WorldWideScience

Sample records for brothers initially diagnosed

  1. Band of Brothers - Warrior Ethos, Unit Effectiveness and the Role of Initial Entry Training

    National Research Council Canada - National Science Library

    Sando, Donald

    2004-01-01

    .... Integral to continued professionalism of the Army is developing cultural attitudes beliefs and behaviors of a Warrior Ethos the culture of disciplined initiative teamwork determination sacrifice...

  2. My Brother Warren.

    Science.gov (United States)

    Forbes, Eric

    1987-01-01

    The younger brother of a hyperactive, severely learning-disabled 21-year-old recounts his feelings regarding lack of parental attention, jealousy toward his older brother, embarrassment, and finally empathy for his older brother. (CB)

  3. Cryptorchidism concordance in monozygotic and dizygotic twin brothers, full brothers, and half-brothers

    DEFF Research Database (Denmark)

    Jensen, Morten Søndergaard; Toft, Gunnar; Thulstrup, Ane Marie

    2010-01-01

    to December 31, 2004. Classic twin method and computerized square dance design. SETTING: Hospitals and outpatient clinics. PATIENT(S): Six groups of boy pairs: boys with no relation, paternal half-brothers, maternal half-brothers, full brothers, dizygotic twin brothers, and monozygotic twin brothers...

  4. Brothers in Arms:

    DEFF Research Database (Denmark)

    Vincent, Stéphanie; Bingley, Paul; Lundborg, Petter

    Family members tend to have similar labor market outcomes, but measuring the contribution of behavioral spillovers is difficult. To identify spillovers between brothers, we exploit Denmark’s largest random assignment – of young men to 8 months of military service – where service status of brothers...

  5. "I Loved My Brother Infinitely…"

    Directory of Open Access Journals (Sweden)

    Pavel Fokin

    2014-12-01

    Full Text Available Abstract Literary heritage of Mikhail Mikhailovich Dostoevsky(1820-1864 is not very abundant and appeals to experts only. His personality is of much more importance for national and world culture. He was a friend and soul mate of his genius brother (almost coeval. Their relations were an essential element of the biography and spiritual identity of Fyodor Dostoevsky. Mikhail was the first and for many years the only interlocutor of F.M. Dostoevsky. His role as an addressee in Fyodor Dostoevsky’s letters cannot be underestimated either. Fyodor Dostoevsky regarded his brother not only as a friend but as a business partner too. Their most successful joint enterprise was publishing of the magazine “Time” (“Vremya” (1861–1863, whose initiator and owner became Mikhail Dostoevsky. After Мikhail’s death Fyodor took charge of his family that had both direct and indirect impact on his own lifestyle. The year 2014 was the 150th anniversary of Mikhail Dostoevsky’s death. In this regard, the State Literature Museum organized an exposition titled “I loved my brother infinitely...” in the F.M. Dostoevsky Museum-Apartment. It was the first exposition dedicated to the personality of Mikhail Dostoevsky and his literary heritage. A lot of exhibit items had never been exposed before.

  6. 75 FR 71458 - Warner Brothers Entertainment, Inc., Warner Brothers Theatrical Enterprises, Including Workers of...

    Science.gov (United States)

    2010-11-23

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,775] Warner Brothers Entertainment, Inc., Warner Brothers Theatrical Enterprises, Including Workers of the Following Operating Entities: Burbank Television Enterprises LLC, Warner Brothers Consumer Products, Inc., Warner Brothers...

  7. Joyce Brothers (1927-2013).

    Science.gov (United States)

    Farley, Frank

    2014-01-01

    Joyce Brothers died May 13, 2013, at age 85, in Fort Lee, New Jersey. She was born in Brooklyn, New York, on October 20, 1927. To the public, Joyce Brothers was the best known psychologist of her time. Brothers's influence on the media, and psychology, was considerable and varied. She became the public face of psychology. As her ascendency as a media psychologist progressed, she reinforced the ideas that a PhD psychologist is called "Doctor"; that a woman can create a career in the field and also raise a family; that there are psychological insights about human behavior that everyone can understand; and that psychologists are not always wearing laboratory coats or talking to people who lie on a couch, but can be lively, engaging, understandable, fun, and down-to-earth people. One might speculate that Joyce Brothers brought a lot of young women into careers in psychology. Brothers created an amazing career which she pursued with style and grace. Stepping outside of a traditional psychological career sometimes drew fire from the profession, in line with frequent criticism of popularizers in psychology and other fields. 2014 APA, all rights reserved

  8. A Case of Ataxia with Isolated Vitamin E Deficiency Initially Diagnosed as Friedreich’s Ataxia

    Directory of Open Access Journals (Sweden)

    Michael Bonello

    2016-01-01

    Full Text Available Ataxia with isolated vitamin E deficiency (AVED is a rare autosomal recessive condition that is caused by a mutation in the alpha tocopherol transfer protein gene. It is almost indistinguishable clinically from Friedreich’s ataxia but with appropriate treatment its devastating neurological features can be prevented. Patients can present with a progressive cerebellar ataxia, pyramidal spasticity, and evidence of a neuropathy with absent deep tendon reflexes. It is important to screen for this condition on initial evaluation of a young patient presenting with progressive ataxia and it should be considered in patients with a long standing ataxia without any diagnosis in view of the potential therapeutics and genetic counselling. In this case report we present a patient who was initially diagnosed with Friedreich’s ataxia but was later found to have AVED.

  9. Bilateral breast in brothers - abreast

    Directory of Open Access Journals (Sweden)

    Altamash Mohammed Yusuf Shaikh

    2013-01-01

    Full Text Available Gynecomastia is a common occurrence in pubertal age group, and is physiological in up to 65 percent of cases. When occurs in the family it should be investigated in order not to miss on a treatable etiology. Two brothers within the same family, presenting with bilateral gynecomastia of different causes and requiring different treatment are presented.

  10. "I Loved My Brother Infinitely…"

    OpenAIRE

    Pavel Fokin

    2014-01-01

    Abstract Literary heritage of Mikhail Mikhailovich Dostoevsky(1820-1864) is not very abundant and appeals to experts only. His personality is of much more importance for national and world culture. He was a friend and soul mate of his genius brother (almost coeval). Their relations were an essential element of the biography and spiritual identity of Fyodor Dostoevsky. Mikhail was the first and for many years the only interlocutor of F.M. Dostoevsky. His role as an addressee in Fyodor Dosto...

  11. Scott Brothers Windows and Doors Information Sheet

    Science.gov (United States)

    Scott Brothers Windows and Doors (the Company) is located in Bridgeville, Pennsylvania. The settlement involves renovation activities conducted at property constructed prior to 1978, located in Pittsburgh, Pennsylvania.

  12. Nature vs. nurture: two brothers with schizophrenia.

    Science.gov (United States)

    Keltner, N L; James, C A; Darling, R J; Findley, L S; Oliver, K

    2001-01-01

    The nature vs. nurture argument as it pertains to two brothers. To explore the synergistic effects of heritability and environment in the cases of two brothers with schizophrenia. Review of the literature and the authors' clinical experience. The nature vs. nurture dichotomy may not be as relevant as looking at the interaction between these two forces.

  13. [Clinical analysis of 138 multiple primary cancers diagnosed of digestive system malignant tumor initially].

    Science.gov (United States)

    Lyu, J M; Xiong, H C; Wu, B; Zhou, X Q; Hu, J

    2018-02-23

    Objective: To study the clinical characteristics, strategy of treatment and prognosis of multiple primary cancers(MPC) diagnosed of digestive system malignant tumor firstly. Methods: From January, 2000 to December, 2015, the clinical, follow-up and prognostic data of 138 MPC patients diagnosed of digestive system malignant tumor firstly were retrospectively analyzed. Results: 138 cases were found in 10 580 cases with malignant tumors, and the incidence was 1.30%. There were 129 cases of duplex primary cancers, 8 cases of triple primary cancers and 1 case of quintuple primary cancers. The repetitive primary cancer was occurred in digestive system (61cases, 44.2%) most frequently, with the next in respiratory system (46 cases, 33.3%). 52.2% (72 cases) suffered second primary cancer in 2 years after first primary cancer diagnosed, and 75.4% (104 cases) in 5 years. The median overall survival in patients with all cancer lesions radically treated was 168 months, better than any other treatment (68 months, P digestive system malignant tumor most frequently occurred in the digestive system and respiratory system. More concern should be attracted in follow-up, especially in the first 5 years. The key to improve patient' prognosis was radical treatment to every primary cancer.

  14. Community-based MDR-TB care project improves treatment initiation in patients diagnosed with MDR-TB in Myanmar.

    Science.gov (United States)

    Wai, Pyae Phyo; Shewade, Hemant Deepak; Kyaw, Nang Thu Thu; Thein, Saw; Si Thu, Aung; Kyaw, Khine Wut Yee; Aye, Nyein Nyein; Phyo, Aye Mon; Maung, Htet Myet Win; Soe, Kyaw Thu; Aung, Si Thu

    2018-01-01

    The Union in collaboration with national TB programme (NTP) started the community-based MDR-TB care (CBMDR-TBC) project in 33 townships of upper Myanmar to improve treatment initiation and treatment adherence. Patients with MDR-TB diagnosed/registered under NTP received support through the project staff, in addition to the routine domiciliary care provided by NTP staff. Each township had a project nurse exclusively for MDR-TB and 30 USD per month (max. for 4 months) were provided to the patient as a pre-treatment support. To assess whether CBMDR-TBC project's support improved treatment initiation. In this cohort study (involving record review) of all diagnosed MDR-TB between January 2015 and June 2016 in project townships, CBMDR-TBC status was categorized as "receiving support" if date of project initiation in patient's township was before the date of diagnosis and "not receiving support", if otherwise. Cox proportional hazards regression (censored on 31 Dec 2016) was done to identify predictors of treatment initiation. Of 456 patients, 57% initiated treatment: 64% and 56% among patients "receiving support (n = 208)" and "not receiving support (n = 228)" respectively (CBMDR-TBC status was not known in 20 (4%) patients due to missing diagnosis dates). Among those initiated on treatment (n = 261), median (IQR) time to initiate treatment was 38 (20, 76) days: 31 (18, 50) among patients "receiving support" and 50 (26,101) among patients "not receiving support". After adjusting other potential confounders (age, sex, region, HIV, past history of TB treatment), patients "receiving support" had 80% higher chance of initiating treatment [aHR (0.95 CI): 1.8 (1.3, 2.3)] when compared to patients "not receiving support". In addition, age 15-54 years, previous history of TB and being HIV negative were independent predictors of treatment initiation. Receiving support under CBMDR-TBC project improved treatment initiation: it not only improved the proportion initiated but also

  15. 78 FR 76969 - Wright Brothers Day, 2013

    Science.gov (United States)

    2013-12-19

    ... boundaries of human imagination and paving the way for over a century of innovation. On Wright Brothers Day... Top, we are raising standards and making STEM education a priority. Last year, we announced plans to...

  16. Cerebrotendinous xanthomatosis: report of two Brazilian brothers.

    NARCIS (Netherlands)

    Lange, M.C.; Zetola, V.F.; Teive, H.; Scola, R.H.; Trentin, A.P.; Zavala, J.A.; Pereira, E.R.; Raskin, S.; Werneck, L.C.; Sistermans, E.A.

    2004-01-01

    Cerebrotendinous xanthomatosis is a treatable rare autossomal recessive disease characterized by lipid storage secondary to a sterol 27-hydroxylase deficiency in the formation of cholic and chenodeoxycholic acids. We describe two Brazilian brothers with cognitive impairement and chronic diarrhea.

  17. Diagnosing Glucose Transporter 1 Deficiency at Initial Presentation Facilitates Early Treatment.

    Science.gov (United States)

    Akman, Cigdem Inan; Yu, Julia; Alter, Aliza; Engelstad, Kristin; De Vivo, Darryl C

    2016-04-01

    To profile the initial clinical events of glucose transporter 1 deficiency syndrome (Glut1 DS) in order to facilitate the earliest possible diagnosis. We retrospectively reviewed 133 patients with Glut1 DS from a single institution. Family interviews and medical record reviews identified the first clinical event(s) reported by the caregivers. Average age of the first event was 8.15 ± 11.9 months (range: 0.01-81). Ninety-one patients experienced the first symptom before age 6 months (68%). Thirty-three additional patients (25%) presented before age 2 years. Only 9 patients (7%), reported the first event after age 2 years. Seizures were the most common first event (n = 81, 61%), followed by eye movement abnormalities (n = 51, 38%) and changes in muscle strength and tone (n = 30, 22%). Eye movement abnormalities, lower cerebrospinal fluid glucose values, and lower Columbia Neurological Scores correlated with earlier onset of the first event (r: -0.17, 0.22, and 0.25 respectively, P < .05). There was no correlation with age of first event and red blood cell glucose uptake or mutation type. Glut1 DS is a treatable cause of infantile onset encephalopathy. Health care providers should recognize the wide spectrum of paroxysmal events that herald the clinical onset of Glut1 DS in early infancy to facilitate prompt diagnosis, immediate treatment, and improved long-term outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Are Bone Turnover Markers Related with Fracture Risk in Initial Diagnose Postmenopausal Osteoporosis? A Cross-Sectional Clinical Study

    Directory of Open Access Journals (Sweden)

    Şeniz Akçay Yalbuzdağ

    2015-08-01

    Full Text Available Objective: In this study, we investigated the relationships between 10 year fracture risk calculated with FRAX assessment tool and bone turnover markers (BTM in women with diagnosed as postmenopausal osteoporosis for the first time. Materials and Methods: After exclusion of the causes of secondary osteoporosis 61 postmenopausal women diagnosed with osteoporosis for the first time were enrolled. Height and weight measurements, comorbid diseases, menopause age, and laboratory investigations were recorded. Lumbar and femur neck and femur total T scores were measured by dual-energy x-ray absorptiometry (DXA. As BTM, serum osteocalcin (OC and urine deoxypridinoline levels were measured. 10-year fracture risk of hip and major osteoporotic fracture was calculated with FRAX assessment tool. Results: The mean age of patients was 61±39 years. Median value of menopause year was 15.13 years (min: 2, max: 40. The median 10-year hip fracture and major osteoporotic fracture risks were calculated as 1.10% (min: 0, max: 23, 6.9% (min: 3, max: 34 respectively. There was no significant relationship between BTM and fracture risk. Positive significant correlation was found between menopause year and hip fracture risk, and between menopause year and major osteoporotic fracture risks (p=0.031, 0.276; p=0.025, r=0.287. Negative significant correlation was detected between body mass index and hip fracture risk (p=0.002, r=-0.392. Conclusion: In our study, we couldn’t find relationship between BTM and fracture risks assessed by using FRAX tool in patients with initially diagnosed of postmenopausal osteoporosis. Further studies are needed to investigate the relationship between BTM and fracture risk in different patient groups. (Turkish Journal of Osteoporosis 2015;21: 58-62

  19. Reducing the time until psychotherapy initiation reduces sick leave duration in participants diagnosed with anxiety and mood disorders.

    Science.gov (United States)

    Alonso, Sandra; Marco, José H; Andani, Joaquín

    2018-01-01

    Sick leave in patients with a mental disorder is characterized by having a long duration. Studies suggest that the time until a patient on sick leave for a common mental health disorder initiates evaluation and treatment by a healthcare professional is an important factor in the duration of the sick leave. However, in these studies, the intervention was not performed by a mental health specialist. The aim of this study was to find out whether the length of sick leave was associated with the time before initiating psychotherapy, age, time until returning to work after psychotherapy ends, and duration of psychotherapy. In a further analysis, we examined whether the model composed of age, duration of psychotherapy, and time before initiating psychotherapy predicted the length of sick leave. The sample consisted of 2,423 participants, 64.1% (n = 1,554) women and 35.9% (n = 869) men, who were on sick leave for anxiety disorders or depressive disorder. The total duration of the sick leave of participants diagnosed with depression and anxiety was positively associated with the time before beginning psychotherapy. Time before beginning psychotherapy predicted the length of sick leave when the variables age and duration of psychotherapy were controlled. It is necessary to reduce the time until beginning psychotherapy in people on sick leave for common mental disorders. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Simple bone cysts of two brothers

    Energy Technology Data Exchange (ETDEWEB)

    An, Seo Young; An, Chang Hyeon; Choi, Karp Shik [Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of)

    2008-09-15

    17-year-old and 14-year-old brothers were referred for evaluation of the cystic lesions on the mandibular anterior area with no symptoms. Neither their mother nor the brothers could recall any past trauma to those areas. Panoramic and intraoral radiographs revealed moderately defined cystic lesions on their mandibular anterior areas. Biopsies on both lesions revealed simple bone cysts. Hereditary cause or familial history of simple bone cysts could not be found in literature review. This case may have been a coincidence. However, further investigation is needed to find the cause of simple bone cysts occurring in patients those are closely related.

  1. Simple bone cysts of two brothers

    International Nuclear Information System (INIS)

    An, Seo Young; An, Chang Hyeon; Choi, Karp Shik

    2008-01-01

    17-year-old and 14-year-old brothers were referred for evaluation of the cystic lesions on the mandibular anterior area with no symptoms. Neither their mother nor the brothers could recall any past trauma to those areas. Panoramic and intraoral radiographs revealed moderately defined cystic lesions on their mandibular anterior areas. Biopsies on both lesions revealed simple bone cysts. Hereditary cause or familial history of simple bone cysts could not be found in literature review. This case may have been a coincidence. However, further investigation is needed to find the cause of simple bone cysts occurring in patients those are closely related.

  2. Living with a brother or sister with epilepsy: siblings' experiences.

    Science.gov (United States)

    Hames, Annette; Appleton, Richard

    2009-12-01

    There is conflicting evidence about the impact of disability upon siblings, and very little research on the siblings of children with epilepsy. There is some evidence that siblings who have less accurate information exhibit more distress. The aim of this study was to assess siblings' response to having a brother or sister with epilepsy and to begin to develop information for them. Parents of children attending paediatric neurology outpatient departments were invited to participate in a pilot study. Parents who consented to take part were asked if they had previously received information for siblings. Parents and siblings participated in a semi-structured interview and siblings were also invited to submit a personal account of living with a brother or sister who had epilepsy. Twenty-five families with a child with epilepsy aged 2.5-15 years initially agreed to take part. None of the families stated that they had ever seen or received any information specifically for siblings. Fourteen siblings from the 25 families, aged 8-25 years, provided a personal account of what it was like living with a brother or sister with epilepsy. Siblings' accounts included both negative and positive feelings, and specifically feelings of care and love for their sibling. This initial study suggests that siblings of children with epilepsy have many positive but also early negative feelings. The results are limited by the size of the study, the fact that most siblings were older sisters, and the mean time since diagnosis was 6 years. Finally, it is hoped that the personal accounts collected in this study will be published for the benefit of other siblings of children with epilepsy.

  3. The Wright Brothers and their First Flight

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 8; Issue 12. The Wright Brothers and their First Flight. O N Ramesh. Article-in-a-Box Volume 8 Issue 12 December 2003 pp 3-4. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/008/12/0003-0004 ...

  4. The Wright Brothers and their First Flight

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 8; Issue 12. The Wright Brothers and their First Flight. O N Ramesh. Article-in-a-Box Volume 8 Issue 12 December 2003 pp 3-4. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/reso/008/12/0003-0004 ...

  5. Influence of initial insulin dosage on blood glucose dynamics of children and adolescents with newly diagnosed type 1 diabetes mellitus.

    Science.gov (United States)

    Wang, Yi; Gong, Chunxiu; Cao, Bingyan; Meng, Xi; Wei, Liya; Wu, Di; Liang, Xuejun; Li, Wenjing; Liu, Min; Gu, Yi; Su, Chang

    2017-05-01

    To investigate the effect of initial insulin dosage on blood glucose (BG) dynamics, β-cell protection, and oxidative stress in type 1 diabetes mellitus. Sixty newly diagnosed type 1 diabetes mellitus patients were randomly assigned to continuous subcutaneous insulin infusions of 0.6 ± 0.2 IU/kg/d (group 1), 1.0 ± 0.2 IU/kg/d (group 2), or 1.4 ± 0.2 IU/kg/d (group 3) for 3 wk. BG was monitored continuously for the first 10 d and the last 2 d of wk 2 and 3. A total of 24-hour urinary 8-iso-PGF2α was assayed on days 8, 9, and 10. The occurrence and duration of the honeymoon period were recorded. Fasting C-peptide and glycosylated hemoglobin (HbA1c) were assayed after 1, 6, and 12 months of insulin treatment. BG decreased to the target range by the end of wk 3 (group 1), wk 2 (group 2), or wk 1 (group 3). The actual insulin dosage over the 3 wk, frequency of hypoglycemia on wk 1 and 2, and median BG at the end of wk 1 differed significantly, but not 8-iso-PGF2α and the honeymoon period in the three groups. No severe hypoglycemia event was observed in any patient, but there was significant difference in the first occurrence of hypoglycemia. Differences in initial insulin dosage produced different BG dynamics in wk 1, equivalent BG dynamics on wk 2 and 3, but had no influence on short- and long-term BG control and honeymoon phase. The wide range of initial insulin dosage could be chosen if guided by BG monitoring. © 2016 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd.

  6. Breast cancer risk associated with atypical hyperplasia and lobular carcinoma in situ initially diagnosed on core-needle biopsy.

    Science.gov (United States)

    Donaldson, Alana R; McCarthy, Caitlin; Goraya, Shazia; Pederson, Holly J; Sturgis, Charles D; Grobmyer, Stephen R; Calhoun, Benjamin C

    2018-02-01

    Breast cancer risk estimates for atypical lesions are based primarily on case-control studies of patients with open biopsies. The authors report the cumulative breast cancer incidence after a core biopsy diagnosis of atypical hyperplasia (ductal or lobular) or lobular carcinoma in situ. A cohort study with central pathology review was conducted on 393 patients who had core biopsy diagnoses of atypical hyperplasia and lobular carcinoma in situ from 1995 through 2010. Follow-up was available for 255 of 264 patients (97%) at a median of 87 months (range, 3-236 months). There were 212 patients (54%) who were not upgraded on excision and had no personal history of breast cancer. Of these, 21 of 212 (9.9%) developed breast cancer, including 15 invasive carcinomas, 4 ductal carcinomas in situ, 1 pleomorphic lobular carcinoma in situ, and 1 unknown type. The prior core biopsy diagnoses were atypical ductal hyperplasia for 11 patients (52%) and atypical lobular hyperplasia/lobular carcinoma in situ in the remaining 10 patients (48%). The number of atypical foci in the core biopsy was not significantly associated with the subsequent development of breast cancer (P = .42). Of the 15 invasive carcinomas, 11 (73%) were ipsilateral, 11 (73%) were pathologic T1 tumors, 5 (33%) were pathologic N1 tumors, 13 (87%) were estrogen receptor-positive, and 1 (7%) was amplified for human epidermal growth factor receptor 2. In patients who had an initial diagnosis of atypical hyperplasia or lobular carcinoma in situ on core biopsy, the 7-year cumulative breast cancer incidence was 9.9%. Most tumors were ipsilateral, stage I, estrogen receptor-positive, invasive carcinomas. The current data support close clinical and radiologic follow-up for more than 5 years in this patient population. Cancer 2018;124:459-65. © 2017 American Cancer Society. © 2017 American Cancer Society.

  7. Morphological and Immunohistochemical Reevaluation of Tumors Initially Diagnosed as Ovarian Endometrioid Carcinoma With Emphasis on High-grade Tumors.

    Science.gov (United States)

    Lim, Diana; Murali, Rajmohan; Murray, Melissa P; Veras, Emanuela; Park, Kay J; Soslow, Robert A

    2016-03-01

    Ovarian endometrioid carcinomas (OEC) of low grade have characteristic morphologic features, but high-grade tumors can mimic high-grade serous and undifferentiated carcinomas. We reviewed tumors initially diagnosed as OEC to determine whether a combination of pathologic and immunohistochemical features can improve histologic subclassification. Tumors initially diagnosed as OEC were reviewed using World Health Organization criteria. We also noted the presence of associated confirmatory endometrioid features (CEFs): (i) squamous metaplasia; (ii) endometriosis; (iii) adenofibromatous background; and (iv) borderline endometrioid or mixed Mullerian component. A tissue microarray was constructed from 27 representative tumors with CEF and 14 without CEF, and sections were stained for WT-1, p16, and p53. Of 109 tumors initially diagnosed as OEC, 76 (70%) tumors were classified as OEC. The median patient age was 55 years, and 75% of patients were younger than 60 years. Ninety-two percent presented with disease confined to the pelvis, and 87% of tumors were unilateral. The median tumor size was 11.8 cm. Only 3% of tumors were high grade (grade 3of 3). Eighty percent of cases had at least 1 CEF, and 59% had at least 2 CEFs. Eleven percent overexpressed p16, 0% overexpressed p53, and 3% expressed WT-1. Only 10% of patients died of disease at last follow-up. Thirty-three (33) tumors, or 30% of tumors originally classified as endometrioid, were reclassified as serous carcinoma (OSC). The median patient age was 54.5 years, and 59% of patients were younger than 60 years of age. Only 27% had disease confined to the pelvis at presentation, 52% of tumors were unilateral, and the median tumor size was 8 cm. Associated squamous differentiation, endometrioid adenofibroma, and endometrioid or mixed Mullerian borderline tumor (CEFs) were not present in any case, but 6% of patients had endometriosis. Approximately one half of the reclassified OSC demonstrated SET-pattern morphology

  8. Newly Diagnosed Meniere's Disease: Clinical Course With Initiation of Noninvasive Treatment Including an Accounting of Vestibular Migraine.

    Science.gov (United States)

    Sbeih, Firas; Christov, Florian; Gluth, Michael B

    2018-03-01

    To describe the course of Meniere's disease with noninvasive treatment during the first few years after initial diagnosis. A retrospective review of consecutive patients with newly diagnosed definite Meniere's disease between 2013 and 2016 and a minimum follow-up of 1 year. Patients received a written plan for low sodium, water therapy, and treatment with a diuretic and/or betahistine. Subjects were screened and treated for vestibular migraine as needed. Vertigo control and hearing status at most recent follow-up were assessed. Forty-four subjects had an average follow up of 24.3 months. Thirty-four percent had Meniere's disease and vestibular migraine, and 84% had unilateral Meniere's disease. Seventy-five percent had vertigo well controlled at most recent follow-up, with only noninvasive treatments. Age, gender, body mass index, presence of vestibular migraine, bilateral disease, and duration of follow-up did not predict noninvasive treatment failure. Worse hearing threshold at 250 Hz and lower pure tone average (PTA) at the time of diagnosis did predict failure. Fifty-two percent of ears had improved PTA at most recent visit, 20% had no change, and 28% were worse Conclusions: Encountering excellent vertigo control and stable hearing after a new diagnosis of Meniere's disease is possible with noninvasive treatments. Worse hearing status at diagnosis predicted treatment failure.

  9. Inherited germline ATRX mutation in two brothers with ATR-X syndrome and osteosarcoma.

    Science.gov (United States)

    Ji, Jianling; Quindipan, Catherine; Parham, David; Shen, Lishuang; Ruble, David; Bootwalla, Moiz; Maglinte, Dennis T; Gai, Xiaowu; Saitta, Sulagna C; Biegel, Jaclyn A; Mascarenhas, Leo

    2017-05-01

    We report a family in which two brothers had an undiagnosed genetic disorder comprised of dysmorphic features, microcephaly, severe intellectual disability (non-verbal), mild anemia, and cryptorchidism. Both developed osteosarcoma. Trio exome sequencing (using blood samples from the younger brother and both parents) was performed and a nonsense NM_000489.4:c.7156C>T (p.Arg2386*) mutation in the ATRX gene was identified in the proband (hemizygous) and in the mother's peripheral blood DNA (heterozygous). The mother is healthy, does not exhibit any clinical manifestations of ATR-X syndrome and there was no family history of cancer. The same hemizygous pathogenic variant was confirmed in the affected older brother's skin tissue by subsequent Sanger sequencing. Chromosomal microarray studies of both brothers' osteosarcomas revealed complex copy number alterations consistent with the clinical diagnosis of osteosarcoma. Recently, somatic mutations in the ATRX gene have been observed as recurrent alterations in both osteosarcoma and brain tumors. However, it is unclear if there is any association between osteosarcoma and germline ATRX mutations, specifically in patients with constitutional ATR-X syndrome. This is the first report of osteosarcoma diagnosed in two males with ATR-X syndrome, suggesting a potential increased risk for cancer in patients with this disorder. © 2017 Wiley Periodicals, Inc.

  10. Laryngologist Leon Zamenhof--brother of Dr. Esperanto.

    Science.gov (United States)

    Wincewicz, Andrzej; Sulkowska, Mariola; Musiatowicz, Marcin; Sulkowski, Stanislaw

    2009-06-01

    To reconstruct the biography of the Polish otorhinolaryngologist Leon Zamenhof (1875-1934), a brother of Ludwik Zamenhof, who is famous for invention of the international language Esperanto. Biographical information was collected from pre-World War II resources. Zamenhof developed several important new forms of treatment to help the hearing impaired. Zamenhof was especially interested in the education of deaf children and the therapy necessary to facilitate their integration into society. His significant achievements were a phonetic method of therapy for the hearing impaired and an automatic device for ear insufflation that was considered indispensable in the management of pyorrhea. In addition, Zamenhof initiated various forms of social support among physicians within the medical community of Warsaw, Poland; made health care available to children with hearing impairments; and organized a Jewish school for deaf children. Zamenhof tried to change public attitudes toward deafness, working to promote the integration of the deaf into wider society. He also translated Polish literature into Esperanto. With similar aims to his brother Ludwik, Leon Zamenhof strived to enhance and broaden communication among people who could not hear and to persuade people to change their attitudes about deafness.

  11. Drs. Smith Brothers: dental surgeons of Calcutta.

    Science.gov (United States)

    Sanjeev, Kumar

    2014-01-01

    During the British raj, India attracted dental practitioners from all over the world who set up practices in the Presidency towns of Calcutta, Bombay, Madras and Bangalore. Lured by the abundant opportunity to make good money, these mercenary but courageous dentists counted Viceroys, Indian royalty and political leaders amongst their clients. Some, like the famous American Smith Brothers of Calcutta, were sought after even by the rulers of neighboring countries. Dr. Mark Smith's hazardous visit to the Amir of Afghanistan made worldwide headlines more than 100 years ago for the fabulous fee he was paid for the dental treatment. This paper briefly describes the exploits and experiences of the Smith brothers while in India.

  12. Seven-month prostate-specific antigen (PSA) is prognostic in patients with prostate cancer initially diagnosed with distant metastases.

    Science.gov (United States)

    Nieder, Carsten; Haukland, Ellinor; Pawinski, Adam; Norum, Jan

    2018-03-05

    Recent research suggests that prostate-specific antigen (PSA) ≤ 0.2 ng/dl at 7 months is prognostic for better survival with androgen deprivation therapy for metastatic hormone-sensitive prostate cancer regardless of chemotherapy with docetaxel. These results were derived from a group of clinical trial participants. Therefore, we performed a confirmatory analysis in patients treated outside of trials. Furthermore, we limited inclusion to those who presented with metastases at the initial diagnosis of prostate cancer (synchronous metastases). A retrospective analysis of a comprehensive regional database was performed. The oncology care in this region (Nordland County, Northern Norway) was provided by one center. Patients who were diagnosed between January 01, 2004 and December 31, 2016 were included. Of 101 patients, 90 were alive at 7 months and had their PSA value measured. Their median age was 68.5 years. Only six patients (7%) achieved PSA ≤ 0.2 ng/dl at 7 months. The median value was 4.05 ng/dl. Median overall survival was shortest in patients with PSA > 4.0 ng/dl (22 months). For patients with PSA between 0.3 and 4.0 ng/dl, median survival was 54 months (p = 0.0001). No further increase was seen in the small group with lower PSA. Statistical significance was also found for a cutoff of ≤ 1.0 ng/dl (55 vs. 32 months). PSA at 7 months predicts overall survival. Given that only 7% of patients achieved PSA ≤ 0.2 ng/dl, confirmation of this particular cutoff requires additional studies in other populations.

  13. Who is my brother's keeper?

    Science.gov (United States)

    Kottow, M H

    2002-02-01

    Clinical and research practices designed by developed countries are often implemented in host nations of the Third World. In recent years, a number of papers have presented a diversity of arguments to justify these practices which include the defence of research with placebos even though best proven treatments exist; the distribution of drugs unapproved in their country of origin; withholding of existing therapy in order to observe the natural course of infection and disease; redefinition of equipoise to a more bland version, and denial of post-trial benefits to research subjects. These practices have all been prohibited in developed, sponsoring countries, even though they invariably have pockets of poverty where conditions comparable to the Third World prevail. Furthermore, the latest update of the Declaration of Helsinki clearly decries double ethical standards in research protocols. Under these circumstances, it does not seem appropriate that First World scholars should propose and defend research and clinical practices with less stringent ethical standards than those mandatory in their own countries. Recent years have witnessed frequent reports of less stringent ethical standards being applied to both clinical and research medical practices, for the most part in the field of drug trials and drug marketing, initiated by developed countries in poorer nations. Still more unsettling, a number of articles have endorsed the policy of employing ethical norms in these host countries, which would be unacceptable to both the legislations and the moral standards of the sponsor nations. Also, these reformulations often contravene the Declaration of Helsinki or one of its updates. This paper is not so much concerned with the actual practices, which have been subjected to frequent scrutiny and publicly decried when gross misconduct occurred. Rather, my concern relates to the approval and support such practices have found in the literature on bioethics from authors who might

  14. Early Antiretroviral Therapy Initiation and Mortality Among Infants Diagnosed With HIV in the First 12 Weeks of Life: Experiences From Kinshasa, DR Congo and Blantyre, Malawi.

    Science.gov (United States)

    Sheahan, Anna; Feinstein, Lydia; Dube, Queen; Edmonds, Andrew; Chirambo, Chawanangwa Mahebere; Smith, Emily; Behets, Frieda; Heyderman, Robert; Van Rie, Annelies

    2017-07-01

    Based on clinical trial results, the World Health Organization recommends infant HIV testing at age 4-6 weeks and immediate antiretroviral therapy (ART) initiation in all HIV-infected infants. Little is known about the outcomes of HIV-infected infants diagnosed with HIV in the first weeks of life in resource-limited settings. We assessed ART initiation and mortality in the first year of life among infants diagnosed with HIV by 12 weeks of age. Cohort of HIV-infected infants in Kinshasa and Blantyre diagnosed before 12 weeks to estimate 12-month cumulative incidences of ART initiation and mortality, accounting for competing risks. Multivariate models were used to estimate associations between infant characteristics and timing of ART initiation. One hundred and twenty-one infants were diagnosed at a median age of 7 weeks (interquartile range, 6-8). The cumulative incidence of ART initiation was 46% [95% confidence interval (CI), 36%, 55%] at 6 months and 70% (95% CI 60%, 78%) at 12 months. Only age at HIV diagnosis was associated with ART initiation by age 6 months, with a subdistribution hazard ratio of 0.70 (95% CI 0.52, 0.91) for each week increase in age at DNA polymerase chain reaction test. The 12-month cumulative incidence of mortality was 20% (95% CI 13%, 28%). Despite early diagnosis of HIV, ART initiation was slow and mortality remained high, underscoring the complexity in translating clinical trial findings and World Health Organization's guidance into real-life practice. Novel and creative health system interventions will be required to ensure that all HIV-infected infants achieve optimal treatment outcomes under routine care settings.

  15. Partial DAZ deletions in a family with five infertile brothers

    NARCIS (Netherlands)

    Gianotten, Judith; Hoffer, Mariëtte J. V.; de Vries, Jan W. A.; Leschot, Nico J.; Gerris, Jan; van der Veen, Fulco

    2003-01-01

    Objective: To study the genetic cause of infertility in a family with five infertile brothers. Design: Case report. Setting: Center for reproductive medicine at a university medical center. Patient(s): Five brothers presenting with primary infertility due to severely impaired spermatogenesis; also,

  16. Homosexuality in men and number of older brothers.

    Science.gov (United States)

    Blanchard, R; Bogaert, A F

    1996-01-01

    This study investigated whether homosexual men have a higher mean birth order than heterosexual men primarily because they have more older brothers or because they have more older siblings of both sexes. For the main analyses, 302 heterosexual men were individually matched on year of birth with an equal number of heterosexual men. Each completed a self-administered, anonymous questionnaire concerning family background and other biodemographic information. Logistic regression analysis showed that homosexuality was positively correlated with the proband's number of older brothers but not with older sisters, younger brothers, younger sisters, or parental age at the time of the proband's birth. Each additional older brother increased the odds of homosexuality by 33%. These results restrict the range of possible theories of the birth order phenomenon to those that can explain not only why older brothers increase the probability of homosexuality in later-born males but also why older sisters neither enhance this effect nor counteract it.

  17. Living kidney transplantation between brothers with unrecognized renal amyloidosis as the first manifestation of familial Mediterranean fever: a case report.

    Science.gov (United States)

    Peces, Ramón; Afonso, Sara; Peces, Carlos; Nevado, Julián; Selgas, Rafael

    2017-08-31

    Familial Mediterranean fever is an autosomal recessive disease characterized by recurrent episodes of fever and polyserositis and by the onset of reactive amyloid-associated amyloidosis. Amyloidosis due to familial Mediterranean fever can lead to end-stage renal disease, culminating in kidney transplantation for some patients. In this study, we report the clinical outcome of two brothers with familial Mediterranean fever who were the inadvertent donor and recipient, respectively, of a kidney. Subsequently, they were diagnosed with renal amyloidosis secondary to familial Mediterranean fever and were successfully treated with anakinra and colchicine. Two brothers with familial Mediterranean fever and renal amyloidosis were the inadvertent donor and recipient, respectively, of a kidney. The recipient had presented recurrent acute febrile episodes of familial Mediterranean fever, developed nephrotic syndrome secondary to amyloidosis and needed bilateral nephrectomy and chronic dialysis. His elder brother, in apparent good health, donated his left kidney to his brother. Immediately after the kidney transplantation, both the donor and recipient presented massive proteinuria, impaired renal function and elevated serum amyloid A levels. Biopsies of the brothers' kidneys showed amyloidosis. Genetic studies thereafter revealed a homozygous variant for the MEFV gene (NM_000243.2.c.2082G > A; p.M694I) in both brothers. At this point, both the donor and recipient were treated with colchicine and anakinra, resulting in improved renal function, decreased proteinuria, undetectable serum amyloid A levels and stable renal function at 62 months of follow-up and no major adverse effects. In familial Mediterranean fever, analyses of the MEFV gene should be performed in potential live kidney donors from a direct family member (either between siblings or between parents and children). In addition, genetic studies are required when consanguinity is suspected between members involved in

  18. Neurological and architectural sinuosities: the Niemeyer brothers.

    Science.gov (United States)

    Cavalcanti, Daniel D; Guasti, José Antonio D; Preul, Mark C

    2010-11-01

    In a family of 7 siblings in Rio de Janeiro, Brazil, 2 of the most remarkable national personalities decided to follow different fields at the beginning of the 20th century. Their life's work would, however, intersect in at least 2 respects: the quest for innovation and a passion for sinuosity. The achievements of Paulo and Oscar Niemeyer are landmarks in the history of neurosurgery and architecture in Brazil. Among his many innovations in neurosurgery, Paulo Niemeyer first described the transventricular amygdalohippocampectomy in 1957 and introduced the operating microscope to neurosurgery in Brazil in 1971. His brother Oscar became a world-renowned representative of the modern architecture movement, sculpting graceful curves from concrete.

  19. Discussing the Life of the Others: Doing Ethnography in the Brazilian Big Brother Fan Community

    Directory of Open Access Journals (Sweden)

    Bruno Campanella

    2009-05-01

    Full Text Available The aim of this paper is to present some of the initial results of ethnographic research conducted in early 2008 with the online fan community of the Brazilian Big Brother (BBB. After a brief introduction to some of the challenges faced by ethnographic work on television audiences in the last couple of decades, the current piece will explore some of the main characteristics constituting this new social space. Beyond the gossiping, and the more immediate talks about behaviors and game strategies of the Big Brother housemates, these forums sometimes trigger exchanges about Brazilian society at large, and the role of television broadcasting in general. Nonetheless, a closer inspection reveals how the debates found in the community are themselves permeated by the participants' struggle for status.

  20. Surgical Treatment for Epstein-Barr Virus Otomastoiditis Complicated by Facial Nerve Paralysis: A Case Report of Two Young Brothers and Review of Literature

    NARCIS (Netherlands)

    Eeten, E. van; Faber, H.T.; Kunst, D.

    2017-01-01

    We report the case of two young brothers with Epstein-Barr virus (EBV) otomastoiditis complicated by a facial nerve paralysis. The boys, aged 7 months (patient A) and 2 years and 8 months (patient B), were diagnosed with a facial nerve paralysis House-Brackmann (HB) grade IV (A) and V (B). After

  1. A Diagnostic Algorithm for Eosinophilic Granulomatosis with Polyangiitis Initially Diagnosed as Lumbar Disc Hernia or Lumbar Spinal Stenosis: Personal Experience and Review of the Literature.

    Science.gov (United States)

    Nagata, Kosei; Yamamoto, Shinichi; Miyoshi, Kota; Sato, Masaki; Arino, Yusuke; Mikami, Yoji

    2016-08-01

    Eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome) is a rare systemic vasculitis and is difficult to diagnose. EGPA has a number of symptoms including peripheral dysesthesia caused by mononeuropathy multiplex, which is similar to radiculopathy due to lumbar disc hernia or lumbar spinal stenosis. Therefore, EGPA patients with mononeuropathy multiplex often visit orthopedic clinics, but orthopedic doctors and spine neurosurgeons have limited experience in diagnosing EGPA because of its rarity. We report a consecutive series of patients who were initially diagnosed as having lumbar disc hernia or lumbar spinal stenosis by at least 2 medical institutions from March 2006 to April 2013 but whose final diagnosis was EGPA. All patients had past histories of asthma or eosinophilic pneumonia, and four out of five had peripheral edema. Laboratory data showed abnormally increased eosinophil counts, and nerve conduction studies of all patients revealed axonal damage patterns. All patients recovered from paralysis to a functional level after high-dose steroid treatment. We shortened the duration of diagnosis from 49 days to one day by adopting a diagnostic algorithm after experiencing the first case.

  2. Diagnosing and Correcting Mass Accuracy and Signal Intensity Error Due to Initial Ion Position Variations in a MALDI TOFMS

    Science.gov (United States)

    Malys, Brian J.; Piotrowski, Michelle L.; Owens, Kevin G.

    2017-12-01

    Frustrated by worse than expected error for both peak area and time-of-flight (TOF) in matrix assisted laser desorption ionization (MALDI) experiments using samples prepared by electrospray deposition, it was finally determined that there was a correlation between sample location on the target plate and the measured TOF/peak area. Variations in both TOF and peak area were found to be due to small differences in the initial position of ions formed in the source region of the TOF mass spectrometer. These differences arise largely from misalignment of the instrument sample stage, with a smaller contribution arising from the non-ideal shape of the target plates used. By physically measuring the target plates used and comparing TOF data collected from three different instruments, an estimate of the magnitude and direction of the sample stage misalignment was determined for each of the instruments. A correction method was developed to correct the TOFs and peak areas obtained for a given combination of target plate and instrument. Two correction factors are determined, one by initially collecting spectra from each sample position used and another by using spectra from a single position for each set of samples on a target plate. For TOF and mass values, use of the correction factor reduced the error by a factor of 4, with the relative standard deviation (RSD) of the corrected masses being reduced to 12-24 ppm. For the peak areas, the RSD was reduced from 28% to 16% for samples deposited twice onto two target plates over two days. [Figure not available: see fulltext.

  3. The Lehman Brothers effect and bankruptcy cascades

    Science.gov (United States)

    Sieczka, P.; Sornette, D.; Holyst, J. A.

    2011-08-01

    Inspired by the bankruptcy of Lehman Brothers and its consequences on the global financial system, we develop a simple model in which the Lehman default event is quantified as having an almost immediate effect in worsening the credit worthiness of all financial institutions in the economic network. In our stylized description, all properties of a given firm are captured by its effective credit rating, which follows a simple dynamics of co-evolution with the credit ratings of the other firms in our economic network. The dynamics resembles the evolution of Potts spin-glass with external global field corresponding to a panic effect in the economy. The existence of a global phase transition, between paramagnetic and ferromagnetic phases, explains the large susceptibility of the system to negative shocks. We show that bailing out the first few defaulting firms does not solve the problem, but does have the effect of alleviating considerably the global shock, as measured by the fraction of firms that are not defaulting as a consequence. This beneficial effect is the counterpart of the large vulnerability of the system of coupled firms, which are both the direct consequences of the collective self-organized endogenous behaviors of the credit ratings of the firms in our economic network.

  4. Complete Heart Block and Persistent Lactic Acidosis as an Initial Presentation of Non-Hodgkin Lymphoma in a Critically Ill Newly Diagnosed AIDS Patient

    Directory of Open Access Journals (Sweden)

    Mohsin Ijaz

    2014-01-01

    Full Text Available A 66-year-old male with newly diagnosed untreated acquired immunodeficiency syndrome (AIDS presented with chronic nonspecific complaints of weakness, fatigue, myalgia, and weight loss. His initial EKG showed complete heart block necessitating temporary pacemaker placement. He had no previous history of cardiac disease. He was also found to have a persistent lactic acidosis and imaging studies showed abdominal lymphadenopathy. The patient underwent biopsy of these lymph nodes and was found to have diffuse large B-cell lymphoma. The hospital course was complicated by respiratory failure requiring mechanical ventilator support and cardiac arrest. Patient remained critically ill; he was not a candidate for chemotherapy and, after a month of hospitalization, he died. Lactic acidosis and heart block as an initial presentation of non-Hodgkin lymphoma in an AIDS patient are an unusual and unique presentation.

  5. Factors associated with β-blocker initiation and discontinuation in a population-based cohort of seniors newly diagnosed with heart failure

    Directory of Open Access Journals (Sweden)

    Girouard C

    2016-09-01

    Full Text Available Catherine Girouard,1–3 Jean-Pierre Grégoire,1–3 Paul Poirier,2,4 Jocelyne Moisan1–3 1Chair on Adherence to Treatments, Université Laval, 2Faculty of Pharmacy, Université Laval, 3Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, 4Quebec Heart and Lung Institute-Université Laval, Quebec City, QC, Canada Purpose: β-Blockers (bisoprolol, carvedilol, and metoprolol are the cornerstone of heart failure (HF management. The incidence rate of β-blocker initiation and discontinuation and their associated factors among seniors with a first HF diagnosis were assessed.Methods: A population-based inception cohort study that included all individuals aged ≥65 years with a first HF diagnosis in Quebec was conducted. β-Blockers initiation among 91,131 patients who were not using β-blockers at the time of HF diagnosis and discontinuation among those who initiated a β-blocker after HF diagnosis were assessed. Stepwise Cox regression analyses were used to calculate hazard ratios (HR and to identify factors associated with β-blocker initiation and discontinuation.Results: After HF diagnosis, 32,989 (36.2% individuals initiated a β-blocker. Of these, 15,408 (46.7% discontinued their β-blocker during the follow-up. Individuals more likely to initiate a β-blocker were those diagnosed in a recent calendar year (2009: HR, 2.11; 95% confidence interval [CI], 2.00–2.23 and diagnosed by a cardiologist (HR, 1.38; 95% CI, 1.34–1.42. Individuals less likely to initiate were those aged ≥90 years (HR, 0.65; 95% CI, 0.61–0.68 and those with chronic obstructive pulmonary disease (HR, 0.66; 95% CI, 0.64–0.68. Individuals more likely to discontinue were those with more than nine medical consultations (HR, 1.14; 95% CI, 1.10–1.18 and those with dementia (HR, 1.13; 95% CI, 1.01–1.27. Individuals less likely to discontinue were those diagnosed in a recent calendar year (2009: HR 0.74; 95% CI, 0.65–0.82 and

  6. Comparing efficacy and survivals of initial treatments for elderly patients with newly diagnosed multiple myeloma: a network meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Liu X

    2016-12-01

    Full Text Available Xiaoping Liu,1,* Jiarui Chen,2,* Yuncen A He,3 Xiangyu Meng,1 Kaili Li,4 Colin K He,5 Shangqin Liu4 1Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, 2School of Basic Medical Science, Wuhan University, Wuhan, Hubei, People’s Republic of China; 3School of Medicine, Case Western Reserve University, Cleveland, OH, USA; 4Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 5Orient Healthcare, New York, NY, USA *These authors contributed equally to this work Objective: The aim of this study was to evaluate the efficacy and clinical outcome of initial therapies for elderly patients with multiple myeloma (MM.Methods: Randomized controlled trials (RCTs were obtained through a comprehensive search. Response rate, progression-free survival (PFS and overall survival (OS were the interested outcome measures. Network meta-analysis (NMA using graph theory methodology to construct an NMA model, and sensitivity analysis were performed.Results: Nineteen RCTs containing 7,235 participants and 17 treatments were included in the NMA. As compared to the classic melphalan plus prednisone (MP regimen, the majority of other initial regimens showed higher rates of complete response/near complete response, overall response rate (ORR and better PFS as well as OS. These four outcomes favored the two lenalidomide plus dexamethasone regimens (continuous lenalidomide and 18 cycles of lenalidomide plus dexamethasone, especially continuous lenalidomide plus dexamethasone regimen, over the majority of other regimens including the two established standard treatments (MP plus thalidomide or bortezomib for elderly patients with newly diagnosed MM.Conclusion: Continuous lenalidomide plus dexamethasone ranked as the best regimen in terms of ORR and OS for the treatment of elderly patients with newly diagnosed MM. Keywords: multiple myeloma, previously untreated, elderly patients

  7. Homozygous PARK7 Mutation in Parkinson’s Disease: Case Report of Two Brothers

    Directory of Open Access Journals (Sweden)

    Hülya Apaydın

    2008-06-01

    Full Text Available OBJECTIVE: Genetic studies for Parkinson’s disease (PD which have been increased during last few years have shown that parkin (PARK2, DJ-1 (PARK7 and PINK-1 (PARK6 mutations can cause autosomal recessive early-onset parkinsonism. OBJECTIVE: The aim of this study was to investigate by genetic screening methods, the presence of possible genetic mutations in two siblings who have developed PD. METHODS: In these two brothers, PD started at the age of 48 with cervical dystonia and bradykinesia on the left arm, and 56 with tremor on the right hand, respectively. Although they had a favorable response to levodopa, they developed wearing-off phenomenon without dyskinesia on the 4th year. Besides dystonia, the younger brother experienced psychosis and impulse control disorder, as well. Family history revealed first degree consanguinity and the father had also a diagnosis of PD. PD progressed rather slowly in both, but unfortunately the older brother died due to lung cancer 10 years after the initial diagnosis of PD, while he was on the stage 2 of Hoehn-Yahr scale. The younger brother is still on our follow-up at the 7th year of his PD. Informed consent was obtained and blood samples were sent to the genetic department of Juntendo University in Japan for genetic analysis. Parkin gene mutation and DJ-1 gene mutation were analyzed on the PARK7 locus, by automated direct nucleotide sequencing and performed gene dosage assay using TaqMan real-time quantitive PCR. RESULTS: After excluding the parkin mutation the presence of PARK7 was detected in both siblings with haplotype analysis. DJ-1 gene mutation analysis responsible for PARK7, revealed a deletion on intron 1. CONCLUSION: A rarely encountered PARK7 mutation was identified in two brothers having slowly progressive PD and a favorable response to levodopa, one of whom also had psychotic symptoms. As in the presented cases, the genetic studies performed on early-onset PD patients with positive family

  8. Environmental behaviour of radioactivity from Chernobyl: Brothers Water study

    International Nuclear Information System (INIS)

    Bonnett, P.J.P.; Appleby, P.G.; Oldfield, F.; Haworth, E.Y.; Hilton, J.; Davison, W.

    1992-01-01

    A study has been carried out to examine the short term behaviour of Chernobyl derived radionuclides together with the longer term patterns of transport of weapons fallout derived 137 Cs first studied on the Brothers Water catchment in the English Lake District in the 1970's. Chernobyl derived radiocaesium is observable in the soils and lake sediments of the catchment. 210 Pb dating and diatom analysis were used to confirm that the lake sediments sampled were undisturbed. A simple box model is used to estimate radionuclide inventories in Brothers Water Lake sediments. Estimates derived using this model are reasonably consistent with estimates obtained from a variety of other sources. (author)

  9. Tolerability of initiation doses of once-monthly paliperidone palmitate in patients with recently diagnosed schizophrenia in an acute treatment trial

    Science.gov (United States)

    Bossie, Cynthia A.; Fu, Dong-Jing; Sliwa, Jennifer Kern; Alphs, Larry; Ma, Yi-Wen

    2011-01-01

    Objective: To examine the tolerability of the recommended initiation doses for once-monthly injectable paliperidone palmitate in patients who have recently been diagnosed with schizophrenia and for whom high doses may pose tolerability concerns. Methods: A post hoc analysis from a 13-week double-blind study of patients with schizophrenia randomized 1:1:1:1 to placebo or paliperidone palmitate at 25, 100, or 150 mg equivalents (mg eq) of paliperidone (corresponding to 39, 156, or 234 mg respectively). This analysis focused on the recently diagnosed subgroup (≤5 years; N = 146) who received the recommended initiation dosage of paliperidone palmitate [150 mg eq on day 1 (n = 109) followed by 100 mg eq on day 8 (n = 39)] or placebo (n = 37). Adverse events (AEs), reported in ≥2% of patients receiving paliperidone palmitate during days 1–7 or ≥5% during days 8–36, and in a higher percentage of patients receiving paliperidone palmitate than placebo, were identified. AE relative risks (RRs) and 95% confidence intervals (CIs) were determined. A RR was considered potentially significant when its 95% CI did not include 1. Results: Overall, day 1–7 AE rates were 37.6% (41 of 109) and 29.7% (11 of 37) with paliperidone palmitate and placebo respectively; injection site pain (5.5% versus 2.7%, RR 2.0; 95% CI 0.25 to 16.37), agitation (4.6% versus 2.7%; RR 1.7; 95% CI 0.21 to 14.06), and headache (3.7% versus 0.0%; RR 3.1; 95% CI 0.17 to 56.41) met the ≥2% criteria. Day 8–36 AE rates were 41.0% (16 of 39) and 37.8% (14 of 37) with paliperidone palmitate and placebo respectively; anxiety (5.1% versus 0.0%; RR 4.8; 95% CI 0.24 to 95.76) met the ≥5% criteria. Key limitations were that some patients may have been ill for a significant time before formal diagnosis and that the number of patients is low in this subgroup, limiting the ability to detect statistical significance for AE RRs. Conclusions: Paliperidone palmitate initiation

  10. 20 CFR 410.214 - Conditions of entitlement; parent, brother, or sister.

    Science.gov (United States)

    2010-04-01

    ... entitlement to brother's benefits may be established for any month before January 1973, based on a disability... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Conditions of entitlement; parent, brother...; Duration of Entitlement; Filing of Claims and Evidence § 410.214 Conditions of entitlement; parent, brother...

  11. Getting Diagnosed

    Science.gov (United States)

    ... also for those with related disorders. How is Marfan syndrome diagnosed? getting_diagnosed.jpg A Marfan diagnosis can ... spinal column). Is there a genetic test for Marfan syndrome? Genetic testing can provide helpful information in some ...

  12. Big Brother gør sit indtog

    DEFF Research Database (Denmark)

    Moeslund, Thomas B.

    2009-01-01

    På grund af frygten for terror er vi i dag parate til at acceptere en grad af overvågning, der før i tiden gav mindelser om George Orwells dystopi 1984. Teknisk er der dog betydelige udfordringer i at få IT-systemerne til at opføre sig som Big Brother. Udgivelsesdato: December...

  13. Freud on Brothers and Sisters: A Neglected Topic

    Science.gov (United States)

    Sherwin-White, Susan

    2007-01-01

    This paper explores Freud's developing thought on brothers and sisters, and their importance in his psychoanalytical writings and clinical work. Freud's work on sibling psychology has been seriously undervalued. This paper aims to give due recognition to Freud's work in this area. (Contains 1 note.)

  14. Propaganda in Warner Brothers World War II Cartoons.

    Science.gov (United States)

    Machowski, James Stanley; Brown, James William

    To examine the role of the animated cartoon in propaganda associated with World War II, 194 of 262 cartoons produced for theatrical release by Warner Brothers, Inc., from 1939 to 1946 were analyzed. Propaganda content was determined by the number and nature of symbols used and the cartoon's "attitudes" toward these symbols. An analysis…

  15. Commissioner for Inland Revenue V Lever Brothers and Unilever Ltd

    African Journals Online (AJOL)

    Lever Brothers, the South African tax case that formed the basis of this research, was concerned with determining the source of interest income. In its time, this was one of the landmark cases and established tax principles that were valid for 54 years, until superseded by changes to legislation. The research presented a ...

  16. Commissioner for Inland Revenue v Lever Brothers and Unilever Ltd

    African Journals Online (AJOL)

    kirstam

    21Key words: Lever Brothers and Unilever; South African income tax; source of income; interest; the “practical man”; the .... facilities, and he housed his employees in a model village of well-built homes on the factory site. ... be cancelled and any excess of the value of the shares over the debt would be adjusted by a money.

  17. Paternity testing in case of brother-sister incest.

    Science.gov (United States)

    Macan, Marijana; Uvodić, Petra; Botica, Vladimir

    2003-06-01

    We performed a paternity test in a case of incest between brother and sister. DNA from blood samples of the alleged parents and their two children was obtained with Chelex DNA extraction method and quantified with Applied Biosystems QuantiBlot quantitation kit. Polymerase chain reaction (PCR) amplification of DNA samples was performed with AmpFlSTR SGM Plus PCR amplification kit and GenePrint PowerPlex PCR amplification kit. The amplified products were separated and detected by using the Perkin Elmer's ABI PRISM trade mark 310 Genetic Analyser. DNA and data analysis of 17 loci and Amelogenin confirmed the suspicion of brother-sister incest. Since both children had inherited all of the obligate alleles from the alleged father, we could confirm with certainty of 99.999999% that the oldest brother in the family was the biological father of both children. Calculated data showed that even in a case of brother-sister incest, paternity could be proved by the analysis of Amelogenin and 17 DNA loci.

