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Sample records for australian case series

  1. Malignant otitis externa: An Australian case series.

    LENUS (Irish Health Repository)

    2012-02-01

    OBJECTIVES: To establish a clinicopathological profile of malignant otitis externa (MOE) in an Australian tertiary referral institution. STUDY DESIGN: Retrospective cohort outcomes study. METHODS: 24 patients were identified with MOE between January 1998 and July 2007. Patients were classified into Radiological Grades I-IV. Laboratory investigations Including C-reactive protein (CRP), white cell count (WCC), glycosylated haemoglobin (HBA1c) and average glucose level over admission were recorded. RESULTS: Radiological Grade was significantly associated with duration of therapy (rank correlation 0.57, p = 0.004). CRP was a useful indicator confirming disease resolution. Diabetics with MOE had elevated average blood sugar levels during their Hospital admission (p < 0.001) and had poor overall glycaemic control represented by Elevated HBA1c scores (p < 0.001). CONCLUSIONS: Malignant otitis externa is a rare disease, which is best managed in a multidisciplinary team setting. This practical grading system can be used to predict the duration of therapy at time of diagnosis, which enables the efficient utilisation of Hospital resources. Poorly controlled diabetics are more susceptible to developing. MOE than diabetics with satisfactory glycaemic control and may represent a subgroup of more brittle diabetics. CRP combined with appropriate clinical and radiological investigations is useful in assessing disease resolution.

  2. Management of ureteric endometriosis associated with hydronephrosis: An Australian case series of 13 patients

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    Smith Ian AR

    2010-02-01

    Full Text Available Abstract Background Hydronephrosis is a rare but serious manifestation of ureteric endometriosis. Findings One hundred and twenty-six women underwent ureterolysis for ureteric endometriosis betweeen and October 1996 and June 2009. Thirteen of the 126 women were identified as having ureteric obstruction at the time of their procedure and were included in the case series. The median age was 39.5 (30 - 63. Chronic pelvic pain was the most common presenting symptom (53.8%. The point of ureteric obstruction was noted to occur most commonly at a small segment of distal left ureter, where it is crossed by the uterine artery (54%. Seven of the 13 women (53.8% were successfully managed with ureterolysis only. Three of the 13 women (21.3% underwent ureterolysis and placement of a double J ureteric stent. Three of the 13 (21.3% required a segmental ureteric resection. There was one incidence of inadvertent thermal ureteric injury which was managed with a ureteric stent. In all cases the hydronephrosis had resolved at six months follow up. Conclusions Our findings support the growing body of literature supporting ureterolysis as the optimal treatment for ureteric endometriosis causing moderate to severe ureteric obstruction.

  3. Nonketotic hyperglycinemia case series

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    Mehtab Iqbal

    2015-01-01

    Full Text Available To present three cases who presented with neonatal hiccups and who were later diagnosed with nonketotic hyperglycinemia (NKH. Case series. We present three babies who presented in neonatal life with hiccups who later were diagnosed with NKH. Two babies presented on the 2nd day of life with hypotonia, poor feeding, and abnormal movements including jitteriness, hiccups, and twitching. The third baby only had transient hiccups lasting for a couple of days in the 1st week of life but later presented at 3 months of age with poor feeding, drowsiness, and jerky movements. All three cases needed extensive investigations before reaching the diagnosis including metabolic screen, lumbar puncture, electroencephalography, and computed tomography/magnetic resonance imaging. The first two babies needed intubation on their 2nd day of life because of apneas in whom later, the care was withdrawn after reaching the diagnosis of NKH because of poor prognosis. The third baby was discharged home on oral dextromethorphan and ketogenic diet. We discuss the importance of early recognition of symptoms (frequent hiccups and investigation needed to reach the diagnosis early as it helps in making decision to either carry on treatment or withdraw care because of poor prognosis. It also helps in genetic counseling and prenatal diagnosis can be offered at the subsequent pregnancy.

  4. Aortic dissection: case series

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    Bhavana Venkata Nagabhushana Rao

    2016-04-01

    Full Text Available Aortic dissection may not be attended by a physician in his lifetime, but he should possess all the clinical acumen to deal with as it is a catastrophic disease. Early and accurate diagnosis will save a life. Here we present three cases we faced in sequence over a period of two months. A case of extensive dissection arch to thoracic aorta, its display in detail. Second case eliciting ambiguity between coronary ischemia and aortic dissection. Management difficulties of such clinician situation are discussed. Third case, the fracture of a renal artery stent leading to severe hypertension, abdominal pain, and aortic dissection. Such case was not described in the literature to our knowledge. [Int J Res Med Sci 2016; 4(4.000: 1268-1271

  5. Tinea incognito: Case series

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    Mikail Yılmaz

    2015-09-01

    Full Text Available Tinea incognito is a dermatophytic infection which has lost its typical clinical appearance because of inappropriate use of topical or systemic corticosteroids. The clinical manifestations of tinea incognito can mimic many dermatoses such as eczema, psoriasis, allergic contact dermatitis, rosacea, seborrheic dermatitis and atopic dermatitis. The diagnosis of tinea incognito is confirmed by direct KOH (potassium hydroxide examination ( native preparation, making the fungal cultures from the lesion and histopathological examination in some cases. Systemic antifungal therapy is recommended in the treatment of tinea incognito. Herein, 10 cases of tinea incognito which mimicking various dermatoses were diagnosed and treated in our clinic in 2014 is presented.

  6. Benefits of e-Learning Benchmarks: Australian Case Studies

    Science.gov (United States)

    Choy, Sarojni

    2007-01-01

    In 2004 the Australian Flexible Learning Framework developed a suite of quantitative and qualitative indicators on the uptake, use and impact of e-learning in the Vocational Education and Training (VET) sector. These indicators were used to design items for a survey to gather quantitative data for benchmarking. A series of four surveys gathered…

  7. Rural Telework: Case Studies from the Australian Outback.

    Science.gov (United States)

    Simpson, Lyn; Daws, Leonie; Pini, Barbara; Wood, Leanne

    2003-01-01

    Case studies of rural teleworking in an Australian government department and a community organization found that a key constraint is lack of telecommunications and services infrastructure. Teleworkers had differing views of working in isolation, depending on the nature of work roles, attitudes toward technology, and personal life experiences.…

  8. Aligning IT and Business Strategy: An Australian University Case Study

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    Dent, Alan

    2015-01-01

    Alignment with business objectives is considered to be an essential outcome of information technology (IT) strategic planning. This case study examines the process of creating an IT strategy for an Australian university using an industry standard methodology. The degree of alignment is determined by comparing the strategic priorities supported by…

  9. Empirical evidence against the exchange rate anomaly: the Australian case

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    Luis A. Gil-Alana

    2006-06-01

    Full Text Available Though there is widespread agreement that the logarithmic spot and forward rates are both integrated of order one (I(1 variables, so that their corresponding returns are I(0 stationary, it has been recently claimed that they may be long memory. In this article, we examine this hypothesis by means of fractional integration techniques. The results based on parametric and semiparametric tests show that though fractional degrees of integration are plausible alternatives, the confidence intervals include the unit root case in both series. In addition, the hypothesis of unbiasedness of the forward rate as a forecaster for the future spot rate cannot be rejected for the Australian daily exchange rate market.Embora haja um acordo difundido de que o ponto logarítmico e as taxas para frente são ambas integradas de variáveis da ordem um (I(1, de modo que seus retornos correspondentes sejam I(0 estacionário, tem-se reivindicado recentemente que elas podem ser memória longa. Neste artigo, examinamos esta hipótese por meio do uso de técnicas fracionárias de integração. Os resultados baseados em testes paramétricos e semiparametricos mostram que embora os graus fracionários de integração sejam alternativas plausíveis, os intervalos de confiança incluem o caso da raiz unitária em ambas as séries. Além disso, a hipótese de não viés da taxa para frente como um preditor para a taxa a vista futura não pode ser rejeitada para o caso australiano.

  10. Osseous genioplasty: A case series

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    Sanjeev N Deshpande

    2011-01-01

    Full Text Available Introduction: The chin (mentum is vital to the human facial morphology as it contributes to the facial aesthetics and harmony both on frontal and lateral views. Osseous genioplasty, the alteration of the chin through skeletal modification, can lead to significant enhancement of the overall facial profile. Aim and Study Design: A case series was designed to study the long-term results of osseous genioplasty in Indian patients with regard to patient satisfaction, complications, and long-term stability. Materials and Methods: All subjects who underwent osseous genioplasty either alone or as a component of orthognathic surgery between January 1992 and December 2010, with a minimum follow-up of 2 years, were included. The genioplasty was performed using standard protocols of assessment and execution. Post-operative evaluation included patient satisfaction, complications and radiological evidence of long-term stability. A comprehensive score was formulated for the purpose of the study. Results: Thirty-seven subjects underwent osseous genioplasty with at least 2 years of follow-up in the study period. This included 17 male and 20 female subjects, with a mean age of 22.8 years (15-52 years and a mean follow-up of 3 years 4 months (2 years to 4 years and 11 months. Nineteen subjects underwent isolated genioplasty while 18 underwent genioplasty as a part of orthognathic surgery. The procedures included advancement (22, pushback (9, side-to-side (4 and vertical reduction (2 genioplasty.Thirty-six subjects (97.3% were extremely pleased with the results with only one subject expressing reservations, without, however, demanding any further procedure. There were no significant complications. The osteotomised segment was well maintained in its new position with good bony union and minimal resorption. Overall, 35 (94.6% cases had excellent results and 2 (4.4% cases had good results, according to the comprehensive score. Conclusions: Osseous genioplasty is a safe

  11. Case, Teacher and School Characteristics Influencing Teachers' Detection and Reporting of Child Physical Abuse and Neglect: Results from an Australian Survey

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    Walsh, Kerryann; Bridgstock, Ruth; Farrell, Ann; Rassafiani, Mehdi; Schweitzer, Robert

    2008-01-01

    Objective: To identify the influence of multiple case, teacher and school characteristics on Australian primary school teachers' propensity to detect and report child physical abuse and neglect using vignettes as short hypothetical cases. Methods: A sample of 254 teachers completed a self-report questionnaire. They responded to a series of 32…

  12. Delusional Parasitosis : Series Of 25 Cases

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    Bhatia M S

    1996-01-01

    Full Text Available A series 25 cases of delusional parasitosis is being reported. There were three cases below 45 years, 12 cases between 46-45 years and 11 cases above 55 years of age, 64% cases were females. A majority of cases (92% had insidious onset. The duration of symptoms in all the cases (except one was 6 months or more. 13 cases presented with infestation with insects over body and 10 cases with insects crawling over scalp. There were three cases each with diabetes mellitus and leprosy. Three cased had dementia, 2 cases had depression and one case presented with trichotillomania. Pimozide was used in22 cases, amitriptyline in 2 cases and fluoxetine in one. 14 cases (52% showed complete remission while receiving drug, 8 cases showed partial improvement and 3 cases did not respond.

  13. Membranous Dysmenorrhea: A Case Series

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    Hatim A. Omar

    2007-01-01

    Full Text Available The purpose was to illustrate the variability of hormonal contraception of patients that presented with membranous dysmenorrheal. A case analysis chart review was completed on six patients referred to a Pediatric Gynecologist in an academic setting. In each case the patient underwent a thorough pelvic and bimanual exam. Following the initial presentation, each patient continued to be followed on a regular visits. Cases: Two were using the transdermal contraceptive patch and oral contraceptive, but following the expulsion of decidual cast, they were both placed on depot medroxyprogesterone acetate (DMPA without further complications. Three of the six cases were on DMPA prior to the similar occurrence of membranous dysmenorrheal and following this incident, continued on DMPA without further problems. The final case was on the transdermal patch prior to decidual cast expulsion and remained on this form of hormonal contraception without further complications. These cases indicate that membranous dysmenorrheal is not limited to the use of DMPA.

  14. Eat, drink and gamble: marketing messages about ‘risky’ products in an Australian major sporting series

    OpenAIRE

    Lindsay, Sophie; Thomas, Samantha; Lewis, Sophie; Westberg, Kate; Moodie, Rob; Jones, Sandra

    2013-01-01

    Background To investigate the alcohol, gambling, and unhealthy food marketing strategies during a nationally televised, free to air, sporting series in Australia. Methods/approach Using the Australian National Rugby League 2012 State of Origin three-game series, we conducted a mixed methods content analysis of the frequency, duration, placement and content of advertising strategies, comparing these strategies both within and across the three games. Results There were a total of 4445 episodes ...

  15. MUCORMYCOSIS – A CASE SERIES.

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    Shankaranarayanan Gopalakrishnan

    2012-04-01

    Full Text Available Mucormycosis is a rare opportunistic fungal infection with a rapidly progressive and fulminantcourse with often fatal outcome. A less fulminant variety of this is the Rhino maxillary subtypewhich usually presents with palatal ulceration, facial swelling, turbinate necrosis and purulentsinusitis. We are reporting our experience of 4 such cases seen during the last 10 yrs. A strongsuspicion, prompt diagnosis with pathological confirmation and aggressive surgical treatmentgives a better outcome.

  16. Atypical medulloblastoma: A case series

    OpenAIRE

    Meshkini, Ali; Vahedi, Amir; Meshkini, Mohammad; Alikhah, Hossein; Naghavi-behzad, Mohammad

    2014-01-01

    Medulloblastoma is common in children as a tumor of midline posterior fossa, which arises from vermis and appears as a homogenously enhancing hyperdense mass on computed tomography scan and is associated with the clinical picture of posterior fossa syndrome. This unique clinic-radiological pattern in considered “typical” medulloblastoma, but medulloblastomas does not follow the typical clinic-radiological pattern in a significant number of children and adult cases. We review here the previous...

  17. Globalisation, Transnational Academic Mobility and the Chinese Knowledge Diaspora: An Australian Case Study

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    Yang, Rui; Welch, Anthony R.

    2010-01-01

    The master discourses of economic globalisation and the knowledge economy each cite knowledge diasporas as vital "trans-national human capital". Based on a case study of a major Australian university, this article examines the potential to deploy China's large and highly-skilled diaspora in the service of Chinese and Australian scientific and…

  18. Case Series Investigations in Cognitive Neuropsychology

    OpenAIRE

    Schwartz, Myrna F.; Dell, Gary S.

    2010-01-01

    Case series methodology involves the systematic assessment of a sample of related patients, with the goal of understanding how and why they differ from one another. This method has become increasingly important in cognitive neuropsychology, which has long been identified with single-subject research. We review case series studies dealing with impaired semantic memory, reading, and language production, and draw attention to the affinity of this methodology for testing theories that are express...

  19. Profilin desensitization: A case series.

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    Nucera, Eleonora; Aruanno, Arianna; Rizzi, Angela; Pecora, Valentina; Patriarca, Giampiero; Buonomo, Alessandro; Mezzacappa, Simona; Schiavino, Domenico

    2016-09-01

    The role of profilin as an allergen has long been questioned. The capacity of profilin to induce respiratory symptoms has recently been demonstrated; moreover, over 50% of patients sensitized to profilin experienced symptoms after the ingestion of plant-derived foods, suggesting that profilin should be considered as a clinically relevant food allergen.We describe the cases of seven allergic patients with oral allergy syndrome and other adverse reactions after eating plant-derived food, that have been undergone to profilin desensitization treatment.The protocol started with a drop of profilin solution (50 µg/mL) diluted 1:10(18) in water until the highest dose of 10 drops of undiluted solution three times a week. At the end of the treatment we observed a decreased mean diameter of profilin wheal in skin prick test (SPT) in five of the seven participants and in profilin specific IgE values in six patients that repeated the test. Regarding basophil activation test (BAT) and the detection of IgG4, we do not have significant results because the tests have to be repeated in some patients. Regarding the double-blind placebo-controlled challenges, after about 10 months of induction phase all the patients showed tolerance to several foods that they previously did not tolerate.Moreover, the immunotherapy with profilin has proved to be safe because no serious adverse events have been reported in our patients.In summary, the results of this exploratory study of sublingual immunotherapy (SLIT) for profilin allergy show that it can be a promising therapeutic option that could modify the clinical reactivity of the patients to the intake of plant-derived food. PMID:26684620

  20. Unusual Cases of Epidermoid cyst: Case Series

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    Lalita Yadav

    2013-09-01

    Full Text Available In the oro-facial region cystic lesions of different etiologies are encountered owing to the presence of the teeth in the jaw bones. A bewildering variety of developmental, odontogenic and non-odontogenic cysts are seen. Epidermoid cyst is a rare developmental cyst of the oro-facial region which results from entrapped epidermal elements without adnexal appendages. Dermoid and epidermoid cysts occur in oro-facial region with an incidence of 6.9-7% and represents less than 0.01% of all oral cavity cysts. Here we report two cases of epidermoid cysts occurring at unusual locations involving upper left maxillary region lateral to the nose and pinna of the ear.

  1. The Primary School in Changing Times: The Australian Experience. Educational Management Series.

    Science.gov (United States)

    Townsend, Tony, Ed.

    Following substantial changes throughout the Australian education system, primary schools are no longer in the protected position of having a regulated flow of clients, a predetermined curriculum, and marginal levels of staff development. This book reviews the impact of this change on Australian primary schools, the people who are involved with…

  2. Case study in time series analysis

    CERN Document Server

    Zhongjie, Xie

    1993-01-01

    This book is a monograph on case studies using time series analysis, which includes the main research works applied to practical projects by the author in the past 15 years. The works cover different problems in broad fields, such as: engineering, labour protection, astronomy, physiology, endocrinology, oil development, etc. The first part of this book introduces some basic knowledge of time series analysis which is necessary for the reader to understand the methods and the theory used in the procedure for solving problems. The second part is the main part of this book - case studies in differ

  3. Rethinking Leadership in the Academy: An Australian Case

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    Bianchini, Stefano; Maxwell, Tudor; Dovey, Ken

    2014-01-01

    As with higher education institutions in other Organisation for Economic Cooperation and Development countries, Australian universities are facing significant challenges. One particular challenge is that of the declining quality of the teaching and learning experience within the academy. This paper describes an attempt to sustain the quality of a…

  4. Inducible urticaria: Case series and literature review.

    Science.gov (United States)

    Amaya, Daniel; Sánchez, Andrés; Sánchez, Jorge

    2016-01-01

    Inducible urticaria is a heterogeneous group of skin disorders characterized by the appearance of wheals, pruritus and/or angioedema, sometimes accompanied by systemic symptoms caused by innocuous stimuli (cold, heat, pressure, etc.). This group of disorders compromises people's quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. The aim of this review is to show an up-to-date overview of the available literature for various types of inducible urticarias, always beginning with an illustrative case and then describing their pathophysiological mechanisms, clinical manifestations, and treatment. PMID:27622434

  5. Cannabinoid-Induced Pancreatitis: A Case Series

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    Kurt A Wargo

    2007-09-01

    Full Text Available Context There is only one previously published case report of acute pancreatitis secondary to the use of tetrahydrocannabinoid. While drugs, in general, account for 2% of all the causes of acute pancreatitis, we add to the literature three additional cases of cannabis-induced pancreatitis. Cases The first case occurred in a 22-year-old man who admitted to smoking tetrahydrocannabinoid heavily over the days prior to admission. The second case involved a 23-year-old man with multiple admissions for tetrahydrocannabinoid-induced pancreatitis. The third case involved a 20-year-old female who admitted to smoking tetrahydrocannabinoid heavily over a period of two weeks prior to admission. In all cases, other causes of pancreatitis were ruled out. Furthermore, the symptoms associated with the acute pancreatitis subsided upon discontinuation of the drug. Conclusion Cannabis is the world’s most popular illicit drug with over 4% of the world’s population using it each year. Despite this, acute pancreatitis is a rarely reported adverse effect of cannabis use. This case series adds to the literature that cannabis does in fact cause pancreatitis and it may be dose related, although the exact mechanism remains unknown.

  6. Securitization of Migration: an Australian case study of global trends

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    Michael Humphrey

    2014-08-01

    Full Text Available Post September 11 migration has increasingly been framed as a security problem. In the 2010 Australian election campaign migration was connected to security (defense of our borders, terrorism and social cohesion and to related issues of insecurity about the future (population size,sustainability and economic growth. Thisframing of migration as a national security issue overlooks the reality that Australian immigration is part of the global flow of population. Migration is an international issue experienced by states as a national question of border control and sovereignty seeking to manage the consequences of global inequality and mobility. This paper analyses the 'security turn' in migration debates in Australia and the North and the way the securitization of migration signifies the transformation of security from the problem of producing national order to the problem of managing global disorder resulting in the merging of national and international security strategies.

  7. Paralytic Shellfish Poisoning: A Case Series

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    William Hurley

    2014-07-01

    Full Text Available We describe a case series of seven patients presenting to an emergency department with symptoms of paralytic shellfish poisoning. They developed varying degrees of nausea, vomiting, diarrhea, weakness, ataxia and paresthesias after eating mussels harvested from a beach near their resort. Four patients were admitted to the hospital, one due to increasing respiratory failure requiring endotracheal intubation and the remainder for respiratory monitoring. All patients made a full recovery, most within 24 hours. The ability to recognize and identify paralytic shellfish poisoning and manage its complications are important to providers of emergency medicine. [West J Emerg Med. 2014;15(4:378-381.

  8. Ictal swearing: a case series and review.

    Science.gov (United States)

    Birca, Veronica; Tayah, Tania; Saint-Hilaire, Jean-Marc; Nguyen, Dang Khoa

    2013-12-01

    Seizures can manifest with ictal swearing but few studies have investigated the localising value of this epileptic manifestation. In this case series and review of the literature, we attempted to determine whether ictal swearing could help localise the epileptic focus. We review two previously published cases and report eight additional epileptic patients with ictal swearing for whom the epileptic focus was determined based on clinical, structural, electrophysiological, and surgical outcome data. Results indicated that ictal swearing occurs more commonly in male subjects and lateralises to the non-dominant hemisphere, but has poor localisation value, arising either from the frontal, parietal, temporal or occipital lobes in different patients. We discuss the significance of these findings. [Published with video sequences]. PMID:24317202

  9. TWO LEVELS SPONDYLOLISTHESIS: A RARE CASE SERIES

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    Bharath Raju

    2014-06-01

    Full Text Available INTRODUCTION: The term "Spondylolisthesis" refers to a condition where one of the vertebrae (usually L5 becomes misaligned anteriorly (slips forward in relation to the vertebra below. This forward slippage is caused by a problem or defect within the pars interarticularis. Occasionally, facet joint and/or posterior neural arch defects may also cause this syndrome as well. We encountered 3 cases of two levels spondylolisthesis, a case series rarely documented. CASE REPORTS: Patient, Kanthaiah 5yrs male, presented with low backache radiating to left lower limb associated with tingling and numbness sensations. X-rays showed spondylolisthesis L4-L5-S1. MRI showed left sided nerve root compression and myelogram showed cut off at L4-L5, L5-S1. Patient had left sided deficits and so the patient was operated and post operatively improved clinically and was followed up regularly. Another patient Muniyamma, 68 yrs female, presented to our hospital 10 yrs back with two levels spondylolisthesis. In a outside hospital, posterior spinal decompression and interbody fusion was done without stabilization at only one level (L4-L5. On subsequent follow up the other level (L5-S1 worsened. Right now patient is not willing for any surgical intervention so we are managing with conservative treatment. Our third patient, Geetha 42yrs female, presented to our hospital with two levels spondylolisthesis, grade 2 at L3-L4 and L4-L5 levels. Patient was operated and has improved clinically. CONCLUSION: Incidence of spondylolisthesis is 3% to 6%. Multilevel spondylolisthesis is rarely documented in literature. This case series is being reported because of the rare documentation

  10. Prestige-Oriented Market Entry Strategy: The Case of Australian Universities

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    Tayar, Mark; Jack, Robert

    2013-01-01

    Through an exploratory case study of four Australian universities this article finds that foreign market entry strategies are shaped by prestige-seeking motivations and a culture of risk aversion. From the market selection, entry mode and higher education literature, a conceptual model, embedded with four propositions, is presented. The model sees…

  11. Catching a Wave: An Australian Case Study on Building Competence in Search of Competitive Advantage.

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    Kellie, Deborah

    1998-01-01

    A case study of an Australian road construction company's skill development project is an example of an attempt to increase competitive advantage through competency acquisition. It remains to be seen whether reconstruction of the company will result in improved productivity and financial performance. (SK)

  12. REGULATION OF AUSTRALIAN MEDICAL PROFESSIONALS AND NATIONAL SECURITY: LESSONS FROM THREE CASE STUDIES.

    Science.gov (United States)

    Faunce, Thomas; McKenna, Michael; Rayner, Johanna; Hawes, Jazmin

    2016-03-01

    In recent times, Australia's national security concerns have had controversial impacts on regulation of Australian medical practitioners in areas related to immigration detention. This column explores three recent case studies relevant to this issue. The first involves the enactment of the Australian Border Force Act 2015 (Cth), which has a significant impact on the regulation of medical professionals who work with people in immigration detention. The second involves the decision of the High Court of Australia in Plaintiff M68/2015 v Minister for Immigration and Border Protection [2016] HCA 1 that an amendment to Australian federal legislation justified sending children back to immigration detention centres in Papua New Guinea and Nauru. This legislation was previously heavily criticised by the Australian Human Rights Commissioner. The third concerns the deregistration of Tareq Kamleh, an Australian doctor of German-Palestinian heritage who came to public attention on ANZAC Day 2015 with his appearance online in a propaganda video for the Islamic State terrorist organisation al-Dawla al-Islamyia fil Iraq wa'al Sham, also known as Islamic State of Iraq and Syria (ISIS) or Daesh. Australia's professional regulatory system should presumptively respect professional virtues, such as loyalty to the relief of individual patient suffering, when dealing with doctors (whether in Australia or ISIS-occupied Syria) working under regimes whose principles appear inconsistent with those of ethics and human rights. PMID:27323633

  13. First reported case of human Australian bat Lyssavirus encephalitis - A case report and imaging findings

    International Nuclear Information System (INIS)

    Full text: In late 1996, a bat carer from Rockhampton died from diffuse encephalitis. She had sustained several scratches to her left arm by fruit bats over the preceding month. She initially complained of left arm pain and numbness but her condition rapidly deteriorated with loss of consciousness and death. Australian bat Lyssavirus (ABL) was detected in her cerebrospinal fluid and neutralising antibodies to classical rabies virus in her serum. Other viral serology was negative. Autopsy revealed neuronal intracytoplasmic eosinophilic inclusions and electron microscopy showed bullet shaped viral particles. A Tc-99m hexamethylpropyleneamine oxime (HMPAO) brain scan demonstrated extensive bilateral areas of severely reduced tracer uptake in both cerebral hemispheres with the subfrontal and parieto-occipital regions the worst affected. Importantly, there was excellent correlation with the magnetic resonance image which showed diffuse cortical high signal on all pulse sequences most marked in the parieto-occipital areas. The CT scan performed at presentation had been normal and an earlier MRI had shown only a small enhancing pontine lesion. This is the first reported case of human infection by the newly identified ABL that has previously only been isolated in fruit bats. The virus belongs to the Rhabdovirus family and Lyssavirus genus and joins six other genotypes, one of which is the classic rabies virus. It has now been identified in four species of Australian fruit bats from north Queensland to Victoria. There is a paucity of knowledge relating to the distribution and transmission of the virus and research is underway to determine the potential public health risk

  14. First reported case of human Australian bat Lyssavirus encephalitis - A case report and imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    King, S.E.; Walker, D.; Fomg, W.F. [Royal Brisbane Hospital, Brisbane, QLD (Australia). Departments of Nuclear Medicine and Radiology

    1998-06-01

    Full text: In late 1996, a bat carer from Rockhampton died from diffuse encephalitis. She had sustained several scratches to her left arm by fruit bats over the preceding month. She initially complained of left arm pain and numbness but her condition rapidly deteriorated with loss of consciousness and death. Australian bat Lyssavirus (ABL) was detected in her cerebrospinal fluid and neutralising antibodies to classical rabies virus in her serum. Other viral serology was negative. Autopsy revealed neuronal intracytoplasmic eosinophilic inclusions and electron microscopy showed bullet shaped viral particles. A Tc-99m hexamethylpropyleneamine oxime (HMPAO) brain scan demonstrated extensive bilateral areas of severely reduced tracer uptake in both cerebral hemispheres with the subfrontal and parieto-occipital regions the worst affected. Importantly, there was excellent correlation with the magnetic resonance image which showed diffuse cortical high signal on all pulse sequences most marked in the parieto-occipital areas. The CT scan performed at presentation had been normal and an earlier MRI had shown only a small enhancing pontine lesion. This is the first reported case of human infection by the newly identified ABL that has previously only been isolated in fruit bats. The virus belongs to the Rhabdovirus family and Lyssavirus genus and joins six other genotypes, one of which is the classic rabies virus. It has now been identified in four species of Australian fruit bats from north Queensland to Victoria. There is a paucity of knowledge relating to the distribution and transmission of the virus and research is underway to determine the potential public health risk

  15. Dance-related concussion: a case series.

    Science.gov (United States)

    Stein, Cynthia J; Kinney, Susan A; McCrystal, Tara; Carew, Elizabeth A; Bottino, Nicole M; Meehan Iii, William P; Micheli, Lyle J

    2014-01-01

    Sport-related concussion is a topic of increasing public and media attention; the medical literature on this topic is growing rapidly. However, to our knowledge no published papers have described concussion specifically in the dancer. This case series involved a retrospective chart review at a large teaching hospital over a 5.5-year period. Eleven dancers (10 female, 1 male) were identified who experienced concussions while in dance class, rehearsal, or performance: 2 in classical ballet, 2 in modern dance, 2 in acro dance, 1 in hip hop, 1 in musical theater, and 3 were unspecified. Dancers were between 12 and 20 years old at the time of presentation. Three concussions occurred during stunting, diving, or flipping. Three resulted from unintentional drops while partnering. Two followed slips and falls. Two were due to direct blows to the head, and one dancer developed symptoms after repeatedly whipping her head and neck in a choreographed movement. Time to presentation in the sports medicine clinic ranged from the day of injury to 3 months. Duration of symptoms ranged from less than 3 weeks to greater than 2 years at last documented follow-up appointment. It is concluded that dancers do suffer dance-related concussions that can result in severe symptoms, limitations in dance participation, and difficulty with activities of daily living. Future studies are needed to evaluate dancers' recognition of concussion symptoms and care-seeking behaviors. Additional work is also necessary to tailor existing guidelines for gradual, progressive, safe return to dance. PMID:24844421

  16. Facial Firework Injury: A Case Series

    Directory of Open Access Journals (Sweden)

    Kashyap Tadisina

    2014-07-01

    Full Text Available Fireworks are used to celebrate a variety of religious, patriotic, and cultural holidays and events around the world. Fireworks are common in the United States, with the most popular holiday for their use being national Independence Day, also known as July Fourth. The use of fireworks within the context of celebrations and holidays presents the ideal environment for accidents that lead to severe and dangerous injuries. Injuries to the face from explosions present a challenging problem in terms of restoring ideal ocular, oral, and facial function. Despite the well documented prevalence of firework use and injury, there is a relatively large deficit in the literature in terms of firework injury that involves the face. We present a unique case series that includes 4 adult male patients all with severe firework injuries to the face that presented at an urban level 1 trauma center. These four patients had an average age of 26.7 years old and presented within 5 hours of each other starting on July Fourth. Two patients died from their injuries and two patients underwent reconstructive surgical management, one of which had two follow up surgeries. We explore in detail their presentation, management, and subsequent outcomes as an attempt to add to the very limited data in the field of facial firework blast injury. In addition, the coincidence of their presentation within the same 5 hours brings into question the availability of the fireworks involved, and the possibility of similar injuries related to this type of firework in the future.

  17. Intramuscular Olanzapine – a UK case series of early cases

    Directory of Open Access Journals (Sweden)

    Taylor Mark

    2007-04-01

    Full Text Available Abstract Background Clinical trials assessing efficacy and safety of Intramuscular (IM Olanzapine in acute schizophrenia and acute mania have previously been undertaken in studies required for drug registration in patients who were required to give informed consent. These patients may have less severe forms of psychosis than patients treated in routine practice. Data derived from naturalistic practice following the launch of IM olanzapine may be helpful for clinicians in assessing efficacy and safety of IM olanzapine. The PANSS-EC scale used in the clinical studies may represent a tool that could be used in routine clinical practice. Case presentation We report on an early unselected case series of 7 patients who received IM olanzapine in routine clinical practice settings in the UK. In this case series, olanzapine IM was generally effective, and no adverse events were reported. Adjunctive benzodiazepines were given concomitantly in 1 of the 7 subjects. This is relevant as concomitant benzodiazepines are not recommended for a minimum of 1 hour post IM olanzapine administration. PANSS-EC data was collected in 2 of the 7 subjects. Conclusion Although patients had greater severity of psychosis than clinical trial patients there were no unexpected findings. In addition the PANSS-EC scale is a scale that may be useful in assessing the efficacy of IM antipsychotics in routine clinical practice.

  18. Indications and Case Series of Intentional Replantation of Teeth

    OpenAIRE

    Asgary, Saeed; Alim Marvasti, Laleh; Kolahdouzan, Alireza

    2013-01-01

    This case series aims to comprehensively introduce intentional replantation with a focus on its indications and case selection in endodontics. In all represented cases, calcium enriched mixture (CEM) cement is used for root-end filling. This case series demonstrates twenty cases of IR and extraoral root-end resection and filling with CEM cement. All the selected teeth had a failed endodontic treatment and required surgical/nonsurgical endodontic (re)treatment or extraction. Subsequent to gent...

  19. An Operating Economic Exposure - Australian Case Study: Foster’s Group Limited Beer

    OpenAIRE

    Scott McCarthy; Adelina Ispriani

    2004-01-01

    This paper uses a large Australian multinational corporation as a case study examining foreign exchange operating exposure. We firstly review the importance of operating exposure for a business and then examine in detail the company’s exposure and policies to manage the exposure. A sensitivity analysis is also conducted to examine how movements in the value of exchange rates affect the company. We conclude with some suggestions as to how the company could further protect itself from adverse m...

  20. The 2Rs – Respect and Responsibility: The Case of Australian Muslim Girls

    OpenAIRE

    Nahid Afrose Kabir

    2009-01-01

    The citizenship debate involves respect and responsibility. In this paper I discuss the case of Australian Muslims girls who in their home environment respect the family values and carry out certain responsibilities assigned to them. In the wider society, they attend schools, do part-time jobs and obey the values of the institutions. However, I question in this paper, whether the family and the wider society are fulfilling their responsibility towards these girls. I discuss the interview r...

  1. Societal acceptance of wind farms: Analysis of four common themes across Australian case studies

    International Nuclear Information System (INIS)

    Australia's renewable energy target (RET) seeks to provide 20 per cent of Australia's electricity generation from renewable energy sources by 2020. As wind power is relatively advanced, it was anticipated that wind power will contribute a major component of the early target. However, high levels of societal resistance to wind farms, combined with new regulatory policies, indicate the RET may not be dominated by wind power. This research involved an examination of seven case studies around wind farm deployment. Qualitative interviews were the primary data for the case studies and analysed using methods informed by grounded theory. Despite the diversity of stakeholder views, the qualitative analysis identified strong community support for wind farms but four common themes emerged that influence this societal acceptance of wind farms in Australia: trust, distributional justice, procedural justice and place attachment. Without addressing these factors through integration into policy development and engagement approaches, wind energy is unlikely to provide the early and majority of new renewable energy. Similar international experiences are incorporated in the discussion of the Australian wind industry's societal acceptance. - Highlights: ► Seven case studies of wind farms in Australia are described. ► Acceptance affects whether wind significantly contributes to the Aust. RE target. ► Four themes were identified regarding societal acceptance of Australian wind farms. ► Four themes are trust, distributional and procedural justice, and place attachment. ► International similarities to the Australian experience are provided

  2. Primary postpartum haemorrhage in an Australian tertiary hospital: a case-control study.

    Science.gov (United States)

    Henry, Amanda; Birch, Mary-Rose; Sullivan, Elizabeth A; Katz, Sue; Wang, Yueping Alex

    2005-06-01

    The present study aimed to determine the incidence of primary postpartum haemorrhage (PPH) after vaginal birth at an Australian tertiary hospital, and to investigate risk factors for primary PPH at this hospital. A case-control study of women delivering vaginally at a tertiary hospital from February to June 2003 was performed. Demographic, antenatal, intrapartum, treatment and outcome data were abstracted from patient records. The study population comprised 125 cases and 125 controls, with a primary PPH rate of 12.1 per 100 vaginal births. Risk factors on multivariate analysis were past history of PPH, second stage labour > 60 min, forceps delivery, and incomplete placenta/ragged membranes. PMID:15904450

  3. A Caucasian Australian presenting with human T-lymphotropic virus type I associated myelopathy: a case report

    Science.gov (United States)

    2014-01-01

    Introduction We report the first known case of human T-lymphotropic virus type I associated myelopathy/tropical spastic paraparesis in an Australian Caucasian, a disease reported in Aboriginal and immigrant populations where the virus is often endemic. Case presentation A 41-year-old Caucasian Australian man had a 3-year background of progressive functional decline from a myelopathy with spastic paraparesis and sphincteric dysfunction. Conclusions Although studies have shown a very low prevalence of human T-lymphotropic virus type I in the greater Australian population, increased focus on Aboriginal health, and the expanding diversity and integration of the Australian population means that presentation of human T-lymphotropic virus type I-associated disease is likely to increase. PMID:25416840

  4. Relationship Contracting: The South Australian Experience - A Case Study

    Directory of Open Access Journals (Sweden)

    Jian Zou

    2012-11-01

    Full Text Available The construction industry has long been accusedof poor performance. The confrontational attitudeof its members and the resultant adversarial atmosphere has been identified as a major factor responsible for this poor performance. A cultural change is required to remove these barriers and to promote optimum project outcomes. Relationship contracting is promoted as a way to support the shift from the adversarial culture to the co-operative and collaborative culture within the industry and the project team.The Adelaide Convention Centre Extensions project was the first in South Australia to be procure und r the principles of relationship contract1ng. Usmg the case study approach, this paper reviews the form of relationship contracting used in this milestone project. The paper documents the lessons learned from this project and makes recommendations that can lead to improvements for future projects.

  5. Pulmonary Artery Agenesis: A Case Series

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    Meltem Ağca

    2015-04-01

    Full Text Available Pulmonary artery agenesis is a rare congenital abnormality in which atresia was encountered in the short segment of the right or left pulmonary arteries. It can be isolated or associated with cardiac abnormalities such as tetralogy of Fallot, septal defects or pulmonary stenosis.The majority of cases are diagnosed in childhood whereas some cases yield no symptoms until adulthood. We evaluated retrospectively 5 pulmonary artery agenesis cases diagnosed in our clinics between 1998-2010 with respect to the literature.

  6. Eat, drink and gamble: marketing messages about ‘risky’ products in an Australian major sporting series

    Science.gov (United States)

    2013-01-01

    Background To investigate the alcohol, gambling, and unhealthy food marketing strategies during a nationally televised, free to air, sporting series in Australia. Methods/approach Using the Australian National Rugby League 2012 State of Origin three-game series, we conducted a mixed methods content analysis of the frequency, duration, placement and content of advertising strategies, comparing these strategies both within and across the three games. Results There were a total of 4445 episodes (mean = 1481.67, SD = 336.58), and 233.23 minutes (mean = 77.74, SD = 7.31) of marketing for alcoholic beverages, gambling products and unhealthy foods and non-alcoholic beverages during the 360 minutes of televised coverage of the three State of Origin 2012 games. This included an average per game of 1354 episodes (SD = 368.79) and 66.29 minutes (SD = 7.62) of alcohol marketing; 110.67 episodes (SD = 43.89), and 8.72 minutes (SD = 1.29) of gambling marketing; and 17 episodes (SD = 7.55), and 2.74 minutes (SD = 0.78) of unhealthy food and beverage marketing. Content analysis revealed that there was a considerable embedding of product marketing within the match play, including within match commentary, sporting equipment, and special replays. Conclusions Sport is increasingly used as a vehicle for the promotion of range of ‘risky consumption’ products. This study raises important ethical and health policy questions about the extent and impact of saturation and incidental marketing strategies on health and wellbeing, the transparency of embedded marketing strategies, and how these strategies may influence product consumption. PMID:23914917

  7. Pneumothorax, music and balloons: A case series

    OpenAIRE

    2013-01-01

    We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of ...

  8. Rhinocerebral mucormycosis: A series of 3 cases

    Directory of Open Access Journals (Sweden)

    Vinay Vaidyanathan

    2012-01-01

    Full Text Available Three cases of rhinocerebral mucormycosis (RCM with different courses of illness following a common standardized treatment protocol are discussed. Seen predominantly in diabetics. Clinical picture is often blurred by overlapping features of chronic rhinosinusitis. CT picture is helpful in assessing extent. Histopathological evidence is diagnostic. We describe three cases of RCM with different presentations but followed same treatment protocol. RCM is not just a disease of chronic uncontrolled diabetics. Its indolent clinical course doesn′t correlate with its aggressive pathology for which strict treatment protocol to be followed. In suspected cases of RCM, improvement of predisposing diseases, radical surgical debridement and effective systemic antifungal therapy must be instituted immediately. Absence of intracranial or orbital extension are indicators of good prognosis. Ketoacidosis is the single most important detrimental factor.

  9. Pneumothorax, music and balloons: A case series

    Directory of Open Access Journals (Sweden)

    Shiferaw Dejene

    2013-01-01

    Full Text Available We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of developing pneumothorax in otherwise healthy individuals. This aspect of pneumothorax development is worthy of further exploration, to better elucidate the mechanism and enhance our understanding of this common respiratory presentation.

  10. Pneumothorax, music and balloons: A case series.

    Science.gov (United States)

    Dejene, Shiferaw; Ahmed, Fahim; Jack, Kastelik; Anthony, Arnorld

    2013-07-01

    We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of developing pneumothorax in otherwise healthy individuals. This aspect of pneumothorax development is worthy of further exploration, to better elucidate the mechanism and enhance our understanding of this common respiratory presentation. PMID:23922614

  11. Common Carotid Artery Occlusion: A Case Series

    OpenAIRE

    Zoltán Bajkó; Rodica Bălaşa; Anca Moţăţăianu; Smaranda Maier; Octavia Claudia Chebuţ; Szabolcs Szatmári

    2013-01-01

    Subjects and Methods. We analysed 5000 cerebrovascular ultrasound records. A total of 0.4% of the patients had common carotid artery occlusion (CCAO). Results. The mean age was 59.8 ± 14.2 years, and the male/female ratio was 2.33. The most frequent risk factors were hypertension, ischaemic heart disease, dyslipidemia, diabetes mellitus, and smoking. Right-sided and left-sided CCAO occurred in 65% and 30% of the cases, respectively, and bilateral occlusion was detected in one case (5%). Paten...

  12. Successful management of hamstring injuries in Australian Rules footballers: two case reports

    Directory of Open Access Journals (Sweden)

    Hoskins Wayne T

    2005-04-01

    Full Text Available Abstract Hamstring injuries are the most prevalent injury in Australian Rules football. There is a lack of evidence based literature on the treatment, prevention and management of hamstring injuries, although it is agreed that the etiology is complicated and multi-factorial. We present two cases of hamstring injury that had full resolution after spinal manipulation and correction of lumbar-pelvic biomechanics. There was no recurrence through preventative treatment over a twelve and sixteen week period. The use of spinal manipulation for treatment or prevention of hamstring injury has not been documented in sports medicine literature and should be further investigated in prospective randomized controlled trials.

  13. Complex and Compound Odontoma: Case Series

    OpenAIRE

    ÜNGÖR, Dr. Dt. Cem; KILIÇ, Dt. İbrahim

    2013-01-01

    Odontomas are considered as developmental anomalies resulting from the growth of completely differentiated epithelial and mesenchymal cells that give rise to ameloblasts and odontoblasts. The exact etiology of odontomes is still not known. Most odontomes are asymptomatic and are discovered during routine radiographic investigations. Odontomas are the most common odontogenic tumours. In this report, 5 odontoma cases ( 2 complex, 3 compaund) and their treatments was presented.

  14. Stiff-Person Syndrome: Case Series

    Directory of Open Access Journals (Sweden)

    Yu Jin Jung

    2014-04-01

    Full Text Available Stiff-person syndrome (SPS is a rare disorder, characterized by progressive fluctuating muscular rigidity and spasms. Glutamic acid decarboxylase (GAD antibody is primarily involved in the pathogenesis of SPS and SPS is strongly associated with other autoimmune disease. Here we report three cases of patients with classical SPS finally confirmed by high serum level of GAD antibodies. All of our patients respond favorably to gamma amino butyric acid-enhancing drugs and immunotherapies.

  15. Herpes simplex encephalitis -A case series

    OpenAIRE

    MANJU, Jyotir; Patil, Shruti; RAU, ATK

    2012-01-01

    The prognosis of Herpes simplex encephalitis (HSE) depends on the early and appropriate administration of specific antiviral therapy. We retrospectively reviewed 42 children with acute CNS infection, over a period of 18 months, of which 4 were positive for HSV antibodies. All four showed CSF pleocytosis, with mildly elevated protein and rising titers of antibodies to HSV in the CSF. All the 4 cases were started on i.v. acyclovir on day 1 and continued for a total duration of 14 days. The pati...

  16. The sweet Christmas rash (case series)

    DEFF Research Database (Denmark)

    Gyldenløve, Mette; Nepper-Christensen, Steen; Thyssen, Jacob P; Faurschou, Annesofie

    2013-01-01

    Christmas tree hypersensitivity is a rare condition, which has so far obtained scarce attention in the medical literature. We present two clinical cases of hypersensitivity associated with Christmas tree exposure, a 51-year-old woman with allergic contact dermatitis and a 41-year-old man with all...... allergic rhinitis. The female patient had a positive patch test reaction to colophony, and the male patient had a positive skin prick test reaction to alternaria mould. Both were successfully advised to avoid prolonged exposure to Christmas trees and buy artificial trees for Christmas....

  17. Global aphasia without hemiparesis: A case series

    Directory of Open Access Journals (Sweden)

    Aparna R Pai

    2011-01-01

    Full Text Available Background: Global aphasia without hemiparesis (GAWH is a rare stroke syndrome characterized by the unusual dissociation of motor and language functions. Issues regarding its etio-pathogenesis, lesion sites, and recovery patterns are extensively being debated in contemporary neuroscience literature. Materials and Methods: Four patients admitted in our hospital between 2005 and 2009 with GAWH caused by ischemic stroke were studied retrospectively with emphasis on number and site of lesions, etiology, and recovery patterns. Results: The clinical findings from our subjects showed that GAWH could result from either single/multiple lesions including subcortical lesions. The recovery was rapid, although not complete. One case evolved into Wernicke′s aphasia as seen in earlier studies. Two subjects revealed evolution to transcortical sensory aphasia and one to Broca′s aphasia which is distinct from previous proposals. Two cases showed lack of clinico-anatomic correlation during recovery. Conclusions: GAWH could result from both embolic and large vessel strokes and single or multiple lesions. The recovery pattern may be variable and may show lack of clinico-anatomical correlation indicating anomalous cerebral functional reorganization, questioning the conventional teaching of language representation in the brain.

  18. Doxycyclin induced esophageal injury: A Case series

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    İsmail Demiryılmaz

    2013-01-01

    Full Text Available Some drugs have been known to damage to esophagusfor a long time. Half of the cases reported are of tetracyclineand its derivatives. The damage caused by thesedrugs is depends on the drug itself and the patient.In this paper we present 5 patients having diagnosedesophageal damage endoscopically after due to doxycyclinuse. The mean age of the patients was 26 years.Three of them for acne and 2 for heir complaints gynecologicalinfection were taking these drugs. Lesions werelocated at the middle in 4 cases and lover part in 1 patient.The common complaint was retrosternal pain and heartburnafter taking the drug with insufficient water or withoutwater. All the patients were relieved by symtomatic teratment.Esophageal damage is to be remembered in patientscomplaning sudden pain and difficult swallowing on doxycyclintreatment and endoscopic procedure should beemployed for definition of diagnosis and evaluation of theseverity of the damage. After treatment, endoscopic controlis not necessary. Physicians must not forget to advicethe patients to take these drugs with splendid amount ofwater.Key words: Doxycycline, esophagus damage, endoscopy

  19. Adverse Events Associated with Yoga: A Systematic Review of Published Case Reports and Case Series

    OpenAIRE

    Cramer, Holger; Krucoff, Carol; Dobos, Gustav

    2013-01-01

    While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopeni...

  20. Mechanics, Problems and Contributions of Tertiary Strategic Alliance: The Case of 22 Australian Universities.

    Science.gov (United States)

    Saffu, Kojo; Mamman, Aminu

    1999-01-01

    A study of international strategic alliances involving 22 Australian universities indicates that a majority of universities have frameworks for internationalization initiatives, with top institutional management instrumental in initiating joint ventures with overseas institutions despite limited resources. Australian universities believe they…

  1. Granulomatous lobular mastitis ,A case series.

    Directory of Open Access Journals (Sweden)

    Ali Pourzand

    2014-05-01

    Full Text Available BACKGROUND: Granulomatous lobular mastitis (GLM is an inflammatory disease of the breast, which can mimic breast cancer in clinical and radiological findings. We conducted the present study in order to determine the diagnostic and other important aspects of this disease. METHODS: In this study, we reviewed the records of 38 patients with granulomatous lobular mastitis in order to describe the clinical, imaging, laboratory, pathologic, and treatment aspects of this disease. RESULTS: All of the patients’ ages were in the range of 22-62 years (mean age: 42 years. All of them had children, history of oral contraceptive pill (OCP usage, antibiotic therapy and mammoplasty. In physical examination, dimpling, edema, inflammation, ulcer, abscess, and firm mass were detected. Size of masses was in the range of 2 × 2 to 8 × 6 cm and their location, in most cases, was in the superior lateral quadrant or central region. In Ultrasonography, a hypoechoic fibroglandular mass and collection, and in pathologic findings, granulomatous reaction was reported. These patients were treated by antibiotics, corticosteroids, and surgery. CONCLUSIONS: GLM is a chronic inflammatory lesion of the breast which can mimic breast cancer. A history of child bearing, lactation, and OCP drug usage have suspicious roles in the formation of GLM. The most common clinical sign in these patients is a painful mass in the breast. We uncovered that clinical and radiological findings are not specific and sufficient for diagnosis of GLM. Therefore, for better diagnosis of this disease, usage of core, incisional, or excisional biopsy are recommended.

  2. Aspergillosis in HIV patients: a case series

    Directory of Open Access Journals (Sweden)

    F Laurent

    2012-11-01

    Full Text Available Purpose: Aspergillosis is uncommon in HIV patients and has been mostly reported in patients with CD4<50/µL. Data on risk factors and prognosis are scarce. We reviewed 19 cases of aspergillosis diagnosed in our HIV cohort. Methods: In the Brussels Saint-Pierre HIV cohort, 19 patients were diagnosed with aspergillosis between 1998 and 2012 (0.87/1000 patient/year of follow-up. We analyzed retrospectively and described localization and invasiveness of aspergillosis, risk factors, treatment and outcome of these patients. Results: Patients were mostly African (74% and mean age was 40 years (22–60. Clinical presentation were 10 invasive aspergillosis (IA (53%, 6 pulmonary aspergilloma (31% and 3 sinus fungal ball (16%. The global mortality was 42%. IA was proven for 3 patients, probable for 4 patients and possible for 3 patients according to IDSA definitions. Risk factors for IA included CD4<200/µL (70%; 40%<50 CD4/µL, corticotherapy (50%, neutropenia (20%, intravenous drug use (20%, cirrhosis (20%. IA arose in the time course of septic shock in 30% and opportunistic infections occurred concomitantly in 40%. Seven patients out of 10 with IA died including 3 patients before antifungal therapy. The 3 survivors recovered without relapse. Four patients were treated with voriconazole, 2 with itraconazole, 2 with liposomal amphotericine, 1 with caspofungine, and 2 with bitherapy. Among patients with aspergilloma (n=6, the major associated risk factor was tuberculosis sequelae (80%. Two patients were successfully treated with surgery and voriconazole, 1 died from massive hemoptysis, 2 were lost to follow-up, 1 is currently asymptomatic without treatment. Among patients with sinus fungal ball (n=3, all recovered without relapse with surgical treatment associated with voriconazole for one. Conclusion: Incidence of aspergillosis in HIV patients remains low but in accordance to previous reports, mortality of IA is high (70%. CD4<200 is the most common risk

  3. Familial expansile osteolysis: An Australian case report of a Paget's Disease Mimic.

    Science.gov (United States)

    Topham, Dean Grant; Sampson, Matthew John

    2016-06-01

    We report a case of familial expansile osteolysis (FEO) with multimodality imaging findings and histopathological correlation in a 42-year-old man presenting to a South Australian Emergency Department. FEO is a unique metabolic bone condition that is similar in some respects to Paget's disease but distinct enough in its clinical, radiological and histological findings to be classified as a separate disease process. It is inherited in an autosomal dominant pattern and typified by increased osteoclast activity, medullary expansion, and hearing and dental problems. These changes can lead to significant morbidity with individuals affected suffering from bone pain and pathological fractures. To the best of the authors' knowledge, there are no reported cases in the literature documenting this disease in Australia. PMID:27258166

  4. Chikungunya – an emerging infection in Bangladesh: a case series

    OpenAIRE

    Hassan, Rashedul; Rahman, Md. Mujibur; Moniruzzaman, Md; RAHIM, Abdur; Barua, Satyajit; Biswas, Rajib; Biswas, Pijous; Mowla, Syed Ghulam Mogni; Chowdhury, MA Jalil

    2014-01-01

    Introduction Chikungunya is an arthropod-borne virus endemic to Africa, Southeast Asia and India that causes acute febrile polyarthralgia and arthritis. In this short case series, we discuss six Bangladeshi patients with chikungunya fever. Though Bangladesh is in endemic zone, it is not common here, hence it demands attention for proper diagnosis and management. Case presentation The six cases of chikungunya we report occurred in native Bangladeshi women with ages ranging from 20 to 50 years ...

  5. Case series of eosinophilic meningoencephalitis from South India

    OpenAIRE

    Parameswaran K

    2006-01-01

    Eosinophilic meningoencephalitis (EM) is a rare type of meningoencephalitis. The objective of this report is to describe a series of EM identified in a specific geographic area over a short period of time. Materials and Methods: This series of cases are described from a neurological center in Central Kerala occuring in the period between February 2004 and June 2006. Results: During this period we had identified ten patients (eight males and two females) with EM. Their mean age was 37.1 ye...

  6. Are there returns from ancillary marketing communication expenditure? - A case study in the Australian financial services sector

    NARCIS (Netherlands)

    V.L. Hodgson; A. Hodgson

    2005-01-01

    This paper tests if there are returns from investing in marketing communications expenditure (MCE) by using excess risk weighted accounting earnings as an output metric.We utilise panel data techniques and a case study of Australian credit unions that successfully invest in core relational activitie

  7. STRATEGIES TO IMPROVE RETENTION OF POSTGRADUATE BUSINESS STUDENTS IN DISTANCE EDUCATION COURSES: An Australian Case

    Directory of Open Access Journals (Sweden)

    David CARROLL,

    2013-01-01

    Full Text Available In spite of the clear value of postgraduate business students to many providers of distance education courses, the factors affecting the retention of these students have received limited attention in the literature. In addressing this gap, this paper presents the findings of a qualitative study into the factors affecting the retention of postgraduate business students at a major Australian distance education university. The findings of this study suggest that a range of situational, dispositional and attitudinal factors impact upon student retention on this context, both as enablers of and obstacles to ongoing participation. In many cases, these factors differ to those identified in the existing literature on student retention. Based on these findings, we present a range of strategies designed to improve the retention of postgraduate business students by maximising enabling factors and minimising the impact of any identified obstacles. Limitations of the study and suggestions for further research are also presented.

  8. Rare Hernias Presenting as Acute Abdomen- A Case Series

    Science.gov (United States)

    Ulahannan, Sansho Elavumkal; Kurien, John S; Joseph, Aneesh; Kurien, Annie Sandhya; Varghese, Sandeep Abraham; Thomas, Bindhya; Varghese, Fobin

    2016-01-01

    Hernia is an abnormal protrusion of an organ or tissue through a defect in its surrounding walls. It can be divided into internal, external and diaphragmatic hernias. Most of them can be asymptomatic. If they become symptomatic they can present with features of intestinal obstruction, incarceration or strangulation. In this case series we compare the incidence of these rare presentations of hernias with world literature and to warn surgeons not to cut the obstructing band in cases of internal hernias. In this case series, we review the clinical details of 7 rare presentations of hernia, who presented with various types of hernias to a tertiary care centre in Kerala over a period of one year. Of these 7 cases 6 cases were internal hernias (3 left paraduodenal hernias, 2 transmesentric hernias, and 1 pericaecal hernia) and a case of spigelian hernia above the level of umbilicus. All of them presented as acute abdomen in the emergency department. Among these 7 cases, only one case was diagnosed preoperatively. Three patients had bowel gangrene and had to undergo resection- anastomosis of the bowel. The survival rate among these cases was 100% as compared to 50% in the world literature if they had been left untreated. Even though internal hernias are a rare entity, we need to have it as a differential diagnosis in case of intestinal obstruction, in a previously non-operated abdomen.

  9. Primary oral malignant melanoma: Clinicopathological series of four cases

    Directory of Open Access Journals (Sweden)

    Ajay Kumar

    2012-01-01

    Full Text Available Melanoma of the oral cavity is a rare malignant disease. On account of the presence at relatively obscure areas in the oral cavity, most of oral malignant melanomas are diagnosed at a late stage. Early diagnosis is essential for successful treatment and perhaps is the key factor in improving the prognosis of oral malignant melanoma. However, no large clinical series exist, and in fact, clinical cases are the sole key source of information. We hereby present a series of four cases of primary oral malignant melanoma of South-East Asian ethnic origin, with long-term, regular follow-up. The age of the patients ranged between 40 and 70 years, with equal sex predilection, and the gingiva was found to be the most common site of its occurrence. Based on clinical and histological parameters, all the cases were diagnosed as primary malignant melanoma, which were further confirmed by using immunohistochemical markers.

  10. UNIVERSITY LIFE AND AUSTRALIAN HOMES: THREE CASE STUDIES OF INTERNATIONAL MUSLIM STUDENTS IN BRISBANE

    Directory of Open Access Journals (Sweden)

    Zulkeplee Othman

    2014-12-01

    Full Text Available Despite a significant increase in enrolments of postgraduate international Muslim students within Australian universities, little is known about their perceptions of life within Australian homes while undertaking their studies. The aim of this study is to investigate the ways in which students’ cultural and religious traditions affect their use of domestic spaces within the homes in which they reside. The research found that participants faced some minor difficulties in achieving privacy, maintaining modesty and extending hospitality while able to perform their daily activities in Australian designed homes. The findings suggest that greater research attention needs to be given to the development of Australian home designs that are adaptable to the needs of a multicultural society. Australian society encompasses diverse cultural customs and requirements with respect to home design, and these are yet to be explored.

  11. Endodontic Periodontic Lesions and Host Modulation – Case Series

    Directory of Open Access Journals (Sweden)

    Afaf Zia

    2015-07-01

    Full Text Available Host modulation, includes inhibition of matrix metalloproteinases, blocking production of proinflammatory cytokines and inhibition of osteoclastic activity, has therapeutic value as adjunctive therapy in treating chronic periodontitis. This case series presented three patients with chief complaint of teeth mobility where endo perio involvement was diagnosed. The endo perio combined lesions generally shows the communication between pulp and periodontal tissues with the same origin of dental infection. Diagnosis in such cases is difficult and generally raising problem in the management. All of the cases were managed by non surgical endodontic therapy combined with host modulation. All local factors causing the lesion were removed. Clinical outcome after six and nine months were quite satisfactory. Combined endo perio cases are challenging to the dentists and involve multidisciplinary involvement. To manage such cases, dentists have to rely on the unconventional techniques.DOI: 10.14693/jdi.v22i1.378

  12. A case series of Osteoid Osteoma: 7 cases

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    Farzan M

    1997-08-01

    Full Text Available Osteoid osteoma is a unique benign primary bone tumor that may present in the metaphyseal diaphyseal areas of the short tubular bones and has also been reported in the carpal bones. It occurs in the first two decades of life. The classic history is bone pain, often relieved by aspirin. The clinical appearance is local swelling and tenderness. The typical radiographic appearance is very characteristic: an eccentric area of cortical sclerosis, frequently with a radiolucent nidus. The lesion does not exceed 1 cm in diameter. The use of a bone scan may be helpful diagnostically, as are the CAT scan and tomography. Doyle et al described seven cases of osteoid osteoma with a prolonged delay in diagnosis, but reported an excellent cure rate following excision. The carpus is not unusual as a site for this tumor, especially the scaphoid. Treatment is windowing with curettage of the tumor nidus. The use of a dental drill to window the phalanx and expose the nidus is very helpful. Removal of the entire nidus is permanently curative, but if a portion of the tumor is missed, prompt recurrence of the symptoms is the rule.

  13. The 2Rs – Respect and Responsibility: The Case of Australian Muslim Girls

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    Nahid Afrose Kabir

    2009-11-01

    Full Text Available The citizenship debate involves respect and responsibility. In this paper I discuss the case of Australian Muslims girls who in their home environment respect the family values and carry out certain responsibilities assigned to them. In the wider society, they attend schools, do part-time jobs and obey the values of the institutions. However, I question in this paper, whether the family and the wider society are fulfilling their responsibility towards these girls. I discuss the interview responses of 39 Muslim girls (15-18 years living in Sydney and Perth. I examine pertinent cases within the framework of relevant academic literature, and argue within the social, religious and cultural context. The issues within the family domain are inter-twined within Islamic religious-cultural arguments, whereas the issues in the public domain are argued on cultural conflict between the Muslims and the wider society. With both arguments I show how some Muslim girls negotiate their identity, and suggest their bicultural identity is assisting them to keep a positive attitude in their everyday life.

  14. DISK BATTERIES IN THE ESOPHAGUS OF NIGERIAN CHILDREN: CASE SERIES

    OpenAIRE

    LUCKY OBUKOWHO ONOTAI; ADAOBI ELIZABETH OSUJI

    2015-01-01

    Foreign body (FB) ingestion is common in clinical practice especially in children. Its impaction in the esophagus constitutes an important cause of morbidity and mortality in our environment. Due to technological advancement and increase use of disk batteries to power children toys and remote control gadgets, ingestion of disk batteries is now commonplace. In our environment there is paucity of information on disk batteries hence we decided to present case series of disk batteries in the esop...

  15. Hereditary nonsyndromic gingival fibromatosis: report of family case series.

    Science.gov (United States)

    Peeran, Syed Wali; Ramalingam, Karthikeyan; Peeran, Syed Ali; Mugrabi, Marei Hamed; Abdulla, Khaled Awidat

    2013-01-01

    Hereditary gingival fibromatosis (HGF) is a rare, benign disorder with slowly progressive enlargement of maxillary and mandibular gingiva. Herewith, we report the first case series of HGF presenting among mother and all of her 3 children. Their complaints included unaesthetic appearance due to gingival growth, malocclusion, and difficulty in mastication. Conventional gingivectomy with oral hygiene measures and regular followup is the treatment of choice for such presentation. PMID:24191204

  16. Hereditary Nonsyndromic Gingival Fibromatosis: Report of Family Case Series

    OpenAIRE

    Syed Wali Peeran; Karthikeyan Ramalingam; Syed Ali Peeran; Marei Hamed Mugrabi; Khaled Awidat Abdulla

    2013-01-01

    Hereditary gingival fibromatosis (HGF) is a rare, benign disorder with slowly progressive enlargement of maxillary and mandibular gingiva. Herewith, we report the first case series of HGF presenting among mother and all of her 3 children. Their complaints included unaesthetic appearance due to gingival growth, malocclusion, and difficulty in mastication. Conventional gingivectomy with oral hygiene measures and regular followup is the treatment of choice for such presentation.

  17. Acute Pancreatitis with Normal Serum Lipase: A Case Series

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    Anish M Shah

    2010-07-01

    Full Text Available Context Acute pancreatitis is diagnosed on the basis of clinical features, biochemical tests and imaging studies. Normal serum amylase level has been reported in the setting of acute pancreatitis but normal serum lipase level in acute pancreatitis is extremely rare. Case report Herein, we present a case series of acute pancreatitis with normal serum lipase levels along with a review of the topic. Conclusion In appropriate clinical setting, the diagnosis of acute pancreatitis should be entertained even with normal serum amylase and lipase levels.

  18. Transitioning beliefs in teachers of Chinese as a foreign language: An Australian case study

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    Robyn Moloney

    2015-12-01

    Full Text Available With the economic rise of China, there is global demand for effective teaching and learning of Chinese as a foreign language (CFL. There has been limited sustained success in Chinese language learning in Australian schools, however, and this has been attributed, amongst other factors, to pedagogy employed by teachers. Today, it is commonplace to understand that educational background influences teacher beliefs which in turn impact pedagogical transition in overseas teaching environments. This exploratory case study reports qualitative analysis of interviews with nine school teachers of CFL in New South Wales, Australia. The study mapped three groups of beliefs within the Chinese teacher group, namely, beliefs which align with principles of traditional Chinese education, beliefs which align with constructivist learning principles and beliefs in transition between. All teachers in the CFL teacher community of practice could be said to be in a fluid process of transition, to find new pedagogical identities and best practice. This study’s findings as to transitioning beliefs, and the study’s recommendations, are of significance in the design of more effective teacher training suitable to achieve successful learning outcomes in Chinese foreign language classrooms.

