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Sample records for primary palmar hyperhidrosis

  1. CT-Guided, Ethanol Sympatholysis for Primary Axillary–Palmar Hyperhidrosis

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    Tsitskari, Maria, E-mail: mariadote@hotmail.com [American Medical Center, Vascular & Interventional Radiology (Cyprus); Friehs, Gerhard, E-mail: gerhardf@amc.com.cy; Zerris, Vassilis, E-mail: vassilisz@amc.com.cy [American Medical Center, Neurosurgery (Cyprus); Georgiades, Christos, E-mail: g-christos@hotmail.com [Johns Hopkins Hospital, Vascular & Interventional Radiology (United States)

    2016-12-15

    PurposePrimary hyperhidrosis is an excessive sweating due to an overactive sympathetic system. Our objective was to test the feasibility and provide early data on the safety/efficacy of CT-guided sympatholysis, for primary hyperhidrosis.Materials and MethodsNine consecutive patients with axillary–palmar hyperhidrosis were treated between 2013 and 2015. CT-guided sympathetic block was performed in the outpatients at T-2, T-3, and T-4, bilaterally using alcohol under local anesthesia. Immediate postprocedure CT was obtained to assess the complications as per Common Terminology Criteria for Adverse Events, version 4. Technical success and clinical success were recorded. Primary and secondary efficacy were assessed by phone and clinical visits; mean follow-up was 12 months (6–26 months). Descriptive statistics was used to report the outcomes.ResultsOne procedure was aborted due to eyelid ptosis after lidocaine injection. All other eight patients (5:3, F:M) (median age 32) had immediate cessation of sweating. Two major complications (pneumothorax, one requiring a chest tube) occurred. Two patients recurred with unilateral and one with bilateral symptoms. One of the unilateral recurrence and the bilateral recurrence patients was retreated successfully. Median follow-up was 1 year. No cases of Horner’s or compensatory hyperhidrosis were observed.ConclusionsCT-guided EtOH sympatholysis for axillary/palmar primary hyperhidrosis is feasible. Technical failure rate was 11 %. Primary and secondary efficacy are 75 and 94 %, respectively, to a median follow-up of 1 year. Risk profile appears favorable. Despite a small sample size, results confirm feasibility and encourage a larger study.

  2. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

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    Aram Baram

    2014-02-01

    Full Text Available Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8% that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4. Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months. A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5% and another patient (2.5% presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353 and 2.5% (p = .552, respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58% compared to palmar type (14, 35.89% or axillary type (7, 17.94%. Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications.

  3. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients.

    Science.gov (United States)

    Rodríguez, Pedro M; Freixinet, Jorge L; Hussein, Mohamed; Valencia, Jose M; Gil, Rita M; Herrero, Jorge; Caballero-Hidalgo, Araceli

    2008-09-01

    Thoracic sympathectomy (TS) is the treatment of choice for severe primary hyperhidrosis. However, complications, side effects and satisfaction have not been well defined. To analyze the complications, side effects, satisfaction degree and quality of life of patients after TS for primary upper limb hyperhidrosis. One-year follow-up after 406 consecutive TS for primary upper limb hyperhidrosis. Bilateral TS was completed in all patients. Complications arose in 23 cases (5.6%), with pneumothorax being the most frequent. The success rate after discharge, 6 and 12 months was respectively, 100%, 98.1% and 96.5% for palmo-axillary hyperhidrosis; 100%, 99.3% and 97.8% for isolated palmar hyperhidrosis and 100%, 85.7% and 71.4% for isolated axillary hyperhidrosis. No persistence of hyperhidrosis was observed. Global recurrence was 3.7% (28.5% axillary hyperhidrosis group). Compensatory sweating (CS) appeared in 55% and was not related to the extension of the TS. Being female was a predisposing factor of CS (p<0.004). Excessive dryness appeared at 9% and was associated with extensive TS (P<0.001). Plantar hyperhidrosis improved at 33.6%, worsened at 10% and remained stable during the follow-up. Satisfaction degree decreased with the passage of time and was associated with recurrence. Quality of life was excellent at discharge, 6 and 12 month in 100%, 100% and 97%, respectively. Pneumothorax is the most frequent complication of TS. CS is the main and undesirable side effect, appears with the passage of time, and is not related to the extension of TS. Being female is the only predictor factor of suffering CS. Plantar hyperhidrosis improves initially, although tends to reappear. Excessive dryness appears in extensive TS and does not improve over time. Postoperative satisfaction degree is high but decreases over time owing to the appearance of recurrence. Effectiveness and the absence of CS determine an excellent quality of life. Six percent of the patients regret the surgery

  4. The Etiology of Primary Hyperhidrosis

    DEFF Research Database (Denmark)

    Hashmonai, Moshe; Cameron, Alan E.P.; Connery, Cliff P.

    2017-01-01

    of patients with hyperhidrosis has been reported. Conclusions: Despite these accumulated data, the etiology of primary hyperhidrosis remains obscure. Nevertheless, three main lines for future research seem to be delineated: genetics, histological observations, and enzymatic studies.......Purpose: Primary hyperhidrosis is a pathological disorder of unknown etiology, affecting 0.6-5% of the population, and causing severe functional and social handicaps. As the etiology is unknown, it is not possible to treat the root cause. Recently some differences between affected and non......-affected people have been reported. The aim of this review is to summarize these new etiological data. Methods: Search of the literature was performed in the PubMed/Medline Database and pertinent articles were retrieved and reviewed. Additional publications were obtained from the references of these articles...

  5. A comparative trial of ice application versus EMLA cream in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis

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    Alsantali A

    2018-04-01

    Full Text Available Adel Alsantali Department of Dermatology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia Background: Botulinum toxin is a safe and effective therapy for palmar hyperhidrosis, but the associated pain from injections limits the usefulness of this method of treatment. Purpose: To evaluate the efficacy of Eutectic Mixture of Local Anesthetics (EMLA cream versus ice application in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis. Methods: In this prospective study, 23 patients underwent palm Botox injections to treat their excessive sweating. In each patient, EMLA cream was applied to one palm and ice was applied directly before the injections in the other palm. Pain was evaluated using a Visual Analog Scale. Results: Statistically, there was a significant difference in pain control between EMLA cream group and ice application group (p<0.05. The average pain score on the hands where EMLA cream was applied was 8.9 (SD=0.81, whereas it was 4.8 (±0.9 in the ice group. Conclusion: In this study, the successful use of ice application in reducing pain by 40% in comparison to EMLA cream during Botox toxin injection for palmar hyperhidrosis is demonstrated.Keywords: ice, local anesthetics, EMLA, palmar hyperhidrosis, Botox injection, pain reduction

  6. Primary hyperhidrosis: Implications on symptoms, daily life, health and alcohol consumption when treated with botulinum toxin.

    Science.gov (United States)

    Shayesteh, Alexander; Boman, Jens; Janlert, Urban; Brulin, Christine; Nylander, Elisabet

    2016-08-01

    Primary hyperhidrosis affects approximately 3% of the population and reduces quality of life in affected persons. Few studies have investigated the symptoms of anxiety, depression and hazardous alcohol consumption among those with hyperhidrosis and the effect of treatment with botulinum toxin. The first aim of this study was to investigate the effect of primary hyperhidrosis on mental and physical health, and alcohol consumption. Our second aim was to study whether and how treatment with botulinum toxin changed these effects. One hundred and fourteen patients answered questionnaires regarding hyperhidrosis and symptoms, including hyperhidrosis disease severity scale (HDSS), visual analog scale (VAS) 10-point scale for hyperhidrosis symptoms, hospital anxiety and depression scale (HADS), alcohol use disorder identification test (AUDIT) and short-form health survey (SF-36) before treatment with botulinum toxin and 2 weeks after. The age of onset of hyperhidrosis was on average 13.4 years and 48% described heredity for hyperhidrosis. Significant improvements were noted in patients with axillary and palmar hyperhidrosis regarding mean HDSS, VAS 10-point scale, HADS, SF-36 and sweat-related health problems 2 weeks after treatment with botulinum toxin. Changes in mean AUDIT for all participants were not significant. Primary hyperhidrosis mainly impairs mental rather than physical aspects of life and also interferes with specific daily activities of the affected individuals. Despite this, our patients did not show signs of anxiety, depression or hazardous alcohol consumption. Treatment with botulinum toxin reduced sweat-related problems and led to significant improvements in HDSS, VAS, HADS and SF-36 in our patients. © 2016 Japanese Dermatological Association.

  7. A comparative trial of ice application versus EMLA cream in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis.

    Science.gov (United States)

    Alsantali, Adel

    2018-01-01

    Botulinum toxin is a safe and effective therapy for palmar hyperhidrosis, but the associated pain from injections limits the usefulness of this method of treatment. To evaluate the efficacy of Eutectic Mixture of Local Anesthetics (EMLA) cream versus ice application in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis. In this prospective study, 23 patients underwent palm Botox injections to treat their excessive sweating. In each patient, EMLA cream was applied to one palm and ice was applied directly before the injections in the other palm. Pain was evaluated using a Visual Analog Scale. Statistically, there was a significant difference in pain control between EMLA cream group and ice application group ( p cream was applied was 8.9 (SD=0.81), whereas it was 4.8 (±0.9) in the ice group. In this study, the successful use of ice application in reducing pain by 40% in comparison to EMLA cream during Botox toxin injection for palmar hyperhidrosis is demonstrated.

  8. Temperament and character properties of primary focal hyperhidrosis patients

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    Ak Mehmet

    2013-01-01

    Full Text Available Abstract Background Primary focal hyperhidrosis is a health problem, which has negative effects on the patient's quality of life and significantly affects the patients’ daily activities, social and business life. The aim of this study is to evaluate temperament and character properties of patients diagnosed with primary focal hyperhidrosis. Methods Fifty-six primary focal hyperhidrosis (22.42 ± 7.80 and 49 control subjects (24.48 ± 5.17 participated in the study. Patients who met the diagnostic criteria for PFH were referred to psychiatry clinic where the subjects were evaluated through Structured Clinical Interview for DSM Disorders-I and Temperament and Character Inventory. Results In order to examine the difference between the PFH and control group in terms of temperament and character properties, one-way Multivariate Analysis of Variance (MANOVA was conducted. In terms of temperament properties, PFH group took significantly higher scores than control group in Fatigability and asthenia dimension. In terms of character properties, PFH group scored significantly lower than control group in Purposefulness , Resourcefulness , Self-Directedness and scored significantly higher than control group in Self-forgetfulness and Self-Transcendence. Conclusion Temperament and character features of PFH patients were different from healthy group and it was considered that these features were affected by many factors including genetic, biological, environmental, socio-cultural elements. During the follow-up of PFH cases, psychiatric evaluation is important and interventions, especially psychotherapeutic interventions can increase the chances of success of the dermatological treatments and can have a positive impact on the quality of life and social cohesion of chronic cases.

  9. Clonidine is effective for the treatment of primary idiopathic hyperhidrosis and hot flushes: a case report.

    Science.gov (United States)

    Albadrani, Ahmed

    2017-01-17

    While primary hyperhidrosis can be seen in men, accompanying hot flushes is rarely seen in men. Primary hyperhidrosis is thought to be related to overactivity of the sympathetic nervous system while hot flushes are believed to be related to altered peripheral vascular reactivity and a narrowed thermoregulatory zone. I report the case of a 29-year-old man of Arab origin who presented to a dermatology clinic with a complaint of generalized sweating, with heavier involvement of his inguinal region, axilla, and lower back. His complaint was associated with a transient hot sensation and erythema over the affected areas. He did not respond to topical antiperspirants containing aluminum chloride, topical aluminum chloride, or to botulinum toxin A injected in both inguinal areas. He was then referred to an endocrinology clinic to rule out secondary causes of hyperhidrosis and hot flushes; a primary diagnosis was confirmed. He did not respond to oral glycopyrrolate and additionally was complaining of its anticholinergic side effects. The glycopyrrolate was then replaced with oral clonidine 0.15 mg twice a day. Clonidine was well tolerated without remarkable side effects and he quickly started to feel marked improvement which was maintained for 2 years. I report an atypical presentation of primary hyperhidrosis and hot flushes that was effectively controlled by clonidine without remarkable side effects. Further research on a large number of patients may be required before recommending clonidine in similar conditions.

  10. Distinguishing hyperhidrosis and normal physiological sweat production

    DEFF Research Database (Denmark)

    Thorlacius, Linnea; Gyldenløve, Mette; Zachariae, Claus

    2015-01-01

    of this study was to establish reference intervals for normal physiological axillary and palmar sweat production. METHODS: Gravimetric testing was performed in 75 healthy control subjects. Subsequently, these results were compared with findings in a cohort of patients with hyperhidrosis and with the results...... 100 mg/5 min. CONCLUSIONS: A sweat production rate of 100 mg/5 min as measured by gravimetric testing may be a reasonable cut-off value for distinguishing axillary and palmar hyperhidrosis from normal physiological sweat production....

  11. Tratamiento videotoracoscópico por puerto único para la hiperhidrosis palmar y axilar idiopática en el niño Videothorascopic sympathicotomy treatment through one port for idiopathic palmar and axillary hyperhidrosis in the child

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    Vivian Vialat Soto

    2013-03-01

    Full Text Available Introducción: la hiperhidrosis primaria es una enfermedad benigna que consiste en la excesiva producción de sudor, principalmente en manos, axilas y pies, y por ello puede llegar a condicionar la vida social y laboral de quien la padece. Objetivo: evaluar los resultados de la técnica simpaticotomía videotoracoscópica por un solo puerto usando oxigenación apneica para lograr el colapso pulmonar. Métodos: estudio descriptivo y transversal a 37 niños operados de enero de 2011 a junio de 2012, con edades comprendidas entre los 11 y 18 años, en el Hospital Pediátrico Universitario de Centro Habana, a los que se analizó: edad, sexo, complicaciones, estadía y grado de satisfacción. Resultados: todos los pacientes tenían las edades mencionadas, fue más frecuente en las hembras (22, 59,5 %, con resultados inmediatos en 36 pacientes (97,3 %, y sequedad e incremento de la temperatura de las manos al finalizar cada hemitórax. No se usaron sonda pleural ni antibióticos posoperatorios. No hubo complicaciones, y la estadía fue corta (97,3 %. El sudor compensatorio se dio en 9 pacientes (24,3 %, y el índice de satisfacción fue del 100 %. Conclusiones: esta técnica quirúrgica pudiera ser una opción terapéutica eficaz para mejorar la calidad de vida desde edades tempranas.Introduction: primary hyperhidrosis is a benign disease that consists of the overproduction of sweating mainly in hands, axillae and feet, which may affect the social and work life of those people who suffer it. Objectives: to evaluate the results of the videothoracoscopic sympathicotomy using apneic oxygenation to reach the pulmonary collapse. Methods: cross-sectional and descriptive study of 37 children aged 11 to 18 years, who were operated on from January 2011 to June 2012 at the university pediatric hospital of Centro Habana. The analyzed variables were sex, age, complications, length of stay at hospital and level of satisfaction. Results: the disease was more

  12. Periostin differentially induces proliferation, contraction and apoptosis of primary Dupuytren's disease and adjacent palmar fascia cells

    International Nuclear Information System (INIS)

    Vi, Linda; Feng, Lucy; Zhu, Rebecca D.; Wu, Yan; Satish, Latha; Gan, Bing Siang; O'Gorman, David B.