  18. Five Martyr Brothers. First Polish hermits and their worship

    Directory of Open Access Journals (Sweden)

    Kinga Blaschke

    2016-12-01

    Full Text Available Brothers Benedict and John, students of Romuald, came to Poland at the invitation of Otto III to convert pagans. Soon the Italian hermits were joined by Polish brothers Isaac and Matthew, who helped them in learning the Slavic language. The hermits, as well as Christinus, well killed in 1003 by thugs who wanted to steal money given by Duke Boleslav to an expedition to Rome, which was aimed at obtaining papal consent for conducting missionary work. Although the hermits died as victims of a robbery, killed by fellow Christians, the pope canonized them as martyrs. Their lives are relatively well-documented: the earliest and the most credible story of the five brothers by Bruno of Querfurt was written as early as five years after their death, although remained unknown until 1883. Another early account is the life of St. Romuald by Piotr Damiani of 1041. The martyrs have been also associated with yet another mysterious work – a gravestone unearthed in 1959 at the external wall of the north Roman apse of the Gniezno Cathedral, considered by most researchers the oldest epigraphic item on the Polish soil. However, the identification of the warriors mentioned in the inscription with 11th century martyrs raises many doubts. The article discusses the above matters, as well as the subject of the development of the worship of the martyr brothers.

  19. The number of cores taken in patients diagnosed with a single microfocus at initial biopsy is a major predictor of insignificant prostate cancer.

    Science.gov (United States)

    Villa, Luca; Capitanio, Umberto; Briganti, Alberto; Abdollah, Firas; Suardi, Nazareno; Salonia, Andrea; Gallina, Andrea; Freschi, Massimo; Russo, Andrea; Castiglione, Fabio; Bianchi, Marco; Rigatti, Patrizio; Montorsi, Francesco; Scattoni, Vincenzo

    2013-03-01

    Patients with a single microfocus of prostate cancer at initial biopsy represent the ideal candidates for active surveillance. We investigate whether the number of cores taken affects the concordance rate between microfocus of prostate cancer and the confirmation of a pathologically insignificant prostate cancer at radical prostatectomy. Data were analyzed from 233 patients with a single microfocus of prostate cancer at initial transrectal prostate biopsy (a single focus of Gleason 6 involving 5% or less of the core) subsequently treated with radical prostatectomy. The chi-square test, cubic spline analyses and logistic regression analyses were used to depict the relationship between the number of cores taken and the probability of confirming the presence of an indolent disease (pathologically confirmed insignificant prostate cancer defined as radical prostatectomy Gleason score 6 or less, tumor volume 0.5 ml or less and organ confined disease). Overall 65 patients (27.9%) showed pathologically confirmed insignificant prostate cancer at radical prostatectomy. The rate of pathologically confirmed insignificant prostate cancer was 3.8%, 29.6% and 39.4% in patients who underwent biopsy of 12 or fewer cores, 13 to 18 cores and 19 or more cores, respectively (p number of cores taken (p cancer. Of patients diagnosed with a single microfocus of prostate cancer the number of biopsy cores taken was a major independent predictor of having pathologically confirmed insignificant prostate cancer at radical prostatectomy. Therefore, when active surveillance is considered as a possible alternative in patients with microfocus of prostate cancer, the number of cores taken should be taken into account in decision making. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. Tibial bone metastasis as an initial presentation of endometrial carcinoma diagnosed by fine-needle aspiration cytology: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sarag Aboujafar Boukhar

    2015-01-01

    Full Text Available Endometrial cancer is the most common gynecologic malignancy in the United States. However, bony metastasis is infrequent and exceptionally rare as the initial presentation. We report a case of a 77-year-old female with a clinically silent endometrial carcinoma who presented with a left tibial metastasis as the first manifestation of her disease. Ours is only the third case diagnosed by fine-needle aspiration (FNA cytology, and the first to detail the cytomorphologic features of metastatic endometrial cancer to bone. These microscopic findings, including three-dimensional cohesive clusters with cellular overlapping and cuboidal to columnar cells exhibiting low nuclear: cytoplasmic ratios and partially vacuolated cytoplasm, differ significantly from those of endometrial carcinoma on a Papanicolaou test. The tumor bore similarity to the more commonly encountered metastatic colon cancer, but immunohistochemical staining enabled reliable distinction between these entities. A review of osseous metastases of endometrial cancer demonstrates a predilection for bones of the lower extremity and pelvis with a predominance of the endometrioid histologic subtype. In about a quarter of the cases, the bony metastasis was the first manifestation of the cancer. FNA was an effective diagnostic modality for this unusual presentation of a common malignancy. Awareness of this entity and its differential diagnosis is essential for accurate and timely diagnosis.

  1. Cobb′s collar occurring in two brothers in a family: A rare entity revisited

    Directory of Open Access Journals (Sweden)

    Partha Pal

    2014-01-01

    Full Text Available Most urethral strictures arise from iatrogenic, traumatic, or inflammatory causes. We report the familial occurrence of a congenital bulbar urethral stricture in two brothers. Retrograde and voiding cystourethrography was performed. A Cobb′s collar was diagnosed after radiological and endoscopic evaluation in both cases and was successfully managed with urethroplasty. Cobb′s collar is a rarely recognized cause of a membranous stricture of bulbar urethra that can lead to several urinary problems. In cases of adolescent and young adults presenting with symptoms of progressive urinary obstruction and enuresis with or without urinary tract infection, Cobb′s collar can be seen as a minor constriction in the bulbar urethra, but is not frequently symptomatic, and the familial occurrence of such a stricture is even rarer.

  2. Lecciones regulatorias de la quiebra de Lehman Brothers

    Directory of Open Access Journals (Sweden)

    William Black

    2010-09-01

    Full Text Available La quiebra de Lehman Brothers el 15 de septiembre de 2008 marcó un parteaguas en la actual crisis financiera/económica mundial. La decisión de las autoridades estadounidenses de no rescatar el banco ha sido objeto a un gran debate público y académico, pero casi siempre carente de una discusión a profundidad sobre el comportamiento del banco. William Black, un exregulador bancario reconocido por detectar los mayores fraudes durante la crisis bancaria de los Savings & Loan en los años ochenta en los Estados Unidos y uno de los criminólogo financiero más activos en la esfera pública estadounidense, ofrece al lector una visión de los negocios turbios de Lehman Brothers que le llevaron a su colapso. Con el respaldo de documentación pública, Black describe y analiza como Lehman Brothers actuaba como un “vector de fraude”, creando y recreando un ambiente criminal en el sector financiero que castiga al comportamiento honesto y premia el crimen financiero. Ese tema, central al entendimiento de la crisis, a la vez poco reconocido, se expone con la maestría de quien es uno de sus mejores conocedores.

  3. A Diagnostic Algorithm for Eosinophilic Granulomatosis with Polyangiitis Initially Diagnosed as Lumbar Disc Hernia or Lumbar Spinal Stenosis: Personal Experience and Review of the Literature

    OpenAIRE

    Nagata, Kosei; Yamamoto, Shinichi; Miyoshi, Kota; Sato, Masaki; Arino, Yusuke; Mikami, Yoji

    2016-01-01

    Eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss syndrome) is a rare systemic vasculitis and is difficult to diagnose. EGPA has a number of symptoms including peripheral dysesthesia caused by mononeuropathy multiplex, which is similar to radiculopathy due to lumbar disc hernia or lumbar spinal stenosis. Therefore, EGPA patients with mononeuropathy multiplex often visit orthopedic clinics, but orthopedic doctors and spine neurosurgeons have limited experience in diagnosing EG...

  4. Thyroid disorders in patients with newly diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28-CRP)

    DEFF Research Database (Denmark)

    Emamifar, Amir; Hangaard, Jørgen; Jensen Hansen, Inger Marie

    2017-01-01

    To determine the prevalence of thyroid disorders among newly diagnosed rheumatoid arthritis (RA) patients and evaluate the association between clinical characteristics of RA and thyroid disorders, and also initial treatment response in the RA patients with thyroid disorders.Newly diagnosed, adult...... years were reviewed to reveal if they had been diagnosed with thyroid disorders or they had abnormal thyroid test.In all, 439 patients were included, female 60.1%, mean age 64.6 ± 15.0 years and disease duration 2.6 ± 1.7 years. Prevalence of thyroid disorders was 69/439 (15.7%) and hypothyroidism...... was the most frequent disorder (30.4%). The presence of thyroid disorders among RA patients was significantly associated with female sex (P thyroid disorders had significantly poorer initial response to RA...

  5. The comparison of family types in fairy tales by brothers Grimm and H. C. Andersen

    OpenAIRE

    Šček, Marjeta

    2014-01-01

    The present thesis entitled The Comparison of Family Types in Fairy Tales by Brothers Grimm and H. C. Andersen consists of two parts: the theoretical and the empirical part. The first part is a brief summary of opuses and biographies of Jacob and Wilhelm Grimm and Hans Christian Andersen, followed by a section describing several different definitions of families and family types. The second part is an analysis of ten fairy tales by brothers Grimm: The Frog King, or Iron Henry, Little Brother ...

  6. Matching osteochondritis dissecans lesions in identical twin brothers.

    Science.gov (United States)

    Richie, Lucas B; Sytsma, Mark J

    2013-09-01

    Osteochondritis dissecans is a disorder of unknown etiology that can result in fragmentation of osteochondral surfaces, most commonly of the knee, shoulder, elbow, and ankle. This may lead to sequelae of pain and an inability to participate in desired activities. Multiple theories exist as to the true cause of the disorder, but none have been fully proven. One such proposed etiology is genetic causation. Familial cases of osteochondritis dissecans are rare, yet these cases offer support to growing evidence that may support a genetic link. This article describes osteochondritis dissecans lesions of the femoral trochlea in monozygotic (identical) twins. Both twins presented with similar symptoms 1 year apart. Neither twin had any clear inciting trauma. Magnetic resonance imaging revealed osteochondral lesions in similar positions of the lateral trochlear of the same knee in both brothers. Osteochondral autograft transfer and tibial tubercle anteromedialization were performed on both patients. An identical postoperative protocol was followed, and recovery with full return to sport was comparable for the brothers. To the authors' knowledge, only 1 other case report exists of osteochondritis dissecans lesions in monozygotic twins. Although debate continues regarding the true etiology of this disorder, cases of identical twins presenting with a similar disease process are highly suggestive of a genetic component and may lead to early identification and treatment of these lesions. Continued research in the area of osteochondritis dissecans and its genetic basis is needed to completely understand this disorder. Copyright 2013, SLACK Incorporated.

  7. The Perceptions and Experiences of Adolescent Siblings Who Have a Brother with Autism Spectrum Disorder

    Science.gov (United States)

    Petalas, Michael A.; Hastings, Richard P.; Nash, Susie; Reilly, Deirdre; Dowey, Alan

    2012-01-01

    Background: There is a dearth of research on the perspectives of adolescent siblings growing up with a brother or sister with an autism spectrum disorder (ASD). Method: Semistructured interviews were used to elicit the perceptions and experiences of 12 typically developing adolescents with a brother with an ASD. Interpretative phenomenological…

  8. Living with a Brother Who Has an Autism Spectrum Disorder: A Sister's Perspective

    Science.gov (United States)

    Connell, Zara O.; Halloran, Maeve O.; Doody, Owen

    2016-01-01

    People with Autism Spectrum Disorder (ASD) are born into families and influence family functioning both positively and negatively. One of the most enduring relationships a person with ASD will have is their relationship with a brother or sister. Services for people with ASD should provide effective support to families, which include brothers,…

  9. "Southern Pop Culture and the Literary Tradition in O Brother, Where Art Thou?"

    DEFF Research Database (Denmark)

    Bjerre, Thomas Ærvold

    2009-01-01

      This essay discusses the Coen brothers movie O Brother, Where Art Thou? (2000). Rather than reading the movie as a modern retelling of The Odyssey, as most critics have done, it is read within a context of Southern literature and history. The essay points out and discusses the many references...

  10. Mothers' differential treatment of adolescent siblings: predicting college attendance of sisters versus brothers.

    Science.gov (United States)

    Bissell-Havran, Joanna M; Loken, Eric; McHale, Susan M

    2012-10-01

    Current estimates suggest that by 2015, 60% of college students will be women, a change since 1970 when 59% were men. We investigated family dynamics that might explain the growing gender gap in college attendance, focusing on an ethnically diverse sample of 522 mixed sex sibling dyads from the National Longitudinal Study of Adolescent Health. We examined whether the difference between sisters' and brothers' reports of their mothers' expectations for, and involvement in, their education during adolescence predicted their differential odds of college attendance seven years later. Sisters were more likely than brothers to attend college, and this gap was more pronounced among non-Whites and non-Asians. Sisters also had higher grades in school than their brothers. Although there were no gender differences overall in maternal educational expectations or involvement, brothers reported greater maternal involvement than sisters in non-White and non-Asian families. After controlling for family background factors, the average of siblings' reports of maternal treatment, and differences between siblings' grades, the results revealed that as sisters reported greater maternal educational expectations than their brothers, it became more likely that only the sister rather than only the brother in the family attended college. The difference between brothers' and sisters' reports of their mothers' educational involvement and their odds of attending college showed the same pattern of association but was not statistically significant. These results suggest that within-family social comparisons may play a role in sisters' and brothers' choices about attending college.

  11. Initial basal cell carcinomas diagnosed in the National Campaign for Skin Cancer Prevention are smaller than those identified by the conventional medical referral system.

    Science.gov (United States)

    Wakiyama, Thweicyka Pinheiro; França, Maria Laura Marconi; Carvalho, Larissa Pierri; Marques, Mariangela Esther Alencar; Miot, Hélio Amante; Schmitt, Juliano Vilaverde

    2017-01-01

    Basal cell carcinoma is the malignant tumor most often diagnosed in the National Campaign for Skin Cancer Prevention (NCSCP). Little is known about the profile of these lesions compared to the profile of lesions diagnosed by conventional routes of public dermatological care. To identify if basal cell carcinomas identified in prevention campaigns and referred to surgery are smaller than those routinely removed in a same medical institution. Cross-sectional study including tumors routed from 2011-2014 campaigns and 84 anatomopathological reports of outpatients. The campaigns identified 223 individuals with suspicious lesions among 2,531 examinations (9%), with 116 basal cell carcinomas removed. Anatomopathological examinations revealed that the primary lesions identified in the national campaigns were smaller than those referred to surgery by the conventional routes of public health care (28 [13-50] x 38 [20-113] mm2, p basal cell carcinoma lesions. Retrospective study and inaccuracies in the measurements of the lesions. The NCSCP promotes an earlier treatment of basal cell carcinomas compared to patients referred to surgery by the conventional routes of public health care, which can result in lower morbidity rates and better prognosis.

  12. Frequency of the HFE C282Y and H63D mutations in Danish patients with clinical haemochromatosis initially diagnosed by phenotypic methods

    DEFF Research Database (Denmark)

    Milman, Nils; Koefoed, Pernille; Pedersen, Palle

    2003-01-01

    idiopathic haemochromatosis diagnosed by phenotypic methods (serum transferrin saturation, serum ferritin, liver biopsy and mobilisable body iron stores). In 32 unrelated patients, frozen blood samples were available for genetic analysis. In a subsequent series of 26 unrelated Danish patients, a phenotypic......: Among the patients, 55 of 58 (94.8%) were C282Y/C282Y homozygous. One 63-year-old woman (1.7%) was compound C282Y/H63D heterozygous. Two women (3.4%), aged 42 and 43 yrs were negative for both the C282Y and the H63D mutation. CONCLUSION: In the Danish population, homozygosity for the C282Y mutation...

  13. Isolated Penile Torsion in Brothers: A Case Report

    Directory of Open Access Journals (Sweden)

    Metin Gunduz

    2012-04-01

    Full Text Available Penile torsion can be congenital and associated with hypospadias and chordee, or can be acquired after circumcision. The incidence of isolated neonatal penile torsion was 1.7 to 27% in the literature. The majority were between 10 and deg; and 20 and deg;. Generally, torsion was to the left in cases. The techniques for correction of penile torsion described in the literature are penile de-gloving and reattaching of skin, resection of Buck's fascia incising the base of the penis and removing angular ellipses of corporeal tissue with subsequent plication of tunica, and dorsal dartos flap rotation in severe cases. In conclusion, penile torsion may be familial. Therefore, brothers should be examined carefully. The degloving and realignment technique is successful in isolated penile torsion. [Arch Clin Exp Surg 2012; 1(2.000: 122-124

  14. Risk factors for disability pension over 11 years in a cohort of young persons initially sick-listed with low back, neck, or shoulder diagnoses.

    Science.gov (United States)

    Borg, Karin; Hensing, Gunnel; Alexanderson, Kristina

    2004-01-01

    A study was undertaken to ascertain whether the differences in risk in relation to gender and citizenship observed in a previous study of the same cohort would remain if more recent data on sickness absence were used. This was an 11-year prospective population-based cohort study. The dataset includes all individuals in a Swedish city who, in 1985, were aged 25-34 and had a sick-leave spell > or = 28 days with neck, shoulder, or back diagnoses (n=213). The data covered the following: for 1985-96, disability pension, emigration, and death; for 1982-96, sickness absence; for 1985, sex and citizenship. The data were subjected to Cox regression analyses with a time-dependent covariate. Disability pension was granted to 22% (n=46) of the cohort. The relative risk for disability pension increased by 9.3 with each sick-leave spell > or = 90 days during the two previous years. The risk was higher for women than men, and also higher for foreign citizens than Swedes. Many studies have revealed a gender difference in the risk of being on disability pension, and it was found that this difference was still apparent when sick leave during the follow-up period is taken into account. Thus, the reason for the gender differences ought to be found among other factors than prior levels of sickness absence. Copyright 2004 Taylor & Francis

  15. Brother Peter of Jesus at Purgatory: rewrites of a historiographyc passage

    Directory of Open Access Journals (Sweden)

    Joan Mahiques Climent

    2016-12-01

    Full Text Available The second volume of the Reforma de los descalzos (Madrid, 1655 of Brother Francis of St. Mary relates that Brother Peter of Jesus, while dying in Bellpuig because of the plague, appeared to a companion in Lleida to say he was in Purgatory. From different printed works and engravings published from 1681 to 1724, we study the relationship between texts and images representing this episode. We also edit two versions written by Brother John of St. Joseph (1642-1718, whose autographs are preserved in mss. 990 and 991 of the University of Barcelona Library.

  16. Macroscopic lymphovascular invasion visualized on mammogram and magnetic resonance imaging: Initially misidentified as ductal carcinoma in situ but properly diagnosed by immunohistochemistry

    Directory of Open Access Journals (Sweden)

    Linda M Sanders

    2017-04-01

    Full Text Available Objectives: Lymphovascular invasion (LVI is a pathologic, microscopic finding associated with invasive cancer, and is a poor prognostic indicator, but has no reported imaging findings. This report presents the first documented case of LVI with seen by imaging. Linear branching microcalcifications were identified on mammography and clumped enhancement was noted on MRI, both imaging findings that are highly predictive of ductal carcinoma in situ (DCIS. Methods: Ultrasound guided core biopsy of the dominant mass was performed, confirming invasive ductal malignancy. Stereotactic biopsy performed on the microcalcifications was initially interpreted by pathology as DCIS. Results: Patient underwent mastectomy. Pathologic evaluation of the surgical specimen confirmed the invasive ductal malignancy. Microcalcifications were re-evaluated with immunohistochemistry (IHC and re-classified as LVI. Radiology images and IHC stains are shown. Conclusion: This is the first report of LVI identified by imaging with findings that mimicked DCIS and initially mis-identified as DCIS by pathology as well. The implications of this overlap in radiologic appearance are discussed.

  17. Mesothelial Inclusions in Pelvic Lymph Nodes Initially Diagnosed as Metastatic Prostate Cancer; the Utility of Second Opinions and Genomic Testing in the Setting of Unexpected Results

    Directory of Open Access Journals (Sweden)

    Fadi Joudi

    2017-01-01

    Full Text Available Benign mesothelial inclusions in pelvic lymph nodes may be mistaken for metastatic disease in the setting of pelvic malignancy. In this case-report a patient with Low-Risk prostate cancer (confirmed by biopsy and genomic testing underwent radical prostatectomy with pelvic lymph node dissection. The initial pathological diagnosis was organ-confined Gleason 3 + 3 = 6 cancer with metastasis to a pelvic lymph node. Upon review of the pathological specimen and immunohistochemical staining the lymph node tissue concerning for metastatic disease was recharacterized as mesothelial in origin. This case illustrates the importance of second opinions and immunohistochemistry for unexpected or unusual pathological findings.

  18. The Failure of Lehman Brothers and Merril Lynch: A Lesson for the ...

    African Journals Online (AJOL)

    DR Nneka

    afrrev.v9i2.9. The Failure of Lehman Brothers and Merril Lynch: A Lesson for the Nigerian Banking Industry. Achugbu, Austine A. Department of Banking and Finance,. Anambra State University, Igbariam Campus,. Anambra State, Nigeria.

  19. 20 CFR 410.340 - Determination of relationship; parent, brother, or sister.

    Science.gov (United States)

    2010-04-01

    ... domiciled (see § 410.392) at the time of his death would find, under the law they would apply in determining..., brother, or sister. Where, under such law, the individual does not bear the relationship to the miner of...

  20. Initial Results of a Prospective Clinical Trial of 18F-Fluciclovine PET/CT in Newly Diagnosed Invasive Ductal and Invasive Lobular Breast Cancers.

    Science.gov (United States)

    Ulaner, Gary A; Goldman, Debra A; Gönen, Mithat; Pham, Hanh; Castillo, Raychel; Lyashchenko, Serge K; Lewis, Jason S; Dang, Chau

    2016-09-01

    (18)F-labeled 1-amino-3-fluorocyclobutane-1-carboxylic acid ((18)F-fluciclovine) is a leucine analog PET/CT radiotracer that depicts amino acid transport into cells. Amino acid transport proteins have been shown to be upregulated in breast malignancies by microarray and immunohistochemical analysis, so we hypothesized that (18)F-fluciclovine may provide a novel method of visualizing breast cancer and now report a prospective clinical trial of (18)F-fluciclovine PET/CT in newly diagnosed advanced local invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC). Twenty-seven women with a new diagnosis of locally advanced IDC (n = 19) or ILC (n = 8) underwent PET/CT of the chest after intravenous administration of 370 MBq of (18)F-fluciclovine. The SUVmax, SUVmean, metabolic tumor volume, and total lesion avidity were obtained for the primary breast tumor, axillary lymph nodes, and extraaxillary lymph nodes. Sites of previously unsuspected malignancy were recorded and confirmed by pathology. Results of (18)F-fluciclovine PET/CT were compared with those of (18)F-FDG PET/CT, when available, using the concordance correlation coefficient. All locally advanced breast cancers were (18)F-fluciclovine-avid. Of 21 patients with pathologically proven axillary nodal metastases, (18)F-fluciclovine-avid axillary nodes were seen in 20. (18)F-fluciclovine detected pathologically proven extraaxillary nodal metastases in 3 patients, including 2 previously unsuspected internal mammary nodes. Fourteen patients underwent (18)F-FDG PET/CT for comparison with (18)F-fluciclovine. Concordance for metabolic tumor volume between (18)F-fluciclovine and (18)F-FDG was strong (concordance correlation coefficient, 0.89; 95% confidence interval, 0.73-0.96), but concordance for SUVmax was weak (concordance correlation coefficient, 0.04; 95% confidence interval, -0.16-0.24). In patients with both modalities available (n = 14), primary ILCs (n = 4) demonstrated (18)F-fluciclovine avidity

  1. Do brothers and sisters of siblings with intelectual disability need the support of social work?

    OpenAIRE

    Cardová, Michaela

    2007-01-01

    This thesis explores the experience and support needs of siblings with a brother or sister with intellectual disability. Through review of what is a quite limited literature and from original qualitative research, involving interviews with siblings, the author examines their social reality, focusing especially on their relationships with their disabled brother or sister and with the wider society. Particular attention is given to identifying to what extent the siblings' lives are influenced b...

  2. The Warner Brothers and Franklin Delano Roosevelt:Connections and Collaborations

    OpenAIRE

    Cohen, Harvey

    2013-01-01

    This working paper traces the history of the Warner brothers and their Hollywood film studio, from their hardscrabble beginnings to their famous championing of a "social realist" aesthetic in their motion pictures released during the 1920s and 1930s. The pre-presidential career of Franklin Delano Roosevelt is also featured and contrasted with that of the Warner Brothers, setting up a discussion of how the Warner Bros. Studio not only supported Roosevelt financially with fundraising events but...

  3. Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects - data from the osteoarthritis initiative

    International Nuclear Information System (INIS)

    Laberge, Marc A.; Baum, Thomas; Virayavanich, Warapat; Nardo, Lorenzo; Link, Thomas M.; Nevitt, M.C.; Lynch, J.; McCulloch, C.E.

    2012-01-01

    To study the effect of BMI on the prevalence, severity, and 36-month progression of early degenerative changes in the knee by using 3T MRI in middle-aged subjects without radiographic osteoarthritis (OA). We examined baseline and 36-month follow-up MR studies from 137 middle-aged individuals (45-55 years old) with risk factors for knee OA but no radiographic OA from the Osteoarthritis Initiative. Subjects were grouped into three categories: normal BMI (BMI 2 , n = 38), overweight (BMI 25-29.9 kg/m 2 , n = 37), and obese (BMI ≥ 30 kg/m 2 , n = 62). Using 3T MRI, cartilage, meniscus, and bone marrow abnormalities were graded using the OA Whole-organ MR Imaging Score (WORMS). The statistical analysis was corrected as necessary for differences in age, sex, and OA risk factors other than BMI. The overall prevalence of lesions was 64% for meniscus and 79% for cartilage (including low grade lesions). At baseline, the prevalence and severity of knee lesions was positively associated with BMI, with a nearly fourfold increase in meniscal tears and more than twofold increase in high-grade cartilage defects in obese individuals relative to normal-weight subjects. Over the 36-month follow-up period, the number of new or worsening cartilage lesions of any grade was significantly higher in obese subjects (p = 0.039), while there was no significant difference in meniscal lesion progression. Obesity was associated with both higher prevalence and severity of early degenerative changes in the knee in middle-aged individuals without radiographic OA and with significantly increased cartilage lesion progression (of any grade) over 36 months. (orig.)

  4. Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects - data from the osteoarthritis initiative

    Energy Technology Data Exchange (ETDEWEB)

    Laberge, Marc A.; Baum, Thomas; Virayavanich, Warapat; Nardo, Lorenzo; Link, Thomas M. [University of California San Francisco, Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, M.C.; Lynch, J.; McCulloch, C.E. [University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

    2012-06-15

    To study the effect of BMI on the prevalence, severity, and 36-month progression of early degenerative changes in the knee by using 3T MRI in middle-aged subjects without radiographic osteoarthritis (OA). We examined baseline and 36-month follow-up MR studies from 137 middle-aged individuals (45-55 years old) with risk factors for knee OA but no radiographic OA from the Osteoarthritis Initiative. Subjects were grouped into three categories: normal BMI (BMI < 25 kg/m{sup 2}, n = 38), overweight (BMI 25-29.9 kg/m{sup 2}, n = 37), and obese (BMI {>=} 30 kg/m{sup 2}, n = 62). Using 3T MRI, cartilage, meniscus, and bone marrow abnormalities were graded using the OA Whole-organ MR Imaging Score (WORMS). The statistical analysis was corrected as necessary for differences in age, sex, and OA risk factors other than BMI. The overall prevalence of lesions was 64% for meniscus and 79% for cartilage (including low grade lesions). At baseline, the prevalence and severity of knee lesions was positively associated with BMI, with a nearly fourfold increase in meniscal tears and more than twofold increase in high-grade cartilage defects in obese individuals relative to normal-weight subjects. Over the 36-month follow-up period, the number of new or worsening cartilage lesions of any grade was significantly higher in obese subjects (p = 0.039), while there was no significant difference in meniscal lesion progression. Obesity was associated with both higher prevalence and severity of early degenerative changes in the knee in middle-aged individuals without radiographic OA and with significantly increased cartilage lesion progression (of any grade) over 36 months. (orig.)

  5. The Montgolfier Brothers and the Invention of Aviation

    Science.gov (United States)

    Moore, Charles B.

    The first hot air balloon ascension over Paris in September 1783 has been described so many times that it and its passengers—the sheep, the rooster, and the duck—have joined Benjamin Franklin and his kite in the folklore of our culture. Not so well known is the earlier history of ballooning; that the brothers Montgolfier had demonstrated their hot air balloons repeatedly for several months prior to the ascent over Paris; or that the physicist Charles, urged onward and financed by an enthusiast, Barthélemy Faujas de Saint-Fond, launched successfully the first fabric balloon filled with hydrogen over Paris more than 3 weeks prior to the memorable ascent of the sheep, and rooster, and the duck.For all of its well-documented detail, the book is readable and enjoyable. It is a well-written but complex book in which Professor Gillispie develops a number of subjects to recreate the era in perspective. The origins and the disposition of the Montgolfiers, the industry of the period, the idea of capturing heated air are all reported in detail. The attempts to obtain government funding and the promotional activities in Paris were forerunners of the modern techniques for obtaining support of research activities.

  6. Exome sequencing identifies mutations in ABCD1 and DACH2 in two brothers with a distinct phenotype

    OpenAIRE

    Zhang, Yanliang; Liu, Yanhui; Li, Ya; Duan, Yong; Zhang, Keyun; Wang, Junwang; Dai, Yong

    2014-01-01

    Background We report on two brothers with a distinct syndromic phenotype and explore the potential pathogenic cause. Methods Cytogenetic tests and exome sequencing were performed on the two brothers and their parents. Variants detected by exome sequencing were validated by Sanger sequencing. Results The main phenotype of the two brothers included congenital language disorder, growth retardation, intellectual disability, difficulty in standing and walking, and urinary and fecal incontinence. T...

  7. Mortality and health-related habits in 900 Finnish former elite athletes and their brothers.

    Science.gov (United States)

    Kontro, Titta Katariina; Sarna, Seppo; Kaprio, Jaakko; Kujala, Urho M

    2018-01-01

    There is conflicting evidence on the associations between participation in vigorous sports, health habits, familial factors and subsequent mortality. We investigated all-cause mortality and health-related behaviour among former elite athletes and their brothers. The mortality of Finnish male former elite athletes, who had represented Finland between 1920 and 1965 (n=900) and their age-matched brothers (n=900), was followed from the time when athlete started an elite athlete career until 31 December 2015. The age-adjusted HRs were calculated by a paired Cox proportional hazards model. In 2001, surviving participants (n=199 athletes and n=199 age-matched brothers) reported their self-rated health (SRH), physical activity, alcohol consumption and smoking habits in the questionnaire. During the total follow-up period, 1296 deaths (72% of the cohort) occurred. The age-adjusted HRs for all-cause mortality in former athletes was 0.75 (95% CI 0.65 to 0.87, Psports and 72.2 years for power sports athletes, and 77.5, 73.7 and 72.2 years for their age-matched brothers, respectively. In 2001, compared with their brothers, former athletes smoked less (Pathletes are more physically active, smoke less, have better self-rated health and live longer than their brothers. Genetic differences between athletes and brothers, aerobic training for endurance elite sports and a healthier lifestyle may all contribute to reduced mortality. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Brother of CDO (BOC) expression in equine articular cartilage.

    Science.gov (United States)

    Vanderman, K S; Tremblay, M; Zhu, W; Shimojo, M; Mienaltowski, M J; Coleman, S J; MacLeod, J N

    2011-04-01

    Brother of CDO (BOC) is a cell surface receptor that derives its name from the structurally related protein, cell adhesion molecule-related/down-regulated by oncogenes (CDO, sometimes CDON). High levels of BOC mRNA and protein expression have been described in embryonic tissues with active cell proliferation and ongoing cellular differentiation(1,2). A microarray-based screen of RNA isolated from 11 different adult equine tissues unexpectedly identified BOC as having an expression pattern restricted to articular cartilage. The objective of this study was to further investigate BOC expression in adult articular cartilage relative to other tissues. Both RT-qPCR and mRNA sequencing confirmed the microarray data. Steady state BOC mRNA levels in articular cartilage were substantially higher than in the other adult tissues tested, neonatal tendon, placenta, and whole embryo. The expression of BOC displayed a pattern of tissue specificity comparable to well established cartilage matrix protein biomarkers. BOC mRNA levels in articular cartilage increased with age, but were rapidly down-regulated when chondrocytes were enzymatically isolated from the cartilage matrix and expanded in monolayer culture. Relative expression patterns of CDO were broadly similar, but displayed lower fold change differences. A functional role in articular cartilage that involves Hedgehog signaling is suggested by the known binding affinity of BOC for all three Hedgehog ligands. These data also extend BOC and CDO biology to a post-mitotic and highly differentiated cell type within a mature tissue. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  9. A missense mutation in MKRN3 in a Danish girl with central precocious puberty and her brother with early puberty

    DEFF Research Database (Denmark)

    Känsäkoski, Johanna; Raivio, Taneli; Juul, Anders

    2015-01-01

    BACKGROUND: Idiopathic central precocious puberty (ICPP) results from the premature reactivation of the hypothalamic-pituitary-gonadal axis leading to development of secondary sexual characteristics prior to 8 y in girls or 9 y in boys. Since the initial discovery of mutations in the maternally...... imprinted MKRN3 gene in 2013, several case reports have described mutations in this gene in ICPP patients from different populations, highlighting the importance of MKRN3 as a regulator of pubertal onset. METHODS: We screened 29 Danish girls with ICPP for mutations in MKRN3. Expression of MKRN3 in human...... hypothalamic complementary DNA (cDNA) was investigated by PCR. RESULTS: One paternally inherited rare variant, c.1034G>A (p.Arg345His), was identified in one girl with ICPP and in her brother with early puberty. The variant is predicted to be deleterious by three different in silico prediction programs...

  10. The Effect of a Multi-Level Intervention on the Initiation of Antiretroviral Therapy (ART) among HIV-Infected Men Who Inject Drugs and Were Diagnosed Late in Thai Nguyen, Vietnam

    Science.gov (United States)

    Zelaya, Carla E.; Le Minh, Nguyen; Lau, Bryan; Latkin, Carl A.; Viet Ha, Tran; Minh Quan, Vu; Mo, Thi Tran; Sripaipan, Teerada; Davis, Wendy W.; Celentano, David D.; Frangakis, Constantine; Go, Vivian F.

    2016-01-01

    Background In Vietnam, an estimated 256,000 people are living with HIV, and 58% of HIV-infections reported are among people who inject drugs (PWID). While antiretroviral therapy (ART) is widely available in Vietnam, marginalized hard-to-reach male PWID, demonstrate significantly reduced and delayed access to ART. Methods We investigated the effect of a randomized four-arm multi-level intervention trial on ART initiation among male PWID. Our analysis was conducted among a subset of trial participants (n = 136), who were newly diagnosed as HIV-infected, treatment naïve, and eligible for ART (baseline late diagnosis). The trial arms included: 1, standard of care (HIV testing and counseling); 2, structural-level intervention (door-to-door communications and community video screenings); 3, individual-level intervention (counseling plus group support); and 4, individual-level plus structural-level intervention. In a time-to-event analysis, we used a non-parametric approach for competing risks to estimate cumulative incidence function (CIF) for ART initiation (event of interest) by arm and the difference in CIF for each trial arm as compared to Arm 1. Follow-up was conducted at 6, 12, 18 and 24 months. Data collection occurred from 2009 to 2013. Findings By 24-months, 61.0% initiated ART, and 30.9% had died prior to ART initiation. In the first 6 months, participants in arm 4 (individual plus community intervention) had a 28% (95% confidence interval (CI): 6–50%) increased probability of initiating ART. Despite increasing coverage of ART in all arms throughout follow-up, participants in arm 4 retained a 31% (95% CI: 5–56%) increased probability of initiating ART. The individual and community components of the intervention were only effective when delivered together. Conclusions Marginalized, hard-to-reach men, who do not routinely engage in HIV services, and therefore come into care late, may benefit significantly from both individual counseling and group support, in

  11. The Effect of a Multi-Level Intervention on the Initiation of Antiretroviral Therapy (ART) among HIV-Infected Men Who Inject Drugs and Were Diagnosed Late in Thai Nguyen, Vietnam.

    Science.gov (United States)

    Zelaya, Carla E; Le Minh, Nguyen; Lau, Bryan; Latkin, Carl A; Viet Ha, Tran; Minh Quan, Vu; Mo, Thi Tran; Sripaipan, Teerada; Davis, Wendy W; Celentano, David D; Frangakis, Constantine; Go, Vivian F

    2016-01-01

    In Vietnam, an estimated 256,000 people are living with HIV, and 58% of HIV-infections reported are among people who inject drugs (PWID). While antiretroviral therapy (ART) is widely available in Vietnam, marginalized hard-to-reach male PWID, demonstrate significantly reduced and delayed access to ART. We investigated the effect of a randomized four-arm multi-level intervention trial on ART initiation among male PWID. Our analysis was conducted among a subset of trial participants (n = 136), who were newly diagnosed as HIV-infected, treatment naïve, and eligible for ART (baseline late diagnosis). The trial arms included: 1, standard of care (HIV testing and counseling); 2, structural-level intervention (door-to-door communications and community video screenings); 3, individual-level intervention (counseling plus group support); and 4, individual-level plus structural-level intervention. In a time-to-event analysis, we used a non-parametric approach for competing risks to estimate cumulative incidence function (CIF) for ART initiation (event of interest) by arm and the difference in CIF for each trial arm as compared to Arm 1. Follow-up was conducted at 6, 12, 18 and 24 months. Data collection occurred from 2009 to 2013. By 24-months, 61.0% initiated ART, and 30.9% had died prior to ART initiation. In the first 6 months, participants in arm 4 (individual plus community intervention) had a 28% (95% confidence interval (CI): 6-50%) increased probability of initiating ART. Despite increasing coverage of ART in all arms throughout follow-up, participants in arm 4 retained a 31% (95% CI: 5-56%) increased probability of initiating ART. The individual and community components of the intervention were only effective when delivered together. Marginalized, hard-to-reach men, who do not routinely engage in HIV services, and therefore come into care late, may benefit significantly from both individual counseling and group support, in combination with community-focused stigma

  12. Extreme right-handedness, older brothers, and sexual orientation in men.

    Science.gov (United States)

    Bogaert, Anthony F

    2007-01-01

    Two of the most consistent correlates of sexual orientation in men are handedness and fraternal birth order (i.e., number of older brothers). In the present study, the relationship among handedness, older brothers, and sexual orientation was studied in 4 samples of heterosexual and gay or bisexual men (N = 944). Unlike previous studies, which have only observed an increased rate of non-right-handedness in gay or bisexual men relative to heterosexual men, an elevated rate of extreme right-handedness was found in gay or bisexual men relative to heterosexual men. The results also demonstrated that older brothers moderate the relationship between handedness and sexual orientation. Specifically, older brothers increase the odds of being gay or bisexual in moderate right-handers only; in both non-right-handers and extreme right-handers, older brothers do not affect (or decrease) the odds of being gay or bisexual. The results have implications for an early neurodevelopmental origin to sexual orientation in men. (c) 2007 APA, all rights reserved.

  13. Evaluation of dredged material proposed for ocean disposal from South Brother Island Channel, New York

    Energy Technology Data Exchange (ETDEWEB)

    Barrows, E.S.; Gardiner, W.W.; Antrim, L.D.; Gruendell, B.D.; Word, J.Q.; Tokos, J.J.S. [Battelle Marine Sciences Laboratory, Sequim, Washington (United States)

    1996-09-01

    South Brother Island Channel was one of seven waterways that the US Army Crops of Engineers-New York District requested the Battelle/Marine Sciences Laboratory to sample and evaluate for dredging and disposal. Tests and analyses were conducted on South Brother Island Channel sediment core samples and evaluations were performed. The evaluation of proposed dredged material from South Brother Island Channel included bulk sediment chemical analyses, chemical analyses of site water and elutriate, water-column and benthic acute toxicity tests, and bioaccumulation studies. Individual sediment core samples collected from Souther Brother Island Channel were analyzed for grain size, moisture content, and total organic carbon. a composite sediment sample, representing the entire area proposed for dredging, was analyzed for bulk density, specific gravity, metals, chlorinated pesticides, polychlorinated biphenyl congers, polynuclear aromatic hydrocarbons, and 1,4- dichlorobenzene. Site water and elutriate water, prepared from the suspended-particle phase of South Brother Island Channel sediment, were analyzed for metals, pesticides, and PCBs.

  14. Reproductive hormones and metabolic syndrome in 24 testicular cancer survivors and their biological brothers

    DEFF Research Database (Denmark)

    Bandak, M.; Jorgensen, N.; Juul, A.

    2017-01-01

    was to clarify if testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to their biological brothers. A cross-sectional study of testicular cancer survivors (ClinicalTrials.gov number, NCT02240966) was conducted between 2014 and 2016. Of 158 testicular...... cancer survivors included, 24 had a biological brother who accepted to participate in the study. Serum levels of reproductive hormones and prevalence of metabolic syndrome according to International Diabetes Federation Criteria and National Cholesterol Education Program (Adult Treatment Panel III...

  15. Intrafamilial Sexual Abuse: Brother-Sister Incest Does Not Differ from Father-Daughter and Stepfather-Stepdaughter Incest.

    Science.gov (United States)

    Cyr, Mireille; Wright, John; McDuff, Pierre; Perron, Alain

    2002-01-01

    A study compared 72 girls (ages 5-16) sexually abused by brothers, fathers, or stepfathers. Results suggested few differences in characteristics of sexual abuse. However, penetration was much more frequent in the sibling incest group. More victims of fathers and brothers manifested clinically significant distress (90%), than stepfather victims…

  16. A novel AVPR2 splice site mutation leads to partial X-linked nephrogenic diabetes insipidus in two brothers.

    Science.gov (United States)

    Schernthaner-Reiter, Marie Helene; Adams, David; Trivellin, Giampaolo; Ramnitz, Mary Scott; Raygada, Margarita; Golas, Gretchen; Faucz, Fabio R; Nilsson, Ola; Nella, Aikaterini A; Dileepan, Kavitha; Lodish, Maya; Lee, Paul; Tifft, Cynthia; Markello, Thomas; Gahl, William; Stratakis, Constantine A

    2016-05-01

    X-linked nephrogenic diabetes insipidus (NDI, OMIM#304800) is caused by mutations in the arginine vasopressin (AVP, OMIM*192340) receptor type 2 (AVPR2, OMIM*300538) gene. A 20-month-old boy and his 8-year-old brother presented with polyuria, polydipsia, and failure to thrive. Both boys demonstrated partial DDAVP (1-desamino-8-D AVP or desmopressin) responses; thus, NDI diagnosis was delayed. While routine sequencing of AVPR2 showed a potential splice site variant, it was not until exome sequencing confirmed the AVPR2 splice site variant and did not reveal any more likely candidates that the patients' diagnosis was made and proper treatment was instituted. Both patients were hemizygous for two AVPR2 variants predicted in silico to affect AVPR2 messenger RNA (mRNA) splicing. A minigene assay revealed that the novel AVPR2 c.276A>G mutation creates a novel splice acceptor site leading to 5' truncation of AVPR2 exon 2 in HEK293 human kidney cells. Both patients have been treated with high-dose DDAVP with a remarkable improvement of their symptoms and accelerated linear growth and weight gain. We present here a unique case of partial X-linked NDI due to an AVPR2 splice site mutation; patients with diabetes insipidus of unknown etiology may harbor splice site mutations that are initially underestimated in their pathogenicity on sequence analysis. • X-linked nephrogenic diabetes insipidus is caused by AVPR2 mutations, and disease severity can vary depending on the functional effect of the mutation. What is New: • We demonstrate here that a splice site mutation in AVPR2 leads to partial X-linked NDI in two brothers. • Treatment with high-dose DDAVP led to improvement of polyuria and polydipsia, weight gain, and growth.

  17. When Your "Problem" Becomes Mine: Adult Female Siblings' Perspectives of Having a Brother with a Disability

    Science.gov (United States)

    Pompeo, Michelle N.

    2009-01-01

    This study is a retrospective look at adult female siblings' perspectives of their childhoods and present identities based on having a brother with a disability. This paper focuses on siblings' experiences within educational and public domains, and how such experiences have shaped their personalities and career choices. Qualitative findings were…

  18. A Thousand Lights [and] A Thousand Lights: Teacher and Parent Guide. Brothers Series.

    Science.gov (United States)

    Benton, Hope

    This book for children (ages 8 to 14) and the accompanying teacher/parent guide present the story of two brothers, one of whom has a severe hearing impairment, who climb up Mt. Fuji in Japan. Information on the disability is presented subtly and incidentally to encourage the reader to relate more personally and foster a deeper level of acceptance…

  19. 3 CFR 8466 - Proclamation 8466 of December 16, 2009. Wright Brothers Day, 2009

    Science.gov (United States)

    2010-01-01

    ... alter our world. Today, we honor the enduring American spirit of creativity and innovation that made the..., the Wright Brothers’ success embodies our Nation’s proud tradition of entrepreneurship. In pursuit of... failures, a skeptical public, and the sheer danger of their endeavors often tempted the brothers to quit...

  20. Brothers with constrictive pericarditis – A novel mutation in a rare disease

    Directory of Open Access Journals (Sweden)

    Devendra V. Patil

    2016-09-01

    Full Text Available Familial constrictive pericarditis is extremely rare. We report a case of two brothers both suffering constrictive pericarditis along with having multiple painless joint deformities. Genetic workup confirmed the clinical diagnosis of camptodactyly-arthropathy-coxa vara-pericarditis (CACP syndrome CACP syndrome and also revealed a rare mutation in the causative gene.

  1. "My Brother": The Recovery of Rocky in Leslie Marmon Silko's "Ceremony"

    Science.gov (United States)

    Bassett, Troy J.

    2004-01-01

    In Leslie Marmon Silko's novel "Ceremony", Rocky appears as Tayo's childhood friend and "brother" and also as a major part of Tayo's prisoner-of-war experiences in the Pacific during World War II. The interpretation of the novel presents both Rocky and Tayo as two men destroyed by the war, the former physically and the latter spiritually.

  2. Traits of ADHD and autism in girls with a twin brother

    DEFF Research Database (Denmark)

    Attermann, Jørn; Obel, Carsten; Bilenberg, Niels

    2012-01-01

    . In conclusion, we found that female twins with a twin brother scored significantly lower in parent-reported traits of ADHD and ASD than those with a twin sister. The reason for this may be parental reporting bias, or confounding by unmeasured variables, or a causal effect of an intrauterine environment modified...

  3. Brother-Sister Incest: Data from Anonymous Computer-Assisted Self Interviews

    Science.gov (United States)

    Stroebel, Sandra S.; O'Keefe, Stephen L.; Beard, Keith W.; Kuo, Shih-Ya; Swindell, Samuel; Stroupe, Walter

    2013-01-01

    Retrospective data were entered anonymously by 1,521 adult women using computer-assisted self interview. Forty were classified as victims of brother-sister incest, 19 were classified as victims of father-daughter incest, and 232 were classified as victims of sexual abuse by an adult other than their father before reaching 18 years of age. The…

  4. Two Brothers, Two Cities: Music Education in Boston and Cincinnati from 1830-1844

    Science.gov (United States)

    Lenzo, Terri Brown; Resta, Craig

    2011-01-01

    The birth of American music education is often attributed solely to Lowell Mason in Boston. His younger brother Timothy, however, was also active at the same time in Cincinnati. This study traces the roots of music education in both cities, but highlights the rarely cited accomplishments of Timothy Mason and his colleagues. Using historical…

  5. Brothers at War? Reflections on an Internecine Conflict between ...

    African Journals Online (AJOL)

    This new thinking put sub-regional organisations like ECOWAS in West Africa and SADC in Southern Africa in a good stead to take this initiative. So far, however, such initiatives in these and other sub-regions have been fraught with problems most of them insurmountable. Using the Ethio-Eritrean conflict as a point of ...

  6. An incest case with three biological brothers as alleged fathers: Even 22 autosomal STR loci analysis would not suffice without the mother.

    Science.gov (United States)

    Canturk, Kemal Murat; Emre, Ramazan; Gurkan, Cemal; Komur, Ilhami; Muslumanoglu, Omer; Dogan, Muhammed

    2016-07-01

    Here, we report an incest paternity case involving three biological brothers as alleged fathers (AFs), their biological sister and her child that was investigated using the Investigator ESSplex Plus, AmpFLSTR Identifiler Plus/Investigator IDplex Plus and PowerPlex 16 kits. Initial duo paternity investigations using 15-loci autosomal short tandem repeat (STR) analyses failed to exclude any of the AFs. Despite the fact that one of the brothers, AF1, had a mismatch with the child at a single locus (D2S1338), the possibility of a single-step mutation could not be ruled out. When the number of autosomal STR loci analysed was increased to 22 without the inclusion of the mother, AF2 and AF3 still could not be excluded, since both of them again had no mismatches with the child. A breakthrough was possible only upon inclusion of the mother so that trio paternity investigations were carried out. This time AF1 and AF2 could be excluded at two loci (D2S1338 and D1S1656) and six loci (vWa, D1S1656, D12S391, FGA, PENTA E and PENTA D), respectively, and AF3 was then the only brother who could not be excluded from paternity. Subsequent statistical analyses suggested that AF3 could be the biological father of the child with a combined paternity index >100 billion and a probability of paternity >99.99999999%. These findings consolidate the fact that complex paternity cases such as those involving incest could benefit more from the inclusion of the mother than simply increasing the number of STR loci analysed. © The Author(s) 2015.

  7. Surgical Treatment for Epstein-Barr Virus Otomastoiditis Complicated by Facial Nerve Paralysis: A Case Report of Two Young Brothers and Review of Literature.

    Science.gov (United States)

    Eeten, Evelien van; Faber, Hubert; Kunst, Dirk

    2017-04-01

    We report the case of two young brothers with Epstein-Barr virus (EBV) otomastoiditis complicated by a facial nerve paralysis. The boys, aged 7 months (patient A) and 2 years and 8 months (patient B), were diagnosed with a facial nerve paralysis House-Brackmann (HB) grade IV (A) and V (B). After unsuccessful pharmacological treatment, patient A underwent mastoidectomy and atticoantrotomy and patient B underwent a transmastoidal surgical decompression of the facial nerve. They recovered to HB grades I and II facial nerve palsy (FNP), respectively. Although rare and relatively unknown, EBV should be considered in the differential diagnosis of children with FNP of unknown cause. Surgical intervention may be a viable therapy with good recovery.

  8. Diagnosing Tic Disorders

    Science.gov (United States)

    ... Submit" /> Information For… Media Policy Makers Diagnosing Tic Disorders Language: English (US) Español (Spanish) Recommend on Facebook ... or postviral encephalitis). Persistent (Chronic) Motor or Vocal Tic Disorder To be diagnosed with a persistent tic disorder, ...

  9. Reproductive hormones and metabolic syndrome in 24 testicular cancer survivors and their biological brothers.

    Science.gov (United States)

    Bandak, M; Jørgensen, N; Juul, A; Lauritsen, J; Kier, M G G; Mortensen, M S; Oturai, P S; Mortensen, J; Hojman, P; Helge, J W; Daugaard, G

    2017-07-01

    Testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to healthy controls. However, because of the fetal etiology of testicular cancer, familial unrelated healthy men might not be an optimal control group. The objective of this study was to clarify if testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to their biological brothers. A cross-sectional study of testicular cancer survivors (ClinicalTrials.gov number, NCT02240966) was conducted between 2014 and 2016. Of 158 testicular cancer survivors included, 24 had a biological brother who accepted to participate in the study. Serum levels of reproductive hormones and prevalence of metabolic syndrome according to International Diabetes Federation Criteria and National Cholesterol Education Program (Adult Treatment Panel III) criteria comprised the main outcome measures of the study. Median age was similar in testicular cancer survivors and their biological brothers [44 years (IQR 39-50) vs. 46 (40-53) years respectively (p = 0.1)]. In testicular cancer survivors, follow-up since treatment was 12 years (7-19). Serum levels of luteinizing hormone and follicle-stimulating hormone were elevated (p ≤ 0.001), while total testosterone, free testosterone, inhibin B and anti-Müllerian hormone were lower (p ≤ 0.001) in testicular cancer survivors than in their biological brothers. The prevalence of metabolic syndrome was similar and apart from HDL-cholesterol, which was lower in testicular cancer survivors (p = 0.01); there were no differences in the individual components of the metabolic syndrome between testicular cancer survivors and their brothers. In conclusion, gonadal function was impaired in testicular cancer survivors, while we did not detect any difference in the prevalence of metabolic syndrome between testicular cancer survivors and their biological brothers. © 2017 American

  10. Undersöka och förbättra Brother Finlands kommunikation, prissättning och leveransserviceelement

    OpenAIRE

    Forssell, Ronny; Nordström, Niklas

    2012-01-01

    Den nuvarande ekonomiska situationen har förorsakat en allt hårdare konkurrens på marknaderna vilket har lett till att företag hamnar kämpa för sina kundrelationer kraftigare. För Brother Finlands verksamhet spelar återförsäljarna en stor roll och därmed vill Brother Finland vara säker på att återförsäljarna är nöjda också i framtiden. Detta var orsaken till att Brother Finland blev intresserad av ett projekt i kundundersökningssyfte. Tre teman som Brother Finland såg som viktiga för en funge...

  11. Brothers and reduction of the birth weight of later-born siblings

    DEFF Research Database (Denmark)

    Nielsen, Henriette Svarre; Mortensen, Laust; Nygaard, Ulrikka

    2008-01-01

    It has been speculated whether maternal immune responses against male-specific minor histocompatibility (H-Y) antigens affect pregnancies negatively. This study explores, on a population level, whether previous births of boys compared with girls are associated with a decrease in birth weight...... of later-born siblings. The population was identified in the Danish Birth Registry and consisted of all Danish women who gave birth to their first-born singleton from 1980 to 1998. The women were followed until 2004, and their subsequent births were recorded. A total of 545,839 second- to fourth......-born children were identified. The authors used linear regression to analyze the association between sex of preceding children and birth weight of subsequent siblings. Brothers compared with sisters reduced the birth weight of later-born siblings. One or two brothers, respectively, reduced the mean birth weight...

  12. Catholic nursing sisters and brothers and racial justice in mid-20th-century America.

    Science.gov (United States)

    Wall, Barbra Mann

    2009-01-01

    This historical article considers nursing's work for social justice in the 1960s civil rights movement through the lens of religious sisters and brothers who advocated for racial equality. The article examines Catholic nurses' work with African Americans in the mid-20th century that took place amid the prevailing social conditions of poverty and racial disempowerment, conditions that were linked to serious health consequences. Historical methodology is used within the framework of "bearing witness," a term often used in relation to the civil rights movement and one the sisters themselves employed. Two situations involving nurses in the mid-20th century are examined: the civil rights movement in Selma, Alabama, and the actions for racial justice in Chicago, Illinois. The thoughts and actions of Catholic sister and brother nurses in the mid-20th century are chronicled, including those few sister nurses who stepped outside their ordinary roles in an attempt to change an unjust system entirely.

  13. ATRX mutation in two adult brothers with non-specific moderate intellectual disability identified by exome sequencing

    OpenAIRE

    Moncini, S.; Bedeschi, M.F.; Castronovo, P.; Crippa, M.; Calvello, M.; Garghentino, R.R.; Scuvera, G.; Finelli, P.; Venturin, M.

    2013-01-01

    In this report, we describe two adult brothers affected by moderate non-specific intellectual disability (ID). They showed minor facial anomalies, not clearly ascribable to any specific syndromic patterns, microcephaly, brachydactyly and broad toes. Both brothers presented seizures. Karyotype, subtelomeric and FMR1 analysis were normal in both cases. We performed array-CGH analysis that revealed no copy-number variations potentially associated with ID. Subsequent exome sequence analysis allow...

