WorldWideScience

Sample records for diagnosing nipple discharge

  1. Nipple Discharge

    Science.gov (United States)

    ... any unexpected nipple discharge evaluated by a doctor. Nipple discharge in men under any circumstances could be a problem and needs further evaluation. One or both breasts may produce a nipple discharge, either spontaneously or when you squeeze your ...

  2. NIPPLE DISCHARGE

    Directory of Open Access Journals (Sweden)

    T. N. Bukharova

    2008-01-01

    Full Text Available According to the data available in the literature, as high as 50% of women have benign breast tumors frequently accompanied by nip- ple discharge. Nipple discharge may be serous, bloody, purulent, and colostric. The most common causes are breast abscess, injury, drugs, prolactinoma, intraductal pappiloma, ductal ectasia, intraductal cancer (not more than 10%.

  3. Galactography in non-lactating nipple discharge

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Myung Ok; Lee, Joo Mi; Moon, Jang Ho; Kang, Ik Won; Chung, Soo Young; Bae, Sang Hoon; Park, Soo Sung [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1988-08-15

    Nipple discharge in non-lactating breast is classified as 2 groups. The first group is stagnation discharge which is determined by an apocrino-like exfoliation and stagnation within the ductal system. The second group is hyperplastic or neoplastic group. The secretory breast disease combined with nipple discharge can not be diagnosed by simple X-ray mammography of ultrasonography. For differential diagnosis of secretory breast disease and for localization of lesions, the galactography is necessary. We analysed 49 cases of galactography is non-lactating breat and obtained following results. 1. The most common cause of discharge was duct ectasis (39%) in stagnation discharge group and papilloma (23%) in hyperplastic discharge group. 2. Hyperplastic discharge group occurred most frequently in 5th decade of age and was discovered more frequently in fatty parenchymal pattern on simple mammography. 3. The most frequent type of nipple discharge was cloudy-milky type in stagnation group and bloody nature in hyperplastic group. 4. The most common cause of bloody discharge was papilloma (58%). 5. The bloody nipple discharge among 56 cases of breast cancer during 4 years occurred only in 5 cases (9%)

  4. Leiomyoma of the nipple diagnosed by MRI

    International Nuclear Information System (INIS)

    Cho, Hyung JI; Kim, Sung Hun; Kang, Bong Joo; Kim, Hanna; Song, Byung Joo; Lee, Ah Won

    2012-01-01

    Leiomyoma of the nipple is a rare, benign, non-epithelial tumor that is thought to arise from smooth muscle fibers in the subareolar tissue of the breast. We report an unusual case of leiomyoma of the nipple in a 32-year-old woman in whom the diagnosis was made by ultrasound-guided core needle biopsy. She came to our hospital complaining of a recently enlarged nipple with discharge and erosion in the region of the left nipple-areolar complex. This mass was evaluated by mammography, ultrasonography, and magnetic resonance imaging (MRI). To the best of our knowledge, this is the first case of a leiomyoma of the nipple examined by MRI. MRI showed an oval mass with circumscribed margins that appeared as an intermediate signal intensity on both T1- and T2-weighted images. A dynamic MRI study showed a rim-enhancing oval mass with delayed persistent enhancement. Ultrasound-guided core needle biopsy revealed spindle cell proliferation consistent with leiomyoma of the nipple

  5. Bloody nipple discharge in a 7-month-old boy.

    LENUS (Irish Health Repository)

    Zaid, Ahmed

    2011-10-01

    Isolated bloody nipple discharge is rare in infancy and is usually idiopathic. Discharge commonly resolves spontaneously, and ultrasonography is a useful diagnostic technique to detect the cause of discharge. The authors report a 7-month-old boy who presented with unilateral spontaneous bloody nipple discharge for 1 month without signs of infection or mass.

  6. Ultrasonographic evaluation of women with pathologic nipple discharge

    International Nuclear Information System (INIS)

    Yoon, Jung Hyun; Yoon, Hae Sung; Kim, Eun Kyung; Moon, Hee Jung; Park, Young Jean Vivian; Kim, Min Jung

    2017-01-01

    Nipple discharge is a common symptom that is alarming for the patient since it can be a presenting symptom of breast cancer. Breast imaging is used to examine women with pathologic nipple discharge in order to detect any lesions that may be present and to assist in the differential diagnosis. The modalities of breast imaging include mammography, breast ultrasonography (US), and magnetic resonance imaging. Breast US is currently considered to be useful for the visualization of ductal structures and intraductal lesions that cause nipple discharge. In this review, we discuss US techniques that assist in the clear visualization of ductal structures and intraductal lesions in patients with nipple discharge. Controversy remains regarding the evaluation and management of patients with nipple discharge, and we summarize the results available in the currently published literature

  7. Ultrasonographic evaluation of women with pathologic nipple discharge

    Directory of Open Access Journals (Sweden)

    Jung Hyun Yoon

    2017-10-01

    Full Text Available Nipple discharge is a common symptom that is alarming for the patient since it can be a presenting symptom of breast cancer. Breast imaging is used to examine women with pathologic nipple discharge in order to detect any lesions that may be present and to assist in the differential diagnosis. The modalities of breast imaging include mammography, breast ultrasonography (US, and magnetic resonance imaging. Breast US is currently considered to be useful for the visualization of ductal structures and intraductal lesions that cause nipple discharge. In this review, we discuss US techniques that assist in the clear visualization of ductal structures and intraductal lesions in patients with nipple discharge. Controversy remains regarding the evaluation and management of patients with nipple discharge, and we summarize the results available in the currently published literature.

  8. Ultrasonographic evaluation of women with pathologic nipple discharge

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jung Hyun; Yoon, Hae Sung; Kim, Eun Kyung; Moon, Hee Jung; Park, Young Jean Vivian; Kim, Min Jung [Dept. of Radiology and Research Institute of Radiologic Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2017-10-15

    Nipple discharge is a common symptom that is alarming for the patient since it can be a presenting symptom of breast cancer. Breast imaging is used to examine women with pathologic nipple discharge in order to detect any lesions that may be present and to assist in the differential diagnosis. The modalities of breast imaging include mammography, breast ultrasonography (US), and magnetic resonance imaging. Breast US is currently considered to be useful for the visualization of ductal structures and intraductal lesions that cause nipple discharge. In this review, we discuss US techniques that assist in the clear visualization of ductal structures and intraductal lesions in patients with nipple discharge. Controversy remains regarding the evaluation and management of patients with nipple discharge, and we summarize the results available in the currently published literature.

  9. Milk Flow Rates from bottle nipples used after hospital discharge.

    Science.gov (United States)

    Pados, Britt Frisk; Park, Jinhee; Thoyre, Suzanne M; Estrem, Hayley; Nix, W Brant

    To test the milk flow rates and variability in flow rates of bottle nipples used after hospital discharge. Twenty-six nipple types that represented 15 common brands as well as variety in price per nipple and store location sold (e.g., Babies R' Us, Walmart, Dollar Store) were chosen for testing. Ten of each nipple type (n = 260 total) were tested by measuring the amount of infant formula expressed in 1 minute using a breast pump. Mean milk flow rate (mL/min) and coefficient of variation (CV) were calculated. Flow rates of nipples within brand were compared statistically. Milk flow rates varied from 1.68 mL/min for the Avent Natural Newborn Flow to 85.34 mL/min for the Dr. Brown's Standard Y-cut. Variability between nipple types also varied widely, from .03 for the Dr. Brown's Standard Level 3 to .37 for MAM Nipple 1 Slow Flow. The extreme range of milk flow rates found may be significant for medically fragile infants being discharged home who are continuing to develop oral feeding skills. The name of the nipple does not provide clear information about the flow rate to guide parents in decision making. Variability in flow rates within nipples of the same type may complicate oral feeding for the medically fragile infant who may not be able to adapt easily to change in flow rates. Both flow rate and variability should be considered when guiding parents to a nipple choice.

  10. [Management of breast nipple discharge: Recommendations].

    Science.gov (United States)

    Ouldamer, L; Kellal, I; Legendre, G; Ngô, C; Chopier, J; Body, G

    2015-12-01

    To investigate diagnostic value of imaging procedures and management strategies of the patients with nipple discharge (ND) to establish management recommendations. Bibliographical search in French and English languages by consultation of PubMed, Cochrane and Embase databases. Although, all ND require an systematic evaluation guided by clinical data, bloody ND could be a predictor of breast cancer risk among different colors of discharge particularly in patients of more than 50 years (LE2). The mammography and breast ultrasography are the imaging procedures to realize in first intention (grade C) but they turn out useful only when they detect radiological abnormalities (LE4). Galactography has only a localizing value of possible ductal abnormalities (when standard imaging procedures is not contributive) (LE4). Thus, in the diagnostic investigation of a suspicious ND, galactography it is not recommended in standard practice (grade C). The breast Magnetic Resonance Imaging (MRI) is recommended when breast standard imaging procedures are not contributive (grade C). The ND cytology is useful only if it is positive (i.e. reveal cancer cells). There is no proof on the diagnostic performance of the cytological analysis of the ND to allow a recommendation on its realization or not. In front of a suspicious ND, when breast-imaging procedures reveals an associated radiological lesion, an adapted percutaneous biopsy is recommended by percutaneous way (grade C). Vacuum-assisted breast biopsies is a diagnostic tool but can also be therapeutic allowing to avoid surgery in case of benign lesion but current literature data do not allow recommendations on the therapeutic aspect of vacuum-assisted breast biopsy (LE4). In the absence of associated radiological signal, and in case of reproducible bloody persistent ND, a pyramidectomy is recommended (grade C). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. The impact of malignant nipple discharge cytology (NDc in surgical management of breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Isabella Castellano

    Full Text Available The role of nipple discharge cytology (NDc in the surgical management of breast cancer patients is unclear. We aimed: (i to evaluate the effect of malignant NDc on the surgical approach to the nipple-areola complex, and (ii to verify the association between malignant NDc and nipple malignancy.We retrospectively analyzed a case series of 139 patients with NDc who underwent breast surgery. The clinical and histological findings, types of surgery with emphasis on nipple-areola complex amputation, immunohistochemical phenotypes of the carcinomas and measurements of the tumor-nipple distance were recorded. Additionally, in patients who showed HER2-positive lesions on definitive surgery, we evaluated the HER2 immunocytochemistry of the NDc smears.Thirty-two malignant and 107 benign/borderline NDc diagnoses were identified. All 32 malignant-NDc cases were histologically confirmed as malignant. Thirty borderline/benign-NDc cases were histologically diagnosed as malignant (sensitivity 58%. The majority of the patients with malignant NDc were treated with nipple-areola complex amputations in both the mastectomy and conservative surgery groups (P<0.001, χ251.77. Nipple involvement was strongly associated with HER2-positive ductal carcinoma in-situ (P<0.001, χ211.98. HER2 immunocytochemistry on the NDc revealed a 100% correlation with the immunocytochemistry performed on the surgical tissues.Malignant NDc influenced surgical management. The association of malignant NDc with nipple involvement is highly related to ductal carcinoma in-situ with HER2 overexpression. In case of HER2 positive NDc, nipple-areola complex involvement is more likely than in HER2 negative cases.

  12. Value of mammography and breast ultrasound in male patients with nipple discharge.

    Science.gov (United States)

    Muñoz Carrasco, Rafaela; Álvarez Benito, Marina; Rivin del Campo, Eleonor

    2013-03-01

    To assess the contribution of mammography and ultrasound in men with nipple discharge. All men with nipple discharge who underwent mammography and/or ultrasound between 1993 and 2011 in our hospital were retrospectively evaluated. Radiological findings were classified according to BI-RADS lexicon. The final diagnosis was made based on histopathological results or clinical-radiological follow-up. The diagnostic performance of physical examination, mammography and ultrasound was calculated and compared. 26 men with 21 mammograms and 19 ultrasounds were reviewed. The final diagnoses were: 6 carcinomas (23.1%), 10 gynaecomastias, 2 pseudogynaecomastias and 8 normal breast tissues. Mammograms and ultrasounds performed on all five patients with infiltrating carcinoma showed a mass (categories 4 and 5). In all these patients except one, a breast mass was also noted and the physical examination was positive or suspected malignancy. In the patient with carcinoma in situ, the only conspicuous clinical sign was bloody nipple discharge and the mammography showed calcifications (category 4) that were not visible on ultrasound. Radiological findings of all patients without malignancy were classified as categories 1 and 2. The diagnostic performance of physical examination was lower than mammography and ultrasound (P>0.05). Mammography was more sensitive than ultrasound (100% vs. 83.3%). Both techniques showed the same specificity (100%). Men with nipple discharge have a high incidence of breast carcinoma. Nipple discharge may be the only clinical sign of carcinoma in situ. Mammography and ultrasound are useful in the evaluation of men with nipple discharge, diagnosing carcinoma in initial stages, avoiding unnecessary biopsies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Galactography: the diagnostic procedure of choice for nipple discharge

    International Nuclear Information System (INIS)

    Tabar, L.; Dean, P.B.; Pentek, Z.

    1983-01-01

    Galactogrpahy was performed in 204 women with a nipple discharge and the secretion confirmed histopathologically. All 116 intraductal tumors (papilloma, papillomatosis, carcinoma), which were associated with a serous or bloody discharge, were detected preoperatively. A palpable mass had little diagnostic significance, and exfoliative cytology was positive in only 11% (2/18) of the patients with carcinoma. The authors recommend that all patients with a spontaneous bloody or serous discharge from a single lactiferous orifice undergo galactography in addition to physical, cytological, and mammographic examination. Intraductal injection of methylene blue dye will demonstrate the affected duct system to the surgeon and can often make surgery less radical or even unnecessary

  14. Bloody nipple discharge (BND) in an 8 months old girl and a 9 months old male--rational diagnostic approach.

    Science.gov (United States)

    Harmsen, S; Mayatepek, E; Klee, D; Meissner, T

    2010-03-01

    Bloody nipple discharge in adults is, in men as well as in women, often a symptom of an underlying malignant disease. In respect of this, multiple invasive and mutilating diagnostic procedures have been performed in infants and older children. Apart from individual cases in older and pubertal children, in childhood benign conditions are most common and can be diagnosed by non-invasive diagnostic procedures. Here we discuss a rational diagnostic approach on the basis of 2 patients with bloody nipple discharge at the age of 8 and 9 months which resolved spontaneously without treatment after 3 and 6 months, respectively. (c) Georg Thieme Verlag KG Stuttgart-New York.

  15. Male ductal carcinoma in situ presenting as bloody nipple discharge: a case report and literature review.

    Science.gov (United States)

    Simmons, Rache M

    2002-01-01

    Male breast carcinoma accounts for 1% of all diagnosed breast carcinoma. Pure ductal carcinoma in situ in men is extremely rare. Unfortunately, male breast cancer is often diagnosed at a late stage because of the minimal awareness of presenting symptoms by the patient and sometimes by the health care provider. Because of this late presentation, the overall prognosis is less favorable. This case is presented to emphasize the importance of recognizing bloody nipple discharge as a clinical sign of male ductal carcinoma in situ and an opportunity for early diagnosis.

  16. Diagnosis of a Nonpalpable Intraductal Papilloma without Radiological Abnormality by Nipple Discharge Smear Examination: A Case Report

    Directory of Open Access Journals (Sweden)

    Anshul Singh

    2014-01-01

    Full Text Available Nipple discharge is the third most common breast complaint after breast pain and breast mass, most commonly associated with endocrine alterations and/or medications, pregnancy, lactation, post lactation, fibrocystic disease, intraductal papilloma, duct ectasia, nipple adenoma, infection, chronic mastitis, subareolar abscess, and least frequently, breast carcinoma. Cytological examination of nipple discharge (ND is a noninvasive method of diagnosing the underlying breast pathology. We report a 46 year old female, who presented with pain and blood-mixed ND from the right breast with an impalpable mass. Cytological examination of the discharge was done and diagnosis of papillary neoplasm with degeneration, metaplasia, and atypia was given, which was further confirmed on histology and positive IHC for HMWCK and p63. Final diagnosis was intraductal papilloma of the lactiferous duct with squamous metaplasia and infarction. Differentiating benign papilloma from a carcinoma is challenging to the cytopathologist and requires clinicopathological correlation and a good knowledge of cytology.

  17. Values of contrast galactography in nonlactating nipple discharge in Korean women

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ki Keun; Park, Yong Hyun; Ji, Hoon; Park, Chang Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1988-10-15

    Nipple discharge is a relatively frequent initial symptom of a pathologic lesion in the nonlactating breast which brings the patient to the physician for treatment. Eventhough only stressful significance of a sanguineous discharge, all type of nipple discharge will indicate that abnormal nipple discharge is a symptom of a pathologic change in the ductal and secretery susrem of the breast, and galactogram often offers information to etiology. Galactography using water soluble contrast media is a valuable procedure to evaluate women with nonlactational nipple discharge or bleeding which are usually due to benign diseases such as intraductal papilloma, papillomatosis, secretory disease or malignant lesions. Contrast galactography can often accomplish such localization and sometimes can suggest or confirm the nature of the pathologic process. Authors have experienced 5077 cases of mammograms, and among them, 195 cases with nipple discharge have been at Youndong Severance Hospital. Yonsei University since October 1, 1983 through June 10, 1988. The results were: 1. Incidence of non lactating nipple discharge was 3.9% among 5077 cases. 2. Most frequent histopathologic disease among surgically confirmed 100 cases was papilloma (35%), which was followed by papillomatosis (28%), fibrocystic disease (14%) and then breat carcinoma (13%). 3. Age distribution of patient of nonlactating nipple discharge showed no differences in comparing to the patients with the same histopathologic disease without nipple discharge. 4. Bloody nipple discharge is the commonest finding (61%) which was followed by serous (22%), milkish (8%), and then seroanguinous (5%) nipple discharge, in analyzing relationship between histopathologic diagnosis and nipple discharge, papilloma and papillomatosis had bloody nipple discharge (69%, 57%), frequently and serous nipple discharge (26%, 25%). Breat cancer had mostly bloody nipple discharge (85%), in contrast to the fibrocystic disease which showed 50

  18. Values of contrast galactography in nonlactating nipple discharge in Korean women

    International Nuclear Information System (INIS)

    Oh, Ki Keun; Park, Yong Hyun; Ji, Hoon; Park, Chang Yun

    1988-01-01

    Nipple discharge is a relatively frequent initial symptom of a pathologic lesion in the nonlactating breast which brings the patient to the physician for treatment. Eventhough only stressful significance of a sanguineous discharge, all type of nipple discharge will indicate that abnormal nipple discharge is a symptom of a pathologic change in the ductal and secretery susrem of the breast, and galactogram often offers information to etiology. Galactography using water soluble contrast media is a valuable procedure to evaluate women with nonlactational nipple discharge or bleeding which are usually due to benign diseases such as intraductal papilloma, papillomatosis, secretory disease or malignant lesions. Contrast galactography can often accomplish such localization and sometimes can suggest or confirm the nature of the pathologic process. Authors have experienced 5077 cases of mammograms, and among them, 195 cases with nipple discharge have been at Youndong Severance Hospital. Yonsei University since October 1, 1983 through June 10, 1988. The results were: 1. Incidence of non lactating nipple discharge was 3.9% among 5077 cases. 2. Most frequent histopathologic disease among surgically confirmed 100 cases was papilloma (35%), which was followed by papillomatosis (28%), fibrocystic disease (14%) and then breat carcinoma (13%). 3. Age distribution of patient of nonlactating nipple discharge showed no differences in comparing to the patients with the same histopathologic disease without nipple discharge. 4. Bloody nipple discharge is the commonest finding (61%) which was followed by serous (22%), milkish (8%), and then seroanguinous (5%) nipple discharge, in analyzing relationship between histopathologic diagnosis and nipple discharge, papilloma and papillomatosis had bloody nipple discharge (69%, 57%), frequently and serous nipple discharge (26%, 25%). Breat cancer had mostly bloody nipple discharge (85%), in contrast to the fibrocystic disease which showed 50

  19. Indicators of breast cancer in patients undergoing microdochectomy for a pathological nipple discharge in a middle-income country.

    Science.gov (United States)

    Lesetedi, Chiapo; Rayne, Sarah; Kruger, Deirdre; Benn, Carol-Ann

    2017-12-01

    The management of a pathological nipple discharge often involves surgery for the exclusion of a malignant etiology. This study aimed to determine the prevalence of cancer in patients who had microdochectomy for pathological nipple discharge in a population in South Africa and to evaluate patients' demographics and clinical characteristics as indicators of underlying cancer and make recommendations for their management in resource-limited settings. Clinical, radiological, and histological data from 153 patients who underwent a microdochectomy for a pathological nipple discharge at two South African breast clinics was collected. Invasive or in situ cancer was found in 12 patients (7.84%), and in all patients, cancer was associated with a bloody nipple discharge. Bloody discharge had a sensitivity of 100% in indicating cancer, specificity of 55.32%, positive predictive value of 16%, and negative predictive value of 100%. Patients with breast cancer were also more likely to be aged 55 y or older (P = 0.04). Preoperative mammogram and ultrasound were poor in detecting cancer (0/12). In our population, a bloody discharge in women aged 55 years or older should mandate a microdochectomy, with selective surgery for younger women and those with nonbloody discharges. Thorough clinical examination to determine the true color and nature of the discharge is vital in the initial assessment of these patients. Preoperative radiology is not helpful in determining the presence of cancer (in an isolated pathological nipple discharge), and microdochectomy still remains the gold standard in diagnosing cancer in these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Nipple Discharge: An Early Warning Sign of Breast Cancer

    Science.gov (United States)

    Parthasarathy, Veda; Rathnam, Usharani

    2012-01-01

    Nipple discharge (ND) can be the earliest presenting symptom of breast cancer. We hereby present two cases of breast cancer with no palpable mass manifesting as isolated ND, which was whitish in color. In both cases, cytology of the discharge revealed highly pleomorphic cells indicating a high grade malignancy. Mammography showed diffuse, extensive microcalcifications. Simple mastectomy with axillary clearance was done. Histology in both cases revealed diffusely spreading intraductal carcinoma, with focus of microinvasion in one case. ND if scanty or not blood stained is often ignored by the patients and at times, the clinicians. This article highlights that ND can be an early warning sign of intraductal carcinomas that are non-invasive in early stage. Irrespective of the color or nature of the discharge, unilateral ND needs to be evaluated. Proper clinical assessment, cytological evaluation of the ND, and mammography ought to be performed in all such cases. Considering the low level of awareness in women regarding the warning signs of breast cancer, the current focus is to create “breast awareness.” Women should be sensitized to recognize any unusual changes in their breasts and report to their health care providers at the earliest. PMID:23189234

  1. 3.0 Tesla breast magnetic resonance imaging in patients with nipple discharge when mammography and ultrasound fail.

    Science.gov (United States)

    Lubina, Nóra; Schedelbeck, Ulla; Roth, Anne; Weng, Andreas Max; Geissinger, Eva; Hönig, Arnd; Hahn, Dietbert; Bley, Thorsten Alexander

    2015-05-01

    To compare 3.0 Tesla breast magnetic resonance imaging (MRI) with galactography for detection of benign and malignant causes of nipple discharge in patients with negative mammography and ultrasound. We prospectively evaluated 56 breasts of 50 consecutive patients with nipple discharge who had inconspicuous mammography and ultrasound, using 3.0 Tesla breast MRI with a dedicated 16-channel breast coil, and then compared the results with galactography. Histopathological diagnoses and follow-ups were used as reference standard. Lesion size estimated on MRI was compared with the size at histopathology. Sensitivity and specificity of MRI vs. galactography for detecting pathologic findings were 95.7 % vs. 85.7 % and 69.7 % vs. 33.3 %, respectively. For the supposed concrete pathology based on MRI findings, the specificity was 67.6 % and the sensitivity 77.3 % (PPV 60.7 %, NPV 82.1 %). Eight malignant lesions were detected (14.8 %). The estimated size at breast MRI showed excellent correlation with the size at histopathology (Pearson's correlation coefficient 0.95, p 3.0 Tesla is an accurate imaging test and can replace galactography in the workup of nipple discharge in patients with inconspicuous mammography and ultrasound. • Breast MRI is an excellent diagnostic tool for patients with nipple discharge. • MRI of the breast reveals malignant lesions despite inconspicuous mammography and ultrasound. • MRI of the breast has greater sensitivity and specificity than galactography. • Excellent correlation of lesion size measured at MRI and histopathology was found.

  2. 3.0 Tesla breast magnetic resonance imaging in patients with nipple discharge when mammography and ultrasound fail

    Energy Technology Data Exchange (ETDEWEB)

    Lubina, Nora; Schedelbeck, Ulla; Weng, Andreas Max; Hahn, Dietbert; Bley, Thorsten Alexander [University of Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Roth, Anne [Centre of Radiology Wuerzburg, Wuerzburg (Germany); Geissinger, Eva [University of Wuerzburg, Institute of Pathology, Wuerzburg (Germany); Hoenig, Arnd [Catholic Clinical Centre Mainz, Department of Obstetrics and Gynecology, Mainz (Germany)

    2015-05-01

    To compare 3.0 Tesla breast magnetic resonance imaging (MRI) with galactography for detection of benign and malignant causes of nipple discharge in patients with negative mammography and ultrasound. We prospectively evaluated 56 breasts of 50 consecutive patients with nipple discharge who had inconspicuous mammography and ultrasound, using 3.0 Tesla breast MRI with a dedicated 16-channel breast coil, and then compared the results with galactography. Histopathological diagnoses and follow-ups were used as reference standard. Lesion size estimated on MRI was compared with the size at histopathology. Sensitivity and specificity of MRI vs. galactography for detecting pathologic findings were 95.7 % vs. 85.7 % and 69.7 % vs. 33.3 %, respectively. For the supposed concrete pathology based on MRI findings, the specificity was 67.6 % and the sensitivity 77.3 % (PPV 60.7 %, NPV 82.1 %). Eight malignant lesions were detected (14.8 %). The estimated size at breast MRI showed excellent correlation with the size at histopathology (Pearson's correlation coefficient 0.95, p < 0.0001). MRI of the breast at 3.0 Tesla is an accurate imaging test and can replace galactography in the workup of nipple discharge in patients with inconspicuous mammography and ultrasound. (orig.)

  3. Breast conserving therapy in breast cancer patients presenting with nipple discharge

    International Nuclear Information System (INIS)

    Obedian, Edward; Haffty, Bruce G.

    2000-01-01

    Purpose: To retrospectively review the outcome of conservatively treated breast cancer patients who present with nipple discharge at initial diagnosis. Methods and Materials: The charts of 1097 patients undergoing conservative surgery and radiation therapy between January 1970 and December 1990 were reviewed. All patient data, including clinical, pathologic, treatment, and outcome variables were entered onto a computerized database. For the current study, specific attention was directed to the initial presenting symptoms and patients were divided into two groups: those presenting at initial diagnosis with nipple discharge (D/C-YES, n = 17), and those presenting without nipple discharge (D/C-NO, n = 1080). Results: As of August 1998, with a median follow-up of 12 years, the 10-year actuarial survival, distant metastasis-free survival, and breast relapse-free survival rates for the overall population were 73%, 78%, and 83%, respectively. Although the D/C-YES and D/C-NO groups were well balanced with respect to the majority of clinical factors, the D/C-YES patients had a higher percentage of DCIS histology (7.3% vs 1.2%, p < 0.01), were less likely to undergo reexcision (12% vs 35%), and were more frequently under age 40 (35% vs 12%) than the D/C-NO patients. Over the time span of this study, status of the final surgical margin was indeterminate in the majority of cases. Local relapses occurred in 6 of the 17 patients in the D/C-YES group, resulting in a 10-year actuarial breast relapse-free survival rate of 50%, which was significantly lower than the 10-year breast relapse-free survival rate of 86% in the D/C-NO population. Among the patients presenting with nipple discharge, those with sacrifice of the nipple areolar complex had a lower local relapse rate than those patients who had conservation of the nipple areolar complex (20% vs 42%), although this difference did not reach statistical significance. Conclusions: Although patients presenting with nipple discharge

  4. Bloody Nipple Discharge in an Adolescent Girl: Unusual Presentation of Juvenile Fibroadenoma

    Directory of Open Access Journals (Sweden)

    Hsien Liu

    2010-06-01

    Full Text Available Fibroadenoma accounts for 50–60% of all breast mass lesions in adolescents. It usually presents as a unilateral palpable breast mass. In contrast, bloody nipple discharge rarely occurs in childhood. We report the case of a 12-year-old pubertal girl who presented with a solitary breast mass and bloody nipple discharge. Physical examination and ultrasound showed a right breast subareolar homogenous mass, about 2.5 cm in diameter, near the lactiferous duct. Histologic diagnosis of the mass revealed a juvenile fibroadenoma with infarction and hemorrhage. The unusual clinical presentation and possible etiology in this patient is described, and the proper management of bloody nipple discharge in pediatric patients is discussed in association with a literature review.

  5. Cytomorphology of nipple discharge and fine needle aspiration of duct papilloma

    Directory of Open Access Journals (Sweden)

    H B Bannur

    2012-01-01

    Full Text Available The primary role of fine needle aspiration (FNA of the breast is the distinction between benign and malignant lesions; but in many cases, additional information may be obtained. The major breast lesions that yield papillary fragments on FNA are papillary carcinoma, papilloma, fibroadenoma, and invasive ductal carcinoma that have a papillary component. We present cytomorphological features of nipple discharge and FNA of breast lump in a 32-year female.

  6. Galactographic differentiation between malignant and benign disease in patients with pathologic nipple discharge

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Nariya; Cho, Hyun Yee [Gil Medical Center, Incheon (Korea, Republic of); Oh, Ki Keun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2003-06-01

    To compare the galactographic findings of malignant and benign disease in patients with pathologic nipple discharge and to analyze the features suggesting malignancy. In 24 patients in whom pathologic nipple discharge had occurred, the findings of preoperative galactography were correlated with those of pathology. Nine of the 24 cases were malignant and the other 15 were benign. Intraductal calcification occurred in five malignant cases (56%) and two (13%) which were benign. Seven malignant cases (78%) involved the segmental ducts, and in eight (89%), the peripheral ducts below the subsegmental duct were involved. Five benign cases (33%) involved the lactiferous sinus, seven (47%) the segmental duct, and two (13%) the subsegmental duct. Distal duct dilatation occurred in four benign cases (27%), while ductal stenosis was noted in six cases (67%) and ductal distortion in seven (78%). A malignant tumor appeared as a multiple (n=5, 56%) or irregular (n=5, 56%) filling defect, and a benign tumor as a single (n=12, 80%), oval (n=6, 40%) or lobular (n=4, 27%) filling defect. At galactography, a malignant tumor frequently appeared as an irregular multiple intraductal filling defect in a peripheral duct. A benign tumor, on the other hand, appeared as an oval or lobular single lesion. The presence of ductal stenosis, distortion and intraductal microcalcifications not opacified by contrast material suggest possible malignancy.

  7. A nomogram based on mammary ductoscopic indicators for evaluating the risk of breast cancer in intraductal neoplasms with nipple discharge.

    Science.gov (United States)

    Lian, Zhen-Qiang; Wang, Qi; Zhang, An-Qin; Zhang, Jiang-Yu; Han, Xiao-Rong; Yu, Hai-Yun; Xie, Si-Mei

    2015-04-01

    Mammary ductoscopy (MD) is commonly used to detect intraductal lesions associated with nipple discharge. This study investigated the relationships between ductoscopic image-based indicators and breast cancer risk, and developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge. A total of 879 consecutive inpatients (916 breasts) with nipple discharge who underwent selective duct excision for intraductal neoplasms detected by MD from June 2008 to April 2014 were analyzed retrospectively. A nomogram was developed using a multivariate logistic regression model based on data from a training set (687 cases) and validated in an independent validation set (229 cases). A Youden-derived cut-off value was assigned to the nomogram for the diagnosis of breast cancer. Color of discharge, location, appearance, and surface of neoplasm, and morphology of ductal wall were independent predictors for breast cancer in multivariate logistic regression analysis. A nomogram based on these predictors performed well. The P value of the Hosmer-Lemeshow test for the prediction model was 0.36. Area under the curve values of 0.812 (95 % confidence interval (CI) 0.763-0.860) and 0.738 (95 % CI 0.635-0.841) was obtained in the training and validation sets, respectively. The accuracies of the nomogram for breast cancer diagnosis were 71.2 % in the training set and 75.5 % in the validation set. We developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge based on MD image findings. This model may aid individual risk assessment and guide treatment in clinical practice.

  8. Does Ultrasound-Guided Directional Vacuum-Assisted Removal Help Eliminate Abnormal Nipple Discharge in Patients with Benign Intraductal Single Mass?

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jung Min; Cho, Na Ri Ya; Moon, Woo Kyung [Seoul National University Hospital, Seoul (Korea, Republic of); Park, Jeong Seon [Hanyang University Hospital, Seoul (Korea, Republic of); Chung, Se Yeong [Seoul National University Boramae Hospital, Seoul (Korea, Republic of); Jang, Mi Jung [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2009-12-15

    To evaluate whether the removal of an intraductal mass using an ultrasound (US)-guided directional vacuum-assisted device can eliminate symptoms in patients presenting with abnormal nipple discharge. Between March 2004 and October 2006, 36 patients who presented with abnormal nipple discharge, underwent US-guided, 11-gauge vacuum-assisted biopsy for a benign intraductal single mass on US. The ability of the procedure to eliminate nipple discharge was evaluated by physical examination during follow-up US. Lesion characteristics, biopsy variables, and histologic features were analyzed to identify factors affecting symptom resolution. Of the 36 lesions, 25 (69%) were intraductal papillomas, 10 (28%) were fibrocystic changes, and one (3%) was a fibroadenoma. The nipple discharge disappeared in 69% (25 of 36) of the women at a mean follow-up time of 25 months (range 12-42 month). There was no difference in the lesion characteristics, biopsy variables, and the histologic features between groups that eliminated the symptom compared those with persistent nipple discharge. US-guided directional vacuum-assisted removal of an intraductal mass appears to eliminate nipple discharge in only 69% of patients and thus, it should not be considered as an alternative to surgical excision.

  9. Bilateral extensive ductitis obliterans manifested by bloody nipple discharge in a patient with long-term diabetes mellitus.

    Science.gov (United States)

    Wang, Zhiqin; Leonard, Morton H; Khamapirad, Tuenchit; Castro, Claudia Y

    2007-01-01

    Ductitis obliterans or mastitis obliterans is a rare late manifestation of mammary ductal ectasia. We describe a long-term diabetic patient who presented with bilateral bloody nipple discharge and poorly defined nodularities around the nipple of both breasts. The ductography showed multiple segments of irregular ductal narrowing and intraluminal filling defects in both breasts. The bilateral resection of the sub-areolar portion of the breast showed exuberant fibrous obliteration of the large- and medium-sized ducts by granulation tissue associated with few histiocytes. Ductal dilatation and intraductal accumulation of histiocytes was also present. This represents a late and florid form of mammary ductal ectasia. Differential diagnostic considerations including fibrocystic changes, diabetic sclerosing lymphocytic lobulitis, idiopathic granulomatous lobular mastitis, and periductal mastitis (Zuska disease) are discussed. Accurate diagnosis can help avoid or limit radical surgeries in this group of patients.

  10. Magnetic resonance imaging in patients with nipple discharge: should we recommend it?

    International Nuclear Information System (INIS)

    Lorenzon, Michele; Zuiani, Chiara; Linda, Anna; Londero, Viviana; Girometti, Rossano; Bazzocchi, Massimo

    2011-01-01

    Comparing the sensitivity of Contrast-Enhanced Magnetic Resonance Imaging (CEMRI), mammography and ultrasonography in patients with nipple discharge (ND). We retrospectively evaluated 38 women with ND who underwent mammography, ultrasound and 1.5 T CEMRI between March 2007 and July 2009. Imaging findings, pathological diagnosis and follow-up data (mean follow-up: 20 months) were compared. Sensitivity and specificity values were reckoned. Statistical differences in sensitivity were assessed. 5/38 malignancies (13.2%; 3 invasive, 2 intraductal; 4 ipsilateral, 1 contralateral to ND), and 14/38 High-Risk Lesion (HRL - 36.8%; 11 intraductal papillomas, 1 papilloma with LCIS, 1 sclerosing papilloma and 1 atypical intraductal hyperplasia, all ipsilateral) were found. CEMRI identified 5/5 cancers and 13/14 HRL (Overall Sensitivity - OSS = 94.7%; Overall Specificity - OSP = 78.9%). 3/5 cancers (1 invasive, 1 in-situ; 1 invasive contralateral) and 2/14 HRL were detected by CEMRI only. Mammography found 2/5 cancer and 3/14 HRL (OSS = 26.3%; OSP = 94.7%). Ultrasound identified 1/5 cancer and 11/14 HRL (OSS = 63.2%; OSP = 84.2). 1/14 HRL was detected by ultrasound only. Compared with mammography and ultrasound, CEMRI showed statistically significantly higher OSS values (p < 0.0001, p = 0.042 respectively). In women with ND, CEMRI should be recommended when conventional imaging is negative. Unexplained ND could be considered an indication for CEMRI. (orig.)

  11. The Effects of Different Breastfeeding Training Techniques Given for Primiparous Mothers Before Discharge on the Incidence of Cracked Nipples.

    Science.gov (United States)

    Eksioglu, Aysun; Yesil, Yesim; Demir Gungor, Dilek; Ceber Turfan, Esin

    2017-06-01

    This research investigated the effects of different breastfeeding training techniques for primiparous mothers before discharge on the incidence of cracked nipples. This was a controlled intervention study that was carried out between 2015 and 2016 on 90 mothers living in İzmir. The mothers were divided into three groups: the demonstration-based training group, brochure group, and routine care-receiving group. The mothers in the "brochure group" were provided with breastfeeding training brochures. Mothers in the demonstration-based training group received one-to-one training using designed doll and puppet tools. The rate of cracked nipples at age 2 weeks was 63.3% in the routine care-receiving group, 56.7% in the brochure group, and 20% in the demonstration-based training group. At the end of the fourth week, the rate was 30% in the routine care-receiving group and less than 10% in the other two groups (p raining group than in the other two groups (p roups in the percentage of exclusive breastfeeding. The results documented that breastfeeding training based on one-to-one demonstration utilizing specially designed audiovisual tools was more effective than the other two methods in the prevention of nipple cracks.

  12. CT-guided thermoplastic assisted segmentectomy is an optimal breast conserving surgery for breast cancer with nipple discharge

    International Nuclear Information System (INIS)

    Makita, Masujiro; Gomi, Naoya; Tachikawa, Tomohiro

    2004-01-01

    Improvement of imaging by injecting contrast agents into the discharging duct and immobilizing the breast mound with a drape-type thermoplastic shell in breast conserving surgery was assessed by evaluating 96 cases of breast cancer patients with nipple discharge treated by partial mastectomy between April 1998 and August 2003. These patients were divided to three groups: Group A was treated by ordinary partial mastectomy or microdochectomy without new methods. Group B underwent contrast imaging without shell immobilization, and Group C received both shell immobilization and contrast imaging. The negative rates of surgical margins in Groups A, B and C were 19.0%, 17.2%, and 37.5%, respectively. The rates of negative ''lateral'' surgical margins in Groups A, B and C were 23.8%, 27.6%, and 50%, respectively. The rate of negative ''lateral'' surgical margins in Group C was significantly higher than that in Group A. Our findings suggest CT-guided thermoplastic assisted segmentectomy, adopting both ductography CT and immobilization by shell, is an optimal breast conserving surgery for breast cancer with nipple discharge. (author)

  13. A novel duct-lobular segmentectomy for breast tumors with nipple discharge using near-infrared indocyanine green fluorescence imaging

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Ohno

    2013-10-01

    Full Text Available A 44-year-old woman was referred to our hospital with pathological nipple discharge from her left breast. Ultrasonography revealed a solid tumor beneath her left areola that measured 17 mm in diameter with a dilated mammary duct. Contrast-enhanced magnetic resonance imaging showed an early-enhanced cystic tumor and a dilated mammary duct. We performed a duct-lobular segmentectomy using near-infrared indocyanine green (ICG-fluorescence imaging. Under general anesthesia, a silicone tube was inserted into an orifice of a fluid-discharging mammary duct, and 1 mL dye-fluorescence liquid containing ICG and indigo carmine was injected into the mammary duct. A periareolar incision was made, and the fluorescence image of the demarcated mammary duct segment was obtained. The mammary duct segment was dissected, along with the demarcation line. The cystic lesion and dilated mammary duct were fully resected, and the pathological diagnosis was intraductal papilloma of the breast. We report that near-infrared ICG fluorescence could be applied for imaging of the mammary duct segment, and the fluorescence image allowed for easier duct-lobular segmentectomy for nipple discharge.

  14. Nipple adenoma in a female patient presenting with persistent erythema of the right nipple skin: case report, review of the literature, clinical implications, and relevancy to health care providers who evaluate and treat patients with dermatologic conditions of the breast skin.

    Science.gov (United States)

    Spohn, Gina P; Trotter, Shannon C; Tozbikian, Gary; Povoski, Stephen P

    2016-05-20

    Nipple adenoma is a very uncommon, benign proliferative process of lactiferous ducts of the nipple. Clinically, it often presents as a palpable nipple nodule, a visible nipple skin erosive lesion, and/or with discharge from the surface of the nipple skin, and is primarily seen in middle-aged women. Resultantly, nipple adenoma can clinically mimic the presentation of mammary Paget's disease of the nipple. The purpose of our current case report is to present a comprehensive review of the available data on nipple adenoma, as well as provide useful information to health care providers (including dermatologists, breast health specialists, and other health care providers) who evaluate patients with dermatologic conditions of the breast skin for appropriately clinically recognizing, diagnosing, and treating patients with nipple adenoma. Fifty-three year old Caucasian female presented with a one year history of erythema and induration of the skin of the inferior aspect of the right nipple/areolar region. Skin punch biopsies showed subareolar duct papillomatosis. The patient elected to undergo complete surgical excision with right central breast resection. Final histopathologic evaluation confirmed nipple adenoma. The patient is doing well 31 months after her definitive surgical therapy. Since nipple adenoma represents a benign proliferative process of the nipple, complete surgical excision is curative. However, the coexistence of nipple adenoma and ipsilateral or contralateral breast cancer is well reported in the literature. The potential for a direct causal link or association of nipple adenoma and breast cancer cannot be fully excluded.

  15. The man with bilateral nipple pain

    Directory of Open Access Journals (Sweden)

    Hong Hooi Chuen

    2013-12-01

    Full Text Available Figure 1 is a picture of a 48-year-old male patient who presents with progressive painful enlargement of the areolae of 10 months’ duration. There was no bleeding or nipple discharge. He was diagnosed with human immunodeficiency virus (HIV infection 16 months ago and was initiated on antiretroviral therapy (ARV, which consisted of zidovudine, lamivudine and efavirenz. As his CD4 cell count at diagnosis was less than 200 cells/mm3, he was prescribed trimethoprim-sulphamethoxazole (Bactrim for prophylaxis against pneumonia due to pneumocystis jirovecii. Physical examination was unremarkable except for bilateral breast enlargement and right-sided old shingles scar in the T4 dermatome distribution.

  16. Nipple Reduction With the Chullo-Hat Technique.

    Science.gov (United States)

    Sim, Hyung-Bo; Sun, Sang-Hoon

    2015-08-01

    Although various techniques of nipple reduction have been described in the literature, many are difficult to design or have unreliable outcomes. For men, as well as women who do not plan to breastfeed, it is not necessary to apply a complicated technique that protects the lactiferous ducts. The authors introduce a simple technique for nipple reduction that has achieved consistent, reproducible results. The desired nipple length is marked, and a chullo-hat excision pattern is drawn. After infiltration of a local anesthetic solution around the nipple, excision of the excess nipple tissue is performed, comprising 2 triangular flaps. The remaining 2 pillars are approximated with 5-0 Nylon simple interrupted sutures. However, the wound is not completely closed in the central area of the nipple, which promotes the drainage of discharge. Fifty-three women (106 nipples) underwent this surgery between December 2009 and December 2013. The follow-up period ranged from 6 months to 2 years (mean, 10 months). No major complications occurred, and the scars were very inconspicuous. The postoperative appearance of nipples was consistently similar in size and shape. This simple technique was safe and effective in nipples of different sizes. The results were reliable and consistent with expectations. Although this study included only women, the authors believe that outcomes would be successful in men as well. 4 Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  17. Validation of hospital discharge diagnoses for hypertensive disorders of pregnancy

    DEFF Research Database (Denmark)

    Møller Luef, Birgitte; Andersen, Louise B; Renault, Kristina Martha

    2016-01-01

    INTRODUCTION: A correct diagnosis of preeclampsia and gestational hypertension is important for treatment and epidemiological studies. Changes in diagnostic criteria and underreporting in certain subsets of patients may hamper validity of the diagnoses. MATERIALS AND METHODS: We validated....... After validation, significantly more patients fulfilled criteria for diagnosis of preeclampsia (n = 163, 7.5%, p = 0.002); more had severe preeclampsia, 14 (0.6%) vs. 70 (3.2%), p hypertension, 62 (2.9%) vs. 46 (2.1%), p = 0.12. The diagnostic sensitivity for preeclampsia...... of hypertensive disorders in pregnancy for research purposes....

  18. Validating diagnoses from hospital discharge registers change risk estimates for acute coronary syndrome

    DEFF Research Database (Denmark)

    Joensen, Albert Marni; Schmidt, E.B.; Dethlefsen, Claus

    2007-01-01

    of acute coronary syndrome (ACS) diagnoses identified in a hospital discharge register changed the relative risk estimates of well-established risk factors for ACS. Methods All first-time ACS diagnoses (n=1138) in the Danish National Patient Registry were identified among male participants in the Danish...

  19. Predictive value of acute coronary syndrome discharge diagnoses in the Danish national patioent registry

    DEFF Research Database (Denmark)

    Joensen, Albert Marni; Jensen, Majken K.; Overvad, Kim

    Background: Updated data on the predictive value of acute coronary syndrome (ACS) diagnoses, including unstable angina pectoris, myocardial infarction and cardiac arrest, in hospital discharge registries are sparse. Design: Validation study. Methods: All first-time ACS diagnoses in the Danish...

  20. Can Concentration - Discharge Relationships Diagnose Material Source During Extreme Events?

    Science.gov (United States)

    Karwan, D. L.; Godsey, S.; Rose, L.

    2017-12-01

    Floods can carry >90% of the basin material exported in a given year as well as alter flow pathways and material sources. In turn, sediment and solute fluxes can increase flood damages and negatively impact water quality and integrate physical and chemical weathering of landscapes and channels. Concentration-discharge (C-Q) relationships are used to both describe export patterns as well as compute them. Metrics for describing C-Q patterns and inferring their controls are vulnerable to infrequent sampling that affects how C-Q relationships are interpolated and interpreted. C-Q relationships are typically evaluated from multiple samples, but because hydrological extremes are rare, data are often unavailable for extreme events. Because solute and sediment C-Q relationships likely respond to changes in hydrologic extremes in different ways, there is a pressing need to define their behavior under extreme conditions, including how to properly sample to capture these patterns. In the absence of such knowledge, improving load estimates in extreme floods will likely remain difficult. Here we explore the use of C-Q relationships to determine when an event alters a watershed system such that it enters a new material source/transport regime. We focus on watersheds with sediment and discharge time series include low-frequency and/or extreme events. For example, we compare solute and sediment patterns in White Clay Creek in southeastern Pennsylvania across a range of flows inclusive of multiple hurricanes for which we have ample ancillary hydrochemical data. TSS is consistently mobilized during high flow events, even during extreme floods associated with hurricanes, and sediment fingerprinting indicates different sediment sources, including in-channel remobilization and landscape erosion, are active at different times. In other words, TSS mobilization in C-Q space is not sensitive to the source of material being mobilized. Unlike sediments, weathering solutes in this watershed

  1. Molluscum contagiosum of nipple

    Directory of Open Access Journals (Sweden)

    Nisha Marwah

    2012-01-01

    Full Text Available Molluscum contagiosum is a virus-induced dermatologic condition causing characteristic pearly lesions on the surface of skin. The lesion is common in children. In adults, it is usually a sexually transmitted disease. Molluscum contagiosum may be found anywhere on the body, although it rarely occurs on the palms and soles. Dermatosis of nipple due to molluscum contagiosum is rare. If it occurs, it is accompanied by lesions in other sites. Isolated involvement of nipple by the virus is unusual and has been reported only once in previous literature to the best of our knowledge. Here, we report this unusual case of isolated molluscum contagiosum of nipple in 30-year-old female.

  2. With Nipple Piercing

    Directory of Open Access Journals (Sweden)

    Mark D. Pearlman

    1995-01-01

    Full Text Available Background: Breast abscesses are typically seen in the setting of complicated mastitis in lactating women. Abscesses resulting from foreign bodies are not commonly seen in the breast. Over the past few decades, body piercing has become increasingly common, yet the infectious morbidity resulting from it is not well recognized. A breast abscess associated with nipple piercing is described in this report.

  3. Paget disease of the male nipple.

    Science.gov (United States)

    El Harroudi, T; Tijami, F; El Otmany, A; Jalil, A

    2010-01-01

    Breast cancer occurring in the mammary gland of men is infrequent. It accounts for 0.8% of all breast cancers, which is less than one per cent of all newly diagnosed male cancers and 0.2% of male cancer deaths. However, Paget disease of the male nipple is extremely rare. We report a single case of Paget disease with infiltrative ductal carcinoma of the breast in a 61-year-old man.

  4. Validation of cardiovascular diagnoses in the Greenlandic Hospital Discharge Register for epidemiological use

    DEFF Research Database (Denmark)

    Tvermosegaard, Maria; Ronn, Pernille Falberg; Pedersen, Michael Lynge

    2018-01-01

    not previously been validated specifically. The objective of the study was to validate diagnoses of CVD in GHDR. The study was conducted as a validation study with primary investigator comparing information in GHDR with information in medical records. Diagnoses in GHDR were considered correct and thus valid......Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In Greenland, valid estimates of prevalence and incidence of CVD do not exist and can only be calculated if diagnoses of CVD in the Greenlandic Hospital Discharge Register (GHDR) are correct. Diagnoses of CVD in GHDR have...... if they matched the diagnoses or the medical information in the medical records. A total of 432 online accessible medical records with a cardiovascular diagnosis according to GHDR from Queen Ingrid's Hospital from 2001 to 2013 (n=291) and from local health care centres from 2007 to 2013 (n=141) were reviewed...

  5. How well do discharge diagnoses identify hospitalised patients with community-acquired infections? - a validation study

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Nielsen, Stig Lønberg; Laursen, Christian Borbjerg

    2014-01-01

    -10 diagnoses was 79.9% (95%CI: 78.1-81.3%), specificity 83.9% (95%CI: 82.6-85.1%), positive likelihood ratio 4.95 (95%CI: 4.58-5.36) and negative likelihood ratio 0.24 (95%CI: 0.22-0.26). The two most common sites of infection, the lower respiratory tract and urinary tract, had positive likelihood......BACKGROUND: Credible measures of disease incidence, trends and mortality can be obtained through surveillance using manual chart review, but this is both time-consuming and expensive. ICD-10 discharge diagnoses are used as surrogate markers of infection, but knowledge on the validity of infections...... in general is sparse. The aim of the study was to determine how well ICD-10 discharge diagnoses identify patients with community-acquired infections in a medical emergency department (ED), overall and related to sites of infection and patient characteristics. METHODS: We manually reviewed 5977 patients...

  6. Cost and quality implications of discrepancies between admitting and discharge diagnoses.

    Science.gov (United States)

    McNutt, Robert; Johnson, Tricia; Kane, Jason; Ackerman, Mariel; Odwazny, Richard; Bardhan, Jaydeep

    2012-01-01

    Presenting and discharge diagnoses of hospitalized patients may differ as a result of patient complexity, diagnostic dilemmas, or errors in clinical judgment at the time of primary assessment. When diagnoses at admission and discharge are not in agreement, this discrepancy may indicate more complex processes of care and resultant costs. It is unclear whether surrogate measures reflecting quality of care are impacted by discrepant diagnoses. To assess whether an association exists between admitting and discharge International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes and other quality markers including hospital length of stay, total cost of care, and 30-day readmission rate. This was a retrospective, cross-sectional analysis of general internal medicine patients aged 18 years and older. Diagnosis discrepancy was defined as a difference between the 3-digit ICD-9 diagnosis code at admission and the principal 3-digit ICD-9 diagnosis code at discharge. Sixty-eight percent of patients had a diagnosis discrepancy. Diagnosis discrepancy was associated with a 0.41-day increase in length of stay (P < .001), $663 increase in direct costs (P < .001), and a 1.55 times greater odds of readmission within 30 days (P < .001). Diagnosis discrepancy was associated with hospital quality outcome measures. This finding likely reflects variations in patients' diagnostic complexity.

  7. Predictive value of stroke discharge diagnoses in the Danish National Patient Register.

    Science.gov (United States)

    Lühdorf, Pernille; Overvad, Kim; Schmidt, Erik B; Johnsen, Søren P; Bach, Flemming W

    2017-08-01

    To determine the positive predictive values for stroke discharge diagnoses, including subarachnoidal haemorrhage, intracerebral haemorrhage and cerebral infarction in the Danish National Patient Register. Participants in the Danish cohort study Diet, Cancer and Health with a stroke discharge diagnosis in the National Patient Register between 1993 and 2009 were identified and their medical records were retrieved for validation of the diagnoses. A total of 3326 records of possible cases of stroke were reviewed. The overall positive predictive value for stroke was 69.3% (95% confidence interval (CI) 67.8-70.9%). The predictive values differed according to hospital characteristics, with the highest predictive value of 87.8% (95% CI 85.5-90.1%) found in departments of neurology and the lowest predictive value of 43.0% (95% CI 37.6-48.5%) found in outpatient clinics. The overall stroke diagnosis in the Danish National Patient Register had a limited predictive value. We therefore recommend the critical use of non-validated register data for research on stroke. The possibility of optimising the predictive values based on more advanced algorithms should be considered.

