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Sample records for breech presentation

  1. Vaginal delivery of breech presentation.

    Science.gov (United States)

    Kotaska, Andrew; Menticoglou, Savas; Gagnon, Robert

    2009-06-01

    To review the physiology of breech birth; to discern the risks and benefits of a trial of labour versus planned Caesarean section; and to recommend to obstetricians, family physicians, midwives, obstetrical nurses, anaesthesiologists, pediatricians, and other health care providers selection criteria, intrapartum management parameters, and delivery techniques for a trial of vaginal breech birth. Trial of labour in an appropriate setting or delivery by pre-emptive Caesarean section for women with a singleton breech fetus at term. Reduced perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short- and long-term maternal morbidity and mortality. Medline was searched for randomized trials, prospective cohort studies, and selected retrospective cohort studies comparing planned Caesarean section with a planned trial of labour; selected epidemiological studies comparing delivery by Caesarean section with vaginal breech delivery; and studies comparing long-term outcomes in breech infants born vaginally or by Caesarean section. Additional articles were identified through bibliography tracing up to June 1, 2008. The evidence collected was reviewed by the Maternal Fetal Medicine Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC) and quantified using the criteria and classifications of the Canadian Task Force on Preventive Health Care. This guideline was compared with the 2006 American College of Obstetrician's Committee Opinion on the mode of term singleton breech delivery and with the 2006 Royal College of Obstetrician and Gynaecologists Green Top Guideline: The Management of Breech Presentation. The document was reviewed by Canadian and International clinicians with particular expertise in breech vaginal delivery. The Society of Obstetricians and Gynaecologists of Canada. SUMMARY STATEMENTS: 1. Vaginal breech birth can be associated with a higher risk of perinatal mortality and short-term neonatal morbidity than

  2. Review: Breech presentation: The controversy continues | Cluver ...

    African Journals Online (AJOL)

    For women with a baby with flexed thighs who progress appropriately in labour with descent and spontaneous birth of the breech, the likelihood of difficulty with the delivery is very small. If progress is not good, even at full cervical dilation, recourse to CS is a safer option than attempts at breech extraction. Training videos are ...

  3. Persistent Breech Presentation in a Bicornuate Uterus: A Case Report

    African Journals Online (AJOL)

    We report a case of persistent breech presentation in a primigravida with bicornuate uterus that was initially diagnosed by early ultrasound scan. Persistent breech presentation later in the pregnancy necessitated an elective caesarean section at term. The diagnosis was confirmed intraoperatively by exteriorizing the uterus.

  4. Breech presentation at a district level hospital in South Africa

    African Journals Online (AJOL)

    2009-03-05

    Mar 5, 2009 ... Conclusion: In a district hospital in South Africa, the mode of delivery for breech presentations is usually a planned Caesarean section. ..... Van Iddekinge B. Risk management: Planned vaginal breech delivery – should this be the mode of choice? The Obstetrician and Gynaecologist 2007;9:171–6. 6.

  5. The relation of breech presentation at term to cerebral palsy

    DEFF Research Database (Denmark)

    Krebs, L; Topp, M; Langhoff-Roos, J

    1999-01-01

    OBJECTIVE: To examine the relation between breech delivery and cerebral palsy, considering the influence of intrauterine growth, low Apgar score at birth, and mode of delivery. DESIGN: Register-based, case-control study. POPULATION: A cohort of infants with cerebral palsy born between 1979 and 1986...... in East Denmark, identified by linkage of the cerebral palsy register with the national birth register. Discharge letters from births of breech infants with cerebral palsy were reviewed. MAIN OUTCOME MEASURES: Presentation, mode of delivery, gestational age, birthweight, Apgar score, type of cerebral...... palsy, severity of handicap. RESULTS: Breech presentation at term was associated with a borderline significantly higher risk of cerebral palsy than vertex presentation (OR 1.56; 95% CI 0.9-2.4). Breech presentation infants more often had a lower Apgar score (

  6. Improving external cephalic version for foetal breech presentation

    Science.gov (United States)

    Zandstra, H.; Mertens, H.J.M.M.

    2013-01-01

    Objectives: If success rate of external cephalic version (ECV) increases, the rate of primary caesarean sections declines. The aims of this retrospective cohort study were to evaluate the ECV and to identify factors associated with the success rate of ECV for breech presentation at term. The second aim of this study was to analyse the outcome of labour of all patients with a foetus in breech near term. Methods: All women with a foetus in breech near or at term were included. Logistic regression analyses were performed to identify the association between patient characteristics and success rate of ECV. Results: The overall rate of successful ECV’s was 19%. Foetal and maternal complications after ECV were negligible. BMI, type of breech and amount of amniotic fluid were significantly correlated with a successful ECV. The rate of primary caesarean sections for the group of patients who underwent an ECV was lower than the rate in the group who did not (52.9% vs. 79.6%). The rate of spontaneous deliveries was increased after ECV (36% versus 12%). After successful ECV the rate of spontaneous deliveries was 75%; after unsuccessful ECV 26.8%. Conclusion: The overall rate of successful ECV was low (19%). BMI, type of breech and amount of amniotic fluid were significantly correlated with a successful ECV. The rate of primary caesarean sections was significantly lower in patients with ECV (52.9% versus 79.6%). The rate of spontaneous deliveries was significantly higher (36% versus 12%). PMID:24753933

  7. Term pregnancy in breech presentation in a unicornuate uterus: a ...

    African Journals Online (AJOL)

    Mullerian anomalies are rare and are associated with poor reproductive outcomes such as pregnancy wastage, preterm birth and malpresentation. This is a case report of an eighteen-year-old woman who presented at 38 weeks gestation in labour with the fetus in breech presentation. A caesarean section was performed, ...

  8. Comparing the Educational Readiness in Children with Breech Presentation Versus Cephalic Presentation

    Directory of Open Access Journals (Sweden)

    Batool Teimoori

    2013-02-01

    Full Text Available Background: Considering the fact that breech presentation is the most common abnormal presentation, the present paper compares the preparation of those people who had been born with breech and cephalic presentation. Materials and Methods: In this cross-sectional study we examines 1847 children in primary schools in Zahedan who had been born in 1994-1999; they were selected randomly from three elementary schools in Zahedan. Questionnaires were used to collect information and information about educational preparation of students were gathered using the standard and approved questionnaires by the Education Department of Iran archived in the patients’ profiles. To analyze the data, t-test and χ2 test had been used and p<0.05 was considered significant.Results: Out of the 1847 examined children , 1446 children (3.78% were male and 401 ones (7/21% were female. 1738 patients (94% had cephalic presentation (evident group and 109 (6% had breech presentation (cases. There was a significant statistical difference among the age averages of the mothers with the fetus presentation (p=0.001 and also among the average marks of the educational preparation of students and the fetus presentation (p=0.017 and children born with the breech presentation had higher scores in preparation. There was no significant difference between the mean score of the educational preparation and child delivery method (p=0.13.Conclusion: This study showed that school preparation scores, regardless of the mode of delivery, in breech presentation are higher than that in cephalic presentation.

  9. Cesarean Section and Right Femur Fracture: A Rare but Possible Complication for Breech Presentation

    Directory of Open Access Journals (Sweden)

    Giampiero Capobianco

    2013-01-01

    Full Text Available Background. The breech extraction of the fetus through the vagina has a greater risk of hip fracture compared with the extraction by abdominal route. Case. A 2390 g female infant was delivered at 39 weeks by elective cesarean section for breech presentation. The newborn sustained a fracture of the right femur. A simple immobilization of the limb in extension led to a complete healing of the fracture without sequelae. Conclusion. Caesarean delivery reduces the risk of causing a traumatic injury of the newborn compared to vaginal delivery, especially with breech presentation but does not eliminate this possible accidental complication.

  10. Breech presentation and the cornual-fundal location of the placenta

    Science.gov (United States)

    Sekulić, Slobodan; Ilinčić, Marko; Radeka, Gordana; Novakov-Mikić, Aleksandra; Simić, Svetlana; Podgorac, Jelena; Keković, Goran

    2013-01-01

    Aim To investigate the association of cornual-fundal location of the placenta and breech presentation at term delivery. Methods This study was conducted at the Department of Obstetrics and Gynecology, Novi Sad, in 2011. The inclusion criteria were delivery at ≥37 weeks of gestation, singleton gestation, and cornual-fundal location of the placenta determined by ultrasonography at ≥37 weeks of gestation when 3/4 or more of the placenta was in the cornual-fundal region. Results Out of 2750 ultrasound examinations performed, 143 showed cornual-fundal location of the placenta (frequency 5.2%). Eighty six cases had cephalic presentation (60.14%) and 57 (39.86%) had breech presentation. Of the remaining cases with non- cornual-fundal location, 2585 had cephalic presentation and 22 (0.84%) had breech presentation. The difference in the frequency of breech presentation between the cornual-fundal and non-cornual-fundal groups was significant (χ2 = 77.78, P < 0.001). Conclusion Cornual-fundal location of the placenta may be an important clue in resolving the etiology of a number of cases of breech presentation at term delivery. PMID:23630148

  11. Neonatal outcomes of preterm infants in breech presentation according to mode of birth in Canadian NICUs.

    Science.gov (United States)

    Lodha, Abhay; Zhu, Qiaohao; Lee, Shoo K; Shah, Prakesh S

    2011-03-01

    Many medical practitioners have adopted the practice of caesarean section for preterm infants in breech presentation based on term infant data. Some studies have highlighted deleterious effects on survival, such as intraventricular haemorrhage and periventricular leucomalacia, while others have reported no difference from the outcomes after vaginal delivery. To compare outcomes of preterm infants of ≤32 weeks' gestational age who were in breech position at the time of birth according to mode of birth in Canadian neonatal intensive care units (NICUs). 29 Canadian NICUs. Neonates admitted to participating NICUs in the Canadian Neonatal Network between 2003 and 2007 were included in this retrospective study. Infants who were in breech position at the time of birth were divided into two groups: vaginal birth (VB) and caesarean section (CS). Data on common neonatal outcomes were compared using univariate and multivariate logistic regression. Neonatal mortality and other neonatal morbidities. Of 3552 preterm infants in breech position at birth, 2937 (83%) were delivered by CS and 615 (17%) by VB. Multivariate regression analysis with adjustment for perinatal risk factors indicated that VB was associated with an increased risk of death (OR 1.7; 95% CI 1.3 to 2.3), chronic lung disease (OR 1.5; 95% CI 1.1 to 1.9) and severe retinopathy of prematurity (OR 1.6; 95% CI 1.1 to 2.3). Vaginal birth for preterm infants in breech presentation is possibly associated with a higher risk of adverse neonatal outcomes compared with caesarean birth in Canadian NICUs. It is not clear whether adverse outcomes are due to the mode of delivery or whether breech birth is associated with other risk factors, an issue that can only be resolved by a randomised controlled trial.

  12. Long-term follow-up of cognitive outcome after breech presentation at birth

    DEFF Research Database (Denmark)

    Sørensen, Henrik Toft; Steffensen, Flemming Hald; Olsen, Jørn

    1999-01-01

    Studies of long-term consequences of birth in breech presentation are sparse. Therefore, we conducted a cohort study linking birth registry data with data collected during evaluation for military service in 4,298 conscripts born between 1973 and 1976. The cognitive functions were measured...

  13. Uptake of external cephalic version for term breech presentation: an Australian population study, 2002-2012.

    Science.gov (United States)

    Bin, Yu Sun; Roberts, Christine L; Nicholl, Michael C; Ford, Jane B

    2017-07-26

    The safety, efficacy, and cost-effectiveness of external cephalic version (ECV) for term breech presentation has been demonstrated. Clinical guidelines recommend ECV for all eligible women, but the uptake of this procedure in the Australian healthcare setting is unknown. This study aimed to describe ECV uptake in New South Wales, the most populous state of Australia, during 2002 to 2012. Data from routine hospital and birth records were used to identify ECVs conducted at ≥36 weeks' gestation. Women with ECV were compared to women who were potentially eligible for but did not have ECV. Eligibility for ECV was based on clinical guidelines. For those with ECV, birth outcomes following successful and unsuccessful procedures were examined. In N = 32,321 singleton breech pregnancies, 10.5% had ECV, 22.3% were ineligible, and 67.2% were potentially eligible but did not undergo ECV. Compared to women who were eligible but who did not attempt ECV, those who had ECV were more likely to be older, multiparous, overseas-born, public patients at delivery, and to deliver in tertiary hospitals in urban areas (p ECV smoked during pregnancy, fewer were morbidly obese, and fewer had a hypertensive disorder of pregnancy, compared to those who were eligible. Caesarean section occurred in 25.9% of successful compared to 95.6% of unsuccessful ECVs. Infant outcomes did not differ by ECV success. The majority of women with a breech presentation did not receive ECV. It is unclear whether this is attributable to issues with service provision or low acceptability among women. Policies to improve access to and information about ECV appear necessary to improve uptake among women with term breech presentation. Improved data collection around the diagnosis of breech presentation, ECV attempts, and outcomes may help to identify specific barriers to ECV uptake.

  14. Factors associated with the success of external cephalic version (ECV) of breech presentation at term.

    Science.gov (United States)

    Obeidat, N; Lataifeh, I; Al-Khateeb, M; Zayed, F; Khriesat, W; Amarin, Z

    2011-01-01

    To evaluate the predictors of success of ECV for breech presentation at term. A retrospective study was conducted over a 3-year period from 2005-2007, where 101 patients who had singleton breech presentation at term were undergoing external cephalic version (ECV) after 37 weeks of gestation at two major teaching hospitals in the North of Jordan. Comparative analysis was made between the successful ECV and unsuccessful ECV groups. The collected data were analysed by using statistical analysis Sudent's t-test and Mann-Whitney test as appropriate and on discrete results chi square or Fisher's exact test when appropriate. The differences were considered significant at a p value of ECV success rate was 72.3%. Favourable factors for success were multiparity (95.5% vs 4.1%, p = 0.0001), flexed breeches (74% vs 26%, p = 0.002), posterior placenta (38.6% vs 16.4%, p = 0.0001) and anterior fetal back (53.4% vs 34.8%, p = 0.03). Once turned the babies remained cephalic until delivery. All the 28 cases who had failed ECV had caesarean section. Among those who had a successful external cephalic version, the incidence of intrapartum caesarean section was only 8.2% which was lower than that of the average of both units caesarean rate (28%). There were no complications related to the ECV procedure in the study. Multiparity, flexed breech, posterior placenta, and anterior foetal back were the most favourable factors for successful ECV in our study. Moreover, with careful evaluation of individual predictors patient selection and success rates can be optimised.

  15. Cost-effectiveness of external cephalic version for term breech presentation

    Directory of Open Access Journals (Sweden)

    Carvalho Brendan

    2010-01-01

    Full Text Available Abstract Background External cephalic version (ECV is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. Methods A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc. was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery, utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY was used to determine cost-effectiveness. Results The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion

  16. The relation of breech presentation at term to epilepsy in childhood

    DEFF Research Database (Denmark)

    Krebs, Lone; Langhoff-Roos, Jens

    2006-01-01

    for epilepsy (OR: 1.2 [95% CI: 1.1, 1.3]). Breech infants with epilepsy were more often small for gestational age (9.7%) than breech infants without epilepsy (4.7%). Vaginal delivery was associated with low Apgar score, but mode of delivery and low Apgar score were not related to epilepsy. CONCLUSION...

  17. Patients' and professionals' barriers and facilitators to external cephalic version for breech presentation at term, a qualitative analysis in the Netherlands

    NARCIS (Netherlands)

    Rosman, A.N.; Vlemmix, F.; Fleuren, M.A.H.; Rijnders, M.E.; Beuckens, A.; Opmeer, B.C.; Mol, B.W.J.; Zwieten, M.C.B. van; Kok, M.

    2014-01-01

    Objective: external cephalic version (ECV) is a relatively simple and safe manoeuvre and a proven effective approach in the reduction of breech presentation at term. There is professional consensus that ECV should be offered to all women with a fetus in breech presentation, but only up to 70% of

  18. Fear for external cephalic version and depression : Predictors of successful external cephalic version for breech presentation at term?

    NARCIS (Netherlands)

    Ciliacus, Emily; van der Zalm, Marieke; Truijens, Sophie E.; Hasaart, Tom H.; Pop, Victor J.; Kuppens, Simone M.

    2014-01-01

    Background Objective was to determine whether fear for external cephalic version (ECV) and depression are associated with the success rate of ECV in women with a breech presentation at term. Methods Prospective study conducted in the Catharina Hospital Eindhoven between October 2007 and May 2012.

  19. Brief report: a cost analysis of neuraxial anesthesia to facilitate external cephalic version for breech fetal presentation.

    Science.gov (United States)

    Carvalho, Brendan; Tan, Jonathan M; Macario, Alex; El-Sayed, Yasser Y; Sultan, Pervez

    2013-07-01

    In this study, we sought to determine whether neuraxial anesthesia to facilitate external cephalic version (ECV) increased delivery costs for breech fetal presentation. Using a computer cost model, which considers possible outcomes and probability uncertainties at the same time, we estimated total expected delivery costs for breech presentation managed by a trial of ECV with and without neuraxial anesthesia. From published studies, the average probability of successful ECV with neuraxial anesthesia was 60% (with individual studies ranging from 44% to 87%) compared with 38% (with individual studies ranging from 31% to 58%) without neuraxial anesthesia. The mean expected total delivery costs, including the cost of attempting/performing ECV with anesthesia, equaled $8931 (2.5th-97.5th percentile prediction interval $8541-$9252). The cost was $9207 (2.5th-97.5th percentile prediction interval $8896-$9419) if ECV was attempted/performed without anesthesia. The expected mean incremental difference between the total cost of delivery that includes ECV with anesthesia and ECV without anesthesia was $-276 (2.5th-97.5th percentile prediction interval $-720 to $112). The total cost of delivery in women with breech presentation may be decreased (up to $720) or increased (up to $112) if ECV is attempted/performed with neuraxial anesthesia compared with ECV without neuraxial anesthesia. Increased ECV success with neuraxial anesthesia and the subsequent reduction in breech cesarean delivery rate offset the costs of providing anesthesia to facilitate ECV.

  20. Fear for external cephalic version and depression: predictors of successful external cephalic version for breech presentation at term?

    Science.gov (United States)

    2014-01-01

    Background Objective was to determine whether fear for external cephalic version (ECV) and depression are associated with the success rate of ECV in women with a breech presentation at term. Methods Prospective study conducted in the Catharina Hospital Eindhoven between October 2007 and May 2012. Participants fulfilled The Edinburgh Depression Scale (EDS) questionnaire and expressed their degree of fear on a visual analogue scale from one to ten before ECV. Obstetric factors were evaluated as well. Primary outcome was the relation between psychological factors (fear for ECV and depression EDS scores) and ECV success rate. Secondary outcome was a possible relation between fear for ECV and increased abdominal muscle tension. Results The overall success rate was 55% and was significantly lower (p ECV and depression EDS-scores were not related with ECV success rate. Parity, placental location, BMI and engagement of the fetal breech were obstetric factors associated with ECV outcome. There was no relation between fear for ECV and abdominal muscle tone. Conclusion Fear for ECV and depression were not related with ECV success rate in this study. Engagement of the fetal breech was the most important factor associated with a successful ECV. Trial registration EBIS: The Eindhoven Breech Intervention Study, NCT00516555. PMID:24620740

  1. Fear for external cephalic version and depression: predictors of successful external cephalic version for breech presentation at term?

    Science.gov (United States)

    Ciliacus, Emily; van der Zalm, Marieke; Truijens, Sophie E; Hasaart, Tom H; Pop, Victor J; Kuppens, Simone M

    2014-03-12

    Objective was to determine whether fear for external cephalic version (ECV) and depression are associated with the success rate of ECV in women with a breech presentation at term. Prospective study conducted in the Catharina Hospital Eindhoven between October 2007 and May 2012. Participants fulfilled The Edinburgh Depression Scale (EDS) questionnaire and expressed their degree of fear on a visual analogue scale from one to ten before ECV. Obstetric factors were evaluated as well. Primary outcome was the relation between psychological factors (fear for ECV and depression EDS scores) and ECV success rate. Secondary outcome was a possible relation between fear for ECV and increased abdominal muscle tension. The overall success rate was 55% and was significantly lower (p Fear for ECV and depression EDS-scores were not related with ECV success rate. Parity, placental location, BMI and engagement of the fetal breech were obstetric factors associated with ECV outcome. There was no relation between fear for ECV and abdominal muscle tone. Fear for ECV and depression were not related with ECV success rate in this study. Engagement of the fetal breech was the most important factor associated with a successful ECV. The Eindhoven Breech Intervention Study, NCT00516555.

  2. A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation.

    Science.gov (United States)

    Liu, Xiaohua; Xue, Aiqin

    2016-12-01

    Although external cephalic version (ECV) can be effective for correcting the fetus in a cephalic presentation, it may be painful for the mother. This study aimed to evaluate the efficacy and safety of remifentanil for pain relief during ECV in China. In all, 152 Chinese parturients with singleton breech presentation were randomly divided into 2 groups, each with 76 patients. All 152 patients were assigned to receive either remifentanil (infused at 0.1 μg/kg/min and demand boluses of 0.1 μg/kg) or saline placebo. The study was performed between January 2012 and December 2015. Outcome measurements included the Numerical Rating Pain Scale score (0-10) after ECV, success rate for ECV, and maternal satisfaction after ECV. Adverse events were also evaluated. The study was completed by 146 patients. Remifentanil showed greater efficacy than placebo in decreasing the pain score immediately after ECV (remifentanil 4.6 ± 2.6 vs placebo 6.5 ± 2.7; P ECV showed a significant difference between the 2 groups (remifentanil 56.5% vs placebo 39.5%; P = 0.04). Maternal satisfaction also showed a significant difference between the 2 groups (remifentanil 9.6 ± 1.4 vs placebo 6.4 ± 3.7; P ECV, and increasing maternal satisfaction during ECV, and is generally well-tolerated without additional adverse effects.

  3. A novel and dedicated multidisciplinary service to manage breech presentation at term; 3 years of experience in a tertiary care maternity unit.

    Science.gov (United States)

    Hickland, Patrick; Gargan, Phyl; Simpson, Jacquie; McCabe, Niamh; Costa, Janitha

    2017-08-09

    In order to provide uniform and unbiased multidisciplinary counselling on the options available, including vaginal breech delivery (VBD) and external cephalic version (ECV), the latter of which could then be performed, a weekly Breech Clinic was introduced to a tertiary care maternity unit in Northern Ireland in June 2013, replacing the traditional ECV Clinic introduced in June 2012. Retrospective data collection was undertaken using clinic proformas, Northern Ireland Maternity System data and case notes of women who attended the clinics (ECV and Breech) from June 2012 to May 2015. There were 434 referrals to the clinic over the 3-year period; 356 women attended. The proportion of women attending increased from 69% to 85% since the introduction of the Breech Clinic. Two hundred and thirty-two were deemed eligible and 179 of these underwent ECV after counselling. Although the proportion of women undergoing ECV decreased from 69% to 46%, 11 women opted for and achieved VBD during the 2 years of the Breech Clinic, compared with one woman in the year of the ECV Clinic. Seventy-one of the attempted ECVs were successful, with 61 women having a normal vaginal delivery. Notably, the success rate of ECV increased from 33% to 42%. The number of caesarean sections performed solely for breech at term decreased from 199 in the 12 months before the introduction of ECV clinic, to 188 during the ECV clinic, and 154 in the final 12 months of Breech Clinic. A dedicated service to counsel women on the management of breech presentation can decrease caesarean sections for breech presentation through increased uptake and success of ECV, and encouraging suitable women to opt for VBD when ECV is unsuccessful, contraindicated or declined.

  4. Time trend in the risk of delivery-related perinatal and neonatal death associated with breech presentation at term.

    Science.gov (United States)

    Pasupathy, Dharmintra; Wood, Angela M; Pell, Jill P; Fleming, Michael; Smith, Gordon C S

    2009-04-01

    To determine the factors associated with the risk of delivery-related perinatal and neonatal death among term infants presenting by the breech and the effect of changes in the mode of delivery on the overall rates of perinatal and neonatal mortality associated with breech presentation. We studied 32,776 singleton term infants presenting breech excluding anomalous and antepartum losses in Scotland between 1985 and 2004, using linked Scottish national registries of pregnancy outcome data and perinatal death data. The event was delivery-related perinatal and neonatal death (i.e. intrauterine fetal death during labour or death of infant in the first 4 weeks of life), subdivided according to intrapartum anoxia or mechanical cause of death. Analysis was by multivariate logistic regression. During the study period, the risk of delivery-related perinatal and neonatal death decreased by 72% (95% CI -1% to 93%), due to a 90% (95% CI 33-99%) reduction in anoxic or mechanical deaths. Both intrapartum (OR 0.16, 95% CI 0.02-0.75) and planned (OR 0.01, 95% CI 0.00-0.09) caesarean delivery were protective against anoxic or mechanical deaths and increased use of planned caesarean delivery accounted for 16% of the decline in anoxic and mechanical deaths over the study period. Increased use of planned caesarean delivery only partly explains the decline in delivery-related perinatal and neonatal death between 1985 and 2004 in Scotland.

  5. Comparison of Apgar scores in breech presentations between vaginal and cesarean delivery.

    Science.gov (United States)

    Fajar, Jonny Karunia; Andalas, Mohd; Harapan, Harapan

    2017-01-01

    The mode of delivery in breech presentation (BP) is controversial. Several studies have reported the advantages and disadvantages of delivery mode in BP. The aim of this study was to compare the Apgar scores in BPs between vaginal and cesarean delivery. A retrospective study was conducted at Dr. Zainoel Abidin General Hospital from January 2010 to December 2012. Data on the mode of delivery and Apgar scores at 1 and 5 min for infants with a BP were extracted from the medical records. Logistic regression was employed to assess the correlation between mode of delivery and Apgar scores. In addition, a meta-analysis was conducted to summarize findings from other regions. A total of 205 (3.9%) BPs among 5252 deliveries between January 2010 and December 2012 were analyzed for this study. There were 26% (52 cases) vaginal and 74% (153 cases) cesarean deliveries. The mode of delivery for BP had a significant association with Apgar score at 1 min (odds ratio [OR] 95% confidence interval [CI] = 6.462 [2.476-16.870], P = 0.0001) and 5 min (OR 95% CI = 7.727 [1.416-42.175], P = 0.018). Our meta-analysis showed that the delivery mode had a significant association with Apgar score in BP (OR: 3.69; 95% CI: 2.18-6.26, P = 0.0001). There was a significant association between Apgar scores in BPs and mode of delivery. Our results suggest better outcomes for cesarean than vaginal delivery in BPs.

  6. Comparison of Apgar scores in breech presentations between vaginal and cesarean delivery

    Science.gov (United States)

    Fajar, Jonny Karunia; Andalas, Mohd; Harapan, Harapan

    2017-01-01

    Objective: The mode of delivery in breech presentation (BP) is controversial. Several studies have reported the advantages and disadvantages of delivery mode in BP. The aim of this study was to compare the Apgar scores in BPs between vaginal and cesarean delivery. Materials and Methods: A retrospective study was conducted at Dr. Zainoel Abidin General Hospital from January 2010 to December 2012. Data on the mode of delivery and Apgar scores at 1 and 5 min for infants with a BP were extracted from the medical records. Logistic regression was employed to assess the correlation between mode of delivery and Apgar scores. In addition, a meta-analysis was conducted to summarize findings from other regions. Results: A total of 205 (3.9%) BPs among 5252 deliveries between January 2010 and December 2012 were analyzed for this study. There were 26% (52 cases) vaginal and 74% (153 cases) cesarean deliveries. The mode of delivery for BP had a significant association with Apgar score at 1 min (odds ratio [OR] 95% confidence interval [CI] = 6.462 [2.476–16.870], P = 0.0001) and 5 min (OR 95% CI = 7.727 [1.416–42.175], P = 0.018). Our meta-analysis showed that the delivery mode had a significant association with Apgar score in BP (OR: 3.69; 95% CI: 2.18–6.26, P = 0.0001). Conclusions: There was a significant association between Apgar scores in BPs and mode of delivery. Our results suggest better outcomes for cesarean than vaginal delivery in BPs. PMID:28757760

  7. Fracture of the Femur of A Newborn after Cesarean Section for Breech Presentation and Fibroid Uterus :A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ibrahima Farikou

    2014-01-01

    Full Text Available Introduction: The practice of cesarean section is known to decrease the occurrence of long bone fractures. We present here an unusual diaphyseal fracture of the femur of a newborn after cesarean section, the only case observed in our 14 years of practice. Case Report: The patient was a 3.4-kg female child born at 38 weeks of gestation. The mother was a primipara and aged 39 years. Ultrasound examination at 20th week revealed intrauterine fibroids with a breech presentation. Therefore, elective cesarean section was indicated. There was no apparent bone disorder that could predispose to sustain femur fracture. The fracture was treated successfully with a bilateral spica cast. The cesarean section was indicated in an aged primipara, bearer of uterine fibroids, and breech presentation. She had a good general health status, but her bone density was unknown since this examination is not routinely performed in our clinical settings in Africa. Conclusion: Elderly age, primipara status, presence of uterine fibroids, and breech presentation are usual indications for cesarean section. However, there are not many reports on femur fracture after cesarean section. Our present case suggests that despite the latest advances in delivery techniques, cesarean section for breech presentation predisposes the neonate to femoral fractures. Keywords: Femur fracture; Cesarean section; Fibroid; Breech presentation; Africa.

  8. Development and validation of an objective structured assessment of technical skill tool for the practice of breech presentation delivery.

    Science.gov (United States)

    Jordan, Alexis; Antomarchi, Julie; Bongain, André; Tran, Antoine; Delotte, Jérome

    2016-08-01

    To develop and test the validity of an Objective Structured Assessment of Technical Skills (OSATS) tool for breech presentation delivery. Monocentric prospective study conducted in the Department of Gynecology, Obstetrics, Fetal Medicine and Reproductive Medicine at the University Hospital of Nice. The study consisted of two parts, the development of the OSATS scoring system and its objective validation. Several experts in obstetrics from university hospital centers and private French hospitals were invited to participate in the development phase of the scoring system. For the validation phase, we formed a group of 20 novices and a group of 20 experts, who had to perform a breech presentation delivery on a simulator, according to a standardized scenario. Each participant was filmed and two experts would then evaluate their performance by viewing anonymized videos and using the OSATS score. The scores obtained by the expert group were significantly higher than those of the novice group, with a total score of 21.73/25 versus 6.95/25 (p skills using a simulator.

  9. Facilitators and barriers to external cephalic version for breech presentation at term among health care providers in the Netherlands: A quantitative analysis

    NARCIS (Netherlands)

    Rosman, A.N.; Vlemmix, F.; Beuckens, A.; Rijnders, M.E.; Opmeer, B.C.; Mol, B.W.J.; Kok, M.; Fleuren, M.A.H.

    2014-01-01

    OBJECTIVE: guidelines recommend that external cephalic version (ECV) should be offered to all women with a fetus in breech presentation at term. However, only 50-60% of the women receive an ECV attempt. We explored the determinants (barriers and facilitators) affecting the uptake of the guidelines

  10. Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

    Science.gov (United States)

    2014-01-01

    Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

  11. Vaginal breech births in a hospital where caesarean section is ...

    African Journals Online (AJOL)

    SCIENTIFIC LETTER. Objectives. Caesarean section has become the preferred delivery method for breech presentation at Chris Hani Baragwanath Academic ... This study has shown that vaginal breech births continue to occur as unexpected events. ... descriptive study was to understand why and how vaginal breech.

  12. Changes in vaginal breech delivery rates in a single large metropolitan area.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2012-06-01

    Vaginal breech delivery rates have been accepted widely to be in decline and the Term Breech Trial (TBT) has recommended delivery of a breech-presenting infant by elective cesarean section delivery. Our aim was to examine the rate of vaginal delivery of term breech pregnancies in the 8 years before and after the publication of the TBT.

  13. Comparison of Fetomaternal Outcome between 47 Deliveries Following Successful External Cephalic Version for Breech Presentation and 7456 Deliveries Following Spontaneous Cephalic Presentation.

    Science.gov (United States)

    de Gregorio, Nikolaus; Friedl, Thomas; Schramm, Amelie; Reister, Frank; Janni, Wolfgang; Ebner, Florian

    2017-08-25

    Achieving a cephalic position after a successful external cephalic version (ECV) is desired to result in delivery and fetal outcomes that are similar to those of deliveries following spontaneous cephalic presentation. We performed a retrospective cohort study including patients with successful ECV following fetal breech position (ECV cohort, n = 47) or with a singleton spontaneous cephalic pregnancy at ≥37 weeks of gestational age (control group, n = 7,456) attempting a vaginal delivery between 2010 and 2013 at the University Hospital Ulm. The mode of delivery and fetal outcome parameters were compared between these 2 groups using nonparametric statistics. ECV cohort and control group did not differ with respect to maternal age, parity, gestational age at birth, and fetal gender. There were no significant differences between the 2 groups with regard to all parameters indicating fetal outcome. However, the rate of cesarean sections was higher after successful ECV compared to spontaneous cephalic presentation (27.7 vs. 12.8%, OR 2.615). While vaginal delivery is less likely to happen after a successful ECV compared to spontaneous cephalic singleton pregnancies, fetal outcome parameters showed no difference between the 2 groups. Physicians should be counseling and encouraging women to attempt ECV, as it is a safe and effective procedure. © 2017 S. Karger AG, Basel.

  14. Breech presentation at term: morbidity and mortality according to the type of delivery at Port Royal Maternity hospital from 1993 through 1999.

    Science.gov (United States)

    Kayem, Gilles; Goffinet, François; Clément, Denis; Hessabi, Madieh; Cabrol, Dominique

    2002-05-10

    To compare neonatal morbidity and mortality at Port Royal Maternity between 1993 and 1999 for infants with a singleton breech presentation born after 37 weeks, according to planned mode of delivery. Retrospective study of 501 patients of whom vaginal delivery was planned in 322 (64%) or/and cesarean in 179 (36%). Severe neonatal morbidity was similar in the two groups (13/322, 4.0% versus 8/179, 4.5%; P=0.82); severe trauma morbidity was not significantly higher in the "planned vaginal delivery" group (3/322, 0.9% versus 1/179, 0.06%; P=0.16); there were no long-term sequelae. Mortality was not higher when vaginal delivery was planned. We have not found in this series any excess of morbidity or mortality attributable to vaginal delivery of breech presentations. This work does not indicate that we should change our obstetrical practice in the light of other recently-published studies.

  15. Bilateral Humerus and Right Femur Fracture in a Newborn after Cesarean Section for Breech Presentation in a Twin Pregnancy: A Very Rare Case Report

    Science.gov (United States)

    Rahul, P; Grover, Amit Rakesh; Ajoy, S M

    2017-01-01

    Introduction: The most common fractures during vaginal delivery occur in the clavicle, humerus, and femur. Cesarean section reduces the chances of a child having a birth injury. However, in some difficult extractions, long bone fractures may occur. Cesarean section further reduces the incidence of birth injuries, especially in a breech delivery. Maneuvers employed during cesarean section, energetic traction, improper uterine incisions, and contracted uterus may cause these injuries. In the medical literature, there are few articles highlighting the occurrence of long bone fractures during cesarean section. There has been no case reported with a combined bilateral humerus and femur fracture in the medical literature. Case Report: A 2-day-old neonate born after cesarean section for breech presentation in a twin pregnancy presented with restricted movements of both his arms and right leg. Infantogram revealed bilateral humerus and right femur fracture. Biochemical tests were normal, and there were no other findings on clinical examination. There was no evidence of child abuse or any positive family history. Child was splinted for 3 weeks. X-rays suggested good callus at the fracture site of the right femur and bilateral humerus fracture were united. Conclusion: To conclude, we would like to emphasize that long bone fractures can happen with cesarean section also. To prevent such untoward complications, during delivery of the baby the surgeon should be very careful, avoid energetic traction and should plan his incisions. Appropriate relaxation of the uterus must be achieved. Clavicles and other long bones should be palpated after a difficult delivery. However, it is important to note that long bone fractures in children heal rapidly without the need for any major intervention. PMID:28630830

  16. Is routine caesarean section necessary for breech-breech and ...

    African Journals Online (AJOL)

    Objective: To determine if perinatal outcome is affected by the route of delivery in breech-breech and breech-transverse twin gestations. Design: Prospective observational study. Setting: Umtala General Hospital, a referral hospital for approximately 32 rural hospitals throughout the former Transkei. Subjects: Twin gestations ...

  17. Consequences of the term breech trial in Denmark

    DEFF Research Database (Denmark)

    Hartnack Tharin, J.E.; Krebs, L.; Rasmussen, S.

    2011-01-01

    Objective. To analyze the consequences of the handling of breech presentation in Denmark after publication of the Term Breech Trial (TBT). Design. Population-based retrospective cohort study. Settings. Data from the National Birth Registry and discharge letters from cases with perinatal death...

  18. Facilitators and barriers to external cephalic version for breech presentation at term among health care providers in the Netherlands: a quantitative analysis.

    Science.gov (United States)

    Rosman, Ageeth N; Vlemmix, Floortje; Beuckens, Antje; Rijnders, Marlies E; Opmeer, Brent C; Mol, Ben Willem J; Kok, Marjolein; Fleuren, Margot A H

    2014-03-01

    guidelines recommend that external cephalic version (ECV) should be offered to all women with a fetus in breech presentation at term. However, only 50-60% of the women receive an ECV attempt. We explored the determinants (barriers and facilitators) affecting the uptake of the guidelines among gynaecologists and midwives in the Netherlands. national online survey. the Netherlands. gynaecologists and midwives. in the online survey, we identified the determinants that positively or negatively influenced the professionals׳ adherence to three key recommendations in the guidelines: (a) counselling, (b) advising for ECV, (c) arranging an ECV. Determinants were identified in a previously performed qualitative study and were categorised into five underlying constructs; attitude towards ECV, professional obligation, outcome expectations, self-efficacy and preconditions for successful ECV. We performed a multivariate analysis to assess the importance of the different constructs for adherence to the guideline. 364 professionals responded to the survey. Adherence varied: 84% counselled, 73% advised, and 82% arranged an ECV for (almost) all their clients. Although 90% of respondents considered ECV to be an effective treatment for preventing caesarean childbirths, only 30% agreed that 'every client should undergo ECV'. Self-efficacy (perceived skills) was the most important determinant influencing adherence. self-efficacy appears to be the most significant determinant for counselling, advising and arranging an ECV. to improve adherence to the guidelines on ECV we must improve self-efficacy. Copyright © 2014. Published by Elsevier Ltd.

  19. Breech repositioning unresponsive to Webster technique: coexistence of oligohydramnios.

    Science.gov (United States)

    Roecker, Christopher B

    2013-06-01

    The purpose of this report is to describe the results of a pregnant woman demonstrating breech fetal presentation who was managed with Webster technique in the presence of oligohydramnios. A 23-year-old primigravida woman sought chiropractic care for the management of breech presentation and bilateral sacroiliac arthralgia at 34 weeks' gestation. Sacral manipulation and abdominal effleurage (Webster Technique) was used to address breech presentation and sacroiliac arthralgia for a total of 7 treatments over a 3 1/2-week duration. The patient's sacroiliac pain reduced from 8/10 to 3/10. However, breech presentation was unchanged at each treatment. At a scheduled prenatal surveillance during the 37th week of gestation, the midwife detected vaginal bleeding and reduced fundal height, which resulted in hospitalization, diagnosis of oligohydramnios, and an emergency cesarean delivery. For this particular patient, the breech presentation was not corrected using the Webster technique. Clinicians who use the Webster technique to manage breech fetal presentation should be aware of undiagnosed comorbidities as a complicating factor in clinical presentation. Screening for previously undiagnosed comorbidities, such as oligohydramnios, must be considered.

  20. Educational outcomes following breech delivery: a record-linkage study of 456947 children.

    Science.gov (United States)

    Mackay, Daniel F; Wood, Rachael; King, Albert; Clark, David N; Cooper, Sally-Ann; Smith, Gordon C S; Pell, Jill P

    2015-02-01

    Obstetric management of term breech infants changed dramatically following the Term Breech Trial which suggested increased serious neonatal morbidity following trial of labour. Short-term morbidity is a poor proxy of long-term neurological sequelae. We determined whether vaginal breech delivery was associated with educational outcomes. We linked three Scotland-wide administrative databases at an individual level: the ScotXed school census; Scottish Qualifications Authority (SQA) examination results; and Scottish Morbidity Record (SMR02) maternity database. The linkage provided information on singleton children, born at term, attending Scottish schools between 2006 and 2011. Of the 456 947 eligible children, 1574 (0.3%) had vaginal breech deliveries, 12 489 (2.7%) planned caesarean section for breech presentation and 442 090 (96.9%) vaginal cephalic deliveries. The percentage of term breech infants delivered vaginally fell from 23% to 7% among children who started school in 2006 and 2011, respectively. Of children born by vaginal breech delivery, 1.5% had a low 5-min Apgar score (≤3) compared with only 0.4% of those born by either breech caesarean section [adjusted odds ratio (OR) 6.16, 95% confidence interval (CI) 4.44-8.54, p<0.001] or cephalic vaginal delivery (adjusted OR 3.84, 95% CI 2.99-4.93, p<0.001). Children born by vaginal breech delivery had lower examination attainment than those born by either planned caesarean section for breech presentation (adjusted OR 1.16, 95% CI 1.02-1.32, p=0.020) or vaginal cephalic delivery (adjusted OR 1.14, 95% CI 1.01-1.28, p=0.029). Vaginal delivery of term breech infants was associated with lower examination attainment, as well as poorer Apgar scores, suggesting that the adverse effects are not just short-term. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  1. Neonatal Outcome of Term Breech Births: A 15-Year Review at the ...

    African Journals Online (AJOL)

    was associated with significantly increased risk of perinatal death and neonatal morbidity. Keywords breech birth; vaginal delivery; cesarean section; perinatal mortality; Cameroon. 1 Introduction. Breech presentation occurs in about 3% of all term singleton pregnancies [5]. Compared with a fetus with cephalic pre- sentation ...

  2. Breech delivery at a University Hospital in Tanzania

    DEFF Research Database (Denmark)

    Högberg, Ulf; Claeson, Catrin; Krebs, Lone

    2016-01-01

    death (stillbirths + in-hospital neonatal deaths) and moderate asphyxia. Maternal outcomes, such as death, hemorrhage, and length of hospital stay, were also described. Results: The CD rate for breech presentation increased from 28 % in 1999 to 78 % in 2010. Perinatal deaths were associated with vaginal...... sound at admission, and absence of pregnancy-related complication as indication for CD. Of 2,765 mothers who had a breech delivery, 1,655 met the inclusion criteria. Analyses were stratified by mode of delivery, taking into account also other birth characteristics. The outcome measures were perinatal...... delivery (VD) (adjusted odds ratio (aOR) 6.2; 95 % confidence interval (CI) 3.0-12.6) and referral (aOR 2.1; 95 % CI 1.1-3.9), but not with parity, birth weight, or delivery year. Overall perinatal mortality was 5.8 % and this did not decline, due to an increase in stillbirths among vaginal breech...

  3. Breech delivery at a University Hospital in Tanzania

    OpenAIRE

    H?gberg, Ulf; Claeson, Catrin; Krebs, Lone; Svanberg, Agneta Skoog; Kidanto, Hussein

    2016-01-01

    Background: There is a global increase in rates of Cesarean delivery (CD). A minor factor in this increase is a shift towards CD for breech presentation. The aim of this study was to analyze breech births by mode of delivery and investigate short-term fetal and maternal outcomes in a low-income setting. Methods: The study design was cross-sectional and the setting was Muhimbili National Hospital (MNH), Dar-es-Salaam, Tanzania. Subjects were drawn from a clinical database (1999-2010) using the...

  4. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

    NARCIS (Netherlands)

    Vlemmix, F.; Rosman, A.N.; Fleuren, M.A.H.; Rijnders, M.E.B.; Beuckens, A.; Haak, M.C.; Akerboom, B.M.C.; Bais, J.M.J.; Kuppens, S.M.I.; Papatsonis, D.N.; Opmeer, B.C.; Post, J.A.M. van der; Mol, B.W.J.; Kok, M.

