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Sample records for abbreviated emergency laparotomy

  1. A PROSPECTIVE STUDY OF COMPLICATIONS IN EMERGENCY LAPAROTOMY

    OpenAIRE

    Raja Bily Graham; Vijayabhasker

    2016-01-01

    Laparotomy or celiotomy is opening of the peritoneal cavity. Since the emergence of surgery, it is one of the common surgical procedure done for elective and emergency gastrointestinal and sometimes for non-gastrointestinal diseases and it is not always free from complications. The common complications associated with laparotomies are Bleeding, Haematoma, Fever, Surgical Site Infection, Wound dehiscence, Burst abdomen, Ileus, DVT, Subdiaphragmatic abscess, Stitch abscess, Enterocu...

  2. From NELA to EPOCH and beyond: enhancing the evidence base for emergency laparotomy.

    Science.gov (United States)

    Odor, Peter M; Grocott, Michael P W

    2016-01-01

    Around 35,000 patients undergo emergency laparotomy surgery in the UK each year with an in-hospital 30-day mortality estimated as between 11 and 15 %. The recent publication of the First Patient Report of the National Emergency Laparotomy Audit (NELA) has provided a detailed description of individual hospital performance against national standards of care in emergency laparotomy in England and Wales. Although the standards used for audit purposes in NELA are based upon the best currently available evidence, none of the source data derives from randomised controlled studies. This commentary explores the evidence base for the standards evaluated by NELA and highlights recent and forthcoming studies that may substantially contribute to improving the evidence base in this area, thereby improving patient care and strengthening the validity of the NELA audit standards.

  3. Analyzing intra-abdominal pressures and outcomes in patients undergoing emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Khan Shehtaj

    2010-01-01

    Full Text Available Background : Studies have documented the impact of intra-abdominal hypertension (IAH on virtually every organ. However, it still remains strangely underdiagnosed. The aims of the study were to assess, in patients undergoing emergency laparotomy, whether intra-abdominal pressure (IAP is an independent predictor of morbidity and mortality, to evaluate the effects of IAH, and to identify hidden cases of abdominal compartment syndrome (ACS. Materials and Methods : The study comprised 197 patients undergoing emergency laparotomy. IAP was measured preoperatively and then postoperatively at 0, 6, and 24 hours. Duration of hospital stay, occurrence of burst abdomen, and mortality were noted as outcomes. Results : At admission, incidence of IAH was 80%. No significant association was found between IAP and occurrence of burst abdomen (P > 0.1. IAP was found to be a significant predictor of mortality in patients undergoing laparotomy (P < 0.001. Elevated IAP was found to affect all the organ systems adversely. The incidence of post-op ACS was 3.05% in the general population and 13.16% in trauma patients. The mortality rate for this subgroup was 100%. Conclusions : IAP is a significant predictor of mortality in patients undergoing laparotomy. IAH has detrimental effects on various organ systems. A more frequent monitoring with prompt decompression may be helpful in decreasing the mortality rate. Further studies are required to establish a screening protocol in patients undergoing laparotomy to detect and manage cases of IAH and ACS.

  4. Complications after emergency laparotomy beyond the immediate postoperative period - a retrospective, observational cohort study of 1139 patients

    DEFF Research Database (Denmark)

    Toft Tengberg, Line; Cihoric, M; Foss, N B;

    2016-01-01

    %) deaths occurred between 72 h and 30 days after surgery; all of these patients had complications, indicating that there is a prolonged period with a high frequency of complications and mortality after emergency laparotomy. We conclude that peri-operative, enhanced recovery care bundles for preventing......Mortality and morbidity occur commonly following emergency laparotomy, and incur a considerable clinical and financial healthcare burden. Limited data have been published describing the postoperative course and temporal pattern of complications after emergency laparotomy. We undertook...... a retrospective, observational, multicentre study of complications in 1139 patients after emergency laparotomy. A major complication occurred in 537/1139 (47%) of all patients within 30 days of surgery. Unadjusted 30-day mortality was 20.2% and 1-year mortality was 34%. One hundred and thirty-seven of 230 (60...

  5. Transversus abdominis plane block for an emergency laparotomy in a high-risk, elderly patient

    Directory of Open Access Journals (Sweden)

    Surekha S Patil

    2010-01-01

    Full Text Available A 72-year-old male patient with gall bladder perforation and small intestinal obstruction from impacted gall stone was posted for emergency laparotomy. He had congestive heart failure, severe hypertension at admission and history of multiple other coexisting diseases. On admission, he developed pulmonary oedema from systolic hypertension which was controlled by ventilatory support, nitroglycerine and furosemide. Preoperative international normalized ratio was 2.34 and left ventricular ejection fraction was only 20%. Because of risk of exaggerated fall in blood pressure during induction of anaesthesia (general or neuraxial, a transversus abdominis plane block via combined Petit triangle and subcostal technique was administered and supplemented with Propofol sedation.

  6. Spontaneous Rupture of Primary Hepatocellular Carcinoma: Experience of Emergency Laparotomy over a 16-Year Period

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE Spontaneous rupture is an uncommon complication of primary hepatocellular carcinoma (HCC). There is no standard method of treatment, and most often treatment depends on the condition of the patient or the assessment by the surgeon. The aim of this study was to evaluate our experience of emergency laparotomy in the management of spontaneous rupture of HCC.METHODS Retrospective analysis documented 49 rupture HCC cases who received emergency laparotomy from Oct. 1990 to Oct. 2006.RESULTS Thirty-nine cases (79.6%) had a history of hepatitis and 39 cases (79.6%) were accompanied with liver cirrhosis. The most frequent manifestation which was present in 47 cases (95.9%) was sudden right hypochondrial or epigastric pain. Shock was seen in 40 cases (81.6%), and 42 cases (85.7%) had signs of peritonitis. The methods of operation were performed in the number of cases as follows: suture in 5; packing in 2; hepatic artery ligation in 4; hepatectomy in 21; microwave coagulation in 5;microwave coagulation combined with packing in 3; microwave coagulation combined with hepatic artery ligation in 9. Morbidity occurred in 11 cases (22.4%). The overall hospital mortality rate was 10.2%. The mean survival time was 8.8 months. The main causes of death were liver failure and massive variceal bleeding.CONCLUSION Spontaneous rupture of HCC represents a life-threatening condition with an overall poor prognosis. Laparotomy should be the first choice for treating HCC rupture if the proper conditions are present. Liver failure is the vital condition influencing the prognosis.

  7. CLINICAL STUDY ON FACTORS INFLUENCING WOUND DEHISCENCE IN EMERGENCY EXPLORATORY LAPAROTOMY

    Directory of Open Access Journals (Sweden)

    Mrinal

    2016-04-01

    Full Text Available BACKGROUND Wound dehiscence is a mental, financial and physical trauma to patients and has an equivalent effect on surgeon too. Wound dehiscence etches profound morbidity in a patient’s life. There arises an expanding demand in the cost of care, both in terms of increased hospital stay and manpower in nursing and managing of burst wound and its complications. Thus understanding of factors contributing to dehiscence, correctable measures and precautionary steps are very much essential in day-to-day practice of all surgeons. This ignited our thoughts to conduct a study and understand wound healing and dehiscence in a better way. AIM This study was made to find the factors that significantly contribute to wound dehiscence in midline emergency exploratory laparotomy. METHODS The study was conducted in 213 patients who underwent midline emergency exploratory laparotomy in Silchar Medical College and Hospital in Barak Valley, Assam, India, from March 2015 to February 2016. Factors such as age, preoperative albumin, body mass index, haemoglobin, post-operative pulmonary complication, diabetes mellitus, duration of surgery, time of presentation, intraabdominal sepsis/wound infection, raised intra-abdominal pressure, raised creatinine, ascites and malignancy were observed and analysed with odds ratio and P value. RESULTS AND CONCLUSION Risk factors for abdominal wound dehiscence identified in this study include anaemia, hypoalbuminemia, post-operative pulmonary complications, increased intra-abdominal pressure, intra-abdominal sepsis/wound infection, delayed presentation and malignancy.

  8. Add on dexmedetomidine in the treatment of severe alcohol withdrawal in a patient of emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Roshan Madan Shende

    2015-09-01

    Full Text Available According to American statistics 90% of people drink alcohol at some time in life. The estimated prevalence of alcohol abuse among hospitalized in patients is 20 % and 10- 33 % in patients admitted to the ICU. Approximately 18% of these patients will develop alcohol withdrawal syndrome (AWS whose symptoms can include physical and psychological manifestations that range from mild to life threatening. Although AWS has been reported in literature in post-operative periods and in intensive care unit, there is less information on treatment and preparing of a patient with AWS, coming for emergency surgical procedure. The surgical stress and deranged liver functions possess an additional challenge to the anesthesiologist. Here we are reporting the successful management of a case of delirium tremens by using Dexmedetomidine in pre, intra and post-operative period in a patient with hollow viscous perforation for emergency laparotomy. [Int J Res Med Sci 2015; 3(9.000: 2446-2449

  9. Retained Intra-Abdominal Surgical Clamp Complicating Emergency Laparotomy: Incidental Finding on Hysterosalpingogram for Evaluation of Tubal Infertility

    Directory of Open Access Journals (Sweden)

    Adebiyi Gbadebo Adesiyun

    2014-01-01

    Full Text Available The finding of intraperitoneal foreign body complicating surgical intervention broadly remains as an issue of safety in the operative room, a source of emotive concern for the patient, and an upsetting but equally embarrassing situation to the surgeon and the team. However, in the media world, it is a source of sumptuous and captivating headline on the newspaper and to the legal profession, an attractive case to prosecute. A middle age teacher presented with secondary infertility. She had emergency laparotomy fifteen years ago for ruptured tubal ectopic pregnancy in a private hospital and postoperative period was uneventful. Amongst other investigations to find out the cause of infertility, she had hysterosalpingography and a radio-opaque clamp was visualized on the films. She was counselled and had laparotomy. A pair of surgical Kocher clamps was retrieved buried in the mesentery.

  10. ANAESTHETIC MANAGEMENT OF A GERIATRIC PATIENT WITH PARKINSON`S DISEASE AND DIABETES MELLITUS POSTED FOR EMERGENCY LAPAROTOMY

    Directory of Open Access Journals (Sweden)

    Prajwal Patel

    2014-10-01

    Full Text Available Parkinson's disease (PD, one of the most common disabling neurological diseases, affects about 1% of the population over 60 years of age. It is a degenerative disease of the central nervous system caused by the loss of dopaminergic fibers in basal ganglia of the brain. PD is an important cause of perioperative morbidity and with an increasingly elderly population; it is being encountered with greater frequency in surgical patients. Here we report a case of 79year old male with Parkinsonism and diabetes mellitus posted for emergency laparotomy, which we managed successfully with general anesthesia.

  11. Intra-abdominal pressure and possible ways of its drug correction after emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Людмила Василівна Новицька-Усенко

    2015-11-01

    Full Text Available Introduction. Postoperative disorders of gastrointestinal tract (GIT motility are often after abdominal operations. Postoperative enteroparesis is usually accompanied by the raise of intra-abdominal pressure (IAP.Materials and methods. After approval of research by bioethics committee and informed consent 52 patients were prospectively divided in 2 groups depending on the type of postoperative intensive care. Patients underwent operations on abdominal cavity by laparotomy incision on the subject of peritonitis. Patient of the 1 (control group (n=27 after operation received stimulation of GIT with metoclopramide and simethicone.  In the 2 group (n=25 patients received metoclopramide and simethicone. Patients were comparable on age, sex, concomitant pathology, ASA class (IIE-IIIE and the type of operative intervention (laparotomy on the subject of peritonitis. IAP level was studied before operation and at 1,2,3 days after it. IAP was measured by indirect method trough the urinary bladder. The values recommended by the World society of abdominal compartment syndrome were considered as the normal IAP level.  Perfuse pressure (PP in abdominal cavity was calculated by formula: PP=MAP-ICP where MAP – mean arterial pressure. There were also studied indices of the central and peripheral hemodynamics, inflammation markers (leukocytes, fibrinogen level, IL-1α, TNFα, IL-10, leukocytic index of intoxication was calculated. The final point of research was 28 day after operation when we evaluated mortality and life quality on Rancho Los Amigos scale.Results and discussion. We registered the raise of IAP in 63.1% of patients. The value of intra-abdominal pressure exceeded an upper limit of the normal one by 58,5% (р <0,001. Among patients with high IAP 83% had intra-abdominal hypertension (IAH of 1 degree, 17% - of 2 degree.  The development of 3 and 4degree IAH were not observed before operation. PP remained within the normal.Correlative analysis

  12. Anesthetic management of a neonate with arthrogryposis multiplex congenita for emergency laparotomy

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    Rajat Chowdhuri

    2011-01-01

    Full Text Available Arthrogryposis multiplex congenita is a rare disease, characterized by non-progressive, multiple joint contractures since birth. Anesthetic issues include difficult intravenous access, difficult airway management and regional anesthesia. We report the anesthetic management of a six-day-old neonate presenting to the emergency with features of intestinal obstruction, who was detected for the first time to have arthrogryposis multiplex congenita. General anesthesia along with caudal analgesia for peroperative and postoperative pain relief was used. There was an episode of intraoperative hyperthermia, which was tackled successfully. The child had an uneventful post-anesthesia recovery.

  13. Posterior reversible encephalopathy syndrome following an inadvertent dural puncture during an emergency laparotomy for ischemic colitis – a case report

    Directory of Open Access Journals (Sweden)

    Shah R

    2014-01-01

    Full Text Available Reena Shah, Agnieszka Kubisz-Pudelko, Jeremy Reid Yeovil District Hospital, Yeovil, UK Abstract: Posterior reversible encephalopathy syndrome (PRES is a clinico-neuroradiological syndrome characterized by various symptoms of neurological disease. It has commonly been reported in association with acute hypertension, pre-eclampsia, eclampsia, sepsis, and exposure to immunosuppressants. Here, we report on a normotensive woman who developed a severe frontal headache, visual disturbances, and hypertension 3 days after undergoing an emergency laparotomy for ischemic colitis during which she suffered an inadvertent dural puncture. Neuro-imaging revealed features consistent with PRES. The patient went on to make a good recovery, being discharged 21 days postoperatively, with only minor visual disturbances and memory problems. This case highlights the importance of awareness of PRES to all specialties. On reviewing the literature, we feel that PRES may be a potential differential diagnosis to post-procedural neurological symptoms in those patients undergoing routine procedures such as spinal anesthetics or lumbar punctures. Keywords: PRES, neurological disease, lumbar puncture, spinal anesthetic

  14. EMERGENCY LAPAROTOMY AND DEATH IN ECTOPIC PREGNANCY: A RARITY NOWADAYS? A DESCRIPTIVE STUDY OF ECTOPIC PREGNANCY CASES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Suja Mary

    2015-02-01

    Full Text Available Pregnancy implanted outside the endometrial cavity constitutes ectopic gestation. The reproductive performance can be poor following an ectopic pregnancy. The purpose of the study is to emphasize the importance of public awareness about the need for early reporting to hospital in doubtful cases, to analyze the risk factors for ectopic, to study the role of βHCG estimation and transvaginal sonography in early detection in order to preserve the fallopian tube by medical therapy and/or to do early elective surgery preventing emergency laparotomy and death from ectopic pregnancy. METHODOLOGY: All cases of ectopic gestations managed in a tertiary care hospital for a period of one year is reviewed, roughly around 70 cases. The objectives were to analyze demographic characteristics, risk factors, methods of diagnosis and to evaluate the protocol for ectopic management in the hospital. RESULTS: The study showed that the maximum number of ectopic was seen in the 26 - 30 age group and more commonly among multies. Maximum number of ectopic cases is seen between 5.1 to 6 weeks and 80% of the cases are seen in ≤8 weeks. 42/70 patients showed one or more risk factors like previous history of ectopic, LSCS, infertility treatment, sterilization and use of IUCD.82.9% patients presented either with pain alone or pain along with spotting/bleeding p/v. Earlier, majority of the cases were reported after tubal rupture resulting in shock, which sometimes even lead to death. In the present scenario, however, only 2 patients developed hypotension, 11 out of 70 alone required blood transfusion and none required laparotomy. Majority of cases of unruptured ectopic (83% showed <66% rise in βHCG in 48 hours. Pelvic ultrasound and serum βHCG estimation has revolutionized the diagnostic proce ss of ectopic pregnancy enabling detection in the unruptured stage itself in 50% of the cases and the rest in early stages of rupture. In most cases, medical line of management with

  15. Abbreviations in Maritime English

    Science.gov (United States)

    Yang, Zhirong

    2011-01-01

    Aiming at the phenomena that more and more abbreviations occur in maritime English correspondences, the composing laws of the abbreviations in maritime English correspondence are analyzed, and the correct methods to answer the abbreviations are pointed out, and the translation method of abbreviations are summarized in this article, and the…

  16. Early laparotomy after lung transplantation

    DEFF Research Database (Denmark)

    Bredahl, Pia; Zemtsovski, Mikhail; Perch, Michael;

    2014-01-01

    BACKGROUND: Gastrointestinal complications after lung transplantation have been reported with incidence rates ranging from 3% to 51%, but the reasons are poorly understood. We aimed to investigate the correlations between pulmonary diseases leading to lung transplantation and early gastrointestinal...... complications requiring laparotomy after transplantation with outcomes for patients at increased risk. METHODS: In this study we performed a retrospective analysis of data of patients who underwent lung transplantation at our institution from 2004 to 2012. The study period was limited to the first 90 days after...... for time on mechanical ventilation. Among pulmonary diseases and demographics of the patients, no other risk factors were identified for laparotomy. CONCLUSIONS: A1AD was the only significant risk factor identified for gastrointestinal complications that required laparotomy within 3 months after lung...

  17. FDA Acronyms and Abbreviations

    Data.gov (United States)

    U.S. Department of Health & Human Services — The FDA Acronyms and Abbreviations database provides a quick reference to acronyms and abbreviations related to Food and Drug Administration (FDA) activities

  18. Acute Abdomen; Pre and Post-Laparotomy Diagnosis

    Directory of Open Access Journals (Sweden)

    Marjan Laal

    2009-07-01

    Full Text Available Background: Abdominal pain is a common presentation that requires almost immediate management. It is sometimes crucial to diagnose at the earliest and make a decision as to operate. Therefore it is necessary for the physician to be familiar both with the presentations of common causes of abdominal pain and the validity of diagnostic tests.  Diagnosis of acute abdomen before laparotomy is essential in reducing the morbidity and mortality while preventing from unnecessary operations especially where the diagnostic facilities are limited and clinical awareness plays an important role in the diagnosis and management. Objectives: This study attempted to compare pre and post-operative diagnosis in acute abdomen.Materials & Methods: This was an observational study, conducted from February to December 2005. The study included 139 consecutive patients referred to Sina hospital (Tehran, Iran presented with symptoms of acute abdomen, operated to see the negative laparotomy rate, the diagnostic accuracy and predictive values of different investigations in acute abdomen. Statistical analysis was performed using SPSS software version 11.5. P value of Results: All 139 patients with diagnosis of acute abdomen underwent emergency laparotomy. Acute abdomen was most common in the age group 20-29 years with male predominance. Acute appendicitis (57.6% was the most common cause of surgical condition, and then the most common causes of acute abdomen were peritonitis (14.4% and bowel obstruction (7.9% in male and ovarian cyst torsion (24.5% in female patients. The negative laparotomy rate was 12.2% (P value Conclusion: The decision to operate is based on the results of a good history and thorough physical examination(s with the guidance of investigative tools. Diagnostic modalities could guide the physician in confirming the diagnosis. An accurate diagnosis of acute abdomen can avoid from unnecessary operations so reduces the rate of negative laparotomies.

  19. The clinical analysis of the risk factor of convertion from emergency laparoscopic cholecystectomy to laparotomy%急症腹腔镜胆囊切除术中转开腹危险因素的分析

    Institute of Scientific and Technical Information of China (English)

    张立明

    2011-01-01

    time of cholecystitis, gallbladder triangle anatomical levels, gallbladder wall thickness, gallstone incarceration and gangrenous cholecystitis were extracted as the five factors. With Stata 10.0 statistical analysis software, single factor analysis was made to identify the risk factor of emergency LC convertion to open surgery, multiple logistic regression equation of factor analysis was made to predict the possibility of emergency laparoscopic cholecystectomy convertion to open operation and evaluate the effi ciency. Results: One hundred and twenty cases underwent emergency LC, of which 38 cases were converted to open cholecystectomy, conversion rate was 31.67%. Univariate analysis showed that cholecystitis attack > 72h, gallbladder triangle indistinct anatomy, gallbladder wall thickness > 0.5cm and gangrenous cholecystitis were correlate risk factor of LC conversion to open surgery. Logistic regression analysis showed that cholecystitis attack > 72h, gallbladder triangle indistinct anatomy, gallbladder wall thickness > 0.5cm and gangrenous cholecystitis were risk factors of LC convertion to open surgery. Logistic regression equation showed predictive efficiency was 0.9519. Conclusions: Cholecystitis attack > 72h, gallbladder triangle indistinct anatomy, gallbladder wall thickness > 0.5 cm, gangrenous cholecystitis are risk factors of conlversion to laparotomy. LC patients has the more risk factors,the difficulty of operation is greater, the possibility of conversion to open surgery is higher. Preoperative comprehensive evaluation of risk factor is significant for choosing operative method and decreasing conversion rate, can avoid serious complications of LC.

  20. Decompressive laparotomy for abdominal compartment syndrome

    Science.gov (United States)

    Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.

    2016-01-01

    Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380

  1. Deciphering Journal Abbreviations with JAbbr

    OpenAIRE

    Keith Jenkins

    2009-01-01

    JAbbr is an online tool developed at Cornell University to help users decipher journal title abbreviations. This article discusses why these abbreviations are so problematic, and how traditional tools are often insufficient, and then describes the novel approach used by JAbbr. Given an abbreviation, JAbbr creates a regular expression for fuzzy matching, tests it against a list of serial titles extracted from the library catalog, and returns a list of possible matches to the user. JAbbr is ava...

  2. [Giant appendiceal mucocele during laparotomy for acute abdomen. Report of a case and brief review].

    Science.gov (United States)

    Caiazzo, P; Comentale, A; Rampone, B; Di Lascio, P; Morlino, A; Pastore, M; Del Vecchio, G; Tramutoli, P R

    2010-01-01

    The authors describe a case of giant appendiceal mucocele, secondary to a mucinous neoplasm of the appendix, diagnosed during laparotomy for acute abdomen. By a review of the literature they stress the rarity of this lesion, the particular onset in their case as acute complication of appendiceal neoplasm with rupture of the intestinal wall, the difficulties of diagnosis and management in emergency.

  3. Closed-suction drain placement at laparotomy in isolated solid organ injury is not associated with decreased risk of deep surgical site infection.

    Science.gov (United States)

    Mohseni, Shahin; Talving, Peep; Kobayashi, Leslie; Kim, Dennis; Inaba, Kenji; Lam, Lydia; Chan, Linda S; Coimbra, Raul; Demetriades, Demetrios

    2012-10-01

    The purpose of this study was to investigate the role of intra-abdominal closed-suction drainage after emergent trauma laparotomy for isolated solid organ injuries (iSOI) and to determine its association with deep surgical site infections (DSSI). All patients subjected to trauma laparotomy between January 2006 and December 2008 for an iSOI at two Level I urban trauma centers were identified. Patients with isolated hepatic, splenic, or renal injuries were included. Study variables extracted included demographics, clinical characteristics, intra-abdominal injuries, drain placement, DSSI, septic events, intensive care unit and hospital length of stay, and in-hospital mortality. Diagnosis of DSSI was based on abdominal computed tomography scan demonstrating an intra-abdominal collection combined with fever and elevated white blood cell count. For the analysis, patients were stratified based on injury severity. To identify an independent association between closed-suction drain placement and DSSI, stepwise logistic regression analysis was performed. Overall, 142 patients met the inclusion criteria with 80 per cent (n=114) having severe iSOI. In 47 per cent (n=53) of the patients with a severe injury, an intra-abdominal drain was placed. A drain was placed more often in patients with a blunt trauma with more severe injury defined by Injury Severity Score and abdominal Abbreviated Injury Scale Score and those who underwent splenectomy (Pdrain placement (odds ratio, 2.8; 95% confidence interval, 1.0 to 8.2; P=0.046). Subgroup analysis demonstrated those who sustained severe hepatic injury receiving a drain had a significantly increase risk of DSSI (P=0.02). There was no statistical difference in the rate of DSSI based on the presence or absence of an intra-abdominal drain after severe splenic injury (17 vs 18%, P=0.88). The use of intra-abdominal closed-suction drains after iSOI is not associated with decreased risk of DSSI.

  4. Decompressive Abdominal Laparotomy for Abdominal Compartment Syndrome in an Unengrafted Bone Marrow Recipient with Septic Shock

    Directory of Open Access Journals (Sweden)

    Derrick J. N. Dauplaise

    2010-01-01

    Full Text Available Objective. To describe a profoundly immunocompromised (panleukopenia child with septic shock who developed abdominal compartment syndrome (ACS and was successfully treated with surgical decompression. Design. Individual case report. Setting. Pediatric intensive care unit of a tertiary children's hospital. Patient. A 32-month-old male with Fanconi anemia who underwent bone marrow transplantation (BMT 5 days prior to developing septic shock secondary to Streptococcus viridans and Escherichia coli ACS developed after massive fluid resuscitation, leading to cardiopulmonary instability. Interventions. Emergent surgical bedside laparotomy and silo placement. Measurements and Main Results. The patient's cardiopulmonary status stabilized after decompressive laparotomy. The abdomen was closed and the patient survived to hospital discharge without cardiac, respiratory, or renal dysfunction. Conclusions. The use of laparotomy and silo placement in an unengrafted BMT patient with ACS and septic shock did not result in additional complications. Surgical intervention for ACS is a reasonable option for high risk, profoundly immunocompromised patients.

  5. Deciphering Journal Abbreviations with JAbbr

    Directory of Open Access Journals (Sweden)

    Keith Jenkins

    2009-06-01

    Full Text Available JAbbr is an online tool developed at Cornell University to help users decipher journal title abbreviations. This article discusses why these abbreviations are so problematic, and how traditional tools are often insufficient, and then describes the novel approach used by JAbbr. Given an abbreviation, JAbbr creates a regular expression for fuzzy matching, tests it against a list of serial titles extracted from the library catalog, and returns a list of possible matches to the user. JAbbr is available as a web site and as a web service.

  6. Global change: Acronyms and abbreviations

    Energy Technology Data Exchange (ETDEWEB)

    Woodard, C.T. [Oak Ridge National Lab., TN (United States); Stoss, F.W. [Univ. of Tennessee, Knoxville, TN (United States). Energy, Environment and Resources Center

    1995-05-01

    This list of acronyms and abbreviations is compiled to provide the user with a ready reference to dicipher the linguistic initialisms and abridgements for the study of global change. The terms included in this first edition were selected from a wide variety of sources: technical reports, policy documents, global change program announcements, newsletters, and other periodicals. The disciplinary interests covered by this document include agriculture, atmospheric science, ecology, environmental science, oceanography, policy science, and other fields. In addition to its availability in hard copy, the list of acronyms and abbreviations is available in DOS-formatted diskettes and through CDIAC`s anonymous File Transfer Protocol (FTP) area on the Internet.

  7. Will Banning Foreign Abbreviations Help?

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    @@ From early April, China's national broad-caster CCTV banned the use of borrowed English abbreviations such as NBA, GDP, WTO and CPI in all its programs. The move was launched in line with a government directive after several national legislators and political advisors called for the preservation of the Chinese language's purity.

  8. Evaluating clinical abdominal scoring system in predict- ing the necessity of laparotomy in blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Erfantalab-Avini Peyman

    2011-06-01

    Full Text Available 【Abstract】 Objectives: Trauma is among the lead- ing causes of death. Medical management of blunt abdomi- nal trauma (BAT relies on judging patients for whom lap- arotomy is mandatory. This study aimed to determine BAT patients’ signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system (CASS, a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not. Methods: Totally 400 patients suspected of BAT that arrived at the emergency department of two university hos- pitals in Tehran from March 20, 2007 to March 19, 2009 were included in this study. They were evaluated for age, sex, type of trauma, systolic blood pressure, Glasgow coma scale (GCS, pulse rate, time of presentation after trauma, abdomi- nal clinical findings, respiratory rate, temperature, hemoglo- bin (Hb concentration, focused abdominal sonography in trauma (FAST and CASS. Results: Our measurements showed that CASS had an accuracy of 94%, sensitivity of 100%, specificity of 88%, positive predictive value of 90% and negative predictive value of 100% in determining the necessity of laparotomy in BAT patients. Moreover, in our analysis, systolic blood pressure, GCS, pulse rate, Hb concentration, time of presen- tation after trauma, abdominal clinical findings and FAST were also shown to be helpful in confirming the need for laparotomy (P<0.05. Conclusion: CASS is a promising scoring system in rapid detection of the need for laparotomy as well as in minimizing auxiliary expense for further evaluation in BAT patients, thus to promote the cost-benefit ratio and accu- racy of diagnosis. Key words: Abdominal injuries; Laparotomy; Patients; Wounds, nonpenetrating

  9. Evaluating clinical abdominal scoring system in predicting the necessity of laparotomy in blunt abdominal trauma

    Institute of Scientific and Technical Information of China (English)

    Peyman Erfantalab-Avini; Nima Hafezi-Nejad; Mojtaba Chardoli; Vafa Rahimi-Movaghar

    2011-01-01

    Objectives: Trauma is among the leading causes of death. Medical management of blunt abdominal trauma (BAT) relies on judging patients for whom laparotomy is mandatory. This study aimed to determine BAT patients' signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system (CASS), a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not.Methods: Totally 400 patients suspected of BAT that arrived at the emergency department of two university hospitals in Tehran from March 20, 2007 to March 19, 2009 were included in this study. They were evaluated for age, sex,type of trauma, systolic blood pressure, Glasgow coma scale (GCS), pulse rate, time of presentation after trauma, abdominal clinical findings, respiratory rate, temperature, hemoglobin (Hb) concentration, focused abdominal sonography in trauma (FAST) and CASS.Results: Our measurements showed that CASS had an accuracy of 94%, sensitivity of 100%, specificity of 88%,positive predictive value of 90% and negative predictive value of 100% in determining the necessity of laparotomy in BAT patients. Moreover, in our analysis, systolic blood pressure, GCS, pulse rate, Hb concentration, time of presentation after trauma, abdominal clinical findings and FAST were also shown to be helpful in confirming the need for laparotomy (P<0.05).Conclusion: CASS is a promising scoring system in rapid detection of the need for laparotomy as well as in minimizing auxiliary expense for further evaluation in BAT patients, thus to promote the cost-benefit ratio and accuracy of diagnosis.

  10. Classification and Translation of Chinese Abbreviations

    Institute of Scientific and Technical Information of China (English)

    郭颖婷

    2014-01-01

    Chinese abbreviation, containing fewer words and delivering a wealth of information, is a vital component of Chinese language. But the tremendous differences between Chinese and English make it an arduous task to translate Chinese abbreviations into English. Based on the analyses of the structure and patterns of word-formation of Chinese abbreviations, it makes a classifi-cation of Chinese abbreviations, summarize the translation methods, and point out some attention points in translation. A system-atic analysis on the structure and classification of Chinese abbreviations will be beneficial to reduce the mistakes in its translation.

  11. Neuromuscular blockade for improvement of surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Scheppan, Susanne; Kissmeyer-Nielsen, Peter

    2015-01-01

    INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep neuromus......INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep...

  12. Abbreviations

    OpenAIRE

    2014-01-01

    CBA Cost-Benefit Analysis CBD Convention on Biological Diversity CGAPS Coordinating Group on Alien Pest Species CITES Convention on International Trade in Endangered Species of Wild Fauna and Flora CRC Cooperative Research Center for Australian Weed Management DAE Direction des affaires économiques, New Caledonia DAVAR Direction des affaires vétérinaire, alimentaire et rurale, New Caledonia DDE-E Direction du développement économique et de l’environnement, New Caledonia. DDR Direction du déve...

  13. Abbreviations

    OpenAIRE

    2013-01-01

    "AB" The official French logo for certified organic produce ("Agriculture Biologique") CF Conventional farming EF Ecological farming IFS Integrated farming systems LIF Low-input farming OF Organic farming OFgc Organic farming under group certification AFSAA Agence Française de Sécurité Sanitaire des Aliments (French food safety agency) AMAP Association pour le Maintien d'une Agriculture Paysanne (Association for the maintenance of small-scale farming – there is a network of such associations ...

  14. Acronyms, initialisms, and abbreviations: Fourth Revision

    Energy Technology Data Exchange (ETDEWEB)

    Tolman, B.J. [comp.

    1994-04-01

    This document lists acronyms used in technical writing. The immense list is supplemented by an appendix containing chemical elements, classified information access, common abbreviations used for functions, conversion factors for selected SI units, a flowcharting template, greek alphabet, metrix terminology, proofreader`s marks, signs and symbols, and state abbreviations.

  15. Myasthenia Revealed Following Laparotomy - A Case Report

    Directory of Open Access Journals (Sweden)

    Abdelilah GHANNAM

    2015-06-01

    Full Text Available Myasthenia (muscle weakness is a rare neuromuscular disease of which respiratory failure is the main complication. The accidental discovery of such disease in the perioperative period is rare and potentially serious.We report a case of a woman who underwent emergency operation for appendiceal peritonitis, and failed repeatedly at weaning from postoperative mechanical ventilation. The usual etiologies such as postoperative respiratory complications, ventilator-associated pneumonia, acute respiratory distress syndrome complicating the septic shock or having no impact on it, and neuromyopathy’s resuscitation were considered, researched, examined or eliminated.Faced with the diagnostic impasse and the obvious weaning failure, another interview revealed signs of muscle fatigue which led to the diagnosis of myasthenia gravis decompensated perioperatively. Once the diagnosis was confirmed by means of a neostigmine test, the specific treatment began, particularly through plasma exchange sessions, and the process of weaning resumed. The result was complete weaning. A three-month follow-up showed a stable patient with no significant muscular disability.

  16. 40 CFR 600.403-77 - Abbreviations.

    Science.gov (United States)

    2010-07-01

    ... ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy Regulations for 1977 and Later Model Year Automobiles-Dealer Availability of Fuel Economy Information § 600.403-77 Abbreviations....

  17. Comparative Evaluation of Midventral and Flank Laparotomy Approaches in Goat

    Directory of Open Access Journals (Sweden)

    A. A. Abubakar

    2014-01-01

    Full Text Available The aim of the study was to compare two laparotomy approaches (flank and midventral. Ten (n=10 apparently healthy goats of different breeds and sex, average age of 12±2.1 months, and average weight of 13.4±2 kg were used for the investigation. The goats were randomly divided into flank and midventral groups, each group comprising five goats (n=5. Standard aseptic laparotomy was performed under lumbosacral epidural anaesthesia with mild sedation. Postsurgical wound score showed significant difference (P<0.05 in erythema at 18–24 hours and 10–14 days after surgery between the two approaches; significant difference of dehiscence between the two groups was also recorded at 10–14 days after surgery. Total white blood cells (WBC and lymphocytes counts were significantly different (P<0.05 at the first and second week after surgery. There was significant difference of platelets critical value and platelets dimension width at the first and second week after surgery. Significant difference of packed cells volume between the two approaches was also recorded one week after surgery. It was concluded that midventral laparotomy approach can be conveniently and safely performed under aseptic precautions without fear of intra- and postoperative clinical problems.

  18. Management of Ovarian Dermoid Cysts by Laparoscopy Compared With Laparotomy

    Directory of Open Access Journals (Sweden)

    Pang Liyi

    1996-01-01

    Full Text Available Thirty patients with ovarian dermoid cysts removed by laparoscopic surgery were compared with 42 patients with ovarian dermoid cysts removed by laparotomy, with respect to the selection criteria, surgical procedures, operating time, intraoperative and postoperative complications, blood loss, and hospital stay. Although the operating time for unilateral cystectomy, unilateral salpingo-oophorectomy, and bilateral cystectomy performed by laparoscopic surgery was longer (120.3 ± 43.7 min, mean ± SD than those for the same procedures performed by laparotomy (73.9 ± 21.6 min, p < 0.01, we observed a learning curve with a remarkable declining tendency (linear regression model, p < 0.01. At the end of this study, the times taken for laparoscopic procedures were almost the same as those for laparotomy. Less blood loss (18.2 ± 1.7 ml versus 105.9 ± 84.3 ml, p < 0.01 and shorter hospital stay (5.9 ± 1.9 days versus 12.0 ± 2.9 days, p < 0.01 were also found to be advantages of laparoscopic surgery. This article discusses the technical procedures of laparoscopic surgery. The efficiency and safety of operative laparoscopy as an alternative access route for the management of ovarian dermoid cysts were recognized. We stress that strict criteria for selection of patients should always be followed and the necessity of retraining schedules for gynecologists and nursing staff in the speciality of laparoscopic surgery.

  19. A novel abbreviation standard for organobromine, organochlorine and organophosphorus flame retardants and some characteristics of the chemicals

    Science.gov (United States)

    Bergman, Åke; Rydén, Andreas; Law, Robin J.; de Boer, Jacob; Covaci, Adrian; Alaee, Mehran; Birnbaum, Linda; Petreas, Myrto; Rose, Martin; Sakai, Shinichi; Van den Eede, Nele; van der Veen, Ike

    2012-01-01

    Ever since the interest in organic environmental contaminants first emerged 50 years ago, there has been a need to present discussion of such chemicals and their transformation products using simple abbreviations so as to avoid the repetitive use of long chemical names. As the number of chemicals of concern has increased, the number of abbreviations has also increased dramatically, sometimes resulting in the use of different abbreviations for the same chemical. In this article, we propose abbreviations for flame retardants (FRs) substituted with bromine or chlorine atoms or including a functional group containing phosphorus, i.e. BFRs, CFRs and PFRs, respectively. Due to the large number of halogenated and organophosphorus FRs, it has become increasingly important to develop a strategy for abbreviating the chemical names of FRs. In this paper, a two step procedure is proposed for deriving practical abbreviations (PRABs) for the chemicals discussed. In the first step, structural abbreviations (STABs) are developed using specific STAB criteria based on the FR structure. However, since several of the derived STABs are complicated and long, we propose instead the use of PRABs. These are, commonly, an extract of the most essential part of the STAB, while also considering abbreviations previously used in the literature. We indicate how these can be used to develop an abbreviation that can be generally accepted by scientists and other professionals involved in FR related work. Tables with PRABs and STABs for BFRs, CFRs and PFRs are presented, including CAS (Chemical Abstract Service) numbers, notes of abbreviations that have been used previously, CA (Chemical Abstract) name, common names and trade names, as well as some fundamental physico-chemical constants. PMID:22982223

  20. A novel abbreviation standard for organobromine, organochlorine and organophosphorus flame retardants and some characteristics of the chemicals.

    Science.gov (United States)

    Bergman, Ake; Rydén, Andreas; Law, Robin J; de Boer, Jacob; Covaci, Adrian; Alaee, Mehran; Birnbaum, Linda; Petreas, Myrto; Rose, Martin; Sakai, Shinichi; Van den Eede, Nele; van der Veen, Ike

    2012-11-15

    Ever since the interest in organic environmental contaminants first emerged 50years ago, there has been a need to present discussion of such chemicals and their transformation products using simple abbreviations so as to avoid the repetitive use of long chemical names. As the number of chemicals of concern has increased, the number of abbreviations has also increased dramatically, sometimes resulting in the use of different abbreviations for the same chemical. In this article, we propose abbreviations for flame retardants (FRs) substituted with bromine or chlorine atoms or including a functional group containing phosphorus, i.e. BFRs, CFRs and PFRs, respectively. Due to the large number of halogenated and organophosphorus FRs, it has become increasingly important to develop a strategy for abbreviating the chemical names of FRs. In this paper, a two step procedure is proposed for deriving practical abbreviations (PRABs) for the chemicals discussed. In the first step, structural abbreviations (STABs) are developed using specific STAB criteria based on the FR structure. However, since several of the derived STABs are complicated and long, we propose instead the use of PRABs. These are, commonly, an extract of the most essential part of the STAB, while also considering abbreviations previously used in the literature. We indicate how these can be used to develop an abbreviation that can be generally accepted by scientists and other professionals involved in FR related work. Tables with PRABs and STABs for BFRs, CFRs and PFRs are presented, including CAS (Chemical Abstract Service) numbers, notes of abbreviations that have been used previously, CA (Chemical Abstract) name, common names and trade names, as well as some fundamental physico-chemical constants.

  1. The association of perioperative dexamethasone, smoking and alcohol abuse with wound complications after laparotomy

    DEFF Research Database (Denmark)

    Dahl, Rikke M; Wetterslev, Jørn; Jorgensen, Lars N;

    2014-01-01

    perioperative administration of dexamethasone, pre-operative smoking or alcohol abuse is, however, uncertain. METHODS: This study was a post hoc analysis of data from the PROXI randomized trial in 1386 patients who underwent emergency or elective laparotomy. We assessed the associations of use of dexamethasone......, smoking status and alcohol abuse with the primary outcome, being a composite of SSI, anastomotic leak, wound dehiscence, burst abdomen and 30-day mortality. RESULTS: The primary outcome occurred in 21% of patients receiving dexamethasone versus 28% of patients not receiving dexamethasone...... abdomen (3.8% vs 2.4%, P = 0.04). In alcohol abusers, the primary outcome occurred in 48%, compared with 25% in patients who did not abuse alcohol (P = 0.0006). Burst abdomen occurred more commonly in alcohol abusers (15% vs 2.3%, P 

  2. MBA: a literature mining system for extracting biomedical abbreviations

    Directory of Open Access Journals (Sweden)

    Lei YiMing

    2009-01-01

    Full Text Available Abstract Background The exploding growth of the biomedical literature presents many challenges for biological researchers. One such challenge is from the use of a great deal of abbreviations. Extracting abbreviations and their definitions accurately is very helpful to biologists and also facilitates biomedical text analysis. Existing approaches fall into four broad categories: rule based, machine learning based, text alignment based and statistically based. State of the art methods either focus exclusively on acronym-type abbreviations, or could not recognize rare abbreviations. We propose a systematic method to extract abbreviations effectively. At first a scoring method is used to classify the abbreviations into acronym-type and non-acronym-type abbreviations, and then their corresponding definitions are identified by two different methods: text alignment algorithm for the former, statistical method for the latter. Results A literature mining system MBA was constructed to extract both acronym-type and non-acronym-type abbreviations. An abbreviation-tagged literature corpus, called Medstract gold standard corpus, was used to evaluate the system. MBA achieved a recall of 88% at the precision of 91% on the Medstract gold-standard EVALUATION Corpus. Conclusion We present a new literature mining system MBA for extracting biomedical abbreviations. Our evaluation demonstrates that the MBA system performs better than the others. It can identify the definition of not only acronym-type abbreviations including a little irregular acronym-type abbreviations (e.g., , but also non-acronym-type abbreviations (e.g., .

  3. 40 CFR 86.203-94 - Abbreviations.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.203-94 Section 86.203-94 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Later Model Year Gasoline-Fueled New Light-Duty Vehicles, New Light-Duty Trucks and New...

  4. The stylistic coloring of abbreviation in Business English

    Institute of Scientific and Technical Information of China (English)

    李美玲

    2011-01-01

    It is obvious to apply different vocabulary in various styles. As application of vocabulary becomes more, the distinct stylistic coloring is forming gradually. In this paper, it studies the definitions, structures, features ,of abbreviation in Business English. After that, it summarizes the stylistic coloring of abbreviation in Business English, and proves the necessity and importance to study abbreviation in Business English.

  5. Abdominal injury patterns in patients with seatbelt signs requiring laparotomy

    Directory of Open Access Journals (Sweden)

    Seema Biswas

    2014-01-01

    Full Text Available Aims: We analyzed our series of patients with seatbelt signs (bruising that underwent laparotomy in order to correlate injury pattern with clinical course and outcome. Materials and Methods: Retrospective analysis of patients with seatbelt signs presenting to the level 1 Trauma Unit between 2005 and 2010 was performed. We evaluated the nature of injuries during laparotomy associated with seatbelt signs and their treatment and complications. Results: There were 41 patients, 25 (61% male, with a median age of 26 years. Median injury severity score (ISS was 25 (range 6-66 and overall mortality was 10% (four patients. Patients were classified into three groups according to time from injury to surgery. Median time to surgery for the immediate group (n = 12 was 1.05 h, early group (n = 22 was 2.7 h, and delayed group (n = 7 was 19.5 h. Patients in the immediate group tended to have solid organ injuries; whereas, patients in the delayed group had bowel injury. Patients with solid organ injuries were found to be more seriously injured and had higher mortality (P < 0.01 and morbidity compared with patients with the "classic" bowel injury pattern associated with a typical seatbelt sign. Conclusion: Our data suggest that there is a cohort of patients with seatbelt injury who have solid organ injury requiring urgent intervention. Solid organ injuries associated with malpositioned seatbelts lying higher on the abdomen tend to result in hemodynamic instability necessitating immediate surgery. They have more postoperative complications and a greater mortality. Seatbelt signs should be accurately documented after any car crash.

  6. Predictive Potential of Heart Rate Complexity Measurement: An Indication for Laparotomy Following Solid Organ Injury

    Directory of Open Access Journals (Sweden)

    Foroutan

    2015-11-01

    Full Text Available Background Nonlinear analysis of heart rate variability (HRV has been recently used as a predictor of prognosis in trauma patients. Objectives We applied nonlinear analysis of HRV in patients with blunt trauma and intraperitoneal bleeding to assess our ability to predict the outcome of conservative management. Patients and Methods An analysis of electrocardiography (ECG from 120 patients with blunt trauma was conducted at the onset of admission to the emergency department. ECGs of 65 patients were excluded due to inadequacy of noise-free length. Of the remaining 55 patients, 47 survived (S group and eight patients died in the hospital (Non-S group. Nineteen patients were found to have intra-abdominal bleeding, eight of which ultimately underwent laparotomy to control bleeding (Op group and 11 underwent successful non-operative management (non-Op. Demographic data including vital signs, glasgow coma scale (GCS, arterial blood gas and injury severity scores (ISS were recorded. Heart rate complexity (HRC methods, including entropy, were used to analyze the ECG. Results There were no differences in age, gender, heart rate (HR and blood pressure between the S and Non-S groups. However, approximate entropy, used as a method of HRC measurement, and GCS were significantly higher in S group, compared to the Non-S group. The base deficit and ISS were significantly higher in the Non-S group. Regarding age, sex, ISS, base deficit, vital signs and GCS, no difference was found between Op and Non-Op groups. Approximate entropy was significantly lower in the Op group, compared to the Non-Op group. Conclusions The loss of HRC at the onset of admission may predict mortality in patients with blunt trauma. Lower entropy, in recently admitted patients with intra-abdominal bleeding, may indicate laparotomy when the vital signs are stable.

  7. Nasogastric intubation causes gastroesophageal reflux in patients undergoing elective laparotomy.

    LENUS (Irish Health Repository)

    Manning, B J

    2012-02-03

    BACKGROUND: The routine use of nasogastric tubes in patients undergoing elective abdominal operation is associated with an increased incidence of postoperative fever, atelectasis, and pneumonia. Previous studies have shown that nasogastric tubes have no significant effect on the incidence of gastroesophageal reflux or on lower esophageal sphincter pressure in healthy volunteers. We hypothesized that nasogastric intubation in patients undergoing laparotomy reduces lower esophageal sphincter pressure and promotes gastroesophageal reflux in the perioperative period. METHODS: A prospective randomized case-control study was undertaken in which 15 consenting patients, admitted electively for bowel surgery, were randomized into 2 groups. Group 1 underwent nasogastric intubation after induction of anesthesia, and Group 2 did not. All patients had manometry and pH probes placed with the aid of endoscopic vision at the lower esophageal sphincter and distal esophagus, respectively. Nasogastric tubes, where present, were left on free drainage, and sphincter pressures and pH were recorded continuously during a 24-hour period. Data were analyzed with 1-way analysis of variance. RESULTS: The mean number of reflux episodes (defined as pH < 4) in the nasogastric tube group was 137 compared with a median of 8 episodes in the group managed without nasogastric tubes (P =.006). The median duration of the longest episode of reflux was 132 minutes in Group 1 and 1 minute in Group 2 (P =.001). A mean of 13.3 episodes of reflux lasted longer than 5 minutes in Group 1, with pH less than 4 for 37.4% of the 24 hours. This was in contrast to Group 2 where a mean of 0.13 episodes lasted longer than 5 minutes (P =.001) and pH less than 4 for 0.2% of total time (P =.001). The mean lower esophageal sphincter pressures were lower in Group 1. CONCLUSIONS. These findings demonstrate that patients undergoing elective laparotomy with routine nasogastric tube placement have significant gastroesophageal

  8. Abbreviated guide pneumatic conveying design guide

    CERN Document Server

    Mills, David

    1990-01-01

    Abbreviated Guide: Pneumatic Conveying Design Guide describes the selection, design, and specification of conventional pneumatic conveying systems. The design procedure uses previous test data on the materials to be conveyed. The book also discusses system economics, operating costs, the choice of appropriate components or systems, system control, and system flexibility. The design system involves the type of conveying system for installation, the pipeline parameters, and also the plant components. System selection covers the properties of the material to be conveyed, plant layout, material pr

  9. 40 CFR 205.155 - Motorcycle class and manufacturer abbreviation.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Motorcycle class and manufacturer abbreviation. 205.155 Section 205.155 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Motorcycle class and manufacturer abbreviation. (a) Motorcycles must be grouped into classes determined...

  10. 32 CFR 516.3 - Explanation of abbreviations and terms.

    Science.gov (United States)

    2010-07-01

    ... AUTHORITIES AND PUBLIC RELATIONS LITIGATION General § 516.3 Explanation of abbreviations and terms. (a) The Glossary contains explanations of abbreviations and terms. (b) The masculine gender has been used throughout this regulation for simplicity and consistency. Any reference to the masculine gender is...

  11. LAPAROSCOPY VERSUS LAPAROTOMY IN THE REPAIR OF VENTRAL HERNIAS: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Paula Marcela Vilela CASTRO

    2014-09-01

    Full Text Available Objective To compare the laparotomy and laparoscopy techniques for correction of ventral hernia when related to perioperative complications, length of hospitalization, surgical time, and recurrence of hernia. Methods This was a systematic review of randomized controlled trials, which included studies retrieved from four databases (MEDLINE, Embase, Cochrane and LILACS, using a combination of the terms (Hernia, Ventral and (Laparoscopy and (Laparotomy. Results Six randomized trials were included, totaling 566 patients, 283 in the Laparoscopy group and 283 in the Laparotomy group. Laparoscopy reduced the risk of infection of the surgical wound (NNT = 5 and seroma formation (NNT = 13 and less length hospitalization (P = 0.02 compared to laparotomy in the correction of ventral hernias. Furthermore, laparoscopy increased the incidence of enterotomy (NNH = 25 and post operative pain (NNH = 8 and longer surgical time (P = 0.0009 when compared with laparotomy. There was no difference related to abscess (P = 0.79, hematoma (P = 0.43 and recurrency of ventral hernias (P = 0.25. Conclusions In the correction of ventral hernias, the use of laparoscopic technique is effective to reduce infections of the surgical wound and seroma formation, as well as, decrease the length hospitalization.

  12. Surgical findings during exploratory laparotomy are closely related to mortality in premature infants with necrotising enterocolitis

    DEFF Research Database (Denmark)

    Hansen, M L; Juhl, Sandra Meinich; Fonnest, G;

    2017-01-01

    AIM: This study investigated whether a correlation existed between surgical findings during the first laparotomy for necrotising enterocolitis (NEC) and death and, or, disease progression. METHODS: We included infants admitted within one day of birth to our tertiary neonatal department at Rigshos......AIM: This study investigated whether a correlation existed between surgical findings during the first laparotomy for necrotising enterocolitis (NEC) and death and, or, disease progression. METHODS: We included infants admitted within one day of birth to our tertiary neonatal department...... at Rigshospitalet, Denmark, from 2006 to 2015, who underwent a laparotomy for acute NEC. They were classified according to the locality and extent of intestinal necrosis by a paediatric surgeon, based on the surgical findings. We correlated the surgical findings with postoperative outcomes, namely death and, or...

  13. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...... to rise as the population ages, this review summarises the evidence on which such guidance is based, and provides information about how anaesthetists might participate in audit and research aimed at improving local and national outcomes for these most vulnerable of patients....

  14. Conventional laparotomy for management of caesarean scar ectopic pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Nilesh C. Mhaske

    2015-10-01

    Full Text Available Increase in the rates of caesarean deliveries has led to a concurrent rise in the number of caesarean scar ectopic pregnancies (CSEP. With recent advances, diagnosis can be made at an early gestational age, hence facilitating a prompt intervention. With the varied treatment options available, choosing the right one may possess a clinical dilemma. However, in a low resource setting, conventional laparotomy may be the only option feasible. A case of CSEP managed with laparotomy is presented. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1581-1584

  15. Ultrasound-guided quadratus lumborum block as a postoperative analgesic technique for laparotomy.

    Science.gov (United States)

    Kadam, Vasanth Rao

    2013-10-01

    The quadratus lumborum (QL) block as a postoperative analgesic method following abdominal surgery has been described by Blanco for superficial surgeries but not used for major laparotomy. This ipsilateral QL block had low pain scores and opioid use on day one with sensory block upto T8-L1. The options of various volume used and pros and cons are discussed.

  16. Ultrasound-guided quadratus lumborum block as a postoperative analgesic technique for laparotomy

    OpenAIRE

    Vasanth Rao Kadam

    2013-01-01

    The quadratus lumborum (QL) block as a postoperative analgesic method following abdominal surgery has been described by Blanco for superficial surgeries but not used for major laparotomy. This ipsilateral QL block had low pain scores and opioid use on day one with sensory block upto T8-L1. The options of various volume used and pros and cons are discussed.

  17. Ultrasound-guided quadratus lumborum block as a postoperative analgesic technique for laparotomy

    Directory of Open Access Journals (Sweden)

    Vasanth Rao Kadam

    2013-01-01

    Full Text Available The quadratus lumborum (QL block as a postoperative analgesic method following abdominal surgery has been described by Blanco for superficial surgeries but not used for major laparotomy. This ipsilateral QL block had low pain scores and opioid use on day one with sensory block upto T8-L1. The options of various volume used and pros and cons are discussed.

  18. Deferred Primary Anastomosis Versus Diversion in Patients with Severe Secondary Peritonitis Managed with Staged Laparotomies

    NARCIS (Netherlands)

    Ordonez, Carlos A.; Sanchez, Alvaro I.; Pineda, Jaime A.; Badiel, Marisol; Mesa, Rafael; Cardona, Uriel; Arias, Rafael; Rosso, Fernando; Granados, Marcela; Gutierrez-Martinez, Maria I.; Ochoa, Juan B.; Peitzman, Andrew; Puyana, Juan-Carlos

    2010-01-01

    There is inconclusive data on whether critically ill individuals with severe secondary peritonitis requiring multiple staged laparotomies may became eligible candidates for deferred primary anastomoses (DPA). We sought to compare a protocol for DPA against a protocol for diversion in severely ill cr

  19. Hoofdpijn na een laparotomie : een chronisch subduraal hematoom na epidurale anesthesie

    NARCIS (Netherlands)

    Heeman, Annelies E; Reidinga, Auke C; Groen, Rob J M; Wierda, J M K H Mark; Schiere, Sjouke

    2009-01-01

    A 63-year-old man underwent an exploratory laparotomy because of rectal carcinoma. The operation was performed under general anaesthesia in combination with epidural anaesthesia. Since the operation the patient complained of a headache. Eight weeks after the operation he was hospitalized because of

  20. Laparotomy in mice induces blood cell expression of inflammatory and stress genes.

    Science.gov (United States)

    Ko, Fred; Isoda, Fumiko; Mobbs, Charles

    2015-04-01

    Surgical trauma induces immune and stress responses although its effects on postsurgical inflammatory and stress gene expression remain poorly characterized. This study sought to improve current scientific knowledge by investigating the effects of laparotomy on mouse blood cell inflammatory and stress gene expression. Three-month-old male C57BL/6J mice were subjected to 2% isoflurane or 2% isoflurane with laparotomy and sacrificed 4 h postintervention. Blood was collected and blood cell expression of 158 genes central to inflammatory and stress responses was assayed using quantitative polymerase chain reaction arrays. Mice subjected to isoflurane with laparotomy, compared with mice receiving isoflurane alone, had >2-fold upregulation of genes in inflammation (Osm, IL1rn, IL1b, and Csf1), oxidative stress (Hmox1), heat shock (Hspa1b), growth arrest (Cdkn1a), and DNA repair (Ugt1a2). These genes demonstrated similar expression patterns by Pearson correlation and cluster analysis. Thus, laparotomy induces coordinated, postsurgical blood cell expression of unique inflammatory and stress genes whose roles in influencing surgical outcomes need further investigation.

