A Solitary Fibrous Tumor of the Pleura Revealed by Hiccups

Directory of Open Access Journals (Sweden)

A. Chafik

2011-01-01

Full Text Available Solitary fibrous tumors of the pleura are rare and benign primary localized tumors; they possess a malignant potential and thus should be excised. We report a case of a 43-year-old woman, who had suffered for 5 years from right basithoracic pain associated with progressive dyspnea and persistent hiccups during the last 6 months. We have not found any similar case in the literature. Further testing after excision by thoracotomy revealed a solitary fibrous pleural tumor. A brief discussion of the clinical presentation and incidence of these tumors is included.

Hiccups

Science.gov (United States)

... Information Drug Information, Search Drug Names, Generic and Brand Natural Products, Search Drug Interactions Pill Identifier News & Commentary ALL NEWS > Resources First Aid Videos Figures 3D Models Images Infographics Audio Pronunciations The One-Page Manual of ...

Diaphragm myoclonus followed by generalised atonia in a patient with trisomy 4p: unusual semiology in an unusual condition.

Science.gov (United States)

Varley, James; Wehner, Tim; Sisodiya, Sanjay

2015-12-01

In this report, we describe a female patient with trisomy 4p, a rare genetic condition, with unusual seizure semiology. The patient is one of the oldest reported survivors with this condition. This semiology was noted while she was being monitored by inpatient video telemetry. We observed a series of myoclonic shoulder jerks, followed by hiccup-like episodes, and finally an atonic head drop. Corresponding ictal EEG showed semi-rhythmic high-amplitude slow waves with spikes superimposed over the frontotemporal areas. This semiology was confirmed as habitual by her parents. Subsequent hiccup-like episodes had no EEG correlate, and the head drop was again associated with semi-rhythmic high-amplitude slow waves and superimposed spikes, more prominent over the right hemisphere. In addition, we review the several cases in which hiccups have been associated with seizures and how this may relate to the neural pathways involved in the pathophysiology of hiccups. We believe the ictal hiccup-like episodes followed by atonia to be a seizure semiology that has not previously been documented. [Published with video sequence].

Persistent singultus due to uremia: report of a pediatric case and review of the literature Singulto (hipo persistente provocado por uremia: Reporte de un caso pediátrico y revisión de la literatura

Directory of Open Access Journals (Sweden)

José William Cornejo Ochoa

2002-04-01

Full Text Available Singultus or hiccups is a breathing thing disorder that, in contrast with nausea, vomiting or cough, does not confer any protection. There exist many different causes of hiccups as well as varied treatments. Chronic hiccups is seldom reported but it may worsen or complicate other diseases. We report the case of a 13 year-old girl with prolonged hiccups due to uremia. Although diverse pharmacologic treatments were used, only hemodialysis controlled the hiccups. El singulto o hipo es un trastorno de la coordinación de la respiración, que a diferencia de reflejos como la tos, las náuseas o el vómito, no tiene ninguna repercusión de protección para el ser humano. Se han establecido muchas causas y también múltiples tratamientos. Los casos de hipo crónico son escasos en la literatura y con frecuencia deterioran el estado de salud de la persona o complican las enfermedades de base. Se presenta un caso pediátrico de singulto prolongado provocado por uremia, que a pesar de implementar varios tratamientos farmacológicos, sólo cedió con la hemodiálisis. Se realiza una revisión del tema.

Analysis of sparse data in logistic regression in medical research: A newer approach

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S Devika

2016-01-01

Full Text Available Background and Objective: In the analysis of dichotomous type response variable, logistic regression is usually used. However, the performance of logistic regression in the presence of sparse data is questionable. In such a situation, a common problem is the presence of high odds ratios (ORs with very wide 95% confidence interval (CI (OR: >999.999, 95% CI: 999.999. In this paper, we addressed this issue by using penalized logistic regression (PLR method. Materials and Methods: Data from case-control study on hyponatremia and hiccups conducted in Christian Medical College, Vellore, Tamil Nadu, India was used. The outcome variable was the presence/absence of hiccups and the main exposure variable was the status of hyponatremia. Simulation dataset was created with different sample sizes and with a different number of covariates. Results: A total of 23 cases and 50 controls were used for the analysis of ordinary and PLR methods. The main exposure variable hyponatremia was present in nine (39.13% of the cases and in four (8.0% of the controls. Of the 23 hiccup cases, all were males and among the controls, 46 (92.0% were males. Thus, the complete separation between gender and the disease group led into an infinite OR with 95% CI (OR: >999.999, 95% CI: 999.999 whereas there was a finite and consistent regression coefficient for gender (OR: 5.35; 95% CI: 0.42, 816.48 using PLR. After adjusting for all the confounding variables, hyponatremia entailed 7.9 (95% CI: 2.06, 38.86 times higher risk for the development of hiccups as was found using PLR whereas there was an overestimation of risk OR: 10.76 (95% CI: 2.17, 53.41 using the conventional method. Simulation experiment shows that the estimated coverage probability of this method is near the nominal level of 95% even for small sample sizes and for a large number of covariates. Conclusions: PLR is almost equal to the ordinary logistic regression when the sample size is large and is superior in small cell

"More Than Words" : Social Validation in Close Relationships

NARCIS (Netherlands)

Koudenburg, Namkje; Gordijn, Ernestine H.; Postmes, Tom

2014-01-01

Conversations are susceptible to many disturbances: A speaker's hesitations, distractions, or, when communicating online, technical hiccups that may cause brief delays. Research among previously unacquainted individuals revealed that brief disruptions in conversational flow can have profound social

Is Nuchal Cord a Perfect Scapegoat: A Retrospective Analysis from ...

African Journals Online (AJOL)

Mubeen

considered as significant. Results: The nuchal cord group did not have any significant difference in the mode of delivery or fetal .... at risk of umbilical cord compression compensation, are hiccups ... Staying in touch with the journal. 1) Table of ...

Information resources and access in Delta State University library ...

African Journals Online (AJOL)

It was revealed in the study that due to various internet hiccups and financial problems affecting library services the use of ICTs in information retrieval has not fully gain ed ground. Based on the findings, pertinent recommendations were made. Key Words: Information , Resources, Access, Library, University, Abraka , Nigeria ...

Scratch to state-of-the-art: setting up a new robotic facility in a developing country.

Science.gov (United States)

Bora, G S; Mavuduru, R S; Devana, S K; Singh, S K; Mandal, A K

2018-03-01

The potential challenges encountered for setting up a robotic assisted surgical facility in developing country like India are many. We describe the initial hurdles and troubleshooting in establishing a facility of such kind. This experience might help to decrease initial hiccups in setting up such an innovative technology at other institutes.

Analysis of Dietary Intake during Consecutive-Day Chemotherapy for Bone and Soft-Tissue Sarcomas

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Yuta Hori

2018-01-01

Full Text Available BackgroundBone and soft tissue sarcomas are commonly treated with consecutive-day chemotherapy regimens consisting of multiple anticancer agents. Chemotherapy-induced nausea and vomiting (CINV is a serious adverse effect of these regimens and may result in decreased energy intake during chemotherapy. Decreased energy intake may lead to undernutrition and may cause adverse effects on patient quality of life and survival.MethodsPatients with bone and soft tissue sarcomas who received consecutive-day chemotherapy were retrospectively evaluated. CINV and dietary energy intake were assessed, as well as the occurrences of hiccups and constipation during chemotherapy.ResultsA total of 13 patients, 10 males and 3 females, with a total 16 chemotherapy courses were included in the study. All patients received antiemetic prophylaxis. The CINV control rate, defined as no emesis and no rescue therapy, gradually decreased from chemotherapy day 1 (94% to day 5 (75%. Four patients experienced emesis, two of whom had been treated with a cisplatin-containing regimen. Decreased dietary energy intake was possibly associated with CINV during chemotherapy. Anorexia was grade 2 except for one case of grade 3. The incidences of hiccups and constipation were high on days 3–5.ConclusionAntiemetic prophylaxis treatment did not prevent emesis due to consecutive-day chemotherapy, especially with cisplatin-containing regimens, in patients with bone and soft-tissue tumors. Dietary energy intake decreased during chemotherapy, and this appeared to be associated with CINV. In addition, the incidence of hiccups and constipation increased during the course of consecutive-day chemotherapy regimens. Although these results are based on a small number of patients, it may be important to observe nutritional status during chemotherapy, as this may reflect a patient’s general condition. Nutritional counseling might be useful in supporting nutritional status in patients undergoing

Author Details

African Journals Online (AJOL)

Yazıcıoğlu, B. Vol 20, No 7 (2017) - Articles Treatment of resistant idiopathic hiccups with pulse radio frequency on phrenic nerve and gabapentin: A case report. Abstract PDF. ISSN: 1119-3077. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

Mobile Phone Service Process Hiccups at Cellular Inc.

Science.gov (United States)

Edgington, Theresa M.

2010-01-01

This teaching case documents an actual case of process execution and failure. The case is useful in MIS introductory courses seeking to demonstrate the interdependencies within a business process, and the concept of cascading failure at the process level. This case demonstrates benefits and potential problems with information technology systems,…

Treatment of Resistant Idiopathic Hiccups with Pulse Radio ...

African Journals Online (AJOL)

2016-10-20

Oct 20, 2016 ... relief from symptoms, the patient accepted oral therapy this time. Gabapentin 300 .... A venous catheter was ... recommended in single or combined treatment of chronic ... Gastric distension, peptic ulcer disease, gastric cancer, ...

GFC, tax hiccup fail to slow Oz momentum

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-07-15

Once again there is a promising outlook for Australia's coal producers, with Asia's seemingly insatiable appetite for both thermal and coking coal driving expansion of production and export capacity. The article reports on recent developments at ports and coal terminals and on plans to further improve rail transport of coal. 2 photos.

Irreversible Coma clinicopathologic correlations in 79 observations

OpenAIRE

Jerí, F. Raúl

2014-01-01

Clinical and developmental data of 79 patients suffering from deep coma associated with isoelectric electroencephalogram for at least 24 consecutive hours are presented. The neuropathological study showed that the vast majority had ischemic lesions in the cerebral cortex hiccups field , cerebellum , striatum , thalamus and to a lesser extent , in the brain - stem . Failed to check precise relationship between the clinical manifestations of the specific nerve dysfunction and destruction of neu...

New thoughts on the treatment of common complications of advanced liver cancer by external therapy of traditional Chinese medicine

OpenAIRE

PAN Shasha

2017-01-01

Cancerous pain, hepatic ascites and intractable hiccups are common complications in patients with advanced liver cancer, but clinical symptomatic treatment cannot achieve satisfactory results. This article reviews the application of external therapy of traditional Chinese medicine in the treatment of common complications in patients with advanced liver cancer and analyzes the clinical effect and feasibility of common therapeutic methods used in treatment, such as plaster sticking therapy, tum...

Fast and interrupted expansion in cyclic void growth in dusty plasma

International Nuclear Information System (INIS)

Van de Wetering, F M J H; Brooimans, R J C; Nijdam, S; Beckers, J; Kroesen, G M W

2015-01-01

Low-pressure acetylene plasmas are able to spontaneously form dust particles. This will result in a dense cloud of solid particles that is levitated in the plasma. The formed particles can grow up to micrometers. We observed a spontaneous interruption in the expansion of the so-called dust void. A dust void is a macroscopic region in the plasma that is free of nanoparticles. The phenomenon is periodical and reproducible. We refer to the expansion interruption as ‘hiccup’. The expanding void is an environment in which a new cycle of dust particle formation can start. At a certain moment in time, this cycle reaches the (sudden) coagulation phase and as a result the void will temporarily shrink. To substantiate this reasoning, the electron density is determined non-intrusively using microwave cavity resonance spectroscopy. Moreover, video imaging of laser light scattering of the dust particles provides their spatial distribution. The emission intensity of a single argon transition is measured similarly. Our results support the aforementioned hypothesis for what happens during the void hiccup. The void dynamics preceding the hiccup are modeled using a simple analytical model for the two dominant forces (ion drag and electric) working on a nanoparticle in a plasma. The model results qualitatively reproduce the measurements. (paper)

Techniques for the Detection of Faulty Packet Header Modifications

Science.gov (United States)

2014-03-12

uses this variant as its protection scheme. We had to modify the kernel’s socket API so that an application could specially request protection via...kernel’s socket API . Deriving inspiration from the socket API changes made by the TCP Fast Open extension [58], we added a new flag, MSG_HICCUPS, that...PlanetLab nodes, we geolocated all 199 nodes using the MaxMind GeoLite country database [63]. The results of that break- down are shown in Table 7.4 by

Management of empyema of gallbladder with percutaneous cholecysto-duodenal stenting in a case of hilar cholangiocarcinoma treated with common bile duct metallic stenting

Directory of Open Access Journals (Sweden)

Sheo Kumar

2011-01-01

Full Text Available Empyema of the gallbladder develops when the gallbladder neck is obstructed in the presence of infection, preventing pus from draining via the cystic duct. Treatment options include cholecystectomy or, in patients with comorbidities, drainage via percutaneous cholecystostomy, later followed by cholecystectomy. Here, we describe a 59-year-old man who presented with complaints of recurrent hiccups and was found to have cholangiocarcinoma causing obstruction to cystic duct drainage. The patient was managed successfully by percutaneous transhepatic cholecysto-duodenal self-expandable covered metal stent.