    2010-01-01

    Background: Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for

  5. Implementation of the external cephalic version in breech delivery Dutch national implementation study of external cephalic version

    NARCIS (Netherlands)

    Vlemmix, Floortje; Rosman, Ageeth N.; Fleuren, Margot A. H.; Rijnders, Marlies E. B.; Beuckens, Antje; Haak, Monique C.; Akerboom, Bettina M. C.; Bais, Joke M. J.; Kuppens, Simone M. I.; Papatsonis, Dimitri N.; Opmeer, Brent C.; van der Post, Joris A. M.; Mol, Ben Willem J.; Kok, Marjolein

    2010-01-01

    ABSTRACT: BACKGROUND: Breech presentation occurs in 3 to 4 % of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch

  6. A Rare Complication of a Vaginal Breech Delivery

    Directory of Open Access Journals (Sweden)

    H. C. Vergers-Spooren

    2011-01-01

    Full Text Available Rectal lesions without anal sphincter trauma in childbirth are only sporadically described in literature. We describe the case of a 29-year-old primigravida who delivered a child in frank breech presentation. During the second stage of labour a foot presented transanally through a rectal laceration with intact anal sphincters. The laceration was repaired immediately after delivery in theatre. Follow-up visits showed a properly cured laceration and no complaints of incontinence or foul discharge.

  7. The Impact of an ECV Service is Limited by Antenatal Breech Detection: A Retrospective Cohort Study.

    Science.gov (United States)

    Hemelaar, Joris; Lim, Lee N; Impey, Lawrence W

    2015-06-01

    External cephalic version (ECV) reduces the chance of breech presentation at term birth and lowers the chance of a cesarean delivery. ECV services are now in place in many units in the United Kingdom but their effectiveness is unknown. The aim of this study was to investigate the reasons for breech presentation at term birth. We performed a retrospective cohort study of 394 consecutive babies who were in breech presentation at term birth in a large United Kingdom maternity unit that offers ECV. The cohort was analyzed over two time periods 10 years apart: 1998-1999 and 2008-2009. Only 33.8 percent of women had undergone a (failed) ECV attempt. This low proportion was mainly because breech presentation was not diagnosed antenatally (27.9%). Other contributing factors were: ECV not offered by clinicians (12.2%), ECV declined by women (14%), and contraindications to ECV (10.7%). Over the 10-year period, the proportion of breech presentations that were not diagnosed antenatally increased from 23.2 to 32.5 percent (p = 0.04), which constituted 52.8 percent of women who had not undergone an ECV attempt in 2008-2009. Failure of clinicians to offer ECV reduced from 21.6 to 3.0 percent (p = 0.0001) and the proportion of women declining ECV decreased from 19.1 to 9.0 percent (p = 0.005). Overall, ECV attempts increased from 28.9 to 38.5 percent (p = 0.05). Although ECV counseling, referral, and attempt rates have increased, failure to detect breech presentation antenatally is the principal barrier to successful ECV. Improved breech detection would have a greater impact than methods to increase ECV success rates. © 2015 Wiley Periodicals, Inc.

  8. Hypopituitarism in two brothers born by breech delivery.

    Science.gov (United States)

    del Rincón, J P; Lerman, I; Vázquez-Lamadrid, J; Gómez-Pérez, F J; Granados, J; Morales, J J; Mutchinick, O

    1999-01-01

    To describe two brothers with hypopituitarism who had been born by breech delivery and to discuss whether this condition corresponds to a familial form or to a pituitary stalk section as a result of the breech delivery. We present the clinical, biochemical, and magnetic resonance imaging (MRI) characteristics of two Mexican brothers, 19 and 21 years old, with hypopituitarism and a history of breech delivery. Physical examination of both patients showed short stature with normal body proportions, an obviously younger appearance than that expected for their chronologic age, high-pitched voice, irregularly positioned teeth, no axillary or pubic hair, and prepubertal genitalia. Biochemical testing showed low thyroxine and free thyroxine values with inadequate or normal thyrotropin, low basal testosterone, and mildly increased serum prolactin levels. Stimulation tests showed a normal and a delayed thyrotropin response to thyrotropin-releasing hormone, subnormal serum cortisol, considerably blunted growth hormone (GH) response to insulin-induced hypoglycemia, and absence of GH response to GH-releasing hormone in both cases. MRI showed an ectopic neuropituitary gland. In case 1, a caudal portion of a very thin pituitary stalk was observed, suggesting the preservation of a vascular component of the stalk. Because both parents of these brothers shared the major histocompatibility complex haplotype HLA-A*2301, B*3501, DRB1*0407, DQA1*03, DQB1*0201, consanguinity was suggested. The phenotype of these patients differs from that described in families with POU1F1 (Pit-1) and PROP1 mutations. These cases are most likely related to an autosomal recessive gene mutation that warrants further research. To our knowledge, this is the first report of hypopituitarism in two brothers born by breech delivery.

  9. The influence of counseling on the mode of breech birth: A single-center observational prospective study in The Netherlands.

    Science.gov (United States)

    Abdessalami, Souhailla; Rota, Hanneke; Pereira, Gabriella Dias; Roest, Jan; Rosman, Ageeth N

    2017-12-01

    women in the Netherlands, with a fetus in breech presentation, are thoroughly counseled to make an informed choice for the mode of delivery. The aim of this study was to assess the influence of counseling techniques on women's choices for the mode of delivery and subsequently to compare fetal and maternal outcomes of vaginal breech birth versus planned caesarean section. we performed an observational prospective study. Data on breech deliveries were prospectively collected. We used ANOVA to identify variables influencing women's choice for the mode of delivery. the obstetric department of the Red Cross Hospital in Beverwijk, the Netherlands. women with a singleton gestation (>37 + 0 weeks) and a fetus in breech presentation were included. between January 2007 and December 2015 364 women were included. Counseling technique (p =mode of delivery. Of all included women 33% (N = 119) opted for a vaginal breech delivery and 52% (N = 190) opted for a planned cesarean section. 15% (N = 55) were unexpected breeches. Of the planned vaginal delivery group 66% (N = 79) delivered vaginal, whereas 99.5% (N = 189) of the women in the planned cesarean section group underwent a planned cesarean section. There were no significant differences in maternal and neonatal outcomes. women's choice on the mode of delivery and the eventual modus partus of fetuses in breech presentation is strongly influenced by the counseling technique. Vaginal breech birth in low-risk women is a safe option without long term morbidity in neonates. counselors should be aware of their influence on women's choice for mode of delivery in breech presentation. Counseling should be done using evidence based information. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. ANAMNESTIC AND POPULATION CHARACTERISTICS OF THE BREECH DELIVERIES IN SUMADIJA REGION

    Directory of Open Access Journals (Sweden)

    Bozidar Jovanovic

    2008-04-01

    Full Text Available Breech presentation implies vertical position of the fetus, accounting for 3-4% of all monofetal deliveries. Perinatal morbidity and mortality are significantly higher in breech deliveries than in head presentation deliveries.The aim of the investigation was to examine the association between the anamnestic and population characteristics of the breech deliveries and the same characteristics in the head deliveries.Study group included 282 mothers who had breech deliveries and 282 mothers in control group who had head presentation deliveries. All the babies were delivered at the Clinic of Obstetrics and Gyneclogy Kragujevac.The population sample - the subject of the study encompassed mothers from Sumadija region with the center in Kragujevac as the capital and biggest city in the region.Distribution of probabilities according to profession or education of mothers was similar in both groups. The mean age of the mothers in both groups was 26.8 years. Significantly, the largest number of mothers from both groups was between 20 and 29 years of age, e.g. 70 %.With significantly high probability, the pregnancy progression in both groups was positive (85%, without maintaining pregnancy. The presence of associated disease was significantly higher, especially hypertension and diabetes in mothers who had breech deliveries compared to mothers who had head presentation deliveries.

  11. Supporting Women Planning a Vaginal Breech Birth: An International Survey.

    Science.gov (United States)

    Petrovska, Karolina; Watts, Nicole P; Catling, Christine; Bisits, Andrew; Homer, Caroline S E

    2016-12-01

    The aim of this study was to explore the experiences of women who planned a vaginal breech birth. An online survey was developed consisting of questions regarding women's experiences surrounding planned vaginal breech birth. The survey was distributed between April 2014 and January 2015 to closed membership Facebook groups that had a consumer focus on vaginal breech birth. In total, 204 unique responses to the survey were obtained from women who had sought the option of a vaginal breech birth in a previous pregnancy. Most women (80.8%) stated that they were happy with the birth choices they made, and a significant proportion (89.4%) would attempt a vaginal breech birth in subsequent pregnancies. Less than half of women were formally referred to a clinician skilled in vaginal breech birth when their baby was diagnosed breech (41.8%), while the remainder sourced a clinician themselves. Half of the women felt supported by their care provider (56.7%) and less than half (42.3%) felt supported by family and friends. The women who responded to this international survey sought the option of a vaginal breech birth, were subsequently happy with this decision, and would attempt a vaginal breech birth in their next pregnancy. Access to vaginal breech birth is important for some women; however, this choice may be challenging to achieve. Consistent information and support from clinicians is important to assist decision-making. © 2016 Wiley Periodicals, Inc.

  12. Delivery presentations

    Science.gov (United States)

    ... is delivered under the pubic bone. After the shoulder, the rest of the body is usually delivered without a problem. Alternative Names Shoulder presentation; Malpresentations; Breech birth; Cephalic presentation; Fetal lie; ...

  13. Revisiting the mode of delivery and outcome of singleton breech ...

    African Journals Online (AJOL)

    Assisted vaginal breech delivery was associated wilh high rate of low Apgar score (score <7) at the 5th minute when compared 10 elective caesarean section (p = 0,000088). There was an increased rate of special care baby unit admission in the group that had assisted vaginal breech delivery than in those that had elective ...

  14. Vaginal delivery versus cesarean section for term breech delivery

    Directory of Open Access Journals (Sweden)

    Babović Ivana

    2010-01-01

    Full Text Available Background/Aim. The optimal method of delivery for breech presentation at term still remains a matter of controversy. This is probably due to the fact that the skills of vaginal breech delivery are being lost. The aim of this study was to examine risk factors: mother's age, parity, labor's duration, estimated neonatal birth weight for the mode of breech presentation delivery at term as well as the influence of the delivery mode on neonatal outcome. Methods. A retrospective study of 401 terms (more than 37 week's gestation breech deliveries at the Institute of Gynecology and Obstetrics, Belgrade, from 2007 to 2008 was made. The following groups with respect to mode of delivery were included: the group I - vaginal delivery (VD in 139 patients; the group II - urgent cesarean section (UCS in 128 patients; and the group III - elective cesarean section (ECS in 134 patients. Mother's age, parity, duration of VD, neonatal birth weight (BW, the Apgar score at 5th minute, and duration of stay in a neonatal intensive care unit (NICU vere determined. Neonatal mortality and major neonatal morbidity were compared according to the route of delivery. Fetuses and neonates with hemolytic disease and fetal and neonatal anomalies were excluded from the study. For statistical analyses we performed Student's t test, χ2 likelihood ratio, Kruskall-Wallis test, Mann Whitney test, and ANOVA. Results. The mean age of patients in the group I was 28.29 ± 4.97 years, in the group II 29.68 ± 5.92 years and in the group III 30.06 ± 5.41 years. Difference in mother's age between the group I and III was significant (p = 0.022. In the group III there were 73.9% nuliparous similarly to the gropu II (73.4%. We performed ECS in 54.6% of the nuliparous older than 35 years, and 54.4% multiparous younger than 35 years were delivered by VD. The use of oxytocin for stimulation of vaginal labor was not associated with its duration (p = 0.706. Lowset maneuver was performed in 88.5% of

  15. Breech at term--mode of delivery?

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Weber, T

    1995-01-01

    : Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS: A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores...... that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all...

  16. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

    Directory of Open Access Journals (Sweden)

    Papatsonis Dimitri N

    2010-05-01

    Full Text Available Abstract Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV and the Dutch Society for Obstetrics and Gynaecology (NVOG. Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial

  17. The Effect of Variable Composition Equilibrium Thermochemistry in Constant Breech Pressure (CBP) Gun Simulations

    Science.gov (United States)

    2014-01-01

    The Effect of Variable Composition Equilibrium Thermochemistry in Constant Breech Pressure (CBP) Gun Simulations by Anthony J. Kotlar...Effect of Variable Composition Equilibrium Thermochemistry in Constant Breech Pressure (CBP) Gun Simulations Anthony J. Kotlar Weapons and...May 1995 4. TITLE AND SUBTITLE The Effect of Variable Composition Equilibrium Thermochemistry in Constant Breech Pressure (CBP) Gun Simulations 5a

  18. [Neonatal outcome after a planned vaginal breech birth: no association with parity or birth weight, but more birth injuries than in planned cesarean section].

    Science.gov (United States)

    Brouwer, W K; Veenstra van Nieuwenhoven, A L; Santema, J G

    2001-08-11

    To investigate if in a planned vaginal breech delivery parity or birthweight is associated with neonatal outcome. Retrospective analysis of local data from the National Obstetric Registration of the Netherlands. The study concerned outcomes of 516 births of singletons with breech presentation after pregnancies > 37 weeks in the period 1 January 1995 to 31 December 1999 at the Medical Centre Leeuwarden, the Netherlands; there were 448 planned vaginal breech deliveries. Nulliparous and multiparous were separately studied in four birthweight groups ( or = 4000 g). None of the neonates born by primary caesarean experienced birth trauma. In the group with planned vaginal breech delivery 2% of the neonates of nulliparous and 3% of multiparous mothers experienced neonatal morbidity. There was one case of perinatal mortality due to birth trauma (0.2%). The total perinatal morbidity was 6% with no differences between nulliparae and multiparae and between the birthweight groups. In nulliparous, the percentage of emergency caesarean sections rose from 20% in the or = 4000 g birthweight group. Following a planned vaginal breech delivery, no differences were observed in neonatal outcome between nulliparous and multiparous women and between the four birthweight groups. The extent to which the figures were influenced by the selection for primary caesarean section is not clear.

  19. Pregnancy outcome in singleton term breeches from a referral ...

    African Journals Online (AJOL)

    There were no statistically significant differences in the perinatal mortality rates, congenital malformation rates and Apgar score of less than 7 at 5 minutes in babies born by AVBD and CS, (p>0.05). There was statistically significant difference in birth trauma (p<0.00001). Conclusion: Vaginal breech delivery is strongly ...

  20. caesarean section in the management of singleton breech delivery ...

    African Journals Online (AJOL)

    J. Udoma, **A. D. Ekanem. Department 0f*()hstetrics andGynaecology, University ofUyo Teaching Hospital, UyoAkwa Ibom State w University afCalabar Teaching Hospital, Calabar, Nigeria . ABSTRACT,. Objective: To establish the role of Caesarean section in reducing perinatal mortality following singleton breech delivery ...

  1. Pregnancy outcome in singleton term breeches from a referral ...

    African Journals Online (AJOL)

    mortality rates, congenital malformation rates and Apgar score of less than 7 at 5 minutes in babies born by AVBD and CS, (p>0.05). There was statistically significant difference in birth trauma (p<0.00001). Conclusion: Vaginal breech delivery is strongly associated with birth trauma in our community. It is recommended.

  2. Outcome of Singleton Breech Delivery in Wesley Guild Hospital ...

    African Journals Online (AJOL)

    Context: Singleton breech delivery in many developing countries is often associated with poor reproductive outcome largely because of increased perinatal morbidity and mortality. Objective: The aim of this study is to evaluate the impact of antenatal care and delivery in a specialist care unit on fetal outcome in singleton ...

  3. Delivery mode and neonatal outcome after a trial of external cephalic version (ECV): a prospective trial of vaginal breech versus cephalic delivery.

    Science.gov (United States)

    Reinhard, Joscha; Sänger, Nicole; Hanker, Lars; Reichenbach, Lena; Yuan, Juping; Herrmann, Eva; Louwen, Frank

    2013-04-01

    To examine the delivery mode and neonatal outcome after a trial of external cephalic version (ECV) procedures. This is an interim analysis of an ongoing larger prospective off-centre randomised trial, which compares a clinical hypnosis intervention against neuro-linguistic programming (NLP) of women with a singleton breech foetus at or after 37(0/7) (259 days) weeks of gestation and normal amniotic fluid index. Main outcome measures were delivery mode and neonatal outcome. On the same day after the ECV procedure two patients (2 %), who had unsuccessful ECVs, had Caesarean sections (one due to vaginal bleeding and one due to pathological CTG). After the ECV procedure 40.4 % of women had cephalic presentation (n = 38) and 58.5 % (n = 55) remained breech presentation. One patient remained transverse presentation (n = 1; 1.1 %). Vaginal delivery was observed by 73.7 % of cephalic presentation (n = 28), whereas 26.3 % (n = 10) had in-labour Caesarean sections. Of those, who selected a trial of vaginal breech delivery, 42.4 % (n = 14) delivered vaginally and 57.6 % (n = 19) delivered via Caesarean section. There is a statistically significant difference between the rate of vaginal birth between cephalic presentation and trial of vaginal breech delivery (p = 0.009), however, no difference in neonatal outcome was observed. ECV is a safe procedure and can reduce not only the rate of elective Caesarean sections due to breech presentation but also the rate of in-labour Caesarean sections even if a trial of vaginal breech delivery is attempted.

  4. Are intrapartum and neonatal deaths in breech delivery at term potentially avoidable?--a blinded controlled audit

    DEFF Research Database (Denmark)

    Krebs, Lone; Langhoff-Roos, Jens; Bødker, Birgit

    2002-01-01

    The aim of the study was to investigate whether deaths in term breech deliveries could have been avoided with improved care during pregnancy and delivery. All cases of intrapartum/early neonatal death of nonmalformed infants in breech presentation delivered at term in Denmark in the period 1982......-92 were studied. For each of the 12 deaths two controls matched by presentation and planned mode of delivery were selected. Eleven obstetricians assessed the care through narratives that ended when the infant was delivered to umbilicus and stated if the infant died, and whether the "possible death......" was potentially avoidable. The majority thought that 42% of cases and 9% of the controls had died. Antenatal and intrapartum care was suboptimal respectively in 17% and 25% of cases and 4% and 26% of controls. The assumed death was found to have been potentially avoidable in 58% of cases and 17% of controls. Care...

  5. Retention of Vaginal Breech Delivery Skills Taught in Simulation.

    Science.gov (United States)

    Stone, Heather; Crane, Joan; Johnston, Kathy; Craig, Catherine

    2018-02-01

    The optimal frequency of conducting simulation training for high-acuity, low-frequency events in obstetrics and gynaecology residency programs is unknown. This study evaluated retention over time of vaginal breech delivery skills taught in simulation, by comparing junior and senior residents. In addition, the residents' subjective comfort level to perform this skill clinically was assessed. This prospective cohort study included 22 obstetrics and gynaecology residents in a Canadian residency training program. Digital recordings were completed for pre-training, immediate post-training, and delayed (10-26 weeks later) post-training intervals of a vaginal breech delivery simulation, with skill assessment by a blinded observer using a binary checklist. Residents also completed questionnaires to assess their subjective comfort level at each interval. Junior and senior residents had significant improvements in vaginal breech delivery skills from the pre-training assessment to both the immediate post-training assessment (junior, P simulation 10-26 weeks later, although a decline in skills occurred over this time period. Comfort level was positively affected and retained. These results will aid in determining the frequency of simulation teaching for high-acuity, low-frequency events in a residency simulation curriculum. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  6. Contraindications for external cephalic version in breech position at term: a systematic review.

    Science.gov (United States)

    Rosman, Ageeth N; Guijt, Aline; Vlemmix, Floortje; Rijnders, Marlies; Mol, Ben W J; Kok, Marjolein

    2013-02-01

    External cephalic version (ECV) is a safe and effective intervention that can prevent breech delivery, thus reducing the need for cesarean delivery. It is recommended in national guidelines. These guidelines also mention contraindications for ECV, and thereby restrict the application of ECV. We assessed whether the formulation of these contraindications in guidelines are based on empiric data. Systematic review. Pregnant women with a singleton breech presentation from 34 weeks. We searched the National Guideline Clearinghouse, the Cochrane Central Register of Controlled Trials, MEDLINE (1953-2009), EMBASE (1980-2009), TRIP database (until 2011), NHS (National Health Services, until 2011), Diseases database (until 2011) and NICE guidelines (until 2011) for existing guidelines on ECV and studied the reproducibility of the contraindications stated in the guidelines. Furthermore, we systematically reviewed the literature for contraindications and evidence on these contraindications. Contraindications of ECV. We found five guidelines mentioning 18 contraindications, varying from five to 13 per guideline. The contraindications were not reproducible between the guidelines with oligohydramnios as the only contraindication mentioned in all guidelines. The literature search yielded 60 studies reporting on 39 different contraindications, of which we could only assess evidence of six of them. The present study shows that there is no general consensus on the eligibility of patients for ECV. Therefore we propose to limit contraindications for ECV to clear empirical evidence or to those with a clear pathophysiological relevance. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  7. Breech deliveries in Usmanu Danfodiyo University Teaching Hospital Sokoto, Northwestern Nigeria: A 10-year review

    Directory of Open Access Journals (Sweden)

    Karima Tunau

    2013-01-01

    Full Text Available Background: Breech delivery is a major issue in obstetric practice mainly because of the high perinatal morbidity and mortality associated with it. The aims of the study are to determine the prevalence management and perinatal outcome of singleton breech deliveries in our center. Materials and Methods: A retrospective study involving 395 singleton breech deliveries out of 24,160 deliveries conducted at the Usmanu Danfodiyo University Teaching Hospital Sokoto, Sokoto, over a 10-year (2001-2010 period. Results: The prevalence rate of singleton breech delivery was 1.7%. Breech deliveries occurred more in the primigravidae. Most babies (69.1% had vaginal delivery. There was a high caesarean section (CS rate of 30.9%. Babies delivered by CS had better Apgar scores than those delivered through the vagina (P < 0.05. The perinatal mortality rate in breech deliveries (410/1000 was significantly higher than that (101.5/10000 in their cephalic counterparts (P < 0.05. Similarly, perinatal deaths were more common in unbooked than in booked patients (P < 0.05. Conclusion: Breech delivery was frequent in the study population. Singleton breech delivered by CS had better outcome than those who were delivered through the vagina.

  8. The fact and the fiction: A prospective study of internet forum discussions on vaginal breech birth.

    Science.gov (United States)

    Petrovska, Karolina; Sheehan, Athena; Homer, Caroline S E

    2017-04-01

    Women with a breech baby late in pregnancy may use the internet to gather information to assist in decision-making for birth. The aim of this study was to examine how women use English language internet discussion forums to find out information about vaginal breech birth and to increase understanding of how vaginal breech birth is perceived among women. A descriptive qualitative study of internet discussion forums was undertaken. Google alerts were created with the search terms "breech birth" and "breech". Alerts were collected for a one-year period (January 2013-December 2013). The content of forum discussions was analysed using thematic analysis. A total of 50 forum discussions containing 382 comments were collected. Themes that arose from the data were: Testing the waters-which way should I go?; Losing hope for the chance of a normal birth; Seeking support for options-who will listen to me?; Considering vaginal breech birth-a risky choice?; Staying on the 'safe side'-caesarean section as a guarantee; Exploring the positive potential for vaginal breech birth. Women search online for information about vaginal breech birth in an attempt to come to a place in their decision-making where they feel comfortable with their birth plan. This study highlights the need for clinicians to provide comprehensive, unbiased information on the risks and benefits of all options for breech birth to facilitate informed decision-making for the woman. This will contribute to improving the woman's confidence in distinguishing between "the fact and the fiction" of breech birth discussions online. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  9. Breech preterm infants are at risk of developmental dysplasia of the hip.

    Science.gov (United States)

    Quan, Teddy; Kent, Alison L; Carlisle, Hazel

    2013-08-01

    There is uncertainty about the risk of developmental dysplasia of the hip (DDH) in breech preterm infants and therefore uncertainty about the benefits of using ultrasound screening in this population. The aim of this study was to determine if preterm infants born in the breech position are at risk of DDH. A retrospective audit of preterm and term infants born in the breech position was performed to determine the incidence of DDH. Group 1 included breech preterm infants (positive or negative for DDH. Three out of 129 (2.3%) preterm infants screened had DDH. For term infants, 3 out of 163 (1.8%) infants screened had DDH. The odds ratio for DDH in breech preterm infants compared with breech term infants was 1.27 (95% confidence interval 0.25 to 6.40). Preterm infants born in the breech position appear to have a similar incidence of DDH to term infants and thus require similar screening guidelines. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  10. Traumatic Distal Femoral Periostitis of the Newborn: A Breech Delivery Birth Injury

    Science.gov (United States)

    Rutherford, Yvonne; Fomufod, Antoine K.; Gopalakrishnan, Lalapet J.; Beeks, Earl C.

    1983-01-01

    Traumatic femoral epiphyseal periostitis is a rare complication of breech delivery by cesarean section. The clinical course and management of a case of distal femoral periostitis recently encountered by the authors is discussed. ImagesFigure 1 PMID:6644835

  11. Deliberate acquisition of competence in physiological breech birth: A grounded theory study.

    Science.gov (United States)

    Walker, Shawn; Scamell, Mandie; Parker, Pam

    2017-09-29

    Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems. Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear. How do professionals develop competence and expertise in physiological breech birth? Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition. Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners. The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices. Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  12. Objective Evaluation of Subclass Characteristics on Breech Face Marks.

    Science.gov (United States)

    Riva, Fabiano; Hermsen, Rob; Mattijssen, Erwin; Pieper, Pascal; Champod, Christophe

    2017-03-01

    Subclass characteristics can be found on the breech face marks left on spent cartridge cases. Even if they are assumed to be rare and their reported number is small, they can potentially lead to false associations. Subclass characteristics have been studied empirically allowing examiners to recognize them and to understand in which conditions they are produced. Until now, however, their influence on the identification process has not been studied from a probabilistic point of view. In this study, we aim at measuring the effect of these features on the strength of association derived from examinations involving subclass characteristics. The study takes advantage of a 3D automatic comparison system allowing the calculation of likelihood ratios (LRs). The similarities between cartridge case specimens fired by thirteen S&W .40S&W Sigma pistols are quantified, and their respective LRs are computed. The results show that the influence of subclass characteristics on the LRs is limited, even when these features are prevalent among the potential sources considered in a case. We show that the proportion of firearms sharing subclass characteristics should be larger than 40% of the pool of potential firearms for the effect to be significant. © 2016 American Academy of Forensic Sciences.

  13. The effect of intra-uterine breech position on postnatal motor functions of the lower limbs

    NARCIS (Netherlands)

    Sival, D A; Prechtl, H F; Sonder, G H; Touwen, B C

    The effect of intra-uterine movement restriction on the development of motor functions was studied longitudinally by comparing infants born after uncomplicated breech position (n = 13) with control infants (vertex position, n = 5-10). Before birth, fetal leg posture was studied at regular intervals

  14. Contraindications for external cephalic version in breech position at term: A systematic review

    NARCIS (Netherlands)

    Rosman, A.N.; Guijt, A.; Vlemmix, F.; Rijnders, M.; Mol, B.W.J.; Kok, M.

    2013-01-01

    Objective. External cephalic version (ECV) is a safe and effective intervention that can prevent breech delivery, thus reducing the need for cesarean delivery. It is recommended in national guidelines. These guidelines also mention contraindications for ECV, and thereby restrict the application of

  15. Genetic relationships between dagginess, breech bareness, and wool traits in New Zealand dual-purpose sheep.

    Science.gov (United States)

    Pickering, N K; Blair, H T; Hickson, R E; Dodds, K G; Johnson, P L; McEwan, J C

    2013-10-01

    Genetic and phenotypic parameters were estimated for dagginess, breech, wool, and fiber traits from approximately 29,500 progeny born in 2009 and 2010 in New Zealand dual-purpose ram breeding sheep flocks. Dagginess is adherence of fecal matter to the wool, and this study investigates the genetic and phenotypic correlations between dagginess and breech and wool traits. Estimates for heritability were moderate (0.21 to 0.44) for the following traits: dag score at 3 and 8 mo (DAG3, DAG8), breech bareness, wool length, wool bulk (BULK), mean fiber diameter, mean fiber diameter SD, mean fiber diameter CV, curvature (CURV), weaning weight at 3 mo, and autumn BW. Heritability estimates for fleece weight at 12 mo and proportion of medullated fibers were high (0.49 and 0.53, respectively). Dag score at 3 mo and DAG8 had low genetic and phenotypic correlations with all traits. Breech bareness had positive genetic and phenotypic correlations with CURV and BULK and mostly negative genetic correlations with all other wool traits. In summary the quantity and attributes of wool were not primary causative factors in fecal accumulation, leaving fecal consistency and composition as the major factors.

  16. Breech at term--mode of delivery? A register-based study

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Weber, Tom

    1995-01-01

    . Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores......) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores. CONCLUSIONS. Register data on singleton term breech deliveries imply...

  17. Ultrasound Examination for Infants Born Breech by Elective Cesarean Section With a Normal Hip Exam for Instability.

    Science.gov (United States)

    Pacana, Matthew J; Hennrikus, William L; Slough, Jennifer; Curtin, William

    2017-01-01

    Because of the risk of developmental dysplasia of the hip in infants born breech-despite a normal physical exam-the American Academy of Pediatrics (AAP) guidelines recommend ultrasound (US) hip imaging at 6 weeks of age for breech females and optional imaging for breech males. The purpose of this study is to report US results and follow-up of infants born breech with a normal physical exam. The electronic medical record for children born at 1 hospital from 2008 to 2011 was reviewed. Data were analyzed for sex, birth weight, breech position, birth order, ethnicity, US and x-ray results, follow-up, and cost. A total of 237 infants were born breech with a normal physical examination, all delivered by cesarean section. Of the infants, 55% were male and 45% female. About 151 breech infants (64%) with a normal Barlow and Ortolani exam had a precautionary hip US as recommended by the AAP performed at an average of 7 weeks of age. Eighty-six breech infants (35%) did not have an US and were followed clinically. Of the 151 infants that had an US, 140 (93%) were read as normal. None had a dislocated hip. Two patients had a normal physical exam but laxity on US. These 2 patients were the only infants treated in a Pavlik harness. A pediatric orthopaedic surgeon followed those with subtle US findings and no laxity until normal. The decision by the AAP to recommend US screening at 6 weeks of age for infants with a normal physical exam but breech position was based on an extensive literature review and expert opinion. Not all pediatricians are following the AAP guidelines. The decision to perform an US should be done on a case-by-case basis by the examining physician. A more practical, cost-effective strategy would be to skip the US if the physical exam is normal and simply obtain an AP pelvis x-ray at 4 months. Level III-this is a case-control study investigating the outcomes of infants on data drawn from the electronic medical record.

  18. Morbidity and mortality associated with mode of delivery for breech periviable deliveries.

    Science.gov (United States)

    Tucker Edmonds, Brownsyne; McKenzie, Fatima; Macheras, Michelle; Srinivas, Sindhu K; Lorch, Scott A

    2015-07-01

    The purpose of this study was to estimate the odds of morbidity and death that are associated with cesarean delivery, compared with vaginal delivery, for breech fetuses who are delivered from 23-24 6/7 weeks' gestational age. We conducted a retrospective cohort study of state-level maternal and infant hospital discharge data that were linked to vital statistics for breech deliveries that occurred from 23-24 6/7 weeks' gestation in California, Missouri, and Pennsylvania from 2000-2009 (N = 1854). Analyses were stratified by gestational age (23-23 6/7 vs 24-24 6/7 weeks' gestation). Cesarean delivery was performed for 46% (335 fetuses) and 77% (856 fetuses) of 23- and 24-week breech fetuses. In multivariable analyses, overall survival was greater for cesarean-born neonates (adjusted odds ratio [AOR], 3.98; 95% confidence interval [CI], 2.24-7.06; AOR, 2.91; 95% CI, 1.76-4.81, respectively). When delivered for nonemergent indications, cesarean-born survivors were more than twice as likely to experience major morbidity (intraventricular hemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis, asphyxia composite; AOR, 2.83; 95% CI, 1.37-5.84; AOR, 2.07; 95% CI, 1.11-3.86 at 23 and 24 weeks' gestation, respectively). Among intubated neonates, despite a short-term survival advantage, there was no difference in survival to >6-month corrected age (AOR, 1.77; 95% CI, 0.83-3.74; AOR, 1.50; 95% CI, 0.81-2.76, respectively). There was no difference in survival for intubated 23-week neonates who were delivered by cesarean for nonemergent indications or cesarean-born neonates who weighed morbidity for breech periviable neonates. However, among intubated neonates, despite a short-term survival advantage, there was no difference in 6-month survival. Also, cesarean delivery did not increase survival for neonates who weighed morbidity, maternal morbidity, and implications for future pregnancies. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Compound presentation in labour: highlighting the importance of ...

    African Journals Online (AJOL)

    Objective: To describe the occurrence of compound presentation in labour, as an obstetric emergency. Background: Compound presentation is a rare obstetric event, defined as the presentation of the hand or foot alongside the head or breech. It places both mother and baby at severe risk. The presence of skilled attendants ...

  20. Breech at term--mode of delivery? A register-based study

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Weber, Tom

    1995-01-01

    . Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores...... that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all...

  1. Presentation

    Directory of Open Access Journals (Sweden)

    Eduardo Vicente

    2013-06-01

    Full Text Available In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University of São Paulo (ECA-USP. Entitled Radio Beyond Borders the dossier gathers six articles and the intention of reuniting works on the perspectives of usage of such media as much as on the new possibilities of aesthetical experimenting being build up for it, especially considering the new digital technologies and technological convergences. It also intends to present works with original theoretical approach and original reflections able to reset the way we look at what is today already a centennial media. Having broadened the meaning of “beyond borders”, four foreign authors were invited to join the dossier. This is the first time they are being published in this country and so, in all cases, the articles where either written or translated into Portuguese.The dossier begins with “Radio is dead…Long live to the sound”, which is the transcription of a thought provoking lecture given by Armand Balsebre (Autonomous University of Barcelona – one of the most influential authors in the world on the Radio study field. It addresses the challenges such media is to face so that it can become “a new sound media, in the context of a new soundscape or sound-sphere, for the new listeners”. Andrew Dubber (Birmingham City University regarding the challenges posed by a Digital Era argues for a theoretical approach in radio studies which can consider a Media Ecology. The author understands the form and discourse of radio as a negotiation of affordances and

  2. Reverse breech extraction versus the standard approach of pushing the impacted fetal head up through the vagina in caesarean section for obstructed labour: A randomised controlled trial.

    Science.gov (United States)

    Nooh, Ahmed Mohamed; Abdeldayem, Hussein Mohammed; Ben-Affan, Othman

    2017-05-01

    The objective of this study was to assess effectiveness and safety of the reverse breech extraction approach in Caesarean section for obstructed labour, and compare it with the standard approach of pushing the fetal head up through the vagina. This randomised controlled trial included 192 women. In 96, the baby was delivered by the 'reverse breech extraction approach', and in the remaining 96, by the 'standard approach'. Extension of uterine incision occurred in 18 participants (18.8%) in the reverse breech extraction approach group, and 46 (47.9%) in the standard approach group (p = .0003). Two women (2.1%) in the reverse breech extraction approach group needed blood transfusion and 11 (11.5%) in the standard approach group (p = .012). Pyrexia developed in 3 participants (3.1%) in the reverse breech extraction approach group, and 19 (19.8%) in the standard approach group (p = .0006). Wound infection occurred in 2 women (2.1%) in the reverse breech extraction approach group, and 12 (12.5%) in the standard approach group (p = .007). Apgar score vagina.

  3. The Early External Cephalic Version (ECV) 2 Trial: an international multicentre randomised controlled trial of timing of ECV for breech pregnancies.

    Science.gov (United States)

    Hutton, E K; Hannah, M E; Ross, S J; Delisle, M-F; Carson, G D; Windrim, R; Ohlsson, A; Willan, A R; Gafni, A; Sylvestre, G; Natale, R; Barrett, Y; Pollard, J K; Dunn, M S; Turtle, P

    2011-04-01

    To investigate whether initiating external cephalic version (ECV) earlier in pregnancy might increase the rate of successful ECV procedures, and be more effective in decreasing the rate of non-cephalic presentation at birth and of caesarean section. An unblinded multicentred randomised controlled trial. A total of 1543 women were randomised from 68 centres in 21 countries. Women with a singleton breech fetus at a gestational age of 33(0/7) weeks (231 days) to 35(6/7) weeks (251 days) of gestation were included. Participants were randomly assigned to having a first ECV procedure between the gestational ages of 34(0/7) (238 days) and 35(6/7) weeks of gestation (early ECV group) or at or after 37(0/7) (259 days) weeks of gestation (delayed ECV group). The primary outcome was the rate of caesarean section; the secondary outcome was the rate of preterm birth. Fewer fetuses were in a non-cephalic presentation at birth in the early ECV group (314/765 [41.1%] versus 377/768 [49.1%] in the delayed ECV group; relative risk [RR] 0.84, 95% CI 0.75, 0.94, P=0.002). There were no differences in rates of caesarean section (398/765 [52.0%] versus 430/768 [56.0%]; RR 0.93, 95% CI 0.85, 1.02, P=0.12) or in risk of preterm birth (50/765 [6.5%] versus 34/768 [4.4%]; RR 1.48, 95% CI 0.97, 2.26, P=0.07) between groups. External cephalic version at 34-35 weeks versus 37 or more weeks of gestation increases the likelihood of cephalic presentation at birth but does not reduce the rate of caesarean section and may increase the rate of preterm birth. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  4. Repairing the breech

    Directory of Open Access Journals (Sweden)

    Harry C. Boyte

    2012-04-01

    Full Text Available The main obstacle to genuine and productive partnerships between institutions of higher education and the professionals they prepare, on the one side, and communities, on the other, is a “knowledge war,” full of invisible hierarchies and exclusions, producing a hypercompetitive achievement culture. This knowledge war dramatically limits communities’ and citizens’ ability to act on the problems they face today. It also sharply erodes the power of higher education, professionals, and civic leaders to help shape the culture in democratic ways.We have to get beyond arrogant experts and aggrieved communities if we want to develop communities’ capacities to solve problems and also to generate a larger vision of a good society. Community is the living context for evaluating expert knowledge. But without engagement with other ways of knowing appeal to community knowledge can easily produce a Know-Nothing reaction to the larger world.If we are to build communities’ civic agency – capacities to work across differences to meet our common challenges – we need to democratize the politics of knowledge and end the knowledge war. This requires learning from effective community organizing the idea of “schools for public life,” where ordinary people develop skills, habits, and confidence of citizenship. It also means creating what might be called middle spaces, not owned by academics or professionals, but open to academic and scientific knowledge, where different ways of knowing and acting intermingle in creative ways. Middle spaces put science and academic knowledge in the mix, “on tap, not on top.” They also recognize the power and the limits of communal knowledge.Keywordscivic agency, cultural organizing, knowledge war

  5. Discharge of a Pistol Out a Car Window with the Breech Within the Interior of the Car: Analysis of Gunshot Residue on a Car's Interior Surfaces.

    Science.gov (United States)

    Burnett, Bryan R; Lebiedzik, Jozef

    2017-05-01

    The defendant, the driver of the questioned car, allegedly extended his right arm over the passenger seat and fired a single shot from a 380 pistol out the passenger window with the pistol's breech within the car. A simulation of this shooting scenario using the same model car, but different year, was conducted to quantitate gunshot residue (GSR) contamination of interior surfaces within the car. The test car's dash and headliner/window frame above the pistol had the heaviest GSR contamination. The dash GSR from airborne deposition documents a firearm discharge within the vehicle. Transfer from GSR-contaminated hands or clothing to the dash is unlikely. The heavy GSR contamination of the headliner/window frame above the pistol likely documents the window from which the pistol was fired, but additional experiments are needed to verify. © 2016 American Academy of Forensic Sciences.

  6. Maternal and neonatal outcomes of vaginal breech delivery for singleton term pregnancies in a carefully selected Cameroonian population: a cohort study.

    Science.gov (United States)

    Dohbit, Julius Sama; Foumane, Pascal; Tochie, Joel Noutakdie; Mamoudou, Fadimatou; Temgoua, Mazou N; Tankeu, Ronni; Aletum, Veronica; Mboudou, Emile

    2017-11-22

    Vaginal breech delivery (VBD) is known to be associated with more perinatal and maternal complications. Very few studies on the subject have been carried out in poor-resource settings. The aim of this study was to determine maternal and neonatal outcomes in carefully selected cases of VBD for singleton term pregnancies in a tertiary centre in Cameroon. A retrospective cohort study. A tertiary hospital in Yaounde, Cameroon. Cases of VBD of newborns weighing 2500-3500 g were matched in a ratio of 1:4 to consecutive vaginal cephalic deliveries (VCDs) of newborns weighing 2500-3500 g over a 5-year period. Both groups were matched for maternal age and parity. We excluded cases of multiple gestations, footling breech, clinically inadequate maternal pelvis, preterm delivery, post-term pregnancies, fetal demise prior to the onset of labour, placenta praevia and fetal anomaly incompatible with vaginal delivery. Neonatal and maternal adverse outcomes of VBD observed till 6 weeks after delivery analysed using Bonferroni correction. Fifty-three (53) VBDs were matched against 212 VCD. Unlike women who had VCD, those who underwent VBD were more likely to have prolonged labour (OR 8.05; 95% CI 3.00 to 11.47; P<0.001), and their newborns were more likely to suffer from birth asphyxia (OR 10.24; 95% CI 4.92 to 21.31; P<0.001). The study infers a strong association between VBD of singleton term pregnancies and maternofetal morbidity when specific protocols are applied. This, however, failed to translate into higher differences in perinatal mortality. This finding does not discount the role of VBD in low-income countries, but we emphasise the need for specific precautions like close monitoring of labour and adequate anticipation for neonatal resuscitation in order to reduce these complications. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly

  7. To what extent do the presentation of fetus, amniotic fluid index and fetal weight at term affect the cardiac axis?

    Science.gov (United States)

    Gultekin, Ismail Burak; Altınboga, Orhan; Karahanoglu, Ertugrul; Dogan, Nihan Guneri; Icer, Bilal; Alkan, Afra; Kucukozkan, Tuncay

    2016-01-01

    To analyse the change in cardiac axis with advancing gestational age and the factors that may affect it. 45 healthy pregnant women in 20th weeks of gestation were enrolled to the study. The cardiac axis was noted for each participant. The same group was once more assessed at term and the change in cardiac axis was calculated with the difference of cardiac axis at term and the 20th gestational weeks. Change in cardiac axis with advancing gestational weeks and factors that may affect it such as amniotic fluid index (AFI), estimated fetal weight (EFW) at term, actual birth weight and presentation of the fetus at term were evaluated. The median of ages was 28.0 (IQR=12.0)years within a range of 18-39years. The median of change in cardiac axis was 11.0 (IQR=9.0) degrees within a range of 3.0-47.0 degrees. The change in cardiac axis in regard to the fetal presenting part was 11.0 (IQR=8.0) degrees in vertex presentation and 23.50 (IQR=21.0) degrees in breech presentation. 81.1% of the variation in change in cardiac axis was found to be due to the actual birth weight and fetal presentation, with each 100g increase in actual birth weight leads to an increase of 0.375 degrees in cardiac axis. EFW at term, presentation of the fetus and the actual birth weight were all found to be significant in predicting the change in cardiac axis, but not AFI. These findings may have future potential value in evaluating electrocardiogram (ECG), especially of pregnants with extremes of left axis deviation (polyhydramnios, large fetus or breech presentation). Clinicians should be cautious during the interpretation of the ECG in pregnants, especially in those with extremes of left axis deviation because of either polyhydramnios, large fetus or breech presentation. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. An Experimental Investigation of Stresses in a Steel Model of an Overloaded Breech Ring by Means of Photoelastic Coating Technique

    Science.gov (United States)

    1980-08-01

    following the same law of yielding. The shape of the stress strain 4 curve is represented by a parameter in the Ramberg - Osgood equation. It is possible...becomes ^ Ramberg , W. and Osgood , W. R., "Description of Stress-Strain Curves by Three Parameters," NACA TN 902, 1943. ^Mesnager, M., "Sur la...34 to be presented at the International Conference on Reliability Stress Analysis and Failure Presentation, ASME, San Francisco, August 1980. 4. Ramberg

  9. SINGLETON BREECH DELIVERIES IN IBADAN

    African Journals Online (AJOL)

    intrauterine deaths and congenital abnormalities, 524 of these cases were fully studied. Data was collected from the labour ward records, lying-in ward case records and in some cases, the. casefiles of those admitted to the Special Care Baby Unit (SCBU). For the purpose of this study a perinatal death is that of the fetus.

  10. Predictors of success of external cephalic version and cephalic presentation at birth among 1253 women with non-cephalic presentation using logistic regression and classification tree analyses.