  14. Superior efficacy of rituximab-based chemoimmunotherapy as an initial therapy in newly diagnosed patients with B cell indolent lymphomas: long-term results from a single center in China

    International Nuclear Information System (INIS)

    Li, Zengjun; Li, Fei; Yi, Shuhua; Gu, Zhimin; Yu, Zhen; Xu, Yan; Feng, Xiaoyan; Liu, Wei; Zou, Dehui; Qi, Junyuan; Zhan, Fenghuang; Qiu, Lugui

    2015-01-01

    Rituximab has been confirmed to improve the survival of patients with B cell indolent non-Hodgkin lymphomas (B-iNHLs) in Western world as previously reported, however, it is rarely reported in Chinese cohort. This study is to investigate the efficacy and safety of rituximab-based chemoimmunotherapy and select subpopulations most sensitive to the regimen in Chinese B-iNHL patients. 334 B-iNHL patients from our center were retrospectively assessed. Patients received R-based chemoimmunotherapy showed significantly higher rates of overall response (OR) (93.0 % vs. 53.4 %, P < 0.001) and complete response (CR) (63.3 % vs. 16.0 %, P < 0.001) compared with the patients received other therapies. Survival analysis showed that rituximab-based chemoimmunotherapy could obviously improve the progression-free survival (PFS) (110 vs. 49 months, P = 0.001) and overall survival (OS) (120 vs. 72 months, P < 0.001) in patients with B-iNHLs. Interestingly, in chronic lymphocytic leukemia (CLL) patients, we found that the patients with β2-microglobulin (β2-MG) < 3.5 mg/L, lactate dehydrogenase (LDH) < 220 U/L, zeta-chain-associated protein kinase 70 (ZAP-70) negative, and non high-risk genetic abnormality could achieve more benefits from R-based regimens with higher CR rate (P = 0.003, 0.029, 0.013 and 0.038, respectively). Meanwhile, more CLL patients achieved minimal residual disease (MRD) negative after rituximab-based treatment (46.5 % vs. 10.3 %, P < 0.001). Moreover, CLL patients with MRD < 1 %, LDH < 220 U/L, complete remission (CR) or partial remission (PR), β2-MG < 3.5 mg/L and non high-risk cytogenetic abnormality showed superior outcome compared to the controls (P = 0.001, 0.000, 0.000, 0.001 and 0.013, respectively). No other side-effects increased in chemoimmunotherapy group except the elevation of grade 3–4 neutropenia. Our results demonstrate the superior efficacy of rituximab–based chemoimmunotherapy as an initial therapy in Chinese cohort with newly diagnosed B

  15. X-linked mental retardation syndrome: Three brothers with the Brooks-Wisniewski-Brown syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Morava, E.; Storcz, J.; Kosztolanyi, G. [Univ. Medical School, Pecs (Hungary)

    1996-07-12

    We report on 3 brothers with growth and mental retardation, bifrontal narrowness, short palpebral fissures, deeply set eyes with entropion, wide bulbous nose, small mouth, myopia, and spastic diplegia. The patients were born to normal and non-consanguineous parents. The similarity of our cases with those recently reported by Brooks et al. supports their suggestion that these patients are representative of a distinct entity. 8 refs., 3 figs., 1 tab.

  16. On Brothers and Sisters: South Asian and Japanese Idea Systems and their Consequences

    OpenAIRE

    Lyon, Stephen M.

    2017-01-01

    The role expectations of cross siblings varies across culture. Such expectations, while not rigidly prescribing actual behaviors nevertheless influences relations between brothers and sisters in observable ways. In South Asia, a cultural rhetoric of sororal sacrifice and support coupled with fraternal protection are commonplace. While such noble sibling roles are regularly transgressed they remain powerful idioms of the relationship and transgressions require appropriate cultural justificatio...

  17. A new syndrome: multiple congenital abnormalities and mental retardation in two brothers.

    Science.gov (United States)

    Dundar, M; Ozdemir, S Y; Fryns, J P

    2012-01-01

    In this report we present two brothers with abnormal neurological development, hypotonia, short stature, pylorus stenosis, pectus excavatum, brachycephaly due to craniosynostosis, frontal bossing, depressed nasal bridge, high arched-wide palate, downslant palpebral fissures, low-set, large ears, thin upper lip and bilateral cryptorchidism. The brothers were born to a couple of second cousins and were the third and fourth pregnancies of the mother. The father, the mother and the eldest sibling were phenotypically and chromosomally normal. The clinical findings of the brothers were found to be similar. These clinical findings were compared with syndromes showing some of the symptoms, namely Apert, FG, Floating-Harbor, Shprintzen-Goldberg and Rett Syndromes. However, when the findings were detailed, we observed that they did not match completely any of the syndromes in a discernable way. The MECP2 gene mutation was analysed because of mental retardation, poor neurological evolution and large ears, but no mutation was found. So these cases are presented as a new syndrome with apparent autosomal recessive inheritance.

  18. Congenital hypogonadotropic hypogonadism due to GnRH receptor mutations in three brothers reveal sites affecting conformation and coupling.

    Directory of Open Access Journals (Sweden)

    Javier A Tello

    Full Text Available Congenital hypogonadotropic hypogonadism (CHH is characterized by low gonadotropins and failure to progress normally through puberty. Mutations in the gene encoding the GnRH receptor (GNRHR1 result in CHH when present as compound heterozygous or homozygous inactivating mutations. This study identifies and characterizes the properties of two novel GNRHR1 mutations in a family in which three brothers display normosmic CHH while their sister was unaffected. Molecular analysis in the proband and the affected brothers revealed two novel non-synonymous missense GNRHR1 mutations, present in a compound heterozygous state, whereas their unaffected parents possessed only one inactivating mutation, demonstrating the autosomal recessive transmission in this kindred and excluding X-linked inheritance equivocally suggested by the initial pedigree analysis. The first mutation at c.845 C>G introduces an Arg substitution for the conserved Pro 282 in transmembrane domain (TMD 6. The Pro282Arg mutant is unable to bind radiolabeled GnRH analogue. As this conserved residue is important in receptor conformation, it is likely that the mutation perturbs the binding pocket and affects trafficking to the cell surface. The second mutation at c.968 A>G introduces a Cys substitution for Tyr 323 in the functionally crucial N/DPxxY motif in TMD 7. The Tyr323Cys mutant has an increased GnRH binding affinity but reduced receptor expression at the plasma membrane and impaired G protein-coupling. Inositol phosphate accumulation assays demonstrated absent and impaired Gα(q/11 signal transduction by Pro282Arg and Tyr323Cys mutants, respectively. Pretreatment with the membrane permeant GnRHR antagonist NBI-42902, which rescues cell surface expression of many GNRHR1 mutants, significantly increased the levels of radioligand binding and intracellular signaling of the Tyr323Cys mutant but not Pro282Arg. Immunocytochemistry confirmed that both mutants are present on the cell membrane

  19. Congenital Hypogonadotropic Hypogonadism Due to GNRH Receptor Mutations in Three Brothers Reveal Sites Affecting Conformation and Coupling

    Science.gov (United States)

    Tello, Javier A.; Newton, Claire L.; Bouligand, Jerome; Guiochon-Mantel, Anne

    2012-01-01

    Congenital hypogonadotropic hypogonadism (CHH) is characterized by low gonadotropins and failure to progress normally through puberty. Mutations in the gene encoding the GnRH receptor (GNRHR1) result in CHH when present as compound heterozygous or homozygous inactivating mutations. This study identifies and characterizes the properties of two novel GNRHR1 mutations in a family in which three brothers display normosmic CHH while their sister was unaffected. Molecular analysis in the proband and the affected brothers revealed two novel non-synonymous missense GNRHR1 mutations, present in a compound heterozygous state, whereas their unaffected parents possessed only one inactivating mutation, demonstrating the autosomal recessive transmission in this kindred and excluding X-linked inheritance equivocally suggested by the initial pedigree analysis. The first mutation at c.845 C>G introduces an Arg substitution for the conserved Pro 282 in transmembrane domain (TMD) 6. The Pro282Arg mutant is unable to bind radiolabeled GnRH analogue. As this conserved residue is important in receptor conformation, it is likely that the mutation perturbs the binding pocket and affects trafficking to the cell surface. The second mutation at c.968 A>G introduces a Cys substitution for Tyr 323 in the functionally crucial N/DPxxY motif in TMD 7. The Tyr323Cys mutant has an increased GnRH binding affinity but reduced receptor expression at the plasma membrane and impaired G protein-coupling. Inositol phosphate accumulation assays demonstrated absent and impaired Gαq/11 signal transduction by Pro282Arg and Tyr323Cys mutants, respectively. Pretreatment with the membrane permeant GnRHR antagonist NBI-42902, which rescues cell surface expression of many GNRHR1 mutants, significantly increased the levels of radioligand binding and intracellular signaling of the Tyr323Cys mutant but not Pro282Arg. Immunocytochemistry confirmed that both mutants are present on the cell membrane albeit at low

  20. CLINICAL AND FAMILY PROFILE OF PATIENTS DIAGNOSED WITH KERATOCONUS

    Directory of Open Access Journals (Sweden)

    Kalpana

    2015-03-01

    Full Text Available PURPOSE: To screen the first degree relatives of patient diagnosed with keratoconus . MATERIALS AND METHODS : All the patients included in the study, patient details were taken which included - name, age, gender, hospital number, address and family history [pedigree tree] . All the patients underwent refraction, best corrected visual acuity, colour vision , keratometry, intraocular pressure measurement and corneal topography [orbscan]. Family screening was done, which included - refraction, best corrected visual acuity, colour vision, keratometry, intraocular pressure and corneal topography [orbscan]. RESULTS: In this study of 40 eyes, 24 eyes [Right eyes - 12 & Left eyes - 12] i.e. 60% have keratoconus, 3 eyes [2 - Right eyes & 1 - Left eye] i.e.15% have advanced keratoconus, 12 eyes [Right eye - 6 & Left eye - 6] i.e. 30% have VKC & Keratoconus, 1 eye have acute hydrops. Total family members screened 55, out of that 17 members are fathers, 20 members are mothers, 12 members are brothers and 6 are sisters

  1. Exome sequencing identifies mutations in ABCD1 and DACH2 in two brothers with a distinct phenotype.

    Science.gov (United States)

    Zhang, Yanliang; Liu, Yanhui; Li, Ya; Duan, Yong; Zhang, Keyun; Wang, Junwang; Dai, Yong

    2014-09-19

    We report on two brothers with a distinct syndromic phenotype and explore the potential pathogenic cause. Cytogenetic tests and exome sequencing were performed on the two brothers and their parents. Variants detected by exome sequencing were validated by Sanger sequencing. The main phenotype of the two brothers included congenital language disorder, growth retardation, intellectual disability, difficulty in standing and walking, and urinary and fecal incontinence. To the best of our knowledge, no similar phenotype has been reported previously. No abnormalities were detected by G-banding chromosome analysis or array comparative genomic hybridization. However, exome sequencing revealed novel mutations in the ATP-binding cassette, sub-family D member 1 (ABCD1) and Dachshund homolog 2 (DACH2) genes in both brothers. The ABCD1 mutation was a missense mutation c.1126G > C in exon 3 leading to a p.E376Q substitution. The DACH2 mutation was also a missense mutation c.1069A > T in exon 6, leading to a p.S357C substitution. The mother was an asymptomatic heterozygous carrier. Plasma levels of very-long-chain fatty acids were increased in both brothers, suggesting a diagnosis of adrenoleukodystrophy (ALD); however, their phenotype was not compatible with any reported forms of ALD. DACH2 plays an important role in the regulation of brain and limb development, suggesting that this mutation may be involved in the phenotype of the two brothers. The distinct phenotype demonstrated by these two brothers might represent a new form of ALD or a new syndrome. The combination of mutations in ABCD1 and DACH2 provides a plausible mechanism for this phenotype.

  2. Sicilian family with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) and lethal lung disease in one of the affected brothers.

    Science.gov (United States)

    De Luca, Filippo; Valenzise, Mariella; Alaggio, Rita; Arrigo, Teresa; Crisafulli, Giuseppe; Salzano, Giuseppina; Cervato, Sara; Mariniello, Barbara; Lazzarotto, Francesca; Betterle, Corrado

    2008-11-01

    We report the clinical and immunological features of the autoimmune regulator gene (AIRE) in two Sicilian brothers with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED). They were compound heterozygotes with R203X/R257X. Both had oral candidiasis since the first year of life and later developed hypoparathyroidism and Addison disease. The elder brother had experienced recurrent lower respiratory infections since 5 years of age and over the years developed severe obstructive lung disease with bronchiectasis, which led to death at 18 years of age. Both brothers had circulating autoantibodies against tryptophan hydroxylase and serotonin-producing cells were absent in the duodenal mucosa. This was associated with intestinal dysfunction in only the elder brother. (1) In the first Sicilian family with APECED reported up to now we found a heterozygous mutation that had been previously reported only once. (2) In the older brother of this family we observed a severe and lethal lung disease; this case adds to a growing literature describing this association between APECED and respiratory illnesses. (3) Tryptophan hydroxylase antibodies might be hypothesized to be the marker of an autoimmune gastrointestinal illness possibly associated with APECED.

  3. Germline activating MTOR mutation arising through gonadal mosaicism in two brothers with megalencephaly and neurodevelopmental abnormalities.

    Science.gov (United States)

    Mroske, Cameron; Rasmussen, Kristen; Shinde, Deepali N; Huether, Robert; Powis, Zoe; Lu, Hsiao-Mei; Baxter, Ruth M; McPherson, Elizabeth; Tang, Sha

    2015-11-05

    In humans, Mammalian Target of Rapamycin (MTOR) encodes a 300 kDa serine/ threonine protein kinase that is ubiquitously expressed, particularly at high levels in brain. MTOR functions as an integrator of multiple cellular processes, and in so doing either directly or indirectly regulates the phosphorylation of at least 800 proteins. While somatic MTOR mutations have been recognized in tumors for many years, and more recently in hemimegalencephaly, germline MTOR mutations have rarely been described. We report the successful application of family-trio Diagnostic Exome Sequencing (DES) to identify the underlying molecular etiology in two brothers with multiple neurological and developmental lesions, and for whom previous testing was non-diagnostic. The affected brothers, who were 6 and 23 years of age at the time of DES, presented symptoms including but not limited to mild Autism Spectrum Disorder (ASD), megalencephaly, gross motor skill delay, cryptorchidism and bilateral iris coloboma. Importantly, we determined that each affected brother harbored the MTOR missense alteration p.E1799K (c.5395G>A). This exact variant has been previously identified in multiple independent human somatic cancer samples and has been shown to result in increased MTOR activation. Further, recent independent reports describe two unrelated families in whom p.E1799K co-segregated with megalencephaly and intellectual disability (ID); in both cases, p.E1799K was shown to have originated due to germline mosaicism. In the case of the family reported herein, the absence of p.E1799K in genomic DNA extracted from the blood of either parent suggests that this alteration most likely arose due to gonadal mosaicism. Further, the p.E1799K variant exerts its effect by a gain-of-function (GOF), autosomal dominant mechanism. Herein, we describe the use of DES to uncover an activating MTOR missense alteration of gonadal mosaic origin that is likely to be the causative mutation in two brothers who present

  4. The first mutation in CNGA2 in two brothers with anosmia

    DEFF Research Database (Denmark)

    Karstensen, H G; Mang, Y; Fark, T

    2015-01-01

    that the cyclic nucleotide-gated channel subunit CNGA2, expressed in the olfactory epithelium has a crucial role in olfactory signal transduction. We have identified a novel X-linked stop mutation in CNGA2 (c.634C>T, p.R212*) in two brothers with ICA using exome sequencing. No additional mutations in CNGA2 were...... identified in a cohort of 31 non-related ICA individuals. Magnetic resonance brain imaging revealed diminished olfactory bulbs and flattened olfactory sulci. This is the first report of a mutation in the cyclic nucleotide-gated gene CNGA2 and supports the critical role of this gene in human olfaction....

  5. [Two pairs of brothers with juvenile idiopathic arthritis (JIA): case reports].

    Science.gov (United States)

    Robazzi, Teresa Cristina M V; Rios, Gabriela; Castro, Catarina

    2015-01-01

    This is a case report of juvenile idiopathic arthritis (JIA) in two pairs of brothers followed in the department of pediatric rheumatology, Universidade Federal da Bahia. Genetic involvement in JIA pathogenesis is clear and the risk of recurrence among siblings supports this contribution. An important landmark of this discovery involves the acknowledgment of major histocompatibility complex (MHC) polymorphism contribution to JIA development susceptibility. Despite many advances, the numerous available studies cannot explain several implicit mechanisms in JIA pathogenesis yet. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  6. “THE BROTHERS KARAMAZOV” IN GERMAN TRANSLATIONS: TRANSLATING THE RUSSIANNESS OF DOSTOYEVSKY’S STYLE

    Directory of Open Access Journals (Sweden)

    Olga KORENEVSKAYA

    2010-11-01

    Full Text Available : The article investigates the challenges of rendering the peculiarities of Dostoyevsky’s style linked to his philosophy of man and religious attitudes in four German translations of “The Brothers Karamazov”. The category of uncertainty is intrinsic to both Russian mentality and Dostoyevsky’s writing manner. However, the textual markers of uncertainty are perceived by German translators as essentially “foreign” and therefore may hinder the readers’ understanding. The paper reveals various approaches to conveying the desired semantic effect of uncertainty in the translations and points out problematic issues.

  7. Lipid myopathy associated with renal tubular acidosis and spastic diplegia in two brothers.

    Science.gov (United States)

    Tung, Y C; Tsau, Y K; Chu, L W; Young, C; Shen, Y Z

    2001-07-01

    Lipid myopathy is a group of disorders involving mitochondrial fatty acid oxidation. We describe two brothers, 3 years 8 months old and 2 years 9 months old, respectively, with progressive spastic diplegia, developmental delay, failure to thrive, and chronic metabolic acidosis who had lipid myopathy and renal tubular acidosis. Brain magnetic resonance imaging revealed demyelinating changes in the periventricular white matter, which was compatible with spastic diplegia. These symptoms may be related to errors in fatty acid metabolism. Cerebral palsy had been misdiagnosed in both of these patients at another hospital. Therefore, for patients with late-onset and progressive spastic diplegia, detailed investigations for underlying diseases are warranted.

  8. Korean sibling caregivers of individuals diagnosed with schizophrenia

    Directory of Open Access Journals (Sweden)

    Mijung Park

    2017-12-01

    Full Text Available Siblings of individuals diagnosed with schizophrenia are an important source of family caregiving. Unfortunately, limited information is available about sibling caregivers because existing studies have focused on other family relationships such as parents, spouses, and children. To fill the knowledge gap, the purpose of this study is to describe Korean sibling caregivers’ experience with individuals diagnosed with schizophrenia. Guided by Colaizzi’s descriptive phenomenological methodology, we conducted in-depth, semi-structured, face-to-face interviews with eight individuals who have a sibling (1 diagnosed with schizophrenia and (2 hospitalized in an inpatient psychiatric unit. We discerned six key themes: sorrow, burnout, shame, different perspectives in life, acceptance, and responsibility. We categorized these themes into three groups: suffering, hope, and responsibility and obligation. Sibling caregivers of individuals with schizophrenia experience a mixture of several emotions. Participants loved their brother or sister with schizophrenia, but at the same time they felt shame and fear. While they were burdened by the responsibilities of caregiving, they remained loyal to their sibling with schizophrenia, continuing to help their siblings reach their full potential. Although participants were confused about the symptoms of schizophrenia, they were committed to learning more about the illness. Because we conducted the current study in Korea, the findings of this study may be unique to Korea culture. Further studies are needed to compare and contrast nuanced differences in sibling caregivers’ experience among different cultural groups.

  9. Bernoulli Brothers

    Indian Academy of Sciences (India)

    family flourished in business, but afterwards, its descendants. Utpal Mukhopadhyay is a teacher in Barasat. Satyabharati Vidyapith,. West Bengal. The Bernoulli .... problem, experts could readily recognise that the anonymous problem solver was none other than Sir Isaac Newton (1642-. 1727) and Johann commented on it ...

  10. A Monument as a Text, or The Message of the Brothers Dostoevsky

    Directory of Open Access Journals (Sweden)

    Vladimir Zakharov

    2014-12-01

    Full Text Available The article considers the circumstances of the creation of a monument to the writer's mother Maria Fyodorovna Dostoevskaya. Mikhail Andreevich, father of the brothers Dostoevsky, asked Mikhail and Fyodor to compose the text for the monument. In March and April of 1837 the brothers worked out the idea and conception of the monument, wrote the text of the first and fourth epigraphs, chose evangelic verses and an epitaph of N.M. Karamzin. This was their first collective act of creative work embodied in stone. The monument is not only a symbol of love and sorrow for their mother’s death but also hope for her salvation and future resurrection. The brothers’ words and those chosen from the Gospel as well as the Karamzin’s ones have one more meaning. These convey a sense of beingness and an Easter idea of individual creative work. It is necessary to renew the tomb of Maria Fyodorovna Dostoevskaya and bring the monument back to Lazarevskoye cemetery in Moscow.

  11. Birth order and ratio of brothers to sisters in Spanish transsexuals.

    Science.gov (United States)

    Gómez-Gil, Esther; Esteva, Isabel; Carrasco, Rocío; Almaraz, M Cruz; Pasaro, Eduardo; Salamero, Manel; Guillamon, Antonio

    2011-06-01

    Three Western studies have shown that male-to-female (MF) homosexual transsexuals tend to be born later than their siblings and to come from sibships with more brothers than sisters. The objective of this study was to determine whether these variables would be replicated in 530 MF and female-to-male (FM) Spanish transsexuals according to sexual orientation. The results showed that MF homosexual transsexuals had significantly more older brothers than the non-homosexual MF group. Compared with the expected rates in the general population, birth order was significantly higher in both MF (Slater's Index = 0.59; Fraternal Index = 0.61; Sororal Index = 0.58) and FM homosexual transsexuals (Slater's Index = 0.65; Fraternal Index = 0.68; Sororal Index = 0.67), and sibling sex ratio was significantly higher than expected in homosexual MF (sex ratio = 0.55) but not in homosexual FM transsexuals. No significant differences were found in the non-homosexual subgroups. The replication of the later birth order and sibling sex-ratio effect in MF homosexual transsexuals corroborates previous findings in a variety of groups from different cultures and may suggest a common mechanism underlying the etiology of transsexualism.

  12. Big Brother Experiments with the Regional Climate Model COSMO-CLM in an Idealised Setup to Investigate Lateral Boundary Conditions

    Science.gov (United States)

    Leps, Nora; Brauch, Jennifer; Ahrens, Bodo

    2017-04-01

    Our work aims at improving the regional coupled atmosphere-ocean model system COSMO-CLM/NEMO for decadal prediction. We address the different restricting conditions of regional climate modelling: Lower boundary conditions of the atmospheric system in the form of the coupled ocean, initial conditions and lateral boundary conditions of the coupled ocean-atmosphere system. Lateral boundary conditions (LBCs) are known to be an issue in dynamical downscaling with limited area regional climate models, and many studies have investigated the LBCs with regard to, e.g., frequency or resolution of LBCs, position of the domain and spurious effects. By default, the formulation of the LBCs in CCLM is a Davies relaxation scheme, which introduces a sponge layer at the lateral boundaries of the domain to dampen reflection of waves produced in the limited area domain at the prescribed boundaries. With idealised studies, it is possible to investigate the performance of this LBC formulation in CCLM in detail. The used framework is that of "big brother experiments" (BBEs). In a BBE, a high resolution simulation is performed over a larger domain, then its output is filtered to represent coarse-grid input, which is used to drive a nested smaller domain on the same high resolution. The differences between the two simulations can directly be attributed to the LBCs. Such experiments were performed in an idealised setup of a zonal flow over flat terrain or idealised hills with varying domain positions. First experiments show that for these idealised flows the relaxation works well for lateral boundary data on a high spatial resolution for different temporal resolutions. Next we plan to perform simulations with filtered lateral boundary data that only contains large scale features of the flow as well as different settings of the relaxation procedure.

  13. Diagnosing plant problems

    Science.gov (United States)

    Cheryl A. Smith

    2008-01-01

    Diagnosing Christmas tree problems can be a challenge, requiring a basic knowledge of plant culture and physiology, the effect of environmental influences on plant health, and the ability to identify the possible causes of plant problems. Developing a solution or remedy to the problem depends on a proper diagnosis, a process that requires recognition of a problem and...

  14. Being publicly diagnosed

    DEFF Research Database (Denmark)

    Konradsen, Hanne; Lillebaek, Troels; Wilcke, Torgny

    2014-01-01

    INTRODUCTION: Tuberculosis (TB) is a disease which affects people worldwide, but there is knowledge lacking about patients' experiences in low-prevalence and high-income countries. AIM: To provide a theoretical framework for the process of being diagnosed with tuberculosis in a Danish setting. ME...

  15. Sickness absence, social relations, and self-esteem: a qualitative study of the importance of relationships with family, workmates, and friends among persons initially long-term sickness absent due to back diagnoses.

    Science.gov (United States)

    Svensson, Tommy; Müssener, Ulrika; Alexanderson, Kristina

    2010-01-01

    The aim of the present study was to explore and analyze accounts of social interactions and relationships with family, workmates, and friends supplied by persons with experience of sickness absence due to back, neck, or shoulder diagnoses. The focus was on experiences that seemed to involve positive and negative self-evaluative aspects, and therefore may be important to the self-conception and self-esteem of the absentee, and possibly to return to work. The interviewees were women and men between 25 to 34 years of age who had been sickness certified due to back, neck, or shoulder diagnosis. A descriptive and explorative method was used to analyze data from five focus-group interviews. The importance of being supported and encouraged by family members, and the importance of feeling needed at work as well as being part of a social context were aspects stressed by the respondents. Our results indicate that these interactions and relations are important to the absentees' self-esteem, and that this should be taken into account when discussing rehabilitation efforts.

  16. Expression of BCR-ABL, E2A-PBX1, and MLL-AF4 fusion transcripts in newly diagnosed children with acute lymphoblastic leukemia: a Children's Cancer Group initiative.

    Science.gov (United States)

    Gaynon, P S; Crotty, M L; Sather, H N; Bostrom, B C; Nachman, J B; Steinherz, P G; Heerema, N A; Sarquis, M; Tuel-Ahlgren, L; Uckun, F M

    1997-06-01

    We used reverse transcriptase polymerase chain reaction (RT-PCR) assays to examine primary leukemic cells in on-study diagnostic bone marrow specimens from 642 children with newly diagnosed acute lymphoblastic leukemia (ALL) for the expression of MLL-AF4, E2A-PBX1, and BCR-ABL fusion transcripts. All PCR assays were performed centrally in the Children's Cancer Group ALL Biology Reference Laboratory. MLL-AF4 transcript was found in only 0.7% of the study population which excluded infants. E2A-PBX1 transcript was found in 2.5% of the study population and 3.3% of B-precursor cases. Expression was associated with massive hepatomegaly. BCR-ABL transcript was found in 2.3% of cases and correlated with older age, induction failure, and inferior event-free survival (EFS). RT-PCR assays allow rapid identification of patients with MLL-AF4 and BCR-ABL positive ALL. These patients have a poor outcome with contemporary therapy and rapid identification facilitates timely allocation to innovative treatment programs.

  17. ATRX mutation in two adult brothers with non-specific moderate intellectual disability identified by exome sequencing.

    Science.gov (United States)

    Moncini, S; Bedeschi, M F; Castronovo, P; Crippa, M; Calvello, M; Garghentino, R R; Scuvera, G; Finelli, P; Venturin, M

    2013-12-01

    In this report, we describe two adult brothers affected by moderate non-specific intellectual disability (ID). They showed minor facial anomalies, not clearly ascribable to any specific syndromic patterns, microcephaly, brachydactyly and broad toes. Both brothers presented seizures. Karyotype, subtelomeric and FMR1 analysis were normal in both cases. We performed array-CGH analysis that revealed no copy-number variations potentially associated with ID. Subsequent exome sequence analysis allowed the identification of the ATRX c.109C>T (p.R37X) mutation in both the affected brothers. Sanger sequencing confirmed the presence of the mutation in the brothers and showed that the mother is a healthy carrier. Mutations in the ATRX gene cause the X-linked alpha thalassemia/mental retardation (ATR-X) syndrome (MIM #301040), a severe clinical condition usually associated with profound ID, facial dysmorphism and alpha thalassemia. However, the syndrome is clinically heterogeneous and some mutations, including the c.109C>T, are associated with a broad phenotypic spectrum, with patients displaying a less severe phenotype with only mild-moderate ID. In the case presented here, exome sequencing provided an effective strategy to achieve the molecular diagnosis of ATR-X syndrome, which otherwise would have been difficult to consider due to the mild non-specific phenotype and the absence of a family history with typical severe cases.

  18. Liability for Diagnosing Malingering.

    Science.gov (United States)

    Weiss, Kenneth J; Van Dell, Landon

    2017-09-01

    Malingering is a medical diagnosis, but not a psychiatric disorder. The label imputes that an evaluee has intentionally engaged in false behavior or statements. By diagnosing malingering, psychiatrists pass judgment on truthfulness. Evaluees taking exception to the label may claim that the professional has committed defamation of character (libel or slander) when the diagnosis is wrong and costs the claimant money or benefits. Clinicians may counter by claiming immunity or that the diagnosis was made in good faith. This problem has come into focus in military and veterans' contexts, where diagnoses become thresholds for benefits. Through historical and literary examples, case law, and military/veterans' claims of disability and entitlement, the authors examine the potency of the malingering label and the potential liability for professionals and institutions of making this diagnosis. © 2017 American Academy of Psychiatry and the Law.

  19. Incestuous sisters: mate preference for brothers over unrelated males in Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    Adeline Loyau

    Full Text Available The literature is full of examples of inbreeding avoidance, while recent mathematical models predict that inbreeding tolerance or even inbreeding preference should be expected under several realistic conditions like e.g. polygyny. We investigated male and female mate preferences with respect to relatedness in the fruit fly D. melanogaster. Experiments offered the choice between a first order relative (full-sibling or parent and an unrelated individual with the same age and mating history. We found that females significantly preferred mating with their brothers, thus supporting inbreeding preference. Moreover, females did not avoid mating with their fathers, and males did not avoid mating with their sisters, thus supporting inbreeding tolerance. Our experiments therefore add empirical evidence for inbreeding preference, which strengthens the prediction that inbreeding tolerance and preference can evolve under specific circumstances through the positive effects on inclusive fitness.

  20. Brothers with hypospadias, vertebral segmentation defects, and intellectual disability: new syndrome?

    Science.gov (United States)

    Phadke, Shubha R; Ranganath, Prajnya; Boggula, Vijay Raju; Gupta, Divya; Phadke, Rajendra V; Sloman, Melissa; Turnpenny, Peter D

    2012-12-01

    We report on two brothers (born to nonconsanguineous parents) with short stature, hypospadias, scoliosis, vertebral segmentation defects of "spondylocostal dysostosis" type, and intellectual disability. Results of cytogenetic and molecular genetic tests performed, including routine karyotype, MLPA (multiplex ligation-dependent probe amplification) for common microdeletions and subtelomeric copy number variants, microarray-CGH analysis, and sequencing of four Notch signaling pathway genes (DLL3, MESP2, LFNG, and HES7), were all normal. We present a comparison of the condition in the two boys with known syndromes and suggest that they may represent a hitherto unreported syndrome, most likely following autosomal recessive inheritance, though X-linked inheritance is not excluded. Copyright © 2012 Wiley Periodicals, Inc.

  1. [1896: How nascent radiotherapy gathered Roentgen, Pasteur and the Lumière brothers].

    Science.gov (United States)

    Foray, N

    2016-12-01

    On the 4th July, 1896, in his medical office of Les Échelles (Savoie, France), Victor Despeignes performed the very first radiotherapy against cancer, documented by indisputable proofs. However, the intellectual and practical approach that leads to this first radiotherapy may appear unexpected to date. Indeed, it is likely that the treatment that Despeignes applied to his neighbour, who did not suffer from stomach cancer, was born with the indirect support of the Lumière brothers, on the basis of a biological theory (the parasitory theory of cancer) that is irrelevant today, with an experimental protocol based on experiments performed on tuberculosis et in a bifractionated model linked by the constraints of a district medical doctor. Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  2. Hiper-realidade versus sedução: o paradoxo do Big Brother Brasil

    Directory of Open Access Journals (Sweden)

    Felipe da Silva Polydoro

    2011-07-01

    Full Text Available ResumoNeste artigo, jogamos Baudrillard contra si próprio na análise do programa Big Brother Brasil (BBB. Primeiro, desenvolvemos a afirmação do teórico de que este reality show resume-se a refletir o estado de banalidade de uma cultura hiper-real. Em seguida, propomos uma reversão nesta argumentação, ao apontar, no BBB, sinais de um efeito sedutor. No início, recuperarmos alguns pontos da teoria do autor francês e evidenciamos o conceito moderno de realidade, aquilo que desaparece na era da simulação.

  3. Sustained virologic response following HCV eradication in two brothers with X-linked agammaglobulinaemia.

    LENUS (Irish Health Repository)

    Houlihan, Diarmaid D

    2009-08-21

    X-linked agammaglobulinaemia (XLA) is a humoral immunodeficiency syndrome characterized from childhood by the absence of circulating B lymphocytes, absent or reduced levels of serum immunoglobulin and recurrent bacterial infections. For many affected patients, regular treatment with immunoglobulin is life saving. Hepatitis C viral (HCV) infection acquired through contaminated blood products is widely described in this patient cohort. The natural history of HCV infection in patients with XLA tends to follow a more rapid and aggressive course compared to immunocompetent individuals. Furthermore, standard anti-viral therapy appears to be less efficacious in this patient cohort. Here we report the cases of two brothers with XLA who contracted HCV through contaminated blood products. They were treated with a six month course of Interferon alpha-2b and Ribavirin. We report a sustained virologic response five years after completing treatment.

  4. A sterile sperm caste protects brother fertile sperm from female-mediated death in Drosophila pseudoobscura

    DEFF Research Database (Denmark)

    Holman, Luke; Snook, Rhonda R

    2008-01-01

    Spermicide (i.e., female-mediated sperm death) is an understudied but potentially widespread phenomenon that has important ramifications for the study of sexual conflict, postcopulatory sexual selection, and fertility [1, 2]. Males are predicted to evolve adaptations against spermicide, but few...... antispermicidal mechanisms have been definitively identified. One such adaptation may be the enigmatic infertile sperm morphs or "parasperm" produced by many species, which have been hypothesized to protect their fertile brother "eusperm" from spermicide [2, 3]. Here, we show that female Drosophila pseudoobscura...... reproductive tracts are spermicidal and that the survival of eusperm after exposure to the female tract is highest when males produce many parasperm. This study clarifies the adaptive significance of infertile sperm castes, which has remained elusive in Drosophila and other taxa despite much recent interest [2...

  5. [The brothers of Jumiege--the peripheral nervous system in early French mythology].

    Science.gov (United States)

    Brean, Are

    2002-03-20

    This article reviews the process of discovery of the nervous system from Pythagoras (570-500 BC) to Galen (130-201 AD). After Galen, no anatomical studies were performed before the renaissance. According to a legend, probably produced for political reasons, two brothers, sons of the French king Clovis II, revolted against their father and were sentenced to loose their physical powers by having the nerves of their arms and legs cut. They were then set adrift on the river Seine, stranding at the Jumiège monastery. The earliest written version of this legend stems from the fourteenth century; it was probably a part of the local French mythology. This indicates that the existence of the peripheral nervous system, and therefore also in part the knowledge contained in the early anatomical works, quite early may have been more or less known outside academic circles.

  6. CONFESSION AND REPENTANCE IN F. M. DOSTOYEVSKY'S NOVEL THE BROTHERS KARAMAZOV

    Directory of Open Access Journals (Sweden)

    Denis Vladimirovich Vasil'ev

    2014-11-01

    Full Text Available The article deals with the meaning of a penitential confession in Fyodor Dostoyevsky's novel The Brothers Karamazov. It is noted that the penitential confession in the novel exempts from the burden of guilt, allowing the confessor to get rid of spiritual suff erings through the compassion of the person who accepts the confession and shares the guilt with the sinner. It is emphasized that repentance is inseparably linked with overcoming the sense of shame before public exposure and self-obsession with one’s reputation. The attention is paid to mutual confessions in the novel aft er which the heroes step on the path towards transformation. It is concluded that penitential confessions of heroes result in their revival and spiritual renewal, as each of them is given a chance to endure spiritual revolution, to overcome the "hell" and to confirm the validity of Zosima’s idea about common guilt and responsibility.

  7. Old Instruments, New Agendas: The Chemical Brothers and the ARP 2600

    Directory of Open Access Journals (Sweden)

    Hans T. Zeiner-Henriksen

    2014-06-01

    Full Text Available A preference for old vintage music equipment is widespread in electronic dance music. My point of departure for a discussion of this phenomenon is an interview from Keyboard magazine in which the members of the production duo the Chemical Brothers proclaim their fascination with an old analogue synthesizer. Two diverse theoretical approaches will inform and nuance my narrative here. Wiebe E. Bijker’s sociotechnical approach to the development of technology will highlight stages and processes in the transition from analogue to digital technology. In addition, Sarah Thornton’s concept of subcultural capital will direct attention to the old instrument as a prestige item that serves to maintain power structures within the electronic dance music culture.

  8. From Glass Architecture to Big Brother: Scenes from a Cultural History of Transparency

    Directory of Open Access Journals (Sweden)

    Scott McQuire

    2013-09-01

    Full Text Available In this essay, I want to reposition the Big Brother phenomenon in the context of an earlier debate about domestic space which occurred during the emergence of architectural modernism in the first decades of the twentieth century. At issue then was the physical reconstruction of the home, particularly through the increasing use of glass as a design element. While glass architecture is even more prevalent in the present, its spatial impact—particularly in terms of its capacity to alter the relationship between the ‘inside’ and the ‘outside’—has now been matched or exceeded in many respects by the effects of electronic media. By tracing the parallel between the unsettling spatial effects produced by both glass construction and the electronic screen, I will sketch a cultural logic linking the modernist project of architectural transparency to the contemporary repositioning of the home as an interactive media centre.

  9. Observations of Local Seismicity and Harmonic Tremor Using an Ocean Bottom Hydrophone Array at Brothers Volcano, South Kermadec Arc.

    Science.gov (United States)

    Haxel, J. H.; Dziak, R. P.; Lau, T. K.; Matsumoto, H.

    2005-12-01

    The submarine Brothers volcano is an important link in the volcanic chain of the southern Kermadec Arc system in the Southwest Pacific Ocean north of New Zealand. The 3-3.5 km wide caldera has a center depth of 1850m and steep surrounding walls of 300-450m. Active hydrothermal venting distinguished Brothers as a point of focus for the New Zealand American Submarine Ring of Fire (NZASRoF) expeditions in 2004 and 2005. Due to its remote location, moderate to small magnitude seismicity around the Brothers area is largely unknown. In late September 2004, four ocean bottom hydrophones (OBHs) were deployed on the caldera floor. In April 2005, three of the four instruments were recovered intact. These three OBHs continuously recorded, for seven months, the low frequency (0-110Hz) acoustic field around Brothers volcano, in particular seismic P- and S-waves propagating through the crust and acoustic T-waves in the water column . Preliminary analysis reveals seismicity rates on the order of 106 earthquakes per month. In addition to seismic arrivals, low frequency harmonic tremor is frequently and independently observed on each of the OBH instruments, often occurring subsequent to the larger seismic events. Qualitative comparisons of these signals with tremor observed from the Volcano Islands south of Japan (Dziak and Fox, 2002) show them to be nearly equivalent in frequency structure, suggesting the origin of the tremor observed at Brothers may also be attributed to resonance of a magma-gas mixture in a large chamber or conduit near the water/ seafloor boundary.

  10. Extreme intrafamilial variability of Saudi brothers with primary hyperoxaluria type 1

    Directory of Open Access Journals (Sweden)

    Alfadhel M

    2012-08-01

    Full Text Available Majid Alfadhel,1 Khalid A Alhasan,2 Mohammed Alotaibi,3 Khalid Al Fakeeh41Division of Genetics, Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2Division of Nephrology Department of Pediatrics, King Saud University King Khalid University Hospital, Riyadh, Saudi Arabia; 3Department of Radiology, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 4Division of Nephrology, Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi ArabiaBackground: Primary hyperoxaluria type 1 (PH1 is characterized by progressive renal insufficiency culminating in end-stage renal disease, and a wide range of clinical features related to systemic oxalosis in different organs. It is caused by autosomal recessive deficiency of alanine:glyoxylate aminotransferase due to a defect in AGXT gene.Case report: Two brothers (one 6 months old; the other 2 years old presented with acute renal failure and urinary tract infection respectively. PH1 was confirmed by high urinary oxalate level, demonstration of oxalate crystals in bone biopsy, and pathogenic homozygous known AGXT gene mutation. Despite the same genetic background, same sex, and shared environment, the outcome of the two siblings differs widely. While one of them died earlier with end-stage renal disease and multiorgan failure caused by systemic oxalosis, the older brother is pyridoxine responsive with normal development and renal function.Conclusion: Clinicians should be aware of extreme intrafamilial variability of PH1 and international registries are needed to characterize the genotype-phenotype correlation in such disorder.Keywords: primary hyperoxaluria, oxalosis, PH1, intrafamilial variability

  11. Terapia de linguagem de irmãos com transtornos invasivos do desenvolvimento: estudo longitudinal Language therapy of brothers with pervasive developmental disorders: longitudinal study

    Directory of Open Access Journals (Sweden)

    Andréa Regina Nunes Misquiatti

    2010-01-01

    years old - participated in the study. Subjects had diagnosis of autism (Case 1 and pervasive developmental disorder-not otherwise specified (Case 2, respectively. As a procedure for data collection and analysis, a longitudinal study was carried out through a follow up of the cases during the four years of language therapy. The procedure included filmed therapy sessions, documental analysis of information contained in the patients' records regarding anamnesis, assessments and therapeutic reports, and multidisciplinary evaluations and exams. In both cases there was an improvement on visual contact, social interaction, vocabulary and symbolic play. For Case 1, there was an increase from 2.0 to 6.2 communicative acts per minute; for Case 2, an increase from 3.5 to 8.0 acts. Both subjects demonstrated predominance of the verbal communicative mean and greater variety of communicative functions. Other factors influenced these results, such as the intellectual deficiency, the family dynamics, the conflicts on the relationship between the brothers and the school environment in which they were placed. The study confirmed the relevance of the speech-language pathologist in interventions of pervasive developmental disorders, along with multidisciplinary teams, for the discussion of diagnoses and of the most appropriate procedures. Longitudinal studies can contribute for more detailed and reliable analysis of therapeutic intervention in these cases, in order to clarify gaps existent in literature and to support the role of clinical speech-language pathologists.

  12. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ... for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed with Cancer Fertility Preservation for Children Diagnosed ...

  13. Early versus delayed initiation of highly active antiretroviral therapy for HIV-positive adults with newly diagnosed pulmonary tuberculosis (TB-HAART): a prospective, international, randomised, placebo-controlled trial.

    Science.gov (United States)

    Mfinanga, Sayoki G; Kirenga, Bruce J; Chanda, Duncan M; Mutayoba, Beatrice; Mthiyane, Thuli; Yimer, Getnet; Ezechi, Oliver; Connolly, Cathy; Kapotwe, Vincent; Muwonge, Catherine; Massaga, Julius; Sinkala, Edford; Kohi, Wanze; Lyantumba, Lucinda; Nyakoojo, Grace; Luwaga, Henry; Doulla, Basra; Mzyece, Judith; Kapata, Nathan; Vahedi, Mahnaz; Mwaba, Peter; Egwaga, Saidi; Adatu, Francis; Pym, Alex; Joloba, Moses; Rustomjee, Roxana; Zumla, Alimuddin; Onyebujoh, Philip

    2014-07-01

    WHO guidelines recommend early initiation of antiretroviral therapy (ART) irrespective of CD4 cell count for all patients with tuberculosis who also have HIV, but evidence supporting this approach is poor quality. We assessed the effect of timing of ART initiation on tuberculosis treatment outcomes for HIV-positive patients with CD4 counts of 220 cells per μL or more. We did this randomised, placebo-controlled trial between Jan 1, 2008, and April 31, 2013 at 26 treatment centres in South Africa, Tanzania, Uganda, and Zambia. We enrolled HIV-positive patients with culture-confirmed tuberculosis who had tolerated 2 weeks of tuberculosis short course chemotherapy. Participants were randomly allocated (1:1) to early ART (starting after 2 weeks of tuberculosis treatment) or delayed ART (placebo, then starting ART at the end of 6 months of tuberculosis treatment). Randomisation was computer generated, with permuted blocks of size eight, and stratified by CD4 count (220-349 cells per μL vs ≥350 cells per μL). Patients and investigators were masked to treatment allocation until completion of 6-months' tuberculosis treatment, after which the study was open label. The primary endpoint was a composite of failure of tuberculosis treatment, tuberculosis recurrence, and death within 12 months of starting tuberculosis treatment in the modified intention-to-treat population. Secondary endpoints included mortality. The study is registered with controlled-trials.com (ISRCTN77861053). We screened 13,588 patients and enrolled 1675: 834 assigned early ART, 841 delayed ART. The primary endpoint was reached by 65 (8·5%) of 767 patients in the early ART group versus 71 (9·2%) of 771 in the delayed ART group (relative risk [RR] 0·91, 95% CI 0·64-1·30; p=0·9). Of patients with a CD4 cell count of 220-349 cells per μL, 26 (7·9%) of 331 patients versus 33 (9·6%) of 342 reached the primary endpoint (RR 0·80, 95% CI 0·46-1·39; p=0·6). For those with 350 cells per μL or more

  14. Submarine hydrothermal activity and gold-rich mineralization at Brothers Volcano, Kermadec Arc, New Zealand

    Science.gov (United States)

    de Ronde, Cornel E. J.; Massoth, Gary J.; Butterfield, David A.; Christenson, Bruce W.; Ishibashi, Junichiro; Ditchburn, Robert G.; Hannington, Mark D.; Brathwaite, Robert L.; Lupton, John E.; Kamenetsky, Vadim S.; Graham, Ian J.; Zellmer, Georg F.; Dziak, Robert P.; Embley, Robert W.; Dekov, Vesselin M.; Munnik, Frank; Lahr, Janine; Evans, Leigh J.; Takai, Ken

    2011-07-01

    Brothers volcano, of the Kermadec intraoceanic arc, is host to a hydrothermal system unique among seafloor hydrothermal systems known anywhere in the world. It has two distinct vent fields, known as the NW Caldera and Cone sites, whose geology, permeability, vent fluid compositions, mineralogy, and ore-forming conditions are in stark contrast to each other. The NW Caldera site strikes for ˜600 m in a SW-NE direction with chimneys occurring over a ˜145-m depth interval, between ˜1,690 and 1,545 m. At least 100 dead and active sulfide chimney spires occur in this field and are typically 2-3 m in height, with some reaching 6-7 m. Their ages (at time of sampling) fall broadly into three groups: metal-rich, and gas-poor. Calculated end-member fluids from NW Caldera vents indicate that phase separation has occurred, with Cl values ranging from 93% to 137% of seawater values. By contrast, vent fluids at the Cone site are diffuse, noticeably cooler (≤122°C), more acidic (pH 1.9), metal-poor, and gas-rich. Higher-than-seawater values of SO4 and Mg in the Cone vent fluids show that these ions are being added to the hydrothermal fluid and are not being depleted via normal water/rock interactions. Iron oxide crusts 3 years in age cover the main cone summit and appear to have formed from Fe-rich brines. Evidence for magmatic contributions to the hydrothermal system at Brothers includes: high concentrations of dissolved CO2 (e.g., 206 mM/kg at the Cone site); high CO2/3He; negative δD and δ18OH2O for vent fluids; negative δ34S for sulfides (to -4.6‰), sulfur (to -10.2‰), and δ15N2 (to -3.5‰); vent fluid pH values to 1.9; and mineral assemblages common to high-sulfidation systems. Changing physicochemical conditions at the Brothers hydrothermal system, and especially the Cone site, occur over periods of months to hundreds of years, as shown by interlayered Cu + Au- and Zn-rich zones in chimneys, variable fluid and isotopic compositions, similar shifts in 3He/4He

  15. The two Haydns and the brothers hospitallers (Barmherzige Brüder, Fatebene frateli, Osi):The four pupils, the less known sources

    Czech Academy of Sciences Publication Activity Database

    Freemanová, Michaela

    2001-01-01

    Roč. 38, 3-4 (2001), s. 333-342 ISSN 0018-7003 Institutional research plan: CEZ:AV0Z8059909 Keywords : brothers hospitallers, J and M. Haydn, pupils Subject RIV: AL - Art, Architecture, Cultural Heritage

  16. How Is Muscular Dystrophy Diagnosed?

    Science.gov (United States)

    ... Research Information Find a Study Resources and Publications Osteogenesis Imperfecta (OI) Condition Information NICHD Research Information Find ... Print How is muscular dystrophy diagnosed? The first step in diagnosing muscular dystrophy (MD) is a visit ...

  17. Diagnosing Dementia—Positive Signs

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Diagnosing Dementia—Positive Signs Past Issues / Fall 2007 Table of ... easy, affordable blood test that could accurately diagnose Alzheimer's disease (AD)—even before symptoms began to show? Researchers ...

  18. Phelan-McDermid syndrome in two adult brothers: atypical bipolar disorder as its psychopathological phenotype?

    Directory of Open Access Journals (Sweden)

    Verhoeven WMA

    2012-04-01

    Full Text Available Willem MA Verhoeven1,2, Jos IM Egger1,3,4, Marjolein H Willemsen5, Gert JM de Leijer6, Tjitske Kleefstra51Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, 2Erasmus University Medical Centre, Department of Psychiatry, Rotterdam, 3Donders Centre for Cognition, Radboud University Nijmegen, Nijmegen, 4Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, 5Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, 6Dichterbij, Institutes for Intellectual Disabilities, Gennep, The NetherlandsAbstract: The 22q13.3 deletion, or Phelan-McDermid syndrome, is characterized by global intellectual disability, generalized hypotonia, severely delayed or absent speech associated with features of autism spectrum disorder, and minor dysmorphisms. Its behavioral phenotype comprises sleep disturbances, communication deficits, and motor perseverations. Data on psychological dysfunctions are so far not available. Previous studies have suggested that the loss of one copy of the gene SH3 and multiple ankyrin repeat domains 3 (SHANK3 is related to the neurobehavioral phenotype. Additional genes proximal to SHANK3 are also likely to play a role in the phenotype of patients with larger deletions. The present paper describes two adult brothers with an identical 2.15 Mb 22qter (22q13.32q13.33 deletion, of whom the youngest was referred for evaluation of recurrent mood changes. In both patients, magnetic resonance imaging of the brain showed hypoplasia of the vermis cerebelli. Extensive clinical examinations led to a final diagnosis of atypical bipolar disorder, of which symptoms fully remitted during treatment with a mood stabilizer. In the older brother, a similar psychopathological picture appeared to be present, although less severe and with a later onset. It is concluded that the behavioral phenotype of the 22q13.3 deletion syndrome comprises absent or delayed speech and perseverations

  19. Novel PIGT Variant in Two Brothers: Expansion of the Multiple Congenital Anomalies-Hypotonia Seizures Syndrome 3 Phenotype

    Directory of Open Access Journals (Sweden)

    Nadia Skauli

    2016-11-01

    Full Text Available Biallelic PIGT variants were previously reported in seven patients from three families with Multiple Congenital Anomalies-Hypotonia Seizures Syndrome 3 (MCAHS3, characterized by epileptic encephalopathy, hypotonia, global developmental delay/intellectual disability, cerebral and cerebellar atrophy, craniofacial dysmorphisms, and skeletal, ophthalmological, cardiac, and genitourinary abnormalities. We report a novel homozygous PIGT missense variant c.1079G>T (p.Gly360Val in two brothers with several of the typical features of MCAHS3, but in addition, pyramidal tract neurological signs. Notably, they are the first patients with MCAHS3 without skeletal, cardiac, or genitourinary anomalies. PIGT encodes a crucial subunit of the glycosylphosphatidylinositol (GPI transamidase complex, which catalyzes the attachment of proteins to GPI-anchors, attaching the proteins to the cell membrane. In vitro studies in cells from the two brothers showed reduced levels of GPI-anchors and GPI-anchored proteins on the cell surface, supporting the pathogenicity of the novel PIGT variant.

  20. Novel PIGT Variant in Two Brothers: Expansion of the Multiple Congenital Anomalies-Hypotonia Seizures Syndrome 3 Phenotype

    OpenAIRE

    Skauli, Nadia; Wallace, Sean; Chiang, Samuel C. C.; Bar?y, Tuva; Holmgren, Asbj?rn; Stray-Pedersen, Asbj?rg; Bryceson, Yenan T.; Str?mme, Petter; Frengen, Eirik; Misceo, Doriana

    2016-01-01

    Biallelic PIGT variants were previously reported in seven patients from three families with Multiple Congenital Anomalies-Hypotonia Seizures Syndrome 3 (MCAHS3), characterized by epileptic encephalopathy, hypotonia, global developmental delay/intellectual disability, cerebral and cerebellar atrophy, craniofacial dysmorphisms, and skeletal, ophthalmological, cardiac, and genitourinary abnormalities. We report a novel homozygous PIGT missense variant c.1079G>T (p.Gly360Val) in two brothers w...

  1. Megacystis-microcolon-intestinal hypoperistalsis syndrome in a newborn girl whose brother had prune belly syndrome: common pathogenesis?

    Science.gov (United States)

    Oliveira, G; Boechat, M I; Ferreira, M A

    1983-01-01

    A case of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is presented. There were important findings: a urachal remnant and a brother with prune belly syndrome (PBS). After a review of the literature, many common characteristics of MMIHS and PBS are described: flaccid abdomen, dilatation of the urinary tract, intestinal malrotation, cryptorchidism, urachal remnants and familial incidence. MMIHS and PBS may be manifestations of the same underlying process.

  2. Megacystis-microlon-intestinal hypoperistalsis syndrome in a newborn girl whose brother had Prune Belly syndrome: Common Pathogenesis

    International Nuclear Information System (INIS)

    Oliveira, G.; Boechat, M.I.; Fereira, M.A.

    1983-01-01

    A case of Megacystis-Microcolon-Intestinal Hypoperistalsis Syndrome (MMIHS) is presented. There were important findings: a urachal remnant and a brother with Prune Belly Syndrome (PBS). After a review of the literature, many common characteristics of MMIHS and PBS are described: flaccid abdomen, dilatation of the urinary tract, intestinal malrotation, cryptorchidism, urachal remnants and familial incidence. MMIHS and PBS may be manifestations of the same underlying process. (orig.)

  3. Megacystis-microlon-intestinal hypoperistalsis syndrome in a newborn girl whose brother had Prune Belly syndrome: Common Pathogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, G.; Boechat, M.I.; Fereira, M.A.

    1983-07-01

    A case of Megacystis-Microcolon-Intestinal Hypoperistalsis Syndrome (MMIHS) is presented. There were important findings: a urachal remnant and a brother with Prune Belly Syndrome (PBS). After a review of the literature, many common characteristics of MMIHS and PBS are described: flaccid abdomen, dilatation of the urinary tract, intestinal malrotation, cryptorchidism, urachal remnants and familial incidence. MMIHS and PBS may be manifestations of the same underlying process.

  4. Reluctant Romantics – On the fairy tale poetics of the Brothers Grimm and their relationship to German Romanticism

    Directory of Open Access Journals (Sweden)

    Isabel dos Santos

    2014-12-01

    Full Text Available The legacy of the Brothers Grimm continues to fascinate readers and researchers alike. The 200-year anniversary of the first publication of their fairy tales sparked a renewed interest in the life, work and times of the brothers. Fascinated by the past, by the political present and by the literary future of Romanticism, the Brothers Grimm stayed together in an unusual working union. They established what was to become German philology and published many invaluable works on language and history, myths and folk tales. This article will focus on the brothers’ place in German Romanticism through their contribution of fairy tales. The period was marked by political and philosophical thought that emphasised authentic experienced and the spiritual unity of art, science and philosophy. There was a strong call for national emancipation. Literature was required to embody this unity through an established national literature founded on German folk traditions. The Grimms seemed to have heeded that call. But a careful study reveals that their intentions were motivated less by the literary movement than by their own strong convictions which they upheld even at the cost of compromising the authenticity they claimed to uphold in their poetics. The many controversies regarding the origins, collection and editing of the fairy tales is inextricably linked to the brothers’ difficult relationship with the Romantic Movement. Two hundred years later, this article seeks to give an appraisal of the Brothers’ motivation for their poetics and of the research conducted thus far.

  5. Challenging stereotypes? The older woman in the TV series Brothers & Sisters.

    Science.gov (United States)

    Oró-Piqueras, Maricel

    2014-12-01

    The TV series, Brothers & Sisters, broadcast from 2006 to 2011 by ABC (USA) and a year later by Channel 4 (UK) with quite high audience rates, starts when the patriarchal figure, William Walker, dies of a heart attack and two female figures around their sixties come center stage: his wife, Nora Walker, and his long-term lover, Holly Harper. Once the patriarchal figure disappears, the female characters regain visibility by entering the labor market and starting relationships with other men. In that sense, both protagonists experience aging as a time in which they are increasingly freed from social and family constraints. However, their roles as nurturers keep on bringing them back to the domestic space in which they are safe from being involved in uncomfortable and unsuitable situations. Drawing on previous studies on the representation of the older woman in fictional media, this article intends to discern to what extent stereotypes related to the older woman are challenged through the two main protagonists of a contemporary TV series. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. [Cancer of the oral cavity in three brothers of the whole blood in Mauritania].

    Science.gov (United States)

    Baba, Nacer Dine

    2016-01-01

    Major risk factors for cancers of the oral cavity are alcohol and tobacco, but hereditary factors were also identified. This case study aims to illustrate this last component among the most known risk factors. We here report three cases of brothers of the whole blood presenting with cancer of the oral cavity showing rapid development in less than a year in each of them. Additional risk factors other than hereditary factors were: smoking, poor oral hygiene, low fruit and vegetable intake. Hereditary risk has been a controversial issue for a long period of time, but several recent studies have suggested the existence of this risk factor which is consistent with our observation. These studies even showed that hereditary component for carcinomas of the upper aerodigestive tract seems likely; it is important that family members at risk understand that their vulnerability to these tumors can be greatly reduced by stopping smoking, by a moderate consumption of alcohol and a frequent consumption of raw fruits and vegetables. Further studies should be carried out in our country to clarify the respective role of these different risk factors in developing this type of cancer Meanwhile, prevention and early diagnosis are the most appropriate means to fight against this type of cancer.

  7. [Fragile X syndrome and white matter abnormalities: Case study of two brothers].

