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Sample records for presumptive benzocaine-induced methemoglobinemia

  1. Benzocaine-Induced Methemoglobinemia: A Condition of which all Endoscopists Should Be Aware

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    C Armstrong

    2004-01-01

    Full Text Available Methemoglobinemia is a rare complication that can occur with the use of benzocaine-containing compounds. Two cases of methemoglobinemia are reported, and the pathophysiology and treatment of methemoglobinemia are reviewed. Both patients received topical 20% benzocaine spray before endoscopy. Immediately following the procedure, there was a reduction in O2 saturation assessed by pulse oximetry that was refractory to O2 therapy. Dramatic peripheral and central cyanosis developed. O2 saturation measured by pulse oximetry ranged from 83% to 87% on O2 by nasal prongs and 100% O2 by a nonrebreathing mask. Both patients were mildly confused and one patient complained of a significant headache. The diagnosis of methemoglobinemia was considered and arterial blood gas sampling was performed. In both patients, the arterial blood had a chocolate brown colour. A methemoglobin level of 48% and 18% was noted in patient 1 and patient 2, respectively. Both patients were treated with methylene blue, resulting in a significant improvement with gradual normalization of their O2 saturation within 10 min to 30 min. The use of benzocaine spray may not markedly alter the patient's perception of endoscopy and thus, the routine use of these agents should be questioned. If such agents are used, the physician must be aware of this association to prevent a delay in the diagnosis and management of this rare, but potentially lethal, condition.

  2. Drug-Induced Methemoglobinemia: a Case Report and Review of Literature

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    Ahmed Zedan

    2014-01-01

    Full Text Available Drugs, including those used during diagnostic procedures, can have adverse effects and potentially serious side-effects, especially in complicated patients with significant comorbidity. Benzocaine is frequently used as an oropharyngeal anesthetic agent during bronchoscopy, transesophageal echocardiography, and upper GI endoscopy and can cause methemoglobinemia, a potentially life-threatening event if not diagnosed and treated quickly. Co-oximetry is the gold standard for the diagnosis of methemoglobinemia and can quantitate blood levels, which in turn correlate with the clinical presentation and the urgency for treatment. Methylene blue is the treatment of choice for methemoglobinemia. In this case report we discuss the pathophysiology, the clinical presentation, the diagnosis, and the treatment of benzocaine-induced methemoglobinemia.

  3. Marked differences in drug-induced methemoglobinemia in sheep are not due to RBC glucose-6-phosphate dehydrogenase, reduced glutathione, or methemoglobin reductase activity

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    Martin, D.G.; Guertler, A.T.; Lagutchik, M.S.; Woodard, C.L.; Leonard, D.A.

    1993-05-13

    Benzocaine is a commonly used topical anesthetic that is structurally similar to current candidates for cyanide prophylaxis. Benzocaine induces profound methemoglobinemia in some sheep but not others. After topical benzocaine administration certain sheep respond to form MHb (elevated MHb 16-50% after a 56-280 mg dose, a 2-10 second spray with benzocine), while other phenotypically similar sheep fail to significantly form MHb (less than a 2% increase from baseline). Deficiencies in Glucose-6-phosphate dehydrogenase (G-6-PD), reduced glutathione (GSH), and MHb reductase increase the susceptibility to methemoglobinemia in man and animals. Sheep are used as a model for G-6-PD deficiency in man, and differences in this enzyme level could cause the variable response seen in these sheep. Similarly, differences in GSH and MHb reductase could be responsible for the observed differences in MHb formation.

  4. Genetics Home Reference: methemoglobinemia, beta-globin type

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    ... Home Health Conditions Methemoglobinemia, beta-globin type Methemoglobinemia, beta-globin type Printable PDF Open All Close All ... to view the expand/collapse boxes. Description Methemoglobinemia, beta-globin type is a condition that affects the ...

  5. Methemoglobinemia in aluminum phosphide poisoning.

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    Shadnia, Shahin; Soltaninejad, Kambiz; Hassanian-Moghadam, Hossein; Sadeghi, Anahaita; Rahimzadeh, Hormat; Zamani, Nasim; Ghasemi-Toussi, Alireza; Abdollahi, Mohammad

    2011-03-01

    Acute aluminum phosphide (AlP) poisoning is one of the most common causes of acute pesticide poisoning in Iran. Hydrogen phosphide or phosphine gas is produced following reaction of AlP with water even at ambient humidity. Methemoglobinemia is a rare finding following phosphine poisoning. In this paper, two cases of fatal AlP poisoning complicated by methemoglobinemia are reported. Two patients presented following suicidal ingestion of AlP tablets. In the Emergency Department (ED), they received gastric lavage with sodium bicarbonate and potassium permanganate. Both of them received supportive care. In each case, hematuria and hemolysis were significant events. The patients also showed a decrease in O(2) saturation in spite of high FIO(2). Methemoglobin levels of 40% and 30% were detected by co-oximetry. Neither patient responded to treatment (ascorbic acid in one case, methylene blue in the other). Both patients died due to systemic effects of phosphine poisoning. Hemolysis and methemoglobinemia may complicate the course of phosphine poisoning that seems resistant to methylene blue and ascorbic acid. Therefore, other treatments including hyperbaric oxygen therapy and exchange blood transfusion should be considered.

  6. Methemoglobinemia caused by dapsone overdose: Which treatment is best?

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    Ibrahim Toker

    2015-12-01

    Full Text Available Increase of methemoglobin level is named as methemoglobinemia characterized by functional anemia and tissue hypoxia. Methemoglobinemia can be congenital, but acquired form are more often caused by various drugs and toxins. Methylene blue is the most effective antidote for acquired methemoglobinemia. When methylene blue is not available, alternative treatments such as ascorbic acid and hyperbaric oxygen can be useful. In this paper we presented a case of methomoglobinemia due to dapsone overdose. Keywords: Dapsone overdose, Emergency medicine, Methemoglobinemia

  7. Zopiclone induced methemoglobinemia and hemolytic anemia.

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    Chan, Thomas Y K

    2014-05-01

    To characterize the risk of methemoglobinemia and hemolytic anemia following large overdoses of zopiclone, a cyclopyrrolone hypnotic-sedative and a racemic mixture of R-zopiclone and S-zopiclone (eszopiclone). This review included all reports of zopiclone induced methemoglobinemia, hemolytic anemia, and oxidative stress that had been published in medical journals or discussed in continuous medical education (CME) programs. These reports were identified by searching the Medline (1980 - December 9, 2013), China Journal Net (1994 - December 2013), and Google Scholar, using zopiclone, eszopiclone, methemoglobinemia, hemolytic anemia, and oxidative stress as the search terms. Six cases of methemoglobinemia, one case of methemoglobinemia, with concomitant hemolytic anemia, and one case of hemolytic anemia were identified. These complications occurred after large zopiclone overdoses (450 - 3,750, 1,125 - 1,500, and 375 - 750 mg, respectively, i.e., 60 - 500, 150 - 200, and 50 - 100 times the daily dose of 7.5 mg). The resulting methemoglobinemia could be severe (19.4 - 24.5%), while the hemolytic anemia was mild (Hb 9.0 - 9.6 g/dL). Molecular modelling analyses indicate that eszopiclone and its two metabolites will be kinetically labile. Their molecular surfaces have significant amounts of electron-deficient regions. All three compounds are expected to react with cellular nucleophiles, such as glutathione, causing its depletion and oxidative stress. After large overdoses, zopiclone, alone or together with its metabolites, most probably causes oxidative stress in erythrocytes to account for the methemoglobinemia and hemolytic anemia. Further studies are required to determine their incidence and the dose-related capacity of zopiclone and its metabolites in producing erythrocyte oxidative stress.

  8. Methemoglobinemia

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    ... be at risk for a blood disease called G6PD deficiency . They should not take this medicine. If you or your child has G6PD deficiency, always tell your provider before getting treatment. Ascorbic ...

  9. Presumption of Negligence

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    Guerra, Alice; Luppi, Barbara; Parisi, Francesco

    This paper is about the incentive effects of legal presumptions. We analyze three interrelated effects of legal presumptions in a tort setting: (1) incentives to invest in evidence technology; (2) incentives to invest in care-type precautions; and (3) incentives to mitigate excessive activity lev...

  10. Congenital methemoglobinemia. Report of a case

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    Zárate Aspiros Romeo

    2014-07-01

    Full Text Available Methemoglobinemia is a condition in which there are high blood levels of methemoglobin. It may be congenital or acquired. The congenital form (which is rare is the result of a defect in the methemoglobin reductase enzyme, dependent of the nicotinamide adenine dinucleotide phosphate reduced (NADPH; it is also caused by hemoglobinopathies. Congenital methemoglobinemia type 2 constitutes 10% of all cases and is usually fatal in early life. Its main feature is progressive neurological deterioration associa- ted with mental retardation, microcephaly, opisthotonos, athetotic movements, and generalized hypertonia. We report the case of a newborn with cyanosis from birth in whom perinatal hypoxia, pulmonary disease, heart failure and sepsis were ruled out, hence methemoglobin levels were requested, which led to the diagnosis of congenital methemoglobinemia based on a methemoglobin of 29.6%. Methemoglobin values were investigated in his 2 years old brother, who was cyanotic and showed progressive psychomotor retardation from birth; his methemoglobin was 30%. We concluded that both patients had type 2 hereditary methemoglobinemia in view of the severe neu- rological disorders of the older brother. Treatment with ascorbic acid was initiated in both siblings, resulting in the disappearance of cyanosis in the newborn.

  11. Methemoglobinemia secondary to cleaning solution ingestion.

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    Freeman, L; Wolford, R W

    1996-01-01

    Methemoglobinemia is a rare cause of cyanosis in pediatric patients. A 16-month-old male presented to the Emergency Department cyanotic and short of breath after ingestion of a hair-care-equipment cleaning solution. After calling the salon and consulting Poisindex, the substance was found to be Mar-V-cide, containing 20% Hyamine 3500, 50% cationic detergents, 20% isopropyl alcohol, and 1% sodium nitrite, which caused the methemoglobinemia in this case. Initial pulse oximetry on room air was 72% and improved minimally with supplemented oxygen. The patient's methemoglobin level was 63%. Methylene blue was administered (2 mg/kg intravenously), and the patient rapidly improved. Nitrates occur in high concentrations in some food and water. Infants are particularly susceptible to chronic nitrate-induced methemoglobinemia because of their low stomach acid production, large numbers of nitrite-reducing bacteria, and the relatively easy oxidation of fetal hemoglobin. Acute nitrite toxicity results from industrial exposure, accidental ingestion (e.g., abuse of organic nitrites as an aphrodisiac, especially in the male homosexual population), and suicidal ingestion. Methemoglobinemia may occur in a number of drug or chemical ingestions, but a comprehensive review of the literature failed to identify a similar reported case.

  12. Methemoglobinemia in aluminium phosphide poisoning in rats.

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    Lall, S B; Peshin, S S; Mitra, S

    2000-01-01

    Aluminium phosphide (AlP) a grain fumigant is the leading cause of intentional poisoning in North India. The mechanisms involved in toxicity are not known and there is no antidote till date. The present study was carried out to investigate the oxygen free radical generation, methemoglobinemia and effect of methylene blue treatment on survival time in rat model of AlP poisoning. AlP (50 mg/kg, intragastric) was administered in one group and the other group received AlP + Methylene Blue (MB) (0.1%, 1 mg/kg/5 min, i.v.). Malonyldialdehyde (MDA) and methemoglobin (MeHb) levels were measured at 10 and 30 min intervals. Blood MDA levels increased at 10 and 30 min after AlP exposure with simultaneous rise in MeHb levels suggesting methemoglobinemia could be due to increased oxygen free radical generation. Methylene blue caused a significant fall in both the parameters with prolongation of survival time. It is concluded that AlP causes methemoglobinemia responding to methylene blue treatment.

  13. Dapsone-Induced Methemoglobinemia: A Dose Related Occurrence?

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    Esbenshade, Adam J; Ho, Richard H.; Shintani, Ayumi; Zhao, Zhiguo; Smith, Lesley-Ann; Friedman, Debra L.

    2011-01-01

    Objectives Dapsone, used for Pneumocystis jiroveci (PCP) prophylaxis, is associated with increased risk of methemoglobinemia. Absence of cytochrome b5 reductase enzyme activity (CYB5RA) causes congenital methemoglobinemia, but its role in dapsone-associated methemoglobinemia is unknown. We sought to elucidate drug-related risk factors for dapsone-associated methemoglobinemia in pediatric oncology patients, including contribution of CYB5RA. Patients and Methods Among 167 pediatric patients treated for hematologic malignancies or aplastic anemia who received dapsone for PCP prophylaxis, demographic and dapsone treatment data were retrospectively collected. Drug-related risk factors were evaluated by Cox proportional hazards, and in a cross-sectional subgroup of 40 patients, CYB5RA was assessed. Results Methemoglobinemia (median methemoglobin level = 9.0% [3.5–22.4]) was documented in 32 patients (19.8%). There was a 73% risk reduction in methemoglobinemia with dosing ≥20% below the target dose 2mg/kg/day (HR = 0.27; 95% confidence interval (CI) 0.09, 0.78; p=0.016), while methemoglobinemia risk was increased with dosing ≥20% above the target dose (HR = 6.25; 95% CI 2.45, 15.93; pdapsone. Conclusions Methemoglobinemia occurred in almost 20% of pediatric oncology patients receiving dapsone for PCP prophylaxis. Higher dapsone dosing is associated with increased risk. A cross-sectionally acquired CYB5RA level was not associated with methemoglobinemia risk. Studies are needed to define biologic correlates of methemoglobinemia and evaluate lower dapsone doses for PCP prophylaxis. PMID:21246536

  14. Dapsone-induced methemoglobinemia: a dose-related occurrence?

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    Esbenshade, Adam J; Ho, Richard H; Shintani, Ayumi; Zhao, Zhiguo; Smith, Lesley-Ann; Friedman, Debra L

    2011-08-01

    Dapsone, used for Pneumocystis jiroveci (PCP) prophylaxis, is associated with increased risk of methemoglobinemia. Absence of cytochrome b5 reductase enzyme activity causes congenital methemoglobinemia, but its role in dapsone-associated methemoglobinemia is unknown. The authors sought to elucidate drug-related risk factors for dapsone-associated methemoglobinemia in pediatric oncology patients, including contribution of cytochrome b5 reductase enzyme activity. Among 167 pediatric patients treated for hematologic malignancies or aplastic anemia who received dapsone for PCP prophylaxis, demographic and dapsone treatment data were retrospectively collected. Drug-related risk factors were evaluated by Cox proportional hazards, and in a cross-sectional subgroup of 40 patients, cytochrome b5 reductase enzyme activity was assessed. Methemoglobinemia (median methemoglobin level = 9.0% [3.5-22.4]) was documented in 32 (19.8%) patients. There was a 73% risk reduction in methemoglobinemia with dosing ≥20% below the target dose of 2 mg/kg/d (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.09-0.78; P = .016), whereas methemoglobinemia risk was increased with dosing ≥20% above the target dose (HR, 6.25; 95% CI, 2.45-15.93; P dapsone. Methemoglobinemia occurred in almost 20% of pediatric oncology patients receiving dapsone for PCP prophylaxis. Higher dapsone dosing is associated with increased risk. A cross-sectionally acquired cytochrome b5 reductase enzyme activity level was not associated with methemoglobinemia risk. Studies are needed to define biologic correlates of methemoglobinemia and evaluate lower dapsone doses for PCP prophylaxis. Copyright © 2011 American Cancer Society.

  15. Difference of the clinical course and outcome between dapsone-induced methemoglobinemia and other toxic-agent-induced methemoglobinemia.

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    Kim, Youn-Jung; Sohn, Chang Hwan; Ryoo, Seung Mok; Ahn, Shin; Seo, Dong Woo; Lee, Yoon-Seon; Lee, Jae Ho; Oh, Bum Jin; Lim, Kyoung Soo; Kim, Won Young

    2016-08-01

    Acquired methemoglobinemia is a potentially fatal condition that leads to tissue hypoxia. Although the clinical features of methemoglobinemia depend on the methemoglobin levels, the clinical course would differ depending on the causative agents. We attempted to clarify this issue by comparing the clinical course of methemoglobinemia caused by dapsone and that caused by other toxic agents. A retrospective case-control study was performed. All patients with methemoglobinemia and who were admitted to the emergency department (ED) of our hospital from 1 January 2002 to 31 December 2014 were included. Of the 34 patients with methemoglobinemia, 15 ingested dapsone (14 with acute overdose and one with chronic therapeutic use) and 19 had been exposed to other toxic agents, such as sodium nitrites, indoxacarb, primaquine, and lidocaine. The clinical characteristics and the course of dapsone-induced and other toxic-agent-induced methemoglobinemia were compared. There was no significant difference in clinical presentation and methemoglobin level (38.5% vs. 35.0%, p = 0.456) upon their ED arrival between the two groups. However, the methemoglobin level after use of methylene blue and the total dose of methylene blue were higher in patients with dapsone-induced methemoglobinemia than in those with other agent-induced methemoglobinemia (11.9% vs. 1.7%, p = 0.001, 455 mg vs. 144 mg, p = 0.006). The majority of dapsone-induced methemoglobinemia (93.3%) required more than 72 h for normalization of the methemoglobin level, despite the use of methylene blue. Five of the study patients died due to multiorgan failure, and all of whom were inpatients with dapsone-induced methemoglobinemia. The clinical course of dapsone-induced methemoglobinemia was worse than that of other toxic-agent-induced methemoglobinemia despite no significant difference in their initial clinical presentation. Continuous treatment with serial monitoring of the serum methemoglobin is necessary

  16. Dapsone-induced methemoglobinemia: a primer for clinicians.

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    Barclay, James A; Ziemba, Stamatina E; Ibrahim, Rami B

    2011-09-01

    To present a comprehensive review of dapsone-induced methemoglobinemia and its management. Literature retrieval was accessed through MEDLINE (1966-March 2011), Cochrane Library, and EMBASE, using the terms dapsone and methemoglobinemia. All case reports, small case series, and randomized controlled trials published in English were evaluated. Because of the absence of comprehensive updates on this topic since 1996, publications between 1997 and March 2011 were included in this review. Between 1997 and March 2011, the majority of publications describing methemoglobinemia associated with dapsone use reported this adverse effect at therapeutic doses. Excluding overdose situations, 18 described symptomatic dapsone-associated methemoglobinemia and clinical presentation ranging from cyanosis to dyspnea. In almost all of the accounts, patients had a concurrent event such as anemia or pneumonia, suggesting an interplay between these comorbidities and the onset of symptomatic methemoglobinemia. Delayed hemolytic anemia was seen in patients with high methemoglobin levels at presentation. Management in most cases consisted of administration of methylene blue. Overall, most reports described a successful outcome, and no mortality resulted from methemoglobinemia associated with therapeutic use. Clinicians should recognize methemoglobinemia as an adverse effect associated with dapsone use and the potential factors that precipitate it. They should also know how to promptly and effectively manage this event.

  17. The Beef Jerky Blues: Methemoglobinemia From Home Cured Meat.

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    Theobald, Jillian L; Spoelhof, Rachel; Pallasch, Erin M; Mycyk, Mark B

    2016-09-30

    Methemoglobinemia can result from ingestion of nitrite- or nitrate-containing foods. Here, we report a case where an adolescent girl and her father developed clinically significant methemoglobinemia after ingestion of "homemade" beef jerky prepared with sodium nitrate salt purchased at a local grocery store. Both had palpitations, dyspnea, and visible mucosal cyanosis. The daughter had a methemoglobin level of 44.2% and the father's methemoglobin level was 34.2%. Prompt recognition of methemoglobinemia is important for initiating antidotal therapy with methylene blue.

  18. Transient methemoglobinemia in three neonates due to maternal pudendal anesthesia

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    Erol, S.; Celik, I.H.; Demirel, N.

    2017-01-01

    Methemoglobin (MetHb) is a form of hemoglobin which contains iron in ferric state. The delivery of oxygen to tissues is impaired and cellular hypoxia develops with an increase in MetHb levels. Methemoglobinemia is a rare but potentially lethal complication of local anesthetics. In this clinical brief, three cases of transient neonatal methemoglobinemia, caused by maternal pudendal anesthesia with prilocaine, are reported. (author)

  19. Cost of Beauty; Prilocaine Induced Methemoglobinemia

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    Elif KILICLI

    2014-12-01

    Full Text Available SUMMARY: Prilocaine induced methemoglobinemia is a rare entity. In the present paper, the authors aim to draw attention to the importance of this rare condition by reporting this case. A 30-year-old female presented to Emergency Department with headache, dispnea and cyanosis. The patient has a history of 1000–1200 mg of prilocaine subcutaneous injection for hair removal at a beauty center, 5 hours ago. Tension arterial: 130/73 mmHg, pulse: 103/minute, body temperature: 37 °C and respiratory rate: 20/minute. The patient had acral and perioral cyanosis. Methemoglobin was measured 14.1% in venous blood gas test. The patient treated with 3 gr ascorbic acid intravenously. The patient was discharged free of symptoms after 48 hours of observation. Emergency physician should consider methemoglobinemia in presentation of dispnea and cyanosis after injection of prilocaine. ÖZET: Prilokaine bağlı gelişen methemoglobinemi nadir görülen bir durumdur. Bu yazıda epilasyon öncesi kullanılan prilokaine sekonder gelişen methemoglobinemi olgusunu sunarak nadir görülen bu durumun önemine işaret etmek istiyoruz. Otuz yaşında kadın acil servise baş ağrısı, dispne ve siyanoz şikayetleri ile başvurdu. Hastaya beş saat öncesinde bir güzellik merkezinde epilasyon öncesinde yaklaşık 1000–1200 mg prilokain subkutan enjeksiyonu yapıldığı öğrenildi. Başvuruda kan basıncı 130/73 mmHg, nabız 103/dk, vücut ısısı 37 °C ve solunum sayısı 20/dk olarak kaydedilmişti. Hastanın akral siyanozu belirgindi. Venöz kan gazında methemoglobin düzeyi %14.1 olarak ölçüldü. Hastaya 3 g intravenöz askorbik asit uygulandı. Tedavi sonrası semptomları gerileyen ve komplikasyon geliştirmeyen hasta 48 saat sonra taburcu edildi. Acil servis doktorları, prilokain enjeksiyonu sonrası gelişen dispne ve siyanoz ayırıcı tanısında mutlaka methemoglobinemiyi akla getirmelidirler. Key words: Methemoglobinemia, prilocaine, cyanosis

  20. [Association of benzocaine and paracetamol with neonatal-acquired methemoglobinemia].

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    Lepe-Zúñiga, José L; Aguilar-Gómez, Luis E; Godínez-Téllez, Noemí C

    Drug-induced acquired methemoglobinemia in the newborn is a rare event; however, when it develops, early diagnosis and proper treatment become paramount because it can evolve rapidly into a particularly serious disease causing permanent brain damage or death. We report a unique case of severe methemoglobinemia that developed in a newborn associated with a minimal application of a benzocaine healing cream to an anal surgical wound while on acetaminophen. In addition to benzocaine as the primary cause in this case, we raise the possibility that acetaminophen-a mild oxidant-increased the susceptibility of the patient to benzocaine, leading to severe clinical methemoglobinemia based on the known immaturity of the enzymatic systems involved in caines and acetaminophen clearance in the newborn. Treatment of methemoglobinemia is reviewed. Methemoglobinemia is a serious condition that can be easily induced by the use of oxidant medications in the newborn like local anesthetics. The possibility of unexpected drug to drug interactions, particularly between commonly used medications such as acetaminophen with other methemoglobin-causing agents, must always be kept in mind. Because of the possible deleterious consequences, mandatory labelling of caine-containing local anesthetic creams, gels and sprays with a warning for the likelihood of causing severe methemoglobinemia in children is recommended. Also, prohibiting their use in the newborn becomes mandatory. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  1. Methemoglobinemia and dapsone levels in patients with leprosy

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    Jose Luiz Fernandes Vieira

    Full Text Available The objective of this work was to determine the methemoglobinemia and correlate with dapsone levels in multibacillary leprosy patients under leprosy multi-drug therapy. Thirty patients with laboratory and clinical diagnosis of multibacillary leprosy were enrolled. Dapsone was analyzed by high performance liquid chromatography and methemoglobinemia by spectrophotometry. The mean dapsone concentrations in male was 1.42 g/mL and in female was 2.42 g/mL. The mean methemoglobin levels in male was 3.09 µg/mL; 191%, and in female was 2.84 ± 1.67%. No correlations were seen between dapsone levels and methemoglobin in male and female patients. Our results demonstrated that the dosage of dapsone in leprosy treatment does not promote a significant methemoglobinemia.

  2. Medical image of the week: methemoglobinemia

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    Raschke RA

    2018-01-01

    Full Text Available No abstract available. Article truncated at 150 words. A 62-year-old man with a sternal infection post-coronary artery bypass grafting was transferred because of increasing oxygen requirements, decreased mental status and Candida paralopsis fungemia. He had been treated with multiple antibiotics including sulfonamides and had eventually undergone a tracheostomy. Cetacaine was used for complaints of a sore throat. Physical examination showed cyanotic lips and tongue (Figure 1A. Blood drawn was a chocolate brown color (Figure 2. His SpO2 was 88%, however, arterial blood gases showed his SaO2 was 100% and his PaO2 453 mmHg. Co-oximetry showed 26% methemoglobin. He was administered 0.2mL/kg of 1% solution of methylene blue and his cyanosis rapidly cleared (Figure 1B. Methemoglobinemia is a condition characterized by increased quantities of hemoglobin with iron oxidized to the ferric (Fe3+ form (1. Methemoglobin is useless as an oxygen carrier and thus causes a varying degree of cyanosis and hypoxia. It can be genetic but is usually caused …

  3. A case of Occupational Methemoglobinemia (MetHb: A Rare Entity and Unique Treatment

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    Suvarna Patil

    2017-11-01

    Full Text Available Methemoglobinemia is acute emergency which have precise and effective treatment if instituted in time. Methemoglobinemia due to chemical exposure is a known entity. But it required a high index of suspicion to look for it in busy casualty. Treatment with methylene blue is safe and truly lifesaving if instituted in time. Here we are presenting a case of Occupational methemoglobinemia who was treated successfully.

  4. Identifying the Cause of the "Saturation Gap": Two Cases of Dapsone-induced Methemoglobinemia.

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    Furuta, Kenjiro; Ikeo, Satoshi; Takaiwa, Takuya; Ikeda, Satoshi; Nishiyama, Akihiro; Yokoyama, Toshihide; Ito, Akihiro; Tokioka, Fumiaki; Tanaka, Maki; Yoshioka, Hiroshige; Tachibana, Hiromasa; Arita, Machiko; Hashimoto, Toru; Ishida, Tadashi

    2015-01-01

    Diaphenylsulfone (DDS: Dapsone) is used for Pneumocystis pneumonia (PCP) prophylaxis, and methemoglobinemia has rarely been reported as a side effect of DDS. We herein report two cases of DDS-related methemoglobinemia in an 81-year-old man with organizing pneumonia and an 84-year-old woman with eosinophilic pneumonia under treatment with prednisolone. Both patients initially received trimethoprim/sulfamethoxazole for PCP prophylaxis and were switched to DDS due to side effects and subsequently exhibited a clinically unexplainable decrease in SpO2. Methemoglobinemia was diagnosed based on the findings of arterial blood gas analyses. In both cases, the methemoglobinemia improved after discontinuing DDS.

  5. Methemoglobinemia in Young Patients With Hematologic Cancer or Aplastic Anemia Treated With Dapsone

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    2017-04-13

    Chronic Myeloproliferative Disorders; Leukemia; Lymphoma; Lymphoproliferative Disorder; Methemoglobinemia; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Myelodysplastic/Myeloproliferative Neoplasms; Nonmalignant Neoplasm

  6. Unusual complication of aluminum phosphide poisoning: Development of hemolysis and methemoglobinemia and its successful treatment.

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    Soltaninejad, Kambiz; Nelson, Leiws S; Khodakarim, Nastaran; Dadvar, Zohreh; Shadnia, Shahin

    2011-04-01

    Methemoglobinemia and hemolysis are rare findings following phosphine poisoning. In this paper, a case of aluminum phosphide (AlP) poisoning complicated by methemoglobinemia and hemolysis with a successful treatment is reported. A 28-year-old male patient presented following intentional ingestion of an AlP tablet. In this case, hematuria, hemolysis and methemoglobinemia were significant events. A methemoglobin level of 46% was detected by CO-oximetry. The patient was treated with ascorbic acid and methylene blue and he also received supportive care. Two weeks after admission, the patient was discharged from the hospital. Hemolysis and methemoglobinemia may complicate the course of phosphine poisoning.

  7. High-dose vitamin C management in dapsone-induced methemoglobinemia.

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    Park, Sin-Youl; Lee, Kyung-Woo; Kang, Tae-Sin

    2014-06-01

    Methylene blue is the first-choice treatment of methemoglobinemia, but it is not readily available in most Korean emergency departments because of an import suspension. An 84-year-old woman with dapsone-induced massive methemoglobinemia visited our emergency department for unclear mentality and cyanosis. Because methylene blue was not available, we intravenously administrated vitamin C (VC) for symptomatic methemoglobinemia, although VC is not a universally accepted treatment. Vitamin C (10 g intravenously) administered 6 hourly successfully treated the dapsone-induced methemoglobinemia and did not adversely affect renal functions. Thus,we recommend that if methylene blue is unavailable, 6 hourly intravenous administrations of 10 g of VC should be considered for dapsone-induced methemoglobinemia.

  8. Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures

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    Vallurupalli S

    2011-07-01

    Full Text Available Srikanth Vallurupalli1, Shalini Manchanda21Division of General Internal Medicine, Department of Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA; 2Division of Pulmonary, Allergy, Critical Care, and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USAIntroduction: Methemoglobinemia is a recognized complication of the use of topical anesthetic sprays. The true scope of the problem or the risk with different topical anesthetic sprays and endoscopic procedures is unknown.Methods: We retrospectively identified all cases of methemoglobinemia that occurred in a university affiliated community hospital from 2001 to 2007.Results: Eleven cases of methemoglobinemia were identified over the 6-year period. Nine (82% occurred with use of benzocaine spray during transesophageal echocardiography (TEE. Patients who developed methemoglobinemia secondary to the topical anesthetic spray compared to other causes were more likely to be older, have lower mean hemoglobin levels (10.5 ± 0.5 g/dL vs 11.3 ± 0.0 g/dL, and a higher mean methemoglobin concentration at diagnosis (40.8% ± 5.2% vs 24% ± 10%. However, only age reached statistical significance (P = 0.004.Conclusion: In a university-affiliated community hospital, topical anesthetic sprays account for most of the burden of methemoglobinemia. Benzocaine use in the context of TEE caused more methemoglobinemia compared to lidocaine and other endoscopic procedures. This observation supports previous data and findings deserve further study.Keywords: methemoglobinemia, benzocaine, lidocaine, transesophageal echocardiography, endoscopy

  9. Case Report of Methemoglobinemia in a Toddler Secondary to Topical Dapsone Exposure.

    Science.gov (United States)

    Graff, Danielle M; Bosse, George M; Sullivan, Janice

    2016-08-01

    Aczone gel 5% contains dapsone and is a commonly used topical dermatologic therapy for acne in adolescents and adults. We describe the first reported pediatric case of a previously healthy girl presenting with acute onset of methemoglobinemia after exposure to her sibling's Aczone gel. The patient was successfully treated with methylene blue initially and subsequently needed an additional dose for rebound methemoglobinemia. This case demonstrates the complications of systemic absorption of dapsone in the pediatric population resulting in clinically significant methemoglobinemia from a single topical application. Copyright © 2016 by the American Academy of Pediatrics.

  10. Detecting Methemoglobinemia in Animals with a Drop of Blood.

    Directory of Open Access Journals (Sweden)

    Toni G Patton

    Full Text Available A major concern during pesticide development and use is the impact on non-target species, such as raptors or domestic cats and dogs. Sodium nitrite and para-aminopropiophenone (PAPP are two toxicants currently being studied for the control of invasive species, such as starlings and feral swine. When given to an animal these compounds oxidize hemoglobin, which renders it unable to carry oxygen resulting in methemoglobinemia. This study developed a method to estimate methemoglobin levels in mammals and birds by examining the efficacy of sodium nitrite to induce the conversion of hemoglobin to methemoglobin. Varying concentrations of sodium nitrite were added to aliquots of coyote, vole, feral swine, starling, and duck blood, collected from captive animals. The blood samples were analyzed spectrophotometrically to determine percent methemoglobin and digitally to determine red color values (RCV associated with different methemoglobin levels. The avian and mammalian blood reached 100% methemoglobin levels at 200 mM and 15 mM sodium nitrite, respectively. All animals had similar RCV for a given percent methemoglobin. In conclusion, this study developed a procedure to quickly determine methemoglobin levels in mammals and birds. Furthermore, percent methemoglobin can be estimated with one standard curve from any animal species and an image of a blood spot. The technique will be useful during field studies, in agricultural areas, or in a veterinarian's office for the rapid diagnosis of methemoglobinemia in non-target animals that have eaten toxicants/baits or baited animals.

  11. Acute visual loss following dapsone-induced methemoglobinemia and hemolysis.

    Science.gov (United States)

    Hanuschk, Delphine; Kozyreff, Alexandra; Tafzi, Naima; Tennstedt, Dominique; Hantson, Philippe; Saint-Marcoux, Franck

    2015-06-01

    While methemoglobinemia is a possible complication of chronic dapsone therapy or of acute overdose, serious adverse manifestations related to methemoglobin formation remain rare. We present an unusual case with severe ischemic retinal injury. A 30-year-old African woman presented with a sudden decrease of visual acuity secondary to retinal ischemia. She was chronically treated with dapsone (50 mg/day) for a dermatologic disease and denied any drug overdose. However, the determination of serum dapsone level on admission revealed a largely supratherapeutic concentration (20,044 μg/ml compared with 1-3.5 ± 0.5 μg/ml for therapeutic levels). The methemoglobin level at admission was 32% (sulfhemoglobin 1.2%), with hemoglobin level, 7.4 g/dl, schistocytes count, 2-5%, lactate dehydrogenase level, 580 IU/l, and haptoglobin level, dapsone, the severity of visual injury was associated with dapsone-induced methemoglobinemia and hemolysis, and perhaps also with some hematologic predisposing factors.

  12. Auditors' Professional Skepticism: Neutrality versus Presumptive Doubt

    NARCIS (Netherlands)

    Groot, T.L.C.M.; Quadackers, L.M.; Wright, A.

    2014-01-01

    Although skepticism is widely viewed as essential to audit quality, there is a debate about what form is optimal. The two prevailing perspectives that have surfaced are "neutrality" and "presumptive doubt." With neutrality, auditors neither believe nor disbelieve client management. With presumptive

  13. Acute methemoglobinemia associated with ochronotic valvular heart disease: report of a case.

    Science.gov (United States)

    Uchiyama, C; Kondoh, H; Shintani, H

    2010-03-01

    We describe the first reported case of acute methemoglobinemia associated with ochronotic valvular heart disease. A 79-year-old man with ochronotic valvular heart disease experienced decreased urinary output starting 9 days after an operation. Thereafter, the patient's methemoglobin concentration acutely increased, indicating systemic cyanosis, while the arterial partial oxygen pressure (PaO (2)) was maintained at around 200 mmHg. In patients with ochronotic valvular heart disease, acute methemoglobinemia may occur, as in cases of renal failure or oliguresis.

  14. Methemoglobinemia associated with loxoscelism Meta-hemoglobinemia associada ao loxoscelismo

    Directory of Open Access Journals (Sweden)

    Orlando C. de O. Barreto

    1990-02-01

    Full Text Available In twenty five patients who presented the cutaneous form of loxoscelism, serum haptoglobin and lactic dehydrogenase, erythrocyte glucose-6-phosphate dehydrogenase, glutathione reductase, glutathione peroxidase, methemoglobin, bilirubin and reticulocytes were investigated after bite. No hemolysis was detected but an increase in methemoglobin was found in 54% of the cases; in 7% it was between 1.1% and 2%, in 27% it ranged from 2.1% to 4%, and in 20% from 4.1% to 8%. Blood samples of a normal, blood group 0 individual and of a patient who exhibited methemoglobinemia after Loxosceles bite were incubated separately with antisera against Loxosceles gaucho, Crotalus terrificus, Bothrops jararaca, with Loxosceles gaucho venom and 0.3% phenol. No methemoglobin was found after 1, 4,8 and 15 days in both sets of samples. At the 25th day all the samples, including the controls, exhibited similar methemoglobin reductase decrease. The data suggest that the methemoglobinemia which occurs in 50% of the patients probably arises from in vivo venom metabolism, inasmuch as the crude venom does not induce methemoglobinemia.Vinte e cinco pacientes que apresentaram a forma cutânea do loxoscelismo foram estudados após a picada, determinando-se a glicose-6-fosfato desidrogenase, glutationa redutase e glutationa peroxidase eritrocitárias, haptoglobina e latico desidrogenase séricas, bilirrubina, reticulócitos e meta-hemoglobina. Não foi observada hemólise aumentada, mas foi detectado aumento da meta-hemoglobina em 54% dos casos: em 7% entre 1,1% e 2%, em 27% variou de 2,1% a 4%, e em 20% de 4,1 a 8%. Amostras de sangue de um indivíduo normal do grupo 0 de uma paciente que exibiu meta-hemoglobina após picada por Loxosceles foram incubadas separadamente com anti-soros contra Loxosceles gancho, Crotalus terrificus e Bothrops jararaca, com veneno de Loxosceles gaucho e fenol a 3%, e não se detectou aumento de meta-hemoglobina depois de 1, 4, 8 e 15 dias em todas

  15. Dapsone induced methemoglobinemia in a patient with glioblastoma

    Science.gov (United States)

    Walker, Julie G.; Kadia, Tapan; Brown, Latrondria; Juneja, Harinder S.; de Groot, John F.

    2015-01-01

    Primary brain tumor patients have multiple risk factors for Pneumocystis jiroveci and may require prophylaxis with TMP-SMZ or dapsone. Although dapsone is generally safe and efficacious, we present a case of a patient diagnosed with a brain stem glioblastoma who developed methemoglobinemia and haemolytic anemia after presenting with worsening confusion and cardiopulmonary system dysfunction. This case highlights one of the potentially severe complications associated with dapsone therapy. Although this illustrates an unusual toxicity of dapsone, a high index of suspicion should be given to high-risk patients due to ethnic heritage, anemia, or advanced age. Furthermore, given the toxicities of TMP-SMZ and dapsone, further work is needed to determine the threshold CD4+ count at which empiric prophylaxis should be initiated. PMID:19219404

  16. Myths, presumptions, and facts about obesity

    DEFF Research Database (Denmark)

    Casazza, Krista; Fontaine, Kevin R; Astrup, Arne

    2013-01-01

    Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations...

  17. Presumptive Eligibility for Medicaid and CHIP Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — Health care providers and Head Start programs can play a major role in finding and enrolling uninsured children through presumptive eligibility. States can authorize...

  18. 28 CFR 80.10 - Rebuttable presumption.

    Science.gov (United States)

    2010-07-01

    ... conformity with the Department's present enforcement policy, is in compliance with those provisions of the FCPA. Such a presumption may be rebutted by a preponderance of the evidence. In considering the...

  19. Severe methemoglobinemia caused by continuous lidocaine infusion in a term neonate.

    Science.gov (United States)

    Bohnhorst, Bettina; Hartmann, Hans; Lange, Matthias

    2017-05-01

    Neonates and young infants are especially prone to develop drug-induced methemoglobinemia. Therefore, lidocaine is not licensed as local anesthetic in children below the age of 3 months. However, its systemic use is advocated for neonatal seizures. Cardiac arrhythmia has been reported as sole major side effect. Here we report a case of severe methemoglobinemia caused by continuous infusion of lidocaine in a term neonate with neonatal seizures. The increase of methemoglobin up to 13.8% was accompanied by hypoxemia and cyanosis, necessitating additional inspired oxygen and CPAP ventilation. After stopping lidocaine infusion methemoglobin levels fell and the neonate could be weaned from ventilation. Neonates treated with lidocaine for seizures must be monitored for the occurrence of methemoglobinemia. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  20. Upward trend of dapsone-induced methemoglobinemia in renal transplant community
.

    Science.gov (United States)

    Salim, Sohail Abdul; Ramachandran Nair, Lakshmi; Palabindala, Venkataraman; Craici, Iasmina

    2017-09-01

    Dapsone, a sulfone antibiotic, is used for prophylaxis of Pneumocystis jirovecii pneumonia in patients with documented sulfa allergy. Acquired methemoglobinemia caused by dapsone is not uncommon in patients with normal glucose-6-phosphate dehydrogenase (G6PD) levels. Discrepancy between oxygen saturation measured by pulse oximetry and arterial oxygen saturation (SpO2) readings, a phenomenon known as "saturation gap," is noted with cases of methemoglobinemia. Although its prevalence in renal transplant patients is poorly described, there is evidence that its incidence is increasing. Here we describe a case series of 4 patients who were switched from trimethoprim-sulfamethoxazole (TMP-SMX) to dapsone and subsequently developed methemoglobinemia. Symptoms occur at varying methemoglobin levels and are more severe in patients with pre-existing coronary disease or chronic lung disease. Early recognition and cessation of dapsone is imperative, especially in renal transplant.
.

  1. Misleading presumption of a generalized Hartman effect

    International Nuclear Information System (INIS)

    Simanjuntak, Herbert P.; Pereyra, Pedro

    2007-07-01

    We analyze different examples to show that the so-called generalized Hartman effect is an erroneous presumption. The results obtained for electron tunneling and transmission of electromagnetic waves through superlattices and Bragg gratings show clearly the resonant character of the phase time behavior where a generalized Hartman effect is expected. A reinterpretation of the experimental results in double Bragg gratings is proposed. (author)

  2. outcome of presumptive versus rapid diagnostic tests

    African Journals Online (AJOL)

    GB

    2010-03-02

    Mar 2, 2010 ... diagnostic test in the management of children with this overlap, but this has not been evaluated. Therefore, the objective of this study was to compare the clinical outcome of presumptive versus malaria rapid diagnostic test - ... the rain forest belt of Nigeria, an area with perennial malaria trans mission.

  3. Microbiological studies of blood specimen from presumptively ...

    African Journals Online (AJOL)

    Three hundred and fifteen blood samples were obtained from presumptively diagnosed typhoid patients who were referred for Widal Serological test at four diagnostic centres. The blood samples were subjected to bacteriological investigations. Salmonella and non-Salmonella organisms isolated were identified according ...

  4. 15 CFR 990.13 - Rebuttable presumption.

    Science.gov (United States)

    2010-01-01

    ...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OIL POLLUTION ACT REGULATIONS... assessment of damages to natural resources made by a Federal, State, or Indian trustee in accordance with this part shall have the force and effect of a rebuttable presumption on behalf of the trustee in any...

  5. Successful treatment of methemoglobinemia in an elderly couple with severe cyanosis: two case reports

    Directory of Open Access Journals (Sweden)

    Su Ying-Fu

    2012-09-01

    Full Text Available Abstract Introduction Methemoglobinemia should be considered in all cyanotic patients who remain unresponsive to oxygen therapy. Rapid diagnosis is very important in emergency cases. Here, we present the cases of two patients, a married couple, admitted to our hospital with methemoglobinemia after exposure to sodium nitrite. Case presentation Two patients, a married couple, presented with methemoglobinemia. The 72-year-old Taiwanese man and 68-year-old Taiwanese woman were referred to our hospital with dizziness and tachypnea. On examination, their mucous membranes were cyanotic, and their blood samples showed the classic ‘chocolate brown’ appearance. The man also reported having experienced twitching of his right arm for a few minutes before arrival at the hospital. The symptoms of both patients failed to improve in response to supplemental oxygen delivered via oxygen masks, although the arterial blood gas data of these patients were normal and their pulse oximetry showed oxyhemoglobin levels of approximately 85%. A carbon monoxide-oximeter showed that the man’s methemoglobin concentration was 48.3%, and the woman’s was 36.4%. Methylene blue (100mg was administered intravenously to both patients, and their symptoms improved dramatically. They were admitted to the intensive care unit and discharged three days later, without neurological sequelae. Conclusion Severe methemoglobinemia is a life-threatening condition and, if untreated, may result in death. Early diagnosis and appropriate antidotal treatment are crucial in treating this emergency situation.

  6. Myths, Presumptions, and Facts about Obesity

    Science.gov (United States)

    Casazza, Krista; Fontaine, Kevin R.; Astrup, Arne; Birch, Leann L.; Brown, Andrew W.; Bohan Brown, Michelle M.; Durant, Nefertiti; Dutton, Gareth; Foster, E. Michael; Heymsfield, Steven B.; McIver, Kerry; Mehta, Tapan; Menachemi, Nir; Newby, P.K.; Pate, Russell; Rolls, Barbara J.; Sen, Bisakha; Smith, Daniel L.; Thomas, Diana M.; Allison, David B.

    2013-01-01

    BACKGROUND Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may divert attention away from useful, evidence-based information. METHODS Using Internet searches of popular media and scientific literature, we identified, reviewed, and classified obesity-related myths and presumptions. We also examined facts that are well supported by evidence, with an emphasis on those that have practical implications for public health, policy, or clinical recommendations. RESULTS We identified seven obesity-related myths concerning the effects of small sustained increases in energy intake or expenditure, establishment of realistic goals for weight loss, rapid weight loss, weight-loss readiness, physical-education classes, breast-feeding, and energy expended during sexual activity. We also identified six presumptions about the purported effects of regularly eating breakfast, early childhood experiences, eating fruits and vegetables, weight cycling, snacking, and the built (i.e., human-made) environment. Finally, we identified nine evidence-supported facts that are relevant for the formulation of sound public health, policy, or clinical recommendations. CONCLUSIONS False and scientifically unsupported beliefs about obesity are pervasive in both scientific literature and the popular press. (Funded by the National Institutes of Health.) PMID:23363498

  7. Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures

    OpenAIRE

    Vallurupalli, Srikanth; Manchanda, Shalini

    2011-01-01

    Srikanth Vallurupalli1, Shalini Manchanda21Division of General Internal Medicine, Department of Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA; 2Division of Pulmonary, Allergy, Critical Care, and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USAIntroduction: Methemoglobinemia is a recognized complication of the use of topical anesthetic sprays. The true scope of the problem or the risk with different to...

  8. A Case Report of Prilocaine-Induced Methemoglobinemia after Liposuction Procedure

    Directory of Open Access Journals (Sweden)

    Birdal Yildirim

    2015-01-01

    Full Text Available Prilocaine-induced methemoglobinemia is a rarely seen condition. In this paper, a case is presented with methemoglobinemia developed secondary to prilocaine use in a liposuction procedure, and the importance of this rarely seen condition is emphasized. A 20-year-old female patient presented with complaints of prostration, lassitude, shivering, shortness of breath, and cyanosis. It was learned that the patient underwent nearly 1000 mg prilocaine infiltration 8 hours priorly during a liposuction procedure. At admission, her blood pressure (130/80 mmHg, pulse rate (140 bpm, body temperature (36°C, and respiratory rate (40/min were recorded. The patient had marked acrocyanosis. The arterial blood gas methemoglobin level was measured as 40%. The patient received oxygen therapy with a mask and was administered vitamin C in normal saline (500 mg tid, N-acetylcysteine (300 mg tid, and 50 mg 10% methylene blue in the intensive care unit of the internal medicine department. Methemoglobin level dropped down to 2% after her treatment with methylene blue and she was clinically cured and discharged 2 days later. Emergency service physicians should remember to consider methemoglobinemia when making a differential diagnosis between dyspnea and cyanosis developing after prilocaine infiltration performed for liposuctions in the adult age group.

  9. 20 CFR 410.462 - Presumption relating to respirable disease.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Presumption relating to respirable disease... Pneumoconiosis § 410.462 Presumption relating to respirable disease. (a) Even though the existence of... was employed for 10 years or more in the Nation's coal mines and died from a respirable disease, it...

  10. An Atypical Case of Methemoglobinemia due to Self-Administered Benzocaine

    Directory of Open Access Journals (Sweden)

    Thomas M. Nappe

    2015-01-01

    Full Text Available Acquired methemoglobinemia is an uncommon hemoglobinopathy that results from exposure to oxidizing agents, such as chemicals or medications. Although, as reported in the adult population, it happens most often due to prescribed medication or procedural anesthesia and not due to easily accessed over-the-counter medications, the authors will describe an otherwise healthy male adult with no known medical history and no prescribed medications, who presented to the emergency department reporting generalized weakness, shortness of breath, headache, dizziness, and pale gray skin. In addition, the patient reported that he also had a severe toothache for several days, which he had been self-treating with an over-the-counter oral benzocaine gel. Ultimately, the diagnosis of methemoglobinemia was made by clinical history, physical examination, and the appearance of chocolate-colored blood and arterial blood gas (ABG with cooximetry. After 2 mg/kg of intravenous methylene blue was administered, the patient had complete resolution of all signs and symptoms. This case illustrates that emergency physicians should be keenly aware of the potential of toxic hemoglobinopathy secondary to over-the-counter, nonprescribed medications. Discussion with patients regarding the dangers of inappropriate use of these medicines is imperative, as such warnings are typically not evident on product labels.

  11. A Minimalist and Garantistic Conception of the Presumption of Innocence

    Directory of Open Access Journals (Sweden)

    Jordi Ferrer Beltrán

    2018-03-01

    Full Text Available The article aims to address the multiple faces that the presumption of innocence incorporates in modern legal systems from a critical perspective. In this sense, an analytical methodology seeks to demonstrate that some of these faces overlap with other legal rights and institutes, which, far from increasing the guarantees of citizens, leads to confusion and lack of controllability of judicial decisions. Thus, it is defended the conceptual and practical convenience of thinking the presumption of innocence avoiding overlaps with other legal rights or concepts, as standards of proof or burden of proof rules. Hence the reference to a minimalist and guarantistic conception of the presumption of innocence and, and, as will be seen, the defense of the presumption of innocence as a second order rule whose application would make sense in contexts of uncertainty about the satisfaction of the standard of proof.

  12. The Presumption of Innocence as a Counterfactual Principle

    Directory of Open Access Journals (Sweden)

    Ferry de Jong

    2016-01-01

    Full Text Available This article’s primary aim is to highlight the essentially critical potential of the presumption of innocence, as well as the need for this critical potential to be duly recognized. It is argued that the essential meaning of the presumption of innocence is best understood when approached from what is referred to as its counterfactual status. As a first step, the different values and functions that are attributed to the presumption of innocence in contemporary legal literature are discussed, in order to provide an outline of the central ideas it contains or is supposed to contain. Subsequently, the concept of ‘counterfactuality’ is introduced and it is argued that a counterfactual perspective can further clarify the nature of the presumption of innocence. Next, a number of fundamental shifts in society and criminal justice are discussed that affect the presumption of innocence and that lend a large measure of urgency to disclosing its essence and critical potential. The conclusion argues that today’s threats to the presumption of innocence are of a fundamental nature, and that attempts to preserve the principle’s efficacy should focus on the value attached to its counterfactual and critical nature.