    Science.gov (United States)

    Hutton, Eileen K; Simioni, Julia C; Thabane, Lehana

    2017-08-01

    Among women with a fetus with a non-cephalic presentation, external cephalic version (ECV) has been shown to reduce the rate of breech presentation at birth and cesarean birth. Compared with ECV at term, beginning ECV prior to 37 weeks' gestation decreases the number of infants in a non-cephalic presentation at birth. The purpose of this secondary analysis was to investigate factors associated with a successful ECV procedure and to present this in a clinically useful format. Data were collected as part of the Early ECV Pilot and Early ECV2 Trials, which randomized 1776 women with a fetus in breech presentation to either early ECV (34-36 weeks' gestation) or delayed ECV (at or after 37 weeks). The outcome of interest was successful ECV, defined as the fetus being in a cephalic presentation immediately following the procedure, as well as at the time of birth. The importance of several factors in predicting successful ECV was investigated using two statistical methods: logistic regression and classification and regression tree (CART) analyses. Among nulliparas, non-engagement of the presenting part and an easily palpable fetal head were independently associated with success. Among multiparas, non-engagement of the presenting part, gestation less than 37 weeks and an easily palpable fetal head were found to be independent predictors of success. These findings were consistent with results of the CART analyses. Regardless of parity, descent of the presenting part was the most discriminating factor in predicting successful ECV and cephalic presentation at birth. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. Congenital Uterovaginal Prolapse Present at Birth

    African Journals Online (AJOL)

    common risk factor (85% of cases).[1-4] Occult spina bifida as occurred in the index patient is not common. Defective innervations of the pelvic floor muscle in meningomyelocele may lead to weakened support of the uterus and vagina. The rise in fetal intra-abdominal pressure during breech delivery stretches the pelvic floor.

  12. CATCHY PRESENTATIONS

    DEFF Research Database (Denmark)

    Eriksen, Kaare; Tollestrup, Christian; Ovesen, Nis

    2011-01-01

    and ideas in many areas and avoiding “Death by Powerpoint”. This paper discusses the need and tools for making short presentations and describes the result from a business development project where engineering graduate students in architecture and design used the Pecha Kucha format to present...

  13. Information Presentation

    Science.gov (United States)

    Holden, Kritina L.; Thompson, Shelby G.; Sandor, Aniko; McCann, Robert S.; Kaiser, Mary K.; Adelstein, Barnard D.; Begault, Durand R.; Beutter, Brent R.; Stone, Leland S.; Godfroy, Martine

    2009-01-01

    The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew. In addition to addressing display design issues associated with information formatting, style, layout, and interaction, the Information Presentation DRP is also working toward understanding the effects of extreme environments encountered in space travel on information processing. Work is also in progress to refine human factors-based design tools, such as human performance modeling, that will supplement traditional design techniques and help ensure that optimal information design is accomplished in the most cost-efficient manner. The major areas of work, or subtasks, within the Information Presentation DRP for FY10 are: 1) Displays, 2) Controls, 3) Procedures and Fault Management, and 4) Human Performance Modeling. The poster will highlight completed and planned work for each subtask.

  14. Poster Presentations

    National Research Council Canada - National Science Library

    2017-01-01

    [...]high index of suspicion was observed when other 4 patients presented with biopsy proven secondary membranous with history of intake of indigenous medications and all were shown to have increased urinary mercury levels...

  15. CERN presentations

    CERN Multimedia

    CERN. Geneva

    2011-01-01

    Presentation by CERN (10 minutes each) Rolf Landua - Education and Outreach Salvatore Mele - Open Access Jean-Yves Le Meur - Digital Library in Africa Francois Fluckiger - Open Source/Standards (tbc) Tim Smith - Open Data for Science Tullio Basiglia - tbc

  16. Voting Present

    Directory of Open Access Journals (Sweden)

    James Lo

    2013-12-01

    Full Text Available During his time as a state senator in Illinois, Barack Obama voted “Present” 129 times, a deliberate act of nonvoting that subsequently became an important campaign issue during the 2008 presidential elections. In this article, I examine the use of Present votes in the Illinois state senate. I find evidence that Present votes can largely be characterized as protest votes used as a legislative tool by the minority party. Incorporating information from Present votes into a Bayesian polytomous item-response model, I find that this information increases the efficiency of ideal point estimates by approximately 35%. There is little evidence of significant moderation by Obama when Present votes are accounted for, though my results suggest that Obama’s voting record may have moderated significantly before his subsequent election to the U.S. Senate. My results also suggest that because legislative nonvoting may occur for a variety of reasons, naive inclusion of nonvoting behavior into vote choice models may lead to biased results.

  17. Technical presentation

    CERN Multimedia

    FI Department

    2008-01-01

    RADIOSPARES, the leading catalogue distributor of components (electronic, electrical, automation, etc.) and industrial supplies will be at CERN on Friday 3 October 2008 (Main Building, Room B, from 9.00 a.m. to 3.00 p.m.) to introduce its new 2008/2009 catalogue. This will be the opportunity for us to present our complete range of products in more detail: 400 000 part numbers available on our web site (Radiospares France, RS International, extended range of components from other manufacturers); our new services: quotations, search for products not included in the catalogue, SBP products (Small Batch Production: packaging in quantities adapted to customers’ requirements); partnership with our focus manufacturers; demonstration of the on-line purchasing tool implemented on our web site in conjunction with CERN. RADIOSPARES will be accompanied by representatives of FLUKE and TYCO ELECTRONICS, who will make presentations, demonstrate materials and answer any technical questio...

  18. Technical presentation

    CERN Multimedia

    FP Department

    2009-01-01

    07 April 2009 Technical presentation by Leuze Electronics: 14.00 – 15.00, Main Building, Room 61-1-017 (Room A) Photoelectric sensors, data identification and transmission systems, image processing systems. We at Leuze Electronics are "the sensor people": we have been specialising in optoelectronic sensors and safety technology for accident prevention for over 40 years. Our dedicated staff are all highly customer oriented. Customers of Leuze Electronics can always rely on one thing – on us! •\tFounded in 1963 •\t740 employees •\t115 MEUR turnover •\t20 subsidiaries •\t3 production facilities in southern Germany Product groups: •\tPhotoelectric sensors •\tIdentification and measurements •\tSafety devices

  19. Elective cesarean delivery for term breech

    DEFF Research Database (Denmark)

    Krebs, Lone; Langhoff-Roos, Jens

    2003-01-01

    and anemia (RR 0.91; 95% CI 0.84, 0.97), and operations for wound infection (RR 0.69; 95% CI 0.57, 0.83) than emergency cesarean delivery. There was a higher rate of puerperal fever and pelvic infection (RR 1.20; 95% CI 1.11, 1.25) than for vaginal delivery. Thromboembolic disease occurred in 0.1% of women...... with cesarean delivery, and anal sphincter rupture occurred in 1.7% of women with vaginal delivery. Elective cesarean delivery was not associated with subsequent ectopic pregnancy, miscarriage, placental complications, uterine rupture, or adverse neonatal outcome. Women with elective cesarean delivery were more...... often delivered by elective cesarean in their second pregnancy, compared with women delivered vaginally (RR 1.25; 95% CI 1.21, 1.29). Elective cesarean delivery was associated with a lower rate of a subsequent delivery during the study period and a longer mean delivery interval than for vaginal delivery...

  20. The effects of the term breech trial on vaginal breech delivery 8 years on

    LENUS (Irish Health Repository)

    Hehir, MP

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011

  1. Breech Babies: What Can I Do If My Baby Is Breech?

    Science.gov (United States)

    ... Andrew S. Coco, M.D., M.S., and Stephanie D. Silverman, M.D.(American Family Physician 09/01/98) ... and ChildbirthUltrasound During PregnancyA fetal ultrasound is a test that uses sound waves to create an image ...

  2. Saudi Arabia

    African Journals Online (AJOL)

    Summary. Objective: To compare the pregnancy outcome in women with singleton breech presentation at term delivered by caesarean section (CS) and vaginal breech delivery. Design: A retrospective study. Setting: Abha Maternity hospital, Saudi Arabia. Material and Methods: 573 women with singleton breech.

  3. Virtual Presenters: Towards Interactive Virtual Presentations

    NARCIS (Netherlands)

    Nijholt, Antinus; Cappellini, V.; Hemsley, J.

    2005-01-01

    We discuss having virtual presenters in virtual environments that present information to visitors of these environments. Some current research is surveyed and we will look in particular to our research in the context of a virtual meeting room where a virtual presenter uses speech, gestures, pointing

  4. Presentation rubric: improving faculty professional presentations.

    Science.gov (United States)

    Hayne, Arlene N; McDaniel, Gretchen S

    2013-01-01

    This article describes the content of a presentation evaluation rubric for use in the development and improvement in faculty performance to enhance learning. Lectures or professional presentations require skills that can be learned through the use of evidence-based practices for all forms of public speaking. A core competency of nursing faculty is to serve as a role model in skilled oral communication. The use of an evaluation presentation rubric can increase faculty competency in this area. © 2013 Wiley Periodicals, Inc.

  5. Making your presentation fun: creative presentation techniques

    Energy Technology Data Exchange (ETDEWEB)

    KEENEN,MARTHA JANE

    2000-05-18

    What possesses someone to volunteer and go through hoops and red tape to make a presentation at a conference? For that matter, why does anyone ever present anything to anyone? Actually, presentations are a fact of life and there are many reasons for doing a presentation and doing it well. New and existing staff need training and orientation to the way things are done here. Handing all of them a manual and hoping they read it is pretty much a waste of paper. On the other hand, an effective, entertaining and upbeat presentation on the relevant topics is more likely to stick with those people. They will even have a name and face to remember and seek out when they have an issue on or with that topic. This can be a very effective beginning for networking with new peers. The presenter is seen as knowledgeable, as a source of information on company topics and possibly evaluated as a potential mentor or future manager. Project staff and/or peers benefit from clear, concise, presentations of topical knowledge. This is one way that a group working on various aspects of the same project or program can stay in touch and in step with each other. Most importantly, presentations may be the best or only door into the minds (and budgets) of management and customers. These presentations are a wonderful opportunity to address legal and compliance issues, budget, staffing, and services. Here is a chance, maybe the only one, to demonstrate and explain the wonderfulness of a program and the benefit they get by using the services offered most effectively. An interactive presentation on legal and compliance issues can be an effective tool in helping customers and/or management make good risk management decisions.

  6. What Risk Factors and Characteristics Are Associated With Late-presenting Dislocations of the Hip in Infants?

    Science.gov (United States)

    Mulpuri, Kishore; Schaeffer, Emily K; Andrade, Janice; Sankar, Wudbhav N; Williams, Nicole; Matheney, Travis H; Mubarak, Scott J; Cundy, Peter J; Price, Charles T

    2016-05-01

    Most infants with developmental dysplasia of the hip (DDH) are diagnosed within the first 3 months of life. However, late-presenting DDH (defined as a diagnosis after 3 months of age) does occur and often results in more complex treatment and increased long-term complications. Specific risk factors involved in late-presenting DDH are poorly understood, and clearly defining an associated set of factors will aid in screening, detection, and prevention of this condition. Using a multicenter database of patients with DDH, we sought to determine whether there were differences in (1) risk factors or (2) the nature of the dislocation (laterality and joint laxity) when comparing patients with early versus late presentation. A retrospective review of prospectively collected data from a multicenter database of patients with dislocated hips was conducted from 2010 to 2014. Baseline demographics for fetal presentation (cephalic/breech), birth presentation (vaginal/cesarean), birth weight, maternal age, maternal parity, gestational age, family history, and swaddling history of patients were compared among nine different sites for patients who were enrolled at age younger than 3 months and those enrolled between 3 and 18 months of age. A total of 392 patients were enrolled at baseline between 0 and 18 months of age with at least one dislocated hip. Of that group, 259 patients were younger than 3 months of age and 133 were 3 to 18 months of age. The proportion of patients with DDH who were enrolled and followed at the nine participating centers was 98%. A univariate/multivariate analysis was performed comparing key baseline demographics between early- and late-presenting patients. After controlling for relevant confounding variables, two variables were identified as risk factors for late-presenting DDH as compared with early-presenting: cephalic presentation at birth and swaddling history. Late-presenting patients were more likely to have had a cephalic presentation than early-presenting

  7. Develop your presentation skills

    CERN Document Server

    Theobald, Theo

    2016-01-01

    Going beyond handling nerves and presenting PowerPoint slides, the third edition of "Develop Your Presentation Skills "offers practical advice on developing a captivating presentation, constructing compelling content, and boosting self-confidence. The book includes three new chapters on delivering a "stripped down"presentation, using new media to engage with the audience, and handling being asked to present on short notice."

  8. Subpart AA Training Presentations

    Science.gov (United States)

    EPA has produced the following training presentation(s) for reporters subject to this subpart. Generally, these presentations explain how to use the reporting system e-GGRT to submit annual GHG reports to EPA.

  9. Subpart HH Training Presentations

    Science.gov (United States)

    EPA has produced the following training presentation(s) for reporters subject to this subpart. Generally, these presentations explain the rule or show how to use the reporting system e-GGRT to submit annual GHG reports to EPA.

  10. Subpart W Training Presentations

    Science.gov (United States)

    EPA has produced the following training presentation(s) for reporters subject to this subpart. Generally, these presentations explain the rule or show how to use the reporting system e-GGRT to submit annual GHG reports to EPA.

  11. Subpart DD Training Presentations

    Science.gov (United States)

    EPA has produced the following training presentation(s) for reporters subject to this subpart. Generally, these presentations explain the rule or show how to use the reporting system e-GGRT to submit annual GHG reports to EPA.

  12. NITRD Presentation Library

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — This resource is a collection of presentations, reports, and webinars given by a broad range of presenters from academia, government, and private sectors at various...

  13. Presenting Food Science Effectively

    Science.gov (United States)

    Winter, Carl K.

    2016-01-01

    While the need to present food science information effectively is viewed as a critical competency for food scientists by the Institute of Food Technologists, most food scientists may not receive adequate training in this area. Effective presentations combine both scientific content and delivery mechanisms that demonstrate presenter enthusiasm for…

  14. Rotating Poster Presentations

    Science.gov (United States)

    Lagares, Manuel; Reisenleutner, Sandra

    2017-01-01

    Oral presentations are a common practice in foreign language classes, often used to assess students' speaking skills. Usually, the presentations are delivered by students in front of the class, often with PowerPoint slides or Prezi as support. However, frequently the audience does not engage with the presentation and thus, the benefits of this…

  15. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. This presentation was presented in a Wind Powering America webinar on August 15, 2012 and is now available through the Wind Powering America website.

  16. Innovative presentations for dummies

    CERN Document Server

    Anthony, Ray

    2014-01-01

    Be the speaker they follow with breakthrough innovative presentations Innovative Presentations For Dummies is a practical guide to engaging your audience with superior, creative, and ultra-compelling presentations. Using clear language and a concise style, this book goes way beyond PowerPoint to enable you to reimagine, reinvent, and remake your presentations. Learn how to stimulate, capture, and hold your audience in the palm of your hand with sound, sight, and touch, and get up to speed on the latest presentation design methods that make you a speaker who gets audiences committed and acting

  17. CERN Electronics Pool presentations

    CERN Multimedia

    2011-01-01

    The CERN Electronics Pool has organised a series of presentations in collaboration with oscilloscope manufacturers. The last one will take place according to the schedule below.   Time will be available at the end of the presentation to discuss your personal needs. The Agilent presentation had to be postponed and will be organised later. -     Lecroy: Thursday, 24 November 2011, in 530-R-030, 14:00 to 16:30.

  18. Hyponatraemia - presentations and management.

    Science.gov (United States)

    Dineen, Rosemary; Thompson, Christopher J; Sherlock, Mark

    2017-06-01

    Hyponatraemia is the most common electrolyte disturbance encountered in clinical practice. It is associated with -significant morbidity and mortality, thus appropriate investigation and treatment is essential. Hyponatraemia presents with a spectrum of clinical presentations ranging from no symptoms to life-threatening neurological sequelae. Hyponatraemia has multiple aetiologies and distinguishing the underlying aetiology facilitates appropriate treatment. This review provides an overview of the presentations and approaches to management of this common clinical condition. © Royal College of Physicians 2017. All rights reserved.

  19. Unusual presentation of entomophthoromycosis

    OpenAIRE

    Michael R; Michael J; Mathews M; Rupa V

    2009-01-01

    Rhinoentomophthoromycosis caused by Conidiobolus sp commonly presents as a chronic granulomatous lesion that affects the rhinofacial subcutaneous tissue. We present an 18-year-old girl who presented with progressive bilateral proptosis and loss of vision since 2 weeks. Biopsy and fungal cultures confirmed diagnosis of Conidiobolus sp infection of the paranasal sinuses bilaterally with orbital extension and blindness. The clinical picture was complicated by the presence of sputum-positive ...

  20. Presentation skills for nurses.

    Science.gov (United States)

    Foulkes, Mark

    2015-02-20

    This article emphasises the importance of effective presentation skills. Such skills allow nurses to share knowledge and expertise and to communicate clearly in a range of workplace scenarios. Nurses are increasingly being asked to present in formal and informal situations, such as conferences, poster presentations, job interviews, case reports and ward-based teaching. This article explores the principles underpinning the development of these skills, discusses the situations in which they could be applied and demonstrates how nurses might improve and develop as presenters.

  1. Presentation of celiac disease.

    Science.gov (United States)

    Reilly, Norelle Rizkalla; Fasano, Alessio; Green, Peter H R

    2012-10-01

    The mode of presentation of patients with celiac disease has changed dramatically over the recent decades, with diarrheal or classic presentations becoming less common. This trend is most markedly seen in children, whose main presentations include recurrent abdominal pain, growth issues, and screening groups at risk. Among adults, presentations include diarrhea, anemia, osteoporosis, and recognition at endoscopy performed for gastroesophageal reflux disease, as well as screening. The groups most commonly screened include family members of patients with celiac disease, Down syndrome, and autoimmune diseases. Copyright © 2012. Published by Elsevier Inc.

  2. Scientific papers and presentations

    National Research Council Canada - National Science Library

    Davis, Martha

    2005-01-01

    This book provides practical instruction for writing first drafts, reviewing and revising, communicating clearly and concisely, adhering to stylistic principles, presenting data in tables and figures...

  3. Fostering oral presentation performance

    OpenAIRE

    Ginkel, van, J.R.; Gulikers, Judith; Biemans, Harm; Mulder, Martin

    2017-01-01

    Previous research revealed significant differences in the effectiveness of various feedback sources for encouraging students’ oral presentation performance. While former studies emphasised the superiority of teacher feedback, it remains unclear whether the quality of feedback actually differs between commonly used sources in higher education. Therefore, this study examines feedback processes conducted directly after 95 undergraduate students’ presentations in the following conditions: teacher...

  4. Print advertising: Celebrity presenters

    National Research Council Canada - National Science Library

    Rossiter, John R; Smidts, Ale

    2012-01-01

    .... The theory's characteristics are visibility (widely well-known, necessary for celebrity presenters and creatable via advertising for “real people” presenters and animated characters), credibility (expertise and trustworthiness), attraction (likability and role-model identification), and power (for coercive persuasion that rarely applies ...

  5. Conjugando el presente

    Directory of Open Access Journals (Sweden)

    Héctor Rojas Herazo

    1968-06-01

    Full Text Available La añoranza suele ser, casi siempre, la línea critica de menor resistencia. El lema de que "todo tiempo pasado fue mejor" tiene un poco la culpa. En cualquier orden del conocimiento el pasado sigue el verdadero presente. Ese presente en que nos gusta respirar y vivir. Nada de compromiso circundante. Nada de inmediatez.

  6. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M. M.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented in a webinar given by the California Energy Commission.

  7. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented in a Power Systems Engineering Research Center webinar on September 4, 2012.

  8. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M.; Mai, T.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented in an Union of Concerned Scientists webinar on June 12, 2012.

  9. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M.

    2012-10-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It is being presented at the Utility Variable-Generation Integration Group Fall Technical Workshop on October 24, 2012.

  10. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M. M.

    2012-09-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050.

  11. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-10-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050.

  12. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-11-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050.

  13. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2013-04-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050.

  14. UTM Weather Presentation

    Science.gov (United States)

    Chan, William N.; Kopardekar, Parimal H.; Carmichael, Bruce; Cornman, Larry

    2017-01-01

    Presentation highlighting how weather affected UAS operations during the UTM field tests. Research to develop UAS weather translation models with a description of current and future work for UTM weather.

  15. Atypical Presentation of Neurosyphilis

    Directory of Open Access Journals (Sweden)

    L C Anand

    1980-01-01

    Full Text Available Five cases of neurospyhilis with atypical manifestation have been reported. Of these four cases presented as acute neurological illness and showed variable recovery after antisyp′iiilitic therapy. One of these cases had parinaud sip which was unaffected by treatment One case presented as dementia and gave poor response to therapy. In only one of these five cases was reagin in CSF demonstrated. Lange′s colloidal gold test was negative in all. As such failure to demonstrate reagin in CSF does not rule out the diagnosis of neurosyphilis. In an antibiotic era patients may inadvertently receive some antibiotics prior to presentation to a clinician and therefore are unlikely to present with typical neurological and laboratory findings.

  16. Workshop Presentations: RSW Analysts

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. They detail the analytical results generated by each of the participating analysis teams for the...

  17. Workshop Presentations: HIRENASD Analysts

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. They detail the analytical results generated by each of the participating analysis teams for the HIRENASD.

  18. Workshop Presentations: BSCW Analysts

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. They detail the analytical results generated by each of the participating analysis teams for the...

  19. Fostering oral presentation performance

    NARCIS (Netherlands)

    Ginkel, van Stan; Gulikers, Judith; Biemans, Harm; Mulder, Martin

    2017-01-01

    Previous research revealed significant differences in the effectiveness of various feedback sources for encouraging students’ oral presentation performance. While former studies emphasised the superiority of teacher feedback, it remains unclear whether the quality of feedback actually differs

  20. Contents of Presentation

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Contents of Presentation. Introduction on Power Quality (PQ). PQ Definitions. PQ Standards. Causes of PQ problems. PQ Mitigation Methods. Improved Power Quality Converters. Conclusion.

  1. PRESENT STATUS IN INDIA

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. PRESENT STATUS IN INDIA. FIXED LINES – 36 MILLION. MOBILE CONNECTIONS – 14 MILLION. TELEDENSITY APPROXIMATELY 5. INTERNET CONNECTIONS – 5 MILLION. INTERNET USERS NEARLY – 25 MILLION.

  2. Going beyond methodological presentism

    DEFF Research Database (Denmark)

    Schmidt, Garbi

    2017-01-01

    Denmark is an example of a country where the idea of historical ethnic homogeneity stands strong. This article challenges this historical presentism: the scholarly and societal tendency to understand social phenomena within a limited contemporary framework, neglecting possible effects and similar......Denmark is an example of a country where the idea of historical ethnic homogeneity stands strong. This article challenges this historical presentism: the scholarly and societal tendency to understand social phenomena within a limited contemporary framework, neglecting possible effects...

  3. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M. M.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented to the 2012 Western Conference of Public Service Commissioners, during their June, 2012, meeting. The Western Conference of Public Service Commissioners is a regional association within the National Association of Regulatory Utility Commissioners (NARUC).

  4. Stellar Presentations (Abstract)

    Science.gov (United States)

    Young, D.

    2015-12-01

    (Abstract only) The AAVSO is in the process of expanding its education, outreach and speakers bureau program. powerpoint presentations prepared for specific target audiences such as AAVSO members, educators, students, the general public, and Science Olympiad teams, coaches, event supervisors, and state directors will be available online for members to use. The presentations range from specific and general content relating to stellar evolution and variable stars to specific activities for a workshop environment. A presentation—even with a general topic—that works for high school students will not work for educators, Science Olympiad teams, or the general public. Each audience is unique and requires a different approach. The current environment necessitates presentations that are captivating for a younger generation that is embedded in a highly visual and sound-bite world of social media, twitter and U-Tube, and mobile devices. For educators, presentations and workshops for themselves and their students must support the Next Generation Science Standards (NGSS), the Common Core Content Standards, and the Science Technology, Engineering and Mathematics (STEM) initiative. Current best practices for developing relevant and engaging powerpoint presentations to deliver information to a variety of targeted audiences will be presented along with several examples.

  5. The psychological present.

    Science.gov (United States)

    Hayes, L J

    1992-01-01

    The present paper compares behavior-analytic and cognitive treatments of the concept of psychological history with regard to its role in current action. Both treatments take the position that the past bears some responsibility for the present, and are thereby obligated to find a means of actualizing the past in the present. Both do so by arguing that the past is brought to bear in the present via the organism. Although the arguments of the two positions differ on this issue, neither provides a complete account. An unconventional treatment of psychological history is proposed, the logic of which is exemplified in anthropological, biological, and psychological perspectives. The unconventional treatment in psychological perspective holds that (a) the organism's interaction with its environment, not the organism itself, changes with experience; and (b) the past interactions of an organism exist as, and only as, the present interactions of that organism. This solution to the problem of psychological history provides obligations and opportunities for analysis that are not available when the more conventional positions of cognitivism and behavior analysis are adopted.

  6. Unusual presentation of entomophthoromycosis

    Directory of Open Access Journals (Sweden)

    Michael R

    2009-01-01

    Full Text Available Rhinoentomophthoromycosis caused by Conidiobolus sp commonly presents as a chronic granulomatous lesion that affects the rhinofacial subcutaneous tissue. We present an 18-year-old girl who presented with progressive bilateral proptosis and loss of vision since 2 weeks. Biopsy and fungal cultures confirmed diagnosis of Conidiobolus sp infection of the paranasal sinuses bilaterally with orbital extension and blindness. The clinical picture was complicated by the presence of sputum-positive cavitatory pulmonary tuberculosis, which was diagnosed at the same time. To our knowledge, this is the first such case to be reported from India. We also discuss the management of entomophthoromycosis. Despite many reports of success, there remains no consensus on the treatment of Conidiobolus infections of the nose and the paranasal sinuses with antifungal agents.

  7. Unusual presentation of entomophthoromycosis.

    Science.gov (United States)

    Michael, R C; Michael, J S; Mathews, M S; Rupa, V

    2009-01-01

    Rhinoentomophthoromycosis caused by Conidiobolus sp commonly presents as a chronic granulomatous lesion that affects the rhinofacial subcutaneous tissue. We present an 18-year-old girl who presented with progressive bilateral proptosis and loss of vision since 2 weeks. Biopsy and fungal cultures confirmed diagnosis of Conidiobolus sp infection of the paranasal sinuses bilaterally with orbital extension and blindness. The clinical picture was complicated by the presence of sputum-positive cavitatory pulmonary tuberculosis, which was diagnosed at the same time. To our knowledge, this is the first such case to be reported from India. We also discuss the management of entomophthoromycosis. Despite many reports of success, there remains no consensus on the treatment of Conidiobolus infections of the nose and the paranasal sinuses with antifungal agents.

  8. Melanoma: Clinical Presentations.

    Science.gov (United States)

    Kibbi, Nour; Kluger, Harriet; Choi, Jennifer Nam

    2016-01-01

    The malignant cell in melanoma is the melanocyte. Because melanocytes are located in the basal layer of the epidermis, melanoma is most commonly seen on the skin. However, melanoma can also arise on mucosal surfaces such as the oral cavity, the upper gastrointestinal mucosa, the genital mucosa, as well as the uveal tract of the eye and leptomeninges. Melanomas tend to be pigmented but can also present as pink or red lesions. They can mimic benign or other malignant skin lesions. This chapter presents the spectrum of typical and less typical presentations of melanoma, as well as patterns of spread. It is divided into (1) cutaneous lesions; (2) patterns of regional spread, (3) non-cutaneous lesions; and (4) distant metastases.

  9. Milk: Past and Present

    Science.gov (United States)

    Bulajić, S.; Đorđević, J.; Ledina, T.; Šarčević, D.; Baltić, M. Ž.

    2017-09-01

    Although milk/dairy consumption is part of many cultures and is recommended in most dietary guidelines around the world, its contribution to overall diet quality remains a matter of controversy, leading to a highly polarized debate within the scientific community, media and public sector. The present article, at first, describes the evolutionary roots of milk consumption, then reviews the milk-derived bioactive peptides as health-promoting components. The third part of the article, in general, presents the associations between milk nutrients, disease prevention, and health promotion.

  10. Book Presentation | 27 February

    CERN Multimedia

    The CERN Library

    2013-01-01

    "A caccia del bosone di Higgs. Magneti, governi, scienziati e particelle nell'impresa scientifica del secolo" by Luciano Maiani and Romeo Bassoli, published by Mondadori. On Wednesday 27 February Luciano Maiani will present the book "A caccia del bosone di Higgs. Magneti, governi, scienziati e particelle nell'impresa scientifica del secolo". More information here. The presentation will take place in the Council Chamber at 16.00 and will be followed by a debate and book signing. The book will be on sale. You are cordially invited.

  11. Hand dermatitis: uncommon presentations.

    Science.gov (United States)

    Bauer, Andrea

    2005-01-01

    Hand dermatitis is a common diagnosis seen in dermatologic and general practice. It can present with typical morphology, but uncommon manifestations are possible. This review reports on common and uncommon presentations of irritant and allergic hand dermatitis focusing on uncommon localizations, time course, and morphology such as follicular, pustular, bullous, ulcerous, exudative erythema multiforme-like, purpuric, lichenoid, pigmented, and depigmented skin lesions. Clinical diagnosis can be challenging. Even histopathology is not always very helpful. Thorough evaluation of the patient's history and investigation of clinical morphology are the cornerstones of diagnosis.

  12. Analyzing in the present

    DEFF Research Database (Denmark)

    Revsbæk, Line; Tanggaard, Lene

    2015-01-01

    The article presents a notion of “analyzing in the present” as a source of inspiration in analyzing qualitative research materials. The term emerged from extensive listening to interview recordings during everyday commuting to university campus. Paying attention to the way different parts...... of various interviews conveyed diverse significance to the listening researcher at different times became a method of continuously opening up the empirical material in a reflexive, breakdown-oriented process of analysis. We argue that situating analysis in the present of analyzing emphasizes and acknowledges...

  13. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented at the 2012 RE AMP Annual Meeting. RE-AMP is an active network of 144 nonprofits and foundations across eight Midwestern states working on climate change and energy policy with the goal of reducing global warming pollution economy-wide 80% by 2050.

  14. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    DeMeo, E.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented at Wind Powering America States Summit. The Summit, which follows the American Wind Energy Association's (AWEA's) annual WINDPOWER Conference and Exhibition, provides state Wind Working Groups, state energy officials, U.S. Energy Department and national laboratory representatives, and professional and institutional partners an opportunity to review successes, opportunities, and challenges for wind energy and plan future collaboration.

  15. Interactive Presentation of Content

    Science.gov (United States)

    Magdin, Martin; Turcáni, Milan; Vrábel, Marek

    2009-01-01

    In the paper we discus about design of universal environment for solution of creating effective multimedia applications with accent on the implementation of interactive elements with the possibility of using the adaptive systems (AS). We also discuss about possibilities of offline presentation of this interactive multimedia adaptive animations…

  16. PowerPoint Presentation

    Indian Academy of Sciences (India)

    Table of contents. PowerPoint Presentation · CHANDIPURA VIRUS · Slide 3 · Slide 4 · Slide 5 · VIRUSES · PROPERTIES OF VIRUSES · CLASSIFICATION OF VIRUSES · VIRUS FAMILIES · VIRUS FAMILIES – contd · General Classification · Slide 12 · Slide 13 · Slide 14 · Slide 15 · Slide 16 · Slide 17 · Slide 18 · Slide 19.

  17. Presentation of 2004 earnings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-03-01

    This presentation offers financial information on the AREVA Group earnings for the year 2004. With manufacturing facilities in over 40 countries and a sales network in over 100, Areva offers customers technological solutions for nuclear power generation and electricity transmission and distribution. The Group also provides interconnect systems to the telecommunications, computer and automotive markets. (A.L.B.)

  18. Presentism and black holes

    NARCIS (Netherlands)

    Sengers, G. (Geurt)

    2017-01-01

    textabstractIn a recent publication in the European Journal for Philosophy of Science (Romero and Pérez, European Journal for Philosophy of Science, 4, 293–308, 2014), Romero and Pérez claim to reveal new trouble for the already difficult life of presentism in relativistic spacetimes. Their argument

  19. Generating Embodied Information Presentations

    NARCIS (Netherlands)

    Theune, Mariet; Heylen, Dirk K.J.; Nijholt, Antinus; Stock, O.; Zancanaro, M

    2005-01-01

    The output modalities available for information presentation by embodied, human-like agents include both language and various nonverbal cues such as pointing and gesturing. These human, nonverbal modalities can be used to emphasize, extend or even replace the language output produced by the agent.

  20. ORIGINAL RESEARCH PRESENTATIONS

    African Journals Online (AJOL)

    13. ORIGINAL RESEARCH PRESENTATIONS. ABSTRACT. Objectives. To determine factors contributing to home delivery in Kongwa District. Methods: A community-based cross-sectional study was conducted in September 2009 in which women of child-bearing age were interviewed. The variables mainly included:.

  1. Econophysics: Past and present

    Science.gov (United States)

    de Area Leão Pereira, Eder Johnson; da Silva, Marcus Fernandes; Pereira, H. B. B.

    2017-05-01

    This paper provides a brief historical review of the relationship between economics and physics, beginning with Adam Smith being influenced by Isaac Newton's ideas up to the present day including the new econophysics discipline and some of the tools applied to the economy. Thus, this work is expected to motivate new researchers who are interested in this new discipline.

  2. Assessing oral presentation performance

    NARCIS (Netherlands)

    Ginkel, van Stan; Laurentzen, Ramona; Mulder, Martin; Mononen, Asko; Kyttä, Janika; Kortelainen, Mika J.

    2017-01-01

    Purpose: The purpose of this paper is to design a rubric instrument for assessing oral presentation performance in higher education and to test its validity with an expert group. Design/methodology/approach: This study, using mixed methods, focusses on: designing a rubric by identifying

  3. PowerPoint Presentation

    Indian Academy of Sciences (India)

    Table of contents. PowerPoint Presentation · There are 5 Speakers- The Ultimate dream is to get the Road map for connectivity to NE · Witnessing the Revolution · Some History · Slide 5 · Itanium® Processor Family Roadmap ... Growth of Wireless & Internet- Source Motorola · Convergence · Internet Alone is Not Enough…

  4. El escenario del presente

    Directory of Open Access Journals (Sweden)

    Cruz, Manuel

    2008-12-01

    Full Text Available The disappearance of the idea of progress in post-Enlightenment thought constitutes one of the central tenets of the network of topics that make up contemporary social imagery. However, that tenet, which in a sense has been present from the origins of the Enlightment tradition, produces discursive effects of significant relevance, a particular kind of perverse effects related to thought, not always legitimized enough to certify that disappearance.

    La desaparición de la idea de progreso en el pensamiento postilustrado constituye uno de los convencimientos centrales del entramado de tópicos que forman el imaginario social contemporáneo. Pero dicho convencimiento, en cierto modo presente desde los orígenes de la propia tradición ilustrada, da lugar a efectos discursivos de considerable importancia, a una particular modalidad de efectos perversos en materia de pensamiento, no siempre suficientemente aquilatados al certificar dicha desaparición.

  5. [Metachromatic Leukodystrophy. Case Presentation].

    Science.gov (United States)

    Espejo, Lina María; de la Espriella, Ricardo; Hernández, José Fernando

    Metachromatic leukodystrophy (MLD) is a rare demyelinating disease (prevalence 1:40 000), also called arylsulfatase A deficiency (ARS-A), which may present with neurological and psychiatric symptoms. Clinical assessment may be difficult, due to unspecific signs and symptoms. A case is presented of a 16 year-old female patient seen in psychiatry due to behavioural changes, psychosis, and with impaired overall performance. She was initially diagnosed with schizophrenia, but the Nuclear Magnetic Resonance (NMR) scan and laboratory tests lead to the diagnosis of MLD. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. Presentation = Speech + Slides

    Directory of Open Access Journals (Sweden)

    Derik Badman

    2008-12-01

    Full Text Available Back in October, Aaron Schmidt posted “HOWTO give a good presentation” to his blog walking paper. His second bullet point of “thoughts” on good presentations is: Please don’t fill your slides with words. Find some relevant and pretty pictures to support what you’re saying. You can use the pictures to remind yourself what you’re going [...

  7. Generating Embodied Information Presentations

    OpenAIRE

    Theune, Mariet; Heylen, Dirk K. J.; Nijholt, Antinus; Stock, O.; Zancanaro, M

    2005-01-01

    The output modalities available for information presentation by embodied, human-like agents include both language and various nonverbal cues such as pointing and gesturing. These human, nonverbal modalities can be used to emphasize, extend or even replace the language output produced by the agent. To deal with the interdependence between language and nonverbal signals, their production processes should be integrated. In this chapter, we discuss the issues involved in extending a natural langu...

  8. Unusual presentation of phaeochromocytoma.

    Science.gov (United States)

    Hope, D C D; Palan, J M

    2016-05-10

    A 44-year-old woman, with a background of heart, lung and renal transplantation secondary to cystic fibrosis and type 1 diabetes, presented with tachycardia, hyperglycaemia, nausea and vomiting. She was initially managed for diabetic ketoacidosis with severe dehydration. However, persistent episodic hypertension and tachycardia led the investigating team to identify significantly raised urinary metanephrines and a left-sided adrenal mass; Iodine-123-meta-iodobenzylguanidine single photon emission computer tomography scan (MIBG SPECT/CT) showed avid uptake of tracer, confirming a left-sided phaeochromocytoma. She was started on medical management and is awaiting an elective laparoscopic procedure. This case describes the presentation of a unilateral phaeochromocytoma as ketoacidosis in a patient with type 1 diabetes with no other apparent precipitant. This highlights the metabolic counter-regulatory effect of excess catecholamines in addition to the inotropic/chronotropic effects that are associated with this adrenal tumour. Recognition of atypical signs and symptoms may point towards an atypical precipitant of diabetic ketoacidosis-a medical emergency presenting to front-line clinicians. 2016 BMJ Publishing Group Ltd.

  9. Bad (Re)Presentations

    CERN Multimedia

    Computer Security Team

    2013-01-01

    This time, we would like to address copyright violations (again) - but with a twist. While previous articles focussed on “Music, videos and the risk for CERN” or on software licences, the focus is now on using photos, music and images “found” on the Web for presentations, publications and web pages…   Just recently, a video produced for CERN and published on YouTube and Facebook used background music from a contemporary popular artist. However, the people responsible failed to obtain the appropriate permission to actually use that music. They thought that having bought it on iTunes was sufficient. But it was not: “buying” means you have the right to listen, but not the right for further distribution or re-publication. As a result, the videos were pulled from YouTube and Facebook. Similarly, how many of us integrate graphics and images “found” on the Web into our presentations?  How many of us...

  10. Determining the number of test fires needed to represent the variability present within 9mm Luger firearms.

    Science.gov (United States)

    Law, Eric F; Morris, Keith B; Jelsema, Casey M

    2017-07-01

    Many studies have been performed in recent years in the field of firearm examination with the goal of providing an objective method for comparisons of fired cartridge cases. No published research to support the number of test fires needed to represent the variability present within the impressions left on a cartridge case could be found. When a suspect firearm is submitted to a firearm examiner, typically two to four test fires are performed. The recovered cartridge cases are compared to each other to determine which characteristics from the firearm are reproducing, and then compared to any cartridge cases collected at a crime scene. The aim of this research was to determine the number of test fires examiners should perform when a suspect firearm is submitted to the lab to balance cartridge case acquisition time with performance accuracy. Each firearm in the IBIS(®) database at West Virginia University(®) is represented by approximately 100 fired cartridge case entries. Random samples of cartridge cases were taken separately from the breech face match score and firing pin match score lists. This subset was compared to the total match distribution of the firearm using a hybrid equivalence test to determine if the subset of similarity scores were statistically equivalent to the larger distribution of scores. For the sampled distribution to remain above 80% equivalent to the match distribution, a minimum of 15 cartridge cases should be used to model the match distribution, based on IBIS(®) scores. Thirty cartridge cases is a conservative estimate, allowing one to determine that the location and dispersion of the match and sampling distributions are equivalent with nearly 100% probability. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Giving effective presentations.

    Science.gov (United States)

    Englehart, Nadine

    2004-03-01

    Apprehension about oral communication, or public speaking is rated as the number one fear among most individuals. Developing skill in, and comfort with, public speaking is important whether we are presenting oral reports and proposals, responding to questions, or training co-workers. Effective speakers are able to communicate information in a way that stimulates interest, helps the audience to understand and remember, and influences attitudes and behaviours. Many of us think that effective speakers are born rather than made. In truth most successful speakers work hard and invest a great deal of time and effort in to improving their speaking capabilities. Effective public speaking is a learned skill and activity that requires lots of practice. Like other learned skills, having a strategy with clear action steps can help you achieve your goal.

  12. Living in the Present

    Directory of Open Access Journals (Sweden)

    Angela Barns

    2015-12-01

    Full Text Available This article presents the findings from a qualitative research project exploring eight women’s experiences of living with rheumatoid arthritis (RA. Through semistructured interviews, the women provided insights into the physical, emotional, and social impacts of RA and the “work” involved in negotiating its influence in the everyday life. In narrating their experiences of adapting to RA, the women express a common desire for “normalcy,” to return to a time and space before the disruption of RA. The women’s accounts also emphasized the interrelatedness between bodily experience and constructions of self, highlighting the corporeal nature of RA and the constant shaping and reshaping of personal meanings and values.

  13. Presente continuo [Ressenya

    OpenAIRE

    Sánchez-Biosca, Vicente

    2002-01-01

    Albera, François (ed.): Eisenstein dans le texte, número monográfico de Cinémas, vol. 11-nº 2-3, primavera 2001 S.M. Eisenstein: Hacia una teoría del montaje, Barcelona, Paidós, 2001, dos volúmenes La presente reseña se ocupa de dos libros en torno a la vanguardia artística en su relación con el cine y la Teoría general del montaje de S.M. Eisenstein y reflexiona sobre las articulaciones que la obra de Eisenstein tuvo con la vanguardia francesa, alemana y, sobre todo, rusa de los años...

  14. Film Presentation: Die Urknallmaschine

    CERN Multimedia

    Carolyn Lee

    2010-01-01

    Die Urknallmaschine, an Austrian film by Gerd Baldauf, narrated by Norbert Frischauf (Alpha Österreich - ORF, 2009).  In CERN’s gigantic complex particles are accelerated to almost the speed of light, brought to collision and made to divide into even smaller particles. Public opinion of CERN’s research is also divided. Sceptics fear that black holes may be created. Might the goal to study the origin of the world lead to its destruction? The Austrian researcher Norbert Frischauf worked at CERN for many years. With his guidance it is possible to explore the world’s largest research centre, get a glimpse of the fascinating work the scientists do there and take a crash course in particle physics. Die Urknallmaschine will be presented on Friday, 25 June from 13:00 to 14:00 in the Main Auditorium. Language: German

  15. RESRAD model presentation

    Energy Technology Data Exchange (ETDEWEB)

    Yu, C.; Faillace, E.; Chen, S.Y. [Argonne National Lab., IL (United States); Wallo, A. III; Williams, W.A.; Peterson, H.; Domotor, S. [Dept. of Energy, Washington, DC (United States)

    1998-05-01

    RESRAD was one of the multimedia models selected by the US Nuclear Regulatory Commission (NRC) to include in its workshop on radiation dose modeling and demonstration of compliance with the radiological criteria for license termination. This paper is a summary of the presentation made at the workshop and focuses on the 10 questions the NRC distributed to all participants prior to the workshop. The code selection criteria, which were solicited by the NRC, for demonstrating compliance with the license termination rule are also included. Among the RESRAD family of codes, RESRAD and RESRAD-BUILD are designed for evaluating radiological contamination in soils and in buildings. Many documents have been published to support the use of these codes. This paper focuses on these two codes. The pathways considered, the databases and parameters used, quality control and quality assurance, benchmarking, verification and validation of these codes, and capabilities as well as limitations of these codes are discussed in detail.

  16. Breech delivery at term in Denmark, 1982-92

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J

    1999-01-01

    ,476) in Denmark, 1982-92, a review of medical records of all (n = 218) cases with Apgar score deaths and 412 controls, was performed. Planned vaginal delivery was associated with a 15 times greater risk of low Apgar score than elective Caesarean section...

  17. MSG RAO Presentation

    Science.gov (United States)

    Oriol-Pibernat, E.; Govaerts, Y.

