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Sample records for cases ulcera penetrante

  1. ULCERA GASTRODUODENAL EM CÃES

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    Francisco Assis Uma Costa

    1993-12-01

    Full Text Available As ulcerações no sistema digestivo de cães são consideradas raras. São descritos dois casos de úlcera gastroduodenal em cães. O primeiro animal apresentou úlcera no duodeno próxima!. O segundo mostrou úlcera perfurada na região pilórica do estômago. Nenhum dos animais apresentou evidências de sangramento, mas as lesões eram profundas e arredondadas. Não houve evidência de patologias concorrentes.

  2. Lesão da valva tricúspide por trauma torácico penetrante Lesión de la válvula tricúspide por trauma torácico penetrante Tricuspid valve lesion due to penetrating chest trauma

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    Renata de Carvalho Bicalho Carneiro

    2010-02-01

    Full Text Available As lesões da valva tricúspide decorrentes de trauma torácico penetrante são raras e frequentemente subdiagnosticadas. O objetivo deste relato é descrever um caso de insuficiência tricúspide grave secundária a acidente por arma branca com evolução insidiosa, diagnosticada 19 anos após o ocorrido. O caso enfatiza a importância do acompanhamento adequado dos pacientes vítimas de trauma torácico penetrante por longo período após a injúria, para detecção de possíveis complicações tardias do trauma.Las lesiones de la válvula tricúspide resultantes de trauma torácico penetrante son raras y frecuentemente subdiagnosticadas. El objetivo de este relato es describir un caso de insuficiencia tricúspide severa secundaria a accidente por arma blanca con evolución insidiosa, diagnosticada 19 años tras lo sucedido. El caso enfatiza la importancia del seguimiento adecuado de los pacientes víctimas de trauma torácico penetrante por largo período tras la injuria, para detección de posibles complicaciones tardías del trauma.Tricuspid valve lesions caused by penetrating chest trauma are rare and often underdiagnosed. The objective of this report is to describe a case of severe tricuspid insufficiency secondary to a knifing incident with an insidious evolution, diagnosed 19 years after the incident. The case emphasizes the importance of adequate follow-up of patients that are victims of penetrating chest trauma for a long period after the injury, to detect possible late complications of the trauma.

  3. Lesão cerebral penetrante por grande fragmento de fibra de amianto tratada por craniectomia descompressiva: relato de caso Penetrating brain injury due to a large asbestos fragment treated by decompressive craniectomy: case report

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    Gustavo Cardoso de Andrade

    2004-12-01

    Full Text Available Relata-se caso de paciente de 22 anos vítima de traumatismo cranioencefálico penetrante por fragmento de fibra de amianto medindo 15 x 12 cm, e seu tratamento bem sucedido por craniectomia descompressiva. Ao contrário da lesão encefálica por projétil de arma de fogo, lesão encefálica penetrante por objeto de baixa energia é incomum. A maioria dos casos relatados na literatura envolve lesões cranio-orbitárias ou autoflagelação em pacientes psiquiátricos. O caso relatado torna-se especial em virtude das grandes dimensões do objeto penetrante, do tratamento por craniectomia descompressiva e do bom resultado funcional alcançado.We report the case of a 22-year-old man victim of penetrating brain injury due to a 15 x 12 asbestos fragment and a successfully treatment via decompressive craniectomy. Unlike gunshot wounds to the head, penetrating brain injury from low energy objects are unusual. Most cases reported involve cranio-orbitary injuries as well as self inflicted lesions in mentally ill patients. The reported case is noteworthy due to the large dimensions of the foreign body, the treatment via decompressive craniectomy and the good patient functional outcome.

  4. Herida penetrante del cráneo Skull penetrating wound

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    Yvei González Orlandi

    2011-06-01

    Full Text Available El traumatismo craneoencefálico es común en los servicios de urgencia de instituciones que atienden a pacientes politraumatizados y se ha convertido en un problema de salud para muchos países. El traumatismo penetrante del cráneo ocupa un lugar especial por su baja frecuencia. En este trabajo se presenta el caso de un paciente varón, de 52 años de edad, que sufrió una herida penetrante del cráneo producida por un arma blanca que quedó retenida en la región frontotemporal izquierda. Tras un estudio imaginológico se procedió al tratamiento quirúrgico de urgencia, y el paciente evoluciona satisfactoriamente después de 25 días de hospitalización. En la actualidad se encuentra en tratamiento de rehabilitación por una hemiparesia derecha residual.The cranioencephalic trauma is common in the emergence centers to care for patients with multiple traumata and it becames in a health problem in many countries. Skull penetrating trauma is located in a special place due to its low frequency. In present paper a case of male patient aged 52 severely skull-injured with penetrating wound caused by a cold steel that remained introduced into the left frontotemporal region. After an imaging study the emergence surgical treatment was applied and patient evolves adequately after 25 days of hospitalization. Nowadays, she is under rehabilitation treatment due to a residual right hemiparesis.

  5. Ceratoplastia penetrante e glaucoma Penetrating keratoplasty and glaucoma

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    Márcio Eulálio Barreto Soares

    2007-08-01

    Full Text Available O objetivo deste artigo é discutir os conhecimentos atuais sobre a abordagem clínica e terapêutica da ceratoplastia penetrante e do glaucoma a ela associado.The aim of this article is to make a review about glaucoma associated with penetrating keratoplasty, describing since its incidence and risk factors until the different options for treatment.

  6. Lesiones penetrantes y transfixiantes en los traumatismos abiertos del tórax

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    Sosa Delgado, Diego; González López, José; Hernández Varea, José; Conde Castells, Luis; González Martínez, Pablo

    2001-01-01

    La gravedad y el peligro para la vida que acompañan a las lesiones penetrantes y transfixiantes del tórax y la necesidad de una respuesta inmediata con un diagnóstico y tratamiento precoz, motivaron a profundizar en el estudio de estos traumatismos, evaluar la aplicación oportuna del tratamiento quirúrgico, determinar los agentes vulnerantes causales, los órganos más afectados y las complicaciones. Se realizó un estudio retrospectivo en 116 pacientes atendidos en el Hospital Militar Central "...

  7. Traumatismos raquimedulares penetrantes em adolescentes Traumatismos raquimedulares penetrantes en adolescentes Penetrating spinal cord injuries in adolescents

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    Marcelo Campos Moraes Amato

    2009-09-01

    Full Text Available OBJETIVO: analisar a conduta em uma série de adolescentes com traumatismos raquimedulares penetrantes (TRMp e, confrontando com a literatura, estabelecer a melhor estratégia terapêutica para esses pacientes. MÉTODOS: avaliação retrospectiva de prontuários médicos de dez pacientes, nove do sexo masculino e um do feminino, com TRMp e menores de 18 anos, tratados à nível hospitalar. Analisou-se a anamnese, o exame neurológico e os exames de imagem. A conduta terapêutica variou entre cirurgia ou conservador. RESULTADOS: a média de idade foi de 16 anos (13 a 18 anos. A mediana de hospitalização inicial foi de 11 dias (4 a 180 dias. Quatro pacientes foram submetidos à laminectomia, um ao desbridamento da lesão e os demais a tratamento conservador. Só um paciente, foi submetido à laminectomia, que migrou para Frankel E. Nenhum paciente apresentou infecção da ferida ou instabilidade tardia da coluna vertebral. CONCLUSÃO: as lesões medulares secundárias desempenham pouca importância no resultado neurológico, o que leva à definição clínica do quadro na admissão hospitalar da maioria dos casos. Houve uma nítida predominância de TRMp em adolescentes do sexo masculino. Não ocorreu diferença significativa entre as condutas realizadas em relação ao resultado neurológico, à infecção e instabilidade. O tratamento deve ser individualizado, não negligenciando o tratamento clínico e considerando a cirurgia apenas em casos específicos.OBJETIVO: analizar la conducta en una serie de adolescentes con traumatismos raquimedulares penetrantes (TRMp y confrontar con la literatura, además de establecer la mejor estrategia terapéutica para eses pacientes. MÉTODOS: evaluación retrospectiva de historias clínicas de diez pacientes, nueve masculinos y un femenino de TRMp menores de 18 años, tratados a nivel hospitalar. Se analizó la anamnesis, el examen neurológico y los exámenes de imagen. La conducta terapéutica vari

  8. Eficácia na utilização de córneas no transplante penetrante

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    Ghanem Vinícius Coral

    2003-01-01

    Full Text Available OBJETIVOS: 1 Verificar qual o impacto da criação do Cadastro Técnico Único (CTU para o Hospital das Clínicas da Universidade de Campinas (Unicamp no tempo de preservação de córneas utilizadas em transplantes penetrantes eletivos, e 2 comparar a incidência de falência primária em transplantes penetrantes de córnea nos períodos pré e pós-criação do CTU. MÉTODOS: Foi realizado estudo retrospectivo no Hospital de Clínicas da Unicamp, avaliando-se 15 transplantes penetrantes de córnea consecutivos entre 1 de janeiro e 30 de abril de 2000 e 24 transplantes consecutivos entre 1 de maio e 20 de setembro de 2000 (córneas sob o controle do Cadastro Técnico Único, num total de 39 transplantes. RESULTADOS: O tempo médio entre a preparação das córneas e o transplante foi de 3,8 dias (±1,78 no período pré-CTU, e de 6,0 dias (±2,97 no período pós-CTU, representando aumento no tempo de preservação de 36,7%. Houve diferença estatisticamente significativa (p=0,02 entre os dois grupos. Nenhum caso de falência primária do enxerto foi observado entre os 39 pacientes transplantados nos dois grupos. CONCLUSÃO: Com base nestes resultados, conclui-se que a nova disposição do Sistema Estadual de Transplantes aumentou de forma estatisticamente significativa o período de permanência das córneas no meio de preservação, o que pode comprometer o tempo de vida útil do transplante, aumentar a incidência de falência primária ou levar a maior número de córneas perdidas por excederem o tempo de preservação limite, preconizado na literatura.

  9. Fatores preditivos de morbidade e mortalidade no trauma penetrante do cólon

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    Thiago Rodrigues Araujo Calderan

    2014-01-01

    Resumo: A lesão de cólon, que ocorre em 25% a 41% dos ferimentos por projétil de arma de fogo (FPAF) e em 5% a 20% dos ferimentos por arma branca (FAB) que acometem o abdome, apesar de possuir baixa mortalidade, apresenta uma alta morbidade. O presente estudo teve como objetivo analisar quais os fatores prognósticos envolvidos no aumento da morbidade e da mortalidade no trauma penetrante do cólon. Foi realizado um estudo retrospectivo de 21 anos, em que 462 pacientes foram admitidos com traum...

  10. Traumatismo penetrante facial por arpón. A propósito de un caso

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    Pablo Veiga San Román

    2015-01-01

    Full Text Available Los traumatismos penetrantes causados por el disparo de un fusil de pesca submarina son extremadamente raros. El tratamiento quirúrgico está condicionado por el «mecanismo de barba», que impide una retirada segura de la flecha en sentido contrario al de su entrada, ya que la aleta del fusil provocaría graves daños. Presentamos un caso clínico y un sistema sencillo de bloqueo del retroceso de la aleta que permitió una retirada segura en sentido retrógrado.

  11. Herida penetrante del tórax por un proyectil de arma de fuego localizado inicialmente en el ventrículo izquierdo y luego en la arteria renal derecha

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    Cosío Lima, Ludmila; Gámiz González, Raúl; Cosío Pascal, Miguel

    2017-01-01

    Resumen: Objetivo: Presentar un caso de herida penetrante del corazón con migración del proyectil y comentar los criterios actuales para el manejo de este tipo de pacientes. Las heridas por proyectil de arma de fuego penetrantes a tórax cada día son más frecuentes en todo el mundo y traen aparejada una mortalidad considerable, ya que el calibre y el poder de las armas también son actualmente más letales. Los heridos que logran llegar vivos al hospital están generalmente supeditados a la atenc...

  12. Lesiones penetrantes maxilofaciales: Presentación de 4 casos Penetrating maxillofacial injuries: Report of 4 cases

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    José Manuel Díaz Fernández

    2006-09-01

    Full Text Available Una historia y examen físico detallado deben ser imperativos en todos los pacientes con sospechas de lesiones penetrantes de la región maxilofacial por parte del cirujano maxilofacial, con participación activa y frecuente de oftalmólogos, otorrinolaringólogos y neurocirujanos, incluso ante lesiones aparentemente triviales. La exploración por radiografías simples, ultrasonidos y especialmente la tomografía axial computadorizada de reconstrucción tridimensional, constituye la mejor vía para detectar lesiones oculares y/ u orbitarias, fracturas del complejo craneofacial, precisar localización, naturaleza y relación del objeto hiriente con órganos y estructuras anatómicas importantes. Se presentan 4 pacientes con este tipo de lesiones proporcionadas por 3 tipos de objetos de naturaleza y características diferentes. Se enfatiza en los aspectos terapéuticos y se ilustra el trabajo con imágenes por rayos X simples y TAC. Se emiten consideraciones a tener presentes en este tipo de lesiones resaltando aquellas con extensión intracraneal.A medical history and a detailed physical examination should be imperative in all the patients with suspicion of penetrating injuries of the maxillofacial region, on the part of the maxillofacial surgeon with an active and frequent participation of ophthalmologists, otorhinolaryngologists and neurosurgeons, even in the case of apparently trivial injuries. The exploration by simple X rays, ultrasounds and, specially, computerized axial tomography of tridimensional reconstruction is the best way to detect ocular and/or orbital injuries, fractures of the craniofacial complex , and to determine the localization, nature and relation of the wounding object to organs and important anatomical structures. 4 patients with this type of injuries produced by three types of objects of different nature and characteristics are presented. Emphasis is made on the therapeutic aspects and the paper is illustrated with

  13. Resultados e indicações de ceratoplastias penetrantes realizadas por médicos em treinamento, num país em desenvolvimento Indications and results of penetrating keratoplasty performed by training physicians in a developing country

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    Marta Ferrari Teixeira

    2001-11-01

    Full Text Available Objetivos: Avaliar as indicações mais freqüentes, bem como o resultado da acuidade visual final após a ceratoplastia penetrante, realizadas por residentes em treinamento. Métodos: Avaliaram-se retrospectivamente 159 casos de ceratoplastia penetrante realizadas no período de janeiro de 1991 a outubro de 1998, na Faculdade de Medicina de São José do Rio Preto - Hospital de Base, correlacionando-os em termos de indicação para ceratoplastia penetrante e acuidade visual final. O tempo mínimo de acompanhamento para obtenção da acuidade visual final foi de seis meses. Para comparação e análise estatística da acuidade visual final, os casos de ceratoplastia penetrante foram divididos em seis grupos de diagnóstico pré-operatório: ceratocone, ceratopatia bolhosa pseudofácica, ceratopatia bolhosa afácica, distrofia endotelial de Fuchs, ceratopatia em faixa e leucomas. Todas as cirurgias foram realizadas por residentes em treinamento, sob supervisão docente. Resultados: O ceratocone foi o grupo que atingiu um maior aumento médio de acuidade visual pós-operatória em linhas (7,55 ± 2,83 e a ceratopatia em faixa o menor (0,33 ± 3,20. Constatou-se significativa diferença entre as indicações encontradas nos países desenvolvidos, onde se observa predominância de ceratocone. De acordo com nosso estudo, as principais indicações para ceratoplastia penetrante foram, em ordem decrescente, leucoma, ceratopatia bolhosa pseudofácica, ceratocone, distrofia endotelial de Fuchs, ceratopatia bolhosa afácica e ceratopatia em faixa. Conclusão: O ceratocone apresentou diferença significativa (p Purpose: This study was designed to evaluate the most frequent indications, as well as the results of final visual acuity (VA after penetrating keratoplasty (PK, performed by residents. Methods: A consecutive series of 159 cases of PK was followed during the period from January 1991 to October 1998, at the Medical School of São Jose do Rio Preto

  14. Úlceras penetrantes aórticas múltiples y aneurisma torácico descendente

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    María Bueno

    2006-01-01

    Full Text Available Las úlceras penetrantes de aorta (UPA están causadas por ruptura de una placa aterosclerótica. Asociadas a hematoma intramural, son equivalentes a una disección. Evolucionan a disección, ruptura y aneurismas. Varón de 78 años con antecedentes de hipertensión y neoplasia de colon intervenida con enfermedad residual. En la TC de control aparece imagen de aneurisma de aorta torácica descendente. La RM muestra UPA y aneurisma (Fig. 1. Se realizó tratamiento endovascular por vía femoral y anestesia general, monitorizando la presión del líquido cefalorraquídeo. Se excluyeron el aneurisma y las úlceras (Fig. 2. Fue dado de alta en 48 h.

  15. Indicações para ceratoplastia penetrante no Hospital das Clínicas-UNICAMP Penetrating keratoplasty indications in "Hospital das Clínicas-UNICAMP"

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    Vanessa Gonçalves Crespi Flores

    2007-06-01

    Full Text Available OBJETIVO: Determinar as principais causas de indicação de transplante penetrante no Hospital das Clínicas-UNICAMP no período de janeiro de 1999 a dezembro de 2003. MÉTODOS: Estudo de série de casos, retrospectivo, não comparativo. Os autores revisaram os prontuários de 857 pacientes submetidos à ceratoplastia penetrante no Hospital das Clínicas-UNICAMP entre 1999-2003 e os classificaram em categorias diagnósticas de indicação para cirurgia. RESULTADOS: Dentre os 857 prontuários revisados a idade variou de 0-88 anos (média 44 anos±1,2. Dentre as principais causas de indicação de transplante de córnea encontramos: ceratocone em 427 casos (49,82%; úlcera de córnea infecciosa perfurada ou não, 152 casos (17,74%; falência de transplante prévio, 87 casos (10,15%; ceratopatia bolhosa, 72 casos (8,40%; distrofia de Fuchs, 59 casos (6,88%; seqüela de tracoma, 28 casos (3,27%; outras causas, 32 casos (3,74%. Entre as crianças até 10 anos a principal causa de indicação de transplante foram as úlceras infecciosas (77,78% e entre 11-50 anos o ceratocone foi a principal causa (71,65%. CONCLUSÕES: Este estudo foi composto por uma população jovem e as principais causas de indicação de transplante foram o ceratocone e os transplantes tectônicos.PURPOSE: To determine the main causes of penetrating keratoplasty indications at "Hospital das Clínicas-UNICAMP" (January, 1999 to December, 2003. METHODS: A non-comparative, retrospective series of case studies. The authors reviewed the files of 857 patients who underwent penetrating keratoplasty at "Hospital das Clínicas-UNICAMP" between 1999-2003 and classified them into different categories according to diagnostic indication for surgery. RESULTS: The age range was between 0-88 years (average 44 years ±1.2. The main causes of penetrating keratoplasty were: keratoconus in 427 cases (49.82%; 152 cases (17.74% of corneal ulceration (perforated or not; corneal graft failure in 87

  16. Trombose da artéria carótida interna devida a trauma penetrante no pálato mole: relato de caso

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    BORGES GUILHERME

    1999-01-01

    Full Text Available Descrevemos caso de trauma penetrante na região oral em criança, evoluindo com oclusão da artéria carótida interna e déficit neurológico correspondente. A tomografia computadorizada e a ressonância nuclear magnética demonstram a oclusão completa da artéria carótida interna. Enfatizamos esta rara complicação de trauma oral, comum em crianças e discutimos os aspectos patogênicos.

  17. HERIDAS PENETRANTES POR ARMAS DE FUEGO EN EL SISTEMA NERVIOSO CENTRAL: PRIMERA PARTE: ASPECTOS HISTÓRICOS Y NOCIONES DE BALÍSTICAS

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    LUQUE S, JORGE ENRIQUE

    2007-01-01

    Las heridas penetrantes al sistema nervioso central han sido desde épocas históricas un reto para el manejo médico, dada su complejidad, fisiopatología y la pobre recuperación de este tipo de lesiones. Aun en la época actual, con el sinnúmero de adelantos tecnológicos y el conocimiento cada vez más preciso de su fisiopatología, se continúan generando una serie de controversias acerca de su manejo. Desafortunadamente, la multitud de conflictos armados y la fácil disponibilidad de armas en el m...

  18. MORTALIDAD DE TRANSFUSIÓN MASIVA TEMPRANA EN PACIENTES CON TRAUMA PENETRANTE EN EL HOSPITAL UNIVERSITARIO SAN JORGE DE PEREIRA

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    Juan Pablo Arismendy-Muñoz

    2011-01-01

    Full Text Available La violencia y la accidentalidad son causas frecuentes de trauma en Colombia. Diferentes alternativas sobre el correcto manejo del paciente traumatizado han sido elaboradas debido a la necesidad de mejorar los protocolos para modificar de manera favorable el pronóstico de los pacientes; uno de estos ha sido la implementación de hemotransfusión masiva temprana. Se realizó un estudio con el objetivo de Identificar el número de pacientes ingresados al Hospital Universitario San Jorge de Pereira con trauma penetrante a cuello, tórax, abdomen y extremidades que cumplieron criterios para hemotransfusión masiva temprana y determinar el porcentaje de los que fueron transfundidos durante los meses de Febrero y Marzo de 2010. A partir de esto se llevó a cabo un estudio descriptivo que incluyó 64 historias clínicas de pacientes con diagnostico de trauma penetrante en las zonas anatómicas ya descritas, ingresados al Hospital universitario San Jorge de Pereira empleando un instrumento que incluía los criterios para hemotransfusión temprana y algunas variables epidemiológicas. Los resultados reflejan que el 3% de los pacientes incluidos, tenían criterios para trasfusión masiva temprana, esta no fue empleada en su protocolo de reanimación y el 97% de los pacientes estudiados no cumplía criterios de transfusión. Para determinar la utilidad de la trasfusión masiva temprana en el Hospital Universitario San Jorge, se requiere la implementación de protocolos de reanimación en los cuales se incluya los criterios de trasfusión temprana, con la finalidad de poder evaluar sobrevida en investigaciones ulteriores.

  19. Mortalidad de transfusión masiva temprana en pacientes con trauma penetrante en el hospital universitario San Jorge de Pereira

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    Juan Pablo Arismendy-Muñoz

    2012-09-01

    Full Text Available La violencia y la accidentalidad son causas frecuentes de trauma en Colombia. Diferentes alternativas sobre el correcto manejo del paciente traumatizado han sido elaboradas debido a la necesidad de mejorar los protocolos para modificar de manera favorable el pronóstico de los pacientes; uno de estos ha sido la implementación de hemotransfusión masiva temprana. Se realizó un estudio con el objetivo de Identificar el número de pacientes ingresados al Hospital Universitario San Jorge de Pereira con trauma penetrante a cuello, tórax, abdomen y extremidades que cumplieron criterios para  hemotransfusión masiva temprana y  determinar el porcentaje de los que fueron transfundidos durante los meses de Febrero y Marzo de 2010. A partir de esto se llevó a cabo un estudio descriptivo que incluyó 64 historias clínicas de pacientes con diagnostico de trauma penetrante en las zonas anatómicas ya descritas, ingresados al Hospital universitario San Jorge de Pereira empleando un instrumento que incluía los criterios para hemotransfusión temprana y algunas variables epidemiológicas. Los resultados reflejan que el 3% de los pacientes incluidos, tenían criterios para trasfusión masiva temprana, esta no fue empleada en su protocolo de reanimación y el 97% de los pacientes estudiados no cumplía criterios de transfusión. Para determinar la utilidad de la trasfusión masiva temprana en el Hospital Universitario San Jorge, se requiere la implementación de protocolos de reanimación en los cuales se incluya los criterios de trasfusión temprana,  con la finalidad de poder evaluar sobrevida en investigaciones  ulteriores

  20. Ulceração das placas psoriáticas - efeito cutâneo adverso do metotrexato em altas doses no tratamento da psoríase: relato de três casos

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    Ataíde Deborah Skusa de Torre

    2003-01-01

    Full Text Available Os autores relatam três casos de pacientes portadores de psoríase que utilizaram inadvertidamente doses elevadas de metotrexato e apresentaram ulceração das lesões cutâneas de psoríase. Os efeitos adversos cutâneos do metotrexato são raros, algumas vezes dose-dependentes, outras idiossincrásicos ou relacionados com alteração de metabolização da droga, ou, ainda, interações medicamentosas

  1. Perfil epidemiológico do trauma ocular penetrante antes e após o novo código de trânsito

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    Silber,Paulo Caldas; Souza,Luciene Barbosa de; Tongu,Maira Tiyomi Sacata

    2002-01-01

    Objetivo: Comparar o perfil epidemiológico dos pacientes com trauma ocular penetrante (TOP) antes e após a regulamentação do novo código de trânsito. Métodos: Estudo retrospectivo de 253 pacientes com TOP examinados na Seção de Trauma Ocular (UNIFESP) de janeiro de 1997 a abril de 1999. Os pacientes foram divididos em dois grupos: Grupo I, pacientes com trauma ocular antes da implantação do novo código; Grupo II, história de trauma após sua implantação. Os pacientes foram avaliados em relação...

  2. Endoftalmite por Candida albicans após transplante penetrante de córnea: relato de caso Candida albicans endophthalmitis following penetrating corneal graft: case report

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    Glaucio de Godoy

    2004-04-01

    Full Text Available Os autores relatam o caso de uma paciente submetida a transplante penetrante de córnea por ceratocone que evoluiu com resposta inflamatória exacerbada durante o período pós-operatório, suspeitando-se, inicialmente, de rejeição atípica e intensa ao botão doador. Houve períodos de melhora, seguidos por períodos de piora a cada tentativa de se reduzir o corticóide tópico. Iniciou-se terapia imunossupressora com ciclosporina via oral e altas doses de corticóide tópico, porém, a paciente desenvolveu endoftalmite por Candida albicans com acometimento do segmento anterior do olho e do corpo vítreo, mas sem surgimento de lesões coriorretinianas. Evoluiu de forma satisfatória após três injeções de anfotericina B 5µg intravítrea, cetoconazol 400 mg/dia via oral e clotrimazol tópico de 4/4 horas. Os autores discutem também as principais possibilidades de contaminação da paciente, sendo o quadro infeccioso provavelmente relacionado ao procedimento cirúrgico.The authors report a case of a patient submitted to penetrating corneal graft for keratoconus with an exaggerated inflammatory response during the postoperative period. The patient was suspected of having an atypical rejection to the donor button. There were periods of improvement, followed by periods of worsening of the inflammation at each attempt of reducing the topical corticosteroid. After initiating immunosuppressive therapy with cyclosporin and high doses of topical corticosteroid, the patient developed Candida albicans endophthalmitis affecting the anterior segment of the eye and the vitreous body, but sparing the chorioretina. The patient improved after three injections of 5 µg intravitreal amphotericin B, 400 mg oral ketoconazole daily and topical clotrimazole every four hours. The authors also discuss the main possibilities of contamination of the patient, the infectious picture probably being related to the surgical procedure.

  3. Guía de práctica clínica: cuidado de enfermería en UCI a la persona con trauma torácico penetrante

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    Myriam Parra

    2014-07-01

    Full Text Available En Colombia la violencia y sus múltiples manifestaciones constituyen hoy un problema multidimensional, socioculturalmente relevante y de elevada complejidad. Desde el campo de la salud, la violencia en Colombia es el principal problema de salud pública. Las estadísticas con relación a este fenómeno muestran que el trauma en el mundo occidental constituye la tercera causa de muerte después del cáncer y de las enfermedades cardiovasculares. La población más afectada por trauma es la menor de 45 años, presentando la máxima incidencia entre los 20 y 40 años. El trauma penetrante del tórax usualmente es causado por heridas por arma blanca o por arma de fuego. Mientras que el trauma cerrado ocurre por golpes, compresión o desaceleración, especialmente como consecuencia de accidentes de tráfico. Hablar de intervenciones o cuidados de enfermería eficaces para el cuidado de pacientes con trauma de tórax penetrante implica revisar en la literatura científica los resultados de estudios cualitativos y cuantitativos que aborden este tema. La técnica más indicada desde la labor investigativa es el diseño de una guía de manejo clínico basada en la evidencia científica. El objetivo fue diseñar una guía de práctica clínica basada en la evidencia para el cuidado de enfermería a la persona con trauma torácico penetrante en la Unidad de Cuidado Intensivo, con el fin de proporcionar la mejor evidencia para el cuidado. La metodología para el diseño de ésta fue la práctica de enfermería basada en la evidencia. Este proceso se desarrolló en cinco fases: a Selección y prelación del tema; b Elaboración de preguntas teniendo como base la metodología PICOT; c Los dominios definidos de enfermería y la determinación de desenlaces; d Búsqueda y síntesis de la evidencia; f Identificación de los estudios y la calificación de la evidencia. Se elaboraron 16 preguntas a partir de los dominios de enfermería definidos: dominio de diagn

  4. Trauma inguinal penetrante com formação de fístula arteriovenosa e pseudoaneurisma: relato de caso

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    Frederico Michelino de Oliveira

    2015-12-01

    Full Text Available Resumo Os autores apresentam um relato de caso de vítima de acidente de trabalho com ferimento penetrante em região inguinal direita com peça metálica em espiral, que evoluiu com fístula arteriovenosa da artéria femoral profunda com a veia femoral profunda associado a pseudoaneurisma envolvendo essas estruturas e a veia femoral comum. As fístulas arteriovenosas ocorrem frequentemente após traumas e a associação com pseudoaneurisma é fato raro, devendo ser tratadas precocemente após seu diagnóstico. O ultrassom duplex é atualmente o exame mais utilizado para a avaliação inicial e a arteriografia, o padrão ouro para diagnóstico. No paciente em questão foi realizado tratamento convencional com abordagem cirúrgica direta, sutura arterial e ligaduras venosas. Entretanto, nos dias atuais a cirurgia endovascular e a compressão guiada por ultrassom são métodos terapêuticos que têm sido utilizados com sucesso. O paciente evoluiu sem intercorrência, recebendo alta para acompanhamento ambulatorial com preservação do membro.

  5. Emprego experimental da poliuretana derivada de óleo de mamona (Ricinus communis L: em implantes lamelares, interlamelares e penetrantes na córnea de coelhos

    Directory of Open Access Journals (Sweden)

    Adriana Morales

    2005-02-01

    Full Text Available Há muito que se estudam métodos e materiais reparadores de córnea, em busca de uma melhor reposição tecidual e, principalmente, manutenção ou recuperação da visão. A pesquisa de novos biomateriais tem permitido produzir próteses capazes de desempenhar a função requerida, sem reação importante. Conhecendo-se os bons resultados obtidos com a utilização da poliuretana vegetal derivada de óleo de mamona (Ricinus communis L. em vários procedimentos, estudou-se sua implantação, em forma de membrana, na córnea, objetivando oferecer novo material para a reparação de lesões corneanas e a confecção de ceratopróteses biologicamente inertes. Utilizaram-se 28 coelhos, divididos em dois grupos (G1 e G2 e estes em subgrupos para avaliações de implantes lamelares e interlamelares aos 2, 7, 15, 30, 60 e 120 dias, e implantes penetrantes, aos 2, 7, 15, 30 e 60 dias de pós-operatório. Estudaram-se parâmetros como neovascularização, inflamação, transparência de córneas e implantes, bem como a aderência e viabilidade destes, através de exames oculares, e histopatológicos à microscopia óptica. Observou-se reação inflamatória branda em todos os períodos. Os implantes lamelares e penetrantes permitiram reparação da córnea e manutenção da integridade dos globos oculares, embora sofressem deiscência entre 5 e 28 dias de pós-operatório. Concluiu-se pela boa biocompatibilidade do material e pela possibilidade de empregar-se o polímero na reparação corneana e, possivelmente, em ceratopróteses.

  6. Trauma abdominal penetrante: quando não operar - relato de caso

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    Marlon Moda

    2015-10-01

    Full Text Available Introdução: A conduta em ferimento por arma de fogo (FAF abdominalmanteve-se inalterada durante décadas, com a laparotomia diagnóstica sendoobrigatória. No entanto, este conceito tem sido desafiado em alguns centroscom a prática do tratamento não operatório (TNO em casos selecionados.Uma das razões para a relutância em se adotar o TNO em pacientes comferimentos penetrantes de órgãos sólidos é a preocupação com outras lesões,como perfurações de vísceras ocas. Porém, a correta seleção de pacientespermite que o sucesso do tratamento seja atingido. Objetivo: Relatar o caso depaciente vítima de FAF em região dorsal com lesão diafragmática e hepática.Método: Informações obtidas por meio de anamnese, exame físico, e métodosde imagem aos quais o paciente foi submetido e revisão da literatura. Relatodo caso: Paciente jovem, encaminhado à unidade de emergência 60 minutosapós sofrer FAF em região dorsal. Estável hemodinamicamente, apresentavadiscreta dor abdominal a palpação e orifício de entrada de FAF em regiãoparavertebral direita em nível de T12 com projétil palpável em 5ºEIC na linhahemiaxilar direita. Resultado USG FAST negativo e TC de abdome demonstrouperfuração diafragmática e pequena área de contusão hepática e pulmonar,com pouco líquido livre em cavidade abdominal. Optou-se por realizar TNO,tendo o paciente permanecido estável e sem alterações em exames físico elaboratoriais e recebido alta no 6º dia. Conclusões: Na maioria das vezes osangramento de lesão de fígado cessa espontaneamente, em relação à lesãodo diafragma direito, o fígado oferece proteção bloqueando o orifício da lesão,impedindo, a migração das vísceras para o tórax. Dessa forma, a opção derealizar TNO, quando as condições necessárias estão presentes, não é,apenas, cientificamente correta, mas eticamente justificável.

  7. Uso do radar penetrante no solo (GPR na investigação dos solos dos tabuleiros costeiros no litoral norte do estado da Bahia

    Directory of Open Access Journals (Sweden)

    J. M. Ucha

    2002-06-01

    Full Text Available Foram estudados nove perfis ao longo de uma toposseqüência sobre os sedimentos do Grupo Barreiras, na Fazenda Rio Negro, município de Entre Rios (BA, utilizando a prospecção eletromagnética por meio do Radar Penetrante no Solo - "Ground-penetrating radar - GPR", objetivando analisar a utilização dessa ferramenta na aquisição de informações sobre as feições que ocorrem no solo, mediante a comparação entre os radargramas obtidos e a descrição pedológica. O equipamento utilizado foi um Geophysical Survey System modelo GPR SR system-2, com antena de 80 MHz. A análise radargramétrica confirmou o aparecimento dos fragipãs e duripãs em profundidade, que ocorrem sempre acompanhados de um processo de transformação dos solos do tipo Latossolo Amarelo e Argissolo Amarelo em Espodossolo. Os padrões de reflexão mostram claramente os domínios dos solos argilosos e dos solos arenosos, com e sem a presença dos horizontes endurecidos.

  8. Resultados pressóricos da esclerectomia profunda não penetrante no tratamento do glaucoma primário de ângulo aberto Tensional results of non-penetrating deep sclerectomy in the treatment of primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Ricardo Augusto Paletta Guedes

    2004-08-01

    Full Text Available OBJETIVO: O presente estudo tem como objetivo avaliar a eficácia, por meio da análise de seus resultados pressóricos, da esclerectomia profunda não penetrante para tratamento cirúrgico do glaucoma primário de ângulo aberto. MÉTODOS: Estudo retrospectivo de 104 olhos operados pela técnica de esclerectomia profunda não penetrante de 1999 a 2002. Nos casos em que havia risco para falência da bolsa filtrante (idade inferior a 45 anos, negros, cirurgia ocular prévia a mitomicina C foi utilizada. A análise dos resultados foi feita avaliando-se a pressão intra-ocular final. A taxa de sucesso foi calculada para toda a população e separando os grupos com e sem utilização de mitomicina C. RESULTADO: Para uma pressão intra-ocular pré-operatória média de 22,57±4,92 mmHg, os autores encontraram uma pressão intra-ocular pós-operatória média de 14,22±2,89 mmHg com tempo médio de acompanhamento de 19,4 meses. A mitomicina C foi utilizada em 80 olhos. O sucesso absoluto (pressão PURPOSE: The aim of this study is to assess the efficacy, of the non-penetrating procedure for surgical treatment of primary open-angle glaucoma, by the analysis of its tensional results. METHODS: Retrospective study of 104 eyes with primary open-angle glaucoma submitted to a non-penetrating deep sclerectomy from 1999 to 2002. Mitomycin C was used in cases with high risk for bleb failure, such as, age under 45 years, blacks, previous ocular surgery. Final mean intraocular pressure was observed and success rate was calculated for the whole population and for each group (with and without mitomycin C RESULTS: For a mean preoperative intraocular pressure of 22.57±4.92 mmHg, the authors found a mean final intraocular pressure of 14.22±2.89 mmHg. Mitomycin C was used in 80 eyes. Absolute success (intraocular pressure <18mmHg without medication for the entire group was 82.7%, with a follow-up of 19.4 months on average. Success rate after 3 years of follow-up, by

  9. Natural latex graft in lamellar and penetrating sclerectomies in rabbits Enxerto de látex natural na cicatrização de esclerectomias lamelar e penetrante em coelhos

    Directory of Open Access Journals (Sweden)

    Ivia Carmem Talieri

    2009-09-01

    Full Text Available The objective of study was to investigate the effects of natural latex with 0.1% of polylysine on lamellar and penetrating scleroctomies in rabbits. Two groups of twelve rabbits each (lamellar GI and penetrating GII were studied. Scleral square incisions near the limbus were performed on the left eye of each animal. The latex biomembrane was fixed to the recipient sclera and it covered with a conjunctival flap. The clinical evaluations were followed for 60 days. Aplannation tonometry, binocular indirect ophthalmoscopy and slit-lamp biomicroscopy were performed during evaluation. Bright field microscopy and polarization microscopy were employed. Blepharospasm, graft infection, mucoid ocular discharge and chemosis were not observed in either treatment group. The conjunctival hyperemia varied from moderate to hardly noticeable. The postoperative IOP was not statiscally significant, comparing to the preoperative IOP, for GI and GII. The histopathology by polarization microscopy showed that the neoformed tissue was primarily dependent on adjacent vascularized tissues and was constituted by collagen type III. Both groups presented optimum graft adhesion to the receiving sclera. The natural latex biomembrane with 0.1% polylysine constitutes a new alternative for scleral reconstruction. Furthermore, this is a durable material, easy to obtain and manipulate.Este trabalho teve como objetivo investigar os efeitos do látex natural com polilisina a 0,1% na cicatrização de esclerectomias lamelar e penetrante em coelhos. Foram estudados dois grupos de 12 coelhos (GI - lamelar e GII - penetrante. As esclerectomias foram realizadas no olho esquerdo de cada animal. A biomembrana de látex foi fixada à esclera receptora e foi recoberta com conjuntiva bulbar. As avaliações clínicas foram realizadas durante 60 dias. Para tal, empregaram-se a tonometria de aplanação, a oftalmoscopia indireta binocular e a biomicroscopia em lâmpada de fenda. Realizou-se an

  10. Estudo retrospectivo dos transplantes penetrantes de córnea da Santa Casa de Porto Alegre Retrospective study of penetrating keratoplasty at the Santa Casa of Porto Alegre

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    Caroline Fabris

    2001-10-01

    Full Text Available Objetivos: Traçar o perfil clínico e social dos pacientes submetidos a transplante de córnea e avaliar as principais indicações desses transplantes, tempo de espera para doação e os índices de sucesso, rejeição e falência dos transplantes penetrantes de córnea. Métodos: Foram analisados retrospectivamente os prontuários de 87 pacientes submetidos a transplante penetrante de córnea no Serviço de Oftalmologia da Santa Casa de Porto Alegre entre janeiro de 1990 e dezembro de 1998, totalizando 91 olhos. Destes, 56 pacientes foram chamados para avaliação clínica do enxerto durante o levantamento de dados para este estudo. Resultados: Considerando-se os 91 transplantes (87 pacientes, 53 (60,9% foram realizados em pacientes do sexo masculino e 34 (39%, do sexo feminino. A idade variou de 3 a 89 anos, com média de 42,3 ± 19,8 anos. As principais indicações para transplante de córnea foram ceratocone em 32 (35% olhos, ceratopatia bolhosa (pós-facectomia, distrofia de Fuchs e outros em 24 (26,4%, trauma mecânico em 9 (9,9%, causas infecciosas em 9 (9,9%, queimadura química em 2 (2,2%, queimadura térmica em 1 (1,1% e outras causas em 14 (15,4% olhos. O tempo médio de espera por doação de córnea foi de 17,3 ± 9,9 meses. Do total de 91 olhos transplantados, 25 (27,5% apresentaram rejeição e 12 (13,2% olhos apresentaram falência do transplante. Conclusões: Este estudo mostrou a epidemiologia dos pacientes transplantados. A falta de dados seriados devido à alta precoce e perda de acompanhamento dos pacientes tornou impossível a análise e a comparação dos resultados pós-operatórios com outros estudos.Purpose: To describe the clinical and social profile of recipient patients of transplanted corneas, and to evaluate main indications for corneal transplants, waiting time for donor tissue, and percentages of success, rejection and failure of penetrating keratoplasty. Methods: Retrospective chart review of 87 patients

  11. Contribution to the study of the arterial vascularization of the testicles in donkey of the Pega race

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    André Luiz Quagllato Santos

    1993-12-01

    Full Text Available Estudou-se o comportamento da artéria testicular e seus ramos, bem como o número e distribuição dos vasos penetrantes, em 30 pares de testículos de jumentos da raça Pega, adultos e procedentes de várias regiões do Estado de Minas Gerais, mediante a análise de esquemas de modelos obtidos por corrosão após injeção de acetato de “vinyl”. Observou-se que nestes animais essa artéria oferece quatro arranjos vasculares diferentes, de acordo com sua divisão com predomínio de um ou outro dos vasos resultantes na irrigação do órgão. Quanto à distribuição dos vasos penetrantes, por quadrante, em mediana, faz-se de maneira que nos testículos direitos o quadrante mais povoado é o craniomedial (17.0, sendo seguido pelos quadrantes caudomedial e craniolateral (15,5 e caudolateral (15,0. Por outro lado, nos testículos esquerdos o quadrante caudolateral mostra o maior número de vasos penetrantes (18,5, seguido pelos quadrantes craniolateral (17,0, craniomedial (16,0 e caudomedial (14.0. Indentificou-se a presença de anastomoses que ocorrem entre a artéria testicular e seus ramos ou entre os diferentes colaterais cedidos pela própria artéria. Relativamente ao número total de vasos penetrantes, encontrou-se em mediana, 66,5 e 66,0 vasos para os testículos direitos e esquerdos, respectivamente, o que estatisticamente não é significante ao nível de α = 0,05, quando comparamoso número de vasos penetrantes dos testículos direitos e esquerdos.

  12. Mannan-binding lectin and healing of a radiation-induced chronic ulcer--a case report on mannan-binding lectin replacement therapy

    DEFF Research Database (Denmark)

    Maaløe, Nanna; Bonde, C; Laursen, I

    2011-01-01

    Mannan-binding lectin is an important component of innate immunity, and insufficiency is associated with several clinical disorders. Recently, experimental replacement therapy with plasma-derived mannan-binding lectin has become an option. The current article presents the case of a patient with a...

  13. Tensional results of non-penetrating deep sclerectomy in the treatment of primary open-angle glaucoma

    OpenAIRE

    Guedes, Ricardo Augusto Paletta; Guedes, Vanessa Maria Paletta

    2004-01-01

    OBJETIVO: O presente estudo tem como objetivo avaliar a eficácia, por meio da análise de seus resultados pressóricos, da esclerectomia profunda não penetrante para tratamento cirúrgico do glaucoma primário de ângulo aberto. MÉTODOS: Estudo retrospectivo de 104 olhos operados pela técnica de esclerectomia profunda não penetrante de 1999 a 2002. Nos casos em que havia risco para falência da bolsa filtrante (idade inferior a 45 anos, negros, cirurgia ocular prévia) a mitomicina C foi utilizada. ...

  14. Retrospective study of penetrating keratoplasty at the Santa Casa of Porto Alegre

    OpenAIRE

    Fabris, Caroline; Corrêa, Zélia Maria S.; Marcon, Alexandre S.; Castro, Terla Nunes de; Marcon, Ítalo Mundialino; Pawlowski, Cristiane

    2001-01-01

    Objetivos: Traçar o perfil clínico e social dos pacientes submetidos a transplante de córnea e avaliar as principais indicações desses transplantes, tempo de espera para doação e os índices de sucesso, rejeição e falência dos transplantes penetrantes de córnea. Métodos: Foram analisados retrospectivamente os prontuários de 87 pacientes submetidos a transplante penetrante de córnea no Serviço de Oftalmologia da Santa Casa de Porto Alegre entre janeiro de 1990 e dezembro de 1998, totalizando 91...

  15. Trauma hepático: análise do tratamento com balão intra-hepático em um hospital universitário de Curitiba

    OpenAIRE

    Smaniotto,Benjamin; Bahten,Luiz Carlos Von; Nogueira Filho,Dorivam Celso; Tano,Agajanian Lumi; Thomaz Junior,Laertes; Fayad,Omar

    2009-01-01

    OBJETIVO: Discutir a estratégia cirúrgica para tratamento de lesões hepáticas penetrantes graves através de tamponamento com balão intra-hepático. MÉTODOS: Estudo retrospectivo com 18 pacientes com trauma hepático penetrante, tratados com balão, atendidos em um hospital de referência em trauma no sul do Brasil. Foram avaliados: idade, sexo, grau da lesão hepática, segmentos acometidos, quantidade de solução salina infundida no balão intra-hepático e seu tempo de permanência, lesões associadas...

  16. Trauma abdominal penetrante consecutivo à corrente elétrica industrial

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    Átila Varela Velho

    Full Text Available The authors present a case report of a victim of high power electric shock. The main electric lesion was a penetrating abdominal wound with loss of substance of the abdominal wall and an electric lesion of the hepatic segment and of the gallbladder. The surgical treatment included hepatic segmentectomy, cholecystectomy, repair of the abdominal wall with Marlex prosthesis and skin graft, besides the debridment of the lesions of extremities. The postoperative evolution was satisfactory and the follow-up for 6 months didn't show any sequelae.

  17. Necrotizing nocardial scleritis after combined penetrating keratoplasty and phacoemulsification with intraocular lens implantation: a case report and review of the literature Esclerite necrosante por Nocardia após ceratoplastia penetrante e facoemulsificação com implante de lente intra-ocular: caso clínico e revisão de literatura

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    Jerome Charles Ramos-Esteban

    2007-03-01

    Full Text Available We report the history and clinical presentation of an 88-year-old female with Fuchs dystrophy who developed an acute anterior necrotizing scleritis in her left eye 23 months after an uncomplicated combined penetrating keratoplasty and phacoemulsification with intraocular lens implantation which progressed to slceral perforation with uveal prolapses. The patient underwent a complete systemic work-up for both autoimmune and infectious causes of scleritis. Surgical specimens of the area of scleral perforation were sent for histology and microbiologic studies. Analysis of surgical specimens revealed the presence of culture-proven Nocardia asteroides as a causative agent for the patient's scleral perforation. Results of her systemic autoimmune work-up were not conclusive. Successful treatment with tectonic scleral reinforcement with donor corneal tissue and preserved pericardium, oral and topical trimethoprim-sulfamethoxazole and topical amikacin salvaged the globe and increased vision. The patient's final best-corrected visual acuity sixteen months after her last operation remains 20/70. Prompt surgical intervention with submission of appropriate specimens for pathological diagnosis and microbiology, along with consultation with rheumatologic and infectious disease specialists, are mandatory to minimize visual loss in cases of suspected infectious necrotizing scleritis.Relato de caso de esclerite necrosante aguda, evoluindo para perfuração escleral com prolapso uveal, 23 meses após procedimento de ceratoplastia penetrante e facoemulsificação com implante de lente intra-ocular no olho esquerdo sem intercorrências.A paciente foi submetida à avaliação completa auto-imune para esclerite. Biópsia da área de perfuração escleral foi encaminhada para avaliação patológica e microbiológica. Análise de material cirúrgico revelou presença de cultura proveniente de Nocardia asteroides como agente causal da perfuração escleral. Resultados de

  18. Corneal stromal dystrophies: a clinical pathologic study Distrofia corneana estromal: um estudo clínicopatológico

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    Elvira Barbosa Abreu

    2012-12-01

    Full Text Available INTRODUCTION: Corneal dystrophy is defined as bilateral and symmetric primary corneal disease, without previous associated ocular inflammation. Corneal dystrophies are classified according to the involved corneal layer in superficial, stromal, and posterior dystrophy. Incidence of each dystrophy varies according to the geographic region studied. PURPOSE: To evaluate the prevalence of stromal corneal dystrophies among corneal buttons specimens obtained by penetrating keratoplasty (PK in an ocular pathology laboratory and to correlate the diagnosis with patient age and gender. METHODS: Corneal button cases of penetrating keratoplasty from January-1996 to May-2009 were retrieved from the archives of The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry, Montreal, Canada. The cases with histopathological diagnosis of stromal corneal dystrophies were stained with special stains (Peroxid acid Schiff, Masson trichrome, Congo red analyzed under polarized light, and alcian blue for classification and correlated with epidemiological information (age at time of PK and gender from patients' file. RESULTS: 1,300 corneal buttons cases with clinical diagnose of corneal dystrophy were retrieved. Stromal corneal dystrophy was found in 40 (3.1% cases. Lattice corneal dystrophy was the most prevalent with 26 cases (65%. Nineteen were female (73.07% and the PK was performed at average age of 59.3 years old. Combined corneal dystrophy was found in 8 (20% cases, 5 (62.5% of them were female and the average age of the penetrating keratoplasty was 54.8 years old. Granular corneal dystrophy was represented by 5 (12.5% cases, and 2 (40% of them were female. Penetrating keratoplasty was performed at average age of 39.5 years old in granular corneal dystrophy cases. Macular corneal dystrophy was present in only 1 (2.5% case, in a 36 years old female. CONCLUSION: Systematic histopathological approach and evaluation, including special stains in all stromal

  19. Clinical application of a 3D-printed scaffold in chronic wound treatment: a case series.

    Science.gov (United States)

    Sun, Haining; Lv, Huayao; Qiu, Fanghui; Sun, Duolun; Gao, Yue; Chen, Ning; Zheng, YongKe; Deng, Kunxue; Yang, Yaya; Zhang, Haitao; Xu, Tao; Ren, Dongni

    2018-05-02

    This case series evaluates the safety and effectiveness of 3D-printed scaffold in chronic wounds. The scaffold is a composite of natural and synthetic materials, and can be prepared in the form of powder or membrane. We recruited patients with pressure ulcera (PU) and/or a diabetic foot ulcers (DFU). We used two methods: 3D-printed scaffolds alone, or 3D-printing powder mixed with platelet-rich fibrinogen (PRF). Clinicians and patients were asked to rate the scaffold's ease of application and comfort during use. A total of five patients were recruited; four with a PU and one with a DFU. For the patient treated with the 3D-printed scaffold membrane (n=1), their PU healed in 28 days, and for patients treated with the 3D-printed scaffold powder (n=2), their PUs healed in 54 days. For the patients treated with the 3D-printing powder mixed with PRF (n=2), the patient with a PU healed in 11 days, and the patient with the DFU healed in 14 days. All clinicians rated the 3D-printed scaffold as 'easy' or 'very easy' to use, and patients rated their comfort during wear and at dressing change as 'good' or 'very good'. This study demonstrated that 3D-printed scaffold was convenient to use, have the potential to improve wound healing rates, and provided a safe and effective way for treating chronic wounds.

  20. Linfoma cutâneo primário de grandes células B de apresentação atípica: relato de caso Primary cutaneous large B-cell lymphoma of atypical presentation: case report

    OpenAIRE

    Antônio René Diógenes de Sousa; Igor Santos Costa; Edmar Fernandes de Araujo Filho; Natália Braga Hortêncio Jucá; Weline Lucena Landim Miranda

    2011-01-01

    Linfomas cutâneos primários são definidos como neoplasias linfocíticas que se apresentam clinicamente na pele sem doença extracutânea no momento do diagnóstico e até por 6 meses após. Os autores relatam o caso de um paciente masculino, idoso, com história de pápulas em axila, há 3 meses, que evoluíram para ulceração. Ao exame, úlcera profunda de bordos irregulares, infiltrados, em axila direita. Exames físico e complementares não evidenciaram doença à distância. O histopatológico mostra infil...