  13. Outcome of Presumptive Versus Rapid Diagnostic Tests-Based ...

    African Journals Online (AJOL)

    First, 50 children with malaria-pneumonia symptom overlap were consecutively enrolled and treated presumptively with antibiotics and antimalarials irrespective of malaria test result (control arm).Then, another 50 eligible children were enrolled and treated with antibiotics with/out antimalarials based on rapid diagnostic test ...

  14. Factors influencing utilization of intermittent presumptive treatment of ...

    African Journals Online (AJOL)

    Background: Intermittent presumptive treatment of malaria in pregnancy (IPTp) is one of the recommended interventions by World Health Organization to mitigate the impact of malaria in pregnancy in malaria stable transmission zones such as Sub Saharan regions so as to ensure the best outcome for both the mother and ...

  15. Health Seeking Behaviour among Individuals with Presumptive Tuberculosis in Zambia

    NARCIS (Netherlands)

    Chanda-Kapata, Pascalina; Kapata, Nathan; Masiye, Felix; Maboshe, Mwendaweli; Klinkenberg, Eveline; Cobelens, Frank; Grobusch, Martin P.

    2016-01-01

    Tuberculosis (TB) prevalence surveys offer a unique opportunity to study health seeking behaviour at the population level because they identify individuals with symptoms that should ideally prompt a health consultation. To assess the health-seeking behaviour among individuals who were presumptive TB

  16. operation and effect of presumptions in civil proceedings

    African Journals Online (AJOL)

    eliasn

    “Although presumption is not evidence and has no weight as such, it does make a ..... intelligence to appreciate the difficulties of the subject-matter has approached .... facts exists. This envisages the existence of another fact or aggregate of facts, called the presumed fact or fact(s) that must be assumed in the absence of.

  17. 47 CFR 76.906 - Presumption of no effective competition.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Presumption of no effective competition. 76.906... competition. In the absence of a demonstration to the contrary, cable systems are presumed not to be subject to effective competition. ...

  18. Is psychosocial risk prevention possible? Deconstructing common presumptions

    OpenAIRE

    Leka, Stavroula; Van Wassenhove, Wim; Jain, Aditya Kailash

    2015-01-01

    This paper tackles a much debated and often misunderstood issue in the modern world of work, psychosocial risks. Although the prevalence and impact of psychosocial risks is now widely acknowledged as a priority in health and safety in Europe, there remains resistance by key stakeholders in prioritizing psychosocial risk management both in business and policy making. This paper explores why this is still the case by discussing three presumptions in relation to the current state of the art in t...

  19. Ranitidine treatment inducing methemoglobinemia in male Wistar rats Metemoglobinemia induzida pela ranitidina em ratos

    Directory of Open Access Journals (Sweden)

    Wilson Roberto Malfará

    2005-06-01

    Full Text Available Drug idiosyncrasy is an adverse event of unknown etiology that occurs in a small fraction of people taking a drug. The histamine-2 (H2-receptor antagonist ranitidine causes idiosyncratic reactions in patients. To investigate the hypothesis that ranitidine could induce hematological toxic effects, the drug was administered intraperitoneally (ip to two of six groups of 200-220 g male Wistar rats (n=6. Group I received as single dose of saline solution (NaCl, 200 µL Group II received 200 µL of NaCl, ip, at 0, 24, 48 and 72 h, Group III (controls of the vehicle received as single dose of dimethyl sulfoxide (DMSO, 200µL, ip, Group IV (controls of the vehicle received 200 µL of DMSO, ip, at 0, 24, 48, and 72 h, Group V received a single dose of 100 mg/kg of ranitidine in 200 µL of DMSO ip, Group VI received 50 mg/kg of ranitidine, in 200 µL of DMSO, ip, at 0, 24, 48, and 72 h. Erythrograms, leucograms were measured; percent methemoglobin content of the blood was analyzed spectophotometrically. Methemoglobinemia increased to a significant extent following ranitidine treatment, in both study groups. White blood cell and neutrophil counts showed a discrete reduction following either regime of treatment. A marginal mobilization of the neutrophil pool probably occured. Following the multiple dose regime, leukocyte counts increased, but their distribution maintenance profile remained the same. The administration of ranitidine to rats induces methemoglobinemia in the administered doses, suggesting that from a certain concentration and dosage scheme the substance can be methemeglobinemia inductor.A idiossincrasia a fármacos é um evento adverso de origem desconhecida, que acontece em poucas pessoas. É conhecido que a ranitidina, um antagonista de receptores H2, causa reações idiossincrásicas. Para investigar uma possível indução da ranitidina em relação a hemotoxicidade, o fármaco foi administrado intraperitonealmente (i.p. em dois de seis

  20. L-arginine, a nitric oxide precursor, reduces dapsone-induced methemoglobinemia in rats

    Directory of Open Access Journals (Sweden)

    Natália Valadares de Moraes

    2012-03-01

    Full Text Available Dapsone use is frequently associated to hematological side effects such as methemoglobinemia and hemolytic anemia, which are related to N-hydroxylation mediated by the P450 enzyme system. The aim of the present study was to evaluate the influence of L-arginine supplementation, a precursor for the synthesis of nitric oxide, as single or multiple dose regimens on dapsone-induced methemoglobinemia. Male Wistar rats were treated with L-arginine at 5, 15, 30, 60 and 180 mg/kg doses (p.o., gavage in single or multiple dose regimens 2 hours prior to dapsone administration (40 mg/kg, i.p.. The effect of the nitric oxide synthase inhibitor L-NAME was investigated by treatment with multiple doses of 30 mg/kg (p.o., gavage 2 hours before dapsone administration. Blood samples were collected 2 hours after dapsone administration. Erythrocytic methemoglobin levels were assayed by spectrophotometry. The results showed that multiple dose supplementations with 5 and 15 mg/kg L-arginine reduced dapsone-induced methemoglobin levels. This effect is mediated by nitric oxide formation, since the reduction in methemoglobin levels by L-arginine is blocked by simultaneous administration with L-NAME, a nitric oxide synthase inhibitor.O uso da dapsona é frequentemente associado a efeitos adversos hematológicos, como a metemoglobinemia e anemia hemolítica, ambos relacionados com a N-hidroxilação mediada pelo sistema P450. O objetivo do estudo foi avaliar a influência da suplementação de L-arginina, um precursor da síntese de óxido nítrico, administrado em regime de dose única ou múltipla na metemoglobinemia induzida pela dapsona. Ratos machos Wistar foram tratados com L-arginina (po, gavagem em dose única ou múltipla de 5, 15, 30, 60 e 180 mg/kg 2 horas antes da administração de dapsona (40 mg/kg, ip. O efeito do L-NAME, um inibidor de óxido nítrico sintase (NOS, foi avaliado através do tratamento com doses múltiplas de 30 mg/kg. Amostras de sangue

  1. Dapsone-induced methemoglobinemia in renal transplant recipients: more prevalent than previously thought.

    Science.gov (United States)

    Mitsides, N; Green, D; Middleton, R; New, D; Lamerton, E; Allen, J; Redshaw, J; Chadwick, P R; Subudhi, C P K; Wood, G

    2014-02-01

    After an outbreak of Pneumocystis pneumonia (PCP) in our nephrology unit, dapsone was used as the second-line chemoprophylactic agent. Dapsone is the most common cause of drug-induced methemoglobinemia (MHb). Its prevalence is poorly described in the renal transplant population. Because dapsone is excreted by the kidneys, we hypothesized that the rate of MHb in these patients would be higher than previously reported. We aimed to describe the demographics, risk factors, and presenting features of MHb in these renal transplant patients. Twenty-six transplant recipients commenced on dapsone for chemoprophylaxis against PCP from February to September 2011. All patients had normal glucose-6-phosphate dehydrogenase levels before treatment. Characteristics of patients with MHb were compared with those of the rest of the cohort to determine potential risk factors. Twelve (46%) patients developed MHb (levels 6.4 ± 4.1%). Six (50%) of the patients with MHb were asymptomatic on presentation. Cases had a mean drop in hemoglobin of 19 ± 7%. MHb led to five admissions (median length of stay 5 days, range 1-10 days). MHb level showed a strong correlation with the length of stay (correlation coefficient 0.762, P = 0.002). This is the highest reported prevalence of MHb, to our knowledge, in patients receiving dapsone, and its use led to significant hospitalization in this population. This study raises concerns about the use of dapsone as chemoprophylaxis in renal transplant recipients. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Brain iron accumulation in unexplained fetal and infant death victims with smoker mothers-The possible involvement of maternal methemoglobinemia

    Directory of Open Access Journals (Sweden)

    Corna Melissa F

    2011-07-01

    Full Text Available Abstract Background Iron is involved in important vital functions as an essential component of the oxygen-transporting heme mechanism. In this study we aimed to evaluate whether oxidative metabolites from maternal cigarette smoke could affect iron homeostasis in the brain of victims of sudden unexplained fetal and infant death, maybe through the induction of maternal hemoglobin damage, such as in case of methemoglobinemia. Methods Histochemical investigations by Prussian blue reaction were made on brain nonheme ferric iron deposits, gaining detailed data on their localization in the brainstem and cerebellum of victims of sudden death and controls. The Gless and Marsland's modification of Bielschowsky's was used to identify neuronal cell bodies and neurofilaments. Results Our approach highlighted accumulations of blue granulations, indicative of iron positive reactions, in the brainstem and cerebellum of 33% of victims of sudden death and in none of the control group. The modified Bielschowsky's method confirmed that the cells with iron accumulations were neuronal cells. Conclusions We propose that the free iron deposition in the brain of sudden fetal and infant death victims could be a catabolic product of maternal methemoglobinemia, a biomarker of oxidative stress likely due to nicotine absorption.

  3. Chlamydial cervicitis: testing the practice guidelines for presumptive diagnosis.

    Science.gov (United States)

    Sellors, J; Howard, M; Pickard, L; Jang, D; Mahony, J; Chernesky, M

    1998-01-13

    To test the recommendation from the Canadian guidelines for sexually transmitted diseases (STDs) that mucopurulent endocervical discharge and 10 or more polymorphonuclear leukocytes (PMNs) per high-power field of a Gram-stained endocervical smear or, when Gram staining is not possible, the presence of endocervical discharge and one of edema, erythema or induced mucosal bleeding of the cervix can be considered diagnostic for chlamydial cervicitis. A total of 596 consecutive women attending 2 family planning clinics for routine care underwent vaginal speculum examination and were tested for Chlamydia trachomatis and Neisseria gonorrhoeae. PMN counts from Gram-stained endocervical smears and the presence or absence of putative indicators of chlamydial infection were recorded. The prevalence of chlamydial cervicitis was 6.2% (37/596), and no women tested positive for N. gonorrhoeae. Presumptive diagnosis of chlamydial cervicitis based on the guidelines criteria of mucopurulent endocervical discharge and 10 or more PMN per high-power microscopic field had a sensitivity and specificity of 18.9% and 97.0% respectively, a positive predictive value of 29.2% and a positive likelihood ratio (LR) of 6.2 (p = 0.003). Presumptive diagnosis based on endocervical discharge with edema, erythema or induced mucosal bleeding of the cervix had a sensitivity and specificity of 43.2% and 80.0% respectively, a positive predictive value of 12.5% and a positive LR of 2.2 (p = 0.002). In the presence of bacterial vaginosis or vaginitis, the LR for the criteria of mucopurulent endocervical discharge and 10 or more PMN per high-power field was 5.4 (p = 0.04), whereas the LR was 4.3 (p = 0.10) if bacterial vaginosis and vaginitis were absent. In this setting, the practice of making a presumptive diagnosis of chlamydial cervicitis on the basis of the criteria given in the Canadian STD guidelines was not supported.

  4. Health Seeking Behaviour among Individuals with Presumptive Tuberculosis in Zambia.

    Science.gov (United States)

    Chanda-Kapata, Pascalina; Kapata, Nathan; Masiye, Felix; Maboshe, Mwendaweli; Klinkenberg, Eveline; Cobelens, Frank; Grobusch, Martin P

    2016-01-01

    Tuberculosis (TB) prevalence surveys offer a unique opportunity to study health seeking behaviour at the population level because they identify individuals with symptoms that should ideally prompt a health consultation. To assess the health-seeking behaviour among individuals who were presumptive TB cases in a national population based TB prevalence survey. A cross sectional survey was conducted between 2013 and 2014 among 66 survey clusters in Zambia. Clusters were census supervisory areas (CSAs). Participants (presumptive TB cases) were individuals aged 15 years and above; having either cough, fever or chest pain for 2 weeks or more; and/or having an abnormal or inconclusive chest x-ray image. All survey participants were interviewed about symptoms and had a chest X-ray taken. An in-depth interview was conducted to collect information on health seeking behaviour and previous TB treatment. Of the 6,708 participants, the majority reported at least a history of chest pain (3,426; 51.1%) followed by cough (2,405; 35.9%), and fever (1,030; 15.4%) for two weeks or more. Only 34.9% (2,340) had sought care for their symptoms, mainly (92%) at government health facilities. Of those who sought care, 13.9% (326) and 12.1% (283) had chest x-ray and sputum examinations, respectively. Those ever treated for TB were 9.6% (644); while 1.7% (114) was currently on treatment. The average time (in weeks) from onset of symptoms to first care-seeking was 3 for the presumptive TB cases. Males, urban dwellers and individuals in the highest wealth quintile were less likely to seek care for their symptoms. The likelihood of having ever been treated for TB was highest among males, urban dwellers; respondents aged 35-64 years, individuals in the highest wealth quintile, or HIV positive. Some presumptive TB patients delay care-seeking for their symptoms. The health system misses opportunities to diagnose TB among those who seek care. Improving health-seeking behaviour among males, urban

  5. PRESUMPTIVE PIT VIPER ENVENOMATION IN PSITTACINES IN A BRAZILIAN ZOO.

    Science.gov (United States)

    Dislich, Mathias; Wohlsein, Peter; Croukamp, Anna Sophie; Neumann, Ulrich

    2017-09-01

    Snake bites represent a serious public health risk in many regions of the globe, especially in tropical areas. Clinical signs and postmortem changes are well described in human and other mammalian species. However, detailed case reports about venomous snake attacks in avian species are limited. This report describes presumptive fatal envenomations in three psittacines caused by pit vipers in a Brazilian zoo. In one case, a Brazilian lancehead (Bothrops moojeni) was captured in the aviary. In all three cases the dermis around the suspected snake bite area exhibited hemorrhages and edema. Histologically, degeneration and necrosis of subcutaneous musculature were observed. Lung, heart, and kidneys displayed focal hemorrhages. The local changes are similar to those described for mammalian patients including humans. However, except for the parenchymatous hemorrhages, additional external and internal gross and histopathological lesions were missing. After ruling out other causes, such as aggression and dicoumarinic intoxication, the presumptive diagnosis of snake envenomation was made. The smaller size and variabilities of pathophysiological effects of the venom in parrots might explain the different lesion patterns observed, compared with mammals. Possibly, the birds may have reacted differently to envenomation by pit vipers and died before the venom could cause macroscopic and histological changes often observed in mammals.

  6. Presumption of Innocence and Public Safety: A Possible Dialogue

    Directory of Open Access Journals (Sweden)

    Ana Aguilar-Garcia

    2014-12-01

    Full Text Available In Mexico, increasing demands for public safety coupled with the need for a more effective criminal justice system resulted in the security and justice constitutional reform of 2008. The outcome was a constitutional framework with provisions based on the highest standards of human rights on the one hand, and on the other, exceptional measures that restrict rights in an attempt to improve public safety. Unfortunately, the crime rate and incidence of unreported crime have changed little. When public safety is demanded, a clear, rational and concrete response is required. Limiting the alternatives to pre-trial detention or increasing penalties is rarely the appropriate response. This paper focuses on pre-trial detention and non-custodial measures supported by the new criminal justice system, how they relate to the principle of the presumption of innocence and the tension between this and the punitive demands for increased imprisonment. In addition, this study discusses a technical solution, found in pre-trial services, which seeks to balance the presumption of innocence and the right to personal liberty with public safety.

  7. 20 CFR 410.458 - Irrebuttable presumption of death due to pneumoconiosis-survivor's claim.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Irrebuttable presumption of death due to... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.458 Irrebuttable presumption of death due to pneumoconiosis—survivor's...

  8. 75 FR 25161 - Defense Federal Acquisition Regulation Supplement; Presumption of Development at Private Expense

    Science.gov (United States)

    2010-05-07

    ... Acquisition Regulation Supplement; Presumption of Development at Private Expense AGENCY: Defense Acquisition... the presumption of development at private expense for major systems; and section 815(a)(2) of the NDAA... Expense--Technical Data The validation of asserted restrictions on technical data is based on statutory...

  9. USE OF PRESUMPTIVE TAXATION IN FACILITATING SMALL BUSINESS TAX COMPLIANCE

    Directory of Open Access Journals (Sweden)

    Victoria IORDACHI

    2016-07-01

    Full Text Available The actuality of this article is determined by the necessity of implementing fiscal simplicity for increasing tax compliance through fiscal education of small business representatives. In many developing and transition countries, micro and small enterprises are the most rapidly growing business segment. Tax compliance attitude within this sector varies significantly because high conformation costs and difficult formalization procedures can determine many small enterprises to operate in the informal economy. Thus tax regulation of small enterprises is crucial in the process of small entrepreneurs fiscal education and tax simplification of SMEs in many countries becomes one of the most efficient instruments. The main research methods were systemic analysis and logic synthesis. The main results obtained in article, as a result of research, are identification, analysis and systematization of foreign countries’ practices in implementing presumptive tax design and elaboration of some recommendations on fiscal simplicity.

  10. Doxorubicin chemotherapy for presumptive cardiac hemangiosarcoma in dogs†.

    Science.gov (United States)

    Mullin, C M; Arkans, M A; Sammarco, C D; Vail, D M; Britton, B M; Vickery, K R; Risbon, R E; Lachowicz, J; Burgess, K E; Manley, C A; Clifford, C A

    2016-12-01

    Sixty-four dogs were treated with single-agent doxorubicin (DOX) for presumptive cardiac hemangiosarcoma (cHSA). The objective response rate (CR + PR) was 41%, and the biologic response rate (CR + PR + SD), or clinical benefit, was 68%. The median progression-free survival (PFS) for treated dogs was 66 days. The median survival time (MST) for this group was 116 days and was significantly improved compared to a MST of 12 days for untreated control dogs (P = 0.0001). Biologic response was significantly associated with improved PFS (P < 0.0001) and OS (P < 0.0001). Univariate analysis identified larger tumour size as a variable negatively associated with PFS. The high rate of clinical benefit and improved MST suggest that DOX has activity in canine cHSA. © 2014 John Wiley & Sons Ltd.

  11. 38 CFR 1.18 - Guidelines for establishing presumptions of service connection for former prisoners of war.

    Science.gov (United States)

    2010-07-01

    ... establishing presumptions of service connection for former prisoners of war. 1.18 Section 1.18 Pensions... Guidelines for establishing presumptions of service connection for former prisoners of war. (a) Purpose. The Secretary of Veterans Affairs will establish presumptions of service connection for former prisoners of war...

  12. Presumptive red maple (Acer rubrum) toxicosis in Grevy's zebra (Equus grevyi).

    Science.gov (United States)

    Weber, M; Miller, R E

    1997-03-01

    Two female Grevy's zebras (Equus grevyi), one juvenile and one adult, were treated for hemolytic anemia. The juvenile survived, but the adult animal, which also had methemoglobinemia, was euthanized after it failed to recover from anesthesia. Significant pathologic findings in the adult zebra included generalized icterus, hemoglobinuric nephrosis, and paracentral hepatic necrosis. Serum titers for known infectious causes of anemia were negative. Examination of the zebra holding areas revealed two hybrid red maple (Acer sp.) trees. There was no known exposure to other hemolytic agents. This is the first report of probable red maple-induced hemolysis in zebra.

  13. Magnetic resonance imaging of presumptive lumbosacral discospondylitis in a dog

    International Nuclear Information System (INIS)

    Kraft, S.L.; Mussman, J.M.; Smith, T.; Biller, D.S.; Hoskinson, J.J.

    1998-01-01

    three-year-old male Boxer dog had hyperesthesia, symmetrical epaxial, gluteal and hind limb muscular atrophy and rear limb ataxia. Neurological deficits included decreased conscious proprioception of the left hind limb, decreased withdrawal and increased patellar reflexes of both hind limbs. The dog had a urinary tract infection with positive culture for Staphylococcus intermedius. On survey radiography of the lumbosacral spine there was active bone proliferation spanning the L7 S1 intervertebral disc space with an epidural filling defect at the ventral aspect of the vertebral canal on epidurography. On magnetic resonance imaging (MRI), findings were similar to those described for human diskospondylitis including altered signal intensity and nonuniform contrast enhancement of the L7-S1 intervertebral disc, adjacent vertebral end plates and epidural and sublumbar soft tissues. Although skeletal radiography is usually sufficient to reach a diagnosis of discospondylitis, MRI of this patient made it possible to reach a presumptive diagnosis of discospondylitis prior to development of definitive radiographic abnormalities

  14. High diagnostic value of general practitioners' presumptive diagnosis for pyelonephritis, meningitis and pancreatitis.

    Science.gov (United States)

    Sriskandarajah, Srishamanthi; Carter-Storch, Rasmus; Frydkjær-Olsen, Ulrik; Mogensen, Christian Backer

    2016-01-01

    In Denmark, patients referred from the general practitioner (GP) to the emergency department (ED) can be referred with either specific symptoms or with a presumptive diagnosis. The aim of the present study was to evaluate the diagnostic accuracy for various presumptive diagnoses made by the GP in a population acutely referred to an ED. This was a retrospective cohort study of all registered acute referrals for admission to Kolding ED in 2010. Eight presumptive diagnoses were selected for further studies: meningitis, acute coronary syndrome (ACS), pulmonary embolism, pneumonia, pancreatitis, deep venous thrombosis (DVT), pyelonephritis and intestinal obstruction. The presumptive diagnoses were compared with the final diagnosis on discharge. Sensitivity, specificity, predictive values and likelihood ratios were calculated. A total of 8,841 patients were enrolled. The highest and lowest sensitivities were seen for DVT (90%) and meningitis (36%), respectively; and the highest and lowest values for specificity were observed for meningitis (99%) and ACS (30%), respectively. The positive predictive value had a wide range with the lowest value for ACS (9%) and the highest for pneumonia (59%). For pyelonephritis, meningitis and pancreatitis, the likelihood ratio of a positive test was above 10. The likelihood ratio of a negative test was above 0.1 for all diagnoses. Patients referred with the presumptive diagnoses pyelonephritis, meningitis and pancreatitis had a high likelihood of having the disease in question. It is important not to discard any of the included presumptive diagnoses even if the GPs fail to suggest them on admission. none. none.

  15. Presumption of service connection for osteoporosis for former prisoners of war. Final rule.

    Science.gov (United States)

    2009-08-28

    The Department of Veterans Affairs (VA) is amending its adjudication regulations to establish a presumption of service connection for osteoporosis for former Prisoners of War (POWs) who were detained or interned for at least 30 days and whose osteoporosis is at least 10 percent disabling. The amendment implements a decision by the Secretary to establish such a presumption based on scientific studies. VA is additionally amending its adjudication regulations to establish a presumption of service connection for osteoporosis for POWs who were detained or interned for any period of time, have a diagnosis of posttraumatic stress disorder (PTSD), and whose osteoporosis is at least 10 percent disabling. This amendment reflects statutory provisions of the Veterans' Benefits Improvement Act of 2008.

  16. High diagnostic value of general practitioners' presumptive diagnosis for pyelonephritis, meningitis and pancreatitis

    DEFF Research Database (Denmark)

    Sriskandarajah, Srishamanthi; Carter-Storch, Rasmus; Frydkjær-Olsen, Ulrik

    2016-01-01

    by the GP in a population acutely referred to an ED. METHODS: This was a retrospective cohort study of all registered acute referrals for admission to Kolding ED in 2010. Eight presumptive diagnoses were selected for further studies: meningitis, acute coronary syndrome (ACS), pulmonary embolism, pneumonia......, pancreatitis, deep venous thrombosis (DVT), pyelonephritis and intestinal obstruction. The presumptive diagnoses were compared with the final diagnosis on discharge. Sensitivity, specificity, predictive values and likelihood ratios were calculated. RESULTS: A total of 8,841 patients were enrolled. The highest...... for pneumonia (59%). For pyelonephritis, meningitis and pancreatitis, the likelihood ratio of a positive test was above 10. The likelihood ratio of a negative test was above 0.1 for all diagnoses. CONCLUSIONS: Patients referred with the presumptive diagnoses pyelonephritis, meningitis and pancreatitis had...

  17. A PCR-based strategy for simple and rapid identification of rough presumptive Salmonella isolates

    DEFF Research Database (Denmark)

    Hoorfar, Jeffrey; Baggesen, Dorte Lau; Porting, P.H.

    1999-01-01

    The purpose of the present study was to investigate the application of ready-to-go Salmonella PCR tests, based on dry chemistry, for final identification of rough presumptive Salmonella isolates. The results were compared with two different biotyping methods performed at two different laboratorie...... (serogroup D). In conclusion, rough presumptive Salmonella isolates can be conveniently confirmed to the serogroup-revel, using the pre-mixed PCR tests. The system can be easily implemented in accredited laboratories with limited experience in molecular biology....

  18. 20 CFR 410.450 - Death due to pneumoconiosis, including statutory presumption.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Death due to pneumoconiosis, including... COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.450 Death due to pneumoconiosis, including statutory presumption...

  19. 20 CFR 410.418 - Irrebuttable presumption of total disability due to pneumoconiosis.

    Science.gov (United States)

    2010-04-01

    ... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.418 Irrebuttable presumption of total disability due to pneumoconiosis... miner was totally disabled due to pneumoconiosis at the time of his death, if he is suffering or...

  20. Authority, Freedom and Liberal Judgment: The Presumptions and Presumptuousness of Whately, Mill and Tocqueville.

    Science.gov (United States)

    Whedbee, Karen

    1998-01-01

    Examines the conflict between individualism and communitarianism (and its implications for rhetorical theory) by examining the historical debate between liberals and conservatives during and after the French Revolution. Shows how Richard Whately's notions of "presumption" and "burden of proof" (further developed by Mill and…

  1. The Principle of the Presumption of Innocence and its Challenges in ...

    African Journals Online (AJOL)

    The administration of the criminal justice system tries to strike a balance between the search for truth and the fairness of the process. To this end, the law should protect individual rights and impose various legal burdens on the state. One such tool is the principle of the presumption of innocence until proven guilty. This is a ...

  2. Effects of surveillance on the rule of law, due process and the presumption of innocence

    NARCIS (Netherlands)

    Galetta, Antonella; de Hert, Paul; Wright, D.; Kreissl, R.

    2015-01-01

    This contribution focuses on the impact of surveillance on the rule of law, due process and the presumption of innocence, key values and principles of a democratic order. It illustrates how they are implemented and enforced in contemporary surveillance societies, while referring to European law and

  3. The Ethics of Fertility Preservation for Paediatric Cancer Patients: From Offer to Rebuttable Presumption.

    Science.gov (United States)

    McDougall, Rosalind

    2015-11-01

    Given advances in the science of fertility preservation and the link between fertility choices and wellbeing, it is time to reframe our ethical thinking around fertility preservation procedures for children and young people with cancer. The current framing of fertility preservation as a possible offer may no longer be universally appropriate. There is an increasingly pressing need to discuss the ethics of failing to preserve fertility, particularly for patient groups for whom established techniques exist. I argue that the starting point for deliberating about a particular patient should be a rebuttable presumption that fertility preservation ought to be attempted. Consideration of the harms applicable to that specific patient may then override this presumption. I outline the benefits of attempting fertility preservation; these justify a presumption in favour of the treatment. I then discuss the potential harms associated with fertility preservation procedures, which may justify failing to attempt fertility preservation in an individual patient's particular case. Moving from a framework of offer to one of rebuttable presumption in favour of fertility preservation would have significant implications for medical practice, healthcare organizations and the state. © 2015 John Wiley & Sons Ltd.

  4. Presumptive self-diagnosis of malaria and other febrile illnesses in ...

    African Journals Online (AJOL)

    Self-diagnosis of influenza, yellow fever, typhoid, and pneumonia was also common. Conclusion: Self-diagnosis and presumptive treatment with antimalarial drugs and other antibiotic medications that are readily available without a prescription may compromise health outcomes for febrile adults and children. Key words: ...

  5. 77 FR 12522 - Tentative Eligibility Determinations; Presumptive Eligibility for Psychosis and Other Mental Illness

    Science.gov (United States)

    2012-03-01

    ...; Presumptive Eligibility for Psychosis and Other Mental Illness AGENCY: Department of Veterans Affairs. ACTION... psychosis within specified time periods and for Persian Gulf War veterans who developed a mental illness other than psychosis within two years after service and within two years after the end of the Persian...

  6. 78 FR 28140 - Tentative Eligibility Determinations; Presumptive Eligibility for Psychosis and Other Mental Illness

    Science.gov (United States)

    2013-05-14

    ...; Presumptive Eligibility for Psychosis and Other Mental Illness AGENCY: Department of Veterans Affairs. ACTION... care eligibility for veterans of certain wars and conflicts who developed psychosis within specified time periods and for Persian Gulf War veterans who developed a mental illness other than psychosis...

  7. 77 FR 76170 - Presumption of Exposure to Herbicides for Blue Water Navy Vietnam Veterans Not Supported

    Science.gov (United States)

    2012-12-26

    ... during the Vietnam War. After careful review of the IOM report, the Secretary determines that the... served in deep-water naval vessels off the coast of Vietnam during the Vietnam War are referred to as... DEPARTMENT OF VETERANS AFFAIRS Presumption of Exposure to Herbicides for Blue Water Navy Vietnam...

  8. 47 CFR 51.230 - Presumption of acceptability for deployment of an advanced services loop technology.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Presumption of acceptability for deployment of an advanced services loop technology. 51.230 Section 51.230 Telecommunication FEDERAL COMMUNICATIONS... following circumstances, where the technology: (1) Complies with existing industry standards; or (2) Is...

  9. Growth characteristics of liquid cultures increase the reliability of presumptive identification of Mycobacterium tuberculosis complex.

    Science.gov (United States)

    Pinhata, Juliana Maira Watanabe; Felippe, Isis Moreira; Gallo, Juliana Failde; Chimara, Erica; Ferrazoli, Lucilaine; de Oliveira, Rosangela Siqueira

    2018-04-23

    We evaluated the microscopic and macroscopic characteristics of mycobacteria growth indicator tube (MGIT) cultures for the presumptive identification of the Mycobacterium tuberculosis complex (MTBC) and assessed the reliability of this strategy for correctly directing isolates to drug susceptibility testing (DST) or species identification. A total of 1526 isolates of mycobacteria received at the Instituto Adolfo Lutz were prospectively subjected to presumptive identification by the observation of growth characteristics along with cord formation detection via microscopy. The presumptive identification showed a sensitivity, specificity and accuracy of 98.8, 92.5 and 97.9 %, respectively. Macroscopic analysis of MTBC isolates that would have been erroneously classified as non-tuberculous mycobacteria based solely on microscopic morphology enabled us to direct them rapidly to DST, representing a substantial gain to patients. In conclusion, the growth characteristics of mycobacteria in MGIT, when considered along with cord formation, increased the reliability of the presumptive identification, which has a great impact on the laboratory budget and turnaround times.

  10. Detection of presumptive Bacillus cereus in the Irish dairy farm environment

    Directory of Open Access Journals (Sweden)

    O’Connell A.

    2016-12-01

    Full Text Available The objective of the study was to isolate potential Bacillus cereus sensu lato (B. cereus s.l. from a range of farm environments. Samples of tap water, milking equipment rinse water, milk sediment filter, grass, soil and bulk tank milk were collected from 63 farms. In addition, milk liners were swabbed at the start and the end of milking, and swabs were taken from cows’ teats prior to milking. The samples were plated on mannitol egg yolk polymyxin agar (MYP and presumptive B. cereus s.l. colonies were isolated and stored in nutrient broth with 20% glycerol and frozen at -80 °C. These isolates were then plated on chromogenic medium (BACARA and colonies identified as presumptive B. cereus s.l. on this medium were subjected to 16S ribosomal RNA (rRNA sequencing. Of the 507 isolates presumed to be B. cereus s.l. on the basis of growth on MYP, only 177 showed growth typical of B. cereus s.l. on BACARA agar. The use of 16S rRNA sequencing to identify isolates that grew on BACARA confirmed that the majority of isolates belonged to B. cereus s.l. A total of 81 of the 98 isolates sequenced were tentatively identified as presumptive B. cereus s.l. Pulsed-field gel electrophoresis was carried out on milk and soil isolates from seven farms that were identified as having presumptive B. cereus s.l. No pulsotype was shared by isolates from soil and milk on the same farm. Presumptive B. cereus s.l. was widely distributed within the dairy farm environment.

  11. HIV-infected presumptive tuberculosis patients without tuberculosis: How many are eligible for antiretroviral therapy in Karnataka, India?

    Directory of Open Access Journals (Sweden)

    Ajay M.V. Kumar

    2017-03-01

    Full Text Available For certain subgroups within people living with the human immunodeficiency virus (HIV [active tuberculosis (TB, pregnant women, children <5 years old, and serodiscordant couples], the World Health Organization recommends antiretroviral therapy (ART irrespective of CD4 count. Another subgroup which has received increased attention is “HIV-infected presumptive TB patients without TB”. In this study, we assess the proportion of HIV-infected presumptive TB patients eligible for ART in Karnataka State (population 60 million, India. This was a cross-sectional analysis of data of HIV-infected presumptive TB patients diagnosed in May 2015 abstracted from national TB and HIV program records. Of 42,585 presumptive TB patients, 28,964 (68% were tested for HIV and 2262 (8% were HIV positive. Of the latter, 377 (17% had active TB. Of 1885 “presumptive TB patients without active TB”, 1100 (58% were already receiving ART. Of the remaining 785 who were not receiving ART, 617 (79% were assessed for ART eligibility and of those, 548 (89% were eligible for ART. About 90% of “HIV-infected presumptive TB patients without TB” were eligible for ART. This evidence supports a public health approach of starting all “HIV-infected presumptive TB patients without TB” on ART irrespective of CD4 count in line with global thinking about ‘test and treat’.

  12. Value of polymerase chain reaction in patients with presumptively diagnosed and treated as tuberculous pericardial effusion

    International Nuclear Information System (INIS)

    Rehman, H.; Hafizullah, M.; Shah, S.T.; Khan, S.B.; Hadi, A.; Ahmad, F.; Shah, I.; Gul, A.M.

    2012-01-01

    Objective: To know the sensitivity of polymerase chain reaction (PCR) in pericardial fluid and response to antituberculous treatment (ATT) in PCR positive patients who were presumptively diagnosed and treated as tuberculous pericardial effusion. Methodology: This was a descriptive cross sectional study carried out from June 1, 2009 to 31 May 2010 at Cardiology Department, Lady Reading Hospital, Peshawar. Patients with presumptive diagnosis and receiving treatment for tuberculous pericardial effusion were included. Pericardial fluid sample was aspirated under fluoroscopy for the routine work up. The specimens were subjected to PCR detection of mycobacterium tuberculous DNA. Results: During 12 month study period, a total of 54 patients with large pericardial effusion presented to Cardiology department, Lady Reading Hospital, Peshawar. Of them, 46 patients fulfilled the criteria for presumptive diagnosis of tuberculous pericardial effusion. PCR for mycobacterium tuberculous DNA in pericardial fluid was positive in 45.7%(21). Patients were followed for three months. In PCR positive group, 01 patient while in PCR negative group 3 patients were lost to follow up. Among PCR positive patients 17(85%) while in PCR negative group 11(47.82%) patient responded to ATT both clinically and echo-cardio graphically. We found that patients who were PCR positive responded better to therapy than those who were PCR negative and this finding was statistically significant (p=0.035). Conclusion: PCR, with all its limitations, is potentially a useful diagnostic test in patients with presumptively diagnosed tuberculous pericardial effusion. A PCR positive patient responds better to therapy as compared to PCR negative patient. (author)

  13. The use of elemental microanalysis in verification of the composition of presumptive amalgam tattoo.

    Science.gov (United States)

    Hartman, L C; Natiella, J R; Meenaghan, M A

    1986-08-01

    Routine histochemistry, special stains, and energy dispersive x-ray microanalysis (EDX) were used to analyze 15 cases of presumptive amalgam tattoo. Histologically, the fine, spherical, golden brown granules of amalgam were remarkably similar to hemosiderin and melanin granules, and routine and special stains were not always reliable in differentiating one from the others. EDX provided a simple, fast, inexpensive, and reliable method for identifying the precise elemental composition of the pigmented material.

  14. Comparative Evaluation of Four Presumptive Tests for Blood to Detect Epithelial Injury on Fish

    Energy Technology Data Exchange (ETDEWEB)

    Colotelo, Alison HA; Smokorowski, Karen; Haxton, Tim; Cooke, Steven J.

    2014-06-01

    Current methods of fish epithelial injury detection are limited to gross macroscopic examination that has a subjective bias as well as an inability to reliably quantify the degree of injury. Fluorescein, a presumptive test for blood, has been shown to have the capability to detect and quantify fish epithelial injury. However, there are several other presumptive tests for blood (Bluestar*, phenolphthalein, and HemastixH) that may have benefits over the use of fluorescein, particularly for field research on wild fish. This study investigated the capabilities of these four tests to detect and quantify a variety of injuries commonly encountered by fish (abrasion, cuts, fin frays, and punctures) using the freshwater bluegill Lepomis macrochirus as a model. Fluorescein was consistently found to be the most reliable (i.e., detected the highest proportion of true positive results and rarely detected false positive reactions) of the four presumptive tests for blood compared. Further testing was conducted to examine the reliability of fluorescein. By 24 h after an injury was inflicted, the injury was no longer detectable by fluorescein, and when fluorescein was applied to an injured fish, the fluorescein was no longer detectable 3 h after application. In a comparison of two common anaesthetics used in fisheries research, there was no significant difference in the proportion of injury detected when 3- aminobenzoic acid ethyl ester methanesulfate (tricaine) was used compared with a clove oil and ethanol (1:9) solution. In summary, fluorescein was the most reliable presumptive test for blood examined in this study for the detection and quantification of recent (hours) fish epithelial injury.

  15. 12 CFR 225.139 - Presumption of continued control under section 2(g)(3) of the Bank Holding Company Act.

    Science.gov (United States)

    2010-01-01

    ... situations in which there may be a risk that the divestiture will not result in the complete termination of a... the kinds of indebtedness that, standing alone, support a presumption that the creditor is able to...

  16. Community referral for presumptive TB in Nigeria: a comparison of four models of active case finding

    Directory of Open Access Journals (Sweden)

    A. O. Adejumo

    2016-02-01

    Full Text Available Abstract Background Engagement of communities and civil society organizations is a critical part of the Post-2015 End TB Strategy. Since 2007, many models of community referral have been implemented to boost TB case detection in Nigeria. Yet clear insights into the comparative TB yield from particular approaches have been limited. Methods We compared four models of active case finding in three Nigerian states. Data on presumptive TB case referral by community workers (CWs, TB diagnoses among referred clients, active case finding model characteristics, and CWs compensation details for 2012 were obtained from implementers and CWs via interviews and log book review. Self-reported performance data were triangulated against routine surveillance data to assess concordance. Analysis focused on assessing the predictors of presumptive TB referral. Results CWs referred 4–22 % of presumptive TB clients tested, and 4–24 % of the total TB cases detected. The annual median referral per CW ranged widely among the models from 1 to 48 clients, with an overall average of 13.4 referrals per CW. The highest median referrals (48 per CW/yr and mean TB diagnoses (7.1/yr per CW (H =70.850, p < 0.001 was obtained by the model with training supervision, and $80/quarterly payments (Comprehensive Quotas-Oriented model. The model with irregularly supervised, trained, and compensated CWs contributed the least to TB case detection with a median of 13 referrals per CW/yr and mean of 0.53 TB diagnoses per CW/yr. Hours spent weekly on presumptive TB referral made the strongest unique contribution (Beta = 0.514, p < 0.001 to explaining presumptive TB referral after controlling for other variables. Conclusion All community based TB case-finding projects studied referred a relative low number of symptomatic individuals. The study shows that incentivized referral, appropriate selection of CWs, supportive supervision, leveraged treatment support roles, and a

  17. Characteristics of presumptive idiopathic disseminated intravascular coagulation during second-trimester induced abortion.

    Science.gov (United States)

    York, Sloane; Lichtenberg, E Steve

    2012-05-01

    Disseminated intravascular coagulation (DIC) is a serious and relatively uncommon complication of induced or spontaneous abortion or delivery. Occasionally, it has been reported in the absence of predisposing conditions. Little information in the literature describing idiopathic DIC or the treatment of patients with DIC exists. From 2002 through 2008, 24 cases of presumptive idiopathic DIC occurred following dilation and evacuation (D&E) abortion between 13 5/7 and 23 6/7 weeks' estimated gestational age at a Midwestern ambulatory surgical center. The characteristics of each patient, their pregnancies and surgical experiences were examined and compared with a temporally matched control group of D&E patients. We explored whether the index cases had a predominance of any historical, clinical or reproductive characteristics compared with controls matched for demographic and reproductive landmarks. Overall incidence of presumptive idiopathic DIC was 1.8 per 1000 D&E cases. Compared with matched controls, there was a greater likelihood of DIC with more advanced gestation (p=.009); no case of DIC was under 17 weeks' gestational age. Increased bleeding occurred at a mean time of 153 min after completion of surgery (range, 55-491 min; median, 131 min). Nineteen of 24 cases were successfully treated at the surgical center after receiving 6 to 8 units of fresh-frozen plasma (FFP); 5 cases were transferred to a hospital for further treatment. The abnormal bleeding of presumptive DIC typically begins to appear within 2 h after uncomplicated D&E and is more likely to occur at 17 weeks' estimated gestational age and more. With rapid diagnosis and treatment, most patients were able to be treated in an outpatient setting with up to 6 to 8 units of FFP and rehydration. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Three cases of a presumptive atypical myopathy in New Zealand horses.

    Science.gov (United States)

    McKenzie, R K; Gibson, I R; Ritmeester, A

    2013-11-01

    Three weanling Thoroughbred fillies were presented during autumn with depression, muscle rigidity and, in one case, colic symptoms and cardiovascular shock. All fillies had abnormal physical examinations that included elevated heart rates and respiratory rates coupled with muscle rigidity through the back and rump. Biochemistry revealed markedly elevated creatinine kinase and aspartate aminotransferase which indicated a myopathy. All three horses were diagnosed with presumptive equine atypical myopathy. The horses received supportive therapy as per the literature available at the time regarding this condition; two responded to supportive therapy and survived, and one was euthanased due to a rapid deterioration in clinical status. Following post mortem of one case, histology of the trapezius muscle demonstrated an acute, severe myofibre degeneration. Atypical myopathy and a very similar disorder termed seasonal pasture myopathy in North America are potentially fatal, pasture-related syndromes that have been described in Europe and America but have not been previously described in New Zealand. This report describes three presumptive cases of this unique syndrome in New Zealand for the first time; it outlines the characteristics of the condition; and includes recently published information regarding diagnosis and treatment.

  19. Membrane filtration test for rapid presumptive differentiation of four Candida species.

    Science.gov (United States)

    Bauters, T G; Peleman, R; Moerman, M; Vermeersch, H; de Looze, D; Noens, L; Nelis, H J

    1999-05-01

    A rapid enzymatic two-step test for the presumptive differentiation of four Candida species commonly occurring in various clinical samples is described. The technique involves membrane filtration of a liquid sample, followed by preincubation of the membrane filter on Sabouraud glucose agar supplemented with ticarcillin-clavulanic acid to yield microcolonies. In a separate assay step, parts of the filter are placed on absorbent pads impregnated with fluorogenic 4-methylumbelliferyl (4-MU) enzyme substrates (4-MU-N-acetyl-beta-D-galactosaminide, 4-MU-phosphate, 4-MU-pyrophosphate, and 4-MU-beta-D-galactoside) in combination with 0.1% digitonin acting as a membrane permeabilizer. The membrane filter in contact with the assay medium is incubated to allow cleavage of the enzyme substrate, resulting in fluorescent microcolonies under long-wavelength UV light. This approach, tested on 301 clinical samples, is able to presumptively differentiate C. albicans, C. glabrata, C. krusei, and C. tropicalis and to distinguish them from other Candida spp. in about 9 to 11 h. Overall agreement with the conventional methods of 94.4% (one Candida species present in the sample) to 83.8% (multiple Candida spp. present) was obtained. The false-negative rates with reference to identification by traditional methods were 1.3% (single species) and 3.8% (multiple species).

  20. Presumptive brain influx of large neutral amino acids and the effect of phenylalanine supplementation in patients with Tyrosinemia type 1.

    Science.gov (United States)

    van Ginkel, Willem G; van Vliet, Danique; Burgerhof, Johannes G M; de Blaauw, Pim; Rubio Gozalbo, M Estela; Heiner-Fokkema, M Rebecca; van Spronsen, Francjan J

    2017-01-01

    Hereditary Tyrosinemia type 1 (HT1) is a rare metabolic disease caused by a defect in the tyrosine degradation pathway. Current treatment consists of 2-(2-nitro-4-trifluoromethylbenoyl)-1,3-cyclohexanedione (NTBC) and a tyrosine and phenylalanine restricted diet. Recently, neuropsychological deficits have been seen in HT1 patients. These deficits are possibly associated with low blood phenylalanine concentrations and/or high blood tyrosine concentrations. Therefore, the aim of the present study was threefold. Firstly, we aimed to calculate how the plasma amino acid profile in HT1 patients may influence the presumptive brain influx of all large neutral amino acids (LNAA). Secondly, we aimed to investigate the effect of phenylalanine supplementation on presumptive brain phenylalanine and tyrosine influx. Thirdly, we aimed to theoretically determine minimal target plasma phenylalanine concentrations in HT1 patient to ensure adequate presumptive brain phenylalanine influx. Data of plasma LNAA concentrations were obtained. In total, 239 samples of 9 HT1 children, treated with NTBC, diet, and partly with phenylalanine supplementation were collected together with 596 samples of independent control children. Presumptive brain influx of all LNAA was calculated, using Michaelis-Menten parameters (Km) and Vmax-values obtained from earlier articles. In HT1 patients, plasma concentrations and presumptive brain influx of tyrosine were higher. However, plasma and especially brain influx of phenylalanine were lower in HT1 patients. Phenylalanine supplementation did not only tend to increase plasma phenylalanine concentrations, but also presumptive brain phenylalanine influx, despite increased plasma tyrosine concentrations. However, to ensure sufficient brain phenylalanine influx in HT1 patients, minimal plasma phenylalanine concentrations may need to be higher than considered thus far. This study clearly suggests a role for disturbed brain LNAA biochemistry, which is not well

  1. Potencialização do efeito metemoglobinizante da dapsona em ratos pela N-acetilcisteína Potentiation of dapsone induced methemoglobinemia by N-acetylcysteine in rats

    Directory of Open Access Journals (Sweden)

    Natália Valadares de Moraes

    2008-03-01

    Full Text Available Dapsona (DDS (4,4'diaminodifenilsulfona, fármaco de escolha para o tratamento da hanseníase, freqüentemente induz anemia hemolítica e metemoglobinemia. A N-hidroxilação, uma de suas principais vias de biotransformação, é constantemente relacionada com a metemoglobinemia observada com o uso do fármaco. Com o objetivo de prevenir a hemotoxicidade induzida pela DDS, N-acetilcisteína, fármaco precursor de glutationa, foi administrada em associação com DDS em ratos machos Wistar pesando 220-240 g. Os animais foram anestesiados e o sangue coletado da aorta para determinação da concentração plasmática de DDS por CLAE, determinação dos níveis de metemoglobina e de glutationa eritrocitária por espectrofotometria, e avaliação de parâmetros bioquímicos e hematológicos. Os resultados obtidos mostraram que a N-acetilcisteína potenciou o efeito metemoglobinizante da dapsona devido ao aumento de sua concentração plasmática e conseqüente aumento da formação da N-hidroxilamina. Concluímos que as interações medicamentosas com a dapsona exigem estudos individualizados a fim de evitar os efeitos adversos do fármaco.Dapsone (DDS (4,4'diaminodiphenylsulfone, the drug of choice for the treatment of leprosy, frequently induces hemolytic anemia and methemoglobinemia. N-hydroxylation, one of the major pathways of biotransformation, has been constantly related to the methemoglobinemia after the use of the drug. In order to prevent the dapsone-induced hemotoxicity, N-acetylcysteine, a drug precursor of glutathione, was administered in combination with DDS to male Wistar rats, weighting 220-240 g. The animals were then anaesthetized and blood was collected from the aorta for determination of plasma DDS concentration by HPLC, determination of methemoglobinemia and glutathione by spectrophotometry, and for biochemical and hematological parameters. Our results showed that N-acetylcysteine enhanced dapsone-induced methemoglobinemia due to

  2. Presumptive intraperitoneal envenomation resulting in hemoperitoneum and acute abdominal pain in a dog.

    Science.gov (United States)

    Istvan, Stephanie A; Walker, Julie M; Hansen, Bernard D; Hanel, Rita M; Marks, Steven L

    2015-01-01

    To describe the clinical features, diagnostic findings, treatment, and outcome of a dog with acute abdominal pain and hemoperitoneum secondary to a presumptive intraperitoneal (IP) snakebite. A 10-month-old castrated male mixed-breed dog was evaluated for suspected snake envenomation. The dog presented recumbent and tachycardic with signs of severe abdominal pain. Two cutaneous puncture wounds and hemoperitoneum were discovered during evaluation. Ultrasonographic examination revealed communication of the wounds with the peritoneal cavity. The dog was treated with supportive care, parenteral analgesia, packed red blood cell and fresh frozen plasma transfusions, crotalid antivenom, and placement of an IP catheter to provide local analgesia. The dog recovered fully and was discharged 5 days after initial presentation. To our knowledge, this is the first report of IP envenomation accompanied by hemorrhage treated with continuous IP analgesia in the veterinary literature. © Veterinary Emergency and Critical Care Society 2015.

  3. Ground red hot pepper agar in the isolation and presumptive identification of Cryptococcus neoformans.

    Science.gov (United States)

    Stepanović, S; Vuković, D; Radonjić, I; Dimitrijević, V; Svabić-Vlahović, M

    2002-11-01

    The study compared ground red hot pepper agar (GRHP) and Guizotia abyssinica creatinine agar (GACA), a medium routinely used for isolation of Cryptococcus neoformans. In order to confirm the capacity of GRHP to support the Cr. neoformans growth and pigment production, 15 strains were inoculated onto GRHP and GACA. No significant differences in the growth and pigmentation of the tested strains on the two media were noted. As heavily contaminated specimens, 50 samples of pigeon droppings were examined by plating on GRHP and GACA, which resulted in the isolation of 14 and nine Cr. neoformans strains, respectively. The results indicate that GRHP, as a result of its superior selectivity and significant reduction of contaminant growth, provides better conditions than GACA for isolation and presumptive identification of Cr. neoformans from heavily contaminated specimens.

