WorldWideScience

Sample records for case study review

  1. BOOK REVIEW: Case Studies in Knowledge Management

    OpenAIRE

    Reviewed by Dr. Adnan BOYACI

    2005-01-01

    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…...

  2. 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

  3. 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.

  4. [Acute pancreatitis and pregnancy: Cases study and literature review].

    Science.gov (United States)

    Charlet, P; Lambert, V; Carles, G

    2015-06-01

    To describe issues associated with the diagnosis of acute pregnancy-associated pancreatitis. Retrospective study of cases presenting at our establishment from 2002 to 2012. These cases were defined on the basis of the association of abdominal pain, serum lipase levels three times normal values, or signs of pancreatitis on ultrasound scans carried out on women pregnant at the time of diagnosis. A retrospective analysis of the medical files of these patients was carried out, considering epidemiological and etiological criteria, the treatments administered and maternal/fetal fate. We identified 10 cases during the study period, corresponding to an incidence of 1/1942. In 70% of cases, the patient was in the last three months of pregnancy. The pain was atypical in 70% of cases and ultrasound revealed biliary lithiasis in 30% of cases. None of the women died. In terms of neonatal morbidity, there were five preterm births, including one of an infant that died at the age of seven days. We then carried out a literature review, from which we determined the most appropriate course of action in cases of acute pancreatitis during pregnancy. Pancreatitis should be considered in pregnant women with abdominal pains because this diagnosis is easy to confirm and maternal and fetal outcomes are essentially dependent on the early etiological management of this condition. Preterm birth is the predominant factor for neonatal morbidity. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. 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...

  12. Case Study and Review: Treatment of Tricuspid Prosthetic Valve Thrombosis

    OpenAIRE

    Yi Zhang, David; Lozier, Jay; Chang, Richard; Sachdev, Vandana; Chen, Marcus Y.; Audibert, Jennifer L.; Horvath, Keith A.; Rosing, Douglas R.

    2011-01-01

    Prosthetic valve thrombosis (PVT) is a severe and life-threatening complication of heart valve replacement. Conventional therapy is surgical thrombectomy or valve replacement. Medical thrombolysis is another emerging option. We report the case of a 57 year old woman with a history of Ebstein anomaly who underwent successful treatment of a tricuspid prosthetic valve thrombosis with intra-atrial infusion of very low dose recombinant tissue plasminogen activator (tPA). We review the presentation...

  13. 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.

  14. Book Review: Climate Justice: Case Studies in Global and Regional ...

    African Journals Online (AJOL)

    Abstract. Book Title: Climate Justice: Case Studies in Global and Regional Governance Challenges. Book Author: Randall S. Abate (Ed.) Environmental Law Institute Washington DC 2016. ISBN 978-1-58576-181-4 ...

  15. Case Study and Review: Treatment of Tricuspid Prosthetic Valve Thrombosis

    Science.gov (United States)

    Yi Zhang, David; Lozier, Jay; Chang, Richard; Sachdev, Vandana; Chen, Marcus Y.; Audibert, Jennifer L.; Horvath, Keith A.; Rosing, Douglas R.

    2011-01-01

    Prosthetic valve thrombosis (PVT) is a severe and life-threatening complication of heart valve replacement. Conventional therapy is surgical thrombectomy or valve replacement. Medical thrombolysis is another emerging option. We report the case of a 57 year old woman with a history of Ebstein anomaly who underwent successful treatment of a tricuspid prosthetic valve thrombosis with intra-atrial infusion of very low dose recombinant tissue plasminogen activator (tPA). We review the presentation, etiology, diagnosis, and treatment of the tricuspid PVT emphasizing a modified medical option as a safe, minimally invasive alternative to surgical intervention or conventional medical therapy for tricuspid valve thrombosis. PMID:22000268

  16. 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

  17. 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…

  18. 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…

  19. 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.

  20. 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

  1. 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…

  2. Gamification and Enterprise Architecture – literature review and case studies

    DEFF Research Database (Denmark)

    Ullerup, Ask; Andreasen, Kristian Emil; Tambo, Torben

    , as improved e-business, as cross-channel motivators, as constituents of loyalty creation, and as proxies for manual customer interaction. In a case of specialty retailing, gamification was found to be relatively well matching strategic marketing objectives, integration in to existing technology, and channel...... on technology and business and to develop a set of governing enterprise architecture principles for the gamified enterprise. Gamification must serve a clearly formulated strategic purpose in order to avoid customer dissatisfaction, erroneous spending, secure customer service readiness, and maintain sufficient...... strategy. The retailer thus realised a high degree of “gamification readiness” and could for its product and customer segment demonstrate gamification as a positive contribution to market positioning. Both the increased level of consumer interaction and the corporate insight gained illustrate gamification...

  3. Papilomatosis in dogs: literature review and study of twelve cases

    OpenAIRE

    Fernandes, Marta Catarina; Universidade Estadual Paulista; Ribeiro, Márcio Garcia; Universidade Estadual Paulista; Fedato, Fabiana Pólis; Paes, Antonio Carlos; Universidade Estadual Paulista; Megid, Jane; Universidade Estadual Paulista

    2009-01-01

    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...

  4. 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.

  5. 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

  6. 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

  7. Bipartite Medial Cuneiform: Case Report and Retrospective Review of 1000 Magnetic Resonance (MR Imaging Studies

    Directory of Open Access Journals (Sweden)

    Geraldine H. Chang

    2014-01-01

    Full Text Available Objective. To present a unique case report of a Lisfranc fracture in a patient with a bipartite medial cuneiform and to evaluate the prevalence of the bipartite medial cuneiform in a retrospective review of 1000 magnetic resonance (MR imaging studies of the foot. Materials and Methods. Case report followed by a retrospective review of 1000 MR imaging studies of the foot for the presence or absence of a bipartite medial cuneiform. Results. The incidence of the bipartite medial cuneiform is 0.1%. Conclusion. A bipartite medial cuneiform is a rare finding but one with both clinical and surgical implications.

  8. 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.

  9. 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…

  10. Body image in cancer survivors : a systematic review of case-control studies

    NARCIS (Netherlands)

    Lehmann, Vicky; Hagedoorn, Mariët; Tuinman, Marrit A

    2014-01-01

    PURPOSE: There is common consensus that cancer and its treatment can impair the body, but combined evidence of the previous literature in cancer survivors is missing. Therefore, we reviewed body image in cancer survivors and focused on case-control studies, in order to draw conclusions as to whether

  11. Body image in cancer survivors : a systematic review of case-control studies

    NARCIS (Netherlands)

    Lehmann, Vicky; Hagedoorn, Mariet; Tuinman, Marrit A.

    2015-01-01

    There is common consensus that cancer and its treatment can impair the body, but combined evidence of the previous literature in cancer survivors is missing. Therefore, we reviewed body image in cancer survivors and focused on case-control studies, in order to draw conclusions as to whether body

  12. 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

  13. Generalisability in economic evaluation studies in healthcare: a review and case studies.

    Science.gov (United States)

    Sculpher, M J; Pang, F S; Manca, A; Drummond, M F; Golder, S; Urdahl, H; Davies, L M; Eastwood, A

    2004-12-01

    To review, and to develop further, the methods used to assess and to increase the generalisability of economic evaluation studies. Electronic databases. Methodological studies relating to economic evaluation in healthcare were searched. This included electronic searches of a range of databases, including PREMEDLINE, MEDLINE, EMBASE and EconLit, and manual searches of key journals. The case studies of a decision analytic model involved highlighting specific features of previously published economic studies related to generalisability and location-related variability. The case-study involving the secondary analysis of cost-effectiveness analyses was based on the secondary analysis of three economic studies using data from randomised trials. The factor most frequently cited as generating variability in economic results between locations was the unit costs associated with particular resources. In the context of studies based on the analysis of patient-level data, regression analysis has been advocated as a means of looking at variability in economic results across locations. These methods have generally accepted that some components of resource use and outcomes are exchangeable across locations. Recent studies have also explored, in cost-effectiveness analysis, the use of tests of heterogeneity similar to those used in clinical evaluation in trials. The decision analytic model has been the main means by which cost-effectiveness has been adapted from trial to non-trial locations. Most models have focused on changes to the cost side of the analysis, but it is clear that the effectiveness side may also need to be adapted between locations. There have been weaknesses in some aspects of the reporting in applied cost-effectiveness studies. These may limit decision-makers' ability to judge the relevance of a study to their specific situations. The case study demonstrated the potential value of multilevel modelling (MLM). Where clustering exists by location (e.g. centre or

  14. 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.

  15. A Rare Case of Primary Tubular Adenocarcinoma of the Thymus, Enteric Immunophenotype: A Case Study and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Hae Yoen Jung

    2015-07-01

    Full Text Available Thymic carcinomas are uncommon malignant tumors, and thymic adenocarcinomas are extremely rare. Here, we describe a case of primary thymic adenocarcinoma in a 59-year-old woman. Histological examination of the tumor revealed tubular morphology with expression of cytokeratin 20 and caudal-type homeobox 2 according to immunohistochemistry, suggesting enteric features. Extensive clinical and radiological studies excluded the possibility of an extrathymic primary tumor. A review of the literature revealed only two global cases of primary tubular adenocarcinomas of the thymus with enteric immunophenotype.

  16. A review of published analyses of case-cohort studies and recommendations for future reporting.

    Directory of Open Access Journals (Sweden)

    Stephen J Sharp

    Full Text Available The case-cohort study design combines the advantages of a cohort study with the efficiency of a nested case-control study. However, unlike more standard observational study designs, there are currently no guidelines for reporting results from case-cohort studies. Our aim was to review recent practice in reporting these studies, and develop recommendations for the future. By searching papers published in 24 major medical and epidemiological journals between January 2010 and March 2013 using PubMed, Scopus and Web of Knowledge, we identified 32 papers reporting case-cohort studies. The median subcohort sampling fraction was 4.1% (interquartile range 3.7% to 9.1%. The papers varied in their approaches to describing the numbers of individuals in the original cohort and the subcohort, presenting descriptive data, and in the level of detail provided about the statistical methods used, so it was not always possible to be sure that appropriate analyses had been conducted. Based on the findings of our review, we make recommendations about reporting of the study design, subcohort definition, numbers of participants, descriptive information and statistical methods, which could be used alongside existing STROBE guidelines for reporting observational studies.

  17. 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.

  18. Direct Training to Improve Educators' Treatment Integrity: A Systematic Review of Single-Case Design Studies.

    Science.gov (United States)

    Fallon, Lindsay M; Kurtz, Kathryn D; Mueller, Marlana R

    2017-06-15

    In consultation, school psychologists may offer educators direct training to support the implementation of classroom interventions aimed to improve student outcomes. The purpose of this study was to conduct a systematic literature review of single-case design research studies during which educators received direct training to implement a classroom intervention, specifically instructions, modeling, practice, and feedback. Two doctoral students in school psychology screened 228 articles and evaluated 33 studies to determine if direct training is effective and an evidence-based practice per single-case design standards proposed by the What Works Clearinghouse. Results of the review indicate that there is support for the practice to be deemed evidence-based and associated with better intervention implementation than before its application. Implications include direct training being considered for intensive, complex interventions to promote educator success with implementation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. 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

  20. 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.

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

    Science.gov (United States)

    Elsler, Dietmar; Treutlein, Daniela; Rydlewska, Iza; Frusteri, Liliana; Krüger, Henning; Veerman, Theo; Eeckelaert, Lieven; Roskams, Nele; Van Den Broek, Karla; Taylor, Terry N

    2010-06-01

    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 about different incentive schemes and their main characteristics such as effectiveness, efficiency, and feasibility. The focal point and topic centre network of the European Agency for Safety and Health at Work were used to collect case studies about incentive schemes aimed at supporting the prevention of occupational accidents and diseases in enterprises. Such incentives are rarely described in the scientific literature. To be considered for this review, studies had to focus on external financial benefits that could be provided as part of an insurance-related incentive or a governmental subsidy scheme. In total, 14 cases were included in the review: 6 insurance premium- and 8 subsidy-based schemes. Of these, 13 contained an evaluation of the incentive scheme, of which 7 use quantitative criteria. Three cases provided sufficient data to conduct a cost-benefit analysis. Most qualitative evaluations related to the successful management of the program and the effectiveness of the promoted measures in the workplace. Regarding the latter, quantitative criteria covered accident rates, sick leave, and general improvement in working conditions. The cost-benefit analyses all resulted in a positive payout ratio, ranging from 1.01-4.81 euros return for every 1 euro invested. Generally, we found economic incentive schemes to be feasible and reasonably effective. However, analysis regarding the efficiency of such schemes is scarce and our evaluation of the cost-benefit analysis had to rely on few cases that, nevertheless, delivered positive results for large samples. Besides this finding, our study also revealed deficits in the quality of evaluations. In order to enable policy-makers to make

  2. 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.

  3. 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

  4. Environmental Factors Contributing to Wrongdoing in Medicine: A Criterion-Based Review of Studies and Cases

    Science.gov (United States)

    DuBois, James M.; Carroll, Kelly; Gibb, Tyler; Kraus, Elena; Rubbelke, Timothy; Vasher, Meghan; Anderson, Emily E.

    2012-01-01

    In this paper we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research. PMID:23226933

  5. 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.

  6. 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.

  7. 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

  8. Staphylococcus sciuri: An Entomological Case Study and a Brief Review of the Literature.

    Science.gov (United States)

    Washington, Michael A; Kajiura, Lauren; Leon, Mark K H; Agee, Willie; Barnhill, Jason

    2015-01-01

    Staphylococcus sciuri is an emerging gram-positive bacterial pathogen that is infrequently isolated from cases of human disease. This organism is capable of rapid conversion from a state of methicillin sensitivity to a state of methicillin resistance and has been shown to express a set of highly effective virulence factors. The antibiotic-resistance breakpoints of S. sciuri differ significantly from the more common Staphylococcus species. Therefore, the rapid identification of S. sciuri in clinical material is a prerequisite for the proper determination of the antibiotic-resistance profile and the rapid initiation of antimicrobial therapy. Here, we present a brief literature review of S. sciuri and an entomological case study in which we describe the colonization of an American cockroach with this agent. In addition, we discuss potential implications for the distribution and evolution of antibiotic-resistant members of the genus Staphylococcus. 2015.

  9. Endoscopic ultrasound-guided ethanol ablation of pancreatic neuroendocrine tumours: A case study and literature review.

    Science.gov (United States)

    Armellini, Elia; Crinò, Stefano F; Ballarè, Marco; Pallio, Socrate; Occhipinti, Pietro

    2016-02-10

    Here we offer a review of the literature regarding endoscopic ultrasound-guided ethanol ablation for pancreatic neuroendocrine tumours and describe the case of a cystic tumour completely ablated after a multisession procedure. A total of 35 PubMed indexed cases of treated functioning and non-functioning pancreatic neuroendocrine tumours resulted from our search, 29 of which are well-documented and summarised. Endoscopic ultrasound-guided ethanol ablation appears as a local, minimally invasive treatment of pancreatic neuroendocrine tumours, suitable for selected patients. This technique appears feasible, relatively safe and efficient, especially when applied to symptom relief in functioning tumours, aiming at loss of endocrine secretion. For non-functioning tumours, where the goal is complete tissue ablation, eus guided ethanol ablation can provide good results for patients who are unfit for surgery or for those who refuse surgical resection. Its role in "fit for surgery" patients requires assessment through further studies.

  10. Eruptive vellus hair cysts: report of a new case with immunohistochemical study and literature review.

    Science.gov (United States)

    Zaharia, Daniela; Kanitakis, Jean

    2012-01-01

    Eruptive vellus hair cysts (EVHC) are rather uncommon lesions, of which 222 cases have been published in the literature. Their etiopathogenesis is poorly known. We report herein a new typical case of EVHC that was studied immunohistochemically. A 15-year-old male presented with a 4-year history of progressively developing small brown-gray papules on the trunk and extremities. Microscopically the lesions consisted of small epidermoid cysts containing vellus hairs. Immunohistochemically, the lesions expressed keratin 1/10, calretinin and p63 but no epithelial membrane antigen, filaggrin or androgen receptors. A review of the relevant literature shows that EVHC may be inherited or acquired and may be associated to other genodermatoses, namely sebocystomatosis. They could be due to hamartomatous follicular growth, to a trouble in infundibular keratinization leading to vellus hair follicle occlusion, or represent an example of acquired hamartoma. Although benign, this condition is difficult to treat. Copyright © 2012 S. Karger AG, Basel.

  11. 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.

  12. 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

  13. 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

  14. Injury Risk for Research Subjects With Spina Bifida Occulta in a Repeated Impact Study: A Case Review.

    Science.gov (United States)

    1996-01-01

    Advisory Report No.72. 1975; 1-7. 2. Avrahami E, Frishman E, Fridman Z, Azor M. Spina bifida occulta of SI is not an innocent finding. Spine . 1994; 19(1...USAARL Report No. 96-05 Injury Risk for Research Subjects With Spina Bifida Occulta in a Repeated Impact Study: A Case Review By John P. Albano...TITLE (Include Security Classification) Injury risk for research subjects with spina bifida occulta in a repeated impact study: A case review 12

  15. Patient co-payment and adherence to statins: a review and case studies.

    Science.gov (United States)

    Simoens, Steven; Sinnaeve, Peter R

    2014-02-01

    This study aims to review the international literature about whether there is an association between co-payment and statin adherence, and to present case studies to illustrate the impact of a reduction in patient co-payment associated with generic drugs on improving therapy adherence. Studies that examined the impact of patient co-payment on statin adherence were identified in PubMed, Cochrane Central Register of Controlled Trials and EconLit up to January 2013. A standardized data extraction form was completed for each included study, collecting information about country, sample, setting, adherence measure, design, results about the impact of co-payment on statin adherence, and methodological quality. Two cases from the outpatient clinic of one the authors (PRS) were added. The literature supported a statistically significant negative association between co-payment and statin adherence. This association appeared to be influenced by the absolute level of co-payments, the size of the co-payment change, whether co-payment increases or decreases, the time horizon over which the impact of a co-payment change is examined, the type of drug for which co-payment changes (e.g. generic or branded drug), the availability of alternative drugs and switching behaviour. Two case studies illustrated that cost issues are important to patients and that patient adherence to statin therapy improved following a switch to generic statins. Current studies have demonstrated that statin adherence is influenced by co-payment and a range of patient, physician and pharmacy characteristics. Nevertheless, the power of these models to explain the variation in adherence remains limited.

  16. 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.

  17. 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

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

    Science.gov (United States)

    Schmitt, Ara

    2011-01-01

    This commentary pertains to 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) regarding pediatric leukemia. The authors present a literature review regarding leukemia in…

  19. 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…

  20. Compound odontoma in the mandible--case study and literature review.

    Science.gov (United States)

    Tuczyńska, Agata; Bartosik, Dariusz; Abu-Fillat, Yasmin; Sołtysik, Anna; Matthews-Brzozowska, Teresa

    2015-01-01

    Odontomas constitute a developmental defect of hard dental tissues and are classified as benign odontogenic tumours. They are composed of all dental structures and tissues: enamel, dentin, cementum and pulp. As regards histomorphological features, two types of odontomas have been differentiated: complex and compound. Odontomas represent from 4.7% to 76% of odontogenic tumours. Their aetiology has not been fully understood, yet injury, infection and genetic factors are often named among the causes. Odontomas are usually detected by chance in radiographic images taken in relation to disrupted eruption or mislocation of teeth. To present the case study of an erupting compound odontoma on the right side of the mandible in an 11-year-old girl. The analysis covered medical documentation of the patient, diagnostic casts, orthopantomographs and cone beam computed tomography scans. The case study has been complemented with the review of up-to-date literature. A lesion composed of 30 odontoids was removed during one-day surgery without subsequent augmentation with bone substitute material. There were no post-surgery complications. A follow-up orthopantomograph taken 3 months later showed that the wound had been healing correctly, which made it possible to plan subsequent orthodontic treatment with a fixed appliance. 1. Odontomas are benign lesions which can be removed during one-day surgery without the absolute need of augmentation with xenogenic or allogenic material. 2. The pressure exerted by the plate of a removable appliance is very likely to initiate the eruption of the odontoma.

  1. Can major systematic reviews influence practice patterns? A case study of episiotomy trends.

    Science.gov (United States)

    Shen, Yu-Chu; Sim, Wee Chung; Caughey, Aaron B; Howard, David H

    2013-12-01

    Episiotomy is one of the most commonly performed procedures among women of childbearing age in the United States. In 2005, a major systematic review conducted by Hartmann and colleagues recommended against routine use of episiotomy and was widely covered in the media. We assessed the impact of the Hartman et al. study on episiotomy trend. Based on 100% hospital discharge data from eight states in 2003-2008, we used interrupted time series regression models to estimate the impact of the Hartman et al. review on episiotomy rates. We used mixed-effects regression models to assess whether interhospital variation was reduced over time. After controlling for underlying trend, episiotomy rates dropped by 1.4 percentage points after Hartman et al. publication (p < 0.01 for spontaneous delivery; p < 0.1 for operative delivery). The publication has smaller effect on government hospitals as compared to private hospitals. Mixed effects models estimated negative correlation between cross-time and cross-hospital variations in episiotomy rates, indicating reduced cross-hospital variation over time. Our results suggested that there has been a gradual decline in episiotomy rates over the period 2003-2008, and that synthesis of evidence showing harms from routine episiotomy had limited impact on practice patterns in the case of episiotomy. The experience of episiotomy illustrates the challenge of using comparative effectiveness and evidenced-based medicine to reduce use of unnecessary procedures.

  2. 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.

  3. 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

  4. 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.

  5. Hypersexuality in neurocognitive disorders in elderly people - a comprehensive review of the literature and case study.

    Science.gov (United States)

    Ibrahim, Chady; Reynaert, Christine

    2014-11-01

    Hypersexuality is defined as an increase in libido. It is often confounded with sexual disinhibition and inappropriate sexual behavior directed against oneself or against others. It is described in 2.9 to 8% of patients living at home and in 3.8 to 7% of patients in institutions. The pathophysiology of hypersexuality is complex. Several brain areas are involved. The psychological factors are also important. We found it useful to present a clinical case of a patient who presented with symptoms of hypersexuality and to discuss the diagnosis and the management. Data collection was based on the case of a patient hospitalized in the Department of Psychosomatic medicine in CHU Mont-Godinne - Yvoir - Belgium in February 2013. For the literature review, we used the database PubMed with the following keywords: hypersexuality, dementia. A total of 40 articles were selected for this study. The patient had symptoms of hypersexuality, and hyperorality in the context of delirium induced by benzodiazepine withdrawal. A blood test and brain imaging were normal. She was put under risperidone 2 mg with complete resolution of symptoms within a few days. The diagnosis of Kluver-Bucy syndrome in the context of a minor neurocognitive disorder was retained. Management is mainly non-pharmacological using behavioral techniques. The education of the patient, his partner and caregivers are essential. Pharmacotherapy is sometimes necessary. It is reserved as a last resort because of the serious side effects of the drugs used.

  6. 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.

  7. Systematic review of sensory integration therapy for individuals with disabilities: Single case design studies.

    Science.gov (United States)

    Leong, H M; Carter, Mark; Stephenson, Jennifer

    2015-12-01

    Sensory integration therapy (SIT) is a controversial intervention that is widely used for people with disabilities. Systematic analysis was conducted on the outcomes of 17 single case design studies on sensory integration therapy for people with, or at-risk of, a developmental or learning disability, disorder or delay. An assessment of the quality of methodology of the studies found most used weak designs and poor methodology, with a tendency for higher quality studies to produce negative results. Based on limited comparative evidence, functional analysis-based interventions for challenging behavior were more effective that SIT. Overall the studies do not provide convincing evidence for the efficacy of sensory integration therapy. Given the findings of the present review and other recent analyses it is advised that the use of SIT be limited to experimental contexts. Issues with the studies and possible improvements for future research are discussed including the need to employ designs that allow for adequate demonstration of experimental control. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    OpenAIRE

    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 anth...

  11. Review of Ginkgo biloba-induced toxicity, from experimental studies to human case reports.

    Science.gov (United States)

    Mei, Nan; Guo, Xiaoqing; Ren, Zhen; Kobayashi, Daisuke; Wada, Keiji; Guo, Lei

    2017-01-02

    Ginkgo biloba seeds and leaves have been used as a traditional herbal remedy for thousands of years, and its leaf extract has been consumed as a botanical dietary supplement for decades. Ginkgo biloba extract is a complex mixture with numerous components, including flavonol glycosides and terpene lactones, and is one of the most widely sold botanical dietary supplements worldwide. Concerns about potential health risks for the general population have been raised because of the widespread human exposure to Ginkgo biloba and its potential toxic and carcinogenic activities in rodents. The National Toxicology Program conducted 2-year gavage studies on one Ginkgo biloba leaf extract and concluded that there was clear evidence of carcinogenic activity of this extract in mice based on an increased incidence of hepatocellular carcinoma and hepatoblastoma. Recently, Ginkgo biloba leaf extract has been classified as a possible human carcinogen (Group 2B) by the International Agency for Research on Cancer. This review presents updated information on the toxicological effects from experimental studies both in vitro and in vivo to human case reports (caused by ginkgo seeds or leaves), and also summarizes the negative results from relatively large clinical trials.