  19. The discourse of "social licence to operate": case study of the Australian wind industry

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    Nina L. Hall

    2014-12-01

    Full Text Available Social Licence to Operate is a concept from the mining industry that reflects the ongoing acceptance or approval for a development granted by local stakeholders. It is now being applied by wind farm developers. Using the Australian wind industry as a case study, this discourse analysis examined how Social Licence to Operate is perceived and operationalised, and the key themes in this conceptual and applied discourse. Discourse analysis acknowledges that language choices are not accidental and discourse reflects power relationships. The wind industry representatives interviewed considered power over the Social Licence to Operate was shared with community stakeholders. They recognised the stakeholders' power to delay or prevent projects, but rejected the notion that every stakeholder group should have veto power. Social Licence to Operate is seen by the wind industry through a business-oriented perspective, with an emphasis on business risk, and they describe the opposition to wind farms by invoking a metaphor of "battle". The industry respondents described Social Licence to Operate as incorporating the values of trust, transparency and participation—which all contribute to creating "authentic" relationships. These findings can inform Social Licence to Operate research, engagement practices, and also encourage reflection by industry representatives on their implicit intentions for stakeholder engagement.

  20. Time series analysis of the impact of tobacco control policies on smoking prevalence among Australian adults, 2001?2011

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    Melanie A Wakefield

    2014-06-01

    Full Text Available Objective To determine the impact of tobacco control policies and mass media campaigns on smoking prevalence in Australian adults. Methods Data for calculating the average monthly prevalence of smoking between January 2001 and June 2011 were obtained via structured interviews of randomly sampled adults aged 18 years or older from Australia’s five largest capital cities (monthly mean number of adults interviewed: 2375. The influence on smoking prevalence was estimated for increased tobacco taxes; strengthened smoke-free laws; increased monthly population exposure to televised tobacco control mass media campaigns and pharmaceutical company advertising for nicotine replacement therapy (NRT, using gross ratings points; monthly sales of NRT, bupropion and varenicline; and introduction of graphic health warnings on cigarette packs. Autoregressive integrated moving average (ARIMA models were used to examine the influence of these interventions on smoking prevalence. Findings The mean smoking prevalence for the study period was 19.9% (standard deviation: 2.0%, with a drop from 23.6% (in January 2001 to 17.3% (in June 2011. The best-fitting model showed that stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns independently explained 76% of the decrease in smoking prevalence from February 2002 to June 2011. Conclusion Increased tobacco taxation, more comprehensive smoke-free laws and increased investment in mass media campaigns played a substantial role in reducing smoking prevalence among Australian adults between 2001 and 2011.

  1. Time series analysis of the impact of tobacco control policies on smoking prevalence among Australian adults, 2001–2011

    Science.gov (United States)

    Coomber, Kerri; Durkin, Sarah J; Scollo, Michelle; Bayly, Megan; Spittal, Matthew J; Simpson, Julie A; Hill, David

    2014-01-01

    Abstract Objective To determine the impact of tobacco control policies and mass media campaigns on smoking prevalence in Australian adults. Methods Data for calculating the average monthly prevalence of smoking between January 2001 and June 2011 were obtained via structured interviews of randomly sampled adults aged 18 years or older from Australia’s five largest capital cities (monthly mean number of adults interviewed: 2375). The influence on smoking prevalence was estimated for increased tobacco taxes; strengthened smoke-free laws; increased monthly population exposure to televised tobacco control mass media campaigns and pharmaceutical company advertising for nicotine replacement therapy (NRT), using gross ratings points; monthly sales of NRT, bupropion and varenicline; and introduction of graphic health warnings on cigarette packs. Autoregressive integrated moving average (ARIMA) models were used to examine the influence of these interventions on smoking prevalence. Findings The mean smoking prevalence for the study period was 19.9% (standard deviation: 2.0%), with a drop from 23.6% (in January 2001) to 17.3% (in June 2011). The best-fitting model showed that stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns independently explained 76% of the decrease in smoking prevalence from February 2002 to June 2011. Conclusion Increased tobacco taxation, more comprehensive smoke-free laws and increased investment in mass media campaigns played a substantial role in reducing smoking prevalence among Australian adults between 2001 and 2011. PMID:24940015

  2. Ocular dirofilariasis: A case series of 8 patients

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    Chris D Kalogeropoulos

    2014-01-01

    Full Text Available Purpose: Dirofilaria repens is an endemic parasite in Mediterranean countries that mostly affects animals. Rarely, however, it can infect humans. This case series presents patients with ocular infections due to D. repens. Materials and Methods: A chart review was performed of patients with ocular dirofilariasis after the year 2000, treated at a tertiary referral centre in Greece. Data were collected on the ocular, microbiological, or/and histopathological aspects and treatment. Results: Eight cases of unilateral ocular dirofilariasis were identified, of which 5 were subconjunctival (1 masquerading as nodular scleritis and were removed through a conjunctival incision, 2 cases were intravitreal and were removed with vitrectomy, and 1 was intraorbital (adjacent to the roof of the orbit. The latter appeared as an encapsulated mass and subsequent histological examination revealed the presence of the parasite. Of the 8 cases recorded after the year 2000, 7 appeared within the last 6 years (4 cases within the last 3 years. The majority of cases involved residents of the Ionian Islands (7 of 8 cases. Conclusions: D. repens can affect various ocular and periocular tissues. A progressive increase in the incidence of dirofilariasis was observed, which is potentially associated with climate changes in warm and moist areas where this parasite is endemic.

  3. Waardenburg Syndrome: A Report of Two Familial Case Series

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    Safal Khanal, BOptom

    2013-12-01

    Full Text Available Background: Waardenburg syndrome is a rare autosomally-inherited developmental disorder characterized by sensorineural deafness in association with pigmentary anomalies comprising various ocular features including dystopia canthorum, iris heterochromia, eyebrow flare, and fundus alterations. It is a congenital non-progressive genetic disorder that has been found to result in hearing loss, reduced vision, reduced self esteem, problems related to appearance, and decreased intellectual functioning.Case Reports: We report two familial case series that presented with the characteristic ocular findings and the systemic features of Waardenburg syndrome. The first series comprised a 32-year-old father with his two sons aged nine and six years. Two female siblings, aged 10 and eight years, both with cochlear implants, were included in the second series.Conclusion: Waardenburg syndrome manifests differently with dissimilar genetic penetration even within the same family. Some individuals will require no treatment, while others may need treatment or surgery for other abnormalities. Appropriate measures can be undertaken to negotiate the disabilities resulting from the ocular conditions associated with this syndrome.

  4. Gastroparesis in patients with inactive Crohn's disease: a case series

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    Oyen Wim JG

    2007-03-01

    Full Text Available Abstract Background Few studies have described patients with foregut dysmotility in inflammatory bowel disease. The aim of this case series was to evaluate clinical characteristics of 5 patients with inflammatory bowel disease and symptoms and signs of upper gut dysmotility. Case presentations We describe a series of four patients with Crohn's disease and one with indeterminate colitis who presented with severe symptoms and signs of gastroparesis. We reviewed medical records of all cases. Gastric emptying of a solid meal was assessed by scintigraphy. Small bowel enteroclysis, gastroduodenoscopy and colonoscopy with biopsies were performed to estimate the activity of the disease and to exclude organic obstruction. None of the patients had any signs of active inflammation or stricture. All of the patients had markedly delayed gastric emptying with a mean t 1/2 of 234 minutes (range 110–380 minutes; normal values 54–94 minutes. Conclusion Clinicians should consider impaired gastric emptying when evaluating patients with Crohn's disease and severe symptoms of upper gut dysmotility, which cannot be attributed to active inflammation or organic obstruction of the digestive tract. Symptoms in these patients are refractory to various therapeutic interventions including tube feeding and gastric surgery.

  5. Surgical management of generalized gingival enlargement - a case series

    International Nuclear Information System (INIS)

    Generalized gingival enlargement is characterized by massive and exuberant gingival overgrowth that poses social, aesthetic, phonetic and functional problems for the patient. Therefore, it requires meticulous management. Objective: To describe the surgical management of generalized gingival enlargement by electrosurgical excision of patients presenting to a tertiary care centre. Study Design: Case series. Materials and Methods: The study was conducted at the Department of Oral and Maxillofacial Surgery, de'Montmorency College of Dentistry, Lahore, from January 2010 to December 2012. A total of sixteen patients were operated by using electrosurgical approach under general anaesthesia for surgical excision of generalized gingival enlargement. Results: All of the sixteen patients, 11 males and 5 females, showed excellent healing postoperatively without any recurrent gingival overgrowth. Discussion: To the best of our knowledge, the current study presents the largest case series of generalized gingival enlargement. Most of these cases were with massive disease due to lack of information of the study population about their disease, delay in referral by the general dental practitioners, painless and innocent nature of the problem. Early referral of such patients to tertiary care centers can prevent the patients from social and psychological embarrassment. Conclusion: Electrosurgical excision is an excellent surgical technique for management of generalized gingival enlargement. Moreover, cross comparative studies are required to establish some diagnostic and therapeutic standards for such patients. (author)

  6. Managing Australian Defence Force Activities in Marine Protected Areas:Using Jervis Bay as a Case Study

    Institute of Scientific and Technical Information of China (English)

    Brian Lees

    2008-01-01

    <正>Australian Defence Force has done training activities in marine areas even some marine protected areas for a long time.These activities may cause pollution to the environment and related animals both directly and indirectly.So it is necessary to do some research on the environmenta1 influence of ADF activities and try our best to protect the natural environment.In this essay,we take Jervis Bay Marine Park as a case study to study the methods of environmental management of Australian Defence Force Activities.Through our spot investigation,we found that the ADF has some special power in JBMP and their activities certainly did negative impact on not only the environment but also the surrounding communities.To solve these problems,the common citizens and the authority of ADF must shape a good relationship to reduce misunderstanding and the environmental management in Jervis Bay Marine Park should be increased in the future.

  7. A 'cold-case' review of historic aboriginal and European-Australian encounters with toxic blooms of cyanobacteria.

    Science.gov (United States)

    Sadgrove, Nicholas John

    2012-09-01

    Interest in preserving the cultural knowledge of Aboriginal Australians continues to rise. Various studies have erupted which aim to redefine knowledge that was once lost or obscured in writing and hitherto ignored. Recognising and acknowledging the traditional Aboriginal knowledge of the Australian environment helps to strengthen Aboriginal identity and gives credibility to the rising paradigm of ecotechnology in historic pre-European Australia. This review aims to establish knowledge of a traditional awareness of factors leading towards eutrophication in water resource management. Journals from pioneering explorers were examined for evidence of cyanobacterial blooms and examples of Aboriginal water resource management practices that aimed at avoiding health threats from poor water quality. Some cultural practices, focused on water resource management, are discussed with brief mentioned of the Waugal. It is concluded that in some cases the incorporation of scientific laws into mythology is a form of conceptual modelling compatible with science if examined carefully. PMID:22777052

  8. Pulmonary alveolar proteinosis in children: A case series

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    Seyyed Ahmad Tabatabaei

    2010-01-01

    Full Text Available Pulmonary alveolar proteinosis, (PAP is a rare disease of unknown etiology, characterized by accumulation of intraalveolar proteinaceous material which is rich in lipid and positive on periodic acid-Schiff stain. Two clinically different pediatric types have been defined as congenital PAP which is fulminant and fatal, and a late-onset PAP which is similar to the adult form and less severe. Eight children with late-onset PAP were hospitalized from 1998 to 2005 in Mofid Children Hospital. Characteristics of these patients and the methods of diagnosis and treatment are presented in this case series.

  9. Case Series of Synthetic Cannabinoid Intoxication from One Toxicology Center

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    Kenneth D. Katz

    2016-05-01

    Full Text Available Synthetic cannabinoid use has risen at alarming rates. This case series describes 11 patients exposed to the synthetic cannabinoid, MAB-CHMINACA who presented to an emergency department with life-threatening toxicity including obtundation, severe agitation, seizures and death. All patients required sedatives for agitation, nine required endotracheal intubation, three experienced seizures, and one developed hyperthermia. One developed anoxic brain injury, rhabdomyolysis and died. A significant number were pediatric patients. The mainstay of treatment was aggressive sedation and respiratory support. Synthetic cannabinoids pose a major public health risk. Emergency physicians must be aware of their clinical presentation, diagnosis and treatment.

  10. Can masturbatory guilt lead to severe psychopathology: a case series.

    Science.gov (United States)

    Aneja, Jitender; Grover, Sandeep; Avasthi, Ajit; Mahajan, Sudhir; Pokhrel, Prabhakar; Triveni, Davuluri

    2015-01-01

    Masturbation is common in all societies. Despite being common, it is admonished culturally and almost all religions prohibit masturbation and consider it an act of immorality. The prohibition for masturbation leads to a lot of cultural beliefs, including certain myths, which influence sexual behavior of the person. The impact of these common cultural myths associated with masturbation, are clinically understood as Dhat syndrome and masturbatory guilt. Although there is a reasonable literature on Dhat syndrome, there is limited literature with regard to masturbatory guilt especially linking the same with axis-I psychopathology. In this case series, three cases of masturbatory guilt are presented in whom masturbatory guilt was associated with manifestation of severe psychopathology. This report suggests that masturbatory guilt must be enquired for in patients presenting with severe mental disorder. PMID:25722518

  11. Lie-series for orbital elements -- II. The spatial case

    CERN Document Server

    Pál, András

    2016-01-01

    If one has to attain high accuracy over long timescales during the numerical computation of the N-body problem, the method called Lie-integration is one of the most effective algorithms. In this paper we present a set of recurrence relations with which the coefficients needed by the Lie-integration of the orbital elements related to the spatial N-body problem can be derived up to arbitrary order. Similarly to the planar case, these formulae yields identically zero series in the case of no perturbations. In addition, the derivation of the formulae has two stages, analogously to the planar problem. Namely, the formulae are obtained to the first order, and then, higher order relations are expanded by involving directly the multilinear and fractional properties of the Lie-operator.

  12. Can masturbatory guilt lead to severe psychopathology: A case series

    Directory of Open Access Journals (Sweden)

    Jitender Aneja

    2015-01-01

    Full Text Available Masturbation is common in all societies. Despite being common, it is admonished culturally and almost all religions prohibit masturbation and consider it an act of immorality. The prohibition for masturbation leads to a lot of cultural beliefs, including certain myths, which influence sexual behavior of the person. The impact of these common cultural myths associated with masturbation, are clinically understood as Dhat syndrome and masturbatory guilt. Although there is a reasonable literature on Dhat syndrome, there is limited literature with regard to masturbatory guilt especially linking the same with axis-I psychopathology. In this case series, three cases of masturbatory guilt are presented in whom masturbatory guilt was associated with manifestation of severe psychopathology. This report suggests that masturbatory guilt must be enquired for in patients presenting with severe mental disorder.

  13. Chediak-Higashi Syndrome: A Case Series from Karnataka, India.

    Science.gov (United States)

    Rudramurthy, Pradeep; Lokanatha, Hemalata

    2015-01-01

    Chediak-Higashi syndrome (CHS) is a rare autosomal recessive disease, characterized by partial oculocutaneous albinism, frequent pyogenic infections, and the presence of abnormal large granules in leukocytes and other granulecontaining cells. The abnormal granules are readily seen in blood and marrow granulocytes. Other clinical features include silvery hair, photophobia, nystagmus and hepatosplenomegaly. However, the presence of abnormal giant intracytoplasmic granules in neutrophils and their precursors are diagnostic of CHS. Here, we present a series of five cases, out of which four presented in the accelerated phase. In all the five cases, the giant granules were noted predominantly in the cytoplasm of lymphocytes, which is a rare occurrence compared to those present in the granulocytes. PMID:26538743

  14. Peptide receptor radionuclide therapy of neuroendocrine tumors: Case series

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    Matović Milovan

    2012-01-01

    Full Text Available Background: Peptide Receptor Radionuclide Therapy (PRRT is novel and efficacious treatment of neuroendocrine tumors (NETs. Methods: Twenty-seven patients (14 females, 13 males, mean age 54.37±11.14 years; range 30-74 years with progressive, metastatic neuroendocrine tumors, were treated at least once during the period of 31 months (from July the 6th 2009 to February the 6th 2012 with PRRT in Nuclear Medicine Center, Clinical Center Kragujevac. There were carcinoids in 8 cases (6pts had intestinal and 2pts had lung carcinoid, medullary thyroid carcinoma in 5 cases, pancreatic carcinoma in 3 cases, paraganlioma in 2 cases, pheochromocytoma in 2 cases and in 7 cases primary tumors were not detected. We used 56 doses of different kinds of radiopharmaceuticals: 32 doses of 90Y-DOTATOC, 12 doses of 177Lu-DOTATATE, and 12 doses combining the 90Y-DODTATOC and 177Lu-DOTATATE. The PRRT was given in cycles: 12 pts received one cycle, 9 pts two cycles, 4 pts three cycles, 1 patient 4cycles and 2 pts five cycles of PRRT. The radioactivity was 3.2-7.40 GBq per cycle, and intervals between cycles ranged from 6 to 8 weeks. Results: The response to PRRT was assessed by morphological imaging (MSCT and MRI as well as by tumor marker follow up (CgA, 5-HIAA, catecholamines, CT and CEA. Seven pts (25.9% had partial response (PR, 17 pts (63.0% had stable disease (SD, and 3 pts (11.1% had progressive disease (PD. None of our patients had complete response (CR. All patients received PRRT under renal protection with amino acid infusions. In spite of this precaution, two patients with previously diagnosed diabetes mellitus suffered from serious deterioration of renal function after PRRT. Conclusion: The efficacy and safety of PRRT observed in our case series was in accordance with previously published data.

  15. Reporting Islam in Australian Newspapers: the case of the proposed Elermore Vale mosque

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    Caitlin McGregor

    2013-10-01

    Full Text Available This paper uses the local case study of a proposed mosque development in the Newcastle suburb of Elermore Vale as an example of how Islam has been reported in the Australian media. The media reports analysed were published in Newcastle's local newspaper The Herald between February 2010, when the Newcastle Muslim Association purchased the land for the proposed development, and March 2012, when the Land and Environment Court ruled against the proposal. The discourses evident in the newspaper content reveal a clear undercurrent of racism within the local reporting against the Muslim community and, it may be argued, are representative of a larger trend of Islamophobia in the West. While the key community protest group Elermore Vale Community for Appropriate Residential and Environment Strategies (EV CARES attempted to discuss the mosque proposal by raising planning issues appropriate property development matters, anti­Muslim sentiment was clearly evident in many of the articles.Illustrations of Edward Said's (1978, 2004 concept of 'Orientalism' emerged through the reporting, where Islam, and by extension the Newcastle Muslim Association, was portrayed as being different, strange and threatening to the local community. The fact that this kind of anti­Muslim sentiment can be identified in local media products is indicative of the challenges for local media groups covering local media events, as it represents how a local matter can become contentious due to globally recognised concerns. In this instance, those concerns are the perceived threat of Muslim fundamentalism and Islam to the West. Discursive analysis of The Herald's reports demonstrates that discourses of power, religion, 'the Other', 'community' and 'the victim' are prevalently portrayed. Furthermore, these portrayals contribute to anti­Muslim attitudes communicated by key parties in the articles, who use the Islamic religion as an identifier; the marginalisation of the Muslim community

  16. Health inequalities, physician citizens and professional medical associations: an Australian case study

    Directory of Open Access Journals (Sweden)

    Naccarella Lucio

    2007-08-01

    Full Text Available Abstract Background As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the basis of evidence and feasibility. Drawing this line between obligation and aspiration is a part of the work of professional medical colleges and associations, and in doing so they must respond to members as well as a range of other interest groups. Our aim was to explore the usefulness of Gruen's model of physician responsibility in defining how professional medical colleges and associations should lead the profession in responding to socioeconomic health inequalities. Methods We report a case study of how the Royal Australian College of General Practitioners is responding to the issue of health inequalities through its work. We undertook a consultation (80 interviews with stakeholders internal and external to the College and two focus groups with general practitioners and program and policy review of core programs of College interest and responsibility: general practitioner training and setting of practice standards, as well as its work in public advocacy. Results Some strategies within each of these College program areas were seen as legitimate professional obligations in responding to socioeconomic health inequality. However, other strategies, while potentially professional obligations within Gruen's model, were nevertheless contested. The key difference between these lay in different moral orientations. Actions where agreement existed were based on an ethos of care and compassion. Actions that were contested were based on an ethos of justice and human rights. Conclusion Colleges and professional medical associations have a role in explicitly leading a debate about values

  17. Provision of a Medicines Information Service to Consumers on Facebook: An Australian Case Study

    Science.gov (United States)

    Chen, Timothy F; Spagnardi, Sarah; Beer, Troy; Aslani, Parisa

    2015-01-01

    Background Social networking sites (SNSs) have changed the way people communicate. They may also change the way people seek health advice. Objective This study describes the provision of a medicines information service on Facebook to individual consumers. It aimed to discuss the pros and cons, and inform health and pharmacy stakeholders and researchers about the opportunities and challenges of providing such a service. Methods We adopted an exploratory approach using a case study method. Results NPS MedicineWise, an independent, not-for-profit Australian organization, runs a public question-and-answer service on Facebook, dubbed Pharmacist Hour. Consumers following the organization’s Facebook page are invited to post medication-related questions often with a suggested health topic. A wide range of questions and comments are posted related to medication usage. The pharmacist answers the queries, providing evidence-based medicines information and using consumer-friendly language, during the specific 1-hour period. The most popular questions in the past 12 months were related to adverse effects, treatment options for conditions, and drug interactions. The service had a mean number of engagements (defined as a like or share of the Pharmacy Hour post) of 38 (SD 19) people and a mean 5 (SD 3) questions per session. Conclusions The Pharmacist Hour Facebook service addresses the medicines information needs of consumers and indirectly promotes other appropriate and relevant NPS MedicineWise products and services to further assist consumers. The service offers a new medium for a quality use of medicines organization committed to promoting awareness about the correct and safe use of medicines in Australia. PMID:26596328

  18. Are clerical workers proletarian? A case study of the Australian Public Service.

    Science.gov (United States)

    Matheson, Craig

    2007-12-01

    This paper explores whether clerical workers have been proletarianized by using the Australian Public Service (APS) as a case study. It shows that before the late 1980s the market, work and status situations of APS clerks were predominantly proletarian since they were typified by limited career prospects, low skill requirements, restricted autonomy; low organizational status and estrangement from senior management. This proletarian class situation was reflected in an order taker's culture of informality, cynicism, hedonism and alienation. Since the late 1980s however technological change and workplace restructuring have markedly reduced the number of unskilled and lower paid jobs in the APS, thereby belying widespread predictions of deskilling. I conclude that proletarianization is more likely to have arisen from a decline in the status of clerical work during the course of the twentieth century rather than from a process of deskilling. Notwithstanding the fact that their class situations were predominantly proletarian, most clerks have identified as middle class. We can attribute this not only to the fact that their class situations differ from those of manual workers, as noted by Lockwood, but also to a widespread tendency to identify as middle class, the tendency of many female clerks to base their class identity on their husband's occupation and the fact that popular stereotypes tend to equate class with occupation. It is difficult to decide if clerks are proletarian since 1. Their class situations display a mixture of proletarian and middle-class characteristics 2. They exhibit diverse class identities, social origins, marriage partners and cultural attributes and 3. They occupy different positions on different aspects of inequality. We are therefore unable to allocate them en bloc to a single uniform class. I conclude that while a minority of clerks are proletarian most are better described as middle class. PMID:18076387

  19. Paediatric nasopharyngeal rhabdomyosarcoma: a case series and literature review

    International Nuclear Information System (INIS)

    Full text: Rhabdomyosarcoma (RMS) is the most common soft tissue tumour in children, with the head and neck region accounting for 35-40% of cases. Nasopharyngeal RMSs tend to grow rapidly and invade adjacent structures. Both the intergroup Rhabdomyosarcoma studies and the European Studies have established that the ideal management of this disease is multimodal, using a combination of surgery, chemotherapy and radiotherapy. This case series examines the role of radiotherapy in the management of paediatric nasopharyngeal RMSs, with particular reference to long-term morbidity and disease-free survival. The cases of five children with nasopharyngeal RMS were reviewed and a systematic review of the literature contained in the PubMed databases was conducted to establish 24 individually detailed cases. Management in all patients was multimodal, using a combination of chemotherapy, radiotherapy as well as surgery. External beam radiotherapy is an integral component of treatment for nasopharyngeal RMSs. With more patients surviving for longer periods, more long-term sequelae of radiotherapy have been reported. Complications include sensorineural deafness, endocrine manifestations following radiation of the pituitary gland, cranial nerve palsies, second malignancies within the radiation field, cataract formation, retinopathy and growth disturbance. Morbidity from radiotherapy may be considerable and depends on the field and dose of radiation. Current advances in radiotherapy are aimed at improving the rate of tumour control and reducing such complications. Recent improvements in imaging and conformal techniques have the potential to reduce the morbidity associated with radiotherapy in this cohort.

  20. Rapidly destructive osteoarthritis of the hip joint: a case series

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    McMurtrie A

    2008-01-01

    Full Text Available Abstract Background Rapidly destructive arthrosis of the hip is a rare and incompletely understood disorder with scarce literature about variations in natural history within a population. Methods A series of cases from North Wales with rapid progressive joint destruction and extensive subchondral bone loss in the femoral head and acetabulum are presented. Radiographic findings mimicked those of other disorders such as septic arthritis, rheumatoid and seronegative arthritis, primary osteonecrosis with secondary osteoarthritis, or neuropathic osteoarthropathy, but none of the patients had clinical, pathologic, or laboratory evidence of these entities. Results Rapid progression of hip pain and disability was a consistent clinical feature. The average duration of symptoms was 1.4 years. Radiographs obtained at various intervals before surgery (average 14 months in 18 patients documented rapid hip destruction, involvement being unilateral in 13 cases. All patients underwent total hip arthroplasty, and osteoarthritis was confirmed at pathologic examination. Conclusion The authors postulate that these cases represent an uncommon subset of osteoarthritis and regular review, both clinically and radiologically, are required to assess speed of progression and prevent rapid loss of bone stock without the surgeon being aware. These cases are unsuitable for being placed on long waiting list due to technical difficulties in delayed surgery and compromised outcome following surgery.

  1. Pneumothoraces in a Neonatal Tertiary Care Unit: Case Series

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    Rehan Ali

    2013-01-01

    Full Text Available Objective: Neonatal pneumothoraces are associated with high mortality. Prompt recognition to minimize its complications is paramount for ultimate outcome of these babies.Methods: A retrospective case series study was carried out at Aga khan University Hospital, from January 2010 to December 2010 to determine the etiology and outcome of neonates with pneumothorax in a neonatal tertiary care unit.Results: Ten neonates diagnosed radiologically with pneumothoraces were included. M: F ratio was 1:2.3. Birth weight ranged from 1750-3600 grams with a mean of 2100 grams. The occurrence of pneumothoraces was 50% on the left side, 20% on right, and 30% were bilateral. Primary etiology included pneumonia and sepsis (30%, hyaline membrane disease (20%, meconium aspiration syndrome (20% and congenital diaphragmatic hernia (10%. Spontaneous pneumothoraces were present in 20% of cases. In our study, the incidence of neonatal pneumothoraces was 2.5/1000 births compared to 10-15/1000 in Denmark, 10-20/1000 in Turkey and 6.3/1000 from Vermont Oxford Group. Despite the small number of cases, one incidental finding was the occurrence of pneumothorax, which declined in elective cesarean section after 37 weeks gestation i.e., 1.3 of 1000 births. Mortality was 60% determined mainly by the primary etiology and other co-morbid conditions.Conclusion: The study showed a higher number of mortality cases (60%. Although, it was difficult to draw a conclusion from the limited number of cases, there may be a benefit on neonatal respiratory outcome to be obtained by better selection of mothers and by waiting until 37 weeks before performing elective cesarean section. Adequate clinician training in soft ventilation strategies will reduce the occurrence of pneumothoraces.

  2. Various hysterosalpingography findings of female genital tuberculosis: A case series

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    Nargess Afzali

    2013-01-01

    Full Text Available Background: Genital tuberculosis is a chorionic disease and mostly occurs by haematogenous spread from extra genital source like lungs, peritoneum, lymph nodes and bones. Transmission through a sexual intercourse is also possible. Since the majority of patients are in reproductive ages, involvement of fallopian tubes and endometrium cause infertility in patients. Cases: Reviewing 4 cases of female genital tuberculosis, which referred to an infertility treatment center with various symptoms, we encountered various appearances on hysterosalpingography (HSG. Conclusion: The genitourinary tract is the most common site of extra pulmonary TB. The primary focus of genital tuberculosis is fallopian tubes, which are almost always affected bilaterally but not symmetrically. Because of common involvement of fallopian tubes and endometrial cavity, disease causes infertility. Diagnosis is not easy because genital tuberculosis has a wide range of clinical and radiological manifestations with slow growing symptoms. Detailed hysterosalpingography finding may be helpful in better diagnosis of the disease. This case series aims to depict the various hystrosalpingographic appearances and pathology produced by tuberculosis and related literatures are reviewed in order to establish a better diagnostic evaluation of genital tuberculosis

  3. Pulmonary Alveolar Proteinosis in Children: A case series

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    seyyed Ahmad Tabatabaei

    2010-01-01

    Full Text Available Pulmonary Alveolar Proteinosis(PAP is a rare disease of unknown etiology, characterized by the accumulation of proteinoceous material in the alveoli that is rich in lipid and is positive on periodic acid-Schiff(PAS stain. PAP is rare in children. Two forms are encountered in pediatric practice: congenital alveolar proteinosis (CAP and a later–onset form that is generally less severe. Broncho-alveolar lavage is the key to diagnosis. Therapeutic lung lavages are the only effective treatment for severe cases. Other therapeutic trials have been proposed such as: lung transplantation, adminstration of GM- CSF and gene-therapy. This case series presents six cases of PAP which were diagnosed by open lung biopsy in Mofid children hospital in Tehran capital city over a three-year period (2003–2006 and one in 1998. The aim of the present study was to provide detailed data on the characteristics of these patients and the methods of diagnosis and treatment.

  4. Glaucoma Surgery in Pregnancy: A Case Series and Literature Review.

    Science.gov (United States)

    Razeghinejad, Mohammad Reza; Masoumpour, Masoumeh; Eghbal, Mohammad Hossein; Myers, Jonathan S; Moster, Marlene R

    2016-09-01

    Glaucoma management in pregnant patients is a real challenge, especially when the glaucoma is not controlled with medications. We report the results of 6 incisional glaucoma surgeries for the management of medically uncontrolled glaucoma patients during pregnancy. This retrospective, case series was conducted on the 6 eyes of 3pregnant patients with uncontrolled glaucoma using maximum tolerable medications. Details of the glaucoma surgical management of these patients as well as their postoperative care and pregnancy and clinical outcomes on longitudinal follow-up are discussed. All 3 patients had juvenile open-angle glaucoma and were on various anti-glaucoma medications, including oral acetazolamide. The first case described underwent trabeculectomy without antimetabolites in both eyes because of uncontrolled intraocular pressure with topical medications. The surgery was done with topical lidocaine jelly and subconjunctival lidocaine during the second and third trimesters. The second patient had an Ahmed valve implantation in both eyes during the second and third trimesters because of uncontrolled IOP with topical medications and no response to selective laser trabeculoplasty. Surgery was done with topical tetracaine and subconjunctival and sub-Tenon's lidocaine. The third case had a Baerveldt valve implantation under general anesthesia in the second trimester. In selected pregnant glaucoma patients with medically uncontrolled intraocular pressure threatening vision, incisional surgery may lead to good outcomes for the patient with no risk for the fetus. PMID:27582594

  5. Adverse events in cancer genetic testing: the third case series.

    Science.gov (United States)

    Bonadies, Danielle C; Brierley, Karina L; Barnett, Rachel E; Baxter, Melanie D; Donenberg, Talia; Ducaine, Whitney L; Ernst, Michelle E; Ernstx, Michelle E; Homer, Jeanne; Judkins, Megan; Lovick, Niki M; Powers, Jacquelyn M; Stanislaw, Christine; Stark, Elizabeth; Stenner, Rio C; Matloff, Ellen T

    2014-01-01

    After repeated media attention in 2013 due to the Angelina Jolie disclosure and the Supreme Court decision to ban gene patents, the demand for cancer genetic counseling and testing services has never been greater. Debate has arisen regarding who should provide such services and the quality of genetics services being offered. In this ongoing case series, we document 35 new cases from 7 states (California, Connecticut, Florida, Georgia, Missouri, Pennsylvania, and Utah) and the District of Columbia of adverse outcomes in cancer genetic testing when performed without the involvement of a certified genetic counselor. We identified 3 major themes of errors: wrong genetic tests ordered, genetic test results misinterpreted, and inadequate genetic counseling. Patient morbidity and mortality were an issue in several of these cases. The complexity of cancer genetic testing and counseling has grown exponentially with the advent of multigene panels that include rare genes and the potential for more variants of uncertain significance. We conclude that genetic counseling and testing should be offered by certified genetics providers to minimize the risks, maximize the benefits, and utilize health care dollars most efficiently. PMID:25098283

  6. Using Aptitude Testing to Diversify Higher Education Intake--An Australian Case Study

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    Edwards, Daniel; Coates, Hamish; Friedman, Tim

    2013-01-01

    Australian higher education is currently entering a new phase of growth. Within the remit of this expansion is an express commitment to widen participation in higher education among under-represented groups--in particular those from low socioeconomic backgrounds. This paper argues that one key mechanism for achieving this goal should be the…

  7. Impact in Vocational Education and Training Research: The Case of the Australian VET Research Consortium

    Science.gov (United States)

    Harris, Roger; Clayton, Berwyn

    2010-01-01

    "Impact" is a notion that is not very well understood in research. Within Australian higher education, it has been bandied about within such frameworks as the "Research Quality Framework" ("RQF") and Excellence in Research for Australia (ERA). Vocational education and training (VET) research is not immune from these movements, and increasingly,…

  8. Australian Aboriginal Unemployment: Is It a Case of Psychological Readiness or Racism?

    Science.gov (United States)

    Davidson, Graham

    Australian aboriginal unemployment stands at somewhere between 45 percent and 80 percent, a situation caused, according to certain observers, by aboriginal attitudes and values regarding work and by educational disadvantage, not by anything in the working environment. According to this view, aborigines are said to be lacking in motivation, to…

  9. Patterns of Student Enrolment and Attrition in Australian Open Access Online Education: A Preliminary Case Study

    Science.gov (United States)

    Greenland, Steven J.; Moore, Catherine

    2014-01-01

    Swinburne University of Technology has experienced tremendous growth in open access online learning and as such is typical of the many Australian institutions that have ventured into online tertiary education. While research in online education continues to expand, comparatively little investigates students' enrolment and attrition. This research…

  10. Outdoor Adventure in Australian Outdoor Education: Is It a Case of Roast for Christmas Dinner?

    Science.gov (United States)

    Lugg, Alison

    2004-01-01

    Outdoor adventure activities, typically originating from other countries, form the basis of most Australian outdoor education programs. Research on adventure-based outdoor education in Australia and elsewhere has tended to focus on determining the benefits of participating in such programs. Less attention has been paid to a critical examination of…

  11. Snus (nass and oral cancer: A case series report

    Directory of Open Access Journals (Sweden)

    Maryam Alsadat Hashemipour

    2013-01-01

    Full Text Available Snus (nass is a form of snuff used in a similar manner to American dipping tobacco, but it does not typically result in a need for spitting. Possible hazards associated with this material include malignant and premalignant lesions in the oral cavity and gastrointestinal tract. The use of smokeless tobacco has increased in the Middle East in recent decades, particularly among teenagers and young adults. Therefore, practitioners must be able to recognize malignant and premalignant lesions. Although, an estimated 10-25% of the world′s population uses smokeless tobacco, this practice is virtually unknown in Iran. The aim of this study is to report a series of cases of squamous cell carcinoma and verrucous carcinoma occurring in the users of snus, who referred to the Department of Oral Medicine in Kerman Dental School.

  12. Adverse events associated with yoga: a systematic review of published case reports and case series.

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    Holger Cramer

    Full Text Available While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5% affected the musculoskeletal system; 14 (18.4% the nervous system; and 9 (11.8% the eyes. Fifteen cases (19.7% reached full recovery; 9 cases (11.3% partial recovery; 1 case (1.3% no recovery; and 1 case (1.3% died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.

  13. Acute sterile endophthalmitis following intravitreal bevacizumab: case series

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    Orozco-Hernández A

    2014-09-01

    Full Text Available Axel Orozco-Hernández,1 Ximena Ortega-Larrocea,1 Gustavo Sánchez-Bermúdez,1 Gerardo García-Aguirre,1 Virgilio Morales Cantón,1 Raul Velez-Montoya2 1Retina Department, Asociación para Evitar la Ceguera en México IAP, Mexico City, Mexico; 2Department of Ophthalmology, University of Colorado School of Medicine, Rocky Mountain Lions Eye Institute, Aurora, CO, USA Background: Since the ophthalmological community adopted the use of intravitreal bevacizumab as an accepted off-label treatment for neovascular diseases, the amount of knowledge regarding its effects and properties has been increasing continually. In the last few years, there have been an increasing number of reports about sterile intraocular inflammation and intraocular pressure elevations after intravitreal bevacizumab. In the following case series, we describe the clinical presentation and outcomes of ten consecutive cases of patients developing mild-to-severe sterile intraocular inflammation after intravitreal bevacizumab and their management. Methods: This report presents a retrospective case series. We reviewed the medical records of ten consecutive patients from a group of 46, in whom repackaged bevacizumab in individual aliquots from two vials from the same batch were used. All surgical procedures were performed using standard sterile techniques in the operating room. At each follow-up visit, patients underwent a complete ophthalmological examination including visual acuity assessment, intraocular pressure, biomicroscopy, and posterior fundus examination. Results: Ten patients presented sterile endophthalmitis with an onset time of 3.5±1.95 days. The clinical characteristics were mild pain, slight visual loss, conjunctival hyperemia, and various degrees of intraocular inflammation with microhypopyon. All cultures were negative. All patients were managed with topical steroids and antibiotics, except two, in whom, due to severe vitreous cells, intravitreal antibiotics were

  14. Neuroendocrine tumors presenting with thyroid gland metastasis: a case series

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    Sivrikoz Emre

    2012-02-01

    Full Text Available Abstract Introduction Autopsy series have shown that metastasis to the thyroid gland has occurred in up to 24% of patients who have died of cancer. Neuroendocrine tumors may metastasize to thyroid gland. Case presentations Case 1 was a 17-year-old Turkish woman who was referred from our Endocrinology Department for a thyroidectomy for treatment of neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination results were consistent with a neuroendocrine tumor; neoplastic cells showed strong immunoreactivity to chromogranin A and synaptophysin, but the immunohistochemical profile was inconsistent with medullary thyroid carcinoma in that the tumor was negative for calcitonin, carcinoembryonic antigen, and thyroid transcription factor-1. Case 2 was a 54-year-old Turkish woman who presented with a 3-cm nodule on her right thyroid lobe. She had undergone surgery for a right lung mass four years previously. After a right pneumonectomy, thymectomy and lymph node dissection, a typical carcinoid tumor was diagnosed. Under ultrasonographic guidance, fine needle aspiration biopsy of her right thyroid pole nodule was performed and the biopsy was compatible with a neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination indicated three nodular lesions, 5 cm and 0.4 cm in diameter in her right lobe and 0.1 cm in diameter in her left lobe. The tumors were consistent with a neuroendocrine phenotype, showing strong immunoreactivity to chromogranin A and synaptophysin. Conclusion Thyroid nodules detected during follow-up of neuroendocrine tumor patients should be thoroughly investigated. A fine needle aspiration biopsy of the thyroid confirms the diagnosis in most cases and leads to appropriate management of those patients and may prevent unnecessary treatment approaches.

  15. Assessing “gas transition” pathways to low carbon electricity – An Australian case study

    International Nuclear Information System (INIS)

    industries may involve minimising energy sourced from gas, and increasing renewable generation. In the Australian case study considered, the modelling suggests it is appropriate to target renewable energy penetrations approaching 60% of energy by 2030 and 80–100% by 2050. In the lowest cost and lowest risk portfolios, firm capacity is provided primarily by the transition of existing coal-fired plant into a peaking role, and later by further investment in peaking open cycle gas turbine plant. These results are found to be robust to a wide range of assumptions around future carbon prices

  16. Soil formation rates determined from Uranium-series isotope disequilibria in soil profiles from the southeastern Australian highlands

    Science.gov (United States)

    Suresh, P. O.; Dosseto, A.; Hesse, P. P.; Handley, H. K.

    2013-10-01

    The sustainability of soil resources is determined by the balance between the rates of production and removal of soils. Samples from four weathering profiles at Frogs Hollow in the upper catchment area of the Murrumbidgee River (southeastern Australia) were analyzed for their uranium-series (U-series) isotopic composition to estimate soil production rates. Sequential leaching was conducted on sample aliquots to assess how U-series nuclides are distributed between primary and secondary minerals. Soil is increasingly weathered from bottom to top which is evident from the decrease in (234U/238U) ratios and increase in relative quartz content with decreasing soil depth. One soil profile shows little variation in mineralogy and U-series geochemistry with depth, explained by the occurrence of already extensively weathered saprolite, so that further weathering has minimal effect on mineralogy and geochemistry. Al2O3 is mobilized from these soils, and hence a silicon-based weathering index treating Al2O3 as mobile is introduced, which increases with decreasing soil depth, in all profiles. Leached and unleached aliquots show similar mineralogy with slight variation in relative concentrations, whereas the elemental and isotopic composition of uranium and thorium show notable differences between leached and unleached samples. Unleached samples show systematic variations in uranium-series isotopic compositions with depth compared to leached samples. This is most likely explained by the mobilization of U and Th from the samples during leaching. Soil residence times are calculated by modeling U-series activity ratios for each profile separately. Inferred timescales vary up to 30 kyr for unleached aliquots from profile F1 to up to 12 kyr for both leached and unleached aliquots from profile F2. Muscovite content shows a linear relationship with U-series derived soil residence times. This relationship provides an alternative method to estimate residence timescales for profiles with

  17. LIPOMA OF HAND AND FINGER : A 6 PATIENT CASE SERIES

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    Prakash Kumar

    2014-01-01

    Full Text Available INTRODUCTION: Lipoma , the ubiquitous benign tumor , is not very common in the hand and that to involving the palmar space or finger is very rare. This series of case presentation lays emphasis on consideration of lipoma in the differential diagnosis of swellings/ soft tissue tumors of the hand and the use o f imaging studies in their diagnosis. We report a ser ies of six cases of lipoma in different parts and planes of hand , involving palm and fingers . An uncommon site , size , shape , plane and age of occurrence of this common tumor warrants it’s reporting and an effort had been made to highlight the management. CONCLUSION : Hand lipoma is rare entity for a surgeon in the differential diagnosis of soft tissue tumors with radiology being an invaluable tool. Though rare but frequently seen in this pa rt of country , Precise surgical techniques with a sound anatomic knowledge helps in complete excision without damaging the vital structures and abates recurrences Lipoma , subcutaneous , mid - palmar space.

  18. The Histopathological Spectrum of Pyogenic Granuloma: A Case Series

    Science.gov (United States)

    Shrestha, Sajeev

    2016-01-01

    Background. Pyogenic granuloma is a reactive tumor-like lesion commonly affecting the oral cavity. These lesions usually appear as localized solitary nodule with a sessile or pedunculated base and colour varying from red, purplish, or pink, depending on the vascularity of the lesion. Pyogenic granuloma shows predilection for gingiva and is usually slow growing, but at times it shows rapid growth. The natural course of this lesion can be categorized into three distinct phases, namely, (i) cellular phase, (ii) capillary phase/vascular phase, and (iii) involutionary phase. Histopathologically, pyogenic granuloma is classified into lobular capillary hemangioma (LCH) and non-lobular capillary hemangioma (non-LCH). Case Presentation. In this series, four cases (varied age groups and both genders) of pyogenic granuloma showing varying histopathological presentation in relation to its clinical course have been described. The lesion in its early phase reveals diffuse endothelial cells, with few budding into capillaries. Among the capillary phase, the LCH type shows numerous blood vessels organized into lobular aggregates whereas the non-LCH type does not show any such organization and resembles granulation tissue. The involutionary phase shows healing of the lesion and is characterized by extensive fibrosis in the connective tissue. Conclusion. In conclusion, knowledge of the various histopathological presentation of this lesion is necessary for proper identification. PMID:27382492

  19. The Histopathological Spectrum of Pyogenic Granuloma: A Case Series

    Directory of Open Access Journals (Sweden)

    Vinay Marla

    2016-01-01

    Full Text Available Background. Pyogenic granuloma is a reactive tumor-like lesion commonly affecting the oral cavity. These lesions usually appear as localized solitary nodule with a sessile or pedunculated base and colour varying from red, purplish, or pink, depending on the vascularity of the lesion. Pyogenic granuloma shows predilection for gingiva and is usually slow growing, but at times it shows rapid growth. The natural course of this lesion can be categorized into three distinct phases, namely, (i cellular phase, (ii capillary phase/vascular phase, and (iii involutionary phase. Histopathologically, pyogenic granuloma is classified into lobular capillary hemangioma (LCH and non-lobular capillary hemangioma (non-LCH. Case Presentation. In this series, four cases (varied age groups and both genders of pyogenic granuloma showing varying histopathological presentation in relation to its clinical course have been described. The lesion in its early phase reveals diffuse endothelial cells, with few budding into capillaries. Among the capillary phase, the LCH type shows numerous blood vessels organized into lobular aggregates whereas the non-LCH type does not show any such organization and resembles granulation tissue. The involutionary phase shows healing of the lesion and is characterized by extensive fibrosis in the connective tissue. Conclusion. In conclusion, knowledge of the various histopathological presentation of this lesion is necessary for proper identification.

  20. Case series of eosinophilic meningoencephalitis from South India

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    Parameswaran K

    2006-01-01

    Full Text Available Eosinophilic meningoencephalitis (EM is a rare type of meningoencephalitis. The objective of this report is to describe a series of EM identified in a specific geographic area over a short period of time. Materials and Methods: This series of cases are described from a neurological center in Central Kerala occuring in the period between February 2004 and June 2006. Results: During this period we had identified ten patients (eight males and two females with EM. Their mean age was 37.1 years (range 15-60 years. Main symptomatologies were fever, severe headache, body pain, abdominal pain and arthralgia. One patient was in akinetic rigid state with coma. All patients had peripheral eosinophilia. The cerebrospinal fluid (CSF of all patients showed eosinophilic pleocytosis. The mean CSF white cell count was 588 cells. CSF differential count showed 50-70% eosinophils. CSF glucose levels were normal but proteins were markedly raised (mean CSF protein was 180 mg/dl. MRI brain showed T2 hyperintensities diffusely in periventricular white matter in the comatose patient. Contrast enhanced CT scan of the brain was normal in others. All eight male patients gave history of eating "raw flesh of Monitor Lizard" (Iguana some three to fourteen days prior to the onset of symptoms. There was no such history for the female patients. Considering the history of exposure and eosinophilic meningitis we suspected a meningoencephalitis with Angiostrongylus cantonensis and treated them with albendazole, steroid and other supportive measures. All of them recovered. Conclusion: Eosinophilic meningitis (EM is a rare condition and in this locality, a CNS infection with Agiostrongylus cantonensis is highly likely. AC is a parasite in monitor lizard. Human infection occurs from consumption of uncooked flesh or blood of infected lizards. Physicians need to maintain a high index of suspicion and enquire for any exposure to uncooked meat or blood of monitor lizard when faced with EM

  1. "Unwell while Aboriginal": iatrogenesis in Australian medical education and clinical case management

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    Ewen SC

    2016-05-01

    Full Text Available Shaun C Ewen,1 David Hollinsworth2 1Melbourne Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, 2Indigenous Studies, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, QLD, Australia Introduction: Attention to Aboriginal health has become mandatory in Australian medical education. In parallel, clinical management has increasingly used Aboriginality as an identifier in both decision making and reporting of morbidity and mortality. This focus is applauded in light of the gross inequalities in health outcomes between indigenous people and other Australians. Methods: A purposive survey of relevant Australian and international literature was conducted to map the current state of play and identify concerns with efforts to teach cultural competence with Aboriginal people in medical schools and to provide “culturally appropriate” clinical care. The authors critically analyzed this literature in light of their experiences in teaching Aboriginal studies over six decades in many universities to generate examples of iatrogenic effects and possible responses. Results and discussion: Understanding how to most effectively embed Aboriginal content and perspectives in curriculum and how to best teach and assess these remains contested. This review canvasses these debates, arguing that well-intentioned efforts in medical education and clinical management can have iatrogenic impacts. Given the long history of racialization of Aboriginal people in Australian medicine and the relatively low levels of routine contact with Aboriginal people among students and clinicians, the review urges caution in compounding these iatrogenic effects and proposes strategies to combat or reduce them. Conclusion: Long overdue efforts to recognize gaps and inadequacies in medical education about Aboriginal people and their health and to provide equitable health services

  2. Asset Allocation and Diversification by Real Estate Sector Within a Portfolio: Two Australian Case Studies

    OpenAIRE

    Mike Wallace

    1992-01-01

    The research results presented in this paper are a subset of a more extensive investigation of asset allocation and investment diversification in a pooled or mixed asset portfolio including bonds, equities and real estate in real property form, and listed and unlisted property trusts as they are termed in Australia. Australian property trusts are analogous to Real Estate Investment Trusts (REITs) in the United States. This empirical research study is exploratory in nature, and concentrates sp...

  3. "Unwell while Aboriginal": iatrogenesis in Australian medical education and clinical case management

    OpenAIRE

    Ewen SC; Hollinsworth D

    2016-01-01

    Shaun C Ewen,1 David Hollinsworth2 1Melbourne Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, 2Indigenous Studies, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, QLD, Australia Introduction: Attention to Aboriginal health has become mandatory in Australian medical education. In parallel, clinical management has increasingly used Aboriginality as an identifier in both de...

  4. "Unwell while Aboriginal": iatrogenesis in Australian medical education and clinical case management

    OpenAIRE

    Ewen, Shaun

    2016-01-01

    Shaun C Ewen,1 David Hollinsworth2 1Melbourne Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, 2Indigenous Studies, Faculty of Arts, Business and Law, University of the Sunshine Coast, Sippy Downs, QLD, Australia Introduction: Attention to Aboriginal health has become mandatory in Australian medical education. In parallel, clinical management has increasingly used Aboriginality as an identifier in bot...

  5. Case series: toxicity from 25B-NBOMe--a cluster of N-bomb cases.

    Science.gov (United States)

    Gee, Paul; Schep, Leo J; Jensen, Berit P; Moore, Grant; Barrington, Stuart

    2016-01-01

    Background A new class of hallucinogens called NBOMes has emerged. This class includes analogues 25I-NBOMe, 25C-NBOMe and 25B-NBOMe. Case reports and judicial seizures indicate that 25I-NBOMe and 25C-NBOMe are more prevalently abused. There have been a few confirmed reports of 25B-NBOMe use or toxicity. Report Observational case series. This report describes a series of 10 patients who suffered adverse effects from 25B-NBOMe. Hallucinations and violent agitation predominate along with serotonergic/stimulant signs such as mydriasis, tachycardia, hypertension and hyperthermia. The majority (7/10) required sedation with benzodiazepines. Analytical method 25B-NBOMe concentrations in plasma and urine were quantified in all patients using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Peak plasma levels were measured between 0.7-10.1 ng/ml. Discussion The NBOMes are desired by users because of their hallucinogenic and stimulant effects. They are often sold as LSD or synthetic LSD. Reported cases of 25B- NBOMe toxicity are reviewed and compared to our series. Seizures and one pharmacological death have been described but neither were observed in our series. Based on our experience with cases of mild to moderate toxicity, we suggest that management should be supportive and focused on preventing further (self) harm. High doses of benzodiazepines may be required to control agitation. Patients who develop significant hyperthermia need to be actively managed. Conclusions Effects from 25B-NBOMe in our series were similar to previous individual case reports. The clinical features were also similar to effects from other analogues in the class (25I-NBOMe, 25C-NBOMe). Violent agitation frequently present along with signs of serotonergic stimulation. Hyperthermia, rhabdomyolysis and kidney injury were also observed. PMID:26621342

  6. Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2007. A report of the Australian Mycobacterium Reference Laboratory Network.

    Science.gov (United States)

    Lumb, Richard; Bastion, Ivan; Carter, Robyn; Jelfs, Peter; Keehner, Terillee; Sievers, Aina

    2009-09-01

    The Australian Mycobacterium Reference Laboratory Network collects and analyses laboratory data on new cases of disease caused by the Mycobacterium tuberculosis complex. In 2007, a total of 872 cases were identified by bacteriology; an annual reporting rate of 4.1 cases per 100,000 population. Isolates were identified as M. tuberculosis (n=867), M. africanum (n=4) and M. bovis (n=1). Fifteen children aged under 10 years had bacteriologically-confirmed tuberculosis. Results of in vitro drug susceptibility testing were available for 871 of 872 isolates for isoniazid (H), rifampicin (R), ethambutol (E), and pyrazinamide (Z). A total of 98 (11.3%) isolates of M. tuberculosis were resistant to at least one of these anti-tuberculosis agents. Resistance to at least H and R (defined as multi-drug resistance, MDR) was detected in 24 (2.8%) isolates, all from overseas-born patients; 17 were from the respiratory tract (sputum n=16, endotracheal aspirate n=1). Thirteen patients with MDR-TB were from the Papua New Guinea-Torres Strait Islands zone. Of the 98 M. tuberculosis isolates resistant to at least one of the standard drugs, 54 (55.1%) were from new cases, 9 (9.2%) from previously treated cases, and no information was available on the remaining 35 cases. Seven were Australian-born, 90 were overseas- born, and the country of birth of 1 was unknown. Of the 90 overseas-born persons with drug resistant disease, 66 (73.3%) were from 5 countries: India (n=16); Papua New Guinea (n=15); the Philippines (n=12); Vietnam (n=12); and China (n=11). No XDR-TB was detected in 2007. PMID:20043600

  7. Application of FEPs analysis to identify research priorities relevant to the safety case for an Australian radioactive waste facility

    International Nuclear Information System (INIS)

    The Australian Nuclear Science and Technology Organisation (ANSTO) has established a project to undertake research relevant to the safety case for the proposed Australian radioactive waste facility. This facility will comprise a store for intermediate level radioactive waste, and either a store or a near-surface repository for low-level waste. In order to identify the research priorities for this project, a structured analysis of the features, events and processes (FEPs) relevant to the performance of the facility was undertaken. This analysis was based on the list of 137 FEPs developed by the IAEA project on 'Safety Assessment Methodologies for Near Surface Disposal Facilities' (ISAM). A number of key research issues were identified, and some factors which differ in significance for the store, compared to the repository concept, were highlighted. For example, FEPs related to long-term groundwater transport of radionuclides are considered to be of less significance for a store than a repository. On the other hand, structural damage from severe weather, accident or human interference is more likely for a store. The FEPs analysis has enabled the scientific research skills required for the inter-disciplinary project team to be specified. The outcomes of the research will eventually be utilised in developing the design, and assessing the performance, of the future facility. It is anticipated that a more detailed application of the FEPs methodology will be undertaken to develop the safety case for the proposed radioactive waste management facility. (authors)

  8. Double tibial osteotomy for bow leg patients: A case series

    Directory of Open Access Journals (Sweden)

    Khalilollah Nazem

    2013-01-01

    Full Text Available Background: High tibia osteotomy (HTO is a common surgical operation for correction of genu varum deformity. In some patients, there are concurrent tibia vara and genu varum (bow leg. This study aimed to consider the possibility of better correction of bow leg deformity after double level tibial osteotomy (DLTO. Materials and Methods: A case series of 10 patients of genu varum in addition to tibia vara (bow leg deformity who were referred to orthopedic ward of an academic hospital of Isfahan- Iran during 2009-2011 were included in the study. The mean age was 17.3 ± 3.1 years and all of them underwent DLTO. The results of treatment have been assessed based on clinical and radiological parameters before and after surgery. Results: The mean pre- and post operative values for Tibia-Femoral Angle, Medial Proximal of Tibia Angle (MPTA, and Lateral Distal of Tibia Angle (LDTA were 18.13 ± 3.05° vs. 3.93 ± 0.66°, 79.13 ± 3.4° vs. 89.7 ± 1.8° and 96.40 ± 1.8° vs. 88.73 ± 3.0° respectively (P < 0.05. Improvement of all radiological parameters was meaningful. Seventy three percent of patients had normal mechanical axis of limb after surgery. The remaining cases had varus deformity in distal femur that was corrected by valgus supracondylar osteotomy in an additional operation. Limited range of motion (ROM near knee and ankle was not observed. Conclusion : DLTO correct bow leg deformity in the point of alignment of limb and paralleling of knee and ankle joint more effectively. This method can be used in metabolic and congenital bow leg which deformities are present in throughout of the lower limb. We described this technique for the first time.

  9. Frequency of the ATM IVS10-6T→G variant in Australian multiple-case breast cancer families

    International Nuclear Information System (INIS)

    Germline mutations in the genes BRCA1 and BRCA2 account for only a proportion of hereditary breast cancer, suggesting that additional genes contribute to hereditary breast cancer. Recently a heterozygous variant in the ataxia–telangiectasia mutated (ATM) gene, IVS10-6T→G, was reported by an Australian multiple-case breast cancer family cohort study (the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer) to confer a substantial breast cancer risk. Although this variant can result in a truncated ATM product, its clinical significance as a high-penetrance breast cancer allele or its role as a low-penetrance risk-modifier is controversial. We determined the frequency of ATM IVS10-6T→G variants in a cohort of individuals affected by breast and/or ovarian cancer who underwent BRCA1 and BRCA2 genetic testing at four major Australian familial cancer clinics. Seven of 495 patients (1.4%) were heterozygous for the IVS10-6T→G variant; the carrier rate in unselected Australian women with no family history of breast cancer is reported to be 6 of 725 (0.83%) (P = 0.4). Two of the seven probands also harboured a pathogenic BRCA1 mutation and one patient had a BRCA1 unclassified variant of uncertain significance. These findings indicate that the ATM IVS10-6T→G variant does not seem to occur at a significantly higher frequency in affected individuals from high-risk families than in the general population. A role for this variant as a low-penetrance allele or as a modifying gene in association with other genes (such as BRCA1) remains possible. Routine testing for ATM IVS10-6T→G is not warranted in mutation screening of affected individuals from high-risk families

  10. Percutaneous Liver Biopsies Guided with Ultrasonography: A Case Series

    International Nuclear Information System (INIS)

    Although liver biopsy is an easy procedure for hospitalized patients and outpatients, some complications may occur. To evaluate the efficiency, complications, safety and clinicopathological utility of ultrasonographic-guided percutaneous liver biopsy in diffuse liver disease. In our retrospective study, we evaluated ultrasound-assisted needle biopsies that were performed in outpatients from October 2006 to July 2010. The liver biopsies were performed following one-night fasting using the tru-cut biopsy gun (18-20 gauge) after marking the best seen and hypovascular part of the liver, distant enough from the adjacent organs. A total of 1018 patients were referred to our radiology department. Most of the patients had hepatitis B (60.6%). The biopsy specimens were recorded and sent to our pathology department for histopathological examination. According to the results of our series, percutaneous liver biopsy using the tru-cut biopsy gun guided by ultrasonography can be performed safely. We resolve that routine ultrasound of the puncture site is a quick, effective and safe procedure. The complication rate is very low. The US-assisted percutaneous liver biopsy should be used for all cases

  11. Descemet's membrane detachment in horses; case series and literature review.

    Science.gov (United States)

    Matas Riera, Màrian; Donaldson, David; Priestnall, Simon Lawrence

    2015-09-01

    The aim of this article was to describe Descemet's membrane detachment (DMD) following phacoemulsification in five equine eyes and to review the human literature on this topic. In the last decade, there has been increased reporting of DMD in the human literature, in particular following cataract surgery. The natural history of DMD remains unknown and although various medical and surgical treatments have been advocated there is no recognized 'gold standard' treatment for DMD. This case series reports the diagnosis of DMD in four horses (5 eyes) in association with phacoemulsification surgery. The diagnosis of DMD in these patients was made intra-operatively, postoperatively or on subsequent histopathological examination. The surgical reports, photographic or video recordings, and ultrasound data were evaluated and possible factors associated with the pathophysiology of DMD are discussed. This is the first description of DMD in the veterinary literature, and the authors believe that DMD might hitherto have been overlooked in veterinary ophthalmology due to a lack of awareness of the condition. The possible causes, clinical signs, and treatment of DMD as described in the human literature are also reviewed. PMID:25180582

  12. Adverse clinical sequelae after skin branding: a case series

    Directory of Open Access Journals (Sweden)

    Raza Shahzad

    2009-01-01

    Full Text Available Abstract Introduction Branding refers to a process whereby third degree burns are inflicted on the skin with a hot iron rod or metallic object. Branding employs the phenomenon of "counter irritation," and is widely used by faith healers in developing countries for therapeutic purposes. Some methods, which are very crude and inhuman, carry a large risk of complications. The purpose of this study is to present a series of complications and to familiarize clinicians with this dangerous method of treatment. Case presentation Four Pakistani patients, three male and one female, ranging from 25 to 60 years of age "branded" with a red hot iron rod for various medical reasons presented with severe medical complications to our tertiary care hospital. The mean duration between the procedure and presentation to the hospital was 6 days. At the time of admission, two patients had septic shock, one patient had cavernous sinus thrombosis and one patient had multiple splenic abscesses. All patients received standard care for wound management and systemic infections. Two patients eventually died during the course of treatment. Conclusion Severe complications from branding are troublesome and the potential risks of this treatment outweigh its benefits. Globally, there is a great need for heightened awareness about the dangers of branding among patients and physicians, as this will have an important effect on patients who seek branding for various medical conditions.

  13. Odontoma serie de casos: Revisión de literatura Odontoma case series: Review of literature

    Directory of Open Access Journals (Sweden)

    J. Harris Ricardo

    2011-02-01

    Full Text Available El odontoma es el tumor odontogénico más frecuente en cavidad oral, compuesto por una mezcla de células odontogénicas formando dentina y esmalte, presenta células y tejidos normales pero de estructura defectuosa, estos tejidos se encuentran en el área del cuerpo donde se presenta su crecimiento, al examen radiográfico se puede presentar imágenes radiopacas como un gran número de dientes rudimentarios llamados dentículos, en este caso se conoce como odontoma compuesto o presentarse imagen radiopaca como conglomeraciones amorfas, recibiendo el nombre de odontoma complejo. Su etiología se le relaciona con restos paradentales de Malassez, procesos inflamatorios, traumatismos, se le asocia en algunos casos con el quiste odontogénico calcificante, son asintomáticos, producen retención dentaria. El tratamiento es quirúrgico y su recurrencia es baja. Se reporta serie de casos que acudieron al servicio de estomatología y cirugía oral de la Universidad de Cartagena con impresión diagnostica de odontoma, se realizaron los procedimientos quirúrgicos confirmando los diagnósticos con los reportes histopatológicos.Odontoma is the most frequent odontogenic tumor in oral cavity, comprising a mixture of odontogenic cells forming dentin and enamel. It shows cells and normal tissues but in abnormal structure. These tissues are located in the area of the body where it presents its growth. Under radiographic examination may be radiopaque images as a large number of rudimentary teeth called denticles, in this case is known as compound odontoma or presented as conglomerates amorphous radiopaque image, receiving the name of complex odontoma. Its etiology is related to remnants of Malassez paradontals, inflammatory processes. Trauma is sometimes associated with calcifying odontogenic cyst. Generally are asymptomatic, produce tooth retention. Treatment is surgical and recurrence is low. Is reported in the present paper a number of cases that went to

  14. Liver Damage Associated with Polygonum multiflorum Thunb.: A Systematic Review of Case Reports and Case Series

    Directory of Open Access Journals (Sweden)

    Xiang Lei

    2015-01-01

    Full Text Available Objective. To summarize the characteristics and analysis of relevant factors and to give references for prevention and further study of liver damage associated with Polygonum multiflorum Thunb. (HSW, we provide a systematic review of case reports and case series about liver damage associated with HSW. Methods. An extensive search of 6 medical databases was performed up to June 2014. Case reports and case series involving liver damage associated with HSW were included. Results. This review covers a total of 450 cases in 76 articles. HSW types included raw and processed HSW decoction pieces and many Chinese patent medicines that contain HSW. Symptoms of liver damage occur mostly a month or so after taking the medicine, mainly including jaundice, fatigue, anorexia, and yellow or tawny urine. Of the 450 patients, two cases who received liver transplantation and seven who died, the remaining 441 cases recovered or had liver function improvement after discontinuing HSW products and conservative care. Conclusion. HSW causes liver toxicity and may cause liver damage in different degrees and even lead to death; most of them are much related to long-term and overdose of drugs. Liver damage associated with HSW is reversible, and, after active treatment, the majority can be cured. People should be alert to liver damage when taking HSW preparations.