New thoughts on the treatment of common complications of advanced liver cancer by external therapy of traditional Chinese medicine

Directory of Open Access Journals (Sweden)

PAN Shasha

2017-12-01

Full Text Available Cancerous pain, hepatic ascites and intractable hiccups are common complications in patients with advanced liver cancer, but clinical symptomatic treatment cannot achieve satisfactory results. This article reviews the application of external therapy of traditional Chinese medicine in the treatment of common complications in patients with advanced liver cancer and analyzes the clinical effect and feasibility of common therapeutic methods used in treatment, such as plaster sticking therapy, tumor thermotherapy, interventional therapy combined with traditional Chinese medicine, and sonophoresis of traditional Chinese medicine.

Intractable hiccups due to herpetic esophagitis in an immunocompromised patient

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John Harris

2016-01-01

This case illustrates an exceptionally rare presentation of herpetic esophagitis in an immunocompromised host. As novel immunotherapeutic/suppressive agents continue to emerge, the evolving role of herpes virus prophylaxis and diagnosis of atypical presentations in new host populations is a topic of growing importance.

[Star fruit (Averrhoa carambola) toxic encephalopathy].

Science.gov (United States)

Signaté, A; Olindo, S; Chausson, N; Cassinoto, C; Edimo Nana, M; Saint Vil, M; Cabre, P; Smadja, D

2009-03-01

Ingestion of star fruit (Averrhoa carambola) can induce severe intoxication in subjects with chronic renal failure. Oxalate plays a key role in the neurotoxicity of star fruit. We report the cases of two patients with unknown chronic renal insufficiency who developed severe encephalopathy after ingestion of star fruit. The two patients developed intractable hiccups, vomiting, impaired consciousness and status epilepticus. Diffusion-weighted MR imaging showed cortical and thalamic hyperintense lesions related to epileptic status. They improved after being submitted to continuous hemofiltration which constitutes the most effective treatment during the acute phase.

Negative Pressure Pulmonary Edema Following use of Laryngeal Mask Airway (LMA

Directory of Open Access Journals (Sweden)

Yesim Bayraktar

2013-06-01

Full Text Available Negative pressure pulmonary edema (NPPE following upper airway obstruction is a non-cardiogenic pulmonary edema. The first cause in the etiology of NPPE is developed laryngospasm after intubation or extubation, while the other causes are epiglotitis, croup, hiccups, foreign body aspiration, pharyngeal hematoma and oropharyngeal tumors.The Late diagnosis and treatment causes high morbidity and mortality. The protection of the airway and maintainance of arterial oxygenation will be life saving.In this article we aimed to report  a case of negative pressure pulmonary edema, resolved succesfully after treatment, following use of laryngeal mask airway (LMA.

Treatment of singultus by sexual stimulation: Who was George T Dexter, MD (c1812-?)?

Science.gov (United States)

Petroianu, Georg A

2016-05-01

This short report attempts to shed light on the interesting but controversial personality of George T Dexter (ca1812 -?), the physician who first described manipulation of the female genitalia in a hysterical impressionable girl as being associated with the termination of singultus. Although his interaction with the young female patient would not meet today's ethical standards, his medical observation was valid and contributes to our understanding of the pathophysiology of singultus. He was well ahead of his colleagues who presented hiccup therapy case reports with similar or related pathophysiology mechanisms some 150 years later. © IMechE 2014.

Upper gastrointestinal symptoms in patients with advanced cancer: relationship to nutritional and performance status.

Science.gov (United States)

Bovio, G; Montagna, G; Bariani, C; Baiardi, P

2009-10-01

The goals of the study were to determine the relationship of upper gastrointestinal symptoms with nutritional status and to assess their association with performance status in patients with advanced cancer. We studied 143 patients (50 F, 93 M, mean age 68 +/- 11 years, mean body mass index 22.39 +/- 4.3 kg/m(2)). Assessed symptoms were the following: anorexia, nausea, vomiting, dysphagia for solids, dysphagia for liquids, xerostomia, hypogeusia, dysgeusia, hiccup and chewing disturbances. We determined anthropometric parameters, daily energy intake and serum albumin, prealbumin and transferrin. The most common upper gastrointestinal symptoms were xerostomia (73%), anorexia (49%) and chewing disturbances (40%). Fifty-four percent of patients had weight loss greater than 10%. Seventy-three patients (51%) had daily energy intake lower than their resting energy expenditure. Mean serum prealbumin, albumin and transferrin were below normal range. Mean Eastern Cooperative Oncology Group performance status scale was 3.1 +/- 0.49. Symptoms were often strongly correlated, and usually, patients experienced at least three upper gastrointestinal symptoms at the same time. Anorexia, nausea and vomiting were the symptoms mostly correlated with other symptoms. A correlation was found between vomiting and hiccup. Energy intake (EI) was the nutritional parameter mostly affected by upper gastrointestinal symptoms; moreover, EI is the most predictive factor of upper gastrointestinal symptoms, particularly xerostomia, anorexia and dysphagia for solids. Upper gastrointestinal symptoms are linked to nutritional parameters: In particular, energy intake represents the most predictive variable of symptom occurrence. The performance status is not affected by upper gastrointestinal symptoms. A rigorous nutritional assessment and the managing of upper gastrointestinal symptoms are crucial in patients with advanced cancer.

Membranous nephropathy with Neuromyelitis optica spectrum disorder.

Science.gov (United States)

Li, Xiangling; Wang, YanQiang

2017-07-01

Membranous nephropathy (MN) accompanying Neuromyelitis optica spectrum disorders (NMOSD) has rarely been described previously. We recently presented a 45-year-old Chinese male presenting with recurrent lower extremity pitting edema, or eyelid edema, proteinuria and hyperlipidemia. especially intractable hiccup and vomiting, painful tonic spasm (PTS) as the revealing symptom of a demyelinating disorder of central nervous system. The kindey biopsy specimen showed MN stage 2. Serological testing revealed antibodies AQP4, MRI head and spine revealed medulla oblongata and C1-C2 cervical vertebra lesions. Treatment with methylprednisolone, cyclophosphamide, azathioprine resulted in consistent clinical improvement. Copyright © 2017 Elsevier B.V. All rights reserved.

TINY HICCUPS TO TITANIC EXPLOSIONS: Tackling Transients in Anomalous X-ray Pulsars

Science.gov (United States)

Kaspi, Victoria

2011-09-01

The past decade has seen major progress in neutron star astrophysics, with the discovery of magnetars in general, and the recognition that the Anomalous X-ray Pulsars (AXPs) fall in this class. AXPs have recently revealed surprising and dramatic variability behavior, which theorists have begun to show are highly constraining of physical models of magnetars, including their crusts, atmospheres, coronae and magnetospheres. In this proposal, we request Chandra/ACIS-S Target-of-Opportunity observations of one major Anomalous X-ray Pulsar (AXP) outburst in AO13, in order to study in detail the evolution of the spectrum, pulsed fraction and pulse profile, for quantitative confrontation with recently developed models for the structure and electrodynamics of magnetars.

Primary extragonadal germinoma of the medulla oblongata.

Science.gov (United States)

Nakatsuka, Shin-ichi; Tateishi, Akihiro; Nagano, Teruaki; Kimura, Hayato; Nakajo, Kazuya; Takahashi, Jun; Taki, Takuyu

2012-06-01

Extragonadal germ cell tumors rarely arise from the brain stem. In this report, the authors present a rare case of germinoma developing in the medulla oblongata. A 31-year-old woman complained of intractable hiccups, hoarseness, and swallowing disturbance. Magnetic resonance imaging showed a tumor located on the dorsal part of the medulla oblongata without any abnormalities in the pineal body and suprasellar regions. Histological diagnosis of surgically resected tumor was germinoma. Tumor cells were positive for alkaline phosphatase, c-kit, octamer-binding transcription factor 3/4, cytokeratin, and epithelial membrane antigen in immunohistochemistry. The patient received adjuvant chemotherapy and irradiation to the residual tumor and cerebral ventricles. The patient is alive without recurrence 6 months after the surgery.

An update on the evidence for the efficacy and safety of rituximab in the management of neuromyelitis optica

Science.gov (United States)

Collongues, Nicolas; de Seze, Jérôme

2016-01-01

Neuromyelitis optica spectrum disorders (NMOSDs) is a new concept which includes classical neuromyelitis optica (NMO) and partial forms of NMO such as recurrent optic neuritis with positive aquaporin-4 antibodies (AQP4) or brainstem symptoms (intractable hiccups or vomiting). This disease is clearly distinguished from multiple sclerosis (MS) and the therapeutic approach is clearly different. Rituximab is actually considered to be one of the most efficient treatments of NMOSD, even if class I studies are clearly lacking. In the present review, we describe the state of the art about rituximab treatment in NMOSD, including adults and children, plus its efficacy and tolerance and we also underline the questions that should be addressed in the near future. PMID:27134673

An update on the evidence for the efficacy and safety of rituximab in the management of neuromyelitis optica.

Science.gov (United States)

Collongues, Nicolas; de Seze, Jérôme

2016-05-01

Neuromyelitis optica spectrum disorders (NMOSDs) is a new concept which includes classical neuromyelitis optica (NMO) and partial forms of NMO such as recurrent optic neuritis with positive aquaporin-4 antibodies (AQP4) or brainstem symptoms (intractable hiccups or vomiting). This disease is clearly distinguished from multiple sclerosis (MS) and the therapeutic approach is clearly different. Rituximab is actually considered to be one of the most efficient treatments of NMOSD, even if class I studies are clearly lacking. In the present review, we describe the state of the art about rituximab treatment in NMOSD, including adults and children, plus its efficacy and tolerance and we also underline the questions that should be addressed in the near future.

Intoxication by star fruit (Averrhoa carambola) in six dialysis patients? (Preliminary report)

Science.gov (United States)

Neto, M M; Robl, F; Netto, J C

1998-03-01

We observed six cases of patients in a dialysis programme who were apparently intoxicated by ingestion of star fruit. After ingestion of 2-3 fruits or 150-200 ml of the fruit juice, the six patients, who had previously been stable in a regular dialysis programme, developed a variety of symptoms ranging from insomnia and hiccups to agitation, mental confusion and (in one case) death. In preliminary investigations to characterize the hypothetical neurotoxin in the fruit, an extract, when injected intraperitoneally or intracerebroventricularly in rats, provoked persistent convulsions of the tonic-clonic type. It appears that star fruit (Averrhoa carambola) contains an excitatory neurotoxin. Patients with renal failure on conservative or dialysis treatment should be dissuaded from ingestion of the fruit.

[A case of mFOLFOX6-induced lactic acidosis in a patient with colon cancer].

Science.gov (United States)

Ito, Atene; Kawamoto, Kazuyuki; Park, Taebun; Ito, Tadashi

2014-11-01

Leucovorin calcium, 5-fluorouracil, and oxaliplatin (FOLFOX) therapy is a standard chemotherapy regimen used to treat colorectal cancer. Peripheral nerve disorder and myelosuppression are frequently reported treatment-related adverse events. With modified FOLFOX6 (mFOLFOX6) therapy, adverse events of an altered mental state with reversible posterior leukoencephalopathy and hypoammonemia have been reported, while lactic acidosis is uncommon. We describe a case of mFOLFOX6 - induced lactic acidosis in a 64-year-old man with colorectal cancer who underwent pelvic exenteration following chemotherapy. Postoperative histopathological analysis revealed residual cancer. Following the commencement of mFOLFOX6 therapy, the patient experienced emesis, hiccupping, and an altered mental state. Laboratory testing revealed only severe lactic acidosis, while diagnostic imaging was unrevealing. All symptoms quickly improved upon the administration of intravenous infusion of sodium bicarbonate.

Postoperative singultus: an osteopathic approach.

Science.gov (United States)

Petree, Kristie; Bruner, Jonathan

2015-03-01

Singultus, or hiccups, is a common medical condition. Despite exponential leaps in medicine, the pathophysiologic cause remains poorly defined. Persistent singultus has been associated with conditions such as pulmonary embolism and myocardial infarction. Singultus is also a well-known postoperative complication. The criterion standard of care for patients with singultus involves ruling out lethal pathologic causes, attempting physical stimulation with Valsava maneuvers or drinking water, and, if no relief has been achieved, administering drugs to ease the symptoms. The authors report a case of a man whose postoperative singultus was successfully managed with osteopathic manipulative treatment. This approach addresses many of the possible underlying neuromechanical causes of the aberrant reflex with minimal potential for adverse effects. Physicians should consider osteopathic manipulative treatment in the care of patients with singultus. © 2015 The American Osteopathic Association.

ECG movement artefacts can be greatly reduced with the aid of a movement absorbing device

DEFF Research Database (Denmark)

Harrison, Adrian Paul; Wandall, Kirsten; Thorball, Jørgen

2007-01-01

Accurate ECG signal analysis can be confounded by electric lead, and/or electrode movements varying in origin from, for example, hiccups, tremor or patient restlessness. ECG signals recorded using either a conventional electrode holder or with the aid of an electrode holder capable of absorbing...... movement artefacts, were measured on a healthy human subject. Results show a greatly improved stability of the ECG signal recorded using an electrode holder capable of absorbing movement artefacts during periods of lead disturbance, and highlight the movement artefacts that develop when the recording lead...... of a conventional ECG electrode holder is tugged or pulled during theperiod of monitoring. It is concluded that the new design of ECG electrode holder will not only enable clearer signal recordings for clinical assessment, but will reduce the ECG artefacts associated with the transportation of patients, and may...

UNITED KINGDOM: under pressure

International Nuclear Information System (INIS)

Anon.