  1. Minimal laparotomy management of a giant ovarian cystic teratoma in adolescence

    Directory of Open Access Journals (Sweden)

    Toshihiro Yasui

    2015-06-01

    Full Text Available Giant ovarian cysts in adolescents are very rare. Those treatment by laparotomy or laparoscopic surgery is discussed with gynecologists and pediatric surgeons because its limited working space and risk of rupture and malignancy. We present a case of minimal laparotomy management of a giant ovarian cystic teratoma in adolescent. A 13-year-old girl presented with abdominal pain and constipation. A CT scan showed a giant simple ovarian cystic tumor in her abdomen measuring 29 × 13 × 24 cm. We made a 3-cm Pfannenstiel incision and inserted an Alexis wound retractor XS. The cyst was completely aspirated without spillage in the intraperitoneal space. In total, 6L of murky brown fluid was aspirated from the cyst. There was no ovarian tissue visible on the cyst wall. The left tube and right ovary and tube were intact. The cyst wall and left ovary tube were dissected free by using a LigaSure. Postoperative recovery was uneventful. Pathological assessment revealed a mature cystic teratoma. The ovarian tissue was included in the part of the cyst wall. We were able to safely perform with minimal laparotomy. Therefore, we consider the for cases of giant ovarian tumors, minimal laparotomy surgery is useful from the safety and cosmetic perspective.

  2. [Should routine exploratory laparotomy be performed in the presence of an abdominal wound? Discussion apropos of 176 cases].

    Science.gov (United States)

    Guiberteau, B; Kohen, M; Borde, L; Sartre, J Y; Bourseau, J C; Le Neel, J C

    1992-10-01

    Management of abdominal wounds is presently the subject of discussion between the partisans of routine laparotomy and those preferring "armed" surveillance. Results of study of a series of 176 abdominal wounds subjected to surgical dogma showed: that the diagnosis of non penetrating wounds (17.6%) was not always evident, due either to their anatomical localization (frontier region wounds) or to insufficient local exploration in urgent cases (6.6% of false-negatives), that the existence of serious clinical signs (50 cases) was always associated with one or more visceral lesions, requiring urgent laparotomy with a morbidity of 20% and a mortality of 8% (4 cases), that in the case of asymptomatic penetrating wounds (96 cases), routine laparotomy did nevertheless allow the diagnosis of visceral lesions in 50 cases (including 23 major lesions) but was of no utility in 46 cases (31.5% of blind laparotomies for the total series). The elevated proportion of useless laparotomies (30% in the literature), the result of a dogmatic attitude, or the risk of a delayed intervention (5 to 8%) in the series practising the selective method, led to a modification in the authors' attitude. The existence of serious signs should obviously result in a laparotomy. In their absence, and when confronted with a penetrating or doubtful (frontier region) wound, an exploratory celioscopy is proposed to ensure complete abdominal exploration, to confirm the presence or absence of penetration, to treat minimal lesions and to perform a classical laparotomy in case of evident necessity.

  3. Hargreaves does not evaluate nociception following a surgical laparotomy in Xenopus leavis frogs.

    Science.gov (United States)

    Vachon, P

    2014-10-01

    The present study was performed to determine the effectiveness of the Hargreaves test for the evaluation of nociception in frogs, more precisely to determine if cutaneous thresholds to a radiant heat stimulus would increase with analgesics following an abdominal laparotomy performed under general anaesthesia. Non breeding female Xenopus leavis frogs (3 groups (non-anaesthetized, anaesthetized with tricaine methanesulfonate (MS222), with or without an abdominal laparotomy) were used to evaluate the effectiveness of the Hargreaves test. Cutaneous thresholds were evaluated at baseline and following anaesthetic recovery (over 8 h) at six different body locations. Increased reaction times were observed in the gular area only at 1 h post-recovery following a MS222 bath immersion in frogs with (p leavis frogs.

  4. Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohn's disease

    DEFF Research Database (Denmark)

    Almen, Sven; Granerus, Göran; Ström, Magnus

    2007-01-01

    Background: Leukocyte scintigraphy is a noninvasive investigation to assess inflammation. We evaluated the utility of labeled leukocytes to detect small bowel inflammation and disease complications in Crohn's disease and compared it to whole small bowel enteroscopy and laparotomy findings. Methods......: Scintigraphy with technetium-99m exametazime-labeled leukocytes was prospectively performed in 48 patients with Crohn's disease a few days before laparotomy; 41 also had an intraoperative small bowel enteroscopy. The same procedures were performed in 8 control patients. Independent grading of scans...... was compared with the results of enteroscopy and with surgical, histopathologic, and clinical data. Results: In the 8 control patients leukocyte scan, endoscopy, and histopathology were all negative for the small bowel. In patients with Crohn's disease and small bowel inflammation seen at enteroscopy and...

  5. Laparoscopy vs. laparotomy for embryo transfer to produce transgenic goats (Capra hircus).

    Science.gov (United States)

    Shin, Sang Tae; Jang, Sung Keun; Yang, Hong Suk; Lee, Ok Keun; Shim, Yhong Hee; Choi, Won Il; Lee, Doo Soo; Lee, Gwan Sun; Cho, Jong Ki; Lee, Young Won

    2008-03-01

    This study was performed to produce transgenic Korean native goat (Capra hircus) by laparoscopic embryo transfer (ET) to overcome the limitations of ET performed by laparotomy. Transgenic embryos were produced by DNA pronuclear microinjection of in vivo zygotes. The recipient goats were synchronized for estrus by using an introvaginal progesterone devices as a controlled internal drug-releasing insert (CIDR) for 13 days and injection of 400 IU PMSG 48 h before removal of the insert. Embryos were transferred on day 3 and 4 after removal of the insert. Recipient goats were deprived of feed for 48 h, then suspended in a laparotomy cradle at an angle of 45 degrees . After obtaining a sufficient pneumoperitoneum, the laparoscope and forceps were inserted abdominally through 5 mm trocar sleeves. Examination of the ovaries and uterus was performed and then 213 embryos were transferred into the oviducts via the infundibula of 76 recipient goats. To compare pregnancy rates, ET was also performed by laparotomy in 82 recipient goats. The pregnancies in the recipient goats were diagnosed by ultrasound on day 30 after embryo transfer. The pregnancy rate with laparoscopic ET was significantly higher than with ET performed by laparotomy (46.1% vs. 28.6%, p < 0.05). In addition, the pregnancy rates were compared between ovulated and non-ovulated ovaries of the recipient goats in the laparoscopic ET group. No significant difference was observed between the pregnancy rates of ovulated and non-ovulated ovaries (41.3% vs. 33.3%, p < 0.05) suggesting that ET may also be possible in non-ovulated recipients through artificial rupture of Graafian follicles. These results suggest that laparoscopic ET is a highly efficient method for the transfer of goat embryos.

  6. 76 FR 13880 - Investigational New Drug Applications and Abbreviated New Drug Applications; Technical Amendment

    Science.gov (United States)

    2011-03-15

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Parts 312 and 314 Investigational New Drug Applications and Abbreviated New Drug Applications; Technical Amendment AGENCY: Food and Drug Administration... amending its investigational new drug application (IND) regulations and abbreviated new drug...

  7. Predicting Chinese Abbreviations from Definitions: An Empirical Learning Approach Using Support Vector Regression

    Institute of Scientific and Technical Information of China (English)

    Xu Sun; Hou-Feng Wang; Bo Wang

    2008-01-01

    In Chinese, phrases and named entities play a central role in information retrieval. Abbreviations, however,make keyword-based approaches less effective. This paper presents an empirical learning approach to Chinese abbreviation prediction. In this study, each abbreviation is taken as a reduced form of the corresponding definition (expanded form),and the abbreviation prediction is formalized as a scoring and ranking problem among abbreviation candidates, which are automatically generated from the corresponding definition. By employing Support Vector Regression (SVR) for scoring,we can obtain multiple abbreviation candidates together with their SVR values, which are used for candidate ranking.Experimental results show that the SVR method performs better than the popular heuristic rule of abbreviation prediction.In addition, in abbreviation prediction, the SVR method outperforms the hidden Markov model (HMM).

  8. Abbreviated Pandemic Influenza Planning Template for Primary Care Offices

    Energy Technology Data Exchange (ETDEWEB)

    HCTT CHE

    2010-01-01

    The Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices is intended to assist primary care providers and office managers with preparing their offices for quickly putting a plan in place to handle an increase in patient calls and visits, whether during the 2009-2010 influenza season or future influenza seasons.

  9. 16 CFR 300.9 - Abbreviations, ditto marks, and asterisks.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations, ditto marks, and asterisks..., ditto marks, and asterisks. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other symbols in...

  10. 27 CFR 19.726 - Authorized abbreviations to identify spirits.

    Science.gov (United States)

    2010-04-01

    ... records: Kinds of spirits Abbreviations Alcohol A Brandy BR Bourbon Whisky BW Canadian Whisky CNW Completely Denatured Alcohol CDA Corn Whisky CW Grain Spirits GS Irish Whisky IW Light Whisky LW Malt Whisky MW Neutral Spirits NS Neutral Spirits Grain NSG Rye Whisky RW Scotch Whisky SW Specially...

  11. 21 CFR 314.127 - Refusal to approve an abbreviated new drug application.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Refusal to approve an abbreviated new drug... HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.127 Refusal to approve an abbreviated new...

  12. Comparison of Robotic Surgery with Laparoscopy and Laparotomy for Treatment of Endometrial Cancer: A Meta-Analysis

    OpenAIRE

    Longke Ran; Jing Jin; Yan Xu; Youquan Bu; Fangzhou Song

    2014-01-01

    Purpose To compare the relative merits among robotic surgery, laparoscopy, and laparotomy for patients with endometrial cancer by conducting a meta-analysis. Methods The MEDLINE, Embase, PubMed, Web of Science, and Cochrane Library databases were searched. Studies clearly documenting a comparison between robotic surgery and laparoscopy or between robotic surgery and laparotomy for endometrial cancer were selected. The outcome measures included operating time (OT), number of complications, len...

  13. Efficacy of Sustained-Release Buprenorphine in an Experimental Laparotomy Model in Female Mice.

    Science.gov (United States)

    Kendall, Lon V; Wegenast, Daniel J; Smith, Brian J; Dorsey, Kathryn M; Kang, Sooah; Lee, Na Young; Hess, Ann M

    2016-01-01

    Mice purportedly require dosing with the opioid buprenorphine (Bup-HCl) at least every 8 to 12 h to maintain an adequate plane of analgesia. Here we used an experimental laparotomy model to determine the clinical efficacy of sustained-release formulations of buprenorphine (Bup-SR) after surgery in mice. Female CD1 mice underwent laparotomy and received either Bup-SR (0.6 mg/kg), Bup-HCl (0.1 mg/kg every 12 h), or saline (every 12 h). Pain was assessed at 1, 3, 6, 12, 24, 48, and 72 h according to the frequency of several behaviors (general activity, wheel-running activity, rearing, grooming, wound licking, orbital tightening, and percentage of integrated nest material) and daily body weight. Over time, wheel running was increased and wound licking was decreased in Bup-SR-treated mice compared with Bup-HCl- and saline-treated mice. Compared with Bup-HCl- and saline-treated mice, Bup-SR-treated mice had increased general activity and percentage of integrated nest material and decreased orbital tightening for 1 to 6 h after surgery. The Bup-HCl- and saline-treated mice had similar general activity, orbital tightening scores, and wheel running activity. Rearing activity and body weight did not differ throughout the study, and none of the observed behaviors differed between groups at 24, 48, and 72 h after surgery. These results suggest that Bup-SR at 0.6 mg/kg provides adequate analgesia after laparotomy in mice and can be used as an alternative analgesic in this context. Furthermore, Bup-HCl at 0.1 mg/kg every 12 h may be inadequate in providing analgesia for abdominal procedures in mice.

  14. Computed tomography, lymphography, and staging laparotomy: correlations in initial staging of Hodgkin disease

    Energy Technology Data Exchange (ETDEWEB)

    Castellino, R.A.; Hoppe, R.T.; Blank, N.; Young, S.W.; Neumann, C.; Rosenberg, S.A.; Kaplan, H.S.

    1984-07-01

    One hundred twenty-one patients with newly diagnosed, previously untreated Hodgkin disease underwent abdominal and pelvic computed tomographic (CT) scanning and bipedal lymphography. These studies were followed by staging laparotomy, which included biopsy of the liver, retroperitoneal and mesenteric lymph nodes, and splenectomy. Correlation of the results of the imaging studies with the histopathologic diagnoses revealed a small - but significant - increased accuracy of lymphography compared with CT in assessing the retroperitoneal lymph nodes. The theoretical advantages of CT scanning in detecting lymphomatous deposits in lymph nodes about the celiac axis and the mesentery, or in the liver and spleen, were not confirmed.

  15. Comparison of robotic surgery with laparoscopy and laparotomy for treatment of endometrial cancer: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Longke Ran

    Full Text Available To compare the relative merits among robotic surgery, laparoscopy, and laparotomy for patients with endometrial cancer by conducting a meta-analysis.The MEDLINE, Embase, PubMed, Web of Science, and Cochrane Library databases were searched. Studies clearly documenting a comparison between robotic surgery and laparoscopy or between robotic surgery and laparotomy for endometrial cancer were selected. The outcome measures included operating time (OT, number of complications, length of hospital stay (LOHS, estimated blood loss (EBL, number of transfusions, total lymph nodes harvested (TLNH, and number of conversions. Pooled odds ratios and weighted mean differences with 95% confidence intervals were calculated using either a fixed-effects or random-effects model.Twenty-two studies were included in the meta-analysis. These studies involved a total of 4420 patients, 3403 of whom underwent both robotic surgery and laparoscopy and 1017 of whom underwent both robotic surgery and laparotomy. The EBL (p = 0.01 and number of conversions (p = 0.0008 were significantly lower and the number of complications (p<0.0001 was significantly higher in robotic surgery than in laparoscopy. The OT, LOHS, number of transfusions, and TLNH showed no significant differences between robotic surgery and laparoscopy. The number of complications (p<0.00001, LOHS (p<0.00001, EBL (p<0.00001, and number of transfusions (p = 0.03 were significantly lower and the OT (p<0.00001 was significantly longer in robotic surgery than in laparotomy. The TLNH showed no significant difference between robotic surgery and laparotomy.Robotic surgery is generally safer and more reliable than laparoscopy and laparotomy for patients with endometrial cancer. Robotic surgery is associated with significantly lower EBL than both laparoscopy and laparotomy; fewer conversions but more complications than laparoscopy; and shorter LOHS, fewer complications, and fewer transfusions but a longer OT

  16. Robert's uterus: modern imaging techniques and ultrasound-guided hysteroscopic treatment without laparoscopy or laparotomy.

    Science.gov (United States)

    Ludwin, A; Ludwin, I; Martins, W P

    2016-10-01

    Robert's uterus is a unique malformation, described as a septate uterus with a non-communicating hemicavity, consisting of a blind uterine horn usually with unilateral hematometra, a contralateral unicornuate uterine cavity and a normally shaped external uterine fundus. The main symptom in affected young women is pelvic pain that becomes intensified near menses. We describe the case of a 22-year-old woman who was referred for diagnostic assessment and treatment of a congenital uterine anomaly. We used three-dimensional sonohysterography with volume-contrast imaging, HDLive rendering mode and automatic volume calculation (SonoHysteroAVC) for the diagnosis, surgical planning and postoperative evaluation. These imaging techniques provided a complete understanding of the internal and external uterine structures, enabling us to perform a minimally invasive hysteroscopic metroplasty, guided by transrectal ultrasound, and therefore avoiding the need for laparotomy/laparoscopy. The outcome of treatment was considered satisfactory; menstruation ceased to be painful and, after two hysteroscopic procedures, the communicating 0.3-cm(3) hemicavity was visualized as a 3.6-cm(3) normalized uterine cavity using the same imaging techniques. The findings of this case report raise questions about the embryological origin of Robert's uterus, the suitability of current classification systems, and the role of more invasive approaches (laparoscopy/laparotomy) and surgical procedures (horn resection/endometrectomy) that do not aim to improve uterine cavity shape and volume in women with this condition. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  17. A comparative study of outcome of the absorbable suture polydioxanone and nonabsorbable suture polypropylene in laparotomy wound closure

    Directory of Open Access Journals (Sweden)

    Kiran Shankar H.

    2016-06-01

    Full Text Available Background: Abdominal wound closure is one of the common operations for a general surgeon. Prevention of complications is important to reduce post-operative morbidity and mortality. Post-operative wound pain, wound infection, wound dehiscence, suture sinus formation; palpable knots and incisional hernia are the parameters are to be studied. Therefore, the present study was undertaken to compare polydioxanone and polypropylene suture material for abdominal fascial closure regarding morbidity in terms of post-operative wound complications. Methods: Patients admitted in the department of surgery, who undergo laparotomy operations, with midline abdominal incisions were included in the study. The recruited subjects were divided into Group-A, whom abdominal incisions are closed with non-absorbable suture material polypropylene and Group-B whom abdominal incisions are closed with absorbable suture material polydioxanone. Data was expressed as percentages. Results: The incidence of wound pain was observed in all the patients in both immediate and delayed post-operative period in the polypropylene suture material compared to polydioxanone. The incidence of wound infection was higher in polypropylene (24% compared to PDS (2%. There were 4% cases of wound dehiscence in the present study. The incidence of suture sinus formation was higher in the polypropylene suture material (9% compared to the polydioxanone suture material (2% in the delayed postoperative period. The incidence of palpable knots was higher in the polypropylene suture material (23% compared to the polydioxanone suture material. No cases of incisional hernia were reported with polydioxanone suture material. Conclusions: The overall morbidity from abdominal closure was considerably reduced in the Polydioxanone group. We encountered reduction in wound complications like burst abdomen, wound infection, wound pain, suture sinus formation, palpable knots and incisional hernia. Therefore

  18. Implantation of peritoneal catheters by laparotomy: nephrologists obtained similar results to general surgeons

    Directory of Open Access Journals (Sweden)

    Restrepo CA

    2014-10-01

    Full Text Available Cesar A Restrepo, Carlos Alberto Buitrago, Cielo Holguin Division of Nephrology, Department of Health Sciences, Caldas University, Caldas, ColombiaPurpose: To analyze the complications and costs of minilaparotomies performed by a nephrologist (group A compared with conventional laparotomies performed by a surgeon (group B for peritoneal catheter implantation.Setting: Two university hospitals (Santa Sofia and Caldas in Manizales, Caldas, Colombia.Methods: The study included stage 5 chronic kidney disease patients, with indication of renal replacement therapy, who were candidates for peritoneal dialysis and gave informed consent for a peritoneal catheter implant. Minilaparotomies were performed by a nephrologist in a minor surgery room under local anesthesia. Conventional laparotomies were performed by a surgeon in an operating room under general anesthesia.Results: Two nephrologists inserted 157 peritoneal catheters, and seven general surgeons inserted 185 peritoneal catheters. The groups had similar characteristics: the mean age was 55 years, 49.5% were men, and the primary diagnoses were diabetic nephropathy, hypertensive nephropathy, and unknown etiology. The implant was successful for 98.09% of group A and 99.46% of group B. There was no procedure-related mortality. The most frequent complications in the first 30 days postsurgery in group A versus group B, respectively, were: peritonitis (6.37% versus 3.78%, exit-site infection (3.82% versus 2.16%, tunnel infection (0% versus 0.54%, catheter entrapment by omentum (1.27% versus 3.24%, peritoneal effluent spillover (1.91% versus 2.16%, draining failure (4.46% versus 6.49%, hematoma (0% versus 1.08%, catheter migration with kinking (3.18% versus 2.70%, hemoperitoneum (1.27% versus 0%, and hollow viscera accidental puncture (1.91% versus 0.54%. There were no statistically significant differences in the number of complications between groups. In 2013, the cost of a surgeon-implanted peritoneal

  19. Robotic surgery compared with laparotomy for high-grade endometrial cancer.

    Science.gov (United States)

    Pant, Alok; Schink, Julian; Lurain, John

    2014-06-01

    High-grade endometrial cancer often presents with occult metastatic disease and this presentation pattern can be considered a contraindication to minimally invasive surgery. We sought to compare the surgical and oncologic outcomes of patients with high-grade endometrial cancer who underwent surgical management/staging via the robotic approach versus the traditional open approach. A retrospective analysis was performed of patients with high-grade endometrial cancer who were treated at a single institution from January 2008 through December 2011. High-grade endometrial histology was defined as FIGO grade 2 or 3 endometrioid, serous, clear cell or uterine carcinosarcoma. Pre-operatively, all patients had clinical stage I disease based on a combination of physical examination and imaging studies. Baseline patient demographics, operative results, complications and oncologic outcomes were analyzed. Eighty consecutive patients were included. Forty-seven patients underwent surgical management using the robotic approach and 33 patients underwent a traditional operation via laparotomy. The groups were well matched in terms of age, body mass index, medical co-morbidities, stage and histology. The average hospital stay for patients who underwent open surgery was significantly longer than for those who underwent a robotic approach [5.6 versus 1.4 days (p = 0.0001)]. Of the patients who underwent robotic surgery, 7/47 (15 %) experienced an operative complication versus 18/33 (55 %) in the open surgery cohort (p = 0.002). The average number of pelvic lymph nodes retrieved in each cohort was 12. The average number of para-aortic lymph nodes retrieved in each group was 4. On final pathologic analysis, 20 patients in the robotic surgery arm were found to have disease that had spread beyond the uterus (43 %), compared to 14 in the traditional surgery group (42 %). There were 11/47 (23 %) recurrences in the robotic surgery group during the study period, compared to 8/33 (24

  20. Echinococcosis of Iliopsoas Muscle and Anaphylaxis as the Cause of Urgent Laparotomy

    Directory of Open Access Journals (Sweden)

    A Petrić

    2014-12-01

    Full Text Available Echinococcosis is an infectious disease which in humans is caused by the larval stadium of two types of parasites (Echinococcus granulosus and Echinococcus multilocularis. It is most frequently localized in the liver, lungs and rarely in muscles. The parasite significantly affects the immune system of the host, which is why anaphylactic reactions are not rare, especially in cases of cyst rupture. This paper presents the case of a 53-year old woman who had urgent laparotomy on the presumed basis of rupture of ovarian tumour, with intra-abdominal haemorrhage and shock. It turned out to be echinococcosis of the iliopsoas muscle and anaphylactic reaction. The differential diagnosis of adnexal tumours should take into consideration echinococcosis as well. Symptoms of anaphylactic shock in the case of parasitic cyst rupture can easily be confused with the signs of haemorrhagic shock.

  1. Retrospective analysis of exploratory laparotomies in 192 Andalusian horses and 276 horses of other breeds.

    Science.gov (United States)

    Muñoz, E; Argüelles, D; Areste, L; Miguel, L San; Prades, M

    2008-03-08

    The medical records of 468 horses that underwent 490 exploratory laparotomies for the correction of gastrointestinal diseases were reviewed to search for differences between Andalusian horses and other breeds. The seasonal distribution of surgical colics and their outcome and complications were also investigated. Bivariant analysis was used to compare the horses' age, gender and breed with the type of surgery, the bowel affected and the type of colic, and all these variables were compared in relation to euthanasia during surgery, complications, short-term survival and seasonal distribution. A total of 405 horses survived the surgery and 329 were discharged from the hospital. Horses less than one year old had better short-term survival than older horses. Andalusian horses suffered more inguinal hernias than the other breeds and were more prone to suffer laminitis as a complication. Colic surgery and inguinal hernias were also more common in the summer.

  2. Laparotomy enables retrograde dilatation and stent placement for malignant esophago-respiratory fistula

    Directory of Open Access Journals (Sweden)

    Iskender Özcan

    2008-01-01

    Full Text Available Abstract Background Malignant esophageal stenosis with complete obstruction and esophagorespiratory fistula (ERF is difficult to treat with standard endoscopic techniques. Case presentation We report a patient in whom with local recurrence of esophageal carcinoma an esophagotracheal fistula occurred. Initially the patient had undergone esophageal resection with interposition of a gastric tube. Due to complete obstruction of the lumen by recurrent tumor conventional transoral stent placement failed. For retrograde dilatation a laparotomy was performed. Via a duodenal incision endoscopic access to the gastric tube was achieved. Using a guidewire the esophageal obstruction was traversed and dilated. Then it was possible to place an esophageal stent via an antegrade approach. Conclusion Open surgery enables a safe access for retrograde endoscopic therapy in patients who had undergone esophageal resection with gastric interposition.

  3. 16 CFR 303.5 - Abbreviations, ditto marks, and asterisks prohibited.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations, ditto marks, and asterisks... Abbreviations, ditto marks, and asterisks prohibited. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other...

  4. 21 CFR 314.153 - Suspension of approval of an abbreviated new drug application.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Suspension of approval of an abbreviated new drug... HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG FDA... new drug application. (a) Suspension of approval. The approval of an abbreviated new drug...

  5. 21 CFR 314.101 - Filing an application and receiving an abbreviated new drug application.

    Science.gov (United States)

    2010-04-01

    ... new drug application. 314.101 Section 314.101 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.101 Filing an application and receiving an abbreviated new drug application. (a)(1) Within 60 days after FDA receives...

  6. 77 FR 50702 - Ranbaxy Laboratories Limited; Withdrawal of Approval of 27 Abbreviated New Drug Applications

    Science.gov (United States)

    2012-08-22

    ... Abbreviated New Drug Applications AGENCY: Food and Drug Administration, HHS. ACTION: Notice. ] SUMMARY: The Food and Drug Administration (FDA) is withdrawing approval of 27 abbreviated new drug applications... introduction into interstate commerce of products without approved new drug applications violates section...

  7. Automatic Word Sense Disambiguation of Acronyms and Abbreviations in Clinical Texts

    Science.gov (United States)

    Moon, Sungrim

    2012-01-01

    The use of acronyms and abbreviations is increasing profoundly in the clinical domain in large part due to the greater adoption of electronic health record (EHR) systems and increased electronic documentation within healthcare. A single acronym or abbreviation may have multiple different meanings or senses. Comprehending the proper meaning of an…

  8. 78 FR 26785 - Guidance for Industry: Implementation of an Acceptable Abbreviated Donor History Questionnaire...

    Science.gov (United States)

    2013-05-08

    ...The Food and Drug Administration (FDA) is announcing the availability of a document entitled ``Guidance for Industry: Implementation of an Acceptable Abbreviated Donor History Questionnaire and Accompanying Materials for Use in Screening Frequent Donors of Blood and Blood Components'' dated May 2013. The guidance document recognizes the abbreviated donor history questionnaire and accompanying......

  9. 76 FR 65735 - Draft Guidance for Industry: Implementation of Acceptable Abbreviated Donor History Questionnaire...

    Science.gov (United States)

    2011-10-24

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft document entitled ``Guidance for Industry: Implementation of Acceptable Abbreviated Donor History Questionnaire and Accompanying Materials for Use in Screening Frequent Donors of Blood and Blood Components'' dated October 2011. The draft guidance document recognizes the abbreviated donor history questionnaire and......

  10. Evaluation of sub-fascial lidocaine infusion in post-operative pain management following laparotomy

    Directory of Open Access Journals (Sweden)

    F. Eshghi

    2008-01-01

    Full Text Available  AbstractBackground and Purpose: One of the important problems of major abdominal surgery is post-operative pain control. There are different modalities to control the pain after surgery, such as oral, local or intravenous analgesic drugs, regional nerve block, epidural catheters and pain killer pumps with their own benefits and complications. The aim of this study was to evaluate the effect of continuous peritoneal infusion of lidocaine by a pain killer pump for post-operative pain management following laparotomy.Materials and Methods: This double blind randomized clinical trial was performed on 76 patients (38 cases and 38 controls who underwent laparotomy with midline incision, in Imam Hospital, Sari, Iran, in 2008. Two groups were matched in age and sex. After surgery a catheter infusion pump was prepared for all patients. In case group, 2% lidocaine (20mg/kg/day and for control, normal saline infused for 24 hours. Pain score (Visual Analog Scale, blood pressure, heart rate, respiratory rate, temperature and analgesic requirement was evaluated in 4, 10, 16 and 24 hours after surgery. Results analyzed by means of SPSS (15 software and chi-square, t test and repeated measurement. The p value less than 0.05 was considered to be significant statistically.Results: 76 patients, 39 (51.3% females and 37 (48.7% males, with mean age of 47.03±15.2 years were studied. There was no significant difference in age, sex and weight between two groups. The mean of admission days was 5.03±0.6 in case and 5.29±1.3 in control, with no significant difference between them. Mean of opiod consumption was 16.05±13.05 mg and 25.39±11.4 mg in case and control respectively (P= 0.002. Mean of VAS score, blood pressure, heart rate, respiratory rate and temperature in case group was less than control group and the difference was significant statistically. Pain severity changes during 4, 10, 16 and 24 hours following surgery were significantly different in two

  11. 76 FR 26307 - Guidance for Industry on the Submission of Summary Bioequivalence Data for Abbreviated New Drug...

    Science.gov (United States)

    2011-05-06

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on the Submission of Summary Bioequivalence Data for Abbreviated New Drug Applications; Availability AGENCY: Food and Drug Administration, HHS... guidance for industry entitled ``Submission of Summary Bioequivalence Data for Abbreviated New...

  12. Compression and the origins of Zipf's law of abbreviation

    CERN Document Server

    Ferrer-i-Cancho, R; Seguin, C

    2015-01-01

    Languages across the world exhibit Zipf's law of abbreviation, namely more frequent words tend to be shorter. The generalized version of the law, namely an inverse relationship between the frequency of a unit and its magnitude, holds also for the behaviors of other species and the genetic code. The apparent universality of this pattern in human language and its ubiquity in other domains calls for a theoretical understanding of its origins. We generalize the information theoretic concept of mean code length as a mean energetic cost function over the probability and the magnitude of the symbols of the alphabet. We show that the minimization of that cost function and a negative correlation between probability and the magnitude of symbols are intimately related.

  13. Results of Second-Look Laparotomy in Advanced Ovarian Cancer: One Single Center Experience

    Science.gov (United States)

    Damak, Tarak; Chargui, Riadh; Ben Hassouna, Jamel; Hechiche, Monia; Rahal, Khaled

    2012-01-01

    Objective. The goal of the study was to analyse the results of 85 cases of second-look laparotomy (SLL) and explore the influence of this procedure on survival. Patients and Methods. We reviewed retrospectively 85 cases of SLL collected and treated in our institute between 1994 and 2003. Results. Complete pathologic response (CPR) was 25.8%, microscopic disease (Rmicro) was 38.8%, and macroscopic disease (Rmacro) was 35.4%. In patients with negative SLL results, disease recurrence was diagnosed in 41%. The 3- and 5-year overall survival rates for the entire population were 91% and 87%, respectively. The 3- and 5-year disease-free survivals were, respectively, 76.3% and 58.5% in negative SLL versus 55.7% and 16% in positive SLL. The difference between the group of patients with complete response (76%) and the patients with residual microscopic disease (72%) was not significant. The tumoral residuum after initial surgery was the only prognostic factor influencing significantly the disease-free survival. On Cox regression model analysis, only initial tumoral residuum (P = 0.04) and tumoral residuum after SLL (P = 0.02) were independent prognostic factors for survival. Conclusions. The most important advantage of SLL is the early detection of recurrence and thus the early administration of consolidation treatment resulting in a better prognosis. PMID:23119177

  14. 21 CFR 314.152 - Notice of withdrawal of approval of an application or abbreviated application for a new drug.

    Science.gov (United States)

    2010-04-01

    ... or abbreviated application for a new drug. 314.152 Section 314.152 Food and Drugs FOOD AND DRUG... APPROVAL TO MARKET A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.152 Notice of withdrawal of approval of an application or abbreviated application for a new drug. If the Food and...

  15. Pharmacist and Physician Interpretation of Abbreviations for Acetaminophen Intended for Use in a Consumer Icon

    Directory of Open Access Journals (Sweden)

    Saul Shiffman

    2015-10-01

    Full Text Available Concomitant use of multiple acetaminophen medications is associated with overdose. To help patients identify acetaminophen medications and thus avoid concomitant use, an icon with an abbreviation for “acetaminophen” has been proposed for all acetaminophen medications. This study assessed pharmacists’ and physicians’ use and interpretation of abbreviations for “acetaminophen”, to identify abbreviations with other meanings that might cause confusion. Physicians (n = 150 reported use and interpretation of candidate abbreviations Ac and Acm. Pharmacists (n = 150 interpretations of prescription orders using the candidate abbreviations APAP, Ac, Ace and Acm in typed, handwritten or spoken form, were judged for critical confusions likely to cause patient harm. Critical confusion was rare, except for omission by pharmacists of the acetaminophen dose for Hydrocodone/APAP prescriptions (10%. Ac was in common use to indicate “before meals”, and was interpreted as such, but some physicians (8% said they use Ac to indicate anticoagulant drugs. Most pharmacists (54% interpreted Ace as acetaminophen, and none interpreted it as referring to ACE-inhibitors. Acm was rarely used in prescriptions, had no common interfering meanings, and was often (63% interpreted as acetaminophen, especially when prescribed in combination with an opiate (85%. The data validated concerns about abbreviations in prescribing: all abbreviations resulted in some misinterpretations. However, Acm was rarely misinterpreted, was readily associated with “acetaminophen”, and seemed appropriate for use in a graphic icon to help consumers/patients identify acetaminophen medications.

  16. Reinfusion of aspirated pericardial blood during CPB. Part I. Hypothesis: laparotomy sponges are a significant part of the CPB circuit?

    Science.gov (United States)

    Bull, Brian S; Hay, Karen

    2005-01-01

    Blood accumulating in the pericardial sac is routinely reinfused during cardiopulmonary bypass (CPB) surgery. Such reinfusion has been associated with an increased incidence of serious complications such as coagulopathy, systemic inflammation, and neurologic sequelae. We hypothesize that some of these complications occur because the reinfused blood has been exposed to and activated by laparotomy sponges used to elevate the heart during vein graft emplacement. Such laparotomy sponges expose accumulating pericardial blood to a large, raw, cotton surface with an area approximately five times that of the CPB circuit (excluding the biocompatible oxygenator membrane). Because the reinfused blood has been exposed to this surface, the sponge becomes, in essence, a significant-though inapparent-part of the CPB circuit. Steps should be taken to either eliminate the sponge or to reduce the area of this foreign surface and make it more biocompatible.

  17. Emergency presurgical visit

    Directory of Open Access Journals (Sweden)

    Alfredo Castro Díaz

    2009-07-01

    Full Text Available The objective has been to create a Protocol of Structured Presurgical Visit applicable to the patients who are undergoing an emergency surgery, to provide the user and his family all the necessary cares on the basis of those nursing diagnosis that prevail in all the cases of surgical emergency interventions. The used method has been an analysis of the emergency surgical interventions more prevalent from February 2007 until October 2008 in our area (a regional hospital, and statistic of those nursing diagnosis that more frequently appeared in these interventions, the previous moment to the intervention and in addition common to all of them. The results were the following ones: the more frequent emergency operations were: Caesarean, ginecological curettage, laparotomy, help in risk childbirth, orthopaedic surgery and appendectomy. The more frequent nursing diagnosis in all the emergency operations at the previous moment of the intervention were: risk of falls, pain, anxiety, deficit of knowledge, risk of infection, movement stress syndrome, risk of hemorrhage, cutaneous integrity deterioration. The conclusion is that users present at the previous moment to an emergency operation several problems, which force to the emergency surgical ward nurse to the introduction of the nursing methodology, in order to identify the problems, to mark results and to indicate the interventions to achieve those results, besides in a humanitarian way and with quality. This can be obtained by performing a Structured Emergency Presurgical Visit.

  18. Assessment of post-laparotomy pain in laboratory mice by telemetric recording of heart rate and heart rate variability

    Directory of Open Access Journals (Sweden)

    Kasermann Hans P

    2007-08-01

    Full Text Available Abstract Background Pain of mild to moderate grade is difficult to detect in laboratory mice because mice are prey animals that attempt to elude predators or man by hiding signs of weakness, injury or pain. In this study, we investigated the use of telemetry to identify indicators of mild-to-moderate post-laparotomy pain. Results Adult mice were subjected to laparotomy, either combined with pain treatment (carprofen or flunixin, 5 mg/kg s/c bid, for 1 day or without pain relief. Controls received anesthesia and analgesics or vehicle only. Telemetrically measured locomotor activity was undisturbed in all animals, thus confirming that any pain experienced was of the intended mild level. No symptoms of pain were registered in any of the groups by scoring the animals' outer appearance or spontaneous and provoked behavior. In contrast, the group receiving no analgesic treatment after laparotomy demonstrated significant changes in telemetry electrocardiogram recordings: increased heart rate and decreased heart rate variability parameters pointed to sympathetic activation and pain lasting for 24 hours. In addition, core body temperature was elevated. Body weight and food intake were reduced for 3 and 2 days, respectively. Moreover, unstructured cage territory and destroyed nests appeared for 1–2 days in an increased number of animals in this group only. In controls these parameters were not affected. Conclusion In conclusion, real-time telemetric recordings of heart rate and heart rate variability were indicative of mild-to-moderate post-laparotomy pain and could define its duration in our mouse model. This level of pain cannot easily be detected by direct observation.

  19. Perioperative nutritional management of patients undergoing laparotomy Cuidados nutricionales perioperatorios en pacientes sometidos a laparotomía

    OpenAIRE

    M. I. Toulson Davisson Correia; P. Costa Fonseca; G. A. Machado Cruz

    2009-01-01

    Objectives: Lack of routine patient's nutritional assessment and prescription of long fasting periods throughout the perioperative period are still widely prevalent despite the advances in surgical care. Therefore, the aim of this study was to assess nutritional routines in two surgical wards. Methods: Adult patients undergoing laparotomy at two distinct units (gastrointestinal and gynecologic) in two public hospitals (one of them a university) were enrolled. Patients were divided in minor an...

  20. Processes and changes in Minas Gerais’ 18th century abbreviations: regularity and rupture

    Directory of Open Access Journals (Sweden)

    Aléxia Teles Duchowny

    2015-02-01

    Full Text Available This study analyzed 18th century abbreviations from documents written in Arraial do Tijuco, today Diamantina, in Minas Gerais, Brazil. Brachygraphic resources used in religious brotherhoods’ commitments from different social strata were compared to test two hypotheses: (i abbreviations reflect differences between strata and therefore (ii they allow identifying the degree of literacy of writing subjects. The analysis undertaken do not attest the correctness of assumptions, but the generalizations reached indicate that abbreviations, as any other linguistic phenomenon, suffer systematic, organized and multiple change processes, a different result from those that the meagre literature on the subject provides.

  1. Increased mortality in the elderly after emergency abdominal surgery

    DEFF Research Database (Denmark)

    Svenningsen, Peter; Manoharan, Thukirtha; Foss, Nicolai B

    2014-01-01

    INTRODUCTION: The purpose of this study was to evaluate the relation between preoperative delay and mortality in surgical patients undergoing primary emergency laparotomy (PEL) in an unselected, well-described patient cohort in a university hospital setting. MATERIAL AND METHODS: This study was a...

  2. Modeling the structure of the attitudes and belief scale 2 using CFA and bifactor approaches: Toward the development of an abbreviated version.

    Science.gov (United States)

    Hyland, Philip; Shevlin, Mark; Adamson, Gary; Boduszek, Daniel

    2014-01-01

    The Attitudes and Belief Scale-2 (ABS-2: DiGiuseppe, Leaf, Exner, & Robin, 1988. The development of a measure of rational/irrational thinking. Paper presented at the World Congress of Behavior Therapy, Edinburg, Scotland.) is a 72-item self-report measure of evaluative rational and irrational beliefs widely used in Rational Emotive Behavior Therapy research contexts. However, little psychometric evidence exists regarding the measure's underlying factor structure. Furthermore, given the length of the ABS-2 there is a need for an abbreviated version that can be administered when there are time demands on the researcher, such as in clinical settings. This study sought to examine a series of theoretical models hypothesized to represent the latent structure of the ABS-2 within an alternative models framework using traditional confirmatory factor analysis as well as utilizing a bifactor modeling approach. Furthermore, this study also sought to develop a psychometrically sound abbreviated version of the ABS-2. Three hundred and thirteen (N = 313) active emergency service personnel completed the ABS-2. Results indicated that for each model, the application of bifactor modeling procedures improved model fit statistics, and a novel eight-factor intercorrelated solution was identified as the best fitting model of the ABS-2. However, the observed fit indices failed to satisfy commonly accepted standards. A 24-item abbreviated version was thus constructed and an intercorrelated eight-factor solution yielded satisfactory model fit statistics. Current results support the use of a bifactor modeling approach to determining the factor structure of the ABS-2. Furthermore, results provide empirical support for the psychometric properties of the newly developed abbreviated version.

  3. 75 FR 77897 - Long Walk National Historic Trail Feasibility Study, Abbreviated Final Environmental Impact...

    Science.gov (United States)

    2010-12-14

    ... trail would be designated, emphasizing the removal experiences common to both tribes. An auto tour route... National Park Service Long Walk National Historic Trail Feasibility Study, Abbreviated Final Environmental Impact Statement, National Trails Intermountain Region, NM AGENCY: National Park Service,...

  4. Adaptation of abbreviated mathematics anxiety rating scale for engineering students

    Science.gov (United States)

    Nordin, Sayed Kushairi Sayed; Samat, Khairul Fadzli; Sultan, Al Amin Mohamed; Halim, Bushra Abdul; Ismail, Siti Fatimah; Mafazi, Nurul Wirdah

    2015-05-01

    Mathematics is an essential and fundamental tool used by engineers to analyse and solve problems in their field. Due to this, most engineering education programs involve a concentration of study in mathematics courses whereby engineering students have to take mathematics courses such as numerical methods, differential equations and calculus in the first two years and continue to do so until the completion of the sequence. However, the students struggled and had difficulties in learning courses that require mathematical abilities. Hence, this study presents the factors that caused mathematics anxiety among engineering students using Abbreviated Mathematics Anxiety Rating Scale (AMARS) through 95 students of Universiti Teknikal Malaysia Melaka (UTeM). From 25 items in AMARS, principal component analysis (PCA) suggested that there are four mathematics anxiety factors, namely experiences of learning mathematics, cognitive skills, mathematics evaluation anxiety and students' perception on mathematics. Minitab 16 software was used to analyse the nonparametric statistics. Kruskal-Wallis Test indicated that there is a significant difference in the experience of learning mathematics and mathematics evaluation anxiety among races. The Chi-Square Test of Independence revealed that the experience of learning mathematics, cognitive skills and mathematics evaluation anxiety depend on the results of their SPM additional mathematics. Based on this study, it is recommended to address the anxiety problems among engineering students at the early stage of studying in the university. Thus, lecturers should play their part by ensuring a positive classroom environment which encourages students to study mathematics without fear.

  5. Penatalaksanaan Anestesi pada Pasien dengan Sick Sinus Syndrome yang Menjalani Laparotomi Ec Perforasi Gaster

    Directory of Open Access Journals (Sweden)

    Radian Ahmad Halimi

    2013-04-01

    Full Text Available SA node dysfunction, or known as Sick Sinus Syndrome is the common cause of disrythmia and can be caused by intrinsic and extrinsic factors of the SA node. The diagnose performed by the occurrence of bradi- takhikardia episode and the clinical symptoms, could be syncope, palpitation, or maybe asymptomatic. Some of the literature defined that the perioperative management of sick sinus syndrome is preoperative insertion of pacemaker (transcutaneal or transvenous pacing. A 75 years old man underwent laparotomy with diffuse peritonitis caused by gastric perforation. In preoperative clinical evaluation the patients revealed full awake ( compos mentis, with history of uncontrolled hypertension. In physical exammination a severe bradicardia was found with pulse of 31x/minute, and the blood pressure was 190/100 mmHg. In this rural hospital there was no fascility to insert the pace-maker. The organ perfusion was considered to be optimal from clinical evaluation ( proved by the wakefullness, SpO2 99%, and diuresis 1cc/kgBW after optimalization . The chest X’ray showed a cardiomegali without the sign of pulmonary congestion. The laboratory test were within normal limit including the renal function test ( creatinin; 0,97 mg/dl, and ureum 82,6 mg/dl. We decided to perform general anesthesia in this procedure. Before the induction while patient still awake, fentanyl 2µg/kgBW was given intravenously. Fifteen menue after fentanyl administration induction of anesthesia performed and initiated with propofol intravenous injection slowly until patients felt asleep, than intubated after muscle relaxant intravenous reached the onset After intubation the pulse / heart rate of patients rose to 44 – 90x/minute. While the pulse was 90/ minute the heart rythm of the patients became irregular, a multifocal ventricular extra systole occured, and it was reversible when the heart rate back to 44x/ minute. We decided to maintain the heart rate between 35 – 40dmitted to

  6. Ovariectomy by laparotomy, a video-assisted approach or a complete laparoscopic technique in Santa Ines sheep

    OpenAIRE

    Teixeira, P. P. M; Padilha, L. C.; Motheo,T.F.; M.A.M. Silva; Oliveira, M.e.f. [UNESP; Silva, A. S. L. DA; Barros,F.F.P.C; Coutinho, L. N. [UNESP; F.N. Flores; Lopes,M.C.S.; Rodrigues, L. F. S.; W.R.R. Vicente

    2011-01-01

    The aim of the study was to compare the use of open ovariectomy, to the video-assisted laparoscopic approach or total laparoscopic ovariectomy in Santa Ines ewes. Surgical time and body weight gain/loss were recorded and post-surgical pain assessed using a behavioral scale. Laparotomy involved a longer surgical time (75 +/- 29.5 min), than the video-assisted (37.5 +/- 13.04 min; p < 0.05) or total laparoscopic approach (27.5 +/- 2.89; p < 0.01). Behavioral pain recorded score was higher for t...

  7. Perbandingan Pemulihan Bising Usus pada Pasien Pascaoperasi Histerektomi per Laparotomi Menggunakan Analgetik Kombinasi Ketamin-Morfin dengan Morfin Intravena

    Directory of Open Access Journals (Sweden)

    Irvan Setiawan

    2015-03-01

    Full Text Available Gastrointestinal dysfunction is the most common post anaesthesia complication. The aim of this study is to compare the recovery of bowel sounds between combination of ketamine-morphine analgesia to morphine alone. This is a randomized controlled study on 36 patients with American Society of Anesthesiologist (ASA physical status I and II who underwent hysterectomy per laparotomy at Dr. Hasan Sadikin Bandung during April–August 2012. Both groups received an initial dose of morphine 0.03 mg/kgBW, while K group received intravenous ketamine 4 μg/kgBW/min, and the M group received morphine 10 μg/kgBW/hr. The results were analyzed using t-test and Mann Whitney test with a confidence level of 95% and were considered significant if p<0.05. The results of this study showed that the recovery time of bowel sounds in K group was significantly faster than in the M group (p<0.05. In conclusion, recovery of bowel sounds is faster in analgesia using combination of ketamine-morphine than morphine in postoperative hysterectomy per laparotomy patients.

  8. RESULTS OF SECOND-LOOK LAPAROTOMY WITH EXTENSIVE DISSECTION OF RETROPERITONEAL LYMPH NODE IN OVARIAN CANCER PATIENTS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To evaluate retrospectively the results of extensive lymphadenectomy during second-look laparotomy on patients with ovarian cancer. Methods: A total of 63 patients with ovarian malignancies received second-look laparotomy (SLL). Retroperitoneal lymph nodes, including pelvic and para-aortic lymph nodes below the level of left renal vein, were extensively dissected. Results: Of the 63 patients, residual tumor was found in 24 (38.0%) on SLL. The frequency of residual tumor was positively correlated with the clinical stage and with the amount of tumor left after initial debulking but not with degree of differentiation of tumor cells. Lymph node metastasis(LNM) was pathologically confirmed in 19 cases (30.2%), of which no residual tumor was found in 8 patients. Tumor recurred in only 4 of the 39 patients (10.3%) with negative SLL. The overall 3- and 5-year survival rate were 75.0% and 68.0%, respectively. Conclusion: Extensive retroperitoneal lymph node dissection was recommended during SLL. It favored a decrease in recurrence rate in ovarian cancer patients negative on SLL.

  9. Supra-transumbilical laparotomy (STL approach for small bowel atresia repair: Our experience and review of the literature

    Directory of Open Access Journals (Sweden)

    Ernesto Leva

    2013-01-01

    Full Text Available Background: Supra-Transumbilical Laparotomy (STL has been used in paediatric surgery for a broad spectrum of abdominal procedures. We report our experience with STL approach for small bowel atresia repair in newborns and review previous published series on the topic. Patients and Methods: Fourteen patients with small bowel atresia were treated via STL approach at our Institution over a 5-year period and their charts were retrospectively reviewed. Results: STL procedure was performed at mean age of 3.1 day. No malrotation disorders were detected with pre-operative contrast enema. Eight patients (54.1% presented jejunal atresia, five (35.7% ileal atresia, and one (7.1% multiple ileal and jejunal atresias. Standard repair with primary end-to-back anastomosis was performed in all but one patient. In the newborn with multiple atresia, STL incision was converted in supra-umbilical transverse incision due to difficulty of exposition. After surgery, one patient developed anastomotic stricture, and another developed occlusion due to adhesions: Both infants required second laparotomy. No infections of the umbilical site were recorded, and cosmetic results were excellent in all patients. Conclusions: Increasing evidence suggests that STL approach for small bowel atresia is feasible, safe and provides adequate exposure for small bowel atresia surgery. When malrotation and colonic/multiple atresia are pre-operatively ruled out, STL procedure can be choosen as first approach.

  10. Gonococcal peritonitis diagnosed post laparotomy in a 38-year-old woman: a case report

    OpenAIRE

    Wilmore, Stephanie MS; Reynolds, Carl J

    2009-01-01

    A 38-year-old South African lady with a background history of cervical intra-epithelial neoplasia and recent colposcopy presented to the emergency department with severe abdominal pain. Initial investigations were non-diagnostic and despite empirical antibiotic therapy the patient developed peritonism. Post-laprotomy the diagnosis of severe pelvic inflammatory disease and peritonitis secondary to infection with Neisseria Gonorrhoea was made.

  11. Gonococcal peritonitis diagnosed post laparotomy in a 38-year-old woman: a case report.

    Science.gov (United States)

    Wilmore, Stephanie Ms; Reynolds, Carl J

    2009-09-01

    A 38-year-old South African lady with a background history of cervical intra-epithelial neoplasia and recent colposcopy presented to the emergency department with severe abdominal pain. Initial investigations were non-diagnostic and despite empirical antibiotic therapy the patient developed peritonism. Post-laprotomy the diagnosis of severe pelvic inflammatory disease and peritonitis secondary to infection with Neisseria Gonorrhoea was made.

  12. Effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. A randomized, placebo controlled pilot study

    Directory of Open Access Journals (Sweden)

    Jusset Teresa García-Navia

    2016-01-01

    Full Text Available Background and goal of study: there is evidence that perioperative intravenous ketamine and lidocaine reduce postoperative pain, postoperative opioids consumption, shortens hospital stay and accelerates intestinal function recovery. However, it has not been studied the beneficial effects in the intraoperative period. The aim of this study was to evaluate the effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. Materials and methods: we performed a single-centre, prospective, randomized, double-blinded, placebo-controlled study. We included 33 patients (11 in the ketamine group, 11 in the lidocaine group and 11 in the placebo group. Postoperative analgesia was accomplished by patient-controlled morphine. Patients were randomly assigned to receive either a 1.5 mg/kg of 2% lidocaine, 0.5 mg/kg of 5% ketamine or 0.9% saline bolus. The primary outcome was the opioids consumption during surgery. The secondary outcomes included: emergence time, pain scores, opioids consumption within 24 h after surgery and side effects. Results: decreased intraoperative opioids requirements were noted in the experimental groups (ketamine: 402.3 } 106.3 and lidocaine: 397.7 } 107.5, compared with saline: 561.4 } 97.1; p = 0.001. We found a positive correlation between intraoperative opioids consumption and emergence time (r = 0.864, p < 0.001. There was no significant difference between the groups in VAS pain scores at rest within the first 24 postoperative hours. Total morphine consumption within 24 h after surgery did not differ significantly among the groups (placebo: 27.54 } 11.75; ketamine: 30.95 } 7.88; lidocaine 34.77 } 10.25; p = 0.26. Postoperative nausea and vomiting were more common in placebo group (it was observed in 3 subjects in ketamine group, in 5 subjects in lidocaine group and in 9 subjects in placebo group; p = 0

  13. 76 FR 64951 - Apothecon et al.; Withdrawal of Approval of 103 New Drug Applications and 35 Abbreviated New Drug...

    Science.gov (United States)

    2011-10-19

    ... HUMAN SERVICES Food and Drug Administration Apothecon et al.; Withdrawal of Approval of 103 New Drug Applications and 35 Abbreviated New Drug Applications; Correction AGENCY: Food and Drug Administration, HHS... new drug applications (NDAs) and 35 abbreviated new drug applications (ANDAs) from multiple...

  14. 78 FR 25749 - Submission of New Drug Application/Abbreviated New Drug Application Field Alert Reports: Notice...

    Science.gov (United States)

    2013-05-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Submission of New Drug Application/Abbreviated New Drug... submit new drug application (NDA) and abbreviated new drug application (ANDA) Field Alert Reports...

  15. 77 FR 16039 - Abbott Laboratories et al.; Withdrawal of Approval of 35 New Drug Applications and 64 Abbreviated...

    Science.gov (United States)

    2012-03-19

    ... Drug Applications and 64 Abbreviated New Drug Applications AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is withdrawing approval of 35 new drug applications (NDAs) and 64 abbreviated new drug applications (ANDAs) from multiple applicants. The holders...

  16. A woman presenting with postabortal pyomyoma and treated with exploratory laparotomy with myomectomy and fistulectomy: a case report

    Directory of Open Access Journals (Sweden)

    Saravanan M. Rajalakshmi

    2016-10-01

    Full Text Available Pyomyoma (suppurative leiomyoma of the uterus is a rare condition resulting from infarction and infection of a leiomyoma. It is more usual in pregnant women or postmenopausal women who have vascular disease. The condition is usually fatal unless treated with appropriate antibiotics and surgical intervention. We report a case of a 42-year-old woman who presented with abdominal pain and lump abdomen for 6 months with fever over a period of one month with anaemia for which she was readmitted. She had a history of incomplete abortion with fibroid with red degeneration for which check evacuation was done one and half months before readmission. During the course of treatment in hospital she developed an umbilical fistula with continuous drainage of pus. Her clinical presentation proved to be a diagnostic dilemma mimicking other clinical entities including Tuberculosis and ovarian cancer. Her blood culture and urine culture were sterile. She was widal (dilution positive and Mantoux negative. Her pus culture from umbilical wound and vaginal swab culture revealed growth of E- coli sensitive to gentamicin and amoxicillin clavulanic acid. An ultrasound scan suggested uterine fibroid with mixed echogenic collection in pelvic cavity with fistulous communication to the umbilicus, but a Magnetic resonance imaging scan suggested a big mass that appeared heterogeneous with fluid filled areas in posterior wall. She was treated with several courses of antibiotics and finally had to undergo laparotomy. During laparotomy, it was found that a large pyomyoma came into view which was successfully removed followed by fistulectomy by surgeon. The patient had uneventful recovery till discharge from hospital. The diagnosis of pyomyoma should be considered in perimenopausal women with large fibroids and pyrexia of unknown origin. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3626-3629

  17. Effective Municipal Emergency Planning for People With Disabilities and Others With Access and Functional Needs

    Science.gov (United States)

    2012-09-01

    LIST OF ACRONYMS AND ABBREVIATIONS ADA Americans with Disabilities Act AFN Access and Functional Needs CEMA California Emergency Management...Needs Support Services (“FNSS”), planning against risks identified in the City.”46 Additionally, the California Emergency Management Agency ( CEMA

  18. Psychometric Properties of the Abbreviated Perceived Motivational Climate in Exercise Questionnaire

    Science.gov (United States)

    Moore, E. Whitney G.; Brown, Theresa C.; Fry, Mary D.