  15. Congenital Zika syndrome with arthrogryposis: retrospective case series study

    Science.gov (United States)

    Filho, Epitacio Leite Rolim; Lins, Otavio Gomes; Aragão, Maria de Fátima Viana Vasco; Brainer-Lima, Alessandra Mertens; Cruz, Danielle Di Cavalcanti Sousa; Rocha, Maria Angela Wanderley; Sobral da Silva, Paula Fabiana; Carvalho, Maria Durce Costa Gomes; do Amaral, Fernando José; Gomes, Joelma Arruda; Ribeiro de Medeiros, Igor Colaço; Ventura, Camila V; Ramos, Regina Coeli

    2016-01-01

    Objective To describe the clinical, radiological, and electromyographic features in a series of children with joint contractures (arthrogryposis) associated with congenital infection presumably caused by Zika virus. Design Retrospective case series study. Setting Association for Assistance of Disabled Children, Pernambuco state, Brazil. Participants Seven children with arthrogryposis and a diagnosis of congenital infection presumably caused by Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Main clinical, radiological, and electromyographic findings, and likely correlation between clinical and primary neurological abnormalities. Results The brain images of all seven children were characteristic of congenital infection and arthrogryposis. Two children tested positive for IgM to Zika virus in the cerebrospinal fluid. Arthrogryposis was present in the arms and legs of six children (86%) and the legs of one child (14%). Hip radiographs showed bilateral dislocation in seven children, subluxation of the knee associated with genu valgus in three children (43%), which was bilateral in two (29%). All the children underwent high definition ultrasonography of the joints, and there was no evidence of abnormalities. Moderate signs of remodeling of the motor units and a reduced recruitment pattern were found on needle electromyography (monopolar). Five of the children underwent brain computed tomography (CT) and magnetic resonance imaging (MRI) and the remaining two CT only. All presented malformations of cortical development, calcifications predominantly in the cortex and subcortical white matter (especially in the junction between the cortex and white matter), reduction in brain volume, ventriculomegaly, and hypoplasia of the brainstem and cerebellum. MRI of the spine in four children showed apparent thinning of the cord and reduced ventral roots. Conclusions Congenital Zika syndrome should be added to the differential diagnosis of congenital

  16. The Use of Scaffolding in the Financial Planning Classroom: An Australian Case Study

    Directory of Open Access Journals (Sweden)

    Janet Cowen

    2011-09-01

    Full Text Available This paper focuses on changes that can be adopted to ease students’ difficulties when challenged to prepare a personal financial plan. It reports the experiences of one Australian university’s use of a ‘scaffolding’ approach that was developed specifically to support students with this task. Such scaffolds provide a support for students to accomplish the task of constructing the financial plan by providing them with early, but temporary, supporting structures at particular points in the process. Over time these supports are removed. This pedagogic approach has proved successful and has assisted students in building confidence in, and mastery of, the financial planning process.

  17. Drivers of Productivity: a Case Study of the Australian Construction Industry

    Directory of Open Access Journals (Sweden)

    Will Chancellor

    2015-08-01

    Full Text Available Australian construction productivity has grown slowly since 1985 and remains arguably stagnant. The importance of this study is therefore to examine several factors through to be drivers of construction productivity and to understand possible avenues for improvement. The drivers tested are research and development, apprentices, wage growth, unionisation and safety regulation. Expenditure on research and development and the number of apprentices were found to be drivers of productivity growth in Victoria, New South Wales and Western Australia. These findings are important because collectively, these three states account for a majority of construction activity in Australia.

  18. Do Australian Fire Brigades Owe a Common Law Duty of Care? A Review of Three Recent Cases

    Directory of Open Access Journals (Sweden)

    Michael Eburn

    2013-12-01

    Full Text Available The law regarding the fire service’s liability for alleged negligence in the way they plan for or respond to a fire is reasonably untested. This paper reports on three cases that were decided in 2012 by the Supreme Courts of New South Wales, Tasmania and the Australian Capital Territory. It is argued that the weight of authority is that the fire brigades are established to provide fire services for the common good, not for individual benefit, and the financial burden of unfortunate operational decisions should be borne by insurers or by the uninsured. Even so, two Supreme Courts have arrived at different conclusions with respect to the question of whether or not the NSW Rural Fire Service owes a common law duty of care to those at risk from bushfire. It is therefore argued that the issue of duty of care would benefit from a determination by the High Court of Australia.

  19. Early Prenatal Diagnosis of Conjoined Twins: Case Series

    OpenAIRE

    Orkun Cetin; Zehra Kurdoglu; Numan Cim; Recep Yildizhan; Guler Sahin; Mertihan Kurdoglu

    2015-01-01

    Introduction: Conjoined twins are complicated and unusual form of monozygotic twins. We present early prenatal diagnosis of three cases of conjoined twins by 2-dimensional (2D) ultrasound between 9-10 weeks of gestation. Case presentation: In the first case, we prenatally diagnosed parapagus dicephalus dibrachus dipus with 2- dimensional ultrasound at gestational age of 10 weeks 4 days. In the second case, we detected parapagus dicephalus at the 10 weeks 2 days gestation. In the third case...

  20. Culture, history, and health in an Australian aboriginal community: the case of utopia.

    Science.gov (United States)

    Anderson, Heather; Kowal, Emma

    2012-01-01

    The poor health of Indigenous Australians is well established. However, the health of residents of one remote community in the Northern Territory of Australia called Utopia has been found recently to be much better than expected. In this article, we draw on historical anthropological research to explain this finding. We trace how cultural and social structures were maintained through changing eras of government policy from the 1930s, and show how these structures strengthened psychosocial determinants of health. We argue that the mainstream psychosocial determinants of social cohesion and self-efficacy are usefully reconceptualized in an Indigenous context as connectedness to culture and land, and collective efficacy, respectively. Continuity of cultural and social structures into the 1940s was facilitated by a combination of factors including the relatively late colonial occupation, the intercultural practices typical of the pastoral industry, the absence of a mission or government settlement, and the individual personalities and histories of those connected to Utopia. PMID:22881383

  1. Responding to the Challenges of Providing Mental Health Services to Refugees: An Australian Case Report.

    Science.gov (United States)

    Kaplan, Ida; Stow, Hardy David; Szwarc, Josef

    2016-01-01

    There has been a growing recognition of the mental health needs of refugees in countries of settlement, as many are survivors of torture and other traumatic events experienced in countries of origin, during flight, and in places of temporary refuge. The challenges in providing access to services and quality mental health care arise not only from the fact that refugees generally come from cultures very different to the societies in which they settle and are not proficient in the languages of their new homes. Other significant barriers relate to the impact of the trauma and psychosocial stressors they experience despite finding apparent security. In response to the challenges, specialist agencies have developed ways of providing services that are trauma-informed, culture-informed, and holistic. This paper describes an Australian example of a mental health clinic as part of a community-based service for refugees who are survivors of torture and other traumatic events. PMID:27524758

  2. Facial contouring with parascapular free flap: A case series of 22 cases

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    Guru Dayal Singh Kalra

    2013-01-01

    Full Text Available Background: The facial asymmetry correction in complex craniofacial malformations presents a challenging problem for reconstructive surgeons. Progressive hemifacial atrophy (HFA and hemifacial microsomia (HFM can manifest in different grades of severity. Most patients require only soft-tissue augmentation. Free flaps are the best option for correction of severe facial soft-tissue deficiency. Materials and Methods: Twenty-two patients of HFM and HFA were included in this study from January 2006 to March 2009 in the Department of Plastic and Reconstructive Surgery, SMS Medical College and Hospital. In all cases, atrophy correction was done using de-epithelialised parascapular free flap with the de-epithelialised surface was placed under the skin. A small skin paddle was taken for monitoring. Results: All cases were reconstructed with de-epithelialised parascapular free flap. There was no flap loss in this series. Hematoma was noted in five cases. Debulking and removal of skin paddle were done in all cases after 6 months. Atrophy recurrence was not observed in any of the cases on follow-up. Conclusion: Contouring of face in cases of HMF and HFA is satisfactorily done with the parascapular free flap. It gives better cosmetic results with minimal donor site morbidity. Facial vessels are better recipient vessels for anastomosis. Keeping de-epithelialised surface of flap under the skin helped in preventing sagging.

  3. PSS Case Book: A workbook in the PROTEUS series

    DEFF Research Database (Denmark)

    Neugebauer, Line Maria; Mougaard, Krestine; Andersen, Jakob Axel Bejbro; McAloone, Tim C.; Bey, Niki; Hsuan, Juliana; Ahm, Thorkild

    The transformation process towards a PSS-oriented company is describes, through the presentation of the best pracice cases. Each case describes motivations, challenges, business models and PSS offerings....

  4. Is modern external beam radiotherapy with androgen deprivation therapy still a viable alternative for prostate cancer in an era of robotic surgery and brachytherapy: a comparison of Australian series

    International Nuclear Information System (INIS)

    We compare the results of modern external-beam radiotherapy (EBRT), using combined androgen deprivation and dose-escalated intensity-modulated radiotherapy with MRI-CT fusion and daily image guidance with fiducial markers (DE-IG-IMRT), with recently published Australian series of brachytherapy and surgery. Five-year actuarial biochemical disease-free survival (bDFS), metastasis-free survival (MFS) and prostate cancer-specific survival (PCaSS) were calculated for 675 patients treated with DE-IG-IMRT and androgen deprivation therapy (ADT). Patients had intermediate-risk (IR) and high-risk (HR) disease. A search was conducted identifying Australian reports from 2005 onwards of IR and HR patients treated with surgery or brachytherapy, reporting actuarial outcomes at 3 years or later. With a median follow-up of 59 months, our 5-year bDFS was 93.3% overall: 95.5% for IR and 91.3% for HR disease. MFS was 96.9% overall (99.0% IR, 94.9% HR), and PCaSS was 98.8% overall (100% IR, 97.7% HR). Prevalence of Grade 2 genitourinary and gastrointestinal toxicity at 5 years was 1.3% and 1.6%, with 0.3% Grade 3 genitourinary toxicity and no Grade 3 gastrointestinal toxicity. Eight reports of brachytherapy and surgery were identified. The HDR brachytherapy series' median 5-year bDFS was 82.5%, MFS 90.0% and PCaSS 97.9%. One surgical series reported 5-year bDFS of 65.5% for HR patients. One LDR series reported 5-year bDFS of 85% for IR patients. Modern EBRT is at least as effective as modern Australian surgical and brachytherapy techniques. All patients considering treatment for localised prostate cancer should be referred to a radiation oncologist to discuss EBRT as an equivalent option.

  5. Carbamazepine-induced Stevens Johnson syndrome: a case series of three case reports

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    Arvind Kumar

    2015-08-01

    Full Text Available Carbamazepine is an iminostilbene derivative that was initially used as an antiepileptic but has been used with increased frequency for different indications including chronic pain, trigeminal neuralgia, and herpetic neuralgias. This has resulted in increased incidence of carbamazepine related adverse effects such as nausea, vomiting, and serious hematological toxicities such as aplastic anemia, agranulocytosis, eosinophilia, lymphadenopathy, and splenomegaly. Life-threatening hypersensitivity reactions such as Steven Johnson syndrome (SJS and toxic epidermal necrolysis can also occur. We hereby present a series of three cases that were prescribed carbamazepine for different indications and presented with SJS. [Int J Basic Clin Pharmacol 2015; 4(4.000: 797-801

  6. Eosinophilic Gastroenteritis Presenting as Intestinal Obstruction - A Case Series

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    Amita Krishnappa

    2011-07-01

    Full Text Available Eosinophilic Gastroenteritis is a rare disease characterized by infiltration of the gastrointestinal tract by an increased number of eosinophils as compared to the normal. The anatomic location and intensity of the infiltrate decides the varied clinical symptomatology with which these patients present. The present report deals with four cases, all presenting with clinical signs of intestinal obstruction A laparotomy performed revealed a stricture in the first case, superficial ulcers and adhesions in the second case, an ileocaecal mass in the third case and volvulus formation in the fourth case. Eosinophilic gastroenteritis was confirmed on histopathology in all the four cases. All the four patients experienced relief of symptoms after resection. It is essential to diagnose the disease to differentiate it from other conditions presenting as intestinal obstruction. The cases are presented because of the rarity of occurrence and presentation. Relevant literature has been reviewed.

  7. Towards Inclusion: An Australian Perspective

    Science.gov (United States)

    Forbes, Fiona

    2007-01-01

    This article outlines the views of the Australian Special Education Principals' Association (ASEPA) on inclusion and the impact this is having on Australian Government Schools from a school based perspective. ASEPA is a relatively young association and was formed in 1997 out of the need to put forward the case to support students with special…

  8. Paracoccidioidomycosis case series with and without central nervous system involvement

    OpenAIRE

    Vinicius Sousa Pietra Pedroso; Ana Claudia Lyon; Stanley de Almeida Araújo; Juliana Márcia Ribeiro Veloso; Enio Roberto Pietra Pedroso; Antônio Lucio Teixeira

    2012-01-01

    INTRODUCTION: Paracoccidioidomycosis (PCM) is the most important systemic mycosis in South America. Central nervous system involvement is potentially fatal and can occur in 12.5% of cases. This paper aims to contribute to the literature describing eight cases of neuroparacoccidioidomycosis (NPMC) and compare their characteristics with patients without neurological involvement, to identify unique characteristics of NPCM. METHODS: A cohort of 213 PCM cases was evaluated at the Infectious Diseas...

  9. Case series of syphilis and HIV co-infections

    OpenAIRE

    Abdul Wahab, Asrul; Rahman, M. M.; Mohammad, Marlyn; Hussin, Salasawati

    2013-01-01

    Syphilis and HIV co-infection are indeed dangerous combinations. The present communication describes three different cases of syphilis and HIV co-infection in young men. The first case is a 25-year-old medical graduate with a primary and secondary syphilis lesions at time of presentation. The second case is a 24-year-old government officer with right eye posterior uveitis where the serology tests for syphilis were reactive. His HIV tests were also positive. The final case is a 25-year-old hom...

  10. Nazi medical experiments on Australian prisoners of war: Commentary on the testimony of an Australian soldier.

    Science.gov (United States)

    Weisz, George M

    2015-12-01

    Archival research reveals that Australian prisoners of war were exposed to non-consensual medical experiments during World War II. This article discusses the first known case of an Australian soldier exposed to German medical experiments. PMID:26939510

  11. English language proficiency and employment: A case study of Bangladeshi graduates in Australian employment market

    Directory of Open Access Journals (Sweden)

    Raqib Chowdhury

    2013-04-01

    Full Text Available Recent literature has suggested that the relationship between globalisation and the English language implicates employability in the job market. Although the effects are uneven in different occupational groups and in different countries, such relationship is growing in significance to policy makers. This paper has explored the hitherto unstudied relationship between English language proficiency and employment and the success of Bangladeshi graduates in Australia to establish how English language skills influence the employment mechanism in the Australian job market for graduates from a non-English speaking South East Asian country. The study was carried out following an interpretive approach as its overall aim was to understand the role of English language skills of university graduates in determining their employment opportunities and career prospects in Australia. It was found that in various ways one’s English language skills influence prospects of employment, especially in contributing to the possibility of “secure” and “better” jobs. The research findings may inform educational policy planners, teacher educators, employers and career advisers to optimise English language learning programs that support increased employability through English.

  12. Fostering eGovernment as State Social Responsibility (SSR: Case Study of an Australian City Council

    Directory of Open Access Journals (Sweden)

    Sinara Rao Karna

    2012-12-01

    Full Text Available           Democracies around the world now face Citizen-apathy. This is a concern now more than ever faced by countries around the globe. eGovernment is undoubtedly a platform to deliberate and enable citizens regain confidence and faith in democratic  processes. Citizens now seek Verifiable, Open, Transparent, Empathetic, Responsive and Sensitive Electronic Democracy and Government (VOTERS EDG, Karna, 2012. Similar to corporate world, there are voices stressing on govenments for the need to understand the stakeholders, their involvement, relationships and responsibilities of a state in eGovernance. Citizens everywhere now demand Verifiable, Open, Transparent, Empathetic, Responsive and Sensitive Electronically Democratic Government as a State Social Responsibity (SSR. Peoples movements and outbursts against authorities with the help of Word of Mouse (Karna, 2012 have established that transparent and open governance is the need of the hour. This paper presents findings of the study conducted in an Australian City Council for preparing the city council for ‘City e-readiness’ to initiate e-Government activities. We propose the idea of ‘Centrality of Citizens’ in context of eGovernment. We further build upon the original concept of deeming eGovernment as ‘State Social Responsibility’ (SSR (Karna, 2010, by governments at all levels.  

  13. Methodology Series Module 2: Case-control Studies.

    Science.gov (United States)

    Setia, Maninder Singh

    2016-01-01

    Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias. PMID:27057012

  14. Methodology series module 2: Case-control studies

    Directory of Open Access Journals (Sweden)

    Maninder Singh Setia

    2016-01-01

    Full Text Available Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases, whereas others do not have the outcome of interest (referred to as controls. The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective. It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias.

  15. Filicide-Suicide: Case Series and Review of the Literature.

    Science.gov (United States)

    Shields, Lisa B E; Rolf, Cristin M; Goolsby, Mary E; Hunsaker, John C

    2015-09-01

    Homicide-suicides or "dyadic deaths" refer to a homicide followed by the suicide of the perpetrator within 1 week of the homicide. A unique subset is filicide-suicide: a parent kills his/her child before committing suicide. Shooting is the preferred method for both the homicide and suicide. The perpetrator has depression in most cases.We present 3 cases of filicide-suicide. In case 1, a divorced mother with schizophrenia and bipolar disorder shot her son and herself. In case 2, a father shot his son and himself while involved in a child-custody dispute. In case 3, a father, experiencing a divorce and financial difficulties, and his daughter with Angelman syndrome succumbed to carbon monoxide poisoning.The forensic pathologist should be aware of the psychosocial dynamics that interplay in filicide-suicide. Diligent attention to a parent's life stressors may aid in determining risk factors for filicide-suicide. PMID:26087315

  16. CASE SERIES ON PHYLLODES TUMOUR OF THE BREAST

    Directory of Open Access Journals (Sweden)

    Sri

    2015-11-01

    Full Text Available : BACKGROUND: Phyllodes tumor of breast is one of the rare neoplasms comprising less than 1% of all breast tumours.aim of the study is to evaluate the clinical charecteristics, treatment regimens and complications of phyllodes tumor in our institution. PATIENTS AND METHODS: We have retrospectively reviewed the medical records of 2 years from 2013 to 2015 of patients who presented to our department, government general hospital, Kakinada. RESULTS: 342 patients presented with breast tumors of which 126 are malignant and 216 are benign. Phyllodes tumor constituted 8 cases of the total breastlump cases presented in our institution from 2013 to 2015. 3 out of 8 cases are recurrent. CONCLUSION: In benign cases wide local excision with clear margins is sufficient to prevent recurrence. In recurrent and malignant cases simple mastectomy has to be done.

  17. Down Syndrome with Different Hematological Manifestations: A Short Series of 3 Cases with Review of Literature

    OpenAIRE

    Manivannan, Prabhu; Prasaad, Priavadhana Rajan; Kar, Rakhee; Basu, Debdatta

    2012-01-01

    Children with Down syndrome (DS) present with a spectrum of hematolymphoid malignancies ranging from transient myeloproliferative disorder (TMD) which regress spontaneously to frank acute leukemia of both myeloid and lymphoid lineage. Here we present a series of three cases with different manifestation in DS. Three cases of DS presented with TMD, acute myeloid leukemia (AML–M2) and acute megakaryoblastic leukemia (AMKL), respectively. This case series displays the spectrum of hematological ma...

  18. [Spiegelian hernia. Apropos of a series of 31 cases].

    Science.gov (United States)

    Ondo N'Dong, F; Lorofi, R; Comes, G; Bellamy, J; Diané, C

    1992-04-01

    31 cases of spiegelian hernias are reported. It is one of the world biggest statistics of this affection. The patients were divided in 18 women and 13 men, with an average of 45 years old. The hernia was located on the right side of the abdomen in 16 cases and on the left side in 13 cases. In two cases, the affection was bilateral. In 14 cases, there was an incarceration. No strangulation was observed. The rare forms can be divided in massive form, tumoral, crawling (in the old man), spread (in the infant and the woman). The spiegelian hernia can be associated with one or more other kinds of hernias. 27 patients underwent an operation. In all the cases, an direct approach was used. There was no post operative complications. We want to emphazise the high frequence of this affection in Gabon, and the fact that most of the cases have been observed within the same area, in the south of the country. A study researching predictive factors could be interesting to be realised in this area. PMID:1527192

  19. Tonsillitis with acute myeloid leukemia: a case series for caution.

    Science.gov (United States)

    Thakur, Jagdeep S; Mohindroo, N K; Sharma, D R; Mohindroo, Shobha; Thakur, Anamika

    2013-01-01

    Worldwide, tonsillitis is very common. The most common etiology is cross-infection with bacteria and viruses. These cases are managed with antibiotics and anti-inflammatory drugs without any further investigation because the diagnosis is based on simple clinical examination. Usually, leukemia presents with bleeding, weight loss, lymphadenopathy, fever, and frequent infection. Tonsillitis is a rare first presentation of leukemia. We present 3 cases in which the diagnosis of leukemia was made on routine examination, and in 1 case diagnosis was suspected during tonsillectomy. PMID:23599112

  20. Gynecologic findings in Goltz syndrome: A case series.

    Science.gov (United States)

    Adeyemi-Fowode, Oluyemisi A; Mansouri, Roshanak; Dietrich, Jennifer E

    2016-03-01

    There is limited information available related to the gynecologic findings in Goltz syndrome. We report exclusively on external genitalia findings in 17 girls with a known diagnosis of focal dermal hypoplasia. This is the largest series to date. Some of our findings have been reported previously; however, some novel features including short perineum body not previously mentioned are noted as well. We recommend referral to a pediatric gynecologist for early evaluation of the reproductive tract as this can have an impact on the future fertility of these girls. © 2016 Wiley Periodicals, Inc. PMID:27001927

  1. Breast Cancer in Transgender Veterans: A Ten-Case Series.

    Science.gov (United States)

    Brown, George R

    2015-03-01

    All known cases of breast cancer in patients with a diagnosis consistent with transgender identification were identified in the Veterans Health Administration (1996-2013). Ten cases were confirmed: seven birth sex females and three birth sex males. Of the three birth sex males, two identified as gender dysphoric male-to-female and one identified as transgender with transvestic fetishism. The birth sex males all presented with late-stage disease that proved fatal, whereas most of the birth sex female transgender veterans presented with earlier stage disease that could be treated. These cases support the importance of screening for breast cancer using standard guidelines in birth sex males and females. Family history of breast cancer should be obtained from transgender people as part of routine care. This report expands the known cases of breast cancer in transgender persons from 5 to 12 (female-to-male) and from 10 to 13 (male-to-female). PMID:26790021

  2. Transmetatarsal Amputation: A Case Series and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ryan McCallum

    2012-01-01

    Full Text Available Foot ulceration is a major cause of morbidity amongst patients with diabetes. In severe cases of ulceration, osteomyelitis and amputation can ensue. A distinct lack of agreement exists on the most appropriate level of amputation in cases of severe foot ulceration/infection to provide predictable healing rates. This paper provides an overview of the transmetatarsal amputation (TMA as a limb salvage procedure and is written with the perspective and experiences of the Department of Podiatric Surgery at West Middlesex University Hospital (WMUH. We have reflected on the cases of 11 patients (12 feet and have found the TMA to be an effective procedure in the management of cases of severe forefoot ulceration and infection.

  3. Cases Series of Malignant Lymphohematopoietic Disorder in Korean Semiconductor Industry

    OpenAIRE

    Kim, Eun-A; Lee, Hye-Eun; Ryu, Hyung-Woo; Park, Seung-Hyun; Kang, Seong-Kyu

    2011-01-01

    Objectives Seven cases of malignant lymphohematopoietic (LHP) disorder were claimed to have developed from occupational exposure at two plants of a semiconductor company from 2007 to 2010. This study evaluated the possibility of exposure to carcinogenic agents for the cases. Methods Clinical courses were reviewed with assessing possible exposure to carcinogenic agents related to LHP cancers. Chemicals used at six major semiconductor companies in Korea were reviewed. Airborne monitoring for ch...

  4. Proximal Interruption of the Pulmonary Artery: A Case Series.

    Science.gov (United States)

    Anand, S H; Jasper, Anitha; Mani, Sunithi Elizabeth; Joseph, Elizabeth; Mathai, John

    2015-12-01

    We present a few cases of Proximal Interruption of the Pulmonary Artery, an uncommon developmental anomaly associated with congenital heart disease. The cases had varied clinical presentations. Chest radiograph showed a hypoplastic lung with an ipsilateral small hilum on the side of the interruption and hyperinflation of the contralateral lung. Contrast CT confirmed the diagnosis, demonstrating non-visualization of the left or right pulmonary artery, and other related findings. PMID:26816968

  5. Pancreatitis secondary to Ascaris Lumbricoides: A case series analysis

    OpenAIRE

    Ab hameed Raina, Ghulam Nabi Yattoo, Feroz Ahmad Wani, Reyaz Ahmad Para, Khaild Hamid Changal, Arshed Hussain Parry

    2013-01-01

    Ascaris lumbricoides infestations are endemic in tropical countries. Ascaris lumbricoides is the second most common intestinal parasite world-wide and, although the infection can be asymptomatic, in some cases it can present with complications, such as acute pancreatitis. Pancreatitis secondary to ascaris is more common in females. We describe three cases who presented with Ascaris lumbricoides-induced acute pancreatitis and all of them were females and were diagnosed on ultrasonography. In t...

  6. Irreversible electroporation of lung neoplasm: A case series

    OpenAIRE

    Usman, Mumal; Moore, William; Talati, Ronak; Watkins, Kevin; Bilfinger, Thomas V.

    2012-01-01

    Summary Background Percutaneous irreversible electroporation (IRE) of lung tumors is a new minimally invasive technique which has recently been used in the treatment of soft tissue tumors. Case Reports The case histories are presented of two patients with unresectable malignancies in the lung, who underwent irreversible electroporation as a treatment attempt. The procedure was performed under CT guidance and was uneventful. Conclusions At follow up 6 months later, the tumors both appeared to ...

  7. Neuroinfection as a Mask of Lung Cancer: A Case Series

    OpenAIRE

    Kuklińska, Beata; Moniuszko-Malinowska, Anna; Mróz, Robert; Pancewicz, Sławomir; Zajkowska, Joanna

    2016-01-01

    Introduction. The diagnosis of lung cancer may still be difficult due to the fact that the first symptoms very often mimic symptoms of other diseases. Case Presentation. In this paper we present two cases, in which initial diagnosis of neuroinfection delayed proper diagnosis. Conclusion. Based on our experience we concluded that neurological symptoms in the area endemic for tick-borne diseases suggesting neuroinfection require careful differential diagnosis. Moreover, neurological symptoms in...

  8. Cysticercosis of the eye in south India - A case series

    Directory of Open Access Journals (Sweden)

    Kaliaperumal S

    2005-01-01

    Full Text Available Purpose: To study the clinical presentation and treatment outcome of patients with ocular cysticercosis in southern India. Methods: This study included 10 patients who were diagnosed to have ocular or adnexal cysticercosis over a period of one year in Pondicherry, India. The clinical presentation, results of investigation and treatment outcome of the cases were analysed retrospectively. Results: Age of these patients ranged from 12 to 55 years. Four presented with loss of vision, two with a swelling in the eyelid, one with proptosis, one with diplopia and two with conjunctival involvement. ELISA for cysticercus antibodies in serum was positive in all cases. Albendazole and prednisolone were given for the treatment of these cases. Two patients responded well to treatment and were completely cured of the disease. There was partial improvement in 6 cases. Surgery in the form of excision was performed in two cases following a course of medical therapy. There was no significant change in visual acuity in eyes with intraocular cysticercosis following treatment. Conclusion: Ultrasonography B scan and ELISA for anticysticercal antibodies help to establish the diagnosis of ocular cysticercosis. A combination of oral albendazole and corticosteroids is found to be effective in confirmed cases. Intraocular cysticercosis is associated with a poor prognosis for vision.

  9. Using renewables to hedge against future electricity industry uncertainties—An Australian case study

    International Nuclear Information System (INIS)

    A generation portfolio modelling was employed to assess the expected costs, cost risk and emissions of different generation portfolios in the Australian National Electricity Market (NEM) under highly uncertain gas prices, carbon pricing policy and electricity demand. Outcomes were modelled for 396 possible generation portfolios, each with 10,000 simulations of possible fuel and carbon prices and electricity demands. In 2030, the lowest expected cost generation portfolio includes 60% renewable energy. Increasing the renewable proportion to 75% slightly increased expected cost (by $0.2/MWh), but significantly decreased the standard deviation of cost (representing the cost risk). Increasing the renewable proportion from the present 15% to 75% by 2030 is found to decrease expected wholesale electricity costs by $17/MWh. Fossil-fuel intensive portfolios have substantial cost risk associated with high uncertainty in future gas and carbon prices. Renewables can effectively mitigate cost risk associated with gas and carbon price uncertainty. This is found to be robust to a wide range of carbon pricing assumptions. This modelling suggests that policy mechanisms to promote an increase in renewable generation towards a level of 75% by 2030 would minimise costs to consumers, and mitigate the risk of extreme electricity prices due to uncertain gas and carbon prices. - Highlights: • A generation portfolio with 75% renewables in 2030 is the most optimal in terms of cost, cost risk and emissions. • Investment in CCGT is undesirable compared to renewables given the cost risk due to gas and carbon price uncertainties. • Renewables can hedge against extreme electricity prices caused by high and uncertain carbon and gas prices. • Existing coal-fired plants still play a key role by moving into a peaking role to complement variable renewables. • Policy mechanisms to promote renewable generation are important

  10. Quantifying fish assemblages in large, offshore marine protected areas: an Australian case study.

    Science.gov (United States)

    Hill, Nicole A; Barrett, Neville; Lawrence, Emma; Hulls, Justin; Dambacher, Jeffrey M; Nichol, Scott; Williams, Alan; Hayes, Keith R

    2014-01-01

    As the number of marine protected areas (MPAs) increases globally, so does the need to assess if MPAs are meeting their management goals. Integral to this assessment is usually a long-term biological monitoring program, which can be difficult to develop for large and remote areas that have little available fine-scale habitat and biological data. This is the situation for many MPAs within the newly declared Australian Commonwealth Marine Reserve (CMR) network which covers approximately 3.1 million km2 of continental shelf, slope, and abyssal habitat, much of which is remote and difficult to access. A detailed inventory of the species, types of assemblages present and their spatial distribution within individual MPAs is required prior to developing monitoring programs to measure the impact of management strategies. Here we use a spatially-balanced survey design and non-extractive baited video observations to quantitatively document the fish assemblages within the continental shelf area (a multiple use zone, IUCN VI) of the Flinders Marine Reserve, within the Southeast marine region. We identified distinct demersal fish assemblages, quantified assemblage relationships with environmental gradients (primarily depth and habitat type), and described their spatial distribution across a variety of reef and sediment habitats. Baited videos recorded a range of species from multiple trophic levels, including species of commercial and recreational interest. The majority of species, whilst found commonly along the southern or south-eastern coasts of Australia, are endemic to Australia, highlighting the global significance of this region. Species richness was greater on habitats containing some reef and declined with increasing depth. The trophic breath of species in assemblages was also greater in shallow waters. We discuss the utility of our approach for establishing inventories when little prior knowledge is available and how such an approach may inform future monitoring

  11. Quantifying fish assemblages in large, offshore marine protected areas: an Australian case study.

    Directory of Open Access Journals (Sweden)

    Nicole A Hill

    Full Text Available As the number of marine protected areas (MPAs increases globally, so does the need to assess if MPAs are meeting their management goals. Integral to this assessment is usually a long-term biological monitoring program, which can be difficult to develop for large and remote areas that have little available fine-scale habitat and biological data. This is the situation for many MPAs within the newly declared Australian Commonwealth Marine Reserve (CMR network which covers approximately 3.1 million km2 of continental shelf, slope, and abyssal habitat, much of which is remote and difficult to access. A detailed inventory of the species, types of assemblages present and their spatial distribution within individual MPAs is required prior to developing monitoring programs to measure the impact of management strategies. Here we use a spatially-balanced survey design and non-extractive baited video observations to quantitatively document the fish assemblages within the continental shelf area (a multiple use zone, IUCN VI of the Flinders Marine Reserve, within the Southeast marine region. We identified distinct demersal fish assemblages, quantified assemblage relationships with environmental gradients (primarily depth and habitat type, and described their spatial distribution across a variety of reef and sediment habitats. Baited videos recorded a range of species from multiple trophic levels, including species of commercial and recreational interest. The majority of species, whilst found commonly along the southern or south-eastern coasts of Australia, are endemic to Australia, highlighting the global significance of this region. Species richness was greater on habitats containing some reef and declined with increasing depth. The trophic breath of species in assemblages was also greater in shallow waters. We discuss the utility of our approach for establishing inventories when little prior knowledge is available and how such an approach may inform future

  12. Comparison of several BHT correction methods: a case study on an Australian data set

    Science.gov (United States)

    Goutorbe, Bruno; Lucazeau, Francis; Bonneville, Alain

    2007-08-01

    Bottom-hole temperatures (BHT) from oil exploration provide useful constraints on the subsurface thermal regime, but they need to be corrected to obtain the equilibrium temperature. In this work, we introduce several BHT correction methods and compare them using a large Australian data set of more than 650 groups of multiple BHT measurements in about 300 oil exploration boreholes. Existing and suggested corrections are classified within a coherent framework, in which methods are divided into: line/cylinder source; instantaneous/continuous heat extraction; one/two component(s). Comparisons with reservoir test temperatures show that most of the corrections lead to reliable estimates of the formation equilibrium temperature within +/-10°C, but too few data exist to perform an intercomparison of the models based on this criterion. As expected, the Horner method diverges from its parent models for small elapsed times (or equivalently large radii). The mathematical expression of line source models suffers from an unphysical delay time that also restrains their domain of applicability. The model that takes into account the difference of thermal properties between circulating mud and surrounding rocks-that is the two-component model-is delicate to use because of its high complexity. For these reasons, our preferred correction methods are the cylindrical source models. We show that mud circulation time below 10 hr has a negligible effect. The cylindrical source models rely on one parameter depending on the thermal diffusivity and the borehole radius, which are poorly constrained, but the induced uncertainty on the extrapolations remains reasonably low.

  13. Chinese and Australian Year 3 Children's Conceptual Understanding of Science: A multiple comparative case study

    Science.gov (United States)

    Tao, Ying; Colette Oliver, Mary; Venville, Grady Jane

    2012-04-01

    Children have formal science instruction from kindergarten in Australia and from Year 3 in China. The purpose of this research was to explore the impact that different approaches to primary science curricula in China and Australia have on children's conceptual understanding of science. Participants were Year 3 children from three schools of high, medium and low socio-economic status in Hunan Province, central south China (n = 135) and three schools of similar socio-economic status in Western Australia (n = 120). The students' understanding was assessed by a science quiz, developed from past Trends in Mathematics and Science Study science released items for primary children. In-depth interviews were carried out to further explore children's conceptual understanding of living things, the Earth and floating and sinking. The results revealed that Year 3 children from schools of similar socio-economic status in the two countries had similar conceptual understandings of life science, earth science and physical science. Further, in both countries, the higher the socio-economic status of the school, the better the students performed on the science quiz and in interviews. Some idiosyncratic strengths and weaknesses were observed, for example, Chinese Year 3 children showed relative strength in classification of living things, and Australian Year 3 children demonstrated better understanding of floating and sinking, but children in both countries were weak in applying and reasoning with complex concepts in the domain of earth science. The results raise questions about the value of providing a science curriculum in early childhood if it does not make any difference to students' conceptual understanding of science.

  14. From the Billabong to the Mainstream? A Teachers' Guide to Australian Training & Literacy Policy Developments 1974-1998. Research into Practice Series Number 6.

    Science.gov (United States)

    Kell, Peter

    This document traces Australian training and literacy policy developments from 1974 to 1998. The document begins with a brief discussion of the global political, educational, social, and economic trends that have affected Australia's training and literacy policies. Discussed next are major events of the four policy "epochs" in Australia's…

  15. Anticonvulsant hypersensitivity syndrome associated with carbamazepine administration: Case series

    Directory of Open Access Journals (Sweden)

    Maulin Mehta

    2014-01-01

    Full Text Available Hypersensitivity reactions are common adverse drug reactions (ADRs associated with antiepileptics. Carbamazepine is one of the routinely prescribed drugs for the treatment of epilepsy and neuropathic pain. ADRs due to carbamazepine range from mild maculopapular rash to severe anticonvulsant hypersensitivity syndrome (AHS. AHS is the triad of fever, rash, and internal organ involvement occurring 1-8 weeks after exposure to an anticonvulsant (1 in 1,000 to 10,000 exposures. Spontaneously reported three cases of AHS-drug hypersensitivity reactions induced by carbamazepine are discussed here. Seven to ten days after starting therapy, patients developed maculopapular skin rashes, fever and liver or kidney involvement. The causal relationship between drug and ADR was found to be ′certain′ in one case and ′probable′ in other two cases with both WHO-UMC and Naranjo causality assessment scale. All the three cases show category 4a according to Hartwig′s severity scale as ADR was the cause for hospital admission. On assessing preventability of ADRs by modified Schumock and Thorntons′ scale, one case was falling into category of ′definitely preventable′ and other two were ′not preventable′. AHS is rare but serious reaction with carbamazepine which requires vigilant monitoring by physicians to avoid major consequences.

  16. Early Prenatal Diagnosis of Conjoined Twins: Case Series

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    Orkun Cetin

    2015-07-01

    Full Text Available Introduction: Conjoined twins are complicated and unusual form of monozygotic twins. We present early prenatal diagnosis of three cases of conjoined twins by 2-dimensional (2D ultrasound between 9-10 weeks of gestation. Case presentation: In the first case, we prenatally diagnosed parapagus dicephalus dibrachus dipus with 2- dimensional ultrasound at gestational age of 10 weeks 4 days. In the second case, we detected parapagus dicephalus at the 10 weeks 2 days gestation. In the third case, we diagnosed thoracopagus at the 9 weeks 6 days of gestation, using 2D ultrasound. After proper counselling, all of the patients opted early pregnancy termination due to the poor prognosis of conjoined twins. Conclusion: Early prenatal detection of conjoined twinning is important for the gestational course. Conjoined twinning could be identified in early first trimester with cautious and comprehensive view by experienced sonographers. Early and accurate prenatal diagnosis of conjoined twinning allows preferable counselling of the parents and gives a chance for early termination of pregnancy.

  17. Transverse facial cleft: A series of 17 cases

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    L K Makhija

    2011-01-01

    Full Text Available Introduction: Transverse facial cleft (Tessier type 7 or congenital macrostomia is a rare congenital anomaly seldom occurring alone and is frequently associated with deformities of the structures developing from the first and second branchial arches. The reported incidence of No. 7 cleft varies from 1 in 60,000 to 1 in 300,000 live births. Material and Methods: Seventeen patients of transeverse facial cleft who presented to us in last 5 years were included in the study. Their history regarding familial and environmental predispositions was recorded. The cases were analysed on basis of sex, laterality, severity, associated anomalies and were graded according to severity. They were operated by z plasty technique and were followed up for 2 years to look for effectiveness of the technique and its complications. Result: Out of the seventeen patients of transverse cleft, none had familial predilection or any environmental etiology like antenatal radiological exposure or intake of drugs of teratogenic potential. Most of the patients (9/17 were associated with hemifacial microsomia and 1 patient was associated with Treacher Colin′s Syndrome. Out of the 6 cases of Grade I clefts, 4 were isolated transverse clefts and of the 10 patients of Grade II clefts, 7 were associated with hemifacial microsomia. We encountered only one case of Grade III Transverse Cleft which was not only associated with hemifacial microsomia but also had cardiac anomaly. Out of the17 cases, 15 were operated and in most of them the outcome was satisfactory.

  18. Balloon atrial septostomy under echocardiographic guide: case series

    Directory of Open Access Journals (Sweden)

    SM Meraji

    2012-12-01

    Full Text Available Background: Balloon atrial septostomy is an emergent procedure in pediatric cardiology. Nowadays, most patients in need of the procedure have acceptable outcomes after surgical repair. Thus, it is important to perform this procedure as safe as possible. By performing early arterial switch operation and prostaglandin infusion, the rate of balloon atrial septostomy has markedly decreased. However, not all centers performing early arterial switch repairs have abandoned atrial septostomy, even in patients who respond favorably to prostaglandin infusion.Case presentation: In total, eight 1- to 15-day old term neonates admitted in Shahid Rajaee Heart Center in Tehran, Iran from October 2009 to February 2011, with congenital heart diseases were scheduled for balloon atrial septostomy. In six cases the procedure was done exclusively under echocardiographic guidance and in two cases with the help of fluoroscopy. Success was defined as the creation of an atrial septal defect with a diameter equal to or more than 5 mm and ample mobility of its margins.Results: Male sex was predominant (87% and the mean age of the neonates was six days. The diagnosis in all cases was simple transposition of great arteries. The procedure was successful in all patients with any cardiovascular complication.Conclusion: Balloon atrial septostomy is an emergent procedure that can be done safely and effectively under echocardiographic guidance. According to the feasibility of this technique it could be performed fast, safe and effective at bedside, avoiding patient transportation to hemodynamic laboratory or referral center.

  19. Massive localized lymphedema: A case series and literature review

    OpenAIRE

    Evans, Robin James; Scilley, Chris

    2011-01-01

    Massive localized lymphedema (MLL) has received very little attention in the literature, mainly because it is misdiagnosed as well-differentiated liposarcoma. MLL is painless and often malignant, and usually presents in morbidly obese patients. Two cases of MLL are discussed in this article – both in women who weighed more than 200 kg – to assist physicians in decision making.

  20. Traumatic abdominal wall hernia in two adults: a case series

    Directory of Open Access Journals (Sweden)

    Agarwal Nitin

    2009-06-01

    Full Text Available Abstract Introduction Traumatic hernia of the abdominal wall is a rare entity. A large proportion of reported cases are in children with a particular type of injury, i.e. from a handlebar injury. In adults, the presentation can vary substantially and the diagnosis is difficult. We present two cases in adults, with widely varying presentations and management. Case presentations A 40-year-old woman from rural north India presented with a low-velocity blunt injury to the lower abdomen. She was attacked by a bull. She had a clinically evident abdominal fascial disruption with intact skin, and was hemodynamically stable. An emergency mesh repair of the defect was performed, and she recovered well. A 38-year-old man from rural north India presented with blunt trauma to the abdomen following a motor vehicle accident. He was stable, with a central abdominal parietal wall swelling and bruising. A computed tomography scan revealed herniation of bowel loops in the area with minor intra-abdominal injuries. A laparotomy, resection-anastomosis of the ischemic bowel, and primary repair of the defect was performed and he recovered well. Conclusion Following blunt abdominal trauma, particularly high-velocity injuries, a high index of suspicion must be reserved for parietal wall swellings, as missed hernias in this setting have a high risk of strangulation. Computed tomography is the best aid to diagnosis. Management of each case needs to be individualized.

  1. Patchy alopecia areata sparing gray hairs: a case series

    OpenAIRE

    Jia, Wei-Xue; Mao, Qiu-Xia; Xiao, Xue-Min; Li, Zhi-Liang; Yu, Rui-xing; Li, Cheng-Rang

    2014-01-01

    Alopecia areata is an unpredictable, non-scarring hair loss condition. Patchy alopecia areata sparing gray hairs is rare. Here we present 4 cases with patchy non-scarring hair loss, which attacked pigmented hairs only and spared gray hairs. It should be differentiated from vitiligo, colocalization of vitiligo and alopecia areata, and depigmented hair regrowth after alopecia areata.

  2. The productivity-inflation nexus: the case of the Australian mining sector

    International Nuclear Information System (INIS)

    This paper examines the causal links between productivity growth and two price series given by domestic inflation and the price of mineral products in Australia's mining sector for the period 1968/1969 to 1997/1998. The study also uses a stochastic translog cost frontier to generate improved estimates of total factor productivity (TFP) growth. The results indicate negative unidirectional causality running from both price series to mining productivity growth. Regression analysis further shows that domestic inflation has a small but adverse effect on mining productivity growth, thus providing some empirical support for Australia's 'inflation first' monetary policy, at least with respect to the mining sector. Inflation in mineral price, on the other hand, has a greater negative effect on mining productivity growth via mineral export growth. (author)

  3. Case series in drug safety: a review to determine characteristics and quality.

    Science.gov (United States)

    Abou Chakra, Claire Nour; Pariente, Antoine; Pinet, Marion; Nkeng, Lenhangmbong; Moore, Nicholas; Moride, Yola

    2010-12-01

    Case series and case reports are a cornerstone of drug safety research; however, the characteristics of case series published in the literature remain poorly examined. A narrative review of case series addressing drug safety, published in the literature between 1 January 2003 and 15 July 2009, and identified through a PubMed search, was conducted in order to determine their characteristics and quality according to the criteria found in the US FDA Pharmacovigilance Guidance 2005. Of 130 publications that met the search criteria, 11.5% included an analytical component and 88.5% were descriptive. The median number of cases included in a given case series was 7 (range 2-2195) and the median time period for recruitment of the cases was 23 months (range 0.5-96). Overall, 43.1% of case series consisted of individual case reports, while 24.6% originated from cohorts and 21% from pharmacovigilance databases. Of the case series, 65.1% concerned adults (age ≥18 years), 11.6% elderly (age ≥65 years) and 8.5% youth (<18 years). Adverse effects involved mainly the skin (18.5%) and the circulatory system (13.8%). The main suspected drug classes (Anatomical Therapeutic Chemical classification) were nervous system drugs (23.1%) and antineoplastic and immunomodulating agents (20.0%). On average, six out of the possible nine US FDA Pharmacovigilance Guidance Criteria were fulfilled, with 27% of publications fulfilling at least seven criteria. Only 10% reported data on co-morbidity. In conclusion, this review highlights the reporting gaps and heterogeneity in published case series with respect to size, recruitment period and quality. PMID:21077699

  4. Efficient nitrogen recycling through sustainable use of organic wastes in agriculture - an Australian case study

    Science.gov (United States)

    Rigby, Hannah; Landman, Michael; Collins, David; Walton, Katrina; Penney, Nancy; Pritchard, Deborah

    2014-05-01

    The effective recycling of nutrients in treated sewage sludge (biosolids) domestic (e.g. source separated food waste), agricultural, and commercial and industrial (C&I) biowastes (e.g. food industry wastes, papermill sludge) for use on land, generally following treatment (e.g. composting, anaerobic digestion or thermal conversion technologies) as alternatives to conventional mineral fertilisers in Australia can have economic benefits, ensure food security, and close the nutrient loop. In excess of 75% of Australian agricultural soils have less than 1% organic matter (OM), and, with 40 million tonnes of solid waste per year potentially available as a source of OM, biowastes also build soil carbon (C) stocks that improve soil structure, fertility and productivity, and enhance soil ecosystem services. In recent years, the increasing cost of conventional mineral fertilisers, combined with changing weather patterns have placed additional pressure on regional and rural communities. Nitrogen (N) is generally the most limiting nutrient to crop production, and the high-energy required and GHGs associated with its manufacture mean that, additionally, it is critical to use N efficiently and recycle N resources where possible. Biosolids and biowastes have highly variable organic matter (OM) and nutrient contents, with N often present in a variety of forms only some of which are plant-available. The N value is further influenced by treatment process, storage and fundamental soil processes. The correct management of N in biowastes is essential to reduce environmental losses through leaching or runoff and negative impacts on drinking water sources and aquatic ecosystems. Gaseous N emissions also impact upon atmospheric quality and climate change. Despite the body of work to investigate N supply from biosolids, recent findings indicate that historic and current management of agricultural applications of N from biosolids and biowastes in Australia may still be inefficient leading

  5. Securing Institutional Legitimacy or Organisational Effectiveness? A Case Examining the Impact of Public Sector Reform Initiatives in an Australian Local Authority

    OpenAIRE

    Zahirul Hoque

    2005-01-01

    The article considers the impact of a major initiative (the National Competition Policy) and pieces of legislation (the Local Government Act and the Local Government Finance Standards) on the internal practices of a large Australian local authority. A theoretical framework is developed using new public management (NPM) and neo-institutional theory literatures to explain the findings. A case study approach was applied to collect the data for the research. The findings reveal that the National ...

  6. Australian Hackers and Ethics

    OpenAIRE

    Warren, M. J.; W. Hutchinson

    2003-01-01

    The aim of the paper is to look at the way hackers act and ways in which society can protect itself. The paper will show the current views and attitudes of hackers in an Australian context. The paper will also include a case study to show how a hacking incident can develop and how technology can be used to protect against hacking.

  7. Clinical Use of Laser-Microtextured Abutments: A Case Series.

    Science.gov (United States)

    Shapoff, Cary A; Babushkin, Jeffrey A; Wohl, David J

    2016-01-01

    This article discusses the clinical use of laser-microtextured abutments on dental implant restorations. Four cases are presented, each using one of the four commercially available laser-microtextured abutment styles. Numerous preclinical and clinical studies have shown the positive effects of laser microtexturing on the implant platform in limiting crestal bone loss and benefiting soft tissue stability. Other histologic studies of laser microtexturing on the implant abutment have demonstrated the ability of this specific feature to block epithelial downgrowth and provide a functional connective tissue attachment to the abutment surface. Other abutment designs, styles, and materials have only demonstrated a soft tissue seal with epithelial adhesion and a circular ring of connective tissue fibers around the abutment without direct contact. This article presents clinical and radiographic case examples from a private practice perspective on the longterm successful use of microtextured abutments with respect to crestal bone levels, exceptional soft tissue health, and stability with minimal sulcular depth. PMID:27560683

  8. Probable Nootropicinduced Psychiatric Adverse Effects: A Series of Four Cases

    Science.gov (United States)

    Ajaltouni, Jean

    2015-01-01

    The misuse of nootropics—any substance that may alter, improve, or augment cognitive performance, mainly through the stimulation or inhibition of certain neurotransmitters—may potentially be dangerous and deleterious to the human brain, and certain individuals with a history of mental or substance use disorders might be particularly vulnerable to their adverse effects. We describe four cases of probable nootropic-induced psychiatric adverse effects to illustrate this theory. To the best of our knowledge this has not been previously reported in the formal medical literature. We briefly describe the most common classes of nootropics, including their postulated or proven methods of actions, their desired effects, and their adverse side effects, and provide a brief discussion of the cases. Our objective is to raise awareness among physicians in general and psychiatrists and addiction specialists in particular of the potentially dangerous phenomenon of unsupervised nootropic use among young adults who may be especially vulnerable to nootropics’ negative effects. PMID:27222762

  9. Probable Nootropicinduced Psychiatric Adverse Effects: A Series of Four Cases.

    Science.gov (United States)

    Talih, Farid; Ajaltouni, Jean

    2015-01-01

    The misuse of nootropics-any substance that may alter, improve, or augment cognitive performance, mainly through the stimulation or inhibition of certain neurotransmitters-may potentially be dangerous and deleterious to the human brain, and certain individuals with a history of mental or substance use disorders might be particularly vulnerable to their adverse effects. We describe four cases of probable nootropic-induced psychiatric adverse effects to illustrate this theory. To the best of our knowledge this has not been previously reported in the formal medical literature. We briefly describe the most common classes of nootropics, including their postulated or proven methods of actions, their desired effects, and their adverse side effects, and provide a brief discussion of the cases. Our objective is to raise awareness among physicians in general and psychiatrists and addiction specialists in particular of the potentially dangerous phenomenon of unsupervised nootropic use among young adults who may be especially vulnerable to nootropics' negative effects. PMID:27222762

  10. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series.

    Science.gov (United States)

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  11. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series

    Directory of Open Access Journals (Sweden)

    Naina Pattnaik

    2015-01-01

    Full Text Available Cases described here discuss interdisciplinary (periodontal and behavioral approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions.

  12. Flatfoot in Müller-Weiss syndrome: a case series

    Directory of Open Access Journals (Sweden)

    Wang Xu

    2012-08-01

    Full Text Available Abstract Introduction Spontaneous osteonecrosis of the navicular bone in adults is a rare entity, known as Müller-Weiss syndrome. We report here on our experience with six patients with Müller-Weiss syndrome accompanied by flatfoot deformity, but on a literature search found no reports on this phenomenon. Because the natural history and treatment are controversial, an understanding of how to manage this deformity may be helpful for surgeons when choosing the most appropriate operative procedure. Case presentation Six patients (five women, one man; average age, 54 years with flatfoot caused by osteonecrosis of the navicular bone were followed up between January 2005 and December 2008 (mean follow-up period, 23.2 months. Conservative treatment, such as physical therapy, and non-steroidal anti-inflammatory drugs were used, but failed. Physical examinations revealed flattening of the medial arch of the involved foot and mild tenderness at the mid-tarsal joint. Weight-bearing X-rays (anterior-posterior and lateral views, computed tomography, and MRI scans were performed for each case. Talonavicular joint arthrodesis was performed in cases of single talonavicular joint arthritis. Triple arthrodesis was performed in cases of triple joint arthritis to reconstruct the medial arch. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale; the scores were 63.0 pre-operatively and 89.8 post-operatively. All patients developed bony fusion. Conclusions The reason for the development of flatfoot in patients with Müller-Weiss syndrome is unknown. Surgical treatment may achieve favorable outcomes in terms of deformity correction, pain relief, and functional restoration. The choice of operative procedure may differ in patients with both flatfoot and posterior tibial tendon dysfunction.

  13. Paracoccidioidomycosis case series with and without central nervous system involvement

    Directory of Open Access Journals (Sweden)

    Vinicius Sousa Pietra Pedroso

    2012-10-01

    Full Text Available INTRODUCTION: Paracoccidioidomycosis (PCM is the most important systemic mycosis in South America. Central nervous system involvement is potentially fatal and can occur in 12.5% of cases. This paper aims to contribute to the literature describing eight cases of neuroparacoccidioidomycosis (NPMC and compare their characteristics with patients without neurological involvement, to identify unique characteristics of NPCM. METHODS: A cohort of 213 PCM cases was evaluated at the Infectious Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, from October 1976 to August 2008. Epidemiological, clinical, laboratory, therapeutic and follow-up data were registered. RESULTS: Eight patients presented NPCM. The observed NPCM prevalence was 3.8%. One patient presented the subacute form of PCM and the other seven presented the chronic form of the disease. The parenchymatous form of NPCM occurred in all patients. 60% of the patients who proceeded from the north/ northeast region of Minas Gerais State developed NPCM. The neurological involvement of a mother and her son was observed. NPCM patients exhibited demographical and clinical profiles similar to what is described in the literature. When NPCM cases were compared to PCM patients, there were differences in relation to origin and positive PCM family history. CONCLUSIONS: The results corroborate the clinical view that the neurological findings are extremely important in the evaluation of PCM patients. Despite the limitations of this study, the differences in relation to patient's origins and family history point to the need of further studies to determine the susceptibility factors involved in the neurological compromise.

  14. Probable Nootropicinduced Psychiatric Adverse Effects: A Series of Four Cases

    OpenAIRE

    Talih, Farid; Ajaltouni, Jean

    2015-01-01

    The misuse of nootropics—any substance that may alter, improve, or augment cognitive performance, mainly through the stimulation or inhibition of certain neurotransmitters—may potentially be dangerous and deleterious to the human brain, and certain individuals with a history of mental or substance use disorders might be particularly vulnerable to their adverse effects. We describe four cases of probable nootropic-induced psychiatric adverse effects to illustrate this theory. To the best of ou...

  15. Treatment of epidermoid tumors with gamma knife radiosurgery: Case series

    OpenAIRE

    Javier A Jacobo Vasquez; Julio R Fonnegra; Juan C Diez; Andres Fonnegra

    2016-01-01

    Background: Epidermoid tumors (ETs) are benign lesions that are treated mainly by means of surgical resection, with overall good results. External beam radiotherapy is an alternative treatment for those recurrent tumors, in which a second surgery might not be the best choice for the patient. A little information exists about the effectiveness of gamma knife radiosurgery for the treatment of newly diagnosed and recurrent ETs. We present three cases of ETs treated with gamma knife radiosurgery....

  16. Metformin-induced lactic acidosis: a case series

    OpenAIRE

    Silvestre Joana; Carvalho Susana; Mendes Vitor; Coelho Luis; Tapadinhas Camila; Ferreira Pedro; Povoa Pedro; Ceia Fatima

    2007-01-01

    Abstract Introduction Unlike other agents used in the treatment of type 2 diabetes mellitus, metformin has been shown to reduce mortality in obese patients. It is therefore being increasingly used in higher doses. The major concern of many physicians is a possible risk of lactic acidosis. The reported frequency of metformin related lactic acidosis is 0.05 per 1000 patient-years; some authors advocate that this rate is equal in those patients not taking metformin. Case presentation We present ...

  17. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series

    OpenAIRE

    Naina Pattnaik; Anurag Satpathy; Rinkee Mohanty; Rashmita Nayak; Surjeet Sahoo

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Thr...

  18. Inflammatory Pseudotumor of the Temporal Bone: A Case Series

    OpenAIRE

    Strasnick, Barry; Vaughan, Andrew

    2008-01-01

    Inflammatory pseudotumor is a non-neoplastic inflammatory process. Histologically these lesions appear as an inflammatory infiltrate with a fibrotic background. Clinical presentations vary from slow growth with minimal mass effect, to bony destruction that can mimic malignancy. Although they occur most commonly in the orbit, there are a growing number of case reports of tumors of the temporal bone and skull base. Inflammatory pseudotumors of the temporal bone are best treated by excision, wi...

  19. Benign Paroxysmal Positional Vertigo After Nonotologic Surgery: Case Series

    OpenAIRE

    Kansu, Leyla; Aydin, Erdinc; Gulsahi, Kamran

    2012-01-01

    Benign paroxysmal positional vertigo is one of the most common types of vertigo caused by peripheral vestibular dysfunction. Although head trauma, migraine, long-term bed rest, Ménière disease, viral labyrinthitis, and upper respiratory tract infections are believed to be predisposing factors, most cases of benign paroxysmal positional vertigo are idiopathic. Ear surgery is another cause, but after non-otologic surgery, attacks of benign paroxysmal positional vertigo are rare. We describe thr...

  20. Cognitive Behavior Therapy for Stuttering: A Case Series

    OpenAIRE

    Reddy R; Sharma M.; Shivashankar N

    2010-01-01

    The present investigation was aimed at studying the efficacy of cognitive behavior therapy (CBT) in reducing the symptoms of stuttering and dysfunctional cognitions and in enhancing assertiveness and quality of life in clients with stuttering. Five clients with stuttering who met the inclusion criteria (male clients with diagnosis of stuttering) and exclusion criteria (clients with brian damage), substance abuse or mental retardation were enrolled for the study. A single-case design was adopt...

  1. Acetabular fractures following rugby tackles: a case series

    Directory of Open Access Journals (Sweden)

    Morris Seamus

    2011-10-01

    Full Text Available Abstract Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting 'the tackle' to only two players may well reduce the likelihood of this life-altering injury.

  2. Acetabular fractures following rugby tackles: a case series

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-10-05

    Abstract Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting \\'the tackle\\' to only two players may well reduce the likelihood of this life-altering injury.

  3. Minimally Invasive Surgical Treatment of Acute Epidural Hematoma: Case Series

    Science.gov (United States)

    2016-01-01

    Background and Objective. Although minimally invasive surgical treatment of acute epidural hematoma attracts increasing attention, no generalized indications for the surgery have been adopted. This study aimed to evaluate the effects of minimally invasive surgery in acute epidural hematoma with various hematoma volumes. Methods. Minimally invasive puncture and aspiration surgery were performed in 59 cases of acute epidural hematoma with various hematoma volumes (13–145 mL); postoperative follow-up was 3 months. Clinical data, including surgical trauma, surgery time, complications, and outcome of hematoma drainage, recovery, and Barthel index scores, were assessed, as well as treatment outcome. Results. Surgical trauma was minimal and surgery time was short (10–20 minutes); no anesthesia accidents or surgical complications occurred. Two patients died. Drainage was completed within 7 days in the remaining 57 cases. Barthel index scores of ADL were ≤40 (n = 1), 41–60 (n = 1), and >60 (n = 55); scores of 100 were obtained in 48 cases, with no dysfunctions. Conclusion. Satisfactory results can be achieved with minimally invasive surgery in treating acute epidural hematoma with hematoma volumes ranging from 13 to 145 mL. For patients with hematoma volume >50 mL and even cerebral herniation, flexible application of minimally invasive surgery would help improve treatment efficacy. PMID:27144170

  4. Epithelioid Angiosarcoma of the Bladder: A Series of 9 Cases.

    Science.gov (United States)

    Matoso, Andres; Epstein, Jonathan I

    2015-10-01

    Primary angiosarcoma of the bladder is very rare, with approximately 30 cases reported in the literature. Those with epithelioid morphology are even rarer, with only single-case reports published. We describe the histopathologic features and clinical follow-up of 9 patients with epithelioid angiosarcoma (EA) of the bladder retrieved from our Surgical Pathology files from 1998 to 2014. Eight cases were consults. The mean age at presentation was 65 years (range, 39 to 85 y). The M:F ratio was 8:1. The clinical presentation was hematuria and bladder mass in all cases. Six patients had a history of radiotherapy to the pelvis, 5 to treat prostate cancer and 1 to treat uterine cervical cancer. The time from radiotherapy to the diagnosis of EA ranged from 6 to 15 years. The average size of the tumor was 4 cm. (range, 1 to 8 cm.). The submitting diagnoses were poorly differentiated carcinoma (n=5), high-grade invasive urothelial carcinoma (n=3), and atypical vascular proliferation (n=1). Morphologically, the tumors were composed of nests and sheets of highly atypical cells with high nuclear to cytoplasmic ratio, occasional intracytoplasmic lumens, and a hemorrhagic background. None of the cases showed any urothelial carcinoma component. Three patients showed in addition usual angiosarcoma in the resection specimen. By immunohistochemistry, 5/9 cases were positive for cytokeratins, including CK7 (n=3), AE1/AE3 (n=3), and Cam5.2 (n=1). All cases were positive for at least 1 endothelial marker, including CD31 (n=7), CD34 (n=2), FVIII (n=3), and ERG (n=2). Urothelial markers (p63 and GATA3) were consistently negative. Surgical treatment included transurethral resection of the bladder (TURB) only (n=5), TURB followed by cystoprostatectomy (n=2), TURB followed by partial cystectomy (n=1), and cystoprostatectomy only (n=1). The tumor involved the muscularis propria in 5/9 patients, the periureteric adipose tissue in 1 patient, and the prostate and seminal vesicles in 1 patient

  5. Meeting Indigenous peoples' objectives in environmental flow assessments: Case studies from an Australian multi-jurisdictional water sharing initiative

    Science.gov (United States)

    Jackson, Sue; Pollino, Carmel; Maclean, Kirsten; Bark, Rosalind; Moggridge, Bradley

    2015-03-01

    The multi-dimensional relationships that Indigenous peoples have with water are only recently gaining recognition in water policy and management activities. Although Australian water policy stipulates that the native title interests of Indigenous peoples and their social, cultural and spiritual objectives be included in water plans, improved rates of Indigenous access to water have been slow to eventuate, particularly in those regions where the water resource is fully developed or allocated. Experimentation in techniques and approaches to both identify and determine Indigenous water requirements will be needed if environmental assessment processes and water sharing plans are to explicitly account for Indigenous water values. Drawing on two multidisciplinary case studies conducted in Australia's Murray-Darling Basin, we engage Indigenous communities to (i) understand their values and explore the application of methods to derive water requirements to meet those values; (ii) assess the impact of alternative water planning scenarios designed to address over-allocation to irrigation; and (iii) define additional volumes of water and potential works needed to meet identified Indigenous requirements. We provide a framework where Indigenous values can be identified and certain water needs quantified and advance a methodology to integrate Indigenous social, cultural and environmental objectives into environmental flow assessments.

  6. A review of Computer Science resources for learning and teaching with K-12 computing curricula: an Australian case study

    Science.gov (United States)

    Falkner, Katrina; Vivian, Rebecca

    2015-10-01

    To support teachers to implement Computer Science curricula into classrooms from the very first year of school, teachers, schools and organisations seek quality curriculum resources to support implementation and teacher professional development. Until now, many Computer Science resources and outreach initiatives have targeted K-12 school-age children, with the intention to engage children and increase interest, rather than to formally teach concepts and skills. What is the educational quality of existing Computer Science resources and to what extent are they suitable for classroom learning and teaching? In this paper, an assessment framework is presented to evaluate the quality of online Computer Science resources. Further, a semi-systematic review of available online Computer Science resources was conducted to evaluate resources available for classroom learning and teaching and to identify gaps in resource availability, using the Australian curriculum as a case study analysis. The findings reveal a predominance of quality resources, however, a number of critical gaps were identified. This paper provides recommendations and guidance for the development of new and supplementary resources and future research.