  4. A presumptive case of Human rabies: a rare survived case in rural Ghana

    Directory of Open Access Journals (Sweden)

    Paschal Awingura Apanga

    2016-11-01

    Full Text Available Rabies remains endemic in Ghana and continues to pose a major public health threat to humans and animals with nearly hundred percent (100% case fatality rate in humans. We report of a presumptive case of human rabies whose survival was a rare occurrence in rural Ghana. Lessons from this case study provides a critically needed focus in helping improve rabies surveillance and case management in Ghana. We report of the survival of a 36 year old man who developed clinical rabies three weeks after he was bitten by his dog while restraining the dog with a chain. Prior to this he did not observe any abnormal or rabid behaviour in the dog. Following the bite, he did not immediately resort to hospital treatment, but rather to traditional application of herbs to the laceration he sustained after the bite. Reason given for not seeking immediate hospital treatment was that the dog was not rabid and lack of funds to seek hospital care. However, he began to show symptoms consistent with rabies virus infection after 10 days and was subsequently rushed to the hospital by relatives. At the hospital, he was administered human immune tetanus immunoglobulin, diazepam, ceftriaxone, paracetamol and intravenous fluids. No rabies vaccine was administered. Six days after commencing treatment patient became well, showed no signs of confused state of mind, hydrophobia nor photophobia. He was discharged home after 13 days of commencing treatment. This study provides insight on a presumptive case of Human rabies case that survived despite non-administration of rabies vaccine during esposure. It also exposes the weaknesses in the health and veterinary systems in rural Ghana regarding rabies surveillance and case management.

  5. 41 CFR 301-10.5 - What are the presumptions as to the most advantageous method of transportation?

    Science.gov (United States)

    2010-07-01

    ... presumptions as to the most advantageous method of transportation? 301-10.5 Section 301-10.5 Public Contracts... most advantageous method of transportation? (a) Common carrier. Travel by common carrier is presumed to be the most advantageous method of transportation and must be used when reasonably available. (b...

  6. A novel nine base deletion mutation in NADH-cytochrome b5 reductase gene in an Indian family with recessive congenital methemoglobinemia-type-II

    Directory of Open Access Journals (Sweden)

    Prashant Warang

    2015-12-01

    Full Text Available Recessive hereditary methemoglobinemia (RCM associated with severe neurological abnormalities is a very rare disorder caused by NADH- cytochrome b5 reductase (cb5r deficiency (Type II. We report a case of 11 month old male child who had severe mental retardation, microcephaly and gross global developmental delay with methemoglobin level of 61.1%. The diagnosis of NADH-CYB5R3 deficiency was made by the demonstration of significantly reduced NADH-CYB5R3 activity in the patient and intermediate enzyme activity in both the parents. Mutation analysis of the CYB5R gene revealed a novel nine nucleotide deletion in exon 6 leading to the elimination of 3 amino acid residues (Lys173, Ser174 and Val 175. To confirm that this mutation was not an artifact, we performed PCR-RFLP analysis using the restriction enzyme Drd I. As the normal sequence has a restriction recognition site for Drd I which was eliminated by the deletion, a single band of 603-bp was seen in the presence of the homozygous mutation. Molecular modeling analysis showed a significant effect of these 3 amino acids deletion on the protein structure and stability leading to a severe clinical presentation. A novel homozygous 9 nucleotide deletion (p.K173–p.V175del3 is shown to be segregated with the disease in this family. Knowing the profile of mutations would allow us to offer prenatal diagnosis in families with severe neurological disorders associated with RCM — Type II.

  7. Comparative evaluation of chromogenic agar medium and conventional culture system for isolation and presumptive identification of uropathogens.

    Science.gov (United States)

    Akter, Laila; Haque, Rezwana; Salam, Md Abdus

    2014-09-01

    Urine is the most frequent specimen received for culture/sensitivity by clinical laboratories. The microbiological performance of HiCrome UTI agar medium was compared with Blood agar and MacConkey agar for isolation and presumptive identification of bacteria from urine culture. A total of 443 consecutively collected midstream and/or catheter-catch urine samples from patients attending the Islami Bank Medical College Hospital, Rajshahi, Bangladesh during January to December, 2012 were cultured. Urine samples showing pus cells ≥ 5/HPF were inoculated on to Blood agar (BA), MacConkey agar (MAC) and HiCrome UTI agar (CA) media simultaneously and incubated overnight aerobically at 37(0)C. Rate of isolation and presumptive identification of bacterial species were compared for different media. Culture yielded a total of 199 bacterial isolates from 189 (42.67%) positive plates including 179 (40.40%) unimicrobial and 10 (2.26%) polymicrobial (mixed growth of pair of bacteria) growths. Both HiCrome UTI agar and Blood agar media supported 100% growths while 151 (75.88%) growths were observed on MacConkey agar. The rate of presumptive identification was found significantly higher on HiCrome UTI agar (97.49%) than MAC agar (67.34%) (P<0.001) as primary urine culture medium. Of 199 isolates, E. coli was found to be the leading uropathogen isolated from 118 (59.30%) samples with its presumptive identification rate of 95.76%, 93.22% and 5.93% on CA, MAC and BA respectively. All 10 (100%) polymicrobial growths were demonstrated distinctly on CA against only 01(10%) on each BA and MAC. HiCrome UTI agar was found to be more useful as primary urine culture medium in both higher rate of isolation and presumptive identification of uropathogens in comparison to conventional media. Its inherent characteristics in demonstrating polymicrobial growth and ease of rapid identification by distinct colony colour are unique.

  8. Neuron Types in the Presumptive Primary Somatosensory Cortex of the Florida Manatee (Trichechus manatus latirostris).

    Science.gov (United States)

    Reyes, Laura D; Stimpson, Cheryl D; Gupta, Kanika; Raghanti, Mary Ann; Hof, Patrick R; Reep, Roger L; Sherwood, Chet C

    2015-01-01

    Within afrotherians, sirenians are unusual due to their aquatic lifestyle, large body size and relatively large lissencephalic brain. However, little is known about the neuron type distributions of the cerebral cortex in sirenians within the context of other afrotherians and aquatic mammals. The present study investigated two cortical regions, dorsolateral cortex area 1 (DL1) and cluster cortex area 2 (CL2), in the presumptive primary somatosensory cortex (S1) in Florida manatees (Trichechus manatus latirostris) to characterize cyto- and chemoarchitecture. The mean neuron density for both cortical regions was 35,617 neurons/mm(3) and fell within the 95% prediction intervals relative to brain mass based on a reference group of afrotherians and xenarthrans. Densities of inhibitory interneuron subtypes labeled against calcium-binding proteins and neuropeptide Y were relatively low compared to afrotherians and xenarthrans and also formed a small percentage of the overall population of inhibitory interneurons as revealed by GAD67 immunoreactivity. Nonphosphorylated neurofilament protein-immunoreactive (NPNFP-ir) neurons comprised a mean of 60% of neurons in layer V across DL1 and CL2. DL1 contained a higher percentage of NPNFP-ir neurons than CL2, although CL2 had a higher variety of morphological types. The mean percentage of NPNFP-ir neurons in the two regions of the presumptive S1 were low compared to other afrotherians and xenarthrans but were within the 95% prediction intervals relative to brain mass, and their morphologies were comparable to those found in other afrotherians and xenarthrans. Although this specific pattern of neuron types and densities sets the manatee apart from other afrotherians and xenarthrans, the manatee isocortex does not appear to be explicitly adapted for an aquatic habitat. Many of the features that are shared between manatees and cetaceans are also shared with a diverse array of terrestrial mammals and likely represent highly conserved

  9. Abandoning presumptive antimalarial treatment for febrile children aged less than five years--a case of running before we can walk?

    Directory of Open Access Journals (Sweden)

    Mike English

    2009-01-01

    Full Text Available Current guidelines recommend that all fever episodes in African children be treated presumptively with antimalarial drugs. But declining malarial transmission in parts of sub-Saharan Africa, declining proportions of fevers due to malaria, and the availability of rapid diagnostic tests mean it may be time for this policy to change. This debate examines whether enough evidence exists to support abandoning presumptive treatment and whether African health systems have the capacity to support a shift toward laboratory-confirmed rather than presumptive diagnosis and treatment of malaria in children under five.

  10. New culture medium for the presumptive identificaion of Candida albicans and Cryptococcus neoformans.

    Science.gov (United States)

    Fleming, W H; Hopkins, J M; Land, G A

    1977-02-01

    A new medium composed of Tween 80, oxgall, caffeic acid, and Davis agar (TOC) that provides for the rapid presumptive identification of Candida albicans and Cryptococcus neoformans is described herein. C. albicans is differentiated from other yeasts by the sequential production of germ tubes and chlamydospores. In a comparison with cormeal agar control plates, there was an increase of chlamydospore-forming strains of C. albicans (97.1% versus 87.2%) and a decrease in the time required for chlamydospore formation (24 h versus 48 h). C. neoformans produced a brown pigment of TOC, which is specific for its identification, thus differentiating it from the other yeasts. A comparison of 24-h pigment production by C. neoformans on TOC with that of birdseed agar showed a dark, coffee brown color in the former cultures and a light brown color in the latter. The change in pigmentation of C. neoformans, as well as morphological changes in C. albicans, can be induced within 3 to 12 h and in not more than 24 h on the TOC medium.

  11. Should sputum-negative presumptive TB patients be actively followed to identify missing cases in India?

    Science.gov (United States)

    Waikar, S; Pathak, A; Ghule, V; Kapoor, A; Sagili, K; Babu, E R; Chadha, S

    2017-12-21

    Setting: Sputum smear microscopy, the primary diagnostic tool used for diagnosis of tuberculosis (TB) in India's Revised National TB Control Programme (RNTCP), has low sensitivity, resulting in a significant number of TB cases reported as sputum-negative. As the revised guidelines pose challenges in implementation, sputum-negative presumptive TB (SNPT) patients are subjected to 2 weeks of antibiotics, followed by chest X-ray (CXR), resulting in significant loss to care among these cases. Objective: To determine whether reducing delays in CXR would yield additional TB cases and reduce initial loss to follow-up for diagnosis among SNPT cases. Methods: In an ongoing intervention in five districts of Maharashtra, SNPT patients were offered upfront CXR. Results: Of 119 male and 116 female SNPT patients with a mean age of 45 years who were tested by CXR, 32 (14%) were reported with CXR suggestive of TB. Administering upfront CXR in SNPT patients yielded twice as many additional cases, doubling the proportion of cases detected among all those tested as against administering CXR 2 weeks after smear examination. Conclusion: Our interventional study showed that the yield of TB cases was significantly greater when upfront CXR examination was undertaken without waiting for a 2-week antibiotic trial.

  12. Treatment of presumptive primary immune-mediated thrombocytopenia with mycophenolate mofetil versus cyclosporine in dogs.

    Science.gov (United States)

    Cummings, F O; Rizzo, S A

    2017-02-01

    The objective of this study was to compare hospitalisation duration, survival times, adverse events and cost of therapy in dogs with presumptive primary immune-mediated thrombocytopenia undergoing therapy with mycophenolate mofetil and corticosteroids versus cyclosporine and corticosteroids. A retrospective study of medical case records of dogs with presumed primary immune-mediated thrombocytopenia was conducted. Data collected included signalment, presenting complaints, haematologic and biochemical profiles, vector-borne disease testing, thoracic and abdominal radiographs, abdominal ultrasound, medications administered, duration of hospitalisation, 30- and 60-day survival, adverse events and cost of therapy. Variables were compared between dogs treated solely with mycophenolate mofetil and corticosteroids or cyclosporine and corticosteroids. A total of 55 dogs with primary immune-mediated thrombocytopenia were identified. Eighteen were excluded because multiple immunosuppressive medications were used during treatment. Hospitalisation times, 30-day survival and 60-day survival times were similar between both groups. Dogs in the mycophenolate mofetil/corticosteroid group experienced fewer adverse events than the cyclosporine/corticosteroid group. Therapy with mycophenolate mofetil was less expensive than that with cyclosporine. These results suggest that using the combination of mycophenolate mofetil and corticosteroids appears to be as effective as cyclosporine and corticosteroids in the treatment of presumed primary immune-mediated thrombocytopenia in dogs. Adverse events were less common and cost of therapy was lower in the mycophenolate mofetil group. Additional larger prospective, controlled, double-masked, outcome-based, multi-institutional studies are required to substantiate these preliminary findings. © 2017 British Small Animal Veterinary Association.

  13. Rapid presumptive "fingerprinting" of body fluids and materials by ATR FT-IR spectroscopy.

    Science.gov (United States)

    Elkins, Kelly M

    2011-11-01

    Human body fluids and materials were evaluated using attenuated total reflectance Fourier transform infrared spectroscopy. Purified proteins, cosmetics, and foodstuffs were also assayed with the method. The results of this study show that the sampled fluids and materials vary in the fingerprint region and locations of the amide I peaks because of the secondary structure of the composite proteins although the C = O stretch is always present. The distinct 1016 cm(-1) peak serves as a signature for semen. The lipid-containing materials (e.g., fingerprints, earwax, tears, and skin) can also be easily separated from the aqueous materials because of the strong CH(3) asymmetric stretch of the former. Blood-saliva and blood-urine mixtures were also successfully differentiated using combinations of peaks. Crime scene investigators employing rapid, portable, or handheld infrared spectroscopic instruments may be able to reduce their need for invasive, destructive, and consumptive presumptive test reagents in evaluating trace evidence. © 2011 American Academy of Forensic Sciences.

  14. Case report 471: Hemophilic pseudotumors (presumptive diagnosis) and hemophilic arthropathy of elbow

    International Nuclear Information System (INIS)

    Hermann, G.; Gilbert, M.

    1988-01-01

    A case has been presented of a 72-year-old man on whom an excretory urogram showed the incidental findings of two soft tissue masses in the abdomen containing considerable deposits of calcium. The history was interesting in that the patient was classic hemophiliac with Factor VIII level less than 1%, who first developed symptoms and signs of multiple hemarthroses affecting the knees, ankles, elbows, and shoulders at the age of nine years. Secondary hemophilic arthropathy followed, particularly advanced in the right elbow. Total knee replacements were performed within the last 10 years. A mass within the muscles of the right chest wall, superficial to the ribs, was surgically removed. The abdominal masses in this case were studied with CT and showed considerable calcification with a fibrous wall. Surgical removal of pseudotumors is usually undertaken following diagnosis because the natural history includes continuous enlargement and destruction of the adjacent tissues. Because of the age of the patient and the significant cardiac history, it was considered inappropriate to undertake surgery for the masses in the abdomen which were considered presumptively to be pseudotumors. The clinical, radiological, and pathological aspects of pseudotumor of hemophilia were reviewed. In this case, besides the masses in the abdomen, hemophilic arthropathy of an elbow was illustrated and a soft tissue mass in the right chest wall was demonstrated radiologically and the pathological specimen shown after surgical excision. (orig.)

  15. Late latent syphilis in a patient with end-stage renal disease and presumptive penicillin allergy.

    Science.gov (United States)

    Grice, Karen T; Day, Sarah A

    2014-04-01

    Pharmacotherapy challenges in a case of late latent syphilis complicated by end-stage renal disease and presumptive penicillin allergy are described. A 58-year-old white woman was admitted to the hospital for symptoms including altered mental status, shortness of breath, and chest pain. The initial workup isolated syphilis immunoglobulin G antibody. A treponemal test was reactive, and a nontreponemal test was nonreactive; analysis of cerebrospinal fluid did not indicate neurosyphilis. The patient was diagnosed as having late latent syphilis of unknown duration, for which the standard treatment is intramuscular penicillin G benzathine 2.4 million units once weekly for three weeks. Given the patient's advanced renal disease and other serious comorbidities, there were concerns about the potential need for renal dosage adjustment and repeated desensitization. However, given the slow absorption and long half-life of penicillin G and published data indicating its safe use in the context of hemodialysis, the treating clinicians decided to proceed with penicillin G therapy at the usual dose after an oral penicillin desensitization protocol; repeat desensitization before two subsequent injections was not performed. The patient completed the full course of penicillin G without incident. Notably, skin testing was not performed to definitively establish penicillin allergy. Microbiological testing to determine a cure of syphilis was not performed. After the completion of an oral desensitization protocol, the standard three-dose regimen of intramuscular penicillin G for late latent syphilis was safely administered to a hemodialysis patient without dosage adjustment or repeated desensitization.

  16. Isolated homonymous hemianopsia due to presumptive cerebral tubercular abscess as the initial manifestation of human immunodeficiency virus infection

    Directory of Open Access Journals (Sweden)

    Sujit Gharai

    2012-01-01

    Full Text Available We report a case of isolated homonymous hemianopsia due to presumptive cerebral tubercular abscess as the initial manifestation of human immunodeficiency virus (HIV infection. A 30-year-old man presented to our outpatient department with sudden loss of visibility in his left visual field. He had no other systemic symptoms. Perimetry showed left-sided incongruous homonymous hemianopsia denser above the horizontal meridian. Magnetic resonance imaging revealed irregular well-marginated lobulated lesions right temporo-occipital cerebral hemisphere and left high fronto-parietal cerebral hemisphere suggestive of brain tubercular abscess. Serological tests for HIV were reactive, and the patient was started only on anti-tubercular drugs with the presumptive diagnosis of cerebral tubercular abscess. Therapeutic response confirmed the diagnosis. Atypical ophthalmic manifestations may be the initial presenting feature in patients with HIV infection. This highlights the need for increased index of suspicion for HIV infection in young patients with atypical ophthalmic manifestations.

  17. Lancefield grouping and smell of caramel for presumptive identification and assessment of pathogenicity in the Streptococcus milleri group.

    OpenAIRE

    Brogan, O; Malone, J; Fox, C; Whyte, A S

    1997-01-01

    AIM: To evaluate Lancefield grouping and caramel smell for presumptive identification of the Streptococcus milleri group, and to find whether Lancefield group, species, or protein profile correlated with virulence or infection site. METHODS: Prospective studies were made of 100 consecutive streptococcal isolates in blood cultures or pus from 100 patients in whom the severity of infection was categorised as serious, moderate, or not significant. The usefulness of Lancefield group and the caram...

  18. High pre-diagnosis attrition among patients with presumptive MDR-TB: an operational research from Bhopal district, India.

    Science.gov (United States)

    Shewade, Hemant Deepak; Kokane, Arun M; Singh, Akash Ranjan; Verma, Manoj; Parmar, Malik; Chauhan, Ashish; Chahar, Sanjay Singh; Tiwari, Manoj; Khan, Sheeba Naz; Gupta, Vivek; Tripathy, Jaya Prasad; Nagar, Mukesh; Singh, Sanjai Kumar; Mehra, Pradeep Kumar; Kumar, Ajay Mv

    2017-04-04

    Pre-diagnosis attrition needs to be addressed urgently if we are to make progress in improving MDR-TB case detection and achieve universal access to MDR-TB care. We report the pre-diagnosis attrition, along with factors associated, and turnaround times related to the diagnostic pathway among patient with presumptive MDR-TB in Bhopal district, central India (2014). Study was conducted under the Revised National Tuberculosis Control Programme setting. It was a retrospective cohort study involving record review of all registered TB cases in Bhopal district that met the presumptive MDR-TB criteria (eligible for DST) in 2014. In quarter 1, Line Probe Assay (LPA) was used if sample was smear/culture positive. Quarter 2 onwards, LPA and Cartridge-based Nucleic Acid Amplification Test (CbNAAT) was used for smear positive and smear negative samples respectively. Pre-diagnosis attrition was defined as failure to undergo DST among patients with presumptive MDR-TB (as defined by the programme). Of 770 patients eligible for DST, 311 underwent DST and 20 patients were diagnosed as having MDR-TB. Pre-diagnosis attrition was 60% (459/770). Among those with pre-diagnosis attrition, 91% (417/459) were not identified as 'presumptive MDR-TB' by the programme. TAT [median (IQR)] to undergo DST after eligibility was 4 (0, 10) days. Attrition was more than 40% across all subgroups. Age more than 64 years; those from a medical college; those eligible in quarter 1; patients with presumptive criteria 'previously treated - recurrent TB', 'treatment after loss-to-follow-up' and 'previously treated-others'; and patients with extra-pulmonary TB were independent risk factors for not undergoing DST. High pre-diagnosis attrition was contributed by failure to identify and refer patients. Attrition reduced modestly with time and one factor that might have contributed to this was introduction of CbNAAT in quarter 2 of 2014. General health system strengthening which includes improvement in

  19. The distribution of presumptive thoracic paraganglionic tissue in the common marmoset (Callithrix jacchus

    Directory of Open Access Journals (Sweden)

    Clarke J.A.

    2002-01-01

    Full Text Available The aortic-pulmonary regions (APR of seven adult marmosets (Callithrix jacchus and the region of the right subclavian artery of a further three marmosets were diffusion-fixed with 10% buffered formol-saline solution. In both regions serial 5-µm sections were cut and stained by the Martius yellow, brilliant crystal scarlet and soluble blue method. Presumptive thoracic paraganglionic (PTP tissue was only observed in the APR. PTP tissue was composed of small groups of cells that varied in size and number. The distribution of the groups of cells was extremely variable, so much so that it would be misleading to attempt to classify their position; they were not circumscribed by a connective tissue capsule, but were always related to the thoracic branches of the left vagus nerve. The cells lay in loose areolar tissue characteristic of this part of the mediastinum and received their blood supply from small adjacent connective tissue arterioles. Unlike the paraganglionic tissue found in the carotid body the cells in the thorax did not appear to have a profuse capillary blood supply. There was, however, a close cellular-neural relationship. The cells, 10-15 µm in diameter, were oval or rounded in appearance and possessed a central nucleus and clear cytoplasm. No evidence was found that these cells possessed a 'companion' cell reminiscent of the arrangement of type 1 and type 2 cells in the carotid body. In conclusion, we found evidence of presumed paraganglionic tissue in the APR of the marmoset which, however, did not show the characteristic histological features of the aortic body chemoreceptors that have been described in some non-primate mammals. A survey of the mediastina of other non-human primates is required to establish whether this finding is atypical for these animals.

  20. Presumptive subarticular stress reactions of the knee: MRI detection and association with meniscal tear patterns

    International Nuclear Information System (INIS)

    Yao, Lawrence; Stanczak, Jeffrey; Boutin, Robert D.

    2004-01-01

    MRI detects subchondral marrow findings in painful knees which bear resemblance to spontaneous osteonecrosis of the knee (SONK). Gathering evidence suggests that the primary or predominant pathogenesis of these lesions is physical stress. This study analyzes the patient characteristics and meniscal pathology associated with these lesions - herein referred to as ''presumptive subarticular stress related'' (PSSR) lesions. All patients were scanned using a standardized imaging protocol. The criterion for a PSSR lesion was a subchondral marrow edema pattern encompassing a more focal, low-signal zone adjacent to or contiguous with the subchondral cortex. Patients were identified using an electronic database search of cases reported by one experienced musculoskeletal radiologist. Twenty-five PSSR lesions were identified among 1,948 MRI evaluations of the knee. Twenty-one PSSR lesions occurred in the medial compartment, and four occurred in the lateral compartment. There was no sex predilection. Patients with PSSR lesions were older than other patients undergoing MRI evaluation (mean 66 years versus 52 years, P<0.001). Meniscal tears occurred more commonly in cases with PSSR lesions than in the group as a whole (76% versus 45%, P<0.001). Radial and posterior root tears were more common in knees with PSSR lesions than in other knees with meniscal tears (53% versus 26%, P<0.01). PSSR lesions are associated with meniscal tears and, more specifically, with meniscal tear patterns that dramatically increase contact forces across the knee joint. This observation supports the hypothesis that mechanical stress is important in the pathogenesis of these subarticular lesions that are detected by MRI. (orig.)

  1. Presumptive subarticular stress reactions of the knee: MRI detection and association with meniscal tear patterns

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Lawrence [Diagnostic Radiology Department, National Institutes of Health, Building 10, Room 1C640, 10 Center Drive, MSC 1182, MD 20892-1182, Bethesda (United States); Stanczak, Jeffrey [Fairfax Radiological Consultants, PC, 2722 Merrilee Drive, Suite 230, VA 22031, Fairfax (United States); Boutin, Robert D. [MedTel International, 1430 Spring Hill Road, State 500, VA 22102, Mclean (United States)

    2004-05-01

    MRI detects subchondral marrow findings in painful knees which bear resemblance to spontaneous osteonecrosis of the knee (SONK). Gathering evidence suggests that the primary or predominant pathogenesis of these lesions is physical stress. This study analyzes the patient characteristics and meniscal pathology associated with these lesions - herein referred to as ''presumptive subarticular stress related'' (PSSR) lesions. All patients were scanned using a standardized imaging protocol. The criterion for a PSSR lesion was a subchondral marrow edema pattern encompassing a more focal, low-signal zone adjacent to or contiguous with the subchondral cortex. Patients were identified using an electronic database search of cases reported by one experienced musculoskeletal radiologist. Twenty-five PSSR lesions were identified among 1,948 MRI evaluations of the knee. Twenty-one PSSR lesions occurred in the medial compartment, and four occurred in the lateral compartment. There was no sex predilection. Patients with PSSR lesions were older than other patients undergoing MRI evaluation (mean 66 years versus 52 years, P<0.001). Meniscal tears occurred more commonly in cases with PSSR lesions than in the group as a whole (76% versus 45%, P<0.001). Radial and posterior root tears were more common in knees with PSSR lesions than in other knees with meniscal tears (53% versus 26%, P<0.01). PSSR lesions are associated with meniscal tears and, more specifically, with meniscal tear patterns that dramatically increase contact forces across the knee joint. This observation supports the hypothesis that mechanical stress is important in the pathogenesis of these subarticular lesions that are detected by MRI. (orig.)

  2. Death by caffeine: presumptive malicious poisoning of a dog by incorporation in ground meat.

    Science.gov (United States)

    Tawde, S N; Puschner, B; Albin, T; Stump, S; Poppenga, R H

    2012-12-01

    A 4-year-old, 37 kg, male German shepherd developed hyperthermia, tachycardia, and agitation following consumption of ground meat found in the backyard of its owner. When presented to a veterinary clinic, plasma ethylene glycol (EG) testing was positive, and the dog was given ethanol and lactated Ringer's solution intravenously. Approximately 11 h postexposure the dog died. Among tissues submitted for toxicological analysis, urine was negative for EG, ground meat was negative for certain drugs of abuse, and gastric contents were negative for zinc/aluminum phosphide and metaldehyde. Analysis of gastric contents by gas chromatography-mass spectrometry confirmed the presence of caffeine. Caffeine concentration in the ground meat was estimated at 1 %. Caffeine is a methylxanthine alkaloid with a reported canine oral median lethal dose (MLD(50)) of 140 mg/kg (range 120-200 mg/kg). A commercially available 200-mg tablet formulation of caffeine was considered to be a possible source but this was not confirmed. By conservative estimates, the dog would need to ingest approximately 500-550 g of the meat to reach the MLD(50). Acute intoxication affects the cardiovascular, pulmonary, neurologic, gastrointestinal, and metabolic systems. Although no tablet remnants were observed in the bait, tablets could have been crushed and/or dissolved. Other potential caffeine sources include guarana, brewed and concentrated coffee, and caffeine-containing beverages. Based on the history, clinical signs, and the detection of caffeine in the gastric contents and meat, a presumptive diagnosis of malicious caffeine poisoning was made. A suggested treatment regimen for caffeine intoxication in dogs is described. While few cases of accidental ingestion of caffeine by dogs have been described, the intentional use of a concentrated caffeine source to cause mortality in a dog has not been previously reported.

  3. Electrodiagnostic studies in presumptive primary hypothyroidism and polyneuropathy in dogs with reevaluation during hormone replacement therapy.

    Science.gov (United States)

    Giza, Elżbieta Gabriela; Płonek, Marta; Nicpoń, Józef Marian; Wrzosek, Marcin Adam

    2016-05-21

    Peripheral neuropathy is the most common neurological manifestation of canine hypothyroidism. Data concerning electrodiagnostic studies in hypothyroid associated polyneuropathy in dogs are very limited and usually lack a reevaluation after hormone replacement therapy. The objective of this study was to perform a detailed, retrospective analysis of electromyographic (EMG), motor nerve conduction velocity (MNCV), F-wave and brainstem auditory evoked response (BAER) findings in 24 dogs with presumptive primary hypothyroidism and polyneuropathy with a comparison of the results before and after initiation of levothyroxine treatment with the assessment of the clinical outcome. The results obtained from hypothyroid dogs showed a significant reduction in MNCV at a proximal-distal and middle-distal stimulation, decreased amplitudes of compound muscle action potentials (CMAP), an increased CMAP duration and a prolonged distal latency prior to treatment. Fifty percent of the dogs had an increased F-wave latency. A normal BAER recording was found in 78 % of the hypothyroid patients without vestibular impairment. Bilaterally increased peak V latencies and increased interpeak I-V latencies were found in the remaining individuals. Dogs with concurrent vestibular impairment had ipsilaterally increased peak latencies with normal interpeak latencies and decreased amplitudes of wave I and II. A comparison of the findings before and after 2 months of treatment revealed a decrease in the pathological activity on EMG, an improvement of proximal, middle and distal CMAP amplitudes and an increase in the proximal-distal conduction velocity in all dogs. F-wave latency improved in 38 % of dogs. The BAER reexamination revealed a persistent prolongation of peak I, II, III and V latencies and decreased wave I amplitude on the affected side in all dogs manifesting vestibular signs. Conversely, in dogs without vestibular signs, the peak V and interpeak I-V latencies decreased to normal values

  4. Comparison of clinical signs and outcomes between dogs with presumptive ischemic myelopathy and dogs with acute noncompressive nucleus pulposus extrusion.

    Science.gov (United States)

    Fenn, Joe; Drees, Randi; Volk, Holger A; De Decker, Steven

    2016-10-01

    OBJECTIVE To compare clinical signs and outcomes between dogs with presumptive ischemic myelopathy and dogs with presumptive acute noncompressive nucleus pulposus extrusion (ANNPE). DESIGN Retrospective study. ANIMALS 51 dogs with ischemic myelopathy and 42 dogs with ANNPE examined at 1 referral hospital. PROCEDURES Medical records and MRI sequences were reviewed for dogs with a presumptive antemortem diagnosis of ischemic myelopathy or ANNPE. Information regarding signalment, clinical signs at initial examination, and short-term outcome was retrospectively retrieved from patient records. Long-term outcome information was obtained by telephone communication with referring or primary-care veterinarians and owners. RESULTS Compared with the hospital population, English Staffordshire Bull Terriers and Border Collies were overrepresented in the ischemic myelopathy and ANNPE groups, respectively. Dogs with ANNPE were significantly older at disease onset and were more likely to have a history of vocalization at onset of clinical signs, have spinal hyperesthesia during initial examination, have a lesion at C1-C5 spinal cord segments, and be ambulatory at hospital discharge, compared with dogs with ischemic myelopathy. Dogs with ischemic myelopathy were more likely to have a lesion at L4-S3 spinal cord segments and have long-term fecal incontinence, compared with dogs with ANNPE. However, long-term quality of life and outcome did not differ between dogs with ischemic myelopathy and dogs with ANNPE. CONCLUSIONS AND CLINICAL RELEVANCE Results revealed differences in clinical signs at initial examination between dogs with ischemic myelopathy and dogs with ANNPE that may aid clinicians in differentiating the 2 conditions.

  5. [Acquired methemoglobinemia: a case report].

    Science.gov (United States)

    Benini, D; Vino, L; Fanos, V

    1998-01-01

    When an infant presents severe cyanosis which is not associated with respiratory distress, methaemoglobinemia should always be suspected. In children its main inducers are contaminated water or vegetable broths with high nitrate levels (especially spinach and carrots) used to prepare powdered formula or soups. Children affected with methaemoglobinemia have a peculiar lavender colour. Blood from the heel sticks is chocolate-brown and does not become pink when exposed to room air. Diagnosis can be confirmed by excluding other causes of cyanosis and by spectrophotometric analysis of blood for methaemoglobin. When methaemoglobin's levels reach 60% or more, the patient will collapse and become comatose and may die. Therapy with methylene blue results in prompt relief. In this article we report a case of methaemoglobinemia due to the administration of powdered formula mixed with vegetable broths to a newborn aged 16 days. Furthermore we will present a short review of literature regarding methaemoglobinemia caused by toxic agents over the last 10 years.

  6. [A presumption calculating formula of the X-ray spectrum generated from a molybdenum target X-ray tube].

    Science.gov (United States)

    Kato, Hideki; Fujii, Shigehisa; Shirakawa, Seiji; Suzuki, Yusuke; Nishii, Yoshio

    2011-01-01

    A presumption calculating formula of the X-ray spectrum generated from a molybdenum target X-ray tube is presented. The calculation procedure is to add an amount of characteristic X-ray photons that corresponds to the ratio of characteristic photons and bremsstrahlung photons to the bremsstrahlung spectrum obtained using semiempirical calculation. The bremsstrahlung spectrum was calculated by using a corrected Tucker's formula. The corrected content was a formula for calculating the self-absorption length in the target that originated in the difference of the incident angle to the target of the electron and the mass stopping power data. The measured spectrum was separated into the bremsstrahlung component and the characteristic photon component, and the ratio of the characteristic photons and bremsstrahlung photons was obtained. The regression was derived from the function of the tube voltage. Based on this calculation procedure, computer software was constructed that can calculate an X-ray spectrum in arbitrary exposure conditions. The X-ray spectrum obtained from this presumption calculating formula and the measured X-ray spectrum corresponded well. This formula is very useful for analyzing various problems related to mammography by means of Monte Carlo simulations.

  7. Influence of Seasonal Environmental Variables on the Distribution of Presumptive Fecal Coliforms around an Antarctic Research Station

    Science.gov (United States)

    Hughes, Kevin A.

    2003-01-01

    Factors affecting fecal microorganism survival and distribution in the Antarctic marine environment include solar radiation, water salinity, temperature, sea ice conditions, and fecal input by humans and local wildlife populations. This study assessed the influence of these factors on the distribution of presumptive fecal coliforms around Rothera Point, Adelaide Island, Antarctic Peninsula during the austral summer and winter of February 1999 to September 1999. Each factor had a different degree of influence depending on the time of year. In summer (February), although the station population was high, presumptive fecal coliform concentrations were low, probably due to the biologically damaging effects of solar radiation. However, summer algal blooms reduced penetration of solar radiation into the water column. By early winter (April), fecal coliform concentrations were high, due to increased fecal input by migrant wildlife, while solar radiation doses were low. By late winter (September), fecal coliform concentrations were high near the station sewage outfall, as sea ice formation limited solar radiation penetration into the sea and prevented wind-driven water circulation near the outfall. During this study, environmental factors masked the effect of station population numbers on sewage plume size. If sewage production increases throughout the Antarctic, environmental factors may become less significant and effective sewage waste management will become increasingly important. These findings highlight the need for year-round monitoring of fecal coliform distribution in Antarctic waters near research stations to produce realistic evaluations of sewage pollution persistence and dispersal. PMID:12902283

  8. Forensic Identification of Human Blood: comparison of two one-step presumptive tests for blood screening of crime scene samples.

    Directory of Open Access Journals (Sweden)

    Ana Flávia Belchior Andrade

    2014-08-01

    Full Text Available Blood is the most common body fluid found at crime scenes. One-step presumptive tests have been designed as a rapid immunological test for the qualitative detection of human hemoglobin in stool samples (faecal occult blood their usefulness for forensic purposes has been demonstrated before. In this study we compare Hexagon OBTI kit and FOB One-step Bioeasy kit sensitivity in the analysis of diluted blood samples. With Hexagon OBTI, positive test results are achieved in whole blood dilutions up to 1:1.000. Sensitivity decreased with aged samples, if samples were not stored under low temperatures regardless of which presumptive test is used. Whole blood tests must take into consideration that “hook” effect may interfere. Comparing both tests, OBTI Hexagon Kit is more sensible to detect diluted blood, showing a wider detection window in all conditions. This is interesting when analyzing forensic samples as forensic analysts usually do not know about the history of the analyzed sample before its collection.

  9. Scientific Opinion on a Qualified Presumption of Safety (QPS) approach for the safety assessment of botanicals and botanical preparations

    DEFF Research Database (Denmark)

    Pilegaard, Kirsten

    The Qualified Presumption of Safety (QPS) approach, initially developed for the assessment of microorganisms referred to EFSA and added to the food chain is equally applicable to the assessment of botanicals or botanical preparations. Using the principles to establish the suitability of a botanical...... preparation for QPS status, it has been possible to develop a structured assessment scheme that provides a practical method for assessing botanicals and botanical preparations for which an adequate body of knowledge exists and therefore without the need for further testing. Reiterative applications...... of the assessment scheme to related botanicals or different botanical preparations obtained from the same plant variety can allow a QPS status to be derived for specific groupings. However, the particularity of botanicals that may be presented in a wide variety of forms or whose morphology and chemical composition...

  10. Presumptive meningoencephalitis secondary to extension of otitis media/interna caused by Streptococcus equi subspecies zooepidemicus in a cat.

    Science.gov (United States)

    Martin-Vaquero, Paula; da Costa, Ronaldo C; Daniels, Joshua B

    2011-08-01

    A 5-year-old castrated male domestic longhair cat was presented with neurological signs consistent with a central vestibular lesion and left Horner's syndrome. Computed tomography images revealed hyperattenuating, moderately contrast-enhancing material within the left tympanic bulla, most consistent with left otitis media/interna. Marked neutrophilic pleocytosis was identified on cerebrospinal fluid analysis. Streptococcus equi subspecies zooepidemicus (SEZ) was isolated from the cerebrospinal fluid. Intracranial extension of otitis media/interna is relatively infrequent in small animals. There are no reports of otitis media/interna caused by SEZ in dogs or cats. This is the first report of otitis media/interna and presumptive secondary meningoencephalitis caused by SEZ in a cat. Copyright © 2011 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

  11. Differentiation of presumptive primordial germ cell (pPGC)-like cells in explants into PGCs in experimental tadpoles

    Energy Technology Data Exchange (ETDEWEB)

    Ikenishi, K.; Okuda, T.; Nakazato, S.

    1984-05-01

    A single blastomere containing the ''germ plasm'' of 32-cell stage Xenopus embryos was cultured with (/sup 3/H)thymidine until the control embryos developed to the neurula stage. The explants, showing a spherical mass in which the nuclei of all cells were labeled, were implanted into the prospective place of presumptive primordial germ cells (pPGCs) in the endodermal cell mass of unlabeled host embryos of the neurula stage. Labeled PGCs as well as unlabeled, host PGCs were found in the genital ridges of experimental tadpoles. This indicates that the precursor of germ cells, corresponding to pPGCs in normal embryos of the neurula stage, in the explants migrated to genital ridges just at the right moment to become PGCs, and suggests that the developmental process progressed normally, even in the explants, as far as the differentiation of pPGCs is concerned.

  12. Medical professionals convicted of accessing child pornography--presumptive lifetime prohibition on paediatric practice? Health Care Complaints Commission v Wingate.

    Science.gov (United States)

    Shats, Kathy; Faunce, Thomas

    2008-05-01

    Health Care Complaints Commission v Wingate [2007] NSWCA 326 concerns an appeal from the New South Wales Medical Tribunal regarding its findings on professional misconduct outside the practice of medicine in relation to a doctor convicted of possessing child pornography. The latest in a number of cases on this issue in Australia, it highlights the complexity of such decisions before medical tribunals and boards, as well as the diversity of approaches taken. Considering both this case and the recent Medical Practitioners Board of Victoria case of Re Stephanopoulos [2006] MPBV 12, this column argues that Australian tribunals and medical boards may not yet have achieved the right balance here in terms of protecting public safety and the reputation of the profession as a whole. It makes the case for a position statement from Australian professional bodies to create a presumption of a lifetime prohibition on paediatric practice after a medical professional has been convicted of accessing child pornography.

  13. Further studies on the reliability of the bacitracin inhibition test for the presumptive identification of Lancefield group A streptococci.

    Science.gov (United States)

    Coleman, D J; McGhie, D; Tebbutt, G M

    1977-01-01

    The reliability of the bacitracin inhibition test to differentiate between 125 Lancefield group A and 122 non-group A beta-haemolytic streptococci was studied. Bacitracin discs containing 0-02, 0-04, or 0-1 international units and the conditions recommended by both the Association of Clinical Pathologists and the Federal Drug Administration for routine sensitivity testing were used. The results suggest that the presence or absence of a zone of inhibition around a 0-04 unit disc can be used routinely for the presumptive identification of group A streptococci and that a specific zone size can be used for reading the test only with a 0-1 unit disc. PMID:325019

  14. Lancefield grouping and smell of caramel for presumptive identification and assessment of pathogenicity in the Streptococcus milleri group.

    Science.gov (United States)

    Brogan, O; Malone, J; Fox, C; Whyte, A S

    1997-04-01

    To evaluate Lancefield grouping and caramel smell for presumptive identification of the Streptococcus milleri group, and to find whether Lancefield group, species, or protein profile correlated with virulence or infection site. Prospective studies were made of 100 consecutive streptococcal isolates in blood cultures or pus from 100 patients in whom the severity of infection was categorised as serious, moderate, or not significant. The usefulness of Lancefield group and the caramel smell for presumptive identification was examined, and the relation of the S milleri species, Lancefield group, and SDS-PAGE protein analysis to severity of infection and infection site was investigated. Lower respiratory tract and genital tract specimens, strict anaerobes, group D streptococci, and strains identified as Streptococcus pneumoniae, Streptococcus pyogenes, or Streptococcus agalactiae were excluded. Most streptococci occurring in pure or significant growth density were S milleri group (87/100; 87%, 95% confidence interval 0.81-0.93). Of these, 89.7% (78/87; 0.84-0.96) were associated with infection. Lancefield group F antigen predominated (41/87; 47.1%, 0.38-0.56). Lancefield group F alone or accompanied by the caramel smell had a specificity of 100%, but a sensitivity of only 47.3% for group F alone, and 19.5% for group F accompanied by the caramel smell. There was no significant association between species, Lancefield group, and severity of infection, site of infection, or pathogenicity. SDS-PAGE analysis failed to discriminate between strains. Neither species nor Lancefield antigen was related to the site of infection. The presence of Lancefield group F antigen alone or accompanied by a caramel smell was a useful indicator for the S milleri group when present, but was too insensitive to use as a screening test. Most streptococci occurring in pure culture or in significant growth density were of clinical importance. Such organisms should be identified to species level to

  15. Health centre versus home presumptive diagnosis of malaria in southern Ghana: implications for home-based care policy.

    Science.gov (United States)

    Dunyo, S K; Afari, E A; Koram, K A; Ahorlu, C K; Abubakar, I; Nkrumah, F K

    2000-01-01

    A study was conducted in 1997 to compare the accuracy of presumptive diagnosis of malaria in children aged 1-9 years performed by caretakers of the children to that of health centre staff in 2 ecological zones in southern Ghana. Similar symptoms were reported in the children at home and at the health centre. In the home setting, symptoms were reported the same day that they occurred, 77.6% of the children with a report of fever were febrile (axillary temperature > or = 37.5 degrees C) and 64.7% of the reports of malaria were parasitologically confirmed. In the health centre, the median duration of symptoms before a child was seen was 3 days (range 1-14 days), 58.5% of the children with a report of fever were febrile and 62.6% of the clinically diagnosed cases were parasitologically confirmed. In the 2 settings almost all the infections were due to Plasmodium falciparum. Parasite density was 3 times higher in the health centre cases compared to the home-diagnosed cases. Early and appropriate treatment of malaria detected in children by caretakers may prevent complications that arise as a result of persistence of symptoms and attainment of high parasitaemic levels.

  16. Cost of presumptive source term Remedial Actions Laboratory for energy-related health research, University of California, Davis

    International Nuclear Information System (INIS)

    Last, G.V.; Bagaasen, L.M.; Josephson, G.B.; Lanigan, D.C.; Liikala, T.L.; Newcomer, D.R.; Pearson, A.W.; Teel, S.S.

    1995-12-01

    A Remedial Investigation/Feasibility Study (RI/FS) is in progress at the Laboratory for Energy Related Health Research (LEHR) at the University of California, Davis. The purpose of the RI/FS is to gather sufficient information to support an informed risk management decision regarding the most appropriate remedial actions for impacted areas of the facility. In an effort to expedite remediation of the LEHR facility, the remedial project managers requested a more detailed evaluation of a selected set of remedial actions. In particular, they requested information on both characterization and remedial action costs. The US Department of Energy -- Oakland Office requested the assistance of the Pacific Northwest National Laboratory to prepare order-of-magnitude cost estimates for presumptive remedial actions being considered for the five source term operable units. The cost estimates presented in this report include characterization costs, capital costs, and annual operation and maintenance (O ampersand M) costs. These cost estimates are intended to aid planning and direction of future environmental remediation efforts

  17. Use of CHROMagar Candida for the presumptive identification of Candida species directly from clinical specimens in resource-limited settings

    Science.gov (United States)

    Nadeem, Sayyada Ghufrana; Hakim, Shazia Tabassum; Kazmi, Shahana Urooj

    2010-01-01

    Introduction Identification of yeast isolated from clinical specimens to the species level has become increasingly important. Ever-increasing numbers of immuno-suppressed patients, a widening range of recognized pathogens, and the discovery of resistance to antifungal drugs are contributing factors to this necessity. Material and methods A total of 487 yeast strains were studied for the primary isolation and presumptive identification, directly from clinical specimen. Efficacy of CHROMagar Candida has been evaluated with conventional methods including morphology on Corn meal–tween 80 agar and biochemical methods by using API 20 C AUX. Results The result of this study shows that CHROMagar Candida can easily identify three species of Candida on the basis of colonial color and morphology, and accurately differentiate between them i.e. Candida albicans, Candida tropicalis, and Candida krusei. The specificity and sensitivity of CHROMagar Candida for C. albicans calculated as 99%, for C. tropicalis calculated as 98%, and C. krusei it is 100%. Conclusion The data presented supports the use of CHROMagar Candida for the rapid identification of Candida species directly from clinical specimens in resource-limited settings, which could be very helpful in developing appropriate therapeutic strategy and management of patients. PMID:21483597

  18. [Presumptive identification of Cryptococcus gattii isolated from Terminalia catappa in Montería city, Córdoba, Colombia].

    Science.gov (United States)

    Contreras Martínez, Orfa Inés; Aycardi Morinelli, María Paulina; Alarcón Furnieles, Jany Luz; Jaraba Ramos, Aparicio Manuel

    2011-01-01

    the members of the Cryptococcus neoformans species complex are responsible for cryptococcosis in animals and humans. Human infection is thought to be acquired by inhalation of airborne propagules from an environmental source; therefore it is greatly important to study their habitat. to determine the ecological relationship of Cryptococcus gattii with Terminalia catappa trees present in urban areas of Montería city in Colombia. a total of 163 Terminalia catappa trees were selected; some samples were taken from the bark, the leaves, the flowers, the fruits of these trees and from the surrounding soil. The yeast was isolated using the Guizotia abyssinica seed agar medium; it was identified thanks to biochemical and morphologic tests whereas the right variety was determined by L-canavanine-glycine-bromothymol blue (CGB), D-proline and D-tryptophan tests. there was obtained 9.050 CFU/g isolate of Cryptococcus spp., 5.795 CFU/g of which were presumptively identified as Cryptococcus gattii. The highest percentage of isolates was found in flowers, followed by bark and fruits, presenting small cellular and capsular sizes. These isolates were more frequent in the south of the city, followed by the center zone and the lowest percentage in the northern zone. these findings confirmed the close relationship of Cryptococcus gattii and Terminalia catappa, being this the first study conducted in Monteria city. These results give us meaningful information for understanding and analyzing the epidemiology of cryptococcosis in Monteria city, Colombia.

  19. Golgi Analysis of Neuron Morphology in the Presumptive Somatosensory Cortex and Visual Cortex of the Florida Manatee (Trichechus manatus latirostris).

    Science.gov (United States)

    Reyes, Laura D; Harland, Tessa; Reep, Roger L; Sherwood, Chet C; Jacobs, Bob

    2016-01-01

    The current study investigates neuron morphology in presumptive primary somatosensory (S1) and primary visual (V1) cortices of the Florida manatee (Trichechus manatus latirostris) as revealed by Golgi impregnation. Sirenians, including manatees, have an aquatic lifestyle, a large body size, and a relatively large lissencephalic brain. The present study examines neuron morphology in 3 cortical areas: in S1, dorsolateral cortex area 1 (DL1) and cluster cortex area 2 (CL2) and in V1, dorsolateral cortex area 4 (DL4). Neurons exhibited a variety of morphological types, with pyramidal neurons being the most common. The large variety of neuron types present in the manatee cortex was comparable to that seen in other eutherian mammals, except for rodents and primates, where pyramid-shaped neurons predominate. A comparison between pyramidal neurons in S1 and V1 indicated relatively greater dendritic branching in S1. Across all 3 areas, the dendritic arborization pattern of pyramidal neurons was also similar to that observed previously in the afrotherian rock hyrax, cetartiodactyls, opossums, and echidnas but did not resemble the widely bifurcated dendrites seen in the large-brained African elephant. Despite adaptations for an aquatic environment, manatees did not share specific neuron types such as tritufted and star-like neurons that have been found in cetaceans. Manatees exhibit an evolutionarily primitive pattern of cortical neuron morphology shared with most other mammals and do not appear to have neuronal specializations for an aquatic niche. © 2016 S. Karger AG, Basel.

  20. Assessing the impact of common forensic presumptive tests on the ability to obtain results using a novel rapid DNA platform.

    Science.gov (United States)

    Donachie, Gillian E; Dawnay, Nick; Ahmed, Romana; Naif, Sarah; Duxbury, Nicola J; Tribble, Nicholas D

    2015-07-01

    The rise of DNA evidence to the forefront of forensic science has led to high sample numbers being submitted for profiling by investigators to casework laboratories: bottleneck effects are often seen resulting in slow turnaround times and sample backlog. The ParaDNA(®) Screening and Intelligence Tests have been designed to guide investigators on the viability of potential sources of DNA allowing them to determine which samples should be sent for full DNA analysis. Both tests are designed to augment the arsenal of available forensic tests for end users and be used concurrently to those commonly available. Therefore, assessing the impact that common forensic tests have on such novel technology is important to measure. The systems were tested against various potential inhibitors to which samples may be exposed as part of the investigative process. Presumptive test agents for biological materials (blood, semen and saliva) and those used as fingerprint enhancement agents were both used. The Screening Test showed a drop in performance following application of aluminium powder and cyanoacrylate (CNA) on fingerprints samples; however this drop in performance was not replicated with high template DNA. No significant effect was observed for any agent using the Intelligence Test. Therefore, both tests stand up well to the chemical agents applied and can be used by investigators with confidence that system performance will be maintained. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. La noción de presunción más allá del Derecho = The notion of presumption beyond the field of Law

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    Javier Ramia

    2017-09-01

    Full Text Available Resumen: Es bien conocido que las presunciones juegan un papel de gran importancia en el campo del Derecho. Ahora bien, tal vez no lo es tanto que presunción es una noción que se estudia con un valor en cierta medida diferente más allá de las fronteras de esta disciplina, en campos como la Teoría de la Argumentación, la Epistemología y la Pragmática. En este artículo nos proponemos, de un lado, ofrecer una visión general de qué se entiende por presunción en dichos campos de estudio y, de otro, dar unas pinceladas acerca de su vinculación con la noción jurídica.Abstract: It is common knowledge that presumptions play a paramount role within the field of Law. Nonetheless, it may not be widely known that presumption is a notion that is studied with a partly different meaning beyond the boundaries of this subject, in fields of knowledge such as Argumentation Theory, Epistemology and Pragmatics. In this paper we aim to briefly present what presumption stands for in these fields of knowledge and give some hints on the way in which these uses are related to the legal notion.