  12. "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…

  13. Indigenous Efforts at Individualizing Program Review: A Case Study. ASHE 1986 Annual Meeting Paper.

    Science.gov (United States)

    Lincoln, Yvonna S.

    An expanded program review process that includes qualitative, ethnographic, retrospective, and subjective data is described. At the University of Kansas, qualitative indicators were developed and methods were designed to implement them. Reviews were moved from a process of reacting to quantitative self-studies to a procedure that involved:…

  14. 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.

  15. 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.

  16. [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

  17. 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.

  18. 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.

  19. Contribution of genetics to the study of animal personalities: a review of case studies

    NARCIS (Netherlands)

    Van Oers, K.; de Jong, G.; Van Noordwijk, A.J.; Kempenaers, B.; Drent, P.J.

    2005-01-01

    The need for evolutionary studies on quantitative traits that integrate genetics is increasing. Studies on consistent individual differences in behavioural traits provide a good opportunity to do controlled experiments on the genetic mechanisms underlying the variation and covariation in complex

  20. 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)

  1. 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.

  2. Ethics review of multisite studies: the difficult case of community-based indigenous health research.

    Science.gov (United States)

    Studdert, David M; Vu, Tamara M; Fox, Sarah S; Anderson, Ian P; Keeffe, Jill E; Taylor, Hugh R

    2010-03-01

    Researchers have longstanding concerns about the logistical and administrative burdens posed by ethics review of multisite studies involving human participants. Centralised ethics review, in which approval by one committee has authority across multiple sites, is widely touted as a strategy for streamlining the process. The Harmonisation of Multi-centre Ethical Review (HoMER) project is currently developing such a system for Australia. It is unclear how centralised review will work for multisite Indigenous health research, where the views of local stakeholders are important and community consultation is mandatory. Our recent experience in conducting the National Indigenous Eye Health Survey (NIEHS) shows how elaborate the current ethics approval and community consultation processes can be, and points to several lessons and ideas to guide pending reforms.

  3. Acantholytic squamous cell carcinoma: pathological study of nine cases with review of literature.

    Science.gov (United States)

    Sajin, Maria; Hodorogea Prisăcaru, Alina; Luchian, Mihaela Cristina; Pătraşcu, Oana Maria; Dumitru, Adrian; Costache, Diana; Dumitrescu, Doina; Vrînceanu, Daniela; Voinea, Liliana Mary; Simionescu, Olga; Costache, Mariana

    2014-01-01

    Squamous cell carcinoma (SCC) is classified in many subtypes or forms; one of them is the acantholytic squamous cell carcinoma, also called pseudoglandular, adenoid, epithelioma dyskeratoticum segregans, or adenoacanthoma. Researching and analyzing nine cases of acantholytic squamous cell carcinoma, we intend to verify if the data provided by the cases studied can be validated by the scientific literature. All the cases presented lesions found on the head and neck skin, with two exceptions - one on the larynx and the other one on the tonsil, all of them ulcerated lesions. In two cases, the tumors developed on the skin, in preneoplasic lesions (actinic keratosis). The tumors had dimensions between 4/3/4 mm and 100/90/36 mm. During one year, two of the cases studied presented multiple recurrences. We also found two cases of metatypical carcinoma accompanied the acantholytic variant of squamous cell carcinoma. None of the analyzed cases presented distant metastasis. The histopathological criteria for selection were: keratinised squamous tumor cell type, adenoid structures with round spaces with a defined wall of at least one cell width, spaces with isolated or grouped dyskeratotic acantholytic cells.

  4. Wegener`s granulomatosis and mucoromycosis: A case study and review of literature

    Directory of Open Access Journals (Sweden)

    Sayyed Mojtaba Abtahi

    2012-01-01

    Full Text Available Mucormycosis is a fatal invasive infection which mostly involves diabetic or immunosuppressed patients. Early diagnosis, improving immunosuppression, systemic antifungal therapy, and surgical debridement are necessary for successful treatment. In this case study, we represent a known case of Wegener′s granulomatosis (WG, with concomitant sinusal mucormycosis mimicking vasculitic disease relapse, which was successfully treated with surgical debridement, amphotericine, and intravenous immunoglobuline.

  5. 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…

  6. 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.

  7. A case study evaluation of ethics review systems for multicentre clinical trials.

    Science.gov (United States)

    Hicks, Sian C; James, Rebecca E; Wong, Nicole; Tebbutt, Niall C; Wilson, Kate

    2009-09-07

    To evaluate the difference in time taken for ethics and site governance approval for multicentre clinical trials using two different systems of ethics review. We evaluated the times to final ethics and governance approval for two international, multicentre clinical trials of treatment for metastatic colorectal cancer: the MAX trial, using a non-centralised ethics review system, and the CO.20 trial, using the new New South Wales centralised ethics review system. Time from trial submission to overall study approval. The median time taken to obtain ethics approval for the MAX trial at 16 NSW sites was 100 days (range, 36-161 days). The median time to obtain central ethics approval for the CO.20 trial at 14 NSW sites was 77 days, with an additional 60 days (range 20-79 days) required to obtain site-specific research governance approval. Any difference in time to approval between the review systems was outweighed by the overall time taken. However, the time spent by both the coordinating centre and local sites in collation, submission and correspondence was greatly reduced, and the centralised process allowed for standardised documentation at all study sites.

  8. 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.

  9. Urogenital manifestations in Wegener granulomatosis: a study of 11 cases and review of the literature.

    Science.gov (United States)

    Dufour, Jean-François; Le Gallou, Thomas; Cordier, Jean-François; Aumaître, Olivier; Pinède, Laurent; Aslangul, Elisabeth; Pagnoux, Christian; Marie, Isabelle; Puéchal, Xavier; Decaux, Olivier; Dubois, Alain; Agard, Christian; Mahr, Alfred; Comoz, François; Boutemy, Jonathan; Broussolle, Christiane; Guillevin, Loïc; Sève, Pascal; Bienvenu, Boris

    2012-03-01

    We describe the main characteristics and treatment of urogenital manifestations in patients with Wegener granulomatosis (WG). We conducted a retrospective review of the charts of 11 patients with WG. All patients were men, and their median age at WG diagnosis was 53 years (range, 21-70 yr). Urogenital involvement was present at onset of WG in 9 cases (81%), it was the first clinical evidence of WG in 2 cases (18%), and was a symptom of WG relapse in 6 cases (54%). Symptomatic urogenital involvement included prostatitis (n = 4) (with suspicion of an abscess in 1 case), orchitis (n = 4), epididymitis (n = 1), a renal pseudotumor (n = 2), ureteral stenosis (n = 1), and penile ulceration (n = 1). Urogenital symptoms rapidly resolved after therapy with glucocorticoids and immunosuppressive agents. Several patients underwent a surgical procedure, either at the time of diagnosis (n = 3) (consisting of an open nephrectomy and radical prostatectomy for suspicion of carcinoma, suprapubic cystostomy for acute urinary retention), or during follow-up (n = 3) (consisting of ureteral double J stents for ureteral stenosis, and prostate transurethral resection because of dysuria). After a mean follow-up of 56 months, urogenital relapse occurred in 4 patients (36%). Urogenital involvement can be the first clinical evidence of WG. Some presentations, such as a renal or prostate mass that mimics cancer or an abscess, should be assessed to avoid unnecessary radical surgery. Urogenital symptoms can be promptly resolved with glucocorticoids and immunosuppressive agents. However, surgical procedures, such as prostatic transurethral resection, may be mandatory in patients with persistent symptoms.

  10. [Anatomic variations of the hepatic artery : a study of 33 cases and review].

    Science.gov (United States)

    Daghfous, Amine; Baraket, Oussama; Bedioui, Heykal; Ayadi, Sofiene; Mighri, Mongi; Touinsi, Hassen; Jouini, Mohamed; Kacem, Montacer; Ben Safta, Zoubeir; Sadok, Sassi

    2011-05-01

    The hepatic artery is prone to numerous anatomic variations dictated by certain variables of the organogenesis. Aim : To research study the anatomic variations of the hepatic artery as well as their implications within surgical practice. Study of a post-mortem series of 33 cases of dissection of the hepatic pedicle with fresh corpses (deaths amounting no longer than 24 hours), carried out in conditions that are quite close to those met with the living ones. The common hepatic artery was divided at the foot of the hepatic pedicle into a gastro duodenal artery and into a proper hepatic artery in 94% of the cases. In 6% of the cases, we noticed a three level change, a branching of the average hepatic artery into a gastro duodenal artery, a right hepatic artery and a left hepatic artery. The proper hepatic artery represented the pedicle segment of the hepatic artery in 94% of the cases. In 36% of the cases, the liver was irrigated by two hepatic arteries. In 12% of the cases, there was the matter of the right hepatic artery, branch of the mesenteric artery. In 24% of the cases, there was the matter of the left hepatic artery branch of the left gastric artery. The perfect knowledge in preoperative and preoperative stages of the anatomic variations of the hepatic pedicle is quite essential. Actually, the lack of knowledge of these variations exposes to the risk of certain complications which are sometimes deadly during hepatic transplants, pancreatic surgery, cholecystectomies, through laroscopic way as well as in the treatment of gastro-esophagus surging.

  11. 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.

  12. Personal attributes of authors and reviewers, social bias and the outcomes of peer review: a case study.

    Science.gov (United States)

    Walker, Richard; Barros, Beatriz; Conejo, Ricardo; Neumann, Konrad; Telefont, Martin

    2015-01-01

    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.

  13. Intraocular Gnathostoma spinigerum. Clinicopathologic study of two cases with review of literature.

    Science.gov (United States)

    Biswas, J; Gopal, L; Sharma, T; Badrinath, S S

    1994-01-01

    Live intraocular nematode is a rare occurrence that is mostly reported in Southeast Asian countries. Common nematodes that are seen live in the eye are microfilaria, Gnathostoma, and Angiostrongylus. Approximately 12 cases of intraocular gnathostomiasis have been reported in the literature. Two cases of intraocular gnathostoma, removed by vitrectomy in the first case and by paracentesis in the second case, are reported. Morphologic study of the parasites in wet preparation was performed under dissecting microscope and fixed in Karnovosky's fixative. Light microscopic and scanning electron microscopic studies were also performed. The first patient had anterior uveitis, multiple iris holes, and dense vitreous haze with fibrous proliferation over the optic disc. On resolution of the vitreous haze, a live worm was seen in the vitreous cavity. The second patient had anterior uveitis with secondary glaucoma, multiple iris holes, mild vitritis, and focal subretinal haemorrhage with subretinal tracts. Four days later a live worm was seen in the anterior chamber and removed. Microscopic study of the parasites from both patients revealed typical head bulb with four circumferential rows of hooklets, and fine cuticular spines were seen on the surface of the body. Iris holes, uveitis, and subretinal haemorrhage with subretinal tract can be characteristic features of intraocular gnathostomiasis. Identification of this parasite can be made by typical features, which can be identified on light and scanning electron microscopic study.

  14. 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...

  15. 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

  16. How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies.

    Science.gov (United States)

    Simpson, Eric L; Keck, Laura E; Chalmers, Joanne R; Williams, Hywel C

    2012-07-01

    Eczema prevention is now an active area of dermatologic and allergy research. Defining an incident case is therefore a prerequisite for such a study. We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. We conducted a systematic review of controlled interventional atopic dermatitis prevention studies by using searches of MEDLINE and Cochrane databases for studies published from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. One hundred two studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  17. Granulomatous inflammation in acanthamoeba keratitis: An immunohistochemical study of five cases and review of literature

    Directory of Open Access Journals (Sweden)

    Vemuganti G

    2005-01-01

    Full Text Available Purpose: Acanthamoeba keratitis usually presents as a necrotizing stromal inflammation. We report a rare presentation of granulomatous inflammation in Acanthamoeba keratitis Methods: Retrospective clinico-pathologic case series. Results: Five corneal tissues (3 corneal buttons, 2-eviscerated contents from patients suffering from severe Acanthamoeba keratitis not responding to anti-Acanthamoeba treatment, revealed a florid granulomotous inflammation with multinucleated giant cells in the posterior stroma and around Descemet′s membrane. Phagocytosed parasites were noted within the giant cells. Vascularization of the corneal stroma was noted in two cases. Immunophenotyping revealed a predominance of T lymphocytes and macrophages. Clinically, four of five cases had shown features of limbal and scleral involvement. Conclusion: Granulomatous inflammation in the posterior corneal stroma, is not an uncommon finding in Acanthamoeba keratitis and could possibly be immune-mediated, contributing to persistence and progression of disease. Clinical Relevance: Presence of granulomatous inflammation in Acanthamoeba keratitis, in most cases is associated with limbal and scleral involvement and therefore could be considered as one of the poor prognostic markers. Further studies are required to ascertain the specific clinical features and appropriate management strategies in these cases.

  18. [MALT B cell lymphoma with kidney damage and monoclonal gammopathy: a case study and literature review].

    Science.gov (United States)

    Peces, R; Vega-Cabrera, C; Peces, C; Pobes, A; Fresno, M F

    2010-01-01

    We report a case of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) involving the left kidney and simultaneous onset of a monoclonal gammopathy IgM kappa. No predisposing local inflammatory condition was identified. Following left nephrectomy, the renal specimen showed the centrocyte like cells and lymphoid cells in the lymphoepithelial lesions were positive for CD20 and CD79α. The neoplastic cells expressed monotypic cytoplasmic IgM kappa. The demonstration of bone marrow cells of B-lineage expressing the same monoclonal protein as the tumor suggested bone marrow involvement, even in the absence of identical morphology. Despite chemotherapy and rituximab treatment, clinical follow-up showed right kidney extension with high-grade transformation, and finally systemic dissemination. This case illustrates that the kidney is among the sites that may be involved by MALT B-cell lymphomas in a primary or secondary fashion, and the need for expanded investigation of the possible dissemination. We review the literature on this unusual extranodal lymphoma.

  19. 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

  20. 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.

  1. 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.

  2. 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...

  3. A review on analytical techniques for natural convection investigation in a heated closed enclosure: Case study

    Directory of Open Access Journals (Sweden)

    Minea Alina Adriana

    2015-01-01

    Full Text Available The aim of this paper is to present a theoretical analysis of a few convection problems. The investigations were started from the geometry of a classic muffle manufactured furnace. During this analytical study, different methodologies have been carefully chosen in order to compare and evaluate the effects of applying different analytical methods of the convection heat transfer processes. In conclusion, even if there are available a lot of analytical methods, natural convection in enclosed enclosures can be studied correctly only with numerical analysis. Also, in this article is presented a case study on natural convection application in a closed heated enclosure.

  4. 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.

  5. Molecular and cytogenetic abnormalities in acute myeloid leukemia: review and case studies

    Directory of Open Access Journals (Sweden)

    Elvira Deolinda Rodrigues Pereira Velloso

    2011-06-01

    Full Text Available Objective: To study the frequency of mutations that maylead to a good or bad prognosis, as well as their relation withthe karyotype and immunophenotype in patients with acutemyeloid leukemia. Methods: Thirty samples of patients withacute myeloid leukemia were studied, in which FLT3-ITD, FLT3-TKD and NPM1 mutations were investigated. All samples weresubmitted to immunophenotyping and 25 to karyotyping. Results:An occurrence of 33.3% NPM1 mutation and an equal numberof FLT3-ITD mutation were observed. When only the cases withnormal karyotype were studied, this figures increased to 50 and40%, respectively. Eight percent of cases with normal karyotypeand genotype NPM1+/FLT3- were included in the group of acutemyeloid leukemia with good prognosis. The typical phenotypeof acute myeloid leukemia with normal karyotype and mutatedNPM1 (HLA-DR and CD34 negative was not observed in thissmall series. Conclusion: Good prognosis cases were identifiedin this series, emphasizing the need to include new geneticmarkers in the diagnostic routine for the correct classification ofacute myeloid leukemia, to more properly estimate prognosis anddetermine treatment.

  6. Multiple sclerosis in the real world: A systematic review of fingolimod as a case study.

    Science.gov (United States)

    Ziemssen, Tjalf; Medin, Jennie; Couto, C Anne-Marie; Mitchell, Catherine R

    2017-04-01

    The aim of our study was to systematically review the growing body of published literature reporting on one specific multiple sclerosis (MS) treatment, fingolimod, in the real world to assess its effectiveness in patients with MS, evaluate methodologies used to investigate MS in clinical practice, and describe the evidence gaps for MS as exemplified by fingolimod. We conducted a PRISMA-compliant systematic review of the literature (cut-off date: 4 March 2016). Published papers reporting real-world data for fingolimod with regard to clinical outcomes, persistence, adherence, healthcare costs, healthcare resource use, treatment patterns, and patient-reported outcomes that met all the eligibility criteria were included for data extraction and quality assessment. Based on 34 included studies, this analysis found that fingolimod treatment improved outcomes compared to the period before treatment initiation and was more effective than interferons or glatiramer acetate. However, among studies comparing fingolimod with natalizumab, overall trends were inconsistent: some reported natalizumab to be more effective than fingolimod and others reported similar effectiveness for natalizumab and fingolimod. These studies illustrate the challenges of investigating MS in the real world, including the subjectivity in evaluating some clinical outcomes and the heterogeneity of methodologies used and patient populations investigated, which limit comparisons across studies. Gaps in available real-world evidence for MS are also highlighted, including those relating to patient-reported outcomes, combined clinical outcomes (to measure overall treatment effectiveness), and healthcare costs/resource use. The included studies provide good evidence of the real-world effectiveness of fingolimod and highlight the diversity of methodologies used to assess treatment benefit in clinical practice. Future studies could address the evidence gaps found in the literature and the challenges associated

  7. 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

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Meriastuti - Ginting

    2015-06-01

    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

  10. 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 

  11. CASE STUDY

    African Journals Online (AJOL)

    2012-03-01

    Mar 1, 2012 ... a small papule on the glans of his penis which increased in size and ulcerated. He subsequently developed a yellow non-odorous urethral discharge. On review of symptoms, he denied associated fevers and chills, or trauma to the site. He had no significant previous medical history and denied cigarette ...

  12. Visual analysis in single case experimental design studies: brief review and guidelines.

    Science.gov (United States)

    Lane, Justin D; Gast, David L

    2014-01-01

    Visual analysis of graphic displays of data is a cornerstone of studies using a single case experimental design (SCED). Data are graphed for each participant during a study with trend, level, and stability of data assessed within and between conditions. Reliable interpretations of effects of an intervention are dependent on researchers' understanding and use of systematic procedures. The purpose of this paper is to provide readers with a rationale for visual analysis of data when using a SCED, a step-by-step guide for conducting a visual analysis of graphed data, as well as to highlight considerations for persons interested in using visual analysis to evaluate an intervention, especially the importance of collecting reliability data for dependent measures and fidelity of implementation of study procedures.

  13. CASE STUDY

    African Journals Online (AJOL)

    vascular disease necessitating bilateral amputations at the knee. The patient had no ... patients on long-term treatment and those on protease inhibitor (PI) regimens.1,2 We present a rare case of atypical lipodystrophy, presenting as multiple subcutaneous lipomas, in a patient who had been on a non-PI. ARV regimen for 6 ...

  14. Case study

    African Journals Online (AJOL)

    Point mutations in the human fibroblast growth factor receptor 3 (FGFR3) gene are well documented in inherited skeletal anomalies, such as achondroplasia and thanatophoric dysplasia, that are associated in most cases of dwarfism.10 In addition, an oncogenic role has been proposed for mutant FGFR.11 Recently,.

  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. Household-Level Coastal Adaptation and Its Drivers: A Systematic Case Study Review.

    Science.gov (United States)

    Koerth, Jana; Vafeidis, Athanasios T; Hinkel, Jochen

    2017-04-01

    Evidence-based information on household-level adaptation is an important element of integrated management of vulnerable coastal regions. A growing number of empirical studies deal with household-level adaptation at the coast in different regions. This article provides a systematic review of these studies. We analyze studies according to how households in different parts of the world are currently adapting, or how they are intending to adapt, and identify explanatory factors for adaptation behavior and intention. We find that households implement a broad range of adaptation measures and that adaptation behavior is explained by individual factors such as socioeconomic and cognitive variables, experience, and perceived responsibilities. Nonpersonal characteristics have also been used to explain adaptation behavior and intention but have not been extensively investigated. Few studies employ qualitative research methods and use inductive approaches as well as models stemming from behavioral economics. Our findings suggest that coastal risk management policies should communicate the efficacy of household-level adaptation, in addition to information about flood risk, in order to encourage coastal households in their adaptation activities. In this context, we discuss the role of resources and responsibility of households for their adaptation behavior. We describe the lessons learnt and formulate a research agenda on household-level adaptation to coastal flood risk. In practice, coastal risk management policies should further promote individually driven adaptation by integrating it in adaptation strategies and processes. © 2016 Society for Risk Analysis.

  17. [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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    Loro, Manuel; Arce, Rosa M.; Ortega, Emilio

    2014-01-01

    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

  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. Global neonatal and perinatal mortality: a review and case study for the Loreto Province of Peru

    Directory of Open Access Journals (Sweden)

    Warren JB

    2012-10-01

    Full Text Available Jamie B Warren,1 William E Lambert,2 Rongwei Fu,2 JoDee M Anderson,1 Alison B Edelman31Department of Pediatrics, 2Department of Public Health and Preventive Medicine, 3Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USABackground: Millennium Development Goal 4 calls for the reduction of the under-five mortality rate by two-thirds between 1990 and 2015. To reach this goal, neonatal mortality must be decreased. The lack of information on global neonatal and perinatal mortality impedes appropriate implementation of interventions, as vital registration systems are not available for the majority of the world's neonatal deaths. Verbal autopsy (VA is a tool that has been used to determine cause of death. Recent studies have attempted to standardize and validate the use of this tool in resource-limited areas. The World Health Organization (WHO International Standard VA Questionnaire was used to conduct a needs assessment in nine rural Peruvian villages. The goal was to determine the neonatal mortality rate (NMR, perinatal mortality rate (PMR, and causes of, and risk factors for, death in these villages.Methods: Eligible women were interviewed using the WHO International Standard VA Questionnaire or a set of questions based on the WHO VA Questionnaire. NMR and PMR were calculated using a generalized estimating equation model. Three neonatologists independently reviewed VA records to provide cause of death determination. Reviewer agreement was assessed using percent agreement. Fisher's exact test was used to determine risk factors associated with death.Results: The NMR was 31.4 per 1000 live births and the PMR was 49.7 per 1000 pregnancies. The main contributor to neonatal death was infection (43%. Percent agreement among reviewers was 90.5% and 38.9% for cause of neonatal death and stillbirth, respectively. Risk factors for death were pregnancy with twins (P = 0.001, preterm delivery (P = 0.003, and cesarean

  3. Donor organ shortage crisis: a case study review of a financial incentive-based system.

    Science.gov (United States)

    Al Sebayel, M; Alenazi, A M; Sabbagh, R; Al Ageel, T; Al Enazi, M; Al Bahili, H; Elsiesy, H

    2014-01-01

    Current organ supply system depends on altruistic noncoercive donation, which has failed to meet the demand of organ transplantation. Providing financial incentives to donors is one of several approaches to address organ shortage. However, its feasibility is debatable as it relates to medical, ethical, and economic dimensions. An incentive-based procurement system (IBPS) applied by the Mobile Donor Action Team (MDAT) was instituted in Riyadh, Saudi Arabia, resulting in a 3-fold increase in donation rate. The goal of this study was to provide a qualitative review of a 7-year experience with IBPS. A qualitative approach was used. Documents were reviewed to create a chronological audit and shape interview questions. Sampling was purposeful and inclusive of MDAT members. Semi-structured interviews were conducted, and findings were subjected to thematic analysis. Documents reflected the evolution of MDAT. The essence of MDAT is field work and liberal use of financial incentives, which resulted in a 3-fold increase in the donation rate. MDAT members believed that IBPS is the main reason behind this increase. Moreover, IBPS is viewed as acceptable from a moral, ethical, and religious standpoint, with a high degree of professional satisfaction. Theoretical assumptions doubted the feasibility of IBPS. This real-life experience with IBPS proved the contrary. The findings may be applicable only to the setting in Riyadh, Saudi Arabia, however; further research is thus needed to explore its transferability to other settings. IBPS may be an alternative to altruistic noncoercive donation and should be piloted in different settings. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. MSG and hydrolyzed vegetable protein induced headache: review and case studies.

    Science.gov (United States)

    Scopp, A L

    1991-02-01

    Monosodium glutamate (MSG), an established headache trigger, has become far more prevalent in canned, packaged and prepared foods over the past decade. The presence of MSG in food may be difficult to detect since the terms "natural flavor," "flavoring," or "hydrolyzed vegetable protein (HVP)," all may appear on food labels to refer to MSG, according to current FDA food labeling codes. HVP typically contains 10-30% MSG. Case studies are presented in which the elimination of all food sources of MSG resulted in decreased headache frequency. Information and food lists helpful in identifying dietary MSG and HVP are presented. When patients are put on an MSG-free trial diet, attention needs to be given to identification of the wide variety of foods containing MSG and HVP.

  5. 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…

  6. 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…

  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. Presentation and conservative management of acute calcific tendinopathy: a case study and literature review.