    2015-01-01

    The purpose of this study was to develop an abbreviated version of the Perceived Motivational Climate in Exercise Questionnaire (PMCEQ-A) to provide a more practical instrument for use in applied exercise settings. In the calibration step, two shortened versions' measurement and latent model values were compared to each other and the original…

  19. Abbreviated Title of the Artwork in the System of Signs by Ch. Peirce

    Directory of Open Access Journals (Sweden)

    Grigoriy Valeryevich Tokarev

    2015-09-01

    Full Text Available The article is devoted to the semiotic aspect of the functioning of the abbreviated title of the postmodern artwork. The authors analyze the relationship of title-sign to the object which it replaces. The title is considered from the perspective of three main features peculiar of the sign in accordance with the Charles S. Peirce's theory. This fact allows us to conclude that, being a sign, the abbreviated title replaces a literary text, which is also expressed in symbolic form of the author's knowledge of reality. In this aspect the title becomes the metasign of its text. It is shown that in this connection, decoding and interpretation process take place in two stages – before reading the text and in the process of its reading and interpretation. It is alleged that the result of the interpretation of the title depends on the reader's competence which is determined by their individual literary scope, as well as by the skills of productive work with the text. On the basis of the classification of signs created by Charles Pierce, it was found that the abbreviated title has a complex semiotic nature combining the features of indexicality, conventionality, and iconicity, the latter of which may be present only in the abbreviated title.

  20. Relationship between Acceptable Noise Level and the Abbreviated Profile of Hearing Aid Benefit

    Science.gov (United States)

    Freyaldenhoven, Melinda C.; Nabelek, Anna K.; Tampas, Joanna W.

    2008-01-01

    Purpose: This study investigated the relationship between acceptable noise levels (ANLs) and the Abbreviated Profile of Hearing Aid Benefit (APHAB; R. M. Cox & G. C. Alexander, 1995). This study further examined the APHAB's ability to predict hearing aid use. Method: ANL and APHAB data were collected for 191 listeners with impaired hearing,…

  1. 78 FR 52931 - Draft Guidance for Industry on Abbreviated New Drug Applications: Stability Testing of Drug...

    Science.gov (United States)

    2013-08-27

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Abbreviated New Drug Applications: Stability Testing of Drug Substances and Products, Questions and Answers; Availability AGENCY... announcing the availability of a draft guidance for industry entitled ``ANDAs: Stability Testing of...

  2. 77 FR 58999 - Draft Guidance for Industry on Abbreviated New Drug Applications: Stability Testing of Drug...

    Science.gov (United States)

    2012-09-25

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Abbreviated New Drug... availability of a draft guidance for industry entitled ``ANDAs: Stability Testing of Drug Substances and... of a draft guidance for industry entitled ``ANDAs: Stability Testing of Drug Substances and...

  3. 75 FR 73108 - Guidance for Industry on Abbreviated New Drug Applications: Impurities in Drug Products...

    Science.gov (United States)

    2010-11-29

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Abbreviated New Drug Applications...: The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry...) guidance for industry ``Q3B(R) Impurities in New Drug Products,'' which was announced in August 2006....

  4. 78 FR 37231 - Guidance for Industry; Guidance on Abbreviated New Drug Applications: Stability Testing of Drug...

    Science.gov (United States)

    2013-06-20

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry; Guidance on Abbreviated New Drug... the availability of a guidance for industry entitled ``ANDAs: Stability Testing of Drug Substances and... generic drug review, FDA is recommending that the generic drug industry follow the approach in...

  5. New drug applications and abbreviated new drug applications; technical amendment. Final rule; technical amendment.

    Science.gov (United States)

    2009-03-06

    The Food and Drug Administration (FDA) is amending its new drug application (NDA) and abbreviated new drug application (ANDA) regulations to update agency contacts for patent information and patent notifications and to correct an inaccurate cross-reference. This action is being taken to ensure accuracy and clarity in the agency's regulations.

  6. 21 CFR 314.150 - Withdrawal of approval of an application or abbreviated application.

    Science.gov (United States)

    2010-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW... that is described in the application or abbreviated application and that is essential to show that the... or contract research organization that conducted a bioavailability or bioequivalence study...

  7. Evaluating an Abbreviated Version of the Hispanic Stress Inventory for Immigrants

    Science.gov (United States)

    Cavazos-Rehg, Patricia A.; Zayas, Luis H.; Walker, Mark S.; Fisher, Edwin B.

    2006-01-01

    This study evaluates an abbreviated version of the Hispanic Stress Inventory-Immigrant version (HSI-I) with a nonclinical sample of 143 adult Hispanic immigrants residing in a large midwestern city. The HSI-I consists of 73 items and 5 distinct subscales that assess psychosocial experiences on five dimensions, namely, occupational/economic,…

  8. 75 FR 37295 - Change of Address; Abbreviated New Drug Applications; Technical Amendment

    Science.gov (United States)

    2010-06-29

    ...The Food and Drug Administration (FDA) is amending its regulations to update the address for applicants to submit abbreviated new drug applications (ANDAs) and ANDA amendments, supplements, and resubmissions. FDA is also updating the address for ANDA applicants to submit investigational new drug applications (INDs) for in vivo bioavailability and bioequivalence studies in humans that are......

  9. The Maximum Entropy Approach to Record Abbreviation for Optimal Record Control.

    Science.gov (United States)

    Goyal, P.

    1983-01-01

    Tests performed on 6,260 titles from 3 machine-readable British National Bibliography files using an entropy based technique for abbreviation of text strings for use as a control code found that more than 94 percent of the titles generated a unique seven character code. Six references and an illustrative example are appended. (EJS)

  10. Symbolic Capital in a Virtual Heterosexual Market: Abbreviation and Insertion in Italian iTV SMS

    Science.gov (United States)

    Herring, Susan C.; Zelenkauskaite, Asta

    2009-01-01

    This study analyzes gender variation in nonstandard typography--specifically, abbreviations and insertions--in mobile phone text messages (SMS) posted to a public Italian interactive television (iTV) program. All broadcast SMS were collected for a period of 2 days from the Web archive for the iTV program, and the frequency and distribution of…

  11. The Use of Abbreviations in English-Medium Astrophysics Research Paper Titles: A Problematic Issue

    Science.gov (United States)

    Méndez, David I.; Alcaraz, M. Ángeles

    2015-01-01

    In this study, we carry out a qualitative and quantitative analysis of abbreviations in 300 randomly collected research paper titles published in the most prestigious European and US-based Astrophysics journals written in English. Our main results show that the process of shortening words and groups of words is one of the most characteristic and…

  12. Late radiation injuries of the gastrointestinal tract in the H2 and H5 EORTC Hodgkin's disease trials: emphasis on the role of exploratory laparotomy and fractionation.

    Science.gov (United States)

    Cosset, J M; Henry-Amar, M; Burgers, J M; Noordijk, E M; Van der Werf-Messing, B; Meerwaldt, J H; van der Schueren, E

    1988-09-01

    Out of 516 patients who entered in the two successive EORTC trials H2 and H5 for supra-diaphragmatic stages I and II Hodgkin's disease (HD), and who received an infra-diaphragmatic irradiation, 36 (7%) developed late radiation injuries of the gastrointestinal tract (GIT). Twenty-five patients presented with ulcers (stomach or duodenum), 2 with severe gastritis, 6 with small bowel obstruction or perforation and 3 patients had both an ulcer and bowel obstruction. A previous laparotomy played an important role. While the complication rate was 2.7% without any previous abdominal surgery, it was 11.5% after laparotomy (p less than 0.001). Fractionation was also found to be of importance in the occurrence of complications: three different weekly schedules were used -5 x 2 Gy, 4 x 2.5 Gy and 3 x 3.3 Gy; the GIT complication rates were 4, 9 and 22%, respectively (p less than 0.001). When combining laparotomy and fractionation, we found that the patients who were treated using 5 weekly fractions of 2 Gy without any prior laparotomy had a very low rate of late digestive complications (1%), whereas the patients who received 3 weekly fractions of 3.3 Gy after laparotomy presented a 39% complication rate. The other subgroups of patients were at an intermediate risk (from 5 to 13%) of late digestive injuries. Since most patients received 40 Gy with only very small variations, the influence of the radiation dose could not be investigated.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Local and systemic chemotherapy with taurolidine and taurolidine/heparin in colon cancer-bearing rats undergoing laparotomy.

    Science.gov (United States)

    Braumann, Chris; Ordemann, Jürgen; Kilian, Maik; Wenger, Frank A; Jacobi, Christoph A

    2003-01-01

    Experimental studies in the therapy of malignant abdominal tumors have shown that different cytotoxic agents suppress the intraperitoneal tumor growth. Nevertheless, a general accepted approach to prevent tumor recurrences does not exist. Following subcutaneous and intraperitoneal injection of 10(4) colon adenocarcinoma cells (DHD/K12/TRb), the influences of both taurolidine or taurolidine/heparin on intraperitoneal and subcutaneous tumor growth was investigated in 105 rats undergoing midline laparotomy. The animals were randomized into 7 groups and operated on during 30 min. To investigate the intraperitoneal (local) influence of either taurolidine or heparin on tumor growth, the substances were applied intraperitoneally. Systemic and intraperitoneal effects were evaluated after intravenous injection of the substances. Both application forms were also combined to analyze synergistic effects. Tumor weights, as well as the incidence of abdominal wound metastases, were determined four weeks after the intervention. In order to evaluate the effects of the agents, blood was taken to determine the peripheral leukocytes counts. Intraperitoneal tumor growth in rats receiving intraperitoneal application of taurolidine (median 7.0 mg, P = 0.05) and of taurolidine/heparin (median 0 mg, P = 0.02) was significantly reduced when compared to the control group (median 185 mg). The simultaneous instillation of both agents also reduced the intraperitoneal tumor growth (median 4 mg, P = 0.04), while the intravenous injection of the substances caused no local effect. In contrast, the subcutaneous tumor growth did not differ among all groups. In all groups, abdominal wound recurrences were rare and did not differ. Independent of the agents and the application form, the operation itself caused a slight leukopenia shortly after the operation and a leukocytosis in the following course. Intraperitoneal therapy of either taurolidine or in combination with heparin inhibits local tumor growth

  14. McArthur-Bates Communicative Development Inventory (CDI: Proposal of an abbreviate version

    Directory of Open Access Journals (Sweden)

    Chamarrita Farkas Klein

    2011-01-01

    Full Text Available The McArthur-Bates Communicative Development Inventories (CDI assesses language development en children, through a significant caregiver report. The first inventory assesses verbal and non verbal language in infants who are from 8 to 18 months old and it is composed of 949 items distributed in 6 scales. This study proposes an abbreviate form of this instrument, and was tested on families and educators of 130 Chilean children of 11-15 months old. Analyses related to the items, reliability and validity of the instrument and factorial analyses of subscales were realized. The abbreviate version consider 241 items distributed in 4 scales. The evaluation of the psychometric properties of the instrument was acceptable, demonstrating adequate reliability and validity.

  15. Financial reporting by small companies in the UK: the demand for abbreviated accounts

    OpenAIRE

    Collis, Jill

    2003-01-01

    The aim of the study is to provide generalisble evidence of the utility of the statutory financial statements of small companies to the directors. It took the form of a postal questionnaire survey of the directors of a tranche of 385 companies meeting the EC size criteria for a small company. This paper focuses on the factors that influence the filing choices of the directors of these small companies and the demand for abbreviated accounts.

  16. Abbreviated epitaxial growth mode (AGM) method for reducing cost and improving quality of LEDs and lasers

    Energy Technology Data Exchange (ETDEWEB)

    Tansu, Nelson; Chan, Helen M; Vinci, Richard P; Ee, Yik-Khoon; Biser, Jeffrey

    2013-09-24

    The use of an abbreviated GaN growth mode on nano-patterned AGOG sapphire substrates, which utilizes a process of using 15 nm low temperature GaN buffer and bypassing etch-back and recovery processes during epitaxy, enables the growth of high-quality GaN template on nano-patterned AGOG sapphire. The GaN template grown on nano-patterned AGOG sapphire by employing abbreviated growth mode has two orders of magnitude lower threading dislocation density than that of conventional GaN template grown on planar sapphire. The use of abbreviated growth mode also leads to significant reduction in cost of the epitaxy. The growths and characteristics of InGaN quantum wells (QWs) light emitting diodes (LEDs) on both templates were compared. The InGaN QWs LEDs grown on the nano-patterned AGOG sapphire demonstrated at least a 24% enhancement of output power enhancement over that of LEDs grown on conventional GaN templates.

  17. BUSINESS ENGLISH OUTSIDE THE BOX. BUSINESS JARGON AND ABBREVIATIONS IN BUSINESS COMMUNICATION

    Directory of Open Access Journals (Sweden)

    Pop Anamaria-Mirabela

    2014-12-01

    Full Text Available Business English is commonly understood language, yet Harvard Business Review called business jargon “The Silent Killer of Big Companies”. As we all have been taught in school, we are aware of the fact that in communication we must comply with linguistic rules so that our message gets across succinctly. Yet, there is one place where all these rules can be omitted (at least in the recent decades: the corporate office. Here, one can use euphemisms and clichés, can capitalize any word that is considered important, the passive voice is used wherever possible and abbreviations occur in every sentence. The worst part is that all of these linguistic enormities are carried out deliberately. The purpose of this paper is to analyse to what extent business jargon and abbreviations have affected business communication (which most of the time, it is filled with opaque language to mask different activities and operations and the reasons for which these linguistic phenomena have become so successful in the present. One of the reasons for the research is that in business English, jargon can be annoying because it overcomplicates. It is frequently unnecessary and it can transform a simple idea or instruction into something very confusing. It is true that every field has its jargon. Education, journalism, law, politics, medicine, urban planning – no filed is immune. Yet, it seems that business jargon has been described as “the most annoying”. Another reason is that jargon tends to be elitist. Those who do not understand the terms feel confused and uncertain. The paper starts with defining these two concepts, business jargon and abbreviations, and then it attempts to explain the “unusual” pervasion of these, both in business communication and in everyday communication. For this, the paper includes a list with the most common business jargon and abbreviations. In this view, the authors have accessed different economic blogs and specialty journals

  18. Effects of SK-896, a new human motilin analogue ([Leu13]motilin-Hse), on postoperative ileus in dogs after laparotomy.

    Science.gov (United States)

    Furuta, Yoshiyuki; Takeda, Motohiro; Nakayama, Yukiharu; Ito, Mikio; Suzuki, Yoshio

    2002-08-01

    The effects of SK-896, a new human motilin analogue ([Leu13]motilin-Hse), on digestive tract motility in postoperative ileus were evaluated in a dog model of ileus after laparotomy. SK-896 was intravenously administered at 0.17, 0.33 and 0.67 microg/kg starting soon after operation and then at 6-h intervals, for a total of 9 times. SK-896 progressively, dose-dependently and significantly increased the duodenal motility from 1 h after operation. The recovery time of the gastrointestinal-interdigestive migrating complex (GI-IMC) activity, which is an indicator of normal gastrointestinal tract activity after laparotomy, was 56.5 +/- 5.0 h in the control group. SK-896 significantly shortened this recovery time. On the other hand, the plasma SK-896 concentrations declined diexponentially after administration, and can be described by a linear pharmacokinetic model within the dose range used. In addition, the pharmacokinetics of SK-896 did not change significantly at any postoperative time. There was no correlation between the plasma SK-896 concentrations and the intensity of duodenal motility, because the activity in the duodenum decreased transiently 13 h after laparotomy and increased with time thereafter. The changes in the activity are considered to reflect the progressive changes in the state of ileus. In conclusion, SK-896 increased the duodenal motility significantly, shortening the recovery time of GI-IMC-like activity in dogs with post-laparotomy ileus. Therefore, it is expected from these results that SK-896 would be useful and effective for the treatment of gastroparalysis after abdominal surgery.

  19. Laparoscopy versus mini-laparotomy peritoneal catheter insertion of ventriculoperitoneal shunts: a systematic review and meta-analysis.

    Science.gov (United States)

    He, Mingliang; Ouyang, Leping; Wang, Shengwen; Zheng, Meiguang; Liu, Anmin

    2016-09-01

    OBJECTIVE Ventriculoperitoneal (VP) shunt treatment is the main treatment method for hydrocephalus. The traditional operative approach for peritoneal catheter insertion is mini-laparotomy. In recent years, laparoscopy-assisted insertion has become increasingly popular. It seems likely that use of an endoscope could lower the incidence of shunt malfunction. However, there is no consensus about the benefits of laparoscopy-assisted peritoneal catheter insertion. METHODS A systematic search was performed using the PubMed, Embase, ScienceDirect, and Cochrane Library databases. A manual search for reference lists was conducted. The protocol was prepared according to the interventional systematic reviews of the Cochrane Handbook, and the article was written on the basis of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. RESULTS Eleven observational trials and 2 randomized controlled trials were included. Seven operation-related outcome measures were analyzed, and 3 of these showed no difference between operative techniques. The results of the meta-analysis are as follows: in the laparoscopy group, the rate of distal shunt failure was lower (OR 0.41, 95% CI 0.25-0.67; p = 0.0003), the absolute effect is 7.11% for distal shunt failure, the number needed to treat is 14 (95% CI 8-23), operative time was shorter (mean difference [MD], -12.84; 95% CI -20.68 to -5.00; p = 0.001), and blood loss was less (MD -9.93, 95% CI -17.56 to -2.31; p = 0.01). In addition, a borderline statistically significant difference tending to laparoscopic technique was observed in terms of hospital stay (MD -1.77, 95% CI -3.67 to 0.13; p = 0.07). CONCLUSIONS To some extent, a laparoscopic insertion technique could yield a better prognosis, mainly because it is associated with a lower distal failure rate and shorter operative time, which would be clinically relevant.

  20. Quality of life and sexuality in disease-free survivors of cervical cancer after radical hysterectomy alone: A comparison between total laparoscopy and laparotomy.

    Science.gov (United States)

    Xiao, Meizhu; Gao, Huiqiao; Bai, Huimin; Zhang, Zhenyu

    2016-09-01

    The aim of the present study was to evaluate the possible differences between total laparoscopy and laparotomy regarding their impact on postoperative quality of life and sexuality in disease-free cervical cancer survivors who received radical hysterectomy (RH) and/or lymphadenectomy alone and were followed for >1 year.We reviewed all patients with cervical cancer who had received surgical treatment in our hospital between January 2001 and March 2014. Consecutive sexually active survivors who received RH and/or lymphadenectomy for early stage cervical cancer were enrolled and divided into 2 groups based on surgical approach. Survivors were interviewed and completed validated questionnaires, including the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items, the Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI).In total, 273 patients with histologically confirmed cervical cancer were retrospectively reviewed. However, only 64 patients had received RH and/or lymphadenectomy alone; 58 survivors meeting the inclusion criteria were enrolled, including 42 total laparoscopy cases and 16 laparotomy cases, with an average follow-up of 46.1 and 51.2 months, respectively. The survivors in the 2 groups obtained good and similar scores on all items of the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items and Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items, without significant differences after controlling for covariate background characteristics. To the date of submission, 21.4% (9/42) of cases in the total laparoscopy group and 31.2% (5/16) of cases in the laparotomy group had not resumed sexual behavior after RH. Additionally

  1. Salvage of relapse of patients with Hodgkin's disease in clinical stages I or II who were staged with laparotomy and initially treated with radiotherapy alone. A report from the international database on Hodgkin's disease

    DEFF Research Database (Denmark)

    Specht, L; Horwich, A; Ashley, S

    1994-01-01

    To analyze presentation variables that might indicate a high or low likelihood of success of the treatment of patients relapsing after initial radiotherapy of Hodgkin's disease in clinical Stages I or II who were staged with laparotomy....

  2. Effect of Ultrasound Guided Rectus Sheath Block on Postoperative Analgesia after Laparotomy with Transverse Incision in Children

    Directory of Open Access Journals (Sweden)

    Aydin Halefoglu

    2015-09-01

    Material and Methods: Forty patients with ASA I-II physical status, aged 3-7 years and undergoing laparotomy with transverse incision were randomly allocated into two groups. Patients were administered general anesthesia and before the beginning of surgery ultrasound guided RSB with 0.2 mL/kg, 0.25% of levobupivacaine and thirty minutes before the surgery the loading dose of morphine of 0.1 mg/kg intravenously were received in group RSB and group M, respectively. Analgesic drug pump with 0.01 mg/kg bolus doses of morphine and 30 minutes lockout interval was set up postoperatively in both groups. Concentrations (% and consumed amounts (mL/h of sevoflurane during the surgery and systolic and diastolic blood pressure, heart rate, and peripheral oxygen saturation values were recorded both intraoperative and postoperative period in each groups. Analgesic consumption with postoperative analgesic drug pump, FLACC pain scores, sedation level, nausea, vomiting, supplemental analgesic requirement and side effects were also recorded. Results: Demographic data and hemodynamic parameters were similar in both groups excepting that systolic arterial pressure values were reduced in group RSB than in group M. Inhaled concentration and consumed amounts of sevoflurane were decreased in group RSB compared with group M. Averages of consumptions of sevoflurane were 18.7+/-2.1 mL/h and 21.5 +/-2.9 mL/h in group RSB and group M, respectively (p<0.001. Postoperative FLACC scores, sedation scores, and morphine consumption for 24 hours were lower in group RSB than in group M (p<0.001. Three patients had nausea in group M, however no nausea and vomiting was observed in group RSB and any patients did not need supplemental analgesia postoperatively. Conclusions: Ultrasound guided RSB is superior to intravenous morphine according to intraoperative anesthetic gas consumption and postoperative pain control in children undergoing abdominal surgery using transverse incision. [Cukurova Med J 2015; 40

  3. Abbreviations, acronyms, and initialisms frequently used by Martin Marietta Energy Systems, Inc.. Second edition

    Energy Technology Data Exchange (ETDEWEB)

    Miller, J.T.

    1994-09-01

    Guidelines are given for using abbreviations, acronyms, and initialisms (AAIs) in documents prepared by US Department of Energy facilities managed by Martin Marietta Energy Systems, Inc., in Oak Ridge, Tennessee. The more than 10,000 AAIs listed represent only a small portion of those found in recent documents prepared by contributing editors of the Information Management Services organization of Oak Ridge National Laboratory, the Oak Ridge K-25 Site, and the Oak Ridge Y-12 Plant. This document expands on AAIs listed in the Document Preparation Guide and is intended as a companion document

  4. Attenuation by phentolamine of hypoxia and levcromakalim-induced abbreviation of the cardiac action potential.

    OpenAIRE

    Tweedie, D.; Boachie-Anash, G.; Henderson, C. G.; Kane, K. A.

    1993-01-01

    1. The effects of phentolamine (5-30 microM) and glibenclamide (10 microM) on action potential characteristics were examined in guinea-pig papillary muscle exposed to either hypoxia or levcromakalim (20 microM). 2. The hypoxia-induced abbreviation of action potential duration (APD) and effective refractory period (ERP) were attenuated but not abolished by glibenclamide (10 microM). Hypoxia reduced APD by 24 +/- 2 vs 65 +/- 4% in glibenclamide- and vehicle-treated tissue, respectively. 3. Phen...

  5. An abbreviated version of the brief assessment of cognition in schizophrenia (BACS

    Directory of Open Access Journals (Sweden)

    MD Yasuhiro Kaneda

    2015-06-01

    Full Text Available Background and Objectives: A short version of the Brief Assessment of Cognition in Schizophrenia (BACS was derived. Methods: We calculated the corrected item-total correlation (CITC for each test score relative to the composite score, and then computed the proportion of variance that each test shares with the global score excluding that test (Rt² = CITCt² and the variance explained per minute of administration time for each test (Rt²/mint. Results and Conclusions: The 3 tests with the highest Rt²/mint, Symbol Coding, Digit Sequencing, and Token Motor, were selected for the Abbreviated BACS.

  6. Comparison between computed tomography with oral oil-based contrast and laparotomy for gastric cancer staging; Tomografia computerizada con contraste oral graso frente a lapartomia en la estadificacion del cancer gastrico

    Energy Technology Data Exchange (ETDEWEB)

    Marco, S. F.; Garcia-Vila, J. H.; Cervera, J.; Gomez, R.; Piqueras, R. M.; Perona, I.; Escrig, J.; Salvador, J. L. [Hospital General de Castello. Castellon (Spain)

    2000-07-01

    To compare the utility of conventional computed tomography (CT) with oral oil-based contrast with that of laparotomy in the preoperative staging of gastric cancer. We prospectively studied 41 patients diagnosed as having gastric adenocarcinoma according to the results of endoscopy and biopsy. Applying the TNM classification for gastric cancer staging, we compared the findings in CT associated with oral oil-based contrast and intraoperative staging with definitive postoperative pathological staging. Definitive pathological studies demonstrated that there were 7 stage T1-T2 lesions, 26 stage T3 and 8 stage T4. The assessment of lymph node involvement showed that 10 patients presented stage N0 and 31 stage N1-N3. Ten patients had metastases. The diagnostic reliability for tumor staging according to CT was 56% versus 80% for laparotomy. In the determination of nodal involvement CT had a diagnostic yield of 71% versus 6% for laparotomy. Metastatic disease was correctly diagnosed by CT in 83% of cases versus 88% by laparotomy. There were no statistically significant differences between CT with oral oil-based contrast and laparotomy for the staging of nodal involvement and metastases. However, the CT diagnosis was significantly more reliable than laparotomy for the determination of tumor infiltration. (Author) 21 refs.

  7. Diabetic Emergencies

    Science.gov (United States)

    ... Emergencies A-Z Share this! Home » Emergency 101 Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  8. Childhood Emergencies

    Science.gov (United States)

    ... emergency physicians. They receive comprehensive training in treating childhood emergencies and have more training in pediatric emergencies than other physicians, including pediatricians. Does Your Child's School Know About Food Allergies? - 8/10/2015 The nation's emergency physician ...

  9. Randomized comparison of polyglycolic acid and polyglyconate sutures for abdominal fascial closure after laparotomy in patients with suspected impaired wound healing

    DEFF Research Database (Denmark)

    Osther, P J; Gjøde, P; Mortensen, Sophie Berit Bondegaard

    1995-01-01

    A randomized study of abdominal fascial closure using interrupted polyglyconate and polyglycolic acid sutures after laparotomy was carried out in 204 consecutive patients with suspected impaired wound healing. There were no statistically significant differences between the two sutures with regard...... to the development of fascial disruption and incisional hernia. Wound infection demanding surgical intervention was found in 7 per cent of patients with polyglyconate sutures and in 16 per cent of those with polyglycolic acid sutures (P = 0.04). Monofilament polyglyconate suture does not reduce the incidence...

  10. [Anesthetic management of exploratory laparotomy for a patient with panperitonitis with hyperkalemia: a case report of spontaneous rupture of the urinary bladder].

    Science.gov (United States)

    Kotani, Kohei; Takaki, Osamu

    2006-07-01

    A 71-year-old woman was admitted with panperitonitis, hyperkalemia and acute renal failure. Immediately after a large amount of ascites had been drained by laparotomy, hyperkalemia and acidosis were remarkably improved. During the operation, rupture of the urinary bladder was detected and repaired. The level of potassium and renal function became normal the next morning, and it seemed that peritoneal-self-dialysis had been related to hyperkalemia and acute renal failure. Rupture of the urinary bladder is very rare but should be considered in any cases of acute abdomen with hyperkalemia and acute renal failure.

  11. [A study on the abbreviated form of the Eysenck Personality Questionnaire Revised-Abbreviated (EPQR-A) in a student population].

    Science.gov (United States)

    Bouvard, M; Aulard-Jaccod, J; Pessonneaux, S; Hautekeete, M; Rogé, B

    2010-12-01

    The aim of this paper is to examine the short questionnaire of the Eysenck Personality Questionnaire Revised (the Eysenck Personality Questionnaire Revised-Abbreviated [EPQR-A]) among a student population. University students were invited, in groups, to fill in the forms proposed. Three sites were compared, representing a sample of 346 participants (Chambéry=118 subjects [44 males and 74 females]; Lille=110 subjects [50 males and 60 females] and Toulouse=118 subjects [60 males and 58 females]). The three groups of students have comparable scores on the EPQR-A wherever they live (Chambéry, Lille or Toulouse). Moreover, neither the age nor the gender allowed the detection of differences between subjects. Our sample of students is situated in the range of a "normal" group of students. Regarding the internal consistency coefficients, the French version we used of the neuroticism and the extraversion scales of the EPQR-A obtained a satisfactory result. The internal consistency coefficient of psychoticism was rather low (<70). This unsatisfactory level of internal reliability for the psychoticism is also found in the English version [7]. The four-factor model of the EPQR-A is judged to be an adequate explanation of the data. In the end, self-esteem correlated positively with extraversion and negatively with neuroticism. On the other hand, there is no link between psychoticism and self-esteem.

  12. 21 CFR 314.430 - Availability for public disclosure of data and information in an application or abbreviated...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Availability for public disclosure of data and... APPROVAL TO MARKET A NEW DRUG Miscellaneous Provisions § 314.430 Availability for public disclosure of data... acknowledged, no data or information in the application or abbreviated application is available for...

  13. 78 FR 60292 - Draft Guidance for Industry on Abbreviated New Drug Application Submissions-Refuse-to-Receive...

    Science.gov (United States)

    2013-10-01

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Abbreviated New Drug Application Submissions--Refuse-to-Receive Standards; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of a...

  14. The Revised Junior Eysenck Personality Questionnaire (JEPQ-R): Dutch replications of the full length, short, and abbreviated forms

    NARCIS (Netherlands)

    Scholte, R.H.J.; Bruyn, E.E.J. De

    2001-01-01

    This study examines the full-length, short and abbreviated forms of the Revised Junior Eysenck Personality Questionnaire (JEPQ-R) in a Dutch sample of 215 boys and 207 girls, aged 12–14. The reliability and concurrent validity of the scales of the full-length form (JEPQ-R, 81 items), short form (JEP

  15. Performance of an Abbreviated Version of the Lubben Social Network Scale among Three European Community-Dwelling Older Adult Populations

    Science.gov (United States)

    Lubben, James; Blozik, Eva; Gillmann, Gerhard; Iliffe, Steve; von Renteln-Kruse, Wolfgang; Beck, John C.; Stuck, Andreas E.

    2006-01-01

    Purpose: There is a need for valid and reliable short scales that can be used to assess social networks and social supports and to screen for social isolation in older persons. Design and Methods: The present study is a cross-national and cross-cultural evaluation of the performance of an abbreviated version of the Lubben Social Network Scale…

  16. Matching Element Symbols with State Abbreviations: A Fun Activity for Browsing the Periodic Table of Chemical Elements

    Science.gov (United States)

    Woelk, Klaus

    2009-01-01

    A classroom activity is presented in which students are challenged to find matches between the United States two-letter postal abbreviations for states and chemical element symbols. The activity aims to lessen negative apprehensions students might have when the periodic table of the elements with its more than 100 combinations of letters is first…

  17. Development of an Abbreviated Social Phobia and Anxiety Inventory (SPAI) Using Item Response Theory: The SPAI-23

    Science.gov (United States)

    Roberson-Nay, Roxann; Strong, David R.; Nay, William T.; Beidel, Deborah C.; Turner, Samuel M.

    2007-01-01

    An abbreviated version of the Social Phobia and Anxiety Inventory (SPAI) was developed using methods based in nonparametric item response theory. Participants included a nonclinical sample of 1,482 undergraduates (52% female, mean age = 19.4 years) as well as a clinical sample of 105 individuals (56% female, mean age = 36.4 years) diagnosed with…

  18. Abbreviated bibliography on energy development—A focus on the Rocky Mountain Region

    Science.gov (United States)

    Montag, Jessica M.; Willis, Carolyn J.; Glavin, Levi W.

    2011-01-01

    Energy development of all types continues to grow in the Rocky Mountain Region of the western United States. Federal resource managers increasingly need to balance energy demands, effects on the natural landscape and public perceptions towards these issues. To assist in efficient access to valuable information, this abbreviated bibliography provides citations to relevant information for myriad of issues for which resource managers must contend. The bibliography is organized by seven large topics with various sup-topics: broad energy topics (energy crisis, conservation, supply and demand, etc.); energy sources (fossil fuel, nuclear, renewable, etc.); natural landscape effects (climate change, ecosystem, mitigation, restoration, and reclamation, wildlife, water, etc.); human landscape effects (attitudes and perceptions, economics, community effects, health, Native Americans, etc.); research and technology; international research; and, methods and modeling. A large emphasis is placed on the natural and human landscape effects.

  19. Decompressive laparotomy in the treatment of severe acute pancreatitis complicated with abdominal compartment syndrome%开腹减压治疗重症急性胰腺炎并发腹腔间室综合征

    Institute of Scientific and Technical Information of China (English)

    朱维铭; 龚剑峰

    2008-01-01

    Abdominal compartment syndrome(ACS)is an important factor contributing to the multiple organ dysfunction syndrome which is commonly seen in patients with severe acute pancreatitis(SAP).As a life-saving procedure,decompressive laparotomy is widely applied to patients with SAP complicated with ACS,especially to patients with edema of the visceral tissues caused by massive fluid resuscitation at the early stage of the disease.However,decompressive laparotomy should be adopted with caution since it is associated with enteroatmospherie fistula,intraabdominal infection,postoperative ileus,third space losses,hypothermia and hemia.Therefore,decompressive laparotomy should only be considered after conservative management had failed.The indications for decompressive laparotomy are as follows:(1)intraabdominal pressure>25 nnn Hg;(2)adequate ventilation of the patient is difficult;(3)pereutaneous drainage of ascites is not helpful.Timely temporal abdominal closure is helpful in preventing complications.Infected peripanereatie necrosis is the indication for peripancreatic exploration or necroseetomy.A thorough knowledge of decompressive laparotomy is essential for individualized management of patients with SAP complicated with ACS.

  20. Perioperative nutritional management of patients undergoing laparotomy Cuidados nutricionales perioperatorios en pacientes sometidos a laparotomía

    Directory of Open Access Journals (Sweden)

    M. I. Toulson Davisson Correia

    2009-08-01

    Full Text Available Objectives: Lack of routine patient's nutritional assessment and prescription of long fasting periods throughout the perioperative period are still widely prevalent despite the advances in surgical care. Therefore, the aim of this study was to assess nutritional routines in two surgical wards. Methods: Adult patients undergoing laparotomy at two distinct units (gastrointestinal and gynecologic in two public hospitals (one of them a university were enrolled. Patients were divided in minor and major (groups A and B procedures and were nutritionally assessed at admission. Daily diet intake and a 24 hour recall were performed. Patients rated the quality of the meals, as well asregistered the reasons for not ingesting it fully. Results: Patients in group B presented with poorer nutritional status. Group A patients resumed oral diets on the first post operative day and most of them received regular diets (85.5%. In group B, only 4.7% were allowed a regular diet on the first PO day, 7.0% received soft diets, 30.2% full liquid diets, 27.9% clear liquids and the remaining 30.2% were on NPO. Patients in this group had a slower progression of diets from liquid to regular solid meals, with 7% of them still on NPO on the fifth PO day. Contrary to group B, patients in group A did not present with cumulative caloric and protein deficits throughout the postoperative period. Overall tolerance of the early diet was good. Conclusion: Malnutrition is still high among major surgical patients. Early oral nutrition can be feasible and well tolerated with few side effects, when prescribed.Objetivos: La falta de la valoración nutricional rutinaria del paciente y la prescripción de largos periodos de ayuno durante el periodo perioperatorio siguen siendo muy prevalentes a pesar de los avances en los cuidados quirúrgicos. Por lo tanto, el objetivo de este estudio fue evaluar las rutinas de valoración nutricional en dos guardias quirúrgicas. Métodos: Se reclutaron

  1. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Groen, Aard J.; Sijde, van der Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies an

  2. Jejunal diverticulosis presenting as an acute emergency.

    Science.gov (United States)

    Khan, Huma Sabir; Ayyaz, Mahmood

    2015-04-01

    Diverticulosis of jejunum is a relatively rare disease of bowel. Jejunal diverticula are false diverticula with projections of mucosa and serosa without the muscular layer. These manifest as diverticulitis, bleeding, perforation or intestinal obstruction. There should be a high index of suspicion when patients present with chronic central abdominal pain, malabsorption and anaemia. Sometimes they are just incidentally picked up on investigations. Laparoscopy can be valuable in diagnosis and treatment as most of the times jejunal diverticulosis can be treated conservatively with surgery required for generalized peritonitis and massive gastrointestinal bleeding. A 33-year man repeatedly presented to emergency with abdominal pain which resolved with analgesics until he developed constipation, vomiting, fever and severe abdominal pain. He had to undergo laparotomy which revealed multiple jejunal diverticula. Resection of the involved gut portion was done. The patient did fine postoperatively.

  3. [The role of laparoscopy in emergency abdominal surgery].

    Science.gov (United States)

    Balén, E; Herrera, J; Miranda, C; Tarifa, A; Zazpe, C; Lera, J M

    2005-01-01

    Abdominal emergencies can also be operated on through the laparoscopic approach: the approach can be diagnostic laparoscopy, surgery assisted by laparoscopy or laparotomy directed according to the findings of the laparoscopy. The general contraindications refer above all to the state of haemodynamic instability of the patient and to seriously ill patients (ASA IV). In the absence of any specific counter-indications for the specific laparoscopic procedure to be carried out, many abdominal diseases requiring emergency surgery can be performed with the laparoscopic approach. The most frequent indications are appendicitis, acute colecistitis, gastroduodenal perforation, occlusion of the small intestine, and some abdominal traumas. With a correct selection of patients and the appropriate experience of the surgeon, the results are excellent and better than open surgery (less infection of the wound, complications, hospital stay and postoperative pain). A detailed explanation is given of the basic aspects of the surgical technique in the most frequent procedures of emergency laparoscopy.

  4. Emerging Hopes

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China looks to strategically important emerging industries for innovation-driven economic growthc hina will soon announce a decision to rev up seven strategically impor- tant emerging industries,said the National

  5. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... prevents pregnancy in the same way as regular birth control pills: By preventing or delaying the release of an ...

  6. The Convergent, Discriminant, and Concurrent Validity of Scores on the Abbreviated Self-Leadership Questionnaire

    Directory of Open Access Journals (Sweden)

    Faruk Şahin

    2015-10-01

    Full Text Available The present study reports the psychometric properties of a short measure of self-leadership in the Turkish context: the Abbreviated Self-Leadership Questionnaire (ASLQ. The ASLQ was examined using two samples and showed sound psychometric properties. Confirmatory factor analysis showed that nine-item ASLQ measured a single construct of self-leadership. The results supported the convergent and discriminant validity of the one-factor model of the ASLQ in relation to the 35-item Revised Self-Leadership Questionnaire and General Self-Efficacy scale, respectively. With regard to internal consistency and test-retest reliability, the ASLQ showed acceptable results. Furthermore, the results provided evidence that scores on the ASLQ positively predicted individual's self-reported task performance and self-efficacy mediated this relationship. Taken together, these findings suggest that the Turkish version of the ASLQ is a reliable and valid measure that can be used to measure self-leadership as one variable of interest in the future studies.

  7. Validity and Reliability of the Abbreviated Barratt Impulsiveness Scale in Spanish (BIS-15S)*

    Science.gov (United States)

    Orozco-Cabal, Luis; Rodríguez, Maritza; Herin, David V.; Gempeler, Juanita; Uribe, Miguel

    2010-01-01

    Objective This study determined the validity and reliability of a new, abbreviated version of the Spanish Barratt Impulsiveness Scale (BIS-15S) in Colombian subjects. Method The BIS-15S was tested in non-clinical (n=283) and clinical (n=164) native Spanish-speakers. Intra-scale reliability was calculated using Cronbach’s α, and test-retest reliability was measured with Pearson correlations. Psychometric properties were determined using standard statistics. A factor analysis was performed to determine BIS-15S factor structure. Results 447 subjects participated in the study. Clinical subjects were older and more educated compared to non-clinical subjects. Impulsivity scores were normally distributed in each group. BIS-15S total, motor, non-planning and attention scores were significantly lower in non-clinical vs. clinical subjects. Subjects with substance-related disorders had the highest BIS-15S total scores, followed by subjects with bipolar disorders and bulimia nervosa/binge eating. Internal consistency was 0.793 and test-retest reliability was 0.80. Factor analysis confirmed a three-factor structure (attention, motor, non-planning) accounting for 47.87% of the total variance in BIS-15S total scores. Conclusions The BIS-15S is a valid and reliable self-report measure of impulsivity in this population. Further research is needed to determine additional components of impulsivity not investigated by this measure. PMID:21152412

  8. Abbreviated New Drug Applications and 505(b)(2) Applications. Final rule.

    Science.gov (United States)

    2016-10-06

    The Food and Drug Administration (FDA, the Agency, or we) is issuing a final rule to implement Title XI of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), which amended provisions of the Federal Food, Drug, and Cosmetic Act (the FD&C Act) that govern the approval of 505(b)(2) applications and abbreviated new drug applications (ANDAs). This final rule implements portions of Title XI of the MMA that pertain to provision of notice to each patent owner and the new drug application (NDA) holder of certain patent certifications made by applicants submitting 505(b)(2) applications or ANDAs; the availability of 30-month stays of approval on 505(b)(2) applications and ANDAs that are otherwise ready to be approved; submission of amendments and supplements to 505(b)(2) applications and ANDAs; and the types of bioavailability and bioequivalence data that can be used to support these applications. This final rule also amends certain regulations regarding 505(b)(2) applications and ANDAs to facilitate compliance with and efficient enforcement of the FD&C Act.

  9. A Confirmatory Factor Analysis of the Structure of Abbreviated Math Anxiety Scale

    Directory of Open Access Journals (Sweden)

    Farahman Farrokhi

    2011-06-01

    Full Text Available "nObjective: The aim of this study is to explore the confirmatory factor analysis results of the Persian adaptation of Abbreviated Math Anxiety Scale (AMAS, proposed by Hopko, Mahadevan, Bare & Hunt. "nMethod: The validity and reliability assessments of the scale were performed on 298 college students chosen randomly from Tabriz University in Iran. The confirmatory factor analysis (CFA was carried out to determine the factor structures of the Persian version of AMAS. "nResults: As expected, the two-factor solution provided a better fit to the data than a single factor. Moreover, multi-group analyses showed that this two-factor structure was invariant across sex. Hence, AMAS provides an equally valid measure for use among college students. "nConclusions:  Brief AMAS demonstrates adequate reliability and validity. The AMAS scores can be used to compare symptoms of math anxiety between male and female students. The study both expands and adds support to the existing body of math anxiety literature.

  10. Development of an abbreviated Career Indecision Profile-65 using item response theory: The CIP-Short.

    Science.gov (United States)

    Xu, Hui; Tracey, Terence J G

    2017-03-01

    The current study developed an abbreviated version of the Career Indecision Profile-65 (CIP-65; Hacker, Carr, Abrams, & Brown, 2013) by using item response theory. In order to improve the efficiency of the CIP-65 in measuring career indecision, the individual item performance of the CIP-65 was examined with respect to the ordering of response occurrence and gender differential item functioning. The best 5 items of each scale of the CIP-65 (i.e., neuroticism/negative affectivity, choice/commitment anxiety, lack of readiness, and interpersonal conflicts) were retained in the CIP-Short using a sample of 588 college students. A validation sample (N = 174) supported the reliability and structural validity of the CIP-Short. The convergent and divergent validity of the CIP-Short was additionally supported in the findings of a hypothesized differential relational pattern in a separate sample (N = 360). While the current study supported the CIP-Short being a sound brief measure of career indecision, the limitations of this study and suggestions for future research were discussed as well. (PsycINFO Database Record

  11. Emergent Expertise?

    Science.gov (United States)

    McGivern, Patrick

    2014-01-01

    The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

  12. Salvage of relapse of patients with Hodgkin's disease in clinical stages I or II who were staged with laparotomy and initially treated with radiotherapy alone. A report from the international database on Hodgkin's disease

    DEFF Research Database (Denmark)

    Specht, L.; Horwich, A.; Ashley, S.

    1994-01-01

    patients in the International Database on Hodgkin's Disease who were initially in clinical Stages I or II, who were staged with laparotomy, and who relapsed after initial treatment with irradiation alone. Factors analyzed for outcome after first relapse included initial stage, age, sex, histology...

  13. Portal and systemic serum growth factor and acute-phase response after laparotomy or partial hepatectomy in patients with colorectal liver metastases : A prognostic role for C-reactive protein and hepatocyte growth factor

    NARCIS (Netherlands)

    de Jong, KP; Hoedemakers, RMJ; Fidler, [No Value; Bijzet, J; Limburg, PC; Peeters, PMJG; de Vries, EGE; Slooff, MJH

    2004-01-01

    Background: Growth factors play a role in wound healing and tumour growth. The aim of this study was to compare the effect of partial hepatectomy (PH) and laparotomy on serum levels of growth factors and acute-phase proteins in patients with colorectal liver metastases and to correlate these levels

  14. Mini-laparotomy with abdominal wall lifting for partial gastrectomy in patients with early gastric mucosal cancer at lesser curvature of the middle stomach.

    Science.gov (United States)

    Tomita, Ryouichi; Fujisak, Shigeru; Park, Yeong Ji

    2009-01-01

    Partial gastrectomy (PG) is the most frequently adopted minimally invasive procedure for early gastric cancer (EGC), especially mucosal cancer (MC). The aim of this study was to introduce a minimally invasive procedure, i.e., minilaparotomy with abdominal wall lifting for PG in patients with early mucosal gastric cancer at the lesser curvature of the middle stomach. Well differentiated adenocarcionoma in MC at the lesser curvature of the middle stomach was selected, where no lymph node metastasis (NO) was confirmed using ultrasonic endoscopy, CT, and MRI during the preoperative examinations. PG was also chosen for patients with a tumor size of 2cm or less and non-depressive type in whom endoscopic mucosal resection (EMR) or endoscopic submucosal resection (ESD) was not possible. Five MC patients (3 men and 2 women, aged 44-62 years, mean age 53.3 years) underwent mini-laparotomy with abdominal wall lifting for PG. Our procedure involved a 6 cm upper abdominal median incision made at the beginning of the operation. The upper abdominal wall was lifted by a subcutaneous Kirshner wire. The small wound was also pulled upward and/or laterally by Kent retractors and conventional surgical instruments were used through the wound. The middle stomach could be detected through the small wound and partially resected, approximately 1 cm from the tumor edge under the guide of the endoscope. The resected stomach margin was stitched layer-to-layer. In this way, PG was easily completed. The total surgical time was 71.8 +/- 12.9 min and the mean estimated blood loss was 30.8 +/- 20.5 ml. Day of starting diet was 3 +/- 0.7 days after operation. Post-operative hospitalization was 8.2 +/- 1.3 days. There was no surgical mortality. All subjects were satisfied with this procedure. Mini-laparotomy with abdominal wall lifting is a safe and efficient technique in the treatment of PG for MC with NO at the lesser curvature of the middle stomach when EMR or ESD is impossible.

  15. Towards a Theory and View of Teaching Compressed and Abbreviated Research Methodology and Statistics Courses

    Directory of Open Access Journals (Sweden)

    James Carifio

    2007-01-01

    Full Text Available One of the highly questionable effects of educational reform and other curriculum reshaping factors at both the high school, post-secondary and graduate levels has been the shift to teaching compressed, pared-down or abbreviated courses in still needed or required subject-matter that became de-emphasized in the current educational reformation. Research methodology, particularly the highly quantitative and experimental kind and statistics, are two still needed to some degree subject matters that has been especially affected by this demotion and compression movement at the pre-service, in-service, professional development, undergraduate, continuing education and graduate levels, even though the professional areas of education, science, business, politics and most other areas (including history have become far more quantitative and objective research oriented than in the past. Until there are more enlightened policy shifts, effective means of teaching such compressed courses need to be devised and tested, if only to lessen the negative outcomes of such critical courses. This article, therefore, analyzes compressed courses from the point of view of cognitive learning and then describes 5 methods and approaches that were tested to improve the effectiveness of research methodology and statistics courses taught in these formats. Each of the formats helped to reduce student stress and anxiety about the content and its compressed presentation and improved understanding and achievement. The theory and view developed in this article is also applicable to similar compressed courses for scientific and/or technical content which are currently prevalent in allied health and biotechnology areas.

  16. The Modified Abbreviated Math Anxiety Scale: A Valid and Reliable Instrument for Use with Children

    Science.gov (United States)

    Carey, Emma; Hill, Francesca; Devine, Amy; Szűcs, Dénes

    2017-01-01

    Mathematics anxiety (MA) can be observed in children from primary school age into the teenage years and adulthood, but many MA rating scales are only suitable for use with adults or older adolescents. We have adapted one such rating scale, the Abbreviated Math Anxiety Scale (AMAS), to be used with British children aged 8–13. In this study, we assess the scale's reliability, factor structure, and divergent validity. The modified AMAS (mAMAS) was administered to a very large (n = 1746) cohort of British children and adolescents. This large sample size meant that as well as conducting confirmatory factor analysis on the scale itself, we were also able to split the sample to conduct exploratory and confirmatory factor analysis of items from the mAMAS alongside items from child test anxiety and general anxiety rating scales. Factor analysis of the mAMAS confirmed that it has the same underlying factor structure as the original AMAS, with subscales measuring anxiety about Learning and Evaluation in math. Furthermore, both exploratory and confirmatory factor analysis of the mAMAS alongside scales measuring test anxiety and general anxiety showed that mAMAS items cluster onto one factor (perceived to represent MA). The mAMAS provides a valid and reliable scale for measuring MA in children and adolescents, from a younger age than is possible with the original AMAS. Results from this study also suggest that MA is truly a unique construct, separate from both test anxiety and general anxiety, even in childhood. PMID:28154542

  17. Dental Emergencies

    OpenAIRE

    Domb, Ivor

    1982-01-01

    Emergency dental problems can result from trauma, dental pathology, or from dental treatment itself. While the physician can treat many instances of dental trauma, the patient should see a dentist as soon as possible so that teeth can be saved. Emergency treatment of dental pathology usually involves relief of pain and/or swelling. Bleeding is the most frequent post-treatment emergency. The physician should be able to make the patient comfortable until definitive dental treatment can be avail...

  18. Predictive and prognostic values of cancer-associated serum antigen (CASA) and cancer antigen 125 (CA 125) levels prior to second-look laparotomy for ovarian cancer.

    Science.gov (United States)

    Kierkegaard, O; Mogensen, O; Mogensen, B; Jakobsen, A

    1995-11-01

    CA 125 and cancer-associated serum antigen (CASA) were measured prior to second-look laparotomy (SLL) to investigate their predictive and prognostic values in 93 patients treated for epithelial ovarian cancer FIGO stage II, III, or IV. Residual tumor was diagnosed at the SLL in 58 patients (62%). The optimal cutoff level was 15 U/ml for CA 125 and 8 U/ml for CASA. Using these levels, the sensitivity for detection of residual tumor was 40% for CA 125 and 22% for CASA. The combined use of the markers resulted in a sensitivity of 47% (diagnostic gain 6.9%; 95% confidence interval (CI), 0.14-13.44%). Microscopic tumor volumes were equally diagnosed by CASA and CA 125. The independent prognostic value of CA 125 (RR = 2.6; 95% CI, 2.0-3.2) and CASA (RR = 2.2; CI, 1.5-2.9) was established by means of Cox regression analysis of the covariation between survival, age, FIGO stage, histopathology, tumor grade, and bulk of residual tumor at the primary operation and CA 125 and CASA before the SLL. In conclusion, we found that CASA could supplement CA 125 measurement prior to SLL and reduce the number of SLLs. Furthermore, CASA had an independent prognostic value for survival which may be used together with other information in the planning of further treatment of the individual patient.

  19. Emergency Shelters

    DEFF Research Database (Denmark)

    Popovic Larsen, Olga; Lee, Daniel Sang-Hoon; Eskemose Andersen, Jørgen;

    2013-01-01

    The report gives all the research, teaching, seminars carried in the duration of the shelter cluster. It concludes with proposing relevant research agendas in the field of emergency architecture......The report gives all the research, teaching, seminars carried in the duration of the shelter cluster. It concludes with proposing relevant research agendas in the field of emergency architecture...

  20. Vascular emergencies.

    Science.gov (United States)

    Semashko, D C

    1997-01-01

    This article reviews the initial assessment and emergent management of several common as well as uncommon vascular emergencies. Aortic dissection, aneurysms, and arterial occlusive disease are familiar but challenging clinical entities. Less frequently encountered conditions are also discussed including an aortic enteric fistula, mesenteric venous thrombosis, phlegmasia alba dolens, and subclavian vein thrombosis.

  1. Does a booster intervention augment the preventive effects of an abbreviated version of the coping power program for aggressive children?

    Science.gov (United States)

    Lochman, John E; Baden, Rachel E; Boxmeyer, Caroline L; Powell, Nicole P; Qu, Lixin; Salekin, Karen L; Windle, Michel

    2014-01-01

    Booster interventions have been presumed to be important methods for maintaining the effects of evidence-based programs for children with behavioral problems, but there has been remarkably little empirical attention to this assumption. The present study examines the effect of a child-oriented booster preventive intervention with children who had previously received an abbreviated version (24 child sessions, 10 parent sessions) of the Coping Power targeted prevention program. Two hundred and forty-one children (152 boys, 89 girls) were screened as having moderate to high levels of aggressive behavior in 4th grade, then half were randomly assigned to receive the abbreviated Coping Power program in 5th grade, and half of the preventive intervention children were then randomly assigned to a Booster condition in 6th grade. The Booster sessions consisted of brief monthly individual contacts, and were primarily with the children. Five assessments across 4 years were collected from teachers, providing a three-year follow-up for all children who participated in the project. Results indicated that the abbreviated Coping Power program (one-third shorter than the full intervention) had long-term effects in reducing children's externalizing problem behaviors, proactive and reactive aggression, impulsivity traits and callous-unemotional traits. The Booster intervention did not augment these prevention effects. These findings indicate that a briefer and more readily disseminated form of an evidence-based targeted preventive intervention was effective. The findings have potential implications for policy and guidelines about possible intervention length and booster interventions.

  2. Emergency contraception.

    Science.gov (United States)

    Van Look, P F; von Hertzen, H

    1993-01-01

    The term 'emergency contraception', as employed in this paper, refers to methods that are used as emergency procedures to prevent pregnancy following unprotected intercourse. Alternative, less appropriate, terms are postcoital and 'morning-after' contraception. References to postcoital preparations can be found as far back as 1500 BC in Egyptian papyri, but it was not until fairly recently that contraceptive research has been able to at least partially fulfill that need. The development of hormonal methods of emergency contraception goes back to the 1960s when the first human trials of postcoitally administered high-dose oestrogens were undertaken. Combined oestrogen- progestogen combination therapy (the so-called Yuzpe regimen) was introduced in the early 1970s, while the postcoital insertion of an intrauterine contraceptive device (IUD) for emergency contraception was first reported in 1976. Other compounds that have been tested more recently include levonorgestrel, the antiprogestogen mifepristone, and danazol. Although there is some debate about the magnitude of the protective effect, few people question the important role that emergency contraception can play in preventing unwanted pregnancy and hence maternal mortality and morbidity resulting from unsafe abortion. Given that the most often used methods of emergency contraception, namely the Yuzpe regimen and postcoital insertion of an IUD, rely on technology that has been available for some 30 years, family planning programmes that claim to be concerned with improving women's reproductive health, cannot really be excused if they do not provide emergency contraception as part of their routine services.

  3. Emergency Contraception

    Science.gov (United States)

    ... the pill that contains ulipristal acetate reduces the risk of pregnancy more effectively than pills that contain levonorgestrel.It is important to remember that emergency contraceptive pills will not prevent pregnancy if you have ...

  4. Eye emergencies

    Science.gov (United States)

    ... eds. Duane's Foundations of Clinical Ophthalmology . Philadelphia, PA: Lippincott Williams and Wilkins; 2013:vol. 3, chap 6. ... Practice of Emergency Medicine . 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009:chap 54-61. Sharma R, ...

