All patients received PRRT under renal protection with amino acid infusions. In spite of this precaution, two patients with previously diagnosed diabetes mellitus suffered from serious deterioration of renal function after PRRT. Conclusion: The efficacy and safety of PRRT observed in our case series was in accordance with previously published data.
Full Text Available Abstract Background Rapidly destructive arthrosis of the hip is a rare and incompletely understood disorder with scarce literature about variations in natural history within a population. Methods A series of cases from North Wales with rapid progressive joint destruction and extensive subchondral bone loss in the femoral head and acetabulum are presented. Radiographic findings mimicked those of other disorders such as septic arthritis, rheumatoid and seronegative arthritis, primary osteonecrosis with secondary osteoarthritis, or neuropathic osteoarthropathy, but none of the patients had clinical, pathologic, or laboratory evidence of these entities. Results Rapid progression of hip pain and disability was a consistent clinical feature. The average duration of symptoms was 1.4 years. Radiographs obtained at various intervals before surgery (average 14 months in 18 patients documented rapid hip destruction, involvement being unilateral in 13 cases. All patients underwent total hip arthroplasty, and osteoarthritis was confirmed at pathologic examination. Conclusion The authors postulate that these cases represent an uncommon subset of osteoarthritis and regular review, both clinically and radiologically, are required to assess speed of progression and prevent rapid loss of bone stock without the surgeon being aware. These cases are unsuitable for being placed on long waiting list due to technical difficulties in delayed surgery and compromised outcome following surgery.
This study reports the application and outcomes of Conversation Analysis (CA)-motivated interaction-focused therapy for a case series of eight couples managing the impact of aphasia on their conversations. It builds on previously reported interaction-focused therapy case studies (e.g. Lock, Wilkinson, & Bryan, 2001, Wilkinson, Bryan, Lock & Sage, 2010; Wilkinson, Lock, Bryan & Sage, 2011). Therapy was individualised for each couple, based on CA findings, but taking account of language, cognit...
Muhammad Wasif Saif
Full Text Available Context Poorly differentiated neuroendocrine carcinoma of the pancreas is a rare and aggressive tumor. The combination of etoposide and cisplatin is considered as the first-line treatment, but no recommendations exist for further treatment after progression. Case series We report here case series of three patients who received gemcitabine as salvage chemotherapy in patients with poorly differentiated neuroendocrine carcinoma of the pancreas. All the three patients achieved clinical benefit with manageable toxicities. The survival was 5.5, 8, and 9 months respectively after the beginning of gemcitabine in these three patients. Conclusions This case series of patients with poorly differentiated neuroendocrine carcinoma of the pancreas who received gemcitabine as salvage chemotherapy suggests that gemcitabine could be an effective salvage treatment. Future studies to investigate gemcitabine in this setting are warranted.
Teeley, Aubriana M; Soltani, Maryam; Wiechman, Shelley A; Jensen, Mark P; Sharar, Sam R; Patterson, David R
This case series evaluated the use of virtual reality hypnosis (VRH) for the treatment of pain associated with multiple fractures from traumatic injuries. VRH treatment was administered on 2 consecutive days, and pain and anxiety were assessed each day before and after VRH treatment as well as on Day 3, which was 24 hours after the second treatment session. Pain reduction from baseline to Day 3 was from 70% to 30%, despite opioid analgesic use remaining stable. The subjective pain reduction reported by patients was encouraging, and the results of this case series suggest the importance of further study of VRH with larger samples using randomized controlled trials. PMID:22443021
Ryan K. Lanier
Full Text Available Background: Current medical and scientific research indicates that rosacea, a chronic and often debilitating skin condition that primarily affects the central face, may be caused by an overactive or excessive inflammatory immune response. Regardless of etiology, the accompanying redness and inflammation is unsightly and difficult for the patient. Anatabine is an alkaloid from the plant family Solanaceae that has been shown in several preclinical studies to modulate proinflammatory signaling pathways. Objective: A cream containing anatabine was developed and evaluated in an open-label case series study for safety and effects on the appearance of the skin in 10 patients with mild to moderate rosacea. Methods: Patients applied the cream to the face twice daily for a period of 30 days. Patients and the study physician completed safety and efficacy assessments at study end. Results: Results showed that 50% of the patients self-reported improvement in the appearance of their skin, and the physician noted improvement in 70% of the patients. Photographs taken before and after 30 days of cream use provide visual evidence of the improvement in several patients. There were no complications or adverse events reported by any of the patients in the study, indicating that the anatabine cream was safe and very well tolerated. Conclusion: The results of this open-label case series show that a facial cream containing anatabine can improve the appearance of the skin in patients with mild to moderate rosacea and suggest that a double-blind, vehicle-controlled trial in a larger number of subjects is warranted.