    2009-01-01

    Dupuytren's disease, (DD), is a fibroproliferative condition of the palmar fascia in the hand, typically resulting in permanent contracture of one or more fingers. This fibromatosis is similar to scarring and other fibroses in displaying excess collagen secretion and contractile myofibroblast differentiation. In this report we expand on previous data demonstrating that POSTN mRNA, which encodes the extra-cellular matrix protein periostin, is up-regulated in Dupuytren's disease cord tissue relative to phenotypically normal palmar fascia. We demonstrate that the protein product of POSTN, periostin, is abundant in Dupuytren's disease cord tissue while little or no periostin immunoreactivity is evident in patient-matched control tissues. The relevance of periostin up-regulation in DD was assessed in primary cultures of cells derived from diseased and phenotypically unaffected palmar fascia from the same patients. These cells were grown in type-1 collagen-enriched culture conditions with or without periostin addition to more closely replicate the in vivo environment. Periostin was found to differentially regulate the apoptosis, proliferation, α smooth muscle actin expression and stressed Fibroblast Populated Collagen Lattice contraction of these cell types. We hypothesize that periostin, secreted by disease cord myofibroblasts into the extra-cellular matrix, promotes the transition of resident fibroblasts in the palmar fascia toward a myofibroblast phenotype, thereby promoting disease progression.

  13. Treatment of primary axillary hyperhidrosis by fractional microneedle radiofrequency: Is it still effective after long-term follow-up?

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    Bahareh Abtahi-Naeini

    2016-01-01

    Full Text Available Background: Primary axillary hyperhidrosis (PAH is a chronic idiopathic disorder causing major stress in patients. Among the common therapies for PAH, only surgical interventions have proven feasible as a permanent solution. Objective and Aim: The aim of this study was to evaluate the efficacy and safety of fractional microneedle radiofrequency (FMR as an alternative permanent treatment for PAH with long-term follow-up. Materials and Methods: This was a single-blind, sham-controlled comparative study. Twenty-five patients with severe PAH were provided three treatments of FMR at 3-week intervals (the treatment group, and a control group was provided the sham treatment. Clinical efficacy was evaluated using the hyperhidrosis disease severity scale (HDSS at baseline and the end of the study, as well as during the 1 year follow-up phase. Results: HDSS demonstrated significant improvement after treatment in the treatment group compared to the sham control. The mean (±standard deviation of HDSS in the group being treated with radiofrequency was 2.50 (±0.88 after 1 year follow-up, and that of the control group was 3.38 (±0.49; P < 0.001. Follow-up results show that there were 10 patients (41.6% with no relapse and 11 patients (45.9% with relapse after 1 year. There was a significant correlation between HDSS changes in relapse and body mass index (BMI (P = 0.03. Conclusion: Treatment of PAH with FMR is a safe and noninvasive procedure with a positive therapeutic effect on HDSS. It is recommended, however, that sessions of FMR be repeated after 1 year, particularly in overweight patients with high BMIs. Clinical Trial Registration: IRCT2013111915455N1. Level of Evidences: Level II-1.

  14. Hyperhidrosis (Excessive Sweating)

    Science.gov (United States)

    ... who have this type are otherwise healthy. In medical terminology, the word “primary” means that the cause is not another medical condition. Secondary hyperhidrosis In medical terminology, “secondary” means that the excessive sweating (hyperhidrosis) has ...

  15. Quality of life in patients with primary axillary hyperhidrosis before and after treatment with fractionated microneedle radiofrequency

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    Bahareh Abtahi-Naeini

    2015-01-01

    Full Text Available Background: Primary axillary hyperhidrosis (PAH is a common condition with a great impact on the patient′s quality of life (QOL. It is associated with serious social, emotional, and occupational distress. The aim of this study was to investigate the QOL in patients with PAH before and after treatment with fractionated microneedle radiofrequency (FMR. Materials and Methods: We evaluated 25 patients with severe PAH. Each patient had three sessions of FMR treatment using a novel applicator at 3-week intervals. The study was based on Dermatology Life Quality Index (DLQI Questionnaires. Patients were evaluated at baseline and 3 months after the last session. Results: Our patients included 32% males and 68% females. The mean ± standard deviation (SD age of subjects was 30.2 ± 6.27 years. The mean ± SD of the DLQI before and after treatment was 12.96 ± 5.93, and 4.29 ± 2.21, respectively. There was a statistically significant difference between the before and after intervention (P < 0.001. No major, permanent adverse effects were shown. Conclusion: Treatment with FMR can improve the DLQI of patients with PAH.

  16. Unilateral hyperhidrosis and hypothermia

    DEFF Research Database (Denmark)

    Dyring-Andersen, B; Kamp, S; Madelung, A

    2016-01-01

    A 34-year old man presented at the Department of Dermato-allergology, Herlev and Gentofte Hospital with unilateral hyperhidrosis localized to the right axilla through approximately 10 years without progression of symptoms. The patient often experienced that his right hand was colder than the left...

  17. Keratosis Punctata of Palmar Creases

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    T P Thankappan

    1982-01-01

    Full Text Available Five cases of keratosis punctata of palmar creases which isaa variant of keratosis punctata are reported. Two of these cases were associated with psoriasis and one case with dermatitis herpetiformis. Familial tendency was noticed in 4 cases.

  18. Hyperhidrosis-psychiatric Study and Behaviour Therapy

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    P V Pradhan

    1984-01-01

    Full Text Available Eleven patients suffering from hyperhidrosis were psychiatrically studied. Seven of them were given behaviour therapy. Majority of the patients had -an unhappy childhood and long - standing and continuing psychological stress. None of them had obvious, coexisting psychiatric condition.. Thus, hyperhidrosis was the sole, expression of their psychological conflicts. Of the 7 patients treated 71% showed improvement with relaxation and systemic desentiziation which,was maintained for a_ period of at least 6 months.

  19. Hyperhidrosis

    Science.gov (United States)

    ... dark blue color wherever there is excess sweat. Paper test. Special paper is placed on the affected area to absorb ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  20. Zumbi dos Palmares: a afroresiliencia

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    Josué Petrônio Quirino de Oliveira

    2017-10-01

    Full Text Available O artigo buscou fazer uma releitura de Zumbi dos Palmares sob o prisma da resiliência, demonstrando uma visão singular ao olhar para os escravos nos quilombos e suas histórias de superação e transformação perante as adversidades, levando não só a reconstruir o imaginário afrodescendente brasileiro com o caleidoscópio da resiliência, mas revelar que a resiliência sempre foi inerente a história dos negros no Brasil. Para tanto se caracterizou como uma pesquisa exploratória com abordagem qualitativa e procedimentos bibliográficos que foram essenciais para a construção do artigo, amadurecendo e ampliando os conhecimentos envolvidos na temática. Nesta abordagem o quilombo dos Palmares foi um conjunto complexo de condições, atitudes e ações que apesar das adversidades tiveram resultados positivos, os fatos demonstraram que os negros nos quilombos foram uma prova que a resiliência negra não foi apenas um fator individual, mas uma característica comunitária que desencadeou um processo de ruptura e recuperação social, um grito de liberdade em defesa da consciência de uma raça, e de um povo. Zumbi não foi apenas um líder de um movimento libertário que marcou a história dos negros oriundos de Pernambuco e Alagoas, mas a história de uma raça por gerações no país, que se tornou sinônimo de resiliência.

  1. A surprising palmar nevus: A case report

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    Rana Rafiei

    2018-02-01

    Full Text Available Raised palmar or plantar nevus especially in white people is an unusual feature. We present an uncommon palmar compound nevus in a 26-year-old woman with a large diameter (6 mm which had a collaret-shaped margin. In histopathologic evaluation intralymphatic protrusions of nevic nests were noted. This case was surprising to us for these reasons: size, shape, location and histopathology of the lesion. Palmar nevi are usually junctional (flat and below 3 mm diameter and intra lymphatic protrusion or invasion in nevi is an extremely rare phenomenon.

  2. Resolution of Postural Orthostatic Tachycardia Syndrome After CT-Guided, Percutaneous T2 Ethanol Ablation for Hyperhidrosis

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    Brock, Malcolm, E-mail: mabrock@jhmni.edu [Johns Hopkins University, Department of Thoracic Surgery, Center for Sweat Disorders (United States); Chung, Tae Hwan, E-mail: Tchang7@jhmi.edu [Johns Hopkins University, Physical Medicine and Rehabilitation (United States); Gaddam, Sathvika Reddy, E-mail: drsathvikareddy@yahoo.com; Kathait, Anjaneya Singh, E-mail: askathait@gmail.com [Johns Hopkins University, Vascular & Interventional Radiology (United States); Ober, Cecily, E-mail: ceober21@gmail.com [Johns Hopkins University, Department of Thoracic Surgery (United States); Georgiades, Christos, E-mail: cgeorgi@jhmi.edu [Johns Hopkins University, Vascular & Interventional Radiology (United States)

    2016-12-15

    Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experienced resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome.

  3. Management of essential hyperhidrosis of upper limbs by ...

    African Journals Online (AJOL)

    Introduction: Essential hyperhidrosis is an idiopathic condition characterized by markedly excessive sweating especially in the hands. Objective: This study was done to evaluate the functional results of radiofrequency thermocoagulation of T2 ganglion in 10 patients suffered from essential hyperhidrosis of both upper limbs.

  4. Management of essential hyperhidrosis of upper limbs by ...

    African Journals Online (AJOL)

    Wael Fouad

    Abstract Introduction: Essential hyperhidrosis is an idiopathic condition characterized by mark- edly excessive sweating especially in the hands. Objective: This study was done to evaluate the functional results of radiofrequency thermocoagu- lation of T2 ganglion in 10 patients suffered from essential hyperhidrosis of both ...

  5. Palmar dislocation of scaphoid and lunate

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    Khalid Koulali Idrissi

    2011-11-01

    Full Text Available A palmar dislocation of scaphoid and lunate is uncommon. We have found only 19 reported cases in the literature. We reported a simultaneous, divergent dislocation. The closed reduction followed by percutaneous pinning has given a good result without avascular necrosis of any carpal bone.

  6. Palmar-plantar erythrodysesthesia associated with capecitabine ...

    African Journals Online (AJOL)

    We report a case of a 62 year-old patient who developed Palmar-plantar erythrodysesthesia upon receiving four cycles of capacitabine-based chemotherapy. She was on post surgical adjuvant treatment for invasive well differentiated adenocarcinoma of the colon. The clinical and therapeutic aspects of this ...

  7. Resources for hyperhidrosis sufferers, patients, and health care providers.

    Science.gov (United States)

    Pieretti, Lisa J

    2014-10-01

    The excessive sweating of hyperhidrosis creates profound psychosocial, professional, and financial burdens on the individual sufferer; it contributes to impaired self-worth and self-efficacy, decreased satisfaction in all relationships, avoidance of specific careers, and increased expenditures on everything from clothing to medical treatment. Despite morbidity equal to other well-known dermatologic conditions, hyperhidrosis has historically been underacknowledged and undertreated because of the lack of accessible, scientifically accurate information and dispersal of that information within patient and medical communities. Thankfully, the development of the Internet and the work of the not-for-profit International Hyperhidrosis Society (IHHS) have increased awareness of hyperhidrosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. The impact of hyperhidrosis on patients' daily life and quality of life: a qualitative investigation.

    Science.gov (United States)

    Kamudoni, P; Mueller, B; Halford, J; Schouveller, A; Stacey, B; Salek, M S

    2017-06-08

    An understanding of the daily life impacts of hyperhidrosis and how patients deal with them, based on qualitative research, is lacking. This study investigated the impact of hyperhidrosis on the daily life of patients using a mix of qualitative research methods. Participants were recruited through hyperhidrosis patient support groups such as the Hyperhidrosis Support Group UK. Data were collected using focus groups, interviews and online surveys. A grounded theory approach was used in the analysis of data transcripts. Data were collected from 71 participants, out of an initial 100 individuals recruited. Seventeen major themes capturing the impacts of hyperhidrosis were identified; these covered all areas of life including daily life, psychological well-being, social life, professional /school life, dealing with hyperhidrosis, unmet health care needs and physical impact. Psychosocial impacts are central to the overall impacts of hyperhidrosis, cutting across and underlying the limitations experienced in other areas of life.

  9. "Palmar pivot flap" for resurfacing palmar lateral defects of the fingers.

    Science.gov (United States)

    Yam, Andrew; Peng, Yeong-Pin; Pho, Robert Wan-Heng

    2008-12-01

    Soft tissue defects on the lateral borders of the digits are difficult to reconstruct using local or local-regional flaps. We describe a "palmar pivot flap" to resurface an adjacent defect on the palmar-lateral aspect of the digit. The surgical technique is described. This flap is an axial pattern flap based on the subcutaneous transverse branches of the digital artery. The flap is pivoted up to 90 degrees on the neurovascular bundle in its base, into an adjacent defect. The flap can be raised from either the proximal or the middle phalangeal segments. It can cover defects sited from the level of the proximal interphalangeal joint up to the fingertip. The donor defect is limited to the same digit and is covered with a full-thickness skin graft. We have used this flap on 3 patients with defects at the middle phalangeal segment, the distal interphalangeal joint, and the fingertip. All healed primarily. One patient had a mild flexion contracture of the proximal interphalangeal joint, whereas the other 2 had no complications. The patients with distal interphalangeal joint and fingertip defects had excellent sensation in the flap (2-point discrimination of 5-6 mm). The palmar pivot flap is useful for resurfacing otherwise difficult defects on the lateral borders of the digits around and distal to the proximal interphalangeal joint, including those at the fingertip. It provides sensate, glabrous skin. The donor defect is on the same digit and is well hidden, producing an aesthetic and functional reconstruction.

  10. Contact sensitivity in palmar hyperkeratotic dermatitis

    Directory of Open Access Journals (Sweden)

    Minocha Y

    1993-01-01

    Full Text Available 230 patients presenting with palmar hyperkeratotic dermatitis were investigated by patch tests against various antigens depending upon occupation of the patients. Contact sensitivity was detected in 130 patients comprising of housewives (55, businessmen (20, farmers (15, teachers / clerks / students (13, doctors and nurses (9, factory workers and labourers (8, massons (7 and motor mechanics (3. Vegetables were found to be the most common agents followed by detergents and metals predominantly affecting housewives. Among the vegetables, garlic and onion were the most potent sensitizers whereas nickel was a common sensitizer among metals. Occupational factors were seen to have some influence in relation to the causative agents as indicated by higher positivity of vegetables in housewives; detergents, metals, rubber, leather, plastics in businessmen, teachers, clerks and students; fertilizers or animal foods in farmers; drugs in doctors and nurses and chromium and cobalt in massons.