    Science.gov (United States)

    Wallach, E; Bieth, E; Sevely, A; Cances, C

    2017-03-01

    Fragile X syndrome is the most usual cause of hereditary intellectual deficiency. Typical symptoms combine intellectual deficiency, social anxiety, intense emotional vigilance, and a characteristic facial dysmorphy. This is subsequent to a complete mutation of the FMR1 gene, considering a semidominant transmission linked to the unstable X. The expansion of the CGG triplet greater than 200 units combined with a high methylation pattern lead to a transcriptional silence of the FMR1 gene, and the protein product, the FMRP, is not synthesized. This protein is involved in synaptic plasticity. Brain MRI can show an increased volume of the caudate nucleus and hippocampus, combined with hypoplasia of the cerebellar vermis. Fragile X Associated Tremor Ataxia Syndrome (FXTAS) syndrome is a neurodegenerative disorder occurring in carriers of the premutation in FMR1. Brain MRI shows an increased T2 signal in the middle cerebellar peduncles. This syndrome is linked to a premutation in the FMR1 gene. We report here the case of two brothers presenting a typical fragile X symptomatology. Brain MRI showed hyperintensities of the middle cerebellar peduncles. Such MRI findings support the assumption of a genetic mosaicism. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Super Mario brothers and sisters: Associations between coplaying video games and sibling conflict and affection.

    Science.gov (United States)

    Coyne, Sarah M; Jensen, Alexander C; Smith, Nathan J; Erickson, Daniel H

    2016-02-01

    Video games can be played in many different contexts. This study examined associations between coplaying video games between siblings and levels of affection and conflict in the relationship. Participants were 508 adolescents (M age = 16.31 years of age, SD = 1.08) who completed questionnaires on video game use and sibling relationships. Participants were recruited from a large Northwestern city and a moderate city in the Mountain West of the United States. Video games played between siblings were coded by an independent sample to assess levels of physical aggression and prosocial behavior in each game. Playing video games with a sibling was associated with higher levels of sibling affection for both boys and girls, but higher levels of conflict for boys only. Playing a violent video game with a brother was associated with lower levels of conflict in the sibling relationship, whereas playing a prosocial video game was not related to any sibling outcome. The value of video games in sibling relationships will be discussed, with a focus on the type of game and the sex of the adolescent. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  9. 'The brothers Karamazov' and 'On the open road': F. M. Dostoevsky and Steve Tesich's moral imperative

    Directory of Open Access Journals (Sweden)

    Šoškić Radoje V.

    2012-01-01

    Full Text Available The present paper strives to analyze the play On the Open Road, the most famous and most popular play by American-Serbian playwright and screenwriter Steve Tesich, comparing some of its elements and ideas to F. M. Dostoevsky's novel The Brothers Karamazov, whose episodic interpolation yet its moral centre - the legend of the Grand Inquisitor, inspired Tesich to use the motif of Christ's Second Coming in his play. In this play, Tesich deliberately resorts to allegory in order to critically perceive and react to the growing deterioration of the moral sensibility of Western civilization embroiled in hypocrisy and lies. The murder of Christ, from Tesich's perspective, is a dramatic example of the process of killing what is best in man, a process that is constantly repeated in the dehumanized social order that is imposed by force, and persists due to the use of force. Tesich, as well as his contemporary Arthur Miller, dramatizes the killing of God in man as the killing and drying up of man's creative potentialities and conscience. .

  10. Sixty Days Remaining, Forty Years of CERN, Two Brothers, One Exclusive Interview

    CERN Multimedia

    2001-01-01

    Twins Marcel and Daniel Genolin while sharing memories of their CERN experiences, point out just how much smaller the Meyrin site once was. In a place such as CERN where the physical sciences are in many ways the essence of our daily lives and where technological advancement is an everyday occurrence, it is easy to lose track of the days, months, and even years. But last week twin brothers, Daniel and Marcel Genolin, hired in the early sixties and getting ready to end their eventful forty year CERN experiences, made it clear that the winds of time bluster past us whether we are aware or not. 'CERN was very small when we started' says Marcel, who has worked in transport during his entire time here. A lot has changed. 'When I got here there were no phones in peoples' houses' he recalls,'when there were problems in the control room with the PS (Proton Synchrotron) they used to get a megaphone and tell us {the transport service} to go and get the necessary physicists from their homes in the area. We had to lo...

  11. Diagnosing oceanic nutrient deficiency

    Science.gov (United States)

    Moore, C. Mark

    2016-11-01

    The supply of a range of nutrient elements to surface waters is an important driver of oceanic production and the subsequent linked cycling of the nutrients and carbon. Relative deficiencies of different nutrients with respect to biological requirements, within both surface and internal water masses, can be both a key indicator and driver of the potential for these nutrients to become limiting for the production of new organic material in the upper ocean. The availability of high-quality, full-depth and global-scale datasets on the concentrations of a wide range of both macro- and micro-nutrients produced through the international GEOTRACES programme provides the potential for estimation of multi-element deficiencies at unprecedented scales. Resultant coherent large-scale patterns in diagnosed deficiency can be linked to the interacting physical-chemical-biological processes which drive upper ocean nutrient biogeochemistry. Calculations of ranked deficiencies across multiple elements further highlight important remaining uncertainties in the stoichiometric plasticity of nutrient ratios within oceanic microbial systems and caveats with regards to linkages to upper ocean nutrient limitation. This article is part of the themed issue 'Biological and climatic impacts of ocean trace element chemistry'.

  12. Finding Common Ground: Use of a Geographically-Framed Landscape Template as an Integrating Platform for an International Education Initiative

    Science.gov (United States)

    Brierley, Gary; Li, Xilai; Qiao, Youming; Huang, He Qing; Wang, Zhaoyin

    2018-01-01

    This situated case study outlines how a place-based landscape template provided an integrative platform for the environmental arm of a cross-disciplinary international education initiative, the Three Brothers Project, wherein geographers at the University of Auckland worked alongside engineers at Tsinghua University in Beijing to support…

  13. Legal consequences for torture in children cases: the Gomez Paquiyauri Brothers vs Peru case.

    Science.gov (United States)

    Tinta, Monica Feria

    2009-01-01

    The Gomez Paquiyauri Brothers case, before the Inter-American Court of Human Rights, was the first international case concerning the protection of children in the context of armed conflict where an international court stated the law concerning the duties of States towards children even in the context of war, and provided for reparations. As such it represents a landmark decision. The case arose from the illegal detention, torture and extrajudicial execution of two minors, Emilio and Rafael Gomez Paquiyauri, at the hands of Peruvian Police in 1991, under the Fujimori Administration at a time when the internal war in Peru was at its peak. Unlike most cases coming to the jurisdiction of the Inter-American Court, the case had been subject to domestic criminal investigations that had led to the convictions of two low ranking policemen. Yet a more subtle pattern of impunity lied at the root of the case. Torture had been denied by the State, and the prosecutions of low ranking policemen had intended to cover up the responsibility of those who ordered a policy of torture and executions (including the existence of secret codes for the torture and elimination of suspects of "terrorism") during the years of the internal armed conflict in Peru. The joint work of legal and medical expertise in the litigation of the case permitted the establishment of the facts and the law, obtaining an award of 740,500 dollars for the victims and a number of measures of reparation including guarantees of non-repetition and satisfaction, such as the naming of a school after the victims.

  14. A Song in the Dark. Francis of Assisi’s Canticle of Brother Sun

    Directory of Open Access Journals (Sweden)

    Speelman Willem Marie

    2016-10-01

    Full Text Available The Canticle of the Creatures or Canticle of Brother Sun is based on a particular way of perceiving reality. Francis, who had turned away from ‘the world’, discovered a different way of looking at it. This is a divine way of perceiving, in which the senses do not grasp reality, but accept it as it communicates itself. This way of perceiving is only possible if one does not attempt to master the environment, but allows one’s senses to be weak. It is significant, therefore, that this song of praise was born at a moment of the utmost despair and weakness. The song’s content is in line with this weak perception: it is not about Francis who praises God and (or for His creatures, but rather it is a testimony that the creatures-the elements-are already praising God, and a prayer that He should let Himself be praised by the creatures. Also in line with this weak perception is the fact that the creatures are praised just as they communicate themselves to Francis: as bodies. The theology of this song is that the creatures through their bodies resonate (strengthen, and colour the blessings that come from God, thereby making His blessing present here on earth. Francis’ role is to give a voice and a language to the heavenly praises as they resound in his environment. The transformative power of this song is that we, whether consciously or not, do the same thing when we participate in this song.

  15. Brown and polar bear Y chromosomes reveal extensive male-biased gene flow within brother lineages.

    Science.gov (United States)

    Bidon, Tobias; Janke, Axel; Fain, Steven R; Eiken, Hans Geir; Hagen, Snorre B; Saarma, Urmas; Hallström, Björn M; Lecomte, Nicolas; Hailer, Frank

    2014-06-01

    Brown and polar bears have become prominent examples in phylogeography, but previous phylogeographic studies relied largely on maternally inherited mitochondrial DNA (mtDNA) or were geographically restricted. The male-specific Y chromosome, a natural counterpart to mtDNA, has remained underexplored. Although this paternally inherited chromosome is indispensable for comprehensive analyses of phylogeographic patterns, technical difficulties and low variability have hampered its application in most mammals. We developed 13 novel Y-chromosomal sequence and microsatellite markers from the polar bear genome and screened these in a broad geographic sample of 130 brown and polar bears. We also analyzed a 390-kb-long Y-chromosomal scaffold using sequencing data from published male ursine genomes. Y chromosome evidence support the emerging understanding that brown and polar bears started to diverge no later than the Middle Pleistocene. Contrary to mtDNA patterns, we found 1) brown and polar bears to be reciprocally monophyletic sister (or rather brother) lineages, without signals of introgression, 2) male-biased gene flow across continents and on phylogeographic time scales, and 3) male dispersal that links the Alaskan ABC islands population to mainland brown bears. Due to female philopatry, mtDNA provides a highly structured estimate of population differentiation, while male-biased gene flow is a homogenizing force for nuclear genetic variation. Our findings highlight the importance of analyzing both maternally and paternally inherited loci for a comprehensive view of phylogeographic history, and that mtDNA-based phylogeographic studies of many mammals should be reevaluated. Recent advances in sequencing technology render the analysis of Y-chromosomal variation feasible, even in nonmodel organisms. © The Author 2014. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution. All rights reserved. For permissions, please e

  16. Power in Play: A Foucauldian Reading of A.O. Soyinka’s The Trials of Brother Jero

    Directory of Open Access Journals (Sweden)

    Mahboobeh Davoodifar

    2015-12-01

    Full Text Available This work utilizes Foucault’s articulations on the power strategies of our contemporary society. To him the subject’s constitution is never a purely passive effect of power on the subject but requires the subject’s own activity. This necessitates the existence of a dynamic, mutually affecting relationship, implying that one can be both dominated and dominate at different times and in different contexts. This article aims to analyze the Nigerian Noble Laureate, Wole Soyinka’s play The Trials of Brother Jero, a prophetical play that criticizes the ills of society through its satirical depiction, in the light of Foucault’s conceptualizations on power. To do this, the article first clarifies Foucault’s mature understanding of the operation of power and then attempts to provide an in-depth analysis of the structure of the power regime and its relations in the play, tactics of domination, and more importantly, the characters’ relations to the existing system of power. The study of the language and the dialogue of the main characters, Brother Jero, Amope, Chume and a Member of Federation House not only exposes the sources of operating power relations, but it also highlights the characters’ desire for power and the way it flows and slips from one character to another. The findings of the paper reveals that power is not concentrated on merely one character or institution within the play, rather, it circulates, and through the active resistance of the dominated characters, it constantly engenders new meanings within the structure of the play. In The Trials of Brother Jero, different characters have the desire to use power against each other and the resistance of each of them indicates that power is neither possessive nor repressive. Keywords: Michel Foucault, Power, Pastoral Power, Resistance, Wole Soyinka

  17. A Clarion Call for Social Work Attention: Brothers and Sisters of Persons With Acquired Brain Injury in the United States.

    Science.gov (United States)

    Degeneffe, Charles Edmund

    2016-08-11

    This article presents a clarion call for increased social work attention to the needs of siblings of persons with acquired brain injury (ABI) in the United States. The article overviews how siblings are psychosocially affected, how they provide care to the injured brothers and sisters, and how they personally develop as a result of their experiences. The article highlights the fact that social workers and other professionals often overlook the needs of siblings of persons with ABI and makes an appeal for social workers to advance clinical practice and research to benefit this often neglected population.

  18. Race and the refusal to name racism: consumption, identity and choice in the Celebrity Big Brother House

    OpenAIRE

    Thomas, Dania

    2009-01-01

    The centrality of consumption in the resolution of the ‘race row’ in the Celebrity Big Brother(CBB) House 2007 characterizes ‘the consumption politics of race’ engendered in response to ‘racism lite’ (adopting Mary Riddell’s term) - forms of racial harm articulated in normative frames specific to the entertainment industry. The regulatory response to racism litewas premised on a radical and post-modern framing of race and racial harm. When compared with the responses to racism outside the CBB...

  19. Structures, stability, mechanical and electronic properties of a-boron and its twined brother a*-boron

    OpenAIRE

    He, Chaoyu; Zhong, Jianxin

    2013-01-01

    The structures, stability, mechanical and electronic properties of a-boron and its twined brother a*-boron have been studied by first-principles calculations. Both a-boron and a*-boron consist of equivalent icosahedra B12 clusters in different connecting configurations of "3S-6D-3S" and "2S-6D-4S", respectively. The total energy calculations show that a*-boron is less stable than a-boron but more favorable than beta-boron and Gamma-boron at zero pressure. Both a-boron and a*-boron are confirm...

  20. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... Provider Pocket Guides Provider Guides Fertility Preservation for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed ... Patient Pocket Guides Patient Guides Fertility Preservation for Women Diagnosed with Cancer Fertility Preservation for Men Diagnosed ...

  1. Understanding Prostate Cancer: Newly Diagnosed

    Science.gov (United States)

    ... vs Cancer Contact Us Newly Diagnosed with Prostate Cancer Prostate Cancer Basics About the Prostate Risk Factors Prostate ... when my.. Donors Patient Stories About the Prostate Cancer Foundation The Prostate Cancer Foundation (PCF) is the world’s leading philanthropic ...

  2. How to diagnose cardiac tamponade

    NARCIS (Netherlands)

    van Steijn, JHM; Sleijfer, DT; van der Graaf, WTA; van der Sluis, A; Nieboer, P

    Malignant pericardial effusion is a potentially fatal complication of malignancy unless recognised and treated promptly. Patients with this condition are often difficult to diagnose. Physical examination, chest radiography and electrocardiography have poor diagnostic values in identification of

  3. Culture-independent characterization of a novel microbial community at a hydrothermal vent at Brothers volcano, Kermadec arc, New Zealand

    Science.gov (United States)

    Stott, M. B.; Saito, J. A.; Crowe, M. A.; Dunfield, P. F.; Hou, S.; Nakasone, E.; Daughney, C. J.; Smirnova, A. V.; Mountain, B. W.; Takai, K.; Alam, M.

    2008-08-01

    The bacterial and archaeal diversity of a hydrothermal vent microbial community at Brothers volcano situated in the Kermadec arc, ˜400 km off the north coast of New Zealand, was examined using culture-independent molecular analysis. An unusual microbial community was detected with only 1% and 40% of the bacterial phylotypes exhibiting >92% small subunit (SSU) rRNA gene sequence similarity with cultivated and noncultivated microbes, respectively. Of the 29 bacterial representative phylotypes, over one third of the SSU rRNA gene sequences retrieved belonged to uncultivated candidate divisions including OP1, OP3, OP5, OP8, OD1, and OP11. All archaeal phylotypes belonged to the phylum Euryarchaeota in the uncultivated groups deep hydrothermal vent euryarchaeotal (DHVE) I and II or to the phylum Korarchaeota. Like the bacterial clone library, only a small proportion of archaeal SSU rRNA gene sequences (˜2% and 20%) displayed >92% sequence identity with any archaeal isolates or noncultivated microbes, respectively. Although the bacterial phylotypes detected were phylogenetically most similar to microbial communities detected in methane, hydrocarbon, and carbon dioxide-based hydrothermal and seep environments, no phylotypes directly associated with anaerobic methane oxidation and mcrA activity could be detected. The geochemical composition of the vent fluids at the Brothers-lower cone sample site is unusual and we suggest that it may play a prominent role in the species selection of this microbial community.

  4. Different types of glomerulonephritis associated with the dysregulation of the complement alternative pathway in 2 brothers: A case report.

    Science.gov (United States)

    Chen, Pei; Zhu, Li; Yu, Feng; Han, Sha-Sha; Meng, Si-Jun; Guo, Wei-Yi; Zhang, Hong; Song, Yan

    2017-06-01

    C3 glomerulonephritis (C3GN) and complement-mediated hemolytic uremic syndrome (HUS) both result from the abnormal regulation of the complement system. A significant number of patients with C3GN or complement-mediated HUS have mutations of more than 1 complement protein. This discovery has had a major impact on identifying the underlying cause of familial C3GN or complement-mediated HUS. We report the cases of 2 brothers (herein referred to as patient II-1 and patient II-9), both with complement disorders that differed in their clinical and genetic features. Patient II-1 clinically presented with nephrotic syndrome and acute kidney injury and pathologically presented with C3GN combined with thrombotic microangiopathy (TMA) and subacute tubulointerstitial nephritis. Meanwhile, patient II-9 clinically presented with HUS and pathologically presented with TMA combined with acute severe tubular injury. Screenings for genetic mutations contributed to complement system dysregulation were performed on patient II-1. The genome sequencing identified that patient II-1 had a heterozygous mutation in the C3 gene (c.C1774T/p.R592W). Nine other relatives of the brothers were checked for this C3 mutation and only the daughter of patient II-1 (herein referred to as patient III-2) carried it, but so far, she does not have any clinical manifestations of kidney disease. Family members with a dysregulation of the complement alternative pathway may differ in its clinical and genetic features.

  5. Discordant Clinical Course of Vitamin-D-Hydroxylase (CYP24A1 Associated Hypercalcemia in Two Adult Brothers With Nephrocalcinosis

    Directory of Open Access Journals (Sweden)

    Tilman Jobst-Schwan

    2015-08-01

    Full Text Available Background/Aims: Hypercalcemia can result in nephrocalcinosis/nephrolithiasis and may lead to renal failure. Idiopathic infantile hypercalcemia is caused by mutations of the CYP24A1 gene, which regulates vitamin D activity. Classically infants present with hypercalcemia. Recently, a number of individuals have been reported with late onset clinical manifestation or late diagnosis in adulthood. All these patients are believed to show hypercalciuria. Methods: We report a 24 year old patient of healthy consanguine parents. Genetic analysis was performed by Sanger sequencing of the CYP24A1 gene in the index patient and targeted exon 2 analysis of all other family members. Results: The patient was hospitalized with severe malaise during an acute EBV-infection. He showed hypercalcemia > 3mmol/l and acute, hypovolemic renal failure with profound nephrocalcinosis, but no hypercalciuria. Genetic workup revealed a homozygous loss-of-function mutation p.E143del in the CYP24A1 gene. His clinically asymptomatic brother showed nephrocalcinosis of lesser degree. Repeatedly, low parathyroid hormone levels were detected in both brothers. Conclusion: This family displays the highly variable phenotype of CYP24A1 biallelic mutation carriers. CYP24A1 associated disease is an important differential diagnosis for the workup and counseling of infants as well as adults with hypercalcemia since a proper genetic diagnosis may result in therapeutic consequences.

  6. The early course of newly diagnosed asthma.

    Science.gov (United States)

    Ernst, Pierre; Cai, Bing; Blais, Lucie; Suissa, Samy

    2002-01-01

    We describe the intensity of therapy for patients with newly diagnosed asthma and how it changed during subsequent years in relation to age, sex, and initial level of therapy. We examined a cohort of 13,671 patients in Saskatchewan, Canada, who were initially between the ages of 5 and 44 years. Patients were followed prospectively, and the intensity of asthma therapy was measured during successive 12-month periods. Based on the intensity of asthma drug therapy during the first year after entry into the cohort, 6661 patients (48.7%) were initially prescribed therapy judged to be appropriate for mild asthma, and 977 (7.1%) were dispensed medications in a manner suggesting their asthma was severe; the remaining 6033 (44.1%) were classified as receiving treatment of intermediate intensity. Among patients initially classified as receiving treatment appropriate for mild disease, only about 3% were dispensed medications that suggested that their asthma had become severe during up to 5 years of follow-up. Intensity of therapy waned in a substantial proportion of patients who were initially classified as having severe asthma, especially if they were initially younger than 15 years of age. Thirty-four per 100 patients initially younger than 15 years old were receiving medications appropriate for mild asthma, and 23 per 100 such patients received no medication for asthma during a 12-month period when followed up to 5 years. Patients with asthma who are initially treated with therapy appropriate for mild asthma are rarely treated later with therapy suggesting the advent of severe disease. Patients initially dispensed medications suggesting the presence of severe asthma often see the intensity of treatment wane over time.

  7. Palmo-Plantar hyperkeratosis, intellectual disability, and spastic paraplegia in two maternal half brothers: further evidence for an X-linked inheritance.

    Science.gov (United States)

    Isidor, Bertrand; Lefebvre, Tiphaine; Barbarot, Sébastien; Perrier, Julie; Mercier, Sandra; Péréon, Yann; Le Caignec, Cédric; David, Albert

    2013-06-01

    In 1983, Fitzsimmons et al. reported four brothers with an unrecognized disorder characterized by intellectual disability, spastic paraplegia, and palmo-plantar hyperkeratosis (OMIM 309500). In this report, we describe a family in which two males, maternal half-brothers, had learning disabilities. Both patients also showed spasticity in the lower limbs and palmo-plantar hyperkeratosis. The mother of the affected boys had learning difficulties but did not show any dermatological symptoms. This report confirms that the association of features reported by Fitzsimmons et al. is a distinct entity and further suggests an X-linked mode of inheritance. Copyright © 2013 Wiley Periodicals, Inc.

  8. Brother of the regulator of the imprinted site (BORIS variant subfamily 6 is a novel target of lung cancer stem-like cell immunotherapy.

    Directory of Open Access Journals (Sweden)

    Ryota Horibe

    Full Text Available Lung cancer is one of the most common malignancies with a high rate of mortality. Lung cancer stem-like cells (CSCs/ cancer-initiating cells (CICs play major role in resistance to treatments, recurrence and distant metastasis and eradication of CSCs/CICs is crucial to improve recent therapy. Cytotoxic T lymphocytes (CTLs are major effectors of cancer immunotherapy, and CTLs recognize antigenic peptides derived from antigens that are presented by major histocompatibility complex (MHC class I molecules. In this study, we analyzed the potency of a cancer-testis (CT antigen, brother of the regulator of the imprinted site variant subfamily 6 (BORIS sf6, in lung CSC/CIC immunotherapy. BORIS sf6 mRNA was expressed in lung carcinoma cells (9/19, especially in sphere-cultured lung cancer stem-like cells, and in primary lung carcinoma tissues (4/9 by RT-PCR. Immunohistochemical staining using BORIS sf6-specific antibody revealed that high expression of BORIS sf6 is related to poorer prognosis. CTLs could be induced by using a human leukocyte antigen, (HLA-A2 restricted antigenic peptide (BORIS C34_24(9, from all of 3 HLA-A2-positive individuals, and CTL clone cells specific for BORIS C34_24(9 peptide could recognize BORIS sf6-positive, HLA-A2-positive lung carcinoma cells. These results indicate that BORIS sf6 is a novel target of lung cancer immunotherapy that might be useful for targeting treatment-resistant lung cancer stem-like cells.

  9. Diagnoser

    DEFF Research Database (Denmark)

    Waaddegaard, Mette; Lau, Marianne Engelbrecht; Schousboe, Birgitte Hartvig

    2012-01-01

    Spiseforstyrrelser er psykiske sygdomme, hvor forholdet til mad, krop og spisning er så forstyrret, at det går ud over ens sundhed og sociale liv. Man skelner typisk mellem anoreksi, bulimi og tvangsoverspisning, men der findes næsten lige så mange kombinationer af spiseforstyrrelsessymptomer, som...

  10. Correlation of antemortem diagnoses and postmortem diagnoses in ...

    African Journals Online (AJOL)

    Background: The postmortem examination is a veritable means of ascertaining the correct diagnoses. Over the years, there has been a severe drop in the number of requests for postmortem examination despite its numerous advantages and benefits. The study is aimed at showing the pivotal role of the autopsy in medical ...

  11. Gaucher's disease diagnosed by splenectomy.

    Science.gov (United States)

    Adas, Mine; Adas, Gokhan; Karatepe, Oguzhan; Altiok, Merih; Ozcan, Deniz

    2009-08-01

    Splenectomy continues to find common therapeutic indications for hematologic disorders. In addition, recently it is also performed in surgical clinics to assist diagnose of some illnesses. Gaucher's disease, especially Type I, is the most frequently encountered lysosomal storage disorder in man. Manifestations of it are highly variable. The most frequently found symptoms include splenomegaly with anaemia and thrombocytopenia, mostly due to hypersplenism, hepatomegaly and bone disease. Four patients were reported in the present study. Three of them were easily diagnosed with Gaucher's disease via bone marrow cytology, and one with Gaucher's disease was detected by pathological examination following the splenectomy. For the pouse of diagnosis of the Gaucher's disease, performing surgery is generally not necessary. However, for the cases of difficult to diagnose by classical methods, the corect diagnosis of Gaucher's disease can only be made by a special operation.

  12. Nursing diagnoses in overweight adolescents

    Directory of Open Access Journals (Sweden)

    Raphaela Santos do Nascimento Rodrigues

    2013-05-01

    Full Text Available This study aimed to identify nursing diagnoses in overweight adolescents from public schools, according to the International Classification for Nursing Practice. A population-based cross-sectional study that investigated the socio-demographic, behavioural and psychological characteristics of adolescents aged from 10 to 14 years. 11 nursing diagnoses were identified: "Risk of overweight", "Risk of impaired adolescent development", "Risk of insecurity in parental role performance", "Risk of the family impaired ability to manage diet regime", "Risk of impaired ability to manage diet regime", "Risk of lack of knowledge of dietary regime", "Risk of excess food intake", "Risk of negative self-image", "Risk of low self-esteem", "Risk of impaired social well-being" and "Impaired exercise pattern". These diagnoses reflect the multifactorial nature of obesity, highlighting the need for interdisciplinary and intersectoral articulation of nursing interventions for prevention and control of overweight.

  13. How to diagnose acute appendicitis

    DEFF Research Database (Denmark)

    Mostbeck, Gerhard; Adam, E Jane; Nielsen, Michael Bachmann

    2016-01-01

    and complementary imaging with MRI/CT if indicated. Accordingly, both ionizing radiation to our patients and cost of pre-therapeutic diagnosis of AA will be low, with low negative appendectomy and perforation rates. Main Messages • Ultrasound (US) should be the first imaging modality for diagnosing acute...... to keep both the negative appendectomy rate and the perforation rate low. Introduced in 1986, graded-compression ultrasound (US) has well-established direct and indirect signs for diagnosing AA. In our opinion, US should be the first-line imaging modality, as graded-compression US has excellent...

  14. Immunological methods for diagnosing neurocysticercosis

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, R.E.; Estrada, J.J.; Grogl, M.

    1989-01-31

    A method is described for diagnosing active human neurocysticercosis by detecting the presence of at least one Taenia solium larval antigen in cerebrospinal fluid, which comprises: contacting cerebrospinal fluid from a human to be diagnosed with a solid support, wherein the support binds with a Taenia solium larval antigen if present, contacting the support with a first antibody, wherein the first antibody binds with a larval Taenia solium antigen if present in the cerebrospinal fluid, contacting the solid support with a detectable second antibody which will bind with the first antibody, and detecting the second antibody bound to the support.

  15. "I like that He Always Shows Who He Is": The Perceptions and Experiences of Siblings with a Brother with Autism Spectrum Disorder

    Science.gov (United States)

    Petalas, Michael A.; Hastings, Richard P.; Nash, Susie; Dowey, Alan; Reilly, Deirdre

    2009-01-01

    Semi-structured interviews were used to explore the perceptions and experiences of eight typically developing siblings in middle childhood who had a brother with autism spectrum disorder (ASD). The interviews were analysed using interpretative phenomenological analysis (IPA). The analysis yielded five main themes: (i) siblings' perceptions of the…

  16. "My Brother Likes Meeting New People, but Don't Ask Him Any Direct Questions": Involving Adults with Autism plus Learning Disability in a Qualitative Research Project

    Science.gov (United States)

    Tozer, Rosemary; Atkin, Karl; Wenham, Aniela

    2014-01-01

    Adult siblings of people with autism and a learning disability have hitherto been largely overlooked by research, policy and practice in the UK. As part of a qualitative study focussing on adult siblings, we met twelve people with autism plus severe learning disability with their brother or sister. Individually tailored resources were used to make…

  17. Adolescent Siblings of Individuals with and without Intellectual and Developmental Disabilities: Self-Reported Empathy and Feelings about Their Brothers and Sisters

    Science.gov (United States)

    Shivers, Carolyn M.; Dykens, Elisabeth M.

    2017-01-01

    Siblings of brothers or sisters with intellectual and developmental disabilities (IDD) are important but understudied family members. As many previous studies have relied on parent report of sibling outcomes, the use of sibling self-report is an important addition to the research. This study assessed the feelings of adolescent siblings toward…

  18. 'A Strange Mixture of Caring and Corruption': Residential Care in Christian Brothers Orphanages and Industrial Schools during Their Last Phase, 1940s to 1960s.

    Science.gov (United States)

    Coldrey, Barry

    2000-01-01

    Explores the two Christian Brothers religious orders of the Roman Catholic Church. Focuses on the Irish Congregation that has been controversial, specifically in its residential care for neglected, orphaned, and delinquent children. States that allegations of physical, sexual, and emotional abuse has been reported in their institutions. (CMK)

  19. Samuel Alderman Lomas (1838-1901) the man with two gravestones, his brother Muscot Atkin Lomas (1840-1907) and their lives in Victorian asylums.

    Science.gov (United States)

    Hilton, Claire; Hilton, Benjamin

    2009-05-01

    Samuel Alderman Lomas died in the Hertfordshire County Asylum, Hill End, St Albans in 1901. He was buried in the asylum cemetery where two gravestones bear his name. This paper traces his life history and that of his brother Muscot Atkin Lomas. Both were classed as idiots in Victorian society and spent most of their lives -- from childhood until death -- in asylums.

  20. Diagnoses and interventions in podiatry.

    NARCIS (Netherlands)

    Zuijderduin, W.M.; Dekker, J.

    1996-01-01

    In the present study a quantitative description is given of diagnoses and interventions in podiatry. Data are used from a survey on podiatry practice in The Netherlands. Data have been recorded by 36 podiatrists on 897 patients. Information was gathered on patient characteristics, the medical

  1. Information dissipation as an early-warning signal for the Lehman Brothers collapse in financial time series

    Science.gov (United States)

    Quax, Rick; Kandhai, Drona; Sloot, Peter M. A.

    2013-05-01

    In financial markets, participants locally optimize their profit which can result in a globally unstable state leading to a catastrophic change. The largest crash in the past decades is the bankruptcy of Lehman Brothers which was followed by a trust-based crisis between banks due to high-risk trading in complex products. We introduce information dissipation length (IDL) as a leading indicator of global instability of dynamical systems based on the transmission of Shannon information, and apply it to the time series of USD and EUR interest rate swaps (IRS). We find in both markets that the IDL steadily increases toward the bankruptcy, then peaks at the time of bankruptcy, and decreases afterwards. Previously introduced indicators such as `critical slowing down' do not provide a clear leading indicator. Our results suggest that the IDL may be used as an early-warning signal for critical transitions even in the absence of a predictive model.

  2. Recurrent episodes of myoglobinuria, mental retardation and seizures but no hemolysis in two brothers with phosphoglycerate kinase deficiency.

    Science.gov (United States)

    Coppens, Sandra; Koralkova, Pavla; Aeby, Alec; Mojzikova, Renata; Deconinck, Nicolas; Kadhim, Hazim; van Wijk, Richard

    2016-03-01

    We report two brothers with mild intellectual deficiency, exercise intolerance, rhabdomyolysis, seizures and no hemolysis. Phosphoglycerate kinase (PGK) activity was strongly decreased in their red blood cells. Subsequent molecular analysis of PGK1 revealed hemizygosity for a novel mutation c.756 + 3A > G, in intron 7. Analysis of the effect of this mutation on pre-mRNA processing demonstrated markedly decreased levels of normal PGK1 mRNA. In addition, the c.756 + 3A > G change resulted in abnormally spliced transcripts. If translated, these transcripts mostly encode for C-terminally truncated proteins. The consequences of the c.756 + 3A > G mutation is discussed, as well as the genotype-to-phenotype correlation with regard to previously described mutations (PGK Fukuroi and PGK Antwerp), which also result in C-terminal truncated proteins. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Cognitive ability in young adulthood and risk of dementia in a cohort of Danish men, brothers, and twins

    DEFF Research Database (Denmark)

    Osler, Merete; Christensen, Gunhild T.; Garde, Ellen

    2017-01-01

    INTRODUCTION: We examined the association between cognitive ability in young adulthood and dementia in Danish men, brothers, and male twins. METHODS: In total, 666,986 men born between 1939 and 1959 were identified for dementia diagnosis in national registries from 1969 to 2016. The association...... between cognitive ability from draft board examination and dementia was examined using Cox regression. RESULTS: During a 44-year follow-up, 6416 (0.96%) men developed dementia, 1760 (0.26%) and 970 (0.15%) of which were classified as Alzheimer's and vascular dementia, respectively. Low cognitive ability...... was associated with increased risk of dementia (hazard ratio [HR]per SD decrease 1.33 [95% confidence interval {CI} = 1.30-1.35]) with the strongest associations for vascular dementia (HRper SD decrease 1.47 [95% CI = 1.31-1.56]) and a weaker for Alzheimer's disease (HRper SD decrease 1.07 [95% CI = 1...

  4. Gabriel García Márquez's «Eréndira» and the Brothers Grimm

    Directory of Open Access Journals (Sweden)

    Joel Hancock

    1978-08-01

    Full Text Available García Márquez's long story «La increíble y triste historia de la Cándida Eréndira y de su abuela desalmada» is studied in the light of the structures and themes of the fairy tale, particularly of the type collected by the Grimm brothers. Dimensions of special interest are the organizational framework of the narrative, the portrayal of characters, and certain motifs, all of which are strongly reminiscent of Grimm's Fairy Tales . These elements are examined as representative of those morphologies which Vladimir Propp delineates for the genre of the fairy tale in his Morphology of the Folktale .

  5. brother of cdo (umleitung) is cell-autonomously required for Hedgehog-mediated ventral CNS patterning in the zebrafish

    Science.gov (United States)

    Bergeron, Sadie A.; Tyurina, Oksana V.; Miller, Emily; Bagas, Andrea; Karlstrom, Rolf O.

    2011-01-01

    The transmembrane protein Brother of Cdo (Boc) has been implicated in Shh-mediated commissural axon guidance, and can both positively and negatively regulate Hedgehog (Hh) target gene transcription, however, little is known about in vivo requirements for Boc during vertebrate embryogenesis. The zebrafish umleitung (umlty54) mutant was identified by defects in retinotectal axon projections. Here, we show that the uml locus encodes Boc and that Boc function is cell-autonomously required for Hh-mediated neural patterning. Our phenotypic analysis suggests that Boc is required as a positive regulator of Hh signaling in the spinal cord, hypothalamus, pituitary, somites and upper jaw, but that Boc might negatively regulate Hh signals in the lower jaw. This study reveals a role for Boc in ventral CNS cells that receive high levels of Hh and uncovers previously unknown roles for Boc in vertebrate embryogenesis. PMID:21115611

  6. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for Children Diagnosed with Cancer Ask Your Doctor Information for ...

  7. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult ...

  8. Diagnosing GORD in respiratory medicine

    Directory of Open Access Journals (Sweden)

    Chris James Timms

    2011-07-01

    Full Text Available Gastroesophageal reflux disease is increasing in prevalence and is associated with several lung diseases such as asthma and COPD. Current diagnostic methods are imperfect, being insensitive, nonspecific, expensive or invasive. An accurate diagnosis of GORD can aid effective treatment with a significant clinical impact. Novel methods such as exhaled breath condensate analysis and electronic nose technology have the potential to improve the accuracy of diagnosing GORD.

  9. A designated centre for people with disabilities operated by Brothers of Charity Services Ireland, Limerick

    LENUS (Irish Health Repository)

    Hegarty, M

    2010-11-01

    As increasing demand for organs is a challenge for transplant services worldwide it is essential to audit the process of organ donation. To address this, a national audit of potential organ donors was undertaken across hospitals with Intensive Care Units (N = 36). Questionnaires were returned on all patients (n = 2073) who died in these units from 1\\/9\\/07-31\\/8\\/08; 200 (10%) of these patients were considered for Brain Stem Testing (BST), 158 patients (79%) were diagnosed Brain Stem Dead (BSD) and 138 patients (87%) became potential donors. Consent for donation was given by 92 (69%) next of kin and 90 potential donors (65%) became organ donors. There was no evidence of a large number of potential organ donors being missed. Recommendations included completion of BSTs on all appropriate patients, development of support on BST, referral of all BSD patients to the Organ Procurement Service; enhanced co-ordination within hospitals and sustained information\\/education campaigns.

  10. The lived experiences of rural women diagnosed with the human ...

    African Journals Online (AJOL)

    2017-09-26

    Sep 26, 2017 ... simultaneously initiated on antiretroviral treatment (ART). An HIV diagnosis ... study was to explore the lived experiences of women diagnosed with HIV in the antenatal period in a rural area in the Eastern Cape province of South .... her life to fulfil mothering responsibilities, are reported facilitators of ART for ...

  11. Diagnosing ectopic pregnancy in the emergency setting.

    Science.gov (United States)

    Lee, Robert; Dupuis, Carolyn; Chen, Byron; Smith, Andrew; Kim, Young H

    2018-01-01

    Ectopic pregnancy is the implantation of a fertilized egg outside the uterine endometrial cavity. For women presenting to the emergency department with abdominal pain and/or vaginal bleeding, ectopic pregnancy is an important diagnostic consideration. The diagnosis is made based on laboratory values and ultrasound imaging findings. The ultrasound appearance of both normal early pregnancy and ectopic pregnancy are variable and often subtle, presenting diagnostic challenges for radiologists. This pictorial essay describes and illustrates the sonographic findings of ectopic pregnancy and reviews the differential diagnoses that can mimic ectopic pregnancy on ultrasound. With the possibility of medical management, the value of early detection and prompt initiation of treatment has increased in improving clinical outcomes and preventing the complications of ectopic pregnancy.

  12. Diagnosing ectopic pregnancy in the emergency setting

    Directory of Open Access Journals (Sweden)

    Robert Lee

    2018-01-01

    Full Text Available Ectopic pregnancy is the implantation of a fertilized egg outside the uterine endometrial cavity. For women presenting to the emergency department with abdominal pain and/or vaginal bleeding, ectopic pregnancy is an important diagnostic consideration. The diagnosis is made based on laboratory values and ultrasound imaging findings. The ultrasound appearance of both normal early pregnancy and ectopic pregnancy are variable and often subtle, presenting diagnostic challenges for radiologists. This pictorial essay describes and illustrates the sonographic findings of ectopic pregnancy and reviews the differential diagnoses that can mimic ectopic pregnancy on ultrasound. With the possibility of medical management, the value of early detection and prompt initiation of treatment has increased in improving clinical outcomes and preventing the complications of ectopic pregnancy.

  13. « Nous sommes tous frères ». Les valeurs des Elephants de Brother, club de baseball professionnel à Taiwan “We are all Brothers”. The Values of Brother Elephants, professional baseball club in Taiwan

    Directory of Open Access Journals (Sweden)

    Jérôme Soldani

    2013-06-01

    Full Text Available À Taiwan, où le baseball est considéré comme le « sport national », les équipes professionnelles sont la propriété de grandes firmes locales et ne sont pas formellement attachées à une municipalité. Ce sont elles-mêmes de petites entreprises qui proposent, en archétype de société, un mode de fonctionnement interne qui repose sur des valeurs autour desquelles se fédèrent leurs supporters. Basée sur une enquête ethnographique de douze mois, notamment au sein de la formation professionnelle des Elephants de Brother, cette contribution montrera comment celle-ci se donne à voir comme une entreprise structurée autour de valeurs morales entendues comme « traditionnelles » et dont les joueurs de l’équipe sont érigés en parangons. Le modèle d’une famille unie et strictement hiérarchisée est mis en exergue par les propriétaires du club et son iconographie. Mais ces représentations se heurtent à la réalité de la pratique quotidienne et aux affaires de corruption qui sapent régulièrement l’image de la ligue professionnelle taiwanaise.In Taiwan, where baseball is considered as the national sport, professional teams are owned by large local firms and are not formally attached to a municipality. They are themselves small companies offering an archetypal society, whose mode of internal operations are based on values around which to unite their fans. Based on an ethnographic study of twelve months, particularly among the professional team of Brother Elephants, this contribution will show how it is to be seen as an enterprise structured around moral values understood as traditional and whose players are established as paragons. The model of a united family and strictly hierarchical is highlighted by the owners of the club and its iconography. But these representations are faced with the reality of daily practice and corruption that regularly undermine the image of the Taiwanese professional league.

  14. Observer variation in target volume delineation of lung cancer related to radiation oncologist-computer interaction: A 'Big Brother' evaluation

    International Nuclear Information System (INIS)

    Steenbakkers, Roel J.H.M.; Duppen, Joop C.; Fitton, Isabelle; Deurloo, Kirsten E.I.; Zijp, Lambert; Uitterhoeve, Apollonia L.J.; Rodrigus, Patrick T.R.; Kramer, Gijsbert W.P.; Bussink, Johan; Jaeger, Katrien De; Belderbos, Jose S.A.; Hart, Augustinus A.M.; Nowak, Peter J.C.M.; Herk, Marcel van; Rasch, Coen R.N.

    2005-01-01

    Background and purpose: To evaluate the process of target volume delineation in lung cancer for optimization of imaging, delineation protocol and delineation software. Patients and methods: Eleven radiation oncologists (observers) from five different institutions delineated the Gross Tumor Volume (GTV) including positive lymph nodes of 22 lung cancer patients (stages I-IIIB) on CT only. All radiation oncologist-computer interactions were recorded with a tool called 'Big Brother'. For each radiation oncologist and patient the following issues were analyzed: delineation time, number of delineated points and corrections, zoom levels, level and window (L/W) settings, CT slice changes, use of side windows (coronal and sagittal) and software button use. Results: The mean delineation time per GTV was 16 min (SD 10 min). The mean delineation time for lymph node positive patients was on average 3 min larger (P=0.02) than for lymph node negative patients. Many corrections (55%) were due to L/W change (e.g. delineating in mediastinum L/W and then correcting in lung L/W). For the lymph node region, a relatively large number of corrections was found (3.7 corr/cm 2 ), indicating that it was difficult to delineate lymph nodes. For the tumor-atelectasis region, a relative small number of corrections was found (1.0 corr/cm 2 ), indicating that including or excluding atelectasis into the GTV was a clinical decision. Inappropriate use of L/W settings was frequently found (e.g. 46% of all delineated points in the tumor-lung region were delineated in mediastinum L/W settings). Despite a large observer variation in cranial and caudal direction of 0.72 cm (1 SD), the coronal and sagittal side windows were not used in 45 and 60% of the cases, respectively. For the more difficult cases, observer variation was smaller when the coronal and sagittal side windows were used. Conclusions: With the 'Big Brother' tool a method was developed to trace the delineation process. The differences between

  15. Comedia del valor de las letras y las armas: New Light on the Story of Captive Captain and his Brothers (DQ 1, 37-45

    Directory of Open Access Journals (Sweden)

    Clark Colahan

    2015-12-01

    Full Text Available The tale of the captive captain, Ruy Pérez de Viedma, and his brothers, as well as Don Quixote’s discourse on arms and letters which serves as its prologue, have been well studied, but a model combining both parts of this thematic unit found in the first part of Don Quixote has not been previously identified. The anonymous late-sixteenth-century play Comedia del valor de las letras y las armas, here studied as a source for the first time, may well have been known to Cervantes and provides extensive parallels of theme and characterization to Cervantes’ treatment of both Renaissance discourse on preserving peace and the folktale of three brothers and their respective professions. It brings into sharp focus that these chapters resolve the debate between arms and letters in favor of a third element, social power and money.

  16. Non-marfan idiopathic medionecrosis (cystic medial necrosis) presenting with multiple visceral artery aneurysms and diffuse connective tissue fragility: Two brothers

    International Nuclear Information System (INIS)

    Kubota, Jun; Tsunemura, Mami; Amano, Shigeko; Tokizawa, Shigemi; Oowada, Susumu; Shinkai, Hiroko; Maehara, Yasunobu; Endo, Keigo

    1997-01-01

    Two brothers with multiple visceral artery aneurysms or dilatations and diffuse connective tissue fragility who did not have clinical features of Marfan syndrome are reported. One presented with retroperitoneal hemorrhage during angiography, and idiopathic medionecrosis was proved by resection of the aneurysms. These cases belong to the heterogeneous group of Marfan syndrome. The angiographical features (multiple dilation of visceral arteries) suggests fragility of connective tissue and is predictive of hazards during and after a catheterization and operation

  17. THE EVANGELICAL AS THE NATIVE IN THE “BROTHERS KARAMAZOV” AND IN “A WRITER’S DIARY” (1876–1877) BY FYODOR DOSTOEVSKY

    OpenAIRE

    Elena A. Fedorova

    2015-01-01

    The article identifi es the reasons for Fyodor Dostoevsky’s appeal to the traditions of Old Russian literature in “A Writer’s Diary” during the Russian-Turkish war. One of the main reasons is seeking for national foundations of Russian spirituality. The writer learned the world of medieval literacy getting acquainted with hagiography, walking, spiritual eloquence. Later Dostoevsky reverted to the Old Russian monuments in the course of his work on the novel “The Brothers Kara...

  18. [Sense of coherence and ways of coping in the relationship with brother or sister in healthy siblings of mentally ill persons].

    Science.gov (United States)

    Osuchowska-Kościjańska, Anna; Charzyńska, Katarzyna; Chadzyńska, Małgorzata; Drozdzyńska, Anna; Kasperek-Zimowska, Beata; Bednarek, Agata; Sawicka, Maryla

    2014-01-01

    The aim of the present study was to investigate sense of coherence in healthy siblings of persons suffering from schizophrenia as well as their ways of coping in the relationship with ill brother or sister. 40 healthy brothers and sisters of persons with ICD- 10 diagnosis of F20 to F29 participated in the present study. Orientation to Life Scale (SOC- 29) was used to assess sense of coherence and Ways of Coping with Stress questionnaire (SRSS) was used to examine stress coping strategies. Mean global score of siblings of persons with schizophrenia was 111 points. Subjects used coping strategies focused on problem significantly more often than those focused on emotions. Therapeutic work with healthy siblings should focus on strengthening sense of personal competence, development of personal resources and different ways of coping with stress, investigation of emotions that healthy siblings experience in the relationship with ill brother or sister as well as supporting the process of accepting changes in the relationship with the ill sibling.

  19. Three years follow-up of pamidronate therapy in two brothers with osteoporosis-pseudoglioma syndrome (OPPG) carrying an LRP5 mutation.

    Science.gov (United States)

    Barros, Elizabete Ribeiro; Dias da Silva, Magnus R; Kunii, Ilda S; Lazaretti-Castro, Marise

    2008-08-01

    Osteoporosis-pseudoglioma (OPPG) is a rare syndrome characterized by severe osteoporosis and ocular defects caused by homozygotic inactivation mutations in the LRP5 gene. Bisphosphonate has been demonstrated to improve bone mineral density (BMD) in children with OPPG. We present here a 3 years follow-up of two brothers with OPPG carrying a novel mutation in the LRP5 gene, who were treated with intravenous pamidronate. We looked for a mutation in the LRP5 gene in two brothers (12 and 4 years old) with clinical features of OPPG (blindness, low BMD and fragility fractures) and in their consanguineous parents to confirm the diagnosis of OPPG. The patients were treated with bisphosphonate for 3 years. They received 1 mg/kg/day of pamidronate for 2 consecutive days, every 3 months during the first year, and every 4 months in subsequent years. Calcium, phosphorus, total alkaline phosphatase, parathyroid hormone, hepatic transaminases, creatinine and hemogram tests were performed before each infusion. Bone densitometry was performed at baseline and at the end of the follow-up. The affected brothers carry a missense mutation in the third codon of exon 8 (AAT-->ATT) that led to the exchange of an asparagine for an isoleucine (N531I). Both parents were found to be heterozygous for this mutation. The intravenous pamidronate therapy was safe for up to 3 years of use. Moreover, increased BMD and decreased fracture rate were observed in our patients with OPPG.

  20. A designated centre for people with disabilities operated by Brothers of Charity Services South East, Tipperary

    LENUS (Irish Health Repository)

    Nicholl, Honor

    2014-04-01

    In 2010\\/12 an innovative children\\'s palliative care interprofessional educational project funded by the Irish Hospice Foundation was undertaken in a University faculty (Trinity College Dublin). This initiative responded to international educational recommendations to meet the palliative care needs of children. The project involved the development and delivery of 3 standalone modules at Master\\'s level and a substantive research evaluation of the project to examine stakeholders and students perspectives to provide an insight into their experiences and to gather data for future developments. The research evaluation was conducted in two parts, part one sought students\\' evaluation and part two sought stakeholders\\

  1. Paraphilic diagnoses in DSM-5.

    Science.gov (United States)

    Krueger, Richard B; Kaplan, Meg S

    2012-01-01

    The DSM-5 has been under revision since 1999 and is scheduled for publication in 2013. This article will review the major proposed modifications of the Paraphilias. The information reviewed was obtained from PubMed, PsychInfo, the DSM-5.org website and other sources and reviewed. Pedohebephilia, Hypersexual Disorder and Paraphilic Coercive Disorder are new proposed diagnoses. Paraphilias have been assigned their own chapter in DSM- 5 and a distinction has been made between Paraphilias and Paraphilic Disorders. Victim numbers have been included in diagnosis of paraphilias that involve victims and remission and severity measures have been added to all paraphilias. Transvestic Disorder can apply to males or females, Fetishistic Disorder now includes partialism, and Sexual Masochism Disorder has Asphyxiophilia as a specifier. This study is based on a literature review and influenced by the knowledge and biases of the authors. The Paraphilic Disorders Section of the DSM-5 represents a significant departure from DSMIV-TR.

  2. A novel homozygous AP4B1 mutation in two brothers with AP-4 deficiency syndrome and ocular anomalies.

    Science.gov (United States)

    Accogli, Andrea; Hamdan, Fadi F; Poulin, Chantal; Nassif, Christina; Rouleau, Guy A; Michaud, Jacques L; Srour, Myriam

    2018-04-01

    Adaptor protein complex-4 (AP-4) is a heterotetrameric protein complex which plays a key role in vesicle trafficking in neurons. Mutations in genes affecting different subunits of AP-4, including AP4B1, AP4E1, AP4S1, and AP4M1, have been recently associated with an autosomal recessive phenotype, consisting of spastic tetraplegia, and intellectual disability (ID). The overlapping clinical picture among individuals carrying mutations in any of these genes has prompted the terms "AP-4 deficiency syndrome" for this clinically recognizable phenotype. Using whole-exome sequencing, we identified a novel homozygous mutation (c.991C>T, p.Q331*, NM_006594.4) in AP4B1 in two siblings from a consanguineous Pakistani couple, who presented with severe ID, progressive spastic tetraplegia, epilepsy, and microcephaly. Sanger sequencing confirmed the mutation was homozygous in the siblings and heterozygous in the parents. Similar to previously reported individuals with AP4B1 mutations, brain MRI revealed ventriculomegaly and white matter loss. Interestingly, in addition to the typical facial gestalt reported in other AP-4 deficiency cases, the older brother presented with congenital left Horner syndrome, bilateral optic nerve atrophy and cataract, which have not been previously reported in this condition. In summary, we report a novel AP4B1 homozygous mutation in two siblings and review the phenotype of AP-4 deficiency, speculating on a possible role of AP-4 complex in eye development. © 2018 Wiley Periodicals, Inc.

  3. A dictionary without definitions: romanticist science in the production and presentation of the Grimm brothers' German dictionary, 1838-1863.

    Science.gov (United States)

    Kistner, Kelly

    2014-12-01

    Between 1838 and 1863 the Grimm brothers led a collaborative research project to create a new kind of dictionary documenting the history of the German language. They imagined the work would present a scientific account of linguistic cohesiveness and strengthen German unity. However, their dictionary volumes (most of which were arranged and written by Jacob Grimm) would be variously criticized for their idiosyncratic character and ultimately seen as a poor, and even prejudicial, piece of scholarship. This paper argues that such criticisms may reflect a misunderstanding of the dictionary. I claim it can be best understood as an artifact of romanticist science and its epistemological privileging of subjective perception coupled with a deeply-held faith in inter-subjective congruence. Thus situated, it is a rare and detailed case of Romantic ideas and ideals applied to the scientific study of social artifacts. Moreover, the dictionary's organization, reception, and legacy provide insights into the changing landscape of scientific practice in Germany, showcasing the difficulties of implementing a romanticist vision of science amidst widening gaps between the public and professionals, generalists and specialists.

  4. Hasil Rancang Bangun Sistem ERP dengan SDLC Model Waterfall: Studi Kasus Sistem Inventori PT Pan Brothers, Tbk.

    Directory of Open Access Journals (Sweden)

    Harijanto Pangestu

    2012-12-01

    Full Text Available Competition in the business world effects the use of information technology. To achieve competitive advantage in the global competition, PT Pan Brothers, Tbk. should establish an integrated information system based on ERP (Enterprise Resource Planning. With the ERP system, information will be accurate and up-todate to support strategic decision making. It takes conscientious planning in building the ERP system. Management information systems development projects have a very important role. One determining component is how to choose and use appropriate information systems development method. SDLC (system development life cycle is growing very rapidly along with the development of information technology. It is necessary to choose the right SDLC in building an integrated system based on ERP. Each SDLC models has advantages and disadvantages. SDLC models will only be optimal if used according to the situation and conditions. Waterfall model provides clear deliverables and milestones, good documentation, easy to understand, easy to implement, emphasizes on good procedural workmanship (precoding design. Some of its weaknesses are difficult to integrate risk management, high cost change documents, high administrative costs, often late completion thus.To avoid them, there should be a well-planned project management and steps properly so it can be on time and will not exceed budget.

  5. Columbia River wildlife mitigation habitat evaluation procedures report: Scotch Creek Wildlife Area, Berg Brothers, and Douglas County pygmy rabbit projects

    International Nuclear Information System (INIS)

    Ashley, P.R.; Ratassepp, J.; Berger, M.; Judd, S.L.

    1997-01-01

    This Habitat Evaluation Procedure study was conducted to determine baseline habitat units (HUs) on the Scotch Creek, Mineral Hill, Pogue Mountain, Chesaw and Tunk Valley Habitat Areas (collectively known as the Scotch Creek Wildlife Area) in Okanogan County, Sagebrush Flat and the Dormaler property in Douglas County, and the Berg Brothers ranch located in Okanogan County within the Colville Reservation. A HEP team comprised of individuals from the Washington Department of Fish and Wildlife, the Confederated Tribes of the Colville Reservation, and the Natural Resources Conservation Service (Appendix A) conducted baseline habitat surveys using the following HEP evaluation species: mule deer (Odocoileus hemionus), sharp-tailed grouse (Tympanuchus phasianellus), pygmy rabbit (Brachylagus idahoensis), white-tailed deer (Odocoileus virginiana), mink (Mustela vison), Canada goose (Branta canadensis), downy woodpecker (Picoides pubescens), Lewis woodpecker (Melanerpes lewis), and Yellow warbler (Dendroica petechia). Results of the HEP analysis are listed below. General ratings (poor, marginal, fair, etc.,) are described in Appendix B. Mule deer habitat was marginal lacking diversity and quantify of suitable browse species. Sharp-tailed grouse habitat was marginal lacking residual nesting cover and suitable winter habitat Pygmy rabbit habitat was in fair condition except for the Dormaier property which was rated marginal due to excessive shrub canopy closure at some sites. This report is an analysis of baseline habitat conditions on mitigation project lands and provides estimated habitat units for mitigation crediting purposes. In addition, information from this document could be used by wildlife habitat managers to develop management strategies for specific project sites

  6. A tragédia da impossibilidade do evento: Os Maias; o Big Brother e a pedagogia dos media

    Directory of Open Access Journals (Sweden)

    Orlando Grossegesse

    2010-01-01

    Full Text Available O romance Os Maias (1888 de Eça de Queiroz pertence ao cânone da Literatura Portuguesa. Questionando a leitura integral de textos literários no Ensino Secundário, a definição de Os Maias no sistema sócio-comunicativo da época como romance de conversação leva à descoberta do seu carácter dilemático numa sociedade dos média. No cerne desta abordagem está uma reinterpretação do incesto, evento que irrompe na vida social da alta sociedade lisboeta representada no romance. Esta representação é comparada ao Big Brother, levando a uma crítica da cultura que também diz respeito à actualidade. The novel Os Maias (1888, by Eça de Queiroz, belongs to the canons of Portuguese literature. Questioning the integral reading of literary texts in secondary school education, the definition of Os Maias in the sociocommunicative system of the time as a conversation novel highlights its dilemma in the media society. At the bottom of this approach lies the reinterpretation of incest, an event that bursts into the social life of Lisbon high society represented in the novel. This representation is compared with “Big Brother”, leading to a critique of culture that is also related to current times.

  7. Columbia River Wildlife Mitigation Habitat Evaluation Procedures Report / Scotch Creek Wildlife Area, Berg Brothers, and Douglas County Pygmy Rabbit Projects.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul R.

