WorldWideScience

Sample records for case study review

  1. Review of ORD Nanomaterial Case Studies Workshop

    Science.gov (United States)

    The following is a letter report from the Executive Committee of the BOSC concerning the review of the ORD Nanomaterial Case Studies Workshop: Developing a Comprehensive Environmental Assessment Research Strategy for Nanoscale Titanium Dioxide.

  2. Reverse logistics: A review of case studies

    NARCIS (Netherlands)

    Brito, de M.P.; Dekker, Rommert; Flapper, S.D.P.; Fleischmann, B.; Klose, A.

    2004-01-01

    This paper gives an overview of scientific literature that describes and discusses cases of reverse logistics activities in practice. Over sixty case studies are considered. Based on these studies we are able to indicate critical factors for the practice of reverse logistics. In addition we compare

  3. BOOK REVIEW: Case Studies in Knowledge Management

    Directory of Open Access Journals (Sweden)

    Reviewed by Dr. Adnan BOYACI

    2005-10-01

    Full Text Available 161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…etc. Because of the growingimportance and the popularity of the KM either as a research topic or specialized coursesubject, a crucial need for understanding, conceptualization and implementation of KM asa system has emerged since the mid 1990’s. In this sense, the book contributes criticallyto fill the gap between theory and implementation as a teaching material.This edited book is published by Idea Group Publishing. The book has twenty chaptersdivided into seven sections. In addition to a section of authors’ biography contributing thebook and an index, there is a preface that the basic terms and key concepts underliningthe cases discussed following chapters, which is explained in a schematized way.Besides the editor, total of 47 authors have contributed to the book. These authors arefrom different countries, academic backgrounds, and institutions. Although approximatelyone third of the authors are from USA, the rest of the authors are from Canada, England,Austria, Germany, Australia, New Zealand, Egypt, Bahrain and China. The authorsrepresent a variety of universities, private companies, and military institutions. Most ofthem have strong professional backgrounds, which help them address the issues bothfrom theoretical and practical perspectives. Contributions of authors having differentbackgrounds and institutions enable the book to have very comprehensive spectrum andthis makes the book attractive practically for those working different sectors

  4. Qualitative case study methodology in nursing research: an integrative review.

    Science.gov (United States)

    Anthony, Susan; Jack, Susan

    2009-06-01

    This paper is a report of an integrative review conducted to critically analyse the contemporary use of qualitative case study methodology in nursing research. Increasing complexity in health care and increasing use of case study in nursing research support the need for current examination of this methodology. In 2007, a search for case study research (published 2005-2007) indexed in the CINAHL, MEDLINE, EMBASE, PsychINFO, Sociological Abstracts and SCOPUS databases was conducted. A sample of 42 case study research papers met the inclusion criteria. Whittemore and Knafl's integrative review method guided the analysis. Confusion exists about the name, nature and use of case study. This methodology, including terminology and concepts, is often invisible in qualitative study titles and abstracts. Case study is an exclusive methodology and an adjunct to exploring particular aspects of phenomena under investigation in larger or mixed-methods studies. A high quality of case study exists in nursing research. Judicious selection and diligent application of literature review methods promote the development of nursing science. Case study is becoming entrenched in the nursing research lexicon as a well-accepted methodology for studying phenomena in health and social care, and its growing use warrants continued appraisal to promote nursing knowledge development. Attention to all case study elements, process and publication is important in promoting authenticity, methodological quality and visibility.

  5. A parathyroid adenoma case study: Protocol review

    International Nuclear Information System (INIS)

    Sorensen, B.J.; Chu, J.M.G.

    1998-01-01

    Full text: Technetium-99m ( 99m Tc) Sestamibi as opposed to Thallous-201 Chloride and 99m Tc Sodium Pertechnetate subtraction, has become the radiopharmaceutical of choice for detection of parathyroid adenomas. A 17-year-old female patient presented to the department for a parathyroid 99m Tc Sestamibi scan to evaluate possible parathyroid adenoma/s. She was initially admitted with increasing serum Calcium levels, polyuria, abdominal pain and general malaise. The patient was injected with 900MBq of 99m Tc Sestamibi, and a pinhole dynamic at a distance of 10 cm from the neck was acquired followed by a 5-minute static image at 7 cm. Single Photon Emission Computed Tomography (SPECT) was then performed on a dual-head gamma camera followed by an anterior and posterior 10-minute static image. At 3 and 5 hours post injection the 10-minute static image was repeated. This study was reported as normal with uniform uptake and washout of the tracer over the 5-hour period. An ultrasound study was performed, and it showed a lesion believed to be a parathyroid adenoma measuring 2.2 x 0.8 x 0.4 cm in size in the right upper lobe of the thyroid. A subsequent thyroid scan was performed to confirm that it was non-functioning thyroid tissue. The patient was injected with 250MBq of 99m Tc Sodium Pertechnetate and scanned with a pinhole collimator at a distance of 7 cm. When the 99m Tc Sestamibi and 99m Tc Sodium Pertechnetate scan were viewed together, it was clear that there was excess 99m Tc Sestamibi distribution on the right upper lobe of the thyroid, which washed out over time. This corresponded to the ultrasound findings and was confirmed at surgery to be a parathyroid adenoma. A 99m Tc Sodium Pertechnetate scan and an ultrasound are now also routinely performed on patients presenting for 99m Tc Sestamibi parathyroid scans

  6. A parathyroid adenoma case study: Protocol review

    Energy Technology Data Exchange (ETDEWEB)

    Sorensen, B.J.; Chu, J.M.G. [Liverpool Hospital, NSW (Australia). Department of Nuclear Medicine and Clinical Ultrasound

    1998-06-01

    Full text: Technetium-99m ({sup 99m}Tc) Sestamibi as opposed to Thallous-201 Chloride and {sup 99m}Tc Sodium Pertechnetate subtraction, has become the radiopharmaceutical of choice for detection of parathyroid adenomas. A 17-year-old female patient presented to the department for a parathyroid {sup 99m}Tc Sestamibi scan to evaluate possible parathyroid adenoma/s. She was initially admitted with increasing serum Calcium levels, polyuria, abdominal pain and general malaise. The patient was injected with 900MBq of {sup 99m}Tc Sestamibi, and a pinhole dynamic at a distance of 10 cm from the neck was acquired followed by a 5-minute static image at 7 cm. Single Photon Emission Computed Tomography (SPECT) was then performed on a dual-head gamma camera followed by an anterior and posterior 10-minute static image. At 3 and 5 hours post injection the 10-minute static image was repeated. This study was reported as normal with uniform uptake and washout of the tracer over the 5-hour period. An ultrasound study was performed, and it showed a lesion believed to be a parathyroid adenoma measuring 2.2 x 0.8 x 0.4 cm in size in the right upper lobe of the thyroid. A subsequent thyroid scan was performed to confirm that it was non-functioning thyroid tissue. The patient was injected with 250MBq of {sup 99m}Tc Sodium Pertechnetate and scanned with a pinhole collimator at a distance of 7 cm. When the {sup 99m}Tc Sestamibi and {sup 99m}Tc Sodium Pertechnetate scan were viewed together, it was clear that there was excess {sup 99m}Tc Sestamibi distribution on the right upper lobe of the thyroid, which washed out over time. This corresponded to the ultrasound findings and was confirmed at surgery to be a parathyroid adenoma. A {sup 99m}Tc Sodium Pertechnetate scan and an ultrasound are now also routinely performed on patients presenting for {sup 99m}Tc Sestamibi parathyroid scans

  7. DEVELOPMENT OF CROSS-BORDER AREAS. STUDY CASES REVIEW

    Directory of Open Access Journals (Sweden)

    Marcela\tȘLUSARCIUC

    2015-06-01

    Full Text Available The paper aims to review study cases found in the scientific literature concerning the development of cross- border areas in European Union and its neighbourhood. The introductory part of the paper is drawing few considerations about the cross-border areas. Further we identified in the specific literature relevant study cases that provide lessons learned, tools and models that can contribute to the development of the cross-border areas. The last part of the paper is focusing on an inquiry about how this lessons, learned, tools and models may be adapted in case of cross-border areas along the Romanian border with the EU Eastern Neighbourhood.

  8. Histological Stains: A Literature Review and Case Study.

    Science.gov (United States)

    Alturkistani, Hani A; Tashkandi, Faris M; Mohammedsaleh, Zuhair M

    2015-06-25

    The history of histology indicates that there have been significant changes in the techniques used for histological staining through chemical, molecular biology assays and immunological techniques, collectively referred to as histochemistry. Early histologists used the readily available chemicals to prepare tissues for microscopic studies; these laboratory chemicals were potassium dichromate, alcohol and the mercuric chloride to harden cellular tissues. Staining techniques used were carmine, silver nitrate, Giemsa, Trichrome Stains, Gram Stain and Hematoxylin among others. The purpose of this research was to assess past and current literature reviews, as well as case studies, with the aim of informing ways in which histological stains have been improved in the modern age. Results from the literature review has indicated that there has been an improvement in histopathology and histotechnology in stains used. There has been a rising need for efficient, accurate and less complex staining procedures. Many stain procedures are still in use today, and many others have been replaced with new immunostaining, molecular, non-culture and other advanced staining techniques. Some staining methods have been abandoned because the chemicals required have been medically proven to be toxic. The case studies indicated that in modern histology a combination of different stain techniques are used to enhance the effectiveness of the staining process. Currently, improved histological stains, have been modified and combined with other stains to improve their effectiveness.

  9. Humanitarian logistics: Review and case study of Zimbabwean experiences

    Directory of Open Access Journals (Sweden)

    Charles Mbohwa

    2010-11-01

    Full Text Available This paper reviews and presents findings on mini-case studies done on the difficulties and problems faced by humanitarian organisations in running logistics systems in Zimbabwe. Document analysis was done and this was complemented by mini-case studies and semi-structured interviews and site visits. Mini-case studies of the operations of the World Food Programme, the International Red Cross Society and the Zimbabwe Red Cross Society, the World Health Organisation, the United Nations Children's Fund and the Zimbabwean Civil Protection Organisation in Zimbabwe are discussed. These clarify the difficulties and problems faced such as the lack of trained logistics personnel, lack of access to specialised humanitarian logistics courses and research information, the difficulty in using and adapting existing logistics systems in attending to humanitarian logistics and the lack of collaborative efforts that address the area specifically. This study seeks to use primary and secondary information to inform decision-making in humanitarian logistics with possible lessons for neighbouring countries, other regions in Africa and beyond. Activities on collaborative networks that are beneficial to humanitarian logistics are also suggested.

  10. Review of extended producer responsibility: A case study approach.

    Science.gov (United States)

    Gupt, Yamini; Sahay, Samraj

    2015-07-01

    Principles of extended producer responsibility have been the core of most of the recent policies and legislation dealing with the end-of-life management of recyclable goods. This article makes an exploratory review of 27 cases of extended producer responsibility from developed and developing economies with and without informal recycling, to ascertain the most important aspect of extended producer responsibility. A comparative analysis of the cases with respect to role of stakeholders in the upstream and downstream stages of the extended producer responsibility has been carried out. Further, the study uses exploratory factor analysis to determine the important aspects of the extended producer responsibility in practice using 13 variables identified from the review. Findings of the comparative analysis reveal that financial responsibility of the producers and separate collecting and recycling agencies contributed significantly to the success of the extended producer responsibility-based environmental policies. Regulatory provisions, take-back responsibility and financial flow come out to be the three most important aspects of the extended producer responsibility. Presence of informal sector had a negative impact on the regulatory provisions. The outcomes of this study could serve as a guideline for designing of effective extended producer responsibility-based policies. © The Author(s) 2015.

  11. Current management of bronchiectasis: review and 3 case studies.

    Science.gov (United States)

    Silverman, Enid; Ebright, Linda; Kwiatkowski, Marianne; Cullina, Joanne

    2003-01-01

    Bronchiectasis is the abnormal, irreversible dilatation of diseased bronchi. Permanently dilated airways, usually in the medium-sized bronchi, are inflamed and often obstructed with thick, purulent secretions. Known causative factors include postinfection bronchial damage, postinhalation injury, hypersensitivity reactions, and congenital airway obstructive disorders. Typical symptoms include sputum overproduction, fever, pleurisy, dyspnea, and chronic cough. Diagnosis involves radiographic studies and pulmonary function testing. Treatment includes oral, aerosolized, or intravenous antibiotic therapy according to the severity of the exacerbation, and mucus clearance by means of bronchial hygiene assistive devices, chest physiotherapy, postural drainage, and high-frequency chest compression. We present a review of bronchiectasis and offer 3 case studies illustrating current management of different presentations, including use of aerosolized antibiotics for patients infected with Pseudomonas aeruginosa. Although an adjunctive program of pulmonary rehabilitation may be useful for patients with bronchiectasis, no confirming studies have been performed to date, and additional research in this area is warranted.

  12. Educational data mining: a sample of review and study case

    Directory of Open Access Journals (Sweden)

    Alejandro Pena, Rafael Domínguez, Jose de Jesus Medel

    2009-12-01

    Full Text Available The aim of this work is to encourage the research in a novel merged field: Educational data mining (EDM. Thereby, twosubjects are outlined: The first one corresponds to a review of data mining (DM methods and EDM applications. Thesecond topic represents an EDM study case. As a result of the application of DM in Web-based Education Systems (WBES,stratified groups of students were found during a trial. Such groups reveal key attributes of volunteers that deserted orremained during a WBES experiment. This kind of discovered knowledge inspires the statement of correlational hypothesisto set relations between attributes and behavioral patterns of WBES users. We concluded that: When EDM findings aretaken into account for designing and managing WBES, the learning objectives are improved

  13. Ethics policy review: a case study in quality improvement.

    Science.gov (United States)

    Frolic, Andrea Nadine; Drolet, Katherine

    2013-02-01

    Policy work is often cited as one of the primary functions of Hospital Ethics Committees (HECs), along with consultation and education. Hospital policies can have far reaching effects on a wide array of stakeholders including, care providers, patients, families, the culture of the organisation and the community at large. In comparison with the wealth of information available about the emerging practice of ethics consultation, relatively little attention has been paid to the policy work of HECs. In this paper, we hope to advance the development of best practices in HEC policy work by describing the quality improvement process that we undertook at Hamilton Health Sciences, Hamilton, Ontario, Canada. In the first section of the paper we describe the context of our HEC policy work, and the shortcomings of our historical review process. In subsequent sections, we detail the quality improvement project we undertook in 2010, the results of the project and the specific tools we developed to enhance the quality of HEC policy work. Our goal in sharing this organisational case study is to prompt other HECs to publish qualitative descriptions of their policy work, in order to generate a body of knowledge that can inform the development of best practices for ethics policy review.

  14. Cost of dengue outbreaks: literature review and country case studies.

    Science.gov (United States)

    Stahl, Hans-Christian; Butenschoen, Vicki Marie; Tran, Hien Tinh; Gozzer, Ernesto; Skewes, Ronald; Mahendradhata, Yodi; Runge-Ranzinger, Silvia; Kroeger, Axel; Farlow, Andrew

    2013-11-06

    Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save--through early response activities--resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems.The country case studies--conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the different cost components (vector control

  15. Cost of dengue outbreaks: literature review and country case studies

    Science.gov (United States)

    2013-01-01

    Background Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save – through early response activities – resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Methods Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Results Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems. The country case studies – conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the

  16. Nanomaterial Case Studies: Nanoscale Titanium Dioxide (External Review Draft)

    Science.gov (United States)

    This draft document presents two case studies of nanoscale titanium dioxide (nano-TiO2) used (1) to remove arsenic from drinking water and (2) as an active ingredient in topical sunscreen. The draft case studies are organized around a comprehensive environmental asses...

  17. Draft Benzene Case Study Review - Second Prospective Report Study Science Advisory Board Review, March 2008

    Science.gov (United States)

    EPA developed a methodology for estimating the health benefits of benzene reductions and has applied it in a metropolitan-scale case study of the benefits of CAA controls on benzene emissions to accompany the main 812 analysis.

  18. Performance of air sparging systems -- A review of case studies

    International Nuclear Information System (INIS)

    Bass, D.H.; Brown, R.A.

    1995-01-01

    In situ air sparging is a commonly used remediation technology which volatilizes and enhances aerobic biodegradation of contamination in Groundwater and saturated zone soil. Recently, some questions have been raised regarding the effectiveness of air sparging. To address these questions the results of 21 sparging case studies have been compiled to shed light on how well air sparging achieves permanent reduction in groundwater contaminant concentrations. The case studies included both chlorinated solvents and petroleum hydrocarbon contamination, and covered a wide range of soil conditions and sparge system parameters. In each case study, groundwater concentrations were compared before sparging was initiated, just before sparging was terminated, and in the months following shutdown of the sparging system

  19. Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals

    Science.gov (United States)

    Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

    2017-01-01

    Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation. PMID:29046660

  20. Hair toe tourniquets: a review of two case studies.

    Science.gov (United States)

    Booth, Julia; Morse, Tim

    2018-05-22

    Digit hair tourniquets are relatively uncommon. There are reports in the literature of hair tourniquets involving other appendages, such as the penis and uvula, however the phenomenon is not widely recognised and is often overlooked by healthcare professionals. This article discusses two case studies in which hair was responsible for creating a tourniquet around a digit. The article explores possible causes and management options for patients, with reference to the case studies. Midwives and health visitors are central to minimising the risk of injury to children as they can educate expectant mothers about this potential problem. © 2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  1. How Does Student Peer Review Influence Perceptions, Engagement and Academic Outcomes? A Case Study

    Science.gov (United States)

    Mulder, Raoul; Baik, Chi; Naylor, Ryan; Pearce, Jon

    2014-01-01

    Involving students in peer review has many pedagogical benefits, but few studies have explicitly investigated relationships between the content of peer reviews, student perceptions and assessment outcomes. We conducted a case study of peer review within a third-year undergraduate subject at a research-intensive Australian university, in which we…

  2. The zebrafish genome: a review and msx gene case study.

    Science.gov (United States)

    Postlethwait, J H

    2006-01-01

    Zebrafish is one of several important teleost models for understanding principles of vertebrate developmental, molecular, organismal, genetic, evolutionary, and genomic biology. Efficient investigation of the molecular genetic basis of induced mutations depends on knowledge of the zebrafish genome. Principles of zebrafish genomic analysis, including gene mapping, ortholog identification, conservation of syntenies, genome duplication, and evolution of duplicate gene function are discussed here using as a case study the zebrafish msxa, msxb, msxc, msxd, and msxe genes, which together constitute zebrafish orthologs of tetrapod Msx1, Msx2, and Msx3. Genomic analysis suggests orthologs for this difficult to understand group of paralogs.

  3. Case studies in the retailer internationalization: a literature review

    Directory of Open Access Journals (Sweden)

    Renata Maria de Almeida Bastos Gomes

    2017-04-01

    Full Text Available Research on retail internationalization (RI has undergone an intense development phase since the 1990s, dominated by quantitative research and based on the retail experience of large-scale retailers formats such as supermarkets. However, the internationalization of the retail sector has evolved into areas that existing models have not been able to explain, generating a demand for more thorough research. The result has been an increase of articles published since the early 2000s based on research of an exploratory and qualitative nature, such as case studies. In this article, main contributions are identified in RI arising from case studies resulting from the selection and analysis of 48 articles published in academic journals between 2000 and 2015. As a result, relevant findings on the steps of the RI process are presented, such as input modes for franchise, international divestment, and characteristics of the RI process of specific types of firms, such as fashion retailers and small- and medium-size retailers.

  4. Brief Report: Autism Spectrum Disorder and Substance Use Disorder: A Review and Case Study

    Science.gov (United States)

    Rengit, Ashy C.; McKowen, James W.; O'Brien, Julie; Howe, Yamini J.; McDougle, Christopher J.

    2016-01-01

    There is limited literature available on the comorbidity between autism spectrum disorder (ASD) and substance use disorder (SUD). This paper reviews existing literature and exemplifies the challenges of treating this population with a case report of an adult male with ASD and DSM-5 alcohol use disorder. This review and case study seeks to…

  5. Case Study: University of Anyplace: Strategic Legal Risk Review.

    Science.gov (United States)

    Hall, John T.; Ferguson, Rowan

    2000-01-01

    Considers legal issues and risks faced by a fictional American university as it seeks to establish an operation based in London. Addresses the first step in the process of risk management, the risk review exercise, and provides an explanation of the legal issues involved to allow progression to the second stage in the process (evaluation of the…

  6. Letter Report for the Review of ORD Nanomaterial Case Studies Workshop (August 2010)

    Science.gov (United States)

    The following is a letter report from the Executive Committee of the BOSC concerning the review of the ORD Nanomaterial Case Studies Workshop: Developing a Comprehensive Environmental Assessment Research Strategy for Nanoscale Titanium Dioxide.

  7. Intrauterine exposure to carbamazepine and specific congenital malformations : systematic review and case-control study

    NARCIS (Netherlands)

    Jentink, Janneke; Dolk, Helen; Loane, Maria A.; Morris, Joan K.; Wellesley, Diana; Garne, Ester; de Jong-van den Berg, Lolkje

    2010-01-01

    Objective To identify specific major congenital malformations associated with use of carbamazepine in the first trimester of pregnancy. Design A review of all published cohort studies to identify key indications and a population based case-control study to test these indications. Setting Review of

  8. Using Peer Reviews to Examine Micropolitics and Disciplinary Development of Engineering Education: A Case Study

    Science.gov (United States)

    Beddoes, Kacey

    2014-01-01

    This article presents a case study of the peer review process for a feminist article submitted to an engineering education journal. It demonstrates how an examination of peer review can be a useful approach to further understanding the development of feminist thought in education fields. Rather than opposition to feminist thought per se, my…

  9. A methodological review of qualitative case study methodology in midwifery research.

    Science.gov (United States)

    Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

    2016-10-01

    To explore the use and application of case study research in midwifery. Case study research provides rich data for the analysis of complex issues and interventions in the healthcare disciplines; however, a gap in the midwifery research literature was identified. A methodological review of midwifery case study research using recognized templates, frameworks and reporting guidelines facilitated comprehensive analysis. An electronic database search using the date range January 2005-December 2014: Maternal and Infant Care, CINAHL Plus, Academic Search Complete, Web of Knowledge, SCOPUS, Medline, Health Collection (Informit), Cochrane Library Health Source: Nursing/Academic Edition, Wiley online and ProQuest Central. Narrative evaluation was undertaken. Clearly worded questions reflected the problem and purpose. The application, strengths and limitations of case study methods were identified through a quality appraisal process. The review identified both case study research's applicability to midwifery and its low uptake, especially in clinical studies. Many papers included the necessary criteria to achieve rigour. The included measures of authenticity and methodology were varied. A high standard of authenticity was observed, suggesting authors considered these elements to be routine inclusions. Technical aspects were lacking in many papers, namely a lack of reflexivity and incomplete transparency of processes. This review raises the profile of case study research in midwifery. Midwives will be encouraged to explore if case study research is suitable for their investigation. The raised profile will demonstrate further applicability; encourage support and wider adoption in the midwifery setting. © 2016 John Wiley & Sons Ltd.

  10. Methodology or method? A critical review of qualitative case study reports

    Directory of Open Access Journals (Sweden)

    Nerida Hyett

    2014-05-01

    Full Text Available Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12, social sciences and anthropology (n=7, or methods (n=15 case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

  11. Methodology or method? A critical review of qualitative case study reports

    Science.gov (United States)

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

    2014-01-01

    Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners. PMID:24809980

  12. Institutional ethical review and ethnographic research involving injection drug users: a case study.

    Science.gov (United States)

    Small, Will; Maher, Lisa; Kerr, Thomas

    2014-03-01

    Ethnographic research among people who inject drugs (PWID) involves complex ethical issues. While ethical review frameworks have been critiqued by social scientists, there is a lack of social science research examining institutional ethical review processes, particularly in relation to ethnographic work. This case study describes the institutional ethical review of an ethnographic research project using observational fieldwork and in-depth interviews to examine injection drug use. The review process and the salient concerns of the review committee are recounted, and the investigators' responses to the committee's concerns and requests are described to illustrate how key issues were resolved. The review committee expressed concerns regarding researcher safety when conducting fieldwork, and the investigators were asked to liaise with the police regarding the proposed research. An ongoing dialogue with the institutional review committee regarding researcher safety and autonomy from police involvement, as well as formal consultation with a local drug user group and solicitation of opinions from external experts, helped to resolve these issues. This case study suggests that ethical review processes can be particularly challenging for ethnographic projects focused on illegal behaviours, and that while some challenges could be mediated by modifying existing ethical review procedures, there is a need for legislation that provides legal protection of research data and participant confidentiality. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Video Cases in Teacher Education: A review study on intended and achieved learning objectives by video cases

    NARCIS (Netherlands)

    Geerts, Walter; Van der Werff, Anne; Hummel, Hans; Van Geert, Paul

    2014-01-01

    This literature review focuses on the use of video cases in the education of preservice teachers as a means of achieving higher order learning objectives that are necessary for gaining situated knowledge. An overview of both intended and achieved learning objectives in relevant studies involving

  14. Case Study in Public Administration: A Critical Review of Brazilian Scientific Production

    Directory of Open Access Journals (Sweden)

    Mariana Guerra

    2015-03-01

    Full Text Available This paper presents a critical review of 47 articles published between 2006 and 2011 to identify how case studies have been applied in Brazilian research on public administration. In addition to their theoretical and methodological characteristics, four further specific topics of interest were addressed: (a what is meant by case study; (b the relationship between the phenomenon of interest and the case under investigation; (c the possibility of replication; and (d how the supposed method contributes towards the development of the field of public administration. The main inconsistencies found were: the methodological descriptions are confusing; the results are inconsistent compared with data gathering procedures and data analysis techniques; a lack of information about the number of interviewed individuals; and no descriptions of research variables. The results suggest the reviewed case studies present methodological inconsistencies and limitations, which undermine their scientific value and relevance to academic work in Brazil.

  15. Review Article: Structural flood-protection measures referring to several European case studies

    Science.gov (United States)

    Kryžanowski, A.; Brilly, M.; Rusjan, S.; Schnabl, S.

    2014-01-01

    The paper presents a review of structural measures that were taken to cope with floods in some cities along the Danube River, such as Vienna, Bratislava, and Belgrade. These cities were also considered as case studies within the KULTURisk project. The structural measures are reviewed and compared to each other according to the type, duration of application, the return period of the design flood event, how the project measures are integrated into spatial planning and the problems that occur in the flood defences today. Based on this review, some suggestions are given on how to improve the flood risk management in flood-prone areas.

  16. The Somalia Country Case Study. Mid-Decade Review of Progress towards Education for All.

    Science.gov (United States)

    Bennaars, Gerard A.; Seif, Huda A.; Mwangi, Doris

    In 1995, the International Consultative Forum on Education for All commissioned case studies in developing countries as part of a mid-decade review of progress in expanding access to basic education. This paper examines the situation in Somalia, where civil war has completely destroyed the infrastructure of education. Part 1 summarizes Somalia's…

  17. Osteogenesis imperfecta - iconographic study of two cases and review of the literature

    International Nuclear Information System (INIS)

    Souza, Ricardo Pires de; Fernandes, Cintia; Hilario, Marcelo Cobra; Barros, Wagner Moraes; Soares, Aldemir Humberto

    1996-01-01

    The authors present a literature review about osteogenesis imperfecta, a disease that leads to bone fragility and low height patterns caused by an abnormality of the collagen synthesis. The iconographic study is based on two cases of the tarda type. (author)

  18. Online and Paper Evaluations of Courses: A Literature Review and Case Study

    Science.gov (United States)

    Morrison, Keith

    2013-01-01

    This paper reviews the literature on comparing online and paper course evaluations in higher education and provides a case study of a very large randomised trial on the topic. It presents a mixed but generally optimistic picture of online course evaluations with respect to response rates, what they indicate, and how to increase them. The paper…

  19. A review of case studies evaluating economic incentives to promote occupational safety and health

    NARCIS (Netherlands)

    Elsler, D.; Treutlein, D.; Rydlewska, I.; Frusteri, L.; Krüger, H.; Veerman, T.; Eeckelaert, L.; Roskams, N.; Broek, K. van den; Taylor, T.N.

    2010-01-01

    Objectives: In many European countries, external economic incentives are discussed as a policy instrument to promote occupational safety and health (OSH) in enterprises. This narrative case study review aims to support policy-makers in organizations providing such incentives by supplying information

  20. The dynamics of utilization review: a case study of 44 Massachusetts hospitals.

    Science.gov (United States)

    Gertman, P M; Egdahl, R E

    1978-10-01

    Utilization review programs have existed on a national basis for over a decade, but relatively little is known about the patients who are scrutinized and what actions are taken to correct unnecessary use. In the fall of 1976, 44 of the 122 Massachusetts hospitals participated in a two-week in depth study of their utilization review activities. Over 22,000 admission and extended stay reviews were performed during this time period, and of these, 2,120 patients' continued stays in the hospital were questioned. In five admission review cases and 79 extended stay review cases, the UR committee formally terminated continued health insurance benefits, and in 12 admission reviews and 74 extended stay reviews, questioning by the UR committee led the attending physician to discharge the patient earlier than would have otherwise occurred. Ninety-four percent of the terminations occurred in Medicare patients and the median age of these patients exceeded 80 years. For medical patients, a disproportionate share of all those cases questioned and of those terminated occurred in chronic illness categories, such as cancer, heart failure, and organic brain syndromes. A higher than expected percentage of surgical cases questioned by the UR committee were in neurosurgical, cardiovascular and orthopedic procedure groups. The frequency with which UR committees identified and acted upon cases suggests that effective self-policing is occurring. A large portion of the utilization problem, however, may be related to the unavailability of appropriate sub-acute care for patients with chronic medical illness or surgical procedures which require long postoperative rehabilitation and recuperation.

  1. Use of Comparative Case Study Methodology for US Public Health Policy Analysis: A Review.

    Science.gov (United States)

    Dinour, Lauren M; Kwan, Amy; Freudenberg, Nicholas

    There is growing recognition that policies influence population health, highlighting the need for evidence to inform future policy development and reform. This review describes how comparative case study methodology has been applied to public health policy research and discusses the methodology's potential to contribute to this evidence. English-language, peer-reviewed articles published between 1995 and 2012 were sought from 4 databases. Articles were included if they described comparative case studies addressing US public health policy. Two researchers independently assessed the 20 articles meeting review criteria. Case-related characteristics and research design tactics utilized to minimize threats to reliability and validity, such as the use of multiple sources of evidence and a case study protocol, were extracted from each article. Although comparative case study methodology has been used to analyze a range of public health policies at all stages and levels, articles reported an average use of only 3.65 (out of 10) research design tactics. By expanding the use of accepted research design tactics, public health policy researchers can contribute to expanding the evidence needed to advance health-promoting policies.

  2. Peer Review in Controversial Topics—A Case Study of 9/11

    Directory of Open Access Journals (Sweden)

    John D. Wyndham

    2017-06-01

    Full Text Available Beginning with an historical reminiscence, this paper examines the peer review process as experienced by authors currently seeking publication of their research in a highly controversial area. A case study of research into the events of 9/11 (11 September 2001 illustrates some of the problems in peer review arising from undue influences based on financial and political considerations. The paper suggests that ethical failures, rather than flaws in the process itself, are mainly responsible for perceived problems. The way forward lies in improved ethics and a more open process. In addition, editorial review boards and peer review strategies would help to improve the ethics of peer review in general.

  3. Review of GIF PR and PP Evaluation Case Study for Application to Pyroprocessing

    Energy Technology Data Exchange (ETDEWEB)

    Kim, H. M.; Ahn, S. K.; Kwon, E. H.; Kim, H. D. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-05-15

    This paper has summarized and reviewed the ESFR case study, as it relates to the application of the evaluation methods to pyroprocessing facilities as well as the sodium fast reactor fuel cycle in the future as a self-assessment study. The GIF PR and PP evaluation methodology and the case study both addressed physical protection, but this paper focuses only on proliferation resistance. It does not consider physical protection. The Generation IV International Forum (GIF) emphasizes proliferation resistance and physical protection (PR and PP) as one of the main aspects to be considered regarding future nuclear energy systems (NESs). As such, the PR and PP Working Group developed an evaluation methodology and applied it to the Example Sodium Fast Reactor (ESFR) as a case study. This paper has summarized and reviewed the ESFR case study, as it relates to the application of the evaluation methods to pyroprocessing facilities as well as the sodium fast reactor fuel cycle in the future as a self-assessment study. The GIF PR and PP evaluation methodology and the case study both addressed physical protection, but this paper focuses only on proliferation resistance. It does not consider physical protection.

  4. Review of GIF PR and PP Evaluation Case Study for Application to Pyroprocessing

    International Nuclear Information System (INIS)

    Kim, H. M.; Ahn, S. K.; Kwon, E. H.; Kim, H. D.

    2014-01-01

    This paper has summarized and reviewed the ESFR case study, as it relates to the application of the evaluation methods to pyroprocessing facilities as well as the sodium fast reactor fuel cycle in the future as a self-assessment study. The GIF PR and PP evaluation methodology and the case study both addressed physical protection, but this paper focuses only on proliferation resistance. It does not consider physical protection. The Generation IV International Forum (GIF) emphasizes proliferation resistance and physical protection (PR and PP) as one of the main aspects to be considered regarding future nuclear energy systems (NESs). As such, the PR and PP Working Group developed an evaluation methodology and applied it to the Example Sodium Fast Reactor (ESFR) as a case study. This paper has summarized and reviewed the ESFR case study, as it relates to the application of the evaluation methods to pyroprocessing facilities as well as the sodium fast reactor fuel cycle in the future as a self-assessment study. The GIF PR and PP evaluation methodology and the case study both addressed physical protection, but this paper focuses only on proliferation resistance. It does not consider physical protection

  5. Improving case study research in medical education: a systematised review.

    Science.gov (United States)

    Cheek, Colleen; Hays, Richard; Smith, Janie; Allen, Penny

    2018-05-01

    Case study research (CSR) is a research approach that guides holistic investigation of a real phenomenon. This approach may be useful in medical education to provide critical analyses of teaching and learning, and to reveal the underlying elements of leadership and innovation. There are variations in the definition, design and choice of methods, which may diminish the value of CSR as a form of inquiry. This paper reports an analysis of CSR papers in the medical education literature. The review aims to describe how CSR has been used and how more consistency might be achieved to promote understanding and value. A systematised review was undertaken to quantify the number of CSR articles published in scholarly medical education journals over the last 10 years. A typology of CSR proposed by Thomas and Myers to integrate the various ways in which CSR is constructed was applied. Of the 362 full-text articles assessed, 290 were excluded as they did not meet the eligibility criteria; 76 of these were titled 'case study'. Of the 72 included articles, 50 used single-case and 22 multi-case design; 46 connected with theory and 26 were atheoretical. In some articles it was unclear what the subject was or how the subject was being analysed. In this study, more articles titled 'case study' failed than succeeded in meeting the eligibility criteria. Well-structured, clearly written CSR in medical education has the potential to increase understanding of more complex situations, but this review shows there is considerable variation in how it is conducted, which potentially limits its utility and translation into education practice. Case study research might be of more value in medical education if researchers were to follow more consistently principles of design, and harness rich observation with connection of ideas and knowledge to engage the reader in what is most interesting. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  6. Health Services for Management of Chronic Non-Cancer Pain in Kuwait: A Case Study Review.

    Science.gov (United States)

    Lakha, S Fatima; Pennefather, Peter; Badr, Hanan E; Mailis-Gagnon, Angela

    2016-01-01

    The experience of chronic pain is universal, yet pain management services delivered by health professionals vary substantially, depending on the context and patient. This review is a part of a series that has examined the issue of chronic non-cancer pain services and management in different global cities. The review is structured as a case study of the availability of management services for people living with chronic non-cancer pain within the context of the Kuwaiti health systems, and the cases are built from evidence in the published literature identified through a comprehensive review process. The evolution of the organizational structure of the public and private health systems in Kuwait is described. These are discussed in terms of their impact on the delivery of comprehensive chronic pain management service by health professionals in Kuwait. This review also includes a description of chronic pain patient personas to highlight expected barriers as well as compliance issues with services likely to be encountered in Kuwait. The case study analysis and persona descriptions illustrate a need to move beyond pain symptom management towards considering the entire person and his/her individual experience of pain such that health care success is judged by enhancement of patient well-being rather than access to services. A road map for improving integrative chronic pain management in Kuwait is discussed. © 2015 S. Karger AG, Basel.

  7. Matched case-control studies: a review of reported statistical methodology

    Directory of Open Access Journals (Sweden)

    Niven DJ

    2012-04-01

    Full Text Available Daniel J Niven1, Luc R Berthiaume2, Gordon H Fick1, Kevin B Laupland11Department of Critical Care Medicine, Peter Lougheed Centre, Calgary, 2Department of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaBackground: Case-control studies are a common and efficient means of studying rare diseases or illnesses with long latency periods. Matching of cases and controls is frequently employed to control the effects of known potential confounding variables. The analysis of matched data requires specific statistical methods.Methods: The objective of this study was to determine the proportion of published, peer reviewed matched case-control studies that used statistical methods appropriate for matched data. Using a comprehensive set of search criteria we identified 37 matched case-control studies for detailed analysis.Results: Among these 37 articles, only 16 studies were analyzed with proper statistical techniques (43%. Studies that were properly analyzed were more likely to have included case patients with cancer and cardiovascular disease compared to those that did not use proper statistics (10/16 or 63%, versus 5/21 or 24%, P = 0.02. They were also more likely to have matched multiple controls for each case (14/16 or 88%, versus 13/21 or 62%, P = 0.08. In addition, studies with properly analyzed data were more likely to have been published in a journal with an impact factor listed in the top 100 according to the Journal Citation Reports index (12/16 or 69%, versus 1/21 or 5%, P ≤ 0.0001.Conclusion: The findings of this study raise concern that the majority of matched case-control studies report results that are derived from improper statistical analyses. This may lead to errors in estimating the relationship between a disease and exposure, as well as the incorrect adaptation of emerging medical literature.Keywords: case-control, matched, dependent data, statistics

  8. An International Review of Eco-City Theory, Indicators, and Case Studies

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Williams, Christopher [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-03-01

    This report is intended to answer the question: “What international experiences with ‘eco-cities’ can help the central Chinese government evaluate the performance of Chinese cities that pursue ‘lowcarbon’ urban development?” To answer this question, we reviewed the literature on eco-cities and closely related concepts, surveyed performance indicators used to evaluate sustainable urban development around the world, and compiled case studies of exceptional eco- and sustainable cities.

  9. Benzene Case Study Final Report - Second Prospective Report Study Science Advisory Board Review, July 2009

    Science.gov (United States)

    EPA developed a methodology for estimating the health benefits of benzene reductions and has applied it in a metropolitan-scale case study of the benefits of CAA controls on benzene emissions to accompany the main 812 analysis.

  10. Oral lymphoepithelial cyst: A clinicopathological study of 26 cases and review of the literature.

    Science.gov (United States)

    Sykara, Maria; Ntovas, Panagiotis; Kalogirou, Eleni-Marina; Tosios, Konstantinos I; Sklavounou, Alexandra

    2017-08-01

    Τo describe the clinicopathological features of 26 oral lymphoepithelial cysts (LECs) and review the literature. Twenty-six cases of oral LECs diagnosed during a 37-year period were retrospectively collected. The patients' gender and age, as well as the main clinical features of the cysts were retrieved from the requisition forms. The main microscopic features were recorded after reevaluation of all cases. Pubmed and Google Scholar electronic databases were searched with the key word "oral LEC". Inclusion criteria were the microscopic confirmation of LEC diagnosis and the report at least two of three main clinical features (gender, age and cyst's location). The 26 oral LECs represented 0.08% of 31,564 biopsies accessioned during the study period. They affected 25 patients, 14 females and 11 males with a mean age of 33.04±9.81 years. They appeared as smooth (92%) nodules, with soft (24%) or firm (76%) consistency and normal (28%), yellow to normal (20%), yellow (32%) or white (20%) hue, in the tongue (69.23%) or the floor of mouth (30.77%). They were covered by parakeratinized squamous (92.31%) or non-keratinized (7.69%) epithelium and contained desquamated epithelial cells, amorphous eosinophilic material and/or inflammatory cells (100%). The lymphoid tissue surrounded the cystic cavity partially (34.62%) or completely (65.38%), often in a follicular pattern with prominent germinal centers (53.85%). Literature review yielded 316 cases of oral LECs derived from 25 case reports, 3 case studies/retrospective studies with detailed information for each case and 7 studies with summarized data. Oral LEC is a pathologic entity with discrete clinical presentation that is, however, commonly misdiagnosed in clinical practice as other, mostly benign, entities. Its pathogenesis remains obscure, as its clinicopathologic features are consistent with both theories suggested up to date. Key words: Oral lymphoepithelial cyst; developmental cyst; non odontogenic cyst; lymphoid

  11. MINI REVIEW ARTICLE:Immunohistochemistry of Epithelioid Soft Tissue Sarcomas, Literature Review Based on Case Studies

    Directory of Open Access Journals (Sweden)

    Megha Joshi

    2012-07-01

    Full Text Available Neoplasms with epithelioid histology may be diagnostically challenging. Immunohisto chemistry (IHC can aid in confirming thedifferential diagnosis of mesotheliomas, melanomas, lymphomas, and soft tissue sarcomas, all tumors that can present with an epithelioid histology. Immunohistochemistry can also assist in confirming the type of sarcomas. Using cases diagnosed in acommunity hospital setting over a ten year period, the use of IHC in sarcomas will be illustrated.

  12. A probabilistic safety assessment PEER review: Case study on the use of probabilistic safety assessment for safety decisions

    International Nuclear Information System (INIS)

    1989-10-01

    The purpose of this case study is to illustrate, using an actual example, the organizing and carrying out of an independent peer review of a draft full-scope (level 3) probabilistic safety assessment. The specific findings of the peer review are of less importance than the approach taken, the interaction between sponsor and study team, and the technical and administrative issues that can arise during a peer review. This case study will examine the following issues: how the scope of the peer review was established, based on how it was to be used by the review sponsoring body; how the level of effort was determined, and what this determination meant for the technical quality of the review; how the team of peer reviewers was selected; how the review itself was carried out; what findings were made; what was done with these findings by both the review sponsoring body and the PSA analysis team. 9 refs, 2 figs, 1 tab

  13. Case-Control Studies of Sporadic Enteric Infections: A Review and Discussion of Studies Conducted Internationally from 1990 to 2009

    Science.gov (United States)

    Fullerton, Kathleen E.; Scallan, Elaine; Kirk, Martyn D.; Mahon, Barbara E.; Angulo, Frederick J.; de Valk, Henriette; van Pelt, Wilfrid; Gauci, Charmaine; Hauri, Anja M.; Majowicz, Shannon; O’Brien, Sarah J.

    2015-01-01

    Epidemiologists have used case-control studies to investigate enteric disease outbreaks for many decades. Increasingly, case-control studies are also used to investigate risk factors for sporadic (not outbreak-associated) disease. While the same basic approach is used, there are important differences between outbreak and sporadic disease settings that need to be considered in the design and implementation of the case-control study for sporadic disease. Through the International Collaboration on Enteric Disease “Burden of Illness” Studies (the International Collaboration), we reviewed 79 case-control studies of sporadic enteric infections caused by nine pathogens that were conducted in 22 countries and published from 1990 through to 2009. We highlight important methodological and study design issues (including case definition, control selection, and exposure assessment) and discuss how approaches to the study of sporadic enteric disease have changed over the last 20 years (e.g., making use of more sensitive case definitions, databases of controls, and computer-assisted interviewing). As our understanding of sporadic enteric infections grows, methods and topics for case-control studies are expected to continue to evolve; for example, advances in understanding of the role of immunity can be used to improve control selection, the apparent protective effects of certain foods can be further explored, and case-control studies can be used to provide population-based measures of the burden of disease. PMID:22443481

  14. Resident Perspectives of an Interactive Case Review Following Independent Didactic Study as a Method of Teaching a Pediatric Imaging Curriculum.

    Science.gov (United States)

    Rozenberg, Aleksandr; Dheer, Sachin; Nazarian, Levon N; Long, Suzanne S

    The ABR has recently changed the format of the board examination, in which the oral examination was replaced by a computer based multiple-choice test. The purpose of this study was to determine resident's perceptions of a new conference resembling the new ABR format. Residents were requested to review a series of didactic pediatric imaging presentations prior to attending case conference. During conference, unknown cases reflecting the subject matter from the didactic presentations were presented along with multiple-choice questions. We then surveyed resident perspectives after each case conference. Between 14 and 18 residents were surveyed at the end of each subspecialty case review presentation. About 94% of resident respondents felt that the independent didactic study followed by an interactive case review session would better prepare them for the ABR certification exams, compared to didactic lectures alone. Furthermore, 95% of the respondents indicated that they preferred the independent didactic review followed by interactive case review versus didactic lecture alone. Most the respondents (85%) felt that combining independent didactic review with interactive unknown case sessions made the material more interesting and provided greater understanding of the material. There was no statistically significant difference in the distribution of answers across the subspecialty sessions (p > .05). Radiology residents favorably reviewed the combination of independent review of didactic material prior to interactive case review. Material presented in this fashion is felt to be more interesting and is thought to result in enhanced understanding of pediatric radiology material. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Improving the implementation of health workforce policies through governance: a review of case studies.

    Science.gov (United States)

    Dieleman, Marjolein; Shaw, Daniel Mp; Zwanikken, Prisca

    2011-04-12

    Responsible governance is crucial to national development and a catalyst for achieving the Millennium Development Goals. To date, governance seems to have been a neglected issue in the field of human resources for health (HRH), which could be an important reason why HRH policy formulation and implementation is often poor. This article aims to describe how governance issues have influenced HRH policy development and to identify governance strategies that have been used, successfully or not, to improve HRH policy implementation in low- and middle-income countries (LMIC). We performed a descriptive literature review of HRH case studies which describe or evaluate a governance-related intervention at country or district level in LMIC. In order to systematically address the term 'governance' a framework was developed and governance aspects were regrouped into four dimensions: 'performance', 'equity and equality', 'partnership and participation' and 'oversight'. In total 16 case studies were included in the review and most of the selected studies covered several governance dimensions. The dimension 'performance' covered several elements at the core of governance of HRH, decentralization being particularly prominent. Although improved equity and/or equality was, in a number of interventions, a goal, inclusiveness in policy development and fairness and transparency in policy implementation did often not seem adequate to guarantee the corresponding desirable health workforce scenario. Forms of partnership and participation described in the case studies are numerous and offer different lessons. Strikingly, in none of the articles was 'partnerships' a core focus. A common theme in the dimension of 'oversight' is local-level corruption, affecting, amongst other things, accountability and local-level trust in governance, and its cultural guises. Experiences with accountability mechanisms for HRH policy development and implementation were lacking. This review shows that the term

  16. Drug abuse identification and pain management in dental patients: a case study and literature review.

    Science.gov (United States)

    Hussain, Fahmida; Frare, Robert W; Py Berrios, Karen L

    2012-01-01

    Properly identifying patients with a history of drug abuse is the first step in providing effective dental care. Dental professionals need to be fully aware of the challenges associated with treating this population. In the current study, the authors analyzed the physical and oral manifestations of illicit drug abuse to aid in the identification of patients who abuse drugs and the pain management strategies needed to treat them. The authors also present a clinical case of a patient with unique skin lesions and discuss the typical clinical findings of drug abuse based on a literature review.

  17. Esthesioneuroblastoma: a case report of diffuse subdural recurrence and review of recently published studies

    International Nuclear Information System (INIS)

    Capelle, L.; Krawitz, H.

    2008-01-01

    Esthesioneuroblastoma is a rare malignancy arising from the olfactory epithelium. We present a case history of a 75-year-old man who presented with a Kadish stage C esthesioneuroblastoma and underwent craniofacial surgery and adjuvant radiotherapy. Two years later he was found to have diffuse subdural deposits with distant bone and nodal metastases, treated with further radiotherapy. The patient's condition subsequently deteriorated and he died. Given this unusual pattern of failure, we review the recent published studies regarding the natural history, treatment and outcome for this tumour.

  18. Coffin-Siris syndrome: review and presentation of new cases from a questionnaire study.

    Science.gov (United States)

    Fleck, B J; Pandya, A; Vanner, L; Kerkering, K; Bodurtha, J

    2001-02-15

    To clarify the phenotypic variability of Coffin-Siris syndrome, we present a review of the literature and 18 new cases. We performed a questionnaire study of patients ascertained through an international support group. Information on their sibs was available for comparison. The most frequent findings include some degree of mental retardation or developmental delay, "coarse" facial appearance, feeding difficulties, frequent infections, and hypoplastic to absent fifth fingernails and fifth distal phalanges. We discuss the key manifestations for diagnosis, medical and developmental implications, and possible pathogenesis. Copyright Wiley-Liss. Inc.

  19. Citation searching: a systematic review case study of multiple risk behaviour interventions.

    Science.gov (United States)

    Wright, Kath; Golder, Su; Rodriguez-Lopez, Rocio

    2014-06-03

    The value of citation searches as part of the systematic review process is currently unknown. While the major guides to conducting systematic reviews state that citation searching should be carried out in addition to searching bibliographic databases there are still few studies in the literature that support this view. Rather than using a predefined search strategy to retrieve studies, citation searching uses known relevant papers to identify further papers. We describe a case study about the effectiveness of using the citation sources Google Scholar, Scopus, Web of Science and OVIDSP MEDLINE to identify records for inclusion in a systematic review.We used the 40 included studies identified by traditional database searches from one systematic review of interventions for multiple risk behaviours. We searched for each of the included studies in the four citation sources to retrieve the details of all papers that have cited these studies.We carried out two analyses; the first was to examine the overlap between the four citation sources to identify which citation tool was the most useful; the second was to investigate whether the citation searches identified any relevant records in addition to those retrieved by the original database searches. The highest number of citations was retrieved from Google Scholar (1680), followed by Scopus (1173), then Web of Science (1095) and lastly OVIDSP (213). To retrieve all the records identified by the citation tracking searching all four resources was required. Google Scholar identified the highest number of unique citations.The citation tracking identified 9 studies that met the review's inclusion criteria. Eight of these had already been identified by the traditional databases searches and identified in the screening process while the ninth was not available in any of the databases when the original searches were carried out. It would, however, have been identified by two of the database search strategies if searches had been

  20. Implementing maternal death surveillance and response: a review of lessons from country case studies.

    Science.gov (United States)

    Smith, Helen; Ameh, Charles; Roos, Natalie; Mathai, Matthews; Broek, Nynke van den

    2017-07-17

    Maternal Death Surveillance and Response (MDSR) implementation is monitored globally, but not much is known about what works well, where and why in scaling up. We reviewed a series of country case studies in order to determine whether and to what extent these countries have implemented the four essential components of MDSR and identify lessons for improving implementation. A secondary analysis of ten case studies from countries at different stages of MDSR implementation, using a policy analysis framework to draw out lessons learnt and opportunities for improvement. We identify the consistent drivers of success in countries with well-established systems for MDSR, and common barriers in countries were Maternal Death Review (MDR) systems have been less successful. MDR is accepted and ongoing at subnational level in many countries, but it is not adequately institutionalised and the shift from facility based MDR to continuous MDSR that informs the wider health system still needs to be made. Our secondary analysis of country experiences highlights the need for a) social and team processes at facility level, for example the existence of a 'no shame, no blame' culture, and the ability to reflect on practice and manage change as a team for recommendations to be acted upon, b) health system inputs including adequate funding and reliable health information systems to enable identification and analysis of cases c) national level coordination of dissemination, and monitoring implementation of recommendations at all levels and d) mandatory notification of maternal deaths (and enforcement of this) and a professional requirement to participate in MDRs. Case studies from countries with established MDSR systems can provide valuable guidance on ways to set up the processes and overcome some of the barriers; but the challenge, as with many health system interventions, is to find a way to provide catalytic assistance and strengthen capacity for MDSR such that this becomes embedded in

  1. Accounting for multiple births in neonatal and perinatal trials: systematic review and case study.

    Science.gov (United States)

    Hibbs, Anna Maria; Black, Dennis; Palermo, Lisa; Cnaan, Avital; Luan, Xianqun; Truog, William E; Walsh, Michele C; Ballard, Roberta A

    2010-02-01

    To determine the prevalence in the neonatal literature of statistical approaches accounting for the unique clustering patterns of multiple births and to explore the sensitivity of an actual trial to several analytic approaches to multiples. A systematic review of recent perinatal trials assessed the prevalence of studies accounting for clustering of multiples. The Nitric Oxide to Prevent Chronic Lung Disease (NO CLD) trial served as a case study of the sensitivity of the outcome to several statistical strategies. We calculated odds ratios using nonclustered (logistic regression) and clustered (generalized estimating equations, multiple outputation) analyses. In the systematic review, most studies did not describe the random assignment of twins and did not account for clustering. Of those studies that did, exclusion of multiples and generalized estimating equations were the most common strategies. The NO CLD study included 84 infants with a sibling enrolled in the study. Multiples were more likely than singletons to be white and were born to older mothers (P accounted for clustering were statistically significant; analyses assuming independence were not. The statistical approach to multiples can influence the odds ratio and width of confidence intervals, thereby affecting the interpretation of a study outcome. A minority of perinatal studies address this issue. Copyright 2010 Mosby, Inc. All rights reserved.

  2. Assessing the impact of systematic reviews on future research: two case studies.

    Science.gov (United States)

    Viswanathan, Meera; Nerz, Patrick; Dalberth, Barbara; Voisin, Christiane; Lohr, Kathleen N; Tant, Elizabeth; Jonas, Daniel E; Carey, Timothy

    2012-07-01

    To evaluate the impact of systematic reviews on research funded by the Agency for Healthcare Research and Quality (AHRQ) through Evidence-based Practice Centers (EPCs), and to identify barriers to and facilitators for the effects of these documents on future research. Two AHRQ systematic reviews were selected as case studies to evaluate their impact on future research. Key citations generated by these reports were identified through ISI Web of Science and PubMed Central and traced forward to identify effects on subsequent studies through citation analysis from updated systematic reviews on the topics. Requests for applications and program announcements from the NIH Guide for Grants and Contracts website were reviewed and dissemination data were obtained from AHRQ. Finally, interviews were conducted with 13 key informants to help identify short-, medium- and long-term impacts of the EPC reviews. The measurable impact of the two EPC reviews is demonstrably greater on short-term outcomes (greater awareness of the issues) than on medium-term (e.g., the generation of new knowledge) or long-term outcomes (e.g., changes in patient practice or health outcomes). Factors such as the topic and the timing of the report relative to the development of the field may explain the impact of these two AHRQ reports. The degree to which the new research can be directly attributed to the AHRQ reviews remains unclear. Key informants discussed several benefits stemming from the EPC reports, including providing a foundation for the research community on which to build, heightening awareness of the gaps in knowledge, increasing the quality of research and sparking new directions of research. However, the degree to which these reports were influential hinged on several factors including marketing efforts, the very nature of the reports and other influences external to the EPC domain. The findings outlined in this article illustrate the importance of numerous factors influencing future

  3. Quality function deployment in healthcare: a literature review and case study.

    Science.gov (United States)

    Gremyr, Ida; Raharjo, Hendry

    2013-01-01

    This article aims to provide a literature review on the use of quality function deployment (QFD) in healthcare and a case study in order to provide contextual knowledge as a means of improving applications of QFD in healthcare. The literature search was done via Google Scholar, PubMed/MEDLINE, and Web of Science using the keywords "quality function deployment" and "healthcare"; focusing on journal publications and their related citations. The case study was done within a design for Six Sigma project (DFSS) in a Swedish hospital. Empirical data were collected through face-to-face interviews and project documentation. Four potentials (better understanding of customers' needs and wants, identification of opportunities for process improvement, effective system thinking approach, and better communication and more transparent process) and three antecedents (understanding the customer, understanding the customer's needs, and finding ways to prioritize and translate those needs) of QFD application in healthcare were identified from the literature review. From the case study, the application of QFD leads to an increased awareness of a complex multiple-customer concept, traceability of the improvement strategies in a more structured way, and the formation of a new process organization. A time study at one clinic (cardiology) before and after the project within which the QFD was used showed that the time spent on prescription of medication has decreased by more than 20 percent. This has increased the time that doctors can spend with their patients. This paper highlights the potentials and antecedents of applying QFD in healthcare from previous research. Furthermore, the practical findings obtained from applying QFD in the project can also provide some useful insights for practitioners. The novel contribution is two-fold. First, it is the identification of the potentials and antecedents of using QFD in healthcare context. Second, it is the findings and learning from a

  4. Guillain-Barré syndrome associated with monosialotetrahexosylganglioside: three cases study and literature review

    Directory of Open Access Journals (Sweden)

    ZENG Ke-bin

    2013-04-01

    Full Text Available Background Monosialotetrahexosylganglioside (GM1 is a kind of ganglioside extracted from the neural cells of pig brain, which involves in the pathophysiological processes of neurogenesis, and plays an important role in neural formation, growth and differentiation. GM1 is widely used in the treatment for vascular brain injury and traumatic brain and spinal cord injury, promoting and protecting the recovery of nerve cells. Besides, it can improve the behavior disorders of patients with Parkinson's disease. However, as it is widely used in clinical practice, its adverse reaction has been gradually discovered. There is some evidence to suggest Guillain-Barré syndrome (GBS may occur after GM1 injection intravenously. Both clinical manifestations and possible mechanism of GBS associated with GM1 are unclear, and need further study. Methods Three cases of GBS associated with GM1 were clinically observed including cerebrospinal fluid (CSF testing and nerve conduction studies. These cases were analyzed and subjected to assessment with literature review. Results Three male patients (with the age 39-65 of GBS were observed after injection of GM1 intravenously. At 9-14 days, they developed weakness of all limbs and were unable to stand upright with decreased muscle tone in limbs and absent deep tendon reflexes, accompanied by dyspnea (1 case, albuminocytological dissociation (1 case and axonal degeneration of peripheral nerve (1 case. Conclusion GBS may occur occasionally in patients treated with GM1 injection intravenously for 9-14 days, and the prognosis is not favorable. The possible mechanism is that exogenous gangliosides could be immunogenic and may occasionally result in neural axonal degeneration.

  5. A Review of Case-Based Learning Practices in an Online MBA Program: A Program-Level Case Study

    Science.gov (United States)

    Lee, Seung-hee; Lee, Jieun; Liu, Xiaojing; Bonk, Curt J.; Magjuka, Richard J.

    2009-01-01

    This study examines how a case-based learning approach was used and facilitated in online business education. Perceptions of students and instructors regarding the practices of case-based learning in online environments are explored in terms of instructional design, facilitation, and technology support. This study finds case-based learning to be a…

  6. Systemic rhabdomyosarcoma presenting as leukemia: case report with ultrastructural study and reviews.

    Science.gov (United States)

    Huntrakoon, M; Callaway, L A; Vergara, G G

    1987-08-01

    A 20-year-old white male was initially suspected clinically and pathologically of having an acute lymphoblastic leukemic process because of fatigue, severe anemia, thrombocytopenia, a leuko-erythroblastic peripheral blood picture, and a diffusely infiltrated bone marrow. Subsequent review of the bone marrow material indicated cytologic features consistent with either an embryonal, undifferentiated small cell mesenchymal malignancy or reticulo-endothelial malignancy. Ultimately, the electron microscopic (EM) study of the tumor proved to be diagnostic of rhabdomyosarcoma. An extensive search for a primary site of rhabdomyosarcoma did not show any lesion, although the genitourinary region was clinically suspected. The clinical course was a rapidly downhill one with extensive bone and CNS involvement. The patient died 5 months later. An autopsy permit was not obtained. This case emphasizes the occasional tendency of rhabdomyosarcoma to masquerade as a hematopoietic malignancy at the time of presentation and the usefulness of EM study in confirming a diagnosis.

  7. Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A Review and Neuropsychological Case Study.

    Science.gov (United States)

    Loughan, Ashlee R; Allen, Aislyn; Perna, Robert; Malkin, Mark G

    2016-01-01

    Anti-N-Methyl-d-Aspartate Receptor (NMDAR) Encephalitis is an autoimmune-mediated encephalitis, which may be associated with a tumor, which occurs when antibodies bind central NMDA receptors. Although typically diagnosed in women, approximately 20% of cases have been males. Due to the challenges with identification, imaging, and diverse symptom presentation, this syndrome is often misdiagnosed. Accurate diagnosis may provide an opportunity for introduction of disease-modifying therapies, which may alter disease trajectory. Moreover, neuropsychology has yet to fully clarify the pattern of impairments expected with this disorder. This manuscript reviews a single case study of a 42-year-old male diagnosed with NMDAR encephalitis. Neuropsychological evaluation was completed subsequent to diagnosis, treatment, and rehabilitation. Ongoing patient complaints, approximately six months post diagnosis, included reduced sustained attention, poor word retrieval, and daily forgetfulness. Adaptive skills were improved following rehabilitation. Direct testing revealed mildly impaired sustained attention, processing speed, oral word fluency, and executive functioning. All other cognitive domains were within estimated premorbid range, low average to average. Neuropsychological deficits were consistent with mild frontal brain dysfunction and continued recovery. This case illustrates the need for medical and psychological practitioners to understand NMDAR encephalitis, its symptom presentation, and related neuropsychological impact; particularly with the potential for misdiagnosis.