  8. Hyperkeratosis of the nipple and areola.

    Science.gov (United States)

    Kuhlman, D S; Hodge, S J; Owen, L G

    1985-10-01

    Hyperkeratosis of the nipple and areola is a rare condition. We report two cases of hyperkeratosis of the nipple and areola occurring in men with no underlying endocrinopathy or synthetic estrogenic drug therapy. Both patients demonstrated prompt resolution of the hyperkeratosis of the nipples with a keratolytic gel. Because our cases were not associated with ichthyosis or epidermal nevus, they best fit into the category of nevoid hyperkeratosis of the nipples.

  9. Effects of menthol essence and breast milk on the improvement of nipple fissures in breastfeeding women

    Directory of Open Access Journals (Sweden)

    Sedigheh Amir Ali Akbari

    2014-01-01

    Full Text Available Background: Nipple fissure is a common disorder during breastfeeding. With high prevalence of nipple fissures and its impacts on breastfeeding, as well as the existence of evidence in favor of the application of peppermint as an antiinflammatory and antiinfection herb, the purpose of this study is to determine the effect of Menthol essence on improving nipple fissures in the primiparous breastfeeding women. Materials and Methods: This study was conducted using a clinical trial method. Samples were divided randomly into two groups of 55 women. The women in the peppermint group applied four drops of Menthol essence on their nipple and areola after each feeding. The control group applied four drops of their own milk on the nipple and areola after each feeding. Then, the two groups were studied on days 10 and 14 postpartum. For intensity of pain, the visual analog scale (0-10 cm and to measure the severity of damage, Amir scale (1-10 cm were applied and the existence or lack of nipple discharge was also recorded. The data were analyzed using SPSS 17 software. Results: The mean intensity of pain and nipple fissure before treatment (8.55 ± 1.74 and day 10 after delivery (4.26 ± 1.57 and before treatment and day 14 after delivery in the case group (1.32 ± 1.02 had a significant difference (P < 0.001. Nipple discharge between the two groups, before treatment (%75.2 and day 10 after delivery (%31.6 and before treatment and day 14 after delivery (%15.7, the case group had a significant difference (P < 0.001. Conclusion: Menthol essence can improve nipple fissures in the primiparous breastfeeding women.

  10. A Novel Nipple Reconstruction Technique for Maintaining Nipple Projection: The Boomerang Flap.

    Science.gov (United States)

    Kim, Young-Eun; Hong, Ki Yong; Minn, Kyung Won; Jin, Ung Sik

    2016-09-01

    Nipple-areolar complex (NAC) reconstruction is the final step in the long journey of breast reconstruction for mastectomy patients. Successful NAC reconstruction depends on the use of appropriate surgical techniques that are simple and reliable. To date, numerous techniques have been used for nipple reconstruction, including contralateral nipple sharing and various local flaps. Recently, it has been common to utilize local flaps. However, the most common nipple reconstruction problem encountered with local flaps is the loss of nipple projection; there can be approximately 50% projection loss in reconstructed nipples over long-term follow-up. Several factors might contribute to nipple projection loss, and we tried to overcome these factors by performing nipple reconstructions using a boomerang flap technique, which is a modified C-V flap that utilizes the previous mastectomy scar to maintain long-term nipple projection.

  11. A Novel Nipple Reconstruction Technique for Maintaining Nipple Projection: The Boomerang Flap

    Directory of Open Access Journals (Sweden)

    Young-Eun Kim

    2016-09-01

    Full Text Available Nipple-areolar complex (NAC reconstruction is the final step in the long journey of breast reconstruction for mastectomy patients. Successful NAC reconstruction depends on the use of appropriate surgical techniques that are simple and reliable. To date, numerous techniques have been used for nipple reconstruction, including contralateral nipple sharing and various local flaps. Recently, it has been common to utilize local flaps. However, the most common nipple reconstruction problem encountered with local flaps is the loss of nipple projection; there can be approximately 50% projection loss in reconstructed nipples over long-term follow-up. Several factors might contribute to nipple projection loss, and we tried to overcome these factors by performing nipple reconstructions using a boomerang flap technique, which is a modified C–V flap that utilizes the previous mastectomy scar to maintain long-term nipple projection.

  12. The use of nipple shields: A review

    Directory of Open Access Journals (Sweden)

    Selina Chow

    2016-11-01

    Full Text Available A nipple shield is a breastfeeding aid with a nipple-shaped shield that is positioned over the nipple and areola prior to nursing. Nipple shields are usually recommended to mothers with flat nipples or in cases in which there is a failure of the baby to effectively latch onto the breast within the first two days postpartum. The use of nipple shields is a controversial topic in the field of lactation. Its use has been an issue in the clinical literature since some older studies discovered reduced breast milk transfer when using nipple shields, while more recent studies reported successful breastfeeding outcomes. The purpose of this review was to examine the evidence and outcomes with nipple shield use. Methods: A literature search was conducted in Ovid MEDLINE, OLDMEDLINE, EMBASE Classic, EMBASE, Cochrane Central Register of Controlled Trials and CINAHL. The primary endpoint was any breastfeeding outcome following nipple shield use. Secondary endpoints included the reasons for nipple shield use and the average/median length of use. For the analysis, we examined the effect of nipple shield use on physiological responses, premature infants, mothers’ experiences, and health professionals’ experiences. Results: The literature search yielded 261 articles, 14 of which were included in this review. Of these 14 articles, three reported on physiological responses, two reported on premature infants, eight reported on mothers’ experiences, and one reported on health professionals’ experiences. Conclusion: Through examining the use of nipple shields, further insight is provided on the advantages and disadvantages of this practice, thus allowing clinicians and researchers to address improvements on areas that will benefit mothers and infants the most.

  13. Validity of Principal Diagnoses in Discharge Summaries and ICD-10 Coding Assessments Based on National Health Data of Thailand.

    Science.gov (United States)

    Sukanya, Chongthawonsatid

    2017-10-01

    This study examined the validity of the principal diagnoses on discharge summaries and coding assessments. Data were collected from the National Health Security Office (NHSO) of Thailand in 2015. In total, 118,971 medical records were audited. The sample was drawn from government hospitals and private hospitals covered by the Universal Coverage Scheme in Thailand. Hospitals and cases were selected using NHSO criteria. The validity of the principal diagnoses listed in the "Summary and Coding Assessment" forms was established by comparing data from the discharge summaries with data obtained from medical record reviews, and additionally, by comparing data from the coding assessments with data in the computerized ICD (the data base used for reimbursement-purposes). The summary assessments had low sensitivities (7.3%-37.9%), high specificities (97.2%-99.8%), low positive predictive values (9.2%-60.7%), and high negative predictive values (95.9%-99.3%). The coding assessments had low sensitivities (31.1%-69.4%), high specificities (99.0%-99.9%), moderate positive predictive values (43.8%-89.0%), and high negative predictive values (97.3%-99.5%). The discharge summaries and codings often contained mistakes, particularly the categories "Endocrine, nutritional, and metabolic diseases", "Symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified", "Factors influencing health status and contact with health services", and "Injury, poisoning, and certain other consequences of external causes". The validity of the principal diagnoses on the summary and coding assessment forms was found to be low. The training of physicians and coders must be strengthened to improve the validity of discharge summaries and codings.

  14. Is chronic nipple piercing associated with hyperprolactinemia?

    Science.gov (United States)

    Sun, Grace E Ching; Pantalone, Kevin M; Gupta, Manjula; Kennedy, Laurence; Nasr, Christian; Constantiner, Marigel; Hamrahian, Amir H; Hatipoglu, Betul

    2013-09-01

    Literature on hyperprolactinemia in the setting of a nipple piercing is limited to individuals with concomitant breast/chest wall infection. It is unclear if chronic nipple stimulation from a piercing alone can cause sustained elevations of serum prolactin. Nipple piercing is emerging as a more mainstream societal form of body art, and the answer to this clinical question would potentially alter patient management. Our aim was to assess serum prolactin levels in subjects with nipple piercing. Inclusion criteria were as follows: men and women ≥ 18 years old with nipple piercing(s) present > 6 months. Exclusion criteria included: women who are pregnant, lactating or men and eight women were enrolled. Median (range) ages for men and women were 33 (24-42) and 27 years (23-42), respectively. All except one subject had bilateral piercings. The median interval from nipple piercing to blood draw was 4.0 (2.0-12.0) years. None of the subjects had hyperprolactinemia. Median (range) prolactin levels for men and women were 5.6 ng/mL (3.8-7.4) and 8.0 ng/mL (2.8-10.9), respectively. Our results suggest that in the absence of any concomitant infection, chronic nipple piercing is not associated with hyperprolactinemia.

  15. Nipple placement in simple mastectomy with free nipple grafting for severe gynecomastia.

    Science.gov (United States)

    Murphy, T P; Ehrlichman, R J; Seckel, B R

    1994-11-01

    Severe gynecomastia with excessive skin is difficult to treat by only periareolar excision or suction-assisted lipectomy or both. In these patients, total mastectomy and free nipple grafting may be the best option. Placement of the nipple, however, has been arbitrary. With use of 20 "aesthetically perfect" men as models, standard nipple distances were identified. The average sternal notch-to-nipple measurement was 21 cm. In addition, two consistent ratios were identified. The nipple plane was located 0.33 times the distance from the sternal notch to the pubis, and the internipple distance was 0.23 times the chest circumference. With use of preoperatively obtained measurements of the sternal notch to pubis and chest circumference, accurate nipple placement can be accomplished.

  16. Metastatic syringoid eccrine carcinoma of the nipple

    Directory of Open Access Journals (Sweden)

    Ballardini P

    2012-07-01

    Full Text Available Pierluigi Ballardini,1 Guido Margutti,1 Massimo Pedriali,2 Patrizia Querzoli21Department of Internal Medicine, Hospital of the Delta, Lagosanto, 2Institute of Pathology, S Anna Hospital, Ferrara, ItalyAbstract: Syringoid eccrine carcinoma is a very rare skin tumor. Herein we describe a 72-year-old male patient presenting with a syringoid eccrine carcinoma of the nipple with associated axillary lymph node metastases. Surgery associated with adjuvant radiotherapy was performed. To the best of our knowledge, this is the first case of syringoid eccrine carcinoma of the nipple ever reported.Keywords: syringoid carcinoma, nipple, axillary metastases, radiotherapy

  17. The data quality of splenomegaly ICD-10 diagnoses in a population-based hospital discharge registry

    DEFF Research Database (Denmark)

    Rotbain, E. C.; Lund Hansen, Dennis; Frederiksen, H.

    2015-01-01

    of our knowledge, accurate data on the risk of hematological malignancies, hepatic diseases and storage diseases among patients with splenomegaly have never been reported. The aim of this pilot study is to investigate the validity of the splenomegaly ICD-10 diagnoses, in order to ascertain...

  18. Study of the cathodic region of a hydrogen luminescent discharge: spectroscopic diagnoses

    International Nuclear Information System (INIS)

    Barbeau, Claude

    1991-01-01

    This research thesis addresses the study of the cathodic region of a hydrogen luminescent discharge in direct current, and belongs to the field of studies on plasma-surface interactions, notably in order to understand and optimise electric discharges in H_2CH_4 mixtures used for steel cementation and hard carbon deposition. The author first presents the main characteristics of the abnormal discharge, and details operation conditions as well as the characteristics of the different experimental assemblies. The experimental study of the cathodic region has been mainly performed by high resolution emission spectroscopy, and multi-photon laser spectroscopy (laser-induced fluorescence, optogalvanic effect). In the second part, the author reports an analysis of the Doppler broadening of emission profiles of atomic lines (notably the Balmer series). Experimental results are compared with those of Monte Carlo simulation which addresses mechanisms of creation of excited atoms as well as their energetic distribution. The next parts report the development of methods and techniques for the measurement of the electric field of the cathodic drop and of gas temperature, experimental results and their interpretation [fr

  19. 21 CFR 880.5640 - Lamb feeding nipple.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Lamb feeding nipple. 880.5640 Section 880.5640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Devices § 880.5640 Lamb feeding nipple. (a) Identification. A lamb feeding nipple is a device intended for...

  20. Maternal Clinical Diagnoses and Hospital Variation in the Risk of Cesarean Delivery: Analyses of a National US Hospital Discharge Database

    Science.gov (United States)

    Kozhimannil, Katy B.; Arcaya, Mariana C.; Subramanian, S. V.

    2014-01-01

    Background Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women's clinical diagnoses. Methods and Findings Using data from the 2009 and 2010 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project—a 20% sample of US hospitals—we analyzed data for 1,475,457 births in 1,373 hospitals. We fitted multilevel logistic regression models (patients nested in hospitals). The outcome was cesarean (versus vaginal) delivery. Covariates included diagnosis of diabetes in pregnancy, hypertension in pregnancy, hemorrhage during pregnancy or placental complications, fetal distress, and fetal disproportion or obstructed labor; maternal age, race/ethnicity, and insurance status; and hospital size and location/teaching status. The cesarean section prevalence was 22.0% (95% confidence interval 22.0% to 22.1%) among women with no prior cesareans. In unadjusted models, the between-hospital variation in the individual risk of primary cesarean section was 0.14 (95% credible interval 0.12 to 0.15). The difference in the probability of having a cesarean delivery between hospitals was 25 percentage points. Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics (0.16 [95% credible interval 0.14 to 0.18]). A limitation is that these data, while nationally representative, did not contain information on parity or gestational age. Conclusions Variability across hospitals in the individual risk of cesarean section is not decreased by accounting for differences in maternal diagnoses. These findings highlight

  1. Galactography paper in the handling of patient with secretion for the nipple: Comparison with cytology

    International Nuclear Information System (INIS)

    Gonzalez C, Aurelio; Ortiz U, Jaime Eduardo; Patino P, Jairo Hernando; Diaz G, Constanza

    1993-01-01

    It was done galactography and cytology in 30 patients with spontaneous secretion through the nipple. The haematic secretion was the most frequent (43.3%). the fibrocystic changes were the most common case of diagnosed telorrea by the two methods (60% by galactography and 56.7% by cytology), which coincide in the papilloma diagnose in 50% of the cases and in the 70,6% in the non-tumoral benign pathology diagnose. The galactography continues being the elected method to evaluate the patients with haematic secretion, keeping the cytology as a complementary exam

  2. Appropriate location of the nipple-areola complex in males.

    Science.gov (United States)

    Shulman, O; Badani, E; Wolf, Y; Hauben, D J

    2001-08-01

    Gynecomastia is a common deformity encountered by plastic surgeons. The appropriate location of the nipple-areola complex is a major determinant of the aesthetic success of the procedure. To study the natural location of the nipple-areola complex in the normally built male, 50 nonobese men with no evidence of gynecomastia and an average age of 27.9 years were examined. Three ratios were calculated and found to be relatively constant; they were the ratio between the height of the nipple and the height of the patient, the ratio between the distance between the nipples and chest circumference, and the ratio between the suprasternal notch-to-nipple distance and the height of the patient. Using these three parameters, a method of locating the nipple-areola complex on the male chest wall was devised. The method is advocated as a reliable, simple, and useful technique.

  3. Nipple adenoma in a 2-year-old boy.

    Science.gov (United States)

    Fujisawa, Kou; Kato, Motoi; Kono, Tatsuki; Utsunomiya, Hiroki; Watanabe, Azusa; Watanabe, Shoji

    2018-05-01

    Nipple adenoma is an uncommon proliferative process of the breast and predominantly occurs in women aged 40-50. Its incidence is extremely low in men, and it has not been reported in a boy. Although nipple adenoma is rare and benign, being familiar with it is important because it clinically resembles Paget disease and histologically adenocarcinoma. We report a case of nipple adenoma in a boy. © 2018 Wiley Periodicals, Inc.

  4. Nipple-areolar complex (nac) composite grafts in the Management ...

    African Journals Online (AJOL)

    composite” graft. This is because the skin of the areola and especially the nipple are usually thicker than the case is in the usual full-thickness skin grafts (FTSG). In traditional breast reductions, the nipple-areolar complex is located to its new position ...

  5. Nipple-Sparing Mastectomy Improves Long-Term Nipple But Not Skin Sensation After Breast Reconstruction: Quantification of Long-Term Sensation in Nipple Sparing Versus Non-nipple Sparing Mastectomy.

    Science.gov (United States)

    Rodriguez-Unda, Nelson A; Bello, Ricardo J; Clarke-Pearson, Emily M; Sanyal, Abanti; Cooney, Carisa M; Manahan, Michele A; Rosson, Gedge D

    2017-06-01

    Changes in breast sensation after reconstruction are expected. Return of breast sensation after reconstruction and whether nipple-sparing mastectomy offers a substantial benefit in terms of sensation has been inconsistently documented in the literature. We conducted the current study using the pressure-specified sensory device to quantify postoperative breast sensation in patients undergoing nipple-sparing versus non-nipple-sparing mastectomy. Consecutive adult women who underwent nipple-sparing (NSM) and non-NSM (NNSM) and were at least 18 months postreconstruction were included. Breast measurements were taken in 4 quadrants (upper/lower lateral, upper/lower medial) and nipple. Averaged skin cutaneous thresholds [(UL+LL+UM+LM)/4] and nipple sensation between NSM and NNSM were compared as the primary outcome measure. A generalized estimating equations model was used; univariate and multivariate variable analyses were done when appropriate. Forty-four patients (74 breasts) were examined (53 NNSM vs 21 NSM). The groups were further subdivided into autologous versus implant-based reconstruction. Averaged cutaneous skin thresholds for quadrants were better for the NSM, 51.8(±24.5) g/mm versus NNSM, 56.5(±25.7) g/mm, although this difference was not statistically significant. However, NSM breasts measured higher nipple or nipple area sensitivity, 44.5(±30.8) g/mm versus NNSM, 83.8(±27.4) g/mm (P sensation was the number of revision surgeries, especially after third revision. Breast sensation is decreased after reconstruction in both NSM and NNSM, but nipple sensation or nipple area is better preserved in NSM breasts. Number of revision surgeries (>3) was a predictor of decreased sensation.

  6. Duodenal ileus caused by a calf feeding nipple in a cow

    Directory of Open Access Journals (Sweden)

    Gerspach Christian

    2011-01-01

    Full Text Available Abstract Background The aim of this report was to describe duodenal obstruction caused by a rubber foreign body in a cow. Case Presentation The clinical, biochemical and ultrasonographic findings in a five-year-old Swiss Braunvieh cow with duodenal ileus caused by a calf feeding nipple are described. The main clinical signs were anorexia, ruminal tympany, decreased faecal output and abomasal reflux syndrome. Ultrasonographic examination revealed reticular hyperactivity and a dilated duodenum. A diagnosis of duodenal ileus was made and the cow underwent right-flank laparotomy, which revealed a dilation of the cranial part of the duodenum because of obstruction by a pliable foreign body. This was identified via enterotomy as a calf feeding nipple. The cow was healthy at the time of discharge four days after surgery and went on to complete a successful lactation. Conclusions To our knowledge, this is the first description of duodenal obstruction by a calf feeding nipple. This is an interesting case, which broadens the spectrum of the causes of duodenal ileus, which is usually caused by obstruction of the duodenum by a phytobezoar.

  7. Fractures in Individuals with and without a History of Infantile Autism. A Danish Register Study Based on Hospital Discharge Diagnoses

    Science.gov (United States)

    Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

    2012-01-01

    We compared the prevalence and types of fractures in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with 336 matched controls from the general population. All participants were screened through the nationwide Danish National Hospital Register. The average observation time was 30.3 years (range 27.3-30.4…

  8. Acellular dermal matrix based nipple reconstruction: A modified technique

    Directory of Open Access Journals (Sweden)

    Raghavan Vidya

    2017-09-01

    Full Text Available Nipple areolar reconstruction (NAR has evolved with the advancement in breast reconstruction and can improve self-esteem and, consequently, patient satisfaction. Although a variety of reconstruction techniques have been described in the literature varying from nipple sharing, local flaps to alloplastic and allograft augmentation, over time, loss of nipple projection remains a major problem. Acellular dermal matrices (ADM have revolutionised breast reconstruction more recently. We discuss the use of ADM to act as a base plate and strut to give support to the base and offer nipple bulk and projection in a primary procedure of NAR with a local clover shaped dermal flap in 5 breasts (4 patients. We used 5-point Likert scales (1 = highly unsatisfied, 5 = highly satisfied to assess patient satisfaction. Median age was 46 years (range: 38–55 years. Nipple projection of 8 mm, 7 mm, and 7 mms were achieved in the unilateral cases and 6 mm in the bilateral case over a median 18 month period. All patients reported at least a 4 on the Likert scale. We had no post-operative complications. It seems that nipple areolar reconstruction [NAR] using ADM can achieve nipple projection which is considered aesthetically pleasing for patients.

  9. Fractures in Individuals With and Without a History of Infantile Autism. A Danish Register Study Based on Hospital Discharge Diagnoses

    DEFF Research Database (Denmark)

    Mouridsen, Svend-Erik; Rich, Bente; Isager, Torben

    2012-01-01

    observation time was 30.3 years (range 27.3-30.4 years), and mean age at follow-up was 42.7 years (range 27.3-57.3 years). Of the 118 individuals with IA, 14 (11.9%) were registered with at least one fracture diagnosis against 83 (24.7%) in the comparison group (p = 0.004; OR = 0.41; 95%CI 0......We compared the prevalence and types of fractures in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with 336 matched controls from the general population. All participants were screened through the nationwide Danish National Hospital Register. The average.......22-0.76), but the nature of their fractures seems somewhat different. Epilepsy was a risk factor, but only in the comparison group. Our results lend no support to the notion that fracture is a common comorbid condition in a population of people diagnosed with IA as children....

  10. Immunophenotype of nipple adenoma in a male patient.

    Science.gov (United States)

    Fernandez-Flores, Angel; Suarez-Peñaranda, Jose-Manuel

    2011-03-01

    Adenoma of the nipple is rare in men. It must be distinguished from a breast carcinoma and from Paget disease. In this sense, immunohistochemistry can be of some help. In women, for instance, immunoexpression of c-erbB-2 favors a diagnosis of Paget disease, according to some studies. Nevertheless, we have not found any studies on HER2/neu status, estrogen receptors, or progesterone receptors in nipple adenoma of male patients. We present a case of an adenoma of the nipple in a 21-year-old man in which we carried out a wide immunohistochemical study. The lesion did not express estrogen receptors, progesterone receptors, or androgen receptors. The HercepTest was negative. Smooth muscle Actin and p63 were remarked in the basal layer of the tumoral tubules, supporting the benignancy of the lesion. This case of adenoma of the nipple in a male shows an immunophenotype that is similar to the ones reported in female patients.

  11. original Article double-nippled ureteroneocystostomy: A novel ...

    African Journals Online (AJOL)

    The lowest segment of the dilated obstructed ureter is transected and passed through the bladder dome for ... conclusion: Double-nippled ureteroneocystostomy is a safe and efficient surgical modality for ..... Strup SE, Bagley DH. Endoscopic ...

  12. Biologic Collagen Cylinder with Skate Flap Technique for Nipple Reconstruction

    Directory of Open Access Journals (Sweden)

    Brian P. Tierney

    2014-01-01

    Full Text Available A surgical technique using local tissue skate flaps combined with cylinders made from a naturally derived biomaterial has been used effectively for nipple reconstruction. A retrospective review of patients who underwent nipple reconstruction using this technique was performed. Comorbidities and type of breast reconstruction were collected. Outcome evaluation included complications, surgical revisions, and nipple projection. There were 115 skate flap reconstructions performed in 83 patients between July 2009 and January 2013. Patients ranged from 32 to 73 years old. Average body mass index was 28.0. The most common comorbidities were hypertension (39.8% and smoking (16.9%. After breast reconstruction, 68.7% of the patients underwent chemotherapy and 20.5% underwent radiation. Seventy-one patients had immediate breast reconstruction with expanders and 12 had delayed reconstruction. The only reported complications were extrusions (3.5%. Six nipples (5.2% in 5 patients required surgical revision due to loss of projection; two patients had minor loss of projection but did not require surgical revision. Nipple projection at time of surgery ranged from 6 to 7 mm and average projection at 6 months was 3–5 mm. A surgical technique for nipple reconstruction using a skate flap with a graft material is described. Complications are infrequent and short-term projection measurements are encouraging.

  13. Biologic collagen cylinder with skate flap technique for nipple reconstruction.

    Science.gov (United States)

    Tierney, Brian P; Hodde, Jason P; Changkuon, Daniela I

    2014-01-01

    A surgical technique using local tissue skate flaps combined with cylinders made from a naturally derived biomaterial has been used effectively for nipple reconstruction. A retrospective review of patients who underwent nipple reconstruction using this technique was performed. Comorbidities and type of breast reconstruction were collected. Outcome evaluation included complications, surgical revisions, and nipple projection. There were 115 skate flap reconstructions performed in 83 patients between July 2009 and January 2013. Patients ranged from 32 to 73 years old. Average body mass index was 28.0. The most common comorbidities were hypertension (39.8%) and smoking (16.9%). After breast reconstruction, 68.7% of the patients underwent chemotherapy and 20.5% underwent radiation. Seventy-one patients had immediate breast reconstruction with expanders and 12 had delayed reconstruction. The only reported complications were extrusions (3.5%). Six nipples (5.2%) in 5 patients required surgical revision due to loss of projection; two patients had minor loss of projection but did not require surgical revision. Nipple projection at time of surgery ranged from 6 to 7 mm and average projection at 6 months was 3-5 mm. A surgical technique for nipple reconstruction using a skate flap with a graft material is described. Complications are infrequent and short-term projection measurements are encouraging.

  14. [Anatomical study of men's nipple areola complex].

    Science.gov (United States)

    Vaucher, R; Dast, S; Assaf, N; Sinna, R

    2016-06-01

    The surgical approach of gynecomastia, sexual reassignment surgery in female-to-male transsexuals and the increase of number of obese wishing to turn to plastic surgery led us to deepen the anatomical knowledge of the nipple areola complex (NAC) in men, poorly retailed in the literature. By inspiring us of the methodology of a Japanese study, we studied 50 healthy volunteers male, from 18 to 55 years old, from July till August 2015. We measured various distances relative to the NAC to define its vertical and horizontal position, as well as the internipple distance according to the size, to the weight and to the body mass index (BMI). At the end of the analysis, we were able to underline a lower vertical thoracic position of the NAC in the tall category of person, a more side horizontal position to the subject presenting a high BMI and a linear relation between the BMI and the internipple (Em) defined by (Em)=8.96×BMI. The surgeon's judgment and the desires of the patient are essentials basis of therapeutics decisions that could be lean on this anatomical study, which allowed to establish an idea of the cartography of the NAC in man. It will be interesting and necessary to confront it with other studies with larger scale. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Management of flat or inverted nipples with simple rubber bands.

    Science.gov (United States)

    Chakrabarti, Kamalendu; Basu, Subhra

    2011-08-01

    Occurrences of flat or inverted nipples are not uncommon problems, and although they should not preclude breastfeeding, they often seriously hamper initiation and continuation of breastfeeding. Various therapies including nipple exercise, breast shells, inverted syringes, or surgical corrections have been reported with varying success rates. A new method has been devised by the authors that consisted of tying a rubber band around the base of the nipple, with the help of a syringe applicator, to make it prominent. Latex rubber bands cut from condom rims were used in this study. The band had to be worn only during feeding. This method was tested on 19 mothers with flat, inverted, or otherwise deformed nipples. The babies were born in hospitals and were between 9 and 38 days old, mostly fed by bottle feeding, at the time of presentation. The mothers had been counseled about the importance of good attachment during breastfeeding and shown the new method. They were instructed to use the method at home and attend follow-up on day 3, day 7, and day 28. Sixty-three percent of mothers could achieve latching at the breast with good attachment within 3 days, and all did by the end of the month, as nipples no longer remained a problem. The insufficiency of milk was gradually taken care of by frequent suckling with time. No complications like pain or slipping of the band were reported. This simple method may be a good bedside solution for flat/retracted nipples. The authors strongly believe that if the new method is applied immediately after birth under supervision, no mother with nipple problem will be required to feed nonhuman milk to her baby.

  16. Gynecomastia associated with herniated nipples: an optimal surgical approach.

    Science.gov (United States)

    Jaiswal, Rohit; Pu, Lee L Q

    2012-04-01

    Gynecomastia is a common disorder observed in male plastic surgery patients. Treatment options may include observation, surgical excision, or liposuction techniques. Congenital herniated nipple is a more rare condition, especially in male patients. We present the case of a 12-year-old boy with bilateral gynecomastia and herniated nipple-areolar complexes. A staged repair was undertaken in this patient with grade 2 gynecomastia. The first operation was ultrasonic liposuction bilaterally, yielding 200 mL of aspirate from the left and 400 mL on the right, to correct the gynecomastia. The second procedure, performed 6 months later, was a bilateral periareolar mastopexy to repair the herniated nipple-areolar complexes. The result of the first procedure was flattened and symmetrical breast tissue bilaterally, essentially a correction of the gynecomastia. The herniated nipples were still present, however. Bilateral periareolar mastopexies were then performed with resulting reduction of the herniations. There were no complications with either procedure, and a good cosmetic result was achieved. A staged surgical approach was successful in correcting both conditions with an excellent aesthetic result and the advantage of decreased risk for nipple complications.

  17. Nipple adenoma arising from axillary accessory breast: a case report

    Directory of Open Access Journals (Sweden)

    Shioi Yoshihiro

    2012-11-01

    Full Text Available Abstract Nipple adenoma is a relatively rare benign breast neoplasm, and cases of the disease arising from the axillary accessory breast have very seldom been reported in the English literature. We report a case of nipple adenoma arising from axillary accessory breast including clinical and pathological findings. An 82-year-old woman presented with the complaint of a small painful mass in the right axilla. Physical examination confirmed a well-defined eczematous crusted mass that was 8 mm in size. The diagnosis of nipple adenoma was made from an excisional specimen on the basis of characteristic histological findings. Microscopic structural features included a compact proliferation of small tubules lined by epithelial and myoepithelial cells, and the merging of glandular epithelial cells of the adenoma into squamous epithelial cells in the superficial epidermal layer. Because clinically nipple adenoma may resemble Paget’s disease and pathologically can be misinterpreted as tubular carcinoma, the correct identification of nipple adenoma is an important factor in the differential diagnosis for axillary tumor neoplasms. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1186821489769063

  18. Florid papillomatosis of the nipple. A study of 51 patients, including nine with mammary carcinoma.

    Science.gov (United States)

    Rosen, P P; Caicco, J A

    1986-02-01

    The present study was undertaken to review the pathology of florid papillomatosis (FP) of the nipple and to examine the relationship of FP to breast carcinoma. Clinical features of 49 women studied did not differ appreciably from those noted on prior reports, except that in one instance the lesion was probably congenital. Histologically, three distinct growth patterns were found: sclerosing papillomatosis (17 cases), papillomatosis (12 cases), and adenosis (3 cases). In 17 other cases, mixtures of these proliferative patterns were seen. FP with the sclerosing papillomatosis pattern more frequently had areas of focal necrosis in hyperplastic ducts and scattered mitoses, features that might be interpreted as evidence of carcinoma. No prognostic significance can be attributed to these patterns, since all types were cured by excision with follow-up that averaged 8.3 years. Seven of the 49 women had carcinoma in the same breast as FP: Two women had invasive carcinoma that appeared to arise from FP, and four women had concurrent invasive carcinomas that were separate from the FP; the seventh woman developed diffuse intraductal carcinoma 10 years after FP was excised from the same breast. Three of the seven women were also treated for contralateral breast carcinoma. Also reviewed were lesions from two men who had carcinoma arising in FP. One had intraductal carcinoma with Paget's disease and the other had invasive carcinoma. Appreciation of the diverse histological patterns of FP may be helpful in avoiding an erroneous diagnosis of carcinoma. Features indicative of carcinoma arising in FP are Paget's disease and areas of invasion. FP of the nipple is rarely the substrate for mammary carcinoma and is adequately treated by local excision. Coexistence with carcinoma elsewhere in the same or opposite breast occurs often enough to warrant thorough examination of the breasts when FP of the nipple is diagnosed. The risk of subsequent carcinoma following excision of FP appears to

  19. Nipple piercing may be contraindicated in male patients with chest implants.

    Science.gov (United States)

    de Kleer, N; Cohen, M; Semple, J; Simor, A; Antonyshyn, O

    2001-08-01

    The authors present a man who underwent chest augmentation and nipple piercing. The patient developed chronic nipple infection, which led to unnecessary invasive diagnostic procedures, serious implant infection, and eventually urgent explantation. This unfavorable scenario illustrates the distinct features of the procedure in men, which includes close proximity of the nipple to the implant and reduced awareness by health care providers. Based on this case the authors recommend avoiding nipple piercing in men with chest implants.

  20. Breast abscess after nipple piercing: sonographic findings with clinical correlation.

    Science.gov (United States)

    Leibman, A Jill; Misra, Monika; Castaldi, Maria

    2011-09-01

    The purpose of this series was to review the spectrum of clinical and sonographic features associated with infection after nipple piercing. Between 2002 and 2010, 6 patients presented to our breast center with a breast abscess after nipple piercing. A retrospective analysis of the imaging findings was performed with clinical and pathologic correlation. Patients with breast infections after nipple piercing tend to be young, and the timing since piercing varies from 2 weeks to 17 months. Sonography showed a complex or hypoechoic mass in 5 of 6 patients. Treatment of breast abscesses included surgical incision and drainage, percutaneous drainage, and antibiotic therapy. Surgical evacuation is commonly performed; however, sonographically guided aspiration may be an appropriate management strategy.

  1. Polyurethane Foam Wound Dressing Technique for Areola Skin Graft Stabilization and Nipple Protection After Nipple-Areola Reconstruction.

    Science.gov (United States)

    Satake, Toshihiko; Muto, Mayu; Nagashima, Yu; Haga, Shoko; Homma, Yuki; Nakasone, Reiko; Kadokura, Marina; Kou, Seiko; Fujimoto, Hiroshi; Maegawa, Jiro

    2018-04-01

    We describe a new wound management technique using a soft dressing material to stabilize the areola skin graft and protect the nipple after nipple-areola reconstruction at the final stage of breast reconstruction. We introduced a center-fenestrated multilayered hydrocellular polyurethane foam dressing material that provides adequate pressure and retains a moist environment for a smooth skin graft "take." Moreover, the reconstructed nipple can be monitored at any time through the fenestrated window for adequate blood circulation. Altogether, this simple and inexpensive wound dressing technique improves the clinical outcome. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  2. Computerized nipple identification for multiple image analysis in computer-aided diagnosis

    International Nuclear Information System (INIS)

    Zhou Chuan; Chan Heangping; Paramagul, Chintana; Roubidoux, Marilyn A.; Sahiner, Berkman; Hadjiiski, Labomir M.; Petrick, Nicholas

    2004-01-01

    Correlation of information from multiple-view mammograms (e.g., MLO and CC views, bilateral views, or current and prior mammograms) can improve the performance of breast cancer diagnosis by radiologists or by computer. The nipple is a reliable and stable landmark on mammograms for the registration of multiple mammograms. However, accurate identification of nipple location on mammograms is challenging because of the variations in image quality and in the nipple projections, resulting in some nipples being nearly invisible on the mammograms. In this study, we developed a computerized method to automatically identify the nipple location on digitized mammograms. First, the breast boundary was obtained using a gradient-based boundary tracking algorithm, and then the gray level profiles along the inside and outside of the boundary were identified. A geometric convergence analysis was used to limit the nipple search to a region of the breast boundary. A two-stage nipple detection method was developed to identify the nipple location using the gray level information around the nipple, the geometric characteristics of nipple shapes, and the texture features of glandular tissue or ducts which converge toward the nipple. At the first stage, a rule-based method was designed to identify the nipple location by detecting significant changes of intensity along the gray level profiles inside and outside the breast boundary and the changes in the boundary direction. At the second stage, a texture orientation-field analysis was developed to estimate the nipple location based on the convergence of the texture pattern of glandular tissue or ducts towards the nipple. The nipple location was finally determined from the detected nipple candidates by a rule-based confidence analysis. In this study, 377 and 367 randomly selected digitized mammograms were used for training and testing the nipple detection algorithm, respectively. Two experienced radiologists identified the nipple locations

  3. Basal cell carcinoma of the nipple. Report of two cases.

    Science.gov (United States)

    Cain, R J; Sau, P; Benson, P M

    1990-02-01

    Two cases of basal cell carcinoma of the nipple are presented, bringing the total number of reported cases to 15. The majority, including our two patients, are elderly men. This finding suggests a causal role of exposure to ultraviolet radiation. In our cases excision was curative.

  4. Basal cell carcinoma of the nipple-areola complex.

    Science.gov (United States)

    Ferguson, Mark S; Nouraei, S A Reza; Davies, Ben J H; McLean, N R

    2009-11-01

    Basal cell carcinoma (BCC) of the nipple-areola complex is uncommon. It has been suggested that BCCs in this region behave more aggressively, with a higher potential for distant spread, than in other anatomical sites. To address questions about etiology, behavior, optimal treatment, and prognosis of this entity. A literature search identifying all cases of BCC of the nipple and nipple-areola complex in the English literature from 1893 to 2008. Thirty-four cases of BCC of the nipple, areola, or both were identified, mostly affecting middle-aged men. The majority of patients were treated with tissue-sparing surgery. There was a metastatic rate of 9.1%, and one patient died from the disease (3.0%). The optimal treatment of this condition should be local excision, but patients with this condition should be followed up for primary site recurrence and axillary metastasis, because there is greater incidence than with BCC at other anatomical sites. Furthermore, proven axillary metastasis should be surgically treated.

  5. Double-nippled ureteroneocystostomy: a novel surgical technique in ...

    African Journals Online (AJOL)

    The lowest segment of the dilated obstructed ureter is transected and passed through the bladder dome for ureterovesical implantation. The distal 3 cm is folded twice like a sleeve to fashion a double-nippled valve. Evaluation of the appearance and function of the ureter and ipsilateral renal function was done by laboratory, ...

  6. Angina - discharge

    Science.gov (United States)

    Chest pain - discharge; Stable angina - discharge; Chronic angina - discharge; Variant angina - discharge; Angina pectoris - discharge; Accelerating angina - discharge; New-onset angina - discharge; Angina-unstable - discharge; ...

  7. Why do mothers use nipple shields and how does this influence duration of exclusive breastfeeding?

    DEFF Research Database (Denmark)

    Kronborg, Hanne; Foverskov, Else; Nilsson, Ingrid

    2017-01-01

    with introducing nipple shields were lower- gestational age and birthweight. The use of nipple shields was furthermore found to be associated with a threefold increased risk of earlier cessation of exclusive breastfeeding: among primiparae odds ratio = 3.80 (confidence interval 2.61–5.53); among multiparae odds......The present study addressed the contentious discussions about the benefits and risks of nipple shield use. The objective was to explore self-reported reasons for using a nipple shield and examine associations pertaining to the mother, the infant and duration of breastfeeding. Data were collected...... breastfeeding period. Primiparae used nipple shields more often than multiparae, and early breastfeeding problems as well as background factors like lower age, education and higher body mass index were associated with a higher likelihood of using nipple shields. Characteristics of infants associated...

  8. Basal cell carcinoma of the nipple - an unusual location in a male patient.

    Science.gov (United States)

    Avci, Oktay; Pabuççuoğlu, Uğur; Koçdor, M Ali; Unlü, Mehtat; Akin, Ciler; Soyal, Cüneyt; Canda, Tülay

    2008-02-01

    Although basal cell carcinoma is extremely common, it only rarely occurs on the nipple. Men are affected more often than women. Basal cell carcinoma of the nipple-areola complex may be more aggressive as metastases to regional lymph nodes have been reported. We report a basal cell carcinoma of the nipple with features of a fibroepithelioma of Pinkus in a man and review the literature.

  9. An anatomic study of nipple position and areola size in Asian men.

    Science.gov (United States)

    Kasai, Shogo; Shimizu, Yusuke; Nagasao, Tomohisa; Ohnishi, Fumio; Minabe, Toshiharu; Momosawa, Akira; Kishi, Kazuo

    2015-02-01

    In planning gender-reassignment surgery for biological women and treating men with gynecomastia, surgeons must have a thorough understanding of anatomically correct nipple positions and appropriate areola sizes in men. The authors sought to determine whether body height or body mass index (BMI) affects nipple position or areola size in men. Anatomic measurements of the nipples and areolae of 50 Japanese men were obtained. A relative coordinate system was defined, where the medial-lateral and superior-inferior positions of the nipple were quantitatively indicated by distance ratios between anatomic landmarks. Nipple positions were evaluated for each patient by referring to this coordinate system, and the positions were compared between groups categorized by body height or BMI. Nipple position was not significantly affected by body height. However, the nipple tended to be located more laterally in participants with higher BMI. The vertical nipple position differed between standing and supine positions. Tall men had larger areolae than short men; however, areola size did not differ with respect to BMI. Nipple position and areola size vary by body shape. Consideration of the differences is recommended when performing procedures such as female-to-male gender-reassignment surgery or correction of gynecomastia. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  10. Primary Buttonhole Mastopexy and Nipple-Sparing Mastectomy: A Preliminary Report.

    Science.gov (United States)

    Salibian, Arthur H; Harness, Jay K; Mowlds, Donald S

    2016-10-01

    Patients undergoing nipple-sparing mastectomy and immediate-implant based reconstruction occasionally require a mastopexy based on their breast size and degree of ptosis. Previous reports have shown the feasibility of mastopexy-nipple-sparing mastectomy in selected patients to raise the nipple up to 5 cm. Major mastopexy with nipple transposition more than 6 cm in conjunction with nipple-sparing mastectomy for therapeutic indications has not been described. The authors review their experience with primary buttonhole mastopexy performed in conjunction with nipple-sparing mastectomy. Between 2008 and 2014, 16 patients (32 breasts) underwent bilateral primary mastopexy and nipple-sparing mastectomy with immediate staged implant-based reconstruction. The Passot buttonhole technique was used for the mastopexy in all patients, raising the nipple from 7 to 12 cm. Tumor-related data, risk factors, breast size, degree of ptosis, expander size, fill volume, selection criteria, and complications are discussed. The average follow-up period was 33 months (range, 14 to 80 months). There were no tumor recurrences, and all patients completed their reconstruction. Two patients required removal of the expander and delayed reconstruction because of infection and implant exposure due to nipple-areola loss. The reasons for nipple-areola loss and technical modifications to enhance skin viability by retaining a thin layer of subareolar breast tissue for removal during the second-stage implant exchange are discussed. Primary mastopexy using the buttonhole technique performed together with nipple-sparing mastectomy is a safe procedure with predictable results in patients with very large or ptotic breasts requiring lifts greater than 6 cm. The success of the combined procedure depends on preserving a thin layer of subareolar breast tissue and removing it at the time of implant exchange.

  11. Nipple/Breast stimulation and sexual arousal in young men and women.

    Science.gov (United States)

    Levin, Roy; Meston, Cindy

    2006-05-01

    The role of nipple/breast stimulation in influencing sexual arousal in men and women during lovemaking has only been the subject of opinion-based comment rather than evidence-based study. No attempt to question people about such sexual behavior has ever been undertaken. The study was designed to ascertain the effects of nipple/breast manipulation in young men and women on their sexual arousal. A short questionnaire about nipple/breast stimulation during sexual activity was administered to 301 (148 men; 153 women) sexually experienced undergraduates (age range 17-29 years, 95% between 18 and 22). Replies to questions in questionnaire. The major findings in regard to the women were that 81.5% reported that stimulation of their nipples/breasts caused or enhanced their sexual arousal, 78.2% agreed that when sexually aroused such manipulation increased their arousal, 59.1% had asked to have their nipples stimulated during lovemaking, and only 7.2% found that the manipulation decreased their arousal. In regard to the men, 51.7% reported that nipple stimulation caused or enhanced their sexual arousal, 39% agreed that when sexually aroused such manipulation increased their arousal, only 17.1% had asked to have their nipples stimulated, and only 7.5% found that such stimulation decreased their arousal. Manipulation of the nipples/breasts causes or enhances sexual arousal in approximately 82% of young women and 52% of young men with only 7-8% reporting that it decreased their arousal.

  12. Paget's disease of the nipple. A continuing enigma

    DEFF Research Database (Denmark)

    Osther, P J; Balslev, Erik; Blichert-Toft, M

    1990-01-01

    the multicentricity of breast cancer. The literature is reviewed. Clinical, histologic (including classification), histochemical and electron microscopy observations and diagnostic considerations are discussed. Diagnosis is often delayed, with adverse consequences for treatment. The nipple lesions may be accompanied...... by ductal carcinoma of local or more extensive in situ type, or invasive tumour. Lymph-node metastasis seems to be the most important prognostic factor. The merits of radical vs. modified radical mastectomy and local excision, with or without adjuvant radiotherapy, are considered. Major studies of breast...

  13. [Benign cutaneous lymphadenosis (Bäfverstedt's disease) of the nipple (author's transl)].

    Science.gov (United States)

    Kindermann, G; Sebicke, E

    1977-12-01

    Benign circumscribed cutaneous lymphadenosis of the areola of the nipple (Bäfverstedt's disease) occurs in children and adults. We observed 11 cases: 3 men, 3 children and 6 women. The areola undergoes rapid swelling and becomes red. At times the nipple itself is included. Unilateral enlargment and distortion of the nipple area becomes apparent. Sometimes this is associated with a tumor-like infiltration of the retro-mammillary tissue. In Contradistinction to Pagets disease of the nipple and to a mammillary adenoma there is no eczema and no ulceration. The clinical features and the typical pruritic course establish the diagnosis. Healing is spontaneous, but protracted. The aetiology is probably of an inflammatory nature. Treatment with short courses of antibiotics and anti-inflammatory agents resulted in a faster reduction of the cutaneous signs and corroborated the clinical diagnosis. We consider surgical treatment as unnecessary because circumscript benign lymphadenosis of the nipple area has a harmless course.

  14. A New Local Flap Nipple Reconstruction Technique Using Dermal Bridge and Preoperatively Designed Tattoo

    Science.gov (United States)

    Iwahira, Yoshiko

    2017-01-01

    Background: Nipple–areolar reconstruction is the final step in breast reconstruction. Reconstruction using local flaps and tattooing is useful in cases of bilateral reconstruction, a small nipple–areolar complex (NAC) as the donor site, and avoiding disturbance of the normal side and other body parts. However, this method can cause projection loss and color fading of the nipple. Moreover, the breast mound is reconstructed with an implant. Methods: We performed nipple–areolar reconstruction of 90 nipples using clover-designed flaps oriented at 120 degrees and tattooing after breast silicone implantation in 64 women. The tattoo was designed before flap operation and stained darker. Following donor site closure, a dermal flap was made as a bridge for nipple support. The nipple space was separated by the dermal flap from the breast mound and was filled with subcutaneous tissue. The size of the reconstructed nipple projection was measured postoperatively and 1 year later. The projection maintenance rate was calculated. Results: The heights of the nipple projection were 11.3 ± 1.8 mm (95% confidence interval [CI]: 10.9–11.7) just after the operation and 6.09 ± 2.4 mm (95% CI: 5.6–6.6) 1 year later. The actual range of nipple projection between these 2 heights was 5.2 ± 2.4 mm (95% CI: 4.7–5.7). The maintenance rate of the reconstructed nipple projection after 12 months was 54.1 ± 20.9 (95% CI: 49.7–58.5). The nipple color was maintained for over a year. Conclusions: Our nipple–areolar reconstruction technique could maintain the projection and color of the reconstructed nipple for a long period. Good outcomes were obtained in this implant-based breast reconstruction. PMID:28507843

  15. The White Nipple Sign: Please Do Not Disturb

    Directory of Open Access Journals (Sweden)

    Naser M. Khan

    2011-07-01

    Full Text Available Blood spurting or oozing from a varix confirms the diagnosis of variceal hemorrhage. In most cases of variceal hemorrhage, however, the bleeding has ceased by the time endoscopy is performed. Endoscopists rely on identification of stigmata of recent hemorrhage to determine whether varices are the cause of bleeding and to predict the likelihood of rebleeding. Most of the attention has focused on red color signs, such as red wale markings, described by Beppu et al. [Gastrointest Endosc 1981;27:213–218] and well known to endoscopists. Here we describe our experience with a less recognized stigma of variceal hemorrhage known as the ‘white nipple sign’, which resulted in active hemorrhage when manipulated.

  16. Nevoid hyperkeratosis of the nipple and the areola.

    Science.gov (United States)

    Alonso-Corral, Maria Jose; Garrido-Colmenero, Cristina; Martinez-Ortiz, Fernando; Ruiz-Villaverde, Ricado

    2016-02-17

    A 25-year-old woman presented to our dermatology unit with progressive diffuse thickening of the both areolas. A skin biopsy was taken from the right areola showing irregular filiform acanthosis with elongation and anastomosis of rete ridges, irregular orthokeratotic hyperkeratosis, pseudocyst formation, and hyperpigmentation of the basal layer. The cause of nevoid hyperkeratosis of the nipple and areola is unknown. Eighty percent of cases occur in women and are often manifested during puberty or pregnancy. The disease may also occur in men receiving hormonal therapy. There is no uniformly effective treatment. Dermatologists, gynecologists, and general practitioners have an important part to play in recognizing this condition that may be underdiagnosed because of lack of awareness.

  17. Surgical outcomes and nipple projection using the modified skate flap for nipple-areolar reconstruction in a series of 422 implant reconstructions.

    Science.gov (United States)

    Zhong, Toni; Antony, Anu; Cordeiro, Peter

    2009-05-01

    Numerous techniques have been used in an attempt to achieve long-term nipple projection following nipple-areolar reconstruction (NAR). A common setback, however, is the diminution of projection over time; this phenomenon is particularly evident following implant based breast reconstruction. The purpose of this report was thus to evaluate surgical outcomes and long-term nipple projection with the use of "modified skate flap" technique in exclusively implant based postmastectomy reconstructions. A retrospective review was performed for the period between 1993 and 2007. All consecutive patients with 2-staged tissue expander/implant reconstructions followed by NAR using the modified skate flap technique performed by the senior author (P.C.) were identified in a prospectively maintained breast reconstruction database. Only patients with a minimum of 1-year follow-up were included in the study. Patients with a history of irradiation to the breast were excluded from nipple projection assessment. Clinical outcome measurements included long-term nipple projection as well as incidence of complications from the NAR procedure using the modified skate flap technique. Over the 15-year study period, 475 patients underwent 2-staged tissue expander/implant reconstruction followed by NAR using the modified skate flap technique. Of these, there was a total of 292 patients with the minimum requirement of 1-year follow-up post NAR (61% follow-up rate). The total number of reconstructed nipple areolar complexes evaluated in this series was 422 (130 bilateral and 162 unilateral NAR). Forty patients (28 unilateral and 12 bilateral NAR) who received radiation to their breasts were excluded from nipple projection assessment. At a median follow-up of 44 months (range: 12-84 months), mean nipple projection was 2.5 mm (range: 1-4 mm). Minor complications occurred in 7.2% of the patients (n = 292). Skin graft donor site dehiscence was the most common complication (3.1%) followed by partial skin

  18. The preference for water nipples vs. water bowls in dairy goats

    Directory of Open Access Journals (Sweden)

    Andersen Inger L

    2011-09-01

    Full Text Available Abstract Background Previous studies have reported that the design of the water dispensers can influence the water intake in farm animals. Horses and dairy cows seem to prefer to drink from an open surface whereas sheep and pigs apparently prefer water nipples, probably because of the worse water quality in water bowls. The aim of the present study was to examine the preference of dairy goats for water nipples or water bowls. Methods In each of the two experiments (exp. 1, dry goats, exp. 2 lactating goats, 42 dairy goats were allotted into 6 groups of 7 goats. In period 1, the goats had access to a water nipple. In period 2, they had access to a water bowl and in period 3 (preference test they had access to both a water nipple and a water bowl. Water usage and wastage was recorded and water intake (water usage - water wastage was calculated for each group for the two last days of each period. In experiment 2, water samples from each dispenser were analyzed for heterotrophy germs at 22°C, Escherichia coli and turbidity. Results Water usage was higher from water nipples than from water bowls both in experiment 1 (dry goats and experiment 2 (lactating goats. There was however, no difference in water intake from water nipples and water bowls. In the preference test (period 3, the water intake tended to be higher from the water nipple than from the water bowl both for the dry goats (exp. 1 and lactating goats (exp. 2. Especially for the dry goats, the differences between groups were large. Turbidity and heterotrophy germs were much higher in the samples from the water bowls than from the water nipples. Water wastage from the water bowls was negligible compared to the water nipples. From the water nipples the water wastage was 30% and 23% of water usage for the dry and lactating goats respectively. Conclusions We conclude that type of water dispenser (nipple or bowl was probably of minor importance for water intake in goats, but water bowls had a

  19. Configuration and localization of the nipple-areola complex in men.

    Science.gov (United States)

    Beer, G M; Budi, S; Seifert, B; Morgenthaler, W; Infanger, M; Meyer, V E

    2001-12-01

    The causes of bilateral absence of the nipple-areola complex in men are seldom congenital, but attributable rather to destruction as a result of trauma, or after mastectomy in female-to-male transsexuals and in male breast cancer, or after the correction of extreme bilateral gynecomastia. Such a bilateral loss becomes a major reconstructive challenge with respect to the configuration and localization of a new nipple-areola complex. Because there is very little information available in the literature, we carried out a cross-sectional study on the configuration and localization of the nipple-areola complex in men.A total of 100 healthy men aged 20 to 36 years were examined under standardized conditions. The first part of the study dealt with the configuration of the nipple-areola complex (dimensions, round or oval shape). The second part concentrated on the localization of the complex on the thoracic wall with respect to anatomic landmarks and in correlation to various parameters such as weight and height of the body, circumference of the thorax, length of sternum, and position in the intercostal space. Of the 100 subjects examined, 91 had oval and seven had a round nipple-areola complex. An asymmetry between the right and the left side was found in two cases. The mean ratio of the horizontal/vertical diameter of an oval nipple-areola complex was 27:20 mm and the mean diameter for a round nipple-areola complex was 23 mm. The center of the nipple-areola complex was in the fourth intercostal space in 75 percent and in the fifth intercostal space in 23 percent of the subjects. To localize the nipple-areola complex on the thoracic wall de novo, at least two reproducible measurements proved to be necessary, composed of a horizontal line (distance from the midsternal line to the nipple = A) and a vertical line (distance from the sternal notch to the intersection of line A, = B). The closest correlation for the horizontal distance A was given by the circumference of the

  20. Gynecomastia Surgery Is Associated with Improved Nipple Location in Young Korean Patients

    Directory of Open Access Journals (Sweden)

    Bo Hyung Lee

    2014-11-01

    Full Text Available BackgroundGynecomastia is benign enlargement of breast tissue in males and is fairly common. Mastectomy not only helps in improving the shape of anterior chest, but can also improve the location of nipple. Therefore, a principle element of mastectomy design is defining the normal location of nipple based on major anatomical reference points. Here, the nipple location was compared for before and after gynecomastia surgery. In addition, the same was also compared between male patients undergoing gynecomastia surgery and control group of subjects without gynecomastia.MethodsWe retrospectively analyzed gynecomastia patients who underwent conventional subcutaneous mastectomy. Preoperative and postoperative anatomical landmark distances and chest circumferences were measured and compared to the same anthropometric data from 20 healthy adult male controls.ResultsNipple locations were compared among 13 patients and 20 controls. The mean weight of resected breast tissue was 246 g, and overall patient satisfaction grade was 4.3 out of 5. In the patient group, the slopes for the height-distance from the sternal notch to the nipple and chest circumference-distance between the mid-line of the sternum and the nipple were 0.175 and 0.125 postoperatively, respectively. The slopes of the control group were 0.122 and 0.177, respectively; these differences were statistically significant (P<0.05.ConclusionsNipple positions were considerably lower in patients with gynecomastia than in control subjects. Subcutaneous mastectomy was associated with mild elevations, but postoperative locations were still lower compared to controls. Further efforts are needed to improve the location of postoperative nipple-areola complex in patients with gynecomastia.