    Science.gov (United States)

    Scibek, Jason S; Carcia, Christopher R

    2012-11-01

    The efficacy of a variety of noninvasive, conservative management techniques for calcific tendinopathy has been investigated and established for improving pain and function and/or facilitating a decrease in the size or presence of calcium deposits. Surprisingly, few have reported on the use of traditional therapeutic exercise and rehabilitation alone in the management of this condition, given the often spontaneous resorptive nature of calcium deposits. The purpose of this case is to present the results of a conservative approach, including therapeutic exercise, for the management of calcific tendinopathy of the supraspinatus, with an emphasis on patient outcomes. The patient was a self-referred 41-y-old man with complaints of acute right-shoulder pain and difficulty sleeping. Imaging studies revealed liquefied calcium deposits in the right supraspinatus. The patient reported constant pain at rest (9/10) and tenderness in the area of the greater tuberosity. He exhibited a decrease in all shoulder motions and had reduced strength. The simple shoulder test (SST) revealed limited function (0/12). Conservative management included superficial modalities and medication for pain and a regimen of scapulothoracic and glenohumeral range-of-motion (ROM) and strengthening exercises. At discharge, pain levels decreased to 0/10 and SST scores increased to 12/12. ROM was full in all planes, and resisted motion was strong and pain free. The patient was able to engage in endurance activities and continue practicing as a health care provider. The outcomes with respect to pain, function, and patient satisfaction provide evidence to support the use of conservative therapeutic interventions when managing patients with acute cases of calcific tendinopathy. Successful management of calcific tendinopathy requires attention to outcomes and an understanding of the pathophysiology, prognostic factors, and physical interventions based on the current stage of the calcium deposits and the

  10. Crossed Aphasia and Visuo-Spatial Neglect Following a Right Thalamic Stroke: A Case Study and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Lieve De Witte

    2008-01-01

    Full Text Available Crossed aphasia in dextrals (CAD following pure subcortical lesions is rare. This study describes a right-handed patient with an ischemic lesion in the right thalamus. In the post-acute phase of the stroke, a unique combination of ‘crossed thalamic aphasia’ was found with left visuo-spatial neglect and constructional apraxia. On the basis of the criteria used in Mariën et al. [67], this case-report is the first reliable representative of vascular CAD following an isolated lesion in the right thalamus. Furthermore, this paper presents a detailed analysis of linguistic and cognitive impairments of ‘possible’ and 'reliable' subcortical CAD-cases published since 1975. Out of 25 patients with a pure subcortical lesion, nine cases were considered as ‘possibly reliable or reliable’. A review of these cases reveals that: (1 demographic data are consistent with the general findings for the entire group of vascular CAD, (2 the neurolinguistic findings do not support the data in the general CAD-population with regard to (a the high prevalence of transcortical aphasia and (b the tendency towards a copresence of an oral versus written language dissociation and a ‘mirror-image’ lesion-aphasia profile, (3 subcortical CAD is not a transient phenomenon, (4 the lesion-aphasia correlations are not congruent with the high incidence of anomalous cases in the general CAD-population, (5 neuropsychological impairments may accompany subcortical CAD.

  11. Coccygodynia review: coccygectomy case series.

    Science.gov (United States)

    Awwad, Waleed Mohammad; Saadeddin, Munir; Alsager, Jbreel Nasser; AlRashed, Fahad Mohammad

    2017-10-01

    Coccygodynia is a pain of the coccyx that is typically exaggerated by pressure. Management includes anti-inflammatory medications, physiotherapy, and coccyx manipulation. Coccygectomy is the surgical approach for treating coccygodynia when the conservative management fails. Generally, coccygectomy yields good results. Its most common complication is wound infection. To determine the effectiveness of coccygectomy in patients with coccygodynia. A retrospective review of 70 patients (52 females and 18 males) with coccygodynia at King Khalid University Hospital in Riyadh was carried out, and the outcomes were studied. Twenty patients did not respond to conservative management; therefore, bimanual coccyx manipulation was done. Eleven were identified with instability and did not respond to coccygeal manipulation. Coccygectomy was performed on 8 patients while 3 declined. All patients who underwent coccygectomy showed improvement of their symptoms. One case of superficial wound infection and delayed wound healing was encountered. Coccygectomy provides effective pain relief to patients not responding to conservative therapies.

  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. Case Series Review

    African Journals Online (AJOL)

    open registry

    studied. The male to female ratio was 1:1.74. Eighty of them underwent caesarean section (38 .... The use of oxytocin rather than ergometrine to contract the uterus after delivery of the baby as noted previously6, gentle surgery and avoidance of hypotension will prevent vomiting ultimately. The pulse rate and blood pressure ...

  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. Family Physician–Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review

    Science.gov (United States)

    Khanassov, Vladimir; Vedel, Isabelle

    2016-01-01

    PURPOSE Dementia case management (CM) in primary care is a complex intervention aimed at identifying the various needs of patients with dementia and their caregivers, as well as the organization and coordination of care. A key element of CM is the collaboration of family physicians with case managers. We conducted a systematic mixed-studies review to identify the needs of the patient-caregiver dyad and the effects of CM. METHODS We searched MEDLINE, PsycINFO, and EMBASE up to October 2014, regardless of the study design. Our main outcomes were needs of patients and their caregivers and the effects of CM on these needs. We used narrative syntheses to develop a taxonomy of needs and to describe the effects of CM on those needs. We used meta-analysis to calculate the prevalence of needs and the standardized mean differences to evaluate the effects of CM on the needs identified. RESULTS Fifty-four studies were included. We identified needs of the patient-caregiver dyad and needs of the patient and caregiver individually. CM addressed the majority of the identified needs. Still, some very common needs (eg, early diagnosis) are overlooked while other needs (eg, education on the disease) are well addressed. Fully establishing the value of CM is difficult given the small number of studies of CM in primary care. CONCLUSIONS There is good evidence that case managers, in collaboration with family physicians, have a pivotal role in addressing the needs of the patient-caregiver dyad. PMID:26951593

  16. Updating a systematic review – what difference did it make? Case study of nicotine replacement therapy

    Directory of Open Access Journals (Sweden)

    Lancaster Tim

    2001-11-01

    Full Text Available Abstract Aims To examine the effect of updating a systematic review of nicotine replacement therapy on its contents and conclusions. Methods We examined the effects of regular updating of a systematic review of nicotine replacement therapy for smoking cessation. We considered two outcomes. First, we assessed the effect of adding new data to meta-analyses, comparing results in 2000 with the results in 1994. Second, we assessed qualitatively the ways inwhich the nature of the questions addressed by the review had changed between the two dates. For the first outcome, we compared the number of trials, the pooled estimate of effect using the odds ratio, and the results of pre-specified subgroup analyses, for nicotine gum and patch separately. Using a test for interaction, we assessed whether differences between estimates were statistically significant. Results There were ten new trials of nicotine gum between 1994 and 2000, and the meta-analytic effect changed little. For the nicotine patch the number of trials increased from 9 to 30, and the meta-analytic effect fell from 2.07 (95% CI 1.64 – 2.62 to 1.73 (95% CI 1.56 – 1.93. Apparent differences in relative effect in sub-groups found in 1994 were not found in 2000. The updated systematic review addressed a number of questions not identified in the original version. Conclusions Updating the meta-analyses lead to a more precise estimate of the likely effect of the nicotine patch, but the clinical message was unchanged. Further placebo controlled NRT trials are not likely to add to the evidence base. It is questionable whether updating the meta-analyses to include them is worthwhile. The content of the systematic review has, however, changed, with the addition of data addressing questions not considered in the original review. There is a tension between the principle of identifying the important questions prior to conducting a review, and keeping the review up to date as primary research identifies

  17. 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.

  18. 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.

  19. Nurse-Designed Care Models and Culture of Health: Review of Three Case Studies.

    Science.gov (United States)

    Grant, Martsolf; Diana J, Mason; Jennifer, Sloan; Cheryl G, Sullivan; Antonia M, Villarruel

    2018-01-01

    The Robert Wood Johnson Foundation (RWJF) recently made a commitment to advancing a national culture of health (COH)-an action framework developed by RWJF that focuses on well-being and equity with the goal of empowering and supporting people to lead healthier lives where they live, learn, work, and play, now and in generations to come. Nurses are well positioned to provide care that is consistent with, and contributes to, a COH in their communities. RWJF contracted with the American Academy of Nursing (the Academy) with a subcontract to the RAND Corporation to explore the ways that innovative nurse-designed models of care are currently advancing a COH. This article presents findings from case studies of three nurse-designed care models that have been recognized as innovative by the Academy's Edge Runner program, which identifies nurses who have designed innovations to remedy challenges in the delivery of health care or address an unmet health need of a population, and who can demonstrate positive clinical and financial outcomes. Findings indicate that nurse-designed models of care focus extensively on activities in the four different "action areas" set forth in RWJF's COH framework: making health a shared value; fostering cross-section collaboration to improve well-being; creating healthier, more equitable communities; and strengthening integration of health services and systems. Strong leadership and broad community support were key to the success of each of these models. A persistent challenge was identifying a sustainable funding mechanism for community-level efforts aimed at addressing social determinants of health-most of these efforts are currently grant-funded.

  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. 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.

  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. 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 and bi...

  4. Climate Change Vulnerability Assessments: Four Case Studies of Water Utility Practices (External Review Draft)

    Science.gov (United States)

    EPA has released this draft document solely for the purpose of pre-dissemination peer review under applicable information quality guidelines. This document has not been formally disseminated by EPA. It does not represent and should not be construed to represent any Agency policy ...

  5. 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...

  6. 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…

  7. 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.

  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. Metastatic Penile Carcinomas: A Study of Nine Cases and Review of ...

    African Journals Online (AJOL)

    Objective: Primary penile carcinoma is one of the rarest male genital tract tumors in Turkey, because circumcision is performed routinely. In general, metastatic carcinoma of the penis is the second most common penile tumor. Despite the fact that the penis is rarely affected by metastases, there have been 319 cases reported ...

  10. Nanomaterial Case Study: A Comparison of Multiwalled Carbon Nanotube and Decabromodiphenyl Ether Flame-Retardant Coatings Applied to Upholstery Textiles (Independent Peer Review Draft)

    Science.gov (United States)

    This Independent Peer Review Draft document presents a case study of multiwalled carbon nanotubes (MWCNTs); it focuses on the specific example of MWCNTs as used in flame-retardant coatings applied to upholstery textiles. This case study is organized around the comprehensive envir...

  11. 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.

  12. 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.

  13. 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

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

    Science.gov (United States)

    JACKSON, CLAIRE; SHAW, SARA; JANAMIAN, TINA

    2016-01-01

    Policy Points: 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. Context 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. Methods 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. Findings 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

  15. Coxsackie B virus serology and Type 1 diabetes mellitus: a systematic review of published case-control studies.

    Science.gov (United States)

    Green, J; Casabonne, D; Newton, R

    2004-06-01

    Enteroviruses, in particular Coxsackie B4, have been implicated in the aetiology of Type 1 diabetes mellitus, but the epidemiological evidence has not been systematically evaluated. Systematic review of evidence from published controlled studies of the relationship between Coxsackie B virus serology and incident or prevalent Type 1 diabetes mellitus. Studies were identified through a Medline search (1966 to 2002), supplemented by references from identified papers and hand search of relevant journals. All studies (full papers, abstracts or letters) with data adequate for calculation of unadjusted odds ratios (with 95% confidence intervals) for Type 1 diabetes mellitus in relation to Coxsackie B virus serology were included. The review included 26 case-control studies; no cohort study met the inclusion criteria. Odds ratios for Type 1 diabetes mellitus in serology-positive vs. serology-negative subjects ranged from 0.2 to 22.3. For Coxsackie B (any serotype) 7/13 studies had point estimates significantly greater than 1.0 (P Coxsackie B3, Coxsackie B4 and Coxsackie B5-specific assays, 1/11, 6/17 and 1/11 studies, respectively, had point estimates significantly greater than 1.0. Summary odds ratios were not calculated because of doubts about the validity of individual study estimates, heterogeneity between studies, and the possibility of publication bias. The results of these studies are inconsistent and do not provide convincing evidence for or against an association between Coxsackie B virus infection and Type 1 diabetes mellitus. Better designed studies using effective assays are needed to resolve this important issue.

  16. 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.

  17. The syndrome of progressive posterior cortical dysfunction: A multiple case study and review

    Directory of Open Access Journals (Sweden)

    Renata Areza-Fegyveres

    Full Text Available Abstract Dementia presenting with prominent higher order visual symptoms may be observed in a range of neurodegenerative conditions and is often challenging to diagnose. Objectives: To describe cases of progressive dementia presenting with prominent visual cortical symptoms. Methods: We conducted a retrospective search of cases of progressive dementia with predominant visual symptoms, seen at our dementia unit from 1996 to 2006. Results: Twelve patients (5 men, 7 women were identified, with ages ranging from 49 to 67 years. At the first examination, the duration of the symptoms ranged from one to ten years and the Mini-Mental State Examination scores from 7 to 27. Eleven patients presented with predominant visuospatial symptoms (partial or complete Balint syndrome and one with visuoperceptive impairment. Other reported manifestations were: constructional apraxia in 11 patients, partial or complete Gerstmann syndrome in ten, ideomotor apraxia in nine, hemineglect or extinction in four patients, alien hand phenomenon in three, and prosopagnosia in one patient. Memory loss was reported by ten patients, but was not the main complaint in any of these cases. Insight was relatively preserved in five patients even after a long period following the onset of symptoms. Six patients developed parkinsonism during evolution. Clinical diagnoses were possible or probable AD in seven patients, cortico-basal degeneration in four, and dementia with Lewy body in one. Conclusions: Clinicians should consider this condition especially in presenile patients with slowly progressive higher-order visual symptoms. Although described in association with different conditions, it may also occur in Alzheimer disease.

  18. Psoas compartment disease studied by computed tomography: analysis of 50 cases and subject review

    Energy Technology Data Exchange (ETDEWEB)

    Feldberg, M.A.M.; Koehler, P.R.; van Waes, P.F.G.M.

    1983-08-01

    Fifty patients with disease involving the psoas compartment were analyzed. There were 27 patients with inflammation, 17 with tumor, and 6 with hemorrhage. In all but 3 cases the disease did not originate in the psoas but spread there from neighboring structures. Disease processes followed the fascial planes in patients with abscesses and hemorrhage but were less predictable with tumors. All three types of lesions were similar radiographically and were often indistinguishable. Asymmetry of the muscle mass, regions of decreased density, and opacification of fat in the peri- and pararenal compartments were the most frequent signs of disease. Computed tomography is recommended as the diagnostic procedure of choice.

  19. Postirradiation neurofibrosarcomas. A clinicopathologic, immunohistochemical and ultrastructural study of a case with a review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Pasquier, B.; Pasquier, D.; Le Marc' hadour, F.; Martin-Ramos, J.; Stoebner, P.; Couderc, P.

    1988-12-01

    A case of postirradiation neurofibrosarcoma (NFS) developed in the left crural nerve in a 37-year-old man with no evidence of neurofibromatosis is presented. Seven years earlier this patient was treated for an immature teratoma of the left testis. Total radiation dose delivered to the site of development of the NFS was estimated at 59 Gys. Histological and ultrastructural findings in the tumor included schwann cell, fibroblastic and/or histiocytic features. Immunohistochemical studies showed strong positivity for S100 protein in numerous tumor cells. Radiation-induced NFS are very uncommon and aggressive neoplasms. A review of the literature yielded less than 50 cases. Most patients are adults (mean age 41.2 years) and many (46.8%) have Von Recklinghausen disease. Mean latency between irradiation and onset of clinical manifestations was 16 years (range 2-41 years). The most common primary cancers were malignant lymphomas. In approximately one third of cases the NFS developed following irradiation for a non-malignant tumorous or non-tumorous lesion. Twenty-nine of the 32 patients with adequate follow ups died (90.6%). Mean survival following surgery was 20.8 months (range 5-61 months). Mean survival at five years was 12.5%. On the basis of data from the literature, histopathologic, immunohistochemical and ultrastructural features of these tumors developed from nerve sheaths and whose histogenesis is still controversial, are discussed.

  20. A rare location of benign osteoblastoma: case study and a review of the literature.

    Science.gov (United States)

    Caltabiano, R; Serra, A; Bonfiglio, M; Platania, N; Albanese, V; Lanzafame, S; Cocuzza, S

    2012-11-01

    Osteoblastoma is a solitary, benign bone tumor that is rarely localized in the frontal sinus. It consists of hypocellular mineralized tissue that may form large masses or irregular trabeculae. A 31 year old man came to our attention with a 7 month history of diplopia, photophobia, frontal headhaches and progressive exophthalmos with proptosis of the left eye. The patient was submitted to computed tomography (CT) which allowed to appraise the extension of the lesion. The mass expanded inside the left frontal sinus and the upper ethmoidal cells invading the left orbital roof. Considering the extension of the tumor, the site and the connections with contiguous structures, a combination of endoscopic endonasal technique with intraorbital approach was performed. At histological examination typical features of benign osteoblastoma were observed. The sites of predilection for the tumor are the long bones, vertebral column, and small bones of hands and feet. Its occurrence in the skull and jaw bones is relatively rare and represents only 15% of all osteoblastomas. To our knowledge, only 5 cases of osteoblastoma of the frontal sinus have been previously reported in the English-language literature. This report describes a case of benign osteoblastoma in a rare site, namely, the frontal sinus with particular attention about the differential diagnosis and the treatment.    

  1. School-Based Peer-Related Social Competence Interventions for Children with Autism Spectrum Disorder: A Meta-Analysis and Descriptive Review of Single Case Research Design Studies

    Science.gov (United States)

    Whalon, Kelly J.; Conroy, Maureen A.; Martinez, Jose R.; Werch, Brittany L.

    2015-01-01

    The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to facilitate the peer-related social competence of children with autism spectrum disorder (ASD). Reviewed studies employed a single-case experimental design, targeted peer-related social competence, included children 3-12 years old…

  2. 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.

  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. 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.

  5. 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

  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. Familial Adenomatous Polyposis (FAP)-A Case Study and Review of Literature.

    Science.gov (United States)

    Dalavi, Santosh Bhimrao; Vedpalsingh, Tanwar Harshwardhan; Bankar, Sanket Subhash; Ahmed, Mohd Hamid Shafique; Bhosale, Dattatray Nivrutti

    2015-03-01

    Familial adenomatous polyposis (FAP) is a syndrome characteristically having numerous (hundreds to thousands) polyps in the epithelium of the large intestines with an autosomal dominant inheritance caused by germ line mutations in adenomatous polyposis coli (APC) gene in chromosome 5q21. Most FAP patients have a family history of colorectal polyps and cancer but 25-30% of them are "de novo", without any clinical or genetic evidence of FAP in family members. Prophylactic proctocolectomy is required in almost all patients since all affected patients inevitably develop cancer. We report a case of a 32-year-old man who presented with vague abdominal complaints without any family history, which on evaluation as found to have multiple colorectal polyps and underwent a prophylactic proctocolectomy with end continent ileostomy. Two of his children were evaluated and found to have multiple colorectal polyps on colonoscopy and have been advised regular follow up annually. In conclusion, patients with FAP may present with vague abdominal complaints and without any family history, hence need to be carefully evaluated. Good patient compliance is of prime importance in deciding the treatment and surveillance modality subsequently determining the prognosis of patients with FAP.

  9. Familial Adenomatous Polyposis (FAP)—A Case Study and Review of Literature

    Science.gov (United States)

    Dalavi, Santosh Bhimrao; Vedpalsingh, Tanwar Harshwardhan; Ahmed, Mohd Hamid Shafique; Bhosale, Dattatray Nivrutti

    2015-01-01

    Familial adenomatous polyposis (FAP) is a syndrome characteristically having numerous (hundreds to thousands) polyps in the epithelium of the large intestines with an autosomal dominant inheritance caused by germ line mutations in adenomatous polyposis coli (APC) gene in chromosome 5q21. Most FAP patients have a family history of colorectal polyps and cancer but 25-30% of them are "de novo", without any clinical or genetic evidence of FAP in family members. Prophylactic proctocolectomy is required in almost all patients since all affected patients inevitably develop cancer. We report a case of a 32-year-old man who presented with vague abdominal complaints without any family history, which on evaluation as found to have multiple colorectal polyps and underwent a prophylactic proctocolectomy with end continent ileostomy. Two of his children were evaluated and found to have multiple colorectal polyps on colonoscopy and have been advised regular follow up annually. In conclusion, patients with FAP may present with vague abdominal complaints and without any family history, hence need to be carefully evaluated. Good patient compliance is of prime importance in deciding the treatment and surveillance modality subsequently determining the prognosis of patients with FAP. PMID:25954663

  10. 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 ...

  11. 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…

  12. 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.

  13. 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

    2015-01-01

    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. PMID:27134699

  14. Case Study: Writing a Journal Case Study

    Science.gov (United States)

    Prud'homme-Genereux, Annie

    2016-01-01

    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 describes incorporating a journal article into the classroom by first converting it into a case study.

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

    Science.gov (United States)

    Yuan, Shi-Min

    2015-01-01

    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. 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. 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.

  16. 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.

  17. A review of potable water accessibility and sustainability issues in developing countries - case study of Uganda.

    Science.gov (United States)

    Nayebare, Shedrack R; Wilson, Lloyd R; Carpenter, David O; Dziewulski, David M; Kannan, Kurunthachalam

    2014-01-01

    Providing sources of sustainable and quality potable water in Uganda is a significant public health issue. This project aimed at identifying and prioritizing possible actions on how sustainable high quality potable water in Uganda's water supply systems could be achieved. In that respect, a review of both the current water supply systems and government programs on drinking water in Uganda was completed. Aspects of quantity, quality, treatment methods, infrastructure, storage and distribution of water for different water systems were evaluated and compared with the existing water supply systems in the U.S., Latin America and the Caribbean, for purposes of generating feasible recommendations and opportunities for improvement. Uganda utilizes surface water, groundwater, and rainwater sources for consumption. Surface water covers 15.4% of the land area and serves both urban and rural populations. Lake Victoria contributes about 85% of the total fresh surface water. Potable water quality is negatively affected by the following factors: disposal of sewage and industrial effluents, agricultural pesticides and fertilizers, and surface run-offs during heavy rains. The total renewable groundwater resources in Uganda are estimated to be 29 million m3/year with about 20,000 boreholes, 3000 shallow-wells and 200,000 springs, serving more than 80% of the rural and slum communities. Mean annual rainfall in Uganda ranges from 500 mm to 2500 mm. Groundwater and rainwater quality is mainly affected by poor sanitation and unhygienic practices. There are significant regional variations in the accessibility of potable water, with the Northeastern region having the least amount of potable water from all sources. Uganda still lags behind in potable water resource development. Priorities should be placed mainly on measures available for improvement of groundwater and rainwater resource utilization, protection of watersheds, health education, improved water treatment methods and

  18. 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.

  19. A Case Study and Review of Nanotechnology and Nanomaterials in Green Architecture

    OpenAIRE

    Babak Daryoush; Amirpejman Darvish

    2013-01-01

    Research methodology in this research is applied based on the objective and its objective is to obtain the consensus of experts familiar with the topic of study. This study seeks to deconstruct the conventional structures with green architecture topics such as the reduced power consumption and to make the application of technologies in achieving the objectives of green architecture computational and executive by entering the topic of Nanomaterials and its applied application in green architec...

  20. Molecular and cytogenetic abnormalities in acute myeloid leukemia: review and case studies

    OpenAIRE

    Velloso,Elvira Deolinda Rodrigues Pereira; Motta,Carlos Henrique Ares Silveira da; Furtado,Juliana Braga; Bacal,Nydia Strachman; Silveira,Paulo Augusto Achucarro; Moyses,Cynthia Bachir; Sitnik,Roberta; Pinho,João Renato Rebello

    2011-01-01

    Objective: To study the frequency of mutations that may lead to a good or bad prognosis, as well as their relation with the karyotype and immunophenotype in patients with acute myeloid leukemia. Methods: Thirty samples of patients with acute myeloid leukemia were studied, in which FLT3-ITD, FLT3-TKD and NPM1 mutations were investigated. All samples were submitted to immunophenotyping and 25 to karyotyping. Results: An occurrence of 33.3% NPM1 mutation and an equal number of FLT3-ITD mutatio...

  1. Book Review of Emerging Markets for Ecosystem Services: A Case Study of the Panama Canal Watershed

    Science.gov (United States)

    This book is an outstanding contribution to our current, applied knowledge on markets of ecosystems services. In an integrated framework of study, the authors assessed the opportunities and limitations of carbon sequestration mainly via reforestation, hydrological services (water quantity and qualit...

  2. 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...

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

    OpenAIRE

    Miguel CS; Chaim-Avancini TM; Silva MA; Louzã MR

    2015-01-01

    Carmen Sílvia Miguel, Tiffany M Chaim-Avancini, Maria Aparecida Silva, Mario Rodrigues LouzãAdult Attention Deficit Hyperactivity Disorder Program (PRODATH), Institute of Psychiatry, University of São Paulo, São Paulo, BrazilBackground: 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 o...