  8. Giant gastrointestinal stromal tumour of rare sarcomatoid epithelioid subtype: Case study and literature review

    Science.gov (United States)

    Lech, Gustaw; Korcz, Wojciech; Kowalczyk, Emilia; Guzel, Tomasz; Radoch, Marcin; Krasnodębski, Ireneusz Wojciech

    2015-01-01

    Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract, but they represent less than 3% of all gastrointestinal tract malignancies. This is a detailed case study of a 52-year-old male patient treated for very uncommon histological subtype of gastric GIST with atypical clinical presentation, asymptomatic progress and late diagnosis. The resected tumour, giant in diameters, was confirmed to represent the most rare histopathologic subtype of GISTs - sarcomatoid epithelioid GIST. We report this case and review the literature with a special focus on pathomorphological evaluation, biological aggressiveness and prognostic factors. To our knowledge this is the first report of giant GIST of very uncommon sarcomatoid epithelioid subtype. It is concluded that clinicians should pay attention to the fact that initial diagnosis may be delayed due to mildly asymptomatic and non-specific clinical presentation. Asymptomatic tumours diagnosed at a late stage, which is often the case, can be large on presentation. Prognosis for patients diagnosed with GIST depend on tumour size, mitotic rate, histopathologic subtype and tumour location. That is why early diagnosis and R0 resection, which is usually feasible and safe even in giant gastric sarcomatoid epithelioid subtype of GISTs, are the key factors for further treatment and good prognosis. PMID:25805949

  9. Adapting Peer Review to an Online Course: An Exploratory Case Study

    Science.gov (United States)

    Knight, Linda V.; Steinbach, Theresa A.

    2011-01-01

    With demonstrated benefits to higher level learning, peer review in the classroom has been well researched and popular since at least the 1990s. However, little or no prior studies exist into the peer review process for online courses. Further, we found no prior research specifically addressing the operational aspects of online peer review. This…

  10. Visual memory effects on intraoperator study design: determining a minimum time gap between case reviews to reduce recall bias.

    Science.gov (United States)

    Campbell, W Scott; Talmon, Geoffrey A; Foster, Kirk W; Baker, John J; Smith, Lynette M; Hinrichs, Steven H

    2015-03-01

    The objective of this research was to determine test intervals between intraoperator case reviews to minimize the impact of recall. Three pathologists were presented with a group of 120 slides and subsequently challenged with a study set of 120 slides after 2-week and 4-week intervals. The challenge set consisted of 60 slides seen during the initial review and 60 slides previously unseen within the study. Pathologists rendered a diagnosis for each slide and indicated whether they recalled seeing the slide previously (yes/no). Two weeks after having been shown 60 cases from a challenge set of 120 cases, the pathologists correctly remembered 26, 22, and 24 cases or 40% overall. After 4 weeks, the pathologists correctly recalled 31% of cases previously seen. Pathologists were capable of recalling from memory cases seen previously at 2 and 4 weeks. Recall rates may be sufficiently high to affect intraobserver study design. Copyright© by the American Society for Clinical Pathology.

  11. Case Study Research Methodology

    Directory of Open Access Journals (Sweden)

    Mark Widdowson

    2011-01-01

    Full Text Available Commenting on the lack of case studies published in modern psychotherapy publications, the author reviews the strengths of case study methodology and responds to common criticisms, before providing a summary of types of case studies including clinical, experimental and naturalistic. Suggestions are included for developing systematic case studies and brief descriptions are given of a range of research resources relating to outcome and process measures. Examples of a pragmatic case study design and a hermeneutic single-case efficacy design are given and the paper concludes with some ethical considerations and an exhortation to the TA community to engage more widely in case study research.

  12. Mobile Educational Augmented Reality Games: A Systematic Literature Review and Two Case Studies

    Directory of Open Access Journals (Sweden)

    Teemu H. Laine

    2018-03-01

    Full Text Available Augmented reality (AR has evolved from research projects into mainstream applications that cover diverse fields, such as entertainment, health, business, tourism and education. In particular, AR games, such as Pokémon Go, have contributed to introducing the AR technology to the general public. The proliferation of modern smartphones and tablets with large screens, cameras, and high processing power has ushered in mobile AR applications that can provide context-sensitive content to users whilst freeing them to explore the context. To avoid ambiguity, I define mobile AR as a type of AR where a mobile device (smartphone or tablet is used to display and interact with virtual content that is overlaid on top of a real-time camera feed of the real world. Beyond being mere entertainment, AR and games have been shown to possess significant affordances for learning. Although previous research has done a decent job of reviewing research on educational AR applications, I identified a need for a comprehensive review on research related to educational mobile AR games (EMARGs. This paper explored the research landscape on EMARGs over the period 2012–2017 through a systematic literature review complemented by two case studies in which the author participated. After a comprehensive literature search and filtering, I analyzed 31 EMARGs from the perspectives of technology, pedagogy, and gaming. Moreover, I presented an analysis of 26 AR platforms that can be used to create mobile AR applications. I then discussed the results in depth and synthesized my interpretations into 13 guidelines for future EMARG developers.

  13. Performance of Modular Prefabricated Architecture: Case Study-Based Review and Future Pathways

    Directory of Open Access Journals (Sweden)

    Fred Edmond Boafo

    2016-06-01

    Full Text Available Even though tightened building energy efficiency standards are implemented periodically in many countries, existing buildings continually consume a momentous quota of the total primary energy. Energy efficiency solutions range from material components to bulk systems. A technique of building construction, referred to as prefabricated architecture (prefab, is increasing in reputation. Prefab encompasses the offsite fabrication of building components to a greater degree of finish as bulk building structures and systems, and their assembly on-site. In this context, prefab improves the speed of construction, quality of architecture, efficiency of materials, and worker safety, while limiting environmental impacts of construction, as compared to conventional site-built construction practices. Quite recently, a 57 story skyscraper was built in 19 days using prefabricated modules. From the building physics point of view, the bulk systems and tighter integration method of prefab minimizes thermal bridges. This study seeks to clearly characterize the levels of prefab and to investigate the performance of modular prefab; considering acoustic constrain, seismic resistance, thermal behavior, energy consumption, and life cycle analysis of existing prefab cases and, thus, provides a dynamic case study-based review. Generally, prefab can be categorized into components, panels (2D, modules (3D, hybrids, and unitized whole buildings. On average, greenhouse gas emissions from conventional construction were higher than for modular construction, not discounting some individual discrepancies. Few studies have focused on monitored data on prefab and occupants’ comfort but additional studies are required to understand the public’s perception of the technology. The scope of the work examined will be of interest to building engineers, manufacturers, and energy experts, as well as serve as a foundational reference for future study.

  14. Invasive lobular carcinoma of the male breast – a systematic review with an illustrative case study

    Science.gov (United States)

    Senger, Jenna-Lynn; Adams, Scott J; Kanthan, Rani

    2017-01-01

    Male breast cancer is rare, comprising only 1% of all mammary cancers; invasive ductal carcinoma is by far the commonest subtype in both men and women. Though lobular breast cancer is the second most common subtype seen in women, such cancers are extremely uncommon in men, and this is likely related to the lack of lobular development in the male breast. Thus, due to the rarity of this subtype among breast cancers, compounded by the overall rarity of breast cancer in men, current understanding of the pathogenesis of this disease and its management is largely derived from case series and extrapolation of information from the larger cohort of female patients. This paper provides a systematic review on invasive lobular carcinoma of the male breast in the context of an illustrative case study. A comprehensive analysis of the National Cancer Institute’s Surveillance, Epidemiology, and End Results Data 1973–2013 leading to an exploration of the pathogenesis, epidemiology, clinical presentation, diagnosis, tumor characteristics, and management of lobular breast carcinoma in men is also discussed. Lobular subtype of breast cancer remains an enigmatic elusive disease that needs additional research to unravel its overall pathogenesis and molecular profile to provide insight for improved therapeutic management options. PMID:28553141

  15. Invasive lobular carcinoma of the male breast - a systematic review with an illustrative case study.

    Science.gov (United States)

    Senger, Jenna-Lynn; Adams, Scott J; Kanthan, Rani

    2017-01-01

    Male breast cancer is rare, comprising only 1% of all mammary cancers; invasive ductal carcinoma is by far the commonest subtype in both men and women. Though lobular breast cancer is the second most common subtype seen in women, such cancers are extremely uncommon in men, and this is likely related to the lack of lobular development in the male breast. Thus, due to the rarity of this subtype among breast cancers, compounded by the overall rarity of breast cancer in men, current understanding of the pathogenesis of this disease and its management is largely derived from case series and extrapolation of information from the larger cohort of female patients. This paper provides a systematic review on invasive lobular carcinoma of the male breast in the context of an illustrative case study. A comprehensive analysis of the National Cancer Institute's Surveillance, Epidemiology, and End Results Data 1973-2013 leading to an exploration of the pathogenesis, epidemiology, clinical presentation, diagnosis, tumor characteristics, and management of lobular breast carcinoma in men is also discussed. Lobular subtype of breast cancer remains an enigmatic elusive disease that needs additional research to unravel its overall pathogenesis and molecular profile to provide insight for improved therapeutic management options.

  16. High-Stakes Systematic Reviews: A Case Study From the Field of Teen Pregnancy Prevention.

    Science.gov (United States)

    Goesling, Brian; Oberlander, Sarah; Trivits, Lisa

    2016-08-19

    Systematic reviews help policy makers and practitioners make sense of research findings in a particular program, policy, or practice area by synthesizing evidence across multiple studies. However, the link between review findings and practical decision-making is rarely one-to-one. Policy makers and practitioners may use systematic review findings to help guide their decisions, but they may also rely on other information sources or personal judgment. To describe a recent effort by the U.S. federal government to narrow the gap between review findings and practical decision-making. The Teen Pregnancy Prevention (TPP) Evidence Review was launched by the U.S. Department of Health and Human Services (HHS) in 2009 as a systematic review of the TPP literature. HHS has used the review findings to determine eligibility for federal funding for TPP programs, marking one of the first attempts to directly link systematic review findings with federal funding decisions. The high stakes attached to the review findings required special considerations in designing and conducting the review. To provide a sound basis for federal funding decisions, the review had to meet accepted methodological standards. However, the review team also had to account for practical constraints of the funding legislation and needs of the federal agencies responsible for administering the grant programs. The review team also had to develop a transparent process for both releasing the review findings and updating them over time. Prospective review authors and sponsors must recognize both the strengths and limitations of this approach before applying it in other areas. © The Author(s) 2016.

  17. Review of human error analysis methodologies and case study for accident management

    International Nuclear Information System (INIS)

    Jung, Won Dae; Kim, Jae Whan; Lee, Yong Hee; Ha, Jae Joo

    1998-03-01

    In this research, we tried to establish the requirements for the development of a new human error analysis method. To achieve this goal, we performed a case study as following steps; 1. review of the existing HEA methods 2. selection of those methods which are considered to be appropriate for the analysis of operator's tasks in NPPs 3. choice of tasks for the application, selected for the case study: HRMS (Human reliability management system), PHECA (Potential Human Error Cause Analysis), CREAM (Cognitive Reliability and Error Analysis Method). And, as the tasks for the application, 'bleed and feed operation' and 'decision-making for the reactor cavity flooding' tasks are chosen. We measured the applicability of the selected methods to the NPP tasks, and evaluated the advantages and disadvantages between each method. The three methods are turned out to be applicable for the prediction of human error. We concluded that both of CREAM and HRMS are equipped with enough applicability for the NPP tasks, however, compared two methods. CREAM is thought to be more appropriate than HRMS from the viewpoint of overall requirements. The requirements for the new HEA method obtained from the study can be summarized as follows; firstly, it should deal with cognitive error analysis, secondly, it should have adequate classification system for the NPP tasks, thirdly, the description on the error causes and error mechanisms should be explicit, fourthly, it should maintain the consistency of the result by minimizing the ambiguity in each step of analysis procedure, fifty, it should be done with acceptable human resources. (author). 25 refs., 30 tabs., 4 figs

  18. "Clustering" Documents Automatically to Support Scoping Reviews of Research: A Case Study

    Science.gov (United States)

    Stansfield, Claire; Thomas, James; Kavanagh, Josephine

    2013-01-01

    Background: Scoping reviews of research help determine the feasibility and the resource requirements of conducting a systematic review, and the potential to generate a description of the literature quickly is attractive. Aims: To test the utility and applicability of an automated clustering tool to describe and group research studies to improve…

  19. Multivariate statistical process control in product quality review assessment - A case study.

    Science.gov (United States)

    Kharbach, M; Cherrah, Y; Vander Heyden, Y; Bouklouze, A

    2017-11-01

    According to the Food and Drug Administration and the European Good Manufacturing Practices (GMP) guidelines, Annual Product Review (APR) is a mandatory requirement in GMP. It consists of evaluating a large collection of qualitative or quantitative data in order to verify the consistency of an existing process. According to the Code of Federal Regulation Part 11 (21 CFR 211.180), all finished products should be reviewed annually for the quality standards to determine the need of any change in specification or manufacturing of drug products. Conventional Statistical Process Control (SPC) evaluates the pharmaceutical production process by examining only the effect of a single factor at the time using a Shewhart's chart. It neglects to take into account the interaction between the variables. In order to overcome this issue, Multivariate Statistical Process Control (MSPC) can be used. Our case study concerns an APR assessment, where 164 historical batches containing six active ingredients, manufactured in Morocco, were collected during one year. Each batch has been checked by assaying the six active ingredients by High Performance Liquid Chromatography according to European Pharmacopoeia monographs. The data matrix was evaluated both by SPC and MSPC. The SPC indicated that all batches are under control, while the MSPC, based on Principal Component Analysis (PCA), for the data being either autoscaled or robust scaled, showed four and seven batches, respectively, out of the Hotelling T 2 95% ellipse. Also, an improvement of the capability of the process is observed without the most extreme batches. The MSPC can be used for monitoring subtle changes in the manufacturing process during an APR assessment. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  20. Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Guilherme Karam Corrêa Leite

    Full Text Available CONTEXT AND OBJECTIVE: The incidence of scar endometrioma ranges from 0.03 to 3.5%. Certain factors relating to knowledge of the clinical history of the disease make correct diagnosis and treatment difficult. The aim here was to identify the clinical pattern of the disease and show surgical results. The literature on this topic was reviewed. DESIGN AND SETTING: Retrospective descriptive study at Hospital Municipal Maternidade - Escola Dr. Mário de Moraes Altenfelder Silva. METHODS: Data from the medical records of patients with preoperative diagnoses of scar endometrioma who underwent operations between 2001 and 2007 were surveyed and reviewed. The postoperative diagnosis came from histopathological analysis. The main information surveyed was age, obstetric antecedents, symptoms, tumor location, size and palpation, duration of complaint, diagnosis and treatment. All patients underwent tumor excision with a safety margin. RESULTS: There were 33 patients, of mean age 30.1 ± 5.0 years (range: 18-41 years. The total incidence was 0.11%: 0.29% in cesarean sections and 0.01% in vaginal deliveries. Twenty-nine tumors (87.9% were located in cesarean scars, two (6.0% in episiotomy scars and two (6.0% in the umbilical region. The main symptom was localized cyclical pain (66.7%, of mean duration 30.5 months (± 23. Surgical treatment was successful in all cases. CONCLUSION: This is an uncommon disease. The most important diagnostic characteristic is coincidence of painful symptoms with menstruation. Patients undergoing cesarean section are at greatest risk: relative risk of 27.37 (P < 0.01. The surgical treatment of choice is excision of the endometrioma with a safety margin.

  1. [Wells Syndrome in children and atopy: Retrospective study of 11 cases and review of the literature].

    Science.gov (United States)

    Brun, J; Chiaverini, C; Bessis, D; Bourrat, E; Lasek-Duriez, A; Hadj-Rabia, S; Boralevi, F; Lacour, J-P

    2015-05-01

    Well's syndrome, or eosinophilic cellulitis, is rare in childhood, with fewer than 40 pediatric cases being reported since 1979. The physiopathology is unknown. In February 2012, members of the research group of the Department of Pediatric Dermatology Society submitted their case of Wells' syndrome in children aged 0-15 years. Details of clinical, biological and histological features and of therapeutic strategies were collected by physicians using a standardized questionnaire. Pictures were reviewed by the authors. Eleven patients were included (average age: 6 years), with a strong prevalence of atopy (63%). Two types of clinical manifestation were noted: single or multiple cellulitis associated or not with vesiculobullous lesions and fixed urticaria. Eighty-two percent of patients had pruritus and 73% had eosinophilia. For all patients, histological examination of skin biopsies showed an eosinophilic infiltrate extending in the dermis with associated Sweet-like neutrophilic infiltrate being seen in 2 patients. The course of the disease was protracted (mean duration: 8 months) with flare-ups. Treatment varied depending on the doctors (topical or systemic steroids, tacrolimus and dapsone). Our study confirms some of the data in the literature concerning the clinical, histological features and course of Well's syndrome in children. The key information is the high prevalence of atopic children hitherto unreported. In a setting of insect bites, vaccination, infection or traumatism, this unusual background could explain the onset of inflammatory reaction with eosinophils. Oral or topical steroids appear to be the first-line treatment in children when necessary. Well's syndrome in children is rare and characterized by its polymorphism. We report for the first time in a series of patients a high prevalence of atopy, which raises new perspectives in understanding these rare diseases. We propose topical steroids as first-line therapy in children with superficial lesions

  2. Desert Dust and Health: A Central Asian Review and Steppe Case Study

    Directory of Open Access Journals (Sweden)

    Troy Sternberg

    2017-11-01

    Full Text Available In Asian deserts environmental and anthropomorphic dust is a significant health risk to rural populations. Natural sources in dry landscapes are exacerbated by human activities that increase the vulnerability to dust and dust-borne disease vectors. Today in Central and Inner Asian drylands, agriculture, mining, and rapid development contribute to dust generation and community exposure. Thorough review of limited dust investigation in the region implies but does not quantify health risks. Anthropogenic sources, such as the drying of the Aral Sea, highlight the shifting dust dynamics across the Central EurAsian steppe. In the Gobi Desert, our case study in Khanbogd, Mongolia addressed large-scale mining’s potential dust risk to the health of the local population. Dust traps showed variable exposure to particulates among herder households and town residents; dust density distribution indicated that sources beyond the mine need to be considered when identifying particulate sources. Research suggests that atmospheric dust from multiple causes may enhance human particulate exposure. Greater awareness of dust in greater Central Asia reflects community concern about related health implications. Future human well-being in the region will require more thorough information on dust emissions in the changing environment.

  3. Are Private Interests Clouding the Peer-Review Process of the WHO Bulletin? A Case Study.

    Science.gov (United States)

    Homedes, Nuria; Ugalde, Antonio

    2016-01-01

    Readers' trust on the medical literature has been eroded, and journal editors and some editorial boards are taking measures to ensure that authors fully and accurately report research findings and disclose conflicts of interest. This article describes a case study in which the papers editor of the World Health Organization (WHO) Bulletin influenced the content of an article that had been approved by the external reviewers. The editor objected to the publication of the large price differentials of the new molecular entities (NMEs) across the Latin American countries where they had been tested and the limited added therapeutic value of the NMEs that had been assessed by independent drug bulletins. This article summarizes the exchanges with WHO staff and posits the hypothesis that the WHO Bulletin might be affected by the shifts in WHO financing. Several authors have raised concern about the impact of financial conflicts of interest in WHO activities in the field of nutrition, intellectual property, and in the emergency response to the flu pandemic. Moreover, it has been reported that powerful WHO contributors pressured WHO into revising its publication policy. This is the first time that authors question if these conflicts of interest are also affecting the editorial independence of the WHO Bulletin.

  4. Conflicting Incentives Risk Analysis: A Case Study of the Normative Peer Review Process

    Directory of Open Access Journals (Sweden)

    Gaute Wangen

    2015-07-01

    Full Text Available This paper presents an approach to conduct risk assessments of complex incentive systems, using a case study of the normative Peer Review Process (PRP. This research centers on appliances and adaptations of the Conflicting Incentives Risk Analysis (CIRA. First as an approach to Root Cause Analysis of a known incident, and then for a full assessment of the incentives in the PRP together with possible risk treatments. CIRA uses an alternative notion of risk, where risk modeling is in terms of conflicting incentives between the risk owner and the stakeholders concerning the execution of actions. Compared to traditional risk assessment approaches, CIRA provides an insight into the underlying incentives behind a risk, and not just the technical vulnerability, likelihood and consequence. The main contributions of this work are an approach to obtain insight into incentives as root causes, and an approach to detecting and analyzing risks from incentives in the normative PRP. This paper also discusses risk treatments in terms of incentives to make the PRP more robust, together with a discussion of how to approach risk analysis of incentives.

  5. Desert Dust and Health: A Central Asian Review and Steppe Case Study.

    Science.gov (United States)

    Sternberg, Troy; Edwards, Mona

    2017-11-03

    In Asian deserts environmental and anthropomorphic dust is a significant health risk to rural populations. Natural sources in dry landscapes are exacerbated by human activities that increase the vulnerability to dust and dust-borne disease vectors. Today in Central and Inner Asian drylands, agriculture, mining, and rapid development contribute to dust generation and community exposure. Thorough review of limited dust investigation in the region implies but does not quantify health risks. Anthropogenic sources, such as the drying of the Aral Sea, highlight the shifting dust dynamics across the Central EurAsian steppe. In the Gobi Desert, our case study in Khanbogd, Mongolia addressed large-scale mining's potential dust risk to the health of the local population. Dust traps showed variable exposure to particulates among herder households and town residents; dust density distribution indicated that sources beyond the mine need to be considered when identifying particulate sources. Research suggests that atmospheric dust from multiple causes may enhance human particulate exposure. Greater awareness of dust in greater Central Asia reflects community concern about related health implications. Future human well-being in the region will require more thorough information on dust emissions in the changing environment.

  6. Environmental-impact assessment of dams and reservoir projects (review and a case study)

    International Nuclear Information System (INIS)

    Shah, S.M.

    2009-01-01

    Dams and reservoirs are among one of the most sensitive of all development Project, in terms of pervasiveness of their influence in altering the environmental conditions and resources. In the present study, major dams and reservoir projects are reviewed, from the environmental point of view. Dams and Reservoir projects bring about major changes in the immediate environment, thus affecting public health, settlements, farmlands, roads and historical sites. Impacts on human population and wildlife may be profound. Tropical diseases, involving fresh-water hosts or vectors in their transmission, are often common around new reservoirs. Large lakes create limnological changes, excessive evaporation, seepage, disturbance in water-table and increased tendencies of landslides and earthquakes. Micro climatic changes are possible, such as fog formation, increased cloudiness and modified rainfall-patterns. Retention of sediment results in silting up of reservoirs. Water shortages on mountain rivers may leave unsightly dry river-beds below a dam. Sediment deposition and growth of vegetation in reservoir affects the water-extraction for navigation power-generation and fishing. Various dams and reservoir projects in the world are critically studied, in terms of creating environmental impacts. The Kala Bagh Dam project (Pakistan), which is ready for construction, has been analysed as a case study, by matrix method. Analyses show that adverse effects of this dam are less than the benefits. It is recommended that based on the experience, appropriate lines and strategies may be drawn up to evaluate the local projects. Multidisciplinary experts need to be involved, for assessing environmental impacts and suggesting mitigation measures, to combat the adverse effects. (author)

  7. Dual pathology in Rasmussen's encephalitis: a study of seven cases and review of the literature.

    Science.gov (United States)

    Takei, Hidehiro; Wilfong, Angus; Malphrus, Amy; Yoshor, Daniel; Hunter, Jill V; Armstrong, Dawna L; Bhattacharjee, Meenakshi B

    2010-08-01

    Dual pathology has previously been reported in less than 10% of cases of Rasmussen's encephalitis (RE). Given the rarity of RE, it appears unlikely that dual pathology in RE is merely a coincidence. We therefore reviewed all cases of RE experienced in our institution to assess for an additional/associated pathology. A total of seven patients with RE were identified in our archives. Seven children (4 boys and 3 girls, age range: 3-16 years, mean: 9.5 years) with medically refractory epilepsy underwent surgical resection for intractable seizures. The surgical specimens were examined with routine neurohistological techniques, and immunohistochemistry was performed with an extensive panel of antibodies for viruses, lymphocytes, microglia/macrophages, human leukocyte antigen (HLA)-DR, astrocytes, and neurons. Relevant literature was reviewed. Microscopically, all seven cases demonstrated the inflammatory pathology of RE in the cortex and white matter with leptomeningeal and perivascular lymphocytic infiltration, microglial nodules with/without neuronophagia, neuronal loss and gliosis. The HLA-DR antibody was extremely helpful in highlighting the extent of microglial cell proliferation/activation that was not appreciable with standard histology. An unexpected finding in all seven cases was the presence of cortical dysplasia. In our series of seven cases, there was co-occurrence of the inflammatory/destructive pathology of RE with malformative/dysplastic features in cortical architecture in 100% of cases, raising questions about the possible relationships between the two entities. Awareness of the possibility of dual pathology in RE is important for clinical and pathological diagnosis, and may affect the management and outcome of these patients. Immunohistochemistry is very helpful to make a definitive diagnosis of both pathologies.

  8. CASE STUDY

    African Journals Online (AJOL)

    2011-06-02

    Jun 2, 2011 ... immunosuppression associated with HIV/AIDS puts them at a higher risk of developing oesophageal cancer. 47. CASE STUDY. A 49-year-old man was diagnosed as HIV infected, with a CD4 count of 60 cells/µl. He was started on an antiretroviral treatment regimen comprising zidovudine, lamivudine and ...

  9. Retrospective study of 338 canine oral melanomas with clinical, histologic, and immunohistochemical review of 129 cases.

    Science.gov (United States)

    Ramos-Vara, J A; Beissenherz, M E; Miller, M A; Johnson, G C; Pace, L W; Fard, A; Kottler, S J

    2000-11-01

    Diagnostic records from 338 canine oral melanomas in 338 dogs received at the Veterinary Medical Diagnostic Laboratory (1992-1999) were reviewed. Of these tumors, 122 plus an additional 7 metastatic melanomas of unknown origin were selected for clinical follow-up, histologic review, and immunohistochemistry. Chow Chow, Golden Retriever, and Pekingese/Poodle mix breeds were overrepresented, whereas Boxer and German Shepherd breeds were underrepresented. There was no gender predisposition and the average age at presentation was 11.4 years. Forty-nine dogs were euthanized due to recurrence or metastasis. The average postsurgical survival time was 173 days. The gingiva and the labial mucosa were the most common sites. Most tumors were composed of either polygonal cells (27 cases, 20.9%), spindle cells (44 cases, 34.1%), or a mixture of the two (polygonal and spindle) (54 cases, 41.9%). Clear cell (3 cases, 2.3%) and adenoid/papillary (1 case, 0.8%) patterns were uncommon. The metastases of 6/6 oral melanomas had morphologic and immunohistochemical features similar to those of the primary tumors. Immunohistochemically, Melan A was detected in 113/122 oral (92.6%) and 5/7 (71.9%) metastatic melanomas. Only 4/163 nonmelanocytic tumors were focally and weakly positive for Melan A. Antibodies against vimentin, S100 protein, and neuron-specific enolase stained 129 (100%), 98 (76%), and 115 (89.1%) of 129 melanomas, respectively. Antibodies against other melanocytic-associated antigens (tyrosinase, glycoprotein 100) did not yield adequate staining. We conclude that Melan A is a specific and sensitive marker for canine melanomas.

  10. Commentary on "Childhood Leukemia Survivors and Their Return to School: A Literature Review, Case Study, and Recommendations"

    Science.gov (United States)

    Long, Lori A.

    2011-01-01

    This is a commentary on the article, "Childhood Leukemia Survivors and Their Return to School: A Literature Review, Case Study, and Recommendations" by D. Scott Hermann, Jill R. Thurber, Kenneth Miles, and Gloria Gilbert in this issue (2011). This article addresses issues related to the compatibility of the suggested practices with contemporary…

  11. Improving Diabetes Care in the Military Primary Care Clinic: Case Study Review

    Science.gov (United States)

    2016-03-23

    This research study combines qualitative and quantitative methodology in reflectively exploring positive case studies to ascertain strategies that...enabled patients to engage in self-management. Moreover, this study seeks to better understand how applying the ADA Standards of Care in a military

  12. A solitary bronchial papilloma with unusual endoscopic presentation: case study and literature review

    Directory of Open Access Journals (Sweden)

    Frejeville Marie

    2009-08-01

    Full Text Available Abstract Background Solitary endobronchial papillomas (SEP are rare tumors and most of them are described by case report. A misdiagnosis is common with viral related papillomas. A histopathological classification has recently permitted a major advancement in the understanding of the disease. Case Presentation We report a case of a mixed bronchial papilloma with an unusual endoscopic presentation. The literature was extensively reviewed to ascertain the unusual characteristics of the current case. A 39-year of age male was referred to our institution for the investigation of a slight hemoptysis. Routine examination was normal. A fibroscopy revealed an unusual feature of the right main bronchus. The lesion was a plane, non-bleeding, non-glistering sub-mucosal proliferation. No enhanced coloration was noticed. Biopsies revealed a mixed solitary bronchial papilloma. In situ HPV hybridization was negative. Endoscopic treatment (electrocautery was effective with no relapse. Conclusion This lesion contrasts with the data of the literature where papilloma were described as wart-like lesions or cauliflower tumors, with symptoms generally related to bronchial obstruction. We advise chest physicians to be cautious with unusually small swollen lesions of the bronchi that may reveal a solitary bronchial papilloma. Endoscopic imaging can significantly contribute to the difficult diagnosis of SEP by pulmonary physicians and endoscopists.

  13. Conduct of a meta review of programme evaluations : a case study of the SEARCH Program

    OpenAIRE

    Dickson, Rumona; Tight, Malcolm; Saunders, Murray

    2012-01-01

    This thesis presents a retrospective case study that critically examines the evaluations that were undertaken as part of a continuing professional development (CPD) programme for health care professionals. The case is the SEARCH Program, an innovative CPD programme, which was designed to promote the implementation of evidence based practice (EBP) within the existing health care system in Alberta, Canada. Two approaches from the ‘using’ branch of Alkin and Chrisite’s evaluation theory tree are...

  14. Integrating Enterprise Resource Planning (SAP) in the Accounting Curriculum: A Systematic Literature Review and Case Study

    Science.gov (United States)

    Blount, Yvette; Abedin, Babak; Vatanasakdakul, Savanid; Erfani, Seyedezahra

    2016-01-01

    This study investigates how an enterprise resource planning (ERP) software package SAP was integrated into the curriculum of an accounting information systems (AIS) course in an Australian university. Furthermore, the paper provides a systematic literature review of articles published between 1990 and 2013 to understand how ERP systems were…

  15. Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

    Science.gov (United States)

    Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

    2015-12-01

    To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

  16. Granulosa cell tumor of ovary: A clinicopathological study of four cases with brief review of literature

    Directory of Open Access Journals (Sweden)

    B R Vani

    2014-01-01

    Full Text Available Introduction: Adult granulosa cell tumor (GCT is a rare ovarian malignancy having good prognosis in comparison with other epithelial tumors. The study aims to collect data of all granulosa cell tumors diagnosed in ESIC Medical College & PGIMSR, Rajajinagar, Bangalore over the last 3 years and to describe the patient profile, ultrasonographic and various histopathological features.Materials and Methods: A total of 4 granulosa cell tumors were diagnosed in ESIC Medical College & PGIMSR, Rajajinagar, Bangalore during the period from June 2010 to June 2013. The patient′s age, clinical manifestations, radiological and histopathological findings were evaluated.Results: All 4 patients were diagnosed as adult granulosa cell tumor, three of four cases were in premenopausal age group and one case was in perimenopausal age. The clinical manifestations were menorrhagia and abdominal pain. Ultrasonographically, 2 cases of granulosa cell tumors were both solid and cystic and one case each was either solid or cystic. Histologically, variety of patterns like diffuse, trabecular, cords, spindle and clear cells were noted. Both Call-Exner bodies and nuclear grooves were observed in all cases. All four cases showed simple hyperplasia without atypia endometrial findings. Follow up on all patients revealed no evidence of recurrence.Conclusion: Granulosa cell tumor of the ovary is a rare ovarian entity. The important prognostic factor is staging of the tumor. Staging and histopathology helps in prediction of survival. Also diligent endometrial pathology has to be sorted to rule out endometrial carcinoma.

  17. Implications of applying methodological shortcuts to expedite systematic reviews: three case studies using systematic reviews from agri-food public health.

    Science.gov (United States)

    Pham, Mai T; Waddell, Lisa; Rajić, Andrijana; Sargeant, Jan M; Papadopoulos, Andrew; McEwen, Scott A

    2016-12-01

    The rapid review is an approach to synthesizing research evidence when a shorter timeframe is required. The implications of what is lost in terms of rigour, increased bias and accuracy when conducting a rapid review have not yet been elucidated. We assessed the potential implications of methodological shortcuts on the outcomes of three completed systematic reviews addressing agri-food public health topics. For each review, shortcuts were applied individually to assess the impact on the number of relevant studies included and whether omitted studies affected the direction, magnitude or precision of summary estimates from meta-analyses. In most instances, the shortcuts resulted in at least one relevant study being omitted from the review. The omission of studies affected 39 of 143 possible meta-analyses, of which 14 were no longer possible because of insufficient studies (studies generally resulted in less precise pooled estimates (i.e. wider confidence intervals) that did not differ in direction from the original estimate. The three case studies demonstrated the risk of missing relevant literature and its impact on summary estimates when methodological shortcuts are applied in rapid reviews. © 2016 The Authors. Research Synthesis Methods Published by John Wiley & Sons Ltd. © 2016 The Authors. Research Synthesis Methods Published by John Wiley & Sons Ltd.

  18. Modification of Personal Hygiene and Grooming Behaviors with Contingency Contracting: A Brief Review and Case Study.

    Science.gov (United States)

    Allen, Sarah J.; Kramer, Jack J.

    1990-01-01

    Presents discussion of basic components and characteristics of contingency contracts. Includes case study in which contingency contracting procedures were integrated within a behavioral consultation model used by a school psychologist consulting with a classroom teacher to modify personal hygiene of 12-year-old male. (Author/ABL)

  19. BASINS and WEPP Climate Assessment Tools (CAT): Case Study Guide to Potential Applications (External Review Draft)

    Science.gov (United States)

    This draft report supports application of two recently developed water modeling tools, the BASINS and WEPP climate assessment tools. The report presents a series of short case studies designed to illustrate the capabilities of these tools for conducting scenario based assessments...

  20. Comprehensive Review and Case Study on the Management of Buried Penis Syndrome and Related Panniculectomy

    Science.gov (United States)

    Burns, Hadley; Chowdhry, Saeed; Lee, Thomas; Schulz, Steven; Wilhelmi, Bradon J.

    2018-01-01

    Objective: This paper discusses the various surgical techniques and outcomes associated with management of buried penis syndrome. Methods: Presented is the case of a 49-year-old man with morbid obesity, leading to massive panniculus and buried penis. We review our technique for reconstruction of the buried penis and treatment of the overlying large panniculus. Literature search was conducted to review current techniques in correcting buried penis syndrome. Results: The patient underwent a successful panniculectomy with removal of all excess skin and tissue. Thoughtful planning and coordination between plastic surgery and urology were paramount to externalize the penis for an excellent functional and cosmetic result. Conclusions: Management of a buried, hidden penis is complex and difficult. Patients are often obese and have poor hygiene due to the inability to cleanse areas that are entrapped by excessive fat. Following removal of the overhanging panniculus, satisfactory reconstruction of a hidden penis is possible when proper care is taken to adhere the base of the penis to the pubis. Split-thickness skin grafts are often necessary but depend on the viability of the penile skin and whether it is restricting penile length. Complications with wound dehiscence and infection are not uncommon; however, patients generally recover well, are satisfied with results, and are reported to have fully regained urinary and sexual functions following surgical correction of the buried penis. PMID:29467914

  1. Casing study

    Energy Technology Data Exchange (ETDEWEB)

    Roche, P.

    2000-12-01

    An unorthodox method of casing drilling used by Tesco Corporation at a gas well in Wyoming to drill deeper using casings as drillpipe is discussed. The process involves either rotating the casing as drill string or using a downhole mud motor to rotate the bit. In this instance, the surface hole and the production hole were casing-drilled to a record 8,312 feet by rotating the casing. The 8 1/2-inch surface hole was drilled with 7-inch casing to 1,200 feet using a Tesco underreamer and a polycrystalline pilot bit; drilling and cementing was completed in 12 1/2 hours. The 6 1/4-inch production hole was drilled with 4 1/2-inch casing and the bottomhole assembly was retrieved after 191 hours rotating. This case was the first in which the entire well was casing-drilled from surface to TD. Penetration rate compared favorably with conventional methods: 12 1/2 hours for casing-drilling to 18.9 hours for conventional drilling, despite the fact that the casing-drilling technology is still in its infancy. It is suggested that casing-drilling has the potential to eliminate the need for the drillpipe entirely. If these expectations were to be realised, casing-drilling could be one of the most radical drilling changes in the history of the oil and gas industry. 1 photo.

  2. Papillary tumor of the pineal region: two case studies and a review of the literature.

    Science.gov (United States)

    Rickard, Kyle A; Parker, John R; Vitaz, Todd W; Plaga, Alexis R; Wagner, Stephanie; Parker, Joseph C

    2011-01-01

    Papillary tumor of the pineal region (PTPR) is a newly recognized distinct entity in the 2007 World Health Organization nomenclature. This tumor is characterized by epithelial-appearing areas with papillary features and more densely cellular areas that often display ependymal-like differentiation. Ultrastructurally, this rare neuroepithelial tumor possesses neuroendocrine, secretory, and ependymal organelles that likely originate from the subcommissural organ (SCO) near the aqueduct of Sylvius. To date, approximately fifty-seven described cases worldwide have been recognized, with ages ranging from 5 years to 66 years (mean age=32 years). Clinical presentation most often includes headache and obstructive hydrocephalus. The tumor, which is well circumscribed, may be cystic and radiographically is often considered to be consistent with the findings of a pineocytoma. Microscopic evaluation often demonstrates a lesion with papillary areas lined by epithelioid tumor cells with eosinophilic cytoplasm and more cellular areas with cells exhibiting clear or vacuolated cytoplasm. Perivascular and true rosettes may be identified. Distinctive immunohistochemical features including reactivity for keratins (AE1/AE3, CAM 5.2, CK18) and only focal GFAP staining help distinguish this neoplasm from an ependymoma. The relative paucity of data compiled for this tumor makes giving an accurate diagnosis and prognosis a daunting task. We discuss two additional cases of PTPR that presented to us within a three-month span in order to more fully elucidate the possible presentations of this rare entity. Furthermore, we examine now 59 reported cases of PTPR in order to review the current diagnostic and treatment modalities in addition to exploring emerging research encompassing this unusual neoplasm.

  3. Biodiversity as a multidimensional construct: a review, framework and case study of herbivory's impact on plant biodiversity

    Science.gov (United States)

    Naeem, S.; Prager, Case; Weeks, Brian; Varga, Alex; Flynn, Dan F. B.; Griffin, Kevin; Muscarella, Robert; Palmer, Matthew; Wood, Stephen; Schuster, William

    2016-01-01

    Biodiversity is inherently multidimensional, encompassing taxonomic, functional, phylogenetic, genetic, landscape and many other elements of variability of life on the Earth. However, this fundamental principle of multidimensionality is rarely applied in research aimed at understanding biodiversity's value to ecosystem functions and the services they provide. This oversight means that our current understanding of the ecological and environmental consequences of biodiversity loss is limited primarily to what unidimensional studies have revealed. To address this issue, we review the literature, develop a conceptual framework for multidimensional biodiversity research based on this review and provide a case study to explore the framework. Our case study specifically examines how herbivory by whitetail deer (Odocoileus virginianus) alters the multidimensional influence of biodiversity on understory plant cover at Black Rock Forest, New York. Using three biodiversity dimensions (taxonomic, functional and phylogenetic diversity) to explore our framework, we found that herbivory alters biodiversity's multidimensional influence on plant cover; an effect not observable through a unidimensional approach. Although our review, framework and case study illustrate the advantages of multidimensional over unidimensional approaches, they also illustrate the statistical and empirical challenges such work entails. Meeting these challenges, however, where data and resources permit, will be important if we are to better understand and manage the consequences we face as biodiversity continues to decline in the foreseeable future. PMID:27928041

  4. Biodiversity as a multidimensional construct: a review, framework and case study of herbivory's impact on plant biodiversity.

    Science.gov (United States)

    Naeem, S; Prager, Case; Weeks, Brian; Varga, Alex; Flynn, Dan F B; Griffin, Kevin; Muscarella, Robert; Palmer, Matthew; Wood, Stephen; Schuster, William

    2016-12-14

    Biodiversity is inherently multidimensional, encompassing taxonomic, functional, phylogenetic, genetic, landscape and many other elements of variability of life on the Earth. However, this fundamental principle of multidimensionality is rarely applied in research aimed at understanding biodiversity's value to ecosystem functions and the services they provide. This oversight means that our current understanding of the ecological and environmental consequences of biodiversity loss is limited primarily to what unidimensional studies have revealed. To address this issue, we review the literature, develop a conceptual framework for multidimensional biodiversity research based on this review and provide a case study to explore the framework. Our case study specifically examines how herbivory by whitetail deer (Odocoileus virginianus) alters the multidimensional influence of biodiversity on understory plant cover at Black Rock Forest, New York. Using three biodiversity dimensions (taxonomic, functional and phylogenetic diversity) to explore our framework, we found that herbivory alters biodiversity's multidimensional influence on plant cover; an effect not observable through a unidimensional approach. Although our review, framework and case study illustrate the advantages of multidimensional over unidimensional approaches, they also illustrate the statistical and empirical challenges such work entails. Meeting these challenges, however, where data and resources permit, will be important if we are to better understand and manage the consequences we face as biodiversity continues to decline in the foreseeable future. © 2016 The Authors.

  5. Biodiversity as a multidimensional construct: a review, framework and case study of herbivory's impact on plant biodiversity

    DEFF Research Database (Denmark)

    Naeem, S.; Prager, Case; Weeks, Brian

    2016-01-01

    on understory plant cover at Black Rock Forest, New York. Using three biodiversity dimensions (taxonomic, functional and phylogenetic diversity) to explore our framework, we found that herbivory alters biodiversity's multidimensional influence on plant cover; an effect not observable through a unidimensional...... approach. Although our review, framework and case study illustrate the advantages of multidimensional over unidimensional approaches, they also illustrate the statistical and empirical challenges such work entails. Meeting these challenges, however, where data and resources permit, will be important if we...

  6. Factors Affecting the Success of Conserving Biodiversity in National Parks: A Review of Case Studies from Africa

    Directory of Open Access Journals (Sweden)

    Moses Muhumuza

    2013-01-01

    Full Text Available National Parks are a cornerstone for biodiversity conservation in Africa. Two approaches are commonly used to sustain biodiversity in National Parks. Past and current studies show that both approaches are generally ineffective in conserving biodiversity in National Parks in Africa. However, there are a handful of cases where these approaches have been successful at conserving biodiversity in National Parks. The question this paper attempts to answer is why in some cases these approaches have been successful and in other cases they have failed. A metadata analysis of 123 documents on case studies about conservation of biodiversity in National Parks in Africa was conducted. A series of search engines were used to find papers for review. Results showed that all factors responsible for both the success and failure of conserving biodiversity in National Parks in various contexts were socioeconomic and cultural in nature. The highest percentage in both successful case studies (66% and unsuccessful cases studies (55% was associated with the creation and management of the park. These results suggest that future conservation approaches in National Parks in Africa should place more emphasis on the human dimension of biodiversity conservation than purely scientific studies of species and habitats in National Parks.

  7. GM2 gangliosidosis in a UK study of children with progressive neurodegeneration: 73 cases reviewed.

    Science.gov (United States)

    Smith, Nicholas J; Winstone, Anne Marie; Stellitano, Lesley; Cox, Timothy M; Verity, Christopher M

    2012-02-01

    To report the demographic, phenotypic, and time-to-diagnosis characteristics of children with GM2 gangliosidosis referred to the UK study of Progressive Intellectual and Neurological Deterioration. Case notification is made via monthly surveillance card, administered by the British Paediatric Surveillance Unit to all UK-based paediatricians; children with GM2 gangliosidosis were identified from cases satisfying inclusion in the UK study of Progressive Intellectual and Neurological Deterioration and analysed according to phenotypic and biochemical categories. Between May 1997 and January 2010, 73 individuals with GM2 gangliosidoses were reported: 40 with Tay-Sachs disease, 31 with Sandhoff disease, and two with GM2 activator protein deficiency. Together they account for 6% (73/1164) of all diagnosed cases of progressive intellectual and neurological deterioration. The majority (62/73) were sporadic index cases with no family history. Children of Pakistani ancestry were overrepresented in all subtypes, particularly juvenile Sandhoff disease, accounting for 10 of 11 notified cases. Infantile-onset variants predominated (55/73); the mean age at onset of symptoms was 6.2 and 4.7 months for infantile-onset Tay-Sachs and Sandhoff disease respectively, and 26.2 and 34.7 months for the corresponding juvenile-onset variants. Time to diagnosis averaged 7.4 months and 28.0 months in infantile- and juvenile-onset disease respectively. GM2 gangliosidosis is a significant cause of childhood neurodegenerative disease; timely diagnosis relies upon improved clinical recognition, which may be increasingly important as specific therapies become available. There is a potential benefit from the introduction of screening programmes for high-risk ethnic groups. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

  8. Software Design Reviews Using the Software Architecture Analysis Method: A Case Study

    Science.gov (United States)

    2000-02-01

    Management, pp. 323-356, JAI Press Inc. Stake, R. E. (1994). Case Studies. In Handbook of Qualitative Research. (N. K. Denzin and Y. S. Lincoln . Eds.), pp. 236...Henderson and Gabb 1997). References Adler, P. A. and P. Adler (1994). Observational Techniques. In Handbook of Qualitative Research. (N. K. Denzin and Y...S. Lincoln . Eds.), pp. 377-392, SAGE Publications, Thousand Oaks, California. ADO (1998). Electronic Systems Acquisition Division Compendium

  9. Preventive home care of frail older people: a review of recent case management studies.

    Science.gov (United States)

    Hallberg, Ingalill Rahm; Kristensson, Jimmie

    2004-09-01

    Preventive actions targeting community-dwelling frail older people will be increasingly important with the growing number of very old and thereby also frail older people. This study aimed to explore and summarize the empirical literature on recent studies of case/care management interventions for community-dwelling frail older people and especially with regard to the content of the interventions and the nurse's role and outcome of it. Very few of the interventions took either a preventive or a rehabilitative approach using psycho-educative interventions focusing, for instance, on self-care activities, risk prevention, health complaints management or how to preserve or strengthen social activities, community involvement and functional ability. Moreover, it was striking that very few included a family-oriented approach also including support and education for informal caregivers. Thus it seems that the content of case/care management needs to be expanded and more influenced by a salutogenic health care perspective. Targeting frail older people seemed to benefit from a standardized two-stage strategy for inclusion and for planning the interventions. A comprehensive geriatric assessment seemed useful as a base. Nurses, preferably trained in gerontological practice, have a key role in case/care management for frail older people. This approach calls for developing the content of case/care management so that it involves a more salutogenic, rehabilitative and family-oriented approach. To this end it may be useful for nurses to strengthen their psychosocial skills or develop close collaboration with social workers. The outcome measures examined in this study represented one of three perspectives: the consumer's perspective, the perspective of health care consumption or the recipient's health and functional ability. Perhaps effects would be expected in all three areas and thus these should be included in evaluative studies in addition to measures for family and/or informal

  10. CASE STUDY

    African Journals Online (AJOL)

    HIV infection has several oral manifestations, including oral candidiasis and oral hairy leucoplakia. Occasionally unusual presentations requiring rigorous investigations are seen, and in these cases the diagnosis sometimes remains a dilemma owing to limited investigation facilities.1-3 We present the case of a patient who.

  11. Interleukin gene polymorphisms and breast cancer: a case control study and systematic literature review

    International Nuclear Information System (INIS)

    Balasubramanian, SP; Azmy, IAF; Higham, SE; Wilson, AG; Cross, SS; Cox, A; Brown, NJ; Reed, MW

    2006-01-01

    Interleukins and cytokines play an important role in the pathogenesis of many solid cancers. Several single nucleotide polymorphisms (SNPs) identified in cytokine genes are thought to influence the expression or function of these proteins and many have been evaluated for their role in inflammatory disease and cancer predisposition. The aim of this study was to evaluate any role of specific SNPs in the interleukin genes IL1A, IL1B, IL1RN, IL4R, IL6 and IL10 in predisposition to breast cancer susceptibility and severity. Candidate single nucleotide polymorphisms (SNPs) in key cytokine genes were genotyped in breast cancer patients and in appropriate healthy volunteers who were similar in age, race and sex. Genotyping was performed using a high throughput allelic discrimination method. Data on clinico-pathological details and survival were collected. A systematic review of Medline English literature was done to retrieve previous studies of these polymorphisms in breast cancer. None of the polymorphisms studied showed any overall predisposition to breast cancer susceptibility, severity or to time to death or occurrence of distant metastases. The results of the systematic review are summarised. Polymorphisms within key interleukin genes (IL1A, IL1B, IL1RN, IL4R, IL6 and IL10 do not appear to play a significant overall role in breast cancer susceptibility or severity

  12. Postmortem bone marrow analysis in forensic science: study of 73 cases and review of the literature.

    Science.gov (United States)

    Tattoli, Lucia; Tsokos, Michael; Sautter, Julia; Anagnostopoulos, Joannis; Maselli, Eloisa; Ingravallo, Giuseppe; Delia, Mario; Solarino, Biagio

    2014-01-01

    In forensic sciences, bone marrow (BM) is an alternative matrix in postmortem toxicology because of its good resistance to autolysis and contaminations. Nevertheless, few studies have been focused on postmortem BM morphological changes after pathological stimuli. We examined 73 BM samples from forensic autopsies; causes of death were both natural and traumatic. BM samples were collected from the sternum by needle aspiration and biopsy; in selected cases, immunohistochemistry was performed. Few autolytic changes were found; BM cellularity decreased with increasing age and postmortem interval. Notable cell changes were detected in 45 cases (61.64%): neoplastic (n=4), and non-neoplastic BM findings (n=41), including multiorgan failure/sepsis (n=26), myelodisplastic-like conditions (n=11), and anaphylactic reactions (n=4). The results showed that BM cellularity supported circumstantial and autopsy findings, suggesting that BM samples could be a useful tool in forensic science applications. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. Fuzzy Continuous Review Inventory Model using ABC Multi-Criteria Classification Approach: A Single Case Study

    Directory of Open Access Journals (Sweden)

    Meriastuti - Ginting

    2015-07-01

    Full Text Available Abstract. Inventory is considered as the most expensive, yet important,to any companies. It representsapproximately 50% of the total investment. Inventory cost has become one of the majorcontributorsto inefficiency, therefore it should be managed effectively. This study aims to propose an alternative inventory model,  by using ABC multi-criteria classification approach to minimize total cost. By combining FANP (Fuzzy Analytical Network Process and TOPSIS (Technique of Order Preferences by Similarity to the Ideal Solution, the ABC multi-criteria classification approach identified 12 items of 69 inventory items as “outstanding important class” that contributed to 80% total inventory cost. This finding  is then used as the basis to determine the proposed continuous review inventory model.This study found that by using fuzzy trapezoidal cost, the inventory  turnover ratio can be increased, and inventory cost can be decreased by 78% for each item in “class A” inventory.Keywords:ABC multi-criteria classification, FANP-TOPSIS, continuous review inventory model lead-time demand distribution, trapezoidal fuzzy number 

  14. Bowel ischaemia and cocaine consumption: case study and review of the literature

    Directory of Open Access Journals (Sweden)

    Almudena Martínez-Vieira

    2014-05-01

    Full Text Available Background: Amongst others, cocaine consumption has a detrimental effect in the vascular supply to the mesenteric area causing abdominal ischemic changes. Early recognition of these changes and adequate treatment are essential to avoid serious complications and possible death of the patient from sepsis. Case report: In this case study, the subject is a 40-years-old gentleman presenting with acute abdominal pain due to multiple ischemic changes in both small bowel and sigmoid loops. The patient required emergency surgical intervention consisting of bowel resection and anastomosis. The pathologic analysis of the segment showed transmural necrosis and necrotizing phlebitis caused by the ingestion of drugs or toxic agents. The patient later confirmed the habitual consumption of cocaine. Discussion: The increase in cocaine consumption and other recreational toxins substructed from erythroyilon coca alcaloids amongst young people have generated a large number of admissions to Hospital Accident and Emergency Departments with patients complaining of acute abdominal pain. In many of these cases, surgical intervention is required and in some cases patients will sadly die without a proper diagnosis. Some of the most common effects of cocaine and its compounds includes; hollow viscus perforation, gastro-intestinal bleed, and other vascular problems such as enteritis and ischemic colitis. It appears clear that there is a great need for an advance history taking of these patients and their habit to cocaine and other drugs together with a urine test for drug screening. These together with a suspicion of a non- occlusive ischemic bowel caused by the effects of cocaine in young adults with no cardiac risk factors will guide clinicians and establish, and plan the correct treatment for these categories of patients.

  15. Why Public Comments Matter: The Case of the National Institutes of Health Policy on Single Institutional Review Board Review of Multicenter Studies.

    Science.gov (United States)

    Ervin, Ann-Margret; Taylor, Holly A; Ehrhardt, Stephan; Meinert, Curtis L

    2018-03-06

    In 2014, the National Institutes of Health (NIH) requested public comments on a draft policy requiring NIH-funded, U.S.-based investigators to use a single institutional review board (sIRB) for ethical review of multicenter studies. The authors conducted a directed content analysis and qualitative summary of the comments and discuss how they shaped the final policy. Two reviewers independently assessed support for the policy from a review of comments responding to the draft policy in 2016. A reviewer conducted an open text review to identify prespecified and additional comment themes. A second researcher reviewed 20% of the comments; discrepancies were resolved through discussion. The NIH received 167 comments: 65% (108/167) supportive of the policy, 23% (38/167) not supportive, and 12% (21/167) not indicating support. Clarifications or changes to the policy were suggested in 102/167 comments (61%). Criteria for selecting sIRBs were addressed in 32/102 comments (31%). Also addressed were IRB responsibilities (39/102; 38%), cost (27/102; 26%), the role of local IRBs (14/102; 14%), and allowable policy exceptions (19/102; 19%). The NIH further clarified or provided additional guidance for selection criteria, IRB responsibilities, and cost in the final policy (June 2016). Local IRB reviews and exemptions guidance were unchanged. In this case study, public comments were effective in shaping policy as the NIH modified provisions or planned supplemental guidance in response to comments. Yet critical knowledge gaps remain and empirical data are necessary. The NIH is considering mechanisms to support the establishment of best practices for sIRB implementation.

  16. case study

    African Journals Online (AJOL)

    Elton

    particularly in patients who commence ART with low CD4 counts and established opportunistic infections. IRIS results from a pathological inflammatory response to pre-existing infective, host or other antigens, alive or dead, causing clinical deterioration in HIV-infected patients after initiating ART.1 A case definition for IRIS ...

  17. CASE STUDY

    African Journals Online (AJOL)

    2010-09-01

    Sep 1, 2010 ... of the two diseases surgery can be successful, recovery can be similar to that .... lymphocytes predominated in 68% of cases, and that there was an .... using ferritin is the fact that it acts as an acute-phase reactant and will be ...

  18. [Acute pulmonary edema and pregnancy: a descriptive study of 15 cases and review of the literature].

    Science.gov (United States)

    Dolley, P; Lebon, A; Beucher, G; Simonet, T; Herlicoviez, M; Dreyfus, M

    2012-11-01

    To describe the incidence and the etiologies of acute pulmonary edema (APE) and the diagnostic procedure used during pregnancy and immediate post-partum. We analyzed records from a search of codes of heart failure and APE as well as from the term "pulmonary edema" in computerized obstetric records from 2002 to 2010 in a university center of level 3. We identified maternal characteristics, the term of appearance and route of delivery, the time between symptoms and diagnosis, additional tests performed, and data from echocardiography. Fifteen patients had an APE during pregnancy or in the immediate post-partum period during the study period (0.05%). The mean age was 28.6 years and the mean term of appearance was 31.2±3.1 weeks of amenorrhea. The diagnosis was made in 11 cases (73.3%) before delivery and in four during post-partum. The main etiology was preeclampsia (46.6%) followed by heart disease (26.7%), then tocolysis and overfilling (13.3%). In 55% of cases, we found a diagnostic wander characterized by carrying out further unnecessary tests. The echocardiography has led to a change in management in 27.3% of cases. The APE is a rare event during pregnancy and the post-partum period and its main etiology is preeclampsia. Some other etiologies are avoidable like the use of beta-agonists by intravenous route. The diagnosis is sometimes difficult, but the realization of a chest X-ray, a simple and inexpensive test, is enough to confirm it. Copyright © 2012. Published by Elsevier Masson SAS.

  19. Review of Dengue hemorrhagic fever fatal cases seen among adults: a retrospective study.

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    Sing-Sin Sam

    Full Text Available BACKGROUND: Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if there have been changes in the presentation of severe to fatal dengue. Nine of ten fatal cases involved adult females with a median age of 32 years. All had secondary dengue infection. The mean duration of illness prior to hospitalization was 4.7 days and deaths occurred at an average of 2.4 days post-admission. Gastrointestinal pain, vomiting, diarrhea, intravascular leakages and bleeding occurred in the majority of cases. DSS complicated with severe bleeding, multi-organ failure and coagulopathy were the primary causes of deaths. Seven patients presented with thrombocytopenia and hypoalbuminemia, five of which had hemoconcentration and increased ALT and AST indicative of liver damage. Co-morbidities particularly diabetes mellitus was common in our cohort. Prominent unusual presentations included acute renal failure, acute respiratory distress syndrome, myocarditis with pericarditis, and hemorrhages over the brain and heart. CONCLUSIONS: In our cohort, dengue fatalities are seen primarily in adult females with secondary dengue infection. The majority of the patients presented with common clinical and laboratory warning signs of severe dengue. Underlying co-morbidities may contribute to the rapid clinical deterioration in severe dengue. The uncommon presentations of dengue are likely a reflection of the changing demographics where adults are now more likely to contract dengue in dengue endemic regions.

  20. Road-corridor planning in the EIA procedure in Spain. A review of case studies

    Energy Technology Data Exchange (ETDEWEB)

    Loro, Manuel, E-mail: manuel.loro@upm.es [Department of Urban and Regional Planning and Environment, Civil Engineering School, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Transport Research Centre (TRANSyT-UPM) Universidad Politécnica de Madrid, ETSI Caminos, Canales y Puertos, Prof. Aranguren s/n, 28040 Madrid (Spain); Centro de investigación del transporte, TRANSyT-UPM, ETSI Caminos, Canales y Puertos, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Arce, Rosa M., E-mail: rosa.arce.ruiz@upm.es [Department of Urban and Regional Planning and Environment, Civil Engineering School, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Transport Research Centre (TRANSyT-UPM) Universidad Politécnica de Madrid, ETSI Caminos, Canales y Puertos, Prof. Aranguren s/n, 28040 Madrid (Spain); Centro de investigación del transporte, TRANSyT-UPM, ETSI Caminos, Canales y Puertos, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Ortega, Emilio, E-mail: e.ortega@upm.es [Transport Research Centre (TRANSyT-UPM) Universidad Politécnica de Madrid, ETSI Caminos, Canales y Puertos, Prof. Aranguren s/n, 28040 Madrid (Spain); Centro de investigación del transporte, TRANSyT-UPM, ETSI Caminos, Canales y Puertos, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Department of Construction and Rural Roads, Forestry Engineering School, Universidad Politécnica de Madrid, Ciudad Universitaria s/n, 28040 Madrid (Spain); and others

    2014-01-15

    The assessment of different alternatives in road-corridor planning must be based on a number of well-defined territorial variables that serve as decision making criteria, and this requires a high-quality preliminary environmental assessment study. In Spain the formal specifications for the technical requirements stipulate the constraints that must be considered in the early stages of defining road corridors, but not how they should be analyzed and ranked. As part of the feasibility study of a new road definition, the most common methodology is to establish different levels of Territorial Carrying Capacity (TCC) in the study area in order to summarize the territorial variables on thematic maps and to ease the tracing process of road-corridor layout alternatives. This paper explores the variables used in 22 road-construction projects conducted by the Ministry of Public Works that were subject to the Spanish EIA regulation and published between 2006 and 2008. The aim was to evaluate the quality of the methods applied and the homogeneity and suitability of the variables used for defining the TCC. The variables were clustered into physical, environmental, land-use and cultural constraints for the purpose of comparing the TCC values assigned in the studies reviewed. We found the average quality of the studies to be generally acceptable in terms of the justification of the methodology, the weighting and classification of the variables, and the creation of a synthesis map. Nevertheless, the methods for assessing the TCC are not sufficiently standardized; there is a lack of uniformity in the cartographic information sources and methodologies for the TCC valuation. -- Highlights: • We explore 22 road-corridor planning studies subjected to the Spanish EIA regulation. • We analyze the variables selected for defining territorial carrying capacity. • The quality of the studies is acceptable (methodology, variable weighting, mapping). • There is heterogeneity in the

  1. Vascular Parkinsonism and cognitive impairment: literature review, Brazilian studies and case vignettes

    Directory of Open Access Journals (Sweden)

    Thiago Cardoso Vale

    Full Text Available ABSTRACT Vascular Parkinsonism (VP is a form of secondary Parkinsonism resulting from cerebrovascular disease. Estimates of the frequency of VP vary greatly worldwide; 3% to 6% of all cases of Parkinsonism are found to have a vascular etiology. In a Brazilian community-based study on Parkinsonism, 15.1% of all cases were classified as VP, the third most common form, with a prevalence of 1.1% in an elderly cohort. Another Brazilian survey found a prevalence of 2.3% of VP in the elderly. VP is usually the result of conventional vascular risk factors, particularly hypertension, leading to strategic infarcts of subcortical gray matter nuclei, diffuse white matter ischaemic lesions and less commonly, large vessel infarcts. Patients with VP tend to be older and present with gait difficulties, symmetrical predominant lower-body involvement, poor levodopa responsiveness, postural instability, falls, cognitive impairment and dementia, corticospinal findings, urinary incontinence and pseudobulbar palsy. This article intends to provide physicians with an insight on the practical issues of VP, a disease potentially confounded with vascular dementia, idiopathic Parkinson's disease, dementia with Lewy bodies and other secondary causes of Parkinsonism.