  11. Electrocautery versus Ultracision versus LigaSure in Surgical Management of Hyperhidrosis.

    Science.gov (United States)

    Divisi, Duilio; Di Leonardo, Gabriella; De Vico, Andrea; Crisci, Roberto

    2015-12-01

    The aim of the study was to evaluate the sympathectomy procedures for primary hyperhidrosis in terms of complications and effectiveness. From January 2010 to September 2012 we performed 130 sympathectomies in 65 patients, 27 males (42%) and 38 females (58%). Electrocoagulation was used in 20 procedures (15%), ultrasonic scalpel in 54 (42%), and radiofrequency dissector in 56 (43%). Seven patients (11%) underwent bilateral sympathectomy in the same surgical session, while in 58 (89%) the right surgical approach was delayed 30 days from the first procedure. We noticed 12 complications (9%): (a) chest pain in 6 patients (4 with electrocoagulation, 1 with ultrasonic scalpel, and 1 with radiofrequency dissector), which disappeared in 20 ± 1 day; (b) paresthesias in 3 electrocoagulation patients, was solved in 23 ± 5 days; (c) bradycardia in 1 ultrasonic patient, normalized in 4th postoperative hour; (d) unilateral relapse in 2 electrocoagulation patients after the second side approach, positively treated in 1 patient by resurgery in video-assisted thoracoscopy (VAT). The quality-adjusted life year and the quality of life evaluation revealed a statistically significant improvement (p = 0.02) in excessive sweating and general satisfaction after surgery, with Ultracision and LigaSure showing better findings than electrocoagulation. The latest generation devices offered greater efficacy in the treatment of hyperhidrosis, minimizing complications and facilitating the resumption of normal work and social activity of patients. Georg Thieme Verlag KG Stuttgart · New York.

  12. Connective Tissue Degeneration: Mechanisms of Palmar Fascia Degeneration (Dupuytren's Disease)

    NARCIS (Netherlands)

    Karkampouna, S.; Kreulen, M.; Obdeijn, M. C.; Kloen, P.; Dorjée, A. L.; Rivellese, F.; Chojnowski, A.; Clark, I.; Kruithof-de Julio, Marianna

    2016-01-01

    Dupuytren's disease is a connective tissue disorder of the hand causing excessive palmar fascial fibrosis with associated finger contracture and disability. The aetiology of the disease is heterogeneous, with both genetic and environmental components. The connective tissue is abnormally infiltrated

  13. [Focal hyperhidrosis.Quality of life, socioeconomic importance and use of internal medicinal therapy].

    Science.gov (United States)

    Rzany, B; Müller, C; Hund, M

    2012-06-01

    Focal hyperhidrosis can have a substantial influence on the professional, physical, emotional and social life of those affected. This becomes clear when the results of quality of life studies and Health Service Research studies are reviewed, e.g. affected patients were prepared to contribute additional money for treatment of hyperhidrosis. The systemic therapy of focal hyperhidrosis with oral anticholinergic agents is a quite economical treatment strategy. These products can be administered continuously or sporadically. However, only good clinical date for the continous treatment exists. Focal hyperhidrosis is a disease which requires our full attention. It should be discussed whether e.g. QoL questionnaires should be used routinelly.

  14. Imaginando Palmares: a obra de Gayl Jones

    Directory of Open Access Journals (Sweden)

    Stelamaris Coser

    2005-01-01

    Full Text Available http://dx.doi.org/10.1590/S0104-026X2005000300010 O longo poema narrativo Song for Anninho (1981, da escritora negra Gayl Jones (Estados Unidos, interfere na narrativa da história colonial brasileira ao resgatar a figura feminina na República de Palmares, reescrever a saga de resistência dos palmaristas do ponto de vista imaginário de uma mulher negra do século XVII e, através dela, reinventar o cotidiano, os amores, as disputas e os sonhos das pessoas comuns que integravam o quilombo. O texto reflete sobre a verdade histórica, o aspecto construído de documentos, as seleções e exclusões da linguagem, e a importância do relato oral para o conhecimento de vivências e identidades à margem da história oficial. Nessa versão especial, o relato dramático do sonho, da luta e da destruição do mais famoso quilombo brasileiro usa a imaginação literária para expandir a memória e os arquivos de um dos fatos mais importantes da história das Américas, contribuindo para estimular o diálogo interamericano e iluminar a diáspora africana no Brasil e no continente.

  15. Uruguay project - Metalic silicon manufacturing. Palmar location study

    International Nuclear Information System (INIS)

    2003-01-01

    This work is about the Soriano town possibilities offered to Rima Industrial S.A in relation with the metallic silicon project in Uruguay. In this zone there is the Palmar hydroelectric plant with a capacity of 33 MW and its development is part of the Rio Negro river

  16. Imaginando Palmares: a obra de Gayl Jones Imagining Palmares: the work of Gayl Jones

    Directory of Open Access Journals (Sweden)

    Stelamaris Coser

    2005-12-01

    Full Text Available O longo poema narrativo Song for Anninho (1981, da escritora negra Gayl Jones (Estados Unidos, interfere na narrativa da história colonial brasileira ao resgatar a figura feminina na República de Palmares, reescrever a saga de resistência dos palmaristas do ponto de vista imaginário de uma mulher negra do século XVII e, através dela, reinventar o cotidiano, os amores, as disputas e os sonhos das pessoas comuns que integravam o quilombo. O texto reflete sobre a verdade histórica, o aspecto construído de documentos, as seleções e exclusões da linguagem, e a importância do relato oral para o conhecimento de vivências e identidades à margem da história oficial. Nessa versão especial, o relato dramático do sonho, da luta e da destruição do mais famoso quilombo brasileiro usa a imaginação literária para expandir a memória e os arquivos de um dos fatos mais importantes da história das Américas, contribuindo para estimular o diálogo interamericano e iluminar a diáspora africana no Brasil e no continente.The long narrative poem Song for Anninho (1981, written by black U.S. writer Gayl Jones, interferes in the narrative of Brazilian colonial history as it highlights the female presence in the Republic of Palmares, rewrites the tale of resistance from the point of view of a black woman in the 17th Century, and, through her, reinvents the everyday lives, loves, disputes, and dreams of common people in the quilombo. The text reflects about historical truth, the constructed character of documents, selections and exclusions in language, and the importance of oral accounts to give visibility to experiences and identities marginalized by official history. In this special version, the dramatic report of the dreams, struggles, and destruction of the most famous Brazilian quilombo uses literary imagination to expand the memory and the archives of one of the most important facts in the history of the Americas, contributing to stimulate

  17. Prevention of palmar-plantar erythrodysesthesia with an antiperspirant in breast cancer patients treated with pegylated liposomal doxorubicin (SAKK 92/08).

    Science.gov (United States)

    Templeton, Arnoud J; Ribi, Karin; Surber, Christian; Sun, Hong; Hsu Schmitz, Shu-Fang; Beyeler, Michael; Dietrich, Daniel; Borner, Markus; Winkler, Annette; Müller, Andreas; von Rohr, Lukas; Winterhalder, Ralph C; Rochlitz, Christoph; von Moos, Roger; Zaman, Khalil; Thürlimann, Beat J K; Ruhstaller, Thomas

    2014-06-01

    Elevated concentrations of doxorubicin are found in eccrine sweat glands of the palms and soles. We therefore evaluated an antiperspirant as preventive treatment for palmar-plantar erythrodysesthesia (hand-foot syndrome) in patients with metastatic breast cancer treated with pegylated liposomal doxorubicin. An antiperspirant containing aluminum chlorohydrate or placebo cream was applied to the left or right hand and foot in a double-blinded manner (intra-patient randomization). The primary endpoint was the rate of grade 2 or 3 palmar-plantar erythrodysesthesia. A secondary endpoint was the patient-reported symptom burden (tingling, numbness, pain, or skin problems). Using McNemar's matched pairs design, 53 patients were needed to detect a 20% difference between the treatment and placebo sides with a significance level of 5% and power of 90%. Grade 2 or 3 PPE occurred in 30 (58%) of 52 evaluable patients; in six patients adverse effects occurred on the placebo side but not on the treatment side, whereas one patient developed palmar-plantar erythrodysesthesia on the treatment side only (P = 0.07). Four patients developed grade 2 or 3 palmar-plantar erythrodysesthesia on their foot on the placebo side but not on the treatment side (P = 0.05). In the cohort with grade 2 or 3 palmar-plantar erythrodysesthesia there was a trend towards fewer dermatologic symptomatologies with the active treatment (P = 0.05), and no difference for other adverse events. Using topical aluminum chlorohydrate as an antiperspirant appears to reduce the incidence of grade 2 or 3 palmar-plantar erythrodysesthesia following pegylated liposomal doxorubicin chemotherapy for metastatic breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. A study investigating patients' experience of hospital and home iontophoresis for hyperhidrosis.

    LENUS (Irish Health Repository)

    McAleer, Maeve Aine

    2014-08-01

    Iontophoresis is an effective and safe treatment for hyperhidrosis. We investigated patients\\' experiences with the Idrostar® home iontophoresis unit (STD Pharmaceuticals, Hereford, UK) considering compliance and efficacy.

  19. Imaging of compound palmar ganglion with pathologic correlation

    Directory of Open Access Journals (Sweden)

    Sourav Talukder

    2014-12-01

    Full Text Available Compound palmar ganglion, or chronic flexor tenosynovitis, most commonly of tuberculousorigin, is a rare extrapulmonary manifestation of tuberculosis (TB. The flexor synovialsheath is not a common site for TB but, once involved, causes rapid involvement of all flexortendons. We discuss the case of a 70-year-old farmer who presented to us with pain and progressive swelling of the palmar aspect of the wrist. On clinical examination, swelling both above and below the proximal wrist crease was found, with positive cross-fluctuation. Onultrasonography and magnetic resonance imaging, features suggestive of compound palmarganglion were present. The patient underwent surgical resection (extensive tenosynovectomyand chemotherapy. Post-operative histopatholgical findings correlated with the radiological features.

  20. Fingertip Replantation With Palmar Venous Anastomoses in Children.

    Science.gov (United States)

    Wen, Gen; Xu, Jia; Chai, Yi-Min

    2017-06-01

    Fingertip amputation in children is difficult to manage using microsurgical replantation techniques and many salvage procedures have failed owing to the nonavailability of suitable veins for anastomosis in the fingertip. This study reviewed our experience of pediatric fingertip replantation involving palmar venous anastomoses and evaluated the clinical outcomes. From October 2008 to May 2013, 21 pediatric fingertips that had been completely amputated at or distal to the distal interphalangeal joint of the finger, or at or distal to the interphalangeal joint of the thumb were managed using complete replantation. One artery was anastomosed for revascularization with or without nerve repair, and a palmar venous anastomosis was performed to reestablish the outflow system. Twenty (95.2%) of the 21 fingertips survived. One replant involving an avulsion amputation of the left little finger failed, and the patient underwent stump cap-plasty. Excellent restoration of finger motion, pinch strength, and appearance was observed during the mean 39.9-month (range, 18-65 months) follow-up. The mean regained static 2-point discrimination sensation was 3.8 mm (range, 3.2-4.2 mm). All of the children and their families were satisfied with the surgical outcomes. Successful palmar venous anastomosis appears to promote the survival of replanted fingertips in children. Given that the procedure may simplify postoperative care, minimize complications, and achieve a high survival rate, it should be attempted if the technical expertise is available.

  1. Simpatectomia por videotoracoscopia no tratamento da hiperhidrose palmar: implicações anestésicas Simpatectomia por videotoracoscopia en el tratamiento de la hiperhidrosis palmar: implicaciones anestésicas Thoracoscopic sympathectomy to treat palmar hyperhydrosis: anesthetic implications

    Directory of Open Access Journals (Sweden)

    Monia Di Lara Dias

    2005-06-01

    creciente el número de procedimientos. La introducción de la videotoracoscopia mejoró la técnica, redujo la morbidad, el tiempo quirúrgico y el tiempo de permanencia hospitalaria. El adecuado manoseo anestésico, monitorización continuada y las técnicas a disposición permiten que el procedimiento sea realizado con seguridad o se modifiquen las conductas de acuerdo con las observaciones clínicas y las respuestas del paciente a las alteraciones dinámicas consecuentes de la cirugía y terapéutica farmacológica. Sería entonces, deber del anestesiologista disponer con criterio y buen sentido de las alternativas disponibles para asegurar al paciente un procedimiento seguro, una recuperación rápida con la menor morbidad posible.BACKGROUND AND OBJECTIVES: Primary hyperhydrosis is a disorder characterized by excessive diffuse or localized sweating. There are several noninvasive therapeutic methods which in general do not solve the problem generating even more anxiety, and time and money wasting for hyperhydrosis patients. Partial thoracic sympathetic chain resection is indicated for palmar hyperhydrosis and may be performed by thoracoscopic surgery with good results and few complications. This review aimed at discussing possible anesthetic techniques for this procedure, as well as possible complications and their management. CONTENTS: It is estimated that the incidence of primary hyperhydrosis varies from 0.6% to 1%, being more frequent in young patients. While in most cases axillary and plantar sweating causes discomfort only, excessive palmar sweating causes social, professional and psychological problems. Thoracoscopic sympathectomy has been performed in several hospitals and is increasing in number. Unless there are specific counterindications, bilateral sympathectomy is performed under general anesthesia through a double or single lumen catheter, with or without intrapleural carbon dioxide inflation. Major postoperative cares are early pneumothorax or residual

  2. A systematic review of microwave-based therapy for axillary hyperhidrosis.

    Science.gov (United States)

    Hsu, Tzu-Herng; Chen, Yu-Tsung; Tu, Yu-Kang; Li, Chien-Nien

    2017-10-01

    To systematically analyse the literature on the use of the microwave-based device for subdermal thermolysis of the axilla and its efficacy for the treatment of axillary hyperhidrosis. A systematic review was conducted using PubMed, Embase, SCOPUS and Cochrane databases on 2 June 2016. The inclusion criteria including: (1) studies with human subjects, (2) full-text articles published in English, (3) a microwave-based device used to treat axillary hyperhidrosis and (4) trials that precisely evaluated axillary hyperhidrosis. Exclusion criteria were the following: (1) studies that did not fit the inclusion criteria mentioned above and (2) case reports and reviews. We reviewed five clinical trials and 189 patients, all of which were published between 2012 and 2016. There was one randomized controlled trial, one retrospective study and the remainder were prospective studies. Although all of the studies were conducted with a small sample size, the results indicated that microwave-based device treatment of axillary hyperhidrosis had long-term efficacy with mild adverse effects. In addition, most patients were satisfied with the outcomes in these studies. Microwave-based device treatment may be an effective alternative treatment for axillary hyperhidrosis. However, further investigation is necessary to determine its long-term efficacy and safety.

  3. Replantation of multi-level fingertip amputation using the pocket principle (palmar pocket method).

    Science.gov (United States)

    Arata, J; Ishikawa, K; Soeda, H; Kitayama, T

    2003-07-01

    Two cases of multi-level fingertip amputation are presented. In each case, replantation was achieved in a two-stage procedure, involving reattachment, de-epithelialisation and insertion into a palmar pocket in stage 1, followed by removal from the palmar pocket 16 days later. The cases are described and the technique is discussed.

  4. Phytolith analysis in fluvial quaternary sediment (San Salvador and Palmar formation) Uruguay river and Argentina eastern

    International Nuclear Information System (INIS)

    Patterer, N.; Passeggi, E.; Zucol, A.; Brea, M.; Krohling, D.