  7. Orbital and adnexal tuberculosis: a case series from a South Indian population

    OpenAIRE

    Babu, Kalpana; Mukhopadhyay, Moupia; Bhat, Soumya S; Chinmayee, JT

    2014-01-01

    Background Orbital tuberculosis (OTb) is rare and may be regarded as a manifestation of extrapulmonary tuberculosis. We report an interesting case series of six patients with varied presentations of orbital and adnexal tuberculosis in a South Indian patient population. Results A retrospective, interventional case series of six patients diagnosed with orbital and adnexal tuberculosis on the basis of clinical, radiological and histopathological evaluations between 2010 and 2013 was performed. A...

  8. Ethnic Differences in the Quality of the Interview Process and Implications for Survey Analysis: The Case of Indigenous Australians.

    Directory of Open Access Journals (Sweden)

    Francisco Perales

    Full Text Available Comparable survey data on Indigenous and non-Indigenous Australians are highly sought after by policymakers to inform policies aimed at closing ethnic socio-economic gaps. However, collection of such data is compromised by group differences in socio-economic status and cultural norms. We use data from the Household, Income and Labour Dynamics in Australia Survey and multiple-membership multilevel regression models that allow for individual and interviewer effects to examine differences between Indigenous and non-Indigenous Australians in approximate measures of the quality of the interview process. We find that there are both direct and indirect ethnic effects on different dimensions of interview process quality, with Indigenous Australians faring worse than non-Indigenous Australians in all outcomes ceteris paribus. This indicates that nationwide surveys must feature interview protocols that are sensitive to the needs and culture of Indigenous respondents to improve the quality of the survey information gathered from this subpopulation.

  9. Ethnic Differences in the Quality of the Interview Process and Implications for Survey Analysis: The Case of Indigenous Australians.

    Science.gov (United States)

    Perales, Francisco; Baffour, Bernard; Mitrou, Francis

    2015-01-01

    Comparable survey data on Indigenous and non-Indigenous Australians are highly sought after by policymakers to inform policies aimed at closing ethnic socio-economic gaps. However, collection of such data is compromised by group differences in socio-economic status and cultural norms. We use data from the Household, Income and Labour Dynamics in Australia Survey and multiple-membership multilevel regression models that allow for individual and interviewer effects to examine differences between Indigenous and non-Indigenous Australians in approximate measures of the quality of the interview process. We find that there are both direct and indirect ethnic effects on different dimensions of interview process quality, with Indigenous Australians faring worse than non-Indigenous Australians in all outcomes ceteris paribus. This indicates that nationwide surveys must feature interview protocols that are sensitive to the needs and culture of Indigenous respondents to improve the quality of the survey information gathered from this subpopulation. PMID:26091283

  10. Neonates presenting with severe complications of frenotomy: a case series

    Directory of Open Access Journals (Sweden)

    Opara Peace I

    2012-03-01

    Full Text Available Abstract Introduction Tongue-tie or ankyloglossia is an anatomic variation in which the lingual frenulum is thick, short or tight. It may be asymptomatic, or present with complications like breast feeding difficulties or speech, dental and cosmetic problems. The treatment of this condition, where indicated, is frenotomy. This procedure usually has few or no complications. However, when it is done by untrained personnel, it may lead to life-threatening complications. This paper highlights complications that could arise from improper treatment of ankyloglossia. Case presentation Case 1 was a one-day-old male neonate, a Nigerian of Igbo ethnicity, who was admitted with bleeding from the mouth and passage of dark stools after clipping of the frenulum by a traditional birth attendant. He was severely pale and in hypovolemic shock, with a severed frenulum which was bleeding actively. His packed cell volume was 15%. He was resuscitated with intravenous fluids and a blood transfusion. The bleeding was controlled using an adrenaline pack. He also received antibiotics. He was discharged five days later. Case 2 was a three-day-old male neonate, a Nigerian of Ikwerre ethnicity, who was admitted with profuse bleeding from a soft tissue injury under the tongue, after clipping of the frenulum by a community health worker. He was severely pale and lethargic. He was resuscitated with intravenous fluids and a blood transfusion. The bleeding vessel was ligated with repair of the soft tissue. He also received antibiotics and was discharged home one week later. Conclusion Treatment of tongue-tie, a benign condition, when done by untrained personnel may result in life-threatening complications. Clinicians should pay more attention to parents' worries about this condition and give adequate counseling or refer them to trained personnel for surgical intervention where clinically indicated.

  11. Superhero‐related injuries in paediatrics: a case series

    Science.gov (United States)

    Davies, Patrick; Surridge, Julia; Hole, Laura; Munro‐Davies, Lisa

    2007-01-01

    Five cases of serious injuries to children wearing superhero costumes, involving extreme risk‐taking behaviour, are presented here. Although children have always displayed behaviour seemingly unwise to the adult eye, the advent of superhero role models can give unrealistic expectations to the child, which may lead to serious injury. The children we saw have all had to contemplate on their way to hospital that they do not in fact possess superpowers. The inbuilt injury protection which some costumes possess is also discussed. PMID:17337680

  12. A CASE SERIES OF CYSTIC LESIONS OF CONJUNCTIVA

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    Srinivas Rao

    2015-05-01

    Full Text Available INTRODUCTION: Cysticercosis is the most common parasitic disease of the nervous system. The disease occurs when humans become the intermediate host in the life cycle of Taenia solium by ingesting its eggs from contaminated food. The most common sites of involvement of cysticerci are soft tissue , eye and central nervous system. Unusual location of the cysts may result in uncommon manifestations. Ocular cysticercosis can involve both the intraocular and extra ocular muscle. Extra ocular muscle cysticercosis is rare. PRESENTATION OF CAS ES : In the department of ophthalmology , G.S.L medical college , Rajahmundry we are reporting 6 cases of cystic lesions of eye

  13. Imaging of Various Aspects of Neurofibromatosis Involvement: Case Series

    OpenAIRE

    Nazila Tayari; Amirhossein Ghazavi; Ali Hekmatnia

    2010-01-01

    Neurofibromatosis (NF) is often noticed at birth or soon after. NF is divided into two types: NF type 1 is a complex of cutaneous and deep neural tumors. It is an autosomal dominant familial disorder. CNS is affected in about 15% of the cases. Optic nerve gliomas have a high degree of association with NF 1."nNF type 2 is much less commonly seen. It is also inherited as an autosomal dominant trait. Bilateral acoustic neuromas are pathognomonic of NF 2 and may be associated with meningioma...

  14. Metoprolol-induced visual hallucinations: a case series

    Directory of Open Access Journals (Sweden)

    Goldner Jonathan A

    2012-02-01

    Full Text Available Abstract Introduction Metoprolol is a widely used beta-adrenergic blocker that is commonly prescribed for a variety of cardiovascular syndromes and conditions. While central nervous system adverse effects have been well-described with most beta-blockers (especially lipophilic agents such as propranolol, visual hallucinations have been only rarely described with metoprolol. Case presentations Case 1 was an 84-year-old Caucasian woman with a history of hypertension and osteoarthritis, who suffered from visual hallucinations which she described as people in her bedroom at night. They would be standing in front of the bed or sitting on chairs watching her when she slept. Numerous medications were stopped before her physician realized the metoprolol was the causative agent. The hallucinations resolved only after discontinuation of this medication. Case 2 was a 62-year-old Caucasian man with an inferior wall myocardial infarction complicated by cardiac arrest, who was successfully resuscitated and discharged from the hospital on metoprolol. About 18 months after discharge, he related to his physician that he had been seeing dead people at night. He related his belief that since he 'had died and was brought back to life', he was now seeing people from the after-life. Upon discontinuation of the metoprolol the visual disturbances resolved within several days. Case 3 was a 68 year-old Caucasian woman with a history of severe hypertension and depression, who reported visual hallucinations at night for years while taking metoprolol. These included awakening during the night with people in her bedroom and seeing objects in her room turn into animals. After a new physician switched her from metoprolol to atenolol, the visual hallucinations ceased within four days. Conclusion We suspect that metoprolol-induced visual hallucinations may be under-recognized and under-reported. Patients may frequently fail to acknowledge this adverse effect believing that they

  15. Metformin-induced lactic acidosis: a case series

    Directory of Open Access Journals (Sweden)

    Silvestre Joana

    2007-10-01

    Full Text Available Abstract Introduction Unlike other agents used in the treatment of type 2 diabetes mellitus, metformin has been shown to reduce mortality in obese patients. It is therefore being increasingly used in higher doses. The major concern of many physicians is a possible risk of lactic acidosis. The reported frequency of metformin related lactic acidosis is 0.05 per 1000 patient-years; some authors advocate that this rate is equal in those patients not taking metformin. Case presentation We present two case reports of metformin-associated lactic acidosis. The first case is a 77 year old female with a past medical history of hypertension and type 2 diabetes mellitus who had recently been prescribed metformin (3 g/day, perindopril and acetylsalicylic acid. She was admitted to the emergency department two weeks later with abdominal pain and psychomotor agitation. Physical examination revealed only signs of poor perfusion. Laboratory evaluation revealed hyperkalemia, elevated creatinine and blood urea nitrogen and mild leukocytosis. Arterial blood gases showed severe lactic acidemia. She was admitted to the intensive care unit. Vasopressor and ventilatory support was initiated and continuous venovenous hemodiafiltration was instituted. Twenty-four hours later, full clinical recovery was observed, with return to a normal serum lactate level. The patient was discharged from the intensive care unit on the sixth day. The second patient is a 69 year old male with a past medical history of hypertension, type 2 diabetes mellitus and ischemic heart disease who was on metformin (4 g/day, glycazide, acetylsalicylic acid and isosorbide dinitrate. He was admitted to the emergency department in shock with extreme bradycardia. Initial evaluation revealed severe lactic acidosis and elevated creatinine and urea. The patient was admitted to the Intensive Care Unit and commenced on continuous venovenous hemodiafiltration in addition to other supportive measures. A

  16. Intracranial Pressure Monitoring in Acute Liver Failure: Institutional Case Series.

    Science.gov (United States)

    Maloney, Patrick R; Mallory, Grant W; Atkinson, John L D; Wijdicks, Eelco F; Rabinstein, Alejandro A; Van Gompel, Jamie J

    2016-08-01

    Acute liver failure (ALF) has been associated with cerebral edema and elevated intracranial pressure (ICP), which may be managed utilizing an ICP monitor. The most feared complication of placement is catastrophic intracranial hemorrhage in the setting of severe coagulopathy. Previous studies reported hemorrhage rates between 3.8-22 % among various devices, with epidural catheters having lower hemorrhage rates and precision relative to subdural bolts and intraparenchymal catheters. We sought to identify institutional hemorrhagic rates of ICP monitoring in ALF and its associated factors in a modern series guided by protocol implantation. Patient records treated for ALF with ICP monitoring at Mayo Clinic in Rochester, MN from 1995 to 2014 were reviewed. Protocalized since 1995, epidural (EP) ICP monitors were first used followed by intraparenchymal (IP) for stage III-IV hepatic encephalopathy. The following variables and outcomes were collected: patient demographics, ICPs and treatment methods, laboratory data, imaging studies, number of days for ICP monitoring, radiographic and symptomatic hemorrhage rates, orthotopic liver transplantation rates, and death. A total of 20 ICP monitors were placed for ALF, 7 EP, and 13 IP. International normalized ratio (INR) at placement of an EP monitor was 2.4 (1.7-3.2) with maximum of 2.7 (2.0-3.6) over the following 2.3 (1-3) days. Mean EP ICP at placement was 36.3 (11-55) and maximum of 43.1 (20-70) mm Hg. INR at placement of an IP monitor was 1.3 (hepatic encephalopathy. Monitored patients in both groups experienced elevations of ICP in the setting of intermittent coagulopathy. Severity of coagulopathy did not influence hemorrhage rate. Yet, hemorrhages related to IP monitoring can be catastrophic and may add to the overall mortality. PMID:26966022

  17. BISPHOSPHONATES IN LANGERHANS CELL HISTIOCYTOSIS: AN INTERNATIONAL RETROSPECTIVE CASE SERIES

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    Deepak Chellapandian

    2016-07-01

    Full Text Available Background: Bone is the most common organ of involvement in patients with Langerhans cell histiocytosis (LCH, which is often painful and associated with significant morbidity from pathological fractures. Current first-line treatments include chemotherapy and steroids that are effective but often associated with adverse effects, whereas the disease may reactivate despite an initial response to first-line agents. Bisphosphonates are osteoclast inhibitors that have shown to be helpful in treating bone lesions of LCH. To date, there are no large international studies to describe their role in treating bone lesions of LCH. Method: We conducted a multicenter retrospective review of 13 patients with histologically proven LCH, who had received bisphosphonates either at diagnosis or at disease reactivation. Results: Ten patients (77% had a single system bone disease, and 3 (23% had bone lesions as part of multisystem disease. Median follow-up time post-bisphosphonate therapy was 4.6 years (range, 0.8 to 8.2 years. Treatment with bisphosphonates was associated with significant pain relief in almost all patients. Twelve  (92% achieved resolution of active bone lesions, and 10 out of them had no active disease for a median of 3.5 years (range, 0.8 to 5 years. One patient did not respond. No major adverse effects were reported in this series.  Conclusion: Bisphosphonates are well-tolerated drugs that can significantly improve bone pain and induce remission in active bone LCH. Future prospective studies evaluating the role of bisphosphonates in LCH are warranted.

  18. Hemophagocytic lymphohistiocytosis: a case series of a Brazilian institution

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    Daniela Guimarães Rocha Ferreira

    2014-12-01

    Full Text Available Objective:To describe the clinical and laboratory presentation of hemophagocytic lymphohistiocytosis in children treated at a referral institution.Methods:A retrospective descriptive study was carried out of seven children diagnosed with hemophagocytic lymphohistiocytosis between 2010 and 2012. The criteria for diagnosis were those proposed by the Histiocyte Society. When indicated, immunochemotherapy was prescribed according to the HLH94 and HLH2004 protocols of the Histiocyte Society.Results:The patients' ages at diagnosis ranged from one month to nine years. All patients had splenomegaly, fever, anemia, thrombocytopenia, hyperferritinemia and hypertriglyceridemia. Bone marrow hemophagocytosis was detected in six patients. In six cases, infectious diseases triggered the syndrome. In two cases, associated with visceral leishmaniasis, remission was achieved after treatment of the underlying infection. Three patients, who had Epstein–Barr-related hemophagocytic lymphohistiocytosis, required treatment with immunochemotherapy. They are alive and in remission; one patient had symptoms of juvenile rheumatoid arthritis and another, who was suspected of having primary hemophagocytic lymphohistiocytosis, entered into remission after bone marrow transplantation. Two deaths (28.6% occurred in patients with suspected primary hemophagocytic lymphohistiocytosis; one whose clinical picture was triggered by cytomegalovirus infection did not respond to immunochemotherapy and the other died before any specific treatment was provided.Conclusion:As reported before, hemophagocytic lymphohistiocytosis has a multifaceted presentation with nonspecific signs and symptoms. In secondary forms, remission may be achieved by treating the underlying disease. In the primary forms, remission may be achieved with immunochemotherapy, but bone marrow transplantation is required for cure.

  19. A case series of scrub typhus in obstetrics.

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    G K, Poomalar; R, Rekha

    2014-12-01

    Scrub typhus is endemic and re-emerging in eastern and southern Asia. Illness varies from mild and self-limiting to fatal. Only few studies were published about its effect in maternal and neonatal outcome. A retrospective analysis was done in six prenatal and two postnatal women with scrub typhus. Details about clinical presentation, investigations, treatment given, response to treatment and pregnancy outcome were collected. The common symptoms were fever with chills, vomiting, myalgia, headache and abdominal pain. Typical features of eschar and lymphadenopathy were noted in only two cases. Two patients presented with jaundice and altered liver function test. Two patients presented with breathlessness. One patient developed oligohydramnios. Two postnatal women developed scrub typhus following blood transfusion for postpartum haemorrhage. Because of its high prevalence, scrub typhus should be included in fever investigations in endemic areas, even in the absence of eschar. Early diagnosis of cases will help in less severe organ damage and easy recovery with antibiotics. Few evidences state that scrub typhus can spread through blood transfusion. Correlation between blood transfusion and scrub typhus has to be further evaluated. PMID:25653996

  20. Zolpidem dependence case series: possible neurobiological mechanisms and clinical management.

    Science.gov (United States)

    Liappas, I A; Malitas, P N; Dimopoulos, N P; Gitsa, O E; Liappas, A I; Nikolaou, Ch K; Christodoulou, G N

    2003-03-01

    Zolpidem is a short-acting imidazopyridine hypnotic that is an agonist at the gamma-aminobutyric acid A type (GABAA) receptor. It has been suggested that it acts selectively on alpha1 subunit-containing GABAA benzodiazepine (BZ1) receptors presenting (contrary to classic benzodiazepines) low or no affinity for other subtypes. Therefore, it has been proposed that it lacks the benzodiazepines-like side-effects, having minimal abuse and dependence potential. Nevertheless, there is a considerable number of zolpidem dependence case reports in the literature. We present eight cases of zolpidem abuse and dependence without criminal record, without history of substance abuse (except for one alcohol abuser), with minor psychiatric disorders, who took zolpidem after physicians prescription in order to deal with their insomnia. However, they became zolpidem abusers not craving its sedative, but its anxiolytic and stimulating action, which helped them to cope with everyday activities. It is possible that, in the high doses that our patients used, zolpidem abandons its selectivity for BZ1 receptors and demonstrates all the actions of classic benzodiazepines. Molecular biology, via possible mutations on GABA receptors, may provide some answers as to why our eight patients (who did not differ much from the thousands of insomniacs who use zolpidem) and other zolpidem abusers, raised the dose progressively, and sought something from the drug other than hypnotic action. PMID:12680751

  1. Pleuroperitoneal Leak Complicating Peritoneal Dialysis: A Case Series

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    C. Kennedy

    2011-01-01

    Full Text Available Pressure related complications such as abdominal wall hernias occur with relative frequency in patients on peritoneal dialysis. Less frequently, a transudative pleural effusion containing dialysate can develop. This phenomenon appears to be due to increased intra-abdominal pressure in the setting of congenital or acquired diaphragmatic defects. We report three cases of pleuroperitoneal leak that occurred within a nine-month period at our institution. We review the literature on this topic, and discuss management options. The pleural effusion resolved in one patient following drainage of the peritoneum and a switch to haemodialysis. One patient required emergency thoracocentesis. The third patient developed a complex effusion requiring surgical intervention. The three cases highlight the variability of this condition in terms of timing, symptoms and management. The diagnosis of a pleuroperitoneal leak is an important one as it is managed very differently to most transudative pleural effusions seen in this patient population. Surgical repair may be necessary in those patients who wish to resume peritoneal dialysis, or in those patients with complex effusions. Pleuroperitoneal leak should be considered in the differential diagnosis of a pleural effusion, particularly a right-sided effusion, in a patient on peritoneal dialysis.

  2. Complications during pharmacological stress echocardiography: a video-case series

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    Bigi Riccardo

    2005-09-01

    Full Text Available Abstract Background Stress echocardiography is a cost-effective tool for the modern noninvasive diagnosis of coronary artery disease. Several physical and pharmacological stresses are used in combination with echocardiographic imaging, usually exercise, dobutamine and dipyridamole. The safety of a stress is (or should be a major determinant in the choice of testing. Although large scale single center experiences and multicenter trial information are available for both dobutamine and dipyridamole stress echo testing, complications or side effects still can occur even in the most experienced laboratories with the most skilled operators. Case presentation We decided to present a case collection of severe complications during pharmacological stress echo testing, including a ventricular tachycardia, cardiogenic shock, transient ischemic attack, torsade de pointe, fatal ventricular fibrillation, and free wall rupture. Conclusion We believe that, in this field, every past complication described is a future complication avoided; what happens in your lab is more true of what you read in journals; and Good Clinical Practice is not "not having complications", but to describe the complications you had.

  3. Bipolar disorder and antithyroid antibodies: review and case series.

    Science.gov (United States)

    Bocchetta, Alberto; Traccis, Francesco; Mosca, Enrica; Serra, Alessandra; Tamburini, Giorgio; Loviselli, Andrea

    2016-12-01

    Mood disorders and circulating thyroid antibodies are very prevalent in the population and their concomitant occurrence may be due to chance. However, thyroid antibodies have been repeatedly hypothesized to play a role in specific forms of mood disorders. Potentially related forms include treatment-refractory cases, severe or atypical depression, and depression at specific phases of a woman's life (early gestation, postpartum depression, perimenopausal). With regard to bipolar disorder, studies of specific subgroups (rapid cycling, mixed, or depressive bipolar) have reported associations with thyroid antibodies. Offspring of bipolar subjects were found more vulnerable to develop thyroid antibodies independently from the vulnerability to develop psychiatric disorders. A twin study suggested thyroid antibodies among possible endophenotypes for bipolar disorder. Severe encephalopathies have been reported in association with Hashimoto's thyroiditis. Cases with pure psychiatric presentation are being reported, the antithyroid antibodies being probably markers of some other autoimmune disorders affecting the brain. Vasculitis resulting in abnormalities in cortical perfusion is one of the possible mechanisms. PMID:26869176

  4. Pleuroperitoneal leak complicating peritoneal dialysis: a case series.

    LENUS (Irish Health Repository)

    Kennedy, C

    2012-02-01

    Pressure related complications such as abdominal wall hernias occur with relative frequency in patients on peritoneal dialysis. Less frequently, a transudative pleural effusion containing dialysate can develop. This phenomenon appears to be due to increased intra-abdominal pressure in the setting of congenital or acquired diaphragmatic defects. We report three cases of pleuroperitoneal leak that occurred within a nine-month period at our institution. We review the literature on this topic, and discuss management options. The pleural effusion resolved in one patient following drainage of the peritoneum and a switch to haemodialysis. One patient required emergency thoracocentesis. The third patient developed a complex effusion requiring surgical intervention. The three cases highlight the variability of this condition in terms of timing, symptoms and management. The diagnosis of a pleuroperitoneal leak is an important one as it is managed very differently to most transudative pleural effusions seen in this patient population. Surgical repair may be necessary in those patients who wish to resume peritoneal dialysis, or in those patients with complex effusions. Pleuroperitoneal leak should be considered in the differential diagnosis of a pleural effusion, particularly a right-sided effusion, in a patient on peritoneal dialysis.

  5. Congenital portosystemic shunts with and without gastrointestinal bleeding - case series

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    Gong, Ying; Chen, Jun; Chen, Qi; Ji, Min; Pa, Mier; Qiao, Zhongwei [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China); Zhu, Hui [Fudan University Shanghai Cancer Center, Department of Radiology, Shanghai (China); Zheng, Shan [Children' s Hospital of Fudan University, Department of Surgery, Shanghai (China)

    2015-12-15

    The clinical presentation of congenital portosystemic shunt is variable and gastrointestinal bleeding is an uncommon presentation. To describe the imaging features of congenital portosystemic shunt as it presented in 11 children with (n = 6) and without gastrointestinal bleeding (n = 5). We performed a retrospective study on a clinical and imaging dataset of 11 children diagnosed with congenital portosystemic shunt. A total of 11 children with congenital portosystemic shunt were included in this study, 7 with extrahepatic portosystemic shunts and 4 with intrahepatic portosystemic shunts. Six patients with gastrointestinal bleeding had an extrahepatic portosystemic shunt, and the imaging results showed that the shunts originated from the splenomesenteric junction (n = 5) or splenic vein (n = 1) and connected to the internal iliac vein. Among the five cases of congenital portosystemic shunt without gastrointestinal bleeding, one case was an extrahepatic portosystemic shunt and the other four were intrahepatic portosystemic shunts. Most congenital portosystemic shunt patients with gastrointestinal bleeding had a shunt that drained portal blood into the iliac vein via an inferior mesenteric vein. This type of shunt was uncommon, but the concomitant rate of gastrointestinal bleeding with this type of shunt was high. (orig.)

  6. Imaging of Various Aspects of Neurofibromatosis Involvement: Case Series

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    Nazila Tayari

    2010-05-01

    Full Text Available Neurofibromatosis (NF is often noticed at birth or soon after. NF is divided into two types: NF type 1 is a complex of cutaneous and deep neural tumors. It is an autosomal dominant familial disorder. CNS is affected in about 15% of the cases. Optic nerve gliomas have a high degree of association with NF 1."nNF type 2 is much less commonly seen. It is also inherited as an autosomal dominant trait. Bilateral acoustic neuromas are pathognomonic of NF 2 and may be associated with meningiomas or ependymo-mas."nTypical clinical manifestations of neurofibromatosis are cafe-au-lait spots and multiple cutaneous tumors. There are also bone involvement as scoliosis, pseudoarthrosis of long bones, scalloping of vertebral bodies, abnormal rib tubulation, and defective ossification of the posterior superior wall of the orbit."nExtraskeletal manifestations of neurofibromatosis include gliomas of the optic nerves, pheochromocytoma, aneurysms of cerebral and renal arteries, acoustic neurilemmoma and superficial skin nodular neurofibromas."nHere, we intend to present images of several cases of neurofibromatosis with different aspects of involvement of the body. "nKeywords: Neurofibromatosis, Glioma, Schwannoma, Neurinoma

  7. Cecal bascule after spinal cord injury: A case series report

    Science.gov (United States)

    Ishida, Yuichi; McLean, Susan F.; Tyroch, Alan H.

    2016-01-01

    Introduction Cecal bascule is a rare cause of intestinal obstruction associated with upward and anterior folding of the ascending colon. We report three patients who presented with spinal cord injury complicated with a cecal bascule. Diagnosis and management of cecal bascule is discussed. Presentation of cases Patient 1: 59-year-old male sustained a traumatic brain injury and cervical spinal cord injury after a motorcycle crash. He had abdominal distension and the diagnosis of cecal bascule was made. Cecopexy was performed. Patient 2: 51-year-old male sustained an unstable C7 vertebral fracture with a cord contusion and quadriplegia after a diving incident. After an unsuccessful medical management of the colonic distension, the patient was taken for a laparotomy and cecal bascule was found. A cecostomy and a cecopexy were performed. Patient 3: 63-year-old male was transferred after a fall. He had diffuse degenerative changes in the thoracic and lumbar spine. He was found to have a perforated cecal bascule. He had a right hemicolectomy with an ileocolic anastomosis. Discussion We suggest the possibility of spinal cord injury being a risk factor for cecal bascule. Currently, right hemicolectomy is recommended for the treatment of cecal bascule. Cecopexy is also acceptable treatment option for a case in which the patient will be undergoing an operation with an insertion of hardware. Conclusion The diagnosis of cecal bascule should be considered for trauma patients with cecal distention without delay in order to prevent disastrous complications. PMID:27077698

  8. Marfan Syndrome in an Iranian Family: A Case Series

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    Mohammad Hossein Davari

    2015-07-01

    Full Text Available Marfan syndrome (MFS is a genetic disorder which is inherited by autosomal dominant traits. In MFS, lens displacement and cardiovascular involvement are important causes of morbidity and mortality in the clinical course of the disease. In this case study, the ocular involvement in a family with severe penetration of MFS is reported. Twelve members of a family (father, two daughters, three sons, and six grandchildren had MFS. Lens ectopia was the most common ophthalmic involvement among the family (100%. Other ocular involvements were as follows; Hypoplastic iris or ciliary’s muscle hypoplasia (50%, on gated eyeball (42%, flat cornea (30%, glaucoma and cataract (25%, retinal detachment (16%. Three members of the family underwent eye surgery including lens extraction, glaucoma surgery and retinal surgery.

  9. Connecting Hospitalized Patients with Their Families: Case Series and Commentary

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    Kourosh Parsapour

    2011-01-01

    Full Text Available The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six cases were managed during a five-year period (2006 to 2010. The most common reasons for using Family-Link were related to the logistical challenges of traveling to and from the hospital—principally due to distance, time, family commitments, and/or personal cost. We conclude that videoconferencing provides a solution to some barriers that may limit family presence and participation in care for hospitalized patients, and as a patient-centered innovation is likely to enhance patient and family satisfaction.

  10. Safety of escitalopram in pregnancy: a case series

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    Bellantuono C

    2013-09-01

    Full Text Available Cesario Bellantuono, Francesca Bozzi, Laura Orsolini Psychiatric Unit and DEGRA Center, United Hospital and Academic Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy Background: The aim of this paper is to report maternal and neonatal outcomes in pregnant women treated with escitalopram during pregnancy and breastfeeding. Methods: Women enrolled in the DEGRA Database at the Clinic of Affective Disorders in Pregnancy and Postpartum in Italy, treated during pregnancy with escitalopram and followed up throughout pregnancy, were included in this study. All patients provided written informed consent and the study was approved by the local ethics committee. Psychiatric diagnoses were assessed using the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition Axis I Disorders and symptoms were assessed using the Hamilton Rating Scale for Depression (17 items and Hamilton Rating Scale for Anxiety (14 items. Clinical and sociodemographic characteristics as well as maternal and neonatal outcomes were recorded. Results: The case histories of seven pregnant women treated for depression and/or anxiety disorders with escitalopram were reported. Four women were also treated with benzodiazepines. All pregnancies were full-term and all newborns had normal Apgar scores. There were no major malformations or miscarriages following exposure to escitalopram. Mild withdrawal syndrome was reported only in a newborn who was also exposed to a benzodiazepine. Two infants exposed to escitalopram during breastfeeding did not show any health problems. Conclusion: Our experience with use of escitalopram in pregnant women did not reveal any maternal or neonatal concerns. However, considering the few cases analyzed and the paucity of published literature, no conclusions can be drawn on its safety profile in pregnancy and breastfeeding. Keywords: escitalopram, pregnancy

  11. Anaesthesia for parturients with severe cystic fibrosis: a case series.

    LENUS (Irish Health Repository)

    Deighan, M

    2014-02-01

    Cystic fibrosis affects 1 in 1600-2500 live births and is inherited in an autosomal recessive manner. It primarily involves the respiratory, gastrointestinal and reproductive tracts, with impaired clearance of, and obstruction by, increasingly viscous secretions. Severe respiratory disease, diabetes and gastro-oesophageal reflux may result. Improvements in medical management and survival of cystic fibrosis patients means more are committing to pregnancies. Although guidance for anaesthesia in this patient group is available, management and outcome data associated with more severe cases are sparse. Patients with severe cystic fibrosis require multidisciplinary input and should be managed in a tertiary referral centre. Close monitoring of respiratory function and preoperative optimisation during pregnancy are mandatory. The risk of preterm labour and delivery is increased. Pregnancy and delivery can be managed successfully, even in patients with FEV1 <40% predicted. Neuraxial anaesthesia and analgesia should be the technique of choice for delivery. Postoperative care should be carried out in a critical care setting with the provision of postoperative ventilation if necessary.

  12. Lassa fever presenting as acute abdomen: a case series.

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    Dongo, Andrew E; Kesieme, Emeka B; Iyamu, Christopher E; Okokhere, Peter O; Akhuemokhan, Odigie C; Akpede, George O

    2013-01-01

    Lassa fever, an endemic zoonotic viral infection in West Africa, presents with varied symptoms including fever, vomiting, retrosternal pain, abdominal pain, sore-throat, mucosal bleeding, seizures and coma. When fever and abdominal pain are the main presenting symptoms, and a diagnosis of acute abdomen is entertained, Lassa fever is rarely considered in the differential diagnosis, even in endemic areas. Rather the diagnosis of Lassa fever is suspected only after surgical intervention. Therefore, such patients often undergo unnecessary surgery with resultant delay in the commencement of ribavirin therapy. This increases morbidity and mortality and the risk of nosocomial transmission to hospital staff. We report 7 patients aged between 17 months and 40 years who had operative intervention for suspected appendicitis, perforated typhoid ileitis, intussuception and ruptured ectopic pregnancy after routine investigations. All seven were post-operatively confirmed as Lassa fever cases. Four patients died postoperatively, most before commencement of ribavirin, while the other three patients eventually recovered with appropriate antibiotic treatment including intravenous ribavirin. Surgeons working in West Africa should include Lassa fever in the differential diagnosis of acute abdomen, especially appendicitis. The presence of high grade fever, proteinuria and thrombocytopenia in patients with acute abdomen should heighten the suspicion of Lassa fever. Prolonged intra-operative bleeding should not only raise suspicion of the disease but also serve to initiate precautions to prevent nosocomial transmission. PMID:23597024

  13. Lassa fever presenting as acute abdomen: a case series

    Science.gov (United States)

    2013-01-01

    Lassa fever, an endemic zoonotic viral infection in West Africa, presents with varied symptoms including fever, vomiting, retrosternal pain, abdominal pain, sore-throat, mucosal bleeding, seizures and coma. When fever and abdominal pain are the main presenting symptoms, and a diagnosis of acute abdomen is entertained, Lassa fever is rarely considered in the differential diagnosis, even in endemic areas. Rather the diagnosis of Lassa fever is suspected only after surgical intervention. Therefore, such patients often undergo unnecessary surgery with resultant delay in the commencement of ribavirin therapy. This increases morbidity and mortality and the risk of nosocomial transmission to hospital staff. We report 7 patients aged between 17 months and 40 years who had operative intervention for suspected appendicitis, perforated typhoid ileitis, intussuception and ruptured ectopic pregnancy after routine investigations. All seven were post-operatively confirmed as Lassa fever cases. Four patients died postoperatively, most before commencement of ribavirin, while the other three patients eventually recovered with appropriate antibiotic treatment including intravenous ribavirin. Surgeons working in West Africa should include Lassa fever in the differential diagnosis of acute abdomen, especially appendicitis. The presence of high grade fever, proteinuria and thrombocytopenia in patients with acute abdomen should heighten the suspicion of Lassa fever. Prolonged intra-operative bleeding should not only raise suspicion of the disease but also serve to initiate precautions to prevent nosocomial transmission. PMID:23597024

  14. Cognitive behavior therapy for stuttering: a case series.

    Science.gov (United States)

    Reddy, R P; Sharma, M P; Shivashankar, N

    2010-01-01

    The present investigation was aimed at studying the efficacy of cognitive behavior therapy (CBT) in reducing the symptoms of stuttering and dysfunctional cognitions and in enhancing assertiveness and quality of life in clients with stuttering. Five clients with stuttering who met the inclusion criteria (male clients with diagnosis of stuttering) and exclusion criteria (clients with brian damage), substance abuse or mental retardation were enrolled for the study. A single-case design was adopted. The pre-, mid- and post-assessment were carried out using Stuttering Severity Scale (SSI), Perception of Stuttering Inventory (PSI), Beck's Anxiety Inventory (BAI), Dysfunctional Attitude (DAS), Fear of Negative Evaluation (FNE), Assertiveness Scale (AS), Rosenberg's Self-Esteem Scale (RSES), and World Health Organization - Quality of Life Scale (WHO-QOL). Five clients received cognitive behavioral intervention comprising of psycho-education, relaxation, deep breathing, humming, prolongation, cognitive restructuring, problem-solving strategies and assertiveness. At post-treatment assessment, there was improvement. The findings of the study are discussed in the light of available research work, implications, limitations of the study and suggestions for future research. PMID:21799560

  15. Gastroparesis secondary to a demyelinating disease: a case series

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    Bonino John

    2007-01-01

    Full Text Available Abstract Background Gastroparesis has a number of etiologies. The main ones are secondary to a complication from diabetes mellitus, related to post vagotomy or post gastric surgical resections, or idiopathic when the etiology is unclear. Gastroparesis secondary to a demyelinating disease of the brain is unusual. Case presentation A 22-year-old woman was referred for acute onset of intractable nausea and vomiting. She also had cerebellar deficits, dysphagia and paresthesias. Magnetic resonance imaging (MRI of the brain revealed an isolated area of demyelination in the medullary region. Another 24-year-old woman had a similar presentation with right hemiplegia and MRI of the brain revealed a distal medullary region. Both these patients had an abnormal gastric emptying test. Gastroparesis and neurological deficits improved with intravenous corticosteroids. While the former patient has had no further recurrences, the latter patient developed multiple sclerosis within three months of presentation. Conclusion A demyelinating disease is a rare cause gastropareis, but should be suspected when symptoms of gastroparesis are associated with neurological deficits. MRI might help in the diagnosis and intravenous coriticosteroids can address the underlying disease process and improve gastric emptying, especially when used early during the course of the disease.

  16. Cognitive behavior therapy for Stuttering: A case series

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    Reddy R

    2010-01-01

    Full Text Available The present investigation was aimed at studying the efficacy of cognitive behavior therapy (CBT in reducing the symptoms of stuttering and dysfunctional cognitions and in enhancing assertiveness and quality of life in clients with stuttering. Five clients with stuttering who met the inclusion criteria (male clients with diagnosis of stuttering and exclusion criteria (clients with brian damage, substance abuse or mental retardation were enrolled for the study. A single-case design was adopted. The pre-, mid- and post-assessment were carried out using Stuttering Severity Scale (SSI, Perception of Stuttering Inventory (PSI, Beck′s Anxiety Inventory (BAI, Dysfunctional Attitude (DAS, Fear of Negative Evaluation (FNE, Assertiveness Scale (AS, Rosenberg′s Self-Esteem Scale (RSES, and World Health Organization - Quality of Life Scale (WHO-QOL. Five clients received cognitive behavioral intervention comprising of psycho-education, relaxation, deep breathing, humming, prolongation, cognitive restructuring, problem-solving strategies and assertiveness. At post-treatment assessment, there was improvement. The findings of the study are discussed in the light of available research work, implications, limitations of the study and suggestions for future research.

  17. Piano Pedagogy with a Student Who Is Blind: An Australian Case

    Science.gov (United States)

    Power, Anne; McCormack, Dorothy

    2012-01-01

    Teaching and learning piano poses challenges when the student is clinically blind. This article addresses the following question: What can be learned from a case study of teaching piano successfully to a student who is blind? The article has three purposes. The first is to document the achievements of a young student who met these challenges. The…

  18. Using a Client Survey to Support Continuous Improvement: An Australian Case Study in Managing Change

    Science.gov (United States)

    Besch, Janice

    2014-01-01

    With the arrival of online survey tools that are low-cost, readily available and easy to administer, all organizations have access to one of the most effective mechanisms for determining quality improvement priorities and measuring progress towards achieving those priorities over time. This case study outlines the use made of this simple tool by a…

  19. Endophthalmitis in Boston keratoprosthesis: case series and review of literature.

    Science.gov (United States)

    Chhablani, Jay; Panchal, Bhavik; Das, Taraparasad; Pathegay, Avinash; Motukupally, Swapna R; Pappuru, Rajeev Reddy; Basu, Sayan; Sangwan, Virender

    2015-10-01

    To report the clinical and microbiological characteristics of infectious endophthalmitis after Boston type I keratoprosthesis (B-K-Pro) implantation. Retrospective analysis of 136 eyes that received a B-K-Pro type 1 between 1999 and 2012 was performed. Five eyes with a diagnosis of exogenous endophthalmitis after B-K-pro type 1 were identified and information about demographic data, indication for K-Pro, post-operative bandage contact lens use, post-operative prophylactic antibiotic use, timing and clinical presentation of endophthalmitis, gram stain and culture results of intraocular fluid and preoperative and post-operative visual acuity were collected. The incidence of endophthalmitis was 3.67% (5 of 136 eyes) and average time to develop endophthalmitis was 5.62 months (range 2 days to 8 months). Mean patient age was 31.4 years (5 to 65 years). The surgical indications included corneal injury due to chemical burns (n = 2), multiple failed grafts secondary to microbial keratitis (n = 2) and congenital glaucoma with congenital herpetic keratitis (n = 1). Post-Boston K-Pro, the visual acuity ranged from light perception (LP) to 20/50. K-pro was explanted in 4 patients. There was bacterial and fungal growth in two patients each and one vitreous did not grow anything. All the eyes were phthisical at last visit. Infectious endophthalmitis after K-Pro implantation in our study had a higher incidence, early onset and extremely poor visual outcome compared with post-cataract surgery endophthalmitis, as reported in literature. Not only bacterial but also fungal infections are an important etiology for infectious endophthalmitis in these cases. PMID:25183460

  20. Transverse lag screw fixation in midline mandibulotomy. A case series.

    Science.gov (United States)

    Serletti, J M; Pacella, S J; Coniglio, J U; Norante, J D

    2000-03-01

    Vertical midline mandibulotomy has provided a relatively simple and efficient means of obtaining access to intraoral tumors that are too large or too posterior to be removed transorally. Midline mandibulotomy has had the advantage of nerve and muscle preservation and places the osteotomy outside the typical field of radiotherapy, in contrast to lateral and paramedian osteotomies. Plate and screw fixation has been the usual means of osteosynthesis for these mandibulotomies; however, plate contouring over the symphyseal surface has been a time-consuming process. Unless the plate was contoured exactly, mandibular malalignment and malocclusion in dentulous patients has occurred. Use of parallel transverse lag screws has become a popular method of osteosynthesis for parasymphyseal fractures, and we have extended their use for mandibulotomy fixation. This paper reports our clinical experience with transverse lag screw fixation of midline mandibulotomies in 9 patients from 1994 to 1997. There were 7 men and 2 women with a mean age of 56 (range 35 to 71 years). The pathological diagnosis in all patients was squamous cell carcinoma; 8 cases were primary, and 1 patient presented with recurrent tumor. No tumors involved the mandibular periosteum. One patient had had previous radiotherapy, and 3 patients underwent postoperative radiotherapy. The mean follow-up has been 17 months (range 9 to 27). There was 1 minor complication and 1 major complication related to our technique. The major complication was a delayed nonunion of the mandibulotomy. This occurred because the 2 parallel screws were placed too close to one another, and this placement resulted in a delayed sagittal fracture of the anterior cortex and subsequent nonunion. Transverse lag screw fixation has not affected occlusion in our dentulous patients. Speech and diet were normal in the majority of our patients. Transverse lag screw fixation of the midline mandibulotomy has been a relatively safe, rapid, and reliable

  1. Mechanical thrombectomy for ischaemic stroke: the first UK case series.

    Directory of Open Access Journals (Sweden)

    Nasar Ahmad

    Full Text Available BACKGROUND AND PURPOSE: Endovascular treatments have the potential to accelerate reperfusion in acute ischaemic stroke with large vessel occlusion. In the UK only a few stroke centres offer this interventional option. The University Hospital of North Staffordshire (UHNS has treated the largest number of cases in the UK. Results of the first 106 endovascular treatments (EVT are presented here. METHODS: All patients treated with EVT (intra-arterial thrombolysis (IAT, mechanical thrombectomy (MT or both, or an attempt at intervention for acute stroke at UHNS, Stoke-on-Trent, UK, were entered into a prospective register. Baseline demographic and clinical data, the National Institutes for Health Stroke Scale (NIHSS, imaging results including Thrombolysis in Cerebral Infarction (TICI score, and complications were recorded. Mortality, and modified Rankin score (mRS were assessed at 90 days. RESULTS: From December 2009 to January 2013 106 patients (mean age 64 years, median baseline NIHSS 18 were treated with EVT (thrombectomy ± IAT 83%, IAT alone 13%, neither 4%. Seventy-eight per cent of occlusions were in the anterior circulation. Intravenous bridging thrombolysis was performed in 81%. Revascularization was successful (TICI 2b/3 in 84%. The median time from stroke onset to the end of the procedure was 6 h 03 min. A good outcome (mRS ≤ 2 at 90 days was achieved in 48% with a mortality of 15%. Fatal or nonfatal symptomatic intracranial haemorrhage (sICH within 10 days occurred in 9%. The median length of stay was 14 days (31% discharged home ≤ 7 days. CONCLUSIONS: EVT led to good clinical outcomes in almost 50% of patients with severe strokes.

  2. Improvement in hearing after chiropractic care: a case series

    Directory of Open Access Journals (Sweden)

    Di Duro Joseph O

    2006-01-01

    Full Text Available Abstract Background The first chiropractic adjustment given in 1895 was reported to have cured deafness. This study examined the effects of a single, initial chiropractic visit on the central nervous system by documenting clinical changes of audiometry in patients after chiropractic care. Case presentation Fifteen patients are presented (9 male, 6 female with a mean age of 54.3 (range 34–71. A Welch Allyn AudioScope 3 was used to screen frequencies of 1000, 2000, 4000 and 500 Hz respectively at three standard decibel levels 20 decibels (dB, 25 dB and 40 dB, respectively, before and immediately after the first chiropractic intervention. Several criteria were used to determine hearing impairment. Ventry & Weinstein criteria of missing one or more tones in either ear at 40 dB and Speech-frequency criteria of missing one or more tones in either ear at 25 dB. All patients were classified as hearing impaired though greater on the right. At 40 dB using the Ventry & Weinstein criteria, 6 had hearing restored, 7 improved and 2 had no change. At 25 dB using the Speech-frequency criteria, none were restored, 11 improved, 4 had no change and 3 missed a tone. Conclusion A percentage of patients presenting to the chiropractor have a mild to moderate hearing loss, most notably in the right ear. The clinical progress documented in this report suggests that manipulation delivered to the neuromusculoskeletal system may create central plastic changes in the auditory system.

  3. Morgellons disease, illuminating an undefined illness: a case series

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    Harvey William T

    2009-07-01

    Full Text Available Abstract Introduction This review of 25 consecutive patients with Morgellons disease (MD was undertaken for two primary and extremely fundamental reasons. For semantic accuracy, there is only one "proven" MD patient: the child first given that label. The remainder of inclusive individuals adopted the label based on related descriptions from 1544 through 1884, an internet description quoted from Sir Thomas Browne (1674, or was given the label by practitioners using similar sources. Until now, there has been no formal characterization of MD from detailed examination of all body systems. Our second purpose was to differentiate MD from Delusions of Parasitosis (DP, another "informal" label that fit most of our MD patients. How we defined and how we treated these patients depended literally on factual data that would determine outcome. How they were labeled in one sense was irrelevant, except for the confusing conflict rampant in the medical community, possibly significantly skewing treatment outcomes. Case presentation Clinical information was collected from 25 of 30 consecutive self-defined patients with Morgellons disease consisting of laboratory data, medical history and physical examination findings. Abnormalities were quantified and grouped by system, then compared and summarized, but the numbers were too small for more complex mathematical analysis. The quantification of physical and laboratory abnormalities allowed at least the creation of a practical clinical boundary, separating probable Morgellons from non-Morgellons patients. All the 25 patients studied meet the most commonly used DP definitions. Conclusions These data suggest Morgellons disease can be characterized as a physical human illness with an often-related delusional component in adults. All medical histories support that behavioral aberrancies onset only after physical symptoms. The identified abnormalities include both immune deficiency and chronic inflammatory markers that

  4. Provision of a Medicines Information Service to Consumers on Facebook: An Australian Case Study

    OpenAIRE

    Benetoli, Arcelio; Chen, Timothy F; Spagnardi, Sarah; Beer, Troy; Aslani, Parisa

    2015-01-01

    Background Social networking sites (SNSs) have changed the way people communicate. They may also change the way people seek health advice. Objective This study describes the provision of a medicines information service on Facebook to individual consumers. It aimed to discuss the pros and cons, and inform health and pharmacy stakeholders and researchers about the opportunities and challenges of providing such a service. Methods We adopted an exploratory approach using a case study method. Resu...

  5. Management, Conservation and Farming of Saltwater Crocodiles: An Australian Case Study of Sustainable Commercial Use

    OpenAIRE

    Clement A. Tisdell; Swarna Nantha, Hemanath

    2005-01-01

    Opinions differ about what types of policies are likely to be most effective in conserving wildlife species. For example, the Convention on International Trade in Endangered Species of Wild Flora and Fauna (CITES) is based on the premise that curbing the commercial use of endangered species favours their conservation, whereas the Convention on Biological Diversity envisages the possibility that such use may contribute to the conservation of species. In Australia, as illustrated in the case of...

  6. Aortic complications following pediatric heart transplantation: A case series and review

    Directory of Open Access Journals (Sweden)

    Sean M Lang

    2016-01-01

    Full Text Available Aortic complications occur rarely after pediatric orthotopic heart transplantation, but are typically accompanied by catastrophic events. We describe the three cases of major aortic complications in our experience of 329 pediatric heart transplants. This case series and review highlight the important risk factors for aortic complications after heart transplantation.

  7. Clinical experiences of delayed contrast enhancement with cardiac computed tomography: case series

    OpenAIRE

    Sidhu Manavjot S; Ghoshhajra Brian B; Uthamalingam Shanmugam; Kilcullen Niamh; Engel Leif-Christopher; Medina Hector M; Venkatesh Vikram; Vorasettakarnkij Yongkasem; Hoffmann Udo; Cury Ricardo C; Abbara Suhny; Brady Thomas J

    2013-01-01

    Abstract Background Myocardial delayed enhancement (MDE) by gadolinium-enhanced cardiac MRI is well established for myocardial scar assessment in ischemic and non-ischemic heart disease. The role of MDE by cardiac CT (CT-MDE) is not yet defined. Findings We reviewed all clinical cases of CT-MDE at a tertiary referral center to present the cases as a case series. All clinical cardiac CT exams which utilized CT-MDE imaging between January 1, 2005 and October 1, 2010 were collected as a series a...

  8. Transformation of the Australian Public Sector and Environmental Accounting Practices: the Case of Water in 2001

    Directory of Open Access Journals (Sweden)

    David Moore

    2008-03-01

    Full Text Available This paper analyses a case study undertaken in 2001 of a Victorian public sector water utility to examine theimplications of public sector ‘modernisation’ reforms of the 1980s and 1990s for the adoption ofenvironmental accounting (EA procedures within the Victorian water industry. Legislative reforms haveresulted in the allocation of overhead costs for the purpose of segmented reporting and to measure the ‘fullcost’ of departments. This was consistent with the “managerialist”, “marketization” and “strategic” phases ofpublic sector ‘modernisation’ reforms, but did not measure the full economic (environmental cost. Theapplication of full cost recovery for the purpose of efficiency was further evidence of the impact of publicsector modernisation reforms but did not extend to the recovery of externalities. Private environmental costswere traced and integrated into direct cost categories, consistent with the philosophy of managerialism. Costswere measured for the purposes of promoting the contracting out of selected services and functions. Therewas limited adoption of environmental accounting practices, due to the absence of environmental accountingmeasurement guidelines. Staff interviewed recognized the importance of environmental issues, but were yetto appreciate the benefits of adopting EA practices. Subsequent to the case study, the Victorian governmentintroduced legislation that required water authorities to make provisions for environmental contributions, astep towards accounting for environmental externalities. This was the beginning of the “sustainability” phaseof public sector ‘modernisation’ reforms.

  9. What makes a ‘National’ War Memorial? The Case of the Australian Ex-Prisoners of War Memorial

    Directory of Open Access Journals (Sweden)

    Lachlan Grant

    2006-03-01

    Full Text Available The Australian Ex-Prisoners of War Memorial was unveiled in Ballarat to great fanfare in February 2004. Struggling to overcome serious setbacks in order to raise the necessary funds to construct the $2 million memorial over more than a period of four years, the memorial, listing the names of all Australian prisoners of war from all conflicts was judged by the Federal Government to be nothing but a ‘local’ memorial rather than a ‘national’ memorial. The article investigates whether this issue is at all associated with the ambiguity and difficulty of incorporating prisoners of war into the Anzac legend or whether there were other factors at hand deciding the official ‘national’ status of the first war memorial to list the names of all Australian prisoners of war. The importance of this issue reveals how government bureaucracy and party politics can influence the future and potential public significance of a war memorial.

  10. Applications of time-series analysis to mood fluctuations in bipolar disorder to promote treatment innovation: a case series.

    Science.gov (United States)

    Holmes, E A; Bonsall, M B; Hales, S A; Mitchell, H; Renner, F; Blackwell, S E; Watson, P; Goodwin, G M; Di Simplicio, M

    2016-01-01

    Treatment innovation for bipolar disorder has been hampered by a lack of techniques to capture a hallmark symptom: ongoing mood instability. Mood swings persist during remission from acute mood episodes and impair daily functioning. The last significant treatment advance remains Lithium (in the 1970s), which aids only the minority of patients. There is no accepted way to establish proof of concept for a new mood-stabilizing treatment. We suggest that combining insights from mood measurement with applied mathematics may provide a step change: repeated daily mood measurement (depression) over a short time frame (1 month) can create individual bipolar mood instability profiles. A time-series approach allows comparison of mood instability pre- and post-treatment. We test a new imagery-focused cognitive therapy treatment approach (MAPP; Mood Action Psychology Programme) targeting a driver of mood instability, and apply these measurement methods in a non-concurrent multiple baseline design case series of 14 patients with bipolar disorder. Weekly mood monitoring and treatment target data improved for the whole sample combined. Time-series analyses of daily mood data, sampled remotely (mobile phone/Internet) for 28 days pre- and post-treatment, demonstrated improvements in individuals' mood stability for 11 of 14 patients. Thus the findings offer preliminary support for a new imagery-focused treatment approach. They also indicate a step in treatment innovation without the requirement for trials in illness episodes or relapse prevention. Importantly, daily measurement offers a description of mood instability at the individual patient level in a clinically meaningful time frame. This costly, chronic and disabling mental illness demands innovation in both treatment approaches (whether pharmacological or psychological) and measurement tool: this work indicates that daily measurements can be used to detect improvement in individual mood stability for treatment innovation (MAPP

  11. Contact tracing of in-flight measles exposures: lessons from an outbreak investigation and case series, Australia, 2010

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    Christine Selvey

    2011-08-01

    Full Text Available Objective: To describe a 2010 outbreak of nine cases of measles in Australia possibly linked to an index case who travelled on an international flight from South Africa while infectious.Methods: Three Australian state health departments, Victoria, Queensland and New South Wales, were responsible for the investigation and management of this outbreak, following Australian public health guidelines.Results: An outbreak of measles occurred in Australia after an infectious case arrived on a 12-hour flight from South Africa. Only one of four cases in the first generation exposed to the index case en route was sitting within the two rows recommended for contact tracing in Australian and other guidelines. The remaining four cases in subsequent generations, including two health care workers, were acquired in health care settings. Seven cases were young adults. Delays in diagnosis and notification hampered disease control and contact tracing efforts.Conclusion: Review of current contact tracing guidelines following in-flight exposure to an infectious measles case is required. Alternative strategies could include expanding routine contact tracing beyond the two rows on either side of the case’s row or expansion on a case-by-case basis depending on cabin layout and case and contact movements in flight. Releasing information about the incident by press release or providing generic information to everyone on the flight using e-mail or text messaging information obtained from the relevant airline, may also be worthy of consideration. Disease importation, inadequately vaccinated young adults and health care-related transmission remain challenges for measles control in an elimination era.

  12. Australian Extinctions

    Science.gov (United States)

    Science Teacher, 2005

    2005-01-01

    Massive extinctions of animals and the arrival of the first humans in ancient Australia--which occurred 45,000 to 55,000 years ago--may be linked. Researchers at the Carnegie Institution, University of Colorado, Australian National University, and Bates College believe that massive fires set by the first humans may have altered the ecosystem of…

  13. What makes a ‘National’ War Memorial? The Case of the Australian Ex-Prisoners of War Memorial

    OpenAIRE

    Lachlan Grant

    2006-01-01

    The Australian Ex-Prisoners of War Memorial was unveiled in Ballarat to great fanfare in February 2004. Struggling to overcome serious setbacks in order to raise the necessary funds to construct the $2 million memorial over more than a period of four years, the memorial, listing the names of all Australian prisoners of war from all conflicts was judged by the Federal Government to be nothing but a ‘local’ memorial rather than a ‘national’ memorial. The article investigates whether this issu...

  14. Síndrome de Gorlin-Goltz: Serie de 7 casos Gorlin-Goltz Syndrome: A 7 cases serie

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    S. Rosón-Gómez

    2009-10-01

    Full Text Available El Síndrome Névico Basocelular (SNBC o Síndrome de Gorlin- Goltz es un trastorno autosómico dominante, caracterizado principalmente por carcinomas basocelulares, múltiples queratoquistes y anomalías esqueléticas. El presente trabajo revisa a este desconocido síndrome dada la importancia que tiene para nosotros como especialistas. Presentamos un total de siete casos recogidos por el Servicio Cirugía Oral y Maxilofacial desde 1992 al 2008, con seguimiento medio de 10 años, determinamos la frecuencia de las características clínicas en nuestra serie de SNBC y el manejo terapéutico de las mismas.Nevoid Basal Cell Carcinoma Syndrome (NBCSS or Gorlin-Goltz Syndrome is an autosomal dominant disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocysts and skeletal anomalies. This report reviews current knowledge of this disorder that is important to us as specialists. The authors reviewed seven case files from the Department of Oral and Maxillofacial Surgery of H. U. La Princesa from 1992-2008. The average follow up was 10 years; we determine the frequency of the clinical features and treatment in our series of NBCCS.

  15. Trachoma control in two Central Australian Aboriginal communities: a case study.

    Science.gov (United States)

    Lansingh, Van C; Mukesh, Bickol N; Keeffe, Jill E; Taylor, Hugh R

    2010-08-01

    This prospective case study assessed the additional impact of environmental changes (E) within the SAFE strategy in controlling trachoma in two Aboriginal communities (populations 315 and 385) in Central Australia. Baseline levels for trachoma, facial cleanliness, and nasal discharge were measured in children <15 years old. Health and facial cleanliness promotion were initiated in each community and housing and environmental improvements were made in one community. Azithromycin was distributed to all members of each community (coverage 55-73%). Assessments of trachoma and facial cleanliness were made at 3, 6, and 12 months post-intervention. Baseline trachoma rates were similar for the two communities (48 and 50%). Rates were significantly lower at 3, 6, and 12 months compared to baseline, but there was no significant difference between the two communities. The A/F components of the SAFE strategy significantly reduced the prevalence of trachoma; however, while the E intervention did not bring any apparent benefits, several factors might have masked them. PMID:20358257

  16. Gemcitabine as Salvage Treatment in Patients with Poorly Differentiated Pancreatic Neuroendocrine Tumors: A Case Series

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    Muhammad Wasif Saif

    2014-01-01

    Full Text Available Context Poorly differentiated neuroendocrine carcinoma of the pancreas is a rare and aggressive tumor. The combination of etoposide and cisplatin is considered as the first-line treatment, but no recommendations exist for further treatment after progression. Case series We report here case series of three patients who received gemcitabine as salvage chemotherapy in patients with poorly differentiated neuroendocrine carcinoma of the pancreas. All the three patients achieved clinical benefit with manageable toxicities. The survival was 5.5, 8, and 9 months respectively after the beginning of gemcitabine in these three patients. Conclusions This case series of patients with poorly differentiated neuroendocrine carcinoma of the pancreas who received gemcitabine as salvage chemotherapy suggests that gemcitabine could be an effective salvage treatment. Future studies to investigate gemcitabine in this setting are warranted.

  17. The case for a southeastern Australian Dust Bowl, 1895-1945

    Science.gov (United States)

    Cattle, Stephen R.

    2016-06-01

    Australia has an anecdotal history of severe wind erosion and dust storm activity, but there has been no lasting public perception of periods of extreme dust storm activity in this country, such as that developed in the USA following the Dust Bowl of the 1930s. Newspaper accounts of droughts and dust storms in southeastern (SE) Australia between 1895 and 1945 suggest that, at various times, the scale of these events was comparable to those experienced in the USA Dust Bowl. During this 50-year period, average annual rainfall values in this region were substantially below long-term averages, air temperatures were distinctly warmer, marginal lands were actively cropped and grazed, and rabbits were a burgeoning grazing pest. From the beginning of the Federation Drought of 1895-1902, dust storm activity increased markedly, with the downwind coastal cities of Sydney and Melbourne experiencing dust hazes, dust storms and falls of red rain relatively regularly. Between 1935 and 1945, Sydney and Melbourne received ten and nine long-distance dust events, respectively, with the years of 1938 and 1944/45 being the most intensely dusty. Entire topsoil horizons were blown away, sand drift was extreme, and crops and sheep flocks were destroyed. Although these periods of extreme dust storm activity were not as sustained as those experienced in the USA in the mid-1930s, there is a strong case to support the contention that SE Australia experienced its own extended, somewhat episodic version of a Dust Bowl, with a similar combination of causal factors and landscape effects.

  18. Virtual reality hypnosis pain control in the treatment of multiple fractures: a case series.

    Science.gov (United States)

    Teeley, Aubriana M; Soltani, Maryam; Wiechman, Shelley A; Jensen, Mark P; Sharar, Sam R; Patterson, David R

    2012-01-01

    This case series evaluated the use of virtual reality hypnosis (VRH) for the treatment of pain associated with multiple fractures from traumatic injuries. VRH treatment was administered on 2 consecutive days, and pain and anxiety were assessed each day before and after VRH treatment as well as on Day 3, which was 24 hours after the second treatment session. Pain reduction from baseline to Day 3 was from 70% to 30%, despite opioid analgesic use remaining stable. The subjective pain reduction reported by patients was encouraging, and the results of this case series suggest the importance of further study of VRH with larger samples using randomized controlled trials. PMID:22443021

  19. Returnees, Student-Migrants and Second Chance Learners: Case Studies of Positional and Transformative Outcomes of Australian International Education

    Science.gov (United States)

    Robertson, Shanthi; Hoare, Lynnel; Harwood, Aramiha

    2011-01-01

    There is a clear need for new research into the work and life outcomes for graduates of Australian international education. Drawing upon divergent post-study transitions, this article aims to present a multi-faceted, qualitative foundation for the consideration of both positional and transformative impacts of international education on graduates'…

  20. Developing Tests for the Assessment of Traditional Language Skill: A Case Study in an Indigenous Australian Community

    Science.gov (United States)

    Loakes, Deborah; Moses, Karin; Simpson, Jane; Wigglesworth, Gillian

    2012-01-01

    This article reports on the development and piloting of a vocabulary recognition test designed for Indigenous Australian children. The research is both application oriented and development oriented. The aims of the article are to determine how well the test is used as a test instrument and the extent to which children recognize vocabulary items in…

  1. Australian Hackers and Ethics

    Directory of Open Access Journals (Sweden)

    M.J. Warren

    2003-05-01

    Full Text Available The aim of the paper is to look at the way hackers act and ways in which society can protect itself. The paper will show the current views and attitudes of hackers in an Australian context. The paper will also include a case study to show how a hacking incident can develop and how technology can be used to protect against hacking.

  2. A case series examination of interaction-focused therapy for aphasia

    OpenAIRE

    Fox, Sarah

    2014-01-01

    This study reports the application and outcomes of Conversation Analysis (CA)-motivated interaction-focused therapy for a case series of eight couples managing the impact of aphasia on their conversations. It builds on previously reported interaction-focused therapy case studies (e.g. Lock, Wilkinson, & Bryan, 2001, Wilkinson, Bryan, Lock & Sage, 2010; Wilkinson, Lock, Bryan & Sage, 2011). Therapy was individualised for each couple, based on CA findings, but taking account of language, cognit...

  3. Chronic recurrent multifocal osteomyelitis: case series of four patients treated with biphosphonates.

    OpenAIRE

    Ferraria, N; Marques, JG; Ramos, F.; Lopes, G.; Fonseca, JG; Neves, MC

    2014-01-01

    Aim: To report and describe a series of four cases of chronic recurrent multifocal osteomyelitis (CRMO) and to discuss therapeutic options, particularly bisphosphonate therapy. Methods: Retrospective review of four CRMO cases in two Pediatric Units in Lisbon, between 2005 and 2010. Results: Median age of first CRMO symptoms was 11.3 years (range 9-13). The more affected sites were the metaphysis of the long bones, pelvis and coxofemoral joints. Median number of initial bony lesions for each p...

  4. Amyand's hernia-a vermiform appendix presenting in an inguinal hernia: a case series

    OpenAIRE

    Pavlidis Theodoros; Ballas Konstantinos; Symeonidis Nikolaos; Tsitlakidis Anastasios; Pavlidis Efstathios; Baltatzis Minas; Lalountas Miltiadis; Psarras Kyriakos; Sakantamis Athanassios

    2011-01-01

    Abstract Introduction A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand's hernia. Here we present a case series of four men with Amyand's hernia. Case presentations We retrospectively studied 963 Caucasian patients with inguinal hernia who were admitted to our surgical department over a 12-year period. Four patients presented with Amyand's hernia (0.4%). A 32-year-old Caucasian man had an inflamed vermiform appendix in his hernial sac (acute appendicitis), presen...