    1997-01-01

    This Habitat Evaluation Procedure study was conducted to determine baseline habitat units (HUs) on the Scotch Creek, Mineral Hill, Pogue Mountain, Chesaw and Tunk Valley Habitat Areas (collectively known as the Scotch Creek Wildlife Area) in Okanogan County, Sagebrush Flat and the Dormaler property in Douglas County, and the Berg Brothers ranch located in Okanogan County within the Colville Reservation. A HEP team comprised of individuals from the Washington Department of Fish and Wildlife, the Confederated Tribes of the Colville Reservation, and the Natural Resources Conservation Service (Appendix A) conducted baseline habitat surveys using the following HEP evaluation species: mule deer (Odocoileus hemionus), sharp-tailed grouse (Tympanuchus phasianellus), pygmy rabbit (Brachylagus idahoensis), white-tailed deer (Odocoileus virginiana), mink (Mustela vison), Canada goose (Branta canadensis), downy woodpecker (Picoides pubescens), Lewis woodpecker (Melanerpes lewis), and Yellow warbler (Dendroica petechia). Results of the HEP analysis are listed below. General ratings (poor, marginal, fair, etc.,) are described in Appendix B. Mule deer habitat was marginal lacking diversity and quantify of suitable browse species. Sharp-tailed grouse habitat was marginal lacking residual nesting cover and suitable winter habitat Pygmy rabbit habitat was in fair condition except for the Dormaier property which was rated marginal due to excessive shrub canopy closure at some sites. This report is an analysis of baseline habitat conditions on mitigation project lands and provides estimated habitat units for mitigation crediting purposes. In addition, information from this document could be used by wildlife habitat managers to develop management strategies for specific project sites.

  8. Fertility Preservation for Children Diagnosed with Cancer

    Science.gov (United States)

    ... website. Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open ... Diagnosed with Cancer You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation ...

  9. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... for Children Diagnosed with Cancer You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer ... SJ, et al. Incorporating fertility preservation into the care of young oncology patients. Cancer. 2010;117:4- ...

  10. Two Silent Brothers. Althusser and Foucault at the Crossroads of Ideology

    Directory of Open Access Journals (Sweden)

    Diego Melegari

    2014-07-01

    Full Text Available The article aims to reinterpret the relationship between Louis Althusser and Michel Foucault on the specific ground of the notion of "Ideology." If Foucault's critique addresses initially the alleged opposition between ideological discourse and scientific discourse, this does not seem to fade in the seventies, despite the convergence of Foucault's "microphysics of power"with Althusser's insistence on the "material" character of ideology. To explain the persistence of this comparison and of this tension the author shows how with it are involved highly problematic knots for the whole Foucault's thought: the status of representation and truth, the inner existence and temporality of capitalism and, in particular, the relationship between criticism and politics.

  11. Driver’s Big Brother: How Smartphones Can Increase Driver’s Awareness

    Directory of Open Access Journals (Sweden)

    Ashraf Khalil

    2012-10-01

    Full Text Available Using mobile devices while driving has been widely shown to pose serious safety risk. Various approaches aim at mitigating the risk of mobile devices while driving. Some initiatives have focused on increasing drivers’ awareness of such potential risk. Along the same vein, we present a model, and its implementation, for assessing the degree of distraction that drivers experience while using phones during driving. Based on data collected during each driving session, the application gives statistics, such as keypad interaction, number and length of phone calls and the driving speed, to the driver. This should increase the awareness of drivers by helping them understand how much distraction they got involved with during driving and how much hazardous they can be to themselves and to others. Our experiments with drivers demonstrated the potential of the application at highlighting risky behavior, promoting awareness and motivating better driving.

  12. Manufacturing Initiative

    Data.gov (United States)

    National Aeronautics and Space Administration — The Advanced Manufacturing Technologies (AMT) Project supports multiple activities within the Administration's National Manufacturing Initiative. A key component of...

  13. [Differential diagnoses of West syndrome].

    Science.gov (United States)

    Fejerman, Natalio

    2013-09-06

    This study describes the clinical and electroencephalographic characteristics of epileptic spasms, and more especially those that occur during the first two years of life (infantile spasms). West syndrome has been clearly defined as the association between infantile spasms with an electroencephalographic pattern of hypsarrhythmia. Although intellectual deficit appears in almost all cases in which infantile spasms are not controlled with medication, this is a developmental aspect of the condition and not a manifestation that must necessarily be present in order to define the syndrome. The analysis of the interictal and ictal electroencephalogram readings, together with the clinical characteristics of the spasms and the neurological examination of patients, provides some orientation as regards the causations. Despite the spectrum that the title of this work focuses on, the study does not cover the treatment of early infants with West syndrome. Emphasis is placed on the differential diagnoses of West syndrome with other epileptic syndromes that manifest in the first two years of life, and more especially with a series of abnormal non-epileptic motor phenomena that occur in early infants. All these last non-epileptic disorders are displayed in a table, but benign myoclonus of early infancy or Fejerman syndrome is given as a paradigmatic example for the differential diagnosis. The primordial aim is to prevent neurologically healthy early infants from receiving antiepileptic drugs and even adrenocorticotropic hormone or corticoids due to a mistaken diagnosis.

  14. Attention Deficit Hyperactivity Disorder Erroneously Diagnosed and Treated as Bipolar Disorder

    Science.gov (United States)

    Atmaca, Murad; Ozler, Sinan; Topuz, Mehtap; Goldstein, Sam

    2009-01-01

    Objective: There is a dearth of literature on patients erroneously diagnosed and treated for bipolar disorder. Method: The authors report a case of an adult with attention deficit hyperactivity disorder erroneously diagnosed and treated for bipolar disorder for 6 years. At that point, methylphenidate was initiated. The patient was judged to be a…

  15. A designated centre for people with disabilities, operated by Brothers of Charity Services Clare, Clare

    LENUS (Irish Health Repository)

    Rock, Kathy

    2010-01-01

    ABSTRACT: INTRODUCTION: Hypercalcaemic hyperparathyroid crisis is a rare but life-threatening complication of primary hyperparathyroidism. Parathyroid carcinoma is a rare malignancy with an incidence of 0.5% to 4% of all reported cases of primary hyperparathyroidism. CASE PRESENTATION: We report the case of a 60-year-old Caucasian man with hypercalcaemic hyperparathyroid crisis associated with parathyroid carcinoma. He presented with a classic hypercalcaemic syndrome and his serum calcium and parathyroid hormone levels were at 4.65 mmol\\/L and 1743 ng\\/L, respectively. He initially presented with a two-week history of weakness and lethargy and a one-week history of vomiting, polyuria and polydipsia. An emergency left thyroid lobectomy and left lower parathyroidectomy were performed. There was a prompt decrease in his parathyroid hormone level immediately after surgery. Histology revealed that our patient had a 4-cm parathyroid carcinoma. CONCLUSION: In patients with parathyroid carcinoma, the optimal surgical treatment is en bloc resection with ipsilateral thyroid lobectomy and removal of any enlarged or abnormal lymph nodes. Surgery is the only curative treatment. In our patient, prompt surgical intervention proved successful. At six months the patient is well with no evidence of disease recurrence. This case highlights the importance of considering a hyperparathyroid storm in the context of a parathyroid carcinoma. Parathyroid carcinoma is a rare entity and our knowledge is mainly derived from case reports and retrospective studies. This case report increases awareness of this serious and life-threatening complication. This report also illustrates how prompt and appropriate management provides the best outcome for the patient.

  16. Cerebrotendinous xanthomatosis: report of two Brazilian brothers Xantomatose cerebrotendínea: relato de dois irmãos brasileiros

    Directory of Open Access Journals (Sweden)

    Marcos Christiano Lange

    2004-12-01

    Full Text Available Cerebrotendinous xanthomatosis is a treatable rare autossomal recessive disease characterized by lipid storage secondary to a sterol 27-hydroxylase deficiency in the formation of cholic and chenodeoxycholic acids. We describe two Brazilian brothers with cognitive impairement and chronic diarrhea. One of them also presents bilateral cataracts. Neurological findings were progressive walking deficit, limb ataxia and pyramidal signs. Both patients had bilateral Achilles tendon xanthomata. Magnetic resonance image showed signal alterations in cerebellar hemispheres. We describe these cases with molecular genetic analysis confirming diagnosis and comparing with previous literature. The CYP27A1 gene study showed a C1187T mutation on exon 6.Xantomatose cerebrotendínea é doença autossômica recessiva tratável causada pelo acúmulo de lipídeos por deficiência da enzima 27-esterol hidroxilase na produção de ácido cólico e deoxicólico. Descrevemos dois irmãos brasileiros com dificuldade cognitiva e diarréia crônica. Um deles apresentava catarata bilateral. Os achados neurológicos foram dificuldade progressiva para deambular, ataxia de membros e sinais piramidais. Ambos tinham xantomas de tendão aquileu bilateralmente. O exame de ressonância magnética revelou áreas de sinal hiperintenso em ambos os hemisférios cerebelares. Descrevemos os casos com diagnóstico genético comparando-os com a literatura. O estudo do gene CYP27A1 demonstrou a mutação C1183T no exon 6.

  17. Diagnosing Vincent van Gogh, an expedition from the sources to the present "mer à boire".

    Science.gov (United States)

    Voskuil, Piet

    2013-08-01

    The paintings and writings of Vincent van Gogh are widely admired for their great artistic value. This makes it interesting for doctors and patient groups to mold van Gogh's disease into a figurehead of their own specialty or illness. The recent article of ter Borg and Kasteleijn (2012) [1] in this Journal had a welcome approach by placing the diagnoses given in his lifetime in a historical and cultural context. In this article, the author will explore the diagnosis of epilepsy, adding more details without jumping quickly to conclusions. Apart from the information of eyewitnesses, special efforts are made to look critically at the medical sources as well as to investigate the original family chronicles. There is no easy access to that information. The Dutch vocabulary in the family notes made it tempting, for earlier scholars in this field, to easily link all kinds of attacks in family members to the original diagnosis of epilepsy. A part of the archives of the Willem Arntszhuis Utrecht describing the last days of Vincent's brother Theo, so far published only in Dutch (Voskuil, 2009 [16]), is included here. To integrate all this information, interdisciplinary research in a nonmutually excluding, but complementary, synthesis of today's knowledge is the most fruitful way to understand Vincent's behavior and its disturbances while continuing to admire his beautiful art. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Sharp interstitial Nefritis, Value Diagnoses of the Ultrasound

    International Nuclear Information System (INIS)

    Castillo, Luis Fernando; Rivera, Humberto; Andrade, Rafael E; Garcia, Diego

    1994-01-01

    Two cases of young patients are revised and they present a clinical picture of acute renal insufficiency of unknown aetiology. This fact was no suspected initially but thanks to the help of ultrasound and the clinical history it was possible to diagnose as an acute interstitial nephritis due to hypersensitivity to drugs. The classification of this illness is revised as well as its etiopathogenic clinical picture and ultrasound diagnosis

  19. A designated centre for people with disabilities operated by Brothers of Charity Services Galway, Galway

    LENUS (Irish Health Repository)

    Murphy, Andrew W

    2005-07-29

    BACKGROUND: The aim of the SPHERE study is to design, implement and evaluate tailored practice and personal care plans to improve the process of care and objective clinical outcomes for patients with established coronary heart disease (CHD) in general practice across two different health systems on the island of Ireland. CHD is a common cause of death and a significant cause of morbidity in Ireland. Secondary prevention has been recommended as a key strategy for reducing levels of CHD mortality and general practice has been highlighted as an ideal setting for secondary prevention initiatives. Current indications suggest that there is considerable room for improvement in the provision of secondary prevention for patients with established heart disease on the island of Ireland. The review literature recommends structured programmes with continued support and follow-up of patients; the provision of training, tailored to practice needs of access to evidence of effectiveness of secondary prevention; structured recall programmes that also take account of individual practice needs; and patient-centred consultations accompanied by attention to disease management guidelines. METHODS: SPHERE is a cluster randomised controlled trial, with practice-level randomisation to intervention and control groups, recruiting 960 patients from 48 practices in three study centres (Belfast, Dublin and Galway). Primary outcomes are blood pressure, total cholesterol, physical and mental health status (SF-12) and hospital re-admissions. The intervention takes place over two years and data is collected at baseline, one-year and two-year follow-up. Data is obtained from medical charts, consultations with practitioners, and patient postal questionnaires. The SPHERE intervention involves the implementation of a structured systematic programme of care for patients with CHD attending general practice. It is a multi-faceted intervention that has been developed to respond to barriers and solutions to

  20. A designated centre for people with disabilities operated by Brothers of Charity Services Roscommon, Roscommon

    LENUS (Irish Health Repository)

    Murphy, Andrew W

    2005-07-29

    BACKGROUND: The aim of the SPHERE study is to design, implement and evaluate tailored practice and personal care plans to improve the process of care and objective clinical outcomes for patients with established coronary heart disease (CHD) in general practice across two different health systems on the island of Ireland. CHD is a common cause of death and a significant cause of morbidity in Ireland. Secondary prevention has been recommended as a key strategy for reducing levels of CHD mortality and general practice has been highlighted as an ideal setting for secondary prevention initiatives. Current indications suggest that there is considerable room for improvement in the provision of secondary prevention for patients with established heart disease on the island of Ireland. The review literature recommends structured programmes with continued support and follow-up of patients; the provision of training, tailored to practice needs of access to evidence of effectiveness of secondary prevention; structured recall programmes that also take account of individual practice needs; and patient-centred consultations accompanied by attention to disease management guidelines. METHODS: SPHERE is a cluster randomised controlled trial, with practice-level randomisation to intervention and control groups, recruiting 960 patients from 48 practices in three study centres (Belfast, Dublin and Galway). Primary outcomes are blood pressure, total cholesterol, physical and mental health status (SF-12) and hospital re-admissions. The intervention takes place over two years and data is collected at baseline, one-year and two-year follow-up. Data is obtained from medical charts, consultations with practitioners, and patient postal questionnaires. The SPHERE intervention involves the implementation of a structured systematic programme of care for patients with CHD attending general practice. It is a multi-faceted intervention that has been developed to respond to barriers and solutions to

  1. A designated centre for people with disabilities operated by Brothers of Charity Services Roscommon

    LENUS (Irish Health Repository)

    2012-05-23

    AbstractBackgroundRadiotherapy (RT) and androgen-deprivation therapy (ADT) are standard treatments for advanced prostate cancer (PC). Tumor vascularization is recognized as an important physiological feature likely to impact on both RT and ADT response, and this study therefore aimed to characterize the vascular responses to RT and ADT in experimental PC.MethodsUsing mice implanted with CWR22 PC xenografts, vascular responses to RT and ADT by castration were visualized in vivo by DCE MRI, before contrast-enhancement curves were analyzed both semi-quantitatively and by pharmacokinetic modeling. Extracted image parameters were correlated to the results from ex vivo quantitative fluorescent immunohistochemical analysis (qIHC) of tumor vascularization (9 F1), perfusion (Hoechst 33342), and hypoxia (pimonidazole), performed on tissue sections made from tumors excised directly after DCE MRI.ResultsCompared to untreated (Ctrl) tumors, an improved and highly functional vascularization was detected in androgen-deprived (AD) tumors, reflected by increases in DCE MRI parameters and by increased number of vessels (VN), vessel density ( VD), and vessel area fraction ( VF) from qIHC. Although total hypoxic fractions ( HF) did not change, estimated acute hypoxia scores ( AHS) – the proportion of hypoxia staining within 50 μm from perfusion staining – were increased in AD tumors compared to in Ctrl tumors. Five to six months after ADT renewed castration-resistant (CR) tumor growth appeared with an even further enhanced tumor vascularization. Compared to the large vascular changes induced by ADT, RT induced minor vascular changes. Correlating DCE MRI and qIHC parameters unveiled the semi-quantitative parameters area under curve ( AUC) from initial time-points to strongly correlate with VD and VF, whereas estimation of vessel size ( VS) by DCE MRI required pharmacokinetic modeling. HF was not correlated to any DCE MRI parameter, however, AHS may be estimated after

  2. A designated centre for people with disabilities operated by Brothers of Charity Services South East, Waterford

    LENUS (Irish Health Repository)

    Barnett, Julie

    2011-05-13

    coherent messages to consumers in Europe. Discussion The FoodRisC project offers a unique approach to the investigation of food risk\\/benefit communication. The effective spread of food risk\\/benefit information will assist initiatives aimed at reducing the burden of food-related illness and disease, reducing the economic impact of food crises and ensuring that confidence in safe and nutritious food is fostered and maintained in Europe.

  3. CT scanning for diagnosing blunt ureteral and ureteropelvic junction injuries

    Directory of Open Access Journals (Sweden)

    Chu Peter

    2008-02-01

    Full Text Available Abstract Background Blunt ureteral and ureteropelvic (UPJ injuries are extremely rare and very difficult to diagnose. Many of these injuries are missed by the initial trauma evaluation. Methods Trauma registry data was used to identify all blunt trauma patients with ureteral or UPJ injuries, from 1 April 2001 to 30 November 2006. Demographics, injury information and outcomes were determined. Chart review was then performed to record initial clinical and all CT findings. Results Eight patients had ureteral or UPJ injuries. Subtle findings such as perinephric stranding and hematomas, and low density retroperitoneal fluid were evident on all initial scans, and prompted delayed excretory scans in 7/8 cases. As a result, ureteral and UPJ injuries were diagnosed immediately for these seven patients. These findings were initially missed in the eighth patient because significant associated visceral findings mandated emergency laparotomy. All ureteral and UPJ injuries have completely healed except for the case with the delay in diagnosis. Conclusion Most blunt ureteral and UPJ injuries can be identified if delayed excretory CT scans are performed based on initial CT findings of perinephric stranding and hematomas, or the finding of low density retroperitoneal fluid.

  4. Diagnosing the tight building syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Rogers, S.A.

    1987-12-01

    Formaldehyde is but one of many chemicals capable of causing the tight building syndrome or environmentally induced illness (EI). The spectrum of symptoms it may induce includes attacks of headache, flushing, laryngitis, dizziness, nausea, extreme weakness, arthralgia, unwarranted depression, dysphonia, exhaustion, inability to think clearly, arrhythmia or muscle spasms. The nonspecificity of such symptoms can baffle physicians from many specialties. Presented herein is a simple office method for demonstrating that formaldehyde is among the etiologic agents triggering these symptoms. The very symptoms that patients complain of can be provoked within minutes, and subsequently abolished, with an intradermal injection of the appropriate strength of formaldehyde. This injection aids in convincing the patient of the cause of the symptoms so he can initiate measure to bring his disease under control.

  5. Efforts to enrich evidence for accurate diagnoses

    Directory of Open Access Journals (Sweden)

    Wei Wang

    2016-10-01

    Full Text Available There are always difficulties to gain accurate diagnoses for complicated disease conditions, especially for the diagnoses of disorders with similar characteristics. With advanced technology, clinicians are able to detect tiny changes during the on-going diseased processes. Research papers in the current issue help to understand some features of some disorders. In this case, the current issue would provide some references or hints to the accurate diagnoses and the precisional therapies for some disorders.

  6. A case report of Chinese brothers with inherited MECP2-containing duplication: autism and intellectual disability, but not seizures or respiratory infections.

    Science.gov (United States)

    Xu, Xiu; Xu, Qiong; Zhang, Ying; Zhang, Xiaodi; Cheng, Tianlin; Wu, Bingbing; Ding, Yanhua; Lu, Ping; Zheng, Jingjing; Zhang, Min; Qiu, Zilong; Yu, Xiang

    2012-08-21

    Autistic spectrum disorders (ASDs) are a family of neurodevelopmental disorders with strong genetic components. Recent studies have shown that copy number variations in dosage sensitive genes can contribute significantly to these disorders. One such gene is the transcription factor MECP2, whose loss of function in females results in Rett syndrome, while its duplication in males results in developmental delay and autism. Here, we identified a Chinese family with two brothers both inheriting a 2.2 Mb MECP2-containing duplication (151,369,305 - 153,589,577) from their mother. In addition, both brothers also had a 213.7 kb duplication on Chromosome 2, inherited from their father. The older brother also carried a 48.4 kb duplication on Chromosome 2 inherited from the mother, and a 8.2 kb deletion at 11q13.5 inherited from the father. Based on the published literature, MECP2 is the most autism-associated gene among the identified CNVs. Consistently, the boys displayed clinical features in common with other patients carrying MECP2 duplications, including intellectual disability, autism, lack of speech, slight hypotonia and unsteadiness of movement. They also had slight dysmorphic features including a depressed nose bridge, large ears and midface hypoplasia. Interestingly, they did not exhibit other clinical features commonly observed in American-European patients with MECP2 duplication, including recurrent respiratory infections and epilepsy. To our knowledge, this is the first identification and characterization of Chinese Han patients with MECP2-containing duplications. Further cases are required to determine if the above described clinical differences are due to individual variations or related to the genetic background of the patients.

  7. A case report of Chinese brothers with inherited MECP2-containing duplication: autism and intellectual disability, but not seizures or respiratory infections

    Directory of Open Access Journals (Sweden)

    Xu Xiu

    2012-08-01

    Full Text Available Abstract Background Autistic spectrum disorders (ASDs are a family of neurodevelopmental disorders with strong genetic components. Recent studies have shown that copy number variations in dosage sensitive genes can contribute significantly to these disorders. One such gene is the transcription factor MECP2, whose loss of function in females results in Rett syndrome, while its duplication in males results in developmental delay and autism. Case presentation Here, we identified a Chinese family with two brothers both inheriting a 2.2 Mb MECP2-containing duplication (151,369,305 – 153,589,577 from their mother. In addition, both brothers also had a 213.7 kb duplication on Chromosome 2, inherited from their father. The older brother also carried a 48.4 kb duplication on Chromosome 2 inherited from the mother, and a 8.2 kb deletion at 11q13.5 inherited from the father. Based on the published literature, MECP2 is the most autism-associated gene among the identified CNVs. Consistently, the boys displayed clinical features in common with other patients carrying MECP2 duplications, including intellectual disability, autism, lack of speech, slight hypotonia and unsteadiness of movement. They also had slight dysmorphic features including a depressed nose bridge, large ears and midface hypoplasia. Interestingly, they did not exhibit other clinical features commonly observed in American-European patients with MECP2 duplication, including recurrent respiratory infections and epilepsy. Conclusions To our knowledge, this is the first identification and characterization of Chinese Han patients with MECP2-containing duplications. Further cases are required to determine if the above described clinical differences are due to individual variations or related to the genetic background of the patients.

  8. Comparison between high-resolution climate simulations using single- and double-nesting approaches within the Big-Brother experimental protocol

    Science.gov (United States)

    Matte, Dominic; Laprise, René; Thériault, Julie Mireille

    2016-12-01

    Regional climate models (RCM) are widely used to downscale global climate models' (GCMs) simulations. As the resolution of RCM increases faster than that of GCM used for climate-change projections till the end of this century, the resolution jump will become an issue. Cascade with multiple nesting offers an approach to reach high resolution while keeping reasonable computational cost. Few studies have addressed whether the best results are obtained with the single- or multiple-nesting approaches. In this study the results obtained with single and double nesting are compared within the idealised "perfect model" framework of the Big-Brother Experiment. This method consists in first realizing a simulation, nicknamed the Big-Brother (BB) simulation, on a relatively large domain at the desired resolution, to serve as reference dataset. The BB results are then processed by a low-pass filter to emulate a coarse-resolution dataset to be used as LBC to drive further simulations, nicknamed the Little-Brother (LB) simulations, using an identical model formulation and resolution as the BB simulation. For the single nesting, the LB simulations are directly simulated, while for the double nesting a surrogate intermediate-resolution simulation is used. The study of the time-mean (stationary) component shows that little difference is noted between the single- and double-nesting approaches. The time-deviation (transient-eddy) component, however, shows important differences. The double-nesting approach weakly degrades the large scales but allows a significant reduction of the required domain size to allow adequate spin-up of fine-scale features. This results in an important saving in the computational cost.

  9. Adult onset supranuclear ophthalmoplegia, cerebellar ataxia, and neurogenic proximal muscle weakness in a brother and sister: another hexosaminidase A deficiency syndrome.

    Science.gov (United States)

    Harding, A E; Young, E P; Schon, F

    1987-01-01

    An Ashkenazi Jewish brother and sister developed progressive ataxia and proximal neurogenic muscle weakness, associated with supranuclear ophthalmoplegia, in the fourth decade of life. Hexosaminidase A activity, assayed using both synthetic and natural substrates, was severely reduced in the patients' plasma, leukocytes, and skin fibroblasts. Enzyme activity in their parents was in a similar range to that seen in heterozygotes for Tay-Sachs disease. The increasing evidence for marked clinical and molecular heterogeneity in the GM2 gangliosidoses warrants their consideration in the diagnosis of multisystem degenerative neurological disorders, even if onset of symptoms is in adult life. Images PMID:2956362

  10. From experience: applying the risk diagnosing methodology

    NARCIS (Netherlands)

    Keizer, Jimme A.; Halman, Johannes I.M.; Song, Michael

    2002-01-01

    No risk, no reward. Companies must take risks to launch new products speedily and successfully. The ability to diagnose and manage risks is increasingly considered of vital importance in high-risk innovation. This article presents the Risk Diagnosing Methodology (RDM), which aims to identify and

  11. The failure diagnoses of nuclear reactor systems

    International Nuclear Information System (INIS)

    Sheng Huanxing.

    1986-01-01

    The earlier period failure diagnoses can raise the safety and efficiency of nuclear reactors. This paper first describes the process abnormality monitoring of core barrel vibration in PWR, inherent noise sources in BWR, sodium boiling in LMFBR and nuclear reactor stability. And then, describes the plant failure diagnoses of primary coolant pumps, loose parts in nuclear reactors, coolant leakage and relief valve location

  12. Immunoparesis in newly diagnosed Multiple Myeloma patients

    DEFF Research Database (Denmark)

    Sørrig, Rasmus; Klausen, Tobias W; Salomo, Morten

    2017-01-01

    Immunoparesis (hypogammaglobulinemia) is associated to an unfavorable prognosis in newly diagnosed Multiple myeloma (MM) patients. However, this finding has not been validated in an unselected population-based cohort. We analyzed 2558 newly diagnosed MM patients in the Danish Multiple Myeloma...

  13. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... website. Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open ... Diagnosed with Cancer You are here Home » Patients Fertility Preservation for Children Diagnosed with Cancer Fertility Preservation ...

  14. Immunoparesis in newly diagnosed Multiple Myeloma patients

    DEFF Research Database (Denmark)

    Sørrig, Rasmus; Klausen, Tobias W.; Salomo, Morten

    2017-01-01

    Immunoparesis (hypogammaglobulinemia) is associated to an unfavorable prognosis in newly diagnosed Multiple myeloma (MM) patients. However, this finding has not been validated in an unselected population-based cohort. We analyzed 2558 newly diagnosed MM patients in the Danish Multiple Myeloma Reg...

  15. Prevalence and associated factors of incidentally diagnosed ...

    African Journals Online (AJOL)

    Background: Prostatic carcinoma carries a high morbidity and mortality if it is not diagnosed early. In resource limited countries, patients are at increased risk of being diagnosed late as they are operated for presumed benign prostatic hyperplasia. The information on the magnitude and risk factors of this problem in

  16. 'Brothers in arms'

    DEFF Research Database (Denmark)

    Adamsen, L; Rasmussen, J M; Pedersen, L S

    2001-01-01

    The study investigated how a group intervention programme (13 sessions over 16 weeks), designed for men with cancer (n = 17), affected their sense of well-being and had a positive impact on their ability to cope with the physical, psychological and social consequences of living with cancer. The c...

  17. My Brother the Mexican

    Directory of Open Access Journals (Sweden)

    K. Angelique Dwyer

    2017-10-01

    Full Text Available El “Piti” le decían, I never knew why. We lived just outside “El Barrio,” at least that’s what they called it, ‘cause it took too long to say “Tlachichilco del Carmen.” Nobody called it that, but my mom. She would make us go to El Barrio a vender “panquecitos.” Two little gringüitos selling cupcakes en la plaza. ...

  18. Big Brother Not Needed.

    Science.gov (United States)

    Heinen, Edward

    1983-01-01

    Cites the recent United States State Department's labeling of recent Canadian films--one on nuclear war and two on acid rain--as political propaganda as a sign of the need to review the nature of propaganda. Suggests that teaching students to intelligently evaluate propaganda is preferable to submitting to government dictum. (MM)

  19. Band of Brothers

    DEFF Research Database (Denmark)

    Pærregaard, Karsten

    2011-01-01

    Kapitlet diskuterer den rolle, som katolske broderskaber spiller i peruanske migranters religiøse praksis i USA, Spanien og andre lande. Den introducerer kort de katolske broderskabers historie i Spanien og det kolonial Latin Amerika og undersøger derpå det spirituelle slægtskab, som forbinder pe...

  20. Mercury is Moon's brother

    International Nuclear Information System (INIS)

    Ksanfomalifi, L.V.

    1976-01-01

    The latest information on Mercury planet is presented obtained by studying the planet with the aid of radar and space vehicles. Rotation of Mercury about its axis has been discovered; within 2/3 of its year it executes a complete revolution about its axis. In images obtained by the ''Mariner-10'' Mercurys surface differs little from that of the Moon. The ''Mariner-10'' has also discovered the Mercurys atmosphere, which consists of extremely rarefied helium. The helium is continuously supplied to the planet by the solar wind. The Mercury's magnetic field has been discovered, whose strength is 35 x 10 -4 at the Equator and 70 x 10 -4 E at the poles. The inclination of the dipole axis to the Mercury's rotation axis is 7 deg

  1. Identifying Malnutrition: Nutritional Status in Newly Diagnosed Patients With Cancer.

    Science.gov (United States)

    Krishnasamy, Karthikayini; Li Yoong, Tang; Mei Chan, Chong; Peng Choong, Lau; Chinna, Karuthan

    2017-02-01

    Malnutrition is common among patients with cancer, but little attention is given to its risks and consequences. The aim of this study is to assess the nutritional status and identify the factors associated with malnutrition among newly diagnosed patients with cancer. Patients admitted with newly diagnosed cancer at a teaching hospital in Malaysia were recruited from January to April 2015. Nutritional status was assessed before treatment initiation, and patients were classified into three categories. A total of 132 pretreatment patients were recruited into the study. About half were severely malnourished. Patients with stage III cancer had the highest prevalence of severe malnourishment. Clinical parameters and disease characteristics were significantly associated with nutritional status. Demographic variables were also statistically significantly associated with severe nutritional status.

  2. Validation studies of nursing diagnoses in neonatology

    Directory of Open Access Journals (Sweden)

    Pavlína Rabasová

    2016-03-01

    Full Text Available Aim: The objective of the review was the analysis of Czech and foreign literature sources and professional periodicals to obtain a relevant comprehensive overview of validation studies of nursing diagnoses in neonatology. Design: Review. Methods: The selection criterion was studies concerning the validation of nursing diagnoses in neonatology. To obtain data from relevant sources, the licensed professional databases EBSCO, Web of Science and Scopus were utilized. The search criteria were: date of publication - unlimited; academic periodicals - full text; peer-reviewed periodicals; search language - English, Czech and Slovak. Results: A total of 788 studies were found. Only 5 studies were eligible for content analysis, dealing specifically with validation of nursing diagnoses in neonatology. The analysis of the retrieved studies suggests that authors are most often concerned with identifying the defining characteristics of nursing diagnoses applicable to both the mother (parents and the newborn. The diagnoses were validated in the domains Role Relationship; Coping/Stress tolerance; Activity/Rest, and Elimination and Exchange. Diagnoses represented were from the field of dysfunctional physical needs as well as the field of psychosocial and spiritual needs. The diagnoses were as follows: Parental role conflict (00064; Impaired parenting (00056; Grieving (00136; Ineffective breathing pattern (00032; Impaired gas exchange (00030; and Impaired spontaneous ventilation (00033. Conclusion: Validation studies enable effective planning of interventions with measurable results and support clinical nursing practice.

  3. Sources of prescription opioids among diagnosed opioid abusers.

    Science.gov (United States)

    Shei, Amie; Rice, J Bradford; Kirson, Noam Y; Bodnar, Katharine; Birnbaum, Howard G; Holly, Pamela; Ben-Joseph, Rami

    2015-04-01

    Diversion and abuse of prescription opioids are important public health concerns in the US. This study examined possible sources of prescription opioids among patients diagnosed with opioid abuse. Commercially insured patients aged 12-64 diagnosed with opioid abuse/dependence ('abuse') were identified in OptumHealth Reporting and Insights medical and pharmacy claims data, 2006-2012, and required to have continuous eligibility over an 18 month study period surrounding the first abuse diagnosis. We examined whether abusers had access to prescription opioids through their own prescriptions and/or to diverted prescription opioids through family members' prescriptions obtained prior to the abuser's first abuse diagnosis. For comparison, we examined access to prescription opioids of a reference population of non-abusers. Sensitivity analyses focused on patients initially diagnosed with opioid dependence and, separately, abusers not previously treated with buprenorphine. Of the 9291 abusers meeting the selection criteria, 79.9% had an opioid prescription prior to their first abuse diagnosis; 20.1% of abusers did not have an opioid prescription prior to their first abuse diagnosis, of whom approximately half (50.8%) had a family member who had an opioid prescription prior to the abuser's first abuse diagnosis (compared to 42.2% of non-abusers). Similar results were found among patients initially diagnosed with opioid dependence and among abusers not previously treated with buprenorphine. The study relied on the accuracy of claims data to identify abusers, but opioid abuse is often undiagnosed. In addition, only prescription claims that were reimbursed by a health plan were included in the analysis. While most abusers had access to prescription opioids through their own prescriptions, many abusers without their own opioid prescriptions had access to prescription opioids through family members and may have obtained prescription opioids that way. Given the study design and

  4. Eating Disorders in Connection with other Diagnoses

    OpenAIRE

    Vavrušková, Marie

    2016-01-01

    Poruchy příjmu potravy ve spojitosti s jinými diagnózami. Eating Disorders in Connection with other Diagnoses Bc. Marie Vavrušková The aim of this thesis, which focuses on the topic "Eating Disorders in Connection with Other Diagnoses," is to introduce the different types of eating disorders that have been previously diagnosed (anorexia nervosa, bulimia nervosa, psychogenic overeating and new forms of eating disorders), to specify the medical treatment offered to patients in the Czech Republi...

  5. Initial Study

    DEFF Research Database (Denmark)

    Torp, Kristian

    2009-01-01

    Congestion is a major problem in most cities and the problem is growing (Quiroga, 2000) (Faghri & Hamad, 2002). When the congestion level is increased the drivers notice this as delays in the traffic (Taylor, Woolley, & Zito, 2000), i.e., the travel time for the individual driver is simply...... increased. In the initial study presented here, the time it takes to pass an intersection is studied in details. Two major signal-controlled four-way intersections in the center of the city Aalborg are studied in details to estimate the congestion levels in these intersections, based on the time it takes...

  6. Instrumented Pipeline Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Thomas Piro; Michael Ream

    2010-07-31

    This report summarizes technical progress achieved during the cooperative agreement between Concurrent Technologies Corporation (CTC) and U.S. Department of Energy to address the need for a for low-cost monitoring and inspection sensor system as identified in the Department of Energy (DOE) National Gas Infrastructure Research & Development (R&D) Delivery Reliability Program Roadmap.. The Instrumented Pipeline Initiative (IPI) achieved the objective by researching technologies for the monitoring of pipeline delivery integrity, through a ubiquitous network of sensors and controllers to detect and diagnose incipient defects, leaks, and failures. This report is organized by tasks as detailed in the Statement of Project Objectives (SOPO). The sections all state the objective and approach before detailing results of work.

  7. How Do Health Care Providers Diagnose Vaginitis?

    Science.gov (United States)

    ... used to diagnose vaginitis. 1 Centers for Disease Control and Prevention. (2010). Self-study STD ... Halvorson New Chief of Gynecologic Health and Disease Branch Division of Epidemiology, Statistics, ...

  8. How Do Health Care Providers Diagnose Endometriosis?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose endometriosis? Surgery is currently the only ... larger incision—is used to make a diagnosis. Health care providers may also use imaging methods to produce ...

  9. Nursing diagnoses in women deprived of freedom

    Directory of Open Access Journals (Sweden)

    Izabelle de Freitas Ferreira

    2016-05-01

    Full Text Available Objective: to analyze the nursing diagnoses profile of women deprived of freedom, using the International Classification for Nursing® Practice version 1.0. Methods: a descriptive study, conducted with 186 women deprived of freedom. Nursing Diagnoses were extrapolated based on the clinical data of the participants, collected through a structured form and clinical reasoning. Results: there were 44 nursing diagnostic statements, among the most common, there were: infection risk (70.9%; fluid intake, decreased (61.2%; Sleep, impaired (60.7%; tobacco abuse, started (51.6%; health seeking behavior, committed (50.0%. Conclusion: the diagnoses are related to factors that compromise the biopsychosocial health. The nurse, health staff member in the prison setting, must recognize and assess the individual and collective needs of women deprived of freedom. The inference of nursing diagnoses, based on clinical reasoning, contributes to a humanized, empathic and special care.

  10. How Are Obesity and Overweight Diagnosed?

    Science.gov (United States)

    ... Facebook Twitter Pinterest Email Print How are obesity & overweight diagnosed? Using Body Mass Index The most common way to determine if a person is overweight or obese is to calculate body mass index ( ...

  11. ADHD: the impact when not diagnosed

    OpenAIRE

    Souza,Isabella de; Mattos,Paulo; Pina,Camila; Fortes,Didia

    2008-01-01

    ADHD is a highly prevalent disorder in childhood with social, academic and familial difficulties when not diagnosed and treated correctly. The aim of this case report is to demonstrate the impairment of ADHD among generations of the same family.

  12. How Is Spinal Cord Injury (SCI) Diagnosed?

    Science.gov (United States)

    ... Research Information Find a Study Resources and Publications Spinal Cord Injury (SCI) Condition Information NICHD Research Information Find a ... Care Providers Home Health A to Z List Spinal Cord Injury (SCI) Condition Information How is it diagnosed? Share ...

  13. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult survivors of childhood cancer ... study approved by an IRB . Resources For more information about infertility risk and fertility preservation options for ...

  14. How Are Pelvic Floor Disorders Diagnosed?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How are pelvic floor disorders diagnosed? A physical exam may be all ... fee ). This test is used to evaluate the pelvic floor and rectum while the patient is having a ...

  15. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... study approved by an IRB . Resources For more information about infertility risk and fertility preservation options for children diagnosed with cancer: Visit SaveMyFertility. ...

  16. Diagnosing Diabetes and Learning about Prediabetes

    Science.gov (United States)

    ... for the past 2 to 3 months. The advantages of being diagnosed this way are that you ... Email: Sign Up Thank you for signing up ' + ' '); $('.survey-form').show(); }, success: function (data) { $('#survey-errors').remove(); $('. ...

  17. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... be fertility preservation options available and having your child see a reproductive specialist in a timely manner ... there are options for preserving fertility in your child diagnosed with cancer. You may be focused on ...

  18. Challenges in diagnosing tuberculosis in children

    DEFF Research Database (Denmark)

    Rahman, Nadia; Pedersen, Karin Kæreby; Rosenfeldt, Vibeke

    2012-01-01

    Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country.......Clinical investigations of childhood tuberculosis (TB) are challenged by the paucibacillary nature of the disease and the difficulties in obtaining specimens. We investigated the challenges in diagnosing TB in children in a low-incidence country....

  19. Diagnosing, managing, and preventing cracked tooth syndrome.

    Science.gov (United States)

    Wright, Edward F; Bartoloni, Joseph A

    2012-01-01

    Cracked tooth syndrome (CTS) can be a perplexing disorder to diagnose and manage. Many practitioners wonder whether the latest dental materials and adhesives can or should be used when restoring these teeth. The authors reviewed the literature and developed recommendations for how to diagnose and manage CTS and prevent it in susceptible teeth. As the population continues to age and people retain their teeth longer, it is anticipated that patients will present even more frequently with symptoms of CTS.

  20. Openness initiative

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, S.S. [Los Alamos National Lab., NM (United States)

    1995-12-31

    Although antinuclear campaigns seem to be effective, public communication and education efforts on low-level radioactive waste have mixed results. Attempts at public information programs on low-level radioactive waste still focus on influencing public opinion. A question then is: {open_quotes}Is it preferable to have a program focus on public education that will empower individuals to make informed decisions rather than trying to influence them in their decisions?{close_quotes} To address this question, a case study with both quantitative and qualitative data will be used. The Ohio Low-Level Radioactive Waste Education Program has a goal to provide people with information they want/need to make their own decisions. The program initiated its efforts by conducting a statewide survey to determine information needed by people and where they turned for that information. This presentation reports data from the survey and then explores the program development process in which programs were designed and presented using the information. Pre and post data from the programs reveal attitude and knowledge shifts.

  1. Radiological diagnoses of chelonians from 1929 to 1995

    International Nuclear Information System (INIS)

    Kuellinger, K.

    2003-07-01

    In the present study 200 x-rays of 116 chelonians taken during the period between 1929 and 1995 were re-diagnosed. The current diagnoses were compared with those made at the time of the x-rays. The anatomy and physiology of the chelonians are described in the bibliography and an overview is given of radiographic examination of chelonians, including radiographic anatomy and interpretation. The aetiology of some of the diseases frequently occurring in chelonians is described. This is followed by a list of the animals examined according to species, sex and age. An explanation is given of the new standardized method of evaluation. The results are described according to organ systems and, in addition, attention is given to radiographic technique, positioning and anti-radiation precautions. Some interesting cases were selected for special attention and illustrated using photographs of the x-rays. Furthermore, the degree of correspondence between the results obtained in this study with those found in reference literature is discussed. A comparison is made between the initial and current diagnoses. (author)

  2. Sociodemographic Study of Danish Individuals Diagnosed with Transsexualism

    DEFF Research Database (Denmark)

    Simonsen, Rikke; Hald, Gert Martin; Giraldi, Annamaria

    2015-01-01

    -initiated hormonal sex reassignment (SR) (treatment with cross-sex hormones). The MtF and FtM groups did not differ in years of school, educational level, employment, or engagement in marriage and cohabitation. CONCLUSIONS: As approximately half of MtF started cross-sex hormonal SR without attending a gender unit......INTRODUCTION: Male-to-female (MtF) and female-to-male (FtM) individuals with transsexualism (International Classification of Diseases-10) may differ in core clinical and sociodemographic variables such as age, sexual orientation, marriage and parenthood, school, educational level, and employment......, for clinical treatment initiatives for individuals diagnosed with transsexualism. METHODS: Follow-up of 108 individuals who had permission to undergo sex reassignment surgery (SRS, meaning castration and genital plastic surgery) over a 30-year period from 1978 to 2008 through the Gender Identity Unit...

  3. Improving Multiple Fault Diagnosability using Possible Conflicts

    Science.gov (United States)

    Daigle, Matthew J.; Bregon, Anibal; Biswas, Gautam; Koutsoukos, Xenofon; Pulido, Belarmino

    2012-01-01

    Multiple fault diagnosis is a difficult problem for dynamic systems. Due to fault masking, compensation, and relative time of fault occurrence, multiple faults can manifest in many different ways as observable fault signature sequences. This decreases diagnosability of multiple faults, and therefore leads to a loss in effectiveness of the fault isolation step. We develop a qualitative, event-based, multiple fault isolation framework, and derive several notions of multiple fault diagnosability. We show that using Possible Conflicts, a model decomposition technique that decouples faults from residuals, we can significantly improve the diagnosability of multiple faults compared to an approach using a single global model. We demonstrate these concepts and provide results using a multi-tank system as a case study.

  4. Reliability of clinical ICD-10 schizophrenia diagnoses

    DEFF Research Database (Denmark)

    Jakobsen, Klaus D; Frederiksen, Julie N; Hansen, Thomas

    2005-01-01

    Concern has been expressed as to the reliability of clinical ICD-10 diagnosis of schizophrenia. This study was designed to assess the diagnostic reliability of the clinical ICD-10 diagnosis of schizophrenia in a random sample of Danish in- and outpatients with a history of psychosis. A sample...... value (87%) of ICD-10 schizophrenia and an overall good agreement between clinical and OPCRIT-derived diagnoses (kappa=0.60). An even higher positive predictive value was obtained when diagnoses were amalgamated into a diagnostic entity of schizophrenia-spectrum disorders (98%). Near perfect agreement...... was seen between OPCRIT-derived ICD-10 and DSM-IV diagnoses (kappa=0.87). Thus, this study demonstrates high reliability of the clinical diagnosis of schizophrenia and even more so of the diagnosis of schizophrenia-spectrum disorder....

  5. [Community pneumonia - fundamentals of diagnosing and treatment].

    Science.gov (United States)

    Kolek, Vítězslav

    Pneumonia is the most serious respiratory disease which causes more than 3 000 deaths per year in the Czech Republic. Community-acquired pneumonia is contracted in the ordinary life environment outside of hospitals, its development is caused by known infectious agents which mostly exhibit satisfactory sensitivity to antibiotics. Diagnosing, prevention and treatment of the disease are described including considerations of individual evaluation of the risk of complications and possible death. The strategy of administering antibiotics is discussed.Key words: antibiotics - community-acquired pneumonias - diagnosing - treatment.

  6. Why Is Diagnosing Pediatric Malnutrition Important?

    Science.gov (United States)

    Corkins, Mark R

    2017-02-01

    The literature indicates that pediatric malnutrition is more common than the number of times it is actually diagnosed. A new pediatric malnutrition definition is now available with criteria to make the diagnosis. If pediatric malnutrition is present, it should be diagnosed for financial, educational, and research purposes as well as the effects on patient development and mortality. These reasons extend beyond the health of an individual patient to potential impacts on society as a whole. When all of these reasons are examined and added, making the diagnosis of pediatric malnutrition becomes an obligation of the pediatric caregiver.

  7. How Do Health Care Providers Diagnose Adrenal Gland Disorders?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose adrenal gland disorders? Methods for diagnosing ... Tumors To diagnose an adrenal gland tumor, a health care provider may order one or more tests. 3 ...

  8. High prevalence of tuberculosis diagnosed during autopsy ...

    African Journals Online (AJOL)

    The primary aims of tuberculosis (TB) control programmes is early diagnosis and prompt treatment of infectious cases to limit transmission. Failure to diagnose and adequately treat TB could lead to premature death and unrecognized transmission of Mycobacterium tuberculosis. The proportion of missed TB cases has not ...

  9. Chest Radiographic Findings in Newly Diagnosed Pulmonary ...

    African Journals Online (AJOL)

    Five hundred newly diagnosed cases of Pulmonary Tuberculosis were treated with directly observed short-course treatment and 100 of them had chest radiographic examination done. The various chest radiographic patterns in the 100 subjects were studied and included: Fluffy exudative changes 80(80%), fibrosis 70(70%) ...

  10. Demographic profile of patients diagnosed with intracranial ...

    African Journals Online (AJOL)

    Background: Meningiomas are common brain tumours and display gender, racial and ethnic differences in their demographic profile. The demographic profile of our patients diagnosed with intracranial meningiomas is presented and compared with the literature. Objectives: To determine the age, gender, racial and ethnic ...

  11. Pijnlijke temporomandibulaire disfuncties: diagnose en behandeling

    NARCIS (Netherlands)

    Lobbezoo, F.; Aarab, G.; Knibbe, W.; Koutris, M.; Warnsinck, C.J.; Wetselaar, P.; Visscher, C.M.

    2016-01-01

    Painful temporomandibular disorders (TMD pain) are common among the general population. The most common sub diagnoses are myalgia (jaw-muscle pain) and arthralgia (temporomandibular joint pain). The aetiology of TMD pain has a multifactorial nature, and its diagnosis and possible treatment often

  12. Diagnosing the Diagnostics: Misconceptions of Twelfth Grade ...

    African Journals Online (AJOL)

    Diagnosing the Diagnostics: Misconceptions of Twelfth Grade Students on Selected Chemistry Concepts in Two Preparatory Schools in Eastern Ethiopia. ... African Journal of Chemical Education ... To attain these goals, respective data were gathered through open-ended test and three-tier chemistry misconception test.

  13. Histologically diagnosed cancers in South Africa, 1988

    African Journals Online (AJOL)

    causing familial hypercholesterolemia in a South African of Indian origin. Biochim Biophys Acta 1993; 1182: 75-82. Mricans: familial hypercholesterolemia in Indians and familial defective apolipoprotein B-IOO. PhD thesis, Universiry of Cape. Town, 1992. Histologically diagnosed cancers in South Africa, 1988. F. SITAS.

  14. Eating Disorder Diagnoses: Empirical Approaches to Classification

    Science.gov (United States)

    Wonderlich, Stephen A.; Joiner, Thomas E., Jr.; Keel, Pamela K.; Williamson, Donald A.; Crosby, Ross D.

    2007-01-01

    Decisions about the classification of eating disorders have significant scientific and clinical implications. The eating disorder diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) reflect the collective wisdom of experts in the field but are frequently not supported in…

  15. Diagnosing Chronic Rhinosinusitis: a Literature update | Lobo ...

    African Journals Online (AJOL)

    Diagnosing chronic rhinosinusitis has undergone significant changes since the advent of sensitive but costly diagnostic aids like endoscopy, computed tomography scanning and magnetic resonance imaging. Other new conditions like migraine without aura, mid-segment facial pain and atypical facial pain can present with ...

  16. Clinical heterogeneity in newly diagnosed Parkinson's disease

    NARCIS (Netherlands)

    Post, Bart; Speelman, Johannes D.; de Haan, Rob J.

    2008-01-01

    OBJECTIVE: To determine clinical heterogeneity in newly diagnosed Parkinson's disease using cluster analysis and to describe the subgroups in terms of impairment, disability, perceived quality of life, and use of dopaminergic therapy. METHODS: We conducted a k-means cluster analysis in a prospective

  17. Disseminated cutaneous histoplasmosis in newly diagnosed HIV

    OpenAIRE

    Soza, Gabriela M.; Patel, Mahir; Readinger, Allison; Ryan, Caitriona

    2016-01-01

    We present a woman with a widespread severe papulopustular eruption, fever, and fatigue of 5 weeks' duration. HIV infection was diagnosed, with an absolute CD4+ count of 3 cells/µL. The eruption was consistent with disseminated cutaneous histoplasmosis. The clinical manifestations and management of cutaneous histoplasmosis are reviewed.

  18. Diagnosing Rheumatoid Arthritis | Gotlieb | South African Family ...

    African Journals Online (AJOL)

    South African Family Practice. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 45, No 4 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Diagnosing Rheumatoid Arthritis. D Gotlieb. Abstract. No Abstract. Full Text:.

  19. Diagnosing Rheumatoid Arthritis | Gotlieb | South African Family ...

    African Journals Online (AJOL)

    South African Family Practice. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 45, No 4 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Diagnosing Rheumatoid Arthritis. D Gotlieb. Abstract.

  20. A pancreatic neuroendocrine tumor diagnosed during the ...

    African Journals Online (AJOL)

    Pancreatic neuroendocrine tumors (PNET) are increasingly being discovered. A case of PNET diagnosed and treated during the management of acute appendicitis is presented and discussed. The importance of imaging modalities in patients with acute abdominal pain is emphasized. To the best our knowledge, this is the ...

  1. Diagnosing Febrile Illness in a Returned Traveler

    Centers for Disease Control (CDC) Podcasts

    2012-03-01

    This podcast will assist health care providers in diagnosing febrile illness in patients returning from a tropical or developing country.  Created: 3/1/2012 by National Center for Enteric, Zoonotic, and Infectious Diseases (NCEZID).   Date Released: 3/1/2012.

  2. Medicinalindustrien har brug for diagnoser som ADHD

    DEFF Research Database (Denmark)

    Fugl, Marie

    2008-01-01

    Det er ikke første gang, at medicinalindustriens evne til at finde nye markeder har medført nye eller bredere diagnoser. I det forrige årti så vi et parallelt forløb mellem et boom i antallet af depressionsdiagnoser og forbruget af lykkepiller. Interview med sociolog Thomas Brante. Udgivelsesdato...

  3. Bordetella pertussis diagnosed by polymerase chain reaction

    DEFF Research Database (Denmark)

    Birkebaek, N H; Heron, I; Skjødt, K

    1994-01-01

    The object of this work was to test the polymerase chain reaction (PCR) for demonstration of Bordetella pertussis (BP) in nasopharyngeal secretions. The method was applied to patients with recently diagnosed pertussis, as verified by BP culture. In order to test the sensitivity and specificity...

  4. Experiences of being diagnosed with osteoporosis

    DEFF Research Database (Denmark)

    Rothmann, Mette Juel; Jakobsen, P R; Myhre Jensen, Charlotte

    2018-01-01

    This systematic review provides synthesised knowledge and guidance to health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. Using individuals' experiences and meanings can promote tailored and targeted information and guida......This systematic review provides synthesised knowledge and guidance to health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. Using individuals' experiences and meanings can promote tailored and targeted information...... and guidance on osteoporosis, bone care and treatment at different stages of the osteoporosis trajectory. INTRODUCTION: To be diagnosed with osteoporosis with or without fragility fractures affects individuals differently. The aim of this review was firstly to aggregate existing qualitative evidence regarding...... an individual's experience of being diagnosed with osteoporosis at different stages, and secondly, to use a systematic approach to develop a conceptual understanding of central issues relevant for health professionals in order to provide support and guidance to patients/individuals. METHODS: This study used...

  5. Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.

    Science.gov (United States)

    Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen

    2018-02-06

    Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.

  6. Sibling Death after Being Thrown from Window by Brother with Autism: Defenestration, an Emerging High-Risk Behavior

    Directory of Open Access Journals (Sweden)

    Osman Sabuncuoglu

    2015-01-01

    Full Text Available Children diagnosed with autistic spectrum disorders (ASD may have serious behavioral problems such as aggression, self-injury, and violence. However, the literature on ASD either overrules any correlation between aggression and ASD or maintains the fact that the efforts to link them have so far been inconclusive. Although severe forms of violence are extremely rare in children with autism, there are a few cases reported in the literature with significant harm to siblings. We hereby report an 8-year-old boy with ASD who caused the death of his sibling by throwing her out of the window. Shared similarities of all defenestration cases indicate a pattern of high-risk behavior threatening the survival of minors. We recommend precautions against this high-risk behavior in children with ASD.

  7. Spiral CT in diagnosing of heavier forms of lung tuberculosis in childhood

    International Nuclear Information System (INIS)

    Miladinovska, S.; Grunevski, M.; Temelkovska, S; Dilberovska, M.; Jovanovski, D.

    2003-01-01

    Purpose: We show several cases od severe forms of tuberculosis of the lung, diagnosed with spiral CT. Material and methods: We elaborated selected material of heavier forms of lung tuberculosis for a period of 5 years (1998 - 2002( in children at the age 0 - 16 years that we treated at our hospital at the department for lung TBC. Among other examinations such as laboratory, microbiological, Mantu test, also conventional X ray in PA and lateral projection was done in all patients. In the more severe form of lung TBC also spiral CT was performed for achieving the precise diagnose. Results: From totally 761 diagnosed patients with primary and post-primary TBC in 14 patients it was necessary to perform spiral CT. The results were as follows: We proved specific endo bronchitis in 5 cases; cavernous hollowness in 9 cases; pleural exudation in 6 cases. In 1 patient besides TBC we diagnosed a congenital anomaly of the lung. In 1 patient besides TBC of the lung we diagnosed TBC on the vertebral body with kyphosis. Discussion: Tuberculosis is of great economical and social importance. The conventional x ray test is often sufficient when diagnosing TBC. In exceptional cases in the initial forms, for confirming of the diagnose, it is necessary to perform also CT

  8. Patients with newly diagnosed Rheumatoid Arthritis are at increased risk of Diabetes Mellitus

    DEFF Research Database (Denmark)

    Emamifar, Amir; Levin, Klaus; Jensen Hansen, Inger Marie

    2018-01-01

    AIMS: To reveal the prevalence of Diabetes Mellitus (DM) in patients with newly diagnosed Rheumatoid Arthritis (RA) and evaluate the association between clinical characteristics of RA and DM as well as treatment response in newly diagnosed RA patients with DM. METHODS: Newly diagnosed, adult, RA......-C-reactive protein (DAS28-CRP) at the time of diagnosis and after 4 months (±1-2 months) of treatment initiation were extracted from Danbio Registry. To reveal the presence of DM, patients' electronic medical records were reviewed. The prevalence of DM in our patients was compared (using an age- and gender......, RF, anti-CCP as well as ANA. Additionally, presence of DM in the RA patients was not a negative predictor of treatment response measured by the European League Against Rheumatism (EULAR) response criteria and ∆DAS28-CRP. CONCLUSION: Newly diagnosed RA patients are at higher risk of DM (13% versus 5...

  9. Hospital-diagnosed dementia and suicide

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Zarit, Steven H; Conwell, Yeates

    2008-01-01

    OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individuals....... During this period, 136 persons who previously had been diagnosed with dementia died by suicide. Men and women aged 50-69 years with hospital presentations of dementia have a relative suicide risk of 8.5 (95% confidence interval: 6.3-11.3) and 10.8 (95% confidence interval: 7.4-15.7), respectively. Those...... who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men...