Full Text Available Background: Genital tuberculosis is a chorionic disease and mostly occurs by haematogenous spread from extra genital source like lungs, peritoneum, lymph nodes and bones. Transmission through a sexual intercourse is also possible. Since the majority of patients are in reproductive ages, involvement of fallopian tubes and endometrium cause infertility in patients. Cases: Reviewing 4 cases of female genital tuberculosis, which referred to an infertility treatment center with various symptoms, we encountered various appearances on hysterosalpingography (HSG. Conclusion: The genitourinary tract is the most common site of extra pulmonary TB. The primary focus of genital tuberculosis is fallopian tubes, which are almost always affected bilaterally but not symmetrically. Because of common involvement of fallopian tubes and endometrial cavity, disease causes infertility. Diagnosis is not easy because genital tuberculosis has a wide range of clinical and radiological manifestations with slow growing symptoms. Detailed hysterosalpingography finding may be helpful in better diagnosis of the disease. This case series aims to depict the various hystrosalpingographic appearances and pathology produced by tuberculosis and related literatures are reviewed in order to establish a better diagnostic evaluation of genital tuberculosis
Razeghinejad, Mohammad Reza; Masoumpour, Masoumeh; Eghbal, Mohammad Hossein; Myers, Jonathan S; Moster, Marlene R
Glaucoma management in pregnant patients is a real challenge, especially when the glaucoma is not controlled with medications. We report the results of 6 incisional glaucoma surgeries for the management of medically uncontrolled glaucoma patients during pregnancy. This retrospective, case series was conducted on the 6 eyes of 3pregnant patients with uncontrolled glaucoma using maximum tolerable medications. Details of the glaucoma surgical management of these patients as well as their postoperative care and pregnancy and clinical outcomes on longitudinal follow-up are discussed. All 3 patients had juvenile open-angle glaucoma and were on various anti-glaucoma medications, including oral acetazolamide. The first case described underwent trabeculectomy without antimetabolites in both eyes because of uncontrolled intraocular pressure with topical medications. The surgery was done with topical lidocaine jelly and subconjunctival lidocaine during the second and third trimesters. The second patient had an Ahmed valve implantation in both eyes during the second and third trimesters because of uncontrolled IOP with topical medications and no response to selective laser trabeculoplasty. Surgery was done with topical tetracaine and subconjunctival and sub-Tenon's lidocaine. The third case had a Baerveldt valve implantation under general anesthesia in the second trimester. In selected pregnant glaucoma patients with medically uncontrolled intraocular pressure threatening vision, incisional surgery may lead to good outcomes for the patient with no risk for the fetus. PMID:27582594
Bonadies, Danielle C; Brierley, Karina L; Barnett, Rachel E; Baxter, Melanie D; Donenberg, Talia; Ducaine, Whitney L; Ernst, Michelle E; Ernstx, Michelle E; Homer, Jeanne; Judkins, Megan; Lovick, Niki M; Powers, Jacquelyn M; Stanislaw, Christine; Stark, Elizabeth; Stenner, Rio C; Matloff, Ellen T
After repeated media attention in 2013 due to the Angelina Jolie disclosure and the Supreme Court decision to ban gene patents, the demand for cancer genetic counseling and testing services has never been greater. Debate has arisen regarding who should provide such services and the quality of genetics services being offered. In this ongoing case series, we document 35 new cases from 7 states (California, Connecticut, Florida, Georgia, Missouri, Pennsylvania, and Utah) and the District of Columbia of adverse outcomes in cancer genetic testing when performed without the involvement of a certified genetic counselor. We identified 3 major themes of errors: wrong genetic tests ordered, genetic test results misinterpreted, and inadequate genetic counseling. Patient morbidity and mortality were an issue in several of these cases. The complexity of cancer genetic testing and counseling has grown exponentially with the advent of multigene panels that include rare genes and the potential for more variants of uncertain significance. We conclude that genetic counseling and testing should be offered by certified genetics providers to minimize the risks, maximize the benefits, and utilize health care dollars most efficiently. PMID:25098283
Urban, M.; Schmullius, C. C.; Hese, S.; Herold, M.
°C. MODIS land surface temperature values from 8-day composites with a spatial resolution of 1 km were used to identify the location of the arctic tree line by this 10 °C temperature threshold. At the Yamal Peninsula deviations of the mean summer temperatures and the tree line reference is observable. Since the tree growth might be limited by factors like available nutrients, hydrology and length of growing season, additional information like land cover data, Normalized Differenced Vegetation Indices (NDVI) time series and soil maps will be integrated into the analysis.
Full Text Available While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5% affected the musculoskeletal system; 14 (18.4% the nervous system; and 9 (11.8% the eyes. Fifteen cases (19.7% reached full recovery; 9 cases (11.3% partial recovery; 1 case (1.3% no recovery; and 1 case (1.3% died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.
Le Grange, Daniel; Binford, Roslyn; Loeb, Katharine L.
Objective: The purpose of this study was to describe a case series of children and adolescents (mean age = 14.5 years, SD = 2.3; range 9-18) with anorexia nervosa who received manualized family-based treatment for their eating disorder. Method: Forty-five patients with anorexia nervosa were compared pre- and post-treatment on weight and menstrual…
Salbach-Andrae, Harriet; Bohnekamp, Inga; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Miller, Alec L.
The aim of this study was to describe a case series of adolescents (mean age = 16.5 years, SD = 1.0) with anorexia nervosa (AN) and bulimia nervosa (BN) who received dialectical behavior therapy (DBT). Twelve outpatients with AN and BN took part in 25 weeks of twice weekly therapy consisting of individual therapy and a skills training group.…
Herreid, Clyde Freeman
This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)
Full Text Available Axel Orozco-Hernández,1 Ximena Ortega-Larrocea,1 Gustavo Sánchez-Bermúdez,1 Gerardo García-Aguirre,1 Virgilio Morales Cantón,1 Raul Velez-Montoya2 1Retina Department, Asociación para Evitar la Ceguera en México IAP, Mexico City, Mexico; 2Department of Ophthalmology, University of Colorado School of Medicine, Rocky Mountain Lions Eye Institute, Aurora, CO, USA Background: Since the ophthalmological community adopted the use of intravitreal bevacizumab as an accepted off-label treatment for neovascular diseases, the amount of knowledge regarding its effects and properties has been increasing continually. In the last few years, there have been an increasing number of reports about sterile intraocular inflammation and intraocular pressure elevations after intravitreal bevacizumab. In the following case series, we describe the clinical presentation and outcomes of ten consecutive cases of patients developing mild-to-severe sterile intraocular inflammation after intravitreal bevacizumab and their management. Methods: This report presents a retrospective case series. We reviewed the medical records of ten consecutive patients from a group of 46, in whom repackaged bevacizumab in individual aliquots from two vials from the same batch were used. All surgical procedures were performed using standard sterile techniques in the operating room. At each follow-up visit, patients underwent a complete ophthalmological examination including visual acuity assessment, intraocular pressure, biomicroscopy, and posterior fundus examination. Results: Ten patients presented sterile endophthalmitis with an onset time of 3.5±1.95 days. The clinical characteristics were mild pain, slight visual loss, conjunctival hyperemia, and various degrees of intraocular inflammation with microhypopyon. All cultures were negative. All patients were managed with topical steroids and antibiotics, except two, in whom, due to severe vitreous cells, intravitreal antibiotics were
Full Text Available : BACKGROUND: Phyllodes tumor of breast is one of the rare neoplasms comprising less than 1% of all breast tumours.aim of the study is to evaluate the clinical charecteristics, treatment regimens and complications of phyllodes tumor in our institution. PATIENTS AND METHODS: We have retrospectively reviewed the medical records of 2 years from 2013 to 2015 of patients who presented to our department, government general hospital, Kakinada. RESULTS: 342 patients presented with breast tumors of which 126 are malignant and 216 are benign. Phyllodes tumor constituted 8 cases of the total breastlump cases presented in our institution from 2013 to 2015. 3 out of 8 cases are recurrent. CONCLUSION: In benign cases wide local excision with clear margins is sufficient to prevent recurrence. In recurrent and malignant cases simple mastectomy has to be done.