  2. Formation, clearance, deposition, pathogenicity, and identification of biopharmaceutical-related immune complexes: review and case studies.

    Science.gov (United States)

    Rojko, Jennifer L; Evans, Mark G; Price, Shari A; Han, Bora; Waine, Gary; DeWitte, Mark; Haynes, Jill; Freimark, Bruce; Martin, Pauline; Raymond, James T; Evering, Winston; Rebelatto, Marlon C; Schenck, Emanuel; Horvath, Christopher

    2014-06-01

    Vascular inflammation, infusion reactions, glomerulopathies, and other potentially adverse effects may be observed in laboratory animals, including monkeys, on toxicity studies of therapeutic monoclonal antibodies and recombinant human protein drugs. Histopathologic and immunohistochemical (IHC) evaluation suggests these effects may be mediated by deposition of immune complexes (ICs) containing the drug, endogenous immunoglobulin, and/or complement components in the affected tissues. ICs may be observed in glomerulus, blood vessels, synovium, lung, liver, skin, eye, choroid plexus, or other tissues or bound to neutrophils, monocytes/macrophages, or platelets. IC deposition may activate complement, kinin, and/or coagulation/fibrinolytic pathways and result in a systemic proinflammatory response. IC clearance is biphasic in humans and monkeys (first from plasma to liver and/or spleen, second from liver or spleen). IC deposition/clearance is affected by IC composition, immunomodulation, and/or complement activation. Case studies are presented from toxicity study monkeys or rats and indicate IHC-IC deposition patterns similar to those predicted by experimental studies of IC-mediated reactions to heterologous protein administration to monkeys and other species. The IHC-staining patterns are consistent with findings associated with generalized and localized IC-associated pathology in humans. However, manifestations of immunogenicity in preclinical species are generally not considered predictive to humans. © 2014 by The Author(s).

  3. Use of Evidence from Systematic Reviews to Inform Commissioning Decisions: A Case Study

    Science.gov (United States)

    Chambers, Duncan; Grant, Rod; Warren, Erica; Pearson, Sally-Anne; Wilson, Paul

    2012-01-01

    Systematic reviews provide high-level evidence but there are barriers to their use by policy makers. This paper reports the preparation and evaluation of an evidence briefing, using systematic reviews and other existing sources of synthesised evidence, to support a possible reorganisation of services for young people with eating disorders in an…

  4. Bound by Tradition? Peer Review and New Scholarship: An Institutional Case Study

    Science.gov (United States)

    White, Barbara Jo; Cruz, Laura; Ellern, Jill; Ford, George; Moss, Hollye

    2012-01-01

    Peer review is by no means a routine process for traditional, or basic, research. Even so, peer review is even less routinized for other forms of scholarship. In 1990, Ernest Boyer called for a reconsideration of scholarship and extended the definition to be inclusive of non-traditional modes of scholarly production and delivery. However, peer…

  5. Working in Triads: A Case Study of a Peer Review Process

    Science.gov (United States)

    Grainger, Peter; Bridgstock, Martin; Houston, Todd; Drew, Steve

    2015-01-01

    Peer review of teaching has become an accepted educational procedure in Australia to quality assure the quality of teaching practices. The institutional implementation of the peer review process can be viewed as genuine desire to improve teaching quality or an imposition from above as a measure of accountability and performativity. One approach is…

  6. Undergraduate Program Review Processes: A Case Study in Opportunity for Academic Libraries

    Science.gov (United States)

    Costella, John; Adam, Tom; Gray, Fran; Nolan, Nicole; Wilkins, Catherine

    2013-01-01

    How can an academic library most effectively participate and expand its contributions to program reviews at the institutional level? By becoming involved in undergraduate reviews, college and university libraries can articulate new and enhanced roles for themselves on campus. Academic libraries have always contributed to a variety of institutional…

  7. Atypical course oferysipelas and coexisting infections. Case study and literature review

    Directory of Open Access Journals (Sweden)

    Anna Martyniuk

    2015-12-01

    Full Text Available Erysipelas is  an acute, erythematous, rapidly spreading skin infection, usually caused by beta-haemolytic group A Streptococcus bacteria. The disease is usually located on the legs and toes, less frequently on the face. One of the predisposing factors for the development of erysipelas are coexisting infections. The aim of the work was to attempt to determine whether there was any connection between the atypical course of erysipelas and Helicobacter pylori infection in a 47-year-old female patient. The patient had a history of treatment for chronic otitis media with effusion and recurring abdominal pain. The current disease started abruptly with fever, erythematous skin lesion located on the right cheek and severe pain in the right ear. After a few days, the facial erythema got worse, oedema appeared on the right side of the face and redness, oedema and pain in the auricle could be observed. After examinations by an ENT specialist and a dermatologist, erysipelas of the face, auricle and external auditory meatus was diagnosed. The diagnosis was confirmed by bacteriological examination. As a result of antibiotic therapy skin lesions subsided and the patient’s general condition improved. As the dyspeptic symptoms exacerbated, a diagnostic test was performed and a coexisting Helicobacter pylori infection was diagnosed. The overall clinical picture and data obtained from medical literature suggest that the coexisting Helicobacter pylori infection could have contributed to both the chronic otitis media with effusion and atypical course of erysipelas. According to medical literature, in the case of patients with dyspeptic symptoms, Helicobacter pylori bacteria can be transferred from the lining of the stomach upwards to the oral cavity, middle ear and paranasal sinuses. Kariya et al. in their review of original work suggested that Helicobacter pylori may contribute to the exacerbation of an existing inflammation in

  8. Case Study: Testing with Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman

    2015-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  9. Four cases of variations in the forearm extensor musculature in a study of hundred limbs and review of literature

    Directory of Open Access Journals (Sweden)

    Rao Mohandas

    2006-01-01

    Full Text Available All surgeons must bear in mind the existence of muscular variations when performing common tendon transfers. Presence of additional bellies and tendons of existing muscles or presence of additional muscles in unusual locations might misguide a surgeon, during surgery and also during diagnosis. In the present paper we are reporting four cases of variations encountered during the study of extensor muscles of the forearm in 100 limbs. In Case 1, additional bellies of extensor carpi radialis longus and extensor carpi radialis brevis and multiple tendons of insertion of abductor pollicis longus were observed in a single limb. In Case 2, an additional belly of the abductor pollicis longus was observed. In Case 3, a short muscle on the dorsum of the hand going to the index finger [extensor indicis brevis (EIB] was found in addition to the normal extensor indicis (EI. It was also observed that some of the most superficial fleshy fibers of EIB were getting inserted into the tendon of EI. In Case 4, a rare incidence of extensor digiti medii proprius was observed. Further, the related literature is reviewed and the clinical and surgical importance of these muscular variations in diagnosis and proper planning of treatment is discussed.

  10. A hybrid model for combining case-control and cohort studies in systematic reviews of diagnostic tests

    Science.gov (United States)

    Chen, Yong; Liu, Yulun; Ning, Jing; Cormier, Janice; Chu, Haitao

    2014-01-01

    Systematic reviews of diagnostic tests often involve a mixture of case-control and cohort studies. The standard methods for evaluating diagnostic accuracy only focus on sensitivity and specificity and ignore the information on disease prevalence contained in cohort studies. Consequently, such methods cannot provide estimates of measures related to disease prevalence, such as population averaged or overall positive and negative predictive values, which reflect the clinical utility of a diagnostic test. In this paper, we propose a hybrid approach that jointly models the disease prevalence along with the diagnostic test sensitivity and specificity in cohort studies, and the sensitivity and specificity in case-control studies. In order to overcome the potential computational difficulties in the standard full likelihood inference of the proposed hybrid model, we propose an alternative inference procedure based on the composite likelihood. Such composite likelihood based inference does not suffer computational problems and maintains high relative efficiency. In addition, it is more robust to model mis-specifications compared to the standard full likelihood inference. We apply our approach to a review of the performance of contemporary diagnostic imaging modalities for detecting metastases in patients with melanoma. PMID:25897179

  11. Stratigraphic architecture of hydromagmatic volcanoes that have undergone vent migration: a review of Korean case studies

    Science.gov (United States)

    Sohn, Y.

    2011-12-01

    Recent studies show that the architecture of hydromagmatic volcanoes is far more complex than formerly expected. A number of external factors, such as paleohydrology and tectonics, in addition to magmatic processes are thought to play a role in controlling the overall characteristics and architecture of these volcanoes. One of the main consequences of these controls is the migration of the active vent during eruption. Case studies of hydromagmatic volcanoes in Korea show that those volcanoes that have undergone vent migration are characterized by superposition or juxtaposition of multiple rim deposits of partial tuff rings and/or tuff cones that have contrasting lithofacies characteristics, bed attitudes, and paleoflow directions. Various causes of vent migration are inferred from these volcanoes. Large-scale collapse of fragile substrate is interpreted to have caused vent migration in the Early Pleistocene volcanoes of Jeju Island, which were built upon still unconsolidated continental shelf sediments. Late Pleistocene to Holocene volcanoes, which were built upon a stack of rigid, shield-forming lava flows, lack features due to large-scale substrate collapse and have generally simple and circular morphologies either of a tuff ring or of a tuff cone. However, ~600 m shift of the eruptive center is inferred from one of these volcanoes (Ilchulbong tuff cone). The vent migration in this volcano is interpreted to have occurred because the eruption was sourced by multiple magma batches with significant eruptive pauses in between. The Yangpori diatreme in a Miocene terrestrial half-graben basin in SE Korea is interpreted to be a subsurface equivalent of a hydromagmatic volcano that has undergone vent migration. The vent migration here is inferred to have had both vertical and lateral components and have been caused by an abrupt tectonic activity near the basin margin. In all these cases, rimbeds or diatreme fills derived from different source vents are bounded by either

  12. Homocyst(e)ine and cardiovascular disease: a systematic review of the evidence with special emphasis on case-control studies and nested case-control studies.

    Science.gov (United States)

    Ford, Earl S; Smith, S Jay; Stroup, Donna F; Steinberg, Karen K; Mueller, Patricia W; Thacker, Stephen B

    2002-02-01

    Elevated concentrations of homocyst(e)ine are thought to increase the risk of vascular diseases including coronary heart disease and cerebrovascular disease. We searched MEDLINE (1966-1999), EMBASE (1974-1999), SciSearch (1974- 1999), and Dissertation Abstracts (1999) for articles and theses about homocyst(e)ine concentration and coronary heart disease and cerebrovascular disease. We included 57 publications (3 cohort studies, 12 nested case-control studies, 42 case-control studies) that reported results on 5518 people with coronary heart disease (11,068 control subjects) and 1817 people with cerebrovascular disease (4787 control subjects) in our analysis. For coronary heart disease, the summary odds ratios (OR) for a 5-micromol/l increase in homocyst(e)ine concentration were 1.06 (95% CI : 0.99-1.13) for 2 publications of cohort studies, 1.23 (95% CI : 1.07-1.41) for 10 publications of nested case-control studies, and 1.70 (95% CI : 1.50-1.93) for 26 publications of case-control studies. For cerebrovascular disease, the summary OR for a 5-micromol/l increase in homocyst(e)ine concentration were 1.10 (95% CI : 0.94-1.28) for 2 publications of cohort studies, 1.58 (95% CI : 1.35-1.85) for 5 publications of nested case-control studies, and 2.16 (95% CI : 1.65-2.82) for 17 publications of case-control studies. Prospective studies offer weaker support than case-control studies for an association between homocyst(e)ine concentration and cardiovascular disease. Although other lines of evidence support a role for homocyst(e)ine in the pathogenesis of cardiovascular disease, more information from prospective epidemiological studies or clinical trials is needed to clarify this role.

  13. Campylobacter epidemiology: a descriptive study reviewing 1 million cases in England and Wales between 1989 and 2011.

    Science.gov (United States)

    Nichols, Gordon L; Richardson, Judith F; Sheppard, Samuel K; Lane, Chris; Sarran, Christophe

    2012-01-01

    To review Campylobacter cases in England and Wales over 2 decades and examine the main factors/mechanisms driving the changing epidemiology. A descriptive study of Campylobacter patients between 1989 and 2011. Cases over 3 years were linked anonymously to postcode, population density, deprivation indices and census data. Cases over 5 years were anonymously linked to local weather exposure estimates. Patients were from general practice, hospital and environmental health investigations through primary diagnostic laboratories across England and Wales. There were 1 109 406 cases. Description of changes in Campylobacter epidemiology over 23 years and how the main drivers may influence these. There was an increase in Campylobacter cases over the past 23 years, with the largest increase in people over 50 years. Changes in the underlying population have contributed to this, including the impacts of population increases after World War I, World War II and the 'baby boom' of the 1960s. A recent increase in risk or ascertainment within this population has caused an increase in cases in all age groups from 2004 to 2011. The seasonal increase in cases between weeks 18 (Early May) and 22 (Early June) was consistent across ages, years and regions and was most marked in children and in more rural regions. Campylobacter prevalence by week in each region correlated with temperature 2 weeks before. There were higher prevalences in areas with a low population density, low deprivation and lower percentage of people of ethnic origin. Data from sero-phage and multilocus sequence typing show a few common types and many uncommon types. The drivers/mechanisms influencing seasonality, age distribution, population density, socioeconomic and long-term differences are diverse and their relative contributions remain to be established. Surveillance and typing provide insights into Campylobacter epidemiology and sources of infection, providing a sound basis for targeted interventions.

  14. Lipase applications in oil hydrolysis with a case study on castor oil: a review.

    Science.gov (United States)

    Goswami, Debajyoti; Basu, Jayanta Kumar; De, Sirshendu

    2013-03-01

    Lipase (triacylglycerol acylhydrolase) is a unique enzyme which can catalyze various types of reactions such as hydrolysis, esterification, alcoholysis etc. In particular, hydrolysis of vegetable oil with lipase as a catalyst is widely studied. Free lipase, lipase immobilized on suitable support, lipase encapsulated in a reverse micelle and lipase immobilized on a suitable membrane to be used in membrane reactor are the most common ways of employing lipase in oil hydrolysis. Castor oil is a unique vegetable oil as it contains high amounts (90%) of a hydroxy monounsaturated fatty acid named ricinoleic acid. This industrially important acid can be obtained by hydrolysis of castor oil. Different conventional hydrolysis processes have certain disadvantages which can be avoided by a lipase-catalyzed process. The degree of hydrolysis varies widely for different lipases depending on the operating range of process variables such as temperature, pH and enzyme loading. Immobilization of lipase on a suitable support can enhance hydrolysis by suppressing thermal inactivation and estolide formation. The presence of metal ions also affects lipase-catalyzed hydrolysis of castor oil. Even a particular ion has different effects on the activity of different lipases. Hydrophobic organic solvents perform better than hydrophilic solvents during the reaction. Sonication considerably increases hydrolysis in case of lipolase. The effects of additives on the same lipase vary with their types. Nonionic surfactants enhance hydrolysis whereas cationic and anionic surfactants decrease it. A single variable optimization method is used to obtain optimum conditions. In order to eliminate its disadvantages, a statistical optimization method is used in recent studies. Statistical optimization shows that interactions between any two of the following pH, enzyme concentration and buffer concentration become significant in presence of a nonionic surfactant named Span 80.

  15. Odontogenic myxoma: A 63-year retrospective multicenter study of 85 cases in a Brazil population and a review of 999 cases from literature.

    Science.gov (United States)

    Vasconcelos, Ana Carolina Uchoa; Silveira, Felipe Martins; Gomes, Ana Paula Neutzling; Tarquinio, Sandra Beatriz Chaves; Sobral, Ana Paula Veras; de Arruda, José Alcides Almeida; da Silva, Leorik Pereira; da Silveira, Marcia Maria Fonseca; Barbosa, Larissa Ferreira; Kato, Camila de Nazaré Alves de Oliveira; Jaeger, Filipe; da Silva, Tarcília Aparecida; Mesquita, Ricardo Alves

    2018-01-01

    Odontogenic myxoma (OM) is an uncommon neoplasm of the jaws. Considering the importance of defining the relative incidence and demographic profile of these lesions in South America, the aim of this study was to analyze the clinical and imagiological features of OM from three South American oral pathology services and to discuss these findings in light of the literature. Data regarding age, gender, anatomic site, and imagiological features from 85 cases of OM were collected. Additionally, we did a review of OM studies published in three electronic databases. Among 63 450 oral biopsies, 1178 (1.85%) were odontogenic tumors (World Health Organization - 2017), of which 85 (7.21%) met the criteria of OM. The mean age was 30.7 years (range: 10-61 years; SD: 12.22). Forty-five (52.9%) cases occurred in females and 40 (47.1%) in males (ratio: 1:1.12). Maxilla was affected in 44 cases (53%) and mandible in 39 (47%). Of the 41 informed cases (48.2%), all of them were radiolucent lesions. The literature review indicated a majority of mean ages in third decade and a predilection for females, mandible, and multilocular radiolucent lesions. The features of OM samples have strong similarity to that reported in studies from other continents. It is possible to infer that geographic variation does not help to explain some differences observed in the clinical features of OM. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Primary Leiomyosarcoma of the Adrenal Gland: A Case Report with Immunohistochemical Study and Literature Review

    Directory of Open Access Journals (Sweden)

    Murat Tolga Gulpinar

    2014-01-01

    Full Text Available Primary adrenal leiomyosarcoma is extremely rare tumor. We report a case with adrenal leiomyosarcoma. Our case was a 48-year-old man who presented with lower urinary tract symptoms. Ultrasonography and magnetic resonance imaging revealed approximately 9 cm solid mass originating from right adrenal gland. He underwent right adrenalectomy. Pathology of the specimen showed histologic and immunohistochemical features of adrenal leiomyosarcoma.

  17. Space geodiversity review: a case study in the southwestern region of Paraná State, Brazil.

    Science.gov (United States)

    Manosso, Fernando; Tauana Basso, Bruna; Alcindo Da Roza, Douglas; Souza dos Santos, Daniel

    2015-04-01

    types, landforms, occurrence of fossils, drainage system, soil and other processes that outline the geodiversity. In addition to the wealth index number, which presents a quantity and area ratio, another way of analyzing the geodiversity of a case study is the abundance, dominance or the relative frequency of geodiversity (Carcavilla et al, 2007). As for the southwestern region of Paraná State case study, we used a set of cartographic databases at the 1:250.000 scale; for example: geomorphological and soil compartments, rivers, geological formations, structural lineaments, as well as temperature, rainfall and humidity average maps. The maps were organized relating the attribute tables, quantifying the sum of different elements each sample cell contained in a regular grid of 4km2. As a result, a map of the geodiversity wealth index of the region has been generated. High geodiversity wealth index comprises more carved valleys with steep slopes on some structural lines; on the other hand, less wealthy areas are located on softer relief plateaus with large hills, more homogeneous soils and lower relief structural control. These results, as well as adjustments and efficiency of the method seem to indicate an important tool for area management, especially regarding the selection of priority areas for nature conservation.

  18. How cushion communities are maintained in alpine ecosystems: A review and case study on alpine cushion plant reproduction

    Directory of Open Access Journals (Sweden)

    Jianguo Chen

    2017-08-01

    Full Text Available Cushion species occur in nearly all alpine environments worldwide. In past decades, the adaptive and ecosystem-engineering roles of such highly specialized life forms have been well studied. However, the adaptive strategies responsible for cushion species reproductive success and maintenance in severe alpine habitats remain largely unclear. In this study, we reviewed the current understanding of reproductive strategies and population persistence in alpine cushion species. We then present a preliminary case study on the sexual reproduction of Arenaria polytrichoides (Caryophyllaceae, a typical cushion species inhabiting high elevations of the Himalaya Hengduan Mountains, which is a hotspot for diversification of cushion species. Finally, we highlight the limitations of our current understanding of alpine cushion species reproduction and propose future directions for study.

  19. Social Housing Policies and Best Practice Review for Retrofit Action - Case Studies from Parma (IT)

    Science.gov (United States)

    Gherri, Barbara; Cavagliano, Chiara; Orsi, Samuele

    2017-10-01

    The paper aims at investigating the most suitable Energy Saving Measures -ESMs- for the retrofitting of Social Housing Stock -SHS- in Europe. A global awareness has been increasing, as well as education and training among architects and building sectors employees, in order to identify tailored financing schemes and advanced integrated retrofitting solutions. Several European financed programmes have been tested so far and the results are here summarized and deeply investigated in order to increase the energy performance of social housing buildings, to improve knowledge of problems associated with the retrofitting of these households, in order to provide the most appropriate solutions to be applied. Afterward, the best practices selected have been applied to some study cases in Italy, to demonstrate that the large variety of SH programmes in Europe can seriously be used, promoting the best practises’ application. A lot of theoretical and analytical work has been carried out by many European projects in the last decade, defining different approaches according to typologies of social housing buildings, focusing on national or regional regulation, on existing typologies and building techniques, on retrofitting solutions, on energy saving strategies and other managing approaches and energy saving devices. Due to the high participation of social housing organisations -SHO- and related European financed programmes, this academic research is focused on the most effective ESMs in order to encompass a large variety of needs and related solutions, even though some of them are still on course and other ones have already been completed. This research clearly demonstrates the valuable contribution these kinds of programme have in exchanging and sharing of knowledge and experience in the field of retrofit of Social Housing building across Europe, in order to primary improve the energy performance of the existing building stock and the quality of life of their inhabitants.

  20. Urban Metal Flows - A Case Study of Stockholm. Review and Conclusions

    International Nuclear Information System (INIS)

    Bergbaeck, B.; Johansson, K.; Mohlander, U.

    2001-01-01

    Metals have rapidly accumulated in the anthroposphere, especially in urban areas, indicating possible environmental and resource problems. Here, Stockholm City was chosen for a case study of urban metal flows, i.e. metal inflow to, metals in the stock of,and metal outflow from the anthroposphere to the biosphere. The metal stock of Stockholm is large and still growing. The large amounts of metals in the solid waste fraction totally dominate the outflow from the city. For major parts of the stock, the emissions from goods in use are negligible. There are, however,goods applications corresponding to significant emissions: e.g. the traffic sector (Cu, Zn, Cr, Ni, Pb), the tapwater system (Cu), roofs/fronts or other metal surfaces (Cu, Zn). Today's known metal flows from the anthroposphere of Stockholm to the biosphere and sewage sludge are quantitatively dominated by Zn(34 ton y -1 ) and Cu (14 ton y -1 ). Historical and present emissions have resulted in high metal concentrations in sediments (especially Cd, Hg and Pb, but also Cu and Zn), groundwater (Cu, Hg) and in soils (Hg, Cu, Pb). At present the annual median concentrations are below the Swedish limits for metals in sewage sludge, even if the safety margins are small for Cd, Hg and to some extent Cu. The flows of Cu and Zn to Stockholm soils are high with a significant accumulation indicating an environmental impact in a longer time perspective.High levels of metals in surface sediments in the water environments reflects an ongoing input where these metals are transported from known (Cu, Zn) and or partly unknown (Cd, Hg, Pb) sources. In future urban areas, monitoring of metal flows must be performed both in the anthroposphere and the biospherein order to have a pro active approach to urban environmental problems and to get prompt answers to measures taken

  1. [Prevention in times of economic crisis and spending review. The Lazio Region as a study case].

    Science.gov (United States)

    Di Marco, Marco; Marzuillo, Carolina; De Vito, Corrado; Matarazzo, Azzurra; Massimi, Azzurra; Villari, Paolo

    2013-01-01

    With cutbacks being implemented across a wide range of social and government programs throughout Europe and the rest of the world, preventive services have become more vulnerable. In this context, it is essential to properly focus the debate on public healthcare expenditure, stressing that financing preventive services is not merely a cost, but an investment in citizen well-being as well as economic stability and development. In Italy indeed all seem to agree on three priorities: i) strengthening prevention activities; ii) reorganization of hospital care; and iii) reinforcement of primary care. A plenty of data are available in Italy from some recently published authoritative reports. Given that health policies should be driven by a solid evidence base, it is important to look at the available data to understand if these priorities are justified. The Lazio Region, which is particularly under pressure since it is one of the regions with a formal regional recovery plan (Piano di Rientro), was chosen as a case-study. In the Lazio Region public health care expenditure is particularly high, but the health care expenditure for prevention activities is among the lowest of the Italian Regions. Major weakness points documented by the essential levels of care indicators included recommended vaccinations coverage, oncological screening programs, residential beds for the elderly and persons with disability and hospital care efficiency. Avoidable mortality is higher in the Lazio than in the rest of the country, as well as the prevalence of some major behavioral risk factors. Even if all data available support the choice to consider prevention activities as a priority, it is essential to increasing the value of prevention, investing money in preventive interventions of proven effectiveness and cost-effectiveness and promoting synergies with institutions outside the health care sector, implementing in a more efficient way the principle of Health in All Policies.

  2. Life review as a way to enhance personal growt in midlife: A case study

    NARCIS (Netherlands)

    Bohlmeijer, Ernst Thomas; Westerhof, Gerben Johan

    2013-01-01

    Life review may not only be beneficial for people in the last stages of their lives but for middle-aged people as well. Memories are the building blocks of life stories as imaginative and creative productions that each of us constructs and reconstructs as we move through our adult years. When

  3. The Reasons Requirement in International Investment Arbitration: Critical Case Studies (book review)

    DEFF Research Database (Denmark)

    Tang, Yi Shin

    2008-01-01

    3. In the article, the Researcher reviews the work of Professors Guillermo A. Alvarez and W. Michael Reisman from Yale Law School, regarding the mechanisms of international investment arbitration and their importance for developing countries. The article provides a critical perspective on the aut...

  4. The Flipped Classroom in Further Education: Literature Review and Case Study

    Science.gov (United States)

    Little, Christopher

    2015-01-01

    The flipped classroom seeks to remove didactic instruction from the classroom and deliver it via electronic videos outside of the classroom, leaving contact time free for more interactive and engaging teaching and learning activities. This paper has two distinct aims: (1) to conduct a literature review of published UK-based "flipped…

  5. [Granulomatous lobular mastitis associated with mammary duct ectasia: a clinicopathologic study of 32 cases with review of literature].

    Science.gov (United States)

    Cheng, Juan; Ding, Hua-ye; DU, Yu-tang

    2013-10-01

    To study the clinicopathologic features of granulomatous lobular mastitis and mammary duct ectasia. The clinicopathologic data from August 2005 to May 2013 of 32 cases of granulomatous lobular mastitis and mammary duct ectasia were retrospectively reviewed. The age of patients ranged from 26 to 45 years. Two patients had no history of delivery. Fourteen patients had no history of lactation or lactational disorder in the lesional side. Most of the remaining patients had history of breast feeding. Gross examination showed that the lesions were poorly circumscribed and varied from 3 to 12 cm in greatest dimension. Tiny abscess cavities, ranging from 0.1 to 0.5 cm in diameter and containing light yellowish to greyish secretion, were demonstrated. Histologic examination showed granuloma formation and ductal dilatation. Eleven patients had received antibiotic treatment. Twelve cases were complicated by sinus formation related to skin incision and drainage. The duration of follow-up ranged from 5 to 90 months. Three cases showed ipsilateral recurrence and 3 cases had similar pathology in the contralateral breast. Four patients defaulted follow-up. Granulomatous lobular mastitis is associated with mammary duct ectasia. Accurate pathologic diagnosis is prudent for clinical management and control of local recurrence.

  6. Postictal psychosis and its electrophysiological correlates in invasive EEG: a case report study and literature review.

    Science.gov (United States)

    Kuba, Robert; Brázdil, Milan; Rektor, Ivan

    2012-04-01

    We identified two patients with medically refractory temporal lobe epilepsy, from whom intracranial EEG recordings were obtained at the time of postictal psychosis. Both patients had mesial temporal epilepsy associated with hippocampal sclerosis. In both patients, the postictal psychosis was associated with a continual "epileptiform" EEG pattern that differed from their interictal and ictal EEG findings (rhythmical slow wave and "abortive" spike-slow wave complex activity in the right hippocampus and lateral temporal cortex in case 1 and a periodic pattern of triphasic waves in the contacts recording activity from the left anterior cingulate gyrus). Some cases of postictal psychosis might be caused by the transient impairment of several limbic system structures due to the "continual epileptiform discharge" in some brain regions. Case 2 is the first report of a patient with TLE in whom psychotic symptoms were associated with the epileptiform impairment of the anterior cingulate gyrus. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Torsion of the uterus with myomas in a postmenopausal woman – case study and review of the literature

    Directory of Open Access Journals (Sweden)

    Dobrosława Sikora-Szczęśniak

    2014-05-01

    Full Text Available Introduction : Torsion of the uterus is defined as a rotation of more than 45° around the long axis of the uterus; 2/3 of cases are dextrorotations. The extent of rotation usually ranges from 45° to 180°. Objective: The purpose of the article was to present a case study of a postmenopausal woman with uterine torsion and myomas and to review the articles discussing the problem of rotated non-pregnant uterus. Material and methods : The article analyses the course of an extremely uncommon pathology, i.e. uterine torsion in a 67-year-old patient. Laparotomy exposed the uterus with myomas and numerous hemorrhages, rotated by 180° to the right side, size of 350 × 300 × 200 mm and bilateral necrosis of the ovaries. Moreover, we present a review of articles discussing surgical management in case of rotated non-pregnant uterus. Results and discussion: The patient was operated on by a team of gynecologists and surgeons. The uterus was derotated and total hysterectomy with salpingoophorectomy was performed. A fragment of the hepatic oval ligament was excised and periumbilical hernioplasty was performed. The patient was released home on the 10th day following the operation. Conclusions : If women complain of pain located within the small pelvis and abdominal cavity it is necessary to remember that it might result from the torsion of reproductive organs which is an uncommon condition but poses a health or life threat to patients. Surgical treatment of uterine torsion is successful if promptly implemented; in certain cases it is even possible to spare the patient’s fertility.

  8. Network Resilience Analysis: Review Of Concepts And A Country-Level. Case Study

    Directory of Open Access Journals (Sweden)

    Mariusz Kamola

    2014-01-01

    Full Text Available This paper presents the rationale behind performing an analysis of Internet resilience in the sense of maintaining a connection of autonomous systems in the presence of failures or attacks — on a level of a single country. Next, the graph of a network is constructed that represents interconnections between autonomous systems. The connectivity of the graph is examined for cases of link or node failure. Resilience metrics are proposed, focusing on a single autonomous system or on overall network reliability. The process of geographic location of networking infrastructure is presented, leading to an analysis of network resilience in the case of a joint failure of neighboring autonomous systems.

  9. Bias due to differential participation in case-control studies and review of available approaches for adjustment.

    Science.gov (United States)

    Aigner, Annette; Grittner, Ulrike; Becher, Heiko

    2018-01-01

    Low response rates in epidemiologic research potentially lead to the recruitment of a non-representative sample of controls in case-control studies. Problems in the unbiased estimation of odds ratios arise when characteristics causing the probability of participation are associated with exposure and outcome. This is a specific setting of selection bias and a realistic hazard in many case-control studies. This paper formally describes the problem and shows its potential extent, reviews existing approaches for bias adjustment applicable under certain conditions, compares and applies them. We focus on two scenarios: a characteristic C causing differential participation of controls is linked to the outcome through its association with risk factor E (scenario I), and C is additionally a genuine risk factor itself (scenario II). We further assume external data sources are available which provide an unbiased estimate of C in the underlying population. Given these scenarios, we (i) review available approaches and their performance in the setting of bias due to differential participation; (ii) describe two existing approaches to correct for the bias in both scenarios in more detail; (iii) present the magnitude of the resulting bias by simulation if the selection of a non-representative sample is ignored; and (iv) demonstrate the approaches' application via data from a case-control study on stroke. The bias of the effect measure for variable E in scenario I and C in scenario II can be large and should therefore be adjusted for in any analysis. It is positively associated with the difference in response rates between groups of the characteristic causing differential participation, and inversely associated with the total response rate in the controls. Adjustment in a standard logistic regression framework is possible in both scenarios if the population distribution of the characteristic causing differential participation is known or can be approximated well.

  10. Operational readiness review of the Low Level Waste vaults at Savannah River Site: A case study

    International Nuclear Information System (INIS)

    Ahmad, M.; McVay, C.; Venkatesh, S.

    1994-01-01

    Low Level radioactive Waste (LLW) at the Savannah River Site at Aiken, South Carolina, has traditionally been disposed of using engineered trenches in accordance with the guidelines and technology existing at the time. Recently, subgrade concrete vaults known as E-Area Vaults (EAV) have been constructed at SRS. The EAV project is a comprehensive effort for upgrading LLW disposal at SRS based on meeting the requirements of current Department of Energy (DOE) Orders, and addressing more stringent federal and state regulations. The EAV is a first of its kind state-of-the-art facility designed and built in the United States to receive LLW. Westinghouse Savannah River Company (WSRC) conducted an Operational Readiness Review (ORR) of the vaults prior to startup. The objective of the EAV ORR was to perform a comprehensive review of the operational readiness of the facilities per DOE guidelines including Defense Nuclear Facilities Safety Board (DNFSB) recommendations. This review included assessing construction of the vaults as per design, adequate approved procedures, and training of all the personnel associated with the facility operations. EAV ORR incorporated the lessons learned from other DOE ORRs, included DNFSB recommendations, used a graded approach, and utilized subject matter experts for each functional area of assessment

  11. The acute radiation syndrome: A study of ten cases and a review of the problem

    Energy Technology Data Exchange (ETDEWEB)

    Hempelmann, L.H.; Lisco, H.

    1950-03-17

    In this report ten cases of acute radiation syndrome are described resulting from two accidents occurring at the Los Alamos Scientific Laboratory of unique nature involving fissionable material. These cases are described in considerable detail. The report comprises ten sections. This volume, part II of the report, is comprised of sections entitled: (1) the Biological Basis for the Clinical Response seen in the Acute radiation Syndrome, (2) Clinical Signs and Symptoms, (3) Discussion of Hematological Findings, (4) Chemistry of the Blood and Urine, (5) Discussion of Pathological Findings, and (6) Reconsiderations of the Calculated Radiation Doses in Terms of the Observed Biological Response of the Patients. This report was prepared primarily for the clinician who is interested in radiation injuries and therefore emphasis has been placed on the correlation of clinical and pathological changes with the type of cytogenetic change known to be produced by ionizing radiation.

  12. Campylobacter jejuni Bacteremia in a Liver Cirrhosis Patient and Review of Literature: A Case Study

    OpenAIRE

    Yoon, Jin Gu; Lee, Saem Na; Hyun, Hak Jun; Choi, Min Joo; Jeon, Ji Ho; Jung, Eunju; Kang, Seonghui; Kim, Jeeyong; Noh, Ji Yun; Choi, Won Suk; Song, Joon Young; Cheong, Hee Jin; Kim, Woo Joo

    2017-01-01

    Campylobacter infection causes gastrointestinal symptoms such as abdominal pain or diarrhea. Occasionally, Campylobacter bacteremia affects immunocompromised patients; however, serious outcomes are known to be rare. Here, we present a case of a patient with Campylobacter bacteremia who had underlying liver cirrhosis. The patient had fever and diarrhea. These symptoms subsided after treatment with cefotaxime. Campylobacter jejuni was isolated in the blood culture after 10 days. In addition, pr...

  13. Clarifying the distinction between case series and cohort studies in systematic reviews of comparative studies: potential impact on body of evidence and workload

    Directory of Open Access Journals (Sweden)

    Tim Mathes

    2017-07-01

    Full Text Available Abstract Distinguishing cohort studies from case series is difficult. We propose a conceptualization of cohort studies in systematic reviews of comparative studies. The main aim of this conceptualization is to clarify the distinction between cohort studies and case series. We discuss the potential impact of the proposed conceptualization on the body of evidence and workload. All studies with exposure-based sampling gather multiple exposures (with at least two different exposures or levels of exposure and enable calculation of relative risks that should be considered cohort studies in systematic reviews, including non-randomized studies. The term “enables/can” means that a predefined analytic comparison is not a prerequisite (i.e., the absolute risks per group and/or a risk ratio are provided. Instead, all studies for which sufficient data are available for reanalysis to compare different exposures (e.g., sufficient data in the publication are classified as cohort studies. There are possibly large numbers of studies without a comparison for the exposure of interest but that do provide the necessary data to calculate effect measures for a comparison. Consequently, more studies could be included in a systematic review. Therefore, on the one hand, the outlined approach can increase the confidence in effect estimates and the strengths of conclusions. On the other hand, the workload would increase (e.g., additional data extraction and risk of bias assessment, as well as reanalyses.

  14. Accidental phosgene gas exposure: A review with background study of 10 cases

    Directory of Open Access Journals (Sweden)

    Arvind Kumar Vaish

    2013-01-01

    Full Text Available Here, authors present a review on clinical presentation and management of exposure of phosgene gas after reviewing the literature by searching with keywords phosgene exposure on Google, Cochrane, Embase and PubMed with a background of experience gained from 10 patients who were admitted to our institute after an accidental phosgene exposure in February 2011 nearby a city in India. Phosgene is a highly toxic gas, occupational workers may have accidental exposure. The gas can also be generated inadvertently during fire involving plastics and other chemicals and solvents containing chlorine, which is of concern to emergency responders. Phosgene inhalation may cause initially symptoms of respiratory tract irritation, patients feel fine thereafter, and then die of choking a day later because of build up of fluid in the lungs (delayed onset non-cardiogenic pulmonary edema. Phosgene exposure is associated with significant morbidity and mortality. Patients with a history of exposure should be admitted to the hospital for a minimum of 24 h for observation because of the potential for delayed onset respiratory failure and acute respiratory distress syndrome.

  15. A review of overseas financing mechanisms and incentives for commercial renewable energy projects. V. 2: Case study countries

    International Nuclear Information System (INIS)

    1996-01-01

    This second volume of a major study conducted for the United Kingdom Department of Trade and Industry aims to review financing mechanisms and incentives for the commercialisation of renewable energy projects. The countries included in this volume present case studies from countries identified as having particularly interesting current or past policies for the development and commercialisation of renewable energy technologies, namely Austria, Denmark, Germany, Greece, India, The Netherlands, Spain and two states in the United States of America. Data is presented on key facts, energy issues and organizations as well as energy and environmental policy for each country. The electricity supply industry, possibilities for renewable energy development, and incentive mechanisms in appropriate areas for development are also described for each country. (UK)

  16. Review of guidelines and literature for handling missing data in longitudinal clinical trials with a case study.

    Science.gov (United States)

    Liu, M; Wei, L; Zhang, J

    2006-01-01

    Missing data in clinical trials are inevitable. We highlight the ICH guidelines and CPMP points to consider on missing data. Specifically, we outline how we should consider missing data issues when designing, planning and conducting studies to minimize missing data impact. We also go beyond the coverage of the above two documents, provide a more detailed review of the basic concepts of missing data and frequently used terminologies, and examples of the typical missing data mechanism, and discuss technical details and literature for several frequently used statistical methods and associated software. Finally, we provide a case study where the principles outlined in this paper are applied to one clinical program at protocol design, data analysis plan and other stages of a clinical trial.

  17. Achieving Research Impact Through Co-creation in Community-Based Health Services: Literature Review and Case Study.

    Science.gov (United States)

    Greenhalgh, Trisha; Jackson, Claire; Shaw, Sara; Janamian, Tina

    2016-06-01

    Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-is an increasingly popular approach to aligning research and service development. It has potential for "moving beyond the ivory towers" to deliver significant societal impact via dynamic, locally adaptive community-academic partnerships. Principles of successful co-creation include a systems perspective, a creative approach to research focused on improving human experience, and careful attention to governance and process. If these principles are not followed, co-creation efforts may fail. Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-reflects a "Mode 2" relationship (knowledge production rather than knowledge translation) between universities and society. Co-creation is widely believed to increase research impact. We undertook a narrative review of different models of co-creation relevant to community-based health services. We contrasted their diverse disciplinary roots and highlighted their common philosophical assumptions, principles of success, and explanations for failures. We applied these to an empirical case study of a community-based research-service partnership led by the Centre of Research Excellence in Quality and Safety in Integrated Primary-Secondary Care at the University of Queensland, Australia. Co-creation emerged independently in several fields, including business studies ("value co-creation"), design science ("experience-based co-design"), computer science ("technology co-design"), and community development ("participatory research"). These diverse models share some common features, which were also evident in the case study. Key success principles included (1) a systems perspective (assuming emergence, local adaptation, and nonlinearity); (2) the framing of research as a creative enterprise with human experience at its core; and (3) an emphasis on process (the framing of the program, the nature of

  18. A review of biogas applications across continents - Case study of Thailand, Ghana & Denmark

    DEFF Research Database (Denmark)

    Lybæk, Rikke; Ackom, Emmanuel; Bensah, Edem Cudjoe

    This paper analyses the biogas development within Ghana, Thailand and Denmark to shed light on the different development patterns and future trends that is seen within the biogas sector. Literature review in the form of journal articles and reports is assessed, interviews with agricultural......, that large public support in the form of governmental grants and development aid has shaped the current platform for the technologies within all three countries, and that continuous support are needed. This is especially required in Ghana, where the need for finance and appropriate policy frameworks...... are required to move forward. Thailand and Denmark has set up support programs and emphasized on using industrial organic feedstock for biogas production, and Denmark has formulated political targets for utilizing organic household waste as biogas feedstock. For all three countries apply, despite...

  19. Review of Least Cost Analysis of Social Landscapes. Archaeological Case Studies [Book

    Directory of Open Access Journals (Sweden)

    Irmela Herzog

    2013-07-01

    Full Text Available The application of least cost analysis by archaeologists in Northern America and Europe has increased considerably during the last decade, and the readily available tools for this purpose have led to a much wider interest in the application of this set of techniques for research. The volume under review mainly presents the papers held at the symposium "Tracing trails and modeling movement: Understanding past cultural landscapes and social networks through least cost analysis". This symposium was organised by the editors of the volume at the 74th Annual Meeting of the Society for American Archaeologists in Atlanta in April 2009. As the book, which contains 14 chapters by 18 - all US-based - contributors, took three years to appear, inevitably some references to more recent publications on the subject of least cost analysis (LCA were not included. The volume starts with an introduction and fairly basic applications of LCA, i.e. a methodology to reconstruct patterns of human movement in space; this is followed by two parts, each consisting of three papers with new ideas for LCA applications or more advanced methods for calculating LCA. The final part presents three papers discussing different aspects of LCA raised in the first parts of the volume and general issues of methodology. In the introductory chapter the editors describe the intention of the book. It is designed "to be a guidebook for archaeologists interested in using LCA to answer behavioral questions". They explain that LCA is based on the assumption that humans tend to economise many aspects of their behaviour. They emphasise that LCA is not an end in itself but a tool which should be used properly. This ambitious goal is however not necessarily matched by the contributions to the volume, in this reviewer's eyes. Some examples are presented here to show that LCA requires a clear understanding of its methodology and that outcomes need to be validated.

  20. Collaborative Procurement within Enterprise Networks: A Literature Review, a Reference Framework and a Case Study

    Science.gov (United States)

    Cagnazzo, Luca; Taticchi, Paolo; Bidini, Gianni; Sameh, Mohamed

    Collaboration among companies is nowadays a success leverage from those involved, especially for SMEs. The networking advantages are several and among them, reducing costs is a critical one. Costs reduction due to the possibility of Collaborative Procurement (CP) among partners is one of the most important achievements in a network. While the literature available offers good bases for managing single contractor procurement issues, little research addresses the case of CP within Enterprise Networks (ENs). This paper explore the mentioned issue and proposes a general framework for managing CP in ENs, those with the Virtual Development Office (VDO) structure. The findings from the application of the framework proposed in an Italian network are highlighted so as to provide preliminary results and drive future research.

  1. Primary adrenal leiomyosarcoma: A case report with immunohistochemical study and review of literature

    Directory of Open Access Journals (Sweden)

    Sanjay D Deshmukh

    2013-01-01

    Full Text Available Primary adrenal mesenchymal tumors are exceptionally rare. Diagnosis is based entirely on histological and immunohistochemical evaluation which is indispensable not only for determining tumor type but also for predicting biological behavior. We report a rare case of primary leiomyosarcoma of the left adrenal gland, in a 60 year old woman who presented with flank pain. Computed tomography revealed a well defined left adrenal tumor which was surgically resected. Histological examination of the tumor showed malignant spindle cells in interlacing fascicles and whorls. Nuclear pleomorphism, tumor giant cells and abnormal mitotic figures were seen. On immunohistochemistry, the tumor cells showed reactivity for smooth muscle actin, vimentin and desmin; and were negative for cytokeratin, S100 protein, CD117 and HMB-45. A diagnosis of primary adrenal leiomyosarcoma was offered. Postoperative recovery of the patient was uneventful and the patient was symptom free with no evidence of tumor metastasis or recurrence 21 months after surgery.

  2. Visual art in hospitals: case studies and review of the evidence.

    Science.gov (United States)

    Lankston, Louise; Cusack, Pearce; Fremantle, Chris; Isles, Chris

    2010-12-01

    In 2006 a Department of Health Working Group on Arts and Health reported that the arts have 'a clear contribution to make and offer major opportunities in the delivery of better health, wellbeing and improved experience for patients, service users and staff alike'. In this review we examine the evidence underpinning this statement and evaluate the visual art of three of Scotland's newest hospitals: the Royal Infirmary of Edinburgh, the new Stobhill Hospital, and the new Victoria Infirmary in Glasgow. We conclude that art in hospitals is generally viewed positively by both patients and staff, but that the quality of the evidence is not uniformly high. Effects may be mediated by psychological responses to colour hue, brightness and saturation. Colours that elicit high levels of pleasure with low levels of arousal are most likely to induce a state of calm, while those causing displeasure and high levels of arousal may provoke anxiety. The fact that patients frequently express a preference for landscape and nature scenes is consistent with this observation and with evolutionary psychological theories which predict positive emotional responses to flourishing natural environments. Contrary to a view which may prevail among some contemporary artists, patients who are ill or stressed about their health may not always be comforted by abstract art, preferring the positive distraction and state of calm created by the blues and greens of landscape and nature scenes instead.

  3. Visual art in hospitals: case studies and review of the evidence

    Science.gov (United States)

    Lankston, Louise; Cusack, Pearce; Fremantle, Chris; Isles, Chris

    2010-01-01

    Summary In 2006 a Department of Health Working Group on Arts and Health reported that the arts have ‘a clear contribution to make and offer major opportunities in the delivery of better health, wellbeing and improved experience for patients, service users and staff alike’. In this review we examine the evidence underpinning this statement and evaluate the visual art of three of Scotland's newest hospitals: the Royal Infirmary of Edinburgh, the new Stobhill Hospital, and the new Victoria Infirmary in Glasgow. We conclude that art in hospitals is generally viewed positively by both patients and staff, but that the quality of the evidence is not uniformly high. Effects may be mediated by psychological responses to colour hue, brightness and saturation. Colours that elicit high levels of pleasure with low levels of arousal are most likely to induce a state of calm, while those causing displeasure and high levels of arousal may provoke anxiety. The fact that patients frequently express a preference for landscape and nature scenes is consistent with this observation and with evolutionary psychological theories which predict positive emotional responses to flourishing natural environments. Contrary to a view which may prevail among some contemporary artists, patients who are ill or stressed about their health may not always be comforted by abstract art, preferring the positive distraction and state of calm created by the blues and greens of landscape and nature scenes instead. PMID:21127332

  4. Non-safety piping operability review case study -- Today and tomorrow

    International Nuclear Information System (INIS)

    Flensburg, W.C.; Adams, T.M.

    1995-01-01

    During a 1993 Outage at the Perry Nuclear Power Station, a condition report was issued which identified potential intersystem loss of water between the Emergency Closed Cooling Water System and the Nuclear Closed Cooling Water System during a design basis event. The review of this condition report indicated that if a SSE (safe shutdown earthquake) event were to occur during a design basis event components important to plant safety could potentially be adversely affected if non-seismic/non-safety portions of the Nuclear Closed Cooling Water System could not maintain pressure boundary integrity as a result of the seismic loadings. Presented in this paper are steps, criteria, and methodology used to demonstrate the seismic acceptability of the affected portion of the Nuclear Closed Cooling Water System Piping. Also discussed are the potential benefits and applicability of a recently developed EPRI non-safety, non-seismic operability procedure. This discussion includes the potential cost savings which could have arisen from application of this recently developed procedure

  5. Water and Carbon Footprint of Wine: Methodology Review and Application to a Case Study

    Directory of Open Access Journals (Sweden)

    Sara Rinaldi

    2016-07-01

    Full Text Available Life cycle assessments (LCAs play a strategic role in improving the environmental performance of a company and in supporting a successful marketing communication. The high impact of the food industry on natural resources, in terms of water consumption and greenhouse gases emission, has been focusing the attention of consumers and producers towards environmentally sustainable products. This work presents a comprehensive approach for the joint evaluation of carbon (CF and water (WF footprint of the wine industry from a cradle to grave perspective. The LCA analysis is carried out following the requirements of international standards (ISO/TS 14067 and ISO 14046. A complete review of the water footprint methodology is presented and guidelines for all the phases of the evaluation procedure are provided, including acquisition and validation of input data, allocation, application of analytic models, and interpretation of the results. The strength of this approach is the implementation of a side-by-side CF vs. WF assessment, based on the same system boundaries, functional unit, and input data, that allows a reliable comparison between the two indicators. In particular, a revised methodology is presented for the evaluation of the grey water component. The methodology was applied to a white and a red wine produced in the same company. A comparison between the two products is presented for each LCA phase along with literature results for similar wines.

  6. Radiation recall dermatitis induced by sorafenib. A case study and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Stieb, Sonja [University Hospital Zurich, Department of Radiation Oncology, Zurich (Switzerland); Paul Scherrer Institute, Villigen PSI, Center for Proton Therapy, Villigen (Switzerland); Riesterer, Oliver; Bruessow, Cornelia; Guckenberger, Matthias [University Hospital Zurich, Department of Radiation Oncology, Zurich (Switzerland); Pestalozzi, Bernhard [University Hospital Zurich, Department of Oncology, Zurich (Switzerland); Weiler, Stefan [University Hospital and University of Zurich, Department of Clinical Pharmacology and Toxicology, Zurich (Switzerland)

    2016-05-15

    Radiation recall dermatitis (RRD) is an acute inflammatory reaction confined to previously irradiated skin, mainly subsequent to the administration of certain chemotherapeutics. Here we present a rare case of RRD induced by the oral multikinase inhibitor sorafenib. A 77-year-old male with hepatocellular carcinoma was irradiated at ten different sites for bone metastases with 20-36 Gray in 5-12 fractions from January to March 2015. Sorafenib 400 mg was administered twice daily from mid-March. One week later the patient presented with fever and erythematous lesions on the right upper arm, mandible, and trunk. All skin symptoms were confined to previously irradiated areas. After RRD was diagnosed by exclusion of other causes and skin biopsy, sorafenib was paused. With the administration of topical corticosteroids and oral antihistamines, the skin reaction subsided within several days. Sorafenib was readministered after 3 weeks, which did not lead to recurrence of RRD but did cause fluctuating fever. Only four other such cases have been reported in the literature and WHO pharmacovigilance database on individual case safety reports. The current report is the first to show a potential relationship between the severity of sorafenib-induced RRD and radiation dose, histopathological features, and simultaneous acute radiation dermatitis and mucositis. RRD induced by sorafenib is a rare phenomenon, but should be considered in patients showing erythematous skin lesions 1-2 weeks after initiation of the drug, predominantly in areas where skin has been irradiated with an equivalent dose ≥ 30 Gy. Discontinuation of sorafenib with possible readministration should be evaluated with respect to the clinical situation and severity of reaction. (orig.) [German] Recall-Strahlendermatitis (RRD) ist eine akute Entzuendungsreaktion der Haut in zuvor bestrahlten Arealen, welche meist nach Einnahme bestimmter Chemotherapeutika auftritt. Nachfolgend praesentieren wir einen seltenen Fall von

  7. Childhood Laryngeal Dystonia Following Bilateral Globus Pallidus Abnormality: A Case Study and Review of Literature

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Saeedi Borujeni

    2017-01-01

    Full Text Available Introduction:Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia. Case Report:In this paper a 7.5-year-old boy suffering from laryngeal dystonia with bilateral lesions in Globus Pallidus is presented. The patient also suffered from swallowing problems, monotone voice, vocal tremor, hypersensitivity of gag reflex, and stuttering. Drug treatment failed to cure him; therefore, he was referred to rehabilitation therapy.  Conclusion:In conclusion, special attention should be brought upon laryngeal dystonia, especially in patients showing Extra-pyramidal symptoms and/or abnormalities of the basal ganglia. In children, laryngeal dystonia may be potentially fatal. Lack of consideration for this condition during rehabilitation therapy can lead to serious consequences for a child.

  8. Homework policy review: A case study of a public school in the ...

    African Journals Online (AJOL)

    A key concern today is the question of homework in our nation's public schools. In this study, an investigation was conducted with the first no-homework policy, which has been introduced in one of the primary schools in the Western Cape. This study seeks to determine whether a no-homework policy will validate a positive ...

  9. Homework Policy Review: A Case Study of A Public School in the Western Cape Province

    Science.gov (United States)

    Pfeiffer, Verbra

    2018-01-01

    A key concern today is the question of homework in our nation's public schools. In this study, an investigation was conducted with the first no-homework policy, which has been introduced in one of the primary schools in the Western Cape. This study seeks to determine whether a no-homework policy will validate a positive or negative effect on…

  10. The Impact of Online Social Networks on Health and Health Systems: A Scoping Review and Case Studies.

    Science.gov (United States)

    Griffiths, Frances; Dobermann, Tim; Cave, Jonathan A K; Thorogood, Margaret; Johnson, Samantha; Salamatian, Kavé; Gomez Olive, Francis X; Goudge, Jane

    2015-12-01

    Interaction through online social networks potentially results in the contestation of prevailing ideas about health and health care, and to mass protest where health is put at risk or health care provision is wanting. Through a review of the academic literature and case studies of four social networking health sites (PatientsLikeMe, Mumsnet, Treatment Action Campaign, and My Pro Ana), we establish the extent to which this phenomenon is documented, seek evidence of the prevalence and character of health-related networks, and explore their structure, function, participants, and impact, seeking to understand how they came into being and how they sustain themselves. Results indicate mass protest is not arising from these established health-related networking platforms. There is evidence of changes in policy following campaigning activity prompted by experiences shared through social networking such as improved National Health Service care for miscarriage (a Mumsnet campaign). Platform owners and managers have considerable power to shape these campaigns. Social networking is also influencing health policy indirectly through increasing awareness and so demand for health care. Transient social networking about health on platforms such as Twitter were not included as case studies but may be where the most radical or destabilizing influence on health care policy might arise.

  11. Prognostic prediction of troponins in cardiac myxoma: case study with literature review

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2015-04-01

    Full Text Available AbstractObjective:It was supposed that troponins in cardiac myxoma patients might be in a same fashion as in the conditions without myocardial injury. In order to verify this hypothesis, troponins in cardiac myxoma patients were discussed by presenting a comprehensive retrieval of the literature with incorporating the information of a recent patient.Methods:Postoperative detections of troponin I, creatine kinase isoenzyme MB (CK-MB and N-terminal pro-B-type natriuretic peptide revealed elevated troponin I and CK-MB and normal N-terminal pro-B-type natriuretic peptide. Postoperative troponin I and CK-MB shared a same trend, reaching a peak value at postoperative hour 2, gradually decreased on postoperative day 1, and reached a plateau on postoperative days 7 and 13. A significant correlation could be noted between the postoperative values of the two indicators (Y=0.0714X + 0.6425, r2=0.9111, r=0.9545, P=0.0116. No significant linear correlation between troponin I and N-terminal pro-B-type natriuretic peptide were found. Literature review of troponins in cardiac myxoma patients revealed the uncomplicated patients had a normal or only slightly elevated troponin before open heart surgery. However, the complicated patients (with cerebral or cardiac events showed a normal preoperative troponin in 3 (23.1% and an elevated troponin in 10 (76.9% patients (χ2=7.54, P=0.0169, Fisher's exact test. The overall quantitative result of troponin I was 2.45±2.53 µg/L, and that of troponin T was 3.10±4.29 mg/L, respectively.Conclusion:Troponins are not necessarily elevated in patients with a cardiac myxoma without coronary syndrome. By contrast, patients with a cardiac myxoma with an elevated troponin may herald the presence of an associated coronary event. An old cerebral infarct does not necessarily cause an elevation of troponin or B-type natriuretic peptide, or new neurological events, but might lead to a delayed awakening.

  12. A review of nerve conduction studies in cases of suspected compression neuropathies of the upper limb.

    LENUS (Irish Health Repository)

    Neligan, A

    2010-01-01

    Entrapment neuropathies, particularly those affecting upper limbs, are common reasons for referral for nerve conduction studies (NCS). However, concordance between clinical findings and NCS findings, especially in patients being considered for intervention including decompressive surgery, has not been assessed.

  13. CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

    Science.gov (United States)

    Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

  14. Recruitment and retention of health professionals across Europe : A literature review and multiple case study research

    NARCIS (Netherlands)

    Kroezen, Marieke; Dussault, Gilles; Craveiro, Isabel; Dieleman, Marjolein; Jansen, Christel; Buchan, James; Barriball, Louise; Rafferty, Anne Marie; Bremner, Jeni; Sermeus, Walter

    2015-01-01

    Many European countries are faced with health workforce shortages and the need to develop effective recruitment and retention (R&R) strategies. Yet comparative studies on R&R in Europe are scarce. This paper provides an overview of the measures in place to improve the R&R of health professionals

  15. Form follows function? Proposing a blueprint for ecosystem service assessments based on reviews and case studies

    NARCIS (Netherlands)

    Seppelt, R.; Fath, B.; Burkhard, B.; Fisher, J.L.; Grêt-Regamey, A.; Lautenbach, S.; Pert, P.; Hotes, S.; Spangenberg, J.; Verburg, P.H.; Oudenhoven, van A.P.E.

    2012-01-01

    Ecosystem service assessments (ESA) hold the promise of supporting the quantification and valuation of human appropriation of nature and its goods and services. The concept has taken flight with the number of studies published on the topic increasing rapidly. This development, and the variation of

  16. WETLANDS AND WATER QUALITY TRADING: REVIEW OF CURRENT SCIENCE AND ECONOMIC PRACTICES WITH SELECTED CASE STUDIES

    Science.gov (United States)

    The study evaluates the technical, economic, and administrative aspects of establishing water quality trading (WQT) programs where the nutrient removal capacity of wetlands is used to improve water quality. WQT is a potentially viable approach for wastewater dischargers to cost-e...

  17. Cement burns: retrospective study of 18 cases and review of the literature.

    Science.gov (United States)

    Poupon, M; Caye, N; Duteille, F; Pannier, M

    2005-11-01

    Cement is increasingly used in the construction industry, but the occurrence of cement burns is rarely reported. This retrospective study concerns patients treated for cement burns in our unit between 1997 and 2002. Eighteen patients 18-64 years of age, treated previously in our unit for cement burns, were interviewed by telephone for evaluation. The mean time since treatment was 39 months. Burns were predominantly seen on the lower limbs, and a third occurred during an accident on the job. All deep burns were excised, and 16 patients received grafts. Mean hospital stay was 10 days, and mean sick leave 2 months. Our study indicated that all patients were poorly informed about cement-related risks. Surgical treatment of full-thickness cement burns at diagnosis enables rapid healing with a minimum of sequelae and reduces the high socioeconomic costs resulting from these lesions. This study indicates once again the need to improve preventive measures; which are very often inadequate because of lack of awareness of risks.

  18. [Management of eyelid carcinomas: Retrospective bicentric study of 64 cases and review of the literature].

    Science.gov (United States)

    Echchaoui, A; Benyachou, M; Houssa, A; Kajout, M; Oufkir, A A; Hajji, C; Daoudi, R; Hafidi, J; El Mazouz, S; Gharib, N; Abbassi, A

    2016-02-01

    To study the epidemiologic, clinical and histological aspects of eyelid carcinomas in our context, and to evaluate our surgical management on an oncological, functional and aesthetic level. This work is a retrospective bicentric study extended over a 5-year period between January 2009 and December 2013, including 64 patients with eyelid carcinoma undergoing surgery in the Plastic and Reconstructive Surgery Department at the Avicenne University Hospital of Rabat and in the ENT/Head and Neck Surgery Department at the Hassan II University Hospital of Fez. The study included 25 men and 39 women with a mean age of 60.6 ± 15.33 years. Advanced age and chronic sun exposure were the most important risk factors. The most commonly involved site was the lower eyelid (53%). Histological examination emphasized the very high prevalence of basal cell carcinoma (90.62%). Surgical treatment was performed in all our patients followed by an extemporaneous and/or standard histological examination of the surgical specimen. Exenteration was performed in one patient with adjuvant radiation therapy. Reconstruction incorporated a variety of techniques, of which total skin graft and Mustardé flap were the most common in our series. Aside from a few complications, the postoperative results were satisfactory for the majority of our patients. Malignant tumors of the eyelids, of which basal cell carcinoma is the most common, pose a therapeutic problem where surgery remains the most utilized treatment option. The best treatment is prevention and diagnosis of early lesions to improve prognosis and to avoid worse outcomes. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Neurofibromatosis type 1 and attention deficit hyperactivity disorder: a case study and literature review

    Science.gov (United States)

    Miguel, Carmen Sílvia; Chaim-Avancini, Tiffany M; Silva, Maria Aparecida; Louzã, Mario Rodrigues

    2015-01-01

    Background The cognitive profile of children with neurofibromatosis type 1 (NF1) and attention deficit hyperactivity disorder (ADHD) has been well characterized, but few studies have evaluated the cognitive abilities of adults with NF1 and ADHD. Objectives We investigated 1) the cognitive profile of an adult patient with NF1 and inattention problems, 2) changes in his cognition after 14 months of follow-up, and 3) whether the patient exhibited comorbid NF1 and ADHD or secondary ADHD-like symptoms. Methods We administered neuropsychological tests of executive function, attention, verbal and visual memory, visuospatial function, and language during two evaluations separated by 14 months. Results We found no changes in sustained attention, language, or verbal memory. Visual memory, verbal learning, selective attention inhibitory control, and problem solving declined over time, whereas visual search, psychomotor speed, visuospatial function, and mental flexibility improved. Conclusion Our patient exhibited a cognitive profile characteristic of both NF1 and ADHD, leading to the hypothesis that the patient had comorbid ADHD instead of secondary ADHD-like symptoms. More studies are necessary to characterize the cognition of patients with NF1 and ADHD. PMID:25848279

  20. Building theories from case study research: the progressive case study

    NARCIS (Netherlands)

    Steenhuis, H.J.; de Bruijn, E.J.