  5. Emerging boundaries

    DEFF Research Database (Denmark)

    Løvschal, Mette

    2014-01-01

    This article proposes a processual ontology for the emergence of man-made, linear boundaries across northwestern Europe, particularly in the first millennium BC. Over a significant period of time, these boundaries became new ways of organizing the landscape and settlements—a phenomenon that has...... of this phenomenon emerged along equivalent trajectories. At the same time, variation in the regional incorporation of these linear phenomena points toward situation-specific applications and independent development....

  6. [Laparotomy closure in advanced peritonitis].

    Science.gov (United States)

    Bensman, V M; Savchenko, Yu P; Shcherba, S N; Golikov, I V; Triandafilov, K V; Chaikin, V V; Pyatakov, S N; Saakyan, A S; Saakyan, E A

    Цель - улучшить результаты лечения распространенного перитонита. Материал и методы. Изучены результаты лечения 743 больных с распространенным перитонитом. В зависимости от способов лечения сформированы 2 основные группы и 1 группа сравнения (контроль). Результаты. Использование программированных релапаротомий в сочетании с закрытием лапаротомной раны съемными дренирующими мышечно-апоневротическими швами (СДМАШ) позволило снизить летальность при вторичном и третичном распространенном перитоните с 47,8±2,7 до 24,1±2,3% (p<0,001) и в 4 раза уменьшить частоту послеоперационных нагноений (p<0,001). При стойкой абдоминальной гипертензии отказ от СДМАШ и закрытие раны только кожными швами обеспечили дальнейшее снижение летальности до 15,8±2,7% (р<0,05). Закрытие больших эвентрационных дефектов брюшной стенки с помощью свободной дермопластики также способствовало снижению летальности. Выводы. Программированные релапаротомии в сочетании с наложением СДМАШ являются методом выбора при лечении больных с распространенным перитонитом. Отказ от шва апоневроза с завершением операции только швом кожной раны показан при неустранимой абдоминальной гипертензии. Большие эвентрационные дефекты всегда требуют пластического закрытия. Балльная оценка общего состояния больных с распространенным перитонитом по шкале АРАСНЕ III имеет достоверное прогностическое значение.

  7. Physiologic mastectomy via flank laparotomy.

    Science.gov (United States)

    Allen, Andrew J; Barrington, George M; Parish, Steve M

    2008-11-01

    Physiologic mastectomy can be used as a salvage procedure in cases of chronic suppurative mastitis, gangrenous mastitis, or chronic, severe mastitis associated with organisms liberating endotoxin or exotoxin. The surgical technique involves ligation of the major arterial blood supply (external pudendal artery) to the corresponding half of the mammary gland, which results in decreased systemic absorption of toxins and gland atrophy. The technique is performed with the cow standing, and it is relatively atraumatic. This procedure is a simple, yet effective alternative to radical mastectomy for unresponsive mastitis cases in genetically or otherwise valuable cattle.

  8. EMERGENCY CALLS

    CERN Multimedia

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  9. Anorectal emergencies.

    Science.gov (United States)

    Lohsiriwat, Varut

    2016-07-14

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up.

  10. Emerging images

    KAUST Repository

    Mitra, Niloy J.

    2009-01-01

    Emergence refers to the unique human ability to aggregate information from seemingly meaningless pieces, and to perceive a whole that is meaningful. This special skill of humans can constitute an effective scheme to tell humans and machines apart. This paper presents a synthesis technique to generate images of 3D objects that are detectable by humans, but difficult for an automatic algorithm to recognize. The technique allows generating an infinite number of images with emerging figures. Our algorithm is designed so that locally the synthesized images divulge little useful information or cues to assist any segmentation or recognition procedure. Therefore, as we demonstrate, computer vision algorithms are incapable of effectively processing such images. However, when a human observer is presented with an emergence image, synthesized using an object she is familiar with, the figure emerges when observed as a whole. We can control the difficulty level of perceiving the emergence effect through a limited set of parameters. A procedure that synthesizes emergence images can be an effective tool for exploring and understanding the factors affecting computer vision techniques. © 2009 ACM.

  11. Coelomogenesis during the abbreviated development of the echinoid Heliocidaris erythrogramma and the developmental origin of the echinoderm pentameral body plan.

    Science.gov (United States)

    Morris, Valerie B

    2011-01-01

    The development of the coeloms is described in an echinoid with an abbreviated larval development and shows the early morphogenesis of the coeloms of the adult stage. The development is described from images obtained by laser scanning confocal microscopy. The development in Heliocidaris erythrogramma is asymmetric with a larger left coelom forming on the larval-left side and a smaller right coelom forming on the larval-right side. The right coelom forms after the development of the left coelom is well advanced. The hydrocoele forms from the anterior part of the left coelom. The five lobes of the hydrocoele from which the pentamery of the adult derives take shape on the outer, distal wall of the anterior part of the left coelom. The hydrocoele separates from the more posterior part of the left coelom, which becomes the left posterior coelom. The lobes of the hydrocoele are named, based on the site of the connexion of the stone canal to the hydrocoele. The mouth is assumed to form by penetration through only the outer, distal wall of the hydrocoele and the ectoderm. Both larval and adult polarities are evident in this larva. A comparison with coelomogenesis in the asteroid Parvulastra exigua, which also has an abbreviated development, leads to predictions of homology between the echinoderm and chordate phyla that do not require the hypothesis of a dorsoventral inversion event in chordates.

  12. Self efficacy for fruit, vegetable and water intakes: Expanded and abbreviated scales from item response modeling analyses

    Directory of Open Access Journals (Sweden)

    Cullen Karen W

    2010-03-01

    Full Text Available Abstract Objective To improve an existing measure of fruit and vegetable intake self efficacy by including items that varied on levels of difficulty, and testing a corresponding measure of water intake self efficacy. Design Cross sectional assessment. Items were modified to have easy, moderate and difficult levels of self efficacy. Classical test theory and item response modeling were applied. Setting One middle school at each of seven participating sites (Houston TX, Irvine CA, Philadelphia PA, Pittsburg PA, Portland OR, rural NC, and San Antonio TX. Subjects 714 6th grade students. Results Adding items to reflect level (low, medium, high of self efficacy for fruit and vegetable intake achieved scale reliability and validity comparable to existing scales, but the distribution of items across the latent variable did not improve. Selecting items from among clusters of items at similar levels of difficulty along the latent variable resulted in an abbreviated scale with psychometric characteristics comparable to the full scale, except for reliability. Conclusions The abbreviated scale can reduce participant burden. Additional research is necessary to generate items that better distribute across the latent variable. Additional items may need to tap confidence in overcoming more diverse barriers to dietary intake.

  13. Emerging Powers, Emerging Markets, Emerging Societies

    DEFF Research Database (Denmark)

    Sørensen, Camilla T. N.

    2016-01-01

    How are small states managing the shift under way in the global economic and political order from the United States and Europe towards other regions, especially Asia? In the International Relations literature, there is a tendency to focus on the great powers – they set the scene, and the small...... this in order to analyse the Danish foreign policy reactions to the changing world order and show how the emergence of new powers is gradually affecting Denmark’s foreign policy priorities and its “policy profile....

  14. Hematologic emergencies

    Directory of Open Access Journals (Sweden)

    Daniele Vallisa

    2012-01-01

    Full Text Available In recent years, the surprising progress made in other areas of hematology (advances in the understanding of leukemogenesis, improved transplant techniques has been conspicuously absent in the management of hematologic emergencies. And yet, every step toward greater knowledge, every new treatment option will be of little value unless we are able to manage the acute complications of hematologic diseases. These complications are better defined as hematologic emergencies, and they are characterized by a high rate of mortality. This review is based on a search of the literature that was initially confined to articles published in the journal Hematology from 2000 to 2009. The search was then extended to the Cochrane Library and to Pub Med in February 2010 with the following Keywords emergencies; urgencies; hematology. The same key words were employed in a search of the archives of Blood and the New England Journal of Medicine from 2000 to 2010. The results confirm that hematologic emergencies can be caused by hematologic malignancies as well as by non-neoplastic hematologic diseases. Within the former category; this review examines the causes; manifestations; treatment and prevention of disseminated intravascular coagulation; superior vena caval syndrome; spinal cord compression; tumor lysis syndrome; hyperleukocytosis; and hypercalcemia. We also review emergency situations associated with non-neoplatic haematological diseases; such as thrombotic thrombocytopenic purpura; drug-induced hemolytic anemia; and acute sickle-cell crisis.

  15. Mensuração da gravidade do trauma com as versões 1998 e 2005 da Abbreviated Injury Scale

    OpenAIRE

    Maria Carolina Barbosa Teixeira Lopes; Iveth Yamaguchi Whitaker

    2014-01-01

    Objetivo: Comparar a gravidade das lesões e do trauma mensurada pelas versões da Abbreviated Injury Scale 1998 e 2005 e verificar a mortalidade nos escores Injury Severity Score e New Injury Severity Score nas duas versões.Método: Estudo transversal e retrospectivo analisou lesões de pacientes de trauma, de três hospitais universitários do município de São Paulo, Brasil. Cada lesão foi codificada com Abbreviated Injury Scale 1998 e 2005. Os testes estatísticos aplicados foram Wilcoxon, McNema...

  16. Impact of an Abbreviated Cardiac Enzyme Protocol to Aid Rapid Discharge of Patients with Cocaine-associated Chest Pain in the Clinical Decision Unit

    Directory of Open Access Journals (Sweden)

    Faheem W. Guirgis

    2014-03-01

    Full Text Available Introduction: In 2007 there were 64,000 visits to the emergency department (ED for possible myocardial infarction (MI related to cocaine use. Prior studies have demonstrated that low- to intermediate-risk patients with cocaine-associated chest pain can be safely discharged after 9-12 hours of observation. The goal of this study was to determine the safety of an 8-hour protocol for ruling out MI in patients who presented with cocaine-associated chest pain. Methods: We conducted a retrospective review of patients treated with an 8-hour cocaine chest pain protocol between May 1, 2011 and November 30, 2012 who were sent to the clinical decision unit (CDU for observation. The protocol included serial cardiac biomarker testing with Troponin-T, CK-MB (including delta CK-MB, and total CK at 0, 2, 4, and 8 hours after presentation with cardiac monitoring for the observation period. Patients were followed up for adverse cardiac events or death within 30 days of discharge. Results: There were 111 admissions to the CDU for cocaine chest pain during the study period. One patient had a delta CK-MB of 1.6 ng/ml, but had negative Troponin-T at all time points. No patient had a positive Troponin-T or CK-MB at 0, 2, 4 or 8 hours, and there were no MIs or deaths within 30 days of discharge. Most patients were discharged home (103 and there were 8 inpatient admissions from the CDU. Of the admitted patients, 2 had additional stress tests that were negative, 1 had additional cardiac biomarkers that were negative, and all 8 patients were discharged home. The estimated risk of missing MI using our protocol is, with 99% confidence, less than 5.1% and with 95% confidence, less than 3.6% (99% CI, 0-5.1%; 95% CI, 0-3.6%. Conclusion: Application of an abbreviated cardiac enzyme protocol resulted in the safe and rapid discharge of patients presenting to the ED with cocaine-associated chest pain. [West J Emerg Med. 2014;15(2:180–183.

  17. Emergency management of complicated jejunal diverticulosis.

    Science.gov (United States)

    Johnson, Kevin N; Fankhauser, Grant T; Chapital, Alyssa B; Merritt, Marianne V; Johnson, Daniel J

    2014-06-01

    Jejunal diverticulosis is a rare condition that is usually found incidentally. It is most often asymptomatic but presenting symptoms are nonspecific and include abdominal pain, nausea, diarrhea, malabsorption, bleeding, obstruction, and/or perforation. A retrospective review of medical records between 1999 and 2012 at a tertiary referral center was conducted to identify patients requiring emergency management of complicated jejunal diverticulosis. Complications were defined as those that presented with inflammation, bleeding, obstruction, or perforation. Eighteen patients presented to the emergency department with acute complications of jejunal diverticulosis. Ages ranged from 47 to 86 years (mean, 72 years). Seven patients presented with evidence of free bowel perforation. Six had either diverticulitis or a contained perforation. The remaining five were found to have gastrointestinal bleeding. Fourteen of the patients underwent surgical management. Four patients were successfully managed nonoperatively. As a result of the variety of presentations, complications of jejunal diverticulosis present a diagnostic and therapeutic challenge for the acute care surgeon. Although nonoperative management can be successful, most patients should undergo surgical intervention. Traditional management dictates laparotomy and segmental jejunal resection. Diverticulectomy is not recommended as a result of the risk of staple line breakdown. The entire involved portion of jejunum should be resected when bowel length permits.

  18. Emergency preparedness

    CERN Document Server

    Cennini, E; Oortman Gerlings, P

    2009-01-01

    On September 19th 2008, a technical fault was at the centre of a sequence of events which hampered the performance of certain equipments of the LHC 3-4 sector. Once the first effects of this sequence of events were detected, the behaviour of the CERN staff confronted to this complex and critical situation became the centre of the risk control process. During such a downward spiral the preparation of all stakeholders is essential and should respect the (apparently) basic principles of emergency preparedness. Preparedness towards normal operation of CERN facilities towards minor up to major emergency situations will be presented. The main technical, organisational and legal frameworks of the CERN emergency preparedness will be recalled, highlighting the CERN risk management and risk control strategy. Then, the sequence of events experienced by different stakeholders on September 19th will be reported, thus starting the learned lessons process.

  19. APRENDIZAJE EN CIRUGÍA MEDIANTE LAPARATOMÍA EXPLORATORIA POR TRAUMA PENETRANTE. EXPERIENCIA EN EL HOSPITAL GENERAL DE CIUDAD JUÁREZ Learning in laparotomy-based abdominal surgery for managinf penetrating trauma: experience in the Ciudad Juárez General Hospital

    Directory of Open Access Journals (Sweden)

    Lenin Enríquez-Domínguez

    2011-01-01

    abdominal trauma over the course of a year. The variables analysed were cause of the lesion, type of laparotomy, the role played by the resident assistant / surgeon, damaged organs, established treatment, complications and mortality. This was a cross-sectional descriptive study. Analysis was done with percentages as means of summary and Pearson’s chi-square test for obtaining significant differences. Results. 203 patients underwent laparotomy, 109 were wounded by firearms and 105 had knife wounds. 139 therapeutic laparotomies were performed, 49 nontherapeutic ones and 15 damage-control surgeries. 24 were attended by first-year residents, 85 by second-year ones and 94 by residents in their third year. 184 of the 272 wounds were in hollow viscera, 78 in solid organs and 10 were vascular wounds; 28 post-surgical complications occurred, the most common ones being sepsis (8 patients and surgical site infection (5 cases. Conclusions. An important part of a surgeon’s training concerns acquiring technical abilities in the operating room and the integral management of patients suffering abdominal trauma from the time of their being admitted to the emergency room. Clear parameters have not been established regarding the number of patients who should be evaluated or the number of surgical procedures which must be performed during a resident’s formation

  20. Thyroid emergencies.

    Science.gov (United States)

    Klubo-Gwiezdzinska, Joanna; Wartofsky, Leonard

    2012-03-01

    This review presents current knowledge about the thyroid emergencies known as myxedema coma and thyrotoxic storm. Understanding the pathogenesis of these conditions, appropriate recognition of the clinical signs and symptoms, and their prompt and accurate diagnosis and treatment are crucial in optimizing survival.

  1. Emergency Preparedness

    CERN Document Server

    2001-01-01

    The trends of RPC work in the area of preparedness for nuclear and radiological accidents are listed. RPC in cooperation with Swedish Government developed the project on preparation for iodine prophylaxis in case of accident at Ignalina NPP and arranged seminar on emergency preparedness issues in 2001.

  2. Studying Emerge

    DEFF Research Database (Denmark)

    Davies, Sarah Rachael; Selin, Cynthia; Rodegher, Sandra

    2015-01-01

    The Emerge event, held in Tempe, AZ in March 2012, brought together a range of scientists, artists, futurists, engineers and students in order to experiment with innovative methods for thinking about the future. These methodological techniques were tested through nine workshops, each of which made...

  3. Emerging Materiality

    DEFF Research Database (Denmark)

    Bertelsen, Olav Wedege; Breinbjerg, Morten; Pold, Søren

    2009-01-01

    The authors examine how materiality emerges from complex chains of mediation in creative software use. The primarily theoretical argument is inspired and illustrated by interviews with two composers of electronic music. The authors argue that computer mediated activity should not primarily...

  4. Emergence delirium

    DEFF Research Database (Denmark)

    Munk, Louise; Andersen, Lars Peter Holst; Gögenur, Ismail

    2013-01-01

    Emergence delirium (ED) is a well-known phenomenon in the postoperative period. However, the literature concerning this clinical problem is limited. This review evaluates the literature with respect to epidemiology and risk factors. Treatment strategies are discussed. The review concludes...

  5. Postmodern Emergence

    Science.gov (United States)

    Somerville, Margaret

    2007-01-01

    This paper is a work-in-progress in which the author will begin to articulate the elements of a new methodology that she is calling, for the moment, a methodology of postmodern emergence. She explores this approach through examples from her own research journals that follow her research-in-process and from observing student work-in-progress. She…

  6. 21 CFR 314.107 - Effective date of approval of a 505(b)(2) application or abbreviated new drug application under...

    Science.gov (United States)

    2010-04-01

    ... introduction into interstate commerce when approval of the application or abbreviated application for the drug... for 5 years of exclusive marketing under § 314.108(b)(2) and the patent owner or its representative or... application first commences commercial marketing of its drug product; or (ii) The date of a decision of...

  7. The Self-report Standardized Assessment of Personality-abbreviated Scale: Preliminary results of a brief screening test for personality disorders

    NARCIS (Netherlands)

    Germans, S.; Heck, G.L. van; Moran, P.; Hodiamont, P.P.G.

    2009-01-01

    Objective The internal consistency, test-retest reliability and validity of the Self-report Standardized Assessment of Personality-abbreviated Scale (SAPAS-SR) as a screening instrument for personality disorders were studied in a random sample of 195 Dutch psychiatric outpatients, using the Structu

  8. Myeloproliferative neoplasm (MPN) symptom assessment form total symptom score: Prospective international assessment of an abbreviated symptom burden scoring system among patients with MPNs

    NARCIS (Netherlands)

    R.M. Emanuel (Robyn); A.C. Dueck (Amylou); H.L. Geyer (Holly); J.J. Kiladjian; S. Slot (Stefanie); S. Zweegman (Sonja); P.A.W. te Boekhorst (Peter); S. Commandeur (Suzan); H. Schouten (Harry); F. Sackmann (Federico); A.K. Fuentes (Ana Kerguelen); D. Hernández-Maraver (Dolores); C. Pahl (Clemens); M. Griesshammer (Martin); F. Stegelmann (Frank); K. Doehner (Konstanze); T. Lehmann (Thomas); K. Bonatz (Karin); A. Reiter (Alfred); F. Boyer (Francoise); J. Etienne (Jerome); J.-C. Ianotto (Jean-Christophe); D. Ranta (Dana); L. Roy (Lydia); J.-Y. Cahn (Jean-Yves); C.N. Harrison (Claire); D. Radia (Deepti); P. Muxi (Pablo); N. Maldonado (Norman); C. Besses (Carlos); F. Cervantes (Francisco); P.L. Johansson (Peter); T. Barbui (Tiziano); G. Barosi (Giovanni); A.M. Vannucchi (Alessandro); F. Passamonti (Francesco); B. Andreasson (Bjorn); M.L. Ferarri (Maria); A. Rambaldi (Alessandro); J. Samuelsson (Jan); G. Birgegard (Gunnar); A. Tefferi (Ayalew); A.A. Mesa

    2012-01-01

    textabstractPurpose: Myeloproliferative neoplasm (MPN) symptoms are troublesome to patients, and alleviation of this burden represents a paramount treatment objective in the development of MPN-directed therapies. We aimed to assess the utility of an abbreviated symptom score for the most pertinent a

  9. Screening for personality disorder with the Standardised Assessment of Personality: Abbreviated Scale (SAPAS: further evidence of concurrent validity

    Directory of Open Access Journals (Sweden)

    Moran Paul

    2010-01-01

    Full Text Available Abstract Background The assessment of personality disorders (PD is costly and time-consuming. There is a need for a brief screen for personality disorders that can be used in routine clinical settings and epidemiological surveys. Aims: To test the validity of the Standardised Assessment of Personality: Abbreviated Scale (SAPAS as a screen for PD in a clinical sample of substance abusers. Methods Convergent validity of the SAPAS with both categorical and dimensional representations of personality disorders was estimated. Results In this sample, the SAPAS correlated well with dimensional representations of cluster A and C personality disorders, even after controlling for ADHD symptoms, anxiety/depression symptoms and recent substance use. The SAPAS was also significantly associated with total number of PD criteria, although correlation with categorical measures of PD was weak. Conclusions The SAPAS is an valid brief screen for PD as assessed dimensionally.

  10. Measuring health outcomes of a multidisciplinary care approach in individuals with chronic environmental conditions using an abbreviated symptoms questionnaire

    Directory of Open Access Journals (Sweden)

    Roy Fox

    2008-12-01

    Full Text Available Roy Fox1, Tara Sampalli1, Jonathan Fox11Nova Scotia Environmental Health Centre, Fall River, NS, CanadaAbstract: The Nova Scotia Environmental Health Centre is a treatment facility for individuals with chronic environmental conditions such as multiple chemical sensitivity, chronic fatigue syndrome, fibromyalgia, chronic respiratory conditions and in some cases chronic pain. The premise of care is to provide a patient-centred multidisciplinary care approach leading to self-management strategies. In order to measure the outcome of the treatment in these complex problems, with overlapping diagnoses, symptoms in many body systems and suspected environmental triggers, a detailed symptoms questionnaire was developed specifically for this patient population and validated. Results from a pilot study in which an abbreviated symptoms questionnaire based on the top reported symptoms captured in previous research was used to measure the efficacy of a multidisciplinary care approach in individuals with multiple chemical sensitivity are presented in this paper. The purpose of this study was to examine the extent, type and patterns of changes over time in the top reported symptoms with treatment measured using the abbreviated symptoms questionnaire. A total of 183 active and 109 discharged patients participated in the study where the health status was measured at different time periods of follow up since the commencement of treatment at the Centre. The findings from this study were successful in generating an initial picture of the nature and type of changes in these symptoms. For instance, symptoms such as difficulty concentrating, sinus conditions and tiredness showed early improvement, within the first 6 months of being in treatment, while others, such as fatigue, hoarseness or loss of voice, took longer while others showed inconsistent changes warranting further enquiry. A controlled longitudinal study is planned to confirm the findings of the pilot study

  11. Emergency Contraception

    Directory of Open Access Journals (Sweden)

    Gemzell-Danielsson K

    2010-01-01

    Full Text Available There have been numerous attempts to control fertility after unprotected sexual intercourse. From very bizarre methods like the vaginal application of Coca Cola to the more serious attempts using calcium antagonists influencing fertility parameters in sperm to hormonal methods or intrauterine devices. So far, hormonal methods preventing or delaying ovulation have proved to be the most popular starting with the combination of ethinyl estradiol and levonorgestrel, known as the Yuzpe regimen. The first dose had to be taken within 72 hours of unprotected intercourse, a second one 12 hours later. Later on, levonorgestrel alone, at first in a regimen similar to the Yuzpe method (2 × 0.75 mg 12 hours apart showed to be more successful, eventually resulting in the development of a 1.5 mg levonorgestrel pill that combined good efficacy with a high ease of use. It has become the standard method used up to this day in most countries. Since the mid 1970s copper IUDs have been used for emergency contraception, which show a high efficacy. Their disadvantages lie in the fact that emergency contraception is considered an off label use and that they might not be acceptable for every patient. Mifepristone in doses of 10 or 25 mg is being used successfully as an emergency contraceptive in China, but has never received any significant consideration in Western countries. The most recent development is the approval of the selective progesterone receptor modulator ulipristal acetate in the dosage of 30 mg for emergency contraception up to 5 days after unprotected intercourse, combining the safe and easy application of the single dose levonorgestrel pill with an even higher efficacy. Several efficacious and easy to use methods for emergency contraception are available on the market today with the most widely spread being levonorgestrel in a single dose of 1.5 mg (given as one tablet of 1.5 mg or 2 tablets of 0.75 mg each for administration up to 3 days after

  12. Emerging Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter

    ) and books (e.g. Goldstein 2007; Benito and Narula 2007). This paper takes stock of the mounting trend of outward FDI from emerging economies, with special focus on a group of five countries, which are becoming increasingly economically and politically influential, viz. the ‘BRICS' countries. An ‘S......' is appended here to the conventional acronym of ‘BRIC' (Brazil, Russia, India, China) to include the largest economy on the African continent, South Africa. The five BRICS countries produced some USD25 billion of outward FDI flows in 2004, corresponding to some 3 percent of world FDI flows and well over half...... (61 percent) of total developing country outflows. OFDI from the BRICS countries has grown rapidly over the last few years, while still remaining modest compared to many developed countries. Following a brief discussion of FDI and emerging economies in general the article proceeds to hypothesise...

  13. Emerging Technologies

    OpenAIRE

    Salgar, S. M.

    2004-01-01

    Phenomenal advancements have taken place in the field of Information and communication technologies in the last decade. Spectacular and innovative changes are expected to take place in these fields in coming decade. Networking technologies are going through a sea change. This paper enumerates the likely networking technologies which are emerging, particularly WLANs. Most of the personal communication in the country will be through cellular/ mobile technologies, which are also covered in the p...

  14. Emerging jets

    Energy Technology Data Exchange (ETDEWEB)

    Schwaller, Pedro; Stolarski, Daniel [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Weiler, Andreas [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2015-02-15

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilities for discovery at LHCb are also discussed.

  15. Consequences of peritonism in an emergency department setting

    DEFF Research Database (Denmark)

    Bjørsum-Meyer, Thomas; Schmidt, Thomas A.

    2013-01-01

    Background: In patients who were referred to the emergency department (ED) with abdominal pain, it is crucial to determine the presence of peritonism to allow for appropriate handling and subsequent referral to stationary departments. We aimed to assess the incidence of perceived peritonism...... on the patients with abdominal pain. Following a physical examination, the patients with abdominal pain were divided into those who had clinical signs of peritonism and those who did not. Results: Among the 1,270 patients admitted to the ED, 10% had abdominal pain. In addition, 41% of these patients were found...... to have signs indicative of peritonism, and 90% were admitted to the Department of Surgery (DS). Also, 24% of those patients with signs of peritonism and admission to the DS underwent surgical intervention in terms of laparotomy/laparoscopy. Five of the patients without peritonism underwent surgery...

  16. Management of Hepatic Rupture Diagnosed after an Emergency Cesarean Section

    Directory of Open Access Journals (Sweden)

    Gianluca Raffaello Damiani

    2014-01-01

    Full Text Available A careful management of hepatic capsular rupture, with massive hemoperitoneum which occurred 14 hours after an emergency cesarean section at 36 weeks of gestation, is meticulously reported. The grade of hepatic involvement varies from minor capsular laceration to extensive parenchymal rupture. Our management involved a combination of surgical interventions and aggressive supportive care. The patient was discharged after 53 days and 4 laparotomies and an unsuccessful attempt of superselective artery embolization. Ultrasound after 40 days from the last surgery showed uniform hepatic parenchyma free of focal lesions. Due to the rarity and the unpredictability nature of this devastating event we believe necessary to report our experience, reinforcing the importance of the postsurgery management.

  17. 腹腔镜与开腹手术治疗胆总管囊肿的临床对比研究%Clinical comparison of laparoscope and laparotomy in treatment of chole-dochocyst

    Institute of Scientific and Technical Information of China (English)

    王朝晖; 杜志勇; 全昌银

    2015-01-01

    Objective:To explore the clinical efficacy and safety of laparoscope and laparotomy in the treatment of choledocho-cyst.Methods:A total of 98 infants with congenital choledochocyst were randomly divided into laparoscope group treated with laparo-scope and laparotomy group with laparotomy to incise the cyst.The differences of surgical duration,intra-operative hemorrhagic vol-ume,postoperative evacuation time,feeding time and hospital stays between two groups were observed and complications were recor-ded.Results:Both group had no intra-operative death.Only 1 infant in laparoscope group was transferred to laparotomy due to severe adhesion,whereas all infants in laparotomy group finished the surgery successfully.Laparoscope group was evidently longer in surgical duration but significantly lower in intra-operative hemorrhagic volume and markedly shorter in postoperative evacuation time,feeding time and hospital stays than laparotomy group (P 0.05).Conclusion:Compared with laparomoty,laparoscope is longer in surgical duration but smaller in trauma and quicker in postoperative recovery without increasing the development of complications in treating choledochocyst,so selection of proper surgical method based on the real conditions of patients can improve their clinical benefits.%目的:探讨腹腔镜与开腹手术治疗胆总管囊肿的临床疗效与安全性。方法:先天性胆总管囊肿患儿98例随机分为腹腔镜组(腹腔镜下切除囊肿)和开腹组(开腹手术切除囊肿),观察两组手术时间、术中出血量、术后排气时间、进食时间以及住院时间差异,并记录并发症。结果:两组均未发生围术期死亡病例。腹腔镜组有1例因粘连较重,中转开腹手术;开腹组患儿均顺利完成手术。腹腔镜组手术时间长于开腹组,但术中出血少于开腹组,术后排气时间、进食时间及住院时间均短于开腹组(P <0.01)。两组术后主要并发症为胆漏

  18. Avaliação muscular respiratória nas toracotomias e laparotomias superiores eletivas Respiratory muscle evaluation in elective thoracotomies and laparotomies of the upper abdomen

    Directory of Open Access Journals (Sweden)

    Laryssa Milenkovich Bellinetti

    2006-04-01

    Full Text Available OBJETIVO: Verificar se existe associação entre a função muscular respiratória pré-operatória abaixo dos valores previstos e a incidência de complicações pós-operatórias e o óbito, nas laparotomias superiores e toracotomias eletivas. MÉTODOS: Estudo de coorte prospectivo, no qual 70 pacientes acima de dezoito anos foram acompanhados, em dois hospitais similares. A avaliação durante a internação pré-operatória classificou-os em não expostos (50 ou expostos (20, estes quando os valores das pressões respiratórias máximas foram abaixo de 75% dos valores previstos. O acompanhamento foi feito até a alta hospitalar, verificando-se a incidência de pneumonia, insuficiência respiratória aguda, broncoespasmo, ventilação mecânica prolongada, atelectasia, derrame pleural, pneumotórax e óbito nos dois grupos. Realizou-se análise comparativa entre os grupos e cálculo do risco relativo. RESULTADOS: A incidência total de complicações pós-operatórias da amostra foi de 22,86% (16/70; no grupo exposto foi de 55% (11/20 e no grupo não exposto de 10% (5/50. Os pacientes expostos apresentaram risco relativo de 5,5 (intervalo de confiança de 95% entre 2,19 e 13,82. CONCLUSÃO: Os resultados indicaram que a função muscular respiratória pré-operatória abaixo do valor previsto esteve associada a um risco relativo maior de complicações pós-operatórias nas cirurgias pesquisadas.OBJECTIVE: To identify any possible relation between lower than predicted preoperative respiratory muscle function and the incidence of postoperative respiratory complications and death in elective thoracotomies and laparotomies of the upper abdomen. METHODS: A prospective cohort study was conducted, in which 70 patients over the age of 18 were monitored in two similar hospitals. In the preoperative evaluation performed at admission, patients were classified as presenting respiratory muscle function (as determined by measurement of maximal respiratory

  19. Is it an Emergency?

    Science.gov (United States)

    ... Emergency 101 Share this! Home » Emergency 101 Is it an Emergency? Medical emergencies can be frightening and ... situation. Here you can find information about emergencies. It is essential to know how to recognize the ...

  20. Clinical analysis on conversion to laparotomy during laparoscopic cholecystectomy:report of 30 cases%腹腔镜胆囊切除术中转开腹30例临床分析

    Institute of Scientific and Technical Information of China (English)

    黄鑫; 洪建文; 詹泽锋; 谢志伟; 王森辉

    2014-01-01

    Objective To investigate the causes and prevention of conversion to laparotomy during laparoscopic cholecystectomy. Methods Clinical data of 30 out of 770 patients converting to laparotomy during laparoscopic cholecystectomy in Guangdong Chaozhou Central Hospital from February 2007 to January 2013 were analyzed retrospectively. There were 13 males and 17 females with age ranging from 25 to 81 years old and a median age of 48 years old. The informed consents of all patients were obtained and the ethical committee approval was received. Laparoscopic cholecystectomy was performed in the patients under endotracheal general anesthesia using the conventional 4-port approach. The causes of conversion to laparotomy during laparoscopic cholecystectomy and the incidence of postoperative complications of the patients were observed. Results The incidence of conversion to laparotomy during laparoscopic cholecystectomy was 3.9%(30/770). The causes of conversion to laparotomy were adhesion at Calot's triangle (n=12), gallbladder bed bleeding (n=6), gallbladder artery bleeding (n=4), dense adhesion around the gallbladder with difficult dissecting (n=4), dissatisfactory treatment of the gallbladder stump (n=1), liver surface laceration (n=1), gallbladder carcinoma (n=1). All the converted laparotomies were completed at one time. No complication was observed in all patients after operation. Conclusions The common causes for conversion to laparotomy during laparoscopic cholecystectomy were unclear dissection at Calot's triangle and around the gallbladder, gallbladder bed or gallbladder artery bleeding, dissatisfactory treatment of gallbladder stump, liver surface laceration, gallbladder cancer, etc. Improving the preoperative evaluation, intraoperative appropriate treatment of the Calot's triangle and gallbladder bed are the keys to prevent conversion to laparotomy during laparoscopic cholecystectomy.%目的探讨腹腔镜胆囊切除术中转开腹的原因及预防

  1. Postoperative Complications Leading to Death after Coagulum Pyelolithotomy in a Tetraplegic Patient: Can We Prevent Prolonged Ileus, Recurrent Intestinal Obstruction due to Adhesions Requiring Laparotomies, Chest Infection Warranting Tracheostomy, and Mechanical Ventilation?

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2013-01-01

    Full Text Available A 22-year-old male sustained C-6 tetraplegia in 1992. In 1993, intravenous pyelography revealed normal kidneys. Suprapubic cystostomy was performed. He underwent open cystolithotomy in 2004 and 2008. In 2009, computed tomography revealed bilateral renal calculi. Coagulum pyelolithotomy of left kidney was performed. Pleura and peritoneum were opened. Peritoneum could not be closed. Following surgery, he developed pulmonary atelectasis; he required tracheostomy and mechanical ventilation. He did not tolerate nasogastric feeding. CT of abdomen revealed bilateral renal calculi and features of proximal small bowel obstruction. Laparotomy revealed small bowel obstruction due to dense inflammatory adhesions involving multiple small bowel loops which protruded through the defect in sigmoid mesocolon and fixed posteriorly over the area of previous intervention. All adhesions were divided. The wide defect in mesocolon was not closed. In 2010, this patient again developed vomiting and distension of abdomen. Laparotomy revealed multiple adhesions. He developed chest infection and required ventilatory support again. He developed pressure sores and depression. Later abdominal symptoms recurred. This patient’s general condition deteriorated and he expired in 2011. Conclusion. Risk of postoperative complications could have been reduced if minimally invasive surgery had been performed instead of open surgery to remove stones from left kidney. Suprapubic cystostomy predisposed to repeated occurrence of stones in urinary bladder and kidneys. Spinal cord physicians should try to establish intermittent catheterisation regime in tetraplegic patients.

  2. [Urological emergencies].

    Science.gov (United States)

    Danuser, H; Ackermann, D K; Studer, U E

    1993-04-17

    Every general practitioner has to deal with urologic emergencies. The most frequent illnesses are urinary retention, acute scrotum, priapism, macrohematuria, nephritic colic, obstructive pyelonephritis and pyonephrosis. Whereas urinary retention, as well as acute ureteric stone colic must generally be treated by the practitioner, the urologist must often be consulted in case of an acute scrotum or for priapism. Testicular torsion is one situation, where surgical treatment needs to be performed within 6 hours. Of utmost importance is his timely assistance with the obstructive pyelonephritis and pyonephrosis. These are initially often not recognized, especially because the first ultrasound examination of the intrarenal pyelone may not show a dilatation of the collecting system despite obstruction. If the adequate treatment with drainage and antibiotics is applied too late, this can result in serious and potentially lethal consequences.

  3. A rare case of mature cystic teratoma in the emergency department

    Institute of Scientific and Technical Information of China (English)

    Zeynep Konyar; Gokhan Eyupoglu; Mehmet Tatli; Ozlem Guneysel

    2016-01-01

    Teratomas are the most common germ cell tumors among pediatric and female patients, which originates from germ cells layers and can be located everywhere in bodies. They are diagnosed by ultrasonography (US), which was characterized by calcification and cystic anechoic view. Our aim is to attract attention to a 21-year-old female patient with complaint of acute abdominal pain diagnosed with teratoma by early radiological im-aging. The female patient admitted to the emergency department with a new onset of abdominal pain at the lower and left sides of the abdomen for a week. The suprapubic and left costovertebral angle tenderness were found in her physical examination. We firstly chose US for imaging. The US of the abdomen showed multiple cystic masses around uterus. Heterogeneous cystic and calcified lesions were detected on the patients computerized tomography scan, and considered as teratoma. A laparotomy was per-formed by gynecologists. At laparotomy, lobulated cystic masses were removed and the left ovary had been detorsioned. She has been discharged after two days of postoperative observation. For patients of young females with abdominal pain such as rare gyneco-logical diseases, teratoma and ovarian torsion, in the emergency department should be considered and early imaging should be performed.

  4. CLINICAL AND ERITROLEUCOMETRIC EVALUATION OF COLIC HORSES SUBMITTED TO LAPAROTOMY AND SURVIVED OR NOT AVALIAÇÃO CLÍNICA E ERITROLEUCOGRAMA DE EQÜINOS COM CÓLICA SUBMETIDOS À LAPAROTOMIA, SOBREVIVENTES E NÃO SOBREVIVENTES

    Directory of Open Access Journals (Sweden)

    Aureo Evangelista Santana

    2009-12-01

    Full Text Available

    Seventy horses were utilized, twenty healthy horses (GI and fifty colic horses which survived (GII, n=25 or not (GIII, n=25 after laparotomy. Clinical examination was carried out and blood samples were collected before laparotomy (T0 and after laparotomy (T24h-T240h. Animals from GII, at T0 and animals from GIII, at T0, T24h, T48h, T72h, T96h, T120h, T168h and T240h after laparotomy presented increase of respiratory and heart rates, tissue perfusion time, red blood cell, leukocyte, and packed cell volume. In the same moments the animals from GII and GIII presented decrease of concentration of total plasmatic proteins. The intensity and persistence of theses alterations relates negatively to the animals recuperation and were attributed the time, localization and, severity of obstruction. Laboratorial and clinical analysis in series can be useful for the prognosis of post-operative recovery after laparotomy.

    KEY WORDS: Acute abdomen, equine, haemogram. 
    Utilizaram-se setenta equinos, vinte sadios (GI e cinquenta com cólica, submetidos à laparotomia, sobreviventes (GII, n=25 e não sobreviventes (GIII, n=25. O exame clínico e a colheita das amostras de sangue foram realizados antes da laparotomia (T0 e diariamente, a partir da cirurgia, até o décimo dia após a intervenção (T24h - T10o dia. No T0, observou-se aumento dos valores da frequência cardíaca e respiratória, do tempo de perfusão tecidual, do número de hemácias, do volume globular e do número de leucócitos nos equinos dos grupos GII e GIII, que ainda se mantiveram até o décimo dia pós-operatório nos animais do grupo GIII. Nesses mesmos momentos e animais verificou-se diminuição na concentração das proteínas plasmáticas totais. A intensidade e a persistência das alterações relacionaram-se negativamente com a recuperação dos animais e foram atribuídas ao tempo, à localização e à gravidade do processo obstrutivo. A

  5. Analysis of risk factors for conversion of laparoscopic cholecystectomy to laparotomy%腹腔镜胆囊切除术中转开腹的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    朱建华; 韩江; 陈益鸣; 王炜; 乔弟; 马大喜; 汪运节; 高书平

    2012-01-01

    目的 探讨腹腔镜胆囊切除术(LC)中转开腹的危险因素.方法 1020例LC患者,选取其中36例中转开腹患者作为病例组,108例LC成功患者作为对照组,采用单因素分析和非条件Loistic回归模型分析LC中转开腹的危险因素.结果 年龄>65岁(OR=3.234,95% CI:0.532~6.853),病程>72 h(OR=2.342,95% CI:0.568~5.656),上腹部手术史(OR=2.453,95% CI:0.345~7.453),胆囊壁厚度≥6 mm(OR=2.453,95% CI:0.453~6.343),白细胞计数≥15.0×109/L(OR=4.532,95% CI:0.535~8.329)是LC中转开腹的危险因素.结论 术前综合评估患者具有的危险因素进而选择手术方案,对降低LC中转开腹率具有重要的临床意义.%Objective To investigate the risk factors for conversion of laparoscopic cholecystectomy (LC) to laparotomy.Methods In 1020 LC patients,36 patients with conversion of LC to laparotomy were chosen as the case group,108 patients with successful LC were chosen as the control group.Univariate analysis and Logistic multivariate regression model were used to analyze the risk factors for conversion of LC to laparotomy.Results Age > 65 years (0R=3.234,95% CI:0.532-6.853),course of disease > 72h (OR =2.342,95% CI:0.568 ~ 5.656),history of upper abdominal operation (OR =2.453,95% CI:0.345-7.453),thickness of gallbladder wall ≥ 6 mm (OR =2.453,95% CI:0.453-6.343),white bloodcell count > 15.0 × 109/L (OR =4.532,95% CI:0.535-8.329) were risk factors for conversion of LC to laparotomy.Conclusion Preoperative comprehensive evaluation the risk factors and selecting suitable program have important clinical significant in reducing the rate of conversion LC to laparotomy.

  6. Development and validation of a complementary map to enhance the existing 1998 to 2008 Abbreviated Injury Scale map

    Directory of Open Access Journals (Sweden)

    McLellan Susan

    2011-05-01

    Full Text Available Abstract Introduction Many trauma registries have used the Abbreviated Injury Scale 1990 Revision Update 98 (AIS98 to classify injuries. In the current AIS version (Abbreviated Injury Scale 2005 Update 2008 - AIS08, injury classification and specificity differ substantially from AIS98, and the mapping tools provided in the AIS08 dictionary are incomplete. As a result, data from different AIS versions cannot currently be compared. The aim of this study was to develop an additional AIS98 to AIS08 mapping tool to complement the current AIS dictionary map, and then to evaluate the completed map (produced by combining these two maps using double-coded data. The value of additional information provided by free text descriptions accompanying assigned codes was also assessed. Methods Using a modified Delphi process, a panel of expert AIS coders established plausible AIS08 equivalents for the 153 AIS98 codes which currently have no AIS08 map. A series of major trauma patients whose injuries had been double-coded in AIS98 and AIS08 was used to assess the maps; both of the AIS datasets had already been mapped to another AIS version using the AIS dictionary maps. Following application of the completed (enhanced map with or without free text evaluation, up to six AIS codes were available for each injury. Datasets were assessed for agreement in injury severity measures, and the relative performances of the maps in accurately describing the trauma population were evaluated. Results The double-coded injuries sustained by 109 patients were used to assess the maps. For data conversion from AIS98, both the enhanced map and the enhanced map with free text description resulted in higher levels of accuracy and agreement with directly coded AIS08 data than the currently available dictionary map. Paired comparisons demonstrated significant differences between direct coding and the dictionary maps, but not with either of the enhanced maps. Conclusions The newly

  7. Nano Revolution--Big Impact: How Emerging Nanotechnologies Will Change the Future of Education and Industry in America (and More Specifically in Oklahoma). An Abbreviated Account

    Science.gov (United States)

    Holley, Steven E.

    2009-01-01

    Scientists are creating new and amazing materials by manipulating molecules at the ultra-small scale of 0.1 to 100 nanometers. Nanosize super particles demonstrate powerful and unprecedented electrical, chemical, and mechanical properties. This study examines how nanotechnology, as the multidisciplinary engineering of novel nanomaterials into…

  8. Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref) in north Indian patients with bronchial asthma: an evaluation using Rasch analysis

    OpenAIRE

    Aggarwal, Ashutosh N.; Agarwal, Ritesh; Gupta, Dheeraj

    2014-01-01

    Background: There is no disease-specific instrument to describe health-related quality of life (HRQoL) in Indian patients with asthma. However, an abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref), a generic Hindi HRQoL measure, has been developed and validated in India. Aims: To evaluate the WHOQOL-Bref in adult patients with asthma and to test possible modifications to the instrument to improve its psychometric adequacy. Methods: Sixty-seven patients with ast...

  9. Math Anxiety Assessment with the Abbreviated Math Anxiety Scale: Applicability and usefulness: insights from the Polish adaptation

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    Krzysztof eCipora

    2015-11-01

    Full Text Available Math anxiety has an important impact on mathematical development and performance. However, although math anxiety is supposed to be a transcultural trait, assessment instruments are scarce and are validated mainly for Western cultures so far. Therefore, we aimed at examining the transcultural generality of math anxiety by a thorough investigation of the validity of math anxiety assessment in Eastern Europe. We investigated the validity and reliability of a Polish adaptation of the Abbreviated Math Anxiety Scale (AMAS, known to have very good psychometric characteristics in its original, American-English version as well as in its Italian and Iranian adaptations.We also observed high reliability, both for internal consistency and test-retest stability of the AMAS in the Polish sample. The results also show very good construct, convergent and discriminant validity: The factorial structure in Polish adult participants (n = 857 was very similar to the one previously found in other samples; AMAS scores correlated moderately in expected directions with state and trait anxiety, self-assessed math achievement and skill as well temperamental traits of emotional reactivity, briskness, endurance and perseverance. Average scores obtained by participants as well as gender differences and correlations with external measures were also similar across cultures. Beyond the cultural comparison, we used path model analyses to show that math anxiety relates to math grades and self-competence when controlling for trait anxiety.The current study shows transcultural validity of math anxiety assessment with the AMAS.

  10. Math Anxiety Assessment with the Abbreviated Math Anxiety Scale: Applicability and Usefulness: Insights from the Polish Adaptation.

    Science.gov (United States)

    Cipora, Krzysztof; Szczygieł, Monika; Willmes, Klaus; Nuerk, Hans-Christoph

    2015-01-01

    Math anxiety has an important impact on mathematical development and performance. However, although math anxiety is supposed to be a transcultural trait, assessment instruments are scarce and are validated mainly for Western cultures so far. Therefore, we aimed at examining the transcultural generality of math anxiety by a thorough investigation of the validity of math anxiety assessment in Eastern Europe. We investigated the validity and reliability of a Polish adaptation of the Abbreviated Math Anxiety Scale (AMAS), known to have very good psychometric characteristics in its original, American-English version as well as in its Italian and Iranian adaptations. We also observed high reliability, both for internal consistency and test-retest stability of the AMAS in the Polish sample. The results also show very good construct, convergent and discriminant validity: The factorial structure in Polish adult participants (n = 857) was very similar to the one previously found in other samples; AMAS scores correlated moderately in expected directions with state and trait anxiety, self-assessed math achievement and skill as well temperamental traits of emotional reactivity, briskness, endurance, and perseverance. Average scores obtained by participants as well as gender differences and correlations with external measures were also similar across cultures. Beyond the cultural comparison, we used path model analyses to show that math anxiety relates to math grades and self-competence when controlling for trait anxiety. The current study shows transcultural validity of math anxiety assessment with the AMAS.

  11. Comparative study on the impact of laparoscopy and abdominal laparotomy to maternal-fetal at gestation period%妊娠期腹腔镜与开腹手术对母胎影响的对比研究

    Institute of Scientific and Technical Information of China (English)

    黄晓晖; 范保维; 罗喜平; 金文艳; 曾俐琴; 陈丹

    2014-01-01

    Objective To compare and analyze the impact on maternal-fetal of laparoscopy and abdominal laparotomy and evaluate the safety of laparoscopy during pregnancy.Methods In this prospective controlled study,20 pregnant patients underwent a laparoscopy,and the other 20 pregnant patients underwent an exploratory laparotomy during the same period of time.The parameters including anesthesia time,operative time,blood loss,arterial blood gas analysis in the fifteen minute after surgery,uterine artery blood flow,postoperative pain,postoperative recovery and pregnancy outcomes were collected.Results The anesthesia time and the operative time in laparoscopic group were significantly shorter than those in laparotomy group [(18.91 ± 8.76) min vs (35.28 ± 14.67) min,t=4.28,P < 0.05,(17.85 ± 6.32) min vs (30.27 ± 10.41) min,t=4.56,P < 0.05].The blood loss was significantly different during laparoscopic group and laparotomy group [(15.48 ± 10.24) ml vs (25.48 ± 15.56) ml,t=2.40,P < 0.05].The stubbs catheter time,postoperative ambulation time,postoperative discharge time in the laparoscopic group were (6.58 ± 0.92) h,(6.98 ± 1.69) h and (18.52 ± 3.45) h respectively,while those were (24.63 ± 3.85) h,(25.37 ± 5.34) h,(23.67 ± 7.81) h in the laparotomy group (t=2.70,14.68,20.39; all P < 0.05).The postoperative pain by laparoscopy was significantly lighter than that by laparotomy (P < 0.05).There was no statistical significant difference between arterial blood gas analysis and uterine artery blood flow in two groups (P > 0.05),and we didn't see any difference from abortion rate,premature birth rate,term delivery rate,the rate of birth defects,neonatal Apgar score and full-term birth weight.Conclusion Compared with laparotomy,laparoscopy has relatively less impact on maternal-fetal,and it won't increase the risk of adverse pregnancy outcomes.%目的 对比分析妊娠期腹腔镜与开腹手术对母胎影响的情况,评估妊娠期腹腔镜的安全性.方法

  12. 两种不同类型的缩略词语:用语缩略与造词缩略——兼论海峡两岸缩略词语的类型差异%Two kinds of Abbreviations:Abbreviations about Using and Abbreviation about Coinages——On Different Types across the Taiwan Strait

    Institute of Scientific and Technical Information of China (English)

    刁晏斌

    2011-01-01

    Abbreviations in Modern Chinese are a very complex set which can be divided as abbreviations about using and abbreviation about coinages,depending on their generated motivations and generative process.The former focuses on the convenient form of language use about the relatively fixed form of language.The latter is a kind of combination which is not associated with a relatively fixed strictly corresponded to the original style,using the abbreviated form of word-building materials.They have different focuses and correspond to different issues.The mechanism and procedure of generating and the surface meanings are also different.In the framework of dichotomy,there are significant difference between abbreviations in Taiwan Mandarin and mainland Mandarin: as to abbreviations about using,it includes less Numeral Compact Expressions,more common names and more compaction of Three-syllable words;as to abbreviation about coinages,it includes less fixed terms but more temporary words.%现代汉语缩略词语是一个非常复杂的集合,可以根据其产生动机和生成过程等的差异,分为"用语的缩略"和"造词的缩略",前者因着眼于对已有相对固定语言形式的便捷使用而生,后者则是不与某一相对固定的原式严格对应的、利用缩略性构词材料构成的组合形式。二者的着眼点不同,对应物不同,产生机制和过程不同,在表义上也有差异。在这个二分的框架下,可以看到台湾"国语"缩略词语与普通话的明显差异:就用语缩略来说,是数字略语少、合称多、三音节词的简缩多;就造词缩略来看,则是固定词少而临时词多。

  13. Choice of Operative Technique for Emergency Cases of Sigmoid Volvulus in a Tertiary Care Hospital of Gujarat

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    Patel Upendra

    2012-04-01

    Full Text Available Introduction: Sigmoid volulus is by far the most common type of volvulus, accounting for 75 to 90 % of all volvulus. Most common presenting symptom is abdominal pain and constipation. . It may be initially managed by sigmoidoscopy or rectal tube insertion but where fear of compromised vascular supply of the sigmoid colon is associated, immediate laparotomy after resuscitation must be undertaken to avoid gangrene and septic shock. The primary objective of the study is to demonstrate the most suitable procedure for management of patients with sigmoid volvulus needing emergency surgery. Methodology: All patients presenting with volvulus and needing emergency operative intervention during 1 years duration from January 2010 to December 2011 were included in this study. Total 41 patients were included in the study of which 25 presented with gangrenous sigmoid colon on laparotomy and viable sigmoid colon was present in the remaining 16 cases. Comparison is done with respect to mortality and early morbidity associated with different operative procedures. Results: Highest mortality i.e. 33.3% observed among patients who underwent primary resection and anastomosis without proximal colostomy. Wound infection was more common following all forms of stoma procedure. Conclusion: Hartmann’s procedure goes a long way in decreasing mortality due to sigmoid volvulus in the emergency setting. [National J of Med Res 2012; 2(2.000: 226-228

  14. Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury

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    Fine, Philip R

    2008-11-01

    Full Text Available Objective: To determine the relationship between emergent intubation (emergency department and field intubation cases combined and mortality in patients with traumatic brain injury (TBI while controlling for injury severity.Methods: Retrospective observational study of 981 (35.2% intubated, 64.8% not intubated patients with TBI evaluating the association between intubation status and mortality. Logistic regression was used to analyze the data. Injury severity measures included Head/Neck Abbreviated Injury Scale (H-AIS, systolic blood pressure, type of head injury (blunt vs. penetrating, and a propensity score combining the effects of several other potential confounding variables. Age was also included in the model.Results: The simple association of emergent endotracheal intubation with death had an odds ratio (OR of 14.3 (95% CI = 9.4 – 21.9. The logistic regression model including relevant covariates and a propensity score that adjusted for injury severity and age yielded an OR of 5.9 (95% CI = 3.2 – 10.9.Conclusions: This study indicates that emergent intubation is associated with increased risk of death after controlling for a number of injury severity indicators. We discuss the need for optimal paramedic training, and an understanding of the factors that guide patient selection and the decision to intubate in the field. [WestJEM.2008;9:184-189

  15. DESENVOLVIMENTO DE MODELO DE PERITONITE BACTERIANA PARA AVALIAÇÃO DO TRATAMENTO MEDIANTE ACESSO LAPAROTÔMICO E VIDEO-LAPAROSCÓPICO DEVELOPMENT A MODEL OF BACTERIAL PERITONITES FOR THE EVALUATION OF THE TREATMENTS THROUGH LAPAROTOMY AND LAPAROSCOPY

    Directory of Open Access Journals (Sweden)

    W. Salgado Jr

    2001-01-01

    Full Text Available Introdução: O emprego do acesso videolaparoscópico no tratamento das afecções digestivas que cursam com peritonite generalizada é motivo de controvérsia. Objetivo: Desenvolver um modelo de peritonite bacteriana para avaliação do tratamento mediante acesso laparotômico e videolaparoscópico. Métodos: Ratos machos Wistar foram submetidos à ligadura de ceco (CLP sob molde rígido de 3mm de diâmetro; na seqüência foram feitas 14 punções no ceco com agulha 15X10. Após 6 horas de indução da peritonite, os animais foram tratados mediante laparotomia ou videolaparoscopia e avaliados com base nas hemoculturas e na taxa de mortalidade. O tratamento consistiu de tiflectomia seguida ou não de lavagem da cavidade peritoneal com solução fisiológica. Resultado: A mortalidade após CLP sem tratamento foi de 90% em uma semana. As hemoculturas positivas para bactérias após 3 horas variaram de 80 a 100% e após 24 horas de 60 a 80%, nos animais tratados com laparotomia sem lavagem do peritôneo e com videolaparoscopia seguida ou não de lavagem peritoneal. Todavia, a mortalidade após laparotomia foi de 20% e após videolaparoscopia foi de 80%. Conclusão: O modelo experimental desenvolvido induz a peritonite grave, e a bacteremia associada ao tratamento videolaparoscópico tem alta letalidade.Introduction: The use of videolaparoscopy in the treatment of digestive diseases, associated with generalized peritonitis, is controverted. Objective: To develop a model of bacterial peritonitis for the evaluation of the treatments through laparotomy and through videolaparoscopy. Methods: Male Wistar rats were submitted to occlusion of the ceacum (CLP on a rigid mold of 3mm diameter, followed by 14 punctures of the ceacum with a 15 x 10 needle. Six hours after the induction of peritonitis, the animals were treated by laparotomy or videolaparoscopy, while analysing blood cultures and the mortality rates. The treatment involved typhlectomy followed or

  16. Abbreviation of larval development and extension of brood care as key features of the evolution of freshwater Decapoda.