  1. A difícil trajetória da mulher no patriarcalismo

    Directory of Open Access Journals (Sweden)

    Full Text Available Amnéris Maroni Abordo a “inveja do pênis” a partir de duas escolas de psicologia profunda: a psicanálise e a psicologia analítica. Interessa-me, sobretudo, o desenvolvimento emocional e mental dessas mulheres. Enfatizo três categorias: o furor julgador, o pensamento penetrante e o pensamento acolhimento. Essas três modalidades de experiência emocional e mental estão referidas, no artigo, ao real, à realidade interna e externa. O furor julgador desencadeia, através de opiniões irrefletidas e tradicionais, ataques à realidade externa e interna, ataques aos elos de ligação. O pensamento penetrante tenta inquirir, penetrar nos segredos da realidade vista como ambígua, indiscriminada, obscura, inconsciente. Com o pensamento acolhimento o real é colhido na própria fonte; o real se dá (conjunto ao pensamento.

  2. Carcinoma epidermóide oral em paciente jovem: relato de caso e revisão da literatura Oral squamous cell carcinoma in a young patient: case report and literature review

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    Silvio K. Hirota

    2006-06-01

    Full Text Available O carcinoma epidermóide constitui a neoplasia maligna mais comum da boca, afetando principalmente indivíduos com mais de 50 anos. Sua ocorrência em jovens, com idade inferior a 40 anos, é rara (1 a 6% dos casos. Descreve-se um caso de carcinoma epidermóide acometendo dorso e borda da língua, classificado como T2N1M0 (estádio III, em paciente do sexo feminino, leucoderma, 25 anos, não-fumante e não-etilista. A apresentação inicial do caso era de ulceração profunda com dor intensa. Fatores predisponentes locais e gerais, diagnóstico diferencial e prognóstico são discutidos, bem como a revisão da literatura referente a diversos aspectos do carcinoma epidermóide em jovens.Squamous cell carcinoma is the most common malignant neoplasm of the oral cavity, usually affecting individuals over 50 years of age. It rarely occurs in patients who are less than 40 years old (1 to 6%. This report describes a case of squamous cell carcinoma, staged T2N1M0 (stage III, involving the lateral border and dorsal surface of the tongue of a 25-year-old white female patient, with no smoking or drinking habits. Initial tumor presentation was of deep ulceration and intense pain. This report focuses on the etiological factors, differential diagnosis and prognosis related to the case. Additionally, a brief literature review regarding squamous cell carcinoma in young patients is also included.

  3. Ulcera cutanea provocada por hongos del genero Fusarium

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    Negroni Ricardo

    1997-01-01

    Full Text Available Se presenta el caso de un paciente oriundo y procedente del Paraguay, de 40 años de edad, portador de una ulceración crónica en cara externa del pie izquierdo, de 2 meses de evolución, debida a una hialohifomicosis por Fusarium oxysporum. Se destacan las características clínicas, métodos de diagnóstico y terapeútica de esta micosis, además de las diferentes etiologías a considerar en el diagnóstico diferencial de una úlcera en personas procedentes del área tropical o subtropical.

  4. Indicações de transplante de córnea no Hospital São Geraldo da Universidade Federal de Minas Gerais Indications for penetrating corneal graft at the São Geraldo Hospital of Minas Gerais Federal University

    Directory of Open Access Journals (Sweden)

    Rafael Canhestro Neves

    2010-04-01

    Full Text Available OBJETIVO: Confrontar com a literatura os dados relacionados à idade, sexo e indicação dos transplantes penetrantes de córnea efetuados no Hospital São Geraldo da Universidade Federal de Minas Gerais (UFMG, de janeiro de 1999 a dezembro de 2005. MÉTODOS: Realizou-se estudo retrospectivo de 887 ceratopatias penetrantes, com dados obtidos dos arquivos da Central Estadual de Notificação de Minas Gerais, MG Transplantes, e dos prontuários dos pacientes do Departamento de Córnea do Hospital São Geraldo. Os dados analisados foram: idade, sexo e diagnóstico pré-operatório das alterações corneanas. As indicações de transplante do período de janeiro de 1999 a junho de 2002 foram comparadas as de julho de 2002 a dezembro de 2005. RESULTADOS: A média da idade dos pacientes foi de 48,3 anos, variando de 4 meses a 97 anos. As principais indicações de transplante penetrante de córnea foram: lesão ulcerativa (34,95%, ceratocone (16,35%, ceratopatia bolhosa do psedofácico (16,01%, leucoma (14,09%, falência primária (7,89%, rejeição (5,64%, distrofia endotelial de Fuchs (1,92%, outras distrofias (1,47%, causa indeterminada (1,23% e outras causas (0,45%. CONCLUSÃO: A principal indicação de transplante foi para úlcera de córnea em vias de perfuração ou perfurada, responsável por 310 ceratopatias penetrantes. As indicações eletivas mais frequentes de transplantes foram para ceratocone, ceratopatia bolhosa do psedofácico e leucoma, com o crescimento das indicações para ceratopatia bolhosa do psedofácico no período. Mesmo com um aumento significativo no número de transplantes realizados, estratégias que busquem reduzir a alta incidência de ceratopatias penetrantes emergenciais decorrentes de úlceras corneanas devem ser implantadas.PURPOSE: To determine and compare with the literature data related on age, sex and the main indications for penetrating keratoplasty at the São Geraldo Hospital of Federal Universidade of

  5. Efecto del calcio en aplicaciones precosecha y poscosecha sobre la severidad de antracnosis (Colletotrichum gloeosporioides y la calidad de frutos de papaya (Carica papaya

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    Daniel Saborío

    2000-01-01

    Full Text Available Se evalu6 el efecto de aplicaciones pre- cosecha y poscosecha de calcio en papaya va- riedad "criolla" sabre la severidad de antracno- sis (CoUetotrichum gloeosporioides y varia- hIes de calidad del fruto. Los tratamientos pre- cosecha fueron 4: aspersi6n de CaCl2 al 1% Y 4% (2 aplicaciones: <40 dfas posantesis (dpa y entre 100-140 dpa con el penetrante alquilaril- polimero (NP- 7 Bayer (0.4 mIlL, CaCO3 al suelo (1 ton/ha, 70 dpa y testigo (0% Ca. El diseno experimental fue un BCA (4 repeticio- nes de 20 frutos. Los tratamientos poscosecha fueron 3: inmersiones par 5 min con 0%, 1 % Y 4% de CaCI2, con el mismo penetrante. El dise- no experimental fue un BCA (3 repeticiones de 15 frutas. Se evalu6 severidad, % calcio en cascara, brix, pH, % acidez, firmeza (cascara y pulpa y % de madurez. En la aplicaci6n de cal- cia precosecha la severidad fue: 1 % CaC12 con 6%, testigo 7%, CaCO3 9% y 4% CaC12 con 11 %, no se encontr6 que el Ca tuviera un efec-

  6. Early X-ray diagnosis of coxarthrosis

    International Nuclear Information System (INIS)

    Lingg, G.; Nebel, G.

    1982-01-01

    Radiological and pathological comparisons on specimen of femurhead and neck at autopsy have shown a statistical relationship between osteophytosis of the femoral head and ulcerations of the joint cartilage. Especially there are highly significant relationships between the length of osteophytes and the diameter of the ulcera. The 'plaque'-sign shows to be a very sensitive indicator of early arthrosis. So there exist semiquantitative parameters for the X-ray diagnosis of early coxarthrosis. (orig.) [de

  7. Early x-ray diagnosis of coxarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Lingg, G.; Nebel, G.

    Radiological and pathological comparisons on specimen of femur head and neck at autopsy have shown a statistical relationship between osteophytosis of the femoral head and ulcerations of the joint cartilage. Especially, there are highly significant relationships between the length of osteophytes and the diameter of the ulcera. The 'plaque'-sign is shown to be a very sensitive indicator of early arthrosis. So there exist semiquantitative parameters for the X-ray diagnosis of early coxarthrosis.

  8. PREVALENCIA DE LESIONES RELACIONADAS CON LA DEPENDENCIA EN PACIENTES HOSPITALIZADOS

    OpenAIRE

    Herrero-Montes, Manuel; Olavarría-Beivide, Encarnación; Parás-Bravo, Paula; Cacidedo-González, Raquel; Revuelta-Arroyo, Rosana; Gómez-Muñoz, Isabel

    2015-01-01

    Objetivos Determinar la prevalencia puntual de lesiones relacionadas con la dependencia (LRD) en pacientes hospitalizados en el Hospital Sierrallana/ Tres Mares (HSLL), Cantabria. Clasificar las lesiones según los criterios propuestos por el Grupo Nacional para el Estudio y Asesoramiento en Ulceras por Presión y Heridas Crónicas (GNEAUPP) en su documento técnico Nº II (mayo 2014). Métodos Estudio de prevalencia. Población: Pacientes ingresados en el área de hospitalización del ...

  9. Ulcera gastro duodenal y parasitosis en Bogotá, D.E.

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    Alberto Albornoz Plata

    1956-08-01

    Full Text Available Posiblemente la úlcera péptica ocupa los primeros puestos en frecuencia en las Estadísticas Gastroenterológicas. Su tratamiento contempla la erradicación o control de cualquier otra enfermedad concomitante: así es frecuente que al tratar una Sinusitis o al controlar un estado emocional, el tratamiento antiulceroso adquiere un terreno firme y así hay más probabilidad de éxito.

  10. Caracterización y tratamiento de las úlceras por presión en instituciones de salud pública y privada y residencias geriátricas del Uruguay

    OpenAIRE

    García Parodi, Lucía

    2013-01-01

    El presente estudio tiene como objetivo conocer las características que presentan las Ulceras por Presión ( localización, severidad de las lesiones, antigüedad) y cuales son las estrategias de tratamiento existentes ( toma de decisión, tipo de cura, frecuencia, existencia de protocolos institucionales) por parte del personal sanitario que asiste a los pacientes hospitalizados en instituciones de salud públicas y privadas y residenciales geriátricos del Uruguay. Máster en Gestión Integral e...

  11. VI Jornada y I Taller en Medicina Equina : Avances diagnósticos y terapéuticos en patologías de pie, tórax y abdomen

    OpenAIRE

    Facultad de Ciencias Veterinarias

    2016-01-01

    Presentación Programa Ponencias Infecciones por Corynebacterium pseudotuberculosis en caballos: Aumento de la frecuencia y propagación a nuevas regiones de América del Norte | S. J. Spier y V. Azevedo Abscesos abdominales por Corynebacterium pseudotuberculosis | MaryBeth Whitcomb & Sharon Spier Traumatismos penetrantes del casco de equino - Diagnóstico y tratamiento incluyendo perfusión regional de la porción distal de los miembros | Isabelle Kilcoyne Actualización en diagnó...

  12. Estudo retrospectivo de 207 casos de tumores mamários em gatas

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    Monique Togni

    2013-03-01

    Full Text Available Este estudo teve como objetivos determinar os tumores mais prevalentes em gatos e relacionar os tumores mamários a alguns de seus fatores prognósticos. Os arquivos do Laboratório de Patologia Veterinária (LPV da Universidade Federal de Santa Maria (UFSM foram revisados e um total de 1.427 protocolos de biopsias e necropsias de felinos, entre 2000 e 2011, foi encontrado. Com base nas informações dos arquivos, foi estabelecida a relação entre os tumores e alguns fatores como sexo, idade, raça, estado reprodutivo, uso de contraceptivos, número e localização das glândulas afetadas, ulcerações, tamanho do neoplasma, metástases distantes e para os linfonodos. Assim, observou-se que os tumores de mama foram o segundo diagnóstico mais prevalente, após os tumores de pele. Todos os gatos com tumores mamários eram fêmeas, sendo os sem raça definida e os idosos os mais afetados. Os neoplasmas malignos foram diagnosticados com maior frequência, seguidos pelos tumores não neoplásicos e pelos neoplasmas benignos. Os tumores menores eram, na sua maioria, carcinomas. Ulcerações estavam presentes não só em neoplasmas malignos, mas também em alterações não neoplásicas. Metástases distantes foram encontradas principalmente nos pulmões e na pele.

  13. Incidência de fístulas digestivas nos ferimentos toracoabdominais

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    Mario Mantovani

    Full Text Available Os ferimentos penetrantes localizados na transição toracoabdominal (FTA, além da dificuldade diagnóstica, merecem especial atenção em relação à conduta adotada para o controle das complicações abdominais. Os autores analisaram 110 pacientes atendidos na Disciplina de Cirurgia do Trauma do Departamento de Cirurgia da UNICAMP, de 1988 a 1998, apresentando ferida penetrante toracoabdominal e submetidos à laparotomia exploradora com drenagem pleural fechada. As fístulas digestivas foram estudadas quanto à incidência, ao tratamento e à evolução pós-operatória. Do total de pacientes, 91 (82,7% eram do sexo masculino e 19 (17,3% do sexo feminino. A faixa etária situou-se entre 13 e 63 anos. Os FTA foram causados por projétil de arma de fogo (PAF em 60 (54,5% casos e por arma branca (FAB em 50 (45,5%. As fístulas digestivas ocorreram em seis (5,4% dos pacientes estudados, sendo quatro (3,6% casos de fístula pancreática, um (0,9% de fístula gástrica e um (0,9% de fístula biliar, todos tratados de maneira conservadora, apresentando evolução favorável com resolução espontânea.

  14. Perfil epidemiológico do trauma ocular penetrante antes e após o novo código de trânsito Epidemiological profile of penetrating ocular trauma before and after the new traffic code

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    Paulo Caldas Silber

    2002-08-01

    Full Text Available Objetivo: Comparar o perfil epidemiológico dos pacientes com trauma ocular penetrante (TOP antes e após a regulamentação do novo código de trânsito. Métodos: Estudo retrospectivo de 253 pacientes com TOP examinados na Seção de Trauma Ocular (UNIFESP de janeiro de 1997 a abril de 1999. Os pacientes foram divididos em dois grupos: Grupo I, pacientes com trauma ocular antes da implantação do novo código; Grupo II, história de trauma após sua implantação. Os pacientes foram avaliados em relação a diferentes aspectos do trauma e exame oftalmológico. Resultados: Os achados epidemiológicos em relação à idade, sexo e raça foram similares em ambos os grupos. No grupo I, os pacientes entre 21 e 50 anos apresentaram distribuição similar quanto à etiologia do trauma, ao passo que no grupo II, no mesmo intervalo de idade, predominaram os acidentes automobilísticos. Em relação ao uso do cinto de segurança, 60% e 92% dos pacientes não estavam usando o cinto, nos grupos I e II, respectivamente. 60% dos pacientes no grupo II mencionaram consumo de álcool, contra 40%, no grupo I. Conclusão: Apesar das medidas de impacto tomadas pelo governo para controlar os acidentes, os danos do trauma ocular continuam relacionados a fatores passíveis de prevenção, como o uso do cinto de segurança e consumo de álcool.Purpose: To study the epidemiologic profile of the patients with penetrating ocular trauma (POT before and after the application of the new traffic code. Methods: Retrospective study of 253 patients with POT examined at the Ocular Trauma Section (UNIFESP from January 1997 to April 1999. The patients were divided into 2 groups: Group I, patients with ocular trauma before the new traffic code; Group II, trauma history after the new code. The patients were evaluated regarding different aspects on trauma and ophthalmic evaluation. Results: The epidemiological findings regarding age, sex and race were similar in both groups. In

  15. Capacidad predictiva de las escalas de valoración de riesgo de úlceras por presión y otras lesiones relacionadas con la dependencia en el paciente crítico

    OpenAIRE

    Roca Biosca, Maria Alba

    2016-01-01

    Las ulceras por presión (UPP) suponen un problema de salud que afecta a todos los niveles asistenciales y que adquiere una especial relevancia en las Unidades de Cuidados Intensivos donde encontramos niveles de prevalencia muy altos. Históricamente el término “úlcera por presión” ha sido el empleado para denominar tanto a aquellas lesiones cuyo mecanismo causal es la presión, como a aquellas que responden a etiologías distintas. Agrupar bajo un único nombre (UPP) a lesiones cuyo origen es ...

  16. Paniculite pancreática como a primeira manifestação de doença visceral: relato de caso Pancreatic panniculitis as the first manifestation of visceral disease: case report

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    Fernanda Homem de Mello de Souza

    2011-08-01

    Full Text Available A paniculite pancreática, condição patológica rara, acomete 2-3% dos pacientes com doença do pâncreas. Em 40% dos casos, precede manifestações de doença pancreática. Relata-se caso de paciente feminina, 71 anos, surgimento há 1 mês de nódulos eritematosos nas pernas que evoluíram para ulceração e saída de conteúdo amarelado. Sem sintomas abdominais. A biópsia revelou macrófagos vacuolizados e necrose gordurosa representada por áreas anfofílicas, de material amorfo. Exame laboratorial e TAC demonstraram pancreatite crônica. Presume-se que a liberação de enzimas pancreáticas, tais como a tripsina, pode aumentar a permeabilidade da microcirculação e, então, a lípase e a amilase causariam a necrose de gordura subcutânea observada nas lesões. Na histologia, observam-se "células fantasmas" e paniculite septal de início e posteriormente lobular. O tratamento direciona-se a resolução da doença basePancreatic panniculitis is a rare pathological condition affecting 2-3% of patients with pancreatic disease. In 40% of cases the condition precedes manifestations of pancreatic disease. We report the case of a 71-year-old female who presented with an erythematous tender node which had appeared one month previously, progressing to ulceration and yellowish exudation. No abdominal symptoms. Biopsy revealed fat necrosis and vacuolated macrophages represented by amorphous amphophilic areas. Laboratory examination and CT scan revealed chronic pancreatitis. It is assumed that release of pancreatic enzymes such as trypsin may enhance the permeability of the microcirculation leading to lipase and amylase causing the subcutaneous fat necrosis observed in the lesions. Histology showed "ghost cells" and, firstly, septal panniculitis, followed later by lobular panniculitis. Treatment focused on resolution of the underlying pancreatic disease

  17. ANÁLISE CLÍNICA E HISTOLÓGICA DA UTILIZAÇÃO DA RESINA ACRÍLICA AUTOPOLIMERIZÁVEL NAS FRATURAS DE MANDÍBULA E MAXILA E SEPARAÇÃO DA SÍNFISE MENTONIANA EM CÃES E GATOS CLINICAL AND HISTOLOGICAL EVALUATION OF ACRYLIC RESIN IN THE FRACTURE OF THE MANDIBLE AND MAXILLA AND SEPARATION OF MANDIBULAR SYMPHISIS IN DOGS AND CATS

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    Marco Antonio Gioso

    2001-04-01

    Full Text Available O trabalho foi desenvolvido em duas fases. A primeira constou de aplicação de resina acrílica autopolimerizável sobre dentes de cães experimentais, sem condicionamento ácido do esmalte dental; a gengiva foi analisada histologicamente nos períodos de um, três, sete, 14, 21 e 30 dias. A segunda fase foi conduzida em 20 cães e 10 gatos com fraturas do sistema estomatognático, atendidos no Ambulatório Central da FMVZ/USP. Nessa segunda fase, clínica, foi aplicado condicionamento ácido do esmalte. A resina era usada nas fraturas rostrais às raízes distais do primeiro molar inferior e do quarto pré-molar superior, bem como na separação da sínfise mentoniana. Os resultados da primeira fase mostraram que mesmo sem o condicionamento ácido houve aderência da resina acrílica sobre os dentes, embora houvesse necessidade de maior volume do material, o que provocou ulcerações dos tecidos moles da boca. Essa fase também evidenciou, à sondagem, que o epitélio de aderência sulcular permaneceu aderido, além de gengivite, ulceração da gengiva, língua e mucosa alveolar. A análise histológica revelou predominantemente ulceração dos tecidos em contato com a resina. Na segunda fase, todos os animais evidenciaram consolidação óssea das fraturas, além de gengivite e ulceração. Lesões periodontais foram encontradas em dois animais dos quais a resina foi removida tardiamente, com quatro e 12 meses após a aplicação, respectivamente. Em ambas as fases, os animais adaptaram-se bem à resina sobre os dentes.This paper was performed in two phases. In the first one, the stability of the acrylic resin over the teeth of dogs, without enamel acid conditioning, the clinical and histological reaction on the gingiva were analyzed in periods of 1, 3, 7, 14, 21 and 30 days. The second phase was conducted in 20 dogs and 10 cats, with acid etching technique. The resin was used in the rostral fractures to the distal roots of the lower first

  18. Postoperative irradiation of endometrial cancer by iridium afterloading technique

    International Nuclear Information System (INIS)

    Kucera, H.; Weghaupt, K.

    1988-01-01

    From 1981 to 1986 708 patients were operated and postoperativly treated by total hysterectomy, bilateral salpingo-oophorectomy and postoperative vaginal irradiation with high-dose-afterloading (iridium 192). A percutaneous irradiation (cobalt 60) was done in stage I cases only when myometrial infiltration was deep. Highly differentiated tumors with infiltration of the first and second thirth of the myometrium were treated by vaginal irradiation alone. Poorly differentiated tumors with infiltration of the second and third thirth of the myometrium were treated by vaginal and percutaneous irradiation. A group of 125 cases with good prognosis and with postoperative vaginal irradiation alone had the same five-year-survival of 83% as a group of 152 cases with bad prognosis treated by vaginal and percutaneous irrradiation. This result shows clearly the importance of additional irradiation of the pelvis in cases with bad prognosis factors. The incidence of radiation side effect in all 708 cases was: cystitis 4.6%, proctitis 5.2%, vaginal or rectal ulcera 1.4% and fistulas 0.2%. Cases with vaginal irradiation alone and with the optimal intravaginal fraction dose of 700 cGy (twice) had the lowest level of side effects: cystitis 3.8% proctitis 2.1%, vaginal necrosis 0.7%, no further severe complications. None of the patients with postoperative vaginal irradiation alone had a vaginal recurrence. The incidence of recurrences in 708 patients was 1.6%. All recurrence cases in stage I (0.7%) had bad prognosis factors and were treated with vaginal and percutaneous irradiation. (orig./MG) [de

  19. Therapy and prophylaxis of acute and late radiation-induced sequelae of the esophagus

    International Nuclear Information System (INIS)

    Zimmermann, F.B.; Geinitz, H.; Feldmann, H.J.

    1998-01-01

    Background: Radiation-induced esophagitis is a frequent acute side effect in curative and palliative radiotherapy of thoracal and cervical tumors. Late reactions are rare but might be severe. Methods: A resarch for reports on prophylactic and supportive therapies of radiation-induced esophagitis was performed (Medline, Cancerlit, and others). Results: Nutrition must be ensured and symptomatic relief of sequelae is important, especially in the case of dysphagia. The latter can be improved by topic or systemic analgetics. If esophageal spasm occurs, calcium antagonists might help. In case of gastro-esophageal reflux proton pump inhibitors should be used. There is no effective prophylactic measure for radiation esophagitis. Late side effects with clinical relevance are rare in conventional radiotherapy. Chronic ulcera, fistula or stenosis may develop. Before any treatment, a tumor infiltration of the esophagus should be excluded by biopsy. This can lead more often to late complications than radiation therapy itself. Nutrition should be ensured by endoscopic dilation, stent-implantation, or endoscopic percutaneous gastrostomy. Local injection of steroids might be used to avoid an early restenosis. Conclusions: An intensive symptomatic therapy of acute esophagitis is reasonable. Effective prophylaxis do not exist. Late radiation induced sequelae is rare. Therefore, a tumor recurrence should be excluded in cases of dysphagia. Securing nutrition by PEG, stent, or port is well in the fore. (orig.) [de

  20. Ensayo no destructivo de soldaduras en pernos conectores mediante inspección acústica

    OpenAIRE

    Aznar, A.; Cervera, J.; Ortiz, J.; Hernando, J. I.

    2012-01-01

    Los pernos conectores aportan múltiples ventajas de uso, entre las que se encuentra el elevado margen de seguridad que ofrecen sus soldaduras ejecutadas mediante arco eléctrico. Estas soldaduras, aunque ampliamente fiables, son difícilmente comprobadas mediante ensayos no destructivos. Aparte de la inspección visual, que aporta gran información sobre la calidad de ejecución de la soldadura, el resto de ensayos no destructivos (líquidos penetrantes, partículas magnéticas, ultrasonidos, radiogr...

  1. Cirugía de control de daños: alternativa quirúrgica eficaz para el trauma hepático grave Damage control surgery: efficacious surgical alternative for severe hepatic

    OpenAIRE

    Darwin Aníbal Iñaguazo Sánchez; Javier Mora Lazo; Jonathan Cobos Mina

    2007-01-01

    El trauma hepático se halla con mayor frecuencia en un individuo politraumatizado con alteraciones hemodinámicas y contusiones intraabdominales. Corresponden a lesiones penetrantes 80 % y 20 %, a trauma cerrado. Aproximadamente 3 % de estos pacientes acuden a los servicios de emergencias en shock hipovolémico grave. La mortalidad por trauma hepático ha disminuido considerablemente, lo que refleja no solo los avances en la atención médica prehospitalaria, sino también la adquisición de nuevas ...

  2. ESTADO ACTUAL DEL TRATAMIENTO MEDICO DE LA ULCERA PEPTICA, EXPERIENCIA COLOMBIANA

    Directory of Open Access Journals (Sweden)

    Alberto Albornoz Plata

    1984-07-01

    Full Text Available

    SUMARIO

    a La úlcera péptica en la actualidad ha sufrido un cambio positivo en su tratamiento médico y prevención desde el año 77, año de la introducción de la cimetidina y posteriormente con el hallazgo de otras drogas similares aún más potentes como la ranitidina, la oxmetidina y la droga antimuscarínica pirenzepina.
    En el futuro se vislumbra poder utilizar drogas anti-enzimáticas de acción sobre la célula
    parietal para bloquear sistemas enzimáticos necesarios para la producción del HCL (tipo omeprazoles, timotrazoles y fenoctimina.
    b Gracias a esas drogas la dieta es amplia, fácil de cumplir sin alterar los actos sociales y de trabajo del paciente. Todo esto obra indirectamente como un SISTEMA ANTI-STRESS ya que el paciente, sintiéndose mejor, pudiendo dormir por no tener dolor, llevando una vida normal tanto social como de trabajo, vive más tranquilo y más confiado. Todo esto le
    confiere un estado de seguridad, de tranquilidad y bienestar tanto mental como fisico.

    Los anti-ácidos se usan en plan opcional y ocupan un segundo lugar muy distante en la terapéutica antiulcerosa.
    Los antiguos anticolinérgicos prácticamente están entrando en la historia pasada de la farmacología como drogas antiulcerosas.
    c Un estudio multicéntrico colombiano con pirenzapina en 59 pacientes con enfermedad ulcerosa produce eficacia terapéutica en eI91.5% que es una cifra similar a la obtenida en otros países de Europa,

    Canadá y Estados Unidos, cifras que allí van desde el 68 hasta el 95% de éxito; los efectos colaterales son mínimos (algunos casos de sequedad bucal sin afectar las esferas sexual, hepática o cerebral.
    d La citoprotección que se logra con las drogas específicas es en la actualidad un gran avance terapéutico cuando hay necesidad de utilizar aspirinas, aspirinoides y/o esteroides en pacientes ulcerosos o con historia de enfermedad digestiva alta y más aún si hay antecedentes hemorrágicos.

  3. Massa paranasal: dacrioestenose congênita? Relato de caso Paranasal mass: congenital dacryostenosis? Case report

    Directory of Open Access Journals (Sweden)

    Claudia Akemi Shiratori

    2004-10-01

    Full Text Available O objetivo deste é descrever uma criança portadora de massa paranasal, atentando para a importância dos diagnósticos diferenciais. RELATO DO CASO: ACS, 6 meses, sexo feminino, desde o nascimento apresentando abaulamento não inflamatório, no canto medial do olho esquerdo, lacrimejamento e hiperemia no olho direito. Ao exame apresentava fenômeno de Bell negativo bilateral, lagoftalmo à direita, ulceração e opacidade corneana à direita; presença de lesão arredondada, de superfície lisa no canto medial do olho esquerdo, sem sinais inflamatórios, medindo aproximadamente 2 cm de diâmetro, não pulsátil. À palpação, a lesão era elevada, de consistência fibroelástica, imóvel, indolor, irredutível. À propedêutica das vias lacrimais, não havia refluxo à compressão, o teste de Milder foi negativo em ambos olhos e as vias apresentavam-se pérvias à dacriocistografia. O exame tomográfico revelou tratar-se de meningocele fronto-etmoidal. COMENTÁRIOS: Os autores chamam a atenção para a adequada semiologia para a investigação das massas paranasais, a fim de se instituir o adequado tratamento.Report of a child presenting a paranasal mass, and discussion of the importance of the differential diagnosis. CASE REPORT: ACS, 6 months old, female, presenting a non inflammatory nodulation on the left medial canthus; tearing and redness in the right eye since birth. On examination, there were bilateral lagophthalmos and corneal ulceration and opacity at the right side; on the left medial canthus there was a rounded lesion with a smooth surface, without inflammation, with an approximately 2-cm diameter. On palpation, the lesion was elevated, fibroelastic, non-mobile, painless, and irreductible. Tear or discharge reflux was absent on lacrimal pathway compression, Milder's test was negative on both sides. Dacryocystographic examination showed normal lacrimal drainage of the paranasal sinus system. Computadorized tomography revealed a

  4. Efeito imunossupressor da ciclosporina intra-muscular administrada em diferentes períodos pós-operatórios em um modelo de transplante penetrante de córnea em ratos Immunosuppressive effect of intramuscular cyclosporine used at different post-operative period on a penetrating keratoplasty model in the rat

    Directory of Open Access Journals (Sweden)

    Roberto von Hertwig

    1999-12-01

    Full Text Available Objetivo: Avaliar o efeito imunossupressor da ciclosporina intramuscular (I.M., administrada por tempo limitado em diferentes períodos do pós-operatório, no transplante penetrante de córnea em um modelo experimental em rato, por meio de avaliação clínica e anátomo-patológica do enxerto corneano. Método: Foram utilizados ratos isogênicos Fischer como doadores e Lewis como receptores, em um modelo ortotópico de transplante de córnea. A administração de ciclosporina I.M. 10 mg/kg/dia foi iniciada em diferentes períodos nos grupos estudados: no pós-operatório imediato, no 7º dia pós-operatório e no 9º dia pós-operatório. A ciclosporina quando iniciada foi administrada até o 30º dia pós-operatório. Um grupo controle não recebeu a ciclosporina I.M. Os enxertos corneanos foram avaliadas clínica e histologicamente. Resultados: Rejeição foi observada nas primeiras três semanas do pós-operatório em 100% dos casos no grupo controle (n = 5 que não recebeu a ciclosporina. Os ratos tratados com ciclosporina (n = 15 apresentaram rejeição em apenas um caso, que teve curta evolução e poucos sinais clínicos. Os estudos histológicos confirmaram as avaliações clínicas. O grupo controle apresentou infiltrado no enxerto corneal com predomínio de linfócitos sobre neutrófilos com mais neovasos, com mais fibrose e com infiltrado inflamatório mais intenso do que os grupos tratados com ciclosporina. Conclusão: Os dados obtidos indicam que a ciclosporina I.M., pode ter efeito benéfico sobre o controle da rejeição do transplante de córnea, mesmo na sua fase ativa.Purpose: Corneal graft rejection suppression after intramus-cular cyclosporine administration at different periods of time was studied on a penetrating keratoplasty rejection model in the rat. Methods: Inbred Lewis rats were used as recipients and Fischer rats were used as donors in a orthotopic rejection model of corneal transplantation. Intramuscular injection

  5. Hemorragia digestiva alta severa por úlceras de Cameron. Reporte de caso

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    Carolina Salinas

    2016-01-01

    Full Text Available Se reporta el caso de una mujer anciana con hemorragia digestiva alta y choque hipovolémico secundario a úlceras de Cameron. Dado que estas lesiones se caracterizan por presentar cuadros crónicos de hemorragia sin aparente repercusión, se hace una revisión de esta exótica causa de sangrado digestivo masivo con repercusión hemodinámica. Estas ulceras se deben a abrasión de la mucosa por la contracción del diafragma durante los movimientos respiratorios, lo que genera pérdidas crónicas de sangre.

  6. Aproximación a una escala de valoración de úlcera por presión en la unidad de cuidados intensivos del Complejo Hospitalario de Navarra - A

    OpenAIRE

    Saboya Saboya, Liz Amparo

    2013-01-01

    Las ulceras por Presión (UPP) son lesiones de rápida aparición y lenta curación, donde la frecuencia en pacientes críticos, en la Unidad de Cuidados Intensivos (UCI) representa hoy en día un grave problema. Los pacientes son más vulnerables a su aparición durante las primeras semanas de ingreso en la unidad, incrementándose cuando el paciente tiene mayor gravedad, pudiendo llegar incluso hasta la muerte. Para ello el primer paso en su prevención consistirá en la determinación de las UPP, a tr...

  7. Diário póstumo de Eugênio Montale

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    Égide Guareschi

    2017-10-01

    Full Text Available Este ensaio pretende examinar a abrangência de alguns elementos paratextuais, a partir dos delineamentos teóricos de Gérard Genette, que foram importantes na tradução brasileira de Diário Póstumo, obra poética de Eugênio Montale. Esse livro póstumo é dedicado à poeta Annalisa Cima e, além de possuir uma linguagem penetrante e íntima, é entremeado por referências extratextuais e pelas sutilezas do estilo montaliano, as quais desafiam os tradutores de sua obra.

  8. Hepatic trauma: a 21-year experience

    OpenAIRE

    Zago, Thiago Messias; Pereira, Bruno Monteiro; Nascimento, Bartolomeu; Alves, Maria Silveira Carvalho; Calderan, Thiago Rodrigues Araujo; Fraga, Gustavo Pereira

    2013-01-01

    OBJETIVO: avaliar os aspectos epidemiológicos, conduta, morbidade e resultados do tratamento trauma hepático. MÉTODOS: estudo retrospectivo de doentes com mais de 13 anos de idade admitidos em um hospital universitário de 1990 a 2010, submetidos ao tratamento cirúrgico ou não operatório (TNO). RESULTADOS: foram admitidos 748 pacientes com trauma hepático. O mecanismo de trauma mais frequente foi o trauma penetrante (461 casos; 61,6%). O trauma fechado ocorreu em 287 pacientes (38,4%). De acor...

  9. Embolização arterial no tratamento de hemobilia pós-trauma hepático: relato de caso

    OpenAIRE

    Queiroz,Hercilia Maria Carvalho; Costa,Francisco de Assis; Campos Junior,Manoel Messias de; Aquino,Ricardo Leite de; Linhares Filho,Frederico Augusto de Carvalho; Otoch,Marcelo

    2012-01-01

    Hemobilia é causa rara de hemorragia digestiva e complicação incomum no trauma hepático. Ocorre devido à comunicação entre ductos biliares e vasos intra-hepáticos. Os autores relatam um caso de paciente vítima de ferimento penetrante abdominal que evoluiu, após três meses da hepatorrafia, com dor, icterícia e hemorragia digestiva. Foi realizada angiografia, que demonstrou pseudoaneurisma de artéria hepática direita, e efetuada embolização com sucesso.

  10. Complicaciones usuales post-drenaje pleural con tubos endotorácico en el trauma torácico no

    OpenAIRE

    Juan C Araujo-Cuauro; Fernando Fernández-Parra; Edwinis Garcia-Fontalvo; Milagros Sánchez

    2016-01-01

    Las lesiones por trauma torácico que ameriten hospitalización, y la inserción de un tubo endotorácico El objetivo de la investigación es identificar las complicaciones post-drenaje pleural con tubos endotorácico en el trauma torácico no quirúrgico. Se trata de estudio prospectivo descriptivo y observacional de las historias clínicas de admisión de los pacientes con traumatismo torácico contuso o penetrante no quirúrgico, que ingresaron durante el período co...

  11. Canine Visceral Leishmaniasis in Rio de Janeiro, Brazil: clinical, parasitological, therapeutical and epidemiological findings (1977-1983

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    Mauro C. A. Marzochi

    1985-09-01

    Full Text Available Forty dogs from the periphery of the city of Rio de Janeiro were studied. All dogs where diagnosed as positive for leishmaniasis either parasitologically and/or serologically. Among them, 19 came from areas where only Visceral Leishmaniasis (VL occurs (Realengo, Bangu, Senador Camará. Clinical signs of the disease were seen in 36.8% of the cases, including emaciation - 100%, lymphadenopathy and depilation - 85.7%. The other 21 dogs came from an area (Campo Grande where both diseases (VL, and American Cutaneous Leishmaniasis - ACL occur. Clinical signs of the disease, mainly cutaneous or mucocutaneous ulcers were seen in 76.2% of the cases. Leishmania parasites were found in 39 cases: 22% in viscera, 42.5% in viscera and normal skin and 35% in cutaneous or mucocutaneous ulcers. All the Leishmania stocks isolated from dogs which came from Realengo, Bangu, Senador Camará (VL area, and from Campo Grande (VL + ACL area were characterized as L. donovani (except in one case according to their schizodeme, zymodeme and serodeme. The only stock characterized as L. b. braziliensis, was isolated from the lymph node of a dog from Campo Grande with visceral disease and without skin lesions. Antimony therapy attempted in eight Leishmania donovani positive dogs was unsuccessful.Durante inquéritos caninos realizados na periferia da cidade do Rio de Janeiro, foram estudados clínica e laboratorialmente 40 cães. Todos apresentavam diagnóstico parasitológico e/ou sorológico de leishmaniose. Dentre esses, 19 procediam de áreas de ocorrência de leishmaniose visceral (LV - Realengo, Bangu e Senador Camará. Sinais clínicos sugestivos da infecção foram observados em 36,8% deles (incluindo emagrecimento - 100%, linfadenopatia e depilação - 85,7%. Outros 21 cães procediam da área de Campo Grande onde tanto a LV como a leishmaniose tegumentar americana (LTA ocorrem. Sinais clínicos da infecção por Leishmania, principalmente ulcerações cutâneas e

  12. Epidermólise bolhosa distrófica recessiva mitis: relato de caso clínico Recessive dystrophic epidermolysis bullosa mitis: case report

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    Thaiz Gava Rigoni Gürtler

    2005-10-01

    Full Text Available As epidermólises bolhosas são dermatoses bolhosas congênitas que levam à formação de bolhas espontaneamente ou após trauma. São reconhecidos três grupos de da doença, de acordo com o segundo consenso internacional: simples, juncional e distrófica. Nas formas distróficas, o defeito genético deve-se à mutação no gene COL7A1, responsável pela codificação do colágeno VII, principal constituinte das fibrilas de ancoragem, que participam na aderência da lâmina densa à derme. Os autores relatam o caso de paciente do sexo feminino, de 15 anos, apresentando ulcerações nas pernas, bolhas serosas e lesões atrófico-acastanhadas nos braços e tronco. Foram observadas distrofias ungueais e alterações dentárias, iniciadas a partir do nascimento. O exame histopatológico da bolha revelou quadro compatével com epidermólise bolhosa, que, associado aos dados clínicos, permitiram a classificação do caso na forma distrófica recessiva mitis.Epidermolysis bullosa are congenital bullous dermatoses that lead to spontaneous or post-traumatic formation of blisters. There are three recognized disease groups, according to the second international consensus: simplex, junctional and dystrophic. The genetic defect of the dystrophic forms is due to a mutation in the COL7A1 gene, which is responsible for codifying collagen VII, the main representative of anchoring fibrils, which participate in the adherence of the "lamina densa" to the dermis. The authors describe a case of a 15 year-old female patient who presented ulcers on her legs, serous blisters and atrophic scars on her arms and body. Dystrophic ungual and dental abnormalities had also been observed since her birth. Blister histopathological examination was compatible with epidermolysis bullosa, which, in association with clinical data, allowed the classification of recessive distrophic epidermolysis bullosa.

  13. Bulbar ulcer and homeopathy. Ulcera bulbar y homeopatía. Úlcera bulbar y homeopatía.

    OpenAIRE

    Fabio S. Mangolini

    2003-01-01

    It is reported a case of bulbar ulcer healed after homeopathic treatment. This case serves to illustrate the efficacy of Homeopathy even when the patient concomitantly uses conventional remedies. The ulcer was anatomically healed notwithstanding H. pylori positive tests both before and after the treatment.

  14. Principais indicações de transplante penetrante de córnea em um serviço de referência no interior de São Paulo (Sorocaba - SP, Brasil Major indications for corneal penetrating keratoplasty at a reference service in São Paulo state (Sorocaba - SP, Brazil

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    Miguel José Calix Netto

    2006-10-01

    Full Text Available OBJETIVOS: Identificar as principais indicações de transplante penetrante de córnea e fornecer o perfil demográfico e epidemiológico dos pacientes encaminhados ao Projeto de triagem de transplante do Hospital Oftalmológico de Sorocaba. MÉTODOS: Foram analisados retrospectivamente os prontuários dos pacientes, no período de junho a dezembro de 2003, que foram encaminhados para o Projeto Transplante de Córnea em nosso serviço. RESULTADOS: Dos 171 pacientes estudados, 102 (59,6% pacientes eram do sexo masculino, 69 (40,3% do sexo feminino; a média de idade foi de 37 anos, 106 (49% possuíram indicação de transplante de córnea. Procedência dos pacientes encaminhados ao projeto transplante: São Paulo (68%, Minas Gerais (6%, Paraná (6%, Rio de Janeiro (5%, Maranhão (3% e outros (12%. As principais indicações de transplante de córnea em nosso estudo foram: ceratocone 65%, ceratopatia bolhosa do pseudofácico 21%, leucoma corneano 10%, distrofia de Fuchs 1,9%, distrofia lattice 0,9% e síndrome de Steven Johnson 0,9%. CONCLUSÃO: Muitos pacientes encaminhados para transplante em nosso serviço não apresentavam indicação para o mesmo, fato que demonstra o desconhecimento dos oftalmologistas gerais sobre as indicações reais do transplante de córnea. Quanto às principais doenças indicadas para transplante o ceratocone predominou, seguido da ceratopatia bolhosa do pseudofácico.PURPOSE: To identify the main indications for corneal transplantation, analyze the results and provide demographic and epidemiological profile of patients referred to the Corneal Transplantation Project. METHODS: A retrospective analysis, from June to December 2003, of patients referred to the Corneal Transplantation Project. RESULTS: Total of 171 patients. One hundred and two (59.6% patients were male and 69 (40.3% female; mean age was 37 years. One hundred and six (49% patients had indication for corneal transplantation. The origins of patients were

  15. La traza foucaulteana en el debate filosófico contemporáneo en torno a la biopolítica

    OpenAIRE

    Podestá, Beatriz; Genovese, Cristina

    2011-01-01

    Parece evidente que la discusión en torno a la categoría de “biopolítica” se ha intensificado en las últimas décadas como intento de comprender la lógica profunda de las recientes e inéditas derivas sociales, culturales y políticas del mundo contemporáneo. Desde la vida individual a la vida social, desde el cuerpo tecnológico al cuerpo social, nada escaparía a esta sutil y penetrante tendencia. No en vano en su obra Homo sacer Agamben, siguiendo ciertos desarrollos de Foucault y Arendt, co...

  16. Ecografía fast en la evaluación de pacientes traumatizados

    OpenAIRE

    Felipe Catán, G.; Diva Villao, M.; Cristián Astudillo, D.

    2011-01-01

    El manejo inicial de los pacientes politraumatizados es uno de los mayores desafíos de la práctica clínica, ya que se requiere tomar decisiones muy rápidas basadas principalmente en criterios clínicos. La ecografía FAST ha demostrado ser útil para la detección de sangrado en el tórax y el abdomen, además de permitir detectar taponamiento cardiaco en paciente con trauma torácico penetrante y sospechar la presencia de neumotórax. Esto la ha transformado en una herramienta valiosa para la toma d...

  17. Pilomatricoma recidivado em região superciliar esquerda: relato de caso Recurrent pilomatricoma on the left eyebrow: case report

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    Marcio Henrique Mendes

    2009-06-01

    Full Text Available Pilomatricoma é um tumor benigno oriundo do folículo pilossebáceo, que surge como nódulo intradérmico durante a infância na maioria dos casos. Geralmente é recoberto por pele normal, alcança em média diâmetro de 1,5 cm e frequentemente não recidiva após exérese cirúrgica. Os autores descrevem um caso no qual uma lesão tumoral iniciou seu crescimento na região superciliar esquerda de um paciente de 26 anos, sendo realizada exérese total da mesma e diagnóstico através do exame anatomopatológico de pilomatricoma. Esta lesão teve um crescimento lento, de aproximadamente dois anos, segundo o paciente. Decorridos oito meses da intervenção cirúrgica houve novo crescimento tumoral no local, desta vez de maneira rápida e exacerbada e com ulceração de pequena área da pele que recobria a lesão, induzindo, portanto, suspeita de malignidade. Realizada nova exérese com margem de segurança, o exame anatomopatológico confirmou ser a lesão um pilomatricoma, não possuindo a peça cirúrgica sinais de malignização. O paciente encontra-se em seguimento há um ano, sem sinais de recidiva até o momento.Pilomatricoma is a benign neoplasm originated in the pilosebaceous follicle wich appears as an intradermal nodule during childhood, in most cases. It is generally covered with normal skin, reaching a diameter of 1.5 cm on average, and it often shows no recurrence after surgical excision. The authors describe a case in wich a 26-year-old patient presented a tumoral lesion on the upper left superciliary area was submitted to total excision, and diagnosed as pilomatricoma by the histological study. According to the patient, this lesion had a progressive and slow growth of about two years. Eight months after the first surgical intervention, there was a new tumor growth in the region, this time quicker and worsen, with ulceration on the small skin area that covered the lesion, thus leading to malignity suspicion. After the conduction of

  18. [Care plan for patients in prone decubitus. An experience from practice].

    Science.gov (United States)

    Oliva Torras, E; Subirana Casacuberta, M; Sebastià, M P; Jover Sancho, C; Solà Solé, N

    1995-01-01

    Offering a specific integral attention to patients with SDRA in prone decubitus positions makes us establish a performance plan with the aim to know the problems derived from the change in position, the time staying in prone decubitus and to standardize a care plan. We review the clinic records of the patients admitted in our unit from March '93 to March '95 who were positioned in prone decubitus. Taking as a base the nursing care model of V. Henderson and the taxonomy of NANDA, we analyse the needs which have been altered, and determine the nursing diagnosis, complications and most frequent interdependent problems establishing the aim to accomplish, planning the performance and rationalization. Five patients were positioned in prone decubitus before planning the performance and four more afterwards. All the patients tolerated SNG diet keeping a correct bowel transit. One patient showed an ulcera at frontal level. There were neither comeal ulceras nor alterations in the oral mucossa. The vascular accesses remained permeable. DP caused facial and periorbital edema in all the patients. We did not observe any increase in the amount of bronchial secretions. The eight patients who tolerated the change in position stayed in prone decubitus for an average of 77 hours, with a range of 10 to 216 hours. Four patients were discharged from the hospital, two of whom showed movility alterations, independently of the time staying in prone decubitus. We state explicitly the nursing care, determine five nursing diagnosis, one problem and seven interdependent complications. Establishing the nursing care from the experience and review of the records has allowed us to be more specific and objective. Standardizing the specific care plans makes the nursing care easier when dealing with real problems as well as with the care of complications derived from this situation.

  19. Freqüência de lesões gástricas em suínos destinados ao abate na região de Ribeirão Preto, SP

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    Carvalho L.F.O.S.

    1999-01-01

    Full Text Available Foram colhidos e examinados 1085 estômagos de suínos, machos castrados ou fêmeas, todos com idade entre 140 e 150 dias. As lesões encontradas foram classificadas de acordo com a localização, tipo e severidade. A análise macroscópica revelou que 694 (64% estômagos apresentavam algum tipo de lesão. A paraqueratose foi identificada como alteração patológica única em 213 (19,6% estômagos. Em outros 319 (29,4% estômagos, ela estava associada apenas a processos erosivos ou associada a erosões e úlceras. Erosões isoladas ou associadas a ulcerações foram identificadas em 121 (11,2% animais, enquanto que úlceras, foram verificadas em 41 (3,8% animais. A avaliação por regiões, revelou que 62,8% apresentaram lesões na região gastresofágica e apenas 6,6% na região fúndica do órgão. Tais achados sugerem a existência de diferentes causas na etiopatogenia desses dois processos gástricos. A ulceração gastresofágica estava presente em 213 (19,6% animais, dos quais 22,7% eram machos castrados e 16,5% eram fêmeas, fato que evidencia possível influência do sexo na freqüência dessa patologia em suínos. Os exames microscópicos, realizados em parte das amostras, apenas confirmaram as alterações, já identificadas pelo exame macroscópico. Apenas o exame macroscópico conduz a resultados confiáveis na avaliação de lesões gástricas em suínos.

  20. Clinical multiphoton tomography and clinical two-photon microendoscopy

    Science.gov (United States)

    König, Karsten; Bückle, Rainer; Weinigel, Martin; Elsner, Peter; Kaatz, Martin

    2009-02-01

    We report on applications of high-resolution clinical multiphoton tomography based on the femtosecond laser system DermaInspectTM with its flexible mirror arm in Australia, Asia, and Europe. Applications include early detection of melanoma, in situ tracing of pharmacological and cosmetical compounds including ZnO nanoparticles in the epidermis and upper dermis, the determination of the skin aging index SAAID as well as the study of the effects of anti-aging products. In addition, first clinical studies with novel rigid high-NA two-photon 1.6 mm GRIN microendoscopes have been conducted to study the effect of wound healing in chronic wounds (ulcus ulcera) as well as to perform intrabody imaging with subcellular resolution in small animals.

  1. Discurso, gesto y comunicación en la liturgia visigoda (589-711

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    Eleonora Dell’Elicine

    2009-01-01

    Full Text Available « Tu nombre es aroma penetrante » (Ct 1, 3.Apenas comenzadas las actas del tercer concilio de Toledo de 589, los obispos allí reunidos establecieron solemnemente el siguiente artículo :« En reverencia a la santa fe, y para ayudar a las débiles inteligencias de los hombres, por indicación del píisimo y gloriosísimo señor y Rey Recaredo, estableció el santo concilio que en todas las iglesias de España, Galia y Galicia (… se recite el símbolo de la fe del Concilio de Constantinopla (…, para q...

  2. La obra de Manuel Martín Serrano vista desde América Latina. Epistemologías iberoamericanas en ciencias de la comunicación. La contribución estratégica de Manuel Martín Serrano al pensamiento trasformador latinoamericano

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    Alberto Efendy Maldonado Gómez de la Torre

    2011-09-01

    Full Text Available Este artículo busca una interpretación histórica crítica de las configuraciones mediáticas y sociales, situados en los años 1980, la irrupción transformadora de la teoría de la mediación social de Manuel Martín Serrano. Muestra como la teoría de este autor se constituyó en una vertiente crítica relevante para el proceso de confrontación y desmontaje de la hegemonía penetrante del funcionalismo en el campo de investigación y producción teórica en comunicación.

  3. La radio no está amenazada por internet

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    Bruce Girard

    2015-01-01

    Full Text Available La radio es mucho más penetrante y asequible, el uso de los servicios de Internet puede contribuir a informar mejor a sus clientes y establecer interactividad. En vista que por ahora la accesibilidad del Internet es accesible solo a unos pocos, para la radio no es una amenaza el Internet. Enuncia los roles de la radio y señala que está considerada como un vínculo comunitario. Trata además sobre las radio-cadenas satelitales, la radio e Internet: convergencia para la democracia y el crecimiento de la brecha de los que acceden a la información.

  4. Herida precordial por arma blanca

    OpenAIRE

    Marcelo F. Jiménez; Nuria Novoa; José Luis Aranda; Gonzalo Varela

    2005-01-01

    Varón de 42 años con esquizofrenia paranoide. Intento de suicidio con tres autolesiones por arma blanca (Fig. 1). Fue traído al hospital en estado consciente, taquicárdico, taquipneico y con tensión arterial (TA) de 140/90 mmHg. Fue trasladado al quirófano, donde se practicó una toracotomía axilar izquierda sin extraer el arma. Durante la intervención se apreciaron tres heridas incisas, dos no penetrantes, hemotórax de 150 ml, herida pericárdica de 4 cm, sin lesiones cardíacas. La hoja del ar...