  5. Primary Synovial Sarcoma of the Pharynx: A Series of Five Cases and Literature Review.

    Science.gov (United States)

    Fatima, Syeda Samia; Din, Nasir Ud; Ahmad, Zubair

    2015-12-01

    Synovial sarcoma comprises approximately 10 % of all soft tissue sarcomas. Although synovial sarcoma has been reported in practically every organ, the extremities are the commonest site of occurrence followed by the head and neck. Primary synovial sarcoma of the pharynx is rare and only case reports have been published. We report a series of five cases of primary synovial sarcoma involving the pharynx. PMID:26022274

  6. Immediate and non-immediate allergic reactions to amoxicillin present a diagnostic dilemma: a case series

    OpenAIRE

    Weisser, Caroline; Ben-Shoshan, Moshe

    2016-01-01

    Background Allergic reactions to amoxicillin are very common occurrences in the pediatric age group; however, onset of symptoms can present a diagnostic dilemma. Case presentation We present a case series that describes three children (8-year-old white girl, 2-year-old white boy and 14-month-old Chinese boy) who presented with varied onset of allergic reactions to amoxicillin, specifically immediate (within the first hour after exposure) and non-immediate onset. One child developed immediate ...

  7. Ganglion cysts of the cruciate ligaments: a series of 31 cases and review of the literature

    OpenAIRE

    Mao Yongtao; Dong Qirong; Wang Yi

    2012-01-01

    Abstract Background A case series for ganglion cyst of the cruciate ligament with MRI findings, clinical presentation, and management options along with review of literature is presented. Methods Of 8663 consecutive patients referred for knee MR imaging, 31 were diagnosed with ganglion cysts of the cruciate ligaments, including 21 men and 10 women of ages 12 to 73 years (mean: 37). A review of charts revealed that knee pain was the chief complaint in all cases. Arthroscopic debridement of gan...

  8. Surrogacy as a good option for treatment of repeated implantation failure: a case series

    OpenAIRE

    Maryam Eftekhar; Nastaran Aflatoonian; Behrooz Aflatoonian; Elham Rahmani; Abass Aflatoonian

    2013-01-01

    Abstract Background: Repeated implantation failure (RIF) is defined as pregnancy failure after two to six times with at least ten high grade embryo transfer to uterus. A variety of causes have been anticipated for RIF, including anatomical, autoimmune, genetics, endocrine and thrombotic anomalies. Factors responsible for RIF have important implication regarding treatment however in many couples a perfect cause cannot be found. Cases: In these case series, we reported nine couples with RIF tha...

  9. Parenteral lidocaine for treatment of intractable renal colic: a case series

    OpenAIRE

    Vaezi Hassan; Mohammadi Dawood; Hassanzadeh Kamaleddin; Soleimanpour Hassan; Esfanjani Robab

    2011-01-01

    Abstract Introduction We report a case series of successful treatment of intractable renal colic using parenteral lidocaine. Case presentation Because of inconsistent responses to standard treatment with opioids and non-steroidal anti-inflammatory drugs in patients with renal colic pain, we decided to begin a trial of a single intravenous dose of lidocaine (approximately 1.5 mg/kg) slowly in eight patients with intractable renal colic who were referred to our emergency medicine department. Th...

  10. Management of amlodipine-induced gingival enlargement: Series of three cases

    OpenAIRE

    Srivastava Amit; Kundu Debabrata; Bandyopadhyay Prasanta; Pal Asit

    2010-01-01

    Gingival enlargement is one of the side effects associated with certain drugs. Amlodipine, a calcium channel blocker, used as antihypertensive drug has been found associated with gingival hyperplasia. This case series presents diagnosis and management of amlodipine-induced gingival hyperplasia. Amlodipine-induced gingival enlargement was diagnosed and managed by thorough scaling and root planning. Drug substitution and surgical intervention was performed in first two cases. The pathogenesis o...

  11. Validation of a home safety questionnaire used in a series of case-control studies

    OpenAIRE

    Watson, Michael; Benford, Penny; Coupland, Carol; Clacy, Rose; Hindmarch, Paul; Majsak-Newman, Gosia; Deave, Toity; Kendrick, Denise

    2014-01-01

    Objective To measure the validity of safety behaviours, safety equipment use and hazards reported on a questionnaire by parents/carers with children aged under 5 years participating in a series of home safety case-control studies. Methods The questionnaire measured safety behaviours, safety equipment use and hazards being used as exposures in five case-control studies. Responses to questions were compared with observations made during a home visit. The researchers making observations were bli...

  12. Local Graft Irradiation for Kidney Allograft Rejection: A Case Series and Review of the Literature

    OpenAIRE

    Fallahzadeh, Mohammad Kazem; Khan, Sarah; Zibari, Gazi B.; Patil, Sandeep; Singh, Neeraj

    2014-01-01

    Introduction: Due to its immunosuppressive properties, local graft irradiation (LGI) has been proposed as a second line therapy for treatment of acute kidney rejection. Case Presentation: In this case-series we report 6 patients with biopsy proven acute kidney allograft rejection refractory to conventional antirejection therapy who underwent LGI for treatment of acute rejection at our center. Three of these patients had living donor transplants, 2 had deceased donor transplants, and one had r...

  13. Manualized Family-Based Treatment for Anorexia Nervosa: A Case Series.

    Science.gov (United States)

    Le Grange, Daniel; Binford, Roslyn; Loeb, Katharine L.

    2005-01-01

    Objective: The purpose of this study was to describe a case series of children and adolescents (mean age = 14.5 years, SD = 2.3; range 9-18) with anorexia nervosa who received manualized family-based treatment for their eating disorder. Method: Forty-five patients with anorexia nervosa were compared pre- and post-treatment on weight and menstrual…

  14. Dialectical Behavior Therapy of Anorexia and Bulimia Nervosa among Adolescents: A Case Series

    Science.gov (United States)

    Salbach-Andrae, Harriet; Bohnekamp, Inga; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Miller, Alec L.

    2008-01-01

    The aim of this study was to describe a case series of adolescents (mean age = 16.5 years, SD = 1.0) with anorexia nervosa (AN) and bulimia nervosa (BN) who received dialectical behavior therapy (DBT). Twelve outpatients with AN and BN took part in 25 weeks of twice weekly therapy consisting of individual therapy and a skills training group.…

  15. A Case Series of Marijuana Exposures in Pediatric Patients Less than 5 Years of Age

    Science.gov (United States)

    Wang, George Sam; Narang, Sandeep K.; Wells, Kathryn; Chuang, Ryan

    2011-01-01

    Objective: In Colorado, there has been a large increase in medical marijuana dispensaries and licenses for the use of medical marijuana over the past year. This is a retrospective case series of marijuana exposures that have presented to the emergency department (ED) in children less than 5 years of age. Methods: We performed a retrospective chart…

  16. Neurosis meets psychosis: Case series from a tertiary care center in South India

    OpenAIRE

    Dholakia, Saumil Y.; Chandramouleeswaran Susmita; Krishna Das Ranjit; Yogendra Singh; Deepa Braganza

    2015-01-01

    The utility of the terms psychosis and neurosis in psychiatry have maintained their dichotomous stance since ages. Clinical observations and etiological hypothesis of psychiatric disorders have kept this polarity intact since the times of Freud and Jung. This case series attempts to revisit this perennial psychiatric controversy.

  17. Publishing and Australian Literature: Crisis, Decline or Transformation?

    Directory of Open Access Journals (Sweden)

    Katherine Bode

    2010-09-01

    Full Text Available The globalisation and consolidation of book publishing is widely seen as having negative consequences for Australian literature. Some commentators argue that this shift is detrimental to Australian literature as a whole; others identify the growth of multinational publishing conglomerates with a specific decline in Australian literary fiction. This article explores both positions, first identifying and investigating trends in Australian novel publication and comparing these to trends in the publication of novels from other countries as well as other Australian-originated literature (specifically, poetry and auto/biography. It then considers the specific case of Australian literary fiction, before looking in detail at the output of large publishers of Australian novels. This analysis reveals a recent decline in Australian novel and poetry titles, but offers a more complex picture of this trend than dominant expressions of nostalgia and alarm about the fate of Australian literature and publishing would suggest.

  18. Gilles De La Tourette′s Syndrome : A Case Series Of 14 Patients From India

    Directory of Open Access Journals (Sweden)

    Anil Gurtoo

    2005-01-01

    Full Text Available Background: Gilles de la Tourette′s Syndrome (GTS is a neuropsychiatric disorder characterized by motor and vocal tics associated with obsessive compulsive disorder (OCD and attention deficit hyperactivity disorder (ADHD. This syndrome is often misdiagnosed as psychiatric disorder, therefore neuropsychiatric evaluation in patients suffering from it is very essential to make the correct diagnosis. Few reports, mostly single case reports of GTS from India have been published, this series attempts to define the clinical spectrum of patients from India. Aim : To study the clinical profile of patients with GTS in India. Setting and Design : Prospective hospital based study. Material and Methods : Ct scan of the head and EEG were done in all the 14 cases in addition to clinical history and detailed neurological examination. The diagnosis of GTS was made according to Tourette Syndrome Classification Study Criteria Group. Findings were statistically analyzed. Results : In all a total of 101 simple motor tics and 21 complex motor tics were observed in 14 cases. Most common site of simple motor tics was the facio-nuchal region (70% and type was eyebrow raising seen in 10 cases (71%. Commonest type of complex motor tics nose blowing (35%. Vocal tics were found in all 14 cases, simple (56%, being more common than complex vocal tics i.e, coprolalia (42%. Throat clearing was found in (50% cases and was the most positive in 28%. OCD was seen in 64% and ADHD in 28%. All the 14 cases Responded well to treatment. Conclusion : The clinical profile of patients in our case series is similar to those reported from the western countries with the exception of coprolalia, and ADHD, the incidence of which is higher in this case series.

  19. Applying data mining techniques to medical time series: an empirical case study in electroencephalography and stabilometry.

    Science.gov (United States)

    Anguera, A; Barreiro, J M; Lara, J A; Lizcano, D

    2016-01-01

    One of the major challenges in the medical domain today is how to exploit the huge amount of data that this field generates. To do this, approaches are required that are capable of discovering knowledge that is useful for decision making in the medical field. Time series are data types that are common in the medical domain and require specialized analysis techniques and tools, especially if the information of interest to specialists is concentrated within particular time series regions, known as events. This research followed the steps specified by the so-called knowledge discovery in databases (KDD) process to discover knowledge from medical time series derived from stabilometric (396 series) and electroencephalographic (200) patient electronic health records (EHR). The view offered in the paper is based on the experience gathered as part of the VIIP project. Knowledge discovery in medical time series has a number of difficulties and implications that are highlighted by illustrating the application of several techniques that cover the entire KDD process through two case studies. This paper illustrates the application of different knowledge discovery techniques for the purposes of classification within the above domains. The accuracy of this application for the two classes considered in each case is 99.86% and 98.11% for epilepsy diagnosis in the electroencephalography (EEG) domain and 99.4% and 99.1% for early-age sports talent classification in the stabilometry domain. The KDD techniques achieve better results than other traditional neural network-based classification techniques. PMID:27293535

  20. Chest x-ray in Q-fever pneumonia: a series of 71 cases

    International Nuclear Information System (INIS)

    Chest X ray features of 71 cases of Q-fever serologically confirmed and with clinical manifestations of acute respiratory disease were retrospectively assessed in order to evaluate the radiographic features. In 68 cases (96%) The X-ray films were abnormal. Segmental consolidation, sometimes multiple and bilateral were tue most usual findings. Nodular opacities were found in 6 cases (9%) and can mimic a tumor. Cavitacion , a very unusual findings, was found in two nodular consolidations(two patients). Laminar atelectasis was less common than proviously reported. As in other series, total resolution or with minimal scars occurs within 3 months 15 refs

  1. Ethnomedicine and dominant medicine in multicultural Australia: a critical realist reflection on the case of Korean-Australian immigrants in Sydney

    Science.gov (United States)

    Han, Gil-Soo; Ballis, Harry

    2007-01-01

    Background Viewed through the micro focus of an interpretive lens, medical anthropology remains mystified because interpretivist explanations seriously downplay the given context in which individual health seeking-behaviours occur. This paper draws upon both the interpretivist and political economy perspectives to reflect on the ethno medical practices within the Korean-Australian community in Sydney. Methods We draw on research data collected between 1995 and 1997 for an earlier study of the use of biomedical and traditional medicine by Korean-Australians in Sydney. A total of 120 interviews were conducted with a range of participants, including biomedical doctors, traditional health professionals, Korean community leaders and Korean migrants representing a range of socio-economic backgrounds and migration patterns. Results and Discussion First, the paper highlights the extent to which the social location of migrants in a host society alters or restructures their initial cultural practices they bring with them. Second, taking hanbang medicine in the Korean-Australian community as an illustrative case, the paper explores the transformation of the dominant biomedicine in Australia as a result of the influx of ethnomedicine in the era of global capitalism and global movement. Conclusion In seeking to explain the popularity and supply of alternative health care, it is important to go beyond the culture of each kind of health care itself and to take into consideration the changes occurring at societal, national and global levels as well as consequential individual response to the changes. New social conditions influence the choice of health care methods, including herbal/alternative medicine, health foods and what are often called New Age therapies. PMID:17201916

  2. Ethnomedicine and dominant medicine in multicultural Australia: a critical realist reflection on the case of Korean-Australian immigrants in Sydney

    Directory of Open Access Journals (Sweden)

    Ballis Harry

    2007-01-01

    Full Text Available Abstract Background Viewed through the micro focus of an interpretive lens, medical anthropology remains mystified because interpretivist explanations seriously downplay the given context in which individual health seeking-behaviours occur. This paper draws upon both the interpretivist and political economy perspectives to reflect on the ethno medical practices within the Korean-Australian community in Sydney. Methods We draw on research data collected between 1995 and 1997 for an earlier study of the use of biomedical and traditional medicine by Korean-Australians in Sydney. A total of 120 interviews were conducted with a range of participants, including biomedical doctors, traditional health professionals, Korean community leaders and Korean migrants representing a range of socio-economic backgrounds and migration patterns. Results and Discussion First, the paper highlights the extent to which the social location of migrants in a host society alters or restructures their initial cultural practices they bring with them. Second, taking hanbang medicine in the Korean-Australian community as an illustrative case, the paper explores the transformation of the dominant biomedicine in Australia as a result of the influx of ethnomedicine in the era of global capitalism and global movement. Conclusion In seeking to explain the popularity and supply of alternative health care, it is important to go beyond the culture of each kind of health care itself and to take into consideration the changes occurring at societal, national and global levels as well as consequential individual response to the changes. New social conditions influence the choice of health care methods, including herbal/alternative medicine, health foods and what are often called New Age therapies.

  3. Tubercular Uveitis with Ocular Manifestation as the First Presentation of Tuberculosis: A Case Series.

    Science.gov (United States)

    Shah, Jayashree S; Shetty, Niharika; Shah, Sharath Kumar D; Shah, Neelesh Kumar S

    2016-03-01

    Tuberculosis is very common disease in India. It is one of the most common causes of Granulomatous Uveitis in our Country even today. So the strongest suspicion in our mind when we are treating a case of Uveitis, should be TB. We reviewed all the cases of clinically suspected ocular tuberculosis attending the Ophthalmology OPD of Sri Siddhartha Medical College between December 2012 and December 2014 who were refractory to routine uveitis management and later on responded to anti-Tubercular treatment. History of TB contact, Ocular manifestation, Demographic Profile of the patients, Diagnostic test, Treatment regime were looked into. Here by we present a case series of 15 cases of refractory uveitis that later were detected to be of tuberculous origin. We studied the characteristic features, complications and correlation of mantoux test, ESR and Koch's contact with these cases. PMID:27134908

  4. Late-life homicide-suicide: a national case series in New Zealand.

    Science.gov (United States)

    Cheung, Gary; Hatters Friedman, Susan; Sundram, Frederick

    2016-01-01

    Homicide-suicide is a rare event, but it has a significant impact on the family and community of the perpetrator and victim(s). The phenomenon of late-life homicide-suicide has not been previously studied in New Zealand, and there is only limited data in the international literature. The aim of this study is to systematically review coroners' records of late-life homicide-suicides in New Zealand. After ethics approval was granted, the Coronial Services of New Zealand was approached to provide records of all closed cases with a suicide verdict (age 65+) over a five-year period (July 2007-December 2012). Of the 225 suicides, 4 cases of homicide-suicide were identified (an estimated incidence of 0.12 per 100,000 per persons year). All four perpetrators were men; three had been farmers. Their ages ranged from 65 to 82. One case occurred in the context of an underlying psychiatric illness (psychotic depression in bipolar disorder). Firearms were used in three cases. Two cases were categorized as spousal/consortial subtype, one case as filicide-suicide, and one case as siblicide-suicide. The prospect of major social upheaval in the form of losing their homes was present in all four cases. The findings of this case series were consistent with the limited existing literature on homicide-suicide. Age-related biopsychosocial issues were highlighted in this case series of late-life homicide-suicide. Additionally, evaluating firearm licences in high-risk groups may represent a prevention strategy. PMID:25735608

  5. A case-series study of cerebral venous thrombosis in women using short course oral contraceptive

    Science.gov (United States)

    Khomand, Payam; Hassanzadeh, Kambiz

    2016-01-01

    Background: We report a case series of cerebral vein thrombosis (CVT) in women who used oral contraceptive pill (OCP) in the Muslims Ramadan and fasting month. Methods: This study was a retrospective case series of 9 patients with diagnosis of CVT, who admitted in the neurology ward of Tohid Hospital of Sanandaj, Iran, in July-August 2014-2015. Results: Patients had no history of thrombosis before. They were treated with oral contraceptive more than 1 month to be able to fast during Ramadan. They did not have other possible risk factors for CVT. A headache was the most common in 9/9 patients (100%) followed by vomiting and vertigo. Conclusion: We found that high rate of CVT in female population during Ramadan indicates that it needs be considered as a specific risk factor and should be considered by healthcare system. PMID:27326364

  6. Disulfiram-induced reversible hypertension: A prospective case series and review of the literature

    Directory of Open Access Journals (Sweden)

    Ranganath R Kulkarni

    2014-01-01

    Full Text Available Disulfiram (DSF is one of the recommended aids in the management of selected patients with alcohol dependence. Hypertension (HTN as an adverse effect of DSF therapy is less understood. In our prospective case series of 7 subjects with co-morbid alcohol and nicotine dependence, a temporal, dose-dependent, and reversible grade 1-3 HTN within 1-6 weeks of initiation of DSF therapy (125-500 mg/day with no other detectable causes of HTN was noted. Challenges and strategies surrounding diagnosis and treatment along with mean change and percentage rise in blood pressure are described. Literature review and clinical description of case series may suggest neurobiological role in its causation. HTN may be a clinically significant, dose-dependent, and reversible adverse effect of DSF therapy, especially in co-morbid alcohol and nicotine-dependent patients. Awareness amongst clinicians may render better health care delivery to subjects with alcohol dependence.

  7. Ornamental Stones and Gemstones: The limits of heritage stone designation: The case for and against Australian Precious Opal

    Science.gov (United States)

    Cooper, Barry

    2015-04-01

    When the international designation of natural stone types was first mooted in 2007, stones that were utilised in building and construction were the primary focus of attention. However following public discussion it soon became apparent that sculptural stones, stone used for utilitarian purposes such as millstones, as well as archaeological materials including stones used by early man could all be positively assessed as a potential Global Heritage Stone Resource (GHSR). Over the past 2 years it has been realised there is also a range of ornamental and semi-precious stones that may also be considered in the same international context. Examples in this respect include Imperial Porphyry sourced from Egypt that was much prized in the ancient world and "Derbyshire Blue John" a variety of fluorspar from central England that was used for vases, chalices, urns, candle sticks, jars, bowls door, jewellery and fire-place surrounds, especially in the 18th and 19th centuries. It is at this point that rock materials, sometimes used as gemstones, impinge on the domain of typical heritage stones. In Australia, the gemstone most identifiable with the country is precious opal formed by sedimentary processes in the Great Artesian Basin. In this paper the question is asked whether "Australian Precious Opal" could be or should be considered as a heritage stone of international significance. Immediately Australian Precious Opal satisfies several GHSR criteria including historic use for more than 50 years and wide-ranging utilisation for prestige jewellery around the world. It is also recognised as a cultural icon including association with national identity in Australia as it is legally defined as Australia's "National Gemstone" as well as being the "Gemstone Emblem" for the State of South Australia. Opal continues to be mined. Designation of Australian Precious Opal as a Global Heritage Stone Resource would likely involve formal international recognition of Australian opal in the

  8. Australian Research Council

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    @@ Introduction The Australian Research Council(ARC) is the Australian Government's main agency for allocating research funding to academics and researchers in Australian universities.Its mission is to deliver policy and programs that advance Australian research and innovation globally and benefit the community.

  9. Rare case of congenital anomaly in two different gestational ages: a case series

    OpenAIRE

    John, Lopamudra B.; Sendhil Coumary A; Seetesh Ghose

    2013-01-01

    Acrania is a rare congenital anomaly involving faulty development of membranous flat bones of neurocalvarium. Commonest differential diagnosis is anencephaly. The first case was diagnosed in a second gravida at 13 weeks and terminated by vaginal misoprostol instillation. The second case was diagnosed only by scan at 32 weeks in an unbooked second gravida with previous LSCS. She underwent emergency LSCS for failed induction and a fresh stillborn baby of 1.9 kg was born. [Int J Reprod Contracep...

  10. Evaluation of reagent strips in detecting asymptomatic bacteriuria in early pregnancy: prospective case series.

    OpenAIRE

    Tincello, D. G.; Richmond, D. H.

    1998-01-01

    OBJECTIVE: To evaluate the performance of reagent test strips in screening pregnant women for asymptomatic bacteriuria at their first visit to an antenatal clinic. DESIGN: Prospective case series. SETTING: Antenatal clinic of a large inner city maternity hospital. SUBJECTS: All women attending for their first antenatal clinic. Patients taking antibiotics for any reason and those with urinary tract symptoms were excluded. INTERVENTION: A midstream urine specimen was divided; half was sent for ...

  11. Prehospital Use of the Intubating Laryngeal Mask Airway in Patients with Severe Polytrauma: A Case Series

    Directory of Open Access Journals (Sweden)

    Andrew M. Mason

    2009-01-01

    Full Text Available A case series of five patients is described demonstrating the utility of the intubating laryngeal mask airway in the prehospital setting, both as a primary airway rescue device and as a bridge to tracheal intubation. All patients were hypoxaemic, had sustained severe polytrauma and were trapped in their vehicles following road traffic collisions. A probability of survival study showed better-than-predicted outcomes for the group as a whole.

  12. Pediatric seizure-related posttraumatic stress and anxiety symptoms treated with EMDR: a case series

    OpenAIRE

    Dautovic, Elmedina; De Roos, Carlijn; Rood, Yanda; Dommerholt, Agnes; Rodenburg, Roos

    2016-01-01

    Purpose: To examine the potential effects of eye movement desensitization and reprocessing (EMDR) in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design.Methods: Five children (aged 8–18) with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED) pre- and post-EMDR and at 3-m...

  13. Endovascular management of vein of galen aneurysm malformation: A series of two case reports

    Directory of Open Access Journals (Sweden)

    Lakshmi Sudha Prasanna Karanam

    2011-01-01

    Full Text Available Vein of Galen Aneurysm malformation is one of the most difficult intracranial vascular lesions to manage. The difficulty in management of its shunts is aggravated by the hemodynamic effect and shunting reflected in the growing brain of infants and children. At present, the therapeutic options are widened by the opening of a new horizon in Intervention Neuroradiology. We present a series of two case reports of these malformations treated using the endovascular method, at our institution.

  14. Development of Emotion Acceptance Behavior Therapy for Anorexia Nervosa: A Case Series

    OpenAIRE

    Wildes, Jennifer E.; Marcus, Marsha D.

    2010-01-01

    This case series describes the development of a novel psychotherapeutic intervention for older adolescents and adults with anorexia nervosa (AN). Emotion acceptance behavior therapy (EABT) is based on a model that emphasizes the role of anorexic symptoms in facilitating avoidance of emotions. EABT combines standard behavioral interventions that are central to the clinical management of AN with psychotherapeutic techniques designed to increase emotion awareness, decrease emotion avoidance, and...

  15. Pituitary hyperplasia: case series and literature review of an under-recognised and heterogeneous condition

    OpenAIRE

    De Sousa, Sunita M C; Earls, Peter; McCormack, Ann I

    2015-01-01

    Summary Pituitary hyperplasia (PH) occurs in heterogeneous settings and remains under-recognised. Increased awareness of this condition and its natural history should circumvent unnecessary trans-sphenoidal surgery. We performed an observational case series of patients referred to a single endocrinologist over a 3-year period. Four young women were identified with PH manifesting as diffuse, symmetrical pituitary enlargement near or touching the optic apparatus on MRI. The first woman presente...

  16. Awake tracheal intubation using Pentax airway scope in 30 patients: A Case series

    OpenAIRE

    Payal Kajekar; Cyprian Mendonca; Rati Danha; Carl Hillermann

    2014-01-01

    Background and Aims: Pentax airway scope (AWS) has been successfully used for managing difficult intubations. In this case series, we aimed to evaluate the success rate and time taken to complete intubation, when AWS was used for awake tracheal intubation. Methods: We prospectively evaluated the use of AWS for awake tracheal intubation in 30 patients. Indication for awake intubation, intubation time, total time to complete tracheal intubation, laryngoscopic view (Cormack and Lehane grade), to...

  17. Excessive sweepstakes participation in patients with dementia in Hawai'i: a case series.

    Science.gov (United States)

    Tamura, Bruce K; Wong, Warren F; Sezginsoy, Banu; Masaki, Kamal H

    2006-12-01

    We report a case series of 11 patients with excessive sweepstakes participation on initial geriatric consultation in Honolulu. Ten of these patients had dementia, mostly Alzheimer's disease, with Folstein MiniMental Status Exam scores ranging from 17-29/30. Money lost ranged from 6,600 dollars to 200,000-400,000 dollars. Physicians need to have a high index of suspicion and the public needs to be educated about simple preventive strategies. PMID:17319475

  18. Kinematic Changes in Swallowing After Surgical Removal of Anterior Cervical Osteophyte Causing Dysphagia: A Case Series

    OpenAIRE

    Jeong, Hyeonghui; Seo, Han Gil; Han, Tai Ryoon; Chung, Chun Kee; Oh, Byung-Mo

    2014-01-01

    This retrospective case series included five patients who underwent surgical resection of the cervical anterior osteophyte due to dysphagia. Videofluoroscopic swallowing studies (VFSSs) were performed before and after surgery on each patient, and kinematic analysis of the video clips from the VFSS of a 5-mL liquid barium swallow was carried out. Functional oral intake improved after surgery in 3/4 patients who had required a modified diet before surgery. Kinematic analysis showed increases in...

  19. Niemann-Pick disease type C: a case series of Brazilian patients

    OpenAIRE

    Paulo José Lorenzoni; Elaine Cardoso; Ana C.S. Crippa; Charles Marques Lourenço; Fernanda Timm Seabra Souza; Roberto Giugliani; Maria Luiza Saraiva-Pereira; Salmo Raskin; Isac Bruck; Cláudia S. K. Kay; Rosana H. Scola; Werneck, Lineu C.; Teive, Hélio A.G.

    2014-01-01

    The aim of the study was to analyze a series of Brazilian patients with Niemann-Pick disease type C (NP-C). Method Correlations between clinical findings, laboratory data, molecular findings and treatment response are presented. Result The sample consisted of 5 patients aged 8 to 26 years. Vertical supranuclear gaze palsy, cerebellar ataxia, dementia, dystonia and dysarthria were present in all cases. Filipin staining showed the “classical” pattern in two patients and a “variant” pattern i...

  20. Correction of tear trough deformity with a cohesive polydensified matrix hyaluronic acid: a case series

    OpenAIRE

    Huber-Vorländer J; Kürten M

    2015-01-01

    Jürgen Huber-Vorländer, Martin KürtenFort Malakoff Klinik, Mainz, GermanyAbstract: The tear trough or infraorbital hollow is a challenging area to treat, and only a few fillers are suitable for this delicate area. We report on a European case series of six subjects with mild to severe tear troughs who received treatment with cohesive polydensified matrix (CPM®) technology hyaluronic acid gel (Belotero® Balance). The product was injected as small depo...

  1. Unicameral bone cysts managed with CHRONOS bone graft substitute: A case series.

    OpenAIRE

    Benjamin, Biju; Ketan PANDE

    2013-01-01

    A unicameral bone cyst (UBC) may require surgery if its location increases the risk for pathologic fracture, or if it is painful or increasing in size. This case series demonstrates that curettage and grafting with a bone graft substitute alone can result in healing of the UBC. Three children with UBC and pathological fractures were treated with curettage and grafting using bone graft substitute beta-tricalcium phosphate granules (CHRONOS). All three went on to full union of the fracture and ...

  2. Late-onset Diogenes syndrome in Chinese – an elderly case series in Hong Kong

    OpenAIRE

    Chan, Sau Man Sandra; Leung, Pui Yiu Vivian; Chiu, Fung Kum Helen

    2007-01-01

    We review a consecutive case series of elders presenting to a regional psychogeriatric service in Hong Kong in 1996–2001. Eighteen elders (aged 65 and over) fulfilled the classical symptoms of Diogenes syndrome (extreme squalor, neglected physical state, unhygienic condition & social isolation with or without hoarding). A diverse clinical and socio-demographic profile was observed. Most of our clients suffered from different stages of dementia. Other diagnoses such as schizophrenia and alcoho...

  3. Juvenile nasopharyngeal angiofibroma: case series of Caribbean University Hospital. Cartagena. Colombia

    OpenAIRE

    Padilla Luis Fernando; Torres-Guerrero Arnulfo; Milanés-Pérez Rosa; Vélez-Duncan Carlos; Torres-Tabares Tonny

    2010-01-01

    Objective: to describe the management and surgical options used in the service of Otorhinolaryngology, Hospital Universitario del Caribe for the management of juvenile nasopharyngeal angiofibroma (JNA).Methodology: case series of patients with JNA, during the years 2007-2010, which were staged according to the classification of FISCH (1983). The extent of tumor, preoperative studies, surgical approach, results and complications were evaluated. Results: six male patients were diagnosed and tre...

  4. Pediatric seizure-related posttraumatic stress and anxiety symptoms treated with EMDR: a case series

    OpenAIRE

    Elmedina Dautovic; Carlijn de Roos; Yanda van Rood; Agnes Dommerholt; Roos Rodenburg

    2016-01-01

    Purpose: To examine the potential effects of eye movement desensitization and reprocessing (EMDR) in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design. Methods: Five children (aged 8–18) with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED) pre- and post-EMDR and at 3-...

  5. Psychotic symptoms in refugees diagnosed with PTSD: a series of case reports

    DEFF Research Database (Denmark)

    Norredam, Marie; Jensen, Mette; Ekstrøm, Morten

    2011-01-01

    In our clinical work, we treat refugees who have been exposed to trauma and who subsequently develop psychotic symptoms. However, the literature does not address the relationship between refugees with depression, post-traumatic stress disorder (PTSD) and psychotic symptoms. Therefore the aim of...... this study is firstly to present a series of cases showing how psychotic symptoms may present in refugees diagnosed with PTSD, and secondly to discuss the underlying explanations of the involved psychopathology....

  6. ED-12WIDESPREAD SYSTEMIC METASTASES FROM MEDULLOBLASTOMA WITHOUT EVIDENCE OF ACTIVE CNS INVOLVEMENT: A CASE SERIES

    OpenAIRE

    Kumthekar, Priya; Singh, Simran; Smiley, Natasha Pillay; Lulla, Rishi

    2014-01-01

    This case series describes two patients with previously treated medulloblastoma who present with systemic metastases without evidence of central nervous system (CNS) disease. Patient #1 is male who presented at age 29 with pathology confirmed medulloblastoma treated with complete surgical resection followed by radiation (36 Gy craniospinal plus posterior fossa boost). Subsequently, he received cisplatin, cytoxan, and vincristine. One year later, he developed back pain and urinary retention. I...

  7. Application of Plasma Exchange in Patients with History of Unexplained Recurrent Abortion: A Case Series

    OpenAIRE

    Azadeh Ghaheri; Farzane Jamdar; Mohammad Ali Roghaei

    2013-01-01

    Background: Immune-mediated recurrent pregnancy loss (RPL) has received more attention than any other single etiologic classification. Individuals with rare blood group P have an antipp1pk antibody in their serum, which causes recurrent abortion in the early stages. Materials and Methods: In this case series study, 11 patients with unexplained RPL who had anti-P antibody in their serum were treated by plasma exchange during their next pregnancies. To evaluate the efficacy of the treatment, we...

  8. How Do Students Use Their Mobile Devices to Support Learning? A Case Study from an Australian Regional University

    OpenAIRE

    Farley, Helen; Murphy, Angela; Johnson, Chris; Carter, Brad; Lane, Michael; Midgley, Warren; Hafeez-Baig, Abdul; Dekeyser, Stijn; Koronios, Andy

    2015-01-01

    Though universities are eager to leverage the potential of mobile learning to provide learning flexibly, most balk at the cost of providing students with mobile hardware. The practice of ‘bring your own device'(BYOD) is often mooted as a cost-effective alternative. This paper provides a snapshot of student ownership of mobile devices at a regional Australian university. Our research shows that students do have access to and use a wide range of devices. However, the delivery of learning is cha...

  9. Preamputation mirror therapy may prevent development of phantom limb pain: a case series.

    Science.gov (United States)

    Hanling, Steven R; Wallace, Scott C; Hollenbeck, Kerry J; Belnap, Brian D; Tulis, Matthew R

    2010-02-01

    We report the cases of 4 patients who performed daily mirror therapy for 2 wk before undergoing elective limb amputation. One patient experienced no phantom limb pain (PLP). Two patients experienced rare episodes of mild PLP without effect on their participation in physical therapy (PT) or their quality of life. One patient reported daily, brief episodes of moderate PLP without effect on his participation in PT or his stated quality of life. These results indicate that preoperative mirror therapy may improve postamputation PT compliance and decrease the incidence of PLP. Future prospective studies are needed to confirm the results of this case series. PMID:19917622

  10. Successful Rituximab Therapy in Steroid-Resistant, Cryptogenic Organizing Pneumonia: A Case Series.

    Science.gov (United States)

    Shitenberg, Dorit; Fruchter, Oren; Fridel, Ludmila; Kramer, Mordechai R

    2015-01-01

    Cryptogenic organizing pneumonia (COP) is an interstitial lung disease that is usually responsive to corticosteroid treatment. The treatment of COP has not been studied in randomized controlled trials; thus, treatment decisions are based on practice guidelines. We herein present, for the first time, 4 cases of patients with biopsy-proven COP who did not respond to corticosteroids but benefited from rituximab therapy. This report consists of a retrospective case series of patients who experienced steroid-resistant, biopsy-proven COP. Patients included in this case series suffered from acute or chronic COP and did not respond to corticosteroid treatment for a few weeks to months but later responded to rituximab. In a series of 4 patients, 1 patient had a complete radiological and clinical response after rituximab therapy, and the steroids could be gradually tapered. Three patients had a chronic course but had been able to lower steroid dosage or even discontinue the drug after being treated with rituximab. Since 40% of the patients with COP do not respond to or stay dependent on steroids, we think that even the ability to lower the steroid dosage by using rituximab as a steroid-sparing agent with a good safety profile is worth the effort. However, further studies are warranted. PMID:26045243

  11. Evaluation of Streptococcus pneumoniae in bile samples: A case series review.

    Science.gov (United States)

    Itoh, Naoya; Kawamura, Ichiro; Tsukahara, Mika; Mori, Keita; Kurai, Hanako

    2016-06-01

    Although Streptococcus pneumoniae is an important pathogen of humans, pneumococcal cholangitis is rare because of the rapid autolysis of S. pneumoniae. The aim of this case series was to review patients with bile cultures positive for S. pneumoniae. This study was a single center retrospective case series review of patients with S. pneumoniae in their bile at a tertiary-care cancer center between September 2002 and August 2015. Subjects consisted of all patients in whom S. pneumoniae was isolated in their bile during the study period. Bile specimens for culture were obtained from biliary drainage procedures such as endoscopic retrograde biliary drainage, endoscopic nasobiliary drainage, and percutaneous transhepatic biliary drainage. There were 20 patients with bile cultures positive for S. pneumoniae during the study period. All patients presented with extrahepatic obstructive jaundice due to hepatopancreatobiliary tumors. Nineteen of 20 patients underwent the placement of plastic intrabiliary tubes. The mean time between the first-time drainage and the positive culture was 26 days (range 0-313 days). Although 12 of 20 patients met our definition of cholangitis, 5 were clinically treated with antibiotics based on a physician's assessment of whether there was a true infection. The present study is the largest case series of patients with S. pneumoniae in their bile. Based on our findings, the isolation of S. pneumoniae from bile may be attributed to the placement of biliary drainage devices. PMID:27025902

  12. Inferior dislocation of the hip: a case series and literature review

    Directory of Open Access Journals (Sweden)

    Aggarwal Sameer

    2012-11-01

    Full Text Available 【Abstract】 Inferior hip dislocation is the rarest type among all hip dislocations. Very few cases have been re-ported in the English literature. Most of the earlier reported cases involves the pediatric age group. No single case series could be found in the English literature. We came across 4 cases of inferior hip dislocation with a varied age profile (range 10 to 56 years, mean 33.8 years. Patients with this disease usually complained of pain and kept the thigh flexed and abducted. The diagnosis can be confirmed by radiographs which reveal that the long axis of the femur varies in alignment with respect to the spine from parallel to an angle almost 90° away from the axis. In our series, closed reduction was successful in all patients, either under seda-tion or general anaesthesia. Skin traction for a period of 6 weeks was applied in all of them and follow-up revealed pain-free, stable and mobile hips. In this study we present the details of these cases along with a review of literature discussing the various modes and mechanisms that pro-duce inferior hip dislocation. Key words: Hip dislocation; Therapeutics; Traction; Weight-bearing

  13. Inferior dislocation of the hip: a case series and literature review

    Institute of Scientific and Technical Information of China (English)

    Sameer Aggarwal; Vishal Kumar; Kishan Ramachandra Bhagwat; Vokkaleri Shankaranarayana Shashikanth; Holalu Shankaralingegowda Ravikumar

    2012-01-01

    Inferior hip dislocation is the rarest type among all hip dislocations.Very few cases have been reported in the English literature.Most of the earlier reported cases involves the pediatric age group.No single case series could be found in the English literature.We came across 4 cases of inferior hip dislocation with a varied age profile (range 10 to 56 years,mean 33.8 years).Patients with this disease usually complained of pain and kept the thigh flexed and abducted.The diagnosis can be confirmed by radiographs which reveal that the long axis of the femur varies in alignment with respect to the spine from parallel to an angle almost 90° away from the axis.In our series,closed reduction was successful in all patients,either under sedation or general anaesthesia.Skin traction for a period of 6 weeks was applied in all of them and follow-up revealed pain-free,stable and mobile hips.In this study we present the details of these cases along with a review of literature discussing the various modes and mechanisms that produce inferior hip dislocation.

  14. Pleomorphic xanthoastrocytoma: magnetic resonance imaging findings in a series of cases with histopathological confirmation

    Directory of Open Access Journals (Sweden)

    Vinícius Trindade Gonçalves

    2013-01-01

    Full Text Available Pleomorphic xanthoastrocytoma (PXA is a rare glioma. This paper aimed to analyze magnetic resonance imaging (MRI characteristics in a series of patients diagnosed with PXA. We analyzed MRI findings in 9 patients with histopathologic diagnosis of PXA in our department over the last 12 years. The mean age of patients was 27.3 years. Cortical location was observed in all cases. The lesion imaging was solid-cystic in six cases. In eight cases, the solid component presented hypo or isointense on T1 and iso or hyperintense on T2. Contrast enhancement in the solid component was observed in eight cases. The observed imaging pattern of PXA was superficial location with leptomeningeal involvement, solid-cystic pattern and contrast enhancement in the solid component. We should consider that the association between PXA and other cortical tumors may occur, particularly, with gangliogliomas, which tend to be the main differential diagnosis in MRI.

  15. Treatment of Klebsiella Pneumoniae Carbapenemase (KPC infections: a review of published case series and case reports

    Directory of Open Access Journals (Sweden)

    Lee Grace C

    2012-12-01

    Full Text Available Abstract The emergence of Klebsiella pneumoniae carbapenemases (KPCs producing bacteria has become a significant global public health challenge while the optimal treatment remains undefined. We performed a systematic review of published studies and reports of treatment outcomes of KPC infections using MEDLINE (2001–2011. Articles or cases were excluded if one of the following was fulfilled: no individual patient data provided, no treatment regimen specified, no treatment outcome specified, report of colonization, or greater than three antibiotics were used to treat the KPC infection. Data extracted included patient demographics, site of infection, organism, KPC subtype, antimicrobial therapy directed at KPC-infection, and treatment outcome. Statistical analysis was performed in an exploratory manner. A total of 38 articles comprising 105 cases were included in the analysis. The majority of infections were due to K. pneumoniae (89%. The most common site of infection was blood (52%, followed by respiratory (30%, and urine (10%. Forty-nine (47% cases received monotherapy and 56 (53% cases received combination therapy directed at the KPC-infection. Significantly more treatment failures were seen in cases that received monotherapy compared to cases who received combination therapy (49% vs 25%; p= 0.01. Respiratory infections were associated with higher rates of treatment failure with monotherapy compared to combination therapy (67% vs 29% p= 0.03. Polymyxin monotherapy was associated with higher treatment failure rates compared to polymyxin-based combination therapy (73% vs 29%; p= 0.02; similarly, higher treatment failure rates were seen with carbapenem monotherapy compared to carbapenem-based combination therapy (60% vs 26%; p= 0.03. Overall treatment failure rates were not significantly different in the three most common antibiotic-class combinations: polymyxin plus carbapenem, polymyxin plus tigecycline, polymyxin plus aminoglycoside (30%, 29

  16. Rare case of congenital anomaly in two different gestational ages: a case series

    Directory of Open Access Journals (Sweden)

    Lopamudra B. John

    2013-04-01

    Full Text Available Acrania is a rare congenital anomaly involving faulty development of membranous flat bones of neurocalvarium. Commonest differential diagnosis is anencephaly. The first case was diagnosed in a second gravida at 13 weeks and terminated by vaginal misoprostol instillation. The second case was diagnosed only by scan at 32 weeks in an unbooked second gravida with previous LSCS. She underwent emergency LSCS for failed induction and a fresh stillborn baby of 1.9 kg was born. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 240-241

  17. Modelling and forecasting Australian domestic tourism

    OpenAIRE

    George Athanasopoulos; Rob J Hyndman

    2006-01-01

    In this paper, we model and forecast Australian domestic tourism demand. We use a regression framework to estimate important economic relationships for domestic tourism demand. We also identify the impact of world events such as the 2000 Sydney Olympics and the 2002 Bali bombings on Australian domestic tourism. To explore the time series nature of the data, we use innovation state space models to forecast the domestic tourism demand. Combining these two frameworks, we build innovation state s...

  18. Paracetamol serum concentrations in preterm infants treated with paracetamol intravenously: a case series

    Directory of Open Access Journals (Sweden)

    van Ganzewinkel Christ-jan JLM

    2012-01-01

    Full Text Available Abstract Introduction Until now, studies on paracetamol given intravenously have mainly been performed with the pro-drug propacetamol or with paracetamol in preterm babies above 32 weeks of gestation. Studies in these babies indicate that intravenous paracetamol is tolerated well, however studies on the efficacy of intravenous paracetamol are lacking. There are no pharmacokinetic data on the administration of multiple doses of paracetamol in preterm babies with a gestational age below 32 weeks. Case presentation We present a case series of nine Caucasian preterm babies, six boys and three girls, with a mean gestational age of 28.6 weeks (range 25.9 to 31.6 weeks. Case one, a girl with a gestational age of 25 weeks and six days, presented with necrotizing enterocolitis. In the second case, a female baby with a gestational age of 26 weeks and two days presented with hematoma. In case three, a female baby with a gestation of 26 weeks and one day developed intraventricular hemorrhage. In case four, a male baby with a gestational age of 31 weeks and four days presented with pain after vacuum delivery. Case five, a female baby born after a gestation of 29 weeks and six days presented with hematoma. In case six, a male baby with a gestation of 30 weeks and six days presented with hematoma. In case seven, a male baby, born with a gestational age of 30 weeks and six days, presented with caput succedaneum and hematoma. In case eight, a male baby, born after a gestation of 28 weeks and four days, developed abdominal distention. Case nine, a female baby, born with a gestational age of 27 weeks and three days presented with hematoma. These babies were treated with intravenous paracetamol 15 mg/kg every six hours. Serum concentrations and aspartate transaminase were determined after prolonged administration. Pain scores were assessed using the Premature Infant Pain Profile. Conclusion Paracetamol serum concentrations ranged from 8 to 64 mg/L after eight to 12

  19. Conservative Nonsurgical Treatment of Class 4 Invasive Cervical Resorption: A Case Series.

    Science.gov (United States)

    Salzano, Stefano; Tirone, Federico

    2015-11-01

    External cervical resorption, also called invasive cervical resorption (ICR), is a pathological process difficult to diagnose that causes a progressive replacement of dentin by granulation tissue and results in complete tooth destruction. According to the literature, class 4 ICR can be expected to have success rates of 12.5% if treated. In this case series, we show nonsurgical conservative treatment of 4 patients affected by class 4 ICR. In 4 patients affected by class 4 ICRs, granulomatous tissue was orthograde removed with the help of an operating microscope and cone-beam computed tomographic imaging. The teeth were devitalized, the granulomatous tissue was mechanically removed, and the defects were filled with either mineral trioxide aggregate or Biodentine (Septodont, Saint-Maur-des-Fossés, France). After a follow-up period varying from 18 months for case 1 to 4 months for case 4, neither signs of periradicular bone rarefaction nor recurrence of resorption were observed. The teeth were asymptomatic, and conservative restorations appeared to be in excellent condition. Given the results achieved in this case series, it may be assumed that many class 4 ICRs could be successfully treated with the help of an operating microscope and cone-beam computed tomographic imaging. PMID:26395913

  20. Diagnostic role of magnetic resonance angiography in Swyer James syndrome: Case series of two cases

    OpenAIRE

    Parashari Umesh; Singh Ragini; Parihar Anit; Aga Pallavi; Yadav Rajesh

    2010-01-01

    Swyer James syndrome is a rare syndrome which occurs due to viral illness in early childhood. The post infective obliterative bronchiolitis results in arrest of lung growth and alveolarization with reduced vascularity resulting in classical radiological features. We describe two cases of patients fulfilling all the criteria of the syndrome - 1) Unilateral hyperlucent small lung in chest radiograph with air trapping on expiration, small ipsilateral hila and pulmonary artery. 2) Diffuse decreas...

  1. Measles outbreak in South of iran, where vaccine coverage was high: a case-series study.

    Directory of Open Access Journals (Sweden)

    Mohsen Moghadam

    2014-03-01

    Full Text Available Measles is a highly contagious viral disease that remains an important cause of mortality among children despite the availability of a safe and effective vaccine around the world. We aimed this study to show a measles out-break occurring.In early 2012, a report of measles outbreak was recorded on center for disease control (CDC of Fars province, south of Iran. With this case-series study, characteristics of cases and network transition model were described.The primary case was an Afghan refugee who is likely to carry the measles virus from its country or from anywhere in Iran to Koordeh, a small village in south of Iran. Followed by the Afghan case, 6 secondary and tertiary cases including rural health worker, were occurred. Except a case of 35 year old, in which her vaccination status was unknown, all cases has had adherence to vaccination protocol.More immunologic and vaccine quality investigations are needed to find the main cause of the outbreak. Nonetheless, due to the warm weather, probable bad temperature management of cold chain and technical problem in vaccination are the main suspicious reasons of the outbreak.

  2. Pandemic influenza A (H1N1) 2009 with neurological manifestations, a case series

    Science.gov (United States)

    Noriega, Luis Miguel; Verdugo, Renato J.; Araos, Rafael; Munita, José Manuel; Díaz, Violeta; Marcotti, Alejandra; Perez, Jorge; Gonzalez, Patricia; Thompson, Luis; Canals, Magdalena; Hoppe, Arnold; Mounts, Anthony W.; Vial, Pablo A.

    2010-01-01

    Please cite this paper as: Noriega et al. (2010) Pandemic influenza a (H1N1) 2009 with neurological manifestations, a case series. Influenza and Other Respiratory Viruses 4(3), 117–120. Objectives  Describe a series of atypical presentations of pandemic influenza A (H1N1) 2009. Methods  Description of case series using hospital records. Results  Six patients aged 1 to 65 years with confirmed pandemic influenza A (H1N1) 2009 infection presented with neurological complications within 2 to 5 days after the first signs of influenza‐like illness. All six were admitted with seizures or altered mental status. No abnormalities were found in brain scans or cerebral spinal fluid studies of any of the six. All were discharged without sequelae within days of admission. Conclusions  This is only the second report of pandemic influenza presenting with neurological manifestations. Clinicians caring for patients when pandemic influenza is prevalent in their communities should maintain a high level of awareness of the potential atypical presentations with which this disease can appear. PMID:20409207

  3. Ganglion cysts at the gastrocnemius origin: a series of ten cases

    International Nuclear Information System (INIS)

    To describe ganglion cysts arising close to the origin of the medial and lateral head of gastrocnemius as identified on magnetic resonance (MR) imaging. We present a series of ten cases of ganglion cysts arising close to the gastrocnemius origin from the medial and lateral femoral condyles. These were collected over a 6-year period from our imaging database. All patients attended for routine MR imaging of the knee with a variety of clinical presentations. Data collected included patient demographics, ganglion size, ganglion site, clinical presentation and ancillary MR imaging findings. The ten patients in this series consisted of seven males and three females, five right and five left knees, age range 27-68 years, mean age 40.6 years. The mean maximal dimension of the ganglion cysts was 26 mm, range 15-40 mm. The medial gastrocnemius origin was involved in eight patients and the lateral origin in two patients. The MR imaging findings consisted of both uni- and multi-loculated cysts, often containing numerous septations with fluid signal characteristics. The cysts were extra-capsular with no clear communication with the joint. One patient presented with a popliteal soft tissue mass and none of the cases required surgical intervention for cyst removal. MR imaging may identify ganglion cysts arising in an intra- or extra-articular site around the knee. This series documents the MR imaging characteristics of ganglion cysts arising close to the gastrocnemius origin and discusses the relevance of this imaging finding. (orig.)

  4. Ganglion cysts at the gastrocnemius origin: a series of ten cases

    Energy Technology Data Exchange (ETDEWEB)

    James, S.L.J. [RNOH Stanmore, Department of Radiology, Middlesex (United Kingdom); Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Connell, D.A.; Saifuddin, A. [RNOH Stanmore, Department of Radiology, Middlesex (United Kingdom); Bell, J. [Kingston Hospital NHS Trust, Department of Orthopaedic Surgery, Surrey (United Kingdom)

    2007-02-15

    To describe ganglion cysts arising close to the origin of the medial and lateral head of gastrocnemius as identified on magnetic resonance (MR) imaging. We present a series of ten cases of ganglion cysts arising close to the gastrocnemius origin from the medial and lateral femoral condyles. These were collected over a 6-year period from our imaging database. All patients attended for routine MR imaging of the knee with a variety of clinical presentations. Data collected included patient demographics, ganglion size, ganglion site, clinical presentation and ancillary MR imaging findings. The ten patients in this series consisted of seven males and three females, five right and five left knees, age range 27-68 years, mean age 40.6 years. The mean maximal dimension of the ganglion cysts was 26 mm, range 15-40 mm. The medial gastrocnemius origin was involved in eight patients and the lateral origin in two patients. The MR imaging findings consisted of both uni- and multi-loculated cysts, often containing numerous septations with fluid signal characteristics. The cysts were extra-capsular with no clear communication with the joint. One patient presented with a popliteal soft tissue mass and none of the cases required surgical intervention for cyst removal. MR imaging may identify ganglion cysts arising in an intra- or extra-articular site around the knee. This series documents the MR imaging characteristics of ganglion cysts arising close to the gastrocnemius origin and discusses the relevance of this imaging finding. (orig.)

  5. Using Web 2.0 Technologies for Collaborative Learning in Distance Education—Case Studies from an  Australian University

    Directory of Open Access Journals (Sweden)

    David Lloyd

    2012-03-01

    Full Text Available This paper explores the use of Web 2.0 technologies for collaborative learning in a higher education context. A review of the literature exploring the strengths and weaknesses of Web 2.0 technology is presented, and a conceptual model of a Web 2.0 community of inquiry is introduced. Two Australian case studies are described, with an ex-poste evaluation of the use of Web 2.0 tools. Conclusions are drawn as to the potential for the use of Web 2.0 tools for collaborative e-learning in higher education. In particular, design and integration of Web 2.0 tools should be closely related to curriculum intent and pedagogical requirements, care must be taken to provide clear guidance on both expected student activity and learning expectations, and there is a clear need to develop, support and encourage strong interaction both between teachers and students, and amongst the students themselves.

  6. Upper airway alterations/abnormalities in a case series of obstructive sleep apnea patients identified with cone-beam CT

    International Nuclear Information System (INIS)

    There are many factors that influence the configuration of the upper airway and may contribute to the development of obstructive sleep apnea (OSA). This paper presents a series of 12 consecutive OSA cases where various upper airway alteration/abnormalities were identified using 3D anatomic reconstructions generated from cone-beam CT (CBCT) images. Some cases exhibited more than one type of abnormality and below we describe each of the six types identified with CBCT in this case series. (orig.)

  7. Upper airway alterations/abnormalities in a case series of obstructive sleep apnea patients identified with cone-beam CT

    Energy Technology Data Exchange (ETDEWEB)

    Shigeta, Y.; Shintaku, W.H.; Clark, G.T. [Orofacial Pain/Oral Medicine Center, Div. of Diagnostic Sciences, School of Dentistry, Univ. of Southern California, Los Angeles, CA (United States); Enciso, R. [Div. of Craniofacial Sciences and Therapeutics, School of Dentistry, Univ. of Southern California, Los Angeles, CA (United States); Ogawa, T. [Dept. of Fixed Prosthodontic Dentistry, Tsurumi Univ., School of Dental Medicine, Tsurumi (Japan)

    2007-06-15

    There are many factors that influence the configuration of the upper airway and may contribute to the development of obstructive sleep apnea (OSA). This paper presents a series of 12 consecutive OSA cases where various upper airway alteration/abnormalities were identified using 3D anatomic reconstructions generated from cone-beam CT (CBCT) images. Some cases exhibited more than one type of abnormality and below we describe each of the six types identified with CBCT in this case series. (orig.)

  8. Direct Cranial Nerve Involvement by Gliomas: Case Series and Review of the Literature.

    Science.gov (United States)

    Mabray, M C; Glastonbury, C M; Mamlouk, M D; Punch, G E; Solomon, D A; Cha, S

    2015-07-01

    Malignant gliomas are characterized by infiltrative growth of tumor cells, including along white matter tracts. This may result in clinical cranial neuropathy due to direct involvement of a cranial nerve rather than by leptomeningeal spread along cranial nerves. Gliomas directly involving cranial nerves III-XII are rare, with only 11 cases reported in the literature before 2014, including 8 with imaging. We present 8 additional cases demonstrating direct infiltration of a cranial nerve by a glioma. Asymmetric cisternal nerve expansion compared with the contralateral nerve was noted with a mean length of involvement of 9.4 mm. Based on our case series, the key imaging feature for recognizing direct cranial nerve involvement by a glioma is the detection of an intra-axial mass in the pons or midbrain that is directly associated with expansion, signal abnormality, and/or enhancement of the adjacent cranial nerves. PMID:25857757

  9. Cogan's Syndrome in Patients With Inflammatory Bowel Disease - A Case Series

    DEFF Research Database (Denmark)

    Vavricka, Stephan R; Greuter, Thomas; Scharl, Michael; Mantzaris, Gerassimos; Shitrit, Ariella B; Filip, Rafal; Karmiris, Konstantinos; Thoeringer, Christoph K; Boldys, Hubert; Wewer, Anne V; Yanai, Henit; Flores, Cristina; Schmidt, Carsten; Kariv, Revital; Rogler, Gerhard; Rahier, Jean-François

    2015-01-01

    BACKGROUND: Cogan's syndrome (CSy) is a very rare autoimmune disorder, mainly affecting the inner ear and the eye, and is associated with inflammatory bowel disease (IBD). METHODS: This was a European Crohn's and Colitis Organisation (ECCO) retrospective observational study, performed as part of...... the CONFER project. A call to all ECCO members was made to report concomitant CSy and inflammatory bowel disease (IBD) cases. Clinical data were recorded in a standardized questionnaire. RESULTS: This international case series reports on 22 concomitant CSy-IBD cases from 14 large medical centres. Mean...... duration of IBD until diagnosis of CSy was 8.7 years (range 0.0-38.0) and mean age at CSy diagnosis was 44.6 years (range 9.0-67.0). Six patients had underlying ulcerative colitis (UC) and 16 had Crohn's disease. Eleven patients (50%) had active disease at CSy diagnosis. Sixteen patients were under IBD...

  10. POSTMENOPAUSAL BLEEDING: HISTOPATHOLOGICAL SPECTRUM AND ASSOCIATION WITH AGE AND CLEAR SPAN: CASE SERIES OF 328 CASES

    Directory of Open Access Journals (Sweden)

    Ruchita

    2014-06-01

    Full Text Available : Introduction: Postmenopausal bleeding is defined as vaginal bleeding occurring after twelve months of amenorrhea in a woman of the age where the menopause can be expected. With increase in life expectancy, a larger proportion of female population will be in postmenopausal age group; hence, the incidence of postmenopausal bleeding is expected to increase. AIM: We studied the prevalence of malignancy as well as the histopathological spectrum of genital tract lesions in cases of postmenopausal bleeding. The association between age, period between cessation of menses and onset of bleeding per vaginum (clear span was also studied. RESULTS: Malignant causes were more common (58.5% than benign causes and included cervical carcinoma, malignant uterine tumors (13.1%, carcinoma vagina (4.3%, malignant ovarian tumors (5.5%, carcinoma vulva (0.9% and carcinoma fallopian tube (0.3%. Squamous cell carcinoma was the commonest among cervical malignancies. The benign causes included polyps (16.5%, endometrial hyperplasia (4.9%, adenomyosis (2.7%, atrophic endometrium (2.4%, cervicitis (2.1%, leiomyoma (1.8%, proliferative endometrium (1.5%, endometritis (1.5%, secretory endometrium (1.2%, retained IUCD (0.9% and uterovaginal prolapse (0.6%. The likelihood of malignancy increased significantly with advancing age (p-value 0.042. The clear span of cases with malignant tumors was significantly longer than the clear span of cases with benign lesions. Hence, the likelihood of malignancy increased with length of clear span (p-value 0.00809. CONCLUSION: Any postmenopausal patient with vaginal bleeding needs to be investigated thoroughly to determine the cause of the bleeding and should be considered to have abnormal histopathology until proved otherwise

  11. Hypnosis delivered through immersive virtual reality for burn pain: A clinical case series.

    Science.gov (United States)

    Patterson, David R; Wiechman, Shelley A; Jensen, Mark; Sharar, Sam R

    2006-04-01

    This study is the first to use virtual-reality technology on a series of clinical patients to make hypnotic analgesia less effortful for patients and to increase the efficiency of hypnosis by eliminating the need for the presence of a trained clinician. This technologically based hypnotic induction was used to deliver hypnotic analgesia to burn-injury patients undergoing painful wound-care procedures. Pre- and postprocedure measures were collected on 13 patients with burn injuries across 3 days. In an uncontrolled series of cases, there was a decrease in reported pain and anxiety, and the need for opioid medication was cut in half. The results support additional research on the utility and efficacy of hypnotic analgesia provided by virtual reality hypnosis. PMID:16581687

  12. Acquired Factor XIII Inhibitor in Hospitalized and Perioperative Patients: A Systematic Review of Case Reports and Case Series.

    Science.gov (United States)

    Tone, Kira J; James, Tyler E; Fergusson, Dean A; Tinmouth, Alan; Tay, Jason; Avey, Marc T; Kilty, Shaun; Lalu, Manoj M

    2016-07-01

    Factor XIII (FXIII) cross-links fibrin monomers to support clot stabilization and wound healing. Acquired FXIII deficiency is caused by autoantibodies that inhibit FXIII and can result in bleeding despite normal routine coagulation test results. Given the rarity of this disease, large clinical studies are not feasible. We therefore conducted a systematic review of case reports and case series of acquired FXIII inhibitor to evaluate potential management and treatment strategies for acquired FXIII inhibitor in hospitalized and/or perioperative patients. A systematic search of MEDLINE, Embase, and Web of Science identified reports of hospitalized and perioperative patients with acquired FXIII deficiency. No restrictions were placed on language or publication type. Article screening and data extraction were performed independently by 2 abstractors. Completeness of reporting was evaluated according to modified elements from the CAse REport (CARE) guidelines. A total of 1028 citations were reviewed, with 36 case reports and 3 case series meeting eligibility criteria (63 patients total). The mean age was 60 (range, 9-87) years with balanced sex representation. At presentation, 48 patients (76%) had intramuscular or subcutaneous bleeding, and 34 patients (54%) had external or surgical bleeding. All cases were diagnosed by initially detecting a FXIII deficiency and then identifying the inhibitor. Clinical improvement in bleeding was seen in patients receiving FXIII concentrate (13/17 patients), cryoprecipitate (5/8), and plasma (10/18). Inhibitor reduction was seen in patients who received rituximab (6/6 patients), plasma exchange (2/2), intravenous immunoglobulin (4/5), steroid (15/20), and cyclophosphamide (10/15). Concurrent initiation of multiple therapies and obvious lack of control comparisons made direct association to outcomes difficult to establish. Outcomes were reported for 55 patients, with 25 patients (45%) having complete inhibitor eradication and 15 patients

  13. Molecular phylogenetics of the Anolis onca series: a case history in retrograde evolution revisited.

    Science.gov (United States)

    Nicholson, Kirsten E; Mijares-Urrutia, Abraham; Larson, Allan

    2006-09-15

    Anoles of the Anolis onca series represent a dramatic case of retrograde evolution, exhibiting great reduction (A. annectens) and loss (A. onca) of the subdigital pads considered a key innovation for the evolutionary radiation of anoles in arboreal environments. We present a molecular phylogenetic analysis of these anoles and their closest known relatives (A. auratus, A. lineatus, A. meridionalis, and A. nitens) using new mitochondrial DNA sequence data from the ND2 gene, five tRNA genes (tRNA(Trp), tRNA(Ala), tRNA(Asn), tRNA(Cys), tRNA(Tyr)), the origin of light-strand replication, and a portion of the CO1 gene (1,446 aligned base positions, 612 parsimony informative). Our results confirm monophyly of the A. onca series and suggest an evolutionary separation of approximately 10 million years between A. annectens and A. onca. Evolution of subdigital structure in this series illustrates ectopic expression of developmental programs that replace flexible subdigital lamellae of the toepad with rigid, keeled scales resembling dorsal digital scales. Our phylogenetic results indicate that narrowing of the toepad in A. auratus evolved separately from toepad reduction in the A. onca series. Expansion of the subdigital lamellae along the phalanges in A. auratus appears to compensate constriction of lamellae by digital narrowing, maintaining greater climbing capability in this species. Toepad evolution in the lineage ancestral to A. auratus features changes of the same developmental modules as the A. onca series but in the opposite direction. Large molecular distances between geographic populations of A. auratus indicate that its derived toepad structure is at least 9 million years old. PMID:16506231

  14. Greenhouse gas network design using backward Lagrangian particle dispersion modelling − Part 1: Methodology and Australian test case

    Directory of Open Access Journals (Sweden)

    T. Ziehn

    2014-09-01

    Full Text Available This paper describes the generation of optimal atmospheric measurement networks for determining carbon dioxide fluxes over Australia using inverse methods. A Lagrangian particle dispersion model is used in reverse mode together with a Bayesian inverse modelling framework to calculate the relationship between weekly surface fluxes, comprising contributions from the biosphere and fossil fuel combustion, and hourly concentration observations for the Australian continent. Meteorological driving fields are provided by the regional version of the Australian Community Climate and Earth System Simulator (ACCESS at 12 km resolution at an hourly timescale. Prior uncertainties are derived on a weekly timescale for biosphere fluxes and fossil fuel emissions from high-resolution model runs using the Community Atmosphere Biosphere Land Exchange (CABLE model and the Fossil Fuel Data Assimilation System (FFDAS respectively. The influence from outside the modelled domain is investigated, but proves to be negligible for the network design. Existing ground-based measurement stations in Australia are assessed in terms of their ability to constrain local flux estimates from the land. We find that the six stations that are currently operational are already able to reduce the uncertainties on surface flux estimates by about 30%. A candidate list of 59 stations is generated based on logistic constraints and an incremental optimisation scheme is used to extend the network of existing stations. In order to achieve an uncertainty reduction of about 50%, we need to double the number of measurement stations in Australia. Assuming equal data uncertainties for all sites, new stations would be mainly located in the northern and eastern part of the continent.