  10. Sociodemographic Study of Danish Individuals Diagnosed with Transsexualism

    Science.gov (United States)

    Simonsen, Rikke; Hald, Gert Martin; Giraldi, Annamaria; Kristensen, Ellids

    2015-01-01

    Introduction Male-to-female (MtF) and female-to-male (FtM) individuals with transsexualism (International Classification of Diseases-10) may differ in core clinical and sociodemographic variables such as age, sexual orientation, marriage and parenthood, school, educational level, and employment. Assessing and understanding the implication of such differences may be a key to developing appropriate and effective treatment and intervention strategies for this group. However, research in the area remains sparse and is often on small populations, making the generalization of results from current studies on individuals diagnosed with transsexualism difficult. Aims (i) To describe and assess key sociodemographic and treatment-related differences between MtF and FtM individuals in a Danish population of individuals diagnosed with transsexualism; (ii) to assess possible implications of such difference, if any, for clinical treatment initiatives for individuals diagnosed with transsexualism. Methods Follow-up of 108 individuals who had permission to undergo sex reassignment surgery (SRS, meaning castration and genital plastic surgery) over a 30-year period from 1978 to 2008 through the Gender Identity Unit in Copenhagen, Denmark. The individuals were identified through Social Security numbers. Clinical and sociodemographic data from medical records were collected. Results The sex ratio was 1.16:1 (MtF : FtM). Mean age at first referral was 26.9 (standard deviation [SD] 8.8) years for FtM and 30.2 (SD 9.7) for MtF individuals. Compared with MtF, FtM had a significantly lower onset age (before 12 years of age) and lower age when permission for SRS was granted. Further, FtM individuals were significantly more often gynephilic (sexually attracted to females) during research period and less likely to start self-initiated hormonal sex reassignment (SR) (treatment with cross-sex hormones). The MtF and FtM groups did not differ in years of school, educational level, employment

  11. Nanostructure-initiator mass spectrometry biometrics

    Science.gov (United States)

    Leclerc, Marion; Bowen, Benjamin; Northen, Trent

    2015-09-08

    Several embodiments described herein are drawn to methods of identifying an analyte on a subject's skin, methods of generating a fingerprint, methods of determining a physiological change in a subject, methods of diagnosing health status of a subject, and assay systems for detecting an analyte and generating a fingerprint, by nanostructure-initiator mass spectrometry (NIMS).

  12. Sarcoidosis Incidentally Diagnosed: A Case Report

    Directory of Open Access Journals (Sweden)

    Besir Kesici

    2014-01-01

    Full Text Available Sarcoidosis is a chronic, granulomatous condition with unknown cause. Because most of the patients are free of clinical symptoms, sarcoidosis should be considered in differential diagnosis if noncaseous granuloma is noted in biopsies, performed for other reasons. With no clinical symptoms, our patient was diagnosed with sarcoidosis upon identifying noncaseous granuloma in the lymph node biopsy material collected during the laparoscopic operation, performed for gallbladder polyp.

  13. Missed opportunities to diagnose child physical abuse.

    Science.gov (United States)

    Thorpe, Elizabeth L; Zuckerbraun, Noel S; Wolford, Jennifer E; Berger, Rachel P

    2014-11-01

    This study aimed to determine the incidence of missed opportunities to diagnose abuse in a cohort of children with healing abusive fractures and to identify patterns present during previous medical visits, which could lead to an earlier diagnosis of abuse. This is a retrospective descriptive study of a 7-year consecutive sample of children diagnosed with child abuse at a single children's hospital. Children who had a healing fracture diagnosed on skeletal survey and a diagnosis of child abuse were included. We further collected data for the medical visit that lead to the diagnosis of child abuse and any previous medical visits that the subjects had during the 6 months preceding the diagnosis of abuse. All previous visits were classified as either a potential missed opportunity to diagnose abuse or as an unrelated previous visit, and the differences were analyzed. Median age at time of abuse diagnosis was 3.9 months. Forty-eight percent (37/77) of the subjects had at least 1 previous visit, and 33% (25/77) of those had at least 1 missed previous visit. Multiple missed previous visits for the same symptoms were recorded in 7 (25%) of these patients. The most common reason for presentation at missed previous visit was a physical examination sign suggestive of trauma (ie, bruising, swelling). Missed previous visits occurred across all care settings. One-third of young children with healing abusive fractures had previous medical visits where the diagnosis of abuse was not recognized. These children most commonly had signs of trauma on physical examination at the previous visits.

  14. CLINICAL RECOMMENDATIONS FOR DIAGNOSING SEPSIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    R. F. Tepaev

    2015-01-01

    Full Text Available Sepsis is one of the leading causes of child lethality. Timely diagnostics is the most important condition for treating sepsis successfully. This study contains analysis of recommendations on diagnosing the syndrome of systemic inflammatory response, sepsis, severe sepsis and septic shock of the Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012,published in 2013. The modern perceptions of systemic inflammation during sepsis and sterile inflammation are highlighted.

  15. Diagnosing dying: an integrative literature review

    Science.gov (United States)

    Kennedy, Catriona; Brooks-Young, Patricia; Brunton Gray, Carol; Larkin, Phil; Connolly, Michael; Wilde-Larsson, Bodil; Larsson, Maria; Smith, Tracy; Chater, Susie

    2014-01-01

    Background To ensure patients and families receive appropriate end-of-life care pathways and guidelines aim to inform clinical decision making. Ensuring appropriate outcomes through the use of these decision aids is dependent on timely use. Diagnosing dying is a complex clinical decision, and most of the available practice checklists relate to cancer. There is a need to review evidence to establish diagnostic indicators that death is imminent on the basis of need rather than a cancer diagnosis. Aim To examine the evidence as to how patients are judged by clinicians as being in the final hours or days of life. Design Integrative literature review. Data sources Five electronic databases (2001–2011): Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, MEDLINE, EMBASE, PsycINFO and CINAHL. The search yielded a total of 576 hits, 331 titles and abstracts were screened, 42 papers were retrieved and reviewed and 23 articles were included. Results Analysis reveals an overarching theme of uncertainty in diagnosing dying and two subthemes: (1) ‘characteristics of dying’ involve dying trajectories that incorporate physical, social, spiritual and psychological decline towards death; (2) ‘treatment orientation’ where decision making related to diagnosing dying may remain focused towards biomedical interventions rather than systematic planning for end-of-life care. Conclusions The findings of this review support the explicit recognition of ‘uncertainty in diagnosing dying’ and the need to work with and within this concept. Clinical decision making needs to allow for recovery where that potential exists, but equally there is the need to avoid futile interventions. PMID:24780536

  16. Can Crohn's disease be diagnosed at laparotomy?

    OpenAIRE

    Butterworth, R J; Williams, G T; Hughes, L E

    1992-01-01

    The typical macroscopic features of Crohn's disease have been well described and are widely regarded as sufficient to diagnose the disease at laparotomy. We report six patients undergoing laparotomy for symptomatic Crohn's disease, shown radiologically, who were found to have macroscopically normal small bowel despite careful examination of the bowel by an experienced surgeon. In four cases resection was deferred, but all subsequently deteriorated and required further surgery. Minor abnormali...

  17. CLINICAL RECOMMENDATIONS FOR DIAGNOSING SEPSIS IN CHILDREN

    OpenAIRE

    R. F. Tepaev

    2015-01-01

    Sepsis is one of the leading causes of child lethality. Timely diagnostics is the most important condition for treating sepsis successfully. This study contains analysis of recommendations on diagnosing the syndrome of systemic inflammatory response, sepsis, severe sepsis and septic shock of the Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012,published in 2013. The modern perceptions of systemic inflammation during sepsis and sterile ...

  18. Neural network to diagnose lining condition

    Science.gov (United States)

    Yemelyanov, V. A.; Yemelyanova, N. Y.; Nedelkin, A. A.; Zarudnaya, M. V.

    2018-03-01

    The paper presents data on the problem of diagnosing the lining condition at the iron and steel works. The authors describe the neural network structure and software that are designed and developed to determine the lining burnout zones. The simulation results of the proposed neural networks are presented. The authors note the low learning and classification errors of the proposed neural networks. To realize the proposed neural network, the specialized software has been developed.

  19. Test Differences in Diagnosing Reading Comprehension Deficits

    Science.gov (United States)

    Keenan, Janice M.; Meenan, Chelsea E.

    2012-01-01

    We examined the implications of test differences for defining and diagnosing comprehension deficits using reading comprehension tests. We had 995 children complete the Gray Oral Reading Test-3, the Qualitative Reading Inventory-3, the Woodcock-Johnson Passage Comprehension-3, and the Peabody Individual Achievement Test, and compared which children were identified by each test as being in the lowest 10%. Although a child who performs so poorly might be expected to do poorly on all tests, we found that the average overlap between tests in diagnosing comprehension difficulties was only 43%. Consistency in diagnosis was greater for younger children, when comprehension deficits are due to weaker decoding skills, than for older children. Inconsistencies between tests were just as evident when identifying the top performers. The different children identified as having a comprehension deficit by each test were compared on four profile variables - word decoding skill, IQ, ADHD symptoms, and working memory skill – to understand the nature of the different deficits assessed by each test. Theoretical and practical implications of these test differences in defining and diagnosing comprehension deficits are discussed. PMID:22442251

  20. Fuzzy expert system for diagnosing diabetic neuropathy.

    Science.gov (United States)

    Rahmani Katigari, Meysam; Ayatollahi, Haleh; Malek, Mojtaba; Kamkar Haghighi, Mehran

    2017-02-15

    To design a fuzzy expert system to help detect and diagnose the severity of diabetic neuropathy. The research was completed in 2014 and consisted of two main phases. In the first phase, the diagnostic parameters were determined based on the literature review and by investigating specialists' perspectives ( n = 8). In the second phase, 244 medical records related to the patients who were visited in an endocrinology and metabolism research centre during the first six months of 2014 and were primarily diagnosed with diabetic neuropathy, were used to test the sensitivity, specificity, and accuracy of the fuzzy expert system. The final diagnostic parameters included the duration of diabetes, the score of a symptom examination based on the Michigan questionnaire, the score of a sign examination based on the Michigan questionnaire, the glycolysis haemoglobin level, fasting blood sugar, blood creatinine, and albuminuria. The output variable was the severity of diabetic neuropathy which was shown as a number between zero and 10, had been divided into four categories: absence of the disease, (the degree of severity) mild, moderate, and severe. The interface of the system was designed by ASP.Net (Active Server Pages Network Enabled Technology) and the system function was tested in terms of sensitivity (true positive rate) (89%), specificity (true negative rate) (98%), and accuracy (a proportion of true results, both positive and negative) (93%). The system designed in this study can help specialists and general practitioners to diagnose the disease more quickly to improve the quality of care for patients.

  1. Diagnosing Homo sapiens in the fossil record.

    Science.gov (United States)

    Stringer, Christopher Brian; Buck, Laura Tabitha

    2014-01-01

    Diagnosing Homo sapiens is a critical question in the study of human evolution. Although what constitutes living members of our own species is straightforward, in the fossil record this is still a matter of much debate. The issue is complicated by questions of species diagnoses and ideas about the mode by which a new species is born, by the arguments surrounding the behavioural and cognitive separateness of the species, by the increasing appreciation of variation in the early African H. sapiens record and by new DNA evidence of hybridization with extinct species. This study synthesizes thinking on the fossils, archaeology and underlying evolutionary models of the last several decades with recent DNA results from both H. sapiens and fossil species. It is concluded that, although it may not be possible or even desirable to cleanly partition out a homogenous morphological description of recent H. sapiens in the fossil record, there are key, distinguishing morphological traits in the cranium, dentition and pelvis that can be usefully employed to diagnose the H. sapiens lineage. Increasing advances in retrieving and understanding relevant genetic data provide a complementary and perhaps potentially even more fruitful means of characterizing the differences between H. sapiens and its close relatives.

  2. Do we still need autopsy in times of modern multislice computed tomography?-Missed diagnoses in the emergency room.

    Science.gov (United States)

    Euler, S A; Kastenberger, T; Attal, R; Rieger, M; Blauth, M; Petri, M

    2017-01-01

    In spite of increasing quality of emergency room (ER) assessment in trauma patients and improved accuracy of modern multislice computed tomography (MSCT), the number of potentially missed diagnoses is still controversial. The aim of this study was to compare the initial findings of ER assessment and MSCT to the findings during autopsy in trauma patients not surviving the first 48 h after admission. We hypothesized that autopsy was more accurate than MSCT in diagnosing potentially fatal diagnoses. Between January 2004 and September 2007, all trauma patients undergoing ER treatment in our institution who deceased within 48 h after admission were analyzed regarding diagnoses from initial ER assessment, including MSCT, and diagnoses from autopsy. Data were prospectively collected and retrospectively analyzed. Autopsy reports were compared to diagnoses of ER assessment and MSCT. Missed diagnoses (MD) and missed potentially fatal diagnoses (MPFD) were analyzed. Seventy-three patients with a mean age of 53.2 years were included into the study. Sixty-three percent were male. Autopsy revealed at least one missed diagnosis in 25% of the patients, with the thoracic area accounting for 67% of these. At least one MPFD was found in 4.1% of the patients, all of them being located in the thorax. Total numbers of MD and MPFD were significantly lower for the newer CT generation (64 MSCT, N = 11), compared to older one (4 MSCT, N = 26). As determined by autopsy, modern multislice computed tomography is an accurate method to diagnose injuries. However, 25% of all diagnoses, and 4.1% of potentially fatal diagnoses are still missed in trauma patients, who deceased within the first 48 h after admission. Therefore, autopsy seems to be necessary to determine potentially missed diagnoses for both academic and medicolegal reasons as well as for quality control.

  3. Initiation devices, initiation systems including initiation devices and related methods

    Energy Technology Data Exchange (ETDEWEB)

    Daniels, Michael A.; Condit, Reston A.; Rasmussen, Nikki; Wallace, Ronald S.

    2018-04-10

    Initiation devices may include at least one substrate, an initiation element positioned on a first side of the at least one substrate, and a spark gap electrically coupled to the initiation element and positioned on a second side of the at least one substrate. Initiation devices may include a plurality of substrates where at least one substrate of the plurality of substrates is electrically connected to at least one adjacent substrate of the plurality of substrates with at least one via extending through the at least one substrate. Initiation systems may include such initiation devices. Methods of igniting energetic materials include passing a current through a spark gap formed on at least one substrate of the initiation device, passing the current through at least one via formed through the at least one substrate, and passing the current through an explosive bridge wire of the initiation device.

  4. Metastatic calcification in a patient with multiple myeloma diagnosed as SDRA

    International Nuclear Information System (INIS)

    Munive, Abraham Ali; Ojeda Leon, Paulina; Caicedo, Monica

    2001-01-01

    We present the case of a 44 year-old man with multiple myeloma who presented with a fever that is managed initially as pneumonia multilobar and later because of the persistence of alveolar infiltrates and severe; hypoxaemia as SDRA. The patient in the end passed away and was diagnosed with a metastatic calcification through open lung biopsy

  5. Chikungunya virus infection: report of the first case diagnosed in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Isabella Gomes Cavalcanti de Albuquerque

    2012-02-01

    Full Text Available Initially diagnosed in Africa and Asia, the Chikungunya virus has been detected in the last three years in the Caribbean, Italy, France, and the United States of America. Herein, we report the first case for Rio de Janeiro, Brazil, in 2010.

  6. CHD7 mutations in patients initially diagnosed with Kallmann syndrome - the clinical overlap with CHARGE syndrome

    NARCIS (Netherlands)

    Jongmans, M. C. J.; van Ravenswaaij-Arts, C. M. A.; Pitteloud, N.; Ogata, T.; Sato, N.; Claahsen-van der Grinten, H. L.; van der Donk, K.; Seminara, S.; Bergman, J. E. H.; Brunner, H. G.; Crowley, W. F.; Hoefsloot, L. H.

    Kallmann syndrome (KS) is the combination of hypogonadotropic hypogonadism and anosmia or hyposmia, two features that are also frequently present in CHARGE syndrome. CHARGE syndrome is caused by mutations in the CHD7 gene. We performed analysis of CHD7 in 36 patients with KS and 20 patients with

  7. Congenital bronchopulmonary foregut malformation initially diagnosed as esophageal atresia type C: challenging diagnosis and treatment

    NARCIS (Netherlands)

    Boersma, Doeke; Koot, Bart G.; van der Griendt, Erik Jonas; van Rijn, Rick R.; van der Steeg, Alida F.

    2012-01-01

    Communicating bronchopulmonary foregut malformations are extremely rare congenital malformations, characterized by a communicating fistula between an isolated part of the respiratory system and the esophagus or the stomach. In this article, we present a case of esophageal atresia type C, later

  8. Eosinophilic funiculitis initially diagnosed as irreducible inguinal hernia: A case report

    Directory of Open Access Journals (Sweden)

    Kohei Yamada

    2017-01-01

    Conclusion: Eosinophilic funiculitis is very rare; only three cases have been reported to date. We should always consider unusual causes of groin masses during a surgical approach to hernia-like lesions.

  9. Initial and follow-up MRI in a case of early diagnosed Reye's syndrome

    International Nuclear Information System (INIS)

    Ozdoba, C.; Pfenninger, J.; Schroth, G.

    1997-01-01

    Early MRI in a case of clinically established Reye's syndrome confirmed CT findings of compressed ventricles and additionally demonstrated signal alterations in the thalamus, mesencephalon and pons. On follow-up MRI the pontine lesion had vanished by 1 week later, while the thalamic lesion persisted for more than 2 months. The patient, however, recovered without neurological sequelae. (orig.). With 3 figs

  10. Sociodemographic Study of Danish Individuals Diagnosed with Transsexualism

    Directory of Open Access Journals (Sweden)

    Rikke Simonsen, MA

    2015-06-01

    Conclusions: As approximately half of MtF started cross-sex hormonal SR without attending a gender unit, future treatment needs to focus on this group of MtF individuals in order to accommodate the medical risks of self-initiated hormonal treatment.Earlier intervention with adolescents appears necessary since three-quarters of FtM individuals before age 12 had problems with their assigned sex. For both MtF and FtM, we found problems in areas of school, education, and employment and recommend further help in these core areas. Simonsen R, Hald GM, Giraldi A, and Kristensen E. Sociodemographic study of danish individuals diagnosed with transsexualism. Sex Med 2015;3:109–117.

  11. A multiparous woman with lately diagnosed multilevel left ventricular obstruction

    International Nuclear Information System (INIS)

    Rahman, M. N.; Gul, I.; Nabi, A.

    2017-01-01

    A 56-year hypertensive, multiparous woman presented to the cardiology unit with Canadian Cardiovascular Society (CCS) class-III angina and worsening dyspnea for the past few weeks. Her clinical examination showed high blood pressure and mid-systolic crescendo-decrescendo murmur radiating to carotids. However, there was no radio-femoral delay or significant blood pressure difference between her arms. Her transthoracic echocardiography (TTE) revealed moderate aortic stenosis (AS) and mid cavity left ventricular outflow (LVO) obstruction. Left heart catheterization (LHC) showed coarctation of aorta with extensive collaterals, mid cavity LVO obstruction, and moderate AS. Thus, she was diagnosed as a case of multi-level LVO obstruction including mid cavity LVO obstruction AS and coarctation of aorta. She underwent stenting of aortic coarctation as the initial step of graded approach to her disease, and is doing well. (author)

  12. Four Cases of Parkinson Disease Diagnosed During the Postpartum Period.

    Science.gov (United States)

    Maltête, David; Grangeon, Lou; Le Goff, Floriane; Ozel, Gulden; Fetter, Damien; Ahtoy, Patrick; Temgoua, Olivier; Rouillé, Audrey; Lefaucheur, Romain

    2017-07-01

    There is little experience with the effect of pregnancy on Parkinson disease because the number of women with Parkinson disease who are of childbearing age is small. We report four cases beginning during the postpartum period and discuss the potential contribution of different factors that may influence the occurrence of Parkinson disease in this time period. Four women aged 29-35 years developed arm tremor, shoulder pain, dizziness, or decreased dexterity of the hand in the first few days or months after childbirth. They were initially diagnosed with postpartum depression or psychogenic parkinsonism. Finally, dopamine transporter imaging confirmed the diagnosis of young-onset Parkinson disease. Early-onset Parkinson disease may present in postpartum women. In women with atypical motor symptoms in addition to depression, this diagnosis should be considered.

  13. The paths of salvation and eternal condemnation: The presence of the allegory in the History of the Elected Pilgrim and his Brother Precito (1682, de Alexandre de Gusmão

    Directory of Open Access Journals (Sweden)

    José Adriano Filho

    2015-04-01

    Full Text Available The repercussions of the echoes of the Council of Trent (1546-1563, the Counter Reform movement, and the repercussions they had on the artistic production in the Catholic world. The pedagogical-didactic intents behind its composition are grounded on the belief that art could be an effective tool for reconverting of the faithful and for indoctrination in the values of the Catholic faith. Considering that, this paper aims at presenting the way allegory became an important tool for the interpretation and construction of religious discourse, as we can see in the History of the Elected Pilgrim and his Brother Precito. The book is an allegorical narrative that presents the history of two pilgrim brothers born in Egypt from where they set out with the intention of making a fortune (one brother goes to Jerusalem, and the  other one goes to Babylon. In this way, the book presents continuity with the medieval pattern that highlights the journey, especially the path for salvation. The readiness of allegory to transmit abstract concepts through concrete visualizations allied to a form of indirect expression made it a powerful, didactic, apologetic, and entertaining tool for that time.

  14. Best waveform score for diagnosing keratoconus

    Directory of Open Access Journals (Sweden)

    Allan Luz

    2013-12-01

    Full Text Available PURPOSE: To test whether corneal hysteresis (CH and corneal resistance factor (CRF can discriminate between keratoconus and normal eyes and to evaluate whether the averages of two consecutive measurements perform differently from the one with the best waveform score (WS for diagnosing keratoconus. METHODS: ORA measurements for one eye per individual were selected randomly from 53 normal patients and from 27 patients with keratoconus. Two groups were considered the average (CH-Avg, CRF-Avg and best waveform score (CH-WS, CRF-WS groups. The Mann-Whitney U-test was used to evaluate whether the variables had similar distributions in the Normal and Keratoconus groups. Receiver operating characteristics (ROC curves were calculated for each parameter to assess the efficacy for diagnosing keratoconus and the same obtained for each variable were compared pairwise using the Hanley-McNeil test. RESULTS: The CH-Avg, CRF-Avg, CH-WS and CRF-WS differed significantly between the normal and keratoconus groups (p<0.001. The areas under the ROC curve (AUROC for CH-Avg, CRF-Avg, CH-WS, and CRF-WS were 0.824, 0.873, 0.891, and 0.931, respectively. CH-WS and CRF-WS had significantly better AUROCs than CH-Avg and CRF-Avg, respectively (p=0.001 and 0.002. CONCLUSION: The analysis of the biomechanical properties of the cornea through the ORA method has proved to be an important aid in the diagnosis of keratoconus, regardless of the method used. The best waveform score (WS measurements were superior to the average of consecutive ORA measurements for diagnosing keratoconus.

  15. Diagnosing stuttering in the school environment.

    Science.gov (United States)

    Susca, Michael

    2002-08-01

    School speech-language pathologists work in settings that present multiple challenges to diagnosing stuttering in students. Perceiving stuttering as a communication impairment allows integration of various issues with criteria from the Individuals with Disabilities Education Act 1997 into an effective diagnostic plan. Assessment from multiple perspectives reveals motor, linguistic, social, affective, and cognitive issues related to communication and educational competencies. Common sense and pragmatic communication concerns related to children who stutter are described. Clinical questions, observations, issues, and tasks are explored as parts of the assessment process. The multidimensional assessment of student-centered issues helps the clinician determine eligibility qualifications, develop individual education plans, and meet full-inclusion educational requirements.

  16. Benign intracranial hypertension diagnosed with bilateral papilloedema

    Directory of Open Access Journals (Sweden)

    K. C. Phillips

    2013-12-01

    Full Text Available This article presents a case of benign intracranial hypertension (BIH diagnosed from the presence of papilloedema. This potentially sight-threatening condition particularly affects younger obese females and can be idiopathic, caused by adverse reaction to certain prescription medications or by systemic disease. Prompt treatment is essentialto avoid optic atrophy and low energy diet and exercise forms part of long-term treatment to avoid relapse. Optometrists can play a critical primary health care role in the detection of papilloedema and referring appropriately.

  17. CT heads diagnosing chest pathology? Whatever next?

    Energy Technology Data Exchange (ETDEWEB)

    Holdsworth, Gary, E-mail: gary.holdsworth@midyorks.nhs.uk [Radiology Department, Midyorks Hospitals NHS Trust, Pinderfields General Hospital Aberford Road Wakefield, West Yorkshire, WF1 4DG (United Kingdom); Clarke, Ruth, E-mail: ruth.clarke@midyorks.nhs.uk [Radiology Department, Midyorks Hospitals NHS Trust, Pinderfields General Hospital Aberford Road Wakefield, West Yorkshire, WF1 4DG (United Kingdom)

    2011-11-15

    This case report presents two cases where subcutaneous emphysema visualised on computerised tomography examinations of the head subsequently led to the diagnoses of pathology within the thorax. The pathophysiology of traumatic subcutaneous emphysema within the head and neck is briefly discussed, along with examples of other causes of this condition within this anatomical region. The primary aim of this report is to draw attention to the necessity for a thorough review of any CT head examination, including both intra- and extra-cranial structures, undertaken at a variety of window settings.

  18. Neuroimaging differential diagnoses to abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Aix Marseille University, UMR CNRS 7339, Marseille (France); Brunel, Herve; Dory-Lautrec, Philippe [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Chabrol, Brigitte [AP-HM Timone, Department of Pediatric Neurology, Marseille (France)

    2016-05-15

    Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury. (orig.)

  19. Patient specific modelling in diagnosing depression

    DEFF Research Database (Denmark)

    Ottesen, Johnny T.

    2015-01-01

    Depression is a very common disease. Approximately 10% of people in the Western world experience severe depression during their lifetime and many more experience a mild form of depression. It is commonly believed that depression is caused by malfunctions in the biological system constituted...... diagnoses more precise and to offer individual treatment plans and drug design. Efficient and reliable methods for parameter estimation are crucial. Presently we are investigating how well the Metropolis-Hastings Algorithm of the Bayesian Markov Chain Monte Carlo (MCMC) method for estimating the parameters...

  20. Diagnosing ADHD in Danish primary school children

    DEFF Research Database (Denmark)

    Tegtmejer, Thyge; Hjörne, Eva; Säljö, Roger

    2017-01-01

    This study of institutional categorization reports an investigation of the practices, procedures and assumptions of psychiatric staff members when diagnosing ADHD. The main data upon which the study is based consist of transcribed audio recordings of meetings in the psychiatric clinic. Here...... children referred from primary schools on the suspicion of ADHD are attended to. The tools and procedures for gathering information are shown to produce decontextualized and individualizing representations of children’s conduct. The evaluation against a number of norms is found to be central. Finally...

  1. Neuroimaging differential diagnoses to abusive head trauma

    International Nuclear Information System (INIS)

    Girard, Nadine; Brunel, Herve; Dory-Lautrec, Philippe; Chabrol, Brigitte

    2016-01-01

    Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury. (orig.)

  2. Tryptase in diagnosing adverse suspected anaphylactic reaction.

    Science.gov (United States)

    Michalska-Krzanowska, Grazyna

    2012-01-01

    Determination of serum mast cell tryptase (MCT) is becoming more widely used in diagnosing allergic reactions involving mast cells. It can help evaluate the allergenic effects of drugs administered during anesthesia and the perioperative period. Until now, data about the role of tryptase in the body has not been clarified yet. Patients with elevated MCT levels should undergo further testing to find out the causative agent of a potential allergic reaction. Patients with normal tryptase concentration should also undergo further diagnosis if they manifest clinical symptoms of a severe anaphylactic reaction.

  3. Problems in diagnosing odontogenic myxoma: case report.

    Science.gov (United States)

    Butt, F M A; Chindia, M L; Wakoli, K A

    2007-03-01

    Tumours and tumour-like growths arising from odontogenic tissues constitute a heterogenous group of lesions whose diagnosis can be particularly challenging on the part of both surgeons and pathologists. In children, these lesions are even more difficult to clinically and histopathologically diagnose definitively because of the concurrent diverse embryologic differentiation of dental tissues. A case is presented of a 12 year-old boy who was subjected to inappropriate primary management of a left mandibular mass, due apparently to inadequate consultation to establish an accurate diagnosis.

  4. THE EVANGELICAL AS THE NATIVE IN THE “BROTHERS KARAMAZOV” AND IN “A WRITER’S DIARY” (1876–1877 BY FYODOR DOSTOEVSKY

    Directory of Open Access Journals (Sweden)

    Elena A. Fedorova

    2015-11-01

    Full Text Available The article identifi es the reasons for Fyodor Dostoevsky’s appeal to the traditions of Old Russian literature in “A Writer’s Diary” during the Russian-Turkish war. One of the main reasons is seeking for national foundations of Russian spirituality. The writer learned the world of medieval literacy getting acquainted with hagiography, walking, spiritual eloquence. Later Dostoevsky reverted to the Old Russian monuments in the course of his work on the novel “The Brothers Karamazov” (in particular on the chapter “Th e Russian Monk”. As follows from the comparison of the texts the dominant qualities of the ideal image of a Russian saint are repentance, humility and suff ering, desire for purifi cation, spiritual ability to resist the evil. The ideal form of existence of Russian people becomes conciliarism. The type of historicism is the movement to the Last Judgment. Gospel allusions and metaphors reinforce the author’s interpretation. Th us, Dostoevsky carries on the dialogue with the evangelical word at an ideological, imaginative, genre, motive and narrative level of the text. Th e hallmark of the works of Fyodor Dostoevsky who followed the evangelical tradition, becomes a dialogical word.

  5. A Significant Source for the Madeleine and Other Major Episodes in Combray: Proust's Intertextual Use of Pierre Loti's My Brother Yves

    Directory of Open Access Journals (Sweden)

    Richard M. Berrong

    2014-01-01

    Full Text Available The most famous passage in Marcel Proust’s In Search of Lost Time , and one of the most famous passages in Western literature, is the moment when the narrator sips tea while eating a shell-shaped pastry called a madeleine and suddenly recalls very vividly an apparently long-forgotten scene from his childhood. From this episode Proust developed his theories about involuntary memory and its important role in our emotional welfare. Proust was an avid reader of the French novelist Pierre Loti when he was young. Contemporary accounts show that he was able to recite whole passages from Loti’s work in public from memory. This article demonstrates the extent to which Proust made intertextual use of scenes from Loti’s novel My Brother Yves in constructing the madeleine and other famous passages in Combray , the first section of In Search of Lost Time. It does not attempt to question the originality of Proust’s work. Rather, building on previous studies of intertextuality in Proust, it seeks to show how the author went about creating his work and dialoguing with at least some of his potential contemporary readers.

  6. Characteristics of Cu isotopes from chalcopyrite-rich black smoker chimneys at Brothers volcano, Kermadec arc, and Niuatahi volcano, Lau basin

    Science.gov (United States)

    Berkenbosch, H. A.; de Ronde, C. E. J.; Paul, B. T.; Gemmell, J. B.

    2015-10-01

    We analysed primary chalcopyrite from modern seafloor `black smoker' chimneys to investigate high-temperature hydrothermal Cu isotope fractionation unaffected by metamorphism. Samples came from nine chimneys collected from Brothers volcano, Kermadec arc, and Niuatahi volcano, Lau backarc basin. This is the first known study of Cu isotopes from submarine intraoceanic arc/backarc volcanoes, with both volcanoes discharging significant amounts of magmatic volatiles. Our results ( n = 22) range from δ65Cu = -0.03 to 1.44 ± 0.18 ‰ (2 sd), with the majority of samples between ˜0.00 and 0.50 ‰. We interpret this cluster ( n = 17) of lower δ65Cu values as representing a mantle source for the chimney Cu, in agreement with δ65Cu values for mantle rocks. The few higher δ65Cu values (>0.90 ‰) occur (1) within the same chimneys as lower values, (2) randomly distributed within the chimneys (i.e. near the top and bottom, interior and exterior), and (3) within chalcopyrite of approximately the same age (responsible for the observed isotopic fractionation. When compared to global δ65Cu data for primary chalcopyrite, volcanic arc chimneys are most similar to porphyry copper deposits that also form from magmatic-hydrothermal processes in convergent tectonic settings.

  7. Diagnosing method for nuclear power plant

    International Nuclear Information System (INIS)

    Sonoda, Yukio.

    1991-01-01

    When an abnormality occurs in a nuclear power plant, the abnormality is diagnosed, at present, graphic waveforms obtained by applying signal processing such as high speed Fourier transformation, etc. to fluctuation ingredients (noises) of process signals such as neutron fluxes, and plotting a power spectral density relative to a frequency. However, expert technical knowledges are required for interpreting the waveforms and it is difficult for field operators and persons for maintenance to judge them. Then, in the present invention, patterns of the power spectral density are inputted for pattern recognition by using a neural net so that any of patterns experienced in the past can be identified. If an unknown pattern appears, it is automatically studied for identification in subsequent cases. Then, the known abnormality of the plant can be monitored and causes thereof can be identified in an early stage, as well as it is possible to diagnose unknown abnormalities in subsequent situation. This method is effective for monitoring and maintaining the integrity, and can avoid unnecessary scram to improve plant operation factor. (N.H.)

  8. Vehicle Fault Diagnose Based on Smart Sensor

    Science.gov (United States)

    Zhining, Li; Peng, Wang; Jianmin, Mei; Jianwei, Li; Fei, Teng

    In the vehicle's traditional fault diagnose system, we usually use a computer system with a A/D card and with many sensors connected to it. The disadvantage of this system is that these sensor can hardly be shared with control system and other systems, there are too many connect lines and the electro magnetic compatibility(EMC) will be affected. In this paper, smart speed sensor, smart acoustic press sensor, smart oil press sensor, smart acceleration sensor and smart order tracking sensor were designed to solve this problem. With the CAN BUS these smart sensors, fault diagnose computer and other computer could be connected together to establish a network system which can monitor and control the vehicle's diesel and other system without any duplicate sensor. The hard and soft ware of the smart sensor system was introduced, the oil press, vibration and acoustic signal are resampled by constant angle increment to eliminate the influence of the rotate speed. After the resample, the signal in every working cycle could be averaged in angle domain and do other analysis like order spectrum.

  9. Comparison of radiological measures for diagnosing flatfoot

    International Nuclear Information System (INIS)

    Lo, Huan-Chu; Chu, Wencheng; Wu, Weikai; Hsieh, Hsin; Chou, Chiehping; Sun, Shaoen; Chou, Pinya; Liao, Chenhui; Guan, Xiaoyun; Li, Shuchee

    2012-01-01

    Background. In the Taiwanese military, flatfoot is indicated by a calcaneal-fifth metatarsal angle (arch angle) =165 deg . However, the arch angle is not always easily defined. Purpose. To assess correlations between the arch angle and other radiographic measures and thus identify an alternative radiographic measure for diagnosing flatfoot. Material and Methods Eighty-seven male Taiwanese military recruits were studied (median age 22 years, interquartile range 20-23 years). Lateral, weight-bearing radiographs were taken. Five radiographic measurements, including the calcaneal-fifth metatarsal angle (arch angle), medial arch angle (MAA), calcaneal pitch angle (CP), talus angle (TA), and talar-first metatarsal angle (TFM) were made. Correlations between the arch angle and all other measures were determined. A cut-off value for predicting flatfoot (arch angle ≥165 deg ) was determined for each measure using the Youden index and receiver-operating characteristic (ROC) curves were generated for each measure to assess diagnostic accuracy. Results. All measures were significantly correlated with arch angle (P 9.5 deg ) had the highest specificity (90.3% vs. 88.75 for CP <12.3 deg ). Conclusion. CP is inversely correlated with arch angle in Taiwanese male military recruits. CP < 12.3 deg is a significant predictor of flatfoot. Assessment of CP may be used as an alternative means of diagnosing flatfoot when the arch angle is not easily defined

  10. Beyond the DSM: trends in psychiatry diagnoses

    Directory of Open Access Journals (Sweden)

    Andre Russowsky Brunoni

    Full Text Available Abstract Background: Although widely used in clinical practice and research, Diagnostic and Statistical Manual of Mental Disorders (DSM diagnoses have low validity: patients with different mental disorders can share similar symptoms, while those with the same diagnosis might have different symptoms. In fact, the DSM diagnostic system has been considered one of the main obstacles for further development of psychiatric research. Recently, it has been proposed that psychiatry nosology should be reframed according to a biologically-based etiology. Objectives: To review present and past endeavors of establishing an etiology-based nosology. Methods: Comprehensive review of articles on the topic. Results: From Hippocrates onwards, multiple attempts have been undertaken aiming to move etiology and nosology closer. The most recent efforts are represented by Developmental Psychopathology (DP and the Research Domain Criteria (RDoC, which presents an operational matrix recommended to be used in clinical research instead of the DSM diagnoses. Discussion: The DSM-based nosology is faulty. RDoC and DP might be interesting alternatives for an etiology-based nosology. However, while DP has already brought promising results, RDoC is a novel proposal, whose advantages and disadvantages should gradually be identified in the upcoming years.

  11. Illness perspectives of Thais diagnosed with schizophrenia.

    Science.gov (United States)

    Sanseeha, Ladda; Chontawan, Ratanawadee; Sethabouppha, Hunsa; Disayavanish, Chamlong; Turale, Sue

    2009-09-01

    This study explored the perceptions of 18 people diagnosed with schizophrenia from 1-10 years to uncover how they perceived themselves and their illness. It also involved 12 family members who added their perceptions. The data were collected using in-depth interviews, reflective journaling, and observations. The data were analyzed through the lens of Heidegger's hermeneutic phenomenology. Four themes emerged: perceptions of mental illness, perceptions of the causes of illness, perceptions of discrimination, and attempting to live with schizophrenia. The findings included strong underlying cultural and spiritual beliefs, and attitudes unique to the Thai participants, including the causation of schizophrenia by supernatural powers, black magic, and bad karma stemming from past deeds. Understanding the perceptions of the participants might help health-care providers to be more sensitive to those living with schizophrenia in Thailand and elsewhere. In particular, the findings could be useful in informing psychiatric careproviders about developing better caring systems for clients diagnosed with schizophrenia. This should help the sufferers of schizophrenia to live their lives to their own satisfaction and as normally as possible.

  12. Diagnosing MOV problems using comparative trace analysis

    International Nuclear Information System (INIS)

    Leon, R.L.

    1992-01-01

    The paper presents the concept of comparative trace analysis and shows it to be very effective in diagnosing motor operated valve (MOV) problems. Comparative trace analysis is simply the process of interpreting simultaneously gathered traces, each presenting a different perspective on the same series of events. The opening and closing of a motor operated valve is such a series of events. The simultaneous traces are obtained using Liberty Technologies' Valve Operation Test and Evaluation System (VOTES)reg-sign. The traces include stem thrust, motor current, motor power factor, motor power, switch actuations, vibration in three different frequency bands, spring pack displacement, and spring pack force. Spare and auxiliary channels enable additional key parameters to be measured, such as differential pressure and stem displacement. Though not specifically illustrated in this paper, the VOTES system also provides for FFT analysis on all traces except switches

  13. Discrete event systems diagnosis and diagnosability

    CERN Document Server

    Sayed-Mouchaweh, Moamar

    2014-01-01

    Discrete Event Systems: Diagnosis and Diagnosability addresses the problem of fault diagnosis of Discrete Event Systems (DES). This book provides the basic techniques and approaches necessary for the design of an efficient fault diagnosis system for a wide range of modern engineering applications. The different techniques and approaches are classified according to several criteria such as: modeling tools (Automata, Petri nets) that is used to construct the model; the information (qualitative based on events occurrences and/or states outputs, quantitative based on signal processing and data analysis) that is needed to analyze and achieve the diagnosis; the decision structure (centralized, decentralized) that is required to achieve the diagnosis. The goal of this classification is to select the efficient method to achieve the fault diagnosis according to the application constraints. This book focuses on the centralized and decentralized event based diagnosis approaches using formal language and automata as mode...

  14. Automated diagnostic kiosk for diagnosing diseases

    Science.gov (United States)

    Regan, John Frederick; Birch, James Michael

    2014-02-11

    An automated and autonomous diagnostic apparatus that is capable of dispensing collection vials and collections kits to users interesting in collecting a biological sample and submitting their collected sample contained within a collection vial into the apparatus for automated diagnostic services. The user communicates with the apparatus through a touch-screen monitor. A user is able to enter personnel information into the apparatus including medical history, insurance information, co-payment, and answer a series of questions regarding their illness, which is used to determine the assay most likely to yield a positive result. Remotely-located physicians can communicate with users of the apparatus using video tele-medicine and request specific assays to be performed. The apparatus archives submitted samples for additional testing. Users may receive their assay results electronically. Users may allow the uploading of their diagnoses into a central databank for disease surveillance purposes.

  15. Diagnosing organizational culture: An empirical investigation

    Directory of Open Access Journals (Sweden)

    Manouchehr Jofreh

    2013-09-01

    Full Text Available Investigating the behavior of members of an organization is a basic step in understanding the organization's culture. In fact, it is always necessary to consider organization culture when a new action is about to happen. In fact, by leveraging culture, it is getting easier to accomplish other tasks within organization. In this paper, we present an empirical investigation to find important factors influencing organizational culture in banking industry. The proposed study uses Denison’s standard questionnaire for diagnosing organizational culture. Cronbach alpha has been calculated as 0.927, which is well about the acceptable limit. The results indicate that dimensions of job involvement (2.961 and organizational mission (2.914 are in better position compared with dimensions of compatibility (2.724 and consistency (2.621. The study proposes a new comprehensive organizational framework, which helps building new strategies.

  16. Method of diagnosing the control rod operation

    International Nuclear Information System (INIS)

    Nakaniwa, Tomoko; Kudo, Mitsuru.

    1983-01-01

    Purpose: To confirm the soundness of a control rod operation at high accuracy. Method: By utilizing the fact that a control rod position indicating system outputs digitalized decimal signals, position signals are outputted as below: a stop position signal when a magnet is opposed to an odd number limit switch; a drift position signal when it is opposed to an even number limit switch; and a blank position signal when it is not opposed to a limit switch. Since the standard signal pattern is present for the order of signal change due to the displacement of the magnet i.e., stop position→blank position→drift position, absolute position change and the time for passing the limit switch, the standard pattern is stored in an operation diagnosis unit and compared with the data upon actual driving to diagnose the control rod operation collectively. (Sekiya, K.)

  17. Diagnosing kidney disease in the genetic era.

    Science.gov (United States)

    Prakash, Sindhuri; Gharavi, Ali G

    2015-07-01

    Recent technological improvements have increased the use of genetic testing in the clinic. This review serves to summarize the many practical benefits of genetic testing, discusses various methodologies that can be used clinically, and exemplifies ways in which genetics is propelling the field forward in nephrology. The advent of next-generation sequencing and microarray technologies has heralded an unprecedented number of discoveries in the field of nephrology, providing many opportunities for incorporating genomic diagnostics into clinical care. The use of genetic testing, particularly in pediatrics, can provide accurate diagnoses in puzzling cases, resolve misclassification of disease, and identify subsets of individuals with treatable conditions. Genetic testing may have broad benefits for patients and their families. Knowing the precise molecular etiology of disease can help clinicians determine the exact therapeutic course, and counsel patients and their families about prognosis. Genetic discoveries can also improve the classification of kidney disease and identify new targets for therapy.

  18. Dermoscopy of difficult-to-diagnose Melanomas

    Directory of Open Access Journals (Sweden)

    Papageorgiou Chrysoula

    2016-09-01

    Full Text Available Dermoscopy is a non-invasive procedure that allows the evaluation of cutaneous lesions, and is considered to be a useful tool that improves the diagnostic accuracy of melanoma. Many dermoscopic criteria of melanoma have been established and several algorithms have been created for melanoma detection. However, the recognition of some melanomas remains challenging. Melanomas on specific body sites, melanomas in patients with multiple atypical moles, and nodular melanomas represent the most difficult-to-recognize melanoma subtypes, since they typically lack the “classic” melanoma-specific criteria. This paper provides an update on dermoscopy of difficult-to-diagnose melanomas by summarizing the newest data. Lastly, we highlight the importance of digital dermoscopy in the follow-up of melanocytic lesions for the detection of incipient melanomas while maintaining a low excision rate.

  19. Diagnosing dehydration? Blend evidence with clinical observations.

    Science.gov (United States)

    Armstrong, Lawrence E; Kavouras, Stavros A; Walsh, Neil P; Roberts, William O

    2016-11-01

    The purpose of the review is to provide recommendations to improve clinical decision-making based on the strengths and weaknesses of commonly used hydration biomarkers and clinical assessment methods. There is widespread consensus regarding treatment, but not the diagnosis of dehydration. Even though it is generally accepted that a proper clinical diagnosis of dehydration can only be made biochemically rather than relying upon clinical signs and symptoms, no gold standard biochemical hydration index exists. Other than clinical biomarkers in blood (i.e., osmolality and blood urea nitrogen/creatinine) and in urine (i.e., osmolality and specific gravity), blood pressure assessment and clinical symptoms in the eye (i.e., tear production and palpitating pressure) and the mouth (i.e., thirst and mucous wetness) can provide important information for diagnosing dehydration. We conclude that clinical observations based on a combination of history, physical examination, laboratory values, and clinician experience remain the best approach to the diagnosis of dehydration.

  20. Optical coherence tomography for diagnosing periodontal disease

    Science.gov (United States)

    Colston, Bill W., Jr.; Everett, Matthew J.; Da Silva, Luiz B.; Otis, Linda L.; Nathel, Howard

    1997-05-01

    We have, in this preliminary study, investigated the use of optical coherence tomography for diagnosis of periodontal disease. We took in vitro OCT images of the dental and periodontal tissues from a young pig and compared them to histological sections. These images distinguish tooth and soft tissue relationships that are important in diagnosing and assessing periodontal disease. We have imaged the attachment of gingiva to the tooth surface and located the cemento-enamel junction. This junction is an important reference point for defining attachment level in the diagnosis of periodontal disease. the boundary between enamel and dentin is also visible for most of the length of the anatomical crown, allowing quantitation of enamel thickness and character.

  1. Diagnosing Myocardial Contusion after Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Zahra Alborzi

    2016-10-01

    Full Text Available A myocardial contusion refers to a bruise of the cardiac muscle, the severity of which can vary depending on the severity of the injury and when the injury occurs. It is a major cause of rapid death which happens after blunt chest trauma and should be suspected at triage in the emergency department. We demonstrated that suspected myocardial contusion patients who have normal electrocardiograms (ECGs and biomarker tests can be safely discharged. However, if the test results are abnormal, the next steps should be echocardiography and more advanced measures. Diagnosing myocardial contusion is very difficult because of its nonspecific symptoms. If a myocardial contusion happens, cardiogenic shock or arrhythmia must be anticipated, and the patient must be carefully monitored.

  2. Excess mortality in patients diagnosed with hypothyroidism

    DEFF Research Database (Denmark)

    Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind

    2013-01-01

    Background: Although hypothyroidism is associated with increased morbidity, an association with increased mortality is still debated. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism influences mortality. Methods: In an observational cohort study from...... January 1, 1978 until December 31, 2008 using record-linkage data from nationwide Danish health registers, 3587 singletons and 682 twins diagnosed with hypothyroidism were identified. Hypothyroid individuals were matched 1:4 with nonhypothyroid controls with respect to age and gender and followed over...... a mean period of 5.6 years (range 0-30 years). The hazard ratio (HR) for mortality was calculated using Cox regression analyses. Comorbidity was evaluated using the Charlson score (CS). Results: In singletons with hypothyroidism, the mortality risk was increased (HR 1.52; 95% confidence interval [CI]: 1...

  3. Diagnosing chronic thromboembolic pulmonary hypertension: current perspectives

    Directory of Open Access Journals (Sweden)

    Hadinnapola C

    2014-09-01

    Full Text Available Charaka Hadinnapola, Deepa Gopalan, David P Jenkins Papworth Hospital National Health Service Foundation Trust, Papworth Everard, Cambridge, United Kingdom Abstract: Chronic thromboembolic pulmonary hypertension is a rare and relatively poorly understood disease. It remains underdiagnosed and is often not recognized in primary and secondary care, as its symptoms are nonspecific and there are few clinical signs until late in the disease process. However, pulmonary endarterectomy (PEA offers a potential cure for patients with this type of pulmonary hypertension; therefore, it is important that they are identified and diagnosed in a timely manner. PEA is associated with a 2.2%–5% risk of significant morbidity and mortality, even in experienced PEA centers. Therefore, once chronic thromboembolic pulmonary hypertension is diagnosed, further assessment of operability and patient selection is crucial. Assessment of operability involves determining the distribution and burden of chronic thromboembolic disease, assessing pulmonary hemodynamics, and assessing the functional impairment of the patient. Ventilation perfusion scintigraphy is of value in screening for the presence of chronic thromboembolic disease. However, computer tomography pulmonary angiography and magnetic resonance pulmonary angiography are now increasingly used to image the vascular occlusions directly. This allows assessment of the surgically accessible disease burden. Some centers still advocate conventional selective pulmonary angiography for the latter. Right-heart catheterization remains the gold standard for assessing pulmonary hemodynamics. Higher pulmonary vascular resistances are associated with poorer outcomes as well as increased risks at the time of surgery. This is in part because of the presence of more distal chronic thromboembolic material and distal pulmonary artery remodeling. However, in experienced centers, these patients are being operated on safely and with good

  4. Causes and outcome of prenatally diagnosed hydronephrosis

    International Nuclear Information System (INIS)

    Ahmadzadeh, Ali; Tahmasebi, Morteza; Gharibvand, Mohammad Momen

    2009-01-01

    Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with ultrasonography (U/S). Hydronephrosis may be obstructive or nonobstructive; obstructive lesions are more harmful to the developing kidneys. The aim of the study was to evaluate the causes of renal pelvic dilatation and the outcome of postnatal treatment in infants with hydronephrosis diagnosed prenatally with U/S. We prospectively studied 67 (60 males) newborns with hydronephrosis diagnosed prenatally and confirmed postnatally with U/S from Sept. 2005 to Oct. 2007. The patients were allocated to three groups based on the mea-surement of the anteroposterior renal pelvic diameter (APRPD) in transverse plane: mild (6-9.9 mm), moderate (10-14.9 mm) and severe (> 15 mm) hydronephrosis. Voiding cystourethrography (VCUG) was obtained in all of the patients to rule out vesicoureteral reflux (VUR). In cases with negative VUR, Diethylenetriamine-pentaacetic acid (DTPA) scan with diuretic renography was performed to detect ureteropelvic joint obstruction (UPJO). Twenty two cases (32.8%) had mild, 20 (29.9%) had moderate, and 25 (37.3%) had severe hydronephrosis. The causes of hydronephrosis were VUR (40.2%), UPJO (32.8%), posterior urethral valves (PUVs) (13.4 %), and transient hydronephrosis (13.4 %). The lesion was obstructive in 37 (55.2%) infants. Totally, 33 (49.2%) patients with hydronephrosis (9 mild, 9 moderate, and 15 severe) subsequently developed complications such as UTI and renal insufficiency, or required surgery. Associated abnormalities were observed in 15 (22.4%) patients. We conclude that every newborn with any degree of hydronephrosis should be assessed postnatally for specific diagnosis and treatment. (author)

  5. Provocation tests in diagnosing drug hypersensitivity.

    Science.gov (United States)

    Bousquet, Philippe-Jean; Gaeta, Francesco; Bousquet-Rouanet, Laure; Lefrant, Jean-Yves; Demoly, Pascal; Romano, Antonino

    2008-01-01

    A position paper by the European Network for Drug Allergy (ENDA), the European Academy of Allergology and Clinical Immunology (EAACI) interest group on drug hypersensitivity, defines drug provocation tests (DPTs) as "the controlled administration of a drug in order to diagnose drug hypersensitivity reactions". The DPT is widely considered to be the "gold standard" to establish or exclude the diagnosis of hypersensitivity to a certain substance, as it not only reproduces hypersensitivity symptoms, but also any other adverse clinical manifestation, irrespective of the mechanism. The DPT can be harmful and thus should only be considered after balancing the risk-benefit ratio in the individual patient. The ENDA position paper specifies two main indications for DPTs with the suspected compounds: 1. to exclude hypersensitivity in non-suggestive histories of drug hypersensitivity and in patients with non-specific symptoms, such as vagal symptoms under local anesthesia; 2. to establish a firm diagnosis in suggestive histories of drug hypersensitivity with negative, non-conclusive, or non-available allergologic tests. A positive DPT result optimizes allergen avoidance, while a negative one allows a false label of drug hypersensitivity to be removed. For these reasons, DPTs are often carried out to exclude a diagnosis of hypersensitivity to beta-lactams when other allergologic tests are negative. DPTs are also performed when the sensitivity of allergologic tests for evaluating allergic reactions to certain drugs, such as non-beta-lactam antibiotics, heparins, and glucocorticoids, is limited. On the other hand, DPTs are also performed to diagnose hypersensitivity reactions to nonsteroidal anti-inflammatory drugs in subjects with the cross-reactive pattern, because both skin tests and in vitro diagnostic methods are ineffective in such patients.

  6. Nursing diagnoses determined by first year students: a vignette study.

    Science.gov (United States)

    Hakverdioğlu Yönt, Gülendam; Korhan, Esra Akın; Erdemir, Firdevs; Müller-Staub, Maria

    2014-02-01

    The study aimed to determine the ability of first year students in identifying nursing diagnoses. In a descriptive evaluation study, an expert-validated vignette containing 18 nursing diagnoses was used. The students determined 15 nursing diagnoses. The highest percentages of diagnoses identified were disturbed sleep pattern and nutrition imbalance. Students also considered medical diagnoses as nursing diagnoses: hypertension and tachycardia. Despite the fact that students were only at the end of their first semester and had limited clinical experience, they successfully identified the majority of nursing diagnoses. Patient case study vignettes are recommended for education. To foster students' knowledge and experience, it is also suggested that evaluating nursing diagnoses in clinical practicals becomes a requirement. © 2013 NANDA International, Inc.

  7. How Do Health Care Providers Diagnose Osteogenesis Imperfecta?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose osteogenesis imperfecta (OI)? If OI is moderate or severe, health care providers usually diagnose it during prenatal ultrasound at ...

  8. How Do Health Care Providers Diagnose Phenylketonuria (PKU)?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose phenylketonuria (PKU)? Nearly all cases of PKU are diagnosed ... Human Services. Baby's First Test. (n.d.). Classic phenylketonuria . Retrieved May 15, 2012, from http://www.babysfirsttest. ...

  9. How Do Health Care Providers Diagnose Spina Bifida?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose spina bifida? Doctors diagnose spina bifida before or after the infant is born. Spina bifida occulta might not be identified until late childhood ...

  10. How Do Health Care Providers Diagnose Turner Syndrome?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose Turner syndrome? Health care providers use a combination of physical ... the X chromosomes is partially or completely missing. Turner syndrome also can be diagnosed during pregnancy by testing ...

  11. Queer diagnoses revisited: The past and future of homosexuality and gender diagnoses in DSM and ICD.

    Science.gov (United States)

    Drescher, Jack

    2015-01-01

    The American Psychiatric Association (APA) recently completed a several year process of revising the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). During that time, there were objections raised to retaining DSM's gender identity disorder diagnoses and calls to remove them, just as homosexuality had been removed from DSM-II in 1973. At the conclusion of the DSM-5 revision process, the gender diagnoses were retained, albeit in altered form and bearing the new name of 'gender dysphoria'. The author of this paper was a member of the DSM-5 Workgroup on Sexual and Gender Identity Disorders and presently serves on the WHO Working Group on Sexual Disorders and Sexual Health. Both groups faced similar tasks: reconciling patients' needs for access to care with the stigma of being given a psychiatric diagnosis. The differing nature of the two diagnostic manuals led to two different outcomes. As background, this paper updates the history of homosexuality and the gender diagnoses in the DSM and in the International Statistical Classification of Diseases and Related Health Problems (ICD) as well as what is expected to happen to the homosexuality and gender diagnoses following the current ICD-11 revision process.

  12. Delayed diagnoses of cervical intraepithelial neoplasia and cancer after negative evaluation for atypical glandular cell pap smear: does age matter?

    Science.gov (United States)

    Valdini, Anthony F; Augart, Carolyn L; Olivieri, Michelle

    2013-10-01

    At initial evaluation, 1 in 6 women with atypical glandular cells (AGCs) on Pap smear has cervical intraepithelial neoplasia (CIN) or cancer. Years later, a greater-than-expected incidence of "significant delayed diagnoses" has been reported in women who had negative initial evaluation results. This study aimed to test the premise that AGC represents a lesser future risk for CIN 2/CIN 3/carcinoma in situ (CIS) and cancer after negative evaluation results in a population diagnosed at a young age (Pap smears (1997-2010); 213 were diagnosed with AGC, and 117 met inclusion criteria. Completed evaluation was consistent with American Society for Colposcopy and Cervical Pathology guidelines without finding CIN 2/CIN 3/CIS or cancer. Follow-up lasted for longer than 1 year. Categorical data were evaluated with χ. During the follow-up period that averaged for 85.3 months, the cohort had 4.5 mean Pap smears and reported 46 cytological diagnoses of low-grade squamous intraepithelial lesions, 3 diagnoses of high-grade squamous intraepithelial lesions, and 10 repeated diagnoses of AGCs. Two CIN 2/CIN 3/CIS lesions, 1 cervical cancer, and 1 endometrial intraepithelial neoplasia were confirmed on biopsy. Average age of patients at index Pap smear was 34.2 years (range = 15-64 years). Compared with a published report where the average age at index Pap smear was 41.5 years, our cohort developed a total of 4.3% significant delayed diagnoses versus 10.8% (significant difference, p = .046). During a 7-year follow-up, this cohort of 117 women with AGC and negative initial evaluation findings developed fewer significant delayed diagnoses than expected when compared with an older reported group and had no new extragynecological cancers. Age seems to be a risk factor for delayed diagnoses in patients with AGC.

  13. Time trend in diagnosing dementia in secondary care

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Waltoft, Berit Lindum; Kessing, Lars Vedel

    2010-01-01

    To study the trend of diagnosing dementia in the secondary health care sector over time, we conducted a nationwide longitudinal study of the incidence and prevalence of registered dementia diagnoses in the Danish national hospital registers.......To study the trend of diagnosing dementia in the secondary health care sector over time, we conducted a nationwide longitudinal study of the incidence and prevalence of registered dementia diagnoses in the Danish national hospital registers....