  5. Vascularização arterial do testículo de suínos

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    Aníbal de Sant'anna Moretti

    1992-12-01

    Full Text Available Utilizando 30 pares de testículos de suínos, com idade compreendida entre 6 a 10 meses, procedentes do Campus Administrativo de Pirassununga, da Universidade de São Paulo e da Seara Industrial dc Xanxerê S.A., Santa Catarina, estudou-se a vascularização arterial mediante análise de moldes da artéria testicular, obtidos pela injeção de vynil. Na vascularização do órgão, a artéria testicular forneceu: (a em 50,0% das preparações, número variável de ramos laterais e mediais, ocorrendo em 31,7%, predominância dos ramos laterais; (b em 43,3% um ramo medial e outro lateral, havendo em 30% das peças, predomínio do ramo medial; (c em 6,7% dos moldes, os ramos ventral e dorsal, notando-se predomínio do ramo ventral, na vascularização do órgão. Nas preparações em que a artéria testicular fornecia número variável de ramos laterais e mediais, observou-se em mediana e nos quadrantes dorsolateral, dorsomedial, ventrolateral e ventromedial, respectivamente, 27,0; 26,0; 38,0; 28,0 vasos penetrantes quanto da predominância dos laterais e 24,0; 24,0; 30,0 e 33,0 no caso do predomínio dos mediais. Quando a artéria testicular cedeu dois ramos, o medial e o lateral, os valores foram, respectivamcntc, 25,0; 24,0; 35,0; 28,0 com predominância do medial e de 33,0; 33,5; 38,0; 37,5 com predominância do lateral. Quando emitiu os ramos dorsal e ventral, verificou-se, respectivamente 30,5; 24,5; 26,5 e 28,0 quando da predominância do ventral. Observou-se em 30 preparações (50% ramos laterais ou mediais cedendo vasos penetrantes a quadrantes opostos ao destino principal do vaso que lhe deu origem. Foi verificada a presença de ramos adicionais, específicos, originados da artéria testicular antes desta ceder os ramos lateral e medial, e os ramos ventral e dorsal. Foram identificadas em 95% das preparações, anastomoses entre a artéria testicular e seus ramos principais e colaterais, bem como dos ramos adicionais. A ocorrência se

  6. Linfoma cutâneo primário de grandes células B de apresentação atípica: relato de caso Primary cutaneous large B-cell lymphoma of atypical presentation: case report

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    Antônio René Diógenes de Sousa

    2011-06-01

    Full Text Available Linfomas cutâneos primários são definidos como neoplasias linfocíticas que se apresentam clinicamente na pele sem doença extracutânea no momento do diagnóstico e até por 6 meses após. Os autores relatam o caso de um paciente masculino, idoso, com história de pápulas em axila, há 3 meses, que evoluíram para ulceração. Ao exame, úlcera profunda de bordos irregulares, infiltrados, em axila direita. Exames físico e complementares não evidenciaram doença à distância. O histopatológico mostra infiltrado dérmico denso e difuso de linfócitos atípicos. A imuno-histoquímica evidencia expressão de antígenos CD20 e bcl-2, com CD10 negativo, configurando diagnóstico de linfoma cutâneo difuso de grandes células B. Neste tipo de linfoma, é rara a manifestação cutânea primária, assim como a incidência é menor em homens e a localização, mais comum em membros inferioresPrimary cutaneous lymphomas are defined as lymphocytic neoplasias that present themselves clinically in the skin without extracutaneous disease at diagnosis and up to 6 months after it. The authors report the case of an elderly male patient, with a three- month-history of papules in the axilla which evolved into painful ulceration. Examination found deep ulcer with irregular borders ,infiltrates, in the right axilla. Physical and additional examinations did not evidence disease at distance. Histopathology revealed dense and diffuse dermic sample infiltrate of atypical lymphocytes. Imunohistochemistry shows expression of CD20 and bcl-2 antigens , with negative CD10, configuring diagnosis of cutaneous large B-cell lymphoma. In this type of cutaneous lymphoma, primary cutaneous manifestation is rare ,the incidence in men is lower and it is most commonly located in the lower limbs

  7. Analysis of the Revised Trauma Score (RTS) in 200 victims of different trauma mechanisms.

    Science.gov (United States)

    Alvarez, Bruno Durante; Razente, Danilo Mardegam; Lacerda, Daniel Augusto Mauad; Lother, Nicole Silveira; VON-Bahten, Luiz Carlos; Stahlschmidt, Carla Martinez Menini

    2016-01-01

    to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS) in trauma victims treated at a university hospital. we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected) from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1) penetrating trauma to the abdomen and chest, (G2) blunt trauma to the abdomen and chest, and (G3) traumatic brain injury. The variables we analyzed were: gender, age, day of week, mechanism of injury, type of transportation, RTS, hospitalization time and mortality. we analyzed 200 patients, with a mean age of 36.42 ± 17.63 years, and 73.5% were male. The mean age was significantly lower in G1 than in the other groups (p grupos foram criados: (G1) trauma penetrante em abdome e tórax, (G2) trauma contuso em abdome e tórax, e (G3) trauma cranioencefálico. As variáveis analisadas foram: sexo, idade, dia da semana, mecanismo de trauma, tipo de transporte, RTS, tempo de internamento e mortalidade. analisou-se 200 pacientes, com média de idade de 36,42 ± 17,63 anos, sendo 73,5% do sexo masculino. A média de idade no G1 foi significativamente menor do que nos demais grupos (p grupos (p grupos G1, G2 e G3, respectivamente. A mediana do RTS entre os óbitos foi 5,49, 7,84 e 1,16, respectivamente, para os três grupos. a maioria dos pacientes eram homens jovens. O RTS mostrou-se efetivo na predição de mortalidade no trauma cranioencefálico, entretanto falhou ao analisar pacientes vítimas de trauma contuso e penetrante.

  8. Soroprevalência de anticorpos contra o antígeno CagA do Helicobacter pylori em pacientes com úlcera gástrica na região Norte do Brasil Seroprevalence of antibodies against the CagA antigen the Helicobacter pylori in patients with gastric ulcer in the North region of Brazil

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    Luisa Caricio Martins

    2002-08-01

    Full Text Available O Helicobacter pylori é um agente patogênico largamente distribuído no mundo, estando envolvido no desenvolvimento de várias doenças gastrointestinais. Atualmente a infecção pela cepa virulenta (CagA+ do H. pylori é considerado um dos principais fatores etiológicos para o desenvolvimento de ulcerações gástricas. Baseado nessa informação, investigamos a soroprevalência das cepas virulentas entre os pacientes com úlcera gástrica da nossa região, utilizando testes sorológicos para detecção de anticorpos contra o H. pylori e a proteína CagA. Sendo observado que 82% (45/55 dos pacientes estavam infectados pela cepa virulenta, entre esses 89% (40/45 apresentaram grau de inflamação aumentado na mucosa gástrica, com denso infiltrado de leucócitos no tecido, o que provavelmente favoreceu a formação das ulcerações gástricas.Helicobacter pylori is a pathogenic agent with a worldwide distribution and is involved in the development of many gastrointestinal diseases. Nowadays infection with the virulent strain CagA+ of H. pylori is considered one of the main etiological factors in the development of gastric ulcer. Based on this information, we investigated the seroprevalence of virulent strains among patients with gastric ulcer from one region, using serologic tests to detect antibodies against H. pylori and CagA protein. Infection by the virulent strain was found in 82% (40/55 of the patients, and among these, 89% (40/45 presented an increased degree of inflammation in the gastric mucosa, with a dense infiltration of leukocytes in the tissue, which probably favored the formation of gastric ulcer. We concluded that the presence of the virulent strain is related to the development of an increased inflammation in the gastric mucosa.

  9. Pitiose eqüina no Pantanal brasileiro: aspectos clínico-patológicos de casos típicos e atípicos Equine pythiosis in the Brazilian Pantanal region: clinical and pathological findings of typical and atypical cases

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    Adriana B. Monteiro Leal

    2001-12-01

    Full Text Available A pitiose eqüina é doença endêmica no Pantanal Brasileiro e causa prejuízos significativos a eqüinocultura. Neste trabalho são relatados 16 casos de pitiose subcutânea em eqüinos no Pantanal Sul-Matogrossense, que foram divididos em onze casos típicos e cinco casos atípicos, de acordo com o quadro clínico e o tempo de duração das lesões. O diagnóstico foi confirmado pela detecção de anticorpos específicos pelo teste ELISA, isolamento do agente e histopato-lógico. A duração da doença variou entre 1 e 6 meses nos casos típicos e superior a 12 meses nos casos atípicos. As lesões dos casos típicos caracterizavam-se por granulomas subcutâneos, ulcerados, com abundante secreção serossangui-nolenta e prurido. Nos casos atípicos foram observadas lesões subcutâneas caracterizadas por grandes massas "tumorais" circunscritas, recobertas por pele escura, sem ulcerações e com pouca secreção. Os animais estavam em bom estado nutricional e as lesões apresentavam-se de aspecto organizado, às vezes pedunculadas. Histologicamente, foi observado tecido de granulação com muitos eosinófilos nos casos típicos, enquanto os atípicos, se caracterizaram por hiperplasia pseudo-epiteliomatosa da epiderme e infiltrado eosinofílico. As características clínicas e histopato-lógicas completas das duas formas clínicas e os possíveis fatores responsáveis pelas diferenças entre as duas formas são apresentados e discutidos.Equine pythiosis is an endemic disease of horses and causes significant economic losses to equine breeding in the Brazilian Pantanal. This article describes 16 cases of subcutaneous pythiosis in horses from that region. The clinical cases were divided in typical (11 and atypical (5, according to the clinical features and duration of the disease. The clinical diagnosis was confirmed by detection of specific antibodies by ELISA, isolation of the agent and histopathology. The duration of the disease varied from 1

  10. Pneumotórax hipertensivo na sala de recuperação pós-anestésica: relato de caso Pneumotórax hipertensivo en la sala de recuperación pos-anestésica: relato de caso Tension pneumothorax in post-anesthetic care unit: case report

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    Ana Claudia Chiaratti Mega

    2004-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Há 100% de prevalência de pneumotórax nos casos de trauma penetrante torácico, sendo que o pneumotórax hipertensivo pode ser desencadeado, entre outras causas, por uma lesão pulmonar não diagnosticada inicialmente, ou associado à ventilação mecânica, apresentando alta taxa de mortalidade. O objetivo deste relato é apresentar um caso de pneumotórax hipertensivo diagnosticado na Sala de Recuperação Pós-Anestésica (SRPA. RELATO DO CASO: Paciente do sexo masculino, 34 anos, estado físico ASA I E, vítima de lesões por arma de fogo. Foi submetido a laparotomia exploradora e exploração de artéria e veia femorais à direita, sob anestesia geral balanceada com indução em seqüência rápida, com estabilidade hemodinâmica durante todo o procedimento cirúrgico. Na SRPA, apresentou instabilidade hemodinâmica, com insuficiência respiratória, sudorese, taquicardia e hipertensão arterial. A tomografia computadorizada de tórax evidenciou hemopneumotórax à direita, sendo imediatamente drenado. Foi transferido para o Centro de Terapia Intensiva, apresentando melhora progressiva do quadro, com alta hospitalar, sem seqüelas, após 22 dias. CONCLUSÕES: O pneumotórax hipertensivo é uma doença letal que pode ser facilmente reconhecida através dos exames clínico e radiológico; devendo ser sempre suspeitado na presença de traumatismo torácico, e neste caso, deve-se realizar imediatamente a drenagem de tórax antes da ventilação mecânica e de procedimentos cirúrgicos.JUSTIFICATIVA Y OBJETIVOS: Hay 100% de prevalencia de pneumotórax en los casos de trauma penetrante torácico, siendo que el pneumotórax hipertensivo puede ser desencadenado, entre otras causas, por una lesión pulmonar no diagnosticada inicialmente, o asociado a la ventilación mecánica, presentando alta tasa de mortalidad. El objetivo de este relato es presentar un caso de pneumotórax hipertensivo diagnosticado en la Sala de

  11. Manifestações cutâneas das trombofilias Cutaneous manifestations of thrombophilia

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    Paulo Ricardo Criado

    2008-12-01

    Full Text Available O escopo deste artigo é revisar os estados de hipercoagulabilidade sangüínea (trombofilias mais provavelmente encontrados por dermatologista. Seus sinais cutâneos incluem o livedo reticular, necrose cutânea, ulcerações e isquemia digital, púrpura retiforme, além de úlceras nas pernas. Revisamos seu tratamento adequado, bem como ressaltamos as manifestações cutâneas que impõem pesquisa laboratorial de trombofilias e os exames indicados nessas situações.The aim of this article is to review the hypercoagulable states (thrombophilia most probably found by dermatologists; their cutaneous signs including livedo racemosa, skin necrosis, digital ischemia and ulcerations, retiform purpura and leg ulcers; their appropriate treatment; to describe the skin manifestations that require laboratory tests for thrombophilias and the tests indicated in these clinical conditions.

  12. Indicadores tácticos asociados a la creación de ocasiones de gol en fútbol profesional

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    Joaquín González-Ródenas

    2015-01-01

    Full Text Available El objetivo de este estudio fue describir cómo son creadas las ocasiones de gol en fútbol profesional, te- niendo en cuenta indicadores tácticos ofensivos y la posición del equipo rival. 335 posesiones finalizadas en ocasión de gol durante los 16 partidos de fase elimina- toria del Mundial de futbol 2010 fueron analizadas. De cada posesión, 15 dimensiones tácticas fueron evaluadas mediante metodología observacional usando el instru- mento REOFUT. El 61,2% de las ocasiones de gol fueron creadas por ataque organizado, el 18,8% a través de contraataque y el 20,0% mediante acción a balón para- do. El ataque organizado se caracterizó por iniciarse en zonas no invasivas del rival (63,4%, con acción inicial no penetrante (62,4% y usando 4 o más pases (62,0%. El contraataque se inició en zonas invasivas del rival (71,4% con acción inicial penetrante (76,2% y usando 3 o menos pases (67,8%. Las ocasiones de gol produ- cidas por contraataques tuvieron lugar en sub-espacios más invasivos (p = 0.023 que aquellas producidas por el ataque organizado aunque para ambos la Zona Retrasa- da Rival fue donde más ocasiones de gol se produjeron (42,9% vs 36,1%, respectivamente. En las acciones a ba- lón parado destacaron los saques de esquina (49,3% y el tiro libre (44,3%. Indicadores tácticos como el tipo de ataque, el nivel de invasión sobre el rival, la penetración inicial y el número de pases deberían tenerse en cuenta en el análisis y entrenamiento del desarrollo de las po- sesiones en fútbol. Además, la zona retrasada rival es clave para la culminación de ocasiones de gol en fútbol profesional.

  13. Traumatismos de veia cava inferior

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    Cleinaldo de Almeida Costa

    Full Text Available OBJETIVO: Avaliar a incidência, o perfil clínico e as estratégias operatórias dos ferimentos de Veia Cava Inferior (VCI. MÉTODOS: Foram analisados retrospectivamente os prontuários de 76 doentes com ferimento de VCI atendidos nos dois prontossocorros de Manaus, no período de janeiro de 1997 a julho de 2002. Mecanismo de lesão, mortalidade, estado hemodinâmico, índice de trauma abdominal penetrante (PATI, achados intra-operatórios e conduta cirúrgica foram estudados. RESULTADOS: Quarenta e nove (65% doentes sofreram lesão por arma branca, 26 (34% por arma de fogo e um por traumatismo abdominal fechado. Quarenta e um (54% doentes sobreviveram. Quase todos chegaram acordados, entretanto 40% estavam hipotensos (pressão arterial sistólica < 70mmHg. O índice de trauma abdominal penetrante (PATI médio foi maior que 40. À laparotomia, todos demonstraram sangramento retroperitoneal ativo ou hematoma retroperitoneal em expansão. Vinte e um pacientes possuíam lesão de VCI retro-hepática, enquanto nos outros 55 a lesão era infra-hepática. O reparo operatório predominante foi a venorrafia lateral em 65 doentes. Houve necessidade de tóraco-freno-laparotomia em quatro doentes do total de oito doentes que foram à toracotomia direita por lesão retro-hepática. Foram realizados shunts átrio-cavais em seis doentes, dos quais três sobreviveram. CONCLUSÕES: O ferimento de VCI é uma lesão de alta letalidade e possui uma relação intrínseca com a violência urbana. A sobrevivência depende de uma imediata e vigorosa reposição de volume, um manejo operatório adequado e todo esforço em evitar-se hipotermia.

  14. Evaluation by computerized morphometry of histopathological alterations of the colon wall in segments with and without intestinal transit in rats Avaliação por morfometria computadorizada das alterações histopatológicas da parede cólica em segmentos com e sem trânsito intestinal em ratos

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    Marcos Vieira de Sousa

    2008-10-01

    intestinal mucosa, increased number of caliciform cells, greater vascular congestion of the submucosal layer and inflammatory reaction were related to increasing length of time without transit.OBJETIVO: Avaliar por método de imagem assistida por computador as alterações histopatológicas da parede cólica em segmentos providos e desprovidos de trânsito intestinal e relacioná-las ao tempo de exclusão. MÉTODOS: Trinta ratos Wistar machos foram submetidos à derivação do trânsito no cólon esquerdo por meio de colostomia proximal e fístula mucosa distal. Os animais foram divididos em três grupos experimentais segundo o sacrifício ter sido realizado seis, doze e dezoito semanas após o procedimento cirúrgico inicial. Segmentos dos cólons providos e desprovidos de trânsito foram submetidos a estudo histopatológico. Foram analisadas as variáveis: comprimento das criptas cólicas, ulceração na mucosa, espessura das camadas muscular da mucosa, submucosa e muscular própria, congestão vascular, número de células caliciformes e graduação inflamatória comparando os dois segmentos cólicos nos diferentes grupos experimentais. As variáveis, comprimento das criptas intestinais, espessura das camadas muscular da mucosa, submucosa e muscular própria foram mensuradas por método de imagem assistida por computador. Na análise estatística foram utilizados testes de igualdade de médias e medianas, análise de variância e correlação estabelecendo-se nível de significância de cinco por cento. RESULTADOS: A exclusão de trânsito mostrou-se associada à redução do comprimento das criptas cólicas, aumento da espessura das camadas muscular da mucosa, submucosa e muscular própria. Verificou-se maior quantidade de ulcerações na mucosa e maior grau de inflamação com o progredir do tempo de exclusão. Houve correlação significante entre as ulcerações da mucosa, congestão vascular da submucosa, aumento da espessura das camadas submucosa e muscular pr

  15. Profilaxis para sangrado por ulceras de estrés en la unidad de cuidados intensivos

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    J.M. Avendaño-Reyes

    2014-01-01

    Conclusiones: La hospitalización en la unidad de cuidados intensivos por sí sola no justifica la profilaxis. Los IBP son por lo menos tan efectivos como los H2RA. Debemos individualizar el tratamiento de cada paciente en la unidad de cuidados intensivos, determinando el riesgo y evaluando la necesidad de comenzar la profilaxis.

  16. Aplicación de un protocolo en cicatrización de ulceras por decúbito

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    Porras Janeth

    1993-04-01

    Full Text Available

    Las úlceras por decúbito han constituido un problema de enfermería que ha transcendido a lo largo de la historia. Para su solución se han aplicado diversos y variados tratamientos que han evolucionado desde la utilización de medidas caseras, hasta sofisticados materiales, productos y protocolos cuidadosamente investigados en Canadá, Estados Unidos, Inglaterra y otros. En Colombia, la experiencia en el manejo de estos, ha sido el uso indiscriminado y poco sistematizado a medida que van invadiendo el mercado. Existen múltiples factores concurrentes y predisponentes en la formación de las úlceras los cuales han persistido a pesar de las reiteradas alternativas de solución, mediante la aplicación de protocolos de atención que no han logrado su comprobación en el campo clínico.

  17. Pseudo-aneurisma post-traumático de tronco de arteria coronaria izquierda Post-traumatic false (pseudo aneurysm of the left main coronary artery

    Directory of Open Access Journals (Sweden)

    Melina M. Gallo

    2011-08-01

    Full Text Available El pseudo-aneurisma de arteria coronaria es extremadamente raro. Su historia natural es poco conocida y su tratamiento discutido. Se presenta el caso de un paciente con pseudo-aneurisma de tronco de la coronaria izquierda e infarto antero-apical del ventrículo izquierdo cinco años después de un paro cardíaco secundario a un traumatismo no penetrante de tórax. Se consideró entonces que la lesión no era pasible de corrección percutánea o quirúrgica por lo que se optó por tratamiento médico conservador. Una angiografía coronaria por tomografía computarizada multicorte realizada 10 años después del evento inicial mostró ausencia de progresión de la lesión.Coronary pseudo-aneurysm is an extremely rare entity. Its natural history is scarcely known and its treatment is controversial. We report a case of pseudo-aneurysm of the left main coronary artery associated with an antero-apical infarct of the left ventricle diagnosed five years after a cardiac arrest following a non-penetrating thoracic trauma. The patient was treated conservatively because percutaneous or surgical correction were not considered suitable for this lesion. A multidetector computed tomography coronary angiogram performed 10 years after the initial event showed no evidence of progression.

  18. Doença de Crohn gastroduodenal ¾ relato de quatro casos e revisão da literatura

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    ABRAHÃO Jr Luiz João

    2001-01-01

    Full Text Available Racional -- A doença de Crohn pode acometer todo o tubo digestivo, porém o envolvimento gastroduodenal é classicamente descrito como raro (0,5% a 13%. Objetivos - Descrever os achados clínicos, radiológicos, endoscópicos e o tratamento de quatro pacientes com doença de de Crohn gastroduodenal e rever a literatura. Pacientes e Métodos - Quatro pacientes (um homem de 24 anos e três mulheres de 37, 66 e 74 anos com epigastralgia, emagrecimento e febre baixa foram acompanhados nos hospitais das Universidades Federais do Rio de Janeiro e Fluminense. Diarréia intermitente e artralgia/artrite estavam presentes em dois e uma paciente foi operada de urgência por síndrome de obstrução pilórica. Exames laboratoriais revelaram anemia em uma das pacientes, sendo normais nos demais. Os estudos baritados revelaram ulcerações aftóides no estômago e duodeno, assim como ulcerações em íleo terminal e deformidades em ambos. Os achados endoscópicos compreenderam úlceras aftóides e serpiginosas e lesões polipóides no antro gástrico e úlceras geográficas em duodeno. Colonoscopia foi realizada em dois pacientes, revelando ileíte ulcerada em um e pancolite ulcerada em outro. O exame histopatológico revelou processo inflamatório crônico inespecífico sem granulomas, sendo excluídas outras causas de doença granulomatosa gástrica. Instituído tratamento com prednisona e inibidores de bomba de prótons, com remissão da doença em dois pacientes e evolução para síndrome de estenose pilórica em um (submetido a gastroenteroanastomose. Conclusão - A doença de Crohn gastroduodenal possui características clínicas, terapêuticas e prognósticas distintas. O avanço da endoscopia digestiva e a adoção de novos critérios para o diagnóstico histopatológico tem demonstrado incidência maior (17 a 75% que a previamente relatada.

  19. Leishmaniosis cutanea: manifestación clínica inusual

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    Aidé Sandoval-Juárez

    Full Text Available Las manifestaciones clínicas de la leishmaniosis son variables y están relacionadas con la especie infectante, su relación con el medioambiente y con la respuesta inmune del hospedero. Se presenta un caso de leishmaniosis andina cutánea tardía con una manifestación extensa. El caso se confirmó a través de estudios microbiológicos e inmunológicos, la identificación se realizó mediante secuenciamiento del gen del citocromo b, determinándose la especie como Leishmania (Leishmania amazonensis. La paciente recibió tratamiento con estibogluconato sódico y al término de la terapia, mostró mejoría clínica de las lesiones. Se recomienda considerar a la leishmaniosis en el diagnóstico diferencial cuando se atienda ulceras crónicas dermatológicas atípicas.

  20. Pseudo-aneurisma post-traumático de tronco de arteria coronaria izquierda

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    Melina M. Gallo

    2011-08-01

    Full Text Available El pseudo-aneurisma de arteria coronaria es extremadamente raro. Su historia natural es poco conocida y su tratamiento discutido. Se presenta el caso de un paciente con pseudo-aneurisma de tronco de la coronaria izquierda e infarto antero-apical del ventrículo izquierdo cinco años después de un paro cardíaco secundario a un traumatismo no penetrante de tórax. Se consideró entonces que la lesión no era pasible de corrección percutánea o quirúrgica por lo que se optó por tratamiento médico conservador. Una angiografía coronaria por tomografía computarizada multicorte realizada 10 años después del evento inicial mostró ausencia de progresión de la lesión.

  1. Ceratocone: fatores prognósticos Keratoconus: prognosis factors

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    Rosana Molina Saraiva Elias

    2005-08-01

    Full Text Available OBJETIVO: Estudar pacientes portadores de ceratocone numa faixa etária menor do que a usual e tentar detectar algum fator que possa influenciar no prognóstico e na evolução da doença. MÉTODOS: Foram analisados pacientes menores de 15 anos, com diagnóstico de ceratocone. Todos se submeteram a um questionário, exame ocular e ceratoscopia computadorizada. Estes pacientes foram divididos em 3 grupos e submetidos a um teste com lente de contato: 1 um grupo em que foi possível a adaptação de lente de contato; 2 um grupo em que foi indicado o transplante penetrante de córnea; 3 um grupo em que foi indicada a correção com óculos. RESULTADOS: Pacientes com acuidade visual de 20/40 ou maior, geralmente não evoluíram para transplante no período estudado. Ao contrário, pacientes com visão de 20/60 ou menor, evoluíram para transplante penetrante mais rapidamente. Ao serem estudados casos em faixa etária menor (10-15 anos, 44% evoluíram para transplante. Observa-se que o ápice corneano tem localização muito variável, o que explica os diferentes níveis de dificuldade na adaptação de lentes de contato. Todos os pacientes com ápice deslocado superiormente e valores maiores que 66 D foram encaminhados para cirurgia, ao passo que olhos com valores menores que 66 D tiveram sucesso na adaptação. Nos olhos com ápice central, a adaptação foi mais fácil. Nos casos de ápice inferior não foi possível determinar um padrão para indicação de cirurgia. Nos olhos adaptados com lente de contato e curvatura menor que 51,10 D houve menos chance de evolução para transplante penetrante de córnea, quando comparados com pacientes de curvatura 57,60 ou maior. CONCLUSÃO: Pacientes com curvaturas maiores que 57,40, acuidade menor que 20/60 e com idade menor de 18 anos tem uma chance maior de evoluir para transplante de córnea. Quando o ápice do ceratocone é central a adaptação de lente de contato fica mais fácil.PURPOSE: To study

  2. Pé Diabético – Relato de Caso e Protocolo Assistencial do Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre

    Directory of Open Access Journals (Sweden)

    Gabriela Heiden Teló

    2011-01-01

    Full Text Available A infecção do pé é uma importante causa de morbidade em pacientes com diabetes melito, sendo responsável pela maioria dos casos de amputação não traumática de membros inferiores. A ulceração, secundária principalmente à neuropatia diabética, deformidade e trauma, é o principal fator de risco para infecção. Prevenção e identificação precoce dessas alterações, com tratamento apropriado, constituem ferramentas essenciais para diminuir a morbidade relacionada. Neste artigo, relatamos o caso de um paciente com diabetes melito tipo 2 e infecção de pé diabético, com predominância de componente neuropático, e descrevemos o protocolo assistencial recomendado pelo Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre (HCPA.

  3. Tratamiento médico de la úlcera péptica

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    Alberto Albornoz Plata

    1958-09-01

    Full Text Available El tratamiento médico de la ulcera péptica, se basa esencialmente en aliviar los síntomas, lograr su cicatrización, evitar las complicaciones y procurar que las recurrencias sean mínimas o tolerables; además en la actualidad tiene una gran importancia el aspecto preventivo: un paciente con antecedentes ulcerosos o con herencia ulcerosa, debe quedar instruido por su médico, sobre la naturaleza de la enfermedad y sobre aquellas medidas de orden preventivo que debe observar toda la vida para evitar la enfermedad; cobra especial interés, en estos momentos en que infinidad de drogas que podemos llamar GASTROTOXICAS son de uso frecuente en medicina general y para muchas enfermedades que ahora tienen una alta incidencia, el uso de cortisona y derivados en enfermedades del colágeno, artritis, alergias, etc.; tranquilizadores e hipotensores a base de Rauwolfia; analgésicos de tan amplio uso como la aspirina, etc., etc.

  4. Suprimento arterial do lobo torácico do timo em suínos da linhagem "Rezende"

    Directory of Open Access Journals (Sweden)

    Gonçalez Patrícia Orlandini

    2003-01-01

    Full Text Available Foram dissecados 30 exemplares de fetos de suínos da linhagem "Rezende", após injeção do sistema vascular arterial, via artéria aorta descendente torácica, com Neoprene látex "450" corado com pigmento específico e fixação em solução aquosa de formol a 10%, para a observação da origem, número e ordenação das artérias destinadas ao lobo torácico do timo. O antímero esquerdo foi irrigado por ramos diretos das artérias torácica interna esquerda (96,66%, cervical superficial esquerda (40,00%, torácica interna direita (26,66%, tronco braquiocefálico (20,00%, subclávia esquerda (10,00%, carótida comum esquerda (10,00%, vertebral esquerda (6,66%, cervical superficial direita (6,66%, tronco bicarotídico (6,66%, torácica externa direita (3,33% e axilar esquerda (3,33%; ramos indiretos foram provenientes das artérias torácica interna esquerda (40,00%, cervical superficial esquerda (23,33% e subclávia esquerda (3,33%. O antímero direito foi irrigado por ramos diretos, provenientes das artérias torácica interna direita (63,33%, cervical superficial direita (13,33%, carótida comum direita (6,66%, torácica externa direita (3,33% e subclávia direita (3,33%; ramos indiretos foram originários das artérias torácica interna direita (20,00%, cervical superficial direita (10,00%, torácica externa direita (3,33% e subclávia direita (3,33%. A massa tímica do antímero direito esteve presente em 43,33% dos casos, ausente em 30,00% e reduzida em 26,66%, sendo observado de 1 a 7 ramos penetrantes em seu parênquima. A massa tímica do antímero esquerdo foi encontrada em 100,00% das dissecações, recebendo de 2 a 9 ramos penetrantes.

  5. Peptiske ulcera i Danmark, 1981-1993. Analyse af data fra landspatient- og dødsårsagsregisteret

    DEFF Research Database (Denmark)

    Andersen, I B; Bonnevie, O; Jørgensen, T

    1999-01-01

    The aim of this study was to determine whether the improvements in the treatment of peptic ulcers are associated with decreasing age- and sex-specific hospitalization and death rates for peptic ulcers in Denmark. The study was based on all discharges as registered in the National Hospital Dischar...

  6. Manejo inicial y conceptos en trauma: vía aérea, reposición de volumen, toracotomía de urgencia

    Directory of Open Access Journals (Sweden)

    M. Mario Uribe, Dr.

    2011-09-01

    En este artículo se tratan aquellas patologías que ponen en peligro la vida del paciente y que precisan acciones terapéuticas inmediatas, como son la obstrucción de vía aérea, el neumotórax a tensión, el taponamiento cardiaco, neumotórax simple y neumotórax abierto. El shock, definido por un grado severo de hipoperfusión tisular, necesita ser corregido mediante una infusión adecuada de volumen incluyendo factores de coagulación para evitar el círculo vicioso de la llamada “tríada letal” que corresponde a hemorragia, hipotermia y coagulopatía, que a su vez perpetúa la hemorragia. La toracotomía de reanimación tiene indicaciones precisas y sus resultados dependen de la etiología del traumatismo, siendo mejor al utilizarse en lesiones penetrantes cardiacas y con el menor tiempo en que se efectúa.

  7. Teoria dei quanti di luce

    CERN Document Server

    Einstein, Albert

    1992-01-01

    In questo scritto un’intuizione storica limpida e penetrante, con la quale il giovane Einstein pose le basi per i successivi studi sulla teoria della relatività, è consegnata al lettore in forma chiara ed essenziale. Nel 1905, appena ventiseienne, Einstein intervenne nel dibattito sulle leggi di distribuzione della radiazione luminosa che all’epoca animava gli ambienti scientifici e che si inseriva nel più ampio processo di revisione delle scienze fisiche e naturali. Il giovane scienziato tentò di dimostrare come «...una radiazione monocromatica di densità ridotta... si comporta, per quanto riguarda la termodinamica, come se fosse composta da quanti di energia indipendenti l’uno dall’altro». In altre parole, nel caso limite di basse temperature e piccole lunghezze d’onda, la teoria ondulatoria della luce, tradizionalmente accettata e riconosciuta dai fisici, sembrava destituita di ogni fondamento, e si faceva strada l’ipotesi che la radiazione viaggiasse “a pacchetti”. Lo sviluppo succe...

  8. Herida precordial por arma blanca

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    Marcelo F. Jiménez

    2005-04-01

    Full Text Available Varón de 42 años con esquizofrenia paranoide. Intento de suicidio con tres autolesiones por arma blanca (Fig. 1. Fue traído al hospital en estado consciente, taquicárdico, taquipneico y con tensión arterial (TA de 140/90 mmHg. Fue trasladado al quirófano, donde se practicó una toracotomía axilar izquierda sin extraer el arma. Durante la intervención se apreciaron tres heridas incisas, dos no penetrantes, hemotórax de 150 ml, herida pericárdica de 4 cm, sin lesiones cardíacas. La hoja del arma blanca penetraba a través del diafragma produciendo una herida incisa en el lóbulo hepático izquierdo (Fig. 2. Se extrajo el arma y se suturó la laceración hepática. El paciente fue trasladado el cuarto día a la Unidad de Psiquiatría.

  9. Megacólon tóxico fatal por cytomegalovirus em paciente com retocolite ulcerativa idiopática: relato de caso e revisão de literatura Fatal toxic megacolon due to cytomegalovirosis in a patient with ulcerative colitis: case report and review

    Directory of Open Access Journals (Sweden)

    Sérgio Ossamu IOSHII

    2002-04-01

    Full Text Available Racional - O megacólon tóxico é complicação grave e pouco freqüente na retocolite ulcerativa idiopática. Ocorre, geralmente, em pacientes cuja doença ativa é resistente ao tratamento clínico e, em algumas situações, o fator desencadeante é desconhecido. A infecção pelo cytomelogalovirus em seres humanos em geral é evento subclínico; entretanto, em pacientes imunocomprometidos a primoinfecção ou mesmo a reativação de infecção latente pode ter amplas repercussões clínicas, uma das quais o desencadeamento de megacólon tóxico. Objetivo - Descrever um caso de megacólon tóxico fatal por cytomegalovirose em paciente com retocolite ulcerativa idiopática. Paciente - Masculino, 38 anos, com clínica de diarréia e perda ponderal cuja investigação mostrou tratar-se de retocolite ulcerativa idiopática e para a qual foi instituída terapêutica imunossupressora vigorosa. Resultados - Evoluiu com quadro clínico de megacólon tóxico, sendo submetido a colectomia total. Complicações clínicas culminaram no óbito pós-operatório e o estudo anatomopatológico do cólon revelou doença ativa, associada a ulcerações confluentes na base das quais foram observadas células com alterações características da cytomegalovirose. Conclusão - A cytomegalovirose deve ser considerada como um dos agentes causadores de megacólon tóxico em retocolite ulcerativa.Background - The toxic megacolon is a rare and severe complication of ulcerative colitis. In general it complicates patients with active colitis that are resistant to clinical treatment and, in some cases, the developing factor is unknown. Cytomegalovirus infection in humans in general is a subclinical condition. However, in patients with immunodeficiency the primary infection or the reactivation of latent infection could have enormous clinical effects. One of these effects is the toxic megacolon. Aim - To report a case of fatal toxic megacólon due to cytomegalovirosis in a

  10. Cutaneous blastomycosis: a clue to a systemic disease Blastomicose cutânea: um sinal de doença sistêmica

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    Alex G Ortega-Loayza

    2013-04-01

    Full Text Available A 55-year-old male presented with back pain and slightly tender annular plaques with central ulceration on his face. A skin biopsy revealed scattered yeast with broad based buds. A CT scan of the abdomen revealed a pathologic T12 fracture. Tissue obtained from the spine confirmed budding yeasts. The patient was diagnosed with disseminated blastomycosis. The patient was treated with amphotericin and itraconazole and completely recovered.Paciente do sexo masculino, com 55 anos de idade, compareceu ao ambulatório com dores na costa e placas anulares ligeiramente sensíveis, com ulceração central na face. Uma biópsia cutânea revelou levedura disseminada, com brotos de base larga. A tomografia computadorizada do abdômen revelou uma fratura patológica da T12. Amostra de tecido obtido da coluna vertebral confirmou levedura em fase de brotamento. O paciente foi diagnosticado com blastomicose disseminada. Após tratamento com anfotericina e itraconazol, o paciente teve recuperação completa.

  11. Estefanofilariose em humanos: ocorrência e mecanismos de transmissão Stephanofilariasis in humans: occurrence and transmission mechanisms

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    Antonio Pereira de Novaes

    2007-04-01

    Full Text Available Descreve-se aqui o encontro do helminto Stephanofilaria spp., em dermatite nodular ulcerativa em seres humanos, sendo as ulceras pesquisadas de dimensões variadas e com alguns anos de existência. Acredita-se que, a presença desse parasita, que afeta diversas espécies de animais domésticos e silvestres, possa agravar o quadro com as lesões produzidas nos vasos venosos e linfáticos, reduzindo a circulação, retardando a cicatrização. O ciclo deste parasita no ser humano, também é descrito.This work describes the occurrence of the helminth Stephanofilaria spp in ulcerative nodular dermatitis in humans. The ulcers observed presented a variety of sizes and some years of existence. It is believed that the presence of this parasite, which affects several domestic and wild animal species, may harm human health through lesions produced in venous and lymphatic vessels that reduce blood circulation and retard the healing process. The cycle of this parasite in humans is also described.

  12. PREVENÇÃO E TRATAMENTO DE ÚLCERAS POR PRESSÃO NO COTIDIANO DE ENFERMEIROS INTENSIVISTAS

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    Jaiany Alencar Rolim

    2013-01-01

    Full Text Available Estudio exploratorio con objetivo de identificar las acciones de prevención y tratamiento de ulceras por presión, planeadas y/o ejecutadas por enfermeros en la Unidad de Cuidados Intensivos, la importancia atribuida a las intervenciones y las dificultades encontradas en la ejecución de estas. Se llevó a cabo en una Unidad de Cuidados Intensivos de Hospital Universitario, con la participación de nueve enfermeras. Los datos obtenidos a través de entrevistas se analizaron de acuerdo a técnica del Discurso del Sujeto Colectivo, y destacó el cambio de posición entre las medidas de prevención y atención curativa como el tratamiento principal de la úlcera por presión. Las dificultades señaladas por las enfermeras fueron las deficiencias en recursos humanos, en número, la formación y falta de adhesión de los miembros del equipo; y en los recursos materiales para promover la comodidad y seguridad del paciente.

  13. El Segundo Cerebro del ser humano.

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    Rocío Ponce

    2015-10-01

    Este articulo tiene por objetivo principal analizar la participación del segundo cerebro en la conducta del hombre, con la ayuda de una nueva especialidad de medicina, la Neurogastroenterología, con su explicación se determina la reacción que existe entre el cerebro mesenterio y el cerebro central, se identifica a cada uno en sus funciones, se efectúa un análisis referencial de como el estrés influye en la conducta, produciendo una crisis. Que se manifiestan con trastornos fisiológicos y psicológicos, como diarreas o estreñimiento, con dolor y trastornos de ansiedad, cansancio, insomnio, falta de concentración perdida de la memoria y a su vez ulceras gástricas, hipertensión, gases, que no necesariamente se debe solamente a un problema estomacal producido por una mala ingesta de alimentos, sino por comportamientos emocionales que repercuten negativamente en esta parte del cuerpo. Se comprobará la influencia del segundo cerebro en la impulsividad y sus daños colaterales en el organismo

  14. Experiência inicial com a ceratoprótese de Dohlman-Doane: relato de casos Experience with Dohlman-Doane keratoprosthesis: case reports

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    Andressa Prestes Stolz

    2008-04-01

    Full Text Available OBJETIVO: Relatar a evolução de 9 olhos (8 pacientes submetidos ao implante da ceratoprótese de Dohlman-Doane tipo 1, com tempo médio de seguimento de 11,2 meses (2 a 25 meses. MÉTODOS: Trabalho retrospectivo, não comparativo, intervencionista de uma série de casos. Quanto à doença de base, em 4 olhos foram queimadura alcalina, 3 falência de múltiplos transplantes de córnea, 1 síndrome de Stevens-Johnson e 1 queimadura térmica. A acuidade visual pré-operatória era de movimento de mãos ou pior em todos os olhos. Três olhos apresentavam glaucoma pré-operatório, sendo submetidos a implante valvulado de Ahmed. RESULTADOS: A acuidade visual com correção pós-operatória foi melhor ou igual a 20/100 em 88,9% dos olhos e melhor ou igual a 20/40 em 44,4% dos olhos. Como intercorrências pós-operatórias, 3 olhos apresentaram opacidade de cápsula posterior tratada com capsulotomia com YAG laser; 3 olhos membrana retroprotética de fibrina tratada com injeção tPA ou corticoterapia; 2 olhos glaucoma tratado com medicação; 1 olho "melting" corneano tratado com a troca do botão e 1 olho endoftalmite fúngica tratada com transplante a quente, vitrectomia anterior, explante da ceratoprótese e da LIO e tratamento antifúngico. CONCLUSÃO: A ceratoprótese de Dohlman-Doane é uma boa opção para casos graves de cegueira corneana, em que o transplante penetrante de córnea não apresenta bom prognóstico. Sua principal vantagem é não necessitar imunossupressão sistêmica. Casos de queimadura alcalina e de alta chance de rejeição apresentaram os melhores resultados.PURPOSE: To describe 9 eyes in 8 patients who received Dohlman-Doane type 1 keratoprosthesis (KPro with a mean follow-up of 11.2 months (2 to 25 months. METHODS: A retrospective, non-comparative interventional case series. Previous corneal disease was alcaline burn in 4 eyes, multiple graft failure in 3 eyes, Stevens-Johnson syndrome in 1 eye and thermal injury in 1

  15. Tratamento das ulcerações traumáticas bucais causadas por aparelhos ortodônticos Treatment of the mouth traumatic ulcers caused by orthodontic appliances

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    Antonio Adilson Soares de Lima

    2005-10-01

    Full Text Available As lesões de aspecto ulcerado na mucosa bucal são um achado comum na clínica odontológica e geralmente são ocasionados por trauma mecânico devido a próteses mal adaptadas, aparelhos ortodônticos e dentes com coroas ou restaurações fraturadas. Contudo, os indivíduos nos quais a lesão persiste por mais de três semanas deverão ser submetidos à biopsia ou outros exames para excluir algumas lesões de caráter neoplásico ou outras condições, tais como as infecções crônicas e as doenças de caráter imunológico. Durante o tratamento ortodôntico, a dor e o desconforto da mucosa bucal podem acontecer como resultado do traumatismo mecânico dos aparelhos, ocasionado pela fricção aumentada entre o tecido da mucosa e a superfície dos braquetes. Atualmente, o ortodontista possui poucos recursos para prevenir ou aliviar esta irritação na mucosa. O objetivo deste artigo é orientar o ortodontista para o manejo mais adequado destas lesões visando o seu diagnóstico correto, o alívio dos sintomas que estas costumam provocar e o tratamento mais adequado para cada tipo de caso.Mouth ulcers are one of the most commom complaints in the dental clinic. They are, in general, caused for mechanic traumatism induced by non-fitted dentures, orthodontic appliances and fracturated crowns and fillings. Nevertheless, those lesions that have persisted for more than three weeks should be submitted to biopsy or other exams to exclude neoplasic, infectious or immunologic lesions. During the orthodontic treatment, pain and soreness of the oral mucosa can occur as the result of mechanic traumatism caused by increased friction between soft tissues and brackets. Nowadays, the professional owns few resources to prevention or relieve this irritation on the oral mucosa. The aim of this article is to guide the orthodontist to realize the correct diagnoses of the mouth ulcers, the relieve the symptoms and the exact treatment for each type of case.

  16. Selective proximal vagotomy with and without pyloroplasty

    International Nuclear Information System (INIS)

    Brodersen, E.

    1984-01-01

    It was the aim of the study described here to gain information relevant to the well-being of patients subjected to selective proximal vagotomy with or without pyroloplasty as soon as possible after surgery. For this purpose, particular care was taken to ascertain the frequency of recidivation and the post-operative occurrence of disturbances in the emptying of gastric contents. In 35 patients solely undergoing SPV and a further 12 individuals, where both SPV and pyroloplasty had been performed, gastric emptying was monitored using a gamma camera and computer system. All patients were given a standardised test meal consisting of 500 ml ready-made milk labeled with 2 mCi 99mTc-HSA. After the patients had been assigned to different study groups according to the gastric emptying rates established in the individual cases, it became evident that there was a correlation between gastric emptying time (T/2) and the occurrence of post-operative discomfort. In the majority of patients the gastric emptying rate was found to be increased as compared to individuals with a healthy stomach. Among a total of 8 patients showing delayed gastric emptying only one, who solely underwent SPV, reported post-operative discomfort. Markedly increased rates of gastric emptying (T/2 ≤ 5 min) were predominantly determined in patients subjected to SPV in conjunction with pyroloplasty. A dumping syndrome and diarrhea were diagnosed in every third patient. Clinical follow-up studies and questionnaires distributed among the study patients showed relapses to occur with a frequency of 6.7%, the recidivation of ulcera being confined to the group of patients merely undergoing SPV. (TRV) [de

  17. Selective proximal vagotomy with and without pyloroplasty. A clinical follow-up study in connection with radiopharmaceutical measurements to monitor gastric emptying. Die selektiv proximale Vagotomie mit und ohne Pyloroplastik. Eine klinische Nachuntersuchung und nuklearmedizinische Magenentleerungsmessung

    Energy Technology Data Exchange (ETDEWEB)

    Brodersen, E

    1984-03-30

    It was the aim of the study described here to gain information relevant to the well-being of patients subjected to selective proximal vagotomy with or without pyroloplasty as soon as possible after surgery. For this purpose, particular care was taken to ascertain the frequency of recidivation and the post-operative occurrence of disturbances in the emptying of gastric contents. In 35 patients solely undergoing SPV and a further 12 individuals, where both SPV and pyroloplasty had been performed, gastric emptying was monitored using a gamma camera and computer system. All patients were given a standardised test meal consisting of 500 ml ready-made milk labeled with 2 mCi 99mTc-HSA. After the patients had been assigned to different study groups according to the gastric emptying rates established in the individual cases, it became evident that there was a correlation between gastric emptying time (T/2) and the occurrence of post-operative discomfort. In the majority of patients the gastric emptying rate was found to be increased as compared to individuals with a healthy stomach. Among a total of 8 patients showing delayed gastric emptying only one, who solely underwent SPV, reported post-operative discomfort. Markedly increased rates of gastric emptying (T/2 less than or equal to 5 min) were predominantly determined in patients subjected to SPV in conjunction with pyroloplasty. A dumping syndrome and diarrhea were diagnosed in every third patient. Clinical follow-up studies and questionnaires distributed among the study patients showed relapses to occur with a frequency of 6.7%, the recidivation of ulcera being confined to the group of patients merely undergoing SPV. (TRV).

  18. CASE REPORT CASE CASE Post-traumatic cholesteatoma … a ...

    African Journals Online (AJOL)

    CASE REPORT. CASE. 46. SA JOURNAL OF RADIOLOGY • July 2008. CASE. Abstract. Temporal bone fractures and their acute complications have been well described in radiology and ENT journals; this is in contrast to ... post-traumatic cholesteatomas and made postulations on their origin. Since then, there have been ...

  19. Pyoderma gangrenosum as a initial manifestation of ulcerative proctocolitis

    Directory of Open Access Journals (Sweden)

    Carla Bortolin Fonseca

    2011-09-01

    Full Text Available pyoderma gangrenosum is a rare inflammatory skin condition characterized by progressive and recurrent skin ulceration of destructive course. It is usually associated with rheumatoid arthritis, paraproteinemia, myeloproliferative diseases and inflammatory bowel diseases, especially non-specific ulcerative proctocolitis. In these situations, skin lesions are described as concurrent with the intestinal condition. However, reports on pyoderma gangrenosum preceding intestinal findings are less frequent. The authors describe a case of a woman with febrile condition associated with skin lesions diagnosed by biopsy as pyoderma gangrenosum. Two weeks later, she developed diarrhea, arthralgia and sepsis, being diagnosed as ulcerative proctocolitis. After the administration of the treatment for ulcerative proctocolitis, she showed improvements in sepsis care, remission of diarrhea and regression of skin lesions. This case highlights the importance of considering pyoderma gangrenosum as a manifestation associated with inflammatory bowel disease, regardless of its timing in relation to intestinal symptoms.Pioderma gangrenoso é uma forma de inflamação cutânea, caracterizada por ulceração progressiva e recorrente da pele, com curso destrutivo. Geralmente é associada à artrite reumatoide, paraproteinemia, doenças mieloproliferativas e doença inflamatória intestinal, em especial retocolite ulcerativa inespecífica. Em tais casos, as lesões cutâneas são descritas concomitantes ao quadro intestinal, porém, relatos com descrição de pioderma gangrenoso precedendo achados intestinais são menos frequentes. Os autores relatam caso de mulher com quadro febril associado a lesões cutâneas diagnosticadas por biópsia como pioderma gangrenoso. Duas semanas depois, apresentou diarreia, artralgia e sepse sendo diagnosticada retocolite ulcerativa. Com o tratamento para retocolite ulcerativa apresentou melhora do quadro séptico, remissão da diarreia e

  20. Ensaios terapêuticos com penicilina: IV - Bouba - (Framboesia, pian, yaws: tratamento das ulcerações gomosas, periostites, osteites áreas de rarefação óssea e gangoza (Rhinopharyngitis mutilans

    Directory of Open Access Journals (Sweden)

    F. Nery Guimarães

    1945-04-01

    Full Text Available Six patients of terciary yaws, were treated with Penicillin in small dosis at Evandro Chagas Hospital of the Oswaldo Cruz Institute. The lesions presented by the patients were: gummatous ulcerations, periostitis, osteitis, osteoporosis and gangoza (rhinopharyngitis mutilans. In all cases, clinic recovery were obtained, the time of treatment varying from 2 to 8 months. The total amount of oxford units 'per" subject varied from 48.000 to 586.800 Patients with bone lesions, ever after the treatment, has not showed complete recomposition of the bone structure, ever so aparently healing and with negative sorologics tests. Identical results has been observed in patient showing the same lesions and treated with neo-arsphenamine. The patients are still under observations at the Hospital.

  1. The Case for Case Reports

    Directory of Open Access Journals (Sweden)

    George R. Saade

    2011-09-01

    Full Text Available If you are reading a hard copy of this editorial, then you are holding in hand the first issue of the American Journal of Perinatology Reports, or AJP Reports as we like to refer to it. Welcome to AJP Reports and thank you for taking the time to peruse it. I hope you find many of the reports interesting and helpful. The editorial team and publisher are very pleased to be able to bring this journal to our readers. Judging by the journal title, the editorial team, and the layout you may have already guessed that this is a companion to the American Journal of Perinatology. We will continue to publish original articles and topical reviews in the American Journal of Perinatology, but all case reports or case series will be referred to AJP Reports. Some may question the need for more case reports. Our decision to start AJP Reports obviously indicates that we think that case reports can be useful. I can refer to several diseases, treatment complications, and procedures that were first brought to the attention of healthcare providers through case reports. The best example of the usefulness of case reports is probably in infectious diseases. In the early phases of an emerging infectious disease, the case report or case series are usually the first clues of a problem. HIV was first brought to the attention of the medical community by case reports.[1] [2] [3] In our own field, the first attempts at treatment of twin-to-twin transfusion syndrome (TTTS using laser coagulation were reported in a case series.[4] After additional reports about the use of laser in TTTS, a randomized trial was performed that cemented laser photocoagulation as a therapeutic modality for TTTS.[5] While case reports or series are not considered the highest form of evidence, they are frequently the first form of evidence and the nudge that starts the cascade of investigation that ultimately leads to high-level evidence. Therefore, their impact on clinical practice may be easily

  2. 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.