    2006-01-01

    Meredith (1998) argues for more case and field research studies in the field of operations management. Based on a literature review, we discuss several existing approaches to case studies and their characteristics. These approaches include; the Grounded Theory approach which proposes no prior

  1. Important considerations for feasibility studies in physical activity research involving persons with multiple sclerosis: a scoping systematic review and case study.

    Science.gov (United States)

    Learmonth, Yvonne C; Motl, Robert W

    2018-01-01

    Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis (MS). There is disagreement regarding the strength of this research, perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing. We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS. A systematic scoping review was conducted based on a literature search of five databases to identify feasibility processes described in preliminary studies of physical activity in MS. We read and extracted methodology from each study based on the following feasibility metrics: process (e.g. recruitment), resource (e.g. monetary costs), management (e.g. personnel time requirements) and scientific outcomes (e.g. clinical/participant reported outcome measures). We illustrate the use of the four feasibility metrics within a randomised controlled trial of a home-based exercise intervention in persons with MS. Twenty-five studies were identified. Resource feasibility (e.g. time and resources) and scientific outcomes feasibility (e.g. clinical outcomes) methodologies were applied and described in many studies; however, these metrics have not been systematically addressed. Metrics related to process feasibility (e.g. recruitment) and management feasibility (e.g. human and data management) are not well described within the literature. Our case study successfully enabled us to address the four feasibility metrics, and we provide new information on management feasibility (i.e. estimate data completeness and estimate data entry) and scientific outcomes feasibility (i.e. determining data collection materials appropriateness). Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility. This review serves as a clarion call for feasibility trials that will

  2. Mucinous Breast Cancer: a Review Study of 5 Year Experience from a Hospital-Based Series of Cases.

    Science.gov (United States)

    Dumitru, Adrian; Procop, Alexandru; Iliesiu, Andreea; Tampa, Mircea; Mitrache, Luminita; Costache, Mariana; Sajin, Maria; Lazaroiu, Anca; Cirstoiu, Monica

    2015-03-01

    Mucinous carcinoma (also known as colloid carcinoma) is a particular type of breast cancer characterized by the presence of extracellular mucin and is linked with a more favorable prognosis than invasive breast carcinoma of no special type. Mucinous carcinoma of the breast is an uncommon form of breast tumor, often presenting as a lobulated, moderately well circumscribed mass on mammography, sonography, and MRI imaging. It accounts for 1 to 7% of all breast cancers. Pure mucinous breast carcinomas are rare and account for about 2% of all primary breast carcinomas. Metastatic disease happens at a lower rate than in other types of invasive carcinoma. We present our 5 year experience with this particular pathology in a retrospective review study. We identified 25 patients with mixed and pure mucinous breast cancer, the tumor size varied greatly from 2 to 19 cm in diameter. A subset of mixed mucinous carcinomas (8 cases) showed neuroendocrine differentiation or other associated premalignant lessions. Mucinous carcinoma of the breast is a rare entity with a favorable prognosis due to low incidence of lymph node metastases. Pure mucinous breast carcinoma has an even rare.

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

    Science.gov (United States)

    Falkner, Katrina; Vivian, Rebecca

    2015-10-01

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

  4. Social, Organizational, and Contextual Characteristics of Clinical Decision Support Systems for Intensive Insulin Therapy: A Literature Review and Case Study

    Science.gov (United States)

    Campion, Thomas R.; Waitman, Lemuel R.; May, Addison K.; Ozdas, Asli; Lorenzi, Nancy M.; Gadd, Cynthia S.

    2009-01-01

    Introduction: Evaluations of computerized clinical decision support systems (CDSS) typically focus on clinical performance changes and do not include social, organizational, and contextual characteristics explaining use and effectiveness. Studies of CDSS for intensive insulin therapy (IIT) are no exception, and the literature lacks an understanding of effective computer-based IIT implementation and operation. Results: This paper presents (1) a literature review of computer-based IIT evaluations through the lens of institutional theory, a discipline from sociology and organization studies, to demonstrate the inconsistent reporting of workflow and care process execution and (2) a single-site case study to illustrate how computer-based IIT requires substantial organizational change and creates additional complexity with unintended consequences including error. Discussion: Computer-based IIT requires organizational commitment and attention to site-specific technology, workflow, and care processes to achieve intensive insulin therapy goals. The complex interaction between clinicians, blood glucose testing devices, and CDSS may contribute to workflow inefficiency and error. Evaluations rarely focus on the perspective of nurses, the primary users of computer-based IIT whose knowledge can potentially lead to process and care improvements. Conclusion: This paper addresses a gap in the literature concerning the social, organizational, and contextual characteristics of CDSS in general and for intensive insulin therapy specifically. Additionally, this paper identifies areas for future research to define optimal computer-based IIT process execution: the frequency and effect of manual data entry error of blood glucose values, the frequency and effect of nurse overrides of CDSS insulin dosing recommendations, and comprehensive ethnographic study of CDSS for IIT. PMID:19815452

  5. Social, organizational, and contextual characteristics of clinical decision support systems for intensive insulin therapy: a literature review and case study.

    Science.gov (United States)

    Campion, Thomas R; Waitman, Lemuel R; May, Addison K; Ozdas, Asli; Lorenzi, Nancy M; Gadd, Cynthia S

    2010-01-01

    Evaluations of computerized clinical decision support systems (CDSS) typically focus on clinical performance changes and do not include social, organizational, and contextual characteristics explaining use and effectiveness. Studies of CDSS for intensive insulin therapy (IIT) are no exception, and the literature lacks an understanding of effective computer-based IIT implementation and operation. This paper presents (1) a literature review of computer-based IIT evaluations through the lens of institutional theory, a discipline from sociology and organization studies, to demonstrate the inconsistent reporting of workflow and care process execution and (2) a single-site case study to illustrate how computer-based IIT requires substantial organizational change and creates additional complexity with unintended consequences including error. Computer-based IIT requires organizational commitment and attention to site-specific technology, workflow, and care processes to achieve intensive insulin therapy goals. The complex interaction between clinicians, blood glucose testing devices, and CDSS may contribute to workflow inefficiency and error. Evaluations rarely focus on the perspective of nurses, the primary users of computer-based IIT whose knowledge can potentially lead to process and care improvements. This paper addresses a gap in the literature concerning the social, organizational, and contextual characteristics of CDSS in general and for intensive insulin therapy specifically. Additionally, this paper identifies areas for future research to define optimal computer-based IIT process execution: the frequency and effect of manual data entry error of blood glucose values, the frequency and effect of nurse overrides of CDSS insulin dosing recommendations, and comprehensive ethnographic study of CDSS for IIT. Copyright (c) 2009. Published by Elsevier Ireland Ltd.

  6. Coherence of evidence from systematic reviews as a basis for evidence strength - a case study in support of an epistemological proposition

    Directory of Open Access Journals (Sweden)

    Mickenautsch Steffen

    2012-01-01

    Full Text Available Abstract Background This article aims to offer, on the basis of Coherence theory, the epistemological proposition that mutually supportive evidence from multiple systematic reviews may successfully refute radical, philosophical scepticism. Methods A case study including seven systematic reviews is presented with the objective of refuting radical philosophical scepticism towards the belief that glass-ionomer cements (GIC are beneficial in tooth caries therapy. The case study illustrates how principles of logical and empirical coherence may be applied as evidence in support of specific beliefs in healthcare. Results The results show that radical scepticism may epistemologically be refuted on the basis of logical and empirical coherence. For success, several systematic reviews covering interconnected beliefs are needed. In praxis, these systematic reviews would also need to be of high quality and its conclusions based on reviewed high quality trials. Conclusions A refutation of radical philosophical scepticism to clinical evidence may be achieved, if and only if such evidence is based on the logical and empirical coherence of multiple systematic review results. Practical application also requires focus on the quality of the systematic reviews and reviewed trials.

  7. Eye movement desensitization and reprocessing (EMDR) for DSM-5 posttraumatic stress disorder (PTSD) in adults with intellectual disabilities: A case study review.

    Science.gov (United States)

    Jowett, Sally; Karatzias, Thanos; Brown, Michael; Grieve, Alan; Paterson, Douglas; Walley, Robert

    2016-11-01

    People with intellectual disabilities may be at a greater risk for exposure to traumatic events and consequently develop posttraumatic stress disorder (PTSD). Although eye movement desensitization and reprocessing (EMDR) is an established treatment for PTSD in the general population, research on people with intellectual disabilities is limited. This review aims to critically appraise for the 1st time case studies published in this area, because no controlled investigations are available at present. An in-depth literature review was conducted, and 6 case studies were identified from peer-reviewed journals describing EMDR therapy for psychological trauma in 14 adults with a mild to severe intellectual disability. These case studies were reviewed in terms of methods of assessing PTSD and trauma histories and delivery of EMDR therapy in order to establish the usefulness and acceptability of this intervention for people with intellectual disabilities. All cases demonstrated improvement in symptoms following EMDR therapy, with around half of the cases stating no disturbance at posttreatment and at follow-up assessments. No adverse effects were reported, demonstrating that EMDR is well tolerated by people with intellectual disabilities. EMDR is a safe and acceptable intervention for people with intellectual disabilities, and there is now sufficient evidence to conduct a randomized control trial to establish its effectiveness for DSM-5 PTSD in this population group. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Applicability of bioanalysis of multiple analytes in drug discovery and development: review of select case studies including assay development considerations.

    Science.gov (United States)

    Srinivas, Nuggehally R

    2006-05-01

    The development of sound bioanalytical method(s) is of paramount importance during the process of drug discovery and development culminating in a marketing approval. Although the bioanalytical procedure(s) originally developed during the discovery stage may not necessarily be fit to support the drug development scenario, they may be suitably modified and validated, as deemed necessary. Several reviews have appeared over the years describing analytical approaches including various techniques, detection systems, automation tools that are available for an effective separation, enhanced selectivity and sensitivity for quantitation of many analytes. The intention of this review is to cover various key areas where analytical method development becomes necessary during different stages of drug discovery research and development process. The key areas covered in this article with relevant case studies include: (a) simultaneous assay for parent compound and metabolites that are purported to display pharmacological activity; (b) bioanalytical procedures for determination of multiple drugs in combating a disease; (c) analytical measurement of chirality aspects in the pharmacokinetics, metabolism and biotransformation investigations; (d) drug monitoring for therapeutic benefits and/or occupational hazard; (e) analysis of drugs from complex and/or less frequently used matrices; (f) analytical determination during in vitro experiments (metabolism and permeability related) and in situ intestinal perfusion experiments; (g) determination of a major metabolite as a surrogate for the parent molecule; (h) analytical approaches for universal determination of CYP450 probe substrates and metabolites; (i) analytical applicability to prodrug evaluations-simultaneous determination of prodrug, parent and metabolites; (j) quantitative determination of parent compound and/or phase II metabolite(s) via direct or indirect approaches; (k) applicability in analysis of multiple compounds in select

  9. Case-control studies on the relationship between onchocerciasis and epilepsy: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Christoph Kaiser

    Full Text Available OBJECTIVE: A systematic review and meta-analysis of all available case-control studies on the relationship between onchocerciasis and epilepsy. Because age and level of onchocerciasis endemicity in the area of residence are major determinants for infection, an additional analysis was performed, restricted to studies achieving control of these confounding factors. DATA SOURCES: Medical databases, the "African Neurology Database, Institute of Neuroepidemiology and Tropical Neurology, Limoges," reference lists of relevant articles, commercial search engines, up to May 2012. METHODS: We searched for studies examining infection status with Onchocerca volvulus in persons with epilepsy (PWE and without epilepsy (PWOE providing data suitable for the calculation of pooled odds ratios (ORp and/or standardized mean differences (SMD using random-effects models. RESULTS: Eleven studies providing data of qualitative skin biopsies for diagnosis of onchocerciasis were identified. Combined analysis on the total sample of 876 PWE and 4712 PWOE resulted in an ORp of 2.49 (95% confidence interval (95%CI: 1.61-3.86, p<0.001. When this analysis was restricted to those studies achieving control for age, residence and sex (367 PWE, 624 PWOE, an ORp of 1.29 (95% CI: 0.93-1.79; p = 0.139 was found. Presence of nodules for diagnosis of onchocerciasis was analyzed in four studies (225 PWE, 189 PWOE; ORp 1.74; 95%CI: 0.94-3.20; p<0.076, including two studies of the restricted analysis (106 PWE, 106 PWOE; ORp 2.81; 95%CI: 1.57-5.00; p<0.001. One study examined quantitative microfilariae counts in patients without preceding microfilaricidal treatment and demonstrated significantly higher counts in PWE than in PWOE. INTERPRETATION: Our results strengthen the hypothesis that, in onchocerciasis foci, epilepsy and infection with O. volvulus are associated. Analysis of indicators giving information on infection intensity, namely nodule palpation and quantitative microfilaria

  10. Flexible image evaluation: iPad versus secondary-class monitors for review of MR spinal emergency cases, a comparative study.

    Science.gov (United States)

    McNulty, Jonathan P; Ryan, John T; Evanoff, Michael G; Rainford, Louise A

    2012-08-01

    Studies have highlighted the potential of handheld viewing devices for rapid diagnosis and increased smartphone usage among physicians and radiologists is known as is the clinical applicability of hand-held devices for computed tomography (CT) spinal injury cases. Magnetic resonance (MR), however, is the accepted gold standard for spinal imaging, providing visualization of both ligament and spinal cord pathology. This study investigated the diagnostic accuracy of the iPad, the most probable alternative display device outside the radiology environment and financially viable alternative, when reviewing emergency spinal MR images, in comparison with secondary-class LCD devices in the case of the interpretation of CT and MR imaging examinations. In total 31 MR cases including both positives (n = 13) containing one of four possible presentations: spinal cord compression, cauda equine syndrome, spinal cord hemorrhage, or spinal cord edema and controls (n = 18) were reviewed. Ziltron iPad software facilitated the display of cases and the receiver operating characteristic (ROC) analysis. Thirteen American Board of Radiology board-certified radiologists reviewed all cases on both displays. Standardized viewing conditions were maintained. Dorfman-Berbaum-Metz multireader-multicase (DBM MRMC) analysis was performed including random readers/random cases, fixed readers/random cases and random readers/fixed cases. No differences of statistical significance (P ≤ .05) could be found in terms of area under the curve, sensitivity and specificity between the iPad and secondary-class display. The iPad performed with equal diagnostic accuracy when compared with the secondary-class LCD device after DBM MRMC analysis, demonstrating the iPad as an option to aid initial review of MR spinal emergency cases. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

  11. Project management case studies

    CERN Document Server

    Kerzner, Harold R

    2013-01-01

    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  12. Basic Education for Girls in Yemen: Country Case Study and Analysis. Mid-Decade Review of Progress towards Education for All.

    Science.gov (United States)

    Beatty, Sharon

    In 1995, the International Consultative Forum on Education for All (EFA) commissioned case studies in developing countries as part of a mid-decade review of progress in expanding access to basic education. This paper examines provision of basic education (grades 1-9) in Yemen, focusing on obstacles to girls' education in rural areas. The report…

  13. Osteogenesis imperfecta - iconographic study of two cases and review of the literature; Osteogenese imperfeita - revisao da literatura e iconografia baseada em dois casos

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Ricardo Pires de; Fernandes, Cintia; Hilario, Marcelo Cobra; Barros, Wagner Moraes; Soares, Aldemir Humberto [Hospital Heliopolis, Sao Paulo, SP (Brazil)

    1996-07-01

    The authors present a literature review about osteogenesis imperfecta, a disease that leads to bone fragility and low height patterns caused by an abnormality of the collagen synthesis. The iconographic study is based on two cases of the tarda type. (author) 9 refs., 3 figs.

  14. Institutional review board challenges related to community-based participatory research on human exposure to environmental toxins: A case study

    Directory of Open Access Journals (Sweden)

    Rudel Ruthann A

    2010-07-01

    Full Text Available Abstract Background We report on the challenges of obtaining Institutional Review Board (IRB coverage for a community-based participatory research (CBPR environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership. Conclusions IRBs and funders should develop clear, routine review guidelines that respect the unique qualities of CBPR, while researchers and community partners can educate IRB staff and board members about the objectives, ethical frameworks, and research methods of CBPR. These strategies can better protect research participants from the harm of unnecessary delays and exclusion from the research process, while facilitating the ethical communication of study results to participants and communities.

  15. An approach to review design bases and safety analysis of earlier generation atomic power plants; a case study of TAPS

    International Nuclear Information System (INIS)

    Malhotra, P.K.; Bajaj, S.S.

    2002-01-01

    The twin unit boiling water reactor (BWR) station at TAPS has completed 30 years of power operation and for further extending plant operating life, a fresh extensive exercise involving review of plant operating performance, aging management and review of design bases and safety analysis has been carried out. The review exercise resulted in assessment of acceptability of identified non-conformances and recommendation for compensatory measures in the form of design modification or plant operating procedures. The second part of the exercise is related to safety analysis, which is carried out in view of the plant modifications done and advances taken place in methodologies of analytical techniques. Chiefly, it involves LOCA analysis done for various break sizes at different locations and plant transient studies. It also includes the fatigue analysis of the reactor pressure vessel. The related review approach adopted is presented here

  16. Exposure of children with developmental delay to social determinants of poor health: cross-sectional case record review study.

    Science.gov (United States)

    Emerson, E; Brigham, P

    2015-03-01

    Research on child development in general has highlighted the importance that the family environment plays in mediating the pathway between exposure to low socio-economic position (SEP) and child well-being. While child developmental models in intellectual disability have highlighted the interplay between social context, family environment and child development, little empirical work has attempted to formally evaluate the evidence in support of specific mediating pathways between low SEP and child outcomes. Secondary analysis of cross-sectional confidentialized needs analysis data collected in three Primary Care Trusts in England covering a total population of 1.25 million people. Case record reviews were undertaken for 46 023 households, 2236 (4.9%) of which contained a child in the target age range with developmental delay. Children with developmental delay, when compared with their non-disabled peers, were at significantly increased risk of poorer health outcomes and of being exposed to a wide range of social determinants of poor health. Controlling for between-group differences in exposure to social determinants of poor health reduced the risk of developmental delay being associated with poorer health outcomes by 45% for behaviour problems and 89% for risk of significant harm. For children with developmental delay, parenting difficulties appears to play a particularly significant role in partially mediating the effects of low SEP. The findings of the present study point to the potential effectiveness of family-focused early intervention to prevent the emergence and escalation of behavioural difficulties and health problems in children with developmental delay. © 2014 John Wiley & Sons Ltd.

  17. Form follows function? Proposing a blueprint for ecosystem service assessment studies based on reviews and case studies

    NARCIS (Netherlands)

    Seppelt, R.; Fath, B.; Burkhard, B.; Fisher, J.L.; Gret-Regamay, A.; Lautenbach, S.; Pert, P.; Hotes, S.; Spangenberg, J.; Verburg, P.H.; van Oudenhoven, A.P.E.

    2012-01-01

    Ecosystem service assessments (ESA) hold the promise of supporting the quantification and valuation of human appropriation of nature and its goods and services. The concept has taken flight with the number of studies published on the topic increasing rapidly. This development, and the variation of

  18. Schooling's "Contribution" to Contemporary Violent Conflict: Review of Theoretical Ideas and Case Studies in the Field of Education and Conflict

    Science.gov (United States)

    Matsumoto, Mitsuko

    2015-01-01

    Some argue that the field of study of "education and conflict" has yet to be solidified since its emergence in the 1990s, partly due to the weak theory base. This article reviews the literature on the "contribution" of schooling in contemporary violent conflict, via three strands of theoretical ideas, to demonstrate the…

  19. Review Article: Yamada, Jeni "Laura: A Case for the Modularity of Language"; Tomasello, Michael "First Verbs: A Case Study of Early Grammatical Development."

    Science.gov (United States)

    Shatz, Marilyn

    1994-01-01

    Jeni Yamada's "Laura" and Michael Tomasello's "First Verbs" continue a tradition of providing useful information on the language ability of individuals in a depth rarely found in multisubject studies; however, these efforts are unusual for case studies in that both take strong theoretical positions on the essence of language and language learning.…

  20. DKA with Severe Hypertriglyceridemia and Cerebral Edema in an Adolescent Boy: A Case Study and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Tansit Saengkaew

    2016-01-01

    Full Text Available A 13-year-old adolescent boy with type 1 diabetes mellitus (1b presented with diabetic ketoacidosis (DKA and cerebral edema. Grossly lipemic serum and lipemia retinals due to extremely high triglyceride (TG level were observed without evidence of xanthoma or xanthelasma. Cerebral edema was treated by appropriate ventilation and mannitol administration. Normal saline was carefully given and regular insulin was titrated according to blood sugar levels. Triglyceride levels were reduced from 9,800 mg/dL to normal range within 9 days after conventional treatment was commenced without antilipid medication. Based on our review of the literature, this is the first reported case of confirmed pediatric DKA with severe hypertriglyceridemia and cerebral edema. In patients with DKA and hypertriglyceridemia, clinicians should be mindful of the possibility of associated acute pancreatitis and cerebral edema.

  1. Creating a Safe Space: A Case Study of Complex Trauma and a Call for Proactive Comprehensive Psychoeducational Assessments and Reviews

    Science.gov (United States)

    Mainwaring, Debra J.

    2015-01-01

    This article advocates for proactive, dynamic and comprehensive psycho-educational assessments for children and young people who have a history of complex trauma, because of its known effects on development and learning. A case study is shared of a young woman with a history of complex trauma because of exposure to parental neglect, multiple…

  2. Using Educational Neuroscience and Psychology to Teach Science. Part 1: A Case Study Review of Cognitive Load Theory (CLT) and Cognitive Acceleration through Science Education (CASE)

    Science.gov (United States)

    Jenkins, Rebecca Torrance

    2017-01-01

    This article is the first of a two-part series that explores science teachers' and their pupils' experiences of using different pedagogical approaches based on understandings of how brains learn. For this case-study research, nine science teachers were interviewed and four teachers self-selected to trial a pedagogical approach, new to them, from…

  3. 451 Case studies Cardiac

    African Journals Online (AJOL)

    Marinda

    Case Studies. 29 ... A case of a 26-year-old ASA I physical status male undergoing septoplasty had an abrupt ... myocardial infarction, severe hypertensive crisis, cerebral .... or no formal management is required in an ASA I patient.8 One.

  4. Pituitary macroadenomas: reviews of 60 cases

    International Nuclear Information System (INIS)

    Santos, Alair Augusto S.M.D. dos; Fontes, Cristina Asvolinsque P.; Magnago, Marcelo; Moreira, Denise Madeira; Andreiuolo, Pedro Angelo; Oliveira, Fernando Barros de; Teixeira, Ricardo Tostes D.; Correa, Saul Orlando C.

    2000-01-01

    We reviewed 60 cases of patients with pituitary macroadenomas who were submitted to magnetic resonance imaging evaluations at private institutions in Niteroi and Rio de Janeiro, Brazil. The aim of this study was to demonstrate the advantages of magnetic resonance imaging in the diagnosis and follow-up of these patients. Macroprolactinomas were the most prevalent tumors. We also observed four growth-hormone (GH) secreting macroadenomas with clinical signs of acromegaly, and one GH- and prolactin-secreting macroadenoma. Seven patients presented pituitary apoplexy and hyperintense signal on T1-W images before contrast medium (gadolinium) administration suggestive of intratumoral bleeding. The follow-up of 15 cases demonstrated a reduction in the size of the tumor after surgery, clinical treatment or radiotherapy. Magnetic resonance imaging is important for the study of pituitary macroadenomas, particularly before surgery, as it shows the involvement of adjacent structures, specially the cavernous sinus, optic chiasm and pituitary stalk compression. (author)

  5. Periodontal disease as a risk factor for adverse pregnancy outcomes: a systematic review and meta-analysis of case-control studies.

    Science.gov (United States)

    Corbella, Stefano; Taschieri, Silvio; Francetti, Luca; De Siena, Francesca; Del Fabbro, Massimo

    2012-07-01

    Periodontal disease is a highly prevalent group of illnesses of microbial etiology, whose consequence is a severe breakdown of tooth-supporting structures. A link between periodontal infection and several systemic conditions, among which adverse pregnancy outcomes, has been suggested in the recent years. The aim of this review based on case-control studies was to evaluate if periodontal disease could be considered as a risk factor for preterm birth, low birth-weight and preterm low birth-weight. An electronic search (via Pubmed) was performed for case-control studies investigating the relationship between periodontal disease and adverse pregnancy outcomes. From the initially retrieved 417 articles, 17 case-control studies, accounting for a total of 10,148 patients, were included in the review and in the meta-analysis. The estimated odds ratio was 1.78 (CI 95%: 1.58, 2.01) for preterm birth, 1.82 (CI 95%: 1.51, 1.20) for low birth-weight and 3.00 (CI 95%: 1.93, 4.68) for preterm low birth-weight. Despite the results of the analysis of pooled data suggested a link between periodontal diseases and adverse pregnancy outcomes, the presence of important confounders, whose effect could not be addressed, prevents a validation of the meta-analysis outcomes. Further more accurate investigations based on individual data analysis could give a better insight into the topic of the present review.

  6. Ortner's syndrome: case series and literature review.

    Science.gov (United States)

    Subramaniam, Vijayalakshmi; Herle, Adarsha; Mohammed, Navisha; Thahir, Muhammad

    2011-01-01

    More than a century ago, Ortner described a case of cardiovocal syndrome wherein he attributed a case of left vocal fold immobility to compression of the recurrent laryngeal nerve by a dilated left atrium in a patient with mitral valve stenosis. Since then, the term Ortner's syndrome has come to encompass any nonmalignant, cardiac, intrathoracic process that results in embarrassment of either recurrent laryngeal nerve-usually by stretching, pulling, or compression; and causes vocal fold paralysis. Not surprisingly, the left recurrent laryngeal nerve, with its longer course around the aortic arch, is more frequently involved than the right nerve, which passes around the subclavian artery. To discuss the pathogenesis of hoarseness resulting from cardiovascular disorders involving the recurrent laryngeal nerve along with the findings of literature review. This paper reports a series of four cases of Ortner's syndrome occurring due to different causes. Case study. Ortner's syndrome could be a cause of hoarseness of voice in patients with cardiovascular diseases. Although hoarseness of voice is frequently encountered in the Otolaryngology outpatient department, cardiovascular- related hoarseness is an unusual presentation. Indirect laryngoscopy should be routinely performed in all cases of heart disease.

  7. Tympanoplasty Outcomes: A Review of 789 Cases

    Directory of Open Access Journals (Sweden)

    Shabbir Indorewala

    2015-03-01

    Full Text Available Introduction: Tympanoplasty is indicated to restore hearing disability and prevent recurrent otorrhea.  Materials and Methods: This study was a retrospective review of patients who underwent tympanoplasty with or without mastoidectomy over a 1-year period.  Results: A total of 789 tympanoplasties were reviewed, with a male-to-female ratio of 1:1.1. In total, 91% and 9% of tympanoplasties were performed without and with mastoidectomy, respectively. Complete graft take was observed in 98.6% of cases. Approximately 25% of patients had an air-bone gap (ABG gap ≤20dB pre-operatively, increasing to 75.6% post-operatively. ABG closure improved from 0.8% to 46.7%. Mean ABG improved from 26.30 ±8.1dB pre-operatively to 14 ± 10.41dB post- operatively (t=28.7, P

  8. Clinicopathologic and radiologic features of extraskeletal myxoid chondrosarcoma: a retrospective study of 40 Chinese cases with literature review.

    Science.gov (United States)

    Shao, Rui; Lao, I Weng; Wang, Lei; Yu, Lin; Wang, Jian; Fan, Qinhe

    2016-08-01

    The aim of this study is to describe the clinicopathologic and radiologic features of 40 cases of extraskeletal myxoid chondrosarcoma (EMC) from China. There were 25 males and 15 females (sex ratio, 1.7:1). Apart from an adolescent, all patients were adults with a median age of 49years. Twenty-four tumors (60%) occurred in the lower limb and limb girdles, especially the thigh, followed by the upper limb and limb girdles (20%) and trunk (10%). Other less commonly involved locations included the head and neck, sacrococcygeal region, and perineum. Tumors ranged in size from 1.5 to 19cm (mean, 7cm). By radiology, they appeared as hypoattenuated or isoattenuated masses on computed tomography with hyperintense signal on T2-weighted magnetic resonance imaging. Intralesional hypointense septa were present in most cases. Of the 40 tumors, 30 belonged to the classic subtype, whereas 9 cases were cellular, and 1 case had a rhabdoid phenotype. Tumor cells showed variable expression of synaptophysin (36%), S-100 protein (29%), epithelial membrane antigen (11%), and neuron-specific enolase (7%). Ki-67 index was remarkably higher in the cellular variant (mean, 30%). EWSR1-related rearrangement was detected in 12 of 14 cases tested by fluorescence in situ hybridization using break-apart probes. The overall 5- and 7-year survival was 71% and 60%, respectively. Awareness of the imaging features may help pathologists in the diagnosis of EMC. Fluorescence in situ hybridization also serves as a useful diagnostic tool for EMC, especially in the distinction from its mimics. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Review of pollutant lead decline in urban air and human blood: A case study from northwestern Europe

    Science.gov (United States)

    Petit, Daniel; Véron, Alain; Flament, Pascal; Deboudt, Karine; Poirier, André

    2015-09-01

    A review of the transient decline of pollutant lead in the air (PbA) and the blood (PbB) has been conducted in order to assess the relationship between these environmental reservoirs. We have demonstrated that PbA decreased 20 to 100 times more than PbB for the past 30 years, suggesting another significant intake besides airborne lead to explain lead accumulated in humans. This trend has also been observed in two blood surveys we have completed in 1976-1978 and 2008-2009 in northern France and Belgium. Nowadays, the mean PbB (1.5-3.5 μg/dL) remains at least 100 times higher than the estimated non-contaminated PbB. Lead isotope imprints in blood could help decipher specific contamination cases, and were coherent with the decline of PbA, but could not help discriminate the source of blood lead owing to the lack of source imprints, especially from dietary intakes. Correlations between recent PbB, isotopic imprints and the age of the subjects suggested that lead released from bones has become a significant source of lead in blood. The significant cause for human exposure to lead may have shifted from direct pollutant lead input accumulated in exogenous reservoirs (air and diet) to endogenous lead release from bone tissues consequential to metabolic calcium homeostasis and bone turnover.

  10. Random Versus Nonrandom Peer Review: A Case for More Meaningful Peer Review.

    Science.gov (United States)

    Itri, Jason N; Donithan, Adam; Patel, Sohil H

    2018-05-10

    Random peer review programs are not optimized to discover cases with diagnostic error and thus have inherent limitations with respect to educational and quality improvement value. Nonrandom peer review offers an alternative approach in which diagnostic error cases are targeted for collection during routine clinical practice. The objective of this study was to compare error cases identified through random and nonrandom peer review approaches at an academic center. During the 1-year study period, the number of discrepancy cases and score of discrepancy were determined from each approach. The nonrandom peer review process collected 190 cases, of which 60 were scored as 2 (minor discrepancy), 94 as 3 (significant discrepancy), and 36 as 4 (major discrepancy). In the random peer review process, 1,690 cases were reviewed, of which 1,646 were scored as 1 (no discrepancy), 44 were scored as 2 (minor discrepancy), and none were scored as 3 or 4. Several teaching lessons and quality improvement measures were developed as a result of analysis of error cases collected through the nonrandom peer review process. Our experience supports the implementation of nonrandom peer review as a replacement to random peer review, with nonrandom peer review serving as a more effective method for collecting diagnostic error cases with educational and quality improvement value. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. Necrotizing enterocolitis - review of 34 cases

    International Nuclear Information System (INIS)

    Goncalves, E.G.; Abbud, E.A.; Duarte, F.B.

    1990-01-01

    Thirty-four cases of neonatal necrotizing enterocolitis are reviewed. The authors took into consideration the actual criteria of classification, and demonstrated the pre-disposal factors and the correlation between clinical and roentgenographics findings in this condition. (author)

  12. Secondary acute leukemia - review of 15 cases

    Energy Technology Data Exchange (ETDEWEB)

    Venugopal, P; Rajni, A; Gopal, R; Saikia, T; Kurkure, P A; Nair, C N; Advani, S H

    1988-12-01

    Acute leukemia is a rare complication of long-term chemotherapy, immunosuppressive therapy and radiotherapy. With improved survival in cancer patients resulting from modern methods of investigations and treatment, more case of secondary leukemia have come to light. In this review, fifteen cases of secondary leukemia, its prognostic implications and methods to reduce the risk of its development are emphasised. Relevant literature is also reviewed. (author). 3 tabs., 24 refs.

  13. Applying systematic review search methods to the grey literature: a case study examining guidelines for school-based breakfast programs in Canada.

    Science.gov (United States)

    Godin, Katelyn; Stapleton, Jackie; Kirkpatrick, Sharon I; Hanning, Rhona M; Leatherdale, Scott T

    2015-10-22

    Grey literature is an important source of information for large-scale review syntheses. However, there are many characteristics of grey literature that make it difficult to search systematically. Further, there is no 'gold standard' for rigorous systematic grey literature search methods and few resources on how to conduct this type of search. This paper describes systematic review search methods that were developed and applied to complete a case study systematic review of grey literature that examined guidelines for school-based breakfast programs in Canada. A grey literature search plan was developed to incorporate four different searching strategies: (1) grey literature databases, (2) customized Google search engines, (3) targeted websites, and (4) consultation with contact experts. These complementary strategies were used to minimize the risk of omitting relevant sources. Since abstracts are often unavailable in grey literature documents, items' abstracts, executive summaries, or table of contents (whichever was available) were screened. Screening of publications' full-text followed. Data were extracted on the organization, year published, who they were developed by, intended audience, goal/objectives of document, sources of evidence/resources cited, meals mentioned in the guidelines, and recommendations for program delivery. The search strategies for identifying and screening publications for inclusion in the case study review was found to be manageable, comprehensive, and intuitive when applied in practice. The four search strategies of the grey literature search plan yielded 302 potentially relevant items for screening. Following the screening process, 15 publications that met all eligibility criteria remained and were included in the case study systematic review. The high-level findings of the case study systematic review are briefly described. This article demonstrated a feasible and seemingly robust method for applying systematic search strategies to

  14. [Case and studies].

    Science.gov (United States)

    Schubert, András

    2015-11-15

    Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

  15. Towards a methodology for cluster searching to provide conceptual and contextual "richness" for systematic reviews of complex interventions: case study (CLUSTER).

    Science.gov (United States)

    Booth, Andrew; Harris, Janet; Croot, Elizabeth; Springett, Jane; Campbell, Fiona; Wilkins, Emma

    2013-09-28

    Systematic review methodologies can be harnessed to help researchers to understand and explain how complex interventions may work. Typically, when reviewing complex interventions, a review team will seek to understand the theories that underpin an intervention and the specific context for that intervention. A single published report from a research project does not typically contain this required level of detail. A review team may find it more useful to examine a "study cluster"; a group of related papers that explore and explain various features of a single project and thus supply necessary detail relating to theory and/or context.We sought to conduct a preliminary investigation, from a single case study review, of techniques required to identify a cluster of related research reports, to document the yield from such methods, and to outline a systematic methodology for cluster searching. In a systematic review of community engagement we identified a relevant project - the Gay Men's Task Force. From a single "key pearl citation" we conducted a series of related searches to find contextually or theoretically proximate documents. We followed up Citations, traced Lead authors, identified Unpublished materials, searched Google Scholar, tracked Theories, undertook ancestry searching for Early examples and followed up Related projects (embodied in the CLUSTER mnemonic). Our structured, formalised procedure for cluster searching identified useful reports that are not typically identified from topic-based searches on bibliographic databases. Items previously rejected by an initial sift were subsequently found to inform our understanding of underpinning theory (for example Diffusion of Innovations Theory), context or both. Relevant material included book chapters, a Web-based process evaluation, and peer reviewed reports of projects sharing a common ancestry. We used these reports to understand the context for the intervention and to explore explanations for its relative

  16. Neuropsychiatric perspectives on nodding syndrome in northern Uganda: a case series study and a review of the literature.

    Science.gov (United States)

    Musisi, S; Akena, D; Nakimuli-Mpungu, E; Abbo, C; Okello, J

    2013-06-01

    Nodding Syndrome (NS), previously called Nodding Disease, is a chronic and debilitating illness affecting thousands of children aged 3-18 years in post-conflict Northern Uganda and South Sudan. Characterised by malnutrition, stunted growth, mental retardation and seizures, some researchers have designated it as epilepsy. With reports appearing in Northern Uganda in1997, NS reached epidemic proportions around 2000-2003 when people were moved into Internally Displaced People's (IDP) camps. Investigations for infections (onchocerciasis) and toxins have been inconclusive as to cause, treatment or outcome. No study has addressed the possible relationship of NS to childhood war-trauma experiences. To explore a possible relationship of exposure to prolonged war-trauma and the emergence of epidemic NS in Northern Uganda. This study was a case-series descriptive psychiatric naturalistic field observations of NS cases from homesteads in Northern Uganda and psychiatric investigations and treatment of NS cases referred to Mulago National Referral and Teaching Hospital. Detailed Psychiatric clinical evaluations and field observations revealed that NS children had been exposed to severe war-related psychological and physical trauma as well as non-specific CNS insults including untreated CNS infections/infestations and malnutrition possibly causing seizures. Many children suffered post-traumatic stress disorder (PTSD) and depression. NS could present as an association of childhood complex PTSD, (called Developmental Trauma Disorder), occurring in the chronically war-traumatised children of Northern Uganda, complicated by severe prolonged depression with its characteristic symptoms of psychomotor retardation, anxiety, anhedonia and anorexia. This, coupled with food shortages, resulted in malnutrition, wasting and stunted growth with severe avitaminoses. Many children had seizures. All this calls for multi-disciplinary treatment approaches.

  17. The obstetric performance of United Kingdom asylum seekers from Somalia: a case-control study and literature review.

    Science.gov (United States)

    Yoong, W; Kolhe, S; Karoshi, Mahantesh; Ullah, M; Nauta, M

    2005-01-01

    Little published research exists regarding obstetric performance of immigrant women in the United Kingdom. The aim of this study was to evaluate the obstetric performance and fetal outcomes of Somalian women who received prenatal care and requested to deliver at a teaching hospital in North London. This is a case-control study in which consecutive Somalian women were identified as index cases and the subsequent British-born Caucasian women listed in the delivery book served as controls. 69 index and 69 control cases were analyzed. Fifty-five percent of the Somalian women spoke little or no English. Half (50%) had undergone circumcision, the majority being type I WHO classification of female genital circumcision, which did not require significant surgical intervention prior to labor; 13% had cesarean sections, 13% instrumental vaginal deliveries, and 74% had vaginal deliveries. The Somalian women had higher parity (2.35 vs. 1.18) and were more likely to be grand multiparous (9/69 vs. 1/69) compared to controls. Epidural use was less frequent in Somalian women, but otherwise there were no significant differences between the two groups with regard to maternal age, rates of induction of labor, cesarean sections, duration of labor, premature deliveries, instrumental deliveries, and birth weights. The demographic characteristics of the Somalian female population appear to exert minimal effect on obstetric and fetal outcomes. This may be due to the increased vigilance exercised by health professionals as well as to the fact that recent arrivals are from more urban and westernized areas in Somalia.

  18. Excision of Oral Submucous Fibrosis and Reconstruction with Full Thickness Skin Graft: A Case Study and Review of the Literature

    Science.gov (United States)

    Alshadwi, Ahmad; Bhatia, Ishwar

    2012-01-01

    Oral submucous fibrosis is a chronic debilitating disease characterized by gradually increasing fibrosis of the oral cavity and pharynx, mainly the buccal mucosa, resulting in trismus. The highest incidence of oral submucous fibrosis is seen in South India due to various deleterious habits. In spite of the numerous medical modalities employed in the management of oral submucous fibrosis, occasionally surgical intervention becomes inevitable. Various surgical approaches have been used to reconstruct the surgical defects following excision of fibrous bands. Full thickness skin grafts have been described in the literature with variable outcomes. In the present study a 38-year-old male presented with severe oral submucous fibrosis of the buccal mucosa, which was successfully treated and reconstructed using full thickness skin graft with stable functional result after one year of treatment. An integrated review of the literature regarding etiology, histopathology, diagnostic, and treatment modalities of the disease follows. PMID:23304568

  19. Impedance of SOFC electrodes: A review and a comprehensive case study on the impedance of LSM:YSZ cathodes

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Hjelm, Johan

    2014-01-01

    It was shown through a comprehensive impedance spectroscopy study that the impedance of the classic composite LSM:YSZ (lanthanum strontium manganite and yttria stabilized zirconia) solid oxide fuel cell (SOFC) cathode can be described well with porous electrode theory. Furthermore, it was illustr......It was shown through a comprehensive impedance spectroscopy study that the impedance of the classic composite LSM:YSZ (lanthanum strontium manganite and yttria stabilized zirconia) solid oxide fuel cell (SOFC) cathode can be described well with porous electrode theory. Furthermore......, it was illustrated through a literature review on SOFC electrodes that porous electrode theory not only describes the classic LSM:YSZ SOFC cathode well, but SOFC electrodes in general. The extensive impedance spectroscopy study of LSM:YSZ cathodes consisted of measurements on cathodes with three different sintering...... temperatures and hence different microstructures and varying degrees of LSM/YSZ solid state interactions. LSM based composite cathodes, where YSZ was replaced with CGO was also studied in order to acquire further knowledge on the chemical compatibility between LSM and YSZ. All impedance measurements were...

  20. Potential effects of urbanization on urban thermal comfort, a case study of Nairobi city, Kenya: A review

    Directory of Open Access Journals (Sweden)

    Ongoma Victor

    2016-01-01

    Full Text Available This study reviews the effect of urbanization on human thermal comfort over Nairobi city in Kenya. Urbanization alters urban center's land use and land cover, modifying the climate of the urban setting. The modification in climate affects human comfort and the environment at large. This study focuses on the recent studies conducted in Nairobi city and many other cities globally to examine modification of wind, temperature and humidity over Nairobi. There was observed reduction in wind speed and relative humidity over the city, posing threat to human and animal comfort and the environment at large. The city of Nairobi, just like other cities globally is observed to experience urban heat island (UHI. The observed increase in minimum temperature as compared to maximum temperature signifies overall warming. A combination of all these changes reduces human comfort. Borrowing lessons from developed cities, increasing the urban forest cover is thus suggested as one of the practical and effective measures that can help prevent further modification of weather and urban climates. The study recommends further research involving multi-sectoral urban stake holders, on forcing driving urban thermal comfort. In the short term, design and construction of appropriate structures can help minimize energy consumption and emissions, thus enhancing comfort.

  1. A Review of Plastic-Associated Pressures: Cetaceans of the Mediterranean Sea and Eastern Australian Shearwaters as Case Studies

    Directory of Open Access Journals (Sweden)

    Maria Cristina Fossi

    2018-05-01

    Full Text Available Impacts of debris on marine fauna occur throughout the marine ecosystems, with adverse impacts documented on over 1,400 species; impacts can be divided into those arising from entanglement, and those from ingestion. Ingestion of, and entanglement in, debris has been documented in over 60% of all cetacean species. Seabirds are also impacted by debris predominately through entanglement and ingestion, with the number of species negatively impacted increasing from 138 to 174 over the past two decades. In the marine environment, cetaceans and seabirds are widely regarded as reliable sentinels due to their position near the top of the marine food web, conspicuous nature, and reliance on marine resources; for this reason, this paper is focused on seabirds and cetaceans as sentinels of ocean change. In particular, two case studies are considered in relation to different levels of environmental anthropogenic impact: the cetaceans of the Mediterranean Sea and seabirds of eastern Australia. Here we describe two recent studies used to diagnose the toxicological stress related to debris-associated pressures in cetaceans and seabirds. These studies highlight the diversity and scale of impacts being felt by marine species and the role these organisms can play in our society as charismatic sentinels of ocean health. Seabirds and marine mammals are exposed, in these key areas, to a variety of adversities that potentially decrease their survival or reproductive success. These include weather, food shortages, predators, competitors, parasites, disease, and human-induced effects and plastic pollution. Each factor affects seabirds and marine mammals in a different way, but more importantly, factors can also interact and create impacts far greater than any one factor alone. The Australian and Mediterranean case studies presented here emphasize the need to consider multiple sources of mortality when developing management plans for the conservation of vulnerable

  2. Cytogenetic study of preleukemic phases and of acute leukemia secondary to chemo- and/or radiotherapy. Review of the literature (102 cases)

    International Nuclear Information System (INIS)

    Smadja, N.; Krulik, M.; Debray, J.

    1982-01-01

    A review of the literature upon 102 cases with cytogenetic study of preleukemic states (Prel.) and/or acute secondary leukemia (ASL) following chemotherapy and/or radiotherapy treatment has been made. The karyotype was almost always abnormal (91% of cases). There was a predominance of hypodiploidy with abnormalities including chromosome number 5 (-5 ou 5q-) and/or number 7 (7- or 7q-) (chromosomes studied with banding). The abnormalities were present in preleukemia state. The pattern of the acute secondary leukemia was particularly different from that acute leukemia de novo: high frequency of preleukemia state, ANLL type of leukemia, very bad prognosis, importance of cytogenetic abnormalities. There was a great interest in the study of the karyotype for the previous detection in ASL: this allowed their discovery as soon as the preleukemia state [fr

  3. Candida endocarditis: systematic literature review from 1997 to 2014 and analysis of 29 cases from the Italian Study of Endocarditis.

    Science.gov (United States)

    Giuliano, Simone; Guastalegname, Maurizio; Russo, Alessandro; Falcone, Marco; Ravasio, Veronica; Rizzi, Marco; Bassetti, Matteo; Viale, Pierluigi; Pasticci, Maria Bruna; Durante-Mangoni, Emanuele; Venditti, Mario

    2017-09-01

    Candida Endocarditis (CE) is a deadly disease. It is of paramount importance to assess risk factors for acquisition of both Candida native (NVE) and prosthetic (PVE) valve endocarditis and relate clinical features and treatment strategies with the outcome of the disease. Areas covered: We searched the literature using the Pubmed database. Cases of CE from the Italian Study on Endocarditis (SEI) were also included. Overall, 140 cases of CE were analyzed. Patients with a history of abdominal surgery and antibiotic exposure had higher probability of developing NVE than PVE. In the PVE group, time to onset of CE was significantly lower for biological prosthesis compared to mechanical prosthesis. In the whole population, greater age and longer time to diagnosis were associated with increased likelihood of death. Patients with effective anti-biofilm treatment, patients who underwent cardiac surgery and patients who were administered chronic suppressive antifungal treatment showed increased survival. For PVE, moderate active anti-biofilm and highly active anti-biofilm treatment were associated with lower mortality. Expert commentary: Both NVE and PVE could be considered biofilm-related diseases, pathogenetically characterized by Candida intestinal translocation and initial transient candidemia. Cardiac surgery, EAB treatment and chronic suppressive therapy might be crucial in increasing patient survival.

  4. A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly.

    Directory of Open Access Journals (Sweden)

    Maria Benedetta Michelazzo

    2017-03-01

    Full Text Available Background. Aging is frequently accompanied by chronic diseases; as a consequence, older people are often exposed to polypharmacy that has been associated with negative health-consequences. The aim of this study is to conduct a systematic review of the literature reporting on the effectiveness of different approaches to reduce polypharmacy in the elderly. Methods. We conducted a comprehensive literature search of MEDLINE, Scopus and ISI Web of Knowledge databases. Eligible studies were case-series reporting outcomes of interventions aimed at reducing polypharmacy and its consequences in the elderly. A quality appraisal of the studies included was performed. Results. Nineteen studies were included, of which six conducted in community setting, seven in hospital setting, and six in nursing homes. Seventeen of them were judged as moderate quality, and two of them as poor quality. The majority of the interventions were carried out by pharmacists, alone (35% or with other professionals (40%. Interventions consisted in pharmacotherapy reviews based on various tools and software; in some cases educational interventions were performed for review-performers and patients. Studies conducted in community-setting provided also a feedback to primary care physician. The outcomes included five categories: therapy’s characteristics (e.g. number of drugs, appropriate prescriptions, quality of life, health-related outcomes, costs, healthcare services’ utilization. Therapy-related outcomes were those more affected by all types of interventions. Conclusion. Interventions aimed at reviewing patients’ therapy are effective in optimizing the use of drugs, and could be considered also  in improving quality of life, healthcare costs, services’ utilization, and health-related outcomes.

  5. Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake.

    Science.gov (United States)

    Chi, Donald L

    2013-01-01

    Tooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown. To conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB) intake among Alaska Native children. Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, the terms "Alaska Native", "children" and "oral health" were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970-2012) for relevant clinical trials and evaluation studies. Eighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children. Few oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions are promising approaches to improve the oral and systemic health of Alaska Native

  6. Kimura's Disease without Peripheral Eosinophilia: An Unusual and Challenging Case Simulating Venous Malformation on Imaging Studies-Case Report and Review of literature.

    Science.gov (United States)

    Dokania, Vivek; Patil, Digvijay; Agarwal, Ketan; Thakur, Prajakta; Prajapati, Piyush

    2017-06-01

    Kimura's Disease (KD) is a rare chronic inflammatory disorder presenting as multiple painless solitary subcutaneous nodules, predominantly in the head and neck region and frequently associated with regional lymphadenopathy and/or salivary gland involvement. Because of painless nature and indolent course, there is usually a delay in the patient's presentation. KD may radiologically mimic other chronic inflammatory conditions like tuberculosis, vascular malformations and neoplasms. Clinical correlation and histological evaluation along with elevated peripheral eosinophil and serum IgE level are considered important for confirmatory diagnosis. We report a case of painless swelling over right submandibular region extending to the right superficial parotid. The haematological reports were within normal limits. Ultrasound (USG), Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiogram (MRA) favoured a diagnosis of venous malformation. However, histopathological examination of excised lesion confirmed a diagnosis of KD. This case proves the possibility of the KD even in the absence of peripheral eosinophilia and/ or elevated serum IgE level, and may mimic venous malformation on imaging studies. Therefore, KD must find a place in the differentials of solitary painless neck swelling even in the absence of peripheral eosinophilia and/or elevated IgE level.

  7. Citrus waste as feedstock for bio-based products recovery: Review on limonene case study and energy valorization.

    Science.gov (United States)

    Negro, Viviana; Mancini, Giuseppe; Ruggeri, Bernardo; Fino, Debora

    2016-08-01

    The citrus peels and residue of fruit juices production are rich in d-limonene, a cyclic terpene characterized by antimicrobial activity, which could hamper energy valorization bioprocess. Considering that limonene is used in nutritional, pharmaceutical and cosmetic fields, citrus by-products processing appear to be a suitable feedstock either for high value product recovery or energy bio-processes. This waste stream, more than 10MTon at 2013 in European Union (AIJN, 2014), can be considered appealing, from the view point of conducting a key study on limonene recovery, as its content of about 1%w/w of high value-added molecule. Different processes are currently being studied to recover or remove limonene from citrus peel to both prevent pollution and energy resources recovery. The present review is aimed to highlight pros and contras of different approaches suggesting an energy sustainability criterion to select the most effective one for materials and energy valorization. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Septic Systems Case Studies

    Science.gov (United States)

    A collection of septic systems case studies to help community planners, elected officials, health department staff, state officials, and interested citizens explore alternatives for managing their decentralized wastewater treatment systems.

  9. HYDROGEOLOGIC CASE STUDIES

    Science.gov (United States)

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

  10. A Psychobiographical Case Study

    African Journals Online (AJOL)

    man, and cancer fighter. This psychobiographical case study entailed a psychosocial-historical ... does not draw more attention as a research method, as this approach has .... of the applied Levinsonian theory to the life of Jobs against the ...

  11. A case study and literature review of surgical treatment for brachial plexus pain caused by Pancoast syndrome

    Directory of Open Access Journals (Sweden)

    Xian Hang

    2016-10-01

    Full Text Available This study reports the diagnosis and treatment of brachial plexus-associated intractable pain caused by Pancoast syndrome, along with the associated literature review, based on a patient we attended to in April 2011. A full examination was performed after his admission, and neurolysis was conducted on the right brachial plexus of lower trunk. Follow-ups and treatment evaluations were carried out 1, 2, 3, and 6 months after the initial neurolysis procedure, which was followed by a radiation therapy two months later. The patient’s pain symptoms were relieved and he partially regained sense awareness and movement of his right hand. We found that early clinical manifestations of Pancoast syndrome are atypical and are sometimes difficult to detect. It is very similar to brachial plexus injury-related pain, and the patient must be referred to an orthopaedics or hand surgery specialist for treatment. Therefore, improving medical practitioners’ general understanding of this disease is essential in order to avoid potential misdiagnoses.

  12. Qualitative Case Study Guidelines

    Science.gov (United States)

    2013-11-01

    Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln , Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study...Rinehart & Winston 39. Stake, R. E. (1994) Case Studies. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage

  13. Prepublication Review of Government Employee Speech: A Case Study of the Department of Defense and United States Air Force Security/Policy Review Programs.

    Science.gov (United States)

    Warden, Michael L.

    Since 1957 the Department of Defense has subjected all forms of speech of U.S. military personnel meant for publication to prepublication review based on security and policy criteria. The historical development of the Defense Department's prepublication review program and its specific implementation by the U.S. Air Force lead to questions of First…

  14. Review on international sediment initiative case studies%国际泥沙计划案例研究综述

    Institute of Scientific and Technical Information of China (English)

    刘成; 刘桉

    2017-01-01

    Affected by the global changes and many other factors,many river basins in the world are experiencing serious sediment problems and the importance of integrated sediment management has been increasing highlighted.This paper presents an overview on the case studies on sediment management of river basins carried by the International Sediment Initiative (ISI)-IHP-UNESCO.It is concluded that geographical conditions,socio-economic conditions and constructions of hydraulic engineering have major impacts on sediment yield,sediment transportation and water utilization in the river basins.The main sediment problems faced by the world's major river basins at present includes acceleration of soil erosion,reservoir sedimentation,the reduction of downstream sediment load and the destruction of ecological balance.Measures of integrated sediment management for river basins are put forward by summarizing sediment management technologies raised in the ISI case studies,including technical measures such as reservoir sedimentation management,sediment bed load management,land management,soil and water conservation technologies,as well as organization and legal measures.%在全球变化等多种因素的影响下,许多流域的泥沙问题严重,泥沙管理的重要性日益突出.通过对联合国教科文组织国际泥沙计划所开展的案例研究进行综述,认识到自然地理特征、社会经济条件、水利工程建设对流域产沙、输沙和水资源利用有重要影响.土壤侵蚀加速、水库淤积、下游输沙量减少和生态平衡破坏是目前全球各大流域面临的主要问题.综合各项案例,研究泥沙管理技术,提出流域综合泥沙管理的策略,包括水库淤积管理、推移质泥沙管理、土地管理和水土保持等技术手段,以及法律、行政和组织措施.

  15. Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study.

    Science.gov (United States)

    Lissak, Gadi

    2018-07-01

    A growing body of literature is associating excessive and addictive use of digital media with physical, psychological, social and neurological adverse consequences. Research is focusing more on mobile devices use, and studies suggest that duration, content, after-dark-use, media type and the number of devices are key components determining screen time effects. Physical health effects: excessive screen time is associated with poor sleep and risk factors for cardiovascular diseases such as high blood pressure, obesity, low HDL cholesterol, poor stress regulation (high sympathetic arousal and cortisol dysregulation), and Insulin Resistance. Other physical health consequences include impaired vision and reduced bone density. Psychological effects: internalizing and externalizing behavior is related to poor sleep. Depressive symptoms and suicidal are associated to screen time induced poor sleep, digital device night use, and mobile phone dependency. ADHD-related behavior was linked to sleep problems, overall screen time, and violent and fast-paced content which activates dopamine and the reward pathways. Early and prolonged exposure to violent content is also linked to risk for antisocial behavior and decreased prosocial behavior. Psychoneurological effects: addictive screen time use decreases social coping and involves craving behavior which resembles substance dependence behavior. Brain structural changes related to cognitive control and emotional regulation are associated with digital media addictive behavior. A case study of a treatment of an ADHD diagnosed 9-year-old boy suggests screen time induced ADHD-related behavior could be inaccurately diagnosed as ADHD. Screen time reduction is effective in decreasing ADHD-related behavior. Components crucial for psychophysiological resilience are none-wandering mind (typical of ADHD-related behavior), good social coping and attachment, and good physical health. Excessive digital media use by children and adolescents

  16. Global incidence and case fatality rate of pulmonary embolism following major surgery: a protocol for a systematic review and meta-analysis of cohort studies.

    Science.gov (United States)

    Temgoua, Mazou N; Tochie, Joel Noutakdie; Noubiap, Jean Jacques; Agbor, Valirie Ndip; Danwang, Celestin; Endomba, Francky Teddy A; Nkemngu, Njinkeng J

    2017-12-04

    Pulmonary embolism (PE) is a life-threatening condition common after major surgery. Although the high incidence (0.3-30%) and mortality rate (16.9-31%) of PE in patients undergoing major surgical procedures is apparent from findings of contemporary observational studies, there is a lack of a summary and meta-analysis data on the epidemiology of postoperative PE in this same regard. Hence, we propose to conduct the first systematic review to summarise existing data on the global incidence, determinants and case fatality rate of PE following major surgery. Electronic databases including MEDLINE, EMBASE, SCOPUS, WHO global health library (including LILACS), Web of Science and Google scholar from inception to April 30, 2017, will be searched for cohort studies reporting on the incidence, determinants and case fatality rate of PE occurring after major surgery. Data from grey literature will also be assessed. Two investigators will independently perform study selection and data extraction. Included studies will be evaluated for risk of bias. Appropriate meta-analytic methods will be used to pool incidence and case fatality rate estimates from studies with identical features, globally and by subgroups of major surgical procedures. Random-effects and risk ratio with 95% confidence interval will be used to summarise determinants and predictors of mortality of PE in patients undergoing major surgery. This systematic review and meta-analysis will provide the most up-to-date epidemiology of PE in patients undergoing major surgery to inform health authorities and identify further research topics based on the remaining knowledge gaps. PROSPERO CRD42017065126.

  17. Melorheostosis: a review of 23 cases

    Energy Technology Data Exchange (ETDEWEB)

    Freyschmidt, J. [Dept. of Radiology, Zentralkrankenhaus Bremen (Germany)

    2001-03-01

    The aim of this study was to review clinical and radiological signs of melorheostosis in a large series of cases. Family history, patient history, clinical data and radiological features of 23 consecutive cases of melorheostosis were investigated. Criteria for establishing the diagnosis ''melorheostosis'' were defined. Sixteen patients (mean age 34 years, equal ratio between genders) had chronic pain in the affected limb(s) and/or subcutaneous fibrosis and/or various skin lesions. Number of involved bones: one bone (n = 10); two bones (n = 4); three or more bones (n = 9). Anatomic distribution: upper extremity (n = 5); lower extremity (n = 16); upper and lower extremity (n = 1); sacrum (n = 1). Radiologic pattern: osteoma-like (n = 7); classic candle wax appearance (n = 5); myositis ossificans-like (n = 1); osteopathia striata-like (n = 6); mixed pattern (n = 4). Patterns different from the appearance formerly judged to be ''classic'' prevail. The standard concept of disease manifestation has to be adjusted. Pathogenesis remains unclear. The classic theory claims the presence of an early embryonic infection of a sensory nerve inducing changes in the respective sclerotome, but we propose the concept of mosaicism as a better explanation for the sporadic occurrence, the asymmetric ''segmental'' pattern with variable extent of involvement and equal gender ratio of the disease. (orig.)

  18. Melorheostosis: a review of 23 cases

    International Nuclear Information System (INIS)

    Freyschmidt, J.

    2001-01-01

    The aim of this study was to review clinical and radiological signs of melorheostosis in a large series of cases. Family history, patient history, clinical data and radiological features of 23 consecutive cases of melorheostosis were investigated. Criteria for establishing the diagnosis ''melorheostosis'' were defined. Sixteen patients (mean age 34 years, equal ratio between genders) had chronic pain in the affected limb(s) and/or subcutaneous fibrosis and/or various skin lesions. Number of involved bones: one bone (n = 10); two bones (n = 4); three or more bones (n = 9). Anatomic distribution: upper extremity (n = 5); lower extremity (n = 16); upper and lower extremity (n = 1); sacrum (n = 1). Radiologic pattern: osteoma-like (n = 7); classic candle wax appearance (n = 5); myositis ossificans-like (n = 1); osteopathia striata-like (n = 6); mixed pattern (n = 4). Patterns different from the appearance formerly judged to be ''classic'' prevail. The standard concept of disease manifestation has to be adjusted. Pathogenesis remains unclear. The classic theory claims the presence of an early embryonic infection of a sensory nerve inducing changes in the respective sclerotome, but we propose the concept of mosaicism as a better explanation for the sporadic occurrence, the asymmetric ''segmental'' pattern with variable extent of involvement and equal gender ratio of the disease. (orig.)