  14. Functional neurologic recovery in two dogs diagnosed with severe

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    2015-04-01

    Full Text Available Traumatic injuries to the vertebral column, spinal cord, and cauda equina nerve roots occur frequently in human and veterinary medicine and lead to devastating consequences. Complications include partial or complete loss of motor, sensory, and visceral functions, which are among the main causes of euthanasia in dogs. The present case report describes neurological functional recovery in two dogs that were treated surgically for severe spinal fracture and vertebral luxation. In the first case, a stray, mixed breed puppy was diagnosed with thoracolumbar syndrome and Schiff-Scherrington posture, as well as a T13 caudal epiphyseal fracture with 100% luxation between vertebrae T13 and L1; despite these injuries, the animal did show deep pain sensation in the pelvic limbs. Decompression through hemilaminectomy and spinal stabilization with vertebral body pins and bone cement were performed, and the treatment was supplemented with physiotherapy and acupuncture . In the second case, a mixed breed dog was diagnosed with a vertebral fracture and severe luxation between L6 and L7 after a vehicular trauma, but maintained nociception and perineal reflex. Surgical stabilization of the spine was performed using a modified dorsal segmental fixation technique Both patients showed significant recovery of neurological function. Complete luxation of the spinal canal observed radiographically does not mean a poor prognosis, and in some cases, motor, sensory, and visceral functions all have the potential for recovery. In the first case the determining factor for good prognosis was the presence of deep pain perception, and in the second case the prognosis was determined by the presence of sensitivity and anal sphincter tone during the initial neurological examination

  15. Diagnosing periprosthetic infection: false-positive intraoperative Gram stains.

    Science.gov (United States)

    Oethinger, Margret; Warner, Debra K; Schindler, Susan A; Kobayashi, Hideo; Bauer, Thomas W

    2011-04-01

    Intraoperative Gram stains have a reported low sensitivity but high specificity when used to help diagnose periprosthetic infections. In early 2008, we recognized an unexpectedly high frequency of apparent false-positive Gram stains from revision arthroplasties. The purpose of this report is to describe the cause of these false-positive test results. We calculated the sensitivity and specificity of all intraoperative Gram stains submitted from revision arthroplasty cases during a 3-month interval using microbiologic cultures of the same samples as the gold standard. Methods of specimen harvesting, handling, transport, distribution, specimen processing including tissue grinding/macerating, Gram staining, and interpretation were studied. After a test modification, results of specimens were prospectively collected for a second 3-month interval, and the sensitivity and specificity of intraoperative Gram stains were calculated. The retrospective review of 269 Gram stains submitted from revision arthroplasties indicated historic sensitivity and specificity values of 23% and 92%, respectively. Systematic analysis of all steps of the procedure identified Gram-stained but nonviable bacteria in commercial broth reagents used as diluents for maceration of periprosthetic membranes before Gram staining and culture. Polymerase chain reaction and sequencing showed mixed bacterial DNA. Evaluation of 390 specimens after initiating standardized Millipore filtering of diluent fluid revealed a reduced number of positive Gram stains, yielding 9% sensitivity and 99% specificity. Clusters of false-positive Gram stains have been reported in other clinical conditions. They are apparently rare related to diagnosing periprosthetic infections but have severe consequences if used to guide treatment. Even occasional false-positive Gram stains should prompt review of laboratory methods. Our observations implicate dead bacteria in microbiologic reagents as potential sources of false-positive Gram

  16. CT pulmonary angiography: increasingly diagnosing less severe pulmonary emboli.

    Directory of Open Access Journals (Sweden)

    Andrew J Schissler

    Full Text Available It is unknown whether the observed increase in computed tomography pulmonary angiography (CTPA utilization has resulted in increased detection of pulmonary emboli (PEs with a less severe disease spectrum.Trends in utilization, diagnostic yield, and disease severity were evaluated for 4,048 consecutive initial CTPAs performed in adult patients in the emergency department of a large urban academic medical center between 1/1/2004 and 10/31/2009. Transthoracic echocardiography (TTE findings and peak serum troponin levels were evaluated to assess for the presence of PE-associated right ventricular (RV abnormalities (dysfunction or dilatation and myocardial injury, respectively. Statistical analyses were performed using multivariate logistic regression.268 CTPAs (6.6% were positive for acute PE, and 3,780 (93.4% demonstrated either no PE or chronic PE. There was a significant increase in the likelihood of undergoing CTPA per year during the study period (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.04-1.07, P<0.01. There was no significant change in the likelihood of having a CTPA diagnostic of an acute PE per year (OR 1.03, 95% CI 0.95-1.11, P = 0.49. The likelihood of diagnosing a less severe PE on CTPA with no associated RV abnormalities or myocardial injury increased per year during the study period (OR 1.39, 95% CI 1.10-1.75, P = 0.01.CTPA utilization has risen with no corresponding change in diagnostic yield, resulting in an increase in PE detection. There is a concurrent rise in the likelihood of diagnosing a less clinically severe spectrum of PEs.

  17. Mediastinal goiter diagnosed by functional imaging | Michels ...

    African Journals Online (AJOL)

    In the next step, we initiated radionuclide imaging with technetium-99m pertechnetate (Tc-99m) and radioiodine (I-123). Low uptake of Tc-99m and intense accumulation of I-123 after 2 and 24 h to the mediastinal mass suggested that the mass was a mediastinal goiter. Based on iodine uptake and the fact that our patient ...

  18. Síndrome de Waardenburg: achados audiológicos em 2 irmãos Waardenburg's syndrome: audiological findings in 2 brothers

    Directory of Open Access Journals (Sweden)

    Carlos Henrique F. Martins

    2003-01-01

    Full Text Available A síndrome de Waardenburg foi inicialmente descrita em 1951 por P.J. Waardenburg, como uma condição autossômica dominante que apresenta penetrância e expressividade variáveis de seus caracteres. Os sinais clínicos mais frequentes são: deslocamento lateral dos cantos internos dos olhos (telecanto, hiperplasia da porção medial dos supercílios (sinofris, base nasal proeminente e alargada, alterações na pigmentação da íris e da pele, surdez congênita, mecha branca frontal ou encanecimento precoce. Este estudo foi realizado em dois irmãos de uma família, que apresentavam características clínicas da síndrome de Waardenburg, entre elas a deficiência auditiva. Os pacientes foram submetidos à uma avaliação otorrinolaringológica, audiológica e genética.Waardenburg's Syndrome, first described in 1951 by P.J. Waardenburg, is an autossomal dominant condition with variable penetrance and expressivity of its features. The clinical signs are lateral displacement of the inner canthi of the eyes, confluent eyebrows, broad and prominent nasal root, pigmentation changes of the irises and skin, sensorineural deafness, white forelock or early graying of the hair. This study was based on two brothers who presented a typical clinical picture of Waardenburg's Syndrome, including hearing loss. Otolaryngological, audiological and genetical evaluations were conducted.

  19. ['Charitable brothers' in charge of hospitals in early modern times: The hospital in Linz/Austria and its patients up to c. 1780].

    Science.gov (United States)

    Watzka, Carlos

    2008-01-01

    The article deals with the history of the Hospital of the Brothers of St. John of God (in German: "Barmherzige Brüder"; official name "Ordo Hospitalarius Sancti Joannis a Deo") in the capital of Upper Austria, Linz, from its founding in 1757 to c. 1780. Primarily, the organisational development and the patients of the institute are discussed. The order's hospital already functioned as a medical hospital for the treatment of acute diseases: It was oriented towards the reestablishment of health of its inmates during short time and offered treatment by a staff of learned medical experts, among them academically trained physicians. The accommodation of the patients yet took place in a largely undifferentiated manner, as most of them were situated in a large common hall. This was obviously a consequence of the comparatively little capacity of the organisation, too, which sustained about 12 beds in the beginning, and about 20 around 1780. Nonetheless, the number of patients treated there summed up to nearly 1% of the entire male population of Upper Austria even during the first decade of its existence. In early modern time, only men were admitted to this hospital, the average age of them being only ca. 30 years. As far as social status is concerned, most of them (according to a representative sample out of the admissions of 1757-1767) were handicraftsmen (more than two thirds), labourers and servants. Thus, the organisation was obviously destined to broad social strata, but by no way displays itself as a poorhouse. Average annual mortality was 10 to 13%, which is comparable to that of other hospitals of the order in 18th century Austria. Most of the admitted persons suffered from "fever" or inner diseases and were dismissed as healed already after some weeks of stay.

  20. All mammalian Hedgehog proteins interact with cell adhesion molecule, down-regulated by oncogenes (CDO) and brother of CDO (BOC) in a conserved manner.

    Science.gov (United States)

    Kavran, Jennifer M; Ward, Matthew D; Oladosu, Oyindamola O; Mulepati, Sabin; Leahy, Daniel J

    2010-08-06

    Hedgehog (Hh) signaling proteins stimulate cell proliferation, differentiation, and tissue patterning at multiple points in animal development. A single Hh homolog is present in Drosophila, but three Hh homologs, Sonic Hh, Indian Hh, and Desert Hh, are present in mammals. Distribution, movement, and reception of Hh signals are tightly regulated, and abnormal Hh signaling is associated with developmental defects and cancer. In addition to the integral membrane proteins Patched and Smoothened, members of the Drosophila Ihog family of adhesion-like molecules have recently been shown to bind Hh proteins with micromolar affinity and positively regulate Hh signaling. Cell adhesion molecule-related, down-regulated by oncogenes (CDO) and Brother of CDO (BOC) are the closest mammalian relatives of Drosophila Ihog, and CDO binds Sonic Hh with micromolar affinity and positively regulates Hh signaling. Despite these similarities, structural and biochemical studies have shown that Ihog and CDO utilize nonorthologous domains and completely different binding modes to interact with cognate Hh proteins. We report here biochemical and x-ray structural studies of Sonic, Indian, and Desert Hh proteins both alone and complexed with active domains of CDO and BOC. These results show that all mammalian Hh proteins bind CDO and BOC in the same manner. We also show that interactions between Hh proteins and CDO are weakened at low pH. Formation of Hh-mediated Hh oligomers is thought to be an important feature of normal Hh signaling, but no conserved self-interaction between Hh proteins is apparent from inspection of 14 independent Hh-containing crystal lattices.

  1. Fetal MRI clues to diagnose cloacal malformations

    Energy Technology Data Exchange (ETDEWEB)

    Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Patel, Manish N.; Kraus, Steven [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Levitt, Marc A.; Pena, Alberto [Cincinnati Children' s Hospital Medical Center, Colorectal Center for Children, Pediatric Surgery, Cincinnati, OH (United States); Lim, Foong-Yen; Crombleholme, Timothy M. [Cincinnati Children' s Hospital Medical Center, Fetal Care Center of Cincinnati, Pediatric Surgery, Cincinnati, OH (United States); Linam, Leann E. [Arkansas Children' s Hospital, Department of Radiology, Little Rock, AR (United States)

    2011-09-15

    Prenatal US detection of cloacal malformations is challenging and rarely confirms this diagnosis. To define the prenatal MRI findings in cloacal malformations. We performed a retrospective study of patients with cloacal malformations who had pre- and post-natal assessment at our institution. Fetal MRI was obtained in six singleton pregnancies between 26 and 32 weeks of gestation. Imaging analysis was focused on the distal bowel, the urinary system and the genital tract and compared with postnatal clinical, radiological and surgical diagnoses. The distal bowel was dilated and did not extend below the bladder in five fetuses. They had a long common cloacal channel (3.5-6 cm) and a rectum located over the bladder base. Only one fetus with a posterior cloacal variant had a normal rectum. Three fetuses had increased T2 signal in the bowel and two increased T1/decreased T2 signal bladder content. All had renal anomalies, four had abnormal bladders and two had hydrocolpos. Assessment of the anorectal signal and pelvic anatomy during the third trimester helps to detect cloacal malformations in the fetus. The specificity for this diagnosis was highly increased when bowel fluid or bladder meconium content was identified. (orig.)

  2. [How to diagnose and treat limb apraxia].

    Science.gov (United States)

    Dovern, A; Fink, G R; Weiss, P H

    2011-06-01

    Apraxia is a disorder of higher motor cognition. Deficits in imitating abstract and symbolic gestures as well as deficits in appropriate tool use are common apraxic symptoms which, importantly, cannot be explained by primary sensorimotor deficits alone. In spite of the relevance of apraxia for neurorehabilitation and the individual stroke patient's prognosis, apraxia is to date still too rarely diagnosed and treated. In this review the currently published assessments for the diagnosis of apraxia are evaluated. Based on this, an apraxia screening instrument as well as a diagnostic test for clinical use are recommended. In addition, different published approaches to the therapy for apraxia are described. Although current evidence is scarce, the gesture training suggested by Smania and co-workers can be recommended as a therapy for apraxia, because its effects were shown to extend to activities of daily living and to persist for at least two months after completion of the training. This review aims at directing the clinician's attention to the importance of apraxia. Moreover, it provides the interested reader with instruments for a reliable diagnosis and effective treatment of apraxia. These are also important prerequisites for further research into the neurobiological mechanisms underlying apraxia and the development of new therapy strategies leading to an evidence-based effective treatment of apraxia. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Diagnosing Anomalous Network Performance with Confidence

    Energy Technology Data Exchange (ETDEWEB)

    Settlemyer, Bradley W [ORNL; Hodson, Stephen W [ORNL; Kuehn, Jeffery A [ORNL; Poole, Stephen W [ORNL

    2011-04-01

    Variability in network performance is a major obstacle in effectively analyzing the throughput of modern high performance computer systems. High performance interconnec- tion networks offer excellent best-case network latencies; how- ever, highly parallel applications running on parallel machines typically require consistently high levels of performance to adequately leverage the massive amounts of available computing power. Performance analysts have usually quantified network performance using traditional summary statistics that assume the observational data is sampled from a normal distribution. In our examinations of network performance, we have found this method of analysis often provides too little data to under- stand anomalous network performance. Our tool, Confidence, instead uses an empirically derived probability distribution to characterize network performance. In this paper we describe several instances where the Confidence toolkit allowed us to understand and diagnose network performance anomalies that we could not adequately explore with the simple summary statis- tics provided by traditional measurement tools. In particular, we examine a multi-modal performance scenario encountered with an Infiniband interconnection network and we explore the performance repeatability on the custom Cray SeaStar2 interconnection network after a set of software and driver updates.

  4. Optical coherence tomography in diagnosing cervical cancer

    Science.gov (United States)

    Kuznetzova, Irina A.; Shakhova, Natalia M.; Kachalina, Tatiana S.; Gladkova, Natalia D.; Myakov, Alexey V.; Iksanov, Rashid R.; Feldchtein, Felix I.

    2000-05-01

    Cervical cancer remains one of the most significant problem in oncogynecology. It tends towards treatment approaches that provide termination of pathological processes along with preservation of the patient's life quality. There is a need in earlier and more accurate diagnosis of pathological states, objective assessment of physiological processes, and adequate monitoring of the course of treatment. In our previous publications we have reported unique capabilities of the Optical Coherence Tomography (OCT) to image in vivo the mucosa structure of the cervix and to monitor various physiological and pathological alterations. In this report, we present results of OCT application to diagnose different stages of cervical cancer and to control its treatment at early stages. We have performed OCT-colposcopy in 11 female patients with cervical cancer to derive OCT criteria of this disease, to provide exact demarcation of a pathological area, and to determine a real size of a tumor. We have found that, in general, borders of a tumor, defined visually and detected with OCT by violation of the basement membrane in exocervix, do not coincide. The mismatch depends on a stage of cancer and can be as much as several millimeters. This information is especially important for evaluation of linear dimension of tumors with 3 - 5 mm invasion and also for differential diagnosis between the T1 and T2 stages with cancer extension onto vagina.

  5. Diagnosing Beijing 2020: Mapping the Ungovernable City

    Directory of Open Access Journals (Sweden)

    Robin Visser

    2014-07-01

    Full Text Available Beijing Municipality, characterised by the ‘off-ground’ architecture distinguishing neo-liberal privatisation, is attempting to mitigate the damaging effects of rampant development on the social fabric, cultural heritage, and the environment by adopting sustainable urban planning. I argue that the sustainability rhetoric in the Beijing Municipality 2020 Plans functions in part as strategic metaphors masking unnamed, imminent threats to governance. In this article I diagnose four Beijing plans (Beijing 2006-2015 ‘Rail Transit Plan’ for Compact City, Beijing 2005-2020 ‘Underground Space Plan’ for Alternative Space, Beijing 2006-2020 ‘Undeveloped Area Plan’ for Ecological Responsibility, and Beijing 2006-2010 ‘Low-income Housing Plan’ for Affordability and Liveability. A diagrammatics of the plans illuminates not so much a mapping of Beijing’s future as the forms of spontaneity preoccupying the nation at this historical juncture. The Beijing 2020 plan, as city mapping more generally, discloses the imminence of ungovernable city. The fact that citizens are demanding greater authority over Beijing governance suggests that radical alterations to its urban fabric and quality of life have incited the imminent sociability that is the city.

  6. Diagnosing and managing patients with drug hypersensitivity.

    Science.gov (United States)

    Fernandez, Javier; Doña, Inmaculada

    2018-01-01

    Diagnosing and managing drug hypersensitivity is challenging because there are no clear limits between different types of drug reactions. Distinguishing between type A (predictable) and type B (hypersensitivity) reactions when a drug is introduced on the market is not easy. When many people use a drug, adverse reactions can occur, conditioned by diverse genetic profiles, viral infections or concomitant therapy. Occasionally the only tool clinicians have on which to base the diagnosis is the clinical history. Skins tests or in vitro tests sometimes have low sensitivity or are unavailable, and drug provocation tests may be dangerous or strictly forbidden in case of severe cutaneous reactions. Areas covered: This paper reviews the diagnosis and management of the two main types of immunological reactions: IgE-mediated immediate drug hypersensitivity reactions (IDHRs) and non-immediate drug hypersensitivity reactions (NIDHRs). Expert commentary: Although Europe and the United States use different diagnostic methods, patients with history of drug hypersensitivity must avoid the suspicious drug, and clinicians must assess tolerance to safe alternatives under medical surveillance. Sometimes desensitization may be required. There is a consensus about the need to perform genetic testing for specific drugs and give patients proper documentation to prevent future exposure to culprit drugs.

  7. The lived experiences of rural women diagnosed with the human immunodeficiency virus in the antenatal period.

    Science.gov (United States)

    Fords, Genevieve Marion; Crowley, Talitha; van der Merwe, Anita S

    2017-12-01

    In South Africa, pregnant women are diagnosed with human immunodeficiency virus (HIV) at antenatal clinics and simultaneously initiated on antiretroviral treatment (ART). An HIV diagnosis together with the initiation of ART has an emotional impact that may influence how pregnant women cope with pregnancy and their adherence to a treatment plan. The aim of the study was to explore the lived experiences of women diagnosed with HIV in the antenatal period in a rural area in the Eastern Cape province of South Africa. A qualitative approach with a descriptive phenomenological design was utilised. The study applied purposive sampling to select participants from a local community clinic in the Eastern Cape. Ten semistructured interviews were conducted, transcribed and analysed using Colaizzi's framework. Four themes formed the essential structure of the phenomenon being investigated: a reality that hits raw, a loneliness that hurts, hope for a fractured tomorrow and support of a few. Although the participants had to accept the harsh reality of being diagnosed with HIV and experienced loneliness and the support of only a few people, they had hope to live and see the future of their children. Women diagnosed with HIV during pregnancy are ultimately concerned with the well-being of their unborn children, and this concern motivates their adherence to ART. Women's lived experiences are situated in their unique sociocultural context, and although some known challenges remain, counselling and support strategies need to be informed by exploring context-specific issues and involving the local community.

  8. Do clinical diagnoses correlate with pathological diagnoses in cardiac transplant patients? The importance of endomyocardial biopsy

    DEFF Research Database (Denmark)

    Luk, Adriana; Metawee, Mohammed; Ahn, Eric

    2009-01-01

    . Patient records were reviewed for preoperative clinical diagnoses and other relevant data, including pretransplant endomyocardial biopsy (EMB) results, information regarding left ventricular assist devices and, finally, evidence of disease recurrence in the grafted heart. RESULTS: A shift......BACKGROUND: Heart transplantation remains the last treatment option for patients with end-stage cardiac disease. Such diseases include ischemic cardiomyopathy, nonischemic cardiomyopathy and other conditions such as arrhythmogenic right ventricular dysplasia, cardiac sarcoidosis and cardiac...

  9. Initialized Fractional Calculus

    Science.gov (United States)

    Lorenzo, Carl F.; Hartley, Tom T.

    2000-01-01

    This paper demonstrates the need for a nonconstant initialization for the fractional calculus and establishes a basic definition set for the initialized fractional differintegral. This definition set allows the formalization of an initialized fractional calculus. Two basis calculi are considered; the Riemann-Liouville and the Grunwald fractional calculi. Two forms of initialization, terminal and side are developed.

  10. Defining safe criteria to diagnose miscarriage: prospective observational multicentre study

    Science.gov (United States)

    Preisler, Jessica; Kopeika, Julia; Ismail, Laure; Vathanan, Veluppillai; Farren, Jessica; Abdallah, Yazan; Battacharjee, Parijat; Van Holsbeke, Caroline; Bottomley, Cecilia; Gould, Deborah; Johnson, Susanne; Stalder, Catriona; Van Calster, Ben; Hamilton, Judith; Timmerman, Dirk

    2015-01-01

    Objectives To validate recent guidance changes by establishing the performance of cut-off values for embryo crown-rump length and mean gestational sac diameter to diagnose miscarriage with high levels of certainty. Secondary aims were to examine the influence of gestational age on interpretation of mean gestational sac diameter and crown-rump length values, determine the optimal intervals between scans and findings on repeat scans that definitively diagnose pregnancy failure.) Design Prospective multicentre observational trial. Setting Seven hospital based early pregnancy assessment units in the United Kingdom. Participants 2845 women with intrauterine pregnancies of unknown viability included if transvaginal ultrasonography showed an intrauterine pregnancy of uncertain viability. In three hospitals this was initially defined as an empty gestational sac <20 mm mean diameter with or without a visible yolk sac but no embryo, or an embryo with crown-rump length <6 mm with no heartbeat. Following amended guidance in December 2011 this definition changed to a gestational sac size <25 mm or embryo crown-rump length <7 mm. At one unit the definition was extended throughout to include a mean gestational sac diameter <30 mm or embryo crown-rump length <8 mm. Main outcome measures Mean gestational sac diameter, crown-rump length, and presence or absence of embryo heart activity at initial and repeat transvaginal ultrasonography around 7-14 days later. The final outcome was pregnancy viability at 11-14 weeks’ gestation. Results The following indicated a miscarriage at initial scan: mean gestational sac diameter ≥25 mm with an empty sac (364/364 specificity: 100%, 95% confidence interval 99.0% to 100%), embryo with crown-rump length ≥7 mm without visible embryo heart activity (110/110 specificity: 100%, 96.7% to 100%), mean gestational sac diameter ≥18 mm for gestational sacs without an embryo presenting after 70 days’ gestation (907/907 specificity: 100%, 99.6% to

  11. Diagnosing delayed ettringite formation in concrete structures

    International Nuclear Information System (INIS)

    Thomas, Michael; Folliard, Kevin; Drimalas, Thano; Ramlochan, Terry

    2008-01-01

    There has been a number of cases involving deteriorated concrete structures in North America where there has been considerable controversy surrounding the respective contributions of alkali-silica reaction (ASR) and delayed ettringite formation (DEF) to the observed damage. The problem arises because the macroscopic symptoms of distress are not unequivocal and microscopical examinations of field samples often reveal evidence of both processes making it difficult to separate the individual contributions. This paper presents the results of an investigation of a number of concrete columns carrying a raised expressway in North America; prior studies had implicated both DEF and ASR as possible causes of deterioration. Although the columns were not deliberately heat-cured, it is estimated that the peak internal temperature would have exceeded 70 deg. C and perhaps even 80 deg. C, in some cases. The forensic investigation included scanning electron microscopy with energy-dispersive X-ray analysis and expansion testing of cores extracted from the structure. Small-diameter cores stored in limewater expanded significantly (0.3 to 1.3%) and on the basis of supplementary tests on laboratory-produced concrete specimens it was concluded that expansion under such conditions is caused by DEF as the conditions of the test will not sustain ASR. In at least one column, DEF was diagnosed as the sole contributory cause of damage with no evidence of any contribution from ASR or any other deterioration process. In other cases, both ASR and DEF were observed to have contributed to the apparent damage. Of the columns examined, only concrete containing fly ash appeared to be undamaged. The results of this study confirm that, under certain conditions, the process of DEF (acting in isolation of other processes) can result in significant deterioration of cast-in-place reinforced concrete structures

  12. Ivory vertebra: imaging findings in different diagnoses

    Directory of Open Access Journals (Sweden)

    Richard Andreas Braun

    2016-04-01

    Full Text Available Abstract Low back pain is often managed at all levels of healthcare. In general, diagnostic investigation begins with radiography of the lumbar spine. In addition to the most common findings, radiologists can identify increased density of a vertebral body, referred to as ivory vertebra. The objective of this study was to describe the main diseases that can present with this radiologic sign, such as Hodgkin lymphoma, Paget's disease, metastatic prostate cancer, breast cancer, and osteomyelitis. It is extremely important that radiologists be aware of this finding in order to inform the requesting physician of the possible etiologies, given that it can be the initial radiologic presentation for these diseases.

  13. Ivory vertebra: imaging findings in different diagnoses

    Energy Technology Data Exchange (ETDEWEB)

    Braun, Richard Andreas; Goldman, Suzan Menasce; Fernandes, Eloy de Avila [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Milito, Carlos Felipe do Rego Barros, E-mail: braunrich@gmail.com [Universidade de Sao Paulo (InRad/HC/FM/USP), Sao Paulo, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas. Institutlo de Radiologia

    2016-03-15

    Low back pain is often managed at all levels of health care. In general, diagnostic investigation begins with radiography of the lumbar spine. In addition to the most common findings, radiologists can identify increased density of a vertebral body, referred to as ivory vertebra. The objective of this study was to describe the main diseases that can present with this radiologic sign, such as Hodgkin lymphoma, Paget's disease, metastatic prostate cancer, breast cancer, and osteomyelitis. It is extremely important that radiologists be aware of this finding in order to inform the requesting physician of the possible etiologies, given that it can be the initial radiologic presentation for these diseases. (author)

  14. Alternative splicing of exon 17 and a missense mutation in exon 20 of the insulin receptor gene in two brothers with a novel syndrome of insulin resistance (congenital fiber-type disproportion myopathy)

    DEFF Research Database (Denmark)

    Vorwerk, P; Christoffersen, C T; Müller, J

    1999-01-01

    to be compound heterozygotes for mutations in the IR gene. The maternal allele was alternatively spliced in exon 17 due to a point mutation in the -1 donor splice site of the exon. The abnormal skipping of exon 17 shifts the amino acid reading frame and leads to a truncated IR, missing the entire tyrosine kinase......The insulin receptor (IR) in two brothers with a rare syndrome of congenital muscle fiber type disproportion myopathy (CFTDM) associated with diabetes and severe insulin resistance was studied. By direct sequencing of Epstein-Barr virus-transformed lymphocytes both patients were found...

  15. Mallory-Weiss tear diagnosed in the immediate postpartum period: a case report.

    Science.gov (United States)

    Parva, Mehdi; Finnegan, Mark; Keiter, Cary; Mercogliano, Giancarlo; Perez, Christian M

    2009-08-01

    Mallory-Weiss tears occur rarely during pregnancy, labour and delivery, and the puerperium, despite the increased frequency of retching and vomiting. We describe a Mallory-Weiss syndrome diagnosed during the immediate postpartum period in a 34-year-old primigravida. The syndrome initially manifested as lower gastrointestinal bleeding and melena. If unrecognized, this complication may lead to life-threatening internal bleeding. It is important to look for an occult bleeding source with such a presentation, and prompt intervention is essential.

  16. Noninfectious differential diagnoses of pneumonia; Nichtinfektioese Differenzialdiagnosen von Pneumonien

    Energy Technology Data Exchange (ETDEWEB)

    Wielandner, A.; Toelly, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Wien (Austria); Agarwal, P. [Medizinische Universitaet Freiburg, Universitaetsklinik fuer Radiologie, Freiburg (Germany); Bardach, C. [Krankenhaus Hietzing, Abteilung fuer Radiologie, Wien (Austria)

    2017-01-15

    In patients with a clinical suspicion of pneumonia, typical clinical and laboratory features along with the detection of infiltrates on chest X-ray are as a rule considered diagnostic and therapy is immediately initiated; however, studies have shown that in up to 5% of patients with an initial suspicion of pneumonia, another noninfectious pulmonary disease was the underlying cause. Early recognition and differentiation of diseases mimicking pneumonia are prerequisites for an adequate therapy. The aim of this review is to present the important noninfectious differential diagnoses of pneumonia and to provide the reader with tools for a systematic diagnostic approach. A literature search was carried out. As alterations in the lungs often result in similar imaging appearances and a differentiation between transudates, exsudates, blood and cells is not feasible by chest X-ray or CT, a systematic approach is essential to make an appropriate diagnosis. Hence, consideration of the temporal course, predominant pattern, distribution of findings, additional findings and clinical presentation are indispensable. (orig.) [German] Bei der Verdachtsdiagnose Pneumonie sind die Kombination aus typischer Klinik, Labor und der Nachweis einer Verdichtung in der Roentgenthoraxaufnahme in der Regel diagnostisch und es wird umgehend mit der Therapie begonnen. Studien haben jedoch gezeigt, dass bei bis zu 5 % der Patienten mit Erstverdacht auf Pneumonie eine andere (pulmonale) Erkrankung zugrunde liegt. Ein fruehzeitiges Erkennen und eine Differenzierung von Erkrankungen, die eine Pneumonie vortaeuschen, sind fuer die weitere Behandlung essenziell. Uebersicht ueber wesentliche nichtinfektioese Differenzialdiagnosen der Pneumonie. Es wurde eine Literaturrecherche durchgefuehrt. Da krankhafte Lungenveraenderungen oft aehnliche Bilder hervorrufen und anhand der Roentgenthoraxaufnahme oder der CT-Untersuchung nicht zwischen Blut, Transsudat, Exsudat und Zellen differenziert werden kann, ist

  17. ABPM is best for diagnosing hypertension in primary care.

    Science.gov (United States)

    Hodgkinson, James; Wood, Sally; Martin, Una; McManus, Richard

    2011-10-01

    Ambulatory blood pressure monitoring (ABPM) is more accurate than clinic and home monitoring in diagnosing hypertension. A diagnostic strategy for hypertension using ABPM following an initial raised clinic reading would reduce misdiagnosis and NHS costs. If the first and second measurements taken during a consultation are both > or = 140/90 mmHg, 24-hour ABPM should be used to confirm the diagnosis of hypertension. Home monitoring can be used to confirm the diagnosis if the patient cannot tolerate ABPM. In cases of severe hypertension (clinic BP > or = 180/110 mmHg) and evidence of target organ damage, antihypertensive drug treatment should be started immediately without waiting for the results of ABPM or home monitoring. ABPM estimates true mean BP more accurately than clinic measurement because multiple readings are taken. It has been shown to have better correlation with a range of cardiovascular outcomes and end organ damage, Out-of-office methods can enable a diagnosis to be made more quickly. The benefits of these techniques, in particular ABPM, include the correct diagnosis of white coat hypertension and improved diagnostic accuracy. The weight of evidence suggests ABPM is the best prognostic indicator, followed by home then clinic monitoring. Stage 1 patients should only be offered antihypertensives if they have increased cardiovascular risk due to concurrent diabetes, chronic kidney disease, established CVD, target organ damage or a 10-year CVD risk >20%. Stage 2 patients should all be offered antihypertensives following ABPM or home monitoring, irrespective of their background cardiovascular risk.

  18. Comparing the Accuracy in Diagnosing Periapical Lesions by Conventional and Direct Digital Radiography

    Directory of Open Access Journals (Sweden)

    Ajay Parihar

    2010-01-01

    Full Text Available This study investigated the accuracy of diagnosing periapical lesions through conventional radiography (CR and direct digital radiography (DDR technique. A total of 170 patients with clinically suspected periapical pathosis and 30 normal subjects were included in the study. Both the conventional and digital images were taken with same exposure parameters keeping the film without lead foil and sensor simultaneously, to standardize the images. One endodontist and two oral radiologists evaluated all conventional and digital images and gave their final diagnosis for each technique separately. The diagnostic accuracy of each observer and image mode was calculated as the areas under receiver operating characteristic (ROC curves. The mean values were statistically compared with the Wilcoxon′s signed rank test. In results the intraobserver variation and interobserver variation were high with conventional radiographic technique in diagnosing initial periapical lesions. There was a slight increase in the mean values for digital technique and in the accuracy of diagnosing the periapical lesions but using wilcoxon signed rank test the z-value was 1.367 and p-value was 0-172. The results of this study suggest that for the diagnosis of initial periradicular pathosis, the difference between the conventional and Trophy RVG 5000 DDR systems is insignificant However, some advantages like elimination of chemical processing, immediate observation of radiographic images, ability to enhance images, and data storage make DDR preferable in comparison with CR for diagnosis of initial periapical lesions.

  19. Big Brother, little brother en de discussie over privacy

    NARCIS (Netherlands)

    Dr. Martijn de Groot

    2014-01-01

    In 1949 publiceerde George Orwell zijn boek ‘1984’, waarin hij een beklemmende samenleving beschrijft: een wereld die totaal gecontroleerd wordt door de overheid, waarbij élke stap die je doet wordt geregistreerd en zelfs het denken aan banden is gelegd. Nu, 65 jaar later, lijkt het niet Big

  20. Diagnosing family health and programming action.

    Science.gov (United States)

    1986-01-01

    This discussion considers the concepts of health and primary health before focusing on diagnosing community health. It is important to know what the concepts of health, of various diseases, and death represent for the population in which one is working. The primary health care (PHC) policy, for which many countries have opted since 1978, aimed at providing a more satisfactory response to the health needs expressed by the people, both felt and true needs. Frequently, health policy is defined at the national level. Guidelines for work are sent to the small clinics at the grassroots level, but this downward flowing system does not respect the PHC policy. The objective of PHC is to consider the grassroots level as the point of departure. The starting point is families, both urban and rural population groups, the underprivileged as well as the others, those who attend the health units and those who never attend because there are none. This system, which goes from the bottom to the top, is still far from being operational everywhere and often is in conflict with the classical system, with which it coexists. If a health team is to achieve a community health diagnosis, it must have sufficient knowledge of the geographic sector served by the health unit. The techniques used for diagnosis are epidemiological studies, listening to individuals, observations of the surroundings and of behavior, and sociological or epidemiological surveys. Quantitative data and the results of listening, observation, and surveys should be written down regularly. A "health notebook" or "daily narration" book for the neighborhood, village, or district should tell of the life of the people, or at least of those elements of it which affect health or nutrition. The health of each family should be recorded in a "family file" containing information on the sociocultural and economic background of the family, how it is housed, a "record card" for each of its members, so that the evolution of his

  1. Outcome of Endodontically Treated Teeth Diagnosed With Cracked Tooth

    Science.gov (United States)

    2015-06-01

    population of 8, 175 patients (3). When diagnosed with reversible pulpitis and restored with a crown, 21 % of these teeth were reported to require...3.7% with split tooth, and 1.9% as fractured cusp (13). Other possible diagnoses include reversible pulpitis , postoperative sensitivity, galvanic...irreversible pulpitis , RCT followed by crown placement is the recommended treatment (4). In a study of 49 patients diagnosed with irreversible pulpitis , teeth

  2. Clinical Prediction Model for Time in Therapeutic Range While on Warfarin in Newly Diagnosed Atrial Fibrillation.

    Science.gov (United States)

    Williams, Brent A; Evans, Michael A; Honushefsky, Ashley M; Berger, Peter B

    2017-10-12

    Though warfarin has historically been the primary oral anticoagulant for stroke prevention in newly diagnosed atrial fibrillation (AF), several new direct oral anticoagulants may be preferred when anticoagulation control with warfarin is expected to be poor. This study developed a prediction model for time in therapeutic range (TTR) among newly diagnosed AF patients on newly initiated warfarin as a tool to assist decision making between warfarin and direct oral anticoagulants. This electronic medical record-based, retrospective study included newly diagnosed, nonvalvular AF patients with no recent warfarin exposure receiving primary care services through a large healthcare system in rural Pennsylvania. TTR was estimated as the percentage of time international normalized ratio measurements were between 2.0 and 3.0 during the first year following warfarin initiation. Candidate predictors of TTR were chosen from data elements collected during usual clinical care. A TTR prediction model was developed and temporally validated and its predictive performance was compared with the SAMe-TT 2 R 2 score (sex, age, medical history, treatment, tobacco, race) using R 2 and c-statistics. A total of 7877 newly diagnosed AF patients met study inclusion criteria. Median (interquartile range) TTR within the first year of starting warfarin was 51% (32, 67). Of 85 candidate predictors evaluated, 15 were included in the final validated model with an R 2 of 15.4%. The proposed model showed better predictive performance than the SAMe-TT 2 R 2 score ( R 2 =3.0%). The proposed prediction model may assist decision making on the proper mode of oral anticoagulant among newly diagnosed AF patients. However, predicting TTR on warfarin remains challenging. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  3. Reduced parasympathetic tone in newly diagnosed essential hypertension

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar Goit

    2016-03-01

    Conclusion: These findings suggest that HRV is reduced in subjects with newly diagnosed essential hypertension and the parasympathetic dysregulation is present in the early stage of essential hypertension.

  4. Modifying DRG-PPS to include only diagnoses present on admission: financial implications and challenges.

    Science.gov (United States)

    Zhan, Chunliu; Elixhauser, Anne; Friedman, Bernard; Houchens, Robert; Chiang, Yen-Pin

    2007-04-01

    The inability to distinguish complications acquired in hospital from comorbid conditions that are present on admission (POA) has long hampered the use of claims data in quality and safety research. Now pay-for-performance initiatives and legislation requiring Medicare to reduce payment for acquired infections add imperative for POA coding. This study used data from 2 states currently coding POA to assess the financial impact if Medicare pays based on POA conditions only and to examine the challenges in implementing POA coding. Medicare payments were calculated based first on all diagnoses and then on POA diagnoses in the Medicare discharge abstracts from California and New York in 2003, using the Diagnosis Related Group (DRG)-based Prospective Payment System (PPS) formula. The potential savings that result from excluding non-POA diagnoses were calculated. Patterns of POA coding were explored. Medicare could have saved $56 million in California, $51 million in New York, and $800 million nationwide in 2003 had it paid hospital claims based only on POA diagnoses. Approximately 15% of the claims had non-POA codes, but only 1.4% of the claims were reassigned to lower-cost DRGs after excluding non-POA diagnoses. Excluding non-POA diagnoses resulted in reduced payment for operating costs, but increased outlier payments because some of the claims were designated as "unusually high cost" in the lower-cost DRGs. POA coding patterns suggest some problems in current POA coding. To be consistent with pay-for-performance principles and make claims data more useful for quality assurance, incorporating POA coding into DRG-PPS could produce sizable savings for Medicare.

  5. Dioxin Exposure Initiative

    Science.gov (United States)

    The Dioxin Exposure Initiative (DEI) is no longer active. This page contains a summary of the dioxin exposure initiative with illustrations, contact and background information.Originally supported by scientist Matthew Lorber, who retired in Mar 2017.

  6. 20 CFR 410.610 - Administrative actions that are initial determinations.

    Science.gov (United States)

    2010-04-01

    ... HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Determinations of Disability, Other... § 410.511(a)). (n) Support of parent, brother, or sister. The Administration shall make findings..., brother, or sister, meets the requirements for support from the miner set forth in the pertinent...

  7. Characteristics of children presenting with newly diagnosed type 1 ...

    African Journals Online (AJOL)

    Of these, half a million are children under the age of 15 years diagnosed with type 1 diabetes. Type 1 diabetes is increasing in incidence worldwide at a rate of 2 - 5% per year, and roughly 200 children are diagnosed with new-onset type 1 diabetes every day.[1] The condition is increasing in all age groups, with a ...

  8. Terahertz otoscope and potential for diagnosing otitis media.

    Science.gov (United States)

    Ji, Young Bin; Moon, In-Seok; Bark, Hyeon Sang; Kim, Sang Hoon; Park, Dong Woo; Noh, Sam Kyu; Huh, Yong-Min; Suh, Jin-Seok; Oh, Seung Jae; Jeon, Tae-In

    2016-04-01

    We designed and fabricated a novel terahertz (THz) otoscope to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application.

  9. Terahertz otoscope and potential for diagnosing otitis media

    OpenAIRE

    Ji, Young Bin; Moon, In-Seok; Bark, Hyeon Sang; Kim, Sang Hoon; Park, Dong Woo; Noh, Sam Kyu; Huh, Yong-Min; Suh, Jin-Seok; Oh, Seung Jae; Jeon, Tae-In

    2016-01-01

    We designed and fabricated a novel terahertz (THz) otoscope to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application.

  10. Quality of life in children with undiagnosed and diagnosed asthma

    NARCIS (Netherlands)

    van Gent, R.; van Essen, L.E.; Rovers, M.M.; Kimpen, J.L.; van der Ent, C.K.; de Meer, G.

    This study describes the impact of undiagnosed and diagnosed asthma on quality of life in schoolchildren aged 7-10 years and their caregivers in a cross-sectional community-based study. Diagnosed asthma was defined as the parents' confirmation of a physician's diagnosis of asthma. Undiagnosed asthma

  11. Problems faced by newly diagnosed diabetes mellitus patients at ...

    African Journals Online (AJOL)

    Diabetes mellitus can be a frightening experience for newly diagnosed patients. The aim of this study was to determine and describe the problems faced by newly diagnosed diabetes mellitus patients at primary healthcare facilities at Mopani district, Limpopo Province. A qualitative, descriptive and contextual research ...

  12. Collective Thomson scattering capabilities to diagnose fusion plasmas

    DEFF Research Database (Denmark)

    Korsholm, Søren Bang; Bindslev, Henrik; Furtula, Vedran

    2010-01-01

    Collective Thomson scattering (CTS) is a versatile technique for diagnosing fusion plasmas. In particular, experiments on diagnosing the ion temperature and fast ion velocity distribution have been executed on a number of fusion devices. In this article the main aim is to describe the technique, ...

  13. Diagnosing and reporting of occupational diseases: a quality improvement study

    NARCIS (Netherlands)

    Spreeuwers, D.; de Boer, A. G. E. M.; Verbeek, J. H. A. M.; van Beurden, M. M.; van Dijk, F. J. H.

    2008-01-01

    AIM: To assess the need for quality improvement of diagnosing and reporting of noise-induced occupational hearing loss and occupational adjustment disorder. METHODS: Performance indicators and criteria for the quality of diagnosing and reporting were developed. Self-assessment questionnaires were

  14. Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is ...

    African Journals Online (AJOL)

    Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is Pre and Post Counseling Still Being Adequately Practiced? ... A case of attempted suicide in a recently diagnosed HIV positive subject without adequate counseling is reported. Subject ... Key Words: Suicide Attempt, HIV/AIDS, Pre and Post test Counseling.

  15. Assessment for markers of nephropathy in newly diagnosed type 2 ...

    African Journals Online (AJOL)

    Objective: To assess for markers of nephropathy in newly diagnosed type 2 diabetics, using blood pressure levels, endogenous creatinine clearance and urinary protein excretion as markers of renal disease. Study design: Ninety newly diagnosed type 2 diabetics were studied within 6 weeks of diagnosis. They were in ...

  16. Profile of clinically-diagnosed dementias in a neuropsychiatric ...

    African Journals Online (AJOL)

    Alzheimer's disease (AD), whose prevalence ranges between 1.41 % and 1.86%, being the most common type.6,7. However, in a previous retrospective study of clinically- diagnosed dementing illnesses in Ibadan, 37 cases of dementia diagnosed according to the ICD-9 and DSM-IIIR criteria were seen over a six year ...

  17. Developing of a Computerized Brain Diagnosing System for Case ...

    African Journals Online (AJOL)

    The main purpose of this project is to design a computerized brain diagnosing system that would be used in carrying out the daily diagnosing activity in the clinic. The developed computerized system has numerous advantages over manual operation which is very tedious and time consuming. As part of the research method ...

  18. Ethical dilemma and moral distress: proposed new NANDA diagnoses.

    Science.gov (United States)

    Kopala, Beverly; Burkhart, Lisa

    2005-01-01

    To propose two NANDA diagnoses--ethical dilemma and moral distress--and to distinguish between the NANDA diagnosis decisional conflict and the proposed nursing diagnosis of ethical dilemma. Journal articles, books, and focus group research findings. Moral/ethical situations exist in health care. Nurses' experiences of ethical dilemmas and moral distress are extrapolated to the types and categories of ethical dilemmas and moral distress that patients experience and are used as the basis for development of two new nursing diagnoses. The two proposed NANDA diagnoses fill a void in current standardized terminology. It is important that nurses have the ability to diagnose ethical or moral situations in health care. Currently, NANDA does not offer a means to document this important phenomenon. The creation of two sets of nursing diagnoses, ethical dilemma and moral distress, will enable nurses to recognize and track nursing care related to ethical or moral situations.

  19. Nursing diagnoses in a Brazilian intensive care unit.

    Science.gov (United States)

    de Fátima Lucena, Amália; de Barros, Alba Lúcia Bottura Leite

    2006-01-01

    To identify the nursing diagnoses and their most frequent related factors or risk factors in patients admitted to an intensive care unit (ICU). Descriptive cross-sectional study with information from 991 admissions to an ICU during a 6-month period. Sixteen nursing diagnoses resulting from hospitalization were most frequently identified; six had percentages greater than 40% with 29 related/risk factors. The resulting averages were 6.9 diagnoses per hospitalization and 1.2 related/risk factors per nursing diagnoses. The nursing diagnoses identified seemed to be common to the clinical practice of nursing and their fundamental related/risk factors to precise clinical judgment, thus providing a basis for interventions for a desired outcome. The findings have contributed to the development of the standardized nursing language usage in Brazilian nursing practices.

  20. Nursing diagnoses in patients with chronic venous ulcer: observational study

    Directory of Open Access Journals (Sweden)

    Glycia de Almeida Nogueira

    2015-06-01

    Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients.  Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.

  1. Increase in depression diagnoses and prescribed antidepressants among young girls

    DEFF Research Database (Denmark)

    Skovlund, Charlotte Wessel; Kessing, Lars Vedel; Mørch, Lina Steinrud

    2017-01-01

    AIMS: To analyse trends in depression diagnoses and antidepressant use according to age and gender. METHODS: Nationwide cohort study including all women and men of 10-49 years living in Denmark during 2000-2013. The Psychiatric Registry and Prescription Registry provided data on depression...... diagnoses and antidepressant medication, respectively. Incidence rates as well as 1-year prevalence rates were calculated. RESULTS: The incidence and 1-year prevalence rates of depression diagnoses increased during 2000-2013. The women/men rates were 2.0 for both 1-year prevalence of depressions diagnoses...... and antidepressant use. For adolescent girls, the absolute increase was 3 per 1000 for depression diagnoses and 8 per 1000 for first use of antidepressants, compared to boys who had an increase of 1.1 and 3 per 1000, respectively. Before puberty, boys and girls had almost the same incidence rates of both depression...

  2. Do clinical diagnoses correlate with pathological diagnoses in cardiac transplant patients? The importance of endomyocardial biopsy

    DEFF Research Database (Denmark)

    Luk, Adriana; Metawee, Mohammed; Ahn, Eric

    2009-01-01

    BACKGROUND: Heart transplantation remains the last treatment option for patients with end-stage cardiac disease. Such diseases include ischemic cardiomyopathy, nonischemic cardiomyopathy and other conditions such as arrhythmogenic right ventricular dysplasia, cardiac sarcoidosis and cardiac...... of 296 surgically excised hearts over a 20-year period (January 1987 to July 2006) at one institution were examined. Patients were separated into groups based on year of heart transplantation. The tissue was examined to determine the underlying cardiac pathology leading to congestive heart failure...... amyloidosis. OBJECTIVE: To review the changes that have occurred over time in the etiology of heart disease in patients requiring heart transplantation, and to compare the clinical and histological diagnoses of explanted hearts from patients with progressive cardiac disease. METHODS: The pathological findings...

  3. Is Serial Testing Required to Diagnose Imported Malaria in the Era of Rapid Diagnostic Tests?

    Science.gov (United States)

    Pasricha, Janet M.; Juneja, Surender; Manitta, Joseph; Whitehead, Susan; Maxwell, Ellen; Goh, Wai-Keong; Pasricha, Sant-Rayn; Eisen, Damon P.

    2013-01-01

    Exclusion of malaria traditionally requires three negative serial thick and thin blood films. However, many clinical laboratories now routinely perform rapid diagnostic tests (RDTs) in addition to blood films when malaria is suspected. We sought to determine whether serial testing is necessary in this setting. We examined 388 cases of malaria diagnosed during 1999–2010 at three laboratories in Melbourne, Australia. For each case, we ascertained whether the diagnosis was made on initial or follow-up testing. Nine cases (3.5%) were diagnosed after a negative initial blood film and RDT: 7 Plasmodium vivax, 1 P. ovale, and 1 P. falciparum. Of four case-patients with P. vivax in which clinical data were available, all had recent exposure to antimalarial medication. Our data suggest that among patients who have not received recent anti-malarial therapy, and when RDTs are performed and blood films are prepared, most malaria diagnoses are made by using the first set of tests. PMID:23208885

  4. HEMODYNAMIC AND METABOLIC EFFECTS OF NEBIVOLOL IN LOCOMOTIVE CREW STAFF WITH NEWLY DIAGNOSED ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    I. V. Osipova

    2010-01-01

    Full Text Available Aim. To evaluate influence of long-term monotherapy with nebivolol on blood pressure (BP (office BP; self-monitoring BP, pre-trip BP monitoring, ambulatory BP monitoring (ABPM and metabolic blood profile in locomotive crew staff with newly diagnosed arterial hypertension (HT.Material and methods. Locomotive crew engineers and their assistants (n=50; age 20-55 y.o. with newly diagnosed HT 1-2 degree with moderate-to-high cardiovascular risk were included into the open prospective uncontrolled study. The study duration was 12 months. The office BP level, heart rate were evaluated initially, in 12 weeks and 12 months of treatment; pre-trip BP level – one time per month; ABPM and blood biochemical tests (glucose and lipid profile - initially and in 12 months of therapy. Data of BP self-monitoring, nebivolol treatment compliance and safety was also evaluated.Results. Long-term monotherapy with nebivolol allowed reaching the target level of office BP, self-monitoring BP, ABPM. Nebivolol provided BP control both in working days and in week end. Efficacy of nebivolol monotherapy was 88%. Nebivolol therapy improved basic ABPM indicators (load pressure, variability, daily rhythm, pulse BP, heart rate. Nebivolol had no significant negative metabolic effects, 78% of patients demonstrated sufficient compliance with nebivolol treatment. Adverse reaction (bradycardia was observed in 2 (4% patients.Conclusion. Nebivolol has high antihypertensive efficacy, metabolic neutrality and good safety profile in the locomotive crew staff with newly diagnosed HT.

  5. Depression diagnoses following the identification of bipolar disorder: costly incongruent diagnoses

    Directory of Open Access Journals (Sweden)

    Schultz Jennifer F

    2010-06-01

    Full Text Available Abstract Background Previous research has documented that the symptoms of bipolar disorder are often mistaken for unipolar depression prior to a patient's first bipolar diagnosis. The assumption has been that once a patient receives a bipolar diagnosis they will no longer be given a misdiagnosis of depression. The objectives of this study were 1 to assess the rate of subsequent unipolar depression diagnosis in individuals with a history of bipolar disorder and 2 to assess the increased cost associated with this potential misdiagnosis. Methods This study utilized a retrospective cohort design using administrative claims data from 2002 and 2003. Patient inclusion criteria for the study were 1 at least 2 bipolar diagnoses in 2002, 2 continuous enrollment during 2002 and 2003, 3 a pharmacy benefit, and 4 age 18 to 64. Patients with at least 2 unipolar depression diagnoses in 2003 were categorized as having an incongruent diagnosis of unipolar depression. We used propensity scoring to control for selection bias. Utilization was evaluated using negative binomial models. We evaluated cost differences between patient cohorts using generalized linear models. Results Of the 7981 patients who met all inclusion criteria for the analysis, 17.5% (1400 had an incongruent depression diagnosis (IDD. After controlling for background differences, individuals who received an IDD had higher rates of inpatient and outpatient psychiatric utilization and cost, on average, an additional $1641 per year compared to individuals without an IDD. Conclusions A strikingly high proportion of bipolar patients are given the differential diagnosis of unipolar depression after being identified as having bipolar disorder. Individuals with an IDD had increased acute psychiatric care services, suggesting higher levels of relapses, and were at risk for inappropriate treatment, as antidepressant therapy without a concomitant mood-stabilizing medication is contraindicated in bipolar

  6. Fragile X syndrome: a review of clinical and molecular diagnoses.

    Science.gov (United States)

    Ciaccio, Claudia; Fontana, Laura; Milani, Donatella; Tabano, Silvia; Miozzo, Monica; Esposito, Susanna

    2017-04-19

    Fragile X Syndrome (FXS) is the second cause of intellectual disability after Down syndrome and the most prevalent cause of intellectual disability in males, affecting 1:5000-7000 men and 1:4000-6000 women. It is caused by an alteration of the FMR1 gene, which maps at the Xq27.3 band: more than 99% of individuals have a CGG expansion (>200 triplets) in the 5' UTR of the gene, and FMR1 mutations and duplication/deletion are responsible for the remaining (<1%) molecular diagnoses of FXS. The aim of this review was to gather the current clinical and molecular knowledge about FXS to provide clinicians with a tool to guide the initial assessment and follow-up of FXS and to offer to laboratory workers and researchers an update about the current diagnostic procedures. FXS is a well-known condition; however, most of the studies thus far have focused on neuropsychiatric features. Unfortunately, some of the available studies have limitations, such as the paucity of patients enrolled or bias due to the collection of the data in a single-country population, which may be not representative of the average global FXS population. In recent years, insight into the adult presentation of the disease has progressively increased. Pharmacological treatment of FXS is essentially symptom based, but the growing understanding of the molecular and biological mechanisms of the disease are paving the way to targeted therapy, which may reverse the effects of FMRP deficiency and be a real cure for the disease itself, not just its symptoms. The clinical spectrum of FXS is wide, presenting not only as an isolated intellectual disability but as a multi-systemic condition, involving predominantly the central nervous system but potentially affecting any apparatus. Given the relative high frequency of the condition and its complex clinical management, FXS appears to have an important economic and social burden.