  3. Distrofia de Schnyder

    Directory of Open Access Journals (Sweden)

    Zaadia Pérez Parra

    Full Text Available Entre las distrofias estromales encontramos la distrofia de Schnyder, que se caracteriza por ser bilateral y progresiva. Su diagnóstico es relativamente sencillo cuando se presenta con cristales de colesterol y fosfolípidos. El estudio histológico y la microscopia confocal confirman el diagnóstico. Presentamos dos casos clínicos de distrofia de Schnyder, en pacientes del sexo femenino, quienes acudieron a la consulta y refirieron disminución de la visión y cambio de coloración de los ojos. Los hallazgos clínicos y la microscopia confocal confirman el diagnóstico de distrofia de Schnyder, la cual se caracteriza por la presencia de cristales en el estroma anterior central de distribución anular o disciforme, asociado a arco lipoide y haze en la media periferia. La fotoqueratectomía con excímer láser cuando la afección se limita al estroma anterior, o la queratoplastia penetrante en casos más avanzados, constituyen el arsenal terapéutico en esta afección.

  4. Acerca de los estilos cognitivos: dependencia- independencia de campo

    Directory of Open Access Journals (Sweden)

    Anibal Meza

    1987-12-01

    Full Text Available Se ofrece una breve revisión de la literatura sobre los Estilos Cognitivos de Dependencia- Independencia del Campo (De-le. Se hace notar la ausencia de investigaciones peruanas sobre el tema y se delimita al ámbito de la temática De-le. Se da cuenta del origen de la De-le como constructo, anclándolo al interior del constructo mayor "diferenciación psicológica". Se reseñan los modos de evaluación y se enlistan las características de la De-le como estilos cognitivos (son dimensiones penetrantes del funcionamiento individual, son variables de proceso antes que de contenido y constituyen una dimensión bipolar y de valor neutral. Se ven las relaciones De-le -conducta interpersonal: tipo de orientación interpersonal, responsividad a claves sociales e intereses y respuestas interpersonales típicas. Finalmente, se examinan los orígenes ontogenético (restringiendo la revisión a efectos de entrenamiento y la crianza infantil y cultural de la De-le.

  5. Trauma da Veia Porta

    Directory of Open Access Journals (Sweden)

    Gustavo Pereira Fraga

    Full Text Available OBJETIVO: O trauma da veia porta é raro e freqüentemente fatal por causa de exsanguinação e alta incidência de lesões de estruturas adjacentes. Devido às pecualiaridades desta lesão e diferentes condutas propostas na literatura, o objetivo dos autores é relatar a experiência neste tipo de lesão. MÉTODO: Estudo retrospectivo, de janeiro de 1994 e dezembro de 2001, de 1370 pacientes submetidos à laparotomia devido trauma abdominal. Entre esses, 15 pacientes apresentavam lesão da veia porta. As lesões foram classificadas conforme a sua extensão e localização. RESULTADOS: O mecanismo de trauma predominante foi o penetrante. O diagnóstico da lesão foi realizado no intraoperatório. Os procedimentos executados foram: sutura, anastomose término-terminal e ligadura da veia porta. A mortalidade foi de 53,3%. CONCLUSÃO: A lesão da veia porta possui alta taxa de mortalidade e o atendimento adequado está diretamente relacionado à sobrevida.

  6. Facoemulsificación en casos especiales: Instituto Cubano de Oftalmología “Ramón Pando Ferrer”, 2002-2005 Phacoemulsification applied to special cases in “Ramon Pando Ferrer” Cuban Institute of Ophthalmology, 2002-2005

    Directory of Open Access Journals (Sweden)

    Juan Raúl Hernández Silva

    2006-06-01

    Full Text Available La cirugía de catarata ha llegado a un nivel de perfección que no existen barreras para no realizar una facoemulsificación. Nuestra principal motivación para la realización de este trabajo, es estudiar los resultados en casos especiales y su comportamiento en nuestro medio. Los casos especiales comprenden severa miopía e hipermetropía, poscirugía refractiva, pupila pequeña, uveítis, catarata congénita, catarata subluxada, trauma, catarata hipermadura, catarata combinada con vitrectomía, queratoplastia penetrante y glaucoma. En todos estos casos las técnicas de facoemulsificación se han perfeccionado y se han introducido instrumentos accesorios que contribuyen al éxito quirúrgico y a disminuir al mínimo las complicaciones derivadas de la cirugía en ojos, que son potencialmente complicados para el preoperatorio. Entre las causas más frecuentes de pupila pequeña incluyen, agentes miótico usados de forma crónica, síndrome exfoliativo, síndrome de Horner, secundarias a traumas e inflamaciones .Se realizó un estudio descriptivo, prospectivo de corte trasversal, cuyo universo estuvo constituido por 39 pacientes (ojos del Centro de Microcirugía Ocular (CMO del Instituto Cubano de Oftalmología “Ramón Pando Ferrer” seleccionados mediante un muestreo simple aleatorio, cuya edad promedio fue de 61 años. La mayoría de los pacientes presentaron dureza del cristalino altos y tiempo promedio de ultrasonido bajos. La agudeza visual preoperatoria y posoperatoria promedio con corrección mejoró significativamente en cuatro líneas de la cartilla de Snellen. El astigmatismo inducido por la cirugía fue bajo. Finalmente se analizaron las complicaciones y se detallaron los accidentes que ocurrieron durante el acto quirúrgico, y se observó que la ruptura de cápsula posterior y la salida de vítreo fueron los eventos los más frecuentesCataract surgery has come to an improvement level that today there are no barriers to

  7. Effect of Cissus quadrangularis on gastric mucosal defensive factors in experimentally induced gastric ulcer-a comparative study with sucralfate.

    Science.gov (United States)

    Jainu, Mallika; Devi, C S Shyamala

    2004-01-01

    Cissus quadrangularis is an indigenous plant commonly mentioned in Ayurveda for treatment of gastric ulcers. The ulcer-protective effect of a methanolic extract of C. quadrangularis (CQE) was comparable to that of the reference drug sucralfate. Further, gastric juice and mucosal studies showed that CQE at a dose of 500 mg/kg given for 10 days significantly increased the mucosal defensive factors like mucin secretion, mucosal cell proliferation, glycoproteins, and life span of cells. The present investigation suggests that CQE not only strengthens mucosal resistance against ulcerogens but also promotes healing by inducing cellular proliferation. Thus, CQE has potential usefulness for treatment of peptic ulcer disease.

  8. Epidemiología de la ulcera péptica en siete consultorios del médico de la familia

    Directory of Open Access Journals (Sweden)

    Roberto Alvarez Sintes

    1995-06-01

    Full Text Available Se realiza un estudio en 7 consultorios médicos del Policlínico Docente "Tomás Romay", del municipio Artemisa, para analizar algunos aspectos epidemiológicos de la úlcera péptica en pacientes dispensarizados en las historias clínicas familiares por esta enfermedad. Se encontró una prevalencia del 1%. La úlcera gástrica fue más frecuente después de los 40 años de edad. Se investiga, además, su relación con los hábitos tóxicos, el régimen de alimentación previo, el grupo sanguíneo, los antecedentes familiares y el estrés. Las manifestaciones clínicas más frecuentes fueron: el dolor, la acidez y la pirosisA study was conducted in 7 medical offices from "Tomás Romay" Teaching Polyclin cs, Artemisa municipality in order to analyze certain epidemiologic aspects of peptic ulcer in dispenzarized patients. A prevalence of 1 % was observed. Gastric ulcer was found to be more frequent after 40 years of age. The relation of peptic ulcer to toxic habits, previous feeding practices, blood group, familial history and stress, is also under research. The most frequent clinical manifestations were: pain, acidity, and pyrosis.

  9. Wound healing effects of dipeptidyl peptidase-4 inhibitors: An emerging concept in management of diabetic foot ulcer-A review.

    Science.gov (United States)

    Saboo, Apoorva; Rathnayake, Ayeshmanthe; Vangaveti, Venkat N; Malabu, Usman H

    2016-01-01

    Dipeptidyl peptidase-4 (DPP-4) inhibitors have a well-known effect on glycaemic control in patients with diabetes but little is known on their wound healing role in this group of population. This paper reviews the effects of DPP-4 inhibitors on wound healing of diabetic foot ulcers. Published data on effects and mechanism of DDP-4 inhibitors on wound healing were derived from Medline, PubMed and Google Scholar search of English language literature from 1994 to 2014 using the key words such as "DPP-4 inhibitors", "endothelial healing" "diabetes" and "chronic ulcers". DPP-4 inhibitors show a potential benefit in processes of wound healing in diabetic chronic foot ulcers. The enzyme inhibitors promote recruitment of endothelial progenitor cells and allow the final scaffolding of wounds. Furthermore DPP-4 inhibitors augment angiogenesis and have widespread effects on optimising the immune response to persistent hypoxia in chronic diabetes wounds. DPP-4 inhibitors show promise in the local wound healing of diabetic foot ulcers in addition to its already established glycaemic control. In the light of high rate of amputations due to non-healing ulcers with profound psychological and economical liability, more investigations on the usefulness of DPP-4 inhibitors in the high risk diabetes population are needed. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  10. Case - Case-Law - Law

    DEFF Research Database (Denmark)

    Sadl, Urska

    2013-01-01

    Reasoning of the Court of Justice of the European Union – Constr uction of arguments in the case-law of the Court – Citation technique – The use of formulas to transform case-law into ‘law’ – ‘Formulaic style’ – European citizenship as a fundamental status – Ruiz Zambrano – Reasoning from...

  11. Simultaneous canine distemper encephalitis and canine parvovirus infection with distemper-associated cardiac necrosis in a pup Infecção simultânea por vírus da cinomose e da parvovirose associada à necrose cardíaca em um canino

    Directory of Open Access Journals (Sweden)

    Selwyn Arlington Headley

    2003-12-01

    Full Text Available Simultaneous infection of canine distemper virus and canine parvovirus associated with distemper myocardial degeneration and necrosis is described in a pup. The dog demonstrated myoclonus, nystagmus, enamel hypoplasia, abdominal pustules, and bilateral corneal ulceration clinically. Demyelinating encephalitis, myocardial degeneration and necrosis with mineralization, and necrosis, hemorrhage and fusion of intestinal villi were observed. The lesions observed in this dog are characteristic of a dual infection of canine distemper virus and canine parvovirus.Descreve-se a infecção simultânea de cinomose e parvovirose associada à degeneração e necrose do miocárdio em um cão. Clinicamente, o cão apresentou mioclonias, nistagmo, hipoplasia do esmalte dentário, pústulas abdominais e ulceração bilateral da córnea. Foram observadas encefalite desmielinzante, degeneração e necrose do miocárdio com mineralização, e necrose, hemorragia e fusão das vilosidades intestinais. As lesões observadas neste cão são características com uma infecção pelos vírus da cinomose e da parvovirose.

  12. [Treatment and prevention of erosive and ulcerative lesions in the stomach and duodenum caused by intake of non-steroidalanti-inflammatory drugs].

    Science.gov (United States)

    Luzina, E V

    2014-01-01

    Therapy with non-steroidal anti-inflammatory drugs (NSAIDs) is a diffcult task. Good anti-inflammatory effect increases the risk of gastrointestinal complications with a frequency of 10-50%. The risk further increases with age (above 60-70 yr), the history of ulcer disease concomitant intake of acetylsalicylic acid, anticoagulants, and glucocorticosteroids. Long-term antisecretory therapy with proton pump inhibitors, e.g., esomeprazole, was shown to be an effective prophylactic tool. This drug maintains the intragastric pH value above 4 for 15 hr on the average. The risk of erosive and ulceraive lesions in the stomach and duodenum significantly decreases by selective cyclooxygenase-2 inhibitors, e.g., coxibs, that however increase the risk of thrombotic cardiovascular complications. The author proposes recommendations on the use of NSAIDs in the patients at risk of serious gastrointestinal and cardiovascular pathology. Naproxen in combination with proton pitmp inhibitors is the drug of choice among NSAIDs. Vimovo is a fixed combination of naproxen and esomeprazole. Results of comparative studies on the efficacy of vimovo and celecoxib are presented along with the data on the safety of this. combination compared with that of naproxen monotherapy

  13. Clinical and histopathological profile of basal cell carcinoma in a population from Criciúma, Santa Catarina, Brazil Perfil clínico e histopatológico do carcinoma basocelular em amostra populacional de Criciúma, SC, Brasil

    Directory of Open Access Journals (Sweden)

    Letícia Pangendler Peres

    2012-08-01

    Full Text Available Basal cell carcinoma is a local, invasive epidermal neoplasia, the most common type of which is nodular basal cell carcinoma. The objective of the present study was to evaluate the occurrence of basal cell carcinoma, characterizing its distribution in accordance with patients' age, gender, the site of the lesion and its histopathological characteristics. Anatomopathology reports of cases of basal cell carcinoma diagnosed in Criciúma, Santa Catarina, Brazil between June 2005 and June 2007 were analyzed. A descriptive, observational, cross-sectional study was conducted. The majority of patients were females over 40 years of age. Most of the tumors were of the nodular type and were situated on the face. There was ulceration in 27.5%, infiltration in 24.5% and invasion of the deep dermis in 61.8%. Local data must be evaluated in order to emphasize the importance of early diagnosis.O carcinoma basocelular é uma neoplasia epidérmica invasiva local, cujo tipo mais frequente é nódulo-ulcerativo. O objetivo foi estudar a ocorrência de CBC, caracterizando sua distribuição segundo idade, sexo, localização e características histopatológicas. Analisaram-se laudos anatomopatológicos de CBC, diagnosticados em Criciúma/SC, entre junho de 2005 e junho de 2007. Elaborou-se um estudo descritivo, observacional e transversal. Predominou após os 40 anos, no sexo feminino, do tipo nodular e localizado na face. Houve ulceração em 27,5%, infiltração em 24,5%, invasão de derme profunda em 61,8%, entre outros. É necessário conhecer dados locais para reforçar a importância do diagnóstico precoce.

  14. Verificação da infecção de moscas da família Tachinidae pela Empusa Cohn, 1855: essas moscas, sugando ulceras lepróticas, se infestaram com o bacilo de Hansen

    Directory of Open Access Journals (Sweden)

    H. C. de Souza-Araujo

    1944-08-01

    Full Text Available The A. refers that, in his last study, in his last studying trip to Colonia Santa Fé, Minas Gerais State, last month of March (autumn, had captured many wild flies (all from Tachinidae family, according to various entomologists of the Instituto Oswaldo Cruz, on a leprotic ulceration of the left leg of a lepromatous case of leprosy. The microscopical examination of the abdominal material from sch flies proved the presence, in rather great number, of HANSEN bacilli and a fungus of the genus Empusa COHN 1855. The A. intends to continue, next summer, such interesting research.

  15. Endoftalmitis por Pseudomonas aeruginosa posterior a queratoplastia penetrante, reporte de caso con investigación epidemiológica

    Directory of Open Access Journals (Sweden)

    Claudia Blanco

    2010-09-01

    Conclusiones. El sitio de la extracción de las corneas debe garantizar una preparación antiséptica y una recuperación aséptica del tejido donante pues en este estudio aunque no se pudo establecer con certeza la fuente de la infección, los hallazgos llevaron a sospechar una posible contaminación en la morgue.

  16. 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.

  17. Case management.

    Science.gov (United States)

    Woodward, Judy; Rice, Eve

    2015-03-01

    Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Stories as case knowledge: case knowledge as stories.

    Science.gov (United States)

    Cox, K

    2001-09-01

    Every case contains a human story of illness and a medical story of disease, which together cover person management, case management, health system management and self-management. Much of that management can be learned via a thorough set of stories of typical and atypical core cases compiled by clinical teachers. Stories provide a highly flexible framework for illustrating the lessons of experience, the tips and traps for young players, and the dilemmas requiring careful judgement in the trade-offs between benefits and risks. Listening to real stories unfold is much more fun than being lectured (and better remembered). Stories illustrate 'what can happen' in a case as a guide to 'what to do'. A story begins with a real world situation with some predicament and a (causal) sequence of events or plot in which things are resolved one way or another. Patients tell their illness story; their clinician translates that into a disease story. Stories sort out what is important in such a predicament, consider the strategy and tactics of what to do, and speak about the outcomes. Each local situation provides relevance, context and circumstantial detail. Stories about case management can encapsulate practical knowledge, logical deduction, judgement and decision making, sharing with the student all the ingredients that develop expertise. Sometimes it is the plot that is important, sometimes the detail, sometimes it is the underlying message, the parable that resonates with the listener's experiences and feelings.1 Stories can also accommodate the complexity of multiple variables and the influence of other stakeholders, the uncertainties and dilemmas within the trade-offs, and the niceties of 'informed judgement'. This paper makes four points. First, clinical stories recount pointed examples of 'what happened' that expand our expertise in handling 'a case like that'. Second, cases are the unit of clinical work. Case stories expand the dimensions and details of case knowledge

  19. Confiabilidade intra e interexaminador da análise por padrões de impressão de plantigrafias de pessoas diabéticas obtidas com o Harris Mat Inter- and intra-examiner reliability of footprint pattern analysis obtained from diabetics using the Harris Mat

    Directory of Open Access Journals (Sweden)

    Lígia L. Cisneros

    2010-06-01

    Full Text Available INTRODUÇÃO: A hiperpressão plantar é um fator de risco comprovado para a ulceração em portadores de diabetes mellitus. O "Harris and Beath Footprinting Mat" é um dos instrumentos usados nas avaliações para rastreamento do risco de ulceração nos pés desses pacientes. Não há relatos na literatura sobre estudos da confiabilidade da análise das impressões plantares usando o critério de padrões de impressão. OBJETIVO: O objetivo deste estudo foi avaliar a confiabilidade inter e intraexaminador da análise dos padrões de impressão plantar obtida com o "Harris and Beath Footprinting Mat". MÉTODOS: As impressões plantares de 41 sujeitos foram obtidas usando o plantígrafo. As imagens foram submetidas à análise de três examinadores independentes. Para verificar a confiabilidade intraexaminador, um dos examinadores repetiu a análise após uma semana. RESULTADOS: O coeficiente de Kappa ponderado foi excelente (Kp>0,80 para as análises inter e intraexaminador para a maioria dos pontos estudados em ambos os pés. CONCLUSÃO: O critério de análise por padrões de impressão plantar obtidas com o "Harris and Beath Footprinting Mat" apresentou boa confiabilidade e de alta a excelente concordância para as condições inter e intraexaminador. Esse método é confiável para análises que envolvam um ou mais examinadores.INTRODUCTION: High plantar pressure is a proven risk factor for ulceration among individuals with diabetes mellitus. The Harris and Beath footprinting mat is one of the tools used in screening for foot ulceration risk among these subjects. There are no reports in the literature on the reliability of footprint analysis using print pattern criteria. OBJECTIVE: The aim of this study was to evaluate the inter- and intra-examiner reliability of the analysis of footprint patterns obtained using the Harris and Beath footprinting mat. METHODS: Footprints were taken from 41 subjects using the footprinting mat. The images were

  20. Location of gliomas in relation to mobile telephone use: a case-case and case-specular analysis

    DEFF Research Database (Denmark)

    Larjavaara, Suvi; Schüz, Joachim; Swerdlow, Anthony

    2011-01-01

    approaches: In a case-case analysis, tumor locations were compared with varying exposure levels; in a case-specular analysis, a hypothetical reference location was assigned for each glioma, and the distances from the actual and specular locations to the handset were compared. The study included 888 gliomas......The energy absorbed from the radio-frequency fields of mobile telephones depends strongly on distance from the source. The authors' objective in this study was to evaluate whether gliomas occur preferentially in the areas of the brain having the highest radio-frequency exposure. The authors used 2...... from 7 European countries (2000-2004), with tumor midpoints defined on a 3-dimensional grid based on radiologic images. The case-case analyses were carried out using unconditional logistic regression, whereas in the case-specular analysis, conditional logistic regression was used. In the case-case...

  1. [Case-non case studies: Principles, methods, bias and interpretation].

    Science.gov (United States)

    Faillie, Jean-Luc

    2017-10-31

    Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  2. Using existing case-mix methods to fund trauma cases.

    Science.gov (United States)

    Monakova, Julia; Blais, Irene; Botz, Charles; Chechulin, Yuriy; Picciano, Gino; Basinski, Antoni

    2010-01-01

    Policymakers frequently face the need to increase funding in isolated and frequently heterogeneous (clinically and in terms of resource consumption) patient subpopulations. This article presents a methodologic solution for testing the appropriateness of using existing grouping and weighting methodologies for funding subsets of patients in the scenario where a case-mix approach is preferable to a flat-rate based payment system. Using as an example the subpopulation of trauma cases of Ontario lead trauma hospitals, the statistical techniques of linear and nonlinear regression models, regression trees, and spline models were applied to examine the fit of the existing case-mix groups and reference weights for the trauma cases. The analyses demonstrated that for funding Ontario trauma cases, the existing case-mix systems can form the basis for rational and equitable hospital funding, decreasing the need to develop a different grouper for this subset of patients. This study confirmed that Injury Severity Score is a poor predictor of costs for trauma patients. Although our analysis used the Canadian case-mix classification system and cost weights, the demonstrated concept of using existing case-mix systems to develop funding rates for specific subsets of patient populations may be applicable internationally.

  3. LEVANTAMENTO DOS CASOS DE TRAUMATISMO OCULAR NUM HOSPITAL DE EMERGÊNCIA

    Directory of Open Access Journals (Sweden)

    MARIA ALZETE DE LIMA

    2010-01-01

    Full Text Available Los objetivos del estudio fueron estimar la incidencia e identificar los tipos de traumas y las circunstancias relacionadas a los casos de los pacientes atendidos en un servicio de urgencia oftalmológica, Ceará, Brasil. Estudio descriptivo, cuantitativo, realizado con 845 víctimas de traumas. Se evaluó: sexo, edad, origen, causa y tipo de trauma. La recogida de datos fue llevada a cabo mediante entrevista y el registro del historial médico de los casos. El sexo masculino, 663(78,5% fue más susceptible a los traumas oculares, causados por cuerpo extraño, 321(40,89%, y accidente de tráfico, 147 (18,73%. En el sexo femenino prevaleció el accidente doméstico, 49 (40,2%. La mayoría pertenecía al rango de 20 a 29 años de edad, 196 (25,0%, y procedente de la capital, 530 (67,5%. La herida penetrante fue el principal tipo de trauma. Ante la magnitud del problema, es importante que se tomen medidas de promoción en salud que ayuden a prevenir los traumatismos oculares.

  4. Vínculos de poder y de sujeción: una lectura de “Cuchillo y madre” y “Tango” de Luisa Valenzuela

    Directory of Open Access Journals (Sweden)

    David García Pérez

    2014-06-01

    Full Text Available Luisa Valenzuela (Buenos Aires, 1938 es una de las voces femeninas más reconocidas de las letras latinoamericanas: narradora inteligente y penetrante en sus juicios, a través de sus relatos manifiesta el espíritu libre y propositivo de la literatura latinoamericana femenina. En este trabajo se analizan los cuentos “Cuchillo y madre” y “Tango”, en los que es posible identificar los espacios de lo femenino, que suelen ser muy reducidos, aparentemente. La mujer ha tenido que luchar para que éstos se abran e, incluso, se reconozca la manera en que contribuye a la creación de los mismos. Los espacios que le han sido vedados han sido definidos, paradójicamente, desde la perspectiva que el hombre tiene sobre lo femenino. El espacio femenino por antonomasia es el hogar, al menos desde la visión patriarcal que priva en Latinoamérica. Es en él donde la mujer aprende a reconocer el mundo y a sí misma. Su esencia se mira a través de un cedazo, se hila en un bastidor, se guisa a fuego lento con las limitaciones de una sociedad masculinizada.

  5. CASING DRILLING TECHNOLOGY

    Directory of Open Access Journals (Sweden)

    Nediljka Gaurina-Međimurec

    2005-12-01

    Full Text Available Casing drilling is an alternative option to conventional drilling and uses standard oilfield casing instead of drillstring. This technology is one of the greatest developments in drilling operations. Casing drilling involves drilling and casing a well simultaneously. In casing driling process, downhole tools can be retrieved, through the casing on wire-line, meaning tool recovery or replacement of tools can take minutes versus hours under conventional methods. This process employs wireline-retrievable tools and a drill-lock assembly, permitting bit and BHA changes, coring, electrical logging and even directional or horizontal drilling. Once the casing point is reached, the casing is cemented in place without tripping pipe.

  6. The case for the case report: refine to save.

    LENUS (Irish Health Repository)

    Lennon, P

    2012-01-31

    INTRODUCTION: The case report is the cornerstone of both medical teaching and writing. However, during recent years the value of the case report has been questioned, so much so that it has been abandoned by many journals. The aim of this study was to assess case reports published by the Irish Journal of Medical Science (IJMS) and to examine ways to preserve this type of article. METHODS: A review of all single-patient case reports published in the IJMS in 2008 and 2009. RESULTS: Forty-eight cases were published from nine countries. The range of authors was 2-11, length 525-1,787 words and number of references 4-24. All cases contained abstracts. CONCLUSION: Stricter guidelines with regards to a shorter more focused article should help to preserve this form of publication.

  7. CASE REPORT CASE CASE R The many faces of hydatid disease

    African Journals Online (AJOL)

    CASE R. Case report. A 35-year-old man presented with a right chest wall mass. Chest radio- graphs revealed pleural thickening underlying a soft tissue mass which obscured the 5th to 7th ribs, and an expansile osteolytic lesion of the 7th rib. Ultrasound examination demonstrated a fluid-filled cystic lesion of the chest wall ...

  8. CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

    Science.gov (United States)

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

  9. Case series

    African Journals Online (AJOL)

    ebutamanya

    2015-01-29

    Jan 29, 2015 ... for tinnitus (Table 1). The otomicroscopic examination shows: central non marginal perforation in 29 patients, posterior perforation in 17 patients and anterior perforation in 14 patients. The tympanic cavity was dry in 27 cases, wet in 18 cases and inflammatory in the. 15 remaining cases. The conralateral ear ...

  10. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-02-12

    Feb 12, 2015 ... Abstract. Vaginal metastasis from pancreatic cancer is an extreme case and often indicates a poor prognosis. We present a case of pancreatic carcinoma with metastasis to the vagina that was discovered by vaginal bleeding. To our knowledge, this is the third case in the world of a primary pancreatic.

  11. Useful Business Cases

    DEFF Research Database (Denmark)

    Nielsen, Peter Axel; Persson, John Stouby

    2017-01-01

    during implementation and value creation. This article presents lessons learned from our action research, lessons that we incorporated into a business case method and subsequently evaluated with IS managers. There are three lessons on: (1) improving the content of business cases, (2) how to develop...... research study seeks to improve the usefulness of business cases in IS projects. We used collaborative action research with Danish municipalities to improve their practices when developing and using business cases and to change their perceptions of what constitutes a good business case that is useful...... business cases, and (3) the use of business cases in subsequent value creation. These lessons summarize our findings and the contributions are that we in the business case method propose to: (1) include minimal contents, (2) develop social commitment, and (3) structure for dynamic use during value creation...

  12. Pythiosis with atypical location in the soft palate in a horse in Southern Brazil

    Directory of Open Access Journals (Sweden)

    C.K. Rossato

    Full Text Available RESUMO A pitiose é uma enfermidade piogranulomatosa causada pelo oomiceto aquático Pythium insidiosum, que acomete várias espécies domésticas, assim como a humana. O presente relato refere-se à descrição de um caso de pitiose em um equino, fêmea, da raça Crioula, criado na região Sul do Brasil com história clínica de emagrecimento progressivo, disfagia e dificuldade respiratória. Macroscopicamente, o palato mole estava aumentado de tamanho e deslocado caudalmente, resultando em obstrução física da nasofaringe. Ao corte, essa massa era branca-amarelada, fibrosa e com áreas de ulceração. Na análise histopatológica, havia inflamação piogranulomatosa, com focos necróticos associados a imagens negativas tubuliformes de hifas fúngicas. A coloração de Grocott demonstrou inúmeras hifas septadas e ramificadas, as quais foram marcadas positivamente para anticorpos contra P. insidiosum na imuno-histoquímica. O diagnóstico de pitiose foi baseado nos achados macro e microscópicos e confirmado pela técnica de imuno-histoquímica.

  13. Pure Case and Prepositional Case in Russian

    DEFF Research Database (Denmark)

    Durst-Andersen, Per; Lorentzen, Elena

    2017-01-01

    By considering Russian case as the nominal equivalent to mood whereby its semantic functions are emphasized at the expense of its syntactic functions, it is demonstrated that the nominative, accusative, vocative and genitive cases constitute a mini system in which the nominative and the accusative...

  14. Trauma ocular aberto: características de casos atendidos no complexo Hospitalar Padre Bento de Guarulhos Ocular open trauma: characteristics of admitted cases at the Padre Bento Hospital of Guarulhos, SP

    Directory of Open Access Journals (Sweden)

    Mônica Weyll

    2005-08-01

    Full Text Available OBJETIVOS: Estudos em centros oftalmológicos têm sido realizados com a finalidade de decifrar as principais causas e características epidemiológicas do trauma ocular. Nestes estudos observa-se uma variação na distribuição epidemiológica do trauma ocular e uma carência na educação e conscientização da sociedade sobre as medidas preventivas no Brasil. O objetivo deste estudo é identificar a incidência do trauma ocular aberto no serviço de emergência do Complexo Hospitalar Padre Bento de Guarulhos. MÉTODOS: Este é um estudo transversal descritivo realizado no período de setembro de 2003 a abril de 2004. Foram incluídos no trabalho, todos os pacientes atendidos no PS de Oftalmologia com diagnóstico de trauma ocular aberto. Foram obtidos alguns dados sobre o paciente: idade, sexo, profissão, uso de equipamento de trabalho, uso de óculos, uso de cinto de segurança, tipo de acidente, olho acometido, tempo decorrido até o primeiro atendimento oftalmológico e qual o primeiro local de atendimento. RESULTADOS: A média de idade foi de 34,35 anos, sendo o sexo masculino o mais acometido (87%. O acidente automobilístico foi o mais freqüente. A baixa acuidade visual foi importante fator de procura precoce pelo serviço de emergência, sendo que 92,3% dos pacientes o fizeram em menos de 12 horas de decorrido o trauma. CONCLUSÃO: O trauma penetrante corneano foi o tipo de lesão ocular mais observado. Os pacientes mais acometidos são adultos jovens, do sexo masculino, vítimas de acidente automobilístico, sendo o olho direito o mais acometido. A complicação imediata mais observada foi a baixa acuidade visual.PURPOSE: This study tends to identify the incidence of ocular open trauma at the emergency service of the "Complexo Hospitalar Padre Bento of Guarulhos, SP". METHODS: It is a descriptive transversal study performed in a period of four months at the "Complexo Hospitalar Padre Bento". All patients admitted at the emergency

  15. Running casing on conventional wells with Casing Drilling {sup TM} technology

    Energy Technology Data Exchange (ETDEWEB)

    Warren, T.M.; Schneider, W.P.; Johns, R.P.; Zipse, K.D. [Tesco Corp., Calgary, AB (Canada)

    2004-07-01

    Casing Drilling{sup TM} is a newly developed and efficient well construction method that combines drilling and casing running processes into a single operation. This radical change to the entire well casing running process eliminates standard components and processes that are inefficient and hazardous. The commercialization of this new technology has resulted in the development of custom equipment and procedures designed to efficiently handle casings on a drilling rig, including conventionally drilled wells. The technology offers safer casing running operations and makes it possible to ream casing to the bottom. In addition, less people are needed to operate the portable Casing Drive System (CDS). One of the primary components of the system is the top drive which provides the power for rotation and torque. The CDS supports full axial and torsional load for running the casing. The well can be circulated while running the casing. The casing can be washed and reamed to the bottom whenever a tight hole is encountered. Thirty one operators have successfully used the CDS on more than 150 onshore and offshore wells in 7 countries. 13 refs., 2 tabs., 12 figs.

  16. Comparison of Emergency Medicine Malpractice Cases Involving Residents to Non-Resident Cases.

    Science.gov (United States)

    Gurley, Kiersten L; Grossman, Shamai A; Janes, Margaret; Yu-Moe, C Winnie; Song, Ellen; Tibbles, Carrie D; Shapiro, Nathan I; Rosen, Carlo L

    2018-04-17

    Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013. The CBS database is a national repository that contains professional liability data on > 400 hospitals and > 165,000 physicians, representing over 30% of all malpractice cases in the U.S (> 350,000 claims). We compared cases naming residents (either alone or in combination with an attending) to those that did not involve a resident (non-resident cohort). We reported the case statistics, allegation categories, severity scores, procedural data, final diagnoses and contributing factors. Fisher's exact test or t-test was used for comparisons (alpha set at 0.05). Eight hundred and forty-five EM cases were identified of which 732 (87%) did not name a resident (non-resident cases), while 113 (13%) included a resident (resident cases) (Figure 1). There were higher total incurred losses for non-resident cases (Table 1). The most frequent allegation categories in both cohorts were "Failure or Delay in Diagnosis/Misdiagnosis" and "Medical Treatment" (non-surgical procedures or treatment regimens i.e. central line placement). Allegation categories of Safety and Security, Patient Monitoring, Hospital Policy and Procedure and Breach of Confidentiality were found in the non-resident cases. Resident cases incurred lower payments on average ($51,163 vs. $156,212 per case). Sixty six percent (75) of resident vs 57% (415) of non-resident cases were high severity claims

  17. Ceratectomia lamelar anterior profunda usando a técnica "big-bubble" em pacientes com ceratocone

    Directory of Open Access Journals (Sweden)

    Sandro Antonini Coscarelli

    2012-02-01

    Full Text Available OBJETIVOS: Avaliar através de um estudo retrospectivo pacientes com ceratocone, a partir do 12º mês após a ceratectomia lamelar anterior profunda usando a técnica "big-bubble". MÉTODOS: Estudo retrospectivo de consecutivos 79 olhos de 71 pacientes com ceratocone moderado a grave, com baixa acuidade visual após as correções ópticas e intolerantes à adaptação de lente de contato. Todos os transplantes foram realizados pelo mesmo experiente cirurgião, no período de janeiro de 2007 a fevereiro de 2009, utilizando a técnica de ceratectomia lamelar anterior profunda pelo "big-bubble". Os dados analisados foram sexo, idade, paquimetria corneana, densidade endotelial, astigmatismo dinâmico e melhor acuidade visual corrigida (BCVA após a ceratectomia. RESULTADOS: A idade média verificada foi de 30,4 (± 10,2 anos, com 39 (54,9% do sexo feminino e 32 (45,1% do masculino. A paquimetria ultrassônica média foi de 518,6 (± 29,5 μm. Setenta e dois (91,1% dos transplantes realizados obtiveram acuidade visual dinâmica corrigida melhor ou igual a 20/50. A média do astigmatismo dinâmico foi de - 3,5 (± 1,5 dioptrias cilíndricas. A média da densidade endotelial encontrada conforme a faixa etária teve a distribuição com os pacientes de 11 a 20 anos com 3.053 (± 532 cél/mm²; 21 a 30 anos com 2.674 (± 725 cél/mm²; 31 a 40 anos com 2.737 (± 575 cél/mm²; 41 a 50 anos com 2.585 (± 476 cél/mm² e 51 a 60 anos com 2.398 (± 667 cél/mm². Microperfuração no per-operatório teve uma incidência de 8,8%. CONCLUSÃO: A ceratectomia lamelar anterior profunda pela técnica "big-bubble" é um valioso tratamento para pacientes com ceratocone, alcançando uma melhor acuidade visual corrigida final semelhante ao transplante penetrante. A contagem média de células endoteliais apresenta-se dentro da normalidade para a faixa etária após o procedimento. Não foram encontradas córneas rejeitadas ou com edema após a retirada de todos os

  18. Amastigota forms resembling Leishmania sp. on corneal ulceration in a dog: case report Formas amastigotas compatíveis com Leishmania sp. em ulceração corneal de cão: relato de caso

    Directory of Open Access Journals (Sweden)

    F.L.C. Brito

    2007-02-01

    Full Text Available One dog with visceral leishmaniasis is reported presenting cutaneous lesions, cachexia, and corneal ulceration. Parasitological and serological diagnoses were performed by exam of contents of the aspirative punction of the bone marrow and by immunofluorecence, respectively. Amastigota forms resembling Leishmania sp. were visualized by citology.Relata-se o caso de um cão com leishmaniose visceral apresentando lesões cutâneas, caquexia e úlcera de córnea. Realizou-se o diagnóstico parasitológico e sorológico por meio de exame do material da medula óssea e por imunofluorescência indireta, respectivamente. À citologia da úlcera corneana, visibilizaram-se formas amastigotas compatíveis com Leishmania sp.

  19. Cryptococcosis in captive cheetah (Acinonyx jubatus : two cases : case report

    Directory of Open Access Journals (Sweden)

    L.A. Bolton

    1999-07-01

    Full Text Available Cryptococcus neoformans is a yeast-like organism associated with pulmonary, meningoencephalitic, or systemic disease. This case report documents 2 cases of cryptococcosis with central nervous system involvement in captive cheetah (Acinonyx jubatus. In both cases the predominant post mortal lesions were pulmonary cryptococcomas and extensive meningoencephalomyelitis. Both cheetahs tested negative for feline immunodeficiency virus and feline leukaemia virus. The organism isolated in Case 2 was classified as Cryptococcus neoformans var. gattii, which is mainly associated with disease in immunocompetent hosts.

  20. 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

  1. Aspectos epidemiológicos das lesões no pé e tornozelo do paciente diabético Epidemiological aspects of foot and ankle injury in the diabetic patient

    Directory of Open Access Journals (Sweden)

    Ricardo Cardenuto Ferreira

    2010-01-01

    Full Text Available OBJETIVO: Identificar o perfil epidemiológico dos pacientes que procuram tratamento ortopédico das complicações nos pés e tornozelos relacionadas ao diabetes, além de correlacionar à sequência de eventos que culminam na amputação da extremidade. MÉTODO: analisamos os dados de prontuário de 300 pacientes no período compreendido entre março de 1997 a julho de 2006. RESULTADOS: A média de idade foi 61 anos, destes, duzentos e setenta e três pacientes (91% apresentavam diagnóstico de diabetes do tipo II, onde somente 49 (16,3% faziam controle regular da glicemia. Quatrocentos e cinco extremidades apresentavam problemas afetando a função do pé ou tornozelo, detacando-se: 102 extremidades (34% com lesões osteoarticulares relacionadas a neuroartropatia de Charcot; 181 extremidades (60,4% com ulceração crônica e 97 extremidades (32,4% com infecção. Após tempo médio de seguimento 14 pacientes (4,6% foram a óbito. CONCLUSÃO: A ulceração na planta dos pés foi a complicação mais frequente na nossa série de pacientes que, estavam na sétima década de vida, apresentavam diabetes do tipo II, faziam uso irregular de insulina e não realizavam controle adequado da glicemia. A perda da sensibilidade protetora nos pés, em associação com deformidade pré-existente, foi identificada como a principal causa das infecções secundárias culminando com a amputação da extremidade.OBJECTIVE: To identify the epidemiological profile of patients undergoing orthopedic treatment for complications of the feet and ankles due to diabetes, and to try to establish the sequence of events that led to amputation of the limb. METHOD: The medical records of 300 diabetic patients treated from March, 1997 to July, 2006 were systematically reviewed. RESULTS: The mean age of the patients was 61 years. Of these, two hundred and seventy three (91% were diagnosed with type II diabetes, but only 49 (16.3% had proper medical supervision and control of

  2. Case Report Case Report

    African Journals Online (AJOL)

    User

    2013-03-26

    Mar 26, 2013 ... c Medicine and Palliative Cancer Care: A Case Report. Sanjoy Kumar Pal ... us complementary and alternative therapies for treatment about the .... controlled trials that homeopathy may be effective for the treatment of ...

  3. Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

    Science.gov (United States)

    Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

    2017-01-01

    Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

  4. FHEO Filed Cases

    Data.gov (United States)

    Department of Housing and Urban Development — The dataset is a list of all the Title VIII fair housing cases filed by FHEO from 1/1/2007 - 12/31/2012 including the case number, case name, filing date, state and...

  5. APRENDIZAJE EN CIRUGÍA MEDIANTE LAPARATOMÍA EXPLORATORIA POR TRAUMA PENETRANTE. EXPERIENCIA EN EL HOSPITAL GENERAL DE CIUDAD JUÁREZ

    Directory of Open Access Journals (Sweden)

    Lenin Enríquez Domínguez

    2011-01-01

    Conclusiones. Durante la formación del cirujano es importante el desarrollo de las habilidades técnicas en la sala de operaciones y el manejo integral del paciente con trauma abdominal desde su ingreso a la sala de urgencias. No se han establecidos parámetros claros en cuanto al número de pacientes que deben ser evaluados ni el número de procedimientos quirúrgicos que se deben realizar durante la formación un residente.

  6. Case series

    African Journals Online (AJOL)

    abp

    2013-06-20

    Jun 20, 2013 ... ... by a persistent neurological deficit in 2 cases, and infection in 2 cases controlled ... Upper cervical spine injuries are frequent due to increasing number .... the patient; it also takes more time for fracture healing and expose.

  7. Comparative Test Case Specification

    DEFF Research Database (Denmark)

    Kalyanova, Olena; Heiselberg, Per

     This document includes a definition of the comparative test cases DSF200_3 and DSF200_4, which previously described in the comparative test case specification for the test cases DSF100_3 and DSF200_3 [Ref.1]....... This document includes a definition of the comparative test cases DSF200_3 and DSF200_4, which previously described in the comparative test case specification for the test cases DSF100_3 and DSF200_3 [Ref.1]....

  8. The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

    Science.gov (United States)

    Hogan, Tierney D

    2005-01-01

    A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff.

  9. Case Study Research Methodology

    Directory of Open Access Journals (Sweden)

    Mark Widdowson

    2011-01-01

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

  10. Case report

    African Journals Online (AJOL)

    abp

    2015-08-31

    Aug 31, 2015 ... Dual intersection syndrome of the forearm: a case report. Bouchra Zhari1,& ... We reported a case of a 60-year-old man presented to our formation with painful swelling on .... With a fiddling clinical observation and diagnosis.

  11. Case-positive versus case-negative designs for low-rate lithium thionyl chloride cells

    Science.gov (United States)

    Mahy, T. X.

    1982-03-01

    Case polarity design choices are discussed. Two examples of case-negative designs are presented. One battery is thionyl chloride limited and the other is lithium limited. The case-positive design is thionyl chloride limited. It is found that the case-positive/case-negative design consideration does not seem to have much bearing on storage. However, during low rate discharge, the case-negative cells show a steadily decreasing capacity as you go to lower and lower rates.

  12. CASE REPORT CASE CASE Conned by Conn's syndrome

    African Journals Online (AJOL)

    2008-01-08

    Jan 8, 2008 ... ing of the aldosterone-producing adenoma (APA) can prove challenging but is nonetheless very important for surgical planning and cure. We present two patients with MRI (magnetic resonance imaging) confirma- tion of APA with negative and equivocal CT (computed tomography) scans. Case 1.

  13. 40 CFR 63.53 - Application content for case-by-case MACT determinations.

    Science.gov (United States)

    2010-07-01

    ... consistent with § 63.52(f). The owner or operator may recommend a specific design, equipment, work practice... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Application content for case-by-case... Act Sections, Sections 112(g) and 112(j) § 63.53 Application content for case-by-case MACT...

  14. case series

    African Journals Online (AJOL)

    Administrator

    Key words: Case report, case series, concept analysis, research design. African Health Sciences 2012; (4): 557 - 562 http://dx.doi.org/10.4314/ahs.v12i4.25. PO Box 17666 .... According to the latest version of the Dictionary of. Epidemiology ...

  15. Case series

    African Journals Online (AJOL)

    abp

    30 mai 2017 ... All patients underwent systematic plaster immobilization for a period of ... On average, nails were removed after about 6 ... cases), osteitis associated with material (2 cases), refracture (3 ... Although intramedullary nailing ideally is an osteosynthesis ..... intramedullary fixation of pediatric forearm fractures.

  16. Stades method for surgical correction of upper eyelid trichiasis-entropion: results and follow-up in 21 cases Método de Stades para a correção da triquíase-entrópio da pálpebra superior: resultados e acompanhamento de 21 casos

    Directory of Open Access Journals (Sweden)

    José Luiz Laus

    2000-08-01

    Full Text Available Trichiasis is a condition in which lhe cuia and facial hairs grow toward lhe córnea or the conjunctiva. The hairs arising from normal sites are pointed aí an abnormal direction. This condition may be caused by prominent nasal folds, entropion, blepharospasm, slipped facial mask and dermoids. The upper eyelid trichiasis-entropion with lower eyelid entropionectropion frequentiy occurs in oíder English Cocker Spaniels. The ocular signs often are epiphora, blepharospasm, conjunctivitis, keratitis and comeal ulceratíon. Treatment depenas on the severity ofthe condition and must eliminate the ocular contact by misdirected cuia that irritate the eyeball. This report presents a retrospective study of21 patients with bilateral diffüse trichiasis (15 English Cocker Spaniels; 2 Basset hounds; l Bloodhound; l Fila Brasileiro and 2 mongrel dogs. The procedure described by Stades was employed m ali cases. Postoperatively, topical chioramphenicol oiníment (qid was appiied in the conjunctival soe and on the open woundfor 2 weeks. Sutures were removed 10 days after surgery. Correction ofpositioning ofthe upper eyelid was successfúl and its apposition to córnea was normal. In most of the cases the reepithelialiwtion was complete one month after surgery. No signs ofrecurrence werefound and there appeared to be no loss of normal fünction of the eyelid in the 21 dogs available for follow-up examination in a maximum period of 36 months.Triquíase é a condição na qual os cílios e os cabelos faciais crescem em direção à córnea ou conjuntiva. Os pêlos que surgem de locais normais estão apontados em uma direção anormal. Essa condição pode ser causada por dobras nasais proeminentes, entrópio, blefarospasmo, pele facial redundante e dennóides. A triquíase-entrópio da pálpebra superior associada ao entrópio-ectrópio da pálpebra inferior, frequentemente, ocorre em English Cocker Spaniels idosos. Os sinais oculares são frequentemente ep

  17. Improving Casing Integrity by Induction Brazing of Casing Connections

    NARCIS (Netherlands)

    Ernens, Dennis; Hariharan, Hari; van Haaften, Willem Maarten; Pasaribu, Rihard; Jabs, Matthew; McKim, Richard

    2017-01-01

    Brazing technology allows metallurgical joining of dissimilar materials using a filler material. In this paper brazing technology applied to casing connections is presented. The initial application was triggered by challenges with mechanical and pressure integrity after expansion of casing

  18. Case-based reasoning

    CERN Document Server

    Kolodner, Janet

    1993-01-01

    Case-based reasoning is one of the fastest growing areas in the field of knowledge-based systems and this book, authored by a leader in the field, is the first comprehensive text on the subject. Case-based reasoning systems are systems that store information about situations in their memory. As new problems arise, similar situations are searched out to help solve these problems. Problems are understood and inferences are made by finding the closest cases in memory, comparing and contrasting the problem with those cases, making inferences based on those comparisons, and asking questions whe

  19. Codification of Some Usage Cases of Lithuanian Language Cases and Prepositions

    Directory of Open Access Journals (Sweden)

    Vidas Valskys

    2013-12-01

    Full Text Available The present article is related to analysing several cases of the relationship between usage of cases and prepositions with the norms indicated in the syntax booklet “Language Advice”. The article is a discussion regarding some normative evaluation aspects regarding the usage of the preposition “greta” (next to having the meaning of exception (exclusion, usage of the adjectivised instrumental case in constructions with the verb “(pavirsti” (to turn, to become, to grow, to get and some cases of the postposition “dėka” (with the help of. Utmost attention is paid to discussion of (nonnormative evaluation of some constructions including usage of the said cases and prepositions that are doubtful in some aspects, their presentation in normative sources and further prospects related to further codification of the said cases. The article is based on vast empirical materials: examples from the “Corpus of the Contemporary Lithuanian”, the Internet and other texts related to contemporary usage.

  20. Case Report

    African Journals Online (AJOL)

    Sarra

    failure and/or per vaginum (PV) leaN of dialysate. Case report: A ... had PV leaN of the dialysate that was misinterpreted by the .... as part of the management of this infection. On the .... case, we believe that laparoscopy represents a good tool.

  1. Clinical cases

    International Nuclear Information System (INIS)

    Servente, L.

    2012-01-01

    This presentation is about clinical cases and the contribution of the PET - CT Fag application in the diagnosis and treatment of different types of cancer. The cases presented were: neck diseases, epidermoid carcinoma, liver damage and metastasize, lymphoma, thrombosis, colonic cancer and lung disease

  2. Dermatology case

    Directory of Open Access Journals (Sweden)

    Catarina Lacerda

    2017-11-01

    Full Text Available Aims: To report a case of uncharacteristic presentation of Parvovirus B19. This virus causes some atypical cutaneous rash such as papular-purpuric “gloves and socks” syndrome which is a rare entity, self-limited and resolves spontaneously to cure. Case Report: Authors describe a case of a six-year-old boy who went to the Emergency Department with a cutaneous rash initially on a finger and then mouth, hands and feet followed by fever. He fully recovered without sequelae. Conclusions: It is important to consider this agent as a possible responsible for atypical purpuric rash.

  3. Contemplating case mix: A primer on case mix classification and management.

    Science.gov (United States)

    Costa, Andrew P; Poss, Jeffery W; McKillop, Ian

    2015-01-01

    Case mix classifications are the frameworks that underlie many healthcare funding schemes, including the so-called activity-based funding. Now more than ever, Canadian healthcare administrators are evaluating case mix-based funding and deciphering how they will influence their organization. Case mix is a topic fraught with technical jargon and largely relegated to government agencies or private industries. This article provides an abridged review of case mix classification as well as its implications for management in healthcare. © 2015 The Canadian College of Health Leaders.

  4. Impact of lens case hygiene guidelines on contact lens case contamination.

    Science.gov (United States)

    Wu, Yvonne T; Teng, Yuu Juan; Nicholas, Mary; Harmis, Najat; Zhu, Hua; Willcox, Mark D P; Stapleton, Fiona

    2011-10-01

    Lens case contamination is a risk factor for microbial keratitis. The effectiveness of manufacturers' lens case cleaning guidelines in limiting microbial contamination has not been evaluated in vivo. This study compared the effectiveness of manufacturers' guidelines and an alternative cleaning regimen. A randomized cross-over clinical trial with two phases (n = 40) was performed. Participants used the lens types of their choice in conjunction with the provided multipurpose solution (containing polyhexamethylene biguanide) for daily wear. In the manufacturers' guideline phase, cases were rinsed with multipurpose solution and air dried. In the alternative regimen phase, cases were rubbed, rinsed with solution, tissue wiped, and air-dried face down. The duration of each phase was 1 month. Lens cases were collected at the end of each phase for microbiological investigation. The levels of microbial contamination were compared, and compliance to both regimens was assessed. The case contamination rate was 82% (32/39) in the manufacturers' guideline group, compared with 72% (28/39) in the alternative regimen group. There were significantly fewer (p = 0.004) colony forming units (CFU) of bacteria from cases used by following the alternative regimen (CFU range of 0 to 10, and median of 12 CFU per well) compared with that of the manufacturer's guidelines (CFU range of 0 to 10, and median of 28 CFU per well). The compliance level between both guidelines was not significantly different (p > 0.05). The alternative guidelines are more effective in eliminating microbial contamination from lens cases than that of the current manufacturer's guideline. Simply incorporating rubbing and tissue-wiping steps in daily case hygiene reduces viable organism contamination.

  5. Case report

    African Journals Online (AJOL)

    abp

    8 mai 2013 ... subsequent conception and placenta accreta: a case report. American Journal of Obstetrics and Gynecology. September. 2012; 207(3 ) : e7-e8. PubMed | Google Scholar. 5. Umashankar T, Patted S, Handigund R. Endometrial osseous metaplasia: Clinicopathological study of a case and literature review.

  6. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-12-04

    Dec 4, 2015 ... was made, while maintaining of valproic acid and clonazepam.This combination allowed a partial remission, allowing a best level of adaptation, it has been maintained. The clozapine has not been tried in this case. Discussion. This case illustrates the presentation of Schizophrenia characterized.

  7. 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.