Pavlidis Theodoros; Ballas Konstantinos; Symeonidis Nikolaos; Tsitlakidis Anastasios; Pavlidis Efstathios; Baltatzis Minas; Lalountas Miltiadis; Psarras Kyriakos; Sakantamis Athanassios
Abstract Introduction A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand's hernia. Here we present a case series of four men with Amyand's hernia. Case presentations We retrospectively studied 963 Caucasian patients with inguinal hernia who were admitted to our surgical department over a 12-year period. Four patients presented with Amyand's hernia (0.4%). A 32-year-old Caucasian man had an inflamed vermiform appendix in his hernial sac (acute appendicitis), presen...
Full Text Available Abstract Introduction Autopsy series have shown that metastasis to the thyroid gland has occurred in up to 24% of patients who have died of cancer. Neuroendocrine tumors may metastasize to thyroid gland. Case presentations Case 1 was a 17-year-old Turkish woman who was referred from our Endocrinology Department for a thyroidectomy for treatment of neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination results were consistent with a neuroendocrine tumor; neoplastic cells showed strong immunoreactivity to chromogranin A and synaptophysin, but the immunohistochemical profile was inconsistent with medullary thyroid carcinoma in that the tumor was negative for calcitonin, carcinoembryonic antigen, and thyroid transcription factor-1. Case 2 was a 54-year-old Turkish woman who presented with a 3-cm nodule on her right thyroid lobe. She had undergone surgery for a right lung mass four years previously. After a right pneumonectomy, thymectomy and lymph node dissection, a typical carcinoid tumor was diagnosed. Under ultrasonographic guidance, fine needle aspiration biopsy of her right thyroid pole nodule was performed and the biopsy was compatible with a neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination indicated three nodular lesions, 5 cm and 0.4 cm in diameter in her right lobe and 0.1 cm in diameter in her left lobe. The tumors were consistent with a neuroendocrine phenotype, showing strong immunoreactivity to chromogranin A and synaptophysin. Conclusion Thyroid nodules detected during follow-up of neuroendocrine tumor patients should be thoroughly investigated. A fine needle aspiration biopsy of the thyroid confirms the diagnosis in most cases and leads to appropriate management of those patients and may prevent unnecessary treatment approaches.
Full Text Available Victor C Kok1,2 1Division of Palliative Medicine and Hospice Palliative Care Team, Kuang Tien General Hospital, 2Department of Biomedical Informatics, Asia University Taiwan, Taichung, Taiwan Background: The use of compassionate extubation (CE to alleviate suffering by terminating mechanical ventilation and withdrawing the endotracheal tube requires professional adherence and efficiency. The Hospice Palliative Care Act, amended on January 9, 2013, legalizes the CE procedure in Taiwan. Methods: From September 20, 2013 to September 2, 2014, the hospice palliative care team at a community hospital received 20 consultations for CE. Eight cases were excluded because of non-qualification. Following approval from the Ethics Committee, the medical records of the remaining 12 patients were reviewed and grouped by the underlying disease: A, “terminal-stage cancer”; B, “non-cancer out-of-hospital cardiac arrest”; and C, “non-cancer organ failure”. Time to extubation using a cut-off at 48 hours was assessed. Results: The mean ages of patients (standard deviation in groups A, B, and C were 66.3 (14.9 years, 72 (19.1 years, and 80.3 (4.0 years, respectively. The mean number of days of intubation at consultation were 6.8 (4.9, 7.3 (4.9, and 179.3 (271.6, respectively. The mean total doses of opioids (as morphine-equivalent dose in the 24 hours preceding CE were 76 (87.5 mg, 3.3 (5.8 mg, and 43.3 (15.3 mg. The median times from extubation (range to death were 97 (0.2–245 hours, 0.3 (0.2–0.4 hours, and 6.1 (3.6–71.8 hours. Compared to those requiring <48-hour preparatory time, patients requiring >48 hours to the moment of CE were younger (62.8 years vs 75.5 years, required a mean time of 122 hours (vs 30 hours to CE (P=0.004, had shorter length of stay (33.3 days vs 77.8 days, required specialist social worker intervention in 75% of cases (vs 37.5%, and had a median duration of intubation of 11.5 days (vs 5.5 days. Conclusion: CE
Kim, Eun-A; Lee, Hye-Eun; Ryu, Hyung-Woo; Park, Seung-Hyun; Kang, Seong-Kyu
Objectives Seven cases of malignant lymphohematopoietic (LHP) disorder were claimed to have developed from occupational exposure at two plants of a semiconductor company from 2007 to 2010. This study evaluated the possibility of exposure to carcinogenic agents for the cases. Methods Clinical courses were reviewed with assessing possible exposure to carcinogenic agents related to LHP cancers. Chemicals used at six major semiconductor companies in Korea were reviewed. Airborne monitoring for ch...