  1. Mesostructure of Ordered Corneal Nano-nipple Arrays: The Role of 5-7 Coordination Defects

    Science.gov (United States)

    Lee, Ken C.; Yu, Qi; Erb, Uwe

    2016-06-01

    Corneal nano-nipple structures consisting of hexagonally arranged protrusions with diameters around 200 nm have long been known for their antireflection capability and have served as biological blueprint for solar cell, optical lens and other surface designs. However, little is known about the global arrangement of these nipples on the ommatidial surface and their growth during the eye development. This study provides new insights based on the analysis of nano-nipple arrangements on the mesoscale across entire ommatidia, which has never been done before. The most important feature in the nipple structures are topological 5- and 7-fold coordination defects, which align to form dislocations and interconnected networks of grain boundaries that divide the ommatidia into crystalline domains in different orientations. Furthermore, the domain size distribution might be log-normal, and the domains demonstrate no preference in crystal orientation. Both observations suggest that the nipple growth process may be similar to the nucleation and growth mechanisms during the formation of other crystal structures. Our results are also consistent with the most recently proposed Turing-type reaction-diffusion process. In fact, we were able to produce the key structural characteristics of the nipple arrangements using Turing analysis from the nucleation to the final structure development.

  2. A Supernumerary Nipple-Like Clinical Presentation of Lymphangioma Circumscriptum.

    Science.gov (United States)

    Taylor, Dustin; Kash, Natalie; Silapunt, Sirunya

    2018-01-01

    Lymphangioma circumscriptum is a superficially localized variant of lymphangioma. The characteristic clinical presentation is a "frogspawn" grouping of vesicles or papulovesicles on the proximal limb or limb girdle areas. Though most lymphangiomas develop congenitally, the lymphangioma circumscriptum subtype is known to present in adults. We report a case of lymphangioma circumscriptum on the left inframammary area of an African American female with an unusual supernumerary nipple-like clinical presentation. Our patient presented with a firm, smooth, hypopigmented papule, and the clinical diagnosis of keloid was made initially. However, she returned reporting growth of the lesion and was noted to have a firm, exophytic, lobulated, pink to skin-colored nodule. Histopathological examination demonstrated dilated lymphatic vessels, consistent with the diagnosis of lymphangioma. The presentation as a firm, hypopigmented papule and later exophytic, lobulated, skin-colored nodule in our case represents a clinical presentation of lymphangioma circumscriptum not previously described in the literature. Correct diagnosis in lymphangioma circumscriptum is vital, as recurrence following surgical resection and secondary development of lymphangiosarcoma and squamous cell carcinoma following treatment with radiation have been reported. Thus, it is important to consider lymphangioma circumscriptum in the differential of similar lesions in the future to allow appropriate diagnosis, treatment, and monitoring.

  3. One-Stage Nipple and Breast Reconstruction Following Areola-Sparing Mastectomy

    Directory of Open Access Journals (Sweden)

    Hye Ri Kim

    2013-09-01

    Full Text Available BackgroundSkin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM.MethodsAmong the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview.ResultsDuring the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur.ConclusionsSince one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.

  4. Mycobacterium fortuitum and anaerobic breast abscess following nipple piercing: case presentation and review of the literature.

    Science.gov (United States)

    Bengualid, Victoria; Singh, Veera; Singh, Herpreet; Berger, Judith

    2008-05-01

    Body piercing has become increasingly prevalent. We describe a case of breast infection with combined mycobacteria and anaerobe following nipple piercing, and review the literature. A 17-year-old female developed a breast abscess 4 months after nipple piercing. Cultures grew Prevotalla melangenica and Mycobacterium fortuitum. She required drainage and antibiotic treatment. Three months into her treatment she stopped her medications, relapsed, and required drainage. Two months later, on antimycobacteria therapy, her wound is healing. Review of the infectious complications of nipple piercing yielded 12 cases, 5 of which had a foreign body. The pathogens isolated (coagulase negative staphylococcus, mycobacteria, streptococcus, anaerobe, and gordonia) are not the usual organisms to be isolated from a breast abscess. This could result from reporting bias or the presence of a foreign body, the nipple ring. The three cases of mycobacteria, in addition to ours, are reviewed. The average age is 22 years. Three to 9 months elapsed between piercing and infection. All cases required drainage. Antimycobacteria therapy was used in three of the four cases for 10 days to 6 months. With the increasing prevalence of body piercing, it is important to document and report infections. We describe a breast abscess following nipple piercing with combined anaerobic and a mycobacterial pathogens. This underscores the need for obtaining cultures including anaerobes and mycobacteria.

  5. One-stage nipple and breast reconstruction following areola-sparing mastectomy.

    Science.gov (United States)

    Kim, Hye Ri; Lim, Jin Soo; Kim, Sue Min; Jung, Sung No; Yoo, Gyeol; Rha, Eun Young

    2013-09-01

    Skin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM) has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM. Among the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview. During the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur. Since one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.

  6. Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements.

    Science.gov (United States)

    Salgarello, Marzia; Visconti, Giuseppe; Barone-Adesi, Liliana

    2010-11-01

    Nipple-sparing mastectomy is gaining widespread popularity, as it could allow improved aesthetic outcome without increasing oncologic risk. To investigate the reconstructive issues experienced with immediate implant reconstruction, the authors reviewed the cosmetic outcomes of their series. The authors retrospectively analyzed the data on 33 cases of nipple-sparing mastectomy for both cancer and prophylaxis with immediate implant reconstruction using the submusculo-subfascial pocket. Cosmetic evaluation methods were clinical and photography-based assessments and a patient-satisfaction survey. The average follow-up period was 26.8 months. No nipple-areola complex cancer involvement was registered. The reconstructive outcomes ranged from good to excellent in 83 percent of the cases. Patients' satisfaction was high to very high, except in one patient who experienced total nipple-areola complex loss (one breast, 2.4 percent). Overall, early minor complications were registered in four breasts (9.5 percent) and late minor complications in five cases (12 percent). The authors' series suggest that nipple-sparing mastectomy is an option for carefully selected and screened patients. Larger studies with longer follow-up are needed, however. On the whole, the immediate one-stage implant reconstruction with hyperprojected anatomical gel implants represents a valid option. The skin incision algorithm proposed, which is based on the breast size, shape, and previous scars, might aid in the decision-making process to achieve satisfying results using this procedure. The radial approaches represent a good compromise between the oncologic and reconstructive procedures.

  7. Breast abscess following nipple piercing: a case report and review of the literature.

    Science.gov (United States)

    Kapsimalakou, Smaragda; Grande-Nagel, Isabell; Simon, Martin; Fischer, Dorothea; Thill, Marc; Stöckelhuber, Beate M

    2010-12-01

    Nipple piercing gains popularity and social acceptance within the last years, especially among young people. The medical literature reports an increase of complications in the post-piercing period. We report a case of a young woman, who presented with a light enlargement of the right breast and tenderness in the retroareolar region following nipple piercing 5 months ago. On ultrasound, a poorly marginated hypoechoic lesion was seen which was suspicious of an inflammation. After 1 week of antibiotic therapy, the mass had enlarged. As carcinoma could not be excluded, open biopsy was performed. Histology showed signs of chronic mastitis. To date, only a few reports of breast abscess after nipple piercing have been published. With the increasing prevalence of body piercing, it is important to document and report infections which may be discovered many months following piercing. Carcinoma can mimic breast abscess and should be included in the differential diagnosis.

  8. Calcitonin gene-related peptide (CGRP) in the nipple of the rat mammary gland

    DEFF Research Database (Denmark)

    Thulesen, J; Rasmussen, T N; Schmidt, P

    1994-01-01

    The distribution of nerve fibres immunoreactive to calcitonin gene-related peptide (CGRP) was investigated by immunohistochemistry in nipples and mammary glands from lactating and non-lactating rats and compared to the immunoreactivity of other neuropeptides including substance P (SP), neuropepti...... in the nipples of the pregnant (day 10) rats exceeded almost ninefold the maximum concentration of SP (7.7 +/- 2.0 pmol/g).(ABSTRACT TRUNCATED AT 250 WORDS)....... The location of SP-IR appeared to be comparable to CGRP-IR, but in fewer fibres. Dense NPY-IR networks of nerve fibres were closely associated with the fascicles of smooth musculature in the core of the nipple base. In contrast, VIP-IR fibres were only sparsely present, and SOM-IR was not detected...

  9. [Brownish coloration of the left nipple in a 60-year-old woman].

    Science.gov (United States)

    Blum, A; Hartmann, K W; Rütten, A

    2010-01-01

    Pigmented Paget disease of the nipple is a rare disease. We report on a 60-year-old woman in whom this diagnosis was made based on clinical findings, dermoscopy, histology and immunohistology. Circumscribed pigmentation of the nipple includes a wide spectrum of benign and malignant differential diagnostic considerations. Dermoscopy can enhance the clinical diagnosis. Biopsies should always be performed on unclear pigmentation of the nipple in both women and men. On histology, rare melanocytic tumors must be differentiated from pigmented Paget disease and pigmented Bowen disease. Pagetoid intraepithelial cells of a melanocytic tumor are positive for S100, HMB45 or melan A, but not for cytokeratins. Intraepithelial tumor cells of Paget disease are positive for cytokeratin 7. The clear cells in Bowen diseases are usually not positive for cytokeratin 7 and are also negative for all melanocytic markers.

  10. Basal cell carcinoma of the nipple-areola complex: a case report.

    Science.gov (United States)

    Huang, Ching-Wen; Pan, Ching-Kuen; Shih, Teng-Fu; Tsai, Cheng-Chien; Juan, Chung-Chou; Ker, Chen-Guo

    2005-10-01

    Basal cell carcinoma (BCC) of the nipple-areola complex is very rare. Only 24 cases were reported in the literature and 17 (70.8%) of these cases arose in men. Most of the cases were treated with simple excision. We report on a case of BCC of the nipple-areola complex in a 46-year-old woman, treated with partial mastectomy. Metastasis to the axillary lymph nodes had been noted in 3 (12.5%) of the 24 reported cases of BCC of the nipple-areola complex. Thus, we applied the concept of the sentinel lymph node to detect possible metastases of axillary lymph nodes, letting us avoid the unnecessary axillary lymph node dissection and possible future morbidity.

  11. Basal cell carcinomas of the areola-nipple complex: case reports and review of the literature.

    Science.gov (United States)

    Betti, Roberto; Martino, Patrizia; Moneghini, Laura; Vergani, Raffaelle; Tolomio, Elena; Crosti, Carlo

    2003-11-01

    Two white men 57 and 39 years old, and a 47-year-old white woman were seen with slowly developing papulo-nodular lesions of the areola-nipple complex. None of the patients presented with regional lymphadenopathy, history of trauma, or relevant sun-exposure. After excison of the mass, the histologic diagnosis of basal cell carcinoma was made. At two years of follow-up, no recurrence was evident. The low incidence of basal cell carcinoma in this particular site allows us to consider the areola-nipple complex location as unusual. Moreover, literature reports do not suggest that these BCCs have an increased potential for malignancy. The treatment options depend on the extension of the tumor and on the possible involvement of the areola-nipple complex and mammary tissue.

  12. PREVENTION OF NIPPLE CRACKS OF THE MAMMARY GLAND IN THE EARLY POSTNATAL PERIOD

    Directory of Open Access Journals (Sweden)

    Marina L. Travina

    2017-01-01

    Full Text Available Preservation and prolongation of the lactation period is not only a guarantee of the child's full physical and mental development but also one of the most important methods for reducing the risk of developing breast cancer. Problems with the mammary gland nipple in a woman in the early postnatal period lead to a refusal of lactation. We carried out a retrospective analysis (period from 2010 to 2016 of the causes of traumatizing mammary gland nipples in the early postnatal period in 172 women (mean age 29.1 ± 4.3 years. Methods of prevention and treatment of nipple injuries in the early postnatal period have been offered for the lactation period prolongation.

  13. Establishment of an immunocompetent nipple valve anastomosis to prevent faecal reflux after ileocolic resection in dogs.

    Science.gov (United States)

    Ecker, K W; Pistorius, G; Menger, M D; Feifel, G

    2000-05-01

    To construct an immunocompetent nipple valve anastomosis (NVA) to exclude faecal reflux and compare it with an end-to-end anastomosis to see if it would prevent recurrent inflammation caused by intraluminal bacterial antigens in Crohn's disease. Laboratory study. Teaching hospital, Germany. Two groups of six beagle dogs each of which had NVA or end-to-end anastomosis. Construction of a NVA by stapling the telescoped nipple, and replacing the ileal mucosa on the valve by colonic mucosa; end-to-end anastomosis. Radiological, bacteriological, angiographic, and morphometric results. Absolute retrograde pressure-competence and free orthograde permeability of the NVA resulted in significantly lower intestinal bacterial counts compared with the end-to-end anastomosis (p < 0.05). Transposition of colonic mucosa was successful as demonstrated by revascularisation from the ileal nipple and looked normal on morphometry. If NVA were constructed in patients with Crohn's disease, recurrences should be prevented, which would verify the immunopathogenetic hypothesis of new inflammation.

  14. Pancreatitis - discharge

    Science.gov (United States)

    Chronic pancreatitis - discharge; Pancreatitis - chronic - discharge; Pancreatic insufficiency - discharge; Acute pancreatitis - discharge ... You were in the hospital because you have pancreatitis. This is a swelling of the pancreas. You ...

  15. Effects of laser-assisted lipolysis on nipple-areola complex.

    Science.gov (United States)

    Sönmez Ergün, Selma; Kayan, Reşit Burak; Güleş, Mustafa Ekrem; Kuzu, İsmail Melih

    2017-08-01

    Gynecomastia, as a most common benign condition, represents itself as the enlargement of the male breast and also nipple-areola complex as the severity of the condition increases. With this study, we aimed to clarify the effects of 980-nm diode laser on nipple-areola complex (NAC). Although numerous open techniques have been described to correct gynecomastia, nowadays trends have shifted to minimally invasive techniques such as laser-assisted lipolysis (LAL). A total of 25 patients with bilateral gynecomastia treated with LAL by using a 980-nm diode laser. The resultant contour and reduced size of the complex were satisfactory. LAL leads to significant reduction of the size of NAC.

  16. The preference for water nipples vs. water bowls in dairy goats

    OpenAIRE

    B?e, Knut E; Ehrlenbruch, Rebecca; Andersen, Inger L

    2011-01-01

    Abstract Background Previous studies have reported that the design of the water dispensers can influence the water intake in farm animals. Horses and dairy cows seem to prefer to drink from an open surface whereas sheep and pigs apparently prefer water nipples, probably because of the worse water quality in water bowls. The aim of the present study was to examine the preference of dairy goats for water nipples or water bowls. Methods In each of the two experiments (exp. 1, dry goats, exp. 2 l...

  17. Heart pacemaker - discharge

    Science.gov (United States)

    Cardiac pacemaker implantation - discharge; Artificial pacemaker - discharge; Permanent pacemaker - discharge; Internal pacemaker - discharge; Cardiac resynchronization therapy - discharge; CRT - discharge; ...

  18. Diagnosing Flu

    Science.gov (United States)

    ... Types Seasonal Avian Swine Variant Pandemic Other Diagnosing Flu Questions & Answers Language: English (US) Español Recommend on ... How do I know if I have the flu? Your respiratory illness might be the flu if ...

  19. An electron microscopic study of clinical Paget's disease of the nipple

    DEFF Research Database (Denmark)

    Jahn, H; Osther, P J; Nielsen, E H

    1995-01-01

    An ultrastructural study of the epidermis from eight patients with clinical Paget's disease of the nipple supports the epidermotropic theory. There was no evidence that the Paget's cells originated from keratinocytes. We propose the hypothesis that Paget's cells represent transformed ductal cells...

  20. Community feedback on the JustMilk Nipple Shield Delivery System ...

    African Journals Online (AJOL)

    Background. Infant medication administration is a major public-health challenge, especially in rural or low-resource areas. The JustMilk Nipple Shield Delivery System (NSDS) is a novel method of infant medication delivery designed to address some of these challenges. Objective. To explore the acceptability of the JustMilk ...

  1. MR imaging of the skin and nipple of the breast: differentiation between tumour recurrence and post-treatment change

    International Nuclear Information System (INIS)

    Ralleigh, G.; Walker, A.E.; Hall-Craggs, M.A.; Lakhani, S.R.; Saunders, C.

    2001-01-01

    Contrast-enhanced MR imaging of the breast has been found to be valuable in the assessment of local recurrence of previously treated breast cancer. We looked specifically at the appearances of the skin and nipple of the treated breast in order to describe the appearances of post-treatment change and recurrence in this region. Thirty-nine women treated for breast cancer had MR imaging of one or both breasts reviewed retrospectively with particular attention to the nipple and skin. The skin and chest wall were assessed for patients with mastectomies. All available histology of the skin and/or nipple, obtained following MR imaging, was reviewed. In patients who did not undergo surgery following MR imaging, clinical follow-up was obtained. Six of 39 cases had nodular enhancing areas seen on MR imaging, which correlated with histology demonstrating tumour recurrence within the skin and/or nipple. Of the remaining 33 patients, changes of linear or diffuse enhancement were seen in the skin and/or nipple of 15 patients. These changes were shown to be benign post-treatment changes at surgery/biopsy in 4 cases or by clinical follow-up in the remainder. In this article we demonstrate differing patterns of contrast enhancement within the skin and nipple in recurrent breast carcinoma vs post-treatment changes. This suggests that contrast-enhanced MR imaging of the breast may be a useful tool in differentiating tumour recurrence from post-treatment changes within the skin and nipple. (orig.)

  2. Medical Injury Identification Using Hospital Discharge Data

    National Research Council Canada - National Science Library

    Layde, Peter M; Meurer, Linda N; Guse, Clare; Meurer, John R; Yang, Hongyan; Laud, Prakash; Kuhn, Evelyn M; Brasel, Karen J; Hargarten, Stephen W

    2005-01-01

    .... The development, validation, and testing of screening criteria for medical injury was based on International Classification of Disease code discharge diagnoses using 2001 patient data from Wisconsin hospitals...

  3. Inverted Nipple Correction with Selective Dissection of Lactiferous Ducts Using an Operative Microscope and a Traction Technique.

    Science.gov (United States)

    Sowa, Yoshihiro; Itsukage, Sizu; Morita, Daiki; Numajiri, Toshiaki

    2017-10-01

    An inverted nipple is a common congenital condition in young women that may cause breastfeeding difficulty, psychological distress, repeated inflammation, and loss of sensation. Various surgical techniques have been reported for correction of inverted nipples, and all have advantages and disadvantages. Here, we report a new technique for correction of an inverted nipple using an operative microscope and traction that results in low recurrence and preserves lactation function and sensation. Between January 2010 and January 2013, we treated eight inverted nipples in seven patients with selective lactiferous duct dissection using an operative microscope. An opposite Z-plasty was added at the junction of the nipple and areola. Postoperatively, traction was applied through an apparatus made from a rubber gasket attached to a sterile syringe. Patients were followed up for 15-48 months. Adequate projection was achieved in all patients, and there was no wound dehiscence or complications such as infection. Three patients had successful pregnancies and subsequent breastfeeding that was not adversely affected by the treatment. There was no loss of sensation in any patient during the postoperative period. Our technique for treating an inverted nipple is effective and preserves lactation function and nipple sensation. The method maintains traction for a longer period, which we believe increases the success rate of the surgery for correction of severely inverted nipples. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  4. [Banana peel: a possible source of infection in the treatment of nipple fissures].

    Science.gov (United States)

    Novak, Franz Reis; de Almeida, João Aprígio Guerra; de Souza e Silva, Rosana

    2003-01-01

    To study the microbiology of banana peel being sold in the city of Rio de Janeiro, in an attempt to determine the possibility that the peel may represent a source of infection for women who use it to treat nipple fissures. The following microorganisms were studied in 20 banana peel samples: mesophiles, total coliforms, fecal coliforms, Pseudomonas aeruginosa, lipolytic and proteolytic microorganisms, molds and yeasts, lactic bacteria, and coagulase-positive staphylococcus. The microbiological analyses revealed the occurrence of several typical groups of microorganisms, with the following distribution of positive results being detected in banana peel samples: mesophiles, 100%; total coliforms, 20%; coagulase-positive staphylococcus, 25%; molds and yeasts, 30%; proteolytic microorganisms, 70%; lipolytic microorganisms, 30%, and lactic bacteria, 95%. Fecal coliforms and Pseudomonas aeruginosa were not isolated. The results show the presence of potentially pathogenic microorganisms in levels which could compromise the microbiological quality of the banana peel. Its use for the treatment of nipple fissures can initiate an infectious process.

  5. Klinefelter's syndrome associated with breast carcinoma and Paget's disease of the nipple.

    Science.gov (United States)

    Moshakis, V; Fordyce, M J; Griffiths, J D

    1983-09-01

    We describe a patient with Klinefelter's syndrome associated with multi-focal breast carcinoma and Paget's disease of the nipple. Reviewing the 16 previously documented cases in the world literature, it is apparent that patients with this syndrome have an increased incidence of breast carcinoma. There is no evidence to date to suggest that such tumour is morphologically or biologically different from breast cancer in females and normal men.

  6. One-Stage Nipple and Breast Reconstruction Following Areola-Sparing Mastectomy

    Directory of Open Access Journals (Sweden)

    Hye Ri Kim

    2013-09-01

    Full Text Available Background Skin-sparing mastectomy with immediate breast reconstruction is increasinglybecoming a proven surgical option for early-stage breast cancer patients. Areola-sparingmastectomy (ASM has also recently become a popular procedure. The purpose of this articleis to investigate the reconstructive and aesthetic issues experienced with one-stage nippleand breast reconstruction using ASM.Methods Among the patients who underwent mastectomy between March 2008 and March2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwentASM and immediate breast reconstruction with simultaneous nipple reconstructionusing the modified C-V flap. The cosmetic outcomes of this series were reviewed by plasticsurgeons and patient self-assessment and satisfaction were assessed via telephone interview.Results During the average 11-month follow-up period, there were no cases of cancer recurrence,the aesthetic outcomes were graded as excellent to very good, and all of the patientswere satisfied. Two patients developed a gutter-like depression around the reconstructednipple, and one patient developed skin erosion in a small area of the areola, which healedwith conservative dressing. The other complications, such as necrosis of the skin flap or areola,seroma, hematoma, or fat necrosis did not occur.Conclusions Since one-stage nipple and breast reconstruction following ASM is an oncologicallysafe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical optionfor early breast cancer patients.

  7. Primary male neuroendocrine adenocarcinoma involving the nipple simulating Merkel cell carcinoma - a diagnostic pitfall.

    Science.gov (United States)

    Mecca, Patricia; Busam, Klaus

    2008-02-01

    Male breast cancer is a rare entity accounting for Nipple skin/subcutaneous tumors in men are even rarer. Likewise, true neuroendocrine carcinoma of the breast, defined as > 50% of tumor cells staining for either chromogranin or synaptophysin, is not a common entity, usually occurring in older women. We present the case of a 70-year-old man with a slowly growing nipple mass that had enlarged over the previous 1.5 years. The histology consisted of nests, trabeculae and sheets of basaloid cells with rare abortive gland formation and a pushing edge. The case was originally misdiagnosed as a Merkel cell carcinoma, based largely on histologic morphology. Strong staining for synaptophysin (in greater than 50% of cells), CD56, keratins AE1 : AE3 and Cam 5.2, as well as estrogen receptor and progesterone receptor was noted. Myoepithelial cells within in situ areas were identified using stains for calponin and 4A4, supporting a primary mammary duct origin. Additionally, a substantial portion of cells stained for Gross Cystic Disease Fluid Protein-15 (GCDFP-15), confirming some overlap with sweat duct differentiation. To the best of our knowledge, although reported in the male breast, no case of primary nipple neuroendocrine carcinoma in a male patient has been reported in the literature. The gender of the patient and association with the skin of the chest wall probably contributed to the original misdiagnosis of Merkel cell carcinoma in this patient.

  8. The perchlorate discharge test with {sup 123}I for the diagnosis of the Pendred syndrome in children; Der Depletionstest mit {sup 123}Iod zur Diagnose des Pendred-Syndroms bei Kindern

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, K.; Fischer, S. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany)

    2009-03-15

    The method for the diagnosis of the Pendred Syndrome in children by the Perchlorate discharge test using {sup 123}I is described. The older child, who has the Pendred Syndrome and the obligatory hearing deficit, frequently has neither a goitre nor hypothyroidism, but other investigations (bone growth, scars and function tests) can also show changes. However a more certain diagnosis of this disorder in children is possible by the perchlorate discharge test using {sup 123}I. (orig.)

  9. Review of Nipple Reconstruction Techniques and Introduction of V to Y Technique in a Bilateral Wise Pattern Mastectomy or Reduction Mammaplasty

    OpenAIRE

    Riccio, Charles A.; Zeiderman, Matthew R.; Chowdhry, Saeed; Wilhelmi, Bradon J.

    2015-01-01

    Introduction: Nipple-areola complex reconstruction (NAR) is the final procedure in breast reconstruction after the majority of mastectomies. Many methods of NAR have been described, each with inherent advantages and disadvantages depending on local healthy tissue availability, previous scarring and procedures, and the operative morbidity of the NAR technique. Nipple reconstructions may be complicated by scars or previous nipple reconstruction, making the procedure more challenging. We propose...

  10. Shoulder replacement - discharge

    Science.gov (United States)

    Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; Arthroplasty - shoulder - discharge

  11. Evolution in Monitoring of Free Flap Autologous Breast Reconstruction after Nipple-Sparing Mastectomy: Is There a Best Way?

    Science.gov (United States)

    Frey, Jordan D; Stranix, John T; Chiodo, Michael V; Alperovich, Michael; Ahn, Christina Y; Allen, Robert J; Choi, Mihye; Karp, Nolan S; Levine, Jamie P

    2018-05-01

    Free flap monitoring in autologous reconstruction after nipple-sparing mastectomy remains controversial. The authors therefore examined outcomes in nipple-sparing mastectomy with buried free flap reconstruction versus free flap reconstruction incorporating a monitoring skin paddle. Autologous free flap reconstructions with nipple-sparing mastectomy performed from 2006 to 2015 were identified. Demographics and operative results were analyzed and compared between buried flaps and those with a skin paddle for monitoring. Two hundred twenty-one free flaps for nipple-sparing mastectomy reconstruction were identified: 50 buried flaps and 171 flaps incorporating a skin paddle. The most common flaps used were deep inferior epigastric perforator (64 percent), profunda artery perforator (12.1 percent), and muscle-sparing transverse rectus abdominis myocutaneous flaps (10.4 percent). Patients undergoing autologous reconstructions with a skin paddle had a significantly greater body mass index (p = 0.006). Mastectomy weight (p = 0.017) and flap weight (p < 0.0001) were significantly greater in flaps incorporating a skin paddle. Comparing outcomes, there were no significant differences in flap failure (2.0 percent versus 2.3 percent; p = 1.000) or percentage of flaps requiring return to the operating room (6.0 percent versus 4.7 percent; p = 0.715) between groups. Buried flaps had an absolute greater mean number of revision procedures per nipple-sparing mastectomy (0.82) compared with the skin paddle group (0.44); however, rates of revision procedures per nipple-sparing mastectomy were statistically equivalent between the groups (p = 0.296). Although buried free flap reconstruction in nipple-sparing mastectomy has been shown to be safe and effective, the authors' technique has evolved to favor incorporating a skin paddle, which allows for clinical monitoring and can be removed at the time of secondary revision. Therapeutic, III.

  12. Multiple primary syphilis on the lip, nipple-areola and penis: An immunohistochemical examination of Treponema pallidum localization using an anti-T. pallidum antibody.

    Science.gov (United States)

    Fukuda, Hidetsugu; Takahashi, Misaki; Kato, Keiichi; Oharaseki, Toshiaki; Mukai, Hideki

    2015-05-01

    Primary syphilis caused by Treponema pallidum usually develops after sexual contact as an initial solitary sclerosis or hard chancre in the genital region. We describe a case of primary syphilis at three sites in genital and extragenital regions of a man who had sex with men. A 29-year-old man visited our hospital for skin lesions on his lower lip, nipple-areola and penis. A positive syphilis serological test for rapid plasma reagin had a titer of 1:16; the patient also tested positive for specific antibodies against T. pallidum, with a cut-off index of 39.0. Histopathological examination of a nipple-areola biopsy specimen revealed a thickened epidermis and dense infiltration of inflammatory cells extending from the upper dermal layers to the deep dermis. The inflammatory cells were composed of abundant lymphocytes, plasma cells, histiocytes and neutrophils. Immunohistochemical staining for T. pallidum using an anti-T. pallidum antibody showed numerous spirochetes in the lower portion of the epidermis, scattered inside inflammatory cell infiltrate and perivascular sites throughout the dermis. Based on these findings, the patient was diagnosed with primary syphilis. Treatment with oral amoxicillin hydrate was started. Five days after starting treatment, a diffuse maculopapular rash (syphilitic roseola) occurred on his trunk and extremities. Perivascular cuffing due to T. pallidum was present throughout the dermis in the biopsy specimen of a localized lesion of primary syphilis. Moreover, syphilitic roseola, which indicates generalized dissemination of T. pallidum, developed during the course of treatment for primary syphilis. Therefore, we considered perivascular cuffing to be indicative of the dissemination phase. © 2015 Japanese Dermatological Association.

  13. Breastfeeding or nipple stimulation for reducing postpartum haemorrhage in the third stage of labour.

    Science.gov (United States)

    Abedi, Parvin; Jahanfar, Shayesteh; Namvar, Farideh; Lee, Jasmine

    2016-01-27

    Oxytocin and prostaglandin are hormones responsible for uterine contraction during the third stage of labour. Receptors in the uterine muscles are stimulated by exogenous or endogenous oxytocin leading to uterine contractions. Nipple stimulation or breastfeeding are stimuli that can lead to the secretion of oxytocin and consequent uterine contractions. Consequently, uterine contractions can reduce bleeding during the third stage of labour. To investigate the effects of breastfeeding or nipple stimulation on postpartum haemorrhage (PPH) during the third stage of labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 July 2015) and reference lists of retrieved studies. Randomised and quasi-randomised controlled trials comparing breast stimulation, breastfeeding or suckling for PPH in the third stage of labour were selected for this review. Two review authors independently assessed studies for inclusion in terms of risk of bias and independently extracted data. Disagreements were resolved by a third review author. We included four trials (4608 women), but only two studies contributed data to the review's analyses (n = 4472). The studies contributing data were assessed as of high risk of bias overall. One of these studies was cluster-randomised and conducted in a low-income country and the other study was carried out in a high-income country. All four included studies assessed blood loss in the third stage of labour. Birth attendants estimated blood loss in two trials. The third trial assessed the hematocrit level on the second day postpartum to determine the effect of the bleeding. The fourth study measured PPH ≥ 500 mL. Nipple stimulation versus no treatmentOne study (4385 women) compared the effect of suckling versus no treatment. Blood loss was not measured in 114 women (59 in control group and 55 in suckling group). After excluding twin pregnancies, stillbirths and neonatal deaths, the main analyses for this trial were performed on

  14. Trans-nipple removal of fibro-glandular tissue in gynaecomastia surgery without additional scars: An innovative approach

    Directory of Open Access Journals (Sweden)

    R K Mishra

    2014-01-01

    Full Text Available Context: The established techniques that have been used to treat gynaecomastia are said to have relatively less patient satisfaction rate as they leave some visible scars or mild elevation over the nipple areola complex, resulting in aesthetically unsatisfactory results. Even the slightest elevation or smallest scar over nipple areola complex leave patients extremely self conscious and in a dilemma of having a second intervention to get rid of that blemish. Aims: The aim of the study is to achieve - A flat chest without adding a scar and with no chances of re-occurrence of the condition. This article suggests an innovative approach to address the problem. Materials and Methods: The author presents trans-nipple incision approach for the delivery of fibro-glandular tissue component following liposuction for maximum patient satisfaction. This method consists of a unique small criss-cross incision right on the nipple itself for retrieving any volume of tough fibro-glandular tissues. Between the duration of January 2012 to October 2013, 28 male patients of different ages were operated with this technique. Results: The surgery resulted in well-shaped, symmetric chest contour without any visible elevation or additional scars on nipple areola complex. No complications were noticed in any of the patients. Conclusions: The presented technique is proved to have a high patient satisfaction rate and to be promising method to achieve good aesthetic results in gynaecomastia surgery.

  15. The frequency of using different types of pacifier and bottle nipple among 1-24 months old children

    Directory of Open Access Journals (Sweden)

    Hamidreza Poureslami

    2016-03-01

    Full Text Available BACKGROUND AND AIM: Sucking of some types of a pacifier may be a risk factor for mal-development of orofacial structures and malocclusion. This study assessed the prevalence of using of different types of pacifier and bottle nipple among 1-24 months old children in Kerman, Iran. METHODS: In this cross-sectional study, a total of 300 mothers interviewed at 20 specialized private pediatric offices in Kerman. The mothers had 1-24 months old children. A checklist includes items about pacifier sucking, bottle feeding habits, as well as mothers’ ability to recognize different kinds of available pacifier and bottle nipple was used. RESULTS: The rate of pacifier-sucking was 37.3%, and use of bottle feeding was 42.3%, and among of the users, 24.0 and 35.7% were used orthodontic (functional types of pacifier and bottle nipple respectively. However, only 28.7% of mothers had adequate ability to recognize orthodontic pacifier and bottle nipple. CONCLUSION: The rates of using orthodontic kind of pacifier and bottle nipple were low, and a few mothers had adequate ability to recognize their differences.

  16. Nipple- and areola-sparing mastectomy for the treatment of breast cancer.

    Science.gov (United States)

    Mota, Bruna S; Riera, Rachel; Ricci, Marcos Desidério; Barrett, Jessica; de Castria, Tiago B; Atallah, Álvaro N; Bevilacqua, Jose Luiz B

    2016-11-29

    The efficacy and safety of nipple-sparing mastectomy and areola-sparing mastectomy for the treatment of breast cancer are still questionable. It is estimated that the local recurrence rates following nipple-sparing mastectomy are very similar to breast-conserving surgery followed by radiotherapy. To assess the efficacy and safety of nipple-sparing mastectomy and areola-sparing mastectomy for the treatment of ductal carcinoma in situ and invasive breast cancer in women. We searched the Cochrane Breast Cancer Group's Specialized Register, the Cochrane Center Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), Embase (via OVID) and LILACS (via Biblioteca Virtual em Saúde [BVS]) using the search terms "nipple sparing mastectomy" and "areola-sparing mastectomy". Also, we searched the World Health Organization's International Clinical Trials Registry Platform and ClinicalTrials.gov. All searches were conducted on 30th September 2014 and we did not apply any language restrictions. Randomised controlled trials (RCTs) however if there were no RCTs, we expanded our criteria to include non-randomised comparative studies (cohort and case-control studies). Studies evaluated nipple-sparing and areola-sparing mastectomy compared to modified radical mastectomy or skin-sparing mastectomy for the treatment of ductal carcinoma in situ or invasive breast cancer. Two review authors (BS and RR) performed data extraction and resolved disagreements. We performed descriptive analyses and meta-analyses of the data using Review Manager software. We used Cochrane's risk of bias tool to assess studies, and adapted it for non-randomised studies, and we evaluated the quality of the evidence using GRADE criteria. We included 11 cohort studies, evaluating a total of 6502 participants undergoing 7018 procedures: 2529 underwent a nipple-sparing mastectomy (NSM), 818 underwent skin-sparing mastectomy (SSM) and 3671 underwent traditional mastectomy, also known as modified radical

  17. Does Smoking History Confer a Higher Risk for Reconstructive Complications in Nipple-Sparing Mastectomy?

    Science.gov (United States)

    Frey, Jordan D; Alperovich, Michael; Levine, Jamie P; Choi, Mihye; Karp, Nolan S

    2017-07-01

    History of smoking has been implicated as a risk factor for reconstructive complications in nipple-sparing mastectomy (NSM), however there have been no direct analyses of outcomes in smokers and nonsmokers. All patients undergoing NSM at New York University Langone Medical Center from 2006 to 2014 were identified. Outcomes were compared for those with and without a smoking history and stratified by pack-year smoking history and years-to-quitting (YTQ). A total of 543 nipple-sparing mastectomies were performed from 2006 to 2014 with a total of 49 in patients with a history of smoking. Reconstructive outcomes in NSM between those with and without a smoking history were equivalent. Those with a smoking history were not significantly more likely to have mastectomy flap necrosis (p = 0.6251), partial (p = 0.8564), or complete (p = 0.3365) nipple-areola complex (NAC) necrosis. Likewise, active smokers alone did not have a higher risk of complications compared to nonsmokers or those with smoking history. Comparing nonsmokers and those with a less or greater than 10 pack-year smoking history, those with a > 10 pack-year history had significantly more complete NAC necrosis (p = 0.0114, smoking history or >5 YTQ prior to NSM were equivalent to those without a smoking history. We demonstrate that NSM may be safely offered to those with a smoking history although a > 10 pack-year smoking history or <5 YTQ prior to NSM may impart a higher risk of reconstructive complications, including complete NAC necrosis. © 2017 Wiley Periodicals, Inc.

  18. Review of nipple reconstruction techniques and introduction of v to y technique in a bilateral wise pattern mastectomy or reduction mammaplasty.

    Science.gov (United States)

    Riccio, Charles A; Zeiderman, Matthew R; Chowdhry, Saeed; Wilhelmi, Bradon J

    2015-01-01

    Nipple-areola complex reconstruction (NAR) is the final procedure in breast reconstruction after the majority of mastectomies. Many methods of NAR have been described, each with inherent advantages and disadvantages depending on local healthy tissue availability, previous scarring and procedures, and the operative morbidity of the NAR technique. Nipple reconstructions may be complicated by scars or previous nipple reconstruction, making the procedure more challenging. We propose the use of the V-Y advancement flap as a new method that is suitable for both novice and experienced surgeons wishing to broaden their range of techniques for difficult nipple reconstructions. A traditional V-Y advancement flap is lifted at the site of the future nipple. Mastectomy scars from prior mastectomy, mammoplasty, or nipple reconstruction can be incorporated into the flap. The flap is folded caudally upon itself and the secondary defect at the apex of the flap is linearly closed. At 6-month postoperative evaluation, adequate nipple projection and patient satisfaction were achieved with this method. The V-Y advancement flap is a suitable method for achieving satisfactory results when faced with challenging NAR. The method is easy to perform, reproducible, has low operative morbidity, and incorporates previous wise pattern mastectomy or mammaplasty scars into the newly reconstructed nipple, thereby decreasing new scar formation on the breast and leading to favorable cosmetic results.

  19. Robotic da Vinci Xi-assisted nipple-sparing mastectomy: First clinical report.

    Science.gov (United States)

    Sarfati, Benjamin; Honart, Jean-Francois; Leymarie, Nicolas; Rimareix, Francoise; Al Khashnam, Heba; Kolb, Frederic

    2018-05-01

    Nipple-sparing mastectomy (NSM) is increasingly popular for the treatment of selected breast cancers and prophylactic mastectomy. Surgical scarring and esthetic outcomes are important patient-related cosmetic considerations. Today, the concept of minimally invasive surgery has become popular, especially using robotic surgery. The authors report the first case of NSM using the latest version of the da Vinci Xi surgical system (Xi). The final incision used to remove the entire mammary gland was located behind the axillary line. In this position, hidden by the arm of the patient, the incision was not visible and was compatible with immediate breast reconstruction. © 2017 Wiley Periodicals, Inc.

  20. Promising results after single-stage reconstruction of the nipple and areola complex

    DEFF Research Database (Denmark)

    Børsen-Koch, Mikkel; Bille, Camilla; Thomsen, Jørn B

    2013-01-01

    Introduction: Reconstruction of the nipple-areola complex (NAC) traditionally marks the end of breast reconstruction. Several different surgical techniques have been described, but most are staged procedures. This paper describes a simple single-stage approach. Material and Methods: We used...... reconstruction was 43 min. (30-50 min.). Conclusion: This simple single-stage NAC reconstruction seems beneficial for both patient and surgeon as it seems to be associated with faster reconstruction and reduced procedure-related time without compromising the aesthetic outcome or the morbidity associated...

  1. A common cancer in an uncommon location: A case report of squamous cell carcinoma of the nipple

    Directory of Open Access Journals (Sweden)

    Kelly Dye

    2017-01-01

    Conclusion: The cases of SCC of the Nipple demonstrate the importance of recognizing changes of the skin even in locations not typically associated with SCC (American Cancer Society, 2015; Scotto et al., 1983; Pendse and O’Connor, 2015; Loveland-Jones et al., 2010; Brookes et al., 2005; Sofos et al., 2013; King and Kremer, 2012; Venkataseshan et al., 1994; Hosaka et al., 2011 [1–9]. We concluded with a future suggestion of investigating possible risk factors specific to SCC of the breast or nipple.

  2. Reconstructive approach for patients with augmentation mammaplasty undergoing nipple-sparing mastectomy.

    Science.gov (United States)

    Alperovich, Michael; Choi, Mihye; Frey, Jordan D; Karp, Nolan S

    2014-09-01

    Nipple-sparing mastectomy (NSM) is a recent advance in the therapeutic and prophylactic management of breast cancer; however, the procedure is associated with increased reconstructive complications. Data on NSM after previous breast augmentation are limited. The authors compared reconstructive complications after NSM between patients with previously augmented breasts and a larger cohort that had not undergone prior augmentation. An approach to NSM that involves 2-stage reconstruction in augmented patients is also described. Medical records of NSMs performed at New York University Langone Medical Center from 2006 to 2013 were reviewed. Data points evaluated included patient characteristics, comorbidities, breast implant plane, and reconstructive complications. Fisher's exact and t tests were used for the comparisons. During the study period, NSMs were performed in 17 augmented breasts at this institution. After NSM, 15 of these breasts underwent implant-based reconstruction and 2 breasts underwent microvascular free flaps. Reconstructive complications included 1 hematoma managed nonoperatively (5.9%) and 1 partial necrosis of the nipple-areola complex (NAC) (5.9%). Compared with the larger nonaugmented cohort (n=332), patients with previously augmented breasts had fewer complications, and there were no statistically significant differences in the rates of mastectomy flap necrosis, partial NAC necrosis, complete NAC necrosis, hematoma, capsular contracture, explantation, implant displacement, seroma, or breast cellulitis. The results indicate that NSM reconstruction is associated with minimal complications in patients with previous augmentation mammaplasty. 4. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

  3. "Seeing Is Believing": Dermatoscope Facilitated Breast Examination of the Breastfeeding Woman with Nipple Pain.

    Science.gov (United States)

    Naimer, Sody A; Silverman, William F

    2016-09-01

    It is well recognized that breastmilk provides optimal nutrition and immunological protection for infants. Many women, however, experience nipple pain while breastfeeding, leading to premature cessation of nursing. To overcome these difficulties, timely diagnosis is crucial to effectively treat the underlying pathology and permit resumption of breastfeeding. Examination of the superficial breast plays a key role in accurate diagnosis. Traditional direct inspection is clearly inadequate for this task. The dermatoscope is a useful tool, enlarging and illuminating an area of epidermis to obtain an optimal image. Improvements in dermoscopy involving polarization obviate the need for full contact with the examined surface, thereby providing anatomical detail in three dimensions. A novel practice presented in this article features clinical cases introducing this technique as it is applied to the lactating breast, conclusively distinguishing normal from abnormal and illustrating the efficacy and added diagnostic value of this approach. The dermoscope is shown to facilitate identification of the causes of nipple pain ranging from asymptomatic candidal infection to exquisitely painful, minute traumatic erosions, aiding, thereby, in diagnosis of the underlying causes of nursing difficulties. Improved wound surveillance and standardization for purposes of research documentation are additional benefits anticipated with the use of breast dermoscopy. We conclude that real-time, high-quality, magnified imaging of the lactating breast represents a recognizable advance in pursuit of a rapid and accurate technique that aids in the identification of the factors responsible for lesions affecting nursing women. Moreover, it features an already existing technology requiring little training at a reasonable cost.

  4. Pigmented Basal cell carcinoma of nipple and areola in a male breast - a case report with review of literature.

    Science.gov (United States)

    Kalyani, R; Vani, B R; Srinivas, Murthy V; Veda, P

    2014-03-01

    Basal cell carcinoma is a common skin cancer worldwide. However basal cell carcinoma of nipple and areola complex is rare, commonly seen in males in elderly age group. The tumor has aggressive behavior with increased tendency for metastasis. We present a case in a 78 year male in the left breast.

  5. Bilateral DCIS following gynecomastia surgery. Role of nipple sparing mastectomy. A case report and review of literature☆

    Science.gov (United States)

    Noor, L.; McGovern, P.; Bhaskar, P.; Lowe, J.W.

    2011-01-01

    Bilateral ductal carcinoma in situ of breast is a very rare disease in men. Ductal carcinoma in situ (DCIS) is an abnormal proliferation that involves the ductal epithelium and it has the potential of evolving into an invasive tumour. Gynaecomastia (female like breast in men) is a benign condition though it is associated with a reported 3% incidence of unilateral invasive breast cancer.2 Synchronous bilateral breast cancer in association with gynaecomastia is exceptionally rare. The recommended treatment for DCIS in male is mastectomy. So far only 2 cases of bilateral DCIS in male patients has been reported in the literature treated with skin and nipple sparing mastectomies. We report another case of synchronous bilateral DCIS in a male treated with skin and nipple sparing mastectomies. A 44 year-old man with history of long-standing gynecomastia. He had no identifiable risk factor for the development of cancer. His pre operative assessment of breast including mammograms was normal. He underwent bilateral subcutaneous mastectomies, with subsequent incidental diagnosis of synchronous bilateral ductal carcinoma in situ. The case was discussed in multidisciplinary team meeting and the need for further surgery was felt including excision of nipple areola complex. However considering patient wishes, cosmetic outcome and recent literature it was decided to preserve nipple areola complex (NAC) with regular follow up evaluation. Our patient at completion of 18 months of treatment is doing well with no signs of local recurrence. PMID:22096697

  6. Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon L; Bille, Camilla; Reitsma, Laurens C

    2017-01-01

    BACKGROUND: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satis...

  7. Ileostomy - discharge

    Science.gov (United States)

    ... dried fruits (such as raisins), mushrooms, chunky relishes, coconut, and some Chinese vegetables. Tips for when no ... ask your doctor Living with your ileostomy Low-fiber diet Small bowel resection - discharge Total colectomy or ...

  8. Proteins and carbohydrates in nipple aspirate fluid predict the presence of atypia and cancer in women requiring diagnostic breast biopsy

    International Nuclear Information System (INIS)

    Qin, Wenyi; Gui, Gerald; Zhang, Ke; Twelves, Dominique; Kliethermes, Beth; Sauter, Edward R

    2012-01-01

    Herein we present the results of two related investigations. The first study determined if concentrations in breast nipple discharge (ND) of two proteins (urinary plasminogen activator, uPA and its inhibitor, PAI-1) predicted the presence of breast atypia and cancer in pre- and/or postmenopausal women requiring surgery because of a suspicious breast lesion. The second study assessed if these proteins increased the predictive ability of a carbohydrate (Thomsen Friedenreich, TF) which we previously demonstrated predicted the presence of disease in postmenopausal women requiring surgery. In the first study we prospectively enrolled 79 participants from whom we collected ND, measured uPA and PAI-1 and correlated expression with pathologic findings. In the second study we analyzed 35 (uPA and PAI-1 in 24, uPA in an additional 11) ND samples collected from different participants requiring breast surgery, all of whom also had TF results. uPA expression was higher in pre- and PAI-1 in postmenopausal women with 1) cancer (DCIS or invasive) vs. either no cancer (atypia or benign pathology, p = .018 and .025, respectively), or benign pathology (p = .017 and .033, respectively); and 2) abnormal (atypia or cancer) versus benign pathology (p = .018 and .052, respectively). High uPA and PAI-1 concentrations and age were independent predictors of disease in premenopausal women, with an area under the curve (AUC) of 83-87% when comparing diseased vs. benign pathology. uPA, TF, and age correctly classified 35 pre- and postmenopausal women as having disease or not 84-91% of the time, whereas combining uPA+PAI-1+TF correctly classified 24 women 97-100% of the time. uPA and PAI-1 concentrations in ND were higher in women with atypia and cancer compared to women with benign disease. Combining uPA, PAI-1 and TF in the assessment of women requiring diagnostic breast surgery maximized disease prediction. The assessment of these markers may prove useful in early breast cancer detection

  9. The Aesthetically Ideal Position of the Nipple-Areola Complex on the Breast.

    Science.gov (United States)

    Lewin, Richard; Amoroso, Matteo; Plate, Nikolina; Trogen, Clara; Selvaggi, Gennaro

    2016-10-01

    Several studies have attempted to identify an objective description of the aesthetically ideal breast, but they have all suffered in their reliability because of having several intrinsic limitations. It is therefore essential to design a template of ideal breast features in order to predict and evaluate aesthetic outcomes in both reconstructive and cosmetic breast surgery. The aim of this study was to determine the aesthetically preferred position of the nipple-areola complex on the breast. A questionnaire was sent by regular mail to 1000 men and 1000 women aged between 16 and 74 years. They were asked to rank the attractiveness of a series of breasts of women in images with different NAC positions. The images showed breasts from two different angles: 12 frontal-view images with both breasts shown, and five side-view images with only one breast shown. All of the breasts had equal dimensions and proportions, with the same areola size but different NAC positions. Statistical analysis of data was carried out. Eight hundred and thirteen of 2000 participants completed the questionnaire. The NAC placement preferred by both genders had a ratio of 40:60 x and 50:50 y, which means that it was best situated in the middle of the breast gland vertically and slightly lateral to the midpoint horizontally. Significant differences were found between the age and gender subgroup preferences. This study identified the preferred position of the nipple-areola complex on the female breast in the general population. This is an important information when planning breast reconstructive and cosmetic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  10. Guinea pig (Cavia porcellus) drinking preferences: do nipple drinkers compensate for behaviourally deficient diets?

    Science.gov (United States)

    Balsiger, A; Clauss, M; Liesegang, A; Dobenecker, B; Hatt, J-M

    2017-10-01

    When offered diets with hay ad libitum, rabbits (Oryctolagus cuniculus) clearly prefer open dishes over nipple drinkers, but whether this preference also applies in guinea pigs (Cavia porcellus) is unsure. We tested the drinker preference of 10 guinea pigs when offered open dishes (OD) and nipple drinkers (ND) simultaneously and measured the amount of water consumed by each animal on four different diets (grass hay 100%, or as 10% of intake on diets of fresh parsley, seed mix or pelleted complete feed, respectively) on either of the drinking systems. All animals ingested the hay portion of the combined diets first. The amount of water consumed differed significantly between individual animals. Animals drank less water on parsley than on the other diets. Nine of 10 animals clearly preferred ND when having a choice, and eight of these drank more when on ND only. The difference between the drinking systems was not consistent across all diets: on hay, similar amounts of water were drunk when on OD or ND only. Differences in water intake were reflected in urine production. Because drinking from ND in guinea pigs involves jaw movements similar to those in chewing, the results could suggest that when motivation for oral processing behaviour is not satisfied by a diet, animals may respond in using ND beyond physiological water necessity. Whereas physiological water requirements are probably better investigated with other drinking systems due to a possible overestimation when using ND, offering ND to pet guinea pigs most likely offers a form of behavioural enrichment that at the same time may increase water intake and hence act as prophylaxis against urolithiasis. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

  11. Peroxide alkaline for cleansing the baby bottle nipple to prevent oral thrush relaps

    Directory of Open Access Journals (Sweden)

    Maharani Laillyza Apriasari

    2013-06-01

    Full Text Available Background: Oral candidiasis is the most prevalent opportunistic infection affecting the oral mucosa. A number of predisposing factors have the capacity to convert Candida from the normal commensal flora to a pathogenic organism. Oral candidiasis is divided into primary and secondary infection. The primary infections are restricted to the oral and perioral sites, where as secondary infections are accompanied by sistemic mucocutaneous manifestation. Oral thrush is one of the candidiasis primary infection. Some presdiposing factors of oral thrush are neonatal, old people, or where oral microflora is disturbed by the treatment with broad spectrum antibiotics. Final diagnosis is determined by fungal culture examination, although through clinical examination oral thrush can be determined by swabbing the white pseudomembran. Purpose: This case report presents about the importance of using the antiseptic cleanser for baby bottle nipple to prevent oral thrush relaps and shows about peroxide alkaline as the alternatif of antiseptic cleanser for baby bottle nipple that can substitute chlorhexidine gluconat 0.2%. Case: A baby girl, 15 months old, when she was suffering influenza the pediatry gave amoxycillin 125 mg three times a day for ten days. Then the white plaque appeared on her dorsum of tongue. The therapy was Gentian Violet 1% four times a day for ten days was applied on dorsum of the tongue. The patient was suspected to suffer alergy reaction after using nistatin oral suspension four times a day had applied for 1 day. The instruction was doing sterilization for the baby bottle nipple in boiling water. Three days after the baby was cured, the white plaque was appeared on upper n lower lips mucous. Case management: The diagnosis was Oral thrush. The therapy was Gentian violet 1% four times a day for ten days that applied on upper and lower lips mucous. The instruction was doing the sterilization for baby bottle nipple in denture cleanser contain

  12. Discharge Dialogue

    DEFF Research Database (Denmark)

    Horsbøl, Anders

    2012-01-01

    For several years, efforts have been made to strengthen collaboration between health professionals with different specializations and to improve patient transition from hospital to home (care). In the Danish health care system, these efforts have concentrated on cancer and heart diseases, whereas...... coordinator, employed at the hospital, is supposed to anticipate discharge and serve as mediator between the hospital and the municipal home care system. Drawing on methods from discourse and interaction analysis, the paper studies the practice of the discharge coordinator in two encounters between patients...... how the home context provides different resources for identification of patient needs and mutual decision making....