  2. Gene Xpert for Direct Detection of Mycobacterium Tuberculosis in Stool Specimens from Children with Presumptive Pulmonary Tuberculosis.

    Science.gov (United States)

    Moussa, Husseiny Sh; Bayoumi, Faten Sayed; Mohamed, Ahmed Mohamed Ali

    2016-01-01

    Gene Xpert(GX) is a novel real time polymerase chain reaction (RT-PCR) assay which was endorsed by the World Health Organization (WHO) in 2011 for tuberculosis (TB) diagnosis and susceptibility to refampicin(RIF). To evaluate GX for direct diagnosis of TB in stool samples from children with suspected pulmonary Tuberculosis (PTB). Children older than one year and younger than 16 years with presumptive PTB were enrolled and classified to five clinical categories based on clinical, radiological, and laboratory findings: confirmed TB, probable TB, possible TB, Unlikely TB, and not TB. Two stool samples were collected from each child and tested for the presence of Mycobacterium tuberculosis (MTB) by GX and the obtained results were compared to Lowenstien-Jensen (LJ) culture as a gold standard. In total, 115 children were enrolled. 36 had been confirmed with TB, 61 probably TB, 10 possible TB, 5 unlikely TB, and 3 not TB. GX had a sensitivity of 83.33 and 80.56 % and specificity of 98.73 and 99.36 % by patients and samples respectively. GX was positive in 83.3% of confirmed TB as well as 1.6 and 0.8% of probable TB cases by patients and samples respectively. GX provided timely results with quit acceptable sensitivity and good specificity compared to LJ culture. In this study, sensitivity calculations take into account only children with confirmed TB. GX could not detect TB in children with probable TB, so it should not be used alone for TB diagnosis. Further studies for GX stool protocol optimization and assessment is required. © 2016 by the Association of Clinical Scientists, Inc.

  3. Decision of Habeas Corpus n. 126.292: Relativization of the Principle of Presumption of Innocence and the Constitutional Jurisdiction in Perspective

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    Hamilton da Cunha Iribure Júnior

    2016-10-01

    Full Text Available The article aims to analyze the breach of the presumption of innocence with the anticipation of the sentence before the final judgment of conviction, in a recent decision of the Supreme Court. Adopted documentary analytical methodology. Assumes that fundamental rights are not absolute and must be relativized. Deals with the constitutional jurisdiction in this perspective and the limits of the judicial role in the exercise of interpretation of the law. One of the conclusions is that the relativization of fundamental rights in Brazil follows tendency to give in proceedings other than the Constitutional Court.

  4. Cost-Effectiveness Analysis of Test-Based versus Presumptive Treatment of Uncomplicated Malaria in Children under Five Years in an Area of High Transmission in Central Ghana

    DEFF Research Database (Denmark)

    Tawiah, Theresa; Hansen, Kristian Schultz; Baiden, Frank

    2016-01-01

    (ACT) in all suspected malaria patients. The use of malaria rapid diagnostic tests (mRDTs) would make it possible for prescribers to diagnose malaria at point-of-care and better target the use of antimalarials. Therefore, a cost-effectiveness analysis was performed on the introduction of m......RDTs for management of malaria in under-five children in a high transmission area in Ghana where presumptive diagnosis was the norm in public health centres. Methods: A cluster-randomised controlled trial where thirty-two health centres were randomised into test-based diagnosis of malaria using mRDTs (intervention...

  5. Restricting Access to ART on the Basis of Criminal Record : An Ethical Analysis of a State-Enforced "Presumption Against Treatment" With Regard to Assisted Reproductive Technologies.

    Science.gov (United States)

    Thompson, Kara; McDougall, Rosalind

    2015-09-01

    As assisted reproductive technologies (ART) become increasingly popular, debate has intensified over the ethical justification for restricting access to ART based on various medical and non-medical factors. In 2010, the Australian state of Victoria enacted world-first legislation that denies access to ART for all patients with certain criminal or child protection histories. Patients and their partners are identified via a compulsory police and child protection check prior to commencing ART and, if found to have a previous relevant conviction or child protection order, are given a "presumption against treatment." This article reviews the legislation and identifies arguments that may be used to justify restricting access to ART for various reasons. The arguments reviewed include limitations of reproductive rights, inheriting undesirable genetic traits, distributive justice, and the welfare of the future child. We show that none of these arguments justifies restricting access to ART in the context of past criminal history. We show that a "presumption against treatment" is an unjustified infringement on reproductive freedom and that it creates various inconsistencies in current social, medical, and legal policy. We argue that a state-enforced policy of restricting access to ART based on the non-medical factor of past criminal history is an example of unjust discrimination and cannot be ethically justified, with one important exception: in cases where ART treatment may be considered futile on the basis that the parents are not expected to raise the resulting child.

  6. Presumptive myocarditis with ST-Elevation myocardial infarction presentation in young males as a new syndrome. Clinical significance and long term follow up

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    Tritto Cristina

    2011-01-01

    Full Text Available Abstract Background Acute myocarditis may mimic myocardial infarction, since affected patients complain of "typical" chest pain, the ECG changes are identical to those observed in acute coronary syndromes, and serum markers are increased. We describe a case series of presumptive myocarditis with ST segment elevation on admission ECG. Methods and Results From 1998 to 2009, 21 patients (20 males; age 17-42 years were admitted with chest pain, persistent ST segment elevation, serum enzyme and troponine release. All but one patients had fever and flu-like symptoms prior to admission. No abnormal Q wave appeared in any ECG tracing, and angiography did not show significant coronary artery disease. Patients remained asymptomatic at long term follow-up, except 2 who experienced a late relapse, with the same clinical, electrocardiographic and serum findings as in the first clinical presentation. Conclusion Presumptive myocarditis of possible viral origin characterized by ST elevation mimicking myocardial infarction, good short term prognosis and some risk for recurrence is relatively frequent in young males and appears as a distinct clinical condition.

  7. Effect of Test-Based versus Presumptive Treatment of Malaria in Under-Five Children in Rural Ghana--A Cluster-Randomised Trial.

    Science.gov (United States)

    Baiden, Frank; Bruce, Jane; Webster, Jayne; Tivura, Mathilda; Delmini, Rupert; Amengo-Etego, Seeba; Owusu-Agyei, Seth; Chandramohan, Daniel

    2016-01-01

    Malaria-endemic countries in sub-Saharan Africa are shifting from the presumptive approach that is based on clinical judgement (CJ) to the test-based approach that is based on confirmation through test with rapid diagnostic tests (RDT). It has been suggested that the loss of the prophylactic effect of presumptive-administered ACT in children who do not have malaria will result in increase in their risk of malaria and anaemia. We undertook a cluster-randomized controlled trial to compare the effects of the presumptive approach using clinical judgment (CJ-arm) and the test-based approach using RDTs (RDT-arm in a high-transmission setting in Ghana. A total of 3046 eligible children (1527 in the RDT arm and 1519 in the CJ- arm) living around 32 health centres were enrolled. Nearly half were female (48.7%) and 47.8% were below the age of 12 months as at enrolment. Over 24-months, the incidence of all episodes of malaria following the first febrile illness was 0.64 (95% CI 0.49-0.82) and 0.76 (0.63-0.93) per child per year in the RDT and CJ arms respectively (adjusted rate ratio 1.13 (0.82-1.55). After the first episode of febrile illness, the incidence of severe anaemia was the same in both arms (0.11 per child per year) and that of moderate anaemia was 0.16 (0.13-0.21) vs. 0.17 (0.14-0.21) per child year respectively. The incidence of severe febrile illness was 0.15 (0.09, 0.24) in the RDT arm compared to 0.17 (0.11, 0.28) per child per year respectively. The proportion of fever cases receiving ACT was lower in the RDT arm (72% vs 81%; p = 0.02). The test-based approach to the management of malaria did not increase the incidence of malaria or anaemia among under-five children in this setting. ClinicalTrials.gov NCT00832754.

  8. Prospective evaluation of the chromogenic medium CandiSelect 4 for differentiation and presumptive identification of non-Candida albicans Candida species.

    Science.gov (United States)

    Zhao, Liang; de Hoog, G Sybren; Cornelissen, Akke; Lyu, Qian; Mou, Lili; Liu, Taohua; Cao, Yu; Vatanshenassan, Mansoureh; Kang, Yingqian

    2016-02-01

    Rapid identification of pathogenic yeasts is a crucial step in timely and appropriate antifungal therapy. For diagnostics in the clinical laboratory, simplified alternatives to barcoding are needed. CandiSelect 4 (CS4) medium, a chromogenic medium for isolation of clinical yeasts, allows routine recognition of Candida albicans and presumptive identification of Candida tropicalis, Candida glabrata, and Candida krusei. We evaluated an extension of this method with 46 non-Candida albicans Candida (NCAC) and 7 Malassezia species. The medium supported growth of all species tested and a wide diversity of cultural types were observed. Colony colours were in violet, turquoise (including green and blue), or white tinges. Eight NCAC species produced violet pigmentation similar to that of C. albicans. Most NCAC species, including C. glabrata and C. tropicalis were distributed in the turquoise group. Malassezia species were invariably blue. Copyright © 2015 The British Mycological Society. Published by Elsevier Ltd. All rights reserved.

  9. Genetics Home Reference: autosomal recessive congenital methemoglobinemia

    Science.gov (United States)

    ... cell types. Each hemoglobin molecule contains four iron atoms, which are needed to carry oxygen. In normal ... direct-to-consumer genetic testing? What is precision medicine? What is newborn screening? New Pages Obstructive sleep ...

  10. Rare Case of Methemoglobinemia Complicating Pregnancy

    Directory of Open Access Journals (Sweden)

    S. Verma

    2016-01-01

    Full Text Available A patient at 38 weeks of gestation when taken for emergency cesarean section had her oxygen saturation of 66 to 70% (by saturation probe on monitor in operation theatre. She was otherwise asymptomatic but her oxygen saturation was persistently low on the monitors. Her arterial blood gas analysis showed all parameters to be normal. Her electrocardiography was normal. Her surgery was imperative but due to her reduced oxygen saturation she became a high-risk case. In presence of senior consultants of anesthesia and gynecology and under high-risk consent she had an uneventful cesarean delivery. Physician and cardiologist opinions were sought thereafter. The outcomes and the results of our efforts to find the etiology of her reduced saturation on monitors despite being clinically asymptomatic lead to the disclosure of this rare hemoglobinopathy. Mother and baby had uneventful course after delivery and were discharged well.

  11. Enhancing TB case detection: experience in offering upfront Xpert MTB/RIF testing to pediatric presumptive TB and DR TB cases for early rapid diagnosis of drug sensitive and drug resistant TB.

    Directory of Open Access Journals (Sweden)

    Neeraj Raizada

    Full Text Available Diagnosis of pulmonary tuberculosis (PTB in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India.The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU, with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm.4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8 pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2 of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4 who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV for rifampicin resistance detection was high (98%, CI 90.1-99.9, with no statistically significant variation with respect to past history of treatment.Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising

  12. Potential risks, prognostic indicators, and diagnostic and treatment modalities affecting survival in dogs with presumptive aspiration pneumonia: 125 cases (2005-2008).

    Science.gov (United States)

    Tart, Kelly M; Babski, Danielle M; Lee, Justine A

    2010-06-01

    To evaluate a clinical population of dogs diagnosed with presumptive aspiration pneumonia (AP) and determine diagnostic and treatment modalities contributing to survival. Retrospective study. A university veterinary teaching hospital in an urban setting. One hundred and twenty-five dogs with presumed AP treated from 2005 to 2008. None. Dogs with presumptive AP identified by a review of medical records had an overall survival of 81.6% (102/125). Male large-breed dogs (mean 24.9 kg; 82/125) were overrepresented and were more likely to develop AP in this study population. Recent anesthesia had been performed in 16% (20/125), and vomiting was reported in 64% (80/125). The most common radiographic findings were a predominantly alveolar pattern (187/272, [68.8%] total lung lobes) in the right middle lung lobe (80/115, [69.6%]). A mean of 2 lung lobes were involved radiographically, and the relationship between survival and the number of lung lobes affected was statistically significant (P=0.04). Neutrophilia with a left shift was common with no significant change on consecutive daily evaluations. The mean PaO(2) was 77.7 mm Hg (SD, 17.5 mm Hg) (range, 40.7-100 mm Hg) with a median alveolar-arterial gradient of 41.1 mm Hg (range, 8.1-81.8 mm Hg). In this study population, 37.6% (47/125) of dogs had microbial cultures performed and of these, 76.6% (36/47) were positive for growth; Escherichia coli (38.8%), Mycoplasma spp. (21.3%), Pasturella spp. (19.1%), and Staphylococcus spp. (17%) were the most common isolates in either single or multiagent infections. No treatment modality was statistically associated with increased survival. Colloid therapy was a negative prognostic indicator. In this study the overall prognosis for AP was good. Patients with only 1 affected lung lobe appeared more likely to survive. Supportive treatment modalities are warranted for the hospitalized patient, although no individual treatment method was found to be clearly superior to others.

  13. Incremental detection of pulmonary tuberculosis among presumptive patients by GeneXpert MTB/RIF® over fluorescent microscopy in Mwanza, Tanzania: an operational study

    Directory of Open Access Journals (Sweden)

    Jeremiah Seni

    2015-06-01

    Full Text Available Laboratory confirmation among presumptive tuberculosis (PTB patients is pivotal in ensuring prompt management. Limited information exists in Tanzania regarding the performance of GeneXpert MTB/RIF® in comparison with conventional methods. An operational study was conducted involving 806 PTB patients at Sekou Toure Hospital in Mwanza, Tanzania from June to November 2013. Patients’ information was obtained and their respective sputum samples analyzed by lightemitting diode fluorescent microscopy (LED FM and GeneXpert MTB/RIF®. The mean age of study participants was 39.6±16.0 years, with males accounting for 50.5%. The majority of patients (97.5% were new cases. The proportions of PTB patients confirmed by LED FM and GeneXpert MTB/RIF® were 14.1% (114/806 and 23.7% (191/806 respectively, resulting into a 9.6% incremental detection rate by GeneXpert MTB/RIF® over LED FM. The detection rate among HIV positive individuals was also higher [23.6% (63/267 vs 14.2% (38/267, respectively], with an incremental detection of 9.4%. The incremental detection of PTB by GeneXpert MTB/RIF® over LED FM calls for expansion of its use to increase detection of smear negative PTB among people living with HIV.

  14. Comprehensive Laboratory Evaluation of a Highly Specific Lateral Flow Assay for the Presumptive Identification of Bacillus anthracis Spores in Suspicious White Powders and Environmental Samples.

    Science.gov (United States)

    Ramage, Jason G; Prentice, Kristin W; DePalma, Lindsay; Venkateswaran, Kodumudi S; Chivukula, Sruti; Chapman, Carol; Bell, Melissa; Datta, Shomik; Singh, Ajay; Hoffmaster, Alex; Sarwar, Jawad; Parameswaran, Nishanth; Joshi, Mrinmayi; Thirunavkkarasu, Nagarajan; Krishnan, Viswanathan; Morse, Stephen; Avila, Julie R; Sharma, Shashi; Estacio, Peter L; Stanker, Larry; Hodge, David R; Pillai, Segaran P

    2016-01-01

    We conducted a comprehensive, multiphase laboratory evaluation of the Anthrax BioThreat Alert(®) test strip, a lateral flow immunoassay (LFA) for the rapid detection of Bacillus anthracis spores. The study, conducted at 2 sites, evaluated this assay for the detection of spores from the Ames and Sterne strains of B. anthracis, as well as those from an additional 22 strains. Phylogenetic near neighbors, environmental background organisms, white powders, and environmental samples were also tested. The Anthrax LFA demonstrated a limit of detection of about 10(6) spores/mL (ca. 1.5 × 10(5) spores/assay). In this study, overall sensitivity of the LFA was 99.3%, and the specificity was 98.6%. The results indicated that the specificity, sensitivity, limit of detection, dynamic range, and repeatability of the assay support its use in the field for the purpose of qualitatively evaluating suspicious white powders and environmental samples for the presumptive presence of B. anthracis spores.

  15. Comprehensive laboratory evaluation of a specific lateral flow assay for the presumptive identification of abrin in suspicious white powders and environmental samples.

    Science.gov (United States)

    Ramage, Jason G; Prentice, Kristin Willner; Morse, Stephen A; Carter, Andrew J; Datta, Shomik; Drumgoole, Rahsaan; Gargis, Shaw R; Griffin-Thomas, Latoya; Hastings, Rebecca; Masri, Heather P; Reed, Matthew S; Sharma, Shashi K; Singh, Ajay K; Swaney, Erin; Swanson, Tanya; Gauthier, Cheryl; Toney, Denise; Pohl, Jan; Shakamuri, Priyanka; Stuchlik, Olga; Elder, Ian A; Estacio, Peter L; Garber, Eric A E; Hojvat, Sally; Kellogg, Richard B; Kovacs, Gerald; Stanker, Larry; Weigel, Linda; Hodge, David R; Pillai, Segaran P

    2014-01-01

    Abrin is a heterodimeric toxin present in the seeds of the Abrus precatorius plant. The easily obtainable seeds can yield a highly toxic product that can be used in various types of biocrimes and terrorism-related activities, including "white-powder" letters. Although the vast majority of these threats are hoaxes, the lack of rapid and reliable detection assays for abrin, such as lateral flow assays (LFAs), can be an impediment to accurate and rapid hazard assessment. One of the complicating factors associated with LFAs is the use of antibodies of poor affinity and specificity that cross-react with near neighbors or that bind to plant lectins, which are capable of nonspecifically cross-linking the capture and detector antibodies. Because of the critical need to promote public safety and public health, we conducted a comprehensive laboratory evaluation of a commercial LFA for the rapid detection of abrin. This study was conducted using comprehensive inclusivity and exclusivity panels of abrin and near-neighbor plant materials, along with panels of lectins, related proteins, white powders, and environmental background material, to determine the sensitivity, specificity, limit of detection, dynamic range, and repeatability of the assay for the specific intended use of evaluating suspicious white powders and environmental samples for the presumptive presence of abrin.

  16. Standardization and evaluation of the CAMP reaction for the prompt, presumptive identification of Streptococcus agalactiae (Lancefield group B) in clinical material.

    Science.gov (United States)

    Darling, C L

    1975-02-01

    Primary cultures of clinical material were screened for the presence of colonies suspected of being Streptococcus agalactiae (Lancefield group B). Sixty-three such cultures and 108 other isolates of beta-hemolytic streptococci (groups A, C, and G), encountered during the first 3 months of the investigation, were studied by Lancefield grouping, sodium hippurate hydrolysis, and a standardized CAMP test. All streptococci were inoculated perpendicularly to streaks of a beta-toxin-producing staphylococcus on sheep blood agar plates and incubated aerobically in a candle jar and anaerobically at 37 C. Plates were examined after 5 to 6 and 18 h of incubation. The production of a distinct "arrowhead" of hemolysis was indicative of a positive CAMP reaction. All group B streptococci produced a positive CAMP reaction in the candle jar or anaerobically, usually within 5 to 6 h, and aerobically after 18 h of incubation. All group A streptococci produced a positive reaction only under anaerobic conditions. Groups C and G streptococci were negative under all atmospheres. The CAMP reaction is a prompt and reliable procedure for the presumptive identification of group B streptococci when a candle jar atmosphere is used during incubation.

  17. Outcome of Patients Admitted with Presumptive Diagnosis of Influenza During 2009 Emerging H1N1 Pandemia in Referral Hospital of Ardabil City

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    Shahram Habibzadeh

    2013-06-01

    Full Text Available Background & Objectives: Considering new pandemic attack with new emerging (H1N1 influenza virus, the study was designed for evaluating clinical and epidemiologic characteristics of patients in Imam Khomeini hospital, admitted with presumptive diagnosis of H1N1 influenza . In all of the patients clinical and paraclinical findings and outcome (including mortality rate and definitive diagnosis were evaluated. Bed occupancy rate in infectious disease ward and ICU and also mean days of admission were calculated.   Methods: This is a cross sectional study . All 118 patients with acute respiratory symptoms and possible diagnosis of emerging H1N1 influenza that had been admitted at least 24 hours in hospital from 20 October to 1 February 2009 were enrolled in the study. Data collection was done based on questionnaires, with a team other than researchers. The questionnaire included demographic data , clinical symptoms , laboratory findings , radiographic manifestations and outcome of patients. Data analysis was performed with SPSS software version16.   Results: A total of 118 patients were studied: 71 patients ( 60.2% were female and 47 patients ( 39.8% were male. Mean ( ± SD age of admitted patients was 33.81 ± 15.64 years old. The most of admitted patients were in age range of 15 to 30 years old. The most common findings in CXR were bilateral respiratory consolidations and the most common symptoms were fever, weakness and fatigue. About 12.7% of patients had diarrhea. Leukopenia (WBC 10000 occurred respectively in 4.58% and 33.2% of cases . Nine patients (7% were admitted in ICU. I n 21 patients (18% RT-PCR test results were positive and three of these patients had been admitted in ICU. In patients admitted in ICU while their diagnosis was confirmed, mortality was 33%. 48.3% of patients had at least one predisposing medical condition . Total admission days were 577 days, consisting 519 days in infectious disease ward and 58 days in ICU. Average of

  18. Risk factors for presumptive melanoma in skin cancer screening: American Academy of Dermatology National Melanoma/Skin Cancer Screening Program experience 2001-2005.

    Science.gov (United States)

    Goldberg, Matthew S; Doucette, John T; Lim, Henry W; Spencer, James; Carucci, John A; Rigel, Darrell S

    2007-07-01

    Since its inception in 1985, the American Academy of Dermatology (AAD) National Melanoma/Skin Cancer Screening Program has strived to enhance early detection of cutaneous malignant melanoma (MM) by providing nationwide skin cancer education campaigns in combination with free skin cancer screenings. To analyze the AAD screening data from 2001 to 2005 in order to identify factors associated with MM detection, and thereby derive a model of increased likelihood for MM detection through visual skin examinations at screenings. Patients completed a standardized AAD pre-screening form with historical and phenotypic information. Clinicians then recorded suspected clinical findings noted at visual skin examination. Statistical analyses were conducted using SPSS 14 (SPSS Inc., Chicago, Ill). Five factors, which can be remembered with the acronym HARMM, independently increased the likelihood of suspected MM being found in the 362,804 persons screened: History of previous melanoma (odds ratio [OR] = 3.3; 95% confidence interval [CI], 2.9-3.8); Age over 50 (OR = 1.2; 95% CI, 1.1-1.3); Regular dermatologist absent (OR = 1.4; 95% CI, 1.3-1.5); Mole changing (OR = 2.0; 95% CI, 1.9-2.2); and Male gender (OR = 1.4; 95% CI, 1.3-1.5). Individuals at highest risk (4 or 5 factors) comprised only 5.8% of the total population, yet accounted for 13.6% of presumptive MM findings, and were 4.4 times (95% CI, 3.8-5.1) more likely to be diagnosed with suspected MM than individuals at lowest risk (0 or 1 factor). Receipt of a total skin examination at screening independently increased the likelihood for identifying suspected MM (OR = 1.4; 95% CI, 1.3-1.6). However, significantly fewer screenees in the highest risk group versus those in the lowest risk group underwent total skin examinations (53.7% vs 62.5%). Risk factors studied limited to variables collected in screenee enrollment form. A higher-risk subgroup of the skin cancer screening population can be identified through assessment of MM

  19. Presumption of lawful acquirement of property and confiscation of unlawfully acquired property in the case-law of the Romanian Constitutional Court. The reference constitutional framework for regulating of the extended confiscation

    Directory of Open Access Journals (Sweden)

    Marieta SAFTA

    2012-06-01

    Full Text Available This study examines - from a dual perspective - historical and teleological, the constitutional provisions that enshrine the presumption of lawful acquirement of assets, including the development and interpretation thereof in the case-law of the Constitutional Court, in order to create a framework for analysis of Law no. 63/2012 amending and supplementing the Criminal Code and Law no. 286/2009 on the Criminal Code, a law that establishes the measure of extended confiscation, expression of international regulatory concerns in this area.

  20. The sensitivity and specificity of using a computer aided diagnosis program for automatically scoring chest X-rays of presumptive TB patients compared with Xpert MTB/RIF in Lusaka Zambia.

    Directory of Open Access Journals (Sweden)

    Monde Muyoyeta

    Full Text Available OBJECTIVE: To determine the sensitivity and specificity of a Computer Aided Diagnosis (CAD program for scoring chest x-rays (CXRs of presumptive tuberculosis (TB patients compared to Xpert MTB/RIF (Xpert. METHOD: Consecutive presumptive TB patients with a cough of any duration were offered digital CXR, and opt out HIV testing. CXRs were electronically scored as normal (CAD score ≤ 60 or abnormal (CAD score > 60 using a CAD program. All patients regardless of CAD score were requested to submit a spot sputum sample for testing with Xpert and a spot and morning sample for testing with LED Fluorescence Microscopy-(FM. RESULTS: Of 350 patients with evaluable data, 291 (83.1% had an abnormal CXR score by CAD. The sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of CXR compared to Xpert were 100% (95%CI 96.2-100, 23.2% (95%CI 18.2-28.9, 33.0% (95%CI 27.6-38.7 and 100% (95% 93.9-100, respectively. The area under the receiver operator curve (AUC for CAD was 0.71 (95%CI 0.66-0.77. CXR abnormality correlated with smear grade (r = 0.30, p<0.0001 and with Xpert CT(r = 0.37, p<0.0001. CONCLUSIONS: To our knowledge this is the first time that a CAD program for TB has been successfully tested in a real world setting. The study shows that the CAD program had high sensitivity but low specificity and PPV. The use of CAD with digital CXR has the potential to increase the use and availability of chest radiography in screening for TB where trained human resources are scarce.

  1. Increased risk of fluorosis and methemoglobinemia diseases from ...

    African Journals Online (AJOL)

    Current assessments of the impacts of climate variability and change on water resources commonly exclude groundwater. Thus, the identification of actual and potential health threatening elements in the groundwater, and linking up to climate variation and change at hydrologic catchment scale is an important ingredient for ...

  2. Validez del diagnóstico presuntivo de leishmaniasis cutánea realizado por mediadores comunitarios en Colombia The validity of a presumptive diagnosis of cutaneous leishmaniasis performed by community health workers in Colombia

    Directory of Open Access Journals (Sweden)

    Juana Sánchez

    2007-06-01

    captación activa de casos en la comunidad.OBJECTIVE: To validate a method for the presumptive diagnosis of cutaneous leishmaniasis based on the observation of clinical-epidemiological criteria, carried out by community health workers in three endemic municipalities in Santander, a department in northeastern Colombia. METHODS: This evaluation study of diagnostic technologies was based on a cross-sectional sampling of suspected cases of cutaneous leishmaniasis in the municipalities of Rionegro, El Playón, and Landázuri. After being trained, the community health workers carried out the presumptive diagnoses of cutaneous leishmaniasis between October 2004 and November 2005. At the time of diagnosis, the health workers also collected samples for confirmatory diagnosis through Field's stain method, culturing, and polymerase chain reaction. Four criteria were used to assess the validity of the presumptive diagnoses carried out by the health workers: sensitivity, specificity, positive predictive value, and negative predictive value. Replicability among the health workers was estimated through their observed level of agreement. RESULTS: According to the laboratory tests, of the 196 patients studied, 33 (16.8% were negative and 163 (83.2% were positive. For all the levels of certainty of the clinical diagnosis, the sensitivity was between 52% and 98% (k(1, 0 = 39.0% and the specificity between 9% and 55% (k(0, 0 = 14.0%. The area under the receiver operating characteristic curve was 56.5% (95% confidence interval: 45.6% to 67.4%. The proportion of positive agreement and of negative agreement was 86.3% and 43.5%, respectively. CONCLUSIONS: The sensitivity of the presumptive diagnosis carried out by the health workers surpasses that of the parasitological diagnostic methods generally used in the three endemic areas, but its specificity is much lower. Even though this approach is not useful as a diagnostic test for cutaneous leishmaniasis or as a criterion for deciding to proceed

  3. Matrix effect and cross-reactivity of select amphetamine-type substances, designer analogues, and putrefactive amines using the Bio-Quant direct ELISA presumptive assays for amphetamine and methamphetamine.

    Science.gov (United States)

    Apollonio, Luigino G; Whittall, Ian R; Pianca, Dennis J; Kyd, Jennelle M; Maher, William A

    2007-05-01

    The aim of this study was to evaluate the Bio-Quant Direct ELISA assays for amphetamine and methamphetamine in the routine presumptive screening of biological fluids. Standard concentration curves of the target analytes were assayed to assess sensitivity, and known concentrations of common amphetamine-type substances (ephedrine, pseudoephedrine, phentermine), designer analogues (MDA, MDMA, MDEA, MBDB, PMA, 4-MTA, 2CB), and putrefactive amines (phenylethylamine, putrescine, tryptamine, tyramine) were analyzed to determine cross-reactivity. Results of the standard curve studies show the capacity of both Direct ELISA kits to confidently detect down to 3 ng/mL interday (PBS matrix; CVs 6.3-15.5%). Cross-reactivity relative to that of 50 ng/mL preparations of the target compounds demonstrated that the Direct ELISA kit for amphetamine also detected MDA (282%), PMA (265%), 4-MTA (280%), and phentermine (61%), and the Direct ELISA for methamphetamine also assayed positive for MDMA (73%), MDEA (18%), pseudoephedrine (19%), MBDB (8%), and ephedrine (9%). Matrix studies demonstrated that both ELISA kits could be applied to screening of blood, urine, and saliva to a concentration of 6 ng/mL or lower. In conclusion, the Bio-Quant Direct ELISA kits for amphetamine and methamphetamine are fast and accurate and have demonstrated themselves to be useful tools in routine toxicological testing.

  4. 12 CFR 925.17 - Rebuttable presumptions.

    Science.gov (United States)

    2010-01-01

    ... Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK MEMBERS AND HOUSING ASSOCIATES... are in substantial compliance with all aspects of the enforcement action; or (ii) Written analysis. A written analysis acceptable to the Bank indicating that the applicant or its directors or senior officers...

  5. Presumptive Versus Directed Treatment Of Uncomplicated Malaria ...

    African Journals Online (AJOL)

    placed in the OPD and thick blood films were prepared ... film results. Prescribers in the OPD were aware of the screening process. Daily tallies in the Pharmacy were made as described above. Phase III: Two weeks prior to Phase III, the results of. Phase II were .... nual yearly drug budget for the Dept of Orthopaedics.

  6. Presumptive diagnosis of Avian encephalomyelitis in Japanese ...

    African Journals Online (AJOL)

    A report of Avian encephalomyelitis outbreak in two flocks of adult Japanese quail is presented. High mortalities, tremor, ataxia and lateral recumbency were the prominent clinical signs observed. Absence of gross pathology and microscopic lesions of gliosis, neuronal degeneration, meningitis, congested blood vessel with ...

  7. 26 CFR 1.341-3 - Presumptions.

    Science.gov (United States)

    2010-04-01

    ... of the transactions described in § 1.341-1 the fair market value of the section 341 assets held by it constitutes 50 percent or more of the fair market value of its total assets and the fair market value of the... accrual basis, on July 31, 1955, owned assets with the following fair market values: Cash, $175,000; note...

  8. Immunodiagnostic confirmation of hydatid disease in patients with a presumptive diagnosis of infection Confirmación inmunodiagnóstica de la hidatidosis en pacientes con diagnóstico presuntivo de la infeccion

    Directory of Open Access Journals (Sweden)

    V. M. Varela-diaz

    1984-04-01

    Full Text Available Information obtained from the routine application of hydatid immunodiagnostic techniques in different clinical situations over a seven-year period is presented. The Immunoelectrophoresis test was used until it was replaced by the simpler, more sensitive and equally specific arc 5 double diffusion (DD5 test. Examination of sera from 1,888 patients with signs and/or symptoms compatible with hydatid disease revealed that the presurgical confirmation of Echinococcus granulosus infection is only obtained by detection of anti-antigen 5 antibodies. The latter were not found in 1,539 presumptive hydatidosis patients whose definitive diagnoses corresponded to other disease conditions. However, false positive latex agglutination test results were obtained in two cases. In all patients whose preoperative serum showed three or more uncharacteristic bands in the absence of anti-antigen 5 antibodies, hydatid cysts were found sur gically. DD5 testing of a fluid sample collected by puncture established its hydatid etiology. Post-operative monitoring of hydatidosis patients demonstrated that persistence of DD5-positivity two years after surgery established the presence of other cysts. Further evidence was obtained in patients with hydatid cysts in intrathoracic, abdominal or other locations associating cyst membrane integrity, antigen release and immunodiagnostic test positivity.Se presenta la información obtenida de la aplicación de las técnicas inmunodiagnósticas para hidatidosis en diferentes situaciones clínicas durante un período de 7 años. Se empleó la prueba de inmunoelectroforesis hasta que se la sustituyó por la prueba de doble difusión arco 5 (DD5, igualmente específica pero de mayor sensibilidad y sencillez. El examen de sueros de 1 888 pacientes con signos y/o sintomas compatibles con la hidatidosis reveló que la confirmación prequirúrgica de la infeccion por Echinococcus granulosus sólo se obtiene mediante la detección de anticuerpos

  9. Estudio en niños con diagnóstico presuntivo de toxocariasis en Santa Fe, Argentina Analysis of children with a presumptive diagnosis of toxocariasis in Santa Fe, Argentina

    Directory of Open Access Journals (Sweden)

    Ubaldo O. Martín

    2008-10-01

    the larvae migrate through the capillaries, taking up residence in different tissues. Clinical manifestations are associated with mechanical and/or reaction damage caused by these parasites larvae. Clinical diagnosis is difficult. The method applied in this work is the demonstration of antibodies against the helminth in the blood of children, target host population of this parasitic disease. An ELISA test was performed using T. canis larval excretory-secretory products as antigen. A total of 100 children presumptively diagnosed of toxocariasis that had been derived from different services of the Regional Children’s Hospital for complementary studies, were included in the analysis. The test detected two different populations: infected (59 and non-infected (41. The statistical analysis showed a non significant association between infection and sex (p = 0.279. Infected subjects tended to be older than the non infected (p = 0.009. Eosinophilia was detected in 100% of seropositive children and in 85.2% of the seronegative. There was no significant association between infection and leucocytosis ( = 0.950. The association of these two parameters was significantly higher among infected patients (R = 0.918. Respiratory symptoms and signs were more frequently detected in the positive population (p = 0.05. Dogs tenancy was as frequent among infected as in the non infected homes (p = 0.53. According to these results, prevention, early diagnosis and opportune treatment for toxocariasis should be considered as prioritary health activities in this region.

  10. Heinz body anemia in a dog that had been sprayed with skunk musk.

    Science.gov (United States)

    Zaks, Karen L; Tan, Emmeline O; Thrall, Mary Anna

    2005-05-01

    A 5-year-old pit bull-type dog was examined because of lethargy and black feces, and a presumptive diagnosis of methemoglobinemia was made on the basis of grossly visible brown discoloration of the mucous membranes and urine. Heinz body formation was seen on examination of blood smears, and severe anemia developed 3 days later. The dog did not have any history of exposure to toxins or drugs that have been associated with Heinz body formation. The only remarkable historical finding was that the dog had been wandering loose the day prior to initial examination and returned home smelling strongly of skunk spray. Skunk spray contains thiols and other compounds that are strong oxidizing agents. It was speculated that the methemoglobinemia and Heinz body anemia were a result of exposure to these compounds. Skunk interactions with dogs usually have malodorous but otherwise harmless results. However, findings in this dog suggest that more serious consequences may develop in isolated cases.

  11. Acute Poisoning with Dapsone and Olanzapine: Severe Methemoglobinemia and Coma with a Favourable Outcome.

    Science.gov (United States)

    Iliev, Yanko T; Zagorov, Marin Y; Grudeva-Popova, Janet G

    2015-01-01

    Dapsone is a drug commonly used in the treatment of leprosy. In Europe it is rarely prescribed, mostly for the treatment of skin diseases such as dermatitis herpetiformis. Poisoning with dapsone is rare and reports of such cases are of interest for toxicological practice. We describe the only acute dapsone poisoning in a caseload series of 21,000 intoxications treated in the Clinical Toxicology Clinic at St George University Hospital in Plovdiv, Bulgaria between 1999 and 2013. We report on a 36-year-old woman who attempted deliberate self-poisoning with an ingestion of approximately 4.5 g of dapsone and 0.3 g of olanzapine. On admission, the patient was in a state of severe intoxication and comatose. On admission to hospital 9 hours after the ingestion, the methemoglobin level was 51.7%. The patient recovered 8 days later. She received complex treatment including intubation, ventilation, repeated gastric lavage, hemodialysis, blood exchange transfusion and antidote treatment with methylene blue. She was discharged in good clinical condition with minimal organ damage such as mild toxic hepatitis.

  12. Methemoglobinemia and ascorbate deficiency in hemoglobin E β thalassemia: metabolic and clinical implications

    Science.gov (United States)

    Allen, Angela; Fisher, Christopher; Premawardhena, Anuja; Bandara, Dayananda; Perera, Ashok; Allen, Stephen; St Pierre, Timothy; Olivieri, Nancy

    2012-01-01

    During investigations of the phenotypic diversity of hemoglobin (Hb) E β thalassemia, a patient was encountered with persistently high levels of methemoglobin associated with a left-shift in the oxygen dissociation curve, profound ascorbate deficiency, and clinical features of scurvy; these abnormalities were corrected by treatment with vitamin C. Studies of erythropoietin production before and after treatment suggested that, as in an ascorbate-deficient murine model, the human hypoxia induction factor pathway is not totally dependent on ascorbate levels. A follow-up study of 45 patients with HbE β thalassemia showed that methemoglobin levels were significantly increased and that there was also a significant reduction in plasma ascorbate levels. Haptoglobin levels were significantly reduced, and the high frequency of the 2.2 haptoglobin genotype may place an additional pressure on ascorbate as a free-radical scavenger in this population. There was, in addition, a highly significant correlation between methemoglobin levels, splenectomy, and factors that modify the degree of globin-chain imbalance. Because methemoglobin levels are modified by several mechanisms and may play a role in both adaptation to anemia and vascular damage, there is a strong case for its further study in other forms of thalassemia and sickle-cell anemia, particularly when splenic function is defective. PMID:22885163

  13. A case of methemoglobinemia after ingestion of an aphrodisiac, later proven as dapsone.

    Science.gov (United States)

    Lee, S W; Lee, J Y; Lee, K J; Kim, M; Kim, M J

    1999-08-01

    Methemoglobin (MetHb) is an oxidation product of hemoglobin in which the sixth coordination position of ferric iron is bound to a water molecule or to a hydroxyl group. The most common cause of acquired MetHb-emia is accidental poisoning which usually is the result of ingestion of water containing nitrates or food containing nitrite, and sometimes the inhalation or ingestion of butyl or amyl nitrite used as an aphrodisiac. We herein report a case of MetHb-emia after ingestion of an aphrodisiac, later identified as dapsone by gas chromatograph/mass selective detector (GC/MSD). A 24-year old male was admitted due to cyanosis after ingestion of a drug purchased as an aphrodisiac. On arterial blood gas analysis, pH was 7.32, PaCO2 26.8 mmHg, PaO2 75.6 mmHg, and bicarbonate 13.9 mmol/L. Initial pulse oxymetry was 89%. With 3 liter of nasal oxygen supplement, oxygen saturation was increased to 90-92%, but cyanosis did not disappear. Despite continuous supplement of oxygen, cyanosis was not improved. On the fifth hospital day, MetHb was 24.9%. Methylene blue was administered (2 mg/kg intravenously) and the patient rapidly improved. We proved the composition of aphrodisiac as dapsone by the method of GC/MSD.

  14. Burdens of Proof, Presumptions and Standards of Proof in Criminal ...

    African Journals Online (AJOL)

    Worku_Y

    6 Id, at 377; CRM Dlamini (2003), 'The Burden of Proof: Its Role and Meaning', 14 .... The prosecutor loses on the case if it fails to preliminarily discharge its ..... Failure to successfully discharge one's form of burden of proof at the right time with the required intensity of proof entails irreversible consequences. As most of the.

  15. 129 microbiological studies of blood specimen from presumptively ...

    African Journals Online (AJOL)

    It is ogften fatal if allowed to progress for long, undetected and untreated. It has continued to pose serious epidemiological problems due to its high mortality and ..... Cross-reactivity between O-antigens of Pseudomonas aeruginosa and Salmonella spp. had also been observed (18). The isolation of organisms which are not ...

  16. THE PRINCIPLE OF THE PRESUMPTION OF INNOCENCE AND ...

    African Journals Online (AJOL)

    SimenehKA

    This is a constitutional principle under Ethiopian law and requires the public prosecutor to prove each element .... application of the principle of utility in the administration of the criminal justice aims at maximizing the correct results5 by ..... Texts, Cases and Problems 4th Ed.,. (New York: Aspen Law and Business), at 767.

  17. Actin microfilaments in presumptive statocytes of root caps and coleoptiles

    Science.gov (United States)

    White, R. G.; Sack, F. D.

    1990-01-01

    Rhodamine-phalloidin was used to determine the distribution of actin microfilament bundles (mfb) in cells thought to be the site of gravity perception (statocytes) in coleoptiles and root caps of Zea mays and Hordeum vulgare. In coleoptile cells, amyloplasts were usually observed in close proximity to thick mfb, which often appeared to divide into finer mfb adjacent to individual amyloplasts. The nucleus in these cells was surrounded by an extensive network of mfb, which were connected to thicker transvacuolar mfb. Columella cells of the root cap contained an extensive reticulum of fine mfb throughout the protoplast, but lacked the much thicker mfb seen in coleoptile cells. The distribution and extent of mfb observed in fixed cells correlates with patterns of streaming and amyloplast movement seen in living cells. A possible role for actin mfb in the perception of gravity is discussed.

  18. Chlamydial cervicitis: testing the practice guidelines for presumptive diagnosis

    OpenAIRE

    Sellors, J; Howard, M; Pickard, L; Jang, D; Mahony, J; Chernesky, M

    1998-01-01

    OBJECTIVE: To test the recommendation from the Canadian guidelines for sexually transmitted diseases (STDs) that mucopurulent endocervical discharge and 10 or more polymorphonuclear leukocytes (PMNs) per high-power field of a Gram-stained endocervical smear or, when Gram staining is not possible, the presence of endocervical discharge and one of edema, erythema or induced mucosal bleeding of the cervix can be considered diagnostic for chlamydial cervicitis. METHODS: A total of 596 consecutive...

  19. 10 CFR 1045.15 - Classification and declassification presumptions.

    Science.gov (United States)

    2010-01-01

    ... experimental physics, engineering, materials science, biology and medicine; (2) Magnetic confinement fusion... Section 1045.15 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND... before applying the criteria in § 1045.16. (b) Not all areas of nuclear-related information are covered...

  20. 29 CFR 458.28 - Presumption of validity.

    Science.gov (United States)

    2010-07-01

    ... ratified after a fair hearing either before the executive board or before such other body as may be... clear and convincing proof that the trusteeship was not established or maintained in good faith for... invalid in any such proceeding, unless the labor organization shall show by clear and convincing proof...

  1. Veterans Affairs: Presumptive Service Connection and Disability Compensation

    Science.gov (United States)

    2011-03-28

    exposure in numerous epidemiologic studies.25 This law also established a program to provide disability compensation to radiation-exposed veterans who...to include a “medically unexplained chronic multisymptom illness (such as chronic fatigue syndrome, fibromyalgia , and irritable bowel syndrome) that...conduct an epidemiological study of the possible health effects in veterans who served in Vietnam of exposure to dioxin as found in herbicides including

  2. Presumptive Ischemic Brain Infarction in a Dog with Evans’ Syndrome

    Directory of Open Access Journals (Sweden)

    Angelo Pasquale Giannuzzi

    2014-01-01

    Full Text Available A ten-year-old neutered female mixed breed dog was referred for pale mucous membrane and acute onset of right prosencephalic clinical signs. Brain magnetic resonance imaging was suggestive for right middle cerebral artery ischemic stroke. Based on cell blood count, serum biochemistry and serologic tests and flow cytometric detection of anti-platelets and anti-red blood cells antibodies, a diagnosis of immunomediated haemolytic anemia associated with thrombocytopenia of suspected immunomediated origin was done. Immunosuppresive therapy with prednisone was started and the dog clinically recovered. Two months later complete normalization of CBC and serum biochemistry was documented. The dog remained stable for 7 months without therapy; then she relapsed. CBC revealed mild regenerative anemia with spherocytosis and thrombocytopenia. A conclusive Evans’ syndrome diagnosis was done and prednisone and cyclosporine treatment led to normalization of physical and CBC parameters. The dog is still alive at the time the paper submitted. Possible thrombotic etiopathogenetic mechanisms are illustrated in the paper and the authors suggest introducing Evans’ syndrome in the differential diagnosis list for brain ischemic stroke in dogs.

  3. Performance of modified WHO presumptive criteria for diagnosis of ...

    African Journals Online (AJOL)

    Background: Making a diagnosis of HIV infection in children aged less than 18 months remains a challenge in low resource settings like Zambia due to the limited availability of gold standard testing with HIV DNA PCR. Clinicians in rural areas have to depend on clinical diagnosis to start HAART asthey wait for the dry blood ...

  4. Prospective Teachers Proportional Reasoning and Presumption of Student Work

    Directory of Open Access Journals (Sweden)

    Mujiyem Sapti

    2015-08-01

    Full Text Available This study aimed to describe the proportional reasoning of prospective teachers and their predictions about students' answers. Subjects were 4 prospective teacher  7th semester Department of Mathematics Education, Muhammadiyah University of Purworejo. Proportional reasoning task used to obtain research data. Subjects were asked to explain their reasoning and write predictions of student completion. Data was taken on October 15th, 2014. Interviews were conducted after the subjects completed the task and recorded with audio media. The research data were subject written work and interview transcripts. Data were analyzed using qualitative analysis techniques. In solving the proportional reasoning task, subjects using the cross product. However, they understand the meaning of the cross product. Subject also could predict students' reasoning on the matter.

  5. Lifestyle, nutrition and breast cancer: facts and presumptions for consideration

    OpenAIRE

    Ferrini, Krizia; Ghelfi, Francesca; Mannucci, Roberta; Titta, Lucilla

    2015-01-01

    Breast cancer is the most common cancer in women worldwide, and the high incidence of this cancer coupled with improvements in initial treatments has led to an ever-increasing number of breast cancer survivors. Among the prospective epidemiological studies on diet and breast cancer incidence and recurrence, to date, there is no association that is strong, reproducible and statistically significant, with the exception of alcohol intake, overweight, and weight gain. Nevertheless, many beliefs a...

  6. Common variable immunodeficiency in three horses with presumptive bacterial meningitis.

    Science.gov (United States)

    Pellegrini-Masini, Alessandra; Bentz, Amy I; Johns, Imogen C; Parsons, Corrina S; Beech, Jill; Whitlock, Robert H; Flaminio, M Julia B F

    2005-07-01

    Three adult horses were evaluated for signs of musculoskeletal pain, dullness, ataxia, and seizures. A diagnosis of bacterial meningitis was made on the basis of results of CSF analysis. Because primary bacterial meningitis is so rare in adult horses without any history of generalized sepsis or trauma, immune function testing was pursued. Flow cytometric phenotyping of peripheral blood lymphocytes was performed, and proliferation of peripheral blood lymphocytes in response to concanavalin A, phytohemagglutinin, pokeweed mitogen, and lipopolysaccharide was determined. Serum IgA, IgM, and IgG concentrations were measured by means of radial immunodiffusion, and serum concentrations of IgG isotypes were assessed with a capture antibody ELISA. Serum tetanus antibody concentrations were measured before and 1 month after tetanus toxoid administration. Phagocytosis and oxidative burst activity of isolated peripheral blood phagocytes were evaluated by means of simultaneous flow cytometric analysis. Persistent B-cell lymphopenia, hypogammaglobulinemia, and abnormal in vitro responses to mitogens were detected in all 3 horses, and a diagnosis of common variable immunodeficiency was made.

  7. Household Expenditure on Treatment of Presumptive Malaria in a ...

    African Journals Online (AJOL)

    Background: Malaria is endemic in Nigeria and there is a vicious cycle between it and poverty. It contributes towards poverty, while poverty influences the risk of its infection. Majority of Nigerians, 70%, live in rural areas, below poverty line. They earn less than $1.25 a day. Subsistence farming is their main occupation.

  8. 8 CFR 101.1 - Presumption of lawful admission.

    Science.gov (United States)

    2010-01-01

    ... United States across the Canadian border prior to October 1, 1906; an alien who establishes that while a... establishes that he is of a race indigenous to, and a native of a country within, the Asiatic zone defined in...

  9. 8 CFR 1101.1 - Presumption of lawful admission.

    Science.gov (United States)

    2010-01-01

    ... Newfoundland, he entered the United States across the Canadian border prior to October 1, 1906; an alien who... zone. An alien who establishes that he is of a race indigenous to, and a native of a country within...

  10. 129 microbiological studies of blood specimen from presumptively ...

    African Journals Online (AJOL)

    patient' serum for salmonella antibodies is a rapid tool in the diagnosis of enteric fever, but can afford an indirect ... which various dilutions of patient's serum are mixed with drops of either O or H-antigen of Salm. Typhi .... biochemical characterization and sero-typing are essential for complete identification of salmonella.

  11. Use of CHROMagar Candida for the presumptive identification of ...

    African Journals Online (AJOL)

    2010-02-09

    Feb 9, 2010 ... white edges of C. krusei, slightly white pale pink edges and small pink to purple colonies of C. guilliermondii, can easily be differentiated from Candida norvegensis which also produces purple color colonies. The edges of all colored colonies were paler and dark centered and the colony size was between ...

  12. 20 CFR 416.934 - Impairments which may warrant a finding of presumptive disability or presumptive blindness.

    Science.gov (United States)

    2010-04-01

    ...) Allegation of total blindness; (d) Allegation of bed confinement or immobility without a wheelchair, walker... arms. (g) Allegation of Down syndrome. (h) Allegation of severe mental deficiency made by another...

  13. Methemoglobinemia and Failure to Thrive as a Result of FPIES to Soy Formula with Resolution on Amino Acid Based Formula

    Science.gov (United States)

    2017-11-01

    protein-induced enterocolitis syndrome (FPIES) is a severe, non-lgE mediated gastrointestinal food allergy syndrome. Despite being a recognized entity...methemoglobin of 15.1 %. Later evaluation of the metabolic acidosis revealed normal urine electrolytes, stool pH of 6 and positive (3+) fecal...mediated Gastrointestinal Food Allergies in Children. Pediatric Allergy and Immunology. 2017;28:6- 17. 3. Leonard SA, A Nowak-Wegrzyn. Food Protein

  14. Methemoglobinemia hemotoxicity of some antimalarial 8-aminoquinoline analogues and their hydroxylated derivatives: density functional theory computation of ionization potentials

    Science.gov (United States)

    The administration of primaquine (PQ), an essential drug for treatment and radical cure of malaria, can lead to methemoglobin formation and life-threatening hemolysis for glucose-6-phosphate dehydrogenase deficient patients. The ionization potential (IP, a quantitative measure of the ability to lose...