  15. Searching for public benefits in solar subsidies: A case study on the Australian government's residential photovoltaic rebate program

    International Nuclear Information System (INIS)

    The Australian Government ran a renewable energy program in the 2000s that provided rebates to householders who acquired solar Photovoltaic (PV) energy systems. Originally called the Photovoltaic Rebate Program (PVRP), it was rebranded the Solar Homes and Communities Plan (SHCP) in November 2007. This paper evaluates both the PVRP and SHCP using measures of cost-effectiveness and fairness. It finds that the program was a major driver of a more than six-fold increase in PV generation capacity in the 2000s, albeit off a low base. In 2010, solar PV's share of the Australian electricity market was still only 0.1%. The program was also environmentally ineffective and costly, reducing emissions by 0.09 MtCO2-e/yr over the life of the rebated PV systems at an average cost of between AU$238 and AU$282/tCO2-e. In addition, the data suggest there were equity issues associated with the program, with 66% of all successful applicants residing in postal areas that were rated as medium-high or high on a Socio-economic Status (SES) scale. - Research highlights: → We evaluated a solar photovoltaic (PV) rebate program. → The program was ineffective, reducing emissions by 0.09 MtCO2-e/yr. → The average abatement cost was ∼AU$250/tCO2-e. → The program had a relatively minor impact as an industry assistance measure. → The distribution of rebates was skewed toward higher SES areas.

  16. Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

    Directory of Open Access Journals (Sweden)

    Regina Helena Garcia Martins

    2014-12-01

    Full Text Available Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations. Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. Results: 28 patients (26 women and 2 men were assessed. Their occupations included: housekeeper (n = 17, teacher (n = 4, salesclerk (n = 4, nurse (n = 1, retired (n = 1, and psychologist (n = 1. Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed.

  17. Diagnostic role of magnetic resonance angiography in Swyer James syndrome: Case series of two cases

    Directory of Open Access Journals (Sweden)

    Parashari Umesh

    2010-01-01

    Full Text Available Swyer James syndrome is a rare syndrome which occurs due to viral illness in early childhood. The post infective obliterative bronchiolitis results in arrest of lung growth and alveolarization with reduced vascularity resulting in classical radiological features. We describe two cases of patients fulfilling all the criteria of the syndrome - 1 Unilateral hyperlucent small lung in chest radiograph with air trapping on expiration, small ipsilateral hila and pulmonary artery. 2 Diffuse decrease in attenuation of lung parenchyma with bronchiectasis and reduction in vascularity. 3 Unilateral pruned tree appearance on angiography (MRA. The clinical presentation was recurrent chest infection in a child and infrequent bouts of hemoptysis in a middle aged female. The study demonstrates the role of magnetic resonance angiography in diagnosing the condition.

  18. Child Maltreatment: Types and effects: Series of six cases from a university hospital in Oman

    OpenAIRE

    Muna Al-Saadoon; Marwan Al-Sharbati; Ibtisam El Nour; Basma Al-Said

    2012-01-01

    Child maltreatment (CM) is common worldwide, and can take many forms. It may even endanger the child’s life, especially when younger children are the victims. CM affects the child’s quality of life and consequently leads to long term issues to be dealt with by the child, family and community. This case series discusses six children who have been subjected to CM, and diagnosed by the child protection team of the departments of Child Health and Behavioural Medicine at Sultan Qaboos University H...

  19. IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME IN NON HIV CHILDREN ON ANTI TUBERCULAR TREATMENT : A CASE SERIES

    Directory of Open Access Journals (Sweden)

    Archana

    2015-07-01

    Full Text Available Immune reconstitution inflammatory syndrome (IRIS in a patient on anti - tubercular treatment (ATT in the setting of antiretroviral therapy (ART is well described, but it is not as common in non - HIV patients . Distinguishing this paradoxical reaction (PR from disease progression or treatment failure is an important issue in CNS tuberculosis management . Thus one must keep a watch for neurological deterioration in a child with CNS TB. We are presenting a case series of three non HIV children who developed TB - IRIS while on anti - tubercular drugs, who subsequently responded to steroids along with continuation of ATT.

  20. Glycation and oxidative stress in the failure of dental implants: a case series

    OpenAIRE

    Pietropaoli, Davide; Ortu, Eleonora; Severino, Marco; Ciarrocchi, Irma; Gatto, Roberto; Monaco, Annalisa

    2013-01-01

    Background The aim of this case series/control study is to investigate the presence of the Advanced Glycation End products (AGEs) and oxidative stress in periimplantitis. The study group was composed of five dental implants, failed within 6 months after implantation, taken from 5 subjects (3 M/2 F) aged between 43–57 years and stored in isotonic liquid before freezing at -80°C, according to literature. All the implants had been placed using traditional submerged technique. The whole saliva wa...

  1. Time Series Analysis of Wheat flour Price Shocks in Pakistan: A Case Analysis

    Directory of Open Access Journals (Sweden)

    Asad Raza Abdi

    2013-10-01

    Full Text Available The current research investigates the wheat flour Price Shocks in Pakistan: A case analysis. Data was collected by using secondary sources by using Time series Analysis, and data were analyzed by using SPSS-20 version. It was revealed that the price of wheat flour increases from last four decades, and trend of price shocks shows that due to certain market variation and supply and demand shocks also play a positive relationship in price shocks in the wheat prices. It was further revealed that Government should take certain measures to Stable prices of wheat in Pakistan.

  2. Home IV Antibiotic Therapy and Exercise Capacity in Children with CF: A Case Series

    OpenAIRE

    Cox, Narelle S.; McKay, Karen O.; Follett, Jennifer M.; Alison, Jennifer A

    2011-01-01

    Purpose: This case series describes the effect of home intravenous (IV) antibiotic therapy on spirometry and exercise capacity in a group of children with cystic fibrosis (CF). Methods: Outcomes from 10 children with CF who were prescribed a 14-day course of home IV antibiotics for a respiratory exacerbation are reported. All children performed spirometry and a modified shuttle test (MST) before and after 14-days of home IV therapy. Results: After 14 days, FEV1 increased by mean (± SE) 12 ± 4...

  3. 120 Cases of Shoulder Dislocation referred to Emergency Department during One Year; a Case Series Study

    Directory of Open Access Journals (Sweden)

    Payman Asadi

    2015-05-01

    Full Text Available Shoulder dislocation is identified as displacement of humerus head from the glenoid cavity of scapula bone, which makes up about 50% of total joint dislocations. Taking into account the importance of the side effects and disabilities caused by this type of dislocation and that it can be prevented, the present study was designed aiming to evaluate the epidemiologic characteristics of the patients with shoulder dislocation. In this retrospective cross-sectional study, all the patients referred to the emergency department (ED with complaint of shoulder dislocation throughout one year were evaluated. Demographic data and characteristics regarding the type of dislocation, presence of accompanying fractures, mechanism of dislocation, history of dislocation and the method of reduction were extracted from the patients’ profiles and recorded in a checklist designed for this purpose. Data were then statistically analyzed using SPSS version 19. Statistics showed that 120 patients with the mean age of 39.3 ± 21.2 years had been admitted to ED of the studied center in one year (79.2% male. The most common type of dislocation was anterior dislocation (95.8% and in the right shoulder (52.5% and the most common cause was falling on open arm (34.2%. Reduction method was non-operative in 93.3% of the cases and surgery in 6.7%. Based on the results of this study, in the studied population, most patients with shoulder dislocation were young men who had an anterior dislocation in their right shoulder because of falling on out stretched hand and treated with close reduction.

  4. Epilepsy and violence: case series concerning physical trauma in children of persons with epilepsy

    Directory of Open Access Journals (Sweden)

    Gauffin H

    2014-11-01

    Full Text Available Helena Gauffin1,2 Anne-Marie Landtblom1–4 1Department of Neurology, Linköping University, Linköping, Sweden; 2Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; 3Neurology Unit, Department of Medical Specialist, General Hospital, Department of Medicine and Health Sciences, IMM, County Council, Linköping University, Motala, Sweden; 4Department of Neuroscience, Uppsala University, Uppsala, Sweden Abstract: Historically, epilepsy has been associated with violence, but more recent studies have emphasized genetic and psychosocial factors as more important. The case series presented here aim to highlight the difficult situation the affected children are in. We report on three cases when children have been traumatized and, in one case, even been killed by their parent who was diagnosed with epilepsy. In the first case, we describe a woman with juvenile myoclonic epilepsy who was sentenced to forensic psychiatry care for killing her child. She lived under difficult psychosocial circumstances and a suicide attempt contributed to what happened. The second case describes a man with post-traumatic seizures who was sentenced for child abuse. Ictal or postictal violence was considered in these two cases but a causal link between the violence and epilepsy has not been established. In the third case, we describe a woman with focal epilepsy and psychogenic non-epileptic seizures (PNESs. Her child was hurt and frightened in relation to violent seizures, which were regarded as PNESs. This case series demonstrates that children of parents with epilepsy can be in a vulnerable situation. No causality has been established between the seizures and these events, so consequently other factors such as psychosocial stress, low cognitive function, and a suicide attempt must also be considered as important. When a child is hurt by a parent with epilepsy the patient must be closely examined to determine the role of the seizures

  5. Ultrasound of the sural nerve: Normal anatomy on cadaveric dissection and case series

    International Nuclear Information System (INIS)

    The sural nerve is a small sensory nerve innervating the lateral aspect of the ankle and foot. Clinical symptoms of pathology may present as atypical sensory changes in this region. We present the normal anatomy and ultrasound technique for examination of the sural nerve based on an anatomical dissection, as well as imaging in a normal volunteer. We also present a case series (n = 10) of different conditions of the sural nerve that we encountered based on a review of interesting cases from 4 institutions. The pathological conditions included neuropathy related to stripping or venous laser surgery, compression by abscess, Lyme disease, nerve tumors, traumatic transsection, and encasement by fibrous plaque and edema. Ultrasound with its exquisite resolution is the preferred imaging method for examining the sural nerve in patients with unexplained sensory changes at the lateral aspect of the ankle and foot

  6. Iniencephaly: Radiological and pathological features of a series of three cases

    Directory of Open Access Journals (Sweden)

    Panduranga Chikkannaiah

    2014-01-01

    Full Text Available Iniencephaly is a rare form of neural tube defect with an incidence of 0.1-10 in 10,000 pregnancies. It is characterized by the presence of occipital bone defects at foramen magnum, fixed retroflexion of head, spinal dysmorphism, and lordosis of cervicothoracic vertebrae. It is usually associated with central nervous system, gastrointestinal, and cardiovascular anomalies. We present radiological and autopsy findings in a series of 3 cases of iniencephaly (gestational ages 29.3, 23, and 24 weeks first fetus in addition showed omphalocele, pulmonary hypoplasia, two lobes in right lung, accessory spleen, atrial septal defect, bilateral clubfoot, ambiguous genitalia, and single umbilical artery. Second fetus was a classical case of iniencephaly apertus with spina bifida. Third fetus had colpocephaly and bifid spine.

  7. The Emergence of Zoonotic Onchocerca lupi Infection in the United States--A Case-Series.

    Science.gov (United States)

    Cantey, Paul T; Weeks, Jessica; Edwards, Morven; Rao, Suchitra; Ostovar, G Amin; Dehority, Walter; Alzona, Maria; Swoboda, Sara; Christiaens, Brooke; Ballan, Wassim; Hartley, John; Terranella, Andrew; Weatherhead, Jill; Dunn, James J; Marx, Douglas P; Hicks, M John; Rauch, Ronald A; Smith, Christiana; Dishop, Megan K; Handler, Michael H; Dudley, Roy W R; Chundu, Kote; Hobohm, Dan; Feiz-Erfan, Iman; Hakes, Joseph; Berry, Ryan S; Stepensaski, Shelly; Greenfield, Benjamin; Shroeder, Laura; Bishop, Henry; de Almeida, Marcos; Mathison, Blaine; Eberhard, Mark

    2016-03-15

    This case-series describes the 6 human infections with Onchocerca lupi, a parasite known to infect cats and dogs, that have been identified in the United States since 2013. Unlike cases reported outside the country, the American patients have not had subconjunctival nodules but have manifested more invasive disease (eg, spinal, orbital, and subdermal nodules). Diagnosis remains challenging in the absence of a serologic test. Treatment should be guided by what is done for Onchocerca volvulus as there are no data for O. lupi. Available evidence suggests that there may be transmission in southwestern United States, but the risk of transmission to humans is not known. Research is needed to better define the burden of disease in the United States and develop appropriately-targeted prevention strategies. PMID:26611778

  8. Subcutaneous intralesional Ksharodaka injection: A novel treatment for the management of Warts: A case series

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    Manohar S Gundeti

    2014-01-01

    Full Text Available Warts are generally managed using cryosurgery, keratolytic ointments, curettage and electrodessication. Warts, vis-a-vis Charmakila, in Ayurvedic classical texts are classified into different types depending on the dominance of dosha. Ayurveda prescribes oral medications, topical use of Kshara (alkaline ash of herbs, Agni (thermal cautery and Shastrakarma (surgery for removal of Charmakila. Use of topical Kshara in the form of powder, aqueous solution i.e. Ksharodaka and Ksharasutra (thread smeared with Kshara for warts has been reported. However, these methods necessitate multiple sittings and takea longer duration for removal of the warts. Herewith, we report a case series of different types of warts treated with intralesional infiltration of Apamarga Ksharodaka (AK, i.e. aqueous solution of Apamarga (Achyranthes aspera Kshara. We observed that all these warts took a minimum of 2-6 days to shed off, leaving minor scars. There were no adverse reactions reported in any of these cases.

  9. Ultrasound of the sural nerve: Normal anatomy on cadaveric dissection and case series

    Energy Technology Data Exchange (ETDEWEB)

    Belsack, Dries, E-mail: dries.belsack@uzbrussel.be [Department of Radiology, UZ Brussel, Laarbeeklaan 101, 1090 Jette, Brussels (Belgium); Jager, Tjeerd, E-mail: tjeerd.jager@asz.be [Department of Radiology, Aalsters Stedelijk Ziekenhuis, Merestraat 80, 9300 Aalst (Belgium); Scafoglieri, Aldo, E-mail: aldo.scafoglieri@vub.ac.be [Department of Experimental Anatomy, Free University Brussels, Laarbeeklaan 103, 1090 Jette (Belgium); Vanderdood, Kurt, E-mail: kvanderd@yahoo.com [Department of Radiology, Maaslandziekenhuis, Dr H van der Hoffplein 1, 6162 Sittard-Geleen, Sittard (Netherlands); Van Hedent, Eddy, E-mail: eddy.vanhedent@asz.be [Department of Radiology, Aalsters Stedelijk Ziekenhuis, Merestraat 80, 9300 Aalst (Belgium); Vanhoenacker, Filip, E-mail: filip.vanhoenacker@telenet.be [Department of Radiology, AZ Sint-Maarten, Duffel-Mechelen, Rooienberg 25, 2570 Duffel (Belgium); Marcelis, Stefaan, E-mail: stefaan.marcelis@sintandriesstielt.be [Department of Radiology, Sint Andriesziekenhuis, Krommewalstraat 11, 8700 Tielt (Belgium); De Maeseneer, Michel, E-mail: michel.demaeseneer@uzbrussel.be [Department of Radiology, UZ Brussel, Laarbeeklaan 101, 1090 Jette, Brussels (Belgium)

    2013-11-01

    The sural nerve is a small sensory nerve innervating the lateral aspect of the ankle and foot. Clinical symptoms of pathology may present as atypical sensory changes in this region. We present the normal anatomy and ultrasound technique for examination of the sural nerve based on an anatomical dissection, as well as imaging in a normal volunteer. We also present a case series (n = 10) of different conditions of the sural nerve that we encountered based on a review of interesting cases from 4 institutions. The pathological conditions included neuropathy related to stripping or venous laser surgery, compression by abscess, Lyme disease, nerve tumors, traumatic transsection, and encasement by fibrous plaque and edema. Ultrasound with its exquisite resolution is the preferred imaging method for examining the sural nerve in patients with unexplained sensory changes at the lateral aspect of the ankle and foot.

  10. Cranial nerve injuries with supraglottic airway devices: a systematic review of published case reports and series.

    Science.gov (United States)

    Thiruvenkatarajan, V; Van Wijk, R M; Rajbhoj, A

    2015-03-01

    Cranial nerve injuries are unusual complications of supraglottic airway use. Branches of the trigeminal, glossopharyngeal, vagus and the hypoglossal nerve may all be injured. We performed a systematic review of published case reports and case series of cranial nerve injury from the use of supraglottic airway devices. Lingual nerve injury was the most commonly reported (22 patients), followed by recurrent laryngeal (17 patients), hypoglossal (11 patients), glossopharyngeal (three patients), inferior alveolar (two patients) and infra-orbital (one patient). Injury is generally thought to result from pressure neuropraxia. Contributing factors may include: an inappropriate size or misplacement of the device; patient position; overinflation of the device cuff; and poor technique. Injuries other than to the recurrent laryngeal nerve are usually mild and self-limiting. Understanding the diverse presentation of cranial nerve injuries helps to distinguish them from other complications and assists in their management. PMID:25376257

  11. Invasive Cervical Resorption: A Case Series with 3-Year Follow-Up.

    Science.gov (United States)

    Lo Giudice, Giuseppe; Matarese, Giovanni; Lizio, Angelo; Lo Giudice, Roberto; Tumedei, Margherita; Zizzari, Vincenzo Luca; Tetè, Stefano

    2016-01-01

    Invasive cervical resorption (ICR) lesion is an aggressive form of tooth destruction that usually begins immediately below the epithelial attachment. It has been described as a purely inflammatory reaction that can be started by microorganism infection, or an aseptic resorptive process that can be secondarily infected. The potential etiologic and predisposing factors for ICR are orthodontic treatment, traumatic injuries, bleaching, periodontal therapy, and idiopathic factors. This case series with a 3-year follow-up shows that Class 2 ICR lesions have a good prognosis in 100% of cases. Class 3 ICR lesions should be considered at risk. However, in the authors' experience, the treatment of Class 3 ICR lesions is compatible with tooth maintenance. PMID:26697558

  12. Management of amlodipine-induced gingival enlargement: Series of three cases

    Directory of Open Access Journals (Sweden)

    Srivastava Amit

    2010-01-01

    Full Text Available Gingival enlargement is one of the side effects associated with certain drugs. Amlodipine, a calcium channel blocker, used as antihypertensive drug has been found associated with gingival hyperplasia. This case series presents diagnosis and management of amlodipine-induced gingival hyperplasia. Amlodipine-induced gingival enlargement was diagnosed and managed by thorough scaling and root planning. Drug substitution and surgical intervention was performed in first two cases. The pathogenesis of gingival enlargement is uncertain and the treatment is still largely limited to the maintenance of an improved level of oral hygiene and surgical removal of the overgrown tissue. Several factors may influence the relationship between the drugs and gingival tissues as discussed by Seymour et al. Meticulous oral hygiene maintenance, switchover to alternative drug, professional scaling and root planning and surgical excision of enlarged gingival tissue may help overcome the effect of these drugs.

  13. Current features of primary tuberculosis on medical imaging based on a series of fourteen cases

    International Nuclear Information System (INIS)

    Active pulmonary tuberculosis, a source of contamination, is currently undergoing a recrudescence in developed countries, particularly in clinical contexts of immuno-depression. The authors report a retrospective series of 14 cases of primary tuberculosis in a paediatric population (7 girls and 7 boys) with a mean age of 3.5 years (range: 4 months - 16 years) observed over a 3-year period. After reviewing the current radiological features of patent primary tuberculosis, the authors emphasize the contribution of chest CT scan in latent forms with a normal chest x-ray and a difficult bacteriological diagnosis. Imaging remains an essential tool in early diagnosis, therapeutic management and active surveillance of this form. The authors propose a decisional flow-chart in the case of suspected primary tuberculosis in children. (authors). 20 refs., 8 figs

  14. Photodynamic Therapy as Novel Treatment for Halitosis in Adolescents: A Case Series Study

    Science.gov (United States)

    Lopes, Rubia Garcia; de Santi, Maria Eugenia Simões Onofre; Franco, Bruno Edin; Deana, Alessandro Melo; Prates, Renato Araujo; França, Cristiane Miranda; Fernandes, Kristianne Porta Santos; Ferrari, Raquel Agnelli Mesquita; Bussadori, Sandra Kalil

    2014-01-01

    Introduction: Halitosis is a common problem that affects a large portion of the population worldwide. The origin of this condition is oral in 90% of cases and systemic in 10% of cases. The foul odor is caused mainly by volatile sulfur compounds produced by Gram-negative bacteria. However, it has recently been found that anaerobic Gram-positive bacteria also produce hydrogen sulfide (H2S) in the presence of amino acids, such as cysteine. Light with and without the combination of chemical agents has been used to induce therapeutic and antimicrobial effects. In photodynamic therapy, the antimicrobial effect is confined to areas covered by the photosensitizing dye. The aim of the present case series study was to evaluate the antimicrobial effect of photodynamic therapy on halitosis in adolescents through the analysis of volatile sulfur compounds measured using a sulfide meter (Halimeter®). Methods: Five adolescents aged 14 to 16 years were evaluated using a sulfide meter before and one hour after photodynamic therapy, which involved the use of methylene blue 0.005% on the middle third and posterior thirds of the dorsum of the tongue and nine points of laser irradiation in the red band (660 nm) with an energy dose of 9 J, power output of 100 mW and 90-seconds exposure time. Results: A 31.8% reduction in the concentration of volatile sulfur compounds was found in the comparison of the initial and final readings. The statistically significant reduction (p = 0.0091) led to an absence of halitosis following treatment (mean: 58.2 ppb). Conclusion: Photodynamic therapy seems to be effective on reduction the concentration of volatile sulfur compounds.Considering the positive effects of photodynamic therapy in this case series, further studies involving microbiological analyses should be conducted to allow comparisons of the results. PMID:25653814

  15. Pancreatico-Pleural and Bronchial Fistulae and Associated Pseudocysts: Case Series

    Directory of Open Access Journals (Sweden)

    Shiran A Shetty

    2014-09-01

    Full Text Available Context Pancreatico-pleural fistula is rare complication of chronic or acute pancreatitis. Previous studies have reported imaging features and various management options of this condition including conservative/medical management, endoscopic treatments and surgery. This article reviews the myriad of imaging appearances of this condition in multimodality imaging and different strategies for the successful management in a short case series. Methods After obtaining the institutional ethics committee approval, retrospective review of the medical records of five patients of pancreatico-pleural fistulae who were diagnosed and successfully managed in our hospital in 2012 and 2013 was done. Follow up with out patient records of these patients was also included.Findings were compared with the current available literature on this entity. Results and discussion Pancreatico-pleural fistulae presents with massive pleural effusion. A high index of suspicion is essential for accurate diagnosis. Demonstration of the fistulous tracts requires cross sectional imaging with contrast enhanced CT being most commonly used and affords accurate diagnosis. MRI demonstrates the tracts and ductal disruptions with greater detail and are helpful in confirming the CT findings. Endoscopic ultrasound and ERCP also offer potential of diagnosis, although being technically demanding and invasive is reserved for interventions. Management of these conditions should be initially conservative with endoscopic stenting being offered in selected cases with favourable anatomy and not responding to conservative management. Surgery is reserved for cases not responding to conservative and endoscopic management. Conclusion In conclusion this case series highlights the clinical and imaging spectrum of pancreatico-pleural fistulae and provides insight into the different management strategies that can be adopted for this condition.

  16. Alemtuzumab use in neuromyelitis optica spectrum disorders: a brief case series.

    Science.gov (United States)

    Azzopardi, Laura; Cox, Amanda L; McCarthy, Claire L; Jones, Joanne L; Coles, Alasdair J

    2016-01-01

    Alemtuzumab is an anti-CD52 monoclonal antibody recently licensed for use in relapsing-remitting multiple sclerosis. Here, we report our experience of its use in neuromyelitis optica (NMO) spectrum disorders. A retrospective case review of patients treated with alemtuzumab in Cambridge, UK, was conducted to identify those who fulfil the criteria for NMO spectrum disorder. Three cases were identified. Case 1, 9-year-old female, presented with transverse myelitis and bilateral optic neuritis,with one lower medullary and several longitudinally extensive cord lesions. Despite immunosuppression including two courses of alemtuzumab, she continued to relapse, was wheelchair bound and registered blind by age 12, and died at age 18. Case 2, 41-year-old female, presented with bilateral optic neuritis and transverse myelitis with longitudinally extensive cervical cord lesions. Despite three courses of alemtuzumab, she had five relapses with visual impairment and new cord lesions. She later developed tumefactive white matter lesions and died aged 51.Case 3, 31-year-old female, presented with transverse myelitis with longitudinally extensive cervical cord lesions and positive aquaporin-4 antibody. After one course of alemtuzumab, she relapsed with 4 episodes of myelitis with new enhancing lesions and accumulating disability. She became relapse free after rituximab and mycophenolate mofetil. From this case series, we conclude that alemtuzumab failed to prevent disabling relapses and poor outcome in NMO. We hypothesise that rituximab is more effective, as in case 3, because it causes much more prolonged B lymphocyte depletion than alemtuzumab. We therefore caution against the use of alemtuzumab in NMO. PMID:26477020

  17. Child Maltreatment; Types and effects: Series of six cases from a university hospital in Oman

    Directory of Open Access Journals (Sweden)

    Muna Al-Saadoon

    2012-02-01

    Full Text Available Child maltreatment (CM is common worldwide, and can take many forms. It may even endanger the child’s life, especially when younger children are the victims. CM affects the child’s quality of life and consequently leads to long term issues to be dealt with by the child, family and community. This case series discusses six children who have been subjected to CM, and diagnosed by the child protection team of the departments of Child Health and Behavioural Medicine at Sultan Qaboos University Hospital (SQUH, Oman. The aim of this case series is to increase the level of awareness of CM among Oman’s medical professionals and to highlight the difficulties encountered in diagnosing and providing optimal care for these children. Although treatment is provided in Oman’s health care system, it is clear that there are gaps in the existing system which affect the quality of child protection services provided to the children and their families.

  18. Treatment of paraphilia in young adults with leuprolide acetate: a preliminary case report series.

    Science.gov (United States)

    Saleh, Fabian M; Niel, Tracey; Fishman, Marc J

    2004-11-01

    Some juveniles who engage in sexual offenses may have a paraphilia, a psychiatric disorder characterized by a pervasive pattern of deviant and impairing sexual fantasies, thoughts, and/or behaviors. Though there is no known cure for these conditions, paraphilias can be effectively managed using a multimodal treatment approach. This may include the use of psychotherapeutic and pharmacological treatment interventions, including antiandrogen medications. One such agent, leuprolide acetate (leuprolide), a luteinizing hormone-releasing-hormone agonist, has been shown to be effective in reducing paraphilic symptoms in adult patients. To date, however, there is no published data on its use and effectiveness in adolescent and young adult paraphilic patients. This study consists of a case report series of six young adult patients treated with leuprolide. All subjects had been diagnosed with at least one paraphilia (i.e., Pedophilia, Sexual Sadism, Frotteurism, and Paraphilia Not Otherwise Specified). All subjects had been refractory to treatment in a residential program for adolescent sex offenders prior to initiation of leuprolide. All six subjects reported a reduction in sexually deviant symptoms following treatment with leuprolide. Clinicians rated four as much improved and two as moderately improved. The treatment was well tolerated in all six subjects. This preliminary case series supports the conclusion that leuprolide deserves further examination as a potentially safe and effective component in the treatment of young adult patients with paraphilia. PMID:15568711

  19. A self-controlled case series to assess the effectiveness of beta blockers for heart failure in reducing hospitalisations in the elderly

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    Pratt Nicole L

    2011-07-01

    Full Text Available Abstract Background To determine the suitability of using the self-controlled case series design to assess improvements in health outcomes using the effectiveness of beta blockers for heart failure in reducing hospitalisations as the example. Methods The Australian Government Department of Veterans' Affairs administrative claims database was used to undertake a self-controlled case-series in elderly patients aged 65 years or over to compare the risk of a heart failure hospitalisation during periods of being exposed and unexposed to a beta blocker. Two studies, the first using a one year period and the second using a four year period were undertaken to determine if the estimates varied due to changes in severity of heart failure over time. Results In the one year period, 3,450 patients and in the four year period, 12, 682 patients had at least one hospitalisation for heart failure. The one year period showed a non-significant decrease in hospitalisations for heart failure 4-8 months after starting beta-blockers, (RR, 0.76; 95% CI (0.57-1.02 and a significant decrease in the 8-12 months post-initiation of a beta blocker for heart failure (RR, 0.62; 95% CI (0.39, 0.99. For the four year study there was an increased risk of hospitalisation less than eight months post-initiation and significant but smaller decrease in the 8-12 month window (RR, 0.90; 95% CI (0.82, 0.98. Conclusions The results of the one year observation period are similar to those observed in randomised clinical trials indicating that the self-controlled case-series method can be successfully applied to assess health outcomes. However, the result appears sensitive to the study periods used and further research to understand the appropriate applications of this method in pharmacoepidemiology is still required. The results also illustrate the benefits of extending beta blocker utilisation to the older age group of heart failure patients in which their use is common but the evidence is

  20. Potential utility of precision medicine for older adults with polypharmacy: a case series study

    Directory of Open Access Journals (Sweden)

    Finkelstein J

    2016-04-01

    Full Text Available Joseph Finkelstein,1 Carol Friedman,1 George Hripcsak,1 Manuel Cabrera2 1Department of Biomedical Informatics, 2Department of Medicine, Columbia University, New York, NY, USA Abstract: Pharmacogenomic (PGx testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as “CYP3A4/CYP3A5 poor metabolizer”, which affected metabolism of eleven prescribed drugs. The second case had “CYP2D6 rapid metabolizer” status affecting three prescribed medications, two of which were key drugs for managing this patient's chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug–drug interactions. Both patients with significant drug–gene interactions had a history of frequent hospitalizations (six and 23, respectively, whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to

  1. Representations and coverage of non-English-speaking immigrants and multicultural issues in three major Australian health care publications

    OpenAIRE

    Garrett, Pamela W; Dickson, Hugh G; Whelan, Anna Klinken; Whyte, Linda

    2010-01-01

    Background No recent Australian studies or literature, provide evidence of the extent of coverage of multicultural health issues in Australian healthcare research. A series of systematic literature reviews in three major Australian healthcare journals were undertaken to discover the level, content, coverage and overall quality of research on multicultural health. Australian healthcare journals selected for the study were The Medical Journal of Australia (MJA), The Australian Health Review (AH...

  2. Potential Impact of Dietary Choices on Phosphorus Recycling and Global Phosphorus Footprints: The Case of the Average Australian City.

    Science.gov (United States)

    Metson, Geneviève S; Cordell, Dana; Ridoutt, Brad

    2016-01-01

    Changes in human diets, population increases, farming practices, and globalized food chains have led to dramatic increases in the demand for phosphorus fertilizers. Long-term food security and water quality are, however, threatened by such increased phosphorus consumption, because the world's main source, phosphate rock, is an increasingly scarce resource. At the same time, losses of phosphorus from farms and cities have caused widespread water pollution. As one of the major factors contributing to increased phosphorus demand, dietary choices can play a key role in changing our resource consumption pathway. Importantly, the effects of dietary choices on phosphorus management are twofold: First, dietary choices affect a person or region's "phosphorus footprint" - the magnitude of mined phosphate required to meet food demand. Second, dietary choices affect the magnitude of phosphorus content in human excreta and hence the recycling- and pollution-potential of phosphorus in sanitation systems. When considering options and impacts of interventions at the city scale (e.g., potential for recycling), dietary changes may be undervalued as a solution toward phosphorus sustainability. For example, in an average Australian city, a vegetable-based diet could marginally increase phosphorus in human excreta (an 8% increase). However, such a shift could simultaneously dramatically decrease the mined phosphate required to meet the city resident's annual food demand by 72%. Taking a multi-scalar perspective is therefore key to fully exploring dietary choices as one of the tools for sustainable phosphorus management. PMID:27617261

  3. Pregnancy and radiotherapy : management options for minimising risk, case series and comprehensive literature review

    International Nuclear Information System (INIS)

    Full text: This article reviews the efficacy and safety of radiotherapy in patients with cancer who are pregnant. Our review provided extended follow-up results in nine cases, presents a technical discussion on measures taken to minimise foetal radiation exposure and provides a comprehensive summary of the literature. Nine patients who received radiotherapy while pregnant are described. The clinical presentation and outcomes of these and 100 additional cases identified on a systematic literature review are presented. Comparisons of scattered radiation doses from three linear accelerators are presented. The average maternal follow-up in our series was 8.9 years with one patient having a recurrence of their astrocytoma. In terms of foetal outcome, there were one death in utero, one elective termination of pregnancy and one on which no data were available. Six children, on whom long-term follow-up (average 10.3 years) was obtainable, were in good health. Overall, there had been 109 cases of radiotherapy in pregnancy that met our search criteria with 13 adverse outcomes and a median follow-up of 37 months. Comparisons of three linear accelerators demonstrated significant differences in the amount of scattered radiation to the abdominal surface. In summary radiotherapy during pregnancy can be associated with a significant number of adverse outcomes. While it may be difficult for a patient not to attribute these effects to radiotherapy, it is also difficult to define the mechanisms by which radiotherapy would have caused them, if that were the case.

  4. Nasopharyngeal Masses Arising from Embryologic Remnants of the Clivus: A Case Series.

    Science.gov (United States)

    Sajisevi, Mirabelle; Hoang, Jenny K; Eapen, Rose; Jang, David W

    2015-11-01

    Objectives This study aims to (1) discuss rare nasopharyngeal masses originating from embryologic remnants of the clivus, and (2) discuss the embryology of the clivus and understand its importance in the diagnosis and treatment of these masses. Design and Participants This is a case series of three patients. We discuss the clinical and imaging characteristics of infrasellar craniopharyngioma, intranasal extraosseous chordoma, and canalis basilaris medianus. Results Case 1: A 16-year-old male patient with a history of craniopharyngioma resection, who presented with nasal obstruction. A nasopharyngeal cystic mass was noted to be communicating with a patent craniopharyngeal canal. Histology revealed adamantinomatous craniopharyngioma. Case 2: A 43-year-old male patient who presented with nasal obstruction and headache. Computed tomography (CT) and magnetic resonance imaging revealed an enhancing polypoid mass in the posterior nasal cavity abutting the clivus. Histopathology revealed chondroid chordoma. Case 3: A 4-year-old female patient with a recurrent nasopharyngeal polyp. CT cisternogram showed that this mass may have risen from a bony defect of the middle clivus suggestive of canalis basilaris medianus. Conclusions Understanding the embryology of the clivus is crucial when considering the differential diagnosis of a nasopharyngeal mass. Identification of characteristic findings on imaging is critical in the diagnosis and treatment of these lesions. PMID:26623237

  5. "The Sacred Spark of Wonder": Local Museums, Australian Curriculum History, and Pre-Service Primary Teacher Education: A Tasmanian Case Study

    Science.gov (United States)

    Brett, Peter

    2014-01-01

    This article explores the intersections between museum learning in a distinctive Tasmanian setting, the possibilities of a new national History curriculum, and the evolving views and professional practices of pre-service primary teachers at one Australian university. Following a brief overview of the framework for local and Australian history that…

  6. BOOMERANG - the Australian light source

    International Nuclear Information System (INIS)

    A proposal has been prepared for the installation in Australia of a national high performance synchrotron light facility called Boomerang. The Boomerang proposal had its origin in the establishment of the Australian Synchrotron Research Program (ASRP) which was one of the seven Major National Research Facilities announced by the Federal Government in December 1995. The ASRP provides the opportunity and funding for Australian researchers to access international synchrotron facilities, specifically two consortia at the Advanced Photon Source (APS) at the Argonne National Laboratory, USA and continued interaction with the Photon Factory at the KEK Laboratory in Japan. The ASRP was the successor to the Australian National Beamline Facility project (ANBF) which began in 1991 following the ASTEC inquiry titled 'Small Country - Big Science'. The Federal Government also provided funding for a Feasibility Study to determine the value of establishing an Australian-based synchrotron radiation facility. The Feasibility Study was completed in August 1998 and endorsed by the institutional members of the ASRP and the research community in general. The study concluded that, on the data available in Australia, there was a strong case for the installation of an Australian-based facility. The study considered several options for an Australian-based facility and recommended that these options and the data supporting the general conclusions receive further investigation. A mission was arranged to a select group of overseas laboratories to explore these questions in detail. The review team included a mix of scientific and industrial experience and also represented the interests of the ASRP and an Industrial Synchrotron Consortium based in Victoria. Based on the conclusions of the overseas mission and incorporating the advice of all international specialists in the design and use of synchrotron facilities consulted during the mission, the most cost-effective option was an extended

  7. Ophthalmologic manifestations of focal dermal hypoplasia (Goltz syndrome): A case series of 18 patients.

    Science.gov (United States)

    Gisseman, Jordan D; Herce, Honey H

    2016-03-01

    Focal Dermal Hypoplasia (FDH) or Goltz syndrome is a rare multi-system disorder with cutaneous, ocular, dental, and skeletal anomalies due to dysplasia of mesoectodermal derived tissues. It is an X-linked inheritance syndrome caused by mutations in the PORCN gene. This study is aimed to investigate the ocular findings in patients with Goltz syndrome. To date, there have been a limited number of case reports on the ocular manifestations of FDH. This is a prospective, non-consecutive, observational case series. Prospective ophthalmologic evaluation was performed on 18 patients with confirmed genetic testing for FDH, Goltz Syndrome, as a component of a larger multi-subspecialty study to better characterize the findings of this condition. Special attention was placed on evaluating the incidence of anophthalmia, microphthalmia, colobomas (iris, optic nerve, and/or retinal), cataracts, nystagmus, and strabismus. A complete ophthalmologic exam was done on all the patients. The mean patient age was 12.8 years (1-55 years). Eighty-nine percent were female and 77% (14/18) of patients had some form of an ophthalmologic manifestation of the condition. Ophthalmological findings included chorioretinal colobomas (61%), iris colobomas (50%), microphthalmia (44%), anophthalmia (11%), cataracts (11%), and conjunctival and eyelid papillomas (5%). Nystagmus was present in 33% and strabismus in 22% of the patients. Visual acuity ranged from 20/20 to no light perception. This study demonstrates a higher incidence of ophthalmologic manifestations as previously reported (77% vs. 40%). To our knowledge, this is the largest case series reported in the literature with 18 patients. © 2016 Wiley Periodicals, Inc. PMID:27001926

  8. Diagnostic criteria and follow-up in neuroendocrine cell hyperplasia of infancy: a case series

    Directory of Open Access Journals (Sweden)

    Vivianne Calheiros Chaves Gomes

    2013-09-01

    Full Text Available OBJECTIVE: Neuroendocrine cell hyperplasia of infancy (NEHI is a form of childhood interstitial lung disease characterized by tachypnea, retractions, crackles, and hypoxia. The aim of this study was to report and discuss the clinical, imaging, and histopathological findings in a series of NEHI cases at a tertiary pediatric hospital, with an emphasis on diagnostic criteria and clinical outcomes. METHODS: Between 2003 and 2011, 12 full-term infants were diagnosed with NEHI, based on clinical and tomographic findings. Those infants were followed for 1-91 months. Four infants were biopsied, and the histopathological specimens were stained with bombesin antibody. RESULTS: In this case series, symptoms appeared at birth in 6 infants and by 3 months of age in the remaining 6. In all of the cases, NEHI was associated with acute respiratory infection. The most common initial chest HRCT findings were ground-glass opacities that were in the middle lobe/lingula in 12 patients and in other medullary areas in 10. Air trapping was the second most common finding, being observed in 7 patients. Follow-up HRCT scans (performed in 10 patients revealed normal results in 1 patient and improvement in 9. The biopsy findings were nonspecific, and the staining was positive for bombesin in all samples. Confirmation of NEHI was primarily based on clinical and tomographic findings. Symptoms improved during the follow-up period (mean, 41 months. A clinical cure was achieved in 4 patients. CONCLUSIONS: In this sample of patients, the diagnosis of NEHI was made on the basis of the clinical and tomographic findings, independent of the lung biopsy results. Most of the patients showed clinical improvement and persistent tomographic changes during the follow-up period, regardless of the initial severity of the disease or type of treatment.

  9. Clinical experiences of delayed contrast enhancement with cardiac computed tomography: case series

    Directory of Open Access Journals (Sweden)

    Sidhu Manavjot S

    2013-01-01

    Full Text Available Abstract Background Myocardial delayed enhancement (MDE by gadolinium-enhanced cardiac MRI is well established for myocardial scar assessment in ischemic and non-ischemic heart disease. The role of MDE by cardiac CT (CT-MDE is not yet defined. Findings We reviewed all clinical cases of CT-MDE at a tertiary referral center to present the cases as a case series. All clinical cardiac CT exams which utilized CT-MDE imaging between January 1, 2005 and October 1, 2010 were collected as a series and their findings were also compared with available myocardial imaging to assess for myocardial abnormalities, including echocardiography (wall motion, morphology, cardiac MRI (delayed enhancement, morphology, SPECT MPI (perfusion defects. 5,860 clinical cardiac CT exams were performed during the study period. CT-MDE was obtained in 18 patients and was reported to be present in 9 patients. The indications for CT-MDE included ischemic and non-ischemic heart diseases. In segments positive for CT-MDE, there was excellent agreement of CT with other modalities: echocardiography (n=8 demonstrated abnormal morphology and wall motion (k=1.0 and k=0.82 respectively; prior MRI (n=2 demonstrated abnormal delayed enhancement (MR-MDE (k=1.0; SPECT MPI (n=1 demonstrated fixed perfusion defects (k=1.0. In the subset of patients without CT-MDE, no abnormal segments were identified by echocardiography (n=8, MRI (n=1 and nuclear MPI (n=0. Conclusions CT-MDE was performed in rare clinical situations. The indications included both ischemic and non-ischemic heart disease and there was an excellent agreement between CT-MDE and abnormal myocardium by echocardiography, cardiac MRI, and nuclear MPI.

  10. Tumors of the Major Salivary Glands. A Case Series Study Tumores de las glándulas salivales mayores. Estudio de una serie de casos

    OpenAIRE

    Teresita Barrios; Arelis Duménico Soler; Raúl López Fernández; Enrique Pérez Abreus; Julio Romero Rodríguez; Yordany Boza Mejías

    2012-01-01

    Background: the study of salivary gland neoplasms is one of the most complex issues of cancer of the head and neck. Objective: to determine the behavior of tumors of the major salivary glands. Method: an observational-descriptive-retrospective case series in the Maxillofacial Surgery Department of the Hospital General Universitario Dr. Gustavo Lima Aldereguía of Cienfuegos, in the period from January 2000 through December 2009. Results: tumors of the major salivary glands occurred in the stu...

  11. Climate change, water security and the need for integrated policy development: the case of on-farm infrastructure investment in the Australian irrigation sector

    International Nuclear Information System (INIS)

    The Australian Government is currently addressing the challenge of increasing water scarcity through significant on-farm infrastructure investment to facilitate the adoption of new water-efficient pressurized irrigation systems. However, it is highly likely that conversion to these systems will increase on-farm energy consumption and greenhouse gas (GHG) emissions, suggesting potential conflicts in terms of mitigation and adaptation policies. This study explored the trade-offs associated with the adoption of more water efficient but energy-intensive irrigation technologies by developing an integrated assessment framework. Integrated analysis of five case studies revealed trade-offs between water security and environmental security when conversion to pressurized irrigation systems was evaluated in terms of fuel and energy-related emissions, except in cases where older hand-shift sprinkler irrigation systems were replaced. These results suggest that priority should be given, in implementing on-farm infrastructure investment policy, to replacing inefficient and energy-intensive sprinkler irrigation systems such as hand-shift and roll-line. The results indicated that associated changes in the use of agricultural machinery and agrochemicals may also be important. The findings of this study support the use of an integrated approach to avoid possible conflicts in designing national climate change mitigation and adaptation policies, both of which are being developed in Australia. (letter)

  12. Retrospective testing and case series study of porcine delta coronavirus in U.S. swine herds.

    Science.gov (United States)

    McCluskey, Brian J; Haley, Charles; Rovira, Albert; Main, Rodger; Zhang, Yan; Barder, Sunny

    2016-01-01

    Porcine deltacoronavirus (PDCoV) was first reported in the United States (US) in February 2014. This was the second novel swine enteric coronavirus detected in the US since May 2013. In this study, we conducted retrospective testing of samples submitted to three veterinary diagnostic laboratories where qualifying biological samples were derived from previously submitted diagnostic case submissions from US commercial swine farms with a clinical history of enteric disease or from cases that had been previously tested for transmissible gastroenteritis virus, PEDV, or rotavirus. Overall, 2286 banked samples were tested from 27 States. Samples were collected in 3 separate years and in 17 different months. Test results revealed 4 positive samples, 3 collected in August 2013 and 1 collected in October 2013. In addition, a case series including 42 operations in 10 States was conducted through administration of a survey. Survey data collected included information on characteristics of swine operations that had experienced PDCoV clinical signs. Special emphasis was placed on obtaining descriptive estimates of biosecurity practices and disease status over time of each operation. Clinical signs of PDCoV were reported to be similar to those of PEDV. The average number of animals on each operation exhibiting clinical signs (morbidity) and the average number of case fatalities was greatest for suckling and weaned pigs. Average operation-level weaned pig morbidity was greatest in the first week of the outbreak while average operation-level suckling pig case fatality was greatest in the second week of the outbreak. The survey included questions regarding biosecurity practices for visitors and operation employees; trucks, equipment and drivers; and feed sources. These questions attempted to identify a likely pathway of introduction of PDCoV onto the operations surveyed. PMID:26603048

  13. A Genuine Career or Impossible Heroism? Experiencing the Role of the Head of School: An Australian Case Study

    Science.gov (United States)

    Stratford, Elaine

    2012-01-01

    Studies since the mid-1980s suggest that university heads of schools experience the role as a series of tensions between enlightenment and enterprise-building agendas. It is apparent that the headship requires skills in management and capacities in leadership not necessarily furnished via typical academic pathways. In such light, the present…

  14. Unani Treatment Decreased Fibrosis and Improved Liver Functions in Decompensated Cirrhosis of Liver: A Case Series

    Directory of Open Access Journals (Sweden)

    Akhtar Siddiqui

    2016-03-01

    Full Text Available At present, liver transplantation remains the only curative option for the patients with cirrhosis and end-stage liver diseases. The survival rate and recurrent diseases remain the major issues in the patient post-transplantation. Unani medicine is one of the oldest traditional systems of medicine which has been treating chronic liver diseases and cirrhosis (Talayyaful-Kabid for centuries. The current study aimed to assess the impact of Unani treatment on decompensated cirrhosis and collect data to warrant further clinical trials. Authors conducted a case series on five patients with decompensated cirrhosis and portal hypertension. The disease was confirmed through FibroScan and ultrasound and treated with Unani treatment orally for seven months. Results were evaluated based on FibroScan, liver function test (LFT, EuroQol-5D (EQ5D, Child-Pugh and TTO-TIME (trade-off question. Significant improvements in LFT, fibrosis and quality of life were achieved in the studied patients. The literature related to the herbal constituents of chief medicines used to treat in this case was reviewed. The herbs proved their potential anti-oxidative, anti-inflammatory, hepato-protective, immuno-modulator and antiviral activities, suggesting plausible mechanisms of action in the cases. The preliminary findings indicated the potential therapeutic role of Unani treatment in decompensated cirrhosis. Clinical trials should be conducted to explore further therapeutic potential of Unani treatment in decompensated cirrhosis.

  15. Oxaliplatin-induced severe anaphylactic reactions in metastatic colorectal cancer: Case series analysis

    Directory of Open Access Journals (Sweden)

    Chao-Wen Hsu

    2012-01-01

    Full Text Available AIM: To investigate oxaliplatin-induced severe anaphylactic reactions (SAR in metastatic colorectal cancer in a retrospective case series analysis and to conduct a systemic literature review. METHODS: During a 6-year period from 2006 to 2011 at Kaohsiung Veterans General Hospital, a total of 412 patients exposed to oxaliplatin-related chemotherapy were retrospectively reviewed. Relevant English-language studies regarding life-threatening SAR following oxaliplatin were also reviewed in MEDLINE® and PubMed® search. RESULTS: Eight patients (1.9%, 8 of 412 cases were identified. Seven patients were successful resuscitated without any sequelae and one patient expired. We changed the chemotherapy regimen in five patients and rechallenged oxaliplatin use in patient 3. Twenty-three relevant English-language studies with 66 patients were reported. Patients received a median of 10 cycles of oxaliplatin (range, 2 to 29. Most common symptoms were respiratory distress (60%, fever (55%, and hypotension (54%. Three fatal events were reported (4.5%. Eleven patients (16% of the 66 cases were rechallenged by oxaliplatin. CONCLUSION: SAR must be considered in patients receiving oxaliplatin-related chemotherapy, especially in heavily pretreated patients. Further studies on the mechanism, predictors, preventive methods and management of oxaliplatin-related SAR are recommended.

  16. Ganglion cysts of the cruciate ligaments: a series of 31 cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Mao Yongtao

    2012-08-01

    Full Text Available Abstract Background A case series for ganglion cyst of the cruciate ligament with MRI findings, clinical presentation, and management options along with review of literature is presented. Methods Of 8663 consecutive patients referred for knee MR imaging, 31 were diagnosed with ganglion cysts of the cruciate ligaments, including 21 men and 10 women of ages 12 to 73 years (mean: 37. A review of charts revealed that knee pain was the chief complaint in all cases. Arthroscopic debridement of ganglion cyst was performed in 11 patients. Results MRI proved to be a valuable tool in diagnosing and deciding management of these cases. All 11 patients who underwent arthroscopic treatment were symptom-free on a minimum follow-of one year. Conclusion Cyst formation associated with cruciate ligament of the knee is an infrequent cause of knee pain. MR imaging was important in confirming the cyst lesions and provided useful information prior to arthroscopy. Arthroscopic debridement of ganglion cyst produced excellent outcome without recurrence. This study describes the pertinent MRI and intraoperative findings of ganglion cyst.

  17. [Aspects of the tuberculosis of the child: a series of 153 cases].

    Science.gov (United States)

    Barchiche, N A; Berkani, A; Chernai, M; Aitabdeslam, S; Meguenni, W

    2010-04-01

    Known as White Plague xvii and xviii centuries. It is a present disease with 1.7 billions inhabitants who are touched (OMS). Disease of future with eight to 10 millions of new cases per year (99% of countries underdeveloped are touched). It kills more than other infectious disease: with three millions of death (deaths) among which 3105 children per year. Twenty-four thousand one hundred and three new cases a day and 7103 deaths in the daytime, because of the epidemic of the AIDS and the resistance of the BK. The authors report a series of 153 cases of tuberculosis at old children of some months of life in 15 and a half year follow-up and took care at the level of various services of the CHU of Tizi-Ouzou brought together in one and a half decade (15 years). Whole preference of the male achievement, touching quite sectors of society especially the most deprived one third of the children are schooled, little complicated and three deaths recorded. PMID:19892476

  18. Diagnosis of pericardial cysts using diffusion weighted magnetic resonance imaging: A case series

    Directory of Open Access Journals (Sweden)

    Mousavi Negareh

    2011-09-01

    Full Text Available Abstract Introduction Congenital pericardial cysts are benign lesions that arise from the pericardium during embryonic development. The diagnosis is based on typical imaging features, but atypical locations and signal magnetic resonance imaging sequences make it difficult to exclude other lesions. Diffusion-weighted magnetic resonance imaging is a novel method that can be used to differentiate tissues based on their restriction to proton diffusion. Its use in differentiating pericardial cysts from other pericardial lesions has not yet been described. Case presentation We present three cases (a 51-year-old Caucasian woman, a 66-year-old Caucasian woman and a 77-year-old Caucasian woman with pericardial cysts evaluated with diffusion-weighted imaging using cardiac magnetic resonance imaging. Each lesion demonstrated a high apparent diffusion coefficient similar to that of free water. Conclusion This case series is the first attempt to investigate the utility of diffusion-weighted magnetic resonance imaging in the assessment of pericardial cysts. Diffusion-weighted imaging may be a useful noninvasive diagnostic tool for pericardial cysts when conventional imaging findings are inconclusive.

  19. IMPACT OF SEQUENTIAL NEOADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED BREAST CANCER: A SERIES OF 10 CASES

    Directory of Open Access Journals (Sweden)

    Gopa

    2014-04-01

    Full Text Available Breast cancer currently is a major health problem among women worldwide accounting for around 13.7% cancer deaths, nearly 1/3rd of it being due to Locally advanced breast cancer (LABC. Despite progress achieved in diagnosis & therapy of Breast cancer, LABC remains a major clinical challenge and in efforts to increase pCR, CCR & DFS in LABC, Neoadjuvant or primary chemotherapy followed by locoregional therapy and adjuvant systemic CT is well accepted treatment strategy since last 3 decades. Further to address the issue of drug resistance in NACT sequential anthracycline-taxane NACT has been evaluated by many researchers and has resulted in better outcome in terms of overall survival and pCR. In this study we have evaluated 4 cycles of sequential anthracycline-taxane, 2 cycles of Cyclophosphamide, Epirubicin, Fluracil +2 cycles of Docetaxel, Epirubicin (CEF- DE NACT in a series of 10 cases of ER/PR +ve, Her -2 neu negative patients of LABC. 9/10 cases were rendered operable after primary chemotherapy and were subjected to further 4 cycles of adjuvant chemotherapy (1 cycle CEF, 1 cycle DE, 2cycles single agent Docetaxel, followed by locoregional RT. This tailored sequential NACT protocol in our subgroup of patient was well tolerated, well accepted and resulted in substantial increase in operability with CCR & DFS in 6/10 cases on 3 years follow up and pCR in one patient. Sequential NACT needs further validation by more RCT with extensive follow up

  20. A case series of laparoscopic components separation and rectus medialization with laparoscopic ventral hernia repair.

    Science.gov (United States)

    Malik, Kashif; Bowers, Steven P; Smith, C Daniel; Asbun, Horacio; Preissler, Susanne

    2009-10-01

    Laparoscopic ventral hernia repair has been shown to offer improved patient recovery, when compared to open repair. It has also been shown to offer a lower complication rate. However, in patients with high body-mass index and large defects, the intraperitoneal on-lay technique of laparoscopic repair is criticized for an increased incidence of failure. In 1990, a study introduced the technique of open-component separation, hence enabling the medialization of the rectus muscle and decreasing the incidence of recurrence associated with primary repair. Open-component separation is associated with increased wound problems due to extensive dissection. Different laparoscopic and endoscopic modifications to the open-component-separation technique have been tried to minimize wound problems. In this article, we present our case series of 4 patients involving the laparoscopic component-separation technique of rectus medialization and, laparoscopic ventral hernia combined. This is one of the first series ever reported to involve both modalities of hernia repair in using an exclusive laparoscopic technique. PMID:19694565

  1. Cerebral oxygenation monitoring in patients with bilateral carotid stenosis undergoing urgent cardiac surgery: Observational case series

    Science.gov (United States)

    Aktuerk, Dincer; Mishra, Pankaj Kumar; Luckraz, Heyman; Garnham, Andrew; Khazi, Fayaz Mohammed

    2016-01-01

    Background: Patients with significant bilateral carotid artery stenosis requiring urgent cardiac surgery have an increased risk of stroke and death. The optimal management strategy remains inconclusive, and the available evidence does not support the superiority of one strategy over another. Materials and Methods: A number of noninvasive strategies have been developed for minimizing perioperative stroke including continuous real-time monitoring of cerebral oxygenation with near-infrared spectroscopy (NIRS). The number of patients presenting with this combination (bilateral significant carotid stenosis requiring urgent cardiac surgery) in any single institution will be small and hence there is a lack of large randomized studies. Results: This case series describes our early experience with NIRS in a select group of patients with significant bilateral carotid stenosis undergoing urgent cardiac surgery (n = 8). In contrast to other studies, this series is a single surgeon, single center study, where the entire surgery (both distal ends and proximal ends) was performed during single aortic clamp technique, which effectively removes several confounding variables. NIRS monitoring led to the early recognition of decreased cerebral oxygenation, and corrective steps (increased cardiopulmonary bypass flow, increased pCO2, etc.,) were taken. Conclusion: The study shows good clinical outcome with the use of NIRS. This is our “work in progress,” and we aim to conduct a larger study. PMID:26750675

  2. Cerebral oxygenation monitoring in patients with bilateral carotid stenosis undergoing urgent cardiac surgery: Observational case series

    Directory of Open Access Journals (Sweden)

    Dincer Aktuerk

    2016-01-01

    Full Text Available Background: Patients with significant bilateral carotid artery stenosis requiring urgent cardiac surgery have an increased risk of stroke and death. The optimal management strategy remains inconclusive, and the available evidence does not support the superiority of one strategy over another. Materials and Methods: A number of noninvasive strategies have been developed for minimizing perioperative stroke including continuous real-time monitoring of cerebral oxygenation with near-infrared spectroscopy (NIRS. The number of patients presenting with this combination (bilateral significant carotid stenosis requiring urgent cardiac surgery in any single institution will be small and hence there is a lack of large randomized studies. Results: This case series describes our early experience with NIRS in a select group of patients with significant bilateral carotid stenosis undergoing urgent cardiac surgery (n = 8. In contrast to other studies, this series is a single surgeon, single center study, where the entire surgery (both distal ends and proximal ends was performed during single aortic clamp technique, which effectively removes several confounding variables. NIRS monitoring led to the early recognition of decreased cerebral oxygenation, and corrective steps (increased cardiopulmonary bypass flow, increased pCO 2 , etc., were taken. Conclusion: The study shows good clinical outcome with the use of NIRS. This is our "work in progress," and we aim to conduct a larger study.

  3. Transcranial Direct Current Stimulation combined with treadmill training in the subacute phase following stroke: case series

    DEFF Research Database (Denmark)

    Figlewski, Krystian; Nielsen, Jørgen Feldbæk; Blicher, Jakob;

    Background Stroke is a common cause of gait impairment and regaining a normal gait is a major target in stroke rehabilitation. To facilitate motor recovery after stroke, a variety of experimental approaches have been tested. Recent developments include non-invasive brain stimulation techniques such...... as transcranial Direct Current Stimulation (tDCS). In neurophysiologic studies an imbalance of interhemispheric interactions has been demonstrated which is believed to interfere with the recovery process. This imbalance can be ameliorated by upregulation of the excitability in the lesioned hemisphere...... symmetry (Fig.3). No major side effects were reported. Conclusions This case series supports the feasibility of anodal tDCS combined with body weight support treadmill training and demonstrates that this type of intervention carries potential for strategy to improve gait recovery in early phase of...

  4. Vertical Ridge Augmentation and Soft Tissue Reconstruction of the Anterior Atrophic Maxillae: A Case Series.

    Science.gov (United States)

    Urban, Istvan A; Monje, Alberto; Wang, Hom-Lay

    2015-01-01

    Severe vertical ridge deficiency in the anterior maxilla represents one of the most challenging clinical scenarios in the bone regeneration arena. As such, a combination of vertical bone augmentation using various biomaterials and soft tissue manipulation is needed to obtain successful outcomes. The present case series describes a novel approach to overcome vertical deficiencies in the anterior atrophied maxillae by using a mixture of autologous and anorganic bovine bone. Soft tissue manipulation including, but not limited to, free soft tissue graft was used to overcome the drawbacks of vertical bone augmentation (eg, loss of vestibular depth and keratinized mucosa). By combining soft and hard tissue grafts, optimum esthetic and long-term implant prosthesis stability can be achieved and sustained. PMID:26357691

  5. Male lupus: a diagnosis often delayed--a case series and review of the literature.

    LENUS (Irish Health Repository)

    Ambrose, N L

    2012-02-01

    INTRODUCTION: Systemic lupus erythematosus (SLE) is an auto-immune disease that is characterised by autoantibody production. Male lupus is rare, apart from at either end of the age spectrum. AIM: In this series, we review the histories of six male lupus patients attending our service. RESULTS: Our patients presented in middle age and tended to develop haematological abnormalities, renal involvement and neurological manifestations which preceded the onset of their skin and joint complaints. Our patients accrued damage rapidly and overall did badly. They tended to respond sub-optimally to standard treatments. These cases highlight the need an increased awareness that male SLE patients present with a wide variety of symptoms, and that they accrue damage quickly. There is a need for timely diagnosis and appropriate initiation of treatment. This may help avoid preventable organ damage and increase the survival of men with SLE.

  6. Fine-needle aspiration cytology of subcutaneous cysticercosis: A series of five cases

    Directory of Open Access Journals (Sweden)

    Kusum D Jashnani

    2016-01-01

    Full Text Available Taenia solium, a potentially dangerous parasite, causes human cysticercosis that can cause a gamut of manifestations affecting the various systems of the body. Sometimes, parasitic infestations present as only superficial palpable subcutaneous or intramuscular nodules that are usually mistaken for lymph nodes or benign tumors like lipoma, neurofibroma, or epidermal inclusion cysts. Fine-needle aspiration cytology (FNAC has emerged as a useful tool in the diagnosis of these superficial parasitic lesions. It also helps in avoiding unnecessary open biopsy to obtain a diagnosis. We, herein, report a series of five cases of subcutaneous cysticercosis at different sites (axilla, chest wall, abdominal wall, lateral neck, and cheek misdiagnosed as lipomas and lymph nodes and finally diagnosed on FNAC.

  7. CALCIFIED URACHAL REMNANT MIMICKING AS BLADDER WALL CALCIFICATION – CASE SERIES

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    Parthasarathi

    2014-01-01

    Full Text Available Computer tomography of kidneys , ureters and bladder (CT KUB is the main investigation in suspected renal tract calculi. Ultrasound of kidneys , ureters and bladder (KUB region can come in hand during acute conditions especially in patients with ureteric calculus causing hydronephrosis and hydroureter. However , several patholog ies other than renal tract calculi can cause apparent urinary bladder calcification. We describe series of cases who presented with renal colic. CT KUB performed on admission revealed a calcified urachal remnant mimicking a urinary bladder wall calcificati on , confirmed by reviewing the multi - planar reformatted images. We also discuss the differential diagnoses that should be considered when presented with urinary bladder calcification. Our study shows urachus calcification is much more common in patients t han previously taught and more common in older patients of more than 50 years than younger patients. Males are commonly affected than females.

  8. Endobronchial cryotherapy facilitates end-stage treatment options in patients with bronchial stenosis: A case series.

    LENUS (Irish Health Repository)

    Fitzmaurice, Gerard J

    2014-04-01

    In keeping with international trends, lung cancer incidence and mortality are increasing among the Irish population with many patients presenting with advanced disease that excludes the potential for curative management. Consequently palliative treatment options for this patient group are being increasingly explored with various degrees of success. Endobronchial stenosis represents a particularly challenging area of management among these patients and a number of techniques have been described without the identification of a single gold standard. We report our experience of the first time use of endobronchial cryotherapy in Ireland with reference to a case series, including an example of its use in the management of benign disease, in order to support patients with borderline lung function and enable definitive palliative treatment.

  9. Transphyseal spread of benign tumors and infections in pediatric patients: A series of six cases

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    Bagaria Vaibhav

    2005-06-01

    Full Text Available Epiphyseal extension of benign pathology is regarded as an infrequent occurrence. This observation has been attributed to anatomical and biochemical phenomenon unique to physeal cartilage. We report a retrospective series of six patients over a period of 4 years, diagnosed with benign pathologies that showed crossing of an open physeal plate by the disease. Four of these cases were infections and two were benign tumors. The patients were aged between 5 and 11 years, all of them were treated at a tertiary referral centre and followed up for a minimum period of 6 months to evaluate the progress of disease. The findings are more than just a pathological curiosity as they alter the management and surgical procedure that needs to be performed for these conditions. The recognition of the fact that benign tumors may occasionally present with transphyseal spread will prevent unjustified radical procedures that are best reserved for aggressive malignant conditions.

  10. Surgical techniques for the treatment of ankyloglossia in children: a case series

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    Marina Azevedo JUNQUEIRA

    2014-06-01

    Full Text Available This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.

  11. Efficacy of topical photodynamic therapy for keratoacanthomas: A case-series of four patients

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    Maria M Farias

    2012-01-01

    Full Text Available Topical photodynamic therapy (PDT is an excellent treatment option for various non-melanoma skin cancers and precancerous lesions, including actinic keratosis, Bowen′s disease, and basal cell carcinoma. The clinical use of PDT includes a broad range of neoplastic, inflammatory, and infectious skin diseases. There is also anecdotal evidence suggesting the efficacy of PDT for the treatment of keratoacanthomas (KA. We report a case-series of four patients with solitary KA confirmed by histology, treated with topical PDT with methylaminolevulinic acid (MAL cream. After three sessions of PDT, the lesions completely disappeared. There was no evidence of recurrence and excellent cosmetic outcome was achieved after three years of follow-up. Topical photodynamic therapy with MAL can be a therapeutic alternative for KA with good clinical and cosmetic outcomes.