  4. Gastric schwannoma: a clinicopathologic study of 51 cases and critical review of the literature.

    Science.gov (United States)

    Voltaggio, Lysandra; Murray, Rebecca; Lasota, Jerzy; Miettinen, Markku

    2012-05-01

    Schwannoma is a rare gastrointestinal mesenchymal tumor, as the vast majority of gastric mesenchymal tumors are gastrointestinal stromal tumors. In this study, we analyzed clinicopathologically 51 gastric schwannomas. These tumors predominantly occurred in older adults with a marked female predominance (40 women and 11 men; median and mean ages, 60 and 58 years). They variably presented with gastric discomfort, bleeding, or rarely gastric outlet obstruction; and many were incidental findings during other medical procedures. The tumors ranged from 1 to 10.5 cm (median, 4.5 cm). The typical histologic features included spindle cells usually with microtrabecular architecture and focal nuclear atypia, and peritumoral lymphoid cuff, whereas features of soft tissue schwannomas, such as encapsulation, nuclear palisading, vascular hyalinization, and dilatation, were absent or infrequent. Median mitotic count was 2/50 high-power fields, with the highest count being 13/50 high-power fields. No malignant variants were recognized, and long-term follow-up did not reveal recurrences or metastases. Immunohistochemically, all examined tumors were S100 protein positive and most were also GFAP positive, whereas CD34 and NF68 were encountered rarely and all tumors were negative for HMB45, KIT, DOG1/Ano 1, smooth muscle actin, desmin, and synaptophysin. None of the 9 tumors studied contained gastrointestinal stromal tumor-specific KIT or PDGFRA mutations. Fluorescence in situ hybridization studies revealed multiple signals with BCR probe (chromosome 22) and centromeric probes for chromosomes 2 and 18 suggesting polyploidy. These findings indicate that gastric schwannoma is a distinctive form of peripheral nerve sheath tumor that in many ways differs from soft tissue schwannoma. It should be distinguished from gastrointestinal stromal tumor and other mesenchymal tumors of the gastrointestinal tract, such as the S100 protein-positive gastrointestinal clear cell sarcoma and metastatic

  5. GASTRIC SCHWANNOMA – A CLINICOPATHOLOGIC STUDY OF 51 CASES AND CRITICAL REVIEW OF THE LITERATURE

    Science.gov (United States)

    Voltaggio, Lysandra; Murray, Rebecca; Lasota, Jerzy; Miettinen, Markku

    2011-01-01

    Schwannoma is a rare gastrointestinal mesenchymal tumor as the vast majority of gastric mesenchymal tumors are GISTs. In this study, we analyzed clinicopathologically 51 gastric schwannomas. These tumors predominantly occurred in older adults with a marked female predominance (40 women and 11 men, median and mean ages, 60 and 58 years). They variably presented with gastric discomfort, bleeding, or rarely by gastric outlet obstruction, and many were incidental findings during other medical procedures. The tumors ranged from 1–10.5 cm (median, 4.5 cm). The typical histologic features included spindle cells usually with microtrabecular architecture and focal nuclear atypia, and peritumoral lymphoid cuff, whereas features of soft tissue schwannomas, such as encapsulation, nuclear palisading, vascular hyalinization and dilatation, were absent or infrequent. Median mitotic count was 2/50 HPFs, with the highest count being 13/50 HPFs. No malignant variants were recognized, and long-term follow-up did not reveal recurrences or metastases. Immunohistochemically, all examined tumors were S100 protein positive and most were also GFAP positive, whereas CD34 and NF68 were encountered rarely and all tumors were negative for HMB45, KIT, DOG1/Ano 1, SMA, desmin, and synaptophysin. None of the 9 tumors studied contained GIST-specific KIT or PDGFRA mutations. FISH studies revealed multiple signals with BCR probe (chromosome 22) and centromeric probes for chromosomes 2 and 18 suggesting polyploidy. These findings indicate that gastric schwannoma is a distinctive form of peripheral nerve sheath tumor that in many ways differs from soft tissue schwannoma. It should be distinguished from GIST and other mesenchymal tumors of the gastrointestinal tract, such as the S100 protein-positive gastrointestinal clear cell sarcoma and metastatic melanoma. PMID:22137423

  6. [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.

  7. Environmental protection for geothermic exploratory drilling in Mexico: Review of a case study

    Energy Technology Data Exchange (ETDEWEB)

    Ortega-Rubio, A.; Diaz, S.; Arguelles, C.; Arriaga, L. [Centro de Investigaciones Biologicas del Noveste, La Paz (Mexico)

    1995-06-01

    Mexican legislation specifically establishes very particular measures in order to prevent and/or to mitigate the potential environmental impacts produced by geothermic exploratory drilling. During 1991, we developed an environmental impact assessment study to evaluate the possible environmental impacts produced by the exploratory drilling at the Las Tres Virgenes Geothermic field. We determined that the geothermic electrical project activities analysed have observed most of the official recommendations. As a result, all the potential environmental impacts are local, restricted in extent and time, and mitigated or reversed. 12 refs., 1 fig., 1 tab.

  8. 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

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

    Directory of Open Access Journals (Sweden)

    Miguel CS

    2015-03-01

    Full Text Available Carmen Sílvia Miguel, Tiffany M Chaim-Avancini, Maria Aparecida Silva, Mario Rodrigues LouzãAdult Attention Deficit Hyperactivity Disorder Program (PRODATH, Institute of Psychiatry, University of São Paulo, São Paulo, BrazilBackground: 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.Keywords: ADHD, executive function, NF1, low-grade pontine glioma, cognition

  10. The challenge of external validity in policy-relevant systematic reviews: a case study from the field of substance misuse.

    Science.gov (United States)

    Pearson, Mark; Coomber, Ross

    2010-01-01

    To critically evaluate the methods utilized in the conduct of a systematic review in the field of substance misuse. Participant-observation in the review process, semi-structured interviews with review team members and management and structured observation of the process of guidance development. An 'arm's-length' government body. Review team members, management and the committee responsible for producing evidence-based guidance for policy and practice. Data from interviews and (participant-)observation were reflected upon critically in order to increase understanding of the systematic review process. The application of systematic review methods produced an evidence base that did not inform the development of guidance to the extent that it could have done: (i) an emphasis upon internal research validity produced an evidence base with an emphasis on short-term interventions at the level of the individual; (ii) criteria for appraising the external validity of studies were not developed sufficiently; and (iii) the systematic review of evidence and development of guidance are strongly reliant upon the judgement of reviewers and committee members. Prioritizing internal validity in a systematic review risks producing an evidence base that is not informed adequately by the wider determinants of health and which does not give sufficient consideration to external validity. The use of appropriate methods requires that commissioners of systematic reviews are clear at the outset how the review is proposed to be utilized. Review methods such as meta-ethnography and realist synthesis could contribute to making the frameworks within which judgements are made more explicit.

  11. 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

  12. The meaning of 'rural' in rural health: a review and case study from Brazil.

    Science.gov (United States)

    Lourenço, Ana Eliza Port

    2012-01-01

    Health disparities between rural and urban populations are an important global health concern, although ascertaining what constitutes a rural context is a complicated undertaking. This article summarises theoretical contributions that help to explain how uncritical use of rural classifications may interfere with epidemiological data and health policies. Bonfim, a community located in Rio de Janeiro state, Brazil, illustrates the discussion. Bonfim is classified as urban by the Brazilian census, although the community contains farmland, parkland and rural social groups such as family farmers and ecotourism employees. The (mis)classification of Bonfim as urban further complicates the meaning of rural, and thus also what is meant by rural health. Researchers have developed some new rurality indexes to overcome the rural-urban dichotomy and to help understand local scale health determinants. But the obstacles for large-scale studies and government decision-making are still many. 'Rural' is an epidemiological variable that unites in a single indicator diverse life aspects relevant for health purposes. Therefore, to facilitate allocation of health resources based on objective criteria, governments and policy makers must acknowledge the difficulty of defining what rural is and work to improve the definitions they use.

  13. Case Study Teaching

    Science.gov (United States)

    Herreid, Clyde Freeman

    2011-01-01

    This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)

  14. Meta-analysis to determine the effects of plant disease management measures: review and case studies on soybean and apple.

    Science.gov (United States)

    Ngugi, Henry K; Esker, Paul D; Scherm, Harald

    2011-01-01

    in epidemiology and disease management is illustrated with case studies from our work on Phakopsora pachyrhizi on soybean and Erwinia amylovora on apple. We show that although meta-analyses are often used to corroborate and validate general conclusions drawn from more traditional, qualitative reviews, they can also reveal new patterns and interpretations not obvious from individual studies.

  15. A Comparative Review on Computational Modeling Paradigms. A Study on Case-Based Modeling and Political Terrorism

    OpenAIRE

    Voinea, Camelia Florela

    2007-01-01

    We review the advances in Case-Based Computational Modeling on Political Analysis issues. Starting in early „70s, the research on political terrorism has been challenged by the latest advances of terrorism computational modeling research. Nowadays Political Analysis community has a wider perspective over the terrorism research aims, methodology and instruments. Widening up this perspective is not a matter of political analysis and research only, it is as well a long-term effect...

  16. 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.

  17. Clinical features of septic discitis in the UK: a retrospective case ascertainment study and review of management recommendations.

    Science.gov (United States)

    Hopkinson, Neil; Patel, Kamal

    2016-09-01

    Septic discitis is a rare but important cause of spinal pain caused by intervertebral disc infection. This retrospective observational case series analysis will examine the clinical features and management of septic discitis in 23 patients and compare with a similar 2001 study. We will also review the evidence behind management recommendations to identify areas for future research. The incidence of septic discitis was 2 per 100,000 per year. Patients presented with spinal pain (96 %), fever (70 %) and raised inflammatory markers. All patients had blood cultures and 52 % had targeted microbiological analysis. Staphylococcus aureus was the most common causative organism (39 %). Treatment was most often with intravenous flucloxacillin or ceftriaxone. CT-guided sampling for culture before commencing antibiotics increased organism detection from 33 to 67 %, and organism identification reduced the antibiotic course from an average of 142 days to 77 days. An increased number of significant co-morbid conditions were associated with worse outcomes. Results broadly resembled the 2001 study. Key differences were increased use and yield of magnetic resonance imaging and computerised tomography (CT) scanning and more frequent use of intravenous antibiotics. Comparisons between the studies suggest that improvements in the consistency of management have been slow. We suggest this due to the large spectrum of disease and the lack of guidelines in the UK. It is widely recommended to perform blood cultures and CT-guided biopsies before starting antibiotics, but it is unclear how long to withhold antibiotics if cultures remain negative. Six weeks of intravenous followed by 6 weeks of oral therapy is often suggested as treatment, whereas some recommend using inflammatory markers to guide antibiotic duration. Larger studies addressing these specific questions are required to provide more definitive guidance for these clinical decisions.

  18. 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).

  19. 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

  20. 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.

  1. Feasibibility study - cases

    DEFF Research Database (Denmark)

    Lund, Henrik; Hvelplund, Frede Kloster; Sukkumnoed, Decharut

    2004-01-01

    The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation.......The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation....

  2. 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

  3. 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

  4. Influence of Exposure and Toxicokinetics on Measures of Aquatic Toxicity for Organic Contaminants: A Case Study Review

    Science.gov (United States)

    Landrum, Peter F; Chapman, Peter M; Neff, Jerry; Page, David S

    2013-01-01

    This theoretical and case study review of dynamic exposures of aquatic organisms to organic contaminants examines variables important for interpreting exposure and therefore toxicity. The timing and magnitude of the absorbed dose change when the dynamics of exposure change. Thus, the dose metric for interpreting toxic responses observed during such exposure conditions is generally limited to the specific experiment and cannot be extrapolated to either other experiments with different exposure dynamics or to field exposures where exposure dynamics usually are different. This is particularly true for mixture exposures, for which the concentration and composition and, therefore, the timing and magnitude of exposure to individual components of different potency and potentially different mechanisms of action can vary. Aquatic toxicology needs studies that develop temporal thresholds for absorbed toxicant doses to allow for better extrapolation between conditions of dynamic exposure. Improved experimental designs are required that include high-quality temporal measures of both the exposure and the absorbed dose to allow better interpretation of data. For the short term, initial water concentration can be considered a conservative measure of exposure, although the extent to which this is true cannot be estimated specifically unless the dynamics of exposure as well as the toxicokinetics of the chemicals in the exposure scenario for the organism of interest are known. A better, but still limited, metric for interpreting the exposure and, therefore, toxicity is the peak absorbed dose, although this neglects toxicodynamics, requires appropriate temporal measures of accumulated dose to determine the peak concentration, and requires temporal thresholds for critical body residue for each component of the mixture. Integr Environ Assess Manag 2013; 9: 196–210. © 2012 SETAC PMID:23229376

  5. 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…

  6. 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.

  7. 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.

  8. Inducible urticaria: Case series and literature review.

    Science.gov (United States)

    Amaya, Daniel; Sánchez, Andrés; Sánchez, Jorge

    2016-03-03

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

  9. School-based peer-related social competence interventions for children with autism spectrum disorder: a meta-analysis and descriptive review of single case research design studies.

    Science.gov (United States)

    Whalon, Kelly J; Conroy, Maureen A; Martinez, Jose R; Werch, Brittany L

    2015-06-01

    The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to facilitate the peer-related social competence of children with autism spectrum disorder (ASD). Reviewed studies employed a single-case experimental design, targeted peer-related social competence, included children 3-12 years old with an ASD, and took place in school settings. Articles were analyzed descriptively and using the evaluative method to determine study quality. Additionally, effect size estimates were calculated using nonoverlap of all pairs method and Tau-U. A total of 37 studies including 105 children were reviewed. Overall, ES estimates ranged from weak to strong, but on average, the reviewed interventions produced a moderate to strong effect, and quality ratings were generally in the acceptable to high range. Findings suggest that children with ASD can benefit from social skill interventions implemented with peers in school settings.

  10. 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…

  11. 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

    '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...

  12. A review of the data quality and comparability of case-control studies of low-level exposure to benzene in the petroleum industry.

    Science.gov (United States)

    Miller, B G; Fransman, W; Heederik, D; Hurley, J F; Kromhout, H; Fitzsimons, E

    2010-01-01

    Published case-control studies of risks of leukaemia following low exposures to benzene in the distribution of petroleum (gasoline) have not all identified the same level of risk, but the studies have had differences in cohort inclusion, case determination and availability of occupational and lifestyle data. We reviewed the quality and comparability of the data from three (of four) studies. Through site visits, discussions with the investigators and reading study reports, we reviewed and audited the methods used for selecting cases and controls, for estimating individual exposures and for analysing and interpreting the data. Case-control comparisons of exposures were examined using customized graphs. We found that there were no issues of subject selection, methods or general data quality that were likely to have distorted their internal comparisons; we could not check in detail whether the metric for exposure assessments was the same across the studies; the exposure assessments for the Australian study required the least backward estimation, and the Canadian, which also had fewest cases, the most; evidence of an increased risk at higher exposures in Australia was convincing. The findings are consistent with some effect of benzene at higher lifetime exposures. A proposed pooled analysis should improve quantification of any exposure-response relationship.

  13. [Stafne's cavity. Review and apropos of 6 cases].

    Science.gov (United States)

    Grau Cases, J; Gay Escoda, C; Hernández Alfaro, F

    1991-02-01

    A retrospective study of 6 cases of Stafne's static cavities is presented in a review of 1536 cases of maxillary cysts. We have found an incidence 4:2 for men. All cases have been detected casually. The sialography show a relationship between cavities and the submaxillary gland. The treatment was surgical in four cases and conservative in two.

  14. Case study research.

    Science.gov (United States)

    Taylor, Ruth; Thomas-Gregory, Annette

    2015-06-10

    This article describes case study research for nursing and healthcare practice. Case study research offers the researcher an approach by which a phenomenon can be investigated from multiple perspectives within a bounded context, allowing the researcher to provide a 'thick' description of the phenomenon. Although case study research is a flexible approach for the investigation of complex nursing and healthcare issues, it has methodological challenges, often associated with the multiple methods used in individual studies. These are explored through examples of case study research carried out in practice and education settings. An overview of what constitutes 'good' case study research is proposed.

  15. Book Review - Climate Justice: Case Studies in Global and Regional Governance Challenges (Environmental Law Institute Washington DC 2016

    Directory of Open Access Journals (Sweden)

    Paola Villavicencio Calzadilla

    2017-04-01

    Full Text Available Climate Justice: Case Studies in Global and Regional Governance Challenges edited by Randall S Abate, addresses a diverse set of topics related to climate justice, explores the meaning and challenges of this critical issue, and provides factual and legal arguments to explain why fairness should guide the creation of international and national climate-related policy and responses.

  16. External ophthalmomyiasis caused by Dermatobia hominis. A retrospective study of nine cases and a review of the literature.

    Science.gov (United States)

    Denion, Eric; Dalens, Pierre-Henri; Couppié, Pierre; Aznar, Christine; Sainte-Marie, Dominique; Carme, Bernard; Petitbon, Jean; Pradinaud, Roger; Gérard, Max

    2004-10-01

    To report nine cases of external ophthalmomyiasis caused by Dermatobia hominis. Retrospective, non-comparative, interventional case series. Participants consisted of patients (n = 9) presenting at Cayenne Hospital between 1968 and 2003. The location and number of larvae, the larval stage, and the medical and surgical procedures applied were studied in each case. Seven patients had palpebral myiasis (including one with three larvae) and two had conjunctival myiasis. Every patient had palpebral oedema. The larval respiratory pore was located on the palpebral skin or free margin or on the conjunctiva. Movements were present within the lesion in at least three patients. Petroleum ointment or ivermectine solution was used in at least four patients to smother or kill the larvae. Extraction under local anaesthesia was possible in six patients, while three required general anaesthesia. Several larvae may be present in a patient. Topical ivermectine may help to kill the larvae before extraction is attempted.

  17. 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…

  18. The selection of search sources influences the findings of a systematic review of people’s views: a case study in public health

    Directory of Open Access Journals (Sweden)

    Stansfield Claire

    2012-04-01

    Full Text Available Abstract Background For systematic reviews providing evidence for policy decisions in specific geographical regions, there is a need to minimise regional bias when seeking out relevant research studies. Studies on people’s views tend to be dispersed across a range of bibliographic databases and other search sources. It is recognised that a comprehensive literature search can provide unique evidence not found from a focused search; however, the geographical focus of databases as a potential source of bias on the findings of a research review is less clear. This case study describes search source selection for research about people’s views and how supplementary searches designed to redress geographical bias influenced the findings of a systematic review. Our research questions are: a what was the impact of search methods employed to redress potential database selection bias on the overall findings of the review? and b how did each search source contribute to the identification of all the research studies included in the review? Methods The contribution of 25 search sources in locating 28 studies included within a systematic review on UK children’s views of body size, shape and weight was analysed retrospectively. The impact of utilising seven search sources chosen to identify UK-based literature on the review’s findings was assessed. Results Over a sixth (5 out of 28 of the studies were located only through supplementary searches of three sources. These five studies were of a disproportionally high quality compared with the other studies in the review. The retrieval of these studies added direction, detail and strength to the overall findings of the review. All studies in the review were located within 21 search sources. Precision for 21 sources ranged from 0.21% to 1.64%. Conclusions For reducing geographical bias and increasing the coverage and context-specificity of systematic reviews of people’s perspectives and experiences

  19. Lateral temporal encephaloceles: case-based review.

    Science.gov (United States)

    Nagata, Yuichi; Takeuchi, Kazuhito; Kato, Mihoko; Chu, Jonsu; Wakabayashi, Toshihiko

    2016-06-01

    Lateral temporal encephalocele is an extremely rare clinical condition, with only 18 cases presented in the literature to date. No review articles have examined lateral temporal encephalocele in depth. We therefore reviewed past cases of lateral encephalocele to clarify the clinical characteristics of this extremely rare deformity. We also present a case of lateral encephalocele with arachnoid cyst which has never been reported in past reports. We identified 8 reports describing 18 cases of lateral temporal encephalocele. We therefore reviewed 19 cases of lateral temporal encephalocele, including our own experience, and discussed the clinical characteristics of this pathology. All the cases with lateral temporal encephalocele were detected at birth except for an occult case. The majority occurred at the pterion, and occurrence at the asterion appears much rarer. Due to the preference for the pterion, the ipsilateral orbital wall was also distorted in some cases. Lateral temporal encephalocele seems to have fewer associated malformations: only 3 cases of lateral temporal encephalocele had associated malformations, including our case which was associated with intracranial arachnoid cyst. The only case of lateral temporal encephalocele to have shown hydrocephalus was our own case. Patients with this deformity have relatively good prognoses: only 3 of the 19 cases showed delayed psychomotor development during follow-up. Provision of adequate treatment is likely to achieve a good prognosis in patients with lateral temporal encephalocele, so we should keep in mind this deformity when encountering pediatric patients with mass lesions on the temporal cranium.

  20. 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.

  1. Fungal spondylodiscitis in a patient recovered from H7N9 virus infection: a case study and a literature review of the differences between Candida and Aspergillus spondylodiscitis * #

    Science.gov (United States)

    Yu, Lie-dao; Feng, Zhi-yun; Wang, Xuan-wei; Ling, Zhi-heng; Lin, Xiang-jin

    2016-01-01

    To report a rare case of fungal spondylodiscitis in a patient recovered from H7N9 virus infection and perform a literature review of the different characteristics of Candida and Aspergillus spondylodiscitis, we reviewed cases of spondylodiscitis caused by Candida and Aspergillus species. Data, including patients’ information, pathogenic species, treatment strategy, outcomes, and relapses, were collected and summarized. The characteristics of Candida and Aspergillus spondylodiscitis were compared to see if any differences in clinical features, management, or consequences could be detected. The subject of the case study was first misdiagnosed as having a vertebral tumor, and then, following open biopsy, was diagnosed as having fungal spondylodiscitis. The patient made a good recovery following radical debridement. Seventy-seven additional cases of Candida spondylodiscitis and 94 cases of Aspergillus spondylodiscitis were identified in the literature. Patients with Candida spondylodiscitis tended to have a better outcome than patients with Aspergillus spondylodiscitis (cure rate 92.3% vs. 70.2%). Candida was found more frequently (47.8%) than Aspergillus (26.7%) in blood cultures, while neurological deficits were observed more often in patients with Aspergillus spondylodiscitis (43.6% vs. 25.6%). Candida spinal infections were more often treated by radical debridement (60.5% vs. 39.6%). Patients with Candida spondylodiscitis have better outcomes, which may be associated with prompt recognition, radical surgical debridement, and azoles therapy. A good outcome can be expected in fungal spondylodiscitis with appropriate operations and anti-fungal drugs. PMID:27819134

  2. Fungal spondylodiscitis in a patient recovered from H7N9 virus infection: a case study and a literature review of the differences between Candida and Aspergillus spondylodiscitis.

    Science.gov (United States)

    Yu, Lie-Dao; Feng, Zhi-Yun; Wang, Xuan-Wei; Ling, Zhi-Heng; Lin, Xiang-Jin

    To report a rare case of fungal spondylodiscitis in a patient recovered from H7N9 virus infection and perform a literature review of the different characteristics of Candida and Aspergillus spondylodiscitis, we reviewed cases of spondylodiscitis caused by Candida and Aspergillus species. Data, including patients' information, pathogenic species, treatment strategy, outcomes, and relapses, were collected and summarized. The characteristics of Candida and Aspergillus spondylodiscitis were compared to see if any differences in clinical features, management, or consequences could be detected. The subject of the case study was first misdiagnosed as having a vertebral tumor, and then, following open biopsy, was diagnosed as having fungal spondylodiscitis. The patient made a good recovery following radical debridement. Seventy-seven additional cases of Candida spondylodiscitis and 94 cases of Aspergillus spondylodiscitis were identified in the literature. Patients with Candida spondylodiscitis tended to have a better outcome than patients with Aspergillus spondylodiscitis (cure rate 92.3% vs. 70.2%). Candida was found more frequently (47.8%) than Aspergillus (26.7%) in blood cultures, while neurological deficits were observed more often in patients with Aspergillus spondylodiscitis (43.6% vs. 25.6%). Candida spinal infections were more often treated by radical debridement (60.5% vs. 39.6%). Patients with Candida spondylodiscitis have better outcomes, which may be associated with prompt recognition, radical surgical debridement, and azoles therapy. A good outcome can be expected in fungal spondylodiscitis with appropriate operations and anti-fungal drugs.

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

    OpenAIRE

    Lei, Xiang; Chen, Jing; Ren, Jingtian; Li, Yan; Zhai, Jingbo; Mu, Wei; Zhang, Li; Zheng, Wenke; Tian, Guihua; Shang, Hongcai

    2015-01-01

    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 co...

  4. 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.

  5. 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

  6. 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)

  7. a case study

    African Journals Online (AJOL)

    Assessment of (dis)ability in a prospec tive commercial diver with a hand injury – a case study. A case study in disability. W A J (JAck) MeintJes, MB ChB, DOM, FCPHM (SA) Occ Med, MMed (Occ Med). Specialist, Occupational Medicine, Division of Community Health, Department of Interdisciplinary Health Sciences, ...

  8. 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

  9. 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)

    2013-01-01

    Background 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. Methods 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). Results 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

  10. 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.