1994-01-01

While attempting bravely to sustain the legacy left by J.J. Thomson, Rutherford, Chadwick, Cockcroft, Blackett, Dirac and others earlier this century, the United Kingdom, one of the major contributors to CERN, has suffered in recent years from an erosion of the international purchasing power of the pound sterling. At the same time, the national scientific community has squabbled over the apportionment of the research cake. In recent years, the CERN budget has remained constant in real terms, but the pound has drifted steadily down. In 1984 one pound bought 3.15 Swiss francs, now it gets just over 2. The hypersensitivity which left calculations at the mercy of exchange rate hiccups was cushioned in 1988 by a new method of calculating national CERN contributions, introduced by Chris Llewellyn Smith, now the Laboratory's Director General, using less sensitive input data

Halal Logistics Implementation in Malaysia: A Practical View

Science.gov (United States)

Sham, Rohana; Zuraidah Rasi, Raja; Abdamia, Noranita; Mohamed, Suhana; Thahira Bibi, TKM

2017-08-01

Concept of halal is not only acceptable world wide by the Muslim society but also to the non Muslim. However, the implementing of halal logistics in daily operation experience a few difficulties especially on the implementation part. Although there are many academic research paper that highlight the issue of halal logistics and the critical success factor, until today, halal logistics in Malaysia is still experiencing a hiccup. This paper try to highlight a few simple ways of implementation of halal logistics that could enhance the total implementation concept at the very least cost to create benefit to all society. The Paper deals with a few aspect of possible implementation and practice to facilitate the halal logistics approach in daily operation. The main objective is to look at the possible method of implementation and critical success factors towards the implementation of halal logistics operation in daily goods movement in Malaysia.

Dextromethorphan in the treatment of early myoclonic encephalopathy evolving into migrating partial seizures in infancy

Directory of Open Access Journals (Sweden)

Yin-Hsuan Chien

2012-05-01

Full Text Available Epileptic encephalopathy with suppression-burst in electroencephalography (EEG can evolve into a few types of epileptic syndromes. We present here an unusual case of early myoclonic encephalopathy that evolved into migrating partial seizures in infancy. A female neonate initially had erratic myoclonus movements, hiccups, and a suppression-burst pattern in EEG that was compatible with early myoclonic encephalopathy. The seizures were controlled with dextromethorphan (20 mg/kg, and a suppression-burst pattern in EEG was reverted to relatively normal background activity. However, at 72 days of age, alternating focal tonic seizures, compatible with migrating partial seizures in infancy, were demonstrated by the 24-hour EEG recording. The seizures responded poorly to dextromethorphan. To our knowledge, this is the first reported case of early myoclonic encephalopathy evolving into migrating partial seizure in infancy. Whether it represents another age-dependent epilepsy evolution needs more clinical observation.

Conclusive evidence of abrupt coagulation inside the void during cyclic nanoparticle formation in reactive plasma

International Nuclear Information System (INIS)

Wetering, F. M. J. H. van de; Nijdam, S.; Beckers, J.

2016-01-01

In this letter, we present scanning electron microscopy (SEM) results that confirm in a direct way our earlier explanation of an abrupt coagulation event as the cause for the void hiccup. In a recent paper, we reported on the fast and interrupted expansion of voids in a reactive dusty argon–acetylene plasma. The voids appeared one after the other, each showing a peculiar, though reproducible, behavior of successive periods of fast expansion, abrupt contraction, and continued expansion. The abrupt contraction was termed “hiccup” and was related to collective coagulation of a new generation of nanoparticles growing in the void using relatively indirect methods: electron density measurements and optical emission spectroscopy. In this letter, we present conclusive evidence using SEM of particles collected at different moments in time spanning several growth cycles, which enables us to follow the nanoparticle formation process in great detail.

NEONATAL ABSTINENCE SYNDROME - CASE REPORT

Directory of Open Access Journals (Sweden)

Aleksandra Matic

2008-01-01

Full Text Available Neonatal abstinence syndrome (NAS refers to the constellation of signs and symptoms exhibited by a newborn of drug-abusing mother. NAS is multisystemic disorder, most frequently involving central nervous and gastrointestinal systems with irritability, high-pitched cry, hyperactive reflexes, increased muscle tone, tremors, generalized convulsions, feeding and sleeping disorders, tachycardia, tachypnea, apnea, termolability and sweating, frequent hiccups, yawning and sneezing, vomiting, diarrhea and dehydration.Intrauterine narcotic disposition can give some other adverse effects beside NAS: fetal distress, premature birth, intrauterine growth retardation, microcephaly, increased incidence of congenital anomalies (cardiac and genitourinary anomalies, cleft palate, biliar atresia. Significantly increased risks of sudden infant’s death syndrome (SIDS, abnormalities in neurocognitive and behavioral development and deficiency in motor functions have also been noticed after the long-term surveys of these children.This paper is a case report of a newborn with developed clinical signs of NAS, but it also discusses diagnostics and management of such cases

Ebola Virus Disease, Democratic Republic of the Congo, 2014.

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Nanclares, Carolina; Kapetshi, Jimmy; Lionetto, Fanshen; de la Rosa, Olimpia; Tamfun, Jean-Jacques Muyembe; Alia, Miriam; Kobinger, Gary; Bernasconi, Andrea

2016-09-01

During July-November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.

Comparative clinical characteristics of neuromyelitis optica spectrum disorders with and without medulla oblongata lesions.

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Wang, Yanqiang; Zhang, Lei; Zhang, Bingjun; Dai, Yongqiang; Kang, Zhuang; Lu, Ciyong; Qiu, Wei; Hu, Xueqiang; Lu, Zhengqi

2014-05-01

Brainstem involvement, especially the medulla oblongata (MO), has been reported in neuromyelitis optica spectrum disorders (NMOSDs). The purpose of this study was to investigate retrospectively and compare clinical, laboratory, and imaging features of NMOSDs with and without MO lesions. A total of 170 patients with NMOSDs were enrolled, including 44 patients with MO lesions and 126 patients without MO lesions. Clinical features, laboratory tests, and magnetic resonance imaging findings among these patients were assessed. MO lesions were found in 25.9 % of the NMOSDs patients. The mean duration was 13 months. Patients with MO lesions had a higher Annualized relapse rate and Expanded Disability Status Score Scale. Headache, dizziness, nystagmus, dysarthria, intractable hiccup and nausea, choking cough or dysphagia, movement disorders, and neuropathic pain were more common in MO lesion patients. Patients with MO lesions were more frequently complicated with thyroid diseases. Multiple brain involvement, More importantly, Longitudinally extensive transverse myelitis were more frequently found in patients with MO lesions. MO lesions might be a symbol of more severe neurologic deficits and worse prognosis of NMOSDs.

"Stray" achalasia: From gastroenterologist to pulmonologist and back

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Obradović Dušanka

2016-01-01

Full Text Available Introduction. Achalasia is a rare esophageal disorder which, due to frequent presence of both respiratory and gastrointestinal symptoms, can initially be referred either to pulmonologist or gastroenterologist. Case Outline. A 50-year-old patient was initially referred to gastroenterologist with the following symptoms: nausea, vomiting, occasional hiccups, weight loss, chest pain, dysphonia, and dry cough. After chest X-ray, the patient was referred to pulmonologist with differential diagnosis for pulmonary infiltration and thoracic aortic aneurysm. Pulmonologist interpreted chest X-ray as showing paratracheal mediastinal enlargement with air-fluid levels, thus suspecting achalasia. Computed tomography scan of the thorax with per os contrast showed extremely dilated esophagus with food stasis. The patient was then referred to thoracic surgeon, who ordered additional diagnostics (esophageal passage with contrast, esophagomanometry, esophagogastroduodenoscopy, and finally performed Heller myotomy. Postoperatively there were no complications, and the patient was symptom free during the follow-up. Conclusion. Although achalasia can also result in respiratory symptoms, fastidious anamnesis and accurate radiological interpretation are essential for the correct diagnosis.

LHC Report: Towards stable beams and collisions

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CERN Bulletin

2011-01-01

Over the past two weeks, the LHC re-commissioning with beam has continued at a brisk pace. The first collisions of 2011 were produced on 2 March, with stable beams and collisions for physics planned for the coming days. Low intensity beams with just a few bunches of particles were used to test the energy ramp to 3.5 TeV and the squeeze. The results were successful and, as a by-product, the first collisions of 2011 were recorded 2 March. One of the main activities carried out by the operation teams has been the careful set-up of the collimation system, and the injection and beam dump protection devices. The collimation system provides essential beam cleaning, preventing stray particles from impacting other elements of the machine, particularly the superconducting magnets. In addition to the collimation system, also the injection and beam dump protection devices perform a vital machine protection role, as they detect any beam that might be mis-directed during rare, but not totally unavoidable, hardware hiccups...

Epigastric Distress Caused by Esophageal Candidiasis in 2 Patients Who Received Sorafenib Plus Radiotherapy for Hepatocellular Carcinoma: Case Report.

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Chen, Kuo-Hsin; Weng, Meng-Tzu; Chou, Yueh-Hung; Lu, Yueh-Feng; Hsieh, Chen-Hsi

2016-03-01

Sorafenib followed by fractionated radiotherapy (RT) has been shown to decrease the phagocytic and candidacidal activities of antifungal agents due to radiosensitization. Moreover, sorafenib has been shown to suppress the immune system, thereby increasing the risk for candida colonization and infection. In this study, we present the 2 hepatocellular carcinoma (HCC) patients suffered from epigastric distress caused by esophageal candidiasis who received sorafenib plus RT. Two patients who had received sorafenib and RT for HCC with bone metastasis presented with hiccups, gastric ulcer, epigastric distress, anorexia, heart burn, and fatigue. Empiric antiemetic agents, antacids, and pain killers were ineffective at relieving symptoms. Panendoscopy revealed diffuse white lesions in the esophagus. Candida esophagitis was suspected. Results of periodic acid-Schiff staining were diagnostic of candidiasis. Oral fluconazole (150 mg) twice daily and proton-pump inhibitors were prescribed. At 2-weak follow-up, esophagitis had resolved and both patients were free of gastrointestinal symptoms. Physicians should be aware that sorafenib combined with RT may induce an immunosuppressive state in patients with HCC, thereby increasing their risk of developing esophagitis due to candida species.

Fiberoptic bronchoscopic treatment of blood aspiration and use of sugammadex in a patient with epistaxis

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Ryu, Taeha; Kim, Dong Hyuck; Byun, Sung Hye

2018-01-01

Abstract Rationale: In patients with oropharyngeal and nasopharyngeal bleeding, blood aspiration can make airway management difficult and lead to severe pulmonary complications. Patient concerns: A 44-year-old male patient with recurrent epistaxis underwent surgery for hemostasis. The patient aspirated blood through the endotracheal tube when he hiccupped during the surgery. Diagnosis: The patient was diagnosed with blood aspiration after intraoperative fiberoptic bronchoscopy revealed a blood clot and viscous mucus in the airways, but no sign of active bleeding. Interventions: Tracheobronchial suctioning and irrigation with normal saline was performed through the bronchoscope to remove the aspirated blood clot. Prior to emergence from anesthesia, sugammadex was administered to induce complete neuromuscular recovery and enable the patient to cough up any blood remaining in the airways. Outcomes: The patient was successfully extubated and fully recovered with no complications. Lessons: Blood aspiration due to oropharyngeal or nasopharyngeal bleeding can be diagnosed and treated by tracheobronchial suctioning via fiberoptic bronchoscopy. In addition, sugammadex can enable patients to recover spontaneous breathing, facilitate extubation, and enable patients to cough up any blood remaining in the airways. PMID:29642212

Moderate Versus Light Pressure Massage Therapy Leads to Greater Weight Gain in Preterm Infants

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Field, Tiffany; Diego, Miguel A.; Hernandez-Reif, Maria; Deeds, Osvelia; Figuereido, Barbara

2007-01-01

Sixty-eight preterm infants (M GA=3Owks.) were randomly assigned to a moderate or to a light pressure massage therapy group to receive 15 massages 3 times per day for 5 days. Behavior state, stress behaviors and heart rate were recorded for 15 minutes before and during the first 15-minute therapy session. Weight gain was recorded over the 5 day therapy period. The moderate versus light pressure massage group gained significantly more weight per day. During the behavior observations the moderate versus light pressure massage group showed significantly lower increases from the pre-session to the session recording on: 1) active sleep; 2) fussing; 3) crying; 4) movement; and 5) stress behavior (hiccupping). They also showed a smaller decrease in deep sleep, a greater decrease in heart rate and a greater increase in vagal tone. Thus, the moderate pressure massage therapy group appeared to be more relaxed and less aroused than the light pressure massage group which may have contributed to the greater weight gain of the moderate pressure massage therapy group. PMID:17138310

Autoimmune thyroiditis associated with neuromyelitis optica (NMO

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Sudulagunta, Sreenivasa Rao

2015-11-01

Full Text Available Neuromyelitis optica (NMO or Devic’s syndrome is a rare relapsing demyelinating disease of the central nervous system (CNS that mainly affects the spinal cord and optic nerves and shares many clinical and radiological features with multiple sclerosis. The association of NMO with other autoimmune diseases was reported, but very few reports described association with autoimmune thyroid disease. Early differentiation between NMO and multiple sclerosis is very important as the natural course and treatment regimens differ significantly. We report a case of a 50-year-old woman who was admitted initially with vomiting, hiccups and paraesthesias but was not diagnosed with NMO and presented with a severe progression of the disease. The patient was also diagnosed to have autoimmune thyroiditis with lymphocytic infiltration of the thyroid which progressed from hyperthyroidism to hypothyroidism. NMO diagnosis was established with seropositivity for NMO-IgG and MRI showing longitudinally extensive spinal cord lesions (3 or more spinal segments. In spite of treatment, the response was poor due to lack of early diagnosis and aggressive immunosuppressant therapy.