Background. Pyogenic granuloma is a reactive tumor-like lesion commonly affecting the oral cavity. These lesions usually appear as localized solitary nodule with a sessile or pedunculated base and colour varying from red, purplish, or pink, depending on the vascularity of the lesion. Pyogenic granuloma shows predilection for gingiva and is usually slow growing, but at times it shows rapid growth. The natural course of this lesion can be categorized into three distinct phases, namely, (i) cellular phase, (ii) capillary phase/vascular phase, and (iii) involutionary phase. Histopathologically, pyogenic granuloma is classified into lobular capillary hemangioma (LCH) and non-lobular capillary hemangioma (non-LCH). Case Presentation. In this series, four cases (varied age groups and both genders) of pyogenic granuloma showing varying histopathological presentation in relation to its clinical course have been described. The lesion in its early phase reveals diffuse endothelial cells, with few budding into capillaries. Among the capillary phase, the LCH type shows numerous blood vessels organized into lobular aggregates whereas the non-LCH type does not show any such organization and resembles granulation tissue. The involutionary phase shows healing of the lesion and is characterized by extensive fibrosis in the connective tissue. Conclusion. In conclusion, knowledge of the various histopathological presentation of this lesion is necessary for proper identification. PMID:27382492
Full Text Available Background. Pyogenic granuloma is a reactive tumor-like lesion commonly affecting the oral cavity. These lesions usually appear as localized solitary nodule with a sessile or pedunculated base and colour varying from red, purplish, or pink, depending on the vascularity of the lesion. Pyogenic granuloma shows predilection for gingiva and is usually slow growing, but at times it shows rapid growth. The natural course of this lesion can be categorized into three distinct phases, namely, (i cellular phase, (ii capillary phase/vascular phase, and (iii involutionary phase. Histopathologically, pyogenic granuloma is classified into lobular capillary hemangioma (LCH and non-lobular capillary hemangioma (non-LCH. Case Presentation. In this series, four cases (varied age groups and both genders of pyogenic granuloma showing varying histopathological presentation in relation to its clinical course have been described. The lesion in its early phase reveals diffuse endothelial cells, with few budding into capillaries. Among the capillary phase, the LCH type shows numerous blood vessels organized into lobular aggregates whereas the non-LCH type does not show any such organization and resembles granulation tissue. The involutionary phase shows healing of the lesion and is characterized by extensive fibrosis in the connective tissue. Conclusion. In conclusion, knowledge of the various histopathological presentation of this lesion is necessary for proper identification.
This report presents innovative vocational training (VT) initiatives to improve integration of low-skilled workers into lifelong learning and the labor market. Chapter 1 describes study structure and methodology. Chapter 2 addresses the theoretical basis for observing innovations. It analyzes the definition and significance of innovation in system…
Introduction Existing research and treatment for brain injured adults uses cognitive rehabilitation to address memory deficits including compensatory and remedial techniques. Electronic devices such as the Neuropage and palm top computers are effective in compensating for memory deficits. However, these require the user to be trained and proficient in their use. This exploratory study investigates the effectiveness of pre-programmed wireless digital photo frame as a memory aid for adults with...
Aiko Nagai; Yuta Shibamoto; Keiko Ogawa
Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced lymphedema. Saireito (SRT) is a traditional Japanese herbal medicine that has been used for treating edema and inflammation in conditions such as nephritic disease. This study investigated the effect of SRT on lymphedema caused by radiotherapy. Four patients were treated with SRT at a dose of 9 g/day. The severity of lymphedema was evaluated using the Common Terminology Cr...
Ondo N'Dong, F; Lorofi, R; Comes, G; Bellamy, J; Diané, C
31 cases of spiegelian hernias are reported. It is one of the world biggest statistics of this affection. The patients were divided in 18 women and 13 men, with an average of 45 years old. The hernia was located on the right side of the abdomen in 16 cases and on the left side in 13 cases. In two cases, the affection was bilateral. In 14 cases, there was an incarceration. No strangulation was observed. The rare forms can be divided in massive form, tumoral, crawling (in the old man), spread (in the infant and the woman). The spiegelian hernia can be associated with one or more other kinds of hernias. 27 patients underwent an operation. In all the cases, an direct approach was used. There was no post operative complications. We want to emphazise the high frequence of this affection in Gabon, and the fact that most of the cases have been observed within the same area, in the south of the country. A study researching predictive factors could be interesting to be realised in this area. PMID:1527192
Kerzner, Harold R
A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re
Jochen A. G. Jaeger
Full Text Available Landscape fragmentation is increasingly considered an important environmental indicator in the fields of sustainable land use and biodiversity. To set goals for future development and to plan appropriate measures, suitable empirical data on the degree of landscape fragmentation are needed to identify trends and compare different regions. However, there is still a significant lack of data on landscape fragmentation as an indicator, despite the substantial scientific literature on this topic, likely because of confusion over the definition of “fragmentation,” questions associated with scale and data issues, and lack of general agreement on a fragmentation measure. This study presents a state-wide quantitative analysis of landscape fragmentation in Baden-Württemberg, Germany, by means of the "effective mesh size" (meff, which characterizes the anthropogenic penetration of landscapes from a geometric point of view and is based on the probability that two randomly chosen points in a landscape are connected, i.e., not separated by barriers such as roads, railroads, or urban areas. Baden-Württemberg is fragmented to a far greater extent than indicated by previous studies. The meff has decreased by 40% since 1930. This development is strongly related to the growing number of inhabitants, the increased use of motorized vehicles, and the hierarchical regional planning system based on the central place theory. To illustrate the suitability of the meff method for environmental monitoring, as a planning instrument and as an assessment instrument for impact assessment studies, we explored several variations of applying the method with regard to choice of fragmenting elements, consideration of noise bands, spatial differentiation (e.g., administrative districts vs. ecoregions, and way of dealing with patches at the boundaries of the reporting units. Depending on the objectives of the investigation (e.g., recreational quality vs. suitability for wildlife
Full Text Available Purpose: To study the clinical presentation and treatment outcome of patients with ocular cysticercosis in southern India. Methods: This study included 10 patients who were diagnosed to have ocular or adnexal cysticercosis over a period of one year in Pondicherry, India. The clinical presentation, results of investigation and treatment outcome of the cases were analysed retrospectively. Results: Age of these patients ranged from 12 to 55 years. Four presented with loss of vision, two with a swelling in the eyelid, one with proptosis, one with diplopia and two with conjunctival involvement. ELISA for cysticercus antibodies in serum was positive in all cases. Albendazole and prednisolone were given for the treatment of these cases. Two patients responded well to treatment and were completely cured of the disease. There was partial improvement in 6 cases. Surgery in the form of excision was performed in two cases following a course of medical therapy. There was no significant change in visual acuity in eyes with intraocular cysticercosis following treatment. Conclusion: Ultrasonography B scan and ELISA for anticysticercal antibodies help to establish the diagnosis of ocular cysticercosis. A combination of oral albendazole and corticosteroids is found to be effective in confirmed cases. Intraocular cysticercosis is associated with a poor prognosis for vision.