  13. Anti nutritional evaluation of the flour of the nipples of holm oak (quercus ilex) and oak cork (quercus suber) Raw and pressure-sealed

    Energy Technology Data Exchange (ETDEWEB)

    El Mahi, F. Z.

    2009-07-01

    The present study contributes to the development of the food potential of the nipples of oak like new resources likely to be exploited on an industrial scale for their use in animal feeds. Our work relates to two species S of nipples of oak, edible, the homl oak and the other fodder one, the oal cork known for their spontaneousness and their vey significant geographical distribution. (Author)

  14. Anti nutritional evaluation of the flour of the nipples of holm oak (quercus ilex) and oak cork (quercus suber) Raw and pressure-sealed

    International Nuclear Information System (INIS)

    El Mahi, F. Z.

    2009-01-01

    The present study contributes to the development of the food potential of the nipples of oak like new resources likely to be exploited on an industrial scale for their use in animal feeds. Our work relates to two species S of nipples of oak, edible, the holm oak and the other fodder one, the oak cork known for their spontaneousness and their vey significant geographical distribution. (Author)

  15. Angioplasty and stent - heart - discharge

    Science.gov (United States)

    Drug-eluting stents - discharge; PCI - discharge; Percutaneous coronary intervention - discharge; Balloon angioplasty - discharge; Coronary angioplasty - discharge; Coronary artery angioplasty - discharge; Cardiac ...

  16. Radiological discharges

    International Nuclear Information System (INIS)

    Woodliffe, J.

    1990-01-01

    Current practice of North Sea States on the discharge and disposal of liquid radioactive wastes to the North Sea are based on the declaration issued at the Second International Conference on the Protection of the North Sea, known as the London Declaration. This has three main points the first of which emphasises the application of the Best Available Technology to protect the North Sea, the second provides a framework on which future controls on radioactive discharges should be based. The third identifies two parts of the framework; to take into account the recommendations of international organizations and that any repositories of radioactive waste which are built should not pollute the North Sea. This chapter looks at how the concensus based on the London Declaration is working, gauges the progress made in the implementation of the policy goal, identifies existing and future areas for concern and proposes ways of strengthening the control of radioactive discharges. The emphasis is on the United Kingdom practice and regulations for liquid wastes, most of which comes from the Sellafield Reprocessing Plant. (author)

  17. Recipient vessel selection in immediate breast reconstruction with free abdominal tissue transfer after nipple-sparing mastectomy.

    Science.gov (United States)

    Yang, Sung Jun; Eom, Jin Sup; Lee, Taik Jong; Ahn, Sei Hyun; Son, Byung Ho

    2012-05-01

    Nipple-sparing mastectomy (NSM) is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel. Between June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared. Thoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group. The thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.

  18. Recipient Vessel Selection in Immediate Breast Reconstruction with Free Abdominal Tissue Transfer after Nipple-Sparing Mastectomy

    Directory of Open Access Journals (Sweden)

    Sung Jun Yang

    2012-05-01

    Full Text Available BackgroundNipple-sparing mastectomy (NSM is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel.MethodsBetween June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared.ResultsThoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group.ConclusionsThe thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.

  19. Retention of a reconstructed nipple using a C-V flap with different layer thicknesses in the C-flap.

    Science.gov (United States)

    Sowa, Yoshihiro; Itsukage, Sizu; Sakaguchi, Kouichi; Taguchi, Tetsuya; Numajiri, Toshiaki

    2018-04-01

    The C-V flap for nipple reconstruction is now one of standard surgical techniques. But decreased projection is still a problem. In recent years, it has been suggested that projection can be more easily maintained when raising of the C-flap is performed with a split thickness dermis. In this study, we examined whether decrease of projection can be prevented by raising of a C-flap with a split dermis rather than with full dermis. A total of 49 consecutive patients who underwent reconstruction of a nipple using the C-V flap technique were enrolled. The patients included 22 who underwent surgery using a C-flap with a full thickness dermis (Group F), and 27 who underwent surgery with raising of a flap with a split thickness dermis (Group S). The size of the reconstructed nipple was measured at 2 weeks, 6 months and 1 year postoperatively for comparison between Groups F and S. Partial necrosis of the C-flap end occurred in 4 subjects in only Group S. The decrease in projection after 1 year postoperatively in Group S was significantly lower than that in Group F. In contrast, the teat base size in Group F tended to be greater than that in Group S, suggesting a tendency for an expanded base using a flap with a full dermis. Our results indicated that it is recommended to use a C-flap with a split dermis for cases with high projection of the nipple on the contralateral side.

  20. Can Vascular Patterns on Preoperative Magnetic Resonance Imaging Help Predict Skin Necrosis after Nipple-Sparing Mastectomy?

    Science.gov (United States)

    Bahl, Manisha; Pien, Irene J; Buretta, Kate J; Hwang, E Shelley; Greenup, Rachel A; Ghate, Sujata V; Hollenbeck, Scott T

    2016-08-01

    Nipple-areola complex (NAC) and skin flap ischemia and necrosis can occur after nipple-sparing mastectomy (NSM). The purpose of this study was to correlate vascular findings on MRI with outcomes in patients who underwent NSM. Female patients at a single institution who underwent NSM and had a preoperative breast MRI between 2010 and 2014 were identified. Medical records were reviewed for patient demographics, surgical factors, and complications. Magnetic resonance images were reviewed by 2 radiologists, blinded to outcomes, for the presence of dual vs single blood supply to the breast. The association between blood supply on MRI with ischemic and necrotic complications after NSM was analyzed. One hundred and sixty-four NSM procedures were performed in 105 patients (mean age 45.5 years, range 25 to 69 years) who had a preoperative MRI. The majority of procedures were performed for malignancy (89 of 164 [54.3%]) or prophylaxis (73 of 164 [44.5%]). Nipple-areola complex or skin flap ischemia or necrosis occurred in 40 (24.4%) breasts. Ischemia or necrosis after NSM was less likely to occur in breasts with dual compared with single blood supply (20.8% vs 38.2%; p = 0.03). There was no association between surgical complications and age, BMI, smoking history, previous radiation therapy, indication for NSM, surgical specimen weight, surgical incision type, reconstruction approach, or operating surgeon on univariate analysis. Preoperative MRI characterization of breast vascularity can be considered when planning NSM. The presence of a dual blood supply to the breast on MRI is associated with a decreased risk of nipple-areola complex and skin flap ischemia and necrosis after NSM. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  1. A 35-year-old woman presenting with an unusual post-traumatic leiomyoma of the nipple: a case report.

    Science.gov (United States)

    Pavlidis, Leonidas; Vakirlis, Efstratios; Spyropoulou, Georgia-Alexandra; Pramateftakis, Manousos Georgios; Dionyssiou, Dimitris; Demiri, Efterpi

    2013-02-19

    Leiomyoma of the mammary papilla is one of the most uncommon nipple tumors with only 50 cases reported in the literature until now. To the best of our knowledge we present the first report of a nipple leiomyoma that originated from a traumatic abrasion caused by breastfeeding. A 35-year-old healthy Caucasian female with a cauliflower-like tender and pink nodular mass that was approximately 10mm in diameter presented to our out-patients department. The patient suggested that the mass originated from a traumatic abrasion caused by breastfeeding three years ago and it has been slowly growing ever since.An excision biopsy was performed. The histological and immunohistochemical examination confirmed the diagnosis of leiomyoma. There were no postoperative complications or any sign of local recurrence four years postoperatively. Leiomyoma of the mammary papilla is a rare benign neoplasm that usually appears as a solid tender nodule. Differential diagnosis comprises breast carcinoma, leiomyosarcoma and myoid hamartoma. The recommended treatment is complete excision of the tumor with histologically confirmed tumor-free margins otherwise recurrence is possible. A detailed history of the patient's disease can reveal the original etiology. This is an original case report that will have particular interest to plastic surgeons, dermatologists, and pathologists. The pathogenetic mechanism was trauma of the nipple. According to our review of the literature this particular information has never been reported and we think that it may advance our knowledge of this very infrequent tumor.

  2. Hysterectomy - vaginal - discharge

    Science.gov (United States)

    Vaginal hysterectomy - discharge; Laparoscopically assisted vaginal hysterectomy - discharge; LAVH - discharge ... you were in the hospital, you had a vaginal hysterectomy. Your surgeon made a cut in your ...

  3. Application of acoustic emission technique and friction welding for excavator hose nipple

    International Nuclear Information System (INIS)

    Kong, Yu Sik; Lee, Jin Kyung

    2013-01-01

    Friction welding is a very useful joining process to weld metals which have axially symmetric cross section. In this paper, the feasibility of industry application was determined by analyzing the mechanical properties of weld region for a specimen of tube-to-tube shape for excavator hose nipple with friction welding, and optimized welding variables were suggested. In order to accomplish this object, friction heating pressure and friction heating time were selected as the major process variables and the experiment was performed in three levels of each parameter. An acoustic emission(AE) technique was applied to evaluate the optimal friction welding conditions nondestructively. AE parameters of accumulative count and event were analyzed in terms of generating trend of AE signals across the full range of friction weld. The typical waveform and frequency spectrum of AE signals which is generated by friction weld were discussed. From this study the optimal welding variables could be suggested as rotating speed of 1300 rpm, friction heating pressure of 15 MPa, and friction heating time of 10 sec. AE event was a useful parameter to estimate the tensile strength of tube-to tube specimen with friction weld.

  4. Modeling fade patterns of nipple areola complex tattoos following breast reconstruction.

    Science.gov (United States)

    Levites, Heather A; Fourman, Mitchell S; Phillips, Brett T; Fromm, Indira M; Khan, Sami U; Dagum, Alexander B; Bui, Duc T

    2014-12-01

    Nipple-areolar complex (NAC) tattoos are an effective cosmetic solution for creating a finished look following breast reconstruction procedures. NAC tattoos are prone to significant fading, leading patients to seek revisions. This study was designed to quantify changes in NAC tattoo appearance over time. A total of 71 images of 39 patients were analyzed for NAC tattoo color and shape by 5 blinded medical student graders using a customized scoring system. Subsequently, each image was analyzed using ColorPic software (Iconico, New York, NY). Red/green/blue and hue/saturation/value color parameters were collected. Color quantities were normalized to the individual patient's skin tone to control for variability in lighting. Spearman correlations and nonlinear regressions were calculated utilizing GraphPad Prism 6.0 (GraphPad, La Jolla, CA). The length of time after tattoo placement inversely correlated with color score (P tattoo placement was also inversely correlated with all quantitative color parameters. Each color parameter fit a 1-phase exponential decay model. The decline in qualitative color and shape score agrees with clinical experience of tattoo quality declining over time. The color qualities of the tattoo approach those of the patient's skin over time, ultimately reaching a plateau. This can be modeled using a 1-phase decay equation. In practice, tattoo colors may be selected that compensate for the predictable changes that will occur. The results of this study will help optimize tattoo color and may alleviate the need for NAC tattoo revisions.

  5. Diagnosing Tic Disorders

    Science.gov (United States)

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

  6. Lung surgery - discharge

    Science.gov (United States)

    ... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

  7. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  8. Characterisation of zinc delivery from a nipple shield delivery system using a breastfeeding simulation apparatus.

    Directory of Open Access Journals (Sweden)

    Rebekah L Scheuerle

    Full Text Available Zinc delivery from a nipple shield delivery system (NSDS, a novel platform for administering medicines to infants during breastfeeding, was characterised using a breastfeeding simulation apparatus. In this study, human milk at flow rates and pressures physiologically representative of breastfeeding passed through the NSDS loaded with zinc-containing rapidly disintegrating tablets, resulting in release of zinc into the milk. Inductively coupled plasma optical emission spectrometry was used to detect the zinc released, using a method that does not require prior digestion of the samples and that could be applied in other zinc analysis studies in breast milk. Four different types of zinc-containing tablets with equal zinc load but varying excipient compositions were tested in the NSDS in vitro. Zinc release measured over 20 minutes ranged from 32-51% of the loaded dose. Total zinc release for sets tablets of the same composition but differing hardness were not significantly different from one another with P = 0.3598 and P = 0.1270 for two tested pairs using unpaired t tests with Welch's correction. By the same test total zinc release from two sets of tablets having similar hardness but differing composition were also not significantly significant with P = 0.2634. Future zinc tablet composition and formulation optimisation could lead to zinc supplements and therapeutics with faster drug release, which could be administered with the NSDS during breastfeeding. The use of the NSDS to deliver zinc could then lead to treatment and prevention of some of the leading causes of child mortality, including diarrheal disease and pneumonia.

  9. Evolución de los principales diagnósticos al alta hospitalaria de la población penitenciaria de la provincia de Valencia, 2000-2009 Evolution of the main diagnoses of hospital discharges amongst the prison population in Valencia, 2000-2009

    Directory of Open Access Journals (Sweden)

    I. Abad-Pérez

    2011-10-01

    Full Text Available El objetivo de nuestro trabajo ha sido cuantificar la demanda hospitalaria de origen penitenciario y caracterizar los principales diagnósticos como una medida de prevalencia y las patologías transmisibles y su evolución durante el periodo 2000-09. A partir del registro de altas del Consorcio Hospital General Universitario que atiende por convenio la demanda hospitalaria de los centros penitenciarios de Valencia provincia, se realizo un estudio transversal de las frecuencias de los diagnósticos y su distribución de acuerdo a las características personales. Se recuperaron 2.415 altas que tras la eliminación de inconsistencias aportaron 2.332 episodios de hospitalización. La edad media de los sujetos evolucionó desde 32,8 a 39,7 años. Los diagnósticos principales y secundarios agrupados (tabla 2 más frecuentes fueron: 1º. VIH (34,05%, 2º. Hepatitis C (14,67%, 3º. Dependencia Drogas (10,25%, 4º. Neumonías (8,58%, 5º. TBC (7,46%. A lo largo de la década se ha producido un cambio en el patrón infeccioso de la población penitenciaria que podemos considerar relacionado con: el envejecimiento relativo de la población reclusa, la sustitución de la vía intravenosa por otras vías no invasivas, el cambio relativo del origen nacional de los reclusos y los avances terapéuticos en el tratamiento de la infección por VIH.The aim of our study was to quantify the hospital demand originating from prisons and describe the main diagnoses as a measure of prevalence, as well as communicable diseases and their evolution during the period 2000-09. Using the discharge records of the University General Hospital under the terms of an agreement that meets the demand for hospitals from prisons in the province of Valencia, we carried out a cross-sectional study of the frequency distribution of diagnoses and their distribution according to personal characteristics. More than 2,415 discharges were recovered, which, after the removal of inconsistencies

  10. Evaluation of oil-leakage of multi-layered resin-hose clamped with metal nipple and sleeve

    Science.gov (United States)

    Matsuoka, Kenta; Okubo, Kazuya; Fujii, Toru; Nakamura, Chihiro; Fujishita, Yushi; Kusu, Fuko; Matsushita, Masato; Yoshihara, Ryota

    2018-03-01

    The purpose of this study is to investigate the path of occurred oil-leakage of multi-layered resin-hose as one of multifunctional materials around the caulked joint with a metal nipple and sleeve when excessive cyclic internal pressure was applied onto the hose. Equivalent cyclic axial tensile force was substitutively applied to the hose, where same degree of normal stress was produced in longitudinal direction. Excessive 3 and 5 times of the standard load was applied to the hose. Cyclic loading was paused at every 1000 and 10000 cycles and then designed internal pressure was applied to the hose by a hand-operated pump with water in order to check whether the leakage was occurred around the joint and surface of the hose for safety evaluation. Cyclic fatigue life was defined as the number of loading cycles in which the leakage and the initial damage which was the passage of the ultrasonic wave was observed on the cyclic test. Test results showed the fatigue life at which leakage of water was observed was increased 20 times in case of K=3 compared to that in case of K=5. The cycles of initial damage detected by the ultrasonic wave were passed was increased 3.3 times in case of K=3 compared to that in case of K=5. The fluorescent agent penetrated from the core layer of resin hose to the reinforcement layer in which a half cross section along longitudinal direction in failed specimens was observed after the leak test. The original specimens had the gap between the resin-hose and the nipple and then the gap extended and connected during fatigue cyclic. In this study, it was observed that oil was leaked through narrow gap between the nipple and core layer of resin hose.

  11. Prophylactic Nipple-Sparing Mastectomy and Direct-to-Implant Reconstruction of the Large and Ptotic Breast: Is Preshaping of the Challenging Breast a Key to Success?

    Science.gov (United States)

    Gunnarsson, Gudjon L; Bille, Camilla; Reitsma, Laurens C; Wamberg, Peter; Thomsen, Jørn Bo

    2017-09-01

    Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction. Patients seeking risk-reducing nipple-sparing mastectomy/direct-to-implant reconstruction at the authors' institutions deemed unfit for a one-stage procedure based on their previous experience were offered a targeted two-stage, risk-reducing mastopexy/reduction followed by a delayed secondary nipple-sparing mastectomy and direct-to-implant reconstruction. Patients were followed up at 3 weeks and 6 or 12 months. Forty-four reconstructions were performed in 22 patients aged 43 years (range, 26 to 57 years). All 44 procedures were completed successfully without any failure or nipple-areola complex losses. Patients' median body mass index was 30 kg/m (range, 22 to 44 kg/m). Six patients were smokers and one had hypertension. Two patients underwent reoperation because of hematoma and fat necrosis. The authors' results demonstrate that a targeted preshaping mastopexy/reduction followed by nipple-sparing mastectomy/direct-to-implant reconstruction can be safely planned in women who opt for a risk-reducing mastectomy and can be performed successfully with a 3- to 4-month time span between operations. On the basis of these results and the superior cosmetic outcome, the two-stage approach has become the authors' standard of care in all such settings. Therapeutic, IV.

  12. Epithelial cells in nipple aspirate fluid and subsequent breast cancer risk: A historic prospective study

    International Nuclear Information System (INIS)

    Baltzell, Kimberly A; Moghadassi, Michelle; Rice, Terri; Sison, Jennette D; Wrensch, Margaret

    2008-01-01

    Past studies have shown that women with abnormal cytology or epithelial cells in nipple aspirate fluid (NAF) have an increased relative risk (RR) of breast cancer when compared to women from whom NAF was attempted but not obtained (non-yielders). This study analyzed NAF results from a group of women seen in a breast clinic between 1970–1991 (N = 2480). Our analysis presented here is an aggregate of two sub-groups: women with questionnaire data (n = 712) and those with NAF visits beginning in 1988 (n = 238), the year in which cancer case information was uniformly collected in California. Cytological classification was determined for a group of 946 women using the most abnormal epithelial cytology observed in fluid specimens. Breast cancer incidence and mortality status was determined through June 2006 using data from the California Cancer Registry, California Vital Statistics and self-report. We estimated odd ratios (ORs) for breast cancer using logistic regression analysis, adjusting for age. We analyzed breast cancer risk related to abnormality of NAF cytology using non-yielders as the referent group and breast cancer risk related to the presence or absence of epithelial cells in NAF, using non-yielders/fluid without epithelial cells as the referent group. Overall, 10% (93) of the 946 women developed breast cancer during the follow-up period. Age-adjusted ORs and 95% confidence intervals (C.I.) compared to non-yielders were 1.4 (0.3 to 6.4), 1.7 (0.9 to 3.5), and 2.0 (1.1 to 3.6) for women with fluid without epithelial cells, normal epithelial cells and hyperplasia/atypia, respectively. Comparing the presence or absence of epithelial cells in NAF, women with epithelial cells present in NAF were more likely to develop breast cancer than non-yielders or women with fluid without epithelial cells (RR = 1.9, 1.2 to 3.1). These results support previous findings that 1) women with abnormal epithelial cells in NAF have an increased risk of breast cancer when compared to

  13. Tennis elbow surgery - discharge

    Science.gov (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  14. Ankle replacement - discharge

    Science.gov (United States)

    ... total - discharge; Total ankle arthroplasty - discharge; Endoprosthetic ankle replacement - discharge; Osteoarthritis - ankle ... You had an ankle replacement. Your surgeon removed and reshaped ... an artificial ankle joint. You received pain medicine and were ...

  15. Hip fracture - discharge

    Science.gov (United States)

    ... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...

  16. Asthma - child - discharge

    Science.gov (United States)

    Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge ... Your child has asthma , which causes the airways of the lungs to swell and narrow. In the hospital, the doctors and nurses helped ...

  17. Prostate brachytherapy - discharge

    Science.gov (United States)

    Implant therapy - prostate cancer - discharge; Radioactive seed placement - discharge ... You had a procedure called brachytherapy to treat prostate cancer. Your treatment lasted 30 minutes or more, ...

  18. Complications following Nipple-Sparing Mastectomy and Immediate Acellular Dermal Matrix Implant-based Breast Reconstruction—A Systematic Review and Meta-analysis

    Directory of Open Access Journals (Sweden)

    Lene Nyhøj Heidemann, MD

    2018-01-01

    Conclusion:. The use of acellular dermal matrix in nipple-sparing mastectomy and implant-based breast reconstruction can be done with acceptable complication rates in selected patients. We recommend future studies to include specific definitions when reporting complication rates. Furthermore, future studies should elaborate on demographic characteristics of the included study samples and include predictor analysis to enhance knowledge of high risk patients.

  19. Favorable Outcome with Close Margins in Patients Undergoing Nipple/Skin Sparing Mastectomy with Immediate Breast Reconstruction: 5-year Follow-up

    Directory of Open Access Journals (Sweden)

    Enver Özkurt1

    2018-02-01

    Full Text Available Background: Implant-based breast reconstruction after mastectomy has recently been reported to be the preferred type of surgery among breast-specific surgeons and plastic surgeons. Aims: To explore the significant clinicopathological factors associated with long-term outcome related to local recurrences of the nipple among patients who underwent immediate breast reconstruction with tissue expander or implant after mastectomy. Study Design: Retrospective cohort. Methods: From January 2007 to January 2013, 51 breast cancer patients who underwent immediate breast reconstruction with tissue expander or implant were retrospectively analysed. Patients’ demographic data, clinicopathological characteristics, and clinical outcome by disease-free survival and disease-specific survival analyses were determined. Results: The median follow-up was 64 (31-114 months. Of the 57 mastectomies, 41 were skin sparing mastectomy (72% and 16 were nipple-areola sparing mastectomy (28%. Immediate breast reconstruction surgery included tissue expander (n=46, 81% or implant (n=11, 19% placement. The molecular subgroups of 47 invasive cancers were as follows: luminal A (n=23, 49%, luminal B (n=16, 34%, non-luminal HER2 (n=5, 10.6, triple negative breast cancer (n=3, 6.4%. The 5-years disease-specific survival, disease-free survival, and locoregional recurrence-free survival rates were 96.8%, 90%, and 97.6% respectively. Patients with luminal A cancer were found to have an improved 5-year disease-free survival time than other (luminal A; 100% vs. non-luminal A; 78%; p=0.028. Of the 14 nipple-areola sparing mastectomy, 13 had a close median tumour distance to nipple-areola complex (<20 mm with a 5-year locoregional recurrence free survival of 100%. Conclusion: Immediate breast reconstruction with implant or tissue expander can be safely applied in patients undergoing skin sparing mastectomy or nipple-areola sparing mastectomy. Patients with luminal-A type show the most

  20. Being publicly diagnosed

    DEFF Research Database (Denmark)

    Konradsen, Hanne; Lillebaek, Troels; Wilcke, Torgny

    2014-01-01

    a patient with TB, and finally being in medical treatment. Before being diagnosed with TB, patients were weighing between biding their time and deciding to undergo an examination. Social pressure and feelings of social responsibility tended to affect the decision. Having undergone the examination......INTRODUCTION: Tuberculosis (TB) is a disease which affects people worldwide, but there is knowledge lacking about patients' experiences in low-prevalence and high-income countries. AIM: To provide a theoretical framework for the process of being diagnosed with tuberculosis in a Danish setting....... METHOD: A grounded theory design with field studies and qualitative interviews, following the recommendations from Glaser and Strauss. RESULT: A process of being publicly diagnosed was identified, which developed during the patient's trajectory from being on the way to becoming a patient, becoming...

  1. Inframammarial Giant Fibroadenoma Removing and a Nipple-sparing Breast Reconstruction in an Adolescent: A Case Report

    Directory of Open Access Journals (Sweden)

    Ilhan Ciftci

    2015-01-01

    Full Text Available Fibroadenomas are common, benign breast tumors that usually affect women in the second and third decade of life. Giant fibroadenomas often cause significant concern for the patient or family regarding malignant potential and altered breast development. Most fibroadenomas are benign. Local excision of small lesions through a circumareolar or inframammary incision rather than radical surgery is appropriate. Breast ultrasound represents the most commonly used imaging modality for the study of pediatric female breast masses and fibroadenomas. Detailed descriptions of the sonographic appearances of fibroadenomas in young girls are sparse. We believe that surgical treatment for the patient should include tumor extirpation and immediate restoration of breast appearance, minimizing visible scars, protection of the developing breast bud, nipple, and areola. This modality reduces psychosocial comorbidity.

  2. Inframammarial Giant Fibroadenoma Removing and a Nipple-sparing Breast Reconstruction in an Adolescent: A Case Report.

    Science.gov (United States)

    Ciftci, Ilhan; Sekmenli, Tamer; Ozbek, Seda; Karamese, Mehtap; Ugras, Serdar

    2015-01-01

    Fibroadenomas are common, benign breast tumors that usually affect women in the second and third decade of life. Giant fibroadenomas often cause significant concern for the patient or family regarding malignant potential and altered breast development. Most fibroadenomas are benign. Local excision of small lesions through a circumareolar or inframammary incision rather than radical surgery is appropriate. Breast ultrasound represents the most commonly used imaging modality for the study of pediatric female breast masses and fibroadenomas. Detailed descriptions of the sonographic appearances of fibroadenomas in young girls are sparse. We believe that surgical treatment for the patient should include tumor extirpation and immediate restoration of breast appearance, minimizing visible scars, protection of the developing breast bud, nipple, and areola. This modality reduces psychosocial comorbidity.

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

    Science.gov (United States)

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

    2018-05-01

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

  4. Diagnosing plant problems

    Science.gov (United States)

    Cheryl A. Smith

    2008-01-01

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

  5. Quadrantectomy and Nipple Saving Mastectomy in Treatment of Early Breast Cancer: Feasibility and Aesthetic Results of Adjunctive Latissmus Dorsi Breast Reconstruction

    International Nuclear Information System (INIS)

    Bassiouny, M.; El-Marakby, H.H.; Saber, N.; Zayed, S.B.; Shokry, A.

    2005-01-01

    Breast conserving surgery has been a recognised method of treatment of early breast cancer. The treatment methods include quadrantectomy or skin sparing mastectomy combined with ipsilateral axillary nodal dissection followed by radiotherapy. In the current study we evaluate the feasibility and oncologic safety of the quadrantectomy and SSM operations with preservation of the nipple and areola, and the cosmetic results of immediate reconstruction by using the latissmus dorsi flap. Materials and Methods: A breast conservative surgery (quadrantectomy or nipple sparing mastectomy) was carried out in a group of 55 patients with invasive breast cancer treated at the Department of Surgical Oncology, NCl, between January 2001 and April 2004. The selection criteria included those patients who presented with TI or T2 breast cancer and were located at least 2 cm from the nipple as the centre for the nipple areola complex. The age of the patients ranged from 32 years to 65 years. The follow up period ranged from 2 to 33 months with an average of 21 months. Pathological assessment of the specimens showed a negative safety margin in all cases. Most of our cases were invasive duct carcinoma grade 1-2 (42) (75%). The complications of the flap reconstruction included one major sloughing of the Iatissmus dorsi flap, 4 partial flap sloughing, 4 sloughing of the nipple and fat necrosis in 6 patients. The donor site healed normally in all of our cases except for one patient who suffered from a hypertrophic scar which settled down during the follow up period. The aesthetic assessment of the patients, showed an excellent to good results in the majority of cases (42) (75%) while in 6 (12%) results were fair and in 7 (13%) results were poor. Breast conservative surgery with quadrantectomy or skin sparing technique with preservation of the nipple and areola combined with immediate LD flap reconstruction is a valid procedure for treatment of early breast cancer. Immediate reconstruction by

  6. Liability for Diagnosing Malingering.

    Science.gov (United States)

    Weiss, Kenneth J; Van Dell, Landon

    2017-09-01

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

  7. Vessel Sewage Discharges

    Science.gov (United States)

    Vessel sewage discharges are regulated under Section 312 of the Clean Water Act, which is jointly implemented by the EPA and Coast Guard. This homepage links to information on marine sanitation devices and no discharge zones.

  8. Early discharge following birth

    DEFF Research Database (Denmark)

    Nilsson, Ingrid M. S.; Kronborg, Hanne; Knight, Christopher H.

    2017-01-01

    .26–0.48) and primiparous compared to multiparous had an OR of 0.22 (CI 0.17–0.29) for early discharge. Other predictors for early discharge were: no induction of labour, no epidural painkiller, bleeding less than 500 ml during delivery, higher gestational age, early expected discharge and positive breastfeeding experience...

  9. Heart attack - discharge

    Science.gov (United States)

    ... and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Deep vein thrombosis - discharge Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass ... pacemaker - discharge High blood pressure - what to ask your doctor How to read ...

  10. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

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

  11. Diagnoser som styringshybrider

    DEFF Research Database (Denmark)

    Bossen, Claus; Danholt, Peter; Ubbesen, Morten Bonde

    2016-01-01

    - Relaterede Grupper (DRG). DRG er et internationalt udbredt system til at knytte patienter og deres behandlingsomkostninger sammen i faste kategorier med henblik på at måle hospitalers produktivitet. Med afsæt i Science-Technology-Studies (STS)-feltet analyserer artiklen, hvorledes diagnoser overskrider deres......, hvordan DRG-systemet alternativt kan anskues som en samfundsudviklende infrastruktur, idet det forsamler og skaber gensidigt involverende interaktioner imellem politiske, administrative og sundhedsprofessionelle domæner. En sådan indsigt bidrager til en udvidet forståelse af infrastrukturers roller som...

  12. Using the Slug Mucosal Irritation Assay to Investigate the Tolerability of Tablet Excipients on Human Skin in the Context of the Use of a Nipple Shield Delivery System.

    Science.gov (United States)

    Kendall, Richard; Lenoir, Joke; Gerrard, Stephen; Scheuerle, Rebekah L; Slater, Nigel K H; Tuleu, Catherine

    2017-04-01

    Neonates are particularly challenging to treat. A novel patented drug delivery device containing a rapidly disintegrating tablet held within a modified nipple shield (NSDS) was designed to deliver medication to infants during breastfeeding. However concerns exist around dermatological nipple tolerability with no pharmaceutical safety assessment guidance to study local tissue tolerance of the nipple and the areola. This is the first Slug Mucosal Irritation (SMI) study to evaluate irritancy potential of GRAS excipients commonly used to manufacture rapidly disintegrating immediate release solid oral dosage form METHODS: Zinc sulphate selected as the antidiarrheal model drug that reduces infant mortality, was blended with functional excipients at traditional levels [microcrystalline cellulose, sodium starch glycolate, croscarmellose sodium, magnesium stearate]. Slugs were exposed to blends slurried in human breast milk to assess their stinging, itching or burning potential, using objective values such as mucus production to categorize irritation potency RESULTS: Presently an in vivo assay, previously validated for prediction of ocular and nasal irritation, was used as an alternative to vertebrate models to anticipate the potential maternal dermatological tolerability issues to NSDS tablet components. The excipients did not elicit irritancy. However, mild irritancy was observed when zinc sulphate was present in blends. These promising good tolerability results support the continued investigation of these excipients within NSDS rapidly disintegrating tablet formulations. Topical local tolerance effects being almost entirely limited to irritation, the slug assay potentially adds to the existing preformulation toolbox, and may sit in between the in vitro and existing in vivo assays.

  13. Diagnosing night sweats.

    Science.gov (United States)

    Viera, Anthon J; Bond, Michael M; Yates, Scott W

    2003-03-01

    Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain important diagnostic considerations in patients with night sweats, other diagnoses to consider include human immunodeficiency virus, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, and several less common diseases. Antihypertensives, antipyretics, other medications, and drugs of abuse such as alcohol and heroin may cause night sweats. Serious causes of night sweats can be excluded with a thorough history, physical examination, and directed laboratory and radiographic studies. If a history and physical do not reveal a possible diagnosis, physicians should consider a purified protein derivative, complete blood count, human immunodeficiency virus test, thyroid-stimulating hormone test, erythrocyte sedimentation rate evaluation, chest radiograph, and possibly chest and abdominal computed tomographic scans and bone marrow biopsy.

  14. Diagnosable structured logic array

    Science.gov (United States)

    Whitaker, Sterling (Inventor); Miles, Lowell (Inventor); Gambles, Jody (Inventor); Maki, Gary K. (Inventor)

    2009-01-01

    A diagnosable structured logic array and associated process is provided. A base cell structure is provided comprising a logic unit comprising a plurality of input nodes, a plurality of selection nodes, and an output node, a plurality of switches coupled to the selection nodes, where the switches comprises a plurality of input lines, a selection line and an output line, a memory cell coupled to the output node, and a test address bus and a program control bus coupled to the plurality of input lines and the selection line of the plurality of switches. A state on each of the plurality of input nodes is verifiably loaded and read from the memory cell. A trusted memory block is provided. The associated process is provided for testing and verifying a plurality of truth table inputs of the logic unit.

  15. Diagnosing Dementia—Positive Signs

    Science.gov (United States)

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

  16. Cytologic features of nipple aspirate fluid using an automated non-invasive collection device: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Rowe Leslie R

    2005-08-01

    Full Text Available Abstract Background Detection of cytologic atypia in nipple aspirate fluid (NAF has been shown to be a predictor of risk for development of breast carcinoma. Manual collection of NAF for cytologic evaluation varies widely in terms of efficacy, ease of use, and patient acceptance. We investigated a new automated device for the non-invasive collection of NAF in the office setting. Methods A multi-center prospective observational clinical trial involving asymptomatic women designed to assess fluid production, adequacy, safety and patient acceptance of the HALO NAF Collection System (NeoMatrix, Irvine, CA. Cytologic evaluation of all NAF samples was performed using previously described classification categories. Results 500 healthy women were successfully enrolled. Thirty-eight percent (190/500 produced fluid and 187 were available for cytologic analysis. Cytologic classification of fluid producers showed 50% (93/187 Category 0 (insufficient cellular material, 38% (71/187 Category I (benign non-hyperplastic ductal epithelial cells, 10% (18/187 Category II (benign hyperplastic ductal epithelial cells, 3% (5/187 Category III (atypical ductal epithelial cells and none were Category IV (unequivocal malignancy. Overall, 19% of the subjects produced NAF with adequate cellularity and 1% were found to have cytologic atypia. Conclusion The HALO system is a simple, safe, rapid, automated method for standardized collection of NAF which is acceptable to patients. Cytologic assessment of HALO-collected NAF showed the ability to detect benign and pre-neoplastic ductal epithelial cells from asymptomatic volunteers.

  17. Aluminium, carbonyls and cytokines in human nipple aspirate fluids: Possible relationship between inflammation, oxidative stress and breast cancer microenvironment.

    Science.gov (United States)

    Mannello, F; Ligi, D; Canale, M

    2013-11-01

    The human breast is likely exposed to Al (aluminium) from many sources including diet and personal care products. Underarm applications of aluminium salt-based antiperspirant provide a possible long-term source of exposure, especially after underarm applications to shaved and abraded skin. Al research in breast fluids likely reflects the intraductal microenvironment. We found increased levels of aluminium in noninvasively collected nipple aspirate fluids (NAF) from 19 breast cancer patients compared with 16 healthy control subjects (268 vs 131 μg/l, respectively; p Aluminium content and carbonyl levels showed a significant positive linear correlation (r(2) 0.6628, p aluminium salts) we also found a significantly increased levels of pro-inflammatory cytokines (IL-1β, IL-6, IL-12 p70, and TNF-α) and chemoattractant CC and CXC chemokines (IL-8, MIP-1α and MCP-1). In 12 invasive cancer NAF samples we found a significant positive linear correlation among aluminium, carbonyls and pro-inflammatory IL-6 cytokine (Y = 64.79x-39.63, r(2) 0.8192, p aluminium ions in oxidative and inflammatory status perturbations of breast cancer microenvironment, suggesting aluminium accumulation in breast microenvironment as a possible risk factor for oxidative/inflammatory phenotype of breast cells. © 2013.

  18. Glow discharging device

    International Nuclear Information System (INIS)

    Maeno, Katsuki; Kawasaki, Kozo; Hiratsuka, Hajime; Kawashima, Shuichi.

    1989-01-01

    In a thermonuclear device, etc. impurities adsorbed to inner walls of a vacuum vessel by glow discharge are released to clean the vacuum vessel for preventing intrusion of the impurities into plasmas. The object of the present invention is to minimize the capacity of a power source equipment for the glow discharge device to the least extent. That is, a stabilization resistance is connected in series between each of a plurality of anodes which are inserted and arranged at the inside of a vacuum vessel as a cathode and a power source respectively. The resistance value R is selected so as to satisfy the relation: R < (Vi - Vm)/Ii, in which Vi: glow discharge starting voltage, Vm: glow discharge keeping voltage, Ii: glow discharge starting current. Accordingly, if a voltage is applied from a power source to a plurality of anodes, scattering of electric discharge between the anodes can be suppressed and the effect of voltage drop during discharge by the stabilization resistance can be eliminated. As a result, it is possible to provide an economically advantageous glow discharge device with the capacity for the power source facility being to the least extent. (K.M.)

  19. CO-AXIAL DISCHARGES

    Science.gov (United States)

    Luce, J.S.; Smith, L.P.

    1960-11-22

    A method and apparatus are given for producing coaxial arc discharges in an evacuated enclosure and within a strong, confining magnetic field. The arcs are maintained at a high potential difference. Electrons will diffuse to the more positive arc from the negative arc, and positive ions will diffuse from the more positive arc to the negative arc. Coaxial arc discharges have the advantage that ions which return to strike the positive arc discharge will lose no energy since they do not strike a solid wall or electrode. Those discharges are useful in confining an ionized plasma between the discharges, and have the advantage of preventing impurities from the walls of the enclosure from entering ihe plasma area because of the arc barrier set up bv the cylindrical outer arc.

  20. Modelling electric discharge chemistry

    International Nuclear Information System (INIS)

    McFarlane, J.; Wren, J.C.

    1991-07-01

    The chemistry occurring in a electric discharge was modelled to predict how it would be influenced by discharge conditions. The discharge was characterized by a calculated Boltzmann electron-energy distribution, from which rate constants for electron-molecule processes in air were determined. These rate constants were used in a chemical kinetics calculation that also included reactions between neutral molecules, ions, free radicals and electronically excited species. The model describes how the discharge chemistry was influenced by humidity, electric field, electron number density, and concentrations of key reagents identified in the study. The use of an electric discharge to destroy airborne contaminant molecules was appraised, the targeted contaminants being CF 2 Cl 2 , HCN, and SO 2 . The modelling results indicate that an electric discharge should be able to remove HCN and CF 2 Cl 2 effectively, especially if the discharge conditions have been optimized. Effective destruction is achieved with a moderate electric field (over 1 x 10 -15 V.cm 2 ), a substantial electron number density (over 1 x 10 12 cm -3 ), and the presence of H 2 0 in the process air. The residence time in the discharge was also shown to be important in contaminant destruction. An attempt was made to explain the results of the electric discharge abatement of SO 2 , a component of a simulated flue-gas mixture. Results from the model indicate that the discharge parameters that increase the concentration of hydroxyl radical also increase the rate of decomposition of SO 2 . An objective of the study was to explain the apparent enhancement of SO 2 destruction by the presence of a small amount of NO 2 . It was thought that a likely explanation would be the stabilization of HOSO 2 , an important intermediate in the oxidation of SO 2 by NO 2 . (49 figs., 14 tabs., 75 refs.)

  1. Diagnosing suffering: a perspective.

    Science.gov (United States)

    Cassell, E J

    1999-10-05

    The alleviation of suffering is crucial in all of medicine, especially in the care of the dying. Suffering cannot be treated unless it is recognized and diagnosed. Suffering involves some symptom or process that threatens the patient because of fear, the meaning of the symptom, and concerns about the future. The meanings and the fear are personal and individual, so that even if two patients have the same symptoms, their suffering would be different. The complex techniques and methods that physicians usually use to make a diagnosis, however, are aimed at the body rather than the person. The diagnosis of suffering is therefore often missed, even in severe illness and even when it stares physicians in the face. A high index of suspicion must be maintained in the presence of serious disease, and patients must be directly questioned. Concerns over the discomfort of listening to patients' severe distress are usually more than offset by the gratification that follows the intervention. Often, questioning and attentive listening, which take little time, are in themselves ameliorative. The information on which the assessment of suffering is based is subjective; this may pose difficulties for physicians, who tend to value objective findings more highly and see a conflict between the two kinds of information. Recent advances in understanding how physicians increase the utility of information and make inferences allow one to reliably use the subjective information on which the diagnosis and treatment of suffering depend. Knowing patients as individual persons well enough to understand the origin of their suffering and ultimately its best treatment requires methods of empathic attentiveness and nondiscursive thinking that can be learned and taught. The relief of suffering depends on physicians acquiring these skills.

  2. Discharge lamp technologies

    Science.gov (United States)

    Dakin, James

    1994-01-01

    This talk is an overview of discharge lamp technology commonly employed in general lighting, with emphasis on issues pertinent to lighting for plant growth. Since the audience is primarily from the plant growth community, and this begins the light source part of the program, we will start with a brief description of the discharge lamps. Challenges of economics and of thermal management make lamp efficiency a prime concern in controlled environment agriculture, so we will emphasize science considerations relating to discharge lamp efficiency. We will then look at the spectra and ratings of some representative lighting products, and conclude with a discussion of technological advances.

  3. Capacitor discharge engineering

    CERN Document Server

    Früngel, Frank B A

    1976-01-01

    High Speed Pulse Technology, Volume III: Capacitor Discharge Engineering covers the production and practical application of capacitor dischargers for the generation and utilization of high speed pulsed of energy in different forms. This nine-chapter volume discusses the principles of electric current, voltage, X-rays, gamma rays, heat, beams of electrons, neutrons and ions, magnetic fields, sound, and shock waves in gases and liquids. Considerable chapters consider the applications of capacitor discharges, such as impulse hardening of steel, ultrapulse welding of precision parts, X-ray flash t

  4. Predicting tile drainage discharge

    DEFF Research Database (Denmark)

    Iversen, Bo Vangsø; Kjærgaard, Charlotte; Petersen, Rasmus Jes

    used in the analysis. For the dynamic modelling, a simple linear reservoir model was used where different outlets in the model represented tile drain as well as groundwater discharge outputs. This modelling was based on daily measured tile drain discharge values. The statistical predictive model...... was based on a polynomial regression predicting yearly tile drain discharge values using site specific parameters such as soil type, catchment topography, etc. as predictors. Values of calibrated model parameters from the dynamic modelling were compared to the same site specific parameter as used...

  5. Identification of nursing management diagnoses.

    Science.gov (United States)

    Morrison, R S

    1997-02-01

    Theories from nursing and management provide frameworks for enhancing effectiveness of nursing management practice. The concept nursing management diagnosis has been developed by integrating nursing diagnosis and organizational diagnosis as a basis for nurse manager decision-making. Method triangulation was used to identify problems of managing nursing units, to validate those problems for relevancy to practice, to generate nursing management diagnoses, and to validate the diagnoses. Diagnoses were validated according to a definition of nursing management diagnosis provided. Of the 72 nursing management diagnoses identified, 66 were validated at a 70% level of agreement by nurse managers participating in the study.

  6. Optimal Positioning of the Nipple-Areola Complex in Men Using the Mohrenheim-Estimated-Tangential-Tracking-Line (METT-Line): An Intuitive Approach.

    Science.gov (United States)

    Mett, Tobias R; Krezdorn, Nicco; Luketina, Rosalia; Boyce, Maria K; Henseler, Helga; Ipaktchi, Ramin; Vogt, Peter M

    2017-12-01

    The reconstruction of the body shape after post-bariatric surgery or high-grade gynecomastia involves, besides skin tightening, the repositioning of anatomical, apparent landmarks. The surgeon usually defines these during the preoperative planning. In particular, the positions of the nipple-areola complexes (NAC) should contribute to the gender-appropriate appearance. While in the female breast numerous methods have been developed to determine the optimal position of the NACs, there are only a few, metric and often impractical algorithms for positioning the nipples and areoles in the male. With this study, we show the accuracy of the intuitive positioning of the nipple-areola complex in men. From a pre-examined and measured quantity of 10 young and healthy men, six subjects were selected, which corresponded, on the basis of their chest and trunk dimensions, to the average of known data from the literature. The photographed frontal views were retouched in two steps. Initially, only the NACs were removed and the chest contours were left. In a second step, all contours and the navel were blurred. These pictures were submitted to resident and consultant plastic surgeons, who were asked to draw the missing NACs without any tools. The original positions of the nipples were compared with the inscriptions. Furthermore, the results were compared between the contoured and completely retouched pictures and between the residents and consultants. A total of 8 consultants and 7 residents were included. In the contoured and completely retouched images, a significant deviation of the marked positions of the missing features was found. The height of the NAC was determined somewhat more precisely than the vertical position. There was no significant difference between the contoured and completely retouched images, with a discretely more accurate tendency on the contoured images. In comparison with the professional experience, the consultants were tangentially more precise, but

  7. Is the transposition of the nipple-areolar complex necessary in Simon grade 2b gynecomastia operations using suction-assisted liposuction?

    Science.gov (United States)

    Özalp, Burhan; Berköz, Ömer; Aydınol, Mustafa

    2018-02-01

    The aim of this study was to assess the efficacy of suction-assisted liposuction (SAL) in Simon grade 2b gynecomastia and its effect on sternal notch to nipple areola (SNN) distance. A retrospective analysis was performed on 21 patients with grade 2b gynecomastia who underwent SAL. Preoperative and postoperative SNN distances of the patients were measured, the results were analysed using a Mann-Whitney U test and a p-value gynecomastia and shortens the SNN distance by 1 cm, but further clinical studies are required to support this conclusion.

  8. Electric discharge during electrosurgery.

    Science.gov (United States)

    Shashurin, Alexey; Scott, David; Zhuang, Taisen; Canady, Jerome; Beilis, Isak I; Keidar, Michael

    2015-04-16

    Electric discharge utilized for electrosurgery is studied by means of a recently developed method for the diagnostics of small-size atmospheric plasma objects based on Rayleigh scattering of microwaves on the plasma volume. Evolution of the plasma parameters in the near-electrode sheaths and in the positive column is measured and analyzed. It is found that the electrosurgical system produces a glow discharge of alternating current with strongly contracted positive column with current densities reaching 10(3) A/cm(2). The plasma electron density and electrical conductivities in the channel were found be 10(16) cm(-3) and (1-2) Ohm(-1) cm(-1), respectively. The discharge interrupts every instance when the discharge-driving AC voltage crosses zero and re-ignites again every next half-wave at the moment when the instant voltage exceeds the breakdown threshold.

  9. Vaginal delivery - discharge

    Science.gov (United States)

    Pregnancy - discharge after vaginal delivery ... You may have bleeding from your vagina for up to 6 weeks. Early on, you may pass some small clots when you first get up. Bleeding will slowly become ...

  10. Prostate radiation - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000399.htm Prostate radiation - discharge To use the sharing features on ... keeping or getting an erection may occur after prostate radiation therapy. You may not notice this problem ...

  11. Brain injury - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000163.htm Brain injury - discharge To use the sharing features on ... know was in the hospital for a serious brain injury. At home, it will take time for ...

  12. Brain aneurysm repair - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000123.htm Brain aneurysm repair - discharge To use the sharing features ... this page, please enable JavaScript. You had a brain aneurysm . An aneurysm is a weak area in ...

  13. Brain radiation - discharge

    Science.gov (United States)

    Radiation - brain - discharge; Cancer - brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation ... Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling ...

  14. Atrial fibrillation - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000237.htm Atrial fibrillation - discharge To use the sharing features on this ... have been in the hospital because you have atrial fibrillation . This condition occurs when your heart beats faster ...

  15. Pneumonia - adults - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000017.htm Pneumonia in adults - discharge To use the sharing features on this page, please enable JavaScript. You have pneumonia, which is an infection in your lungs. In ...

  16. Knee arthroscopy - discharge

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000199.htm Knee arthroscopy - discharge To use the sharing features on this ... surgery to treat problems in your knee (knee arthroscopy). You may have been checked for: Torn meniscus. ...

  17. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  18. Shoulder surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000179.htm Shoulder surgery - discharge To use the sharing features on this page, please enable JavaScript. You had shoulder surgery to repair the tissues inside or around your ...

  19. Discharges for lighting

    International Nuclear Information System (INIS)

    Stoffels, W W; Nimalasuriya, T; Flikweert, A J; Mulders, H C J

    2007-01-01

    The most common man-made discharge is a lamp. Even though lamps are often considered a mature technology, the discharge physics is often poorly understood. Two recent initiatives discussed here show that plasma research can help to make significant improvements. First we discuss color separation in metal halide lamps, which is a problem that prevents these highly efficient lamps from being used in more applications. Secondly a novel lamp concept is presented that may replace the current mercury based fluorescent lamps

  20. Discharge lamp technologies

    Energy Technology Data Exchange (ETDEWEB)

    Dakin, J. [GE Lighting, Cleveland, OH (United States)

    1994-12-31

    This talk is an overview of discharge lamp technology commonly employed in general lighting, with emphasis on issues pertinent to lighting for plant growth. Since the audience is primarily from the plant growth community, and this begins the light source part of the program, we will start with a brief description of the discharge lamps. Challenges of economics and of thermal management make lamp efficiency a prime concern in controlled environment agriculture, so we will emphasize science considerations relating to discharge lamp efficiency. We will then look at the spectra and ratings of some representative lighting products, and conclude with a discussion of technological advance. A general overview of discharge lighting technology can be found in the book of Waymouth (1971). A recent review of low pressure lighting discharge science is found in Dakin (1991). The pioneering paper of Reiling (1964) provides a good introduction to metal halide discharges. Particularly relevant to lighting for plant growth, a recent and thorough treatment of high pressure Na lamps is found in the book by deGroot and vanVliet (1986). Broad practical aspects of lighting application are thoroughly covered in the IES Lighting Handbook edited by Kaufman (1984).

  1. Chaos in gas discharges

    International Nuclear Information System (INIS)

    Piel, A.

    1993-01-01

    Many gas discharges exhibit natural oscillations which undergo a transition from regular to chaotic behavior by changing an experimental parameter or by applying external modulation. Besides several isolated investigations, two classes of discharge phenomena have been studied in more detail: ionization waves in medium pressure discharges and potential relaxation oscillations in filament cathode discharges at very low pressure. The latter phenomenon will be discussed by comparing experimental results from different discharge arrangements with particle-in-cell simulations and with a model based on the van-der-Pol equation. The filament cathode discharge has two stable modes of operation: the low current anode-glow-mode and the high current temperature-limited-mode, which form the hysteresis curve in the I(U) characteristics. Close to the hysteresis point of the AGM periodic relaxation oscillations occur. The authors demonstrate that the AGM can be understood by ion production in the anode layer, stopping of ions by charge exchange, and trapping in the virtual cathode around the filament. The relaxation oscillations consist of a slow filling phase and a rapid phase that invokes formation of an unstable double-layer, current-spiking, and ion depletion from the cathodic plasma. The relaxation oscillations can be mode-locked by external modulation. Inside a mode-locked state, a period doubling cascade is observed at high modulation degree

  2. Validation of nursing management diagnoses.

    Science.gov (United States)

    Morrison, R S

    1995-01-01

    Nursing management diagnosis based on nursing and management science, merges "nursing diagnosis" and "organizational diagnosis". Nursing management diagnosis is a judgment about nursing organizational problems. The diagnoses provide a basis for nurse manager interventions to achieve outcomes for which a nurse manager is accountable. A nursing organizational problem is a discrepancy between what should be happening and what is actually happening that prevents the goals of nursing from being accomplished. The purpose of this study was to validate 73 nursing management diagnoses identified previously in 1992: 71 of the 72 diagnoses were considered valid by at least 70% of 136 participants. Diagnoses considered to have high priority for future research and development were identified by summing the mean scores for perceived frequency of occurrence and level of disruption. Further development of nursing management diagnoses and testing of their effectiveness in enhancing decision making is recommended.