Post-Encephalitic Parkinsonism and Sleep Disorder Responsive to Immunological Treatment: A Case Report.

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Brunetti, Valerio; Testani, Elisa; Iorio, Raffaele; Frisullo, Giovanni; Luigetti, Marco; Di Giuda, Daniela; Marca, Giacomo Della

2016-10-01

We describe a 70-year-old man who, after a viral encephalitis associated with pneumonia, progressively developed a parkinsonism associated with lethargy. Encephalitis manifested with persistent hiccups, seizures and impairment of consciousness. After 2 weeks, the initial neurologic symptoms subsided and the patient progressively developed movement disorders (rigidity and bradykinesia, resistant to L-DOPA), lethargy and behavioral hypersomnia. Magnetic resonance imaging showed thalamic and hippocampal signal abnormalities, immunohistochemistry on a mouse brain substrate revealed serum autoantibodies binding to the brainstem neuropil. Polysomnographic monitoring was consistent with a very severe disruption of sleep: the sleep-wake cycle was fragmented, and the NREM-REM ultradian cycle was irregular. Intravenous immune globulin therapy resulted in the complete reversal of the movement and the sleep disorders. Our observation confirms that parkinsonism and sleep disorders may be consequences of encephalitis, that an immune-mediated pathogenesis is likely, and, consequently, that immunotherapy can be beneficial in these patients. The polysomnographic monitoring suggests that lethargia, rather than a mere hypersomnia, is the result of a combination between sleep disruption and altered motor control. © EEG and Clinical Neuroscience Society (ECNS) 2016.

Fatal outcome after ingestion of star fruit (Averrhoa carambola) in uremic patients.

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Chang, J M; Hwang, S J; Kuo, H T; Tsai, J C; Guh, J Y; Chen, H C; Tsai, J H; Lai, Y H

2000-02-01

Clinical outcome of dialysis patients after eating star fruit (Averrhoa carambola) varies, but it may be fatal. In the past 10 years, 20 such patients were treated in our hospital when they developed clinical symptoms after eating the fruit or drinking star fruit juice. Their initial presentations included sudden-onset limb numbness, muscle weakness, intractable hiccups, consciousness disturbance of various degrees, and seizure. No other major events that might be responsible for these symptoms could be identified. Eight patients died, including one patient with a serum creatinine level of 6.4 mg/dL who had not yet begun dialysis. The clinical manifestations of the survivors were similar to those who died except for consciousness disturbance and seizure. Death occurred within 5 days despite emergent hemodialysis and intensive medical care. The survivors' symptoms usually became less severe after supportive treatment, and these patients subsequently recovered without obvious sequelae. The purpose of this article is to report that patients with renal failure who ingest star fruit may develop neurological symptoms and also run the risk for death in severe cases. Mortality may also occur in patients with chronic renal failure not yet undergoing dialysis.

Midazolam conscious sedation in a large Danish municipal dental service for children and adolescents.

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Uldum, Birgitte; Hallonsten, Anna-Lena; Poulsen, Sven

2008-07-01

The aim of this study was to describe the introduction and the first six years use of midazolam for conscious sedation in a municipal dental service in Denmark. In 1998, all dentists were introduced to midazolam conscious sedation. A sedation chart was filled in for each session, and parents' assessment was obtained. In 2004, all clinical materials were collected. Six hundred and eighty sessions were performed; 63.7% of the children were between 2 and 6 years of age; 88.5% belonged to American Society of Anesthesiologists grade 1; 74.8% of the sedations performed used the oral route of administration. Restorations were performed during 60.3% of the sessions, and extractions during 38.4%. Complications during the sessions were rare, the most frequent being double vision (6.1%), hiccups (2.7%), and paradoxical reaction (2.0%). Using Wilton's sedation scale, 42.9% were calm and 27.7% were agitated during treatment, whereas after treatment 61.7% were calm; 80.4% of the parents were very positive towards this sedation method. Sedation with midazolam for dental treatment of children with dental fear and anxiety is a feasible and an efficient method with a low rate of complications. It can probably reduce the need for dental treatment under general anaesthesia.

Typical and atypical clinical presentation of uterine myomas

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Wen-Hsiang Su

2012-10-01

Full Text Available Myoma is the most common benign neoplasm that can occur in the female reproductive system, most frequently seen in women in their 50s. Although the majority of myomas are asymptomatic, some patients have symptoms and/or signs of varying degrees. Typical myoma-related symptoms or signs include: (1 menstrual disturbances like menorrhagia, dysmenorrhea and intermenstrual bleeding, (2 pelvic pain unrelated to menstruation, (3 compression symptoms, similar to a sensation of bloatedness, urinary frequency and constipation, (4 subfertility status such as recurrent abortion, preterm labor, dystocia with an increased incidence of Cesarean section, and postpartum hemorrhage, and (5 cosmetic problems due to increased abdominal girth However, there are undoubtedly some clinical presentations secondary to uterine myomas are not so specific, such as: (1 uncommon compression-related symptoms, (2 cardiac symptom and atypical symptoms secondary to vascular involvement or dissemination, (3 abdominal symptoms mimicking pelvic carcinomatosis, (4 dyspnea, (5 pruritus, (6 hiccup or internal bleeding, and (7 vaginal protruding mass or uterine inversion. Familiarization with these symptoms and awareness of other unusual or atypical presentations of uterine myomas will remind clinical practitioners of their significance, and of the necessity of follow-up examinations and individualized management to fit the needs and childbirth desires of the patients.

High survival rates and associated factors among ebola virus disease patients hospitalized at donka national hospital, conakry, Guinea.

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Qureshi, Adnan I; Chughtai, Morad; Bah, Elhadj Ibrahima; Barry, Moumié; Béavogui, Kézély; Loua, Tokpagnan Oscar; Malik, Ahmed A

2015-02-01

Anecdotal reports suggesting that survival rates among hospitalized patients with Ebola virus disease in Guinea are higher than the 29.2% rate observed in the current epidemic in West Africa. Survival after symptom onset was determined using Kaplan Meier survival methods among patients with confirmed Ebola virus disease treated in Conakry, Guinea from March 25, 2014, to August 5, 2014. We analyzed the relationship between survival and patient factors, including demographics and clinical features. Of the 70 patients analyzed [mean age ± standard deviation (SD), 34 ± 14.1; 44 were men], 42 were discharged alive with a survival rate among hospitalized patients of 60% (95% confidence interval, 41.5-78.5%). The survival rate was 28 (71.8%) among 39 patients under 34 years of age, and 14 (46.7%) among 30 patients aged 35 years or greater (p = 0.034). The rates of myalgia (3 of 42 versus 7 of 28, p = 0.036) and hiccups (1 of 42 versus 5 of 28, p = 0.023) were significantly lower among patients who survived. Our results provide insights into a cohort of hospitalized patients with Ebola virus disease in whom survival is prominently higher than seen in other cohorts of hospitalized patients.

Neurotoxicity following the Ingestion of Bilimbi Fruit (Averrhoa bilimbi) in an End-Stage Renal Disease Patient on Hemodialysis.

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Caetano, Camille Pereira; de Sá, Cinara Barros; Faleiros, Bruno Antônio Paixão; Gomes, Marcelo Fonseca Coutinho Fernandes; Pereira, Edna Regina Silva

2017-01-01

The toxic effects of the ingestion of star fruit (Averrhoa carambola) in chronic kidney disease patients are well described in the literature. Recently, the compound caramboxin has been isolated, explaining the mechanisms of its neurotoxicity. Bilimbi fruit belongs to the family Oxalidaceae, Averrhoa bilimbi species, and exhibits similar biochemical characteristics to star fruit. To report the case of a patient with chronic kidney disease who developed a seizure disorder after the ingestion of bilimbi fruit. A 69-year-old man with chronic kidney disease on hemodialysis therapy had intractable hiccups, myoclonus, and generalized tonic-clonic seizures after the consumption of a moderate amount of bilimbi fruit. The electroencephalogram showed a pattern of seizure disorder despite the use of anticonvulsant drugs. Renal replacement therapy was maintained during the whole period and prescribed according to the patient's hemodynamic status. Despite showing clinical resolution of the seizure disorder, the patient died on the 27th day of hospitalization for infectious complications. The neurologic status without any other known cause and with clear temporal association with the ingestion of the fruit suggests the diagnosis of neurotoxicity. We propose the hypothesis that the bilimbi fruit has neurotoxic effects similar to those exhibited by the star fruit.

With hiccups and bumps: the development of a Rasch-based instrument to measure elementary students' understanding of the nature of science.

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Peoples, Shelagh M; O'Dwyer, Laura M; Shields, Katherine A; Wang, Yang

2013-01-01

This research describes the development process, psychometric analyses and part validation study of a theoretically-grounded Rasch-based instrument, the Nature of Science Instrument-Elementary (NOSI-E). The NOSI-E was designed to measure elementary students' understanding of the Nature of Science (NOS). Evidence is provided for three of the six validity aspects (content, substantive and generalizability) needed to support the construct validity of the NOSI-E. A future article will examine the structural and external validity aspects. Rasch modeling proved especially productive in scale improvement efforts. The instrument, designed for large-scale assessment use, is conceptualized using five construct domains. Data from 741 elementary students were used to pilot the Rasch scale, with continuous improvements made over three successive administrations. The psychometric properties of the NOSI-E instrument are consistent with the basic assumptions of Rasch measurement, namely that the items are well-fitting and invariant. Items from each of the five domains (Empirical, Theory-Laden, Certainty, Inventive, and Socially and Culturally Embedded) are spread along the scale's continuum and appear to overlap well. Most importantly, the scale seems appropriately calibrated and responsive for elementary school-aged children, the target age group. As a result, the NOSI-E should prove beneficial for science education research. As the United States' science education reform efforts move toward students' learning science through engaging in authentic scientific practices (NRC, 2011), it will be important to assess whether this new approach to teaching science is effective. The NOSI-E can be used as one measure of whether this reform effort has an impact.

The Unusual Minimum of Cycle 23: Observations and Interpretation

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Martens, Petrus C.; Nandy, D.; Munoz-Jaramillo, A.

2009-05-01

The current minimum of cycle 23 is unusual in its long duration, the very low level to which Total Solar Irradiance (TSI) has fallen, and the small flux of the open polar fields. The deep minimum of TSI seems to be related to an unprecedented dearth of polar faculae, and hence to the small amount of open flux. Based upon surface flux transport models it has been suggested that the causes of these phenomena may be an unusually vigorous meridional flow, or even a deviation from Joy's law resulting in smaller Joy angles than usual for emerging flux in cycle 23. There is also the possibility of a connection with the recently inferred emergence in polar regions of bipoles that systematically defy Hale's law. Much speculation has been going on as to the consequences of this exceptional minimum: are we entering another global minimum, is this the end of the 80 year period of exceptionally high solar activity, or is this just a statistical hiccup? Dynamo simulations are underway that may help answer this question. As an aside it must be mentioned that the current minimum of TSI puts an upper limit in the TSI input for global climate simulations during the Maunder minimum, and that a possible decrease in future solar activity will result in a very small but not insignificant reduction in the pace of global warming.

Comparison of the clinical symptoms of myocardial infarction in the middle-aged and elderly

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Behzad Taghipour

2014-08-01

Full Text Available Background: Myocardial infarction is a fatal symbol of cardiovascular diseases, which usually occurs in people over 45 years. However, the incidence of factors such as obesity, high blood pressure, diabetes and metabolic syndrome has increased the risk of developing early cardiovascular diseases in the middle-aged people. This study was conducted to compare the clinical manifestation of myocardial infarction in the middle-aged and elderly people. Methods: In this cross-sectional study, the participants were 366 patients less and more than 55 years old with acute myocardial infarction admitted to the CCU of Imam Reza Hospital in Amol. Data were collected using demographic form and a checklist of clinical symptoms. Statistical analysis was performed by SPSS (version 20 using descriptive statistics, chi-square, odds ratio and the Mantel-Haenszel (α= 0.05 and d=0.3. Results: The results showed that patients over 55 years manifested the symptoms of shortness of breath (1.66, weakness (2.62, vomiting (1.98 and hiccups (2.19 more than the patients under55 years. Also, by controlling the confounding effect of gender, these symptoms had emerged in >55 year-old patients than in <55 year-old ones. Conclusion: According to the results, the elderly patients have more chance of manifesting nonspecific symptoms. Therefore, the healthcare providers, especially nurses should be more careful in this regard during the initial assessment.

Success rate of IR midazolam sedation in combination with C-CLAD in pediatric dental patients—a prospective observational study

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Malka Ashkenazi

2014-03-01

Full Text Available Objective. To evaluate the success rate of intra-rectal (IR midazolam in combination with nitrous oxide/oxygen (N2O sedation in young uncooperative dental patients when the local anesthesia is delivered by a computerized controlled local anesthetic delivery (C-CLAD.Study Design. This observational study consisted of 219 uncooperative children (age: 4.3 ± 1.69 y who received IR midazolam (0.4 mg/kg and N2O to complete their dental treatment. Measured variables included: child’s pain disruptive behavior during delivery of anesthesia by C-CLAD (CHEOP Scale, child behavior during treatment (Houpt scale, dental procedure performed, and side effects that appeared during treatment.Results. There was a high level of cooperation (mean score: 6.69 ± 2.1 during administration of local anesthesia. Good-to-excellent behavior was shown by 87% of the children during treatment. Planned treatment was completed by 184 (92% patients. No statistically significant changes were noticed in the oxygen saturation levels before and after treatment. Children with side effects included 3 (1.3% with nistagmus, 5 (2.3% with diplopia, and 18 (8.2% with hiccups. Three consecutive sedations decreased the overall behavior score by 5.7% compared to the first appointment (p < .05.Conclusions. IR midazolam-N2O sedation in combination with C-CLAD is very effective for delivery of dental treatment to young uncooperative children.