    2012-01-01

    This work is about two microfossils fluvial units deposited by the Uruguay river during the Quaternary. These are San Salvador and Palmar formation (Plio-Pleistocene - Upper Pleistocene).The Palmar formation is a band of 4-15 km along the right bank of the Uruguay river outcropping from the eastern provinces of Corrientes and Entre Rios, to Concepcion del Uruguay

  5. Reverse Distal Transverse Palmar Arch in Distal Digital Replantation.

    Science.gov (United States)

    Wei, Ching-Yueh; Orozco, Oscar; Vinagre, Gustavo; Shafarenko, Mark

    2017-11-01

    Refinements in microsurgery have made distal finger replantation an established technique with high success rates and good functional and aesthetic outcomes. However, it still represents a technically demanding procedure due to the small vessel caliber and frequent lack of vessel length, requiring the use of interpositional venous grafts in some instances. We describe a new technique for anastomosis in fingertip replantation, whereby the need for venous grafts is eliminated. Applying the reverse distal transverse palmar arch technique, 11 cases of distal digital replantation were performed between January 2011 and July 2016. The described procedure was used for arterial anastomosis in 10 cases and arteriovenous shunting for venous drainage in 1 case. A retrospective case review was conducted. The technical description and clinical outcome evaluations are presented. Ten of the 11 replanted digits survived, corresponding to an overall success rate of 91%. One replant failed due to venous insufficiency. Blood transfusions were not required for any of the patients. Follow-up (range, 1.5-5 months) revealed near-normal range of motion and good aesthetic results. All of the replanted digits developed protective sensation. The average length of hospital admission was 5 days. All patients were satisfied with the results and were able to return to their previous work. The use of the reverse distal transverse palmar arch is a novel and reliable technique in distal digital replantation when an increase in vessel length is required, allowing for a tension-free arterial repair without the need for vein grafts.

  6. [Circumscribed palmar hypokeratosis (CPM): The diagnostic value of dermoscopy].

    Science.gov (United States)

    Topin-Ruiz, S; Debarre, J-M; Blanchard, E; Kettani, S; Valmier, P-J; Martin, L; Le Corre, Y

    2017-03-01

    Circumscribed palmar hypokeratosis (CPH) is a rare skin disease, first described in 2002, associated with sudden localized reduction of the corneal layer. In most cases, it presents as an isolated rounded erythematous palmar lesion on the thenar eminence. We describe the dermoscopic semiology of CPH in 3 cases. Three patients between the ages of 59 and 72 presented very limited erythematous lesions suggestive of CPH. Dermoscopic examination of these lesions provided similar findings. Biopsy, which was performed in one patient, confirmed the diagnosis of CPH. Two dermoscopic elements of CPH are characteristic: (1) the sides of the lesion have a "stair step" or "geological strata" type of configuration, and the thickness of the different strata varies; (2) the centre of the lesion showed a homogeneous erythematous area with a vascular pattern composed of dotted vessels of the superficial dermis and sometime vascular loops. These dermoscopic aspects are characteristic and enable CPH to be differentiated from Bowen's disease or porokeratosis of Mibelli. In Bowen's disease, there is no stair step like aspect to the sides of lesions; further, the centre of the lesion shows glomerular vessels (coiled vessels) and/or globular vessels (small red clods). In porokeratosis, peripheral keratotic "white track" structures comprise a single pigmented channel or a double white line. There is no "stair step" or central vascular pattern. The dermoscopic semiology of CPH is highly characteristic and enables differentiation from Bowen's disease and porokeratosis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. Hyperhidrosis: an update on prevalence and severity in the United States.

    Science.gov (United States)

    Doolittle, James; Walker, Patricia; Mills, Thomas; Thurston, Jane

    2016-12-01

    Current published estimates of the prevalence of hyperhidrosis in the United States are outdated and underestimate the true prevalence of the condition. The objectives of this study are to provide an updated estimate of the prevalence of hyperhidrosis in the US population and to further assess the severity and impact of sweating on those affected by the condition. For the purposes of obtaining prevalence, a nationally representative sample of 8160 individuals were selected using an online panel, and information as to whether or not they experience hyperhidrosis was obtained. The 393 individuals (210 female, 244 non-Hispanic white, 27 black, mean age 40.3, SE 0.64) who indicated that they have hyperhidrosis were asked further questions, including body areas impacted, severity of symptoms, age of onset, and socioemotional impact of the condition. Current results estimate the prevalence of hyperhidrosis at 4.8 %, which represents approximately 15.3 million people in the United States. Of these, 70 % report severe excessive sweating in at least one body area. In spite of this, only 51 % have discussed their excessive sweating with a healthcare professional. The main reasons are a belief that hyperhidrosis is not a medical condition and that no treatment options exist. The current study's findings with regard to age of onset and prevalence by body area generally align with the previous research. However, current findings suggest that the severity and prevalence are both higher than previously thought, indicating a need for greater awareness of the condition and its associated treatment options among medical professionals.

  8. Deep erosions of the palmar aspect of the navicular bone diagnosed by standing magnetic resonance imaging.

    Science.gov (United States)

    Sherlock, C; Mair, T; Blunden, T

    2008-11-01

    Erosion of the palmar (flexor) aspect of the navicular bone is difficult to diagnose with conventional imaging techniques. To review the clinical, magnetic resonance (MR) and pathological features of deep erosions of the palmar aspect of the navicular bone. Cases of deep erosions of the palmar aspect of the navicular bone, diagnosed by standing low field MR imaging, were selected. Clinical details, results of diagnostic procedures, MR features and pathological findings were reviewed. Deep erosions of the palmar aspect of the navicular bone were diagnosed in 16 mature horses, 6 of which were bilaterally lame. Sudden onset of lameness was recorded in 63%. Radiography prior to MR imaging showed equivocal changes in 7 horses. The MR features consisted of focal areas of intermediate or high signal intensity on T1-, T2*- and T2-weighted images and STIR images affecting the dorsal aspect of the deep digital flexor tendon, the fibrocartilage of the palmar aspect, subchondral compact bone and medulla of the navicular bone. On follow-up, 7/16 horses (44%) had been subjected to euthanasia and only one was being worked at its previous level. Erosions of the palmar aspect of the navicular bone were confirmed post mortem in 2 horses. Histologically, the lesions were characterised by localised degeneration of fibrocartilage with underlying focal osteonecrosis and fibroplasia. The adjacent deep digital flexor tendon showed fibril formation and fibrocartilaginous metaplasia. Deep erosions of the palmar aspect of the navicular bone are more easily diagnosed by standing low field MR imaging than by conventional radiography. The lesions involve degeneration of the palmar fibrocartilage with underlying osteonecrosis and fibroplasia affecting the subchondral compact bone and medulla, and carry a poor prognosis for return to performance. Diagnosis of shallow erosive lesions of the palmar fibrocartilage may allow therapeutic intervention earlier in the disease process, thereby preventing

  9. A comparison of radiography, computed tomography, and magnetic resonance imaging for the diagnosis of palmar process fractures in foals

    International Nuclear Information System (INIS)

    Kaneps, A.J.; Koblik, P.D.; Freeman, D.M.; Pool, R.R.; O'Brien, T.R.

    1995-01-01

    The relative sensitivity of radiography, computed tomography, and magnetic resonance imaging for detecting palmar process fractures of the distal phalanx in foals was determined and the imaging findings were compared with histomorphologic evaluations of the palmar processes. Compared to radiography, computed tomography and magnetic resonance imaging did not improve the sensitivity for detection of palmar process fractures. Statistical agreement for palmar process fracture diagnosis was excellent among the three imaging modalities. Histomorphologic evaluations were more sensitive for diagnosis of palmar process fracture than any of the imaging modalities. Three-dimensional image reconstructions and volume measurements of distal phalanges and palmar process fracture fragments from computed tomography studies provided more complete anatomical information than radiography. Magnetic resonance imaging confirmed that the deep digital flexor tendon insertion on the distal phalanx is immediately axial to the site where palmar process fractures occur, and differentiated cartilage, bone, and soft tissue structures of the hoof

  10. Hyperhidrosis in children and review of its current evidence-based ...

    African Journals Online (AJOL)

    Hyperhidrosis (HH) is excessive sweating that usually interferes with the patient's social life. In more than 80% of the cases, the symptoms start in childhood. Early detection and management can significantly improve the patient's quality of life; however, HH remains widely underdiagnosed and undertreated, particularly ...

  11. Two patients with localised hyperhidrosis of the hand based on functional and structural abnormalities of sweat glands

    DEFF Research Database (Denmark)

    Kristiansen, Bjørn H; Lindahl, Kim H; Pallesen, Kristine A U

    2018-01-01

    A 14-year-old girl and a 30-year-old woman presented with localised hyperhidrosis on the dorsal hand and wrist, respectively, provoked by different stimuli such as physical activity and minor trauma to the skin. The skin was seemingly normal in both patients where an iodine-starch test revealed...... a well-demarcated area of hyperhidrosis. Following histopathological examination, the diagnosis was unilateral localised hyperhidrosis in both cases; one with normal histology and one with a nevus sudoriferous. Both patients were successfully treated with botulinum toxin type A. The 30-year-old woman...... additionally used low-dose propantheline bromide periodically and experienced long-term remission on this therapy. Hyperhidrosis may embarrass and interfere with patients' school and careers, and it is therefore important to tailor an effective individual treatment....

  12. Circumscribed palmar or plantar hypokeratosis: report of a Korean case and published work review.

    Science.gov (United States)

    Lee, Sang Eun; Kim, You Chan; Kim, Soo-Chan

    2006-06-01

    Circumscribed palmar or plantar hypokeratosis is a rare dermatosis characterized by a solitary, well-circumscribed patch with scaly borders chiefly on the palm or sole; it usually occurs in middle-aged or elderly women. We report the case of a 52-year-old Korean woman with two characteristic lesions of circumscribed palmar hypokeratosis on the left palm. Clinically, the lesions simulated porokeratosis of Mibelli, but histologically there was no cornoid lamellation in the serial sections and there were the characteristic histopathological features of circumscribed palmar or plantar hypokeratosis including a stair-like configuration with an abrupt thinning of the stratum corneum and a decreased granular layer. We also review the 16 cases of circumscribed palmar or plantar hypokeratosis reported in the published work.

  13. Glabrous skin reconstruction of palmar/plantar defects: a case for the ...

    African Journals Online (AJOL)

    DR LEGBO

    Methods: A prospective descriptive study of consecutive patients with benign soft tissue palmar/plantar defects .... cannot be closed by direct suturing. In the authors' view ... splintage ) did not lead to joint stiffness since majority were children ...

  14. Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography.

    Science.gov (United States)

    Kaplanoglu, Hatice; Beton, Osman

    2017-04-01

    To evaluate the abnormalities and variations of the arterial system of upper extremities and superficial palmar arch with computed tomography angiography and to guide the clinician during this procedure. A total of 156 upper extremities of 78 cases were retrospectively analyzed using computed tomography angiography. The study was approved by the local ethics committee of the hospital. From the analysis of the computed tomography angiography images, the following information was recorded; the diameters and abnormalities of radial, ulnar and brachial arteries in both upper extremities, the presence of atherosclerotic changes or stenosis in these arteries, whether the superficial palmar arch was complete or incomplete, and arterial dominance. Also, the computed tomography angiography classification of superficial palmar arch distribution and anatomic configuration was performed. The mean baseline diameters of the radial, ulnar and brachial arteries of the cases were; 2.8 ± 0.6, 2.5 ± 0.7, and 4.7 ± 0.6 mm, respectively. A complete superficial palmar arch was observed in 69.2 % of the right hands and 70.5 % of the left hands. For the superficial palmar arches on the right side, the radial artery was dominant in two and the ulnar artery was dominant in 47 with the remaining showing codominance. On the left side, the radial artery was dominant in one hand, with the ulnar artery being dominant in 49 cases, and in 28 cases, there was codominance. In the superficial palmar arch classification, four of the arches (A-D) were defined as complete and the remaining three (E-G) as incomplete. The current study clarified different variations in palmar circulation and forearm arteries to aid the surgeon during trans-radial or trans-ulnar catheterization, hemodialysis, or coronary artery bypass grafting.

  15. A comparative study of thoracoscopic sympathicotomy versus local surgical treatment for axillary hyperhidrosis

    DEFF Research Database (Denmark)

    Heidemann, Erik; Licht, Peter B

    2013-01-01

    Axillary hyperhidrosis affects approximately 1.4% of the population. Medical management is often frustrating, and the response generally transient. Surgical methods include thoracoscopic sympathectomy or sympathicotomy and local axillary surgery such as suction-curettage or en-bloc skin resection....... Many case series with retrospective follow-up are available in the literature, but no comparative studies between surgical techniques have been published....

  16. Role of linoleic acid in arsenical palmar keratosis.

    Science.gov (United States)

    Ahmed, Tarafder S; Misbahuddin, Mir

    2016-03-01

    Chronic arsenic exposure can lead to palmoplantar keratosis. In the stratum corneum of skin, linoleic acid is of the utmost importance to the inflammation, keratinization, and regeneration processes. The aims of this study were: (i) to present quantitative information on the linoleic acid fraction of intercorneocyte lipids, and (ii) to elucidate the role of linoleic acid in the pathophysiology of arsenical keratosis. Lipid extracts were collected from keratotic lesions in seven patients, seven arsenic-exposed subjects, and seven non-exposed control subjects. Linoleic acid levels of the specimens were estimated by reverse-phase high-performance liquid chromatography (RP-HPLC). There was a significant (P keratosis patients (palm: 25.66 ± 4.95 μg/cm(2); dorsum: 28.25 ± 6.20 μg/cm(2)) compared with arsenic-exposed (palm: 2.75 ± 0.85 μg/cm(2); dorsum: 1.96 ± 0.64 μg/cm(2)) and non-exposed (palm: 1.52 ± 0.61 μg/cm(2); dorsum: 1.28 ± 0.39 μg/cm(2)) control subjects. There was no significant difference (P = 0.556) in linoleic acid concentration in the non-affected skin of the dorsum of the hand (28.25 ± 6.20 μg/cm(2)) compared with that in the palmar sites (25.66 ± 4.95 μg/cm(2)) in the patient group. The change in linoleic acid levels in the arsenic-exposed control group did not differ from that in non-exposed controls (P = 1.000). Linoleic acid concentration is elevated in arsenical keratosis; this finding warrants further investigation to ascertain whether linoleic acid plays a direct role in the pathophysiology of arsenical keratosis. © 2015 The International Society of Dermatology.

  17. Analysis of the quantitative dermatoglyphics of the digito-palmar complex in patients with multiple sclerosis.

    Science.gov (United States)

    Supe, S; Milicić, J; Pavićević, R

    1997-06-01

    Recent studies on the etiopathogenesis of multiple sclerosis (MS) all point out that there is a polygenetical predisposition for this illness. The so called "MS Trait" determines the reactivity of the immunological system upon ecological factors. The development of the glyphological science and the study of the characteristics of the digito-palmar dermatoglyphic complex (for which it was established that they are polygenetically determined characteristics) all enable a better insight into the genetic development during early embriogenesis. The aim of this study was to estimate certain differences in the dermatoglyphics of digito-palmar complexes between the group with multiple sclerosis and the comparable, phenotypically healthy groups of both sexes. This study is based on the analysis of 18 quantitative characteristics of the digito-palmar complex in 125 patients with multiple sclerosis (41 males and 84 females) in comparison to a group of 400 phenotypically healthy patients (200 males and 200 females). The conducted analysis pointed towards a statistically significant decrease of the number of digital and palmar ridges, as well as with lower values of atd angles in a group of MS patients of both sexes. The main discriminators were the characteristic palmar dermatoglyphics with the possibility that the discriminate analysis classifies over 80% of the examinees which exceeds the statistical significance. The results of this study suggest a possible discrimination of patients with MS and the phenotypically health population through the analysis of the dermatoglyphic status, and therefore the possibility that multiple sclerosis is genetically predisposed disease.