Vanden Bogaerde, Leonardo; Sennerby, Lars
Background. Hydrophilic and moderately rough implant surfaces have been proposed to enhance the osseointegration response. Aim. The aim of this study was to compare early changes of stability for two implants with identical macrodesign but with different surface topographies. Materials and Methods. In 11 patients, a total of 22 implants (11 bimodal (minimally rough, control) and 11 proactive (moderately rough and hydrophilic, test), Neoss Ltd., Harrogate, UK) were immediately placed into fresh extraction sockets and immediately loaded. The peak insertion torque (IT) was measured in Ncm at placement. Resonance Frequency Analysis (RFA) measurements were made at baseline and 2, 4, 6, and 12 weeks after surgery. Results. The two implant types showed similar IT and RFA values at placement (NS). A dip of RFA values after 2 weeks followed by an increase was observed, where the test implant showed a less pronounced decrease and a more rapid recovery than the control implant. The test implants were significantly more stable than the control ones after 12 weeks. Conclusions. The results from the present study indicated that the hydrophilic and rougher test implant was more resistant to immediate loading and showed a significantly higher stability than the smoother control implant after 12 weeks. PMID:27042180
Full Text Available Eosinophilic meningoencephalitis (EM is a rare type of meningoencephalitis. The objective of this report is to describe a series of EM identified in a specific geographic area over a short period of time. Materials and Methods: This series of cases are described from a neurological center in Central Kerala occuring in the period between February 2004 and June 2006. Results: During this period we had identified ten patients (eight males and two females with EM. Their mean age was 37.1 years (range 15-60 years. Main symptomatologies were fever, severe headache, body pain, abdominal pain and arthralgia. One patient was in akinetic rigid state with coma. All patients had peripheral eosinophilia. The cerebrospinal fluid (CSF of all patients showed eosinophilic pleocytosis. The mean CSF white cell count was 588 cells. CSF differential count showed 50-70% eosinophils. CSF glucose levels were normal but proteins were markedly raised (mean CSF protein was 180 mg/dl. MRI brain showed T2 hyperintensities diffusely in periventricular white matter in the comatose patient. Contrast enhanced CT scan of the brain was normal in others. All eight male patients gave history of eating "raw flesh of Monitor Lizard" (Iguana some three to fourteen days prior to the onset of symptoms. There was no such history for the female patients. Considering the history of exposure and eosinophilic meningitis we suspected a meningoencephalitis with Angiostrongylus cantonensis and treated them with albendazole, steroid and other supportive measures. All of them recovered. Conclusion: Eosinophilic meningitis (EM is a rare condition and in this locality, a CNS infection with Agiostrongylus cantonensis is highly likely. AC is a parasite in monitor lizard. Human infection occurs from consumption of uncooked flesh or blood of infected lizards. Physicians need to maintain a high index of suspicion and enquire for any exposure to uncooked meat or blood of monitor lizard when faced with EM
Full Text Available Abstract Background Coeliac disease in adolescents has been associated with an increased prevalence of depressive and disruptive behavioural disorders, particularly in the phase before diet treatment. We studied the possible effects of a gluten-free diet on psychiatric symptoms, on hormonal status (prolactin, thyroidal function and on large neutral amino acid serum concentrations in adolescents with coeliac disease commencing a gluten-free diet. Methods Nine adolescents with celiac disease, aged 12 to 16 years, were assessed using the semi-structured K-SADS-Present and Lifetime Diagnostic interview and several symptom scales. Seven of them were followed at 1 to 2, 3, and 6 months on a gluten-free diet. Results Adolescent coeliac disease patients with depression had significantly lower pre-diet tryptophan/ competing amino-acid (CAA ratios and free tryptophan concentrations, and significantly higher biopsy morning prolactin levels compared to those without depression. A significant decrease in psychiatric symptoms was found at 3 months on a gluten-free diet compared to patients' baseline condition, coinciding with significantly decreased coeliac disease activity and prolactin levels and with a significant increase in serum concentrations of CAAs. Conclusion Although our results of the amino acid analysis and prolactin levels in adolescents are only preliminary, they give support to previous findings on patients with coeliac disease, suggesting that serotonergic dysfunction due to impaired availability of tryptophan may play a role in vulnerability to depressive and behavioural disorders also among adolescents with untreated coeliac disease.
Gee, Paul; Schep, Leo J; Jensen, Berit P; Moore, Grant; Barrington, Stuart
Background A new class of hallucinogens called NBOMes has emerged. This class includes analogues 25I-NBOMe, 25C-NBOMe and 25B-NBOMe. Case reports and judicial seizures indicate that 25I-NBOMe and 25C-NBOMe are more prevalently abused. There have been a few confirmed reports of 25B-NBOMe use or toxicity. Report Observational case series. This report describes a series of 10 patients who suffered adverse effects from 25B-NBOMe. Hallucinations and violent agitation predominate along with serotonergic/stimulant signs such as mydriasis, tachycardia, hypertension and hyperthermia. The majority (7/10) required sedation with benzodiazepines. Analytical method 25B-NBOMe concentrations in plasma and urine were quantified in all patients using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Peak plasma levels were measured between 0.7-10.1 ng/ml. Discussion The NBOMes are desired by users because of their hallucinogenic and stimulant effects. They are often sold as LSD or synthetic LSD. Reported cases of 25B- NBOMe toxicity are reviewed and compared to our series. Seizures and one pharmacological death have been described but neither were observed in our series. Based on our experience with cases of mild to moderate toxicity, we suggest that management should be supportive and focused on preventing further (self) harm. High doses of benzodiazepines may be required to control agitation. Patients who develop significant hyperthermia need to be actively managed. Conclusions Effects from 25B-NBOMe in our series were similar to previous individual case reports. The clinical features were also similar to effects from other analogues in the class (25I-NBOMe, 25C-NBOMe). Violent agitation frequently present along with signs of serotonergic stimulation. Hyperthermia, rhabdomyolysis and kidney injury were also observed. PMID:26621342
Bustreo, Sara; Osella-Abate, Simona; Cassoni, Paola; Donadio, Michela; Airoldi, Mario; Pedani, Fulvia; Papotti, Mauro; Sapino, Anna; Castellano, Isabella
Although Ki67 index suffers from poor reproducibility, it is one of the most important prognostic markers used by oncologists to select the treatment of estrogen receptor (ER) positive breast cancer patients. In this study, we aim to establish the optimal Ki67 cut-offs for stratifying patient prognosis and to create a comprehensive prognostic index for clinical applications. A mono-institutional cohort of 1.577 human epidermal growth factor receptor 2 negative/ER+ breast cancer patients having complete clinical, histological, and follow-up data was collected. The 14 and 20 % Ki67 cut-offs were correlated to disease-free interval (DFI) and disease-specific survival (DSS). To create a comprehensive prognostic index, we used independent variables selected by uni/multivariate analyses. In terms of DFI and DSS, patients bearing tumors with Ki67 20 % showed the poorest prognosis. Moreover, to tumor size, the number of metastatic lymph nodes and Ki67 > 20 % was given a score value, varying depending on definite cut-offs and used to create a prognostic index, which was applied to the population. Patients with a prognostic index ≥3 were characterized by significant risk of relapse [DFI: Hazard Ratio (HR) = 4.74, p < 0.001] and death (DSS: HR = 5.03, p < 0.001). We confirm that the 20 % Ki67 cut-off is the best to stratify high-risk patients in luminal breast cancers, and we suggest to integrate it with other prognostic factors, to better stratify patients at risk of adverse outcome. PMID:27155668
Magnabosco, C.; Lau, M.; Lindsay, M. R.; Alleva, R.; Stepanauskas, R.; Shivambu, S.; Maphanga, S.; van Heerden, E.; Onstott, T. C.