    2004-11-01

    BACKGROUND The Meteosat Second Generation (MSG) Research Announcement of Opportunity (RAO) was released by ESA and EUMETSAT in 1999, after a first warning issued in September 1998. The RAO main objective is to promote the scientific use of the new MSG satellites outside the operational meteorological user community, also in synergy with ERS and Envisat data. The variety and quality of the selected proposals proved the usefulness of such joint initiative. 2. STATUS OF THE RAO A total of 43 proposals were selected in 1999. Following the delay in the MSG-1 launch (which operational name is Meteosat-8), the PIs were contacted in early 2003 in order to confirm the interest to continue with the project. There were 5 withdrawals due to various reasons. The PIs have been receiving news through a dedicated WEB site or by emails. Each PI has been assigned a correspondent from ESA or EUMETSAT to follow up the project through the site: http://eopi.esa.int/esa/esa where the papers presented at this Workshop will be included as the first report. 3. THE MSG RAO WORKSHOPS In the framework of the MSG RAO, a series of workshops are organised which goal is to establish a structured dialogue and interactions among the MSG Principal Investigators (PIs) and ESA/EUMETSAT, respectively. Each of these workshops is focusing on a specific aspect, in addition to the necessary exchange of information. 4. OBJECTIVES OF THE BOLOGNA WORKSHOP The focus of the first workshop (17-19 May 2000) was on the presentation of MSG features and of all selected RAO projects. It was a starting point for continued interaction within the MSG RAO community (selected PIs and their co-Investigators, Co-Is). The first MSG RAO workshop provided a forum for discussion among scientists, and ESA and EUMETSAT, leading to a continuous scientific co-operation. Requirements and possibilities with regard to data delivery were formulated and discussed at this workshop. In particular, PIs were asked to specify the minimal and

  18. Presentation of Pydio

    CERN Multimedia

    CERN. Geneva

    2014-01-01

    **Pydio is an open-source platform for file sharing and synchronisation.** It is wildly used by enterprises and organizations worldwide, including major universities. Pydio comes with a rich web-based interface, native clients for both iOS and Android mobile devices, and lately a new sync client for desktop platforms. Pydio v6 is of great useability and introduces many new features that makes it the ultimate sharing machine. Its architecture makes it a perfect fit for either easily deploying an on-premise dropbox solution, or building more complicated solutions where the box feature is integrated as OEM. Storage-agnostic, Pydio is a simple layer that can be deployed on top of any storage backend, thus providing scalability and high-availability out-of-the-box. Charles du Jeu is the lead developer of the solution and will briefly present its feature and how it can fit for research and engineering purpose. See https://pyd.io/ for more information.

  19. Sarcoidosis: An unusual presentation.

    Science.gov (United States)

    Madureira, Pedro; Pimenta, Sofia; Cardoso, Hélder; Guimarães Cunha, Rui; Costa, Lúcia

    A 35-year-old man presented with a 3-year history of arthralgia and purple coloration of the skin of his fingers and feet. Hand and foot radiography showed cystic bone lesions on phalanges suggestive of sarcoidosis. Lab tests revealed increased liver enzymes. Liver MRI evidenced an enlarged liver and retroperitoneal lymphadenopathy. Histological analysis of the finger skin, lymph nodes and liver demonstrated the presence of granulomas, confirming the diagnosis of sarcoidosis. The patient started prednisolone with rapid improvement of the symptoms. Skin lesions are divided into two groups: specific for sarcoidosis (with granulomas, lupus pernio-like) and nonspecific (without granulomas, erythema nodosum-like). Specific cutaneous lesions usually cause no other symptoms beyond cosmetic changes. Lupus pernio stands out for having distinctive features but, to the best of our knowledge, the simultaneous involvement of both hands and feet has never been reported. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  20. The laryngocele; case presentation

    Directory of Open Access Journals (Sweden)

    Gabriel V. Berteșteanu

    2016-05-01

    Full Text Available Laryngocele is a rare pathology, but because of their clinical evolution and the symptoms they generate, they should always be considered as a differential diagnosis when investigating neck masses. A laryngocele is basically a herniation of the mucosa of the laryngeal ventricle (Morgagni's ventricle arising usually from the saccular region. This herniation may remain confined to the larynx - in which case the laryngocele is internal- or expand through the thyro-hyoid membrane into the structures of the neck - thus being called an external laryngocele. Usually the laryngocele has both an internal and external component thus being a mixed laryngocele. Diagnosis of laryngoceles still relies heavily on clinical signs such as tympanism, easily depressible neck mass, indirect laryngoscopy, but is now simplified by imagistic investigations (ultrasound, CT and MRI. However, the treatment of this condition is exclusively surgical and consists of total excision of the laryngocele, as well as proper identification of the point of origin from the saccule and also the final suture of the breach in order to prevent recurrence. Investigation of possible causes of obstruction of the laryngeal ventricle should always be performed (because of the possibility of an underlying malignancy as well as a follow-up protocol of the patient, given the risk of relapse. We present a recently diagnosed case of a 32 year old man with mixed laryngocele, which we have operated in our clinic.

  1. Endometriosis Presenting as Hydronephrosis

    Directory of Open Access Journals (Sweden)

    Ahmed Bakheet Zaharani

    2005-01-01

    Full Text Available The most serious urological complication of endometriosis is hydronephrotic renal atrophy secondary to ureteric involvement. As only half of these patients are symptomatic, it is commonly diagnosed late and more by the clinicians awareness and suspicion of this entity. We report a case of an unmarried young female who presented primarily with left loin pain of 2-year duration. She was found to have lower ureteric stricture by an IVU done by her referring doctor. Further workup at our center showed that she had pelvic endometriosis with hydronephrosis secondary to extrinsic ureteric endometriosis. She had a first-degree relative with the same disease. She had no menstrual problems. Diagnostic laparoscopy, biopsy of the lesion, ureteric dilatation with stenting, along with hormonal treatment was given to her as first line of treatment. There was no improvement of the ureteric obstruction even after 6 months of treatment. Finally, surgical excision of the endometrioma, left oophorectomy, along with resection of the ureteric stricture with uretero-ureterostomy was done. This case report includes details of her further management and outcome along with a brief review of literature.

  2. THE UPSIDE OF PRESENTISM

    Directory of Open Access Journals (Sweden)

    Lynn Fendler

    2009-01-01

    Full Text Available El presentismo es visto generalmente como un mal necesario en historiografía. Este artículo explora lo positivo de esta inevitabilidad. Aplicando un enfoque filosófico al análisis discursivo en la tradición de la nueva historia cultural, se distingue -de una parte-¿ entre un uso estratégico del presentismo, y -de otra- un enfoque racionalista en historia. El artículo concluye considerando algunas implicaciones políticas en historiografía de las explicaciones racionalistas y de las explicaciones estratégicamente presentistas. Los modos de comprensión racionalistas inscriben las expectativas del pasado en las visiones del futuro; asignando al historiador el papel de profeta; y perpetuando nociones de agentes ahistóricos. En contraste, las historias estratégicamente presentistas incorporan una orientación que deliberadamente emplea las lentes y perspectivas del presente en orden a tener en cuenta supuestos y perspectivas actuales. Cuando las asunciones son examinadas en relación a las perspectivas presentistas, dichos presupuestos sueltan su rienda en el pensamiento. Dado que el presentismo es inevitable, no debe ser desestimado por completo, sino que debe ser una cuestión sondeada y examinada críticamente. Con dicho foco, el presentismo estratégico en la historiografía debe posibilitar una reflexión sobre los límites de lo que es posible pensar.

  3. Texts of presentation

    Energy Technology Data Exchange (ETDEWEB)

    Magnin, G.; Vidolov, K.; Dufour-Fallot, B.; Dewarrat, Th.; Rose, T.; Favatier, A.; Gazeley, D.; Pujol, T.; Worner, D.; Van de Wel, E.; Revaz, J.M.; Clerfayt, G.; Creedy, A.; Moisan, F.; Geissler, M.; Isbell, P.; Macaluso, M.; Litzka, V.; Gillis, W.; Jarvis, I.; Gorg, M.; Bebie, B.

    2004-07-01

    Implementing a sustainable local energy policy involves a long term reflection on the general interest, energy efficiency, distributed generation and environmental protection. Providing services on a market involves looking for activities that are profitable, if possible in the 'short-term'. The aim of this conference is to analyse the possibility of reconciling these apparently contradictory requirements and how this can be achieved. This conference brings together the best specialists from European municipalities as well as important partners for local authorities (energy agencies, service companies, institutions, etc.) in order to discuss the public-private partnerships concerning the various functions that municipalities may perform in the energy field as consumers and customers, planners and organizers of urban space and rousers as regards inhabitants and economic players of their areas. This document contains the summaries of the following presentations: 1 - Performance contracting: Bulgarian municipalities use private capital for energy efficiency improvement (K. VIDOLOV, Varna (BG)), Contracting experiences in Swiss municipalities: consistent energy policy thanks to the Energy-city label (B. DUFOUR-FALLOT and T. DEWARRAT (CH)), Experience of contracting in the domestic sector (T. ROSE (GB)); 2 - Public procurement: Multicolor electricity (A. FAVATIER (CH)), Tendering for new green electricity capacity (D. GAZELEY (GB)), The Barcelona solar thermal ordinance (T. PUJOL (ES)); 3 - Urban planning and schemes: Influencing energy issues through urban planning (D. WOERNER (DE)), Tendering for the supply of energy infrastructure (E. VAN DE WEL (NL)), Concessions and public utility warranty (J.M. REVAZ (CH)); 4 - Certificate schemes: the market of green certificates in Wallonia region in a liberalized power market (G. CLERFAYT (BE)), The Carbon Neutral{sup R} project: a voluntary certification scheme with opportunity for implementation in other European

  4. Presentation

    Directory of Open Access Journals (Sweden)

    Andrea Cannas

    2015-07-01

    Full Text Available Della dimensione sonora si esaminano alcuni aspetti poco noti e trascurati, o anche meno percepiti, pur facendo parte del soundscape della vita quotidiana odierna. Sono oggetto di analisi, inoltre, musiche, voci e suoni osteggiati da forze e poteri oppure perduti col trascorrere del tempo. Infine un’attenzione particolare è riservata alla polisemia e alla dialettica dei silenzi.

  5. present

    African Journals Online (AJOL)

    for Malawi's language-in-education policies to be successfully implemented, there is need for the involvement of ... system and as a subject of study throughout Malawi's entire education system in the 1969/70 academic ...... Sibayan's (1999:42) comments on the Singapore experiences where similar assumptions led to the ...

  6. Presentation

    Directory of Open Access Journals (Sweden)

    Manuel ALCÁNTARA SÁEZ

    2010-10-01

    Full Text Available Argentina y Uruguay fueron los países más desarrollados de América Latina hasta comienzos de la década de 1970. Aunque muy diferentes en tamaño, atesoran una envidiable dotación en recursos agropecuarios, una frontera abierta desde su independencia hasta comienzos del XX, un fuerte flujo de inmigración europea que contribuyó a modelar sus sociedades, sistemas políticos y relaciones internacionales. Por su «europeísmo» y prosperidad, por el igualitarismo y tamaño de sus clases medias, hasta los años centrales del siglo pasado ambos países eran considerados excepcionales en el contexto latinoamericano.

  7. Interactive Proof Presentations with Cobra

    National Research Council Canada - National Science Library

    Ring, Martin; Lüth, Christoph

    2017-01-01

    We present Cobra, a modern proof presentation framework, leveraging cutting-edge presentation technology together with a state of the art interactive theorem prover to present formalized mathematics as active documents...

  8. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Science.gov (United States)

    2013-01-01

    Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV) and how they want to give birth if the baby remains breech, either by planned caesarean section (CS) or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11) and health professionals who manage breech presentation (n=11) recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the differences between evidence

  9. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Directory of Open Access Journals (Sweden)

    Say Rebecca

    2013-01-01

    Full Text Available Abstract Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV and how they want to give birth if the baby remains breech, either by planned caesarean section (CS or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11 and health professionals who manage breech presentation (n=11 recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the

  10. Creating Presentations on ICT Classes

    Science.gov (United States)

    Marchis, Iuliana

    2010-01-01

    The article focuses on the creation of presentations on ICT classes. The first part highlights the most important steps when creating a presentation. The main idea is, that the computer presentation shouldn't consist only from the technological part, i.e. the editing of the presentation in a computer program. There are many steps before and after…

  11. Put Power into Your Presentations: Using Presentation Software Effectively

    Science.gov (United States)

    Safransky, Robert J.; Burmeister, Marsha L.

    2009-01-01

    Microsoft PowerPoint, Apple Keynote, and OpenOffice Impress are relatively common tools in the classroom and in the boardroom these days. What makes presentation software so popular? As the Chinese proverb declares, a picture is worth a thousand words. People like visual presentations. Presentation software can make even a dull subject come to…

  12. Infantile dystocia fibrosarcoma presentIng as shoulder

    African Journals Online (AJOL)

    fibrosarcoma. •. presentIng as shoulder. M. S. PUZEY, D. F. INNES, C. W. VAN DER ELST. Summary. Congenital (infantile) fibrosarcomas are soft-tissue tumours that usually present after birth. In the case described a large tumour of the right arm caused shoulder dystocia and death of the fetus. S Atr Med J 1989; 76: 73-74.

  13. Dressed to Present: Ratings of Classroom Presentations Vary with Attire

    Science.gov (United States)

    Gurung, Regan A. R.; Kempen, Laura; Klemm, Kayla; Senn, Rebecca; Wysocki, Rosie

    2014-01-01

    This study investigates the effects of formality of dress on ratings of classroom presentations. Participants (N = 65, 66% women) from a Midwestern university in the United States rated three female students giving a presentation designed for a health psychology class in one of four outfits: casual, party, business casual, or business formal.…

  14. Isolated Torticollis May Present as an Atypical Presentation of Meningitis

    Directory of Open Access Journals (Sweden)

    Roger Chirurgi

    2012-01-01

    Full Text Available Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare. Objective. To identify an abnormal presentation of meningitis in an adult immunocompromised patient. Case Report. We present a case of an adult diabetic male who presented multiple times to the ED with complaint of isolated torticollis, who ultimately was diagnosed with bacterial meningitis. Conclusion. We propose that in the absence of sufficient explanation for acute painful torticollis in an immunocompromised adult patient, further evaluation, possibly including a lumbar puncture may be warranted.

  15. Download this PDF file

    African Journals Online (AJOL)

    Krebs L., Langhoft-Ross J, Weber T. Breech at term-mode of delivery? A register based study. Acta ObstetGynae Scan. 1995; 74; 702-706. Keily JL. Mode of delivery and neonatal death in 17,587 infants presenting by the breech. Brit J. ObstetGynaecol. 1991; 98: 898-90-4. Hofmeyr GJ, External cephalic version at term.

  16. Forløsningsmåde ved underkropspraesentation. Selektion ved røntgenologisk baekkenmåling

    DEFF Research Database (Denmark)

    Krebs, L; Nilas, L; Langhoff-Roos, J

    1997-01-01

    , pelvimetry was performed in 74 women, where pelvic dimensions too small for recommendation of vaginal breech delivery were found in 30 cases. The overall rate of caesarean section was 78%, among diagnosed patients it was 84% and 64% among undiagnosed breech presentations. Rates of morbidity (low Apgar score...

  17. Emphysematous pyelonephritis: a rare presentation.

    Directory of Open Access Journals (Sweden)

    Jain S

    2000-01-01

    Full Text Available Emphysematous pyelonephritis is a rare life threatening infection in diabetes characterised by suppurative infection of renal parenchyma and perirenal tissues. It usually presents with fever, nausea, vomiting, abdominal pain, shock, lethargy, and confusion. Diabetic ketoacidosis is an uncommon presentation. In the present case, an elderly female presented with abdominal pain, fever, vomiting, and altered sensorium. She was diagnosed to have diabetic ketoacidosis with metabolic encephalopathy with right emphysematous pyelonephritis. She had an excellent response to medical treatment alone and was later discharged on oral hypoglycaemic agents.

  18. Student Conceptions of Oral Presentations

    Science.gov (United States)

    Joughin, Gordon

    2007-01-01

    A phonographic study of students' experience of oral presentations in an open learning theology programme constituted three contrasting conceptions of oral presentations--as transmission of ideas; as a test of students' understanding of what they were studying; and as a position to be argued. Each of these conceptions represented a combination of…

  19. Presenting the discovery of W

    CERN Multimedia

    CERN PhotoLab

    1983-01-01

    The UA1 results were presented by Carlo Rubbia in the Main Auditorium on 20 January. The photo shows Alan Astbury from back talking to Carlo Rubbia (centre), Between them is Bernard Aubert. On the background, left, stands Peter Kalmus, and, right, massimo Placidi. The UA2 results were presented in the Main Auditorium by Luigi Di Lella on 21 January.

  20. Multiphasic presentation of Rasmussen's encephalitis

    NARCIS (Netherlands)

    Avbersek, A.; Miserocchi, A.; McEvoy, A.W.; Patel, A.V.; Aronica, E.; Blumcke, I.; Jacques, T.S.; Acheson, J.; Thom, M.; Sisodiya, S.M.

    2015-01-01

    Rasmussen's encephalitis is a rare, chronic inflammatory disorder of unknown cause, characterised by drug-resistant focal epilepsy that may rarely present in adolescence or adulthood. We present a case of Rasmussen's encephalitis with prominent recurrent fluctuation in symptoms and well-documented

  1. Task Group 9 Update (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Bosco, N.

    2014-04-01

    This presentation is a brief update of IEC TC82 QA Task Force, Group 9. Presented is an outline of the recently submitted New Work Item Proposal (NWIP) for a Comparative Thermal Cycling Test for CPV Modules to Differentiate Thermal Fatigue Durability.

  2. Unusual Presentation Of Dapsone Syndrome

    Directory of Open Access Journals (Sweden)

    Singh Prabhas Chandra

    2001-01-01

    Full Text Available A 15 year old girl presented with a rare association of generalized maculopapular rash with exfoliation, hepatic involvement, nephritis, arthralgia and repeated serum sickness type of reaction after taking depsone. The case is reported because of its unusual presentation.

  3. Present status of processing method

    Energy Technology Data Exchange (ETDEWEB)

    Kosako, Kazuaki [Sumitomo Atomic Energy Industries Ltd., Tokyo (Japan)

    1998-11-01

    Present status of processing method for a high-energy nuclear data file was examined. The NJOY94 code is the only one available to the processing. In Japan, present processing used NJOY94 is orienting toward the production of traditional cross section library, because a high-energy transport code using a high-energy cross section library is indistinct. (author)

  4. KINECTATION (Kinect for Presentation): Control Presentation with Interactive Board and Record Presentation with Live Capture Tools

    Science.gov (United States)

    Sutoyo, Rhio; Herriyandi; Fennia Lesmana, Tri; Susanto, Edy

    2017-01-01

    Presentation is one the most common activity performed in various fields of work (e.g. lecturer, employee, manager, etc.). The purpose of presentation is to demonstrate or introduce presenters’ idea to the attendees. Within the given time and specific place, presenters must transfer their knowledge and leave great impression for their audience. Generally, presenters use several handy tools such as mouse, presenter, and webcam to help them to navigate their slides. Nevertheless, some of these tools have several constraints and limitations such as not portable and does not support multimedia. In this research, we develop an application that assist presenters to control their presentation materials by using Microsoft KINECT. In this research, we manipulate colour image, image depth, and the skeleton of the presenters captured by the KINECT. Then, we show the post-process image results into the projector screen. The KINECT has more useful than other tools because it supports video and audio recording. Moreover, it also able to capture presenters’ movement that can be used as an input to interact and manipulate the content (i.e. by touching the projection wall). Not only this application provides an alternative in controlling presentation activity, but it also makes the presentation more efficient and attractive.

  5. Dexmedetomidine for an awake fiber-optic intubation of a parturient with Klippel-Feil syndrome, Type I Arnold Chiari malformation and status post released tethered spinal cord presenting for repeat cesarean section

    Directory of Open Access Journals (Sweden)

    Tanmay H. Shah

    2011-08-01

    Full Text Available Patients with Klippel-Feil Syndrome (KFS have congenital fusion of their cervical vertebrae due to a failure in the normal segmentation of the cervical vertebrae during the early weeks of gestation and also have myriad of other associated anomalies. Because of limited neck mobility, airway management in these patients can be a challenge for the anesthesiologist. We describe a unique case in which a dexmedetomidine infusion was used as sedation for an awake fiber-optic intubation in a parturient with Klippel-Feil Syndrome, who presented for elective cesarean delivery. A 36-yearold female, G2P1A0 with KFS (fusion of cervical vertebrae who had prior cesarean section for breech presentation with difficult airway management was scheduled for repeat cesarean delivery. After obtaining an informed consent, patient was taken in the operating room and non-invasive monitors were applied. Dexmedetomidine infusion was started and after adequate sedation, an awake fiberoptic intubation was performed. General anesthetic was administered after intubation and dexmedetomidine infusion was continued on maintenance dose until extubation. Klippel-Feil Syndrome (KFS is a rare congenital disorder for which the true incidence is unknown, which makes it even rare to see a parturient with this disease. Patients with KFS usually have other congenital abnormalities as well, sometimes including the whole thoraco-lumbar spine (Type III precluding the use of neuraxial anesthesia for these patients. Obstetric patients with KFS can present unique challenges in administering anesthesia and analgesia, primarily as it relates to the airway and dexmedetomidine infusion has shown promising result to manage the airway through awake fiberoptic intubation without any adverse effects on mother and fetus.

  6. An unusual presentation of sporotrichosis

    Directory of Open Access Journals (Sweden)

    S S Vaishampayan

    2013-01-01

    Full Text Available Sporotrichosis can mimic a few diseases. Sporotrichosis presenting as a hypoaesthetic plaque or plaque suggestive of leprosy has not been mentioned in literature. Herein we present a case of a 26 years old man who presented with hypoesthetic plaque on left ankle and was clinically diagnosed to have borderline tuberculoid leprosy who later developed few nodules in linear fashion on left leg, which ruptured to form non healing ulcers. Culture from ulcer grew Sporothrix schenckii. Patient was successfully treated with oral potassium iodide.

  7. Galactosemia presenting as recurrent sepsis.

    Science.gov (United States)

    Rathi, Narendra; Rathi, Akanksha

    2011-12-01

    Galactosemia is a treatable metabolic disorder caused by the deficiency of enzyme galactose-1-phosphate uridyl transferase (GALT) and inherited as an autosomal recessive trait. A case of neonate manifesting with recurrent Escherichia coli sepsis is presented here which turned out to be a classic galactosemia. No other common presenting features were observed in this infant except cataract on slit lamp examination. To the best of our knowledge, there is no case of galactosemia reported in literature which presented with recurrent neonatal sepsis without hepatomegaly, hyperbilirubinemia, bleeding disorder, vomiting, diarrhea, failure to thrive, hypoglycemia, coagulopathy, hemolysis or renal tubular acidosis.

  8. Urticarial vasculitis: a unique presentation.

    Science.gov (United States)

    Stigall, Landon E; Sigmon, Justin R; Leicht, Stuart S

    2009-05-01

    Urticarial vasculitis is a relatively rare diagnosis in a patient presenting with urticaria. The process is classically described as a generalized eruption, painful more so than pruritic, lasting longer than 24 hours. Two forms of urticarial vasculitis have been described: ahypocomplementemic form more commonly associated with systemic disease, and a normocomplementemic form that is generally limited to the skin. We report on a uniquely distributed vasculitic eruption restricted mainly to the anterior belt line area in a patient presenting with urticaria and intense pruritus. Urticarial vasculitis as a unique entity is reviewed along with its clinical and histopathologic presentation and the pharmacologic agents used for treatment.

  9. Gearbox Reliability Collaborative Update (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, S.; Keller, J.; Glinsky, C.

    2013-10-01

    This presentation was given at the Sandia Reliability Workshop in August 2013 and provides information on current statistics, a status update, next steps, and other reliability research and development activities related to the Gearbox Reliability Collaborative.

  10. Wind Technologies & Evolving Opportunities (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Robichaud, R.

    2014-07-01

    This presentation covers opportunities for wind technology; wind energy market trends; an overview of the National Wind Technology Center near Boulder, Colorado; wind energy price and cost trends; wind turbine technology improvements; and wind resource characterization improvements.

  11. Conference/workshop presentation materials.

    Science.gov (United States)

    2014-11-01

    Project No. 5-6005-01: Statewide Implementation of Total Pavement Acceptance Device : (TPAD) is coming to completion. During the operating period of the TPAD (January 1, : 2013 through August 31, 2014), the research team gave several presentations an...

  12. HYDROGEOLOGIC CASE STUDIES (DENVER PRESENTATION)

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  13. Research Ethics Timeline (1932-Present)

    Science.gov (United States)

    ... the font size, or print this page. Research Ethics Timeline (1932-Present) by David B. Resnik, J. ... Report becomes a key document in human research ethics regulations in the U.S. 1980 Congress passes the ...

  14. Thyrotoxic crisis presenting with jaundice.

    Science.gov (United States)

    Wickramasinghe, R D S S; Luke, W A N V; Sebastiampillai, B S; Gunathilake, M P M L; Premaratna, R

    2016-06-23

    Thyrotoxic crisis is a medical emergency requiring early diagnosis and urgent management, which can be challenging due to its diverse clinical presentations. While common presentations include fever, sweating, palpitations, tremors and confusion, presence of jaundice is rare. We report a 35-year-old male who presented with jaundice due to cholestasis along with other features of thyrotoxic crisis due to Graves' disease. He had a good clinical recovery with resolution of cholestasis following treatment for thyrotoxic crisis. Jaundice can be a rare manifestation of thyrotoxic crisis, and should be considered in the differential diagnosis when other clinical features of thyrotoxic crisis are present. However secondary causes of jaundice should be looked into and excluded.

  15. BioFuels Atlas (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Moriarty, K.

    2011-02-01

    Presentation for biennial merit review of Biofuels Atlas, a first-pass visualization tool that allows users to explore the potential of biomass-to-biofuels conversions at various locations and scales.

  16. A centralized audio presentation manager

    Energy Technology Data Exchange (ETDEWEB)

    Papp, A.L. III; Blattner, M.M.

    1994-05-16

    The centralized audio presentation manager addresses the problems which occur when multiple programs running simultaneously attempt to use the audio output of a computer system. Time dependence of sound means that certain auditory messages must be scheduled simultaneously, which can lead to perceptual problems due to psychoacoustic phenomena. Furthermore, the combination of speech and nonspeech audio is examined; each presents its own problems of perceptibility in an acoustic environment composed of multiple auditory streams. The centralized audio presentation manager receives abstract parameterized message requests from the currently running programs, and attempts to create and present a sonic representation in the most perceptible manner through the use of a theoretically and empirically designed rule set.

  17. Extradural lipomatosis presenting with paraplegia.

    Directory of Open Access Journals (Sweden)

    Deogaonkar M

    1995-07-01

    Full Text Available An unusual case with spinal extradural lipomatosis in a non-obese and otherwise healthy man is reported. The patient presented with a history of weakness of legs which progressed to paraplegia over a 40 day period.

  18. An Atypical Presentation on Insulinoma

    Science.gov (United States)

    2017-06-16

    commercial entity or an entity seeking to do business with the government. then your presentation should have an ethics review. If your travel is being...need the date (month, day and year) along with the location of your presentation. It is important to update this information so that we can provide...route the request form to clinical investigations. S02 ISG/JAC ( Ethics Review) and Public Affairs (S9 MOW/PA) for review and then forward you a final

  19. Procrastination with variable present bias

    OpenAIRE

    Gravin, Nick; Immorlica, Nicole; Lucier, Brendan; Pountourakis, Emmanouil

    2016-01-01

    Individuals working towards a goal often exhibit time inconsistent behavior, making plans and then failing to follow through. One well-known model of such behavioral anomalies is present-bias discounting: individuals over-weight present costs by a bias factor. This model explains many time-inconsistent behaviors, but can make stark predictions in many settings: individuals either follow the most efficient plan for reaching their goal or procrastinate indefinitely. We propose a modification in...

  20. Retinoblastoma presenting with orbital cellulitis.

    Science.gov (United States)

    Walinjkar, Jaydeep; Krishnakumar, S; Gopal, Lingam; Ramesh, Anita; Khetan, Vikas

    2013-06-01

    To study the effectiveness of pre-enucleation steroids in reducing inflammation in patients with retinoblastoma presenting as orbital cellulitis. Medical records of consecutive retinoblastoma patients presenting at a single tertiary eye care center during a period of 3 years were retrospectively reviewed. For those who presented with orbital cellulitis, clinical, radiological, and histopathological variables were assessed. The effect of pre-enucleation steroids was noted in this group of patients. Of 260 retinoblastoma cases reviewed, 14 had retinoblastoma-associated cellulitis (5.39%). Of these 14 patients, 4 received neoadjuvant chemotherapy and were excluded from the series. Of the remaining 10 cases (mean age at presentation, 14.2 months; mean follow-up, 16.4 months), 9 presented with orbital cellulitis and were included in the study. Radiological imaging depicted intraocular tumors occupying 80% to 100% of the globe in each case. All patients underwent enucleation. Five children received pre-enucleation systemic steroids (mean, 5.4 days), which resulted in a prompt decrease in inflammation. Postenucleation chemotherapy was administered in 4 (6 cycles) and external beam radiation therapy in 1 patient with high-risk histopathological characteristics. Advanced necrotic retinoblastoma with anterior segment involvement may present as orbital cellulitis. Pre-enucleation systemic steroids can aid in the surgical management of these tumors. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  1. Presentation of the ASTRAL software; Presentation du logiciel ASTRAL

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This report presents the ASTRAL software (ASTRAL means technical assistance in post-accidental radioprotection) which is aimed to be used as an aid-to-decision tool in the case of an important release of radionuclides in the environment by assessing radionuclide concentration in different environments and food products, determining the potential exposure to irradiation of concerned populations, foreseeing the evolution of the situation, and proposing different scenarios for the management of contaminated areas. The report describes the software general operation, presents the calculation module (main functionalities, concentration index calculation, dose calculation or radiological impact calculation, how countermeasures are taken into account), the data bases (contextual data, data for radio-ecological calculations and for radiological calculations), the software ergonomics (general principles, result selection and display, result printing and input data). Its briefly evokes the development quality assurance, and describes the software implementation architecture

  2. Auditory presentation of experimental data

    Science.gov (United States)

    Lunney, David; Morrison, Robert C.

    1990-08-01

    Our research group has been working for several years on the development of auditory alternatives to visual graphs, primarily in order to give blind science students and scientists access to instrumental measurements. In the course of this work we have tried several modes for auditory presentation of data: synthetic speech, tones of varying pitch, complex waveforms, electronic music, and various non-musical sounds. Our most successful translation of data into sound has been presentation of infrared spectra as musical patterns. We have found that if the stick spectra of two compounds are visibly different, their musical patterns will be audibly different. Other possibilities for auditory presentation of data are also described, among them listening to Fourier transforms of spectra, and encoding data in complex waveforms (including synthetic speech).

  3. Dexmedetomidine overdosage: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Soumya S Nath

    2013-01-01

    Full Text Available We present a case of dexmedetomidine toxicity in a 3-year-old child. The case report describes the features and outlines the treatment strategy adopted. The child presented with bradypnoea, bradycardia, hypotension, deep hypnosis and miosis. He was successfully managed with oxygen, saline boluses and adrenaline infusion. He became haemodynamically stable with adrenaline infusion. He started responding to painful stimuli in 3 h and became oriented in 7 h. Dexmedetomidine, a selective α2 adrenoceptor agonist, is claimed to have a wide safety margin. This case report highlights the fact that dexmedetomidine administered in a toxic dose may be life-threatening may present with miosis and adrenaline infusion may be a useful supportive treatment.

  4. Neonatal hemophilia: a rare presentation

    Directory of Open Access Journals (Sweden)

    Nuno Ferreira

    2015-12-01

    Full Text Available Hemophilia A is a X-linked hereditary condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased factor VIII activity leads to increased risk of bleeding events. During neonatal period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Subgaleal hemorrhage during neonatal period is a rare, severe extracranial bleeding with high mortality and usually related to traumatic labor or coagulation disorders. Subgaleal hemorrhage complications result from massive bleeding. We present a neonate with unremarkable family history and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe subgaleal bleeding at 52 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding.

  5. Thick Presentism and Newtonian Mechanics

    CERN Document Server

    Lubashevsky, Ihor

    2016-01-01

    In the present paper I argue that the formalism of Newtonian mechanics stems directly from the general principle to be called the principle of microlevel reducibility which physical systems obey in the realm of classical physics. This principle assumes, first, that all the properties of physical systems must be determined by their states at the current moment of time, in a slogan form it is "only the present matters to physics." Second, it postulates that any physical system is nothing but an ensemble of structureless particles arranged in some whose interaction obeys the superposition principle. I substantiate this statement and demonstrate directly how the formalism of differential equations, the notion of forces in Newtonian mechanics, the concept of phase space and initial conditions, the principle of least actions, etc. result from the principle of microlevel reducibility. The philosophical concept of thick presentism and the introduction of two dimensional time---physical time and meta-time that are mut...

  6. Comprehensible Presentation of Topological Information

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Gunther H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Beketayev, Kenes [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bremer, Peer-Timo [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hamann, Bernd [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Haranczyk, Maciej [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hlawitschka, Mario [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Pascucci, Valerio [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-03-05

    Topological information has proven very valuable in the analysis of scientific data. An important challenge that remains is presenting this highly abstract information in a way that it is comprehensible even if one does not have an in-depth background in topology. Furthermore, it is often desirable to combine the structural insight gained by topological analysis with complementary information, such as geometric information. We present an overview over methods that use metaphors to make topological information more accessible to non-expert users, and we demonstrate their applicability to a range of scientific data sets. With the increasingly complex output of exascale simulations, the importance of having effective means of providing a comprehensible, abstract overview over data will grow. The techniques that we present will serve as an important foundation for this purpose.

  7. CLL: Common Leukemia; Uncommon Presentations.

    Science.gov (United States)

    Lad, Deepesh; Malhotra, Pankaj; Varma, Neelam; Sachdeva, Manupdesh Singh; Das, Ashim; Srinivasan, Radhika; Bal, Amanjit; Khadwal, Alka; Prakash, Gaurav; Suri, Vikas; Kumari, Savita; Jain, Sanjay; Varma, Subhash

    2016-09-01

    We report here a series of ten patients with uncommon presentations and associations of chronic lymphocytic leukemia (CLL) not reported hitherto or occasionally reported in literature. The first two cases describe unusual causes of abdominal distension in CLL and unusual sites infiltration by CLL. The next two cases illustrate occurrence of CLL in association with other hematological malignancies. Cases five and six describe unusual infections and their impact on CLL. Cases seven and eight depict associations of rare non-hematological autoimmune conditions with CLL. The last two cases describe transformation at unusual sites. This series of ten cases illustrates how a common leukemia like CLL can present in different forms and how despite so much progress in understanding of this leukemia so little is known of such presentations.

  8. Granuloma faciale -- an unusual presentation.

    Science.gov (United States)

    Mashood, Asher Ahmed

    2006-04-01

    Granuloma faciale is a rare skin disorder, characterized by asymptomatic cutaneous nodules on the face without any systemic manifestations. The disorder mainly affects middle-aged Caucasian males. One such case occurring in a young unmarried lady of "Pathan" descent is presented here. The presentation was unusual due to the history of frequent swelling, redness and heat in her nodules without any known stimuli and spontaneous regression of the nodules to the original size in a few hours. The patient was treated with a combination of cryotherapy and intralesional corticosteroids with excellent results.

  9. Technical presentation: Next Generation Oscilloscopes

    CERN Multimedia

    PH Department

    2011-01-01

      Rohde & Schwarz "Next Generation Oscilloscopes" - Introduction and Presentation Agenda: Wednesday 23 March  -  09:30 to 11:30 (open end) Bldg. 13-2-005 Language: English 09.30 Presentation "Next Generation Oscilloscopes" from Rohde & Schwarz RTO / RTM in theory and practice Gerard Walker 10.15 Technical design details from R&D Dr. Markus Freidhof 10.45 Scope and Probe Roadmap (confidential) Guido Schulze 11.00 Open Discussion Feedback, first impression, wishes, needs and requirements from CERN All 11.30 Expert Talks, Hands on All Mr. Dr. Markus Freidhof, Head of R&D Oscilloscopes, Rohde & Schwarz, Germany; Mr. Guido Schulze, ...

  10. Vitality of optical vortices (Presentation)

    CSIR Research Space (South Africa)

    Roux, FS

    2014-02-01

    Full Text Available This presentation discusses the vitality of optical vortices to distinguish between vortex dipole creation and annihilation events. Vitality is expressed in terms of the transverse 1st and 2nd order derivatives of the optical field. It can be used...

  11. Hypervideos and interactive multimedia presentations

    NARCIS (Netherlands)

    B. Meixner (Britta)

    2017-01-01

    textabstractHypervideos and interactive multimedia presentations allow the creation of fully interactive and enriched video. It is possible to organize video scenes in a nonlinear way. Additional information can be added to the video ranging from short descriptions to images and more videos.

  12. Testing for PV Reliability (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Kurtz, S.; Bansal, S.

    2014-09-01

    The DOE SUNSHOT workshop is seeking input from the community about PV reliability and how the DOE might address gaps in understanding. This presentation describes the types of testing that are needed for PV reliability and introduces a discussion to identify gaps in our understanding of PV reliability testing.

  13. Tuberculosis presenting as posttraumatic panophthalmitis

    Directory of Open Access Journals (Sweden)

    Pankaj Gupta

    2016-01-01

    Full Text Available Panophthalmitis is one of rare manifestations of tuberculosis described in atypical situations such as children, immune compromised patients, or drug abuse. The present report describes the first case of tubercular panophthalmitis developing after trauma in an otherwise healthy adult patient. A 46-year-old female patient presented with corneal infiltrate and endophthalmitis that developed after an injury to right eye with wooden object. Corneal scrapings and vitreous tap were sterile. The patient did not improve with antibiotics and developed panophthalmitis. On evisceration of the painful blind eye, histopathology showed the presence of granulomatous inflammation and acid-fast bacilli. The patient had no other systemic focus of tubercular infection. The patient was managed with anti-tubercular therapy for 6 months. Atypical presentations of tuberculosis like panophthalmitis pose a difficult problem in diagnosis as well as treatment. Direct inoculation of bacilli during trauma is a rare source of infection. This case report presents unusual development of tubercular panophthalmitis following direct inoculation of bacilli during trauma. Ocular tuberculosis should be considered in differential diagnosis of posttraumatic endophthalmitis and panophthalmitis, especially in endemic regions like India.

  14. Rose breeding: past, present, prospects

    NARCIS (Netherlands)

    Vries, de D.P.; Dubois, L.A.M.

    1996-01-01

    In this review the PAST, PRESENT and PROSPECT will be considered as three separate periods in the history of the breeding and development of rose cultivars. The recurring theme is the genetic variation. This theme was chosen because there is justified doubt as to sufficient genetic variation

  15. Understanding Algorithms in Different Presentations

    Science.gov (United States)

    Csernoch, Mária; Biró, Piroska; Abari, Kálmán; Máth, János

    2015-01-01

    Within the framework of the Testing Algorithmic and Application Skills project we tested first year students of Informatics at the beginning of their tertiary education. We were focusing on the students' level of understanding in different programming environments. In the present paper we provide the results from the University of Debrecen, the…

  16. Water plants past and present

    DEFF Research Database (Denmark)

    Riis, T.; Sand-Jensen, K.

    2006-01-01

    How has the condition of the environment developed during the last 100 years? This is an important question because the conditions of the past infl uence those of the present, and knowledge about this development makes it possible to evaluate the causes of changes in species richness, species com...

  17. DOE Collegiate Wind Competition (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Jones, J.

    2014-02-01

    This presentation for the January Stakeholder Engagement and Outreach webinar outlines the expanded need for workers in the wind industry and provides an overview of the DOE Wind Competition (to be held in May 2014) and the guiding principles of the competition.

  18. Slide Composition for Electronic Presentations

    Science.gov (United States)

    Larson, Ronald B.

    2004-01-01

    Instructors who use computer-generated graphics in their lectures have many options to consider when developing their presentations. Experts give different advice on which typefaces, background and letter colors, and background imagery improve communications. This study attempted to resolve these controversies by examining how short-term recall of…

  19. Porphyria Presenting as Diffuse Encephalopathy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-05-01

    Full Text Available An 18-year-old female presenting with seizures, myalgias, abdominal pain, headache and vomiting had multiple large contrast-enhancing white matter lesions on MRI and was diagnosed with acute intermittent porphyria (AIP, in a report from the Department of Neurology, Mayo Clinic, Rochester, MN.

  20. Unusual presentation of gallbladder perforation

    Directory of Open Access Journals (Sweden)

    G. Jayasinghe

    2016-01-01

    Conclusions: Percutaneous abscesses arising from the gallbladder are a rare but potentially serious consequence of acute cholecystitis, and may present in a wide variety of locations. Therefore it is imperative to conduct a full body inspection in the septic patient, even when a source has been identified.

  1. Neonatal presentation of Caroli's disease

    Science.gov (United States)

    Keane, F; Wilkinson, M; Qureshi, S; Reid, C; Baker, A; Mieli-Vergani, G

    1997-01-01

    A neonatal presentation of Caroli's disease with severe cardiac and progressive renal pathology is described. The availability of small paediatric endoscopes ensured early diagnosis. Despite aggressive medical management, the baby died with severe bleeding complications before potentially life saving multiple organ transplantation could take place.

 Keywords: Caroli's disease; endoscopic retrograde cholangiopancreatography; pulmonary artery stenosis PMID:9377141

  2. Neonatal presentation of Caroli's disease

    OpenAIRE

    Keane, F.; Wilkinson, M.; Qureshi, S; Reid, C.; Baker, A.; Mieli-Vergani, G

    1997-01-01

    A neonatal presentation of Caroli's disease with severe cardiac and progressive renal pathology is described. The availability of small paediatric endoscopes ensured early diagnosis. Despite aggressive medical management, the baby died with severe bleeding complications before potentially life saving multiple organ transplantation could take place.

 Keywords: Caroli's disease; endoscopic retrograde cholangiopancreatography; pulmonary artery stenosis

  3. Unusual Presentation of Maydl's Hernia

    African Journals Online (AJOL)

    Maydl's hernia is an uncommon presentation of inguinal hernia whereby predominantly right sided afferent and efferent loops of bowel herniate into the sac with an intervening intra-abdominal loop of bowel that is prone to strangulation. This could be missed if hernia repair is performed with inguinal approach only.

  4. Pulmonary hyalinizing granuloma presenting with dysphagia: a rare presentation.

    Science.gov (United States)

    Khan, Fazal; Hamid, Arsalan; Fatima, Benish; Hashmi, Shiraz; Fatimi, Saulat

    2017-01-01

    A 25-year-old man presented with a 2-month history of dysphagia and past history of pulmonary and intestinal tuberculosis. A barium swallow showed a point of constriction 42 mm above the gastroesophageal junction. Computed tomography revealed large opacities in bilateral lung fields, encroaching more on the esophagus. The lesion progressively compressed the esophagus as it moved inferiorly. A right posterolateral thoracotomy was performed for sub-anatomical resection of the mass. A biopsy revealed homogenous whirling hyalinized collagen fibers, highly suggestive of pulmonary hyalinizing granuloma, with no evidence of malignancy. Pulmonary hyalinizing granuloma should be considered in the differential diagnosis of longstanding dysphagia.

  5. Blau syndrome presenting with ichthyosis.

    Science.gov (United States)

    Masel, Grant; Halbert, Anne

    2005-02-01

    A 12-year-old girl presented with uveitis, joint disease and ichthyosis resembling ichthyosis vulgaris. A biopsy taken from the affected lower leg demonstrated sarcoidal-type granulomas. Synovial biopsy from the knee also showed granulomas. There was a family history of similar clinical features in the patient's younger sister. There were no other systemic features present to suggest a diagnosis of sarcoidosis or other granulomatous disease such as Crohn's disease or tuberculosis. The familial nature of the condition also made these diagnoses less likely. A clinical diagnosis of Blau syndrome was made. Blau syndrome is an uncommon sarcoidosis-like multisystem autosomal-dominant granulomatous disorder caused by mutations in the CARD15 gene. This gene has also recently been found to be a factor in the development of psoriatic arthritis and Crohn's disease. Although many forms of skin involvement have been described in Blau syndrome, this is the first case described of ichthyosis as the primary skin manifestation.