  18. Unilateral Palmar Callus and Irritant Hand Eczema – Underreported Signs of Dependency on Crutches

    Directory of Open Access Journals (Sweden)

    Uwe Wollina

    2018-01-01

    Full Text Available Leg amputees who can’t use prostheses and patients with arthritis are often dependent on crutches. Their chronic use can exert significant friction forces. The palmar skin will respond by forming a hyperkeratotic callus. We report for the first time unilateral palmar callus formation caused by friction from using crutches. Another possible adverse effect is the triggering of irritant contact dermatitis by the handholes of crutches. We report two cases with hand dermatitis due to the chronic dependence on crutches and discuss treatment options.

  19. Thumb fingertip reconstruction with palmar V-Y flaps combined with bone and nail bed grafts following amputation.

    Science.gov (United States)

    Zhou, Xiao; Wang, Libo; Mi, Jingyi; Xu, Yajun; Rui, Yongjun; Xue, Mingyu; Shen, Xiaofang; Qiang, Li

    2015-04-01

    The aim of treating thumb fingertip amputations with no indication for replantation is to reestablish functional and esthetic properties. From March 2005 to October 2008, we treated 14 patients with thumb fingertip amputation using palmar V-Y flaps combined with bone and nail bed grafts. There were 10 men and 4 women, whose ages at surgery ranged from 19 to 63 years (mean 35.8 years). In all, 11 of the injuries occurred in the dominant hand. According to Allen's classification, two were type II, seven were type III, and five were type IV. All patients underwent emergency surgery, with a time delay after injury of 3-12 h (mean 6.4 h). In each case, the amputation was a crush or avulsion injury, making microsurgical replantation not feasible. All of the flaps survived. At 8-17 months (average 12.8 months) of follow-up, the average subjective satisfaction score was 8.64. All patients experienced cold intolerance, and none of the patients complained of dysesthesia. Favorable results (excellent or good) were found in 78.6%. Thin primary nails appeared on the grafted nail bed about 3 weeks after surgery, following which the newly formed nail thickened and developed a more natural appearance. In one case, the new nail plate showed abnormal thickening due to hyperkeratosis. The bone graft healed at 5 weeks. The mean two-point discrimination was 7.5 mm. Grip strength was 10% less than that in the unaffected hand. Metacarpophalangeal and proximal interphalangeal joint mobility losses were less than 10°. All patients returned to their jobs. No patients had postoperative complications. We believe that the combination of palmar V-Y flap and bone and nail bed grafts provides a distinct advantage over other choices. It improves function when replantation is not an option.

  20. Macro fossils vegetable in Palmar formation (later pleistocene) in Entre Rios - Argentina

    International Nuclear Information System (INIS)

    Ramos, R.; Brea, M.; Krohling, D.

    2012-01-01

    This work is about the macro fossil knowledge preserved like wood fossils in the El Palmar Formation (Late Pleistocene) from a systematic - anatomical as well as paleoecological and paleoclimate point of view.The paleo Flora comes from various fossil located in the province of Entre Rios - Argentina

  1. Treatment of fingertip amputation in adults by palmar pocketing of the amputated part.

    Science.gov (United States)

    Jung, Mi Sun; Lim, Young Kook; Hong, Yong Taek; Kim, Hoon Nam

    2012-07-01

    First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm. Of a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results. A composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.

  2. Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

    Directory of Open Access Journals (Sweden)

    Mi Sun Jung

    2012-07-01

    Full Text Available BackgroundFirst suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults.MethodsBetween 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm.ResultsOf a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results.ConclusionsA composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.

  3. Radiographic and pathologic characterization of lateral palmar intercarpal ligament avulsion fractures in the horse.

    Science.gov (United States)

    Beinlich, Christopher P; Nixon, Alan J

    2004-01-01

    In this study, the radiographic and histologic appearance of lateral palmar intercarpal ligament (LPICL) avulsion in the horse was characterized. Thirty-seven horses with radiographic evidence of avulsion fragments originating from the medial palmar aspect of the ulnar carpal bone were examined. The dorsolateral to palmaromedial projection was useful for evaluating the size and shape of the avulsed bone fragment, and the dorsopalmar projection added information on the relative proximity of the fragment to its fracture bed. Radiographic features that differentiated LPICL avulsion from subchondral cystic lesions of the ulnar carpal bone included a variable-sized osseous opacity adjacent to the lucent concavity of the fracture bed and the consistent location within the palmar transition zone at the confluence of LPICL insertion and hyaline cartilage on the palmar surface of the ulnar carpal bone. All 26 horses having surgical removal of the fragments had arthroscopic confirmation that the fragment was within the LPICL. Histologic examination confirmed the fragments were fracture related rather than developmental or the result of dystrophic mineralization. Many of the fragments had attached remnants of a ligament. This study describes the radiographic, surgical, and histologic features in 37 horses which better characterize LPICL avulsion fracture in the carpus and provide differentiating features to assist in separating this syndrome from true osseous cyst-like lesions within the ulnar carpal bone.

  4. Palmar-plantar erythrodysesthesia secondary to docetaxel chemotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Al-Niaimi Amjad

    2011-02-01

    Full Text Available Abstract Introduction Docetaxel is a chemotherapeutic agent used alone or in combination for the management of many neoplastic conditions. Numerous side effects are well described as a consequence. Palmar-plantar erythrodysesthesia, although a relatively common side effect of some types of chemotherapy, occurs infrequently with docetaxel and is often attributed to other drug agents. Case Presentation We report the case of a 66-year-old Caucasian woman who received adjuvant docetaxel monotherapy for invasive breast cancer. She developed palmar-plantar erythrodysesthesia following her first cycle of treatment, which necessitated a change in management. Conclusion Palmar-plantar erythrodysesthesia is a relatively common side effect of cytotoxic chemotherapy, particularly with drugs such as 5-fluorouracil, capecitabine and liposomal doxorubicin. Docetaxel is commonly used both alone and in combination with a number of these agents for the management of various malignant conditions. We would like to highlight the occurrence of palmar-plantar erythrodysesthesia as a result of docetaxel monotherapy so that it can be considered as a potential cause in patients receiving combination treatment with chemotherapeutic agents better known to cause this toxicity.

  5. Geological map of Uruguay Esc 1,100,000. Paso del Palmar Sheet N-19

    International Nuclear Information System (INIS)

    Ford, I.; Montana, J.; Morales, H.

    1990-01-01

    This work is about the geological map of Uruguay Esc.1.100.000 (Paso del Palmar) and the explanatory memoranda which describes the geological , lithological and sedimentological characteristics soils belong to Cretaceous, Tertiary and Quaternary period in San Gregorio, Arapey, Mercedes, Asencio and Fray Bentos formations

  6. Hyperhidrosis Substantially Reduces Quality of Life in Children: A Retrospective Study Describing Symptoms, Consequences and Treatment with Botulinum Toxin

    Directory of Open Access Journals (Sweden)

    Sandra Eriksson Mirkovic

    2017-09-01

    Full Text Available Studies on children with hyperhidrosis are sparse. This retrospective study presents clinical data and quality of life, along with treatment effect and safety of botulinum toxin (BTX. Case reports from 366 children were included to capture the medical history of hyperhidrosis. The total median score of the Dermatology Life Quality Index before treatment was 11 for children aged 16–17 years and 12 for children younger than 16 years. The children described physical, psychosocial and consequence-related symptoms. More than 70% had multifocal hyperhidrosis. BTX-A and/or BTX-B were given to 323 children, 193 of whom received repeated treatments. The highest score in a 5-grade scale concerning treatment effect was reported by 176/193 children, i.e. their “sweating disappeared completely”. No severe adverse events occurred. Focal and multifocal hyperhidrosis in children reduces quality of life considerably. Treatment with BTX-A and/or BTX-B has been performed with success.

  7. Hyperhidrosis in naïve purpose-bred beagle dogs (Canis familiaris).

    Science.gov (United States)

    Carrier, Catherine A; Seeman, Jennifer L; Hoffmann, Guenther

    2011-05-01

    This case study details the unusual clinical findings in a unique paw-pad disorder that recently emerged among 2 male and 1 female naïve purpose-bred beagle dogs (Canis familiaris) newly received into our facility. During acclimation period physical examinations, the affected dogs demonstrated constantly moist, soft paw pads on all 4 feet. No information was available regarding the epidemiology and pathogenesis of this pad condition in beagle dogs. Here, we report the results of physical examination, clinical chemistry analysis, hematology, histopathology, detailed observations, and novel testing techniques performed during the acclimation period. Histopathology of several sections of affected footpads was compared with that of an age-matched dog with clinically normal paw pads. We describe the morphologic features of a distinctive cutaneous canine footpad condition and discuss the possible differential diagnoses. The histologic and clinical features were most consistent with those of hyperhidrosis; to our knowledge, this report is the first description of hyperhidrosis as a distinct condition in purpose-bred beagle dogs.

  8. A influência de palmares e parachute na coordenação dos nados

    OpenAIRE

    Thiago Telles

    2012-01-01

    Resumo: A natação é uma modalidade esportiva que, ao longo dos anos, sofreu modificações, atingindo um alto nível de exigência, o que é refletido nas sessões de treinamentos e nas pesquisas sobre a modalidade. Sendo assim, para otimizar o deslocamento nos nadadores pode-se otimizar a força propulsora. Para isso, pode-se utilizar palmares e parachute. Os palmares tem como função promover o aumento artificial da área da mão, desta maneira, aumenta-se a área frontal da mão do sujeito em contato ...

  9. Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome.

    Science.gov (United States)

    Araújo, Rogério Gayer Machado de; Kouyoumdjian, João Aris

    2007-09-01

    Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU) in electrodiagnosis of carpal tunnel syndrome (CTS). Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands). Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands). PMU was obtained at the usual temperature, >32 degrees C, and after wrist/hand cooling to PMU and mixed ulnar palmar latency in patients versus controls. We concluded that cooling significantly modifies the PMU. We propose that the latencies of compressed nerve overreact to cooling and that this response could be a useful tool for incipient CTS electrodiagnosis. There was a significant latency overreaction of the ulnar nerve to cooling in CTS patients. We hypothesize that subclinical ulnar nerve compression is associated with CTS.

  10. Propuesta de un proyecto comunitario como alternativa de desarrollo del recinto El Palmar mediante el Agroturismo

    OpenAIRE

    Pino Panchig, Silvana Fernanda; Rivera Núñez, Lorena Marisol

    2006-01-01

    Given the above problems, it was necessary to raise a proposal that can be developed in rural areas in which it seeks to improve living conditions by promoting community tourism, agrotourism in this case is an activity for the population of El Palmar can be a source of additional income that depend on their main economic activity, becoming a productive heading over the agricultural enterprise. Ante la problemática antes mencionada, fue necesario plantear una propuesta que pueda ser desarro...

  11. Arthroscopic removal of discrete palmar carpal osteochondral fragments in horses: 25 cases (1999-2013).

    Science.gov (United States)

    Lang, Hayley M; Nixon, Alan J

    2015-05-01

    To characterize discrete palmar carpal osteochondral fragmentation in horses and to document the effect of osteoarthritis and surgical removal of these fragments on functional outcome. Retrospective case series. 25 horses. Medical records and radiographic views were reviewed to identify horses that had radiographic evidence of palmar carpal fragmentation, which was subsequently treated by arthroscopic removal. Information collected included cause of fracture, initial and long-term clinical and radiographic findings, and functional outcome. Palmar carpal fragmentation of 30 carpal bones was identified in 25 unilaterally affected horses. A known traumatic event was reported to cause the fragmentation in 17 of the 25 (68%) horses. Of the 25 horses, 17 (68%) had fragmentation involving the antebrachiocarpal joint, 7 (28%) had fragmentation involving the middle carpal joint, and 1 (4%) had fragmentation involving the carpometacarpal joint. The proximal aspect of the radial carpal bone was the most commonly affected site (12/30 fragments), followed by the accessory carpal bone (6/30). Of the 25 horses, 19 (76%) were not lame (sound) after surgery and returned to their intended use, 4 (16%) were considered pasture sound, and 2 were euthanized (because of severe postoperative osteoarthritis or long bone fracture during recovery from anesthesia). Eight of the 14 horses with preoperative evidence of osteoarthritis returned to function after surgery. Twelve of 17 horses with antebrachiocarpal joint fragments and 6 of 7 horses with middle carpal joint fragments returned to their previous use. Results indicated that the prognosis for horses after arthroscopic removal of palmar carpal osteochondral fragments is good. Early intervention, before the development of osteoarthritis, is recommended.

  12. Comminuted Distal Radial Fracture with Large Rotated Palmar Medial Osteochondral Fragment in the Joint.

    Science.gov (United States)

    Gökkus, Kemal; Sagtas, Ergin; Kesgin, Engin; Aydin, Ahmet Turan

    2018-01-01

    Intra-articular distal radius fractures have long been massively discussed in the literature, but regarding to fractures that possess rotated volar medial fragment in the joint a few amount papers has been written. In this article, we would like to emphasize the significance of the rotated palmar medial (lunate facet) fragment. A 39-year-old man fell from a height of about 3 m and landed on his right outstretched hand; within 40 min, he arrived at our clinic presenting with a severe pain and swelling in his right wrist. Initial X-rays of the wrist revealed dorsal subluxation of the radiocarpal joint with dorsal comminution of the radial articular surface and fracture of the radial styloid process, with (nearly inverted) ~ 140-150° rotation of the palmar medial fragment. With an additional volar approach, the fragment reduced and stabilized with two K-wires and wrist immobilized in external fixator. The patient returned to daily activities without any discomfort and pain after the 1 year from the surgery. Overlooking of palmar rotated osteochondral fragment will cause deficiency to build proper pre-operative strategy to approach the reduction of the fragment. The incompetence of reduction will deteriorate the articular surface and lead to early osteoarthritis of the wrist. The surgeon should detect this fragment and should be familiar with volar approaches of the wrist. Above average surgical experience would be needed for successful reduction.

  13. Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

    Directory of Open Access Journals (Sweden)

    Mi Sun Jung

    2012-07-01

    Full Text Available Background First suggested by Brent in 1979, the pocket principle is an alternative methodfor patients for whom a microsurgical replantation is not feasible. We report the successfulresults of a modified palmar pocket method in adults.Methods Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantationusing palmar pocketing. All patients were adults who sustained a complete fingertip amputationfrom the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crushor avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmarpocketing method following a composite graft in these patients and prepared the pocket in thesubcutaneous layer of the ipsilateral palm.Results Of a total of 10 cases, nine had complete survival of the replantation and one had20% partial necrosis. All of the cases were managed to conserve the fingernails, which led toacceptable cosmetic results.Conclusions A composite graft and palmar pocketing in adult cases of fingertip injuryconstitute a simple, reliable operation for digital amputation extending from the tip to thelunula. These methods had satisfactory results.

  14. Fingertip Replantation Without and With Palmar Venous Anastomosis: Analysis of the Survival Rates and Vein Distribution.

    Science.gov (United States)

    Aksoy, Alper; Gungor, Melike; Sir, Emin

    2017-01-01

    The purpose of this study was to compare the results of fingertip replantations without (artery anastomosis only replantations) and with venous anastomosis (replantations in which both arterial and palmar venous anastomoses were performed). Also, distribution of the veins used for anastomosis was analyzed retrospectively. First 53 digits (47 patients) received only arterial anastomosis (group 1). For relieving venous congestion, external bleeding method was used. Last 41 digits (38 patients) received both arterial and palmar venous anastomoses without external bleeding (group 2). There was statistical significance of the survival rate between group 1 [77.3% (41/53)] and group 2 [92.6% (38/41)] (P = 0.039). Venous congestion was encountered at 10 digits in group 1 (all underwent necrosis totally) and at 3 digits in group 2 (both were moderate and could be salvaged partially) (P = 0.094, no statistical significance). There was statistical significance of the mean operation time for single-fingertip replantation between group 1 (80 ± 7.8 minutes) and group 2 (105 ± 14.5 minutes) (P replantations with palmar venous anastomosis have simpler postoperative care and lower drawbacks as compared with artery anastomosis-only replantations.