The question of "who" is present in extreme environments is one of the major questions surrounding geobiological research. Techniques such as high-throughput sequencing and single cell genomics are illuminating previously unseen organisms that exist in low abundance. Commonly referred to as the "rare biosphere", the contribution of these low abundance organisms and the effect that they have on traditional diversity estimates is poorly understood. Here, we present a study that critically examines the effect that sequencing depth has on the Chao1 alpha diversity estimator and the Sørensen similarity index. This is achieved through (1) a theoretical analysis of simulated community distributions and (2) a comparison between subsurface Sanger-sequenced clone libraries and high-throughput amplicon sequences generated from a 1.3 km deep fracture (Be326_Bh2). The screening of single cells, metagenomics, and metatranscriptomics are then used to assess the authenticity and contribution of rare members identified in the deeply sequenced amplicon datasets of Be326_Bh2. In particular, a "rare" (<1% relative abundance in 16S rDNA V6 amplicon libraries) member of Ignavibacteria that has been identified and sequenced through single cell genomics is molecularly tracked over the course of a 3-year sampling campaign in Be326_Bh2 while other "rare" members prove to be merely sequencing artifacts. Ultimately, these results help us better understand the limitations of methods used to calculate diversity in long-tail environments like the terrestrial deep subsurface and the role that the rare biosphere plays in Be326_Bh2.
Xia, Jiejun; Liu, Zhenyin; Jiang, Hua; Shen, Gang; Li, Haibo; Jiang, Yizhou; Zhang, Jing
Purpose Retinoblastoma is the most common primary malignant intra-ocular tumor in children. Although intra-arterial chemotherapy (IAC) by selectively infusing chemotherapy through the ophthalmic artery has become an essential technique in the treatment of advanced intra-ocular retinoblastoma in children, the outcome of IAC as primary therapy for infants less than 3 months of age remains unknown. In this retrospective study, we reviewed the outcome of IAC as primary therapy for retinoblastoma in infants less than 3 months of age. Methods We retrospectively reviewed ten retinoblastoma patients attending our center from January 2009 to September 2015 and beginning primary IAC before the age of 3 months. The patient characteristics, overall outcomes and therapy-related complications were assessed. Results The mean patient age at the first IAC treatment was 10.4 weeks (range 4.9–12.9 weeks). These eyes were classified according to the International Classification of Retinoblastoma (ICRB) as group A (n = 0), B (n = 2), C (n = 0), D (n = 9), or E (n = 2). A total of 28 catheterizations were performed, and the procedure was stopped in one patient because of internal carotid artery spasm. Each eye received a mean of 2.6 cycles of IAC (range 2–4 cycles). After IAC with a mean follow-up of 28.3 months (range 9–65 months), tumor regression was observed in 12 of 13 eyes. One eye was enucleated due to tumor progression. All patients are alive and no patient has developed metastatic disease or other malignancies. Conclusions Our experience suggests IAC as primary therapy is a feasible and promising treatment for retinoblastoma in infants less than 3 months of age. PMID:27504917
Full Text Available Background: Gilles de la Tourette′s Syndrome (GTS is a neuropsychiatric disorder characterized by motor and vocal tics associated with obsessive compulsive disorder (OCD and attention deficit hyperactivity disorder (ADHD. This syndrome is often misdiagnosed as psychiatric disorder, therefore neuropsychiatric evaluation in patients suffering from it is very essential to make the correct diagnosis. Few reports, mostly single case reports of GTS from India have been published, this series attempts to define the clinical spectrum of patients from India. Aim : To study the clinical profile of patients with GTS in India. Setting and Design : Prospective hospital based study. Material and Methods : Ct scan of the head and EEG were done in all the 14 cases in addition to clinical history and detailed neurological examination. The diagnosis of GTS was made according to Tourette Syndrome Classification Study Criteria Group. Findings were statistically analyzed. Results : In all a total of 101 simple motor tics and 21 complex motor tics were observed in 14 cases. Most common site of simple motor tics was the facio-nuchal region (70% and type was eyebrow raising seen in 10 cases (71%. Commonest type of complex motor tics nose blowing (35%. Vocal tics were found in all 14 cases, simple (56%, being more common than complex vocal tics i.e, coprolalia (42%. Throat clearing was found in (50% cases and was the most positive in 28%. OCD was seen in 64% and ADHD in 28%. All the 14 cases Responded well to treatment. Conclusion : The clinical profile of patients in our case series is similar to those reported from the western countries with the exception of coprolalia, and ADHD, the incidence of which is higher in this case series.
Reddy R; Sharma M.; Shivashankar N
The present investigation was aimed at studying the efficacy of cognitive behavior therapy (CBT) in reducing the symptoms of stuttering and dysfunctional cognitions and in enhancing assertiveness and quality of life in clients with stuttering. Five clients with stuttering who met the inclusion criteria (male clients with diagnosis of stuttering) and exclusion criteria (clients with brian damage), substance abuse or mental retardation were enrolled for the study. A single-case design was adopt...