    Science.gov (United States)

    Vogt, Günter

    2013-02-01

    The transition from marine to freshwater habitats is one of the major steps in the evolution of life. In the decapod crustaceans, four groups have colonized fresh water at different geological times since the Triassic, the freshwater shrimps, freshwater crayfish, freshwater crabs and freshwater anomurans. Some families have even colonized terrestrial habitats via the freshwater route or directly via the sea shore. Since none of these taxa has ever reinvaded its environment of origin the Decapoda appear particularly suitable to investigate life-history adaptations to fresh water. Evolutionary comparison of marine, freshwater and terrestrial decapods suggests that the reduction of egg number, abbreviation of larval development, extension of brood care and lecithotrophy of the first posthatching life stages are key adaptations to fresh water. Marine decapods usually have high numbers of small eggs and develop through a prolonged planktonic larval cycle, whereas the production of small numbers of large eggs, direct development and extended brood care until the juvenile stage is the rule in freshwater crayfish, primary freshwater crabs and aeglid anomurans. The amphidromous freshwater shrimp and freshwater crab species and all terrestrial decapods that invaded land via the sea shore have retained ocean-type planktonic development. Abbreviation of larval development and extension of brood care are interpreted as adaptations to the particularly strong variations of hydrodynamic parameters, physico-chemical factors and phytoplankton availability in freshwater habitats. These life-history changes increase fitness of the offspring and are obviously favoured by natural selection, explaining their multiple origins in fresh water. There is no evidence for their early evolution in the marine ancestors of the extant freshwater groups and a preadaptive role for the conquest of fresh water. The costs of the shift from relative r- to K-strategy in freshwater decapods are traded

  17. SLAM-enriched hematopoietic stem cells maintain long-term repopulating capacity after lentiviral transduction using an abbreviated protocol.

    Science.gov (United States)

    Laje, P; Zoltick, P W; Flake, A W

    2010-03-01

    Gene transfer to long-term repopulating hematopoietic stem cells (HSCs) using integrating viral vectors is an important goal in gene therapy. The SLAM (signaling lymphocyte activation molecule)-family receptors have recently been used for the isolation of highly enriched murine HSCs. This HSC enrichment protocol is relatively simple, and results in an HSC population with comparable repopulating capacity to c-kit(+)lin(-)Sca-1(+) (KSL) HSCs. The capacity to withstand genetic manipulation and, most importantly, to maintain long-term repopulating capacity of SLAM-enriched HSC populations has not been reported. In this study, SLAM-enriched HSCs were assessed for transduction efficiency and in vivo long-term repopulating capacity after lentiviral transduction using an abbreviated transduction protocol and KSL-enriched HSCs as a reference population. SLAM- and KSL-enriched HSCs were efficiently transduced by lentiviral vector using a simple protocol that involves minimal in vitro manipulation and no pre-stimulation. SLAM-HSCs are at least equal to KSL-HSCs with respect to efficiency of transduction and maintenance of long-term repopulating capacity. Although there was a reduction in repopulating capacity related to enrichment and culture manipulations relative to freshly isolated bone marrow (BM) cells, no detrimental effects were identified on long-term competitive capacity related to transduction, as transduced cells maintained stable levels of chimerism in competition with non-transduced cells and freshly isolated BM cells. These results support the SLAM-HSC enrichment protocol as a simple and efficient method for HSC enrichment for gene transfer studies.

  18. An Abbreviated Protocol for In Vitro Generation of Functional Human Embryonic Stem Cell-Derived Beta-Like Cells

    Science.gov (United States)

    Massumi, Mohammad; Pourasgari, Farzaneh; Nalla, Amarnadh; Batchuluun, Battsetseg; Nagy, Kristina; Neely, Eric; Gull, Rida; Nagy, Andras; Wheeler, Michael B.

    2016-01-01

    The ability to yield glucose-responsive pancreatic beta-cells from human pluripotent stem cells in vitro will facilitate the development of the cell replacement therapies for the treatment of Type 1 Diabetes. Here, through the sequential in vitro targeting of selected signaling pathways, we have developed an abbreviated five-stage protocol (25–30 days) to generate human Embryonic Stem Cell-Derived Beta-like Cells (ES-DBCs). We showed that Geltrex, as an extracellular matrix, could support the generation of ES-DBCs more efficiently than that of the previously described culture systems. The activation of FGF and Retinoic Acid along with the inhibition of BMP, SHH and TGF-beta led to the generation of 75% NKX6.1+/NGN3+ Endocrine Progenitors. The inhibition of Notch and tyrosine kinase receptor AXL, and the treatment with Exendin-4 and T3 in the final stage resulted in 35% mono-hormonal insulin positive cells, 1% insulin and glucagon positive cells and 30% insulin and NKX6.1 co-expressing cells. Functionally, ES-DBCs were responsive to high glucose in static incubation and perifusion studies, and could secrete insulin in response to successive glucose stimulations. Mitochondrial metabolic flux analyses using Seahorse demonstrated that the ES-DBCs could efficiently metabolize glucose and generate intracellular signals to trigger insulin secretion. In conclusion, targeting selected signaling pathways for 25–30 days was sufficient to generate ES-DBCs in vitro. The ability of ES-DBCs to secrete insulin in response to glucose renders them a promising model for the in vitro screening of drugs, small molecules or genes that may have potential to influence beta-cell function. PMID:27755557

  19. Use of an abbreviated neuroscience education approach in the treatment of chronic low back pain: a case report.

    Science.gov (United States)

    Louw, Adriaan; Puentedura, Emilio Louie; Mintken, Paul

    2012-01-01

    Chronic low back pain (CLBP) remains prevalent in society, and conservative treatment strategies appear to have little effect. It is proposed that patients with CLBP may have altered cognition and increased fear, which impacts their ability to move, perform exercise, and partake in activities of daily living. Neuroscience education (NE) aims to change a patient's cognition regarding their pain state, which may result in decreased fear, ultimately resulting in confrontation of pain barriers and a resumption of normal activities. A 64-year-old female with history of CLBP was the patient for this case report. A physical examination, the Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire (FABQ), and Zung Depression Scale were assessed during her initial physical therapy visit, immediately after her first physical therapy session, and at 7-month follow-up. Treatment consisted of an abbreviated NE approach, exercises (range of motion, stretches, and cardiovascular), and aquatic therapy. She attended twice a week for 4 weeks, or 8 visits total. Pre-NE, the patient reported NPRS = 9/10; ODI = 54%; FABQ-W = 25/42,; FABQ-PA = 20/24, and Zung = 58. Immediately following the 75-minute evaluation and NE session, the patient reported improvement in all four outcome measures, most notably a reduction in the FABQ-W score to 2/42 and the FABQ-PA to 1/24. At a 7-month follow-up, all outcome measures continued to be improved. NE aimed at decreasing fear associated with movement may be a valuable adjunct to movement-based therapy, such as exercise, for patients with CLBP.

  20. Emergency teams in Danish emergency departments

    DEFF Research Database (Denmark)

    Lafrenz, Thomas; Lindberg, Søren Østergaard; La Cour, Jeppe Lerche;

    2012-01-01

    The use of designated emergency teams for cardiac arrest and trauma patients is widely implemented. However, the use of designated teams in Danish emergency departments (EDs) has not been investigated. Our aim was to investigate the use and staffing of emergency teams in Danish EDs....

  1. [Pediatric emergencies in the emergency medical service].

    Science.gov (United States)

    Silbereisen, C; Hoffmann, F

    2015-01-01

    Out-of-hospital pediatric emergencies occur rarely but are feared among medical personnel. The particular characteristics of pediatric cases, especially the unaccustomed anatomy of the child as well as the necessity to adapt the drug doses to the little patient's body weight, produce high cognitive and emotional pressure. In an emergency standardized algorithms can facilitate a structured diagnostic and therapeutic approach. The aim of this article is to provide standardized procedures for the most common pediatric emergencies. In Germany, respiratory problems, seizures and analgesia due to trauma represent the most common emergency responses. This article provides a practical approach concerning the diagnostics and therapy of emergencies involving children.

  2. Emergency Medical Services

    Science.gov (United States)

    ... and need help right away, you should use emergency medical services. These services use specially trained people and specially equipped facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  3. Emergency care toolkits.

    Science.gov (United States)

    Black, Steven

    2004-06-01

    Emergency care services are the focus of a series of toolkits developed by the NHS National electronic Library for Health to provide resources for emergency care leads and others involved in modernising emergency care, writes Steven Black.

  4. Emerging Pathogens Initiative (EPI)

    Data.gov (United States)

    Department of Veterans Affairs — The Emerging Pathogens Initiative (EPI) database contains emerging pathogens information from the local Veterans Affairs Medical Centers (VAMCs). The EPI software...

  5. Necessity of immediate cardiopulmonary resuscitation in trauma emergency

    Directory of Open Access Journals (Sweden)

    Luciano Baitello

    2010-08-01

    Full Text Available Abstract The ability to respond quickly and effectively to a cardiac arrest situation rests on nurses being competent in the emergency life-saving procedure of cardiopulmonary resuscitation. The objective of the current study was to evaluate the types of trauma and survival of patients that require immediate cardiopulmonary resuscitation in trauma emergencies. A total of 13301 patients treated as accident victims between July 2004 and December 2006 were evaluated in a prospective study. Patients requiring immediate cardiopulmonary resuscitation at admission were identified. The type of injury and the survival of these patients were evaluated. Of the 65 patients included in the study, 30% had suffered from gunshot wounds, 19% had been run over, 18% had been involved in car crashes, 13% in motor cycle accidents, 9% stabbings, 1% by cycle accidents and 10% other types of accidents including burns, hangings and falls. In only 12 of these patients, immediate resuscitation was successful and procedure such as chest drainage, exploratory laparotomy and interventions in the surgical center were performed. However all patients evolved to death; eight within 24 hours, two between 24 and 48 hours and the other 2 after 48 hours. Immediate cardiopulmonary resuscitation after accidents is a sign of high mortality requiring further studies to review indication and the ethical aspects involved.

  6. Comparison on the effect of laparoscopic and laparotomy in treatment of peptic ulcer perforation%腹腔镜与开腹手术治疗消化性溃疡穿孔的效果对比

    Institute of Scientific and Technical Information of China (English)

    于青松

    2014-01-01

    目的:对比分析腹腔镜与开腹手术治疗消化性溃疡穿孔的手术效果。方法选取2011年1月~2013年1月在本院行腹腔镜穿孔修补术的患者40例作为腹腔镜组,另选择同期在本院行开腹子穿孔修补术的40例患者作为对照组,比较两组患者的手术时间、术中出血量、术后排气时间、住院时间及并发症发生情况。结果腹腔镜组患者的术中出血量明显少于对照组(P<0.01);术后排气时间明显短于对照组(P<0.01)、住院时间短于对照组(P<0.05),腹腔镜组的并发症发生率仅为5.0%,明显低于对照组(P<0.05)。结论腹腔镜胃十二指肠溃疡穿孔修补术较开腹手术能减少术中出血量、降低术后发症发生率、缩短住院时间、促进患者术后的恢复,值得临床推广应用。%Objective To compare the effect of laparoscopic and laparotomy in treatment of peptic ulcer perforation. Methods 40 patients with underwent laparoscopic perforation repair from January 2011 to January 2013 in our hospital were selected as the laparoscopic group,and another 40 patients underwent laparotomy perforation repair were selected as the control group at the same period,the amount of bleeding,operation time,postoperative exhaust time, hospitalization time and incidence rate of complication were compared between the two groups. Results The amount of bleeding in the laparoscopic group was significantly less than that in the control group (P<0.01),the exhaust time of laparoscopic group was significantly shorter than the control group (P<0.01),the hospitalization time of the laparoscopic group was shorter than the control group (P<0.05).The incidence rate of complication of the laparoscopic group (5.0%) was significantly lower than that in the control group (P<0.05). Conclusion Laparoscopic in treatment of peptic ulcer perforation compared with la-parotomy can reduce the amount of bleeding,reduce the complications incidence,shorten the

  7. Clinical studies of laparoscopic repair and laparotomy surgery in the treatment of gastric or duodenal ulcer%腹腔镜与开腹胃十二指肠溃疡穿孔修补手术临床研究

    Institute of Scientific and Technical Information of China (English)

    代学峰; 崔海燕

    2015-01-01

    Objective:To observe the curative effect of laparoscopic repair and laparotomy surgery in the treatment of gastric or duodenal ulcer.Methods:The clinical data of 75 cases with gastric or duodenal ulcer from February 2012 to May 2014 were analyzed retrospectively.38 cases were treated with laparoscopic repair in perforated gastric or duodenal ulcer(the laparoscope group).37 cases were treated with laparotomy gastric or duodenal ulcer perforation repair(the open group).We observed the intraoperative and postoperative general index,the recovery time of the postoperative intestinal function and the incidence of postoperative complications and etc in the two groups.Results:The operation time,the hospitalization time,the recovery time of the postoperative intestinal function and the leaving bed time in the laparoscopic group were all shorter than those of the open group, and there were statistical significant differences(P<0.05).The incidence of postoperative complications in the laparoscopic group was 5.26% (2/38);that of the open group was 24.32% (9/37);there was statistical significant difference( χ 2=4.03,P<0.05).The postoperative VAS scores of the laparoscopic patients were significantly lower than that of the open group(t=9.50,P<0.05). Conclusion:Laparoscopic repair in perforated gastric or duodenal ulcer has the advantages of shorter surgery time,quick recovery and lower complication rates comparing with the traditional laparotomy,which is a kind of safe and effective treatment.%目的:观察腹腔镜与开腹行胃十二指肠溃疡穿孔修补术的临床疗效。方法:回顾性分析2012年2月-2014年5月收治胃十二指肠溃疡穿孔患者75例的临床资料,其中38例行腹腔镜胃十二指肠溃疡穿孔修补术(腹腔镜组),37例行胃十二指肠溃疡穿孔修补术(开腹组),观察两组术中、术后一般指标、术后肠道功能恢复时间及术后并发症发生率等。结果:腹腔镜组手术时间

  8. The operation techniques of distal pancreatectomy: laparotomy, laparoscopy or robotic surgery%开腹还是腹腔镜或机器人:胰体尾肿瘤切除方式的选择

    Institute of Scientific and Technical Information of China (English)

    彭承宏; 李花

    2016-01-01

    胰腺外科因其本身手术的复杂性,微创手术的应用一直晚于其他外科.但随着微创外科的逐渐发展,尤其是机器人辅助手术系统问世以来,胰腺外科在微创领域取得了巨大成就.腹腔镜及机器人技术广泛应用于胰腺外科,同时开腹手术技术也在发展,三者各有优劣,如何选择术式成了胰腺外科医师面临的新问题.微创胰体尾切除手术尤其是机器入辅助手术的安全性和可行性已得到多方证实.但即使有诸多优点,腹腔镜手术和机器人辅助手术均无法完全替代开腹手术,胰腺外科医师熟练掌握三种手术方式有助于其得心应手地处理复杂的临床问题.%Due to the operational complexity,the application of minimally invasive surgery in pancreatic procedure has been delayed than other departments.But with the gradual development of minimally invasive surgery,especially since the introduction of robotic surgery system,pancreatic surgery in this field has seen a great number of achievement.Laparoscopic and robotic technology is being widely adopted,while the technique of laparotomy is also developing.These three operation techniques have their advantages and disadvantages.Which method to option for became a new problem for pancreatic surgeons.The safety and feasibility of minimally invasive surgery especially robotic procedure for distal pancreatectomy have been confirmed by many agencies.But even with these advantages,laparoscopic and robotic surgery can not completely replace laparotomy.Pancreatic surgeons need to master these three operation methods to be able to handle complicated clinical situations.

  9. Damage control laparotomy in multiple trauma care: a report of 33 cases%多发伤救治中损害控制性剖腹术33例

    Institute of Scientific and Technical Information of China (English)

    李培源; 孙士锦; 张连阳

    2016-01-01

    目的 探讨损害控制性剖腹术在多发伤救治中的应用及效果. 方法 回顾性分析2009年1月-2015年6月应用损害控制性剖腹术救治的33例多发伤患者的临床资料,其中男24例,女9例;年龄19~68岁,平均41.0岁.致伤原因:交通伤21例,高处坠落伤6例,重物砸伤5例,雷管爆炸伤1例.损伤严重度评分(ISS)14 ~64分,平均27.0分.患者均有腹部创伤;合并脑伤10例次,胸伤23例次,骨盆四肢伤21例次.33例均实施损害控制性剖腹术,完成腹腔内手术后均行暂时性腹腔关闭.观察并统计患者腹腔关闭时间,腹腔高压症(IAH)或腹腔间隙综合征(ACS)的发生及治疗方法,总住院时间和并发症发生情况. 结果 33例中29例在术后5~12 d行早期确定性腹腔关闭,4例植皮覆盖创面形成计划性腹疝.12例出现IAH或ACS,行负压封闭引流(VSD)辅助的腹腔扩容术.患者总住院时间21 ~70 d,平均31.4 d.2例开放性骨折术后创面感染;4例出现腹壁切口感染,经清创+ VSD引流后愈合;腹腔内脓肿1例,经腹腔穿刺引流后治愈.所有患者均顺利出院. 结论 对于合并腹部创伤的多发伤救治,合理应用损害控制性剖腹术安全有效.%Objective To investigate the effect of damage control laparotomy in multiple trauma care.Methods A retrospective review was made on clinical data of 33 multiple trauma cases who received damage control laparotomy from January 2009 to June 2015.Twenty-four cases were males and 9 females, with the age range of 19-68 years(mean, 41.0 years).The trauma causes included traffic injury in 21 cases, high fall injury in 6 cases, falling object injury in 5 cases, and detonator blast injury in 1 case.Injury severity score (ISS) ranged from 14 to 64 points (mean, 27.0 points).All cases presented abdominal injury.Complicated injuries included brain injury in 10 cases, chest injury in 23 cases, and pelvic limb injury in 21 cases.All cases underwent damage control laparotomy

  10. Dissemination of bacteria labeled with technetium-99m after laparotomy and abdominal insufflation with different CO2 pressures on rats; Disseminacao de bacterias marcadas com tecnecio-99m apos laparotomia e insuflacao com diferentes pressoes de CO2 em ratos

    Energy Technology Data Exchange (ETDEWEB)

    Pitombo, Marcos Bettini; Faria, Clarice Abreu dos Santos Albuquerque de; Steinbruck, Klaus [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Escola de Medicina]. E-mail: mpitombo@urbi.com.br; Bernardo, Luciana Camargo; Bernardo Filho, Mario[Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes (IBRAG). Lab. de Radiofarmacia Experimental

    2008-01-15

    Purpose: To asses the dissemination of bacteria labeled with technetium-99m (99mTc) from peritoneal cavity after different surgical procedures. Methods: Bacteria of the Escherichia coli species labeled with 99mTc were used in a concentration of 108 units of colony-makers for ml (UFC/ml) and 1 ml was inoculated through intra-peritoneal via. Forty-eight rats were divided into four groups: control, laparotomy, pneumoperitoneum with 10 mmHg and pneumoperitoneum with 20 mmHg of CO2. Procedures were performed 20 min after injection of the inoculum and lasted 30 min. Animals were sacrificed after six hours (Group 1) and 24 hours (Group 2). Samples of blood, liver and spleen were collected for radioactivity counting. Results: After six hours, indirect detection of the bacteria in different organs was uniform in all groups. After 24 hours, a larger detection of technetium was observed in the livers of animals of the group insufflated with 20 mmHg of CO2, when compared with those of control group (p<0.01). The other groups did not present statistically significant variations. Conclusions: The use of a higher intra-abdominal pressure was associated with a higher bacterial dissemination to the liver. The application of lower intra-abdominal pressures may be associated with a lower dissemination of the infectious status during laparoscopic approach of peritonitis status. (author)

  11. Vasovagal reflex emergency caused by Riedel's thyroiditis: A case report and review of the literature.

    Science.gov (United States)

    Cai, Wei; Kang, Hua; Hai, Tao

    2016-01-01

    Riedel's thyroiditis is a rare type of chronic thyroiditis, associated with fibroinflammatory process and invasion into surrounding tissues, leading to compressive symptoms. A 45-year-old man had a left thyroid mass, presenting with hypotension and bradycardia many times. He was diagnosed with vasovagal reflex caused by cervical vessel compression due to a thyroid lesion. We performed the emergency operation, and most of the left thyroid was removed to relieve the compression on cervical vessels. The result of pathology proved to be Riedel's thyroiditis. The vasovagal reflex did not occur any more during the 28-month follow up, except on the 3(rd) day after the surgery. Six months after the thyroidectomy, the patient was found to have retroperitoneal fibrosis, diagnosed by biopsy during a laparotomy for biliary disease. Riedel's thyroiditis can lead to a vasovagal episode and might not be a primary thyroid disease but rather a manifestation of the systemic disorder, multifocal fibrosclerosis.

  12. OEM Emergency Preparedness Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management compiles a wide variety of information in support of Emergency Preparedness, including certain elements of the System for Risk...

  13. Dog Bite Emergencies

    Science.gov (United States)

    ... Emergency Care Animal Welfare Veterinary Careers Public Health Dog bite emergencies What do I do if I’ ... vaccination records. What do I do if my dog bites someone? Dog bites are scary for everyone ...

  14. HANARO radiation emergency plan

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tai

    1997-10-15

    The emergency plan of HANARO (High-flux advanced Neutron Application Reactor) is prepared based on the Korea Atomic Law, the Civil Defence Law, Disaster Protection Law and the emergency related regulation guides such as the NUREG series from USNRC to ensure adequate response capabilities to the emergency event which would cause a significant risk to the KAERI staffs and the public near to the site. Periodic training and exercise for the reactor operators and emergency staffs will reduce accident risks and the release of radioactivities to the environment. The plan describes the organization and staff's duties in the radiation emergency, classification on the radiation accidents, urgent actions of reactor operators in the early state, emergency response activities, maintenance of emergency equipment, training and exercise to improve response capabilities against emergency accidents. (author). 1 tab., 5 figs.

  15. [Emerging noninfectious diseases].

    Science.gov (United States)

    Consiglio, Ezequiel

    2008-11-01

    In recent years, emerging diseases were defined as being infectious, acquiring high incidence, often suddenly, or being a threat or an unexpected phenomenon. This study discusses the hallmarks of emerging diseases, describing the existence of noninfectious emerging diseases, and elaborating on the advantages of defining noninfectious diseases as emerging ones. From the discussion of various mental health disorders, nutritional deficiencies, external injuries and violence outcomes, work injuries and occupational health, and diseases due to environmental factors, the conclusion is drawn that a wide variety of noninfectious diseases can be defined as emergent. Noninfectious emerging diseases need to be identified in order to improve their control and management. A new definition of "emergent disease" is proposed, one that emphasizes the pathways of emergence and conceptual traits, rather than descriptive features.

  16. Emergency Management Offices - Emergency Management Region (polygon)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — Data available online through GeoStor at http://www.geostor.arkansas.gov. This file contains location information for Emergency Management Regions in the State of...

  17. [Emergent viral infections

    NARCIS (Netherlands)

    Galama, J.M.D.

    2001-01-01

    The emergence and re-emergence of viral infections is an ongoing process. Large-scale vaccination programmes led to the eradication or control of some viral infections in the last century, but new viruses are always emerging. Increased travel is leading to a rise in the importation of exotic infecti

  18. Emerging technology and ethics

    CERN Document Server

    Wakunuma, Kutoma

    2011-01-01

    This e-book on Emerging Technologies and Ethics includes a collection of essays which explore the future and ethics of emerging information and communication technologies. Articles in the collection include an overview of the legal implications which may be relevant to the ethical aspects of emerging technologies and also ethical issues arising from the mass-take up of mobile technologies.

  19. Encountering Meckel's diverticulum in emergency surgery for ascaridial intestinal obstruction

    Directory of Open Access Journals (Sweden)

    Amin Abid

    2010-06-01

    Full Text Available Abstract Background Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. In children with intestinal ascariasis, the diverticulum remains asymptomatic or rarely the Ascaris lumbricoides may lead to its complications in the presence of massive intestinal roundworm load. Given that preoperative diagnosis is seldom carried out, when Meckel's diverticulum is found at laparotomy for obstructive intestinal complications of roundworm, the diverticulum should be removed as complications may occur at any time. The aim of this study was to describe the findings of concomitant presence of Meckel's diverticulum who had surgical intervention in symptomatic intestinal ascariasis in children. Methods A retrospective case review study of 14 children who had surgical intervention for symptomatic intestinal ascariasis having the presence of concomitant Meckel's diverticulum was done. The study was done at SMHS Hospital Srinagar, Kashmir. Results A total of the 14 children who had ascaridial intestinal obstruction with concomitant presence of Meckel's diverticulum were studied. Age of children ranged from 4-12 years, male:female ratio was 1.8:1. Nine patients had asymptomatic Meckel's diverticulum, whereas 5 patients with symptomatic signs were found in the course of emergency surgery for ascaridial intestinal obstruction. Conclusion Meckel's diverticulum in intestinal ascariasis may pursue silent course or may be accompanied with complications of the diverticulitis, perforation or the gangrene. Incidental finding of the Meckel's diverticulum in the intestinal ascariasis should have removal.

  20. Medical emergencies in Goa

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo

    2010-01-01

    Full Text Available Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa′s roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%, which were mainly of the nature of accidents or assaults (17% and fever related (17%. Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa.

  1. Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model Influência da laparoscopia e laparotomia na gasometria, leucócitos e citocinas em modelo de sepse abdominal em ratos

    Directory of Open Access Journals (Sweden)

    Irami Araújo Filho

    2006-04-01

    Full Text Available PURPOSE: Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. METHODS: Wistar rats were randomly assigned to five groups: control (anesthesia only, laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFalpha, IL-1beta, IL-6 were determined in intraperitoneal fluid (by ELISA. Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. RESULTS: Peritoneal TNFalpha, IL-1beta and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (pOBJETIVO: A cirurgia laparoscópica está associada com trauma reduzido e baixa resposta na fase aguda do trauma, quando comparada com a cirurgia aberta. As citocinas e o balanço ácido-base são fatores importantes da resposta biológica ao trauma cirúrgico-anestésico. O objetivo deste estudo foi determinar se o pneumoperitôneo com CO2 altera a expressão das citocinas, a gasometria e a contagem diferencial de leucócitos em ratos com sepse abdominal. MÉTODOS: Ratos Wistar foram aleatoriamente distribuídos em 5 grupos: controle (somente anestesia, laparotomia, pneumoperitôneo com CO2, ligadura e punção do ceco por laparotomia, ligadura e punção do ceco por laparoscopia. Após 30 minutos dos procedimentos, sangue arterial foi colhido para leucometria diferencial em hemocitômetro. TNFalfa, IL-1beta e IL-6 foram dosadas no líquido intraperitoneal (por ELISA. Os parâmetros gasosos foram medidos no sangue arterial e nos exsudatos

  2. The abbreviated impactor measurement (AIM) concept: part 1--Influence of particle bounce and re-entrainment-evaluation with a "dry" pressurized metered dose inhaler (pMDI)-based formulation.

    Science.gov (United States)

    Mitchell, J P; Nagel, M W; Avvakoumova, V; MacKay, H; Ali, R

    2009-01-01

    The abbreviated impactor measurement concept is a potential improvement to the labor-intensive full-resolution cascade impactor methodology for inhaler aerosol aerodynamic particle size distribution (APSD) measurement by virtue of being simpler and therefore quicker to execute. At the same time, improved measurement precision should be possible by eliminating stages upon which little or no drug mass is collected. Although several designs of abbreviated impactor systems have been developed in recent years, experimental work is lacking to validate the technique with aerosols produced by currently available inhalers. In part 1 of this two-part article that focuses on aerosols produced by pressurized metered dose inhalers (pMDIs), the evaluation of two abbreviated impactor systems (Copley fast screening Andersen impactor and Trudell fast screening Andersen impactor), based on the full-resolution eight-stage Andersen nonviable cascade impactor (ACI) operating principle, is reported with a formulation producing dry particles. The purpose was to investigate the potential for non-ideal collection behavior associated with particle bounce in relation to internal losses to surfaces from which particles containing active pharmaceutical ingredient are not normally recovered. Both abbreviated impactors were found to be substantially equivalent to the full-resolution ACI in terms of extra-fine and fine particle and coarse mass fractions used as metrics to characterize the APSD of these pMDI-produced aerosols when sampled at 28.3 L/min, provided that precautions are taken to coat collection plates to minimize bounce and entrainment.

  3. Comparative study of laparoscope and laparotomy D2 radical gastrectomy in the treatment of distal gastric cancer%腹腔镜与开腹远端胃癌D2根治术的对比研究

    Institute of Scientific and Technical Information of China (English)

    何洪生; 曾文龙; 朱柏炼; 杜永御; 赖扬城

    2014-01-01

    目的:通过对比腹腔镜与开腹远端胃癌D2根治术的疗效及安全性,探讨腹腔镜辅助远端胃癌D2根治术的临床价值。方法221例行远端胃癌D2根治术患者,分为两组。其中腹腔镜组115例,开腹组106例,对两组手术时间、术中出血量、术后排气时间、首次进流质时间、淋巴结清扫数目、术后住院天数、并发症进行比较。结果腹腔镜组手术时间、淋巴结清扫数与开腹组差异无统计学意义(P>0.05),而腹腔镜组术中出血量少,术后肛门排气时间早,首次进流质时间早,术后住院时间短,并发症发生率低(P0.05). However, the laparoscope group had fewer intraoperative bleeding volumes, earlier postoperative anal exhaust time, earlier first time of liquid diet, shorter postoperative hospital stays and lower incidence of complications (P<0.05). Conclusion Laparoscope assisted D2 radical gastrectomy in the treatment of distal gastric cancer has small trauma, few bleeding, quick recovery and less complications. The recent curative effect is similar as that of laparotomy, and the treatment is safe and feasible, and worthy of clinical promotion.

  4. Detecting malingering in traumatic brain injury and chronic pain with an abbreviated version of the Meyers Index for the MMPI-2.

    Science.gov (United States)

    Aguerrevere, Luis E; Greve, Kevin W; Bianchini, Kevin J; Meyers, John E

    2008-01-01

    Meyers, Millis, and Volkert [Meyers, J. E., Millis, S. R., & Volkert, K. (2002). A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169] developed a method to detect malingering in chronic pain patients using seven scales from the Minnesota Multiphasic Inventory-2 (MMPI-2). This method may be impractical because two of the scales (Obvious minus Subtle and Dissimulation-revised) are not reported by the commercially available Pearson computerized scoring system. The current study recalculated the Meyers Index using the five Pearson-provided scales in the chronic pain data sets of Meyers et al. [Meyers, J. E., Millis, S. R., & Volkert, K. (2002). A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169] and Bianchini, Etherton, Greve, Heinly, and Meyers [Bianchini, K. J., Etherton, J. L., Greve, K. W., Heinly, M. T., & Meyers, J. E. (in press). Classification accuracy of MMPI-2 validity scales in the detection of pain-related malingering: A known-groups approach. Assessment], and the traumatic brain injury data of Greve, Bianchini, Love, Brennan, and Heinly [Greve, K. W., Bianchini, K. J., Love, J. M., Brennan, A., & Heinly, M. T. (2006). Sensitivity and specificity of MMPI-2 validity scales and indicators to malingered neurocognitive dysfunction in traumatic brain injury. The Clinical Neuropsychologist, 20, 491-512]. Classification accuracy of the abbreviated Meyers Index was comparable to the original. These findings demonstrate that the abbreviated Meyers Index can be used as a substitute of the original Meyers Index without decrements in classification accuracy.

  5. Wound Failure in Laparotomy: New insights

    NARCIS (Netherlands)

    G.H. van Ramshorst (Gabrielle)

    2014-01-01

    markdownabstract__Abstract__ Wound failure is a common complication of abdominal surgery. Its clinical presentation can vary from superficial wound dehiscence to burst abdomen with intraabdominal organs protruding through the wound. In long term, incisional hernia can be considered a representation

  6. Emergency in Burn; Burn in Emergency

    Directory of Open Access Journals (Sweden)

    Yalcin Bayram

    2012-06-01

    Full Text Available Physicians who first meet with burned patients are often emergency service employees. When the patient was admitted to emergency service, especially in patients with major burn injury, is a matter should be dealt with strongly. Before sending the patients to a burn center, some interventions could became life saving which should be done as a first line treatment. Herein, review of the literature related to emergency burn treatment was performed and presented to all physicians as a summary guide. In addition, some questions such as how should be physician, who first meet with the burned patient, evaluated the patient, what should be physician paid attention, which principles should be employed for fluid replacement, how should be approached to burn wound are tried to be addressed. [TAF Prev Med Bull 2012; 11(3.000: 365-368

  7. SUPERVASMOL POISONING: AN EMERGING ENT EMERGENCY

    Directory of Open Access Journals (Sweden)

    Mitta

    2016-05-01

    Full Text Available Poisoning is one of the commonest modes of suicide in India. Supervasmol poisoning is one of the commonest modes of suicidal attempt in our region. The common cause for consumption of hair dye is by suicidal intent or accidental oral ingestion. There is no specific antidote for Supervasmol poisoning. Management is only symptomatic and supportive with emergency tracheostomy in majority of cases. Hence, we conducted this study to emphasize the role of ENT surgeon in Supervasmol poisoning. STUDY DESIGN Prospective study. MATERIALS AND METHODS We present a total of 79 cases of Supervasmol poisoning who attended the Emergency Department of Narayana Medical College and General Hospital, Nellore. RESULTS All patients were between age group 15-35 yrs. Females are more than males. More patients were in second decade; 55 cases presented in acute phase, 51 patients underwent tracheostomy and four patients were brought dead. CONCLUSION Emergency tracheostomy is a life saving measure in severe stridor

  8. Emergências hipertensivas Hypertensive emergencies

    OpenAIRE

    Gilson Soares Feitosa-Filho; Renato Delascio Lopes; Nilson Tavares Poppi; Hélio Penna Guimarães

    2008-01-01

    As urgências e as emergências hipertensivas são ocorrências clínicas que podem representar mais de 25% dos atendimentos a urgências médicas. O médico deverá estar habilitado a diferenciá-las, pois o prognóstico e o tratamento são distintos. Estima-se que 3% de todas as visitas às salas de emergência decorrem de elevações significativas da pressão arterial. Nos quadros relacionados a estes atendimentos, a emergência hipertensiva é a entidade clínica mais grave que merece cuidados intensivos. É...

  9. Patterns of Flux Emergence

    Science.gov (United States)

    Title, A.; Cheung, M.

    2008-05-01

    The high spatial resolution and high cadence of the Solar Optical Telescope on the JAXA Hinode spacecraft have allowed capturing many examples of magnetic flux emergence from the scale of granulation to active regions. The observed patterns of emergence are quite similar. Flux emerges as a array of small bipoles on scales from 1 to 5 arc seconds throughout the region that the flux eventually condenses. Because the fields emerging from the underlying flux rope my appear many in small segments and the total flux (absolute sum) is not a conserved quantity the amount of total flux on the surface may vary significantly during the emergence process. Numerical simulations of flux emergence exhibit patterns similar to observations. Movies of both observations and numerical simulations will be presented.

  10. Theoretical magnetic flux emergence

    OpenAIRE

    MacTaggart, David

    2011-01-01

    Magnetic flux emergence is the subject of how magnetic fields from the solar interior can rise and expand into the atmosphere to produce active regions. It is the link that joins dynamics in the convection zone with dynamics in the atmosphere. In this thesis, we study many aspects of magnetic flux emergence through mathematical modelling and computer simulations. Our primary aim is to understand the key physical processes that lie behind emergence. The first chapter intro...

  11. Emergency Medical Service

    Science.gov (United States)

    1980-01-01

    Lewis Research Center helped design the complex EMS Communication System, originating from space operated telemetry, including the telemetry link between ambulances and hospitals for advanced life support services. In emergency medical use telemetry links ambulances and hospitals for advanced life support services and allows transmission of physiological data -- an electrocardiogram from an ambulance to a hospital emergency room where a physician reads the telemetered message and prescribes emergency procedures to ambulance attendants.

  12. Flux Emergence (Theory

    Directory of Open Access Journals (Sweden)

    Mark C. M. Cheung

    2014-07-01

    Full Text Available Magnetic flux emergence from the solar convection zone into the overlying atmosphere is the driver of a diverse range of phenomena associated with solar activity. In this article, we introduce theoretical concepts central to the study of flux emergence and discuss how the inclusion of different physical effects (e.g., magnetic buoyancy, magnetoconvection, reconnection, magnetic twist, interaction with ambient field in models impact the evolution of the emerging field and plasma.

  13. Thermodynamics and emergent universe

    CERN Document Server

    Ghosh, Saumya

    2016-01-01

    We show that in the isentropic scenario the first order thermodynamical particle creation model gives an emergent universe solution even when the chemical potential is non-zero. However there exists no emergent universe scenario in the second order non-equilibrium theory for the particle creation model. We then point out a correspondence between the particle creation model with barotropic equation of state and the equation of state giving rise to an emergent universe without particle creation in spatially flat FRW cosmology.

  14. Handbook of pulmonary emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Spaquolo, S.V.; Medinger, A

    1986-01-01

    This book presents information on the following topics: clinical assessment of the patient with pulmonary disease; interpretation of arterial blood gases in the emergency patient; life-threatening pneumonia; extrapulmonic ventilatory failure; acute inhalation lung disease; pulmonary edema; near drowning; chest trauma; upper airway emergencies; chronic lung disease with acute respiratory decompensation; acute respiratory failure in the patient with chronic airflow obstruction; asthma; hemoptysis; embolic pulmonary disease; superior vena cava syndrome; catastrophic pleural disease; ventilatory assistance and its complications; and ventilator emergencies.

  15. Flux Emergence (Theory)

    Science.gov (United States)

    Cheung, Mark C. M.; Isobe, Hiroaki

    2014-12-01

    Magnetic flux emergence from the solar convection zone into the overlying atmosphere is the driver of a diverse range of phenomena associated with solar activity. In this article, we introduce theoretical concepts central to the study of flux emergence and discuss how the inclusion of different physical effects (e.g., magnetic buoyancy, magnetoconvection, reconnection, magnetic twist, interaction with ambient field) in models impact the evolution of the emerging field and plasma.

  16. Energy emergency handbook

    Energy Technology Data Exchange (ETDEWEB)

    1979-01-01

    This Handbook identifies selected state and federal measures available to mitigate the impact of an energy emergency, and provides a comprehensive energy emergency communications directory. In the case of state remedial actions, particular emphasis has been placed on typical implementation procedures and likely impacts. The discussions of federal actions focus on initation and implementation procedures. The directory is designed to facilitate communications of all types (telephone, Telex, TWX, or facsimile) among key energy emergency officials in the federal and state governments.

  17. Nonneurologic emergencies in boxing.

    Science.gov (United States)

    Coletta, Domenic F

    2009-10-01

    Professional boxing has done an admirable job in promoting safety standards in its particular sport. However, injuries occur during the normal course of competition and, unfortunately, an occasional life-threatening emergency may arise. Although most common medical emergencies in boxing are injuries from closed head trauma, in this article those infrequent but potentially catastrophic nonneurologic conditions are reviewed along with some less serious emergencies that the physician must be prepared to address.

  18. Delayed emergence after anesthesia.

    Science.gov (United States)

    Tzabazis, Alexander; Miller, Christopher; Dobrow, Marc F; Zheng, Karl; Brock-Utne, John G

    2015-06-01

    In most instances, delayed emergence from anesthesia is attributed to residual anesthetic or analgesic medications. However, delayed emergence can be secondary to unusual causes and present diagnostic dilemmas. Data from clinical studies is scarce and most available published material is comprised of case reports. In this review, we summarize and discuss less common and difficult to diagnose reasons for delayed emergence and present cases from our own experience or reference published case reports/case series. The goal is to draw attention to less common reasons for delayed emergence, identify patient populations that are potentially at risk and to help anesthesiologists identifying a possible cause why their patient is slow to wake up.

  19. Radiological Emergency Response Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — Quality Data Asset includes all current and historical emergency radiological response event and incident of national significance data and surveillance, monitoring,...

  20. EMERGE-ing from the Shadows

    Science.gov (United States)

    Grier, Terry B.

    2014-01-01

    Houston school officials noticed their best performing low-income students weren't applying to Ivy League and selective colleges. In response, they created EMERGE, a program that develops and guides talented youths toward a top-college path.

  1. Emergências hipertensivas Hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Gilson Soares Feitosa-Filho

    2008-09-01

    Full Text Available As urgências e as emergências hipertensivas são ocorrências clínicas que podem representar mais de 25% dos atendimentos a urgências médicas. O médico deverá estar habilitado a diferenciá-las, pois o prognóstico e o tratamento são distintos. Estima-se que 3% de todas as visitas às salas de emergência decorrem de elevações significativas da pressão arterial. Nos quadros relacionados a estes atendimentos, a emergência hipertensiva é a entidade clínica mais grave que merece cuidados intensivos. É caracterizada por pressão arterial marcadamente elevada e sinais de lesões de órgãos-alvo (encefalopatia, infarto agudo do miocárdio, angina instável, edema agudo de pulmão, eclâmpsia, acidente vascular encefálico. O objetivo deste estudo foi apresentar os principais pontos sobre o seu apropriado diagnóstico e tratamento. Foi realizada busca por artigos originais com os unitermos "crise hipertensiva" e "emergência hipertensiva" nas bases de dados Pubmed e MedLine nos últimos dez anos. As referências disponíveis destes artigos foram verificadas. Os artigos foram identificados e revisados e o presente estudo condensa os principais resultados descritos. Para esta revisão foram considerados ensaios clínicos em língua inglesa, estudos retrospectivos e artigos de revisão. A crise hipertensiva é a entidade clínica com aumento súbito da PA (> 180 x 120 mmHg, acompanhada por sintomas, que podem ser leves (cefaléia, tontura, zumbido ou graves (dispnéia, dor precordial, coma e até morte, com ou sem lesão aguda de órgãos-alvo. Se os sintomas forem leves e sem lesão aguda de órgãos alvos, define-se a urgência hipertensiva. Se o quadro clínico apresentar risco de vida e refletir lesão aguda de órgãos-alvo têm-se, então, a emergência hipertensiva. Muitos pacientes também apresentam uma PA elevada demais, por não usarem suas medicações, tratando-se apenas de hipertensão arterial sistêmica crônica n

  2. Efficacy and safety of laparoscopy and laparotomy in the treatment of acute cholecystitis%腹腔镜术和开腹术治疗急性胆囊炎的疗效及安全性分析

    Institute of Scientific and Technical Information of China (English)

    佘明杰; 刘小虎

    2014-01-01

    Objective:To investigate the clinical application value of laparoscopy and laparotomy in the treatment of acute cholecystitis.Methods:129 cases with acute cholecystitis who had been treated by operation from June 2010 to December 2013.We retrospectively analyzed their clinical datas.They were divided into the laparoscopy group(69 cases were treated with laparoscopic cholecystectomy) and the open group(60 cases were treated with conventional open operation) according to the different surgical treatment.We analyzed the operation related index and postoperative condition of the two groups.Results:The operation time, amount of bleeding during operation and postoperative anal exhaust time for the first time of the laparoscopic group were significantly shorter than those of the open group(P<0.01).The postoperative incision infection,bile leakage rate of the laparoscopic group were significantly lower than those in the open group(P<0.05).Conclusion:The laparoscopic cholecystectomy in the treatment of acute cholecystitis with less bleeding,less postoperative complications and other advantages,so it is worthy of clinical application.%目的:探讨腹腔镜胆囊切除术治疗急性胆囊炎的临床应用价值。方法:2010年6月-2013年12月收治行手术治疗的急性胆囊炎患者129例,回顾性分析其临床资料,按照所行治疗术式不同分为腔镜组69例,行腹腔镜下胆囊切除术治疗和开腹组60例,行常规开腹手术治疗,对两组患者手术相关指标及术后情况进行对比分析。结果:腔镜组手术耗时、术中出血量及术后首次肛门排气时间均明显短于开腹组(P<0.01);腔镜组患者术后切口感染、胆汁漏发生率明显低于开腹组(P<0.05)。结论:腹腔镜微创胆囊切除术治疗急性胆囊炎具有出血少、术后并发症少等优势,值得临床推广应用。

  3. Emergency Notification Strategy

    Science.gov (United States)

    Katsouros, Mark

    2014-01-01

    In higher education, the IT department is often the service provider for the institution's emergency notification system (ENS). For many institutions, the complexity of providing emergency notification to students, faculty, and staff makes using a local, on-premise solution unrealistic. But finding the right commercially hosted technical solution…

  4. Emerging wind energy technologies

    DEFF Research Database (Denmark)

    Rasmussen, Flemming; Grivel, Jean-Claude; Faber, Michael Havbro;

    2014-01-01

    This chapter will discuss emerging technologies that are expected to continue the development of the wind sector to embrace new markets and to become even more competitive.......This chapter will discuss emerging technologies that are expected to continue the development of the wind sector to embrace new markets and to become even more competitive....

  5. Quantization of emergent gravity

    Science.gov (United States)

    Yang, Hyun Seok

    2015-02-01

    Emergent gravity is based on a novel form of the equivalence principle known as the Darboux theorem or the Moser lemma in symplectic geometry stating that the electromagnetic force can always be eliminated by a local coordinate transformation as far as space-time admits a symplectic structure, in other words, a microscopic space-time becomes noncommutative (NC). If gravity emerges from U(1) gauge theory on NC space-time, this picture of emergent gravity suggests a completely new quantization scheme where quantum gravity is defined by quantizing space-time itself, leading to a dynamical NC space-time. Therefore the quantization of emergent gravity is radically different from the conventional approach trying to quantize a phase space of metric fields. This approach for quantum gravity allows a background-independent formulation where space-time and matter fields are equally emergent from a universal vacuum of quantum gravity.

  6. Electric power emergency handbook

    Energy Technology Data Exchange (ETDEWEB)

    Labadie, J.R.

    1980-09-01

    The Emergency Electric Power Administration's Emergency Operations Handbook is designed to provide guidance to the EEPA organization. It defines responsibilities and describes actions performed by the government and electric utilities in planning for, and in operations during, national emergencies. The EEPA Handbook is reissued periodically to describe organizational changes, to assign new duties and responsibilities, and to clarify the responsibilities of the government to direct and coordinate the operations of the electric utility industry under emergencies declared by the President. This Handbook is consistent with the assumptions, policies, and procedures contained in the National Plan for Emergency Preparedness. Claimancy and restoration, communications and warning, and effects of nuclear weapons are subjects covered in the appendices.

  7. Emerging patient safety issues under health care reform: follow-on biologics and immunogenicity

    Directory of Open Access Journals (Sweden)

    Liang BA

    2011-12-01

    Full Text Available Bryan A Liang1-3, Timothy Mackey1,41Institute of Health Law Studies, California Western School of Law, 2Department of Anesthesiology, University of California, San Diego School of Medicine, 3San Diego Center for Patient Safety, University of California, San Diego School of Medicine,4Joint Program in Global Health, University of California San Diego-San Diego State University, San Diego, CA, USAAbstract: US health care reform includes an abbreviated pathway for follow-on biologics, also known as biosimilars, in an effort to speed up access to these complex therapeutics. However, a key patient safety challenge emerges from such an abbreviated pathway: immunogenicity reactions. Yet immunogenicity is notoriously difficult to predict, and even cooperative approaches in licensing between companies have resulted in patient safety concerns, injury, and death. Because approval pathways for follow-on forms do not involve cooperative disclosure of methods and manufacturing processes by innovator companies and follow-on manufacturers, the potential for expanded immunogenicity must be taken into account from a risk management and patient safety perspective. The US Institute of Safe Medication Practices (ISMP has principles of medication safety that have been applied in the past to high-risk drugs. We propose adapting ISMP principles to follow-on biologic forms and creating systems approaches to warn, rapidly identify, and alert providers regarding this emerging patient safety risk. This type of system can be built upon and provide lessons learned as these new drug forms are developed and marketed more broadly.Keywords: biosimilars, follow-on biologics, immunogenicity, patient safety, law, health care reform

  8. Munchausen syndrome in the emergency department mostly difficult, sometimes easy to diagnose: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Vanderbruggen Nathalie

    2009-11-01

    Full Text Available Abstract Munchausen syndrome is a rare psychiatric disorder in which patients inflict on themselves an illness or injury for the primary purpose of assuming the sick role. Because these patients can present with many different complaints and clinical symptoms, diagnosis is often made at a later stage of hospitalisation. In contrast we report a case of a 40-year old woman very easy to diagnose with Munchausen syndrome. This trained nurse presented at our emergency department (ED complaining of abdominal pain. Interviewed by the medical trainee, she immediately confessed having put a knitting needle into her urethra four days earlier. She was not able to remove it anymore because it was beyond her reach. Abdominal X-ray confirmed the presence of the needle and a median laparotomy was performed to remove it. The diagnosis of Munchausen syndrome seemed immediately obvious in this case.

  9. Emergency Call Reform

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    China merges several hotline call services in an effort to streamline the urban emergency system Chances are that if you find yourself in a crisis situation in China, dialing the correct emergency number could be a problem. Not because there isn't one, but quite the opposite. China has four main emergency response numbers-110 summons police help in a life-threatening situation, 119 brings out firefighters, 122 gets police activated to sort out traffic accidents and 120 ensures medical help. Along with th...

  10. Cardiovascular hypertensive emergencies.

    Science.gov (United States)

    Papadopoulos, D P; Sanidas, E A; Viniou, N A; Gennimata, V; Chantziara, V; Barbetseas, I; Makris, T K

    2015-02-01

    Inevitably, a small proportion of patients with systematic hypertension will develop hypertensive crisis at some point. Hypertensive crises can be divided into hypertensive emergency or hypertensive urgency according to the presence or lack of acute target organ damage. In this review, we discuss cardiovascular hypertensive emergencies, including acute coronary syndrome, aortic dissection, congestive heart failure, and sympathomimetic hypertensive crises, including those caused by cocaine use. Each presents in a unique fashion, although some hypertensive emergency patients report nonspecific symptoms. Treatment includes several effective and rapid-acting medications to safely reduce the blood pressure, protect remaining end-organ function, relieve symptoms, minimize the risk of complications, and thereby improve patient outcomes.

  11. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  12. Investigate of cause and opportunity of alternative laparotomy in laparoscopic cholecystectomy for ;cholecystitis complicated with gallbladder stone patients%胆囊炎合并胆囊结石患者行腹腔镜胆囊切除术中转开腹的原因及时机探讨

    Institute of Scientific and Technical Information of China (English)

    孔锡根; 万里鹏; 王继阳

    2015-01-01

    Objective To investigate cause and opportunity of alternative laparotomy in laparoscopic cholecystectomy(LC) for cholecystitis complicated with gallbladder stone patients. Methods Clinical data of 83 cholecystitis complicated with gallbladder stone patients were retrospectively analyzed. The patients were divided by surgery condition into laparoscopic cholecystectomy group (group A, n=30), active alternative laparotomy group (group B, n=26), and passive alternative laparotomy group (group C, n=27). Differences of risk factors for alternative laparotomy were compared in the three groups, and their operation process, intraoperative bleeding volume, postoperative exhaust time, and hospital stay were recorded. Results ①Groups B and C had much higher white blood cell count, thickness of gallbladder wall, and history of epigastrium operation than the group A. Their difference had statistical significance (P<0.05). ②After treatment, group A had the shortest operation process, intraoperative bleeding volume, postoperative exhaust time, and hospital stay among the three groups. Those were in middle levels in group B, and those of group C were the longest ones. Their differences had statistical significance (P<0.05). Conclusion Thickness of gallbladder wall, history of epigastrium operation, and white blood cell count are the risk factors of alternative laparotomy in laparoscopic cholecystectomy for cholecystitis complicated with gallbladder stone patients. Active alternative laparotomy according to intraoperative probing status is helpful for improving prognosis quality of patients.%目的:探讨胆囊炎合并胆囊结石患者行腹腔镜胆囊切除术(LC)中转开腹的原因及时机。方法回顾性分析83例胆囊炎合并胆囊结石患者临床病历资料,根据其实际手术情况分成成功完成腹腔镜胆囊切除术组(A组, n=30)、主动中转开腹组(B组, n=26)和被动中转开腹组(C组, n=27)三组。分析三组患者中转开腹危险

  13. Emergency Preparedness at NCI

    Science.gov (United States)

    Information to help prepare for an emergency. Includes resources for patients and health care providers to continue cancer care, NCI contacts for grantees, and resources to prepare and update NCI employees and contractors.

  14. Winter Weather Emergencies

    Science.gov (United States)

    Severe winter weather can lead to health and safety challenges. You may have to cope with Cold related health problems, including ... there are no guarantees of safety during winter weather emergencies, you can take actions to protect yourself. ...

  15. Emergency airway puncture - slideshow

    Science.gov (United States)

    ... presentations/100113.htm Emergency airway puncture - series—Normal anatomy To ... larynx is a tubular structure in the neck, through which air passes to the lungs. The thryoid and cricoid cartilage form the narrowest ...

  16. Emergency Notification System

    Data.gov (United States)

    US Agency for International Development — The USAID ENS provides quick and effective notification messages during any emergency affecting the Ronald Reagan Building, SA-44, Potomac Yards and USAID Washington...

  17. OEM Emergency Response Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management retains records of all incident responses in which it participates. This data asset includes three major sources of information:...

  18. Household Chemical Emergencies

    Science.gov (United States)

    ... order to provide requested information. Follow the emergency operator or dispatcher’s first aid instructions carefully. The first ... many hazardous materials throughout your home. Take a tour of your home to see where these materials ...

  19. Emerging Targets in Photopharmacology

    NARCIS (Netherlands)

    Lerch, Michael M; Hansen, Mickel J; van Dam, Gooitzen M; Szymanski, Wiktor; Feringa, Ben L

    2016-01-01

    The field of photopharmacology uses molecular photoswitches to establish control over the action of bioactive molecules. It aims to reduce systemic drug toxicity and the emergence of resistance, while achieving unprecedented precision in treatment. By using small molecules, photopharmacology provide

  20. Emerging topics in FXTAS

    DEFF Research Database (Denmark)

    Hall, Deborah A; Birch, Rachael C; Anheim, Mathieu

    2014-01-01

    This paper summarizes key emerging issues in fragile X-associated tremor/ataxia syndrome (FXTAS) as presented at the First International Conference on the FMR1 Premutation: Basic Mechanisms & Clinical Involvement in 2013....

  1. LARYNGEAL MYXOMA : EMERGENCY MANAGEMENT

    OpenAIRE

    Budhram Singh; Santosh K Uddesh

    2014-01-01

    A sixty five years male presented with stridor and dysphonia in emergency clinic of Govt. CIMS medical college, Bilaspur. Indirect laryngoscopic examination revealed a polypoidal lesion in glottic chink. CT scan evaluation confirmed the findings of clinical examination. Patient was relived of symptoms after emergency tracheostomy followed by surgical removal of polypoidal lesion from right vocal cord by microlaryngeal surgery. Histopathological examination revealed myxoma. Clinical examinatio...

  2. Emerging zoonotic viral diseases.

    Science.gov (United States)

    Wang, L-F; Crameri, G

    2014-08-01

    Zoonotic diseases are infectious diseases that are naturally transmitted from vertebrate animals to humans and vice versa. They are caused by all types of pathogenic agents, including bacteria, parasites, fungi, viruses and prions. Although they have been recognised for many centuries, their impact on public health has increased in the last few decades due to a combination of the success in reducing the spread of human infectious diseases through vaccination and effective therapies and the emergence of novel zoonotic diseases. It is being increasingly recognised that a One Health approach at the human-animal-ecosystem interface is needed for effective investigation, prevention and control of any emerging zoonotic disease. Here, the authors will review the drivers for emergence, highlight some of the high-impact emerging zoonotic diseases of the last two decades and provide examples of novel One Health approaches for disease investigation, prevention and control. Although this review focuses on emerging zoonotic viral diseases, the authors consider that the discussions presented in this paper will be equally applicable to emerging zoonotic diseases of other pathogen types.