  15. Incomplete longitudinal fracture of the proximal palmar cortex of the third metacarpal bone in horses

    International Nuclear Information System (INIS)

    Ross, M.W.; Ford, T.S.; Orsini, P.G.

    1988-01-01

    Seven horses, 2 to 4 years of age, were examined because of moderate-to-severe forelimb lameness, mild effusion of the middle carpal joint (3 horses), and pain on palpation of the origin of the suspensory ligament (4 horses). The lameness was abolished by anesthetic infiltration of the middle carpal joint in six horses. In four of them, a high palmar nerve block also abolished the lameness. A linear radiolucency in the proximal end of the third metacarpal bone (McIII) was interpreted as an incomplete longitudinal fracture. In one horse, distinct intramedullary sclerosis limited to the palmar cortex was indicative of an incomplete fracture confined to the palmar cortex. No osteoproliferative lesions were identified on the dorsal cortex of any of the horses. Surgical treatment with cortical screws in lag fashion accompanied by a rest period was successful in one horse. In four horses, rest for at least 3 months resulted in clinical soundness. In two horses, a shorter rest period resulted in recurrence of the lameness even though the horses were sound when put back into training. Careful clinical and radiographic examinations helped differentiate incomplete longitudinal fractures from lesions involving the carpus and proximal aspect of the suspensory ligament

  16. A Pseudoaneurysm of the Deep Palmar Arch After Penetrating Trauma to the Hand: Successful Exclusion by Ultrasound Guided Percutaneous Thrombin Injection

    Directory of Open Access Journals (Sweden)

    A. Bosman

    Full Text Available : Introduction: Pseudoaneurysm of the hand is a rare condition; most are treated surgically. Ultrasound guided thrombin injection has not previously been reported as a treatment option for pseudoaneurysms of the deep palmar arch. Report: A man was referred to the emergency department with a swollen, painful hand after penetrating trauma. On physical examination, a pulsating tumor was found on the dorsum of the hand. Imaging revealed a pseudoaneurysm vascularized by the deep palmar arch. Ultrasound guided percutaneous thrombin injection was successfully performed. Conclusion: Thrombin injection might be a safe alternative option in the treatment of pseudoaneurysm of the deep palmar arch. Keywords: Deep palmar arch, Pseudoaneurysm, Thrombin injection

  17. Caracterización del nervio digital palmar en el miembro anterior equino

    Directory of Open Access Journals (Sweden)

    Carolina Ortiz

    2017-05-01

    Full Text Available A partir de 60 miembros anteriores de caballos mestizos recolectados de un matadero en Santiago, Chile, se determinó que lo más frecuente es que el nervio digital palmar emita sus ramas dorsal y palmar antes (33% o al comienzo de la articulación metacarpofalángica (33%. En un 60% de los nervios analizados se evidenció la presencia de una a cuatro ramas accesorias y que ésta se presenta de manera similar entre diversas zonas, siendo la presentación más frecuente (26% en la zona de la articulación interfalángica proximal y que se dirigen hacia dorsal. En un 46,66% de las muestras el nervio digital palmar no se relaciona íntimamente con alguna estructura, seguido con 33,33% por la unión de éste al ligamento del espolón. Es muy poco frecuente que el nervio emita ramas superficiales que se dirijan hacia la dermis (6,66%, que se divida en tres grandes ramas en la articulación metacarpofalángica (3,33% o que pase bajo la arteria digital (3,33%, y más frecuente es que éste se disponga sobre la arteria en algún lugar de su recorrido hecho que ocurrió en el 35% de los casos. Estos resultados se presentan de manera relevante de considerar en procedimientos diagnósticos o quirúrgicos en la zona distal del miembro anterior del equino, ya que pueden alterar su sensibilidad y eficacia.

  18. Diversidad de anfibios anuros del Parque Nacional El Palmar (Provincia de Entre Ríos, Argentina)

    OpenAIRE

    Gangenova, Elena; Guzmán, Atilio; Marangoni, Federico

    2012-01-01

    El Parque Nacional El Palmar (PNEP) es una importante área protegida de la zona este de la provincia de Entre Ríos, Argentina, creado para conservar uno de los últimos fragmentos de palmera yatay (Butia yatay). En este estudio se examina la biodiversidad de la comunidad de anfibios anuros que habitan tres tipos de ambientes del Parque; el pajonal, el pastizal y la selva en galería. Los muestreos se llevaron a cabo entre los meses de primavera-verano de 2008 y 2009. En total se registraron 16 ...

  19. Palmar reconstruction of the triangular fibrocartilage complex for instability of the distal radioulnar joint: a biomechanical study.

    Science.gov (United States)

    Kataoka, T; Moritomo, H; Omokawa, S; Iida, A; Wada, T; Aoki, M

    2013-06-01

    We developed a new triangular fibrocartilage complex reconstruction technique for distal radioulnar joint instability in which the palmar portion of the triangular fibrocartilage complex was predominantly reconstructed, and evaluated whether such reconstruction can restore stability of the distal radioulnar joint in seven fresh cadaver upper extremities. Distal radioulnar joint instability was induced by cutting all soft-tissue stabilizers around the distal ulna. Using a palmar approach, a palmaris longus tendon graft was sutured to the remnant of the palmar radioulnar and ulnocarpal ligaments. The graft was then passed through a bone tunnel created at the fovea and was sutured. Loads were applied to the radius, and dorsopalmar displacements of the radius relative to the ulna were measured using an electromagnetic tracking device in neutral rotation, 60° supination and 60° pronation. We compared the dorsopalmar displacements before sectioning, before reconstruction and after reconstruction. Dorsopalmar instability produced by sectioning significantly improved in all forearm positions after reconstruction.

  20. A prospective randomized study of conservative versus surgical treatment of unstable palmar plate disruption in the proximal interphalangeal finger joint

    DEFF Research Database (Denmark)

    Werlinrud, Jens Christian; Petersen, Kirstin; Lauritsen, Jens

    2013-01-01

    study in which 83 patients were randomly assigned into 2 groups: (1) conservative treatment with a rigid splint for 2 weeks, (2) surgical reattachment of the palmar plate in local anesthesia followed by 2 weeks of immobilization in a plaster cast. Both groups were thereafter treated by taping...... to the neighboring finger for 3 weeks. With regard to hyperextension instability, stiffness, and pain, there is no significant difference in outcome between patients with traumatic palmar plate lesions and hyperextension instability treated with surgical repair and patients treated conservatively with a splint. We...

  1. Radiographic characteristics of the forelimb distal phalanx and microscopic morphology of the lateral palmar process in foals 3-32 weeks old

    International Nuclear Information System (INIS)

    Kaneps, A.J.; Stover, S.M.; O'Brien, T.R.; Pool, R.R.; Willits, N.H.

    1995-01-01

    Developmental morphology of the forelimb distal phalanges and lateral palmar processes of 9 Thoroughbred foals aged 3–32 weeks was assessed using radiography, microradiography and histology. For inclusion in the study, all distal phalanges had no pathologic radiographic abnormalities.Vascular channels that are characteristically found in the dorsal region of the distal phalanx were not evident radiographically in the palmar process. The proximal and distal angles of the palmar processes were separated by a lucent line continuous with the incisure in foals only through 12 weeks of age. The distal phalanges were triangular-shaped in foals 3–12 weeks of age, and were oval-shaped in older foals.The palmar aspect of the distal phalanx was the major contributor to growth of the distal phalanx in the sagittal plane, especially between 3 and 12 weeks of age. Growth of the lateral palmar process occurred through the means of endochondral ossification. The body and cortices of the lateral palmar process were composed of coarse cancellous bone. Porosity within the lateral palmar process was greater in regions sampled axial, compared to abaxial, to the parietal sulcus and did not change with age.A fracture was identified microradiographically and/or histologically in 9 of 18 (50%) and 10 of 17 (59%), respectively, of the lateral palmar processes examined. The fracture line was consistently associated with the parietal sulcus on the dorsal cortical surface and was always immediately abaxial to the deep digital flexor tendon attachment. No age-related morphological changes of the lateral palmar processes were identified with microradiography or histological examinations

  2. Localized palmar-plantar epidermal hyperplasia: a previously undefined dermatologic toxicity to sorafenib.

    Science.gov (United States)

    Beldner, Matthew; Jacobson, Michael; Burges, Gene E; Dewaay, Deborah; Maize, John C; Chaudhary, Uzair B

    2007-10-01

    The development of multitargeted tyrosine kinase inhibitors has provided significant advances in the treatment of renal cell carcinoma. This case describes initial therapy for managing renal cell cancer with the administration of sorafenib, a multitargeted tyrosine kinase inhibitor. We report the development of localized palmar-plantar epidermal hyperplasia, a rare but significant cutaneous adverse event from sorafenib therapy. Mild-to-moderate dermatologic toxicity from sorafenib has been well described in the literature. We also review the current knowledge and the proposed hypothesis for the development of cutaneous events related to tyrosine kinase inhibitors. This particular case represents a unique form of dermatologic toxicity to sorafenib that has not previously been described in the literature.

  3. Soft tissue stabilization for palmar midcarpal instability using a palmaris longus tendon graft.

    Science.gov (United States)

    Chaudhry, Tahseen; Shahid, Mohammed; Wu, Feiran; Mishra, Anuj; Deshmukh, Subodh

    2015-01-01

    To report the results of a technique of soft tissue stabilization for palmar midcarpal instability using a palmaris longus graft. In patients' symptomatic wrists with palmar midcarpal instability that had failed conservative management, we used a dorsal approach and stabilized the hamate and triquetrum by reconstructing the dorsal triquetrohamate ligament. The palmaris longus tendon graft was fixed with bone anchors. Seven wrists in 6 patients were available for follow-up at a mean of 28 months (range, 17-37 mo). There was an overall meaningful improvement in function (mean preoperative Disabilities of the Arm, Shoulder, and Hand score, 49 preoperatively, 28 postoperatively). There was a significant increase in grip strength from 15 to 21 kg. At final follow-up, 2 patients had moderate pain. The others had mild or no pain. Four patients returned to their previous occupation or activity. Patients retained full pronation and supination. When compared with the normal side, flexion was reduced to 71%, extension to 81%, radial deviation to 90%, and ulnar deviation to 65% of the opposite side. Although the mean results show an improvement, one patient had a poor result with deterioration in Disabilities of the Arm, Shoulder, and Hand score in spite of a clinically stable wrist, and another had clinical evidence of recurrent instability during pregnancy. One patient had residual symptoms from a prominent bone anchor. Overall, this technique showed good medium-term results in most of our patients. It retained some midcarpal mobility, eliminated clunking in most patients, and provided a noteworthy improvement in grip strength and function. We continue to use this technique for patients with symptomatic midcarpal instability, but it requires further evaluation with larger patient numbers and a longer follow-up to assess its overall value. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  4. The first Danish family reported with an AQP5 mutation presenting diffuse non-epidermolytic palmoplantar keratoderma of Bothnian type, hyperhidrosis and frequent Corynebacterium infections

    DEFF Research Database (Denmark)

    Krøigård, Anne Bruun; Hetland, Liv Eline; Clemmensen, Ole

    2016-01-01

    hyperhidrosis of the palms and soles along with palmoplantar keratoderma. He reported a very distinctive feature of the disorder, aquagenic wrinkling, as he developed pronounced maceration of the skin with translucent white papules and a spongy appearance following exposure to water. The patient presented...

  5. Predictive value of fever and palmar pallor for P. falciparum parasitaemia in children from an endemic area.

    Science.gov (United States)

    Vinnemeier, Christof David; Schwarz, Norbert Georg; Sarpong, Nimako; Loag, Wibke; Acquah, Samuel; Nkrumah, Bernard; Huenger, Frank; Adu-Sarkodie, Yaw; May, Jürgen

    2012-01-01

    Although the incidence of Plasmodium falciparum malaria in some parts of sub-Saharan Africa is reported to decline and other conditions, causing similar symptoms as clinical malaria are gaining in relevance, presumptive anti-malarial treatment is still common. This study traced for age-dependent signs and symptoms predictive for P. falciparum parasitaemia. In total, 5447 visits of 3641 patients between 2-60 months of age who attended an outpatient department (OPD) of a rural hospital in the Ashanti Region, Ghana, were analysed. All Children were examined by a paediatrician and a full blood count and thick smear were done. A Classification and Regression Tree (CART) model was used to generate a clinical decision tree to predict malarial parasitaemia a7nd predictive values of all symptoms were calculated. Malarial parasitaemia was detected in children between 2-12 months and between 12-60 months of age with a prevalence of 13.8% and 30.6%, respectively. The CART-model revealed age-dependent differences in the ability of the variables to predict parasitaemia. While palmar pallor was the most important symptom in children between 2-12 months, a report of fever and an elevated body temperature of ≥37.5°C gained in relevance in children between 12-60 months. The variable palmar pallor was significantly (p<0.001) associated with lower haemoglobin levels in children of all ages. Compared to the Integrated Management of Childhood Illness (IMCI) algorithm the CART-model had much lower sensitivities, but higher specificities and positive predictive values for a malarial parasitaemia. Use of age-derived algorithms increases the specificity of the prediction for P. falciparum parasitaemia. The predictive value of palmar pallor should be underlined in health worker training. Due to a lack of sensitivity neither the best algorithm nor palmar pallor as a single sign are eligible for decision-making and cannot replace presumptive treatment or laboratory diagnosis.