Matas Riera, Màrian; Donaldson, David; Priestnall, Simon Lawrence
The aim of this article was to describe Descemet's membrane detachment (DMD) following phacoemulsification in five equine eyes and to review the human literature on this topic. In the last decade, there has been increased reporting of DMD in the human literature, in particular following cataract surgery. The natural history of DMD remains unknown and although various medical and surgical treatments have been advocated there is no recognized 'gold standard' treatment for DMD. This case series reports the diagnosis of DMD in four horses (5 eyes) in association with phacoemulsification surgery. The diagnosis of DMD in these patients was made intra-operatively, postoperatively or on subsequent histopathological examination. The surgical reports, photographic or video recordings, and ultrasound data were evaluated and possible factors associated with the pathophysiology of DMD are discussed. This is the first description of DMD in the veterinary literature, and the authors believe that DMD might hitherto have been overlooked in veterinary ophthalmology due to a lack of awareness of the condition. The possible causes, clinical signs, and treatment of DMD as described in the human literature are also reviewed. PMID:25180582
J. Harris Ricardo
Full Text Available El odontoma es el tumor odontogénico más frecuente en cavidad oral, compuesto por una mezcla de células odontogénicas formando dentina y esmalte, presenta células y tejidos normales pero de estructura defectuosa, estos tejidos se encuentran en el área del cuerpo donde se presenta su crecimiento, al examen radiográfico se puede presentar imágenes radiopacas como un gran número de dientes rudimentarios llamados dentículos, en este caso se conoce como odontoma compuesto o presentarse imagen radiopaca como conglomeraciones amorfas, recibiendo el nombre de odontoma complejo. Su etiología se le relaciona con restos paradentales de Malassez, procesos inflamatorios, traumatismos, se le asocia en algunos casos con el quiste odontogénico calcificante, son asintomáticos, producen retención dentaria. El tratamiento es quirúrgico y su recurrencia es baja. Se reporta serie de casos que acudieron al servicio de estomatología y cirugía oral de la Universidad de Cartagena con impresión diagnostica de odontoma, se realizaron los procedimientos quirúrgicos confirmando los diagnósticos con los reportes histopatológicos.Odontoma is the most frequent odontogenic tumor in oral cavity, comprising a mixture of odontogenic cells forming dentin and enamel. It shows cells and normal tissues but in abnormal structure. These tissues are located in the area of the body where it presents its growth. Under radiographic examination may be radiopaque images as a large number of rudimentary teeth called denticles, in this case is known as compound odontoma or presented as conglomerates amorphous radiopaque image, receiving the name of complex odontoma. Its etiology is related to remnants of Malassez paradontals, inflammatory processes. Trauma is sometimes associated with calcifying odontogenic cyst. Generally are asymptomatic, produce tooth retention. Treatment is surgical and recurrence is low. Is reported in the present paper a number of cases that went to
Shapoff, Cary A; Babushkin, Jeffrey A; Wohl, David J
This article discusses the clinical use of laser-microtextured abutments on dental implant restorations. Four cases are presented, each using one of the four commercially available laser-microtextured abutment styles. Numerous preclinical and clinical studies have shown the positive effects of laser microtexturing on the implant platform in limiting crestal bone loss and benefiting soft tissue stability. Other histologic studies of laser microtexturing on the implant abutment have demonstrated the ability of this specific feature to block epithelial downgrowth and provide a functional connective tissue attachment to the abutment surface. Other abutment designs, styles, and materials have only demonstrated a soft tissue seal with epithelial adhesion and a circular ring of connective tissue fibers around the abutment without direct contact. This article presents clinical and radiographic case examples from a private practice perspective on the longterm successful use of microtextured abutments with respect to crestal bone levels, exceptional soft tissue health, and stability with minimal sulcular depth. PMID:27560683
L K Makhija
Full Text Available Introduction: Transverse facial cleft (Tessier type 7 or congenital macrostomia is a rare congenital anomaly seldom occurring alone and is frequently associated with deformities of the structures developing from the first and second branchial arches. The reported incidence of No. 7 cleft varies from 1 in 60,000 to 1 in 300,000 live births. Material and Methods: Seventeen patients of transeverse facial cleft who presented to us in last 5 years were included in the study. Their history regarding familial and environmental predispositions was recorded. The cases were analysed on basis of sex, laterality, severity, associated anomalies and were graded according to severity. They were operated by z plasty technique and were followed up for 2 years to look for effectiveness of the technique and its complications. Result: Out of the seventeen patients of transverse cleft, none had familial predilection or any environmental etiology like antenatal radiological exposure or intake of drugs of teratogenic potential. Most of the patients (9/17 were associated with hemifacial microsomia and 1 patient was associated with Treacher Colin′s Syndrome. Out of the 6 cases of Grade I clefts, 4 were isolated transverse clefts and of the 10 patients of Grade II clefts, 7 were associated with hemifacial microsomia. We encountered only one case of Grade III Transverse Cleft which was not only associated with hemifacial microsomia but also had cardiac anomaly. Out of the17 cases, 15 were operated and in most of them the outcome was satisfactory.