  19. Case report and review of the literature

    African Journals Online (AJOL)

    Access this article online ... Case report and review of the literature .... HTML pages have been optimized of mobile and other hand-held devices (such as ... such as for Windows: Digital Editions, OS X: Calibre/Bookworm, iPhone/iPod Touch/.

  20. Review: Biodiversity conservation strategy in a native perspective; case study of shifting cultivation at the Dayaks of Kalimantan

    Directory of Open Access Journals (Sweden)

    AHMAD DWI SETYAWAN

    2010-07-01

    Full Text Available Setyawan AD. 2010. Biodiversity conservation strategy in a native perspective; case study of shifting cultivation at the Dayaks of Kalimantan. Nusantara Bioscience 2: 97-108. Native tribes generally are original conservationists; they build genuine conservation strategy of natural resources and environment for sustainable living. Dayak is a native tribe of Kalimantan that has been living for thousands of years; they use shifting cultivation to manage the communal forest lands due to Kalimantan’s poor soil of minerals and nutrients, where the presence of phosphorus becomes a limiting factor for crops cultivation. In tropical forests, phosphorus mostly stored in the trees, so to remove it, the forest burning is carried out. Nutrients released into the soil can be used for upland rice (gogo cultivation, until depleted; after that, cultivators need to open a forest, while the old land was abandoned (fallow until it becomes forest again (for 20-25 years. The consecutive land clearing causes the formation of mosaics land with different succession ages and diverse biodiversity. This process is often combined with agroforestry systems (multicultural forest gardens, where the will-be-abandoned fields are planted with a variety of useful trees that can be integrated in forest ecosystems, especially rubber and fruits. These systems of shifting cultivation are often blamed as the main factor of forest degradation and fires, but in the last 300 years, this system has little impact on forest degradation. But, this is relatively low in productivity and subsistent, so it is not suitable for the modern agriculture which demands high productivity and measurable, mass and continuous yield, as well as related to the market. The increased population and industrial development of forestry, plantation, mining, etc. make the communal forest become narrower, so the fallow periods are shortened (5-15 years and the lands are degraded into grasslands. In the future

  1. Rhabdomyolysis in adolescent athletes: review of cases.

    Science.gov (United States)

    Hummel, Kevin; Gregory, Andrew; Desai, Neerav; Diamond, Alex

    2016-01-01

    Rhabdomyolysis is a syndrome characterized by muscle pain, weakness and myoglobinuria and ranges in severity from asymptomatic to life threatening with acute kidney failure. While a common condition in adult populations, it is understudied in pediatrics and the majority of adolescent cases are likely exercise-induced, caused by strenuous exercise in athletes. Recently, in our pediatric sports medicine practice, we have seen numerous cases of late adolescent high school athletes who present with severe muscle pain and were found to have elevated creatine kinase levels. The cases review potential contributing factors including characteristics of the workout, use of supplements, caffeine, medication, and metabolic or genetic predisposition. Treatment for exercised-induced rhabdomyolysis rarely requires more than rehydration. Return to play should be progressive, individualized, and include acclimatization and monitoring of hydration status, though guidelines require further review.

  2. Objectivist case study research

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Fachner, Jörg

    2016-01-01

    be achieved through the use of objectivist case study research. The strength of the case study design is that it allows for uncovering or suggesting causal relationships in real-life settings through an intensive and rich collection of data. According to Hilliard (1993), the opposite applies for extensive......In order to comprehend the impact of music therapy or music therapy processes, a researcher might look for an approach where the topic under investigation can be understood within a broader context. This calls for a rich inclusion of data and consequently a limited number of participants and may...... designs, in which a small amount of data is gathered on a large number of subjects. With the richness of data, the intensive design is ―the primary pragmatic reason for engaging in single-case or small N research‖ (p. 374) and for working from an idiographic rather than a nomothetic perspective....

  3. The study of chromosome aberration yield in human lymphocytes as an indicator of radiation dose. 3. A review of cases investigated: 1971-72

    International Nuclear Information System (INIS)

    Purrott, R.J.; Lloyd, D.C.; Dolphin, G.W.; Eltham, E.J.; Platt, S.K.; Tipper, P.A.; Strange, C.M.

    1973-02-01

    Results from cytogenetic investigations into 54 cases of suspected overexposure to radiation are reviewed. This report is a sequel to NRPB-R5 which contained data from the first 41 studies; results from all 95 investigations have been pooled for general analysis. Brief accounts are given of the circumstances behind the 54 later investigations and where possible physical estimates of dose have been included for comparison. From data on lymphocyte half-life obtained in the first series of cases, an attempt has been made to allow for the loss of damaged cells where the exposure occurred some years previously. The presence of incomplete chromosome damage appears to be characteristic of exposures which occurred some years ago. The ratio of dicentrics to acentrics observed in the accident investigation has been compared with that obtained in recent research studies. The problem of interpreting aberration yield in cases of exposure to kV non-penetrating radiation and to partial body doses, such as to fingers, has been discussed. In addition the problem of selective irradiation of lymphocytes by internally incorporated radionuclides in, for example, lymph nodes and highly vascular tissue, has been examined. Difficulties have been encountered in culturing leukaemic lymphocytes. These and other areas of research which would benefit cytogenetic dosimetry are discussed. (author)

  4. Pneumomediastinum: a rare complication of anorexia nervosa in children and adolescents. A case study and review of the literature

    OpenAIRE

    van Veelen, Ina; Hogeman, Paul H. G.; van Elburg, Annemarie; Nielsen-Abbring, Fenny W.; Heggelman, Ben G. F.; Mahieu, Hans F.

    2007-01-01

    Spontaneous pneumomediastinum is uncommon in paediatric practice. We describe two cases of spontaneous pneumomediastinum in a child and an adolescent with anorexia nervosa. Thorough investigation failed to reveal any underlying cause for secondary pneumomediastinum. Pneumomediastinum in anorexia nervosa can be caused by not only elevated intrathoracic pressures, but also by the poor quality of the alveolar walls due to malnutrition. The incidence of spontaneous pneumomediastinum in anorexia n...

  5. Blunt trauma pancreatic duct injury managed by non-operative technique, a case study and literature review

    Directory of Open Access Journals (Sweden)

    A. Zala

    2015-02-01

    Full Text Available We describe the case of a 15 year old boy who presented with generalised abdominal pain following a seemingly minor collision at weekend soccer. Investigation revealed a grade IV pancreatic injury that was subsequently managed with pancreatic stent insertion by endoscopic retrograde cholangiopancreatography (ERCP and total parenteral nutrition (TPN prior to recommencing low fat diet 10 days post-injury. Keywords: Trauma, Blunt injury, Pancreas, Non-operative

  6. Performance Measurement in Small and Medium-Sized Enterprises - Literature Review and Results from a German Case Study

    DEFF Research Database (Denmark)

    Brem, Alexander; Kreusel, N.; Neusser, N.

    2008-01-01

    factors – Corporate Strategy, software-based Enterprise Resource Planning (ERP) and Activity Based Costing (ABC) – strongly supports the successful implementation of a PMS and its later use. Hence, further research shall include these prerequisites as new variables determining the PMS process. Based......A literature review of Performance Measurement Systems (PMS) in Small- and Medium-sized Enterprises (SMEs) shows that the main contributions focus on the development of theoretical models, but not on guidelines for practical implementation. In this context, an important neglected aspect...

  7. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.

  8. Nuclear forensics case studies

    International Nuclear Information System (INIS)

    Fedchenko, Vitaly

    2016-01-01

    The objective of this presentation is to share three case studies from the Institute of Transuranium Elements (ITU) which describe the application of nuclear forensics to events where nuclear and other radioactive material was found to be out of regulatory control

  9. SCA12 case study

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Genetics; Volume 88; Issue 1. Utilizing linkage disequilibrium information from Indian Genome Variation Database for mapping mutations: SCA12 case study. Samira Bahl Ikhlak Ahmed The Indian Genome Variation Consortium Mitali Mukerji. Research Article Volume 88 Issue 1 April 2009 pp 55- ...

  10. national Case study

    African Journals Online (AJOL)

    This national case study reports on the development of a national network, ... system under the new policy), tends to be limited by content on problems and ... 20 credit programme; and within two Post Graduate Certificate of Education contexts, ...... descriptive with an issues focus (empirical) towards awareness production to.

  11. Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake

    Directory of Open Access Journals (Sweden)

    Donald L. Chi

    2013-08-01

    Full Text Available Background. Tooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown. Objective. To conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB intake among Alaska Native children. Design. Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA Statement, the terms “Alaska Native”, “children” and “oral health” were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970–2012 for relevant clinical trials and evaluation studies. Results. Eighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children. Conclusions. Few oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions

  12. Female serial killing: review and case report.

    Science.gov (United States)

    Frei, Andreas; Völlm, Birgit; Graf, Marc; Dittmann, Volker

    2006-01-01

    Single homicide committed by women is rare. Serial killing is very infrequent, and the perpetrators are usually white, intelligent males with sadistic tendencies. Serial killing by women has, however, also been described. To conduct a review of published literature on female serial killers and consider its usefulness in assessing a presenting case. A literature review was conducted, after searching EMBASE, MEDLINE and PsycINFO. The presenting clinical case is described in detail in the context of the literature findings. Results The literature search revealed few relevant publications. Attempts to categorize the phenomenon of female serial killing according to patterns of and motives for the homicides have been made by some authors. The most common motive identified was material gain or similar extrinsic gratification while the 'hedonistic' sadistic or sexual serial killer seems to be extremely rare in women. There is no consistent theory of serial killing by women, but psychopathic personality traits and abusive childhood experiences have consistently been observed. The authors' case did not fit the description of a 'typical' female serial killer. In such unusual circumstances as serial killing by a woman, detailed individual case formulation is required to make sense of the psychopathology in each case. Publication of cases in scientific journals should be encouraged to advance our understanding of this phenomenon. Copyright (c) 2006 John Wiley & Sons, Ltd.

  13. Hesitation Wounds and Sharp Force Injuries in Forensic Pathology and Psychiatry: Multidisciplinary Review of the Literature and Study of Two Cases.

    Science.gov (United States)

    Karakasi, Maria-Valeria; Nastoulis, Evangelos; Kapetanakis, Stylianos; Vasilikos, Epameinondas; Kyropoulos, Grigorios; Pavlidis, Pavlos

    2016-11-01

    The aim of this paper was to showcase the significant diagnostic value of hesitation wounds in terms of forensic, psychiatric, and medicolegal interest. A number of studies were reviewed to update and summarize the relevant literature on the incidence, distribution, character, and function of hesitation wounds as well as the sociodemographic variables and psychopathology of the inducers. This study also investigates their importance as a forensic criterion in the distinction between suicide and homicide as well as a psychiatric diagnostic tool in suicide prevention. In addition, the paper reports two new cases. Results conclude that there is equal incidence, but different distribution of hesitation wounds between genders. Furthermore, the low dispersion of hesitation wounds contrasts with the high dispersion of defense wounds. The inducers' psychopathology lies principally in Axis I disorders. Finally, there is a comprehensive analysis of non-suicidal self-injury and the role of self-wounding in suicide prevention. © 2016 American Academy of Forensic Sciences.

  14. MRI case studies

    International Nuclear Information System (INIS)

    Huggett, S.; Barber, J.

    1989-01-01

    Three case studies are presented to show the value of magnetic resonance imaging used in conjunction with other imaging techniques. In each case MRI proved a vital diagnostic tool and superior to CT in showing firstly the haematoma in a patient with aphasia and right-sided weakness, secondly the size of the disc herniation in a patient with severe leg and ankle pains and thirdly the existence of a metastatic lesion in a patient with a previous history of breast cancer. 11 figs

  15. [Mixed connective tissue disease: prevalence and clinical characteristics in African black, study of 7 cases in Gabon and review of the literature].

    Science.gov (United States)

    Missounga, Landry; Ba, Josaphat Iba; Nseng Nseng Ondo, Ingrid Rosalie; Nziengui Madjinou, Maria Ines Carine; Malekou, Doris; Mouendou Mouloungui, Emeline Gracia; Nzengue, Emmanuel Ecke; Boguikouma, Jean Bruno; Kombila, Moussavou

    2017-01-01

    The literature reports that mixed connective tissue disease seems more frequent in the black population and among Asians. This study aims to determine the prevalence of mixed connective tissue disease (MCTD) among connective tissue disorders and all rheumatologic pathologies in a hospital population in Gabon as well as to describe the clinical features of this disease. We conducted a retrospective study by reviewing the medical records of patients treated for mixed connective tissue disease (Kasukawa criteria) and other entities of connective tissue disorders (ACR criteria) in the Division of Rheumatology at the University Hospital in Libreville between January 2010 and December 2015. For each case of MCTD the parameters studied were articular and extra-articular manifestations, anti-U1RNP antibodies levels, patient's evolution. Over a period of 6 years, data were collected by medical records of 7 patients out of 6050 patients and 67 cases of connective tissue disorders, reflecting a prevalence of 0.11% and 10.44% respectively. the 7 patients were women (100%), with an average age of 39.5 years. Articular manifestations included: polyarthritis, myalgias, chubby fingers and Raynaud's phenomenon in 87.5%, 87.5%, 28.6% and 14% respectively. The 7 patients had high anti-U1RNP antibodies levels, ranging between 5 and 35N (N≤ 7 IU). A case of death due to pulmonary arterial hypertension (PAH) was certified. This is the largest case series of MCTD reported in Black Africa. The disease seems to be rare among the black Africans; the reason could be genetic. The demographic and clinical aspects appear similar to those in Caucasians, Asians and Blacks except for a low frequency of Raynaud?s phenomenon among Blacks.

  16. Identifying patterns in signs and symptoms preceding the clinical diagnosis of Alzheimer's disease: Retrospective medical record review study and a nested case -control design.

    Science.gov (United States)

    Bature, Fidelia; Pang, Dong; Robinson, Anthea; Polson, Norma; Pappas, Yannis; Guinn, Barbara

    2018-04-04

    Evidence suggests that individuals with Alzheimer's disease (AD) are often diagnosed in the later stages of their disease with a poor prognosis. This study aimed to identify patterns in signs and symptoms preceding the clinical diagnosis of AD to suggest a predictive model for earlier diagnosis of the disease in the primary care. A retrospective medical record review; nested case control design. Participants included one hundred and nine patients from three general practice (GP) surgeries in Milton Keynes and Luton Clinical Commissioning groups (CCG) (37 cases with AD and 72 controls without AD). A retrospective analysis using the logistic regression of the presence of signs and symptoms before the diagnosis of AD was attained. Identification of the timing and sequence of appearance of these presentations as first reported before the clinical diagnosis was measured. Episodic memory with an odds ratio of 1.85 was the most frequent presentation, documented in 1.38% of the controls and 75.6% in cases. Auditory disturbance with an odds ratio of 3.03, which has not previously been noted except in the form of auditory hallucination, could have a diagnostic value. Auditory disturbance, which occurred mostly in the Caucasian females, could discriminate individuals with AD from those without. The symptom, which presented up to 14.5 (mean time) years prior to clinical diagnosis, was identified in Caucasians and mixed race individuals only. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  17. Pneumomediastinum: a rare complication of anorexia nervosa in children and adolescents. A case study and review of the literature

    Science.gov (United States)

    van Veelen, Ina; van Elburg, Annemarie; Nielsen-Abbring, Fenny W.; Heggelman, Ben G. F.; Mahieu, Hans F.

    2007-01-01

    Spontaneous pneumomediastinum is uncommon in paediatric practice. We describe two cases of spontaneous pneumomediastinum in a child and an adolescent with anorexia nervosa. Thorough investigation failed to reveal any underlying cause for secondary pneumomediastinum. Pneumomediastinum in anorexia nervosa can be caused by not only elevated intrathoracic pressures, but also by the poor quality of the alveolar walls due to malnutrition. The incidence of spontaneous pneumomediastinum in anorexia nervosa is probably higher than that recorded, since it resolves spontaneously and, therefore, it can remain undetected. We conclude that it is our considered opinion that malnutrition associated with anorexia nervosa predisposes for spontaneous pneumomediastinum due to weakness of the alveolar wall and the loss of connective tissue. PMID:17333270

  18. Postradiation Osteosarcoma in an Older Prostate Cancer Survivor: Case Study and Literature Review with Emphasis on Geriatric Principles

    Directory of Open Access Journals (Sweden)

    Divya Gumber

    2013-05-01

    Full Text Available The aging population and the increasing number of cancer survivors will likely be associated with more second primary malignancies due to prior cancer treatment. Since the incidence of most cancers increases with age, these treatment-associated second malignancies will likely disproportionately impact older adults. Here, we present the case of a 78-year-old man with a history of localized prostate cancer treated with external beam radiation therapy 11 years prior, who developed osteosarcoma of the ilium. Geriatric screening showed a fit older male with few comorbidities, functional independence and no other geriatric syndromes. Given the patient's preference for a limb-sparing operation, neoadjuvant chemotherapy was undertaken. With the paucity of clinical trial data on osteosarcoma in older adults, the patient was given a regimen of carboplatin (substituted for cisplatin, doxorubicin and methotrexate. Unfortunately, he developed methotrexate-induced acute kidney injury. Chemotherapy was discontinued, and he proceeded to hemipelvectomy. His postoperative course was marked by numerous complications, including delirium, depression and recurrent hospitalizations. He ultimately developed a local recurrence and elected for hospice care. This case highlights the challenges of managing older adults with treatment-associated malignancies. Clinicians face a lack of clinical trial data from which to extrapolate limitations of therapeutic options because of prior therapy and a limited ability to precisely predict which elders will experience adverse outcomes. Better approaches are needed to help older patients make decisions which fulfill their goals of care and to improve the care of older adults with treatment-associated malignancies.

  19. Reexpansion pulmonary edema: review of pediatric cases.

    Science.gov (United States)

    Kira, Shinichiro

    2014-03-01

    Reexpansion pulmonary edema (RPE) is an increased permeability pulmonary edema that usually occurs in the reexpanded lung after several days of lung collapse. This condition is recognized to occur more frequently in patients under the age of 40 years, but there has been no detailed analysis of reported pediatric cases of RPE to date. For this review, PubMed literature searches were performed using the following terms: 're(-)expansion pulmonary (o)edema' AND ('child' OR 'children' OR 'infant' OR 'boy' OR 'girl' OR 'adolescent'). The 22 pediatric cases of RPE identified were included in this review. RPE was reported in almost the entire pediatric age range, and as in adult cases, the severity ranged from subclinical to lethal. No specific treatment for RPE was identified, and treatment was administered according to the clinical features of each patient. Of the 22 reported cases, 10 occurred during the perioperative period, but were not related to any specific surgical procedures or anesthetic techniques, or to the duration of lung collapse. Pediatric anesthesiologists should be aware that pediatric RPE can occur after reexpansion of any collapsed lung and that some invasive therapies can be useful in severe cases. © 2013 John Wiley & Sons Ltd.

  20. Social acceptance of CO{sub 2} storage: Review of case studies and literature review; Aceptabilidad Social del Almacenamiento de CO{sub 2}: Revision de Estudios de Caso y Revision de la Literatura

    Energy Technology Data Exchange (ETDEWEB)

    Sola, R; Oltra, C; Sala, R; Di Masso, M

    2009-12-19

    Stake holder and public acceptance of CCS will play an important role in the efficient technology development. Together with socio-political acceptance, local acceptance could raise significant challenges to CCS deployment. The objective of the present work is to analyse the social acceptance of CO{sub 2} storage. First, we review the social science literature on local reactions and acceptance of risk technology projects. Lessons learned during these last decades around possible local reactions to risk technology facilities could help in the design of communication strategies for the context of CO{sub 2} storage. Second, we review different case studies of European CCS projects in which some strategy of public information, communication or engagement has been initiated from the promoters of the project. (Author) 26 refs.

  1. Testing the emergence of New Caledonia: fig wasp mutualism as a case study and a review of evidence.

    Directory of Open Access Journals (Sweden)

    Astrid Cruaud

    Full Text Available While geologists suggest that New Caledonian main island (Grande Terre was submerged until ca 37 Ma, biologists are struck by the presence of supposedly Gondwanan groups on the island. Among these groups are the Oreosycea fig trees (Ficus, Moraceae and their Dolichoris pollinators (Hymenoptera, Agaonidae. These partners are distributed in the Paleotropics and Australasia, suggesting that their presence on New Caledonia could result from Gondwanan vicariance. To test this hypothesis, we obtained mitochondrial and nuclear markers (5.3 kb from 28 species of Dolichoris, used all available sequences for Oreosycea, and conducted phylogenetic and dating analyses with several calibration strategies. All our analyses ruled out a vicariance scenario suggesting instead that New Caledonian colonization by Dolichoris and Oreosycea involved dispersal across islands from Sundaland ca 45.9-32.0 Ma. Our results show that successful long-distance dispersal of obligate mutualists may happen further suggesting that presence of intimate mutualisms on isolated islands should not be used as a priori evidence for vicariance. Comparing our results to a review of all the published age estimates for New Caledonian plant and animal taxa, we showed that support for a vicariant origin of the island biota is still lacking. Finally, as demonstrating a causal relationship between geology and biology requires independent evidence, we argue that a priori assumptions about vicariance or dispersal should not be used to constrain chronograms. This circular reasoning could lead to under or overestimation of age estimates.

  2. How reliable are case formulations? A systematic literature review.

    Science.gov (United States)

    Flinn, Lucinda; Braham, Louise; das Nair, Roshan

    2015-09-01

    This systematic literature review investigated the inter-rater and test-retest reliability of case formulations. We considered the reliability of case formulations across a range of theoretical modalities and the general quality of the primary research studies. A systematic search of five electronic databases was conducted in addition to reference list trawling to find studies that assessed the reliability of case formulation. This yielded 18 studies for review. A methodological quality assessment tool was developed to assess the quality of studies, which informed interpretation of the findings. Results indicated inter-rater reliability mainly ranging from slight (.1-.4) to substantial (.81-1.0). Some studies highlighted that training and increased experience led to higher levels of agreement. In general, psychodynamic formulations appeared to generate somewhat increased levels of reliability than cognitive or behavioural formulations; however, these studies also included methods that may have served to inflate reliability, for example, pooling the scores of judges. Only one study investigated the test-retest reliability of case formulations yielding support for the stability of formulations over a 3-month period. Reliability of case formulations is varied across a range of theoretical modalities, but can be improved; however, further research is required to strengthen our conclusions. Clinical implications: The findings from the review evidence some support for case formulation being congruent with the scientist-practitioner approach. The reliability of case formulation is likely to be improved through training and clinical experience. Limitations: The broad inclusion criteria may have introduced heterogeneity into the sample, which may have affected the results. Studies reviewed were limited to peer-reviewed journal articles written in the English language, which may represent a source of publication and selection bias. © 2014 The British Psychological Society.

  3. Case study - Czechoslovakia

    International Nuclear Information System (INIS)

    Kovar, P.

    1986-01-01

    In the lecture Case Study - Czechoslovakia with the sub-title 'Unified System of Personnel Preparation for Nuclear Programme in Czechoslovakia' the actual status and the current experience of NPP personnel training and preparation in Czechoslovakia are introduced. The above mentioned training system is presented and demonstrated by the story of a proxy person who is going to become shift engineer in a nuclear power plant in Czechoslovakia. (orig./HP)

  4. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2010-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  5. A systematic review of occupational safety and health business cases.

    Science.gov (United States)

    Verbeek, Jos; Pulliainen, Marjo; Kankaanpää, Eila

    2009-12-01

    Business cases are commonly developed as means to rationalize investment. We systematically reviewed 26 reported cases on occupational safety and health (OSH) interventions to assess if health and productivity arguments make a good business case. To be included in the review, studies had to analyze the costs and benefits, including productivity, of an OSH intervention at the enterprise level. We searched Medline and Embase for studies and used Google search in addition. Two reviewers independently selected studies and extracted data. The intervention profitability was calculated in euros (euro in 2008) as the first year's benefits minus the total intervention costs per worker. The payback period was calculated as the intervention costs divided by the first year's benefits. We found three ex-ante and 23 ex-post cases. In 20 cases, the study design was a before-after comparison without a control group. Generally a 100% reduction of injuries or sickness absence was assumed. In two cases, productivity and quality increases were very large. The main benefit was avoided sick leave. Depreciation or discounting was applied only in a minority of cases. The intervention profitability was negative in seven studies, up to euro 500 per employee in 12 studies and more than euro 500 per employee in seven studies. The payback period was less than half a year for 19 studies. Only a few studies included sensitivity analyses. Few ex-ante business cases for management decisions on OSH are reported. Guidelines for reporting and evaluation are needed. Business cases need more sound assumptions on the effectiveness of interventions and should incorporate greater uncertainty into their design. Ex-post evaluation should be based preferably on study designs that control for trends at a time different from that of the intervention.

  6. PRIMARY CARCINOMA OF THE GALL BLADDER: REVIEW AND STUDY OF EIGHTY CASES IN EMAM-KHOMEINI MEDICAL CENTER

    Directory of Open Access Journals (Sweden)

    M.A.RASHED-MOHASSEL

    1982-05-01

    Full Text Available In a r etrospective s t udy on the c ancer o f the gal l bladder, done in Iran, it s e ems tha t it compr ises 0 . 36% o f a ll the malignant tumors . 1 .7 5% of the patients were fema les and the maximum incidenc e wa s in t he s i x th decade of l i f e. It was interesting t o note that the age ratio bet ween t he males and f ema le s reverses with t he advance o f a ge, s o at the 7th and 8t h decade of life , the inciden ce o f the disease 1n males wa s muc h highe r than f emales."nAt the 8th dec ade , the nun~er of male patients was twice as f emales . The presenting symptoms in most c a ses were; pain,j aun- d ice, l o s s o f we i gh t , and in a f ew c ases t here was a hist or y of long l asting s~np tom s , re fe r able t o the bili a ry s ystem. After admission and surgical opening of the abdomen , 60% o f patie nts we re c ons i dere d ino perable. Al l the pat ients suf fe ring f rom anaplast ic carcinoma , which comprised 5% of all case s , were female and had a long l ast i ng history of gall b ladder infe c tions. The prevalence o f stone f ormation in g a l l blad der malignancie s i s a known f act but whether t he c au s e of thi s coincidenc e i s due t o some factors, suc h as irritation dysp:asia,or only CO~~ Ibi na tion o f t hese , is not def i n i t ly known.

  7. Metastatic craniopharyngioma: case report and literature review.

    Science.gov (United States)

    Frangou, Evan Mark; Tynan, Jennifer Ruth; Robinson, Christopher Adam; Ogieglo, Lissa Marie; Vitali, Aleksander Michal

    2009-09-01

    Distant spread of craniopharyngioma is a rare but important complication. Most cases are a result of spread along the surgical path. We describe a rare case of metastatic leptomeningeal craniopharyngioma as a result of dissemination along CSF pathways in a child. A review of previously described cases is provided. A 14-year-old male was diagnosed with metastatic craniopharyngioma on routine follow-up imaging after multiple surgeries and radiation for locally recurrent craniopharyngioma. The lesion was erosive through the right parietal bone, but had remained clinically silent. The lesion was distant from previous surgical paths. The patient underwent right parietal craniotomy and resection of the lesion. Duraplasty and cranioplasty were necessary for closure. Histopathology confirmed adamantinomatous craniopharyngioma. One-year follow-up demonstrated no recurrence. A review of reported cases suggests that leptomeningeal implantation may be an important step in metastases of craniopharyngioma, although the mechanism is poorly understood. Attention to tumor spillage at the time of surgery may be important in preventing distant recurrences.

  8. Keloidal Scleroderma: Case Report and Review

    Directory of Open Access Journals (Sweden)

    Sama Kassira

    2015-01-01

    Full Text Available Objective. We report a rare case of keloidal scleroderma and provide an analysis of similar cases. Results. A 41 year-old woman presented with dark brown, indurated, exophytic nodules over the chest along with smaller hyperpigmented plaques scattered over the abdomen, with concomitant sclerodactyly. The clinical, laboratory, and pathological findings were consistent with a diagnosis of keloidal scleroderma. The patient was treated with methotrexate, resulting in reduced firmness of her plaques and no new lesions. A literature review of previously reported cases was performed using keywords including keloidal morphea, keloidal scleroderma, nodular morphea, and nodular scleroderma. In our review, the majority of patients were African American and female. 91% of cases had nodular lesions with distribution on the trunk. The majority of patients exhibited sclerodactyly and pulmonary involvement was reported in 28%1. The majority of patients were ANA positive (63% and only 10% demonstrated anti-SCL-70 positivity. Conclusion. Keloidal scleroderma is a rare presentation, which can often be clinically confused with keloid and scar formation. Due to this being a rare variant, our knowledge of treatment options and efficacy is limited. Methotrexate could be considered as an initial treatment option for patients with progressive keloidal scleroderma.

  9. Earthdata Search Client: Usability Review Process, Results, and Implemented Changes, Using Earthdata Search Client as a Case Study

    Science.gov (United States)

    Siarto, Jeff; Reese, Mark; Shum, Dana; Baynes, Katie

    2016-01-01

    User experience and visual design are greatly improved when usability testing is performed on a periodic basis. Design decisions should be tested by real users so that application owners can understand the effectiveness of each decision and identify areas for improvement. It is important that applications be tested not just once, but as a part of a continuing process that looks to build upon previous tests. NASA's Earthdata Search Client has undergone a usability study to ensure its users' needs are being met and that users understand how to use the tool efficiently and effectively. This poster will highlight the process followed for usability study, the results of the study, and what has been implemented in light of the results to improve the application's interface.

  10. Disability Case Review of Administrative Law Judge Hearing Decisions

    Data.gov (United States)

    Social Security Administration — The Disability Case Review is a post-effectuation quality review of administrative law judge (ALJ) disability hearing decisions. This dataset includes results from...

  11. Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies.

    Science.gov (United States)

    Ludwig, Lea; Pasman, Joëlle A; Nicholson, Timothy; Aybek, Selma; David, Anthony S; Tuck, Sharon; Kanaan, Richard A; Roelofs, Karin; Carson, Alan; Stone, Jon

    2018-04-01

    Stressful life events and maltreatment have traditionally been considered crucial in the development of conversion (functional neurological) disorder, but the evidence underpinning this association is not clear. We aimed to assess the association between stressors and functional neurological disorder. We systematically reviewed controlled studies reporting stressors occurring in childhood or adulthood, such as stressful life events and maltreatment (including sexual, physical abuse, and emotional neglect) and functional neurological disorder. We did a meta-analysis, with assessments of methodology, sources of bias, and sensitivity analyses. 34 case-control studies, with 1405 patients, were eligible. Studies were of moderate-to-low quality. The frequency of childhood and adulthood stressors was increased in cases compared with controls. Odds ratios (OR) were higher for emotional neglect in childhood (49% for cases vs 20% for controls; OR 5·6, 95% CI 2·4-13·1) compared with sexual abuse (24% vs 10%; 3·3, 2·2-4·8) or physical abuse (30% vs 12%; 3·9, 2·2-7·2). An association with stressful life events preceding onset (OR 2·8, 95% CI 1·4-6·0) was stronger in studies with better methods (interviews; 4·3, 1·4-13·2). Heterogeneity was significant between studies (I 2 21·1-90·7%). 13 studies that specifically ascertained that the participants had not had either severe life events or any subtype of maltreatment all found a proportion of patients with functional neurological disorder reporting no stressor. Stressful life events and maltreatment are substantially more common in people with functional neurological disorder than in healthy controls and patient controls. Emotional neglect had a higher risk than traditionally emphasised sexual and physical abuse, but many cases report no stressors. This outcome supports changes to diagnostic criteria in DSM-5; stressors, although relevant to the cause in many patients, are not a core diagnostic feature. This

  12. Review of casing while drilling technology

    Directory of Open Access Journals (Sweden)

    Pavković Bojan

    2016-01-01

    Full Text Available Conventional drilling methods have been plagued with huge operational and financial challenges, such as cost of purchasing, inspecting, handling, transporting the drill equipment and most importantly, tripping in-and-out of the drill string whenever the Bottom Hole Assembly (BHA needs a replacement, needs of wiper trip or when total depth is reached. The tripping in-and-out of the drill string not only contributes to Non Productive Time (NPT but also leads to well control difficulties including wellbore instability and lost circulation. All this has led Oil and Gas industry, as well as any other engineering industry, to seek for new ways and methods in order to reduce these problems. Thanks to the advances in technical solutions and constant improvements of conventional drilling methods, a new drilling method - casing while drilling has been developed. Casing Drilling encompasses the process of simultaneously drilling and casing a well, using the active casing and thus optimizes the production. This paper presents a review of casing while drilling method (CwD and its practical usage in drilling wells. The comparison of conventional drilling method and casing while drilling is also presented. The CwD method achieves significantly better results than conventional drilling method.

  13. Trachelectomy: A Review of 15 Cases

    International Nuclear Information System (INIS)

    EL-ZOHAIRY, M.A.

    2010-01-01

    To determine the indications and complications of removal of the retained cervical stump (trachelectomy). Material and Methods: Retrospective review of the records of 15 cases of removal of the retained cervical stump performed at the Department of Surgical Oncology NCI Cairo University and Nasser Institute Cairo between January 2005 and December 2009. Results: Fifteen patients were identified with a mean age of 43.1+8.4 years. The indications for subtotal hysterectomy were uterine fibroids, 7 (46.7%), abnormal bleeding, 5 (33.3%), and ovarian mass, 3 (20%) cases. Route of trachelectomy was abdominal in all cases. The indications for trachelectomy were cervical malignancy in 8 (53.3%), residual tumor at the hysterectomy specimen in 3 (20%), and persistent bleeding in 2 (13.3%) cases. The most common concomitant procedures with the trachelectomy were pelvic lymphadenectomy in 11 (73.3%), and oophorectomy in 10 (66.6%) cases. There were no postoperative mortalities. The most common complications were wound infection, 4 (26.6%), and urinary tract infection, 3 (20%). The mean estimated blood loss was 341.0± 82.3 ml. Hospital stay was 7.915.1 days. The most common histological diagnosis was squamous carcinoma 9 cases (60%). The median follow-up period was 16 months. Conclusion: Subtotal hysterectomy carries the risk of developing a stump cancer. Patient agreement is mandatory. Subtotal hysterectomy should be avoided whenever possible in populations with restricted access to screening programs for cancer of the uterine cervix.

  14. Clinical, pathological, and molecular data on desmoplastic/nodular medulloblastoma: case studies and a review of the literature.

    Science.gov (United States)

    Siegfried, Aurore; Bertozzi, Anne Isabelle; Bourdeaut, Franck; Sevely, Annick; Loukh, Najat; Grison, Camille; Miquel, Catherine; Lafon, Delphine; Sevenet, Nicolas; Pietsch, Torsten; Dufour, Christelle; Delisle, Marie-Bernadette

    2016-01-01

    The aim of this study was to better define the clinical and biopathological features of patients with desmoplastic/nodular medulloblastoma (DNMB) and to further characterize this subgroup. 17 children aged 3 years, and residual tumor may also have been an explanation for recurrence.

  15. Interventions to Support Social Interaction in Children with Autism Spectrum Disorders: A Systematic Review of Single Case Studies

    Science.gov (United States)

    Ozuna, Jennifer; Mavridis, Alexis; Hott, Brittany L.

    2015-01-01

    Social interaction is a core deficit in individuals with autism spectrum disorder (ASD). Therefore, parents and teachers need effective interventions to support students with ASD. This synthesis provides a quantitative analysis of single-subject studies that examine interventions to support social interactions in children with ASD. Results suggest…

  16. Comparative study of the second and third generation of gamma nail for trochanteric fractures: review of 218 cases.

    Science.gov (United States)

    Mingo-Robinet, Juan; Torres-Torres, Miguel; Martínez-Cervell, Carmen; Alonso Del Olmo, Juan Antonio; Rivas Laso, Jose A; Aguado-Hernández, Hector; Burón-Alvarez, Isidro

    2015-03-01

    The aim of this study was to compare the complications of the trochanteric gamma nail (TGN) and the Gamma3 Nail (G3), focusing on cutout failure. Retrospective comparative cohort analysis. Level II Teaching Trauma Center academic trauma center. Two hundred eighteen trochanteric fractures with a mean follow-up of 15 months were included in the study. They were treated either with the TGN or the G3 between January 2005 and December 2010. Bivariate, stratified, and logistic regression analysis was conducted to determine the association between cutout and the independent variables. Proximal anterograde nailing with either the TGN or the G3. Patient age, sex, type of intramedullary device, stability fracture pattern, tip-apex distance (TAD), distraction at the fracture site, cervical angle, and cutout. The relative risk (RR) of cutout was 4.71 times higher in the group treated with G3 (P fractures compared with stable fractures was 3.07 (1.01-9.35). In unstable fractures, the RR of cutout was 8.78 times higher in patients with G3 (P 25 mm (P = 0.4). We have not found any relationship between cutout rate and TAD. Only the fracture pattern and the type of implant have shown to be associated with cutout risk. In our study, Gamma3 Nail has higher cutout rates than TGN in unstable fractures. Therapeutic level III. See Instructions for Authors for a complete description of levels of evidence.

  17. Influence of Aquifer Thermal Energy Storage on groundwater quality: A review illustrated by seven case studies from Belgium

    Directory of Open Access Journals (Sweden)

    Mathias Possemiers

    2014-11-01

    New hydrological insights for the region: The results of the analysis of the hydrochemical data confirm that the small temperature differences (ΔT ≤ 10 at which the ATES systems are operating do not influence the concentrations of the main chemical constituents. Mixing of shallow with deeper groundwater during ATES operation, on the other hand, can alter groundwater quality. The results of this study, however, suggest that the groundwater quality changes are rather small, so that there is no immediate risk for the drinking water supply. However, the installation of ATES systems in the vicinity of public drinking water supply well fields should be handled with care, especially in phreatic aquifers.

  18. A critical review on the reporting of surveys in transdisciplinary research: A case study in Information Systems

    Directory of Open Access Journals (Sweden)

    Judy van Biljon

    2011-12-01

    Full Text Available Variability of goals and evolving research methodologies are fundamental characteristics of transdisciplinary research. This integration of research strategies from different fields complicates the evaluation of transdisciplinary research since the variability of goals drives variability of criteria and quality indicators. The aim of this research is to investigate the implications of using research methods across disciplinary boundaries by drilling down into the use of one research strategy in one research context (Information Systems and a related sub-context (Human-Computer Interaction. Surveys with questionnaires as data-capturing tools were selected as an established research method which is widely used in transdisciplinary research. Questionnaires are one of the most established data capturing tools and yet the validity of questionnaire-based findings have often been questioned. The main problem areas have been identified as the sampling of the data, the questionnaire design and the interpretation of the results. This paper looks into questionnaire reporting practices - an essential determinant in the validity and reliability of survey-based research. The field of Information Systems and Human- Computer Interaction has been chosen as the research context. Information Systems research is by nature interdisciplinary in focusing on social and organisational issues regarding the development and use of software in organisations. Human-Computer Interaction studies address the challenges of making computers and computations useful, usable, and universally accessible to humans. Both Information Systems and Human- Computer Interaction studies address complex, heterogeneous, real-world problems, thereby meeting the first criteria to be classified as transdisciplinary research. The research design entails document analysis of papers presented at conferences in Computer Science and Information Systems over a three-year period to identify trends in the

  19. Case Study - Alpha

    Directory of Open Access Journals (Sweden)

    Stephen Leybourne

    2016-11-01

    Full Text Available This case study was developed from an actual scenario by Dr. Steve Leybourne of Boston University.  The case documents the historical evolution of an organization, and has been used successfully in courses dealing with organizational and cultural change, and the utilization of ‘soft skills’ in project-based management. This is a short case, ideal for classroom use and discussion.  The issues are easily accessible to students, and there is a single wide ranging question that allows for the inclusion of many issues surrounding strategic decision-making, and behavioural and cultural change. Alpha was one of the earlier companies in the USA to invest in large, edge-of-town superstores, with plentiful free vehicle parking, selling food and related household products. Alpha was created in the 1950s as a subsidiary of a major publicly quoted retail group.  It started business by opening a string of very large discount stores in converted industrial and warehouse premises in the south of the United States. In the early days shoppers were offered a limited range of very competitively priced products. When Alpha went public in 1981 it was the fourth largest food retailer in the US, selling an ever-widening range of food and non-food products.  Its success continued to be based on high volume, low margins and good value for money, under the slogan of ‘Alpha Price.’

  20. Steam explosion studies review

    International Nuclear Information System (INIS)

    Hwang, Moon Kyu; Kim, Hee Dong

    1999-03-01

    When a cold liquid is brought into contact with a molten material with a temperature significantly higher than the liquid boiling point, an explosive interaction due to sudden fragmentation of the melt and rapid evaporation of the liquid may take place. This phenomenon is referred to as a steam explosion or vapor explosion. Depending upon the amount of the melt and the liquid involved, the mechanical energy released during a vapor explosion can be large enough to cause serious destruction. In hypothetical severe accidents which involve fuel melt down, subsequent interactions between the molten fuel and coolant may cause steam explosion. This process has been studied by many investigators in an effort to assess the likelihood of containment failure which leads to large scale release of radioactive materials to the environment. In an effort to understand the phenomenology of steam explosion, extensive studies has been performed so far. The report presents both experimental and analytical studies on steam explosion. As for the experimental studies, both small scale tests which involve usually less than 20 g of high temperature melt and medium/large scale tests which more than 1 kg of melt is used are reviewed. For the modelling part of steam explosions, mechanistic modelling as well as thermodynamic modelling is reviewed. (author)

  1. Cloacal Prolapse in Raptors: Review of 16 Cases.

    Science.gov (United States)

    Dutton, Thomas A G; Forbes, Neil A; Carrasco, Daniel Calvo

    2016-06-01

    Sixteen cases of cloacal prolapse in raptors were reviewed in this study. Colonic prolapse was the most common presentation (56% of cases). Red-tailed hawks ( Buteo jamaicensis ) were overrepresented, comprising 66% of colonic prolapse cases. In cases of colonic prolapse, postsurgical stricture formation was a commonly identified complication after resection and anastomosis of the colon. A novel technique was used in 2 cases of colonic prolapse, in which sterile, semirigid rubber tubing was placed in the distal colon and removed per-cloaca at the end of the procedure; this facilitated a secure, fluid-tight anastomosis while maintaining sufficient intestinal lumen. Oviductal prolapse (31% of cases) was associated with the most guarded prognosis (40% treatment success). Cloacoliths were treated successfully in 2 birds (13% of cases) by minimally invasive per-cloacal manual removal.

  2. NOx trade. Case studies

    International Nuclear Information System (INIS)

    Jantzen, J.

    2002-01-01

    Some of the questions with respect to the trade of nitrogen oxides that businesses in the Netherlands have to deal with are dealt with: should a business buy or sell rights for NOx emission; which measures must be taken to reduce NOx emission; how much must be invested; and how to deal with uncertainties with regard to prices. Simulations were carried out with the MOSES model to find the answers to those questions. Results of some case studies are presented, focusing on the chemical sector in the Netherlands. Finally, the financial (dis)advantages of NOx trade and the related uncertainties for a single enterprise are discussed [nl

  3. OBSESSIONS: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-01-01

    Full Text Available Background. Obsessions are one of the most refractory psychiatric disorders. The therapeutic guidelines include a psychopharmacotherapy and the use of behavioural and supportive psychotherapy.Methods. This case report study presents a patient with a homicide obsessions at the forefront and narcissistic personality disorder in background. The use of analytical oriented psychotherapy, which helped to resolve axis-1 symptoms, is described.Conclusions. In the therapy of patients it is important to have the knowledge about the national therapeutic guidelines and critical distance toward them as well. Which therapy to use should be decided by the individual patient’s needs.

  4. The case for addressing gender and power in sexuality and HIV education: a comprehensive review of evaluation studies.

    Science.gov (United States)

    Haberland, Nicole A

    2015-03-01

    Curriculum-based sexuality and HIV education is a mainstay of interventions to prevent STIs, HIV and unintended pregnancy among young people. Evidence links traditional gender norms, unequal power in sexual relationships and intimate partner violence with negative sexual and reproductive health outcomes. However, little attention has been paid to analyzing whether addressing gender and power in sexuality education curricula is associated with better outcomes. To explore whether the inclusion of content on gender and power matters for program efficacy, electronic and hand searches were conducted to identify rigorous sexuality and HIV education evaluations from developed and developing countries published between 1990 and 2012. Intervention and study design characteristics of the included interventions were disaggregated by whether they addressed issues of gender and power. Of the 22 interventions that met the inclusion criteria, 10 addressed gender or power, and 12 did not. The programs that addressed gender or power were five times as likely to be effective as those that did not; fully 80% of them were associated with a significantly lower rate of STIs or unintended pregnancy. In contrast, among the programs that did not address gender or power, only 17% had such an association. Addressing gender and power should be considered a key characteristic of effective sexuality and HIV education programs.

  5. Safety and outcome of treatment of metastatic melanoma using 3-bromopyruvate: a concise literature review and case study.

    Science.gov (United States)

    El Sayed, Salah Mohamed; Mohamed, Walaa Gamal; Seddik, Minnat-Allah Hassan; Ahmed, Al-Shimaa Ahmed; Mahmoud, Asmaa Gamal; Amer, Wael Hassan; Helmy Nabo, Manal Mohamed; Hamed, Ahmed Roshdi; Ahmed, Nagwa Sayed; Abd-Allah, Ali Abdel-Rahman

    2014-07-01

    3-Bromopyruvate (3BP) is a new, promising anticancer alkylating agent with several notable functions. In addition to inhibiting key glycolysis enzymes including hexokinase II and lactate dehydrogenase (LDH), 3BP also selectively inhibits mitochondrial oxidative phosphorylation, angiogenesis, and energy production in cancer cells. Moreover, 3BP induces hydrogen peroxide generation in cancer cells (oxidative stress effect) and competes with the LDH substrates pyruvate and lactate. There is only one published human clinical study showing that 3BP was effective in treating fibrolamellar hepatocellular carcinoma. LDH is a good measure for tumor evaluation and predicts the outcome of treatment better than the presence of a residual tumor mass. According to the Warburg effect, LDH is responsible for lactate synthesis, which facilitates cancer cell survival, progression, aggressiveness, metastasis, and angiogenesis. Lactate produced through LDH activity fuels aerobic cell populations inside tumors via metabolic symbiosis. In melanoma, the most deadly skin cancer, 3BP induced necrotic cell death in sensitive cells, whereas high glutathione (GSH) content made other melanoma cells resistant to 3BP. Concurrent use of a GSH depletor with 3BP killed resistant melanoma cells. Survival of melanoma patients was inversely associated with high serum LDH levels, which was reported to be highly predictive of melanoma treatment in randomized clinical trials. Here, we report a 28-year-old man presented with stage IV metastatic melanoma affecting the back, left pleura, and lung. The disease caused total destruction of the left lung and a high serum LDH level (4,283 U/L). After ethics committee approval and written patient consent, the patient received 3BP intravenous infusions (1-2.2 mg/kg), but the anticancer effect was minimal as indicated by a high serum LDH level. This may have been due to high tumor GSH content. On combining oral paracetamol, which depletes tumor GSH, with 3BP

  6. Spontaneous Arterial Dissection—Risk Factors And Clinical Features: Study Of 70 Cases And Review Of Literature

    Directory of Open Access Journals (Sweden)

    Haniyeh Javanmardi

    2017-02-01

    Full Text Available Dissection refers to a serious condition that begin as a tear or rupture in the inner layers of large vessel wall. Tear allows the blood to surges through the layers, leads to intramural hematoma or an aneurysmal dilatation, either of which can be a source of thromboembolism. Ischemic symptoms in surrounding structures are more often secondary to embolism. Dissections are labeled spontaneous in the absence of major blunt or penetrating trauma. The incidence rates for spontaneous carotid artery dissection have been reported to be 2.5 to 3 per 100,000 population. The average annual incidence for vertebral artery dissection were calculated to be 1 to 1.5 per 100,000. Typical clinical features seen with dissection include unilateral headache, ipsilateral Homer's syndrome, oculosympathetic palsy, prominent neck and facial pain, retinal ischemia, and symptoms of focal brain ischemia due to the site of dissection. The reason of dissection occurrence is still unknown but numerous factors e.g. connective tissue disorders, hyperhomocystinemia, fibromuscular dysplasia, recent infection, etc. may underlie spontaneous or minor trauma dissections. Patients with Spontaneous dissection are more susceptible to developing to stroke and its morbidity and mortality.     In this retrospective study, we evaluate the clinical features, risk factors, treatment and outcome of spontaneous dissection in 70 patients (31 female and 39 male, referred to Namazi hospital between September 2012 and September 2016. The diagnosis of arterial dissection was established by qualified physicians according to radiological and clinical features. Patients with traumatic dissection and a history of major or minor head and neck injury were excluded. Subjects were observed for multiple risk factors such as age dependent risk factors, family history of venous thrombosis, history of trauma, coagulopathies, infectious diseases, systemic disorders, arterio-venous malformations and

  7. Silent Sinus Syndrome: A Retrospective Review of 11 Cases

    Directory of Open Access Journals (Sweden)

    Karima DARGHAL

    2014-06-01

    Full Text Available Objective: The purpose of this study is to describe the clinical and radiological features of SSS, and to review therapeutic possibilities and their outcomes.Patients and Methods: Retrospective observational case series in the department of Arthur Vernes Institute between Mars 2007 and  Novembre 2012. Clinical records, including ophthalmology and otolaryngology evaluations as well as computed tomography scans and operative reports, were carefully examined. A literature review for relevant studies was performed to examine similar cases.Results: Eleven cases of  SSS were identified. Nine men and two women (sex ratio 4.5, aged between 23 and 54 years (mean, 30 years. there was 3 to 4 mm enophthalmos in 10 cases (90.9%, and hypoglobus in all cases, with no effect on visual function. In all 11 cases, the maxillary roof (orbital floor was drawn downwards, and the one or more walls of the maxilla were concave. In 4 cases septal deviation was present. 8 patients (72.7% underwent endoscopic sinus surgery, while 3 refused it. Septoplasty was performed in 4 cases (36.3%.Conclusion: The silent sinus syndrome is a rare entity. It mainly presents as unilateral enophthalmos in younger people and has very characteristic clinical and radiologic signs.This case series reports our diagnostic and therapeutic experience with this syndrome.

  8. Lemierre syndrome: two cases and a review.

    Science.gov (United States)

    Syed, Mohammed Iqbal; Baring, David; Addidle, Michael; Murray, Craig; Adams, Calum

    2007-09-01

    Lemierre syndrome is usually caused by an acute oropharyngeal infection in previously healthy young adults, resulting in thrombophlebitis of the internal jugular vein, leading to metastatic septic embolization and bacteraemia. The usual organism is Fusobacterium necrophorum. Lemierre syndrome, not so long ago labeled as the "forgotten disease," is on the rise. Today with increasing antibiotic-resistant organisms, and decreasing awareness of the syndrome, subsequent re-emergence of this "forgotten disease" is becoming more common in clinical settings. Lemierre syndrome has significant morbidity. Cranial nerve complications associated with the condition have been increasingly diagnosed in the last few years. Looking back at literature on Lemierre syndrome, there have been review articles in medical and microbiology journals but rarely in otolaryngology journals. By presenting our cases we demonstrate the diverse presentations and severity of the illness. A review of the literature and a case report on two cases seen in our institution in the last year are presented. Each of these had varied presentations and neurologic complications-one developed 9th to 12th cranial nerve palsies and Horner syndrome, which have not been described in previous literature, and the other developed polyneuropathy and a frontal lobe infarct among other multisystem complications. Diagnosis of Lemierre syndrome is not always straightforward as clinical features are variable and blood cultures are often negative. Awareness of the syndrome and a high degree of suspicion are needed.

  9. Functioning lipoadenoma of the parathyroid: Case report and literature review

    International Nuclear Information System (INIS)

    Bleiweiss, I.J.; Harpaz, N.; Strauchen, J.A.; Wagner, R.; Biller, H.F.

    1989-01-01

    Lipoadenoma of the parathyroid gland is a rare histologic variant of parathyroid adenoma that is usually functional and associated with clinical hyperparathyroidism. We report a case in which a radiolabeled thallium scan failed to demonstrate evidence of an adenoma, presumably because of the tumor's high fat content. The literature concerning this entity is reviewed. To our knowledge there are no other reported cases in which parathyroid scanning was used in diagnostic studies of parathyroid lipoadenoma. 15 references

  10. Scrotal dog bite: unusual case and review of pediatric literature.

    Science.gov (United States)

    Bertozzi, M; Prestipino, M; Nardi, N; Falcone, F; Appignani, A

    2009-09-01

    Animal bites to human external genitalia are rare. Only a few cases of scrotal dog bite in children have been reported. We present an additional specific case of a scrotal dog bite in a child because the lesion and its repair have not been previously reported in published pediatric studies. A traumatic resection of the right testicular vas deferens was repaired by microsurgical vasoepididymal anastomosis. A review of the published data was also performed to analyze the management of scrotal dog bite lesions.

  11. Vertebral column aggressive osteoblastoma: two cases report and literature review

    International Nuclear Information System (INIS)

    Sabedotti, Ismail Fernando; Sabedotti, Valdir

    2007-01-01

    Osteoblastoma is a bone neoplasy that in most circumstances present a low aggressive aspect on radiographic studies, but in some cases may acquire an aggressive pattern, rupturing the bone cortex and invading nearby structures. Most cases occur on the vertebral column, especially at the posterior arch and occasionally involving the vertebral body. Differential diagnosis of the aggressive form is made with osteosarcomas. This review reports two cases of osteoblastomas involving vertebral column, with an aggressive pattern on radiologic studies, and their histologic confirmation. (author)

  12. CAMERON LESIONS: LITERATURE REVIEW AND CASE PRESENTATION

    Directory of Open Access Journals (Sweden)

    V. V. Vasilenko

    2016-01-01

    Full Text Available Cameron syndrome is the ulcerative or erosive lesions of mucosal layer at the sac of hiatal hernia which can cause chronic occult or overt bleeding and iron-deficiency anemia. Hiatal hernia is a relatively frequent finding, which is in most cases asymptomatic or manifested by dyspeptic symptoms of varying severity. Despite of being a very important association of hiatal hernia Cameron syndrome is not widely represented in medical literature. That`s the reason of a lack of awareness among physicians, surgeons and endoscopists about that pathology. Cameron lesions are significant pathology because they can become a source of chronic occult as well as an acute life-threatening bleeding. Those lesions of upper gastrointestinal tract are often misinterpreted or overlooked during standard diagnostic procedures. It can lead to the misdiagnosis and false ways of treatment. The review focuses on the pathogenesis, main diagnostic problems and treatment options of that pathology. The diagnostics of the Cameron syndrome is difficult because sometimes the lesions can`t be seen on upper gastrointestinal tract endoscopy. The review describes the criteria by which the physician may suspect Cameron syndrome when endoscopy results are not certain. Clinical case represents an important problem which is often faced by the doctors — the severe iron-deficiency anemia refractory to the medication and blood transfusions in the patients with Cameron lesions. It`s very important for doctor to be aware of that complication to include Cameron syndrome into the diagnostic search for the sources of persistent blood loss. Cameron lesions can be asymptomatic as well as be manifested in the form of severe chronic anemia. And that`s the reason why there are an important issue about the proper treatment which have to be provided in each case. The review describes the effectiveness of different treatment options and makes the conclusion about the principles on which doctor can

  13. Emphysematous gastritis: case report and literature review

    International Nuclear Information System (INIS)

    Shipman, P.J.; Drury, P.

    2001-01-01

    Emphysematous gastritis is a rare form of gastritis that results from infection of the stomach wall by gas-forming organisms. Diagnosis of this commonly fatal condition rests on radiological demonstration of gas within the stomach wall. This can be observed on plain radiographs or CT scans of the abdomen. Only by prompt diagnosis and treatment can mortality be avoided. A new case of empysematous gastritis, diagnosed on CT scan by the demonstration of both intramural and portal venous gas, is presented and the literature is reviewed. Copyright (2001) Blackwell Science Pty Ltd

  14. Surfer's myelopathy: case report and review.

    Science.gov (United States)

    Karabegovic, Amna; Strachan-Jackman, Shirley; Carr, David

    2011-09-01

    Nontraumatic spinal cord injury from surfing is a new entity first described in 2004 and likely of ischemic etiology. We report the case of a 25-year-old man who presented to the emergency department with a 2-week history of lower extremity weakness after surfing in Indonesia. The patient reported developing low back pain, lower extremity weakness, sensory changes, and urinary retention shortly after his first surfing lesson. The patient was subsequently diagnosed with surfer's myelopathy. The purpose of this report is to review the clinical presentation, etiology, risk factors, and management of this increasingly described entity.

  15. MR imaging of clear cell sarcoma (malignant melanoma of the soft parts): a multicenter correlative MRI-pathology study of 21 cases and literature review

    International Nuclear Information System (INIS)

    Beuckeleer, L.H. de; Schepper, A.M. de; Vandevenne, J.E.; Bloem, J.L.; Davies, A.M.; Oudkerk, M.; Hauben, E.; Marck, E. van; Somville, J.; Vanel, D.; Steinbach, L.S.; Guinebretiere, J.M.; Hogendoorn, P.C.W.; Mooi, W.J.; Verstraete, K.; Zaloudek, C.; Jones, H.

    2000-01-01

    Objective. To evaluate MR imaging and pathology findings in order to define the characteristic features of clear cell sarcoma of the soft tissues (malignant melanoma of the soft parts).Design and patients. MR examinations of 21 patients with histologically proven clear cell sarcoma of the musculoskeletal system were retrospectively reviewed and assessed for shape, homogeneity, delineation, signal intensities on T1- and T2-weighted images, contrast enhancement, relationship with adjacent fascia or tendon, secondary bone involvement, and intratumoral necrosis. In 19 cases the pathology findings were available for review and for a comparative MR-pathology study.Results. On T1-weighted images, lesions were isointense (n=3), hypointense (n=7) or slightly hyperintense to muscle (n=11). Immunohistochemical examination was performed in 17 patients. All 17 specimens showed positivity for HMB-45 antibody. In nine of 11 lesions with slightly increased signal intensity on T1-weighted images, a correlative MR imaging-pathology study was possible. All nine were positive to HMB-45 antibody.Conclusions. Clear cell sarcoma of the musculoskeletal system often has a benign-looking appearance on MR images. In up to 52% of patients, this lesion with melanocytic differentiation has slightly increased signal intensity on T1-weighted images compared with muscle. As the presence of this relative higher signal intensity on T1-weighted images is rather specific for tumors displaying melanocytic differentiation, radiologists should familiarize themselves with this rare entity and include it in their differential diagnosis when confronted with a well-defined, homogeneous, strongly enhancing mass with slightly higher signal intensity compared with muscle on native T1-weighted images. (orig.)

  16. Cerebral cysticercosis: a review of 42 cases

    International Nuclear Information System (INIS)

    Machado, M.A.; Costa, G.

    1992-01-01

    Forty-two cases of cysticercosis involving the central nervous system using computed tomography are reviewed. The types of involvement were classified according to an evolutionary phase of the larva and its tomographic appearance. Four main types were identified: Type I - seven patients - cysts of several sizes with discrete or no enhancement which correspond to young cysticerci; Type II - nine patients - cystic lesions with ring enhancement with dense walls representing the initial regressive phase of the parasite associated to an adjacent oedema; Type III - three patients - calcifications, mainly intraparenchymatous, presenting enhancement in the periphery without associated oedema; Type IV - two patients - calcifications with no oedema nor enhancement, signifying a residual lesion produced by the parasite. Multiple lesions were present in 26 cases and about 50% of all patients suffered combined forms of neuro cysticercosis. (author)

  17. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    Science.gov (United States)

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  18. A Case Study of Peer Review Practices of Four Adolescent English Language Learners in Face-to-Face and Online Contexts

    Science.gov (United States)

    Vorobel, Oksana

    2013-01-01

    Peer review is a complex collaborative activity, which may engage English language learners in reading, writing, listening, and speaking and carry many potential benefits for their language learning (Hu, 2005). While many research studies focused on peer review practices of adult language learners in academic settings in the USA or abroad in…

  19. Case Study 1

    DEFF Research Database (Denmark)

    Kolbæk, Ditte

    2013-01-01

    This article focuses on measurements on Proactive Reviews - a method of organizational learing. While this article highlights the difficulties of measuring the ROI of knowledge initiatives, it also shows how Proactive Reviews can be measured and aligned with the business strategy....

  20. Tubercular prosthetic joint infection: two case reports and literature review.

    Science.gov (United States)

    Veloci, Sara; Mencarini, Jessica; Lagi, Filippo; Beltrami, Giovanni; Campanacci, Domenico Andrea; Bartoloni, Alessandro; Bartalesi, Filippo

    2018-02-01

    Tubercular prosthetic joint infection (TB-PJI) is an uncommon complication. Lack of evidence of systemic tuberculosis and clinical suspicion could bring a delay in the time of the diagnosis. The aims of this study are to underline the importance of awareness and suspicion of mycobacterial infection in the differential diagnosis in PJI and to evaluate the appropriateness of different therapeutic options. Case report and literature review. We report two cases of TB-PJI after total knee arthroplasty in Caucasian patients without prior history of tubercular disease or exposure. In both cases, the diagnosis was obtained years after the onset of symptoms. Despite that, both patients improved during antitubercular treatment (a four-drug regimen consisting of rifampicin, isoniazid, ethambutol, and pyrazinamide for 2 months, followed by rifampicin and isoniazid). Moreover, after an 18-month course of treatment, there was no need for surgical therapy. The result of the literature review allows us to identify 64 cases of TB-PJI. Many differences in both medical and surgical management have been found, among those reviewed cases. Considering our experience and the literature review, we recommend considering a conservative approach (debridement and adequate antituberculous chemotherapy) as a suitable and safe option.