  6. Diversidad de anfibios anuros del Parque Nacional El Palmar (Provincia de Entre Ríos, Argentina

    Directory of Open Access Journals (Sweden)

    Guzmán, Atilio

    2012-02-01

    Full Text Available El Parque Nacional El Palmar (PNEP es una importante área protegida de la zona este de la provincia de Entre Ríos, Argentina, creado para conservar uno de los últimos fragmentos de palmera yatay (Butia yatay. En este estudio se examina la biodiversidad de la comunidad de anfibios anuros que habitan tres tipos de ambientes del Parque; el pajonal, el pastizal y la selva en galería. Los muestreos se llevaron a cabo entre los meses de primavera-verano de 2008 y 2009. En total se registraron 16 especies de anfibios para el PNEP, distribuidas en 6 familias y 9 géneros. Entre los tipos de ambientes, el pajonal exhibió la mayor diversidad y riqueza de especies. Las abundancias relativas de las especies fueron equitativas dentro de los tres ambientes y existieron diferencias significativas en la composición de especies entre los mismos, siendo el pajonal y el pastizal los más similares. Este trabajo es un aporte significativo al conocimiento de la herpetofauna del PNEP y una base para estudios futuros sobre historia natural de los anfibios. Así también brinda una herramienta para el manejo y conservación del área protegida. El Palmar National Park (NPEP is an important protected area in the eastern of Entre Rios Province, Argentina. It was created for preserving one of the last fragments of yatay palm (Butia yatay. This study examines the biodiversity of the community of anurans that inhabit three types of environments of the Park, the grassland, the straw zone and the gallery forest. Sampling was conducted between the spring-summer 2008 and 2009. There were found 16 species of amphibians for NPEP, belonging to 6 families and 9 genera. Among the types of environments, the straw zone showed the highest diversity and species richness. The relative abundances of the species were equitative in all three environments and there were significant differences in species composition among them being the grassland and pasture the most similar. This work

  7. Comparison of digito-palmar dermatoglyphic traits in children with cerebral palsy and their close family members.

    Science.gov (United States)

    Polovina-Proloscić, Tajana; Milicić, Jasna; Cvjeticanin, Miljenko; Polovina, Andrea; Polovina, Svetislav

    2009-09-01

    Cerebral palsy is one of the main causes of severe disability in children. Sixty children (30 boys and 30 girls) were included in the study. Quantitative digito-palmar dermatoglyphic traits were analyzed. Prints of digito-palmar dermatoglyphs obtained from the children's parents (60 mothers and 60 fathers) and from 400 phenotypically healthy adults from the Zagreb ware used as control groups. Analysis of quantitative dermatoglyphic traits of the digito-palmar complex revealed statistically significant differences in a number of variables between the fathers and their children suffering from cerebral palsy (TRC 180.3 > 158.6), with a greater number of variables involved in male children with cerebral palsy. Some variables showed statistically significant differences in dermatoglyphic patterns between fathers and control group of healthy males as well as between boys with cerebral palsy and healthy control males. Differences in dermatoglyphic patterns were significantly lower between mothers and girls with cerebral palsy (TRC 152.1 mothers and healthy control females. Study results support the hypothesis on the possible role of genetic predisposition in the occurrence of central nervous system lesion, with a more pronounced paternal impact.

  8. Fossil woods of Detarioideae subfamily (Fabaceae) from El Palmar Formation (Late Pleistocene) in South America

    Science.gov (United States)

    Ramos, R. Soledad; Brea, Mariana; Kröhling, Daniela M.

    2017-11-01

    The main aim of the present paper is to describe the first Detarioideae fossil woods from El Palmar Formation (Late Pleistocene) in the Uruguay River Basin (Entre Ríos, Argentina). This study is based on five silicified wood specimens preserved in fluvial deposits, which were transported from their growth site. Two new genera and species are described: Paraoxystigma concordiensis gen. nov and sp. nov. has medium-sized vessels, paratracheal axial parenchyma, heterocellular and multiseriate rays, and diffuse axial canals similar in size and shape to vessels, and Gossweilerodendroxylon palmariensis gen. nov and sp. nov. has medium-sized vessels, alternate intervessel pits, paratracheal and apotracheal axial parenchyma, homocellular and uni to-multiseriate rays, and small diffuse axial canals. These Detarioideae fossil records in south-eastern South America support the existence of a very old relationship with the extant West African forests. Eco-anatomical features observed in these fossil woods, along with the climatic information available from the Nearest Living Relatives (NLRs) comparison, suggest warm and humid climatic conditions for the upper-middle basin of the Uruguay River during some periods of the Late Pleistocene.

  9. Power-assistive finger exoskeleton with a palmar opening at the fingerpad.

    Science.gov (United States)

    Heo, Pilwon; Kim, Jung

    2014-11-01

    This paper presents a powered finger exoskeleton with an open fingerpad, named the Open Fingerpad eXoskeleton (OFX). The palmar opening at the fingerpad allows for direct contact between the user's fingerpad and objects in order to make use of the wearer's own tactile sensation for dexterous manipulation. Lateral side walls at the end of the OFX's index finger module are equipped with custom load cells for estimating the wearer's pinch grip force. A pneumatic cylinder generates assistance force, which is determined according to the estimated pinch grip force. The OFX transmits the assistance force directly to the objects without exerting pressure on the wearer's finger. The advantage of the OFX over an exoskeleton with a closed fingerpad was validated experimentally. During static and dynamic manipulation of a test object, the OFX exhibited a lower safety margin than the closed exoskeleton, indicating a higher ability to adjust the grip force within an appropriate range. Furthermore, the benefit of force assistance in reducing the muscular burden was observed in terms of muscle fatigue during a static pinch grip. The median frequency (MDF) of the surface electromyography (sEMG) signal from the first dorsal interosseous (FDI) muscle displayed a lower reduction rate for the assisted condition, indicating a lower accumulation rate of muscle fatigue.

  10. Anatomy of the palmar cutaneous branch of the median nerve: clinical significance.

    Science.gov (United States)

    DaSilva, M F; Moore, D C; Weiss, A P; Akelman, E; Sikirica, M

    1996-07-01

    A detailed anatomic, histologic, and immunohistochemical study of the palmar cutaneous branch of the median nerve (PCBMN) and its distal arborization was undertaken on 12 fresh human cadaveric hands. Small unmyelinated fibers terminated in the superficial loose connective tissue of the transverse carpal ligament. There were no nerve fibers detected in the deep, dense collagen aspect of the ligament. Based on these findings, during open carpal tunnel release, the skin incision should be placed along the axis of the ring finger to avoid injury to the superficial branches of the PCBMN. When open release is used, the very small terminal branches in the loose tissue of the ligament will be transected; this may in part be responsible for postoperative soft tissue pain. For endoscopic releases, some risk for transection of the main trunk of the PCBMN at the proximal incision exists. Repeated passes of the endoscopic knife should be avoided in an attempt to limit damage to the small fibers in the superficial aspect of the ligament.

  11. Improved identification of the palmar fibrocartilage of the navicular bone with saline magnetic resonance bursography.

    Science.gov (United States)

    Schramme, Michael; Kerekes, Zoltan; Hunter, Stuart; Nagy, Krisztina; Pease, Anthony

    2009-01-01

    Fibrocartilage degeneration is the earliest pathologic finding in navicular disease but remains difficult to detect, even with magnetic resonance (MR) imaging. We hypothesized that injection of the navicular bursa with saline would improve accuracy of MR imaging evaluation of palmar fibrocartilage. Thoracic limbs were collected from 11 horses within 6 h of death. Imaging was performed with a 1.5 T magnet using sagittal 2D proton density and transverse 3D FLASH sequences with fat saturation. For the purpose of determining sensitivity and specificity of the MR images, fibrocartilage was classified as normal or abnormal, based on combination of the findings of gross and microscopic pathology. Thickness of fibrocartilage was measured on histologic sections and corresponding transverse FLASH MR images before and after injection of saline. A paired Student's t-test was used for comparison of measurements. Partial thickness fibrocartilage loss was present in 6 of 22 limbs. Sensitivity of precontrast MR images for detection of lesions was 100% while specificity was 6%. Saline MR arthrography resulted in both sensitivity and specificity of 100% based on consensus review. Mean histologic fibrocartilage thickness was 0.75 +/- 0.12 mm. Mean fibrocartilage thickness on precontrast transverse FLASH images was 0.93 +/- 0.065 and 0.73 +/- 0.09 mm on postsaline images. The histologic cartilage thickness was signficantly different from that in precontrast images (Pfibrocartilage can only be evaluated reliably for the presence of partial thickness lesions after intrabursal injection of saline.

  12. Palmar dermatoglyphics as diagnostic tool: Mayer-rokintansky-kuster-hauser syndrome

    Directory of Open Access Journals (Sweden)

    Kumar A

    2003-03-01

    Full Text Available The congential anomalies involving Mullerian duct dysgenesis, the MRKH (Mayer-Rokitansky-Kuster-Hauser syndrome overlaps a ′community of syndromes′ which share, apart from a complete absence of uterus and vagina, associated presentations that include developmental abnormalities of skeletal, renal, dental and other dysmorphias. First described more than 400 years ago, this complement of anomalies now rechristened, the MRKH syndrome has been extensively studied. Found to occur once in every 4000 females; estimated on its incidence vary from 1/5000 to 1/20,000. Despite its fairly wide prevalence, this syndrome has remained largely underdiagnosed or cryptic. Social and cultural perceptions have perforce driven, the wide existence of the very personal handicap underground and unacceptable. Accidentally discovered during routine examination, during secondarily associated medical problems, the mullerian agenecies syndrome has been subject of a wide range of clinical and laboratory investigations. The oddity in the syndrome is that the patient appears absolutely normal and that it presents with no genetic marker. We herein report the palmar dermatoglyphic and doctylographic features of a patient with MRKH syndrome. However interpretation, show conclusively, at least in this single case that the MRKH syndrome can be diagnosed through its characteristic dermatography patterns. In our view, routine dermatographic study of all live females births may lead to not only an early but also a cost effective diagnostic method.

  13. Treatment of type III middle phalangeal neck fractures through a palmar approach: a case report

    Directory of Open Access Journals (Sweden)

    Lucchina Stefano

    2013-04-01

    Full Text Available 【Abstract】 Phalangeal neck fractures occur almost exclusively in children. We present the case of a 49 years old man with a dislocated fracture of the neck of the middle phalanx with the distal fragment rotated at 180°, due to a traumatic circular saw injury to the left index, which was solved by anatomical reduction and bone fixation with two 1.5 mm Synthes screws and a temporary transarticular K-wire at the distal interphalangeal joint. Zone I flexor digitorum profundus repair was performed using a modification of the Kessler 4-strands core suture and a full-thickness skin graft from the hypothenar eminence was taken to cover the skin gap. At 6-month follow-up the patient was pain-free and with a total active movement equivalent to 190°. No radio-logical signs of avascular necrosis of the head of the middle phalanx or nonunion of the distal fragment was detectable with recovery to the previous manual work. Owing to the position of the phalangeal head maintained in position by the collateral ligaments an anatomic reduction from dorsal approach is difficult to be performed and a longitudinal trac-tion can render the reduction harder too. The volar approach permits an easier reduction of the fracture through a derotation of the distal fragment facing palmar. Key words: Finger phalanges; Fractures, bone; Finger joint

  14. Is there any place for spontaneous healing in deep palmar burn of the child?

    Science.gov (United States)

    Chateau, J; Guillot, M; Zevounou, L; Braye, F; Foyatier, J-L; Comparin, J-P; Voulliaume, D

    2017-06-01

    Child palm burns arise by contact and are often deep. The singular difficulty of such a disease comes from the necessity of the child growth and from the potential occurrence of constricted scars. In order to avoid sequelae, the actual gold standard is to practice an early excision of the burn, followed by a skin graft. The aim of this study is to evaluate the results of spontaneous healing combined with rehabilitation versus early skin grafting and rehabilitation concerning the apparition of sequelae. We performed a retrospective study in two burn centers and one rehabilitation hospital between 1995 and 2010. Eighty-seven hands have been included in two groups: one group for spontaneous healing and the other group for excision and skin grafting. Every child benefited from a specific rehabilitation protocol. The two main evaluation criteria were the duration of permanent splint wearing and the number of reconstructive surgery for each child. The median follow-up duration is about four years. The two groups were comparable. For the early skin grafting group, the splint wearing duration was 1/3 longer than for the spontaneous healing group. Concerning the reconstructive surgery, half of the grafted hands needed at least one procedure versus 1/5 of spontaneous healing hands. Our results show the interest of spontaneous healing in palmar burn in child, this observation requires a specific and intense rehabilitation protocol. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Incomplete palmar fracture of the proximal extremity of the third metacarpal bone in horses: ten cases (1981-1986)

    International Nuclear Information System (INIS)

    Lloyd, K.C.K.; Koblik, P.; Ragle, C.; Wheat, J.D.; Lakritz, J.

    1988-01-01

    In 4 adult horses, simple, non displaced, incomplete fracture of the proximal extremity of the third metacarpal bone (MC3) was identified radiographically only on the dorsopalmar projection. Lameness was slight to moderate. Although nerve blocks of the foot and fetlock did not alter the lameness, high palmar regional nerve block improved the gait in 1 of the 2 horses on which it was performed. Pain on palpation or swollen distal accessory (inferior check) ligament, flexor tendons, and suspensory ligament were not found in any horse. The fracture was localized to the palmar surface of the proximal extremity of the MC3 on the basis of the intense uptake of radiopharmaceutical (99MTc-labeled sodium medronate) observed in that area during the soft tissue and delayed bone phases of a nuclear scintigraphic examination (nuclear scan) performed concurrently with radiography. Of 4 horses evaluated 6 months after the initial diagnosis, 3 had medullary sclerosis without radiographic evidence of fracture; results of follow-up nuclear scintigraphy performed in one of these horses at the same time were normal. Incomplete fracture also was suspected in another 6 adult horses with clinical lameness referable to the proximal extremity of the MC3. Although a fracture line could not be seen radiographically, trabecular hypertrophy and/or medullary sclerosis of the proximal extremity of the MC3 were detected on the dorsopalmar projection. Further, during nuclear scintigraphy, an intense uptake of the radiopharmaceutical was observed on the palmar aspect of the proximal extremity of the MC3 in all 6 horses

  16. Predictive value of fever and palmar pallor for P. falciparum parasitaemia in children from an endemic area.

    Directory of Open Access Journals (Sweden)

    Christof David Vinnemeier

    Full Text Available INTRODUCTION: Although the incidence of Plasmodium falciparum malaria in some parts of sub-Saharan Africa is reported to decline and other conditions, causing similar symptoms as clinical malaria are gaining in relevance, presumptive anti-malarial treatment is still common. This study traced for age-dependent signs and symptoms predictive for P. falciparum parasitaemia. METHODS: In total, 5447 visits of 3641 patients between 2-60 months of age who attended an outpatient department (OPD of a rural hospital in the Ashanti Region, Ghana, were analysed. All Children were examined by a paediatrician and a full blood count and thick smear were done. A Classification and Regression Tree (CART model was used to generate a clinical decision tree to predict malarial parasitaemia a7nd predictive values of all symptoms were calculated. RESULTS: Malarial parasitaemia was detected in children between 2-12 months and between 12-60 months of age with a prevalence of 13.8% and 30.6%, respectively. The CART-model revealed age-dependent differences in the ability of the variables to predict parasitaemia. While palmar pallor was the most important symptom in children between 2-12 months, a report of fever and an elevated body temperature of ≥37.5°C gained in relevance in children between 12-60 months. The variable palmar pallor was significantly (p<0.001 associated with lower haemoglobin levels in children of all ages. Compared to the Integrated Management of Childhood Illness (IMCI algorithm the CART-model had much lower sensitivities, but higher specificities and positive predictive values for a malarial parasitaemia. CONCLUSIONS: Use of age-derived algorithms increases the specificity of the prediction for P. falciparum parasitaemia. The predictive value of palmar pallor should be underlined in health worker training. Due to a lack of sensitivity neither the best algorithm nor palmar pallor as a single sign are eligible for decision-making and cannot replace

  17. Study of palmar dermatoglyphics in patients with essential hypertension between the age group of 20-50 years

    OpenAIRE

    Rudragouda S Bulagouda, Purnima J Patil, Gavishiddppa A Hadimani, Balappa M Bannur, Patil BG, Nagaraj S. Mallashetty, Ishwar B Bagoji

    2013-01-01

    Background: In present study, we tried to determine significant palmar dermatoglyphic parameters in case of essential hypertensive’s in age group between 20-50 years and whether the parameters can be used for screening purpose i.e., early detection of hypertension. Method: With the use of modified Purvis Smith method, Black duplicating ink (Kores, Bombay) was smeared on both hands one by one and prints will be taken by rolling the hands from wrist creases to finger tips on the roller covered ...

  18. An observer-blinded randomized controlled pilot trial comparing localized immersion psoralen-ultraviolet A with localized narrowband ultraviolet B for the treatment of palmar hand eczema.