Spectrum of pediatric neuromyelitis optica.

Science.gov (United States)

Lotze, Timothy E; Northrop, Jennifer L; Hutton, George J; Ross, Benjamin; Schiffman, Jade S; Hunter, Jill V

2008-11-01

Our goal was to describe the spectrum of clinical phenotypes, laboratory and imaging features, and treatment in pediatric patients with neuromyelitis optica. The study consisted of a retrospective chart review of patients followed in a pediatric multiple sclerosis center with a diagnosis of neuromyelitis optica spectrum disorder. Nine patients with neuromyelitis optica spectrum disorders were included, all of whom were female. There were 4 black children, 2 Latin American children, 2 white children, and 1 child of mixed Latin American/white heritage. Median age at initial attack was 14 years (range: 1.9-16 years). Median disease duration was 4 years (range: 0.6-9 years). Tests for neuromyelitis optica immunoglobulin G were positive for 7 patients. Eight patients had transverse myelitis and optic neuritis, and 1 patient had longitudinally extensive transverse myelitis without optic neuritis but had a positive neuromyelitis optica immunoglobulin G antibody titer. Cerebral involvement on MRI was found in all subjects, 5 of whom were symptomatic with encephalopathy, seizures, hemiparesis, aphasia, vomiting, or hiccups. Immunosuppressive therapy reduced attack frequency and progression of disability. Pediatric neuromyelitis optica has a diverse clinical presentation and may be difficult to distinguish from multiple sclerosis in the early stages of the disease. The recognition of the broad spectrum of this disease to include signs and symptoms of brain involvement is aided by the availability of a serum biomarker: neuromyelitis optica immunoglobulin G. Early diagnosis and immunosuppresive treatment may help to slow the accumulation of severe disability.

In Vitro Propagation and Conservation of Inula racemosa Hook. F. an Endangered Medicinal Plant of Temperate Origin

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R. Kaur

2010-07-01

Full Text Available Inula racemosa is an endangered medicinal plant. It is commonly known as Pushkarmool, Pushkar and Manu. The great sage Charaka has characterized it as Hikka magrahana (stops hiccups and Savasahara (helpful in asthma. Also, he has cited it as the best medicament for pleurisy along with cough and asthma (http://enwikipedia.org/wiki/charaka-samhita. Due to the fragile nature of its habitat and exploitation due to its commercial medicinal properties, the species are facing the onslaught of indiscriminate over-exploitation. So far, this plant has not got the required attention from researchers, hence, except for a few efforts, not much work has been done for its cultivation and conservation. Plant tissue culture offers an attractive and quick method for its multiplication and further conservation. In the present investigation, effective procedures for micropropagation and in vitro conservation by vitrification were developed. In vitro propagation using aseptically grown seedlings and in vitro conservation via vitrification were standardized. The in vitro conserved material could be retrieved and multiplied normally on MS (Murashige and Skoog, 1962 medium fortified with 1.00 mg l-1BA (benzyl adenine which has been recorded as the best performing medium for in vitro shoot multiplication. The conserved shoots showed normal in vitro propagation and after retrieval from vitrification, platelets were hardened and successfully established in the experimental fields under Nauni (Solan, HP conditions at an elevation of around 1275 meters above mean sea level.

Ebola outbreak in Conakry, Guinea: epidemiological, clinical, and outcome features.

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Barry, M; Traoré, F A; Sako, F B; Kpamy, D O; Bah, E I; Poncin, M; Keita, S; Cisse, M; Touré, A

2014-12-01

The authors studied the epidemiological, clinical, and outcome features of the Ebola virus disease in patients hospitalized at the Ebola treatment center (ETC) in Conakry to identify clinical factors associated with death. A prospective study was conducted from March 25 to August 20, 2014. The diagnosis of Ebola virus infection was made on real-time PCR. Ninety patients, with a positive test result, were hospitalized. Their mean age was 34.12±14.29 years and 63% were male patients. Most worked in the informal sector (38%) and in the medical and paramedical staff (physicians 12%, nurses 6%, and laboratory technicians 1%). Most patients lived in the Conakry suburbs (74%) and in Boffa (11%). The main clinical signs were physical asthenia (80%) and fever (72%). Hemorrhagic signs were observed in 26% of patients. The comparison of clinical manifestations showed that hiccups (P=0.04), respiratory distress (P=0.04), and hemorrhagic symptoms (P=0.01) were more frequent among patients who died. Malaria (72%) and diabetes (2%) were the most frequent co-morbidities. The crude case fatality rate was 44% [95% confidence interval (33-54%)]. The average hospital stay was 7.96±5.81 days. The first Ebola outbreak in Conakry was characterized by the young age of patients, discrete hemorrhagic signs related to lethality. Its control relies on a strict use of preventive measures. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Issues and concerns in nanotech product development and its commercialization.

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Kaur, Indu Pal; Kakkar, Vandita; Deol, Parneet Kaur; Yadav, Monika; Singh, Mandeep; Sharma, Ikksheta

2014-11-10

The revolutionary and ubiquitous nature of nanotechnology has fetched it a considerable attention in the past few decades. Even though its enablement and application to various sectors including pharmaceutical drug development is increasing with the enormous government aided funding for nanotechnology-based products, however the parallel commercialization of these systems has not picked up a similar impetus. The technology however does address the unmet needs of pharmaceutical industry, including the reformulation of drugs to improve their solubility, bioavailability or toxicity profiles as observed from the wide array of high-quality research publications appearing in various scientific journals and magazines. Based on our decade-long experience in the field of nanotech-based drug delivery systems and extensive literature survey, we perceive that the major hiccups to the marketing of these nanotechnology products can be categorized as 1) inadequate regulatory framework; 2) lack of support and acceptance by the public, practicing physician, and industry; 3) developmental considerations like scalability, reproducibility, characterization, quality control, and suitable translation; 4) toxicological issues and safety profiles; 5) lack of available multidisciplinary platforms; and, 6) poor intellectual property protection. The present review dwells on these issues elaborating the trends followed by the industry, regulatory role of the USFDA and their implication, and the challenges set forth for a successful translation of these products from the lab and different clinical phases to the market. Copyright © 2014 Elsevier B.V. All rights reserved.

Medicinal and cosmetic uses of Bee's Honey - A review.

Science.gov (United States)

Ediriweera, E R H S S; Premarathna, N Y S

2012-04-01

Bee's honey is one of the most valued and appreciated natural substances known to mankind since ancient times. There are many types of bee's honey mentioned in Ayurveda. Their effects differ and 'Makshika' is considered medicinally the best. According to modern scientific view, the best bee's honey is made by Apis mellifera (Family: Apidae). In Sri Lanka, the predominant honey-maker bee is Apis cerana. The aim of this survey is to emphasize the importance of bee's honey and its multitude of medicinal, cosmetic and general values. Synonyms, details of formation, constitution, properties, and method of extraction and the usages of bee's honey are gathered from text books, traditional and Ayurvedic physicians of Western and Southern provinces, villagers of 'Kalahe' in Galle district of Sri Lanka and from few search engines. Fresh bee's honey is used in treatment of eye diseases, throat infections, bronchial asthma, tuberculosis, hiccups, thirst, dizziness, fatigue, hepatitis, worm infestation, constipation, piles, eczema, healing of wounds, ulcers and used as a nutritious, easily digestible food for weak people. It promotes semen, mental health and used in cosmetic purposes. Old bee's honey is used to treat vomiting, diarrhea, rheumatoid arthritis, obesity, diabetes mellitus and in preserving meat and fruits. Highly popular in cosmetic treatment, bee's honey is used in preparing facial washes, skin moisturizers, hair conditioners and in treatment of pimples. Bee's honey could be considered as one of the finest products of nature that has a wide range of beneficial uses.

Clearly delineated lesion in a case of Wallenberg's syndrome by magnetic resonance imaging

International Nuclear Information System (INIS)

Okumiya, Noriya; Yamaguchi, Takenori; Miyashita, Takeshi; Kozuka, Takahiro

1985-01-01

Diagnosis of Wallenberg's syndrome has been made by typical neurological symptoms and signs which are compatible with those of lesion in the lateral aspect of medulla oblongata. Although X-ray CT is an extraordinary useful measure for detecting lesions in the central nervous system, brainstem lesion is difficult to be evaluated by it because of varieties of artifact. A recent advance in techniques of magnetic resonance imaging (MRI) made it possible to produce fairly good images of infratentorial structure without artifact. But, there are no reports on patients with Wallenberg's syndrome whose lesion was clearly delineated by MRI. A 44 year-old man with a history of hypertension was referred to our hospital because of vertigo, pain on the right side of the face, disturbance of swallowing and hiccup 22 days after onset. On admission, neurological examination revealed right Horner's sign, decreased gag reflex and cerebellar ataxia on the right side, and dissociated sensory impairment on the right side of the face and left extremities. Clinical diagnosis of Wallenberg's syndrome was made, but X-ray CT showed no definite lesion in the infratentorial structure. Cerebral angiography revealed occlusion of the right vertebral artery without reflux of contrast media from the left vertebral artery. Then, there was no visualization of the right posterior inferior cerebellar artery. MRI using Magnetom (0.35 Tesla of static magnetic field produced by superconducting magnet) clearly delineated low intensity area in the right lateral aspect of the medulla oblongata. This is the first case of Wallenberg's syndrome whose anatomical lesion was demonstrated by MRI. (author)

Adiabatic pipelining: a key to ternary computing with quantum dots

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Pečar, P.; Ramšak, A.; Zimic, N.; Mraz, M.; Lebar Bajec, I.

2008-12-01

The quantum-dot cellular automaton (QCA), a processing platform based on interacting quantum dots, was introduced by Lent in the mid-1990s. What followed was an exhilarating period with the development of the line, the functionally complete set of logic functions, as well as more complex processing structures, however all in the realm of binary logic. Regardless of these achievements, it has to be acknowledged that the use of binary logic is in computing systems mainly the end result of the technological limitations, which the designers had to cope with in the early days of their design. The first advancement of QCAs to multi-valued (ternary) processing was performed by Lebar Bajec et al, with the argument that processing platforms of the future should not disregard the clear advantages of multi-valued logic. Some of the elementary ternary QCAs, necessary for the construction of more complex processing entities, however, lead to a remarkable increase in size when compared to their binary counterparts. This somewhat negates the advantages gained by entering the ternary computing domain. As it turned out, even the binary QCA had its initial hiccups, which have been solved by the introduction of adiabatic switching and the application of adiabatic pipeline approaches. We present here a study that introduces adiabatic switching into the ternary QCA and employs the adiabatic pipeline approach to successfully solve the issues of elementary ternary QCAs. What is more, the ternary QCAs presented here are sizewise comparable to binary QCAs. This in our view might serve towards their faster adoption.

Lateral medullary infarction with cardiovascular autonomic dysfunction: an unusual presentation with review of the literature.

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Huynh, Tridu R; Decker, Barbara; Fries, Timothy J; Tunguturi, Ajay

2018-01-24

We report an unusual case of lateral medullary infarction presenting with orthostatic hypotension with pre-syncope without vertigo or Horner's syndrome. Case report with review of the literature. A 67-year-old man presented with pre-syncope and ataxia without vertigo. Initial brain CT and MRI were normal. Neurological evaluation revealed right-beating nystagmus with left gaze, vertical binocular diplopia, right upper-extremity dysmetria, truncal ataxia with right axial lateropulsion, and right-facial and lower extremity hypoesthesia. Bedside blood pressure measurements disclosed orthostatic hypotension. He had normal sinus rhythm on telemetry and normal ejection fraction on echocardiogram. A repeat brain MRI disclosed an acute right dorsolateral medullary infarct. Autonomic testing showed reduced heart rate variability during paced deep breathing, attenuated late phase II and phase IV overshoot on Valsalva maneuver, and a fall of 25 mmHg of blood pressure at the end of a 10-min head-up tilt with no significant change in heart rate. These results were consistent with impaired sympathetic and parasympathetic cardiovascular reflexes. He was discharged to acute rehabilitation a week later with residual right dysmetria and ataxia. Lateral medullary infarctions are usually reported as partial presentations of classical lateral medullary syndrome with accompanying unusual symptoms ranging from trigeminal neuralgias to hiccups. Pre-syncope from orthostatic hypotension is a rare presentation. In the first 3-4 days, absence of early DWI MRI findings is possible in small, dorsolateral medullary infarcts with sensory disturbances. Physicians should be aware of this presentation, as early diagnosis and optimal therapy are associated with good prognosis.

Приметы И Их ВерБализация В Tрадициях Двух Славянских Народов : Культурологический И Прагмалингвистический Аспекты

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Норман Борис

2017-06-01

Full Text Available The article deals with folk superstitions (predictions, beliefs common in Russian society, and the corresponding stereotypical expressions, such as: Кончик носа чешется - в рюмку смотреть; Не ешь с ножа - сердитым будешь; Через порог не здороваются; (when starting a journey Присядем на дорожку, etc. The authors show that these expressions are used with a special phatic function: their purpose is to neutralize, to smooth the effects of an uncomfortable situation (something was broken, someone took somebody for someone else, someone hiccupped, any other unpleasant happening, etc.. Therefore, these folk expressions serve as sociolinguistic factors, optimizing the course of a dialogue. The author also gives examples of the “new” superstitions that imitate already known models and that were created with a special game purpose (like Ходить на работу - к деньгам. Examples from Russian fiction and Internet sources are provided. The facts of Russian discourse are compared with the examples from the Czech language and the national specificity of the superstitions is discussed in the article.