  3. 开腹及腹腔镜手术切除胆囊治疗结石性胆囊炎对比观察%Comparison observation laparotomy and laparoscopic cholecystectomy treating calculous cholecystitis

    Institute of Scientific and Technical Information of China (English)

    仲杨

    2016-01-01

    ABSTRAC:Objective To compare the effect of open and laparoscopic cholecystectomy in the treatment of gallstone cholecystitis. Methods in our hospital in January 2013 and 2015 January 100 cases of calculus cholecystitis patients were studied with different surgery were randomly divided into open surgery grouPand the laparoscopic group, there were 50 cases of patients in the laparotomy grouPunderwent conventional open cholecystectomy surgery, the laparoscopic grouPunderwent laparoscopic cholecystectomy, of two groups of patients with operation time, incision length, intraoperative bleeding and hospitalization time and other factors compared. Results compared with the open group, the operation time, incision length, blood loss and postoperative pain time of the laparoscopic grouPwere more ideal,P< 0.05, the difference was statistically significant. And, the proportion of complications of open surgery grouPwas 24%, compared with the open group, the probability of complications of laparoscopic grouPwas 12%, significantly lower,P< 0.05, the difference between the two groups was statistically significant.Conclusion laparoscopic cholecystectomy for gallstone cholecystitis can achieve good clinical results, it is worthy of clinical application in the future.%目的:将开腹及腹腔镜手术切除胆囊治疗结石性胆囊炎的效果进行对比。方法选取本院2013年1月至2015年1月收治的100例结石性胆囊炎患者进行研究,以手术方式的不同随机分为开腹组与腹腔镜组,两组均有50例患者,开腹组行传统开腹胆囊切除手术,腹腔镜组行腹腔镜胆囊切除术,对两组患者的手术时间、切口长度、术中出血量以及住院时间等因素进行比较。结果与开腹组相比,腹腔镜组的手术时间、切口长度、术中出血量以及术后疼痛时间等更为理想,P<0.05,差异具有统计学意义。并且,开腹组并发症所占比例为24.0%,与开腹组相比,腹

  4. 腹腔镜胆囊切除术与开腹胆囊切除术疗效比较%Clinical effect of laparoscopic cholecystectomy and laparotomy surgical treatment with cholecystolithiasis

    Institute of Scientific and Technical Information of China (English)

    张全轴

    2015-01-01

    目的:比较腹腔镜胆囊切除术与开腹胆囊切除术的临床治疗效果。方法收治胆囊结石患者102例,其中采取四孔法腹腔镜胆囊切除术(腔镜组)50例,采取传统开腹胆囊切除术(对照组)52例,比较两组患者的手术时间、术中出血量、术后首次下床时间、术后通气时间、引流管拔除时间、术后住院时间以及术后并发症发生率。结果腔镜组手术时间平均(61.36±10.23) min,术中出血量(21.04±5.44)ml,术后通气时间(1.70±0.64) d,引流管拔除时间(2.26±0.44) d,术后平均住院时间(3.26± 0.44)d。对照组手术时间平均为(80.08±8.44) min,术中出血量为(76.12±7.43) ml,术后通气时间为(3.08±0.75)d,腔镜组上述指标均优于对照组,差异均有统计学意义(P<0.05)。结论在具备良好的腹腔镜手术技术的基础上行腹腔镜胆囊切除术是安全有效的,值得在基层医院推广。%Objective To compare the clinical effect of laparoscopic cholecystectomy and laparotomy surgical treatment with cholecystolithiasis.Methods A total of 102 patients diagnosed as gallbladder stone in our hospital were selected and randomly divided into experimental group and control group.50 cases in experimental group were treated with four-hole laparoscopic cholecystectomy, 52 cases in control group were received conventional open cholecystectomy.The clinical effect were observed and compared by the two groups.Results In the experimental group, the mean operative time (61.36 ±10.23) min, the bleeding amount (21.04 ±5.44) ml, postoperative ventilation time (1.70 ±0.64) d, drainage tube removal time (2.26 ±0.44) d, the mean postoperative hospital stay time (3.26 ±0.44) d, the results were better than the control group, the difference was statistically significant(P<0.05).Postoperative complications had no statistically significant

  5. Evidence-based nursing radical psychological impact on patients undergoing colon cancer with laparotomy%循证护理对开腹结肠癌根治术患者术前心理的影响

    Institute of Scientific and Technical Information of China (English)

    米卫华

    2014-01-01

    Objective To investigate the psychological impact of evidence-based care in patients undergoing colon cancer with laparotomy. Methods 80 cases were divided into two groups, each 40 cases, the observation group were implemented evidence-based nursing interventions in this study, the control group were implemented routine care, such as general care, general psychological care, health education, fears, depression, self-assessment, then patients with nursing intervention tables and Self-Rating Anxiety scale score and intraoperative vital signs during the night before 20:00were compared in the two groups. Results The observation group without fear of proportion was higher than control group (P<0.05), the proportion of moderate fear was more than control group (P<0.05), Self-Rating Depression Scale and the Self-Rating Anxiety Scale scores were lower than control group (P<0.05), systolic blood pressure, diastolic blood pressure were lower than control group (P<0.05), heart rate was slower than control group (P < 0.05). Conclusion The evidence-based psychological interventions for reducing pre-nursing patients undergoing abdominal cancer treatment anxiety and fear has a positive meaning, it can stable the preoperative vital signs.%目的:探讨循证护理对开腹结肠癌根治术患者术前的心理影响。方法选择患者80例,分为两组,各40例,观察组实施本研究循证护理干预方法,对照组则实施常规护理,如一般护理、普通心理护理,健康教育等,比较两组患者护理干预后恐惧情绪、抑郁自评量表和焦虑自评量表得分以及,术前晚20点时的生命体征。结果观察组术前无恐惧比例高于对照组(P<0.05),中度以上恐惧比例低于对照组(P<0.05),抑郁自评量表和焦虑自评量表得分低于对照组(P<0.05),收缩压、舒张压低于对照组(P<0.05),心率慢于对照组(P<0.05)。结论循证护理心理

  6. Transumbilical laparotomy: a cosmetic and minimally invasive operative route in pediatric patients%经脐入路--一种美观与微创的儿童腹部手术径路

    Institute of Scientific and Technical Information of China (English)

    李爱武; 张文同; 李福海; 崔新海; 刘月忠; 庄岩

    2006-01-01

    目的:探讨婴幼儿腹部手术经脐入路这一微创方法的可行性与实用性.方法:沿肚脐右侧环形皱襞作半环形切开,最大不超过270,经腹直肌或中线剪开腹膜,拖出病变或在切口处直视下进行手术操作,可吸收线皮内缝合脐部切口.结果:2001年1月~2005年1月,57例患儿经脐行58项手术,手术时间20~170min,无1例需扩大皮肤切口或转为传统开腹术.除术后1例小肠闭锁新生儿出现吻合口瘘,无其他并发症.术后5~7d愈痊出院,随访3月~4年,切口美观,无脐疝发生.结论:婴幼儿腹部手术经脐入路安全、简便、微创、美观、实用,适用于多种腹部疾病,在其它手术范围年龄及其他系统疾病都有很好的应用前景.%Objective:The feasibility of a minimally invasive cosmetic transbilical laparotomy was studied in fifty-seven pediatric patients.The advantages of this technique will be discussed.Methods:The circumferential incision was made following the ring fold of the right umblilicus,which was less than 2700.The peritoneum was opened in the midline via rectus abdominis.Intra-peritoneal lesions were detected and explored.The surgical procedures were able to be carried out either inside or outside of the peritoneum.After closure of peritoneum,the umbilical incision was closed subcutaneously with an absorbable suture.Results:From January 2001 to January 2005,58 procedures via transumbilical route have been done in 57 pediatric patients.None of those cases required conversion to a traditional abdominal incision.The duration of surgery was from 20 to 170 minutes.All patients were discharged five days postoperatively and follow-up was conducted from 3 months to 4 years.No complications were observed in all but one patient.This patient had a leaking anastamosis.No visible scars were present and the cosmetic results were excellent.All patients had shorter hospital stay and lower operating cost.Conclusion:Transumbilical approach is a

  7. Monitoring equine visceral pain with a composite pain scale score and correlation with survival after emergency gastrointestinal surgery.

    Science.gov (United States)

    van Loon, Johannes P A M; Jonckheer-Sheehy, Valerie S M; Back, Willem; van Weeren, P René; Hellebrekers, Ludo J

    2014-04-01

    Recognition and management of equine pain have been studied extensively in recent decades and this has led to significant advances. However, there is still room for improvement in the ability to identify and treat pain in horses that have undergone emergency gastrointestinal surgery. This study assessed the validity and clinical application of the composite pain scale (CPS) in horses after emergency gastrointestinal surgery. Composite pain scores were determined every 4h over 3 days following emergency gastrointestinal surgery in 48 horses. Inter-observer reliability was determined and another composite visceral pain score (numerical rating scale, NRS) was determined simultaneously with CPS scores. CPS scores had higher inter-observer reliability (r=0.87, K=0.84, Pscores (r=0.68, K=0.72, Pscores compared to horses that were euthanased or had to undergo re-laparotomy (Pscores. In conclusion, the use of the CPS improved objectivity of pain scoring in horses following emergency gastrointestinal surgery. High inter-observer reliability allows for comparisons between different observers. This will be of great benefit in larger veterinary hospitals where several attending clinicians are often involved in the care of each case.

  8. Fatal pancreatic pseudocyst co-infected by Raoultella planticola: an emerging pathogen.

    Science.gov (United States)

    de Campos, Fernando Peixoto Ferraz; Guimarães, Tiago Borges; Lovisolo, Silvana Maria

    2016-01-01

    Raoultella planticola is an aerobic Gram-negative bacterium belonging to the Enterobacteriaceae family. Initially identified in the 1980s, its pathogenic potential was further recognized when the first case of bacteremia was reported. Since then, only a few infections caused by this pathogen have been described. Although considered an opportunistic agent, fatal outcomes are associated with the infection by this pathogen, since it is more prevalent among the patients with immunodeficiency. The authors report the case of a middle-aged man diagnosed with end-stage renal disease and alcoholic pancreatitis, who was admitted to the emergency department with septic shock. Physical examination disclosed peritoneal irritation and a laparotomy was undertaken. Purulent peritonitis was found as well as a retroperitoneal abscess, which was drained. The postoperative period was troublesome, and the patient died. The autopsy showed a ruptured, infected pancreatic cyst and purulent peritonitis, among other findings. The culture of the peritoneal fluid and two blood sample sets were positive for R. planticola. The authors call attention to the importance of this emerging pathogen associated with severe gastrointestinal infections.

  9. The Emerging World Order

    Directory of Open Access Journals (Sweden)

    PETER COLLECOTT

    2014-05-01

    Full Text Available It is common ground amongst almost all commentators that the world has changed radically over the past 25 years – the 25 years since the fall of the Berlin Wall heralded the ending of the Cold War, the reunification of a tragically divided Europe, and the acceleration of the process of globalisation which has its only comparable period in the decades leading up to the First World War in 1914. When analyzing the Emerging World Order it is important to cover more than Brazil economy or any other individual BRICs or other Emerging Powers. Instead, our analysis will provide a global view about the economic and political global power structures which are evolving and forming before our eyes, and then to talk about the challenges these emerging realities pose for us in Europe, and in the West in general.

  10. Hanford Emergency Response Plan

    Energy Technology Data Exchange (ETDEWEB)

    Wagoner, J.D.

    1994-04-01

    The Hanford Emergency Response Plan for the US Department of Energy (DOE), Richland Operations Office (RL), incorporates into one document an overview of the emergency management program for the Hanford Site. The program has been developed in accordance with DOE orders, and state and federal regulations to protect worker and public health and safety and the environment in the event of an emergency at or affecting the Hanford Site. This plan provides a description of how the Hanford Site will implement the provisions of DOE 5500 series and other applicable Orders in terms of overall policies and concept of operations. It should be used as the basis, along with DOE Orders, for the development of specific contractor and RL implementing procedures.

  11. Emergências hipertensivas

    OpenAIRE

    Feitosa-Filho, Gilson Soares; Lopes,Renato Delascio; Poppi, Nilson Tavares; Guimarães,Hélio Penna

    2008-01-01

    As urgências e as emergências hipertensivas são ocorrências clínicas que podem representar mais de 25% dos atendimentos a urgências médicas. O médico deverá estar habilitado a diferenciá-las, pois o prognóstico e o tratamento são distintos. Estima-se que 3% de todas as visitas às salas de emergência decorrem de elevações significativas da pressão arterial. Nos quadros relacionados a estes atendimentos, a emergência hipertensiva é a entidade clínica mais grave que merece cuidados intensivos. É...

  12. Emergent technologies: 25 years

    Science.gov (United States)

    Rising, Hawley K.

    2013-03-01

    This paper will talk about the technologies that have been emerging over the 25 years since the Human Vision and Electronic Imaging conference began that the conference has been a part of, and that have been a part of the conference, and will look at those technologies that are emerging today, such as social networks, haptic technologies, and still emerging imaging technologies, and what we might look at for the future.Twenty-five years is a long time, and it is not without difficulty that we remember what was emerging in the late 1980s. Yet to be developed: The first commercial digital still camera was not yet on the market, although there were hand held electronic cameras. Personal computers were not displaying standardized images, and image quality was not something that could be talked about in a standardized fashion, if only because image compression algorithms were not standardized yet for several years hence. Even further away were any standards for movie compression standards, there was no personal computer even on the horizon which could display them. What became an emergent technology and filled many sessions later, image comparison and search, was not possible, nor the current emerging technology of social networks- the world wide web was still several years away. Printer technology was still devising dithers and image size manipulations which would consume many years, as would scanning technology, and image quality for both was a major issue for dithers and Fourier noise.From these humble beginnings to the current moves that are changing computing and the meaning of both electronic devices and human interaction with them, we will see a course through the changing technology that holds some features constant for many years, while others come and go.

  13. [Emergency Triage. An Overview].

    Science.gov (United States)

    Christ, Michael; Bingisser, Roland; Nickel, Christian Hans

    2016-03-01

    In emergency departments, patients present with different severities of diseases and traumatic injuries. However, patients with severe and life-threatening conditions compete for the same resources such as personal and structure. As a general rule, each patient should receive immediate diagnostic and treatment, independent of his or her severity of disease or traumatic injury. However, an unexpected number of patients presenting to the emergency department at the same time may exceed available resources. Thus, waiting times will occur and management of patients may be impeded. As a consequence, patients with diseases or traumatic injuries with a need for time-critical management, have to be detected at the time of presentation. After categorization, patients have to be prioritized and guided to the correct place of treatment ("triage"). Starting in Australia and the United States, nurse-driven triage systems have been introduced in the emergency departments. Aim of triage is to correctly identify at increased risk of death and guide them to rapid and correct treatment. In Germany, two five-level triage systems have been introduced: Manchester Triage System (MTS) and Emergency Severity Index (ESI). We give an overview of these risk assessment tools and discuss pros and cons. In addition, new options such as "team triage" and a combination with "Early Warning Scores" are reported. In summary, nurse-driven triage is an instrument to improve patient safety in emergency medicine. A structured and systematic triage of patients using validated triage assessment tools are recommended from national and international societies of emergency medicine. Therefore, nurse-driven triage is also a must in Germany.

  14. [Nurse-performed FAST ultrasound in the emergency department: a systematic review].

    Science.gov (United States)

    Storti, Matteo; Musella, Lorenzo; Cianci, Vito

    2013-01-01

    Focused Assessment with Sonography for Trauma (commonly abbreviated as FAST) is considered for patients with blunt abdominal trauma as the gold standard for accident assessment in site. This method is increasingly used even by not radiologists professionals, as well as by nurses who works in emergency settings. This systematic review is aimed at evaluating the effectiveness of ultrasound FAST performed by nurses in emergencies department. Seven databases of primary and secondary literature as well as three national journals relevant to the field were consulted. The review was conducted between March and August 2011 developing 9 search strings. Articles have been critically reviewed by two authors independently. No restriction on language or time of publication have been used. A total of 4767 documents were displayed, of those only 4 were considered to be reviewed. A total of 1035 FAST ultrasound performed by nurses were included. The results show that the use of ultrasound FAST performed by trained nurses is very effective, with a sensitivity of 84% (95% CI 72.1-92.2) and a specificity of 97.37% (95% CI 92.55-99.10) . Practice execution time was an average of 156 seconds (2.6 minutes), median time of 138 seconds (range = 76 to 357). Just one study specified the training course that nurses were required to attend. To sum up, FAST ultrasound performed by nurses have an important role in emergencies management as well as in triage setting as valid screening tool.

  15. Efficiency of emergency exercises

    Energy Technology Data Exchange (ETDEWEB)

    Zander, N. [Bundesamt fuer Strahlenschutz (BfS), Oberschleissheim/Neuherberg (Germany); Sogalla, M. [Gesellschaft fuer Anlagen- und Reaktorsicherheim (GRS) mbH, Koeln (Germany)

    2011-12-15

    In order to cope with accidents beyond the design basis within German nuclear power plants which possibly lead to relevant radiological consequences, the utilities as well as the competent authorities exist emergency organisations. The efficiency, capacity for teamwork and preparedness of such organisations should be tested by regular, efficient exercise activities. Such activities can suitably be based on scenarios which provide challenging tasks for all units of the respective emergency organisation. Thus, the demonstration and further development of the efficiency of the respective organisational structures, including their ability to collaborate, is promoted. (orig.)

  16. LARYNGEAL MYXOMA : EMERGENCY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Budhram Singh

    2014-04-01

    Full Text Available A sixty five years male presented with stridor and dysphonia in emergency clinic of Govt. CIMS medical college, Bilaspur. Indirect laryngoscopic examination revealed a polypoidal lesion in glottic chink. CT scan evaluation confirmed the findings of clinical examination. Patient was relived of symptoms after emergency tracheostomy followed by surgical removal of polypoidal lesion from right vocal cord by microlaryngeal surgery. Histopathological examination revealed myxoma. Clinical examination after eight months showed significant improvement in hoarseness of voice with no evidence of recurrence of lesion. [Natl J Med Res 2014; 4(2.000: 175-177

  17. Identifying oncological emergencies.

    Science.gov (United States)

    Guddati, Achuta K; Kumar, Nilay; Segon, Ankur; Joy, Parijat S; Marak, Creticus P; Kumar, Gagan

    2013-01-01

    Prompt identification and treatment of life-threatening oncological conditions is of utmost importance and should always be included in the differential diagnosis. Oncological emergencies can have a myriad of presentations ranging from mechanical obstruction due to tumor growth to metabolic conditions due to abnormal secretions from the tumor. Notably, hematologic and infectious conditions may complicate the presentation of oncological emergencies. Advanced testing and imaging is generally required to recognize these serious presentations of common malignancies. Early diagnosis and treatment of these conditions can significantly affect the patient's clinical outcome.

  18. Associations between performance on an abbreviated CogState battery, other measures of cognitive function, and biomarkers in people at risk for Alzheimer’s disease

    Science.gov (United States)

    Racine, Annie M.; Clark, Lindsay R.; Berman, Sara E.; Koscik, Rebecca L.; Mueller, Kimberly D.; Norton, Derek; Nicholas, Christopher R.; Blennow, Kaj; Zetterberg, Henrik; Jedynak, Bruno; Bilgel, Murat; Carlsson, Cynthia M.; Christian, Bradley T.; Asthana, Sanjay; Johnson, Sterling C.

    2016-01-01

    It is not known whether computerized cognitive assessments, like the CogState battery, are sensitive to preclinical cognitive changes or pathology in people at risk for Alzheimer’s disease (AD). In 469 late middle-aged participants from the Wisconsin Registry for Alzheimer’s Prevention (mean age 63.8±7 years at testing; 67% female; 39% APOE4+), we examined relationships between a CogState abbreviated battery (CAB) of seven tests and demographic characteristics, traditional paper-based neuropsychological tests as well as a composite cognitive impairment index, cognitive impairment status (determined by consensus review); and biomarkers for amyloid and tau (CSF phosphorylated-tau/Aβ42 and global PET-PiB burden) and neural injury (CSF neurofilament light protein). CSF and PET-PiB were collected in n=71 and n=91 participants, respectively, approximately four years prior to CAB testing. For comparison, we examined three traditional tests of delayed memory in parallel. Similar to studies in older samples, the CAB was less influenced by demographic factors than traditional tests. CAB tests were generally correlated with most paper-based cognitive tests examined and mapped onto the same cognitive domains. Greater composite cognitive impairment index was associated with worse performance on all CAB tests. Cognitively impaired participants performed significantly worse compared to normal controls on all but one CAB test. Poorer One Card Learning test performance was associated with higher levels of CSF phosphorylated-tau/Aβ42. These results support the use of the CogState battery as measures of early cognitive impairment in studies of people at risk for AD. PMID:27589532

  19. Screening for personality disorder in incarcerated adolescent boys: preliminary validation of an adolescent version of the standardised assessment of personality – abbreviated scale (SAPAS-AV

    Directory of Open Access Journals (Sweden)

    Kongerslev Mickey

    2012-07-01

    Full Text Available Abstract Background Personality disorder (PD is associated with significant functional impairment and an elevated risk of violent and suicidal behaviour. The prevalence of PD in populations of young offenders is likely to be high. However, because the assessment of PD is time-consuming, it is not routinely assessed in this population. A brief screen for the identification of young people who might warrant further detailed assessment of PD could be particularly valuable for clinicians and researchers working in juvenile justice settings. Method We adapted a rapid screen for the identification of PD in adults (Standardised Assessment of Personality – Abbreviated Scale; SAPAS for use with adolescents and then carried out a study of the reliability and validity of the adapted instrument in a sample of 80 adolescent boys in secure institutions. Participants were administered the screen and shortly after an established diagnostic interview for DSM-IV PDs. Nine days later the screen was readministered. Results A score of 3 or more on the screening interview correctly identified the presence of DSM-IV PD in 86% of participants, yielding a sensitivity and specificity of 0.87 and 0.86 respectively. Internal consistency was modest but comparable to the original instrument. 9-days test-retest reliability for the total score was excellent. Convergent validity correlations with the total number of PD criteria were large. Conclusion This study provides preliminary evidence of the validity, reliability, and usefulness of the screen in secure institutions for adolescent male offenders. It can be used in juvenile offender institutions with limited resources, as a brief, acceptable, staff-administered routine screen to identify individuals in need of further assessment of PD or by researchers conducting epidemiological surveys.

  20. Risk adapted transmission prophylaxis to prevent vertical HIV–1 transmission: Effectiveness and safety of an abbreviated regimen of postnatal oral Zidovudine

    Directory of Open Access Journals (Sweden)

    Neubert Jennifer

    2013-01-01

    Full Text Available Abstract Background Antiretroviral drugs including zidovudine (ZDV are effective in reducing HIV mother to child transmission (MTCT, however safety concern remains. The optimal duration of postnatal ZDV has not been established in clinical studies and there is a lack of consensus regarding optimal management. The objective of this study was to investigate the effectiveness and safety of a risk adapted two week course of oral postnatal ZDV as part of a combined intervention to reduce MTCT. Methods 118 mother infant pairs were treated according to the German-Austrian recommendations for HIV therapy in pregnancy and in HIV exposed newborns between 2000–2010. In the absence of factors associated with an increased HIV–1 transmission risk, children were assigned to the low risk group and treated with an abbreviated postnatal regimen with oral ZDV for 2 weeks. In the presence of risk factors, postnatal ZDV was escalated accordingly. Results Of 118 mother-infant pairs 79 were stratified to the low risk group, 27 to the high risk group and 11 to the very high risk group for HIV–1 MTCT. 4 children were lost to follow up. Overall Transmission risk in the group regardless of risk factors and completion of prophylaxis was 1.8% (95% confidence interval (CI 0.09–6.6. If transmission prophylaxis was complete, transmission risk was 0.9% (95% CI 0.01-5.7. In the low risk group receiving two week oral ZDV transmission risk was 1.4% (95% CI 0.01–8.4 Conclusion These data demonstrate the effectiveness of a short neonatal ZDV regimen in infants of women on stable ART and effective HIV–1 suppression. Further evaluation is needed in larger studies.

  1. The Emerging Scholarly Brain

    CERN Document Server

    Kurtz, Michael J

    2010-01-01

    It is now a commonplace observation that human society is becoming a coherent super-organism, and that the information infrastructure forms its emerging brain. Perhaps, as the underlying technologies are likely to become billions of times more powerful than those we have today, we could say that we are now building the lizard brain for the future organism.

  2. [Medical emergency teams

    DEFF Research Database (Denmark)

    Bunkenborg, G.; Lund, C.; Petersen, John Asger

    2008-01-01

    The aim of medical emergency teams (MET) is to identify and treat deteriorating patients on general wards, and to avoid cardiac arrest, unplanned intensive care unit admission and death. The effectiveness of METs has yet to be proven, as the only two randomised, controlled trials on the subject...

  3. LNG - emergency control

    Energy Technology Data Exchange (ETDEWEB)

    Berardinelli, Ricardo Porto; Correa, Kleber Macedo; Moura Filho, Nelson Barboza de; Fernandez, Carlos Antonio [TRANSPETRO, Rio de Janeiro, RJ (Brazil); Matos, Jose Eduardo Nogueira de [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2009-07-01

    The operation of liquefied natural gas (LNG) is pioneering within the PETROBRAS System. PETROBRAS Transporte - TRANSPETRO is going to operate two flexible LNG terminals, located in Ceara and Rio de Janeiro. In accordance with the Corporate Health, Safety and Environmental (HSE) Directive - Training, Education and Awareness, PETROBRAS Transporte S.A. - TRANSPETRO has prepared an action plan with the objective of ensuring the operational safety of the undertaking. Among other actions a training program for the emergency control of LNG will be inserted into the timetable. The above mentioned training program was held over a period of 20 hours, and was divided between theory and practice. In the theoretical part, the characteristics of the product, the history of accidents and the emergency response procedures were covered. In the practical part, 3000 gallons of LNG were utilized where the behavior of the product could be confirmed following a confined leak, thereby verifying the efficacy of the emergency control resources. The teaching process of the course was developed in the company through the preparation of specific procedures, emergency plans and the formation of internal instructors. (author)

  4. Historicism and Industry Emergence

    DEFF Research Database (Denmark)

    Kirsch, David; Moeen, Mahka; Wadhwani, Dan

    2014-01-01

    . In this chapter, an alternative approach is explored that focuses on reconstructing causes and processes that time and theory have erased. The emergence of three industries—plant biotechnology, savings banking, and the automobile—shows how time, along with prevailing functional models of industry evolution, leads...

  5. Supervising Emergency Credentialed Teachers.

    Science.gov (United States)

    Neu, Beverly; Hale, Walt

    2000-01-01

    Teachers assigned to teach on an emergency credential are severely challenged by inadequate understanding of classroom management techniques and instructional methods. Also, California's Beginning Teacher Support and Assessment Program is not available to these teachers. This article outlines criteria for principals to include in an inservice…

  6. Emergence of regional clusters

    DEFF Research Database (Denmark)

    Dahl, Michael S.; Østergaard, Christian Richter; Dalum, Bent

    2010-01-01

    The literature on regional clusters has increased considerably during the last decade. The emergence and growth patterns are usually explained by such factors as unique local culture, regional capabilities, tacit knowledge or the existence of location-specific externalities (knowledge spillovers,...

  7. Fire Department Emergency Response

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, A. [Westinghouse Savannah River Company, AIKEN, SC (United States); Bell, K.; Kelly, J.; Hudson, J.

    1997-09-01

    In 1995 the SRS Fire Department published the initial Operations Basis Document (OBD). This document was one of the first of its kind in the DOE complex and was widely distributed and reviewed. This plan described a multi-mission Fire Department which provided fire, emergency medical, hazardous material spill, and technical rescue services.

  8. Emergent Gauge Fields

    CERN Document Server

    Freund, Peter G O

    2010-01-01

    Erik Verlinde's proposal of the emergence of the gravitational force as an entropic force is extended to abelian and non-abelian gauge fields and to matter fields. This suggests a picture with no fundamental forces or forms of matter whatsoever.

  9. CT of Gastric Emergencies.

    Science.gov (United States)

    Guniganti, Preethi; Bradenham, Courtney H; Raptis, Constantine; Menias, Christine O; Mellnick, Vincent M

    2015-01-01

    Abdominal pain, nausea, and vomiting are common presenting symptoms among adult patients seeking care in the emergency department, and, with the increased use of computed tomography (CT) to image patients with these complaints, radiologists will more frequently encounter a variety of emergent gastric pathologic conditions on CT studies. Familiarity with the CT appearance of emergent gastric conditions is important, as the clinical presentation is often nonspecific and the radiologist may be the first to recognize gastric disease as the cause of a patient's symptoms. Although endoscopy and barium fluoroscopy remain important tools for evaluating patients with suspected gastric disease in the outpatient setting, compared with CT these modalities enable less comprehensive evaluation of patients with nonspecific complaints and are less readily available in the acute setting. Endoscopy is also more invasive than CT and has greater potential risks. Although the mucosal detail of CT is relatively poor compared with barium fluoroscopy or endoscopy, CT can be used with the appropriate imaging protocols to identify inflammatory conditions of the stomach ranging from gastritis to peptic ulcer disease. In addition, CT can readily demonstrate the various complications of gastric disease, including perforation, obstruction, and hemorrhage, which may direct further clinical, endoscopic, or surgical management. We will review the normal anatomy of the stomach and discuss emergent gastric disease with a focus on the usual clinical presentation, typical imaging appearance, and differentiating features, as well as potential imaging pitfalls.

  10. National Emergency Communications Plan

    Science.gov (United States)

    2008-07-01

    Integration Center’s ( NIC ) Incident Management Systems Integration Division (IMSID) promotes plain- language standards and associated guidance. o Within...and Command and Control Centers Coordination Centers Lead Agency Supporting/Participating Departments and Agencies National Operations Center ( NOC ...National Guard Bureau NGO Nongovernmental Organization NIC National Integration Center NIEM National Information Exchange Model National Emergency

  11. Emergency Nurses Association

    Science.gov (United States)

    ... Marketplace Emerging Infectious Diseases Contact Us Sponsorship and Advertising ENA Conferences Exhibitors Job Center ENA provides opportunity ... Public Policy Agenda ​​​​​​ Contact ENA Find us on Facebook Join our conversation on Twitter Add us on ...

  12. Emergency medicine in Vietnam.

    Science.gov (United States)

    Richards, J R

    1997-04-01

    The Socialist Republic of Vietnam is one of the poorest countries in the world. Recent economic developments, as the country attempts to start a market economy, have had a profound impact on its health care system. This report describes the state of prehospital and emergency medical care in Vietnam and possibilities for the future.

  13. Emerging Presidential Styles.

    Science.gov (United States)

    Stanton, Thomas C.; Pitsvada, Bernard T.

    1993-01-01

    A study of the state of the college presidency revealed that five broad management issues have emerged: conflict resolution, coping with change, achieving continuity, need for increased collaboration, and justice and ethics in the education enterprise. Implications for managerial practice in the future are analyzed. (MSE)

  14. Emergency medicine: beyond the basics.

    Science.gov (United States)

    Malamed, S F

    1997-07-01

    Medical emergencies can arise in the dental office. Preparedness for these emergencies is predicated on an ability to rapidly recognize a problem and to effectively institute prompt and proper management. In all emergency situations, management is based on implementation of basic life support, as needed. The author describes the appropriate management of two common emergency situations: allergy and chest pain.

  15. The difficult medical emergency call

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Kjærulff, Thora Majlund; Viereck, Søren

    2017-01-01

    BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories and the ......BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories...... and the effect of categorization on mortality. METHODS: Register-based study in a 2-year period based on emergency call data from the emergency medical dispatch center in Copenhagen combined with nationwide register data. Logistic regression analysis (N = 78,040 individuals) was used for identification...

  16. Emerging and Disruptive Technologies

    Science.gov (United States)

    2016-01-01

    Several emerging or disruptive technologies can be identified that might, at some point in the future, displace established laboratory medicine technologies and practices. These include increased automation in the form of robots, 3-D printing, technology convergence (e.g., plug-in glucose meters for smart phones), new point-of-care technologies (e.g., contact lenses with sensors, digital and wireless enabled pregnancy tests) and testing locations (e.g., Retail Health Clinics, new at-home testing formats), new types of specimens (e.g., cell free DNA), big biology/data (e.g., million genome projects), and new regulations (e.g., for laboratory developed tests). In addition, there are many emerging technologies (e.g., planar arrays, mass spectrometry) that might find even broader application in the future and therefore also disrupt current practice. One interesting source of disruptive technology may prove to be the Qualcomm Tricorder XPrize, currently in its final stages. PMID:27683538

  17. Hantaviruses as emergent zoonoses

    Directory of Open Access Journals (Sweden)

    LS Ullmann

    2008-01-01

    Full Text Available Hantaviruses belong to the Bunyaviridae family, which consists of vector-borne viruses. These viruses can provoke two infection types: hemorrhagic fever with renal syndrome (HFRS - which occurs in the Old World - and hantavirus cardiopulmonary syndrome (HCPS - an emergent zoonosis that can be found in many countries of the western hemisphere. Rodents are hantavirus reservoirs and each species seems to host a different virus type. Humans acquire the infection by inhaling contaminated aerosol particles eliminated by infected animals. The factors involved in the emergence of hantavirus infections in the human population include ecological modifications and changes in human activities. The most important risk factor is contact between man and rodents, as a result of agricultural, forestry or military activities. Rodent control remains the primary strategy for preventing hantavirus diseases, including via health education and hygienic habits.

  18. Emergent Complex Network Geometry

    CERN Document Server

    Wu, Zhihao; Rahmede, Christoph; Bianconi, Ginestra

    2014-01-01

    Networks are mathematical structures that are universally used to describe a large variety of complex systems such as the brain or the Internet. Characterizing the geometrical properties of these networks has become increasingly relevant for routing problems, inference and data mining. In real growing networks, topological, structural and geometrical properties emerge spontaneously from their dynamical rules. Nevertheless we still miss a model in which networks develop an emergent complex geometry. Here we show that a single two parameter network model, the growing geometrical network, can generate complex network geometries with non-trivial distribution of curvatures, combining exponential growth and small-world properties with finite spectral dimensionality. In one limit, the non-equilibrium dynamical rules of these networks can generate scale-free networks with clustering and communities, in another limit planar random geometries with non-trivial modularity. Finally we find that these properties of the geo...

  19. Architecture humanitarian emergencies

    DEFF Research Database (Denmark)

    Gomez-Guillamon, Maria; Eskemose Andersen, Jørgen; Contreras, Jorge Lobos

    2013-01-01

    Introduced by scientific articles conserning architecture and human rights in light of cultures, emergencies, social equality and sustainability, democracy, economy, artistic development and science into architecture. Concluding in definition of needs for new roles, processes and education of arc......, Architettura di Alghero in Italy, Architecture and Design of Kocaeli University in Turkey, University of Aguascalientes in Mexico, Architectura y Urbanismo of University of Chile and Escuela de Architectura of Universidad Austral in Chile....

  20. MOBILE AGENT: EMERGING TECHNOLOGY

    OpenAIRE

    RAJGURU P. V. DR. DESHMUKH S. D

    2011-01-01

    Mobile agent technology has been promoted as an emerging technology that makes it much easier to design, implement, and maintain distributed systems, introduction to basic concepts of mobile agents like agent mobility, agent types and places and agent communication. Then benefits of the usage of mobile agents are summarized and illustrated by selected applications. The next section lists requirements and desirable properties for mobile agent languages and systems. We study the main features, ...

  1. Dial "120" for Emergencies

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    AN ambulance sped along the highway to Dongling, a scenic spot in a suburb of Beijing. A few minutes earlier, Beijing Emergency Medical Center’s "120" service received a phone call from Dongling Hospital where a Japanese tourist named Ishisaka Teru had been brought in. When he was touring Dongling, he begun to sweat, felt he couldn’t breathe which developed into an arrhythmia and then he went into shock. He needed immediate medical attention.

  2. Emerging contaminants in groundwater

    OpenAIRE

    Lapworth, Dan; Stuart, Marianne; HART Alwyn; Crane, Emily; Baran, Nicole

    2011-01-01

    The term ‘emerging contaminants’ (ECs) is used to cover not only newly developed compounds but also includes newly discovered compounds in the environment (often due to analytical developments), and compounds that have been recently categorised as contaminants. ECs include a huge array of different compounds (and their metabolites) that are used by society for a range of purposes and include; pharmaceuticals, pesticides, personal care products, veterinary medicines, engineered nano-materials,...

  3. Trusted Emergency Management

    Science.gov (United States)

    2009-03-01

    information that can enable effective emergency response relate to: • Physical security– building plans , transportation logistics, critical control...of government plans ” and information about chemical/biological warfare supplies and antidotes. • Trade secrets – the inner workings of...E. Irvine, T. E. Levin, T. D. Nguyen, and T. M. Vidas , SecureCore software architecture: Trusted path application (TPA) requirements, Tech. Rep. NPS

  4. Emerging therapies in rosacea.

    Science.gov (United States)

    Layton, Alison; Thiboutot, Diane

    2013-12-01

    Rosacea is a common skin disorder with multiple symptoms. The emergence of research that furthers understanding of pathophysiological mechanisms has created new targets for disease treatment. Specifically, there is a need for new treatments that address the various erythematic symptoms associated with rosacea. Systemic and topical therapies have both yielded positive results in treating rosacea with various medications. Subantimicrobial-dose doxycycline is one such promising treatment. Development of novel products in the near future should help achieve more satisfactory outcomes for patients.

  5. Emergent infectious uveitis

    Directory of Open Access Journals (Sweden)

    Khairallah Moncef

    2009-01-01

    Full Text Available Infectious causes should always be considered in all patients with uveitis and it should be ruled out first. The differential diagnosis includes multiple well-known diseases including herpes, syphilis, toxoplasmosis, tuberculosis, bartonellosis, Lyme disease, and others. However, clinicians should be aware of emerging infectious agents as potential causes of systemic illness and also intraocular inflammation. Air travel, immigration, and globalization of business have overturned traditional pattern of geographic distribution of infectious diseases, and therefore one should work locally but think globally, though it is not possible always. This review recapitulates the systemic and ocular mainfestations of several emergent infectious diseases relevant to the ophthalmologist including Rickettsioses, West Nile virus infection, Rift valley fever, dengue fever, and chikungunya. Retinitis, chorioretinitis, retinal vasculitis, and optic nerve involvement have been associated with these emergent infectious diseases. The diagnosis of any of these infections is usually based on pattern of uveitis, systemic symptoms and signs, and specific epidemiological data and confirmed by detection of specific antibody in serum. A systematic ocular examination, showing fairly typical fundus findings, may help in establishing an early clinical diagnosis, which allows prompt, appropriate management.

  6. [Teaching in emergency medicine].

    Science.gov (United States)

    Ayuso, Fernando; Nogué, R; Coll Vinent, Begoña; Fernández Esáin, Begoña; Miró, O

    2010-01-01

    The appropriate care of patients in emergency services can reach a level of complexity as to make a sound training necessary, which should be based on a medical specialty, as happens in the majority of the countries in our context. In Spain at present there is no regulated and homogeneous training in urgency and emergency medicine (UEM), either during the period of undergraduate training (in the form of a universally compulsory subject in the faculties of medicine) or during the postgraduate period (in the form of a medical specialty). In this respect, the definitive approval of the specialty in UEM is currently pending within the framework of a reform of the residence program that will evolve towards a core training program of specialties. Until thus occurs, the reality in Spain is that professionals who work in this care setting possess a heterogeneous training. As a result of this vacuum and the training needs of these professionals, a wide range of specific training proposals has been developed over the years in order to optimise the skills and abilities of the professionals who provide initial emergency care to the patient. A new generation of courses has been set underway using the new didactic methodologies of training, into which didactic tools of e-learning and robotic simulation have been incorporated.

  7. Emergency Response Guideline Development

    Energy Technology Data Exchange (ETDEWEB)

    Gary D. Storrick

    2007-09-30

    Task 5 of the collaborative effort between ORNL, Brazil, and Westinghouse for the International Nuclear Energy Research Initiative entitled “Development of Advanced Instrumentation and Control for an Integrated Primary System Reactor” focuses on operator control and protection system interaction, with particular emphasis on developing emergency response guidelines (ERGs). As in the earlier tasks, we will use the IRIS plant as a specific example of an integrated primary system reactor (IPSR) design. The present state of the IRIS plant design – specifically, the lack of a detailed secondary system design – precludes establishing detailed emergency procedures at this time. However, we can create a structure for their eventual development. This report summarizes our progress to date. Section 1.2 describes the scope of this effort. Section 2 compares IPSR ERG development to the recent AP1000 effort, and identifies three key plant differences that affect the ERGs and control room designs. The next three sections investigate these differences in more detail. Section 3 reviews the IRIS Safety-by-Design™ philosophy and its impact on the ERGs. Section 4 looks at differences between the IRIS and traditional loop PWR I&C Systems, and considers their implications for both control room design and ERG development. Section 5 examines the implications of having one operating staff control multiple reactor units. Section 6 provides sample IRIS emergency operating procedures (EOPs). Section 7 summarizes our conclusions.

  8. Perforated duodenal ulcer: Emerging pattern

    Directory of Open Access Journals (Sweden)

    Murtaza Ali Asger Calcuttawala

    2014-01-01

    Full Text Available Background: A total of 27 patients of perforated duodenal ulcer admitted in our institution between December 2010 and November 2012 were treated and studied. Materials and Methods: All patients were diagnosed on the basis of clinical and radiological findings, exploratory laparotomy was performed and simple closure of perforation with placement of Graham′s omental patch was carried out. This was followed by triple regimen for Helicobacter pylori eradication. Results: All patients were male, maximum incidence (61.54% was noted in the age group of 21-30, ′O′ +ve blood group was most commonly observed in our patients. Eight patients had history suggestive of acute acid peptic disease. Mean time interval between the start of symptoms and surgery was 43 h. No morbidity except minimal pleural effusion was seen in one case. There was no mortality in our series. Conclusion: We conclude that although a number of definitive surgeries have been described for acid peptic disease, but the requirement of such procedures has come down due to increasing use of H. pylori eradication therapy and proton pump inhibitors. However, surgery for complications especially for duodenal ulcer perforation has not reduced concomitantly. Incidence is greater in young males.

  9. Hemograma e proteinograma plasmático de eqüinos hígidos e de eqüinos acometidos por abdômem agudo, antes e após laparotomia Hemogram and plasma proteins of healthy horses and horses with acute abdomen before and after laparotomy

    Directory of Open Access Journals (Sweden)

    J.J. Fagliari

    2002-12-01

    Full Text Available Foram examinados 20 eqüinos adultos, 10 sadios e 10 acometidos por abdômen agudo, submetidos à laparotomia. O exame clínico e a colheita de amostras de sangue foram realizados antes da laparotomia e diariamente, a partir da cirurgia, até o 10º dia após a intervenção. Constatou-se elevação da temperatura retal, das freqüências cardíaca e respiratória, do número de hemácias e de leucócitos, do volume globular e dos valores das proteínas plasmáticas após a cirurgia, em ambos os grupos, porém com valores mais elevados nos animais enfermos, especialmente do número de neutrófilos. O proteinograma plasmático dos eqüinos com abdômen agudo mostrou que houve elevação significativa nas concentrações de proteínas na fase aguda com maiores valores ao redor de 48 horas após a cirurgia. Os resultados indicaram que o padrão de elevação e decréscimo dessas proteínas pode ser útil na definição do prognóstico do quadro clínico de abdômen agudo e da recuperação cirúrgica dos eqüinos.Hemogram and plasma protein concentrations of healthy horses and horses affected with acute abdomen before and after laparotomy were determined to investigate if these determinations can be of help on the diagnosis and prognosis of the post-operative intercurrence. The body temperature, respiratory and heart rates, red blood cell, leukocyte and neutrophil counts, packed cell volume, and plasma protein concentrations increased after laparotomy, mainly in sick horses. Acute phase protein concentrations were higher in the horses affected with acute abdomen than in the healthy horses with the highest values detected at about 48 hours after surgery. The results suggest that determining the level of these proteins can be useful for the diagnosis and prognosis of post-operative recovery after laparotomy in healthy horses and in horses affected with acute abdomen.

  10. Assessment of the effects and limitations of the 1998 to 2008 Abbreviated Injury Scale map using a large population-based dataset

    Directory of Open Access Journals (Sweden)

    Franklyn Melanie

    2011-01-01

    Full Text Available Abstract Background Trauma systems should consistently monitor a given trauma population over a period of time. The Abbreviated Injury Scale (AIS and derived scores such as the Injury Severity Score (ISS are commonly used to quantify injury severities in trauma registries. To reflect contemporary trauma management and treatment, the most recent version of the AIS (AIS08 contains many codes which differ in severity from their equivalents in the earlier 1998 version (AIS98. Consequently, the adoption of AIS08 may impede comparisons between data coded using different AIS versions. It may also affect the number of patients classified as major trauma. Methods The entire AIS98-coded injury dataset of a large population based trauma registry was retrieved and mapped to AIS08 using the currently available AIS98-AIS08 dictionary map. The percentage of codes which had increased or decreased in severity, or could not be mapped, was examined in conjunction with the effect of these changes to the calculated ISS. The potential for free text information accompanying AIS coding to improve the quality of AIS mapping was explored. Results A total of 128280 AIS98-coded injuries were evaluated in 32134 patients, 15471 patients of whom were classified as major trauma. Although only 4.5% of dictionary codes decreased in severity from AIS98 to AIS08, this represented almost 13% of injuries in the registry. In 4.9% of patients, no injuries could be mapped. ISS was potentially unreliable in one-third of patients, as they had at least one AIS98 code which could not be mapped. Using AIS08, the number of patients classified as major trauma decreased by between 17.3% and 30.3%. Evaluation of free text descriptions for some injuries demonstrated the potential to improve mapping between AIS versions. Conclusions Converting AIS98-coded data to AIS08 results in a significant decrease in the number of patients classified as major trauma. Many AIS98 codes are missing from the

  11. Emergency Victim Care. A Textbook for Emergency Medical Personnel.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

    This textbook for emergency medical personnel should be useful to fire departments, private ambulance companies, industrial emergency and rescue units, police departments, and nurses. The 30 illustrated chapters cover topics such as: (1) Emergency Medical Service Vehicles, (2) Safe Driving Practices, (3) Anatomy and Physiology, (4) Closed Chest…

  12. Emergence of Life

    Directory of Open Access Journals (Sweden)

    Marie-Paule Bassez

    2011-09-01

    Full Text Available Indeed, even if we know that many individual components are necessary for life to exist, we do not yet know what makes life emerge. One goal of this journal Life is to juxtapose articles with multidisciplinary approaches and perhaps to answer in the near future this question of the emergence of life. Different subjects and themes will be developed, starting of course with the multiple definitions of life and continuing with others such as: life diversity and universality; characteristics of living systems; thermodynamics with energy and entropy; kinetics and catalysis; water in its different physical states; circulation of sap and blood and its origin; the first blood pump and first heart; the first exchange of nutrients between cells, sap and blood; essential molecules of living systems; chirality; molecular asymmetry and its origin; formation of enantiomer excess and amplification; microscopic observations on a micrometer and sub-micrometer scales, at molecular and atomic levels; the first molecules at the origin of genetic information, viroids, circular RNA; regions of space or the area inside membranes and cells capable of initiating and maintaining life; phenomena at the origin of the emergence of life; molecules studied in the traditional field of chemistry and in the recent field of nanoscience governed by new laws; interaction between the individual molecules and components of living systems; interaction between living systems and the environment; transfer of information through generations; continuation of life from one generation to the next; prebiotic chemistry and prebiotic signatures on Earth, on Mars, on other planets; biosignatures of the first forms of life; fossils and pseudofossils dating 3.5 Ga ago and more recent ones; experimental fossilization; pluricellular eukaryotes dating 2.1 Ga ago; sudden increase in oxygen in the atmosphere around 2.0 to 2.5 Ga ago and its relation to geology; shell symmetry; aging with

  13. Emergence of Life.

    Science.gov (United States)

    Bassez, Marie-Paule

    2011-09-29

    Indeed, even if we know that many individual components are necessary for life to exist, we do not yet know what makes life emerge. One goal of this journal Life is to juxtapose articles with multidisciplinary approaches and perhaps to answer in the near future this question of the emergence of life. Different subjects and themes will be developed, starting of course with the multiple definitions of life and continuing with others such as: life diversity and universality; characteristics of living systems; thermodynamics with energy and entropy; kinetics and catalysis; water in its different physical states; circulation of sap and blood and its origin; the first blood pump and first heart; the first exchange of nutrients between cells, sap and blood; essential molecules of living systems; chirality; molecular asymmetry and its origin; formation of enantiomer excess and amplification; microscopic observations on a micrometer and sub-micrometer scales, at molecular and atomic levels; the first molecules at the origin of genetic information, viroids, circular RNA; regions of space or the area inside membranes and cells capable of initiating and maintaining life; phenomena at the origin of the emergence of life; molecules studied in the traditional field of chemistry and in the recent field of nanoscience governed by new laws; interaction between the individual molecules and components of living systems; interaction between living systems and the environment; transfer of information through generations; continuation of life from one generation to the next; prebiotic chemistry and prebiotic signatures on Earth, on Mars, on other planets; biosignatures of the first forms of life; fossils and pseudofossils dating 3.5 Ga ago and more recent ones; experimental fossilization; pluricellular eukaryotes dating 2.1 Ga ago; sudden increase in oxygen in the atmosphere around 2.0 to 2.5 Ga ago and its relation to geology; shell symmetry; aging with transformation of molecules, of

  14. Factors influencing the suicide intervention skills of emergency medical services providers

    Science.gov (United States)

    Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne

    2017-01-01

    ABSTRACT Background: Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. Aims: To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Method: Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Results: Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers’ ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. Conclusions: In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. Abbreviations: EMS: Emergency medical services; SIRI: Suicide intervention response inventory PMID:28235388

  15. The Emergence of Disruption

    OpenAIRE

    2002-01-01

    We study the influence of technological efficiency and organizational inertia on the emergence of competition when firms decide myopically. Using an agent-based computer simulation model, we observe the competitive reaction of a former monopolist to the advent of a new competitor. While the entrant uses a new technology, the monopolist is free either to stick to his former technology or to switch to the new one. We find that?irrespective of details regarding the demand side?a change of indust...

  16. Corruption in emergency procurement.

    Science.gov (United States)

    Schultz, Jessica; Søreide, Tina

    2008-12-01

    Corruption in emergency procurement reduces the resources available for life-saving operations, lowers the quality of products and services provided, and diverts aid from those who need it most.(1) It also negatively influences public support for humanitarian relief, both in the affected country and abroad. This paper aims to unpack and analyse the following question in order to mitigate risk: how and where does corruption typically occur, and what can be done? Suggested strategies reflect a multi-layered approach that stresses internal agency control mechanisms, conflict-sensitive management, and the need for common systems among operators.

  17. Emergence and Evolution

    DEFF Research Database (Denmark)

    Bullwinkle, Tammy J; Ibba, Michael

    2013-01-01

    ancestor and as such they provide insights into the evolution and development of the extant genetic code. Although the aaRSs have long been viewed as a highly conserved group of enzymes, findings within the last couple of decades have started to demonstrate how diverse and versatile these enzymes really...... are. Beyond their central role in translation, aaRSs and their numerous homologs have evolved a wide array of alternative functions both inside and outside translation. Current understanding of the emergence of the aaRSs, and their subsequent evolution into a functionally diverse enzyme family...

  18. [Allergy-related emergencies].

    Science.gov (United States)

    Kaufman, E; Garfunkel, A; Galili, D; Zusman, S P; Malamed, S F; Findler, M; Elad, S

    2002-01-01

    Allergic reactions can develop to any of the drugs or materials commonly used in dentistry. They exhibit a broad range of clinical signs and symptoms ranging from mild, delayed reactions to immediate and life-threatening reactions developing within seconds. Allergies usually manifest themselves in reactions that are related to histamine release in one of three ways: skin reactions, respiratory problems and anaphylaxis. Anaphylaxis is the most critical allergic reaction in the dental environment. Measures such as airway management, oxygen supplementation, antihistamine, adrenaline and corticosteroid medication, cardiopulmonary resuscitation and evacuation to the emergency room, may be necessary.

  19. Occupational Emergency Medicine - Introduction

    Science.gov (United States)

    2011-01-01

    4302. Respondents should be aware that notwithstanding any other provision of law , no person shall be subject to a penalty for failing to comply with...Under Title III, companie covered under the Hazard Communication Standard are r qulred to make their chemica l inventor ies known to emergency response...anagement howe ver. misp)"l’ed . OCClIj1illi.ll1illllleliicilll’ h olli - ia lly, ~ llb ~l)(’ciJ lty of I’rcvellliV l- Illedi cine, which dut’~ ind "d

  20. Emergency peripartum hysterectomy

    DEFF Research Database (Denmark)

    Jakobsson, Maija; Tapper, Anna-Maija; Colmorn, Lotte Berdiin;

    2015-01-01

    peripartum hysterectomies reached 211, yielding an incidence rate of 3.5/10 000 (95% confidence interval 3.0-4.0) births. Finland had the highest prevalence (5.1) and Norway the lowest (2.9). Primary indications included an abnormally invasive placenta (n = 91, 43.1%), atonic bleeding (n = 69, 32.......7%), uterine rupture (n = 31, 14.7%), other bleeding disorders (n = 12, 5.7%), and other indications (n = 8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum...

  1. Volunteering for Emergency Preparedness

    Science.gov (United States)

    1989-05-01

    Laurier Avenue, West Ottawa KlAOW6 Ontario, CANADA Ms. Sarah Paul Fire and Emergency Services Department - F6 Division Home Office Queen Anne’s Gate London...a0 F,:a-~ ,a. , Ca 0)Ca Q) -Q ’, 0 o o o mCC 03~ 0~ E 0-o c 0 o Ea, ’o ()C E-00)o EL 0) C -- 0 o- 0 W a a’Ca 0 a ’o 𔃺 6 5 E ’ Ca) o o W a)0~ Maa 𔃺

  2. Emergent behaviors of classifier systems

    Energy Technology Data Exchange (ETDEWEB)

    Forrest, S.; Miller, J.H.

    1989-01-01

    This paper discusses some examples of emergent behavior in classifier systems, describes some recently developed methods for studying them based on dynamical systems theory, and presents some initial results produced by the methodology. The goal of this work is to find techniques for noticing when interesting emergent behaviors of classifier systems emerge, to study how such behaviors might emerge over time, and make suggestions for designing classifier systems that exhibit preferred behaviors. 20 refs., 1 fig.

  3. [Pediatric emergencies: Knowledge of basic measures for the emergency physician].

    Science.gov (United States)

    Meyer, S; Grundmann, U; Reinert, J; Gortner, L

    2015-11-01

    Life-threatening pediatric emergencies are relatively rare in the prehospital setting. Thus, the treating emergency physician may not always be familiar with and well trained in these situations. However, pediatric emergencies require early recognition and initiation of specific diagnostic and therapeutic interventions to prevent further damage. The treatment of pediatric emergencies follows current recommendations as detailed in published international guidelines. The aim of this review is to familiarize the emergency physician with general aspects pertinent to this topic-most importantly anatomical and physiological characteristics in this cohort. Also, specific information with regard to analgesia and sedation, which may be warranted in the prehospital setting, will be provided.