  11. 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.

  12. Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: a review of case-control studies.

    Science.gov (United States)

    Martínez-Martínez, Laura-Aline; Mora, Tania; Vargas, Angélica; Fuentes-Iniestra, Mario; Martínez-Lavín, Manuel

    2014-04-01

    Fibromyalgia often coexists and overlaps with other syndromes such as chronic fatigue, irritable bowel syndrome, and interstitial cystitis. Chronic stress has been implicated in the pathogenesis of these illnesses. The sympathetic nervous system is a key element of the stress response system. Sympathetic dysfunction has been reported in these syndromes, raising the possibility that such dysautonomia could be their common clustering underlying pathogenesis. The objective of this study was to carry out a review of all published comparative case-control studies investigating sympathetic nervous system performance in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. Online databases PubMed and EMBASE were accessed using the following key words: autonomic (OR) sympathetic (AND) fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. All entries up to December 10th 2012 were reviewed by 2 independent investigators searching for case-control studies in humans. The Method for Evaluating Research and Guidelines Evidence adapted to the Scottish Intercollegiate Guidelines Network was used to rank the level of evidence contained in the selected articles. A total of 196 articles are included in this review. The most often used methods to assess sympathetic functionality were heart rate variability analysis, sympathetic skin response, tilt table testing, and genetic studies. The majority of studies (65%) described sympathetic nervous system predominance in these overlapping syndromes. In contrast, 7% of the studies found parasympathetic predominance. This review demonstrates that sympathetic nervous system predominance is common in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis. This concordance raises the possibility that sympathetic dysfunction could be their common underlying pathogenesis that brings on overlapping clinical features. The recognition of

  13. 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.

  14. 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...

  15. 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.

  16. 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.

  17. The Climate Change Collection: A Case Study on Digital Library Collection Review and the Integration of Research, Education and Evaluation

    Science.gov (United States)

    McCaffrey, M.

    2005-05-01

    Designed as an pilot project to assess the scientific and pedagogical quality of selected digital resources in the Digital Library for Earth System Education (DLESE), the Climate Change Collection is thematic collection of digital resources relating to the topic of global climate change. Developed through the collaborative efforts of an interdisciplinary review team made up of professionals from the fields of climate research, geoscience education, cognitive psychology, and evaluation, the findings of the project suggest that the user needs of the reviewers should be considered in any review process, that there is inherent value in the collaboration of scientists, teachers and related fields in determining the quality of particular resources, and that the process of preparing for and conducting such reviews and annotations is time-consuming and challenging. Drawing from the experience of prior collection development efforts associated with DLESE, including the Community Review System and the Digital Water Education Library, the Climate Change Collection was developed during the Fall of 2004 and Winter of 2005. Through a series of monthly meetings with the review team facilitated by the Principal Investigator acting as Editor for the collection, and assisted by an online workspace known as a SWIKI, the Climate Change Collection was designed as an experiment in streamlined collection development that may help inform future digital library review and collection-building efforts. The initial meetings focused on training the reviewers, setting context for the review process, and discussing the perspectives of the various participants in the review team. Each participant received a stipend for their involvement in the process. A rubric "scorecard" was developed, tested, and fine-tuned by the review team with a focus primarily on scientific accuracy and the potential for effective use in the classroom. Specific concepts relating to aspects of natural climate variability

  18. 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

  19. Six Heliport Case Studies

    National Research Council Canada - National Science Library

    Peisen, Deborah

    1997-01-01

    .... This report evaluates the dynamics of heliport development and operation in order to achieve greater success rate in the future through the case study investigation of six heliports that have both succeeded and failed...

  20. 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...

  1. 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.

  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...... 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. Safer Amputations: A review o f 158 cases | Unegbu | Nigerian ...

    African Journals Online (AJOL)

    A total of 253 amputations were carried out but only 158 case records were available for review. The age range of study population was 9days-78years.; 46.83% of study population fell within the age bracket of 21-40 years. Trauma related causes were the commonest indications, accounting for 77.58% of cases. Only 2 ...

  4. Ampullary somatostatinoma: psammomatous variant of gastrointestinal carcinoid tumor--an immunohistochemical and ultrastructural study. Report of a case and review of the literature.

    Science.gov (United States)

    Marcial, M A; Pinkus, G S; Skarin, A; Hinrichs, H R; Warhol, M J

    1983-11-01

    A 28-year-old man presented with epigastric pain and obstructive jaundice associated with a histologically and immunologically unusual variant of carcinoid tumor involving the ampulla of Vater. The tumor contained abundant psammoma bodies and exhibited immunoreactivity only for somatostatin. Immunoperoxidase studies for insulin, glucagon, vasoactive intestinal peptide, calcitonin, serotonin, and ACTH had negative results. In contrast to most somatostatinomas of pancreatic origin, clinically this ampullary somatostatinoma was not accompanied by features of the somatostatinoma syndrome. A literature review of the clinical and hormonal features in reported cases of gastrointestinal and pancreatic somatostatinomas is presented.

  5. 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.

  6. Clinical decision limits for interpretation of direct bilirubin--a CALIPER study of healthy multiethnic children and case report reviews.

    Science.gov (United States)

    Devgun, Manjit S; Chan, Man Khun; El-Nujumi, Adil M; Abara, Rosemary; Armbruster, David; Adeli, Khosrow

    2015-01-01

    Measurement of total and direct bilirubin is routinely performed for the differential diagnosis of hyperbilirubinemias. The diagnostic efficiency of a test is dependent on the chosen clinical decision limit. This study is designed to address the clinical decision limits for direct bilirubin. Routine laboratory method was used to measure total and direct bilirubin in children up to the age of 18years. Case study data and serum from a group of healthy children were analyzed and statistical exercise was performed to establish decision limits. The reference interval for total bilirubin was 1-12μmol/L and for direct bilirubin 1-9μmol/L with the median direct bilirubin of 3μmol/L. In 17% of children with non-pathological jaundice, median total bilirubin was 173μmol/L, median direct bilirubin was 8μmol/L and median direct bilirubin percent was 49%. From birth direct bilirubin percentage decreased until total bilirubin was 41μmol/L, then it remained at ≤10%. Albumin increased with age, and was on average 2.4g/L higher when measured using bromocresol-green compared with bromocresol-purple. An increased amount of direct bilirubin was observed when albumin (detected using the bromocresol-purple method) was >35g/L. Direct bilirubin concentration of ≥10μmol/L should be used to consider the presence of conjugated hyperbilirubinemia provided that total bilirubin is also above the reference interval. A high direct bilirubin percentage is unlikely to offer any clinical value when total bilirubin is not increased. It is, however, a useful diagnostic tool when there is a persistence of hyperbilirubinemia or when total bilirubin increases during times of stress with direct bilirubin >10%. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  7. 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

  8. 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

    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 is the ge......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...

  9. The role of external fixation in the treatment of humeral shaft fractures: a retrospective case study review on 85 humeral fractures.

    Science.gov (United States)

    Scaglione, Michelangelo; Fabbri, Luca; Dell' Omo, Dario; Goffi, Andrea; Guido, Giulio

    2015-02-01

    There is no consensus among surgeons on the treatment for humeral fractures: the best it is still a matter of some debate. The aim of our work was to demonstrate that external fixation may be considered a valid method not only in emergencies but also for the definitive treatment of such fractures. We perform a retrospective case study review on 85 humeral fractures, 62 shaft fractures, and 23 extrarticular distal third fractures treated with external fixation. Clinical (Disabilities of the Arm, Shoulder and Hand (DASH) score and SF-36) and radiographic follow-up lasted on average 30 months (minimum 12 to maximum 36). Complete healing of fractures was achieved in 97.6% of cases (83 patients), with an average consolidation time of about 12 weeks (83.2 days). One case of delayed union and one case of refracture were encountered. Eighty-one patients demonstrated SF-36 scores at or above the national average and an average DASH score of 8.9. External fixation of humeral shaft fractures is considered a valid treatment method as it provides good results in terms of stability of reduction, tolerability, healing times, and functional recovery. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. 45 CFR 98.101 - Case Review Methodology.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Case Review Methodology. 98.101 Section 98.101... FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing... conduct comprehensive reviews of case records using a methodology established by the Secretary. For...

  11. 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.)

  12. 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

  13. [Rapunzel syndrome: case report and literature review].

    Science.gov (United States)

    Curioso Vilchez, Walter H; Rivera Vega, Juan; Curioso Abriojo, Walter I

    2002-01-01

    The Rapunzel syndrome is a rare form of gastric trichobezoar crossing the pylorus and extending throughout the bowel. The case of a 22-year-old Peruvian woman is reported. This is the thirteenth patient with Rapunzel syndrome reported in the literature. The epidemiology, clinical manifestations, diagnosis and treatment are briefly reviewed.

  14. Tracheobronchopathia osteochondroplastica: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Junping Sun

    2015-01-01

    Full Text Available Tracheobronchopathia osteochondroplastica (TPO is a rare disorder characterized as multiple osseous or cartilaginous nodules in the submucosa of trachea and main bronchi. TPO remains an under recognized entity due to lack of awareness. Four cases of TPO are reported in this review as well as various facets of TPO description.

  15. Ludwig's angina: case report and review.

    Science.gov (United States)

    Spitalnic, S J; Sucov, A

    1995-01-01

    Modern dental care and use of antibiotics for oral infections have made Ludwig's angina rare. To avoid acute airway obstruction, emergency physicians must be able to rapidly recognize and treat this condition. A typical case of Ludwig's angina is presented, followed by a review of clinical findings and therapeutic modalities. Emphasis is made on airway management, antibiotics, and surgical drainage.

  16. 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- ...

  17. Retrospective Case Studies

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Phillip M.

    1977-09-01

    This project, Retrospective Case Studies (RCS) operates directly under DGE's Resource Exploration and Assessment program. The overall objectives of this project are: (1) to improve the general and specific level of understanding of geothermal systems, and (2) to improve tools and technology for geothermal exploration and assessment.

  18. Chaitanya case study

    International Development Research Centre (IDRC) Digital Library (Canada)

    lremy

    sustainability, that began at our inception 12 years ago. This case study ... women. Over the years, we moved towards building a model of sustainable institutions .... poverty alleviation. However, over the last decade, a number of organizations had gained expertise in organizing and managing SHGs and as a result, very few.

  19. 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

  20. 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.

  1. Expression of dog1 in low-grade fibromyxoid sarcoma: A study of 19 cases and review of the literature.

    Science.gov (United States)

    Vallejo-Benítez, Ana; Rodríguez-Zarco, Enrique; Carrasco, Sara Pabón; Pereira-Gallardo, Sofia; Brugal Molina, Javier; García-Escudero, Antonio; Robles Frías, Antonio; Marcilla, David; González-Cámpora, Ricardo

    2017-10-01

    DOG1 is a highly-sensitive marker often included in the immunohistochemical panel for the diagnosis of gastrointestinal stromal tumors (GISTs). Recent research has shown that DOG1 may also be expressed by low-grade fibromyxoid sarcomas (LGFMSs); this may give rise to diagnostic error when the sarcoma is located in the abdominal cavity. This paper reports on immnohistochemical expression of DOG1 in 19 LGFMSs using two different monoclonal antibodies: K9 (Leica, Novocastra Laboratories, Newcastle upon Tyne, UK) and SP31 (Thermo Scientific, Freemont, USA). All LGFMSs displayed the standard histological pattern of alternating myxoid and fibrous areas, low cellularity and bland spindle-cell morphology. Positive staining for MUC4 was observed in 18/19 cases (94.7%), while there was rearrangement of the FUS gene in 14/19 (73.7%) cases and of the EWR1 gene in 2/19 (10.5%). The sarcoma staining negative for MUC4 displayed FUS gene rearrangement. Whole-section immunohistochemistry revealed positive staining for DOG1 in 8/19 cases (42.1%), though only with clone K9. Cytoplasmic as well as membrane staining was observed in all cases; staining was focal (10-30%) and of varying intensity (1+ to 2+). In conclusion, DOG1 clone K9 exhibited low sensitivity (42.1%) for the diagnosis of LGFMS, although higher than clone SP31. Since the two clones display similar sensitivity and specificity for GIST diagnosis, SP31 would appear to be more specific for this purpose, since no reaction was observed here with LGFMS, a GIST-mimicking lesion. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. 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

  3. 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

  4. 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.

  5. [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.

  6. Innovative Interpretive Qualitative Case Study Research Method ...

    African Journals Online (AJOL)

    lc2o

    SUMMARY. The aim of this paper is to review the methodology for interpretive qualitative case study research method using ... encourages a quantitative approach to research (Darling and. 40. AJPARS ... Interpretive Qualitative Case Study Aligned with Systems Theory for Physiotherapy and Rehabilitation Research. Scott ...

  7. 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.

  8. 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.

  9. 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)

  10. 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.

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

    Science.gov (United States)

    Cruaud, Astrid; Jabbour-Zahab, Roula; Genson, Gwenaëlle; Ungricht, Stefan; Rasplus, Jean-Yves

    2012-01-01

    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.

  12. Rapid induction of multiple resistance mechanisms in Aspergillus fumigatus during azole therapy: a case study and review of the literature.

    Science.gov (United States)

    Camps, Simone M T; van der Linden, Jan W M; Li, Yi; Kuijper, Ed J; van Dissel, Jaap T; Verweij, Paul E; Melchers, Willem J G

    2012-01-01

    Nine consecutive isogenic Aspergillus fumigatus isolates cultured from a patient with aspergilloma were investigated for azole resistance. The first cultured isolate showed a wild-type phenotype, but four azole-resistant phenotypes were observed in the subsequent eight isolates. Four mutations were found in the cyp51A gene of these isolates, leading to the substitutions A9T, G54E, P216L, and F219I. Only G54 substitutions were previously proved to be associated with azole resistance. Using a Cyp51A homology model and recombination experiments in which the mutations were introduced into a susceptible isolate, we show that the substitutions at codons P216 and F219 were both associated with resistance to itraconazole and posaconazole. A9T was also present in the wild-type isolate and thus considered a Cyp51A polymorphism. Isolates harboring F219I evolved further into a pan-azole-resistant phenotype, indicating an additional acquisition of a non-Cyp51A-mediated resistance mechanism. Review of the literature showed that in patients who develop azole resistance during therapy, multiple resistance mechanisms commonly emerge. Furthermore, the median time between the last cultured wild-type isolate and the first azole-resistant isolate was 4 months (range, 3 weeks to 23 months), indicating a rapid induction of resistance.

  13. 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.

  14. Management strategies on the industrialization road of state-of-the-art technologies for e-waste recycling: the case study of electrostatic separation--a review.

    Science.gov (United States)

    Xue, Mianqiang; Li, Jia; Xu, Zhenming

    2013-02-01

    Electronic waste (e-waste) management is pressing as global production has increased significantly in the past few years and is rising continuously at a fast rate. Many countries are facing hazardous e-waste mountains, most of which are disposed of by backyard recyclers, creating serious threats to public health and ecosystems. Industrialization of state-of-the-art recycling technologies is imperative to enhance the comprehensive utilization of resources and to protect the environment. This article aims to provide an overview of management strategies solving the crucial problems during the process of industrialization. A typical case study of electrostatic separation for recycling waste printed circuit boards was discussed in terms of parameters optimization, materials flow control, noise assessment, risk assessment, economic evaluation and social benefits analysis. The comprehensive view provided by the review could be helpful to the progress of the e-waste recycling industry.

  15. 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.

  16. Maxillary myxoma: A case report and review.

    Science.gov (United States)

    Connor, Matthew P; Neilson, Michael; Schmalbach, Cecelia E

    2015-06-01

    An odontogenic myxoma is a rare, benign tumor that is found almost exclusively in the facial bones, usually the mandible. The diagnosis poses a challenge because its features overlap with those of other benign and malignant neoplasms. We present an unusual case of odontogenic myxoma that involved the maxilla, and we review the clinical, radiographic, and histologic characteristics of this case. Even though it is benign, odontogenic myxoma can be locally invasive and cause significant morbidity. Complete surgical excision is the treatment of choice, but it can be challenging because of the tumor's indistinct margins.

  17. Behavioural interventions for sleep problems in people with an intellectual disability: a systematic review and meta-analysis of single case and group studies.

    Science.gov (United States)

    Priday, L J; Byrne, C; Totsika, V

    2017-01-01

    Behavioural interventions are frequently used to address sleep problems in people with intellectual disabilities (ID). The current study aimed to systematically review evidence on the efficacy of behavioural interventions for children and adults with ID and sleep problems. Electronic and hand searches identified seven studies for inclusion (N = 169). Standardised mean difference effect sizes (d) were calculated for group studies (N = 4). Non-overlap effect sizes (Tau-U) were calculated for single case experimental design studies (SCEDs; N = 3). A large effect size (weighted d = 0.923, confidence interval: 0.705 to 1.151) across group studies indicated large improvements in sleep problems following behavioural intervention. Effect size across SCEDs (weighted Tau-U: 0.528, confidence interval: 0.351 to 0.705) indicated a 53% improvement compared with baseline. Sleep initiation and sleep maintenance problems showed significant improvements post-intervention. Follow-up effects were less consistent across study designs and suggested that some sleep problems maintain gains better than others. Meta-analytic evidence from group and SCEDs can provide complementary information about efficacy. Findings propose that behavioural interventions are a promising evidence-based practice for improving sleep problems in people with ID. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  18. Innovative Interpretive Qualitative Case Study Research Method ...

    African Journals Online (AJOL)

    The aim of this paper is to review the methodology for interpretive qualitative case study research method using systems theory. The paper also addresses the underlying assumptions of this research methodology and how these affect the way research questions are answered. In reviewing this methodology, an example is ...

  19. 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.

  20. 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

  1. 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.

  2. 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...

  3. 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.’

  4. [Usefulness of the neuroandrologic profile study in patients with erectile dysfunction: review of a series of 180 cases].

    Science.gov (United States)

    Salinas Casado, J; Vírseda Chamorro, M; Samblas García, R; Esteban Fuertes, M; Aristizábal Agudelo, J M; Blázquez Izquierdo, J; Delgado Martín, J A; Resel Estévez, L

    1996-10-01

    To determine the usefulness of a complete neuroandrologic evaluation and SPACE (Single Potential Analysis Cavernous Electromyography) in the study of impotence. We performed a clinical study, erection test with papaverine-phentolamine and neuroandrologic evaluation (bulbocavernous EMG, S2-S4 evoked potentials, evoked somatosensorial potentials, SPACE, D10-L2 skin sympathetic potentials, cystometrogram, and filling videocystography) in 180 patients consulting for impotence. We observed a relationship between the clinical diagnosis of impotence and the data from the neuroandrogenic study. The results of the study were classified as normal [in the clinical diagnosis of psychogenic impotence (100%), hormonal (80%) and vascular (60%)], abnormal [prevalent in the clinical diagnosis of structural impotence (87%)]. The erection test was mainly negative in all clinical diagnoses of impotence, except in psychogenic and vascular impotence (60% positive tests). The clinical data are useful in the diagnosis of impotence. The pharmacological erection test was not found to be very reliable. Complete neuroandrologic evaluation is indicated in non typified and mixed impotence, and can be performed in neurogenic impotence to identify the level of the lesion. Alone, SPACE does not appear to be useful as a screening test for neurologic lesions, but can be useful as a screening test for neuromuscular cavernous lesions. SPACE is indicated in structural, vascular and hormonal impotence. If SPACE is abnormal, the differential diagnosis between neurogenic and myogenic lesion can be made through a complete neuroandrologic evaluation.

  5. 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…

  6. 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.

  7. [Lupus and pregnancy: study of 26 cases, an internal medicine department experience and review of the literature].

    Science.gov (United States)

    Bellakhal, S; Ben Hassine, L; Cherif, E; Boukhris, I; Azzabi, S; Kaouache, Z; Kooli, C; Khalfallah, N

    2013-12-01

    To study the maternal and fetal outcomes in women with systemic lupus erythematosus. A retrospective study of 26 pregnancies in 15 systemic erythematosus patients diagnosed before or during pregnancy regarding to American College of Rheumatology criteria in a single reference center. The mean patient age was 31.52 years (24-39 years). The mean interval from the diagnosis of the systemic lupus erythematosus to pregnancy was 4.2 years. Eight pregnancies were planned. The flare rate of lupus during pregnancy was 31%, life birth rate was 65% and fetal loss rate was 35%. As an increase in disease activity can occur during pregnancy and because of a higher rate of obstetrical complications in patients with lupus, it is important to carefully plan pregnancy. Pregnancy in lupus patients must be closely monitored by a multispeciality care of the patients. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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)

  13. The study of chromosome aberration yield in human lymphocytes as an indicator of radiation dose. 2. A review of cases investigated: 1970-71

    International Nuclear Information System (INIS)

    Purrott, R.J.; Dolphin, G.W.; Lloyd, D.C.; Rickard, B.; Eltham, E.

    1972-10-01

    The results of cytogenetic investigations into forty-one cases of suspected over exposure to radiation are reviewed. Where possible, comparisons have been made with conventional film badge dosimetry and accident reconstruction investigations. In many cases chromosome dosimetry gave highly comparable results, whilst in cases where no badges were worn or their readings were suspect then very credible dose estimates were obtained. The demonstration of undamaged chromosomes proved most reassuring in instances of zero or trivial doses. Thus it is concluded that chromosome dosimetry is now sufficiently well developed to form a valuable and practicable technique in radiological protection. (author)

  14. Interleukin-4 cytokine single nucleotide polymorphisms in kawasaki disease: a case-control study and a review of knowledge.

    Science.gov (United States)

    Assari, Raheleh; Aghighi, Yahya; Ziaee, Vahid; Sadr, Maryam; Rezaei, Arezou; Rahmani, Farzaneh; Sadr, Zeinab; Raeeskarami, Seyed Reza; Moradinejad, Mohammad Hassan; Rezaei, Nima

    2018-01-01

    Kawasaki disease (KD) is a systemic vasculitis of medium-sized arteries. High levels of interleukin 4 (IL-4) and the dominance of Th2 cytokines seem to be a key feature in the acute phase of KD. In this study, the role of IL-4 and IL-4R gene polymorphisms were investigated in Iranian children with KD. Fifty-five patients with KD and 140 healthy subjects as a control group were enrolled in this study. Single nucleotide polymorphisms (SNPs) of IL-4 gene at positions -1098 (rs2243248), -590 (rs2243250) and -33 (rs2070874), as well as IL-4RA gene at position +1902 (rs180275) were assessed in patients and the control group. The C allele and CC genotype of IL-4 gene at position -590 and at position -33 had positive associations and the CT genotype at -590 was negatively associated with KD (odds ratio (95% CI) = 0.04 [0.01-0.09]). The haplotype TCC was more frequent among the patients, while the haplotypes TTT and TTC had a negative association with KD. IL-4 polymorphisms might be associated with KD in an Iranian population. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  15. Using meta-regression analyses in addition to conventional systematic review methods to examine the variation in cost-effectiveness results : A case study

    NARCIS (Netherlands)

    L.T. Burgers (Laura); F.T. van de Wetering (Fleur); J.L. Severens (Hans); W.K. Redekop (Ken)

    2016-01-01

    textabstractBackground: Systematic reviews of cost-effectiveness analyses summarize results and describe study characteristics. Variability in the study results is often explained qualitatively or based on sensitivity analyses of individual studies. However, variability due to input parameters and

  16. Homosexuality and Employment: A Case Law Review.

    Science.gov (United States)

    Decker, Phillip J.

    1980-01-01

    This study of case law involving job discrimination on the grounds of sexual preference includes many cases showing how homosexuals holding government jobs have been affected. Within certain conditions, such discrimination in the public sector has been found illegal, a fact which could set a benchmark for private industry. (JOW)

  17. 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.

  18. Intravascular Myopericytoma in the Heel: Case Report and Literature Review

    Science.gov (United States)

    Valero, José; Salcini, José L.; Gordillo, Luis; Gallart, José; González, David; Deus, Javier; Lahoz, Manuel

    2015-01-01

    Abstract Intravascular myopericytoma (IVMP), regarded as a variant of myopericytoma, is a rare tumor. Very few cases have been described, none in the foot. The first case of IVMP located in the heel of the foot is described in this article. A literature review is reported of all cases of IVMP published in the English literature. A 48-year-old man possessed an IVMP on the heel of the right foot. The physical examination and histopathological and ultrasound studies are described. The literature review yielded 5 cases of IVMP, 2 of which were in the thigh and 1 each in the oral mucosa, the periorbital region, and the leg. The possibility that these lesions may be malignant suggests that the histopathological study of vascular tumors should include immunohistochemical tests. PMID:25789958

  19. 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

  20. 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.