Clinical features and risk factors for adverse outcome in Ebola virus disease in Moyamba District Sierra Leone.

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Haaskjold, Yngvar Lunde [Haukeland Univ. Hospital, Bergen (Norway); Bolkan, Hakon Angell [St. Olav Hospital, Trondheim (Norway); Krogh, Kurt Østhuus [St. Olav Hospital, Trondheim (Norway); Jongopi, James [Moyamba District Hospital (Sierra Leone); Berg, Ase [Stavanger Univ. Hospital, Stavanger (Norway); Lundeby, Karen Marie [Oslo Univ. Hospital, Oslo (Norway); Mellesmo, Sindre [St. Olav Hospital, Trondheim (Norway); Garces, Pedro San José [Medicos del Mundo, Madrid (Spain); Josendal, Ola [Haukeland Univ. Hospital, Bergen (Norway); Opstad, Asmund [Haraldsplass Diaconal Hospital, Bergen (Norway); Svensen, Erling [Haukeland Univ. Hospital, Bergen (Norway); Univ. of Bergen (Norway); Zabala, Matias [Medicos del Mundo, Madrid (Spain); Kamara, Alfred Sandy [Moyamba District Hospital (Sierra Leone); Riera, Melchor [Medicos del Mundo, Madrid (Spain); Arranz, Javier [Medicos del Mundo, Madrid (Spain); Stamper, Paul D. [MRIGlobal, Frederick, MD (United States); Austin, Paula [Moyamba District Hospital (Sierra Leone); Moosa, Alfredo J. [Moyamba District Hospital (Sierra Leone); Marke, Dennis [Moyamba District Hospital (Sierra Leone); Hassan, Shoaib [World Health Organization (WHO), Geneva (Switzerland); Blomberg, Bjorn [Haukeland Univ. Hospital, Bergen (Norway); Univ. of Bergen (Norway)

2016-05-01

BACKGROUND The current outbreak of Ebola virus disease (EVD) in West Africa has attacked 24000 people, killed more than 10000 and disrupted social life. METHODS We studied retrospectively the clinical presentation and risk factors for fatal outcome in EVD among all patients admitted to the Ebola Treatment Center in Moyamba District, Sierra Leone. RESULTS Among a total of 88 admitted patients, eighty-two were tested by PCR and 31 (38%) were positive for Ebola virus. Ninety percent reported previous contact with EVD patients and 35% had participated in burials of EVD suspect deceased. No healthworkers were admitted. The most common symptoms on admission were weakness (97%), diarrhea (68%), fever (62%), loss of appetite (62%), vomiting (58%), pain in muscles (62%) and joints (55%), headache (55%), abdominal pain (45%) and conjunctivitis (42%). On admission, bleeding was present in one-third (11/31), while more than half (17/31) bled during the hospital stay. Fifty-eight percent (18/31) died, most within 4-11 days of onset. Significant predictors for fatal outcome were shorter time from onset to admission (P=0.02), high initial viral load (P<0.001), bleeding (P=0.004), and severe pain (P=0.001). The only two patients with hiccups died. CONCLUSIONS Bleeding was more common in our cohort than reported elsewhere during this epidemic, and predicted poor prognosis. Severe pain was common, particularly in fatal cases, and calls for improved and safe palliation, for instance with transdermal opiates. The lack of fever in one third of EBV cases may have implications for screening procedures and case definitions.

Adiabatic pipelining: a key to ternary computing with quantum dots

International Nuclear Information System (INIS)

Pecar, P; Zimic, N; Mraz, M; Lebar Bajec, I; Ramsak, A

2008-01-01

The quantum-dot cellular automaton (QCA), a processing platform based on interacting quantum dots, was introduced by Lent in the mid-1990s. What followed was an exhilarating period with the development of the line, the functionally complete set of logic functions, as well as more complex processing structures, however all in the realm of binary logic. Regardless of these achievements, it has to be acknowledged that the use of binary logic is in computing systems mainly the end result of the technological limitations, which the designers had to cope with in the early days of their design. The first advancement of QCAs to multi-valued (ternary) processing was performed by Lebar Bajec et al, with the argument that processing platforms of the future should not disregard the clear advantages of multi-valued logic. Some of the elementary ternary QCAs, necessary for the construction of more complex processing entities, however, lead to a remarkable increase in size when compared to their binary counterparts. This somewhat negates the advantages gained by entering the ternary computing domain. As it turned out, even the binary QCA had its initial hiccups, which have been solved by the introduction of adiabatic switching and the application of adiabatic pipeline approaches. We present here a study that introduces adiabatic switching into the ternary QCA and employs the adiabatic pipeline approach to successfully solve the issues of elementary ternary QCAs. What is more, the ternary QCAs presented here are sizewise comparable to binary QCAs. This in our view might serve towards their faster adoption.

Adiabatic pipelining: a key to ternary computing with quantum dots.

Science.gov (United States)

Pečar, P; Ramšak, A; Zimic, N; Mraz, M; Lebar Bajec, I

2008-12-10

The quantum-dot cellular automaton (QCA), a processing platform based on interacting quantum dots, was introduced by Lent in the mid-1990s. What followed was an exhilarating period with the development of the line, the functionally complete set of logic functions, as well as more complex processing structures, however all in the realm of binary logic. Regardless of these achievements, it has to be acknowledged that the use of binary logic is in computing systems mainly the end result of the technological limitations, which the designers had to cope with in the early days of their design. The first advancement of QCAs to multi-valued (ternary) processing was performed by Lebar Bajec et al, with the argument that processing platforms of the future should not disregard the clear advantages of multi-valued logic. Some of the elementary ternary QCAs, necessary for the construction of more complex processing entities, however, lead to a remarkable increase in size when compared to their binary counterparts. This somewhat negates the advantages gained by entering the ternary computing domain. As it turned out, even the binary QCA had its initial hiccups, which have been solved by the introduction of adiabatic switching and the application of adiabatic pipeline approaches. We present here a study that introduces adiabatic switching into the ternary QCA and employs the adiabatic pipeline approach to successfully solve the issues of elementary ternary QCAs. What is more, the ternary QCAs presented here are sizewise comparable to binary QCAs. This in our view might serve towards their faster adoption.

Intoxication by star fruit (Averrhoa carambola) in 32 uraemic patients: treatment and outcome.

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Neto, Miguel Moyses; da Costa, José Abrão Cardeal; Garcia-Cairasco, Norberto; Netto, Joaquim Coutinho; Nakagawa, Beatriz; Dantas, Marcio

2003-01-01

Clinical symptoms and outcomes of uraemic patients ingesting star fruit are quite variable and may progress to death. The purpose of the present report was to discuss the neurotoxic effects of star fruit intoxication in uraemic patients and to present the efficacy of different therapeutic approaches. We studied a total of 32 uraemic patients who had ingested star fruit. Before the intoxication episodes, 20 patients were on regular haemodialysis, eight were on peritoneal dialysis and four were not yet undergoing dialysis. Two patients were analysed retrospectively from their charts, 17 were directly monitored by our clinic and 13 were referred by physicians from many areas throughout the country, allowing us to follow their outcome from a distance. Intoxicated patients were given different therapeutic approaches (haemodialysis, peritoneal dialysis and supportive treatment), and their outcomes were analysed. The most common symptoms were persistent and intractable hiccups in 30 patients (93.75%), vomiting in 22 (68.7%), variable degrees of disturbed consciousness (mental confusion, psychomotor agitation) in 21 (65.6%), decreased muscle power, limb numbness, paresis, insomnia and paresthesias in 13 (40.6%) and seizures in seven (21.8%). Patients who were promptly treated with haemodialysis, including those with severe intoxication, recovered without sequelae. Patients with severe intoxication who were not treated or treated with peritoneal dialysis did not survive. Haemodialysis, especially on a daily basis, is the ideal treatment for star fruit intoxication. In severe cases, continuous methods of replacement therapy may provide a superior initial procedure, since rebound effects are a common event. Peritoneal dialysis is of no use as a treatment, especially when consciousness disorders ensue.

Mapping for Acute Transvenous Phrenic Nerve Stimulation Study (MAPS Study).

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Dekker, Lukas R C; Gerritse, Bart; Scheiner, Avram; Kornet, Lilian

2017-03-01

Central sleep apnea syndrome, correlated with the occurrence of heart failure, is characterized by periods of insufficient ventilation during sleep. This acute study in 15 patients aims to map the venous system and determine if diaphragmatic movement can be achieved by phrenic nerve stimulation at various locations within the venous system. Subjects underwent a scheduled catheter ablation procedure. During the procedural waiting time, one multielectrode electrophysiology catheter was subsequently placed at the superior and inferior vena cava and the junctions of the left jugular and left brachiocephalic vein and right jugular and right brachiocephalic vein, for phrenic nerve stimulation (1-2 seconds ON/2-3 seconds OFF, 40 Hz, pulse width 210 μs). Diaphragmatic movement was assessed manually and by a breathing mask. During a follow-up assessment between 2 and 4 weeks postprocedure, occurrence of adverse events was assessed. In all patients diaphragmatic movement was induced at one or more locations using a median threshold of at least 2 V and maximally 7.5 V (i.e., e 3.3 mA, 14.2 mA). The lowest median current to obtain diaphragmatic stimulation without discomfort was found for the right brachiocephalic vein (4.7 mA). In 12/15 patients diaphragmatic movement could be induced without any discomfort, but in three patients hiccups occurred. Diaphragmatic stimulation from the brachiocephalic and caval veins is feasible. Potential side effects should be eliminated by adapting the stimulation pattern. This information could be used to design a catheter, combining cardiac pacing with enhancing diaphragm movement during a sleep apnea episode. © 2017 Wiley Periodicals, Inc.

Dexamethasone-Cyclophosphamide Pulse Therapy In Pemphigus : An Appraisal OF Its Outcome In A Tertiary Health Care Center In South India

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Thappa Devinder Mohan

2004-01-01

Full Text Available Dexamethasone-cyclophoshamide pulse (DCP therapy, designed by Pasricha and Gupta for pemphigus was first used in 1981 with the aim of reducing the toxicity of corticosteroids and also to achieve better therapeutic results. We have been using the same pulse therapy and herewith are presenting the results of pulse therapy in pemphigus were included in the study over a period of 6 years. They consisted of 51 cases of pemphigus vulgaris and 4 cases of pemphigus foliaceous. The male to female ration was 1.2:1. The age distribution showed a bimodal pattern with peaks at 21-30 years and 51-60 years. The body surface area involved at the time of initiation of DCP was less than 25% in 25, 25-50% in 19 and more than 50% in 11 cases. Oral cavity was involved in all cases of pemphigus vulgaris and eyes were affected in 4 patients. Twentysix cases were managed with DCP pulses only and were in remission in phase II and three of our patients in remission in phase III relapsed at 6 to 9 months. Interpulse steroids were required to induce remission in 11 patients. The remaining 18 patients did not proceed to phase II as they was either defaulting or had active disease. Only four cases progressed into phase IV and were declared cured. The various complications seen in our patients were candidiasis (n=5, hiccups (2, acneiform eruption (2, iatrogenic Cushing’s syndrome (1, herpes zoster (1, striae distensae (1, umbilical abscess (1, alopecia (1, azoospermia (1 pneumonia (1 and deep vein thrombosis (1. Two Patients on pulse therapy died of septicemia.

Paracoccidioidomicose em hemisfério cerebral e tronco encefálico: relato de caso Paracoccidioidomycosis in cerebral hemisphere and brainstem: case report

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Manoel Baldoino Leal Filho

2006-09-01

Full Text Available Relata-se sobre um homem de 36 anos com passagem quatro anos antes pela selva amazônica. Admitido após seis meses do aparecimento progressivo de tetraparesia, ataxia de marcha, disfagia, disartria, dispnéia e soluço. A ressonância magnética revelou lesão parietoccipital à direita e no bulbo, sendo esta última maior. Investigações para tuberculose e síndrome da imunodeficiência adquirida tiveram resultados negativos. Foi submetido a microcirurgia da lesão do bulbo. O estudo anatomopatológico revelou paracoccidioidomicose. Recebeu tratamento com anfotericina B até 2100 mg, e sulfametoxazol-trimetoprim por três meses, e fisioterapia. Voltou às atividades após seis meses do término do tratamento. Comenta-se sobre a participação do sistema imunológico e das citocinas (interleucinas.We report on a 36 years-old man that had been at the Amazon forest four years before. Six months before the admission he had developed a progressive quadriparesis, gait ataxia, dysphagia, dysarthria, difficulty in breathing and hiccup. The gadolinium-enhanced T1-weighted MRI showed a lesion into the right parietoccipital area and another into the medulla, that was the largest. There was any evidence of tuberculosis or AIDS. The patient was submitted to microsurgical approach to the medulla. Pathological examination revealed paracoccidioidomycosis. Treatment with anphotericin B till 2100mg was administered followed by sulfamethoxazole-trimetoprim for three months plus physical therapy. The patient went back to his activities six months after the end of the treatment. Comments are presented about the participation of the immunological system and of the cytokines (interleukines.

Formulation and stability of an extemporaneously compounded oral solution of chlorpromazine HCl.