  8. Non-destructive testing; Examenes no destructivos

    Energy Technology Data Exchange (ETDEWEB)

    Calva, Mauricio; Loske, Achim [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

    1988-12-31

    The application of non-destructive testing (NDT) in several technical and industrial fields is pointed out, standing out its utilization in the detection of future failures without affecting the examined element. Likewise, the different types of NDTs and their processes, such as x-rays, ultrasoud, magnetic particles, induced currents, penetrating fluids, and optical means, are described. The Non-Destructive Tests Laboratory of the Instituto de Investigaciones Electricas (IIE), plans to create new and more reliable systems independent from the operator`s capacity, to contribute to fulfill the inspection and quality control needs of the generating Mexican power plants. [Espanol] Se senala la aplicacion de los examenes no destructivos (END) a diversos campos tecnicos e industriales, destacando su utilizacion en la deteccion de futuras fallas sin afectar el elemento examinado. Asimismo, se describen los diferentes tipos de END y sus procesos, tales como radiografia, ultrasonido, particulas magneticas, corrientes inducidas, liquidos penetrantes y metodos opticos. El Laboratorio de Pruebas no Destructivas, del Instituto de Investigaciones Electricas (IIE), planea crear sistemas novedosos mas confiables, que no dependan de la capacidad del operador, para contribuir a satisfacer las necesidades de inspeccion y control de calidad que se presentan en las plantas generadoras de energia mexicanas.

  9. Guerra y Paz en el Siglo XXI

    Directory of Open Access Journals (Sweden)

    Alejandro Álvarez Polanco

    2011-05-01

    Full Text Available En “Guerra y Paz en el Siglo XXI”, Eric Hobsbawm desarrolla una selección de penetrantes conferencias, en las cuales ensaya una aguda crítica al imperialismo y la globalización. Lo que le entrega vida a estos nueve ensayos es una crítica sostenida a la idea de que el término del desarrollo histórico sería la conversión del mundo al modelo occidental (Capitalismo y Gobierno Liberal-Democrático y Representativo. Distante de esto, Hobsbawm señala que la actual fase de desarrollo capitalista globalizado estaría minando el orden público, por añadidura al Estado-Nación e incluso la viabilidad de la propia democracia liberal representativa. Por lo tanto, la dispersión de la Unión Soviética no ha significado el nacimiento de un “nuevo orden mundial”, sino más bien la emergencia de un desorden estable, en medio de la pretensión imperial estadounidense por imponer de modo unilateral y por medio de la fuerza, no sólo su hegemonía, sino su visión del mundo como una suerte de pensamiento único...

  10. Contribuição ao estudo da vascularização arterial do testículo de búfalos da raça Murrah

    Directory of Open Access Journals (Sweden)

    Milton Passipieri

    1998-01-01

    Full Text Available Estudamos o comportamento da artéria testicular, o número e a distribuição dos vasos penetrantes em 30 pares de testículos de búfalos da raça Murrah (Bubalus bubalis, com idade entre 8 meses e 5 anos, procedentes da região de Ilha Solteira, no Estado de São Paulo, mediante a análise de moldes obtidos pela injeção de vinil, na artéria testicular e em seguida corrosão do órgão em ácido sulfúrico a 30%. Encontramos mais freqüentemente (68,4% a artéria testicular cedendo dois ramos, o cranial e o caudal, com participação equivalente de ambos os ramos na vascularização do órgão (35,0%, ou com predominância do ramo cranial (21,7% ou do ramo caudal (11,7%. Em outros arranjos, a artéria testicular cede três ramos: o cranial, o médio e o caudal (20,0% ou ainda número variável de ramos craniais (4 a 7 e caudais (3 a 5 (11,6% para a vascularização arterial do testículo.

  11. Non-destructive testing; Examenes no destructivos

    Energy Technology Data Exchange (ETDEWEB)

    Calva, Mauricio; Loske, Achim [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

    1987-12-31

    The application of non-destructive testing (NDT) in several technical and industrial fields is pointed out, standing out its utilization in the detection of future failures without affecting the examined element. Likewise, the different types of NDTs and their processes, such as x-rays, ultrasoud, magnetic particles, induced currents, penetrating fluids, and optical means, are described. The Non-Destructive Tests Laboratory of the Instituto de Investigaciones Electricas (IIE), plans to create new and more reliable systems independent from the operator`s capacity, to contribute to fulfill the inspection and quality control needs of the generating Mexican power plants. [Espanol] Se senala la aplicacion de los examenes no destructivos (END) a diversos campos tecnicos e industriales, destacando su utilizacion en la deteccion de futuras fallas sin afectar el elemento examinado. Asimismo, se describen los diferentes tipos de END y sus procesos, tales como radiografia, ultrasonido, particulas magneticas, corrientes inducidas, liquidos penetrantes y metodos opticos. El Laboratorio de Pruebas no Destructivas, del Instituto de Investigaciones Electricas (IIE), planea crear sistemas novedosos mas confiables, que no dependan de la capacidad del operador, para contribuir a satisfacer las necesidades de inspeccion y control de calidad que se presentan en las plantas generadoras de energia mexicanas.

  12. Case Report

    African Journals Online (AJOL)

    the kidney could still be transplanted successfully. We describe a case of high ureteric injury during multi-organ recovery and successful implantation using a Boari flap ureterocystostomy. Case Report. The donor kidney was procured from a 55-year-old male brain stem deceased donor following intra-cerebral hemorrhage.

  13. Case report

    African Journals Online (AJOL)

    abp

    2016-02-08

    Feb 8, 2016 ... pituitary metastases can be characteristic and evocative but in no case pathognomic. The diabetes insipidus is the most common clinical manifestation of the disease [2, 3]. We report herein a case of an acute adrenal insufficiency revealing pituitary metastases of lung cancer. Patient and observation.

  14. Case report

    African Journals Online (AJOL)

    abp

    2015-08-13

    Aug 13, 2015 ... Middle East, Mediterranean region, Central Europe, Australia and. South America) [1, 2]. The incidence of musculoskeletal echinococcosis including involvement of subcutaneous tissue is 1%-. 5.4% among all cases of hydatid disease [2]. In this report, we present a case of recurrent hydatid cysts involving ...

  15. [Case and studies].

    Science.gov (United States)

    Schubert, András

    2015-11-15

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

  16. No case for Case in locality: Case does not help interpretation when intervention blocks A-bar chains

    Directory of Open Access Journals (Sweden)

    Naama Friedmann

    2017-04-01

    Full Text Available We discuss a robust yet at first sight surprising fact: individuals who have problems understanding sentences with object A-bar movement cannot use overt Case marking of the object to interpret these sentences and to associate the DPs with thematic roles. We tested the effect of overt Case marking of the object in typically developing Hebrew-speaking children by comparing their comprehension of 'which 'object questions with and without the object Case marker 'et', and found that there was no difference in comprehension between the two. A similar pattern was found in an adolescent with syntactic SLI. We then tested the comprehension of object topicalized structures in the order OVS, where the only element identifying these sentences as object-first sentences and distinguishing them from simple SVO sentences was the object marker. We tested this in three populations with object A-bar movement problems: individuals with agrammatism, adolescents with syntactic SLI, and orally-trained children with hearing impairment, as well as in analysis of previous data on typically-developing children acquiring Hebrew. All populations failed to understand the sentence, but did not consistently reverse the thematic roles of the two noun phrases. This suggests that they were sensitive to the presence of the Case marker but could not use it for interpretation. We argue that these findings immediately follow from the way intervention and locality are computed, under the featural Relativized Minimality approach. Case is not among the features triggering movement, therefore a Case difference is not taken into account in trying to build a movement chain across an intervener. As a result, the object chain cannot be built across the intervening subject in the relevant cases, and overt Case marking of the object cannot help rescue the structure. Thematic role assignment in complex movement configurations requires the building of movement chains; if chain formation fails

  17. Case Study: Puttin' on the Ritz: How to Put Science into Cases

    Science.gov (United States)

    Herreid, Clyde Freeman

    2017-01-01

    There are multiple ways to put science into a case. 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 different ways of presenting science in case studies.

  18. Case series

    African Journals Online (AJOL)

    ebutamanya

    2016-04-27

    Apr 27, 2016 ... Laparoscopic surgery for groin hernia in a third world country: a report of 9 cases of ... Concerning mesh repair, the (open) LICHENSTEIN and laparoscopic inguinal hernia techniques are ... Two cases were bilateral, 5 unilateral and all of them primary. ... In Africa, This approach is still marginal; few studies.

  19. Case law

    International Nuclear Information System (INIS)

    2016-01-01

    This section treats of the following case laws: 1 - Case Law France: Conseil d'etat decision, 22 February 2016, EDF v. Republic and Canton of Geneva relative to the Bugey nuclear power plant (No. 373516); United States: Brodsky v. US Nuclear Regulatory Commission, 650 Fed. Appx. 804 (2. Cir. 2016)

  20. Case-by-Case Adjudication and the Path of the Law

    OpenAIRE

    Anthony Niblett

    2013-01-01

    This paper presents a model of judging, illustrating how case law evolves when two types of judges with different policy preferences decide cases narrowly. The model shows that case law is unlikely to reflect the midpoint of the judges' ideal points. The result challenges the conventional wisdom suggesting that balancing ideologically extreme judges will likely yield moderate laws. The model suggests that a centrist executive faced with a sitting extreme left-wing judge should appoint a moder...

  1. Teaching Business French through Case Studies: Presentation of a Marketing Case.

    Science.gov (United States)

    Federico, Salvatore; Moore, Catherine

    The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

  2. Cases. Assisted suicide in The Netherlands : The Chabot Case

    NARCIS (Netherlands)

    Griffiths, John

    1995-01-01

    In earlier decisions the Dutch Supreme Court has recognised a defence of 'necessity," under narrowly-defined circumstances, to a charge of performing euthanasia.2 Its most recent decision deals with assistance with suicide in the case of a person whose suffering is not of somatic origin. The case is

  3. Assembling a Case Study Tool Kit: 10 Tools for Teaching with Cases

    Science.gov (United States)

    Prud'homme-Généreux, Annie

    2017-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. The author shares the strategies and tools that teachers can use to manage a case study classroom effectively.

  4. Case report

    African Journals Online (AJOL)

    ebutamanya

    28 août 2015 ... (intra-osseous synovial cyst) Clinical and therapeutic aspect: case report. Chir Main. 2009 Feb; 28(1):37-41. PubMed |. Google Scholar. 10. Chantelot C, Laffargue P, Masmejean E, Peltier B, Barouk P,. Fontaine C. Fracture of the scaphoid carpal bone secondary to an intraosseous cyst: apropos of a case.

  5. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-01-21

    Jan 21, 2015 ... Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net). Case report. Open Access ... La quantité de tissu neural immature permet d'établir une classification .... Wu X, Han LY, Xu X, Li Z. Recurrent immature teratoma of the ovary: a case report of radical secondary ...

  6. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-10-09

    Oct 9, 2015 ... Aguas SC, Quarracino MC, Lence AN, Lanfranchi-Tizeira HE. Primary melanoma of the oral cavity: ten cases and review of. 177 cases from literature. Medicina oral, patologia oral y cirugia bucal. 2009;14(6):E265-71. PubMed | Google. Scholar. 6. Rapidis AD, Apostolidis C, Vilos G, Valsamis S. Primary.

  7. Case series

    African Journals Online (AJOL)

    abp

    2017-07-13

    Jul 13, 2017 ... Its purpose is to assess the clinical and ... Other circumstances of discovery were atrial fibrillation, ... ventricular pacing (9.1%) and blood pressure intolerance to stress ... The mitral flow was a ... anterior mitral valve's pillar was found in one case with a left ... with a stop at the first level in another case.

  8. Clinical case

    International Nuclear Information System (INIS)

    Garcia Fontes, M

    2012-01-01

    This presentation is about a case of a patient with liver tumor. The ultrasound scan and Tc technique were used for the diagnosis and treatment. The application of PET - CT FDG contributed to detect peripheral cholangiocarcinoma, the lymph node distance to guide the therapeutic and the recurrence in case of a negative morphological methods.

  9. Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

    Science.gov (United States)

    Pai, Aditi

    2014-01-01

    A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

  10. Case report

    African Journals Online (AJOL)

    raoul

    2011-10-20

    Oct 20, 2011 ... Abstract. A 22-year old man was bitten by a snake on his scrotum. This interesting and unusual case occurred in the rural area of District Aligarh, India. The uniqueness of the case lies in the fact that scrotum is an extremely rare and unusual site for snake bite. Further, with negligible local signs of.

  11. Teaching Case: MiHotel--Applicant Processing System Design Case

    Science.gov (United States)

    Miller, Robert E.; Dunn, Paul

    2018-01-01

    This teaching case describes the functionality of an applicant processing system designed for a fictitious hotel chain. The system detailed in the case includes a webform where applicants complete and submit job applications. The system also includes a desktop application used by hotel managers and Human Resources to track applications and process…

  12. Eight cases of parapharyngeal space tumor. Case reports and MRI diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Takagi, Setsuo; Yoshimura, Tadashi; Tanaka, Katsuhiko

    1988-03-01

    Between 1977 and 1987, 8 cases of parapharyngeal space tumor (2 cases of pleomorphic adenoma, and schwannoma, respectively, a case of neurofibroma, neuroblastoma, retension cyst and branchial cleft cyst) were treated in our clinic. There were 4 males and 4 females. This papar reports these cases and discusses the availability of MRI diagnosis. We consider that the x-ray CT is presently most useful for the parapharyngeal space tumor. However, MRI imaged tumor clearly without bone artifacts such as recognized in x-ray CT, and be able to take a information of tumor vascularity. So that MRI is very useful for diagnosis of parapharyngeal space tumor.

  13. Clinical Case Registries (CCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Clinical Case Registries (CCR) replaced the former Immunology Case Registry and the Hepatitis C Case Registry with local and national databases. The CCR:HIV and...

  14. Delusional Parasitosis : Series Of 25 Cases

    Directory of Open Access Journals (Sweden)

    Bhatia M S

    1996-01-01

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

  15. Hemangioma congénito rapidamente involutivo – um diagnóstico infrequente

    Directory of Open Access Journals (Sweden)

    Andreia Alves Martins

    2017-12-01

    Full Text Available Os hemangiomas congénitos rapidamente involutivos (RICH são tumores vasculares raros, que se caraterizam por um desenvolvimento completo ao nascimento e por uma regressão, habitualmente total e espontânea, entre seis a dezoito meses. O diagnóstico é clínico, por vezes auxiliado por exames de imagem e biópsia. Descreve-se o caso de um recém-nascido de termo, fruto de uma gestação vigiada com ecografias obstétricas sem alterações, que apresentava ao nascimento, na face anterior da coxa esquerda, uma massa de 5x4,5cm, mole, depressível, acinzentada, com algumas telangiectasias periféricas e halo periférico esbranquiçado, sem frémito palpável ou ulceração. Hemodinamicamente estável, sem trombocitopenia. A ecografia e a ressonância magnética apoiaram a suspeita clinica de RICH, que foi corroborada imunohistologicamente. Após 15 meses verificou- -se regressão espontânea e completa do tumor. O conhecimento da clínica, evolução e prognóstico deste raro hemangioma é fundamental para o diagnóstico e seguimento adequados, evitando intervenções desnecessárias, assim como para tranquilização dos cuidadores.

  16. Therapy and prophylaxis of acute and late radiation-induced sequelae of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, F.B.; Geinitz, H.; Feldmann, H.J. [Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar, Muenchen (Germany)

    1998-11-01

    Background: Radiation-induced esophagitis is a frequent acute side effect in curative and palliative radiotherapy of thoracal and cervical tumors. Late reactions are rare but might be severe. Methods: A resarch for reports on prophylactic and supportive therapies of radiation-induced esophagitis was performed (Medline, Cancerlit, and others). Results: Nutrition must be ensured and symptomatic relief of sequelae is important, especially in the case of dysphagia. The latter can be improved by topic or systemic analgetics. If esophageal spasm occurs, calcium antagonists might help. In case of gastro-esophageal reflux proton pump inhibitors should be used. There is no effective prophylactic measure for radiation esophagitis. Late side effects with clinical relevance are rare in conventional radiotherapy. Chronic ulcera, fistula or stenosis may develop. Before any treatment, a tumor infiltration of the esophagus should be excluded by biopsy. This can lead more often to late complications than radiation therapy itself. Nutrition should be ensured by endoscopic dilation, stent-implantation, or endoscopic percutaneous gastrostomy. Local injection of steroids might be used to avoid an early restenosis. Conclusions: An intensive symptomatic therapy of acute esophagitis is reasonable. Effective prophylaxis do not exist. Late radiation induced sequelae is rare. Therefore, a tumor recurrenc e should be excluded in cases of dysphagia. Securing nutrition by PEG, stent, or port is well in the fore. (orig.) [Deutsch] Hintergrund: Die radiogene Oesophagitis ist eine haeufige akute Nebenwirkung bei kurativen wie palliativen Bestrahlungen thorakaler und zervikaler Tumoren. Spaete Gewebereaktionen sind selten, koennen aber schwerwiegend sein. Methode: Es wurde eine Literaturrecherche nach prophylaktischen und supportiven Therapien der radiogen verursachten Oesophagitis durchgefuehrt (Medline, Cancerlit und andere). Ergebnisse: Therapeutisch stehen die Sicherung der Ernaehrung und die

  17. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea

    Directory of Open Access Journals (Sweden)

    Jinjoo Oh, Ph.D., RN, GNP

    2017-12-01

    Full Text Available Purpose: The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Methods: Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Results: Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. Conclusion: The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Keywords: case management, focus groups, hospitalization, qualitative research, vulnerable populations

  18. PSS Case Book

    DEFF Research Database (Denmark)

    Neugebauer, Line Maria; Mougaard, Krestine; Andersen, Jakob Bejbro

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

  19. Case law

    International Nuclear Information System (INIS)

    2015-01-01

    This section treats of the two following case laws: Slovak Republic: Further developments in cases related to the challenge by Greenpeace Slovakia to the Mochovce nuclear power plant; United States: Judgment of the Nuclear Regulatory Commission denying requests from petitioners to suspend final reactor licensing decisions pending the issuance of a final determination of reasonable assurance of permanent disposal of spent fuel

  20. Mining with Rare Cases

    Science.gov (United States)

    Weiss, Gary M.

    Rare cases are often the most interesting cases. For example, in medical diagnosis one is typically interested in identifying relatively rare diseases, such as cancer, rather than more frequently occurring ones, such as the common cold. In this chapter we discuss the role of rare cases in Data Mining. Specific problems associated with mining rare cases are discussed, followed by a description of methods for addressing these problems.

  1. Case series: Two cases of eyeball tattoos with short-term complications.

    Science.gov (United States)

    Duarte, Gonzalo; Cheja, Rashel; Pachón, Diana; Ramírez, Carolina; Arellanes, Lourdes

    2017-04-01

    To report two cases of eyeball tattoos with short-term post procedural complications. Case 1 is a 26-year-old Mexican man that developed orbital cellulitis and posterior scleritis 2 h after an eyeball tattoo. Patient responded satisfactorily to systemic antibiotic and corticosteroid treatment. Case 2 is a 17-year-old Mexican man that developed two sub-episcleral nodules in the ink injection sites immediately after the procedure. Eyeball tattoos are performed by non-ophthalmic trained personnel. There are a substantial number of short-term risks associated with this procedure. Long-term effects on the eyes and vision are still unknown, but in a worst case scenario could include loss of vision or permanent damage to the eyes.

  2. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

    Science.gov (United States)

    Oh, Jinjoo; Oh, Seieun

    2017-12-01

    The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

  3. 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

  4. Case-Based Fault Diagnostic System

    International Nuclear Information System (INIS)

    Mohamed, A.H.

    2014-01-01

    Nowadays, case-based fault diagnostic (CBFD) systems have become important and widely applied problem solving technologies. They are based on the assumption that “similar faults have similar diagnosis”. On the other hand, CBFD systems still suffer from some limitations. Common ones of them are: (1) failure of CBFD to have the needed diagnosis for the new faults that have no similar cases in the case library. (2) Limited memorization when increasing the number of stored cases in the library. The proposed research introduces incorporating the neural network into the case based system to enable the system to diagnose all the faults. Neural networks have proved their success in the classification and diagnosis problems. The suggested system uses the neural network to diagnose the new faults (cases) that cannot be diagnosed by the traditional CBR diagnostic system. Besides, the proposed system can use the another neural network to control adding and deleting the cases in the library to manage the size of the cases in the case library. However, the suggested system has improved the performance of the case based fault diagnostic system when applied for the motor rolling bearing as a case of study

  5. Case vignettes of movement disorders.

    Science.gov (United States)

    Yung, C Y

    1983-08-01

    This paper reports five movement disorders cases to serve as a basis for discussion of the problems encountered in the clinical management of these cases, and the pathophysiological mechanisms involved in these disorders as presented. Case 1 is a description of the subjective experience of a patient with acute orofacial dystonia from promethazine. Case 2 is the use of clonazepam is post-head injury tics. Case 3 is the complication from discontinuation of haloperidol and benztropine mesylate treatment. Case 4 is myoclonus in subacute sclerosing Panencephalitis, and Case 5 is rebound tremor from withdrawal of a beta-adrenergic blocker.

  6. Case series

    African Journals Online (AJOL)

    abp

    7 avr. 2016 ... HTA were complicated by heart disease in 24% of cases and by renal disease in 20% of cases ... of clinical specificity. It is not unusual for HTA to be the only manifestation of the disease. In our study we .... Le syndrome de Cushing reste une cause rare d'HTA, sa prévalence dans des centres spécialisés en ...

  7. Is case-chaos methodology an appropriate alternative to conventional case-control studies for investigating outbreaks?

    Science.gov (United States)

    Edelstein, Michael; Wallensten, Anders; Kühlmann-Berenzon, Sharon

    2014-08-15

    Case-chaos methodology is a proposed alternative to case-control studies that simulates controls by randomly reshuffling the exposures of cases. We evaluated the method using data on outbreaks in Sweden. We identified 5 case-control studies from foodborne illness outbreaks that occurred between 2005 and 2012. Using case-chaos methodology, we calculated odds ratios 1,000 times for each exposure. We used the median as the point estimate and the 2.5th and 97.5th percentiles as the confidence interval. We compared case-chaos matched odds ratios with their respective case-control odds ratios in terms of statistical significance. Using Spearman's correlation, we estimated the correlation between matched odds ratios and the proportion of cases exposed to each exposure and quantified the relationship between the 2 using a normal linear mixed model. Each case-control study identified an outbreak vehicle (odds ratios = 4.9-45). Case-chaos methodology identified the outbreak vehicle 3 out of 5 times. It identified significant associations in 22 of 113 exposures that were not associated with outcome and 5 of 18 exposures that were significantly associated with outcome. Log matched odds ratios correlated with their respective proportion of cases exposed (Spearman ρ = 0.91) and increased significantly with the proportion of cases exposed (b = 0.054). Case-chaos methodology missed the outbreak source 2 of 5 times and identified spurious associations between a number of exposures and outcome. Measures of association correlated with the proportion of cases exposed. We recommended against using case-chaos analysis during outbreak investigations. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Twelve cases of multiple myeloma in Nagasaki (especially seven atomic bombing casualty cases). [In Japanese

    Energy Technology Data Exchange (ETDEWEB)

    Ichimaru, M; Yasuhi, S; Ouchuru, S

    1963-12-01

    Since 1958, there have been 12 cases of multiple myeloma in Nagasaki, and among them were 7 cases representing atomic bombing casualties, with 3 cases being with 2 km distance from the hypocenter. The age of onset was between 51 and 69 years, and the sex ratio was 8:4, it occurring mostly in males. Symptoms were predominantly low back pain and chest pain caused by the bone changes in 8 cases. Two cases complained of general malaise and palpitation which resulted from anemia. One developed persistent epistaris, and another complained of diplopia caused by the paralysis of the oculomotor nerve. Peripheral blood in all cases showed anemia, 9 with hyperchromic and 3 with normochromic or hypochromic anemia. Low platelet counts were seen in 3 cases. All showed leukopenia. All cases showed typical ..gamma..-globulin change with a myeloma peak, and in 4 cases showed an increase of ..beta..-globulin. Bence-Jones proteinuria was present in 5 cases. Average course was 1 year 4 months. Among complications, myeloma nephrosis, aplastic anemia, and pneumonia were the most important ones.

  9. Final report on case studies

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  10. Psychotherapy trainees' multicultural case conceptualization content: thematic differences across three cases.

    Science.gov (United States)

    Lee, Debbiesiu L; Sheridan, Daniel J; Rosen, Adam D; Jones, Isaiah

    2013-06-01

    This study examined thematic differences in the multicultural case conceptualization content of 61 psychotherapy trainees across three different cases and trainee demographics (number of multicultural courses completed, years of supervised clinical practicum completed, and White trainee vs. trainee of color). Themes across cases included general counseling skills (attend to affect, build rapport, focus on specific client concerns, use of specific clinical interventions, and use of external resources not related to culture), as well as multicultural specific counseling skills (focus on culture, focus on discrimination, use of culturally competent interventions, and use of external resources related to culture). Thematic differences across case were found in three of the nine themes (affect, culture, discrimination). No systematic differences were found across multicultural training, clinical training, or race. Implications of these results are discussed.

  11. Defining a periodontitis case

    DEFF Research Database (Denmark)

    Baelum, Vibeke; Lopez, Rodrigo

    2012-01-01

    . Conclusions The results indicate that it should be feasible for the periodontal community to reach an agreement over the distinction between a case and a non-case. The classification system proposed by van der Velden is better suited for providing clinicians with a clear image of the case....

  12. Leveraging tuberculosis case relative locations to enhance case detection and linkage to care in Swaziland.

    Science.gov (United States)

    Brunetti, Marie; Rajasekharan, Sathyanath; Ustero, Piluca; Ngo, Katherine; Sikhondze, Welile; Mzileni, Buli; Mandalakas, Anna; Kay, Alexander W

    2018-01-01

    In Swaziland, as in many high HIV/TB burden settings, there is not information available regarding the household location of TB cases for identifying areas of increased TB incidence, limiting the development of targeted interventions. Data from "Butimba", a TB REACH active case finding project, was re-analyzed to provide insight into the location of TB cases surrounding Mbabane, Swaziland. The project aimed to identify geographical areas with high TB burdens to inform active case finding efforts. Butimba implemented household contact tracing; obtaining landmark based, informal directions, to index case homes, defined here as relative locations. The relative locations were matched to census enumeration areas (known location reference areas) using the Microsoft Excel Fuzzy Lookup function. Of 403 relative locations, an enumeration area reference was detected in 388 (96%). TB cases in each census enumeration area and the active case finders in each Tinkhundla, a local governmental region, were mapped using the geographic information system, QGIS 2.16. Urban Tinkhundla predictably accounted for most cases; however, after adjusting for population, the highest density of cases was found in rural Tinkhundla. There was no correlation between the number of active case finders currently assigned to the 7 Tinkhundla surrounding Mbabane and the total number of TB cases (Spearman rho = -0.57, p  = 0.17) or the population adjusted TB cases (Spearman rho = 0.14, p  = 0.75) per Tinkhundla. Reducing TB incidence in high-burden settings demands novel analytic approaches to study TB case locations. We demonstrated the feasibility of linking relative locations to more precise geographical areas, enabling data-driven guidance for National Tuberculosis Programs' resource allocation. In collaboration with the Swazi National Tuberculosis Control Program, this analysis highlighted opportunities to better align the active case finding national strategy with the TB disease

  13. Case Management Directors

    Science.gov (United States)

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations

  14. CASE REPORT CASE A super 'lead pipe' colon: radio-pathological ...

    African Journals Online (AJOL)

    2008-10-15

    Oct 15, 2008 ... cancer in UC. Clearly, correct diagnosis is crucial. Our case not only had severe findings and a diagnosis that predated her surgery, but also had no clinical, radiological or histological features of the other alternative diagnoses. The case demonstrates an unusually severe form of 'lead pipe' colon occurring ...

  15. High laboratory cost predicted per tuberculosis case diagnosed with increased case finding without a triage strategy.

    Science.gov (United States)

    Dunbar, R; Naidoo, P; Beyers, N; Langley, I

    2017-09-01

    Cape Town, South Africa. To model the effects of increased case finding and triage strategies on laboratory costs per tuberculosis (TB) case diagnosed. We used a validated operational model and published laboratory cost data. We modelled the effect of varying the proportion with TB among presumptive cases and Xpert cartridge price reductions on cost per TB case and per additional TB case diagnosed in the Xpert-based vs. smear/culture-based algorithms. In our current scenario (18.3% with TB among presumptive cases), the proportion of cases diagnosed increased by 8.7% (16.7% vs. 15.0%), and the cost per case diagnosed increased by 142% (US$121 vs. US$50). The cost per additional case diagnosed was US$986. This would increase to US$1619 if the proportion with TB among presumptive cases was 10.6%. At 25.9-30.8% of TB prevalence among presumptive cases and a 50% reduction in Xpert cartridge price, the cost per TB case diagnosed would range from US$50 to US$59 (comparable to the US$48.77 found in routine practice with smear/culture). The operational model illustrates the effect of increased case finding on laboratory costs per TB case diagnosed. Unless triage strategies are identified, the approach will not be sustainable, even if Xpert cartridge prices are reduced.

  16. CASE REPORT Degenerative leiomyopathy CASE REPORT

    African Journals Online (AJOL)

    cases the condition was progressive and eventually affected the entire ... been discouraged because of the progressive nature of the disease. A gastrostomy and/or ... which eventually lead to their demise, usually in their late teens.4. 1.

  17. Asynchronous asymmetric form of heterogeneous osteopetrosis: initial case expanded and a new case

    International Nuclear Information System (INIS)

    Young, L.W.; Lachman, R.S.

    2001-01-01

    We have discovered additional serial radiographs and clinical information on the initial case of ''regional osteopetrosis tarda'' that has been included in several editions of Caffey's Pediatric X-Ray Diagnosis. A definite second case was found after a search of radiology teaching files of other selected medical centers and the International Skeletal Dysplasia Registry. Analysis of the sequential unusual radiographic findings of the initial case and the equivalent compelling findings of the second case justifies renewed attention to an asynchronous asymmetric form of heterogeneous osteopetrosis. (orig.)

  18. Recent Case Law

    DEFF Research Database (Denmark)

    Petz, Thomas; Sagaert, Vincent; Østergaard, Kim

    2004-01-01

    In this section authors from various European countries report the recent case law in their country on the field of private patrimonial law, that is decisions on the law of property, juridical acts, the law of obligations, contract law and prescription. The European Review of Private Law (ERPL......) started this section in 2003. The section aims to give our readers an overview of what is happening in the most recent European case law. We have asked the national reporters to report the juridical essence of the decisions given by the highest courts in their country. These national reports...... not relate the facts of the decision, nor the personal opinion of the reporter. One can find discussions on the most important decisions of European courts in ERPL’s case note section. The recent case law section gives overviews of decisions published in periods of four months. The period of January...

  19. Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls.

    Science.gov (United States)

    Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

    2017-06-05

    Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under 'real world' conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential. Published by Elsevier Ltd.

  20. [Case management process identified from experience of nurse case managers].

    Science.gov (United States)

    Park, Eun-Jun; Kim, Chunmi

    2008-12-01

    The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

  1. Case-Based FCTF Reasoning System

    Directory of Open Access Journals (Sweden)

    Jing Lu

    2015-10-01

    Full Text Available Case-based reasoning uses old information to infer the answer of new problems. In case-based reasoning, a reasoner firstly records the previous cases, then searches the previous case list that is similar to the current one and uses that to solve the new case. Case-based reasoning means adapting old solving solutions to new situations. This paper proposes a reasoning system based on the case-based reasoning method. To begin, we show the theoretical structure and algorithm of from coarse to fine (FCTF reasoning system, and then demonstrate that it is possible to successfully learn and reason new information. Finally, we use our system to predict practical weather conditions based on previous ones and experiments show that the prediction accuracy increases with further learning of the FCTF reasoning system.

  2. Breast cancer case using tamoxifen during pregnancy: a case report ...

    African Journals Online (AJOL)

    This is a case of 32 years old nulliparous female who was diagnosed in November 2004 as a case of carcinoma of the right breast , luminal A , (Estrogen Receptor positive Progesterone receptor negative, Her 2 negative, Ki67 10 %), poorly differentiated invasive ductal cancer, TNM stage,T2 N0 MO. She had a wide local ...

  3. Case Study: Let's Get Personal--Putting Personality into Your Cases

    Science.gov (United States)

    Herreid, Clyde Freeman

    2017-01-01

    In this case study, the subject for discussion is the need to use teaching notes in order to add personality to case studies. Personality, it is said, is more important than policy, than demographics, than finances, or amorous peccadillos. Personality is essential. It is the interaction of people that capture our interest, yet, the question is…

  4. RSG Deployment Case Testing Results

    Energy Technology Data Exchange (ETDEWEB)

    Owsley, Stanley L.; Dodson, Michael G.; Hatchell, Brian K.; Seim, Thomas A.; Alexander, David L.; Hawthorne, Woodrow T.

    2005-09-01

    The RSG deployment case design is centered on taking the RSG system and producing a transport case that houses the RSG in a safe and controlled manner for transport. The transport case was driven by two conflicting constraints, first that the case be as light as possible, and second that it meet a stringent list of Military Specified requirements. The design team worked to extract every bit of weight from the design while striving to meet the rigorous Mil-Spec constraints. In the end compromises were made primarily on the specification side to control the overall weight of the transport case. This report outlines the case testing results.

  5. From Use Cases to Activity Cases

    DEFF Research Database (Denmark)

    Bækgaard, Lars

    2005-01-01

    Use cases can be used to capture requirements and to subdivide IT-systems into functionally coherent units. Information systems are activity systems that carry out important business activities. Many systems development methods recognize activity modeling as an important development activity. Use...

  6. Case Study: What Makes a Good Case, Revisited: The Survey Monkey Tells All

    Science.gov (United States)

    Herried, Clyde Freeman; Prud'homme-Genereux, Annie; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

    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. In this month's issue the authors provide a more definitive answer to the "What Makes a Good Case?" question based on a just-completed Survey Monkey survey given to NCCSTS teachers.

  7. Portal cholangiopathy: case report

    Directory of Open Access Journals (Sweden)

    Maria Cecilia Almeida Maia

    2014-01-01

    Full Text Available The present report describes the case of a child that after blunt abdominal trauma presented with portal thrombosis followed by progressive splenomegaly and jaundice. Ultrasonography and percutaneous cholangiography revealed biliary dilatation secondary to choledochal stenosis caused by dilated peribiliary veins, characterizing a case of portal biliopathy. The present case report is aimed at presenting an uncommon cause of this condition.

  8. New guidelines for case reports

    Directory of Open Access Journals (Sweden)

    Mario Delgado-Noguera

    2013-09-01

    Full Text Available The case report or case reports are a frequent type of narrative article in the biomedical literature. Case reports are useful to describe unusual clinical cases, identify adverse effects or benefits of therapies. They are also useful for the description of presentation of rare diseases for educational or scientific purposes. Several groups have worked on reporting guidelines for other designs such as the case of clinical trials (CONSORT Statement or observational studies (STROBE Statement and this journal has been adopted as the guide for authors. Recently, there were presented the Guidelines for writing CAseREports (CARE Statement. The aim of this article is to make them known and comment.

  9. Casing drilling

    Energy Technology Data Exchange (ETDEWEB)

    Heenan, D. [Tesco Corp., Calgary, AB (Canada)

    2003-07-01

    This paper reviewed the experience that Tesco has gained by drilling several wells using only casings as the drill stem. Tesco has manufactured a mobile and compact hydraulic drilling rig called the Casing Drilling {sup TM} system. The system could be very effective and efficient for exploration and development of coalbed methane (CBM) reserves which typically require extensive coring. Continuous coring while drilling ahead, along wire line retrieval, can offer time savings and quick core recovery of large diameter core which is typically required for exploration core desorption tests. The proposed system may also have the potential to core or drill typically tight gas sands or underbalanced wells with air or foam. This would reduce drilling fluid damage while simultaneously finding gas. Compared to conventional drill pipes, Casing Drilling {sup TM} could also be effective with water production from shallow sands because of the smaller annual clearance which requires less air volumes to lift any produced water. 9 figs.

  10. The Legal Case

    NARCIS (Netherlands)

    Sartor, Giovanni; Contissa, Giuseppe; Schebesta, H.; Laukyte, Migle; Lanzi, Paola; Marti, Patrizia; Paola, Tomasello

    2013-01-01

    This paper presents the first release of the Legal Case, recently developed by the ALIAS Project and still under refinement. The Legal Case is a methodological tool intended to address liability issues of automated ATM systems: it provides for a legal risk management process that can be applied

  11. Tuberculosis case-finding in Cambodia: analysis of case notification data, 2000 to 2013

    Science.gov (United States)

    Furphy, Valérie Burrus; Kobayashi, Miwako; Nishikiori, Nobuyuki; Eang, Mao Tan; Yadav, Rajendra-Prasad

    2015-01-01

    The routine tuberculosis (TB) surveillance system in Cambodia has been strengthened under the National TB Programme (NTP). This paper provides an overview of the TB surveillance data for Cambodia at the national level for the period 2000 to 2013 and at the subnational level for 2013. The proportion of the total population that were screened for TB rose from 0.4% in 2001 to 1.1% in 2013, while the smear-positivity rate decreased from 28.9% to 8.1% in the same period. The total number of notified TB cases increased steadily from 2000; this has stabilized in recent years with 39 055 cases notified in 2013. The proportion of all TB cases that were smear-positive decreased from 78% in 2000 to 36% in 2013. Case notification rates (CNRs) for all forms of TB and new smear-positive TB in 2013 were 261 and 94 per 100 000 population, respectively. Higher CNRs were found in the north-western and south-eastern parts of the country and were higher for males especially in older age groups. The increase in TB screening, decline in the smear-positive rate and decline in notified smear-positive TB cases likely reflect a long-term positive impact of the NTP. A negative correlation between the proportion of the population screened and the smear-positivity rate at the subnational level helped identify where to find undiagnosed cases. Subnational differences in case notification of the elderly and in children provide more specific targets for case-finding and further encourage strategic resource allocation. PMID:25960919

  12. Lesões traumáticas do parênquima pulmonar: aspectos na tomografia computadorizada Traumatic lung lesions: computed tomography findings

    Directory of Open Access Journals (Sweden)

    Alessandro Severo Alves de Melo

    2003-06-01

    Full Text Available As lesões pulmonares são achados freqüentes no trauma torácico, sendo cada vez mais diagnosticadas pela tomografia computadorizada, em especial pelo rápido tempo de aquisição decorrente da técnica helicoidal, que permite a avaliação de pacientes em estado grave, possibilitando a adoção de conduta terapêutica eficiente. Os autores estudaram 150 pacientes vítimas de trauma torácico submetidos a tomografia computadorizada, que apresentaram lesões pulmonares, representadas por contusões, atelectasias, lacerações e hematomas pulmonares. As contusões pulmonares se caracterizaram por consolidações e atenuação em vidro fosco, sendo as lesões pulmonares mais comuns. As atelectasias foram observadas com os padrões subsegmentar e compressiva, e foram a segunda lesão mais comum. As lacerações se apresentaram como consolidações com ar ou nível líquido no interior. Os hematomas pulmonares representaram a lesão pulmonar mais rara, presentes em apenas cinco casos, caracterizados por opacidades arredondadas. Neste trabalho o trauma torácico fechado predominou, com 120 casos, enquanto o trauma aberto ocorreu em 30 casos. As causas de trauma fechado, em ordem decrescente de freqüência, foram: colisão automobilística, atropelamento, queda de altura, acidente de motocicleta e espancamento. A forma penetrante de traumatismo torácico decorreu de duas causas de agressão: lesão por arma de fogo e lesão por arma branca.Traumatic lesions of the lung are common findings in patients with thoracic trauma. These lesions are increasingly diagnosed using computed tomography, mostly due to the fast acquisition time helical techniques that allow evaluation of critically ill patients and an efficient therapeutic management. The authors studied 150 patients with thoracic trauma submitted to computed tomography that demonstrated lung contusions, atelectasies, lacerations and hematomas. Lung contusions were the most frequent lesions

  13. Reported cases of selected diseases.

    Science.gov (United States)

    1994-06-01

    The number of reported cases of measles, poliomyelitis, tetanus, diphtheria, and whooping cough for the period of January 1, 1994 to the date of the last report is presented in tabular form by country with a comparison for the same epidemiological period in 1993. The countries included are Bolivia, Colombia, Ecuador, Peru, Venezuela, Argentina, Chile, Paraguay, Uruguay, Brazil, Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, Mexico, Cuba, Haiti, the Dominican Republic, Antigua and Barbuda, the Bahamas, Barbados, Dominica, Grenada, Guyana, Jamaica, Saint Kitts and Nevis, Saint Vincent, Saint Lucia, Suriname, Trinidad and Tobago, Canada, and the US. The figures for measles are given as reported and as confirmed. In some countries, the reported number of cases of measles decreased from 1993 figures (Venezuela 5275 vs. 6060, Paraguay 26 vs. 958, Brazil 272 vs. 958, Canada 30 vs. 38), but, in others, the figure increased from 1993 (Mexico 47 vs. 21, the US 155 vs. 86). There were no reported cases of poliomyelitis for either year in any country. The figures for tetanus are divided into nonneonatal and neonatal. In Brazil the number of nonneonatal cases decreased to 360 from 371 in 1993, and the number of neonatal cases decreased to 28 from 65. In Mexico, nonneonatal cases decreased to 28 from 45, but neonatal cases increased to 23 from 20 in 1993. The number of cases of diphtheria cases in Brazil decreased to 28 from 65 in the same period of 1993. The number of cases of whooping cough decreased to 431 from 1651 in Brazil and to 51 from 70 in Mexico. However, the number of cases in Canada increased to 1047 from 784.

  14. Case Report

    DEFF Research Database (Denmark)

    Bilgin-Freiert, Arzu; Fugleholm, Kåre; Poulsgaard, Lars

    2015-01-01

    We report a case of an intraneural ganglion cyst of the hypoglossal canal. The patient presented with unilateral hypoglossal nerve palsy, and magnetic resonance imaging showed a small lesion in the hypoglossal canal with no contrast enhancement and high signal on T2-weighted imaging. The lesion...... irradiation as an option. This case illustrates a very rare location of an intraneural ganglion cyst in the hypoglossal nerve. To our knowledge there are no previous reports of an intraneural ganglion cyst confined to the hypoglossal canal....

  15. Case Study: A Step-by-Step Guide to Students Writing Case Studies (and Tools for Novice Case Authors)

    Science.gov (United States)

    Prud'homme-Genereux, Annie

    2015-01-01

    In experimenting with ways of structuring the assignment and providing guidance to students, the author developed a series of tools that may be of interest to instructors wishing to implement a case-writing assignment in their course. This assignment is more suited for instructors experienced in case writing, as their knowledge of how to design a…

  16. Case frames as contextual mappings to case law in BestPortal

    NARCIS (Netherlands)

    Hoekstra, R.; Lodder, A.; van Harmelen, F.

    2010-01-01

    This paper introduces case frames as a way to provide a more meaningful structure to vocabulary mappings used to bridge the gap between laymen and legal descriptions of court proceedings. Case frames both reduce the ambiguity of queries, and improve the ability of users to formulate good quality

  17. Patterned genital injury in cases of rape - A case-control study

    DEFF Research Database (Denmark)

    Astrup, Birgitte Schmidt; Ravn, Pernille; Thomsen, Jørgen Lange

    2013-01-01

    A pattern of genital injury that separates trauma seen in sexual assault cases from trauma seen following consensual sexual intercourse has been a matter of debate. This study aimed at clarifying the question by eliminating as many confounders as possible in a prospective, case-control setup. A t...

  18. Case management after long-term absence from work in China: a case report.

    Science.gov (United States)

    Tang, Dan; Yu, Ignatius Tak Sun; Luo, Xiaoyuan; Liang, Youxin; He, Yonghua

    2011-03-01

    Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice. This case report describes Mr. H's RTW process for illustrating the work of a case management team in China. Suggestions on developing and optimizing the process in China are given. After 9 years of absence from work due to severe burn injuries at work, Mr. H was referred for RTW interventions. Mr. H received social and occupational rehabilitation services of 3 months, and the following workplace visits and work trials. After the job placement, the case manager continued the liaison with the worker and employer. Mr. H showed positive changes in occupational and social adjustment after the case management interventions. This was reflected from the shift from the contemplation to action stage on the Lam Assessment of Stages of Employment Readiness. Despite he did not show significant changes on functional capacity and fear avoidance beliefs, Mr. H passed the job credential test and was offered a maintenance technician position at a new company. Both the worker and the employer were satisfied with the outcome of the case management. The RTW interventions carried out by the case managers appeared to be effective within the Chinese system. The results suggested that professional training of case managers, RTW-related policies and technological standards, early integrated interventions should be further developed in China. Disability Adjustment Group Therapy and RTW Support Groups perhaps are useful approaches in workers' returning to work.

  19. Measles cases among adolescents in southern Pakistan 2012-2015: The case for revisiting vaccination strategies.

    Science.gov (United States)

    Shakoor, Sadia; Khan, Erum; Rajput, Muhammad Imran; Rahimoon, Wali Muhammad

    2017-07-03

    Surveillance of adult measles in Pakistan is a challenge as it does not enjoy the status of a reportable disease unlike childhood cases and therefore cases remain undetected and unreported or misdiagnosed. Consequently no data or estimates of young adult cases, seroprevalence, or estimates of susceptible preadolescent or young adult population exist. We have presented both laboratory conformed and clinically suspected cases of measles occurring in adolescents and adults in the southern province of Sindh in Pakistan. Through an examination of 2 independent databases, i.e. a laboratory database of measles IgM positive cases and clinically detected cases on surveillance performed by the Disease Early Warning System, we have analyzed and reported age-specific positivity rates from 2012 to 2015 in Sindh, Pakistan. High rates of laboratory confirmed measles were observed in those aged 9 y and younger. Among adolescents and adults, significantly higher positivity rates were observed among those aged 10-19 y. Clinically detected cases from Sindh showed similar distribution of cases. High burden of cases among children <9 y of age confirm that supplementary immunization activities (SIAs) among this age group are inadequate and need to be strengthened. Cases among those 10-19 y further demonstrate the need for consolidating SIAs with an additional strategy to vaccinate those who remain non-immune at college entry and in institutions where outbreaks can be prevented. Such measures are essential to achieving the goal of measles elimination in the country and region.

  20. Casing Out Evaluation: Expanding Student Interest in Program Evaluation through Case Competitions.

    Science.gov (United States)

    Obrecht, Michael; Porteous, Nancy; Haddock, Blair

    1998-01-01

    Describes the authors' experiences in organizing bilingual evaluation case competitions for the National Capital Chapter of the Canadian Evaluation Society for three years. Competition structure, eligibility, judging, contestant recruiting, and preparing cases are outlined. (SLD)

  1. CLINICAL AND CEPHALOMETRIC ANALYSIS OF THREE CASES WITH PYCNODYSOSTOSIS: CASE REPORTS*

    Directory of Open Access Journals (Sweden)

    Eser ÇAPAN

    2015-01-01

    Full Text Available The aim of this article is to present intra- and extra-oral and cephalometric findings of three patients with a rare disease: the pycnodysostosis. Two cases had skeletal Class III malocclusion due to maxillary retrognathia and one had bimaxillary retrusion with Class I relationship. Total circular crossbite, increased gonial angle and vertical facial proportions, deep-narrow palates and retruded upper lip were found in all cases. Maxillary expansion, face mask treatment or/and orthognathic surgery are treatment alternatives, considering the growth and development. Bone fragility and the risk of osteomyelitis after extractions should be considered in such cases before orthodontic treatment and orthognatic surgery.

  2. Safety case plan 2008

    International Nuclear Information System (INIS)

    2008-07-01

    Following the guidelines set forth by the Ministry of Trade and Industry (now Ministry of Employment and Economy) Posiva is preparing to submit the construction license application for a spent fuel repository by the end of the year 2012. The long-term safety section supporting the license application is based on a safety case, which, according to the internationally adopted definition, is a compilation of the evidence, analyses and arguments that quantify and substantiate the safety and the level of expert confidence in the safety of the planned repository. In 2005, Posiva presented a plan to prepare such a safety case. The present report provides a revised plan of the safety case contents mentioned above. The update of the safety case plan takes into account the recommendations made by the Radiation and Nuclear Safety Authority (STUK) about improving the focus and further developing the plan. Accordingly, particular attention is given to the quality management of the safety case work, the management of uncertainties and the scenario methodology. The quality management is based on the ISO 9001:2000 standard process thinking enhanced with special features arising from STUK's YVL Guides. The safety case production process is divided into four main sub-processes. The conceptualisation and methodology sub-process defines the framework for the assessment. The critical data handling and modelling sub-process links Posiva's main technical and scientific activities to the production of the safety case. The assessment sub-process analyses the consequences of the evolution of the disposal system in various scenarios, classified either as part of the expected evolution or as disruptive scenarios. The compliance and confidence sub-process is responsible for final evaluation of compliance of the assessment results with the regulatory criteria and the overall confidence in the safety case. As in the previous safety case plan, the safety case will be based on several reports, but

  3. A clear case. Selective investment in case management applications can yield significant returns.

    Science.gov (United States)

    Hagland, Mark

    2009-03-01

    Strategically conceived case management system implementation makes good patient care and business sense, CIOs agree. Significant financial savings can be achieved from case management IS implementations, if those implementations are executed in the context of partnership between clinical leaders and the CIO's team. CIOs agree that applying the concept of "investment" to the implementation of case management IT can make resource allocation decisions easier.

  4. 'Case reporting of rare adverse events in otolaryngology': can we defend the case report?

    LENUS (Irish Health Repository)

    Dias, Andrew

    2012-01-31

    The study of errors in medicine has proliferated since the publication of The Institute of Medicine Report \\'TO ERR IS HUMAN\\' in 2000. Case nuances and process of care issues are valuable areas to explore if the goal is to provide the health care worker with the knowledge to avoid future errors. Meta-analysis and randomized controlled trials provide a large data base of evidence towards improvement and opportunities, but it is suggested that case reports can still provide valuable clinical information. The aim is to use the published literature to produce a series of rare harm case reports in E.N.T. The methods include systematic literature review. Journals searched in PUBMED were 60. Rare harm case obtained from the search were 5,322. Rare harm case reports not reported in any other form of evidence-based medicine were 40. Yes, the case report can be defended as it is an important pillar of evidence-based medicine.

  5. SARS: a comparative study on the chest radiography of the mortal cases and the cured cases

    International Nuclear Information System (INIS)

    Jiang Songfeng; Liu Jingxin; Chen Bihua; Zhang Lieguang; Yin Chibiao; Zhang Fuchun

    2003-01-01

    Objective: This study is mainly on the radiological findings of the mortal cases of SARS. Methods: The chest X-ray (CXR) findings of 11 mortal cases of SARS were retrospectively studied, and compared with those of the 249 cured cases. Results: The major CXR findings of the mortal cases were: patchy shadows in 10 cases out of 11 (90.90%), frosted glass like change of the lung fields in 9 (81.82%), diffuse lesions in 11 (100%), and involvement of the bilateral lung. There was a statistical difference between the mortal cases and the cured cases on the following 4 manifestations: large shadows, extensive consolidation, frosted glass like change of the lung fields, and diffuse lesions (P<0.01). Conclusion: Large shadows, extensive consolidation, frosted glass like change of the lung fields, diffuse lesions and the bilateral involvement of the lung are the main CXR findings of the mortal cases of SARS. And extensive consolidation and diffuse involvement are strongly indicative. In most of the mortal cases, the latest CXR demonstrated widespread frosted glass like appearance in the lung fields with air bronchogram

  6. Non-ferromagnetic overburden casing

    Science.gov (United States)

    Vinegar, Harold J.; Harris, Christopher Kelvin; Mason, Stanley Leroy

    2010-09-14

    Systems, methods, and heaters for treating a subsurface formation are described herein. At least one system for electrically insulating an overburden portion of a heater wellbore is described. The system may include a heater wellbore located in a subsurface formation and an electrically insulating casing located in the overburden portion of the heater wellbore. The casing may include at least one non-ferromagnetic material such that ferromagnetic effects are inhibited in the casing.

  7. "Since I have my case manager, I am back to life" case management in Croatia.