  4. Comparison of the Effects of Carbon Dioxide Pneumoperitoneum Laparoscopic Surgery and Laparotomy on Patients with Bacterial Peritonitis%二氧化碳气腹腔镜与开腹手术对细菌性腹膜炎患者疗效的比较

    Institute of Scientific and Technical Information of China (English)

    吴俊强; 彭淮都; 池锐忠

    2014-01-01

    ObjectiveTo explore the effects of carbon dioxide pneumoperitoneum laparoscopic surgery and laparotomy on systemic inflammatory reaction and bacterial translocation in patients with postoperative bacterial peritonitis, so as to provide a reference for improving the treatment of bacterial peritonitis. Methods66 patients with bacterial peritonitis were randomly divided into laparoscopic surgery group and laparotomy group, with 33 in each group. Blood culture, white cell count (WBC), blood levels of C _ reactive protein (CRP), tumour necrosis factor (TNF) and interleukin _ 6 (IL _ 6) before operation and 1 day or 3 days after operation were measured. Incidences of incisional infection and abdominal abscess were observed. ResultsThere was no signiifcant difference in clinical features and laboratory indices between the two groups before operation (allP0.05). Noticeably, blood levels of WBC, CRP, TNF and IL _6 were signiifcantly lower in patients of laparoscopic surgery group than those in laparotomy group (P<0.05 orP<0.01).Conclusion Short _ term effects of carbon dioxide pneumoperitoneum laparoscopic surgery and laparotomy are similar on patients with bacterial peritonitis. However, systemic inlfammatory reaction can signiifcantly inhibited in patients treated by carbon dioxide pneumoperitoneum laparoscopic surgery, so this therapy is worth further research and promoting in clinical practice.%目的:探讨二氧化碳气腹腔镜手术和开腹手术对细菌性腹膜炎术后全身炎症反应及细菌移位的影响,为未来提高细菌性腹膜炎的治疗效果提供参考。方法:66例细菌性腹膜炎患者,随机分为开腹手术组和腹腔镜手术组,每组33例。分别于术前、术后1 d和3 d测定血培养、白细胞总数、C _反应蛋白(CRP)、肿瘤坏死因子(TNF)和白介素(IL)_6的水平,观察切口感染及腹腔脓肿情况。结果:术前2组各项临床及检验指标无显著差异(P>0.05)。术后

  5. Training teams for emergency management

    NARCIS (Netherlands)

    Schaafstal, A.M.; Johnston, J.H.; Oser, R.L.

    2001-01-01

    Emergency management (EM), the decision making involved in directing the relief operation after a disaster or otherwise catastrophic accident is an issue of great public and private concern because of the high stakes involved. Due to the nature of emergencies, and especially mass emergencies, EM tea

  6. Emergency Exercise Participation and Evaluation

    Science.gov (United States)

    Smith, Julie; Black, Lynette; Williams, Linda

    2012-01-01

    Extension is uniquely positioned to participate in emergency exercises, formally or informally, with the goal of engaging community members in emergency and disaster preparedness. With their knowledge of community needs, Extension personnel are valuable resources and can assist emergency managers in the process of identifying local risks and…

  7. Emergency Medical Services Program Guide.

    Science.gov (United States)

    Georgia Univ., Athens. Dept. of Vocational Education.

    This program guide contains the standard emergency medical services curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level workers in the emergency medical services field, and includes job skills in six emergency medical services divisions outlined in the national curriculum:…

  8. Emergency Contraception: a survey of Hospital Emergency Departments Staffs

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2011-03-01

    Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

  9. Emergency Contraception: a survey of Hospital Emergency Departments Staffs

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2011-06-01

    Full Text Available The World Health Organization defines emergency contraception (EC as a means to prevent unwanted pregnancy. In countries where EC is dispensed behind the counter, emergency departments are a preferred point of care for its prescription and dispensing. In light of this situation and as no studies on emergency contraception in emergency departments in Italy have been conducted to date, this study was designed with a view to analyze the responses of emergency room physicians in relation to their prescribing habits and knowledge about the drug and in relation to frequency and profile of women arriving for care at hospital emergency departments in Piedmont and requesting prescription for the morning-after pill. This cross-sectional survey involved 29 hospital emergency departments in Piedmont where no gynecologists are on active duty. The survey instrument was a 24-item questionnaire. Analysis of responses revealed that in the physicians’ opinion the vast majority of requests came from Italian nationals (97% ranging in age from 18 to 30 years (76%, single and not cohabiting with a partner (60%, and nulliparous (64.0%. Women mostly request EC for first-time and the most common reasons were condom breakage or slippage. Just over half the physicians (52% stated that emergency contraception prescription was not an appropriate part of care provided at an emergency department and 72% stated they felt uneasy about prescribing emergency contraception. The survey also revealed gaps in physician knowledge about the pharmacokinetic and pharmacodynamic properties of emergency contraception pills.

  10. Emergent Hyperbolic Network Geometry

    Science.gov (United States)

    Bianconi, Ginestra; Rahmede, Christoph

    2017-02-01

    A large variety of interacting complex systems are characterized by interactions occurring between more than two nodes. These systems are described by simplicial complexes. Simplicial complexes are formed by simplices (nodes, links, triangles, tetrahedra etc.) that have a natural geometric interpretation. As such simplicial complexes are widely used in quantum gravity approaches that involve a discretization of spacetime. Here, by extending our knowledge of growing complex networks to growing simplicial complexes we investigate the nature of the emergent geometry of complex networks and explore whether this geometry is hyperbolic. Specifically we show that an hyperbolic network geometry emerges spontaneously from models of growing simplicial complexes that are purely combinatorial. The statistical and geometrical properties of the growing simplicial complexes strongly depend on their dimensionality and display the major universal properties of real complex networks (scale-free degree distribution, small-world and communities) at the same time. Interestingly, when the network dynamics includes an heterogeneous fitness of the faces, the growing simplicial complex can undergo phase transitions that are reflected by relevant changes in the network geometry.

  11. Communication system for emergency

    Energy Technology Data Exchange (ETDEWEB)

    Ajioka, Yoshiteru [Shizuoka Prefecture (Japan)

    1996-12-01

    People are apprehensive that a strong earthquake with a magnitude of nearly 8 may occur in Tokai area. The whole area of Shizuoka Prefecture has been specified as the specially strengthened region for earthquake disaster measures. This report outlines the communication system for emergency with respect to atomic disaster caused by an earthquake. Previously, wireless receiving system is stationed in the whole area to simultaneously inform the related news to the residents and so, communications with them are possible at any time by using the system. Since mobile wireless receiving sets are stationed in all town halls, self defense organizations and all the places of refuge, mutual communications are possible. These communication system can be utilized for either earthquake or nuclear disaster. Further, Shizuoka general information network system has been established as a communication system for anti-disaster organization and a wireless network via a communication satellite, ``super bird`` has been constructed in addition to the ground network. Therefore, the two communication routes became usable at emergency and the systems are available in either of nuclear disaster or earthquake. (M.N.)

  12. Tactical emergency medical support.

    Science.gov (United States)

    Rinnert, Kathy J; Hall, William L

    2002-11-01

    As increases in criminal activity collide with more aggressive law enforcement postures, there is more contact between police officers and violent felons. Civilian law enforcement special operations teams routinely engage suspects in these violent, dynamic, and complex interdiction activities. Along with these activities comes the substantial and foreseeable risk of death or grievous harm to law officers, bystanders, hostages, or perpetrators. Further, law enforcement agencies who attempt to apprehend dangerous, heavily armed criminals with a special operations team that lacks the expertise to treat the medical consequences that may arise from such a confrontation may be negligent of deliberate indifference. Meanwhile, evidence exists within the military, civilian law enforcement, and medical literature that on-scene TEMS serves to improve mission success and team safety and health, while decreasing morbidity and mortality in the event of an injury or illness suffered during operations. National professional organizations within law enforcement and emergency medicine have identified and support the fundamental need for mission safety and the development of a standard model to train and incorporate TEMS into law enforcement special operations. The overall objective of TEMS is to minimize the potential for injury and illness and to promote optimal medical care from the scene of operations to a definitive care facility. The design, staffing, and implementation of a TEMS program that maximally uses the community resources integrates previously disparate law enforcement, EMS, and emergency medical/trauma center functions to form a new continuum of care [55].

  13. Orion Emergency Mask Approach

    Science.gov (United States)

    Tuan, George C.; Graf, John C.

    2009-01-01

    Emergency mask approach on Orion poses a challenge to the traditional Shuttle or Station approaches. Currently, in the case of a fire or toxic spill event, the crew utilizes open loop oxygen masks that provide the crew with oxygen to breath, but also dumps the exhaled oxygen into the cabin. For Orion, with a small cabin volume, the extra oxygen will exceed the flammability limit within a short period of time, unless a nitrogen purge is also provided. Another approach to a fire or toxic spill event is the use of a filtering emergency masks. These masks utilize some form of chemical beds to scrub the air clean of toxic providing the crew safe breathing air for a period without elevating the oxygen level in the cabin. Using the masks and a form of smoke-eater filter, it may be possible to clean the cabin completely or to a level for safe transition to a space suit to perform a cabin purge. Issues with filters in the past have been the reaction time, breakthroughs, and high breathing resistance. Development in a new form of chemical filters has shown promise to make the filtering approach feasible.

  14. Abdominal emergencies in pediatrics.

    Science.gov (United States)

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  15. [Hypertensive emergency and urgence].

    Science.gov (United States)

    Gegenhuber, Alfons; Lenz, Kurt

    2003-12-01

    DEFINITION, PATHOPHYSIOLOGY, THERAPY: The hypertensive crisis is characterized by a massive, acute rise in blood pressure. Patients with underlying hypertensive disease usually have an increase in systolic blood pressure values > 220 mmHg and diastolic values > 120 mmHg. The severity of the condition, however, is not determined by the absolute blood pressure level but by the magnitude of the acute increase in blood pressure. Thus, in the presence of primarily normotensive baseline values (such as those in eclampsia), even a systolic blood pressure > 170 mmHg may lead to a life-threatening condition. The most important causes are non-compliance (reduction or interruption of therapy), inadequate therapy, endocrine disease, renal (vessel) disease, pregnancy and intoxication (drugs). The management of this condition greatly depends on whether the patient has a hypertensive crisis with organ manifestation (hypertensive emergency) or a crisis without organ manifestation (hypertensive urgency). By documenting the medical history, the medical status and by simple diagnostic procedures, the differential diagnosis can be established at the emergency site within a very short period of time. In the absence of organ manifestations (hypertensive urgency) the patient may have non-specific symptoms such as palpitations, headache, malaise and a general feeling of illness in addition to the increase in blood pressure. In a hypertensive urgency the patient's blood pressure should not be reduced within a few minutes but within a period of 24 to 48 hours. Such adjustment can be achieved on an out-patient basis, however, only if the patient can be followed up adequately for early detection of a renewed attack. In the absence of follow-up facilities, the patient's blood pressure should be reduced over a period of 4 to 6 hours, if necessary in an out-patient emergency service. While intravenous medication is given preference when a rapid effect is desired, oral medication may be used for

  16. Torted and Ruptured Wandering Spleen Presenting as a Surgical Emergency in Pregnancy

    Directory of Open Access Journals (Sweden)

    A. Parvaiz

    2004-01-01

    Full Text Available Wandering spleen (WS is characterised by incomplete fixation of the spleen to its supporting linorenal and gastrosplenic ligaments. It can predispose to life-threatening complications due to torsion of its vascular pedicle, splenic infarction, portal hypertension, and haemorrhage. A 27-year-old, 36-week prima gravida underwent emergency caesarean section for tachycardia and hypotension. A healthy baby girl was delivered. However, she remained shocked despite aggressive fluid therapy and intraoperatively it was noted that there was significant intraperitoneal bleeding and the on-call surgical team was summoned. Midline laparotomy revealed a lacerated, infarcted, hypermobile spleen found with free intraperitoneal bleeding. The unsalvageable spleen was resected and the patient went on to make an excellent recovery. The aetiology of WS is contentious. With an increased frequency among multiparous females of reproductive age, some suggest the hormonal effects of pregnancy as contributing factors. Clinical presentations range from an asymptomatic abdominal mass to acute abdominal pain with hypovolaemic shock. WS poses a serious threat to life due to thrombosis, bleeding, or infarction. Ultrasound scan and CT scan are equally effective in the diagnosis. Patients with asymptomatic WS should be treated with elective splenopexy, however, in the acute presentation, splenectomy is the procedure of choice.

  17. 腹腔镜及开腹手术对胆囊切除后患者肠粘连的临床疗效比较%Clinical efficacy comparison of cystic resection postoperative bowel adhe-sion between the laparoscopic surgey and traditional laparotomy

    Institute of Scientific and Technical Information of China (English)

    成陕林; 胡娟娟; 王新民

    2015-01-01

    目的:比较腹腔镜和传统开腹胆囊切除手术对术后肠粘连的发生率的影响,同时比较两种手术方法对患者术后生存质量的影响。方法随机抽取2012年3月~2014年3月咸阳市中心医院治疗的158例胆囊切除患者,其中开腹胆囊手术患者(开腹组)76例,腹腔镜手术患者(腹腔镜组)82例。通过术后观察与随访,调查两组手术患者术后肠粘连发生率,并且应用消化病生存质量指数(CLQI)对术后患者的生存质量值进行测定。结果腹腔镜组手术时间、术后疼痛时间、排气排便时间、术后下床活动时间、住院时间分别为(57.3±7.2)min、(36.8±4.5)h、(22.6±2.9)h、(20.8±2.9)h、(6.6±0.8)d,明显低于开腹组[(83.9±9.1)min、(72.1±9.7)h、(35.9±4.5)h、(25.4±3.5)h、(10.7±1.3)d],两组比较差异均有统计学意义(P0.05),术后6个月及1年,开腹组患者CLQI[(116.6±11.7)、(119.6±12.3)分]接近正常水平(120~125分),腹腔镜组[(120.5±12.1)、(123.8±12.6)分]已达到正常范围。结论腹腔镜胆囊切除手术较开腹胆囊切除手术肠粘连并发症发生率低,而且术后患者生存质量比后者高,值得进一步应用和推广。%Objective To compare the incidence of postoperative bowel adhesion between the laparoscopic and tradi-tional laparotomy for cystic resection, and compare the postoperative survival quality of patients. Methods 158 patients with gallbladder disease were included from March 2012 to March 2014 in the Center Hospital of Xianyang City. 76 cases were treated with traditional laparotomy for cystic resection (laparotomy group), 82 cases were treated with laparo-scopic for cystic resection (laparoscopic group). The incidence of postoperative bowel adhesion and digestive disease postoperative quality of life index (CLQI) of patients in two groups were observed. Results Operative time, postoperative pain time, exhaust or defecate time, postoperative ambulation time, length of hospital stay of

  18. Emerging infections: a perpetual challenge.

    Science.gov (United States)

    Morens, David M; Folkers, Gregory K; Fauci, Anthony S

    2008-11-01

    Emerging and re-emerging infectious diseases, and their determinants, have recently attracted substantial scientific and popular attention. HIV/AIDS, severe acute respiratory syndrome, H5N1 avian influenza, and many other emerging diseases have either proved fatal or caused international alarm. Common and interactive co-determinants of disease emergence, including population growth, travel, and environmental disruption, have been increasingly documented and studied. Are emerging infections a new phenomenon related to modern life, or do more basic determinants, transcending time, place, and human progress, govern disease generation? By examining a number of historically notable epidemics, we suggest that emerging diseases, similar in their novelty, impact, and elicitation of control responses, have occurred throughout recorded history. Fundamental determinants, typically acting in concert, seem to underlie their emergence, and infections such as these are likely to continue to remain challenges to human survival.

  19. [Hypertensive urgency and emergency].

    Science.gov (United States)

    Henny-Fullin, Katja; Buess, Daniel; Handschin, Anja; Leuppi, Jörg; Dieterle, Thomas

    2015-06-01

    European and North-American guidelines for the diagnosis and therapy of arterial hypertension refer to hypertensive crisis as an acute and critical increase of blood pressure>180/120 mmHg. Presence of acute hypertensive target organ damage, such as stroke, myocardial infarction or heart failure, in this situation defines a “hypertensive emergency”. In these patients, immediate lowering of blood pressure (about 25% within one to two hours) in an intensive care setting is mandatory to prevent further progression of target organ damage. In contrast to hypertensive emergencies, hypertensive urgencies are characterized by an acute and critical increase in blood pressure without signs or symptoms of acute hypertensive target organ damage. In these patients, blood pressure should be lowered within 24 to 48 hours in order to avoid hypertensive target organ damage. In general, hospitalization is not required, and oral antihypertensive therapy usually is sufficient. However, further and continuing outpatient care has to be ensured.

  20. Mechanical Containment in Emergency

    Directory of Open Access Journals (Sweden)

    Nerea Carcoba Rubio

    2012-09-01

    Full Text Available The restraint is a therapeutic measure aimed at blocking partial or widespread in most of the body of a patient to try to ensure the safety of himself or others. In most cases it forces to act against their will, and in a common context of urgency; in such a way that its use applies a therapeutic plan without the consent of the patient and is temporally deprived of freedom of movement. A literature review of the issue has been performed consulting surveillance systems and protocols developed at hospitals in several spanish cities. Also the current legal regulations on health matters relating to the subject are checked.After the analysis of data and evidence, is created a protocol of restraint in emergency and the various functions of the components of the team, to address the situation with greater efficiency and safe as possible.

  1. Emergent Computation Emphasizing Bioinformatics

    CERN Document Server

    Simon, Matthew

    2005-01-01

    Emergent Computation is concerned with recent applications of Mathematical Linguistics or Automata Theory. This subject has a primary focus upon "Bioinformatics" (the Genome and arising interest in the Proteome), but the closing chapter also examines applications in Biology, Medicine, Anthropology, etc. The book is composed of an organized examination of DNA, RNA, and the assembly of amino acids into proteins. Rather than examine these areas from a purely mathematical viewpoint (that excludes much of the biochemical reality), the author uses scientific papers written mostly by biochemists based upon their laboratory observations. Thus while DNA may exist in its double stranded form, triple stranded forms are not excluded. Similarly, while bases exist in Watson-Crick complements, mismatched bases and abasic pairs are not excluded, nor are Hoogsteen bonds. Just as there are four bases naturally found in DNA, the existence of additional bases is not ignored, nor amino acids in addition to the usual complement of...

  2. (non) Emergent Constraints

    Science.gov (United States)

    Jackson, C. S.; Hattab, M. W.; Huerta, G.

    2014-12-01

    Emergent constraints are observable quantities that provide some physical basis for testing or predicting how a climate model will respond to greenhouse gas forcing. Very few such constraints have been identified for the multi-model CMIP archive. Here we explore the question of whether constraints that apply to a single model, a perturbed parameter ensemble (PPE) of the Community Atmosphere Model (CAM3.1), can be applied to predicting the climate sensitivities of models within the CMIP archive. In particular we construct our predictive patterns from multivariate EOFs of the CAM3.1 ensemble control climate. Multiple regressive statistical models were created that do an excellent job of predicting CAM3.1 sensitivity to greenhouse gas forcing. However, these same patterns fail spectacularly to predict sensitivities of models within the CMIP archive. We attribute this failure to several factors. First, and perhaps the most important, is that the structures affecting climate sensitivity in CAM3.1 have a unique signature in the space of our multivariate EOF patterns that are unlike any other climate model. That is to say, we should not expect CAM3.1 to represent the way another models within CMIP archive respond to greenhouse gas forcing. The second, perhaps related, reason is that the CAM3.1 PPE does a poor job of spanning the range of climates and responses found within the CMIP archive. We shall discuss the implications of these results for the prospect of finding emergent constraints within the CMIP archive. We will also discuss what this may mean for establishing uncertainties in climate projections.

  3. Emergent Horava gravity in graphene

    Energy Technology Data Exchange (ETDEWEB)

    Volovik, G.E. [Low Temperature Laboratory, School of Science and Technology, Aalto University, P.O. Box 15100, FI-00076 AALTO (Finland); L. D. Landau Institute for Theoretical Physics, Kosygina 2, 119334 Moscow (Russian Federation); Zubkov, M.A., E-mail: zubkov@itep.ru [ITEP, B.Cheremushkinskaya 25, Moscow, 117259 (Russian Federation)

    2014-01-15

    First of all, we reconsider the tight-binding model of monolayer graphene, in which the variations of the hopping parameters are allowed. We demonstrate that the emergent 2D Weitzenbock geometry as well as the emergent U(1) gauge field appear. The emergent gauge field is equal to the linear combination of the components of the zweibein. Therefore, we actually deal with the gauge fixed version of the emergent 2+1 D teleparallel gravity. In particular, we work out the case, when the variations of the hopping parameters are due to the elastic deformations, and relate the elastic deformations with the emergent zweibein. Next, we investigate the tight-binding model with the varying intralayer hopping parameters for the multilayer graphene with the ABC stacking. In this case the emergent 2D Weitzenbock geometry and the emergent U(1) gauge field appear as well, and the emergent low energy effective field theory has the anisotropic scaling. -- Highlights: •The tight-binding model for graphene with varying hopping parameters is considered. •The emergent gravity and emergent gauge fields are derived. •For the case of the multilayer graphene we obtain the analogue of Horava gravity with anisotropic scaling.

  4. Emergent Spacetime: Reality or Illusion?

    CERN Document Server

    Yang, Hyun Seok

    2015-01-01

    The contemporary physics has revealed growing evidences that the emergence can be applied to not only biology and condensed matter systems but also gravity and spacetime. We observe that noncommutative spacetime necessarily implies emergent spacetime if spacetime at microscopic scales should be viewed as noncommutative. Since the emergent spacetime is a new fundamental paradigm for quantum gravity, it is necessary to reexamine all the rationales to introduce the multiverse hypothesis from the standpoint of emergent spacetime. We argue that the emergent spacetime certainly opens a new perspective that may cripple all the rationales to introduce the multiverse picture. Moreover the emergent spacetime may rescue us from the doomsday of metastable multiverse as quantum mechanics did from the catastrophic collapse of classical atoms.

  5. Emerging optical nanoscopy techniques

    Directory of Open Access Journals (Sweden)

    Montgomery PC

    2015-09-01

    Full Text Available Paul C Montgomery, Audrey Leong-Hoi Laboratoire des Sciences de l'Ingénieur, de l'Informatique et de l'Imagerie (ICube, Unistra-CNRS, Strasbourg, France Abstract: To face the challenges of modern health care, new imaging techniques with subcellular resolution or detection over wide fields are required. Far field optical nanoscopy presents many new solutions, providing high resolution or detection at high speed. We present a new classification scheme to help appreciate the growing number of optical nanoscopy techniques. We underline an important distinction between superresolution techniques that provide improved resolving power and nanodetection techniques for characterizing unresolved nanostructures. Some of the emerging techniques within these two categories are highlighted with applications in biophysics and medicine. Recent techniques employing wider angle imaging by digital holography and scattering lens microscopy allow superresolution to be achieved for subcellular and even in vivo, imaging without labeling. Nanodetection techniques are divided into four subcategories using contrast, phase, deconvolution, and nanomarkers. Contrast enhancement is illustrated by means of a polarized light-based technique and with strobed phase-contrast microscopy to reveal nanostructures. Very high sensitivity phase measurement using interference microscopy is shown to provide nanometric surface roughness measurement or to reveal internal nanometric structures. Finally, the use of nanomarkers is illustrated with stochastic fluorescence microscopy for mapping intracellular structures. We also present some of the future perspectives of optical nanoscopy. Keywords: microscopy, imaging, superresolution, nanodetection, biophysics, medical imaging

  6. Emerging Vaccine Informatics

    Directory of Open Access Journals (Sweden)

    Yongqun He

    2010-01-01

    Full Text Available Vaccine informatics is an emerging research area that focuses on development and applications of bioinformatics methods that can be used to facilitate every aspect of the preclinical, clinical, and postlicensure vaccine enterprises. Many immunoinformatics algorithms and resources have been developed to predict T- and B-cell immune epitopes for epitope vaccine development and protective immunity analysis. Vaccine protein candidates are predictable in silico from genome sequences using reverse vaccinology. Systematic transcriptomics and proteomics gene expression analyses facilitate rational vaccine design and identification of gene responses that are correlates of protection in vivo. Mathematical simulations have been used to model host-pathogen interactions and improve vaccine production and vaccination protocols. Computational methods have also been used for development of immunization registries or immunization information systems, assessment of vaccine safety and efficacy, and immunization modeling. Computational literature mining and databases effectively process, mine, and store large amounts of vaccine literature and data. Vaccine Ontology (VO has been initiated to integrate various vaccine data and support automated reasoning.

  7. Complex emergencies in Indonesia.

    Science.gov (United States)

    Bradt, D A; Drummond, C M; Richman, M

    2001-01-01

    Recently, Indonesia has experienced six major provincial, civil, armed conflicts. Underlying causes include the transmigration policy, sectarian disputes, the Asian economic crisis, fall of authoritarian rule, and a backlash against civil and military abuses. The public health impact involves the displacement nationwide of > 1.2 million persons. Violence in the Malukus, Timor, and Kalimantan has sparked the greatest population movements such that five provinces in Indonesia each now harbor > 100,000 internally displaced persons. With a background of government instability, hyperinflation, macroeconomic collapse, and elusive political solutions, these civil armed conflicts are ripe for persistence as complex emergencies. Indonesia has made substantial progress in domestic disaster management with the establishment of central administrative authority, strategic planning, and training programs. Nevertheless, the Indonesian experience reveals recurrent issues in international humanitarian health assistance. Clinical care remains complicated by absences of treatment protocols, inappropriate drug use, high procedural complication rates, and variable referral practices. Epidemiological surveillance remains complicated by unsettled clinical case definitions, non-standardized case management of diseases with epidemic potential, variable outbreak management protocols, and inadequate epidemiological analytic capacity. International donor support has been semi-selective, insufficient, and late. The militia murders of three UN staff in West Timor prompted the withdrawal of UN international staff from West Timor for nearly a year to date. Re-establishing rules of engagement for humanitarian health workers must address security, public health, and clinical threats.

  8. Emerging Biomarkers in Glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    McNamara, Mairéad G.; Sahebjam, Solmaz; Mason, Warren P., E-mail: warren.mason@uhn.ca [Pencer Brain Tumor Centre, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario M5G 2M9 (Canada)

    2013-08-22

    Glioblastoma, the most common primary brain tumor, has few available therapies providing significant improvement in survival. Molecular signatures associated with tumor aggressiveness as well as with disease progression and their relation to differences in signaling pathways implicated in gliomagenesis have recently been described. A number of biomarkers which have potential in diagnosis, prognosis and prediction of response to therapy have been identified and along with imaging modalities could contribute to the clinical management of GBM. Molecular biomarkers including O(6)-methlyguanine-DNA-methyltransferase (MGMT) promoter and deoxyribonucleic acid (DNA) methylation, loss of heterozygosity (LOH) of chromosomes 1p and 19q, loss of heterozygosity 10q, isocitrate dehydrogenase (IDH) mutations, epidermal growth factor receptor (EGFR), epidermal growth factor, latrophilin, and 7 transmembrane domain-containing protein 1 on chromosome 1 (ELTD1), vascular endothelial growth factor (VEGF), tumor suppressor protein p53, phosphatase and tensin homolog (PTEN), p16INK4a gene, cytochrome c oxidase (CcO), phospholipid metabolites, telomerase messenger expression (hTERT messenger ribonucleic acid [mRNA]), microRNAs (miRNAs), cancer stem cell markers and imaging modalities as potential biomarkers are discussed. Inclusion of emerging biomarkers in prospective clinical trials is warranted in an effort for more effective personalized therapy in the future.

  9. Emergency medicine in Dubai, UAE

    OpenAIRE

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  10. Emergency medicine in Dubai, UAE.

    Science.gov (United States)

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-08-18

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  11. Emergence of communication and language

    CERN Document Server

    Lyon, Caroline; Cangelosi, Angelo

    2010-01-01

    This book brings together work on the emergence of communication language drawing on diverse disciplines, including linguistics, psychology, neuroscience, anthropology and computer science. Computational simulations of the emergence of phenomena associated with communication and language play a key role in illuminating some of the most significant issues, and the renewed scientific interest in language emergence has benefited greatly from research in Artificial Intelligence and Cognitive Science. Starting with a road map chapter pointing to the ways in which disparate disciplines can inform

  12. How can emerging powers speak?

    DEFF Research Database (Denmark)

    Kristensen, Peter Marcus

    2015-01-01

    Emerging powers like China, India and Brazil are receiving growing attention as objects in International Relations (IR) discourse. Scholars from these emerging powers are rarely present as subjects in mainstream IR discourse, however. This paper interrogates the conditions for scholars in emerging...... powers to speak back to the mainstream discipline. It argues, first, that ‘theory speak’ is rare from scholars based in periphery countries perceived to be ‘emerging powers’. Despite increasing efforts to create a ‘home-grown’ theoretical discourse in China, India and Brazil, few articles in mainstream...

  13. Developing protocols for obstetric emergencies.

    Science.gov (United States)

    Roth, Cheryl K; Parfitt, Sheryl E; Hering, Sandra L; Dent, Sarah A

    2014-01-01

    There is potential for important steps to be missed in emergency situations, even in the presence of many health care team members. Developing a clear plan of response for common emergencies can ensure that no tasks are redundant or omitted, and can create a more controlled environment that promotes positive health outcomes. A multidisciplinary team was assembled in a large community hospital to create protocols that would help ensure optimum care and continuity of practice in cases of postpartum hemorrhage, shoulder dystocia, emergency cesarean surgical birth, eclamptic seizure and maternal code. Assignment of team roles and responsibilities led to the evolution of standardized protocols for each emergency situation.

  14. Security and Emergency Management Division

    Data.gov (United States)

    Federal Laboratory Consortium — Volpe's Security and Emergency Management Division identifies vulnerabilities, risks, and opportunities to improve the security of transportation systems, critical...

  15. Medical emergencies in dental practice.

    LENUS (Irish Health Repository)

    Wilson, M H

    2009-06-01

    Serious medical emergencies are fortunately a rare occurrence in the dental practice environment; however, if an emergency situation is encountered a delay in treatment may result in potentially avoidable consequences. The risk of mortality or serious morbidity can be reduced by ensuring that basic emergency equipment and medications are in place, and that the dental team is appropriately trained in basic life support measures. This article aims to provide an overview of the basic emergency medications and equipment that should be present in dental practices, and to discuss specific responses to some of the more common adverse medical events that can present while providing dental treatment.

  16. Emergency Medical Technicians and Paramedics

    Science.gov (United States)

    ... Projected Employment, 2024 Change, 2014-24 Employment by Industry Percent Numeric SOURCE: U.S. Bureau of Labor Statistics, Employment Projections program Emergency medical technicians and paramedics ...

  17. Emergency Preparedness for People Living with HIV

    Science.gov (United States)

    ... Translate Text Size Print Emergency Preparedness Emergencies and HIV/AIDS Emergencies can take many forms. They include ... planning efforts. Emergency Resources for People Living with HIV The Federal Government offers several resources and programs ...

  18. Urgencias respiratorias Respiratory emergencies

    Directory of Open Access Journals (Sweden)

    E. Martínez

    2004-01-01

    Full Text Available Las urgencias respiratorias en un paciente con cáncer pueden tener su origen en patologías de la vía aérea, del parénquima pulmonar o de los grandes vasos. La causa puede ser el propio tumor o complicaciones concomitantes. La obstrucción de la vía aérea debería ser inicialmente evaluada con procedimientos endoscópicos. En situaciones severas, la cirugía raramente es posible. El emplazamiento endobronquial de stents e isótopos radiactivos (braquiterapia, la ablación tumoral por láser o la terapia fotodinámica, pueden aliviar de forma rápida los síntomas y reestablecer el flujo aéreo. El manejo de la hemoptisis depende de la causa que la provoque y de la cuantía de la misma. La broncoscopia sigue siendo el procedimiento de primera línea en la mayor parte de los casos; aporta información diagnóstica y puede interrumpir el sangrado mediante lavados con suero helado, taponamiento endobronquial o inyecciones tópicas de adrenalina o trombina. La radioterapia externa sigue siendo un procedimiento extraordinariamente útil para tratar la hemoptisis de causa tumoral y en situaciones bien seleccionadas la terapia endobronquial con láser o braquiterapia y la embolización arterial bronquial pueden proporcionar un gran rendimiento paliativo. Las urgencias respiratorias por enfermedad del parénquima pulmonar en un paciente oncológico, pueden tener causa tumoral, iatrogénica o infecciosa. El reconocimiento precoz de cada una de ellas determina la administración del tratamiento específico y las posibilidades de éxito.Respiratory emergencies in a patient with cancer can have their origin in pathologies of the airway, of the pulmonary parenchyma or the large vessels. The cause can be the tumour itself or concomitant complications. Obstruction of the airway should be initially evaluated with endoscopic procedures. Surgery is rarely possible in serious situations. The endobronchial placement of stents or radioactive isotopes

  19. Hypoglycemia in Emergency Department

    Institute of Scientific and Technical Information of China (English)

    Yu-Jang Su; Chia-Jung Liao

    2015-01-01

    Objective:To study the epidemiology, etiologies and prognostic factors of hypoglycemia. Methods:A retrospective chart review of hypoglycemic cases from December, 2009 to February, 2012 was conducted to gather the following patient data: age, gender, vital signs at triage, white blood cell count, serum glucose, C-reactive protein, glutamic oxaloacetic transaminase, creatinine, sodium, potassium, past history of liver cirrhosis, uremia, concomitant infection, concomitant cancer/malignancy, length of stay, lack of recent meal, status of acute renal failure and concomitant stroke. A total of 186 cases were enrolled in our study. We analyzed the data using commercial statistics software (SPSS for Windows, version 11.0, SPSS Inc., Chicago, IL). We used the Student's t-test andχ2 test for the statistical analyses, and significance was set at a P value less than 0.05. Results: Hypoglycemia is related to several co-morbidities. In total, 10.2%of the patients had liver cirrhosis and 7.0% had uremia. More than half (55.4%) were bacterial infection during hospitalization. Acute renal failure accounted for 26.3%of the hypoglycemic episodes. In addition to the etiology of infection, the lack of a recent meal accounted for 44.6%hypoglycemic episodes. A total of 2.2%of the cases resulted from an acute cerebrovascular accident. Approximately 8.6%were concomitant with malignancy. Conclusions: When hypoglycemic patients present in the emergency department, physicians should pay attention to the presence of infection, malignancy, liver diseases (liver cirrhosis and biliary tract infection), and acute renal failure.

  20. Emerging pharmacotherapy of tinnitus.

    Science.gov (United States)

    Langguth, Berthold; Salvi, Richard; Elgoyhen, Ana Belén

    2009-12-01

    Tinnitus, the perception of sound in the absence of an auditory stimulus, is perceived by about 1 in 10 adults, and for at least 1 in 100, tinnitus severely affects their quality of life. Because tinnitus is frequently associated with irritability, agitation, stress, insomnia, anxiety and depression, the social and economic burdens of tinnitus can be enormous. No curative treatments are available. However, tinnitus symptoms can be alleviated to some extent. The most widespread management therapies consist of auditory stimulation and cognitive behavioral treatment, aiming at improving habituation and coping strategies. Available clinical trials vary in methodological rigor and have been performed for a considerable number of different drugs. None of the investigated drugs have demonstrated providing replicable long-term reduction of tinnitus impact in the majority of patients in excess of placebo effects. Accordingly, there are no FDA or European Medicines Agency approved drugs for the treatment of tinnitus. However, in spite of the lack of evidence, a large variety of different compounds are prescribed off-label. Therefore, more effective pharmacotherapies for this huge and still growing market are desperately needed and even a drug that produces only a small but significant effect would have an enormous therapeutic impact. This review describes current and emerging pharmacotherapies with current difficulties and limitations. In addition, it provides an estimate of the tinnitus market. Finally, it describes recent advances in the tinnitus field which may help overcome obstacles faced in the pharmacological treatment of tinnitus. These include incomplete knowledge of tinnitus pathophysiology, lack of well-established animal models, heterogeneity of different forms of tinnitus, difficulties in tinnitus assessment and outcome measurement and variability in clinical trial methodology.

  1. Preparing for Emergency Situations

    Science.gov (United States)

    Asproth, Viveca; Amcoff Nyström, Christina

    2010-11-01

    Disaster relief can be seen as a dynamic multi actor process with actors both joining and leaving the relief work during the help and rescue phase after the disaster has occurred. Actors may be governmental agencies, non profit voluntary organisations or spontaneous helpers comprised of individual citizens or temporal groups of citizens. Hence, they will vary widely in agility, competence, resources, and endurance. To prepare for for disasters a net based Agora with simulation of emergency situations for mutual preparation, training, and organisational learning is suggested. Such an Agora will ensure future security by: -Rising awareness and preparedness of potential disaster responders by help of the components and resources in the netAgora environment; -Improving cooperation and coordination between responders; -Improving competence and performance of organisations involved in security issues; -Bridging cultural differences between responders from different organizations and different backgrounds. The developed models are intended to reflect intelligent anticipatory systems for human operator anticipation of future consequences. As a way to catch what should be included in this netbased Agora and to join the split pictures that is present, Team Syntegrity could be a helpful tool. The purpose of Team Syntegrity is to stimulate collaboration and incite cross fertilization and creativity. The difference between syntegration and other group work is that the participants are evenly and uniquely distributed and will collectively have the means, the knowledge, the experience, the perspectives, and the expertise, to deal with the topic. In this paper the possibilities with using Team Syntegrity in preparation for the development of a netbased Agora is discussed. We have identified that Team Syntegrity could be useful in the steps User Integration, Designing the netAgora environment, developing Test Scenarios, and assessment of netAgora environment.

  2. Effect of intermediate care on mortality following emergency abdominal surgery. The InCare trial: study protocol, rationale and feasibility of a randomised multicentre trial

    Directory of Open Access Journals (Sweden)

    Vester-Andersen Morten

    2013-02-01

    Full Text Available Abstract Background Emergency abdominal surgery carries a 15% to 20% short-term mortality rate. Postoperative medical complications are strongly associated with increased mortality. Recent research suggests that timely recognition and effective management of complications may reduce mortality. The aim of the present trial is to evaluate the effect of postoperative intermediate care following emergency major abdominal surgery in high-risk patients. Methods and design The InCare trial is a randomised, parallel-group, non-blinded clinical trial with 1:1 allocation. Patients undergoing emergency laparotomy or laparoscopic surgery with a perioperative Acute Physiology and Chronic Health Evaluation II score of 10 or above, who are ready to be transferred to the surgical ward within 24 h of surgery are allocated to either intermediate care for 48 h, or surgical ward care. The primary outcome measure is all-cause 30-day mortality. We aim to enrol 400 patients in seven Danish hospitals. The sample size allows us to detect or refute a 34% relative risk reduction of mortality with 80% power. Discussion This trial evaluates the benefits and possible harm of intermediate care. The results may potentially influence the survival of many high-risk surgical patients. As a pioneer trial in the area, it will provide important data on the feasibility of future large-scale randomised clinical trials evaluating different levels of postoperative care. Trial registration Clinicaltrials.gov identifier: NCT01209663

  3. Work shifts in Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Roberto Recupero

    2007-06-01

    Full Text Available Emergency Medicine is known as a high stress specialty. The adverse effect of constantly rotating shifts is the single most important reason given for premature attrition from the field. In this work problems tied with night shift work will be taken into account and some solutions to reduce the impact of night work on the emergency physicians will be proposed.

  4. Threat from Emerging Vectorborne Viruses

    Centers for Disease Control (CDC) Podcasts

    2016-06-09

    Reginald Tucker reads an abridged version of the commentary by CDC author Ronald Rosenberg, Threat from Emerging Vectorborne Viruses.  Created: 6/9/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 6/9/2016.

  5. Collaborative Approaches in Emerging Markets

    DEFF Research Database (Denmark)

    Søberg, Peder Veng; Han, Yang

    2011-01-01

    The paper investigates innovative collaboration undertaken by newly established foreign invested R&D units in emerging markets. In particular, the paper investigates how foreign invested newly established R&D centers in emerging markets can leverage local knowledge networks, such as universities...

  6. Monitoring new and emerging risks

    NARCIS (Netherlands)

    Houtman, I.L.D.; Douwes, M.; Zondervan, E.; Jongen, M.

    2014-01-01

    This article, based on recent literature, will identify, define and discuss new and emerging OSH-risks together with the driving forces behind these risks. Emerging risks will be described as being related to physical load and musculoskeletal disorders [MSDs], psychosocial risks, and dangerous subst

  7. Anticipatory Ethics for Emerging Technologies

    NARCIS (Netherlands)

    Brey, P.A.E.

    2012-01-01

    In this essay, a new approach for the ethical study of emerging technology ethics will be presented, called anticipatory technology ethics (ATE). The ethics of emerging technology is the study of ethical issues at the R&D and introduction stage of technology development through anticipation of possi

  8. Wildlife Emergency and Critical Care.

    Science.gov (United States)

    Riley, Jennifer; Barron, Heather

    2016-05-01

    Wildlife patients often present as emergencies. For veterinarians who do not typically treat wildlife, it is important to be able to stabilize and determine the underlying cause of the animal's signs. This article discusses initial assessment, stabilization, and treatment of common emergency presentations in wild birds, reptiles, and mammals.

  9. Digital Media and Emergent Literacy

    Science.gov (United States)

    Hisrich, Katy; Blanchard, Jay

    2009-01-01

    This article discusses digital media and its potential effects on emergent literacy skills development for young children. While the impact of digital media exposure on children's emergent literacy development is largely unknown, it is becoming a significant issue, as more and more young children throughout the world observe and use various forms…

  10. Cognitive Radio for Emergency Networks

    NARCIS (Netherlands)

    Zhang, Qiwei; Kokkeler, A.B.J.; Smit, G.J.M.

    2006-01-01

    In the scope of the Adaptive Ad-hoc Freeband (AAF) project, an emergency network built on top of Cognitive Radio is proposed to alleviate the spectrum shortage problem which is the major limitation for emergency networks. Cognitive Radio has been proposed as a promising technology to solve todayâ?~B

  11. Emergence of Symmetries from Entanglement

    CERN Document Server

    CERN. Geneva

    2016-01-01

    Maximal Entanglement appears to be a key ingredient for the emergence of symmetries. We first illustrate this phenomenon using two examples: the emergence of conformal symmetry in condensed matter systems and  the relation of tensor networks to holography. We further present a Principle of Maximal Entanglement that seems to dictate to a large extend the structure of gauge symmetry.

  12. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... injured patients after these patients reach a hospital emergency department or a trauma center....

  13. Visioning future emergency healthcare collaboration

    DEFF Research Database (Denmark)

    Söderholm, Hanna M.; Sonnenwald, Diane H.

    2010-01-01

    New video technologies are emerging to facilitate collaboration in emergency healthcare. One such technology is 3D telepresence technology for medical consultation (3DMC) that may provide richer visual information to support collaboration between medical professionals to, ideally, enhance patient...... care in real time. Today only an early prototype of 3DMC exists. To better understand 3DMC's potential for adoption and use in emergency healthcare before large amounts of development resources are invested we conducted a visioning study. That is, we shared our vision of 3DMC with emergency room...... physicians, nurses, administrators, and information technology (IT) professionals working at large and small medical centers, and asked them to share their perspectives regarding 3DMC's potential benefits and disadvantages in emergency healthcare and its compatibility and/or lack thereof...

  14. Leucograma e teores plasmáticos de proteínas de fase aguda de eqüinos portadores de abdômen agudo e submetidos à laparotomia Leukogram and plasma acute phase protein concentrations in horses with acute abdomen submitted to treatment by laparotomy

    Directory of Open Access Journals (Sweden)

    J.J. Fagliari

    2008-04-01

    Full Text Available Foram examinados 20 eqüinos adultos portadores de abdômen agudo e submetidos à laparotomia. Dez recuperaram-se sem intercorrência pós-operatória (G1 e 10 foram a óbito sete a 10 dias após a cirurgia, com sinais de choque séptico (G2. Avaliaram-se temperatura retal, freqüências cardíaca e respiratória, tempo de preenchimento capilar e teores plasmáticos das proteínas de fase aguda - fibrinogênio, ceruloplasmina, proteína C-reativa, antitripsina, haptoglobina e glicoproteína ácida -, antes e até sete dias após a laparotomia. As leucometrias às 72h e no sétimo dia pós-operatório dos eqüinos que foram a óbito foram, respectivamente, 34,6% e 57,1%, mais altas que a dos animais curados. Os maiores valores de proteína de fase aguda ocorreram no sétimo dia após a cirurgia; os percentuais de elevação de fibrinogênio, antitripsina, glicoproteina ácida, proteína C-reativa, ceruloplasmina e haptoglobina de eqüinos do G2 em relação ao G1 foram 46,8%, 67,9%, 91,9%, 112,2%, 126,9% e 186,2%, respectivamente.Twenty adult horses with acute abdomen were examined and submitted to treatment by laparotomy; ten had no postoperative complication (group 1, and ten showed septic shock symptom and died from seven to ten days after surgery (group 2. Body temperature, heart and respiratory rates, filling capillary time, and plasma acute phase protein concentrations - fibrinogen, ceruloplasmin, C-reactive protein, antitrypsin, haptoglobin, and acid glycoprotein - were evaluated before laparotomy and until seven days after surgery. White blood cell counts at 72h and seven days after surgery in group 2 animals were, respectively, 34.6% and 57.1%, and were higher than those measured in group 1 horses. The highest values of acute phase proteins occurred on the seventh day after surgery. The increase percentages of fibrinogen, antitrypsin, acid glycoprotein, C-reactive protein, ceruloplasmin, and haptoglobin plasma concentrations in group 2

  15. Emergency thoracotomies: Two center study

    Directory of Open Access Journals (Sweden)

    Sameh Ibrahim Sersar

    2013-01-01

    Full Text Available Introduction and Aim: Emergency thoracotomy is performed either immediately at the scene of injury, in the emergency department or in the operating room. It aims to evacuate the pericardial tamponade, control the haemorrhage, to ease the open cardiac massage and to cross-clamp the descending thoracic aorta to redistribute blood flow and maybe to limit sub-diaphragmatic haemorrhage, bleeding and iatrogenic injury are the common risk factors. We aimed to review our experience in the field of emergency thoracotomies, identify the predictors of death, analyze the early results, detect the risk factors and asses the mortalities and their risk factors. Patients and Methods: Our hospital records of 197 patients who underwent emergency thoracotomy were reviewed. We retrospectively analyzed a piece of the extensive experience of the Mansoura University Hospitals and Mansoura Emergency Hospital; Egypt and Saudi German Hospitals; Jeddah in the last 12 years in the management of trauma cases for whom emergency thoracotomy. The aim was to analyse the early results of such cases and to detect the risk factors of dismal prognosis. Results: Our series included 197 cases of emergency thoractomies in Mansoura; Egypt and SGH; Jeddah; KSA in the last 12 years. The mean age of the victims was 28 years and ranged between 5 and 62 years. Of the 197 patients with emergency thoracotomy, the indications were both penetrating and blunt chest trauma, iatrogenic and postoperative hemodynamito a surgical cause. The commonest indication was stab heart followed by traumatic diaphragmatic ruptures. Conclusion: The results of emergency thoracotomy in our series were cooping with the results of other reports, mainly due to our aggressive measures to achieve rapid stabilization of the hemodynamic condition. We emphasize the importance of emergency medicine education programs on rapid diagnosis of traumatic injuries with early intervention, and adequate hemodynamic and respiratory

  16. Emergency Linkage Mode of Power Enterprise

    Directory of Open Access Journals (Sweden)

    Feng Jie

    2016-01-01

    Full Text Available Power emergency disposal needs take full advantage of the power enterprise within the external emergency power and resources. Based on analyzing and summarizing the relevant experience of domestic and foreign emergency linkage, this paper draws the Emergency Linkage subjects, Emergency Linkage contents, Emergency Linkage level, which are three key elements if power enterprise Emergency Linkage. Emergency Linkage subjects are divided into the two types of inner subjects and the external body; Emergency Linkage contents are in accordance with four phases of prevention, preparedness, response and recovery; Emergency Linkage level is divided into three levels of enterprise headquarter, provincial enterprise and incident unite. Binding power enterprise emergency management practice, this paper studies the internal Emergency Linkage modes (including horizontal mode and vertical mode, external Emergency Linkage mode and comprehensive Emergency Linkage Mode of power enterprise based on Fishbone Diagram and Process Management Technology.

  17. NATO Glossary of Abbreviations Used in NATO Documents and Publications (Glossaire OTAN des Abreviations Utilisees dans les Documents et Publications OTAN)

    Science.gov (United States)

    2007-01-01

    satellites) NASG AOI 1. appel d’offres international NASG 1a. international call for tenders / ICT / 1b. international competitive bidding /ICB/ 1a. NASG 1b...système de réanimation en cas d’urgence NASG ELT 1. emergency locator transmitter ATP-10(D) 1. émetteur de localisation d’urgence NASG 2. équipement limité...the Red Cross ICRC Comité international de la Croix-Rouge /CICR 1./ CICR ICS in-country support CFE Treaty soutien à l’intérieur du pays Traité FCE ICT

  18. Emerging and re-emerging bacterial diseases in India

    Indian Academy of Sciences (India)

    T D Chugh

    2008-11-01

    There has been a remarkable progress in the prevention, control and even eradication of infectious diseases with improved hygiene and development of antimicrobials and vaccines. However, infectious diseases still remain a leading cause of global disease burden with high morbidity and mortality especially in the developing world. Furthermore, there have been threats of new diseases during the past three decades due to the evolution and adaptation of microbes and the re-emergence of old diseases due to the development of antimicrobial resistance and the capacity to spread to new geographic areas. The impact of the emerging and re-emerging diseases in India has been tremendous at socioeconomic and public health levels. Their control requires continuing surveillance, research and training, better diagnostic facilities and improved public health system. Emerging and reemerging zoonotic diseases, foodborne and waterborne diseases and diseases caused by multiresistant organisms constitute the major threats in India. This review of bacterial emerging and re-emerging diseases should be of critical importance to microbiologists, clinicians, public health personnel and policy makers in India.

  19. Emerging & re-emerging infections in India: an overview.

    Science.gov (United States)

    Dikid, T; Jain, S K; Sharma, A; Kumar, A; Narain, J P

    2013-01-01

    The incidence of emerging infectious diseases in humans has increased within the recent past or threatens to increase in the near future. Over 30 new infectious agents have been detected worldwide in the last three decades; 60 per cent of these are of zoonotic origin. Developing countries such as India suffer disproportionately from the burden of infectious diseases given the confluence of existing environmental, socio-economic, and demographic factors. In the recent past, India has seen outbreaks of eight organisms of emerging and re-emerging diseases in various parts of the country, six of these are of zoonotic origin. Prevention and control of emerging infectious diseases will increasingly require the application of sophisticated epidemiologic and molecular biologic technologies, changes in human behaviour, a national policy on early detection of and rapid response to emerging infections and a plan of action. WHO has made several recommendations for national response mechanisms. Many of these are in various stages of implementation in India. However, for a country of size and population of India, the emerging infections remain a real and present danger. A meaningful response must approach the problem at the systems level. A comprehensive national strategy on infectious diseases cutting across all relevant sectors with emphasis on strengthened surveillance, rapid response, partnership building and research to guide public policy is needed.

  20. Emerging & re-emerging infections in India: An overview

    Directory of Open Access Journals (Sweden)

    T Dikid

    2013-01-01

    Full Text Available The incidence of emerging infectious diseases in humans has increased within the recent past or threatens to increase in the near future. Over 30 new infectious agents have been detected worldwide in the last three decades; 60 per cent of these are of zoonotic origin. Developing countries such as India suffer disproportionately from the burden of infectious diseases given the confluence of existing environmental, socio-economic, and demographic factors. In the recent past, India has seen outbreaks of eight organisms of emerging and re-emerging diseases in various parts of the country, six of these are of zoonotic origin. Prevention and control of emerging infectious diseases will increasingly require the application of sophisticated epidemiologic and molecular biologic technologies, changes in human behaviour, a national policy on early detection of and rapid response to emerging infections and a plan of action. WHO has made several recommendations for national response mechanisms. Many of these are in various stages of implementation in India. However, for a country of size and population of India, the emerging infections remain a real and present danger. A meaningful response must approach the problem at the systems level. A comprehensive national strategy on infectious diseases cutting across all relevant sectors with emphasis on strengthened surveillance, rapid response, partnership building and research to guide public policy is needed.

  1. Emerging and Re-Emerging Zoonoses of Dogs and Cats

    Directory of Open Access Journals (Sweden)

    Bruno B. Chomel

    2014-07-01

    Full Text Available Since the middle of the 20th century, pets are more frequently considered as “family members” within households. However, cats and dogs still can be a source of human infection by various zoonotic pathogens. Among emerging or re-emerging zoonoses, viral diseases, such as rabies (mainly from dog pet trade or travel abroad, but also feline cowpox and newly recognized noroviruses or rotaviruses or influenza viruses can sicken our pets and be transmitted to humans. Bacterial zoonoses include bacteria transmitted by bites or scratches, such as pasteurellosis or cat scratch disease, leading to severe clinical manifestations in people because of their age or immune status and also because of our closeness, not to say intimacy, with our pets. Cutaneous contamination with methicillin-resistant Staphylococcus aureus, Leptospira spp., and/or aerosolization of bacteria causing tuberculosis or kennel cough are also emerging/re-emerging pathogens that can be transmitted by our pets, as well as gastro-intestinal pathogens such as Salmonella or Campylobacter. Parasitic and fungal pathogens, such as echinococcosis, leishmaniasis, onchocercosis, or sporotrichosis, are also re-emerging or emerging pet related zoonoses. Common sense and good personal and pet hygiene are the key elements to prevent such a risk of zoonotic infection.

  2. Study on value of Extended-Focused Abdominal Scan For Trauma (e-FAST performed by non-radiologist emergency care doctors in Management of Trauma at Emergency Trauma Centre, Teaching Hospital, Karapitiya,Galle, Sri Lanka

    Directory of Open Access Journals (Sweden)

    Seneviratne RW

    2015-05-01

    Full Text Available Background This study was designed to evaluate the accuracy and usefulness of ultrasound in the hands of emergency physicians and medical officers who are non-radiologistsin assessing Trauma patients at Emergency Trauma Centre(ETC at Teaching Hospital, Karapitiya, Galle, Sri Lanka Methodology We performed an observational study on Trauma patients admitted to Emergency Department at Teaching Hospital, Karapitiya from 1.12.2014 to 31.12.2014 who fulfilled indications for e-FAST using a specially designed performa. Accuracy of eFAST was tested by comparing the original with subsequent imaging, clinical decision by surgeons, findings at surgery or more than one of the above. Results 69 patients fulfilled the entry criteria.Nineteen of the scans were performed by consultants while rest was done by senior medical officers. All of them were trained in eFAST. Of the 20 scans which were positive there were four pneumothoraxes and one haemothorax. 15 scans which were positive for intraperitoneal free fluid were later. Out of 49 Patients who had negative scans 47 did not require surgery or any interventions. Other two required laparotomy later. Sensitivity and specificity ofeFast was 90.4% and 97.9% respectively. Positive predictive value was 95.0% while Negative predictive value was at 95.9% . Conclusions eFAST is a rapidand reliable alternative in detecting free intra-abdominal fluid as well as pneumotorax and haemothorax. It is a safe decision making tool which can be used with confidence and accuracy after brief training and experience by non radiologists which will reduce morbidity and mortality in trauma patients of Sri Lanka.

  3. [Impact of a pre-operative mobilisation program using the Viv-Arte training model based on kinesthetic mobilisation on mobility, pain, and post-operation length of stay of patients receiving an elective medial laparotomy: a prospective, randomised, controlled pilot study].

    Science.gov (United States)

    Haasenritter, Jörg; Eisenschink, Anna Maria; Kirchner, Elisabeth; Bauder-Missbach, Heidi; Brach, Michael; Veith, Jessica; Sander, Silvia; Panfil, Eva-Maria

    2009-02-01

    A medial incision is a common surgical technique to obtain access to the abdomen. Thereby, the muscles involved in movement are manipulated, leading to post-operative restrictions in mobility and pain determined by movement. The aim of this pilot study was to assess the impact of a pre-operative training session using the Viv-Arte model, which is based on kinesthetic mobilisation principles. The parameters to be measured were mobility, pain, and length of hospital stay for patients, who were undergoing elective medial laparotomy. In addition, the study tested the research design and to identify possible effect sizes. The method chosen was a prospective, randomised, controlled, and unblinded design. Twenty-seven patients were involved (median=63 years, 19 of the patients were male) who were to have a medial incision for cystectomy. The intervention involved pre-operative training of post-operative mobility techniques. Mobility was tested using the "Mobilitätstest für Patienten im Akutkrankenhaus (MOTPA) (Mobility test for patients in hospital)"; pain intensity was assessed using the visual analogue scale. The intervention and control groups were comparable for all variables. There were no significant differences in the two groups related to the objectives. It is possible that the study groups or the operationalisation were not appropriate for testing the effects of the intervention. It seems important to continue to develop instruments that are appropriate for measuring the effect of mobility-related interventions.

  4. Emergency Shelter Grantee (ESG) Areas

    Data.gov (United States)

    Department of Housing and Urban Development — The Emergency Shelter Grants (ESG) program is designed to identify sheltered and unsheltered homeless persons, as well as those at risk of homelessness, and provide...