  6. Pronunciation Teaching: Past and Present

    Directory of Open Access Journals (Sweden)

    Saeed Ketabi

    2015-09-01

    Full Text Available Pronunciation, despite being known as an important component of language learning, has not been awarded due attention within the field of language education. This article is a humble attempt to present an overview of the history of pronunciation teaching. Different approaches and methods of language teaching from the late nineteenth century into the new millennium are reviewed and discussed with regard to their stance in pronunciation instruction. Recent trends and issues of pronunciation teaching, e.g. intelligibility and Lingua Franca Core are also highlighted. Discussions like the present one might be beneficial in gaining a better understanding and evaluation of the status quo in order to improve and enhance the status of pronunciation instruction within language pedagogy.

  7. Congenital chloride diarrhea: late presentation

    Directory of Open Access Journals (Sweden)

    Al Bishi L

    2011-04-01

    Full Text Available Laila Al Bishi1, Mustafa Al Toonisi2Pediatric Department, North West Armed Forces Hospital, Tabuk, Kingdom of Saudi ArabiaAbstract: We report the case of a male infant who presented with diarrhea at 6 months of age. He was failing to thrive, and biochemical investigation revealed hypokalemic hypochloremic metabolic alkalosis. Diagnosis of congenital chloride diarrhea was suspected and confirmed by the stool chloride result. He was started on high-dose sodium chloride and potassium chloride to control the electrolyte imbalance. The disease was difficult to control for a year after diagnosis. Late presentation is associated with severe chronic electrolyte disturbances and high-dose replacement therapy.Keywords: congenital chloride diarrhea, hypokalemic hypochloremic metabolic alkalosis, high stool chloride

  8. Xanthoma Disseminatum Presenting with Hoarseness

    Directory of Open Access Journals (Sweden)

    Biswanath Behera

    2017-11-01

    Xanthoma disseminatum is a very rare form of non-Langerhans cell histiocytosis that classically presents with cutaneous xanthomas, mucosal xanthomas, and diabetes insipidus. Hoarseness of voice due to lesions involving the larynx is a rare symptom. Because the disease has punctated, numerous relapses and causes morbidity to the patient, its multisystem manifestations have to be known. Therefore, xanthoma disseminatum has to be kept in mind as a differential  diagnosis for hoarseness of voice.

  9. Syntomatic Tarlov Cyst. Case presentation

    OpenAIRE

    Jorge Luis Castillo López; María E. Jerves Crespo; Victoria E. Solís Espín; Juan C. Vargas Parra

    2017-01-01

    Tarlov or perineural cysts are pathologic deformations located in the space between the Perineurium and endoneurium of spinal roots close to the posterior root ganglion. It is an infrequent disease. Although its etiology is uncertain different theories have been postulated since its discovery. Regularly they are asymptomatic; they are discovered as incidental findings in imaging studies. A case is presented of a patient complaining of a lumbociatalgia of month evolution, without relation with...

  10. Fluorescent compounds present in food

    OpenAIRE

    Soto Serrano, Axel

    2014-01-01

    Póster The food industry demands fast, reliable, cheap and reproducible methods for quality and process control. This bibliographic review work investigates florescence spectroscopy, a method that couldn’t be used in food until the recent technological advances, concretely front-face fluorescence and chemometric tools. This technology presents advantages as compared to classical methods like HPLC or capillary electrophoresis, which require qualified staff, sample preparation and are time-c...

  11. Presentation of the Geocoder software

    OpenAIRE

    Töpel, Mats

    2013-01-01

    geocoder.py is a program written in Python that takes one file containing polygons, and one file with species locality data as input. The program then tests if a species have been recorded inside any of the polygons. The result is presented as a nexus file with "0" indicating absence, and "1" indicating presence of a species in a polygon.  

  12. Presentation : Spatial Analysis and GEOmatics

    OpenAIRE

    Didier Josselin; Thérèse Libourel

    2014-01-01

    SAGEO is the annual International Conference on Spatial Analysis and GEOmatics. It aims to:  present recent and high quality research in the field of Geomatics and Spatial Analysis, bring together researchers from various disciplines, provide an exchange platform on research and development in Geomatics, on a national and international level, for public or private bodies. SAGEO is a good opportunity for two complementary research networks to meet and to discuss their points of view on spatial...

  13. Congenital chloride diarrhea: late presentation

    OpenAIRE

    Al Bishi, Laila; Mustafa,

    2011-01-01

    Laila Al Bishi1, Mustafa Al Toonisi2Pediatric Department, North West Armed Forces Hospital, Tabuk, Kingdom of Saudi ArabiaAbstract: We report the case of a male infant who presented with diarrhea at 6 months of age. He was failing to thrive, and biochemical investigation revealed hypokalemic hypochloremic metabolic alkalosis. Diagnosis of congenital chloride diarrhea was suspected and confirmed by the stool chloride result. He was started on high-dose sodium chloride and potassium chloride to...

  14. Leadership: Past, present, and future

    OpenAIRE

    Antonakis, J.; Cianciolo, A. T.; Sternberg, R. J.

    2004-01-01

    In this introductory chapter, the editors of the present volume provide readers with the background necessary to understand the chapters that follow. They first acquaint readers with the concept of leadership and why leadership is necessary. Then, the editors briefly trace the history of leadership research and examine its major schools, most of which are reviewed in this book. Their historical overview is also necessary as an organizing framework because chapter authors frequently refer to e...

  15. Nocardial mycetoma: Diverse clinical presentations

    Directory of Open Access Journals (Sweden)

    Sharma Nand

    2008-01-01

    Full Text Available Nocardia spp are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia spp occur as a result of local trauma and contamination of the wound. Clinically, it presents as acute infection (abscesses or cellulitis, mycetoma, or sporotrichoid infection. Differential diagnosis includes eumycetoma, chromomycosis, blastomycosis, coccidioidomycosis, sporotrichosis, tuberculosis, botryomycosis, syphilis, yaws, and neoplasia. Its diagnosis is confirmed by demonstrating the causative organism in exudates (as granules, tissue specimens, or cultures. Early diagnosis will obviate need for drastic surgical measures as early institution of chemotherapy is effective in most patients. However, its diagnosis is often delayed due to diverse clinical presentations and for want of clinical suspicion, particularly in non-endemic areas. This paper presents 4 clinical forms of this not so uncommon disease, emphasizing the importance of high index of clinical suspicion, especially in non-endemic regions; and the significance of repeated examination of exudates for Nocardia granules for an early diagnosis.

  16. XPL the Extensible Presentation Language

    Directory of Open Access Journals (Sweden)

    A. Santangelo

    2009-01-01

    Full Text Available The last decade has witnessed a growing interest in the development of web interfaces enabling both multiple ways to access contents and, at the same time, fruition by multiple modalities of interaction (point-and-click, contents reading, voice commands, gestures, etc.. In this paper we describe a framework aimed at streamlining the design process of multi-channel, multimodal interfaces enabling full reuse of software components. This framework is called the eXtensible Presentation architecture and Language (XPL, a presentation language based on design pattern paradigm that keeps separated the presentation layer from the underlying programming logic. The language supplies a methodology to expedite multimodal interface development and to reduce the effort to implement interfaces for multiple access devices, by means of using the same code. This paper describes a methodology approach based on Visual Design Pattern (ViDP and Verbal Design Pattern (VeDP, offering examples of multimodal and multichannel interfaces created with the XPL Editor.

  17. Quantum technology past, present, future: quantum energetics (Conference Presentation)

    Science.gov (United States)

    Choi, Sang H.

    2017-04-01

    Since the development of quantum physics in the early part of the 1900s, this field of study has made remarkable contributions to our civilization. Some of these advances include lasers, light-emitting diodes (LED), sensors, spectroscopy, quantum dots, quantum gravity and quantum entanglements. In 1998, the NASA Langley Research Center established a quantum technology committee to monitor the progress in this area and initiated research to determine the potential of quantum technology for future NASA missions. The areas of interest in quantum technology at NASA included fundamental quantum-optics materials associated with quantum dots and quantum wells, device-oriented photonic crystals, smart optics, quantum conductors, quantum information and computing, teleportation theorem, and quantum energetics. A brief review of the work performed, the progress made in advancing these technologies, and the potential NASA applications of quantum technology will be presented.

  18. Big Data: present and future

    Directory of Open Access Journals (Sweden)

    Mircea Raducu TRIFU

    2014-05-01

    Full Text Available The paper explains the importance of the Big Data concept, a concept that even now, after years of development, is for the most companies just a cool keyword. The paper also describes the level of the actual big data development and the things it can do, and also the things that can be done in the near future. The paper focuses on explaining to nontechnical and non-database related technical specialists what basically is big data, presents the three most important V's, as well as the new ones, the most important solutions used by companies like Google or Amazon, as well as some interesting perceptions based on this subject.

  19. Cartography past, present and future

    CERN Document Server

    Rhind, DW

    2013-01-01

    Making maps dates back at least four thousand years and it is widely recognised that many maps are of great historical value and present a skilled method of summarising the real world on a sheet of paper. Less well known is the judgement involved in the selection and simplification of features, the complex transformation of space and the exacting standards which are needed in cartography. This book is primarily a tribute to Professor F.J. Ormeling, former President and Secretary/Treasurer of the ICA and gives a wide ranging review of the current status of cartography, how this status was atta

  20. Tuberculosis presenting with abdominal lymphadenitis

    OpenAIRE

    Garcia, Rui; Velez, Jorge; Reis, Conceição; Porto, Armando

    2007-01-01

    A tuberculose é uma infecção bacteriana pleomórfica, podendo atingir qualquer tecido ou órgão. O caso clínico relata uma situação que implicou grandes dificuldades de diagnóstico diferencial, sobretudo pela diferente interpretação dos exames auxiliares de diagnóstico. Apesar disso, e após a determinação do diagnóstico certo, instituiu-se um esquema terapêutico segundo as normas aceites e recomendadas, encontrando-se o doente bem. Tuberculosis may target any organ or system and present a...

  1. Tuberculosis presenting as bronchoesophageal fistula

    Directory of Open Access Journals (Sweden)

    Santhosh Narayanan

    2017-01-01

    Full Text Available We report a case of bronchoesophageal fistula associated with tuberculosis. A 25 year old woman presented to us with 3 month history of cough worsening with deglutition. Radiological examination revealed mediastinal lymphadenopathy and bronchoscopy with esophagoscopy confirmed the presence of fistulous communication with features of endobronchial tuberculosis. Histological examination of bronchial biopsy specimen showed non necrotic granuloma with the PCR positive for Mycobacterium tuberculosis in her bronchial secretions. She was begun on antituberculous treatment and became asymptomatic after 2 months. Bronchoscopy done during follow up after 4 months showed normal bronchial lumen with disappearance of fistulous tract. Imaging showed resolution of lung lesions.

  2. Diabetic Myonecrosis: An Atypical Presentation

    Directory of Open Access Journals (Sweden)

    José Hernán Martínez

    2013-01-01

    Full Text Available Diabetic myonecrosis is a frequently unrecognized complication of longstanding and poorly controlled diabetes mellitus. The clinical presentation is swelling, pain, and tenderness of the involved muscle, most commonly the thigh muscles. Management consists of conservative measures including analgesia and rest. Short-term prognosis is good, but long-term prognosis is poor with most patients dying within 5 years. Failure to properly identify this condition will expose the patient to aggressive measures that could result in increased morbidity. To our knowledge this is the first case reported in which there was involvement of multiple muscle groups including upper and lower limbs.

  3. Unusual presentations of accommodative esotropia.

    OpenAIRE

    Pollard, Z F; Greenberg, M F

    2000-01-01

    PURPOSE: Most patients with accommodative esotropia are first examined between the ages of 6 months and 2 years. This paper discusses unusual presentations of accommodative esotropia that occur outside of this age-group and/or have a precipitating event that triggered the esotropia. In a series of patients who were from 5 to 11 years of age, trauma was the precipitating event. In some of the patients under 6 months of age, high myopia, as well as a moderate to large amount of hyperopia, was t...

  4. Presentation at Innoventure Annual Competition

    Energy Technology Data Exchange (ETDEWEB)

    None

    2010-03-31

    This report documents the components of the workshop presented at the recent annual competition for the Innoventure program. The goal of the workshop was to focus on the delivery of science, technology, engineering, and math (STEM) concepts in a hands-on experiential learning format to increase interest in national security careers at NNSA, most of which are in the STEM fields. This work is a part of the National Security Preparedness Project (NSPP), being performed under a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant.

  5. Neuromodulation: present and emerging methods

    Directory of Open Access Journals (Sweden)

    Song eLuan

    2014-07-01

    Full Text Available Neuromodulation has wide ranging potential applications in replacing impaired neural function (prosthetics, as a novel form of medical treatment (therapy, and as a tool for investigating neurons and neural function (research. Voltage and current controlled electrical neural stimulation (ENS are methods that have already been widely applied in both neuroscience and clinical practice for neuroprosthetics. However, there are numerous alternative methods of stimulating or inhibiting neurons. This paper reviews the state-of-the-art in ENS as well as alternative neuromodulation techniques - presenting the operational concepts, technical implementation and limitations - in order to inform system design choices.

  6. Neuromodulation: present and emerging methods.

    Science.gov (United States)

    Luan, Song; Williams, Ian; Nikolic, Konstantin; Constandinou, Timothy G

    2014-01-01

    Neuromodulation has wide ranging potential applications in replacing impaired neural function (prosthetics), as a novel form of medical treatment (therapy), and as a tool for investigating neurons and neural function (research). Voltage and current controlled electrical neural stimulation (ENS) are methods that have already been widely applied in both neuroscience and clinical practice for neuroprosthetics. However, there are numerous alternative methods of stimulating or inhibiting neurons. This paper reviews the state-of-the-art in ENS as well as alternative neuromodulation techniques-presenting the operational concepts, technical implementation and limitations-in order to inform system design choices.

  7. Cutaneous sporotrichosis: Unusual clinical presentations

    Directory of Open Access Journals (Sweden)

    Mahajan Vikram

    2010-01-01

    Full Text Available Three unusual clinical forms of sporotrichosis described in this paper will be a primer for the clinicians for an early diagnosis and treatment, especially in its unusual presentations. Case 1, a 52-year-old man, developed sporotrichosis over pre-existing facial nodulo-ulcerative basal cell carcinoma of seven-year duration, due to its contamination perhaps from topical herbal pastes and lymphocutaneous sporotrichosis over right hand/forearm from facial lesion/herbal paste. Case 2, a 25-year-old woman, presented with disseminated systemic-cutaneous, osteoarticular and possibly pleural (effusion sporotrichosis. There was no laboratory evidence of tuberculosis and treatment with anti-tuberculosis drugs (ATT did not benefit. Both these cases were diagnosed by histopathology/culture of S. schenckii from tissue specimens. Case 3, a 20-year-old girl, had multiple intensely pruritic, nodular lesions over/around left knee of two-year duration. She was diagnosed clinically as a case of prurigo nodularis and histologically as cutaneous tuberculosis, albeit, other laboratory investigations and treatment with ATT did not support the diagnosis. All the three patients responded well to saturated solution of potassium iodide (SSKI therapy. A high clinical suspicion is important in early diagnosis and treatment to prevent chronicity and morbidity in these patients. SSKI is fairly safe and effective when itraconazole is not affordable/ available.

  8. Subacute presentation of propionic acidemia.

    Science.gov (United States)

    Delgado, Carmen; Macías, Carlos; de la Sierra García-Valdecasas, Maria; Pérez, Manuel; del Portal, Luis Ruiz; Jiménez, Luis Manuel

    2007-12-01

    Propionic acidemia is a hereditary metabolic disease caused by a deficiency of enzyme propionyl-CoA carboxylase, which is involved in the catabolism of ramified amino acids, odd-chain fatty acids, and other metabolites; the deficiency of this enzyme leads to an accumulation of toxic substances in the body. There are various forms of clinical presentation (severe neonatal, chronic intermittent, or slow and gradual). The case presented in this study was of a slow and insidious evolution form that was diagnosed when the child was 9 months old. Intracranial magnetic resonance imaging showed a slight increase in the signal intensity in sequences measured in T2 in addition to a restriction of the diffusion at the level of both putamens, which, together with biochemical and genetic analyses, confirmed the diagnosis of propionic acidemia. After initiating treatment involving a diet that was low in proteins, carnitine, and biotin, and an open-formula diet of ramified amino acids, the patient made progress, showing signs of improved hypotonia and increased weight gain. His vomiting stopped, and ketoacidosis was corrected.

  9. STS-81 Post Flight Presentation

    Science.gov (United States)

    1997-01-01

    The flight crew of the STS-81 mission, Commander Michael A. Baker, Pilot Brent W. Jett Jr, and Mission Specialists John M. Grunsfeld, Marsha S. Ivins, Peter J.K. Wisoff, and Jerry M. Linenger present a video mission over-view of their space flight. Images include prelaunch activities such as eating the traditional breakfast, crew suit-up, and the ride out to the launch pad. Also included are various panoramic views of the shuttle on the pad. The crew can be seen being readied in the "white room" for their mission. After the closing of the hatch and arm retraction, launch activities are shown including countdown, engine ignition, launch, and the separation of the Solid Rocket Boosters. During the presentation the astronauts take turns discussing aspects of the mission including: the SPACEHAB a double module that provides additional middeck locker space for secondary experiments. During the five days of docked operations with Mir, the crews is seen transferring water and supplies from one spacecraft to the other.

  10. Atypical presentations of neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    Douglas Sato

    2011-10-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory disease of central nervous system classically characterized by acute, severe episodes of optic neuritis and longitudinally extensive transverse myelitis, usually with a relapsing course. The identification of an autoantibody exclusively detected in NMO patients against aquaporin-4 (AQP-4 has allowed identification of cases beyond the classical phenotype. Brain lesions, once thought as infrequent, can be observed in NMO patients, but lesions have different characteristics from the ones seen in multiple sclerosis. Additionally, some AQP-4 antibody positive patients may present with a variety of symptoms not being restricted to optic neuritis and acute myelitis during the first attack or in a relapse. Examples are not limited to, but may include patients only with brain and/or brainstem lesions, narcolepsy with hypothalamic lesions or patients with intractable hiccups, nausea and vomiting. The prompt identification of NMO patients with atypical presentations may benefit these patients with institution of early treatment to reduce disability and prevent further attacks.

  11. Case presentation – thyroid lymphoma

    Directory of Open Access Journals (Sweden)

    Belkisa Izić

    2011-11-01

    Full Text Available Malignant tumors of the thyroid gland account for about 1% of thenewly diagnosed malignant tumors each year, and their incidence inwomen is twice the incidence in men. According to the WHO classification (2004 thyroid tumors are divided into: carcinoma of the thyroid, adenoma and similar tumors, and other thyroid tumors which include: teratomas, angiosarcomas, paragangliomas and others, as well as primary lymphomas and plasmacytomas. Primary thyroid lymphomasare defined as lymphomas which originate in the thyroid gland. This study presents the case of a 68-year-old patient with a thyroid lymphoma, which caused compression of the airways. In the patientpresented there was reduced activity of the thyroid gland. The dominant symptoms were: breathing difficulties, hoarse voice and the enlargement of the thyroid. An ultrasound examination was performedbefore surgery on the neck, which showed a multinodular thyroid,with compromised and compressed trachea to the right and rear. Anemergency surgical procedure was performed to reduce the tumor.Pathohistological diagnosis confirmed diffuse large B cell lymphoma.The aim of the study was to present a patient with a thyroid lymphoma, who had previously not had any immunological changes to the gland,that is, she had not had any chronic lymphocyte thyroiditis, but due to the compressive syndrome it was necessary to perform an emergencysurgical procedure to reduce the tumor.

  12. Self Presentation dalam Kehidupan Virtual

    Directory of Open Access Journals (Sweden)

    Ita Musfirowati Hanika

    2016-06-01

    Full Text Available Abstract: The Sims 4 is a life simulation digital game, wherein the player can create and manage their virtual world. This research aims to reveal the players’ ideas in constructing their virtual world in this game. It is a qualitative research, using indepth interview to collect the data. Based on Ervin Goffman’s dramaturgy theory, “The presentation of self in everyday life”, this research concludes that The Sims 4 is played like a “real” life to create the expected self-image in the real world. Abstrak: Permainan digital The Sims 4 merupakan permainan simulasi kehidupan yang memberi kesempatan pemainnya untuk menciptakan dan mengatur dunia virtualnya. Tujuan penelitian ini adalah untuk mengungkapkan gagasan yang mendasari pemain dalam mengonstruksi dunia mereka dalam permainan digital. Penelitian ini merupakan penelitian kualitatif dengan wawancara mendalam sebagai metode pengumpulan data. Menggunakan teori dramaturgi Ervin Goffman, “The presentation of self in everyday life”, penelitian ini menyimpulkan bahwa permainan The Sims 4 dijalankan layaknya kehidupan “real” untuk menciptakan citra diri yang diharapkan di dunia nyata.

  13. Leptospirosis presenting as honeymoon fever.

    Science.gov (United States)

    de Sainte Marie, B; Delord, M; Dubourg, G; Gautret, P; Parola, P; Brouqui, P; Lagier, J C

    2015-05-01

    An increasing number of travelers from western countries visit tropical regions, questioning western physicians on the prophylaxis, the diagnosis and the therapeutic management of patients with travel-associated infection. In July 2014, a French couple stayed for an adventure-travel in Columbia without malaria prophylaxis. A week after their return the woman presented with fever, myalgia, and retro-orbital pain. Three days later, her husband presented similar symptoms. In both patients, testing for malaria, arboviruses and blood cultures remained negative. An empirical treatment with doxycycline and ceftriaxone was initiated for both patients. Serum collected from the female patient yielded positive IgM for leptospirosis but was negative for her husband. Positive Real-Time PCR were observed in blood and urine from both patients, confirming leptospirosis. Three lessons are noteworthy from this case report. First, after exclusion of malaria, as enteric fever, leptospirosis and rickettsial infection are the most prevalent travel-associated infections, empirical treatment with doxycycline and third generation cephalosporin should be considered. In addition, the diagnosis of leptospirosis requires both serology and PCR performed in both urine and blood samples. Finally, prophylaxis using doxycycline, also effective against leptospirosis, rickettsial infections or travellers' diarrhea should be recommended for adventure travelers in malaria endemic areas. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Director general presentation to personnel

    CERN Multimedia

    2016-01-01

    Dear Colleagues, Many important discussions are scheduled for the upcoming Council Week (13-17 June) on topics including the Medium-Term Plan, the Pension Fund and other matters of great relevance to us.   I would therefore like to share the main outcome of the week with you and I invite you to join me and the Directors in the Main Auditorium at 10 a.m. on Thursday 23 June. The meeting will last about one hour and a webcast will also be available. Best regards, Fabiola Gianotti DG presentation to personnel Thursday 23 June at 10 am Main Auditorium Retransmission in Council Chamber, IT Auditorium, Kjell Jonhsen Auditorium, Prevessin 864-1-C02 Webcast on cern.ch/webcast More information on the event page.

  15. Uncommon presentation of pulmonary aspergilloma

    Directory of Open Access Journals (Sweden)

    Baradkar V

    2009-01-01

    Full Text Available Cases of pulmonary aspergilloma without any predisposing factors are rarely reported. Clinical presentation varies from case to case. Here, we report a case of pulmonary aspergilloma in a 60-year-old male patient who was admitted to the Intensive Respiratory Care Unit with spontaneous pneumothorax. The patient had a history of dyspnea on exertion since 9 months and mild haemoptysis since the last 6 months. A computerised tomographic scan of the lungs showed a lesion in the left main bronchus along with obstructive emphysema of the right lung, moderate pneumothorax and mediastinal emphysema. Bronchoscopy was performed and the biopsy samples were processed for histopathological examination and culture on Sabouraud′s dextrose agar, which yielded growth of Aspergillus flavus. Repeat sputum samples also yielded the growth of A. flavus . The patient responded to intravenous liposomaamphotericin B and intercostal drainage.

  16. Unusual presentation of spinal lipomatosis

    Directory of Open Access Journals (Sweden)

    Stephenson W

    2014-09-01

    Full Text Available William Stephenson,1 Matthew J Kauflin2,3 1Primary Care, Huntington Veteran's Affairs Medical Center, Huntington, WV, USA; 2Department of Pharmacy, Grandview Medical Center, Dayton, Ohio, OH, USA; 3Ohio Northern University, Ada, Ohio, OH, USA Abstract: Spinal epidural lipomatosis (SEL is a rare condition characterized by overgrowth of normal adipose tissue in the extradural space within the spinal canal that can lead to significant spinal cord compression. It is most commonly reported in patients receiving chronic glucocorticoid therapy. Other causes can include obesity and hypercortisolism. Occasionally, idiopathic SEL will occur in patients with no known risk factors, but cases are more generally reported in obesity and males. We present the case of a 35 year-old non-obese woman found to have rapidly progressive SEL that was not associated with any of the common causes of the disorder. Keywords: lipomatosis, laminectomy, hypercortisolism

  17. An unusual presentation of hypothyroidism.

    Science.gov (United States)

    Soni, Sonia; Singh, Gundeep; Yasir, Subia; Hatipoglu, Betul

    2005-03-01

    We describe a case of a 42-year-old male, with a 5-year history of recurrent gum bleeding, easy bruising, and chronic fatigue who presented for management of possible bleeding complications prior to a planned dental procedure. After extensive work-up, the patient was diagnosed with acquired von Willebrand Disease and underlying hypothyroidism with a thyrotropin (TSH) of 321 mIU/L (0.35-5.5) and total thyroxine (T(4)) of less than 1 microg/dL (4.5-12.5). He was started on levothyroxine and therapy and when compliant with treatment, the mucosal bleeding and symptoms of hypothyroidism were resolved. A subsequent TSH and total T(4) samples were drawn and found to be 6.3 mIU/L and 4.1 microg/dL, respectively.

  18. Sarcoidosis Presenting with Cicatrizing Conjunctivitis.

    Science.gov (United States)

    O'Donnell, John J; Karakus, Sezen; Doroslovacki, Pavle; Akpek, Esen K

    2015-08-01

    To report two patients with sarcoidosis initially presenting with cicatrizing conjunctivitis. Both patients with chronic conjunctivitis were referred for further management. The first patient had conjunctival granulomas, subepithelial fibrosis, and forniceal foreshortening. The second patient had extensive upper and lower conjunctival scarring with forniceal foreshortening and symblepharon formation of both eyes. Conjunctival biopsy specimens revealed noncaseating granulomas. Immunofluorescein studies were negative for immunoreactant deposition in the basement membrane. Because of further diagnostic evaluations, sarcoidosis was determined to be the final cause of the cicatrizing conjunctivitis. Sarcoidosis should be included in the differential diagnosis of cicatrizing conjunctivitis. Recognition of the characteristic noncaseating granulomas in the conjunctival biopsy and initiation of the appropriate evaluations are essential in establishing the diagnosis and determining the extent of systemic involvement.

  19. Atypical presentations of celiac disease

    Directory of Open Access Journals (Sweden)

    Balasa Adriana Luminita

    2016-08-01

    Full Text Available In this study we evaluated the association of celiac disease in 81 children with autoimmune disease and genetic syndromes over a two years periods (January 2014 to July 2016 in Pediatric Clinic in Constanta. Because the extraintestinal symptoms are an atypical presentation of celiac disease we determined in these children the presence of celiac disease antibodies: Anti-tissue Transglutaminase Antibody IgA and IgA total serum level as a screening method followeds in selective cases by Anti-tissue Transglutaminase Antibody IgG, anti-endomysial antibodies, deamidated gliadin antibodies IgA and IgG and intestinal biopsia. In our study 8 patients had been diagnosed with celiac disease with extraintestinal symptoms, of which 4 with type 1 diabetes, 1 patient with ataxia, 2 patients with dermatitis herpetiformis and 1 patient with Down syndrome that associate also autoimmune thyroiditis, alopecia areata, enamel hypoplasia.

  20. Splenic abscess: a rare presentation

    Directory of Open Access Journals (Sweden)

    Mohit Bhatia

    2015-01-01

    Full Text Available Splenic abscess is a rare clinical entity with an incidence of 0.2-0.7% in autopsy-based studies. When untreated, splenic abscess is associated with nearly 100% mortality; in treated patients, the mortality rate is 16.6% during the first 90 days. It mostly occurs in patients with neoplasia, immunodeficiency, trauma, diabetes or splenic infarct. The incidence of splenic abscess is thought to be growing because of the increase in the number of immunocompromised patients who are particularly at risk for this disease and also because of the widespread use of diagnostic modalities. However, the optimal treatment for this remains unclear. We present a case of a 42-year-old man diagnosed with multiloculated splenic abscess and was subjected to splenectomy.

  1. Atmospheric neutrinos - present and future -

    Energy Technology Data Exchange (ETDEWEB)

    Kajita, Takaaki [Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, Univ. of Tokyo, Kashiwa-no-ha 5-1-5, Kashiwa, Chiba 277-8582 (Japan)

    2005-12-15

    Atmospheric neutrinos have been playing a major role in studying neutrino oscillations. The present data are consistent with pure 2 flavor {nu}{sub {mu}}->{nu}{sub {tau}} oscillations. The allowed {nu}{sub {mu}}->{nu}{sub {tau}} oscillation parameter region is sin{sup 2}2{theta}{sub 23}>0.92 and 1.5<{delta}m{sub 23}{sup 2}<3.4x10{sup -3}eV{sup 2} at 90%C.L. Recent data from an L/E analysis showed that the {nu}{sub {mu}} disappearance probability obeys the sinusoidal function as predicted by neutrino oscillations. Future atmospheric neutrino experiments are also discussed emphasizing the measurement of {theta}{sub 13} and the sign of {delta}m{sub 23}{sup 2}.

  2. Neurocysticercosis presenting as pseudobulbar palsy

    Directory of Open Access Journals (Sweden)

    Arinaganahalli Subbanna Praveen Kumar

    2014-01-01

    Full Text Available Neurocysticercosis (NCC is the most common helminthic infestation of the central nervous system (CNS and a leading cause of acquired epilepsy worldwide. The common manifestations of NCC are seizures and headache. The NCC as a cause of pseudobulbar palsy is very unusual and not reported yet in the literature. A pseudobulbar palsy can occur in any disorder that causes bilateral corticobulbar disease. The common etiologies of pseudobulbar palsy are vascular, demyelinative, or motor neuron disease. We report a 38-year-old female patient who presented with partial seizures and pseudobulbar palsy. The MRI brain showed multiple small cysts with scolex in both the cerebral hemispheres and a giant intraparenchymal cyst. Our patient responded well to standard treatment of neurocysticercosis and antiepileptics.

  3. ABSTRACT PRESENTATION--PHARMACEUTICALS AS ...

    Science.gov (United States)

    Pharmaceuticals comprise a large and diverse array of contaminants that can occur in the environmentfrom the combined activities and actions of multitudes of individuals as well as from veterinary andagricultural use. The research focused on in the subtasks is the development and application of state-of the-art technologies to meet the needs of the public, Office of Water, and ORD in the area of Water Quality. Located In the subtasks are the various research projects being performed in support of this Task and more in-depth coverage of each project. Briefly, each project's objective is stated below.Subtask 1: To integrate state-of-the-art technologies (polar organic chemical integrative samplers, advanced solid-phase extraction methodologies with liquid chromatography/electrospray/mass spectrometry) and apply them to studying the sources and fate of a select list of PPCPs. Application and improvement of analytical methodologies that can detect non-volatile, polar, water-soluble pharmaceuticals in source waters at levels that could be environmentally significant (at concentrations less than parts per billion, ppb). IAG with USGS ends in FY05. APM 20 due in FY05.Subtask 2: Coordination of interagency research and public outreach activities for PPCPs. Participate on NSTC Health and Environment subcommittee working group on PPCPs. Web site maintenance and expansion, invited technical presentations, invited articles for peer-reviewed journals, interviews for med

  4. [ISRAEL NEONATOLOGY: PRESENT AND FUTURE].

    Science.gov (United States)

    Dollberg, Shaul

    2016-01-01

    The practice of neonatology in Israel debuted in the 1970s as local enterprises by individual hospitals that needed to provide sick and preterm newly born infants with up-to-date and effective care. Descriptions of research and advances in humane and gentle treatment during neonatal care for preterm infants and their families, as well as prevention of neonatal infections, follow-up of preterm infants and care of full-term infants are presented in this issue. The Israel National Very Low Birth Weight (VLBW) Infant database provides an excellent source of knowledge, which has led to multiple scientific publications. Recent international comparisons of the outcome of preterm VLBW infants, made possible by this unique database in Israel, has provided the neonatal community and the Ministry of Health with insights as to the differences in prognosis between Israel and other countries, especially among extremely low birth weight infants. At the border of viability, mortality in Israelis significantly higher than that reported in other countries and proactive steps undertaken to examine these differences and prompt correctional action should be pursued. The Israel Ministry of Health started positive initiatives and should ensure that their steps are implemented at the preterm infant's bedside.

  5. Neurologic presentation of celiac disease.

    Science.gov (United States)

    Bushara, Khalafalla O

    2005-04-01

    Celiac disease (CD) long has been associated with neurologic and psychiatric disorders including cerebellar ataxia, peripheral neuropathy, epilepsy, dementia, and depression. Earlier reports mainly have documented the involvement of the nervous system as a complication of prediagnosed CD. However, more recent studies have emphasized that a wider spectrum of neurologic syndromes may be the presenting extraintestinal manifestation of gluten sensitivity with or without intestinal pathology. These include migraine, encephalopathy, chorea, brain stem dysfunction, myelopathy, mononeuritis multiplex, Guillain-Barre-like syndrome, and neuropathy with positive antiganglioside antibodies. The association between most neurologic syndromes described and gluten sensitivity remains to be confirmed by larger epidemiologic studies. It further has been suggested that gluten sensitivity (as evidenced by high antigliadin antibodies) is a common cause of neurologic syndromes (notably cerebellar ataxia) of otherwise unknown cause. Additional studies showed high prevalence of gluten sensitivity in genetic neurodegenerative disorders such as hereditary spinocerebellar ataxia and Huntington's disease. It remains unclear whether gluten sensitivity contributes to the pathogenesis of these disorders or whether it represents an epiphenomenon. Studies of gluten-free diet in patients with gluten sensitivity and neurologic syndromes have shown variable results. Diet trials also have been inconclusive in autism and schizophrenia, 2 diseases in which sensitivity to dietary gluten has been implicated. Further studies clearly are needed to assess the efficacy of gluten-free diet and to address the underlying mechanisms of nervous system pathology in gluten sensitivity.

  6. Nuclear Fuels: Present and Future

    Directory of Open Access Journals (Sweden)

    Donald R. Olander

    2009-02-01

    Full Text Available The important new developments in nuclear fuels and their problems are reviewed and compared with the status of present light-water reactor fuels. The limitations of these fuels and the reactors they power are reviewed with respect to important recent concerns, namely provision of outlet coolant temperatures high enough for use in H2 production, destruction of plutonium to eliminate proliferation concerns, and burning of the minor actinides to reduce the waste repository heat load and long-term radiation hazard. In addition to current oxide-based fuel-rod designs, the hydride fuel with liquid metal thermal bonding of the fuel-cladding gap is covered. Finally, two of the most promising Generation IV reactor concepts, the Very High Temperature Reactor and the Sodium Fast Reactor, and the accompanying reprocessing technologies, aqueous-based UREX and pyrometallurgical, are summarized. In all of the topics covered, the thermodynamics involved in the material's behavior under irradiation and in the reprocessing schemes are emphasized.

  7. Presentation Vol. 8 Issue 1

    Directory of Open Access Journals (Sweden)

    Sonia Natalia Cogollo-Ospina

    2017-01-01

    Full Text Available It is with great joy that we share with our readers the fact that our journal has been included in new databases of high prestige. Our journal can now be consulted online at Web of Science, Ulrich web, ERIH Plus, EBSCO, CLASE and we are also members of the Latin American Human Social Science Association of Academic journals. There is also the recognition of our Institution as Universidad Católica Luis Amigó given by the Ministry of Education, that came as a result of cooperative research work and publications. Our celebration is the result of hard work to provide high-quality services and products. We are pleased to present an issue that focuses on questions based on emerging situations that come about as a result of the imperative and domineering discourses of our time; which have become research objects. As usual, there are different topics from different disciplines. In honor of our multidisciplinary approach this issue includes contribution of research papers from the fields of law, psychology, sociology, anthropology, history and social geography, education, social work, political sciences and psychiatry.

  8. Augmented reality: past, present, future

    Science.gov (United States)

    Inzerillo, Laura

    2013-03-01

    A great opportunity has permitted to carry out a cultural, historical, architectural and social research with great impact factor on the international cultural interest. We are talking about the realization of a museum whose the main theme is the visit and the discovery of a monument of great prestige: the monumental building the "Steri" in Palermo. The museum is divided into sub themes including the one above all, that has aroused the international interest so much that it has been presented the instance to include the museum in the cultural heritage of UNESCO. It is the realization of a museum path that regards the cells of the Inquisition, which are located just inside of some buildings of the monumental building. The project, as a whole, is faced, in a total view, between the various competences implicated: historic, chemic, architectonic, topographic, drawing, representation, virtual communication, informatics. The birth of the museum will be a sum of the results of all these disciplines involved. Methodology, implementation, fruition, virtual museum, goals, 2D graphic restitution, effects on the cultural heritage and landscape environmental, augmented reality, Surveying 2D and 3D, hi-touch screen, Photogrammetric survey, Photographic survey, representation, drawing 3D and more than this has been dealt with this research.

  9. A cool present for LEIR

    CERN Multimedia

    2005-01-01

    LEIR (Low Energy Ion Ring), which will supply lead ions to the LHC experiments, has taken delivery of one of its key components, its electron cooling system. From left to right, Gérard Tranquille, Virginia Prieto and Roland Sautier, in charge of the electron cooling system for LEIR at CERN, and Christian Lacroix, in charge of installation for the LEIR machine. On 16 December, the day before CERN's annual closure, the LEIR teams received a rather impressive Christmas present. The "parcel" from Russia, measuring 7 metres in length and 4 metres in height, weighed no less than 20 tonnes! The component will, in fact, be one of the key elements of the future LEIR, namely its electron cooling system. LEIR is one of the links in the injector chain that will supply lead ions to the LHC experiments, in particular ALICE (see Bulletin No. 28/2004 of 5 July 2004), within the framework of the I-LHC Project. The electron cooling system is designed to reduce and standardise transverse ion velocity. This focuses the bea...

  10. [An unusual presentation of sarcoidosis].

    Science.gov (United States)

    Nakano, Y; Matsushita, H

    1997-02-01

    A 52-year-old man was admitted to our hospital with chief complaints of fever, general fatigue, and weight loss. A chest roentgenogram showed hyperinflation and many small nodular shadows in both lung fields. A chest CT scan showed centrilobular shadows distributed equally over all lung fields. Examination of a transbronchial lung biopsy specimen revealed a small non-caseating granuloma composed of a giant cell of Langhans type, epithelioid cells, and a few lymphocytes. There was a dark red eruption about 1 cm in diameter on the right forearm, which had been present for a few years, to the best of the patient's memory. Examination of a skin biopsy specimen revealed many non-caseating granulomas composed of epithelioid cells. Uveitis developed about 2 months after admission. Our diagnosis was sarcoidosis. Steroid therapy was started. The patient's symptoms rapidly disappeared and a chest roentgenogram showed remarkable improvement. We believe this was a very peculiar case of sarcoidosis: the patient had systemic symptoms only, and roentgenographic examinations showed hyperinflation and centrilobular shadows distributed over all lung fields.

  11. [Asbestos: past, present and future].

    Science.gov (United States)

    Seaton, A

    1995-03-11

    Owing to its particular properties asbestos has been widely used for the production of insulating material, for fire proofing, and for strengthening to other materials such as cements and plastics, and thus the story of this mineral was one of progressive commercial success until the middle of this century. However, serious health hazards were realized early: around the turn of the century a progressive form of diffuse fibrosis (asbestosis) in asbestos workers was observed and in 1950 an excess risk of lung cancer, while in 1960 the causal relationship between asbestos and mesothelioma were confirmed. In view of the known potential risks of asbestos and its widespread use in the building industry, more recently asbestos has caused considerable public concern and anxiety. Based on numerous experimental and epidemiological observations, present knowledge of the pathogenic effects of asbestos is sufficient for a number of broad conclusions to be drawn. (1) The amphibole types of asbestos are too dangerous for use as industrial material, and should be banned. (2) Chrysotile can probably be used safely if there is strict control of the workers' dust exposure. (3) It is very unlikely that the general public is at any measurable risk from asbestos in buildings. Exceptions are people working regularly on maintenance tasks involving removing or cutting of asbestos in buildings; such people are properly classified as asbestos workers and should be protected accordingly.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Unusual presentation of oral amyloidosis

    Directory of Open Access Journals (Sweden)

    William P.P Silva

    2015-01-01

    Full Text Available Amyloidosis is a rare disease of difficult diagnosis that occurs due accumulation of amyloid substance localized or systemic. The oral cavity is an unusual site and can be related to both localized and systemic forms and for that reason a full investigation is necessary to determine the extent of the disease. This study reports a case of a 58-year-old melanoderm male patient referred to the Department of Oral and Maxillofacial Surgery with white plaques on the tongue and multiple nodules in the region of the buccal mucosa and labial commissure, with 6 months of evolution and painful symptoms. An incisional biopsy was performed on both sites and histological examination indicated the presence of eosinophilic amorphous material within the connective tissue, positive for crystal violet staining, consistent with amyloidosis. At the present time, there is no consensus on the management of local amyloidosis. Surgical treatment of localized forms is indicated in some cases to reduce the functional prejudice. Moreover, follow-up is mandatory, both to manage recurrences and to monitor the possible evolution of the disease to the systemic form.

  13. STS-93 Post Flight Presentation

    Science.gov (United States)

    1999-01-01

    An overview of Flight STS-93 is presented. The primary objective of the STS-93 mission was to deploy the Advanced X-Ray Astrophysics Facility (AXAF), also known as the Chandra X-ray Observatory. The mission flew on the Columbia Shuttle, on July 22, 1999. This facility is the most sophisticated X-ray observatory ever built. Other payloads on STS-93 were: (1) the Midcourse Space Experiment (MSX), (2) Shuttle Ionospheric Modification with Pulsed Local Exhaust (SIMPLEX), (3) Southwest Ultraviolet Imaging System (SWUIS), (4) Gelation of Sols: Applied Microgravity Research (GOSAMR), Space Tissue Loss-B (STL-B), (5) Light Weight Flexible Solar Array Hinge (LFSAH), (6) Cell Culture Module (CCM), and (7) the Shuttle Amateur Radio Experiment-II (SAREX-II), (8) EarthKam, (9) Plant Growth Investigations in Microgravity (PGIM), (10) Commercial Generic Bioprocessing Apparatus (CGBA), (11) Micro-Electrical Mechanical System (MEMS), and (12) the Biological Research in Canisters (BRIC). The crew was: Eileen M. Collins, Mission Commander, the first female shuttle commander; Jeffrey S. Ashby, Pilot; Steven A. Hawley , Mission Specialist; Catherine G. Coleman, Mission Specialist; Michel Tognini (CNES), Mission Specialist. The video contains views of life aboard the space shuttle. This mission featured both a night launching and a night landing at the Kennedy Space Center.