  3. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

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

  4. Neuroblastoma in Children: Just Diagnosed Information

    Science.gov (United States)

    ... Financial Reports Watchdog Ratings Feedback Contact Select Page Neuroblastoma in Children – Just Diagnosed Home > Cancer Resources > Types ... Diagnosed Just Diagnosed In Treatment After Treatment Diagnosing Neuroblastoma Depending on the location of the tumor and ...

  5. Reconstrucción del complejo areola-pezón: revisión de 60 casos Nipple-areola complex reconstruction: revision of 60 cases

    Directory of Open Access Journals (Sweden)

    R. Fernández García

    2007-06-01

    hay ninguna cuyos resultados se sobrepongan a las demás, pero sí una vez que se reconstruye la areola siendo la técnica que más satisface la del injerto inguinal. A pesar de ello, el aspecto más notable a mejorar está en la reconstrucción del pezón, dada la frecuente disconformidad de las pacientes con la proyección conseguida a lo largo del tiempo por la posible reabsorción del mismo.The creation of the nipple-areola complex is the latest time in breast reconstruction, transforming the reconstruction of the breast mound into a real breast. We have to consider the reconstruction of the areola and the nipple as the culmination of breast reconstruction. There are a lot of documented techniques for nipple-areola complex reconstruction. The aim of this study is to determine the grade of psychological satisfaction of patients after this reconstruction This study was designed as a retrospective clinic review of 60 patients. After reviewing medical histories, the patients were interviewed and asked to complete a questionnaire. The most common desired aspect was to correct the absence/lost of nipple projection. However, 22% of patients answered they would not change anything regarding their reconstruction. The satisfaction with the mammary mound was excellent or good for 68%, normal for 23 % and poor for 9 %. On the other hand, satisfaction for the nippleareola complex reconstruction was excellent or good for 50%, normal for 45% and poor for 5%. There were no statistical differences among the different techniques depending on the time between the mastectomy intervention and the third reconstruction (p=0,06. For nipple reconstruction, the contralateral nipple donation technique offered more satisfaction (2.67 points and projection (7.23 points. In spite of the differences in their means, there were no statistically significant differences. Taking into account the technique used for the areola reconstruction, the donation-graft of inguinal skin was the one that

  6. Immediate breast reconstruction after skin- or nipple-sparing mastectomy for previously augmented patients: a personal technique.

    Science.gov (United States)

    Salgarello, Marzia; Rochira, Dario; Barone-Adesi, Liliana; Farallo, Eugenio

    2012-04-01

    Breast reconstruction for previously augmented patients differs from breast reconstruction for nonaugmented patients. Many surgeons regard conservation therapy as not feasible for these patients because of implant complications, whether radiotherapy-induced or not. Despite this, most authors agree that mastectomy with immediate breast reconstruction is the most suitable choice, ensuring both a good cosmetic result and a low complication rate. Implant retention or removal remains a controversial topic in addition to the best available surgical technique. This study reviewed the authors' experience with immediate breast reconstruction after skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) with anatomically definitive implants. The retrospective records of 12 patients were examined (group A). These patients were among 254 patients who underwent SSM or NSM for breast carcinoma. The control group comprised 12 of the 254 patients submitted to SSM or NSM (group B) who best matched the 12 patients in the studied group. All of them underwent immediate breast reconstruction, with an anatomically definitive implant placed in a submuscular-subfascial pocket. The demographic, technical, and oncologic data of the two groups were compared as well as the aesthetic outcomes using the Breast Q score. The proportion of complications, the type of implant, the axillary lymph node procedure, and the histology were compared between the two groups using Fisher's exact test. Student's t test was used to compare the scores for the procedure-specific modules of the breast Q questionnaire in the two groups. A validated patient satisfaction score was obtained using the breast Q questionnaire after breast reconstruction. The demographic, technical, and oncologic characteristics were not significantly different between the two groups. The previously augmented patients reported a significantly higher level of satisfaction with their breast than the control patients. The scores

  7. Multipactor discharge apparatus

    International Nuclear Information System (INIS)

    1976-01-01

    The invention deals with a multipactor discharge apparatus which can be used for tuning microwave organs such as magnetron oscillators and other cavity resonators. This apparatus is suitable for delivering an improved tuning effect in a resonation organ wherefrom the working frequency must be set. This apparatus is equipped with two multipactor discharge electrodes set in a configuration such to that a net current flows from one electrode to another. These electrodes are parallel and flat. The apparatus can be used in magnetron devices as well for continuous waves as for impulses

  8. Red herring vaginal discharge.

    Science.gov (United States)

    Lee, Jun Hee; Pringle, Kirsty; Rajimwale, Ashok

    2013-09-18

    Labial hair tourniquet syndrome is a rare condition that can be easily misdiagnosed and ultimately lead to irreversible damage. An 11-year-old premenarche girl presented with a 5-day history of pain and swelling in the labia with associated vaginal discharge. The general practitioner treated her with clotrimazole without improvement. On examination, there was an oedematous swelling of the right labia with a proximal hair tourniquet. Local anaesthetic was applied and the hair removed with forceps. There was instant relief of pain and the discharge stopped within 24 h. The patient was sent home with a course of antibiotics.

  9. How Are Learning Disabilities Diagnosed?

    Science.gov (United States)

    ... Research Information Research Goals Activities and Advances Scientific Articles Find a Study Resources and Publications For Patients and Consumers For Researchers and Health Care Providers Home Health A to Z List Learning Disabilities Condition Information How is it diagnosed? Share ...

  10. Common Diagnoses in the NICU

    Science.gov (United States)

    ... breakdown of blood cells, and the liver usually "recycles" it back into the body). Although mild jaundice ... brain). However, PVL can happen without any previous history of bleeding. How is it diagnosed? Often no ...

  11. How to diagnose cardiac tamponade

    NARCIS (Netherlands)

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

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

  12. Travelling-wave-sustained discharges

    International Nuclear Information System (INIS)

    Schlueter, Hans; Shivarova, Antonia

    2007-01-01

    This review is on discharges maintained by travelling waves: new plasma sources, discovered in 1974 and considered as a prototype of the gas discharges according to their definition as nonlinear systems which unify in a self-consistent manner plasmas and fields. In the presentation here of the fluid-plasma models of the diffusion-controlled regime of the travelling-wave-sustained discharges (TWSDs), the basic features of the discharge maintenance-the discharge self-consistency and the electron heating in the high-frequency field-are stressed. Operation of stationary and pulsed discharges, discharge maintenance without and in external magnetic fields as well as discharge production in different gases (argon, helium, helium-argon gas mixtures and hydrogen) are covered. Modulation instability of diffusion-controlled discharges and discharge filamentation at higher gas pressures are also included in the review. Experimental findings which motivate aspects of the reported modelling are pointed out

  13. Sigmoid-vaginal fistula during bevacizumab treatment diagnosed by fistulography.

    Science.gov (United States)

    Hayashi, C; Takada, S; Kasuga, A; Shinya, K; Watanabe, M; Kano, H; Takayama, T

    2016-12-01

    There have been several reports describing rectovaginal fistula development after bevacizumab treatment, and these fistulas were diagnosed by CT scan or colonoscopy. We report a case of sigmoid-vaginal fistula diagnosed by fistulography. The case is a 53-year-old woman who was treated for chronic myelogenous leukaemia and gynaecological cancers 8 years previously. At 52 years of age, she was diagnosed with colon cancer and had a partial colectomy performed. One year after surgery, colon cancer recurred, and she was treated with anticancer agents, including bevacizumab. During chemotherapy, she complained of a foul smelling discharge from the vagina. Fistulography revealed a sigmoid-vaginal fistula. This is the first report of vaginal fistulography performed on a patient who was treated with bevacizumab. Fistulography may be useful for detecting sigmoid-vaginal fistula. © 2016 John Wiley & Sons Ltd.

  14. Discharges from nuclear power stations

    International Nuclear Information System (INIS)

    1991-02-01

    HM Inspectorate of Pollution commissioned, with authorising responsibilities in England and Wales, a study into the discharges of radioactive effluents from Nuclear Power Stations. The study considered arisings from nuclear power stations in Europe and the USA and the technologies to treat and control the radioactive discharges. This report contains details of the technologies used at many nuclear power stations to treat and control radioactive discharges and gives, where information was available, details of discharges and authorised discharge limits. (author)

  15. Diagnoser

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  16. [Early discharge of newborns: what problems should we anticipate?].

    Science.gov (United States)

    Straczek, H; Vieux, R; Hubert, C; Miton, A; Hascoet, J-M

    2008-06-01

    Following Nordic and Anglo-Saxon countries, France is directing towards an early discharge policy from maternity hospitals. French National Authority for Health has published recommendations focusing on the importance to highlight the dangers of such a policy so as to be able to anticipate them. To describe the complications diagnosed in the newborn infants from day 2 to the current hospital's discharge (noteworthy, if infants are discharged early, these complications may occur at home) to determine predictive factors and to validate those proposed by the French National Authority for Health. Prospective study conducted in the maternity ward of Nancy's level III facility, from January 6th to May 6th 2005. Nine hundred and three newborn infants were included. Forty-two (4.6%) presented with complications diagnosed from day 2 to hospital's discharge, among which 4 required urgent neonatal care. The most frequent complication was hyperbilirubinemia: 23 newborns were treated with phototherapy between day 2 and day 10. Statistically significant risk factors of hyperbilirubinemia after day 2 in multivariate analysis were instrumental vaginal delivery (OR=2.94; CI 95% [1.04-8.34]) and jaundice before day 2 (OR=7.39; CI 95% [2.66-20.55]). According to the French National Authority for Health's policy, 33 among 42 infants presenting with a complication would have been withdrawn from an early discharge program. In our population, French National Authority for Health's recommendations were relevant to guide an early discharge project.

  17. Diagnosis of the local thermal equilibrium by optical emission spectroscopy in the evolution of electric discharge

    International Nuclear Information System (INIS)

    Valdivia B, R.; Pacheco S, J.; Pacheco P, M.; Ramos F, F.; Cruz A, A.; Velazquez P, S.

    2008-01-01

    In this work applies the technique of optical emission spectroscopy to diagnose the temperature of the species generated in plasma in the transition to glow discharge arc. Whit this diagnosis is possible to determine the local thermal equilibrium conditions of the discharge. (Author)

  18. Peptic ulcer disease - discharge

    Science.gov (United States)

    ... or raw area in the lining of the stomach (gastric ulcer) or upper part of the small intestine (duodenal ... You have peptic ulcer disease (PUD). You may have had tests to help diagnose your ulcer. One of these tests may have ...

  19. Vessel Sewage Discharges: No-Discharge Zones (NDZs)

    Science.gov (United States)

    States may petition the EPA to establish areas, called no discharge zones (NDZs), where vessel sewage discharges are prohibited. This page describes how NDZs are designated, the types of designations, who enforces them, and how to comply.

  20. Nursing diagnoses in overweight adolescents

    Directory of Open Access Journals (Sweden)

    Raphaela Santos do Nascimento Rodrigues

    2013-05-01

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

  1. Gaucher's disease diagnosed by splenectomy.

    Science.gov (United States)

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

    2009-08-01

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

  2. Psychiatric diagnoses, trauma, and suicidiality

    Directory of Open Access Journals (Sweden)

    Elklit Ask

    2007-04-01

    Full Text Available Abstract Background This study aimed to examine the associations between psychiatric diagnoses, trauma and suicidiality in psychiatric patients at intake. Methods During two months, all consecutive patients (n = 139 in a psychiatric hospital in Western Norway were interviewed (response rate 72%. Results Ninety-one percent had been exposed to at least one trauma; 69 percent had been repeatedly exposed to trauma for longer periods of time. Only 7% acquired a PTSD diagnosis. The comorbidity of PTSD and other psychiatric diagnoses were 78%. A number of diagnoses were associated with specific traumas. Sixty-seven percent of the patients reported suicidal thoughts in the month prior to intake; thirty-one percent had attempted suicide in the preceding week. Suicidal ideation, self-harming behaviour, and suicide attempts were associated with specific traumas. Conclusion Traumatised patients appear to be under- or misdiagnosed which could have an impact on the efficiency of treatment.

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

    African Journals Online (AJOL)

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

  4. Same-day discharge after laparoscopic hysterectomy.

    Science.gov (United States)

    Perron-Burdick, Misa; Yamamoto, Miya; Zaritsky, Eve

    2011-05-01

    To estimate readmission rates and emergency care use by patients discharged home the same day after laparoscopic hysterectomy. This was a retrospective case series of patients discharged home the same-day after total or supracervical laparoscopic hysterectomy in a managed care setting. Chart reviews were performed for outcomes of interest which included readmission rates, emergency visits, and surgical and demographic characteristics. The two hysterectomy groups were compared using χ² tests for categorical variables and t tests or Wilcoxon rank-sum tests for continuously measured variables. One-thousand fifteen laparoscopic hysterectomies were performed during the 3-year study period. Fifty-two percent (n=527) of the patients were discharged home the same-day; of those, 46% (n=240) had total laparoscopic hysterectomies and 54% (n=287) had supracervical. Cumulative readmission rates were 0.6%, 3.6%, and 4.0% at 48 hours, 3 months, and 12 months, respectively. The most common readmission diagnoses included abdominal incision infection, cuff dehiscence, and vaginal bleeding. Less than 4% of patients presented for emergency care within 48 or 72 hours, most commonly for nausea or vomiting, pain, and urinary retention. Median uterine weight was 155 g, median blood loss was 70 mL, and median surgical time was 150 minutes. There was no difference in readmission rates or emergency visits for the total compared with the supracervical laparoscopic hysterectomy group. Same-day discharge after laparoscopic hysterectomy is associated with low readmission rates and minimal emergency visits in the immediate postoperative period. Same-day discharge may be a safe option for healthy patients undergoing uncomplicated laparoscopic hysterectomy.

  5. Immunological methods for diagnosing neurocysticercosis

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-01-31

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

  6. Monitoring of lightning discharge

    International Nuclear Information System (INIS)

    Grigor'ev, V.A.

    2001-01-01

    The paper presents a brief description of a lightning discharge recording system developed at the NPO 'Monitoring Techniques' under the direction of V.M. Moskolenko (Moscow). The system provides information about dangerous environmental occurrences such as tornados and hurricanes, making the forecast of extreme situations possible, especially in the areas of dangerous industries and objects. The created automatic system can be useful in solving the tasks relating to nuclear test monitoring. (author)

  7. Underwater Ship Husbandry Discharges

    Science.gov (United States)

    2011-11-01

    which entered into force in September of 2008, prohibits the use of harmful organotins such as tributyltin ( TBT ) in AFCs used on international...States. The use of TBT AFCs is explicitly prohibited under the VGP, and vessels must remove such coatings or paint over them to prevent toxic ...to hull husbandry include (1) the discharge of toxic chemicals used as biocides in AFCs and (2) biofouling as a vector for aquatic nuisance species

  8. Radioactive wastes and discharges

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The guide sets out the radiation safety requirements and limits for the treatment of radioactive waste. They shall be observed when discharging radioactive substances into the atmosphere or sewer system, or when delivering solid, low-activity waste to a landfill site without a separate waste treatment plan. The guide does not apply to the radioactive waste resulting from the utilisation of nuclear energy or natural resources.

  9. Radioactive wastes and discharges

    International Nuclear Information System (INIS)

    2000-01-01

    The guide sets out the radiation safety requirements and limits for the treatment of radioactive waste. They shall be observed when discharging radioactive substances into the atmosphere or sewer system, or when delivering solid, low-activity waste to a landfill site without a separate waste treatment plan. The guide does not apply to the radioactive waste resulting from the utilisation of nuclear energy or natural resources

  10. Diagnoses and interventions in podiatry.

    NARCIS (Netherlands)

    Zuijderduin, W.M.; Dekker, J.

    1996-01-01

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

  11. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

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

  12. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

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

  13. Plasma Discharge Process in a Pulsed Diaphragm Discharge System

    Science.gov (United States)

    Duan, Jianjin; Hu, Jue; Zhang, Chao; Wen, Yuanbin; Meng, Yuedong; Zhang, Chengxu

    2014-12-01

    As one of the most important steps in wastewater treatment, limited study on plasma discharge process is a key challenge in the development of plasma applications. In this study, we focus on the plasma discharge process of a pulsed diaphragm discharge system. According to the analysis, the pulsed diaphragm discharge proceeds in seven stages: (1) Joule heating and heat exchange stage; (2) nucleated site formation; (3) plasma generation (initiation of the breakdown stage); (4) avalanche growth and plasma expansion; (5) plasma contraction; (6) termination of the plasma discharge; and (7) heat exchange stage. From this analysis, a critical voltage criterion for breakdown is obtained. We anticipate this finding will provide guidance for a better application of plasma discharges, especially diaphragm plasma discharges.

  14. Compact Intracloud Discharges

    Energy Technology Data Exchange (ETDEWEB)

    Smith, David A. [Univ. of Colorado, Boulder, CO (United States)

    1998-11-01

    In November of 1993, mysterious signals recorded by a satellite-borne broadband VHF radio science experiment called Blackboard led to a completely unexpected discovery. Prior to launch of the ALEXIS satellite, it was thought that its secondary payload, Blackboard, would most often detect the radio emissions from lightning when its receiver was not overwhelmed by noise from narrowband communication carriers. Instead, the vast majority of events that triggered the instrument were isolated pairs of pulses that were one hundred times more energetic than normal thunderstorm electrical emissions. The events, which came to be known as TIPPs (for transionospheric pulse pairs), presented a true mystery to the geophysics community. At the time, it was not even known whether the events had natural or anthropogenic origins. After two and one half years of research into the unique signals, two ground-based receiver arrays in New Mexico first began to detect and record thunderstorm radio emissions that were consistent with the Blackboard observations. On two occasions, the ground-based systems and Blackboard even recorded emissions that were produced by the same exact events. From the ground based observations, it has been determined that TIPP events areproduced by brief, singular, isolated, intracloud electrical discharges that occur in intense regions of thunderstorms. These discharges have been dubbed CIDS, an acronym for compact intracloud discharges. During the summer of 1996, ground-based receiver arrays were used to record the electric field change signals and broadband HF emissions from hundreds of CIDS. Event timing that was accurate to within a few microseconds made possible the determination of source locations using methods of differential time of arrival. Ionospheric reflections of signals were recorded in addition to groundwave/line-of-sight signals and were used to determine accurate altitudes for the discharges. Twenty-four CIDS were recorded from three

  15. Continuous pile discharging machine

    International Nuclear Information System (INIS)

    Smith, P.P.

    1976-01-01

    A device for discharging cartridges from tubes under fluid pressure includes a cylindrical housing adapted to be seated in a leak-tight manner on the end of one of the tubes, a chute depending from the cylindrical housing near the end seated on the end of the tube, a rotatable piston having a wrench on the forward end thereof disposed in the cylindrical housing and adapted to manipulate a plug in the end of the tube, and a telescopic hydraulic ram adapted to move the piston toward the plug. In addition the wrench contains a magnet which prevents inadvertent uncoupling of the wrench and the plug. 7 claims, 10 drawing figures

  16. Capacitive discharge exciplex lamps

    Energy Technology Data Exchange (ETDEWEB)

    Sosnin, E A; Erofeev, M V; Tarasenko, V F [High Current Electronics Institute, 2/3, Akademichesky Ave., Tomsk 634055 (Russian Federation)

    2005-09-07

    Simple-geometry exciplex lamps of a novel type excited by a capacitive discharge (CD-excilamps) have been investigated. An efficient radiation has been obtained on KrBr*, KrCl*, XeBr*, XeCl* molecules and I* atom. The highest values of efficiency of various working molecules are approximately 10-18%. The lifetime of the operating gas mixture in KrCl*, XeCl*, I* and XeBr* exciplex lamps excited by a CD is above 1000 h. Owing to the above-mentioned characteristics, the exciplex lamps excited by a CD are supposed to be very promising for various applications.

  17. Capacitive discharge exciplex lamps

    International Nuclear Information System (INIS)

    Sosnin, E A; Erofeev, M V; Tarasenko, V F

    2005-01-01

    Simple-geometry exciplex lamps of a novel type excited by a capacitive discharge (CD-excilamps) have been investigated. An efficient radiation has been obtained on KrBr*, KrCl*, XeBr*, XeCl* molecules and I* atom. The highest values of efficiency of various working molecules are approximately 10-18%. The lifetime of the operating gas mixture in KrCl*, XeCl*, I* and XeBr* exciplex lamps excited by a CD is above 1000 h. Owing to the above-mentioned characteristics, the exciplex lamps excited by a CD are supposed to be very promising for various applications

  18. Continuous pile discharging machine

    Science.gov (United States)

    Smith, Phillips P.

    1976-05-11

    A device for discharging cartridges from tubes under fluid pressure includes a cylindrical housing adapted to be seated in a leak-tight manner on the end of one of the tubes, a chute depending from the cylindrical housing near the end seated on the end of the tube, a rotatable piston having a wrench on the forward end thereof disposed in the cylindrical housing and adapted to manipulate a plug in the end of the tube, and a telescopic hydraulic ram adapted to move the piston toward the plug. In addition the wrench contains a magnet which prevents inadvertent uncoupling of the wrench and the plug.

  19. How to diagnose acute appendicitis

    DEFF Research Database (Denmark)

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

    2016-01-01

    appendicitis (AA). • Primary US for AA diagnosis will decrease ionizing radiation and cost. • Sensitivity of US to diagnose AA is lower than of CT/MRI. • Non-visualization of the appendix should lead to clinical reassessment. • Complementary MRI or CT may be performed if diagnosis remains unclear....... and complementary imaging with MRI/CT if indicated. Accordingly, both ionizing radiation to our patients and cost of pre-therapeutic diagnosis of AA will be low, with low negative appendectomy and perforation rates. Main Messages • Ultrasound (US) should be the first imaging modality for diagnosing acute...... specificity both in the paediatric and adult patient populations. As US sensitivity is limited, and non-diagnostic US examinations with non-visualization of the appendix are more a rule than an exception, diagnostic strategies and algorithms after non-diagnostic US should focus on clinical reassessment...

  20. Clinical Impact of Epileptiform Discharge in Children With Attention-Deficit/Hyperactivity Disorder (ADHD).

    Science.gov (United States)

    Lee, Eun Hye; Choi, Yong Sung; Yoon, Hoi Soo; Bahn, Geon Ho

    2016-04-01

    The aim of this study was to investigate the prevalence and clinical significance of epileptiform discharges in patients with attention-deficit/hyperactivity disorder (ADHD). The authors retrospectively reviewed 180 children who were diagnosed with ADHD and had an electroencephalography (EEG) recording. Epileptiform discharges were found in 29 (16.1%) of 180 patients with ADHD. Of these, 15 (8.3%) had generalized epileptiform discharges and 14 (7.7%) had focal epileptiform discharges. The focal epileptiform discharges were most prevalent from the frontal (5/14) and rolandic area (5/14). Among the 29 patients with epileptiform discharges and ADHD, 5 patients had previous history of epilepsy and 4 patients developed epilepsy later, whereas none of the normal EEG group developed epilepsy. The authors suggest that interictal epileptiform discharges appear to be associated with seizure occurrence in children with ADHD and might reflect maturational pathophysiology overlapping with epilepsy. © The Author(s) 2015.

  1. Cryogenic high current discharges

    International Nuclear Information System (INIS)

    Meierovich, B.E.

    1994-01-01

    Z-pinches formed from frozen deuterium fibers by a rapidly rising current have enhanced stability and high neutron yield. The efforts to understand the enhanced stability and neutron yield on the basis of classical picture of Bennett equilibrium of the current channel has not given satisfactory results. The traditional approach does not take into account the essential difference between the frozen deuterium fiber Z-pinches and the usual Z-pinches such as exploding wires or classical gas-puffed Z-pinches. The very low temperature of the fiber atoms (10 K), together with the rapidly rising current, result in the coexistence of a high current channel with unionized fiber atoms for a substantial period of time. This phenomena lasts during the risetime. This approach takes into account the difference of the breakdown in a dielectric deuterium fiber and the breakdown in a metallic wire. This difference is essential to the understanding of specific features of cryogenic high current discharges. Z-pinches in frozen deuterium fibers should be considered as a qualitatively new phenomenon on the boundary of cryogenic and high current physics. It is a start of a new branch in plasma physics: the physics of cryogenic high current discharges

  2. SVM-based Partial Discharge Pattern Classification for GIS

    Science.gov (United States)

    Ling, Yin; Bai, Demeng; Wang, Menglin; Gong, Xiaojin; Gu, Chao

    2018-01-01

    Partial discharges (PD) occur when there are localized dielectric breakdowns in small regions of gas insulated substations (GIS). It is of high importance to recognize the PD patterns, through which we can diagnose the defects caused by different sources so that predictive maintenance can be conducted to prevent from unplanned power outage. In this paper, we propose an approach to perform partial discharge pattern classification. It first recovers the PRPD matrices from the PRPD2D images; then statistical features are extracted from the recovered PRPD matrix and fed into SVM for classification. Experiments conducted on a dataset containing thousands of images demonstrates the high effectiveness of the method.

  3. Diffusion of condenser water discharge

    International Nuclear Information System (INIS)

    Iwakiri, Toshio

    1977-01-01

    Thermal and nuclear power stations in Japan are mostly located in coastal area, and the cooling water is discharged into sea as warm water. Recently, large interest is taken in this matter, and it is desirable to predict the diffusion of warm discharge accurately and to take effective measures for lowering the temperature. As for the methods of predicting the diffusion of warm discharge, simplified estimation, mathematical analysis and hydrographical model experiment are used corresponding to objects and conditions. As for the measures to lower temperature, the method of discharging warm water into deep sea bottom was confirmed to be very effective. In this paper, the phenomena of diffusion of warm discharge in sea, the methods of predicting the diffusion of warm discharge, and the deep sea discharge as the measure for lowering temperature are outlined. The factors concerning the diffusion of warm discharge in sea are the conditions of discharge, topography and sea state, and the diffusion is roughly divided into mixing diffusion in the vicinity of warm water outlet and eddy diffusion in distant region. It is difficult to change artificially the conditions of diffusion in distant region, and the measures of raising the rate of dilution in near region are effective, therefore the deep sea discharge is adopted. (Kako, I.)

  4. Heart bypass surgery - minimally invasive - discharge

    Science.gov (United States)

    ... invasive direct coronary artery bypass - discharge; MIDCAB - discharge; Robot assisted coronary artery bypass - discharge; RACAB - discharge; Keyhole ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  5. Vaginal Discharge: What's Normal, What's Not

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Vaginal Discharge: What's Normal, What's Not KidsHealth / For Teens / ... Discharge: What's Normal, What's Not Print What Is Vaginal Discharge? Vaginal discharge is fluid that comes from ...

  6. Changes in the in-hospital mortality and 30-day post-discharge mortality in acutely admitted older patients: retrospective observational study

    NARCIS (Netherlands)

    van Rijn, Marjon; Buurman, Bianca M.; MacNeil-Vroomen, Janet L.; Suijker, Jacqueline J.; ter Riet, Gerben; van Charante, Eric P. Moll; de Rooij, Sophia E.

    2016-01-01

    to compare changes over time in the in-hospital mortality and the mortality from discharge to 30 days post-discharge for six highly prevalent discharge diagnoses in acutely admitted older patients as well as to assess the effect of separately analysing the in-hospital mortality and the mortality

  7. Analysis of Multipactor Discharge

    International Nuclear Information System (INIS)

    Lau, Y. Y.

    2005-01-01

    Several comprehensive studies of radio frequency (rf) breakdown and rf heating are reported. They are of general interest to magnetic confinement fusion, rf linac, and high power microwave source development. The major results include: (1) a ground-breaking theory of multipactor discharge on dielectric, including a successful proof-of-principle experiment that verified the newly developed scaling laws, (2) an in depth investigation of the failure mechanisms of diamond windows and ceramic windows, and of the roles of graphitization, thin films of coating and contaminants, and (3) a most comprehensive theory, to date, on the heating of particulates by an electromagnetic pulse, and on the roles of rf magnetic field heating and of rf electric field heating, including the construction of new scaling laws that govern them. The above form a valuable knowledge base for the general problem of heating phenomenology

  8. Radioactive wastes and discharges

    International Nuclear Information System (INIS)

    1993-01-01

    According to the Section 24 of the Finnish Radiation Decree (1512/91), the Finnish Centre for Radiation and Nuclear Safety shall specify the concentration and activity limits and principles for the determination whether a waste can be defined as a radioactive waste or not. The radiation safety requirements and limits for the disposal of radioactive waste are given in the guide. They must be observed when discharging radioactive waste into the atmosphere or sewer system, or when delivering solid low-activity waste to a landfill site without a separate waste disposal plan. The guide does not apply to the radioactive waste resulting from the utilization of nuclear energy of natural resources. (4 refs., 1 tab.)

  9. Dicarboxylic acids from electric discharge

    Science.gov (United States)

    Zeitman, B.; Chang, S.; Lawless, J. G.

    1974-01-01

    An investigation was conducted concerning the possible synthesis of a suite of dicarboxylic acids similar to that found in the Murchison meteorite. The investigation included the conduction of a chemical evolution experiment which simulated electric discharge through the primitive atmosphere of the earth. The suite of dicarboxylic acids obtained in the electric discharge experiment is similar to that of the Murchison meteorite, except for the fact that 2-chlorosuccinic acid is present in the spark discharge.

  10. Validity of rheumatoid arthritis diagnoses in the Danish National Patient Registry

    DEFF Research Database (Denmark)

    Pedersen, M.; Klarlund, M.; Jacobsen, S.

    2004-01-01

    to RA satisfying the ACR 1987 classification criteria was estimated to 26%. Our conclusion is that with careful attention to the limitations in the data, discharge diagnoses for patients with records of RA in the Danish NPR can be used for epidemiological research purposes; however, our findings prompt...... general carefulness when using non-audited registries for research in RA....

  11. Desenvolvimento de Órgãos da Digestão e Rendimento de Carcaça de Frangos de Corte de Diversas Origens Genéticas Criados com Bebedouros Pendular e Nipple Development of Digestive Organs and Carcass Yield of Broilers from Diverse Genetic Origin Raised with Regular or Nipple Drinkers

    Directory of Open Access Journals (Sweden)

    LM Fernandes

    2002-01-01

    Full Text Available O uso de linhas genéticas de diferentes fontes comerciais em programas de reprodução de frangos de corte permite produzir gerações comerciais mais bem adaptadas a realidades diversas e otimizar os potenciais de desempenho do frango de corte com os da reprodutora. Entretanto, a prática predominante no Brasil é o uso de pais e mães de mesma origem. O uso de bebedouros tipo "nipple" vem sendo difundido com a perspectiva de gerar benefícios ainda não comprovados inteiramente na prática. Esse estudo avaliou a evolução dos órgãos da digestão, o desempenho vivo e o rendimento de carcaça e das partes de frangos de corte de diferentes cruzamentos entre reprodutores machos de diversos cruzamentos entre linhagens comerciais (R, I, S, e H com fêmeas também de origem variável (R, I, e H em sistemas de produção com bebedouros pendular ou nipple. As aves dos diferentes cruzamentos apresentaram curvas de crescimento com diferentes intensidades em momentos distintos, determinando desempenhos em peso vivo sempre superiores para o cruzamento RR. O rendimento de peito, entretanto, foi maior para o cruzamento IH. O cruzamento SH, de mais baixo peso corporal, evidenciou rendimentos de carcaça inferiores a todos os demais. O tipo de bebedouro não influenciou nenhum resultado de desempenho vivo ou de rendimento de carcaça, independentemente da linhagem. Os órgãos da digestão apresentaram proporções do peso vivo decrescentes com a idade, mas não evidenciaram efeito de cruzamento entre linhagens ou tipo de bebedouro.Breeding programs using parents from different genetic companies allow the production of commercial generations of broilers directed to attend diverse market situations, but they also serve to optimize the performance of the breeder female. However, this is not a current practice in Brazil where most of the commercial broilers being raised are originated from crosses within the same genetic company. The use of nipple drinkers in

  12. Discharge cleaning for a tokamak

    International Nuclear Information System (INIS)

    Ishii, Shigeyuki

    1983-01-01

    Various methods of discharge cleaning for tokamaks are described. The material of the first walls of tokamaks is usually stainless steel, inconel, titanium and so on. Hydrogen is exclusively used as the discharge gas. Glow discharge cleaning (GDC), Taylor discharge cleaning (TDC), and electron cyclotron resonance discharge cleaning (ECR-DC) are discussed in this paper. The cleaning by GDC is made by moving a movable anode to the center of a tokamak vassel. Taylor found the good cleaning effect of induced discharge by high pressure and low power discharge. This is called TDC. When the frequency of high frequency discharge in a magnetic field is equal to that of the electron cyclotron resonance, the break down potential is lowered if the pressure is sufficiently low. The ECR-CD is made by using this effect. In TDC and ECR-DC, the electron temperature, which has a close relation to the production rate of H 0 , can be controlled by the pressure. In GDC, the operating pressure was improved by the radio frequency glow (RG) method. However, there is still the danger of arcing. In case of GDC and ECR-DC, the position of plasma can be controlled, but not in case of TDC. The TDC is accepted by most of takamak devices in the world. (Kato, T.)

  13. Diagnosing Diabetes and Learning about Prediabetes

    Science.gov (United States)

    ... Listen En Español Diagnosing Diabetes and Learning About Prediabetes There are several ways to diagnose diabetes. Each ... or equal to 200 mg/dl What is Prediabetes? Before people develop type 2 diabetes, they almost ...

  14. Development of an imaging-planning program for screen/film and computed radiography mammography for breasts with short chest wall to nipple distance.

    Science.gov (United States)

    Dong, S L; Su, J L; Yeh, Y H; Chu, T C; Lin, Y C; Chuang, K S

    2011-04-01

    Imaging breasts with a short chest wall to nipple distance (CWND) using a traditional mammographic X-ray unit is a technical challenge for mammographers. The purpose of this study is the development of an imaging-planning program to assist in determination of imaging parameters of screen/film (SF) and computed radiography (CR) mammography for short CWND breasts. A traditional mammographic X-ray unit (Mammomat 3000, Siemens, Munich, Germany) was employed. The imaging-planning program was developed by combining the compressed breast thickness correction, the equivalent polymethylmethacrylate thickness assessment for breasts and the tube loading (mAs) measurement. Both phantom exposures and a total of 597 exposures were used for examining the imaging-planning program. Results of the phantom study show that the tube loading rapidly decreased with the CWND when the automatic exposure control (AEC) detector was not fully covered by the phantom. For patient exposures with the AEC fully covered by breast tissue, the average fractional tube loadings, defined as the ratio of the predicted mAs using the imaging-planning program and mAs of the mammogram, were 1.10 and 1.07 for SF and CR mammograms, respectively. The predicted mAs values were comparable to the mAs values, as determined by the AEC. By applying the imaging-planning program in clinical practice, the experiential dependence of the mammographer for determination of the imaging parameters for short CWND breasts is minimised.

  15. The practice of terminal discharge.

    Science.gov (United States)

    Radha Krishna, Lalit Kumar; Murugam, Vengadasalam; Quah, Daniel Song Chiek

    2017-01-01

    'Terminal discharges' are carried out in Singapore for patients who wish to die at home. However, if due diligence is not exercised, parallels may be drawn with euthanasia. We present a theoretical discussion beginning with the definition of terminal discharges and the reasons why they are carried out in Singapore. By considering the intention behind terminal discharges and utilising a multidisciplinary team to deliberate on the clinical, social and ethical intricacies with a patient- and context-specific approach, euthanasia is avoided. It is hoped that this will provide a platform for professionals in palliative medicine to negotiate challenging issues when arranging a terminal discharge, so as to avoid the pitfall of committing euthanasia in a country such as Singapore where euthanasia is illegal. It is hoped that a set of guidelines for terminal discharges may someday be realised to assist professionals in Singapore and around the world.

  16. The ASDEX Upgrade discharge schedule

    International Nuclear Information System (INIS)

    Neu, G.; Engelhardt, K.; Raupp, G.; Treutterer, W.; Zasche, D.; Zehetbauer, T.

    2007-01-01

    ASDEX Upgrade's recently commissioned discharge control system (DCS) marks the transition from a traditional programmed system to a highly flexible 'data driven' one. The allocation of application processes (APs) to controllers, the interconnection of APs through uniquely named signals, and AP control parameter values are all defined as data, and can easily be adapted to the requirements of a particular discharge. The data is laid down in a set of XML documents which APs request via HTTP from a configuration server before a discharge. The use of XML allows for easy parsing, and structural validation through (XSD) schemas. The central input to the configuration process is the discharge schedule (DS), which embodies the dynamic behaviour of a planned discharge as reference trajectories grouped in segments, concatenated through transition conditions. Editing, generation and validation tools, and version control through CVS allow for efficient management of DSs

  17. Discharge Planning in Chronic Conditions

    Science.gov (United States)

    McMartin, K

    2013-01-01

    Background Chronically ill people experience frequent changes in health status accompanied by multiple transitions between care settings and care providers. Discharge planning provides support services, follow-up activities, and other interventions that span pre-hospital discharge to post-hospital settings. Objective To determine if discharge planning is effective at reducing health resource utilization and improving patient outcomes compared with standard care alone. Data Sources A standard systematic literature search was conducted for studies published from January 1, 2004, until December 13, 2011. Review Methods Reports, randomized controlled trials, systematic reviews, and meta-analyses with 1 month or more of follow-up and limited to specified chronic conditions were examined. Outcomes included mortality/survival, readmissions and emergency department (ED) visits, hospital length of stay (LOS), health-related quality of life (HRQOL), and patient satisfaction. Results One meta-analysis compared individualized discharge planning to usual care and found a significant reduction in readmissions favouring individualized discharge planning. A second meta-analysis compared comprehensive discharge planning with postdischarge support to usual care. There was a significant reduction in readmissions favouring discharge planning with postdischarge support. However, there was significant statistical heterogeneity. For both meta-analyses there was a nonsignificant reduction in mortality between the study arms. Limitations There was difficulty in distinguishing the relative contribution of each element within the terms “discharge planning” and “postdischarge support.” For most studies, “usual care” was not explicitly described. Conclusions Compared with usual care, there was moderate quality evidence that individualized discharge planning is more effective at reducing readmissions or hospital LOS but not mortality, and very low quality evidence that it is more

  18. Recurrent vaginal discharge in children.

    Science.gov (United States)

    McGreal, Sharon; Wood, Paul

    2013-08-01

    Childhood vaginal discharge remains a frequent reason for referral from primary to secondary care. The Pediatric and Adolescent Gynecology (PAG) service at Kettering General Hospital was established in 1993 and provides a specialized service that meets the needs of children with gynaecological conditions. To investigate recurrent vaginal discharge noting symptomatology, defining pathogens, common and rarer causes, exploring management regimes, and any changes in practice over time. Retrospective review spanning 15 years identifying prepubertal children attending the outpatient PAG clinic with recurrent vaginal discharge. We reviewed the medical notes individually. 110 patients were identified; 85% were referred from primary care. The age distribution was bimodal at four and eight years. Thirty-five percent of our patients were discharged after the initial consultation. The commonest cause of discharge was vulvovaginitis (82%). Other important causes included suspected sexual abuse (5%), foreign body (3%), labial adhesions (3%), vaginal agenesis (2%). 35% of patients were admitted for vaginoscopy. Vaginal discharge is the most common gynecological symptom in prepubertal girls and can cause repeated clinical episodes. Vulvovaginitis is the most common cause and often responds to simple hygiene measures. Awareness of the less common causes of vaginal discharge is essential. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  19. A nationwide register study of the characteristics, incidence and validity of diagnosed Tourette syndrome and other tic disorders.

    Science.gov (United States)

    Leivonen, Susanna; Voutilainen, Arja; Hinkka-Yli-Salomäki, Susanna; Timonen-Soivio, Laura; Chudal, Roshan; Gissler, Mika; Huttunen, Jukka; Sourander, Andre

    2014-09-01

    The aim of this study was to describe the characteristics and incidence rates of diagnosed tic disorders in the Finnish Hospital Discharge Register, including changing incidence rates between 1991 and 2010. We also aimed to validate the diagnoses of Tourette's syndrome recorded in the register. Children born between January 1, 1991 and December 31, 2010, who were diagnosed with tic disorders, were identified from the Finnish Hospital Discharge Register (n = 3003). We studied the validity of the Tourette's syndrome diagnoses by reviewing the medical charts of 88 children born since 1997 and carrying out telephone interviews with 55 of their guardians. The incidence rates of all diagnosed tic disorders increased during the study period. A comorbid diagnosis of hyperkinetic disorder diagnosis was recorded in 28.2% of the children with Tourette's syndrome, and the validity of the register-based Tourette's syndrome diagnosis was approximately 95%. This is the first nationwide study to demonstrate the increasing incidence of all register-based tic disorder diagnoses. The validity of the Tourette's syndrome diagnoses in the Finnish Hospital Discharge Register was good, and the data provided are suitable for use in further register-based studies of tic disorders. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  20. Noninfectious differential diagnoses of pneumonia

    International Nuclear Information System (INIS)

    Wielandner, A.; Toelly, A.; Agarwal, P.; Bardach, C.

    2017-01-01

    In patients with a clinical suspicion of pneumonia, typical clinical and laboratory features along with the detection of infiltrates on chest X-ray are as a rule considered diagnostic and therapy is immediately initiated; however, studies have shown that in up to 5% of patients with an initial suspicion of pneumonia, another noninfectious pulmonary disease was the underlying cause. Early recognition and differentiation of diseases mimicking pneumonia are prerequisites for an adequate therapy. The aim of this review is to present the important noninfectious differential diagnoses of pneumonia and to provide the reader with tools for a systematic diagnostic approach. A literature search was carried out. As alterations in the lungs often result in similar imaging appearances and a differentiation between transudates, exsudates, blood and cells is not feasible by chest X-ray or CT, a systematic approach is essential to make an appropriate diagnosis. Hence, consideration of the temporal course, predominant pattern, distribution of findings, additional findings and clinical presentation are indispensable. (orig.) [de

  1. Legal aspects of thermal discharges

    International Nuclear Information System (INIS)

    Martin, A.J.

    1974-01-01

    An overview of those legal areas which directly affect technical and planning decisions is presented in the form of 2 legal approaches which constrain the indiscriminate release of thermal discharges to receiving waters. One takes the form of private remedies which have traditionally been available to aggrieved parties who are in some way damaged by the harmful discharge. The 2nd approach utilizes the various statutory constraints leading to direct governmental action. It appears that statutory law is playing the prominent role in restricting the temperature to which receiving waters may be raised as a result of such discharges by using effluent limitations and water quality standards. (Water Resour. Abstr.)

  2. An introduction to gas discharges

    CERN Document Server

    Howatson, A M

    2013-01-01

    An Introduction to Gas Discharges: Second Edition aims to provide a compact introduction to the subject of gas discharges, which continues to make both scientific and industrial progress. In this second edition, the author has made minor corrections, rewritten and expanded some sections, used SI units and modernized notions, in hopes of making the book more up to date. Included in the book is a short history of the subject, an introduction that enumerates the types of gas discharges, the fundamental processes, and then moves on to the more specific areas such as the breakdown, the self-sustai

  3. CQI project improves discharge process.

    Science.gov (United States)

    1998-08-01

    At Gibson Rehab Center in Williamsport, PA, a continuous quality improvement project to bolster the institution's discharge planning process has resulted in increased satisfaction and an award for quality. The 15-month project was spearheaded by a multidisciplinary team charged with identifying areas that had a significant impact on customer service and suggesting better ways of delivering that service. Among the changes the group suggested were establishing a weekly discharge planning group for new neuro patients, assigning a discharge coordinator for each treatment team, and creating an interdisciplinary communication sheet for the home health therapy staff.

  4. Original Article The incidence of cancer in women presenting with ...

    African Journals Online (AJOL)

    user

    Objectives: To determine the frequency of breast cancer in patients presenting with bloody nipple discharge at the ... cytology of discharges, breast ultrasonography, mammography ... the histologic diagnosis of the nipple discharge. Results.

  5. Vaginal itching and discharge - child

    Science.gov (United States)

    Pruritus vulvae; Itching - vaginal area; Vulvar itching; Yeast infection - child ... Common causes of vaginal itching and discharge in young girls include: Chemicals such as perfumes and dyes in detergents, fabric softeners, creams, ointments, ...

  6. Microwave discharges in capillary tubes

    International Nuclear Information System (INIS)

    Dervisevic, Emil

    1984-01-01

    This research thesis aims at being a contribution to the study of microwave discharge by a surface wave, and more precisely focusses on the discharge in capillary tubes filled with argon. The author first present theoretical models which describe, on the one hand, the propagation of the surface wave along the plasma column, and, on the other hand, longitudinal and radial profiles of the main discharge characteristics. The second part addresses the study of the influence of parameters (gas pressure and tube radius) on discharge operation and characteristics. Laws of similitude as well as empirical relationships between argon I and argon II emission line intensities, electron density, and electric field in the plasma have been established [fr

  7. Ion source of discharge type

    Energy Technology Data Exchange (ETDEWEB)

    Enchevich, I.B. [TRIUMF, Cyclotron Div., Vancouver, British Columbia (Canada); Korenev, S.A. [JINR, Hihg Energy Physics Lab., Dubna, Moscow (Russian Federation)

    1992-07-01

    A new scheme of ion source based on a dielectric surface sliding discharge is described. The conditions to form this type of discharge are analyzed and experimental results are shown. The main parameters of this ion source are: accelerating voltage U = 1/20kV; continuous extracted ion beam; current density j = 0.01/0.5 A/cm{sup 2}; ions of Cl, F, C, H; residual gas pressure P = 10{sup -6} Torr. A magnetic system is used to separate the different types of ions. The dielectric material in the discharge circuit (anode plasma emitter) defines the type of ions. The emission characteristics of plasma emitter and the discharge parameters are presented. The ion current yield satisfies the Child-Langmuir law. (author)

  8. Ion source of discharge type

    International Nuclear Information System (INIS)

    Enchevich, I.B.; Korenev, S.A.

    1992-07-01

    A new scheme of ion source based on a dielectric surface sliding discharge is described. The conditions to form this type of discharge are analyzed and experimental results are shown. The main parameters of this ion source are: accelerating voltage U = 1/20kV; continuous extracted ion beam; current density j = 0.01/0.5 A/cm 2 ; ions of Cl, F, C, H; residual gas pressure P = 10 -6 Torr. A magnetic system is used to separate the different types of ions. The dielectric material in the discharge circuit (anode plasma emitter) defines the type of ions. The emission characteristics of plasma emitter and the discharge parameters are presented. The ion current yield satisfies the Child-Langmuir law. (author)

  9. Synchronous bilateral male breast cancer: a case report.

    Science.gov (United States)

    Sun, Woo-Young; Lee, Ki-Hyeong; Lee, Ho-Chang; Ryu, Dong-Hee; Park, Jin-Woo; Yun, Hyo-Young; Song, Young-Jin

    2012-06-01

    Synchronous bilateral breast cancer is extremely rare in men and has not, up to date, been reported in Korea. A 54-year-old man presented with a palpable mass in the right breast. The right nipple was retracted and bilateral axillary accessory breasts and nipples were present. On physical examination, a 2 cm-sized mass was palpated directly under the right nipple, and, with squeezing, bloody discharge developed in a single duct of the left nipple. There was no palpable mass in the left breast, and axillary lymph nodes were not palpable. Physical examination of external genitalia revealed a unilateral undescended testis on the left side. Synchronous bilateral breast cancer was diagnosed using mammography, ultrasonography, and core-needle biopsy. Histopathological examination revealed invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast. Bilateral total mastectomy, sentinel lymph node biopsy, and excision of accessory breasts in the axilla were performed.

  10. Radioactive discharges from Sellafield (UK)

    International Nuclear Information System (INIS)

    Pentreath, R.J.

    1985-01-01

    This study of low-level liquid radioactive discharges from the British Nuclear Fuels Ltd Sellafield site into the eastern basin of the Irish Sea, prepared on the basis of existing publications and documents, reviews chemical forms and rate of discharges, physical oceanography, sediment distribution and fisheries of the Irish Sea, behaviour of radionuclides in seawater, association with sedimentary materials, accumulation of radionuclides by biological materials, environmental monitoring, surveillance and assessment of radiation exposure of the public and impact on the environment

  11. Chronic obstructive pulmonary disease - adults - discharge

    Science.gov (United States)

    ... coughing up dark mucus Your fingertips or the skin around your fingernails are blue Alternative Names COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; ...

  12. Ballooning stability of JET discharges

    International Nuclear Information System (INIS)

    Huysmans, G.T.A.; Goedbloed, J.P.; Galvao, R.M.O.; Lazzaro, E.; Smeulders, P.

    1989-01-01

    Conditions under which ballooning modes are expected to be excited have recently been obtained in two different types of discharges in JET. In the first type, extremely large pressure gradients have been produced in the plasma core through pellet injections in the current rise phase followed by strong additional heating. In the second type, the total pressure of the discharge is approaching the Troyon limit. The stability of these discharges with respect to the ideal MHD ballooning modes has been studied with the stability code HBT. The equilibria are reconstructed with the IDENTC code using the external magnetic measurements and the experimental pressure profile. The results show that the evaluated high beta discharge is unstable in the central region of the plasma. This instability is related to the low shear and not to a large pressure gradient, as expected at the Troyon limit. In the pellet discharges the regions with the large pressure gradients are unstable to ballooning modes at the time of the beta decay, which ends the period of enhanced performance. The maximum pressure gradient in these discharges is limited by the boundary of the first region of stability. The observed phenomena at the beta decay are similar to those observed at the beta limit in DIII-D and TFTR. (author)

  13. Filamentary and diffuse barrier discharges

    International Nuclear Information System (INIS)

    Kogelschatz, U.

    2001-01-01

    Barrier discharges, sometimes also referred to as dielectric-barrier discharges or silent discharges, are characterized by the presence of at least one insulating layer in contact with the discharge between two planar or cylindrical electrodes connected to an ac power supply. The main advantage of this type of electrical discharge is, that non-equilibrium plasma conditions in atmospheric-pressure gases can be established in an economic and reliable way. This has led to a number of important applications including industrial ozone generation, surface modification of polymers, plasma chemical vapor deposition, excitation of CO 2 lasers, excimer lamps and, most recently, large-area flat plasma display panels. Depending on the application, the width of the discharge gap can range from less than 0.1 mm to about 100 mm and the applied frequency from below line frequency to several gigahertz. Typical materials used for the insulating layer (dielectric barrier) are glass, quartz, ceramics but also thin enamel or polymer layers

  14. Official monitoring of the Brazilian Norm for Commercialization of Food for Nursling and Children of First Infancy, Rubber Nipples, Pacifiers, and Nursing Bottles - NBCAL

    Directory of Open Access Journals (Sweden)

    Fabrício Luiz Silva Bartolini

    2009-09-01

    Full Text Available This work aimed to evaluate advertisement of baby food, rubber nipples, pacifiers and nursing bottles through newspapers as well as on TV, radio, and the internet, in order to check whether the 'Brazilian Norm for Commercialization of Food for Nursling and Children of First Infancy, Rubber Nipples, Pacifiers and Nursing Bottles' (Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância, Bicos, Chupetas e Mamadeiras - NBCAL has been complied. Samples of all the items above were acquired at discount and department stores to check whether labeling was in compliance with the NBCAL. The development of this research as well as the analyses of commercial promotion were carried out in Juiz de Fora - state of Minas Gerais, from May to July 2006, using convenient, non-representative sampling composed of 680 pieces of advertisement. The results obtained through descriptive statistics showed that 564 of the 680 samples analyzed, or 83.0%, did not meet the NBCAL. Irregularities were detected in 100% of the samples advertised on the media and found in hospitals and drugstores; in 70.1% of the samples purchased at supermarkets, in 37% of those from medical clinics and in 86.6% of those found on the internet. The evidences showed that monitoring must be carried out continuously and educational campaigns on the importance of breast-feeding for the full development of children must be addressed to mothers, the food industry and commercial establishments.O presente trabalho teve como objetivo avaliar propagandas e publicidades impressas de alimentos infantis, bicos, chupetas e mamadeiras, além das veiculadas em rádio, TV e internet, para verificar o cumprimento da Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância (NBCAL. Também foi realizada a aquisição de bicos, mamadeiras e chupetas em "lojas de 1,99" e de departamento, para a verificação de rotulagem de acordo

  15. Leptin expression in breast nipple aspirate fluid (NAF) and serum is influenced by body mass index (BMI) but not by the presence of breast cancer.

    Science.gov (United States)

    Sauter, E R; Garofalo, C; Hewett, J; Hewett, J E; Morelli, C; Surmacz, E

    2004-05-01

    While obesity is a known risk factor for postmenopausal breast cancer, the molecular mechanisms involved are unclear. Systemic levels of leptin, the product of the ob (obesity) gene, are increased in obese individuals (body mass index, BMI, over 25) and are higher in women than men. Leptin has been found to stimulate the growth of breast cancer cells in vitro. Our goal was to determine whether leptin was 1) present in nipple aspirate fluid (NAF), and 2) whether NAF leptin levels were associated with a) levels in serum, b) obesity, and c) breast cancer. We collected and evaluated NAF specimens from 83 subjects and serum specimens from 49 subjects. NAF leptin was detectable in 16/41 (39 %) of premenopausal and 21/42 (50 %) postmenopausal subjects. NAF leptin was significantly lower (p = 0.042) in premenopausal than postmenopausal women with a BMI < 25, but not in those with a higher BMI. NAF leptin was significantly associated with BMI in premenopausal (p = 0.011) but not in postmenopausal women. Serum leptin was associated with BMI in both premenopausal and postmenopausal women (p = 0.0001 for both). NAF and serum leptin were associated in premenopausal (p = 0.02) but not postmenopausal women. Neither NAF nor serum leptin was associated with premenopausal or postmenopausal breast cancer. Our findings include that 1) leptin is present in the breast and detectable in a subset of NAF samples, 2) NAF leptin in premenopausal but not postmenopausal women parallels serum leptin levels, and 3) neither NAF nor serum levels of leptin were associated with premenopausal or postmenopausal breast cancer.