  15. Presumptive Acute Neural Toxoplasmosis in a Captive Red-Necked Wallaby (Macropus rufogriseus

    Directory of Open Access Journals (Sweden)

    Carlos Hermosilla

    2010-01-01

    Full Text Available A red-necked male wallaby (Macropus rufogriseus from a German zoo was presented for acute onset of severe neurological signs, including head tremor, lethargy, unresponsiveness, and weakness. Serum biochemical abnormalities included increased LDH- and AST-levels, hyperproteinaemia, and reduced ALT-, ALP-, and creatinine-levels. The wallaby was found serologically positive for Toxoplasma gondii by the indirect haemagglutination test. After initiation of therapy by subcutaneous injections of trimethoprim/sulfadoxin, amelioration of neurological signs was noted and after 10 days the affected wallaby recovered. T. gondii can be confirmed rapidly by serology, and immediate therapy may reduce clinical illness and fatality of the disease within captive macropods.

  16. White monkey syndrome and presumptive copper deficiency in wild savannah baboons.

    Science.gov (United States)

    Markham, A Catherine; Gesquiere, Laurence R; Bellenger, Jean-Philippe; Alberts, Susan C; Altmann, Jeanne

    2011-11-01

    In immature wild savannah baboons (Papio cynocephalus), we observed symptoms consistent with copper (Cu) deficiency and, more specifically, with a disorder referred to as white monkey syndrome (WMS) in laboratory primates. The objectives of this study were to characterize this pathology, and test three hypotheses that (1) Cu deficiency may have been induced by zinc (Zn) toxicity, (2) it may have been induced by molybdenum (Mo) toxicity, and (3) cumulative rainfall during the perinatal period and particularly during gestation is an ecological factor distinguishing infants afflicted with WMS from non-WMS infants. During 2001-2009, we observed 22 instances of WMS out of a total 377 live births in the study population. Visible symptoms exhibited by WMS infants included whitening of the animal's fur and/or impaired mobility characterized by an apparent "stiffening" of the hindlimbs. Occurrence of WMS did not vary significantly by gender. However, among individuals that survived at least 180 days, WMS males had a significantly lower survivorship probability than non-WMS males. Zn/Cu ratios assessed from hair samples of adult female baboons were higher in females who had produced at least one WMS offspring relative to females who had not had a WMS offspring. This was true even when the hair sample was collected long after the birth of the female's afflicted infant. We consider this potentially indicative of a robust tendency for low Cu levels induced by elevated Zn intake in some individuals. No significant differences of Mo/Cu ratios were observed. Cumulative rainfall during gestation (∼179 days) was 50% lower for WMS infants relative to non-WMS infants. In contrast, rainfall for the two classes of infants did not differ in the 180 days before conception or in the 180 days following birth. This finding highlights the importance of prenatal ecological conditions in healthy fetal development with regard to WMS. © 2011 Wiley Periodicals, Inc.

  17. Building a dictionary for genomes: identification of presumptive regulatory sites by statistical analysis.

    Science.gov (United States)

    Bussemaker, H J; Li, H; Siggia, E D

    2000-08-29

    The availability of complete genome sequences and mRNA expression data for all genes creates new opportunities and challenges for identifying DNA sequence motifs that control gene expression. An algorithm, "MobyDick," is presented that decomposes a set of DNA sequences into the most probable dictionary of motifs or words. This method is applicable to any set of DNA sequences: for example, all upstream regions in a genome or all genes expressed under certain conditions. Identification of words is based on a probabilistic segmentation model in which the significance of longer words is deduced from the frequency of shorter ones of various lengths, eliminating the need for a separate set of reference data to define probabilities. We have built a dictionary with 1,200 words for the 6, 000 upstream regulatory regions in the yeast genome; the 500 most significant words (some with as few as 10 copies in all of the upstream regions) match 114 of 443 experimentally determined sites (a significance level of 18 standard deviations). When analyzing all of the genes up-regulated during sporulation as a group, we find many motifs in addition to the few previously identified by analyzing the subclusters individually to the expression subclusters. Applying MobyDick to the genes derepressed when the general repressor Tup1 is deleted, we find known as well as putative binding sites for its regulatory partners.

  18. Community referral for presumptive TB in Nigeria: a comparison of four models of active case finding

    NARCIS (Netherlands)

    Adejumo, A. O.; Azuogu, B.; Okorie, O.; Lawal, O. M.; Onazi, O. J.; Gidado, M.; Daniel, O. J.; Okeibunor, J. C.; Klinkenberg, E.; Mitchell, E. M. H.

    2016-01-01

    Engagement of communities and civil society organizations is a critical part of the Post-2015 End TB Strategy. Since 2007, many models of community referral have been implemented to boost TB case detection in Nigeria. Yet clear insights into the comparative TB yield from particular approaches have

  19. 76 FR 41696 - Presumptive Service Connection for Diseases Associated With Service in the Southwest Asia Theater...

    Science.gov (United States)

    2011-07-15

    ... of this clarifying rule. We note that a Veteran who believes his or her injury, disease, or illness... subparagraph (3) to improve clarity and revising the note to subparagraph (3) to clarify concepts involving... unexplained by any structural, endoscopic, laboratory, or other objective signs of disease or injury and that...

  20. Bet v 1 homologues in strawberry identified as IgE-binding proteins and presumptive allergens.

    Science.gov (United States)

    Karlsson, A L; Alm, R; Ekstrand, B; Fjelkner-Modig, S; Schiött, A; Bengtsson, U; Björk, L; Hjernø, K; Roepstorff, P; Emanuelsson, C S

    2004-12-01

    No strawberry allergen has so far been identified and characterized. Serum samples were collected from patients with a suggestive case history of adverse reactions to strawberry and other fruits. Extracts from fresh and frozen strawberries were analysed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), Western blotting and mass spectrometry. Patient blood samples were analysed for inhibition of IgE binding and basophil degranulation. Several IgE-binding proteins could be detected. In more than half of the patient sera, a 20/18-kDa doublet band was observed in Western blotting. These two bands were excised and analysed by mass spectrometry showing the presence of proteins belonging to the Bet v 1 family of allergens. Inhibition of the IgE binding to the 20/18-kDa doublet was obtained by addition of two recombinantly expressed allergens belonging to the Bet v 1 family (Bet v 1 and Mal d 1) and strawberry protein extract. In a cell-based assay of patient blood samples, basophil degranulation could be induced by strawberry protein extract and by Bet v 1 and Mal d 1. We conclude that strawberry homologues to Bet v 1 may be allergens of importance for adverse reactions to strawberry.

  1. 20 CFR 410.410 - Total disability due to pneumoconiosis, including statutory presumption.

    Science.gov (United States)

    2010-04-01

    ... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.410 Total disability due to pneumoconiosis, including statutory... their death. (For benefits to the eligible survivors of miners whose deaths are determined to have been...

  2. 20 CFR 410.456 - Determining origin of pneumoconiosis, including statutory presumption-survivor's claim.

    Science.gov (United States)

    2010-04-01

    ... SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.456 Determining origin of pneumoconiosis...

  3. 20 CFR 410.416 - Determining origin of pneumoconiosis, including statutory presumption.

    Science.gov (United States)

    2010-04-01

    ... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.416 Determining origin of pneumoconiosis, including statutory...

  4. 20 CFR 410.454 - Determining the existence of pneumoconiosis, including statutory presumption-survivor's claim.

    Science.gov (United States)

    2010-04-01

    ... SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.454 Determining the existence of pneumoconiosis... pulmonary impairment from which the miner was totally disabled (see § 410.412) prior to his death, it will...

  5. 76 FR 11684 - Presumption of Insurable Interest for Same-Sex Domestic Partners

    Science.gov (United States)

    2011-03-03

    ... following: Spouses, former spouses, blood or adopted relatives closer than first cousins, common law spouses... person with whom the employee or Member is living in a relationship that would constitute a common-law marriage in jurisdictions recognizing common-law marriages; (2) For purposes of this section, the term...

  6. 77 FR 42909 - Presumption of Insurable Interest for Same-Sex Domestic Partners

    Science.gov (United States)

    2012-07-20

    ... ``spouses,'' ``former spouses,'' ``blood or adopted relatives closer than first cousins,'' ``common law... relationship that would constitute a common-law marriage in jurisdictions recognizing common-law marriages; (2... would constitute a common-law marriage in jurisdictions recognizing common-law marriages; (2) For...

  7. [Presumptive role of Wolbachia in deltamethrin resistance of Culex pipiens pallens].

    Science.gov (United States)

    Hong, Shan-Chao; Lv, Yuan; Fang, Fu-Jin; Zhu, Chang-Liang

    2014-12-01

    To investigate the relationship between Wolbachia and deltamethrin resistance in Culex pipiens pallens. PCR was used to detect Wolbachia in Culex pipiens pallens and qRT-PCR was performed to determine and compare the expression of Wolbachia between deltamethrin- resistant and - susceptible strains of Culex pipiens pallens. Wolbachia was detected in Culex pipiens pallens in the laboratory. The expression of Wolbachia was 18.42, 3.69, 4.43, 3.96, 6.31, 1.55 and 3.76 folds higher in the deltamethrin-resistant strain than in susceptible strain in the egg, 1st, 2nd, 3rd, 4th stages, and male and female adults, but there was no statistical difference in the pupae stage. The expression of Wolbachia was 2.64 folds higher in deltamethrin-resistant females than in susceptible females which were caught in Jiangxinzhou of Nanjing. Wolbachia is associated with deltamethrin resistance in Culex pipines pallens.

  8. Efficacy, safety and costs of intermittent presumptive treatment for malaria in Tanzania

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Bloch, Paul; Magnussen, Pascal

    2011-01-01

    of users taking a full dose once; saving lives of women, fetuses and newborn babies; and un-bitter taste. The negatives include the: (i) perception about SP causing adverse treatment outcomes, this lowering users' adherence to treatment schedules, including directly observed treatment; (ii) perceived...... possible adverse reactions if SP is used by the users who take alcoholic drinks; (iii) increasing- parasites resistance to SP and HIV infections lowering public trust in SP; (iii) health facilities (HFs), especially the private ones facing SP shortages for free delivery, adding costs mainly to the service...... of stock of SP, and time lost for waiting for services. Moreover, user-fees for ANC services other than IPTp seemed to dissuade some potential clients to attend clinic. Additional findings and discussions are presented. Conclusion When institutionalizing policies, national and international authorities...

  9. Efficacy, safety and costs of intermittent presumptive treatment for malaria in tanzania

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Bloch, Paul; Magnussen, Pascal

    2010-01-01

    of users taking a full dose once; saving lives of women, fetuses and newborn babies; and un-bitter taste. The negatives include the: (i) perception about SP causing adverse treatment outcomes, this lowering users' adherence to treatment schedules, including directly observed treatment; (ii) perceived...... possible adverse reactions if SP is used by the users who take alcoholic drinks; (iii) increasing- parasites resistance to SP and HIV infections lowering public trust in SP; (iii) health facilities (HFs), especially the private ones facing SP shortages for free delivery, adding costs mainly to the service...... of stock of SP, and time lost for waiting for services. Moreover, user-fees for ANC services other than IPTp seemed to dissuade some potential clients to attend clinic. Additional findings and discussions are presented. Conclusion: When institutionalizing policies, national and international authorities...

  10. Predictors and outcomes of mycobacteremia among HIV-infected smear- negative presumptive tuberculosis patients in Uganda

    NARCIS (Netherlands)

    Nakiyingi, Lydia; Ssengooba, Willy; Nakanjako, Damalie; Armstrong, Derek; Holshouser, Molly; Kirenga, Bruce J.; Shah, Maunank; Mayanja-Kizza, Harriet; Joloba, Moses L.; Ellner, Jerrold J.; Dorman, Susan E.; Manabe, Yukari C.

    2015-01-01

    Background: Sputum smear microscopy for tuberculosis (TB) diagnosis lacks sensitivity in HIV-infected symptomatic patients and increases the likelihood that mycobacterial infections particularly disseminated TB will be missed; delays in diagnosis can be fatal. Given the duration for MTB growth in

  11. DEVELOPMENT OF GEOLOGICAL DISTRIBUTION PRESUMPTION METHOD USING OIL PRESSURE RESISTANCE OF THE PLASTIC BOARD DRAIN MACHINE

    Science.gov (United States)

    Hirata, Masafumi; Shiraga, Shinichiro; Shimizu, Hideki; Fukuda, Jun; Kawanabe, Shuu; Nomura, Tadaaki

    Plastic board drain (PBD) method is a consolidation method which can accelerate consolidation by placing a lot of PBD into the soft ground. It is important for PBD method to get information about the layer thickness of soft ground and geological distribution, before designing the optimal arrangement of PBD. However, it is difficult to get the accurate information by soil exploration with an only few samples. In this paper, the simplified estimating equation is proposed that evaluates cone bearing capacity by using oil pressure resistance of placing PBD machine during operating. Furthermore, the system is proposed that can evaluate the distribution in three dimensions of ground strength by using estimated cone bearing capacity. Finally, it was confirmed that this proposed system could evaluate the layer thickness of soft ground and geological distribution accurately.

  12. Efficacy, safety and costs of intermittent presumptive treatment for malaria in tanzania

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Bloch, Paul; Magnussen, Pascal

    2010-01-01

    possible adverse reactions if SP is used by the users who take alcoholic drinks; (iii) increasing- parasites resistance to SP and HIV infections lowering public trust in SP; (iii) health facilities (HFs), especially the private ones facing SP shortages for free delivery, adding costs mainly to the service...... of users taking a full dose once; saving lives of women, fetuses and newborn babies; and un-bitter taste. The negatives include the: (i) perception about SP causing adverse treatment outcomes, this lowering users' adherence to treatment schedules, including directly observed treatment; (ii) perceived...... users and partly HWs who are forced to pay out of their pockets; (iv) HF-based IPTp services forcing pregnant women who reside far away to incur additional costs on re-visiting HFs, including the costs on transport, foods and/or drinks, besides purchasing SP elsewhere when the HFs concerned are out...

  13. Efficacy, safety and costs of intermittent presumptive treatment for malaria in Tanzania

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Bloch, Paul; Magnussen, Pascal

    2011-01-01

    possible adverse reactions if SP is used by the users who take alcoholic drinks; (iii) increasing- parasites resistance to SP and HIV infections lowering public trust in SP; (iii) health facilities (HFs), especially the private ones facing SP shortages for free delivery, adding costs mainly to the service...... of users taking a full dose once; saving lives of women, fetuses and newborn babies; and un-bitter taste. The negatives include the: (i) perception about SP causing adverse treatment outcomes, this lowering users' adherence to treatment schedules, including directly observed treatment; (ii) perceived...... users and partly HWs who are forced to pay out of their pockets; (iv) HFbased IPTp services forcing pregnant women who reside far away to incur additional costs on re-visiting HFs, including the costs on transport, foods and/or drinks, besides purchasing SP elsewhere when the HFs concerned are out...

  14. 76 FR 58144 - Defense Federal Acquisition Regulation Supplement; Presumption of Development Exclusively at...

    Science.gov (United States)

    2011-09-20

    ... proposed for any DFARS coverage related to commercial computer software or documentation. B. Applying Data... deliverable items are computer software or computer software documentation (see 227.72), commercial items... two special categories of items: Commercial items (including commercially available off-the-shelf...

  15. Cost-effectiveness of malaria microscopy and rapid diagnostic tests versus presumptive diagnosis

    DEFF Research Database (Denmark)

    Batwala, Vincent; Magnussen, Pascal; Hansen, Kristian Schultz

    2011-01-01

    ABSTRACT: BACKGROUND: Current Uganda National Malaria treatment guidelines recommend parasitological confirmation either by microscopy or rapid diagnostic test (RDT) before treatment with artemether-lumefantrine (AL). However, the cost-effectiveness of these strategies has not been assessed...... departments were enrolled from March 2010 to February 2011. Of these, a random sample of 1,627 was selected to measure additional socio-economic characteristics. Costing was performed following the standard step-down cost allocation and the ingredients approach. Effectiveness was measured as the number...

  16. Presumption of the prognosis of cerebral infarctions by computed tomography in acute stage

    International Nuclear Information System (INIS)

    Suzuki, Keiji; Niijima, Sumiko; Mizuno, Yoshikuni; Yoshida, Mitsuo.

    1982-01-01

    CT of 74 patients with cerebral infarction (M : F = 42 : 32, 61 +- 12 y.o.) was investigated and a relationship between the prognosis and CT findings was analysed. CT scan was done parallel to the orbitomeatal line with 10 mm thickness, using the EMI 1010 scanner (160 x 160 matrix). In all cases CT was performed within a week from onset. Low density area was measured by planimeter on X-ray film picture. The ratio of minimum lateral ventricular transverse width to diameter of the cerebrum in 3B image was called the cerebroventricular index (CVI). Cortical atrophy was classified into four classes by visual observation. Prognosis was judged by ADL one month after onset and the ADL was classified into five degrees. Cases with larger low density area in the middle cerebral artery area showed poorer prognosis (p 2 . In the perforating artery area, no correlation was observed between size of low density area and prognosis. All cases low density area in posterior portion of the posterior limb of the internal capsule had poor prognosis. Cases with no definite low density area had rather poor prognosis compared to cases with definite low density area in the perforating artery area. The lesion in the former cases might be in either the posterior limb of the internal capsule or the brainstem. Anatomical diagnosis and prognosis of cases with no low density area should, therefore, be carefully judged. Prognosis tended to be poor in cases with CVI over 20% (p < 0.025). Although cases under 60 years old had poor ADL on admission, ADL after one month improved significantly (p < 0.025). (J.P.N.)

  17. Pandora’s Presumption: Drones and the Problematic Ethics of Techno-War

    Directory of Open Access Journals (Sweden)

    Matthew Crosston

    2014-12-01

    Full Text Available Present American policy proclaims the compatibility of drone usage with the traditional Rules of Engagement and the Laws of War. Largely absent in this is an examination of how enemy combatants are being defined on both sides of drone activity: not just the targets and operators but also the relevance of drone technology proliferation. This work engages the void to reveal inconsistent and contradictory ethical standards in American drone policy, based largely on an assumed continued technical preeminence that is by no means guaranteed. The argument is not a humanitarian lament against hegemony: it is a realist argument addressing how ethical inconsistencies in defining American technological warfare compromise the ‘leadership high ground’ for the United States in a manner that carries fairly significant national security blowback potential.

  18. 20 CFR 718.304 - Irrebuttable presumption of total disability or death due to pneumoconiosis.

    Science.gov (United States)

    2010-04-01

    ... International Classification of the Radiographs of the Pneumoconioses of the International Labour Office... Classification of the Pneumoconioses of the Union Internationale Contra Cancer/Cincinnati (1968) (which may be...

  19. Amino acid profiles and presumptive nutritional assessment of single-cell protein from certain lactobacilli.

    Science.gov (United States)

    Erdman, M D; Bergen, W G; Reddy, C A

    1977-04-01

    The amino acid profiles, modified essential amino acid (MEAA) indexes, and in vitro pepsin digestibilities were determined for single-cell protein (SCP) from certain industrially important lactobacilli. For the three parameters examined, substantial differences were seen between different Lactobacillus species and between strains with a given species. SCP from all of the lactobacilli examined appeared relatively high in MEAA indexes and pepsin digestibility. SCP from L. acidophilus 3205 and L. fermenti 3954 had the highest MEAA indexes, whereas L. bulgaricus 2217 and L. thermophilus 3863 had the highest percentage of digestible crude protein. SCP from L. plantarum strains had the lowest MEAA indexes. The essential amino acid compositions of SCP from different lactobacilli appear comparable to that of Food and Agriculture Organization reference protein and SCP from other sources.

  20. Presumptive migrating gall bladder mucocoele in two dogs with gall bladder rupture.

    Science.gov (United States)

    Burchell, R K; Thornton, L; Lim, C K; Murakami, M; Nakamura, Y; Gal, A

    2017-12-13

    A 10-year-old neutered female soft-coated wheaten terrier and a 10-year-old, entire female Pomeranian were presented for vomiting and anorexia. Using ultrasound, an oval structure with a stellate, kiwifruit-like appearance typical of a gall bladder mucocoele was observed in the caudal abdomen of the soft-coated wheaten terrier and adjacent to the liver in the Pomeranian. There was also a moderate volume of abdominal effusion in both dogs. Cytology of the peritoneal fluid indicated a sterile exudative process but varied between the two dogs, with an absence of bile pigment in the soft-coated wheaten terrier and marked bile peritonitis in the Pomeranian. An entire free-floating ectopic mucocoele was confirmed via exploratory laparotomy with concomitant gall bladder rupture and common bile duct obstruction. Both dogs recovered completely after surgery. This is the first report of cases of gall bladder rupture with entire free-floating gall bladder mucocoeles in dogs. © 2017 British Small Animal Veterinary Association.

  1. The extracellular matrix of porcine mature oocytes: Origin, composition and presumptive roles

    Directory of Open Access Journals (Sweden)

    Pivko Juraj

    2003-12-01

    Full Text Available Abstract The extracellular matrix (ECM of porcine mature oocytes was revealed by transmission electron microscopy (TEM after treatment with tannic acid and ruthenium red. Present in the perivitelline space (PVS and on the surface of the zona pellucida (ZP, it appeared to be composed of thin filaments and granules at the interconnections of the filaments, which were interpreted respectively as hyaluronic acid chains and bound proteoglycans. In order to determine whether this material is produced by the corona cells (the same ECM was found also on the surface of the zona pellucida and between cumulus cells or by the oocyte itself, the synthesis of glycoproteins and glycosaminoglycans was checked by autoradiography on semi-thin and thin sections observed by light and electron microscopy. Immature oocytes within or without cumulus cells, were incubated with L [3H-] fucose or L [3H-] glucosamine – precursors respectively of glycoproteins and hyaluronic acid or hyaluronan (HA bound to proteoglycans – for various times (with or without chase and at different stages during in vitro maturation. In the first case, incorporation was found in both cumulus cells and ooplasm (notably in the Golgi area for 3H-fucose and labeled material accumulated in the ECM of the PVS and of the ZP surface. Labeling in the PVS with both precursors was maximum between metaphase I (MI and metaphase II (MII and was partially extracted by hyaluronidase but not by neuraminidase. Tunicamycin, an inhibitor of glycoprotein synthesis, significantly decreased the amount of 3H-fucose labeled molecules in the PVS and increased the incidence of polyspermic penetration during subsequent in vivo fertilization. Since cumulus-free oocytes also secreted 3H-glucosamine containing compounds, both oocyte and cumulus cells probably contribute to the production of the ECM found in the PVS of mature oocytes. ECM and particularly its HA moiety present on both sides of the ZP may constitute a favourable factor for sperm penetration.

  2. Youth’s attitude towards the family as the presumption of generation solidarity consolidation

    OpenAIRE

    Acienė, Elvyra; Čepienė, Ramutė

    2013-01-01

    Changes of traditional family basis and its tendencies to become more modern are analyzed and discussed from different aspects by sociologists, psychologists, teachers and others in their works. A lot of research which analyzes family transformation problems has been made in Lithuania recently. Many authors relate factors of family institution modernization with changes of socialeconomic environment which occurred in the 1990’s and are still continuing. The sequence of priorities changes as w...

  3. Moral regulation and the presumption of guilt in Health Canada's medical cannabis policy and practice.

    Science.gov (United States)

    Lucas, Philippe

    2009-07-01

    This paper is a sociological examination of policies and practices in Health Canada's Marihuana Medical Access Division (MMAD) that presume the illicit intentions and inherent "guilt" of medical cannabis users, hampering safe access to a medicine to which many are legally entitled, and raising doubts about this federal programme's overall effectiveness and constitutional legitimacy. Beginning with a brief historical overview of Canada's federal medical cannabis programme, this paper examines the failure of the MMAD to meet the needs of many sick and suffering Canadians through Hunt's [Hunt, A. (1999). Governing morals: A social history of moral regulation. Cambridge, UK: Cambridge University Press] work on moral regulation and Wodak's [Wodak, A. (2007). Ethics and drug policy. Psychiatry, 6(2), 59-62] critique of "deontological" drug policy strategies. I then cite Tupper's [Tupper, K. W. (2007). The globalization of ayahuasca: Harm reduction or benefit maximization? International Journal of Drug Policy, doi:10.1016/j.drugpo.2006.11.001] argument that shifting to a generative metaphor that constructs certain entheogenic substances as potentially useful "tools" rather than regulating them through inherently moralistic prohibitionist policies would better serve public health, and incorporate Young's [Young, I. M. (1990). Justice and the politics of difference. Princeton, New Jersey: Princeton University Press] theories of domination and oppression to examine the rise of community-base medical cannabis dispensaries as "new social movements". First-hand accounts by medical cannabis patients, federally funded studies, and internal Health Canada communication and documents suggest that current federal policies and practices are blocking safe access to this herbal medicine. The community-based dispensary model of medical cannabis access is a patient-centered "new social movement" that mitigates the stigmatization and moral regulation of their member-clients by creating opportunities for engagement, empowerment and joint knowledge creation. In light of ongoing Charter challenges and patient criticism, the survival of this federal programme will depend on the government's ability to shift away from policies based on the oppression and moral regulation, and towards consequentialist policies that balance harm reduction and benefit maximization. The effectiveness of such an approach is exemplified by the success of the community-based dispensary model which is currently producing more peer-reviewed research and supplying medical cannabis to a far greater number of patients than Health Canada's Marihuana Medical Access Division.

  4. Presumptive horizontal symbiont transmission in the fungus-growing termite Macrotermes natalensis

    DEFF Research Database (Denmark)

    de Fine Licht, Henrik Hjarvard; Boomsma, Jacobus Jan; Aanen, Duur Kornelis

    2006-01-01

    All colonies of the fungus-growing termite Macrotermes natalensis studied so far are associated with a single genetically variable lineage of Termitomyces symbionts. Such limited genetic variation of symbionts and the absence of sexual fruiting bodies (mushrooms) on M. natalensis mounds would...... transmission mode among Macrotermes species implies that vertical symbiont transmission can evolve rapidly. The unexpected finding of horizontal transmission makes the apparent absence of Termitomyces mushrooms on M. natalensis mounds puzzling. To our knowledge, this is the first detailed study of the genetic...

  5. Immunodiagnostic confirmation of hydatid disease in patients with a presumptive diagnosis of injection

    Energy Technology Data Exchange (ETDEWEB)

    Varela-Diaz, V.M.; Coltorti, E.A.

    Information obtained from the routine application of hydatid immunodiagnostic techniques in different clinical situations over a seven-year period is presented. The immunoelectrophoresis test was used and was replaced by the arc 5 double diffusion (DD5) test. Examination of sera from 1.888 patients with signs and/or symptoms comparatible with hydatid disease revealed that the presurgical confirmation of Echinococcus granulosus infection is only obtained by detection of anti-antigen 5 antibodies. In all patients whose preoperative serum showed three or more uncharacteristic bands in the absence of anti-antigen 5 antibodies, hydatid cysts were found surgically. DD5 testing of a fluid sample collected by puncture estabilished its hydatid etiology. Post-operative monitoring of hydatidosis patients demonstrated that persistence of DD5-positivity two years after surgery established the presence of ther cysts.

  6. Hyperspectral imaging for presumptive identification of bacterial colonies on solid chromogenic culture media

    Science.gov (United States)

    Guillemot, Mathilde; Midahuen, Rony; Archeny, Delpine; Fulchiron, Corine; Montvernay, Regis; Perrin, Guillaume; Leroux, Denis F.

    2016-04-01

    BioMérieux is automating the microbiology laboratory in order to reduce cost (less manpower and consumables), to improve performance (increased sensitivity, machine algorithms) and to gain traceability through optimization of the clinical laboratory workflow. In this study, we evaluate the potential of Hyperspectral imaging (HSI) as a substitute to human visual observation when performing the task of microbiological culture interpretation. Microbial colonies from 19 strains subcategorized in 6 chromogenic classes were analyzed after a 24h-growth on a chromogenic culture medium (chromID® CPS Elite, bioMérieux, France). The HSI analysis was performed in the VNIR region (400-900 nm) using a linescan configuration. Using algorithms relying on Linear Spectral Unmixing, and using exclusively Diffuse Reflectance Spectra (DRS) as input data, we report interclass classification accuracies of 100% using a fully automatable approach and no use of morphological information. In order to eventually simplify the instrument, the performance of degraded DRS was also evaluated using only the most discriminant 14 spectral channels (a model for a multispectral approach) or 3 channels (model of a RGB image). The overall classification performance remains unchanged for our multispectral model but is degraded for the predicted RGB model, hints that a multispectral solution might bring the answer for an improved colony recognition.

  7. 20 CFR 404.722 - Rebuttal of a presumption of death.

    Science.gov (United States)

    2010-04-01

    ... DISABILITY INSURANCE (1950- ) Evidence Evidence of Age, Marriage, and Death § 404.722 Rebuttal of a... continued life rather than death. Example 1: Evidence in a claim for surviving child's benefits showed that... wife several days after the disappearance to state he intended to begin a new life in California. In...

  8. Presumptive binge eating disorder in type 2 diabetes mellitus patients and its effect in metabolic control

    Directory of Open Access Journals (Sweden)

    Sandra Soares Melo

    2009-09-01

    Full Text Available Objective: This study sought to determine the presence of diagnosis suggestive of binge eating disorder in individuals with type 2 diabetes mellitus, and to evaluate the influence of such disorder on the metabolic control. Methods: sixty-three patients with type 2 diabetes mellitus and registered  at the Diabetes and Hypertension Program of a Health Unit in the town of Balneário Camboriú, Santa Catarina, Brazil, were evaluated. The diagnosis of binge eating disorder was made by analysis of the Questionnaire on Eating and Weight Patterms – Revised. For the evaluation of metabolic control, 10 ml of blood was collected, and the serum glucose, glycated hemoglobin, tryglicerides, cholestrol and fractions were determined. Weight and height were determined for evaluation of national nutritional state, according to the body mass index. Rresults: Among the evaluated individuals, 29% presented a diagnosis suggestive of binge eating disorder, with higher prevalence among females. The individuals with diagnosis suggestive of binge eating disorder presented a higher average body mass index value than the group without diagnosis. The serum concentrations of glycated hemoglobin (p = 0.02 and triglicerides (p = 0.03 were statistically higher in the group with diagnosis suggestive of binge eating disorder. Cconclusions: Based on the results of this study, it is possible to conclude that the presence of binge eating disorder in individuals with type 2 diabetes mellitus favors an increase in body weight and has a negative influence on metabolic control, contributing to the early emergence of complications related to the disease.

  9. Presumptions for creating the family - friendly organisation at university in the terms of employees

    OpenAIRE

    Sidlauskienė, Virginija

    2011-01-01

    In the Lithuania, particularly since 1998 there has been increased activity in developing equal opportunities legislation and, consequently, in the field of organizational equality between women and men equality policy making. Most academic systems and structures as they exist today are based on models that were constructed centuries ago in a time in which universities were exclusively populated by men. There is a level of scepticisms as to what can be achieved, though. A continuing evident g...

  10. Into the night: camera traps reveal nocturnal activity in a presumptive diurnal primate, Rhinopithecus brelichi.

    Science.gov (United States)

    Tan, Chia L; Yang, Yeqin; Niu, Kefeng

    2013-01-01

    Most living primates exhibit a daytime or nighttime activity pattern. Strict diurnality is thought to be the rule among anthropoids except for owl monkeys. Here we report the diel activity pattern of an Asian colobine, the Guizhou snub-nosed monkey Rhinopithecus brelichi, based on a methodology that relied on using 24-h continuously operating camera traps. We conducted the study in Fanjingshan National Nature Reserve in Guizhou, China from March 22 to May 19 and from June 17 to October 14, 2011. After standardizing all time elements to a meridian-based time according to the geographic coordinates of the study site, we showed unequivocally that the monkeys, though predominantly diurnal, exhibited activity beyond daylight hours throughout the study. Specifically, their activity at night and during twilight periods suggests a complex interplay of behavioral adaptations, among others, to living in a temperate environment where day length and food resources fluctuate substantially across seasons. We contend that, under prevailing ecological conditions, so-called strictly diurnal primates may adjust their activity schedule opportunistically in order to increase energy intake. We also discuss the advantages of using camera traps in primate studies, and how the standardized use of meridian-based time by researchers would benefit comparisons of diel activity patterns among primates.

  11. Presumptive horizontal symbiont transmission in the fungus-growing termite Macrotermes natalensis

    NARCIS (Netherlands)

    Fine Licht, de H.H.; Boomsma, J.J.; Aanen, D.K.

    2006-01-01

    All colonies of the fungus-growing termite Macrotermes natalensis studied so far are associated with a single genetically variable lineage of Termitomyces symbionts. Such limited genetic variation of symbionts and the absence of sexual fruiting bodies (mushrooms) on M. natalensis mounds would be

  12. 38 CFR 3.309 - Disease subject to presumptive service connection.

    Science.gov (United States)

    2010-07-01

    ... organic heart disease, and since hypertension is an early symptom long preceding the development of those... the Secretary determines that the veteran has posttraumatic stress disorder (PTSD). (2) If the veteran...

  13. Presumption of the prognosis of cerebral infarctions by computed tomography in acute stage

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, K. (Fukushima Prefectural Miyashita Hospital (Japan)); Niijima, S.; Mizuno, Y.; Yoshida, M.

    1982-01-01

    CT of 74 patients with cerebral infarction (M : F = 42 : 32, 61 +- 12 y.o.) was investigated and a relationship between the prognosis and CT findings was analysed. CT scan was done parallel to the orbitomeatal line with 10 mm thickness, using the EMI 1010 scanner (160 x 160 matrix). In all cases CT was performed within a week from onset. Low density area was measured by planimeter on X-ray film picture. The ratio of minimum lateral ventricular transverse width to diameter of the cerebrum in 3B image was called the cerebroventricular index (CVI). Cortical atrophy was classified into four classes by visual observation. Prognosis was judged by ADL one month after onset and the ADL was classified into five degrees. Cases with larger low density area in the middle cerebral artery area showed poorer prognosis (p < 0.001). The prognosis tended to be poor if low density area was more than 20 cm/sup 2/. In the perforating artery area, no correlation was observed between size of low density area and prognosis. All cases low density area in posterior portion of the posterior limb of the internal capsule had poor prognosis. Cases with no definite low density area had rather poor prognosis compared to cases with definite low density area in the perforating artery area. The lesion in the former cases might be in either the posterior limb of the internal capsule or the brainstem. Anatomical diagnosis and prognosis of cases with no low density area should, therefore, be carefully judged. Prognosis tended to be poor in cases with CVI over 20% (p < 0.025). Although cases under 60 years old had poor ADL on admission, ADL after one month improved significantly (p < 0.025).

  14. RADIATION THERAPY OF A PRESUMPTIVE URETHRAL TRANSITIONAL CELL CARCINOMA IN AN EASTERN GRAY SQUIRREL (SCIURUS CAROLINENSIS).

    Science.gov (United States)

    Childs-Sanford, Sara E; St-Vincent, Rachel; Hiss, Anne

    2015-12-01

    An adult female Eastern gray squirrel (Sciurus carolinensis), with a previous history of primary renal transitional cell carcinoma treated by nephrectomy, was diagnosed with a metastatic urethral transitional cell carcinoma (TCC) utilizing the veterinary bladder tumor antigen test in combination with other noninvasive diagnostic tests. The squirrel was treated with piroxicam and external beam radiation therapy given in 18 treatments over 30 days to achieve a total of 54 gray. Mild to moderate side effects from the pelvic irradiation were self-limiting and easily managed. Resolution of clinical signs was achieved for approximately 6 mo until recurrence of metastasis. This report represents the first published account of both TCC and external beam radiation therapy in an Eastern gray squirrel.

  15. Operational analysis and further development presumption of a selected hotel in Prague

    OpenAIRE

    Kučerová, Michaela

    2014-01-01

    The aim of the thesis is to assess the current situation in a selected hotel in Prague, compare its competitiveness to the chosen accommodation facilities, and submit proposals and recommendations designed to improve its functioning by introducing innovations in services and hotel equipment. The theoretical part covers the characteristics of accommodation services, hotel marketing and management, and describes the analyses used. The practical part describes the selected hotel in terms of its ...

  16. Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

    Science.gov (United States)

    Martinez, Raquel M.; Hulten, Kristina G.; Bui, Uyen

    2014-01-01

    Lactobacillus spp. are part of the normal human flora and are generally assumed to be nonpathogenic. We determined the genotypic identification of >100 Lactobacillus isolates from clinical specimens in the context of presumed pathogenic potential (e.g., recovered as the single/predominant isolate from a sterile site or at ≥105 CFU/ml from urine). This study assessed the clinical significance and the frequency of occurrence of each Lactobacillus sp. We identified 16 species of Lactobacillus by 16S rRNA gene sequence analysis, 10 of which could not be associated with disease. While Lactobacillus rhamnosus, Lactobacillus gasseri, and Lactobacillus paracasei were associated with infections, L. gasseri was also a common colonizing/contaminating species. Lactobacillus casei, Lactobacillus johnsonii, and Lactobacillus delbrueckii were associated with at least one infection. Species commonly used in probiotic products (e.g., L. rhamnosus and L. casei) were identical, by 16S rRNA gene sequencing, to our isolates associated with disease. Human isolates of Lactobacillus spp. have differing site associations and levels of clinical significance. Knowing the niche and pathogenic potential of each Lactobacillus sp. can be of importance to both clinical microbiology and the food and probiotic supplement industry. PMID:24131686

  17. Extension of the Presumptive Period for Compensation for Gulf War Veterans. Final rule.

    Science.gov (United States)

    2017-10-24

    The Department of Veterans Affairs (VA) is issuing this final rule to affirm its adjudication regulations regarding compensation for disabilities resulting from undiagnosed illnesses suffered by veterans who served in the Persian Gulf War. This amendment is necessary to extend the period during which disabilities associated with undiagnosed illnesses and medically unexplained chronic multi-symptom illnesses must become manifest in order for a Veteran to be eligible for compensation. The intended effect of this amendment is to provide consistency in VA adjudication policy, preserve certain rights afforded to Persian Gulf War (GW) veterans, and ensure fairness for current and future GW veterans.

  18. Insect sex chromosomes. VI. A presumptive hyperactivation of the male X chromosome in Acheta domesticus (L.).

    Science.gov (United States)

    Rao, S R; Ali, S

    1982-01-01

    The functional status of the X chromosome in Acheta domesticus has been analysed at the whole chromosome level on the basis of (1) 3H-thymidine autoradiography, (2) 5-BrdU/AO fluorescence microscopy (3) in vivo 5-BrdU incorporation and (4) 3H-UdR induced aberrations. The rationale of these techniques in relation to the functional aspect of the X chromosome is that the inactive X chromosome would (1) show asynchrony in DNA synthesis, (2) show differential fluorescence, (3) respond differentially to in vivo 5-BrdU treatment and (4) the active X chromosome would show aberrations when treated with 3H-Uridine. From the results, it appears that the X chromosomes in both male (XO) and female (XX) somatic cells of Acheta are euchromatic (active). Further, the single X in the male is transcriptionally as active as the two X chromosomes in the female. In other words, the single X in the male is hyperactive when compared with the single X in the female. From this it is inferred that the male X chromosome is differentially regulated in order to bring about an equalization of it's gene product(s) to that produced by both Xs in the female. Drosophila melanogaster has a comparable system of dosage compensation. Thus, Acheta is yet another insect showing evidence for an X chromosome regulatory mechanism of dosage compensation. Additionally, it is surmised that sex determination in Acheta is based on an autosomes/X chromosome balance mechanism.

  19. The Influence of Education and Socialization on Radicalization: An Exploration of Theoretical Presumptions and Empirical Research

    Science.gov (United States)

    Pels, Trees; de Ruyter, Doret J.

    2012-01-01

    Background and Objective: Research into radicalization does not pay much attention to education. This is remarkable and possibly misses an important influence on the process of radicalization. Therefore this article sets out to explore the relation between education on the one hand and the onset or prevention of radicalization on the other hand.…

  20. Presumptive binge eating disorder in type 2 diabetes mellitus patients and its effect in metabolic control

    OpenAIRE

    Sandra Soares Melo; Cíntia Milene Comelli Odorizzi

    2009-01-01

    Objective: This study sought to determine the presence of diagnosis suggestive of binge eating disorder in individuals with type 2 diabetes mellitus, and to evaluate the influence of such disorder on the metabolic control. Methods: sixty-three patients with type 2 diabetes mellitus and registered  at the Diabetes and Hypertension Program of a Health Unit in the town of Balneário Camboriú, Santa Catarina, Brazil, were evaluated. The diagnosis of binge eating disorder was made by analysis of th...

  1. 75 FR 70162 - Presumptive Service Connection for Diseases Associated With Persian Gulf War Service: Functional...

    Science.gov (United States)

    2010-11-17

    ... chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome) that is defined by a cluster of... characterized by chronic or recurrent symptoms that were present for at least 6 months prior to diagnosis and...

  2. The Influence of Education and Socialization on Radicalization: An Exploration of Theoretical Presumptions and Empirical Research.

    Science.gov (United States)

    Pels, Trees; de Ruyter, Doret J

    2012-06-01

    BACKGROUND AND OBJECTIVE: Research into radicalization does not pay much attention to education. This is remarkable and possibly misses an important influence on the process of radicalization. Therefore this article sets out to explore the relation between education on the one hand and the onset or prevention of radicalization on the other hand. METHOD: This article is a theoretical literature review. It has analyzed empirical studies-mainly from European countries-about the educational aims, content and style of Muslim parents and parents with (extreme) right-wing sympathies. RESULTS: Research examining similarity in right-wing sympathies between parents and children yields mixed results, but studies among adolescents point to a significant concordance. Research also showed that authoritarian parenting may play a significant role. Similar research among Muslim families was not found. While raising children with distrust and an authoritarian style are prevalent, the impact on adolescents has not been investigated. The empirical literature we reviewed does not give sufficient evidence to conclude that democratic ideal in and an authoritative style of education are conducive to the development of a democratic attitude. CONCLUSION: There is a knowledge gap with regard to the influence of education on the onset or the prevention of radicalization. Schools and families are underappreciated sources of informal social control and social capital and therefore the gap should be closed. If there is a better understanding of the effect of education, policy as well as interventions can be developed to assist parents and teachers in preventing radicalization.

  3. 75 FR 59968 - Presumptions of Service Connection for Persian Gulf Service

    Science.gov (United States)

    2010-09-29

    ...) Neuropsychological signs or symptoms. (8) Signs or symptoms involving the respiratory system (upper or lower). (9) Sleep disturbances. (10) Gastrointestinal signs or symptoms. (11) Cardiovascular signs or symptoms. (12..., and respiratory system infections. Chronic meningitis and meningoencephalitis. Deafness. Demyelinating...

  4. 75 FR 13051 - Presumptions of Service Connection for Persian Gulf Service

    Science.gov (United States)

    2010-03-18

    ... respiratory system (upper or lower). (9) Sleep disturbances. (10) Gastrointestinal signs or symptoms. (11... comment period, comments may be viewed online through the Federal Docket Management System at http://www..., if Any, Noted in Italics) Brucellosis Arthritis. Cardiovascular, nervous, and respiratory system...

  5. 20 CFR 410.414 - Determining the existence of pneumoconiosis, including statutory presumption.

    Science.gov (United States)

    2010-04-01

    ... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or...) However, where the evidence shows a work history reflecting many years of such coal mine employment...) of this section, a finding of total disability due to pneumoconiosis may be made if other relevant...

  6. MRI findings in the patients with the presumptive clinical diagnosis of Tolosa-Hunt syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Cakirer, Sinan [Department of Radiology, Neuroradiology Section, Istanbul Sisli Etfal Hospital, 81120 Istanbul (Turkey)

    2003-01-01

    The aim of this study was to present our experience in MRI diagnosis of 23 patients with the clinical findings suggesting Tolosa-Hunt syndrome (THS). Cranial MRI studies of the patients with a clinical history of at least one episode of unilateral or bilateral orbital and periorbital pain, and associated paresis of one or more of third to sixth cranial nerves, were performed on a 1.5-T MRI scanner. Whereas 5 patients had the diagnosis of THS, paracavernous meningiomas in 4 patients, pituitary macroadenomas with cavernous sinus infiltration in 3 patients, Meckel's cave neurinoma in 1 patient, and suprasellar epidermoid in 1 patient were surgically proven MRI findings. Other pathological MRI findings were leptomeningeal metastases in 3 patients, granulomatous pachymeningitis sequelae in 2 patients, and aneurysm with compression on cavernous sinus in 1 patient. Three patients had normal MRI findings. The incidence of radiologically proven diagnosis of THS among the patients with the clinical findings suggesting THS seemed to be low in our study. In conclusion, MRI is the most valuable imaging technique to distinguish THS from other THS-like entities, and permits a precise assessment, management, and therapeutic planning of the underlying pathological conditions. (orig.)

  7. Gastrointestinal stromal tumors as an incidental finding in patients with a presumptive diagnosis of ovarian cancer.

    Science.gov (United States)

    Muñoz, Mario; Ramirez, Pedro T; Echeverri, Carolina; Alvarez, Luis Guillermo; Palomino, Maria Alejandra; Pareja, Luis René

    2012-01-01

    To report the clinical presentation and oncologic outcomes of a series of patients who presented with an abdominal or pelvic mass and were diagnosed with a gastrointestinal stromal tumor (GIST). Data were obtained on all patients who presented with an abdominal or pelvic mass between September 2007 and June 2010 and who were ultimately diagnosed with a GIST. The patients' medical records were reviewed. A literature review was also conducted. Six patients were identified who met the inclusion criteria. All six patients had a tumor in the intestinal tract arising from the small bowel. The mean tumor size was 12 cm (range, 6 to 22 cm). A complete resection was achieved in five of the six patients. There were no intraoperative complications; one patient had a postoperative complication. Two patients were treated with imatinib after surgery. The mean follow-up time was 32 months (range, 0.3 to 40 months). At the last follow-up, five of the six patients were without any evidence of disease. One patient died of an unrelated hepatic encephalopathy. The incidence in our institution is 3%. GISTs are uncommon; however, they should be considered in the differential diagnosis of patients presenting with an abdominal or pelvic mass.

  8. The Influence of Education and Socialization on Radicalization: An Exploration of Theoretical Presumptions and Empirical Research

    NARCIS (Netherlands)

    Pels, T.V.M.; de Ruyter, D.J.

    2012-01-01

    Background and Objective: Research into radicalization does not pay much attention to education. This is remarkable and possibly misses an important influence on the process of radicalization. Therefore this article sets out to explore the relation between education on the one hand and the onset or

  9. 38 CFR 3.318 - Presumptive service connection for amyotrophic lateral sclerosis.

    Science.gov (United States)

    2010-07-01

    ... connection for amyotrophic lateral sclerosis. 3.318 Section 3.318 Pensions, Bonuses, and Veterans' Relief... sclerosis. (a) Except as provided in paragraph (b) of this section, the development of amyotrophic lateral sclerosis manifested at any time after discharge or release from active military, naval, or air service is...

  10. Presumptive diagnosis of leptospirosis before seroconversion: a review of 338 cases in Wallis and Futuna 2008 to 2015.

    Science.gov (United States)

    Massenet, Denis; Couteaux, Clément; Goarant, Cyrille

    2017-04-01

    Leptospirosis is a common condition in Wallis and Futuna, and the definitive diagnosis needs to be established urgently at the first patient consultation, which is usually one to two days after the onset of clinical signs. As a diagnostic aid, a composite index was established based on data from 338 patients seen by the Wallis and Futuna admissions services between 2008 and 2015. The data taken into account include: age and sex of the patient, their home island, the consultation period and the results of leukocytes, platelets, CRP, creatinine and GGT tests combined with 2 major clinical signs, headache and conjunctival suffusion. Then 5 threshold limits were defined for this index, which indicates from very low risk to almost certain biologically confirmed leptospirosis. Other febrile diseases responsible for thrombocytopenia are not found in Wallis and Futuna, which probably explains the good statistical qualities of this index with a value of area under the curve equal to 0.821.

  11. Polioencephalomalacia and Heart Failure Secondary to Presumptive Thiamine Deficiency, Hepatic Lipidosis, and Starvation in 2 Abandoned Siamese Cats.

    Science.gov (United States)

    Anholt, H; Himsworth, C; Britton, A

    2016-07-01

    Two 4-year-old spayed female Siamese cats were seized by the British Columbia Society for the Prevention of Cruelty to Animals after confinement to an abandoned housing unit without food for 9 weeks. One cat was found dead, and the second was euthanized within 24 hours due to neurologic deterioration despite therapy. Polioencephalomalacia of the caudal colliculus, hepatic lipidosis, cachexia, and congestive heart failure with cardiomyocyte atrophy were identified in both cats through postmortem examination and attributed to a prolonged period of starvation. Brain lesions were likely the result of thiamine deficiency (Chastek paralysis), which can be associated with both malnutrition and liver disease. This case highlights the importance of thiamine supplementation during realimentation of cats with hepatic lipidosis. Heart failure resulting from cachexia may have contributed to the death of the first cat and the morbidity of the second cat. © The Author(s) 2016.

  12. Mucocutaneous Leishmaniasis: clinical markers in presumptive diagnosis Leishmaniose mucosa: marcadores clínicos no diagnóstico presuntivo

    Directory of Open Access Journals (Sweden)

    João Luiz Cioglia Pereira Diniz

    2011-06-01

    Full Text Available Mucocutaneous Leishmaniasis (ML can lead to serious sequela; however, early diagnosis can prevent complications. AIM: To evaluate clinical markers for the early diagnosis of ML. MATERIALS AND METHODS: A series study of 21 cases of ML, which were evaluated through clinical interview, nasal endoscopy, biopsy and the Montenegro test. RESULTS: A skin scar and previous diagnosis of cutaneous leishmaniasis (CL were reported in 8(38% patients, and 13(62% of them denied having had previous CL and had no scar. Nasal/oral symptom onset until the ML diagnosis varied from 5 months to 20 years, mean value of 6 years. In the Montenegro test, the average size of the papule was 14.5 mm, which did not correlate with disease duration (p=0.87. The nose was the most often involved site and the extension of the injured mucosa did not correlate with disease duration. The parasite was found in 2 (9.52% biopsy specimens. CONCLUSIONS: ML diagnosis was late. Finding the parasite in the mucosa, cutaneous scar and/or previous diagnosis of CL were not clinical markers for ML. ML diagnosis must be based on the Montenegro test, chronic nasal and/or oral discharge and histological findings ruling out other granulomatous diseases.A leishmaniose cutâneo-mucosa (LM pode deixar sequelas graves. O diagnóstico precoce evita complicações. OBJETIVO: Avaliar marcadores clínicos para o diagnóstico precoce da LM. MATERIAL E MÉTODO: Estudo de série de 21 casos avaliados com diagnóstico confirmado de LM por meio de entrevista, endoscopia nasal, biópsia e teste cutâneo de Montenegro. RESULTADOS: A cicatriz cutânea ou história de leishmaniose cutânea foram observadas em 8 (38% pacientes e 13(62% negaram terem tido forma cutânea e não tinham cicatriz. O início dos sintomas nasais/orais até a definição do diagnóstico variou de 5 meses a 20 anos, média de 6 anos. No teste de Montenegro, o tamanho médio da pápula foi de 14,5mm e não se correlacionou com a duração da doença (p=0,87. O comprometimento nasal predominou e a extensão da lesão não se correlacionou com a duração da doença. Parasitas foram encontrados em 2(9,52% espécimes de lesões biopsiadas. CONCLUSÃO: O diagnóstico da LM foi tardio. O encontro do parasito na mucosa, a cicatriz típica e leishmaniose cutânea prévia não foram marcadores para o diagnóstico de LM. O diagnóstico de LM pode se basear no teste de Montenegro alterado associado a sintomas nasais e/ou orais e exclusão de outras doenças granulomatosas.