  14. Medical informatics: past, present, future.

    Science.gov (United States)

    Haux, Reinhold

    2010-09-01

    To reflect about medical informatics as a discipline. To suggest significant future research directions with the purpose of stimulating further discussion. Exploring and discussing important developments in medical informatics from the past and in the present by way of examples. Reflecting on the role of IMIA, the International Medical Informatics Association, in influencing the discipline. Medical informatics as a discipline is still young. Today, as a cross-sectional discipline, it forms one of the bases for medicine and health care. As a consequence considerable responsibility rests on medical informatics for improving the health of people, through its contributions to high-quality, efficient health care and to innovative research in biomedicine and related health and computer sciences. Current major research fields can be grouped according to the organization, application, and evaluation of health information systems, to medical knowledge representation, and to the underlying signal and data analyses and interpretations. Yet, given the fluid nature of many of the driving forces behind progress in information processing methods and their technologies, progress in medicine and health care, and the rapidly changing needs, requirements and expectations of human societies, we can expect many changes in future medical informatics research. Future research fields might range from seamless interactivity with automated data capture and storage, via informatics diagnostics and therapeutics, to living labs with data analysis methodology, involving sensor-enhanced ambient environments. The role of IMIA, the International Medical Informatics Association, for building a cooperative, strongly connected, and research-driven medical informatics community worldwide can hardly be underestimated. Health care continuously changes as the underlying science and practice of health are in continuous transformation. Medical informatics as a discipline is strongly affected by these

  15. Presentation of adult mitochondrial epilepsy.

    Science.gov (United States)

    Finsterer, Josef; Mahjoub, Sinda Zarrouk

    2013-03-01

    Mitochondrial disorders (MIDs) frequently manifest phenotypically as epilepsy (mitochondrial epilepsy). Mitochondrial epilepsy occurs in early-onset as well as late-onset syndromic and non-syndromic MIDs. We were interested in the types of epilepsy, the prevalence of mitochondrial epilepsy, the type and effectiveness of treatment, and in the outcome of adult MID patients with epilepsy. We retrospectively evaluated adult patients with syndromic or non-syndromic MIDs and epilepsy. MIDs were classified according to the modified Walker criteria as definite, probable, and possible. Epilepsy in adult patients with a MID was classified as "structural/metabolic" in two-thirds of the cases and as "genetic" in one-third of the cases. Although all types of seizures may occur in mitochondrial epilepsy, adult patients most frequently presented with generalised tonic-clonic seizures, partial seizures, convulsive status epilepticus, or non-convulsive status epilepticus. Cerebral imaging was normal in one-third of the patients. Two-thirds of the adult patients with mitochondrial epilepsy who took antiepileptic drugs received monotherapy, one-third combination treatment. The antiepileptic drugs most frequently administered included levetiracetam, lamotrigine, valproic acid, and gabapentin. Antiepileptic drugs were usually well tolerated and the outcome favourable. Adult mitochondrial epilepsy appears to be less frequent than previously believed but the prevalence strongly depends on patient selection. Mitochondrial epilepsy is most frequently "structural/metabolic". AEDs recommended for mitochondrial epilepsy include levetiracetam, lamotrigine, gabapentin and lacosamide. The outcome of mitochondrial epilepsy may be more favourable if mitochondrion-toxic AEDs are avoided. Only if non-mitochondrion-toxic AEDs are ineffective, mitochondrion-toxic AEDs may be used. Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  16. Past and present Aral Sea

    Science.gov (United States)

    Dukhovniy, Viktor; Stulina, Galina; Eshchanov, Odylbek

    2013-04-01

    The tragedy of disappearing of Aral Sea is well known to the World. Before and after collapse of Soviet Union, a huge quantity of scientific and popular editions described with grief the situation around the Aral Sea. After the NIS states became independent, World Bank, UNDP, UNEP in proper competition with each other had provided some assessment of the situation through presentation of some small and medium grants, but after 2000, the local population remained alone with own problems. Although on the eyes of the present generation a unique transformation of great water body into deserts took place, the global scientific community did not find forces and financing for real and detail investigation of the processes accompanying the Sea shrinking and land formation. We should acknowledge and give big respect to NATO, later to German Government that through GTZ (now GIZ) - German International Collaboration Agency - and GFZ (Potzdam) paid attention to this area of environment crisis and organized scientific and protective design in the so-called Priaralie - the territory around the drying Sea and delta of the two rivers - Amudarya and Syrdarya. Thank to this assistance, the local specialists in collaboration with limited a number of foreign scientists (N.Aladin, P.Zavialov, Joop de Schutter, Hans Wilps, Hedi Oberhansli) organized significant works for detail socioeconomic, ecological and hydrological assessment situation in Priaralie and on the Aral sea coast. On this base, Ministry of Agriculture and Water resources of Uzbekistan and State Committee of Water resources of Kazakhstan developed a plan of rehabilitation of Amudarya and Syrdarya deltas and started implementation of these projects. If Kazakh water authority moved ahead in wetland restoration faster, a forestation of delta and drying bed of Aral Sea got big success in Uzbek territory. 244 thousands hectares of saxsaul and tamarix were planted for protection of the Priaralie. By request of GTZ SIC, ICWC

  17. Como responder ao momento presente?

    Directory of Open Access Journals (Sweden)

    Maria Filomena Molder

    2013-12-01

    Full Text Available http://dx.doi.org/10.5007/1984-784X.2013v13n19p13 Foi com esta pergunta — já um efeito de um primeiro encontro entre Irene Pimentel e eu própria — que decidimos desafiar colegas, estudantes e funci­onários da nossa Faculdade, FCSH (Faculdade de Ciências Sociais e Huma­nas, de outras Faculdades da Universidade Nova de Lisboa, de outras Uni­versidades e todos os interessados em con­siderar e discutir em comum aquilo que se passava em Portugal e que no anúncio da Jornada de 6 de De­zembro de 2012 se descrevia como um “processo de desmantela­mento social, económico e cultural sem precedentes — pese embora tantas compara­ções, baseadas na premissa da ‘eterna repetição’ — e cujas consequências não param de exceder as previsões dos responsáveis por esse desmantelamento”. Acedendo com todo o empenho e gratidão ao convite que me foi dirigido por Humberto Brito para fazer uma resenha da Jornada a publicar no primeiro número de Forma de Vida (saúdo a revista e o título, decidi-me, no entanto, a pôr de lado a resenha, que sob a forma de “Editorial” será em breve publi­cada no blogue Responder ao Momento Presente, entre­tanto criado, conjuntamente com os textos escritos pelos nossos convidados, com as parti­cipações de pessoas que corresponderam ao nosso apelo e ainda com contri­bui­ções que se alargaram para lá da Jornada; a que se juntará uma gravação em video, também disponível no Youtube.   Texto publicado originalmente em Forma de Vida, Lisboa, n.1, fev. 2013. Agrade­cemos à autora por permitir a republicação neste número do Boletim. [N.E.

  18. Como responder ao momento presente?

    Directory of Open Access Journals (Sweden)

    Maria Filomena Molder

    2013-06-01

    Full Text Available Foi com esta pergunta — já um efeito de um primeiro encontro entre Irene Pimentel e eu própria — que decidimos desafiar colegas, estudantes e funci­onários da nossa Faculdade, FCSH (Faculdade de Ciências Sociais e Huma­nas, de outras Faculdades da Universidade Nova de Lisboa, de outras Uni­versidades e todos os interessados em con­siderar e discutir em comum aquilo que se passava em Portugal e que no anúncio da Jornada de 6 de De­zembro de 2012 se descrevia como um “processo de desmantela­mento social, económico e cultural sem precedentes — pese embora tantas compara­ções, baseadas na premissa da ‘eterna repetição’ — e cujas consequências não param de exceder as previsões dos responsáveis por esse desmantelamento”. Acedendo com todo o empenho e gratidão ao convite que me foi dirigido por Humberto Brito para fazer uma resenha da Jornada a publicar no primeiro número de Forma de Vida (saúdo a revista e o título, decidi-me, no entanto, a pôr de lado a resenha, que sob a forma de “Editorial” será em breve publi­cada no blogue Responder ao Momento Presente, entre­tanto criado, conjuntamente com os textos escritos pelos nossos convidados, com as parti­cipações de pessoas que corresponderam ao nosso apelo e ainda com contri­bui­ções que se alargaram para lá da Jornada; a que se juntará uma gravação em video, também disponível no Youtube. Texto publicado originalmente em Forma de Vida, Lisboa, n.1, fev. 2013. Agrade­cemos à autora por permitir a republicação neste número do Boletim. [N.E.

  19. An Ever Present Danger: A Concise History of British Military Operations on the North-West Frontier, 1849-1947 (Occasional Paper, Number 33)

    Science.gov (United States)

    2010-06-01

    scale with new breech-loading magazine-fed rifles, all of which used smokeless powder . For example, a British historian noted that; “Tribal made...enable a rifleman to fire over it standing and about two to three feet thick. Large stones were placed on the parapet at intervals, like almonds on a...tipsy- cake , and loopholes were constructed at ground 33 level. It was a tribal custom when attacking a piquet by day or night, to divide into a rifle

  20. Perforated appendicitis presenting as appendicoumbilical fistula.

    Science.gov (United States)

    Killelea, Brigid K; Arkovitz, Marc S

    2006-03-01

    Perforated appendicitis is one of the most common diagnoses treated by pediatric surgeons. Although rare, a perforated appendix can present with a cutaneous fistula. Here we present the second reported case of perforated appendicitis presenting as an appendicoumbilical fistula.

  1. Alopecia as the Presenting Symptom of Syphilis.

    Science.gov (United States)

    Ornelas, Jennifer; Agbai, Oma N; Kiuru, Maija; Sivamani, Raja K

    2015-07-15

    Alopecia can be one of the many symptoms of secondary syphilis and the clinical presentations include essential syphilitic alopecia or symptomatic syphilitic alopecia. In this report, we present a case of a patient with essential syphilitic alopecia whose sole presenting symptom of syphilis was alopecia. Despite an initial negative rapid plasma reagin (RPR) test, he was ultimately found to have syphilis on scalp biopsy. His alopecia improved following treatment with benzathine penicillin. This presentation serves as a reminder to clinicians to be cognizant of alopecia as a presenting sign of syphilis. A review of the specificity and sensitivity of the typical tests used for the diagnosis is presented.

  2. 2016 Annual Technology Baseline (ATB) - Webinar Presentation

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Wesley; Kurup, Parthiv; Hand, Maureen; Feldman, David; Sigrin, Benjamin; Lantz, Eric; Stehly, Tyler; Augustine, Chad; Turchi, Craig; Porro, Gian; O' Connor, Patrick; Waldoch, Connor

    2016-09-13

    This deck was presented for the 2016 Annual Technology Baseline Webinar. The presentation describes the Annual Technology Baseline, which is a compilation of current and future cost and performance data for electricity generation technologies.

  3. Redundant Information Presentation in Hypertext Learning Environments

    NARCIS (Netherlands)

    Bezdan, Eniko; Kester, Liesbeth; Kirschner, Paul A.

    2011-01-01

    Bezdan, E., Kester, L., & Kirschner, P. A. (2011, 29 August). Redundant Information Presentation in Hypertext Learning Environments. Presentation at the pre-conference of the Junior Researchers of EARLI, Exeter, United Kingdom.

  4. Acute myeloid leukemia presenting as galactorrhea

    OpenAIRE

    Nambiar, K. Rakul; Nair, Sreejith G.; Devi, R. Nandini

    2016-01-01

    Acute myeloid leukemia (AML) presents with symptoms related to pancytopenia (weakness, infections, bleeding diathesis) and organ infiltration with leukemic cells. Galactorrhea is an uncommon manifestation of AML. We report a case of AML presenting with galactorrhea.

  5. Seminoma in the testis presenting as hemospermia

    DEFF Research Database (Denmark)

    Beji, Sami; Hoejgaard, Martin; Lyngdorf, Peter

    2012-01-01

    Hemospermia is often considered idiopathic. We report a case of a patient who presented with hemospermia. Scrotal examination and ultrasonography found a testis tumor. This case underscores the importance of scrotal examination and eventually ultrasound in patients presenting with hemospermia....

  6. Four of Ogden Lindsley's Unpublished Presentation Summaries

    Science.gov (United States)

    Starlin, Clay M.

    2010-01-01

    As one might expect from the founder of Precision Teaching, Ogden Lindsley was precise in creating the summaries of his presentations. Ogden took the opportunity to share his latest thinking on a topic in his presentations. However, because the presentation summaries have not been published, many people have missed the advantage of this knowledge.…

  7. Sporotrichoid lupus vulgaris: A rare presentation.

    Science.gov (United States)

    Maheshwari, Anshul; Tiwari, Siddhi; Mathur, Deepak K; Bhargava, Puneet

    2015-01-01

    Lupus vulgaris is the most common presentation of cutaneous tuberculosis in India and can present as papular, nodular, plaque, ulcerative, vegetating, and tumid forms. Unusual variants include the frambesiform, gangrenous, ulcerovegetating, lichen simplex chronicus, myxomatous, and sporotrichoid types. We describe a rare sporotrichoid presentation of lupus vulgaris on the leg of a 28-year-old female of 12 years duration.

  8. Intuitionistic Assessment Of Behavioural Present Value*

    Directory of Open Access Journals (Sweden)

    Piasecki Krzysztof

    2014-07-01

    Full Text Available The article discussesd the impact of chosen behavioural factors on the imprecision of present value assessment. The formal model of behavioural present value is offered as a result of this discussion. The behavioural present value is described here as an intuitionistic fuzzy set. The significance of the replacement of a fuzzy set by an intuitionistic fuzzy set is proved.

  9. Tips to Making Successful School Board Presentations

    Science.gov (United States)

    Cheasty, Michelle

    2011-01-01

    Over the years, the author has had the opportunity to make several presentations to school boards. The author offers some tips and tricks she has learned, having given board presentations about the specific topics she listed in this article, and receiving feedback after each presentation. She points out that the most important thing to keep in…

  10. Congenital hypothyroidism presenting as menorrhagia in adulthood.

    Science.gov (United States)

    Kumar, Sadish; Mahesh, D M; Vignesh, G; Sagili, Haritha; Dhanapathi, H; Hamide, Abdoul

    2013-09-01

    Although hypothyroidism is a common cause of menorrhagia, it is an uncommon presentation of congenital hypothyroidism. We report a case of congenital hypothyroidism presenting in adulthood with severe menorrhagia. Despite the late presentation, she had features to suggest hypothyroidism since birth.

  11. 6th International Immunoglobulin Symposium: poster presentations

    NARCIS (Netherlands)

    Fernandez-Cruz, E.; Kaveri, S. V.; Peter, H.-H.; Durandy, A.; Cantoni, N.; Quinti, I.; Sorensen, R.; Bussel, J. B.; Danieli, M. G.; Winkelmann, A.; Bayry, J.; Käsermann, F.; Späth, P.; Helbert, M.; Salama, A.; van Schaik, I. N.; Yuki, N.

    2009-01-01

    The posters presented at the 6th International Immunoglobulin Symposium covered a wide range of fields and included both basic science and clinical research. From the abstracts accepted for poster presentation, 12 abstracts were selected for oral presentations in three parallel sessions on

  12. 6th International Immunoglobulin Symposium: Poster presentations

    NARCIS (Netherlands)

    Fernandez-Cruz, E.; Kaveri, S.V.; Peter, H.H.; Durandy, A.; Cantoni, N.; Quinti, I.; Sorensen, R.; Bussel, J.B.; Danieli, M.G.; Winkelmann, A.; Bayry, J.; Kaesermann, F.; Spaeth, P.; Helbert, M.; Salama, A.; van Schaik, I.N.; Yuki, N.

    2009-01-01

    P>The posters presented at the 6th International Immunoglobulin Symposium covered a wide range of fields and included both basic science and clinical research. From the abstracts accepted for poster presentation, 12 abstracts were selected for oral presentations in three parallel sessions on

  13. Self-Presentation: A Conceptualization and Model.

    Science.gov (United States)

    Schlenker, Barry R.

    This paper provides a conceptual definition and model of self-presentational behavior. Self-presentation is defined as the attempt to control self-relevant images before real or imagined others. Several aspects of the definition are discussed along with the notion that people's self-presentations represent the choice of the most desirable images…

  14. Interpersonal Barriers to Stopping Animal Abuse: Exploring the Role of Adolescent Friendship Norms and Breeches

    Science.gov (United States)

    Arluke, Arnold

    2012-01-01

    Research into bystander apathy has focused on the barriers to intervening when the perpetrators and witnesses of violence are strangers. Although violence also occurs in the presence of friends, family, and other close ties, it is unclear how these affiliations constrain the behavior of bystanders in these situations. To explore this question,…

  15. A Study of Dynamic Impact Models for Pile-Driver Breech Fatigue System

    Science.gov (United States)

    2008-03-01

    for the energy loss due to impact. Yigit et al. [3] showed that a spring-dashpot model with nonlinear stiffness and damping law gives good results...S. Yigit , A. G. Ulsoy and R. A. Scott, "Spring-Dashpot Models for the Dynamics of a Radially Rotating Beam with Impact," Journal of Sound and... Yigit et al. : “Spring-Dashpot Models for the Dynamics of a Radially rotating Beam with Impact,” J of Sound and Vibration (1990) H.M. Lankarani et al

  16. Optimized Breech Location in the Harry Diamond Laboratories 4-Inch Gas Gun

    Science.gov (United States)

    1982-04-01

    CA 93041 COMMANDER DAVID W. TAYLOR NAVAL SHIP RESEARCH S DEVELOPMENT CENTER ATTN ELIZABETH DEMPSEY, CODE 534 ATTN PAUL GRANVILLE, CODE 581...189 ATTN S. SUGARMAN GREEN ACRES ROAD WEST VALLEY STREAM, NY 11582 BOEING COMPANY AEROSPACE COMPANY PO BOX 3707 ATTN 8K-38, RUTH E. PERRENBOOM

  17. Thermal Management of Rapid Fire Gun Breeches: The Case for Heat Pipes

    Science.gov (United States)

    1992-07-01

    at a Depth of 1 Inch ........................................... 23 10. The Effect of the Presence of an Embedded Heat Pipe: Temperature vs. Tim e...desired, the lower the boiling point of the liquid chosen has to be. Exercising the gun barrel heat transfer algorithm of Polk (1980), the effect of the presence of an

  18. Antigen cross-presentation of immune complexes

    Directory of Open Access Journals (Sweden)

    Barbara ePlatzer

    2014-04-01

    Full Text Available The ability of dendritic cells (DC to cross-present tumor antigens has long been a focus of interest of physicians, as well as basic scientists, that aim to establish efficient cell-based cancer immune therapy. A prerequisite for exploiting this pathway for therapeutic purposes is a better understanding of the mechanisms that underlie the induction of tumor-specific cytotoxic T-lymphocyte (CTL responses when initiated by DCs via cross-presentation. The ability of humans DC to perform cross-presentation is of utmost interest as this cell type is a main target for cell-based immunotherapy in humans. The outcome of a cross-presentation event is guided by the nature of the antigen, the form of antigen uptake and the subpopulation of DCs that performs presentation. Generally, CD8+ DCs are considered to be the most potent cross-presenting DCs. This paradigm, however, only applies to soluble antigens. During adaptive immune responses, immune complexes form when antibodies interact with their specific epitopes on soluble antigens. Immunoglobulin G (IgG immune complexes target Fc-gamma receptors on DCs to shuttle exogenous antigens efficiently into the cross-presentation pathway. This receptor mediated cross-presentation pathway is a well-described route for the induction of strong CD8+ T cell responses. IgG-mediated cross-presentation is intriguing because it permits the CD8- DCs, which are commonly considered to be weak cross-presenters, to efficiently cross-present. Engaging multiple DC subtypes for cross-presentation might be a superior strategy to boost CTL responses in vivo. We here summarize our current understanding of how DCs use IgG-complexed antigens for the efficient induction of CTL responses. Because of its importance for human cell therapy, we also review the recent advances in the characterization of cross-presentation properties of human DC subsets.

  19. Antigen cross-presentation of immune complexes.

    Science.gov (United States)

    Platzer, Barbara; Stout, Madeleine; Fiebiger, Edda

    2014-01-01

    The ability of dendritic cells (DCs) to cross-present tumor antigens has long been a focus of interest to physicians, as well as basic scientists, that aim to establish efficient cell-based cancer immune therapy. A prerequisite for exploiting this pathway for therapeutic purposes is a better understanding of the mechanisms that underlie the induction of tumor-specific cytotoxic T-lymphocyte (CTL) responses when initiated by DCs via cross-presentation. The ability of humans DC to perform cross-presentation is of utmost interest, as this cell type is a main target for cell-based immunotherapy in humans. The outcome of a cross-presentation event is guided by the nature of the antigen, the form of antigen uptake, and the subpopulation of DCs that performs presentation. Generally, CD8α(+) DCs are considered to be the most potent cross-presenting DCs. This paradigm, however, only applies to soluble antigens. During adaptive immune responses, immune complexes form when antibodies interact with their specific epitopes on soluble antigens. Immunoglobulin G (IgG) immune complexes target Fc-gamma receptors on DCs to shuttle exogenous antigens efficiently into the cross-presentation pathway. This receptor-mediated cross-presentation pathway is a well-described route for the induction of strong CD8(+) T cell responses. IgG-mediated cross-presentation is intriguing because it permits the CD8(-) DCs, which are commonly considered to be weak cross-presenters, to efficiently cross-present. Engaging multiple DC subtypes for cross-presentation might be a superior strategy to boost CTL responses in vivo. We here summarize our current understanding of how DCs use IgG-complexed antigens for the efficient induction of CTL responses. Because of its importance for human cell therapy, we also review the recent advances in the characterization of cross-presentation properties of human DC subsets.

  20. Clinical presentation of adult coeliac disease.

    LENUS (Irish Health Repository)

    Tajuddin, T

    2012-02-01

    The mode of presentation of coeliac disease has been changing to more atypical or silent disease. Few studies described the clinical presentation of adult coeliac disease in Ireland in recent years. We retrospectively collected the clinical data for all patients who had a diagnosis of coeliac disease made in our centre between January 07 and December 08. Forty seven adults, predominantly females (n = 30), had a confirmed diagnosis of coeliac disease made during the study period. In our patient cohort, the presenting symptom was diarrhoea in 19 (40%) patients, while 16 patients (34%) did not have any G.I. symptoms, 10 (21%) presented with anaemia. Females presented at a significantly younger age compared to males, with median ages at diagnosis of 44.5 and 57 years, respectively (p = 0.04). Females also presented more commonly with non G.I. symptoms (p = 0.07). The reasons behind this gender difference need further study.

  1. Poster presentations: valuing all forms of evidence.

    Science.gov (United States)

    Halligan, Phil

    2008-01-01

    This paper aims to assist readers who are considering submitting a poster presentation to a conference to appreciate their true worth and demonstrate the important contribution they can make to nursing scholarship and secondly, to provide new insights to conference reviewers who have the task of selecting appropriate contributions for conferences. The author will argue that the use of poster presentations is an ideal opportunity to disseminate research findings and clinical innovations. It offers a new, interesting, and thought-provoking perspective on poster presentations, which includes appraisal of extant literature and reflections about the significance of poster presentations to nursing scholarship. It highlights the benefits of submitting a poster presentation and concludes with some key points for conference reviewers to consider when deciding to select the suitability of abstracts for poster presentations or concurrent sessions.

  2. Mediated Teaching for Information Presenting and Understanding

    Directory of Open Access Journals (Sweden)

    Konstantinas Danaitis

    2011-04-01

    Full Text Available Nowadays media is readily moving into various spheres of life. The computer, projector and screen replace trivial chalk and board. Slides are used in various designated areas: promotional presentations at meetings as a form of communication between participants and also as visual presentation of lecture material content of the report. It was found that a human catches up and remembers only about 10% of what he has read, 20% of what he has heard and even 50% of what he heard and saw. Therefore, high-quality and Professional presentation of information in the slide form has a significant impact on the uptake. The authors present a solution how to present the study material qualitatively and use the media system effectively for teaching computer graphics course. This course is taught for VGTU first or second year students of almost all specialities. This presentation of study materials facilitates the teacher's work and improves the readability and solutions of study materials.

  3. Trismus: An unusual presentation following road accident

    Directory of Open Access Journals (Sweden)

    Thakur Jagdeep

    2007-01-01

    Full Text Available Trismus due to trauma usually follows road accidents leading to massive faciomaxillary injury. In the literature there is no report of a foreign body causing trismus following a road accident, this rare case is an exception. We present a case of isolated presentation of trismus following a road accident. This case report stresses on the thorough evaluation of patients presenting with trismus following a road accident.

  4. Subacute sclerosing panencephalitis presenting as mania

    Directory of Open Access Journals (Sweden)

    Aggarwal Ashish

    2011-01-01

    Full Text Available Subacute sclerosing panencephalitis (SSPE is a rare, invariably fatal degenerative disease of the central nervous system developing after measles infection. Besides neurological symptoms as initial presenting symptoms, rare reports of its presentation with pure psychiatric symptoms have been reported. We here report a case of 14 year old male who initially presented with manic symptoms and then subsequently diagnosed to be suffering from SSPE. Improtance of ruling our organic conditions is emphasized.

  5. Subacute sclerosing panencephalitis presenting as mania

    Science.gov (United States)

    Aggarwal, Ashish; Khandelwal, Ashish; Jain, Manish; Jiloha, R. C.

    2011-01-01

    Subacute sclerosing panencephalitis (SSPE) is a rare, invariably fatal degenerative disease of the central nervous system developing after measles infection. Besides neurological symptoms as initial presenting symptoms, rare reports of its presentation with pure psychiatric symptoms have been reported. We here report a case of 14 year old male who initially presented with manic symptoms and then subsequently diagnosed to be suffering from SSPE. Improtance of ruling our organic conditions is emphasized. PMID:21808475

  6. Extramedullary leukemia in children presenting with proptosis

    OpenAIRE

    Naik Milind; Honavar Santosh G; Vemuganti Geeta K; Murthy Ramesh; Reddy Vijayanand

    2009-01-01

    Abstract Background We highlight the orbital manifestations of acute myeloid leukemia and the role of peripheral blood smear in the diagnosis of these cases. A total of 12 patients who presented with proptosis and were subsequently diagnosed to have acute myeloid leukemia based on incision biopsy or peripheral blood smear were included in the study. Results A retrospective review of all cases of acute myeloid leukemia presenting to the Orbital clinic was performed. The age at presentation, ge...

  7. Eccrine angiomatous hamartoma: Late onset facial presentation

    Directory of Open Access Journals (Sweden)

    Chinmay Halder

    2014-01-01

    Full Text Available Eccrine angiomatous hamartoma (EAH is a very rare benign neoplastic condition characterized by hamartomatous proliferation of eccrine glands and accompanying blood vessels and lymphatics. These lesions are more often present at birth or appear during early infancy and childhood and present as solitary nodule or plaque with occasional pain and sweating. They are generally present on the extremities, mostly the palms and soles. We report here a case of EAH in a 20-year-old female who presented with a solitary angiomatous plaque close to the lower eyelid of the right eye with occasional pain and sweating for its rarity.

  8. Selected Regional Judicial Officer Cases, 2005 - Present

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset contains selected cases involving EPA's Regional Judicial Officers (RJOs) from 2005 to present. EPA's Regional Judicial Officers (RJOs) perform...

  9. Genitourinary complications as initial presentation of inherited ...

    African Journals Online (AJOL)

    Epidermolysis bullosa (EB) is a rare disorder that presents with urological complications. We present a 6-year-old boy admitted with urological symptoms that revealed an inherited EB misdiagnosed. We also review the literature on this disorder and management of the common urological complications.

  10. Speechline - a method for teaching oral presentation

    DEFF Research Database (Denmark)

    Juel, Henrik

    2015-01-01

    The Speech-line method aims at improving the active rhetorical skills of students, i.e. their ability to present academic subjects in a clear and convincing manner. This is relevant not only for everyday classroom work, but also for oral exams, for presenting research projects, and for addressing...

  11. Neurocysticercosis presenting as Millard Gubler syndrome

    Directory of Open Access Journals (Sweden)

    Rajniti Prasad

    2012-01-01

    Full Text Available Neurocysticercosis is a common childhood neurological illness in India. A variety of presentations have been reported in the literature, including weber syndrome. Neurocysticercosis, manifesting as Millard Gubler syndrome, have not been reported in literature. Therefore, we report a child presented to us with Millard Gubler syndrome due to pontomedullary neurocysticercosis and was treated successfully.

  12. Presentation Trainer Prototype 2.0

    NARCIS (Netherlands)

    Schneider, Jan; Börner, Dirk

    2014-01-01

    It is a tool to train nonverbal communication skills for presentations. It was the first tested version of the Presentation Trainer for the PhD project on sensor-based learning support. It includes the first dashboard design of the trainer. Available under the GNU LGPL licence version 3 or higher.

  13. Unusual presentations of childhood acute lymphoblastic leukaemia ...

    African Journals Online (AJOL)

    Childhood acute lymphoblastic leukaemia, (ALL) is increasingly reported to present in an atypical fashion which may have significant implications for treatment outcomes and survival. This case report presents a Nigerian child who's clinical and radiological features together with effusion cytological findings were suggestive ...

  14. Changing Dynamics in the Voluntary Market (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, J.

    2014-12-01

    Voluntary green power markets are those in which consumers and institutions voluntarily purchase renewable energy to match their electricity needs. This presentation, presented at the Renewable Energy Markets Conference in December 2014, outlines the voluntary market in 2013, including community choice aggregation and community solar.

  15. Hansen's disease (HD): unusual presentations | Onyekonwu ...

    African Journals Online (AJOL)

    Hansen's disease (HD): unusual presentations. CL Onyekonwu, YM Olumide, D Altraide, NC Ahamefule, O Ayanlowo, NE Essen, TT Mohammed. Abstract. Although leprosy has well defined clinical presentations which make early diagnosis possible, and curable treatment instituted promptly, new cases continue to emerge ...

  16. Pneumoperitoneum: An unusual presenting finding of perforated ...

    African Journals Online (AJOL)

    Pneumoperitoneum is rarely encountered as a radiographic finding in association with perforated appendicitis in children, and may lead to diagnostic errors. In this paper, we present pneumoperitoneum as a presenting finding of perforated appendicitis in a 2-year-old boy. The term pneumoperitoneum frequently indicates ...

  17. Clinical presentation and precipitating factors of diabetic ...

    African Journals Online (AJOL)

    13.8%), 3(10.3%) and 1(3.4%) presented with vomiting, abdominal pain, Kussmaul's breathing and coma, respectively. Nausea, weight loss and polyphagia each were presented by 2(6.9%) patients. The precipitating factors were infection 15 ...

  18. Central nervous system tuberculomata presenting as internuclear ...

    African Journals Online (AJOL)

    Central nervous system (CNS) tuberculoma can have variable presentation depending upon the site and number of tuberculomata. We are reporting a rare case of a 15 years old girl who presented to our hospital with binocular diplopia on right gaze. Clinical examination revealed left sided internuclear ophthalmoplegia ...

  19. History Making and Present Day Politics

    DEFF Research Database (Denmark)

    Jensen, Steffen Bo

    2008-01-01

    Review of History Making and Present Day Politics: The meaning of Collective Memory in South Africa, by Hans Erik Stolten (ed.). Uppsala: The Nordic Africa Institute, 2007; pp. 376.......Review of History Making and Present Day Politics: The meaning of Collective Memory in South Africa, by Hans Erik Stolten (ed.). Uppsala: The Nordic Africa Institute, 2007; pp. 376....

  20. Present Status of the Experiment TGV II

    Science.gov (United States)

    Štekl, I.; Čermák, P.; Beneš, P.; Brudanin, V. B.; Rukhadze, N. I.; Egorov, V. G.; Kovalenko, V. E.; Kovalík, A.; Salamatin, A. V.; Vylov, Ts.; Šimkovic, F.

    2002-04-01

    Present status of the experiment TGV II is given. The experiment TGV II is devoted to the measurement of double-beta decay of 106Cd and 48Ca. The new HPGe multi-detector TGV spectrometer has been constructed and installed in the Modane underground laboratory (in France). Preliminary results of the first background measurement are presented.

  1. Tumors Presenting as Multiple Cranial Nerve Palsies

    Directory of Open Access Journals (Sweden)

    Kishore Kumar

    2017-04-01

    Full Text Available Cranial nerve palsy could be one of the presenting features of underlying benign or malignant tumors of the head and neck. The tumor can involve the cranial nerves by local compression, direct infiltration or by paraneoplastic process. Cranial nerve involvement depends on the anatomical course of the cranial nerve and the site of the tumor. Patients may present with single or multiple cranial nerve palsies. Multiple cranial nerve involvement could be sequential or discrete, unilateral or bilateral, painless or painful. The presentation could be acute, subacute or recurrent. Anatomic localization is the first step in the evaluation of these patients. The lesion could be in the brain stem, meninges, base of skull, extracranial or systemic disease itself. We present 3 cases of underlying neoplasms presenting as cranial nerve palsies: a case of glomus tumor presenting as cochlear, glossopharyngeal, vagus and hypoglossal nerve palsies, clivus tumor presenting as abducens nerve palsy, and diffuse large B-cell lymphoma presenting as oculomotor, trochlear, trigeminal and abducens nerve palsies due to paraneoplastic involvement. History and physical examination, imaging, autoantibodies and biopsy if feasible are useful for the diagnosis. Management outcomes depend on the treatment of the underlying tumor.

  2. Dandy Walker malformation (variant): late presentation with ...

    African Journals Online (AJOL)

    We present a rare case of Dandy Walker Syndrome in a child who presents with complaints of frontal headache, neck pain, fever, progressive visual impairment and multiple generalized tonic clonic seizures, inability to stand and urinary incontinence. Given the clinical and neuro-imaging findings, the diagnosis of Dandy ...

  3. An unusual presentation of congenital bronchoesophageal fistula ...

    African Journals Online (AJOL)

    An unusual presentation of congenital bronchoesophageal fistula. OM Atalabi, AG Falade, OM Obajimi, OO Akinyinka, SB Lagundoye, PO Ibinaiye. Abstract. We present the case of a 5-week-old neonate with multiple congenital abnormalities including a broncho-oesophageal fistula, which showed radiological features ...

  4. Acute neonatal presentation of a lymphatic malformation

    NARCIS (Netherlands)

    Tang, C.Y.; Wijnen, M.H.; Sambeeck, S.J. van; Halbertsma, F.J.

    2013-01-01

    Oropharyngeal lymphatic malformations usually present with a mass either at birth or in the first 2 years of life. Rarely, lymphatic malformations present with extremely progressive respiratory problems shortly after birth, and usually occur in cases which have remained undetected in the absence of

  5. Acute disseminated encephalomyelitis presenting with hypertensive emergency.

    Science.gov (United States)

    Ganguly, Samrat; Das, Mousumi; Bagchi, Nilay Ranjan

    2014-04-01

    We report a 12-year-old girl presenting with acute disseminated encephalomyelitis (ADEM) along with hypertensive emergency. Hypertension persisted for few weeks following recovery and subsided with oral clonidine. Although autonomic instability in ADEM has been reported before, hypertensive emergency was not previously documented as presenting feature of ADEM.

  6. Cellular schwannoma arising from sigmoid mesocolon presenting ...

    African Journals Online (AJOL)

    We present a case of a 58‑year‑old female with a massive twisted tumor arising from sigmoid mesocolon. The tumor was diagnosed to be a case of cellular schwannoma, an exceedingly rare tumor in this location with rare presentation. Keywords: Pelvis, Retroperitoneum, Schwannoma, Sigmoid mesocolon, Torsion, Tumor ...

  7. Cellular Schwannoma Arising from Sigmoid Mesocolon Presenting ...

    African Journals Online (AJOL)

    We present a case of a 58‑year‑old female with a massive twisted tumor arising from sigmoid mesocolon. The tumor was diagnosed to be a case of cellular schwannoma, an exceedingly rare tumor in this location with rare presentation. Keywords: Pelvis, Retroperitoneum, Schwannoma, Sigmoid mesocolon, Torsion, Tumor.

  8. Clinical Presentation and Histopathological Description of the ...

    African Journals Online (AJOL)

    46987.2

    acute and chronic interstitial nephritis, haemolytic uremic syndrome and many others. Objective: To determine the clinical and histopathological presentation of the spectrum of renal diseases in HIV infected adult patients presenting with renal insufficiency at the University Teaching Hospital,. Lusaka. Methods: This was a ...

  9. Presenting directions with a vibrotactile torso display

    NARCIS (Netherlands)

    Erp, J.B.F. van

    2005-01-01

    Vibrotactile displays covering the torso present spatial information in an intuitive way since the stimuli are directly mapped to the body coordinates; left is left, front is front, etc. The present study investigated the direction in the horizontal plane to which a specific torso location is mapped

  10. Dynamic bowel obstruction: aetiology, clinical presentation ...

    African Journals Online (AJOL)

    This study was conducted to describe in our region, the aetiology, clinical presentation, management and outcome of dynamic bowel obstruction. Data were analyzed using SPSS software system. A total of 342 patients were studied. Males outnumbered females by a ratio of 2.1: 1. The median age of patients at presentation ...

  11. primary pyloroduodenal tuberculosis presenting as gastric outlet ...

    African Journals Online (AJOL)

    computer center

    aggregates of epitheloid cells granulomas,. Langhan's giant cells as well as areas of caseous necrosis along with few glands. The features were typical of tuberculosis. Tissue sections for Acid-fast bacilli was not done since it presented the most florid microscopic presentation and a screening tests for HIV, infection was not ...

  12. Amalgam contact hypersensitivity lesion: an unusual presentation ...

    African Journals Online (AJOL)

    However, ACHL presenting primarily as a black pigmented lesion is extremely rare if not reported. The clinician should be aware of one such presentation of ACHL; we report a unique case of ACHL in a 30‑year‑old female with such a pigmented lesion in close contact with amalgam restorations. The lesion regressed ...

  13. Holocord syrinx presenting as hemi anhidrosis

    Directory of Open Access Journals (Sweden)

    Sunil Kumar

    2013-01-01

    Full Text Available We present a 41-year-old man with Chiari type 1 malformation and syrinx up to tenth thoracic level who presented with left side hemi anhidrosis. Neurological findings of syrinx were absent in this case. Though Horner′s syndrome is reported, this report is probably first.

  14. Rheumatological presentation of developmental bone diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kalifa, Gabriel; Cohen, Pierre alain; Hamidou, Amine

    2000-02-01

    Developmental bone disease may be present, with rheumatological disorders as the major symptoms, even in children. The major lesions encountered are early osteo arthritis, osteo chondromatosis and vertebral involvement with two leading types, pseudo Scheuermann's disease or pseudo ankylosing spondylitis. This paper presents the different features and lists the rheumatological problems in bone dysplasia.

  15. Evaluating the visibility of presentation slides

    Science.gov (United States)

    Sugawara, Genki; Umezu, Nobuyuki

    2017-03-01

    Presentations using slide software such as PowerPoint are widely performed in offices and schools. The improvement of presentation skills among ordinary people is required because these days such an opportunity of giving presentation is becoming so common. One of the key factors for making successful presentation is the visibility of the slides, as well as the contents themselves. We propose an algorithm to numerically evaluate the visibility of presentation slides. Our method receives a presentation as a set of images and eliminates the background from the slides to extract characters and figures. This algorithm then evaluates the visibility according to the number and size of characters, their colors, and figure layouts. The slide evaluation criteria are based on the series of experiments with 20 participants to parameterize typical values for visual elements in slides. The algorithm is implemented on an iMac and takes 0.5 sec. to evaluate a slide image. The evaluation score is given as a value between 0 and 100 and the users can improve their slide pages with lower scores. Our future work includes a series of experiments with various presentations and extending our method to publish as a web-based rating service for learning presentation skills.

  16. Menkes Disease Presenting with Epilepsia Partialis Continua

    Directory of Open Access Journals (Sweden)

    Tamer Rizk

    2014-01-01

    Full Text Available Aim. We aim to describe a female patient with Menkes disease who presented with epilepsia partialis continua. Case Presentation. Seventeen-months-old Saudi infant was presented with repetitive seizures and was diagnosed to have epilepsia partialis continua. Discussion. Menkes disease (OMIM: 309400 is considered a rare, X-linked recessive neurodegenerative disorder resulting from a mutation in the gene coding for the copper transporting ATPase (ATP7A. Affected individuals usually present with kinky hair, skeletal changes, prolonged jaundice, hypothermia, developmental regression, decreased tone, spasticity, weakness, and therapy resistant seizures. Conclusion. Raising awareness of abnormal presentation of this rare disease may help in the control of seizures through subcutaneous copper supplementation.

  17. Fibrillary glomerulonephritis presenting as crescentic glomerulonephritis

    Directory of Open Access Journals (Sweden)

    H H Shah

    2017-01-01

    Full Text Available Fibrillary glomerulonephritis (FGN is a rare primary glomerular disease that commonly presents clinically with hypertension, proteinuria, microscopic hematuria, and varying degree of renal insufficiency. Histologically, FGN can present with different patterns of glomerular injury, more commonly mesangioproliferative, membranoproliferative, and membranous nephropathy. While crescent formation has been described in some kidney biopsy series of FGN, crescentic glomerulonephritis pattern of glomerular injury has been rarely described. Optimal therapy and outcomes in FGN presenting with crescentic GN is not currently known. We report an adult patient who presented with massive proteinuria and severe renal failure. The kidney biopsy revealed crescentic FGN (C-FGN. The patient remained dialysis dependent despite immunosuppressive therapy. We also briefly review FGN, and the few reported cases of C-FGN that presented as rapidly progressive or advanced renal failure in the literature.

  18. The Design Space of Information Presentation

    DEFF Research Database (Denmark)

    May, Michael; Petersen, Johannes

    2007-01-01

    A semiotic approach to the design space of information presentation is presented in which Formal Concept Analysis (FCA) is used to represent and explore attributes of abstract sign types and the media (graphical, haptic, acoustic, gestic) through which they are presented as specific...... representational forms. Early taxonomies in design have typically been incomplete (in only considering graphics) and inconsistent (in the absence of separation between media and sign types). With digital multimedia and the future semantic web, we need a consistent taxonomy to support component-based flexible...

  19. An unusual presentation of galactosemia: Hemophagocytic lymphohistiocytosis

    Directory of Open Access Journals (Sweden)

    Ahmet Afşin Kundak

    2012-12-01

    Full Text Available Hemophagocytic lymphohistiocytosis (HLH is a rare life-threatening condition. Uncontrolled proliferation of activated lymphocytes secreting high amounts of inflammatory cytokines seems to be the main pathogenesis. The diagnosis of HLH can often be difficult. It may presents in many forms such as fever of unknown origin, hepatitis, acute liver failure, and sepsis-like illness. Here we present a newborn galactosemia case presented with HLH. Close monitoring of the diagnostic criteria of HLH during the course of galactosemia-associated hemophagocytosis, both before and after dietary treatment, should be performed in order to fully determine if the triggering mechanism is infection or accumulation of metabolites.

  20. Gynaecomastia as the initial presentation of thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    Triranjan Sanyal

    2012-01-01

    Full Text Available Gynaecomastia is a well-recognized manifestation of thyrotoxicosis occurring in a widely variable percentage. Some studies have reported the percentage to be high as 40% while others report it being around 10%. The variation can be attributed to the difference in the criteria used to define gynae-comaslia or racial factors. However, thyrotoxicosis presenting with gynaceomastia as an intial manifestation is very rare. Only handful case reports are found in literature. Here we present a case of 35-year-old Indian male, with thyrotoxcosis who presented initially with painful bilateral gynaceomastia.

  1. Lichen planus pigmentosus: two atypical presentation

    Directory of Open Access Journals (Sweden)

    Falguni Nag

    2013-01-01

    Full Text Available Lichen planus pigmentosus (LPP is a chronic pigmentary disorder with variable pattern of presentation. We here by present two cases of LPP one with parallel band like pigmentation over abdomen sparing the abdominal skin creases and other with parallel band like pattern following the Blaschko’s lines over left side of the abdomen. Our cases are unique not only for its presentation but also for the pattern of distribution and LPP should be the differential diagnosis in any pigmentary disorders.

  2. Frequency standards for VLBI, present and future

    Science.gov (United States)

    Sydnor, R. L.

    1983-01-01

    During the last several years, J.P.L. has evaluated a number of different types of frequency standards. These evaluations include measurement of environmetal susceptibilities (barometric pressure, humidity, temperature and magnetic field) and evaluation of stability. Data from these tests are presented for quartz oscillators, rubidium vapor standards, cesium beam standards, hydrogen masers (active and passive) and a superconducting cavity stabilized oscillator. Data on reliability and mechanical ruggedness based on actual field use is also presented. A survey of new frequency standards, their likely performance and environmental characteristics is presented.

  3. Conjunctival Eyelashes: A Rare Presentation of Dermoid

    Directory of Open Access Journals (Sweden)

    Gene Kim

    2014-01-01

    Full Text Available Purpose: To describe a previously unreported presentation of a conjunctival dermoid. Case Report: An 8-year-old girl presented with a progressively enlarging mass in the right conjunctival fornix composed of normal appearing eyelashes. The patient had a history of aberrant conjunctival eyelash growth that had caused recurrent conjunctivitis in her right eye over the past few years. The mass was surgically removed and the pathology report revealed it to be a conjunctival dermoid. The patient had an excellent surgical result with normal cosmetic appearance. Conclusion: Mature hair follicle growth from the conjunctiva is another possible presentation of a conjunctival dermoid that can be cured by simple surgical excision.

  4. Offshore Wind Energy Market Overview (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Baring-Gould, I.

    2013-07-01

    This presentation describes the current international market conditions regarding offshore wind, including the breakdown of installation costs, how to reduce costs, and the physical siting considerations considered when planning offshore wind construction. The presentation offers several examples of international existing and planned offshore wind farm sites and compares existing international offshore resources with U.S. resources. The presentation covers future offshore wind trends and cites some challenges that the United States must overcome before it will be able to fully develop offshore wind sites.

  5. Human-machine Interface for Presentation Robot

    Czech Academy of Sciences Publication Activity Database

    Krejsa, Jiří; Ondroušek, V.