  16. Current trends and outcomes of breast reconstruction following nipple-sparing mastectomy: results from a national multicentric registry with 1006 cases over a 6-year period.

    Science.gov (United States)

    Casella, Donato; Calabrese, Claudio; Orzalesi, Lorenzo; Gaggelli, Ilaria; Cecconi, Lorenzo; Santi, Caterina; Murgo, Roberto; Rinaldi, Stefano; Regolo, Lea; Amanti, Claudio; Roncella, Manuela; Serra, Margherita; Meneghini, Graziano; Bortolini, Massimiliano; Altomare, Vittorio; Cabula, Carlo; Catalano, Francesca; Cirilli, Alfredo; Caruso, Francesco; Lazzaretti, Maria Grazia; Meattini, Icro; Livi, Lorenzo; Cataliotti, Luigi; Bernini, Marco

    2017-05-01

    Reconstruction options following nipple-sparing mastectomy (NSM) are diverse and not yet investigated with level IA evidence. The analysis of surgical and oncological outcomes of NSM from the Italian National Registry shows its safety and wide acceptance both for prophylactic and therapeutic cases. A further in-depth analysis of the reconstructive approaches with their trend over time and their failures is the aim of this study. Data extraction from the National Database was performed restricting cases to the 2009-2014 period. Different reconstruction procedures were analyzed in terms of their distribution over time and with respect to specific indications. A 1-year minimum follow-up was conducted to assess reconstructive unsuccessful events. Univariate and multivariate analyses were performed to investigate the causes of both prosthetic and autologous failures. 913 patients, for a total of 1006 procedures, are included in the analysis. A prosthetic only reconstruction is accomplished in 92.2 % of cases, while pure autologous tissues are employed in 4.2 % and a hybrid (prosthetic plus autologous) in 3.6 %. Direct-to-implant (DTI) reaches 48.7 % of all reconstructions in the year 2014. Prophylactic NSMs have a DTI reconstruction in 35.6 % of cases and an autologous tissue flap in 12.9 % of cases. Failures are 2.7 % overall: 0 % in pure autologous flaps and 9.1 % in hybrid cases. Significant risk factors for failures are diabetes and the previous radiation therapy on the operated breast. Reconstruction following NSM is mostly prosthetic in Italy, with DTI gaining large acceptance over time. Failures are low and occurring in diabetic and irradiated patients at the multivariate analysis.

  17. Breast irradiation causes pallor in the nipple-areolar complex in women with Celtic skin type (result from the St. George and Wollongong randomised breast boost trial)

    International Nuclear Information System (INIS)

    Lee, Yoo Young Dominique; Hau, Eric; Browne, Lois H.; Chin, Yaw; Lee, Jessica; Szwajcer, Alison; Cail, Stacy; Nolan, David N.; Graham, Peter H.

    2014-01-01

    The nipple-areolar complex (NAC) has special histological properties with higher melanocyte concentration than breast skin. To date, there are no data describing the late effects on the NAC following breast-conserving therapy (BCT). This study evaluated colour changes in the NAC in patients treated with breast-conserving surgery and adjuvant radiotherapy after 5 years. Digital photographs obtained at 5 years following breast irradiation from the St. George and Wollongong (SGW) trial (NCT00138814) were evaluated by five experts using an iPad® (Apple Inc., Cupertino, CA, USA) application specifically created for this study. The SGW trial randomised 688 patients with Tis-2, N0-1, M0 carcinoma to the control arm of 50Gy in 25 fractions and boost arm of 45Gy in 25 fractions and 16 Gy in 8 fractions electron boost. A total of 141/372 (38%) patients had altered NAC (86% lighter, 10% darker). Patients with Celtic skin type had increased likelihood of having an altered NAC (odds ratio (OR), 1.75 (CI 1.1–2.7, P=0.011)). On subgroup analysis, those with Celtic skin type receiving biologically equivalent dose (BED) Gy3 ≥ 80Gy had OR of 3.03 (95% CI 1.2–7.5, P=0.016) for having altered colour. There was a dose response with more profound changes seen in the NAC compared with irradiated breast skin if BED Gy3 ≥ 80Gy with OR of 2.42 (95% CI 1.1–5.6, P=0.036). In this Caucasian BCT population, over 30% of patients developed lighter NAC and more commonly in women with Celtic skin type. The degree of this effect increased with higher radiation dose.

  18. Classification of electrical discharges in DC Accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Banerjee, Srutarshi, E-mail: sruban.stephens@gmail.com [Accelerator and Pulse Power Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Deb, A.K. [Department of Electrical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302 (India); Rajan, Rehim N. [Accelerator and Pulse Power Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Kishore, N.K. [Department of Electrical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302 (India)

    2016-08-11

    Controlled electrical discharge aids in conditioning of the system while uncontrolled discharges damage its electronic components. DC Accelerator being a high voltage system is no exception. It is useful to classify electrical discharges according to the severity. Experimental prototypes of the accelerator discharges are developed. Photomultiplier Tubes (PMTs) are used to detect the signals from these discharges. Time and Frequency domain characteristics of the detected discharges are used to extract features. Machine Learning approaches like Fuzzy Logic, Neural Network and Least Squares Support Vector Machine (LSSVM) are employed to classify the discharges. This aids in detecting the severity of the discharges.

  19. Estimating sediment discharge: Appendix D

    Science.gov (United States)

    Gray, John R.; Simões, Francisco J. M.

    2008-01-01

    Sediment-discharge measurements usually are available on a discrete or periodic basis. However, estimates of sediment transport often are needed for unmeasured periods, such as when daily or annual sediment-discharge values are sought, or when estimates of transport rates for unmeasured or hypothetical flows are required. Selected methods for estimating suspended-sediment, bed-load, bed- material-load, and total-load discharges have been presented in some detail elsewhere in this volume. The purposes of this contribution are to present some limitations and potential pitfalls associated with obtaining and using the requisite data and equations to estimate sediment discharges and to provide guidance for selecting appropriate estimating equations. Records of sediment discharge are derived from data collected with sufficient frequency to obtain reliable estimates for the computational interval and period. Most sediment- discharge records are computed at daily or annual intervals based on periodically collected data, although some partial records represent discrete or seasonal intervals such as those for flood periods. The method used to calculate sediment- discharge records is dependent on the types and frequency of available data. Records for suspended-sediment discharge computed by methods described by Porterfield (1972) are most prevalent, in part because measurement protocols and computational techniques are well established and because suspended sediment composes the bulk of sediment dis- charges for many rivers. Discharge records for bed load, total load, or in some cases bed-material load plus wash load are less common. Reliable estimation of sediment discharges presupposes that the data on which the estimates are based are comparable and reliable. Unfortunately, data describing a selected characteristic of sediment were not necessarily derived—collected, processed, analyzed, or interpreted—in a consistent manner. For example, bed-load data collected with

  20. Glow discharge in singlet oxygen

    International Nuclear Information System (INIS)

    Vagin, N.P.; Ionin, A.A.; Klimachev, Yu.M.; Sinitsyn, D.V.; Yuryshev, N.N.; Kochetov, I.V.; Napartovich, A.P.

    2003-01-01

    Currently, there is no experimental data on the plasma balance in gas mixtures with a high content of singlet delta oxygen O 2 ( 1 Δ g ). These data can be obtained by studying the parameters of an electric discharge in singlet oxygen produced by a chemical generator. The O 2 ( 1 Δ g ) molecules significantly change the kinetics of electrons and negative ions in plasma. Hence, the discharge conditions at low and high O 2 ( 1 Δ g ) concentrations are very different. Here, the parameters of the positive column of a glow discharge in a gas flow from a chemical singlet-oxygen generator are studied. It is experimentally shown that, at an O 2 ( 1 Δ g ) concentration of 50% and at pressures of 1.5 and 2 torr, the electric field required to sustain the discharge is considerably lower than in the case when all of the oxygen molecules are in the ground state. A theoretical model of the glow discharge is proposed whose predictions are in good agreement with the experimental data

  1. Discharges to prison from medium secure psychiatric units in England and Wales.

    Science.gov (United States)

    Doyle, Michael; Coid, Jeremy; Archer-Power, Laura; Dewa, Lindsay; Hunter-Didrichsen, Alice; Stevenson, Rachel; Wainwright, Verity; Kallis, Costas; Ullrich, Simone; Shaw, Jenny

    2014-09-01

    Early findings from a national study of discharges from 32 National Health Service medium secure units revealed that nearly twice as many patients than expected were discharged back to prison. To compare the characteristics of those discharged back to prison with those discharged to the community, and consider the implications for ongoing care and risk. Prospective cohort follow-up design. All forensic patients discharged from 32 medium secure units across England and Wales over a 12-month period were identified. Those discharged to prison were compared with those who were discharged to the community. Nearly half of the individuals discharged to prison were diagnosed with a serious mental illness and over a third with schizophrenia. They were a higher risk, more likely to have a personality disorder, more symptomatic and less motivated than those discharged to the community. Findings suggest that alternative models of prison mental healthcare should be considered to reduce risks to the patient and the public. Royal College of Psychiatrists.

  2. The Burden of Diagnosed and Undiagnosed Diabetes in Native Hawaiian and Asian American Hospitalized Patients.

    Science.gov (United States)

    Sentell, T L; Cheng, Y; Saito, E; Seto, T B; Miyamura, J; Mau, M; Juarez, D T

    2015-12-01

    Little is known about diabetes in hospitalized Native Hawaiians and Asian Americans. We determined the burden of diabetes (both diagnosed and undiagnosed) among hospitalized Native Hawaiian, Asian (Filipino, Chinese, Japanese), and White patients. Diagnosed diabetes was determined from discharge data from a major medical center in Hawai'i during 2007-2008. Potentially undiagnosed diabetes was determined by Hemoglobin A1c ≥6.5% or glucose ≥200 mg/dl values for those without diagnosed diabetes. Multivariable log-binomial models predicted diabetes (potentially undiagnosed and diagnosed, separately) controlling for socio-demographic factors. Of 17,828 hospitalized patients, 3.4% had potentially undiagnosed diabetes and 30.5% had diagnosed diabetes. In multivariable models compared to Whites, Native Hawaiian and all Asian subgroups had significantly higher percentages of diagnosed diabetes, but not of potentially undiagnosed diabetes. Potentially undiagnosed diabetes was associated with significantly more hospitalizations during the study period compared to both those without diabetes and those with diagnosed diabetes. In all racial/ethnic groups, those with potentially undiagnosed diabetes also had the longest length of stay and were more likely to die during the hospitalization. Hospitalized Native Hawaiians (41%) and Asian subgroups had significantly higher overall diabetes burdens compared to Whites (23%). Potentially undiagnosed diabetes was associated with poor outcomes. Hospitalized patients, irrespective of race/ethnicity, may require more effective inpatient identification and management of previously undiagnosed diabetes to improve clinical outcomes.

  3. Electron runaway in rf discharges

    International Nuclear Information System (INIS)

    Chen, F.F.

    1992-10-01

    The critical electric field is computed as a function of pressure and starting energy for electrons to run away to high energies in moderate pressure discharges. The runaway conditions depend critically on the shape of the elastic cross section vs. energy curve. Computations are made for H, H 2 , and He gases, and it is shown that runaway occurs much more readily in atomic hydrogen than in the other gases. The values of the runaway fields are larger than would normally occur in dc discharges, where large voltages would lead to arc formation. However, in rf discharges such electric fields can be sustained over times long compared to electron transit times but short compared to ion transit times. (author)

  4. Discharge quenching circuit for counters

    International Nuclear Information System (INIS)

    Karasik, A.S.

    1982-01-01

    A circuit for quenching discharges in gas-discharge detectors with working voltage of 3-5 kV based on transistors operating in the avalanche mode is described. The quenching circuit consists of a coordinating emitter follower, amplifier-shaper for avalanche key cascade control which changes potential on the counter electrodes and a shaper of discharge quenching duration. The emitter follower is assembled according to a widely used flowsheet with two transistors. The circuit permits to obtain a rectangular quenching pulse with front of 100 ns and an amplitude of up to 3.2 kV at duration of 500 μm-8 ms. Application of the quenching circuit described permits to obtain countering characteristics with the slope less than or equal to 0.02%/V and plateau extent greater than or equal to 300 V [ru

  5. Difficult diagnoses in the skeletal radiology

    International Nuclear Information System (INIS)

    Freyschmidt, Juergen

    2013-01-01

    The book on difficult diagnoses in the skeletal radiology discusses the path from symptom to diagnoses including image interpretation. Specific case studies concern the skull, the spinal cord, pelvis, shoulder and chest, upper and lower extremities. The used radiological techniques include projecting radiography, computerized tomography, scintiscanning, PET/CT, NNR imaging and ultrasonography.

  6. From experience : applying the risk diagnosing methodology

    NARCIS (Netherlands)

    Keizer, J.A.; Halman, J.I.M.; Song, X.M.

    2002-01-01

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

  7. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

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

  8. Immunoparesis in newly diagnosed Multiple Myeloma patients

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  9. From experience: applying the risk diagnosing methodology

    NARCIS (Netherlands)

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

    2002-01-01

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

  10. The failure diagnoses of nuclear reactor systems

    International Nuclear Information System (INIS)

    Sheng Huanxing.

    1986-01-01

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

  11. Diagnosing differences between business process models

    NARCIS (Netherlands)

    Dijkman, R.M.; Dumas, M.; Reichert, M.; Shan, M.-C.

    2008-01-01

    This paper presents a technique to diagnose differences between business process models in the EPC notation. The diagnosis returns the exact position of a difference in the business process models and diagnoses the type of a difference, using a typology of differences developed in previous work.

  12. State Waste Discharge Permit application, 183-N Backwash Discharge Pond

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    As part of the Hanford Federal Facility Agreement and Consent Order negotiations (Ecology et al. 1994), the US Department of Energy, Richland Operations Office, the US Environmental Protection Agency, and the Washington State Department of Ecology agreed that liquid effluent discharges to the ground on the Hanford Site which affect groundwater or have the potential to affect groundwater would be subject to permitting under the structure of Chapter 173--216 (or 173--218 where applicable) of the Washington Administrative Code, the State Waste Discharge Permit Program. As a result of this decision, the Washington State Department of Ecology and the US Department of Energy, Richland Operations Office entered into Consent Order No. DE91NM-177, (Ecology and DOE-RL 1991). The Consent Order No. DE91NM-177 requires a series of permitting activities for liquid effluent discharges. Liquid effluents on the Hanford Site have been classified as Phase I, Phase II, and Miscellaneous Streams. The Consent Order No. DE91NM-177 establishes milestones for State Waste Discharge Permit application submittals for all Phase I and Phase II streams, as well as the following 11 Miscellaneous Streams as identified in Table 4 of the Consent Order No. DE91NM-177.

  13. Current-Induced Membrane Discharge

    DEFF Research Database (Denmark)

    Andersen, Mathias Bækbo; van Soestbergen, M.; Mani, A.

    2012-01-01

    . Salt depletion leads to a large electric field resulting in a local pH shift within the membrane with the effect that the membrane discharges and loses its ion selectivity. Since salt co-ions, H+ ions, and OH- ions contribute to OLC, CIMD interferes with electrodialysis (salt counterion removal...... neglects chemical effects and remains to be quantitatively tested. Here, we show that charge regulation and water self-ionization can lead to OLC by "current-induced membrane discharge'' (CIMD), even in the absence of fluid flow, in ion-exchange membranes much thicker than the local Debye screening length...

  14. Plasma Discharge in Toroidal System

    International Nuclear Information System (INIS)

    Usada, Widdi; Suryadi; Purwadi, Agus; Kasiyo

    1996-01-01

    A toroidal discharge apparatus has been made as an initial research in magnetic confinement system. This system consists of a capacitor, a RF source, an igniter system, a primary coil, a torus, and completed by Rogowski probe as a current detector. In this system, the discharge occurs when the minimum voltage is operated at 5 kV. The experiment result shows that the coupling factor is 0.35, it is proved that there is an equality between estimated and measurement results of the primary inductance i.e 8.5 μH

  15. Taming Instabilities in Plasma Discharges

    International Nuclear Information System (INIS)

    Klinger, T.; Krahnstover, N. O.; Mausbach, T.; Piel, A.

    2000-01-01

    Recent experimental work on taming instabilities in plasma discharges is discussed. Instead of suppressing instabilities, it is desired to achieve control over their dynamics, done by perturbing appropriately the current flow in the external circuit of the discharge. Different discrete and continuous feedback as well as open-loop control schemes are applied. Chaotic oscillations in plasma diodes are controlled using the OGY discrete feedback scheme. This is demonstrated both in experiment and computer simulation. Weakly developed ionization wave turbulence is tamed by continuous feedback control. Open-loop control of stochastic fluctuations - stochastic resonance - is demonstrated in a thermionic plasma diode. (author)

  16. Where Lies the Fault in Diagnosing Dhat Syndrome among Females? Understanding through a Case Study

    OpenAIRE

    Kar, Sujita Kumar; Singh, Amit

    2017-01-01

    Dhat syndrome is a culture-bound syndrome of South-East Asia, common in young men. However, similar entity has also been described in female patients who attribute their symptoms to nonpathological or physiological vaginal discharge. The current diagnostic system for psychiatric illnesses does not encompass Dhat syndrome in females, and so these group of patients receive alternative diagnoses such as somatoform disorder or depression. As a result of which the focus of unique Dhat syndrome-cen...

  17. VALIDITY OF PARACENTESIS IN DIAGNOSING BLUNT TRAUMA ABDOMEN

    Directory of Open Access Journals (Sweden)

    Fahad Bin Abdul Majeed

    2017-03-01

    Full Text Available BACKGROUND Blunt abdominal trauma is a common case that comes to an emergency department and it is the most easily missed diagnosis resulting in catastrophic consequences. Delay in diagnosing a case is due to the nonspecific character of the symptoms with which it presents. Clinical signs that could be elicited in blunt trauma abdomen are equally nonspecific. Thus, to avoid delay and save the life of the patient, a doctor has to depend on various investigations to rule out blunt trauma abdomen. The modalities which help include paracentesis, diagnostic peritoneal lavage, Focused Abdominal Sonography for Trauma (FAST and ContrastEnhanced Computed Tomography (CECT. To choose the right investigation for the right patient helps in saving precious lives. Validity of each investigation, availability, condition of the patient are the main points to look into before deciding on the right investigative modality. Paracentesis is the simplest investigation that could be done in emergency department and also at the site of accident to triage the patient. Paracentesis has low sensitivity to detect blunt trauma. FAST is a better investigation with higher validity rates than paracentesis. This study aims to validate paracentesis, which is the simplest and commonest investigation used to identify blunt abdominal trauma. MATERIALS AND METHODS In this study, 106 patients who fulfilled the inclusion and exclusion criteria were followed up by detailed history, clinical examination, paracentesis and FAST to identify blunt abdominal trauma and then compared with a gold standard investigation, which was assigned as CECT for haemodynamically stable patients and laparotomy for haemodynamically unstable patients. Commonest organs injured in blunt trauma and their management was noted. Patients were followed up till discharge or death. Subsequently, the data were compiled using excel sheet and evaluated using tables and charts. RESULTS Paracentesis is found to have a

  18. Spheres of discharge of springs

    Science.gov (United States)

    Springer, Abraham E.; Stevens, Lawrence E.

    2009-02-01

    Although springs have been recognized as important, rare, and globally threatened ecosystems, there is as yet no consistent and comprehensive classification system or common lexicon for springs. In this paper, 12 spheres of discharge of springs are defined, sketched, displayed with photographs, and described relative to their hydrogeology of occurrence, and the microhabitats and ecosystems they support. A few of the spheres of discharge have been previously recognized and used by hydrogeologists for over 80 years, but others have only recently been defined geomorphologically. A comparison of these spheres of discharge to classification systems for wetlands, groundwater dependent ecosystems, karst hydrogeology, running waters, and other systems is provided. With a common lexicon for springs, hydrogeologists can provide more consistent guidance for springs ecosystem conservation, management, and restoration. As additional comprehensive inventories of the physical, biological, and cultural characteristics are conducted and analyzed, it will eventually be possible to associate spheres of discharge with discrete vegetation and aquatic invertebrate assemblages, and better understand the habitat requirements of rare or unique springs species. Given the elevated productivity and biodiversity of springs, and their highly threatened status, identification of geomorphic similarities among spring types is essential for conservation of these important ecosystems.

  19. Problems with textile wastewater discharge

    International Nuclear Information System (INIS)

    Rantala, Pentti

    1987-01-01

    The general character of textile industry wastewaters is briefly discussed. General guidelines and practice in Finland when discharging textile industry wastewaters to municipal sewer systems is described. A survey revealed that most municipalities experience some problems due to textile industry wastewaters. Pretreatment is not always practiced and in some cases pretreatment is not operated efficiently. (author)

  20. Discharge measurements at gaging stations

    Science.gov (United States)

    Turnipseed, D. Phil; Sauer, Vernon B.

    2010-01-01

    The techniques and standards for making discharge measurements at streamflow gaging stations are described in this publication. The vertical axis rotating-element current meter, principally the Price current meter, has been traditionally used for most measurements of discharge; however, advancements in acoustic technology have led to important developments in the use of acoustic Doppler current profilers, acoustic Doppler velocimeters, and other emerging technologies for the measurement of discharge. These new instruments, based on acoustic Doppler theory, have the advantage of no moving parts, and in the case of the acoustic Doppler current profiler, quickly and easily provide three-dimensional stream-velocity profile data through much of the vertical water column. For much of the discussion of acoustic Doppler current profiler moving-boat methodology, the reader is referred to U.S. Geological Survey Techniques and Methods 3-A22 (Mueller and Wagner, 2009). Personal digital assistants (PDAs), electronic field notebooks, and other personal computers provide fast and efficient data-collection methods that are more error-free than traditional hand methods. The use of portable weirs and flumes, floats, volumetric tanks, indirect methods, and tracers in measuring discharge are briefly described.

  1. Ions mobilities in corona discharge

    International Nuclear Information System (INIS)

    Bakhtaev, Sh. A.; Bochkareva, G. V.; Sydykova, G. K.

    2000-01-01

    Ion mobility in unipolar corona at small inter-electron distances (up to 0.01 m) when as coroning element serves micro-wire is consider. Experimental data of ion mobility in corona discharge external zone in atmospheric air are obtained and its comparative analysis with known data is worked out. (author)

  2. Air corona discharge chemical kinetics

    International Nuclear Information System (INIS)

    Kline, L.E.; Kanter, I.E.

    1984-01-01

    We have theoretically studied the initial chemical processing steps which occur in pulseless, negative, dc corona discharges in flowing air. A rate equation model is used because these discharges consist of a very small ionization zone near the pin with most of the pin-plane gap filled by a drift zone where both the electric field and the electron density are relatively uniform. The primary activated species are N 2 (A),O and O 2 (a 1 Δ). The predicted activated species density due to one discharge is 100 ppm per ms . mA cm 2 assuming E/n=60 Td. In pure, dry air the final product due to these activated species is primarily O 3 . The NO /sub x/ production is about 0.5 ppm per mA. In moist air there is an additional production of about 1.5 ppm per mA of HO /sub x/ species. The predicted ozone formation reactions will be ''intercepted'' when impurities are present in the air. Impurities present at densities below about 0.1% will react primarily with the activated species rather than with electrons. Hence the predicted activated species density provides an estimate of the potential chemical processing performance of the discharge

  3. Electronic Discharge Letter Mobile App

    NARCIS (Netherlands)

    Lezcano, Leonardo; Triana, Michel; Ternier, Stefaan; Hartkopf, Kathleen; Stieger, Lina; Schroeder, Hanna; Sopka, Sasa; Drachsler, Hendrik; Maher, Bridget; Henn, Patrick; Orrego, Carola; Specht, Marcus

    2014-01-01

    The electronic discharge letter mobile app takes advantage of Near Field Communication (NFC) within the PATIENT project and a related post-doc study. NFC enabled phones to read passive RFID tags, but can also use this short-range wireless technology to exchange (small) messages. NFC in that sense

  4. Discharge cleaning of carbon deposits

    International Nuclear Information System (INIS)

    Mozetic, M.; Vesel, A.; Drenik, A.

    2006-01-01

    Experimental results of discharge cleaning of carbon deposits are presented. Deposits were prepared by creating plasma in pure methane. The methane was cracked in RF discharge at the output power of 250 W. The resultant radicals were bonded to the wall of discharge vessel forming a thin film of hydrogenated black carbon with the thickness of about 200nm. The film was then cleaned in situ by oxygen plasma with the density of about 1x10 16 m -3 , electron temperature of 5 eV, neutral gas kinetic temperature of about 100 0 C and neutral atom density of 6x10 21 m -3 . The treatment time was 30 minutes. The efficiency of plasma cleaning was monitored by optical emission spectroscopy. As long as the wall was contaminated with carbon deposit, substantial emission of the CO molecules was detected. As the cleaning was in progress, the CO emission was decreasing and vanished after 30 minutes when the discharge vessel became free of any carbon. The results are explained by interaction of plasma radicals with carbon deposits. (author)

  5. Validation studies of nursing diagnoses in neonatology

    Directory of Open Access Journals (Sweden)

    Pavlína Rabasová

    2016-03-01

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

  6. The Consistency Between Clinical and Electrophysiological Diagnoses

    Directory of Open Access Journals (Sweden)

    Esra E. Okuyucu

    2009-09-01

    Full Text Available OBJECTIVE: The aim of this study was to provide information concerning the impact of electrophysiological tests in the clinical management and diagnosis of patients, and to evaluate the consistency between referring clinical diagnoses and electrophysiological diagnoses. METHODS: The study included 957 patients referred to the electroneuromyography (ENMG laboratory from different clinics with different clinical diagnoses in 2008. Demographic data, referring clinical diagnoses, the clinics where the requests wanted, and diagnoses after ENMG testing were recorded and statistically evaluated. RESULTS: In all, 957 patients [644 (67.3% female and 313 (32.7% male] were included in the study. Mean age of the patients was 45.40 ± 14.54 years. ENMG requests were made by different specialists; 578 (60.4% patients were referred by neurologists, 122 (12.8% by orthopedics, 140 (14.6% by neurosurgeons, and 117 (12.2% by physical treatment and rehabilitation departments. According to the results of ENMG testing, 513 (53.6% patients’ referrals were related to their referral diagnosis, whereas 397 (41.5% patients had normal ENMG test results, and 47 (4.9% patients had a diagnosis that differed from the referring diagnosis. Among the relation between the referral diagnosis and electrophysiological diagnosis according to the clinics where the requests were made, there was no statistical difference (p= 0.794, but there were statistically significant differences between the support of different clinical diagnoses, such as carpal tunnel syndrome, polyneuropathy, radiculopathy-plexopathy, entrapment neuropathy, and myopathy based on ENMG test results (p< 0.001. CONCLUSION: ENMG is a frequently used neurological examination. As such, referrals for ENMG can be made to either support the referring diagnosis or to exclude other diagnoses. This may explain the inconsistency between clinical referring diagnoses and diagnoses following ENMG

  7. Efeito do estímulo mamário sobre o índice de Bishop em gestações a termo Effect of nipple stimulation on Bishop scores in term pregnancies

    Directory of Open Access Journals (Sweden)

    Alexandre Faisal Cury

    1999-01-01

    Full Text Available Objetivo: avaliar se o estímulo mamário realizado por primigestas, a partir de 40 semanas de idade gestacional, modifica o índice de Bishop. Método: foram estudadas 64 primigestas, sem intercorrências clínicas e/ou obstétricas, divididas em dois grupos. Um deles, chamado de grupo do estímulo mamário (E.M., era composto por 29 gestantes e o outro, chamado de grupo controle (G.C., por 35 gestantes. O E.M. foi orientado a realizar a estimulação do mamilo bilateralmente, em "corda de relógio", com duração de dois minutos de estímulo e cinco de repouso, durante 30 minutos. O estímulo foi realizado três vezes ao dia até completarem-se as 41 semanas de idade gestacional ou a gestante entrar em trabalho de parto. Para análise estatística das diferenças encontradas, utilizou-se o teste t de Student, com nível de significância de 5%. Resultados: uma vez realizado o estímulo mamário no grupo experimental, comparações foram realizadas com o grupo controle, levando-se em conta a época do parto. Os resultados mostraram não haver diferença significativa entre os grupos, no que concerne ao amadurecimento do colo de acordo com o índice de Bishop. Conclusões: não houve diferença no índice de Bishop em primigestas, com 40 semanas de idade gestacional, submetidas ao estímulo mamário, quando comparadas ao grupo controle.Purpose: to evaluate if the nipple stimulation performed by primigravidae, at 40 weeks, modifies Bishop index. Method: 64 primigravidae, without clinical or obstetrical complications were studied, in two groups. One group, called nipple stimulation group (N.S.G. had 29 pregnant women. The other, named control group (C.G. included 35 pregnant women. The N.S.G. performed the nipple stimulation test, bilaterally, from left to right, for two minutes followed by five minutes of rest, during thirty minutes. The test was done three times a day up to 41 weeks of pregnancy or beginning of labor. Statistical analysis of the

  8. National Hospital Discharge Survey: 2005 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    DeFrances, Carol J; Cullen, Karen A; Kozak, Lola Jean

    2007-12-01

    This report presents 2005 national estimates and selected trend data on the use of nonfederal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, Ninth Revision, Clinical Modification codes. The estimates are based on data collected through the National Hospital Discharge Survey. The survey has been conducted annually since 1965. In 2005, data were collected for approximately 375,000 discharges. Of the 473 eligible nonfederal short-stay hospitals in the sample, 444 (94 percent) responded to the survey. An estimated 34.7 million discharges from nonfederal short-stay hospitals occurred in 2005. Discharges used 165.9 million days of care and had an average length of stay of 4.8 days. Persons 65 years and over accounted for 38 percent of the hospital discharges and 44 percent of the days of care. The proportion of discharges whose status was described as routine discharge or discharged to the patient's home declined with age, from 91 percent for inpatients under 45 years of age to 41 percent for those 85 years and over. Hospitalization for malignant neoplasms decreased from 1990-2005. The hospitalization rate for asthma was the highest for children under 15 years of age and those 65 years of age and over. The rate was lowest for those 15-44 years of age. Thirty-eight percent of hospital discharges had no procedures performed, whereas 12 percent had four or more procedures performed. An episiotomy was performed during a majority of vaginal deliveries in 1980 (64 percent), but by 2005, it was performed during less than one of every five vaginal deliveries (19 percent).

  9. New discharge tube with virtual cathode

    International Nuclear Information System (INIS)

    Seidelmann, L.; Aubrecht, L.

    2003-01-01

    Till this time known methods of the excitation of the discharge between electrodes are using either secondary or thermo emission of electrons by the cathode. Usually we speak about the self-maintained discharge. Lifetime of the cathode, that is shortened by the emission, limits in principle, the lifetime of the whole discharge tube. The discharge can, according to the present state of the art, be induced also by the inductive way. Arrangement for excitation of such discharge is rather expensive. The construction of the inductive excited discharge tube is considerably influenced by the necessity of the limitation of the losses in excitation magnetic circuits. Especially length of the discharge and pressure of the working gas are limited by the economic standpoints. Function of the discharge is always connected with unwanted electromagnetic radiation, whose restraint is expensive and represents limiting factor for arrangement of the discharge tube (Authors)

  10. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... options further? Fertility Preservation - Where Does It Fit? Options for Fertility Preservation The following diagram gives a brief description of fertility preservation options available to children diagnosed with cancer before and ...

  11. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... Not an option if there is a high risk of ovarian metastases. Discuss with your doctor. b ... an IRB . Resources For more information about infertility risk and fertility preservation options for children diagnosed with ...

  12. How Do Health Care Providers Diagnose Vaginitis?

    Science.gov (United States)

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

  13. Fertility Preservation for Children Diagnosed with Cancer

    Science.gov (United States)

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

  14. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

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

  15. ADHD: the impact when not diagnosed

    OpenAIRE

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

    2008-01-01

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

  16. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

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

  17. Changes in the in-hospital mortality and 30-day post-discharge mortality in acutely admitted older patients : retrospective observational study

    NARCIS (Netherlands)

    van Rijn, Marjon; Buurman, Bianca M.; Vroomen, Janet L. Macneil; Suijker, Jacqueline J.; ter Riet, Gerben; van Charante, Eric P. Moll; de Rooij, Sophia E.

    Objectives: to compare changes over time in the in-hospital mortality and the mortality from discharge to 30 days postdischarge for six highly prevalent discharge diagnoses in acutely admitted older patients as well as to assess the effect of separately analysing the in-hospital mortality and the

  18. At få en diagnose

    DEFF Research Database (Denmark)

    Olesen, Birgitte Ravn; Jansbøl, Kirsten

    I dette hæfte ligger fokus på døvblindblevnes fortællinger om at have et handicap uden at kende sin diagnose og om at håndtre at få diagnosen RP eller Usher syndrom. Det er karakteristisk for fortællingerne, at det har stor betydning - hvornår i livet, man får sin diagnose - under hvilke...

  19. Challenges in diagnosing tuberculosis in children

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  20. Trajectories of Risk for Specific Readmission Diagnoses after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia.

    Science.gov (United States)

    Krumholz, Harlan M; Hsieh, Angela; Dreyer, Rachel P; Welsh, John; Desai, Nihar R; Dharmarajan, Kumar

    2016-01-01

    The risk of rehospitalization is elevated in the immediate post-discharge period and declines over time. It is not known if the extent and timing of risk vary across readmission diagnoses, suggesting that recovery and vulnerability after discharge differ by physiologic system. We compared risk trajectories for major readmission diagnoses in the year after discharge among all Medicare fee-for-service beneficiaries hospitalized with heart failure (HF), acute myocardial infarction (AMI), or pneumonia from 2008-2010. We estimated the daily risk of rehospitalization for 12 major readmission diagnostic categories after accounting for the competing risk of death after discharge. For each diagnostic category, we identified (1) the time required for readmission risk to peak and then decline 50% from maximum values after discharge; (2) the time required for readmission risk to approach plateau periods of minimal day-to-day change; and (3) the extent to which hospitalization risks are higher among patients recently discharged from the hospital compared with the general elderly population. Among >3,000,000 hospitalizations, the yearly rate of rehospitalization was 67.0%, 49.5%, and 55.3% after hospitalization for HF, AMI, and pneumonia, respectively. The extent and timing of risk varied by readmission diagnosis and initial admitting condition. Risk of readmission for gastrointestinal bleeding/anemia peaked particularly late after hospital discharge, occurring 10, 6, and 7 days after hospitalization for HF, AMI, and pneumonia, respectively. Risk of readmission for trauma/injury declined particularly slowly, requiring 38, 20, and 38 days to decline by 50% after hospitalization for HF, AMI, and pneumonia, respectively. Patterns of vulnerability to different conditions that cause rehospitalization vary by time after hospital discharge. This finding suggests that recovery of various physiologic systems occurs at different rates and that post-discharge interventions to minimize

  1. Trajectories of Risk for Specific Readmission Diagnoses after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia.

    Directory of Open Access Journals (Sweden)

    Harlan M Krumholz

    Full Text Available The risk of rehospitalization is elevated in the immediate post-discharge period and declines over time. It is not known if the extent and timing of risk vary across readmission diagnoses, suggesting that recovery and vulnerability after discharge differ by physiologic system.We compared risk trajectories for major readmission diagnoses in the year after discharge among all Medicare fee-for-service beneficiaries hospitalized with heart failure (HF, acute myocardial infarction (AMI, or pneumonia from 2008-2010.We estimated the daily risk of rehospitalization for 12 major readmission diagnostic categories after accounting for the competing risk of death after discharge. For each diagnostic category, we identified (1 the time required for readmission risk to peak and then decline 50% from maximum values after discharge; (2 the time required for readmission risk to approach plateau periods of minimal day-to-day change; and (3 the extent to which hospitalization risks are higher among patients recently discharged from the hospital compared with the general elderly population.Among >3,000,000 hospitalizations, the yearly rate of rehospitalization was 67.0%, 49.5%, and 55.3% after hospitalization for HF, AMI, and pneumonia, respectively. The extent and timing of risk varied by readmission diagnosis and initial admitting condition. Risk of readmission for gastrointestinal bleeding/anemia peaked particularly late after hospital discharge, occurring 10, 6, and 7 days after hospitalization for HF, AMI, and pneumonia, respectively. Risk of readmission for trauma/injury declined particularly slowly, requiring 38, 20, and 38 days to decline by 50% after hospitalization for HF, AMI, and pneumonia, respectively.Patterns of vulnerability to different conditions that cause rehospitalization vary by time after hospital discharge. This finding suggests that recovery of various physiologic systems occurs at different rates and that post-discharge interventions to

  2. Feasibility of wear compensation in micro EDM milling based on discharge counting and discharge population characterization

    DEFF Research Database (Denmark)

    Bissacco, Giuliano; Hansen, Hans Nørgaard; Tristo, G.

    2011-01-01

    This paper investigates the applicability of real time wear compensation in micro EDM milling based on discharge counting and discharge population characterization. Experiments were performed involving discharge counting and tool electrode wear measurement in a wide range of process parameters...

  3. Severe Tricuspid Regurgitation Diagnosed 13 Years after a Car Accident: A Case Report

    Science.gov (United States)

    Acar, Burak; Suleymanoglu, Muhammed; Burak, Cengiz; Demirkan, Burcu Mecit; Guray, Yesim; Tufekcioglu, Omac; Aydogdu, Sinan

    2015-01-01

    Abstract Blunt chest traumas mostly occur due to car accidents and can cause many cardiac complications such as septal rupture, free-wall rupture, coronary artery dissection or thrombosis, heart failure, arrhythmias, and chordae and papillary muscle rupture. One of the most serious complication is tricuspid regurgitation (TR), which can be simply diagnosed by physical examination and confirmed by echocardiography. We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident. TR was diagnosed with transthoracic echocardiography and three dimensional transthoracic echocardiography had defined the exact pathology of the tricuspid valve. The patient underwent successful surgery with bioprosthetic valve implantation and was discharged at 6th postoperative day without any complication. The patient had no problem according to the follow-up one month and six months after operation. PMID:26157464

  4. Use of bayesian operations for diagnosing accidents

    International Nuclear Information System (INIS)

    Kang, K.M.; Jae, M.; Suh, K.Y.

    2005-01-01

    In complex systems, it is necessary to model a logical representation of the overall system interaction with respect to the individual subsystems. Operators are allowed to follow EOPs (Emergency Operating Procedures) when reactor tripped because of accidents. But, it's very difficult to diagnose accidents and find out appropriate procedures to mitigate current accidents in a given short time. Even if they diagnose accidents, it also has possibility to misdiagnose. TMI accident is a good example of operators' errors. Methodology using Influence Diagrams has been developed and applied for representing the dependency behaviors and uncertain behaviors of complex systems. An example to diagnose the accidents such as SLOCA and SGTR with similar symptoms has been introduced. From the constructed model, operators could diagnose accidents at any states of accidents. This model can offer the information about accidents with given symptoms. This model might help operators to diagnose correctly and rapidly. It might be very useful to support operators to reduce human error. Also, from this study, it is applicable to diagnose other accidents with similar symptoms and to analyze causes of reactor trip. (authors)

  5. Patient input into the development and enhancement of ED discharge instructions: a focus group study.

    Science.gov (United States)

    Buckley, Barbara A; McCarthy, Danielle M; Forth, Victoria E; Tanabe, Paula; Schmidt, Michael J; Adams, James G; Engel, Kirsten G

    2013-11-01

    Previous research indicates that patients have difficulty understanding ED discharge instructions; these findings have important implications for adherence and outcomes. The objective of this study was to obtain direct patient input to inform specific revisions to discharge documents created through a literacy-guided approach and to identify common themes within patient feedback that can serve as a framework for the creation of discharge documents in the future. Based on extensive literature review and input from ED providers, subspecialists, and health literacy and communication experts, discharge instructions were created for 5 common ED diagnoses. Participants were recruited from a federally qualified health center to participate in a series of 5 focus group sessions. Demographic information was obtained and a Rapid Estimate of Adult Literacy in Medicine (REALM) assessment was performed. During each of the 1-hour focus group sessions, participants reviewed discharge instructions for 1 of 5 diagnoses. Participants were asked to provide input into the content, organization, and presentation of the documents. Using qualitative techniques, latent and manifest content analysis was performed to code for emergent themes across all 5 diagnoses. Fifty-seven percent of participants were female and the average age was 32 years. The average REALM score was 57.3. Through qualitative analysis, 8 emergent themes were identified from the focus groups. Patient input provides meaningful guidance in the development of diagnosis-specific discharge instructions. Several themes and patterns were identified, with broad significance for the design of ED discharge instructions. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  6. Relativistic Electrons in Electric Discharges

    DEFF Research Database (Denmark)

    Cinar, Deniz

    at the time when also gigantic electric discharges were observed at 10-90 km altitude in the stratosphere and mesosphere, the so called “jets” and “sprites”, commonly referred to as “Transient Luminous Events” (TLEs). TGFs were _rst thought connected to TLEs, but later research has pointed to lightning......Thunderstorms generate bursts of X- and Gamma radiation. When observed from spacecraft, the bursts are referred to as “Terrestrial Gamma-ray Flashes” (TGFs). They are bremsstrahlung from energetic electrons accelerated in thunderstorm electric _elds. The TGFs were _rst observed in the 90ties...... discharges as the source. The “Atmosphere-Space Interactions Monitor” (ASIM) for the International Space Station in 2016, led by DTU Space, and the French microsatellite TARANIS, also with launch in 2016, will identify with certainty the source of TGFs. In preparation for the missions, the Ph.D. project has...

  7. Runaway electrons in toroidal discharges

    International Nuclear Information System (INIS)

    Knoepfel, H.

    1979-01-01

    Experimental and theoretical studies of runaway electrons in toroidal devices are reviewed here, with particular reference to tokamaks. The complex phenomenology of runaway effects, which have been the subject of research for the past twenty years, is organized within the framework of a number of physical models. The mechanisms and rates for runaway production are discussed first, followed by sections on runaway-driven kinetic relaxation processes and runaway orbit confinement. Next, the equilibrium and stability of runaway-dominated discharges are reviewed. Models for runaway production at early times in the discharge and the scaling of runaway phenomena to larger devices are also discussed. Finally, detection techniques and possible applications of runaways are mentioned. (author)

  8. Energy discharge heater power supply

    International Nuclear Information System (INIS)

    Jaskierny, W.

    1992-11-01

    The heater power supply is intended to supply capacitively stored,energy to embedded heater strips in cryo magnets. The amount of energy can be controlled by setting different charge different capacitor values. Two chassis' can be operated in series or interlocks are provided. The charge voltage, number of capacitors pulse can be monitored. There and dual channel has two discharge supplies in one chassis. This report reviews the characteristics of this power supply further

  9. Electrostatic probes in luminescent discharges

    International Nuclear Information System (INIS)

    Cunha Raposo, C. da.

    1980-01-01

    A system to produce luminescent type plasma by continuos discharge and ionization by high frequency was constructed. The ionization was done in the air and in the argon under pressures from 3 to 10 mmHg. The parameters of a non magnetized collisional plasma and the parameters of a magnetized plasma such as, density, eletron temperature and potential, using a Langmuir probe with plane geometry, were determined. (M.C.K.) [pt

  10. Internal Electrostatic Discharge Monitor - IESDM

    Science.gov (United States)

    Kim, Wousik; Goebel, Dan M.; Jun, Insoo; Garrett, Henry B.

    2011-01-01

    A document discusses an innovation designed to effectively monitor dielectric charging in spacecraft components to measure the potential for discharge in order to prevent damage from internal electrostatic discharge (IESD). High-energy electrons penetrate the structural materials and shielding of a spacecraft and then stop inside dielectrics and keep accumulating. Those deposited charges generate an electric field. If the electric field becomes higher than the breakdown threshold (approx. =2 x 10(exp 5) V/cm), discharge occurs. This monitor measures potentials as a function of dielectric depth. Differentiation of potential with respect to the depth yields electric field. Direct measurement of the depth profile of the potential in a dielectric makes real-time electronic field evaluation possible without simulations. The IESDM has been designed to emulate a multi-layer circuit board, to insert very thin metallic layers between the dielectric layers. The conductors serve as diagnostic monitoring locations to measure the deposited electron-charge and the charge dynamics. Measurement of the time-dependent potential of the metal layers provides information on the amount of charge deposited in the dielectrics and the movement of that charge with time (dynamics).

  11. A holographic method for investigating cylindrical symmetry plasmas resulting from electric discharges

    International Nuclear Information System (INIS)

    Rosu, N.; Ralea, M.; Foca, M.; Iova, I.

    1992-01-01

    A new method based on holographic interferometry in real time with reference fringes for diagnosing gas electric discharges in cylindrical symmetry tubes is presented. A method for obtaining and quantitatively investigating interferograms obtained with a video camera is described. By studying the resulting images frame by frame and introducing the measurements into an adequate computer programme one gets a graphical recording of the radial distribution of the charged particle concentration in the plasma in any region of the tube at a given time, as well as their axial distribution. The real time evolution of certain phenomena occurring in the discharge tube can also be determined by this non-destructive method. The method is used for electric discharges in Ar at average pressures in a discharge tube with hollow cathode effect. (Author)

  12. Study of plasma characteristics in the cathode regime of a nitrogen glow discharge

    International Nuclear Information System (INIS)

    Margulis, Alvaro

    1987-01-01

    This research thesis reports the study of the cathode region, cathodic sheath and negative glow, of a nitrogen glow discharge. The author first presents general data regarding glow discharges, a description of the experimental installation, and measurements of discharge balancing. In the next part, he precisely describes spectroscopic methods, and the implementation of diagnoses from an experimental point of view as well as in terms of space resolution. Results are then presented and interpreted. Measurements concern space distributions of excited species, the determination of axial and radial concentrations of nitrogen ions, axial variations of rotational temperatures of the different species and variations of nitrogen ion vibrational temperature. The laser optogalvanic effect on the nitrogen molecular ion is resolved in time, and compared with the result of a theoretical model based on the mobility difference between the different nitrogen ions. Finally, the author compares experimental results on ion profiles along the discharge axis with results obtained with theoretical models [fr

  13. Leaving the hospital - your discharge plan

    Science.gov (United States)

    ... patientinstructions/000867.htm Leaving the hospital - your discharge plan To use the sharing features on this page, ... once you leave. This is called a discharge plan. Your health care providers at the hospital will ...

  14. EPA Region 1 No Discharge Zones

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset details No Discharge Zones (NDZ) for New England. Boaters may not discharge waste into these areas. Boundaries were determined mostly by Federal...

  15. Early hospital discharge and early puerperal complications.

    Science.gov (United States)

    Ramírez-Villalobos, Dolores; Hernández-Garduño, Adolfo; Salinas, Aarón; González, Dolores; Walker, Dilys; Rojo-Herrera, Guadalupe; Hernández-Prado, Bernardo

    2009-01-01

    To evaluate the association between time of postpartum discharge and symptoms indicative of complications during the first postpartum week. Women with vaginal delivery at a Mexico City public hospital, without complications before the hospital discharge, were interviewed seven days after delivery. Time of postpartum discharge was classified as early (25 hours). The dependent variable was defined as the occurrence and severity of puerperal complication symptoms. Out of 303 women, 208 (68%) were discharged early. However, women with early discharge and satisfactory prenatal care had lower odds of presenting symptoms in early puerperium than women without early discharge and inadequate prenatal care (OR 0.36; 95% confidence intervals = 0.17-0.76). There was no association between early discharge and symptoms of complications during the first postpartum week; the odds of complications were lower for mothers with early discharge and satisfactory prenatal care.

  16. Natural course of hypogonadism diagnosed during hospitalization in aged male patients.

    Science.gov (United States)

    Iglesias, P; Prado, F; Muñoz, A; Guerrero, M T; Macías, M C; Ridruejo, E; Tajada, P; García-Arévalo, C; Díez, J J

    2015-04-01

    Our aim was to assess short-term natural course of hypogonadism diagnosed during hospitalization for acute disease in aged male patients after discharge. A group of 43 hypogonadal males, aged 86.7±5.7 year, was studied. Serum concentrations of testosterone (T) and gonadotropins (follicle-stimulating hormone, FSH, and luteinizing hormone, LH) were measured in every patient both at admission and one month after discharge. Mean serum T at entry was 115.4±48.0 ng/dl. Hypogonadism was hyper-, hypo-, and normogonadotropic in 20 (46.5%), 20 (46.5%), and 3 (7.0%) patients, respectively. One month after discharge serum T concentrations increased significantly (230.9±135.6 ng/dl, phypogonadism (n=16, 32.7%; 82.8±51.6 ng/dl, phypogonadism discovered during hospitalization spontaneously normalize their serum T concentrations one month after discharge. Serum gonadotropin concentrations also increased after discharge. Serum T levels at admission was an independent predictor for the normalization of serum T concentrations.

  17. Early discharge hospital at home.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha

    2017-06-26

    Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit. We searched clinical trials registries. Randomised trials comparing early discharge hospital at home with acute hospital inpatient care for adults. We excluded obstetric, paediatric and mental health hospital at home schemes.   DATA COLLECTION AND ANALYSIS: We followed the standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 32 trials (N = 4746), six of them new for this update, mainly conducted in high-income countries. We judged most of the studies to have a low or unclear risk of bias. The intervention was delivered by hospital outreach services (17 trials), community-based services (11 trials), and was co-ordinated by a hospital-based stroke team or physician in conjunction with community-based services in four trials.Studies recruiting people recovering from strokeEarly discharge hospital at home probably makes little or no difference to mortality at three to six months (risk ratio (RR) 0.92, 95% confidence interval (CI) 0.57 to 1.48, N = 1114, 11 trials, moderate-certainty evidence) and may make little or no difference to the risk of hospital readmission (RR 1.09, 95% CI 0.71 to 1.66, N = 345, 5 trials, low-certainty evidence). Hospital at home may lower the risk of living in institutional setting at six months (RR 0.63, 96% CI

  18. Capacitor discharges, magnetohydrodynamics, X-rays, ultrasonics

    CERN Document Server

    Früngel, Frank B A

    1965-01-01

    High Speed Pulse Technology, Volume 1: Capacitor Discharges - Magnetohydrodynamics - X-Rays - Ultrasonics deals with the theoretical and engineering problems that arise in the capacitor discharge technique.This book discusses the characteristics of dielectric material, symmetrical switch tubes with mercury filling, and compensation conductor forms. The transformed discharge for highest current peaks, ignition transformer for internal combustion engines, and X-ray irradiation of subjects in mechanical motion are also elaborated. This text likewise covers the transformed capacitor discharge in w

  19. Basic Studies of Distributed Discharge Limiters

    Science.gov (United States)

    2014-02-10

    electron avalanche ionization discharges induced by a focused 110 GHz millimeter-wave beam in atmospheric air. Discharges take place in a free volume of...plasma. 3.1.7 Vacuum Ultraviolet emission from pulsed discharges at atmospheric pressure. Fig. 6. Energy level diagram for molecular and...the utilized spectral simulation software, SPECTRAPLOT. 3.1.8 Non-intrusive diagnostic method for dissociation degree in pulsed discharges

  20. Radio frequency discharge with dust particles

    NARCIS (Netherlands)

    Chutov, Y. I.; W. J. Goedheer,; Kravchenko, O. Y.; Zuz, V. M.; Yan, M.; Martins, R.; Ferreira, I.; Fortunato, E.; Kroesen, G.

    2000-01-01

    A 1D PIC/MCC method has been developed for computer simulations of low-pressure RF discharges with dust particles using the method for dust-free discharges. A RF discharge in argon with dust particles distributed uniformly in the interelectrode gap is simulated at parameters providing a possibility

  1. 32 CFR 724.117 - Discharge review.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Discharge review. 724.117 Section 724.117 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NAVAL DISCHARGE REVIEW BOARD Definitions § 724.117 Discharge review. A nonadversary administrative reappraisal at the level of...

  2. Expansion of a nitrogen discharge by sound

    International Nuclear Information System (INIS)

    Antinyan, M.A.; Galechyan, G.A.; Tavakalyan, L.B.

    1992-01-01

    When the background pressure and the discharge current in a gas discharge are raised the plasma column is tightened up into a filament. Then the discharge occupies a region of the discharge tube whose transverse dimensions are substantially less than those of the tube. This contraction phenomenon in discharges restricts the range of parameters used in various devices to the range of relatively low discharge currents and low gas pressures. This contraction interferes with creating high-power gas lasers, since it acts destructively on the lasing process. In order to suppress filamentation of discharges the working gas has been pumped through the system at high speed, with considerable success. The turbulent mixing in the stream plays an important role in creating an uncontracted discharge at high pressures. The purpose of the present work is to study the possibility of undoing the contraction of a nitrogen discharge, which is one of the main components in the operation of a CO 2 laser, by introducing an intense sound wave in the discharge tube. Discharge contraction and the effect of a sound wave propagating along the plasma column have been investigated experimentally in nitrogen by studying the current-voltage characteristics of a contracted discharge. 6 refs., 3 figs

  3. On regulation of radioactive airborne discharge

    International Nuclear Information System (INIS)

    Stroganov, A.A.; Kuryndin, A.V.; Shapovalov, A.S.; Orlov, M.Yu.

    2013-01-01

    Authors present the Russian regulatory basis of radioactive airborne discharges which was updated after enactment of the Methodology for airborne discharge limits development. Criteria for establishing of airborne discharge limits, scope and other features of methodology are also considered in the article [ru

  4. Diagnosing Pelvic Inflammatory Disease with Limited Diagnostic ...

    African Journals Online (AJOL)

    ... We found out that the clinical diagnosis of PID was frequently based on the features of lower abdominal pain, vaginal discharge, fever, lower abdominal tenderness, cervical motion, and adnexal tenderness. Sexual histories of suspected cases were rarely obtained while menstrual and contraceptive histories were scanty.