    Science.gov (United States)

    Gruber, Ema N; Ivezić-Strkalj, Sladana; Agius, Mark; Martić-Biocina, Sanja

    2008-03-01

    The authors present a case report of a patient who was treated by a case manager, a member of a Croatian Community Mental Health (CMH) Team, following the recommendations of WHO 2004 as well as the IRIS guidelines and the Basic Standards for Management of Patients with Serious Mental Illness in the Community (Agius 2005) and using the elements of Clinical case management (Muser 1998), Assertive community treatment model (Burns 1995, Scott 1995, Wolfsan 1990), the personal strength model (Rapp 1988) and Rehabilitation model (Anthony 1993). In order to emphasize the importance of the therapist-patient relationship in the treatment of chronic schizophrenic patients (Ivezic 2001) and creating the group atmosphere a Croatian model of case management is created where the patient's needs and risks are assessed by a multidisciplinary team which also conducts the recommended psychosocial interventions plan. The majority of interventions are conducted in groups. The case manager develops a confident relationship with a patient, nourishes the positive transference and aids the delivery of the treatment. The main goals of the interventions are empowerment of the patient, improvement of his abilities and decreasing of disabilities. The case manager also carries out a full assessment of the needs of the patient's family so that the family or carers are also included in the treatment or support if necessary (Gruber 2006). A case report of a patient and the work of her case manager as well as the case manager's diary (Gruber 2007) and the Croatian model of case management is presented in this article.

  8. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea

    OpenAIRE

    Jinjoo Oh, Ph.D., RN, GNP; Seieun Oh, Ph.D., RN

    2017-01-01

    Purpose: The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for ...

  9. Timeliness of Operating Room Case Planning and Time Utilization: Influence of First and To-Follow Cases

    Directory of Open Access Journals (Sweden)

    Konrad Meissner

    2017-04-01

    Full Text Available Resource and cost constraints in hospitals demand thorough planning of operating room schedules. Ideally, exact start times and durations are known in advance for each case. However, aside from the first case’s start, most factors are hard to predict. While the role of the start of the first case for optimal room utilization has been shown before, data for to-follow cases are lacking. The present study therefore aimed to analyze all elective surgery cases of a university hospital within 1 year in search of visible patterns. A total of 14,014 cases scheduled on 254 regular working days at a university hospital between September 2015 and August 2016 underwent screening. After eliminating 112 emergencies during regular working hours, 13,547 elective daytime cases were analyzed, out of which 4,346 ranked first, 3,723 second, and 5,478 third or higher in the daily schedule. Also, 36% of cases changed start times from the day before to 7:00 a.m., with half of these (52% resulting in a delay of more than 15 min. After 7:00 a.m., 87% of cases started more than 10 min off schedule, with 26% being early and 74% late. Timeliness was 15 ± 72 min (mean ± SD for first, 21 ± 84 min for second, and 25 ± 93 min for all to-follow cases, compared to preoperative day planning, and 21 ± 45, 23 ± 61, and 19 ± 74 min compared to 7:00 a.m. status. Start time deviations were also related to procedure duration, with cases of 61–90 min duration being most reliable (deviation 9.8 ± 67 min compared to 7:00 a.m., regardless of order. In consequence, cases following after 61–90 min long cases had the shortest deviations of incision time from schedule (16 ± 66 min. Taken together, start times for elective surgery cases deviate substantially from schedule, with first and second cases falling into the highest mean deviation category. Second cases had the largest deviations from scheduled times compared to

  10. Pressurized waterproof case electronic device

    KAUST Repository

    Berumen, Michael L.

    2013-01-31

    A pressurized waterproof case for an electronic device is particularly adapted for fluid-tight containment and operation of a touch-screen electronic device or the like therein at some appreciable water depth. In one example, the case may be formed as an enclosure having an open top panel or face covered by a flexible, transparent membrane or the like for the operation of the touchscreen device within the case. A pressurizing system is provided for the case to pressurize the case and the electronic device therein to slightly greater than ambient in order to prevent the external water pressure from bearing against the transparent membrane and pressing it against the touch screen, thereby precluding operation of the touch screen device within the case. The pressurizing system may include a small gas cartridge or may be provided from an external source.

  11. An unusual case of neonatal mastocytoma: A case report

    Directory of Open Access Journals (Sweden)

    Guglielmo Pranteda

    2017-08-01

    Full Text Available Mastocytosis is a group of disorders characterized by the accumulation of mast cells in various tissues. In this article we report an interesting case of cutaneous mastocytoma in a 3-month-old infant. We describe two episodes characterized by an exacerbation of the skin lesion with the typical Darier’s sign. Both of them occurred after breastfeeding. In both episodes, the mother had eaten shrimps before the breastfeeding. This peculiar case, difficult to understand regarding its pathogenesis, was successful resolved just with dietary prescription given to the breast feeding mother.

  12. Making a case for case studies in psychotherapy training

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward; Iwakabe, Shigeru

    2013-01-01

    articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory...... in action; access to whole courses of therapy; access to different approaches; access to significant moments; access to the therapeutic relationship; access to a wide range of client types; access to working in different contexts; and the opportunity of identifying with therapists and clients. Writing...

  13. Case Report: A Unique Case Of Cystic Echinococcosis in a Sahiwal ...

    African Journals Online (AJOL)

    Case Report: A Unique Case Of Cystic Echinococcosis in a Sahiwal Cow in Narok County, Kenya. JA Omega, PK Koskei. Abstract. A three and a half year old pregnant Sahiwal cow born and reared just outside the Maasai Mara National Game Reserve in Narok County, Kenya was noticed to walk slowly, cough occasionally ...

  14. Proceedings CORENDE: Regional congress on nondestructive and structural evaluation; Actas CORENDE: Congreso regional de ensayos no destructivos y estructurales

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    Works are presented at the CORENDE: Regional Congress on Nondestructive and Structural Evaluation organized by the National Atomic Energy Commission and the National Technological University (Mendoza). This congress wants to be the forum where people from research, industry and marketing might meet and discuss ideas towards the fostering of these new cultural habits. Papers covering all disciplines contributing to the evaluation of components, systems and structures are welcome: nondestructive evaluation methods and techniques (ultrasound, eddy currents and other electromagnetic methods, acoustic emission, radiography, thermography, leak testing, dye-penetrants, visual inspection, etc.), personnel certification, welding inspection, nondestructive metallography, optics and lasers, fluid-structure interaction, vibrations, extensometry, modelling of structures refs., ills. [Espanol] Se presentan trabajos de CORENDE: Congreso Regional de Ensayos no Destructivos y Estructurales organizado por la Comision Nacional de Energia Atomica y la Universidad Tecnologica Nacional (Mendoza). Este congreso se propone como un foro de discusion, donde, desde la investigacion hasta la produccion y comercializacion, se intercambien y discutan ideas que sirvan de guia para fomentar ese necesario cambio cultural. Los topicos de discusion incluyen a todas las disciplinas presentes en la evaluacion de componentes, sistemas y estructuras: tecnicas no destructivas (ultrasonido, corrientes inducidas, radiografia industrial, emision acustica, particulas magnetizables, termografia, liquidos penetrantes, ensayos de perdidas, inspeccion visual, etc.), certificacion de personal, inspeccion en soldaduras, replicas metalograficas, tecnicas opticas y laser, interaccion fluido-estructura, vibraciones, extensometria, modelado de estructuras

  15. [Rectal duplication cyst--case report].

    Science.gov (United States)

    Turyna, R; Horák, L; Kucera, E; Hejda, V; Krofta, L; Feyereisl, J

    2009-06-01

    The authors demonstrate a rare case of duplication anomaly of the rectum. Case report. Institute for the Care of Mother and Child, Prague. We present a rare case of cystic rectal duplication in adult, completely removed and histologically confirmed. A literature review was summarized. The case was complicated by delay in diagnosis, multiple operations, and by the association with endometriosis, as well. Mentioned anomaly is published in the Czech literature for the very first time.

  16. Differences in the clinical-epidemiological profile between new cases of tuberculosis and retreatment cases after default

    Directory of Open Access Journals (Sweden)

    Aylana de Souza Belchior

    Full Text Available Abstract OBJECTIVE To identify the socioeconomic and clinical-epidemiological factors related to tuberculosis in new cases and retreatment cases. METHOD Comparative study with 126 patients, of which 42 were retreatment cases after default attended in a reference center, and 84 were new cases completing the first treatment and treated in Basic Health Units. The collection of primary data was through interview, and of secondary data by records of the Notifiable Diseases Information System. Comparative analysis between the two groups. RESULTS The new cases differ from retreatment cases regarding educational level. The clinical-epidemiological profile shows a significant difference in relation to performance of the tuberculin skin test, and the HIV test result (positive in favor of new cases. In relation to performance of sputum culture and the result (positive of the first sputum smear of the first and second samples, in favor of retreatment cases. CONCLUSION The two groups are significantly different in clinical and epidemiological characteristics that show the access to exams.

  17. Preliminary energy demand studies for Ireland: base case and high case for 1980, 1985 and 1990

    Energy Technology Data Exchange (ETDEWEB)

    Henry, E W

    1981-01-01

    The framework of the Base Case and the High Case for 1990 for Ireland, related to the demand modules of the medium-term European Communities (EC) Energy Model, is described. The modules are: Multi-national Macre-economic Module (EURECA); National Input-Output Model (EXPLOR); and National Energy Demand Model (EDM). The final results of the EXPLOR and EDM are described; one set related to the Base Case and the other related to the High Case. The forecast or projection is termed Base Case because oil prices are assumed to increase with general price inflation, at the same rate. The other forecast is termed High Case because oil prices are assumed to increase at 5% per year more rapidly than general price inflation. The EXPLOR-EDM methodology is described. The lack of data on energy price elasticities for Ireland is noted. A comparison of the Base Case with the High Case is made. (MCW)

  18. Case Managers on the Front Lines of Ethical Dilemmas: Advocacy, Autonomy, and Preventing Case Manager Burnout.

    Science.gov (United States)

    Sortedahl, Charlotte; Mottern, Nina; Campagna, Vivian

    The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care. This discussion acknowledges the ethical dilemmas that case managers routinely confront, which empowers them to seek support, guidance, and resources to support ethical practice. In addition, the article seeks to raise awareness of the effects of burnout and moral distress on case managers and others with whom they work closely on interdisciplinary teams.

  19. Describing Case Study Method and Identifying the Factors that Contribute to the Successful Conduct of Case Studies

    OpenAIRE

    Ahmad H. Juma'h; Mustafa Cavus

    2001-01-01

    This article has attempted to describe case study, the limitations and critiques on case study methodology and how the proponents have responded to these. Our special focus have been on the debate on theory building from case study research, and a framework for conducting case study research as well as the factors for a successful case study research. The overall conclusion is that the case study has been inappropriately used to generate theories.

  20. Cheilitis granulomatosa: Case series

    Directory of Open Access Journals (Sweden)

    Sudha Rani Chintagunta

    2017-01-01

    Full Text Available Granulomatous cheilitis is an idiopathic inflammatory disorder characterized by persistent, asymptomatic, diffuse swelling of one or both lips. It is also considered as an oligosymptomatic or monosymptomatic form of Melkersson–Rosenthal syndrome. We herewith report five cases of granulomatous cheilitis of which three cases were females and two were males. The mean age was 41 years. The average duration of symptoms was 2.5 years (2–3 years. Four patients presented with asymptomatic persistent swelling of the upper lip and one patient with lower lip. Two cases showed associated fissuring and angular cheilitis. One case also showed involvement of the left cheek. All the patients showed moderate improvement with combination of minocycline and intralesional triamcinolone therapy.

  1. Measles (Rubeola) Cases and Outbreaks

    Science.gov (United States)

    ... Address What’s this? Submit What's this? Submit Button Measles Cases and Outbreaks Language: English (US) Español (Spanish) ... Español: Casos y brotes de sarampión Number of measles cases by year since 2010 Measles cases per ...

  2. Case-control studies in neurosurgery.

    Science.gov (United States)

    Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

    2014-08-01

    Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure

  3. Case-control studies in diabetes. Do they really use a case-control design?

    Science.gov (United States)

    Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

    2017-07-01

    Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

  4. Case Reports, Case Series - From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education.

    Science.gov (United States)

    Sayre, Jerry W; Toklu, Hale Z; Ye, Fan; Mazza, Joseph; Yale, Steven

    2017-08-07

    Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education.

  5. Three cases of pulmonary varix

    Energy Technology Data Exchange (ETDEWEB)

    Takishima, Teruo; Sakuma, Hajime; Tajima, Tsunemi; Okimoto, Takao; Yamamoto, Keiichiro; Dohi, Yutaka (Saitama Medical School (Japan))

    1982-06-01

    Three cases of pulmonary varix associated with valvular heart disease were reported. Round shadows were clearer on first oblique or lateral films of chest x-ray in all 3 cases. On chest tomograms, the shadows were substantial and round-elliptical. RI angiography with sup(99m)Tc-RBC demonstrated these shadows in agreement with the site of influx of the pulmonary vein into the left atrium in Cases 1 and 3 and with the pulmonary vein slightly apart from the left atrium in Case 2. On CT scans in Cases 1 and 3, enhancement with a contrast medium visualized dilatation of the pulmonary vein close to, and in continuation with, the shadow of the left atrium. The diagnosis of pulmonary varix in agreement with the venous phase of pulmonary angiography was made for all 3 cases. Non-surgical examinations (especially CT scan) proved highly useful for the diagnosis of pulmonary varix.

  6. Five Misunderstandings About Case-Study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2006-01-01

    This article examines five common misunderstandings about case-study research: (a) theoretical knowledge is more valuable than practical knowledge; (b) one cannot generalize from a single case, therefore, the single-case study cannot contribute to scientific development; (c) the case study is most...... useful for generating hypotheses, whereas other methods are more suitable for hypotheses testing and theory building; (d) the case study contains a bias toward verification; and (e) it is often difficult to summarize specific case studies. This article explains and corrects these misunderstandings one...

  7. Retrospective evaluation of childhood alopecia areata cases

    Directory of Open Access Journals (Sweden)

    Munise Daye

    2013-09-01

    Full Text Available Background and design: Approximately 20% of alopecia areata (AA cases are children. There is limited information about childhood AA.We aimed to examine demographic features,treatments and diseases prognosis of child cases of AA that were followed in our clinic. Material and methods: Datas of 110 AA patients who are 16 and under 16 years old were examined retrospectively.The age,gender,disease onset age,duration of disease,types of AA and onset area,nail involvement, accompanying systemic and dermatological diseases,laboratory tests,treatments and the prognosis were evaluated in their follow-up time.Results: Female cases were 46,4%, male cases were 53,6%.The mean age was 10,35 years.The age of disease onset was 8,65 years.Primary onset areas of AA cases were scalp in 83,6%, eyebrows in 5,4%, body hair in 5,4%, eyelashes in 2,7%, eyebrows and eyelashes in 2,7%.Types of disease were AA in 73,4% cases,alopecia totalis in 19% cases, alopecia universalis in 5,4% cases,ophiaisis in 1,8% cases.Nail involvement was established in 36,3% cases. Nevus flammeus was established in 2,7% cases.Mean disease duration was 17,02 months.Accompaying dermatosis were vitiligo in 2,7% cases,atopic dermatitis in 6,3% cases. The accompaying systemic diseases were autoimmune thyroiditis in 1,8% cases and Down's Syndrome in 2,7% cases.Thyroid autoantibodies were high in 0,9% cases.We have treated 24,5% of cases with topical corticosteroid lotion, 30,9% of cases with anthralin, 0,9%of cases with 2% minoxidil lotion, 0,9% of cases with calcipotriol lotion, 1,8% of cases with topical calcineurin inhibitors, 10% of cases with intralesional corticosteroids.We have treated 15,4% of cases with systemic corticosteroids and PUVA therapy who were resistant to topical treatment.We have treated 14,5% of cases with different combinations of topical treatments.Remission was observed in 34,5% of cases.The mean remission duration was 12.2 months.Relapse was observed at a average of two

  8. Case Study: Mini-Case Studies: Small Infusions of Active Learning for Large-Lecture Courses

    Science.gov (United States)

    Carloye, Lisa

    2017-01-01

    In this article, the author introduces the usage of case studies to be an excellent method for engaging students through stories. The author notes she developed a series of mini-case studies that can be implemented, with a little advance preparation, within a 10- to 15-minute window during lecture. What makes them "mini" case studies?…

  9. Ceratoplastia com enxerto autógeno lamelar livre de córnea e pediculado de conjuntiva fixados com adesivo de cianoacrilato em cães Lamellar keratoplasty produced by free corneal autograft and conjuntival pedicle fixed with cyanoacrylate adhesive in dogs

    Directory of Open Access Journals (Sweden)

    Fabrício de Vargas Arigony Braga

    2004-08-01

    Full Text Available A córnea, devido a sua localização externa e exposta, está freqüentemente sujeita a traumas ou processos lesivos como lacerações, perfurações e ulcerações, havendo, em muitos casos a necessidade de correção cirúrgica. Os enxertos pediculados de conjuntiva têm seu uso indicado nestes casos e se prestam bem como medidas de proteção e suporte para as ulcerações, porém impedem a capacidade visual plena do olho afetado. Os transplantes lamelares são outra indicação de tratamento, principalmente quando se deseja prevenir a ocorrência da perda visual. Os adesivos de cianoacrilato foram descobertos no final da década de 40, mas somente foram utilizados em oftalmologia no início da década de 60. Devido a propriedades como boa aderência aos tecidos biológicos, rápida secagem e polimerização, têm sido indicados no tratamento de úlceras profundas ou refratárias, descemetoceles e ainda em pequenas perfurações corneanas. Com o objetivo de testar o adesivo de cianoacrilato na fixação e manutenção de botões córneo-lamelares autógenos e de enxertos pediculados de conjuntiva em úlceras corneanas experimentais, foram utilizados 10 cães, machos ou fêmeas, provenientes do Biotério Central da Universidade Federal de Santa Maria (UFSM. Após anestesia, blefarostase e fixação do globo ocular como de rotina, foram realizadas trepanações compreendendo 2/3 da espessura da córnea sendo de 5,5 mm de diâmetro no olho esquerdo (OE e de 5 mm no olho direito (OD. O botão lamelar resultante do OE foi fixado no leito receptor do OD com o uso de adesivo ao longo das bordas do enxerto e da córnea receptora. No olho esquerdo, após sua confecção, o enxerto de conjuntiva pediculado foi fixado à área receptora também por meio da colocação de adesivo sobre suas bordas. Foi realizada avaliação oftalmológica diária durante 30 dias. Os botões lamelares permaneceram fixados e foram incorporados à córnea receptora. A t

  10. Case-based ethics instruction: the influence of contextual and individual factors in case content on ethical decision-making.

    Science.gov (United States)

    Bagdasarov, Zhanna; Thiel, Chase E; Johnson, James F; Connelly, Shane; Harkrider, Lauren N; Devenport, Lynn D; Mumford, Michael D

    2013-09-01

    Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sense making processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed.

  11. Political Psychopathy : Fujimori case

    OpenAIRE

    Nizama Valladolid, Martin

    2014-01-01

    Seven years after his political fall, Alberto Fujimori Fujimori was extradited from Chile on September 22 of 2007, in order to judge him by two cases of human rights violations and five corruption cases. The mega-trial begun on december 10 of 2007. According to the mediate authorship theory, having led the command in charge of the counterterrorist actions involves him in crimes related to human rights. The Supreme court special penal division judges him by six cases related to human rights, c...

  12. A case of unilateral dysmenorrhea

    Directory of Open Access Journals (Sweden)

    Tulon Borah

    2010-01-01

    Full Text Available Unilateral dysmenorrhea in an adolescent may be associated with uterine malformation. Relevant investigations in suspected cases and timely intervention can prevent future complications in such cases. Here, we present a case of unicornuate uterus with rudimentary horn in an adolescent complaining of unilateral dysmenorrhea.

  13. Xeroderma pigmentosum (case report

    Directory of Open Access Journals (Sweden)

    Dubey Arvind

    1990-01-01

    Full Text Available Xeroderma pigmentosum is a rare, hereditary and fatal disease of the skin. Ocular involvement is known to occur in 80% of cases. A case with typical cutaneous and ocular lesions is reported.

  14. Membranous Dysmenorrhea: A Case Series

    Science.gov (United States)

    Omar, Hatim A.; Smith, Shawn J.

    2007-01-01

    The purpose was to illustrate the variability of hormonal contraception of patients that presented with membranous dysmenorrheal. A case analysis chart review was completed on six patients referred to a Pediatric Gynecologist in an academic setting. In each case the patient underwent a thorough pelvic and bimanual exam. Following the initial presentation, each patient continued to be followed on a regular visits. Cases: Two were using the transdermal contraceptive patch and oral contraceptive, but following the expulsion of decidual cast, they were both placed on depot medroxyprogesterone acetate (DMPA) without further complications. Three of the six cases were on DMPA prior to the similar occurrence of membranous dysmenorrheal and following this incident, continued on DMPA without further problems. The final case was on the transdermal patch prior to decidual cast expulsion and remained on this form of hormonal contraception without further complications. These cases indicate that membranous dysmenorrheal is not limited to the use of DMPA. PMID:18060329

  15. Three cases of pulmonary varix

    International Nuclear Information System (INIS)

    Takishima, Teruo; Sakuma, Hajime; Tajima, Tsunemi; Okimoto, Takao; Yamamoto, Keiichiro; Dohi, Yutaka

    1982-01-01

    Three cases of pulmonary varix associated with valvular heart disease were reported. Round shadows were clearer on first oblique or lateral films of chest x-ray in all 3 cases. On chest tomograms, the shadows were substantial and round-elliptical. RI angiography with sup(99m)Tc-RBC demonstrated these shadows in agreement with the site of influx of the pulmonary vein into the left atrium in Cases 1 and 3 and with the pulmonary vein slightly apart from the left atrium in Case 2. On CT scans in Cases 1 and 3, enhancement with a contrast medium visualized dilatation of the pulmonary vein close to, and in continuation with, the shadow of the left atrium. The diagnosis of pulmonary varix in agreement with the venous phase of pulmonary angiography was made for all 3 cases. Non-surgical examinations (especially CT scan) proved highly useful for the diagnosis of pulmonary varix. (Chiba, N.)

  16. Comparing colon cancer outcomes: The impact of low hospital case volume and case-mix adjustment.

    Science.gov (United States)

    Fischer, C; Lingsma, H F; van Leersum, N; Tollenaar, R A E M; Wouters, M W; Steyerberg, E W

    2015-08-01

    When comparing performance across hospitals it is essential to consider the noise caused by low hospital case volume and to perform adequate case-mix adjustment. We aimed to quantify the role of noise and case-mix adjustment on standardized postoperative mortality and anastomotic leakage (AL) rates. We studied 13,120 patients who underwent colon cancer resection in 85 Dutch hospitals. We addressed differences between hospitals in postoperative mortality and AL, using fixed (ignoring noise) and random effects (incorporating noise) logistic regression models with general and additional, disease specific, case-mix adjustment. Adding disease specific variables improved the performance of the case-mix adjustment models for postoperative mortality (c-statistic increased from 0.77 to 0.81). The overall variation in standardized mortality ratios was similar, but some individual hospitals changed considerably. For the standardized AL rates the performance of the adjustment models was poor (c-statistic 0.59 and 0.60) and overall variation was small. Most of the observed variation between hospitals was actually noise. Noise had a larger effect on hospital performance than extended case-mix adjustment, although some individual hospital outcome rates were affected by more detailed case-mix adjustment. To compare outcomes between hospitals it is crucial to consider noise due to low hospital case volume with a random effects model. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Estudio histopatológico de 19 biopsias cutáneas de pacientes con sida e histoplasmosis diseminada

    Directory of Open Access Journals (Sweden)

    Gerzaín Rodríguez

    2001-06-01

    Full Text Available La histoplasmosis diseminada (HD compromete la piel y la mucosa oronasofaríngea con alta frecuencia. Entre 1.800 enfermos con sida, 19 presentaron HD, todos con compromiso cutáneo o mucocutáneo. Las lesiones cutáneas fueron máculas, pápulas umbilicadas o escamocostrosas, nódulos y úlceras, en tanto que 42% de los pacientes presentaron ulceras orales. Las biopsias mostraron dermatitis perivasculares superficiales y profundas, nodulares y difusas, foliculitis pustulosa o vasculitis con PMN y leucocitoclasia, con cantidades variables del hongo, fagocitado por macrófagos. En 5 biopsias, Histoplasma ca~sulatums e vio dentro de los nervios cutáneos que estaban rodeados de inflamación variable o tenían perinervio desflecado y estaban invadidos por macrófagos con el hongo. Los principales diagnósticos diferenciales histológicos son: vasculitis leucocitoclásica, criptococosis, aftas, paracoccidioidomicosis y leishmaniasis difusa. Los clínicos, laboratoristas y patólogos deben tener en mente la HD en toda úlcera oral o erupción máculo-papular cutánea de pacientes con sida, pues el diagnóstico rápido de la micosis conduce a un tratamiento oportuno y eficaz, que controla la enfermedad. La biopsia es un procedimiento de diagnóstico rápido, seguro y confiable. H. capsulatum es capaz de invadir los nervios cutáneos.

  18. Intoxicação aguda por cobre em ovinos

    Directory of Open Access Journals (Sweden)

    Marcele Bettim Bandinelli

    2013-10-01

    Full Text Available Descrevem-se casos de intoxicação aguda por cobre em ovinos da raça Santa Inês, numa propriedade rural, no Rio Grande do Sul. Três ovelhas recém-paridas, que consumiam ração formulada para bovinos, ingeriram, avidamente, sal mineral comercial para bovinos e apresentaram doença clínica e morte, uma semana após a introdução do sal. Os animais desenvolveram anorexia, permaneceram em decúbito lateral, o qual evoluiu para esternal e apresentaram fasciculação e rigidez muscular generalizada, antes de morrerem. À necropsia de um desses animais, as principais alterações foram hepatomegalia moderada e acentuação do padrão lobular hepático, além de erosões e ulcerações multifocais aleatórias na mucosa abomasal. Na avaliação histológica do fígado, havia necrose hepatocelular centrolobular acentuada e difusa, tumefação de hepatócitos, predominantemente, na região periportal, além de pequena quantidade de células de Kupffer com pigmento granular citoplasmático. O diagnóstico baseou-se na história clínica, nos achados de necropsia e histopatológicos e confirmou-se pelas altas concentrações de cobre detectadas no tecido hepático e nas amostras de ração e sal mineral.

  19. Barrera del desempeño laboral

    Directory of Open Access Journals (Sweden)

    María Del Rosario Alvarez-Ramirez

    2007-12-01

    Full Text Available El estres es un hecho complejo en la vida de toda persona con efectos distintos en cada quien, que no puede ser evitada ya que en todos lo momentos de la vida se esta en riesgo de presentarlo ante cualquier situacion, o una actividad laboral o familiar, que puede llegar a generar cualquier cambio que represente estres. Los sucesos negativos, dario, enfermedad o muerte de un ser querido, son hechos estresantes, asi como los sucesos positivos; ascender en el trabajo trae consigo el estres del nuevo status, de nuevas responsabilidades. Dentro de los trastornos clinicos vinculados al estres hay alteraciones como: trastornos del sumo, ulceras, dolores de cabeza, aceleracion del ritmo cardiaco y otros trastornos como los cardiovasculares: palpitaciones, hipertension arterial, trastornos digestivos, dolores, ardores, vomitos, nauseas, diarrea o estreriimiento y trastornos cutaneos: donde se presenta transpiracion de manos y pies y problemas alergicos. En el estres se pueden llegar a presentar dos tipos de estres: el positivo y el negativo. Los cuales presentan unas caracteristicas muy particulares, como en el estres negativo: una persona se encuentra ante un nitmero creciente de demandas que le plantean dificultad o constituyen una amenaza, se debe mirar el modo de afrontarlas. En el Estres positivo se presenta cuando la percepcion de capacidad de demanda es mucho mas amplia que las verdaderas demandas. Un aspecto fundamental ante la presencia de estres es la practica necesaria de un deporte o la realizacion de actividades recreativas.

  20. Case law

    International Nuclear Information System (INIS)

    2012-01-01

    This section gathers the following case laws: 1 - Canada: Judicial review of Darlington new nuclear power plant project; Appeal decision upholding criminal convictions related to attempt to export nuclear-related dual-use items to Iran: Her Majesty the Queen V. Yadegari; 2 - European Commission: Greenland cases; 3 - France: Chernobyl accident - decision of dismissal of the Court of Appeal of Paris; 4 - Slovak Republic: Aarhus Convention compliance update; 5 - United States: Judgement of a US court of appeals upholding the NRC's dismissal of challenges to the renewal of the operating licence for Oyster Creek Nuclear Generating Station; reexamination of the project of high-level waste disposal site at Yucca Mountain

  1. Rare case of transverse testicular ectopia - Case report and review of literature.

    Science.gov (United States)

    Raj, Vinod; Redkar, Rajeev; Krishna, Swathi; Tewari, Shruti

    2017-01-01

    This case report has been reported in line with the SCARE criteria; Consensus-based surgical case report guidelines of International Journal of Surgery 2016. Transverse Testicular Ectopia (TTE) is a rare condition which manifests with unilateral undescended testis and contralateral hernia. Till now around 100 cases have been described in the literature. The management depends on the anatomy of the vas, vessels and testis found on surgical exploration. An algorithm exists for its management and we propose a modified algorithm for management of TTE. Five year male presented with complaints of unilateral undescended testis on the right and hernia on the left. Clinically the right testis was impalpable and left testis palpable in the left hemiscrotum and fluid hernia on the same side. Transverse testicular ectopia is a rare condition presenting with UDT and contralateral inguinal hernia. Although more than 100 cases have been described in the literature so far, those managed with a transeptal contralateral orchidopexy are two cases to the best of our knowledge. TTE was first described by Von Lenhossek in 1886. The mean age of presentation is around 4 years and most of the cases are diagnosed on surgical exploration. The management of TTE remains controversial even though an algorithm has been described for its management due to its varied presenting scenarios. TTE is a rare condition which requires high index of suspicion for diagnosis preoperatively. Whenever suspected we recommend an USG and/or MRI prior to diagnostic laparoscopy and proceed with orchidopexy. Diagnostic laparoscopy is both helpful in diagnosis and management. Transeptal contralateral orchidopexy gives good tension free fixation of testes in the scrotum.

  2. BOS MOrth cases prize 2011.

    Science.gov (United States)

    Patel, Jigar Vipinchandra

    2013-12-01

    This paper describes the orthodontic treatment of two cases awarded the prize by the British Orthodontic Society for best treated cases submitted for the Membership in Orthodontics. The first case reports on the treatment of a class III malocclusion with increased vertical lower anterior facial proportions and dentoalveolar compensation that was treated with orthodontic camouflage. The second case reports on the treatment of a class II division II malocclusion with reduced vertical lower anterior facial proportions and an overbite complete to the palate, which was treated with orthodontic camouflage.

  3. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille

    2014-01-01

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

  4. A challenging case of invasive pulmonary aspergillosis after near-drowning: a case report and literature review.

    Science.gov (United States)

    Jenks, Jeffrey D; Preziosi, Michael

    2015-09-01

    Near-drowning, a relatively common event, is often complicated by subsequent pneumonia. While endogenous and exogenous bacteria are typical pathogens, rarely fungi are as well. We report a complicated case of invasive pulmonary aspergillosis in a 30-year-old man after a near-drowning event. We also review the medical literature for similar cases. All cases of invasive pulmonary aspergillosis after near-drowning reported in the literature involve Aspergillus fumigatus . The majority of cases involved submersion in stagnant water after a motor vehicle accident (MVA). Treatment varied considerably, with amphotericin B used in the majority of cases. Morbidity was considerable with prolonged hospitalization occurring in every case, and mortality occurring in fifty percent of the reported cases. Although a rare complication of near-drowning, invasive pulmonary aspergillosis can occur and lead to significant morbidity and mortality. After near-drowning A. fumigatus isolated from the respiratory tract should be assumed to be a true pathogen and treated accordingly.

  5. Some of the cases

    DEFF Research Database (Denmark)

    Eller, Nanna Hurwitz; Mogensen, Jørn Thykjær; Gyntelberg, Finn

    2014-01-01

    Some of the cases of acknowledged occupational psychiatric disorder in Denmark have been exposed to negative press coverage. Such individuals might have been exposed to violence to a lower extent than other with an acknowledged psychological work injury. We compared 25 cases with 35 controls...... matched on age and gender. The cases had experienced significantly fewer incidents of violence and had less anxiety and flashback symptoms than the controls. The results suggest that the negative press coverage was the reason for the psychiatric symptoms rather than exposures at the workplace....

  6. 451 Case studies Cardiac

    African Journals Online (AJOL)

    Marinda

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

  7. Five misunderstandings about case study research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2004-01-01

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... useful for generating hypotheses, while other methods aremore suitable for hypotheses testing and theory building; (4) The case study contains a bias toward verification; and (5) It is often difficult to summarize specific case studies. The article explains and corrects these misunderstandings one by one...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without exemplars is an ineffective one. Social science may be strengthened by the execution of more...

  8. Emotion, Engagement, and Case Studies

    Science.gov (United States)

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

    2014-01-01

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

  9. PHAKOMATOSIS PIGMENTOVASCULARIS: REPORT OF A CASE

    Directory of Open Access Journals (Sweden)

    Mostafa Mirshams-Shahshahani

    1995-06-01

    Full Text Available The present study introduces a rare case of phakomatosispigmenJovascularis, which is charaderiud by the existence ofpigmentary naevus ond vascular naevus. Until 1985, 63 cases ofthis syndrome have been reported, mostly in Japon (56 cases. This is the first case of phakomatosis pigmentovascularis, reported in Iran.

  10. "Tuberculosis Case Management" Training.

    Science.gov (United States)

    Knebel, Elisa; Kolodner, Jennifer

    2001-01-01

    The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to…

  11. Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses.

    Science.gov (United States)

    Keogh, Ruth H; Mangtani, Punam; Rodrigues, Laura; Nguipdop Djomo, Patrick

    2016-01-05

    Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

  12. Factors associated with tuberculosis cases in Semarang District, Indonesia: case-control study performed in the area where case detection rate was extremely low.

    Science.gov (United States)

    Rahayu, Sri Ratna; Katsuyama, Hironobu; Demura, Masashi; Katsuyama, Midori; Ota, Yoko; Tanii, Hideji; Higashi, Tomomi; Semadi, Ngakan Putu Djaja; Saijoh, Kiyofumi

    2015-07-01

    Indonesia is ranked as the 4th highest contributor to tuberculosis (TB) in the world. Semarang District in Central Java displays extremely low case detection rate (CDR), possibly contributing to the local prevalence of TB. A case-control study was performed to explore the factors that cause such low CDR. We recruited 129 TB cases and 83 controls that visited the same centers and were not diagnosed with TB. The cases had 7.5 ± 2.3 symptoms/person on average, indicating the delay in diagnosis because the controls only displayed 1.0 ± 1.7. The multiple logistic regression analysis comparing the cases/controls extracted following factors as a risk to have TB: farmer, close contact with TB patients, ignorance of whether Bacillus Calmette-Guérin (BCG) was accepted or no, smoking, low income, a lot of people living in the same room, irregular hand wash before meals, not wash hands after blow, soil floor, and no sunlight and no ventilation in the house. Neither the cases nor the controls knew the symptoms and how to avoid TB infection, which probably caused the delay in diagnosis. It is difficult to change the current living conditions. Thus, the amendment of the community-based education program of TB seems to be required.

  13. Case and Administrative Support Tools

    Science.gov (United States)

    Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help reduce office administrative labor costs while increasing employee effectiveness. CAST supports business functions which rely on and store Privacy Act sensitive data (PII). Specific business processes included in CAST (and respective PII) are: -Civil Rights Cast Tracking (name, partial medical history, summary of case, and case correspondance). -Employment Law Case Tracking (name, summary of case). -Federal Tort Claims Act Incident Tracking (name, summary of incidents). -Ethics Program Support Tools and Tracking (name, partial financial history). -Summer Honors Application Tracking (name, home address, telephone number, employment history). -Workforce Flexibility Initiative Support Tools (name, alternative workplace phone number). -Resource and Personnel Management Support Tools (name, partial employment and financial history).

  14. Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

    Science.gov (United States)

    King, Robert

    2009-05-01

    In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace

  15. Improvement of Students’ Ability to Analyzing Cases on Case Studies Through Journal and Learning Log

    Directory of Open Access Journals (Sweden)

    Riska Ahmad

    2017-08-01

    Full Text Available The purpose of this research is to improve the ability of students in guidance and counseling  to  analyzing the case through journals and learning logs This research is classroom action research consists of two cycles. The research phase consisted of planning, implementation, observation and reflection. The research subject are students in guidance and counseling while they are in sixth semester, totaling 20 people who were taking courses in Case Study. The research instrument is the observation guidelines, assessment rubrics and documentation of case studies in the form of journals and learning logs, and case study reports. The study was conducted collaboratively with student magister’s program guidance and counseling. The results showed that in cycle 1 students are able to identify cases, to develop ideas about the case, select and use instruments to analyze the cause of the problem. The results of the research cycle 2, showed 17 of the 20 students were able to analyze the cause of the problem, select the type of service and provide appropriate assistance in accordance with problem cases. Overall value obtained by the students in the subject of Case Studies also increased. In terms of the ability of explanation of the concept, the concept of truth and creativity, based on the ratings given by fellow students of average ability students were in either category, although there is less good, as are associated with the activity of the opinion and the quality of the opinions expressed.

  16. Genetic Engineering and Sustainable Crop Disease Management: Opportunities for Case-by-Case Decision-Making

    Directory of Open Access Journals (Sweden)

    Paul Vincelli

    2016-05-01

    Full Text Available Genetic engineering (GE offers an expanding array of strategies for enhancing disease resistance of crop plants in sustainable ways, including the potential for reduced pesticide usage. Certain GE applications involve transgenesis, in some cases creating a metabolic pathway novel to the GE crop. In other cases, only cisgenessis is employed. In yet other cases, engineered genetic changes can be so minimal as to be indistinguishable from natural mutations. Thus, GE crops vary substantially and should be evaluated for risks, benefits, and social considerations on a case-by-case basis. Deployment of GE traits should be with an eye towards long-term sustainability; several options are discussed. Selected risks and concerns of GE are also considered, along with genome editing, a technology that greatly expands the capacity of molecular biologists to make more precise and targeted genetic edits. While GE is merely a suite of tools to supplement other breeding techniques, if wisely used, certain GE tools and applications can contribute to sustainability goals.

  17. Shared written case formulations and weight change in outpatient therapy for anorexia nervosa: a naturalistic single case series.

    Science.gov (United States)

    Gladwin, Alice M; Evangeli, Michael

    2013-01-01

    The therapeutic effects of written shared case formulations are underexplored and have not been examined in anorexia nervosa. This study explored the relationship between (a) the delivery (b) the quality of a shared written case formulation and weight in outpatient psychological therapy for anorexia nervosa. A naturalistic single case series approach was used to examine the case notes of women who had attended a specialist eating disorders service over a 2-year period. The case notes of 15 adult women who had undergone outpatient psychological therapy for anorexia nervosa with a shared written case formulation component were reviewed. The impact of the quality of the case formulation on weekly weight was examined for 14 of the clients where the case formulation was available. The nature of the relationship between the delivery of the written shared case formulation and weight was examined for all 15 clients. There was some evidence to support an association between delivery of the shared written case formulation and weight changes (both weight gain [five out of 15 clients] and weight loss [three out of 15 clients]) in individual cases. Higher case formulation quality was related to cases where weight change did not occur. The delivery of case formulations can be associated with important therapeutic change (both beneficial and potentially harmful) in anorexia nervosa. Future research into the causal mechanisms associated with sharing formulations will face the challenge of adopting strategies that allow for an in-depth exploration of complex therapy variables whilst overcoming methodological challenges. Copyright © 2012 John Wiley & Sons, Ltd.

  18. Case-based medical informatics

    Directory of Open Access Journals (Sweden)

    Arocha José F

    2004-11-01

    Full Text Available Abstract Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences

  19. Five misunderstandings about Case-study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... useful for generating hypotheses, while other methods aremore suitable for hypotheses testing and theory building; (4) The case study contains a bias toward verification; and (5) It is often difficult to summarize specific case studies. The article explains and corrects these misunderstandings one by one...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without  exemplars is an ineffective one. Social science may be strengthened by the execution of more...

  20. 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.

  1. Dioctophymiasis: A Rare Case Report.

    Science.gov (United States)

    Chauhan, Sapna; Kaval, Sunil; Tewari, Swati

    2016-02-01

    Dioctophyma renale commonly known as "giant kidney worm' is found in the kidney of carnivorous mammals. Human infestation is rare, but results in destruction of the kidneys. Very few cases have been reported worldwide. We are here reporting a case of Dioctophymiasis in a 35-year-old male patient who presented with retention of urine and subsequent passage of worm and blood in urine. The worm was confirmed as Dioctophyma renale based on its morphology and clinical presentation. This is a very rare case report and to best of our knowledge only two cases have been reported from India.

  2. Urachal endometrioma: a case report.

    LENUS (Irish Health Repository)

    Browne, Katherine M

    2009-01-01

    INTRODUCTION: We discuss a rare presentation of an unusual case of endometrioma. CASE PRESENTATION: A 40-year-old Caucasian woman presented with subacute abdominal pain and a suprapubic mass. A final diagnosis was made after the mass was resected and histopathology confirmed an endometrioma originating from an urachal remnant. Select imaging studies and histopathology are presented in this case report. CONCLUSION: While endometriomata are well known to arise from abdominal scars, the condition described in this case report is a rare example of an endometrioma arising from the urachus. A review of the pathological complications of the urachus is also included.

  3. [Urogenital tuberculosis. Apropos of 40 cases].

    Science.gov (United States)

    el Khader, K; el Fassi, J; Karmouni, T; Tazi, K; Ibnattya, A; Hachimi, M; Lakrissa, A

    1997-01-01

    The authors report a series of 40 cases of genitourinary tuberculosis diagnosed and treated in the department of urology "B" of Avicenne hospital over a 7-year period. The objective of this study is to define the various diagnostic and therapeutic aspects of this disease. The patients were predominantly males (62.5%) with a mean age of 40 years. 25% of cases reported a history of extra-urinary tuberculosis. The very polymorphous clinical presentation is dominated by signs of cystitis (45%). Intravenous urography is frequently suggestive of the diagnosis based on the appearance and multiplicity of the lesions. The radiological lesions most frequently encountered were silent kidney (19 cases) and small tuberculous bladder (11 cases). The definitive diagnosis was established by pathological examination in 38 cases (biopsies, operative specimens, prostatic resection chips) and/or by demonstration of AFB in 2 cases (urine, pus). Tuberculostatic treatment was administered to all patients, either alone (5 cases) or, more usually, in combination with surgical and/or endo-urological treatment (35 cases), reflecting the magnitude and severity of the destructive and scar lesions.

  4. Medico-legal findings, legal case progression, and outcomes in South African rape cases: retrospective review.

    Directory of Open Access Journals (Sweden)

    Rachel Jewkes

    2009-10-01

    Full Text Available BACKGROUND: Health services for victims of rape are recognised as a particularly neglected area of the health sector internationally. Efforts to strengthen these services need to be guided by clinical research. Expert medical evidence is widely used in rape cases, but its contribution to the progress of legal cases is unclear. Only three studies have found an association between documented bodily injuries and convictions in rape cases. This article aims to describe the processing of rape cases by South African police and courts, and the association between documented injuries and DNA and case progression through the criminal justice system. METHODS AND FINDINGS: We analysed a provincially representative sample of 2,068 attempted and completed rape cases reported to 70 randomly selected Gauteng province police stations in 2003. Data sheets were completed from the police dockets and available medical examination forms were copied. 1,547 cases of rape had medical examinations and available forms and were analysed, which was at least 85% of the proportion of the sample having a medical examination. We present logistic regression models of the association between whether a trial started and whether the accused was found guilty and the medico-legal findings for adult and child rapes. Half the suspects were arrested (n = 771, 14% (209 of cases went to trial, and in 3% (31 of adults and 7% (44 of children there was a conviction. A report on DNA was available in 1.4% (22 of cases, but the presence or absence of injuries were documented in all cases. Documented injuries were not associated with arrest, but they were associated with children's cases (but not adult's going to trial (adjusted odds ratio [AOR] for having genital and nongenital injuries 5.83, 95% confidence interval [CI] 1.87-18.13, p = 0.003. In adult cases a conviction was more likely if there were documented injuries, whether nongenital injuries alone AOR 6.25 (95% CI 1.14-34.3, p = 0

  5. Theory testing using case studies

    DEFF Research Database (Denmark)

    Dissing Sørensen, Pernille; Løkke Nielsen, Ann-Kristina

    2006-01-01

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

  6. Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses

    Directory of Open Access Journals (Sweden)

    Ruth H. Keogh

    2016-01-01

    Full Text Available Abstract Background Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Methods Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. Results The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Conclusions Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

  7. Cases for the Net Generation: An Empirical Examination of Students' Attitude toward Multimedia Case Studies

    Science.gov (United States)

    Sheppard, Michael; Vibert, Conor

    2016-01-01

    Case studies have been an important tool in business, legal, and medical education for generations of students. Traditional text-based cases tend to be self-contained and structured in such a way as to teach a particular concept. The multimedia cases introduced in this study feature unscripted web-hosted video interviews with business owners and…

  8. Radiological case

    International Nuclear Information System (INIS)

    Giraldo Estrada, Horacio

    2001-01-01

    The paper analyze the case of a patient (65 year-old) masculine, who consults for precordial pain associated to dyspnoea, left scapular pain and in the shoulder of the same side, of 3 days of evolution that it has been permanent and progressive. He also refers, loss of weight the last 6 months and dyspnoea of effort of 1 month of evolution. He denies chill, fever, cough or expectoration. The patient presents gastric ulcer tried for 1 year, smoker of 2 packages of daily cigarettes of the 15 to the 40 years; all its life worked in masonry. X-rays of the thorax and Tac, among other analyses were done and the case is discusses

  9. Electromagnetic fields in cased borehole

    International Nuclear Information System (INIS)

    Lee, Ki Ha; Kim, Hee Joon; Uchida, Toshihiro

    2001-01-01

    Borehole electromagnetic (EM) measurements, using fiberglass-cased boreholes, have proven useful in oil field reservoir characterization and process monitoring (Wilt et al., 1995). It has been presumed that these measurements would be impossible in steel-cased wells due to the very large EM attenuation and phase shifts. Recent laboratory and field studies have indicated that detection of EM signals through steel casing should be possible at low frequencies, and that these data provide a reasonable conductivity image at a useful scale. Thus, we see an increased application of this technique to mature oilfields, and an immediate extension to geothermal industry as well. Along with the field experiments numerical model studies have been carried out for analyzing the effect of steel casing to the EM fields. The model used to be an infinitely long uniform casing embedded in a homogeneous whole space. Nevertheless, the results indicated that the formation signal could be accurately recovered if the casing characteristics were independently known (Becker et al., 1998; Lee el al., 1998). Real steel-cased wells are much more complex than the simple laboratory models used in work to date. The purpose of this study is to develop efficient numerical methods for analyzing EM fields in realistic settings, and to evaluate the potential application of EM technologies to cross-borehole and single-hole environment for reservoir characterization and monitoring

  10. Bioremediation case studies: Abstracts. Final report

    International Nuclear Information System (INIS)

    Devine, K.

    1992-03-01

    The report contains abstracts of 132 case studies of bioremediation technology applied to hazardous waste clean-up. It was prepared to compile bioremediation studies in a variety of locations and treating diverse contaminants, most of which were previously undocumented. All data are based on vendor-supplied information and there was no opportunity to independently confirm its accuracy. These 132 case studies, from 10 different biotechnology companies, provide users with reference information about on-going and/or completed field applications and studies. About two-thirds of the cases were at full-scale clean-up level with the remainder at pilot or laboratory scale. In 74 percent of the cases, soil was at least one of the media treated. Soil alone accounts for 46 percent of the cases. Petroleum-related wastes account for the largest contaminant with 82 cases. Thirty-one states are represented in the case studies

  11. How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

    Science.gov (United States)

    Fallek, Max

    This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

  12. The role of radionuclide studies in emergency cases

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Hayashida, Kohei; Uehara, Toshiisa

    1982-01-01

    Radionuclide studies have been performed popularly because of its noninvasive and simple method recently. In this study, we applied this technique for the evaluation of emergency cases in cardiovascular diseases. There were 93 cases (1.5%) out of 6163 cases, done during 1981. The subjects were 34 cases of cardiac studies (9 cases of sup(99m)Tc-PYP myocardial imaging, 12 cases of thallium myocardial imaging, 13 cases of cardioangiography), 23 cases of peripheral diseases (12 cases of peripheral angiography, 11 cases of venography), 16 cases of pulmonary imaging, 10 cases of renal studies (6 cases of renal angiography, 9 cases of renal imaging) and 5 cases of brain angiography. These studies were proven to be useful clinically for the evaluation of emergency cases and follow-up studies. In the near future, ''emergency radionuclide studies'' would be benefit for the high-risk patients noninvasively. (author)

  13. Case Briefs in Legal English Classes

    Directory of Open Access Journals (Sweden)

    Bilová Stĕpánka

    2016-06-01

    Full Text Available A case brief can be described as a succinct summary of a case which specifies the facts, procedural history, legal issue(s, court decision and legal reasoning supporting the judgment, even though exact formats may vary. Case briefing is a demanding activity which is required from students during their law studies. The goal is to teach students to focus on the essential parts of the case and to obtain a thorough understanding of the case and the reasoning, which means the students need to employ their analytical and critical thinking skills.

  14. Rhetorical Structure and Linguistic Features of Case Presentations in Case Reports in Taiwanese and International Medical Journals

    Science.gov (United States)

    Hung, Hsuan; Chen, Pi-Ching; Tsai, Jing-Jane

    2012-01-01

    The case presentation is the core section of a medical case report. Issues in the teaching of case report writing have recently been the subject of great interest in medical education, especially in the era of globalization. Given that Taiwanese medical students, residents and junior physicians are requested to write case reports in English and…

  15. Case histories as evidence.

    Science.gov (United States)

    Herxheimer, Andrew; Healy, David; Menkes, David B

    2012-01-01

    In courts case histories play a central part when a crime may have resulted from an effect of a prescribed drug; in civil cases where a person may have suffered damage from a drug; and in coroners' enquiries into the cause of unexplained deaths. The court must decide two important questions: 1. Can the suspected medication(s) cause this kind of effect? 2. Did it (or they) do so in this particular case? Many judges and coroners have not addressed these questions clearly and have not used expert witnesses consistently, on occasion disregarding scientific evidence. Courts need to appoint experts to explain and interpret the scientific evidence. Few judges are equipped to resolve contradictions between different experts. Brief accounts of five cases from four countries illustrate these points. The reluctance of legal processes to implicate drugs as a possible cause of violent behaviour leads to injustice. Courts must be required to obtain appropriate expert evidence, and be given independent data on which drugs can cause such behaviour.

  16. [The case manager--from words to deeds?].

    Science.gov (United States)

    Lindegaard, Birthe Rosenkrantz; Qvist, Peter

    2010-04-19

    Allocation of a case manager is now mandatory for both in- and outpatients in Denmark. Case manager allocation is reported quarterly to the regions and results are generally satisfying. Knowledge about fulfillment of the case manager role is, however, sparse. This study aims to examine the degree of fulfillment of the case manager role for a sample of inpatients. Two medical and two surgical wards participated. Patients were interviewed in relation to discharge while staff assigned as case managers completed a survey. Both patients and case managers answered questions regarding the defined roles as case managers: Planning/coordination, continuous information and discharge planning. 107 of 125 eligible patients were interviewed. Only 25 declared themselves informed about the allocation of a case manager. The patients' assessment of the service provided by the staff in relation to case manager tasks was generally good, but the services were seldom provided by the named case manager. 22% of patients did not experience continuous information, while only 13% did not experience a generally coherent stay in hospital. 110 case managers completed the survey. Less than half felt themselves well informed about the case manager role. Only a few case managers feel that they succeed in fulfilling the role, particularly regarding the participation in discharge planning. There seems to be a need for a targeted effort to improve the conditions for case managers in Danish hospitals in order to meet the intentions of this initiative.

  17. 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

  18. Case-based Agile Fixture Design

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    In order to realize the agility of the fixture design, such asreconfigurability, rescalability and reusability, fixture structure is function unit-based decomposed from a fire-new point of view. Which makes it easy for agile fixture to be reconfigured and modified. Thereby, the base of case-based agile fixture design system info is established.Whole case-based agile fixture design model is presented. In which, three modules are added relative to the other models, including case matching of fixture planning module, conflict arbitration module and agile fixture case modify module. The three modules could solve the previous problem that the experience and result are difficult to be reused in the process of design.Two key techniques in the process of the agile fixture design, the evaluation of case similarity, and restriction-based conflict arbitration, are listed. And some methods are presented to evaluate the similarity and clear up the conflict.