  1. Mediastinal Masses: Review of 105 Cases

    Directory of Open Access Journals (Sweden)

    Pazooki Abdolreza

    2009-10-01

    Full Text Available There has been a highly significant increase in the number of patients with malignant mediastinal tumors in the last four decades. Since these lesions are infrequently encountered and there are very few reports in Iran concerning this issue, we performed this study to review our institutional experience of medias-tinal masses and to compare differences in the clinical spectrum between our study population and other patients studied by various reports. This was a retrospective, descriptive and cross sectional study conducted on 105 patients with mediastinal masses who underwent surgical resection over a 5-year period from 1999 to 2003 in three major hospitals in Tehran. A total of 105 patients with mediastinal masses including 65 males (62% and 40 females (38% with a mean age of 34 years (range,2-80 years who had undergone surgery entered the study. Most mediastinal tumors (47% were identified in the third and fifth decades of life and the most common malignancy during the first four decades of life was malignant lymphoma. Considering the location of mediastinal masses,the anterior mediastinum was the most common site (65% followed by paravertebral sulci (21% and visceral mediastinum (14%.The highest rate of malignancy was observed in visceral mediastinum (73% malignancy rate. Histopathologic evaluation of resected masses revealed twenty two types of tumors of which sixty percent were malignant. Nonspecific symptoms such as dyspnea (41% and cough (40% constituted the most presenting complaints. Twelve percent of patients were completely asymptomatic. The most common complication observed in this series of mediastinal masses was Superior Vena Cava (SVC syndrome. There was no postoperative complication. Crude mortality rate of the whole series was 16%. The prevalence of tumors in our series varied from some previously published reports. We demonstrated definite differences in histologic distribution, age range, malignancy rate and diagnostic

  2. 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)

  3. 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.)

  4. 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

  5. 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

  6. Pseudocirrhosis: A Case Series and Literature Review

    Directory of Open Access Journals (Sweden)

    Abimbola Adike

    2016-07-01

    Full Text Available Pseudocirrhosis describes morphological changes of the liver that closely mimic cirrhosis, without the typical histopathological changes seen in cirrhosis. It most commonly occurs in patients with metastatic breast cancer, although it has been reported in other malignancies as well. Like in cirrhosis, portal hypertension is often seen in patients with pseudocirrhosis. Pseudocirrhosis is a rare but important complication of metastatic cancer. In this case series and literature review, we describe 6 patients with hormone-receptor-positive metastatic breast cancer. We report the significant morbidity associated with pseudocirrhosis in the course of treatment in patients with metastatic breast cancer.

  7. 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; Wolf, Judith R L M

    2013-10-01

    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.

  8. 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

  9. 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....

  10. Case study guidelines.

    Science.gov (United States)

    2017-03-01

    In TxDOT project 0-6817, Review and Evaluation of Current Gross Vehicle Weights and Axle : Load Limits, the project team reviewed the estimated costs imposed by use of overweight (OW) : vehicles and ways to allocate costs to different vehicle classes...

  11. 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

  12. 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.

  13. A review of the data quality and comparability of case-control studies of low-level exposure to benzene in the petroleum industry.

    NARCIS (Netherlands)

    Miller, B.G.; Fransman, W.|info:eu-repo/dai/nl/314000461; Heederik, D.|info:eu-repo/dai/nl/072910542; Hurley, J.F.; Kromhout, H.|info:eu-repo/dai/nl/074385224; Fitzsimons, E.

    2010-01-01

    PURPOSE: Published case-control studies of risks of leukaemia following low exposures to benzene in the distribution of petroleum (gasoline) have not all identified the same level of risk, but the studies have had differences in cohort inclusion, case determination and availability of occupational

  14. An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate (Dbp) Case Study (External Review Draft)

    Science.gov (United States)

    This draft report is a description of an approach to evaluate genomic data for use in risk assessment and a case study to illustrate the approach. The dibutyl phthalate (DBP) case study example focuses on male reproductive developmental effects and the qualitative application of...

  15. 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.

  16. 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

  17. Natural Learning Case Study Archives

    Science.gov (United States)

    Lawler, Robert W.

    2015-01-01

    Natural Learning Case Study Archives (NLCSA) is a research facility for those interested in using case study analysis to deepen their understanding of common sense knowledge and natural learning (how the mind interacts with everyday experiences to develop common sense knowledge). The database comprises three case study corpora based on experiences…

  18. Validation of reference genes for RT-qPCR in marine bivalve ecotoxicology: Systematic review and case study using copper treated primary Ruditapes philippinarum hemocytes.

    Science.gov (United States)

    Volland, Moritz; Blasco, Julián; Hampel, Miriam

    2017-04-01

    The appropriate selection of reference genes for the normalization of non-biological variance in reverse transcription real-time quantitative PCR (RT-qPCR) is essential for the accurate interpretation of the collected data. The use of multiple validated reference genes has been shown to substantially increase the robustness of the normalization. It is therefore considered good practice to validate putative genes under specific conditions, determine the optimal number of genes to be employed, and report the method or methods used. Under this premise, we assessed the current state of reference gene based normalization in RT-qPCR bivalve ecotoxicology studies (post 2011), employing a systematic quantitative literature review. A total of 52 papers met our criteria and were analysed for genes used, the use of multiple reference genes, as well as the validation method employed. We further critically discuss methods for reference gene validation based on a case study using copper exposed primary hemocytes from the marine bivalve Ruditapes philippinarum; including the established algorithms geNorm, NormFinder and BestKeeper, as well as the popular online tool RefFinder. We identified that RT-qPCR normalization is largely performed using single reference genes, while less than 40% of the studies attempted to experimentally validate the expression stability of the genes used. 18s rRNA and β-Actin were the most popular genes, yet their un-validated use did introduce artefactual variance that altered the interpretation of the resulting data. Our findings further suggest that combining the results from multiple individual algorithms and calculating the overall best-ranked gene, as computed by the RefFinder tool, does not by default lead to the identification of the most suitable reference genes. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. 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…

  20. 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…

  1. 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.

  2. [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.

  3. 427 Case studies

    African Journals Online (AJOL)

    Marinda

    2009-05-22

    May 22, 2009 ... No other complications except hypersensitivity to hypnotic agents were observed. Case 2: The patient was a 10-year-old boy with Cornelia de Lange syndrome who underwent dental treatment under general anaesthesia. He had a history and symptoms of obstructive airway disorders in addition to showing ...

  4. 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.

  5. How Environmental "Merchants of Doubt" Use Peer-Reviewed Publication as a Means to Commandeer Scientific Debate: A Case Study of a Publishing Problem.

    Science.gov (United States)

    Siegel, D. I.

    2015-12-01

    This year, the USEPA reported no systemic problem with respect to pollution of potable waters by solutes or natural gas resulting from unconventional drilling for oil and gas, despite attempts by anti-fracking opponents to frighten the public about water pollution from rare circumstances (much as those who have cherry- picked climate data to suggest burning fossil fuels does not affect climate). Scientific "merchants of doubt" have figured out how to use peer-reviewed papers to advocate their bias, regardless of the side for which they advocate. I present a personal example. Prior to the EPA report, authors of a highly-cited peer-reviewed paper argued that more dissolved methane than usual should be expected in ground water located close to unconventional gas wells. This paper figured prominently in the New York State's recent ban on fracking. To test the reproducibility of this conclusion, colleagues and I redid the study but by sampling ~13,000 NE Pennsylvania domestic wells, densely arrayed near ~800 gas wells. Not surprising, we found no systemic relationship between methane in drinking water and proximity to gas wells; failed gas wells actually are rare. The peer reviewed system of publication has been broken for years, because of continual pressure to publish more to achieve academic success coupled to a flood of international submissions. Editors routinely have a difficult time finding senior scientists to agree to review papers, and so they wind up relying more on reviewers suggested by authors, who can and have gamed the peer review system through it. To resolve this problem, I suggest that journal editors be more far more draconian before releasing papers for review and that they enforce clear rubrics to insure that reviewers address reviews properly. Finally, conflict of interest disclosure needs to be clearer, since common assumption that bias inherently evolves from funded research outside of Federal and non-profit organizations, appears to be, at

  6. 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.

  7. 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.

  8. Orofacial pain of cardiac origin: Review literature and clinical cases

    Science.gov (United States)

    Garcia-Vicente, Laia; Jané-Salas, Enric; Estrugo-Devesa, Albert; Chimenos-Küstner, Eduardo; Roca-Elias, Josep

    2012-01-01

    The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Results and conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments. Key words:Orofacial pain, ischemic heart disease, heterotopic pain, odontalgia. PMID:22322488

  9. Autoimmune hepatitis type 2 associated with an unexpected and transient presence of primary biliary cirrhosis-specific antimitochondrial antibodies: a case study and review of the literature

    Directory of Open Access Journals (Sweden)

    Invernizzi Pietro

    2012-07-01

    Full Text Available Abstract Background Unlike other autoimmune liver diseases, primary biliary cirrhosis (PBC has never been reported in early childhood, while type 2 autoimmune hepatitis (AIH is eminently a paediatric disease. Case presentation We describe a case of type 2 AIH with serological positivity for PBC-specific anti-mitochondrial antibodies (AMA in a 3-year old girl. We found this observation intriguing as AMA and indeed an overlap with PBC are virtually absent in Type 2 AIH, a pediatric form of AIH which is distinct precisely because it is characterized by pathognomonic anti-liver kidney microsomal type 1 (LKM-1 showing a remarkable antigen-specificity directed against cytochrome P4502D6. We also review the literature in relation to AMA positivity in paediatric age and adolescence. In our case, the presence of AIH-2-specific anti-LKM-1 and PBC-specific AMA was confirmed by indirect immunofluorescence (IIF, and immunoblotting and ELISA based on recombinant mitochondrial antigens. The clinical, laboratory and histological features of the child are given in detail. Interestingly the mother was AMA positive without other features of PBC. The child was successfully treated with immunosuppression and five years after the original diagnosis is on a low dose of prednisolone and azathioprine, with no signs of relapse. Anti-LKM-1 antibodies are still present in low titres. AMA were detectable for the first 4 years after the diagnosis and disappeared later. Conclusion This is the first case report in the literature of AIH type 2 with an unexpected PBC-specific AMA positivity in a young child. Response to immunosuppressive treatment was satisfactory and similar to that described in AIH. A review of published reports on AMA positivity in paediatric age shows that the antibody may arise in the context of immunodeficiency and is variably associated with liver damage.

  10. 7 CFR 275.12 - Review of active cases.

    Science.gov (United States)

    2010-01-01

    ... information; and any other materials and activity pertinent to the review of the case. The scope of the review... well as other information documented on other portions of the Integrated Worksheet, Form FNS-380, as appropriate. (f) Reporting of review findings. All information verified to be incorrect during the review of...

  11. Medical attention seeking dance injuries: systematic review of case reports.

    Science.gov (United States)

    Anand Prakash, Akilesh

    2017-02-01

    The objective of this study was to conduct a systematic review of case reports documenting the epidemiology of unique and rare musculoskeletal injuries in dancers. A systematic review was conducted online using PubMed and Google Scholar, as per PRISMA guidelines up to July 30, 2016. Predefined eligibility criteria were applied, and the data thus compiled was analysed. Study quality was assessed based on CARE guidelines. 72 studies reporting 92 dance injuries were included in the review. The average age of dancers was 23 years (SD = 10 years) with majority being females (65%). Chronic injuries were the most common presentation with lower extremity injuries being the commonest. Foot and knee injuries were the top two articulations involved across injuries and groups. Overall bony injuries were most frequently reported, with stress injury being the most common type. Conservative approach was the most commonly reported treatment approach across case reports. The methodological quality of case reports included in the study varied considerably and lacked uniformity. The evidence provided, though not sufficient for any recommendation, it should alert the physicians and those concerned with the primary care of the dancers to be vigilant of the eccentricity and severity of the injuries, their atypical presentation, mode, mechanism and trend, thereby being prepared for the unexpected.

  12. Syncope: Case Studies.

    Science.gov (United States)

    Kleyman, Inna; Weimer, Louis H

    2016-08-01

    Syncope, or the sudden loss of consciousness, is a common presenting symptom for evaluation by neurologists. It is not a unique diagnosis but rather a common manifestation of disorders with diverse mechanisms. Loss of consciousness is typically preceded by a prodrome of symptoms and sometimes there is a clear trigger. This article discusses several cases that illustrate the various causes of syncope. Reflex syncope is the most common type and includes neurally mediated, vasovagal, situational, carotid sinus hypersensitivity, and atypical forms. Acute and chronic autonomic neuropathies and neurodegenerative disorders can also present with syncope. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. YEYUNAL DIVERTICULAE: CASE REPORT AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    D. A. Ferreyra

    2014-11-01

    Full Text Available The jejunal diverticula are an uncommon usually asymptomatic small bowel pathology, which should be suspected in cases of malabsorption, anemia, chronic abdominal pain or abdominal discomfort. Complications such as diverticulitis, perforation, bleeding or intestinal obstruction increase morbidity and mortality of the disease. This is a retrospective study based on a case treated at “Hospital Provincial de Rosario”, of a 53 years-old woman that was primarily treated for an intestinal occlusion due to adhesions from previous surgeries. It was primarily interpreted as an ileus from adhesions, but due to its torpid evolution surgical treatment should be performed, where diagnose a complication of this disease. It is concluded that yeyunal diverticulae are generally a benign condition, which affects principally the elder population. Because of its low incidence rate and the inespecificity of its symptoms, it is usually diagnosed during surgery. Incidentally diagnosed asymptomatic diverticula should not be treated due to its low rate of complications. Sometimes, they can lead to complications of surgical treatment. A high level of suspicion because of the high morbidity and mortality in cases of late diagnosis is required. In case of complications, resection of the affected bowel segment is usually the best treatment option. diagnose

  14. 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.

  15. Schinzel–Giedion Syndrome: A Novel Case, Review and Revised ...

    Indian Academy of Sciences (India)

    Administrator

    activity in the every lead, particularly in the parietal-occipital area(obviously on the left), and occasional sharp slow waves in. P3, P4, O1, O2, T3, T4, T5, T6, FP1, FP2, F4, C4, and F8 leads (Figure 1d). 2.2. Genetic analysis and review. We investigated a novel case with SGS in this study. Blood samples were collected from ...

  16. Djenkolism: case report and literature review

    Directory of Open Access Journals (Sweden)

    Bunawan NC

    2014-04-01

    Full Text Available Nur C Bunawan,1 Asghar Rastegar,2 Kathleen P White,3 Nancy E Wang41Alam Sehat Lestari Clinic, West Kalimantan, Borneo, Indonesia; 2Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA; 3General Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; 4Department of Surgery and Pediatric Emergency Medicine, Stanford University School of Medicine, Stanford, CA, USAAbstract: Djenkolism is an uncommon but important cause of acute kidney injury. It sporadically occurs after an ingestion of the djenkol bean (Archidendron pauciflorum, which is native to Southeast Asia. The clinical features defining djenkolism include: spasmodic suprapubic and/or flank pain; urinary obstruction; and acute kidney injury. The precise pathogenesis of acute kidney injury following djenkol ingestion remains unknown. However, it is proposed that an interaction between the characteristics of the ingested beans and the host factors causes hypersaturation of djenkolic acid crystals within the urinary system, resulting in subsequent obstructive nephropathy with sludge, stones, or possible spasms. We report a case of djenkolism from our rural clinic in Borneo, Indonesia. Our systematic literature review identified 96 reported cases of djenkolism. The majority of patients recovered with hydration, bicarbonate therapy, and pain medication. Three patients required surgical intervention; one patient required ureteral stenting for the obstructing djenkolic acid stones. Four of the 96 reported patients died from acute kidney failure. We stress the importance of awareness of djenkolism to guide medical practitioners in the treatment of this rare disease in resource-poor areas in Southeast Asia.Keywords: djenkolism, acute renal failure, acute kidney injury, tropical medicine

  17. 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...

  18. 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.

  19. A review of the data quality and comparability of case-control studies of low-level exposure to benzene in the petroleum industry

    NARCIS (Netherlands)

    Miller, B.G.; Fransman, W.; Heederik, D.; Hurley, J.F.; Kromhout, H.; Fitzsimons, E.

    2010-01-01

    Purpose Published case–control studies of risks of leukaemia following low exposures to benzene in the distribution of petroleum (gasoline) have not all identiWed the same level of risk, but the studies have had diVerences in cohort inclusion, case determination and availability of occupational and

  20. Shark attack: review of 86 consecutive cases.

    Science.gov (United States)

    Woolgar, J D; Cliff, G; Nair, R; Hafez, H; Robbs, J V

    2001-05-01

    On average there are approximately 50 confirmed shark attacks worldwide annually. Despite their rarity, such incidents often generate much public and media attention. The injuries of 86 consecutive victims of shark attack were reviewed from 1980 to 1999. Clinical data retrieved from the South African Shark Attack Files, maintained by the Natal Sharks Board, were retrospectively analyzed to determine the nature, treatment, and outcome of injuries. The majority of victims (n = 68 [81%]) had relatively minor injuries that required simple primary suture. Those patients (n = 16 [19%]) with more extensive limb lacerations longer than 20 cm or with soft-tissue loss of more than one myofascial compartment were associated with higher morbidity and limb loss. In 8 of the 10 fatalities, death occurred as a result of exsanguinating hemorrhage from a limb vascular injury. Victims of shark attack usually sustain only minor injuries. In more serious cases, particularly if associated with a major vascular injury, hemorrhage control and early resuscitation are of utmost importance during the initial management if these patients are to survive.

  1. 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...

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

    Science.gov (United States)

    Lei, Xiang; Chen, Jing; Ren, Jingtian; Li, Yan; Zhai, Jingbo; Mu, Wei; Zhang, Li; Zheng, Wenke; Tian, Guihua; Shang, Hongcai

    2015-01-01

    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. PMID:25648693

  3. 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.

  4. 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…

  5. Kickstarter - A Case Study

    OpenAIRE

    Willumsen, Ea Christina; Byg-Fabritius, Edith Ursula Tvede

    2013-01-01

    This paper is an investigation of the online crowdfunding platform Kickstarter, and discusses what makes a Kickstarter campaign successful. Two previous Kickstarter campaigns have been debated in focus groups interviews, as the basis of the study is a reception analysis of two focus group interviews. Ee apply theories from Schrøder (2000) and Batey (2008) to our analysis to study how the campaigns appeal to their backers. By drawing on ideas from Rogers (2003) and Pine & Gilmore (1998), w...

  6. A Systematic Review of Occupational Health and Safety Business Cases.

    Science.gov (United States)

    Lee, Geunjae

    2018-02-01

    Business cases are arguments developed to secure management commitment and approval for investment in an intervention. This systematic review evaluated 12 experimental and quasi-experimental studies on occupational health and safety interventions (OHSI) in various settings. The search engines used in this systematic review include PubMed, CINAHL, and Scopus. A cost and benefit analysis of OHSI was completed at the organizational level in these studies. The focus of this analysis included sample, design, theoretical framework, interventional strategies, and threats to validity and outcomes. Positive returns on investment of OHSI outcomes were shown in 10 of the studies. The other two studies concluded that their chosen OHSI were not cost-effective.

  7. 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)

  8. [Rheumatic fever--a review of cases].

    Science.gov (United States)

    Rocha, P; Freitas, S; Alvares, S

    2000-09-01

    To analyse clinical presentation of rheumatic fever (RF), with special emphasis on cardiac involvement, electrocardiographic and echocardiographic findings and the outcome of the cases referred to Maria Pia Children's Hospital from January 1990 to September 1999. We retrospectively analyzed the clinical files of all cases referred to pediatric cardiology clinics with the suspicion of acute RF (Group 1) or with rheumatic valvular disease and heart failure (Group 2). In group 1 we studied the following: age and sex distribution, year of diagnosis, presence of Jones criteria treatment and outcome. In group 2 we analysed provenance, age of initial onset of RF, age of cardiology referral, treatment and outcome. Thirteen cases were identified, 8 in groups 1 and 5 in group 2. Group 1 included 3 girls and 2 boys, mean age of 10 years. The diagnosis of RF was based in the presence of 2 major and 1 minor manifestation (4/8), 1 major and 2 minor manifestations (1/8) and chorea in 3 cases associated with clinical carditis in one and subclinical carditis in another. Colour Doppler echocardiography showed pathological mitral regurgitation jet in 6 cases, associated with aortic regurgitation in 2 and dilatation of left ventricle in 3. All were treated with penicillin associated with anti-inflammatory drugs in 5 and haloperidol in 3. Group 2 included 3 girls and 2 boys, mean age 9.56 years. Four were from African countries (Angola and Guinea), and one came from the north of Portugal. The elapsed time between the initial acute attack and cardiology referral varied from 5 months to 3 years. All presented severe mitral insufficiency associated with aortic and/or tricuspid valve lesions, and heart failure. All five underwent valve surgery. The secondary prophylaxis was recommended in every patient. There was a recurrence in a child who had interrupted chemoprophylaxis. The patients from African countries were lost for follow-up. RF still remains a problem in present times, with

  9. A Case Study

    African Journals Online (AJOL)

    user

    Lacks of investment make it difficult for women to earn a living from agriculture. Financially independence of ... 2 Associate Professor; St. Mary's University College; School of Graduate. Studies;Eylachewz@yahoo.com .... lies within 0.5 degree north latitude and 39 degree longitude along the Addis. Ababa Gojjam road.

  10. A Psychobiographical Case Study

    African Journals Online (AJOL)

    but, due to the impact of this, the social world. The study ..... This academic dissertation, by Ndoro (2014), was undertaken in partial fulfilment of the requirements for a Master of Business. Administration (MBA) at a South African university business school ..... era) may thus have precipitated Jobs's marijuana use. (Schlender ...

  11. 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

  12. Nanomaterial Case Study: A Comparison of Multiwalled Carbon Nanotube and Decabromodiphenyl Ether Flame-Retardant Coatings Applied to Upholstery Textiles (External Review Draft)

    Science.gov (United States)

    The draft document is intended to be used as part of a process to identify what is known and, more importantly, what is not yet known that could be of value in assessing the broad implications of specific nanomaterials. Like previous case studies (see History/ Chronology below), ...

  13. 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.

  14. Cockayne's syndrome: a case report. Literature review.

    Science.gov (United States)

    Arenas-Sordo, María de la Luz; Hernández-Zamora, Edgar; Montoya-Pérez, Luis Alberto; Aldape-Barrios, Beatriz Catalina

    2006-05-01

    Cockayne s syndrome is a genetic disorder with a recessive autosomal inheritance, described first by Cockayne in 1936. Patients with this syndrome present failure to thrive, short stature, premature aging, neurological alterations, photosensitivity, delayed eruption of the primary teeth, congenitally absent of some permanent teeth, partial macrodontia, atrophy of the alveolar process and caries. It could be caused by two gene mutations, CNK1 (ERCC8) and ERCC6, located on the 5 and 10 chromosomes respectively, causing two variations of Cockayne s syndrome, CS-A, secondary to a ERCC8 mutation and CS-B with ERCC6 mutation, the last one causes hypersensitivity to the ultraviolet light secondary to a DNA repair defect. The syndrome is also associated with mutations of the XPB, XPD and XPG genes. In this report we present a 9 year and 4 month old patient. He had a height of 94 cm, weight of 8.6 Kg, head circumference of 42 cm. and blood pressure of 120/80. Cachectic habitus, kyphosis, microcephaly, oval face, sunken eyes, a thin and beaklike nose, lack of subcutaneous facial fat (especially in the middle of the face), and large ears give the patient a birdlike appearance. It is notorious the photosensitivity in all the sun-exposed skin. The patient also displays delayed psychomotor skills and mental retardation. In the oral cavity we found deficient hygiene, gingivitis, cervical caries, enamel hipoplasia, abnormal position of the upper and inferior lateral incisors, macrodontia of the upper central teeth, the left one presented a caries. In the x-ray we observed congenital absence of 14, 23 and 24 teeth and mandibular hipoplasia. The aim of this review is to show the dentistry community the characteristics of the Cockayne s syndrome by means of a clinical case.

  15. 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...

  16. Effectiveness of case management for homeless persons: a systematic review

    NARCIS (Netherlands)

    Vet, R. de; Luijtelaar, M.J.A. van; Brilleslijper-Kater, S.N.; Vanderplasschen, W.; Beijersbergen, M.D.; Wolf, J.R.L.M.

    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

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

    NARCIS (Netherlands)

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

    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

  18. 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.

  19. Tongue cancers during pregnancy: Case reports and review of literature.

    Science.gov (United States)

    Mhallem Gziri, Mina; Han, Sileny N; Van Calsteren, Kristel; Heyns, Liesbeth; Delaere, Pierre; Nuyts, Sandra; Van den Heuvel, Frank; Cheron, Anne-Céline; Fossion, Eric; Van den Weyngaert, Danielle; Lok, Christianne; Amant, Frédéric

    2013-04-01

    Due to its rarity, there is no standard treatment for tongue cancers that concur with pregnancy. Treatment depends on the stage of cancer, gestational age of the pregnancy, and the wish of the mother to maintain the pregnancy. The purpose of this study was to review the literature and to report 5 new cases. Twelve cases of tongue cancer during pregnancy were already reported between 1987 and 2009. We report 5 new cases and first administration of concomitant radiochemotherapy for tongue cancer. Median age of the patients was 29 years, 65% of diagnoses were made after the first trimester of pregnancy. Different treatment modalities are used to treat tongue cancer during pregnancy. We hypothesize that tongue cancer treatment adhering to standard protocols provides the best guarantee to cure the mother. Based on a growing experience and insight taking fetal safety into consideration, the available data suggest that standard treatment is a realistic option. Copyright © 2011 Wiley Periodicals, Inc.

  20. 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.