    2012-01-01

    Roč. 6, č. 2 (2012), s. 17-21 ISSN 1897-8649 Institutional research plan: CEZ:AV0Z20760514 Keywords : human- robot interface * mobile robot * presentation robot Subject RIV: JD - Computer Applications, Robot ics

  6. An unusual presentation of juvenile Alexander disease.

    Science.gov (United States)

    Osorio, Maria Joana; Risen, Sarah; Alper, Gulay

    2012-04-01

    Alexander disease is a rare leukodystrophy that most often presents in infancy but also includes neonatal, juvenile, and adult variants. Juvenile Alexander disease presents primarily with bulbar symptoms between 2 and 12 years of age. The diagnosis is often suggested by the clinical course and brain magnetic resonance image pattern and then confirmed by the presence of a mutation in the glial fibrillary acidic protein gene. A young girl presented with globus sensation and magnetic resonance imaging of the brain revealed abnormalities mainly involving white matter tracts of the medulla oblongata and cerebellum. The presence of a mutation in the glial fibrillary acidic protein gene confirmed the diagnosis of juvenile Alexander disease. A high index of clinical suspicion is necessary for the diagnosis of late-onset presentations of Alexander disease.

  7. Wind Technologies and Evolving Opportunities (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Robi Robichaud

    2014-03-01

    This presentation provides an overview of wind energy research being conducted at the National Wind Technology Center, market and technology trends in wind energy, and opportunities for wind technology.

  8. Marine geophysical data management and presentation system

    Digital Repository Service at National Institute of Oceanography (India)

    Kunte, P.D.

    ) of the National Institute of Oceanography, Goa, India. GPDMPS is designed for the computerized storage retrieval and presentation of marine geophysical data and information. For the systematic management of geophysical data and information, GPDMPS is subdivided...

  9. Presentation Trainer Prototype 1.0

    NARCIS (Netherlands)

    Börner, Dirk; Specht, Marcus

    2014-01-01

    This software sketch comprises the first prototype of the presentation trainer. The application uses the Microsoft Kinect sensor and was built using the Processing 1.5.1 development environment. Available under the GNU LGPL licence version 3 or higher.

  10. Trough Receiver Heat Loss Testing (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Lewandowski, A.; Feik, C.; Hansen, R.; Phillips, S.; Bingham, C.; Netter, J.; Forristal, R.; Burkholder, F.; Meglan, B.; Wolfrum, E.

    2006-02-01

    This presentation describes the design, fabrication, and qualification of an experimental capability for thermal loss testing of full-size trough receiver elements; and the testing on a variety of receivers.

  11. Unusual presentation in Axenfeld-Rieger syndrome

    Directory of Open Access Journals (Sweden)

    Rajul S Parikh

    2011-01-01

    Full Text Available We report an unusual presentation of a case of Axenfeld-Rieger (A-R syndrome. A 14-year-old male presented with gradual dimness of vision for 1 year and redness of left eye for 3 days. The patient had megalocornea with Haab′s striae in the right eye and posterior embryotoxon in both the eyes. In the left eye, there was a white cord-like structure traversing the anterior chamber with adhesions to iris tissue along its course. On two antiglaucoma medications, his intraocular pressure (IOP was 22 mm Hg in the right eye and 18 mm Hg in the left eye. Gonioscopy revealed a cord-like structure originating at the level of Schwalbe′s line. He underwent right eye trabeculectomy with mitomycin-C. This case highlights a rare presentation of a strange cord-like structure, a rare presentation of A-R syndrome.

  12. The Bats of Latium : Past and Present

    OpenAIRE

    Crucitti, Pierangelo

    2010-01-01

    After briefly reviewing past research, the present status of our knowledge on the bats of Latium, Central Italy, one of the richest biodiversity districts of the Central Mediterranean Ecoregion, is  outlined, highlighting the contribution of Benedetto Lanza.

  13. Melanoacanthoma: Uncommon presentation of an uncommon condition

    Directory of Open Access Journals (Sweden)

    Resham J Vasani

    2013-01-01

    Full Text Available Melanoacanthoma is very rare variant of seborrheic keratosis presenting as a deeply pigmented benign proliferation of melanocytes and keratinocytes usually presenting over the head, neck and trunk of elderly people. A sixty-two-years-old male was presented with a solitary slow growing asymptomatic hyperpigmented verrucous outgrowth with cerebriform surface measuring 15 cm by 8 cm present over the left inguinal region extending on to the scrotum since past 8 years. There was no associated lymphadenopathy. The histopathology revealed hyperkeratosis, papillomatosis, acanthosis with presence of melanocytes at all levels of epidermis with abundant melanin giving the diagnosis of melanoacanthoma. The patient further underwent surgical excision of the lesion. The case is being reported for its rarity, unusual location, massive size and clinical resemblance to a verrucous carcinoma.

  14. Cloud Based Applications and Platforms (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Brodt-Giles, D.

    2014-05-15

    Presentation to the Cloud Computing East 2014 Conference, where we are highlighting our cloud computing strategy, describing the platforms on the cloud (including Smartgrid.gov), and defining our process for implementing cloud based applications.

  15. National Hydrogen Learning Demonstration Status (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Wipke, K.; Sprik, S.; Kurtz, J.; Ramsden, T.; Ainscough, C.; Saur, G.

    2012-02-01

    This presentation discusses U.S. DOE Learning Demonstration Project goals, fuel cell vehicle and H2 station deployment status, and technical highlights of vehicle and infrastructure analysis results and progress.

  16. Subacute Sclerosing Panencephalitis Presenting with Hemidystonia

    Directory of Open Access Journals (Sweden)

    Hepsen Mine Serin

    2014-06-01

    Full Text Available In this paper, we present a case of subacute sclerosing panencephalitis (SSPE in an 11-year-old boy who presented with hemidystonia. Electroencephalogram (EEG revealed periodic epileptiform discharges which did not disappear with diazepam induction. His cranial magnetic resonance imaging was normal. SSPE diagnosis was considered and it was confirmed with the identification of measles antibodies in cerebrospinal fluid. SSPE is a progressive disease. Hemidystonia is not an expected presentation of SSPE. We aimed to emphasize that SSPE may present with different clinical findings such as hemidystonia. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 137-9

  17. Miller Fisher Syndrome Presenting as Pseudotumor

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-05-01

    Full Text Available Two female children, ages 9 and 2 years, who presented with pseudotumor cerebri and within 2 to 3 days, were diagnosed with Miller Fisher syndrome are reported from the Hopital Universitaire des Enfants Reine Fabiola, Brussels, Belgium.

  18. Explorers Presentation: Explaining the Tides to Children

    OpenAIRE

    Institute, Marine

    2015-01-01

    Explaining the tides to children Presentation includes information about: Orbits of the Earth, Moon and Sun; Moon phases and the lunar cycle; Gravity; Gravity and the tide; Types of tides; The tides and me!; Tide tables; Extra insight

  19. Kawasaki Disease Presenting as Acute Clinical Hepatitis

    Directory of Open Access Journals (Sweden)

    Seyed Ali Jafari

    2013-12-01

    Full Text Available Kawasaki disease is a systemic vasculitis of children. Among gastrointestinal symptoms of this disease jaundice occurs uncommonly. We present a 23 month boy with icter and clinical hepatitis and final diagnosis of kawasaki disease.

  20. Acute Lymphoblastic Leukaemia presenting as Juvenile Idiopathic ...

    African Journals Online (AJOL)

    Acute Lymphoblastic Leukaemia presenting as Juvenile Idiopathic Arthritis in a Nigerian boy. ... This may create considerable diagnostic difficulty and ... of two months duration, had an elevated Rheumatoid factor and X-ray findings suggestive ...

  1. Computer Presentation Programs and Teaching Research Methodologies

    Directory of Open Access Journals (Sweden)

    Vahid Motamedi

    2015-05-01

    Full Text Available Supplementing traditional chalk and board instruction with computer delivery has been viewed positively by students who have reported increased understanding and more interaction with the instructor when computer presentations are used in the classroom. Some problems contributing to student errors while taking class notes might be transcription of numbers to the board, and handwriting of the instructor can be resolved in careful construction of computer presentations. The use of computer presentation programs promises to increase the effectiveness of learning by making content more readily available, by reducing the cost and effort of producing quality content, and by allowing content to be more easily shared. This paper describes how problems can be overcome by using presentation packages for instruction.

  2. The Effect of Summarizing and Presentation Strategies

    Directory of Open Access Journals (Sweden)

    Hooshang Khoshsima

    2014-07-01

    Full Text Available The present study aimed to find out the effect of summarizing and presentation strategies on Iranian intermediate EFL learners’ reading comprehension. 61 students were selected and divided into two experimental and control groups. The homogeneity of their proficiency level was established using a TOEFL proficiency test. The experimental group used the two strategies three sessions each week for twenty weeks, while the control group was not trained on the strategies. After every two-week instruction, an immediate posttest was administered. At the end of the study, a post-test was administered to both groups. Paired-sample t-test and Independent sample t-test were used for analysis. The results of the study revealed that summarizing and presentation strategies had significant effect on promoting reading comprehension of intermediate EFL learners. It also indicated that the presentation strategy was significantly more effective on students’ reading comprehension.

  3. Follicular infundibulum tumour presenting as cutaneous horn

    Directory of Open Access Journals (Sweden)

    Jayaraman M

    1996-01-01

    Full Text Available Tumour of follicular infundibulum is an organoid tumour with a plate like growth attached to the epidermis with connection from the follicular epithelium. We are reporting such a case unusually presenting as cutaneous horn.

  4. Late presentation for HIV care across Europe

    DEFF Research Database (Denmark)

    Mocroft, Amanda; Lundgren, Jens; Antinori, Andrea

    2015-01-01

    Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010-2013. People aged ≥ 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrollment......) after 1 January 2010 with available CD4 count within six months of presentation were included. LP was defined as presentation with a CD4 count HIV diagnosis. Logistic regression investigated changes in LP over time. A total.......02-1.32), and a significant decline in LP in northern Europe (aOR/year later 0.89; 95% CI: 0.85-0.94). Further improvements in effective HIV testing strategies, with a focus on vulnerable groups, are required across the European continent....

  5. Atypical presentations of retroperitoneal giant schwannomas

    Directory of Open Access Journals (Sweden)

    Cetin Dincel

    2011-04-01

    Full Text Available Schwannomas are usually benign rare tumors that originating from Schwann cells of peripheral nerve sheaths. Presentation is generally varied and changed in a non-specific range from abdominal mass, flank pain to incidental findings. Herein we report 2 cases of retroperitoneal giant schwannomas with different clinical presentations, of whom one presented with vague abdominal pain, palpable abdominal mass for 4 years, swelling and bilateral hydronephrosis that caused by giant abdominal mass; the other one presented with right flank pain, rectal hemorrhage and lower extremities edema. Two patients were treated by complete surgical excision of masses. The histological and immunohistochemical diagnosis was reported as benign schwannoma. Both of patients are doing well and had no recurrence in 9 years and 28 months follow-up, respectively.

  6. New hazards in paediatric poisoning presentations.

    LENUS (Irish Health Repository)

    Moore, C

    2015-02-01

    Accidental ingestion is an important preventable cause of childhood morbidity. All accidental ingestion presentations (n = 478) to a tertiary paediatric ED from January 2010 to December 2011 were analysed. These results were compared with a similar study in the same institution ten years previously in 2001 and showed that while accidental ingestions constituted a higher proportion of presentations (0.5% in this study v 0.45% in 2001), fewer had investigations performed (21% v 35%) and fewer were admitted (7% v 20%). Accidental ingestions account for 0.5% of presentations and are an important focus of home safety information for parents and guardians. Paracetamol (n = 67, 14%) and liquid detergent capsules (n = 44, 9.2%) were the two most common substances implicated in these presentations, and have the potential to cause severe morbidity and mortality.

  7. Climate Change Workgroup Reports and Presentations

    Science.gov (United States)

    Climate Change Workgroup reports and presentations to discuss and identify the major issues and potential barriers to implementing the Prevention of Significant Deterioration program under the Clean Air Act for greenhouse gases.

  8. Systemic amyloidosis with an exceptional cutaneous presentation.

    Science.gov (United States)

    Barja, Juan; Piñeyro, Francisca; Almagro, Manuel; Sacristán, Felipe; Rodríguez-Lojo, Romina; Fernández-Jorge, Beatriz; Ruanova, Sonia; García-Silva, Jesus

    2013-01-15

    Alopecia and nail distrophy are rare signs of systemic amyloidosis. We present a case with both manifestations and give a brief review of the cutaneous signs of this disease. A biopsy of affected or unaffected skin may provide the diagnosis.

  9. Simultaneous presentation of ectopic pregnancy and hyperthyroidism.

    Science.gov (United States)

    Lyall, H; Mahmood, T A

    2000-02-01

    Hyperthyroidism is known to occur uncommonly in pregnancy (about 0.5 per 1000). The incidence of ectopic pregnancy is approximately 9.6 per 1000 pregnancies. Both conditions, if unrecognised and untreated can have potentially fatal consequences. We describe a case of hyperthyroidism and ectopic pregnancy presenting concurrently, and highlight the difficulties encountered in diagnosis when two clinical conditions present with indistinguishable clinical signs.

  10. Neurocysticercosis presenting as a 'Stroke Mimic'.

    Science.gov (United States)

    Ghasemi, Reza; Rowe, Aimee; Shah, Rajiv; Venkatesan, Pradhib; England, Timothy J

    2016-01-01

    A 62 year old Nepalese gentleman presented with left sided weakness and sensory loss. Initial brain CT scanning was suggestive of acute infarction but a subsequent MRI scan showed cysts with oedema. Cysticercosis serology was positive and a diagnosis of neurocysticercosis was made. The patient made almost a complete recovery after treatment with albendazole, praziquantel and steroids. Neurocysticercosis should be considered in the diffierential diagnosis when patients originating from endemic areas present with focal neurological deficit.

  11. An unusual presentation of a glomus tumour.

    LENUS (Irish Health Repository)

    Nugent, N

    2011-02-01

    Glomus tumours are benign, soft tissue tumours, usually of fingertips. Classically they present with severe pain, temperature sensitivity and localised tenderness. The diagnosis is often delayed due to sometimes non-specific symptoms and rarity of the disorder. While usually a clinical diagnosis, imaging may be necessary for diagnosis and localisation. We present a case of glomus tumour of the fingertip with an unusual history.

  12. Acute lymphoblastic leukemia presenting with gross hematuria

    OpenAIRE

    Kalbani, Naifain Al; Weitzman, Sheila; Abdelhaleem, Mohamed; Carcao, Manuel; Abla, Oussama

    2007-01-01

    A case of a six-year-old boy presenting with gross hematuria is reported. Investigations revealed the etiology of the hematuria to be thrombocytopenia in the setting of newly diagnosed acute lymphoblastic leukemia. The diagnosis of leukemia was confirmed by bone marrow examination. The patient’s hematuria completely resolved with platelet transfusions. Although thrombocytopenia is a very common presenting feature of acute lymphoblastic leukemia, gross hematuria is exceedingly rare. Thus, thro...

  13. Granuloma annulare presenting as contact dermatitis.

    Science.gov (United States)

    Marty, Chelsy L; Cheng, Janet F

    2005-03-01

    Granuloma annulare is a benign idiopathic disorder of the dermis that has various clinical presentations and an unknown etiology. We discuss a patient who presented with a contact dermatitis that demonstrated granuloma annulare on biopsy. The most likely etiologic agent was a substance known as FAZ (an exhaust product of Kodak DryView laser imaging film), to which the patient was exposed in his occupation.

  14. Quality of Experience for Digital Cinema Presentation

    OpenAIRE

    Rahayu, Fitri N

    2011-01-01

    Multimedia presentations of digital media services and devices are meant for human consumption and interaction. Before consumption by the user, the multimedia signal usually goes through several processing stages. Depending on the technologies, including the applied signal processing algorithms, some stages can introduce artefacts that reduce the quality of the multimedia presentation. Quality is a fundamental aspect for the design of any end-to-end multimedia signal processing architecture. ...

  15. Chest wall tumors presenting as breast lumps.

    Science.gov (United States)

    Shousha, Sami; Sinnett, H Dudley

    2004-01-01

    Two recently seen patients presenting with large breast lumps that proved to be pure mesenchymal tumors arising from the underlying chest wall are presented. One tumor proved to be a giant cell tumor of soft tissue and the other an osteogenic sarcoma. It is suggested that these two cases may not be unique and that some mesenchymal breast tumors might have their origin in the chest wall. Breast computed tomography (CT) scans would help identify similar cases.

  16. NUT carcinoma presenting in the palate

    DEFF Research Database (Denmark)

    Bjornstrup, Libana Raffoul; Reibel, Jesper; Kiss, Katalin

    2017-01-01

    NUT carcinomas (NC) are rare and aggressive tumours characterized by chromosomal rearrangements of the gene encoding for nuclear protein of the testis (NUT) located on chromosome 15q14. This article presents a case of a 60-year-old woman diagnosed with NC presenting as a fast growing primary tumour...... differentiated carcinomas without glandular differentiation arising in the chest, and head and neck (Clin Cancer Res, 18, 2012, 5773)....

  17. Sarcoidosis Presenting as Massive Splenic Infarction

    Directory of Open Access Journals (Sweden)

    Ishita Patel

    2012-01-01

    Full Text Available Sarcoidosis is a multisystem granulomatous disease of unknown aetiology. Granulomatous inflammation involving the spleen is common and associated with splenomegaly. However, massive splenomegaly is a rare occurrence. Infrequently massive splenomegaly can result in splenic infarction. Massive splenic infarction in sarcoidosis has, to our knowledge, not been previously reported. We present a case of a woman presenting with massive splenic infarction and sarcoidosis confirmed by granulomatous inflammation of the liver.

  18. Sarcoidosis presenting as massive splenic infarction.

    Science.gov (United States)

    Patel, Ishita; Ismajli, Mediola; Steuer, Alan

    2012-01-01

    Sarcoidosis is a multisystem granulomatous disease of unknown aetiology. Granulomatous inflammation involving the spleen is common and associated with splenomegaly. However, massive splenomegaly is a rare occurrence. Infrequently massive splenomegaly can result in splenic infarction. Massive splenic infarction in sarcoidosis has, to our knowledge, not been previously reported. We present a case of a woman presenting with massive splenic infarction and sarcoidosis confirmed by granulomatous inflammation of the liver.

  19. Sarcoidosis Presenting as Massive Splenic Infarction

    OpenAIRE

    Ishita Patel; Mediola Ismajli; Alan Steuer

    2012-01-01

    Sarcoidosis is a multisystem granulomatous disease of unknown aetiology. Granulomatous inflammation involving the spleen is common and associated with splenomegaly. However, massive splenomegaly is a rare occurrence. Infrequently massive splenomegaly can result in splenic infarction. Massive splenic infarction in sarcoidosis has, to our knowledge, not been previously reported. We present a case of a woman presenting with massive splenic infarction and sarcoidosis confirmed by granulomatous in...

  20. Apathetic thyrotoxicosis presenting with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Resham R. Poudel

    2014-11-01

    Full Text Available Apathetic form of thyrotoxicosis occurs in the elderly who can present with features of hyperglycemia, hypothyroidism, depression, or an internal malignancy. A clinical suspicion and timely diagnosis of hyperthyroidism is needed to define the correct etiology of existing problems, and to prevent grave complications. We discuss an 84-year-old woman who presented with fatigue and uncontrolled diabetes due to apathetic thyrotoxicosis.

  1. Congenital left atrial appendage aneurysm: Atypical presentation

    Directory of Open Access Journals (Sweden)

    Mehdi Bamous

    2017-01-01

    Full Text Available Congenital left atrial appendage aneurysm is a rare condition caused by dysplasia of the atrial muscles. We report a case of a 14-year-old boy, with a 5-month history of cough and in sinus rhythm. Transthoracic echocardiography and computerized tomographic angiography confirmed the aneurysm of the left atrial appendage which was resected through median sternotomy on cardiopulmonary bypass. This case is presented not only for its rarity but also for its atypical clinical presentation.

  2. Multiple myeloma presenting as mandibular pain

    LENUS (Irish Health Repository)

    Crowley, Miriam

    2016-10-01

    Introduction: Multiple myeloma (MM) is a systemic malignancy of plasma cells defined by monoclonal production of circulating immunoglobulins. Bone pain is a presenting feature in the majority of cases. Treatment may involve intravenous use of bisphosphonates, chemotherapy or haematopoietic stem cell transplantation. Here, we illustrate a first presentation of MM in a patient with mandibular pain and discuss radiographic, diagnostic and treatment challenges of orofacial issues in patients with MM.\\r\

  3. PRESENTATION POTENTIAL USING IN PEDAGOGICAL INTERACTION PROCESS

    Directory of Open Access Journals (Sweden)

    Olga V. Ershova

    2016-01-01

    Full Text Available The given article is aimed at considering multimedia presentation potential and its influence on strengthening classroom teacher-student interaction. In the article the importance of using this kind of activity in the study process is pointed in connection with educational state policy on the one hand. On the other hand, gained students’ skills as a final result of work with presentations met employers’ demand for both parent and world labour-markets and bring competitive benefit to the candidates. Scientific novelty and results. Multimedia presentation is considered as a specific complex of classroom activities. The students are oriented on the self analysis and presentation assessment. It is shown that well-organized process of peer students’ assessment allows to simultaneously helping in solving the didactic and methodical problems. To this purpose the system of assessment criteria should be developed. It has to be clear for students for making assessment feasible and time-saving. The example of a possible variant of criteria system is described; quality of the presentations prepared by students can be defined based on such system criteria. The author also analyzed software products of the three main platforms (Windows, Linux, MacOs which have different tools and allow to follow users’ needs for creating presentations. In the article there is a comparative table of the two most popular software development: the program Microsoft PowerPoint and the web-service Prezi for realizing the relevance of their use in the study process. Practical significance of the present article concludes in author’s suggestions of some recommendations for presentation potential use as a tool of improving pedagogical interaction process with contemporary students. 

  4. Acute neonatal presentation of a lymphatic malformation

    OpenAIRE

    Tang, Chee Yan; Van Wijnen, M; van Sambeeck, S J; Halbertsma, F J J

    2013-01-01

    Oropharyngeal lymphatic malformations usually present with a mass either at birth or in the first 2 years of life. Rarely, lymphatic malformations present with extremely progressive respiratory problems shortly after birth, and usually occur in cases which have remained undetected in the absence of antenatal ultrasound. We report the case of a newborn that required tracheostomy and gastrostomy due to a rapidly expansive lymphatic malformation. MRI showed multilocular microcystic lymphatic mal...

  5. Color Image Quality in Presentation Software

    Directory of Open Access Journals (Sweden)

    Edison Valencia

    2008-01-01

    Full Text Available The color image quality of presentation programs is evaluated and measured using S-CIELAB and CIEDE2000 color difference formulae. A color digital image in its original format is compared with the same image already imported by the program and introduced as a part of a slide. Two widely used presentation programs—Microsoft PowerPoint 2004 for Mac and Apple's Keynote 3.0.2—are evaluated in this work.

  6. Musical hallucination: Silent presentation of stroke

    Directory of Open Access Journals (Sweden)

    Prerna Kukreti

    2016-01-01

    Full Text Available Temporal lobe pathologies have often been associated with psychiatric symptoms. Left temporal lobe pathologies usually present with localizing neurological signs, however, right temporal lobe pathologies often go undetected. Here, we describe a case with unique psychopathology in form of musical hallucinations as the only silent manifestation of underlying right temporal lobe stroke. Case presentation, inherent diagnostic dilemma, and innovative treatment methodology have been described.

  7. The multiple oral presentations of multiple myeloma.

    Science.gov (United States)

    Cardoso, Richard C; Gerngross, Peter J; Hofstede, Theresa M; Weber, Donna M; Chambers, Mark S

    2014-01-01

    The purpose of this case series is to show the varied oral presentations of multiple myeloma, illustrating the importance of carefully surveying the oral cavity for suspicious lesions that could be indicative of palpable disease and/or recurrence. The diagnostic criteria and prognostic features for multiple myeloma were also reviewed. This report focuses on five patients with myeloma manifestations involving the oral cavity, in which the oral presentation of multiple myeloma was an early indication of disease relapse. Although the clinical presentation may be variable, the majority of patients will develop lytic bone lesions and less commonly, extramedullary involvement during the course of their disease. The presentation of myeloma can be varied and the oral presentation, although rare, may be the sole manifestation or part of a group of signs of disease progression. Clinical presentations of patients with myelomatous lesions can mimic common dental pathologies, which then, in turn, can lead to delays in diagnosis and treatment. As members of an interdisciplinary oncology team, it is essential to be familiar with oral manifestations of multiple myeloma and proper diagnostic/biopsy techniques in order to avoid misdiagnosis and treatment delays.

  8. Presenting in Virtual Worlds: Towards an Architecture for a 3D Presenter explaining 2D-Presented Information

    NARCIS (Netherlands)

    van Welbergen, H.; Nijholt, Antinus; Reidsma, Dennis; Zwiers, Jakob; Maybury, M.; Stock, O.; Wahlster, W.

    2005-01-01

    Entertainment, education and training are changing because of multi-party interaction technology. In the past we have seen the introduction of embodied agents and robots that take the role of a museum guide, a news presenter, a teacher, a receptionist, or someone who is trying to sell you

  9. Presenting in Virtual Worlds: Towards an Architecture for a 3D Presenter explaining 2D-Presented Information

    NARCIS (Netherlands)

    van Welbergen, H.; Hendler, J.; Goren-Bar, D.; Nijholt, Antinus; Reidsma, Dennis; Mayora-Ibarra, O.; Zwiers, Jakob

    Meeting and lecture room technology is a burgeoning field. Such technology can provide real-time support for physically present participants, for online remote participation, or for offline access to meetings or lectures. Capturing relevant information from meetings or lectures is necessary to

  10. Extramedullary leukemia in children presenting with proptosis.

    Science.gov (United States)

    Murthy, Ramesh; Vemuganti, Geeta K; Honavar, Santosh G; Naik, Milind; Reddy, Vijayanand

    2009-01-24

    We highlight the orbital manifestations of acute myeloid leukemia and the role of peripheral blood smear in the diagnosis of these cases. A total of 12 patients who presented with proptosis and were subsequently diagnosed to have acute myeloid leukemia based on incision biopsy or peripheral blood smear were included in the study. A retrospective review of all cases of acute myeloid leukemia presenting to the Orbital clinic was performed. The age at presentation, gender, presenting features, duration of symptoms and fundus features were noted. In addition the temporal relationship of the orbital disease to the diagnosis of leukemia, laterality, location of the orbital mass, imaging features and the diagnostic tools used to diagnose leukemia were noted. The median age at presentation was 6 years. The male: female ratio was 0.7:1. None of these patients had been diagnosed earlier as having acute myeloid leukemia. The presenting features included proptosis in all patients, orbital mass in 5 (41.7%), visual symptoms in 2 (16.7%) and subconjunctival hemorrhage in one patient (8.3%). A diagnosis of acute myeloid leukemia was established by incision biopsy in 4 patients, subsequently confirmed by peripheral blood smear testing and bone marrow biopsy in 2 patients which revealed the presence of systemic involvement. Imprint smears of the biopsy identified blasts in 2 of 4 cases. In 8 patients presenting with ocular manifestations, diagnosis was established by peripheral blood smear examination alone which revealed a diagnosis of acute myeloid leukemia. A peripheral blood smear should be performed in all cases of sudden onset proptosis or an orbital mass in children and young adults along with an orbital biopsy. It can always be complemented with a bone marrow biopsy especially in cases of aleukemic leukemia or when the blood smear is inconclusive.

  11. Extramedullary leukemia in children presenting with proptosis

    Directory of Open Access Journals (Sweden)

    Naik Milind

    2009-01-01

    Full Text Available Abstract Background We highlight the orbital manifestations of acute myeloid leukemia and the role of peripheral blood smear in the diagnosis of these cases. A total of 12 patients who presented with proptosis and were subsequently diagnosed to have acute myeloid leukemia based on incision biopsy or peripheral blood smear were included in the study. Results A retrospective review of all cases of acute myeloid leukemia presenting to the Orbital clinic was performed. The age at presentation, gender, presenting features, duration of symptoms and fundus features were noted. In addition the temporal relationship of the orbital disease to the diagnosis of leukemia, laterality, location of the orbital mass, imaging features and the diagnostic tools used to diagnose leukemia were noted. The median age at presentation was 6 years. The male: female ratio was 0.7:1. None of these patients had been diagnosed earlier as having acute myeloid leukemia. The presenting features included proptosis in all patients, orbital mass in 5 (41.7%, visual symptoms in 2 (16.7% and subconjunctival hemorrhage in one patient (8.3%. A diagnosis of acute myeloid leukemia was established by incision biopsy in 4 patients, subsequently confirmed by peripheral blood smear testing and bone marrow biopsy in 2 patients which revealed the presence of systemic involvement. Imprint smears of the biopsy identified blasts in 2 of 4 cases. In 8 patients presenting with ocular manifestations, diagnosis was established by peripheral blood smear examination alone which revealed a diagnosis of acute myeloid leukemia. Conclusion A peripheral blood smear should be performed in all cases of sudden onset proptosis or an orbital mass in children and young adults along with an orbital biopsy. It can always be complemented with a bone marrow biopsy especially in cases of aleukemic leukemia or when the blood smear is inconclusive.

  12. The efficient presentation - obstacles, strategies, success

    Directory of Open Access Journals (Sweden)

    Daniela-Elena Radu

    2007-12-01

    Full Text Available The making of presentations has become an omnipresent act of communication in the companies practice, but also in the didactic one. The notoriety and the increase of the importance of an efficient presentation lie in the transformations felt by a society of knowledge, communication being the answer in front of a constant information wave.Business people look in fear at the preparation of a presentation, the interaction with the audience andtheir feedback, all these leading to a low efficiency in transmitting the message.The speaker must overcome a group of obstacles, the most important being the reduced human capacityto capture the information transmitted orally; in this respect, he has available a group of visual instruments and strategies to capture the attention. In order to achieve efficiency one needs mental and emotional preparation, knowing the audience and the presentation’s objective and eliminating the old listing format in PowerPoint, for focusing the communication of the audience’s necessities. The present essay aims to analyze the verbal, non-verbal and para-verbal communication act that constitutes the base of any presentation, the reasons that lead to failure and the ways to increase efficiency, in order to succeed in transmitting a well structured and easy to remember message.Many researchers and practice workers within the communication, economic but also IT fields, have tried to find the solution for organizing and transmitting the message during a presentation, in accordance with the new technologies. In elaborating the present paper, we have used our personal experience and data obtained through 30 in-depth interviews,with managers in companies such Bostina Asociatii Skoda, Petrom etc.; we have used in our research articles of honored professors in social sciences from the Harvard and Stanford Universities , researches of the Minnesota and Ulster Universities, as well as works of specialists in marketing and information

  13. Clinical presentation of chronic traumatic encephalopathy

    Science.gov (United States)

    Daneshvar, Daniel H.; Baugh, Christine M.; Seichepine, Daniel R.; Montenigro, Philip H.; Riley, David O.; Fritts, Nathan G.; Stamm, Julie M.; Robbins, Clifford A.; McHale, Lisa; Simkin, Irene; Stein, Thor D.; Alvarez, Victor E.; Goldstein, Lee E.; Budson, Andrew E.; Kowall, Neil W.; Nowinski, Christopher J.; Cantu, Robert C.; McKee, Ann C.

    2013-01-01

    Objective: The goal of this study was to examine the clinical presentation of chronic traumatic encephalopathy (CTE) in neuropathologically confirmed cases. Methods: Thirty-six adult male subjects were selected from all cases of neuropathologically confirmed CTE at the Boston University Center for the Study of Traumatic Encephalopathy brain bank. Subjects were all athletes, had no comorbid neurodegenerative or motor neuron disease, and had next-of-kin informants to provide retrospective reports of the subjects' histories and clinical presentations. These interviews were conducted blind to the subjects' neuropathologic findings. Results: A triad of cognitive, behavioral, and mood impairments was common overall, with cognitive deficits reported for almost all subjects. Three subjects were asymptomatic at the time of death. Consistent with earlier case reports of boxers, 2 relatively distinct clinical presentations emerged, with one group whose initial features developed at a younger age and involved behavioral and/or mood disturbance (n = 22), and another group whose initial presentation developed at an older age and involved cognitive impairment (n = 11). Conclusions: This suggests there are 2 major clinical presentations of CTE, one a behavior/mood variant and the other a cognitive variant. PMID:23966253

  14. Emergency Department Presentations following Tropical Cyclone Yasi.

    Science.gov (United States)

    Aitken, Peter; Franklin, Richard Charles; Lawlor, Jenine; Mitchell, Rob; Watt, Kerrianne; Furyk, Jeremy; Small, Niall; Lovegrove, Leone; Leggat, Peter

    2015-01-01

    Emergency departments see an increase in cases during cyclones. The aim of this study is to describe patient presentations to the Emergency Department (ED) of a tertiary level hospital (Townsville) following a tropical cyclone (Yasi). Specific areas of focus include changes in: patient demographics (age and gender), triage categories, and classification of diseases. Data were extracted from the Townsville Hospitals ED information system (EDIS) for three periods in 2009, 2010 and 2011 to coincide with formation of Cyclone Yasi (31 January 2011) to six days after Yasi crossed the coast line (8 February 2012). The analysis explored the changes in ICD10-AM 4-character classification and presented at the Chapter level. There was a marked increase in the number of patients attending the ED during Yasi, particularly those aged over 65 years with a maximum daily attendance of 372 patients on 4 Feb 2011. The most marked increases were in: Triage categories--4 and 5; and ICD categories--diseases of the skin and subcutaneous tissue (L00-L99), and factors influencing health care status (Z00-Z99). The most common diagnostic presentation across all years was injury (S00-T98). There was an increase in presentations to the ED of TTH, which peaked in the first 24-48 hours following the cyclone and returned to normal over a five-day period. The changes in presentations were mostly an amplification of normal attendance patterns with some altered areas of activity. Injury patterns are similar to overseas experience.

  15. Pyomyositis of Obturator Muscles: Unusual Late Presentation.

    Science.gov (United States)

    Soraganvi, Prasad Channappa; Ramakanth, R

    2013-01-01

    Pyomyositis of obturator muscles is rare condition. Late presentation with deformities of hip misleads the clinician. Late presentation (6 weeks) of this condition has not been reported earlier. This report highlights this unusual presentation of Pyomyositis of the obturator muscles. We are reporting a 14year old female patient presented with limp and pain in hip since 6 weeks. Her hip radiographs were unremarkable. Patient was admitted and MRI done. MRI findings were consistent with obturator pyomyositis. Diagnosis of pyomyositis confirmed by MRI and we performed percutaneous aspiration and drained about 25ml of purulent material mixed with blood. The culture grew Staphylococcus aureus. Patient received intravenous antibiotic for 1week and oral antibiotic for 2weeks. Patient was immobilized in fixed skin traction in Thomas splint for 5days, later gentle mobilization was started. Her condition improved dramatically after aspiration. A follow up MRI done at 3 weeks following aspiration revealed a significant reduction in intramuscular collection of obturator internus and obturator externus. Three weeks following aspiration patient was relieved of the pain and was able to walk normally. At 6 months follow up visit patient was asymptomatic. Late presentation of obturator pyomyositis is rare. We emphasise on careful examination and need for early imaging for diagnosis. Percutaneous drainage results in successful treatment.

  16. Pyomyositis of Obturator Muscles: Unusual Late Presentation

    Directory of Open Access Journals (Sweden)

    Prasad Channappa Soraganvi

    2013-04-01

    Full Text Available Introduction: Pyomyositis of obturator muscles is rare condition. Late presentation with deformities of hip misleads the clinician. Late presentation (6 weeks of this condition has not been reported earlier. This report highlights this unusual presentation of Pyomyositis of the obturator muscles. Case Report: We are reporting a 14year old female patient presented with limp and pain in hip since 6 weeks. Her hip radiographs were unremarkable. Patient was admitted and MRI done. MRI findings were consistent with obturator pyomyositis. Diagnosis of pyomyositis confirmed by MRI and we performed percutaneous aspiration and drained about 25ml of purulent material mixed with blood. The culture grew Staphylococcus aureus. Patient received intravenous antibiotic for 1week and oral antibiotic for 2weeks. Patient was immobilized in fixed skin traction in Thomas splint for 5days, later gentle mobilization was started. Her condition improved dramatically after aspiration. A follow up MRI done at 3 weeks following aspiration revealed a significant reduction in intramuscular collection of obturator internus and obturator externus. Three weeks following aspiration patient was relieved of the pain and was able to walk normally. At 6 months follow up visit patient was asymptomatic. Conclusion: Late presentation of obturator pyomyositis is rare. We emphasise on careful examination and need for early imaging for diagnosis. Percutaneous drainage results in successful treatment. Keywords: Pyomyositis, septic arthritis, infection, obturator muscle.

  17. Self presentation in blogs and social networks.

    Science.gov (United States)

    Brivio, Eleonora; Cilento Ibarra, Francesca

    2009-01-01

    Recent approaches to the study of identity in online contexts underline how people on the Internet have multiple identities and are at risk of identity fragmentation. Subjectivities are context-specific, negotiated with other people and actualized in Self Presentations. The aim of this study is to investigate how social media users deal with choices regarding their Self Presentation and how different profiles of the same person relate to one other. Thirty-six users with accounts on two blog-hosting services and one social network website answered an online structured interview and elaborated on the different choices of Self Presentation for each service. Content Results show users accurately and consciously choose the way they present their Self according to their aims, actual and potential readership, and the technical possibilities of the media. Answers also show that people online are conscious of the multiple presentations they enact, and they feel an underlining sense of unity and coherence, which may be traced back to the concept of Self.

  18. Rare presentation of foot postaxial polydactyly.

    Science.gov (United States)

    Rafique, Atif; Arshad, Ambreen; Abu-Zaid, Ahmed

    2014-01-01

    Polydactyly is a prevalent birth anomaly observed in the foot, and a number of classification systems have been suggested for this condition. Postaxial (fifth or little toe) polydactyly is the most common type. We encountered an exceedingly rare presentation of foot postaxial polydactyly that, to our inspection, had neither been previously classified nor described in published studies. In the present report, we have described an otherwise healthy 2-year-old female who had presented to our clinic with an isolated, extra little toe on her left foot. Foot radiographs revealed the presence of all 5 metatarsals; however, the fifth metatarsal was blocked and did not give rise to the fifth toe. Instead, the fifth (medial normal) and sixth (lateral extra) toes had originated from a single, separate accessory bud from the fourth metatarsal, and the main fourth metatarsal had given rise to the normal fourth toe. The lateral sixth toe was excised, and a periosteal sleeve of the excised extra toe was used for reconstruction of the lateral collateral ligament. We propose that this heretofore unmentioned presentation of postaxial polydactyly be added to the existing systems of classification of pedal polydactyly. A review of the published data pertaining to pedal polydactyly has also been presented. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Somatic presentations of distress in China.

    Science.gov (United States)

    Zaroff, Charles M; Davis, J Mark; Chio, Pit Hoi; Madhavan, Deepak

    2012-11-01

    Somatic presentations of distress are common cross-culturally and are thought to predominate in Asian cultures such as that of China. From an etic perspective, researchers utilizing empirically validated standardized assessment measures find that somatic symptoms are no more common in individuals of Chinese descent than they are in individuals of European descent. In contrast, patient presentations are heavily influenced by culture and are associated with patterns of illness behavior. The objective of the current review is to determine the culture-specific factors contributing to somatic presentations and descriptions of distress in China. The current review was based on a literature search of PubMed and PsychInfo using the terms 'China,' 'Asia,' 'somatoform,' 'somatization,' and 'psychogenic.' Factors contributing to somatic presentations of distress in China include stigma and help-seeking behavior, and assessment approaches that ignore culture-specific patterns of symptom reporting, fail to incorporate somatic metaphor and Chinese conceptualizations of distress that emphasize bodily sensation, and ignore the role that culture-specific normative data and culture specific response patterns may produce on assessment results. From an emic perspective, there are numerous factors contributing to the appearance of a predominantly somatic presentation of distress in China. Implications for clinical practice are discussed.

  20. Chondroblastoma patella presenting as a pathological fracture

    Directory of Open Access Journals (Sweden)

    Gudi Narayan

    2008-01-01

    Full Text Available A 24-year-old male presented with an inability to walk after a trivial fall. He had pain and mild swelling anterior to the right knee for the past one year. X-ray showed a transverse fracture of patella with a lytic lesion occupying most of the two halves of the patella. Fine needle aspiration cytology (FNAC of the lytic lesion revealed a few osteoclastic giant cells and occasional osteoblasts against a hemorrhagic background. Patellectomy was performed. Histology revealed trabecular bone admixed with proliferating chondroid tissue at places admixed with myxoid and fibrous tissue with focal areas of calcification suggestive of chondroblastoma. Focal areas showed osteoclastic giant cells with areas of hemorrhage. The purpose is to present a rare tumor occurring at an unusual site which presented as pathological fracture.

  1. Unusual presentation of isolated metacarpal tuberculosis

    Directory of Open Access Journals (Sweden)

    Amine Marzouki

    2012-01-01

    Full Text Available Metacarpal tuberculosis is a rare presentation of the disease; it represents only 1% of all bone sites. The following report documents the case of a 28-year-old female who sought a consultation for a painful right hand following an injury. Radiographs showed a fracture of the distal fifth metacarpal through a lytic lesion. Histology of a biopsy specimen revealed granulomas with caseous necrosis, specific to tuberculosis. The patient experienced a complete recovery with anti-tubercular treatment. This case of an unusual presentation of isolated metacarpal tuberculosis was reported with the intention of highlighting the rarity of this location. It is therefore imperative to bear in mind the possibility of such atypical presentations of tuberculosis when making a rapid and correct diagnosis and prescribing adequate treatment.

  2. Fuzzy net present value for engineering analysis

    Directory of Open Access Journals (Sweden)

    Ali Nazeri

    2012-10-01

    Full Text Available Cash flow analysis is one of the most popular methods for investigating the outcome of an economical project. The costs and benefits of a construction project are often involved with uncertainty and it is not possible to find a precise value for a particular project. In this paper, we present a simple method to calculate the net present value of a cash flow when both costs and benefits are given as triangular numbers. The proposed model of this paper uses Delphi method to figure out the fair values of all costs and revenues and then using fizzy programming techniques, it calculates the fuzzy net present value. The implementation of the proposed model is demonstrated using a simple example.

  3. Auditorium Acoustics From Past to Present

    Directory of Open Access Journals (Sweden)

    Kabiru Maishanu

    2017-01-01

    Full Text Available The main aim of this paper is to identify how acoustics where generally achieve in auditoriums base on the method, technics and the materials been used. This paper will discuss the transition over time. It will cover how the design began from the past (Roman, Greek baroque, renaissance periods to the present (twentieth century. The paper will further discuss some case studies which are from different periods. The selection of the case study was based on their excellent acoustics qualities of the spaces. It will provide better understanding on how acoustics solution where been achieve in auditoriums/theaters from the past to the present. Finally, the paper will point out some major benefits of using acoustics in auditoriums and also discuss on what causes poor quality sound in the present auditoriums and then suggest the use flat panels technology and line-stone material as it has great impact in in achieving good and qualitative acoustics in the past.

  4. Ancient engineers' inventions precursors of the present

    CERN Document Server

    Rossi, Cesare

    2017-01-01

    This book describes the inventions and designs of ancient engineers who are the precursors of the present. The period ranges mainly from 300 B.C. to 1600 A.D. with several exceptions. Many of the oldest inventions are documented by archaeological finds, often very little known, mainly from Pompeii, Herculaneum and Stabiae and reveal a surprising modernity in their conception. Most of the inventions presented in the first four parts of the book were conceived up to the late Roman Empire and may be considered as milestones, each in their respective field. The fifth part concentrates on more recent centuries. The sixth part deals with some building construction techniques. Generally, for each of the presented inventions, three elements of research and reference are provided: written documents (the classics), iconic references (coins, bas-reliefs, etc.) and archaeological findings. The authors did not write this book for engineers only; hence they describe all the devices without assuming wide technical knowledge...

  5. The LHCb Trigger: Present and Future

    CERN Document Server

    Aaij, R

    2012-01-01

    LHCb is a single arm spectrometer covering the pseudo-rapidity range between 1.9 and 4.9, and has been optimised to perform flavour physics measurements at the LHC. The present two stage trigger system is able to select charm and beauty decay products with high efficiency due the highly inclusive approach of triggering on partially reconstructed decays and the use of a novel multivariate classifier at the second stage. The trigger can select both leptonic and purely hadronic decays. The performance of the trigger is determined from the data itself without having to rely on Monte-Carlo simulation and is presented. LHCb has recently submitted their upgrade LOI, which mainly aims at profiting from much larger luminosities by moving towards a single fully software based trigger. The upgrade strategy and expected performance are presented.