  13. Rapid presumptive identification of the Mycobacterium tuberculosis-bovis complex by radiometric determination of heat stable urease

    International Nuclear Information System (INIS)

    Gandy, J.H.; Pruden, E.L.; Cox, F.R.

    1983-01-01

    Simple and rapid Bactec methodologies for the determination of neat (unaltered) and heat stable urease activity of mycobacteria are presented. Clinical isolates (63) and stock cultures (32)--consisting of: M. tuberculosis (19), M. bovis (5), M. kansasii (15), M. marinum (4), M. simiae (3), M. scrofulaceum (16), M. gordonae (6), M. szulgai (6), M. flavescens (1), M. gastri (1), M. intracellulare (6), M. fortuitum-chelonei complex (12), and M. smegmatis (1)--were tested for neat urease activity by Bactec radiometry. Mycobacterial isolates (50-100 mg wet weight) were incubated at 35 degrees C for 30 minutes with microCi14C-urea. Urease-positive mycobacteria gave Bactec growth index (GI) values greater than 100 units, whereas urease-negative species gave values less than 10 GI units. Eighty-three isolates possessing neat urease activity were heated at 80 degrees C for 30 minutes followed by incubation at 35 degrees C for 30 minutes with 1 microCi14C-urea. Mycobacterium tuberculosis-bovis complex demonstrated heat-stable urease activity (GI more than 130 units) and could be distinguished from mycobacteria other than tuberculosis (MOTT), which gave GI values equal to or less than 40 units

  14. Improved blastocyst development of single cow OPU-derived presumptive zygotes by group culture with agarose-embedded helper embryos

    Directory of Open Access Journals (Sweden)

    Dey Shukla

    2011-08-01

    Full Text Available Abstract Background The in vitro culture of presumed zygotes derived from single cow ovum pick-up (OPU is important for the production of quality blastocysts maintaining pedigree. The aim of the present study was to evaluate the agar chip-embedded helper embryo coculture system for single cow OPU-derived zygotes by assessing embryo quality. Methods Cumulus oocyte complexes (COCs were collected from Hanwoo cows with high genetic merit twice a week using the ultra-sound guided OPU technique and from slaughterhouse ovaries. The Hanwoo cow COCs and slaughterhouse ovaries were matured in vitro, fertilized in vitro with thawed Hanwoo sperm and cultured for 24 h. The presumed zygotes were subsequently placed in three different culture systems: (1 control OPU (controlOPU with single cow OPU-derived presumed zygotes (2~8; (2 agar chip-embedded slaughterhouse helper embryo coculture (agarOPU with ten presumed zygotes including all presumed zygotes from a cow (2~8 and the rest from agar chip-embedded slaughterhouse presumed zygotes (8~2; and (3 slaughterhouse in vitro embryo production (sIVP with ten slaughterhouse ovary-derived presumed zygotes, each in 50 μL droplets. Day 8 blastocysts were assayed for apoptosis and gene expression using real time PCR. Results The coculture system promoted higher blastocyst development in OPU zygotes compared to control OPU zygotes cultured alone (35.2 vs. 13.9%; P CD9, 0.4-fold; AKRAB1, 0.3-fold and in cocultured zygotes (CD9, 0.3-fold; AKRAB1, 0.3-fold compared to sIVP blastocysts (1.0-fold. Moreover, genes involved in implantation and/or normal calf delivery were up-regulated (P PGSH2, 5.0-fold; TXN, 4.3-fold; PLAU, 1.7-fold and cocultured zygotes (PGSH2, 14.5-fold; TXN, 3.2-fold; PLAU, 6.8-fold compared to sIVP (1.0-fold blastocysts. However, the expression of PLAC8, TGF-β1, ODC1, ATP5A1 and CASP3 did not differ between the three culture groups. Conclusions Results show that the agar chip-embedded helper embryo coculture system enhances developmental competence and embryo quality in cultures of limited numbers of high pedigree single cow OPU presumed zygotes.

  15. 38 CFR 3.307 - Presumptive service connection for chronic, tropical or prisoner-of-war related disease, or...

    Science.gov (United States)

    2010-07-01

    ... connection for chronic, tropical or prisoner-of-war related disease, or disease associated with exposure to... connection for chronic, tropical or prisoner-of-war related disease, or disease associated with exposure to..., tropical, prisoner of war related disease, or a disease associated with exposure to certain herbicide...

  16. Presumptive identification of Candida species other than C. albicans, C. krusei, and C. tropicalis with the chromogenic medium CHROMagar Candida

    Directory of Open Access Journals (Sweden)

    Horvath Lynn L

    2006-01-01

    Full Text Available Abstract Background CHROMagar Candida (CaC is increasingly being reported as a medium used to differentiate Candida albicans from non-albicans Candida (NAC species. Rapid identification of NAC can assist the clinician in selecting appropriate antifungal therapy. CaC is a differential chromogenic medium designed to identify C. albicans, C. krusei, and C. tropicalis based on colony color and morphology. Some reports have proposed that CaC can also reliably identify C. dubliniensis and C. glabrata. Methods We evaluated the usefulness of CaC in the identification of C. dubliniensis, C. famata, C. firmetaria, C. glabrata, C. guilliermondii, C. inconspicua, C. kefyr, C. lipolytica, C. lusitaniae, C. norvegensis, C. parapsilosis, and C. rugosa. Results Most NAC produced colonies that were shades of pink, lavender, or ivory. Several isolates of C. firmetaria and all C. inconspicua produced colonies difficult to differentiate from C. krusei. Most C. rugosa isolates produced unique colonies with morphology like C. krusei except in a light blue-green color. C. glabrata isolates produced small dark violet colonies that could be differentiated from the pink and lavender colors produced by other species. All seventeen isolates of C. dubliniensis produced green colonies similar to those produced by C. albicans. Conclusion C. glabrata and C. rugosa appear distinguishable from other species using CaC. Some NAC, including C. firmetaria and C. inconspicua, could be confused with C. krusei using this medium.

  17. Identifying interested parts in the implementation of a radiological waste repository in Brazil: presumption of interests and relationships between stakeholders

    International Nuclear Information System (INIS)

    Nouailhetas, Yannick; Mezrahi, Arnaldo

    2009-01-01

    In Brazil, like in many countries, the use of radiation sources of various type and activities in industry, medicine, research and development as well as fuel cycle installations and nuclear reactors are increasing yearly. Consequently final disposal of the wastes generated by those activities represent a very important issue. The challenges arise more than ever from the country's plans to expand the nuclear power program and on the increasing use of radioisotopes. The construction of repositories must have specific site characteristics, design, operational procedures, among other peculiarities together with a safety analysis in order to accomplish needed provisions to restrict risks. Public opinion is currently more concerned about the consequences of global warming than the overall impact of nuclear activities on the environment. The success of finding a place for a repository depends on the participation of the interested parts. It is necessary to ensure that their expectations and needs are known and considered by the repository owners. In general, those expectations involve satisfaction of needs, financial compensation, ethical behavior and regional specificities. In this article, an attempt is made to identify these main involved parts, their wills and concerns, as well as other interest relationships that might arise as a result of this entrepreneurship. It is evident that a number of relationships ranging from partnership to antagonism might arise. So different strategies and considerations should be applied by those responsible for the project in order to optimize the positive aspects of the relationship or conduct with the less favorable ones. (author)

  18. 38 CFR 3.816 - Awards under the Nehmer Court Orders for disability or death caused by a condition presumptively...

    Science.gov (United States)

    2010-07-01

    ...-4, other than chloracne. Those diseases are: (i) Type 2 Diabetes (Also known as type II diabetes mellitus or adult-onset diabetes). (ii) Hodgkin's disease. (iii) Multiple myeloma. (iv) Non-Hodgkin's...

  19. Presumption of shipmaster’s criminal responsibility for narcotic drugs in ship’s cargo – maritime reality check

    Directory of Open Access Journals (Sweden)

    Nikoleta Radionov

    2010-12-01

    Full Text Available In the aftermath of the “Coral Sea” and “Therese” cases, the article deals with the problem of criminalization of the master of the ship for the crime of illicit traffic based on command responsibility. The first part of the article gives the general framework of the crimes of illicit traffic and smuggling by sea, and an overview of the ship security regulations as provided by the ISPS code. In the second part of the article, the position of the master of the ship with respect to responsibility for illicit traffic is emphasised. It starts by explaining details from both “Coral Sea” and “Therese” cases, where masters were indicted and/or prosecuted based solely on their command responsibility. The author tries to elaborate the problem from a maritime law perspective by explaining the evolution and meaning of different aspects of the three functions of the master of the ship today: nautical, administrative and representation of the shipowner. In order to put the potential responsibility of seafarers for the content of cargo into perspective, the reality of containerized cargo shipping is being explained and documented stage-by-stage. Finally, the basic concepts of criminal law are being explained, where principles of “nullumcrimen, nulla poena sine lege” apply. According to that, there can be no analogy between criminal responsibility of the master of the ship for crimes of illicit traffic (where the principle of proven guilt applies with command responsibility for war crimes.

  20. Metabolic encephalopathy and lipid storage myopathy associated with a presumptive mitochondrial fatty acid oxidation defect in a dog

    Directory of Open Access Journals (Sweden)

    Vanessa R Biegen

    2015-11-01

    Full Text Available A 1-year-old spayed female Shih Tzu presented for episodic abnormalities of posture and mentation. Neurologic examination was consistent with a bilaterally symmetric multifocal encephalopathy. The dog had a waxing-and-waning hyperlactemia and hypoglycemia. Magnetic resonance imaging revealed bilaterally symmetric cavitated lesions of the caudate nuclei with less severe abnormalities in the cerebellar nuclei. Empirical therapy was unsuccessful and the patient was euthanized. Post-mortem histopathology revealed bilaterally symmetric necrotic lesions of the caudate and cerebellar nuclei and multi-organ lipid accumulation, including a lipid storage myopathy. Malonic aciduria and ketonuria were found on urinary organic acid screen. Plasma acylcarnitine analysis suggested a fatty acid oxidation defect. Fatty acid oxidation disorders are inborn errors of metabolism documented in humans, but poorly described in dogs. Although neurologic signs have been described in humans with this group of diseases, descriptions of advanced imaging and histopathology are severely lacking. This report suggests that abnormalities of fatty acid metabolism may cause severe, bilateral gray matter necrosis and lipid accumulation in multiple organs including the skeletal muscles, liver, and kidneys. Veterinarians should be aware that fatty acid oxidation disorders, although potentially fatal, may be treatable. A timely definitive diagnosis is essential in guiding therapy.

  1. Community concerns about sex selection: research as a way forward - response to Edgar Dahl's 'The presumption in favour of liberty'.

    Science.gov (United States)

    McMahon, Catherine A

    2004-03-01

    This commentary argues that notwithstanding the implicit logic underpinning philosophical and moral arguments regarding individual rights to access sex selection for non-medical reasons, community concerns about the psychosocial impact of the technology cannot be dismissed or ignored. It is true, however, that such concerns are often based on unsupported assumptions about the impact of the technology on individuals, families and communities and about the propensity of scientists, unless restrained, to act in ways that are irresponsible or dangerous. The research conducted to date has dispelled many of the myths and assumptions about IVF children and their families. Further careful research is now needed to test the extent to which fears and assumptions regarding 'designer babies' are justified.

  2. 26 CFR 53.4958-6 - Rebuttable presumption that a transaction is not an excess benefit transaction.

    Science.gov (United States)

    2010-04-01

    ... exchange for services. The examples are as follows: Example 1. Z is a university that is an applicable tax... survey of compensation for university presidents that indicates university presidents receive annual... has any particular expertise in higher education compensation matters. Given the failure of the survey...

  3. Qualified Presumption of Safety (QPS) is a generic risk assessment approach applied by the European Food Safety Authority (EFSA)

    DEFF Research Database (Denmark)

    Leuschner, R. G. K.; Robinson, T. P.; Hugas, M.

    2010-01-01

    and value of the QPS assessment for EFSA and to explain its principles such as the unambiguous identity of a taxonomic unit, the body of knowledge including potential safety concerns and how these considerations lead to a list of biological agents recommended for QPS which EFSA keeps updated through...

  4. Narrativas da sexualidade: pressupostos para uma poética queer Narratives of sexuality: presumptions for a queer poetics

    Directory of Open Access Journals (Sweden)

    Anselmo Peres Alós

    2010-12-01

    Full Text Available A articulação de uma epistemologia queer permite pensar a textualidade como o lugar de encenação de uma ficção política que questiona os regimes heteronomativos do sexo e do gênero, e propõe uma estratégia de resistência baseada tanto nos corpos e nos prazeres quanto nas políticas de representação e reinvenção das masculinidades e das feminilidades. A partir de uma retomada dos princípios da narratologia, investiga-se de que forma (ou formas o texto narrativo configura-se como espaço de negociação de uma perspectiva queer sobre a nacionalidade, a sexualidade e o gênero na enunciação. Nesse sentido, a literatura reescreve tanto o corpo sexual, tido como o lugar da subjetividade individual, quanto o corpo social/ nacional, entendido como uma ficção reguladora das sociabilidades corporais e sexuais. Com vistas a uma poética queer, busca-se evidenciar as contradições e impasses que emergem na literatura, particularmente em relação a questões de raça, classe e gênero, bem como as potencialidades e os pontos problemáticos da poética queer como lugar de intervenção cultural, no qual são performativamente projetados novos arranjos de legibilidade social.The articulation of a queer epistemology allows us to think about textuality as a place of dramatization of a politic fiction that questions the heteronormative patterns of sex and gender, and proposes a strategy of resistance based both on bodies and pleasures and on politics of representation and reinvention of masculinities and femininities. Through the principles of narratology, it is studied in which way (or ways the narrative is configured as a space of negotiation, from a queer perspective, of nationality, sexuality, and gender in the enunciation. In this sense, literature rewrites both the sexual body, seen as the place of individual subjectivity, and the social/ national body, understood as a fiction that balances body and sexual sociabilities. At last, the contradictions and impasses that emerge from literature are analyzed, particularly in which concerns questions of race, class, and gender, as well as the potentialities and problematic points of a queer poetics as a place of cultural intervention, intending the construction and the comprehension of this queer poetics, where new arranges of social legibility are projected in a performative way.

  5. Presumptive Sources of Fecal Contamination in Four Tributaries to the New River Gorge National River, West Virginia, 2004

    Science.gov (United States)

    Mathes, Melvin V.; O'Brien, Tara L.; Strickler, Kriston M.; Hardy, Joshua J.; Schill, William B.; Lukasik, Jerzy; Scott, Troy M.; Bailey, David E.; Fenger, Terry L.

    2007-01-01

    Several methods were used to determine the sources of fecal contamination in water samples collected during September and October 2004 from four tributaries to the New River Gorge National River -- Arbuckle Creek, Dunloup Creek, Keeney Creek, and Wolf Creek. All four tributaries historically have had elevated levels of fecal coliform bacteria. The source-tracking methods used yielded various results, possibly because one or more methods failed. Sourcing methods used in this study included the detection of several human-specific and animal-specific biological or molecular markers, and library-dependent pulsed-field gel electrophoresis analysis that attempted to associate Escherichia coli bacteria obtained from water samples with animal sources by matching DNA-fragment banding patterns. Evaluation of the results of quality-control analysis indicated that pulsed-field gel electrophoresis analysis was unable to identify known-source bacteria isolates. Increasing the size of the known-source library did not improve the results for quality-control samples. A number of emerging methods, using markers in Enterococcus, human urine, Bacteroidetes, and host mitochondrial DNA, demonstrated some potential in associating fecal contamination with human or animal sources in a limited analysis of quality-control samples. All four of the human-specific markers were detected in water samples from Keeney Creek, a watershed with no centralized municipal wastewater-treatment facilities, thus indicating human sources of fecal contamination. The human-specific Bacteroidetes and host mitochondrial DNA markers were detected in water samples from Dunloup Creek, Wolf Creek, and to a lesser degree Arbuckle Creek. Results of analysis for wastewater compounds indicate that the September 27 sample from Arbuckle Creek contained numerous human tracer compounds likely from sewage. Dog, horse, chicken, and pig host mitochondrial DNA were detected in some of the water samples with the exception of the October 5 sample from Dunloup Creek. Cow, white-tailed deer, and Canada goose DNA were not detected in any of the samples collected from the four tributaries, despite the presence of these animals in the watersheds. Future studies with more rigorous quality-control analyses are needed to investigate the potential applicability and use of these emerging methods. Because many of the detections for the various methods could vary over time and with flow conditions, repeated sampling during both base flow and storm events would be necessary to more definitively determine the sources of fecal contamination for each watershed.

  6. 47 CFR 73.683 - Field strength contours and presumptive determination of field strength at individual locations.

    Science.gov (United States)

    2010-10-01

    ... at distances beyond about 48.3 kilometers (30 miles). Theory would indicate that the field strengths... for satellite retransmission of distant network signals under the copyright law provisions of 17 U.S.C... satellite retransmission of distant network signals under the copyright law provisions of 17 U.S.C. 119(d...

  7. Developmental Validation of the ParaDNA® Screening System - A presumptive test for the detection of DNA on forensic evidence items.

    Science.gov (United States)

    Dawnay, Nick; Stafford-Allen, Beccy; Moore, Dave; Blackman, Stephen; Rendell, Paul; Hanson, Erin K; Ballantyne, Jack; Kallifatidis, Beatrice; Mendel, Julian; Mills, DeEtta K; Nagy, Randy; Wells, Simon

    2014-07-01

    Current assessment of whether a forensic evidence item should be submitted for STR profiling is largely based on the personal experience of the Crime Scene Investigator (CSI) and the submissions policy of the law enforcement authority involved. While there are chemical tests that can infer the presence of DNA through the detection of biological stains, the process remains mostly subjective and leads to many samples being submitted that give no profile or not being submitted although DNA is present. The ParaDNA(®) Screening System was developed to address this issue. It consists of a sampling device, pre-loaded reaction plates and detection instrument. The test uses direct PCR with fluorescent HyBeacon™ detection of PCR amplicons to identify the presence and relative amount of DNA on an evidence item and also provides a gender identification result in approximately 75 minutes. This simple-to-use design allows objective data to be acquired by both DNA analyst and non-specialist personnel, to enable a more informed submission decision to be made. The developmental validation study described here tested the sensitivity, reproducibility, accuracy, inhibitor tolerance, and performance of the ParaDNA Screening System on a range of mock evidence items. The data collected demonstrates that the ParaDNA Screening System identifies the presence of DNA on a variety of evidence items including blood, saliva and touch DNA items. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  8. Central vestibular syndrome in a red fox (Vulpes vulpes with presumptive right caudal cerebral artery ischemic infarct and prevalent midbrain involvement

    Directory of Open Access Journals (Sweden)

    Mario Ricciardi

    2017-06-01

    Full Text Available A wild young male red fox (Vulpes vulpes was found in the mountainous hinterland of Rome (Italy with a heavily depressed mental status and unresponsive to the surrounding environment. Neurological examination revealed depression, left circling, right head tilt, ventromedial positional strabismus and decreased postural reactions on the left side. Neurological abnormalities were suggestive of central vestibular syndrome. Two consecutive MRIs performed with 30 days interval were compatible with lacunar ischemic infarct in the territory of right caudal cerebral artery and its collateral branches. The lesion epicentre was in the right periaqueductal portion of the rostral mesencephalic tegmentum. Neuroanatomical and neurophysiological correlation between lesion localization and clinical presentation are discussed.

  9. Central vestibular syndrome in a red fox (Vulpes vulpes) with presumptive right caudal cerebral artery ischemic infarct and prevalent midbrain involvement.

    Science.gov (United States)

    Ricciardi, Mario; Gernone, Floriana; Simone, Antonio De; Giannuzzi, Pasquale

    2017-01-01

    A wild young male red fox ( Vulpes vulpes ) was found in the mountainous hinterland of Rome (Italy) with a heavily depressed mental status and unresponsive to the surrounding environment. Neurological examination revealed depression, left circling, right head tilt, ventromedial positional strabismus and decreased postural reactions on the left side. Neurological abnormalities were suggestive of central vestibular syndrome. Two consecutive MRIs performed with 30 days interval were compatible with lacunar ischemic infarct in the territory of right caudal cerebral artery and its collateral branches. The lesion epicentre was in the right periaqueductal portion of the rostral mesencephalic tegmentum. Neuroanatomical and neurophysiological correlation between lesion localization and clinical presentation are discussed.

  10. The shortest isoform of dystrophin (Dp40) interacts with a group of presynaptic proteins to form a presumptive novel complex in the mouse brain.

    Science.gov (United States)

    Tozawa, Takenori; Itoh, Kyoko; Yaoi, Takeshi; Tando, So; Umekage, Masafumi; Dai, Hongmei; Hosoi, Hajime; Fushiki, Shinji

    2012-04-01

    Duchenne muscular dystrophy (DMD) causes cognitive impairment in one third of the patients, although the underlying mechanisms remain to be elucidated. Recent studies showed that mutations in the distal part of the dystrophin gene correlate well with the cognitive impairment in DMD patients, which is attributed to Dp71. The study on the expression of the shortest isoform, Dp40, has not been possible due to the lack of an isoform specific antibody. Dp40 has the same promoter as that found in Dp71 and lacks the normal C-terminal end of Dp427. In the present study, we have raised polyclonal antibody against the N-terminal sequence common to short isoforms of dystrophin, including Dp40, and investigated the expression pattern of Dp40 in the mouse brain. Affinity chromatography with this antibody and the consecutive LC-MS/MS analysis on the interacting proteins revealed that Dp40 was abundantly expressed in synaptic vesicles and interacted with a group of presynaptic proteins, including syntaxin1A and SNAP25, which are involved in exocytosis of synaptic vesicles in neurons. We thus suggest that Dp40 may form a novel protein complex and play a crucial role in presynaptic function. Further studies on these aspects of Dp40 function might provide more insight into the molecular mechanisms of cognitive impairment found in patients with DMD.

  11. Prospective evaluation of the chromogenic medium CandiSelect 4 for differentiation and presumptive identification of non-Candida albicans Candida species

    NARCIS (Netherlands)

    Zhao, Liang; de Hoog, G Sybren; Cornelissen, Akke; Lyu, Qian; Mou, Lili; Liu, Taohua; Cao, Yu; Vatanshenassan, Mansoureh; Kang, Yingqian

    Rapid identification of pathogenic yeasts is a crucial step in timely and appropriate antifungal therapy. For diagnostics in the clinical laboratory, simplified alternatives to barcoding are needed. CandiSelect 4 (CS4) medium, a chromogenic medium for isolation of clinical yeasts, allows routine

  12. The “free” movement of Roma in the EU: From the presumption of the fundamental right to housing to forced evictions and expulsion

    Directory of Open Access Journals (Sweden)

    C. COMAN

    2016-11-01

    Full Text Available The aim of this article is to highlight the contradiction between the EU principles ensuring the right of free movement and residence with EU and the legislative frameworks and measures ratified at national level by the member states for managing the inflow of Roma migrants. The first part of the article will underline how the main EU conventions, agreements, and treaties stipulate the right to free movement, residence, and housing of the member state citizens, regardless of their ethnic affiliation, within the EU. The second part will present a synthesis of the housing condition patterns of the Roma from Romania, who migrated to Italy, France, Spain, and United Kingdom, as revealed by the reports of recent researches. In the final section, the article brings a series of measures drawn from recent studies and programs, which might help mitigate these discrepancies.

  13. Use of antenatal care, maternity services, intermittent presumptive treatment and insecticide treated bed nets by pregnant women in Luwero district, Uganda

    Directory of Open Access Journals (Sweden)

    Mufubenga Patrobas

    2008-03-01

    Full Text Available Abstract Background To reduce the intolerable burden of malaria in pregnancy, the Ministry of Health in Uganda improved the antenatal care package by including a strong commitment to increase distribution of insecticide-treated nets (ITNs and introduction of intermittent preventive treatment with sulphadoxine-pyrimethamine for pregnant women (IPTp-SP as a national policy in 2000. This study assessed uptake of both ITNs and IPTp-SP by pregnant women as well as antenatal and maternity care use with the aim of optimizing their delivery. Methods 769 post-partum women were recruited from a rural area of central Uganda with perennial malaria transmission through a cross-sectional, community-based household survey in May 2005. Results Of the 769 women interviewed, antenatal clinic (ANC attendance was high (94.4%; 417 (57.7% visiting initially during the 2nd trimester, 242 (33.5% during the 3rd trimester and 266 (37.1% reporting ≥ 4 ANC visits. About 537 (71% and 272 (35.8% received one or ≥ 2 IPTp-SP doses respectively. Only 85 (15.8% received the first dose of IPTp-SP in the 3rd trimester. ITNs were used by 239 (31.3% of women during pregnancy and 314 (40.8% delivered their most recent pregnancy outside a health facility. Post-partum women who lacked post-primary education were more likely not to have attended four or more ANC visits (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.2–9.3. Conclusion These findings illustrate the need to strengthen capacity of the district to further improve antenatal care and maternity services utilization and IPTp-SP uptake. More specific and effective community health strategies to improve effective ANC, maternity services utilization and IPTp-SP uptake in rural communities should be undertaken.

  14. Evaluation of S-adenosyl l-methionine in a double-blinded, randomized, placebo-controlled, clinical trial for treatment of presumptive osteoarthritis in the dog.

    Science.gov (United States)

    Imhoff, Darren J; Gordon-Evans, Wanda J; Evans, Richard B; Johnson, Ann L; Griffon, Dominique J; Swanson, Kelly S

    2011-02-01

    To evaluate the efficacy of S-adenosyl l-methionine (SAMe) in the treatment of clinically inferred canine osteoarthritis (OA). Six weeks, double-blinded, placebo-controlled, clinical trial. Dogs (n=33) with clinical signs, history, and orthopedic exams consistent with OA. Dogs were block randomized by body condition score (goniometry, and the Canine Brief Pain Inventory (CBPI) at the time of study entrance and at 3 and 6 weeks after entry. Groups were compared using parametric and nonparametric paired tests as appropriate, and numbers needed to treat (NNT) were calculated for the CBPI and peak vertical force (PVF). Both groups (n=15 placebo, n=18 SAMe) had a reduction in mean PVF (P=.02) and vertical impulse (VI; P=.06) from the 1st to 3rd visit. There was no significant difference between the placebo group and SAMe group for PVF, VI, or either part of the CBPI (Severity or Impact). The NNT at 6 weeks for the Severity score was 3, Impact score was 25, and PVF was 45. These data do not support the use of SAMe as an effective stand alone treatment for reducing clinical signs of OA, as measured by PVF, VI, goniometry, CBPI (both Severity and Impact), and examination score within 6 weeks of treatment. © Copyright 2011 by The American College of Veterinary Surgeons.

  15. Comprehensive laboratory evaluation of a highly specific lateral flow assay for the presumptive identification of ricin in suspicious white powders and environmental samples.

    Science.gov (United States)

    Hodge, David R; Prentice, Kristin Willner; Ramage, Jason G; Prezioso, Samantha; Gauthier, Cheryl; Swanson, Tanya; Hastings, Rebecca; Basavanna, Uma; Datta, Shomik; Sharma, Shashi K; Garber, Eric A E; Staab, Andrea; Pettit, Denise; Drumgoole, Rahsaan; Swaney, Erin; Estacio, Peter L; Elder, Ian A; Kovacs, Gerald; Morse, Brenda S; Kellogg, Richard B; Stanker, Larry; Morse, Stephen A; Pillai, Segaran P

    2013-12-01

    Ricin, a heterodimeric toxin that is present in the seeds of the Ricinus communis plant, is the biothreat agent most frequently encountered by law enforcement agencies in the United States. Even in untrained hands, the easily obtainable seeds can yield a highly toxic product that has been used in various types of threats, including "white-powder" letters. Although the vast majority of these threats are hoaxes, an impediment to accurate hazard assessments by first responders is the unreliability of rapid detection assays for ricin, such as lateral flow assays (LFAs). One of the complicating factors associated with LFAs is the incorporation of antibodies of poor specificity that cross-react with near-neighbors or with plant lectins that are capable of nonspecifically cross-linking the capture and detector antibodies. Because of the compelling and critical need to promote the interests of public safety and public health, the Department of Homeland Security conducted a comprehensive laboratory evaluation study of a commercial LFA for the rapid detection of ricin. This study was conducted using comprehensive inclusivity and exclusivity panels of ricin and near-neighbor plant materials, along with panels of lectins and "white-powders," to determine the specificity, sensitivity, limits of detection, dynamic range, and repeatability of the assay for the specific intended use of evaluating suspicious white powders and environmental samples in the field.

  16. Antibiotic prescribing practices for patients with fever in the transition from presumptive treatment of malaria to 'confirm and treat' in Zambia: a cross-sectional study.

    Science.gov (United States)

    Ndhlovu, Micky; Nkhama, Emmy; Miller, John M; Hamer, Davidson H

    2015-12-01

    To evaluate antibiotic use among patients presenting to primary healthcare facilities with febrile illness in Zambia. We analysed data from a 2011 nationwide cross-sectional health facility survey of routine malaria case management in Zambia. Patient consultation observation and medical record charts were used to calculate the proportion of febrile patients who were prescribed antibiotics, stratified by symptoms, health workers' diagnosis and malaria test results. Logistic regression was used to identify factors affecting antibiotic prescribing behaviour. Of 872 patients presenting with fever, 651 (74.6%) were tested for malaria. Among those tested, 608 (93.4%) had analysable results; 230 (37.8%) had positive results. Antibiotics were prescribed to 69/230 (30.0%), 247/378 (65.3%) and 132/221 (59.7%) of those who tested positive, negative and those 'not tested', respectively. Furthermore, antibiotics were prescribed to 36/59 (61.0%) and 242/322 (75.1%) of those diagnosed with diarrhoea and upper respiratory tract infection (URTI), respectively. Among patients prescribed any antibiotic, concurrent antimalarial prescribing occurred in 66/69 (95.6%), 32/247 (12.9%) and 19/132 (14.4%) for those with positive results, negative results and 'not tested', respectively. Respiratory symptoms, diagnosis of URTI, malaria or skin disease and level of health care in the health delivery system were associated with antibiotic prescribing. Testing positive for malaria or receiving a malaria diagnosis was associated with reduced antibiotic prescribing, while testing negative, not being tested or a diagnosis of URTI resulted in higher rates of antibiotic prescribing. There is a need for improving diagnostic capacity for non-malaria causes of febrile illness at healthcare delivery points and limiting antibiotic use to patients with definite bacterial infections. © 2015 John Wiley & Sons Ltd.

  17. Cost-effectiveness analysis of introducing RDTs for malaria diagnosis as compared to microscopy and presumptive diagnosis in central and peripheral public health facilities in Ghana

    DEFF Research Database (Denmark)

    Ansah, Evelyn K; Epokor, Michael; Whitty, Christopher J M

    2013-01-01

    to replacing microscopy by RDT as the cost and proportion of correctly treated patients were similar. Results were sensitive to a decrease in the cost of RDTs, which cost GHS1.72 (US$1.17) per test at the time of the study and to improvements in adherence to negative tests that was just above 50% for both RDTs...

  18. Detection in chick embryo of fetoproteins not recognized by the dam's immune system and of soluble alloantigens. Presumptive teratogenic and abortogenic capacity of their specific IgY

    Directory of Open Access Journals (Sweden)

    Rodríguez-Burgos Antonio

    2003-06-01

    Full Text Available Abstract Background The aim of this work was to detect antigens, non-self to the dam, potentially present in chick embryo prior to organogenesis with a view to establishing the consequences of their neutralization on chick development. To this end, hens were immunized with the extract from embryos incubated for 53 h. Their eggs were either used to isolate immunoglobulins for dot and blot tests or incubated for variable lengths of time. Results Immunoblot tests, using adsorbed primary and secondary antibodies against paternal serum, revealed the presence of at least four antigens of 32, 34, 70 and 200 kDa that can be classified as soluble alloantigens. The same antibodies against chick embryo extracts (between 53 h and 9 showed at least five aged antigens of 34, 52, 90, 200 and 250 kDa, not detected in cock serum, that can thus be considered as soluble, foreign to the immunized hens and transitory antigens. The abnormalities observed included arrested development and fetal death, as well as minor functional damage in the few chicks that were born alive. The ratio of abnormal to normal embryos was 2.85 in the experimental group and 0.43 in the control group. With regard to congenital anomalies it must be said that of the 81 eggs incubated only four chicks were born alive, and of these, only one had a healthy birth and subsequent growth. The other three showed a transitory ataxia and one of them presented adult lumbar scoliosis and asymmetric pelvis. Conclusions The problem of recurrent spontaneous abortions is revisited in the light of these results. Some recent data suggest that soluble alloantigens may be candidates for a new etiological entity in recurrent spontaneous abortions. They can also be the cause of some congenital anomalies. The soluble, foreign, transitory antigens may have a similar effect although there is no supportive data in the literature.

  19. Comprehensive laboratory evaluation of a highly specific lateral flow assay for the presumptive identification of ricin in suspicious white powders and environmental samples

    Science.gov (United States)

    Ricin, a heterodimeric toxin that is present in the seeds of the Ricinus communis plant, is the most frequently encountered biothreat agent by law enforcement agencies in the United States. Even in untrained hands, the easily obtainable seeds can yield a highly toxic product that has been used in v...

  20. Resolution proposition on the acknowledgement of a presumption of a causality relationship between exposure to radiations after a nuclear accident and disease or decease

    International Nuclear Information System (INIS)

    2011-01-01

    This document makes reference to the Chernobyl accident and to the subsequent contamination which occurred in the eastern part of France and Corsica, and also to the fact that a prevalence of thyroid cancers has been noticed in Corsica. Based on these elements, the authors propose a legislative resolution for the recognition of the fact that this radioactivity is responsible for their disease

  1. Prospective purification of perivascular presumptive mesenchymal stem cells from human adipose tissue: process optimization and cell population metrics across a large cohort of diverse demographics.

    Science.gov (United States)

    West, C C; Hardy, W R; Murray, I R; James, A W; Corselli, M; Pang, S; Black, C; Lobo, S E; Sukhija, K; Liang, P; Lagishetty, V; Hay, D C; March, K L; Ting, K; Soo, C; Péault, B

    2016-03-30

    Adipose tissue is an attractive source of mesenchymal stem cells (MSC) as it is largely dispensable and readily accessible through minimally invasive procedures such as liposuction. Until recently MSC could only be isolated in a process involving ex-vivo culture and their in-vivo identity, location and frequency remained elusive. We have documented that pericytes (CD45-, CD146+, and CD34-) and adventitial cells (CD45-, CD146-, CD34+) (collectively termed perivascular stem cells or PSC) represent native ancestors of the MSC, and can be prospectively purified using fluorescence activated cell sorting (FACS). In this study we describe an optimized protocol that aims to deliver pure, viable and consistent yields of PSC from adipose tissue. We analysed the frequency of PSC within adipose tissue, and the effect of patient and procedure based variables on this yield. Within this twin centre study we analysed the adipose tissue of n = 131 donors using flow cytometry to determine the frequency of PSC and correlate this with demographic and processing data such as age, sex, BMI and cold storage time of the tissue. The mean number of stromal vascular fraction (SVF) cells from 100 ml of lipoaspirate was 34.4 million. Within the SVF, mean cell viability was 83 %, with 31.6 % of cells being haematopoietic (CD45+). Adventitial cells and pericytes represented 33.0 % and 8 % of SVF cells respectively. Therefore, a 200 ml lipoaspirate would theoretically yield 23.2 million viable prospectively purified PSC - sufficient for many reconstructive and regenerative applications. Minimal changes were observed in respect to age, sex and BMI suggesting universal potential application. Adipose tissue contains two anatomically and phenotypically discreet populations of MSC precursors - adventitial cells and pericytes - together referred to as perivascular stem cells (PSC). More than 9 million PSC per 100 ml of lipoaspirate can be rapidly purified to homogeneity using flow cytometry in clinically relevant numbers potentially circumventing the need for purification and expansion by culture prior to clinical use. The number and viability of PSC are minimally affected by patient age, sex, BMI or the storage time of the tissue, but the quality and consistency of yield can be significantly influenced by procedure based variables.

  2. Risks of Hemolysis in Glucose-6-Phosphate Dehydrogenase Deficient Infants Exposed to Chlorproguanil-Dapsone, Mefloquine and Sulfadoxine-Pyrimethamine as Part of Intermittent Presumptive Treatment of Malaria in Infants.

    Science.gov (United States)

    Poirot, Eugenie; Vittinghoff, Eric; Ishengoma, Deus; Alifrangis, Michael; Carneiro, Ilona; Hashim, Ramadhan; Baraka, Vito; Mosha, Jacklin; Gesase, Samwel; Chandramohan, Daniel; Gosling, Roland

    2015-01-01

    Chlorproguanil-dapsone (CD) has been linked to hemolysis in symptomatic glucose-6-phosphate dehydrogenase deficient (G6PDd) children. Few studies have explored the effects of G6PD status on hemolysis in children treated with Intermittent Preventive Treatment in infants (IPTi) antimalarial regimens. We sought to examine the joint effects of G6PD status and IPTi antimalarial treatment on incidence of hemolysis in asymptomatic children treated with CD, sulfadoxine-pyrimethamine (SP), and mefloquine (MQ). A secondary analysis of data from a double-blind, placebo-controlled trial of IPTi was conducted. Hemoglobin (Hb) measurements were made at IPTi doses, regular follow-up and emergency visits. G6PD genotype was determined at 9 months looking for SNPs for the A- genotype at coding position 202. Multivariable linear and logistic regression models were used to examine hemolysis among children with valid G6PD genotyping results. Hemolysis was defined as the absolute change in Hb or as any post-dose Hb <8 g/dL. These outcomes were assessed using either a single follow-up Hb on day 7 after an IPTi dose or Hb obtained 1 to 14 or 28 days after each IPTi dose. Relative to placebo, CD reduced Hb by approximately 0.5 g/dL at day 7 and within 14 days of an IPTi dose, and by 0.2 g/dL within 28 days. Adjusted declines in the CD group were larger than in the MQ and SP groups. At day 7, homo-/hemizygous genotype was associated with higher odds of Hb <8 g/dL (adjusted odds ratio = 6.7, 95% CI 1.7 to 27.0) and greater absolute reductions in Hb (-0.6 g/dL, 95% CI -1.1 to 0.003). There was no evidence to suggest increased reductions in Hb among homo-/hemizygous children treated with CD compared to placebo, SP or MQ. While treatment with CD demonstrated greater reductions in Hb at 7 and 14 days after an IPTi dose compared to both SP and MQ, there was no evidence that G6PD deficiency exacerbated the adverse effects of CD, despite evidence for higher hemolysis risk among G6PDd infants.

  3. Risks of hemolysis in glucose-6-phosphate dehydrogenase deficient infants exposed to chlorproguanil-dapsone, mefloquine and sulfadoxine-pyrimethamine as part of intermittent presumptive treatment of malaria in infants

    DEFF Research Database (Denmark)

    Poirot, Eugenie; Vittinghoff, Eric; Ishengoma, Deus

    2015-01-01

    ) antimalarial regimens. We sought to examine the joint effects of G6PD status and IPTi antimalarial treatment on incidence of hemolysis in asymptomatic children treated with CD, sulfadoxine-pyrimethamine (SP), and mefloquine (MQ). METHODS: A secondary analysis of data from a double-blind, placebo...

  4. Measurement of radiocesium concentration in trees using cumulative gamma radiation dose rate detection systems - A simple presumption for radiocesium concentration in living woods using glass-badge based gamma radiation dose rate detection system

    Energy Technology Data Exchange (ETDEWEB)

    Yoshihara, T.; Hashida, S.N. [Plant Molecular Biology, Laboratory of Environmental Science, Central Research Institute of Electric Power Industry (CRIEPI), 1646 Abiko, Chiba 270-1194 (Japan); Kawachi, N.; Suzui, N.; Yin, Y.G.; Fujimaki, S. [Radiotracer Imaging Gr., Quantum Beam Science Center, Japan Atomic Energy Agency (JAEA), 1233 Watanuki, Takasaki, Gunma 370-1292 (Japan); Nagao, Y.; Yamaguchi, M. [Takasaki Advanced Radiation Research Institute, Japan Atomic Energy Agency (JAEA), 1233 Watanuki, Takasaki, Gunma 370-1292 (Japan)

    2014-07-01

    Radiocesium from the severe accident at the Fukushima Dai-ichi Nuclear Power Plant on 11 March 2011 contaminates large areas. After this, a doubt for forest products, especially of mushroom, is indelible at the areas. Pruned woody parts and litters are containing a considerable amount of radiocesium, and generates a problem at incineration and composting. These mean that more attentive survey for each subject is expected; however, the present survey system is highly laborious/expensive and/or non-effective for this purpose. On the other hand, we can see a glass-badge based gamma radiation dose rate detection system. This system always utilized to detect a personal cumulative radiation dose, and thus, it is not suitable to separate a radiation from a specific object. However, if we can separate a radiation from a specific object and relate it with the own radiocesium concentration, it would enable us to presume the specific concentration with just an easy monitoring but without a destruction of the target nature and a complicated process including sampling, pre-treatment, and detection. Here, we present the concept of the measurement and results of the trials. First, we set glass-badges (type FS, Chiyoda Technol Corp., Japan) on a part of bough (approximately 10 cm in diameter) of Japanese flowering cherry trees (Prunus x yedoensis cv. Somei-Yoshino) with four different settings: A, a direct setting without any shield; B, a setting with an aluminum shield between bough and the glass-badge; C, a setting with a lead shield between bough and the glass-badge; D, a setting with a lead shield covering the glass-badge to shut the radiation from the surrounding but from bough. The deduction between the amount of each setting should separate a specific radiation of the bough from unlimited radiation from the surrounding. Even if the hourly dose rate is not enough to count the difference, a moderate cumulative dose would clear the difference. In fact, results demonstrated a significant difference between each settings of A, B, and C and the setting D after 15 days measurement (approx. 50 μSv). It is notable that the 15 days integrated hourly air dose rates (0.25-0.26 μSv h{sup -1}) measured with a NaI scintillator under the bough were almost equal to the cumulative dose measured with the glass-badge with the settings A and B (approx. 90 μSv). At this time, the radiocesium concentration in the bough measured with a Ge-semiconductor detector were 670-1060 Bq kg-DW{sup -1}. In other words, at least this level of radiocesium were detectable by the glass-badge under the condition. Further data are required to establish a specific correlation between the glass-badge detected cumulative dose and the specific radiocesium concentration. In addition, utilization of a recently developed semiconductor-typed cumulative dose detector and/or the improvement of the measurement procedure may advance the detection limitation/accuracy. (authors)

  5. Blue cures blue but be cautious

    Directory of Open Access Journals (Sweden)

    Pranav Sikka

    2011-01-01

    Full Text Available Methemoglobinemia is a disorder characterized by the presence of >1% methemoglobin (metHb in the blood. Spontaneous formation of methemoglobin is normally counteracted by protective enzyme systems, for example, nicotinamide adenine dinucleotide phosphate (NADPH methemoglobin reductase. Methemoglobinemia is treated with supplemental oxygen and methylene blue (1-2 mg/kg administered slow intravenously, which acts by providing an artificial electron acceptor for NADPH methemoglobin reductase. But known or suspected glucose-6-phosphate dehydrogenase (G6PD deficiency is a relative contraindication to the use of methylene blue because G6PD is the key enzyme in the formation of NADPH through pentose phosphate pathway and G6PD-deficient individuals generate insufficient NADPH to efficiently reduce methylene blue to leukomethylene blue, which is necessary for the activation of the NADPH-dependent methemoglobin reductase system. So, we should be careful using methylene blue in methemoglobinemia patient before G6PD levels.

  6. Environmental factors and cultural measures affecting the nitrate content in spinach

    NARCIS (Netherlands)

    Breimer, T.

    1982-01-01

    Ingestion of high amounts of nitrate by man can be considered hazardous to human health. In the human body, nitrate can be reduced to nitrite which may cause methemoglobinemia. Furthermore, the possible formation of N-nitroso-compounds from nitrite and secondary nitrogen compounds in the

  7. 78 FR 40027 - Novaluron; Pesticide Tolerances

    Science.gov (United States)

    2013-07-03

    ... Assessment and Determination of Safety Section 408(b)(2)(A)(i) of FFDCA allows EPA to establish a tolerance... make a determination on aggregate exposure for novaluron including exposure resulting from the... hematotoxic effects such as methemoglobinemia, decreased hemoglobin, decreased hematocrit, and decreased red...

  8. Effects of acute and sub-chronic ammonium nitrate exposure on rat ...

    African Journals Online (AJOL)

    Use of fertilizers like ammonium nitrate (NH4NO3) for agricultural purposes has increasingly contaminated the ecosystem with nitrate and/or nitrites. Nitrite is a toxic substance that can cause multiple physiological effects if allowed to build up to high concentrations in animals such as methemoglobinemia. This work is ...

  9. Nitrate and drinking water from private wells: Will there be an ...

    African Journals Online (AJOL)

    Conclusion: High nitrate levels drinking water is dangerous to health and can cause methemoglobinemia in children. It may also increase cancer risk in adults because nitrate is endogenously reduced to nitrite and subsequent nitrosation reactions give rise to N‑nitroso compounds (NOCs), which are highly carcinogenic ...

  10. Evaluation of Wound Healing Effect of Punica granatum L Peel ...

    African Journals Online (AJOL)

    its potent antimicrobial efficacy. However, silver gets absorbed systemically, and causes systemic complications such as neutropenia, methemoglobinemia and renal toxicity [3]. Therefore, finding more efficient agents with fewer side effects for treatment of burns has always been a priority for researchers. Pomegranate husk ...

  11. Improving Soil Productivity Through Agro-Industrial Waste Recycling ...

    African Journals Online (AJOL)

    Disposal of enormous waste has been a source of worry since the introduction of intensive agriculture. Poor organic waste management is often associated with carcinogenic nitrosamines and in other cases methemoglobinemia (blue baby syndrome). It is therefore suggested waste high in nitrogen and phosphorus be ...

  12. Life-threatening intoxication with methylene bis(thiocyanate: clinical picture and pitfalls. A case report

    Directory of Open Access Journals (Sweden)

    Schnuelle Peter

    2006-04-01

    Full Text Available Abstract Background Methylene bis(thiocyanate (MBT is a microbiocidal agent mainly used in industrial water cooling systems and paper mills as an inhibitor of algae, fungi, and bacteria. Case presentation We describe the first case of severe intoxication following inhalation of powder in an industrial worker. Profound cyanosis and respiratory failure caused by severe methemoglobinemia developed within several minutes. Despite immediate admission to the intensive care unit, where mechanical ventilation and hemodialysis for toxin elimination were initiated, multi-organ failure involving liver, kidneys, and lungs developed. While liver failure was leading, the patient was successfully treated with the MARS (molecular adsorbent recirculating system procedure. Conclusion Intoxication with MBT is a potentially life-threatening intoxication causing severe methemoglobinemia and multi-organ failure. Extracorporeal liver albumin dialysis (MARS appears to be an effective treatment to allow recovery of hepatic function.

  13. 77 FR 61390 - Certain Lined Paper Products From the People's Republic of China: Notice of Final Results and...

    Science.gov (United States)

    2012-10-09

    ... accessory or informational items including but not limited to pockets, tabs, dividers, closure devices... proceedings involving nonmarket economy (``NME'') countries, there is a rebuttable presumption that all...

  14. Four Week Oral Toxicity Study of WR242511 in Dogs. Volume 1

    Science.gov (United States)

    1994-06-03

    gums, tongue and sclera ), and mild to moderate thrombocytopenia were observed in mid and high dose animals. WR242511 treatment induced interstitial...dose males and females. Methemoglobinemia, the desired pharmacologic effect, accompanied by clinical signs of cyanosis (blue gums, tongue and sclera ...unanesthetized and sufficient blood was collected from the jugular vein to measure the following parameters in random order. Water was available ad

  15. Livestock poisoning from oil field drilling fluids, muds and additives.

    Science.gov (United States)

    Edwards, W C; Gregory, D G

    1991-10-01

    The use and potential toxicity of various components of oil well drilling fluids, muds and additives are presented. Many components are extremely caustic resulting in rumenitis. Solvent and petroleum hydrocarbon components may cause aspiration pneumonia and rumen dysfunction. Some additives cause methemoglobinemia. The most frequently encountered heavy metals are lead, chromium, arsenic, lithium and copper. Considerations for investigating livestock poisoning cases and several typical cases are reviewed.

  16. Acetominophen toxicity. Report of two cases.

    Science.gov (United States)

    Golden, D P; Mosby, E L; Smith, D J; Mackercher, P

    1981-04-01

    Both chronic low-dose use within accepted therapeutic limits and acute overdosage of acetominophen with as little as 7 Gm or 150 mg./kg. can result in irreversible centrilobular hepatic necrosis. Prompt and proper treatment with N-acetyl-cysteine in strict adherence to accepted protocol will prevent potentially fatal results. Clinicians who prescribe acetominophen must likewise be cognizant of other potential side effects, such as methemoglobinemia, hemolysis, and prothrombin suppression.

  17. Methylene blue treatment in experimental ischemic stroke: A mini-review

    Directory of Open Access Journals (Sweden)

    Zhao Jiang

    2016-01-01

    Full Text Available Stroke is among the leading causes of death and long-term disability. Methylene blue (MB, a drug grandfathered by the Food and Drug Administration with a long history of safe usage in humans for treating methemoglobinemia and cyanide poisoning, has recently been shown to be neuroprotective in neurodegenerative diseases and brain injuries. The goal of this paper is to review studies on MB in experimental stroke models.

  18. A review of nitrates in drinking water: maternal exposure and adverse reproductive and developmental outcomes Revisão sobre nitratos na água potável: exposição materna e reações adversas ao desenvolvimento reprodutivo

    OpenAIRE

    Deana M. Manassaram; Lorraine C. Backer; Deborah M. Moll

    2007-01-01

    In this review, we present an update on maternal exposure to nitrates in drinking water in relation to possible adverse reproductive and developmental effects, and discuss nitrates in drinking water in the United States. The current standard for nitrates in drinking water is based on retrospective studies and approximates a level that protects infants from methemoglobinemia, but no safety factor is built into the standard. The current standard applies only to public water systems. Animal stud...

  19. Student Musicians' Experiences of Reflexivity during Internships: Personal Narratives and Complex Modalities

    Science.gov (United States)

    Bennett, Dawn; Reid, Anna; Rowley, Jennifer

    2017-01-01

    A presumption behind work-integrated learning activities such as internship programmes is that student thinking will shift as a result of exposure to industry practice. We wondered if all students experience this change in the positive sense that teachers expect. To examine this presumption we asked to what extent and in what ways students…

  20. Post-Elementary Education, Poverty and Development in India

    Science.gov (United States)

    Tilak, Jandhyala B. G.