  1. Correction of Grade 2 Spondylolisthesis Following a Non-Surgical Structural Spinal Rehabilitation Protocol Using Lumbar Traction: A Case Study and Selective Review of Literature

    Science.gov (United States)

    Fedorchuk, Curtis; Lightstone, Douglas F; McRae, Christi; Kaczor, Derek

    2017-01-01

    Objective Discuss the use of non-surgical spinal rehabilitation protocol in the case of a 69-year-old female with a grade 2 spondylolisthesis. A selective literature review and discussion are provided. Clinical Features A 69-year-old female presented with moderate low back pain (7/10 pain) and severe leg cramping (7/10 pain). Initial lateral lumbar x-ray revealed a grade 2 spondylolisthesis at L4-L5 measuring 13.3 mm. Interventions and Outcomes The patient completed 60 sessions of Mirror Image® spinal exercises, adjustments, and traction over 45 weeks. Post-treatment lateral lumbar x-ray showed a decrease in translation of L4-L5 from 13.3 mm to 2.4 mm, within normal limits. Conclusions This case provides the first documented evidence of a non-surgical or chiropractic treatment, specifically Chiropractic BioPhysics®, protocols of lumbar spondylolisthesis where spinal alignment was corrected. Additional research is needed to investigate the clinical implications and treatment methods. PMID:29299090

  2. 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.

  3. 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

  4. 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, ca...

  5. 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....

  6. 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

  7. 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.

  8. Imaging in isolated sacral tuberculosis: a review of 15 cases

    International Nuclear Information System (INIS)

    Patankar, T.; Krishnan, A.; Kale, H.; Prasad, S.; Patkar, D.; Shah, J.; Castillo, M.

    2000-01-01

    Objective. To review imaging studies of isolated involvement of the sacrum due to tuberculosis and determine the role of imaging in the diagnosis and management of these patients.Design and patients. A retrospective analysis of 15 cases of isolated sacral tuberculosis imaged with MR imaging was performed. The CT images were also reviewed where available, and the various lesion characteristics were identified. We also reviewed the medical records in an attempt to determine the impact of the imaging studies on the management of these patients.Results. Fifteen patients (5 male, 10 female) presented with symptoms of 3-15 months' duration. Chronic localized backache with muscle spasm was the commonest presenting symptom; discharging sinuses with abscess formation was found in six patients, five of whom were children. MR imaging of the sacrum revealed a hypointense marrow signal on T1-weighted images and hyperintense signal on T2-weighted images in 14 of 15 patients, the S2 vertebra being always involved. CT revealed osteolytic changes in the sacrum in all the five patients in whom CT was performed. All patients showed marked clinical improvement within 1 year of anti-tuberculous chemotherapy.Conclusion. Isolated tuberculosis of the sacrum is uncommon but should be suspected in patients presenting with chronic low backache or children with discharging sinuses/abscesses and showing sacral destruction on CT or MR imaging. MR imaging can identify cases and enables early institution of anti- tuberculous chemotherapy. (orig.)

  9. Stakeholder involvement in other sectors. High Voltage Electricity Transmission. Case study: CO2 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

    compartmentalising stakeholder involvement. Ms 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

  10. 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...

  11. 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...

  12. 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...

  13. Case Study: Bangladesh Bank Heist

    OpenAIRE

    Md Ahsan Habib

    2017-01-01

    Cyber crime is a threat to our E- commerce . A hacker group named "Lazarus" hacked $951 million from Bangladesh Bank's account. This is the short case study of this incident with professional ethical view.

  14. 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

  15. Anaplastic lymphoma kinase-positive large B-cell lymphoma: Clinico-pathological study of 17 cases with review of literature.

    Directory of Open Access Journals (Sweden)

    Xiang-Nan Jiang

    Full Text Available We retrospectively analysed 17 cases of anaplastic lymphoma kinase-positive large B-cell lymphoma (ALK+, LBCL according to the morphological, immunohistochemical, molecular and clinical features, using which we intend to elucidate the clinicopathological characteristics of this rare entity. In this study, all cases de facto share common features that defined them as a single entity, and various characteristics may expand the spectrum. Among 15 cases, 60% followed an aggressive clinical course with advanced stage and high IPI scores; the median survival of these patients was only 8 months. An analysis showed that both the IPI score and the Ann Arbor stage were significant prognostic factors. Most patients received a chemotherapy regimen including CHOP, CHOEP, EPOCH, and CVAD, and some also underwent localized radiotherapy. However, ALK+, LBCL cases display a dismal clinical outcome and can only be cured with conventional chemotherapy protocols at the stage of localized disease. Novel front-line intensive chemotherapy regimens should therefore be evaluated in this group of patients.

  16. 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.

  17. 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)

  18. 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)

  19. 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.

  20. Klippel–trenaunay syndrome: A case report with radiological review

    Directory of Open Access Journals (Sweden)

    Amit T Kharat

    2016-01-01

    Full Text Available Klippel–Trenaunay Syndrome is a congenital disorder with a rare incidence of 3-5/1,00,000. It is characterized by a triad of capillary malformation (hemangioma or port-wine stain, venous varicosities, and bony or, soft-tissue hypertrophy. The malformation in the capillary is usually limited to a single extremity though multiple extremities can be involved. This disease is subject to significant morbidities such as bleeding, deep vein thrombosis, and embolic complications. Our case study was a young male of 6 years suffering since birth, from a painful port-wine stain on the lateral aspect of the right thigh, enlarged right femur, and soft tissues. Vascular Doppler ultrasound, skeletal X-ray, and magnetic resonance imaging of the limb indicated a Klippel–Trenaunay disease. This article describes a case study of a child presenting with Klippel–Trenaunay including a review of the syndrome and treatment recommendations.

  1. [Calciphylaxis. A review of 9 cases].

    Science.gov (United States)

    Loidi Pascual, Leire; Valcayo Peñalba, Ana; Oscoz Jaime, Saioa; Córdoba Iturriagagoitia, Alicia; Rodil Fraile, Raquel; Yanguas Bayona, Juan Ignacio

    2016-08-19

    Calciphylaxis is a cutaneous ischaemic vascular disease of small vessels with high morbidity and mortality. To date very few series of patients with this disease have been published, none from a Spanish hospital. The main objectives of this work are to analyze the demographic, clinical and histological profile of patients diagnosed in our department to identify risk factors and potential therapeutic strategies. We made a retrospective study of the cases seen in the dermatology department with a diagnosis of calciphylaxis and who had a confirmatory biopsy in the period between January 2010 to August 2015. Nine patients were studied, with an age range of 76-86 years. All had cardiovascular comorbidities and 67% had renal failure. A 33% mortality was observed. Faced with a possible diagnosis of calciphylaxis, a complete blood analysis is mandatory to rule out other causes of skin ulcers. The management of these patients should be undertaken by a multidisciplinary team. We emphasize the role of sodium thiosulfate in the treatment of this condition. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. 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.

  3. 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

    Science.gov (United States)

    Woodfield, Rebecca; Grant, Ian; Sudlow, Cathie L. M.

    2015-01-01

    Objective 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. Methods 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). Results 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. Conclusions Particular stroke-specific codes can yield high PPVs (>90%) for stroke/stroke types. Inclusion of primary care data and combining data sources should

  4. 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

  5. Aphallia: Report of three cases and literature review.

    Science.gov (United States)

    Talebpour Amiri, Fereshteh; Nasiry Zarrin Ghabaee, Davood; Naeimi, Ramezan Ali; Seyedi, Seyed Javad; Mousavi, Seyed Abdollah

    2016-04-01

    Aphallia or penile agenesis is a rare malformation accompanying with no phallus. This anomaly is extremely rare with abnormality of urogenital system and psychological consequences. Its outbreak is estimated 1 out of 10-30 million births. Reviewing 3 cases of male external genitalia agenesis, which associated with multiple anomalies of musculoskeletal, cardiovascular and genitourinary system. Aphallia has psychosocial consequences and a guarded prognosis. This study showed that if the kidney failure is due to its obstruction, these patients will be born in more favorable conditions and the future treatment measures will be directed to keep the external genitalia (male) through timely diagnosis and prenatal surgery and timely bladder drainage.

  6. Nonaqueous synthesis of metal oxide nanoparticles: Short review and doped titanium dioxide as case study for the preparation of transition metal-doped oxide nanoparticles

    Science.gov (United States)

    Djerdj, Igor; Arčon, Denis; Jagličić, Zvonko; Niederberger, Markus

    2008-07-01

    The liquid-phase synthesis of metal oxide nanoparticles in organic solvents under exclusion of water is nowadays a well-established alternative to aqueous sol-gel chemistry. In this article, we highlight some of the advantages of these routes based on selected examples. The first part reviews some recent developments in the synthesis of ternary metal oxide nanoparticles by surfactant-free nonaqueous sol-gel routes, followed by the discussion of the morphology-controlled synthesis of lanthanum hydroxide nanoparticles, and the presentation of structural peculiarities of manganese oxide nanoparticles with an ordered Mn vacancy superstructure. These examples show that nonaqueous systems, on the one hand, allow the preparation of compositionally complex oxides, and, on the other hand, make use of the organic components (initially present or formed in situ) in the reaction mixture to tailor the morphology. Furthermore, obviously even the crystal structure can differ from the corresponding bulk material like in the case of MnO nanoparticles. In the second part of the paper we present original results regarding the synthesis of dilute magnetic semiconductor TiO 2 nanoparticles doped with cobalt and iron. The structural characterization as well as the magnetic properties with special attention to the doping efficiency is discussed.

  7. Acute appendicitis in pregnancy: Case series and review.

    Science.gov (United States)

    Burcu, Busra; Ekinci, Ozgur; Atak, Tuba; Orhun, Kivilcim; Eren, Turgut Tunc; Alimoglu, Orhan

    2016-01-01

    Acute appendicitis is one of the most common acute surgical pathology we encountered. In this study we investigated our pregnant cases of appendicitis, and reviewed literature. A total of 21 pregnant women who underwent appendectomy with the initial diagnosis of acute appendicitis in Istanbul Medeniyet University Clinics of General Surgery between January 2012, and December 2014 were retrospectively analyzed. The patients's ages, trimesters, complaints, abdominal examination, laboratory, and ultrasonographic findings, surgical techniques, complications and hospital stay were noted. The patients were in their first (n=12; 57.1%), second (n=5; 23.8%), and third trimesters (n=4; 19.0%) of their pregnancies Median age was 23.9 years. All of the patients had abdominal pain. Median value of WBC count was 13.297/mm³. Ultrasound was positive in 12 patients (57.1%). In 14 (66.6%) patients McBurney incision, and in 6 (28.6%) cases right paramedian incision were used. One patient (4.8%) underwent laparoscopic appendectomy. Nineteen cases were acute appendicitis (90.5%), and two cases were perforated appendicitis (9.5%). Average hospital stay was 3.8 days. Two cases with perforated acute appendicitis developed wound infection and treated conservatively. There were no fetomaternal mortality. Physiologically anatomic and biochemical changes occurring during pregnancy can delay the diagnosis of acute appendicitis threaten the lives of both the mother and the fetus Therefore, rapid diagnosis and appropriate treatment convey importance.

  8. Asteroid hyalosis: clinical review of 58 cases

    Directory of Open Access Journals (Sweden)

    José Nuno Vargas Galveia

    2013-10-01

    Full Text Available OBJECTIVE: Understand the behavior, functional repercussion and relationship with epidemiological factors of asteroid hyalosis (AH and retrospective observational case series. METHODS: Fifty-eight patients diagnosed with AH (24 women and 34 men were studied. All patients were submitted to a thorough ophthalmological examination. RESULTS: We observed a statistical association between the presence of AH and male sex (p=0,042. An increase in prevalence of this pathology was observed with increasing age. We determined an odds ration of 5,24 of a patient over 50 years old having AH, when compared to patients bellow this threshold. Eighty-six percent of patients had unilateral vitreous deposits. We measured a lower IOP in the affected eye, with the difference being in average 2,68 ± 1,45 mmHg (p=0,037. We observed no statistical association between AH and age related macular degeneration, diabetes or glaucoma. Five eyes were submitted to facoemulsification combined with pars plana vitrectomy with an average gain of 7 lines (Snellen in visual acuity (p=0,03. CONCLUSION: In our sample a clear association between AH, ageing and male sex was observed. The majority of patients had unilateral vitreous deposits. Vitrectomy in association with facoemulsification is a safe and effective intervention in this group of patients.

  9. Leclercia adecarboxylata isolation: case reports and review.

    Science.gov (United States)

    Anuradha, Mokkapati

    2014-12-01

    Leclercia adecarboxylata is usually isolated as a part of polymicrobial cultures in immunocompetent patients, and as a pure culture in immunocompromised persons. Although generally sensitive to most antibiotics, there are reports of resistant strains. Two case reports of L. adecarboxylata isolation in the lab in pure culture in immunocompetent persons are presented here, L. adecarboxylata being isolated from a vaginal swab in the first case and from a gluteal abscess in the second case. Both the isolates were sensitive to most of the antibiotics tested.

  10. Ludwig's angina: a case report and review.

    Science.gov (United States)

    Dreyer, A F; de Kock, S E; Rantloane, J L

    1990-09-01

    A case of Ludwig's angina which developed after mandibular fractures in a 14-year-old male patient is reported. We emphasise the serious nature of this condition and the aggressive treatment it requires. It is important to recognise cases of Ludwig's angina at an early stage, as well as cases which are at risk of developing into true Ludwig's angina if treatment is delayed. Management should be aimed at maintaining an open airway by nasotracheal intubation or cricothyroidotomy, together with treatment of the infection by removal of the source, drainage of pus and parenteral antibiotic therapy. In addition, investigation and management of contributing medical conditions and timely specialist consultation are essential.

  11. Clinical trials and systematic reviews addressing similar interventions for the same condition do not consider similar outcomes to be important: a case study in HIV/AIDS.

    Science.gov (United States)

    Saldanha, Ian J; Li, Tianjing; Yang, Cui; Owczarzak, Jill; Williamson, Paula R; Dickersin, Kay

    2017-04-01

    The usefulness of clinical trials and systematic reviews is compromised when they report different outcomes. We compared outcomes in reviews of HIV/AIDS and the trials included in the reviews. We examined all Cochrane reviews of HIV/AIDS (as of June 2013) that included ≥1 trial and the trials that the reviews included. We compared outcomes within subgroups defined by type of intervention: clinical management, biomedical prevention, behavioral prevention, and health services. We included 84 reviews that encompassed 524 trials. Although the median number of outcomes per trial (8) and per review (7.5) was similar, the trials reported a considerably greater number of unique outcomes than the reviews (779 vs. 218), ranging from 2.3 times greater (clinical management) to 5.4 times greater (behavioral prevention). High proportions of trial outcomes were not in any review: 68% (clinical management) to 83% (behavioral prevention). Lower proportions of review outcomes were not in any trial: 11% (clinical management) to 39% (health services). Outcomes in trials and reviews are not well aligned for appropriate inclusion of trial results in reviews and meta-analyses. Differences in perspectives, goals, and constraints between trialists and reviewers may explain differences in outcomes they consider important. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  12. 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

  13. Traumatic urethrocutaneous fistula: Case report andliterature review ...

    African Journals Online (AJOL)

    % of all trauma cases.Severe penile trauma may be complicated by urethrocutaneous fistula. A 22 year old male patient presentedwith urethrocutaneous fistula following severe crush injury of his penis from the rollers of a baking machine.

  14. Aphallia: Report of three cases and literature review

    Directory of Open Access Journals (Sweden)

    Davood Nasiry Zarrin Ghabaee

    2016-04-01

    Full Text Available Background: Aphallia or penile agenesis is a rare malformation accompanying with no phallus. This anomaly is extremely rare with abnormality of urogenital system and psychological consequences. Its outbreak is estimated 1 out of 10-30 million births. Case: Reviewing 3 cases of male external genitalia agenesis, which associated with multiple anomalies of musculoskeletal, cardiovascular and genitourinary system. Conclusion: Aphallia has psychosocial consequences and a guarded prognosis. This study showed that if the kidney failure is due to its obstruction, these patients will be born in more favorable conditions and the future treatment measures will be directed to keep the external genitalia (male through timely diagnosis and prenatal surgery and timely bladder drainage

  15. Individual and environmental contributions to treatment outcomes following a neuroplasticity-principled speech treatment (LSVT LOUD) in children with dysarthria secondary to cerebral palsy: a case study review.

    Science.gov (United States)

    Boliek, Carol A; Fox, Cynthia M

    2014-08-01

    This study describes the use of a neuroplasticity-principled speech treatment approach (LSVT(®)LOUD) with children who have dysarthria secondary to cerebral palsy. To date, the authors have treated 25 children with mild-to-severe dysarthria, a continuum of gross and fine motor functions, and variable cognitive abilities. From this data set, two case studies are presented that represent as weak or strong responders to LSVT LOUD. These case studies demonstrate how individual and environmental features may impact immediate and lasting responses to treatment. Principles that drive activity-dependent neuroplasticity are embedded in LSVT LOUD and may contribute to positive therapeutic and acoustic outcomes. However, examination of the response patterns indicated that intensity (within and across treatment sessions) is necessary but not sufficient for change. Weak responders may require a longer treatment phase, better timing (e.g., developmentally, socially), and a more prominent desire to communicate successfully during daily activities. Strong responders appear to benefit from the intensity and saliency of treatment as well as from intrinsic and extrinsic rewards for using the trained skills for everyday communication. Finally, possibilities are presented for technological solutions designed to promote accessibility to the intensive task repetition and maintenance required to drive lasting changes.

  16. 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...

  17. 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

  18. 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.

  19. 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....

  20. 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…

  1. Pineal Gland Agenesis: Review and Case Illustration

    OpenAIRE

    Cox, Marcus A; Davis, Michele; Voin, Vlad; Shoja, Mohammadali; Oskouian, Rod J; Loukas, Marios; Tubbs, R. Shane

    2017-01-01

    Agenesis of the pineal gland has rarely been reported in the medical literature. Herein, we report a cadaveric specimen found to have agenesis of the pineal gland. The remaining gross examination of the brain was normal. A review of the literature was performed on this unusual finding.

  2. 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

  3. 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

  4. 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.

  5. 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....

  6. US reactor safety study reviewed

    International Nuclear Information System (INIS)

    1979-01-01

    The policy statement issued by the United States Nuclear Regulatory Commission concerning its views of the Reactor Safety Study (WASH-1400) in the light of criticisms of the study made by a special review group headed by Dr Harold Lewis, is discussed. Dr Lewis appeared before a Congressional sub-committee to discuss the findings of the review group and his testimony is reproduced here. This is considered under the four headings; safety - what is it, WASH-1400 and RARG - what was found, risk assessment methodology -where do we go from here, and are reactors safe. (UK)

  7. 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

  8. Lyme Meningoradiculitis: Case Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Smaranda Maier

    2016-09-01

    Full Text Available The clinical manifestations of Lyme disease are protean. The meningoradiculitis is a common and well-recognized complication of neuroborreliosis but can be easily misdiagnosed without a high degree of clinical suspicion, mainly if the tick bite is not present in the medical history. We report two cases of Lyme meningoradiculitis with excellent outcome after appropriate antibiotic therapy. In an endemic area in case of neurological manifestations suggestive for neuroborreliosis the serological testing for B. burgdorferi in serum and cerebrospinal fluid is imperative for the correct diagnosis.

  9. Using Systematic Reviews and Meta-Analyses to Support Regulatory Decision Making for Neurotoxicants: Lessons Learned from a Case Study of PCBs

    Science.gov (United States)

    Goodman, Michael; Squibb, Katherine; Youngstrom, Eric; Anthony, Laura Gutermuth; Kenworthy, Lauren; Lipkin, Paul H.; Mattison, Donald R.; LaKind, Judy S.

    2010-01-01

    Background Epidemiologic weight-of-evidence reviews to support regulatory decision making regarding the association between environmental chemical exposures and neurodevelopmental outcomes in children are often complicated by lack of consistency across studies. Objective We examined prospective cohort studies evaluating the relation between prenatal and neonatal exposure to polychlorinated biphenyls (PCBs) and neurodevelopment in children to assess the feasibility of conducting a meta-analysis to support decision making. Data extraction/synthesis We described studies in terms of exposure and end point categorization, statistical analysis, and reporting of results. We used this evaluation to assess the feasibility of grouping studies into reasonably uniform categories. Results The current literature includes 11 cohorts of children for whom effects from prenatal or neonatal PCB exposures were assessed. The most consistently used tests included Brazelton’s Neonatal Behavioral Assessment Scale, the neurologic optimality score in the neonatal period, the Bayley Scales of Infant Development at 5–8 months of age, and the McCarthy Scales of Children’s Abilities in 5-year-olds. Despite administering the same tests at similar ages, the studies were too dissimilar to allow a meaningful quantitative examination of outcomes across cohorts. Conclusions These analyses indicate that our ability to conduct weight-of-evidence assessments of the epidemiologic literature on neurotoxicants may be limited, even in the presence of multiple studies, if the available study methods, data analysis, and reporting lack comparability. Our findings add support to previous calls for establishing consensus standards for the conduct, analysis, and reporting of epidemiologic studies in general, and for those evaluating the effects of potential neurotoxic exposures in particular. PMID:20176542

  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. 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.

  13. Sclerosing perineurioma: case report and literature review.

    Science.gov (United States)

    Armengot-Carbo, Miquel; Millán, Fernando; Sanjuan, Josefina; Quecedo, Esther; Gimeno, Enrique

    2014-06-15

    Perineuriomas are rare tumors derived from perineural cells usually presenting as a single asymptomatic papule or nodule located on an extremity of an adult. A sclerosing subtype has been rarely described. We report a case of painful sclerosing perineurioma in a 42-year-old woman.

  14. 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

  15. [Maternity in adolescence: obstetrical analysis and review of the influence of cultural, socioeconomic and psychological factors in a retrospective study of 62 cases].

    Science.gov (United States)

    Faucher, P; Dappe, S; Madelenat, P

    2002-12-01

    To analyse obstetrical outcome of teenage pregnancies and conditions of discharge from the maternity ward. A retrospective study of 62 deliveries of women 13 to 17 years old, between 1997 and 2000. A majority of patients is aged 16 or 17 (92%); 46.8% of teenagers were born in a sub-Saharan African country. The teenagers do not go to school in 45.2% of the cases. The first visit to hospital is late in the pregnancy (40.3% had their first visit after 30 weeks of amenorrhoea). There was no follow-up at all for 17.7% of the pregnancies. The obstetrical outcome is normal in 66.2% of the cases; 93.5% of the children were born after 37 SA and had a normal weight for gestational age; 93.5% were discharged from the maternity ward with their children. A specific follow-up took place for 36.2% of the women. Compared with women from other origins, teenagers born in sub-Saharan Africa more often live with their boyfriend (P = 0.03), who is likely to be over 25 (P = 0.001). Sub-Saharan African women more often return and live at the father's home (P maternity hospital and to provide economical and psychological support during and after pregnancy.

  16. 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.

  17. Bilateral peritonsillar abscess: A case report and pertinent literature review

    Directory of Open Access Journals (Sweden)

    Ibrahim AlAwadh

    2017-01-01

    Conclusion: Based on our case and literature review, we recommend airway management as the first step, followed by further examinations, especially contrast-enhanced computed tomography, in cases of bilateral PTA. This condition lacks the hallmark of unilateral disease and may mimic many conditions, which will have different management approaches.

  18. Hypersensitivity to laminaria: a case report and review of literature.

    Science.gov (United States)

    Sierra, Tania; Figueroa, Melissa M; Chen, Katherine T; Lunde, Britt; Jacobs, Adam

    2015-04-01

    We report a case of laminaria hypersensitivity treated with diphenhydramine and corticosteroids. A literature review identified 10 previously reported cases, with 8 recognized as anaphylaxis, and good outcomes with corticosteroids and antihistamines despite limited epinephrine utilization. Laminaria hypersensitivity is likely IgE mediated with an increased anaphylaxis risk with prior exposure. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. [Actinobacillus actinomycetemcomitans endocarditis. A case report and literature review].

    Science.gov (United States)

    Bansky, G; Russi, E

    1981-07-25

    A case of subacute endocarditis caused by Actinobacillus actinomycetemcomitans is reported. After successful treatment with ampicillin and tobramycin, the destroyed aortic valve was replaced and a communication between an aneurysm of sinus of Valsalva and the right atrium was closed. A further 23 well documented cases from the literature are reviewed.

  20. 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 ...

  1. Widespread scrofuloderma: a case study

    Directory of Open Access Journals (Sweden)

    N. V. Kuzmina

    2014-01-01

    Full Text Available The authors present a case study of scrofuloderma in a female patient aged 55; the patient’s condition was of interest due to the prevalence of the pathology and long-term (25 years undiagnosed skin tuberculosis as a result of problems with the diagnostics of this localization of tuberculosis.

  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. 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....

  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. Benign tumours of the upper gastro-intestinal tract (stomach, duodenum, small bowel): a review of 178 surgical cases. Belgian multicentric study.