  7. Surgical Excision of Benign Papillomas Diagnosed with Core Biopsy: A Community Hospital Approach

    International Nuclear Information System (INIS)

    Rozentsvayg, Eka; Carver, Kristen; Borkar, Sunita; Mathew, Melvy; Enis, Sean; Friedman, Paul

    2011-01-01

    Our goal was to assess the value of surgical excision of benign papillomas of the breast diagnosed on percutaneous core biopsy by determining the frequency of upgrade to malignancies and high risk lesions on a final surgical pathology. We reviewed 67 patients who had biopsies yielding benign papilloma and underwent subsequent surgical excision. Surgical pathology of the excised lesions was compared with initial core biopsy pathology results. 54 patients had concordant benign core and excisional pathology. Cancer (ductal carcinoma in situ and invasive ductal carcinoma) was diagnosed in five (7%) patients. Surgery revealed high-risk lesions in 8 (12%) patients, including atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ. Cancer and high risk lesions accounted for 13 (19%) upstaging events from benign papilloma diagnosis. Our data suggests that surgical excision is warranted with core pathology of benign papilloma

  8. CT-MPR invaluable in diagnosing odontogenic maxillary sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Aoki, Hideaki; Shimazu, Kaoru; Kamada, Morito; Shiroyama, Akihiro; Mouri, Daisuke; Yamashita, Masashi; Kawasaki, Yasunori; Koseki, Takakazu; Mouri, Manabu [Osaka Dental Univ. (Japan)

    2001-08-01

    In everyday examination, it is usual to encounter odontogenic maxillary sinusitis patients. Odontogenic maxillary sinusitis is generally best diagnosed by dental X-ray imaging. Many medical facilities not having a dental X-ray unit use coronal computed tomography (CT) images to diagnose odontogenic maxillary sinusitis. Coronal CT imaging causes artifacts, however due to dental prosthesises. Computed tomography-Multiplanar reformation (CT-MPR) imaging has proved useful in evaluating the paranasal sinus because it is not influenced by dental prosthesises. We evaluated the usefulness of CT-MPR for diagnosing odontogenic maxillary sinusitis by retrospectively analyzing 16 patients, with the following results. We couldn't diagnose all cases of odontogenic maxillary sinusitis in posteroanterior and Waters projection images. Panoramic radiography is needed to diagnose odontogenic maxillary sinusitis. Dental X-ray imaging missed some cases, but all cases were diagnosed by CT-MPR imaging, giving a 100% diagnosestic rate. CT-MPR imaging is thus at least as valuable or better than dental X-ray imaging in diagnosing odontogenic maxillary sinusitis. (author)

  9. Emerging Pathogens Initiative (EPI)

    Data.gov (United States)

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

  10. Gregorio y Francisco Esparza: hermanos enfrentados ante la independencia de Texas, 1835-1836 Gregorio and Francisco Esparza: Brothers Who Fought Each Other During the Independence of Texas, 1835-1836

    Directory of Open Access Journals (Sweden)

    Gustavo Ernesto Emmerich

    2012-08-01

    Full Text Available En 1836 el ejército mexicano tomó el fuerte de El Álamo, en las afueras de San Antonio. Todos sus defensores, que combatían por la independencia de Texas, murieron en la acción, entre ellos Gregorio Esparza, un nativo de esa ciudad. Tras la batalla, su hermano Francisco, enrolado en el bando mexicano, le dio cristiana sepultura. Este artículo examina la saga de ambos hermanos virtualmente desconocida en México. La primera sección de este artículo contextualiza la independencia de Texas, la segunda contiene resultados de investigación documental realizada por el autor sobre Gregorio y Francisco Esparza. La tercera comenta una entrevista realizada a un hijo de Gregorio sobre los papeles de su padre y su tío en El Álamo. La cuarta evalúa críticamente las evidencias. La quinta ofrece una reflexión sobre los motivos que habrían llevado a los hermanos Esparza -y en general a la comunidad texana de origen mexicano- a enfrentarse respecto a la independencia de Texas y, finalmente, en los anexos se transcriben los registros parroquiales y censales de la época y se extractan y comentan diversos relatos del hijo de Gregorio y de otros descendientes.In 1836, the Mexican army captured Fort Alamo outside San Antonio. All its defenders, who were fighting for the independence of Texas, died in action. Among these was Gregorio Esparza, a native of that city. After this battle, his brother Francisco, enlisted in the Mexican army, gave him a Christian burial. This article examines the saga of the two brothers, virtually unknown in Mexico. The first section contextualizes the independence of Texas. The second contains the results of the author's documentary research on Gregorio and Francisco Esparza. The third comments on an interview with one of Gregorio's sons on the roles played by his father and uncle at The Alamo. The fourth critically evaluates the evidence. The fifth provides a reflection on the reasons that led the Esparza brothers -and the

  11. Frequency of chest pain in primary care, diagnostic tests performed and final diagnoses.

    Science.gov (United States)

    Hoorweg, Beatrijs Bn; Willemsen, Robert Ta; Cleef, Lotte E; Boogaerts, Tom; Buntinx, Frank; Glatz, Jan Fc; Dinant, Geert Jan

    2017-11-01

    Observational study of patients with chest pain in primary care: determination of incidence, referral rate, diagnostic tests and (agreement between) working and final diagnoses. 118 general practitioners (GPs) in the Netherlands and Belgium recorded all patient contacts during  2weeks. Furthermore, patients presenting with chest pain were registered extensively. A follow-up form was filled in after 30 days. 22 294 patient contacts were registered. In 281 (1.26%), chest pain was a reason for consulting the GP (mean age for men 54.4/women 53 years). In this cohort of 281 patients, in 38.1% of patients, acute coronary syndrome (ACS) was suspected at least temporarily during consultation, 40.2% of patients were referred to secondary care and 512 diagnostic tests were performed by GPs and consulted specialists. Musculoskeletal pain was the most frequent working (26.1%) and final diagnoses (33.1%). Potentially life-threatening diseases as final diagnosis (such as myocardial infarction) accounted for 8.4% of all chest pain cases. In 23.1% of cases, a major difference between working and final diagnoses was found, in 0.7% a severe disease was initially missed by the GP. Chest pain was present in 281 patients (1.26% of all consultations). Final diagnoses were mostly non-life-threatening. Nevertheless, in 8.4% of patients with chest pain, life-threatening underlying causes were identified. This seems reflected in the magnitude and wide variety of diagnostic tests performed in these patients by GPs and specialists, in the (safe) overestimation of life-threatening diseases by GPs at initial assessment and in the high referral rate we found. © 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 granted.

  12. Intertester reliability of shoulder complaints diagnoses in primary health care.

    Science.gov (United States)

    Storheil, Benny; Klouman, Elise; Holmvik, Stian; Emaus, Nina; Fleten, Nils

    2016-09-01

    Shoulder complaints are frequently encountered in general practice, but precise diagnosing is challenging. This study investigated agreement of shoulder complaints diagnoses between clinicians in a primary health care setting. Cross-sectional study. Four primary health care clinicians used patients' history and functional examination of the shoulder by selective tissue tension techniques (STTs), to diagnose shoulder complaints. 62 patients, aged 18-75 years. Reliability of diagnoses was assessed by observed intertester agreement and Cohen's kappa. A total of 372 diagnostic pairs were available for intertester comparisons. Six diagnoses were assigned by all clinicians; supraspinatus-, infraspinatus-, subscapularis-tendinopathies; chronic subacromial bursitis; glenohumeral capsulitis, and acromioclavicular joint lesion. The observed agreement on these diagnoses ranged from 0.84 for glenohumeral capsulitis to 0.97 for acromioclavicular joint lesion. Kappa scores were 0.46 (95% CI 0.33, 0.58) for chronic subacromial bursitis; 0.53 (95% CI 0.34, 0.68), 0.59 (95% CI 0.47, 0.70), and 0.68 (95% CI 0.53, 0.82) for infraspinatus -, supraspinatus -, and subscapularis-tendinopathy, respectively. For glenohumeral capsulitis and acromioclavicular lesion kappa scores were 0.66 (95% CI 0.57, 0.73) and 0.78 (95% CI 0.61, 0.90). Kappa scores were higher for individual diagnoses than for individual tests, except for limitation in passive abduction (0.70, 95% CI 0.62, 0.78) and passive lateral rotation (0.66, 95% CI 0.57, 0.73). Although experienced clinicians showed substantial intertester agreement, precise diagnoses of shoulder complaints in primary health care remain a challenge. The present results call for further research on refined diagnoses of shoulder complaints. Key points   Based on medical history and a systematic functional examination by selective tissue tension techniques (STTs), we investigated the agreement of shoulder complaints diagnoses across four primary

  13. Winning with Initiative

    Science.gov (United States)

    Morgan, Matthew J.

    2004-01-01

    A common complaint among high school coaches is the lack of initiative shown by some of their players. Coaches expect a certain level of decision-making and independence, and more so from team captains and senior players. Developing leadership skills is a major benefit to athletes who participate at a competitive level, and taking initiative can…

  14. Cornelia de Lange syndrome: To diagnose or not to diagnose in utero?

    Science.gov (United States)

    Avagliano, Laura; Bulfamante, Gaetano Pietro; Massa, Valentina

    2017-06-01

    Cornelia de Lange syndrome (CdLS) is an inherited condition with a wide spectrum of phenotypic anomalies, consisting mainly of growth impairment, multi-organ abnormalities, and neurocognitive delay. Clinical diagnostic criteria after birth are well defined, whereas when to suspect the syndrome during intrauterine life still remains undefined. This review summarizes the main possible prenatal findings in CdLS, suggesting that a skilled ultrasound scan in cases of intrauterine growth restriction associated with other fetal abnormalities may improve the chance of prenatal diagnosis of CdLS, especially in families known to be at high risk. We propose that, following a sequence of detailed scans and examinations, CdLS affected fetuses could be diagnosed in utero, when one or more conditions (among them, intrauterine growth restriction, limb defects, facial abnormalities, diaphragmatic hernia, and heart diseases) are detected, and possibly confirmed by specific molecular testing. Birth Defects Research 109:771-777, 2017. © 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc. © 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc.

  15. More Chemotherapy May Help after Initial Treatment for Childhood Leukemia Fails

    Science.gov (United States)

    A study suggests that at least some children diagnosed with acute lymphoblastic leukemia who respond poorly to initial chemotherapy may do better if they receive additional chemotherapy rather than a stem cell transplant.

  16. Peritoneal drainage versus laparotomy as an initial treatment in ...

    African Journals Online (AJOL)

    Objective To determine whether initial peritoneal drainage (PD) or primary laparotomy is the most effective intervention in very-low-birth-weight and extremely lowbirth- weight infants who are diagnosed with necrotizing enterocolitis (NEC, Bell's stage II and stage III). Patients and methods It is a retrospective chart review ...

  17. Sustainable Agricultural Marketing Initiatives

    Directory of Open Access Journals (Sweden)

    Hakan Adanacıoğlu

    2015-07-01

    Full Text Available Sustainable marketing is a holistic approach that puts equal emphasis on environmental, social equity, and economic concerns in the development of marketing strategies. The purpose of the study is to examine and discuss the sustainable agricultural marketing initiatives practiced throughout the World and Turkey, and to put forth suggestions to further improve the performance of agricultural marketing initiatives in Turkey. Some of the sustainable agricultural marketing initiatives practiced around the world are carried out through civil organizations. Furthermore; some of these initiatives have also launched by farmers, consumers, food processors and retailers. The long-term strategies to increase these initiatives should be determined due to the fact that examples of successful sustainable agricultural marketing initiatives are inadequate and cannot be spread in Turkey. In this context, first of all, the supports provided by the government to improve agricultural marketing systems, such as EU funds for rural development should be compatible with the goals of sustainable marketing. For this purpose, it should be examined whether all proposed projects related to agricultural marketing meet the social, economic, and environmental principles of sustainable marketing. It is important that supporting organizations, especially civil society organisations, should take an active role for faster dissemination and adoption of sustainable agricultural marketing practices in Turkey. These organizations may provide technical assistance in preparing successful project proposals and training to farm groups. In addition, the other organizations, such as local administrations, producers' associations, cooperatives, can contribute to the success of sustainable agricultural marketing initiatives. The use of direct marketing strategies and vertical integration attempts in sustainable agricultural marketing initiatives that will likely be implemented in Turkey is

  18. Accuracy in inference of nursing diagnoses in heart failure patients.

    Science.gov (United States)

    Pereira, Juliana de Melo Vellozo; Cavalcanti, Ana Carla Dantas; Lopes, Marcos Venícios de Oliveira; da Silva, Valéria Gonçalves; de Souza, Rosana Oliveira; Gonçalves, Ludmila Cuzatis

    2015-01-01

    Heart failure (HF) is a common cause of hospitalization and requires accuracy in clinical judgment and appropriate nursing diagnoses. to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients. descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating efficacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected. the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identified by the nursing evaluators. the search for improving diagnostic accuracy reaffirms the need for continuous and specific training to improve the diagnosis capability of nurses. the training allowed the exercise of clinical judgment and better accuracy of nurses.

  19. How Do Health Care Providers Diagnose Neural Tube Defects?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose neural tube defects? Neural tube defects ... AFP, as well as high levels of acetylcholinesterase; health care providers might conduct this test to confirm high ...

  20. How Do Health Care Providers Diagnose Klinefelter Syndrome?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose Klinefelter syndrome (KS)? The only way ... karyotype (pronounced care-EE-oh-type ) test. A health care provider will take a small blood or skin ...

  1. How Do Health Care Providers Diagnose Pregnancy Loss or Miscarriage?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How Do Health Care Providers Diagnose and Treat Pregnancy Loss (Before 20 ... light spotting, or bleeding, she should contact her health care provider immediately. Remember that vaginal bleeding during pregnancy ...

  2. How Do Health Care Providers Diagnose Bacterial Vaginosis (BV)?

    Science.gov (United States)

    ... Share Facebook Twitter Pinterest Email Print How do health care providers diagnose Bacterial Vaginosis (BV)? Diagnosis of BV requires a vaginal exam by a qualified health care provider and the laboratory testing of fluid collected ...

  3. Seven Patients With Transcobalamin Deficiency Diagnosed Between 2010 and 2014

    DEFF Research Database (Denmark)

    Yildirim, Zuhal K; Nexo, Ebba; Rupar, Tony

    2017-01-01

    Transcobalamin deficiency (OMIM 275350) is a rare autosomal recessive disease presenting with nonspecific clinical features in early infancy. We report the clinical and laboratory manifestations of 7 children diagnosed with transcobalamin deficiency. All patients were admitted between 2 and 4...

  4. Nursing diagnoses and interventions in children submitted to cochlear implantation

    Directory of Open Access Journals (Sweden)

    Patrícia Juliana Santos Pereira

    Full Text Available Abstract OBJECTIVE Identifying the main nursing diagnoses and interventions in children submitted to cochlear implant in the immediate postoperative period. METHOD A cross-sectional study conducted between February and April 2016, considering nursing history (anamnesis and physical examination and nursing diagnoses (NANDA - International with their respective interventions (Nursing Intervention Classification - NIC. Descriptive statistical analysis was used to construct the results. RESULTS A total of 19 children participated in this study. The main nursing diagnoses listed were: impaired verbal communication, impaired skin integrity, risk for infection, risk for falls, and risk for bleeding (n=19; 100%. Regarding the nursing interventions, the following prevailed: Improvement in communication: auditory deficit, Skin surveillance, Protection against infection, Prevention of falls and Precautions against bleeding (n=19; 100%. CONCLUSION Nursing diagnoses and interventions related to the cochlear implant postoperative period were related to communication, bleeding control, surgical wound care, infection prevention, comfort and well-being.

  5. [Nursing diagnoses for patients at risk of developing pressure ulcer].

    Science.gov (United States)

    de Araújo, Thiago Moura; de Araújo, Márcio Flávio Moura; Caetano, Joselany Áfio; Galvão, Marli Teresinha Gimenez; Damasceno, Marta Maria Coelho

    2011-01-01

    This cross-sectional study aimed to identify nursing diagnoses in critical patients at risk of developing pressure ulcer. It was carried out at an Intensive Care Unit in Fortaleza-CE, Brazil, using an intentional sample of thirteen subjects at risk of pressure ulcer, evaluated according to the Waterlow scale. In total, 45 nursing diagnoses were evidenced, seventeen of which were clinically significant for the development of pressure ulcer. The frequency levels for nine of these nursing diagnoses were ≥ 80%, mainly: Impaired skin integrity (100%), Impaired walking (87%), Impaired swallowing (80%), Impaired bed mobility (80%) and Impaired gas exchange (80%). The knowledge of those nursing diagnoses is important in detecting the effects and clinical basis of skin lesions.

  6. How Do Health Care Providers Diagnose Down Syndrome?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose Down syndrome? Health care providers can check for Down syndrome ... Down syndrome screening test. 1 Prenatal Screening for Down Syndrome There are several options for Down syndrome prenatal ...

  7. How Do Health Care Providers Diagnose Fragile X Syndrome?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose Fragile X syndrome? Health care providers often use a blood sample ... information helps families and providers to prepare for Fragile X syndrome and to intervene as early as possible. Possible ...

  8. How Do Health Care Providers Diagnose Birth Defects?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose birth defects? Diagnosis of birth defects depends on the specific problem and parts ... a physical examination of the baby immediately after birth. For other conditions, newborn screening or prenatal testing ...

  9. [Research into new methods for diagnosing, treating and preventing tuberculosis

    NARCIS (Netherlands)

    Borgdorff, M.W.; Kolk, A.; Soolingen, D. van; Meer, J.W.M. van der; Ottenhoff, T.H.

    2003-01-01

    Tuberculosis control requires improved diagnostics, drugs, and vaccines. Their development is facilitated by progress in immunology, molecular biology, and genomics. In addition to sputum smear and culture, amplification techniques can already be used to diagnose tuberculosis and antigen-detection

  10. An Event-based Approach to Hybrid Systems Diagnosability

    Data.gov (United States)

    National Aeronautics and Space Administration — Diagnosability is an important issue in the design of diagnostic systems, because it helps identify whether sufficient information is available to distinguish all...

  11. [Whose borderline is it? Reconsidering diagnosing borderline personality].

    Science.gov (United States)

    Gil, Tsvi E

    2008-11-01

    The present article critically discusses diagnosing borderline personality, demonstrating ideas raised with a treated case. In contrast to routine diagnoses made by psychiatrists according to common diagnosing systems (such as the American DSM or the WHO's ICD), we wonder whether this diagnosis reflects a medico-social construct, which is associated to the female status in masculine (or even patriarch) society, and probably associated even to the context of a woman diagnosed by a psychiatric system. In the context of critically viewing aetiological hypotheses to borderline personality (presented in our former article as a personality constellated around complex and prolonged trauma) in this article we suggest viewing borderline behaviours and symptoms as manifestations of coping and survival of a woman-victim in abusing surroundings.

  12. Diagnosing diabetes mellitus in patients with porphyria cutanea tarda

    DEFF Research Database (Denmark)

    Christiansen, Anne L.; Bygum, Anette; Hother-Nielsen, Ole

    2018-01-01

    comorbidities and treatments concerning patients with porphyria cutanea tarda complicate diagnosing these patients with diabetes mellitus. HbA1c, fasting glucose, or oral glucose tolerance are the current available tests, with HbA1c as first choice. Measuring HbA1c requires no fasting, however HbA1c can......The prevalence of diabetes mellitus is increased in patients with porphyria cutanea tarda. Different tests are available for diagnosing and screening for type II diabetes mellitus, however choosing the most suitable test is challenging. The pitfalls in the different tests along with the interfering...... if the patient has no clinical symptoms of diabetes. Diagnosing diabetes mellitus is important for the purpose of early intervention, and this review provides the knowledge needed to diagnose this special patient group properly....

  13. Retrospctive studies of small ruminant diseases diagnosed at the ...

    African Journals Online (AJOL)

    Retrospctive studies of small ruminant diseases diagnosed at the Veterinary Teaching Hospital, University of Agriculture, Makurdi, Nigeria. J.W. Jatfa, A.Y. Adenkola, I Victor, A Kisani, S.S. Adamu, P.A. Onyeyili ...

  14. Validity of stroke diagnoses in a National Register of Patients

    DEFF Research Database (Denmark)

    Krarup, Lars-Henrik; Boysen, Gudrun; Janjua, Huma

    2007-01-01

    Many registers containing routine medical information have been developed for research and surveillance purposes. In epidemiological research assessment of endpoints is often conducted via registers. In the present study we validated stroke and transient ischemic attack (TIA) diagnoses...

  15. Serum clusterin as a marker for diagnosing hepatocellular carcinoma

    African Journals Online (AJOL)

    ) are untreatable because of advanced tumor stages at presentation. Therefore, finding newer markers for screening and diagnosing HCC is of utmost importance. Clusterin (CLU) is a 449 amino acid, heterodimeric glycoprotein with a ...

  16. Defining safe criteria to diagnose miscarriage: prospective observational multicentre study

    OpenAIRE

    Preisler, Jessica; Kopeika, Julia; Ismail, Laure; Vathanan, Veluppillai; Farren, Jessica; Abdallah, Yazan; Battacharjee, Parijat; Van Holsbeke, Caroline; Bottomley, Cecilia; Gould, Deborah; Johnson, Susanne; Stalder, Catriona; Van Calster, Ben; Hamilton, Judith; Timmerman, Dirk

    2015-01-01

    Objectives To validate recent guidance changes by establishing the performance of cut-off values for embryo crown-rump length and mean gestational sac diameter to diagnose miscarriage with high levels of certainty. Secondary aims were to examine the influence of gestational age on interpretation of mean gestational sac diameter and crown-rump length values, determine the optimal intervals between scans and findings on repeat scans that definitively diagnose pregnancy failure.) Design Prospect...

  17. Alternative splicing of exon 17 and a missense mutation in exon 20 of the insulin receptor gene in two brothers with a novel syndrome of insulin resistance (congenital fiber-type disproportion myopathy)

    DEFF Research Database (Denmark)

    Vorwerk, P; Christoffersen, C T; Müller, J

    1999-01-01

    to be compound heterozygotes for mutations in the IR gene. The maternal allele was alternatively spliced in exon 17 due to a point mutation in the -1 donor splice site of the exon. The abnormal skipping of exon 17 shifts the amino acid reading frame and leads to a truncated IR, missing the entire tyrosine kinase......The insulin receptor (IR) in two brothers with a rare syndrome of congenital muscle fiber type disproportion myopathy (CFTDM) associated with diabetes and severe insulin resistance was studied. By direct sequencing of Epstein-Barr virus-transformed lymphocytes both patients were found...... domain. In the correct spliced variant, the point mutation is silent and results in a normally translated IR. The paternal allele carries a missense mutation in the tyrosine kinase domain. All three cDNA variants were present in the lymphocytes of the patients. Purified IR from 293 cells overexpressing...

  18. Pathway to STEM: Using Outreach Initiatives as a Method of Identifying, Educating and Recruiting the Next Generation of Scientists and Engineers

    Science.gov (United States)

    Ortiz-Arias, Deedee; Zwicker, Andrew; Dominguez, Arturo; Greco, Shannon

    2017-10-01

    The Princeton Plasma Physics Laboratory (PPPL) uses a host of outreach initiatives to inform the general population: the Young Women's Conference, Science Bowl, Science Undergraduate Laboratory Internship, My Brother's Keeper, a variety of workshops for university faculty and undergraduate students, public and scheduled lab tours, school and community interactive plasma science demonstrations. In addition to informing and educating the public about the laboratory's important work in the areas of Plasma and Fusion, these outreach initiatives, are also used as an opportunity to identify/educate/recruit the next generation of the STEM workforce. These programs provide the laboratory with the ability to: engage the next generation at different paths along their development (K-12, undergraduate, graduate, professional), at different levels of scientific content (science demonstrations, remote experiments, lectures, tours), in some instances, targeting underrepresented groups in STEM (women and minorities), and train additional STEM educators to take learned content into their own classrooms.

  19. 1996 environmental initiatives report

    International Nuclear Information System (INIS)

    1996-01-01

    Progress by Consumers Gas in addressing environmental challenges were reviewed. Proposed environmental initiatives for the next fiscal year and beyond were introduced. Proposed initiatives were placed into three priority categories, high, medium or low, which together with the environmental management framework form the the utility's overall environmental agenda. High on the list of environmental priorities for the company are atmospheric air emissions, planning and construction practices, energy conservation and efficiency, environmental compliance, and methane emissions. The present state of the initiatives by the various company divisions and regions, compiled from the respective business plans, were reported. 21 figs

  20. Application of qPCR assays for diagnosing causes of viral mink diarrhea. Preliminary results

    DEFF Research Database (Denmark)

    Hartby, Christina Marie; Kvisgaard, Lise Kirstine; Larsen, Lars Erik

    ). Diarrhea in mink can be caused by infectious agents (virus, bacteria and parasites) and food-related/multifactorial conditions. Known enteric viral infections are mink enteritis virus (MEV) and mink astrovirus. Coronaviruses and caliciviruses have also been implicated as potential causes or contributors...... for a quantitative diagnostic approach. We have developed new or adapted previously published real-time PCR/RT-PCR assays for MEV, astrovirus, rota- and coronavirus diagnostics. The technical test validation was initially carried out on archived diarrhea samples from diagnosed positive animals and on normal...

  1. Diagnosing causes of extreme aerosol optical depth events

    Science.gov (United States)

    Bernstein, D. N.; Sullivan, R.; Crippa, P.; Thota, A.; Pryor, S. C.

    2017-12-01

    Aerosol burdens and optical properties exhibit substantial spatiotemporal variability, and simulation of current and possible future aerosol burdens and characteristics exhibits relatively high uncertainty due to uncertainties in emission estimates and in chemical and physical processes associated with aerosol formation, dynamics and removal. We report research designed to improve understanding of the causes and characteristics of extreme aerosol optical depth (AOD) at the regional scale, and diagnose and attribute model skill in simulating these events. Extreme AOD events over the US Midwest are selected by identifying all dates on which AOD in a MERRA-2 reanalysis grid cell exceeds the local seasonally computed 90th percentile (p90) value during 2004-2016 and then finding the dates on which the highest number of grid cells exceed their local p90. MODIS AOD data are subsequently used to exclude events dominated by wildfires. MERRA-2 data are also analyzed within a synoptic classification to determine in what ways the extreme AOD events are atypical and to identify possible meteorological `finger-prints' that can be detected in regional climate model simulations of future climate states to project possible changes in the occurrence of extreme AOD. Then WRF-Chem v3.6 is applied at 12-km resolution and regridded to the MERRA-2 resolution over eastern North America to quantify model performance, and also evaluated using in situ measurements of columnar AOD (AERONET) and near-surface PM2.5 (US EPA). Finally the sensitivity to (i) spin-up time (including procedure used to spin-up the chemistry), (ii) modal versus sectional aerosol schemes, (iii) meteorological nudging, (iv) chemistry initial and boundary conditions, and (v) anthropogenic emissions is quantified. Despite recent declines in mean AOD, supraregional (> 1000 km) extreme AOD events continue to occur. During these events AOD exceeds 0.6 in many Midwestern grid cells for multiple consecutive days. In all

  2. Medical Errors Reduction Initiative

    National Research Council Canada - National Science Library

    Mutter, Michael L

    2005-01-01

    The Valley Hospital of Ridgewood, New Jersey, is proposing to extend a limited but highly successful specimen management and medication administration medical errors reduction initiative on a hospital-wide basis...

  3. Global Methane Initiative

    Science.gov (United States)

    The Global Methane Initiative promotes cost-effective, near-term methane recovery through partnerships between developed and developing countries, with participation from the private sector, development banks, and nongovernmental organizations.

  4. Initial Symptoms of ALS

    Science.gov (United States)

    ... Chapters Certified Centers and Clinics Support Groups About ALS About Us Our Research In Your Community Advocate ... Diagnosis En español Symptoms The initial symptoms of ALS can be quite varied in different people. One ...

  5. Research Programs & Initiatives

    Science.gov (United States)

    CGH develops international initiatives and collaborates with other NCI divisions, NCI-designated Cancer Centers, and other countries to support cancer control planning, encourage capacity building, and support cancer research and research networks.

  6. Nursing Home Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses quality...

  7. PESP Landscaping Initiative

    Science.gov (United States)

    Landscaping practices can positively or negatively affect local environments and human health. The Landscaping Initiative seeks to enhance benefits of landscaping while reducing need for pesticides, fertilizers, etc., by working with partners.

  8. Collaborative Procurement Initiative

    Science.gov (United States)

    GPP's Clean Energy Collaborative Procurement Initiative provides a platform for deploying clean energy technologies across multiple government and educational organizations for maximum impact on installed solar system capacity and local economic activity.

  9. Quality Initiatives - General Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS has developed a standardized approach for the development of quality measures that it uses in its quality initiatives. Known as the Measures Management System...

  10. Initial external events: floods

    International Nuclear Information System (INIS)

    Drumond, M.M.

    1989-12-01

    The initial external event, specifically flood in a Nuclear power plant, and the calculation necessary to determine the contribution of this type of event in a Probabilistic Safety Analysis, are presented. (M.I.)

  11. The Zambia Initiative

    OpenAIRE

    Masaki Watabe

    2005-01-01

    In rural Zambia refugees and host communities are working together to move from relief dependence to self reliance. Could UNHCR’s Zambia Initiative (ZI) be a model for other countries struggling to cope with the protracted presence of refugees?

  12. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  13. RAS Initiative - Events

    Science.gov (United States)

    The NCI RAS Initiative has organized multiple events with outside experts to discuss how the latest scientific and technological breakthroughs can be applied to discover vulnerabilities in RAS-driven cancers.

  14. Diagnosed hypertension in Canada: incidence, prevalence and associated mortality

    Science.gov (United States)

    Robitaille, Cynthia; Dai, Sulan; Waters, Chris; Loukine, Lidia; Bancej, Christina; Quach, Susan; Ellison, Joellyn; Campbell, Norman; Tu, Karen; Reimer, Kim; Walker, Robin; Smith, Mark; Blais, Claudia; Quan, Hude

    2012-01-01

    Background: Hypertension is a leading risk factor for cardiovascular diseases. Our objectives were to examine the prevalence and incidence of diagnosed hypertension in Canada and compare mortality among people with and without diagnosed hypertension. Methods: We obtained data from linked health administrative databases from each province and territory for adults aged 20 years and older. We used a validated case definition to identify people with hypertension diagnosed between 1998/99 and 2007/08. We excluded pregnant women from the analysis. Results: This retrospective population-based study included more than 26 million people. In 2007/08, about 6 million adults (23.0%) were living with diagnosed hypertension and about 418 000 had a new diagnosis. The age-standardized prevalence increased significantly from 12.5% in 1998/99 to 19.6% in 2007/08, and the incidence decreased from 2.7 to 2.4 per 100. Among people aged 60 years and older, the prevalence was higher among women than among men, as was the incidence among people aged 75 years and older. The prevalence and incidence were highest in the Atlantic region. For all age groups, all-cause mortality was higher among adults with diagnosed hypertension than among those without diagnosed hypertension. Interpretation: The overall prevalence of diagnosed hypertension in Canada from 1998 to 2008 was high and increasing, whereas the incidence declined during the same period. These findings highlight the need to continue monitoring the effectiveness of efforts for managing hypertension and to enhance public health programs aimed at preventing hypertension. PMID:22105752

  15. Peanut allergy diagnoses among children residing in Olmsted County, Minnesota.

    Science.gov (United States)

    Rinaldi, Maria; Harnack, Lisa; Oberg, Charles; Schreiner, Pamela; St Sauver, Jennifer; Travis, Lori L

    2012-10-01

    Peanut allergy is a major health concern, particularly in developed countries. Research indicates that as many as 2% of children are allergic to peanuts, which represents a 3-fold increase in diagnoses over the past 2 decades. This population-based descriptive study used the Rochester Epidemiology Project to estimate the prevalence in 2007 and annual incidence rates of peanut allergy diagnoses from 1999 to 2007 among children residing in Olmsted County, Minnesota. Residents of Olmsted County from January 1, 1999, through December 31, 2007, who received medical care at a Rochester Epidemiology Project facility and provided research authorization were eligible for the study. A medical chart review of 547 potential diagnoses resulted in 244 prevalent and 170 incident cases. Annual rates, crude and adjusted for age and sex, were standardized with the use of the indirect method to the Olmsted County population data in 1999. Incidence rate ratios were estimated with Poisson regression. The prevalence in 2007 was 0.65%. Female children were less likely to be diagnosed than male children (incidence rate ratio = 0.18; 95% CI, 0.07-0.48). Children aged birth to 2 years were significantly more likely to be diagnosed than older children aged 3-17 years (incidence rate ratio = 0.001; 95% CI, 0.0004-0.004). A significant 3-fold increasing trend was observed in diagnoses over time from 2.05 cases per 10,000 children in 1999 to 6.88 cases per 10,000 in 2007. Peanut allergies are an increasing concern in Olmsted County, Minnesota, as indicated by a 3-fold increase in diagnoses from 2.05 per 10,000 children in 1999 to 6.88 per 10,000 children in 2007. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  16. Hospital-diagnosed dementia and suicide: a longitudinal study using prospective, nationwide register data

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Zarit, S.H.; Conwell, Yeates

    2008-01-01

    OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individual...... for older adults. Preventive measures should focus on suicidal ideation after initial diagnosis but also acknowledge that suicides can occur well after a dementia diagnosis has been established......OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individuals....... During this period, 136 persons who previously had been diagnosed with dementia died by suicide. Men and women aged 50-69 years with hospital presentations of dementia have a relative suicide risk of 8.5 (95% confidence interval: 6.3-11.3) and 10.8 (95% confidence interval: 7.4-15.7), respectively. Those...

  17. [Solarium-induced pseudoporphyria and variegate porphyria as rare differential diagnoses of porphyria cutanea tarda].

    Science.gov (United States)

    Kochs, C; Mühlenstädt, E; Neumann, N J; Hanneken, S

    2009-10-01

    Three patients presented with typical porphyria cutanea tarda-like vesicles, erosions and scars as well as increased fragility, primarily on the back of the hands. In two of the three, porphyrin workup was normal. Skin biopsy was compatible with porphyria cutanea tarda (PCT) or pseudoporphyria. The common aspect in the patients' history was the frequent use of solaria for many years, so that UV-induced pseudoporphyria was diagnosed. Treatment was strict abstention from UV radiation and regular dermatologic controls for signs of skin damage. Porphyrin analysis in the third patient showed normal excretion of total urine porphyrins and precursors; however, fecal porphyrins were elevated with dominating coproporphyrins in HPLC and the plasma fluorescence scan yielded a peak at 625 nm. Subsequent mutation analysis showed a mutation in the protoporphyrinogen oxidase gene, thereby confirming the diagnosis of variegate porphyria. Five months after the initial diagnosis the patient presented with the first acute attack. Further investigations revealed a metastasized carcinoma of the colon, which probably triggered the acute attack. Our cases show rare differential diagnoses in patients presenting with typical PCT-like skin lesions. The discrimination between porphyria cutanea tarda and its differential diagnoses is very important since it has an important impact not only on the treatment modality but also on the course and the prognosis of the disease.

  18. An update of 77 cases diagnosed as oral hemangiomas based on GLUT-1 positivity.

    Science.gov (United States)

    da Silva Filho, Tiago João; de Oliveira, Denise Hélen Imaculada Pereira; Brasil, Veruska Lima Moura; Nonaka, Cassiano Francisco Weege; da Silveira, Éricka Janine Dantas; Queiroz, Lélia Maria Guedes

    2017-08-01

    To evaluate cases diagnosed as "oral hemangiomas" based on the immunohistochemical expression of human glucose transporter protein (GLUT-1) and on histopathological features, and to investigate whether the classification proposed by the ISSVA was used correctly to classify these lesions. All cases stored in the archives of an Oral Pathology Service and diagnosed as "oral hemangiomas" were reviewed. Seventy-seven cases were analyzed regarding the expression of GLUT-1. GLUT-1(+) specimens were classified as true infantile hemangioma (IH) and GLUT-1(-) specimens were reclassified based on their histopathological features. The nomenclature of these lesions was evaluated and some cases were reclassified. Only 26 (33.8%) of the specimens were indeed IHs. Among the GLUT-1(-) specimens, 20 (26.0%) were reclassified as pyogenic granulomas (PGs) and 31 (40.2%) as vascular malformations. Considering the previously applied nomenclature, only 47.5% of the cases initially diagnosed as "hemangiomas" were IHs. In the group of "capillary hemangiomas", most cases (56.2%) were PGs. Among the three "cellular hemangiomas", two were PGs and one was IH. Most (88.8%) "cavernous hemangiomas" were vascular malformations. Careful and parameterized review of cases of vascular anomalies is necessary using auxiliary tools such as GLUT-1, since the exclusive use of histopathological findings might be insufficient to differentiate some anomalies. Accurate clinical examination and the use of biomarkers such as GLUT-1 are essential for the diagnosis. Copyright © 2017. Published by Elsevier Inc.

  19. I'm a Jesus girl: coping stories of Black American women diagnosed with breast cancer.

    Science.gov (United States)

    Gregg, Godfrey

    2011-12-01

    Breast cancer continues to be the most diagnosed cancer for all women, excluding non-melanoma skin cancer, in the United States. Incidence rates are 1 in 8 for an American woman being diagnosed. Moreover, statistics indicate that every 13 min an American woman dies from complications related to breast cancer. Despite all the gains made in the area of cancer research, Black American women continue to have a 67% higher mortality rate than their White counterparts. There is no preparation for a diagnosis of breast cancer. Upon hearing the words: you have breast cancer, a woman's life is forever altered. The woman's initial reactions of denial and/or anger yield to strategic responses. These responses may strengthen the woman's resiliency both during and following treatments. Research indicates that Black Americans, specifically Black American women, exhibit greater religiosity/spirituality than do other racial/ethnic groups. In addition, the use of religiosity/spirituality by Black Americans increases during a crisis. This qualitative study examines how religiosity/spirituality was utilized as a coping mechanism by a group of Black American women following their diagnoses of breast cancer.

  20. Percutaneous Management of Ureteral Injuries that are Diagnosed Late After Cesarean Section

    Energy Technology Data Exchange (ETDEWEB)

    Ustunsoz, Bahri; Ugurel, Sahin; Duru, Namik Kemal; Ozgok, Yasar; Ustunsoz, Ayfer [GATA Medical Faculty, Ankara (Turkmenistan)

    2008-08-15

    We wanted to present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS). Twenty-two cases with 24 ureteral injuries that were diagnosed late after CS underwent percutaneous nephrostomy (PN), antegrade double J (DJ) catheter placement and balloon dilatation or a combination of these. The time for making the diagnosis was 21 +- 50.1 days. The injury site was the distal ureter in all cases (the left ureter: 13, the right ureter: 7 and bilateral: 2). Fifteen complete ureteral obstructions were detected in 13 cases. Ureteral leakage due to partial (n = 4) or complete (n = 3) rupture was noted in seven cases. Two cases had ureterovaginal fistula. All the cases were initially confirmed with antegrade pyelography and afterwards they underwent percutaneous nephrostomy. Balloon dilatation was needed in three cases. Antegrade DJ stents were placed in 10 cases, including the three cases with balloon dilatation. Repetititon of percutaneous nephrostomy with balloon dilatation and DJ stent placement was needed in one case with complete obstruction. All the cases were followed-up with US in their first week and then monthly thereafter for up to two years. Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%). Percutaneous management is a good alternative for the treatment of post-CS ureteral injuries that are diagnosed late after CS. Percutaneous management is at least preparatory for a quarter of the cases where surgery is unavoidable

  1. Percutaneous Management of Ureteral Injuries that are Diagnosed Late After Cesarean Section

    International Nuclear Information System (INIS)

    Ustunsoz, Bahri; Ugurel, Sahin; Duru, Namik Kemal; Ozgok, Yasar; Ustunsoz, Ayfer

    2008-01-01

    We wanted to present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS). Twenty-two cases with 24 ureteral injuries that were diagnosed late after CS underwent percutaneous nephrostomy (PN), antegrade double J (DJ) catheter placement and balloon dilatation or a combination of these. The time for making the diagnosis was 21 ± 50.1 days. The injury site was the distal ureter in all cases (the left ureter: 13, the right ureter: 7 and bilateral: 2). Fifteen complete ureteral obstructions were detected in 13 cases. Ureteral leakage due to partial (n = 4) or complete (n = 3) rupture was noted in seven cases. Two cases had ureterovaginal fistula. All the cases were initially confirmed with antegrade pyelography and afterwards they underwent percutaneous nephrostomy. Balloon dilatation was needed in three cases. Antegrade DJ stents were placed in 10 cases, including the three cases with balloon dilatation. Repetititon of percutaneous nephrostomy with balloon dilatation and DJ stent placement was needed in one case with complete obstruction. All the cases were followed-up with US in their first week and then monthly thereafter for up to two years. Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%). Percutaneous management is a good alternative for the treatment of post-CS ureteral injuries that are diagnosed late after CS. Percutaneous management is at least preparatory for a quarter of the cases where surgery is unavoidable

  2. IAEA to Help West African Countries Diagnose Ebola

    International Nuclear Information System (INIS)

    2014-01-01

    Full text: The International Atomic Energy Agency (IAEA) will provide specialized diagnostic equipment to help Sierra Leone in its efforts to combat an ongoing Ebola Virus Disease (EVD) outbreak, IAEA Director General Yukiya Amano announced today. Later, the support is planned to be extended to Liberia and Guinea. The support is in line with a UN Security Council appeal and responds to a request from Sierra Leone. The IAEA assistance will supplement the country's ability to diagnose EVD quickly using a diagnostic technology known as Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). The assistance, expected to be delivered in the coming weeks, initiates broader IAEA support to African Member States to strengthen their technological abilities to detect diseases transmitted from animals to humans - zoonotic diseases. The IAEA and the Food and Agriculture Organization of the United Nations have been at the forefront of developing RT-PCR, a nuclear-derived technology which allows EVD to be detected within a few hours, while other methods require growing on a cell culture for several days before a diagnosis is determined. Early diagnosis of EVD, if combined with appropriate medical care, increases the victims' chance of survival and helps curtail the spread of the disease by making it possible to isolate and treat the patients earlier. Health authorities in Sierra Leone and other affected countries are already applying RT-PCR, but their diagnostic capability is limited; there is a shortage of the diagnostic kits and other materials needed for the process and backup equipment is needed to avoid diagnostic downtime in case of equipment failure. The IAEA will support the most affected countries' sustained ability to detect the disease in cooperation with the World Health Organization (WHO) and the United Nations Mission for Ebola Emergency Response. The IAEA, as part of its ongoing work, has helped 32 African countries and several other Member States develop skills

  3. Tuberculosis is frequently diagnosed within 12 months of diabetes mellitus.

    Science.gov (United States)

    Heo, E Y; Choi, N-K; Yang, B R; Koo, B K; Hwang, S-S; Lee, C-H; Kang, Y A

    2015-09-01

    Evidence regarding the effects of tuberculosis (TB) screening among patients with diabetes mellitus (DM) in intermediate TB burden countries is insufficient, and the most appropriate time point for TB screening is unclear. To investigate trends in TB incidence among newly diagnosed DM patients. A retrospective cohort study of the claims database of the Health Insurance Review and Assessment Service in Korea was performed. Participants were newly diagnosed with type 2 DM in 2009. The study outcome was TB incidence between 2009 and 2011 among participants according to duration of type 2 DM. A cohort of 331,601 patients with newly diagnosed type 2 DM in 2009 was identified. During the 3-year follow-up period, 1533 patients were diagnosed with TB. The estimated incidence of TB among newly diagnosed type 2 DM patients was 18/10,000 patient-years (py) (95%CI 17.5-19.4). TB incidence was 33/10,000 py (95%CI 30.0-35.6) in the first 6 months, and 19/10,000 py (95%CI 16.5-20.6) in the following 6-month period. The risk of developing TB was increased among DM patients, particularly during the first 12 months after DM diagnosis.

  4. Vaccination Coverage Among Adults With Diagnosed Diabetes: United States, 2015.

    Science.gov (United States)

    Villarroel, Maria A; Vahratian, Anjel

    2016-12-01

    Data from the National Health Interview Survey •Among adults aged 18 and over with diagnosed diabetes, 61.6% had an influenza vaccine in the past year. •A total of 52.6% of adults with diagnosed diabetes had a pneumococcal vaccine and 17.1% had the 3-dose vaccination schedule for hepatitis B at some point in the past. •Among adults aged 60 and over with diagnosed diabetes, 27.2% had ever had a shingles vaccine. •Among those with diagnosed diabetes, the vaccination coverage for influenza, pneumococcal, and shingles was lowest among poor adults, increased with age, and varied by race and ethnicity. •Hepatitis B vaccination coverage was lowest among poor adults, and it decreased with age. Persons with diabetes are at an increased risk for complications from vaccine-preventable infections (1-3). Several vaccines are recommended for adults with diabetes, including annual vaccination for influenza and at least a one-time dose of pneumococcal vaccine, regardless of age; a shingles vaccine starting at age 60; and a hepatitis B vaccine soon after diabetes diagnosis among those aged 19-59, and based on clinical discretion thereafter (4). This report describes the receipt of select vaccinations among adults with diagnosed diabetes by sex, age, race and ethnicity, and poverty status. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  5. Child Development: New Diagnoses for the NANDA International.

    Science.gov (United States)

    Souza, Juliana Martins de; Cruz, Diná de Almeida Lopes Monteiro da; Veríssimo, Maria De La Ó Ramallo

    2018-04-01

    The paper proposes new diagnoses on child development (CD) for NANDA International. The study followed the recommended steps of Developmental Processes for NANDA International Nursing Diagnoses. It was a secondary analysis study on the findings of a concept analysis study on CD. A proposal of labels and components of three diagnoses: "Delayed child development," "Risk for delayed child development," and "Readiness for enhanced child development." The proposed diagnoses represent all the complexity of CD. The proposed diagnoses can support nurses in the development of a comprehensive care plan on the health of children. OBJETIVO: propor novos diagnósticos de enfermagem para a NANDA-International que abordem o desenvolvimento infantil. MÉTODO: Este estudo seguiu as etapas recomendadas para o desenvolvimento de diagnósticos de enfermagem da NANDA-International. Foi realizado a partir dos resultados da análise de conceito do termo desenvolvimento infantil. Propostos os títulos e os componentes de três diagnósticos: "Atraso no desenvolvimento infantil," "Risco de atraso no desenvolvimento infantil," e "Disposição para desenvolvimento infantil melhorado." CONCLUSÕES: Os diagnósticos propostos contemplam toda a complexidade do desenvolvimento infantil. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Os novos diagnósticos podem subsidiar o enfermeiro na elaboração de um plano de cuidados integrais à saúde da criança. © 2016 NANDA International, Inc.

  6. Patterns of tumor initiation in choroidal melanoma.

    Science.gov (United States)

    Li, W; Judge, H; Gragoudas, E S; Seddon, J M; Egan, K M

    2000-07-15

    This study attempts to document the occurrence of tumors with respect to clock hour location and distance from the macula and to evaluate tumor location in relation to retinal topography and light dose distribution on the retinal sphere. Analysis of patterns of tumor initiation may provide new evidence to clarify the controversy regarding the possible light-related etiology of choroidal melanoma. Incident cases of choroidal and ciliary body melanoma in Massachusetts residents diagnosed between 1984 and 1993 were the basis for analysis. Conventional fundus drawings and photos were used to assess the initiation site of each tumor. The initiation site was defined as the intersect between the largest tumor diameter and the largest perpendicular diameter of the tumor. Initiation sites were recorded using spherical coordinates. The retinal sphere was divided into 61 mutually exclusive sectors defined according to clock hour and anteroposterior distance from the macula. Rates of initiation were computed for each sector, overall, and according to gender and other clinical factors. Results were similar in left and right eyes; therefore, these were combined in analysis. Tumor initiation had a predilection for the macula (P iris color (P = 0.01). Tumor diameters were largest in the peripheral region of the fundus and smallest in the macular and ciliary body zone (P iris color (P = 0.84), or tumor diameter (P = 0.73). Results suggest that tumor initiation is not uniformly distributed, with rates of occurrence concentrated in the macular area and decreasing monotonically with distance from the macula to the ciliary body. This pattern is consistent with the retinal topography and correlates positively with the dose distribution of solar light on the retinal sphere.

  7. Prevalence of nursing diagnoses in an intensive care unit

    Directory of Open Access Journals (Sweden)

    Vinicia de Holanda Cabral

    2017-01-01

    Full Text Available To identify the main nursing diagnostic titles used in the care of critically ill patients hospitalized in an Intensive Care Unit, verifying the presence thereof in the diagnoses of NANDA International’s Taxonomy II. Methods: descriptive and documental study, in which 69 medical records of patients aged over 18 years were consulted. Results: 22 nursing diagnostic titles were found; the most frequent was risk for infection (99.0%, risk for skin integrity (75.0% and risk for aspiration (61.0%. Most diagnoses were in the domains safety/ protection (43.0% and activity/rest (26.5%. Conclusions: authors identified the main nursing diagnostic titles used in the care of critically ill patients admitted to the Intensive Care Unit and the presence thereof in the diagnoses of NANDA International’s Taxonomy II.

  8. Teaching Chinese psychiatrists to make reliable dissociative disorder diagnoses.

    Science.gov (United States)

    Fan, Qing; Yu, Junhan; Ross, Colin A; Keyes, Benjamin B; Dai, Yunfei; Zhang, Tianhong; Wang, Lanlan; Xiao, Zeping

    2011-09-01

    The aim of the study was to assess the outcome of an educational effort by two North American experts in dissociative disorders to teach Chinese psychiatrists to make reliable dissociative disorder diagnoses. In the final phase of the educational effort, 569 patients at Shanghai Mental Health Center completed the Chinese version of the Dissociative Experiences Scale (DES). Patients were then randomly selected in different proportions according to their DES scores: 96 selected patients were then assessed with the Dissociative Disorders Interview Schedule (DDIS) and clinical diagnostic interviews based on DSM-IV criteria. According to the clinical diagnostic interviews, 28 (4.9%) patients were diagnosed as having dissociative disorders. Agreement between the American experts and Chinese psychiatrists for presence or absence of a dissociative disorder was 0.75 using Cohen's kappa. Dissociative disorders can be diagnosed in China with good inter-rater reliability. The authors describe the steps taken to achieve this outcome.

  9. Verification of Opacity and Diagnosability for Pushdown Systems

    Directory of Open Access Journals (Sweden)

    Koichi Kobayashi

    2013-01-01

    Full Text Available In control theory of discrete event systems (DESs, one of the challenging topics is the extension of theory of finite-state DESs to that of infinite-state DESs. In this paper, we discuss verification of opacity and diagnosability for infinite-state DESs modeled by pushdown automata (called here pushdown systems. First, we discuss opacity of pushdown systems and prove that opacity of pushdown systems is in general undecidable. In addition, a decidable class is clarified. Next, in diagnosability, we prove that under a certain assumption, which is different from the assumption in the existing result, diagnosability of pushdown systems is decidable. Furthermore, a necessary condition and a sufficient condition using finite-state approximations are derived. Finally, as one of the applications, we consider data integration using XML (Extensible Markup Language. The obtained result is useful for developing control theory of infinite-state DESs.

  10. [Frequent nursing diagnoses and interventions for women under critical care].

    Science.gov (United States)

    Oliveira, Mirna Fontenele de; Freitas, Maria Célia de

    2009-01-01

    This study aimed at identifying the most frequent Nursing Diagnoses and propose interventions for women under critical care into a maternal intensive care unit in a public hospital in Fortaleza, CE, Brazil. Retrospective study conducted with women's hospital health records. Ten Nursing Diagnoses were elaborated, being four risk: risk of infection, risk of unbalance of liquids volume, risk of aspiration, risk of damaged skin integrity and six real: altered maternity, impaired physical mobility, anxiety and impaired verbal communication. For the referred Nursing Diagnoses, nursing interventions are proposed according to the link between NANDA, NIC and NOC. It was concluded that the use of ND is a necessary technology for the Nursing reality, as it makes possible the integral care.

  11. Development of terahertz otoscope for diagnosing otitis media (Conference Presentation)

    Science.gov (United States)

    Jeon, Tae-In; Ji, Young Bin; Bark, Hyeon Sang; Noh, Sam Kyu; Oh, Seung Jae

    2017-03-01

    A novel terahertz (THz) otoscope is designed and fabricated to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. The inclusion of indium tin oxide (ITO) glass in the THz otoscope allows physicians to diagnose OM with both THz and conventional optical diagnostics. To determine THz diagnostics for OM, we observed reflection signals from samples behind a thin dielectric film and found that the presence of water behind the membrane could be distinguished based on THz pulse shape. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application. The presence of water absorbed by the human membrane was easily distinguished based on differences in pulse shapes and peak-to-peak amplitudes of reflected THz pulses. The potential for early OM diagnosis using the THz otoscope was confirmed by alteration of THz pulse depending on water absorption level.

  12. A Study on Test Technology to Diagnose the Power Apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Kim, K. H.; Kang, Y. S.; Jeon, Y. K.; Lee, W. Y.; Kang, D. S.; Kyu, H. S.; Sun, J. H.; Jo, K. H. [Korea Electrotechnology Research Institute (Korea, Republic of); Jung, J. S.; Mun, Y. T.; Lee, K. H.; Jung, E. H.; Kim, J. H. [Korea Water Resources Corporation (Korea, Republic of)

    1997-02-01

    In this study, we have educated KOWACO(Korea Water Resources Corporation) specialists about the insulation diagnostic technology and trained them the insulation diagnostic test and estimation method of power apparatus. The main results of this study are as follows; A. Education of basic high-voltage engineering. B. Research of insulation characteristic and deterioration mechanism in power apparatus C. Discussion on high-voltage test standard specifications. D. Study on insulation deterioration diagnostics in power apparatus. E. Field testing of insulation diagnosis in power apparatus. F. Engineering of insulation diagnostic testing apparatus to diagnose power apparatus. KOWACO specialists are able to diagnose insulation diagnostic test of power apparatus through this study. As they have instruments to diagnose power apparatus, they can do the test and estimation of the power apparatus insulation diagnosis. (author). refs., figs., tabs.

  13. Correlation between clinical and histopathological diagnoses in periapical inflammatory lesions.

    Science.gov (United States)

    Diegues, Liliane Lopes; Colombo Robazza, Carlos Roberto; Costa Hanemann, João Adolfo; Costa Pereira, Alessandro Antônio; Silva, Cléverson O

    2011-08-01

      The purpose of the present study was to evaluate the correlation between clinical and histopathological diagnoses of periapical inflammatory lesions, focusing mainly on cystic conditions.   Files dating from 1998 to 2006 at the Oral Pathology Laboratory, School of Dentistry, Alfenas Federal University, Brazil, were reviewed to identify cases with histopathological diagnoses of periapical inflammatory lesions. A total of 1788 files were analyzed, and 255 cases were identified with clinical diagnoses of periapical inflammatory lesions.   The most prevalent clinical diagnosis was apical periodontal cyst (59%), followed by periapical granuloma (20%), and dentoalveolar abscess (2%). After histopathological analysis, 53% of the cases represented apical periodontal cyst, 42% periapical granuloma, and 5% dentoalveolar abscess.   The outcomes of the present study show a high prevalence of periapical cysts among periapical inflammatory lesions. Moreover, this study highlights the importance of histopathological evaluation for the correct diagnosis of periapical inflammatory lesions. © 2011 Blackwell Publishing Asia Pty Ltd.

  14. Urinary incontinence nursing diagnoses in patients with stroke

    Directory of Open Access Journals (Sweden)

    Telma Alteniza Leandro

    2015-12-01

    Full Text Available Abstract OBJECTIVE Identifying the prevalence of Stress urinary incontinence (SUI, Urge urinary incontinence (UUI, Functional urinary incontinence (FUI, Overflow urinary incontinence (OUI and Reflex urinary incontinence (RUI nursing diagnoses and their defining characteristics in stroke patients. METHOD A cross-sectional study with 156 patients treated in a neurological clinic. Data were collected through interviews and forwarded to nurses for diagnostic inference. RESULTS 92.3% of the patients had at least one of the studied diagnoses; OUI showed the highest prevalence (72.4%, followed by FUI (53.2%, RUI (50.0%, UUI (41.0% and SUI (37.8%. Overdistended bladder and reports of inability to reach the toilet in time to avoid urine loss were the most prevalent defining characteristics. A statistically significant association of the defining characteristics with the studied diagnosis was verified. CONCLUSION The five incontinence diagnoses were identified in the evaluated patients, with different prevalence.

  15. International EUREKA: Initialization Segment

    International Nuclear Information System (INIS)

    1982-02-01

    The Initialization Segment creates the starting description of the uranium market. The starting description includes the international boundaries of trade, the geologic provinces, resources, reserves, production, uranium demand forecasts, and existing market transactions. The Initialization Segment is designed to accept information of various degrees of detail, depending on what is known about each region. It must transform this information into a specific data structure required by the Market Segment of the model, filling in gaps in the information through a predetermined sequence of defaults and built in assumptions. A principal function of the Initialization Segment is to create diagnostic messages indicating any inconsistencies in data and explaining which assumptions were used to organize the data base. This permits the user to manipulate the data base until such time the user is satisfied that all the assumptions used are reasonable and that any inconsistencies are resolved in a satisfactory manner

  16. Home-based vs inpatient education for children newly diagnosed with type 1 diabetes.

    Science.gov (United States)

    Clapin, H; Hop, L; Ritchie, E; Jayabalan, R; Evans, M; Browne-Cooper, K; Peter, S; Vine, J; Jones, T W; Davis, E A

    2017-11-01

    Initial management of children diagnosed with type 1 diabetes (T1D) varies worldwide with sparse high quality evidence regarding the impact of different models of care. To compare the inpatient model of care with a hybrid home-based alternative, examining metabolic and psychosocial outcomes, diabetes knowledge, length of stay, and patient satisfaction. The study design was a randomized-controlled trial. Inclusion criteria were: newly diagnosed T1D, aged 3 to 16 years, living within approximately 1 hour of the hospital, English-speaking, access to transport, absence of significant medical or psychosocial comorbidity. Patients were randomized to standard care with a 5 to 6 day initial inpatient stay or discharge after 2 days for home-based management. All patients received practical skills training in the first 48 hours. The intervention group was visited twice/day by a nurse for 2 days to assist with injections, then a multi-disciplinary team made 3 home visits over 2 weeks to complete education. Patients were followed up for 12 months. Clinical outcomes included HbA1c, hypoglycemia, and diabetes-related readmissions. Surveys measured patient satisfaction, diabetes knowledge, family impact, and quality of life. Fifty patients were recruited, 25 to each group. There were no differences in medical or psychosocial outcomes or diabetes knowledge. Average length of admission was 1.9 days shorter for the intervention group. Families indicated that with hindsight, most would choose home- over hospital-based management. With adequate support, children newly diagnosed with T1D can be safely managed at home following practical skills training. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia

    DEFF Research Database (Denmark)

    Saglio, Giuseppe; Kim, Dong-Wook; Issaragrisil, Surapol

    2010-01-01

    Nilotinib has been shown to be a more potent inhibitor of BCR-ABL than imatinib. We evaluated the efficacy and safety of nilotinib, as compared with imatinib, in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia (CML) in the chronic phase.......Nilotinib has been shown to be a more potent inhibitor of BCR-ABL than imatinib. We evaluated the efficacy and safety of nilotinib, as compared with imatinib, in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia (CML) in the chronic phase....

  18. Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang [Gachon University of Medicine and Science, Incheon (Korea, Republic of)

    2009-12-15

    Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

  19. No Circadian Variation in Surgeons' Ability to Diagnose Acute Appendicitis

    DEFF Research Database (Denmark)

    Jørgensen, Anders Bech; Amirian, Ilda; Kehlet Watt, Sara

    2016-01-01

    patients were included. There were no age limitations or selection in sex. RESULTS: There was no significant difference in the ability to diagnose appendicitis in day-evening hours vs night hours (p = 0.391), nor was any significant difference found on weekdays (Monday-Thursday) vs weekends (Friday...... of imaging had no effect on the ability to diagnose appendicitis. Male sex showed a higher probability of the diagnosis being appendicitis compared with other or no pathology (odds ratio: 3.094; p

  20. Advances in diagnosing vaginitis: development of a new algorithm.

    Science.gov (United States)

    Nyirjesy, Paul; Sobel, Jack D

    2005-11-01

    The current approach to diagnosing vulvovaginal symptoms is both flawed and inadequate. Mistakes occur at the level of the patient herself, her provider, and the sensitivity of office-based tests. Often, the differential diagnosis is so broad that providers may overlook some of the possibilities. A diagnostic algorithm which separates women into either a normal or elevated vaginal pH can successfully classify most women with vaginitis. Based on the amine test, vaginal leukocytes, and vaginal parabasal cells, those with an elevated pH can be placed into further diagnostic categories. Such an algorithm helps to prioritize different diagnoses and suggest appropriate ancillary tests.