    2007-01-01

    There is a general presumption among many policy makers that secondary and higher education is not necessary for economic growth and development. On the other hand, it is literacy and primary education that is argued to be important. Estimates on internal rate of return also contributed to strengthening of such a presumption. Accordingly,…

  1. Prevalence and susceptibility of salmonella Typhi and salmonella ...

    African Journals Online (AJOL)

    Methods: Blood samples collected from presumptive typhoid fever patients from Ahmadu Bello University (ABU), Federal College of Education (FCE) and presumptive typhoid fever patients that attended two private clinics (Salama Clinics and Savanna Polyclinics) in Zaria were cultured for Salmonella species and identified ...

  2. Characterization of the microflora of lightly salted lumpfish (Cyclopterus lumpus) roe stored at 5 C

    DEFF Research Database (Denmark)

    Basby, Merethe; Jeppesen, V.F.; Huss, Hans Henrik

    1998-01-01

    Numeric taxonomy analysis of 70 lactic acid bacteria (LAB) and 30 Enterobacteriaceae from lightly salted lumpfish roe, showed that Enterobacteriaceae formed three subgroups: Morganella morganii presumptive Serratia liquefaciens and Serratia plymuthica. LAB formed three subgroups of presumptive...... compounds in both pasteurized and fresh roe. One Serratia liquefaciens produced strong off-odors but no volatile sulfur compounds in fresh roe....

  3. Acrocyanosis from phenazopyridine-induced sulfhemoglobinemia mistaken for Raynaud phenomenon.

    Science.gov (United States)

    Kermani, Tanaz A; Pislaru, Sorin V; Osborn, Thomas G

    2009-04-01

    Rheumatologists are often asked to evaluate patients with Raynaud phenomenon. Occasionally, an alternate explanation is revealed such as acrocyanosis. Methemoglobinemia and sulfhemoglobinemia are rare causes of cyanosis that can be medication-induced. Both are known complications of therapy with phenazopyridine. We report an unusual case of a 45-year-old woman in whom sulfhemoglobinemia from chronic therapy with phenazopyridine was misdiagnosed as due to Raynaud phenomenon and limited scleroderma. This case illustrates the importance of taking into account medication-related adverse events when evaluating patients with Raynaud-like phenomenon.

  4. Chronic copper toxicity in a dairy herd

    OpenAIRE

    Perrin, David J.; Schiefer, H. Bruno; Blakley, Barry R.

    1990-01-01

    The addition of excessive copper to a commercially prepared dairy ration caused chronic copper toxicity in a dairy herd. A formulation error by a feed company resulted in copper levels of 800 to 1,000 mg/kg in the “as fed concentrate,” amounting to about 400-500 mg copper/kg of the whole ration. Five animals died with typical signs of acute copper toxicity, including intravascular hemolysis and methemoglobinemia. A further 39 cows died on the farm from a combination of debilitation and second...

  5. Nitrate Removal from Ground Water: A Review

    Directory of Open Access Journals (Sweden)

    Archna

    2012-01-01

    Full Text Available Nitrate contamination of ground water resources has increased in Asia, Europe, United States, and various other parts of the world. This trend has raised concern as nitrates cause methemoglobinemia and cancer. Several treatment processes can remove nitrates from water with varying degrees of efficiency, cost, and ease of operation. Available technical data, experience, and economics indicate that biological denitrification is more acceptable for nitrate removal than reverse osmosis and ion exchange. This paper reviews the developments in the field of nitrate removal processes which can be effectively used for denitrifying ground water as well as industrial water.

  6. Blood Levels of Methemoglobin in Patients with Aluminum Phosphide Poisoning and its Correlation with Patient’s Outcome

    OpenAIRE

    Mostafazadeh, Babak; Pajoumand, Abdolkarim; Farzaneh, Esmaeil; Aghabiklooei, Abbas; Rasouli, Mohammad Reza

    2010-01-01

    Although methemoglobinemia following aluminum phosphide (AlP) intoxication has been reported, probable effect of blood level of methemoglobin (Met-Hb) on outcome of AlP-poisoned patients has not yet been investigated. This study aimed to evaluate blood levels of methemoglobin in patients with AP intoxication and its correlation with patient’s outcome. This prospective study was carried out at the Loghman–Hakim poison hospital from April 2009 to August 2009. All patients aged >12 years who had...

  7. Concurrent Autochthonous Malaria Caused by Plasmodium vivax in Father and Son in Greece.

    Science.gov (United States)

    Dimopoulou, Dimitra; Piperaki, Evangelia-Theofano; Zerva, Loukia; Tsagris, Vasileios; Asprogeraka, Sofia; Kalantzis, Dimitrios; Papaevangelou, Vassiliki

    2017-02-01

    We report the case of a 12-year-old child who was admitted to our Department, with 7 days' history of high fever and splenomegaly. His father had similar symptoms starting on the same day. A rapid test and microscopy for malaria yielded a positive result for Plasmodium vivax Antimalarial therapy was initiated. He developed methemoglobinemia treated with ascorbic acid and had uneventful recovery. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Complications of local anesthesia used in oral and maxillofacial surgery.

    Science.gov (United States)

    Cummings, David R; Yamashita, Dennis-Duke R; McAndrews, James P

    2011-08-01

    Local anesthetics are used routinely in oral and maxillofacial surgery. Local anesthetics are safe and effective drugs but do have risks that practitioners need to be aware of. This article reviews the complications of local anesthesia. A brief history is provided and the regional and systemic complications that can arise from using local anesthesia are discussed. These complications include paresthesia, ocular complications, allergies, toxicity, and methemoglobinemia. Understanding the risks involved with local anesthesia decreases the chances of adverse events occurring and ultimately leads to improved patient care. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Barking up the wrong tree: modern northern European dogs fail to explain their origin

    DEFF Research Database (Denmark)

    Malmström, Helena; Vilà, Carles; Gilbert, M Thomas P

    2008-01-01

    BACKGROUND: Geographic distribution of the genetic diversity in domestic animals, particularly mitochondrial DNA, has often been used to infer centers of domestication. The underlying presumption is that phylogeographic patterns among domesticates were established during, or shortly after the dom...

  10. HIV-associated opportunistic fungal infections

    African Journals Online (AJOL)

    Elton

    to use the. Common site/s laboratory. Clinical. Appropriate. Fungus of infection for diagnosis? specimen laboratory test. Comments. Candida species. Oropharyneal,. Atypical forms. Mucosal. Microscopy. Provides a rapid oesophageal and scrapings, presumptive diagnosis vulvovaginal brushings or mucosa biopsy. Culture.

  11. MICROBIOLOGICAL QUALITIES OF GREEN CHUTNEYS SOLD IN ...

    African Journals Online (AJOL)

    enrichment broth followed by enrichment on Rappaport Vassilidis medium and selection on Xylose-Lysine Deoxycholate agar, presumptive colonies were serotyped; for Shigella loopful of enrichment broth were streaked onto Salmonella, Shigella and ...

  12. 9 CFR 202.103 - Rule 3: Beginning a reparation proceeding.

    Science.gov (United States)

    2010-01-01

    ... address of each partner or member, if a partnership or joint venture is involved; (7) Name and address of... such failure and reasonable opportunity for such complainant to state whether such presumption is...

  13. Testing and examination of TMI-2 electrical components and discrete devices

    International Nuclear Information System (INIS)

    Soberano, F.T.

    1982-11-01

    This report discusses the approach and results of the in situ test conducted on TMI-2 reactor building electrical components and discrete devices. Also included are the necessary presumptions and assumptions to correlate observed anomalies to the accident

  14. Differential Medium for Vibrio cholerae

    Science.gov (United States)

    Schrank, Gordon D.; Stager, Charles E.; Verwey, W. F.

    1973-01-01

    A differential medium designed for rapid presumptive identification of Vibrio cholerae was described and shown to be useful for enumeration of viable cholera vibrios in the presence of other intestinal bacteria. Images PMID:4764406

  15. Comparison of five tests for identification of Staphylococcus aureus from clinical samples

    NARCIS (Netherlands)

    A. Luijendijk (Ad); A.F. van Belkum (Alex); J.A.J.W. Kluytmans (Jan); H.A. Verbrugh (Henri)

    1996-01-01

    textabstractFive different laboratory tests for the identification of Staphylococcus aureus were compared. Analyses of 271 presumptive S. aureus strains, supplemented with 59 well-defined methicillin-resistant S. aureus (MRSA) isolates, were performed. Only the

  16. Literature Reference for Shiga and Shiga-like Toxin (Journal of Clinical Microbiology. 2007. 45(10): 3377–3380)

    Science.gov (United States)

    This procedure describes a rapid optical immunoassay for the detection of Stx-1 and Stx-2 using a commercially available kit for presumptive analysis of aerosol, solid, particulate, liquid and water samples contaminated with Shiga and Shiga-like toxin.

  17. Fusion of a thermophilic phage endolysin to a Clostridium perfringens-specific cell wall binding domain creates an anti-clostridium antimicrobial with improved thermostability

    Science.gov (United States)

    Clostridium perfringens is the third leading cause of human foodborne bacterial disease and is the presumptive etiologic agent of Necrotic enteritis among chickens. Treatment of poultry with antibiotics is becoming less acceptable. Endolysin enzymes are potential replacements for antibiotics. Man...

  18. 77 FR 34801 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota; Regional Haze

    Science.gov (United States)

    2012-06-12

    .... Minnesota has proposed a reasonable progress goal (RPG) that will attain natural visibility conditions in... Reasonable Progress Guidance states that the URP is not a presumptive target for the RPG. The state followed...

  19. The effects of tertiary wastewater treatment on the prevalence of antimicrobial resistant bacteria

    DEFF Research Database (Denmark)

    Guardabassi, L.; Wong, Danilo Lo Fo; Dalsgaard, A.

    2002-01-01

    and anaerobically digested sludge by bacteriological counts on media selective for coliforms (MacConkey agar) and Acinetobacter spp. (Baumann agar). In addition, the level of antimicrobial susceptibility was determined by the disc-diffusion method in 442 Acinetobacter isolates identified by colony hybridisation......-resistant presumptive coliforms and Acinetobacter spp. in treated sewage and digested sludge were not significantly higher compared with raw sewage. On the contrary at one plant, statistically significant decreases were observed in the prevalence of ampicillin-resistant presumptive Acinetobacter spp. (p = 0.......0188) following sewage treatment, and in the prevalence of either ampicillin-resistant presumptive Acinetobacter spp. (p = 0.0013) or ampicillin- and gentamicin-resistant presumptive coliforms (p = 0.0273 and p = 0.0186) following sludge treatment. The results obtained by bacteriological counts were confirmed...

  20. Optimizing resource and energy recovery for materials and waste management

    Science.gov (United States)

    Decisions affecting materials management today are generally based on cost and a presumption of favorable outcomes without an understanding of the environmental tradeoffs. However, there is a growing demand to better understand and quantify the net environmental and energy trade-...

  1. Muuz Abraha Meshesha Abstract This article evaluates the ...

    African Journals Online (AJOL)

    -taxation, low tax compliance behavior, and/or uncertainty on the part of the tax authority and taxpayers attributable to the difficulty of locating the actual amount of tax liability to be paid.4. II. PRESUMPTIVE INCOME TAX ASSESSMENT.

  2. Topology optimization of viscoelastic rectifiers

    DEFF Research Database (Denmark)

    Jensen, Kristian Ejlebjærg; Szabo, Peter; Okkels, Fridolin

    2012-01-01

    An approach for the design of microfluidic viscoelastic rectifiers is presented based on a combination of a viscoelastic model and the method of topology optimization. This presumption free approach yields a material layout topologically different from experimentally realized rectifiers...

  3. Appropriate targeting of artemisinin-based combination therapy by community health workers using malaria rapid diagnostic tests

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Lal, Sham

    2016-01-01

    OBJECTIVE: To compare the impact of malaria rapid diagnostic tests (mRDTs), used by community health workers (CHWs), on the proportion of children therapy (ACT), vs. presumptive treatment. METHODS: Cluster...

  4. Multiplex polymerase chain reaction: Could change diagnosis of ...

    African Journals Online (AJOL)

    acquired infection in critically ill children. The increasing incidence of infections by antibiotic-resistant pathogens adds significantly to the cost of hospital care and to the length of hospital stays. Besides clinical prerequisites for presumptive diagnosis ...

  5. Předpoklady Rakouska pro rozvoj cestovního ruchu

    OpenAIRE

    Zavadilová, Tereza

    2009-01-01

    The bachelor thesis is about the presumptions for the tourism development in Austria. The presumptions are generally characterized in the first part, the second part of the thesis describes Austria, its tourism and the current development of the tourism in Austria. The second part also describes the cultural and natural attractions in Austria; the cultural attractions comprise castles, museums, monasteries, churches etc., the natural attractions describe the Austrian Alps, protected areas, na...

  6. Wnt/beta-catenin signaling plays an essential role in activation of odontogenic mesenchyme during early tooth development

    OpenAIRE

    Chen, Jianquan; Lan, Yu; Baek, Jin-A; Gao, Yang; Jiang, Rulang

    2009-01-01

    Classical tissue recombination studies demonstrated that initiation of tooth development depends on activation of odontogenic potential in the mesenchyme by signals from the presumptive dental epithelium. Although several members of the Wnt family of signaling molecules are expressed in the presumptive dental epithelium at the beginning of tooth initiation, whether Wnt signaling is directly involved in the activation of the odontogenic mesenchyme has not been characterized. In this report, we...

  7. Blue gods, blue oil, and blue people.

    Science.gov (United States)

    Fairbanks, V F

    1994-09-01

    Studies of the composition of coal tar, which began in Prussia in 1834, profoundly affected the economies of Germany, Great Britain, India, and the rest of the world, as well as medicine and surgery. Such effects include the collapse of the profits of the British indigo monopoly, the growth in economic power of Germany based on coal tar chemistry, and an economic crisis in India that led to more humane tax laws and, ultimately, the independence of India and the end of the British Empire. Additional consequences were the development of antiseptic surgery and the synthesis of a wide variety of useful drugs that have eradicated infections and alleviated pain. Many of these drugs, particularly the commonly used analgesics, sulfonamides, sulfones, and local anesthetics, are derivatives of aniline, originally called "blue oil" or "kyanol." Some of these aniline derivatives, however, have also caused aplastic anemia, agranulocytosis, and methemoglobinemia (that is, "blue people"). Exposure to aniline drugs, particularly when two or three aniline drugs are taken concurrently, seems to be the commonest cause of methemoglobinemia today.

  8. In Vitro Protective Effect and Antioxidant Mechanism of Resveratrol Induced by Dapsone Hydroxylamine in Human Cells.

    Science.gov (United States)

    Albuquerque, Rosyana V; Malcher, Nívea S; Amado, Lílian L; Coleman, Michael D; Dos Santos, Danielle C; Borges, Rosivaldo Sa; Valente, Sebastião Aldo S; Valente, Vera C; Monteiro, Marta Chagas

    2015-01-01

    Dapsone (DDS) hydroxylamine metabolites cause oxidative stress- linked adverse effects in patients, such as methemoglobin formation and DNA damage. This study evaluated the ameliorating effect of the antioxidant resveratrol (RSV) on DDS hydroxylamine (DDS-NHOH) mediated toxicity in vitro using human erythrocytes and lymphocytes. The antioxidant mechanism was also studied using in-silico methods. In addition, RSV provided intracellular protection by inhibiting DNA damage in human lymphocytes induced by DDS-NHOH. However, whilst pretreatment with RSV (10-1000 μM significantly attenuated DDS-NHOH-induced methemoglobinemia, but it was not only significantly less effective than methylene blue (MET), but also post-treatment with RSV did not reverse methemoglobin formation, contrarily to that observed with MET. DDS-NHOH inhibited catalase (CAT) activity and reactive oxygen species (ROS) generation, but did not alter superoxide dismutase (SOD) activity in erythrocytes. Pretreatment with RSV did not alter these antioxidant enzymes activities in erythrocytes treated with DDS-NHOH. Theoretical calculations using density functional theory methods showed that DDS-NHOH has a pro-oxidant effect, whereas RSV and MET have antioxidant effect on ROS. The effect on methemoglobinemia reversion for MET was significantly higher than that of RSV. These data suggest that the pretreatment with resveratrol may decrease heme-iron oxidation and DNA damage through reduction of ROS generated in cells during DDS therapy.

  9. In Vitro Protective Effect and Antioxidant Mechanism of Resveratrol Induced by Dapsone Hydroxylamine in Human Cells.

    Directory of Open Access Journals (Sweden)

    Rosyana V Albuquerque

    Full Text Available Dapsone (DDS hydroxylamine metabolites cause oxidative stress- linked adverse effects in patients, such as methemoglobin formation and DNA damage. This study evaluated the ameliorating effect of the antioxidant resveratrol (RSV on DDS hydroxylamine (DDS-NHOH mediated toxicity in vitro using human erythrocytes and lymphocytes. The antioxidant mechanism was also studied using in-silico methods. In addition, RSV provided intracellular protection by inhibiting DNA damage in human lymphocytes induced by DDS-NHOH. However, whilst pretreatment with RSV (10-1000 μM significantly attenuated DDS-NHOH-induced methemoglobinemia, but it was not only significantly less effective than methylene blue (MET, but also post-treatment with RSV did not reverse methemoglobin formation, contrarily to that observed with MET. DDS-NHOH inhibited catalase (CAT activity and reactive oxygen species (ROS generation, but did not alter superoxide dismutase (SOD activity in erythrocytes. Pretreatment with RSV did not alter these antioxidant enzymes activities in erythrocytes treated with DDS-NHOH. Theoretical calculations using density functional theory methods showed that DDS-NHOH has a pro-oxidant effect, whereas RSV and MET have antioxidant effect on ROS. The effect on methemoglobinemia reversion for MET was significantly higher than that of RSV. These data suggest that the pretreatment with resveratrol may decrease heme-iron oxidation and DNA damage through reduction of ROS generated in cells during DDS therapy.

  10. Systemic asphyxiants poisoning

    Directory of Open Access Journals (Sweden)

    Marta M. Cravino

    2007-12-01

    Full Text Available A 20-year-old healthy and apparently eupnoic man was admitted into our hospital because of a strong headache; we noticed tachycardia, tachypnea and decreased O2 saturation. A methemoglobin level of 29,5% was determined in the arterial blood. Some time before, a very old tank of ink had accidentally spilled over his working suit. The toxic agent was identified as aniline, a systemic asphyxiant that is well absorbed through the skin, causing systemic toxicity. The effects of skin absorption can be delayed for several hours. Most adverse health effects of aniline are due to the formation of methemoglobinemia, a disorder characterized by a form of hemoglobin that does not bind oxygen and impairs oxygen transport capacity. When its concentration is elevated in red blood cells a functional anemia and tissue hypoxia may occur. Organs with high oxygen demands (i.e. CNS, cardiovascular system, etc. are usually the first to show toxic effects. The severity of methemoglobinemia symptoms is related to the amount of methemoglobin present in blood and range from a bluish discoloration of the skin and mucous membrane to weakness, seizures, difficulty in breathing, dysrhythmias, acidosis, cardiac or neurologic ischemia. Treatment is determined by symptoms. The first step of therapy is to remove patient from the source of exposure and ensure adequate skin and eye decontamination. It is necessary to ensure adequate ventilation with 100% O2, too. Methylene blue is the first-line antidotal agent.

  11. Value of information analysis for groundwater quality monitoring network design Case study: Eocene Aquifer, Palestine

    Science.gov (United States)

    Khader, A.; McKee, M.

    2010-12-01

    Value of information (VOI) analysis evaluates the benefit of collecting additional information to reduce or eliminate uncertainty in a specific decision-making context. It makes explicit any expected potential losses from errors in decision making due to uncertainty and identifies the “best” information collection strategy as one that leads to the greatest expected net benefit to the decision-maker. This study investigates the willingness to pay for groundwater quality monitoring in the Eocene Aquifer, Palestine, which is an unconfined aquifer located in the northern part of the West Bank. The aquifer is being used by 128,000 Palestinians to fulfill domestic and agricultural demands. The study takes into account the consequences of pollution and the options the decision maker might face. Since nitrate is the major pollutant in the aquifer, the consequences of nitrate pollution were analyzed, which mainly consists of the possibility of methemoglobinemia (blue baby syndrome). In this case, the value of monitoring was compared to the costs of treating for methemoglobinemia or the costs of other options like water treatment, using bottled water or importing water from outside the aquifer. And finally, an optimal monitoring network that takes into account the uncertainties in recharge (climate), aquifer properties (hydraulic conductivity), pollutant chemical reaction (decay factor), and the value of monitoring is designed by utilizing a sparse Bayesian modeling algorithm called a relevance vector machine.

  12. Precarity and Preparedness: Non-Adherence as Institutional Work in Diagnosing and Treating Malaria in Uganda.

    Science.gov (United States)

    Umlauf, René

    2017-07-01

    Access to anti-malarial drugs is increasingly governed by novel regulation technologies like rapid diagnostic tests (RDTs). However, high rates of non-adherence particularly to negative RDT results have been reported, threatening the cost-effectiveness of the two interrelated goals of improving diagnosis and reducing the over-prescription of expensive anti-malarial drugs. Below I set out to reconstruct prior treatment forms like presumptive treatment of malaria by paying particular attention to their institutional groundings. I show how novel regulation technologies affect existing institutions of care and argue that the institutional work of presumptive treatment goes beyond the diagnosis and treatment of a currently observed fever episode. Instead, in contexts of precarity, through what I will call "practices of preparedness," presumptive treatment includes a variety of practices, performances, temporalities, and opportunities that allow individuals to prepare for future episodes of fever.

  13. Medical Eschatologies: The Christian Spirit of Hospital Protocol.

    Science.gov (United States)

    Langford, Jean M

    2016-01-01

    If much has been written of the forms of bodiliness reinforced by hospitals, less attention has been paid to the medicalization of the soul. The medical management of death institutionalizes divisions between body and soul, and matter and spirit, infusing end-of-life care with latent Christian theological presumptions. The invisibility of these presumptions is partly sustained by projecting religiosity on those who endorse other cosmologies, while retaining for medicine a mask of secular science. Stories of conflict with non-Christian patients force these presumptions into visibility, suggesting alternative ethics of care and mourning rooted in other understandings. In this article, I explore one such story. Considering the story as an allegory for how matter and spirit figure in contemporary postmortem disciplines, I suggest that it exposes both the operation of a taboo against mixing material and spiritual agendas, and an assumption that appropriate mourning is oriented toward symbolic homage, rather than concern for the material welfare of the dead.

  14. Tuberculosis among transhumant pastoralist and settled communities of south-eastern Mauritania.

    Science.gov (United States)

    Lô, Aissata; Tall-Dia, Anta; Bonfoh, Bassirou; Schelling, Esther

    2016-01-01

    Transhumant pastoralists of Mauritania were assumed to have a high prevalence of tuberculosis (TB) because of reduced access to diagnostic testing. No population-based survey on TB has been published for Mauritania. The goal of this study was to estimate the prevalence of presumptive TB cases among mobile pastoralists and villagers in a remote zone of Mauritania. In the south-eastern province of Hodh Ech Chargui, 250 adult pastoralists and 250 villagers were randomly enrolled using multistage cluster sampling in February 2012. A TB centre nurse examined participants using a standard clinical protocol, and a participant questionnaire was completed. Focus group discussions and interviews were conducted with community members and health personnel, respectively. Fourteen new presumptive TB cases were identified, leading to an overall prevalence of 2.8%, (95% confidence interval (CI) 1.5-4.7%). The prevalence was non-significantly higher among villagers than pastoralists (3.6% vs. 2.0%). Assuming illness duration was 3 years and all presumptive cases started treatment, an overall crude incidence of 933 cases/100,000 was derived. Five of six presumptive cases in Djiguenni were confirmed by sputum smear microscopy, but none out of eight presumptive cases were confirmed in Néma, although the same nurse performed all clinical examinations in both departments. This result was attributed to the use of expired reagents in Néma. Communities mentioned distance rather than lack of information as the main constraint to seeking diagnosis, but poor diagnostic centre performance also delayed decision-making. TB prevalences were high among both pastoralists and villagers. None of the 14 presumptive cases sought prior diagnostic testing. TB diagnostic centres in the remote rural study zone were poorly equipped. These centres must remain in operation to reduce TB incidence in vulnerable communities in insecure remote rural zones and to reach national health goals.

  15. Tuberculosis among transhumant pastoralist and settled communities of south-eastern Mauritania

    Directory of Open Access Journals (Sweden)

    Aissata Lô

    2016-05-01

    Full Text Available Background: Transhumant pastoralists of Mauritania were assumed to have a high prevalence of tuberculosis (TB because of reduced access to diagnostic testing. No population-based survey on TB has been published for Mauritania. Objective: The goal of this study was to estimate the prevalence of presumptive TB cases among mobile pastoralists and villagers in a remote zone of Mauritania. Design: In the south-eastern province of Hodh Ech Chargui, 250 adult pastoralists and 250 villagers were randomly enrolled using multistage cluster sampling in February 2012. A TB centre nurse examined participants using a standard clinical protocol, and a participant questionnaire was completed. Focus group discussions and interviews were conducted with community members and health personnel, respectively. Results: Fourteen new presumptive TB cases were identified, leading to an overall prevalence of 2.8%, (95% confidence interval (CI 1.5–4.7%. The prevalence was non-significantly higher among villagers than pastoralists (3.6% vs. 2.0%. Assuming illness duration was 3 years and all presumptive cases started treatment, an overall crude incidence of 933 cases/100,000 was derived. Five of six presumptive cases in Djiguenni were confirmed by sputum smear microscopy, but none out of eight presumptive cases were confirmed in Néma, although the same nurse performed all clinical examinations in both departments. This result was attributed to the use of expired reagents in Néma. Communities mentioned distance rather than lack of information as the main constraint to seeking diagnosis, but poor diagnostic centre performance also delayed decision-making. Conclusions: TB prevalences were high among both pastoralists and villagers. None of the 14 presumptive cases sought prior diagnostic testing. TB diagnostic centres in the remote rural study zone were poorly equipped. These centres must remain in operation to reduce TB incidence in vulnerable communities in insecure

  16. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network

    Directory of Open Access Journals (Sweden)

    A. I. Khader

    2013-05-01

    Full Text Available Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i ignore the health risk of nitrate-contaminated water, (ii switch to alternative water sources such as bottled water, or (iii implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012. The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water

  17. Collective acute poisoning by nitrous gases

    Energy Technology Data Exchange (ETDEWEB)

    Touze, M.D.; Desjars, P.; Baron, D.; Tasseau, F.; Delajartre, A.Y.; Nicolas, F.

    1983-09-01

    A collective nitrous fumes poisoning (five cases) is reported. Two patients (case 3 and case 4) were comatose, in severe respiratory distress. Shock and slate blue cyanosis were noted. Physical examination and chest X ray revealed acute pulmonary edema-Methemoglobin levels were 71,3% (case 3) and 58% (case 4). Despite treatment both of them died from severe hypoxia resulting in cardiorespiratory arrest. Post-mortem examination was performed upon these four men. On admission the last one (case 5) was conscious, and in good hemodynamic condition. Acute pulmonary edema and cyanosis were present. Methemoglobin level was 37,3%. This patient recovered appropriate therapy. For case 1 and 2 acute anoxia due to methemoglobinemia seems to be cause of death. For cases 3 and 4 death is due to hypoxemia associated with pulmonary edema.

  18. [Hydrogeology and medicine in the approach to health problems linked to nitrates: examples in Lorraine].

    Science.gov (United States)

    Melet, J J; Morlot, M; Passavy, J; Salado, J

    1980-01-01

    An investigation carried out by French Ministration of Agriculture (S.R.A.E.L.) has worked out an inventory and defined the nitrate amount evolution in waters, specially originated with underground formations, stared out by collectivities. The investigation spreading has brought about some ascertainment in Lorraine country. Particularly, the "Laboratoire d'hygiène et de recherche en santé publique" has so identified in a commune near Nancy, where nitrate amounts in water are particularly high, gastrointestinal troubles probably caused by minor methemoglobinemias which water supply origin have not been locally suspected. This note so shows that medical and paramedical corps cooperation with administrative authorities charged with water resource can attempt some interventions: better diagnosis, population and mayors information, search of technical and administrative settlements according to local environment.

  19. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network

    Science.gov (United States)

    Khader, A. I.; Rosenberg, D. E.; McKee, M.

    2013-05-01

    Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i) ignore the health risk of nitrate-contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome) is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs

  20. PROLONGED USE OF MUL TIDRUG THERAPY FOR L EPROSY LEADING TO MULTIPLE COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Vengadakrishnan

    2015-01-01

    Full Text Available Multidrug therapy (MDT for leprosy was recommended by WHO with a triple drug regimen of Dapsone , Rifampicin and Clofazimine , which is still the best treatment for leprosy. Side effects of these are commonly seen in clinical practice. Herein we present to you a case of 63 year old male patient who presented to the OPD with gastro - intestinal symptoms , paresthesias and difficulty in walking. It was only by proper history taking ( he has been continuing MDT for the past 43 years , the diagnosis could be made. F urther workup revealed presence of methemoglobinemia , atrophic gastritis , peripheral neuropathy and subacute combined degeneration of spinal cord. Prompt treatment and withdrawal of the drug lead to improvement of the symptoms.

  1. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network

    Science.gov (United States)

    Khader, A.; Rosenberg, D.; McKee, M.

    2012-12-01

    Nitrate pollution poses a health risk for infants whose freshwater drinking source is groundwater. This risk creates a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision maker and the expected outcomes from these alternatives. The alternatives include: (i) ignore the health risk of nitrate contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, pollution transport processes, and climate (Khader and McKee, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine where methemoglobinemia is the main health problem associated with the principal pollutant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not-use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs include healthcare for methemoglobinemia, purchase of bottled water, and installation and maintenance of the groundwater monitoring system. At current

  2. Plant growth nutrient (nitrobenzene poisoning with multiple complications

    Directory of Open Access Journals (Sweden)

    Yatendra Singh

    2015-01-01

    Full Text Available Nitrobenzene, a pale yellow oily liquid with an odor of bitter almonds, is used in the synthesis of Aniline dyes, flavoring agent, and also in rubber industry. Recently it is also used as a plant growth nutrient. It causes methemoglobinemia with symptoms including headache, nausea, dizziness, fatigue, shortness of breath, cyanosis, and convulsions. Severe acute exposure to nitrobenzene can cause jaundice, renal failure, and coma, and it may be fatal. We report a case of Plant growth nutrient (nitrobenzene poisoning with multiple complications like hemolytic anemia, renal failure, seizures, and pneumonia. Patient was managed with intravenous methylene blue along with other supportive therapy and survived. So, early aggressive management and a watch on complications might be helpful in saving patient′s life from this poisoning.

  3. AUTOMATED HEMATOLOGY ANALYZERS IN DIAGNOSIS OF PLASMODIUM VIVAX MALARIA: AN ADJUNCT TO CONVENTIONAL MICROSCOPY.

    Directory of Open Access Journals (Sweden)

    Kolakkadan Mubeen Hasaf

    2014-05-01

    Full Text Available Malaria is one of the most pervasive parasitic diseases ever known to mankind affecting nearly 300 million people every year. The need for rapid diagnosis of malaria in tropical and subtropical malaria endemic areas is on the rise. In this study we evaluated the usefulness of hematology autoanalyzers, Sysmex XE-2100 & XT-2000i in the presumptive diagnosis of malaria. Our study shows that abnormalities in WBC/BASO scattergram when combined with presence of thrombocytopenia had a high sensitivity and positive predictive value in the presumptive diagnosis of malaria.

  4. Presunciones, verdad y normas procesales

    Directory of Open Access Journals (Sweden)

    Aguiló Regla, Josep

    2006-12-01

    Full Text Available The aim of this article is threefold: 1 To cast some light on the controversial issue of the “nature” of presumptions in law; to this purpose, showing the gap existing between “is presumable” and “shall be presumed” (or “ought to be presumed” is the way to adequately individuate the idea of “presumption norms”. 2 Once this idea has been made clear, to show the need to bring, in the analysis of it, the distinction between rules and principles; this allows to distinguish, in turn, between presumption norms which are rules (“presumption rules” and presumption norms which are principles (“presumption principles”. 3 To try to dissolve, in theoretical terms, the socalled “iuris et de iure presumptions” (or “conclusive presumptions”; to this end, “presumption norms” (which oblige to presume are distinguished from “presumption-based norms” (which do not oblige to presume.

    El trabajo se propone alcanzar tres objetivos: 1 Aclarar la disputada cuestión de la “naturaleza” de las presunciones en el Derecho; para ello se muestra la distancia que media entre el sintagma “es presumible” y el sintagma “se presumirá (o debe presumirse” como forma de aislar adecuadamente la noción de “normas de presunción”. 2 Aclarada esta noción, mostrar la necesidad de introducir en su análisis la distinción entre reglas y principios; lo que permite distinguir, a su vez, entre normas de presunción-regla (presunciones-regla y normas de presunción- principio (presunciones-principio. 3 Tratar de disolver en términos teóricos las llamadas “presunciones iuris et de iure”, para ello se distingue entre “normas de presunción” (que obligan a presumir y “normas basadas en una presunción” (que no obligan a presumir.

  5. Regulations implementing the Byrd Amendments to the Black Lung Benefits Act: determining coal miners' and survivors' entitlement to benefits. Final rule.

    Science.gov (United States)

    2013-09-25

    This final rule revises the Black Lung Benefits Act (BLBA or Act) regulations to implement amendments made by the Patient Protection and Affordable Care Act (ACA). The ACA amended the BLBA in two ways. First, it revived a rebuttable presumption of total disability or death due to pneumoconiosis for certain claims. Second, it reinstituted automatic entitlement to benefits for certain eligible survivors of coal miners whose lifetime benefit claims were awarded because they were totally disabled due to pneumoconiosis. These regulations clarify how the statutory presumption may be invoked and rebutted and the application and scope of the survivor-entitlement provision. The rule also eliminates several unnecessary or obsolete provisions.

  6. Transcription factors Mix1 and VegT, relocalization of vegt mRNA, and conserved endoderm and dorsal specification in frogs

    OpenAIRE

    Sudou, Norihiro; Garcés-Vásconez, Andrés; López-Latorre, María A.; Taira, Masanori; del Pino, Eugenia M.

    2016-01-01

    The transcription factors VegT and Mix1 are markers of the future gut (presumptive endoderm) of the frog Xenopus laevis. VegT and Mix1 proteins localized to the embryo vegetal hemisphere, providing an equivalent identity to the presumptive endoderm in the five frog species that were analyzed. Moreover, VegT protein localized to the animal hemisphere in embryos of all frogs. Similarly, vegt transcripts relocalized to the dorso-animal region of the egg after fertilization in X. laevis, suggesti...

  7. Ribonucleotide reductase inhibition restores platinum-sensitivity in platinum-resistant ovarian cancer: a Gynecologic Oncology Group Study

    Directory of Open Access Journals (Sweden)

    Kunos Charles

    2012-04-01

    Full Text Available Abstract Background The potent ribonucleotide reductase (RNR inhibitor 3-aminopyridine-2-carboxyaldehyde-thiosemicarbazone (3-AP was tested as a chemosensitizer for restored cisplatin-mediated cytotoxicity in platinum-resistant ovarian cancer. Methods Preclinical in vitro platinum-resistant ovarian cancer cell survival, RNR activity, and DNA damage assays were done after cisplatin or cisplatin plus 3-AP treatments. Six women with platinum-resistant ovarian cancer underwent four-day 3-AP (96 mg/m2, day one to four and cisplatin (25 mg/m2, day two and three infusions every 21 days until disease progression or adverse effects prohibited further therapy. Pre-therapy ovarian cancer tissues were analyzed by immunohistochemistry for RNR subunit expression as an indicator of cisplatin plus 3-AP treatment response. Results 3-AP preceding cisplatin exposure in platinum-resistant ovarian cancer cells was not as effective as sequencing cisplatin plus 3-AP together in cell survival assays. Platinum-mediated DNA damage (i.e., γH2AX foci resolved quickly after cisplatin-alone or 3-AP preceding cisplatin exposure, but persisted after a cisplatin plus 3-AP sequence. On trial, 25 four-day overlapping 3-AP and cisplatin cycles were administered to six women (median 4.2 cycles per patient. 3-AP-related methemoglobinemia (range seven to 10% occurred in two (33% of six women, halting trial accrual. Conclusions When sequenced cisplatin plus 3-AP, RNR inhibition restored platinum-sensitivity in platinum-resistant ovarian cancers. 3-AP (96 mg/m2 infusions produced modest methemoglobinemia, the expected consequence of ribonucleotide reductase inhibitors disrupting collateral proteins containing iron. Trial registry ClinicalTrials.gov NCT00081276

  8. Water quality assessment of underground and surface water ...

    African Journals Online (AJOL)

    conductivity, total hardness and all the species of nitrogen (nitrite, nitrate and ammonium) were higher in the inner city than the remaining water habitats except the outer ground water stations. Conductivity decreased along the presumptive pollution categories significantly, i.e. inner > middle > out skirt (P< 0.05) and showed ...

  9. Download this PDF file

    African Journals Online (AJOL)

    USER

    Listeria. Enrichment broth (LEB) with listeria selective enrichment supplement was used for enrichment. Listeria selective agar base (Oxford formulation) fortified with Listeria selective supplement agar plates were used as the selective media for the presumptive isolation of listeria species from the processed food samples.

  10. Journal of Genetics | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    It has long been noted that high temperature produces great variation in wing forms of the vestigial mutant of Drosophila. Most of the wings have defects in the wing blade and partially formed wing margin, which are the result of autonomous cell death in the presumptive wing blade or costal region of the wing disc.

  11. 76 FR 37407 - Energy Conservation Program: Energy Conservation Standards for Residential Furnaces and...

    Science.gov (United States)

    2011-06-27

    ... Presumption Payback Period G. National Impact Analysis-National Energy Savings and Net Present Value 1... Standards Cases 3. Installed Cost per Unit 4. National Energy Savings 5. Net Present Value of Consumer.... National Impact Analysis a. Significance of Energy Savings b. Net Present Value of Consumer Costs and...

  12. 49 CFR 26.67 - What rules determine social and economic disadvantage?

    Science.gov (United States)

    2010-10-01

    ... significant adverse tax or interest consequences, include only the present value of such assets, less the tax... presumption of disadvantage. (1) If the statement of personal net worth that an individual submits under... disadvantage? 26.67 Section 26.67 Transportation Office of the Secretary of Transportation PARTICIPATION BY...

  13. 28 CFR 32.13 - Definitions.

    Science.gov (United States)

    2010-07-01

    ...; (4) Consumption of controlled substances included on Schedule I of the drug control and enforcement...-adoptive parent) has the role of parent, as shown by convincing evidence. Competent medical evidence to the contrary—The presumption raised by the Act, at 42 U.S.C. 3796(k), is overcome by competent medical evidence...

  14. 31. FACTORS INFLUENCING UTILIZATION OF INTERMITTENT ...

    African Journals Online (AJOL)

    Esem

    Presumptive Treatment of Malaria (IPTp) Services by. Pregnant Women in Sesheke District of Western .... dream of eliminating malaria to near zero by 2015 and also in achieving the Millennium Development Goals ... was calculated using an estimate of expected point prevalence of IPTp coverage in Sesheke (35.5%).

  15. The Problems of Proving Actual or Apparent Bias: An Analysis of ...

    African Journals Online (AJOL)

    This article takes a critical look at the divergent approaches of courts in constructing the meaning of actual and apparent bias in adjudicative contexts. ... which has seemingly emerged is that which weighs the allegations of bias against the presumption of impartiality and the requirements of the double reasonableness test.

  16. Power Measures in Large Weighted Voting Games - Asymptotic Properties and Numerical Methods

    NARCIS (Netherlands)

    Lindner, I.D.

    2004-01-01

    This thesis deals with the asymptotic properties of weighted voting games (WVGs) when there are many ‘small’ voters. It comprises three main parts. Part I is concerned with Penrose’s Limit Theorem (PLT). This research goes back to a presumption of L.S. Penrose concerning an asymptotic property of

  17. Ciguatera: the detection of neurotoxins in carnivorous reef fish from ...

    African Journals Online (AJOL)

    Two barracuda and one snapper tested positive for a sodium-channel activator, i.e. presumptive ciguatoxin, in the N2a assay. LC/MS analyses showed that only these three samples contained high-intensity peaks, with masses of 1 222 amu and 1 279 amu. These results represent the first analytical report indicating the ...

  18. Mutiny by Mutation: Uses of Neoteny in Science Fiction

    Science.gov (United States)

    Honeyman, Susan

    2004-01-01

    Developmentalism and Romanticism represent contrary poles in an absolutist dichotomy that frames most Western discourse on childhood. This opposition is generally recognized in current childhood studies but the former discourse still dominates institutional practices. Both views, however, rely on similar presumptions--that development is a linear…

  19. Laryngeal obstruction caused by lymphoma in an adult dairy cow

    OpenAIRE

    Lardé, Hélène; Nichols, Sylvain; Babkine, Marie; Chénier, Sonia

    2014-01-01

    A Holstein cow was presented for inspiratory dyspnea. Endoscopic evaluation revealed swollen arytenoids and a presumptive diagnosis of bilateral arytenoidal chondritis was made. A partial arytenoidectomy was performed, the right arytenoid was submitted for histopathology, and a diagnosis of laryngeal lymphoma was made. Due to the poor prognosis, the cow was euthanized.

  20. CASE REVIEW (Labor Law) | Fassil | Haramaya Law Review

    African Journals Online (AJOL)

    The author argues that the very purpose of the 'presumption of indefinite period engagement', i.e. job security, should be given effect. More importantly, employers shall not be given discretion to abuse their right to recruit for 'definite period' under the guise of project work refuting the protective purpose of the labour law.

  1. Acute appendicitis: An overview | Saidi | East African Medical Journal

    African Journals Online (AJOL)

    Objective: To provide an overview of the changing epidemiology of acute appendicitis in the developed and developing countries and the presumptive reasons. Data source: Major published series of the last two decades were reviewed using Medline Search and Index Medicus. The myriad of diagnostic approaches ...

  2. [COMPLICATED AMOEBIC APENDICITIS.REPORT OF A CASE

    Science.gov (United States)

    Casavilca Zambrano, Sandro; Gomez Anchante, Victor; Cisneros Gallegos, Eduardo

    2000-01-01

    We report a case of acute abdomen that is operated with the presumptive diagnosis of complicated acute appendicitis. In the histologic examination we make the diagnosis of complicated amoebic appendicitis. We discuss clinical manifestations and histopathologic findings of this unusual presentation of amoebic infection.

  3. 26 CFR 1.897-2 - United States real property holding corporations.

    Science.gov (United States)

    2010-04-01

    ... solely as a creditor (as defined in § 1.897-1(d)) in real property (as defined in § 1.897-(b)) that is... purposes of this paragraph (b)(2)(ii), an entity need not keep all of its books in accordance with U.S.... (iii) Denial of presumption. If the Internal Revenue Service determines, on the basis of information as...

  4. Biodiversity of predominant Bacillus isolated from afitin, iru and ...

    African Journals Online (AJOL)

    Two hundred (200) presumptive isolates of Bacillus collected at different fermentation time from spontaneous fermented samples of afitin, iru and sonru produced in three different regions of Benin were identified at species and strains levels. ITS-PCR-RFLP revealed that 79% of the isolates were really identified as Bacillus, ...

  5. Tuberculosis case finding and mortality prediction

    DEFF Research Database (Denmark)

    Rudolf, F; Wagner, A-J; Back, F M

    2017-01-01

    SETTING: A suburban area of Bissau, the capital of Guinea-Bissau; the study was conducted among presumptive pulmonary tuberculosis (prePTB) patients seeking medical care for signs and symptoms suggestive of PTB. OBJECTIVE: To determine if a clinical TB score and a biomarker suPAR (soluble urokinase...

  6. WAJM 29(2) LATEST.pmd

    African Journals Online (AJOL)

    user1

    radiologic demonstration (using Computed Tomography or. Magnetic Resonance Imaging) of ring-enhanced multiple or single focal intracranial lesions in the presence of immunosuppression and prompt response to presumptive therapy are diagnostic in the absence of histological facilities. The rarity of toxoplasma lesions ...

  7. TB diagnostic process management of patients in a referral hospital in Mozambique in comparison with the 2007 WHO recommendations for the diagnosis of smear-negative pulmonary TB and extrapulmonary TB

    NARCIS (Netherlands)

    Bos, Jeannet C.; Smalbraak, Lisette; Macome, Augusto C.; Gomes, Ermelinda; van Leth, Frank; Prins, Jan M.

    2013-01-01

    In sub-Saharan African countries, the high proportion of smear-negative pulmonary TB (SNTB) and extrapulmonary TB (EPTB) contributes to a delay in TB diagnosis and treatment. We evaluated the TB diagnostic process of adult patients with presumptive TB in a referral hospital in Mozambique according

  8. Texts as Mirrors, Texts as Windows: Black Adolescent Boys and the Complexities of Textual Relevance

    Science.gov (United States)

    Sciurba, Katie

    2015-01-01

    Discussions of culturally relevant and "boy" literature stress the importance of offering readers occasions to see themselves in texts. However, young men of color have had few opportunities within this discourse to reveal their own experiences with literature. Rather than make presumptions about how texts serve as mirrors to them, as…

  9. 76 FR 53404 - Initiation of Antidumping and Countervailing Duty Administrative Reviews and Requests for...

    Science.gov (United States)

    2011-08-26

    ... economy (``NME'') countries, the Department begins with a rebuttable presumption that all companies within..., Ltd. Wuxi Juhua Import/Export Co., Ltd. Well Forge Industries Circular Welded Carbon Quality Steel... Pastificio Tomasello, S.p.A. The People's Republic of China: Circular Welded 1/1/10-12/31/10 Carbon Quality...

  10. 75 FR 22107 - Initiation of Antidumping and Countervailing Duty Administrative Reviews and Request for...

    Science.gov (United States)

    2010-04-27

    ...-market economy (``NME'') countries, the Department begins with a rebuttable presumption that all...: Circular Welded Carbon Steel Pipe and Tube A-549- 3/1/09-2/28/10 502 Saha Thai Steel Pipe Company, Ltd. The... Products Company Limited Circular Welded Austenitic Stainless Pressure 9/5/08--2/28/10 Pipe \\4\\ A-570-930...

  11. Music Therapy as a Caring Intervention: Swedish Musicians Learning a New Professional Field

    Science.gov (United States)

    Petersson, Gunnar; Nystrom, Maria

    2011-01-01

    The question of competence in providing music therapy has rarely been the focus of interest in empirical research, as most music therapy research aims at measuring outcomes. Therefore, the aim of this study is to analyse and describe musicians' learning processes when they study music therapy as a caring intervention. An initial presumption is…

  12. British degrees made in Hong Kong: an inquiry into the role of space and place in transnational education

    NARCIS (Netherlands)

    Leung, W.H.M.; Waters, J.L.

    2013-01-01

    The fundamental logic of transnational education programmes is a one-to-one transfer of institutional capital across space and an unimportance of place. This article interrogates these presumptions and argues that space and place play an important role in transnational education. Drawing on

  13. Rocuronium and sugammadex: An alternative to succinylcholine for electro convulsive therapy in patients with suspected neuroleptic malignant syndrome.

    LENUS (Irish Health Repository)

    Ramamoorthy, Karthik G

    2012-01-31

    We report a case of presumptive neuroleptic malignant syndrome requiring muscle relaxation for electro-convulsive therapy. short acting muscle relaxation without the use of succinylcholine was achieved using rocvronivm reversed with the novel reversal agent sugammadex. We suggest that this combination is a safe and effective alternative to succinylcholine in such cases.

  14. The histone H5 variant in Xenopus laevis

    NARCIS (Netherlands)

    Moorman, A. F.; de Boer, P. A.; Linders, M. T.; Charles, R.

    1984-01-01

    The presumptive histone H5 of Xenopus laevis has been characterized by SDS and acid-urea-Triton polyacrylamide gel electrophoresis and compared with chicken histone H5. Chicken H5 has a lower electrophoretic mobility compared to that of Xenopus H5 in both gel systems. It is shown, using a polyclonal

  15. 27 CFR 53.2 - Attachment of tax.

    Science.gov (United States)

    2010-04-01

    ... passes is dependent upon the intention of the parties as gathered from the contract of sale and the attendant circumstances. In the absence of expressed intention, the legal rules of presumption followed in... sale on credit, the tax attaches whether or not the purchase price is actually collected. (d) Where a...

  16. Are Rights Finally Becoming Fundamental?

    OpenAIRE

    Kristina Nordlander; Patrick Harrison

    2012-01-01

    The EU’s forthcoming direct accession to the ECHR gives the ECtHR and the EU courts the perfect opportunity to find that competition law proceedings must fully respect the fair trial rights and presumption of innocence. Kristina Nordlander & Patrick Harrison (Sidley Austin)

  17. Cloning and characterization of a thermostable 2- deoxy-D-ribose-5 ...

    African Journals Online (AJOL)

    Analysis of the presumptive 2-deoxy-D-ribose 5-phosphate aldolase gene from Aciduliprofundum boonei revealed an open reading frame (ORF) encoding 222 amino acids, which was subcloned and then expressed in Escherichia coli. The recombinant DERA protein was purified to apparent homogeneity. The enzyme ...

  18. Browse Title Index

    African Journals Online (AJOL)

    Items 1 - 50 of 109 ... Vol 5, No 2 (2005), Achromobacter xylosoxidans bacteriaemia in a patient with myocarditis and lobar pneumonia, Abstract ... Vol 4, No 1 (2004), Accessibility of Insecticide Treated Bed Nets and Intermittent Presumptive Treatment of Malaria to Mozambicans obtaining Healthcare in Southern Malawi: A ...

  19. 76 FR 28689 - Microbiology Devices; Classification of In Vitro Diagnostic Device for Bacillus Species Detection

    Science.gov (United States)

    2011-05-18

    ... reagents) are used to microscopically visualize specific binding with cultured bacteria. Gram positive rods with capsules that fluoresce is presumptive evidence for identification of B. anthracis and must be... inaccurate epidemiological information on the presence of anthrax disease in a community. A false negative...

  20. 76 FR 29814 - Statutory Debarment and Reinstatement of BAE Systems plc

    Science.gov (United States)

    2011-05-23

    .... These non-U.S. subsidiaries are: BAE Systems CS&S International, Red Diamond Trading Ltd., and Poseidon...- U.S. subsidiaries: BAE Systems CS&S International, Red Diamond Trading Ltd., and Poseidon Trading... will be an initial presumption of denial for all applications for licenses and other approvals...

  1. Burdens and Standards of Proof in Possession of Unexplained ...

    African Journals Online (AJOL)

    Worku_Y

    Fight against Public Corruption: Identifying the Elements of the Offence under the. Criminal Code of Ethiopia' in ..... of evidential presumption has the effect of transferring or “shifting” evidential burden in respect of the fifth ... under the direct or indirect possession of the accused public servant is a result of some illegal or illicit ...