    Science.gov (United States)

    Mendes da Costa, P; Beernaerts, A

    1993-01-01

    The results of retrospective series counting 178 cases of surgically resected stomach, duodenum and small bowel benign tumours are analysed. It is a Belgian retrospective multicentric study that extend over a mean duration of 7 years 9 months. The main symptoms are haemorrhage, dyspepsia, obstruction and invagination. The most frequent tumours are leiomyoma, adenomatous polyps, lipoma and schwannoma. Preoperative investigations are endoscopy and radiology. To finish off the gastro-duodenal tumours examinations, endoscopy is necessary and arteriography can be helpful in small bowel tumours. Operative mortality of this series is 2.2%; local and general postoperative complications are 34.2%. Observed local recurrence in 118 patients with mean follow-up of 27 months is 1.7%. The authors emphasize the surgical resection necessity of these tumours as their malignant potentiality is not inconsiderable. Considering local recurrence, malign change and afar dissemination, a long-term follow-up is recommended.

  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. Xeroderma pigmentosum: a review and case series.

    Science.gov (United States)

    Butt, Fawzia M A; Moshi, Jeremiah R; Owibingire, Sira; Chindia, Mark L

    2010-10-01

    Xeroderma pigmentosa (XP) is a condition inherited as an autosomal recessive trait and is characterized by photosensitivity, pigmentary changes, premature skin ageing and malignant tumour development resulting from the defect in DNA repair. The management of complications of XP, especially orofacial tumours entails an enormous surgical challenge to the clinicians. We present five cases of XP. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. 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

  9. 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

  10. 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.

  11. Familial polyposis: a case study.

    Science.gov (United States)

    Ben Meir, Zehava; Garber, Anna; Rassin, Michal; Silner, Dina

    2008-01-01

    This article presents a case study of a patient who was treated for 5 years from the time of diagnosis until his death. The patient was diagnosed with familial polyposis at the age of 35 due to a family history of the same. He suffered from low body image and showed a poor response to treatment, especially regarding nutrition. The period of time related to the presentation of symptoms and the patient's subsequent deterioration was characterized by attempts on the part of nursing staff to improve the patient's quality of life. Treatment of multiple fistulae was employed, while keeping the skin intact, along with the creative development of a unique bandaging method. This article describes the course of the patient's disease and specifies his problems and their solutions. It is hoped that presentation of this case will benefit caregiving staff in dealing with similar cases.

  12. 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

  13. Primary orbital melanoma: a case series and literature review.

    Science.gov (United States)

    Figueira, Edwin; Rajak, Saul; McKelvie, Penny; Kalantzis, George; Ismail, Azzam; Gonzales, Michael; James, Craig; McNab, Alan; Selva, Dinesh

    2018-02-01

    Primary orbital melanoma (POM) is a very rare condition. We report further four cases and review all previously reported cases. We present a multicentre retrospective review of patients with POM. Clinical, radiological, surgical, histological, and follow-up data is presented. Four patients with POM were identified between 2000 and 2013. All presented with proptosis and diplopia without reduced vision. Two had known pre-existing blue cell naevi. All were stage T1N0M0. All underwent exenteration with adjuvant radiotherapy. All are disease free at follow-up durations of 24-151 months. The present three cases and review of all cases in the literature suggest a higher likelihood of disease-free survival from primary exenteration (7/8 disease-free survival, 1/8 death from metastatic disease) than wide local excision (7/16 disease-free survival, 9 recurrence or metastasis of whom 4 died). Adjuvant radiotherapy may additionally improve outcomes.

  14. 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.

  15. 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

  16. [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.

  17. 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

  18. Deep Venous Thrombosis with Pulmonary Embolism Related to IVIg Treatment: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Michael T. Flannery

    2015-01-01

    Full Text Available IVIg therapy has potentially been related to arterial and venous therapy. We performed an Ovid review focusing on IVIg and thrombotic events. While a few case reports were reviewed case series and case control studies were particularly reviewed in relation to thrombotic events. Outcomes demonstrate a correlation between underlying cardiovascular risk factors with predominately arterial events which typically occurred within 4–24 hours of infusion. While venous events occurred less commonly they were associated with traditional risk factors and occurred later, typically, 1–7 days following infusion of IVIg. Potential causation of thrombotic events was discussed.

  19. 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%.

  20. 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.

  1. Duchenne muscular dystrophy: Case report and review.

    Science.gov (United States)

    Sinha, Rupam; Sarkar, Soumyabrata; Khaitan, Tanya; Dutta, Soumyajit

    2017-01-01

    Muscular dystrophies are a clinically and heterogeneous group of disorders that all share clinical characteristics of progressive muscular weakness. Duchenne muscular dystrophy (DMD) is the most common X-linked disorder muscular dystrophy in children, presenting in early childhood and characterized by proximal muscle weakness and calf hypertrophy in affected boys. There is usually delay in motor development and eventually wheelchair confinement followed by premature death from cardiac or respiratory complications. Treatment modalities such as corticosteroid therapy and use of intermittent positive pressure ventilation have provided improvements in function, ambulation, quality of life, and life expectancy, although novel therapies still aim to provide a cure for this devastating disorder. Here, we present a case of DMD in a 12-year-old male with remarkable clinical and oral manifestations.

  2. Duchenne muscular dystrophy: Case report and review

    Directory of Open Access Journals (Sweden)

    Rupam Sinha

    2017-01-01

    Full Text Available Muscular dystrophies are a clinically and heterogeneous group of disorders that all share clinical characteristics of progressive muscular weakness. Duchenne muscular dystrophy (DMD is the most common X-linked disorder muscular dystrophy in children, presenting in early childhood and characterized by proximal muscle weakness and calf hypertrophy in affected boys. There is usually delay in motor development and eventually wheelchair confinement followed by premature death from cardiac or respiratory complications. Treatment modalities such as corticosteroid therapy and use of intermittent positive pressure ventilation have provided improvements in function, ambulation, quality of life, and life expectancy, although novel therapies still aim to provide a cure for this devastating disorder. Here, we present a case of DMD in a 12-year-old male with remarkable clinical and oral manifestations.

  3. Dens invaginatus: A review and case series

    Directory of Open Access Journals (Sweden)

    Nesrine Tebbeb

    2018-01-01

    Full Text Available Dens invaginatus (DI (dens in dente is a developmental anomaly resulting from an invagination in part of variable depth of the enamel organ into the dental papilla in the surface of the crown before calcification of the dental tissues. This anomaly usually involves the upper lateral incisors. These teeth are frequently expressed by an unusual form of crown and accentuation in the cingulum or a cusp. They are a target for caries leading to pulp necrosis and apical pathosis, so the diagnosis and early prevention measures are important. When treatment is necessary, conservative, endodontic, and periodontal possibilities are very effective. Surgical interventions are only rarely indicated. The present paper deals with the treatment of series cases with DI.

  4. 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

  5. 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.

  6. 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.

  7. 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)

  8. The Role of Subtotal Petrosectomy in Cochlear Implant Surgery-A Report of 32 Cases and Review on Indications

    NARCIS (Netherlands)

    Free, Rolien H.; Falcioni, Maurizio; Di Trapani, Giuseppe; Giannuzzi, Anna Lisa; Russo, Alessandra; Sanna, Mario

    Objective: To report and review 32 cases of subtotal petrosectomy (SP) in cochlear implant (CI) surgery and to define the indications and contraindications for this procedure Study Design: Retrospective case review + case reports. Setting: Tertiary skull base center. Patients: Cochlear implant

  9. 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.

  10. 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.

  11. Vascular hemichorea: case report and review.

    Science.gov (United States)

    Martínez Alfonzo, Bárbara; Blanco, Andrés Enrique; Rojano, Jairo; Calleja, José Luis

    2014-04-09

    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.

  12. 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.

  13. General review of flashing jet studies.

    Science.gov (United States)

    Polanco, Geanette; Holdø, Arne Erik; Munday, George

    2010-01-15

    The major concern on the management of superheated liquids, in industrial environments, is the large potential hazards involved in cases of any accidental release. There is a possibility that a violent phase change could take place inside the fluid released generating a flashing jet. This violent phase change might produce catastrophic consequences, such as explosions, fires or toxic exposure, in the installations and in the surroundings. The knowledge and understanding of the mechanisms involved in those releases become an important issue in the prevention of these consequences and the minimization of their impact. This work presents a comprehensive review of information about flashing processes. The review begins with a description of the single phase jet followed by a description of the two-phase flashing jet. The concepts and implications of the thermodynamic and mechanical effects on the behaviour of the jets are considered at the beginning of the review. Following the review is devoted to the classification of the different study approaches used to understand flashing processes in the past, highlighting various critical parameters on the behaviour and the hazard consequences of flashing jets. The review also contains an extensive compilation of experimental, theoretical and numerical data relating to these phenomena, which includes information on the distinct characteristics of the jet, since type of jet, velocity distribution, expansion angle and mass phase change all require individual estimation.

  14. 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

  15. Cotton expansion and biodiversity loss in African savannahs, opportunities and challenges for conservation agriculture: a review paper based on two case studies

    NARCIS (Netherlands)

    Baudron, F.; Corbeels, M.; Monicat, F.; Giller, K.E.

    2009-01-01

    We review agricultural impacts on biodiversity and the potential of conservation agriculture in developing productive and environment-friendly cropping systems. We then analyse experiences from two African landscapes of global importance for conservation: the Mid Zambezi Valley in Southern Africa

  16. 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)

  17. 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.

  18. 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

  19. Paraneoplastic dermatomyositis: a study of 12 cases.

    Science.gov (United States)

    Requena, C; Alfaro, A; Traves, V; Nagore, E; Llombart, B; Serra, C; Martorell, A; Guillén, C; Sanmartín, O

    2014-09-01

    Adult dermatomyositis presents as a paraneoplastic syndrome in up to 25% of cases, but no clinical, histologic, or laboratory markers completely specific for paraneoplastic disease in dermatomyositis have been identified to date. Furthermore, studies on adult dermatomyositis do not usually report the frequency of cutaneous features of dermatomyositis in patients with associated cancer. Our aim was to review the characteristics of paraneoplastic dermatomyositis in patients seen at our hospital. We studied 12 cases of paraneoplastic dermatomyositis and recorded patient age and sex, associated cancer, time between onset of dermatomyositis and cancer, emergent cutaneous manifestations, muscle involvement, dysphagia, lung disease, and levels of creatine phosphokinase and circulating autoantibodies. The mean age of the patients was 61 years and the 2 most common malignancies were ovarian cancer and bladder cancer. The mean time between the diagnosis of cancer and dermatomyositis was 7 months and in most cases, the cancer was diagnosed first. Seven patients had amyopathic dermatomyositis. The most common cutaneous signs were a violaceous photodistributed rash sparing the interscapular area and a heliotrope rash, followed by Gottron papules and cuticle involvement. Superficial cutaneous necrosis was observed in 3 cases. Myositis-specific autoantibodies were not detected in any of the 6 patients who underwent this test. Paraneoplastic dermatomyositis is often amyopathic. There are no specific cutaneous markers for malignancy in dermatomyositis. Myositis-specific antibodies are not associated with paraneoplastic dermatomyositis. Copyright © 2013 Elsevier España, S.L.U. y AEDV. All rights reserved.

  20. 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.

  1. Adrenocortical oncocytoma: a case report and review of literature.

    Science.gov (United States)

    Tahar, Gargah T; Nejib, Kaabar N; Sadok, Sayed S; Rachid, Lakhoua M Mohamed

    2008-05-01

    Oncocytic tumors of the adrenal gland are uncommon. Most of these oncocytomas are benign and nonfunctioning. We report the case of functioning adrenocortical located in the right adrenal gland in a 6-year-old girl who presented with pseudoprecocious puberty and elevation of the estradiol level. She had an adrenalectomy. The tumor was small and composed predominantly of oncocytes. No criteria of malignancy were found. A discussion of this case and a review of the literature on this entity are presented.

  2. 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.)

  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. Post-injection Sciatic Neuropathy: A five-year review of cases ...

    African Journals Online (AJOL)

    This study reviewed two hundred and ten cases of PISN among eight hundred paediatric cases seen from January 2004 to December 2008 in the Physiotherapy Clinic of Oni Memorial Children's Hospital in Ibadan, Nigeria. Each patient was evaluated for the limb affected, the health care centre where the injection was ...

  5. Acute flaccid paralysis: a five–year review of cases managed by ...

    African Journals Online (AJOL)

    A 5-year (1999-2004) review of acute flaccid paralysis (AFP) cases managed at the physiotherapy clinic of the University College Hospital, Ibadan Nigeria was carried out. Collection of data involved retrieving the records of all patients seen at the physiotherapy clinic during the study period, from which the paediatric cases ...

  6. 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.

  7. INTERIORITY - a prefab case study

    DEFF Research Database (Denmark)

    Hvejsel, Marie Frier

    and furnishing articulation hereof. In the second volume of the thesis; ‘INTERIORITY: a prefab case study’ this theory of interiority has been endeavored applied in a specific prefab project concerning the development of a novel prefab building system and housing series in collaboration with the Danish prefab......, tectonically. Hence, it has been a particular idea of the study to explore the relation between furniture, the spatial envelope itself, and its construct by using furniture as an architectural concept. Consequently, the thesis has specifically investigated whether this notion of interiority, describing...

  8. [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.

  9. 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.

  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. The case of #arseniclife: Blogs and Twitter in informal peer review.

    Science.gov (United States)

    Yeo, Sara K; Liang, Xuan; Brossard, Dominique; Rose, Kathleen M; Korzekwa, Kaine; Scheufele, Dietram A; Xenos, Michael A

    2017-11-01

    Using the "#arseniclife" controversy as a case study, we examine the roles of blogs and Twitter in post-publication review. The controversy was initiated by a scientific article about bacteria able to substitute arsenic for phosphorus in its genetic material. We present the debate chronologically, using prominent online media to reconstruct the events. Using tweets that discussed the controversy, we conducted quantitative sentiment analysis to examine skeptical and non-skeptical tones on Twitter. Critiques of and studies refuting the arsenic life hypothesis were publicized on blogs before formal publication in traditional academic spaces and were shared on Twitter, influencing issue salience among a range of audiences. This case exemplifies the role of new media in informal post-publication peer review, which can complement traditional peer review processes. The implications drawn from this case study for future conduct and transparency of both formal and informal peer review are discussed.

  12. 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.

  13. 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

  14. 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.

  15. [Frontoparietal hypoperfusion in Capgras syndrome: a case report and review].

    Science.gov (United States)

    Eren, Ibrahim; Civi, Ikbal; Yildiz, Mustafa

    2005-01-01

    Capgras syndrome (CS) is characterized by the delusional belief that a person, usually very close to the patient, has been replaced by a double who is physically very similar to the original. CS is relatively rare, occurring predominantly in course of schizophrenia, particularly of the paranoid sub-type, and less frequently in association with schizoaffective and affective disorder. Recent years have witnessed a sharp increase in the number of published CS cases with an organic etiology; however, CS was considered to have its origins in psychodynamic conflict. We present a patient with the CS and brain SPECT findings whom without psychiatric disorder. As an evaluation of brain SPECT, there have been found a significantly decreased blood flow in bilateral parietal regions and slightly decreased blood flow in bilateral posterior frontal regions. Cerebral dysfunction is proposed to be a central role in CS development. Unilateral right hemisphere lesions occur more frequently than the left; however, the majority of CS cases show bilateral involvement. Pathology involves many parts of the brain, most notably frontal and parietal cortex. Our findings support that frontoparietal dysfunction could be important in the pathogenesis of CS. We reviewed the neurobiology of CS and discussed our findings in this article. CS studies will give a better understanding of the neurobiological basis of psychotic experiences and may contribute to develop a paradigm on researches about other psychotic disorders.

  16. 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

  17. Cycloid psychoses revisited: case reports, literature review, and commentary.

    Science.gov (United States)

    Salvatore, Paola; Bhuvaneswar, Chaya; Ebert, Daniel; Maggini, Carlo; Baldessarini, Ross J

    2008-01-01

    Emil Kraepelin proposed to separate psychiatric disorders with psychotic features into two major categories, dementia praecox (later schizophrenia) and manic-depressive insanity (later bipolar disorder and major depression). Over the past century, there have been many efforts to categorize conditions that do not fit readily in either group. These conditions include many cases of acute psychotic illnesses of limited duration, with recovery between recurrences. For some of these conditions, Karl Kleist proposed the term cycloid psychosis: acute features were psychotic, as in schizophrenia, but the course was episodic, as in manic-depression. His concept was later elaborated by Karl Leonhard and Carlo Perris, and validated by modern studies. Leonhard described three overlapping cycloid subtypes (anxiety-beatific, excited-inhibited confusional, and hyperkinetic-akinetic motility dysfunction forms); Perris proposed a more unitary syndrome with operational diagnostic criteria; and recent investigators have considered relatively affective versus thought-disordered subtypes. The cycloid concept is not explicitly included in standard international diagnostic schemes, but both DSM-IV and ICD-10 have broad categories for acute, recurrent psychotic disorders, whose validity remains insecure. We present two cases of probable cycloid psychosis, review the history of the concept, and propose that it be reconsidered as a clinically useful category whose validity and utility for prognosis and treatment can be further tested.

  18. Invasive Amoebiasis: A Review of Entamoeba Infections Highlighted with Case Reports

    Directory of Open Access Journals (Sweden)

    Christopher Skappak

    2014-01-01

    Full Text Available Entamoeba histolytica infections of the gastrointestinal tract are common in the developing world but rare in North America. The authors present two cases: one involving an individual who had not travelled to an endemic area and another involving an individual who was born in Bulgaria. Both presented with severe abdominal pain and diarrhea. Endoscopic assessment revealed scattered colonic ulcerations and one patient was found to have a liver abscess on imaging. Stool ova and parasite studies were negative in both cases and both were diagnosed on review of colonic biopsies. On review of all Entamoeba cases in the Calgary Health Zone (Alberta, ova and parasite analysis found an average of 63.7 Entamoeba cases per year and a pathology database review revealed a total of seven cases of invasive E histolytica (2001 to 2011. Both patients responded well to antibiotic therapy. E histolytica should be considered in new-onset colitis, especially in individuals from endemic areas.

  19. Amyloid goiter: two cases and a review of the Literature

    International Nuclear Information System (INIS)

    Yildiz, Levent; Kefeli, Mehmet; Kose, Behiye; Baris, Sancar

    2007-01-01

    Although involvement of the thyroid gland by amyloid is a relatively common phenomenon, clinically significant enlargement of the thyroid owing to amyloid deposition is an extremely rare occurrence. We describe two cases of amyloid goiter and review the relevant literature. The first case was systemic amylloidosis secondary to familial Mediterranean fever. The second case was a chronic renal failure patient who presented with an enlarged thyroid and upper airway obstructive symptoms. To date, true amyloid goiter secondary to amyloidosis associated with familial Mediterranean fever has only been reported in twelve patients. (author)

  20. Fibrosarcomatous change in the background of dermatofibrosarcoma protuberans in male breast: Study of a rare case and review of the entity

    Directory of Open Access Journals (Sweden)

    Birinchi Kumar Saikia

    2016-01-01

    Full Text Available Dermatofibrosarcoma protuberans is a cutaneous soft tissue neoplasm with potential for local recurrence but distant metastasis is rare. Trunk and extremities are most commonly involved. This case presented as left-sided breast lump in a male patient. The patient underwent left-sided modified radical mastectomy. Tissues were subjected to histopathological and immunohistochemical test subsequently. The tumor cells showed storiform arrangement with nuclear pleomorphism and increased mitotic figures at places. They were reactive to CD34 and non-reactive to S-100, smooth muscle actin, desmin, cytokeratin and epithelial membrane antigen. The diagnosis of dermatofibrosarcoma protuberans with areas of fibrosarcomatous change was given. Though trunk is a common site for this tumor but its presentation as male breast lump has made the case unique.

  1. Congenital hallux varus: case presentation and review of the literature.

    Science.gov (United States)

    Stanifer, E; Hodor, D; Wertheimer, S

    1991-01-01

    Congenital hallux varus is uncommon as an isolated deformity. Many authors cite this deformity in conjunction with metatarsus varus or talipes equino varus deformities. An unusual case of bilateral congenital hallux varus is presented in a 9-month-old. A review of etiologies and treatment methods are given.

  2. Mature sacrococcygeal teratoma: A case report and literature review ...

    African Journals Online (AJOL)

    Patients and methods: A case report is presented with a review of literature utilising MEDLINE, Microsoft Net and Yahoo search engines. Results: A three day old female baby presented with a mature sacrococcygeal teratoma containing well-developed limb buds. She had surgical excision and primary repair with good ...

  3. 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)

  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. Double mesiodens: a review and report of 2 cases.

    Science.gov (United States)

    Sujlana, Amrita; Pannu, Parampreet; Bhangu, Japneet

    2017-01-01

    Mesiodentes are the most frequently encountered supernumerary teeth. Recently, reports of double mesiodens have increased, which may be due to the availability of better diagnostic methods. This article discusses 2 cases of double mesiodens with varying clinical presentations. In addition, the literature related to the etiology, clinical presentation, diagnosis, and management of mesiodentes is reviewed.

  6. 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.

  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. 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

  9. 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 ...

  10. Contact-lens-related microbial keratitis: case report and review

    Directory of Open Access Journals (Sweden)

    Mark Eltis

    2011-10-01

    Full Text Available Bacterial keratitis is a serious, potentially blinding, complication most often involving overnight contact lens wear. This case report reviews the management of a patient with bacterial keratitis and discusses the etiology, differential diagnosis, classification and risk factors associated with the condition.

  11. 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 ...

  12. Spontaneous coronary artery dissection. Case report and literature review

    DEFF Research Database (Denmark)

    Elming, H; Køber, L

    1999-01-01

    descending artery (LAD). Her condition stabilized during treatment with intravenous heparin, aspirin, nitrates, beta-blockers, digoxin, ACE inhibitor and anticoagulants. At discharge she had no symptoms of heart failure. One hundred and forty one cases from the literature are reviewed with special reference...

  13. Exencefaly. Report of a case and review of literature

    International Nuclear Information System (INIS)

    Costa Machado Junior, Marcos Alberto da; Francischini, Alexandre; Castro, Luiz Eduardo; Oliveira Barbosa, Veronica Aline de; Matos, Hugo

    1998-01-01

    The authors reports a newborn case with central nervous system congenital malformations (exencephaly) characterized by the absence of skullcap bones, and the exposition of malformed brain nervous tissue, recovered by an ashen-blue membrane. A bibliographic review was done focusing the radiological and tomographic findings. (author)

  14. 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 ...

  15. Congenital tuberculosis: A case report and review of the literature ...

    African Journals Online (AJOL)

    Congenital tuberculosis: A case report and review of the literature. O Peterside, OO Adeyemi, OE Kunle - Olowu, FO Akinbami, J Omene, AD Frances. Abstract. Congenital tuberculosis (TB) is a rare infection transmitted from a mother to her foetus, either through an infected placenta or amniotic fluid. Congenital tuberculosis ...

  16. Cytomegalovirus retinitis and HIV: Case reviews from KwaZulu ...

    African Journals Online (AJOL)

    We highlight the poor outcomes of CMV retinitis in three HIV-infected patients who were initiated on antiretroviral therapy (ART). We conducted a retrospective chart review of advanced stage HIV-infected patients with known CMV retinitis. Case 1. A 37-year-old man, with a CD4+ cell count of 35 cells/μL, presented for ART ...

  17. 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.

  18. 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)

  19. Adverse Events of Acupuncture: A Systematic Review of Case Reports

    Science.gov (United States)

    Xu, Shifen; Wang, Lizhen; Cooper, Emily; Zhang, Ming; Manheimer, Eric; Berman, Brian; Shen, Xueyong; Lao, Lixing

    2013-01-01

    Acupuncture, moxibustion, and cupping, important in traditional Eastern medicine, are increasingly used in the West. Their widening acceptance demands continual safety assessment. This review, a sequel to one our team published 10 years ago, is an evaluation of the frequency and severity of adverse events (AEs) reported for acupuncture, moxibustion, and cupping between 2000 and 2011. Relevant English-language reports in six databases were identified and assessed by two reviewers. During this 12-year period, 117 reports of 308 AEs from 25 countries and regions were associated with acupuncture (294 cases), moxibustion (4 cases), or cupping (10 cases). Country of occurrence, patient's sex and age, and outcome were extracted. Infections, mycobacterial, staphylococcal, and others, were the main complication of acupuncture. In the previous review, we found the main source of infection to be hepatitis, caused by reusable needles. In this review, we found the majority of infections to be bacterial, caused by skin contact at acupoint sites; we found no cases of hepatitis. Although the route of infection had changed, infections were still the major complication of acupuncture. Clearly, guidelines such as Clean Needle Technique must be followed in order to minimize acupuncture AEs. PMID:23573135

  20. Eccrine syringofibroadenoma: case report and review of the literature.

    Science.gov (United States)

    Takeda, H; Mitsuhashi, Y; Hayashi, M; Kondo, S

    2001-03-01

    Eccrine syringofibroadenoma (ESFA) is a rare disorder that shows differentiation toward eccrine sweat apparatus. There is a controversy concerning the pathogenesis and differentiation of this tumour. We report a case of ESFA in a 63-year-old Japanese man. We review the literature presenting a classification, including a newly reported subtype. Clinically and pathogenically, ESFA is probably a group of heterogeneous disorders.