  19. Endodontic cellulitis 'flare-up'. Case report.

    Science.gov (United States)

    Matusow, R J

    1995-02-01

    Endodontic cellulitis involves facial swelling which can vary from mild to severe and can occur as a primary case or a flare-up following initial treatment of asymptomatic teeth with periapical lesions. The microbial spectrum in primary cases involves a significant mixture of anaerobic and facultative aerobic microbes, chiefly streptococci. In a previous study, cultures from flare-up cases, utilizing the same anaerobic techniques as in primary cases, revealed an absence of obligate anaerobes and an 80 per cent incidence of facultative aerobic streptococci. These cases also revealed a significant time lapse from onset of symptoms to the cellulitis phase. No sex or age factors were noted in the primary or flare-up cases. The purpose of this case report is to restate a traditional theory, namely, the alteration of the oxidation/reduction potential (Eh), as a major factor for endodontic cellulitis flare-ups; to confirm the pathogenic potential of oral facultative streptococci; and that asymptomatic endodontic lesions tend to exist with mixed aerobic/anaerobic microbial flora.

  20. 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…

  1. Case manager satisfaction in public health.

    Science.gov (United States)

    Schutt, Russell K; Fawcett, Jacqueline; Gall, Gail B; Harrow, Brooke; Woodford, Mary Lou

    2010-01-01

    The purpose of this study was to examine correlates of case managers' satisfaction with their work, services, and service network and to identify connections to service performance and service costs. A decentralized public health program that exemplifies the trend toward more diverse clients and networked services. A mixed method design with 34 case managers. As hypothesized, the case managers' experiences with clients and the service network, and their service effectiveness, were associated with their satisfaction with their jobs and the services they provide. Satisfaction was also positively associated with more timely service delivery. These associations were explained in part by case managers' education and training. Case managers can achieve high levels of job and service satisfaction in outreach programs serving a diverse client population in a decentralized service network. Case managers' job and service satisfaction improves with reduced service problems and service delays and when case managers can devise work-arounds for persistent service problems. Using advanced practice nurses (APN) and providing more on-the-job training may increase case manager satisfaction with their jobs and the services they provide. Special efforts may be needed to prevent a decline in job satisfaction with years of experience.

  2. Isolated adrenal paracoccidioidomycosis: Case report

    International Nuclear Information System (INIS)

    Uribe Castro, Jorge Ricardo; Quintana, Humberto; Puentes, Alix Sofia and others

    2011-01-01

    Even though paracoccidioidomycosis has a relatively high prevalence in Latin America in a systemic form, isolated cases, especially compromising the adrenal glands, are uncommon, with only two reported cases. In this article, we report the case of a 55 year-old male with clinical manifestations of adrenal insufficiency. The only imaging finding was the presence of bilateral adrenal masses. The biopsy showed Paracoccidioides brasiliensis infection.

  3. Case report

    African Journals Online (AJOL)

    abp

    2013-01-09

    . The electrolytes analysis revealed an acute hyponatremia. (sodium concentration 125 mmol/L). Medical treatment consisted of hypertonic saline solution 3%, volume expansion, intubation and ventilation. The presented case ...

  4. Case Report: A Rare Case Report of Frontal Lobe Syndrome

    Directory of Open Access Journals (Sweden)

    Morteza Nouri- Khajavi

    2003-04-01

    Full Text Available The frontal lobe syndrome is a permanent personality change disorder with characteristic clinical pictures, which followed by frontal lobes damage. Clinical picture include: Affective instability, recurrent aggressive behavior, impaired social judgment, apathy and undifferentiating or suspiciousness and paranoid ideations. According DSM-IV classification frontal lobe syndrome named personality change due to head trauma on Axis I. Herein we report a case of 46 years-old man, who has developed behavioral disturbances following head trauma, about 10 years ago. Main clinical figures in this case are apathy, avolition and, undifferentiating. Clinical pictures are constant during these 10 years. The diagnostic approach has been based on patient’s problems history which, has taken from his family, mental status examination, Neurological examination, Brain imaging and Neuropsychological assessments which related to frontal lobes function. Because of rarity & neglection due to mysterious function of frontal lobes, and also considering that personality change from previous level is prominent figure of this syndrome and also brain imaging findings, which compatible with clinical findings, with this aim, we have reported this case.

  5. CASE REPORT A recurrent gestational choriocarcinoma case ...

    African Journals Online (AJOL)

    Admin

    molar pregnancy (Luna Russo et al., 2015). To our knowledge recurrence resulting in rupture 14 month following a live pregnancy is an extremely rare event. Management of gestational trophoblastic disease in our setup poses multiple challenges as seen in this particular case. Serum β-HCG follow up for these patients ...

  6. What is in a Business Case? Business Cases as a Tool‐in‐Use for Promoting Water Stewardship

    DEFF Research Database (Denmark)

    Pedersen, Esben Rahbek Gjerdrum; Lauesen, Linne Marie; Rosati, Francesco

    This paper explores the role of business cases as a tool‐in‐use for decision‐making processes on Water management. The literature is rich on generic discussions of the business case for corporate sustainability, whereas there have been less efforts to examine the concrete use of business cases...... in everyday organisational life. Drawing on the practice‐based management literature, it is concluded that the business case tool has a decisive influence on water management activities among European food companies. However, the analysis also show the business case tool are not set in stone but can...

  7. Characteristics of sick-listing cases that physicians consider problematic--analyses of written case reports.

    Science.gov (United States)

    Engblom, Monika; Alexanderson, Kristina; Rudebeck, Carl Edvard

    2009-01-01

    The aim was to discern common characteristics in the sick-listing cases that physicians in general practice and occupational health services find problematic. Descriptive categorization within a narrative theoretical framework. Sickness-insurance course for physicians in general practice and occupational health services. A total of 195 case reports written by 195 physicians. Main outcome measures. Categories of features regarding medical, work, and social situation as well as medical interventions. Beside age and sex, the following information was often provided: family situation, stressful life events, occupation, problem at work, considerations concerning diagnoses, medical investigations, treatments, and vocational rehabilitation measures. Two-thirds of the patients had been sickness absent for more than a year. The most common type of case reports concerned women, employed in non-qualified nursing occupations, and sick listed due to mental disorders. The most common measures taken by the physicians were referrals to psychotherapy and/or physiotherapy, and prescribing antidepressants (SSRI). Facts about alcohol habits were rarely provided in the cases. Some of the circumstances, such as prolonged sick-listing, are likely to be more or less inevitable in problematic sick-listing cases. Other circumstances, such as stress-full life events, more closely reflect what the reporting physicians find problematic. The categories identified can be regarded as markers of problematic sick-listing cases in general practice and occupational health service.

  8. Selecting appropriate cases when tracing causal mechanisms

    DEFF Research Database (Denmark)

    Beach, Derek; Pedersen, Rasmus Brun

    2016-01-01

    The last decade has witnessed resurgence in the interest in studying the causal mechanisms linking causes and outcomes in the social sciences. This article explores the overlooked implications for case selection when tracing mechanisms using in-depth case studies. Our argument is that existing case...... selection guidelines are appropriate for research aimed at making cross-case claims about causal relationships, where case selection is primarily used to control for other causes. However, existing guidelines are not in alignment with case-based research that aims to trace mechanisms, where the goal...... is to unpack the causal mechanism between X and Y, enabling causal inferences to be made because empirical evidence is provided for how the mechanism actually operated in a particular case. The in-depth, within-case tracing of how mechanisms operate in particular cases produces what can be termed mechanistic...

  9. 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

  10. Case assessments for nuclear medicine registrars

    International Nuclear Information System (INIS)

    Farlow, D.

    1994-01-01

    Westmead Hospital set some of the recent nuclear medicine cases for registrar training. These case assessments have been completed by the registrars and he thought it might be interesting for the general nuclear medicine community to attempt the cases themselves and compare their answers with the model reports and patient follow-ups. Edited versions of two cases and model answers are presented. 35 refs

  11. Ulnar nerve lesion at the wrist and sport: A report of 8 cases compared with 45 non-sport cases.

    Science.gov (United States)

    Seror, P

    2015-04-01

    Reporting clinical and electrodiagnostic characteristics of sport-related ulnar neuropathies at the wrist. Eight sport-related and 45 non-sport-related cases from 53 ulnar neuropathies at the wrist cases over 14 years. Sport-related ulnar neuropathies at the wrist cases were due to cycling (5 cases), kayaking (2 cases), and big-game fishing (1 case). No patient had sensory complaints in ulnar digits, and all had motor impairment. Conduction across the wrist with recording on the first dorsal interosseous muscle was impaired in all cases, with conduction block in 5. Two cyclists showed bilateral ulnar neuropathies at the wrist. All cases recovered within 2 to 6 months with sport discontinuation. Distal lesions of the deep motor branch were more frequent in sport- than non-sport-related cases. The 8 sport-related ulnar neuropathies at the wrist cases involved the deep motor branch. Conduction study to the first dorsal interosseous muscle across the wrist is the key to electrodiagnostics. Bilateral cases in cyclists does not require wrist imaging. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. [Ectopic breast fibroadenoma. Case report].

    Science.gov (United States)

    Senatore, G; Zanotti, S; Cambrini, P; Montroni, I; Pellegrini, A; Montanari, E; Santini, D; Taffurelli, M

    2010-03-01

    Among the rare anomalies of the breast development, polythelia is the most common, between 1% and 5% of women and men present supernumerary nipples. Polymastia, usually presenting as ectopic breast tissue without areola-nipple complex, is seen mostly along the milk line, extending from the axilla to the pubic region. Ectopic breast tissue is functionally analogous to mammary gland and it is subjected to the same alterations and diseases, whether benign or malignant, that affect normal breast tissue. We report the case of a 21 years-old female evaluated by the medical staff after founding a solid nodular mass by suspect axillary lymphadenopathy. Differential diagnosis with lymphoma is the major problem in these cases. The mass was removed and the intraoperative histological examination showed fibroadenoma in axillary supernumerary breast. Presence of ectopic breast tissue is a rare condition; development of benign mass or malignant degeneration is possible, but it is very unusual. In case of polymastia diagnosis is simple; in case of isolated nodule, without local inflammation or infection, there are greater difficulties. Ultrasonography is diagnostic in case of breast fibroadenoma, but it might be inadequate in ectopic localizations owing to the shortage of mammary tissue around the mass. Preoperative diagnosis is important to plan an adequate surgical treatment; lumpectomy is indicated in case of benign tissue; in case of malignancy, therapy is based on the standard treatment used for breast cancer (surgery, chemotherapy and radiation therapy).

  13. Two cases of rheumatoid meningitis.

    Science.gov (United States)

    Magaki, Shino; Chang, Edward; Hammond, Robert R; Yang, Isaac; Mackenzie, Ian R A; Chou, Benedict T; Choi, Soo I; Jen, Joanna C; Pope, Whitney B; Bell, David A; Vinters, Harry V

    2016-02-01

    Central nervous system (CNS) involvement by rheumatoid arthritis (RA) in the form of rheumatoid meningitis (RM) is rare and most commonly occurs in the setting of longstanding severe RA. Due to a wide range of clinical presentations and nonspecific laboratory findings, it presents a diagnostic challenge often requiring brain biopsy. Only a few histopathologically confirmed cases have been described in the literature. Our aim is to describe two cases of RM and review the literature. The first case is of a previously healthy 37-year-old man who presented with severe headaches and focal neurologic deficits. Magnetic resonance imaging demonstrated abnormal leptomeningeal enhancement in the left frontal and parietal sulci. The second case is of a 62-year-old woman with a history of mild chronic joint pain who presented with confusion, personality changes and seizures. Both patients ultimately underwent brain biopsy which demonstrated RM on pathologic examination. Administration of corticosteroids resulted in significant clinical improvement in both cases. To our knowledge, our unusual case of RM in the young man is the fifth reported case of rheumatoid meningitis in a patient with no prior history of RA. Such an atypical presentation makes diagnosis even more difficult and highlights the need for awareness of this entity in the diagnostic consideration of a patient presenting with unexplained neurologic symptoms. Our literature review underscores the clinical and pathologic heterogeneity of CNS involvement in RA. © 2015 Japanese Society of Neuropathology.

  14. Sensitivity analysis for matched pair analysis of binary data: From worst case to average case analysis.

    Science.gov (United States)

    Hasegawa, Raiden; Small, Dylan

    2017-12-01

    In matched observational studies where treatment assignment is not randomized, sensitivity analysis helps investigators determine how sensitive their estimated treatment effect is to some unmeasured confounder. The standard approach calibrates the sensitivity analysis according to the worst case bias in a pair. This approach will result in a conservative sensitivity analysis if the worst case bias does not hold in every pair. In this paper, we show that for binary data, the standard approach can be calibrated in terms of the average bias in a pair rather than worst case bias. When the worst case bias and average bias differ, the average bias interpretation results in a less conservative sensitivity analysis and more power. In many studies, the average case calibration may also carry a more natural interpretation than the worst case calibration and may also allow researchers to incorporate additional data to establish an empirical basis with which to calibrate a sensitivity analysis. We illustrate this with a study of the effects of cellphone use on the incidence of automobile accidents. Finally, we extend the average case calibration to the sensitivity analysis of confidence intervals for attributable effects. © 2017, The International Biometric Society.

  15. Formal Analysis Of Use Case Diagrams

    Directory of Open Access Journals (Sweden)

    Radosław Klimek

    2010-01-01

    Full Text Available Use case diagrams play an important role in modeling with UML. Careful modeling is crucialin obtaining a correct and efficient system architecture. The paper refers to the formalanalysis of the use case diagrams. A formal model of use cases is proposed and its constructionfor typical relationships between use cases is described. Two methods of formal analysis andverification are presented. The first one based on a states’ exploration represents a modelchecking approach. The second one refers to the symbolic reasoning using formal methodsof temporal logic. Simple but representative example of the use case scenario verification isdiscussed.

  16. Gastric pseudolymphoma: Report of 3 cases

    International Nuclear Information System (INIS)

    Lee, Mi Sook; Kim, Ki Whang; Kim, Dong Ik; Lee, Jong Tae; Park, Chang Yun

    1983-01-01

    The pseudolymphoma of the stomach is known to be a benign proliferation of lymphoid tissue, which can be mistaken histologically for malignant lymphoma. The etiology of pseudo lymphoma is controversial, but it B believed to be a manifestation of chronic inflammatory process. Authors present 3 cases of gastric lymphoma. Impression of upper gastrointestinal series were as follows; lymphoma or chronic gastritis in one case, ulcerative carcinoma in another case and early gastric carcinoma in the other case. Initial endoscopic findings suggested infiltrating carcinoma, ulcerative carcinoma and two benign gastric ulcers, respectively. One case was associated with early gastric carcinoma

  17. Gastric pseudolymphoma: Report of 3 cases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mi Sook; Kim, Ki Whang; Kim, Dong Ik; Lee, Jong Tae; Park, Chang Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1983-12-15

    The pseudolymphoma of the stomach is known to be a benign proliferation of lymphoid tissue, which can be mistaken histologically for malignant lymphoma. The etiology of pseudo lymphoma is controversial, but it B believed to be a manifestation of chronic inflammatory process. Authors present 3 cases of gastric lymphoma. Impression of upper gastrointestinal series were as follows; lymphoma or chronic gastritis in one case, ulcerative carcinoma in another case and early gastric carcinoma in the other case. Initial endoscopic findings suggested infiltrating carcinoma, ulcerative carcinoma and two benign gastric ulcers, respectively. One case was associated with early gastric carcinoma.

  18. The input ambiguity hypothesis and case blindness: an account of cross-linguistic and intra-linguistic differences in case errors.

    Science.gov (United States)

    Pelham, Sabra D

    2011-03-01

    English-acquiring children frequently make pronoun case errors, while German-acquiring children rarely do. Nonetheless, German-acquiring children frequently make article case errors. It is proposed that when child-directed speech contains a high percentage of case-ambiguous forms, case errors are common in child language; when percentages are low, case errors are rare. Input to English and German children was analyzed for percentage of case-ambiguous personal pronouns on adult tiers of corpora from 24 English-acquiring and 24 German-acquiring children. Also analyzed for German was the percentage of case-ambiguous articles. Case-ambiguous pronouns averaged 63·3% in English, compared with 7·6% in German. The percentage of case-ambiguous articles in German was 77·0%. These percentages align with the children's errors reported in the literature. It appears children may be sensitive to levels of ambiguity such that low ambiguity may aid error-free acquisition, while high ambiguity may blind children to case distinctions, resulting in errors.

  19. Case Report

    DEFF Research Database (Denmark)

    Søborg, Marie-Louise Kulas; Rosenberg, Jacob; Burcharth, Jakob

    2016-01-01

    Guillain-Barré syndrome (GBS) is an acute ascending peripheral neuropathy, caused by autoimmune damage of the peripheral nerves. GBS can be divided into three subtypes: acute inflammatory demyelinating neuropathy, acute motor axonal neuropathy, and the more rare type, acute motor and sensory axonal...... neuropathy (AMSAN). Reports of AMSAN with onset after epidural anesthesia and spinal surgery are extremely rare, and the linkage between development of GBS and neuroaxial anesthesia remains conclusively unconfirmed. We present a case in which the patient developed subacute motor and predominantly sensory...... neuropathy following epidural blockade. The case emphasizes the need of including AMSAN in differential diagnostic considerations to changes in motor and sensory function following epidural anesthesia, allowing accelerated rehabilitation and relevant alleviating therapy....

  20. Case law

    International Nuclear Information System (INIS)

    2014-01-01

    This section of the Bulletin brings together the texts of the following case laws: Canada: - Judgment of the Federal Court of Canada sending back to a joint review panel for reconsideration the environmental assessment of a proposed new nuclear power plant in Ontario. France : - Conseil d'etat, 24 March 2014 (Request No. 358882); - Conseil d'etat, 24 March 2014 (Request No. 362001). Slovak Republic: - Further developments in cases related to the challenge by Greenpeace Slovakia to the Mochovce nuclear power plant; - Developments in relation to the disclosure of information concerning the Mochovce nuclear power plant. United States: - Initial Decision of the Atomic Safety and Licensing Board Ruling in Favour of Nuclear Innovation North America, LLC (NINA) Regarding Foreign Ownership, Control or Domination

  1. Trichinosis - case presentation

    Directory of Open Access Journals (Sweden)

    Rajko Saletinger

    2007-03-01

    Full Text Available Background: Trichinosis is a widespread zoonosis acquired by ingestion of undercooked meat infected with the larvae of Trichinella parasites. The disease has variable clinical manifestations ranging from asymptomatic to fatal. Majority of infections is caused by Trichinella spiralis, although there are some cases caused by other species. The dramatic decline of trichinosis reflects changes in industrial practices and increased public awareness. The majority of human cases are now associated with wild game meat and noncommercial pork. The case of previously healthy, young man with trichinosis is presented. The disease was determined with serologic testing and cured with albendazole. The source of infection has not been determined.Conclusions: In patients with fever, mialgias and eosinophilia infection with tissue nematodes should always be taken in consideration. In those who have recently consumed raw or undercooked pork and wild game meat we should think about trichinosis. The disease is rare in Slovenia.

  2. Cytological diagnosis of erythema nodosum leprosum in clinically unsuspected cases: A report of two cases

    Directory of Open Access Journals (Sweden)

    Shruti Semwal

    2018-01-01

    Full Text Available Leprosy is a chronic infectious disease caused by Mycobacterium leprae. The manifestations of this disease varies across the spectrum of tuberculoid (TT to lepromatous (LL leprosy.The course of this indolent disease is interrupted by acute exacerbations in the form of leprare actions. Erythema nodosum leprosum (ENL, a type 2 lepra reaction, occurs in lepromatous or borderline lepromatous cases, usually in response to multidrug therapy. Early detection and timely management of these patients is important to reduce the associated morbidity. We report two clinically unusual cases of ENL on fine-needle aspiration cytology. In one case, antileprosy treatment was completed 10 years back, whereas in the other case, ENL was the presenting feature of the disease. Cytological examination of swelling in both the cases showed neutrophils, lymphoid cells, clusters of foamy macrophages, histiocytes, and giant cells. Fite stain was positive, which confirmed the cytological diagnosis of ENL.

  3. Deregulation impacts AMR business cases

    Energy Technology Data Exchange (ETDEWEB)

    Wiebe, M.; Fauth, G.

    2001-09-01

    Meter reading strategy is being affected in fundamental ways by deregulation. For the utilities attempting to cope with meter reading unbundling, the processes, insights and general rules that had been developed prior to 2000 in the field of Automatic Meter Reading can no longer be relied upon to provide useful lessons. The fundamental impact on Automatic Meter Reading (AMR) business case drivers and the increasing complexity of building the business case model result from deregulation and unbundling. More and more, management has come to rely on rigorous business case analysis to compensate for the magnitude of AMR projects on the utility and the scarcity of financial resources. One can now expect the Chief Financial Officer and the Vice President Finance to become active players on AMR project teams in the fields of business case scrutiny and approval. Increasingly, the normal expertise of AMR personnel does not suffice to build a business case acceptable to finance. The financial and economic analysis skills required are ever more complex.

  4. Intrahepatic splenosis: a case report

    International Nuclear Information System (INIS)

    Pekkafali, Zekai; Karsli, Fevzi A.; Silit, Emir; Basekim, Cinar C.; Mutlu, Hakan; Kizilkaya, Esref; Narin, Yavuz

    2002-01-01

    Splenosis is heterotopic autotransplantation and seeding of splenic tissue. In the literature, only a few cases of splenosis involving the liver and the radiologic characteristics of these lesions have been reported. We report a case of intrahepatic splenosis diagnosed by ultrasound, computed tomography, magnetic resonance imaging and scintigraphic features. To our knowledge, our patient is the first case diagnosed only by radiologic and radionuclide examination without any intervention. (orig.)

  5. Pathomorphological study on 106 autopsy cases of Thorotrast-related hepatic malignancies with comparison to non-Thorotrast-related cases

    International Nuclear Information System (INIS)

    Kojiro, Masamichi; Ito, Yuji

    1989-01-01

    The pathomorphological features of 106 autopsy cases of Thorotrast-related malignant tumours of the liver were studied and compared to those of non-Thorotrast-related cases. Among the 106 cases, 44 (41.5%) were cholangiocarcinoma, 42 (39.6%) were angiosarcoma, 17 (16.0%) were hepatocellular carcinoma, and three (2.8%) were double cancers. In contrast, in non-Thorotrast-related cases about 90% of the cases were hepatocellular and angiosarcoma was extremely rare. (author)

  6. Case report 363

    International Nuclear Information System (INIS)

    Langer, R.; Kaufmann, H.J.

    1986-01-01

    In summary, the case is presented of a 10-year-old girl with a fibrosarcoma of the femoral shaft, which showed the radiological and histological features of a malignant bone tumor, but with no findings radiologically pathognomonic of fibrosarcoma. Malignant fibrous histiocytoma, fibrogenic osteosarcoma and even Ewing tumor could present with the same radiological features. Although permeative infiltration of bone (described in this case) is observed in primary fibrosarcoma, it is much more commonly associated with another malignant bone tumor of childhood - Ewing tumor. (orig./SHA)

  7. Case Report

    African Journals Online (AJOL)

    of permanent hemodialysis (HD) vascular access ... This catheter was removed and a translumbar dialysis ... In this case report, we describe a patient with the ... Rheumatology, the isolated detection of antiphospholipid .... Arthritis Rheum.

  8. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-01-06

    Jan 6, 2015 ... optic disc edema and subsequent formation of a macular star [1]. (Figure 1). ... case of bilateral stellate neuroretinitis due to pheochromocytoma. ... clinical examination are irreplaceable, powerful diagnostic tools that.

  9. Vascular colitis: a report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Il; Han, Chang Yul; Han, Man Chung; Choo, Dong Woon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1973-04-15

    The authors report two cases of vascular colitis in Korean with a review of literature. Case I, 20 years old male had severe abdominal pain and bloody diarrhea. Case II was 57 years old male and complained severe abdominal pain. Barium enema colon study on each cases disclosed typical thumbprinting appearance of involved segment. Predisposing factor in case I appeared to be anaphylactoid purpura, and in case II distal obstruction due to adenocarcinoma. The mechanism of vascular was briefly discussed.

  10. Eleven cases of neonatal intracranial hemorrhage

    International Nuclear Information System (INIS)

    Matsuda, Tadashi; Asao, Toyohiko; Shibata, Takeo

    1981-01-01

    Eleven cases of neonatal intracranial hemorrhage were diagnosed and followed up by CT scanning. By CT, hemorrhagic lesions were shown as high density areas in an acute stage and imaged as low density areas after the hemorrhage was absorbed. The time of absorption varies depending upon the site and the severity of hemorrhage. Intraventricular hemorrhage, petechial hemorrhage and subdural hematoma were absorbed rapidly in more than 70% of the exanimed cases, CT scanning 1 - 2 weeks after the onset revealed absorption of hemorrhage. However, the absorption delayed in intracerebral hematoma; CT scan taken after one month showed hemorrhagic lesions remaining in 75% of the cases. In nine cases who survived, following the absorption of the hemorrhagic lesions, cerebral atrophy was observed in 4 cases (44%), ventricular enlargement in 3 cases (33%), and complete recovery in 2 cases (22%). From these results, CT scanning for diagnosis of neonatal intracranial hemorrhage should be done before the hemorrhagic lesion is absorbed (within 7 days of the onset). Follow-up study by CT is important for observing changes and predicting prognosis of intracranial hemorrhage. (Ueda, J.)

  11. ASRM case insulation design and development

    Science.gov (United States)

    Bell, Matthew S.; Tam, William F. S.

    1992-10-01

    This paper describes the achievements made on the Advanced Solid Rocket Motor (ASRM) case insulation design and development program. The ASRM case insulation system described herein protects the metal case and joints from direct radiation and hot gas impingement. Critical failure of solid rocket systems is often traceable to failure of the insulation design. The wide ranging accomplishments included the development of a nonasbestos insulation material for ASRM that replaced the existing Redesigned Solid Rocket Motor (RSRM) asbestos-filled nitrile butadiene rubber (NBR) along with a performance gain of 300 pounds, and improved reliability of all the insulation joint designs, i.e., segmented case joint, case-to-nozzle and case-to-igniter joint. The insulation process development program included the internal stripwinding process. This process advancement allowed Aerojet to match to exceed the capability of other propulsion companies.

  12. 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…

  13. Marketing communication plan. Case: EKOenergy.

    OpenAIRE

    Jäkälä, Elina

    2016-01-01

    This project-based thesis has an objective of creating a marketing communication plan for a non-profit organisation. The marketing communication plan targets other non-profit organisa-tions that the case organisation wants to cooperate with. This thesis will introduce theory about marketing communication, give information about the case organisation’s target audience and present the actual marketing communication plan. Since the case organisation and its target audience are all non-profit...

  14. Trichotillomania in a dementia case

    OpenAIRE

    Caixeta, Leonardo; Lopes, Danielly Bandeira

    2011-01-01

    Abstract We report an 87-year-old male case of hair pulling associated with a white-matter vascular dementia (Binswanger's disease). Trichotillomania in our case did not resolve using mirtazapine or anticholinesterasic medication. Trichotillomania seems to be related to a form of perseveration associated with dementia. The findings in this case suggest the abnormality involving white matter in the pathogenesis of trichotillomania, may constitute a defect in connectivity in the right frontal-s...

  15. Pathomorphological study on 106 autopsy cases of Thorotrast-related hepatic malignancies with comparison to non-Thorotrast-related cases

    International Nuclear Information System (INIS)

    Kojiro, Masamichi; Ito, Yuji

    1989-01-01

    The pathomorphological features of 106 autopsy case of Thorotrast (TH)-related malignant tumours of the liver were studied and compared to those of non-Thorotrast-related cases. Among the 106 cases, 44 (41.5%) were cholangiocarcinoma (CHC), 42(39.6%) were angiosarcoma (AGS), 17(16.0%) were hepatocellular carcinoma (HCC), and three (2.8%) were double cancers. In contrast, in non-Thorotrast-related cases about 90% of the cases were hepatocellular and angiosarcoma was extremely rare. (author)

  16. Vitamin B6 in Health Supplements and Neuropathy: Case Series Assessment of Spontaneously Reported Cases.

    Science.gov (United States)

    van Hunsel, Florence; van de Koppel, Sonja; van Puijenbroek, Eugène; Kant, Agnes

    2018-05-08

    In the literature, vitamin B 6 has been linked to the development of polyneuropathy. Most often, these complaints were seen when taking high doses of vitamin B 6 for a long time. Evidence as to whether a lower dosage range of vitamin B 6 (< 50 mg/day) can also induce neuropathy is scarce. We aim to comprehensively describe the cases of neuropathy associated with vitamin B 6 received by the Netherlands Pharmacovigilance Centre Lareb and to assess the case series concerning the use of vitamin B 6 and neuropathic complaints. We describe the number and nature of the reported cases, including suspect product, dosage, duration of use, and vitamin B 6 serum levels. In addition, we describe the causality for the individual cases (Naranjo Probability Scale) and for the entire case series (Bradford Hill criteria). In total, 90 reports on products containing vitamin B 6 included at least one adverse drug reaction in the standardized Medical Dictionary for Regulatory Activities (MedDRA ® ) query (SMQ; broad) 'peripheral neuropathy'. The amount of vitamin B 6 in the products varied between 1.4 and 100 mg per tablet. The serum vitamin B 6 level was known in 36 cases (88-4338 nmol/l), and the mean serum vitamin B 6 level was 907 nmol/l. However, no statistical correlation between dosage and vitamin B 6 blood levels was found. Causality assessment of the case series of 90 reports to Lareb shows it is plausible for the vitamin B 6 supplements to have caused complaints such as neuropathies. This is especially the case with higher dosages and prolonged use, but dosages < 50 mg/day also cannot be excluded.

  17. The CASE Project: Evaluation of Case-Based Approaches to Learning and Teaching in Statistics Service Courses

    Science.gov (United States)

    Fawcett, Lee

    2017-01-01

    The CASE project (Case-based Approaches to Statistics Education; see www.mas.ncl.ac.uk/~nlf8/innovation) was established to investigate how the use of real-life, discipline-specific case study material in Statistics service courses could improve student engagement, motivation, and confidence. Ultimately, the project aims to promote deep learning…

  18. A case of pancreatolithiasis

    International Nuclear Information System (INIS)

    Sasaki, Fumio; Koga, Sukehiko; Takeuchi, Akira

    1982-01-01

    During 3-year follow-up of a case of pancreatolithiasis localized in the pancreatic head, CT showed sudden new appearance of calculi over an extensive area of the body and tail of the pancreas after acute exacerbation of chronic pancreatitis. This case and the etiology and mechanism of pancreatolithiasis were discussed on the basis of literature. (Chiba, N.)

  19. Aims and harvest of moral case deliberation.

    Science.gov (United States)

    Weidema, Froukje C; Molewijk, Bert A C; Kamsteeg, Frans; Widdershoven, Guy A M

    2013-09-01

    Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses' empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members.

  20. [Research and control of relapse tuberculosis cases].

    Science.gov (United States)

    Yamagishi, Fumio; Toyota, Makoto

    2009-12-01

    With this symposium, we focused on the relapse of tuberculosis in Japan. Out of 19,893 tuberculosis patients registered in 2007 in Japan, 7.48% were classified as relapse cases. Relapse cases have the risk of acquired drug resistance. But we have few analyses of the proportion of relapse tuberculosis cases with standard short course regimens for six months, factors contributing to tuberculosis relapse and the proportion of drug resistance among relapse TB cases in Japan. Therefore we analyzed the relapse tuberculosis cases in two rural areas and three urban areas. We also analyzed the proportion of drug resistance among relapse cases with the data of drug susceptibility survey of Ryoken. 1. Research of relapse tuberculosis cases: Makoto TOYOTA (Kochi City Public Health Center). To clarify the relapse rate and factors contributing to tuberculosis relapse, we investigated the relapse tuberculosis cases in the municipality where the proportion of elderly tuberculosis patients was high. Out of 902 tuberculosis patients registered in Kochi City Public Health Center during 10 years, 20 pulmonary tuberculosis patients were confirmed relapse cases with initial registered records. Pretreatment cavitations, sputum culture positivity at 2 months, medical miss-management (e.g. number of doses, duration of therapy) and poor adherence were considered to be factors contributing to tuberculosis relapse. Out of 20 relapse cases, 12 cases were detected with symptoms, while only 3 cases were detected by examination in law. 2. A clinical study on relapse cases of pulmonary tuberculosis: Shuichi TAKIKAWA (National Hospital Organization Nishibeppu National Hospital). The relapse of pulmonary tuberculosis was investigated. In the cases with a treatment history before short course chemotherapy, drug resistance rate was high, and thus it needs to be cautious of drug resistance at the time of the retreatment. In the cases with a treatment history of short course chemotherapy, relapse cases

  1. Case report

    African Journals Online (AJOL)

    abp

    2017-10-10

    Oct 10, 2017 ... A rare case of important and recurrent abnormal uterine bleeding ... 1Department of Obstetrics and Gynecology, University Hospital of Yopougon, Abidjan, Ivory Coast, .... imaging (MRI) could guide us to the diagnosis.

  2. Case Report

    African Journals Online (AJOL)

    Hamid

    Key words: Case report, composite resin, fiber-reinforced composite. ABSTRACT. A variety of ... investigation will be required to provide additional information on the survival of directly-bonded anterior fixed prosthesis made with FRC systems.

  3. Dermatology case

    Directory of Open Access Journals (Sweden)

    Fernando Mota

    2017-07-01

    In the present case, the patient was referred to the dermatology department due to an atypical lesion with an uncommon location, revealing the importance of a whole body examination in patients with this disease.

  4. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-10-14

    Oct 14, 2015 ... &Corresponding author: Hanane Massit, Department of Gastroenterology II, Mohamed V ... Crohn's disease, accounting for around 30-50 % of cases, its ... manuscript and have equally contributed to its content and to the.

  5. Case series

    African Journals Online (AJOL)

    abp

    2017-05-16

    May 16, 2017 ... Hepatocellular carcinoma: a clinicopathological study of 64 cases ... The presenting clinical symptoms were dominated by abdominal pain (n=34), followed by .... malaise, anorexia or weight loss and nausea or vomiting [4].

  6. Case report

    African Journals Online (AJOL)

    abp

    2017-11-07

    Nov 7, 2017 ... However, auricular disorders are rare and exceptionally inaugural. We describe the case of ... hypothalamic-pituitary axis dysfonction. There was ... tomography, and the salivary gland biopsy confirmed the diagnosis by finding ...

  7. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-03-03

    translucent, hyper-or hypopigmented or erythematous-to- violaceous in color. In addition, epidermal changes may be absent or include atrophy, hyperkeratosis, or telangiectasia [2]. In our case the diagnosis of cutaneous sarcoidosis is ...

  8. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

    Directory of Open Access Journals (Sweden)

    Shankargouda Patil

    Full Text Available Oral submucous fibrosis (OSF is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature.A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study.A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures.Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

  9. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

    Science.gov (United States)

    Patil, Shankargouda; Sarode, Sachin Chakradhar; Sarode, Gargi S; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

    2017-01-01

    Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

  10. TA Treatment of Depression - A Hermeneutic Single-Case Efficacy Design Study - ‘Linda’ - a mixed outcome case

    Directory of Open Access Journals (Sweden)

    Mark Widdowson

    2013-07-01

    Full Text Available Hermeneutic Single-Case EfficacyDesign (HSCED is a systematic case study research method involving the cross-examination of mixed method data to generate both plausible arguments that the client changed due to therapy and alternative explanations. The present study is the fourth article of a case series which has investigated the process and outcome of transactional analysis psychotherapy using Hermeneutic Single-Case Efficacy Design (Elliott 2002. The client, Linda, was a 45 yearold white British woman with mild depression who attended nine sessions of therapy. The conclusion of the judges was that this was a mixed-outcome case:whilst the client improved over the course of therapy and was positive about her experience of therapy, her changes did not last when she experienced considerable stressful events during follow-up. Linda provided a detailed and idiosyncratic description of the aspects of the therapy which were most helpful for her. A cross-case comparison with other cases in this series suggests several interesting features which are worthy of further investigation. Specifically, the use of a shared theoretical framework and an egalitarian therapeutic relationship were helpful. As with other cases in this series, the client experienced positive changes in her interpersonal relationships suggesting that this outcome of TA therapy warrants further investigation

  11. Writing a case report: polishing a gem?

    Science.gov (United States)

    Papanas, N; Lazarides, M K

    2008-08-01

    Case reports describe patient cases which are of particular interest due to their novelty and their potential message for clinical practice. While there are several types of case reports, originality and clinical implications constitute the main virtues by which case reports are judged. Defining the educational message and choosing the right audience are vital steps in the process of writing. Generally, a case report is structured, its main components being the abstract, the introduction, the case description and the discussion. Guidelines and tips for writing case reports are not enough for making a successful author, but they help, especially less experienced doctors, to exercise and improve their writing. If properly prepared, case reports can still communicate new observations in an interesting and pleasant way, thereby enriching our knowledge, even in the era of evidence-based medicine.

  12. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    Science.gov (United States)

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

  13. Casing and liners for drilling and completion

    CERN Document Server

    Byrom, Ted G

    2007-01-01

    The Gulf Drilling Series is a joint project between Gulf Publishing Company and the International Association of Drilling Contractors. The first text in this Series presents casing design and mechanics in a concise, two-part format. The first part focuses on basic casing design and instructs engineers and engineering students how to design a safe casing string. The second part covers more advanced material and special problems in casing design in a user-friendly format. Learn how to select sizes and setting depths to achieve well objectives, determine casing loads for design purposes, design casing properties to meet burst, collapse and tensile strength requirements and conduct casing running operations safely and successfully.

  14. Case law

    International Nuclear Information System (INIS)

    Anon.

    2011-01-01

    This chapter gathers three case laws, one concerning France and the two others concerning the United States. France - Decision of the Administrative Court in Strasbourg on the permanent shutdown of the Fessenheim nuclear power plant: On 9 March 2011, the administrative court in Strasbourg confirmed the government's rejection to immediately close the Fessenheim nuclear power plant, the first unit of which started operation on 1 January 1978. The court rejected the motion of the 'Association trinationale de protection nucleaire' (ATPN) filed against the decision of the Minister of Economy, Industry and Employment to refuse the final shutdown of the plant. The group, which brings together associations as well as French, German and Swiss municipalities, had taken legal action in December 2008. United States - Case law 1 - Judgment of a US Court of Appeals on public access to sensitive security information and consideration of the environmental impacts of terrorist attacks on nuclear facilities: This case concerns 1) the public's right to access classified and sensitive security information relied upon by the US Nuclear Regulatory Commission (NRC) in its environmental review; and 2) the sufficiency of the NRC's environmental review of the impacts of terrorist attacks for a proposed Independent Spent Fuel Storage Installation (ISFSI). In 2003, the NRC ruled that the National Environmental Policy Act (NEPA) did not require the NRC to consider the impacts of terrorist attacks in its environmental review for the proposed ISFSI at the Diablo Canyon Power Plant. ' NEPA mandates that all federal agencies must prepare a detailed statement on the environment impacts before undertaking a major federal action that significantly affects the human environment. In 2004, the San Luis Obispo Mothers for Peace, a group of individuals who live near the Diablo Canyon Power Plant, filed a petition in the US Court of Appeals for the Ninth Circuit challenging the NRC's 2003 decision. The

  15. Trichotillomania in a dementia case

    Directory of Open Access Journals (Sweden)

    Leonardo Caixeta

    Full Text Available Abstract We report an 87-year-old male case of hair pulling associated with a white-matter vascular dementia (Binswanger's disease. Trichotillomania in our case did not resolve using mirtazapine or anticholinesterasic medication. Trichotillomania seems to be related to a form of perseveration associated with dementia. The findings in this case suggest the abnormality involving white matter in the pathogenesis of trichotillomania, may constitute a defect in connectivity in the right frontal-subcortical circuit.

  16. Rhabdomyolysis case based on hypothyroidism

    OpenAIRE

    Bilal Katipoglu; Ihsan Ates; Fatih Acehan; Ayşenur Meteris; Nisbet Yılmaz

    2016-01-01

    Summary Hypothyroidism is a wide clinical spectrum disorder and only a few cases in literature show this. Rhabdomyolysis and acute renal impairment can be seen concurrently in a hypothyroid state. We report a case of severe hypothyroidism with poor drug compliance leading to rhabdomyolysis and acute kidney injury. Learning points: Hypothyroidism is a rare cause of acute kidney injury. In this case report, we studied a rare occurrence of acute renal impairment due to hypothyroidism with poor d...

  17. Case study on bio-remediation. Bio remediation no case study

    Energy Technology Data Exchange (ETDEWEB)

    Cioffi, J; Lehmicke, L

    1993-08-01

    This paper introduces two cases of contamination removal using microorganisms in areas contaminated by harmful substances, carried out by ECOVA Inc. in the U.S.A. One case is a removal of soils over an area of 230,000 m[sup 3] contaminated with petroleum-based substances. The removal was intended to reduce contamination at higher than 15,000 ppm down to 1,000 ppm. Discussions on pilot soils and monitoring of activities of living organisms were carried out to determine an optimal condition. It was found that microorganisms having orange color matters have decomposing capability, produce mucopolysaccharides in long-chained hydrocarbon, and make hydrocarbon soluble. The contaminant removal in this area took 19 months. The decomposition work required consideration on temperatures, moistures, aeration frequencies, and nutrient amounts as the affecting factors. The other case is an experiment on removing perchloroethylene (PCE) and trichloroethylene (TCE) from water in the Savanna River. Microorganisms that decompose only TCE were used, with existing methane as a carbon source. An interim result has been obtained that TCE:PCE changed from 0.65:1 to 0.35:1 in twelve months. There has been neither increase nor decrease in the amount of microorganisms.

  18. A rare case of vulvar squamous cell carcinoma; case presentation

    Directory of Open Access Journals (Sweden)

    Cristina N. Cozma

    2018-05-01

    Full Text Available Objectives. Vulvar cancer is a rare gynecological malignancy, with an incidence of 1.5 per 100 000 women/year. The most common vulvar cancer is developed in squamous cells, the most encountered type of skin cells. Case report. We report a case of a 72-year-old female admitted in the Department of Plastic Surgery of Emergency Clinical Hospital “Prof. Dr. Agrippa Ionescu” with a 5/4.2 cm painful ulcerated tumoral mass located in the vulvar area. The lesion slowly increased in size over the past 12 months. The tumour was surgically removed with oncological safety margins and sent for histopathological evaluation. The histopathological examination revealed an ulcerated squamous carcinoma with lymphovascular and perineural invasion, but with negative margins. Postoperative results were favorable, and no local or general complications were observed. Conclusion. We highlight this case due to its unusual presentation in the clitoral area. Moreover, considering the potential for recurrence we point out the importance of the radical vulvectomy with regional lymphadenectomy and histopathological examination, in order to put a precise diagnosis and ensure the best possible treatment for the patient.

  19. Case series

    African Journals Online (AJOL)

    ebutamanya

    2016-06-02

    Jun 2, 2016 ... Epidemiological aspects of suicide attempts among Moroccan children .... Poorly drug intoxication was found in 25% of cases and included over 10 tablets in ... factors have been identified such as maltreatment, sexual abuse.

  20. Case report

    African Journals Online (AJOL)

    abp

    2013-10-17

    Oct 17, 2013 ... We are reporting a case of hemoperitoneum followed by early post partum collapse due to bleeding ... diagnosis of postpartum hemoperitoneum after a vaginal delivery ... The patient was reviewed two weeks after discharge.

  1. Pressurized waterproof case for electronic device

    KAUST Repository

    Berumen, Michael L.

    2013-01-01

    having an open top panel or face covered by a flexible, transparent membrane or the like for the operation of the touch-screen device within the case. A pressurizing system is provided for the case to pressurize the case and the electronic device therein

  2. Design Case Retrieval by Generic Representations

    NARCIS (Netherlands)

    Achten, H.H.; Gero, J.S.

    2000-01-01

    Case-Based Reasoning and Case-Based Design have been proposed to utilize knowledge of previous design solutions to understand or solve current design problems. Case retrieval is often performed on the basis of verbal indexing systems, whereas in design the use of graphic representations is

  3. CT in three cases of syringomyelia

    International Nuclear Information System (INIS)

    Ugawa, Yoshikazu; Sakuta, Manabu; Yagishita, Akira; Inoue, Kiyoharu.

    1983-01-01

    We presented the results of our experience with metrizamide computed tomographic myelography (MCTM) and myelography in three cases of syringomyelia. In case 1, MCTM revealed Chiari malformation, even though this malformation was not clear in the myelography. In case 3, Chiari malformation was apparent in MCTM and in the myelography. In case 1, CT of the spinal cord without enhancement (plain CT) showed a syrinx in the cervical spinal cord, and MCTM made the syrinx clearer with enhancement. MCTM also demonstrated a cavity at the levels of Th 6 and L 1 of the vertebra. In case 2, a syrinx was disclosed in MCTM, in spite of normal myelography. In case 3, myelography demonstrated a spinal cord swelling. MCTM made a syrinx less clear than plain CT. Not only MCTM but also plain CT is an excellent method for the recognition of syringomyelia. The non-invasive plain CT is the first choice of the examinations in cases with syrinogomyelia, because MCTM may make a syrinx obscure. CT and MCTM have to be performed at many levels of the spinal cord in case with syringomyelia. CT or MCTM may demonstrate a syrinx or a cavity at the levels of the spinal cord, where no syrinx is suspected to exist by clinical features, as well as at the levels appearing normal in the myelography. (author)

  4. Demography and findings of reported rape cases.

    Science.gov (United States)

    Quader, M M; Rahman, M H; Kamal, M; Ahmed, A U; Saha, S K

    2010-01-01

    Six hundred and ninety nine cases of alleged rape were studied by the authors during the period from 2007-2008 at the Mymensingh Medical College, Mymensingh. Of these cases, 122 had positive findings of recent sexual intercourse; 250 cases had the positive findings of habituated sexual intercourse, and 327 cases had no findings of sexual intercourse but they complained of forcible sexual intercourse and found no sign of sexual intercourse. Most of the alleged victims of rape were nulliparous 87.12% and parous was only 12.87%. 430 (61.51%) cases of reported victims who were students of schools and colleges were not considered as rape cases considering their victim's history of love affairs, leaving home secretly with their lovers, living with them for many days. Gang rape was not so common (4.29% of raped cases) in our study. Age groups, their occupations, living areas, time of arrival for medico-legal examination have been studied. Most of the cases were students (61.51%). A few numbers of victims were subjected to gang rape. Examination and reporting the cases have been discussed.

  5. Against Contextualism: Belief, Evidence, & the Bank Cases

    Directory of Open Access Journals (Sweden)

    Logan Paul Gage

    2013-04-01

    Full Text Available http://dx.doi.org/10.5007/1808-1711.2013v17n1p57 Contextualism (the view that ‘knowledge’ and its variants are context-sensitive has been supported in large part through appeal to intuitions about Keith DeRose’s Bank Cases. Recently, however, the contextualist construal of these cases has come under fire from Kent Bach and Jennifer Nagel who question whether the Bank Case subject’s confidence can remain constant in both low- and high-stakes cases. Having explained the Bank Cases and this challenge to them, I argue that DeRose has given a reasonable reply to this initial challenge. However, I proceed to argue that the current stalemate can be broken. Seeking to extend the Bach–Nagel critique, I offer a novel interpretation of the Bank Cases according to which the subject’s evidence changes between low- and high-stakes cases. If I am correct, then, given the amount of support the Bank Cases have been thought to lend contextualism, the case for contextualism is seriously weakened.

  6. On misunderstandings in connection with case-studies

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2005-01-01

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...

  7. Theoretical pluralism in psychoanalytic case studies.

    Science.gov (United States)

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

  8. Theoretical pluralism in psychoanalytic case studies

    Science.gov (United States)

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

  9. Post-external radiotherapy hypothyroidism: 15 cases

    International Nuclear Information System (INIS)

    Kaffel, N.; Mnif, M.; Abid, M.; Daoud, J.

    2001-01-01

    Post-external radiotherapy hypothyroidism: 15 cases. Hypothyroidism frequency is estimated to be between 10 and 45% after radiotherapy alone, and 40 to 67% after radiotherapy associated with thyroidectomy. This hypothyroidism is infra-clinical in 60% of the cases. Our study concerned 15 cases of hypothyroidism after external radiotherapy delivered between and 1991 and 1999. An irradiation of the cervical, cerebral and thorax regions was indicated for different types of cancers. Larynx carcinoma epidermoid was the most frequent cancer (seven cases); the radiation treatment used cobalt 60 with conventional fractionation, i.e., 2 Gy per treatment, five treatments a week. In nine cases, the hypothyroidism was discovered during a systematic examination; it was clinically evident in the six remaining cases. Hypothyroidism appeared after an irradiation dose average of 50 Gy (extremes 30-65 Gy). The average duration of the irradiation was about 7 weeks and the hypothyroidism appeared in a mean 22 months. In all cases, the substituting treatment was initiated with a favorable progression. Faced with the risk of hypothyroidism, it is necessary to check patients who have undergone external irradiation of the neck. (authors)

  10. Case report

    African Journals Online (AJOL)

    abp

    2016-07-20

    Jul 20, 2016 ... Brain abscess caused by streptococcus constellatus are very rarely ... We present a rare case of a left-sided thalamic abscess caused by streptococcus ... examination showed that the patient was lethargic and had right-.

  11. Percutaneous transhepatic cholangiography: analysis of 120 cases

    International Nuclear Information System (INIS)

    Sohn, Hyung Sun; Shin, Kyung Sub; Kang, Hyo Seok

    1981-01-01

    Percutaneous transhepatic cholangiography (PTC) is of value in differential diagnosis of cholestatic diseases. Authors had performed PTC in 120 patients with flexible needle of 23 gauge at the Department of Radiology, Kang Nam St. Mary's Hospital and Myung Dong St. Mary's Hospital during the period from January, 1976 to April, 1980. PTC was accomplished successfully in 112 of 120 patients. Diagnoses included cholangiocarcinomas (27 cases), carcinomas of pancreas head (21 cases), ampullary carcinomas (4 cases), metastatic carcinomas (5 cases), bile duct stones (27 cases), sclerosing cholangitis (6 cases), hepatitis (6 cases), liver cirrhosis (6 cases), post operative adhesions (5 cases), chronic pancreatitis (3 cases), stomach carcinomas (3 cases), clonorchiasis (2 cases), blood clot (1 case), and remaining normal 4 cases. Some characteristic PTC findings were: (1) segmental annular narrowing and abrupt complete obstruction and polyploid filling defects of the bile duct in cholangiocarcinoma, (2) typical nipple or rat-tail appearance of the distal common bile duct in pancreatic head carcinoma, (3) single or multiple sharply and smoothly outlined filling defects within bile duct in all cases of stones, (4) complete obstruction with shallow concavity in ampullary carcinoma, (5) diffuse or segmental narrowing of the intrahepatic bile duct and common bile duct in sclerosing cholangitis, (6) multiple tiny polypoid filling defects of gall bladder, common hepatic duct, and common bile duct in clonorchiasis. (7) normal appearance in hepatitis. The overall diagnostic accuracy of PTC in 66 operated cases was 89.4%, and complications following the examination were significantly reduced by using a fine flexible needle (23 gauge). From the present study it is concluded as follows: 1. To evaluate obstructed or stenosed site accurately, aspiration of bile juice must be preceded by a 23 gauge needle connected to either 10 ml or 5 ml syringe. 2. To diagnose carcinoma of the

  12. Pressurized waterproof case for electronic device

    KAUST Repository

    Berumen, Michael L.

    2013-01-31

    The pressurized waterproof case for an electronic device is particularly adapted for the waterproof containment and operation of a touch-screen computer or the like therein at some appreciable water depth. The case may be formed as an enclosure having an open top panel or face covered by a flexible, transparent membrane or the like for the operation of the touch-screen device within the case. A pressurizing system is provided for the case to pressurize the case and the electronic device therein to slightly greater than ambient in order to prevent the external water pressure from bearing against the transparent membrane and pressing it against the touch screen, thereby precluding operation of the touch screen device within the case. The pressurizing system may be a small gas cartridge (e.g., CO2), or may be provided from an external source, such as the diver\\'s breathing air. A pressure relief valve is also provided.