  6. Lyme arthritis: pathogenesis, clinical presentation, and management.

    Science.gov (United States)

    Puius, Yoram A; Kalish, Robert A

    2008-06-01

    Arthritis is one of the most prominent features of Lyme disease, the tick-borne illness caused by Borrelia burgdorferi. Although the pathogenesis of Lyme arthritis is complex and still under study, the clinical presentation and natural history have been established by long-term observation of untreated and treated patients. This review addresses the clinical presentation of Lyme arthritis as a mono- or oligoarticular relapsing/remitting arthritis primarily affecting the large joints and describes presentations in which arthralgias rather than arthritis are seen. Strategies for diagnosis and treatment are discussed, and methods are reviewed for addressing treatment-refractory Lyme arthritis and arthralgias that may occur after treatment of Lyme disease (sometimes as a component of what is known as the post-Lyme disease syndrome).

  7. Presentation of lipid antigens to T cells.

    Science.gov (United States)

    Mori, Lucia; De Libero, Gennaro

    2008-04-15

    T cells specific for lipid antigens participate in regulation of the immune response during infections, tumor immunosurveillance, allergy and autoimmune diseases. T cells recognize lipid antigens as complexes formed with CD1 antigen-presenting molecules, thus resembling recognition of MHC-peptide complexes. The biophysical properties of lipids impose unique mechanisms for their delivery, internalization into antigen-presenting cells, membrane trafficking, processing, and loading of CD1 molecules. Each of these steps is controlled at molecular and celular levels and determines lipid immunogenicity. Lipid antigens may derive from microbes and from the cellular metabolism, thus allowing the immune system to survey a large repertoire of immunogenic molecules. Recognition of lipid antigens facilitates the detection of infectious agents and the initiation of responses involved in immunoregulation and autoimmunity. This review focuses on the presentation mechanisms and specific recognition of self and bacterial lipid antigens and discusses the important open issues.

  8. Multiple Dural Tuberculomas Presenting as Leptomeningeal Carcinomatosis

    Directory of Open Access Journals (Sweden)

    Hasan Kocaeli

    2011-01-01

    Full Text Available Objective and Importance. We present the rare occurrence of multiple dural-based tuberculomas mimicking leptomeningeal carcinomatosis in a young immunocompetent patient. Clinical Presentation. A 36-year-old man presented with a 2-month history of generalized epileptic activity and altered perception. Neurological examination was remarkable for bilateral Babinski's sign. Cranial magnetic resonance imaging (MRI revealed multiple dural-based enhancing lesions with cerebral edema. Intervention. A right frontal craniotomy was performed for diagnosis. Histological examination revealed multiple confluent necrotizing and nonnecrotizing granulomas with giant cells which was consistent with tuberculosis (TB, and the patient was placed on anti-TB therapy for 24 months. Conclusion. To the best of our knowledge isolated diffuse involvement of the dura mater by TB, mimicking leptomeningeal carcinomatosis, as the sole manifestation of disease has not been reported before. Since pachymeningeal TB is rarely suspected when atypical radiological appearance is combined with the absence of systemic disease, biopsy is inevitably required for diagnosis.

  9. Prallethrin Poisoning Presenting as Status Epilepticus

    Directory of Open Access Journals (Sweden)

    D Vijayaraju

    2014-02-01

    Full Text Available Mosquito repellents contain pyrethroid derivatives, as the active ingredient. Data regarding human toxicity following oral intake is limited. This is a case report of an individual who presented with neurotoxicity following oral ingestion of prallethrin (2.4% w/w of a higher concentration present in formulations commercially available than previously. A 22 year old male presented to the emergency Room (ER in status epilepticus. He was managed in the Intensive Care Unit (ICU. No cause for his status could be determined after all laboratory investigations. A review of history with the patient revealed that he had ingested a bottle of liquid mosquito repellent (45 ml. The patient has had no further symptoms on follow up and has been off anti epileptics. Pyrethroid containing mosquito repellents act on neuronal sodium channels causing hyperexcitiability. With no known specific antidotes, symptomatic treatment is the main stay of management.

  10. Vivos Voco: Herzen's Past, Present, and Future

    Directory of Open Access Journals (Sweden)

    Kathleen Frances Parthe

    2014-11-01

    Full Text Available A close reading of the journalism, correspondence, and memoirs of Alexander Herzen (1812–1870 yields a finely tuned relationship to past, present, and future, but not a complete philosophy of history. Herzen described no system, but repeated key metaphors (e.g., the libretto and concepts (e.g. contingency that reflected his understanding of the historical process. For Herzen, history became interesting when it was relieved of predetermined plots and algebraic formulas. However much he studied Russia’s past and planned its future, his preference was for the present, where freedom is most fully experienced in debate and in the need to choose a path forward. He understood the instrumentality of history in how the lives of ordinary people were affected, which remained his measure of progress. Herzen was a “historian of the present,” and his insights are remarkably applicable to twenty-first-century Russia.

  11. Clinical presentation and staging of Hodgkin lymphoma

    DEFF Research Database (Denmark)

    Gallamini, Andrea; Hutchings, Martin; Ramadan, Safaa

    2016-01-01

    In the present chapter the authors present a brief overview of the diagnostic methods proposed over time for Hodgkin lymphoma (HL) spread detection, moving from surgical procedures, through standard radiological and functional imaging techniques to the present state of the art for HL staging...... will be based on a operator-independent, quantitative readings of the scan thanks to a plethora of sophisticated dedicated software, which are now available, able to quantify every voxel captured by the tumor to display the metabolically active tumor volume. Moreover, new tracers are now available able to track...... the new pathways of cellular metabolism beside glycolysis such as amino acids or purine-analogues or specific oncoproteins; the preliminary, promising results will be reported. Preliminary results from other imaging techniques, such as diffusion-weighted magnetic resonance (DW-MRI) will be also reported....

  12. How to present and publish research results

    Directory of Open Access Journals (Sweden)

    Dekanski Aleksandar

    2014-01-01

    Full Text Available The end of each research is to present its results to the public, especially to those who are engaged in similar research. This is particularly true for scientific research. Scientific paper is written report that contains a presentation of the results of the original scientific research. Its format is defined by centuries-old tradition of writing, the editorial practices of the publishers, scientific ethics, accepted standards and requirements of modern printing and publishing. Unfortunately, the experience of the publishers and editors of scientific books and journals show that a large number of submitted contributions are not meeting the minimum requirements to be even considered. This article indicates the most important principles that one should have in mind during creation of full text paper or presentation of scientific results.

  13. Chikungunya fever presenting with acute optic neuropathy.

    Science.gov (United States)

    Mohite, Abhijit Anand; Agius-Fernandez, Adriana

    2015-07-28

    Chikungunya fever is a vector borne virus that typically causes a self-limiting systemic illness with fever, skin rash and joint aches 2 weeks after infection. We present the case of a 69-year-old woman presenting with an acute unilateral optic neuropathy as a delayed complication of Chikungunya virus (CHIKV) infection contracted during a recent trip to the West Indies. She presented to our ophthalmology department with acute painless visual field loss in the right eye and a recent flu-like illness. She was found to have a right relative afferent pupillary defect (RAPD) with unilateral optic disc swelling. Serology confirmed recent CHIKV infection. Treatment with intravenous methylprednisolone was delayed while awaiting MRI scans and serology results. At 5-month follow-up, there was a persistent right RAPD and marked optic atrophy with a corresponding inferior scotoma in the visual field. 2015 BMJ Publishing Group Ltd.

  14. 6th International Immunoglobulin Symposium: poster presentations.

    Science.gov (United States)

    Fernandez-Cruz, E; Kaveri, S V; Peter, H-H; Durandy, A; Cantoni, N; Quinti, I; Sorensen, R; Bussel, J B; Danieli, M G; Winkelmann, A; Bayry, J; Käsermann, F; Späth, P; Helbert, M; Salama, A; van Schaik, I N; Yuki, N

    2009-12-01

    The posters presented at the 6th International Immunoglobulin Symposium covered a wide range of fields and included both basic science and clinical research. From the abstracts accepted for poster presentation, 12 abstracts were selected for oral presentations in three parallel sessions on immunodeficiencies, autoimmunity and basic research. The immunodeficiency presentations dealt with novel, rare class-switch recombination (CSR) deficiencies, attenuation of adverse events following IVIg treatment, association of immunoglobulin (Ig)G trough levels and protection against acute infection in patients with X-linked agammaglobulinaemia (XLA) and common variable immunodeficiency (CVID), and the reduction of class-switched memory B cells in patients with specific antibody deficiency (SAD). The impact of intravenous immunoglobulin on fetal alloimmune thrombocytopenia, pregnancy and postpartum-related relapses in multiple sclerosis and refractory myositis, as well as experiences with subcutaneous immunoglobulin in patients with multi-focal motor neuropathy, were the topics presented in the autoimmunity session. The interaction of dendritic cell (DC)-SIGN and alpha2,6-sialylated IgG Fc and its impact on human DCs, the enrichment of sialylated IgG in plasma-derived IgG, as wells as prion surveillance and monitoring of anti-measles titres in immunoglobulin products, were covered in the basic science session. In summary, the presentations illustrated the breadth of immunoglobulin therapy usage and highlighted the progress that is being made in diverse areas of basic and clinical research, extending our understanding of the mechanisms of immunoglobulin action and contributing to improved patient care.

  15. IAEA Safeguards: Past, Present, and Future

    Energy Technology Data Exchange (ETDEWEB)

    Santi, Peter A. [Los Alamos National Laboratory; Hypes, Philip A. [Los Alamos National Laboratory

    2012-06-14

    This talk will present an overview of the International Atomic Energy Agency with a specific focus on its international safeguards mission and activities. The talk will first present a brief history of the IAEA and discuss its current governing structure. It will then focus on the Safeguards Department and its role in providing assurance that nuclear materials are being used for peaceful purposes. It will then look at how the IAEA is currently evolving the way in which it executes its safeguards mission with a focus on the idea of a state-level approach.

  16. Late presenting Bochdalek hernia with gastric perforation.

    Science.gov (United States)

    Ozkan, Aybars; Bozkurter Cil, Asudan Tugce; Kaya, Murat; Etcioglu, Inci; Okur, Mesut

    2015-01-01

    Late-onset congenital diaphragmatic hernias that give symptoms beyond the neonatal period are rare and are difficult to diagnose. The diagnosis is usually made in case of complications such as intestinal obstruction, strangulation, and perforation, which further necessitate immediate surgical repair. The case of a 5-year-old child presenting with acute respiratory distress with gastric strangulation and perforation secondary to Bochdalek hernia is reported here. Although presentation in the latter ages is less common, congenital diaphragmatic hernia should be included in the differential diagnosis of respiratory distress in children. Symptoms and diagnostic tools should truly be interpreted. Gastrointestinal complications must urgently be recognized, and early surgical intervention must be performed.

  17. Rapid serial visual presentation design for cognition

    CERN Document Server

    Spence, Robert

    2013-01-01

    A powerful new image presentation technique has evolved over the last twenty years, and its value demonstrated through its support of many and varied common tasks. Conceptually, Rapid Serial Visual Presentation (RSVP) is basically simple, exemplified in the physical world by the rapid riffling of the pages of a book in order to locate a known image. Advances in computation and graphics processing allow RSVP to be applied flexibly and effectively to a huge variety of common tasks such as window shopping, video fast-forward and rewind, TV channel selection and product browsing. At its heart is a

  18. Parotid tumor presenting with hemifacial spasm.

    Science.gov (United States)

    Behbehani, Raed; Hussain, Abdulmohsen E; Hussain, Ali N

    2009-01-01

    A 47-year-old man presented with right parotid swelling and a history of frequent attacks of hemifacial spasm. MRI of the brain and neck showed a mass in the right parotid gland. Fine needle aspiration biopsy of the mass revealed a pleomorphic adenoma of the parotid gland, which was confirmed after total right parotidectomy. His attacks of hemifacial spasm did not improve after surgery and 8 months postoperatively, he received botulinum toxin-A injections, which improved his symptoms. Clinicians need to be aware that patients with occult parotid tumors can present like patients with classic hemifacial spasm.

  19. Superconducting RF Cavities Past, Present and Future

    CERN Document Server

    Chiaveri, Enrico

    2003-01-01

    In the last two decades many laboratories around the world, notably Argonne (ANL), TJNAF (formerly CEBAF), CERN, DESY and KEK, decided to develop the technology of superconducting (SC) accelerating cavities. The aim was either to increase the accelerator energy or to save electrical consumption or both. This technology has been used extensively in the operating machines showing good performances and strong reliability. At present, the technology using bulk niobium (Nb) or Nb coated on copper (Cu) is mature enough to be applied for many different applications, such as synchrotron light sources and spallation neutron drivers. Results, R&D work and future projects will be presented with emphasis on application to linear accelerators.

  20. Presenting Software Metrics Indicators- A Case Study

    DEFF Research Database (Denmark)

    Pantazos, Kostas; Shollo, Arisa; Staron, Miroslaw

    2010-01-01

    decisions based on indicators. In essence, visualizing indicators and their dependencies can communicate the information to the stakeholders efficiently if done correctly, or mislead them if not done properly. In this paper we present results of a case study conducted in a unit of Ericsson. During the case...... study we identified the main requirements for methods for visualizing the indicators, developed these visualizations and conducted a series of interviews evaluating them. The results show that the dashboard presentation is the best solution, but that the simple, tabular visualizations are next best...

  1. Miller Fisher syndrome presenting as palate paralysis.

    Science.gov (United States)

    Noureldine, Mohammad Hassan A; Sweid, Ahmad; Ahdab, Rechdi

    2016-09-15

    We report a 63-year old patient who presented to our care initially with a hypernasal voice followed by ataxia, ptosis, dysphonia, and paresthesias. The patient's history, physical examination, and additional tests led to a Miller Fisher syndrome (MFS) diagnosis. Palatal paralysis as an inaugurating manifestation of MFS is quite rare and requires special attention from neurologists and otolaryngologists. Although it may present as benign as an acute change in voice, early diagnosis and prompt management may prevent further complications. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Allocating Variability and Reserve Requirements (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, B.; King, J.; Milligan, M.

    2011-10-01

    This presentation describes how you could conceivably allocate variability and reserve requirements, including how to allocate aggregation benefits. Conclusions of this presentation are: (1) Aggregation provides benefits because individual requirements are not 100% correlated; (2) Method needed to allocate reduced requirement among participants; (3) Differences between allocation results are subtle - (a) Not immediately obvious which method is 'better'; (b) Many are numerically 'correct', they sum to the physical requirement; (c) Many are not 'fair', Results depend on sub-aggregation and/or the order individuals are included; and (4) Vector allocation method is simple and fair.

  3. Tuberculosis presenting as immune thrombocytopenic purpura

    Directory of Open Access Journals (Sweden)

    Bahadir-Erdogan Beril

    2004-09-01

    Full Text Available Abstract Background Although various hematologic abnormalities are seen in tuberculosis, immune thrombocytopenic purpura is a rare event. Case Presentation We report a case of a 29 year-old male who was presented with immune thrombocytopenia-induced hemoptysis, macroscopic hematuria and generalized petechiae. The patient was found to have clinical, microbiological and radiological evidence of active pulmonary tuberculosis. The immune thrombocytopenic purpura was successfully treated with anti-tuberculous drugs combined with corticosteroids and high dose immune globulin therapy. Conclusion Immune thrombocytopenic purpura can be one of the hematological manifestations of tuberculosis which has a global prevalence with increasing incidence secondary to HIV infection.

  4. Isolated arterioportal fistula presenting with variceal hemorrhage.

    Science.gov (United States)

    Nookala, Anupama; Saberi, Behnam; Ter-Oganesyan, Ramon; Kanel, Gary; Duong, Phillip; Saito, Takeshi

    2013-05-07

    We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension. Etiologies for APFs are comprised of precipitating trauma, malignancy, and hereditary hemorrhagic telangiectasia, but these were not the case in our patient. Idiopathic APFs are usually due to congenital vascular abnormalities and thus usually present in the pediatric setting. This is one of the first cases of adult-onset isolated APF who presented with portal hypertension and was successfully managed through endoscopic hemostasis and subsequent interventional radiological embolization.

  5. An unusual presentation of Tropheryma whipplei infection.

    Science.gov (United States)

    Heavener, Trace; Thompson, Michelle; Patel, Chhaya; Forrester, Lisa; Rawls, Donald

    2017-10-01

    Whipple's disease is an infection caused by the Gram-positive bacillus Tropheryma whipplei. Invasion or uptake of the bacteria can occur in various parts of the body. The differential diagnoses are broad due to the wide spectrum of infection, and the disease is diagnosed based on biopsy of suspected lesions, usually in the small intestine. We present the case of a 56-year-old man with no significant prior medical history who presented with swelling and pain in the left eye. Review of systems revealed 6 months of persistent diarrhea, and intestinal biopsy revealed periodic acid-Schiff-positive macrophages.

  6. Type II lepra reaction: an unusual presentation.

    Science.gov (United States)

    Chauhan, S; D'Cruz, S; Mohan, H; Singh, R; Ram, J; Sachdev, A

    2006-01-27

    Ulcers with maculo-papular rash are an unusual presenting feature of leprosy. They occur as result of neuropathy, type-2 lepra reaction or Lucio's phenomenon. The hall mark of type-2 reaction is erythema nodosum. Very rarely it manifests as ulcerative skin lesions. We describe one such unusual case of a young male who presented with multiple ulcers and maculo-papular rash over the legs, chest and abdomen. In addition to this, he had fever, heart murmur, pulmonary infiltrates, neuropathy, and deranged liver function. A clinical differential diagnosis of infective endocarditis and systemic nectrozing vasculitis was made. Skin biopsy showed dense inflammation with lepra bacilli consistent with type-2 lepra reaction.

  7. Acute neonatal presentation of a lymphatic malformation.

    Science.gov (United States)

    Tang, Chee Yan; Wijnen, M; Sambeeck van, S J; Halbertsma, F J J

    2013-08-01

    Oropharyngeal lymphatic malformations usually present with a mass either at birth or in the first 2 years of life. Rarely, lymphatic malformations present with extremely progressive respiratory problems shortly after birth, and usually occur in cases which have remained undetected in the absence of antenatal ultrasound. We report the case of a newborn that required tracheostomy and gastrostomy due to a rapidly expansive lymphatic malformation. MRI showed multilocular microcystic lymphatic malformation. Intralesional bleomycin injections proved to be successful in this patient. A short review of epidemiology, clinical manifestation and treatment is given.

  8. Postpartum preeclampsia: emergency department presentation and management.

    Science.gov (United States)

    Yancey, Lynne M; Withers, Elizabeth; Bakes, Katherine; Abbott, Jean

    2011-04-01

    Postpartum preeclampsia/eclampsia is the presence of hypertension and proteinuria, with or without seizures, occurring up to 4 weeks after delivery. We describe the Emergency Department (ED) presentation, signs and symptoms, results of diagnostic studies, management, and outcome in a cohort of patients diagnosed with postpartum preeclampsia/eclampsia at our institutions, and use this to review the diagnosis and management of postpartum preeclampsia/eclampsia. A retrospective chart review was conducted at two urban teaching hospitals. Twenty-two cases were identified via ICD-9 (International Classification of Diseases, 9(th) revision) codes of discharge diagnoses over an 8-year period. Only those patients who initially presented to an ED in the postpartum period after hospital discharge were included. A standardized data tool was used to extract demographic data, signs and symptoms of preeclampsia/eclampsia, ancillary studies previously associated with eclamptic pathology, and outcome during admission. Of the 22 women, over half (55%) had not been diagnosed with preeclampsia in the ante- or peripartum period. Common prodromal symptoms and signs in the postpartum presentation included headache, visual changes, hypertension, edema, proteinuria, elevated uric acid, and elevated liver function tests. All 4 patients who seized had prodromal symptoms. Women presented from 3 to 10 days postpartum (median: 5 days). Only 10 women were primiparas. Nineteen women presented with diastolic blood pressures > 90 mm, and only 3 of these had diastolic blood pressures of 110 mm Hg or greater. Postpartum preeclampsia/eclampsia often presents to the ED without a history of preeclampsia during the pregnancy. Further, not all women with this diagnosis who present to the ED in the postpartum period will have each of the "classic" features of this disease, including elevated blood pressure, edema, proteinuria, and hyperreflexia. This report is intended to inform emergency physicians of the

  9. Odontoameloblastoma: A rare case with unusual presentation

    Directory of Open Access Journals (Sweden)

    Supreet Jain

    2016-01-01

    Full Text Available The odontoameloblastoma (OA, also known as ameloblastic odontoma, is a very rare odontogenic tumor that is similar to ameloblastoma in its locally aggressive behavior. OA includes odontogenic ectomesenchyme in addition to odontogenic epithelium that resembles an ameloblastoma both in structure and in behavior. Its clinical presentation, however, often mimics the more innocuous odontoma, and hence, the recognition of its aggressive nature is commonly only ascertained after its histopathologic diagnosis following enucleation. This paper presents a rare case of OA with unusual clinical and radiological features.

  10. Hypopituitarism presenting as congestive heart failure

    Directory of Open Access Journals (Sweden)

    S Giri

    2017-01-01

    Full Text Available Sheehan's syndrome (SS develops as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage and is characterized by various degrees of hypopituitarism. Although the occurrence of SS is now rare, it should still be considered in any woman with a history of peripartum hemorrhage who develops manifestations of pituitary hormone deficiency any time following the event. Appropriate hormone replacement therapy results in marked clinical improvement. We present an unusual case of SS in a young lady who continued to have normal menstruation after the index event, had two spontaneous pregnancies, and was diagnosed only 11 years later when she presented to us with acute heart failure.

  11. Complicated alcohol withdrawal presenting as self mutilation.

    Science.gov (United States)

    Patra, Bichitra Nanda; Sharma, Akhilesh; Mehra, Aseem; Singh, Shubhmohan

    2014-01-01

    Self-mutilation has been defined as deliberate self injury to body tissue without the intent to die. There has been an association between substance abuse and self mutilation. Alcoholic hallucinosis is usually in auditory modality and regarded as harmless. But patients can indulge in self harm behavior when the hallucinosis is commanding type. We are presenting a case in which the patient inflicted multiple stab injury to his own abdomen in response to alcoholic hallucinosis. This has clinical implication to enquire about substance abuse in patients presenting to emergency setting. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  12. Heterozygous familial hypercholesterolemia presenting as chylomicronemia syndrome.

    Science.gov (United States)

    Rosenson, Robert S; Najera, Sherwin D; Hegele, Robert A

    Heterozygous familial hypercholesterolemia (HeFH) is characterized by a twofold elevation in low-density lipoprotein cholesterol. Severe elevations in triglycerides are an uncommon manifestation. In this case report, we discuss an atypical presentation of the chylomicronemia syndrome in a patient with HeFH. Genetic analyses of the low-density lipoprotein receptor mutation and single nucleotide polymorphisms that elevate triglycerides provide confirmation for this atypical presentation of HeFH. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  13. Huntington's disease presenting as amyotrophic lateral sclerosis.

    LENUS (Irish Health Repository)

    Phukan, Julie

    2010-08-01

    We present the clinical, electrophysiological and molecular genetic findings of a 58-year-old male with genetically confirmed Huntington\\'s disease (HD) and concurrent clinically definite ALS by El Escorial criteria. The patient presented with asymmetric upper limb amyotrophy and weakness, and subsequently developed chorea and cognitive change. Genetic testing confirmed the presence of expanded trinucleotide repeats in huntingtin, consistent with a diagnosis of Huntington\\'s disease. This case confirms the rare coexistence of Huntington\\'s disease and motor neuron degeneration.

  14. A standardized rubric to evaluate student presentations.

    Science.gov (United States)

    Peeters, Michael J; Sahloff, Eric G; Stone, Gregory E

    2010-11-10

    To design, implement, and assess a rubric to evaluate student presentations in a capstone doctor of pharmacy (PharmD) course. A 20-item rubric was designed and used to evaluate student presentations in a capstone fourth-year course in 2007-2008, and then revised and expanded to 25 items and used to evaluate student presentations for the same course in 2008-2009. Two faculty members evaluated each presentation. The Many-Facets Rasch Model (MFRM) was used to determine the rubric's reliability, quantify the contribution of evaluator harshness/leniency in scoring, and assess grading validity by comparing the current grading method with a criterion-referenced grading scheme. In 2007-2008, rubric reliability was 0.98, with a separation of 7.1 and 4 rating scale categories. In 2008-2009, MFRM analysis suggested 2 of 98 grades be adjusted to eliminate evaluator leniency, while a further criterion-referenced MFRM analysis suggested 10 of 98 grades should be adjusted. The evaluation rubric was reliable and evaluator leniency appeared minimal. However, a criterion-referenced re-analysis suggested a need for further revisions to the rubric and evaluation process.

  15. perforated meckel's diverticulitis presenting as a mesenteric

    African Journals Online (AJOL)

    Damary

    2006-10-10

    Oct 10, 2006 ... Mayo clinic, symptomatic MD formed 16% of 1,479 diverticulae resected over a period of 52 years (2). The complication described in the 26-year old male in this report was disguised as a mesenteric abscess. A common clinical entity associated with the presentation outlined in this case is complicated.

  16. Scalp psoriasis, clinical presentations and therapeutic management

    NARCIS (Netherlands)

    van de Kerkhof, P. C.; de Hoop, D.; de Korte, J.; Kuipers, M. V.

    1998-01-01

    The scalp is a well-known predilection site for psoriasis. Many patients indicate that scalp psoriasis is both psychologically and socially distressing. The aim of the present investigation is to provide epidemiological data on the various manifestations of scalp psoriasis, as well as on its

  17. Presentation, distribution pattern, and management of diverticular ...

    African Journals Online (AJOL)

    We embark on this study aimed at evaluating the presentation, distribution pattern, and the management of diverticulosis in our tertiary health facility. Materials and Methods: A prospective descriptive study of the cases of diverticular disease seen between January 2007 and December 2011 at Obafemi Awolowo University ...

  18. Lysinuric protein intolerance presenting with multiple fractures

    Directory of Open Access Journals (Sweden)

    Jennifer E. Posey

    2014-01-01

    Full Text Available Lysinuric protein intolerance (LPI is a rare autosomal recessive inborn error of metabolism caused by mutations in SLC7A7, which encodes a component of the dibasic amino acid transporter found in intestinal and renal tubular cells. Patients typically present with vomiting, diarrhea, irritability, failure to thrive, and symptomatic hyperammonemia after protein-rich meals. Long-term complications may include pulmonary alveolar proteinosis, renal disease, and osteoporosis. We present a 5-year-old male who was followed in our skeletal dysplasia clinic for 3 years for multiple fractures, idiopathic osteoporosis, and short stature in the absence of typical features of LPI. Whole exome sequencing performed to determine the etiology of the osteoporosis and speech delay identified a nonsense mutation in SLC7A7. Chromosome microarray analysis identified a deletion involving the second allele of the same gene, and biochemical analysis supported the diagnosis of LPI. Our patient's atypical presentation underscores the importance of maintaining a high index of suspicion for LPI in patients with unexplained fractures and idiopathic osteoporosis, even in the absence of clinical symptoms of hyperammonemia after protein rich meals or other systemic features of classical LPI. This case further demonstrates the utility of whole exome sequencing in diagnosis of unusual presentations of rare disorders for which early intervention may modify the clinical course.

  19. Clinico-Pathologic Presentation and Management of ...

    African Journals Online (AJOL)

    ... clinician of any specialty, however, little or no attention have been given to area of neurological, ophthalmological and auditory complications in these patients. This study is aimed at evaluating the clinical, histological presentation and to highlight the need of multi disciplinary approach in the management of this condition.

  20. delayed presentation of blunt traumatic diaphragmatic heria

    African Journals Online (AJOL)

    Zinox

    the spleen and stomach. Through a left thoracotomy, the herniated organs were reduced and diaphragmatic defect closed with interrupted nylon sutures. A high index of suspicion would minimize the morbidity and mortality associated with delayed diagnosis. Keywords: Trauma, diaphragmatic hernia, delayed presentation.

  1. An Integrated Semasiological and Onomasiological Presentation of ...

    African Journals Online (AJOL)

    seeks to break through this obscurity by providing English translations of a selection of articles spanning thirty ... The conclusion is reached that the semasiological presentation of meaning is most appropri- ately located in the ..... gand (1994: 272-273) and the one for musical instruments quoted by Smit (2000: 178-179).

  2. Celiac Disease Presenting with Immune Thrombocytopenic Purpura

    Directory of Open Access Journals (Sweden)

    Hakan Sarbay

    2017-01-01

    Full Text Available Celiac disease (CD is an immunological disorder. Clinical manifestations occur as a result of intestinal mucosa damage and malabsorption. CD is also associated with extraintestinal manifestations and autoimmune disorders. The coexistence of CD and autoimmune diseases has been described before. In this article, a patient with CD presenting with thrombocytopenia is discussed.

  3. Presentation Trainer Prototype 3.0

    NARCIS (Netherlands)

    Schneider, Jan; Börner, Dirk; Storm, Jeroen

    2014-01-01

    It is a tool to train nonverbal communication skills for public speaking. it was the second tested version of the Presentation Trainer. It includes the second dashboard design and the exercise mode of the trainer. Available under the GNU LGPL licence version 3 or higher.

  4. Congenital Uterovaginal Prolapse Present at Birth

    African Journals Online (AJOL)

    Uterovaginal prolapse (UVP) presenting at birth is very rare. To the best of our knowledge, not more than 20 cases of neonatal UVP have been reported in English literature.[1-11] Utero-vaginal prolapse is the downward descent and protrusion of the uterus and vagina to the exterior via the introitus. It is as a result of ...

  5. Bladder calculus presenting as excessive masturbation.

    Science.gov (United States)

    De Alwis, A C D; Senaratne, A M R D; De Silva, S M P D; Rodrigo, V S D

    2006-09-01

    Masturbation in childhood is a normal behaviour which most commonly begins at 2 months of age, and peaks at 4 years and in adolescence. However excessive masturbation causes anxiety in parents. We describe a boy with a bladder calculus presenting as excessive masturbation.

  6. Atypical tuberculosis presenting with primary infertility and ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is caused by mycobacterium tuberculosis. It remains a public health concern especially in developing country. Pulmonary infection is the main presentation. However, genitourinary TB is common especially with the increase in Human Immunodeficiency virus (HIV) infection. Genitourinary TB is one of the ...

  7. Attitude of Programme Presenters towards Broadcasting of ...

    African Journals Online (AJOL)

    The study assessed the attitude of programme presenters towards broadcasting of agricultural programme on electronic media in Kwara state. A two-stage sampling technique was used in selecting a total of 120 respondents from the broadcasting stations in Kwara state. Frequency counts, percentages, means, standard ...

  8. Injury to presentation delays among musculoskeletal trauma ...

    African Journals Online (AJOL)

    Objective: The study sought determine the time it took patients to arrive in the hospitals and document the various factors associated with delays in presentation to hospital. Design: Prospective study. Setting: Accident and Emergency Department, Mulago Hospital , Kampala, Uganda Methods: All musculoskeletal injury ...

  9. How To Develop Streaming Multimedia Lecture Presentations.

    Science.gov (United States)

    Keefe, Thomas

    This paper show instructors how to develop their own streaming multimedia presentations that can be loaded onto a schools' server and played by students over the Internet. Topics covered include: the use of courseware to create an online course or to complement face-to-face instruction; features of Oncourse, Indiana Universitys proprietary version…

  10. Non Ketotic Hyperosmolar Hyperglycemia presenting as Epilepsia ...

    African Journals Online (AJOL)

    We report a patient with epilepsia partialis continua (EPC) associated with non ketotic hyperosmolar hyperglycemia. EPC is an uncommon presentation of nonketotic hyperglycemia. This case was reported in the Medical Intensive Care Unit in Hamad Medical Corporation, Doha, Qatar. Keywords: Epilepsia partialis continua ...

  11. Original article Clinical Presentation, Pathological Pattern and ...

    African Journals Online (AJOL)

    ABSTRACT. Objective: To report the clinical presentation, pathological pattern and treatment options of Prostate. Cancer (PCa) cases diagnosed at Al-Azhar University Hospitals, Cairo, Egypt over the last 30 years. Patients and Methods: Case sheets and hospital records of 322 consecutive cases of prostate cancer.

  12. 31 CFR 240.4 - Presentment guarantees.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Presentment guarantees. 240.4 Section 240.4 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE... Treasury check, not a counterfeit check. (e) Electronic check. If the check is an electronic check, that...

  13. Charcot arthropathy presenting with primary bone resorption.

    Science.gov (United States)

    Jones, Christopher W; Agolley, David; Burns, Kharis; Gupta, Sanjeev; Horsley, Mark

    2012-09-01

    The clinical presentation of acute Charcot arthropathy in the diabetic population usually follows the Eichenholtz classification. We present three usual cases of Charcot arthropathy presenting with rapid primary bone resorption in the absence of subluxation, dislocation and/or fracture. A review of the literature was performed. To our knowledge Charcot arthropathy has not been previously described as primary bone resorption. Three cases encountered at our specialist multidisciplinary High Risk Foot Clinic (HRFC) presented with primary bony resorption without features of subluxation, dislocation and/or fracture. Aggressive primary bone resorption was initially thought due to infection; a diagnostic dilemma that delayed optimal treatment. Late bone resorption in typical Charcot is linked to unregulated proinflammatory cytokines (IL-1β, IL-6 and TNFα) that lead to increased osteoclastic activity. The pathophysiology of osteolysis in aggressive primary bony resorption may relate to a disturbance in the balance between RANK-L and OPG. Primary resorption of bone without subluxation, dislocation and/or fracture can represent an active Charcot process. Prudent use of serial radiography and early MRI to look for the widespread bone and soft tissue oedema is recommended. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Model for Presenting Resources in Scholar's Portal

    Science.gov (United States)

    Feeney, Mary; Newby, Jill

    2005-01-01

    Presenting electronic resources to users through a federated search engine introduces unique opportunities and challenges to libraries. This article reports on the decision-making tools and processes used for selecting collections of electronic resources by a project team at the University of Arizona (UA) Libraries for the Association of Research…

  15. Delayed presentation and diagnosis of metastatic hepatocellular ...

    African Journals Online (AJOL)

    during pregnancy.[2,3] The finding of a hepatic lesion in pregnancy is often incidental, and the diagnosis of early-stage HCC may be delayed as the symptoms are often nonspecific.[4] We ... presentation and diagnosis of metastatic HCC in pregnancy. ... found to have a thrombocytopenia of 86 × 109/L and a haemoglobin of.

  16. Overview of PVQAT: Update and Perspectives (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Kurtz, S.; Wohlgemuth, J.; Yamamichi, M.; Sample, T.; Kelly, G.; Govind, R.

    2015-02-01

    The presentation provides an overview of PVQAT: International PV Quality Assurance Task Force - historical perspective, projects, climate - specific (use - environment -specific) durability testing, consistency of manufacturing, system verification, IECRE vs PVQAT, how to become involved, current status and multiyear targets, goals for today.

  17. Peer Evaluation of Oral Presentations in Croatia

    Science.gov (United States)

    Kovac, Mirjana Matea; Sirkovic, Nina

    2012-01-01

    This paper aims to explore student engagement in peer evaluation activities related to giving scientific presentations in English (L2) and to investigate student attitudes towards this form of evaluation in the course Communication skills in Croatian (L1). The participants in this study were first-year students of engineering in Split, Croatia.…

  18. Clinical presentation and precipitating factors of diabetic ...

    African Journals Online (AJOL)

    MoZarD

    Sciences, Mwanza, Tanzania. 3Department of Microbiology/Immunology, Weill Bugando School of Medicine, Catholic University of Health and. Allied Sciences, Mwanza, Tanzania. Abstract ... clinic to reduce morbidity and mortality in these patients. Keywords: diabetic ketoacidosis, clinical presentation, precipitating factors, ...

  19. The Arizona striped whiptail: past and present

    Science.gov (United States)

    Brian K. Sullivan; Paul S. Hamilton; Matthew A. Kwiatkowski

    2005-01-01

    We surveyed historic and nearby collecting localities for Aspidoscelis (= Cnemidophorus) arizonae in Cochise and Graham Counties, Arizona, during spring and summer, 2000-2003. Aspidoscelis arizonae was present at or nearby all but one of the historic sites (seven of eight) that we surveyed located near Willcox (...

  20. Histories and Freedom of the Present

    DEFF Research Database (Denmark)

    Vucina, Naja; Drejer, Claus Munch; Triantafillou, Peter

    2011-01-01

    This paper compares the ways in which Michel Foucault and Quentin Skinner’s historical analyses seek to unsettle the limits on present forms of freedom. We do so by comparing their ways of analyzing discourse, rationality and agency. The two authors differ significantly in the ways they deal...

  1. Tenosynovitis: An unusual presentation of leprosy

    Directory of Open Access Journals (Sweden)

    Sukriti Baveja

    2017-01-01

    Full Text Available Tenosynovitis is an uncommon presentation of Type 1 reaction in leprosy. Herein, we report a case of bilateral tenosynovitis of wrist joints who after being unsuccessfully treated by a rheumatologist for several months, was finally diagnosed as a case of Hansen's disease (borderline lepromatous with Type 1 reaction.

  2. Metabolic syndrome among Ghanaian patients presenting with ...

    African Journals Online (AJOL)

    Metabolic syndrome (MetS) is a general risk factor for cardiovascular and chronic kidney disease (CKD) in Western populations. This study assessed the relationship between MetS and its compo-nents in Ghanaian patients presenting with CKD. The study population comprised of 146 non-dialysed individuals with CKD with ...

  3. Language Education: Past, Present and Future

    Science.gov (United States)

    Krashen, Stephen

    2008-01-01

    The recent past in language teaching has been dominated by the Skill-Building Hypothesis, the view that we learn language by first learning about it, and then practicing the rules we learned in output. The present is marked by the emergence of the Comprehension Hypothesis, the view that we acquire language when we understand messages, and is also…

  4. Renal arteriovenous malformation presenting with massive hematuria

    Directory of Open Access Journals (Sweden)

    Shruti P. Gandhi, MD

    2015-01-01

    Full Text Available Renal arteriovenous malformations are abnormal communications between the intrarenal arterial and venous systems. They are a rare cause of hematuria. Color Doppler ultrasonography, multislice CT angiography, and DSA are important tools for making the diagnosis. We describe the case of a 62-year-old man with renal arteriovenous malformation who presented with gross hematuria.

  5. Idiopathic hypertrophic pachymeningitis presenting with occipital ...

    African Journals Online (AJOL)

    Abstract: Background: Although occipital neuralgia is usually caused by degenerative arthropathy, nearly 20 other aetiologies may lead to this condition. Methods: We present the first case report of hypertrophic pachymeningitis revealed by isolated occipital neuralgia. Results and conclusions: Idiopathic hypertrophic ...

  6. Idiopathic hypertrophic pachymeningitis presenting with occipital ...

    African Journals Online (AJOL)

    Background: Although occipital neuralgia is usually caused by degenerative arthropathy, nearly 20 other aetiologies may lead to this condition. Methods: We present the first case report of hypertrophic pachymeningitis revealed by isolated occipital neuralgia. Results and conclusions: Idiopathic hypertrophic ...

  7. Clinicopathological presentation and management outcome of ...

    African Journals Online (AJOL)

    Background: Acute appendicitis is a common cause of acute abdomen and right iliac fossa pain in the study centre with attendant negative appendicectomies. Aim: To study the demographic pattern,aetiology,clinical presentation and management outcome of appendicitis. Methods: This is a retrospective study carried out on ...

  8. Pneumothorax: A rare presentation of pulmonary mycetoma

    Directory of Open Access Journals (Sweden)

    Gupta Prem

    2007-01-01

    Full Text Available Pneumothorax due to mycetoma is extremely rare and has been described only in patients undergoing intensive cytotoxic therapy for hematologic malignancies. A non-immunocompromised subject presenting with pneumothorax due to rupture of the mycetoma into the pleural cavity is being described here.

  9. Dexamethasone induced psychosis presenting with catatonic features

    African Journals Online (AJOL)

    corticosteroids, there are however, few reported cases of catatonia due to steroids. A literature search revealed very few articles written on catatonia due to steroids. We report a case of apparent dexamethasone induced psychosis presenting with features of catatonia. B.O, a 20year old female undergraduate in Nigeria, was.

  10. Clinical presentation of nasopharyngeal cancer in Yemen ...

    African Journals Online (AJOL)

    Objective: To describe clinical presentation of nasopharyngeal cancer. Methods: Study performed on 100 patients who had been histologically diagnosed as having nasopharyngeal cancer between October 2002 and September 2005 in ENT department, Al-Thawra Teaching Hospital, Sana\\'a, Yemen. A detailed medical ...

  11. Benign prostatic hyperplasia presenting with profound hypoglycemia

    African Journals Online (AJOL)

    Neurological disorders related to hypoglycemia were agitation, delirium, impaired higher functions and sleep disorders. However our patient did not present any neurological deficit. The clinical course was favorable. Conclusion: The obstructive renal failure can be a complication of benign prostatic hyperplasia in a final ...

  12. Dexamethasone induced psychosis presenting with catatonic features

    African Journals Online (AJOL)

    disorders, delirium and anxiety disorders due to use of corticosteroids, there are however, few reported cases of catatonia due to steroids. A literature search revealed very few articles written on catatonia due to steroids. We report a case of apparent dexamethasone induced psychosis presenting with features of catatonia.

  13. Extranodal presentation in patients with acquired immunodeficiency ...

    African Journals Online (AJOL)

    Kaposi's sarcoma, non-Hodgkin's lymphoma (NHL), including primary central nervous system lymphoma (PCNSL), and cervical cancer define the acquired immune deficiency syndrome (AIDS). NHL is the second most common malignancy associated with HIV infection. The clinical presentation varies, and while patients ...

  14. Uterine Leiomyosarcoma Presenting as a Recurrent Abdominal ...

    African Journals Online (AJOL)

    This is meant to draw attention to the presentation of leiomyosarcoma as a recurrent abdominopelvic mass following total abdominal hysterectomy and salpingo-oophorectomy and the difference that a detailed histological assessment could make in the proper management of such cases. Case note was reviewed. She was ...

  15. Maxillary brown tumour: unusual presentation of parathyroid ...

    African Journals Online (AJOL)

    This is a report of a maxillary brown tumour caused by primary hyperparathyroidism (HPT) secondary to parathyroid carcinoma. A 62-year-old man presented with a large swelling in the right maxilla, which caused right-sided nasal obstruction, intermittent bleeding and diplopia. A computed tomography scan demonstrated ...

  16. Past and present in work life

    NARCIS (Netherlands)

    Kats, Rachel

    1972-01-01

    The purpose of this analysis was to study multivariate relations between the mobility experiences of immigrant workers and their present work attitudes and behavior. The review of existïng research evidence, of the intricate mobility structure and of wark attitudes and behavior found in the data,

  17. Congenital Duplex Gallbladder Anomaly Presenting as Gangrenous ...

    African Journals Online (AJOL)

    Conclusion: An extensive internet literature search did not reveal any previously described case. This could be the first such case described in the world literature. Though rare, congenital anomalies of the gallbladder must be known to surgeons as they can present unexpectedly and pose diagnostic and operative surgical ...

  18. Histoplasmosis presenting with solitary pulmonary nodule: Two ...

    African Journals Online (AJOL)

    2014-08-04

    Aug 4, 2014 ... acid–Schiff (PAS) revealed numerous uniform oval 1‑ to. 5‑μm PAS‑stained organisms, morphologically consistent with H. capsulatum [Figure 2]. Serological tests and culture. Histoplasmosis presenting with solitary pulmonary nodule: Two cases mimicking pulmonary metastases. C Ye, G Zhang, J Wang1, ...

  19. Response to Questions on Presentation to NAS

    Energy Technology Data Exchange (ETDEWEB)

    Meier, W R

    2011-03-17

    Response to questions on the presentation 'Overview to Chamber and Power Plant Designs for IFE' made at the 1/29-31 meeting of the National Academies Committee on the Prospects for Inertial Confinement Fusion Energy Systems.

  20. Chronic myeloid leukemia presented with priapism: Effective ...

    African Journals Online (AJOL)

    2015-02-01

    Feb 1, 2015 ... of sexual stimulation, trauma, previous similar episodes, use of medications or any chronic illness. On physical examination, the patient had pallor. The spleen and liver. Chronic myeloid leukemia presented with priapism: Effective management with prompt leukapheresis. H Ergenc, C Varım, C Karacaer, ...