  1. The post-closure radiological safety case for a spent fuel repository in Sweden - An international peer review of the SKB license-application study of March 2011

    International Nuclear Information System (INIS)

    2012-01-01

    Sweden is at the forefront among countries developing plans for a deep geological repository of highly radioactive waste. There is no such repository in operation yet worldwide, but Sweden, Finland and France are approaching the licensing stage. At the request of the Swedish government, the NEA organised an international peer review of the post-closure radiological safety case produced by the Swedish Nuclear Fuel and Waste Management Company (SKB) in support of the application for a general licence to construct and operate a spent nuclear fuel geological repository in the municipality of Oesthammar. The purpose of the review was to help the Swedish government, the public and relevant organisations by providing an international reference regarding the maturity of SKB's spent fuel disposal programme vis-a-vis best practices in long-term disposal safety and radiological protection. The International Review Team (IRT) consisted of ten international specialists, who were free of conflict of interest with the SKB and brought complementary expertise to the review. This report provides the background and findings of the international peer review. The review's findings are presented at several levels of detail in order to be accessible to both specialist and non-specialist readers

  2. Obsessive-Compulsive Disorder and quality of life outcomes: protocol for a systematic review and meta-analysis of cross-sectional case-control studies

    Directory of Open Access Journals (Sweden)

    Anna Coluccia

    2015-06-01

    Full Text Available Background. Obsessive-compulsive Disorder (OCD is a chronic disabling psychological condition, which can severely affect quality of life (QOL. Growing interest has been dedicated to assessing which domains of QOL are more severely affected in patients with OCD. However, research yielded conflicting findings. Investigating QOL in OCD could suggest the need for integration of interventions aimed at improving those specific domains more severely impaired by obsessions and compulsions.Methods. We will conduct a systematic review of cross-sectional case-control studies according to PRISMA guidelines, where patients with a primary OCD diagnosis were compared on QOL outcomes with healthy controls. Primary objectives will be to examine differences in QOL outcomes between patients with OCD and healthy controls, and to assess which QOL domains are more severely impaired in patients compared with controls, particularly subjective well-being, social and interpersonal functioning, work functioning, and family functioning. Subsequently, the study will investigate potential moderators of QOL in OCD, including participants characteristics (age, sex, presence of comorbid personality disorders, OCD symptom severity, severity of concurrent depressive symptoms, duration of OCD symptoms, and generational cohort, and study characteristics (date of publication and methodological quality of the studies. Online databases will be searched (PsycINFO, PubMED, Science Direct, Cinahl, Biological Abstracts, Psyclit, Embase, The Cochrane Central Register of Controlled Trials, and Google Scholar. To locate unpublished records, conference abstracts, doctoral dissertations and theses will be handsearched, and experts will be contacted. Statistical analyses will be performed though random effect model meta-analysis. Risk of bias assessments will be conducted using the instrument Methodological Index for Non-Randomized Studies.

  3. Case-only designs in pharmacoepidemiology: a systematic review.

    Directory of Open Access Journals (Sweden)

    Sandra Nordmann

    Full Text Available BACKGROUND: Case-only designs have been used since late 1980's. In these, as opposed to case-control or cohort studies for instance, only cases are required and are self-controlled, eliminating selection biases and confounding related to control subjects, and time-invariant characteristics. The objectives of this systematic review were to analyze how the two main case-only designs - case-crossover (CC and self-controlled case series (SCCS - have been applied and reported in pharmacoepidemiology literature, in terms of applicability assumptions and specificities of these designs. METHODOLOGY/PRINCIPAL FINDINGS: We systematically selected all reports in this field involving case-only designs from MEDLINE and EMBASE up to September 15, 2010. Data were extracted using a standardized form. The analysis included 93 reports 50 (54% of CC and 45 (48% SCCS, 2 reports combined both designs. In 12 (24% CC and 18 (40% SCCS articles, all applicable validity assumptions of the designs were fulfilled, respectively. Fifty (54% articles (15 CC (30% and 35 (78% SCCS adequately addressed the specificities of the case-only analyses in the way they reported results. CONCLUSIONS/SIGNIFICANCE: Our systematic review underlines that implementation of CC and SCCS designs needs to be more rigorous with regard to validity assumptions, as well as improvement in results reporting.

  4. Goiania incident case study

    International Nuclear Information System (INIS)

    Petterson, J.S.

    1988-06-01

    The reasons for wanting to document this case study and present the findings are simple. According to USDOE technical risk assessments (and our own initial work on the Hanford socioeconomic study), the likelihood of a major accident involving exposure to radioactive materials in the process of site characterization, construction, operation, and closure of a high-level waste repository is extremely remote. Most would agree, however, that there is a relatively high probability that a minor accident involving radiological contamination will occur sometime during the lifetime of the repository -- for example, during transport, at an MRS site or at the permanent site itself during repacking and deposition. Thus, one of the major concerns of the Yucca Mountain Socioeconomic Study is the potential impact of a relatively minor radiation-related accident. A large number of potential impact of a relatively minor radiation-related accident. A large number of potential accident scenarios have been under consideration (such as a transportation or other surface accident which results in a significant decline in tourism, the number of conventions, or the selection of Nevada as a retirement residence). The results of the work in Goiania make it clear, however, that such a significant shift in established social patterns and trends is not likely to occur as a direct outcome of a single nuclear-related accident (even, perhaps, a relatively major one), but rather, are likely to occur as a result of the enduring social interpretations of such an accident -- that is, as a result of the process of understanding, communicating, and socially sustaining a particular set of associations with respect to the initial incident

  5. FMCT verification: Case studies

    International Nuclear Information System (INIS)

    Hui Zhang

    2001-01-01

    Full text: How to manage the trade-off between the need for transparency and the concern about the disclosure of sensitive information would be a key issue during the negotiations of FMCT verification provision. This paper will explore the general concerns on FMCT verification; and demonstrate what verification measures might be applied to those reprocessing and enrichment plants. A primary goal of an FMCT will be to have the five declared nuclear weapon states and the three that operate unsafeguarded nuclear facilities become parties. One focus in negotiating the FMCT will be verification. Appropriate verification measures should be applied in each case. Most importantly, FMCT verification would focus, in the first instance, on these states' fissile material production facilities. After the FMCT enters into force, all these facilities should be declared. Some would continue operating to produce civil nuclear power or to produce fissile material for non- explosive military uses. The verification measures necessary for these operating facilities would be essentially IAEA safeguards, as currently being applied to non-nuclear weapon states under the NPT. However, some production facilities would be declared and shut down. Thus, one important task of the FMCT verifications will be to confirm the status of these closed facilities. As case studies, this paper will focus on the verification of those shutdown facilities. The FMCT verification system for former military facilities would have to differ in some ways from traditional IAEA safeguards. For example, there could be concerns about the potential loss of sensitive information at these facilities or at collocated facilities. Eventually, some safeguards measures such as environmental sampling might be seen as too intrusive. Thus, effective but less intrusive verification measures may be needed. Some sensitive nuclear facilities would be subject for the first time to international inspections, which could raise concerns

  6. Tympanoplasty Outcomes: A Review of 789 Cases

    Directory of Open Access Journals (Sweden)

    Shabbir Indorewala

    2015-03-01

     Results: A total of 789 tympanoplasties were reviewed, with a male-to-female ratio of 1:1.1. In total, 91% and 9% of tympanoplasties were performed without and with mastoidectomy, respectively. Complete graft take was observed in 98.6% of cases. Approximately 25% of patients had an air-bone gap (ABG gap ≤20dB pre-operatively, increasing to 75.6% post-operatively. ABG closure improved from 0.8% to 46.7%. Mean ABG improved from 26.30 ±8.1dB pre-operatively to 14 ± 10.41dB post- operatively (t=28.7, P

  7. Final report on case studies

    DEFF Research Database (Denmark)

    Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann

    2012-01-01

    Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, case...... studies attempt to provide as a complete an understanding of a (complex) phenomenon as possible. Within the AEGIS project, survey and case study research are complementary. They are complementary in the sense that the former can provide more generalizable evidence on a phenomenon in terms of cross......-sectional data, while the latter can provide more in-depth (qualitative) understanding on specific issues. In systematically examining the case studies, however, this report goes beyond a typical single case study. Here we provide a synthesis of 86 case studies. Multiple case studies, following similar focus...

  8. 425 Case study

    African Journals Online (AJOL)

    Marinda

    Anaesthesia management of acute aortic dissection type B in ... of a severe, constant abdominal and chest pain radiating to the ... Continuous spinal anaesthesia was induced ... these cases surgical intervention is critical.1,2 Type B of AAD is.

  9. Recreational and occupational field exposure to freshwater cyanobacteria – a review of anecdotal and case reports, epidemiological studies and the challenges for epidemiologic assessment

    Directory of Open Access Journals (Sweden)

    Webb Penelope M

    2006-03-01

    Full Text Available Abstract Cyanobacteria are common inhabitants of freshwater lakes and reservoirs throughout the world. Under favourable conditions, certain cyanobacteria can dominate the phytoplankton within a waterbody and form nuisance blooms. Case reports and anecdotal references dating from 1949 describe a range of illnesses associated with recreational exposure to cyanobacteria: hay fever-like symptoms, pruritic skin rashes and gastro-intestinal symptoms are most frequently reported. Some papers give convincing descriptions of allergic reactions while others describe more serious acute illnesses, with symptoms such as severe headache, pneumonia, fever, myalgia, vertigo and blistering in the mouth. A coroner in the United States found that a teenage boy died as a result of accidentally ingesting a neurotoxic cyanotoxin from a golf course pond. This death is the first recorded human fatality attributed to recreational exposure to cyanobacteria, although uncertainties surround the forensic identification of the suspected cyanotoxin in this case. We systematically reviewed the literature on recreational exposure to freshwater cyanobacteria. Epidemiological data are limited, with six studies conducted since 1990. Statistically significant increases in symptoms were reported in individuals exposed to cyanobacteria compared to unexposed counterparts in two Australian cohort studies, though minor morbidity appeared to be the main finding. The four other small studies (three from the UK, one Australian did not report any significant association. However, the potential for serious injury or death remains, as freshwater cyanobacteria under bloom conditions are capable of producing potent toxins that cause specific and severe dysfunction to hepatic or central nervous systems. The exposure route for these toxins is oral, from ingestion of recreational water, and possibly by inhalation. A range of freshwater microbial agents may cause acute conditions that present with

  10. Criteria Based Case Review: The Parent Child Psychological Support Program

    Directory of Open Access Journals (Sweden)

    Pilar Bujia-Couso

    2010-01-01

    Full Text Available The Parent Child Psychological Support Program (PCPS was established in an area of South West Dublin in 2001. Since then until May 2008 it has offered its services to over 700 children and their parents. This preventative, parenting support service is available to all parents of children aged 3 to 18 months within its catchment area. During periodical visits, the infant’s development and growth are measured and parents receive specific information about their child’s progress. Parents are empowered in their parenting practices, thus promoting consistency and synchrony in parent-child interaction. Between 2001 and 2006, 538 parents and their infants participated in the Program. Out of these cases, 130 (24.16% were considered to require additional support and were included in the Monthly Meeting Case Review (MM based on initial concerns The aims of this study were: 1. to review the first five years of MM cases and to explore the socio-demographic profile of the MM cases in comparison to those not in need of additional support (non-MM and 2. To illustrate an approach to refining the case review process which will inform practice and provides the service providers with better understanding of the early detection of parent-child relation difficulties. In pursuing this goal the cases screened over five years of practice were analyzed to explore the structure of the different factors by using statistical techniques of data reduction, i.e. factor analysis. The results showed that the MM group differed on several socio-demographic dimensions from the non-MM group and there was a four factor structure underlying the case review decision process. Implications of this research are discussed.

  11. [Ataxia telangiectasia: review of 13 new cases].

    Science.gov (United States)

    Valbuena, O; Póo, P; Campistol, J; Vernet, A; Fernández-Alvarez, E; Sierra, I; Gean, E

    1996-01-01

    We report the review of 13 patients who were diagnosed of ataxia telangiectasia before 6 years of age. All of them manifested cerebelous ataxia, oculocutaneus telangiectasias (11), sinopulmonary infections (9), dystonia (9), oculomotor apraxia (9) and Burkitt linfoma (1). We analyse the most common presentation of the disease in early stages and the complementary studies performed. The prompt diagnosis allow us a better control of infections, malignant process and finally the possibility of genetic counseling.

  12. Neurobrucellosis: three case reports and literature review

    Directory of Open Access Journals (Sweden)

    WANG Jia-wei

    2013-01-01

    Full Text Available Background Brucellosis is a multisystem disease which may present with a broad spectrum of clinical manifestations and complications. Neurobrucellosis is an uncommon complication of this infection. This article aims to present clinical manifestations and to discuss the clinical features and management of 3 neurobrucellosis cases. Methods The diagnosis, treatment, laboratory results and accessory examination findings of 3 patients with neurobrucellosis between August 2010 and March 2012 were retrospectively analyzed, and relevant literature was reviewed. Results All the 3 cases had definite history of exposure to epidemic areas or infectious diseases, and history of being infected with Brucella by drinking raw milk. During the screening because of fever for reasons unknown, they were proved to be infected with Brucella by etiological or serological tests. Initial clinical manifestations consisted of fever and headache, with meningitis symptoms and signs, spondylitis, uroschesis and constipation (which might be caused by lumbosacral nerve root lesion, or neurological manifestations in auditory nerve and abducent nerve, such as hearing loss and diplopia. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Conclusion Neurobrucellosis presents with various clinical signs and symptoms, and is often accompanied by systemic infection. Brucellosis should be kept in mind during the screening of fever for reasons unknown, and be differentiated from Mycobacterium tuberculosis infection. The combined treatment by antibotics of different pharmacological mechanisms with full dose and long range is effective, and the prognosis is favorable.

  13. Collaborative Assessment: Middle School Case Study

    Science.gov (United States)

    Parkison, Paul T.

    2014-01-01

    Utilizing a participant observer research model, a case study of the efficacy of a collaborative assessment methodology within a middle school social studies class was conducted. A review of existing research revealed that students' perceptions of assessment, evaluation, and accountability influence their intrinsic motivation to learn. A…

  14. Prader-Willi Disease: A Case Study.

    Science.gov (United States)

    Forbus, William R., III

    A case study focuses on the characteristics and physical management of a 15-year-old with Prader-Willi Syndrome, a birth defect associated with hypotonia, insatiable appetite, hypogonadism, central nervous system dysfunction, and abnormal growth and development . A literature review addresses studies dealing with behavior modification of obesity…

  15. Splenic Abscesses: Review of 29 Cases

    Directory of Open Access Journals (Sweden)

    I-Shun Chiang

    2003-10-01

    Full Text Available Splenic abscess is an unusual and potentially life-threatening disease. Due to the nonspecific clinical picture, it remains a diagnostic challenge. Splenic abscess should be suspected in febrile patients with left upper quadrant tenderness and leukocytosis, and diagnosis confirmed based mostly on imaging studies, microbiologic and/or pathologic evidence, or by response to antibiotic or antifungal treatment. We present 29 cases of splenic abscess treated in our hospital from 1990 to 2001. There were 18 male patients (62% and 11 female patients (38%. Ages ranged from 4 to 85 years, with a median of 44 years. There were five pediatric patients (17% and 24 adults (83%. The most common associated condition was leukemia. Most patients were immunocompromised (72%. The more common signs and symptoms were fever (90%, chills (41%, abdominal pain (31%, and leukocytosis (38%. Ultrasonography of the abdominal cavity was positive in 27 cases (93%; computerized tomography or magnetic resonance imaging was used in 26 patients (90% and was positive in all patients. The abscess was solitary in 21 cases (72% and multiple in eight cases (28%. Positive blood cultures were found in only seven patients (24%. According to the literature, the treatment of choice is still splenectomy, but in our study, the success rate of 75% with antibiotics alone indicates that antibiotic therapy should be considered an important alternative treatment modality in patients not suitable for percutaneous drainage and splenectomy.

  16. Case-mix adjustment for diabetes indicators: a systematic review.

    Science.gov (United States)

    Calsbeek, Hiske; Markhorst, Joekle G M; Voerman, Gerlienke E; Braspenning, Jozé C C

    2016-02-01

    Case-mix adjustment is generally considered indispensable for fair comparison of healthcare performance. Inaccurate results are also unfair to patients as they are ineffective for improving quality. However, little is known about what factors should be adjusted for. We reviewed case-mix factors included in adjustment models for key diabetes indicators, the rationale for their inclusion, and their impact on performance. Systematic review. This systematic review included studies published up to June 2013 addressing case-mix factors for 6 key diabetes indicators: 2 outcomes and 2 process indicators for glycated hemoglobin (A1C), low-density lipoprotein cholesterol, and blood pressure. Factors were categorized as demographic, diabetes-related, comorbidity, generic health, geographic, or care-seeking, and were evaluated on the rationale for inclusion in the adjustment models, as well as their impact on indicator scores and ranking. Thirteen studies were included, mainly addressing A1C value and measurement. Twenty-three different case-mix factors, mostly demographic and diabetes-related, were identified, and varied from 1 to 14 per adjustment model. Six studies provided selection motives for the inclusion of case-mix factors. Marital status and body mass index showed a significant impact on A1C value. For the other factors, either no or conflicting associations were reported, or too few studies (n ≤ 2) investigated this association. Scientific knowledge about the relative importance of case-mix factors for diabetes indicators is emerging, especially for demographic and diabetes-related factors and indicators on A1C, but is still limited. Because arbitrary adjustment potentially results in inaccurate quality information, meaningful stratification that demonstrates inequity in care might be a better guide, as it can be a driver for quality improvement.

  17. Segmented and sectional orthodontic technique: Review and case report

    Directory of Open Access Journals (Sweden)

    Tarek El-Bialy

    2013-01-01

    Full Text Available Friction in orthodontics has been blamed for many orthodontic-related problems in the literature. Much research as well as research and development by numerous companies have attempted to minimize friction in orthodontics. The aim of the present study was to critically review friction in orthodontics and present frictionless mechanics as well as differentiate between segmented arch mechanics (frictionless technique as compared to sectional arch mechanics. Comparison of the two techniques will be presented and cases treated by either technique are presented and critically reviewed regarding treatment outcome and anchorage preservation/loss.

  18. A case study review of technical and technology issues for transition of a utility load management program to provide system reliability resources in restructured electricity markets

    Energy Technology Data Exchange (ETDEWEB)

    Weller, G.H.

    2001-07-15

    Utility load management programs--including direct load control and interruptible load programs--were employed by utilities in the past as system reliability resources. With electricity industry restructuring, the context for these programs has changed; the market that was once controlled by vertically integrated utilities has become competitive, raising the question: can existing load management programs be modified so that they can effectively participate in competitive energy markets? In the short run, modified and/or improved operation of load management programs may be the most effective form of demand-side response available to the electricity system today. However, in light of recent technological advances in metering, communication, and load control, utility load management programs must be carefully reviewed in order to determine appropriate investments to support this transition. This report investigates the feasibility of and options for modifying an existing utility load management system so that it might provide reliability services (i.e. ancillary services) in the competitive markets that have resulted from electricity industry restructuring. The report is a case study of Southern California Edison's (SCE) load management programs. SCE was chosen because it operates one of the largest load management programs in the country and it operates them within a competitive wholesale electricity market. The report describes a wide range of existing and soon-to-be-available communication, control, and metering technologies that could be used to facilitate the evolution of SCE's load management programs and systems to provision of reliability services. The fundamental finding of this report is that, with modifications, SCE's load management infrastructure could be transitioned to provide critical ancillary services in competitive electricity markets, employing currently or soon-to-be available load control technologies.

  19. Testicular Microlithiasis: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Savić Goran

    2017-09-01

    Full Text Available Testicular microlithiasis is a condition characterized by the ultrasonographic findings with multiple microliths, with the prevalence of 0.6% to 9%. This is a condition of unknown etiology; however, in many cases it may be associated with cryptorchidism, Klinefelter syndrome, Down syndrome, varicocele, testicular torsion and male pseudohermaphroditism. Many retrospective studies point to the association between testicular microlithiasis and testicular cancer.

  20. What physicians reason about during admission case review.

    Science.gov (United States)

    Juma, Salina; Goldszmidt, Mark

    2017-08-01

    Research suggests that physicians perform multiple reasoning tasks beyond diagnosis during patient review. However, these remain largely theoretical. The purpose of this study was to explore reasoning tasks in clinical practice during patient admission review. The authors used a constant comparative approach-an iterative and inductive process of coding and recoding-to analyze transcripts from 38 audio-recorded case reviews between junior trainees and their senior residents or attendings. Using a previous list of reasoning tasks, analysis focused on what tasks were performed, when they occurred, and how they related to the other tasks. All 24 tasks were observed in at least one review with a mean of 17.9 (Min = 15, Max = 22) distinct tasks per review. Two new tasks-assess illness severity and patient decision-making capacity-were identified, thus 26 tasks were examined. Three overarching tasks were identified-assess priorities, determine and refine the most likely diagnosis and establish and refine management plans-that occurred throughout all stages of the case review starting from patient identification and continuing through to assessment and plan. A fourth possible overarching task-reflection-was also identified but only observed in four instances across three cases. The other 22 tasks appeared to be context dependent serving to support, expand, and refine one or more overarching tasks. Tasks were non-sequential and the same supporting task could serve more than one overarching task. The authors conclude that these findings provide insight into the 'what' and 'when' of physician reasoning during case review that can be used to support professional development, clinical training and patient care. In particular, they draw attention to the iterative way in which each task is addressed during a case review and how this finding may challenge conventional ways of teaching and assessing clinical communication and reasoning. They also suggest that further research

  1. Spinal Accessory Nerve Duplication: A Case Report and Literature Review

    OpenAIRE

    Papagianni, Eleni; Kosmidou, Panagiota; Fergadaki, Sotiria; Pallantzas, Athanasios; Skandalakis, Panagiotis; Filippou, Dimitrios

    2018-01-01

    Aim of the present study is to expand our knowledge of the anatomy of the 11th cranial nerve and discuss the clinical importance and literature pertaining to accessory nerve duplication. We present one case of duplicated spinal accessory nerve in a patient undergoing neck dissection for oral cavity cancer. The literature review confirms the extremely rare diagnosis of a duplicated accessory nerve. Its clinical implication is of great importance. From this finding, a further extension to our k...

  2. Constitutional trisomy 8 mosaicism syndrome: case report and review.

    Science.gov (United States)

    Udayakumar, Achandira M; Al-Kindy, Adila

    2013-12-01

    Trisomy 8 mosaicism (Warkany syndrome) is a rare viable condition with variable phenotypes, ranging from mild dysmorphic features to severe malformations. Karyotyping and fluorescence in-situ hybridization potentially help detecting this low mosaic clone to confirm the diagnosis of patients with classical and unusual clinical presentations. This report reviews few previous cases to describe our case - a boy who had trisomy 8 mosaicism with severe dysmorphic features, born to a consanguineous Arabic couple. This study concludes that careful cytogenetic diagnoses of trisomy 8 mosaicism is essential for appropriate management and follow up of this rare disorder.

  3. Sarcoidosis: Case Presentation and Literature Review

    Directory of Open Access Journals (Sweden)

    Dayana Alomá Fortún

    2016-09-01

    Full Text Available Sarcoidosis is a systemic disease of unknown etiology in which infectious agents have been implicated, inorganic powders or organic substances, characterized by the presence of necrotizing granulomatous inflammation with no accumulation of CD4 + lymphocytes and monocytes in the affected tissues. It is presented the case of a patient who went to the General University Hospital Dr. Gustavo Aldereguía Lima of Cienfuegos reporting dry cough, fever, chest tightness and slight weight loss three of three months evolution which did not improve despite receiving treatment in his health area. After several studies it was diagnosed a proliferative pulmonary sarcoidosis, systemic granulomatous disease whose etiology remains anonymous. Biopsy remains the basis for definitive diagnosis. As this is a difficult entity to explain and understand, besides being scarcely diagnosed in our area, it is decided to present that clinical case.

  4. Emotion, Engagement, and Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

    2014-01-01

    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  5. Pituicytoma. Case report and literature review

    Directory of Open Access Journals (Sweden)

    Fernando Velandia Hurtado

    2018-04-01

    Full Text Available Pituicytoma is a rare glial tumour located in the sellar and/or suprasellar region of the brain, it originates from pituicytes, and they were included in the World Health Organization (WHO Classification of Central Nervous System Tumours in 2017. As mentioned above it originates from pituicytes cells in the posterior pituitary near the infundibulum. Histological characteristics permits classification and identification among other central nervous system tumours localized in the posterior pituitary or infundibulum. WHO classification describes them as grades such as grade I tumour which has a differentiated structure composed of spindle-shaped cells presumably derived from pituicytes. We report the case of a 37-year-old woman who developed a suprasellar tumour and that it was discovered following a past medical history of amenorrhoea and migraines. Once the lesion was detected in images, the patient rejected surgical treatment even when she developed galactorrhea and preferred medical treatment with cabergoline. However, two years later she developed visual defects due to increase in size by that time accepting surgical treatment. A review of the literature including most common clinical and radiological features of this entity as well as treatment protocols proposed are discussed.

  6. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille

    2014-01-01

    The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different...... research paths....

  7. Design And Implementation Of Online Submission and Peer Review System A Case Study Of E-Journal Of University Of Zakho

    Directory of Open Access Journals (Sweden)

    Karwan Jacksi

    2015-08-01

    Full Text Available Abstract With the aim of designing and implementing a web-based article submission management system for academic research papers several international models such as Elsevier Editorial System and ICOCI International Conference on Computing and Informatics are studied and analyzed. Through this analysis an open access web-based article submission and peer review system for Journal of University of Zakho JUOZ is employed. This kind of systems is not only capable of solving issues such as complex manuscript management time-delays in the process of reviewing and loss of manuscripts that occurs often in off-line paper submission and review processes but also is capable to build the foundation for e-journal publications. Consequently an active and rapid scholarly communication medium can be made. The implementation and deployment of this system can improve the rank of the university and the reputation and the globalization of science and technology research journals.

  8. Pancreaticopericardial Fistula: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Muhammad S. Khan

    2016-01-01

    Full Text Available Purpose. Pancreaticopericardial fistula (PPF is an extremely rare complication of acute or chronic pancreatitis. This paper presents a rare case of PPF and provides systematic review of existing cases from 1970 to 2014. Methods. A PubMed search using key words was performed for all the cases of PPF from January 1970 to December 2014. Fourteen cases were included in the study. The cases were reviewed for demographic characteristics, diagnostic modalities, and treatment. Descriptive analysis of these variables was performed. Results. Median age was 43 years. 78% were known alcoholics and 73.3% had chronic pancreatitis. Dyspnea was present in 78%. Cardiac tamponade was present in 53%; 75% of patients had known chronic pancreatitis (RR = 0.74. Surgery was associated with best treatment outcomes and 50% of patients who underwent endoscopic treatment survived. Conclusion. PPF is a rare disease. This paper indicates that acute cardiac tamponade in patients with history of alcoholism and chronic pancreatitis could be a sign of an existing pancreaticopericardial fistula and early surgical intervention could be life-saving.

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

    Directory of Open Access Journals (Sweden)

    Xiang Lei

    2015-01-01

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

  10. T-cell acute lymphoblastic leukemia associated with complex karyotype and SET-NUP214 rearrangement: a case study and review of the literature.

    Science.gov (United States)

    Lee, Sang-Guk; Park, Tae Sung; Cho, Sun Young; Lim, Gayoung; Park, Gwang Jin; Oh, Seung Hwan; Cho, Eun Hae; Chong, So Young; Huh, Ji Young

    2011-01-01

    SET-NUP214 rearrangements have been rarely reported in T-cell acute lymphoblastic leukemia (T-ALL), acute undifferentiated leukemia, and acute myeloid leukemia, and most documented cases have been associated with normal karyotypes in conventional cytogenetic analyses. Here, we describe a novel case of T-ALL associated with a mediastinal mass and a SET-NUP214 rearrangement, which was masked by a complex karyotype at the time of initial diagnosis. Using multiplex reverse transcriptase-polymerase chain reaction analysis, we detected a cryptic SET-NUP214 rearrangement in our patient. As only 11 cases (including the present study) of T-ALL with SET-NUP214 rearrangement have been reported, the clinical features and treatment outcomes have not been fully determined. Further studies are necessary to evaluate the incidence of SET-NUP214 rearrangement in T-ALL patients and the treatment responses as well as prognosis of these patients.

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

    International Nuclear Information System (INIS)

    Healy, J.N.; Borg, M.F.

    2010-01-01

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

  12. Supply chain strategy: empirical case study in Europe and Asia:

    OpenAIRE

    Sillanpää, Ilkka; Sillanpää, Sebastian

    2014-01-01

    The purpose of this case study research is to present a literature review of supply chain strategy approaches, develop supply chain strategy framework and to validate a framework in empirical case study. Literature review and case study research are the research methods for this research. This study presents the supply chain strategy framework which merges together business environment, corporate strategy, supply chain demand and supply chain strategy. Research argues that all the different c...

  13. Theory testing using case studies

    DEFF Research Database (Denmark)

    Dissing Sørensen, Pernille; Løkke Nielsen, Ann-Kristina

    2006-01-01

    on the strengths of theory-testing case studies. We specify research paths associated with theory testing in case studies and present a coherent argument for the logic of theoretical development and refinement using case studies. We emphasize different uses of rival explanations and their implications for research...... design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive......Case studies may have different research goals. One such goal is the testing of small-scale and middle-range theories. Theory testing refers to the critical examination, observation, and evaluation of the 'why' and 'how' of a specified phenomenon in a particular setting. In this paper, we focus...

  14. Ectopic sphenoid sinus pituitary adenoma (ESSPA) with normal anterior pituitary gland: a clinicopathologic and immunophenotypic study of 32 cases with a comprehensive review of the english literature.

    Science.gov (United States)

    Thompson, Lester D R; Seethala, Raja R; Müller, Susan

    2012-03-01

    Ectopic sphenoid sinus pituitary adenoma (ESSPA) may arise from a remnant of Rathke's pouch. These tumors are frequently misdiagnosed as other neuroendocrine or epithelial neoplasms which may develop in this site (olfactory neuroblastoma, neuroendocrine carcinoma, sinonasal undifferentiated carcinoma, paraganglioma, melanoma). Thirty-two patients with ESSPA identified in patients with normal pituitary glands (intact sella turcica) were retrospectively retrieved from the consultation files of the authors' institutions. Clinical records were reviewed with follow-up obtained. An immunohistochemical panel was performed on available material. Sixteen males and 16 females, aged 2-84 years (mean, 57.1 years), presented with chronic sinusitis, headache, obstructive symptoms, and visual field defects, although several were asymptomatic (n = 6). By definition, the tumors were centered within the sphenoid sinus and demonstrated, by imaging studies or intraoperative examination, a normal sella turcica without a concurrent pituitary adenoma. A subset of tumors showed extension into the nasal cavity (n = 5) or nasopharynx (n = 9). Mean tumor size was 3.4 cm. The majority of tumors were beneath an intact respiratory epithelium (n = 22), arranged in many different patterns (solid, packets, organoid, pseudorosette-rosette, pseudopapillary, single file, glandular, trabecular, insular). Bone involvement was frequently seen (n = 21). Secretions were present (n = 16). Necrosis was noted in 8 tumors. The tumors showed a variable cellularity, with polygonal, plasmacytoid, granular, and oncocytic tumor cells. Severe pleomorphism was uncommon (n = 5). A delicate, salt-and-pepper chromatin distribution was seen. In addition, there were intranuclear cytoplasmic inclusions (n = 25) and multinucleated tumor cells (n = 18). Mitotic figures were infrequent, with a mean of 1 per 10 HPFs and a pituitary hormones included 48% reactive for 2 or more hormones (plurihormonal), and

  15. The peer review gap: A longitudinal case study of gendered publishing and occupational patterns in a female-rich discipline, Western North America (1974-2016.

    Directory of Open Access Journals (Sweden)

    Shannon Tushingham

    Full Text Available Researchers have repeatedly demonstrated that women continue to be underrepresented in publication output in the sciences. This is true even in female-rich fields such as archaeology. Since most gender-related publication studies rely on data from peer-reviewed journals, it would be instructive, though challenging, to also track publication output in non-refereed and professional or industry venues, which tend to be more accessible to those working in extra-academic settings. This comparison is important in fields such as archaeology in which the vast majority (approximately 90% of practitioners in the USA work for private sector cultural resource management firms and federal and state agencies. To understand the dynamics of who publishes where, we compiled a new dataset tracking over 40 years of peer-reviewed versus non-peer-reviewed publications that publish articles on the archaeology of California (an American Indian cultural area including southwest Oregon, most of the state of California, and Baja Mexico and the Great Basin culture area (spanning eight western USA states. Historic gender differences in the publishing output of authors identified as men versus those identified as women were revealed by articles published between 1974 and 2016 in two refereed journals, the Journal of California Anthropology/ Journal of California and Great Basin Anthropology and California Archaeology, and in one un-refereed venue, the Society for California Archaeology Proceedings. Although multiple independent measures indicate that women are contributing and active members of the discipline, publishing records yield more variable results. Specifically, while women have historic and increasingly robust levels of participation in the non-peer-reviewed Proceedings, they remain vastly underrepresented in the two peer-reviewed journals, which are widely regarded as more prestigious and influential. We argue that this "peer review gap" is influenced by

  16. The peer review gap: A longitudinal case study of gendered publishing and occupational patterns in a female-rich discipline, Western North America (1974–2016)

    Science.gov (United States)

    Fulkerson, Tiffany; Hill, Katheryn

    2017-01-01

    Researchers have repeatedly demonstrated that women continue to be underrepresented in publication output in the sciences. This is true even in female-rich fields such as archaeology. Since most gender-related publication studies rely on data from peer-reviewed journals, it would be instructive, though challenging, to also track publication output in non-refereed and professional or industry venues, which tend to be more accessible to those working in extra-academic settings. This comparison is important in fields such as archaeology in which the vast majority (approximately 90%) of practitioners in the USA work for private sector cultural resource management firms and federal and state agencies. To understand the dynamics of who publishes where, we compiled a new dataset tracking over 40 years of peer-reviewed versus non-peer-reviewed publications that publish articles on the archaeology of California (an American Indian cultural area including southwest Oregon, most of the state of California, and Baja Mexico) and the Great Basin culture area (spanning eight western USA states). Historic gender differences in the publishing output of authors identified as men versus those identified as women were revealed by articles published between 1974 and 2016 in two refereed journals, the Journal of California Anthropology/ Journal of California and Great Basin Anthropology and California Archaeology, and in one un-refereed venue, the Society for California Archaeology Proceedings. Although multiple independent measures indicate that women are contributing and active members of the discipline, publishing records yield more variable results. Specifically, while women have historic and increasingly robust levels of participation in the non-peer-reviewed Proceedings, they remain vastly underrepresented in the two peer-reviewed journals, which are widely regarded as more prestigious and influential. We argue that this “peer review gap” is influenced by variation in the

  17. Fuzzy-Set Case Studies

    Science.gov (United States)

    Mikkelsen, Kim Sass

    2017-01-01

    Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…

  18. Methodology for the case studies

    NARCIS (Netherlands)

    Smits, M.J.W.; Woltjer, G.B.

    2017-01-01

    This document is about the methodology and selection of the case studies. It is meant as a guideline for the case studies, and together with the other reports in this work package can be a source of inform ation for policy officers, interest groups and researchers evaluating or performing impact

  19. 7 CFR 275.13 - Review of negative cases.

    Science.gov (United States)

    2010-01-01

    ... State systems, the review date for negative cases could be the date of the agency's decision to deny... household which was listed incorrectly in the negative frame. (f) Demonstration projects/SSA processing. A... 7 Agriculture 4 2010-01-01 2010-01-01 false Review of negative cases. 275.13 Section 275.13...

  20. Case study - Argentina

    International Nuclear Information System (INIS)

    Diaz, E.

    1986-01-01

    Antecedents and experience of nuclear activities in Argentina; the Atomic Energy Commission (CNEA). First development and research activities. Research reactors and radioisotopes plants. Health physics and safety regulations. - Feasibility studies for the first nuclear power plant. Awarding the first plant CNA I (Atucha I). Relevant data related to the different project stages. Plant performance. - Feasibility study for the second nuclear power plant. Awarding the second plant CNE (Central Nuclear Embalse). Relevant data related to established targets. Differences compared with the first station targets. Local participation. Plant performance. (orig./GL)

  1. [Diphenhydramine addiction and detoxification. A systematic review and case report].

    Science.gov (United States)

    Erbe, Sebastian; Bschor, Tom

    2013-07-01

    In many countries diphenhydramine (DPH) is commonly available over the counter, frequently used, and generally regarded as a harmless drug. It is used as a sedative, antiallergic or antiemetic substance. We present a systematic review of literature search in Pubmed from 1972 to 2012 describing DPH addiction. The literature search in reveals that the addictive potential of DPH can be regarded as proved, based on cases series, eight case reports, a pharmacological overview, one uncontrolled, and one randomized, placebo controlled study. In addition we report a case of an abstinent alcoholic patient treated in our department for DPH-dependency. Especially when treating patients with a history of addiction, physicians should consider and check the possibility of a DPH dependency. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Secondary syphilis presenting as leucoderma syphiliticum: case report and review.

    Science.gov (United States)

    Eyer-Silva, Walter de Araujo; Martins, Carlos José; Silva, Guilherme Almeida Rosa da; Acakpovi, Giresse; Pinto, Jorge Francisco da Cunha

    2017-11-06

    Leucoderma syphiliticum (LS), originally described as syphilide pigmentaire, encompasses a spectrum of dyschromic lesions that emerge during the course of secondary syphilis. Very few case reports are available in modern biomedical databases. We present the case of a 57-year-old HIV-infected male patient who presented with several round to oval, non-scaling, slightly raised and well-demarcated hypochromic lesions scattered over the trunk, abdomen, dorsum, and arms. Prior non-treponemal tests were negative for syphilis, but novel studies yielded positive results at high titers. Skin lesions slowly regressed and the hypochromic areas repigmented a few weeks after benzathine penicillin G treatment. This is the first report of LS in an HIV-infected patient. A review of modern and ancient literature was performed. The present case report emphasizes the need for clinicians to have a heightened awareness of the varied and unusual clinical phenotypes of syphilis.

  3. A Critical Review of OSHA Heat Enforcement Cases: Lessons Learned.

    Science.gov (United States)

    Arbury, Sheila; Lindsley, Matthew; Hodgson, Michael

    2016-04-01

    The aim of the study was to review the Occupational Safety and Health Administration's (OSHA) 2012 to 2013 heat enforcement cases, using identified essential elements of heat illness prevention to evaluate employers' programs and make recommendations to better protect workers from heat illness. (1) Identify essential elements of heat illness prevention; (2) develop data collection tool; and (3) analyze OSHA 2012 to 2013 heat enforcement cases. OSHA's database contains 84 heat enforcement cases in 2012 to 2013. Employer heat illness prevention programs were lacking in essential elements such as providing water and shade; adjusting the work/rest proportion to allow for workload and effective temperature; and acclimatizing and training workers. In this set of investigations, most employers failed to implement common elements of illness prevention programs. Over 80% clearly did not rely on national standard approaches to heat illness prevention.

  4. WWC Study Review Guide: Group Design Studies

    Science.gov (United States)

    What Works Clearinghouse, 2018

    2018-01-01

    Underlying all What Works Clearinghouse (WWC) products are WWC Study Review Guides, which are intended for use by WWC certified reviewers to assess studies against the WWC evidence standards. As part of an ongoing effort to increase transparency, promote collaboration, and encourage widespread use of the WWC standards, the Institute of Education…

  5. Design And Implementation Of Online Submission and Peer Review System A Case Study Of E-Journal Of University Of Zakho

    OpenAIRE

    Karwan Jacksi

    2015-01-01

    Abstract With the aim of designing and implementing a web-based article submission management system for academic research papers several international models such as Elsevier Editorial System and ICOCI International Conference on Computing and Informatics are studied and analyzed. Through this analysis an open access web-based article submission and peer review system for Journal of University of Zakho JUOZ is employed. This kind of systems is not only capable of solving issues such as compl...

  6. Adult Craniopharyngioma: Case Series, Systematic Review, and Meta-Analysis.

    Science.gov (United States)

    Dandurand, Charlotte; Sepehry, Amir Ali; Asadi Lari, Mohammad Hossein; Akagami, Ryojo; Gooderham, Peter

    2017-12-18

    The optimal therapeutic approach for adult craniopharyngioma remains controversial. Some advocate for gross total resection (GTR), while others advocate for subtotal resection followed by adjuvant radiotherapy (STR + XRT). To conduct a systematic review and meta-analysis assessing the rate of recurrence in the follow-up of 3 yr in adult craniopharyngioma stratified by extent of resection and presence of adjuvant radiotherapy. MEDLINE (1946-July 1, 2016) and EMBASE (1980-June 30, 2016) were systematically reviewed. From1975 to 2013, 33 patients were treated with initial surgical resection for adult onset craniopharyngioma at our center and were reviewed for inclusion in this study. Data from 22 patients were available for inclusion as a case series in the systematic review. Eligible studies (n = 21) were identified from the literature in addition to a case series of our institutional experience. Three groups were available for analysis: GTR, STR + XRT, and STR. The rates of recurrence were 17%, 27%, and 45%, respectively. The risk of developing recurrence was significant for GTR vs STR (odds ratio [OR]: 0.24, 95% confidence interval [CI]: 0.15-0.38) and STR + XRT vs STR (OR: 0.20, 95% CI: 0.10-0.41). Risk of recurrence after GTR vs STR + XRT did not reach significance (OR: 0.63, 95% CI: 0.33-1.24, P = .18). This is the first and largest systematic review focusing on the rate of recurrence in adult craniopharyngioma. Although the rates of recurrence are favoring GTR, difference in risk of recurrence did not reach significance. This study provides guidance to clinicians and directions for future research with the need to stratify outcomes per treatment modalities. Copyright © 2017 by the Congress of Neurological Surgeons

  7. Disability Case Adjudication and Review System

    Data.gov (United States)

    Social Security Administration — DICARS is the legacy system supporting business processes in the Disability Quality Branches (DQBs). It supports quality reviews of DDS disability determinations....

  8. Case Study: Shiraz Women

    Directory of Open Access Journals (Sweden)

    Bijan Khajehnoori

    2011-04-01

    Full Text Available This study investigated the relationship between lifestyle which seems as a scale of globalization process with body image. Required data was collected by systematic random sampling among 508 women in Shiraz. Based on existing theories and studies theoretical framework has constituted based on Giddens theory. Six hypotheses have been established. For collecting information, survey method and self reported questionnaire were used. In data analysis and explanation, multiple regression and unilateral dispersion analyses were used. The result showed that among effective factors on body image, modern musical lifestyle, religious' lifestyle, leisure lifestyle and participative lifestyle explained 23 percent of variations of body image. Among these variables, only religious lifestyle had negative relationship with body image and other variables had positive relationship with dependant variable.

  9. Centrifugal compressor case study

    Energy Technology Data Exchange (ETDEWEB)

    Eckert, B.

    2010-10-15

    Three centrifugal compressors at a pipeline station were retrofitted with higher head impellers in 2008. The owners of the station experienced vibration problems over the following 2 years that caused transmitter and position failures that were assumed to be flow-induced pulsations. A vibration and pulsation analysis indicated that the shell mode piping vibration excited by the blade pass pulsation was responsible for the failures. This study outlined factors that contributed to the vibration problem. Interferences between the compressor and shell mode piping natural frequencies were predicted, and potential excitation sources were examined. The study demonstrated how centrifugal vibration analyses can be used during the design phase to avoid costly adjustments. Recommendations included the addition of stiffeners to alter the shell modes, and the addition of constrained layer damping material to reduce resonant responses. 2 refs., 1 tab., 12 figs.

  10. Case study: Tourism marketing

    OpenAIRE

    Kennell, James

    2014-01-01

    Tourism can be a challenging subject for students because it is both dynamic and susceptible to economic turbulence and shifts in trends. Tourism: A Modern Synthesis is an essential textbook for tourism students looking for a clear and comprehensive introduction to their studies which helps overcome these challenges. The authors apply a strong business approach to the subject reflecting developments in the teaching and content of modern courses and the text covers both key principles and cont...

  11. Case Study: Derechos Digitales

    Directory of Open Access Journals (Sweden)

    Cameron Neylon

    2017-10-01

    Full Text Available Derechos Digitales is a Latin American advocacy and research network focussed on freedom on the internet, privacy and copyright reform. For the pilot project a specific IDRC funded project was the notional focus of study. However in practice the effort for considering data sharing was aimed at being organisation wide. The organisation already shares reports and other resources (particularly images and infographics by default. While open data was described as being “in the DNA of the organisation” there was little practice across the network of sharing preliminary and in-process materials. Some aspects of data collection on research projects, particularly to do with copyright and legal issues, have significant privacy issues and as the organisation focuses on privacy as one of its advocacy areas this is taken very seriously. Many materials from research projects are not placed online at all. Derechos Digitales run distributed projects and this creates challenges for consistent management. Alongside this the main contact at DD changed during the course of the pilot. This exchange exemplified the challenges of maintaining organisational systems and awareness through a personnel change.

  12. Case study: Khoramdareh County

    Directory of Open Access Journals (Sweden)

    Vahid Riahi Riahi

    2016-10-01

    Full Text Available Environmental sustainability of rural settlements based on a systematic viewpoint may be defined as a realization of sustainable development in different social, economic and environmental aspects of rural areas. Achieving this goal requires that we pay more attention to effective elements and factors through a set of sustainability indices. This research was meant to analyze sustainable factors of rural settlement in three dimensions: environmental, social and economic context using multi-criteria decision analysis and explanation of the relationships between its active and effective factors in the rural area of the Khorramdarreh County in the province of Zanjan. The research method used is the descriptive analytic approach. Data from 287 households were sampled randomly from a total of 1143 households in the four villages including: Rahmat Abad, Alvand, Baghdareh and, Sukhariz (out of 15 villages in the Khorramdarreh County. In the process of doing this research and after calculating the weights, the difference in the sustainability of environmental, social, economic and physical aspects in rural areas of this county have been determined. Data was collected using library and field research through questionnaires. Data analysis was performed by the One-Sample t Test and the Vikur and path analysis techniques, using statistical software SPSS. The findings show that environmental sustainability in the study area is half desirable. Among the different aspects of environmental sustainability, the most effective factors are physical, economic, social and environmental aspects, respectively. Little attention of policy-making –system to socio-cultural and environmental aspects, especially in practice, and rapid and unplanned utilization of production resources are the most important factors affecting this situation in two given dimensions. Although, in programmed documents the planning system agents emphasize on the socio-cultural sustainability

  13. An Analysis of Peer-Reviewed Scores and Impact Factors with Different Citation Time Windows: A Case Study of 28 Ophthalmologic Journals.

    Science.gov (United States)

    Liu, Xue-Li; Gai, Shuang-Shuang; Zhang, Shi-Le; Wang, Pu

    2015-01-01

    An important attribute of the traditional impact factor was the controversial 2-year citation window. So far, several scholars have proposed using different citation time windows for evaluating journals. However, there is no confirmation whether a longer citation time window would be better. How did the journal evaluation effects of 3IF, 4IF, and 6IF comparing with 2IF and 5IF? In order to understand these questions, we made a comparative study of impact factors with different citation time windows with the peer-reviewed scores of ophthalmologic journals indexed by Science Citation Index Expanded (SCIE) database. The peer-reviewed scores of 28 ophthalmologic journals were obtained through a self-designed survey questionnaire. Impact factors with different citation time windows (including 2IF, 3IF, 4IF, 5IF, and 6IF) of 28 ophthalmologic journals were computed and compared in accordance with each impact factor's definition and formula, using the citation analysis function of the Web of Science (WoS) database. An analysis of the correlation between impact factors with different citation time windows and peer-reviewed scores was carried out. Although impact factor values with different citation time windows were different, there was a high level of correlation between them when it came to evaluating journals. In the current study, for ophthalmologic journals' impact factors with different time windows in 2013, 3IF and 4IF seemed the ideal ranges for comparison, when assessed in relation to peer-reviewed scores. In addition, the 3-year and 4-year windows were quite consistent with the cited peak age of documents published by ophthalmologic journals. Our study is based on ophthalmology journals and we only analyze the impact factors with different citation time window in 2013, so it has yet to be ascertained whether other disciplines (especially those with a later cited peak) or other years would follow the same or similar patterns. We designed the survey questionnaire

  14. Review of Case Studies for Quantitative Reasoning: A Casebook of Media Articles by Bernard L. Madison, Stuart Boersma, Caren L. Diefenderfer, and Shannon W. Dingman

    Directory of Open Access Journals (Sweden)

    Samuel L. Tunstall

    2015-07-01

    Full Text Available Bernard L. Madison, Stuart Boersma, Caren L. Diefenderfer, and Shannon W. Dingman. Case Studies for Quantitative Reasoning: A Casebook of Media Articles (Pearson Learning Solutions, 2012. 215 pp. ISBN 9781256512875. Concisely organized and timely to a tee, Case Studies for Quantitative Reasoning contains a wealth of articles and exercises to promote higher-order thinking in any course where quantitative literacy is a goal. The text is a self-contained package complete with just enough mathematics to ensure that all students can join in. It contains a total of twenty-four case studies, each of which highlights how numbers appear in day-to-day media. The text is broken into six broad mathematical topics, each of which includes any background mathematics necessary for reading. Each individual study includes warm-up exercises and follow-up questions that demand critical thinking. Notwithstanding the elementary mathematics prerequisite to read the text, the topics and questions are sufficiently challenging to keep a class – and accompanying instructor – engaged for an entire semester.

  15. Stakeholder involvement in other sectors. High Voltage Electricity Transmission. Case study: CO_2 capture and storage. Common misconceptions on stakeholder involvement - Reviewing deployment of RES

    International Nuclear Information System (INIS)

    Wolsink, Maarten; Komendantova, Nadejda; Kalaydjian, Francois

    2017-01-01

    Komendantova of the International Institute for Applied Systems Analysis pointed out that at higher levels of involvement several different ways can be found to share power. These include distributing responsibilities for planning and decision making (partnership) or allocating a majority of seats on review committees to citizen representatives (citizen control). Alongside choosing the right level of involvement, the approach must be tailored to the setting. Ms Komendantova presented the BESTGRID research project in the European Union, which tested and studied alternative approaches to stakeholder engagement in trans-border high-voltage transmission line projects. Different methods may be needed for engaging specific sets of people, according to such factors as age, technological familiarity, geographic situation and possibly national culture. Mr Kalaydjian pointed to the research project SiteChar-CO2, juxtaposing the reasoning of stakeholders in different locations (in Poland and in Scotland) who held different levels of knowledge of carbon capture and storage technology, and who varied in their proximity to the proposed pilot sites. Their views on economics, risks, etc. in each case also had distinct implications in terms of expected actions by national actors or by local site operators. Stakeholder concerns can be mapped into several main areas, which were echoed by the various studies presented in Session 7. Mr Wolsink insisted on the issue of perceived need for the project, and stakeholders' demand to choose among real options. He described a failed wind power development in the early 2000's which excluded local stakeholders with knowledge and interests in the proposed locations, considered only a narrow set of alternatives without meaningful distinctions between them, and utilised a technocratic decision process that selected an implementation with significant opposition when other locations would have been generally acceptable to stakeholders. BESTGRID found that areas

  16. Giant calculus: review and report of a case.

    Science.gov (United States)

    Woodmansey, Karl; Severine, Anthony; Lembariti, Bakari S

    2013-01-01

    Dental calculus is a common oral finding. The term giant calculus is used to describe unusually large deposits of dental calculus. Several extreme cases have been reported in the dental literature. The specific etiology of these cases remains uncertain. This paper reviews previously reported cases, and presents another extreme example of giant calculus.

  17. Traditional cardiovascular risk factors and coronary collateral circulation: Protocol for a systematic review and meta-analysis of case-control studies.

    Science.gov (United States)

    Xing, Zhenhua; Pei, Junyu; Tang, Liang; Hu, Xinqun

    2018-04-01

    Well-developed coronary collateral circulation usually results in fewer infarct size, improved cardiac function, and fewer mortality. Traditional coronary risk factors (diabetes, hypertension, and smoking) have some effects on coronary collateral circulation. However, the association between these risk factors and coronary collateral circulation are controversial. Given the confusing evidences regarding traditional cardiovascular risk factors on coronary collateral circulation, we performed this meta-analysis protocol to investigate the relationship between traditional risk factors of coronary artery disease and coronary collateral circulation. MEDINE, EMBASE, and Science Citation Index will be searched to identify relevant studies. The primary outcomes of this meta-analysis are well-developed coronary collateral circulation. Meta-analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) of traditional coronary risk factors (diabetes, smoking, hypertriton). Pooled ORs were computed as the Mantel-Haenszel-weighted average of the ORs for all included studies. Sensitivity analysis, quality assessment, publication bias analysis, and the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE) will be performed to ensure the reliability of our results. This study will provide a high-quality synthesis of current evidence of traditional risk factors on collateral circulation. This conclusion of our systematic review and meta-analysis will provide evidence to judge whether traditional risk factors affects coronary collateral circulation.Ethics and dissemination: Ethical approval is not required because our systematic review and meta-analysis will be based on published data without interventions on patients. The findings of this study will be published in a peer-reviewed journal.

  18. Reviewing the Effect of Religion, Materialism and Demographic Features of the Consumer on Mental Involvement in Fashion Clothing (Case Study: Yazd

    Directory of Open Access Journals (Sweden)

    Seyed Mahdi Alhosseini Almodarresi

    2015-12-01

    Full Text Available Among the factors that are necessary to facilitate the consumer’s daily life with high mental involvement, fashion clothing is an important and significant factor for many consumers. According to the importance of the subject, this research reviewed the effect of religion, materialism and demographic features of the consumer on mental involvement in fashion clothing among citizens of Yazd. Confirmatory factor analysis method has been applied in analytical statistics of this research to determine the role and position of each one of the research elements by using Amos software. Correlation test has been used in order to review the relations between fashion clothing involvement and its dimensions, and linear regression test in order to determine the effect manner of involvement in fashion clothing and mental knowledge on confidence in fashion decision making. The statistical population includes all the individuals above 20 years old in Yazd City; the sample size was calculated 99 individuals by using Cochran formula. The research results showed that religion and materialism have significant effect on mental involvement in fashion clothing and involvement has a positive and significant effect on fashion decision making confidence. Furthermore, mental involvements in fashion clothing and mental knowledge have a positive and significant effect on fashion decision making confidence and it was specified in the reviewing of the relation between demographic factors (sex, age,… and the studied variables that the correlation between them was not significant even in the confidence level of 95 percent.

  19. Pitfalls and major issues in the histologic diagnosis of peripheral T-cell lymphomas: results of the central review of 573 cases from the T-Cell Project, an international, cooperative study.

    Science.gov (United States)

    Bellei, Monica; Sabattini, Elena; Pesce, Emanuela Anna; Ko, Young-Hyeh; Kim, Won Seog; Cabrera, Maria Elena; Martinez, Virginia; Dlouhy, Ivan; Paes, Roberto Pinto; Barrese, Tomas; Vassallo, Josè; Tarantino, Vittoria; Vose, Julie; Weisenburger, Dennis; Rüdiger, Thomas; Federico, Massimo; Pileri, Stefano

    2017-12-01

    Peripheral T-cell lymphomas (PTCLs) comprise a heterogeneous group of neoplasms that are derived from post-thymic lymphoid cells at different stages of differentiation with different morphological patterns, phenotypes and clinical presentations. PTCLs are highly diverse, reflecting the diverse cells from which they can originate and are currently sub-classified using World Health Organization (WHO) 2008 criteria. In 2006 the International T-Cell Lymphoma Project launched the T-Cell Project, building on the retrospective study previously carried on by the network, with the aim to prospectively collect accurate data to improve knowledge on this group of lymphomas. Based on previously published reports from International Study Groups it emerged that rendering a correct classification of PTCLs is quite difficult because the relatively low prevalence of these diseases results in a lack of confidence by most pathologists. This is the reason why the T-Cell Project requested the availability of diagnostic material from the initial biopsy of each patient registered in the study in order to have the initial diagnosis centrally reviewed by expert hematopathologists. In the present report the results of the review process performed on 573 cases are presented. Overall, an incorrect diagnosis was centrally recorded in 13.1% cases, including 8.5% cases centrally reclassified with a subtype eligible for the project and 4.6% cases misclassified and found to be disorders other than T-cell lymphomas; 2.1% cases were centrally classified as T-Cell disorders not included in the study population. Thus, the T-Cell Project confirmed the difficulties in providing an accurate classification when a diagnosis of PTCLs is suspected, singled out the major pitfalls that can bias a correct histologic categorization and confirmed that a centralized expert review with the application of adequate diagnostic algorithms is mandatory when dealing with these tumours. Copyright © 2016 John Wiley & Sons

  20. Diprosopus: Systematic review and report of two cases.

    Science.gov (United States)

    Bidondo, María Paz; Groisman, Boris; Tardivo, Agostina; Tomasoni, Fabián; Tejeiro, Verónica; Camacho, Inés; Vilas, Mariana; Liascovich, Rosa; Barbero, Pablo

    2016-12-01

    Diprosopus is a subtype of symmetric conjoined twins with one head, facial duplication and a single trunk. Diprosopus is a very rare congenital anomaly. This is a systematic review of published cases and the presentation of two new cases born in Argentina. We estimated the prevalence of conjoined twins and diprosopus using data from the National Network of Congenital Anomalies of Argentina (RENAC). The prevalence of conjoined twins in RENAC was 19 per 1,000,000 births (95% confidence interval, 12-29). Diprosopus prevalence was 2 per 1,000,000 births (95% confidence interval, 0.2-6.8). In the systematic review, we identified 31 diprosopus cases. The facial structures more frequently duplicated were nose and eyes. Most frequent associated anomalies were: anencephaly, duplication of cerebral hemispheres, craniorachischisis, oral clefts, spinal abnormalities, congenital heart defects, diaphragmatic hernia, thoracic and/or abdominal visceral laterality anomalies. One of the RENAC cases and three cases from the literature had another discordant nonmalformed twin. The conjoined twins prevalence was similar to other studies. The prevalence of diprosopus was higher. The etiology is still unknown. The presence of visceral laterality anomalies may indicate the link between diprosopus and the alteration or duplication of the primitive node in the perigastrulation period (12-15 days postfertilization). Pregnancies of more than two embryos may be a risk factor for diprosopus. Given the low prevalence of this defect, it would be useful to perform studies involving several surveillance systems and international consortiums. Birth Defects Research (Part A), 2016. © 2016 Wiley Periodicals, Inc. Birth Defects Research (Part A) 106:993-1007, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. Larva migrans: a case report and review

    Directory of Open Access Journals (Sweden)

    Velho Paulo Eduardo Neves Ferreira

    2003-01-01

    Full Text Available A case of massive Ancylostoma sp. larval infestation is presented in a patient who had received systemic corticosteroid therapy. What attracts attention in this case is the exuberance and rarity of clinical manifestation. Based on the pertinent literature, we discuss the mechanisms of parasital infection, the natural history of the disease and its treatment.

  2. CANDU: study and review

    Energy Technology Data Exchange (ETDEWEB)

    Morad, César M., E-mail: cesar.morad@usp.br [Universidade de São Paulo (POLI/USP), SP (Brazil). Escola Politécnica; Stefani, Giovanni L. de, E-mail: giovanni.stefani@ipen.br [Instituto de Pesquisas Energéticas e Nucleares (IPEN/CNEN-SP), São Paulo, SP (Brazil); Santos, Thiago A. dos, E-mail: thiago.santos@ufabc.edu.br [Universidade Federal do ABC (UFABC), Santo André, SP (Brazil)

    2017-07-01

    The CANDU (Canadian Deuterium Uranium) is a nuclear reactor developed by AECL (Atomic Energy of Canada Limited). The first small-scale reactor is known as NPD and was made in 1955 and commenced operation in 1962. It is a pressurized heavy water reactor and uses D2O as moderator and coolant and therefore uses natural uranium as fuel. There have been two major types of CANDU reactors, the original design of around 500 MWe that was intended to be used in multi-reactor installations in large plants, and the rationalized CANDU6 which has units in Argentina, South Korea, Pakistan, Romania and China. Throughout the 1980s and 90s the nuclear power market suffered a major crash, with few new plants being constructed in North America or Europe. Design work continued through, however, and a number of new design concepts were introduced that dramatically improved safety, capital costs, economics and overall performance. These Generation III+ and Generation IV machines became a topic of considerable interest in the early 2000s as it appeared a nuclear renaissance was underway and large numbers of new reactors would be built over the next decade. The present work aims to study the reactors of the CANDU type, exploring from its creation to studies directed to G-III and G-IV reactors. (author)

  3. CANDU: study and review

    International Nuclear Information System (INIS)

    Morad, César M.; Santos, Thiago A. dos

    2017-01-01

    The CANDU (Canadian Deuterium Uranium) is a nuclear reactor developed by AECL (Atomic Energy of Canada Limited). The first small-scale reactor is known as NPD and was made in 1955 and commenced operation in 1962. It is a pressurized heavy water reactor and uses D2O as moderator and coolant and therefore uses natural uranium as fuel. There have been two major types of CANDU reactors, the original design of around 500 MWe that was intended to be used in multi-reactor installations in large plants, and the rationalized CANDU6 which has units in Argentina, South Korea, Pakistan, Romania and China. Throughout the 1980s and 90s the nuclear power market suffered a major crash, with few new plants being constructed in North America or Europe. Design work continued through, however, and a number of new design concepts were introduced that dramatically improved safety, capital costs, economics and overall performance. These Generation III+ and Generation IV machines became a topic of considerable interest in the early 2000s as it appeared a nuclear renaissance was underway and large numbers of new reactors would be built over the next decade. The present work aims to study the reactors of the CANDU type, exploring from its creation to studies directed to G-III and G-IV reactors. (author)

  4. Case studies of uncommon headaches.

    Science.gov (United States)

    Evans, Randolph W

    2006-05-01

    The following interesting and uncommon headache disorders are presented through case studies: exploding head syndrome, hypnic headache, neck-tongue syndrome, "Alice in Wonderland" syndrome, nummular headache, red ear syndrome, burning mouth syndrome, spontaneous intracranial hypotension syndrome, and cardiac cephalalgia.