Itoh, Naoya; Kawamura, Ichiro; Tsukahara, Mika; Mori, Keita; Kurai, Hanako
Although Streptococcus pneumoniae is an important pathogen of humans, pneumococcal cholangitis is rare because of the rapid autolysis of S. pneumoniae. The aim of this case series was to review patients with bile cultures positive for S. pneumoniae. This study was a single center retrospective case series review of patients with S. pneumoniae in their bile at a tertiary-care cancer center between September 2002 and August 2015. Subjects consisted of all patients in whom S. pneumoniae was isolated in their bile during the study period. Bile specimens for culture were obtained from biliary drainage procedures such as endoscopic retrograde biliary drainage, endoscopic nasobiliary drainage, and percutaneous transhepatic biliary drainage. There were 20 patients with bile cultures positive for S. pneumoniae during the study period. All patients presented with extrahepatic obstructive jaundice due to hepatopancreatobiliary tumors. Nineteen of 20 patients underwent the placement of plastic intrabiliary tubes. The mean time between the first-time drainage and the positive culture was 26 days (range 0-313 days). Although 12 of 20 patients met our definition of cholangitis, 5 were clinically treated with antibiotics based on a physician's assessment of whether there was a true infection. The present study is the largest case series of patients with S. pneumoniae in their bile. Based on our findings, the isolation of S. pneumoniae from bile may be attributed to the placement of biliary drainage devices. PMID:27025902
Vinicius Sousa Pietra Pedroso
Full Text Available INTRODUCTION: Paracoccidioidomycosis (PCM is the most important systemic mycosis in South America. Central nervous system involvement is potentially fatal and can occur in 12.5% of cases. This paper aims to contribute to the literature describing eight cases of neuroparacoccidioidomycosis (NPMC and compare their characteristics with patients without neurological involvement, to identify unique characteristics of NPCM. METHODS: A cohort of 213 PCM cases was evaluated at the Infectious Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, from October 1976 to August 2008. Epidemiological, clinical, laboratory, therapeutic and follow-up data were registered. RESULTS: Eight patients presented NPCM. The observed NPCM prevalence was 3.8%. One patient presented the subacute form of PCM and the other seven presented the chronic form of the disease. The parenchymatous form of NPCM occurred in all patients. 60% of the patients who proceeded from the north/ northeast region of Minas Gerais State developed NPCM. The neurological involvement of a mother and her son was observed. NPCM patients exhibited demographical and clinical profiles similar to what is described in the literature. When NPCM cases were compared to PCM patients, there were differences in relation to origin and positive PCM family history. CONCLUSIONS: The results corroborate the clinical view that the neurological findings are extremely important in the evaluation of PCM patients. Despite the limitations of this study, the differences in relation to patient's origins and family history point to the need of further studies to determine the susceptibility factors involved in the neurological compromise.
Shah, Jayashree S; Shetty, Niharika; Shah, Sharath Kumar D; Shah, Neelesh Kumar S
Tuberculosis is very common disease in India. It is one of the most common causes of Granulomatous Uveitis in our Country even today. So the strongest suspicion in our mind when we are treating a case of Uveitis, should be TB. We reviewed all the cases of clinically suspected ocular tuberculosis attending the Ophthalmology OPD of Sri Siddhartha Medical College between December 2012 and December 2014 who were refractory to routine uveitis management and later on responded to anti-Tubercular treatment. History of TB contact, Ocular manifestation, Demographic Profile of the patients, Diagnostic test, Treatment regime were looked into. Here by we present a case series of 15 cases of refractory uveitis that later were detected to be of tuberculous origin. We studied the characteristic features, complications and correlation of mantoux test, ESR and Koch's contact with these cases. PMID:27134908
Barwood Cab Fleet Study Summary is the second in a new series called''Alternative Fuel Information Case Studies,'' designed to present real-world experiences with alternative fuels to fleet managers and other industry stakeholders
Andrew M. Mason
Full Text Available A case series of five patients is described demonstrating the utility of the intubating laryngeal mask airway in the prehospital setting, both as a primary airway rescue device and as a bridge to tracheal intubation. All patients were hypoxaemic, had sustained severe polytrauma and were trapped in their vehicles following road traffic collisions. A probability of survival study showed better-than-predicted outcomes for the group as a whole.
Jeong, Hyeonghui; Seo, Han Gil; Han, Tai Ryoon; Chung, Chun Kee; Oh, Byung-Mo
This retrospective case series included five patients who underwent surgical resection of the cervical anterior osteophyte due to dysphagia. Videofluoroscopic swallowing studies (VFSSs) were performed before and after surgery on each patient, and kinematic analysis of the video clips from the VFSS of a 5-mL liquid barium swallow was carried out. Functional oral intake improved after surgery in 3/4 patients who had required a modified diet before surgery. Kinematic analysis showed increases in...
Paulo José Lorenzoni; Elaine Cardoso; Ana C.S. Crippa; Charles Marques Lourenço; Fernanda Timm Seabra Souza; Roberto Giugliani; Maria Luiza Saraiva-Pereira; Salmo Raskin; Isac Bruck; Cláudia S. K. Kay; Rosana H. Scola; Werneck, Lineu C.; Teive, Hélio A.G.
The aim of the study was to analyze a series of Brazilian patients with Niemann-Pick disease type C (NP-C). Method Correlations between clinical findings, laboratory data, molecular findings and treatment response are presented. Result The sample consisted of 5 patients aged 8 to 26 years. Vertical supranuclear gaze palsy, cerebellar ataxia, dementia, dystonia and dysarthria were present in all cases. Filipin staining showed the “classical” pattern in two patients and a “variant” pattern i...
Padilla Luis Fernando; Torres-Guerrero Arnulfo; Milanés-Pérez Rosa; Vélez-Duncan Carlos; Torres-Tabares Tonny
Objective: to describe the management and surgical options used in the service of Otorhinolaryngology, Hospital Universitario del Caribe for the management of juvenile nasopharyngeal angiofibroma (JNA).Methodology: case series of patients with JNA, during the years 2007-2010, which were staged according to the classification of FISCH (1983). The extent of tumor, preoperative studies, surgical approach, results and complications were evaluated. Results: six male patients were diagnosed and tre...
Norredam, Marie; Jensen, Mette; Ekstrøm, Morten
In our clinical work, we treat refugees who have been exposed to trauma and who subsequently develop psychotic symptoms. However, the literature does not address the relationship between refugees with depression, post-traumatic stress disorder (PTSD) and psychotic symptoms. Therefore the aim of...... this study is firstly to present a series of cases showing how psychotic symptoms may present in refugees diagnosed with PTSD, and secondly to discuss the underlying explanations of the involved psychopathology....
Azadeh Ghaheri; Farzane Jamdar; Mohammad Ali Roghaei
Background: Immune-mediated recurrent pregnancy loss (RPL) has received more attention than any other single etiologic classification. Individuals with rare blood group P have an antipp1pk antibody in their serum, which causes recurrent abortion in the early stages. Materials and Methods: In this case series study, 11 patients with unexplained RPL who had anti-P antibody in their serum were treated by plasma exchange during their next pregnancies. To evaluate the efficacy of the treatment, we...