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Prohotsky, Daniel L; Juba, Katherine M; Zhao, Fang

2014-12-01

Chlorpromazine is a phenothiazine antipsychotic which is often used in hospice and palliative care to treat hiccups, delirium, and nausea. With the discontinuation of the commercial oral solution concentrate, there is a need to prepare this product by extemporaneous compounding. This study was initiated to identify an easy-to-prepare formulation for the compounding pharmacist. A stability study was also conducted to select the proper storage conditions and establish the beyond-use date. Chlorpromazine HCl powder and the Ora-Sweet® syrup vehicle were used to prepare the 100 mg/mL solution. Once the feasibility was established, a batch of the solution was prepared and packaged in amber plastic prescription bottles for a stability study. These samples were stored at refrigeration (2-8°C) or room temperature (20-25°C) for up to 3 months. At each monthly time point, the samples were evaluated by visual inspection, pH measurement, and high performance liquid chromatography (HPLC). A separate forced stability study was conducted to confirm that the HPLC method was stability indicating. A clear and colorless solution of 100 mg/mL chlorpromazine HCl was obtained by dissolving the drug powder in Ora-Sweet® with moderate agitation. The stability study results indicated that this solution product remained unchanged in visual appearance or pH at both refrigeration and room temperature for up to 3 months. The HPLC results also confirmed that all stability samples retained 93.6-101.4% of initial drug concentration. Chlorpromazine HCl solution 100 mg/mL can be compounded extemporaneously by dissolving chlorpromazine HCl drug powder in Ora-Sweet®. The resulting product is stable for at least three months in amber plastic prescription bottles stored at either refrigeration or room temperature.

Maternal perception of fetal activity and late stillbirth risk: findings from the Auckland Stillbirth Study.

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Stacey, Tomasina; Thompson, John M D; Mitchell, Edwin A; Ekeroma, Alec; Zuccollo, Jane; McCowan, Lesley M E

2011-12-01

  Maternal perception of decreased fetal movements has been associated with adverse pregnancy outcomes, including stillbirth. Little is known about other aspects of perceived fetal activity. The objective of this study was to explore the relationship between maternal perception of fetal activity and late stillbirth (≥28 wk gestation) risk.   Participants were women with a singleton, late stillbirth without congenital abnormality, born between July 2006 and June 2009 in Auckland, New Zealand. Two control women with ongoing pregnancies were randomly selected at the same gestation at which the stillbirth occurred. Detailed demographic and fetal movement data were collected by way of interview in the first few weeks after the stillbirth, or at the equivalent gestation for control women.   A total of 155/215 (72%) women who experienced a stillbirth and 310/429 (72%) control group women consented to participate in the study. Maternal perception of increased strength and frequency of fetal movements, fetal hiccups, and frequent vigorous fetal activity were all associated with a reduced risk of late stillbirth. In contrast, perception of decreased strength of fetal movement was associated with a more than twofold increased risk of late stillbirth (aOR: 2.37; 95% CI: 1.29-4.35). A single episode of vigorous fetal activity was associated with an almost sevenfold increase in late stillbirth risk (aOR: 6.81; 95% CI: 3.01-15.41) compared with no unusually vigorous activity.   Our study suggests that maternal perception of increasing fetal activity throughout the last 3 months of pregnancy is a sign of fetal well-being, whereas perception of reduced fetal movements is associated with increased risk of late stillbirth. © 2011, Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc.

Baclofen Intoxication

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Canan Bor

2015-12-01

Full Text Available Baclofen is a β-(ρ-chlorophenyl derivative of the neurotransmitter gamma-aminobutyric acid (GABA and is usually prescribed for spasticity of spinal cord origin, intractable hiccup, trigeminal neuralgia, hemifacial spasm, and tardive dyskinesia. The usual recommended daily dose ranges from 40-80 mg, and the total dose should not exceed 80 mg per day. A 41 year old woman using baclofen for migraine therapy intended suicide after a bitter headache attack by taking 37 tablets, 10 mg in each. On arrival to emergency room, she was conscious and co-operable, but somnolent, her pupils were normoisocoric and light reflex was intact bilaterally. On her follow up, respiratory insufficiency and unconsciousness was observed so she was entubated orotracheally and transferred to intensive care unit (ICU for advanced tests and therapy. No pathology was determined on cranial CT. On ICU follow up, she was unconscious and mechanically ventilated, her Glasgow Coma Scale was 3/15 (E1M1VE and pupils were mid-dilated with no light reflex. Since she was again conscious, oriented and co-operable on 19th hour of arrival to ICU and 20th hour of arrival to emergency room, spontaneous breathing trials was started. Extubation was carried out on her 31th hour of arrival to ICU and 32th hour of arrival to emergency room. In conclusion; since baclofen overdose may cause deep coma, it should also be included in differential diagnosis. According to our opinion, performing diagnostic toxicological tests is not always possible that’s why history and physical examination is fundamental in case of baclofen intoxication and we can get good results by giving frequent neurological examination, supportive and extracorporeal therapy in such a case.

Association of renal function and symptoms with mortality in star fruit (Averrhoa carambola) intoxication.

Science.gov (United States)

Chua, Choon-Bing; Sun, Cheuk-Kwan; Tsui, Huan-Wen; Yang, Po-Jen; Lee, Kuo-Hsin; Hsu, Chih-Wei; Tsai, I-Ting

2017-08-01

Star fruit (SF) is a commonly available fruit produced and eaten in tropical and subtropical countries. Since 1993, various reports have described neurotoxicity after eating SF, but this clinical condition remains unfamiliar. We aimed to describe this clinical entity, the role of renal dysfunction in this disorder, treatment strategies, and prognosis of patients with SF intoxication. We conducted a search of PubMed and Google Scholar databases from 1993 to 2016. We included reports describing patients with a clear history of SF ingestion with acute symptoms. We described the demographic characteristics, reported SF intake, treatments used, and outcomes. We reviewed totally 126 patients (male:female = 1.5:1) from 33 articles with mean age 54.4 ± 11 (range: 30-84). The most common symptom was hiccups (65%), whereas confusion and seizure were the most common symptoms associated with mortality (42% and 61%, respectively). Pre-intoxication renal function also affected mortality. While there was no mortality in patients with normal renal function (NRF), the mortality of patients among reported cases with chronic renal insufficiency and end-stage renal disease undergoing dialysis were 36% and 27%, respectively. With the inclusion of patients reported to have NRF, the overall mortality was 24%. Consistently, the number of SF consumed was substantially higher in the patients with NRF than those with renal functional impairment. The most common treatment strategy was hemodialysis (59%). Patients with impaired renal function were at higher risks of SF intoxication. Severe neurologic symptoms mandate immediate medical intervention because of the association between their occurrence and high mortalities. Toxin removal through dialysis, rather than symptomatic relief, seems to be beneficial to patient survival. Early and continuous dialysis appears to alleviate severe symptoms and prevent symptom rebounds.

Negative inotropic and chronotropic effects on the guinea pig atrium of extracts obtained from Averrhoa carambola L. leaves.

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Vasconcelos, C M L; Araújo, M S; Silva, B A; Conde-Garcia, E A

2005-07-01

It has been reported that star fruit can lead to a fatal outcome in uremic patients. The intoxication syndrome consists of hiccups, mental confusion, dizziness, and vomiting. On the other hand, folk medicine uses teas and infusions of carambola leaves to treat headache, vomiting, cough, insomnia, and diabetes. This motivated us to determine if Averrhoa carambola can act on the contractility and automaticity of the guinea pig heart. We measured the atrial isometric force in stimulated left atria and determined the chronotropic changes in spontaneously beating right atria. The carambola leaf extracts (1.5 mg/ml) abolished the contractile force in a concentration-dependent manner. Among the crude, methanolic, ethanolic, aqueous, and acetic extracts, the aqueous one was the most potent (EC50 = 520 +/- 94 microg/ml; flavonoids and tannins are the main constituents; Na+ and K+ contents in 1.0 mg/ml of aqueous extract were 0.12 +/- 0.016 and 1.19 +/- 0.15 mM, respectively). The aqueous extract abolished the positive Bowditch staircase phenomenon and reduced the inotropic response to CaCl2 (0.17-8.22 mM), events that are dependent on the cellular Ca2+ inward current. The adrenergic, muscarinic or opioid membrane receptors do not seem to participate in the mechanism of action of the cardioactive substance(s). In spontaneously beating atria, the aqueous extract promoted a negative chronotropic effect that was antagonized by 0.1 microM isoproterenol bitartrate. With this agonist, the EC50 of the aqueous extract increased from 133 +/- 58 to 650 +/- 100 microg/ml. These data regarding the effect of A. carambola on guinea pig atrial contractility and automaticity indicate an L-type Ca2+ channel blockade.

Negative inotropic and chronotropic effects on the guinea pig atrium of extracts obtained from Averrhoa carambola L. leaves

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Vasconcelos C.M.L.

2005-01-01

Full Text Available It has been reported that star fruit can lead to a fatal outcome in uremic patients. The intoxication syndrome consists of hiccups, mental confusion, dizziness, and vomiting. On the other hand, folk medicine uses teas and infusions of carambola leaves to treat headache, vomiting, cough, insomnia, and diabetes. This motivated us to determine if Averrhoa carambola can act on the contractility and automaticity of the guinea pig heart. We measured the atrial isometric force in stimulated left atria and determined the chronotropic changes in spontaneously beating right atria. The carambola leaf extracts (1.5 mg/ml abolished the contractile force in a concentration-dependent manner. Among the crude, methanolic, ethanolic, aqueous, and acetic extracts, the aqueous one was the most potent (EC50 = 520 ± 94 µg/ml; flavonoids and tannins are the main constituents; Na+ and K+ contents in 1.0 mg/ml of aqueous extract were 0.12 ± 0.016 and 1.19 ± 0.15 mM, respectively. The aqueous extract abolished the positive Bowditch staircase phenomenon and reduced the inotropic response to CaCl2 (0.17-8.22 mM, events that are dependent on the cellular Ca2+ inward current. The adrenergic, muscarinic or opioid membrane receptors do not seem to participate in the mechanism of action of the cardioactive substance(s. In spontaneously beating atria, the aqueous extract promoted a negative chronotropic effect that was antagonized by 0.1 µM isoproterenol bitartrate. With this agonist, the EC50 of the aqueous extract increased from 133 ± 58 to 650 ± 100 µg/ml. These data regarding the effect of A. carambola on guinea pig atrial contractility and automaticity indicate an L-type Ca2+ channel blockade.

Thermodynamics of the Earth

International Nuclear Information System (INIS)

Stacey, Frank D

2010-01-01

Applications of elementary thermodynamic principles to the dynamics of the Earth lead to robust, quantitative conclusions about the tectonic effects that arise from convection. The grand pattern of motion conveys deep heat to the surface, generating mechanical energy with a thermodynamic efficiency corresponding to that of a Carnot engine operating over the adiabatic temperature gradient between the heat source and sink. Referred to the total heat flux derived from the Earth's silicate mantle, the efficiency is 24% and the power generated, 7.7 x 10 12 W, causes all the material deformation apparent as plate tectonics and the consequent geological processes. About 3.5% of this is released in seismic zones but little more than 0.2% as seismic waves. Even major earthquakes are only localized hiccups in this motion. Complications that arise from mineral phase transitions can be used to illuminate details of the motion. There are two superimposed patterns of convection, plate subduction and deep mantle plumes, driven by sources of buoyancy, negative and positive respectively, at the top and bottom of the mantle. The patterns of motion are controlled by the viscosity contrasts (>10 4 : 1) at these boundaries and are self-selected as the least dissipative mechanisms of heat transfer for convection in a body with very strong viscosity variation. Both are subjects of the thermodynamic efficiency argument. Convection also drives the motion in the fluid outer core that generates the geomagnetic field, although in that case there is an important energy contribution by compositional separation, as light solute is rejected by the solidifying inner core and mixed into the outer core, a process referred to as compositional convection. Uncertainty persists over the core energy balance because thermal conduction is a drain on core energy that has been a subject of diverse estimates, with attendant debate over the need for radiogenic heat in the core. The geophysical approach to

[Analysis on composition principles of prescriptions for nausea by using traditional Chinese medicine inheritance support system].

Science.gov (United States)

Han, Qi; Li, Hong-Hai; Fan, Cui-Ping; Liu, Chun; Liang, Yong-Lin

2016-07-01

Nausea is special in the symptoms, and is different from hiccups and vomiting. The main symptom is that the patients throw up the indigested food from the stomach regularly--if the patients have a dinner, they will throw out it in the next morning, or if the patients have a breakfast, they will throw out it at night. Nausea is common in clinic, and different physicians may use different treatment methods for it. This disease also cannot be treated efficiently and may happen repeatedly with the western medicine. In this study, the composition principles of prescriptions in past traditional Chinese medicine for nausea were analyzed and summarized by using traditional Chinese medicine inheritance support system(V2.5), hoping to provide guidance for clinical drug use and summarize the basic rules for treatment of nausea.The prescriptions for nausea in "the prescription of traditional Chinese medicine dictionary" were selected, and the information was entered into the traditional Chinese medicine inheritance support system(TCMISS) to build a database. Data mining methods such as frequency statistics, association rules, complex system entropy clustering were used to analyze and summarize the composition principles of these prescriptions. The herb frequencies of the prescriptions were finally determined; herbs with higher use frequencies were obtained; and the association rules between herbs were found. 19 commonly used herb pairs, 10 core combinations and 10 newly developed prescriptions were found. The basic pathogenesis of nausea in traditional Chinese medicine is the weakness and coldness of spleen and stomach, and the Qi adverseness of stomach. Generations of physicians' main therapeutic method for nausea is mainly to warm the middle and invigorate the spleen, lower Qi and regulate stomach. The commonly used herbs for nausea are ginger, ginseng, large head attractylodes, tuckahoe, licorice, and appropriately supplemented with the herbs of eliminating dampness and

Gaze palsy, hypogeusia and a probable association with miscarriage of pregnancy--the expanding clinical spectrum of non-opticospinal neuromyelitis optica spectrum disorders: a case report.