  5. HYDROGEOLOGIC CASE STUDIES (DENVER PRESENTATION)

    Science.gov (United States)

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

  6. HYDROGEOLOGIC CASE STUDIES (CHICAGO, IL)

    Science.gov (United States)

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

  7. Hydrogeologic Case Studies (Seattle, WA)

    Science.gov (United States)

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

  8. a case study ondo state

    African Journals Online (AJOL)

    user

    the design of a Government Cloud (G-Cloud) network for Ondo State Government which will ... network for a developing economy; a case study of ... France is one of those countries that favour .... Arequipa city. .... Where region 0 = Akure, 1 =.

  9. Experiences of case management with chronic illnesses: a qualitative systematic review.

    Science.gov (United States)

    Joo, J Y; Liu, M F

    2018-03-01

    This qualitative systematic review aimed to identify and synthesize recent qualitative studies to improve understanding of the experiences and perceptions of case management interventions that individuals with chronic illnesses and their caregivers have. Case management has been shown to be effective at improving quality of care and lowering costs for individuals with chronic illnesses. However, no qualitative review has been synthesized with recent qualitative studies about case management experiences by individual with chronic illnesses. This qualitative systematic review uses a thematic synthesis method to review 10 qualitative studies published within the last 10 years, from 2007 to 2016, thereby identifying and discussing the understandings that individuals with chronic illnesses and their caregivers have about case management. From this synthesis, three themes were identified as facilitators of case management (access to healthcare resources, health status supports and emotional aid) and two themes were identified as barriers to it (low information about case management and time constraints). This is the first qualitative systematic review of the perceptions and experiences that individuals with chronic illnesses and their caregivers have about case management. The facilitators of case management can be employed to inform patients about the benefits of case management and to improve population health. The findings about barriers to case management can be used to reform case management for populations with chronic illnesses. These factors should be considered by nursing researchers and healthcare policymakers when implementing case management. © 2018 International Council of Nurses.

  10. When elephants fall asleep: A literature review on elephant rest with case studies on elephant falling bouts, and practical solutions for zoo elephants.

    Science.gov (United States)

    Schiffmann, Christian; Hoby, Stefan; Wenker, Christian; Hård, Therese; Scholz, Robert; Clauss, Marcus; Hatt, Jean-Michel

    2018-05-01

    Little attention has been paid to the resting and sleeping behavior of zoo elephants so far. An important concern is when elephants avoid lying down, due to degenerative joint and foot disease, social structure, or stressful environmental changes. Inability or unwillingness to lie down for resting is an important welfare issue, as it may impair sleep. We emphasize the importance of satisfying rest in elephants by reviewing the literature on resting behavior in elephants (Loxodonta africana and Elephas maximus) as well as the documentation of four cases from European zoos and our own direct observations in a zoo group of four female African elephants during 12 entire days. The common denominator in the case reports is the occurrence of a falling bout out of a standing position subsequently to a cessation of lying rest for different periods of time. Although well-known in horses as "episodic collapse" or "excessive drowsiness," this syndrome has not been described in elephants before. To enable its detection, we recommend nocturnal video monitoring for elephant-keeping institutions. The literature evaluation as well as own observational data suggest an inverse relationship between lying rest and standing rest. Preventative measures consist of enclosure modifications that facilitate lying rest (e.g., sand hills) or standing rest in a leaning position as a substitute. Anecdotal observations suggest that the provision of appropriate horizontal environmental structures may encourage safe, sleep-conducive standing rest. We provide drawings on how to install such structures. Effects of providing such structures should be evaluated in the future. © 2018 Wiley Periodicals, Inc.

  11. Accuracy of Electronic Health Record Data for Identifying Stroke Cases in Large-Scale Epidemiological Studies: A Systematic Review from the UK Biobank Stroke Outcomes Group.

    Directory of Open Access Journals (Sweden)

    Rebecca Woodfield

    Full Text Available Long-term follow-up of population-based prospective studies is often achieved through linkages to coded regional or national health care data. Our knowledge of the accuracy of such data is incomplete. To inform methods for identifying stroke cases in UK Biobank (a prospective study of 503,000 UK adults recruited in middle-age, we systematically evaluated the accuracy of these data for stroke and its main pathological types (ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, determining the optimum codes for case identification.We sought studies published from 1990-November 2013, which compared coded data from death certificates, hospital admissions or primary care with a reference standard for stroke or its pathological types. We extracted information on a range of study characteristics and assessed study quality with the Quality Assessment of Diagnostic Studies tool (QUADAS-2. To assess accuracy, we extracted data on positive predictive values (PPV and-where available-on sensitivity, specificity, and negative predictive values (NPV.37 of 39 eligible studies assessed accuracy of International Classification of Diseases (ICD-coded hospital or death certificate data. They varied widely in their settings, methods, reporting, quality, and in the choice and accuracy of codes. Although PPVs for stroke and its pathological types ranged from 6-97%, appropriately selected, stroke-specific codes (rather than broad cerebrovascular codes consistently produced PPVs >70%, and in several studies >90%. The few studies with data on sensitivity, specificity and NPV showed higher sensitivity of hospital versus death certificate data for stroke, with specificity and NPV consistently >96%. Few studies assessed either primary care data or combinations of data sources.Particular stroke-specific codes can yield high PPVs (>90% for stroke/stroke types. Inclusion of primary care data and combining data sources should improve accuracy in large

  12. A critical review of hydrological data collection for assessing preservation risk for urban waterlogged archaeology: A case study from the City of York, UK.

    Science.gov (United States)

    Holden, Joseph; Howard, Andy J; West, L Jared; Maxfield, Eleanor; Panter, Ian; Oxley, John

    2009-08-01

    Environmental change caused by urban development, possibly augmented by climate change, may result in accelerated decay of in situ archaeological resources. Damage may be related to changes in hydrological processes. Such archaeological resources have to be considered in environmental planning. In this paper we highlight the need for improved hydrological data from urban archaeological sites using the case study of the City of York, UK, arguably one of the most well studied and well preserved urban archaeological environments globally. We suggest that the quality of hydrological data collected during routine surveys and experimental work must be improved and standardised in order for us to produce reliable archaeological risk models for urban sites.

  13. [Sarcoidosis related pleural effusion: 6 case reports and literatures review].

    Science.gov (United States)

    Wang, Feng; Tong, Zhaohui; Wang, Zhen; Wang, Xiaojuan; Xu, Lili

    2015-02-01

    To summarize the clinical features and the diagnosis-treatment points of sarcoidosis related pleural effusion. Six typical sarcoidosis related pleural effusion cases with pathological evidence were reviewed, and the clinical data of these cases were retrospectively analyzed and the related literatures were reviewed. The literature review was carried out respectively with "sarcoidosis", "pleural disease" and "pleural effusion" as the keywords in CNKI and PubMed database by January 2014. Six cases, including 1 male and 5 females, with sarcoidosis related pleural effusions were reported. 3 cases had bilateral effusions, 2 cases had left effusion and 1 case had right effusion. The pleural effusion routine test had a low specificity, which demonstrated that the fluid was exudate and consisted with large number of lymphocytes. 3 of these cases were diagnosed by medical thoracoscopy. Medical thoracoscopy revealed that pleural involvement was variable with multiple nodulespresent in some cases and subtle change in others. A total of 28 literatures and 92 cases with pleural involvement in sarcoidosis were retrieved from CNKI and PubMed database (time range: 2004.1-2014.1), including 59 cases of pleural effusion, 29 cases of pleural thickening, 3 cases of pneumothorax and 1 case of nodules in pleura. Pleural involvement in sarcoidosis was often misdiagnosed or mistreated as tuberculous pleurisy because the routine tests regarding pleural effusion usually had a low specificity. Medical thoracoscopy could provide clinicians with important clues to assist differentiation of the cause for non-conclusive pleural effusion in this situation.

  14. Rat-bite fever in children: case report and review.

    Science.gov (United States)

    Ojukwu, Ifeoma C; Christy, Cynthia

    2002-01-01

    We report 2 cases of rat-bite fever (RBF), a multisystem zoonosis, in children and review the literature. RBF is caused by I of 2 Gram-negative organisms: Streptobacillus moniliformis or, less commonly, Spirillum minus. Both of our cases developed in school-aged girls with a history of rat exposure who presented with a multisystem illness consisting of fever, petechial and purpuric rash, arthralgia and polyarthritis. Both responded promptly to antibiotic treatment. An additional 10 cases from a MEDLINE review (1960-2000) are reviewed. RBF must be included in the differential diagnosis of febrile patients with rashes and a history of exposure to rats.

  15. [Enterococcus faecium lung abscess: one case report and literature review].

    Science.gov (United States)

    Fang, Xiang-Qun; Liu, You-Ning

    2010-02-01

    to study the diagnosis and treatment of enterococcus faecium lung abscess. a retrospective analysis of one case of Enterococcus faecium lung abscess and literature review was conducted. this patient suffered from cough and sputum over 6 months and complicated with hemoptysis over 3 months. Pulmonary embolism and lung cancer were suspected initially. After 2 times of CT-guided percutaneous transthoracic needle aspiration biopsy the diagnosis of pneumonia was made in other hospitals. However, the consolidation in the lung progressed and cavity appeared although antibiotic therapy was conducted. After admission to our hospital, CT-guided percutaneous transthoracic needle aspiration biopsy was made and the lung tissue was sent for bacterial culture. Enterococcus faecium was cultured and it was susceptible to vancomycin, teicoplanin and linezolid. The disease improved significantly after treatment with these 3 antibiotics in turn. In addition, 13 cases of enterococcus pneumonia or lung abscess were reviewed, including 3 cases of enterococcus faecium lung abscess. enterococcus faecium is rarely a pathogen for lung abscess. The diagnosis of enterococcus faecium lung abscess could be confirmed by lung biopsy and bacterial culture of lung tissue which could also provide the susceptibility of antibiotics and guide the antibiotic therapy.

  16. Regulatory review of safety cases and safety assessments - associated challenges

    International Nuclear Information System (INIS)

    Bennett, D.G.; Ben Belfadhel, M.; Metcalf, P.E.

    2006-01-01

    Regulatory reviews of safety cases and safety assessments are essential for credible decision making on the licensing or authorization of radioactive waste disposal facilities. Regulatory review also plays an important role in developing the safety case and in establishing stakeholders' confidence in the safety of the facility. Reviews of safety cases for radioactive waste disposal facilities need to be conducted by suitably qualified and experienced staff, following systematic and well planned review processes. Regulatory reviews should be sufficiently comprehensive in their coverage of issues potentially affecting the safety of the disposal system, and should assess the safety case against clearly established criteria. The conclusions drawn from a regulatory review, and the rationale for them should be reproducible and documented in a transparent and traceable way. Many challenges are faced when conducting regulatory reviews of safety cases. Some of these relate to issues of project and programme management, and resources, while others derive from the inherent difficulties of assessing the potential long term future behaviour of engineered and environmental systems. The paper describes approaches to the conduct of regulatory reviews and discusses some of the challenges faced. (author)

  17. Systematic review of case reports of antiphospholipid syndrome following infection.

    Science.gov (United States)

    Abdel-Wahab, N; Lopez-Olivo, M A; Pinto-Patarroyo, G P; Suarez-Almazor, M E

    2016-12-01

    The objective of this study was to conduct a systematic review of case reports documenting the development of antiphospholipid syndrome or antiphospholipid syndrome-related features after an infection. We searched Medline, EMBASE, Web of Science, PubMed ePubs, and The Cochrane Library - CENTRAL through March 2015 without restrictions. Studies reporting cases of antiphospholipid syndrome or antiphospholipid syndrome-related features following an infection were included. Two hundred and fifty-nine publications met inclusion criteria, reporting on 293 cases. Three different groups of patients were identified; group 1 included patients who fulfilled the criteria for definitive antiphospholipid syndrome (24.6%), group 2 included patients who developed transient antiphospholipid antibodies with thromboembolic phenomena (43.7%), and group 3 included patients who developed transient antiphospholipid antibodies without thromboembolic events (31.7%). The most common preceding infection was viral (55.6%). In cases that developed thromboembolic events Human immunodeficiency and Hepatitis C viruses were the most frequently reported. Parvovirus B19 was the most common in cases that developed antibodies without thromboembolic events. Hematological manifestations and peripheral thrombosis were the most common clinical manifestations. Positive anticardiolipin antibodies were the most frequent antibodies reported, primarily coexisting IgG and IgM isotypes. Few patients in groups 1 and 2 had persistent antiphospholipid antibodies for more than 6 months. Outcome was variable with some cases reporting persistent antiphospholipid syndrome features and others achieving complete resolution of clinical events. Development of antiphospholipid antibodies with all traditional manifestations of antiphospholipid syndrome were observed after variety of infections, most frequently after chronic viral infections with Human immunodeficiency and Hepatitis C. The causal relationship between infection

  18. Hydrocarbon storage caverns overhaul: A case study

    Energy Technology Data Exchange (ETDEWEB)

    McDougall, N. [Bayer Inc., Sarnia, ON (Canada)

    1998-09-01

    Case studies of four hydrocarbon storage cavern overhauls by Bayer Inc., of Sarnia during the period 1993 to 1997 were reviewed and the lessons learned were discussed. Discussions included inspection requirements for each of the caverns, the logistics and planning plant production around the cavern outages, site and cavern preparation, including removal of the casing slips from the well heads. It was emphasized that cavern overhauls can be expensive operations, unless preceded by proper planning. The largest variable cost is likely to be rig time at about $ 2,000 per day. Planning for the unexpected with thoughtful contingencies can reduce costs and avoid expensive delays.

  19. Review of relevant studies of isolated systems

    DEFF Research Database (Denmark)

    Hansen, L.H.; Lundsager, P.

    2001-01-01

    The report presents the results of a review of studies relating to integration of wind energy in isolated power supply systems, based on a systematic literature survey. The purpose of the study is to develop a methodology consisting of a set of guidelinesfor wind energy projects in isolated energy...... systems and a set of tools and models that are operational on an engineering level. The review is based on a literature search in the ETDE Energy Database with a main search covering the period 7/88 to 6/97 andsupplemented by partial update periods. A few newer references have been included in the review...... have been organised according to the following keywords: methods & guides, economics, concept ofapplication, system solutions, case studies, financial programmes, dedicated software tools. None of the found references presents methods or tools that contradict the philosophy of Risø's methodology...

  20. Synovial chondrosarcoma: Report of two cases and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Zamora, E.E. [Department of Orthopaedic Surgery, Hospital Dr. R.A Calderon Guardia, Universidad De Costa Rica, P.O. Box 628-3000, Heredia (Costa Rica); Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna (Italy); Mansor, A. [Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna (Italy); Department of Orthopaedic Surgery, University of Malaya, Kuala Lumpur 59100 (Malaysia); Vanel, D. [Musculoskeletal Oncology Research Center, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna (Italy)], E-mail: dvanel@ior.it; Errani, C.; Mercuri, M. [Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna (Italy); Picci, P. [Musculoskeletal Oncology Research Center, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna (Italy); Alberghini, M. [Musculoskeletal Anatomical Pathology Department, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna (Italy)

    2009-10-15

    Synovial chondrosarcoma is a rare soft tissue tumor that can arise from a previous synovial chondromatosis or as de novo tumor. The clinical and radiological findings of this malignancy are very similar to those of aggressive synovial chondromatosis. Confusion with other joint pathologies makes the diagnosis of synovial chondrosarcoma difficult in most of the cases. We present one recently diagnosed and treated case of synovial chondrosarcoma. The review of our hospital database revealed one more similar case. In both cases the malignancy arose from a pre-existing synovial chondromatosis. We also present a literature review emphasizing the clinical and histological findings of this rare entity.

  1. BERTIELLOSIS IN MAN: A REVIEW OF CASES

    Directory of Open Access Journals (Sweden)

    DENEGRI Guillermo M.

    1997-01-01

    Full Text Available The presence of Bertiella mucronata and Bertiella studeri (Cestoda: Anoplocephalidae in humans is reviewed, and international infection rates and a bibliography included. Taxonomic, biological, epidemiological, pathological, diagnostic, control, prevention and therapeutic aspects of the zoonosis are analyzed, and the increase in zoonotic potentiality of the parasitosis is discussed

  2. Pediatric Nonfracture Acute Compartment Syndrome: A Review of 39 Cases.

    Science.gov (United States)

    Livingston, Kristin; Glotzbecker, Michael; Miller, Patricia E; Hresko, Michael T; Hedequist, Daniel; Shore, Benjamin J

    2016-01-01

    Compartment syndrome in the absence of fracture is rare and poorly described within the pediatric literature. The purpose of this study was to report the varying etiologies, risk factors, and treatment outcomes associated with pediatric nonfracture acute compartment syndrome (NFACS). We conducted a retrospective chart review on 37 children who suffered a NFACS and were treated at a single pediatric trauma center between 1997 and 2013. Demographic, diagnostic, treatment, and outcome characteristics were reviewed. Five causal groups were generated: trauma, exercise related (acute presentation after exercise without trauma), infectious, vascular, and postoperative (in the absence of osteotomy). Univariate and multivariate analyses were performed to identify risk factors of NFACS. P-values 39 cases of NFRCS in 37 children [6 females, 31 males, mean age of 11.7 y (SD+7.2 y)]. The leg was the most commonly involved limb (29 cases, 74%). Diagnosis of NFRCS was made either by compartment pressure monitoring [59%, 23/39 cases, mean pressure 66 mm Hg (SD+28)] or by clinical examination. According to etiology, vascular was most common (11/39, 28%), followed by trauma (10/39, 26%) and postoperative (8/39, 21%), with exertion and infection representing a small proportion (6/39, 15% and 4/39, 10%, respectively). Pain was present in 33 cases (85%), swelling in 28 cases (72%), paresthesias in 13 cases (33%), motor deficit in 12 cases (31%), and poor perfusion in 11 cases (28%). Average time from symptom onset to diagnosis was 48 hours (IQR, 9 to 96 h). At surgery, 21 patients (54%) had evidence of myonecrosis. Children required an average of 3 surgeries for wound closure. The median time to follow-up was 232 days (IQR, 73 to 608 d). A total of 54% made a full recovery, whereas 31% suffered a persistent neurological or functional deficit. NFACS in children is associated with a delay in diagnosis and a high rate of myonecrosis. Timely assessment with high clinical suspicion is

  3. CASE REVIEW (Labor Law) | Fassil | Haramaya Law Review

    African Journals Online (AJOL)

    The Ethiopian labour law seemingly adopts the presumption of 'indefinite period' of engagement for all labour contracts. The burden is then on the employer to prove otherwise i.e. recruitments for definite period or piece work. This case comment drills on the effect of phaseout of project works on labour contract attached to it ...

  4. Cytomegalovirus retinitis and HIV: Case reviews from KwaZulu ...

    African Journals Online (AJOL)

    untreated, CMV retinitis can progress to retinal detachment with ... 1 Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris .... [18] Ocular TB .... patients for publication of these case reviews and accompanying images.

  5. Marfan's syndrome: case report and literature review | Atipo-Tsiba ...

    African Journals Online (AJOL)

    hyperlaxity, arachnodactyly, scoliosis, dolichostenomelia) and cardiovascular system (aortic pathology). The severity of this disease is related to its cardiovascular damage. We proposed to carry out a review of the literature from the first case ...

  6. Anaesthetic technique during awake craniotomy. Case report and literature review

    Directory of Open Access Journals (Sweden)

    M.M. Madriz-Godoy

    2016-07-01

    Results: This case was managed with a scalp nerve block as local anaesthesia plus intravenous sedation without airway instrumentation. We reviewed the literature about patient management during awake craniotomy.

  7. Childhood bruxism: a clinical review and case report.

    Science.gov (United States)

    Gupta, B; Marya, C M; Anegundi, R

    2010-01-01

    The present case report refers to a patient who reported to the department with the complaint of teeth grinding (Bruxism). A brief review of the literature is reported concerning the aetiology, clinical diagnosis and the therapeutic approach of the disease.

  8. Truncus arteriosus communis: report of three cases and review of ...

    African Journals Online (AJOL)

    Objectives: In this paper, we report on three observed cases from which we looked for (in conjunction with literature review) ..... canal, in position of a transient physiological dextroposi- ... such as maternal diabetes mellitus type 1 and 2; chronic.

  9. Retroesophageal right subclavian artery: a case report and review of ...

    African Journals Online (AJOL)

    Retroesophageal right subclavian artery: a case report and review of the literature. Anthony Ocaya. Department ... the left subclavian artery, and the left common carotid artery. Adachi first .... Vol 2, New York: Harper & Row. 1968. 13. Tubbs SR ...

  10. A fibreoptic endoscopic study of upper gastrointestinal bleeding at Bugando Medical Centre in northwestern Tanzania: a retrospective review of 240 cases.

    Science.gov (United States)

    Jaka, Hyasinta; Koy, Mheta; Liwa, Anthony; Kabangila, Rodrick; Mirambo, Mariam; Scheppach, Wolfgang; Mkongo, Eliasa; McHembe, Mabula D; Chalya, Phillipo L

    2012-07-03

    Upper gastrointestinal (GI) bleeding is recognized as a common and potentially life-threatening abdominal emergency that needs a prompt assessment and aggressive emergency treatment. A retrospective study was undertaken at Bugando Medical Centre in northwestern Tanzania between March 2010 and September 2011 to describe our own experiences with fibreoptic upper GI endoscopy in the management of patients with upper gastrointestinal bleeding in our setting and compare our results with those from other centers in the world. A total of 240 patients representing 18.7% of all patients (i.e. 1292) who had fibreoptic upper GI endoscopy during the study period were studied. Males outnumbered female by a ratio of 2.1:1. Their median age was 37 years and most of patients (60.0%) were aged 40 years and below. The vast majority of the patients (80.4%) presented with haematemesis alone followed by malaena alone in 9.2% of cases. The use of non-steroidal anti-inflammatory drugs, alcohol and smoking prior to the onset of bleeding was recorded in 7.9%, 51.7% and 38.3% of cases respectively. Previous history of peptic ulcer disease was reported in 22(9.2%) patients. Nine (3.8%) patients were HIV positive. The source of bleeding was accurately identified in 97.7% of patients. Diagnostic accuracy was greater within the first 24 h of the bleeding onset, and in the presence of haematemesis. Oesophageal varices were the most frequent cause of upper GI bleeding (51.3%) followed by peptic ulcers in 25.0% of cases. The majority of patients (60.8%) were treated conservatively. Endoscopic and surgical treatments were performed in 30.8% and 5.8% of cases respectively. 140 (58.3%) patients received blood transfusion. The median length of hospitalization was 8 days and it was significantly longer in patients who underwent surgical treatment and those with higher Rockall scores (P bleeding, shock, hepatic decompensation, HIV infection, comorbidities, malignancy, age > 60 years and in patients with

  11. Congenital intracranial meningioma. A case report and literature review

    DEFF Research Database (Denmark)

    Madsen, C; Schrøder, H D

    1993-01-01

    A case report of congenital intracranial meningioma is presented. We describe what appears to be the first fetal meningioma of the fibroblastic subtype. The literature is reviewed, and the subtype and sex distribution of fetal meningiomas is discussed.......A case report of congenital intracranial meningioma is presented. We describe what appears to be the first fetal meningioma of the fibroblastic subtype. The literature is reviewed, and the subtype and sex distribution of fetal meningiomas is discussed....

  12. Comparison of seropositivity of human T lymphotropic virus type 1 in mycosis fungoides patients and normal volunteers: A case-control study and review of literature

    Directory of Open Access Journals (Sweden)

    Seirafi Hassan

    2009-01-01

    Full Text Available Background: There have been controversial reports about the possible association between mycosis fungoides (MF, its leukemic variant Sιzary syndrome (SS and human T lymphotropic virus type 1 (HTLV-1 in different geographical regions. Aims: The purpose of this study was to explore any association between MF and presence of HTLV-1 infection in Iran. Methods: In a case-control setting, 150 clinically and histopathologically proven MF patients had been admitted to the tertiary referral skin center during a 10-year period and another 150 normal volunteers had been compared with each other for the presence of HTLV-1 infection. Enzyme-linked immunosorbent assay (ELISA was used to detect antibodies against HTLV-1, and positive results were confirmed with western blotting. Results: Only three MF patients had HTLV-1 infection, whereas two cases of normal subjects had the infection ( P > 0.05. The only three seropositive MF patients were male and from North-Eastern Iran . Conclusion: This study showed that MF does not correlate with HTLV-1 infection in Iran.

  13. Teaching Case: Enterprise Architecture Specification Case Study

    Science.gov (United States)

    Steenkamp, Annette Lerine; Alawdah, Amal; Almasri, Osama; Gai, Keke; Khattab, Nidal; Swaby, Carval; Abaas, Ramy

    2013-01-01

    A graduate course in enterprise architecture had a team project component in which a real-world business case, provided by an industry sponsor, formed the basis of the project charter and the architecture statement of work. The paper aims to share the team project experience on developing the architecture specifications based on the business case…

  14. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Sørensen, Pernille Dissing; Løkke, Ann-Kristina

    2006-01-01

    design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive...

  15. Clostridium cadaveris bacteraemia: two cases and review.

    NARCIS (Netherlands)

    Schade, R.P.; Rijn, M. Van; Timmers, H.J.L.M.; Dofferhoff, A.S.M.; Klaassen, C.H.W.; Meis, J.F.G.M.

    2006-01-01

    Clostridium cadaveris is a strict anaerobic Gram-positive rod that is the most prominent bacterium during the decay of dead bodies. We present 2 rare cases of bacteraemia with C. cadaveris. The source of both infectious episodes was most probably of gastrointestinal origin.

  16. Systemic mastocytosis: Case report with literature review

    Directory of Open Access Journals (Sweden)

    Mitrović Mirjana

    2012-01-01

    Full Text Available Introduction. Mastocytosis is a clonal neoplastic disorder of the mast cells. The clinical signs and symptoms of mastocytosis are heterogeneous ranging from indolent disease with a longterm survival to a highly aggressive neoplasm with survival of about 6 months. Systemic mastocytosis (SM is characterized by mastocyte infiltration of one or more organs, with or without skin involvment. Case Outline. The presented patient presents a highly challenging diagnostic and therapeutic case. A 46-year-old man was referred to our Centre due to the 7-year-long history of hepatosplenomegaly and mild thrombocytopenia. Ultrasound examination showed hepatosplenomegaly (liver 170 mm; spleen 200 mm, platelet count was 90Č109/L, serum tryptase level was elevated and bone marrow biopsy showed infiltration with mast cells (CD117, CD25 and mast cell tryptase positive. Our patient was diagnosed with aggressive systemic mastocytosis (SM according to WHO Classification (2008, although the clinical course of the disease was indolent, without complications for more than 7 years. Because of the ‘intermediate’ course, this patient was referred to as smouldering or intermediate SM and was not treated with cytostatics. Conclusion. Utilizing the established criteria, indolent SM can be discriminated from the aggressive subvariants of SM in most cases. However, a small group of patients, like our case belongs to the „grey zone“. Therapeutic approach to these patients is individual and prognosis is uncertain.

  17. Extraosseous Ewing's sarcoma: review of a case

    International Nuclear Information System (INIS)

    Quevedo Moreno, P.; Hernandez Moreno, L.; Perez Diaz, M.; Lafuente Martinez, J.L.; Arozamena Laso, M.

    1994-01-01

    Extraosseous Ewing's sarcoma (EES) is an uncommon lesion included in the group of soft tissue tumors. We present a case in a 19-year-old woman in which the diagnosis was not initially suspected because of the absence of clinical and radiological evidence. (Author)

  18. Review of the Reported Measures of Clinical Validity and Clinical Utility as Arguments for the Implementation of Pharmacogenetic Testing: A Case Study of Statin-Induced Muscle Toxicity

    Directory of Open Access Journals (Sweden)

    Marleen E. Jansen

    2017-08-01

    Full Text Available Advances from pharmacogenetics (PGx have not been implemented into health care to the expected extent. One gap that will be addressed in this study is a lack of reporting on clinical validity and clinical utility of PGx-tests. A systematic review of current reporting in scientific literature was conducted on publications addressing PGx in the context of statins and muscle toxicity. Eighty-nine publications were included and information was selected on reported measures of effect, arguments, and accompanying conclusions. Most authors report associations to quantify the relationship between a genetic variation an outcome, such as adverse drug responses. Conclusions on the implementation of a PGx-test are generally based on these associations, without explicit mention of other measures relevant to evaluate the test's clinical validity and clinical utility. To gain insight in the clinical impact and select useful tests, additional outcomes are needed to estimate the clinical validity and utility, such as cost-effectiveness.

  19. Radiation Retinopathy: Case report and review

    Directory of Open Access Journals (Sweden)

    Young Lorna

    2007-04-01

    Full Text Available Abstract Background Ocular damage from radiation treatment is a well established phenomenon. Many factors are now known to influence the incidence of radiation retinopathy, including total dosage and daily fraction size. Patients who are diabetic, hypertensive or received previous chemotherapy are more susceptible to radiation retinopathy. Case Presentation A 55 year old male was referred from the oncology department with epiphora. His medical history included Type 2 Insulin treated Diabetes Mellitus and hypertension. One year prior to presentation he had undergone a total rhinectomy with a 4 week course of post-operative radiotherapy for an aggressive sqaumous cell carcinoma of the nose. On examination the visual acuity was noted to be 6/36 left eye and 6/9 right eye. Posterior segment examination revealed marked retinal ischaemia present in the posterior pole and macular region of both eyes. The appearance was not thought to be typical of diabetic changes, radiation retinopathy being the more likely diagnosis especially in view of his history. Over the next four months the vision in both eyes rapidly deteriorated to 3/60 left eye and 1/60 right eye. Bilateral pan retinal photocoagulation was thought to be appropriate treatment at this point. Conclusion This case highlights the importance for ophthalmologists and oncologists to be aware of the close relationship between diabetes and radiation treatment and the profound rapid impact this combination of factors may have on visual function. Radiation is being used with increasing frequency for ocular and orbital disease, because of this more cases of radiation retinopathy may become prevalent. Factors which may potentiate radiation retinopathy should be well known including, increased radiation dosage, increased fraction size, concomitant systemic vascular disease and use of chemotherapy. Counselling should be offered in all cases at risk of visual loss. As no effective treatment currently exists

  20. Advanced nuclear systems. Review study; Fortgeschrittene Nuklearsysteme. Review Study

    Energy Technology Data Exchange (ETDEWEB)

    Liebert, Wolfgang; Glaser, Alexander; Pistner, Christoph [Interdisziplinaere Arbeitsgruppe Naturwissenschaft, Technik und Sicherheit (IANUS), Darmstadt University of Technology, Hochschulstrasse 10, D-64289 Darmstadt (Germany); Baehr, Roland; Hahn, Lothar [Institute for applied ecology (Oeko-Institut), Elisabethenstrasse 55-57, D-64283 Darmstadt (Germany)

    1999-04-01

    The task of this review study is to from provide an overview of the developments in the field of the various advanced nuclear systems, and to create the basis for more comprehensive studies of technology assessment. In an overview the concepts for advanced nuclear systems pursued worldwide are subdivided into eight subgroups. A coarse examination raster (set pattern) is developed to enable a detailed examination of the selected systems. In addition to a focus on enhanced safety features, further aspects are also taken into consideration, like the lowering of the proliferation risk, the enhancement of the economic competitiveness of the facilities and new usage possibilities (for instance concerning the relaxation of the waste disposal problem or the usage of alternative fuels to uranium). The question about the expected time span for realization and the discussion about the obstacles on the way to a commercially usable reactor also play a substantial role as well as disposal requirements as far as they can be presently recognized. In the central chapter of this study, the documentation of the representatively selected concepts is evaluated as well as existing technology assessment studies and expert opinions. In a few cases where this appears to be necessary, according technical literature, further policy advisory reports, expert statements as well as other relevant sources are taken into account. Contradictions, different assessments and dissents in the literature as well as a few unsettled questions are thus indicated. The potential of advanced nuclear systems with respect to economical and societal as well as environmental objectives cannot exclusively be measured by the corresponding intrinsic or in comparison remarkable technical improvements. The acceptability of novel or improved systems in nuclear technology will have to be judged by their convincing solutions for the crucial questions of safety, nuclear waste and risk of proliferation of nuclear weapons

  1. Case Study of 'moral injury' : Format Dutch Case Studies Project

    NARCIS (Netherlands)

    Korver, Sjaak; Walton, Martin N.; van Loenen, Guus

    2017-01-01

    The case study ‘Moral Injury’ traces care provided by a chaplain in a mental health institution to a former military marksman named Hans. Hans was in care at a specialized unit for military veterans with traumas. He sought contact with a chaplain “to set things right with God” and wanted the

  2. Facial duplication: case, review, and embryogenesis.

    Science.gov (United States)

    Barr, M

    1982-04-01

    The craniofacial anatomy of an infant with facial duplication is described. There were four eyes, two noses, two maxillae, and one mandible. Anterior to the single pituitary the brain was duplicated and there was bilateral arhinencephaly. Portions of the brain were extruded into a large frontal encephalocele. Cases of symmetrical facial duplication reported in the literature range from two complete faces on a single head (diprosopus) to simple nasal duplication. The variety of patterns of duplication suggests that the doubling of facial components arises in several different ways: Forking of the notochord, duplication of the prosencephalon, duplication of the olfactory placodes, and duplication of maxillary and/or mandibular growth centers around the margins of the stomatodeal plate. Among reported cases, the female:male ratio is 2:1.

  3. eCompetence Case Studies

    DEFF Research Database (Denmark)

    Jensen, Helle Bækkelund

    2006-01-01

    In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches.......In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

  4. Tracheobronchopathia Osteochondroplastica; Case report and literature review

    Directory of Open Access Journals (Sweden)

    Nasser Al-Busaidi

    2012-02-01

    Full Text Available Tracheobronchopathia osteochondroplastica (TPO is a rare, benign condition involving the trachea. TPO is characterised by osteocartilaginous nodules developing within the submuscosa of the trachea, sparing the posterior wall. We present the first documented case of TPO in Oman in a 25 year-old Omani male who presented with a recurrent, productive cough from which he had suffered throughout the previous two years. Diagnosis was made by characteristic computed tomography scan, bronchoscopic findings, and a histopathological examination.

  5. Adult intussusception: A case series and review

    OpenAIRE

    Shenoy, Santosh

    2017-01-01

    AIM To identify factors differentiating pathologic adult intussusception (AI) from benign causes and the need for an operative intervention. Current evidence available from the literature is discussed. METHODS This is a case series of eleven patients over the age of 18 and a surgical consultation for ?Intussusception? at a single veteran?s hospital over a five-year period (2011-2016). AI was diagnosed on computed tomography (CT) scan and or flexible endoscopy (colonoscopy). Surgical referrals...

  6. Biperiden Dependence: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Fernando Espi Martinez

    2012-01-01

    Full Text Available Anticholinergic drugs are frequently used in psychiatry for the prophylaxis and treatment of extrapiramidal symptoms caused by neuroleptics. Abuse of anticholinergic agents has been reported in patients with psychotic disorders, on treatment with neuroleptics, and polysubstance use disorders. We are reporting the case of a patient who presented with hypoactive delirium as a consequence of biperiden dependence. The clinician must pay special attention to detect anticholinergic misuse in patients presenting with delirium of unknown cause.

  7. Development of the major trauma case review tool.

    Science.gov (United States)

    Curtis, Kate; Mitchell, Rebecca; McCarthy, Amy; Wilson, Kellie; Van, Connie; Kennedy, Belinda; Tall, Gary; Holland, Andrew; Foster, Kim; Dickinson, Stuart; Stelfox, Henry T

    2017-02-28

    As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-review process that includes trauma system safety and human factors. There is no published, evidence-informed standardised tool that considers these factors for use in adult or paediatric trauma case peer-review. The aim of this research was to develop and validate a trauma case review tool to facilitate clinical review of paediatric trauma patient care in extracting information to facilitate monitoring, inform change and enable loop closure. Development of the trauma case review tool was multi-faceted, beginning with a review of the trauma audit tool literature. Data were extracted from the literature to inform iterative tool development using a consensus approach. Inter-rater agreement was assessed for both the pilot and finalised versions of the tool. The final trauma case review tool contained ten sections, including patient factors (such as pre-existing conditions), presenting problem, a timeline of events, factors contributing to the care delivery problem (including equipment, work environment, staff action, organizational factors), positive aspects of care and the outcome of panel discussion. After refinement, the inter-rater reliability of the human factors and outcome components of the tool improved with an average 86% agreement between raters. This research developed an evidence-informed tool for use in paediatric trauma case review that considers both system safety and human factors to facilitate clinical review of trauma patient care. This tool can be used to identify opportunities for improvement in trauma care and guide quality assurance activities. Validation is required in the adult population.

  8. Gorlin-Goltz Syndrome: Case report and literature review.

    Science.gov (United States)

    Ramesh, Maya; Krishnan, Ramesh; Chalakkal, Paul; Paul, George

    2015-01-01

    Gorlin-Goltz syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. This article includes a case report and an extensive review of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumor and treatment modalities.

  9. Review of China's bioethanol development and a case study of fuel supply, demand and distribution of bioethanol expansion by national application of E10

    International Nuclear Information System (INIS)

    Tao, Jing; Yu, Suiran; Wu, Tianxing

    2011-01-01

    The increasing dependence on imported oil and tremendous greenhouse gases (GHG) emission is making the diversification of primary fuel such as petroleum a critical vital energy and environmental issue in China. China is promoting bioethanol by mandatory use in nine provinces and the expansion is on agenda. This paper first reviews China's bioethanol development. Next, suitable feedstock crops for expanded ethanol production are discussed. Particularly, bioethanol expansion by national application of E10 is investigated from perspectives of potential in bioethanol supply, projected ethanol demand, and the possible cost-effective bioethanol distribution system. It is calculated that by making use of un-used land for feedstock planting and introduction of improved feedstock varieties, potential bioethanol production capacity in China will be up to 25.33 million tons per year. Ethanol demand for national application of E10 is projected to be around 7 million tons per year. A linear optimization model is used to consider the economic costs of distributing bioethanol in China. The optimization result suggests that development of bioethanol industry may focus on Henan, Jilin, Anhui, Jiangxi and Sichuan basin. It also estimates 53.79 RMB per ton of bioethanol for downstream rail or truck transportation remain a relatively small fraction of total fuel cost. Thanks to the well developed railway network in China, more bioethanol can be distributed at a relatively modest premium distribution costs and with low environmental influences. -- Highlights: → China's bioethanol development is reviewed. → Ethanol potential, projected demand and efficient distribution system are studied. → We find that nationwide bioethanol application can be commercially viable. → Impacts of oil and feedstock prices on ethanol expansion are discussed. → Ecological impacts of large scale feedstock crop plantation should be inspected.

  10. Case Study on Logistics Performance

    Directory of Open Access Journals (Sweden)

    Shahryar Sorooshian

    2013-05-01

    Full Text Available The paper presents research carried out at a medium‐size manufacturing organization in east Asia. The study tries to highlight the importance of supply chain management; specifically, our aim for this study is to understand logistics and performance measurement in the logistics and supply chain, and we include a theoretical discussion of online data collected and a case study of the logistic performance of a real organization. The study also examines the performance of the selected company, identifies the problems and provides recommendations for improvements. This study can be a guide for business advisers and those interested in analysing company performance, especially from a logistics viewpoint. We also suggest the methodology of this case study for those who want to have a better understanding of a business environment before starting their own business, or for benchmarking practice during strategic planning.

  11. BioFleet case studies

    International Nuclear Information System (INIS)

    2007-01-01

    These six case studies examined the use of different biodiesel blends as fuel supply sources for businesses in British Columbia (BC). In the first case study, 6 municipalities participated in a pilot program designed to compare the performance of biodiesel and diesel fuels. Each municipality operated 2 base vehicles running on conventional diesel along with 2 similar vehicles which used biodiesel. Real time emissions tests and analyses of the vehicles using biodiesel were also conducted by 2 of the participating municipalities. All municipalities participating in the study agreed to purchase significant volumes of biodiesel. The second case study described a pilot study conducted by the City of Vancouver's equipment services branch in 2004. As a result of the study, the city now has over 530 types of equipment that use biodiesel. The third case study described a program designed by TSI Terminals in Vancouver to assess the emission reduction impact of using biodiesel at its port facility. Six different pieces of equipment were used to confirm that biodiesel could be used throughout the terminal. Test results confirmed that biodiesel blends could be used to reduce emissions. Overall emissions were reduced by 30 per cent. The fourth case study described a waste renderer that used a fleet of 36 trucks to deliver raw products to its plants. The company made the decision to use only biodiesel for its entire fleet of trucks. Since July 2005, the company has logged over 1.7 million km using biodiesel blends. The fifth case study described a salmon hatchery that switched from diesel to biodiesel in order to reduce emissions. The biodiesel blends are used to fuel the hatchery's 2 diesel generators. The hatchery has reduced emissions of greenhouse gases (GHGs) by an estimated 1800 tonnes annually. The sixth case study described how the Township of Langley has started using biodiesel for its entire fleet of of approximately 250 pieces of equipment. The township has not

  12. Review of Southern African Studies

    African Journals Online (AJOL)

    Review of Southern African Studies is a multidisciplinary journal of Arts, Social and Behavioural Sciences. Vol 13, No 1 (2009). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Table of Contents. Articles. Health-Care Waste Practices in Selected Health-Care Facilities in Maseru ...

  13. Small Intestinal Bacterial Overgrowth: A Case-Based Review

    Directory of Open Access Journals (Sweden)

    Kristen H. Reynolds

    2015-11-01

    Full Text Available Small intestinal bacterial overgrowth (SIBO is a condition of increased microbial load in the small intestine. The microbes feed on dietary carbohydrates and starches via fermentation, leading to gas production, inflammation and damage to the lining of the small intestine. Clinical presentation is varied, including abdominal pain, bloating, malabsorption and systemic symptoms. SIBO is associated with many challenging and chronic conditions such as fibromyalgia, chronic fatigue and chronic pain syndromes, and has been shown to be a causative factor in two out of three cases of irritable bowel syndrome. Symptoms improve with antimicrobial treatment, but recurrence is common. Many providers may not be aware of SIBO. This narrative review highlights a clinical case and the most recent literature regarding SIBO, including history, clinical presentation, prevalence, pathophysiology, diagnostic workup, treatment and prevention. Integrative medicine approaches, including diet, supplements and manual therapies, are also reviewed. SIBO can be a challenging condition and requires an integrative, patient-centered approach. Further studies are needed to guide clinicians in the workup and treatment of SIBO.

  14. A review of national policies and strategies to improve quality of health care and patient safety: a case study from Lebanon and Jordan.

    Science.gov (United States)

    El-Jardali, Fadi; Fadlallah, Racha

    2017-08-16

    Improving quality of care and patient safety practices can strengthen health care delivery systems, improve health sector performance, and accelerate attainment of health-related Sustainability Development Goals. Although quality improvement is now prominent on the health policy agendas of governments in low- and middle-income countries (LMICs), including countries of the Eastern Mediterranean Region (EMR), progress to date has not been optimal. The objective of this study is to comprehensively review existing quality improvement and patient safety policies and strategies in two selected countries of the EMR (Lebanon and Jordan) to determine the extent to which these have been institutionalized within existing health systems. We used a mixed methods approach that combined documentation review, stakeholder surveys and key informant interviews. Existing quality improvement and patient safety initiatives were assessed across five components of an analytical framework for assessing health care quality and patient safety: health systems context; national policies and legislation; organizations and institutions; methods, techniques and tools; and health care infrastructure and resources. Both Lebanon and Jordan have made important progress in terms of increased attention to quality and accreditation in national health plans and strategies, licensing requirements for health care professionals and organizations (albeit to varying extents), and investments in health information systems. A key deficiency in both countries is the absence of an explicit national policy for quality improvement and patient safety across the health system. Instead, there is a spread of several (disjointed) pieces of legal measures and national plans leading to fragmentation and lack of clear articulation of responsibilities across the entire continuum of care. Moreover, both countries lack national sets of standardized and applicable quality indicators for performance measurement and benchmarking

  15. [Review of 1,172 clinical cases with human communication disorders].

    Science.gov (United States)

    de Díaz, M R; de Pustilnik, N F; Tortolero, Y

    1976-01-01

    The study comprised 1,172 clinical cases that were classified according to sex, age and speech disorders. A review is made on the most common alterations that they present, the selective treatment in each type and their rehabilitation.

  16. Giant cholesteatoma: case and literature review' report

    Directory of Open Access Journals (Sweden)

    Nunes, Leonardo Mendes Acatauassú

    2010-03-01

    Full Text Available Introduction: Cholesteatomas are cystic lesions encased by stratified squamous epithelium, filled for keratin. They are classified in congenital, about of 2-5% and acquired, which are subdivided in primary formed from a tympanic retraction and secondary, originated from epithelium migration through a tympanic perforation. They are tumeurs with an expansive capacity and of bone lysis being able to invade adjacent structures. Case Report: This work reports the case of ONV, 23 years old from Macapá/Amapá. In august 2007, he/she appeared to attendance with a case history of right chronic otorrhea, he/she also reported meningitis and progressive right peripherica facial paralysis. The mastoid tomography demonstrated an hypodense image with density of soft tissues filling the middle ear, destructing the ossicular chain, semicircular canals, cochlea and extending until next to the proximal portion of the internal auditory meatus. He/she was referred to surgery. During the trans-operative it is evidenced an extensive destruction of the cortical layer of the mastoid, which was obstructed by a mass of an yellow coloration, fetid and of the consistent aspect. After the lesion is removed it is verified the presence of fistulae of high debit with posterior fossa. It was proceeded with the fistulae closing with a bone wax and temporal muscle shred. The patient remained confined during 15 days in use wide antimicrobial schema. Currently, it is find in regular accompaniment and in a good general state. Final Comments: This work aims to call attention to the rigorous complications of these pathologies , which despite to be common and to be a benign tumoral lesion can bring severe sequelae to the patient, in the event of the diagnosis and treatment not to be prematurely performed.

  17. Applying a Health Network approach to translate evidence-informed policy into practice: A review and case study on musculoskeletal health

    Directory of Open Access Journals (Sweden)

    Briggs Andrew M

    2012-11-01

    Full Text Available Abstract Background While translation of evidence into health policy and practice is recognised as critical to optimising health system performance and health-related outcomes for consumers, mechanisms to effectively achieve these goals are neither well understood, nor widely communicated. Health Networks represent a framework which offers a possible solution to this dilemma, particularly in light of emerging evidence regarding the importance of establishing relationships between stakeholders and identifying clinical leaders to drive evidence integration and translation into policy. This is particularly important for service delivery related to chronic diseases. In Western Australia (WA, disease and population-specific Health Networks are comprised of cross-discipline stakeholders who work collaboratively to develop evidence-informed policies and drive their implementation. Since establishment of the Health Networks in WA, over 50 evidence-informed Models of Care (MoCs have been produced across 18 condition or population-focused Networks. The aim of this paper is to provide an overview of the Health Network framework in facilitating the translation of evidence into policy and practice with a particular focus on musculoskeletal health. Case presentation A review of activities of the WA Musculoskeletal Health Network was undertaken, focussing on outcomes and the processes used to achieve them in the context of: development of policy, procurement of funding, stakeholder engagement, publications, and projects undertaken by the Network which aligned to implementation of MoCs. The Musculoskeletal Health Network has developed four MoCs which reflect Australian National Health Priority Areas. Establishment of community-based services for consumers with musculoskeletal health conditions is a key recommendation from these MoCs. Through mapping barriers and enablers to policy implementation, working groups, led by local clinical leaders and supported by

  18. Systematic review of studies generating individual participant data on the efficacy of drugs for treating soil-transmitted helminthiases and the case for data-sharing.

    Science.gov (United States)

    Halder, Julia B; Benton, Joanne; Julé, Amélie M; Guérin, Phillipe J; Olliaro, Piero L; Basáñez, María-Gloria; Walker, Martin

    2017-10-01

    Preventive chemotherapy and transmission control (PCT) by mass drug administration is the cornerstone of the World Health Organization (WHO)'s policy to control soil-transmitted helminthiases (STHs) caused by Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm) and hookworm species (Necator americanus and Ancylostama duodenale) which affect over 1 billion people globally. Despite consensus that drug efficacies should be monitored for signs of decline that could jeopardise the effectiveness of PCT, systematic monitoring and evaluation is seldom implemented. Drug trials mostly report aggregate efficacies in groups of participants, but heterogeneities in design complicate classical meta-analyses of these data. Individual participant data (IPD) permit more detailed analysis of drug efficacies, offering increased sensitivity to identify atypical responses potentially caused by emerging drug resistance. We performed a systematic literature review to identify studies concluding after 2000 that collected IPD suitable for estimating drug efficacy against STH. We included studies that administered a variety of anthelmintics with follow ups less than 60 days after treatment. We estimated the number of IPD and extracted cohort- and study-level meta-data. We estimate that there exist individual data on approximately 35,000 participants from 129 studies conducted in 39 countries, including 34 out of 103 countries where PCT is recommended. We find significant heterogeneity in diagnostic methods, times of outcome assessment, and the reported measure of efficacy. We also quantify cohorts comprising pre-school age children, pregnant women, and co-infected participants, including with HIV. We argue that establishing a global IPD repository would improve the capacity to monitor and evaluate the efficacy of anthelmintic drugs, respond to changes and safeguard the ongoing effectiveness of PCT. Establishing a fair, transparent data governance policy will be key for the

  19. Systematic review of studies generating individual participant data on the efficacy of drugs for treating soil-transmitted helminthiases and the case for data-sharing.

    Directory of Open Access Journals (Sweden)

    Julia B Halder

    2017-10-01

    Full Text Available Preventive chemotherapy and transmission control (PCT by mass drug administration is the cornerstone of the World Health Organization (WHO's policy to control soil-transmitted helminthiases (STHs caused by Ascaris lumbricoides (roundworm, Trichuris trichiura (whipworm and hookworm species (Necator americanus and Ancylostama duodenale which affect over 1 billion people globally. Despite consensus that drug efficacies should be monitored for signs of decline that could jeopardise the effectiveness of PCT, systematic monitoring and evaluation is seldom implemented. Drug trials mostly report aggregate efficacies in groups of participants, but heterogeneities in design complicate classical meta-analyses of these data. Individual participant data (IPD permit more detailed analysis of drug efficacies, offering increased sensitivity to identify atypical responses potentially caused by emerging drug resistance.We performed a systematic literature review to identify studies concluding after 2000 that collected IPD suitable for estimating drug efficacy against STH. We included studies that administered a variety of anthelmintics with follow ups less than 60 days after treatment. We estimated the number of IPD and extracted cohort- and study-level meta-data.We estimate that there exist individual data on approximately 35,000 participants from 129 studies conducted in 39 countries, including 34 out of 103 countries where PCT is recommended. We find significant heterogeneity in diagnostic methods, times of outcome assessment, and the reported measure of efficacy. We also quantify cohorts comprising pre-school age children, pregnant women, and co-infected participants, including with HIV.We argue that establishing a global IPD repository would improve the capacity to monitor and evaluate the efficacy of anthelmintic drugs, respond to changes and safeguard the ongoing effectiveness of PCT. Establishing a fair, transparent data governance policy will be key for

  20. Advanced nuclear systems. Review study

    International Nuclear Information System (INIS)

    Liebert, Wolfgang; Glaser, Alexander; Pistner, Christoph; Baehr, Roland; Hahn, Lothar

    1999-04-01

    The task of this review study is to from provide an overview of the developments in the field of the various advanced nuclear systems, and to create the basis for more comprehensive studies of technology assessment. In an overview the concepts for advanced nuclear systems pursued worldwide are subdivided into eight subgroups. A coarse examination raster (set pattern) is developed to enable a detailed examination of the selected systems. In addition to a focus on enhanced safety features, further aspects are also taken into consideration, like the lowering of the proliferation risk, the enhancement of the economic competitiveness of the facilities and new usage possibilities (for instance concerning the relaxation of the waste disposal problem or the usage of alternative fuels to uranium). The question about the expected time span for realization and the discussion about the obstacles on the way to a commercially usable reactor also play a substantial role as well as disposal requirements as far as they can be presently recognized. In the central chapter of this study, the documentation of the representatively selected concepts is evaluated as well as existing technology assessment studies and expert opinions. In a few cases where this appears to be necessary, according technical literature, further policy advisory reports, expert statements as well as other relevant sources are taken into account. Contradictions, different assessments and dissents in the literature as well as a few unsettled questions are thus indicated. The potential of advanced nuclear systems with respect to economical and societal as well as environmental objectives cannot exclusively be measured by the corresponding intrinsic or in comparison remarkable technical improvements. The acceptability of novel or improved systems in nuclear technology will have to be judged by their convincing solutions for the crucial questions of safety, nuclear waste and risk of proliferation of nuclear weapons

  1. Supernumerary teeth: case report and literature review

    International Nuclear Information System (INIS)

    Bolanos Lopez, Violeta

    2008-01-01

    Supernumerary teeth (ST) have been an anomaly of tooth development, this is refered to the increase in the number of pieces in the normal dentition. It can be unique, multiple, unilateral or bilateral, normal or altered form; appear erupted, impacted or retained. Both dentitions are affected, but is most common in the permanent. The literature review has covered and mentioned spanned supernumerary teeth, the definition, etiology, characteristics and classification according to number, position and shape; as diagnose, alterations or clinical sequelae - eruptive associated with them and possible treatments to be done when it occurs. The presence of mechanical accidents have been a frequent complication, within this, displacement of adjacent teeth has been the most common; is associated with different syndromes such as lip and palate cleft; however, they can not be related with pathologies; being mesiodens the most frequent. (author) [es

  2. Case Studies in Sports Nutrition.

    Science.gov (United States)

    Clark, Nancy

    1988-01-01

    This article presents case studies of two athletes who wanted to affect a change in their body weight in order to enhance athletic performance. Each athlete's problem and the nutrition approach used to solve it are discussed. Caloric values of fast foods are listed. (JL)

  3. Shea case study Burkina Faso

    NARCIS (Netherlands)

    S. Drost (Sarah); J.C.A.C. van Wijk (Jeroen); S.R. Vellema (Sietze)

    2012-01-01

    textabstractThis shea case study is part of a larger Partnerships Resource Centre (PrC) project elaborated in tandem with two Dutch non-governmental organisations (NGOs); ICCO and Oxfam Novib. The endeavour of this ‘action research’ project is to combine the expert knowledge of development

  4. The reflexive case study method

    DEFF Research Database (Denmark)

    Rittenhofer, Iris

    2015-01-01

    This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnational...

  5. Superficial siderosis: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Kresojević Nikola D.

    2013-01-01

    Full Text Available Introduction. Superficial siderosis (SS is caused by chronic subarachnoid bleeding and is characterized by free iron and hemosiderin deposition along the pial and subpial structures of central nervous system. SS leads to progressive and irreversible CNS damage. The most common causes of chronic subarachnoidal bleeding are tumors, head and spinal cord trauma, arteriovenous malformations and aneurysms. SS is characterized by clinical triad: sensorineural hearing loss, cerebellar ataxia and piramydal signs. Brain MR imaging is the investigation of choice for the diagnosis of SS. Typical findings include hypointensities seen on T2­weighted MR imaging around the brain, cerebellum, brain stem, spinal cord, VIII cranial nerve and atrophy of cerebellum and medulla. Case Outline. A 71-year­old female patient noticed hand tremor in the middle of the third decade of life, and later slowly progressive bilateral hearing loss. At the age of 64 she developed un­ steady gate, hand clumsiness and dysarthria, to became incapable of independent walking and standing five years later. Clinical course and brain MRI findings were typical for SS, but additional investigation did not reveal the couse of subarahnoidal bleeding. Conclusion. SS represents a rare and under­recognized condition that must be considered in all patients with cerebellar syndrome of unknown cause. Early diagnosis of SS in some cases with identified cause of chronic bleeding allowes therapeutic interventions that may prevent further progression of the disease. [Projekat Ministarstva nauke Republike Srbije, br. 175090

  6. [Chronic pancreatitis: Retrospective review of 121 cases].

    Science.gov (United States)

    Berger F, Zoltán; Mancilla A, Carla

    2016-12-01

    Chronic pancreatitis (CP) is a rare disease in Chile, without a clear explanation for this low prevalence. To analyze the characteristics of our patients with pancreatitis. Retrospective analysis of a database of patients with pancreatitis of a clinical hospital. Morphological proof of diagnosis (calcifications/calculi, alterations of ducts, local complication or histology) was obtained for every patient. History of acute pancreatitis was recorded and exocrine-endocrine function was assessed. We retrieved information of 121 patients with pancreatitis (86 males) in a period of 20 years. The number of cases increased markedly every five years. The calculated incidence and prevalence was 0.8/100,000/year and 6/100,000, respectively. Pancreatic calcifications were initially observed in 93 patients and became evident during the follow-up in another six patients. Severe pain or local complications occurred in 27 patients, requiring surgery in 10 or endoscopic treatment in 15. During the years of follow-up, 55 patients were free of symptoms. Exocrine and endocrine insufficiency was demonstrated and treated in 81 and 67 patients, respectively. Alcoholic etiology was evident in 40% of patients. In 29% no etiology was identified. Mapuche origin was exceptional. Late diagnosis of CP is common, since most of our patients presented with advanced stages. Even though CP is increasingly diagnosed in our hospitals, the number of cases is still far fewer when compared to other countries. Underdiagnosis alone cannot explain this difference and genetic factors might be of importance.

  7. Ciliated Median Raphe Cyst of Perineum Presenting as Perianal Polyp: A Case Report with Immunohistochemical Study, Review of Literature, and Pathogenesis

    Directory of Open Access Journals (Sweden)

    Jayesh Sagar

    2006-01-01

    Full Text Available Median raphe cyst is a very rare, benign congenital lesion occurring mainly on the ventral aspect of the penis, but can develop anywhere in the midline between the external urethral meatus and anus. We report a case of median raphe cyst in the perineum presenting as a perianal polyp in a 65-year-old, English white male with exceptionally rare ciliated epithelium. According to our knowledge, this is the third such case of ciliated median raphe cyst in the English literature. This case, also the first case of ciliated median raphe cyst in the perineum location, focuses on pathogenesis of median raphe cyst.

  8. Ciliated median raphe cyst of perineum presenting as perianal polyp: a case report with immunohistochemical study, review of literature, and pathogenesis.

    Science.gov (United States)

    Sagar, Jayesh; Sagar, Bethani; Patel, Adam F; Shak, D K

    2006-03-05

    Median raphe cyst is a very rare, benign congenital lesion occurring mainly on the ventral aspect of the penis, but can develop anywhere in the midline between the external urethral meatus and anus. We report a case of median raphe cyst in the perineum presenting as a perianal polyp in a 65-year-old, English white male with exceptionally rare ciliated epithelium. According to our knowledge, this is the third such case of ciliated median raphe cyst in the English literature. This case, also the first case of ciliated median raphe cyst in the perineum location, focuses on pathogenesis of median raphe cyst.

  9. Paraneoplastic Ischemic Stroke: Case Report and Review

    Directory of Open Access Journals (Sweden)

    Murat Sumer

    2008-10-01

    Full Text Available OBJECTIVE: Paraneoplastic etiology is not frequent among cerebrovascular disorders. This rare disorder is interesting with different mechanisms, clinical manifestations and treatment options. Diagnosis may be overlooked for its rarity. We present a paraneoplastic ischemic stroke patient with its clinical and imaging characteristics for recalling this rare disease. CASE: A sixty years old woman with a history of ovarian and colon cancer and liver metastasis admitted with acute left sided hemiplegia. Brain magnetic resonance imaging showed multiple ischemic lesions at the same age. Laboratory findings were compatible with chronic disseminated intravascular coagulopathy. She was anticoagulated but the clinical findings were not changed. She died one month after her discharge from the hospital. CONCLUSIONS: Paraneoplastic ischemic stroke is rare and it should be recognized by the clinician to differentiate from other ischemic strokes by its different mechanisms, imaging characteristics and treatment modalities. Prognosis depends on the characteristics of the primary tumor

  10. Traumatic chylothorax: A case report and review

    Directory of Open Access Journals (Sweden)

    Wezi Sendama

    2015-01-01

    Full Text Available Chylothorax is a rare entity characterised by leakage of lymphatic fluid into the pleural cavity from the thoracic duct. We present a case of traumatic chylothorax following a traumatic fracture of the L1 vertebra. An 84-year-old lady presented to the emergency department after being found collapsed at home. She gave a preceding history of one day of diarrhoea. Chest X-ray showed a rightsided effusion. Drainage of the effusion yielded a cloudy, off-white fluid that settled in layers in the drainage container. Pleural fluid examination revealed a lymphocyte-rich transudate with high levels of cholesterol and triglycerides. CT imaging of the chest, abdomen and pelvis revealed an acute left sided pulmonary embolus, and a multisegment burst fracture of the L1 vertebra. The patient was anticoagulated for the pulmonary embolus. Conservative fracture management was advised. Chylous drainage of 1l/24hr was observed. Due to ongoing chylous leak the patient was commenced on a medium-chain fatty acid diet and octreotide. Whilst chylous drainage ceased the patient died from infected pressure sores, malnutrition and acute kidney injury. Spinal trauma can rarely cause disruption of the thoracic duct and chylothorax. Diagnosis of chylothorax hinges on the typically high triglyceride content of chylous fluid and the detection of chylomicrons where the triglyceride concentration is equivocal. Management options for persistently draining chylothorax are varied and range from non-invasive medical measures to radiological and surgical interventions (although the patient in the case we present was an unsuitable candidate for surgery. We discuss pertinent diagnostic testing and put forward possible medical management strategies for chylothorax.