  13. Essential trichomegaly: case report

    Directory of Open Access Journals (Sweden)

    Julia Dutra Rossetto

    2013-02-01

    Full Text Available The present study reports two cases of symptomatic essential trichomegaly. Trichomegaly may develop in various diseases, including anorexia nervosa, hypothyroidism, pregnancy, pretibial myxedema, systemic lupus erythematosus, vernal keratoconjunctivitis, and uveitis. The exact incidence trichomegaly is unknown, and the condition remains sporadically reported. Two cases of symptomatic trichomegaly without any associated systemic disorder are presented in this paper.

  14. Human babesiosis - A case report

    Directory of Open Access Journals (Sweden)

    Marathe A

    2005-01-01

    Full Text Available Babesiosis is an emerging, tick-transmitted, zoonotic disease caused by hematotropic parasites of the genus Babesia. Most cases of Babesial infections in humans have been acquired in temperate regions of the United States, Europe, France and England. A few cases of Babesiosis have been described in other parts of the world, including China, Taiwan, Egypt, South Africa, and Mexico.1,2 We report the first case of human Babesiosis, in a normosplenic, previously healthy individual from India.

  15. 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.

  16. Blastomycosis in Quebec (1981–90: Report of 23 Cases and Review of Published Cases from Quebec

    Directory of Open Access Journals (Sweden)

    G St-Germain

    1993-01-01

    Full Text Available Twenty-three cases of blastomycosis were reported in a survey conducted in the province of Quebec from 1981–90. Thirteen patients resided south of the St Lawrence River and the other 10, north. Two small geographical clusters were apparent in and around the cities of Sherbrooke and Quebec. The male to female ratio was 1.6:1 and the median age was 47 years (range 26 to 77. Lung involvement was observed in 19 cases and was the only site involved in 11. Cutaneous manifestations were reported in 11 cases while bone infection (three cases and central nervous system (CNS infections were also noted. Diagnosis was confirmed by culture in 21 cases and by histopathology in two cases. Of the 21 culture-positive cases, 12 strains of Blastomyces dermatitidis were isolated from lungs, nine from skin, and one each from bone and brain. Serodiagnostic tests by immunodiffusion or complement fixation were positive for only one of the 10 patients known to have been tested. Ten patients were treated with amphotericin B, 11 with ketoconazole, one with fluconazole and eight underwent surgery. While amphotericin B was used in eight of the 10 earliest treated cases, ketoconazole was administered in 10 of the 13 more recent cases. Of the patients for whom follow-up data have been obtained, 21 are reported cured (one of whom was not treated and one patient died of another cause. This survey confirms that blastomycosis is a rare disease in this endemic area and that patterns of therapy are changing.

  17. Two Legionnaires' disease cases associated with industrial waste water treatment plants: a case report

    Directory of Open Access Journals (Sweden)

    Putus Tuula

    2010-12-01

    Full Text Available Abstract Background Finnish and Swedish waste water systems used by the forest industry were found to be exceptionally heavily contaminated with legionellae in 2005. Case presentation We report two cases of severe pneumonia in employees working at two separate mills in Finland in 2006. Legionella serological and urinary antigen tests were used to diagnose Legionnaires' disease in the symptomatic employees, who had worked at, or close to, waste water treatment plants. Since the findings indicated a Legionella infection, the waste water and home water systems were studied in more detail. The antibody response and Legionella urinary antigen finding of Case A indicated that the infection had been caused by Legionella pneumophila serogroup 1. Case A had been exposed to legionellae while installing a pump into a post-clarification basin at the waste water treatment plant of mill A. Both the water and sludge in the basin contained high concentrations of Legionella pneumophila serogroup 1, in addition to serogroups 3 and 13. Case B was working 200 meters downwind from a waste water treatment plant, which had an active sludge basin and cooling towers. The antibody response indicated that his disease was due to Legionella pneumophila serogroup 2. The cooling tower was the only site at the waste water treatment plant yielding that serogroup, though water in the active sludge basin yielded abundant growth of Legionella pneumophila serogroup 5 and Legionella rubrilucens. Both workers recovered from the disease. Conclusion These are the first reported cases of Legionnaires' disease in Finland associated with industrial waste water systems.

  18. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-01-07

    Jan 7, 2015 ... Synchronous malignant renal mass in patient with a Lung cancer: case report and literature ... management and prognosis [4]. Patient and ... classed stage I. The patient got chemo radiotherapy for the lung cancer using ...

  19. Case report

    African Journals Online (AJOL)

    abp

    2017-12-13

    Dec 13, 2017 ... nodules measuring 10-6cm, erythematous, purple color, painful at mobilization ... After multi-disciplinary concertation a ... of view than positivity of AR. In contrast ... Katagiri Y, Ansai S. Two cases of cutaneous apocrine ductal.

  20. Unusual clinical presentation of rare case of vaginal leiomyoma: a case report

    OpenAIRE

    Ishrat Zuber; Purnima K. Nadkarni; Aditi A. Nadkarni; Akshay Nadkarni

    2016-01-01

    Primary vaginal leiomyoma are rare and usually arise from anterior vaginal wall, approximately 330 cases of vaginal fibroid reported in world literature. Vaginal myoma usually presented as discharge per vaginum, abnormal bleeding, pain lower abdomen, dyspareunia etc. We report a case of primary vaginal leiomyoma arising from lateral vaginal wall which is presented clinically as pain in hip joint and radiating to ipsilateral leg which is unusual clinical presentation creating diagnostic dilemm...

  1. 76 FR 6381 - Fee-Generating Cases

    Science.gov (United States)

    2011-02-04

    ... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services...) proposes to amend the Legal Services Corporation's regulation on fee-generating cases to clarify that it... intended. LSC's regulation at 45 CFR part 1609, Fee- Generating Cases, is based on Sec. 1007(b)(1) of the...

  2. Temporal Visualization for Legal Case Histories.

    Science.gov (United States)

    Harris, Chanda; Allen, Robert B.; Plaisant, Catherine; Shneiderman, Ben

    1999-01-01

    Discusses visualization of legal information using a tool for temporal information called "LifeLines." Explores ways "LifeLines" could aid in viewing the links between original case and direct and indirect case histories. Uses the case of Apple Computer, Inc. versus Microsoft Corporation and Hewlett Packard Company to…

  3. [Surrogacy, yes or no? Case report].

    Science.gov (United States)

    Pektorová, M; Ventruba, P

    2015-08-01

    Case study of surrogacy which did not come up to client-couple´s expectation. Case report. Department of Gynaecology and Obstetrics, Uherske Hradiste Hospital a. s., Uherske Hradiste. Description of the case, case study. In the Czech Republic, missing legislation when subject matter is surrogacy does not allow to make a complex legal contract. This fact causes legal uncertainty to all participants. Irresponsible approach of doctors, surrogate mother, client-couple, and in the upshot care of disabled child at government expense can be results.

  4. IT Business Cases in Local Government

    DEFF Research Database (Denmark)

    Nielsen, Peter Axel; Persson, John Stouby

    2012-01-01

    Effective management of value creation with information technology (IT) is increasingly important for local governments (e.g., municipalities). The business case is a tool that has increased popularity in both the public and private sector to support the management of value creation with IT....... However, experiences from local government reveal difficulties in developing effective IT business cases beyond simple cost savings. Based on collaborative action research with Danish municipalities we present insights on contemporary IT business case practices. Based on these insights we formulate...... lessons for business case practices in local government that we have incorporated into a business case method; that has subsequently been evaluated by IT managers in local government. These lessons have been synthesized into the four principles: minimal contents, benefits ownership, dynamic utility...

  5. Case Report

    African Journals Online (AJOL)

    Administratör

    Uterus at 17 Weeks of Amenorrhea: Case Report and Literature. Review ... no bleeding but the patient was noted to have ... urinary tract abnormalities are frequent in ... of MRI [6]. Laparoscopy allows formal confirmation of this type of uterine.

  6. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-11-27

    Nov 27, 2015 ... systemic lupus erythematosus nor other connective tissue disease. Pregnancy was ... day of life, platelet level dropped to 20 x 109/L. The newborn has received platelet ... cases of aplastic anemia or hemolytic anemia [6,7].

  7. Case report

    African Journals Online (AJOL)

    abp

    un cas. Rev Chir Orthop Reparatrice. Appar Mot. 2000;86(1):98-103. PubMed | Google Scholar. 7. Nagamine N, Nohara Y, Ito E. Elastofibroma in Okinawa. A clinicopathologic study of 170 cases. Cancer. 1982;50(9):1794-.

  8. Case report

    African Journals Online (AJOL)

    raoul

    2012-02-22

    Feb 22, 2012 ... cancer. Case report. Written informed consent was obtained from the patient for ... colon and rectum (12 patients), uterus (8 patients), ovary (5 patients), head and neck (tongue, pharynx, larynx, nasal cavity, and mandible) (5 ...

  9. Using Correspondence Analysis in Multiple Case Studies

    NARCIS (Netherlands)

    Kienstra, Natascha; van der Heijden, Peter G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  10. Using correspondence analysis in multiple case studies

    NARCIS (Netherlands)

    Kienstra, N.H.H.; van der Heijden, P.G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  11. 28 CFR 2.17 - Original jurisdiction cases.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Original jurisdiction cases. 2.17 Section... Original jurisdiction cases. (a) Following any hearing conducted pursuant to these rules, the Regional Commissioner may designate that a case should be decided as an original jurisdiction case. If the Regional...

  12. Intelligent Adaptation Process for Case Based Systems

    International Nuclear Information System (INIS)

    Nassar, A.M.; Mohamed, A.H.; Mohamed, A.H.

    2014-01-01

    Case Based Reasoning (CBR) Systems is one of the important decision making systems applied in many fields all over the world. The effectiveness of any CBR system based on the quality of the storage cases in the case library. Similar cases can be retrieved and adapted to produce the solution for the new problem. One of the main issues faced the CBR systems is the difficulties of achieving the useful cases. The proposed system introduces a new approach that uses the genetic algorithm (GA) technique to automate constructing the cases into the case library. Also, it can optimize the best one to be stored in the library for the future uses. However, the proposed system can avoid the problems of the uncertain and noisy cases. Besides, it can simply the retrieving and adaptation processes. So, it can improve the performance of the CBR system. The suggested system can be applied for many real-time problems. It has been applied for diagnosis the faults of the wireless network, diagnosis of the cancer diseases, diagnosis of the debugging of a software as cases of study. The proposed system has proved its performance in this field

  13. Case report

    African Journals Online (AJOL)

    abp

    2012-05-13

    May 13, 2012 ... Missed opportunity for tuberculosis case detection in household contacts in a high ... Maywood, IL, USA, 4College of Public Health, University of Georgia, ... This is an Open Access article distributed under the terms of the ...

  14. Case Report: HIV test misdiagnosis

    African Journals Online (AJOL)

    Case Study: HIV test misdiagnosis 124. Case Report: HIV ... A positive rapid HIV test does not require ... 3 College of Medicine - Johns Hopkins Research Project, Blantyre,. Malawi ... test results: a pilot study of three community testing sites.

  15. 29 CFR 1614.302 - Mixed case complaints.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

  16. Catamenial pneumothorax - case report

    International Nuclear Information System (INIS)

    Hasara, R.; Kudelkova, J.; Pestal, A.; Jedlicka, V.; Capov, I.; Reismullerova, L.

    2014-01-01

    Catamenial pneumothorax is a rare type of spontaneous pneumothorax, developed in women in reproductive age due to the presence of thoracic endometriosis. Medical history is the key to the correct diagnosis. Treatment combines methods of thoracic surgery, together with hormonal substitution therapy and, in rare cases, also gynecological operation. We present the case report of young woman with spontaneous pneumothorax due to thoracic endometriosis. (author)

  17. Extension classification method for low-carbon product cases

    Directory of Open Access Journals (Sweden)

    Yanwei Zhao

    2016-05-01

    Full Text Available In product low-carbon design, intelligent decision systems integrated with certain classification algorithms recommend the existing design cases to designers. However, these systems mostly dependent on prior experience, and product designers not only expect to get a satisfactory case from an intelligent system but also hope to achieve assistance in modifying unsatisfactory cases. In this article, we proposed a new categorization method composed of static and dynamic classification based on extension theory. This classification method can be integrated into case-based reasoning system to get accurate classification results and to inform designers of detailed information about unsatisfactory cases. First, we establish the static classification model for cases by dependent function in a hierarchical structure. Then for dynamic classification, we make transformation for cases based on case model, attributes, attribute values, and dependent function, thus cases can take qualitative changes. Finally, the applicability of proposed method is demonstrated through a case study of screw air compressor cases.

  18. Computerized tomographic evaluations of 37 cases of craniopharyngiomas

    International Nuclear Information System (INIS)

    Nagasawa, Shiro; Yamashita, Junkoh; Handa, Hajime; Takeuchi, Juji.

    1983-01-01

    Although craniopharyngiomas are well known to exhibit three basic CT characteristics: Calcification, cysts, and contrast enhancement (CE), several cases with atypical CT manifestations have been reported lately. These atypical manifestations can be classified into three groups: Unusual extensions of the tumors, high-density cysts, and marked homogeneous CE. The CT scans obtained in our recent series of 37 craniopharyngiomas were evaluated in an attempt to analyze the tumoral extensions, the cyst densities, and the CE, and were compared with those of other, rarer parasellar lesions. Cystic tumors were much more frequent than solid tumors (Table 1); 14 cases (38%) were exclusively cystic; 17 cases (46%), equally cystic and solid, and 6 cases (16%), solid. Calcifications were present in 86% of the children and 43% of the adults. Unusual extensions were noted in 7 cases (Fig. 1, 2): Anteriorly to the frontal fossa (5 cases, 14%), laterally to the temporal fossa (1 case, 3%), or posteriorly to the posterior fossa (1 case, 3%). All these tumors were either purely cystic or equally cystic and solid. Cystic portions were detected in the tumors of 31 cases (Table 2). Although the majority of the cystic portions (25 cases, 81%) were low in density, isodense cysts were observed in 6 cases (19%). Out of 23 cases exhibiting solid portions in the tumors, high-density areas (calcified masses) were detected in 3 cases and mixed-density areas in 20 cases. While these 20 cases all showed CE, marked homogeneous CE were noted in 5 cases (25%). (J.P.N.)

  19. 76 FR 23502 - Fee-Generating Cases

    Science.gov (United States)

    2011-04-27

    ... LEGAL SERVICES CORPORATION 45 CFR Part 1609 Fee-Generating Cases AGENCY: Legal Services... on fee-generating cases to clarify that it applies only to LSC and private non-LSC funds. DATES: This... fee-generating cases to clarify that it applies only to LSC and private non-LSC funds. 76 FR 6381. On...

  20. Casing drilling - first experience in Brazil; Casing drilling - primeira experiencia no Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Placido, Joao Carlos Ribeiro; Medeiros, Fernando; Lucena, Humberto; Medeiros, Joao Carlos Martins de; Costa, Vicente Abel Soares Rosa da; Silva, Paulo Roberto Correa da [PETROBRAS, Rio de Janeiro, RJ (Brazil); Alves, Renato J.M. [Tesco, London (United Kingdom)

    2004-07-01

    This paper describes the 'Casing Drilling' technology and its first experience in Brazil. This new process of casing while drilling was first developed to reduce costs. This system integrates the drilling process and casing running in one operation, promoting a more efficient well construction system, reducing trip time and costs of drill pipes and their transportation. Besides, this methodology intends to eliminate hole problems related to trouble zones with abnormal pressure with loss circulation, to overcome zones with wellbore instabilities, and to facilitate well control. Two companies have been identified using this technology: Tesco and Weatherford. However, there are differences between the techniques used by these companies, which are described in this paper. In the first experience in Brazil, it was decided to field test the technology developed by Tesco. This paper describes the preparation, the operation and the results of this first test. (author)

  1. Dissecting malpractice in pancreaticoduodenectomy cases.

    Science.gov (United States)

    Anandalwar, Seema P; Scholer, Anthony J; Ninan, Gigio; Oliver, Joseph B; Christian, Derick; Eloy, Jean Anderson; Chokshi, Ravi J

    2017-05-15

    Medical malpractice is a growing concern for physicians in all fields. Surgical fields have some of the highest malpractice premiums and litigation rates. Pancreaticoduodenectomy (PD) has become a popular procedure; however, it is still associated with significant morbidity and mortality. This study is the first to analyze factors involved in litigation regarding PD cases. The Westlaw database was searched for jury verdicts and settlements using the terms "medical malpractice" and "pancreaticoduodenectomy". Twenty-nine cases from 1991 to 2012 were initially collected. Seven entries not involving PD and three duplicate cases were excluded. Nineteen cases were included for analysis. Of the 19 cases included in the analysis, three (15.8%) reached a settlement, three (15.8%) were ruled in favor of the plaintiff, and 13 (68.4%) were ruled in favor of the physician. The average settlement award was $398,333 (range, $195,000-500,000), and the average plaintiff award was $4,288,869 (range, $1,066,608-10,300,000). The most common factors raised in litigation included PD being allegedly unnecessary (47.4%), followed by postoperative negligence and misdiagnosis (36.8% each). The most common factors present in litigation included the allegation that PD was unnecessarily performed. The cases that are awarded large monetary sums are those that involve continued medical care. Ways to improve patient safety and limit litigation include increasing transparency and communication with a thorough discussion between surgeon and patient of the most common topics of litigation discussed. Published by Elsevier Inc.

  2. 12 CFR 268.302 - Mixed case complaints.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Mixed case complaints. 268.302 Section 268.302... RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case... discrimination or it may contain additional allegations that the MSPB has jurisdiction to address. A mixed case...

  3. Case Report

    African Journals Online (AJOL)

    Arthritis: a Case Report. Intissar Haddiya*, Hakima Rhou, Loubna Benamar, Fatima Ezzaitouni, Rabia Bayahia, Naima. Ouzeddoun. Unit of Nephrology, Ibn Sina University Hospital, Rabat, Morocco. * Corresponding author; Unit of Nephrology, Ibn Sina University. Hospital, Rabat, Morocco; E. mail: intissarhaddiya@hotmail.

  4. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-11-20

    Nov 20, 2015 ... We report a case of a farmer who has sustained of a severe hand wound due to ... open distal interphalangeal joint dislocation of the 5th finger; flexor tendons were .... biomechanical analysis and clinical application. J Orthop ...

  5. Case series

    African Journals Online (AJOL)

    abp

    2017-09-15

    15 Ebola Virus Disease (EVD) outbreak in West Africa infected more than 28,000 persons out of which 11,000 died [20]. At the height of this outbreak, the huge load of cases and their contacts overwhelmed the response ...

  6. Case report

    African Journals Online (AJOL)

    abp

    2013-02-19

    Feb 19, 2013 ... main disease and 70-80% stenosis of the proximal Left Anterior Descending Artery (LAD). ... He had a successful PTCA + DES stent to the LAD (Figure 3). ... In the case being presented, despite the benign appearance of the.

  7. Case Report

    DEFF Research Database (Denmark)

    Klubien, Jeanett; Borgersen, Dorte Winther; Rosenberg, Jacob

    2016-01-01

    Introduction Perforation of the gallbladder is a benign and common complication during laparoscopic cholecystectomy. However, it may result in stone spilling, which potentially can lead to serious postoperative complications.  Case report A 70-year-old male underwent laparoscopic cholecystectomy...

  8. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-02-13

    Feb 13, 2015 ... mucoid, T.inkin, T. cutaneum) a rate of 11.15%. This rate confirms the one recorded by Pini G & al ... The authors declare no competing interest. Authors' ... due to Trichosporonasahii,first two cases in Chile. Rev. IberoamMicol.

  9. Case report

    African Journals Online (AJOL)

    ebutamanya

    French). 1984;30(3):177-81. PubMed |. Google Scholar. 12. Isla A, Paz JM, Sansivirini F, Zamora P, Garcia Grande A,. Fernandez A. Intramedullary spinal cord metastasis: a case report. J Neurosurg Sci. 2000 Jun; 44(2):99-101.

  10. Software requirements management based on use cases

    International Nuclear Information System (INIS)

    Xiao Jin

    2009-01-01

    In this paper, the requirements management based on use cases is theoretically explored, and a multi-layer use-case model is introduced, which combined with three levels of use cases and a single use-case refinement model. Through the practice in a software project, the multi-layer use-case model provides a good solution on how to control the requirements scope and change, and provides the balance of work assignment between customer departments, information management departments and software development outsourcing team. (authors)

  11. Connection of thin-walled casings

    Energy Technology Data Exchange (ETDEWEB)

    Druyan, V.M.; Grinev, A.F.; Gruzdev, V.D.; Perchanik, V.V.; Syplenko, V.T.

    1981-08-28

    A connection is suggested for castings which contains a nipple and coupling part with conical triangular threading. in order to improve the strength of the connection of thin-walled casings with ratio D/S>22, where D is the outer diameter of the casing, S is the thickness of the wall of the casing, the end of the pipe on the length from the end to the main plane of the thread is conical with constant thickness of the wall and conicity eqal to the conicity of the thread.

  12. [Amyand's hernia--a clinical case].

    Science.gov (United States)

    Savlovschi, C; Brănescu, C; Serban, D; Tudor, C; Găvan, C; Shanabli, A; Comandaşu, M; Vasilescu, L; Borcan, R; Dumitrescu, D; Sandolache, B; Sajin, M; Grădinaru, S; Munteanu, R; Kraft, A; Oprescu, S

    2010-01-01

    Amyand's hernia, a rare entity in the surgical pathology, presupposes the presence of the vermiform appendix inside a inguinal hernia sac (1). The hernia sac peritonitis by appendix swelling is even more rare, very few cases being presented in the surgical literature (1). The preoperatory diagnosis of Amyand's hernia is therefore very difficult. We herein present the case of a 71-year old male patient, operated on an emergency basis for hernia, which eventually turned out to be Amyand's hernia, a case which determined us to research the literature dedicated to this topic.

  13. 45 CFR 400.118 - Case planning.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Case planning. 400.118 Section 400.118 Public... Services § 400.118 Case planning. (a) A State, or its designee under § 400.117, must develop and implement... services. (b) Case planning for unaccompanied minors must, at a minimum, address the following elements: (1...

  14. Day-case laparoscopic Nissen fundoplication.

    LENUS (Irish Health Repository)

    Khan, S A

    2012-01-01

    For day-case laparoscopic surgery to be successful, patient selection is of the utmost importance. This study aimed to assess the feasibility of day-case laparoscopic Nissen fundoplication and to identify factors that may lead to readmission and overstay.

  15. 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…

  16. Pressurized waterproof case electronic device

    KAUST Repository

    Berumen, Michael L.

    2013-01-01

    A pressurized waterproof case for an electronic device is particularly adapted for fluid-tight containment and operation of a touch-screen electronic device or the like therein at some appreciable water depth. In one example, the case may be formed

  17. Case Study: The Chemistry of Cocaine

    Science.gov (United States)

    Dewprashad, Brahmadeo

    2011-01-01

    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 case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

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

    Science.gov (United States)

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

    2009-01-01

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

  19. GLAMUR case-study report: The comparison of three Dutch pork cases (Tasks 3.5)

    NARCIS (Netherlands)

    Oostindië, H.A.; Horlings, L.G.; Broekhuizen, van R.E.; Hees, E.

    2015-01-01

    This report presents the case study results of local-global pork chain performances in The Netherlands. As part of Work Package 3, this case study was carried out in cooperation with our Italian GLAMUR partner. The Dutch pork production sector came up after World War 2 and developed into a highly

  20. SIRENOMELIA: A CASE REPORT

    OpenAIRE

    Wankhede; Shrivastava

    2016-01-01

    The incidence of Sirenomelia is thought to be about 1 in 65,000 live births (Oxford Medical database, Dysmorphology). In Sirenomelia, lower limbs are fused together. Common associated malformations include absent genitalia, imperforate anus, lumbosacral vertebral pelvic abnormalities and renal agenesis. Sirenomelia with craniorachischisis totalis (CT) is a rare fetal malformation, only six cases have been reported in English literature (1-5) and none yet from Asia. Our case is of ...

  1. The case for Dounreay

    International Nuclear Information System (INIS)

    1979-01-01

    This document sets out to state the case for the Commercial Demonstration Fast Reactor and to explain the reasons why it should be situated at Dounreay, Caithness, Scotland. Headings are: the case for CDFR; why should the CDFR be sited in Caithness (Caithness before Dounreay; the social and economic significance of Dounreay; the Caithness economy today; Caithness - the need for jobs); the CDFR and Caithness; conclusions. (U.K.)

  2. Case report

    African Journals Online (AJOL)

    abp

    2013-10-23

    Oct 23, 2013 ... Pyomyositis in Nodding Syndrome (NS) patient - a case report ... B0X 7072, Kampala, Uganda, 3Gulu University, Faculty of Medicine, P.O. B0X 166, Gulu, Uganda .... to pay particular attention to such children who may have.

  3. Case Report

    DEFF Research Database (Denmark)

    Sylvester-Hvid, Amalie; Avnstorp, Magnus B; Wagenblast, Lene

    2017-01-01

    Introduction Breast seroma may be caused by a variety of factors including lymphatic disruption, continuous inflammation and foreign bodies such as breast implants. In cases of breast implants associated seroma the diagnosis of Anaplastic Large Cell Lymphoma (ALCL) should be investigated. Present...

  4. CASE REPORT

    African Journals Online (AJOL)

    2011-12-02

    Dec 2, 2011 ... brain illustrated enhancement of the optic nerves post-. CASE REPORT ... improved bilaterally to 6/18 on the right and 6/12 on the left. There was .... the possible risks versus benefits of steroid therapy and invite them to ...

  5. Effect of the new standards for case logging on resident operative volume: doing better cases or better numbers?

    Science.gov (United States)

    Murthy, Raghav; Shepard, Alex; Swartz, Andrew; Woodward, Ann; Reickert, Craig; Horst, Mathilda; Rubinfeld, Ilan

    2012-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) modified the designation of major (index) operative cases to include those previously considered "minor." This study assessed the potential effect of these changes on resident operative experience. With Institutional Review Board approval, we analyzed National Surgical Quality Improvement Program participant use files for 2005-2008 for general and vascular surgery cases. Primary CPT case coding was mapped to the ACGME major case category using both the old and new classification schemes. The variables were analyzed using χ(2) analysis in SPSS IBM 19 (IBM, Armonk, New York). A total of 576,019 cases were reviewed. Major cases as defined by the new classification represented an increasing proportion of the cases each year, rising from 88.3% in 2005 to 95% by 2008 (p top procedures to include excision of breast lesion (22,175 [12.7%]), laparoscopic gastric bypass (18,825 [10.8%]), ventral hernia repair (14,732 [8.5%]), and appendectomy (10,190 [5.9%]). Of these newly designated major cases, the proportion not covered by residents increased from 22% in 2005 to 44% in 2007 and 2008 (p quality. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. The importance of laboratory re-evaluation in cases of suspected child abuse - A case report.

    Science.gov (United States)

    Woydt, L; König, C; Bernhard, M K; Nickel, P; Dreßler, J; Ondruschka, B

    2017-09-01

    In order to accurately diagnose child abuse or neglect, a physician needs to be familiar with diseases and medical conditions that can simulate maltreatment. Unrecognized cases of abuse may lead to insufficient child protection, whereas, on the other hand, over-diagnosis could be the cause of various problems for the family and their potentially accused members. Regarding child abuse, numerous cases of false diagnoses with undetected causes of bleeding are described in the scientific literature, but, specifically concerning leukemia in childhood, only very few case reports exist. Here, for the first time, we report a case of a 2-year-old boy who got hospitalized twice because of suspicious injuries and psychosocial conspicuities, in a family situation known for repeated endangerment of the child's well-being. After his first hospitalization with injuries typical for child abuse, but without paraclinical abnormalities, medical inspections were arranged periodically. The child was hospitalized with signs of repeated child abuse again five months later. During second admission, an acute lymphoblastic leukemia was revealed by intermittent laboratory examination, ordered due to new bruises with changes in morphology, identifiable as petechial hemorrhages. This case elucidates the discussion of known cases of leukemia in childhood associated with suspected child abuse in order to provide an overview of possible diseases mimicking maltreatment. To arrange necessary supportive examinations, a skillful interaction between pediatrician and forensic pathologist is crucial in the differentiation between accidental and non-accidental injury. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Automation of Test Cases for Web Applications : Automation of CRM Test Cases

    OpenAIRE

    Seyoum, Alazar

    2012-01-01

    The main theme of this project was to design a test automation framework for automating web related test cases. Automating test cases designed for testing a web interface provide a means of improving a software development process by shortening the testing phase in the software development life cycle. In this project an existing AutoTester framework and iMacros test automation tools were used. CRM Test Agent was developed to integrate AutoTester to iMacros and to enable the AutoTester,...

  8. A Case of Familial Polydactyly From Turkey

    Directory of Open Access Journals (Sweden)

    Billur Sezgin

    2016-06-01

    Full Text Available Polydactyly is among the most frequently encountered congenital anomalies of the extremities. Although it is usually presented in an isolated and sporadic manner, familial cases can also be rarely encountered. Such familial polydactyly cases usually follow an autosomal dominant inheritance with variable genetic penetration and are usually bilateral and symmetric. A case of rare familial polydactyly from Turkey is presented. Four siblings, two girls and two boys, presented with bilateral, symmetric preaxial polydactyly affecting both hands and feet. These siblings also had four other unaffected siblings along with an affected father and grandmother (the father’s mother. Although the cases portrayed duplication at different levels, the general definition of familial polydactyly with bilateral, symmetric inheritance is observed in these cases. Other rare familial polydactyly cases have been reported in the literature as well, and this case serves as a typical example of this rare entity from Turkey.

  9. Casing Pipe Damage Detection with Optical Fiber Sensors: A Case Study in Oil Well Constructions

    Directory of Open Access Journals (Sweden)

    Zhi Zhou

    2010-01-01

    Full Text Available Casing pipes in oil well constructions may suddenly buckle inward as their inside and outside hydrostatic pressure difference increases. For the safety of construction workers and the steady development of oil industries, it is critically important to measure the stress state of a casing pipe. This study develops a rugged, real-time monitoring, and warning system that combines the distributed Brillouin Scattering Time Domain Reflectometry (BOTDR and the discrete fiber Bragg grating (FBG measurement. The BOTDR optical fiber sensors were embedded with no optical fiber splice joints in a fiber-reinforced polymer (FRP rebar and the FBG sensors were wrapped in epoxy resins and glass clothes, both installed during the segmental construction of casing pipes. In situ tests indicate that the proposed sensing system and installation technique can survive the downhole driving process of casing pipes, withstand a harsh service environment, and remain intact with the casing pipes for compatible strain measurements. The relative error of the measured strains between the distributed and discrete sensors is less than 12%. The FBG sensors successfully measured the maximum horizontal principal stress with a relative error of 6.7% in comparison with a cross multipole array acoustic instrument.

  10. Case-based reasoning a concise introduction

    CERN Document Server

    López, Beatriz

    2013-01-01

    Case-based reasoning is a methodology with a long tradition in artificial intelligence that brings together reasoning and machine learning techniques to solve problems based on past experiences or cases. Given a problem to be solved, reasoning involves the use of methods to retrieve similar past cases in order to reuse their solution for the problem at hand. Once the problem has been solved, learning methods can be applied to improve the knowledge based on past experiences. In spite of being a broad methodology applied in industry and services, case-based reasoning has often been forgotten in

  11. Worst-case analysis of heap allocations

    DEFF Research Database (Denmark)

    Puffitsch, Wolfgang; Huber, Benedikt; Schoeberl, Martin

    2010-01-01

    the worst-case heap allocations of tasks. The analysis builds upon techniques that are well established for worst-case execution time analysis. The difference is that the cost function is not the execution time of instructions in clock cycles, but the allocation in bytes. In contrast to worst-case execution...... time analysis, worst-case heap allocation analysis is not processor dependent. However, the cost function depends on the object layout of the runtime system. The analysis is evaluated with several real-time benchmarks to establish the usefulness of the analysis, and to compare the memory consumption...

  12. Gregory Bateson: Rumo a uma epistemologia da comunicação

    Directory of Open Access Journals (Sweden)

    Etienne Samain

    2001-01-01

    Full Text Available

    Como se constrói nosso “saber”? Como nascem nossos “conhecimentos” ou, melhor dizendo, as “idéias” que nós fazemos das coisas deste mundo? A partir de que imperativos epistemológicos podemos pensar fundar uma ciência do conhecimento?

    Ao longo de milênios, esses conhecimentos se multiplicaram e se diversificaram. Com eles, emergiram centenas de epistemologias locais que, no entanto, cruzam-se no horizonte de suas indispensáveis inter-relações. Como e até onde uma “Epistemologia da Comunicação” (uma epistemologia, muitas vezes ainda, por demais local participará, no futuro, desta teia de relações e saberá fomentar o que se poderia chamar uma “ecologia do espírito”?

    Para tanto, procura-se delinear, nesta comunicação, alguns parâmetros iniciais de elaboração de uma “Epistemologia da Comunicação”, tirando proveito da gigantesca e complexa obra de Gregory Bateson (1904-1980, um penetrante pensador da questão, que foi, ao mesmo tempo, um biólogo, um antropólogo, um psiquiatra e um amante da comunicação humana.

  13. Caracterización del sacrificio de corderos de pelo a partir de cruces con razas criollas colombianas

    Directory of Open Access Journals (Sweden)

    William Albarracín H.

    2013-03-01

    Full Text Available Objetivo. Evaluar el efecto genético del cruce de corderos Dorper con razas criollas colombianas, tiempo de ayuno y aturdimiento sobre los rendimientos del sacrificio; niveles de glucosa como medida de estrés y pH como calidad de la canal. Materiales y métodos. Se emplearon 60 corderos raza Dorper X criollo criados en pastoreo y semi-estabulación con 10 semanas de edad. Se aplicaron 3 tiempos de ayuno (6, 12 y 18 horas y 2 métodos de aturdimiento (electronarcosis y perno cautivo penetrante, evaluando los rendimientos de canal por pesaje de canales; glucosa en muestras antemortem y postmortem. Resultados. Los resultados obtenidos mostraron que el efecto combinado de ayuno y sistema de cría influencian los rendimientos de canal y subproductos. A tiempos prolongados de ayuno se aumenta la concentración de glucosa en sangre, aunque el tiempo de ayuno incide sobre el pH último. El efecto del aturdimiento, solo se presenta en el cambio de pH durante 24 horas, siendo un efecto de estimulación eléctrica por parte de la electronarcosis. Los animales de raza Dorper x criollo criados en sistema de pastoreo, presentaron mejores rendimientos en canal, pero menores porcentajes de vísceras blancas y rojas. Conclusiones. El porcentaje medio de rendimiento en canal es similar a los presentados en razas puras Dorper siendo viable y comparable este tipo de cruce.

  14. Clinical findings in two cases of atypical scrapie in sheep: a case report

    Directory of Open Access Journals (Sweden)

    Chaplin Melanie

    2007-02-01

    Full Text Available Abstract Background Atypical scrapie is a recently recognised form of transmissible spongiform encephalopathy of sheep that differs from classical scrapie in its neuropathological and biochemical features. Most cases are detected in apparently healthy sheep and information on the clinical presentation is limited. Case presentation This report describes the clinical findings in two sheep notified as scrapie suspects and confirmed as atypical scrapie cases by immunohistochemistry and Western immunoblotting. Although both sheep displayed signs suggestive of a cerebellar dysfunction there was considerable variation in the individual clinical signs, which were similar to classical scrapie. Conclusion Any sheep presenting with neurological gait deficits should be assessed more closely for other behavioural, neurological and physical signs associated with scrapie and their presence should lead to the suspicion of scrapie.

  15. The electrical resistivity method in cased boreholes

    Energy Technology Data Exchange (ETDEWEB)

    Schenkel, C.J.

    1991-05-01

    The use of downhole current sources in resistivity mapping can greatly enhance the detection and delineation of subsurface features. The purpose of this work is to examine the resistivity method for current sources in wells cased with steel. The resistivity method in cased boreholes with downhole current sources is investigated using the integral equation (IE) technique. The casing and other bodies are characterized as conductivity inhomogeneities in a half-space. For sources located along the casing axis, an axially symmetric Green's function is used to formulate the surface potential and electric field (E-field) volume integral equations. The situations involving off-axis current sources and three-dimensional (3-D) bodies is formulated using the surface potential IE method. The solution of the 3-D Green's function is presented in cylindrical and Cartesian coordinate systems. The methods of moments is used to solve the Fredholm integral equation of the second kind for the response due to the casing and other bodies. The numerical analysis revealed that the current in the casing can be approximated by its vertical component except near the source and the axial symmetric approximation of the casing is valid even for the 3-D problem. The E-field volume IE method is an effective and efficient technique to simulate the response of the casing in a half-space, whereas the surface potential approach is computationally better when multiple bodies are involved. Analyzing several configurations of the current source indicated that the casing response is influenced by four characteristic factors: conduction length, current source depth,casing depth, and casing length. 85 refs., 133 figs., 11 tabs.

  16. Use cases versus task descriptions

    DEFF Research Database (Denmark)

    Lauesen, Søren; Kuhail, Mohammad Amin

    2011-01-01

    Abstract. [Context and motivation] Use cases are widely used as a substantial part of requirements, also when little programming is expected (COTS-based systems). [Question/problem] Are use cases effective as requirements? To an-swer this question, we invited professionals and researchers...

  17. Mediastinitis after oesophagoscopy : a case report : case report

    African Journals Online (AJOL)

    Marinda

    of the mediastinal tissues and pleural cavities through digestive juices and bacteria that give rise to cellulitis and suppuration.3. We here report a case in which .... measures and surgical drainage of the retro-oesophageal space if suppuration has developed. Complete healing of the oesophagus may take as long as two ...

  18. Treatment phases in management of a comprehensive restorative case. A case report

    International Nuclear Information System (INIS)

    AlSamh, Duaa Abo; Endo, Cert End

    2008-01-01

    The aim of this case report was to emphasize the value of preforming patient's treatment plan into phases of treatment and encouraging colleagues to apply such phases in the clinical practice for the management of complex restorative cases. Traditional approach to treatment planning has certain merits. However, new treatment approach should improve oral health rather than react to presenting problems and therefore, dentists should aim to convert their irregular attendee to a regular attendee with treatment plan directed to enhance oral health, prevent disease, improve esthetic and free the patient from pain and discomfort. In this report, a complex restorative case of a 16-year-old female patient was managed for comprehensive dental therapy in the form of treatment plan which was divided into phases by way of a ''staircase'' approach with one clinical step being dependent on the previous step. The whole treatment was completed in three months and the results were satisfactory and patient became a highly motivated person with more self-confidence. (author)

  19. Investigation of Energy-Efficient Supermarket Display Cases

    Energy Technology Data Exchange (ETDEWEB)

    Walker, D.H.

    2005-01-21

    Supermarkets represent one of the largest energy-intensive building groups in the commercial sector, consuming 2 to 3 million kWh/yr per store (ES-1). Over half of this energy use is for the refrigeration of food display cases and storage coolers. Display cases are used throughout a supermarket for the merchandising of perishable food products. The cases are maintained at air temperatures ranging from -10 to 35 F, depending upon the type of product stored. The operating characteristics and energy requirements of the refrigeration system are directly related to the refrigeration load. The sources of the display case refrigeration load consist of: (1) Moist and warm air infiltration through the open front of the case--air curtains are employed to inhibit this infiltration, but some ambient air is entrained, which adds a substantial portion to the refrigeration load. (2) Heat conduction through case panels and walls. (3) Thermal radiation from the ambient to the product and display case interior. (4) Internal thermal loads--the use of lights, evaporator fans, periodic defrosts, and antisweat heaters adds to the refrigeration load of the display case as well as directly consuming electric energy. The impact of each of these elements on the refrigeration load is very dependent upon case type (Figure ES-1). For example, air infiltration is the most significant portion of the refrigeration load for open, multi-deck cases, while radiation is the largest part of the load for tub-type cases. The door anti-sweat heaters represent a major share of the refrigeration load for frozen food door reach-in cases. Figure ES-2 shows the distribution of display cases in a typical supermarket (ES-2). Open, multi-deck, medium temperature display cases typically comprise about half of the refrigerated fixtures in a store (ES-3). In addition, medium temperature fixtures and storage coolers account for roughly 70 to 75 percent of the total store refrigeration load with open, multi-deck cases

  20. Student-generated case reports.

    Science.gov (United States)

    Good, Christopher J

    2009-01-01

    When students create teaching materials, learning can be enhanced. Therefore, a project was designed based on the traditional clinical case report and the chiropractic technique and principles curriculum at the University of Bridgeport College of Chiropractic. The objectives were to increase mastery in a clinical topic, increase awareness of different patient presentations and management options, and enhance information technology skills. Following lectures about the components of a case report and neurological reflexes related to visceral comorbidities and subluxation and joint dysfunction, students created a case report based on a template provided by the instructor. A survey gathered student perspectives on the exercise. More than 70% of the surveyed students felt the project was at least moderately helpful in improving understanding of a case report, the condition investigated, their clinical reasoning, and the ability to integrate information. Most felt that they improved their understanding of neurological reflexes, use of the literature, and the practice of evidence-based care. The majority believed that they identified weakness in knowledge, improved self-learning skills, and increased confidence in managing patients. Most enjoyed it at least somewhat and 70% agreed that the project should be continued. Many believed that they were better prepared for national boards and had improved their writing skills.

  1. Associative visual agnosia: a case study.

    Science.gov (United States)

    Charnallet, A; Carbonnel, S; David, D; Moreaud, O

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

  2. Case report

    African Journals Online (AJOL)

    abp

    2017-10-17

    Oct 17, 2017 ... Scholar. 2. Riccardo Campi, Sergio Serni, Maria Rosaria Raspollini,. Agostino Tuccio, Giampaolo Siena, Marco Carini et al. Robot-. Assisted Laparoscopic Vesiculectomy for Large Seminal Vesicle. Cystadenoma: a case report and review of the literature. Clinical Genitourinary Cancer. 2015; 13(5): e369-.

  3. CASE REPORT

    African Journals Online (AJOL)

    NJSR

    cardiac failure, as in our patient, digitalis and radiography are considered before surgical excision. Occasional cases have involuted spontaneously, though a few have metastasized. 5 Other forms of treatment include corticosteroids, and hepatic artery ligation. 7 Malignant transformation has been reported after successful ...

  4. Case Report

    African Journals Online (AJOL)

    through a small clinically-undetectable inguinal hernia, and may require ... conservative approach may be adopted. Case report: An 80 ... gross bilateral scrotal swelling (without cough impulse) ... Tenckhoff catheter was inserted using the open surgical technique ... role of surgery in treating dialysate leaks presenting as.

  5. Case report

    African Journals Online (AJOL)

    abp

    2014-03-28

    Mar 28, 2014 ... Abstract. Cushing syndrome is a hormonal disorder caused by prolonged exposure of body tissue to cortisol. We report two cases of iatrogenic Cushing's syndrome in two Nigerian children following intranasal administration of aristobed-N (Betamethasone+Neomycin) given at a private hospital where.

  6. Case report

    African Journals Online (AJOL)

    abp

    2013-05-21

    May 21, 2013 ... Imperforate Hymen - a rare cause of acute abdominal pain and tenesmus: case report and review of .... did a ten year retrospective analysis of the data of 15 patients treated for ... Low back pain (38-40%) [4, 13, 14]. Occurs as ...

  7. Case report

    African Journals Online (AJOL)

    abp

    15 juin 2016 ... We report the case of a 17-year old admitted with diffuse bone pain, hypercalcemia and thrombopenia. Bone scan showed .... plus rares et ont été rapportée dans des observations isolées [13]. ... hypercalcemia in nude mice.

  8. Case competitions

    DEFF Research Database (Denmark)

    Schjoldager, Anne Gram

    2009-01-01

    The paper presents and discusses a teaching project with case competitions for MA students of specialised translation at the Aarhus School of Business, Aarhus University. Drawing on a series of online questionnaires, the paper ascertains how the project was evaluated by the participating students...

  9. Case series

    African Journals Online (AJOL)

    abp

    2015-01-19

    Jan 19, 2015 ... Child sexual abuse: report of 311 cases with review of literature. Laila Essabar1, Abdenbi Khalqallah2, Badr Sououd Benjelloun Dakhama1,&. 1Department of Paediatric Medical Emergencies of Rabat children's Hospital, Morocco, 2Laboratory of Clinical and Pathological Psychology,. Mohammed V ...

  10. CASE STUDY

    African Journals Online (AJOL)

    2010-09-01

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

  11. [Lobular idiopathic granulomatos mastitis. About 10 cases].

    Science.gov (United States)

    Hmissa, Sihem; Sahraoui, Wassila; Missaoui, Nabiha; Stita, Wided; Mokni, Moncef; Yacoubi, Mohamed T; Khairi, Hedi; Korbi, Sadok

    2006-06-01

    Our retrospective study was performed on 10 cases of granulomatous mastitis registered in Obstetric Gynaecology Department and Pathology Department of CHU F. Hached, Sousse, during 8 years period. The mean age was 36.4 years (range 32-59). Among these 10 cases. 8 were observed in reproductive-age women and 2 were noted in menopausal women. Clinical findings showed unilateral breast nodule associated with inflammatory signs in 4 cases, mammelonary retraction in 2 cases and serous or sero-purulent mamelonnary flow in 4 cases. Mamnmographic examination suggested a malignant tumor in 5 patients. In all cases, the diagnosis is made by histopathology. Surgical treatment consisted in wide excision with drainage or radical mastectomy, eventually with combination with antibiotic therapy and non steroid anti-inflammatory drugs. Prognostic features showed a good cicatrization in 4 cases, local recurrence and cutaneous fistulization in one patient. Granulomatous mastitis aetiology is still unclear, auto-immune aetio-pathogenesis appears more interesting and should be clarified.

  12. Sustainability in the Business Case

    NARCIS (Netherlands)

    Ron Schipper; Gilbert Gilbert Silvius

    2012-01-01

    This paper explores the integration of indicators that reflect the concepts of sustainability into business cases and business case evaluation methods. It is based on the observations that sustainability is one of the most important challenges of our time and that sustainable development requires

  13. [A case of lingual agenesis].

    Science.gov (United States)

    Carinci, F; Felisatti, P; Curioni, C

    1996-01-01

    Lingual agenesis is a rare anomaly caused by failed morphogenesis of the lateral lingual swellings during embriogenesis. Most reported cases have been part of oromandibular limb hypogenesis syndrome (OLHS). A case of lingual agenesis associated with micrognathia and alteration of the hands is reported.

  14. Task descriptions versus use cases

    DEFF Research Database (Denmark)

    Lauesen, Søren; Kuhail, Mohammad Amin

    2011-01-01

    Use cases are widely used as a substantial part of requirements, also when little programming is expected (COTS-based systems, Commercial-Off-The-Shelf). Are use cases effective as requirements? To answer this question, we invited professionals and researchers to specify requirements for the same...

  15. A case-case study of mobile phone use and acoustic neuroma risk in Japan.

    Science.gov (United States)

    Sato, Yasuto; Akiba, Suminori; Kubo, Osami; Yamaguchi, Naohito

    2011-02-01

    Results of case-control studies of mobile phone use and acoustic neuroma have been inconsistent. We conducted a case-case study of mobile phone use and acoustic neuroma using a self-administered postal questionnaire. A total of 1589 cases identified in 22 hospitals throughout Japan were invited to participate, and 787 cases (51%) actually participated. Associations between laterality of mobile phone use prior to the reference dates (1 and 5 years before diagnosis) and tumor location were analyzed. The overall risk ratio was 1.08 (95% confidence interval (CI), 0.93-1.28) for regular mobile phone use until 1 year before diagnosis and 1.14 (95% CI, 0.96-1.40) for regular mobile phone use until 5 years before diagnosis. A significantly increased risk was identified for mobile phone use for >20 min/day on average, with risk ratios of 2.74 at 1 year before diagnosis, and 3.08 at 5 years before diagnosis. Cases with ipsilateral combination of tumor location and more frequently used ear were found to have tumors with smaller diameters, suggesting an effect of detection bias. Furthermore, analysis of the distribution of left and right tumors suggested an effect of tumor-side-related recall bias for recall of mobile phone use at 5 years before diagnosis. The increased risk identified for mobile phone users with average call duration >20 min/day should be interpreted with caution, taking into account the possibilities of detection and recall biases. However, we could not conclude that the increased risk was entirely explicable by these biases, leaving open the possibility that mobile phone use increased the risk of acoustic neuroma. Copyright © 2010 Wiley-Liss, Inc.

  16. Breast nocardiosis: case report

    International Nuclear Information System (INIS)

    Kim, Min Ju; Kim, Sun Mi; Park, Jeong Mi

    2003-01-01

    Nocardiosis is an opportunistic infection occurring in immunocompromised patients. Worldwidely, about four cases of nocardiosis of the breast have been previously reported, but none of these were in Korea. We describe a case of breast nocardiosis associated with pulmonary infection in a patient with Cushing's disease. In our patient, multiple, well-defined, conglomerated, tubular-shaped, isodense mass was revealed at mammography, and an irregular-shaped, ill-defined, heterogeneous echoic mass with movable debris at ultrasonography

  17. Periosteal osteosarcoma: A case report

    Directory of Open Access Journals (Sweden)

    Errol U. Hutagalung

    2003-09-01

    Full Text Available Periosteal osteosarcoma is a rare type of malignant bone neoplasm, with predominantly cartilaginous component and arising on the bone surface. Reports of the case in the literature were rare. Last case was reported by Mayo Clinic in 1999. We report a case of periosteal osteosarcoma in a 17-year-old male, who was treated surgically with a limb salvage procedure, neoadjuvant and adjuvant chemotherapy were also given to the patient. There was no local recurrence and lung metastases up to 14 months after surgery. (Med J Indones 2003; 12: 166-70 Keywords: osteosarcoma, periosteal osteosarcoma, limb salvage

  18. Renal myxoma: a case report

    Directory of Open Access Journals (Sweden)

    Carlos Henrique C Souza

    2015-04-01

    Full Text Available Myxomas are rare tumors that can appear in many anatomical locations. There are only 14 cases of renal involvement documented in the literature. This article reports a case of renal myxoma in an elderly woman with recurrent cystitis. After five years of follow-up, the computed tomography (CT revealed a large solid tumor mass in the left kidney. Tumor resection was performed preserving the affected kidney with histopathological diagnosis of renal myxoma. The objective of this study is to report a rare case of renal myxoma, emphasizing the importance of the differential diagnosis from other benign and malignant mesenchymal tumors.

  19. Hearing impairment associated with oral terbinafine use : a case series and case/non-case analysis in the Netherlands Pharmacovigilance Centre Lareb database and VigiBase™

    NARCIS (Netherlands)

    Scholl, Joep H G; van Puijenbroek, Eugene P

    2012-01-01

    BACKGROUND: The Netherlands Pharmacovigilance Centre Lareb received reports of six cases of hearing impairment in association with oral terbinafine use. This study describes these cases and provides support for this association from the Lareb database for spontaneous adverse drug reaction (ADR)

  20. Trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of extrapulmonary tuberculosis cases in referral hospitals in northern India

    Directory of Open Access Journals (Sweden)

    A K Maurya

    2012-01-01

    Full Text Available Background: Drug-resistant tuberculosis is one of major current challenges to global public health. The transmission of resistant strains is increasing as a burden of multidrug-resistant tuberculosis (MDR-TB patients in extra pulmonary tuberculosis (EPTB cases in India. Aim and Objectives: The aim was to study trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of EPTB in referral hospitals in northern India. Study Design and Setting: A prospectively observational study and referral medical institutions in northern India. Materials and Methods: All EPTB specimens were processed for Ziehl Neelsen staining, BACTEC culture and BACTEC NAP test for Mycobacterium tuberculosis complex. All M. tuberculosis complex isolates were performed for radiometric-based drug susceptibility pattern against streptomycin, isoniazid, rifampicin and ethambutol using the 1% proportion method. Results: We found that 165/756 (20.5% isolates were identified as M. tuberculosis complex by the NAP test. We observed that 39.9% were resistant to first-line antitubercular drugs. The resistance rate was higher in previously treated patients: H (30.3%, R (16.3%, E (15.7% and S (16.3%. MDR-TB was observed in 13.4%, but, in new cases, this was 11.4% and 19.1% of the previously treated patients (P<0.05. Conclusion: MDR-TB is gradually increased in EPTB cases and predominant resistance to previous treated cases of EPTB. The molecular drug sensitivity test (DST method can be an early decision for chemotherapy in MDR-TB patients. The International Standards of TB Care need to be used by the RNTCP and professional medical associations as a tool to improve TB care in the country.