  5. National Hospital Discharge Survey: 2002 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    Kozak, Lola J; Owings, Maria F; Hall, Margaret J

    2005-03-01

    This report presents 2002 national estimates and selected trend data on the use of non-Federal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2002, data were collected for approximately 327,000 discharges. Of the 474 eligible non-Federal short-stay hospitals in the sample, 445 (94 percent) responded to the survey. An estimated 33.7 million inpatients were discharged from non-Federal short-stay hospitals in 2002. They used 164.2 million days of care and had an average length of stay of 4.9 days. Common first-listed discharge diagnoses included delivery, ischemic heart disease, psychoses, pneumonia, and malignant neoplasms. Inpatients had 6.8 million cardiovascular procedures and 6.6 million obstetric procedures. Males had higher rates for cardiac procedures such as cardiac catheterization and coronary artery bypass graft, but males and females had similar rates of pacemaker procedures. The number and rate of all cesarean deliveries, primary and repeat, rose from 1995 to 2002; the rate of vaginal birth after cesarean delivery dropped from 35.5 in 1995 to 15.8 in 2002.

  6. Impact of a telecare service for psichyatric patients at discharge

    Directory of Open Access Journals (Sweden)

    Sofía Martínez Villar

    2012-11-01

    Full Text Available Introduction: Suicide and self harm are two of the mental health problems that require more healthcare attention. When psychiatric patients are discharged back to their homes, must face multiple stress factors, which in many cases, are cause of readmissions, self harm and suicide. Objective: The aim of this study to assess whether a program of nursing telecare improves the adaptation of patient with risk of suicide and self harm at home. Methods: The design of this study is an experimental trial type, which generates two cohorts, an intervention one and a control one. The population of the study are patients diagnosed a major depression or borderline, antisocial, or histrionic personality disorder, admitted in the hospital because of symptom decompensation, and with a nursing diagnosis of risk of suicide, risk of self-harming and risk for self-directed violence. To data recollection, the levels of anxiety, suicidal ideation and the confrontation level at discharge and one month after discharge, the number of psychiatric emergency visits, number of readmissions and number of appointments to which the patient attended at the Mental Health Centre during the month at home, as well as the adherence to medication will be assessed. For the data analysis, the homogeneity of the groups will be eveluated, to then undertake a descriptive study of two cohorts, and then an analytical study for comparison.

  7. The ICD diagnoses of fetishism and sadomasochism.

    Science.gov (United States)

    Reiersøl, Odd; Skeid, Svein

    2006-01-01

    In this article we discuss psychiatric diagnoses of sexual deviation as they appear in the International Classification of Diseases (ICD-10), the internationally accepted classification and diagnostic system of the World Health Organization (WHO). Namely, we discuss the background of three diagnostic categories: Fetishism (F65.0), Fetishistic Transvestism (F65.1), and Sadomasochism (F65.5). Pertinent background issues regarding the above categories are followed by a critique of the usefulness of diagnosing these phenomena today. Specifically, we argue that Fetishism, Fetishistic Transvestism, and Sadomasochism, also labeled Paraphilia or perversion, should not be considered illnesses. Finally, we present the efforts of an initiative known as ReviseF65, which was established in 1997, to abolish these diagnoses.

  8. Reliability of clinical ICD-10 schizophrenia diagnoses

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  9. Experiences of being diagnosed with osteoporosis

    DEFF Research Database (Denmark)

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

    2018-01-01

    This systematic review provides synthesised knowledge and guidance to health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. Using individuals' experiences and meanings can promote tailored and targeted information...... an individual's experience of being diagnosed with osteoporosis at different stages, and secondly, to use a systematic approach to develop a conceptual understanding of central issues relevant for health professionals in order to provide support and guidance to patients/individuals. METHODS: This study used...... of the diagnosis based on self-perceived fracture risk, self-perceived severity of osteoporosis and at the same time, self-perceived health. CONCLUSIONS: This meta-synthesis provides knowledge for health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point...

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

    Science.gov (United States)

    Kolek, Vítězslav

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

  11. Narrow gap electronegative capacitive discharges

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, E.; Lieberman, M. A.; Lichtenberg, A. J. [Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California 94720 (United States)

    2013-10-15

    Narrow gap electronegative (EN) capacitive discharges are widely used in industry and have unique features not found in conventional discharges. In this paper, plasma parameters are determined over a range of decreasing gap length L from values for which an electropositive (EP) edge exists (2-region case) to smaller L-values for which the EN region connects directly to the sheath (1-region case). Parametric studies are performed at applied voltage V{sub rf}=500 V for pressures of 10, 25, 50, and 100 mTorr, and additionally at 50 mTorr for 1000 and 2000 V. Numerical results are given for a parallel plate oxygen discharge using a planar 1D3v (1 spatial dimension, 3 velocity components) particle-in-cell (PIC) code. New interesting phenomena are found for the case in which an EP edge does not exist. This 1-region case has not previously been investigated in detail, either numerically or analytically. In particular, attachment in the sheaths is important, and the central electron density n{sub e0} is depressed below the density n{sub esh} at the sheath edge. The sheath oscillations also extend into the EN core, creating an edge region lying within the sheath and not characterized by the standard diffusion in an EN plasma. An analytical model is developed using minimal inputs from the PIC results, and compared to the PIC results for a base case at V{sub rf}=500 V and 50 mTorr, showing good agreement. Selected comparisons are made at the other voltages and pressures. A self-consistent model is also developed and compared to the PIC results, giving reasonable agreement.

  12. Double discharges in unipolar-pulsed dielectric barrier discharge xenon excimer lamps

    International Nuclear Information System (INIS)

    Liu Shuhai; Neiger, Manfred

    2003-01-01

    Excitation of dielectric barrier discharge xenon excimer lamps by unipolar short square pulses is studied in this paper. Two discharges with different polarity are excited by each voltage pulse (double discharge phenomenon). The primary discharge occurs at the top or at the rising flank of the applied unipolar square pulse, which is directly energized by the external circuit. The secondary discharge with the reversed polarity occurs at the falling flank or shortly after the falling flank end (zero external voltage) depending on the pulse width, which is energized by the energy stored by memory charges deposited by the primary discharge. Fast-speed ICCD imaging shows the primary discharge has a conic discharge appearance with a channel broadening on the anode side. This channel broadening increases with increasing the pulse top level. Only the anode-side surface discharge is observed in the primary discharge. The surface discharge on the cathode side which is present in bipolar sine voltage excitation is not observed. On the contrary, the secondary discharge has only the cathode-side surface discharge. The surface discharge on the anode side is not observed. The secondary discharge is much more diffuse than the primary discharge. Time-resolved emission measurement of double discharges show the secondary discharge emits more VUV xenon excimer radiation but less infrared (IR) xenon atomic emission than the primary discharge. It was found that the IR xenon atomic emission from the secondary discharge can be reduced by shortening the pulse width. The energy efficiency of unipolar-pulsed xenon excimer lamps (the overall energy efficiency of double discharges) is much higher than that obtained under bipolar sine wave excitation. The output VUV spectrum under unipolar pulse excitation is found to be identical to that under sine wave excitation and independent of injected electric power

  13. State waste discharge permit application for cooling water and condensate discharges

    Energy Technology Data Exchange (ETDEWEB)

    Haggard, R.D.

    1996-08-12

    The following presents the Categorical State Waste Discharge Permit (SWDP) Application for the Cooling Water and Condensate Discharges on the Hanford Site. This application is intended to cover existing cooling water and condensate discharges as well as similar future discharges meeting the criteria set forth in this document.

  14. Discharge residence of TLD tagged fish

    International Nuclear Information System (INIS)

    Romberg, G.P.; Prepejchal, W.

    1974-01-01

    Although visual observations suggested that fish remained in the discharge for considerable periods, temperature-sensitive tags indicated the majority of fish spend less than 50 hr or 10 percent of the time at discharge temperatures. During 1974 a second fish tagging study was conducted, using temperature-sensitive tags to yield discharge residence times of Lake Michigan salmonids at Point Beach thermal discharge. Preliminary results revealed that many fish tag values were close to Unit I line indicating that calculated maximum discharge residence times for these fish will be nearly 100 percent of the elapsed time

  15. Some fibrocystic breast change may be caused by sexually transmitted H. pylori during oral nipple contact: supporting literature and case report of resolution after gut H. pylori eradication treatment.

    Science.gov (United States)

    Kast, R E

    2007-01-01

    To briefly review previously published evidence for Helicobacter pylori (Hp), colonization of extra-intestinal sites and suggest an hypothesis that breast acini and ducts be added to this list, concluding such breast colonization is not rare and is a sexually transmitted infection. PubMed literature search and review with a case report. (1) Evidence indicates oral Hp is common and can remain in the mouth after successful eradication in stomach and duodenum. (2) Evidence indicates that the breast is also occasionally colonized by Hp. (3) Hp may be injected retrograde up into ducts of the breast during oral nipple stimulation during sexual activity and this Hp may give rise to some cases of fibrocystic breast change. (4) A case of painful fibrocystic change that had been present for two years in a 27 year old female, resolved after gastrointestinal Hp treatment.

  16. False Labor at Term in Singleton Pregnancies: Discharge After a Standardized Assessment and Perinatal Outcomes.

    Science.gov (United States)

    Nelson, David B; McIntire, Donald D; Leveno, Kenneth J

    2017-07-01

    To evaluate perinatal outcomes in women sent home with a diagnosis of false labor at term and assess the time interval to return for delivery. This was a prospective observational cohort study of women at 37 0/7 to 41 6/7 weeks of gestation without pre-existing medical complications who presented to our hospital-based triage unit with symptoms of labor and underwent a standardized evaluation. Women diagnosed as having false labor with a live singleton fetus in cephalic presentation without a prior cesarean delivery and sent home were compared with a group of similar women diagnosed to be in spontaneous labor. Women with hypertension, diabetes, and known fetal malformations were excluded. Using a perinatal composite outcome of respiratory insufficiency, intraventricular hemorrhage, culture-proven sepsis, Apgar score 3 or less at 5 minutes, phototherapy, and perinatal death, we tested the noninferiority of being sent home compared with being admitted for labor. The relationship of cervical dilatation to the time interval from discharge home to delivery was also analyzed. Between October 2012 and March 2016, a total of 3,949 women met inclusion criteria and were diagnosed with false labor, discharged, and returned to deliver, whereas 2,592 similar women were admitted in early labor. The mean interval from discharge to return was 4.9 days. Cesarean delivery rates were not different between the study groups-11% for both (P=.69), and the perinatal composite outcome rates were not significantly different between those sent home and those admitted-3.2% compared with 3.1% (P=.79). Women with more advanced cervical dilatation at discharge returned and delivered significantly earlier than those with less dilatation regardless of parity. Discharge with false labor at term after a standardized assessment in a triage unit was not associated with increased rates of adverse perinatal composite outcomes or cesarean delivery. The time interval to return for delivery was

  17. Qualidade Higiênico-Sanitária e Demanda de Cloro da Água de Dessedentação de Galinhas de Postura Coletadas em Bebedouros Tipo Nipple e Taça

    Directory of Open Access Journals (Sweden)

    Amaral LA

    2001-01-01

    Full Text Available O objetivo deste estudo foi avaliar a influência de dois tipos de bebedouros nipple e taça, utilizados na dessedentação de aves de postura e o incremento da demanda de cloro na água oferecida pelos dois tipos de bebedouros estudados. Foram realizadas as contagens de coliformes totais, coliformes fecais, Escherichia coli, estreptococos fecais e microrganismos mesófilos. Os resultados obtidos figuraram que as amostras de água dos reservatórios, de ambos os bebedouros, apresentaram-se contaminadas microbiologicamente antes de passarem pelos bebedouros. A contaminação por bactérias de poluição fecal foi maior nas amostras colhidas nos bebedouros tipo taça, assim como eles foram responsáveis por um maior acúmulo de matéria orgânica, tendo então uma elevada demanda de cloro e uma maior influência na depreciação da qualidade da água fornecida às aves. Dos dois tipos de bebedouros estudados, o tipo nipple mostrou ser o menos deletério no que concerne à qualidade da água entretanto, independente do tipo de bebedouro utilizado na dessedentação das aves, a desinfecção da água é um ato imprescindível à manutenção de sua qualidade e à eliminação de futuros patógenos.

  18. [Severe vaginal discharge following rectal surgery].

    Science.gov (United States)

    Burg, L C; Bremers, A J A; Heesakkers, J P F A; Kluivers, K B

    2018-01-01

    Almost 50% of women who have had rectal surgery subsequently develop vaginal discharge. Due to the recurrent and unexpected nature of this heavy discharge, they often experience it as very distressing. Many of these women undergo extensive diagnostic tests that are mainly focused on identifying fistula formation. If no fistula is found, in most cases no other cause for severe vaginal discharge can be demonstrated. In our practice, we saw three patients (49-, 54- and 74-years-old, respectively) with similar severe vaginal discharge after rectal surgery and in whom no explanation for the vaginal discharge could be found. For this reason we conducted a literature search into this condition. Anatomical changes appear to be responsible for heavy vaginal discharge following rectal surgery. Changes in pelvic floor muscles and compression of the distal part of the vagina may lead to pooling of fluid in the proximal part of the vagina, resulting in severe discharge. Symptomatic treatment may reduce the symptoms.

  19. How Do Health Care Providers Diagnose Cushing's Syndrome?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose Cushing syndrome? Diagnosing Cushing syndrome can be complex and difficult. This syndrome is ... health care provider may try different tests. Diagnosing Cushing syndrome often requires several steps. If you are being ...

  20. Anisotropic Percolation Analysis of Discharge

    Science.gov (United States)

    Matsumoto, Shogo; Odagaki, Takashi

    2014-03-01

    Exploiting a nonlinear resistor network on a square lattice in two dimensions, we investigate discharge when two opposite sides of the lattice are subjected to a constant voltage difference. Each site is ionized randomly with a probability in proportion to the square of the strength of the electric field, and the resistivity between two ionized sites is assumed to be 10-6 times smaller than the original resistivity. Using Monte Carlo simulation, we obtain the current and distribution of clusters of ionized sites as functions of the fraction of ionized sites. It is found that a wall of potential drop is formed as the fraction approaches a critical value, which is followed by discharge. The critical value is much smaller than the critical percolation probability of the standard site percolation on the square lattice. We also find that a singular behavior of the cluster distribution is expected at a critical fraction differently from that for the current, and that the critical exponents characterizing the cluster distribution satisfy the scaling relation known for two-dimensional percolation, while the critical exponent of the percolation probability is close to the value reported for a directed percolation.

  1. Electrostatic discharge concepts and definitions

    Energy Technology Data Exchange (ETDEWEB)

    Borovina, Dan L [Los Alamos National Laboratory

    2008-01-01

    Many objects -like a human body, plastic wrap, or a rolling cart -that are electrically neutral, overall, can gain a net electrostatic charge by means of one of three methods: induction, physical transfer, or triboelectric charging (separation of conductive surfaces). The result is a voltage difference between the charged object and other objects, creating a situation where current flow is likely if two objects come into contact or close proximity. This current flow is known as electrostatic discharge, or ESD. The energy and voltage of the discharge can be influenced by factors such as the temperature and humidity in the room, the types of materials or flooring involved, or the clothing and footwear a person uses. Given the possible ranges of the current and voltage characteristic of an ESD pulse, it is important to consider the safety risks associated with detonator handling, assembly and disassembly, transportation and maintenance. For main charge detonators, these safety risks include high explosive violent reactions (HEVR) as well as inadvertent nuclear detonations (lND).

  2. Medicinalindustrien har brug for diagnoser som ADHD

    DEFF Research Database (Denmark)

    Fugl, Marie

    2008-01-01

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

  3. Pijnlijke temporomandibulaire disfuncties: diagnose en behandeling

    NARCIS (Netherlands)

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

    2016-01-01

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

  4. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... diagnosed with cancer. You may be focused on cancer treatment and your child’s immediate health. You may feel ... points can help start the conversation: Cancer and cancer treatment may affect my child’s fertility. Will my child’s ...

  5. Clinical heterogeneity in newly diagnosed Parkinson's disease

    NARCIS (Netherlands)

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

    2008-01-01

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

  6. Diagnosing risks in product-innovation projects

    NARCIS (Netherlands)

    Halman, Johannes I.M.; Keizer, J.A.

    A new method of diagnosing risks in product-innovation projects is introduced in the paper. The method is an improvement on existing risk methods used on product-innovation projects, such as potential problem analysis and failure mode and effects analysis. Technological, organizational and

  7. Diagnosing risks in product-innovation projects

    NARCIS (Netherlands)

    Halman, J.I.M.; Keizer, J.A.

    1994-01-01

    A new method of diagnosing risks in product-innovation projects is introduced in the paper. The method is an improvement on existing risk methods used on product-innovation projects, such as potential problem analysis and failure mode and effects analysis. Technological, organizational and

  8. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

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

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

    African Journals Online (AJOL)

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

  10. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available ... content SaveMyFertility An Online Fertility Preservation Toolkit for Patients and Their Providers Open menu Reprotopia_Main_Menu ... Cancer Fertility Preservation for Children Diagnosed with Cancer Patient Pocket Guides Patient Pocket Guides Patient Guides Fertility ...

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

    African Journals Online (AJOL)

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

  12. Remembering and diagnosing clients: Does experience matter?

    NARCIS (Netherlands)

    Witteman, C.L.M.; Tollenaar, M.S.

    2012-01-01

    Experienced mental health clinicians often do not outperform novices in diagnostic decision making. In this paper we look for an explanation of this phenomenon by testing differences in memory processes. In two studies we aimed to look at differences in accuracy of diagnoses in relation to free

  13. Diagnosing patients with longstanding shoulder joint pain

    DEFF Research Database (Denmark)

    Nørregaard, J; Krogsgaard, M R; Lorenzen, T

    2002-01-01

    OBJECTIVE: To examine the interobserver agreement of commonly used clinical tests and diagnoses in patients with shoulder pain, and the accuracy of these tests and ultrasonographic findings in comparison with arthroscopic findings. METHODS: Eighty six patients with longstanding shoulder joint pain...

  14. Fertility Preservation for Children Diagnosed with Cancer

    Medline Plus

    Full Text Available Sorry, you need to enable JavaScript to visit this website. Skip to main content SaveMyFertility An Online Fertility Preservation Toolkit for ... for Children Diagnosed with Cancer Ask Your Doctor Information for Patients Many adult survivors of childhood cancer ...

  15. Diagnosing Febrile Illness in a Returned Traveler

    Centers for Disease Control (CDC) Podcasts

    2012-03-01

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

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

    African Journals Online (AJOL)

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

  17. On-line Monitoring System Based on Principle of Electro-acoustic Monitoring for Transformer Partial Discharge

    Directory of Open Access Journals (Sweden)

    Guang Ya LIU

    2014-02-01

    Full Text Available Partial discharge inside a transformer is mainly responsible for the insulation aging and damage of the transformer. However, partial discharge is usually accompanied by external signals like sound, light and electrical signals and detectable physical phenomena such as characteristical gas and dielectric loss. Therefore, it is of great significance to monitor online the external signals and phenomena formed during partial discharge of the transformer when the transformer diagnoses faults. This paper gives a comprehensive overview of the electro-acoustic joint monitoring principles and its monitoring systems and the judgment skills concerned, on the basis of which the monitoring system is designed.

  18. Discharge Disposition After Stroke in Patients With Liver Disease.

    Science.gov (United States)

    Parikh, Neal S; Merkler, Alexander E; Schneider, Yecheskel; Navi, Babak B; Kamel, Hooman

    2017-02-01

    Liver disease is associated with both hemorrhagic and thrombotic processes, including an elevated risk of intracranial hemorrhage. We sought to assess the relationship between liver disease and outcomes after stroke, as measured by discharge disposition. Using administrative claims data, we identified a cohort of patients hospitalized with stroke in California, Florida, and New York from 2005 to 2013. The predictor variable was liver disease. All diagnoses were defined using validated diagnosis codes. Ordinal logistic regression was used to analyze the association between liver disease and worsening discharge disposition: home, nursing/rehabilitation facility, or death. Secondarily, multiple logistic regression was used to analyze the association between liver disease and in-hospital mortality. Models were adjusted for demographics, vascular risk factors, and comorbidities. We identified 121 428 patients with intracerebral hemorrhage and 703 918 with ischemic stroke. Liver disease was documented in 13 584 patients (1.7%). Liver disease was associated with worse discharge disposition after both intracerebral hemorrhage (global odds ratio, 1.28; 95% confidence interval, 1.19-1.38) and ischemic stroke (odds ratio, 1.23; 95% confidence interval, 1.17-1.29). Similarly, liver disease was associated with in-hospital death after both intracerebral hemorrhage (odds ratio, 1.33; 95% confidence interval, 1.23-1.44) and ischemic stroke (odds ratio, 1.60; 95% confidence interval, 1.51-1.71). Liver disease was associated with worse hospital discharge disposition and in-hospital mortality after stroke, suggesting worse functional outcomes. © 2016 American Heart Association, Inc.

  19. Numerical Modelling of Electrical Discharges

    International Nuclear Information System (INIS)

    Durán-Olivencia, F J; Pontiga, F; Castellanos, A

    2014-01-01

    The problem of the propagation of an electrical discharge between a spherical electrode and a plane has been solved by means of finite element methods (FEM) using a fluid approximation and assuming weak ionization and local equilibrium with the electric field. The numerical simulation of this type of problems presents the usual difficulties of convection-diffusion-reaction problems, in addition to those associated with the nonlinearities of the charged species velocities, the formation of steep gradients of the electric field and particle densities, and the coexistence of very different temporal scales. The effect of using different temporal discretizations for the numerical integration of the corresponding system of partial differential equations will be here investigated. In particular, the so-called θ-methods will be used, which allows to implement implicit, semi-explicit and fully explicit schemes in a simple way

  20. DISCHARGE VALVE FOR GRANULAR MATERIAL

    Science.gov (United States)

    Stoughton, L.D.; Robinson, S.T.

    1962-05-15

    A gravity-red dispenser or valve is designed for discharging the fueled spherical elements used in a pebble bed reactor. The dispenser consists of an axially movable tube terminating under a hood having side walls with openings. When the tube is moved so that its top edge is above the tops of the side openings the elements will not flow. As the tube is moved downwardly, the elements flow into the hood through the side openings and over the top edge into the tube at an increasing rate as the tube is lowered further. The tube is spaced at all times from the hood and side walls a distance greater than the diameter of the largest element to prevent damaging of the elements when the dispenser is closed to flow. (AEC)

  1. Automatic Regulation of Wastewater Discharge

    Directory of Open Access Journals (Sweden)

    Bolea Yolanda

    2017-01-01

    Full Text Available Wastewater plants, mainly with secondary treatments, discharge polluted water to environment that cannot be used in any human activity. When those dumps are in the sea it is expected that most of the biological pollutants die or almost disappear before water reaches human range. This natural withdrawal of bacteria, viruses and other pathogens is due to some conditions such as the salt water of the sea and the sun effect, and the dumps areas are calculated taking into account these conditions. However, under certain meteorological phenomena water arrives to the coast without the full disappearance of pollutant elements. In Mediterranean Sea there are some periods of adverse climatic conditions that pollute the coast near the wastewater dumping. In this paper, authors present an automatic control that prevents such pollution episodes using two mathematical models, one for the pollutant transportation and the other for the pollutant removal in wastewater spills.

  2. Thermal discharge residence by Lake Michigan Salmonids

    International Nuclear Information System (INIS)

    Romberg, G.P.; Prepejchal, W.

    1975-01-01

    Lake Michigan salmon and trout were tagged with a thermoluminescent dosimeter (TLD) temperature tag to estimate their thermal exposure and residence time at a warm water discharge. Fish were collected, tagged, and released at the Point Beach Nuclear Plant, Two Rivers, Wisconsin, in the fall of 1973 and 1974. Tags were recovered during the same season, primarily from fish recaptured at Point Beach. Average uniform temperature exposure and maximum possible discharge residence time were determined. Appropriate hourly intake and discharge temperatures were averaged to calculate mean temperature exposure for the case of maximum discharge residence. Lowest discharge temperature not included within the period of maximum residence was identified to serve as a possible indicator of avoidance temperature. Mean values for the above parameters were calculated for fish species for each tagging year and are reported with the accompanying range of intake and discharge temperatures

  3. Development of Partial Discharging Simulation Test Equipment

    Science.gov (United States)

    Kai, Xue; Genghua, Liu; Yan, Jia; Ziqi, Chai; Jian, Lu

    2017-12-01

    In the case of partial discharge training for recruits who lack of on-site work experience, the risk of physical shock and damage of the test equipment may be due to the limited skill level and improper operation by new recruits. Partial discharge simulation tester is the use of simulation technology to achieve partial discharge test process simulation, relatively true reproduction of the local discharge process and results, so that the operator in the classroom will be able to get familiar with and understand the use of the test process and equipment.The teacher sets up the instrument to display different partial discharge waveforms so that the trainees can analyze the test results of different partial discharge types.

  4. Five cases of neurocysticercosis diagnosed in Sydney.

    Science.gov (United States)

    Walker, J; Chen, S; Packham, D; McIntyre, P

    1991-12-01

    Cysticercosis, once rare in Australia, is now more frequently diagnosed. This change reflects the countries of origin of new immigrants and the destinations of Australians travelling. Five cases of neurocysticercosis diagnosed at Westmead Hospital in Sydney are described. Two involved Australians, a father and son who had visited eastern and southeastern Asia 10 years before presentation. The other three included immigrants from Chile and India and a visitor from Timor. Ages ranged from 5 to 57 years. Three individuals presented after focal seizures involving the upper limb, one had a long standing history of neurological dysfunction and one suffered from persistent headaches. In all cases computed tomographic scanning (CT) or magnetic resonance imaging (MRI) revealed cystic brain lesions and three of the five were seropositive as well. Four were treated with praziquantel and in one the lesions regressed significantly following treatment. However, the lesion in one case had decreased in size prior to treatment and that in the untreated individual also became smaller.

  5. The impact of three discharge coding methods on the accuracy of diagnostic coding and hospital reimbursement for inpatient medical care.

    Science.gov (United States)

    Tsopra, Rosy; Peckham, Daniel; Beirne, Paul; Rodger, Kirsty; Callister, Matthew; White, Helen; Jais, Jean-Philippe; Ghosh, Dipansu; Whitaker, Paul; Clifton, Ian J; Wyatt, Jeremy C

    2018-07-01

    Coding of diagnoses is important for patient care, hospital management and research. However coding accuracy is often poor and may reflect methods of coding. This study investigates the impact of three alternative coding methods on the inaccuracy of diagnosis codes and hospital reimbursement. Comparisons of coding inaccuracy were made between a list of coded diagnoses obtained by a coder using (i)the discharge summary alone, (ii)case notes and discharge summary, and (iii)discharge summary with the addition of medical input. For each method, inaccuracy was determined for the primary, secondary diagnoses, Healthcare Resource Group (HRG) and estimated hospital reimbursement. These data were then compared with a gold standard derived by a consultant and coder. 107 consecutive patient discharges were analysed. Inaccuracy of diagnosis codes was highest when a coder used the discharge summary alone, and decreased significantly when the coder used the case notes (70% vs 58% respectively, p coded from the discharge summary with medical support (70% vs 60% respectively, p coding with case notes, and 35% for coding with medical support. The three coding methods resulted in an annual estimated loss of hospital remuneration of between £1.8 M and £16.5 M. The accuracy of diagnosis codes and percentage of correct HRGs improved when coders used either case notes or medical support in addition to the discharge summary. Further emphasis needs to be placed on improving the standard of information recorded in discharge summaries. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Case report patients diagnosed with rheumatoid arthritis

    OpenAIRE

    Váňová, Tereza

    2012-01-01

    Title of bachelors thesis: Case report patients diagnosed with rheumatoid arthritis Summary: The work is focused on diseases rheumatoid arthritis and its physiotherapy care. It consists of two parts. Part of the general anatomy of the joint contains a general, deals with the disease rheumatoid arthritis, its diagnosis, treatment and comprehensive rehabilitation treatment. Part has its own special case report physiotherapy sessions on this topic. Key words: rheumatoid arthritis, comprehensive ...

  7. Diagnose, behandling og prognose ved fibromyalgi

    DEFF Research Database (Denmark)

    Danneskiold-Samsøe, Bente; Bartels, Else Marie; Amris, Kirstine

    2010-01-01

    It is important to recognize the diagnosis of fibromyalgia (FM) to adequately advise patients with this chronic pain disease. FM coexists with other rheumatic diseases and may therefore serve as a confounder in connection with estimation of disease activity. The aetiology and pathogenesis of FM...... remain unknown, although central sensitisation seems to play a major role. Following exclusion of a number of differential diagnoses, the remaining patients have several treatment options including centrally-acting medication....

  8. GERD: Diagnosing and treating the burn.

    Science.gov (United States)

    Alzubaidi, Mohammed; Gabbard, Scott

    2015-10-01

    Gastroesophageal reflux disease (GERD) is chronic, very common, and frequently encountered in internal medicine and subspecialty clinics. It is often diagnosed on clinical grounds, but specialized testing such as endoscopy and pH monitoring may be necessary in certain patients. Although proton pump inhibitors (PPIs) are the mainstay of treatment, clinicians should be aware of their short-term and long-term side effects. Copyright © 2015 Cleveland Clinic.

  9. Research In Diagnosing Bearing Defects From Vibrations

    Science.gov (United States)

    Zoladz, T.; Earhart, E.; Fiorucci, T.

    1995-01-01

    Report describes research in bearing-defect signature analysis - use of vibration-signal analysis to diagnose defects in roller and ball bearings. Experiments performed on bearings in good condition and other bearings in which various parts scratched to provide known defects correlated with vibration signals. Experiments performed on highly instrumented motor-driven rotor assembly at speeds up to 10,050 r/min, using accelerometers, velocity probes, and proximity sensors mounted at various locations on assembly to measure vibrations.

  10. Verfahren zur genbasierten Diagnose eines Legasthenierisikos

    OpenAIRE

    Wilcke, Arndt; Ahnert, Peter; Kirsten, Holger; Ligges, Carolin; Boltze, Johannes

    2016-01-01

    Die vorliegende Erfindung betrifft ein Verfahren zur Diagnose eines Legasthenierisikos, umfassend die Schritte: a) Bereitstellung einer Nukleinsäure beinhaltenden Probe von einem zu diagnostizierenden Menschen, b) Bestimmung des Genotyps der Nukleinsäure der Probe für mindestens eine chromosomale Region, ausgewählt aus der Gruppe bestehend aus der Region von Nukleotid 12091000 bis 12200000 des Chromosoms 1, der Region von Nukleotid 89066000 bis 89088000 des Chromosoms 15, der Region von Nukle...

  11. Fatty kidney diagnosed by mortem computed tomography

    DEFF Research Database (Denmark)

    Leth, P. M.

    2016-01-01

    Subnuclear vacuolization of the renal tubular epithelium is indicative of diabetic and alcoholic ketoacidosis and has also been proposed as a postmortem marker for hypothermia. We present for the first time a fatal case of ketoacidosis in combination with exposure where a suspicion of these diagn...... of these diagnoses was raised by a marked radiolucency of the kidneys at post-mortem computed tomography (PMCT). © 2015 Elsevier Ltd....

  12. Neural network to diagnose lining condition

    Science.gov (United States)

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

    2018-03-01

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

  13. Role of secondary emission on discharge dynamics in an atmospheric pressure dielectric barrier discharge

    Energy Technology Data Exchange (ETDEWEB)

    Tay, W. H.; Kausik, S. S.; Yap, S. L.; Wong, C. S., E-mail: cswong@um.edu.my [Plasma Technology Research Centre, Department of Physics, Faculty of Science, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2014-04-15

    The discharge dynamics in an atmospheric pressure dielectric barrier discharge (DBD) is studied in a DBD reactor consisting of a pair of stainless steel parallel plate electrodes. The DBD discharge has been generated by a 50 Hz ac high voltage power source. The high-speed intensified charge coupled device camera is used to capture the images of filaments occurring in the discharge gap. It is observed that frequent synchronous breakdown of micro discharges occurs across the discharge gap in the case of negative current pulse. The experimental results reveal that secondary emissions from the dielectric surface play a key role in the synchronous breakdown of plasma filaments.

  14. Sacrococcygeal Teratoma Presenting with Vaginal Discharge and Polyp in an Infant.

    Science.gov (United States)

    Ladenhauf, Hannah N; Brandtner, M Georgina; Schimke, Christa; Ardelean, Mircia A; Metzger, Roman

    2018-06-01

    Sacrococcygeal teratoma accounts for the most common solid tumor in neonates. Because of improved technology, 50%-70% of cases can be diagnosed antenatally during routine ultrasound screenings. If not diagnosed antenatally, clinical findings at birth are distinct in most cases including a palpable or visible mass. We report an unusual case of a 1-year-old girl who presented with persistent vaginal discharge leading to diagnosis of a mucosal polypoid lesion of the vagina, ultimately revealing a hidden sacrococcygeal teratoma. We suggest thorough investigation of all infants who present with purulent discharge and recurrent vaginal mass; sacrococcygeal teratoma should routinely be considered as a differential diagnosis. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  15. Model of discharge lamps with magnetic ballast

    OpenAIRE

    Molina, Julio; Sainz Sapera, Luis; Mesas García, Juan José; Bergas Jané, Joan Gabriel

    2013-01-01

    Magnetic ballast discharge lamp modeling has been extensively studied because these lamps can be an important source of harmonics. Discharge lamp models usually represent the arc voltage by a square waveform. However, this waveform can be far from actual arc voltages, which affects the accuracy of the lamp models. This paper investigates the actual arc voltage behavior of discharge lamps from laboratory measurements and proposes a novel characterization of these voltages to reformulate the co...

  16. Discharge characteristics of copper vapor laser

    International Nuclear Information System (INIS)

    Nemoto, Koshichi; Fujii, Takashi

    1988-01-01

    This report describes about the copper vapor laser and experimental results of it's discharge characteristics. We measured time varing of plasma regist, and analyzed electron density. (1) The plasma regist is larger than 100Ω at the beginning of discharge, and is rapidly reduced to about 10Ω. (2) The electron density is estimated about 1∼2 x 10 12 /cc at the begining of discharge. (author)

  17. Discharge models through the pressurizer valves

    International Nuclear Information System (INIS)

    Madeira, A.A.

    1985-01-01

    A reliable estimate of discharge through the pressurizer relief and safety valves is of concern to adequately predict the behaviour of RCS pressure during transients. It's investigated the discharge models used by the ALMOD code, and to implement alternative models from the available literature, which are recommended for different conditions of flow that shall exist during transients requiring discharge through the relief and safety valves. (Author) [pt

  18. Fundamental Study on Electrical Discharge Machining

    OpenAIRE

    Uno, Yoshiyuki; Nakajima, Toshikatsu; Endo, Osamu

    1989-01-01

    The generation mechanism of crater in electrical discharge machining is analyzed with a single pulse discharge device for alloy tool steel, black alumina ceramics, cermet and cemented carbide, investigating the gap voltage, the discharge current, the shape of crater, the wear of electrode and so on. The experimental analysis makes it clear that the shape of crater has a characteristic feature for the kind of workpiece. The shape of electrode, which changes with the wear by an electric spark, ...

  19. Secondary mechanisms in a gas discharge

    International Nuclear Information System (INIS)

    Fletcher, J.; Blevin, H.A.

    1978-05-01

    The technique for studying swarms of electrons in a gas discharge by observing the photon flux from the discharge has been adapted to investigate the role of the secondary mechanisms. First results, reported here, show that, contrary to previous indications, ion bombardment of the cathode plays only a negligible, if any, part in the low pressure discharge in hydrogen at E/N approx. less than 200Td

  20. Conflict adaptation in patients diagnosed with schizophrenia.

    Science.gov (United States)

    Abrahamse, Elger; Ruitenberg, Marit; Boddewyn, Sarah; Oreel, Edith; de Schryver, Maarten; Morrens, Manuel; van Dijck, Jean-Philippe

    2017-11-01

    Cognitive control impairments may contribute strongly to the overall cognitive deficits observed in patients diagnosed with schizophrenia. In the current study we explore a specific cognitive control function referred to as conflict adaptation. Previous studies on conflict adaptation in schizophrenia showed equivocal results, and, moreover, were plagued by confounded research designs. Here we assessed for the first time conflict adaptation in schizophrenia with a design that avoided the major confounds of feature integration and stimulus-response contingency learning. Sixteen patients diagnosed with schizophrenia and sixteen healthy, matched controls performed a vocal Stroop task to determine the congruency sequence effect - a marker of conflict adaptation. A reliable congruency sequence effect was observed for both healthy controls and patients diagnosed with schizophrenia. These findings indicate that schizophrenia is not necessarily accompanied by impaired conflict adaptation. As schizophrenia has been related to abnormal functioning in core conflict adaptation areas such as anterior cingulate and dorsolateral prefrontal cortex, further research is required to better understand the precise impact of such abnormal brain functioning at the behavioral level. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Diagnosing Homo sapiens in the fossil record.

    Science.gov (United States)

    Stringer, Christopher Brian; Buck, Laura Tabitha

    2014-01-01

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

  2. Subcutaneous emphysema, a different way to diagnose

    Directory of Open Access Journals (Sweden)

    Bruno José da Costa Medeiros

    Full Text Available Summary Introduction: Subcutaneous emphysema (SE is a clinical condition that occurs when air gets into soft tissues under the skin. This can occur in any part of the body depending on the type of pathology. The most common site is under the skin that covers the chest wall or neck. It is characterized by painless swelling of tissues. The classic clinical sign is a crackling sensation upon touch, resembling that of touching a sponge beneath your fingers. Objective: To describe a new way to diagnose subcutaneous emphysema. Method: Our finding was a matter of serendipity while inspecting a patient with subcutaneous emphysema using a stethoscope. Instead only hearing the patient's chest, the stethoscope was gently pressed against the skin with SE and so we were able to detect a different sound. Results: This new way to diagnose subcutaneous emphysema consists in pressing the diaphragm part of stethoscope against the patient's skin where SE is supposed to be. Thus, we are able to hear a sound of small bubbles bursting. Crackle noise has an acoustic emission energy that varies between 750-1,200 Hz, considered high frequency. Conclusion: Although currently the use of imaging methods is widespread worldwide, we would like to strengthen the value of clinical examination. Auscultation is an essential diagnostic method that has become underestimated with the advances of healthcare and medicine as a whole. We therefore propose a different approach to diagnose SE.

  3. Accuracy and Coverage of Diagnosis and Procedural Coding of Severely Injured Patients in the Finnish Hospital Discharge Register: Comparison to Patient Files and the Helsinki Trauma Registry.

    Science.gov (United States)

    Heinänen, M; Brinck, T; Handolin, L; Mattila, V M; Söderlund, T

    2017-09-01

    The Finnish Hospital Discharge Register data are frequently used for research purposes. The Finnish Hospital Discharge Register has shown excellent validity in single injuries or disease groups, but no studies have assessed patients with multiple trauma diagnoses. We aimed to evaluate the accuracy and coverage of the Finnish Hospital Discharge Register but at the same time validate the data of the trauma registry of the Helsinki University Hospital's Trauma Unit. We assessed the accuracy and coverage of the Finnish Hospital Discharge Register data by comparing them to the original patient files and trauma registry files from the trauma registry of the Helsinki University Hospital's Trauma Unit. We identified a baseline cohort of patients with severe thorax injury from the trauma registry of the Helsinki University Hospital's Trauma Unit of 2013 (sample of 107 patients). We hypothesized that the Finnish Hospital Discharge Register would lack valuable information about these patients. Using patient files, we identified 965 trauma diagnoses in these 107 patients. From the Finnish Hospital Discharge Register, we identified 632 (65.5%) diagnoses and from the trauma registry of the Helsinki University Hospital's Trauma Unit, 924 (95.8%) diagnoses. A total of 170 (17.6%) trauma diagnoses were missing from the Finnish Hospital Discharge Register data and 41 (4.2%) from the trauma registry of the Helsinki University Hospital's Trauma Unit data. The coverage and accuracy of diagnoses in the Finnish Hospital Discharge Register were 65.5% (95% confidence interval: 62.5%-68.5%) and 73.8% (95% confidence interval: 70.4%-77.2%), respectively, and for the trauma registry of the Helsinki University Hospital's Trauma Unit, 95.8% (95% confidence interval: 94.5%-97.0%) and 97.6% (95% confidence interval: 96.7%-98.6%), respectively. According to patient records, these patients were subjects in 249 operations. We identified 40 (16.1%) missing operation codes from the Finnish Hospital

  4. Effects of electric discharges on polymers

    International Nuclear Information System (INIS)

    Bagirov, M.A.

    2002-01-01

    Full text: One of the reasons for the worsening of electrical properties of polymeric isolation in use in the effect of the electric discharges which developing in the gas inclusions and in the interlayer inside the isolation itself. The electrical discharges in the gas gap lead to the electrical growing old and the worsening of its electro physical qualities. We have learned the changes of electrical properties (dielectrical permeability and dielectrical loss, and electrical conductivity, electrical strength) of polymer films under the influence of electrical discharges. This paper shows the ways of increase of stability of polymers to the electrical discharges

  5. Recent trends on electrical discharge technologies

    International Nuclear Information System (INIS)

    Nakano, Toshiki

    2007-01-01

    Recent trends on the research activities of electrical-discharge-related technologies are summarized as well as the policies of the technical committee on electrical discharges (TC-ED) of IEEJ. First, the present situation of electrical discharge research is mentioned by referring to the major subjects which TC-ED is responsible to cover. As an example of the increasingly widespread use of electrical discharge technologies, vacuum electrical insulation in a neutral beam injection system of the International Thermonuclear Experimental Reactor (ITER) device is presented. (author)

  6. Investigations into electrical discharges in gases

    CERN Document Server

    Klyarfel'D, B N

    2013-01-01

    Investigations into Electrical Discharges in Gases is a compilation of scientific articles that covers the advances in the investigation of the fundamental processes occurring in electrical discharges in gases and vapors. The book details the different aspects of the whole life cycle of an arc, which include the initiation of a discharge, its transition into an arc, the lateral spread of the arc column, and the recovery of electric strength after extinction of an arc. The text also discusses the methods for the dynamic measurement of vapor density in the vicinity of electrical discharges, alon

  7. Readiness for hospital discharge: A concept analysis.

    Science.gov (United States)

    Galvin, Eileen Catherine; Wills, Teresa; Coffey, Alice

    2017-11-01

    To report on an analysis on the concept of 'readiness for hospital discharge'. No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research. Literature review and concept analysis. A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied. Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge. This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital. © 2017 John Wiley & Sons Ltd.

  8. Excimer lamp pumped by a triggered discharge

    Energy Technology Data Exchange (ETDEWEB)

    Baldacchini, G.; Bollanti, S.; Di Lazzaro, P.; Flora, F.; Giordano, G.; Letardi, T.; Renieri, A.; Schina, G. [ENEA, Centro Ricerche Frascati, Rome (Italy). Dip. Innovazione; Clementi, G.; Muzzi, F.; Zheng, C.E. [EL.EN. (Electronic Engineering), Florence (Italy)

    1996-11-01

    Radiation characteristics and discharge performances of an excimer lamp are described. The discharge of the HCl/Xe gas mixture at an atmospheric pressure, occurring near the quartz tube wall, is initiated by a trigger wire. A maximum total UV energy of about 0.4 J in a (0.8-0.9) {mu}s pulse, radiated from a 10 cm discharge length, is obtained with a total discharge input energy of 8 J. Excimer lamps are the preferred choice for medical and material processing irradiations, when the monochromaticity or coherence of UV light is not required, due to their low cost, reliability and easy maintenance.

  9. Statistical Analysis of Partial Discharge Characteristics in Transformer Oil at the “Point-Plane” Electrode at Alternating Voltage

    Directory of Open Access Journals (Sweden)

    Korobeynikov S.M.

    2017-08-01

    Full Text Available In this paper, we consider the problems related to measuring and analyzing the characteristics of partial discharges which are the main instrument for oil-filled high-voltage electrical equipment diagnosing. The experiments on recording of partial discharges in transformer oil have been carried out in the “point-plane” electrode system at alternating current. The instantaneous voltage and the apparent charge have been measured depending on the root-mean-square voltage and the phase angle of partial discharges. This paper aimes at carrying out a statistical analysis of the obtained experimental results, in particular, the construction of a parametric probabilistic model of the dependence of the partial discharge inception voltage distribution on the value of the root-mean-square voltage. It differs from usual discharges which occur in liquid dielectric materials in case of sharp inhomogeneous electrode system. It has been suggested that discharges of a different type are the discharges in gas bubbles that occur when partial discharges in a liquid emerge. This assumption is confirmed by the fact that the number of such discharges increases with increasing the root-mean-square voltage value. It is the main novelty of this paper. This corresponds to the nature of the occurrence of such discharges. After rejecting the observations corresponding to discharges in gas bubbles, a parametric probabilistic model has been constructed. The model obtained makes it possible to determine the probability of partial discharge occurrence in a liquid at a given value of the instantaneous voltage depending on the root-mean-square voltage.

  10. Where Lies the Fault in Diagnosing Dhat Syndrome among Females? Understanding through a Case Study.

    Science.gov (United States)

    Kar, Sujita Kumar; Singh, Amit

    2017-01-01

    Dhat syndrome is a culture-bound syndrome of South-East Asia, common in young men. However, similar entity has also been described in female patients who attribute their symptoms to nonpathological or physiological vaginal discharge. The current diagnostic system for psychiatric illnesses does not encompass Dhat syndrome in females, and so these group of patients receive alternative diagnoses such as somatoform disorder or depression. As a result of which the focus of unique Dhat syndrome-centered management gets weakened, affecting the clinical outcome. This case study focuses on the diagnostic dilemmas related to Dhat syndrome in females and pitfalls in the current diagnostic system.

  11. Waiting list paradox: Danish cancer patients diagnosed fast have higher mortality after diagnosis

    DEFF Research Database (Denmark)

    Tørring, Marie Louise; Frydenberg, Morten; Hansen, Rikke Pilegaard

    on hospital discharge diagnoses for the 2004-2005 period, extracted from population-based healthcare databases in the former County of Aarhus, Denmark, and subsequently validated in the National Danish Cancer Registry. All patients with a first-time diagnosis of colon, rectal, lung, skin, breast, or prostate...... with longer diagnostic interval until the reference point of 30 days. For colon, rectal, skin, and breast cancer mortality seemed to increase with diagnostic interval longer than 30 days. The waiting list paradox is manifest in Denmark. We speculate that medical professionals organise the diagnostic pathway......Studies often show that cancer patients diagnosed more rapidly have higher mortality rates than patients with longer waits in the primary and secondary health care sector. Our aim was to examine whether this paradox is manifest in the Danish health care system. The study was based on data...

  12. National Hospital Discharge Survey: 2003 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    Kozak, Lola Jean; Lees, Karen A; DeFrances, Carol J

    2006-05-01

    This report presents 2003 national estimates and trend data on the use of non-Federal short-stay hospitals in the United States. Estimates are provided by patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2003, data were collected for approximately 320,000 discharges. Of the 479 eligible non-Federal short-stay hospitals in the sample, 426 (89 percent) responded to the survey. An estimated 34.7 million inpatients were discharged from non-Federal short-stay hospitals in 2003. They used 167.3 million days of care and had an average length of stay of 4.8 days. Females used almost one-third more days of hospital care than males. Patients with five or more diagnoses rose from 29 percent of discharges in 1990 to 57 percent in 2003. The leading diagnostic category was respiratory diseases for children under 15 years, childbirth for 15-44 year olds, and circulatory diseases for patients 45 years of age and over. Only surgical procedures were performed for 27 percent of discharges, 18 percent had surgical and nonsurgical procedures, and 16 percent had only nonsurgical procedures. A total of 664,000 coronary angioplasties were performed, and stents were inserted during 86 percent of these procedures with drug-eluting stents used in 28 percent. The number and rate of total and primary cesarean deliveries rose from 1995 to 2003. The rate of vaginal birth after cesarean delivery dropped 58 percent, from 35.5 in 1995 to 14.8 in 2003.

  13. National Hospital Discharge Survey: 2001 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    Kozak, Lola Jean; Owings, Maria F; Hall, Margaret J

    2004-06-01

    This report presents 2001 national estimates and selected trend data on the use of non-Federal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Admission source and type, collected for the first time in the 2001 National Hospital Discharge Survey, are shown. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2001, data were collected for approximately 330,000 discharges. Of the 477 eligible non-Federal short-stay hospitals in the sample, 448 (94 percent) responded to the survey. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code numbers. Rates are computed with 2001 population estimates based on the 2000 census. The appendix includes a comparison of rates computed with 1990 and 2000 census-based population estimates. An estimated 32.7 million inpatients were discharged from non-Federal short-stay hospitals in 2001. They used 159.4 million days of care and had an average length of stay of 4.9 days. Common first-listed discharge diagnoses included delivery, psychoses, pneumonia, malignant neoplasm, and coronary atherosclerosis. Males had higher rates for procedures such as cardiac catheterization and coronary artery bypass graft, and females had higher rates for procedures such as cholecystectomy and total knee replacement. The rates of all cesarean deliveries, primary and repeat, rose from 1995 to 2001; the rate of vaginal birth after cesarean delivery dropped 37 percent during this period.

  14. What Controls Submarine Groundwater Discharge?

    Science.gov (United States)

    Martin, J. B.; Cable, J. E.; Cherrier, J.; Roy, M.; Smith, C. G.; Dorsett, A.

    2008-05-01

    Numerous processes have been implicated in controlling submarine groundwater discharge (SGD) to coastal zones since Ghyben, Herzberg and Dupuit developed models of fresh water discharge from coastal aquifers at the turn of the 19th century. Multiple empirical and modeling techniques have also been applied to these environments to measure the flow. By the mid-1950's, Cooper had demonstrated that dispersion across the fresh water-salt water boundary required salt water entrained into fresh water flow be balanced by recharge of salt water across the sediment-water interface seaward of the outflow face. Percolation of water into the beach face from wind and tidal wave run up and changes in pressure at the sediment-water interface with fluctuating tides have now been recognized, and observed, as processes driving seawater into the sediments. Within the past few years, variations in water table levels and the 1:40 amplification from density difference in fresh water and seawater have been implicated to pump salt water seasonally across the sediment- water interface. Salt water driven by waves, tides and seasonal water table fluctuations is now recognized as a component of SGD when it flows back to overlying surface waters. None of these processes are sufficiently large to provide measured volumes of SGD in Indian River Lagoon, Florida, however, because minimal tides and waves exist, flat topography and transmissive aquifers minimize fluctuations of the water table, and little water is entrained across the salt water-fresh water boundary. Nonetheless, the saline fraction of SGD represents more than 99% of the volume of total SGD in the Indian River Lagoon. This volume of saline SGD can be driven by the abundance of burrowing organisms in the lagoon, which pump sufficient amounts of water through the sediment- water interface. These bioirrigating organisms are ubiquitous at all water depths in sandy sediment and thus may provide one of the major sources of SGD world wide

  15. From Patient Discharge Summaries to an Ontology for Psychiatry.

    Science.gov (United States)

    Richard, Marion; Aimé, Xavier; Jaulent, Marie-Christine; Krebs, Marie-Odile; Charlet, Jean

    2017-01-01

    Psychiatry aims at detecting symptoms, providing diagnoses and treating mental disorders. We developed ONTOPSYCHIA, an ontology for psychiatry in three modules: social and environmental factors of mental disorders, mental disorders, and treatments. The use of ONTOPSYCHIA, associated with dedicated tools, will facilitate semantic research in Patient Discharge Summaries (PDS). To develop the first module of the ontology we propose a PDS text analysis in order to explicit psychiatry concepts. We decided to set aside classifications during the construction of the modu le, to focus only on the information contained in PDS (bottom-up approach) and to return to domain classifications solely for the enrichment phase (top-down approach). Then, we focused our work on the development of the LOVMI methodology (Les Ontologies Validées par Méthode Interactive - Ontologies Validated by Interactive Method), which aims to provide a methodological framework to validate the structure and the semantic of an ontology.

  16. [A study of home care needs of patients at discharge and effects of home care--centered on patients discharged from a rural general hospital].

    Science.gov (United States)

    Choi, Y S; Kim, D H; Storey, M; Kim, C J; Kang, K S

    1992-01-01

    The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 and March 1991. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions for these patients were analyzed in this study. The results of the study are summarized as follows: 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3%, health perception, 68.2% self concept, 62.5%, and sleep and rest 62.5%. Looking at the nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 63.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement in digestion and decrease in pain. No

  17. 77 FR 47380 - Final National Pollutant Discharge Elimination System (NPDES) General Permit for Discharges From...

    Science.gov (United States)

    2012-08-08

    ... test fluids, sanitary waste, domestic waste and miscellaneous discharges is authorized. More stringent... permit. Major changes also include definition of ``operator'', acute toxicity test for produced water, spill prevention best management practices, and electronic reporting requirements. To obtain discharge...

  18. Risk perception of future cardiovascular disease in women diagnosed with a hypertensive disorder of pregnancy.

    Science.gov (United States)

    Traylor, Jessica; Chandrasekaran, Suchitra; Limaye, Meghana; Srinivas, Sindhu; Durnwald, Celeste P

    2016-01-01

    The objective of this study is to evaluate a woman's risk perception for future cardiovascular disease (CVD) after being diagnosed with a hypertensive disorder of pregnancy. A prospective cohort of women diagnosed with a hypertensive disorder of pregnancy (HDP) was studied. Each woman completed two surveys, one prior to hospital discharge and one 2 weeks later, designed to assess knowledge of and risk perception for future CVD based on their recent diagnosis of a HDP. Rates of postpartum depression were also assessed. Of the 146 subjects included, 28% were diagnosed with preeclampsia with severe features, 52.1% with preeclampsia with mild features, and 19.9% had chronic hypertension. Women with severe features and those delivering preterm were more likely to report a perception of increased risk of both recurrent HDP in a future pregnancy (p = 0.004 and 0.005, respectively) and hypertension later in life (p = 0.01 and 0.03, respectively). Women delivering preterm were more likely to report an accurate perception of increased risk of myocardial infarction and stroke compared to those delivering at term (p = 0.006 and 0.002, respectively). Disease severity and preterm delivery were associated with a higher likelihood of the perception of an increased risk for both recurrent HDP and hypertension in the future. Only preterm delivery was associated with a higher risk perception for stroke and myocardial infarction. Interventions targeted at improved health awareness in women diagnosed with HDP are warranted.