  11. Medical review practices for driver licensing volume 2: case studies of medical referrals and licensing outcomes in Maine, Ohio, Oregon, Texas, Washington, and Wisconsin.

    Science.gov (United States)

    2017-03-01

    This is the second of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk : drivers. This volume pre...

  12. Left-sided appendicitis: review of 95 published cases and a case report.

    Science.gov (United States)

    Akbulut, Sami; Ulku, Abdullah; Senol, Ayhan; Tas, Mahmut; Yagmur, Yusuf

    2010-11-28

    To give an overview of the literature on left-sided acute appendicitis (LSAA) associated with situs inversus totalis (SIT) and midgut malrotation (MM). We present a new case of LSAA with SIT and a literature review of studies published in the English language on LSAA, accessed via PubMed and Google Scholar databases. Ninety-five published cases of LSAA were evaluated and a 25-year-old female, who presented to our clinic with left lower abdominal pain caused by LSAA, is reported. In the reviewed literature, fifty-seven patients were male and 38 were female with an age range of 8 to 82 years and a median age of 29.1 ± 15.9 years. Sixty-six patients had SIT, 23 had MM, three had cecal malrotation, and two had a previously unnoted congenital abnormality. Fifty-nine patients had presented to the hospital with left lower, 14 with right lower and seven with bilateral lower quadrant pain, and seven subjects complained of left upper quadrant pain. The diagnosis was established preoperatively in 49 patients, intraoperatively in 19, and during the postoperative period in five; 14 patients were aware of having this anomaly. The data of eight patients were not unavailable. Eleven patients underwent laparoscopic appendectomy, which was combined with cholecystectomy in two cases. Histopathological examination of the appendix specimens revealed adenocarcinoma in only two of 95 patients. The diagnosis of left lower quadrant pain is based on well-established clinical symptoms, physical examination and physician's experience.

  13. Papilomatosis in dogs: literature review and study of twelve cases/ Papilomatose oral em cães: revisão da literatura e estudo de doze casos

    Directory of Open Access Journals (Sweden)

    Jane Megid

    2009-07-01

    Full Text Available Canine papillomatosis is an infectious viral disease characterized by oral, cutaneous or ocular papillomas, usually benign. The treatment is indicated in animals, with multiple tumors that produce pharyngeal obstruction, and problems of eating or for aesthetic reasons. Different treatment protocols have been proposed, including surgical excision, cryosurgery, electro surgery, autogenous or recombinant vaccines, imunomodulators drugs, systemic and intralesional chemotherapy. In this study were reviewed the more important aspects of canine oral papillomatosis. In the 12 studied animals, the papillomas were observed predominantly in mouth, gum and palate regions, in puppies until 12 months, presenting combined infection with ehrlichiosis. The treatment using Propionibacterium acnes and/or autogenous vaccine showed efficacy in eight dogs (66.7%.Papilomatose canina é uma enfermidade infecto-contagiosa viral caracterizada pela formação de papilomas orais, cutâneos ou oculares, geralmente benignos. O tratamento é indicado quando ocorre persistência dos tumores, lesões múltiplas causando obstrução faringeana, disfagia ou por razões estéticas. Diferentes protocolos de tratamento são descritos incluindo excisão cirúrgica, criocirurgia, eletrocirurgia, vacinas autógenas ou recombinantes, drogas imunomoduladoras, quimioterapia sistêmica ou intralesional. Foram revisados os principais aspectos clínico-epidemiológicos da papilomatose oral canina. Nos 12 animais estudados foram observados papilomas predominantemente em região de língua, gengiva e palato, com até 12 meses de idade e infecção combinada com erliquiose. O tratamento com Propionibacterium acnes e/ou vacina autócne surtiu efeito em oito animais (66,7%.

  14. First case of bacteremia caused by Moellerella wisconsensis: case report and a review of the literature.

    Science.gov (United States)

    Cardentey-Reyes, A; Jacobs, F; Struelens, M J; Rodriguez-Villalobos, H

    2009-12-01

    Moellerella wisconsensis, a member of the Enterobacteriaceae family, is rarely isolated in clinical specimens. We report here a case of M. wisconsensis infection in a 46-year-old cirrhotic patient with acute cholecystitis. This is the first reported case of a M. wisconsensis infection in Belgium and the first reported case of human bacteremia caused by this bacterium. Our case report is followed by a review of the literature.

  15. Personal attributes of authors and reviewers, social bias and the outcomes of peer review: a case study [v2; ref status: indexed, http://f1000r.es/5gj

    Directory of Open Access Journals (Sweden)

    Richard Walker

    2015-06-01

    Full Text Available Peer review is the "gold standard" for evaluating journal and conference papers, research proposals, on-going projects and university departments. However, it is widely believed that current systems are expensive, conservative and prone to various forms of bias. One form of bias identified in the literature is “social bias” linked to the personal attributes of authors and reviewers. To quantify the importance of this form of bias in modern peer review, we analyze three datasets providing information on the attributes of authors and reviewers and review outcomes: one from Frontiers - an open access publishing house with a novel interactive review process, and two from Spanish and international computer science conferences, which use traditional peer review. We use a random intercept model in which review outcome is the dependent variable, author and reviewer attributes are the independent variables and bias is defined by the interaction between author and reviewer attributes. We find no evidence of bias in terms of gender, or the language or prestige of author and reviewer institutions in any of the three datasets, but some weak evidence of regional bias in all three. Reviewer gender and the language and prestige of reviewer institutions appear to have little effect on review outcomes, but author gender, and the characteristics of author institutions have moderate to large effects. The methodology used cannot determine whether these are due to objective differences in scientific merit or entrenched biases shared by all reviewers.

  16. Pachydermodactyly: a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Paravina Mirjana

    2014-12-01

    Full Text Available Pachydermodactyly is a rare, benign form of digital fibromatosis, characterized by asymptomatic and progressive, periarticular and usually symmetrical soft tissue finger swelling, specifically on the lateral aspects of the proximal interphalangeal joints mainly of the second, third, and fourth fingers; it mostly affects young adolescents and is probably due to repeated mechanical injury of the skin (such as repeated clasping or rubbing of crossed fingers, sometimes as a result of obsessive-compulsive disorder, which must be distinguished from obsessive “chewing pads”. This paper presents a male patient aged 19, who presented with first symptoms at the age of 12, and was diagnosed with periarticular hypertrophy: localized soft tissue thickening around the proximal interphalangeal joints of all fingers except the thumbs; slight hypertrophy of the skin; absence of subjective complaints; normal joint function. Dermatological status on admission revealed: symmetrical soft tissue swelling of all fingers of both hands except the thumbs at the level of the proximal interphalangeal joints; normal appearance of the distal parts of all fingers; thickening at the level of the proximal interphalangeal joints, bilateral, almost symmetrical hypertrophy (ulnar and radial of phalanges of the affected fingers except both index fingers, affecting only the ulnar side. The skin lesions were pain-free on palpation, with homogeneous texture and elastic consistency, freely movable over underlying structures. The affected joints showed no functional deficit. The test results, sonography, radiography and histopathology confirmed our clinical diagnosis-pachydermodactyly. The review of the currently available literature, published between 1973 and 2014, including 99 papers and 160 patients, provided important insight into the characteristics and variations of the disease.

  17. Vascular hemichorea: case report and review

    Directory of Open Access Journals (Sweden)

    Bárbara Martínez Alfonzo

    2014-04-01

    Full Text Available Chorea rarely complicates ischemic or hemorrhagic cerebral vascular lesions. Clinical symptoms usually involve one side of the body while the injury is situated on the contralateral cerebral hemisphere. Spontaneous remission is the norm, but sometimes symptomatic treatment is required. A 58-year-old male patient who suffers from untreated high blood pressure, type II obesity, smokes 6 packs of cigarettes per year and has a moderate intake of alcohol is presented. The patient’s recent history began three days before he appeared at the Emergency Department. His symptoms were ceaseless, involuntary movements in his left arm and foot during day and night with no restriction of voluntary movements. Physical examination and laboratory tests revealed no other findings. Magnetic resonance imaging of the brain showed hyperintensity in the right posterolateral thalamic region consistent with ischemic cerebrovascular disease. Symptomatic therapy was indicated and his underlying conditions were addressed. The importance of this case lies on the low prevalence as well as the scarcity of publications regarding vascular causes of hemichorea, including diagnosis, therapy and prognosis.

  18. Osteopoikilsis - review and contribution with two cases

    International Nuclear Information System (INIS)

    Georgiev, R.; Balev, B.; Baleva, D.; Zonev, K.; Gadancheva, V.; Ikonomov, V.

    2007-01-01

    Osteopoikilosis (osteopathy condensans disseminata, asymptomatic bone dysplasia, spotted bone disease) is an uncommon benign sclerosing bone dysplasia with an autosomal dominant inheritance. The LEMD3 gene is responsible for this bone density disorder. Radiologically, it is characterized by the presence of numerous small (2 - 10 mm), well -defined, oval or round foci of increased radio density. The oval foci are often oriented with their long axes parallel to the shafts of tubular bones. These lesions are symmetrically distributed, and have a predilection for the epiphyseal and metaphyseal regions of long tubular bones, as well as the carpal and tar-sal bones. In the pelvis and scapulae, they are concentrated around the joint. The skull, ribs, spine and clavicles are rarely involved. These lesions may increase or decrease in size and number, or disappear with time. Histologically, these lesions are foci of compact lamellar bone within the spongiosa, with histological features identical to bone islands. We present two cases with detailed imaging examinations, demonstrating the full pattern of the disease. The radiological appearance of the disease is unique. It could resemble other bone diseases and because of that the radiologist must be familiar with it. (authors)

  19. Cemento-osseous dysplasia in Jamaica: review of six cases.

    Science.gov (United States)

    Ogunsalu, C; Miles, D

    2005-09-01

    Six cases of cemento-osseous dysplasia (COD) of the jaw bone in Jamaicans are reviewed. Five were documented over a 15-year period (1980-1995). These include a case of florid cemento-osseous dysplasia (previously called gigantiform cementoma). Three of the initial cases were histologically diagnosed as gigantiform cementoma. There was no indication in the patient's case file whether these were familial or non-familial. The other two cases were diagnosed histologically as periapical cemento-osseous dysplasia and cementoblastoma respectively. Based on the current understanding of the nature of florid-cemento-osseous dysplasia (FLCOD), a new case was diagnosed as such solely on radiological findings. This single case of FLCOD is reported and discussed against the background of other cemento-osseous lesions. Special emphasis is placed on the radiology of COD in this paper. The confirmative role of radiology without the need for histophathology and treatment for asymptomatic FLCOD is emphasized.

  20. Granulicatella adiacens abscess: Two rare cases and review

    Directory of Open Access Journals (Sweden)

    Sangita Gupta

    2018-01-01

    Full Text Available Granulicatella adiacens is a nutritionally variant streptococcus species. These bacteria are rarely isolated in the laboratory due to their fastidious growth requirements. These have been mostly reported from bloodstream infections, infective endocarditis, infections of orbit, nasolacrimal duct and breast implants. Here, we are reporting two cases of subcutaneous abscesses caused by G. adiacens. In first case, it was isolated from abscess around elbow joint and second case was a suprapatellar abscess. We have also reviewed the published data concerning diagnosis and antimicrobial susceptibility pattern of Granulicatella infections and included some Indian cases.

  1. Short-term association between ambient air pollution and pneumonia in children: A systematic review and meta-analysis of time-series and case-crossover studies.

    Science.gov (United States)

    Nhung, Nguyen Thi Trang; Amini, Heresh; Schindler, Christian; Kutlar Joss, Meltem; Dien, Tran Minh; Probst-Hensch, Nicole; Perez, Laura; Künzli, Nino

    2017-11-01

    Ambient air pollution has been associated with respiratory diseases in children. However, its effects on pediatric pneumonia have not been meta-analyzed. We conducted a systematic review and meta-analysis of the short-term association between ambient air pollution and hospitalization of children due to pneumonia. We searched the Web of Science and PubMed for indexed publications up to January 2017. Pollutant-specific excess risk percentage (ER%) and confidence intervals (CI) were estimated using random effect models for particulate matter (PM) with diameter ≤ 10 (PM 10 ) and ≤2.5 μm (PM 2.5 ), sulfur dioxide (SO 2 ), ozone (O 3 ), nitrogen dioxide (NO 2 ), and carbon monoxide (CO). Results were further stratified by subgroups (children under five, emergency visits versus hospital admissions, income level of study location, and exposure period). Seventeen studies were included in the meta-analysis. The ER% per 10 μg/m 3 increase of pollutants was 1.5% (95% CI: 0.6%-2.4%) for PM 10 and 1.8% (95% CI: 0.5%-3.1%) for PM 2.5 . The corresponding values per 10 ppb increment of gaseous pollutants were 2.9% (95% CI: 0.4%-5.3%) for SO 2 , 1.7% (95% CI: 0.5%-2.8%) for O 3 , and 1.4% (95% CI: 0.4%-2.4%) for NO 2 . ER% per 1000 ppb increment of CO was 0.9% (95% CI: 0.0%-1.9%). Associations were not substantially different between subgroups. This meta-analysis shows a positive association between daily levels of ambient air pollution markers and hospitalization of children due to pneumonia. However, lack of studies from low-and middle-income countries limits the quantitative generalizability given that susceptibilities to the adverse effects of air pollution may be different in those populations. The meta-regression in our analysis further demonstrated a strong effect of country income level on heterogeneity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Syndromic odontogenic keratocyst: A case report and review of literature

    Science.gov (United States)

    Arshad, Fazil

    2016-01-01

    Odontogenic keratocysts (OKCs) may occur in two different forms, either as solitary (nonsyndromic OKCs) or as multiple OKCs (syndromic OKCs). Multiple OKCs usually occur as one of the findings in Gorlin–Goltz syndrome with other features such as skin carcinomas and rib, eye, and neurologic abnormalities. We report a rare case of Gorlin–Goltz syndrome in a 20-year-old male patient who presented with a slow growing swelling on lower right and left back teeth region since 2 months. Apart from these, other findings were frontal bossing, depressed nasal bridge, ocular hypertelorism, prominent supra orbital ridge, and mild mandibular prognathism. Excision was done and microscopic study revealed OKC and the follow-up could not be carried out for the complete management. We also presented a review of its pathogenesis, criterion, and differences between syndromic and nonsyndromic OKCs and suggest to thoroughly examine any patient who presents with multiple OKCs to rule out syndromic variety. PMID:27011939

  3. Analytical review of 664 cases of penetrating buttock trauma

    Science.gov (United States)

    2011-01-01

    A comprehensive review of data has not yet been provided as penetrating injury to the buttock is not a common condition accounting for 2-3% of all penetrating injuries. The aim of the study is to provide the as yet lacking analytical review of the literature on penetrating trauma to the buttock, with appraisal of characteristics, features, outcomes, and patterns of major injuries. Based on these results we will provide an algorithm. Using a set of terms we searched the databases Pub Med, EMBASE, Cochran, and CINAHL for articles published in English between 1970 and 2010. We analysed cumulative data from prospective and retrospective studies, and case reports. The literature search revealed 36 relevant articles containing data on 664 patients. There was no grade A evidence found. The injury population mostly consists of young males (95.4%) with a high proportion missile injury (75.9%). Bleeding was found to be the key problem which mostly occurs from internal injury and results in shock in 10%. Overall mortality is 2.9% with significant adverse impact of visceral or vascular injury and shock (P colon, or rectum injuries leading in shot wounds, whilst vascular injury leads in stab wounds (P trauma. In conclusion, penetrating buttock trauma should be regarded as a life-threatening injury with impact beyond the pelvis until proven otherwise. PMID:21995834

  4. Analytical review of 664 cases of penetrating buttock trauma

    Directory of Open Access Journals (Sweden)

    Schulte Klaus-Martin

    2011-10-01

    Full Text Available Abstract A comprehensive review of data has not yet been provided as penetrating injury to the buttock is not a common condition accounting for 2-3% of all penetrating injuries. The aim of the study is to provide the as yet lacking analytical review of the literature on penetrating trauma to the buttock, with appraisal of characteristics, features, outcomes, and patterns of major injuries. Based on these results we will provide an algorithm. Using a set of terms we searched the databases Pub Med, EMBASE, Cochran, and CINAHL for articles published in English between 1970 and 2010. We analysed cumulative data from prospective and retrospective studies, and case reports. The literature search revealed 36 relevant articles containing data on 664 patients. There was no grade A evidence found. The injury population mostly consists of young males (95.4% with a high proportion missile injury (75.9%. Bleeding was found to be the key problem which mostly occurs from internal injury and results in shock in 10%. Overall mortality is 2.9% with significant adverse impact of visceral or vascular injury and shock (P P

  5. Institutional total energy case studies

    Energy Technology Data Exchange (ETDEWEB)

    Wulfinghoff, D.

    1979-07-01

    Profiles of three total energy systems in institutional settings are provided in this report. The plants are those of Franciscan Hospital, a 384-bed facility in Rock Island, Illinois; Franklin Foundation Hospital, a 100-bed hospital in Franklin, Louisiana; and the North American Air Defense Command Cheyenne Mountain Complex, a military installation near Colorado Springs, Colorado. The case studies include descriptions of plant components and configurations, operation and maintenance procedures, reliability, relationships to public utilities, staffing, economic efficiency, and factors contributing to success.

  6. Stochastic efficiency: five case studies

    International Nuclear Information System (INIS)

    Proesmans, Karel; Broeck, Christian Van den

    2015-01-01

    Stochastic efficiency is evaluated in five case studies: driven Brownian motion, effusion with a thermo-chemical and thermo-velocity gradient, a quantum dot and a model for information to work conversion. The salient features of stochastic efficiency, including the maximum of the large deviation function at the reversible efficiency, are reproduced. The approach to and extrapolation into the asymptotic time regime are documented. (paper)

  7. Lactation studies of anticonvulsants: a quality review.

    Science.gov (United States)

    van der Meer, Douwe H; Wieringa, Andre; Wegner, Ilse; Wilffert, Bob; Ter Horst, Peter G J

    2015-04-01

    The aim of this review was to investigate the quality of the current literature on the transfer of anticonvulsants to breast milk to provide an overview of which anticonvulsants are in need of further research. We reviewed the quality of the available lactation studies for 19 anticonvulsants against the guidelines of the Food and Drug Administration (FDA) and the International Lactation Consultant Association (ILCA). Except for one study on lamotrigine and one case report on gabapentin, no study on anticonvulsants had both the absolute infant dose (AID) and milk to plasma ratio (M : P) correctly assessed. Only one study on carbamazepine, phenytoin and vigabatrin was found that correctly assessed the AID. The main cause for this low number is the lack of essential details in published studies, since 25 of 62 studies were case reports, letters or abstracts. Other major shortcomings were the lack of information on sampling methods, the number of samples in a particular dose interval as well as the low number of study participants. The quality of the current literature on the transfer of anticonvulsants to breast milk is low, except for lamotrigine, which makes it hard to draw conclusions about the safety of the use of anticonvulsants during the lactation period. Therefore, further research is needed. © 2014 The British Pharmacological Society.

  8. Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

    Science.gov (United States)

    Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

    2017-01-01

    Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

  9. CAREM X INPRO case study

    International Nuclear Information System (INIS)

    Florido, P.C.; Brasnarof, D.; Delmastro, D.; Azpitarte, O.E.

    2004-01-01

    In order to assess and compare the performance of innovative nuclear energy systems INPRO has defined a set of basic principles, user requirements and criteria to be met in different areas (economics, sustainability and environment, safety, waste management and proliferation). This paper illustrates the use of INPRO methodology to a particular reactor system. Argentina is performing CAREM X Nuclear System Case Study based on CAREM nuclear reactor and Once Through Fuel Cycle, using SIGMA for enriched uranium production, and a deep geological repository for final disposal of high level waste after surface intermediate storage in horizontal natural convection silos, to verify INPRO (International Project on Innovative Nuclear Reactors and Fuel Cycles) methodology. 6 aspects have been considered: 1) enrichment based on Sigma enrichment plant (gas diffusion technology), 2) conversion to UO 2 , 3) fuel manufacturing, 4) CAREM-300 based reactor technology, 5) intermediate spent fuel storage, and 6) deep geological repository of spent fuels. Projections show that developing countries could play a crucial role in the deployment of nuclear energy, in the next fifty years. This case study will be highly useful for checking INPRO methodology for this scenario. In this paper, the preliminary findings of the Case Study are presented, including proposals to improve the INPRO methodology

  10. Postpartum electroconvulsive therapy: a systematic review and case report.

    Science.gov (United States)

    Gressier, Florence; Rotenberg, Samuel; Cazas, Odile; Hardy, Patrick

    2015-01-01

    Postpartum depression can have devastating consequences on the mother and child. Prompt treatment is challenging. Whereas electroconvulsive therapy (ECT) is considered to be an effective treatment modality in severe depression and brings about rapid clinical improvement, little is known about ECT during the postpartum period. We systematically reviewed the literature on the use of ECT during the postpartum period using PubMed, Institute for Scientific Information Web of Knowledge and PsycINFO databases until September 2014, using the search terms "electroconvulsive therapy" or "ECT" and "postpartum". Then, we described the successful treatment with ECT and the joint mother-baby hospitalization of a woman with severe depression. Eight case reports and 8 studies were identified. All of the studies reported that ECT is effective in the postpartum period. It is well tolerated, provides a fast response and allows for breastfeeding. In addition, our case report showed the benefits of the hospitalization of the mother-baby unit. Combined ECT and joint mother-baby hospitalization could be a valuable treatment by targeting both the mother-infant relationship and the maternal depressive symptoms. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Digitization of Full-Text Documents Before Publishing on the Internet: A Case Study Reviewing the Latest Optical Character Recognition Technologies.

    Science.gov (United States)

    McClean, Clare M.

    1998-01-01

    Reviews strengths and weaknesses of five optical character recognition (OCR) software packages used to digitize paper documents before publishing on the Internet. Outlines options available and stages of the conversion process. Describes the learning experience of Eurotext, a United Kingdom-based electronic libraries project (eLib). (PEN)

  12. Medical review practices for driver licensing : Volume 1 : a case study of guidelines and processes in seven U.S. States.

    Science.gov (United States)

    2016-10-01

    This report is the first of three examining driver medical review practices in the United States and how they fulfilled the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk drivers. The aim was not to ...

  13. A case study of Impetigo

    Directory of Open Access Journals (Sweden)

    Mansouri P

    1993-05-01

    Full Text Available This is a report of a case study on 234 patients with impetigo who referred to Razi Dermatology Hospital from April to November, 1989. Treatment was started immediately after obtaining direct smear and performing culture and antibiotic sensitivity test. The most common organism responsible for impetigo was the coagulase-positive staphylococcus (71%. In 13.7% of the cases, the coagulase-negative staphylococcus was grown on culture media, but none of the cultures showed streptococcus as the main organism. Treatment was started with oral penicillin V, oral erythromycin, benzathine penicillin G injection, oral cephalexin, and topical fuccidin. Clinical and bacteriological evaluation after 3-7 days showed that it is preferable to use oral cephalexin instead of other protocols such as oral erythromycin, which has previously been the drug of choice for impetigo. In addition, topical fuccidin with a 75% curative rate was the first drug for treatment, with the same effect as the oral cephalexin

  14. Intraocular gnathostomiasis: report of a case and review of literature.

    Science.gov (United States)

    Pillai, Gopal S; Kumar, Anil; Radhakrishnan, Natasha; Maniyelil, Jayasree; Shafi, Tufela; Dinesh, Kavitha R; Karim, Shamsul

    2012-04-01

    Intraocular gnathostomiasis is a rare parasitic infection caused by the third-stage larvae of spiruroid nematode Gnanthostoma spp. seen mostly in tropical and subtropical regions. It is a food-borne zoonosis caused by ingestion of raw or undercooked freshwater fish, amphibians, reptiles, birds, and mammals, all of which are known to harbor advanced third-stage larvae of Gnanthostoma spp. To date, 74 cases of intraocular gnathostomiasis have been reported from 12 different countries. Only four countries have reported more than 10 cases each, and India shares the rare distinction of being one of them, with 14 cases. Surprisingly, not a single case of cutaneous gnanthostomiasis has ever been reported from India. We present one such case of intraocular gnathostomiasis in a 41-year-old male who presented with an actively motile worm attached to the iris, and we review the pertinent literature of all such cases reported from India.

  15. Examining End-of-Life Case Management: Systematic Review

    Directory of Open Access Journals (Sweden)

    Roger E. Thomas

    2014-01-01

    Full Text Available Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL case management identified 17 research articles, with content analysis revealing two themes: (a seeking to determine or establish the value of EOL case management and (b identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care.

  16. Trombose de seios venosos cerebrais: Estudo de 15 casos e revisão de literatura Cerebral venous thrombosis: Study of fifteen cases and review of literature

    Directory of Open Access Journals (Sweden)

    Paulo Pereira Christo

    2010-01-01

    Full Text Available OBJETIVO: Analisar uma série de 15 pacientes com trombose venosa cerebral (TVC e comparar os resultados com dados da literatura. MÉTODOS: Foram avaliados, por meio de estudo retrospectivo, transversal e descritivo, as características epidemiológicas, o quadro clínico, os fatores de risco e o prognóstico de 15 pacientes com TVC admitidos no serviço de Neurologia da Santa Casa de Belo Horizonte no período de abril de 2007 a Dezembro de 2008. RESULTADOS: O diagnóstico de TVC foi confirmado por exame de ressonância nuclear magnética de encéfalo em 14 casos e por angiografia cerebral em um caso. Os principais fatores de risco identificados foram o uso do anticoncepcional oral (40% e uma história prévia ou familiar de trombose venosa profunda. Trombofilia foi encontrada em dois pacientes (13%. O seio mais acometido foi o transverso (73%, seguido pelo sagital superior, em 53%. Quatro pacientes apresentaram acidente vascular cerebral e outros 5 apresentaram-se apenas com cefaleia isolada. Doze pacientes foram tratados com heparina e anticoagulação oral sequencial. CONCLUSÃO: A terapêutica com heparina na fase aguda seguida do anticoagulante oral demonstrou-se segura e eficaz na prevenção da progressão da doença, de sua recidiva e na rápida recuperação do quadro neurológico de todos os pacientes tratados. A TVC deve ser considerada no diagnóstico de cefaleia secundária mesmo em pacientes com ausência de outros sinais ou sintomas.OBJECTIVE: To analyze a series of 15 patients with cerebral venous thrombosis (CVT who had follow-ups at the neurology service of Santa Casa de Belo Horizonte Hospital from April, 2007 to December, 2008. These results were compared with data in literature. METHODS: Cases were evaluated by retrospective study of the epidemiologic characteristics, signs and symptoms, risk factors and prognosis of 15 patients with cerebral venous thrombosis. RESULTS: Diagnoses were reached through magnetic resonance

  17. Ocular manifestations of Gaucher disease: case report and literature review

    Directory of Open Access Journals (Sweden)

    Mejía-Turizo, Juan Carlos

    2017-07-01

    Full Text Available We report the case of a patient with Gaucher disease (GD type 3b, with a homozygous GBA gene mutation (c.1448T > C p.L483P (L444P. Ocular findings characteristic of this mutation are described, including vitreous condensation and macular edema. To our knowledge this is the first case reported in Colombia with these characteristics. A review of the ocular manifestations of this disease is also presented.

  18. Melioidosis in Malaysia: A Review of Case Reports

    OpenAIRE

    Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini

    2016-01-01

    Background Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. Objective We sought to review case reports of melioidosis from Malaysia. Methods We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outc...

  19. Suprasellar paraganglioma: a case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Naggara, O.; Oppenheim, C.; Meder, J.F. [Centre Hospitalier Sainte-Anne, Department of Neuroradiology, Paris (France); Varlet, P. [Centre Hospitalier Sainte-Anne, Department of Anatomopathology, Paris (France); Page, P. [Centre Hospitalier Sainte-Anne, Department of Neurosurgery, Paris (France)

    2005-10-01

    Paragangliomas arising in the suprasellar region are extremely rare. We report a case of suprasellar paraganglioma in a 47-year-old man who presented with amnesia and impaired visual acuity without any endocrine dysfunction. Magnetic resonance imaging (MRI) showed a large enhancing tumour in the suprasellar area. Following subtotal surgical excision, the diagnosis of paraganglioma was confirmed by pathology. In this case report we describe the MRI pattern of suprasellar paraganglioma and review the literature of this uncommon lesion. (orig.)

  20. SURGICAL ORTHODONTICS: LITERATURE REVIEW AND CASE REPORT

    Directory of Open Access Journals (Sweden)

    Piyush HEDA

    2013-03-01

    Full Text Available Orthognathic surgery is a surgical procedure largely practiced throughout the world for the correction of various maxillofacial deformities. The procedure for correcting a particular deformity will be done after proper evaluation, which includes cephalometric, dental model analysis and photographs. The patient undergoes pre-surgical orthodontic correction for dental compensation, after which surgery is planned. During the last few decades, the profession has witnessed intense interest for the treatment of facial deformities, being widely practiced throughout the world. Orthognathic surgery has become an acceptable treatment plan for patients with various maxillofacial deformities, giving pleasing results. The present study reports the successful treatment method of Class II division 1 malocclusion through orthognathic surgery.

  1. [Compulsive buying disorder: a review and a case vignette].

    Science.gov (United States)

    Tavares, Hermano; Lobo, Daniela Sabbatini S; Fuentes, Daniel; Black, Donald W

    2008-05-01

    Compulsive buying disorder was first described as a psychiatric syndrome in the early twentieth century. Its classification remains elusive, and investigators have debated its potential relationship to mood, substance use, obsessive-compulsive, and impulse control disorders. The objective of this study is to present a review of compulsive buying disorder and present a case vignette. Two databases were reviewed (Medline and PsycINFO) in search for articles published in the last 40 years. Selected terms included oniomania, compulsive buying, and compulsive shopping. Other relevant articles were also identified through reference lists. Compulsive buying disorder is a prevalent and chronic condition that is found worldwide, sharing commonalities with impulse control disorders. In clinical samples, women make up more than 80% of subjects. Its etiology is unknown, but neurobiologic and genetic mechanisms have been proposed. The disorder is highly comorbid with mood, substance use, eating and impulse control disorders. Treatment recommendations derived from the literature and clinical experience suggest that problem shoppers can benefit from psychosocial interventions. Cognitive-behavioral group models appear promising. Medication trials have reported mixed results. The identification and treatment of psychiatric comorbidity is also a key aspect of treatment. In order to determine the validity of compulsive buying disorder, future work should focus on psychopathology and neurobiological findings unique to the syndrome.

  2. Necrotizing fasciitis: 11-year retrospective case review in South Auckland.

    Science.gov (United States)

    Kulasegaran, Suheelan; Cribb, Benjamin; Vandal, Alain C; McBride, Stephen; Holland, David; MacCormick, Andrew D

    2016-10-01

    The aims of this paper were to review our experience with necrotizing fasciitis at Middlemore Hospital and to define the trends in incidence, inpatient mortality and microbiological profile. A computerized search of the electronic medical records was undertaken to identify adult patients with a diagnosis of necrotizing fasciitis between January 2000 and December 2010. A retrospective review of the clinical records was performed. Of the 138 patients with necrotizing fasciitis identified, 129 had their diagnosis confirmed at operation. The mortality at 30 days was 20.3% (95% confidence interval (CI) 13.9%-28.0%). There was a significant reduction in hospital mortality in each successive year of the study period with an odds ratio of 0.84 (95% CI 0.71-0.98, P = 0.03). A pattern of increasing incidence was noted until February 2004 (95% CI September 2002-July 2005). This was followed by a significant decrease in incidence. The empirical antibiotic regime of clindamycin, gentamicin and penicillin provides satisfactory cover against 95% of the causative pathogens. This represents the largest single-centre published case series in New Zealand. Despite concerns of increasing incidence and mortality associated with necrotizing fasciitis in New Zealand, the experience in South Auckland shows a decrease in incidence of necrotizing fasciitis since 2004 and a statistically significant decreasing trend in hospital mortality. © 2015 Royal Australasian College of Surgeons.

  3. Nonverbal Communication, Music Therapy, and Autism: A Review of Literature and Case Example

    Science.gov (United States)

    Silverman, Michael J.

    2008-01-01

    This article presents a review of nonverbal literature relating to therapy, music, autism, and music therapy. Included is a case study of a woman with autism who was nonverbal. The case highlights and analyzes behaviors contextually. Interpretations of communication through the music therapy, musical interactions, and the rapport that developed…

  4. The review of 134 cases colon and rectal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chung Kyu; Choi, Byung Sook [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1971-10-15

    Barium Enema study for colon examination is of great importance in the health care of our people and its value can be increased by a wide understanding of the attendant difficulties and limitation. Since the incidence of the colon and rectal carcinoma is increasing, the barium enema examination is more valuable. Radiologically diagnosed 134 cases of colon and rectal carcinoma from January 1964 to June 1970 have been reviewed at Yensei Univ., College of Medicine. Among the total admission during these years, the ratio of the colon and rectal carcinoma was 0.29 percent, and the incidence among barium enema examination was 5.3%. The peak age range was between 40 and 50 years. The average age of the patients was 46 years. It was more common in male. The clinical picture was rather vague in some cases, especially in the lesions of right colon. The large number of cases has bowel habit change, tarry or bloody stool and abdominal pain. About 60% of the lesions were located in rectum and 40% was proximal portion from the rectum, which could not be completely diagnosed only by digital examination and proctosigmoidoscopy. On roentgenogram, the most common form was encircling type, next was fungating. The positivity for accuracy of the barium enema examination was 90%. Majority of cancers of the colon, particularly those that produce symptoms are relative gross lesions. In daily practise we have to eager to find out small lesions by repeat and complete barium enema examination, including double contrast study. Early diagnosis is an aid immediate, logical objective in attempts to decrease the morbidity and mortality from carcinoma of colon.

  5. The review of 134 cases colon and rectal carcinoma

    International Nuclear Information System (INIS)

    Kim, Chung Kyu; Choi, Byung Sook

    1971-01-01

    Barium Enema study for colon examination is of great importance in the health care of our people and its value can be increased by a wide understanding of the attendant difficulties and limitation. Since the incidence of the colon and rectal carcinoma is increasing, the barium enema examination is more valuable. Radiologically diagnosed 134 cases of colon and rectal carcinoma from January 1964 to June 1970 have been reviewed at Yensei Univ., College of Medicine. Among the total admission during these years, the ratio of the colon and rectal carcinoma was 0.29 percent, and the incidence among barium enema examination was 5.3%. The peak age range was between 40 and 50 years. The average age of the patients was 46 years. It was more common in male. The clinical picture was rather vague in some cases, especially in the lesions of right colon. The large number of cases has bowel habit change, tarry or bloody stool and abdominal pain. About 60% of the lesions were located in rectum and 40% was proximal portion from the rectum, which could not be completely diagnosed only by digital examination and proctosigmoidoscopy. On roentgenogram, the most common form was encircling type, next was fungating. The positivity for accuracy of the barium enema examination was 90%. Majority of cancers of the colon, particularly those that produce symptoms are relative gross lesions. In daily practise we have to eager to find out small lesions by repeat and complete barium enema examination, including double contrast study. Early diagnosis is an aid immediate, logical objective in attempts to decrease the morbidity and mortality from carcinoma of colon

  6. Paget's disease of the vulva: A review of 89 cases

    Directory of Open Access Journals (Sweden)

    Cherry O. Onaiwu

    2017-02-01

    Full Text Available The purpose of this study was to retrospectively review the clinical characteristics and outcomes of a series of women with Paget's disease of the vulva. A retrospective review was performed of 89 women with Paget's disease of the vulva evaluated at a single institution between 1966 and 2010. Medical records were reviewed for demographic information, clinical data, pathologic findings, treatment modalities and outcomes. We found that the primary treatment was surgery for 74 (83.1% patients, with positive margins noted in 70.1% of cases. Five patients (5.6% underwent topical treatment with imiquimod and/or 5-fluorouracil, one patient (1.1% underwent laser ablation and treatment was unknown in 9 patients (10.1%. The majority of patients had multiple recurrences, with 18% having four or more recurrences. There were no significant differences in recurrence rates between patients who underwent surgery and those who did not. Furthermore, there was no association between positive margins following primary surgery and recurrence. Forty-one patients (46.1% were diagnosed with 53 synchronous or metachronous cancers. Seven patients (7.9% were found to have invasive vulvar cancer with 1 mm or more depth of invasion, but none of the patients died of Paget's disease or associated vulvar/vaginal cancer. Our findings suggest that the majority of patients with Paget's disease of the vulva develop multiple recurrences regardless of treatment modality or margin status. Alternatives to surgery are needed to better care for women with this disease.

  7. Hemochromatosis and diabetes mellitus: case report and literature review

    Directory of Open Access Journals (Sweden)

    Karina Biavatti

    2008-12-01

    Full Text Available Hemochromatosis is a disorder characterized by iron storage amended. The acquired form of the disease can be caused by iron overload, alcoholism, infection by  C virus hepatitis, non-alcoholic hepatitis and chronic liver disease. The hereditary form can be caused by different mutations, being the C282Y and H63D the most frequent, 83% of cases are homozigotous for C282Y and 4% are compound heterozygous (C282Y/H63D. Hemochromatosis is a condition that can affect several organs, including: heart, joints, liver, hypothalamus, pituitary, pancreas and gonads. The aim of this study was to report a case of hemochromatosis and review the literature, with special attention to the association of hemochromatosis and diabetes mellitus. Patient 53 years, male presented to the doctor with arthralgia metacarpophalangeal, ankles, knees, coxofemoral right, and cervical and lumbar, complaints of fatigue and weight loss. Between 3 brothers, one of them had a diagnosis of hereditary hemochromatosis, with PCR demonstrating homozygous for C282Y. Labs: GOT 128 U/L, ALT 231 U/L, alkaline phosphatase 258 U/L, abdominal ultrasound with hepatomegaly and spleen at the upper limit of normal. Liver biopsy demonstrated portal fibrosis extension with hemosiderosis intense. It also made the diagnosis of diabetes mellitus. The research confirmed the same mutation of the changing family: homozygous for C282Y

  8. Maternal filicide in a cohort of English Serious Case Reviews.

    Science.gov (United States)

    Sidebotham, Peter; Retzer, Ameeta

    2018-03-02

    A national mixed-methods study of English Serious Case Reviews (SCRs) was carried out to better understand the characteristics and circumstances of maternally perpetrated filicides, to compare these with paternally perpetrated cases, and to identify learning points for mental health professionals. Published reports for all SCRs of children in England dying as a result of abuse or neglect from 2011 to 2014 were subject to qualitative analysis using a system of layered reading and inductive thematic analysis, along with descriptive and comparative quantitative analysis. There were 86 deaths directly attributable to child maltreatment within the immediate family. The mother was the suspected perpetrator in 20. Twelve of the mother perpetrators were victims of domestic violence, while 15 of the father perpetrators were known to be perpetrators of domestic violence. Those deaths resulting from impulsive violence or severe, persistent cruelty are almost exclusively perpetrated by males, while those with an apparent intent to kill the child are slightly more likely to be perpetrated by mothers. Four key themes were identified through the qualitative analysis: domestic violence, maternal mental illness, separation and maternal isolation, and the invisibility of the child. These findings highlight the important role of domestic violence and its interaction with maternal mental health. Professionals working with mothers with mental health problems need to adopt a supportive but professionally curious stance, to be alert to signs of escalating stress or worsening mental ill-health, and to provide supportive and accessible structures for at-risk families.

  9. MULTIPLE PERSONALITY: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-07-01

    Full Text Available Background. Multiple personality disorder is characterised by splited individual ego-states and splited professional community arguing whether this disorder actually exists or not.Methods. In this case report study a supportive psychodynamic psychotherapy of a patient with multiple personality disorder is presented, that lasted for 4.5 years and resulted in ego-reintegration.Conclusions. The spliting between different ego-states is powered by unneutralised aggression with the possibility of hetero- and autoaggressive behaviour. Therefore the patient in the analytically oriented psychotherapeutic process is at high risk and a safe therapeutic (e. g. in-patient setting has to be provided.

  10. Overview of the Case Studies

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul

    2011-01-01

    A series of case studies are used to illustrate many of the underlying modelling principles within the book. To facilitate this, the ICAS-MoT modelling tool has been used. A wide range of application areas have been chosen to ensure that the principal concepts of effective and efficient modelling...... are exercised. Conceptual frameworks for single and multiscale problems are given and explained. The importance of the steps is also explained, through annotated schematic diagrams. The important issues around workflow and data flow are given in diagrammatic form....

  11. Gliomatosis peritonei. Report of two cases and review of literature.

    Science.gov (United States)

    Truong, L D; Jurco, S; McGavran, M H

    1982-07-01

    Gliomatosis peritonei, a rare complication of solid ovarian teratomas, is a miliary, mature glial implantation on the peritoneum or omentum. Two new cases are reported and 30 previously reported cases are reviewed. Gliomatosis peritonei is thought to be benign in almost all cases and thus deserves no treatment except for confirmatory biopsy. It must be differentiated from teratomatous implants because the latter may imply poor prognosis and require aggressive therapy. The prognostic value of serum alpha-fetoprotein levels in patients with immature ovarian teratoma is not conclusive. The presence of glial fibrillary acidic protein confirms the glial nature of the implants.

  12. Mermaid syndrome, Sirenomelia: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Anahita Nosrati

    2013-01-01

    Full Text Available Sirenomelia is a rare anomaly of caudal region of the body presented with fusion of lower limbs in which Genito-urinary, Gastrointestinal, Cardiovascular and Neural tube anomalies are found in most cases. We introduce a case of severe oligohydramnios, which had characteristic aspects of Sirenomelia at the time of delivery and review the pertinent articles. All in all it is our aim to present another case of sirenomelia to add to existing knowledge and data about the condition in order to make an earlier diagnosis and put an end to pregnancy safely in advance.

  13. Georges Bank review studies list

    International Nuclear Information System (INIS)

    1999-01-01

    Federal and provincial legislation placed a moratorium on petroleum exploration and drilling on Georges Bank off southwestern Nova Scotia in 1988. Since that time, a public review was conducted to determine the environmental and socio-economic impacts of petroleum exploration on the area. Several consultant groups have been involved and prepared reports for the consideration of the Minister of Natural Resources Canada and the Minister for the Nova Scotia Department of Natural Resources. One of the consultant groups, CEF Consultants Ltd. of Halifax, Nova Scotia conducted a study which resulted in a series of papers on energy and the offshore, dealing with : (1) hydrocarbon resources, (2) exploring for offshore oil and gas, (3) offshore production, storage and transportation, (4) offshore regulation, (5) the energy context, (6) (study not available), (7) the global environmental implications of new hydrocarbon developments, and (8) communities and change. Other studies were conducted by other groups of consultants involving winds, larvae, ecosystems, an economic profile, and a historical overview of offshore and and gas development. The Ministers of Natural Resources Canada and Nova Scotia Department of Natural Resources are required to make a decision regarding the public review and moratorium by January 1, 2000

  14. Acute Disseminated Encephalomyelitis: A case series and review of literatures

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Rezai

    2013-05-01

    Full Text Available Acute disseminated encephalomyelitis is a rare immune mediated and demyelinating disease of the central nervous system that usually affects children. It is a monophasic disorder related with multifocal neurologic symptoms. In this paper, we report seven cases of Acute disseminated encephalomyelitis in pediatrics in addition; a review of literatures is presented.

  15. Renal Leiomyoma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Noppadol Larbcharoensub

    2017-07-01

    Full Text Available Leiomyoma is an uncommon tumor of the kidney. The authors report a rare case of renal leiomyoma in a 39-year-old male patient who presented with a right flank mass. Laparoscopic nephrectomy was performed. The histopathology and immunohistochemistry confirm the diagnosis of renal leiomyoma. The review of literature in the clinicoradiopathological correlation was illustrated.

  16. Bilateral nasolabial cysts - case report and review of literature

    International Nuclear Information System (INIS)

    Patil, Aruna R; Singh, Abhinav Pratap; Nandikoor, Shrivalli; Meganathan, Prabhu

    2016-01-01

    Nasolabial cyst is a non-odontogenic, extraosseous, soft tissue cyst, commonly unilateral, located in the nasolabial fold. Bilateral nasolabial cysts are of rare occurrence. This case report describes the multimodality imaging appearance of bilateral nasolabial cysts with a review of literature

  17. Endometrial osseous metaplasia: case report with literature review ...

    African Journals Online (AJOL)

    Endometrial osseous metaplasia is a rare pathological condition with mature bone in the endometrium and can be a cause for menorrhagia and infertility as bone in the endometrium acts like intrauterine contraceptive device. We report one such case with brief review of literature in a 28‑year‑old woman presenting with ...

  18. Cleidocranial dysplasia: Report of 4 cases and review

    Directory of Open Access Journals (Sweden)

    Virender Gombra

    2008-01-01

    Full Text Available Patients with cleidocranial dysplasia commonly present with significant dental problems such as retention of multiple deciduous teeth, impaction or delay in eruption of permanent teeth and often, the presence of supernumerary teeth. We report 4 cases of 2 families presenting with cleidocranial dysplasia disorder with their clinical and radiological diagnosis and illustrating its pathogenesis and various treatment modalities, review of literatures.

  19. Lumbar hernia - a case report and review of the literature

    International Nuclear Information System (INIS)

    D'Ippolito, Giuseppe; Yonamine, Claudia

    1999-01-01

    The authors present a case of lumbar hernia of inferior right space (Petit's triangle), classified as acquired hernia and diagnosed by clinical history and computed tomography. Lumbar hernia are quite rare. Authors have done a literature review of this disease. (author)

  20. Poland's syndrome - a case report and review of the literature

    International Nuclear Information System (INIS)

    Carvalho, Antonio Carlos Pires; Nogueira, Juliana Elen; Beze, Rodrigo Santos.

    2000-01-01

    The authors report the case of a patient with congenital anomalies of the left hand associated with total absence of the pectoralis minor muscle and partial absence of the pectoralis major muscle. The radiological findings were assessed and the literature was reviewed. (author)

  1. Gorlin-Goltz Syndrome: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Adrianne Rahde Bischoff

    2014-10-01

    Full Text Available Description of a case report of Gorlin-Goltz Syndrome diagnosed in a male newborn who presented increased head circumference and bifid ribs. Mother and grandmother presented typical physical findings of the syndrome, including palmar pits, odontogenic cysts, and history of multiple skin cancer resections. The diagnosis was based on clinical findings of three relatives. A literature review is also presented.

  2. Lipomatous secretory meningioma: case report and review of the literature

    International Nuclear Information System (INIS)

    Liebig, T.; Hoffmann, T.; Hosten, N.; Sander, B.; Lanksch, W.R.

    1998-01-01

    Secretory meningioma is a rare entity which may be characterised by imaging features unusual for other subtypes of meningoma, such as low attenuation on CT, high (fat-tissue equivalent) signal intensity on T1-weighted MRI, marked surrounding oedema, and irregular contrast enhancement. We report a case of secretory meningioma and review the literature. (orig.) (orig.)

  3. Ankylosing spondylitis: a case report with review of literature ...

    African Journals Online (AJOL)

    Materials and Methods: A case report of a 60 year old Libyan male who has Ankylosing spondylitis and then review the available literature. Results: The patient has been having a chronic low back pain and stiffness for the last 26 years. His symptoms are most severe in morning and improve with movement. He developed ...

  4. Juvenile Fibroadenoma. A Case Report and Literature Review

    International Nuclear Information System (INIS)

    Poveda, Cesar Augusto; Castano Nohora; Sara Jorge Alberto

    2007-01-01

    We report a case of a 10 year old girl who attended to our institution with a big mass in his right breast with fast growing after menarca. The diagnosis of this mass was juvenile fibroadenoma of the breast. We also review key concepts about this entity, its clinical presentation, imaging findings, differential diagnosis treatment and prognosis

  5. Snodgrass repair for distal hypospadias: a review of 75 cases

    African Journals Online (AJOL)

    urologists for distal hypospadias correction. We review our cases to find out whether there was any difference in the rate of urethrocutaneous fistula after the use of single- versus double-layer tubularization, the use of thick versus thin dorsal prepuce subcutaneous flap (DPF), the use of. DPF versus the ventral dartos flap for ...

  6. Lateral subtalar dislocation : Case report and review of the literature

    NARCIS (Netherlands)

    Veltman, Ewout S; Steller, Ernst Ja; Wittich, Philippe; Keizer, Jort

    2016-01-01

    A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis

  7. Geminated tooth : case report and review of literature

    International Nuclear Information System (INIS)

    Bolanos Lopez, Violeta; Rojas Tabash, Fabiola

    2013-01-01

    A review of literature is presented about gemination. The case expounded has been of a female patient 8 years of age, with a geminated maxillary temporal canine, asymptomatic and without treatment. Topics such as definitions, clinical and radiographic characteristics, complications and treatment in the gemination are focussed [es

  8. Alveolar pulmonary proteinosis: case report and literature review

    International Nuclear Information System (INIS)

    Vergara, Erika; Saenz, Alberto; Ojeda, Paulina

    2009-01-01

    We describe the case of a young women with primary alveolar proteinosis, with a short period of symptoms that are uncommon for this disease, without risk factors for this entity, the clinical evolution of the patient and some complications with the treatment. We review the literature for this entity.

  9. Hospital Waste Management - Case Study

    Directory of Open Access Journals (Sweden)

    Beatriz Edra

    2017-07-01

    Full Text Available The importance of waste management in hospitals is indisputable in preserving the environment and protecting public health, but management models are rarely discussed. This study presents the legal and conceptual frameworks of good waste management practices applicable to hospitals and associated indicators. As a case study, the overall performance of Hospital Centre of São João, in Porto, was analysed based on published reports. Data on the production of waste in their different typologies were collected from 2010 to 2016, enabling a correlation of the waste production with the kg/bed/day indicator. The aim of this study was to gather data and discuss trends in a real scenario of evolution over a six-year period in order to contribute to a future research proposal on indicators that can be used as reference for benchmarking the construction of methodological guides for hospital waste management.

  10. Qualitative Case Study Research as Empirical Inquiry

    Science.gov (United States)

    Ellinger, Andrea D.; McWhorter, Rochell

    2016-01-01

    This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

  11. Gastrointestinal stromal tumors in children and young adults: a clinicopathologic, molecular, and genomic study of 15 cases and review of the literature.

    Science.gov (United States)

    Prakash, Sonam; Sarran, Lisa; Socci, Nicholas; DeMatteo, Ronald P; Eisenstat, Jonathan; Greco, Alba M; Maki, Robert G; Wexler, Leonard H; LaQuaglia, Michael P; Besmer, Peter; Antonescu, Cristina R

    2005-04-01

    Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the intestinal tract that typically occur in adults over the age of 40 years. GISTs in younger patients are rare and not well characterized. The objective was to define the characteristics of GISTs in children and young adults (<30 years old). Clinicopathologic and molecular features, including KIT/PDGFRA genotype, in GISTs from 5 children and 10 young adults were analyzed. Gene expression analysis was performed on 5 gastric tumor samples from 2 children, 2 gastric tumors from young adults, and 10 gastric GISTs from older adults using an U133A Affymetrix platform (22,000 genes). All five pediatric GISTs occurred in girls, involved the stomach as multiple nodules, showed predominantly an epithelioid morphology, often involved lymph nodes, and lacked KIT or PDGFRA mutations. Although all five patients developed recurrence (four in the liver, three in the peritoneum, and two in both sites), four are still alive with disease. Of the 10 GISTs in young adults, half occurred in the small bowel and had spindle cell morphology, and one case had lymph node metastasis. KIT mutations were identified in seven cases, four in exon 11 and three in exon 9. Seven patients developed recurrence, and at last follow-up two patients had died of disease. Gene expression analysis showed high expression of PHKA1, FZD2, NLGN4, IGF1R, and ANK3 in the pediatric and young adult versus older adult cases. GISTs that occur in children are a separate clinicopathologic and molecular subset with predilection for girls, multifocal gastric tumors, and wild-type KIT/PDGFRA genotype. In contrast, GISTs in young adults are a more heterogeneous group, including cases that resemble either the pediatric or the older adult-type tumors. The distinct gene expression profile suggests avenues for investigation of pathogenesis and potential therapeutic strategies.

  12. Paediatric empyema: a case report and literature review.

    Science.gov (United States)

    Parsons, S J; Fenton, E; Williams, M

    2005-06-01

    To present a case of bilateral parapneumonic effusions in a child with Pneumococcal pneumonia and bacteraemia managed aggressively with early thoracotomies. The literature from peer reviewed journals is summarized and the different management strategies are discussed. Articles and reviews from peer reviewed journals on the management of empyema in children and adults. Staging of parapneumonic pleural effusions is difficult to assess clinically and radiologically. Most cases can be successfully managed with simple chest tube drainage, plus appropriate antibiotic therapy. However, based on the available evidence for children, thoracotomy with decortication and direct drainage may provide the most effective treatment in terms of length of hospital stay and duration of chest tube insertion, when compared with video assisted thoracoscopic surgery (VATS) or chest tube drainage, with or without intrapleural fibrinolytic therapy. More conservative approaches to treatment of empyema may be appropriate initially to avoid the cosmetic and other disadvantages of thoracotomy. However, delayed surgical drainage increases morbidity and may potentially increase mortality.

  13. Does asymptomatic septal agenesis exist? A review of 34 cases

    Energy Technology Data Exchange (ETDEWEB)

    Belhocine, Ouardia; Andre, Christine; Kalifa, Gabriel; Adamsbaum, Catherine [St Vincent de Paul Hospital, Radiology Department, Paris (France)

    2005-04-01

    Primary septal agenesis (PSA) is a rare brain malformation that can be isolated or part of developmental brain abnormalities (holoprosencephaly, septo-optic dysplasia or cortical malformation). Such associated malformation can be subtle, leading to difficulties in the prenatal management of PSA. Moreover, the neurological prognosis of isolated PSA remains debatable. The aims of the study were to specify the patterns and frequency of brain malformations associated with septal agenesis (SA), to identify the clinical prognosis, and to discuss the aetiology of PSA with the new insights provided by molecular genetics. The study consisted of a 14-year retrospective review of brain MRI in 34 patients having PSA (mean age, 5 years). Chiasm and optic nerves were not evaluated. Post-hydrocephalus SA or incomplete data were excluded. The clinical data were correlated to the MRI patterns. The study disclosed 82.5% associated lesions with MRI (28/34): 11 neuronal migration disorders, 9 holoprosencephalies (HP), 7 pituitary stalk interruptions, 1 corpus callosum partial agenesis; 17.5% (6/34) of cases were apparently isolated PAS. Clinically, the patients had motor dysfunction in 68% (23/34), mental retardation in 65% (22/34), blindness in 24% (8/34), endocrinological defects in 21% (7/34) and epilepsy in 18% (6/34) of cases. Nine percent of patients (3/34) were neurologically normal (including one with scoliosis and two infants younger than 2 years at the last follow-up). Patients with bilateral cortical anomalies and HP (even if mild) had the worst neurological prognosis. A severe motor impairment was present without evidence of hemispheric anomaly in 12% of patients (4/34). Interestingly, the frontal lobes were involved in 90% of cortical anomalies and HP, supporting the malformative aetiology of PSA. PSA rarely appears isolated and severe psychomotor impairment may occur in apparently isolated forms. These unfavourable results should be highlighted and need to be confirmed

  14. Remote Iliac Artery Endarterectomy: A Case Series and Systematic Review.

    Science.gov (United States)

    Bekken, Joost A; de Boer, Sanne W; van der Sluijs, Rogier; Jongsma, Hidde; de Vries, Jean-Paul P M; Fioole, Bram

    2018-02-01

    To evaluate the long-term results of remote iliac artery endarterectomy (RIAE) in 2 vascular referral centers and review existing literature. A retrospective analysis was conducted of 109 consecutive patients (mean age 64.2±10.7 years; 72 men) who underwent 113 RIAE procedures for lower limb ischemia from January 2004 to August 2015 at 2 vascular centers. The majority of limbs (82, 72.6%) had TASC II D lesions (31 TASC II C). Primary outcome measures were primary, assisted primary, and secondary patency. A comprehensive literature search was performed in the PubMed and EMBASE databases to identify all English-language studies published after 1990 reporting the results of RIAE. Technical success was achieved in 95 (84.1%) of the 113 procedures. The complication rate was 13.7%, and 30-day mortality was 0%. At 5 years, primary patency was 78.2%, assisted primary patency was 83.4%, and secondary patency was 86.7%. Hemodynamic success was obtained in 91.7% of patients, and clinical improvement was observed in 95.2%. Freedom from major amputation was 94.7% at 5 years. The systematic review comprised 6 studies including 419 RIAEs, and pooled data showed results similar to the current study. For external iliac artery occlusions extending into the common femoral artery, RIAE appears to be a valuable hybrid treatment option. It combines acceptable morbidity and low mortality with good long-term patency. It has some advantages over an open surgical iliofemoral bypass or complete endovascular revascularization and could be the best treatment option in selected cases.

  15. A parathyroid scintigraphy case study

    International Nuclear Information System (INIS)

    O'Leary, Desiree

    2005-01-01

    Background: There has been much debate concerning the most suitable protocol for parathyroid scintigraphy; the merits of various radiopharmaceuticals versus the correct imaging protocol to visualise both ectopic and anatomically placed adenomas against the various equipment choices have been debated. Aim: To demonstrate, through the use of a case study, the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion. Method: Use is made of Tc99mMIBI, full field chest scintigraphy, a clearly defined imaging protocol and SPECT imaging to locate ectopic parathyroid tissue in a female patient with significant symptoms of parathyroid hyperfunction. Results: A single hyperfunctioning adenoma is located in the pre-carinal area of the mediastinum. Using a radioguided surgical technique the hyperfunctioning tissue is excised and confirmed by histopathology. Conclusion: Whilst a dramatic reduction in patient symptoms was not seen immediately in this patient, the symptoms of the illness have been subsiding since January 2003. This case study demonstrates the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion

  16. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

    Directory of Open Access Journals (Sweden)

    Shankargouda Patil

    Full Text Available Oral submucous fibrosis (OSF is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature.A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study.A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures.Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

  17. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

    Science.gov (United States)

    Patil, Shankargouda; Sarode, Sachin Chakradhar; Sarode, Gargi S; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

    2017-01-01

    Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

  18. Using Correspondence Analysis in Multiple Case Studies

    NARCIS (Netherlands)

    Kienstra, Natascha; van der Heijden, Peter G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  19. Using correspondence analysis in multiple case studies

    NARCIS (Netherlands)

    Kienstra, N.H.H.; van der Heijden, P.G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  20. Association of vitamin D receptor BsmI, TaqI, FokI, and ApaI polymorphisms with susceptibility of chronic periodontitis: A systematic review and meta-analysis based on 38 case -control studies.

    Science.gov (United States)

    Mashhadiabbas, Fatemeh; Neamatzadeh, Hossein; Nasiri, Rezvan; Foroughi, Elnaz; Farahnak, Soudabeh; Piroozmand, Parisa; Mazaheri, Mahta; Zare-Shehneh, Masoud

    2018-01-01

    There has been increasing interest in the study of the association between Vitamin D receptor (VDR) gene polymorphisms and risk of chronic periodontitis. However, the results remain inconclusive. To better understand the roles of VDR polymorphisms (BsmI, TaqI, FokI, and ApaI) in chronic periodontitis susceptibility, we conducted this systematic review and meta-analysis. The PubMed, Google Scholar, and Web of Science database were systemically searched to determine all the eligible studies about VDR polymorphisms and risk of chronic periodontitis up to April 2017. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the associations between VDR polymorphisms and chronic periodontitis risk. All the statistical analyses were performed by Comprehensive Meta-Analysis. All P values were two-tailed with a significant level at 0.05. Finally, a total of 38 case-control studies in 19 publications were identified which met our inclusion criteria. There are ten studies with 866 chronic periodontitis cases and 786 controls for BsmI, 16 studies with 1570 chronic periodontitis cases and 1676 controls for TaqI, five studies with 374 chronic periodontitis cases and 382 controls for FokI, and seven studies with 632 chronic periodontitis cases and 604 controls for ApaI. Overall, no significant association was observed between VDR gene BsmI, TaqI, FokI, and ApaI polymorphisms and risk of chronic periodontitis in any genetic model. Subgroup analysis stratified by ethnicity suggested a significant association between BsmI polymorphism and chronic periodontitis risk in the Caucasian subgroup under allele model (A vs. G: OR = 1.747, 95% CI = 1.099-2.778, P = 0.018). Further, no significant associations were observed when stratified by Hardy-Weinberg equilibrium status for BsmI, TaqI, and ApaI. Our results suggest that BsmI, TaqI, FokI, and ApaI polymorphisms in the VDR gene might not be associated with risk of chronic periodontitis in overall population.