  5. Emergency Medical Service (EMS) Stations

    Data.gov (United States)

    Kansas Data Access and Support Center — EMS Locations in Kansas The EMS stations dataset consists of any location where emergency medical services (EMS) personnel are stationed or based out of, or where...

  6. Emergency preparedness of OSBRA Pipeline

    Energy Technology Data Exchange (ETDEWEB)

    Magalhaes, Milton P.; Torres, Carlos A.R.; Almeida, Francisco J.C. [TRANSPETRO, Rio de Janeiro, RJ (Brazil)

    2009-07-01

    This paper presents the experience of PETROBRAS Transporte S. A. - TRANSPETRO in the preparation for emergencies in the OSBRA pipeline, showing specific aspects and solutions developed. The company has a standardized approach for the emergency management, based on risk analysis studies, risk management plan and contingency plans. To cover almost 1,000 km of pipeline, the Company avails of Emergency Response Centers and Environmental Defense Center, located at strategic points. In order to achieve preparation, fire fighting training and oil leakage elimination training are provided. Additionally, simulation exercises are performed, following a schedule worked out according to specific criteria and guidelines. As a conclusion, a picture is presented of the evolution of the preparation for emergencies in the OSBRA System which bears the enormous responsibility of transporting flammable products for almost 1,000 km of pipeline, crossing 40 municipalities, 3 states and the Federal District. (author)

  7. LOG DURATION EMERGENCY OXYGEN BACKPACK.

    Science.gov (United States)

    A small backpack , for use by Naval aviators, containing a long duration emergency oxygen system and a separate humidifier for the aircraft’s oxygen supply, has been devised and a feasibility model built. (Author)

  8. Poison control center - emergency number

    Science.gov (United States)

    For a POISON EMERGENCY call: 1-800-222-1222 ANYWHERE IN THE UNITED STATES This national hotline number will let you ... is a free and confidential service. All local poison control centers in the United States use this ...

  9. Responding to a Choking Emergency

    Science.gov (United States)

    ... the airway could turn into a complete one. Heimlich Maneuver However, if your youngster cannot breathe at all, ... someone call 911 for emergency services. Perform the Heimlich maneuver on your youngster. For the middle-years child, ...

  10. Energy Emergency and Contingency Planning

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Region 3 document outlines the purpose of Energy Emergency and Contingency Plans. These plans are intended to help refuges continue to function during energy...

  11. Emerging Contaminants in the Environment

    Science.gov (United States)

    This chapter explores the use of mass spectrometry and its application to emerging contaminants (ECs) in the environment; such classes of compounds as organometallics, pharmaceuticals/drugs, nanomaterials, and dispersants (surfactants). Table 1 shows the variety of ECs that are...

  12. Flux Emergence at the Photosphere

    Science.gov (United States)

    Cheung, M. C. M.; Schüssler, M.; Moreno-Insertis, F.

    2006-12-01

    To model the emergence of magnetic fields at the photosphere, we carried out 3D magneto-hydrodynamics (MHD) simulations using the MURaM code. Our simulations take into account the effects of compressibility, energy exchange via radiative transfer and partial ionization in the equation of state. All these physical ingredients are essential for a proper treatment of the problem. In the simulations, an initially buoyant magnetic flux tube is embedded in the upper layers of the convection zone. We find that the interaction between the flux tube and the external flow field has an important influence on the emergent morphology of the magnetic field. Depending on the initial properties of the flux tube (e.g. field strength, twist, entropy etc.), the emergence process can also modify the local granulation pattern. The inclusion of radiative transfer allows us to directly compare the simulation results with real observations of emerging flux.

  13. Responding to a Suicide Emergency

    Science.gov (United States)

    ... have to leave, make sure another friend or family member can stay with the person until they can receive professional help. If a person attempts suicide, immediately call for emergency medical assistance. Administer first ...

  14. [Mechanic reinfusion in emergency surgery].

    Science.gov (United States)

    Ermolov, A S; Khvatov, V B; Kobzeva, E N; Valetova, V V; Makarov, M S

    2012-01-01

    The article highlights techniques and effects of intraoperative mechanic blood reinfusion in patients with trauma and intraabdominal bleeding in extend, exceeding the self circulating blood volume. The high efficacy of the self blood reinfusion during the emergency operation allowed the 2-fold decrease of the hospital and overall mortality. The mechanic blood reinfusion proved to be a safe and clinically effective method of the globular blood volume deficiency compensation, especially in emergency surgery.

  15. Nanotechnology of emerging targeting systems.

    Science.gov (United States)

    Smith, S S

    2008-09-01

    Recent developments in the design and testing of complex nanoscale payload-carrying systems (i.e. systems with payloads that do not exceed 100 nm in size) are the focus of this brief review. Emerging systems include targeted single-walled nanotubes, viral capsids, dendrimers, gold nanoparticles, milled boron carbide nanoparticles, and protein nucleic acid assemblies. Significant advances are emerging with each of these bionanotechnological approaches to cellular targeting.

  16. Extraction de motifs graduels emergents

    OpenAIRE

    Laurent, Anne; Lesot, Marie-Jeanne; Rifqi, Maria

    2015-01-01

    National audience; Mining emerging patterns aims at contrasting data sets and identifying itemsets that characterise a data set by contrast to a reference data set, so as to capture and highlight their differences. This paper considers the case of emerging gradual patterns, to extract discriminant attribute co-variations. It discusses the specific features of these gradual patterns and proposes to transpose an efficient border-based algorithm, justifying its applicability to the gradual case....

  17. Leadership and the emergency department.

    Science.gov (United States)

    LaSalle, Gar

    2004-02-01

    Emergency medicine, as the nation's health care system's safety net, is facing ever increasing demands on its resources and infrastructure. Classic and modern theories of leadership, which include broader based models that in corporate team responsibilities, should be studied by anyone wearing the mantle of leadership in emergency medicine, and the Realpolitik of the modern hospital must be accommodated if leadership efforts are to succeed.

  18. Nanotechnology of emerging targeting systems

    Science.gov (United States)

    SMITH, S. S.

    2011-01-01

    Recent developments in the design and testing of complex nanoscale payload-carrying systems (i.e. systems with payloads that do not exceed 100 nm in size) are the focus of this brief review. Emerging systems include targeted single-walled nanotubes, viral capsids, dendrimers, gold nanoparticles, milled boron carbide nanoparticles, and protein nucleic acid assemblies. Significant advances are emerging with each of these bionanotechnological approaches to cellular targeting. PMID:21687833

  19. A Milestone For Emerging Economies

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The Sanya summit taps the potential of BRICS collaboration On April14,leaders of Brazil,Russia,India,China and South Africa,known as BRICS,held a one-day summit in Sanya,a resort city in south China’s Hainan Province.The group’s third summit presented thriving cooperation momentum among these emerging economies.Achievements The Sanya Declaration was the major policy statement to emerge from the conference.While including economic spheres,

  20. The Comprehensive Emergent Literacy Model

    Directory of Open Access Journals (Sweden)

    Leigh Rohde

    2015-03-01

    Full Text Available The early skills of Emergent Literacy include the knowledge and abilities related to the alphabet, phonological awareness, symbolic representation, and communication. However, existing models of emergent literacy focus on discrete skills and miss the perspective of the surrounding environment. Early literacy skills, including their relationship to one another, and the substantial impact of the setting and context, are critical in ensuring that children gain all of the preliminary skills and awareness they will need to become successful readers and writers. Research findings over the last few decades have led to a fuller understanding of all that emergent literacy includes, resulting in a need for a new, more comprehensive model. A new model, described in this article, strives to explain how emergent literacy can be viewed as an interactive process of skills and context rather than a linear series of individual components. Early literacy learning opportunities are more likely to happen when teachers have a solid knowledge base of emergent literacy and child development. Research has shown that preschool teachers with limited knowledge about literacy development are significantly less able to provide such experiences for children. Teachers will be better able to facilitate all of the components of emergent literacy if they have access to, and understanding of, a model that describes the components, their interactions, and the importance of environmental factors in supporting children.

  1. Effect of emergency operation combined with somatostatin therapy on inflammatory state and liver function levels in patients with acute cholecystitis

    Institute of Scientific and Technical Information of China (English)

    Shi-Zhong Li

    2016-01-01

    Objective:To study the effect of emergency operation combined with somatostatin therapy on inflammatory state and liver function levels in patients with acute cholecystitis.Methods:A total of 146 acute cholecystitis patients who accepted laparoscopic cholecystectomy in our hospital from May 2012 to October 2015 were selected as the research subjects and divided into somatostatin group and normal control group. Then the operation, perioperative energy metabolism as well as postoperative inflammatory state and liver function levels of the two groups were analyzed.Results:Operative field exposure of somatostatin group was clearer, local tissue edema and exudation were lighter and conversion rate to laparotomy was lower; perioperative REE of somatostatin group were significantly lower than those of normal control group; the very day after operation, numeration of leukocyte, neutrophil ratio as well as serum resistin, hypersensitive C-reactive protein and tumor necrosis factor-α, interleukin-6, total bilirubin, alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase levels of somatostatin group were significantly lower than those of normal control group while prealbumin level was significantly higher than that of normal control group.Conclusions:Perioperative application of somatostatin can reduce the body's inflammatory response, local tissue edema and liver function injury. It is an ideal treatment for perioperative acute cholecystitis.

  2. Gallstone Ileus: a Surgical Emergency Presentation Íleo biliar: presentación en la urgencia quirúrgica

    Directory of Open Access Journals (Sweden)

    Reinaldo Jiménez Prendes

    2011-12-01

    Full Text Available The case of a 60 years old female patient with a history of gallstones that was admitted as an emergency because of abdominal pain, vomiting and abdominal distension of 2 days is presented. The patient presented also secondary moderate dehydration. In a simple abdominal radiography, radiological signs of intestinal occlusion were found. Electrolyte imbalance was corrected and an exploratory laparotomy was performed. Through this procedure, a large stone was found in the terminal ileum. Enterolithotomy was performed along with enterorraphy, thus solving the occlusion.Se presenta el caso de una paciente de 60 años de edad, con antecedentes de litiasis vesicular, que ingresó de urgencia por presentar un cuadro de dolor abdominal, vómitos y distensión en el abdomen con 2 días de evolución. De forma secundaria presentó una deshidratación moderada. En la radiografía simple de abdomen se constataron signos radiológicos de oclusión intestinal. Se corrigió el desequilibrio hidroelectrolítico y se realizó una laparotomía exploradora, en la que se encontró un cálculo grande enclavado en el íleon terminal. Se realizó una enterolitotomía con enterorrafia y resolvió el cuadro oclusivo.

  3. Emergency management logistics must become emergency supply chain management.

    Science.gov (United States)

    Young, Richard R; Peterson, Matthew R

    2014-01-01

    Much has been written about how emergency management (EM) needs to look to the future regarding issues of resource management (monetary, human, and material). Constraints on budgets are ongoing and the staffing of emergency response activities is often difficult because volunteers have little to no training. The management of material resources has also been a challenge because 1) the categories of material vary by the type of emergency, 2) the necessary quantities of material are often not located near the ultimate point of need, and 3) the transportation assets are rarely available in the form and quantity required to allow timely and effective response. The logistics and resource management functions of EM (what we refer to as EM logistics) have been largely reactive, with little to no pre-event planning for potential demand. We applied the Supply Chain Operational Reference (SCOR) model to EM logistics in an effort to transform it to an integrated and scalable system of physical, information, and financial flows into which are woven the functions of sourcing, making, delivering, and returning, with an overarching planning function that transcends the organizational boundaries of participants. The result is emergency supply chain management, which embraces many more participants who share in a larger quantity of more useful information about the resources that need to be deployed when responding to and recovering from emergency events.

  4. Alternative management of diabetic ketoacidosis in a Brazilian pediatric emergency department

    Directory of Open Access Journals (Sweden)

    Savoldelli Roberta D

    2010-06-01

    Full Text Available Abstract DKA is a severe metabolic derangement characterized by dehydration, loss of electrolytes, hyperglycemia, hyperketonemia, acidosis and progressive loss of consciousness that results from severe insulin deficiency combined with the effects of increased levels of counterregulatory hormones (catecholamines, glucagon, cortisol, growth hormone. The biochemical criteria for diagnosis are: blood glucose > 200 mg/dl, venous pH 3 mmol/L and presence of ketonuria. A patient with DKA must be managed in an emergency ward by an experienced staff or in an intensive care unit (ICU, in order to provide an intensive monitoring of the vital and neurological signs, and of the patient's clinical and biochemical response to treatment. DKA treatment guidelines include: restoration of circulating volume and electrolyte replacement; correction of insulin deficiency aiming at the resolution of metabolic acidosis and ketosis; reduction of risk of cerebral edema; avoidance of other complications of therapy (hypoglycemia, hypokalemia, hyperkalemia, hyperchloremic acidosis; identification and treatment of precipitating events. In Brazil, there are few pediatric ICU beds in public hospitals, so an alternative protocol was designed to abbreviate the time on intravenous infusion lines in order to facilitate DKA management in general emergency wards. The main differences between this protocol and the international guidelines are: intravenous fluid will be stopped when oral fluids are well tolerated and total deficit will be replaced orally; if potassium analysis still indicate need for replacement, it will be given orally; subcutaneous rapid-acting insulin analog is administered at 0.15 U/kg dose every 2-3 hours until resolution of metabolic acidosis; approximately 12 hours after treatment initiation, intermediate-acting (NPH insulin is initiated at the dose of 0.6-1 U/kg/day, and it will be lowered to 0.4-0.7 U/kg/day at discharge from hospital.

  5. Semiose e emergência

    Directory of Open Access Journals (Sweden)

    Charbel Niño El-Hani

    2008-11-01

    Full Text Available Nosso propósito, neste artigo, é discutir se, e em que sentido, a semiose pode ser caracterizada como processo "emergente" em sistemas semióticos. Não nos interessa quando ou como a semiose emergiu no universo. Como um pré-requisito para a própria formulação desses problemas, estamos interessados em discutir as condições que devem ser satisfeitas para que a semiose possa ser caracterizada como um processo emergente. O primeiro passo foi sumarizar a análise sistemática da variedade de teorias da emergência elaborada por A. Stephan. Ao longo da apresentação, formulamos questões fundamentais, que precisam ser respondidas para qualificar com precisão os objetivos teóricos propostos. Palavras-chave semiose, emergência, estruturalismo hierárquico, C. S. Peirce Abstract In this paper, we intend to discuss whether and in what sense semiosis can be characterised as an "emergent" process in semiotic systems. We are not interested in knowing when or how semiosis emerged in the universe. Rather, as a requisite for the very formulation of these problems, we are interested in discussing the conditions that shall be fulfilled for semiosis to be characterised as an emergent process. The first step was to summarize A. Stephan's systematic analysis of the variety of emergence theories. During the course of the analysis, we pose fundamental questions that need to be answered in order to qualify our theoretical objectives. Key words semiosis, emergence, hierarchical structuralism, C. S. Peirce

  6. Towards the feeling of emergence.

    Science.gov (United States)

    Cambray, Joe

    2006-02-01

    Emergence is a multi-dimensional notion; the meanings it has acquired span the mythopoetic to the scientific, especially as found in complex systems. Examples of emergence in Navaho and Egyptian imagery underscore its diverse cultural origins and applications as well as suggesting an underlying archetypal quality to the core concept. A brief overview of the use of this term in science starting in the 17th century helps to locate the roots of modern emergent views in the philosophy of Leibniz. Jung's own use of early systems approaches was a part of his formulations of a 'third' position associated with the transcendent function. As this paper was delivered at the 50th anniversary conference of the Journal of Analytical Psychology, aspects of the emergence of the Journal within the contents of the first issue are explored. Attention is drawn to several articles, especially a case of brief child therapy done by Robert Moody. His approach to working his case is strikingly modern and vividly demonstrates principles of emergence within the clinical setting. Following this there is a discussion of some neuroscientific research on neural body maps, pointing to the experience of feelings as an emergent process. It is suggested that feelings derive from phase transitions in the brain's body mapping states. A reconsideration of a seeming impasse in the case described by Moody leads instead to a view of the initial phase of treatment as a pre-critical period. Research findings on mirror neurons are presented in terms of the feeling of empathy. Subjective feelings are then shown to be associated with moments of emergence, especially surprise and curiosity, exemplified by a case from the author's practice.

  7. Pre-hospital emergency medicine.

    Science.gov (United States)

    Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E

    2015-12-19

    Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes. The transfer of skills and procedures from hospital care to pre-hospital medicine enables early advanced care across a range of disciplines. The variety of possible pathologies, challenges of environmental factors, and hazardous situations requires management that is tailored to the patient's clinical need and setting. Pre-hospital clinicians should be generalists with a broad understanding of medical, surgical, and trauma pathologies, who will often work from locally developed standard operating procedures, but who are able to revert to core principles. Pre-hospital emergency medicine consists of not only clinical care, but also logistics, rescue competencies, and scene management skills (especially in major incidents, which have their own set of management principles). Traditionally, research into the hyper-acute phase (the first hour) of disease has been difficult, largely because physicians are rarely present and issues of consent, transport expediency, and resourcing of research. However, the pre-hospital phase is acknowledged as a crucial period, when irreversible pathology and secondary injury to neuronal and cardiac tissue can be prevented. The development of pre-hospital emergency medicine into a sub-specialty in its own right should bring focus to this period of care.

  8. [Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital].

    Science.gov (United States)

    Rodríguez Artalejo, F; González Montalvo, J I; Sanz Segovia, F; Jaramillo Gómez, E; Banegas Banegas, J R; Rodríguez Mañas, L; Carbonell Collar, A

    1989-10-14

    The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.

  9. OEM Emergency Prevention and Mitigation Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management maintains information relevant to preventing emergencies before they occur, and/or mitigating the effects of emergency when they...

  10. BUS 438 Concepts of Emerging Markets

    OpenAIRE

    Laynebaril

    2017-01-01

    BUS 438 Concepts of Emerging Markets Click Link Below To Buy: http://hwcampus.com/shop/bus-438-concepts-of-emerging-markets/   BUS438 BUS/438  MODULE 3 ASSIGNMENT 3 Concepts of Emerging Markets [ARGOSY

  11. Emergence Unites Ecology and Society

    Directory of Open Access Journals (Sweden)

    Ronald L. Trosper

    2005-06-01

    Full Text Available The effort to combine analysis of ecosystems and social systems requires a firm theoretical basis. When humans are present in an ecosystem, their actions affect emergent structures; this paper examines forms of emergence that account for the presence of humans. Humans monitor and regulate ecosystems based on their cultural systems. Cultural systems consist of concepts linked in complicated ways that can form consistent world views, can contain inconsistencies, and may or may not accurately model the properties of a social–ecological system. Consequently, human monitoring and regulating processes will differ, depending on cultural systems. Humans, as agents, change or maintain pre-existing material and cultural emergent structures. The presentation is illustrated with a case study of fire-prone forests. The paper shows that explicit attention to emergence serves very well in unifying the following requirements for social–ecological analysis: coherent and observable definitions of sustainability; ways to link ecological and social phenomena; ways to understand cultural reasons for stability and instability in dynamic social–ecological systems; and ways to include human self-evaluation and culture within dynamic models of social–ecological systems. Analysis of cultural emergent structures clarifies many differences in assumptions among the fields of economics, sociology, political science, ecology, and ecological economics. Because it can be readily applied to empirical questions, the framework provides a good way to organize policy analysis that is not dominated by one or another discipline.

  12. In-flight Medical Emergencies

    Directory of Open Access Journals (Sweden)

    Amit Chandra

    2013-09-01

    Full Text Available Introduction: Research and data regarding in-flight medical emergencies during commercial air travel are lacking. Although volunteer medical professionals are often called upon to assist, there are no guidelines or best practices to guide their actions. This paper reviews the literature quantifying and categorizing in-flight medical incidents, discusses the unique challenges posed by the in-flight environment, evaluates the legal aspects of volunteering to provide care, and suggests an approach to managing specific conditions at 30,000 feet.Methods: We conducted a MEDLINE search using search terms relevant to aviation medical emergencies and flight physiology. The reference lists of selected articles were reviewed to identify additional studies.Results: While incidence studies were limited by data availability, syncope, gastrointestinal upset, and respiratory complaints were among the most common medical events reported. Chest pain and cardiovascular events were commonly associated with flight diversion.Conclusion: When in-flight medical emergencies occur, volunteer physicians should have knowledge about the most common in-flight medical incidents, know what is available in on-board emergency medical kits, coordinate their therapy with the flight crew and remote resources, and provide care within their scope of practice. [West J Emerg Med. 2013;14(5:499–504.

  13. Common abdominal emergencies in children.

    Science.gov (United States)

    D'Agostino, James

    2002-02-01

    Because young children often present to EDs with abdominal complaints, emergency physicians must have a high index of suspicion for the common abdominal emergencies that have serious sequelae. At the same time, they must realize that less serious causes of abdominal symptoms (e.g., constipation or gastroenteritis) are also seen. A gentle yet thorough and complete history and physical examination are the most important diagnostic tools for the emergency physician. Repeated examinations and observation are useful tools. Physicians should listen carefully to parents and their children, respect their concerns, and honor their complaints. Ancillary tests are inconsistent in their value in assessing these complaints. Abdominal radiographs can be normal in children with intussusception and even malrotation and early volvulus. Unlike the classic symptoms seen in adults, young children can display only lethargy or poor feeding in cases of appendicitis or can appear happy and playful between paroxysmal bouts of intussusception. The emergency physician therefore, must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints. Eventually, all significant abdominal emergencies reveal their true nature, and if one can be patient with the child and repeat the examinations when the child is quiet, one will be rewarded with the correct diagnosis.

  14. OPPORTUNITIES IN SMR EMERGENCY PLANNING

    Energy Technology Data Exchange (ETDEWEB)

    Moe, Wayne

    2014-06-01

    This paper discusses the results of a cost/benefit-oriented assessment related to sizing of the emergency planning zones (EPZs) for advanced, small modular reactors (SMRs). An appropriately sized EPZ could result in significant cost savings for SMR licensees. Papers published by the U.S. Nuclear Regulatory Commission and other organizations discuss the applicability of current emergency preparedness regulatory requirements to SMRs, including determining an appropriate EPZ size. Both the NRC and the industry recognize that a methodology should be developed for determining appropriate EPZ sizing for SMRs. Relative costs for smaller EPZs envisioned for SMRs have been assessed qualitatively as discussed in this paper. Building off the foundation provided in the earlier papers, this paper provides a quantitative cost/benefit-oriented assessment of offsite emergency planning costs for EPZ sizes that may be justified for SMRs as compared to costs typically incurred for the current fleet of U.S. nuclear power plants. This assessment determined that a licensee utilizing a smaller EPZ could realize significant savings in offsite emergency planning costs over the nominal 40-year lifetime for an SMR. This cost/benefit-oriented assessment suggests that a reduction of the plume exposure pathway EPZ from 10 miles to the site boundary could reduce offsite emergency planning related costs by more than 90% over the 40 year life of a typical single unit nuclear power plant.

  15. Hazardous Materials Management and Emergency Response (HAMMER)

    Data.gov (United States)

    Federal Laboratory Consortium — The Volpentest Hazardous Materials Management and Emergency Response (HAMMER) Federal Training Center is a safety and emergency response training center that offers...

  16. EMERGENCE FROM LOCAL EVALUATION FUNCTION

    Institute of Scientific and Technical Information of China (English)

    HAN Jing; CAI Qingsheng

    2003-01-01

    This paper presents a new look on emergence from the aspect of locality and globality of evaluation functions for solving traditional computer problems. We first translate the Constraint Satisfaction Problem (CSP) into the multi-agent system, and then show how a global solution emerges from the system in which every agent uses a local evaluation function to decide its action, while comparing to other traditional algorithms, such as Local search and Simulated Annealing which use global evaluation functions. We also give some computer experimental results on large-scale N-queen problems and k-Coloring problems, and show that emergence only depends on problem instance, not details of agent settings, i.e. in some CSPs, the system can self-organize to a global solution, but can not in some other CSPs no matter what settings of agents have.

  17. ICT Innovation in Emerging Economies

    DEFF Research Database (Denmark)

    Xiao, Xiao; B. Califf, Christopher; Sarker, Saonee

    2013-01-01

    ICT innovation is known to significantly elevate a country’s growth and to enhance productivity. It is now well-acknowledged that emerging economies are beginning to innovate at a rapid rate despite some of the challenges they face. Given that these countries with such economies now comprise...... research till date has been conducted on this topic, and the few existing studies have failed to catch the attention of the mainstream IS research community. We believe that the absence of studies is primarily due to a lack of understanding of what has been found with respect to ICT innovation in emerging...... economies, what needs to be studied, and how they should be studied. We attempt to contribute in this area by: (1) providing a comprehensive framework of existing research on ICT innovation in emerging economies, (2) highlighting the gaps that have been left behind, and (3) providing specific guidelines...

  18. Emergent Universe with Particle Production

    Science.gov (United States)

    Gangopadhyay, Sunandan; Saha, Anirban; Mukherjee, S.

    2016-10-01

    The possibility of an emergent universe solution to Einstein's field equations allowing for an irreversible creation of matter at the expense of the gravitational field is shown. With the universe being chosen as spatially flat FRW spacetime together with equation of state proposed in Mukherjee et al. (Class. Quant. Grav. 23, 6927, 2006), the solution exists when the ratio of the phenomenological matter creation rate to the number density times the Hubble parameter is a number β of the order of unity and independent of time. The thermodynamic behaviour is also determined for this solution. Interestingly, we also find that an emergent universe scenario is present with usual equation of state in cosmology when the matter creation rate is chosen to be a constant. More general class of emergent universe solutions are also discussed.

  19. Catatonia in the emergency department.

    Science.gov (United States)

    Jaimes-Albornoz, Walter; Serra-Mestres, Jordi

    2012-11-01

    Disturbances of the level of awareness are a frequent motive of attendance to emergency departments where the initial assessment and management will determine the direction of their outcome. The syndrome of catatonia must be taken into consideration and although it is normally associated with psychiatric diagnoses, it is also very often found in a great variety of neurological and medical conditions. Due to the clinical complexity of catatonia, there are still difficulties in its correct identification and initial management, something that leads to diagnostic delays and increased morbidity and mortality. In this article, a review of the literature on catatonia is presented with the aim of assisting emergency department doctors (and clinicians assessing patients in emergency situations) in considering this condition in the differential diagnosis of stupor due to its high frequency of association with organic pathology.

  20. Emergency ultrasound and gallstone ileus.

    Science.gov (United States)

    Zironi, Gianni; Modolon, Cecilia; Cavazza, Mario

    2007-04-01

    Gallstone ileus is an uncommon cause of mechanical obstruction due to a biliary stone that wedges the intestinal lumen. It is a surgical emergency representing a clinical and diagnostic challenge: the clinical manifestations are rarely specific, often causing diagnostic delay that can adversely affect the prognosis. Emergency ultrasound could be useful in assessing the level and identifying the cause of bowel obstruction. We report a case of a 74-year-old patient with a 6-day history of constipation and crampy abdominal pain without previous history of abdominal diseases. Emergency ultrasound led to an early diagnosis showing dilated small bowel loops with a shadowing mass inside consistent with an ileal stone, in the absence of aberrant located stone on plain abdominal film.

  1. Transient stability and emergency control

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Comparability of emergency control strategies with different instability modes is the key issue to decide which control strategy to be implemented. This paper considers that the essential factor causing instability should be used to form a unified standard to assess the effectiveness of control strategies with different instability modes. Thus a switching control stabilization principle was proposed based on elimination of the unbalanced energy between mechanical and electrical energies of generator sets. Along this way, the difficulty of seeking a Lyapunov function was circumvented. According to the principle, an emergency control algorithm framework was established to handle transient stability assessment, control location selection and control amount evaluation. Within the framework, this paper studied instability mode transition, then proposed an algorithm based on prediction function and a new approach to normalized stability margin stemmed from static EEAC method, which can increase comparability of various control locations. The simulations on the New-England System verified the proposed emergency control method for stabilizing transient stability.

  2. The emergency department medical director.

    Science.gov (United States)

    Mayer, T A

    1987-02-01

    This article has presented an overview of the duties, responsibilities, and management roles of the emergency department Medical Director, a position that can be among the most challenging, stimulating, and exciting in medicine. However, prior to accepting a position as an Emergency Department medical director, one should have a clear understanding of what the job entails. Careful discussions with the hospital administration, medical staff, nursing personnel, and staff emergency physicians should be undertaken to learn the perceptions of these people and expectations of the position. Once the job has been accepted, using the roles, responsibilities, and duties detailed herein may be of benefit--but should always be applied with good judgment, tactful cooperation, and common sense. Finally, it should not be surprising to a medical director to find, as Spinoza did many years ago, that the excellent thing he aspires to are as difficult as they are rare.

  3. The Emergence of City Logistics

    DEFF Research Database (Denmark)

    2014-01-01

    Purpose: Many city logistics projects in Europe have failed. The purpose of this article is to increase understanding of how city logistics emerge. A better understanding of the complex organizational processes with many actors and stakeholders in city logistics projects may prevent further...... failures. Design/methodology/approach: Theory on organizational change is applied to capture the processes leading to emergence of city logistics. The methodology is process analysis on a single longitudinal case. Findings: The emergence of the Copenhagen city logistics project can be understood....... The study aims at understanding the social processes towards reduced congestion and greenhouse gas emissions from goods transport in inner cities. Originality/value: By better understanding the organization processes leading to implementation of city logistics, other projects in other cities may learn from...

  4. Emergence: complexity pedagogy in action.

    Science.gov (United States)

    Jonas-Simpson, Christine; Mitchell, Gail; Cross, Nadine

    2015-01-01

    Many educators are looking for new ways to engage students and each other in order to enrich curriculum and the teaching-learning process. We describe an example of how we enacted teaching-learning approaches through the insights of complexity thinking, an approach that supports the emergence of new possibilities for teaching-learning in the classroom and online. Our story begins with an occasion to meet with 10 nursing colleagues in a three-hour workshop using four activities that engaged learning about complexity thinking and pedagogy. Guiding concepts for the collaborative workshop were nonlinearity, distributed decision-making, divergent thinking, self-organization, emergence, and creative exploration. The workshop approach considered critical questions to spark our collective inquiry. We asked, "What is emergent learning?" and "How do we, as educators and learners, engage a community so that new learning surfaces?" We integrated the arts, creative play, and perturbations within a complexity approach.

  5. Emergency contraception: different bioethical perspectives

    Directory of Open Access Journals (Sweden)

    Marco Bo

    2007-10-01

    Full Text Available Emergency contraceptives, in this case post-morning pills, are contraceptive methods used to avoid an unwanted pregnancy after an unprotected sexual intercourse. Their use is feeding a strong ethical debate between subjects for and against their prescription and leading some health professionals to conscientious objection. Among people contrary to prescription some oppose to it because of a general refuse of all contraceptive methods, others considering post-morning pills as abortive. Among people supporting prescription, some consider emergency contraception necessary to assure fundamental women’s rights, in particular the right to sexual auto-determination, while others prescribe emergency contraception only to avoid a greater demand for abortion. It is up to the Italian National Health Service warranting a correct balance between the two opposite positions, that can protect women’s right of access to health services.

  6. Professional Emergence on Transnational Issues

    DEFF Research Database (Denmark)

    Seabrooke, Leonard; Tsingou, Eleni

    2015-01-01

    they are conceptually linked by actors and organizations. A linked ecologies approach asks us to displace locating known actors within structures and instead pays attention to professional interactions on how ‘issue distinctions’ are made, the relationship between issue distinctions and professional tasks, and who......Addressing complex transnational problems requires coordination from different professionals. The emergence of new actors and issues has been addressed by those interested in studies of organizations through concepts and methods that highlight the importance of communities, fields, and networks....... These approaches are important in identifying the sources of what becomes established, but less geared to identifying interactions that are emergent. This article extends a linked ecologies approach to emergence, arguing that interaction on transnational issues should first be understood by how...

  7. The emerging story of emerging technologies in neuropsychiatry.

    Science.gov (United States)

    Coffey, M Justin; Coffey, C Edward

    2016-06-01

    The growth of new technologies in health care is exponential, and the impact of such rapid technological innovation on health care delivery is substantial. This review describes two emerging technologies-mobile applications and wearable technologies-and uses a virtual case report to illustrate the impact of currently available technologies on the health care experience of a patient with neuropsychiatric illness.

  8. Emerging and re-emerging arboviral diseases in Southeast Asia

    Directory of Open Access Journals (Sweden)

    A. P. Dash

    2013-04-01

    Full Text Available Arthropod-borne viruses (arboviruses have become significant public health problems, with the emergence and re-emergence of arboviral diseases nearly worldwide. The most populated Southeast Asia region is particularly vulnerable. The arboviral diseases such as dengue (DEN, Japanese encephalitis (JE, West Nile virus (WNV, chikungunya fever (CHIK, hemorrhagic fevers such as Crimean-Congo hemorrhagic (CCHF fever, Kyasanur forest disease virus (KFDV, etc. are on the rise and have spread unprecedentedly, causing considerable burden of disease. The emergence/re-emergence of these diseases is associated with complex factors, such as viral recombination and mutation, leading to more virulent and adaptive strains, urbanization and human activities creating more permissive environment for vector-host interaction, and increased air travel and commerce. Climate is a major factor in determining the geographic and temporal distribution of arthropods, the characteristics of arthropod life cycles, the consequent dispersal patterns of associated arboviruses, the evolution of arboviruses; and the efficiency with which they are transmitted from arthropods to vertebrate hosts. The present and future arboviral threats must be mitigated by priority actions such as improving surveillance and outbreak response, establishing collaboration and communication intersectorally, and strengthening the prevention and control programmes along with improving biosafety aspects with regards to highly infectious nature of these arboviral diseases. Evidence from research needs to be generated and priority areas for research defined.

  9. The emerging story of emerging technologies in neuropsychiatry

    Science.gov (United States)

    Coffey, M. Justin; Coffey, C. Edward

    2016-01-01

    The growth of new technologies in health care is exponential, and the impact of such rapid technological innovation on health care delivery is substantial. This review describes two emerging technologies—mobile applications and wearable technologies—and uses a virtual case report to illustrate the impact of currently available technologies on the health care experience of a patient with neuropsychiatric illness. PMID:27489452

  10. Emergency department overcrowding: the Emergency Department Cardiac Analogy Model (EDCAM).

    Science.gov (United States)

    Richardson, Sandra K; Ardagh, Michael; Gee, Paul

    2005-01-01

    Increasing patient numbers, changing demographics and altered patient expectations have all contributed to the current problem with 'overcrowding' in emergency departments (EDs). The problem has reached crisis level in a number of countries, with significant implications for patient safety, quality of care, staff 'burnout' and patient and staff satisfaction. There is no single, clear definition of the cause of overcrowding, nor a simple means of addressing the problem. For some hospitals, the option of ambulance diversion has become a necessity, as overcrowded waiting rooms and 'bed-block' force emergency staff to turn patients away. But what are the options when ambulance diversion is not possible? Christchurch Hospital, New Zealand is a tertiary level facility with an emergency department that sees on average 65,000 patients per year. There are no other EDs to whom patients can be diverted, and so despite admission rates from the ED of up to 48%, other options need to be examined. In order to develop a series of unified responses, which acknowledge the multifactorial nature of the problem, the Emergency Department Cardiac Analogy model of ED flow, was developed. This model highlights the need to intervene at each of three key points, in order to address the issue of overcrowding and its associated problems.

  11. The Emergency Landing Planner Experiment

    Science.gov (United States)

    Meuleau, Nocolas F.; Neukom, Christian; Plaunt, Christian John; Smith, David E.; Smith, Tristan B.

    2011-01-01

    In previous work, we described an Emergency Landing Planner (ELP) designed to assist pilots in choosing the best emergency landing site when damage or failures occur in an aircraft. In this paper, we briefly describe the system, but focus on the integration of this system into the cockpit of a 6 DOF full-motion simulator and a study designed to evaluate the ELP. We discuss the results of this study, the lessons learned, and some of the issues involved in advancing this work further.

  12. Psychiatric Emergencies in the Elderly.

    Science.gov (United States)

    Sikka, Veronica; Kalra, S; Galwankar, Sagar; Sagar, Galwankar

    2015-11-01

    With the increasing life expectancy, the geriatric population has been increasing over the past few decades. By the year 2050, it is projected to compose more than a fifth of the entire population, representing a 147% increase in this age group. There has been a steady increase in the number of medical and psychiatric disorders, and a large percentage of geriatric patients are now presenting to the emergency department with such disorders. The management of our progressively complex geriatric patient population will require an integrative team approach involving emergency medicine, psychiatry, and hospitalist medicine.

  13. Emergency Physicians Think in Spirals.

    Science.gov (United States)

    Renouf, Tia; Whalen, Desmond; Pollard, Megan; Dubrowski, Adam

    2015-11-17

    As adult learners, junior clerks on core rotations in emergency medicine (EM) are expected to "own" their patients and follow them from presentation to disposition in the Emergency Department (ED). Traditionally, we teach clerks to present an exhaustive linear list of symptoms and signs to their preceptors. This does not apply well to the fast-paced ED setting. Mnemonics have been developed to teach clerks how to present succinctly and cohesively. To address the need for continual patient reassessment throughout the patient's journey in the ED, we propose a complimentary approach called SPIRAL.

  14. New trends in emerging pathogens.

    Science.gov (United States)

    Skovgaard, Niels

    2007-12-15

    The emergence of pathogens is the result of a number of impact in all parts of the food chain. The emerging technologies in food production explain how new pathogens can establish themselves in the food chain and compromise food safety. The impact of the food technology is analysed for several bacteria, such as Yersinia, Campylobacter, Arcobacter, Helicobacter pullorum, Enterobacter sakazakii, Mycobacterium avium spp. paratuberculosis, prions related to vCJD and others. The importance of the ability of many microbes to form VBNC forms is elaborated on. Research on culture independent methods may address this outstanding issue to the better understanding of emerging pathogens. The "demerging" of pathogens also occur, and examples of this are explained. The reaction of bacteria to stresses and sublethal treatments, and how exposure to one stress factor can confer resistance to other stresses, literally speaking causing contagious resistance, are explained. The implication of this e.g. in modern approaches of food preservation, such as Minimally processed Foods, is considerable. Intestinal colonization of EHEC may be regulated by Quorum sensing, and this ability of microbes plays an important role in the colonization of microbes in food and on food processing equipment, an important factor in the emergence of pathogens. The emergence of Saccharomyces cerevisiae, as an opportunistic human pathogen, used for centuries for food and production of alcoholic beverages, calls for research in molecular tools to distinguish between probiotic and clinical strains. Cyclospora cayetanensis and Norovirus outbreaks can no longer be designated as emerging pathogens, they share however one characteristic in the epidemiology of emerging nature, the importance of the hygiene in the primary production stage, including supply of potable water, and the application of GMP and the HACCP principles in the beginning of the food chain. Hepatitis E virus is a potential emerging food borne

  15. Respiratory Emergencies in Geriatric Patients.

    Science.gov (United States)

    Tyler, Katren; Stevenson, Dane

    2016-02-01

    Acute dyspnea in older patients is a common presentation to the emergency department. Acute dyspnea in older adults is often the consequence of multiple overlapping disorders, such as pneumonia precipitating acute heart failure. Emergency physicians must be comfortable managing patients with acute dyspnea of uncertain cause and varying goals of care. In addition to the important role noninvasive ventilation (NIV) plays in full resuscitation, NIV can be useful as a method of providing supportive or nearly fully supportive care while more information is gathered from the patients and their loved ones.

  16. Emergent Spacetime for Quantum Gravity

    CERN Document Server

    Yang, Hyun Seok

    2016-01-01

    We emphasize that noncommutative (NC) spacetime necessarily implies emergent spacetime if spacetime at microscopic scales should be viewed as NC. In order to understand NC spacetime correctly, we need to deactivate the thought patterns that we have installed in our brains and taken for granted for so many years. Emergent spacetime allows a background-independent formulation of quantum gravity that will open a new perspective to resolve the notorious problems in theoretical physics such as the cosmological constant problem, hierarchy problem, dark energy, dark matter, and cosmic inflation.

  17. Tensile strength study of the abdominal wall following laparotomy synthesis using three types of surgical wires in Wistar rats Estudo da resistência tênsil da parede abdominal após síntese de laparotomia usando três tipos de fios cirúrgicos em ratos Wistar

    Directory of Open Access Journals (Sweden)

    Lucas Félix Rossi

    2008-02-01

    Full Text Available PURPOSE: To study the tensile strength of the abdominal wall following laparotomy synthesis utilizing three types of surgical wires. METHODS: Thirty Wistar rats were randomized into three groups of ten rats each. Each group underwent a 3cm-laparotomy which was closed with 3-0 polyglactin 910, polyglecrapone and catgut wires. After 63 days, euthanasia was performed and part of the abdominal wall was removed with which a strip was produced measuring 2.0 cm in length by 6.0 cm in width comprising the abdominal muscles with the implanted mesh. The sample was fixed in a mechanical test machine in which constant force was applied contrary to the tissue strips. Maximum force was considered, expressed in Newton, until full rupture of the tissue occurred. The non-parametrical Kruskal - Wallis test was used for the statistical analysis, admitting pOBJETIVO: Estudar a resistência tênsil da parede abdominal após síntese de laparotomia utilizando três tipos de fios cirúrgicos. MÉTODOS: Trinta ratos da linhagem Wistar randomizados em três grupos de dez exemplares cada um. Em cada grupo fez-se uma laparotomia de dois centímetros que foi fechada com fios 3-0 de poliglactina 910, poliglecaprone e categute. Após 63 dias, foi feita a eutanásia e retirou-se uma área da parede abdominal com a qual fez-se uma tira medindo 2,0 cm de comprimento por 6,0 cm de largura englobando os músculos abdominais com a tela implantada. A amostra foi fixada em máquina de ensaios mecânicos na qual se aplicou força constante contrária às tiras de tecido. Foi considerada a força máxima expressa em Newton até ocorrer a ruptura total da amostra. Para a análise estatística, utilizou-se teste não paramétrico de Kruskal - Wallis admitindo-se p<0,05. RESULTADOS: A média de resistência do grupo categute foi ligeiramente menor (33.50 N ao da poliglactina (34.23 N, sendo essa diferença não estatisticamente significativa (p=0,733. O grupo poliglecaprone foi o que

  18. Nontherapeutic Laparotomy in American Combat Casualties: A 10-year Review

    Science.gov (United States)

    2014-09-10

    in median (IQR 1YIQR 3). PRBC, packed red blood cell . TABLE 4. ICD-9 Complication Codes for NTLs Complication: ICD-9 Code NTL TL p Abdominal... collision 4.2% 4.5% Discharge status, alive 99.0% 98.6% 0.543 Age 24 (21.0Y28.5) 24 (21.0Y28.0) 0.49 ISS 19 (10.0Y27.0) 25 (17.0Y34.0) G0.0001 AIS score...the TL group compared with the NTL group. Total blood product resuscitation is found in Table 3; patients undergoing TL had higher overall blood

  19. Influence of intense neuromuscular blockade on surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Donatsky, Anders Meller; Jensen, Bente Rona

    2015-01-01

    neuromuscular block on surgical conditions with a subjective rating scale, force needed to close the fascia, incidences of abdominal contractions while suctioning the lungs, width of the wound diastase and operating time as outcome parameters. RESULTS: In all six pigs no abdominal contractions occurred while......, operating time and subjective ratings using a four-point rating scale when comparing no neuromuscular block with intense neuromuscular block. However, these outcomes were related to the order of the suturing round. CONCLUSION: Intense neuromuscular block prevented abdominal muscle contractions but did...

  20. 成人开腹手术术后静脉自控镇痛芬太尼消耗量的影响因素分析%Influencing factors for fentanyl consumption of patient-controlled intravenous analgesia after adult laparotomy

    Institute of Scientific and Technical Information of China (English)

    刘晓; 刘敬臣

    2015-01-01

    Objective To explore the influence factors for fentanyl consumption of patient-controlled analgesia after adult laparotomy to provide clinical references for the individual medication of postoperative patient -controlled analgesia .Methods Eighty patients who underwent selective laparotomy with general anesthesia and agreed to the use of patient-controlled intravenous analgesia after operation were enrolled in the study .The patient′s pain threshold and pain tolerance were measured before operation to evaluate their anxiety level .Total intravenous anesthesia with tracheal intubation was performed .The patient′s gender,age,body height,body weight,type of operation and operation duration were recorded at the end of operation ,and the length of operative incision was measured .Postoperative analgesia pump for patient-controlled intravenous analgesia was performed after operation ,with a drug formulation of dilute solution (150 ml) of fentanyl(1 mg), droperidol(5 mg) and normal saline.The follow up was performed on the 4th,8th,16th and 24th hour after analgesia pump worked .The visual analogue scale(VAS) score,Ramsay score and fentanyl consumption were observed and recorded ,and the body surface area was calculated.The patient′s gender,age,body surface area,pain threshold,pain tolerance,state anxiety score,trait anxiety score,type of operation, operation duration,length of incision and 24-hour fentanyl consumption were analyzed in Stepwise multiple linear regression .Results The effects of gender,body surface area,pain threshold,state anxiety score,trait anxiety score,type of operation and length of incision on fentanyl consumption showed no statistical significance(P>0.05),while the effects of age,pain tolerance and operation duration on fentanyl consumption showed a statistical significance(P<0.05).The regression equation:fentanyl consumption =617.82-36.13 ×pain tolerance-1.25 ×age+0.59 ×operation duration.Conclusion Pain tolerance,age and operation

  1. Emergence

    Directory of Open Access Journals (Sweden)

    Raven John

    2014-07-01

    Full Text Available In this paper I first list a number of areas in which recent research seems to reinforce the need to follow through on activities identified in Simonetta Magari’s article (Magari, Cavaleri 2009. A careful review of research in these areas would lead us into deeply mysterious psychological processes and underline the need to change the most fundamental assumptions on which modern psychology is built. Unfortunately, I am in no position to undertake this review.

  2. Product Innovations in Emerging Economies

    DEFF Research Database (Denmark)

    Xiao, Xiao; Sarker, Saonee; Rai, Sudhanshu

    2011-01-01

    , such as countries that are not considered “developed.” This study aims at examining how firms innovate in emerging economies. Specifically, we focus on the role of collaborative capacity in product innovations. Primary data collected from an ICT project in India has been used to test the relevant hypotheses...

  3. Emergency Management Standards and Schools

    Science.gov (United States)

    National Clearinghouse for Educational Facilities, 2009

    2009-01-01

    This publication discusses emergency management standards for school use and lists standards recommended by FEMA's National Incident Management System (NIMS). Schools are encouraged to review these standards carefully and to adopt, where applicable, those that meet their needs. The lists of standards, resources, and references contained herein…

  4. EMERGENCY TRACHEOSTO MY: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Amarnath

    2015-05-01

    Full Text Available INTRODUCTION: Tracheostomy is a life - saving procedure involving incision on trachea followed by insertion of a tube which maintains the patency of the opening in trachea either temporarily or permanently. In recent years there has been a considerable shift in emphasis regarding the indications for tracheostomy with recognition of more physiological and functional indications where in normal respiratory efficiency is impaired because of patient’s inability to maintain norm al ventilation and control of secretions in addition to those of a strictly obstructive nature. OBJECTIVES: To study various indications, intra and post - operative complications of emergency tracheostomy. METHODS: Present study is a prospective study conduc ted in the patients attended to causality and ENT op with stridor in S. V. R. R. Government Genera l Hospital, Tirupathi during 20 09 - 2011 over a period of two years. Patients of all ages & both sexes are included in this study. All the patients were subject ed to detailed ENT, Head & Neck examination and operated by emergency tracheostomy. Intra operative and post - operative complications were noted during the follow up period of 3 - 6 months. RESULTS: Most common indication of emergency tracheostomy was larynge al malignancy followed by poisoning, head injury, subglottic stenosis and bilateral abductor palsy. Hemorrhage is the most common complication observed followed by surgical emphysema, apnoea etc. CONCLUSSION: Emergency tracheostomy is a safe and reliable m ethod of restoring the airway and also gives ample time for the specialist to plan & execute further management of underlying cause.

  5. Design of an Emergency Footbridge

    NARCIS (Netherlands)

    Rihal, S.; Kamerling, M.W.

    2014-01-01

    This paper will describe the design of a temporary emergency floating footbridge, to be made when the infrastructure is destroyed by a flood, hurricane, tsunami or any other disaster. The bridge is made of identical floating modules. The modules are composed of prefabricated elements: two trusses, a

  6. Emergency Preparedness: Are You Ready?

    Science.gov (United States)

    Harley, Lorraine

    2012-01-01

    Most Americans who consider emergency preparedness think of someone or another country attacking the United States. Most newspaper and televised accounts involve community leaders and policymakers preparing for a terrorist attack. However, anyone who operates a child care center, family child care home, or has children of her own, knows that…

  7. Growing an Emerging Research University

    Science.gov (United States)

    Birx, Donald L.; Anderson-Fletcher, Elizabeth; Whitney, Elizabeth

    2013-01-01

    The emerging research college or university is one of the most formidable resources a region has to reinvent and grow its economy. This paper is the first of two that outlines a process of building research universities that enhance regional technology development and facilitate flexible networks of collaboration and resource sharing. Although the…

  8. Emerging Technologies in Physics Education

    Science.gov (United States)

    Krusberg, Zosia A. C.

    2007-01-01

    Three emerging technologies in physics education are evaluated from the interdisciplinary perspective of cognitive science and physics education research. The technologies--Physlet Physics, the Andes Intelligent Tutoring System (ITS), and Microcomputer-Based Laboratory (MBL) Tools--are assessed particularly in terms of their potential at promoting…

  9. Electronic Whiteboards in Emergency Medicine

    DEFF Research Database (Denmark)

    Rasmussen, Rasmus

    2012-01-01

    As more and more Emergency Departments replace the manual dry-erase whiteboards used for coordination of patient care and communication among clinicians with IT-based electronic whiteboards a need to clarify the effects of implementing these systems arises. This paper seeks to answer this questio...

  10. Financial Services and Emerging Markets

    NARCIS (Netherlands)

    B. Karreman (Bas)

    2011-01-01

    textabstractThis study addresses the organization and strategy of firms in emerging markets with an explicit application to financial services. Given the relevance of a well-functioning financial system for economic growth, understanding the organization and strategy of firms contributing to the dev

  11. Parents' Knowledge of Emergent Literacy.

    Science.gov (United States)

    Meehan, Ellen

    This study investigated parents' knowledge of their child's emergent literacy development by administering parent questionnaires that examined parents' beliefs of literacy learning and the early writing and reading experiences of preschool children in their home. A total of 115 questionnaires were administered to parents with children enrolled in…

  12. Developing an emergency ultrasound app

    DEFF Research Database (Denmark)

    Foss, K. T.; Subhi, Y.; Aagaard, R.

    2015-01-01

    Focused emergency ultrasound is rapidly evolving as a clinical skill for bedside examination by physicians at all levels of education. Ultrasound is highly operator-dependent and relevant training is essential to ensure appropriate use. When supplementing hands-on focused ultrasound courses, e-le...

  13. Design of an Emergency Shelter

    NARCIS (Netherlands)

    Kamerling, M.W.

    2013-01-01

    This paper presents the design of a light and robust temporary emergency shelter with a triangulated polyhedral grid to transfer the lateral and vertical loads efficiently. To simplify the construction the variety of the elements is minimized, only two sizes of elements are applied. For the structur

  14. Emerging trends in surface metrology

    DEFF Research Database (Denmark)

    Lonardo, P.M.; Lucca, D.A.; De Chiffre, Leonardo

    2002-01-01

    Recent advancements and some emerging trends in the methods and instruments used for surface and near surface characterisation are presented, considering the measurement of both topography and physical properties. In particular, surfaces that present difficulties in measurement or require new pro...

  15. Hypernatremia in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Neslihan YÜCE

    2012-05-01

    Full Text Available INTRODUCTION: To determine the symptoms, clinical characteristics, prevalence and outcome of patients with hypernatremia who presented at the emergency department. MATERIAL and METHODS: We retrospectively studied patients who presented at the emergency department with hypernatremia (Na>148 meq/l from January 2008 to December 2008. RESULTS: A total of 25.545 cases presented at the Emergency Department and hypernatremia was seen in 86 patients. The prevalence of hypernatremia was 0.34%. The mean age was 69.5±15.2 (20- 96, median age: 75 years and 51 of them (59% were male. Forty percent of the patients died. There were no significant differences according to age, gender and admission Na levels. A comorbid disease were seen 99% of patients. Cerebrovascular disease(CVD, dementia/Alzheimer and hypertension were the most common co-morbid diseases (respectively, 34%, 34%,and 27%. Central neurological system disorders (such as thrombotic or hemorrhagic CVD, Alzheimer, etc. were seen in 72% of the cases. Fifty patients had acute infection at the time of admission. Acute urinary infection, pneumonia and acute CVD were the most common acute illnesses. CONCLUSION: Hypernatremia is usually seen in the geriatric population and associated with a high mortality and morbidity rate and the majority of patients with hypernatremia have a comorbid disease. The prevalence of hypernatremia was 0.34% in our emergency department.

  16. The Emergence of Homo sapiens.

    Science.gov (United States)

    Rensberger, Boyce

    1980-01-01

    Describes chronologically the evolution of the human race on earth so as to refute Darwin's theory of descent from animals. Skull fragments from sites around the world suggest at least two possible routes toward the emergence of Homo sapiens sapiens. (Author/SK)

  17. Workplace violence in emergency medicine

    Directory of Open Access Journals (Sweden)

    A. Chatterjee*

    2013-12-01

    Conclusion: Violence against ED health care workers is a real problem with significant implications to the victims, patients, and departments/institutions. ED WPV needs to be addressed urgently by stakeholders through continued research on effective interventions specific to Emergency Medicine. Coordination, cooperation, and active commitment to the development of such interventions are critical.

  18. Data modelling for emergency response

    NARCIS (Netherlands)

    Dilo, Arta; Zlatanova, Sidi

    2010-01-01

    Emergency response is one of the most demanding phases in disaster management. The fire brigade, paramedics, police and municipality are the organisations involved in the first response to the incident. They coordinate their work based on welldefined policies and procedures, but they also need the m

  19. How do communication systems emerge?

    Science.gov (United States)

    Scott-Phillips, Thomas C; Blythe, Richard A; Gardner, Andy; West, Stuart A

    2012-05-22

    Communication involves a pair of behaviours--a signal and a response--that are functionally interdependent. Consequently, the emergence of communication involves a chicken-and-egg problem: if signals and responses are dependent on one another, then how does such a relationship emerge in the first place? The empirical literature suggests two solutions to this problem: ritualization and sensory manipulation; and instances of ritualization appear to be more common. However, it is not clear from a theoretical perspective why this should be the case, nor if there are any other routes to communication. Here, we develop an analytical model to examine how communication can emerge. We show that: (i) a state of non-interaction is evolutionarily stable, and so communication will not necessarily emerge even when it is in both parties' interest; (ii) the conditions for sensory manipulation are more stringent than for ritualization, and hence ritualization is likely to be more common; and (iii) communication can arise by a third route, when the intention to communicate can itself be communicated, but this may be limited to humans. More generally, our results demonstrate the utility of a functional approach to communication.

  20. Healthcare quality in Emergency Room

    Directory of Open Access Journals (Sweden)

    P Sarafis

    2009-02-01

    Full Text Available Aim: This study wants to clarify the issue of quality in health but also to determine the qualitative and quantitative quality indicators in Emergency department that their measurement is a discipline to countries developed in the area of health in order to promote quality in emergency care. Measurement of specific indicators through the evaluation of data and results, quality in Emergency Room is verified.Method: Review of relative bibliography was made in electronic bases of Blackwell-Synergy (1990-2008, and Medline (1990-2008 using as key words Emergency Room, safety, quality, responsiveness, satisfaction, effectiveness, efficiency, appropriateness, accessibility, competence. Complementary bibliography was found through other electronic search engines and by reviewing references of already found articles.Results: determinants for quality in the provision of health services were found to be the credibility that consists of the stability of care, the consistency and the duration of performance, the personnel responsiveness and the vigilance to serve the health user, its efficiency, the accessibility of health services, the politeness, understanding and communication of health professionals in relation to their professionalism, the security and the working environment.