  19. Retrospective Analysis of 513 Cases Diagnosed with Rib Fracture Secondary to Blunt Thorax Trauma

    Directory of Open Access Journals (Sweden)

    Serdar Ozkan

    2017-05-01

    Full Text Available Aim: This study aimed to analyze blunt chest trauma cases who were diagnosed with rib fracture and to examine the regional differences likely to appear in trauma cases and treatment approaches. Material and Method: 513 cases who applied to the Emergency Service and Department of Thoracic Surgery between October 2013 and December 2014 due to blunt trauma and were diagnosed with rib fracture were retrospectively examined. The cases were evaluated in terms of etiological factors, thoracic, and other system injuries accompanying the rib fracture, prognosis, and the treatments applied. Results: Isolated rib fracture was present in 266 of the cases. Thoracic organ injuries such as pneumothorax, hemothorax, hemopneumothorax, lung contusion, or laceration and sternal fracture accompanying the rib fracture were present in 247 of the cases. While one or two rib fractures were detected in 298 cases, six or more rib fractures were present in 28 cases. 78.2% of hemothorax cases, 85.3% of pneumothorax cases, 95.4% of hemopneumothorax cases, 81.8% of bilateral pneumothorax cases, 26% of bilateral hemothorax cases, and 71.4% of bilateral hemopneumothorax cases were treated by applying tube thoracostomy. 129 cases diagnosed with thoracic organ injury in addition to rib fracture but not subjected to surgical intervention, and 266 cases diagnosed with isolated rib fracture were discharged with full recovery after appropriate medical treatment. Discussion: Most of the rib fractures occurring due to blunt trauma are treated successfully with medical treatments and conservative approaches and do not need advanced surgical treatments.

  20. Increased mortality in the year following discharge from a paediatric ward in Bissau, Guinea-Bissau

    DEFF Research Database (Denmark)

    Veirum, Jens Erik; Sodeman, Morten; Biai, Sidu

    2007-01-01

    -hospital and 12-month posthospital mortality was 20%. Compared to the mortality level in the community and controlled for other determinants of childhood mortality, children discharged from hospital had 12 times higher risk of dying during the first 2 weeks after discharge. The mortality rate ratio (MR) was 6...... for postdischarge mortality included ethnic group, housing quality and maternal education, and were similar to risk factors for community mortality. The same diagnoses that had high acute mortality, including anaemia, diarrhoea and 'other', were also associated with high postdischarge mortality. CONCLUSION......BACKGROUND: Few studies in developing countries have examined posthospital mortality and little is known about the magnitude of posthospital mortality and risk factors for long-term survival. A better understanding of the determinants of posthospital mortality could help improve discharge policies...

  1. Discharge lamp with reflective jacket

    Science.gov (United States)

    MacLennan, Donald A.; Turner, Brian P.; Kipling, Kent

    2001-01-01

    A discharge lamp includes an envelope, a fill which emits light when excited disposed in the envelope, a source of excitation power coupled to the fill to excite the fill and cause the fill to emit light, and a reflector disposed around the envelope and defining an opening, the reflector being configured to reflect some of the light emitted by the fill back into the fill while allowing some light to exit through the opening. The reflector may be made from a material having a similar thermal index of expansion as compared to the envelope and which is closely spaced to the envelope. The envelope material may be quartz and the reflector material may be either silica or alumina. The reflector may be formed as a jacket having a rigid structure which does not adhere to the envelope. The lamp may further include an optical clement spaced from the envelope and configured to reflect an unwanted component of light which exited the envelope back into the envelope through the opening in the reflector. Light which can be beneficially recaptured includes selected wavelength regions, a selected polarization, and selected angular components.

  2. Fluid jet electric discharge source

    Science.gov (United States)

    Bender, Howard A [Ripon, CA

    2006-04-25

    A fluid jet or filament source and a pair of coaxial high voltage electrodes, in combination, comprise an electrical discharge system to produce radiation and, in particular, EUV radiation. The fluid jet source is composed of at least two serially connected reservoirs, a first reservoir into which a fluid, that can be either a liquid or a gas, can be fed at some pressure higher than atmospheric and a second reservoir maintained at a lower pressure than the first. The fluid is allowed to expand through an aperture into a high vacuum region between a pair of coaxial electrodes. This second expansion produces a narrow well-directed fluid jet whose size is dependent on the size and configuration of the apertures and the pressure used in the reservoir. At some time during the flow of the fluid filament, a high voltage pulse is applied to the electrodes to excite the fluid to form a plasma which provides the desired radiation; the wavelength of the radiation being determined by the composition of the fluid.

  3. The radiofrequency magnetic dipole discharge

    Energy Technology Data Exchange (ETDEWEB)

    Martines, E., E-mail: emilio.martines@igi.cnr.it; Zuin, M.; Cavazzana, R.; Fassina, A.; Spolaore, M. [Consorzio RFX (CNR, ENEA, INFN, Università di Padova, Acciaierie Venete SpA), Corso Stati Uniti 4, 35127 Padova (Italy); Marcante, M. [Dipartimento di Fisica, Università di Trento, via Sommarive 14, 38123 Povo, TN (Italy); TIFPA, Trento Institute for Fundamental Physics and Applications INFN, 38123 Trento (Italy)

    2016-05-15

    This paper describes a novel and simple concept of plasma source, which is able to produce a radiofrequency magnetized discharge with minimal power requirements. The source is based on the magnetron concept and uses a permanent magnet as an active electrode. The dipolar field produced by the magnet confines the electrons, which cause further ionization, thus producing a toroidally shaped plasma in the equatorial region around the electrode. A plasma can be ignited with such scheme with power levels as low as 5 W. Paschen curves have been built for four different working gases, showing that in Helium or Neon, plasma breakdown is easily obtained also at atmospheric pressure. The plasma properties have been measured using a balanced Langmuir probe, showing that the electron temperature is around 3–4 eV and higher in the cathode proximity. Plasma densities of the order of 10{sup 16 }m{sup −3} have been obtained, with a good positive scaling with applied power. Overall, the electron pressure appears to be strongly correlated with the magnetic field magnitude in the measurement point.

  4. The radiofrequency magnetic dipole discharge

    Science.gov (United States)

    Martines, E.; Zuin, M.; Marcante, M.; Cavazzana, R.; Fassina, A.; Spolaore, M.

    2016-05-01

    This paper describes a novel and simple concept of plasma source, which is able to produce a radiofrequency magnetized discharge with minimal power requirements. The source is based on the magnetron concept and uses a permanent magnet as an active electrode. The dipolar field produced by the magnet confines the electrons, which cause further ionization, thus producing a toroidally shaped plasma in the equatorial region around the electrode. A plasma can be ignited with such scheme with power levels as low as 5 W. Paschen curves have been built for four different working gases, showing that in Helium or Neon, plasma breakdown is easily obtained also at atmospheric pressure. The plasma properties have been measured using a balanced Langmuir probe, showing that the electron temperature is around 3-4 eV and higher in the cathode proximity. Plasma densities of the order of 1016 m-3 have been obtained, with a good positive scaling with applied power. Overall, the electron pressure appears to be strongly correlated with the magnetic field magnitude in the measurement point.

  5. Life expectancies for individuals with psychiatric diagnoses.

    Science.gov (United States)

    Hannerz, H; Borgå, P; Borritz, M

    2001-09-01

    The aim of the study was to estimate life expectancies in different diagnostic groups for individuals treated as inpatients at Swedish psychiatric clinics. All individuals, older than 18 y and alive on the first of January 1983, who had been registered in the National Hospital Discharge Registry by a psychiatric clinic in 1978-82, were monitored for mortality during 1983 by using the National Cause of Death Registry. The study group consisted of 91 385 men and 77 217 women. The patients were divided into nine diagnostic groups according to the principal diagnosis registered at the latest discharge. Actuarial mathematics was used to construct life expectancy tables, which present the number of years expected to live, by gender and diagnostic group. Expectancies of life were significantly shortened for both genders and in all nine diagnostic groups (with one exception). Mental disorders in general are life shortening. This fact should be recognised in community health when setting health priorities. It should also be addressed in curricula as well as in treatment and preventive programmes.

  6. Fundus fluorescence Angiography in diagnosing diabetic retinopathy.

    Science.gov (United States)

    Wang, Shuhui; Zuo, Yuqin; Wang, Ning; Tong, Bin

    2017-01-01

    To investigate the manifestation characteristics of fundus fluorescence angiography (FFA) and its values in diagnosing diabetic retinopathy through comparing direct ophthalmoscopy. Two hundred fifty patients (500 eyes) who were suspected as diabetic retinopathy and admitted to the hospital between February 2015 and December 2016 were selected. They underwent direct ophthalmoscopy and FFA. The manifestation characteristics of FFA in the diagnosis of diabetic retinopathy were summarized. The two examination methods were compared. In the diagnosis with direct ophthalmoscopy, 375 eyes out of 500 eyes were diagnosed as diabetic retinopathy (75%); there were 74 eyes at stage I, 88 eyes at stage II, 92 eyes at stage III, 83 eyes of stage IV, 28 eyes of stage V and 10 eyes of stage VI. In the diagnosis with FFA, 465 eyes out of 500 eyes were diagnosed as diabetic retinopathy (93%); there were 94 eyes at stage I, 110 eyes at stage II, 112 at stage III, 92 eyes at stage IV, 41 eyes at stage V and 16 eyes at stage VI. The detection rate of diabetic retinopathy using FFA was significantly higher than that using direct ophthalmoscopy (Pretinopathy (67.96%), 75 eyes had pre-proliferative lesions (16.13%), 149 eyes had proliferative lesions (32.04%), 135 eyes had diabetic maculopathy (29.03%) and 31 eyes had diabetic optic disc lesions (6.67%). The detection rate of diabetic retinopathy using FFA is higher than that using direct ophthalmoscopy. FFA could accurately determine clinical stage. Therefore, it is an important approach in treatment efficacy evaluation and treatment guidance, suggesting a significant application value.

  7. Best waveform score for diagnosing keratoconus

    Directory of Open Access Journals (Sweden)

    Allan Luz

    2013-12-01

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

  8. ARC discharge sliding over a conducting surface

    NARCIS (Netherlands)

    van Goor, F.A.; Mitko, S.; Ochkin, V.N.; Paramonov, A.P.; Witteman, W.J.

    1997-01-01

    Results of experimental and theoretical studies of the arc discharge which slides over the surface of a conductor are reported. Experiments were performed in air and argon ambients at various pressures. It is found that the velocity of the discharge plasma front depends linearly on the strength of

  9. Study of gliding arc discharge plasma

    International Nuclear Information System (INIS)

    Yang Chi; Lin Lie; Wu Bin

    2006-01-01

    The electric parameters change during discharge is studied and the relationship between non-equilibrium degree and parameters is discussed for gliding arc discharges. Using two-channel model, the rules of arc moving due to effect of the airflow is simulated. The numerical simulation results can help analyzing the generation mechanism of gliding arc non-equilibrium plasma. (authors)

  10. Partial discharges and bulk dielectric field enhancement

    DEFF Research Database (Denmark)

    McAllister, Iain Wilson; Johansson, Torben

    2000-01-01

    A consequence of partial discharge activity within a gaseous void is the production of a field enhancement in the solid dielectric in the proximity of the void. This situation arises due to the charge created by the partial discharges accumulating at the void wall. The influence of the spatial...

  11. Capacitor Discharge - A Capacitor Tutorial [video

    OpenAIRE

    Naval Postgraduate School Physics

    2014-01-01

    NPS Physics Physics Demonstrations Here's a capacitor discharge demonstrated by physicist Dr. Dernardo. Dr. D gives a nice capacitor lesson along with some fireworks. Charging and Discharging a Capacitor is dangerous. Do not try this at home. Dr. Bruce Denardo uses eleven 9V batteries, connected in series for a total of 99 creating a pretty large spark.

  12. Parental experiences of early postnatal discharge

    DEFF Research Database (Denmark)

    Nilsson, Ingrid; Danbjørg, Dorthe B.; Aagaard, Hanne

    2015-01-01

    that included both parents, having influence on time of discharge, and getting individualised and available support focused on developing and recognising their own experiences of taking care of the baby. Conclusions and implications for practice the new parents׳ experiences of early discharge and becoming...

  13. THE DISCHARGING EAR: A PRACTICAL APPROACH

    African Journals Online (AJOL)

    Enrique

    The colour of the fluid can suggest the cause of the otorrhoea. A purulent dis- charge indicates the presence of infection, while a bloody discharge may follow trauma or occur with granulation tissue associated with chronic infection. The presence of a mucoid discharge indicates a perforation of the tympanic mem-.

  14. Runaway electron beam in atmospheric pressure discharges

    International Nuclear Information System (INIS)

    Oreshkin, E V; Barengolts, S A; Chaikovsky, S A; Oreshkin, V I

    2015-01-01

    A numerical simulation was performed to study the formation of a runaway electron (RAE) beam from an individual emission zone in atmospheric pressure air discharges with a highly overvolted interelectrode gap. It is shown that the formation of a RAE beam in discharges at high overvoltages is much contributed by avalanche processes. (paper)

  15. The discharge characteristics in nitrogen helicon plasma

    Science.gov (United States)

    Zhao, Gao; Wang, Huihui; Si, Xinlu; Ouyang, Jiting; Chen, Qiang; Tan, Chang

    2017-12-01

    Discharge characteristics of helicon plasma in nitrogen and argon-nitrogen mixtures were investigated experimentally by using a Langmuir probe, a B-dot probe, and an optical emission spectrum. Helicon wave discharge is confirmed by the changes of electron density and electromagnetic signal amplitude with the increasing RF power, which shows three discharge stages in nitrogen, corresponding to E-mode, H-mode, and W-mode discharges in helicon plasma, respectively. Discharge images in the radial cross section at different discharge modes through an intensified charge coupled device (ICCD) show a rapid increase in luminous intensity along with the RF power. When the nitrogen discharge is in the W-mode, the images show that the strongest luminance locates near the plasma boundary and no blue core appears in the axial center of tube, which is always observed in argon W-mode discharge. The "big blue" or blue core is a special character in helicon plasma, but it has not been observed in nitrogen helicon plasma. In nitrogen-argon mixtures, a weak blue core is observed in ICCD images since the nitrogen content is increased. The electric field turns to the periphery in the distribution of the radial field and the electron temperature decreases with the increasing nitrogen content, especially when the blue core disappears. The different behaviors of the electron impact and the energy consumption in nitrogen helicon plasma are suggested to be responsible for the decrease in electron energy and the change in the electric field distribution.

  16. [Severe vaginal discharge following rectal surgery

    NARCIS (Netherlands)

    Burg, L.C.; Bremers, A.J.A.; Heesakkers, J.P.; Kluivers, K.B.

    2018-01-01

    BACKGROUND: Almost 50% of women who have had rectal surgery subsequently develop vaginal discharge. Due to the recurrent and unexpected nature of this heavy discharge, they often experience it as very distressing. Many of these women undergo extensive diagnostic tests that are mainly focused on

  17. Stage-discharge relationship in tidal channels

    Science.gov (United States)

    Kearney, W. S.; Mariotti, G.; Deegan, L.; Fagherazzi, S.

    2016-12-01

    Long-term records of the flow of water through tidal channels are essential to constrain the budgets of sediments and biogeochemical compounds in salt marshes. Statistical models which relate discharge to water level allow the estimation of such records from more easily obtained records of water stage in the channel. While there is clearly structure in the stage-discharge relationship, nonlinearity and nonstationarity of the relationship complicates the construction of statistical stage-discharge models with adequate performance for discharge estimation and uncertainty quantification. Here we compare four different types of stage-discharge models, each of which is designed to capture different characteristics of the stage-discharge relationship. We estimate and validate each of these models on a two-month long time series of stage and discharge obtained with an Acoustic Doppler Current Profiler in a salt marsh channel. We find that the best performance is obtained by models which account for the nonlinear and time-varying nature of the stage-discharge relationship. Good performance can also be obtained from a simplified version of these models which approximates the fully nonlinear and time-varying models with a piecewise linear formulation.

  18. Waste water discharges into natural waters

    International Nuclear Information System (INIS)

    Marri, P.; Barsanti, P.; Mione, A.; Posarelli, M.

    1996-12-01

    The aqueous discharges into natural waters is a very technical solution expecially for surface buoyant discharges. It is not only convenient to limit the concentration levels of the discharges, but also to improve the turbolent processes that diluite the discharge. Mostly these processes depend by some geometric parameters of the discharge and by some physical parameters of the effluent and of the receiving water body. An appropriate choice of some parameters, using also suitable mathematical models, allows to design discharges with a very high dilution; so the decreasing of the pollutant levels is improved and the environmental impact can be reduced versus a not diluted effluent. The simulations of a mathematical model, here described, prove that in some circumstances, expecially in case of discharges of fresh water into saline water bodies with a low velocity of the current, the dilution is poor; the effluent can be trapped in a narrow water surface layer where the pollutant concentrations remain high. also far away from the discharge point

  19. EPA Region 1 No Discharge Zones

    Science.gov (United States)

    This dataset details No Discharge Zones (NDZ) for New England. Boaters may not discharge waste into these areas. Boundaries were determined mostly by Federal Register Environmental Documents in coordination with Massachusetts Coastal Zone Management (MA CZM) and EPA Region 1 Office of Ecosystem Protection (OEP) staff.

  20. Early hospital discharge of the healthy term neonate: the Italian perspective.

    Science.gov (United States)

    Petrone, E; Mansi, G; Tosco, A; Capasso, L; Migliaro, F; Umbaldo, A; Romano, A; Paludetto, R; Raimondi, F

    2008-06-01

    An appropriate timing of hospital discharge of the healthy, term neonate represents a balance between birth medicalization and surveillance of immediate health hazards. In the absence of European recommendations, the authors have conducted a broad national survey on the current policies of neonatal discharge. A 13-item questionnaire was sent to 136 Italian birth centers. Quantitative variables were expressed as mean+/-range. Qualitative variables were expressed as frequencies. chi squared test was used for variables comparison. Mean age at discharge for a vaginally delivered neonate was 72 hours. Twelve percent of centres would not schedule a follow-up appointment. Neonates born after a cesarean section were discharged at a mean age of 97 hours. Almost all centres (95/98) would discharge an healthy infant without risk factors for hyperbilirubinemia with a total serum bilirubin (TSB) of 13 mg/dL at 72 hours but 14.7% of these centers would not recheck TSB. The same healthy neonate would be discharged at the age of 45 hours with a TSB=10 mg/dL in 67/98 centers and in 11.9% of cases would not be rechecked. Most Italian hospitals discharge healthy, term neonates born after spontaneous vaginal delivery (SVD) at over 72 hours of age. This policy should protect from missed diagnoses of clinical importance (e.g. hyperbilirubinemia). On the other hand, a prolonged hospitalization tends to increase maternal discomfort and medical costs. Implementing a protocol of home visits/clinic follow-up appointments after an earlier discharge may minimize health hazards and medical costs and optimizing the patient's feedback.

  1. Diagnosing ADHD in Danish primary school children

    DEFF Research Database (Denmark)

    Tegtmejer, Thyge; Hjörne, Eva; Säljö, Roger

    2018-01-01

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

  2. Neuroimaging differential diagnoses to abusive head trauma

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  3. Postnatal monitoring of prenatal diagnosed hydro nephrosis

    International Nuclear Information System (INIS)

    Bueva, A.; Stefanov, S.; Palashev, Y.

    2011-01-01

    Ultrasound has revolutionized pediatric nephrology in the last decades and has a major impact on management and treatment of several children's kidneys diseases. Hydronephrosis is the most common anomaly in childhood. Progress in fetal imaging in the last years has a important impact in diagnosing congenital hydronephrosis. The current study try to establish authors opinion on problem over coming in the every day practice in pediatric nephrologist - is surgery mandatory in high grade pediatric hydronephrosis. A discussion is undergoing in the literature, following communications that high grade hydronephrosis tend spontaneously to regress in more that 65% according to Koff (2000, 2008)

  4. Neuroimaging differential diagnoses to abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-05-15

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

  5. Trisomy 9 Mosaicism Diagnosed In Utero

    Directory of Open Access Journals (Sweden)

    Hironori Takahashi

    2010-01-01

    Full Text Available We present three cases of trisomy 9 mosaicism diagnosed by amniocentesis with ongoing pregnancies after referral to our center due to fetal abnormalities. Two cases were associated with severe fetal growth restriction (FGR, each of which resulted in an intrauterine fetal demise (IUFD in the third trimester. The other case involved mild FGR with a congenital diaphragmatic hernia and resulted in a live birth with severe development delay. A major prenatal finding of trisomy 9 mosaicism is FGR. Fetuses with trisomy 9 mosaicism can rarely survive in the case of severe FGR.

  6. Bordetella pertussis diagnosed by polymerase chain reaction

    DEFF Research Database (Denmark)

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

    1994-01-01

    The object of this work was to test the polymerase chain reaction (PCR) for demonstration of Bordetella pertussis (BP) in nasopharyngeal secretions. The method was applied to patients with recently diagnosed pertussis, as verified by BP culture. In order to test the sensitivity and specificity...... in 25 patients in whose nasopharyngeal secretions BP had been demonstrated after 4-7 days of culture. The detection limit of PCR in aqueous solution was 1-2 BP bacteria per reaction tube. PCR was 100% specific for BP, showing no response with other Bordetella species or other bacteria known to colonize...

  7. Computing discharge using the index velocity method

    Science.gov (United States)

    Levesque, Victor A.; Oberg, Kevin A.

    2012-01-01

    Application of the index velocity method for computing continuous records of discharge has become increasingly common, especially since the introduction of low-cost acoustic Doppler velocity meters (ADVMs) in 1997. Presently (2011), the index velocity method is being used to compute discharge records for approximately 470 gaging stations operated and maintained by the U.S. Geological Survey. The purpose of this report is to document and describe techniques for computing discharge records using the index velocity method. Computing discharge using the index velocity method differs from the traditional stage-discharge method by separating velocity and area into two ratings—the index velocity rating and the stage-area rating. The outputs from each of these ratings, mean channel velocity (V) and cross-sectional area (A), are then multiplied together to compute a discharge. For the index velocity method, V is a function of such parameters as streamwise velocity, stage, cross-stream velocity, and velocity head, and A is a function of stage and cross-section shape. The index velocity method can be used at locations where stage-discharge methods are used, but it is especially appropriate when more than one specific discharge can be measured for a specific stage. After the ADVM is selected, installed, and configured, the stage-area rating and the index velocity rating must be developed. A standard cross section is identified and surveyed in order to develop the stage-area rating. The standard cross section should be surveyed every year for the first 3 years of operation and thereafter at a lesser frequency, depending on the susceptibility of the cross section to change. Periodic measurements of discharge are used to calibrate and validate the index rating for the range of conditions experienced at the gaging station. Data from discharge measurements, ADVMs, and stage sensors are compiled for index-rating analysis. Index ratings are developed by means of regression

  8. Plasma deposition by discharge in powder

    International Nuclear Information System (INIS)

    El-Gamal, H.A.; El-Tayeb, H.A.; Abd El-Moniem, M.; Masoud, M.M.

    2000-01-01

    Different types of material powders have been fed to the breach of a coaxial discharge. The coaxial discharge is powered from a 46.26 mu F, 24 KV capacitor bank. When the discharge takes place at the breach, the powder is heated and ionized to form a sheath of its material. The plasma sheath is ejected from the discharge zone with high velocity. The plasma sheath material is deposited on a glass substrate. It has been found from scanning electron microscope (SEM) analysis that the deposited material is almost homogenous for ceramic and graphite powders. The grain size is estimated to be the order of few microns. To measure the deposited material thickness the microdensitometer and a suitable arrangement of a laser interferometer and an optical microscope are used. It has also been found that deposited material thickness depends on the discharge number of shots and the capacitor bank energy

  9. Supersonic CO electric-discharge lasers

    Science.gov (United States)

    Hason, R. K.; Mitchner, M.; Stanton, A.

    1975-01-01

    Laser modeling activity is described which involved addition of an option allowing N2 as a second diatomic gas. This option is now operational and a few test cases involving N2/CO mixtures were run. Results from these initial test cases are summarized. In the laboratory, a CW double-discharge test facility was constructed and tested. Features include: water-cooled removable electrodes, O-ring construction to facilitate cleaning and design modifications, increased discharge length, and addition of a post-discharge observation section. Preliminary tests with this facility using N2 yielded higher power loadings than obtained in the first-generation facility. Another test-section modification, recently made and as yet untested, will permit injection of secondary gases into the cathode boundary layer. The objective will be to vary and enhance the UV emission spectrum from the auxiliary discharge, thereby influencing the level of photoionization in the main discharge region.

  10. Paschen like behavior in argon RF discharge

    International Nuclear Information System (INIS)

    Al-Jwaady, Y. I.

    2011-01-01

    A 13.56 MHz radio frequency inductively coupled discharge system is used in this work to study the relation between Argon gas pressure in the discharge chamber and the threshold breakdown RF power needed to create the discharge. Experimental results indicated that although the data involve some features related to the traditional Paschen relation used in Dc discharge, this relation cannot provide a quantitative description of experimental data. For such reason, a modified from Paschen relation is suggested. The modified relation provides good agreement with experimental data. Furthermore, it seems that the Paschen relation will have significant reflections on the behavior of the transit process from capacitive to inductive discharge. This is demonstrated by studying the transit region. (author)

  11. Acoustic effects of single electrostatic discharges

    International Nuclear Information System (INIS)

    Orzech, Łukasz

    2015-01-01

    Electric discharges, depending on their character, can emit different types of energy, resulting in different effects. Single electrostatic discharges besides generation of electromagnetic pulses are also the source of N acoustic waves. Their specified parameters depending on amount of discharging charge enable determination of value of released charge in a function of acoustic descriptor (e.g. acoustic pressure). Presented approach is the basics of acoustic method for measurement of single electrostatic discharges, enabling direct and contactless measurement of value of charge released during ESD. Method for measurement of acoustic effect of impact of a single electrostatic discharge on the environment in a form of pressure shock wave and examples of acoustic descriptors in a form of equation Q=f(p a ) are described. The properties of measuring system as well as the results of regression static analyses used to determine the described relationships are analysed in details. (paper)

  12. Impact of Pharmacist Facilitated Discharge Medication Reconciliation

    Directory of Open Access Journals (Sweden)

    Todd M. Super

    2014-07-01

    Full Text Available Preventable adverse drug events occur frequently at transitions in care and are a problem for many patients following hospital discharge. Many of these problems can be attributed to poor medication reconciliation. The purpose of this study was to assess the impact that direct pharmacist involvement in the discharge medication reconciliation process had on medication discrepancies, patient outcomes, and satisfaction. A cohort study of 70 patients was designed to assess the impact of pharmacist facilitated discharge medication reconciliation at a 204-bed community hospital in Battle Creek, Michigan, USA. Discharge summaries were analyzed to compare patients who received standard discharge without pharmacist involvement to those having pharmacist involvement. The total number of discrepancies in the group without pharmacist involvement was significantly higher than that of the pharmacist facilitated group.

  13. Diagnosis of the local thermal equilibrium by optical emission spectroscopy in the evolution of electric discharge; Diagnostico del equilibrio termico local por espectroscopia optica de emision en la evolucion de una descarga electrica

    Energy Technology Data Exchange (ETDEWEB)

    Valdivia B, R.; Pacheco S, J.; Pacheco P, M.; Ramos F, F.; Cruz A, A. [ININ, Carretera Mexico-Toluca s/n, Ocoyoacac 52750, Estado de Mexico (Mexico); Velazquez P, S. [Instituto Tecnologico de Toluca, Av. Instituto Tecnologico s/n, Ex-Rancho la Virgen, Metepec 52140, Estado de Mexico (Mexico)

    2008-07-01

    In this work applies the technique of optical emission spectroscopy to diagnose the temperature of the species generated in plasma in the transition to glow discharge arc. Whit this diagnosis is possible to determine the local thermal equilibrium conditions of the discharge. (Author)

  14. FDX: a fast discharge homopolar generator

    International Nuclear Information System (INIS)

    Weldon, W.F.; Rylander, H.G.; Woodson, H.H.

    1977-01-01

    A study was undertaken to determine the fundamental limitations to the discharge times of homopolar generators. As a result of the study, a Fast Discharge Experiment (FDX) was proposed. FDX is a small (365 kJ), counterrotating disk type homopolar generator designed to explore the limits to homopolar generator discharge times. The FDX rotors are forged aluminum alloy with flame sprayed copper slip rings. Solid copper graphite brushes are used with a 95% packing factor on the slip rings. The high magnetic field required for fast discharge (3.6 T average) is provided by discharging the CEM 5.0 MJ homopolar generator into a four-turn, graphite-reinforced, room temperature copper coil. Since the field is pulsed and FDX rotors cannot be self motored, they are brought up to speed with two 37 kW air turbines. The two aluminum rotors are 30 cm in diameter and of a rimmed, modified constant stress configuration. They are designed for a maximum operating speed of 28,000 r/min at which point they each store 182.5 kJ and develop 104 V. The aluminum discharge coax is approximately 38 cm in diameter and is designed to carry the 1.88 MA anticipated from a half speed (14,000 r/min) short circuit discharge which would stop the rotors in 1.0 ms. It is predicted that the machine will ring on its own internal impedance for approximately five cycles in this mode. The discharge coax is shorted by four very fast making switches. Additional impedance can be introduced into the discharge circuit by extending the switch coaxes to allow full speed 1.4 MA discharges in approximately 3.5 ms

  15. Numerical investigation of dielectric barrier discharges

    Science.gov (United States)

    Li, Jing

    1997-12-01

    A dielectric barrier discharge (DBD) is a transient discharge occurring between two electrodes in coaxial or planar arrangements separated by one or two layers of dielectric material. The charge accumulated on the dielectric barrier generates a field in a direction opposite to the applied field. The discharge is quenched before an arc is formed. It is one of the few non-thermal discharges that operates at atmospheric pressure and has the potential for use in pollution control. In this work, a numerical model of the dielectric barrier discharge is developed, along with the numerical approach. Adaptive grids based on the charge distribution is used. A self-consistent method is used to solve for the electric field and charge densities. The Successive Overrelaxation (SOR) method in a non-uniform grid spacing is used to solve the Poisson's equation in the cylindrically-symmetric coordinate. The Flux Corrected Transport (FCT) method is modified to solve the continuity equations in the non-uniform grid spacing. Parametric studies of dielectric barrier discharges are conducted. General characteristics of dielectric barrier discharges in both anode-directed and cathode-directed streamer are studied. Effects of the dielectric capacitance, the applied field, the resistance in external circuit and the type of gases (O2, air, N2) are investigated. We conclude that the SOR method in an adaptive grid spacing for the solution of the Poisson's equation in the cylindrically-symmetric coordinate is convergent and effective. The dielectric capacitance has little effect on the g-factor of radical production, but it determines the strength of the dielectric barrier discharge. The applied field and the type of gases used have a significant role on the current peak, current pulse duration and radical generation efficiency, discharge strength, and microstreamer radius, whereas the external series resistance has very little effect on the streamer properties. The results are helpful in

  16. Casca de banana: uma possível fonte de infecção no tratamento de fissuras mamilares Banana peel: a possible source of infection in the treatment of nipple fissures

    Directory of Open Access Journals (Sweden)

    Franz Reis Novak

    2003-06-01

    Full Text Available OBJETIVO: o presente trabalho foi desenvolvido com o objetivo de estudar a microbiota da casca de banana prata, comercializada na cidade do Rio de Janeiro, tentando correlacioná-la com a possibilidade de que seja uma fonte de infecção para a mulher que a utiliza como terapia para fissuras mamilares. MÉTODOS: foram estudados, em 20 amostras de casca de banana, os seguintes microrganismos: mesófilos, coliformes totais, coliformes fecais, Pseudomonas aeruginosa, lipolíticos, proteolíticos, bolores e leveduras, bactérias lácticas e estafilococos coagulase-positiva. RESULTADOS: as análises microbiológicas revelaram a ocorrência de diversos grupos clássicos de microrganismos. A distribuição percentual dos resultados positivos nas amostras de casca de banana, em função das contagens, foram: mesófilos, 100%; coliformes totais, 20%; estafilococos coagulase-positiva, 25%; bolores e leveduras, 30%; proteolíticos, 70%; lipolíticos, 30% e bactérias lácticas, 95%. Coliformes fecais e Pseudomonas aeruginosa não foram isolados. CONCLUSÃO: a avaliação conjunta dos resultados revela a presença de microrganismos potencialmente patogênicos em níveis capazes de comprometer a qualidade microbiológica da casca de banana. A sua aplicação sobre fissuras mamilares para o tratamento destas pode favorecer o início de um processo infeccioso.OBJECTIVE: the objective of the present investigation is to study the microbiology of banana peel being sold in the city of Rio de Janeiro, in an attempt to determine the possibility that the peel may represent a source of infection for women who use it to treat nipple fissures. METHODS: the following microorganisms were studied in 20 banana peel samples: mesophiles, total coliforms, fecal coliforms, Pseudomonas aeruginosa, lipolytic and proteolytic microorganisms, molds and yeasts, lactic bacteria, and coagulase-positive staphylococcus. RESULTS: the microbiological analyses revealed the occurrence of

  17. Comparison of radiological measures for diagnosing flatfoot

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  18. Diagnosing method for nuclear power plant

    International Nuclear Information System (INIS)

    Sonoda, Yukio.

    1991-01-01

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

  19. Diagnosing ignition with DT reaction history

    International Nuclear Information System (INIS)

    Wilson, D. C.; Bradley, P. A.; Herrmann, H. W.; Cerjan, C. J.; Salmonson, J. D.; Spears, B. K.; Hatchet, S. P. II; Glebov, V. Yu.

    2008-01-01

    A full range DT reaction history of an ignition capsule, from 10 9 to 10 20 neutrons/ns, offers the opportunity to diagnose fuel conditions hundreds of picoseconds before and during burn. The burn history begins with a sharp rise when the first shock reaches the center of the capsule. The level of this jump reflects the combined shock strength and the adiabat of DT fuel. Changes to the four laser pulses driving the capsule implosion which are large enough to degrade the yield make measurable changes to the reaction history. Low mode asymmetries grow during convergence but change the reaction history during the final ∼100 ps. High mode asymmetry or turbulence mixing affects only the reaction history within ∼50 ps of peak burn rate. A capsule with a tritium fuel layer containing a small amount of deuterium (∼1%) creates a reaction history similar to the ignition capsule, but without the final ignition burn. A combination of gas Cerenkov detectors and the neutron temporal diagnostic could be capable of diagnosing the full history of ignition and tritium rich capsules.

  20. Diagnosing breast cancer by using Raman spectroscopy

    Science.gov (United States)

    Haka, Abigail S.; Shafer-Peltier, Karen E.; Fitzmaurice, Maryann; Crowe, Joseph; Dasari, Ramachandra R.; Feld, Michael S.

    2005-08-01

    We employ Raman spectroscopy to diagnose benign and malignant lesions in human breast tissue based on chemical composition. In this study, 130 Raman spectra are acquired from ex vivo samples of human breast tissue (normal, fibrocystic change, fibroadenoma, and infiltrating carcinoma) from 58 patients. Data are fit by using a linear combination model in which nine basis spectra represent the morphologic and chemical features of breast tissue. The resulting fit coefficients provide insight into the chemical/morphological makeup of the tissue and are used to develop diagnostic algorithms. The fit coefficients for fat and collagen are the key parameters in the resulting diagnostic algorithm, which classifies samples according to their specific pathological diagnoses, attaining 94% sensitivity and 96% specificity for distinguishing cancerous tissues from normal and benign tissues. The excellent results demonstrate that Raman spectroscopy has the potential to be applied in vivo to accurately classify breast lesions, thereby reducing the number of excisional breast biopsies that are performed. Author contributions: M.F., J.C., R.R.D., and M.S.F. designed research; A.S.H. and K.E.S.-P. performed research; A.S.H. and M.F. analyzed data; and A.S.H. wrote the paper.This paper was submitted directly (Track II) to the PNAS office.Abbreviations: DEH, ductal epithelial hyperplasia; ROC, receiver operating characteristic; N/C, nuclear-to-cytoplasm.

  1. Vehicle Fault Diagnose Based on Smart Sensor

    Science.gov (United States)

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

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

  2. Illness perspectives of Thais diagnosed with schizophrenia.

    Science.gov (United States)

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

    2009-09-01

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

  3. Beyond the DSM: trends in psychiatry diagnoses

    Directory of Open Access Journals (Sweden)

    Andre Russowsky Brunoni

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

  4. Riedel's goitre - rare and difficult to diagnose reason

    International Nuclear Information System (INIS)

    Bula, G.; Truchanowski, W.; Gawrychowski, J.

    2009-01-01

    Introduction: The paper reports a female patient treated surgically for Riedel's goitre. A total of 4775 patients were treated surgically between 1 January 2000 and 31 December 2007 for various types of goitres. Thyroiditis was diagnosed in 193 (4.0%) cases. Among them Riedel's goitre was found in one (0.5%). Case report: A 51-year-old woman P.G. (case record No. 1377/2007) was admitted to our hospital with considerable dyspnea, both inspiratory and expiratory, accompanied by marked stridor and retrosternal goitre, the latter suspected of neoplasmic process. Thyroid gland was hard, its left lobe extending behind the sternum. No disorders in thyroid hormonal function or high antibody titre against thyroid peroxidase were observed. Ultrasonography revealed large thyroid gland with mediastinal invasion, nodulated and hypoechogenic. Fineneedle biopsy suggested thyroid colloidal tumor. X-ray of the chest and neck revealed wide upper portion of the mediastinum and narrow trachea. Laryngological examination confirmed paralysis of left vocal fold. The patient was operated under general endotracheal anesthesia. Both thyroid lobes were partially resected together with the isthmus, and malacic trachea was decompressed. No complications were observed during postoperative period. Paraffin histopathological examination confirmed the presence of Riedel's goitre.The patient was discharged in general good condition. She was under regular follow-up control and died 1.5 year after operation from further progress of the disease. Conclusions: Clinical course of Riedel's goitre may cause remarkable diagnostic problems, and requires a differentiation with thyroid malignant tumor. Surgical treatment of Riedel's goitres helps to quickly obtain correct diagnosis and improve both clinical condition and life comfort of the patients. (authors)

  5. Do coder characteristics influence validity of ICD-10 hospital discharge data?

    Directory of Open Access Journals (Sweden)

    Beck Cynthia A

    2010-04-01

    Full Text Available Abstract Background Administrative data are widely used to study health systems and make important health policy decisions. Yet little is known about the influence of coder characteristics on administrative data validity in these studies. Our goal was to describe the relationship between several measures of validity in coded hospital discharge data and 1 coders' volume of coding (≥13,000 vs. Methods This descriptive study examined 6 indicators of face validity in ICD-10 coded discharge records from 4 hospitals in Calgary, Canada between April 2002 and March 2007. Specifically, mean number of coded diagnoses, procedures, complications, Z-codes, and codes ending in 8 or 9 were compared by coding volume and employment status, as well as hospital type. The mean number of diagnoses was also compared across coder characteristics for 6 major conditions of varying complexity. Next, kappa statistics were computed to assess agreement between discharge data and linked chart data reabstracted by nursing chart reviewers. Kappas were compared across coder characteristics. Results 422,618 discharge records were coded by 59 coders during the study period. The mean number of diagnoses per record decreased from 5.2 in 2002/2003 to 3.9 in 2006/2007, while the number of records coded annually increased from 69,613 to 102,842. Coders at the tertiary hospital coded the most diagnoses (5.0 compared with 3.9 and 3.8 at other sites. There was no variation by coder or site characteristics for any other face validity indicator. The mean number of diagnoses increased from 1.5 to 7.9 with increasing complexity of the major diagnosis, but did not vary with coder characteristics. Agreement (kappa between coded data and chart review did not show any consistent pattern with respect to coder characteristics. Conclusions This large study suggests that coder characteristics do not influence the validity of hospital discharge data. Other jurisdictions might benefit from

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

    DEFF Research Database (Denmark)

    Luk, Adriana; Metawee, Mohammed; Ahn, Eric

    2009-01-01

    . Patient records were reviewed for preoperative clinical diagnoses and other relevant data, including pretransplant endomyocardial biopsy (EMB) results, information regarding left ventricular assist devices and, finally, evidence of disease recurrence in the grafted heart. RESULTS: A shift...... diagnose patients with diseases such as sarcoidosis, amyloidosis and particular types of myocarditis because these can readily recur in the grafted heart. The risk for recurrence must be known to practitioners and, most importantly, to the patient. We strongly recommend the use of EMB if a nonischemic...

  7. Acoustic signal analysis in the creeping discharge

    International Nuclear Information System (INIS)

    Nakamiya, T; Sonoda, Y; Tsuda, R; Ebihara, K; Ikegami, T

    2008-01-01

    We have previously succeeded in measuring the acoustic signal due to the dielectric barrier discharge and discriminating the dominant frequency components of the acoustic signal. The dominant frequency components appear over 20kHz of acoustic signal by the dielectric barrier discharge. Recently surface discharge control technology has been focused from practical applications such as ozonizer, NO X reactors, light source or display. The fundamental experiments are carried to examine the creeping discharge using the acoustic signal. When the high voltage (6kV, f = 10kHz) is applied to the electrode, the discharge current flows and the acoustic sound is generated. The current, voltage waveforms of creeping discharge and the sound signal detected by the condenser microphone are stored in the digital memory scope. In this scheme, Continuous Wavelet Transform (CWT) is applied to discriminate the acoustic sound of the micro discharge and the dominant frequency components are studied. CWT results of sound signal show the frequency spectrum of wideband up to 100kHz. In addition, the energy distributions of acoustic signal are examined by CWT

  8. Surgical discharge summaries: improving the record.

    Science.gov (United States)

    Adams, D C; Bristol, J B; Poskitt, K R

    1993-03-01

    The problem area of communication between hospital and general practitioners may potentially be improved by the advent of new information technology. The introduction of a regional computer database for general surgery allows the rapid automated production of discharge summaries and has provided us with the opportunity for auditing the quality of old and new styles of discharge communication. A total of 118 general practitioners were sent a postal questionnaire to establish their views on the relative importance of various aspects of patient information and management after discharge. A high response rate (97%) indicated the interest of general practitioners in this topic. The majority (73%) believed that summaries should be delayed no more than 3 days. The structured and shortened new format was preferred to the older style of discharge summary. The older format rarely arrived within an appropriate time and its content was often felt to be either inadequate (35%) or excessive (7%) compared with the new format (8% and 1%, respectively). The diagnosis, information given to the patient, clinic date, list of medications and investigations were considered the more important details in the summary. Improvements in the discharge information were suggested and have subsequently been incorporated in our discharge policy. The use of new information technology, intended to facilitate clinical audit, has improved our ability to generate prompt, well-structured discharge summaries which are accepted by the general practitioners.

  9. Pending laboratory tests and the hospital discharge summary in patients discharged to sub-acute care.

    Science.gov (United States)

    Walz, Stacy E; Smith, Maureen; Cox, Elizabeth; Sattin, Justin; Kind, Amy J H

    2011-04-01

    Previous studies have noted a high (41%) prevalence and poor discharge summary communication of pending laboratory (lab) tests at the time of hospital discharge for general medical patients. However, the prevalence and communication of pending labs within a high-risk population, specifically those patients discharged to sub-acute care (i.e., skilled nursing, rehabilitation, long-term care), remains unknown. To determine the prevalence and nature of lab tests pending at hospital discharge and their inclusion within hospital discharge summaries, for common sub-acute care populations. Retrospective cohort study. Stroke, hip fracture, and cancer patients discharged from a single large academic medical center to sub-acute care, 2003-2005 (N = 564) Pending lab tests were abstracted from the laboratory information system (LIS) and from each patient's discharge summary, then grouped into 14 categories and compared. Microbiology tests were sub-divided by culture type and number of days pending prior to discharge. Of sub-acute care patients, 32% (181/564) were discharged with pending lab tests per the LIS; however, only 11% (20/181) of discharge summaries documented these. Patients most often left the hospital with pending microbiology tests (83% [150/181]), particularly blood and urine cultures, and reference lab tests (17% [30/181]). However, 82% (61/74) of patients' pending urine cultures did not have 24-hour preliminary results, and 19% (13/70) of patients' pending blood cultures did not have 48-hour preliminary results available at the time of hospital discharge. Approximately one-third of the sub-acute care patients in this study had labs pending at discharge, but few were documented within hospital discharge summaries. Even after considering the availability of preliminary microbiology results, these omissions remain common. Future studies should focus on improving the communication of pending lab tests at discharge and evaluating the impact that this improved

  10. Hazardous gas treatment by atmospheric discharges

    International Nuclear Information System (INIS)

    Mizeraczyk, J.

    2005-01-01

    The emissions of NO x ; SO x , CO 2 and volatile organic compounds (VOCs) including fluorocarbons to the atmosphere influence heavily our environment, NO x and SO x emitted to the atmosphere are the major cause of acid rains, while CO 2 and VOCs emissions cause the greenhouse effect which leads to abnormal global heating of the atmosphere and creating in a temperature inversion layer that traps gaseous pollutants. Therefore, there is an increasing interest in controlling these emissions. A new technique, which uses the plasma processes induced by energetic electrons, emerges as one of the most effective methods of reducing concentrations of the emitted gaseous pollutants. Various plasma techniques have been tested for gaseous pollution control. The electron bean irradiation was found to be physically and economically efficient for NO x and SO x reduction in the exhaust gases from electrical and heat power plants. The capability of the non-thermal plasmas, produced in atmospheric pressure electrical discharges, for decomposition of the gaseous pollutants has been widely tested. These atmospheric pressure electrical discharges are dielectric barrier discharges, pulsed and de corona discharges (in the reactors with the point-to-plate, wire-cylinder and wire-plate geometries, in the reactors with flow stabilized corona torch and corona radical shower), gliding discharges, inductively coupled high-frequency discharges, ac surface discharges, ac discharges in the packed bed reactors, and microwave torch discharges. In this paper, after reviewing the methods and devices used for producing the non-thermal plasmas for gaseous pollutant control, some results of the laboratory experiments on the plasmas abatement of NO x ; SO x and various VOCs will be presented, followed by a discussion on the energy efficiency and by-products. Also some results obtained in the pilot-plants will be given. finally other possible applications of the presented plasma devices for controlling

  11. 48 CFR 1352.271-81 - Discharge of liens.

    Science.gov (United States)

    2010-10-01

    ...) The contractor shall immediately discharge or cause to be discharged any lien or right in rem of any... done or materials furnished under the contract. If any such lien or right in rem is not immediately discharged, the Government may discharge or cause to be discharged such lien or right at the expense of the...

  12. In-hospital Mobility Variations across Primary Diagnoses among Older Adults

    Science.gov (United States)

    Valiani, Vincenzo; Gao, Shiyao; Chen, Zhiguo; Swami, Sunil; Harle, Christopher A.; Lipori, Gigi; Sourdet, Sandrine; Wu, Samuel; Nayfield, Susan G.; Sabbá, Carlo; Pahor, Marco; Manini, Todd M.

    2016-01-01

    Objectives To examine the relationship between primary diagnoses and mobility impairment and recovery among hospitalized older adults. Design Prospective cohort study. Setting UF Health Shands Hospital, an 852-bed level I trauma center located in Gainesville, Florida. Participants 18,551 older adults (≥65 years) with 29,148 hospitalizations between 1/2009 and 4/2014. Measurements Incident and discharge mobility impairment and recovery were assessed using the Braden activity subscale score that was recorded by the nursing staff at every shift change–approximately three times per day. Primary diagnosis ICD-9 codes were used as predictors and re-categorized by using the Agency for Health Care Research and Quality Clinical Classification Software. Results Out of the 15,498 hospital records where the patient was initially observed to “walk frequently”, 3,186 (20.6%) developed incident mobility impairment (chair-fast or bedfast). Primary diagnoses with a surgical or invasive procedure were the most prevalent (77.2 %) among the hospital observations with incident mobility impairment; otherwise primary diagnoses without surgery were much more associated with discharge mobility impairment (59%). The highest incidence of mobility impairment occurred in patients with heart valve disorders and aortic and peripheral/visceral artery aneurysms (6.24 and 6.05 events per 30 person-days, respectively); septicemia showed the highest incidence rate for mobility limitation at discharge (0.94 events per 30 person-days). Mobility impairment was observed in 13,650 (46.8% of total) records at admission and 5,930 (43.44%) were observed to recover to a state of walking occasionally or frequently. Osteoarthritis and cancer of gastrointestinal organs/peritoneum had the highest incidence rate for mobility recovery (7.68 and 5.63 events per 30 person-days respectively). Conclusions Approximately 1 out of 5 patients who were mobile at admission became significantly impaired during

  13. Flywheel Charge/Discharge Control Developed

    Science.gov (United States)

    Beach, Raymond.F.; Kenny, Barbara H.

    2001-01-01

    A control algorithm developed at the NASA Glenn Research Center will allow a flywheel energy storage system to interface with the electrical bus of a space power system. The controller allows the flywheel to operate in both charge and discharge modes. Charge mode is used to store additional energy generated by the solar arrays on the spacecraft during insolation. During charge mode, the flywheel spins up to store the additional electrical energy as rotational mechanical energy. Discharge mode is used during eclipse when the flywheel provides the power to the spacecraft. During discharge mode, the flywheel spins down to release the stored rotational energy.

  14. Studies on pulsed hollow cathode capillary discharges

    Energy Technology Data Exchange (ETDEWEB)

    Choi, P; Dumitrescu-Zoita, C; Larour, J; Rous, J [Ecole Polytechnique, 91 - Palaiseau (France). Lab. de Physique des Milieux Ionises; Favre, M; Moreno, J; Chuaqui, H; Wyndham, E [Pontificia Univ. Catolica de Chile, Santiago (Chile). Facultad de Fisica; Zambra, M [Comision Chilena de Energia Nuclear, Santiago (Chile); Wong, C S [Univ. of Malaya, Kuala Lumpur (Malaysia). Plasma Research Lab

    1997-12-31

    Preliminary results on radiation characteristics of pulsed hollow cathode capillary discharges are presented. The device combines the on axis electron beam assisted ionization capabilities of the transient hollow cathode discharge with a novel high voltage low inductance geometrical design, which integrates the local energy storage into the electrode system. A nanosecond regime high temperature plasma is produced in a long, high aspect ratio capillary, with light emission in the UV to XUV region. The discharge is operated from near vacuum to pressure in the 1000 mTorr range. (author). 2 figs., 7 refs.

  15. Sizing of an Ammonia Discharge Tank

    Directory of Open Access Journals (Sweden)

    Tuliagenda Beckfords

    2011-01-01

    Full Text Available Phosphate companies use well-stirred tanks to regulate the concentration of ammonia they discharge via their wastewater, preventing ammonia spikes from exceeding the cap set by the Environmental Protection Agency. This report discusses the methods used to determine the minimum possible volume of the tank required to regulate wastewater discharge. With this information, it was determined that the use of a stirring tank is an efficient and cost effective way to regulate ammonia discharge. Based on these results many other companies may use this method to decrease the negative effects of ammonia on the environment.

  16. Hospital-diagnosed dementia and suicide

    DEFF Research Database (Denmark)

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

    2008-01-01

    OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individuals...... who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men...... aged 50+ living in Denmark (N=2,474,767) during January 1, 1990 through December 31, 2000. MEASUREMENTS: Outcome of interest is suicide. Relative risks are calculated based on person-days spent in each stratum. RESULTS: A total of 18,648,875 person-years were observed during the 11-year study period...

  17. Diagnosing the Internal Architecture of Zeolite Ferrierite

    Science.gov (United States)

    Schmidt, Joel E.; Hendriks, Frank C.; Lutz, Martin; Post, L. Christiaan; Fu, Donglong

    2017-01-01

    Abstract Large crystals of zeolite ferrierite (FER) are important model systems for spatially resolved catalysis and diffusion studies, though there is considerable variation in crystal habit depending on the chemical composition and employed synthesis conditions. A synergistic combination of techniques has been applied, including single crystal X‐ray diffraction, high‐temperature in situ confocal fluorescence microscopy, fluorescent probe molecules, wide‐field microscopy and atomic force microscopy to unravel the internal architecture of three distinct FER zeolites. Pyrolyzed template species can be used as markers for the 8‐membered ring direction as they are trapped in the terraced roof of the FER crystals. This happens as the materials grow in a layer‐by‐layer, defect‐free manner normal to the large crystal surface, and leads to a facile method to diagnose the pore system orientation, which avoids tedious single crystal X‐ray diffraction experiments. PMID:28809081

  18. Diagnosing extracranial atherosclerotic diseases with spiral CT

    International Nuclear Information System (INIS)

    Moran, C.J.; Vannier, M.W.; Erickson, K.K.; Broderick, D.F.; Kido, D.K.; Yoffie, R.L.

    1991-01-01

    This paper reports that this discovery study was performed to determine whether extracranial carotid artery plaques could be diagnosed with a new CT technique (spiral CT) that allows nondistorted three-dimensional (3D) reconstructions in the z axis. Twenty carotid arteries were examined with spiral CT in normal volunteers and in patients suspected of having atherosclerotic plaques in the extracranial carotid arteries. The Somatom Plus CT table was advanced at a constant rate, the x-ray tube was continuously rotated, and 3D data were continuously acquired. Sixty milliliters of nonionic contrast medium was injected intravenously previous to and during the acquisition of data. The carotid bifurcations were identified in all patients. Planar images, similar to conventional intraarterial angiograms, were routinely produced from the volumetric CT data

  19. Diagnosing MOV problems using comparative trace analysis

    International Nuclear Information System (INIS)

    Leon, R.L.

    1992-01-01

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

  20. Diagnosing dehydration? Blend evidence with clinical observations.

    Science.gov (United States)

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

    2016-11-01

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