  12. Endoscopic ultrasound guided thrombin injection of angiographically occult pancreatitis associated visceral artery pseudoaneurysms:Case series

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    Shivanand; Gamanagatti; Usha; Thingujam; Pramod; Garg; Surajkumar; Nongthombam; Nihar; Ranjan; Dash

    2015-01-01

    Pseudoaneurysm is a known complication of pancreatitis associated with significant mortality and morbidity. Imaging plays an important role in the diagnosis and management. Computed tomography(CT) helps localize the lesion and the severity of the background pancreatitis but digital subtraction angiography with coil embolization is recommended to avoid bleeding and inadvertent surgery. However, in cases where angiographic coil embolization is not feasible due to technical reasons, thrombin injection via CT or ultrasound guidance remains a viable option and often described in literature. In this series, effort has been made to highlight the role of endoscopic ultrasound guided thrombin instillation especially in patients with poorly visualized pseudoaneurysm on ultrasound thereby avoiding surgery and the associated mortality and morbidity.

  13. Time-series Evidence for Export-led Growth Paradigm: A Case Study of Zimbabwe

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    Cyril A. Ogbokor

    2005-01-01

    Full Text Available The study addresses empirically the Export-led Growth Hypothesis (ELGH using Zimbabwe as a case study. This research work attempts to provide some evidence in this regard by examining the influence of trade on economic growth in the economy and ascertaining if the regressors utilised are good predictors of growth. Ordinary Least Squares (OLS method is resorted in order to estimate the specified equations used in the study. The time-series data utilized runs from 1991 to 2003. The results of the study confirm the existence of the export-led growth model in Zimbabwe. In the face of continual instability in its export receipts, we recommend that fundamental economic and political restructuring should be embarked upon in order to address and subsequently reverse the present situation.

  14. Diagnostic challenges of early Lyme disease: Lessons from a community case series

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    Schwarzwalder Alison

    2009-06-01

    Full Text Available Abstract Background Lyme disease, the most common vector-borne infection in North America, is increasingly reported. When the characteristic rash, erythema migrans, is not recognized and treated, delayed manifestations of disseminated infection may occur. The accuracy of diagnosis and treatment of early Lyme disease in the community is unknown. Methods A retrospective, consecutive case series of 165 patients presenting for possible early Lyme disease between August 1, 2002 and August 1, 2007 to a community-based Lyme referral practice in Maryland. All patients had acute symptoms of less than or equal to 12 weeks duration. Patients were categorized according to the Centers for Disease Control and Prevention criteria and data were collected on presenting history, physical findings, laboratory serology, prior diagnoses and prior treatments. Results The majority (61% of patients in this case series were diagnosed with early Lyme disease. Of those diagnosed with early Lyme disease, 13% did not present with erythema migrans; of those not presenting with a rash, 54% had been previously misdiagnosed. Among those with a rash, the diagnosis of erythema migrans was initially missed in 23% of patients whose rash was subsequently confirmed. Of all patients previously misdiagnosed, 41% had received initial antibiotics likely to be ineffective against Lyme disease. Conclusion For community physicians practicing in high-risk geographic areas, the diagnosis of Lyme disease remains a challenge. Failure to recognize erythema migrans or alternatively, viral-like presentations without a rash, can lead to missed or delayed diagnosis of Lyme disease, ineffective antibiotic treatment, and the potential for late manifestations.

  15. Diffuse panbronchiolitis in an Australian aborigine.

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    Brown, James; Simpson, Graham

    2014-06-01

    Diffuse panbronchiolitis (DPB) is a chronic sino-bronchial disease. It has remained restricted to the Japanese and cases in the West are unusual. We present a patient of Australian aboriginal origin with DPB. The known efficacy of low-dose erythromycin in DPB is again described. Chronic respiratory disease is common in the Australian aboriginal population and DPB should be considered in the differential. PMID:25473569

  16. Shrinking lung syndrome in systemic lupus erythematosus: A case series and review of the literature.

    Science.gov (United States)

    Borrell, Helena; Narváez, Javier; Alegre, Juan José; Castellví, Ivan; Mitjavila, Francesca; Aparicio, María; Armengol, Eulàlia; Molina-Molina, María; Nolla, Joan M

    2016-08-01

    Shrinking lung syndrome (SLS) is a rare and less known complication mainly associated with systemic lupus erythematosus (SLE). In this study, we analyze the clinical features, investigation findings, approaches to management, and outcome in a case series of 9 adult patients with SLE and SLS diagnosed during a 35-year period in 3 referral tertiary care hospitals in Spain. Additionally, we reviewed 80 additional cases previously reported (PubMed 1965-2015). These 80 cases, together with our 9 patients, form the basis of the present analysis.The overall SLS prevalence in our SLE population was 1.1% (9/829). SLS may complicate SLE at any time over its course, and it usually occurs in patients without previous or concomitant major organ involvement. More than half of the patients had inactive lupus according to SELENA-systemic lupus erythematosus disease activity index (SLEDAI) scores. Typically, it presents with progressive exertional dyspnea of variable severity, accompanied by pleuritic chest pain in 76% of the cases.An important diagnostic delay is common. The diagnostic tools that showed better yield for SLS detection are the imaging techniques (chest x-ray and high-resolution computed tomography) along with pulmonary and diaphragmatic function tests. Evaluation of diaphragm dome motion by M-mode ultrasonography and phrenic nerve conduction studies are less useful.There are no standardized guidelines for the treatment of SLS in SLE. The majority of patients were treated with medium or high doses of glucocorticoids. Several immunosuppressive agents have been used in conjunction with steroids either if the patient fails to improve or since the beginning of the treatment. Theophylline and beta-agonists, alone or in combination with glucocorticoids, have been suggested with the intent to increase diaphragmatic strength.The overall long-term prognosis was good. The great majority of patients had significant clinical improvement and stabilization, or mild to moderate

  17. Clinical and laboratory description of a series of cases of acute viral myositis

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    Silvana Paula Cardin

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: Describe the clinical and laboratory profile, follow-up, and outcome of a series of cases of acute viral myositis. METHOD: A retrospective analysis of suspected cases under observation in the emergency department was performed, including outpatient follow-up with the recording of respiratory infection and musculoskeletal symptoms, measurement of muscle enzymes, creatine phosphokinase (CPK, lactate dehydrogenase (LDH, transaminases (AST and ALT, blood count, C-reactive protein, and erythrocyte sedimentation rate in the acute phase and during follow-up until normalization. RESULTS: Between 2000 and 2009, 42 suspected cases were identified and 35 (27 boys were included. The median age was 7 years and the diagnosis was reported in 89% in the first emergency visit. The observed respiratory symptoms were cough (31%, rhinorrhea (23%, and fever (63%, with a mean duration of 4.3 days. Musculoskeletal symptoms were localized pain in the calves (80%, limited ambulation (57%, gait abnormality (40%, and muscle weakness in the lower limbs (71%, with a mean duration of 3.6 days. There was significant increase in CPK enzymes (5507 ± 9180 U/L, LDH (827 ± 598 U/L, and AST (199 ± 245 U/L, with a tendency to leukopenia (4590 ± 1420 leukocytes/mm3. The complete recovery of laboratory parameters was observed in 30 days (median, and laboratory and clinical recurrence was documented in one case after 10 months. CONCLUSION: Typical symptoms with increased muscle enzymes after diagnosis of influenza and self-limited course of the disease were the clues to the diagnosis. The increase in muscle enzymes indicate transient myotropic activity related to seasonal influenza, which should be considered, regardless of the viral identification, possibly associated with influenza virus or other respiratory viruses.

  18. Treatment of hypergranulation tissue in burn wounds with topical steroid dressings: a case series

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    Jaeger M

    2016-08-01

    Full Text Available Marie Jaeger,1,* Moti Harats,1,* Rachel Kornhaber,2 Uri Aviv,1 Amir Zerach,1 Josef Haik1,3 1Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel; 2School of Health Sciences, Faculty of Health, University of Tasmania, Sydney, NSW, Australia; 3Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel *These authors contributed equally to this work. Abstract: Hypergranulation tissue (or also known as overgranulation may negatively influence burn wound healing time and contribute to recurrence of contractures in burn wounds and grafts. Subsequently, the treatment of hypergranulation tissue remains controversial and problematic. In this case series, we aimed to examine the feasibility and document the use of topical hydrocortisone in the treatment of hypergranulation tissue formation resulting from burn wounds. We report five cases where hypergranulation tissue developed following deep dermal/full-thickness burns. Initial burn wound treatment included necrotic tissue debridement, wound cleansing, and Flaminal®. All five cases underwent surgical debridement and split-skin ­grafting. Upon identification of hypergranulation tissue, hydrocortisone acetate 0.25% was applied ­topically as usual care for the treatment of hypergranulation tissue. All five patients had deep dermal/full-thickness burns with a total body surface area ranging from 22% to 61% and were aged from 3–41 years. All five cases developed hypergranulation tissue during their admission after debridement and split-thickness skin grafts. All patients showed an improvement in the treated areas with a complete regression of hypergranulation tissue and closure of the burn wounds. No clinically apparent local or systemic side effects of the treatment were observed. Topical hydrocortisone can be utilized as an effective, inexpensive, and noninvasive practical option in the treatment of hypergranulation tissue resulting from burn wounds

  19. Mitotically active microglandular hyperplasia of the cervix: a case series with implications for the differential diagnosis.

    Science.gov (United States)

    Abi-Raad, Rita; Alomari, Ahmed; Hui, Pei; Buza, Natalia

    2014-09-01

    Microglandular hyperplasia (MGH) is a benign proliferation of endocervical glands with relatively uniform columnar or cuboidal nuclei, and rare to absent mitoses. Endometrial adenocarcinomas with mucinous differentiation or a microglandular pattern can closely mimic MGH, often resulting in a diagnostic dilemma in small biopsy specimens. Rare unusual morphologic features-mild to moderate nuclear atypia, solid or reticular growth pattern, hobnail and signet ring cells-have been previously reported in MGH. We present 9 cases of unusual, mitotically active-between 5 and 11 mitotic figures per 10 HPF-MGH, all of which presented as endocervical polyps and had morphologic features otherwise typical of MGH. The patients' age ranged between 35 and 56 yr, 2 patients were postmenopausal. High-risk human papillomavirus status was available in 7 patients, all of which were negative. The Ki-67 proliferation index ranged between 1% and 15%, and all cases were negative for p16, carcinoembryonic antigen, and vimentin immunostains. The clinical follow-up ranged from 3 to 76.2 mo, with a median of 40.7 mo, all patients were doing well without evidence of endocervical or endometrial malignancy. In summary, this case series documents the presence of rare cases of MGH demonstrating significant mitotic activity (up to 11/10 HPF) without a negative impact on the clinical prognosis. Mitotic activity alone should be interpreted with caution in small biopsy specimens with microglandular growth pattern. Immunohistochemical stains, especially p16, carcinoembryonic antigen, and vimentin, may be helpful-in addition to the patient's clinical history and human papillomavirus status to rule out endocervical or endometrial malignancy. PMID:25083971

  20. Post-surgical wound management of pilonidal cysts with a haemoglobin spray: a case series.

    Science.gov (United States)

    Mustafi, N; Engels, P

    2016-04-01

    Painful acute cysts in the natal cleft or lower back, known as pilonidal sinus disease, are a severe burden to many younger patients. Although surgical intervention is the preferred first line treatment, postsurgical wound healing disturbances are frequently reported due to infection or other complications. Different treatment options of pilonidal cysts have been discussed in the literature, however, no standardised guideline for the postsurgical wound treatment is available. After surgery, a common recommended treatment to patients is rinsing the wound with clean water and dressing with a sterile compress. We present a case series of seven patients with wounds healing by secondary intention after surgical intervention of a pilonidal cyst. The average age of the patients was 40 years old. Of the seven patients, three had developed a wound healing disturbance, one wound had started to develop a fibrin coating and three were in a good condition. The applied wound care regimens comprised appropriate mechanical or autolytic debridement, rinsing with an antimicrobial solution, haemoglobin application, and primary and secondary dressings. In all seven cases a complete wound closure was achieved within an average of 76 days with six out of seven wounds achieving wound closure within 23-98 days. Aesthetic appearance was deemed excellent in five out of seven cases excellent and acceptable in one. Treatment of one case with a sustained healing disturbance did result in wound closure but with a poor aesthetic outcome and an extensive cicatrisation of the new tissue. Based on these results we recommend that to avoid healing disturbances of wounds healing by secondary intention after surgical pilonidal cyst intervention, an adequate wound care regime comprising appropriate wound debridement, rinsing, topically applied haemoglobin and adequate wound dressing is recommendable as early as possible after surgery. PMID:27064368

  1. Wilson's disease in an Australian aborigine.

    Science.gov (United States)

    Crawford, D H; Shepherd, R; Cooksley, W G; Patrick, M; Powell, L W

    1990-01-01

    Wilson's disease is due to a genetically determined defect inherited as an autosomal recessive trait. Most reported cases have been caucasoid. This report describes a case of Wilson's disease in an Australian Aboriginal girl, only the second such case reported. PMID:2129845

  2. Potential utility of precision medicine for older adults with polypharmacy: a case series study

    Science.gov (United States)

    Finkelstein, Joseph; Friedman, Carol; Hripcsak, George; Cabrera, Manuel

    2016-01-01

    Pharmacogenomic (PGx) testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as “CYP3A4/CYP3A5 poor metabolizer”, which affected metabolism of eleven prescribed drugs. The second case had “CYP2D6 rapid metabolizer” status affecting three prescribed medications, two of which were key drugs for managing this patient’s chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug–drug interactions. Both patients with significant drug–gene interactions had a history of frequent hospitalizations (six and 23, respectively), whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to be established. Studies evaluating clinical impact of PGx testing in older adults with polypharmacy are warranted. For practical implementation of pharmacogenomics in routine clinical care, besides

  3. Pediatric seizure-related posttraumatic stress and anxiety symptoms treated with EMDR: a case series

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    Elmedina Dautovic

    2016-07-01

    Full Text Available Purpose: To examine the potential effects of eye movement desensitization and reprocessing (EMDR in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design. Methods: Five children (aged 8–18 with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED pre- and post-EMDR and at 3-month follow-up. Normative deviation scores were calculated to examine the severity of seizure-related posttraumatic stress and anxiety symptoms over time. The reliable change index was calculated for pre- to posttreatment change of seizure-related posttraumatic stress and/or anxiety symptoms. Results: Before EMDR, overall or subscale scores indicated that all children had (subclinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms. Directly after EMDR, most children showed significant and/or clinical individual improvement, and these beneficial effects were maintained or reached at follow-up. The mean number of sessions was 2 (range 1–3, 45 min per session. Conclusions: In case of seizure-related posttraumatic stress and/or anxiety, this study indicates that EMDR is a potentially successful quick and safe psychological treatment for children with epilepsy.

  4. TRAUMATIC HIP DISLOCATION IN CHILDREN YOUNGER THAN 3 YEARS : A SERIES OF 3 CASES

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    Navin

    2015-03-01

    Full Text Available The musculoskeletal anatomy of children is qui te different from that of adults. The capsule, periosteum and other soft tissues surrounding the joints is very pliable and dislocations can occur even following trivial injuries . However dislocation occurring in a child population is a rare entity. There are a few case reports of hip dislocations in children < 3 years. We present here a series of 3 cases of paediatric hip dislocations which presented to us for management. The age of the children were between 24 - 27 months. Incidentally all 3 patients were b oys and all 3 were right sided dislocations. None of them had any associated fractures. Two of them had a fall from height and one child fell off a slide. All 3 patients presented within 5 hours following injury. Closed reduction under anaesthesia was perf ormed and post reduction the children were immobilized in a broom - stick plaster for 6 weeks. All children were followed up with serial x - rays and a MRI done immediately following reduction then at 6 and 18 months. There was no evidence of chondrolysis or a vascular necrosis in any of the children at the last follow - up. They all had full range of movements with no limitation of function. We conclude that with early recognition and early reduction of the hip within the golden period (6 hours the occurrence of complications can be prevented.

  5. Subcutaneous Fungal Cyst Masquerading as Benign Lesions – A Series of Eight Cases

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    Varghese, Renu G’Boy; Phansalkar, Manjiri; Ramdas, Anita; K, Authy; G, Thangiah

    2015-01-01

    Background Subcutaneous fungal infections are caused by penetration of the causative fungi into the subcutaneous layer and are usually localised. We present a series of eight cases with subcutaneous fungal cystic lesions masquerading as benign lesions. Materials and Methods A retrospective study was conducted on subcutaneous fungal infections seen between January 2007 to July 2014 in the Department of Pathology. Eight patients with biopsy proven subcutaneous fungal infection were included. We collected and analysed their demographic, clinical and histopathological details. Results Among eight patients, six were male and two were female. The mean age was 47 years (Range: 21-70). All the eight patients presented with non-tender cystic swelling. The size of the swellings varied from a minimum of 3x3 cm to maximum of 10x4 cm. Out of eight, hand was involved in three, forearm in one, elbow in two, leg in one and foot in one. On H&E staining, all the cases showed fibro collagenous cyst wall, lined by histiocytes, granulomatous reaction, foreign body type of giant cells with acute and chronic inflammatory infiltrate containing fungal elements. Six were identified as hyalohyphomycosis and two were identified as phaeohyphomycotic cysts based on pigmentation of hyphae. Conclusion Fungal infection should be suspected in all subcutaneous cystic lesions. Excised tissue should always be sent for culture and histopathology. PMID:26557537

  6. Amyand's hernia-a vermiform appendix presenting in an inguinal hernia: a case series

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    Pavlidis Theodoros

    2011-09-01

    Full Text Available Abstract Introduction A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand's hernia. Here we present a case series of four men with Amyand's hernia. Case presentations We retrospectively studied 963 Caucasian patients with inguinal hernia who were admitted to our surgical department over a 12-year period. Four patients presented with Amyand's hernia (0.4%. A 32-year-old Caucasian man had an inflamed vermiform appendix in his hernial sac (acute appendicitis, presenting as an incarcerated right groin hernia, and underwent simultaneous appendectomy and Bassini suture hernia repair. Two patients, Caucasian men aged 36 and 43 years old, had normal appendices in their sacs, which clinically appeared as non-incarcerated right groin hernias. Both underwent a plug-mesh hernia repair without appendectomy. The fourth patient, a 25-year-old Caucasian man with a large but not inflamed appendix in his sac, had a plug-mesh hernia repair with appendectomy. Conclusion A hernia surgeon may encounter unexpected intraoperative findings, such as Amyand's hernia. It is important to be prepared and apply the appropriate treatment.

  7. Awake tracheal intubation using Pentax airway scope in 30 patients: A Case series

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    Payal Kajekar

    2014-01-01

    Full Text Available Background and Aims: Pentax airway scope (AWS has been successfully used for managing difficult intubations. In this case series, we aimed to evaluate the success rate and time taken to complete intubation, when AWS was used for awake tracheal intubation. Methods: We prospectively evaluated the use of AWS for awake tracheal intubation in 30 patients. Indication for awake intubation, intubation time, total time to complete tracheal intubation, laryngoscopic view (Cormack and Lehane grade, total dose of local anaesthetic used, anaesthetists rating and patient′s tolerance of the procedure were recorded. Results: The procedure was successful in 25 out of the 30 patients (83%. The mean (standard deviation intubation time and total time to complete the tracheal intubation was 5.4 (2.4 and 13.9 (3.7 min, respectively in successful cases. The laryngeal view was grade 1 in 24 and grade 2 in one of 25 successful intubations. In three out of the five patients where the AWS failed, awake tracheal intubation was successfully completed with the assistance of flexible fibre optic scope (FOS. Conclusion: Awake tracheal intubation using AWS was successful in 83% of patients. Success rate can be further improved using a combination of AWS and FOS. Anaesthesiologists who do not routinely use FOS may find AWS easier to use for awake tracheal intubation using an oral route.

  8. Palliative and Supportive Care in Acrometastasis to the Hand: Case Series

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    Narendra Kumar

    2011-01-01

    Full Text Available Acrometastasis to the hand is an unusual presentation which might mimic an infectious, inflammatory, or a metabolic pathology. We herein describe a case series of three patients of acrometastasis to the hand. We encountered three cases of acrometastasis to the hand attending the departmental clinics from 2007 to 2010. The median age at presentation was noted to be 55 years. All were males. The primaries included squamous cell carcinoma of the skin, larynx, and esophagus. In two patients, acrometastasis was detected at presentation and in one it was detected 2 years postcompletion of radical therapy. Two patients were offered palliative radiation to acrometastasis, and best supportive care was given to one. Palliation achieved after radiation was noted to be modest to good. The brief report highlights the importance of the clinical awareness of metastatic dissemination to unusual sites in the face of increasing cancer survivorship. Acrometastasis portends a poor prognosis with limited survival, and optimal integration of the best supportive care is mandatory. A short course of hypofractionated palliative radiation therapy results in modest to good palliation.

  9. Triceps fascial tongue exposure for total elbow arthroplasty: surgical technique and case series.

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    Marinello, Patrick G; Peers, Sebastian; Styron, Joseph; Pervaiz, Khurram; Evans, Peter J

    2015-06-01

    During a posterior approach to the elbow, the triceps muscle body and tendon insertion must be addressed during exposure. Several methods exist including performing an olecranon osteotomy. The triceps fascial tongue exposure, originally described by Van Gorder in 1940, provides an excellent view of the joint while causing minimal trauma to the extensor mechanism facilitating tendon healing, and easy intraoperative conversion from fracture fixation to a total elbow arthroplasty if a fracture is not able to be reconstructed. Using a standard posterior approach to the elbow, a triceps tongue is created. A distally based flap of the triceps tendon approximately 10 cm long and 2 to 3 cm wide is created and a remnant of the tendon is kept on all sides to secure a meticulous repair with nonabsorbable figure-of-eight sutures at the conclusion of the case. In our case series, 29 patients underwent 30 total elbow arthroplasties. There were no triceps-related failures. This surgical technique is a useful alternative surgical exposure to the posterior elbow for fractures and arthroplasty. PMID:25929418

  10. Parenteral lidocaine for treatment of intractable renal colic: a case series

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    Vaezi Hassan

    2011-06-01

    Full Text Available Abstract Introduction We report a case series of successful treatment of intractable renal colic using parenteral lidocaine. Case presentation Because of inconsistent responses to standard treatment with opioids and non-steroidal anti-inflammatory drugs in patients with renal colic pain, we decided to begin a trial of a single intravenous dose of lidocaine (approximately 1.5 mg/kg slowly in eight patients with intractable renal colic who were referred to our emergency medicine department. The patients were six men and two women with a mean age at diagnosis of 34.62 years (age range, 28 to 42 years. The patients were of Iranian ethnic origin. The patients' degree of pain, based on Visual Analog Scale score upon entering our emergency medicine department, was recorded 10, 20, and 30 minutes after lidocaine injection. The patients' degree of pain decreased from a mean Visual Analog Scale score (±SD of 8.87 ± 0.99 (95% confidence interval (95% CI 8.04 to 9.70 to a mean Visual Analog Scale score (±SD of 1 ± 2.82 (95% CI -1.36 to 3.36 before and 30 minutes after lidocaine treatment, respectively. Two of eight patients experienced transient mild dizziness, and three of eight patients experienced minimal slurring of speech. No patient experienced serious adverse events. Conclusion Parenteral lidocaine treatment can reduce pain dramatically or subtly.

  11. Single-site laparoscopy in gynecology: preliminary study of a series of 50 cases

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    Admário Silva Santos Filho

    2014-12-01

    Full Text Available Objective: to describe the initial experience of a gynecology team, at a tertiary care center, when performing single-port laparoscopic surgery. Methods: this is a retrospective study reviewing the medical records of 50 patients treated at the outpatient gynecology clinic of our institution between June 2012 and July 2013 who underwent single-port laparoscopic surgery. This study was approved by the institution’s Ethics in Research Committee. Results: the mean age of patients is 37.8 years, ranging from 18 to 70 years, and the most frequent surgical indications were adnexal mass (72% and chronic pelvic pain (24%. The mean operative time was 94.4 minutes with a mean hospital stay of 25.8 hours. There were no perioperative complications. We recorded two conversions to laparotomy due to technical difficulties during the procedure. All cases of conversion had pelvic adhesions. All operative complications were successfully treated and none were considered severe. Conclusion: this is one of the largest case series in the literature regarding surgical treatment by single-port laparoscopy in gynecology and presents evidence on reduction of surgical morbidity and satisfactory cosmetic results. We conclude that single-port laparoscopy is a viable minimally invasive technique, and that it contributes to the construction of a new scenario in modern gynecological surgery.

  12. Neuroendocrine tumors of the lung: major radiologic findings in a series of 22 histopathologically confirmed cases

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcel Koenigkam, E-mail: marcelk46@yahoo.com.br [Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (HCFMRP-USP), SP (Brazil); Department of Diagnostic and Interventional Radiology, Heidelberg University (Germany); Barreto, Andre Rodrigues Facanha [Clinica Radius, Clinica Sao Carlos Imagem and Santa Casa de Misericordia de Fortaleza, Fortaleza, CE (Brazil); Chagas Neto, Francisco Abaete [Program of Health Sciences Applied to the Locomotor System - Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), Ribeirao Preto, SP (Brazil); Muglia, Valdair Francisco; Elias Junior, Jorge [Division of Radiology, Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRPUSP), Ribeirao Preto, SP (Brazil)

    2012-07-15

    Objective: To describe key imaging findings in a series of cases of primary neuroendocrine tumors of the lung (NTLs), with emphasis on computed tomography changes. Materials And Methods: Imaging studies of 22 patients (12 men, mean age 60 years) with histopathologically confirmed diagnosis, evaluated in the author's institution during the last five years were retrospectively reviewed by two radiologists, with findings being consensually described focusing on changes observed at computed tomography. Results: The authors have described five typical carcinoids, three atypical carcinoids, three large-cell neuroendocrine carcinomas (LCNCs), and 11 small-cell lung cancers (SCLCs). Only one typical carcinoid presented the characteristic appearance of central endobronchial nodule with distal pulmonary atelectasis, while the others were pulmonary nodules or masses. The atypical carcinoids corresponded to peripheral heterogeneous masses. One out of the three LCNCs was a peripheral homogeneous mass, while the others were ill-defined and heterogeneous. The 11 SCLCs corresponded to central, infiltrating and heterogeneous masses with secondary pleuropulmonary changes. Calcifications were absent both in LGNCs and SCLCs. Metastases were found initially and also at follow-up of all the cases of LCNCs and SCLCs. Conclusion: Although some imaging features may be similar, radiologic findings considered together with clinical information may play a relevant role in the differentiation of histological types of NTLs. (author)

  13. [Work-related stress and mobbing: case series and gender differences].

    Science.gov (United States)

    Tonini, Stefano; Lanfranco, Andrea; Costa, Maria Cristina; Lumelli, Diego; Giorgi, Ines; Mazzacane, Fulvio; Scafa, Fabrizio; Candura, Stefano M

    2011-01-01

    The attention of international agencies and scientific community on mobbing (bullying) and work-related stress is increasing. However, research on gender differences and etiologic agents is still limited. This study describes the gender differences found in victims of mobbing and work-related stress in an Italian case series. Between 2001 and 2009, at the Occupational Medicine Unit of our Institution we examined 345 outpatients (197 women and 148 men) for suspected psychopathological work-related problems. After interdisciplinary diagnostic evaluation, the diagnosis of "mobbing syndrome" was formulated, according to international criteria (ICD-I0 and DSM-IV), in a minority of cases: 35 subjects. In the other workers, we found pre-existing psychiatric conditions (not related to work), or altered relationships dynamics with the colleagues. Significant gender differences emerged among people with "mobbing syndrome": there was a high prevalence of women (65%), with medium to high level of education; the most affected age group was between 34 and 45 years; several occupations were involved, with a clear preponderance of office workers. Women are mostly harassed for personal aspects related to emotional and relational factors; men for the content of their work. The knowledge of the phenomenon is an essential prerogative to contrast mobbing; this can be realized, at a preventive level, only through effective information and training for workers and employers, who have the legal obligation to preserve the integrity of the mental and physical status of their employees during the work. PMID:22452099

  14. A multi-modal treatment approach for the shoulder: A 4 patient case series

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    Pollard Henry

    2005-09-01

    Full Text Available Abstract Background This paper describes the clinical management of four cases of shoulder impingement syndrome using a conservative multimodal treatment approach. Clinical Features Four patients presented to a chiropractic clinic with chronic shoulder pain, tenderness in the shoulder region and a limited range of motion with pain and catching. After physical and orthopaedic examination a clinical diagnosis of shoulder impingement syndrome was reached. The four patients were admitted to a multi-modal treatment protocol including soft tissue therapy (ischaemic pressure and cross-friction massage, 7 minutes of phonophoresis (driving of medication into tissue with ultrasound with 1% cortisone cream, diversified spinal and peripheral joint manipulation and rotator cuff and shoulder girdle muscle exercises. The outcome measures for the study were subjective/objective visual analogue pain scales (VAS, range of motion (goniometer and return to normal daily, work and sporting activities. All four subjects at the end of the treatment protocol were symptom free with all outcome measures being normal. At 1 month follow up all patients continued to be symptom free with full range of motion and complete return to normal daily activities. Conclusion This case series demonstrates the potential benefit of a multimodal chiropractic protocol in resolving symptoms associated with a suspected clinical diagnosis of shoulder impingement syndrome.

  15. A prototype framework for models of socio-hydrology: identification of key feedback loops with application to two Australian case-studies

    Science.gov (United States)

    Elshafei, Y.; Sivapalan, M.; Tonts, M.; Hipsey, M. R.

    2014-01-01

    It is increasingly acknowledged that, in order to sustainably manage global freshwater resources, it is critical that we better understand the nature of human-hydrology interactions at the broader catchment system-scale. Yet to date, a generic conceptual framework for building models of catchment systems that include adequate representation of socioeconomic systems - and the dynamic feedbacks between human and natural systems - has remained elusive. In an attempt to work towards such a model, this paper outlines a generic framework for a model of socio-hydrology that posits a novel construct, a composite Community Sensitivity state variable, as a key link to elucidate the drivers of behavioural response in a hydrological context. The framework provides for both macro-scale contextual parameters, which allow it to be applied across climate, socioeconomic and political gradients, and catchment-specific conditions, by way of tailored "closure relationships", in order to ensure that site-specific and application-specific contexts of socio-hydrologic problems can be accommodated. To demonstrate how such a framework would be applied, two different socio-hydrological case studies, taken from the Australian experience, are presented and discussed. It is envisioned that the application of this framework across study sites and gradients will aid in developing our understanding of the fundamental interactions and feedbacks in such complex human-hydrology systems, and allow hydrologists to participate in the growing field of social-ecological systems modelling.

  16. A prototype framework for models of socio-hydrology: identification of key feedback loops with application to two Australian case-studies

    Directory of Open Access Journals (Sweden)

    Y. Elshafei

    2014-01-01

    Full Text Available It is increasingly acknowledged that, in order to sustainably manage global freshwater resources, it is critical that we better understand the nature of human-hydrology interactions at the broader catchment system-scale. Yet to date, a generic conceptual framework for building models of catchment systems that include adequate representation of socioeconomic systems – and the dynamic feedbacks between human and natural systems – has remained elusive. In an attempt to work towards such a model, this paper outlines a generic framework for a model of socio-hydrology that posits a novel construct, a composite Community Sensitivity state variable, as a key link to elucidate the drivers of behavioural response in a hydrological context. The framework provides for both macro-scale contextual parameters, which allow it to be applied across climate, socioeconomic and political gradients, and catchment-specific conditions, by way of tailored "closure relationships", in order to ensure that site-specific and application-specific contexts of socio-hydrologic problems can be accommodated. To demonstrate how such a framework would be applied, two different socio-hydrological case studies, taken from the Australian experience, are presented and discussed. It is envisioned that the application of this framework across study sites and gradients will aid in developing our understanding of the fundamental interactions and feedbacks in such complex human-hydrology systems, and allow hydrologists to participate in the growing field of social-ecological systems modelling.

  17. Motor cortex stimulation for neuropathic pain syndromes: a case series experience.

    Science.gov (United States)

    Buchanan, Robert J; Darrow, David; Monsivais, Daniel; Nadasdy, Zoltan; Gjini, Klevest

    2014-06-18

    Neuropathic pain is a chronic condition lacking effective management and responding poorly to standard treatment protocols. Motor cortex stimulation has emerged as a new and promising therapeutic tool with outcomes potentially affected by the specific causes and location. In this study we report a series of eight cases in the neurosurgery practice of one of the authors (R.J.B.), including neuropathic pain syndromes of trigeminal or thalamic origin with or without anesthesia dolorosa. Pain relief was evaluated on the basis of comparison of Visual Analog scores at baseline and at 3 months after surgery. In addition, we assessed differences in pain relief outcomes between cases with trigeminal neuralgia and thalamic stroke, as well as cases with or without anesthesia dolorosa (i.e. pain with numbness of the affected area). Visual Analog Scale scores showed a statistically significant decrease of 4.19 (P=0.002) at 3 months follow-up compared with baseline. Pain relief levels in four of five patients in the subgroup with facial pain were higher than 50%, and none of the patients in the subgroup with thalamic and phantom limb pain showed such a good outcome. Furthermore, we found larger pain relief levels in facial pain conditions with versus without anesthesia dolorosa. These results point to utility of motor cortex stimulation in relieving neuropathic pain, as well as better outcomes for patients with facial pain and anesthesia dolorosa. Future studies should incorporate methods to noninvasively trial those patients who may benefit from surgical implantation to predict the outcomes and maximize their negative predictive value. PMID:24780896

  18. Chagasic megacolon and large bowel neoplasms: case series and literature review

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    Maxwel Capsy Boga Ribeiro

    2011-12-01

    Full Text Available There is a clear association between chagasic megaesophagus and the esophageal cancer. On the other hand, the association between chagasic megacolon and intestinal neoplasm is uncommon. There are only a few cases described in literature. We selected two cases of colorectal adenocarcinoma associated with adenoma from 2000 to 2011, which are added to the four patients already described by this group. The mean age of the patients, was 68.5 years. Both had been submitted to surgical resection of the neoplasm. Survival rates ranged and were directly related to tumor staging at the time of diagnosis. In this context, we report our case series and reviwed the corresponding literature, especially the clinical and epidemiological aspects of this rare association.Há uma clara associação entre megaesôfago por doença de Chagas e o câncer esofágico. Ao contrário, tal relação, entre megacólon chagásico e neoplasias do intestino grosso é, reconhecidamente, incomum. Existem poucos casos relatados na literatura. Destacamos, entre 2000 e 2011, dois casos, sendo ambos adenocarcinomas colorretais e associados a adenomas, que se somam aos outros quatro já descritos por este grupo. A média de idade dos pacientes, foi de 68,5 anos. Todos foram submetidos à ressecção cirúrgica da neoplasia. A sobrevida foi variável e diretamente relacionada ao estádio do tumor no momento do diagnóstico. Dentro desse contexto, relatamos essa série de casos e revisamos a literatura correlata, com relação aos aspectos clínicos e epidemiológicos dessa rara associação.

  19. The clinical psychologist and the management of inpatient pain: a small case series

    Directory of Open Access Journals (Sweden)

    Childs SR

    2014-12-01

    communication and to resolve a difficult and potentially risk-laden situation. This small case series discusses the benefits derived from the involvement of a clinical psychologist in the management of inpatient pain, and therefore illustrates the need for novel initiatives for inpatient pain services. However, future research is warranted to validate this approach. Keywords: acute pain, aggression, anxiety, borderline personality disorder, psychology

  20. Convergence in spectral forward modelling: Binominal series solutions vs. direct integral solutions at high degrees - spherical and ellipsoidal case

    Science.gov (United States)

    Rexer, Moritz; Claessens, Sten; Hirt, Christian

    2016-04-01

    The number of relevant terms of binominal series expansions used in spectral forward modelling of the gravitational potential is known to rise substantially as the resolution of the models increases. Here, we investigate and compare the binominal series expansions in forward modelling w.r.t. a sphere and w.r.t. an ellipsoid (Claessens and Hirt, 2013) in view of high degree forward modelling (d/o 10800). The series in each case depend on different parameters - such as elevation of the topographic function or ellipsoidal radius/co-latitude - and reveal different maximum orders of truncation for a 1% convergence level (=relative error). The results are verified in a real data scenario up to d/o 5400 by spot-checks using direct integral solutions that do not depend on binomial series expansions. As a conclusion, our study demonstrates that for d/o 10800 modelling up to 30 terms of the binominal series accounting for the radial integral are needed within the spherical and the ellipsoidal case, while up to 60 terms are needed for the binominal series accounting for the oblateness of Earth in the ellipsoidal case for a convergence at the 1% level. References: Claessens, S.J.; Hirt, C.: Ellipsoidal topographic potential - new solutions for spectral forward gravity modelling of topography with respect to a reference ellipsoid; Journal of Geophysical Research (JGR) - Solid Earth, Vol. 118, DOI: 10.1002/2013JB010457, 2013.

  1. CASE/A - COMPUTER AIDED SYSTEM ENGINEERING AND ANALYSIS, ECLSS/ATCS SERIES

    Science.gov (United States)

    Bacskay, A.

    1994-01-01

    , specific heat, density, and viscosity) is generated at user-selected output intervals and stored for reference. The Integrated Plot Utility (IPU) provides plotting capability for all data output. System utility commands are provided to enable the user to operate more efficiently in the CASE/A environment. The user is able to customize a simulation through optional operations FORTRAN logic. This user-developed code is compiled and linked with a CASE/A model and enables the user to control and timeline component operating parameters during various phases of the iterative solution process. CASE/A provides for transient tracking of the flow stream constituents and determination of their thermodynamic state throughout an ECLSS/ATCS simulation, performing heat transfer, chemical reaction, mass/energy balance, and system pressure drop analysis based on user-specified operating conditions. The program tracks each constituent through all combination and decomposition states while maintaining a mass and energy balance on the overall system. This allows rapid assessment of ECLSS designs, the impact of alternate technologies, and impacts due to changes in metabolic forcing functions, consumables usage, and system control considerations. CASE/A is written in FORTRAN 77 for the DEC VAX/VMS computer series, and requires 12Mb of disk storage and a minimum paging file quota of 20,000 pages. The program operates on the Tektronix 4014 graphics standard and VT100 text standard. The program requires a Tektronix 4014 or later graphics terminal, third party composite graphics/text terminal, or personal computer loaded with appropriate VT100/TEK 4014 emulator software. The use of composite terminals or personal computers with popular emulation software is recommended for enhanced CASE/A operations and general ease of use. The program is available on an unlabeled 9-track 6250 BPI DEC VAX BACKUP format magnetic tape. CASE/A development began in 1985 under contract to NASA/Marshall Space Flight

  2. Why Children Join and Stay in Sports Clubs: Case Studies in Australian, French and German Swimming Clubs

    Science.gov (United States)

    Light, Richard L.; Harvey, Stephen; Memmert, Daniel

    2013-01-01

    This article builds upon research on youth sport clubs conducted from a socio-cultural perspective by reporting on a study that inquired into the reasons why children aged 9-12 joined swimming clubs in France, Germany and Australia. Comprising three case studies it employed a mixed method approach with results considered within the framework of…

  3. Case Series Report on the Effect of Hand Acupuncture - Focusing on 29 Patients with Headache -

    Directory of Open Access Journals (Sweden)

    Seung-Ho Sun

    2011-09-01

    Full Text Available Objectives: The purpose of 29 case series is to report the possibility that a hand acupuncture is effective in relieving headache. Methods: After approval from the Institutional Review Board (IRB, I analyzed 29 cases medical records of outpatients with headache, who visited OO oriental medical hospital from December 2008 to December 2010, who have taken a hand acupuncture's treatment without other intervention, and who were diagnosed with one disease of international classification of headache disease second version (ICHD-2. The data was analyzed with Wilcoxon signed rank test to determine whether a hand acupuncture's treatment differed between before and after treatment's Visual Analogue Scale(VAS according to types of headache and syndrome differentiation. Statistics program was used SPSS 18.0. Differences were considered significant at P<0.05. Results: The VAS of patients with headache was reduced after treatment of hand acupuncture from 6.57±2.04 to 2.90±2.04 for overall headache, from 6.32±2.05 to 2.47±2.03 for tension-type headache(P<0.001, from 7.10±2.18 to 3.70±1.77 for migraine(P<0.001, and from 6.00±1.41 to 2.50±3.54 for headache unspecified. A hand acupuncture produced a decrease in VAS of both ascendant hyperactivity of liver yang(P<0.001 and phlegm turbidity according to syndrome differentiation(P=0.002. No adverse event were encountered in any of the patients. Conclusions: It is suggested that a hand acupuncture may be effective in relieving headache, and could be applicable to first choice of acupuncture treatment for headache.

  4. Improving hand sensibility in vibration induced neuropathy: A case-series

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    Lundborg Göran

    2011-04-01

    Full Text Available Abstract Objectives We report a long-term series of nine workers suffering from vibration-induced neuropathy, after many years of exposure to hand-held vibrating tools at high or low frequency. They were treated with temporary selective cutaneous anaesthesia (EMLA® cream of the forearm repeatedly for a period up to one year (in two cases four years. The aim was to improve their capacity to perceive touch and thereby improve hand function and diminish disability. The treatment principle is based on current concepts of brain plasticity, where a deafferentation of a skin area results in improved sensory function in adjacent skin areas. Methods All participants had sensory hand problems in terms of numbness (median touch thresholds > 70 mg and impaired hand function influencing ADL (mean DASH score 22. After an initial identical self-administered treatment period of 8 weeks (12-15 treatments with increasing intervals they did one treatment every 2-3 month. Results After one year sensibility (touch thresholds and tactile discrimination as well as hand function (mean DASH score 13 were improved in a majority of the cases. Seven of the participants choose to continue the treatment after the first year and two of them have continued at a regular basis for up to four years. A surprising, secondary finding was diminishing nocturnal numbness of the hand and arm in eight of the nine subjects from "frequently" to "hardly ever or never". Conclusions Our observations open new perspectives for treatment of impaired sensibility and hand function in a group of patients with vibration induced hand problems where we have no treatment to offer today.

  5. The modified Pirogoff's amputation in treating diabetic foot infections: surgical technique and case series

    Directory of Open Access Journals (Sweden)

    Aziz Nather

    2014-04-01

    Full Text Available Background: This paper describes the surgical technique of a modified Pirogoff's amputation performed by the senior author and reports the results of this operation in a single surgeon case series for patients with diabetic foot infections. Methods: Six patients with diabetic foot infections were operated on by the National University Hospital (NUH diabetic foot team in Singapore between November 2011 and January 2012. All patients underwent a modified Pirogoff's amputation for diabetic foot infections. Inclusion criteria included the presence of a palpable posterior tibial pulse, ankle brachial index (ABI of more than 0.7, and distal infections not extending proximally beyond the midfoot level. Clinical parameters such as presence of pulses and ABI were recorded. Preoperative blood tests performed included a glycated hemoglobin level, hemoglobin, total white blood cell count, C-reactive protein, erythrocyte sedimentation rate, albumin, and creatinine levels. All patients were subjected to 14 sessions of hyperbaric oxygen therapy postoperatively and were followed up for a minimum of 10 months. Results: All six patients had good wound healing. Tibio-calcaneal arthrodesis of the stump was achieved in all cases by 6 months postoperatively. All patients were able to walk with the prosthesis. Conclusions: The modified Pirogoff's amputation has been found to show good results in carefully selected patients with diabetic foot infections. The selection criteria included a palpable posterior tibial pulse, distal infections not extending proximally beyond the midfoot level, ABI of more than 0.7, hemoglobin level of more than 10 g/dL, and serum albumin level of more than 30 g/L.

  6. Experience of managing complicated diverticulitis of colon: a retrospective case series from south asian country

    International Nuclear Information System (INIS)

    To assess the morbidity and mortality associated with complicated diverticulitis in Pakistan. Methods: The retrospective case series was conducted at an urban tertiary care university hospital of Karachi, Pakistan, comprising data from December 1989 to November 2010. International Classification of Diseases codes for diverticular disease and diverticulitis with abscess, fistula, stricture, bowel obstruction and perforation were obtained from the medical record department. SPSS 19 was used for statistical analysis. Results: A total of 60 (1.9%) cases with complicated diverticulitis were located from among 3170 records reviewed. Mean age was 62.7+-13 years with male-to-female ratio being 36:24. In 37 (62%) patients, the diagnosis was established on computed tomography scan of the abdomen, followed by barium enema in 12 (20%) and colonoscopy in 11 (18%). Post-operative morbidity was observed in 24 (40%) and 7 (16%) expired within 28 days of surgery. Post-operative intra-abdominal sepsis, wound dehiscence and incisional hernia were significantly associated with generalised peritonitis (p <0.05), while admission to intensive care unit was associated with age over 60 years and faecal peritonitis. Post-operative mortality was significantly associated with high American Society of Anaesthesiologists-score III and IV and age above 60 years. Conclusion: Complicated diverticulitis carries significant morbidity and mortality in Pakistani population. Since the trend is on the rise, therefore we propose a prospective multi-centre cohort study to understand the spectrum of disease, management and identification of risk factors to achieve the best possible outcomes in patients with complicated diverticulitis. (author)

  7. Adalimumab in the induction of Crohn's disease remission: results of a Brazilian multicenter case series

    Directory of Open Access Journals (Sweden)

    Paulo Gustavo Kotze

    2011-09-01

    Full Text Available Introduction: Adalimumab (ADA is a subcutaneous fully-human anti-TNF antibody which has a significant role in the management of Crohn's disease (CD. Its efficacy has been demonstrated in several clinical trials. The main objective of this study was to evaluate the role of ADA in the induction of clinical remission in a Brazilian series of CD cases. Method: A retrospective analysis of CD patients treated with ADA was performed in three Brazilian inflammatory bowel diseases (IBD reference centers. The following characteristics were analyzed: gender, age, indication to ADA treatment, type of response, previous exposure to infliximab (IFX, concomitant use of immunomodulators and adverse events, among others. Results: 54 patients (29 females were included in this series, with mean age of 36.72 years (ranging from 15 to 62 years. After induction regimen, 26 patients (48.14% were in clinical remission, 26 (48.14% had partial response, and 2 (3.72% were primary non-responders. After a mean follow-up of 9.83 (2 to 28 months, 17 patients (31.48% presented adverse events. The most common event was pain on the injection site (7 patients - 12.96%. Conclusions: ADA was effective to induce CD remission in this Brazilian case series. The remission and response rates were similar to the literature, as well as the safety profile of this drug.Introdução: O adalimumabe (ADA é um anticorpo anti-fator de necrose tumoral alfa totalmente humano, de uso subcutâneo, com eficácia e perfil de segurança bem determinados na doença de Crohn (DC. O objetivo principal deste estudo foi determinar o papel do ADA na indução da remissão na DC, em uma série brasileira de casos. Método: Estudo retrospectivo, realizado em três centros de referência em doenças inflamatórias intestinais, com usuários do ADA para tratamento da DC. As variáveis analisadas foram: idade, sexo, indicação do tratamento, forma de apresentação da doença, tipo de resposta (total, parcial

  8. Chlorinated pesticides and cancer of the head and neck: a retrospective case series.

    Science.gov (United States)

    Govett, Gregg; Genuis, Stephen John; Govett, Hannah E; Beesoon, Sanjay

    2011-07-01

    Cancer of the head and neck is a pervasive problem with recognized determinants including tobacco use, alcohol consumption, and earlier radiation exposure. Organochlorine pesticides (OCPs) have been shown to have carcinogenic potential in both animals and humans. OCPs have previously been widely used in the agricultural industry of rural Oklahoma. Seven patients from rural Oklahoma with head and neck cancer and without any of the usual risk factors were tested for the presence of OCPs in their adipose tissue. Clinical and toxicological data on each of these patients are presented for consideration. Results were compared with (i) levels from five individuals not experiencing cancer but who lived in the same area, and (ii) adipose tissue OCP levels in other population groups. Each of the seven patients tested had markedly elevated levels of some OCPs in their adipose tissue compared with the cohort of noncancer patients. Further research is required to confirm whether there is a causative link between OCP bioaccumulation and head and neck cancer as suggested by this case series. PMID:21633202

  9. In-office bleaching effects on the pulp flow and tooth sensitivity – case series

    Directory of Open Access Journals (Sweden)

    Andrés Felipe CARTAGENA

    2015-01-01

    Full Text Available Laser Doppler flowmetry (LDF is a noninvasive method capable of evaluating variations in pulp blood flow (PBF and pulp vitality. This method has thus far not been used to assess changes in blood flow after in-office bleaching. The aim of this case series report was to measure changes in PBF by LDF in the upper central incisor of three patients submitted to in-office bleaching. The buccal surfaces of the upper arch were bleached with a single session of 35% hydrogen peroxide gel with three 15-min applications. The color was recorded using a value-oriented Vita shade guide before in-office bleaching and one week after the procedure. The tooth sensitivity (TS in a verbal scale was reported, and PBF was assessed by LDF before, immediately, and one week after the bleaching session. The lower arch was submitted to dental bleaching but not used for data assessment. A whitening degree of 3 to 4 shade guide units was detected. All participants experienced moderate to considerable TS after the procedure. The PBF readings reduced 20% to 40% immediately after bleaching. One week post-bleaching, TS and PBF were shown to be equal to baseline values. A reversible decrease of PBF was detected immediately after bleaching, which recovered to the baseline values or showed a slight increase sooner than one week post-bleaching. The LDF method allows detection of pulp blood changes in teeth submitted to in-office bleaching, but further studies are still required.

  10. Rumination-focused cognitive behaviour therapy for residual depression: a case series.

    Science.gov (United States)

    Watkins, Ed; Scott, Jan; Wingrove, Janet; Rimes, Katharine; Bathurst, Neil; Steiner, Herbert; Kennell-Webb, Sandra; Moulds, Michelle; Malliaris, Yanni

    2007-09-01

    The treatment of chronic and recurrent depression is a priority for the development of new interventions. The maintenance of residual symptoms following acute treatment for depression is a risk factor for both chronic depression and further relapse/recurrence. This open case series provides the first data on a cognitive-behavioural treatment for residual depression that explicitly targets depressive rumination. Rumination has been identified as a key factor in the onset and maintenance of depression, which is found to remain elevated following remission from depression. Fourteen consecutively recruited participants meeting criteria for medication--refractory residual depression [Paykel, E.S., Scott, J., Teasdale, J.D., Johnson, A.L., Garland, A., Moore, R. et al., 1999. Prevention of relapse in residual depression by cognitive therapy--a controlled trial. Archives of General Psychiatry 56, 829-835] were treated individually for up to 12 weekly 60-min sessions. Treatment specifically focused on switching patients from less helpful to more helpful styles of thinking through the use of functional analysis, experiential/imagery exercises and behavioural experiments. Treatment produced significant improvements in depressive symptoms, rumination and co-morbid disorders: 71% responded (50% reduction on Hamilton Depression Rating Scale) and 50% achieved full remission. Treating depressive rumination appears to yield generalised improvement in depression and co-morbidity. This study provides preliminary evidence that rumination-focused CBT may be an efficacious treatment for medication--refractory residual depression. PMID:17367751

  11. Retrospective case series of clinical outcomes associated with chiropractic management for veterans with low back pain

    Directory of Open Access Journals (Sweden)

    Andrew S. Dunn, DC, MS, MEd

    2011-10-01

    Full Text Available Musculoskeletal complaints, most notably low back pain (LBP, are prevalent among veterans. Despite a focus on LBP management by chiropractors within the Veterans Health Administration, limited published accounts detail clinical outcomes with chiropractic management of LBP among veterans. This was a retrospective case series of 171 veterans with a chief complaint of LBP who were managed with chiropractic care. Descriptive statistics and paired t-tests were used, with the Numeric Rating Scale (NRS and the Back Bournemouth Questionnaire (BBQ serving as the outcome measures. A minimum clinically important difference (MCID was set as 30% improvement from baseline for both measures. The mean number of treatments was 8.7. For the NRS, the mean raw score improvement was 2.2 points, representing 37.4% change from baseline; 103 (60.2% patients met or exceeded the MCID. For the BBQ, the mean raw score improvement was 13.6 points, representing 34.6% change from baseline; 92 patients (53.8% met or exceeded the MCID. For this sample of veterans with LBP, the mean percentages of clinical improvement were statistically significant and clinically meaningful for both the NRS and BBQ.

  12. Homocysteine and cognitive impairment; a case series in a General Practice setting

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    McCaddon Andrew

    2006-02-01

    Full Text Available Abstract Background An elevated blood level of homocysteine is a risk factor for cognitive impairment and dementia. Homocysteine can be lowered by folate and/or vitamin B12 supplementation; antioxidants might also be required for optimal reduction in neurovascular tissue. This report presents clinical and radiological findings from administering the antioxidant N-acetylcysteine together with B vitamins to cognitively impaired patients with hyperhomocysteinaemia. Methods A case series (n = 7 performed in a semi-rural General Practice setting. Formal cognitive assessments were performed in five patients, and radiological assessments in one patient, before and after supplementation. Results and discussion The addition of N-acetylcysteine resulted in subjective clinical improvement in all patients, and an objective improvement in cognitive scores in five patients. One patient had radiological evidence of halted disease progression over a twelve month period. Conclusion N-acetylcysteine, together with B vitamin supplements, improves cognitive status in hyperhomocysteinaemic patients. Randomized controlled clinical trials are required to formally evaluate this treatment approach.

  13. Tetrodotoxin poisoning caused by Goby fish consumption in southeast China: a retrospective case series analysis

    Directory of Open Access Journals (Sweden)

    Jie You

    2015-01-01

    Full Text Available OBJECTIVES: To investigate an unusual outbreak of tetrodotoxin poisoning in Leizhou, southeast China, a case series analysis was conducted to identify the source of illness. METHODS: A total of 22 individuals experienced symptoms of poisoning, including tongue numbness, dizziness, nausea and limb numbness and weakness. Two toxic species, Amoya caninus and Yongeichthys nebulosus, were morphologically identified from the batches of gobies consumed by the patients. Tetrodotoxin levels in the blood and Goby fish samples were detected using liquid chromatography-tandem mass spectrometry. RESULTS: The tetrodotoxin levels in the remaining cooked Goby fish were determined to be 2090.12 µg/kg. For Amoya caninus, the toxicity levels were 1858.29 µg/kg in the muscle and 1997.19 µg/kg in the viscera and for Yongeichthys nebulosus, they were 2783.00 µg/kg in the muscle and 2966.21 µg/kg in the viscera. CONCLUSION: This outbreak demonstrates an underestimation of the risk of Goby fish poisoning. Furthermore, the relationships among the toxic species, climates and marine algae present should be clarified in the future.

  14. Permanent molar pulpotomy with a new endodontic cement: A case series

    Directory of Open Access Journals (Sweden)

    Asgary Saeed

    2009-01-01

    Full Text Available The aim of this case series was to determine the clinical and radiographic success rate of pulpotomy, with new endodontic cement (NEC, in human mature permanent molar teeth. Twelve molars with established irreversible pulpitis were selected from patients 14 - 62 years old. The selection criteria included carious pulp exposure with a positive history of lingering pain. After isolation, caries removal, and pulp exposure, pulpotomy with NEC was performed and a permanent restoration was immediately placed. At the first recall (+1 day no patients reported postoperative pain. One wisdom tooth had been extracted after two months because of failure in coronal restoration. Eleven patients were available for the second recall, with a mean time of 15.8 months. Clinical and radiographic examination revealed that all teeth were functional and free of signs and symptoms. Histological examination of the extracted teeth revealed complete dentin bridge formation and a normal pulp. Although the results favored the use of NEC, more studies with larger samples and a longer recall period were suggested, to justify the use of this novel material for treatment of irreversible pulpitis in human permanent molar teeth.

  15. Niemann-Pick disease type C: a case series of Brazilian patients

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    Paulo José Lorenzoni

    2014-03-01

    Full Text Available The aim of the study was to analyze a series of Brazilian patients with Niemann-Pick disease type C (NP-C. Method Correlations between clinical findings, laboratory data, molecular findings and treatment response are presented. Result The sample consisted of 5 patients aged 8 to 26 years. Vertical supranuclear gaze palsy, cerebellar ataxia, dementia, dystonia and dysarthria were present in all cases. Filipin staining showed the “classical” pattern in two patients and a “variant” pattern in three patients. Molecular analysis found mutations in the NPC1 gene in all alleles. Miglustat treatment was administered to 4 patients. Conclusion Although filipin staining should be used to confirm the diagnosis, bone marrow sea-blue histiocytes often help to diagnosis of NP-C. The p.P1007A mutation seems to be correlated with the “variant” pattern in filipin staining. Miglustat treatment response seems to be correlated with the age at disease onset and disability scale score at diagnosis.

  16. Correction of Tear Trough Deformity With a Cohesive Polydensified Matrix Hyaluronic Acid: A Case Series.

    Science.gov (United States)

    Huber-Vorländer, Jürgen; Kürten, Martin

    2015-01-01

    The tear trough or infraorbital hollow is a challenging area to treat, and only a few fillers are suitable for this delicate area. We report on a European case series of six subjects with mild to severe tear troughs who received treatment with cohesive polydensified matrix (CPM®) technology hyaluronic acid gel (Belotero® Balance). The product was injected as small depots (up to ten small boli 0.2 mL maximum each per side) at the supraperiosteal level along or below the orbital rim. Follow-up visits took place at 1, 3, 6, and 9 months after injection for independent evaluation of the clinical effect using the Merz Aesthetics Scale™ for infraorbital hollows and the Global Aesthetic Improvement Scale. Adverse events were also recorded. Mean hollowness scores were considerably improved compared with baseline in all subjects. In all women, the improvements remained throughout the 9-month study, with none reverting to their baseline score. Subjects' satisfaction with treatment was very high throughout the study, and all women stated that they would repeat treatment with the same product. The CPM hyaluronic acid gel was well tolerated. CPM hyaluronic acid gel is a safe and effective treatment for the tear trough area. PMID:26605822

  17. AWAKE CRANIOTOMY USING DEXMEDETOMIDINE INFUSION AND SCALP BLOCK: OUR EXPERIENCE IN SERIES OF CASES

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    Annapurna Sarma

    2015-06-01

    Full Text Available BACKGROUND: Awake craniotomy is an important technique used for brain tumour excision from eloquent cortex. Awake craniotomy allows maximum resection of the tumor with minimum functional impairment . The critical aspect is to maintain adequate analgesia and sedation, hemodynamic stability, airway safety, while keeping the patient awake and cooperative for neurological testing. AIM OF THE STUDY: We are reporting cases series of awake craniotomy under monito red anesthesia care using dexmedetomidine infusion as an adjuvant to scalp block, titrating the sedation level by BIS monitoring. MATERIALS AND METHODS: After careful patient selection and psychological preparation Monitored Anesthesia Care was provided by continuous infusion of dexmedetomidine at a rate of 0.2 - 0.5ug/kg/min titrating sedation score to BIS value of 70 - 90. Bilateral scalp block was administered using 0.5% bupivacaine. For dura mater incision, a pad with 2% lidocaine was applied for 3 minutes . The tumor removal was complete with no neurological deficiency. All the patients were discharged on 5 th postoperative day without complications and with full patient satisfaction. CONCLUSION: We conclude that monitored anesthesia care with dexmedetomidine infusion and scalp block for awake craniotomy is safe and efficacious. Absence of complications and high patient satisfaction score makes this technique close to an ideal technique for awake craniotomy. KEYWORDS: Awake craniotomy; Dexmedetomidine; Scalp b lock; BIS index

  18. Weightlifting's risky new trend: a case series of 41 insulin users.

    Science.gov (United States)

    Ip, Eric J; Barnett, Mitchell J; Tenerowicz, Michael J; Perry, Paul J

    2012-01-01

    Use of performance-enhancing drugs (PEDs) is common among strength-trained individuals, and a growing concern is the misuse of insulin. A 99-item Internet-based survey was posted on discussion boards of various fitness, bodybuilding, weightlifting, and anabolic steroid Web sites between February and June 2009. A case series of 41 nondiabetic insulin users is described. The typical insulin user was 30.7 ± 9.2 years old, male (97.6%), and Caucasian/white (86.8%) who classified himself as a "recreational exerciser" (47.5%). The average insulin user also used anabolic steroids (95.1%) and practiced polypharmacy by incorporating 16.2 ± 5.6 PEDs in his or her yearly routine. Hypoglycemia was reported by most of the subjects (56.8%), and one individual reported unconsciousness. Insulin was obtained most commonly from local sources (e.g., friends, training partners, gym member/dealer; 40.5%) and community pharmacies (37.8%), with most (80.6%) finding it "easy" to acquire their insulin. Strategies aimed to prevent insulin misuse are needed. PMID:22777326

  19. Is mindfulness-based therapy an effective intervention for obsessive-intrusive thoughts: a case series.

    Science.gov (United States)

    Wilkinson-Tough, Megan; Bocci, Laura; Thorne, Kirsty; Herlihy, Jane

    2010-01-01

    Despite the efficacy of cognitive-behavioural interventions in improving the experience of obsessions and compulsions, some people do not benefit from this approach. The present research uses a case series design to establish whether mindfulness-based therapy could benefit those experiencing obsessive-intrusive thoughts by targeting thought-action fusion and thought suppression. Three participants received a relaxation control intervention followed by a six-session mindfulness-based intervention which emphasized daily practice. Following therapy all participants demonstrated reductions in Yale-Brown Obsessive-Compulsive Scale scores to below clinical levels, with two participants maintaining this at follow-up. Qualitative analysis of post-therapy feedback suggested that mindfulness skills such as observation, awareness and acceptance were seen as helpful in managing thought-action fusion and suppression. Despite being limited by small participant numbers, these results suggest that mindfulness may be beneficial to some people experiencing intrusive unwanted thoughts and that further research could establish the possible efficacy of this approach in larger samples. PMID:20041421

  20. Time-series microarray data simulation modeled with a case-control label.

    Science.gov (United States)

    Liu, Y J; Zhang, J Y

    2016-01-01

    With advances in molecular biology, microarray data have become an important resource in the exploration of complex human diseases. Although gene chip technology continues to grow, there are still many barriers to overcome, such as high costs, small sample sizes, complex procedures, poor repeatability, and the dependence on data analysis methods. To avoid these problems, simulation data have a vital role in the study of complex diseases. A simulation method of microarray data is introduced in this study to model the occurrence and development of general diseases. Using classic statistics and control theory, five risk models are proposed. One or more models can be introduced into the baseline simulation dataset with a case-control label. In addition, time-series gene expression data can be generated to model the dynamic evolutionary process of a disease. The prevalence of each model is estimated and disease-associated genes are tested by significance analysis of microarrays. The source code, written in MATLAB, is freely and publicly available at http://sourceforge.net/projects/genesimulation/files/. PMID:27323009

  1. The Use of Computers for Clinical Care: A Case Series of Advanced U.S. Sites

    Science.gov (United States)

    Doolan, David F.; Bates, David W.; James, Brent C.

    2003-01-01

    Objective: To describe advanced clinical information systems in the context in which they have been implemented and are being used. Design: Case series of five U.S. hospitals, including inpatient, ambulatory and emergency units. Descriptive study with data collected from interviews, observations, and document analysis. Measurements: The use of computerized results, notes, orders, and event monitors and the type of decision support; data capture mechanisms and data form; impact on clinician satisfaction and clinical processes and outcomes; and the organizational factors associated with successful implementation. Results: All sites have implemented a wide range of clinical information systems with extensive decision support. The systems had been well accepted by clinicians and have improved clinical processes. Successful implementation required leadership and long-term commitment, a focus on improving clinical processes, and gaining clinician involvement and maintaining productivity. Conclusion: Despite differences in approach there are many similarities between sites in the clinical information systems in use and the factors important to successful implementation. The experience of these sites may provide a valuable guide for others who are yet to start, or are just beginning, the implementation of clinical information systems. PMID:12509360

  2. Postoperative Respiratory Depression Associated with Pregabalin: A Case Series and a Preoperative Decision Algorithm

    Directory of Open Access Journals (Sweden)

    Naveen Eipe

    2011-01-01

    Full Text Available Pregabalin is gaining popularity in the perioperative period for its usefulness in treating neuropathic pain and its apparent opioid-sparing effect. The present report describes the perioperative course of three patients who received pregabalin and experienced significant respiratory depression in the postoperative period. All three patients consented to the report and publication of the present case series. The first patient was elderly with borderline renal dysfunction. She experienced respiratory arrest in the immediate postoperative period following a craniotomy for tumour excision. The second patient presented with severe respiratory depression 12 h after receiving a spinal anesthetic for joint replacement, and was later found to have clinically significant obstructive sleep apnea. The third patient, who was an otherwise healthy elderly individual on benzodiazepines for anxiety, experienced respiratory arrest in the postanesthesia care unit after an uneventful anesthesia for lumbar spine decompression. All of these patients were treated successfully with standard resuscitation measures. Although other causes of respiratory depression in these patients were considered, there appears to be an association between pregabalin and this complication. The present article briefly reviews the evidence regarding the perioperative use of pregabalin. Based on the authors’ experience and the available evidence, they believe that pregabalin may be useful in the management of acute pain in carefully selected patients undergoing certain surgeries. A clinical algorithm has been developed to guide the perioperative use of pregabalin. This algorithm may be helpful in increasing the safety of perioperative pregabalin use.