  2. 20 CFR 410.401 - Scope of subpart D.

    Science.gov (United States)

    2010-04-01

    ...-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.401 Scope of subpart... of his death, or whether his death was due to pneumoconiosis. (b) Pneumoconiosis defined... basis for application of the statutory presumption of disability or death due to pneumoconiosis under...

  3. The Principal and Student Expression: From Armbands to Tatoos.

    Science.gov (United States)

    McCarthy, Martha M.

    1998-01-01

    Since the mid-1980s, judicial decisions have broadened school authorities' discretion to restrict student expression (in oral and written communications, grooming, and attire). The category of protected student expression has eroded. Despite replacement of the "Tinker" presumption favoring student expression with one favoring validity of…

  4. Effect of inulin and probiotic bacteria on growth, survival, immune ...

    African Journals Online (AJOL)

    The effect of inulin and probiotic bacteria on the growth, survival, immune response and viral prevalence of white spot syndrome virus (WSSV) in white shrimp was evaluated. Presumptive bacilli and lactic acid bacteria (LAB) were characterized for hemolytic and enzymatic activity, hydrophobicity and antagonism against ...

  5. Central vestibular syndrome in a red fox ( Vulpes vulpes ) with ...

    African Journals Online (AJOL)

    Central vestibular syndrome in a red fox ( Vulpes vulpes ) with presumptive right caudal cerebral artery ischemic infarct and prevalent midbrain involvement. ... A wild young male red fox (Vulpes vulpes) was found in the mountainous hinterland of Rome (Italy) with a heavily depressed mental status and unresponsive to the ...

  6. Low hepcidin levels in severely anemic malawian children with high incidence of infectious diseases and bone marrow iron deficiency

    NARCIS (Netherlands)

    Jonker, Femkje A. M.; Calis, Job C. J.; Phiri, Kamija; Kraaijenhagen, Rob J.; Brabin, Bernard J.; Faragher, Brian; Wiegerinck, Erwin T.; Tjalsma, Harold; Swinkels, Dorine W.; van Hensbroek, Michael Boele

    2013-01-01

    A reliable diagnostic biomarker of iron status is required for severely anemic children living in malarious areas because presumptive treatment with iron may increase their infection risk if they are not iron deficient. Current biomarkers are limited because they are altered by host inflammation. In

  7. Low hepcidin levels in severely anemic malawian children with high incidence of infectious diseases and bone marrow iron deficiency

    NARCIS (Netherlands)

    Jonker, F.A.; Calis, J.C.; Phiri, K.; Kraaijenhagen, R.J.; Brabin, B.J.; Faragher, B.; Wiegerinck, E.T.G.; Tjalsma, H.; Swinkels, D.W.; Hensbroek, M. Boele van

    2013-01-01

    INTRODUCTION: A reliable diagnostic biomarker of iron status is required for severely anemic children living in malarious areas because presumptive treatment with iron may increase their infection risk if they are not iron deficient. Current biomarkers are limited because they are altered by host

  8. The febrile parturient: choice of anesthesia

    African Journals Online (AJOL)

    QuickSilver

    FEVER: VIRAL ETIOLOGY IN PREGNANCY. Virus-associated symptoms in pregnancy are usually mild. The presumptive diagnosis can be made on the basis of epi- demiological findings or social contacts. Viruses most com- monly encountered in parturients include influenza virus, herpes simplex virus, hepatitis viruses, ...

  9. Download this PDF file

    African Journals Online (AJOL)

    Fr. Ikenga

    but only an accident at conception.21 Despite that, the presumption and research still maintain that males with this extra Y chromosome are predisposed to be violent criminals. 3. Crime, Mens Rea and Behavioural Genetics. A fundamental principle of criminal law is that apart from the physical element, actus reus, a crime.

  10. Volume 9 Number 2

    African Journals Online (AJOL)

    OLUWOLE

    standard curve was prepared with the absorbance values and the concentration of phosphate in the sample was extrapolated from the standard curve. Nitrate. Nitrate was determined by the spectrophotometric sodium ... plating presumptive positive samples on Mac. Conkay agar. Incubation was done at 350C for 48 h.

  11. The Client Company Marginally Utilises the Knowledge of Highly Skilled Temporary Staff

    Science.gov (United States)

    Augustsson, Gunnar

    2016-01-01

    This study is based on the presumption that there is often an underuse of temporary staff in client companies (CC) with highly skilled professionals. The study combines theories of the flexible organisation and a sociocultural perspective on learning within the framework of an inter-organisational context. The data are based partly on 17…

  12. 20 CFR 655.500 - Purpose, procedure and applicability of subparts F and G of this part.

    Science.gov (United States)

    2010-04-01

    ... automated self-unloading conveyor belt or vacuum-actuated system on a vessel and the Administrator has not... of the use of an automated self-unloading conveyor belt or vacuum-actuated system on a vessel. The... automated systems is the prevailing practice. In order to overcome such presumption, it must be shown by the...

  13. 50 CFR 14.4 - What terms do I have to understand?

    Science.gov (United States)

    2010-10-01

    ... zoological park, accredited institution of higher education, accredited member of the American Zoo and.../exporter/owner may rebut this presumption based upon the particular facts and circumstances of each case... varieties), and similar insects that are routinely farm raised. Other Invertebrates: Earthworms and similar...

  14. SAMJ FORUM

    African Journals Online (AJOL)

    out, in a paper in the New England Journal of Medicine in 2003, this could distract people from therapies which we know work in certain conditions. The idea behind race-specific therapy is a presumption that the frequencies of genetic variants that influence the efficacy of the drug are substantially different among races.

  15. Marek's disease in backyard chickens, a study of pathological findings and viral loads in tumorous and non-tumorous birds

    Science.gov (United States)

    Marek’s disease (MD) is a major cause of mortality in backyard chickens. The diagnosis of MD is complex, however, and knowledge on Marek’s disease virus (MDV) in spontaneous field cases such as in backyard chickens is largely unknown. Forty backyard chickens with presumptive MD diagnosis based on hi...

  16. Assessment of commercially packaged water for faecal bacterial ...

    African Journals Online (AJOL)

    Of the 48 sachet water analyzed, 2 (4.2%) were positive for Presumptive Coliform Count (PCC) with the first and second water samples showing a count of 160 MPN/l00mls and 30MPN/100mls respectively. All the bottled water analyzed were negative for PCC. Since the need for consumption of packaged water cannot be ...

  17. Correlates of Adolescent Assertiveness with HIV Avoidance in a Four-Nation Sample

    Science.gov (United States)

    Onuoha, Francis N.; Munakata, Tsunetsugu

    2005-01-01

    Adolescents are frequently admonished to be socially assertive in order to confront negative interpersonal peer influences. Since the advent of HIV/AIDS in human social chemistry, the admonition has become more critical than ever. But the warning is often proffered in the misguided presumption that social assertiveness is the all-required…

  18. An Interdisciplinary Guided Inquiry Laboratory for First Year Undergraduate Forensic Science Students

    Science.gov (United States)

    Cresswell, Sarah L.; Loughlin, Wendy A.

    2015-01-01

    An effective guided inquiry forensic case study (a pharmacy break-in) is described for first-year students. Four robust introductory forensic chemistry and biology experiments are used to analyze potential drug samples and determine the identity of a possible suspect. Students perform presumptive tests for blood on a "point of entry…

  19. International Journal of Health Research

    African Journals Online (AJOL)

    Erah

    2009-12-10

    Dec 10, 2009 ... The International Journal of Health Research is an online international journal allowing free unlimited access to abstract and full-text of ... research articles, 3,000 for technical notes, case reports, commentaries and short communications. ... College of Education (FCE) and presumptive typhoid fever patients ...

  20. 47 CFR 63.23 - Resale-based international common carriers.

    Science.gov (United States)

    2010-10-01

    ... presumption that they lack market power in particular foreign points are available on the International Bureau... 47 Telecommunication 3 2010-10-01 2010-10-01 false Resale-based international common carriers. 63... Supplements § 63.23 Resale-based international common carriers. The following conditions apply to carriers...

  1. The retina of Spalax ehrenbergi: novel histologic features supportive of a modified photosensory role.

    NARCIS (Netherlands)

    Cernuda-Cernuda, R.; Grip, W.J. de; Cooper, H.M.; Nevo, E.; Garcia-Fernandez, J.M.

    2002-01-01

    PURPOSE: The retina of the blind mole rat Spalax ehrenbergi was compared with other vertebrate photosensitive organs in an attempt to correlate its histologic organization with a presumptive nonvisual photoreceptor role. METHODS: The eyes of eight adult animals were analyzed by light and electron

  2. Sustainable natural resource use in rural China: Recent trends and policies

    NARCIS (Netherlands)

    Qu, F.; Kuyvenhoven, A.; Shi, X.; Heerink, N.

    2011-01-01

    In this paper we provide an overview of recent trends in the availability and quality of land and water resources in rural China, and examine the common presumption that rural resources are rapidly degrading in China. Data based on consistent definitions and measurement methods that have recently

  3. An improved predictive association rule based classifier using gain ...

    Indian Academy of Sciences (India)

    Abstract. Health care data diagnosis is a significant task that needs to be exe- cuted precisely, which requires much experience and domain-knowledge. Traditional symptoms-based disease diagnosis may perhaps lead to false presumptions. In recent times, Associative Classification (AC), the combination of association ...

  4. Elusive Sex Acts: Pleasure and Politics in Norwegian Sex Education

    Science.gov (United States)

    Svendsen, Stine H. Bang

    2012-01-01

    While there is little political opposition towards sex education as such in Norway, recent attempts at reforming the subject reveal underlying heteronormative presumptions that seem resistant to reform. While a focus on homosexuality is included in the national curriculum at all levels of compulsory education, the sexual practices involved in…

  5. Effects of social network on production output of maize farmers in ...

    African Journals Online (AJOL)

    Results of the two stage least square reveals the exogeneity of social capital. The existence of bi-directional causality between social capital and maize farmers' productivity indicated the absence of direction of cause-and-effect contrary to a common presumption and thus confirms the exogeneity of social capital. The study ...

  6. Including Leap Year in the Canonical Birthday Problem

    Science.gov (United States)

    Nandor, M. J.

    2004-01-01

    The greatest benefit of including leap year in the calculation is not to increase precision, but to show students that a problem can be solved without such presumption. A birthday problem is analyzed showing that calculating a leap-year birthday probability is not a frivolous computation.

  7. Replication of certain recently classified viruses in Toxorhynchites amboinensis mosquitoes and in mosquito and mammalian cell lines, with implications for their arthropod-borne status.

    Science.gov (United States)

    Zeller, H G; Mitchell, C J

    1989-01-01

    Thirty-one viruses recently placed in taxa were studied for their replication in Toxorhynchites amboinensis by intrathoracic inoculation. Results were compared to those obtained in vitro in mammal and insect cell cultures. These findings provide presumptive evidence for the association of eighteen of these viruses with arthropod vectors.

  8. 76 FR 12651 - Approval and Promulgation of Implementation Plans; State of Oregon; Regional Haze State...

    Science.gov (United States)

    2011-03-08

    ... visibility perceived by the human eye. Most people can detect a change in visibility at one deciview.\\8\\ \\8..., ammonia and volatile organic compounds). Atmospheric fine particulate reduces clarity, color, and visual... 2018. The presumptive NO X emission limit for utility boilers, like PGE Boardman boiler, is 0.23 lb/mm...

  9. The prognostic value of blood lactate levels relative to that of vital signs in the pre-hospital setting: A pilot study

    NARCIS (Netherlands)

    T.C. Jansen (Tim); J. van Bommel (Jasper); J.H. Rommes (Johannes Hans); S.J.M. Schieveld; J. Bakker (Jan); P.G.H. Mulder (Paul)

    2008-01-01

    textabstractIntroduction: A limitation of pre-hospital monitoring is that vital signs often do not change until a patient is in a critical stage. Blood lactate levels are suggested as a more sensitive parameter to evaluate a patient's condition. The aim of this pilot study was to find presumptive

  10. Screening of febrile children on Hospital admission for urinary tract ...

    African Journals Online (AJOL)

    Urinary tract infection (UTI) is one of the most often missed diagnosis in children in the tropics. This is because of the varied and similar presentation of UTI to other common illnesses. A total of 154 patients with various presumptive clinical diagnosis at admission were screened for the presence of UTI. Only 33 (21.4%) ...

  11. Non-tuberculosis mycobacteria: Trend of isolation rate and characteristics of NTM in Cambodia during 2011–2013

    Directory of Open Access Journals (Sweden)

    S Khann

    2015-01-01

    Conclusions: The isolation rate of NTM in Cambodia among presumptive MDR-TB patients was found to be remarkably high and increasing over the last 3 years and strongly correlated with the grade of smear result. Further studies and appropriate managements should be done for those patients.

  12. 76 FR 65315 - Agency Information Collection Activities: Proposed Request and Comment Request

    Science.gov (United States)

    2011-10-20

    ... writing to the above e-mail address. 1. Medical Report on Adult with Allegation of Human Immunodeficiency... applying for Supplemental Security Income (SSI) disability benefits, meets the requirements for presumptive.... Type of Request: Revision of an OMB-approved information collection. Average burden Estimated total...

  13. Competence: Commodification of Human Ability

    Science.gov (United States)

    Han, Soonghee

    2008-01-01

    The purpose of this article is to analyze the meaning and presumptions of competence in the concrete context of knowledge capitalism. First, the nature of competence as a "commodification of human ability" that obtains a standardized monetary value to sell in the labor market, is elucidated by applying Karl Marx's critical theory. Second, it is…

  14. Colorectal cancer presenting as tuboovarian abscess in a 40 year old patient with previous tubal occlusion

    Directory of Open Access Journals (Sweden)

    Joy Anderson

    2016-01-01

    Conclusion: Tuboovarian abscess is rare after tubal occlusion. These patients should be evaluated specifically for nongynecologic etiology, including colorectal cancer. Radiologic studies can be misleading, and surgical exploration should be strongly considered if a woman with a history of tubal occlusion presents with a presumptive tuboovarian abscess, particularly if the abscess contains air.

  15. A protege plug-in for defeasible reasoning

    CSIR Research Space (South Africa)

    Moodley, K

    2012-06-01

    Full Text Available and are both rooted in the notion of Rational Closure developed by Lehmann and Magidor for the propositional case. Here we recast their definitions in a defeasible DL context and define algorithms for prototypical and presumptive reasoning in defeasible DL...

  16. Sustainable natural resource use in rural China: Trends and policies

    NARCIS (Netherlands)

    Qu, F.; Kuyvenhoven, A.; Shi, X.; Heerink, N.

    2010-01-01

    In this paper we provide an overview of recent trends in the availability and quality of land and water resources in rural China, and examine the common presumption that rural resources are rapidly degrading in China. Data based on consistent definitions and measurement methods that have recently

  17. Adoption and validation of Ribonucleotide Reductase (RNR)-based real-time assays for detection of HLB ‘Candidatus Liberibacter asiaticus’ (CLas)

    Science.gov (United States)

    Huanglongbing (HLB), aka Citrus Greening, is a well-known destructive disease that threatens the multi-billion dollar citrus industry in the United States and citrus production in other countries around the world. The presumptive causal agent of HLB, ‘Candidatus Liberibacter asiaticus' (CLas), is of...

  18. Impact of radical nephrectomy on renal functional outcome in ...

    African Journals Online (AJOL)

    H.H. Qureshi

    2015-10-09

    Oct 9, 2015 ... on the presumption by most urologists that RN provided the excel- lent cancer control with little effect on the overall renal function. Most of the functional studies in the past used either serum creati- nine or calculated or estimated glomerular filtration rate (eGFR) for measurement of the kidney function.

  19. preparation and nucleophilic substitution of the 2,4,6

    African Journals Online (AJOL)

    Mgina

    pyridinium salt 3 during preparation or could be the consequence of the nucleophilic substitution reaction. In case of the first presumption, racemization of 3 might have happened via acid mediated tautomerization of the vinylogous compound 5 , an intermediate formed during preparation of the triphenylpyridinium salt ...

  20. 8 CFR 241.13 - Determination of whether there is a significant likelihood of removing a detained alien in the...

    Science.gov (United States)

    2010-01-01

    ... of this chapter; (ii) Aliens subject to a final order of removal who are still within the removal... Service is continuing its efforts to remove the alien, there is no presumptive period of time within which... significant likelihood of removing a detained alien in the reasonably foreseeable future. 241.13 Section 241...

  1. Group Work Management in the Classroom

    Science.gov (United States)

    Forslund Frykedal, Karin; Hammar Chiriac, Eva

    2014-01-01

    This study aims to provide a better understanding of teachers' managing roles when using group work in the classroom. Building on Granström's 2 concepts of leadership and teachership, a more specific aim is to investigate teachers' managing roles when using group work and how teachers' presumptions affect the way in which they manage the…

  2. A comparison of three methods for the isolation of Arcobacter spp. from retail raw poultry in Northern Ireland

    DEFF Research Database (Denmark)

    Scullion, R.; Harrington, C. S.; Madden, R. H.

    2004-01-01

    in a charcoal-based broth containing two antibiotics. Retail poultry samples (n = 50) were obtained from supermarkets in Northern Ireland; the European Community license number was recorded to ensure sample diversity. Presumptive arcobacters were identified using genus-specific and species-specific primers...

  3. Peer Mentoring in Higher Education: Issues of Power and Control

    Science.gov (United States)

    Christie, Hazel

    2014-01-01

    In response to widespread support for mentoring schemes in higher education this article calls for a more critical investigation of the dynamics of power and control, which are intrinsic to the mentoring process, and questions presumptions that mentoring brings only positive benefits to its participants. It provides this more critical appraisal by…

  4. 30 CFR 938.15 - Approval of Pennsylvania regulatory program amendments.

    Science.gov (United States)

    2010-07-01

    .../description April 26, 1983, May 12, 1983 October 5, 1983 Bureau of Water Quality Management Underground Mine... water supply system,” “rebuttable presumption area,” “underground mining,” “underground mining... amendments. 938.15 Section 938.15 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT...

  5. Characterization of two novel nuclear BTB/POZ domain zinc finger isoforms. Association with differentiation of hippocampal neurons, cerebellar granule cells, and macroglia

    DEFF Research Database (Denmark)

    Mitchelmore, Cathy; Kjaerulff, Karen M; Pedersen, Hans C

    2002-01-01

    progenitors as well as in differentiated glia. During embryonic development of the murine cerebral cortex, HOF expression is restricted to the hippocampal subdivision. Expression coincides with early differentiation of presumptive CA1 and CA3 pyramidal neurons and dentate gyrus granule cells, with a sharp...

  6. Antibiotic susceptibilities of Salmonella species prevalent among ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    2016-03-21

    Mar 21, 2016 ... using culture technique. Presumptively positive isolates were further screened biochemically and serologically, using MicrogenTM ...... Aetiology of acute infantile diarrhoea in the south-Eastern Nigeria: An assessment of microbiological and antibiotic sensitivity profile. Internet J. Third. World. Med. 2008;7(1).

  7. 26 CFR 1.6015-3 - Allocation of deficiency for individuals who are no longer married, are legally separated, or are...

    Science.gov (United States)

    2010-04-01

    ... had no knowledge ($600) is valid. Example 6. Disqualified asset presumption. (i) H and W are divorced...) Actual knowledge—(i) In general. If, under section 6015(c)(3)(C), the Secretary demonstrates that, at the time the return was signed, the requesting spouse had actual knowledge of an erroneous item that is...

  8. Trans-activation of an artificial dTam3 transposable element in transgenic tobacco plants

    NARCIS (Netherlands)

    Haring, Michel A.; Teeuwen-de Vroomen, Marianne J.; Nijkamp, H. John J.; Hille, Jacques

    1991-01-01

    In Antirrhinum majus only autonomous Tam3 transposons have been characterized. We investigated whether an artificial dTam3 element, with a deletion in the presumptive transposase coding region, can be trans-activated in tobacco by an activator Tam3 element, which was immobilized by the deletion of

  9. Therapeutic Handling of Marital Infidelity

    Science.gov (United States)

    Peck, Bruce B.

    1975-01-01

    Marital infidelity has two primary dimensions--on overt social-cultural facade and a covert, intense, emotional component. A therapy strategy, based on this formulation and on the presumption that both spouses were equally responsible for the marital fracture, is presented. (Author)

  10. Diagnosis of pulmonary pneumocystosis by microscopy on wet mount preparations

    Directory of Open Access Journals (Sweden)

    BAVA Amadeo Javier

    2002-01-01

    Full Text Available We have compared the searching of the presence of "honeycomb" structures by direct microscopy on wet mount preparations with the direct immunofluorescence (DIF for the diagnosis of Pneumocystis carinii pneumonia (PCP in 115 bronchoalveolar (BAL fluids. The samples belonged to 115 AIDS patients; 87 with presumptive diagnosis of PCP and 28 with presumptive diagnosis other than PCP. The obtained results were coincident in 114 out of 115 studied samples (27 were positive and 87 negative with both techniques. A higher percentage of positive results (32.18% among patients with presumptive diagnosis of PCP with respect to those with presumptive diagnosis other than PCP (3.57% was observed. One BAL fluid was positive only with DIF, showed scarce and isolated P. carinii elements and absence of typical "honeycomb" structures. The searching for "honeycomb" structures by direct microscopy on wet mount preparations could be considered as a cheap and rapid alternative for diagnosis of PCP when other techniques are not available or as screening test for DIF. This method showed a sensitivity close to DIF when it was applied to BAL fluids of AIDS patients with poor clinical condition and it was performed by an experienced microscopist.

  11. Shoreline vegetation distribution in relation to wave exposure and bay characteristics in a tropical great lake, Lake Victoria

    NARCIS (Netherlands)

    Azza, N.; Van de Koppel, J.; Denny, P.; Kansiime, F.

    2007-01-01

    We investigated the presumption that wind-wave exposure is a major regulator of vegetation distribution within lakes. Along a 675-km stretch of shore in northern Lake Victoria (Uganda), the pattern of vegetation distribution in relation to shoreline features, and the variation of shoreline swamp

  12. 77 FR 47514 - Management Contracts-Background Investigations

    Science.gov (United States)

    2012-08-09

    ... rebuttable presumption that ``a tribe, a wholly owned tribal entity, national bank or institutional investor..., employment, investment, productivity, innovation, or the ability of the enterprises, to compete with foreign based enterprises. Unfunded Mandate Reform Act The Commission, as an independent regulatory agency, is...

  13. Gender differences and effect of photophase on Asian citrus psyllid (Diaphorina citri Kuwayama) feeding behavior

    Science.gov (United States)

    Asian citrus psyllid, Diaphorina citri Kuwayama (Hemiptera: Psyllidae), thought to be primarily a phloem-feeding insect, transmits the presumptive pathogen for Huanglongbing, ‘Candidatus Liberibacter asiaticus’. Because this bacterium is restricted to the phloem and bacterial transmission is the res...

  14. How Do Local Governments Decide on Public Policy in Fiscal Federalism?

    DEFF Research Database (Denmark)

    Köthenbürger, Marko

    2008-01-01

    decide on public policy. Unlike the presumption, the paper shows that local governments may choose to optimize over expenditures. The result most notably prevails when federal policy subsidizes local fiscal effort. The results offer a new perspective of the efficiency implications of federal policy...

  15. How do local governments decide on public policy in fiscal federalism?

    DEFF Research Database (Denmark)

    Köthenbürger, Marko

    2011-01-01

    decide on public policy. Unlike the usual presumption, the paper shows that local governments may choose to optimize over expenditures. The result holds when federal policy subsidizes local taxation. The results offer a new perspective of the efficiency implications of federal policy toward local...

  16. Use of Whole-Genome Sequencing to Link Burkholderia pseudomallei from Air Sampling to Mediastinal Melioidosis, Australia.

    Science.gov (United States)

    Currie, Bart J; Price, Erin P; Mayo, Mark; Kaestli, Mirjam; Theobald, Vanessa; Harrington, Ian; Harrington, Glenda; Sarovich, Derek S

    2015-11-01

    The frequency with which melioidosis results from inhalation rather than percutaneous inoculation or ingestion is unknown. We recovered Burkholderia pseudomallei from air samples at the residence of a patient with presumptive inhalational melioidosis and used whole-genome sequencing to link the environmental bacteria to B. pseudomallei recovered from the patient.

  17. Use of Whole-Genome Sequencing to Link Burkholderia pseudomallei from Air Sampling to Mediastinal Melioidosis, Australia

    OpenAIRE

    Currie, Bart J.; Price, Erin P.; Mayo, Mark; Kaestli, Mirjam; Theobald, Vanessa; Harrington, Ian; Harrington, Glenda; Sarovich, Derek S.

    2015-01-01

    The frequency with which melioidosis results from inhalation rather than percutaneous inoculation or ingestion is unknown. We recovered Burkholderia pseudomallei from air samples at the residence of a patient with presumptive inhalational melioidosis and used whole-genome sequencing to link the environmental bacteria to B. pseudomallei recovered from the patient.

  18. 76 FR 16703 - Small Business Jobs Act Tour: Selected Provisions Having an Effect on Government Contracting

    Science.gov (United States)

    2011-03-25

    ... for each individual socioeconomic group? I. Presumption of Loss/Misrepresentation and Annual...., Albuquerque, NM 87102. San Diego, CA April 11, 2011, County Health Begins 9 a.m., Services Complex, Ends 4:15.... Washington, DC TBD TBD. IV. Registration and Oral Presentation Any individual interested in attending and...

  19. Prevalence and antimicrobial profiles of Salmonella serovars from ...

    African Journals Online (AJOL)

    were collected from five different farms and Maiduguri central market from May to August, 2009. Presumptive Salmonella isolates were determined by using the conventional biochemical tests, Serovars were confirmed by serotyping, using slide agglutination technique. Antimicrobial susceptibility test was performed with 17 ...

  20. Frequency and characteristics of battered child syndrome in patients on a paediatric burns unit: A clinical case review

    Directory of Open Access Journals (Sweden)

    M. Gil-Vargas

    2017-07-01

    Conclusions: Having knowledge of and being able to identify battered child syndrome may prevent fatal injuries. It is important to equip healthcare staff on first-contact care units with the knowledge to establish a presumptive diagnosis of child/adolescent abuse. Only through proper investigation of social events may just solutions be sought and implemented.

  1. Microbiological quality of packaged bottled water and public water ...

    African Journals Online (AJOL)

    Bacteriological assessment of five samples of bottled water marketed in Ibadan, Nigeria and same number of public tap water supply (other wise called tap water) in Ibadan city was carried out. The samples were tested for bacterial cells counts, presumptive coliform count and the isolates were characterised using selective ...

  2. Comparison of Rapid Diagnostic Tests and Microscopy for Malaria ...

    African Journals Online (AJOL)

    Presumptive treatment of malaria results in significant overuse of antimalarials. This study compared the diagnostic accuracy of Histidine Rich Protein II and plasmodium lactate dehydrogenase (pLDH)-based Rapid Kits( RDTs)and using expert microscopy as the gold standard for the detection of falciparum and ...

  3. Comparison of Rapid Diagnostic Tests and Microscopy for Malaria

    African Journals Online (AJOL)

    boaz

    Presumptive treatment of malaria results in significant overuse of antimalarials. This study compared the diagnostic accuracy of. Histidine Rich Protein II and plasmodium lactate dehydrogenase (pLDH)-based Rapid Kits( RDTs)and using expert microscopy as the gold standard for the detection of falciparum and ...

  4. Article

    African Journals Online (AJOL)

    2009-06-12

    Jun 12, 2009 ... sexual intercourse. What is not clear, however, is whether gametes outside the human body may only be used for medical or dental purposes, or whether this section only .... has been expressed regarding the role of the presumptions in ..... ticulates it as follows in National Coalition for Gay and Lesbian.

  5. Conditional political budget cycles : a review of recent evidence

    NARCIS (Netherlands)

    de Haan, J.; Klomp, J.G.

    2013-01-01

    Until recently, most research on political budget cycles was based on the (often implicit) presumption that these cycles do not differ across countries. However, more recent studies focus on heterogeneity. This paper surveys studies examining the factors conditioning the occurrence and strength of

  6. Factors governing the removal of faecal indicator bacteria in the ...

    African Journals Online (AJOL)

    Persistence of faecal coliforms, presumptive Vibrio cholerae and Vibrio parahaemolyticus at three stations in Lake Timsah were investigated in 2010. Samples were collected by day and at night. Bacterial counts were highest at the outlet of wastewater discharged into the lake (Station 1). As wastewater mixed with the lake ...

  7. Amodiaquine-associated adverse effects after inadvertent overdose and after a standard therapeutic dose

    DEFF Research Database (Denmark)

    Adjei, G O; Goka, B Q; Rodrigues, O P

    2009-01-01

    A case of an acute dystonic reaction in a child presumptively treated for malaria with amodiaquine, and a case of persistent asymptomatic bradycardia in another child with mild pulmonary stenosis treated with a standard dose of amodiaquine for parasitologically confirmed uncomplicated malaria, is...

  8. 32 CFR 718.1 - General provisions.

    Science.gov (United States)

    2010-07-01

    ... conclusively the death of any person is received in the department, action shall be taken thereon as an official report of death, notwithstanding any prior action relating to death or other status of such person... presumptive death is made by the Secretary of the Navy when a survey of all available sources of information...

  9. Nematode development after removal of egg cytoplasm: absence of localized unbound determinants.

    Science.gov (United States)

    Laufer, J S; von Ehrenstein, G

    1981-01-23

    Embryos of Caenorhabditis elegans develop into fertile adults after cell fragments, containing presumptive cytoplasm of somatic and germ line precursors, are extruded from uncleaved eggs or early blastomeres through laser-induced holes in the eggshells. This suggests that the determinate development of this worm is not dependent on the prelocalization of determinants in specific regions of the egg cytoplasm.

  10. Elastofibroma dorsi: MRI diagnosis in a young girl

    International Nuclear Information System (INIS)

    Devaney, D.; Livesley, P.; Shaw, D.

    1995-01-01

    With indications for computerised imaging expanding, elastofibroma dorsi will probably be seen more frequently. This report describes an elastofibroma presenting in an 11-year-old girl and its appearance by magnetic resonance imaging. Presumptive diagnosis by magnetic resonance imaging may prevent unnecessary radical surgery. (orig.)

  11. Elastofibroma dorsi: MRI diagnosis in a young girl

    Energy Technology Data Exchange (ETDEWEB)

    Devaney, D. [Dept. of Histopathology, Hospital for Sick Children, London (United Kingdom); Livesley, P. [Dept. of Orthopaedics, Hospital for Sick Children, London (United Kingdom); Shaw, D. [Dept. of Paediatric Radiology, Hospital for Sick Children, London (United Kingdom)

    1995-06-01

    With indications for computerised imaging expanding, elastofibroma dorsi will probably be seen more frequently. This report describes an elastofibroma presenting in an 11-year-old girl and its appearance by magnetic resonance imaging. Presumptive diagnosis by magnetic resonance imaging may prevent unnecessary radical surgery. (orig.)

  12. Case Report on Primary Intratesticular Leiomyosarcoma of the ...

    African Journals Online (AJOL)

    Administrator

    The rest of the organs were normal. The patient underwent uncomplicated radical inguinal Orchidectomy with the presumptive diagnosis of intratesticular tumor. ... they don't show such evidence. Abdominal ultrasound is not sensitive enough to pick up retroperitoneal metastasis hence a CT scan is mandatory in patients ...

  13. Evaluation of phenotypic tests to detect carbapenem-resistant Enterobacteriaceae in colonized patients hospitalized in intensive care units

    Directory of Open Access Journals (Sweden)

    Leandro Reus Rodrigues Perez

    2015-07-01

    It is important to state that combined-disk test with phenylboronic acid is not suitable for bacterial identification/isolation. Conversely, selective/chromogenic agar after 48h of incubation showed to be a useful tool, with the advantage of presumptive bacterial identification.

  14. The blameworthiness of health and safety rule violations

    NARCIS (Netherlands)

    P. Mascini (Peter)

    2006-01-01

    textabstractMan-made disasters usually lead to the tightening of safety regulations, because rule breaking is seen as a major cause of them. This reaction is based on the presumptions that the safety rules are good and that the rule-breakers are wrong. The reasons the personnel of a coke factory

  15. Konflikter og vektorbårne sygdomme

    DEFF Research Database (Denmark)

    Bygbjerg, Ib

    2010-01-01

    Based on literature and personal experiences, vector-borne diseases and conflicts are reviewed. Simple rapid diagnostic tests for three important parasitoses are available. Resort is often made to case definitions and to presumptive treatment. Resistance is an emerging problem. Vaccines are still...

  16. Comparison of ViTEK 2, MALDI-TOF and Partial Sequencing of 16S ...

    African Journals Online (AJOL)

    Methods – Ten Brevibacterium spp. were presumptively identified from staphylococci collections due to their characteristic cheesy smell. The selected isolates were identified by MALDI TOF, Vitek 2 identification system and partial sequencing of 16S rRNA gene by standard procedures. The antibiotic susceptibility was ...

  17. The Evolution of the Combined Allied Headquarters in the North African Theater of Operations from 1942 to 1943

    Science.gov (United States)

    2015-05-21

    established US Fifth Army. General Marshall, concerned about a threat from a technically neutral Spain, but sympathetic to Hitler, insisted the new army...to be guided by General Marshall in his role of heir presumptive. He was naturally unable to be didactic on the point, but he left no doubt as to

  18. Learning through Civic Participation: Policy Actors' Perspectives on Curriculum Reform Involvement in Ontario

    Science.gov (United States)

    Pinto, Laura Elizabeth

    2014-01-01

    When citizens participate in policy production, the advantages go beyond policy outcomes--though the presumption is that participation leads to better public policy. Robust democracy characterized by agonistic exchanges among policy actors ought to encourage learning, dialogue, empow­erment, equity, and a shared spirit of inquiry. This article…

  19. Basement membrane proteoglycans and development

    DEFF Research Database (Denmark)

    Couchman, J R; Abrahamson, D R; McCarthy, K J

    1993-01-01

    -CSPG was only strongly expressed in the vasculature invading late comma stage glomeruli, and later in presumptive and mature Bowman's capsule. Over the first six to eight weeks, the capillary basement membranes contained BM-CSPG, but in gradually decreasing amounts until it became completely undetectable...

  20. Tuberculosis mimicking lung cancer

    Directory of Open Access Journals (Sweden)

    I. Hammen

    2015-01-01

    Our case report presents two patients, who were referred to the Thorax diagnostic centre at the Department of Respiratory Medicine, Odense University Hospital, with presumptive diagnosis of neoplasm and had proved lung TB with no evidence of malignancy instead. In the first case diagnosis was confirmed after thoracotomy, in the second case after bronchoscopy.

  1. Email: pattuquayefio@ug.edu.gh

    African Journals Online (AJOL)

    Apusigah

    defined as an assurance of physical and economic access to basic food at all times, while the ... ethnic violence, while Political Security is identified as an assurance that people live in a society that honors their basic ..... presumption is that for such societies, other concerns apart from internal violence such as food rationing ...

  2. Democracy, Religion and Secularism: Reflections on the Public Role of Religion in a Modern Society

    Science.gov (United States)

    Watson, Brenda

    2011-01-01

    The present article focuses on the relationship between democracy and secularism and, in particular, the presumption that a secularist approach is the most practical solution to the problem of pluralism of beliefs. It raises the question of how far those countries in the West which claim to be democratic are justified in the way that they treat…

  3. Leaders in the Crucible: The Moral Voice of College Presidents.

    Science.gov (United States)

    Nelson, Stephen James

    The stories about college presidents in this volume are intended to support the presumption that moral leadership is a fundamental criterion and expectation of those who serve as college presidents. The chapters are: (1) "The Moral Leadership of College Presidents"; (2) "Presidential Perspectives: The Shape of Their Voice"; (3) "Architects of the…

  4. The University of Texas Health Science Center at Houston

    African Journals Online (AJOL)

    Adebimpe Oyeyemi

    A general presumption is that the quality of education provided in a training ... practice and teaching (Boyer, 1990; Graves, 1992; Evans,. 1994). ... restoration, and the promotion of general health and quality of life. Among academics, research publication is critical for promotion and tenure, and is often the sole yardstick for.

  5. 20 CFR 718.303 - Death from a respirable disease.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Death from a respirable disease. 718.303... from a respirable disease. (a)(1) If a deceased miner was employed for ten or more years in one or more coal mines and died from a respirable disease, there shall be a rebuttable presumption that his or her...

  6. Crime and German Decadence

    DEFF Research Database (Denmark)

    Hansen, Kim Toft

    In Crime Stories: Criminalistic Fantasy and the Culture of Crisis in Weimar Germany, Todd Herzog – explicitly or implicitly – deals with different established myths about crime fiction, criminality and its cultural presumptions. It is generally quite seldom – as Herzog does – that the three...

  7. The H3K27me3 demethylase, KDM6B, is induced by Epstein-Barr virus and over-expressed in Hodgkin's Lymphoma

    DEFF Research Database (Denmark)

    Anderton, J A; Bose, S; Vockerodt, M

    2011-01-01

    ), an Epstein-Barr virus (EBV) associated malignancy. KDM6B is over-expressed in primary HL and induced by the EBV oncogene, latent membrane protein (LMP1) in GC B cells, the presumptive progenitors of HL. Consistent with these observations, we found that KDM6B transcriptional targets in GC B cells are enriched...

  8. Resilience and social costs: centralised towns vs. distributed settlements?

    DEFF Research Database (Denmark)

    Hendriksen, Kåre

    In government reports and political debates in Greenland it is often stated, that the divided settlement in general and especially the settlements are too costly, and that the outlying districts in general do not contribute sufficiently to the national economy. This presumption is used as an argu...

  9. Evaluating One-Shot Library Sessions: Impact on the Quality and Diversity of Student Source Use

    Science.gov (United States)

    Howard, Kristina; Nicholas, Thomas; Hayes, Tish; Appelt, Christopher W.

    2014-01-01

    This article examines the presumption that library research workshops will increase the quality, quantity and diversity of sources students use. This study compares bibliographies of research papers written by freshman composition students who received a library research session to those of students who did not receive any library instruction. Our…

  10. 47 CFR 52.107 - Hoarding.

    Science.gov (United States)

    2010-10-01

    ... toll free numbers to a single toll free subscriber will create a rebuttable presumption that the toll... Free Numbers § 52.107 Hoarding. (a) As used in this section, hoarding is the acquisition by a toll free subscriber from a Responsible Organization of more toll free numbers than the toll free subscriber intends to...

  11. As You Like It

    DEFF Research Database (Denmark)

    Manners, Ian

    2010-01-01

    This chapter addresses some of the methodological, theoretical and empirical challenges of studying the European Neighbourhood Policy (ENP). It will argue that analysing the four-year old ENP presents a wide variety of challenges for scholars of the EU's relations with its near neighbours...... these presumptions are determinate in analysing whether ENP is ‘as you like it'....

  12. Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 6: suitability of taxonomic units notified to EFSA until March 2017

    NARCIS (Netherlands)

    Ricci, Antonia; Allende, Ana; Bolton, Declan; Chemaly, Marianne; Davies, Robert; Girones, Rosina; Koutsoumanis, Kostas; Lindqvist, Roland; Nørrung, Birgit; Robertson, Lucy; Ru, Giuseppe; Fernandez Escamez, Pablo Salvador; Sanaa, Moez; Simmons, Marion; Skandamis, Panagiotis; Snary, Emma; Speybroeck, Niko; Kuile, Ter Benno; Threlfall, John; Wahlström, Helene; Cocconcelli, Pier Sandro; Peixe, Luisa; Maradona, Miguel Prieto; Querol, Amparo; Suarez, Juan Evaristo; Sundh, Ingvar; Vlak, Just; Correia, Sandra; Herman, Lieve

    2017-01-01

    The qualified presumption of safety (QPS) concept was developed to provide a harmonised generic pre-evaluation to support safety risk assessments of biological agents performed by EFSA's scientific Panels. The identity, body of knowledge, safety concerns and antimicrobial resistance of valid

  13. Religion, Nature, Science Education and the Epistemology of Dialectics

    Science.gov (United States)

    Alexakos, Konstantinos

    2010-01-01

    In his article "Scientists at Play in a Field of the Lord", David Long (2010) rightly challenges our presumptions of what science is and brings forth some of the disjunctures between science and deeply held American religious beliefs. Reading his narrative of the conflicts that he experienced on the opening day of the Creation Museum, I cannot…

  14. 26 CFR 1.165-13T - Questions and answers relating to the treatment of losses on certain straddle transactions...

    Science.gov (United States)

    2010-04-01

    ... regularly engaged in investing in regulated futures contracts qualify for the profit presumption for all... entered into for profit. For purposes of section 108 of the Act, the term “straddle” has the meaning given... contracts (as defined in Q&A-6 of this section). Straddles in certain listed stock options were not covered...

  15. Interzones of Law and Metaphysics

    DEFF Research Database (Denmark)

    Mossin, Christiane

    and sources of authority. On the basis of a historical-conceptual understanding of law according to which law, social structure and metaphysical presumptions are inescapably intertwined, the dissertation derives from the binding provisions of law certain essential features of social order. More precisely...

  16. 8 CFR 264.2 - Application for creation of record of permanent residence.

    Science.gov (United States)

    2010-01-01

    ... permanent residence. 264.2 Section 264.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION... record of permanent residence. (a) Jurisdiction. An applicant who believes that he/she is eligible for presumption of lawful admission for permanent residence under § 101.1 or § 101.2 of this chapter or for lawful...

  17. Aspergillus pragensis sp nov discovered during molecular reidentification of clinical isolates belonging to Aspergillus section Candidi

    DEFF Research Database (Denmark)

    Lyskova, Pavlina; Hubka, Vit; Kolarik, Miroslav

    2014-01-01

    The identity of nine clinical isolates recovered from Czech patients and presumptively identified as Aspergillus sp. section Candidi based on colony morphology was revised using sequences of beta-tubulin, calmodulin gene sequence, and internal transcribed spacer rDNA. Six isolates were from suspe...

  18. Author Details

    African Journals Online (AJOL)

    Use of Bengezi and Al-Fallouji modifeid Alvarado score as teaching aid for junior doctors in presumptive daignosis of acute appendicitis, the Bayelsa expriernce. Abstract · Vol 5, No 1 (2010) - Articles Neurofibromatosis in children as seen in the University of Port Harcourt Teaching Hospital. Abstract. ISSN: 0795-3038.

  19. Does Childhood Disability Increase Risk for Child Abuse and Neglect?

    Science.gov (United States)

    Leeb, Rebecca T.; Bitsko, Rebecca H.; Merrick, Melissa T.; Armour, Brian S.

    2012-01-01

    In this article we review the empirical evidence for the presumptions that children with disabilities are at increased risk for child maltreatment, and parents with disabilities are more likely to perpetrate child abuse and neglect. Challenges to the epidemiological examination of the prevalence of child maltreatment and disabilities are…

  20. What Does She Expect when She Dresses like That? Teacher Interpretation of Emerging Adolescent Female Sexuality

    Science.gov (United States)

    Rahimi, Regina; Liston, Delores D.

    2009-01-01

    When examining the experiences of adolescent girls, a study into the presumptions teachers have regarding female adolescent sexuality is a very important aspect to explore. This article presents the findings from a study we conducted with eleven middle- and high school teachers in a southeastern state from both rural and urban districts. In-depth…

  1. Multiple Intelligences: Current Trends in Assessment

    Science.gov (United States)

    Harman, Marsha J.; Kordinak, S. Thomas; Bruce, A. Jerry

    2009-01-01

    With his theory of multiple intelligences, Howard Gardner challenged the presumption that intelligence is a single innate entity. He maintained that multiple intelligences exist and are related to specific brain areas and symbol systems. Each of the intelligences has its merits and limits, but by using a multiple intelligences approach, more…

  2. A Case Study of Academic Growth in Schools for the Deaf: The Convergence of Educational Policy and Organizational Theory

    Science.gov (United States)

    Virnig, Sean M.

    2013-01-01

    In this age of educational accountability, public schools are presumed to have the innate organizational capability to meet academic achievement benchmarks. Fair or not, this presumption also extends to schools serving students who are deaf, a population whose academic achievement continues to be unsatisfactory. This dissertation investigated how…

  3. Untitled

    African Journals Online (AJOL)

    clinical diagnosis and presumptive treatment are the only method ... treatment could be administered quickly to reduce morbidity and ..... LGA, Ogun State. f 2'. THICK BLOOD FILM MICROSCOPY. 3 Positive Negative Total. 5 Positive 55 12 67. E. 2 Negative 31 142 173 it]. E Total 86 154 240 ca. Sensitivity: 5_5 x 100 = 63.95.

  4. Some experimental aspects of optimality theoretic pragmatics

    NARCIS (Netherlands)

    Blutner, R.; Németh T., E.; Bibok, K.

    2010-01-01

    The article has three main concerns: (i) it gives a concise introduction into optimality-theoretic pragmatics; (ii) it discusses the relation to alternative accounts (relevance theory and Levinson's theory of presumptive meanings); (iii) it reviews recent findings concerning the psychological

  5. The influence of cellular phone "speak" on isiXhosa rules of ...

    African Journals Online (AJOL)

    In regard to this principle, Brown and Levinson (1987:82) maintain that a "socially neutral presumptive framework for communication" emanates from Grice's maxims and that politeness theory may be a better barometer of cooperation in the first instance. However, cellular phone communication indicates that there is nothing ...

  6. Comparison of identification and antimicrobial resistance pattern of ...

    African Journals Online (AJOL)

    The identified isolates were compared with presumptive identities obtained by growth on MSA, tube coagulation and slide agglutination tests. Antimicrobial susceptibility testing of S. aureus isolates was performed by Kirby Bauer technique while MRSA was screened for by growth on chromIDTM MRSA plate and confirmed ...

  7. Multiple antimicrobial resistance of Escherichia coli and Salmonella ...

    African Journals Online (AJOL)

    Presumptive isolates were subjected to antimicrobial susceptibility testing using 13 panels of antibiotics for both E. coli and Salmonella spp. Results showed that the overall isolation rate of Salmonella spp. was 12 (11.4%), broiler chickens had higher isolation rate 9 (12.0%) of Salmonella than local chickens. However, the ...

  8. Wasmannia Forel(Hymenoptera: Formicidae: Myrmicinae) in Argentina: systematics and distribution

    Science.gov (United States)

    The ant genus Wasmannia is endemic to the Neotropics, with 10 species occurring within the presumptive native range for the genus from Mexico to Argentina. Only the little fire ant, Wasmannia auropunctata is widely distributed being present from central-eastern Argentina to Bermuda, and has become i...

  9. 1 Change and obduracy in university teaching practices: tracing ...

    African Journals Online (AJOL)

    use the sociomaterial notion of obduracy to argue against the presumption that change is a coordinated ... outcomes tends to bracket out both local practices and the meso-level of institutional systems, with the ... student information and learning technology systems, as well as networks around policy and governance, and ...

  10. 42 CFR 457.10 - Definitions and use of terms.

    Science.gov (United States)

    2010-10-01

    ...-income child means a child whose family income is at or below 200 percent of the poverty line for the..., with respect to a child, the effective income level (expressed as a percentage of the poverty line... this chapter. Period of presumptive eligibility has the meaning assigned at § 457.301. Poverty line...

  11. Author Details

    African Journals Online (AJOL)

    Albert, Ejikeme. Vol 20, No 1 (2016) - Articles An Investigation of Presumptive Synergism of Oil Palm Bunch Ash and Sawdust Amendments in Remediation of crude oil Spiked Soil Abstract PDF. ISSN: 1119-8362. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

  12. Antibiotic susceptibilities of Salmonella species prevalent among ...

    African Journals Online (AJOL)

    This study was conducted to assess the prevalence of Salmonella species among children having diarrhea in Katsina State, Nigeria. A total of 220 diarrhea stool samples of children aged five years and below (0-5 years) were collected and screened for Salmonella species using culture technique. Presumptively positive ...

  13. 19 CFR 351.402 - Calculation of export price and constructed export price; reimbursement of antidumping and...

    Science.gov (United States)

    2010-04-01

    ... Export Price, Constructed Export Price, Fair Value, and Normal Value § 351.402 Calculation of export... (date of final determination of sales at less than fair value). (3) Presumption. The Secretary may...) Introduction. In order to establish export price, constructed export price, and normal value, the Secretary...

  14. correlation of who clinical staging with cd4 counts in adult hiv/aids

    African Journals Online (AJOL)

    2011-02-02

    Feb 2, 2011 ... designed to identify HIV/AIDS related clinical events using clinical presentation and simple laboratory and radiological investigations, with the clinical diagnosis being either presumptive or definitive depending on the tiers of investigation carried out. This has enabled. WHO as well as countries in Africa, ...

  15. child bride and child sex: combating child marriages in nigeria

    African Journals Online (AJOL)

    Mofasony

    There are preventive pre-marriage measures to protect children threatened with forced marriages. An application may be made for an Emergency Protection Order. (EPO). Where the EPO is granted, but the parents are the threat to the child, the court could be asked for a presumption of non-contract for the duration of EPO to ...

  16. Social Anxiety in Learning: Stages of Change in a Sample of UK Undergraduates

    Science.gov (United States)

    Topham, Phil; Moller, Naomi; Davies, Hannah

    2016-01-01

    Social anxiety in learning is prevalent amongst traditional-age students and has a marked effect on their engagement with higher education. It receives little attention from academic or support services and there is a presumption that students will manage their anxieties. Yet it is unclear what psychosocial resources they might bring to this task…

  17. Pneumonic Plague Transmission, Moramanga, Madagascar, 2015.

    Science.gov (United States)

    Ramasindrazana, Beza; Andrianaivoarimanana, Voahangy; Rakotondramanga, Jean Marius; Birdsell, Dawn N; Ratsitorahina, Maherisoa; Rajerison, Minoarisoa

    2017-03-01

    During a pneumonic plague outbreak in Moramanga, Madagascar, we identified 4 confirmed, 1 presumptive, and 9 suspected plague case-patients. Human-to-human transmission among close contacts was high (reproductive number 1.44) and the case fatality rate was 71%. Phylogenetic analysis showed that the Yersinia pestis isolates belonged to group q3, different from the previous outbreak.

  18. Rejoinder Authors' reply to the comments made by Suresh Chandra ...

    Indian Academy of Sciences (India)

    Suresh Chandra has started his comments on the presumption that we have used experimental data on De to evaluate it. This seems to be constructed on the basis of our inclusion of De experimental data in table 1 of our paper. We have not used experimental values of De as input for computations. As mentioned on page ...

  19. Ethiopian Journal of Health Sciences - Vol 20, No 3 (2010)

    African Journals Online (AJOL)

    Boy/Girl Friend and Virginity Values, and Stigma Related to Condom among Jimma University Students · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD ... Outcome of Presumptive Versus Rapid Diagnostic Tests-Based Management of Childhood Malaria – Pneumonia Overlap in Urban Nigeria: A Pilot ...

  20. Research

    African Journals Online (AJOL)

    abp

    2013-05-26

    May 26, 2013 ... treatment. While presumptive treatment may be helpful — and perhaps even lifesaving — when the child actually does have malaria, a misdiagnosis may ..... Dengue fever. 0 (0.0%). 0 (0.0%). 0 (0.0%). Households reported a high rate of self-diagnosis for conditions such as influenza (100% of reported ...