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Chang, Thashi; Withana, Milinda

2015-02-10

Neuromyelitis optica is characterised by optic neuritis, longitudinally-extensive transverse myelitis and presence of anti-aquaporin-4 antibodies in the serum. However, non-opticospinal central nervous system manifestations have been increasingly recognised. Awareness of the widening clinical spectrum of neuromyelitis optica (unified within the nosology of 'neuromyelitis optica spectrum disorders') is key to earlier diagnosis and appropriate therapy. We report 2 patients to illustrate the varied clinical manifestations of neuromyelitis optica spectrum disorders while postulating an effect of anti-aquaporin-4 antibodies on the miscarriage of pregnancy. This is the first report of horizontal gaze palsy as a presenting symptom of neuromyelitis optica spectrum disorders. Patient 1: A 17-year-old Sri Lankan female presented with hypersomnolence, lateral gaze palsy and loss of taste of 1 week duration. Two years previously she had presented with intractable hiccups and vomiting followed by a brainstem syndrome. Magnetic resonance imaging showed a lesion in the left cerebellum extending into the pons while lesions in bilateral hypothalami and medulla noted 2 years ago had resolved. Autoimmune, vasculitis and infection screens were negative. Anti-aquaporin-4 antibodies were detected in serum. All her symptoms resolved with immunosuppressive therapy. Patient 2: A 47-Year-old Sri Lankan female presented with persistent vomiting lasting over 3 weeks. Three years previously, at 25-weeks of her 4(th) pregnancy, she had presented with quadriparesis and was found to have a longitudinally extensive transverse myelitis from C2 to T2 vertebral levels, which gradually improved following intravenous steroid therapy. Magnetic resonance imaging showed a hyper-intense lesion in the area postrema and longitudinally extensive atrophy of the cord corresponding to her previous myelitis. Autoimmune, vasculitis and infection screens were negative. Anti-aquaporin-4 antibodies were detected in

Neurotoxic effects of carambola in rats: the role of oxalate.

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Chen, Chien-Liang; Chou, Kang-Ju; Wang, Jyh-Seng; Yeh, Jeng-Hsien; Fang, Hua-Chang; Chung, Hsiao-Min

2002-05-01

Carambola (star fruit) has been reported to contain neurotoxins that cause convulsions, hiccups, or death in uremic patients, and prolong barbiturate-induced sleeping time in rats. The constituent responsible for these effects remains uncertain. Carambola contains a large quantity of oxalate, which can induce depression of cerebral function and seizures. This study was conducted to investigate the role of oxalate in carambola toxicity in rats. The effects on barbiturate-induced sleeping time and death caused by intraperitoneal administration of carambola juice were observed in Sprague-Dawley rats. To obtain a dose-dependent response curve and evaluate the lethal dose, rats were treated with serial amounts of pure carambola juice diluted with normal saline in a volume of 1:1. To test the role of oxalate in the neurotoxic effect of carambola, either 5.33 g/kg carambola after oxalate removal or 5.33 g/kg of pure carambola juice diluted with normal saline were administered intraperitoneally, while the control group was given normal saline before pentobarbital injection. The effects of carambola and oxalate-removed carambola on barbiturate-induced sleeping time were compared with those of saline. To assess the lethal effect of oxalate in carambola, we gave rats chemical oxalate at comparable concentrations to the oxalate content of carambola. Carambola juice administration prolonged barbiturate-induced sleeping time in a dose-dependent manner. The sleeping time of rats that received normal saline and 1.33 g/kg, 2.67 g/kg, 5.33 g/kg, and 10.67 g/kg of carambola juice were 66 +/- 16.6, 93.7 +/- 13.4, 113.3 +/- 11.4, 117.5 +/- 29.0, and 172.5 +/- 38.8 minutes, respectively. The three higher-dose groups had longer sleeping times than controls (p carambola juice. Four of eight rats in the 10.67-g/kg group and all rats in the 21.33 g/kg and chemical oxalate groups died after seizure. Lethal doses of carambola juice were rendered harmless by the oxalate removal procedure

Complications after transcatheter arterial chemoembolization via the inferior phrenic arteries: incidence, risk factors, and prophylaxis

International Nuclear Information System (INIS)

Wang Maoqiang; Liu Fengyong; Guan Jun; Gu Xiaofang; Lin Hanying; Wang Zhiqiang

2004-01-01

Objective: To investigate the frequency, patterns of the angiographic findings and risk factors for development of complications after transcatheter arterial chemoembolization (TACE) via the inferior phrenic artery (IPA). Methods: One hundred and sixty eight patients with hepatic tumor fed by the IPA underwent a total of 226 procedures of TACE of the IPA, with combined routine TACEO (88.7%) or without (11.3%) the combination of routine TACE of the hepatic artery. TACE of the malignancy was performed with an emulsion of iodized oil and anti-cancer agents and then followed by gelatin sponge particle injection. The complications were assessed on clinical observation, laboratory tests, and computed tomographic (CT) images after TACE of the IPA; and finally were correlated with the angiographic findings of the IPA. Results: The tumor supplied by IPA was noted at initial TACE in 25 (14.9%), at successive TACE in 97 (57.8%), after percutaneous tumor ablation guided by ultrasound in 28 (16.7%), and after hepatic surgery in 18 (10.7%) cases. The abnormal findings on arteriography showed enlargement of the IPA with tumor staining in all cases, dense non-tumor staining in 61 (36.3%), artery-to-artery anastomosis in 62(36.9%), arteriovenous shunts in 12(7.1%) cases. 96.4% of these patients complained of shoulder pain during TACE of the IPA. The cumulative complication rate after the procedure was 8.9%, including hiccup in 13 cases (5.8%), chest pain with cough and mild hemoptysis in 9 (4.0%), phrenoparalysis in 8 (3.5%), angina with abnormal ECG in 4 (1.8%), increasing of CPK, AST, and ALT significantly in 6 (2.7%), transient myeloparalysis in 2 (0.9%), and subphrenic abscess in 2 cases (0.9%). Two patients with the subphrenic abscess were successfully treated with percutaneous catheter drainage and antibiotics. The symptoms of these mild complications subsided with symptomatic treatment. Conclusions: Complications of TACE via the IPA occur in about 9% of the patients and

"Nosso Darfur, Darfur deles": a política desviante do Sudão e a nascente "limpeza étnica" em uma emergente anarquia Africana "Our Darfur, their Darfur": Sudan's politics of deviance and the rising "ethnic-cleansing" in an African emerging anarchy

Directory of Open Access Journals (Sweden)

Isiaka Alani Badmus

2008-08-01

behaviours, rooted in its quest to establish a theocratic state and export its radical ideology overseas, have pitted the RoS with the wider international community. Drawing from Khartoum's current military engagements in Darfur and previous similar operations, this study contends strongly that for Sudan to come out of its present political hiccup, its rulers must jettison its lopsided policies in peference for the ones that are inclusive of all ethnic formations in the country with sincerity of purpose. In the final analysis, it is argued that this can only becomes meaningful within the context of improved socio-economic conditions. This, stricto sensus, calls for the Africa's development partners and the wider international community's economic support to Sudan.

Intoxicação por carambola em paciente com insuficiência renal crônica: relato de caso Star fruit intoxication in a chronic renal failure patient: case report

Directory of Open Access Journals (Sweden)

Fábio Gonzaga Moreira

2010-12-01

survival rate is 62% and for those above this age and with diabetes mellitus, just 23%. Star fruit is native from Asia, and widespread in tropical countries; this fruit was reported as having a neurotoxin able to cause serious neurological changes in chronic renal disease patients. These may range from mild features, such as hiccup and confusion, to serious episodes with seizures and death. This neurotoxin apparently inhibits specifically the GABAergic conduction system. This paper describes a case involving a chronic renal disease patient who, after ingesting star fruit, featured malaise, nausea and vomiting, followed by repeated convulsions and died even though undergoing conventional hemodialysis therapy.

Práticas populares de mães adolescentes no cuidado aos filhos Prácticas populares de madres adolescentes en el cuidado a los hijos General practice of teenage mothers caring for their children

Directory of Open Access Journals (Sweden)

Keli Regiane Tomeleri

2009-06-01

�N: Los profesionales de salud precisan conocer las creencias y prácticas de las madres adolescentes para entonces planificar, de la mejor forma posible, la asistencia a ser prestada al binomio madre-hijo.OBJECTIVE: To identify and describe popular practices of teenage mothers caring for their children during the first six month after birth. METHODS: A qualitative approach was used with six teenage mothers from the city of Cambé, PR. Data were collected through semi-structured interviews from February to April 2007. Interviews were conducted in the participants' home in four different times (one week, one month, four months, and six months after the birth. RESULTS: Findings suggested that teenage mothers use popular practices that were part of their family and community culture when caring for their children. These popular practices included cross breast-feeding, teas, syrups, and blessing's plays to treat adverse events, and popular beliefs regarding the umbilical stump, hiccups, and sleeping pattern. CONCLUSION: Health professionals must be aware of practices and beliefs of teenage mothers in order to plan quality care to the mother-child binomial.

Biomimetic Membrane for CO2 Capture from Flue Gas

Energy Technology Data Exchange (ETDEWEB)

Michael C. Trachtenberg

2007-05-31

model that supports prediction of heat transfer profiles for larger permeators Tasks 3. 4.1, 4.2--Temperature Range of Enzymes--The goal was to determine if the enzyme operating temperature would limit the range of thermal conditions available to the capture system. We demonstrated the ability of various isozymes (enzyme variants) to operate from 4-85 C. Consequently, the operating characteristics of the enzyme are not a controlling factor. Further, any isozyme whose upper temperature bound is at least 10 C greater than that of the planned inlet temperature will be stable under unanticipated, uncontrolled 'hiccups' in power plant operation. Task 4.4, 4.4--Examination of the Effects of SOx and NOx on Enzyme Activity (Development of Flue Gas Composition Acceptance Standards)--The purpose was to define the inlet gas profile boundaries. We examined the potential adverse effects of flue gas constituents including different acids from to develop an acceptance standard and compared these values to actual PC flue gas composition. Potential issues include changes in pH, accumulation of specific inhibitory anions and cations. A model was developed and validated by test with a SO{sub 2}-laden stream. The predicted and actual data very largely coincided. The model predicted feed stream requirements to allow continuous operation in excess of 2500 hours. We developed operational (physical and chemical) strategies to avoid or ameliorate these effects. Avoidance, the preferred strategy (noted above), is accomplished by more extensive cleanup of the flue gas stream. Task 5--Process Engineering Model--We developed a process-engineering model for two purposes. The first was to predict the physical and chemical status at each test point in the design as a basis for scale-up. The second was to model the capital and operating cost of the apparatus. These were accomplished and used to predict capex, opex and cost of energy. Task 6--Preliminary Commercialization Plan--We carried out

Heating the Chromosphere in the Quiet Sun

Science.gov (United States)

Kohler, Susanna

2018-04-01

The best-studied star the Sun still harbors mysteries for scientists to puzzle over. A new study has now explored the role of tiny magnetic-field hiccups in an effort to explain the strangely high temperatures of the Suns upper atmosphere.Schematic illustrating the temperatures in different layers of the Sun. [ESA]Strange Temperature RiseSince the Suns energy is produced in its core, the temperature is hottest here. As expected, the temperature decreases further from the Suns core up until just above its surface, where it oddly begins to rise again. While the Suns surface is 6,000 K, the temperature is higher above this: 10,000 K in the outer chromosphere.So how is the chromosphere of the Sun heated? Its possible that the explanation can be found not amid high solar activity, but in quiet-Sun regions.In a new study led by Milan Goi (Lockheed Martin Solar and Astrophysics Laboratory, Bay Area Environmental Research Institute), a team of scientists has examined a process that quietly happens in the background: the cancellation of magnetic field lines in the quiet Sun.Activity in a SupergranuleTop left: SDO AIA image of part of the solar disk. The next three panels are a zoom of the particular quiet-Sun region that the authors studied, all taken with IRIS at varying wavelengths: 1400 (top right), 2796 (bottom left), and 2832 (bottom right). [Goi et al. 2018]The Sun is threaded by strong magnetic field lines that divide it into supergranules measuring 30 million meters across (more than double the diameter of Earth!). Supergranules may seem quiet inside, but looks can be deceiving: the interiors of supergranules contain smaller, transient internetwork fields that move about, often resulting in magnetic elements of opposite polarity encountering and canceling each other.For those internetwork flux cancellations that occur above the Suns surface, a small amount of energy could be released that locally heats the chromosphere. But though each individual event has a small

PACMan to Help Sort Hubble Proposals

Science.gov (United States)

Kohler, Susanna

2017-04-01

reviewers: it found that nearly all of the reviewers (92%) asked to serve in the last cycle were appropriate reviewers for the subject area based on their ADS publication record.There are still some hiccups in automating this process for instance, finding the reviewers on ADS can require human intervention due to names not being unique. As the scientific community moves toward persistent and distinguishable identifiers (like ORCIDs), however, this problem will be mitigated.Strolger and collaborators believe that PACMan demonstrates a promising means of increasing the efficiency and impartiality of the HST proposal sorting process. This tool will likely be used to assist or replace humans in this processin future HST and JWST cycles.CitationLouis-Gregory Strolger et al 2017 AJ 153 181. doi:10.3847/1538-3881/aa6112