  3. Recovery of brachial plexus lesions resulting from heavy backpack use: A follow-up case series

    Directory of Open Access Journals (Sweden)

    Pihlajamäki Harri K

    2011-03-01

    Full Text Available Abstract Background Brachial plexus lesions as a consequence of carrying a heavy backpack have been reported, but the typical clinical course and long-term consequences are not clear. Here we evaluated the clinical course and pattern of recovery of backpack palsy (BPP in a large series of patients. Methods Thirty-eight consecutive patients with idiopathic BPP were identified from our population of 193,450 Finnish conscripts by means of computerised register. A physiotherapist provided instructions for proper hand use and rehabilitative exercises at disease onset. The patients were followed up for 2 to 8 years from the diagnosis. We also searched for genetic markers of hereditary neuropathy with pressure palsies. Mann-Whitney U-test was used to analyze continuous data. The Fischer's exact test was used to assess two-way tables. Results Eighty percent of the patients recovered totally within 9 months after the onset of weakness. Prolonged symptoms occurred in 15% of the patients, but daily activities were not affected. The weight of the carried load at the symptom onset significantly affected the severity of the muscle strength loss in the physiotherapeutic testing at the follow-up. The initial electromyography did not predict recovery. Genetic testing did not reveal de novo hereditary neuropathy with pressure palsies. Conclusions The prognosis of BPP is favorable in the vast majority of cases. Electromyography is useful for diagnosis. To prevent brachial plexus lesions, backpack loads greater than 40 kg should be avoided.

  4. Correction of tear trough deformity with a cohesive polydensified matrix hyaluronic acid: a case series

    Directory of Open Access Journals (Sweden)

    Huber-Vorländer J

    2015-06-01

    Full Text Available Jürgen Huber-Vorländer, Martin KürtenFort Malakoff Klinik, Mainz, GermanyAbstract: The tear trough or infraorbital hollow is a challenging area to treat, and only a few fillers are suitable for this delicate area. We report on a European case series of six subjects with mild to severe tear troughs who received treatment with cohesive polydensified matrix (CPM® technology hyaluronic acid gel (Belotero® Balance. The product was injected as small depots (up to ten small boli 0.2 mL maximum each per side at the supraperiosteal level along or below the orbital rim. Follow-up visits took place at 1, 3, 6, and 9 months after injection for independent evaluation of the clinical effect using the Merz Aesthetics Scale™ for infraorbital hollows and the Global Aesthetic Improvement Scale. Adverse events were also recorded. Mean hollowness scores were considerably improved compared with baseline in all subjects. In all women, the improvements remained throughout the 9-month study, with none reverting to their baseline score. Subjects’ satisfaction with treatment was very high throughout the study, and all women stated that they would repeat treatment with the same product. The CPM hyaluronic acid gel was well tolerated. CPM hyaluronic acid gel is a safe and effective treatment for the tear trough area.Keywords: Belotero® Balance, cohesive polydensified matrix (CPM®, hyaluronic acid, infraorbital hollow, tear trough

  5. Community referral in home management of malaria in western Uganda: A case series study

    Directory of Open Access Journals (Sweden)

    Nsungwa-Sabiiti Jesca

    2006-03-01

    Full Text Available Abstract Background Home Based Management of fever (HBM was introduced as a national policy in Uganda to increase access to prompt presumptive treatment of malaria. Pre-packed Chloroquine/Fansidar combination is distributed free of charge to febrile children Methods A case-series study was performed during 20 weeks in a West-Ugandan sub-county with an under-five population of 3,600. Community drug distributors (DDs were visited fortnightly and recording forms collected. Referred children were located and primary caretaker interviewed in the household. Referral health facility records were studied for those stating having completed referral. Results Overall referral rate was 8% (117/1454. Fever was the main reason for mothers to seek DD care and for DDs to refer. Twenty-six of the 28 (93% "urgent referrals" accessed referral care but 8 (31% delayed >24 hours. Waiting for antimalarial drugs to finish caused most delays. Of 32 possible pneumonias only 16 (50% were urgently referred; most delayed ≥ 2 days before accessing referral care. Conclusion The HBM has high referral compliance and extends primary health care to the communities by maintaining linkages with formal health services. Referral non-completion was not a major issue but failure to recognise pneumonia symptoms and delays in referral care access for respiratory illnesses may pose hazards for children with acute respiratory infections. Extending HBM to also include pneumonia may increase prompt and effective care of the sick child in sub-Saharan Africa.

  6. Thrombotic events in patients with antiphospholipid syndrome treated with rivaroxaban: a series of eight cases.

    Science.gov (United States)

    Signorelli, Flavio; Nogueira, Felipe; Domingues, Vinicius; Mariz, Henrique Ataide; Levy, Roger A

    2016-03-01

    The current treatment for antiphospholipid syndrome (APS) with thrombotic manifestation is long-term anticoagulation. Vitamin K antagonists (VKA) are usually the agents of choice. However, VKA limitations, such as unpredictable anticoagulation effects due to interaction with diet and other drugs, require regular monitoring. This may impact on patients' quality of life. Since the approval of new oral anticoagulants (NOAC) for non-valvular atrial fibrillation and deep vein thrombosis prevention, much has been speculated about its use in APS patients. We report here a series of eight APS patients with failure of thrombotic prevention during rivaroxaban use. All patients had venous thrombosis as the initial manifestation of APS, and two of them also had arterial manifestations. Three patients had triple antibody positivity. Five patients developed arterial events during the treatment with rivaroxaban. Until the results of ongoing trials of rivaroxaban for APS are presented, NOAC should not be recommended to APS patients. Our preliminary experience as well cases previously reported in the literature suggest that there is a high-risk group that is less protected with rivaroxaban, namely those with previous arterial thrombosis or triple positivity. VKA remains to be the mainstay treatment for thrombotic APS. PMID:26219490

  7. Application of Plasma Exchange in Patients with History of Unexplained Recurrent Abortion: A Case Series

    Directory of Open Access Journals (Sweden)

    Azadeh Ghaheri

    2013-01-01

    Full Text Available Background: Immune-mediated recurrent pregnancy loss (RPL has received more attentionthan any other single etiologic classification. Individuals with rare blood group P have an antipp1pkantibody in their serum, which causes recurrent abortion in the early stages.Materials and Methods: In this case series study, 11 patients with unexplained RPL whohad anti-P antibody in their serum were treated by plasma exchange during their nextpregnancies. To evaluate the efficacy of the treatment, we monitored fetal developmentusing ultrasonography and intensive prenatal care. All calculations were performed withthe SPSS version 16.Results: All patients who were treated by plasma exchange progressed to live birth. Themean gestational age at the time of termination was 37.5 ± 0.69 weeks. The mean weightof the newborns was 2729.09 ± 389.88 g. None of the newborns required exchange transfusion.Conclusion: P-incompatibility is one rare but important cause of unexplained RPL and also abasis for therapeutic intervention via early antibody removal by plasma exchange.

  8. Tuberculosis Case Finding in Benin, 2000-2014 and Beyond: A Retrospective Cohort and Time Series Study.

    Science.gov (United States)

    Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D; Anagonou, Séverin

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The "R" software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15-34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887

  9. Tuberculosis Case Finding in Benin, 2000–2014 and Beyond: A Retrospective Cohort and Time Series Study

    Science.gov (United States)

    Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D.; Anagonou, Séverin

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The “R” software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15–34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887

  10. Invasive Complete Hydatidiform Moles: Analysis of a Case Series With Genotyping.

    Science.gov (United States)

    Bynum, Jennifer; Murphy, Kathleen M; DeScipio, Cheryl; Beierl, Katie; Adams, Emily; Anderson, Derek; Vang, Russell; Ronnett, Brigitte M

    2016-03-01

    Complete hydatidiform moles (CHM) are purely androgenetic conceptions, with most (∼85%) arising from fertilization of an egg lacking maternal DNA by a single sperm that duplicates (homozygous/monospermic 46,XX) and a small subset arising via fertilization by 2 sperms (heterozygous/dispermic 46,XY or 46,XX). It remains controversial if heterozygous/dispermic CHMs have a significantly greater risk of persistent gestational trophoblastic disease. Analysis of zygosity of CHMs with and without invasion at presentation, including invasive CHMs with concurrent atypical trophoblastic proliferations concerning for or consistent with choriocarcinoma, has not been specifically addressed. In a prospective series of 1024 products of conception specimens subjected to immunohistochemical analysis of p57 expression and molecular genotyping with short tandem-repeat markers, 288 CHMs were diagnosed, of which 126 were genotyped, including 16 invasive CHMs. Zygosity was compared between those with and without invasion. Of the 16 study cases, 12 (75%) were homozygous/monospermic XX and 4 (25%) were heterozygous/dispermic (3 XY and 1 XX). Of the 110 genotyped noninvasive CHMs, 96 (87%) were homozygous/monospermic XX and 14 (13%) were heterozygous/dispermic (12 XY, 2 XX). Comparison of the zygosity results for the invasive CHMs (study group) with the noninvasive CHMs in the database did not demonstrate a statistically significant difference (P=0.24, Fisher exact test). In addition, of the 3 cases associated with metastatic gestational trophoblastic disease (pulmonary nodules) at presentation, 2 were homozygous/monospermic XX, indicating that this form is not without risk of significant gestational trophoblastic disease. Thus, the current study has demonstrated a higher frequency of heterozygous/dispermic CHMs among invasive cases compared with those lacking invasion, but does not support the use of zygosity data for risk assessment of CHMs. A persistent, unresolved diagnostic challenge

  11. How safe is Australian Radiotherapy?

    International Nuclear Information System (INIS)

    Many incidents and near-incidents are known to occur in Australian radiation oncology departments. The vast majority of incidents are minor in nature; however a small percentage represent major threats to good patient care, administrative structures and public confidence. A small but regular number of incidents result in ad-hoc local and/or State committees of inquiry or Tort actions and inevitably have substantial personal and departmental repercussions. Apart from some local databases on treatment delivery incidents maintained by radiation therapists, no systematic data collection or analysis of treatment incidents exists for radiation oncology in Australia. This paper argues the case for a prospective, systematic approach to the recording and analysis of treatment-related incidents and near incidents. Major barriers to such a scheme, including fear of litigation, misuse of information and lack of understanding on the nature of an incident are discussed. Copyright (2003) Australian Institute of Radiography

  12. Time Series Analysis OF SAR Image Fractal Maps: The Somma-Vesuvio Volcanic Complex Case Study

    Science.gov (United States)

    Pepe, Antonio; De Luca, Claudio; Di Martino, Gerardo; Iodice, Antonio; Manzo, Mariarosaria; Pepe, Susi; Riccio, Daniele; Ruello, Giuseppe; Sansosti, Eugenio; Zinno, Ivana

    2016-04-01

    The fractal dimension is a significant geophysical parameter describing natural surfaces representing the distribution of the roughness over different spatial scale; in case of volcanic structures, it has been related to the specific nature of materials and to the effects of active geodynamic processes. In this work, we present the analysis of the temporal behavior of the fractal dimension estimates generated from multi-pass SAR images relevant to the Somma-Vesuvio volcanic complex (South Italy). To this aim, we consider a Cosmo-SkyMed data-set of 42 stripmap images acquired from ascending orbits between October 2009 and December 2012. Starting from these images, we generate a three-dimensional stack composed by the corresponding fractal maps (ordered according to the acquisition dates), after a proper co-registration. The time-series of the pixel-by-pixel estimated fractal dimension values show that, over invariant natural areas, the fractal dimension values do not reveal significant changes; on the contrary, over urban areas, it correctly assumes values outside the natural surfaces fractality range and show strong fluctuations. As a final result of our analysis, we generate a fractal map that includes only the areas where the fractal dimension is considered reliable and stable (i.e., whose standard deviation computed over the time series is reasonably small). The so-obtained fractal dimension map is then used to identify areas that are homogeneous from a fractal viewpoint. Indeed, the analysis of this map reveals the presence of two distinctive landscape units corresponding to the Mt. Vesuvio and Gran Cono. The comparison with the (simplified) geological map clearly shows the presence in these two areas of volcanic products of different age. The presented fractal dimension map analysis demonstrates the ability to get a figure about the evolution degree of the monitored volcanic edifice and can be profitably extended in the future to other volcanic systems with

  13. Environmental Kuznets revisited. Time-series versus panel estimation. The CO2-case

    International Nuclear Information System (INIS)

    According to the Environmental Kuznets Curve (EKC) hypothesis economic growth and improving environmental quality are compatible. An inverted U-shaped relationship would exist between economic performance and environmental quality suggesting that after some threshold a growing economy would cause smaller pollution. Usually the EKC hypothesis is tested for pooled panel data of some (sub)set of environmental indicators and GDP. The essential assumption behind pooling the observations of different countries in one panel is that the outcome of the economic process would be the same for all countries with respect to emissions. That is, the curvature of the Income-Emission Relation (IER) is the same for the pooled countries as far as they have the same GDP range. In our study we show this methodology to be misleading for at least the special case of carbon dioxide (CO2) emissions and the GDP level. Using OECD-wide data from 1960 to 1990, we find that the pooled estimation results show positive auto-correlation. Other studies correct for this problem. However, as we show, it seems more likely that the estimated regression model is not correct due to the pooling of the country observations. Testing the model per country reveals that the IER is very different for countries. While some countries show growing carbon dioxide emissions per capita with increasing income, others show a stabilizing pattern or even an EKC. This indicates that estimations based on pooling techniques can bias the conclusion about the true IER leading to unjustified inferences on the existence of the EKC. Extending the basic model may result in the justification of pooling. However, our estimations including country specific variables, like population density, openness of the economy and the availability of own fuel sources (endowment effects), do not make us optimistic. The autocorrelation problem remains. If a more general model can not be found the only remaining conclusion is that testing the EKC

  14. Does situs inversus totalis preclude liver donation in living donor liver transplantation? A series of 3 cases from single institution

    OpenAIRE

    Selvakumar N.; Neerav Goyal; Mohammed Nayeem; Sandeep Vohra; Subash Gupta

    2016-01-01

    Introduction: Liver transplantation (LT) is the gold standard for decompensated Chronic Liver Disease (CLD) in individuals satisfying the selection criteria. Organ scarcity is the rate limiting step in liver transplantation across the globe. Expanding the donor pool is practiced by transplant surgeons across the globe in view of perennial donor organ scarcity and ever increasing organ demand. Presentation of case: We have presented series of 3 cases of liver transplantation (LT) with modif...

  15. Clinical Practice as Natural Laboratory for Psychotherapy Research: A Guide to Case-Based Time-Series Analysis

    Science.gov (United States)

    Borckardt, Jeffrey J.; Nash, Michael R.; Murphy, Martin D.; Moore, Mark; Shaw, Darlene; O'Neil, Patrick

    2008-01-01

    Both researchers and practitioners need to know more about how laboratory treatment protocols translate to real-world practice settings and how clinical innovations can be systematically tested and communicated to a skeptical scientific community. The single-case time-series study is well suited to opening a productive discourse between practice…

  16. Advantages of the Multiple Case Series Approach to the Study of Cognitive Deficits in Autism Spectrum Disorder

    Science.gov (United States)

    Towgood, Karren J.; Meuwese, Julia D. I.; Gilbert, Sam J.; Turner, Martha S.; Burgess, Paul W.

    2009-01-01

    In the neuropsychological case series approach, tasks are administered that tap different cognitive domains, and differences within rather than across individuals are the basis for theorising; each individual is effectively their own control. This approach is a mainstay of cognitive neuropsychology, and is particularly suited to the study of…

  17. Therapeutic Assessment for Preadolescent Boys with Oppositional Defiant Disorder: A Replicated Single-Case Time-Series Design

    Science.gov (United States)

    Smith, Justin D.; Handler, Leonard; Nash, Michael R.

    2010-01-01

    The Therapeutic Assessment (TA) model is a relatively new treatment approach that fuses assessment and psychotherapy. The study examines the efficacy of this model with preadolescent boys with oppositional defiant disorder and their families. A replicated single-case time-series design with daily measures is used to assess the effects of TA and to…

  18. Variations in Clinical Presentation of Ocular Syphilis: Case Series Reported From a Growing Epidemic in the United States.

    Science.gov (United States)

    Marx, Grace E; Dhanireddy, Shireesha; Marrazzo, Jeanne M; Tuddenham, Susan A; Rompalo, Anne M; Leone, Peter A; Gaydos, Charlotte A; Rietmeijer, Cornelis A

    2016-08-01

    Ocular syphilis, a form of neurosyphilis, has been increasingly diagnosed in the United States. This case series summarizes the course of 6 patients recently diagnosed with ocular syphilis, emphasizing the varied sociodemographic factors and the wide range of symptoms and outcomes that are seen in patients with this disease. PMID:27419818

  19. Biotinidase Deficiency: A Reversible Neurometabolic Disorder (An Iranian Pediatric Case Series

    Directory of Open Access Journals (Sweden)

    Parvaneh KARIMZADEH

    2013-11-01

    Full Text Available  How to Cite This Article: Karimzadeh P, Ahmadabadi F, Jafari N, Jabbehdari S, Alaee MR, Ghofrani M, Taghdiri MM, Tonekaboni SH. Biotinidase Deficiency: A Reversible Neurometabolic Disorder (An Iranian Pediatric Case Series. Iran J Child Neurol. 2013 Autumn; 7(4:47- 52. ObjectiveBiotinidase deficiency is one of the rare congenital metabolic disorders with autosomal recessive inheritance. If this disorder is diagnosed in newborn period, could be prevented well from mental and physical developmentaldelay and most of clinical manifestations.Materials & MethodsThe patients were diagnosed as biotinidase deficiency in Neurology Department of Mofid Children’s Hospital in Tehran, Iran, between 2009 and 2012 were included in this study. This study was conducted to define the age, gender, past medical history, developmental status, general appearance, clinical manifestations, neuroimaging findings, and response to treatment in 16 patients with biotinidase deficiency in this department.ResultsIn clinical presentation, cutaneous lesions were not found in 37% of the patients and 43% patients had not alopecia. 75% patients had abnormal neuroimaging that in 56% of them, generalized brain atrophy and myelination delay were found. Results of the present study showed the efficacy of biotin in early diagnosed patients with seizure and dermatological manifestations. The seizure and skin manifestations were improved after biotin therapy.ConclusionAccording to the results of this study, we suggest that early assessment and diagnosis have an important role in the prevention of disease progression and clinical signs. ReferencesWolf B.Disorders of biotin metabolism. In: Scriver CR,Beaudet AL, Sly W, et al.,eds. The Metabolic and MolecularBases of Inherited Disease, 8thed. New York,NY:McGraw-Hill;2001: 3935-3962.Rathi N, RathiM.Biotinidase deficiency with hypertonia as unusual feature.IndianPediatr. 2009;46(1:65-67.Wolf B.Worldwide survey of neonatal screening for

  20. Somatosensory Rehabilitation for Neuropathic Pain in Burn Survivors: A Case Series.

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    Nedelec, Bernadette; Calva, Valerie; Chouinard, Annick; Couture, Marie-Andrée; Godbout, Elisabeth; de Oliveira, Ana; LaSalle, Léo

    2016-01-01

    Neuropathic pain is an enormous rehabilitation challenge that has a substantial negative effect on patient function and quality of life. Somatosensory rehabilitation is a novel, nonpharmacological intervention described by Spicher based on the neuroplasticity of the somatosensory system. The rationale for somatosensory rehabilitation is that treating hypoesthesia will decrease neuropathic pain. Particularly for those with established neuropathic pain, the hypoesthesia may be masked by mechanical allodynia, which must be treated before treating the underlying hyposensitive zone. This case series describes the outcome of 17 burn survivors treated with somatosensory rehabilitation for their neuropathic pain. Before initiating treatment a modified version of the McGill Pain Questionnaire-short form (Questionnaire de la douleur St. Antoine, QDSA) was completed with the patients. The total score (×/64) was converted to percentage. The mechanical allodynia was assessed with the Rainbow Pain Scale that uses touch with the 15-g Semmes Weinstein Monofilaments (SWMs) and that was rated as painful on the visual analog scale (3/10 or resting pain + 1/10), as the criteria for mechanical allodynia. The severity level was assessed using seven predetermined SWMs to identify the smallest that elicited pain. The treatment consisted of avoiding all touch in the allodynic zone while concurrently providing proximal sensory and vibratory counter stimulation. Once the mechanical allodynia was eliminated, the underlying hypoesthesia was treated. Hypoesthesia was evaluated with the SWMs, and the percent improvement from baseline was calculated. The sensory reeducation treatment for hypoesthesia consisted of touch discrimination, texture perception, and vibratory stimulation. Seventeen patients (71/29% male/female, 21 ± 25% TBSA burned, 486 ± 596 days postburn) were evaluated and treated. Of these 15 initially presented with mechanical allodynia. The SWM scores had improved by 27 ± 21

  1. Redefining & Leading the Academic Discipline in Australian Universities

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    Harkin, Damien G.; Healy, Annah H.

    2013-01-01

    Disciplines have emerged as an alternative administrative structure to departments or schools in Australian universities. We presently investigate the pattern of discipline use and by way of case study examine a role for distributed leadership in discipline management. Over forty per cent of Australian universities currently employ disciplines,…

  2. Volitional cycling augmented by functional electrical stimulation in hemiparetic adolescents: A case series study

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    Peri Elisabetta

    2013-01-01

    Full Text Available The aim of this work was to assess the feasibility of a treatment based on volitional cycling augmented by Functional Electrical Stimulation (FES on hemiparetic adolescents. Six chronic hemiparetic adolescents were included in a case series study. Patients underwent FES-cycling training combined with voluntary pedaling. The intervention consisted of 21 sessions lasting 30 minutes each. Patients were evaluated before, after training, and at a 3-month follow-up visit through clinical scales (Winter scale, observational gait scale, gross motor function measurement, Boyd test and Ashworth scale, a standard gait analysis and a voluntary pedaling test. Results were compared with an age-matched healthy control group (N=6. Two subjects withdrew the study before the completion of the intervention. Concerning the four remaining subjects, the clinical scales showed a slight level of disability already at baseline and no changes were observed after the intervention. In terms of walking ability, some significant improvements (Kruskal-Wallis test, p-value<0.05 were obtained after training in two out of four subjects: an increase of about 16% and 41% of the ankle range of motion and of about 18% and 33% of the ankle propelling power were achieved for two subjects, respectively. During pedaling, the work produced by the paretic leg while pulling the pedal significantly increased in 3 out of 4 subjects. In one subject a more symmetrical cycling movement was observed, whilst for another subject a significant improvement in terms of co-contraction between rectus femoris and biceps femoris was achieved. In conclusion, this study assessed the feasibility of FES-cycling training on hemiparetic adolescents, but did not provide evidences about the effectiveness of this intervention in improving motor recovery and walking ability. However, since only a small group of patients with a low level of disability was involved in the study, further investigations are needed to

  3. Conjugal Parkinsonism and Parkinson Disease: A Case Series with Environmental Risk Factor Analysis

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    Sterling, Callen; Racette, Brad A.

    2009-01-01

    PD occurring in married couples, “conjugal PD” represents a unique opportunity to study environmental risk factors for PD due to the shared environment. This retrospective study of non-related married individuals who both presented to the Washington University Movement Disorders Center between 1994 and 2005 investigated the clinical presentation, therapy response, and disease course in conjugal PD subjects. In addition, an occupational, residential, and environmental survey was administered to elucidate potential shared environmental risk factors. Eighteen married subjects had a clinical picture suggestive of idiopathic Parkinson disease. Average age of motor symptom onset was 66.1 (±6.22) years in women, 63.4 (±7.87) years in men. Subjects cohabitated an average of 39.9 years prior to motor symptom onset in the first affected spouse and an average of nine years elapsed prior to symptom onset in their partner. Disease course in conjugal pairs varied substantially. Seventeen out of eighteen subjects reported at least one environmental exposure of interest. Concordant exposures were residential, non-occupational pesticide and heavy metal exposure, each reported by 77.8% (7/9) of couples. Multiple exposures were reported by 88.9% (16/18) of subjects, most often residential agricultural chemical and heavy metal in combination. This case series of conjugal PD suggests that combined residential exposures may be important in the pathogenesis of idiopathic PD. Larger conjugal PD studies may permit stratification of concordant environmental exposures to determine dose responsiveness and relative contributions to PD risk. PMID:19818671

  4. Treatment of hepatic encephalopathy by on-line hemodiafiltration: a case series study

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    Sugiyama Mitsugi

    2010-05-01

    Full Text Available Abstract Background It is thought that a good survival rate of patients with acute liver failure can be achieved by establishing an artificial liver support system that reliably compensates liver function until the liver regenerates or a patient undergoes transplantation. We introduced a new artificial liver support system, on-line hemodiafiltration, in patients with acute liver failure. Methods This case series study was conducted from May 2001 to October 2008 at the medical intensive care unit of a tertiary care academic medical center. Seventeen consecutive patients who admitted to our hospital presenting with acute liver failure were treated with artificial liver support including daily on-line hemodiafiltration and plasma exchange. Results After 4.9 ± 0.7 (mean ± SD on-line hemodiafiltration sessions, 16 of 17 (94.1% patients completely recovered from hepatic encephalopathy and maintained consciousness for 16.4 ± 3.4 (7-55 days until discontinuation of artificial liver support (a total of 14.4 ± 2.6 [6-47] on-line hemodiafiltration sessions. Significant correlation was observed between the degree of encephalopathy and number of sessions of on-line HDF required for recovery of consciousness. Of the 16 patients who recovered consciousness, 7 fully recovered and returned to society with no cognitive sequelae, 3 died of complications of acute liver failure except brain edema, and the remaining 6 were candidates for liver transplantation; 2 of them received living-related liver transplantation but 4 died without transplantation after discontinuation of therapy. Conclusions On-line hemodiafiltration was effective in patients with acute liver failure, and consciousness was maintained for the duration of artificial liver support, even in those in whom it was considered that hepatic function was completely abolished.

  5. New Deep Dermal ADM Incorporates Well in Case Series of Complex Breast Reconstruction Patients.

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    Wilson, Henry Benjamin

    2015-05-01

    Breast cancer patients with significant comorbidities present reconstructive challenges due to a predictably high complication rate. During expander-based breast reconstruction, human acellular dermal matrix (ADM) is often used to prevent pectoralis muscle retraction, facilitate early expansion, and improve cosmetic outcome. Device infection and chronic seroma have been correlated to the addition of the graft by some large database reports but not others. This study describes the first reported experience with a new deep dermal ADM, FlexHD® Pliable™ (MTF, Edison, NJ). Sixteen breasts in 10 consecutive patients identified retrospectively and followed prospectively had immediate expander-based breast reconstruction utilizing the new ADM. Patient comorbidities were catalogued, complications were recorded, and overall reconstructive success was assessed. At implant exchange, the ADM was examined for tissue ingrowth and biopsied for histologic examination. All 16 breasts had successful reconstructions. Two breasts (12.5%) developed device infection, requiring removal and later replacement of the expander. One breast (6.7%) developed chronic seroma, also requiring expander removal and later replacement. All the complicated patients had significant comorbidities, including obesity in all 3. At expander removal, the FlexHD Pliable showed near-complete visual tissue incorporation in 14 of 16 breasts (88%). This case series demonstrates significant reconstructive success in challenging patients utilizing a novel ADM. Visual and histologic assessment of tissue ingrowth into the graft suggests the high rate of complication may be due to patient comorbidities rather than addition of ADM. Additional experience is needed to confirm and the study is ongoing. PMID:26020380

  6. Minimally Invasive Pyeloplasty in Horseshoe Kidneys with Ureteropelvic Junction obstruction: A case series

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    Stephen Faddegon

    2013-04-01

    Full Text Available Background and Purpose Horseshoe kidney is an uncommon renal anomaly often associated with ureteropelvic junction (UPJ obstruction. Advanced minimally invasive surgical (MIS reconstructive techniques including laparoscopic and robotic surgery are now being utilized in this population. However, fewer than 30 cases of MIS UPJ reconstruction in horseshoe kidneys have been reported. We herein report our experience with these techniques in the largest series to date. Materials and Methods We performed a retrospective chart review of nine patients with UPJ obstruction in horseshoe kidneys who underwent MIS repair at our institution between March 2000 and January 2012. Four underwent laparoscopic, two robotic, and one laparoendoscopic single-site (LESS dismembered pyeloplasty. An additional two pediatric patients underwent robotic Hellstrom repair. Perioperative outcomes and treatment success were evaluated. Results Median patient age was 18 years (range 2.5-62 years. Median operative time was 136 minutes (range 109-230 min. and there were no perioperative complications. After a median follow-up of 11 months, clinical (symptomatic success was 100%, while radiographic success based on MAG-3 renogram was 78%. The two failures were defined by prolonged t1/2 drainage, but neither patient has required salvage therapy as they remain asymptomatic with stable differential renal function. Conclusions MIS repair of UPJ obstruction in horseshoe kidneys is feasible and safe. Although excellent short-term clinical success is achieved, radiographic success may be lower than MIS pyeloplasty in heterotopic kidneys, possibly due to inherent differences in anatomy. Larger studies are needed to evaluate MIS pyeloplasty in this population.

  7. ED-12WIDESPREAD SYSTEMIC METASTASES FROM MEDULLOBLASTOMA WITHOUT EVIDENCE OF ACTIVE CNS INVOLVEMENT: A CASE SERIES

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    Kumthekar, Priya; Singh, Simran; Smiley, Natasha Pillay; Lulla, Rishi

    2014-01-01

    This case series describes two patients with previously treated medulloblastoma who present with systemic metastases without evidence of central nervous system (CNS) disease. Patient #1 is male who presented at age 29 with pathology confirmed medulloblastoma treated with complete surgical resection followed by radiation (36 Gy craniospinal plus posterior fossa boost). Subsequently, he received cisplatin, cytoxan, and vincristine. One year later, he developed back pain and urinary retention. Imaging of his spine showed widespread bony metastases without parenchymal CNS disease. Biopsy of the left acetabulum confirmed metastatic medulloblastoma. He is currently enrolled on study with LDE225 versus temozolomide. Surveillance imaging to date is negative for intracranial metastasis, but does show extensive bony metastases involving the total spine, pelvis, ribs, sternum, clavicles, humeri, and femurs. Patient #2 is a female who presented at 32 years with severe headaches, nausea and vomiting found to have pathology confirmed medulloblastoma. She was lost to follow up temporarily, but presented again months later with headaches. She had a recurrent mass and underwent repeat resection. MRI of the spine showed nodular enhancement of the sacral nerve roots compatible with leptomeningeal spread. She underwent craniospinal radiation 36 Gy with a boost to the lumbar region and posterior fossa. One year after initial diagnosis, she presented with hypotension, tachycardia, and fatigue. Neuroimaging showed improved enhancement of the sacral nerve roots and brain imaging showed stable postsurgical changes. Systemic imaging, however, revealed widespread metastatic disease in the lymphatic system, liver, lung, and bones. The patient passed away a few months later. Medulloblastoma can metastasize outside the central nervous system (CNS), however typically does so concurrently with CNS progression. Here we present two adult patients with widely metastatic medulloblastoma systemically

  8. Combined spinal epidural anesthesia for laparoscopic appendectomy in adults: A case series

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    Rajesh S Mane

    2012-01-01

    Full Text Available Background: Laparoscopy is one of the most common surgical procedures and is the procedure of choice for most of the elective abdominal surgeries performed preferably under endotracheal general anesthesia. Technical advances in the field of laparoscopy have helped to reduce surgical trauma and discomfort, reduce anesthetic requirement resulting in shortened hospital stay. Recently, regional anaesthetic techniques have been found beneficial, especially in patients at a high risk to receive general anesthesia. Herewith we present a case series of laparoscopic appendectomy in eight American Society of Anaesthesiologists (ASA I and II patients performed under spinal-epidural anaesthesia. Methods: Eight ASA Grade I and II adult patients undergoing elective Laparoscopic appendectomy received Combined Spinal Epidural Anaesthesia. Spinal Anaesthesia was performed at L 2 -L 3 interspace using 2 ml of 0.5% (10 mg hyperbaric Bupivacaine mixed with 0.5ml (25 micrograms of Fentanyl. Epidural catheter was inserted at T 10 -T 11 interspace for inadequate spinal anaesthesia and postoperative pain relief. Perioperative events and operative difficulty were studied. Systemic drugs were administered if patients complained of shoulder pain, abdominal discomfort, nausea or hypotension. Results: Spinal anaesthesia was adequate for surgery with no operative difficulty in all the patients. Intraoperatively, two patients experienced right shoulder pain and received Fentanyl, one patient was given Midazolam for anxiety and two were given Ephedrine for hypotension. The postoperative period was uneventful. Conclusion: Spinal anaesthesia with Hyperbaric Bupivacaine and Fentanyl is adequate and safe for elective laparoscopic appendectomy in healthy patients but careful evaluation of the method is needed particularly in compromised cardio respiratory conditions.

  9. Values-Based Education in Schools in the 2000s: The Australian Experience

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    Leichsenring, Andrew

    2010-01-01

    This thesis explores the teaching of values in Australian schools through a framework established by the Australian Federal government during the 2000s. This paper focuses on: the approaches employed by the Australian Federal government in the implementation of Values Education; and the application of cases of values-based education utilized by…

  10. Paediatric Australian bat lyssavirus encephalomyelitis - sequential MRI appearances from symptom onset to death

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    Shetty, Umesh; Phillips, Mark; Walsh, Mark [Mater Hospital and Lady Cilento Children' s Hospital Medical Imaging Department, Brisbane, QLD (Australia); Francis, Joshua R. [Royal Darwin Hospital, Department of Paediatrics, Darwin (Australia)

    2015-10-15

    Human infection with Australian bat lyssavirus is extremely rare. Here we present the craniospinal findings in a fatal case of Australian bat lyssavirus infection in an 8-year-old child. MRI plays a very important role, not only in the diagnostic work-up of Australian bat lyssavirus infection but also in the prognostic assessment. (orig.)

  11. Paediatric Australian bat lyssavirus encephalomyelitis - sequential MRI appearances from symptom onset to death

    International Nuclear Information System (INIS)

    Human infection with Australian bat lyssavirus is extremely rare. Here we present the craniospinal findings in a fatal case of Australian bat lyssavirus infection in an 8-year-old child. MRI plays a very important role, not only in the diagnostic work-up of Australian bat lyssavirus infection but also in the prognostic assessment. (orig.)

  12. Can Species Traits Predict the Susceptibility of Riverine Fish to Water Resource Development? An Australian Case Study

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    Rolls, Robert J.; Sternberg, David

    2015-06-01

    Water resource developments alter riverine environments by disrupting longitudinal connectivity, transforming lotic habitats, and modifying in-stream hydraulic conditions. Effective management of anthropogenic disturbances therefore requires an understanding of the range of potential ecosystem effects and the inherent traits symptomatic of elevated vulnerability to disturbance. Using 42 riverine fish native to South Eastern Australia as a case study, we quantified six morphological, behavioral, and life-history traits to classify species into groups reflecting potential differences in their response to ecosystem changes as a result of water resource development. Classification analysis identified five strategies based on fish life-history dispersal requirements, climbing potential, and habitat preference. These strategies in turn highlight the potential species at risk from the separate impacts of water resource development and inform management decisions to mitigate those risks. Swimming ability did not contribute to distinguishing species into functional groups, likely due to methodological inconsistencies in quantifying swimming performance that may ultimately hinder the ability of fish passage facilities to function within the physical capabilities of species at risk of habitat fragmentation. This study improves our ability to predict the performance of groups of species at risk from the multiple environmental changes imposed by humans and goes beyond broad-scale dispersal requirements as a predictor of individual species response.

  13. A case study of physical and social barriers to hygiene and child growth in remote Australian Aboriginal communities

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    Grace Jocelyn

    2009-09-01

    Full Text Available Abstract Background Despite Australia's wealth, poor growth is common among Aboriginal children living in remote communities. An important underlying factor for poor growth is the unhygienic state of the living environment in these communities. This study explores the physical and social barriers to achieving safe levels of hygiene for these children. Methods A mixed qualitative and quantitative approach included a community level cross-sectional housing infrastructure survey, focus groups, case studies and key informant interviews in one community. Results We found that a combination of crowding, non-functioning essential housing infrastructure and poor standards of personal and domestic hygiene underlie the high burden of infection experienced by children in this remote community. Conclusion There is a need to address policy and the management of infrastructure, as well as key parenting and childcare practices that allow the high burden of infection among children to persist. The common characteristics of many remote Aboriginal communities in Australia suggest that these findings may be more widely applicable.

  14. Revisiting the Occupational Aspirations and Destinations of Anglo-Australian and Chinese-Australian High School Students

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    Malik, Ranbir Singh

    2015-01-01

    Evidence from Australia lends support to the "Asian high achieving syndrome" in Chinese-Australian students and "self-deprivation syndrome" in Anglo-Australian students. Applying ethnographic case studies approach for doctoral thesis the author collected data on a longitudinal basis from homes and school of these students. All…

  15. PECTUS EXCAVATUM: REPARACIóN CON LA TéCNICA DE NUSS. SERIE DE 10 CASOS Pectus excavatum: repair with Nuss technique. A series of 10 cases

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    Fernando Fierro-ávila

    2009-01-01

    observation upon the open procedure changed radically the treatment and has been rapidly adopted by surgeons all around the world. Objetive. This study evaluates the results of the MIRPE in the Clínica Infantil Colsubsidio. Materials and methods. We carried out a case series of patients treated with the Nuss procedure betweeen December 2004 and July 2008. Information was gathered from medical records , considering personal and familiar past medical history, laboratory and radiologic tests. Results of the procedure were evaluated, including duration of the procedure, early and late onset complications and analgesic use. Results. 10 patients between 13 and 17 years were included, 90 percent were men. The cosmetic result was satisfactory in all cases. The most frequent complications were pneumothorax and dislodgement of the bar; We did not find any case of infection, allergy, pleural effusion, pericarditis or hemothorax. Conclusions. This descriptive study allows us to compare our early experience with the worldwide reports, finding that it is a safe and reproducible technique, with good results in most patients; It also has a more prompt functional recovery and satisfactory esthetic result. Complications in our series were similar to the reported in the literature.

  16. Radiotherapy in fascial fibromatosis: a case series, literature review and considerations for treatment of early-stage disease

    International Nuclear Information System (INIS)

    Palmar and plantar fascial fibromatoses are benign hyperproliferative disorders of the deep fascia of the palm and sole. This study seeks to examine the role of radiotherapy in the management of fascial fibromatosis. Six consecutive cases of early-stage fascial fibromatosis treated with radiotherapy at the Adelaide Radiotherapy Centre between July 2008 and May 2011 were analysed. The results of the case series were compared with a systematic review of the literature. All six cases regressed or showed a reduction of symptoms following radiotherapy. Treatment was well tolerated with minor toxicities. Median follow-up for the case series was 38.5 months. The systematic review identified seven studies describing the use of radiotherapy as primary treatment for fascial fibromatosis between 1946 and 2013. The literature indicates that radiotherapy can prevent disease progression and improve symptoms for early-stage disease, with low likelihood of significant toxicities. Early results from our case series are consistent with the literature, showing that radiotherapy can provide an effective management option for patients with early-stage fascial fibromatosis, and justify consideration of radiotherapy as a primary treatment for early-stage disease.

  17. Intrathecal Ziconotide and Morphine for Pain Relief: A Case Series of Eight Patients with Refractory Cancer Pain, Including Five Cases of Neuropathic Pain

    OpenAIRE

    de la Calle Gil, Ana Bella; Peña Vergara, Isaac; Cormane Bornacelly, María Auxiliadora; Pajuelo Gallego, Antonio

    2015-01-01

    Introduction Studies have shown that, at low doses and with careful titration, combination therapy with intrathecal ziconotide and morphine results in rapid control of opioid-refractory cancer pain. However, there is a lack of published data regarding the efficacy and safety of intrathecal ziconotide specifically for the treatment of neuropathic cancer pain. Case series Case reports of ziconotide intrathecal infusion in eight patients (age 45–71 years; 75% male) with chronic, uncontrolled can...

  18. The Australian National Seismograph Network

    OpenAIRE

    D. Jepsen

    1994-01-01

    The Australian Seismological Centre of the Australian Geological Survey Organisation, operates and co-operates a national seismograph network consisting of 24 analogue and 8 digitally telemetred (3 broadband) stations (see fig. 1 and table 1). The network covers the Australian continent and the Australian Antarctic Territory.

  19. The Australian National Seismograph Network

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    D. Jepsen

    1994-06-01

    Full Text Available The Australian Seismological Centre of the Australian Geological Survey Organisation, operates and co-operates a national seismograph network consisting of 24 analogue and 8 digitally telemetred (3 broadband stations (see fig. 1 and table 1. The network covers the Australian continent and the Australian Antarctic Territory.

  20. Measurement of inter- and intra-annual variability of landscape fire activity at a continental scale: the Australian case

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    Williamson, Grant J.; Prior, Lynda D.; Jolly, W. Matt; Cochrane, Mark A.; Murphy, Brett P.; Bowman, David M. J. S.

    2016-03-01

    Climate dynamics at diurnal, seasonal and inter-annual scales shape global fire activity, although difficulties of assembling reliable fire and meteorological data with sufficient spatio-temporal resolution have frustrated quantification of this variability. Using Australia as a case study, we combine data from 4760 meteorological stations with 12 years of satellite-derived active fire detections to determine day and night time fire activity, fire season start and end dates, and inter-annual variability, across 61 objectively defined climate regions in three climate zones (monsoon tropics, arid and temperate). We show that geographic patterns of landscape burning (onset and duration) are related to fire weather, resulting in a latitudinal gradient from the monsoon tropics in winter, through the arid zone in all seasons except winter, and then to the temperate zone in summer and autumn. Peak fire activity precedes maximum lightning activity by several months in all regions, signalling the importance of human ignitions in shaping fire seasons. We determined median daily McArthur forest fire danger index (FFDI50) for days and nights when fires were detected: FFDI50 varied substantially between climate zones, reflecting effects of fire management in the temperate zone, fuel limitation in the arid zone and abundance of flammable grasses in the monsoon tropical zone. We found correlations between the proportion of days when FFDI exceeds FFDI50 and the Southern Oscillation index across the arid zone during spring and summer, and Indian Ocean dipole mode index across south-eastern Australia during summer. Our study demonstrates that Australia has a long fire weather season with high inter-annual variability relative to all other continents, making it difficult to detect long term trends. It also provides a way of establishing robust baselines to track changes to fire seasons, and supports a previous conceptual model highlighting multi-temporal scale effects of climate in

  1. Asperger syndrome in India: Findings from a case-series with respect to clinical profile and comorbidity

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    Priya Sreedaran

    2015-01-01

    Full Text Available Asperger syndrome (AS is an autism spectrum disorder with a high rate of psychiatric comorbidity. We describe the clinical profile and psychiatric comorbidity in a series of affected individuals referred to an Indian general hospital psychiatry setting. Gilliam Asperger′s disorder scale was used to evaluate the clinical characteristics while Mini-International Neuropsychiatric Interview (MINI-KID and MINI-PLUS were used to assess psychiatric comorbidity. The profile of subjects with AS in our case-series appears similar to that published elsewhere with high rates of psychiatric comorbidity. Mental health professionals should evaluate for psychiatric comorbidity in individuals with autism spectrum disorders.

  2. Asperger syndrome in India: findings from a case-series with respect to clinical profile and comorbidity.

    Science.gov (United States)

    Sreedaran, Priya; Ashok, M V

    2015-01-01

    Asperger syndrome (AS) is an autism spectrum disorder with a high rate of psychiatric comorbidity. We describe the clinical profile and psychiatric comorbidity in a series of affected individuals referred to an Indian general hospital psychiatry setting. Gilliam Asperger's disorder scale was used to evaluate the clinical characteristics while Mini-International Neuropsychiatric Interview (MINI)-KID and MINI-PLUS were used to assess psychiatric comorbidity. The profile of subjects with AS in our case-series appears similar to that published elsewhere with high rates of psychiatric comorbidity. Mental health professionals should evaluate for psychiatric comorbidity in individuals with autism spectrum disorders. PMID:25969609

  3. Pericardite: série de 84 casos consecutivos Pericarditis: series of 84 consecutive cases

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    Marco Tulio Zanettini

    2004-04-01

    Full Text Available OBJETIVO: Identificar características clínicas, laboratoriais e ecocardiográficas diferenciais em indivíduos com diagnóstico de pericardite secundária e idiopática. MÉTODOS: De janeiro/1999 a dezembro/2001, foram identificados 84 pacientes com diagnóstico clínico e ecocardiográfico de pericardite em clínica de cardiologia. Foram estudados, retrospectivamente, quanto à idade, sexo, características antropométricas, hábitos, pressão arterial casual, causas potenciais, comorbidades, sinais e sintomas, medicação e complicações. Os indivíduos foram divididos em 2 grupos: grupo A constituído de 61 pacientes com causas potenciais conhecidas e grupo B com 23 casos considerados idiopáticos. Os grupos foram comparados, utilizando-se o teste do Qui-quadrado, considerando-se estatisticamente significativas as associações com p OBJECTIVE: To identify differential clinical, laboratory, and echocardiographic characteristics in persons with diagnosed idiopathic and secondary pericarditis. METHODS: From January 1999 to December 2001, 84 patients with clinically and echocardiographically diagnosed pericarditis were identified in a heart clinic. These patients were analyzed according to age, sex, anthropometric measurements, body habitus, casual blood pressure (BP, signs and symptoms, morbid history, medicines and complications. The individuals were divided into 2 groups: group A comprised 61 patients with known causes of pericarditis and group B comprised 23 patients with idiopathic causes. The groups were compared with chi-square test. P<0.05 was considered statistically significant. RESULTS: The population of these 2 groups was similar in age, sex, anthropometric measures, body habitus, and casual BP. In group B (idiopathic, 23 (100% cases were diagnosed between April and August versus 24 (39.4% in the same period for group A (P<0.01. Twenty-three (100% group B patients received anti-influenza vaccine versus none in group A

  4. Living with aphasia: three Indigenous Australian stories.

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    Armstrong, Elizabeth; Hersh, Deborah; Hayward, Colleen; Fraser, Joan; Brown, Melita

    2012-06-01

    The incidence of cardiovascular disorders and stroke in Australian Aboriginal communities is more than twice as high as non-Indigenous Australians. Approximately 30% of people who survive stroke are left with some level of aphasia, and yet Indigenous Australians appear to be infrequent users of speech-language pathology services, and there is virtually no research literature about the experiences of aphasia for this group of people. This paper presents the stories of living with aphasia for three Indigenous Australian men living in Perth, Western Australia. Their narratives were collected by an Indigenous researcher through in-depth, supported interviews, and were explored using both within-case and cross-case analyses for common and recurring themes. It is argued that there is value for speech-language pathologists, and other health professionals, to be aware of the broad experiences of living with aphasia for Indigenous Australians because their stories are rarely heard and because, as with people with aphasia generally, they are at risk of social isolation and tend to lack visibility in the community. This study explores the key issues which emerge for these three men and highlights the need for further research in this area. PMID:22472033

  5. Epileptic Electroencephalography Profile Associates with Attention Problems in Children with Fragile X Syndrome: Review and Case Series.

    Science.gov (United States)

    Cowley, Benjamin; Kirjanen, Svetlana; Partanen, Juhani; Castrén, Maija L

    2016-01-01

    Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability and a variant of autism spectrum disorder (ASD). The FXS population is quite heterogeneous with respect to comorbidities, which implies the need for a personalized medicine approach, relying on biomarkers or endophenotypes to guide treatment. There is evidence that quantitative electroencephalography (EEG) endophenotype-guided treatments can support increased clinical benefit by considering the patient's neurophysiological profile. We describe a case series of 11 children diagnosed with FXS, aged one to 14 years, mean 4.6 years. Case data are based on longitudinal clinically-observed reports by attending physicians for comorbid symptoms including awake and asleep EEG profiles. We tabulate the comorbid EEG symptoms in this case series, and relate them to the literature on EEG endophenotypes and associated treatment options. The two most common endophenotypes in the data were diffuse slow oscillations and epileptiform EEG, which have been associated with attention and epilepsy respectively. This observation agrees with reported prevalence of comorbid behavioral symptoms for FXS. In this sample of FXS children, attention problems were found in 37% (4 of 11), and epileptic seizures in 45% (5 of 11). Attention problems were found to associate with the epilepsy endophenotype. From the synthesis of this case series and literature review, we argue that the evidence-based personalized treatment approach, exemplified by neurofeedback, could benefit FXS children by focusing on observable, specific characteristics of comorbid disease symptoms. PMID:27462212

  6. Congenital cystic disorders of lung masquerading as complicated pneumonia and pneumothorax: A case series

    OpenAIRE

    Nandi, Madhumita; Mondal, Rakesh

    2013-01-01

    Abstract. Congenital cystic adenomatoid malformation and congenital lobar emphysema are rare embryonic congenital disorders of lung. We report seven such cases of congenital cystic pulmonary disorders out of which, four cases were of congenital cystic adenomatoid malformation and three cases of congenital lobar emphysema. All cases presented with recurrent or persistent pulmonary infection and pneumothorax. These cases had been masquerading as pneumonia and/ or its complication and were treat...

  7. Methylmalonic Acidemia: Diagnosis and Neuroimaging Findings of This Neurometabolic Disorder (An Iranian Pediatric Case Series

    Directory of Open Access Journals (Sweden)

    Parvaneh KARIMZADEH

    2013-08-01

    Full Text Available How To Cite This Article: Karimzadeh P, Jafari N, Jabbehdari S, Taghdiri MM, Nemati H, Saket S, Alaee MR, Ghofrani M, Tonakebni SH. Methylmalonic Acidemia: Diagnosis and Neuroimaging Findings of This Neurometabolic Disorder (An Iranian Pediatric Case Series. Iran J Child Neurol. 2013 Summer; 7(3: 63-66. ObjectiveMethylmalonic acidemia is one of the inborn errors of metabolism resulting in the accumulation of acylcarnitine in blood and increased urinary methylmalonic acid excretion. This disorder can have symptoms, such as neurological and gastrointestinal manifestations, lethargy, and anorexia.Materials & MethodsThe patients who were diagnosed as methylmalonic acidemia in the Neurology Department of Mofid Children’s Hospital in Tehran, Iran, between 2002 and 2012 were included in our study. The disorder was confirmed by clinical findings, neuroimaging findings, and neurometabolic and geneticassessment in reference laboratory in Germany. We assessed the age, gender, past medical history, developmental status, clinical manifestations, and neuroimaging findings of 20 patients with methylmalonic acidemia.ResultsEighty percent of the patients were offspring of consanguineous marriages. Half of the patients had Failure to thrive (FTT due to anorexia; 85% had history of developmental delay or regression, and 20% had refractory seizure, which all of them were controlled. The patients with methylmalonic acidemia were followed for approximately 5 years and the follow-up showedthat the patients with early diagnosis had a more favorable clinical response in growth index, refractory seizure, anorexia, and neurodevelopmental delay. Neuroimaging findings included brain atrophy, basal ganglia involvement (often in putamen, and periventricular leukomalacia.ConclusionAccording to the results of this study, we suggest that early assessment and diagnosis have an important role in the prevention of disease progression and clinical signs.References:1. Trinh BC

  8. Joubert Syndrome in Three Children in A Family: A Case Series

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    Javad AKHONDIAN

    2013-02-01

    Full Text Available AbstractHow to Cite This Article: Akhondian J, Ashrafzadeh F, Beiraghi Toosi M, MOazen N, Mohammadpoor T, Karimi R. Joubert Syndrome in Three Children in a family: A Case Series. Iran J Child Neurol. 2013 Winter: 7(1; 39-42. Joubert  syndrome  (JS  is  a  rare  autosomal  recessive  central  nervous system malformation characterized by hypoplasia of the cerebellar vermis,hypotonia and abnormal psychomotor development, along with altered respiratory pattern and various ophthalmologic features.Here, we describe three children with Joubert syndrome in a family that had almost similar presentations, including ataxia, developmental delay, mental retardation and ocular disorders.Prevalence of Joubert syndrome is about 1 in 100,000 live birth. It may be accompanied by other organs’ disorders. The molar tooth sign is pathognomonic for joubert syndrome that is ascertained by brain MRI. References1. Ahmed J, Ali US. Joubert syndrome with nephronophthisis in neurofibromatosis type 1. Saudi J Kidney Dis Transpl 2011;22(4:788-91.2. Singh P, Goraya JS, Saggar K, Ahluwalia A. A report of Joubert syndrome in an infant, with literature review. J Pediatr Neurosci 2011;6(1:44-7.3. Brancati F, Dallapiccola B, Valente EM. Joubert Syndrome and related disorders. Orphanet J Rare Dis 2010;5:20.4. Malaki M, Nemati M, Shoaran M. Joubert syndrome presenting as unilateral dysplastic kidney, hypotonia, and respiratory problem. Saudi J Kidney Dis Transpl 201;23(2:325-9.5. Louie CM, Gleeson JG. Genetic basis of Joubert syndrome and related disorders of cerebellar development. Hum Mol Genet 2005; 15;14 Spec No. 2:R235-42.6. Gill H, Muthusamy B, Atan D, Williams C, Ellis M. Joubert syndrome presenting with motor delay and oculomotor apraxia. Case Rep Pediatr 2011;2011:262641.7. Duldulao NA, Lee S, Sun Z. Cilia localization is essential for in vivo functions of the Joubert syndrome protein Arl13b/Scorpion. Development 2009;136(23:4033-42.8. Parisi MA. Clinical and

  9. Ultrasound-Guided Intercostobrachial Nerve Block for Intercostobrachial Neuralgia in Breast Cancer Patients: A Case Series.

    Science.gov (United States)

    Wisotzky, Eric M; Saini, Vikramjeet; Kao, Cyrus

    2016-03-01

    This case series describes 3 cases in which ultrasound-guided intercostobrachial perineural injection was used for intercostobrachial neuralgia, a common cause of postmastectomy pain syndrome. All cases had undergone modified radical mastectomy with axillary lymph node dissection for breast cancer. Two cases developed axillary and unilateral chest wall pain. The third case initially presented with axillary pain and lateral shoulder pain 1 year out from radical mastectomy. After a cervical epidural steroid injection, her lateral shoulder pain resolved, but she continued to have residual chest wall paresthesia. It was at this time, we decided to treat with an intercostobrachial nerve perineural injection. Injury to the intercostobrachial nerve is thought to be a common cause of postmastectomy pain. In our case series, all patients had pain relief after the intercostobrachial perineural injection. There is a relative dearth of published information on the treatment of postmastectomy pain and more specifically intercostobrachial neuralgia. We review the anatomy of the intercostobrachial nerve and its variants, etiologies of intercostobrachial neuralgia, and current indications and methods of an intercostobrachial perineural injection. PMID:26493855

  10. Infiltrating ductal carcinoma breast with central necrosis closely mimicking ductal carcinoma in situ (comedo type: a case series

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    Pervez Shahid

    2007-09-01

    Full Text Available Abstract Here we present a series of infiltrative ductal carcinoma breast cases (infiltrative ductal carcinoma with central necrosis so closely mimicking 'DCIS with central comedo necrosis' that on initial morphological analysis these foci of tumors were labeled as DCIS (high grade, comedo. However on further histological work up and by using immunohistochemistry (IHC for myoepithelial markers it was later confirmed that these were foci of infiltrative ductal carcinoma breast with central necrosis. This case series gives the realization that a breast carcinoma may be partly or entirely DCIS like yet invasive. In such a dilemma IHC especially for assessment of myoepithelial lining is very useful to differentiate DCIS comedo from invasive carcinoma with central necrosis.

  11. Prospective small bowel mucosal assessment immediately after chemoradiotherapy of unresectable locally advanced pancreatic cancer using capsule endoscopy: a case series.

    Science.gov (United States)

    Yamashina, Takeshi; Takada, Ryoji; Uedo, Noriya; Akasaka, Tomofumi; Hanaoka, Noboru; Takeuchi, Yoji; Higashino, Koji; Ioka, Tatsuya; Ishihara, Ryu; Teshima, Teruki; Nishiyama, Kinji; Iishi, Hiroyasu

    2016-01-01

    In this case series, three consecutive patients with unresectable locally advanced pancreatic cancer (ULAPC) underwent capsule endoscopy (CE) before and after chemoradiotherapy (CRT) to evaluate duodenal and jejunal mucosa, and to examine the relationship between CE findings and dose distribution. CE after CRT showed duodenitis and proximal jejunitis in all three patients. The most inflamed region was the third part of the duodenum, and in dose distribution, this was the closest region to the center of irradiation. This case series shows that CE can safely diagnose acute duodenitis and proximal jejunitis caused by CRT for ULAPC, and that dose distribution is possible to predict the degree of duodenal and jejunal mucosal injuries. PMID:27366048

  12. Spontaneously resolving cerebellar syndrome as a sequelae of dengue viral infection: a case series from Sri Lanka.

    Science.gov (United States)

    Weeratunga, Praveen N; Caldera, H P Manjula C; Gooneratne, I Kishara; Gamage, Ranjanie; Perera, W Sujith P; Ranasinghe, Gayan V; Niraj, Mahboob

    2014-06-01

    Sri Lanka is hyperendemic for dengue viral infection. Dengue has a wide spectrum of neurological manifestations including previously reported Sri Lankan cases with a 6th nerve palsy and a cerebellar syndrome from a co-infection with dengue and Epstein-Barr virus. This series describes a spontaneously resolving cerebellar syndrome following a dengue viral infection. Dengue is potentially an important cause of cerebellar syndromes in countries hyperendemic for the disease; patients need further studies to identify the responsible serotypes. PMID:23840070

  13. Antipsychotic dose escalation as a trigger for Neuroleptic Malignant Syndrome (NMS): literature review and case series report

    OpenAIRE

    Langan Julie; Martin Daniel; Shajahan Polash; Smith Daniel J

    2012-01-01

    Abstract Background “Neuroleptic malignant syndrome” (NMS) is a potentially fatal idiosyncratic reaction to any medication which affects the central dopaminergic system. Between 0.5% and 1% of patients exposed to antipsychotics develop the condition. Mortality rates may be as high as 55% and many risk factors have been reported. Although rapid escalation of antipsychotic dose is thought to be an important risk factor, to date it has not been the focus of a published case series or scientifica...

  14. Peritoneal inclusion cysts in patients affected by Crohn's disease: magnetic resonance enterography findings in a case series.

    Science.gov (United States)

    Mazziotti, Silvio; D'Angelo, Tommaso; Racchiusa, Sergio; Salamone, Ignazio; Blandino, Alfredo; Ascenti, Giorgio

    2016-01-01

    Peritoneal inclusion cystarises when fluid produced by ovary is trapped within peritoneal adhesions. In this article, we describe a case series of patients affected by Crohn's disease, undergoing to magnetic resonance enterography, in whom it was possible not only to monitor the pathological findings of small bowel but also to primarily diagnose the presence of peritoneal inclusion cysts. The current knowledge of peritoneal inclusion cyst concomitant to Crohn's disease is still limited, often leading radiologists to misdiagnose it. PMID:26456117

  15. Prospective small bowel mucosal assessment immediately after chemoradiotherapy of unresectable locally advanced pancreatic cancer using capsule endoscopy: a case series

    OpenAIRE

    Yamashina, Takeshi; Takada, Ryoji; Uedo, Noriya; Akasaka, Tomofumi; Hanaoka, Noboru; Takeuchi, Yoji; Higashino, Koji; Ioka, Tatsuya; Ishihara, Ryu; Teshima, Teruki; Nishiyama, Kinji; Iishi, Hiroyasu

    2016-01-01

    In this case series, three consecutive patients with unresectable locally advanced pancreatic cancer (ULAPC) underwent capsule endoscopy (CE) before and after chemoradiotherapy (CRT) to evaluate duodenal and jejunal mucosa, and to examine the relationship between CE findings and dose distribution. CE after CRT showed duodenitis and proximal jejunitis in all three patients. The most inflamed region was the third part of the duodenum, and in dose distribution, this was the closest region to the...

  16. Renal papillary calcification and the development of calcium oxalate monohydrate papillary renal calculi: a case series study

    OpenAIRE

    Grases, Fèlix; Costa-Bauzá, Antonia; Rafel M. Prieto; Conte, Antonio; Servera, Antonio

    2013-01-01

    Background The objective of this study is to determine in a case series (four patients) how calcified deposits in renal papillae are associated with the development of calcium oxalate monohydrate (COM) papillary calculi. Methods From the recently collected papillary calculi, we evaluated retrospectively patients, subjected to retrograde ureteroscopy, with COM papillary lithiasis. Results The COM papillary calculi were found to result from subepithelial injury. Many of these lesions underwent ...

  17. Rehabilitation of resorbed mandibular ridges using mini implant retained overdentures: A case series with 3 year follow-up.

    Science.gov (United States)

    Kumari, Pooja; Verma, Mahesh; Sainia, Vikrant; Gupta, Rekha; Gill, Shubhra

    2016-01-01

    With the increasing average life expectancy of human beings, the need to cater geriatric patients is ever increasing. Complete dentures are an indispensable tool in this regard. The loose and unstable lower complete denture owing to residual ridge resorption is one of the most common problems faced by edentulous patients. Dental implant retained overdentures have emerged as an efficient treatment modality for such patients. Though useful, not every patient is a suitable candidate to go for conventional implant-borne prosthesis, limitation being the available bone width. In such cases, mini implants may be used for augmenting the retention of the dentures and improving the quality of life of patients. In this case series, rehabilitation of three compromised cases with mini implant retained overdentures have been described wherein patients are experiencing instability of lower denture due to thin resorbed mandibular ridges. In one of the cases, three mini implants placed in A, C, and E position were splinted using a cemented bar to retain the mandibular denture. The other two cases were rehabilitated using unsplinted ball type one piece mini implants placed in A, C, and E position in one case and B and D position in another case. Though splinted bar design should be preferred but the lack of available vertical space precluded the utilization of bar in other two cases. The results were found to be satisfactory with no complications reported during a follow-up period of over 3 years in all the cases. PMID:27141177

  18. Hospital visits due to domestic violence from 1994 to 2011 in the Solomon Islands: a descriptive case series.

    Science.gov (United States)

    Farrell, Penny C; Negin, Joel; Houasia, Patrick; Munamua, Alex B; Leon, David P; Rimon, Mia; Martiniuk, Alexandra L C

    2014-09-01

    The Solomon Islands has one of the highest rates of domestic violence in the world. This paper is a descriptive case series of all cases of domestic violence presenting to the Solomon Islands National Referral Hospital (NRH) over 18 years. Data were routinely collected from a database of all patients who were treated by NRH general surgery and orthopedic clinicians between 1994 and 2011, inclusive. The total number of cases in the injury database as a result of domestic violence was 387. The average number of cases in the database per year from 1994 to 2011 was 20. There were 6% more female patients (205 of 387; 53%) than male (182 of 387; 47%). Of the cases in which the perpetrator of the violence against a female patient was specified (111 of 205 female cases), 74% (82 of 111) were the patient's husband. Only 5% (5 of 111) of cases in females were inflicted by another female. This analysis provides the best available information on domestic violence cases requiring a visit to a tertiary hospital in a Pacific Island in the specified time period and is undoubtedly an under-estimate of the total cases of domestic violence. Preventing and treating domestic violence in the Solomon Islands and in the Pacific is an important challenge and there is a significant role for secondary and tertiary health services in screening for and preventing domestic violence. PMID:25285254

  19. Canal mandibular bífido: Presentación de una serie de casos Bifid mandibular canal: Case series report

    Directory of Open Access Journals (Sweden)

    C.L. Guzmán Zuluaga

    2012-04-01

    Full Text Available La ubicación y configuración de las variaciones del canal mandibular son relevantes en diferentes procedimientos clínicos de la mandíbula. En esta serie de casos un radiólogo evaluó el recorrido del canal mandibular identificando la presencia y tipos de canales bífidos. Se observaron cuatro pacientes con canal mandibular bífido tipo retromolar y tres sujetos con canal bífido tipo anterior sin convergencia. En otro paciente se encontraron forámenes dentarios bífidos bilaterales. La Tomografía Computarizada de Haz de Cono, permite la identificación oportuna de condiciones preexistentes como variaciones en la morfología natural de los canales mandibulares, previniendo efectiva y precozmente las consecuencias neurológicas que se derivan de una lesión del nervio dentario inferior.The location and configuration of the mandibular canal variations are relevant in different clinical procedures of the jaw. In this case series, a radiologist assessed the mandibular canal route identifying the presence and types of bifid canals. Four patients with type bifid mandibular retromolar canal and three subjects with type bifida anterior canal without convergence were observed. In one patient, bilateral bifid tooth foramina was found. Computed Tomography Cone Beam allows identification of preexisting conditions such as variations in the natural morphology of the mandibular canals, preventing effective and early neurological consequences arising from alveolar nerve injury.

  20. Australian G20 Presidency

    OpenAIRE

    Andrei G. Sakharov; Andrei V. Shelepov; Elizaveta A. Safonkina; Mark R. Rakhmangulov

    2015-01-01

    The 2014 Australian presidency took place against the backdrop of multiple challenges in both global economy and international politics, with Ukrainian crisis, Syrian conflict, Islamic State, and Ebola. Thus, despite being an economic forum, the G20 could not avoid addressing these issues, with discussions taking place during the bilateral meetings and on the sidelines of the forum. The article attempts to analyze the Australian G20 Presidency within a functional paradigm, assessing G20 perfo...