    Science.gov (United States)

    Brass, D; Fouweather, T; Stocken, D D; Macdonald, C; Wilkinson, J; Lloyd, J; Farr, P M; Reynolds, N J; Hampton, P J

    2017-12-13

    Hand eczema is a common inflammatory dermatosis that causes significant patient morbidity. Previous studies comparing psoralen-ultraviolet A (PUVA) with narrowband ultraviolet B (NB-UVB) have been small, nonrandomized and retrospective. To conduct an observer-blinded randomized controlled pilot study using validated scoring criteria to compare immersion PUVA with NB-UVB for the treatment of chronic hand eczema unresponsive to topical steroids. Sixty patients with hand eczema unresponsive to clobetasol propionate 0·05% were randomized to receive either immersion PUVA or NB-UVB twice weekly for 12 weeks with assessments at intervals of 4 weeks. The primary outcome measure was the proportion of patients achieving 'clear' or 'almost clear' Physician's Global Assessment (PGA) response at 12 weeks. Secondary outcome measures included assessment of the modified Total Lesion and Symptom Score (mTLSS) and the Dermatology Life Quality index (DLQI). In both treatment arms, 23 patients completed the 12-week assessment for the primary outcome measure. In the PUVA group, five patients achieved 'clear' and eight 'almost clear' [intention-to-treat (ITT) response rate 43%]. In the NB-UVB group, two achieved 'clear' and five 'almost clear' (ITT response rate 23%). For the secondary outcomes, median mTLSS scores were similar between groups at baseline (PUVA 9·5, NB-UVB 9) and at 12 weeks (PUVA 3, NB-UVB 4). Changes in DLQI were similar, with improvements in both groups. In this randomized pilot trial recruitment was challenging. After randomization, there were acceptable levels of compliance and safety in each treatment schedule, but lower levels of retention. Using validated scoring systems - PGA, mTLSS and DLQI - as measures of treatment response, the trial demonstrated that both PUVA and NB-UVB reduced the severity of chronic palmar hand eczema. © 2017 British Association of Dermatologists.

  19. Secuencia constructiva de las plazas en el Grupo Principal de El Palmar, Campeche, México Constructive Sequence of Plazas in the Main Group of El Palmar, Campeche, México

    Directory of Open Access Journals (Sweden)

    Kenichiro Tsukamoto

    2012-01-01

    Full Text Available La ubicación y dimensión de los espacios abiertos fueron aspectos considerados al planificar las ciudades de las Tierras Bajas Mayas en el periodo prehispánico. Las plazas eran los espacios políticos donde las élites gobernantes legitimaban a sus autoridades y manifestaban a otros participantes sus capacidades para comunicarse con los ancestros o deidades. Este trabajo se centra en la secuencia constructiva de ocho plazas en el Grupo Principal del sitio arqueológico de El Palmar, Campeche, México. Los resultados obtenidos durante las temporadas de campo en el 2007 y el 2009 indican que las grandes plazas fueron construidas durante la segunda mitad del Clásico Temprano (400-600 d.C. y que en ellas se celebraron ceremonias públicas inscritas en los monumentos conmemorativos.The location and dimension of open spaces were important aspects involved in Maya Lowlands planning during the prehispanic period. Plazas were political spaces in which ruling elites legitimated their authorities and manifested to other participants their capacities of communication with ancestors or deities. This paper focuses on the construction sequence of eight plazas at the Main Group of El Palmar, Campeche, Mexico. The results recovered from the 2007 and 2009 fieldwork seasons indicate that large plazas were build during the second part of the Early Classic period (400-600 AD, with the erection of commemorative monuments narrating public ceremonies.

  20. LAS COMUNIDADES VEGETALES DE LA SABANA DEL PARQUE NACIONAL EL PALMAR (ARGENTINA

    Directory of Open Access Journals (Sweden)

    William B. Batista

    2014-01-01

    Full Text Available El Parque Nacional El Palmar, Entre Ríos, preserva desde 1965 el mayor remanente de la sabana de Butia yatay , un ecosistema rico en especies amenazado por la actividad humana. Para estudiar el funcio - namiento de este ecosistema y gestionar su preservación, es necesario contar con una adecuada carac - terización de la heterogeneidad de su vegetación. En este trabajo presentamos una clasificación fitoso - ciológica de las comunidades vegetales de la sabana del Parque, describimos su estructura, composición y diversidad florística y detallamos su distribución en el paisaje. Con el fin de estratificar la obtención de datos, delimitamos primero las principales unidades geomorfológicas del paisaje. En la primavera de 1999 y en el verano siguiente, realizamos censos florísticos completos en 73 “stands” de sabana con diferentes historias de incendio, distribuidos en las diferentes unidades geomorfológicas. Utilizamos técnicas de análisis multivariado y clasificación numérica para agrupar los censos en comunidades y las especies en grupos florísticos. Finalmente, resumimos las diferencias entre las comunidades en un esca - lamiento multidimensional métrico. Obtuvimos 7 comunidades, descriptas por 20 grupos florísticos. El patrón de similitudes entre estas comunidades sugiere que la heterogeneidad florística se ordena según dos componentes, uno asociado con diferencias en la textura del suelo y el otro con diferencias en el régimen de humedad del suelo. Tres de las comunidades, afines entre sí, se distribuyen en las terrazas altas e interfluvios que conforman la matriz del paisaje, en correspondencia con diferencias graduales de topografía y suelos. Estas comunidades cambian sucesionalmente por el avance de la lignificación des - encadenada por la exclusión del ganado y mantenida por la escasez de incendios naturales. Las restantes cuatro comunidades aparecen estrictamente asociadas con afloramientos rocosos, dep

  1. Two Paraneoplastic Autoimmune Syndromes: Limbic Encephalitis and Palmar Fasciitis in a Patient with Small Cell Lung Cancer.

    Science.gov (United States)

    Lazarev, Irina; Shelef, Ilan; Refaely, Yael; Ariad, Samuel; Ifergane, Gal

    2015-09-07

    Small cell lung cancer (SCLC) is characterized by a relatively high rate of autoimmune phenomena. Paraneoplastic limbic encephalitis (PLE) is an autoimmune syndrome in which a non-neural tumor containing an antigen normally present in the nervous system precipitates an antibody attack on neural tissues. Patients with PLE usually present with rapidly progressive short-term memory deficits, confusion or even dementia. Palmar fasciitis and polyarthritis syndrome (PFPAS) is another autoimmune syndrome characterized by rheumatologic manifestations, especially involving the palms of the hands. We report a case of a 59-year old woman who presented with worsening neurological symptoms of two-week duration, and later coma. The combined clinical, serological, and imaging studies suggested a diagnosis of PLE. A chest computed tomographic scan showed a 1.2 cm-diameter mass in the upper lobe of the left lung that was surgically removed and showed SCLC. Following surgery, neurological symptoms rapidly improved, allowing the patient to receive adjuvant chemotherapy. While in remission for both SCLC and PLE, the patient developed pain, soft-tissue swelling, and stiffness in both palms, suggesting the diagnosis of PFPAS. Five months following the diagnosis of palmar fasciitis, SCLC relapsed with mediastinal and cervical lymphadenopathy. This case report underlines the continuous interaction of SCLC with the immune system, expressed by coexistence of two rare paraneoplastic diseases, PLE, and PFPAS, in a patient with SCLC. While symptoms related to PLE preceded the initial diagnosis of SCLC, other symptoms related to PFPAS preceded relapse.

  2. Two paraneoplastic autoimmune syndromes: limbic encephalitis and palmar fasciitis in a patient with small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Irina Lazarev

    2015-09-01

    Full Text Available Small cell lung cancer (SCLC is characterized by a relatively high rate of autoimmune phenomena. Paraneoplastic limbic encephalitis (PLE is an autoimmune syndrome in which a non-neural tumor containing an antigen normally present in the nervous system precipitates an antibody attack on neural tissues. Patients with PLE usually present with rapidly progressive short-term memory deficits, confusion or even dementia. Palmar fasciitis and polyarthritis syndrome (PFPAS is another autoimmune syndrome characterized by rheumatologic manifestations, especially involving the palms of the hands. We report a case of a 59-year old woman who presented with worsening neurological symptoms of two-week duration, and later coma. The combined clinical, serological, and imaging studies suggested a diagnosis of PLE. A chest computed tomographic scan showed a 1.2 cm-diameter mass in the upper lobe of the left lung that was surgically removed and showed SCLC. Following surgery, neurological symptoms rapidly improved, allowing the patient to receive adjuvant chemotherapy. While in remission for both SCLC and PLE, the patient developed pain, soft-tissue swelling, and stiffness in both palms, suggesting the diagnosis of PFPAS. Five months following the diagnosis of palmar fasciitis, SCLC relapsed with mediastinal and cervical lymphadenopathy. This case report underlines the continuous interaction of SCLC with the immune system, expressed by coexistence of two rare paraneoplastic diseases, PLE, and PFPAS, in a patient with SCLC. While symptoms related to PLE preceded the initial diagnosis of SCLC, other symptoms related to PFPAS preceded relapse.

  3. Knowledge about useful entomofauna in the county of La Purísima Palmar de Bravo, Puebla State, Mexico

    Directory of Open Access Journals (Sweden)

    D. H. Zetina

    2007-06-01

    Full Text Available Eighteen species of edible insects belonging to 15 families of six orders of Insecta were recorded in the county of La Purísima Palmar de Bravo in Puebla State, Mexico. They had the following taxonomic distribution among the different families: Lygaeidae, Pentatomidae, Membracidae, Cercopidae, Psocidae, Melolonthidae, Curculionidae, Cossidae, Megathymidae, Pyralidae, Geometridae and Apidae, all with a single recorded species; the families Acrididae, Formicidae and Vespidae with two species in each family. The latter were the most abundant families, and Hymenoptera was the most salient order with five species. Three species were reported as new registers of edible insects for Mexico and also for the world. The nutritive value of insects in terms of macro and micronutrients is discussed.

  4. Incidence of palmar process fractures of the distal phalanx and association with front hoof conformation in foals.

    Science.gov (United States)

    Faramarzi, B; McMicking, H; Halland, S; Kaneps, A; Dobson, H

    2015-11-01

    Recent studies indicate a high prevalence of fractures of the palmar processes (PP) of the distal phalanx in foals. However, information on the prevalence of such fractures in different breeds and the effect of predisposing factors, such as hoof conformation, is limited. To examine the prevalence of distal phalanx PP fractures in foals and report the relationship of distal limb and hoof conformation with the prevalence of fracture. Longitudinal study. Front hooves of 19 Thoroughbred, Quarter Horse and Arabian foals were examined. Digital radiographic and photographic images of the distal aspect of the forelimbs were taken at ∼2.5 month intervals. Five radiographic projections of each limb were as follows: lateromedial; horizontal beam dorsopalmar; dorso60°proximal-palmarodistal oblique; dorso60°proximo45°lateral-palmarodistomedial oblique; and dorso60°proximo45°medial-palmarodistolateral oblique. The relationship between measurements and the prevalence of fractures was assessed by 3-way ANOVA. Fractures were found in 74% (n = 14) of the foals during the study period. The prevalences of lateral PP and medial PP fractures were not significantly different. Several hoof measurements were associated with PP fractures. Longer dorsal length of the distal phalanx was associated with medial PP fractures, while smaller lateral angle and shorter lateral palmar length were associated with a higher prevalence of lateral PP fractures. This study revealed a high prevalence of PP fractures in young foals, particularly in Thoroughbred foals. The hoof conformation may be one of the contributory factors to PP fractures in foals. © 2014 EVJ Ltd.

  5. Avaliação de populações de Butia capitata de Santa Vitória do Palmar Performance of populations of Butia capitata of Santa Vitória do Palmar

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    Elisane Schwartz

    2010-09-01

    Full Text Available O gênero Butia pertence à família Arecaceae e possui cinco espécies com ocorrência no Rio Grande do Sul. A espécie Butia capitata está recebendo atenção especial, não só pelo seu uso no consumo in natura como também em formas processadas. No entanto, mesmo sendo uma espécie que tem sua utilização registrada desde os tempos pré-históricos, vem sendo explorada apenas de modo extrativista, como a maioria das espécies de frutíferas nativas. Além disso, a espécie está seriamente comprometida em médio prazo pela ausência de regeneração natural e com risco muito alto de extinção num futuro próximo. Nesse sentido, o objetivo deste trabalho foi comparar os frutos, a partir de parâmetros químicos e físicos, e também observar os dados produtivos das plantas de três populações de butiazeiros do município de Santa Vitória do Palmar-RS. Os dados foram obtidos em experimentos conduzidos na safra de 2005/2006 e na safra de 2006/2007, em três propriedades localizadas em Santa Vitória do Palmar. Os resultados permitiram verificar que as propriedades e ou variações genéticas entre as populações de Butia capitata avaliadas propiciaram variabilidade para duração do ciclo, coloração da epiderme dos frutos, volume de suco produzido, relação entre sólidos solúveis totais e acidez titulável, características biométricas de fruto e produtividade anual. Uma das populações, denominada Celina, apresentou maior produtividade e rendimento industrial. As populações Celina e São José apresentaram as melhores características biométricas de fruto. A população Aguiar apresentou a melhor relação entre sólidos solúveis totais e acidez titulável.The genus Butia belongs to the Arecaceae family and shows five species occurring in Rio Grande de Sul. The specie Butia capitata requires special attention, not just for its use as fresh consumption but also as processed product. However, even having its use recorded since

  6. Emergency management of traumatic collateral palmar digital nerve defect inferior to 30 mm by venous grafting. Report of 12 clinical cases.

    Science.gov (United States)

    Laveaux, C; Pauchot, J; Obert, L; Choserot, V; Tropet, Y

    2011-02-01

    When traumatic collateral palmar digital nerve defect occurs, emergency venous grafting is an alternative to the two-step nervous grafting procedure. During the course of a monocentric retrospective study, 12 cases of emergency venous grafting were reviewed by a single independent examiner 11 months, at least, post-intervention. Clinical and functional evaluation was carried out, together with a self-assessment of the results by the patient. Data were compacted using a filtering method and the final result was considered in terms of "good" or "bad". Good result was observed in ten cases out of 12. Bad results were associated with poor sensory recovery in the two other cases. In one of these, the bad result was also related to severe symptoms in cold conditions and a troublesome hyperesthesia. Through a review of the literature, we justify the emergency treatment of nerve defects of the collateral palmar digital nerves with venous grafting. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  7. [Unidirectional versus multidirectional palmar locking osteosynthesis of unstable distal radius fractures: comparative analysis with LDR 2.4 mm versus 2.7 mm matrix-Smartlock].

    Science.gov (United States)

    Hakimi, M; Jungbluth, P; Gehrmann, S; Nowak, J; Windolf, J; Wild, M

    2010-03-01

    Due to advances in the development of the unidirectional locking plates there is now an increased use of multidirectional palmar locking plates in the treatment of distal radius factures. The purpose of this study was to evaluate a possible improvement of the treatment and results. This prospective cohort study investigated 40 patients with C1 and C2 Colles' fractures who had been treated with unidirectional and multidirectional locking plates. The average time for the follow-up examinations was 12.3 months (range 12-15 months) after surgery. The intra-operative functional (neutral-zero method), radiological and subjective (DASH score, VAS) results were evaluated. The intra-operative fluoroscopy time of the unidirectional group was 58 s shorter compared to the multidirectional group. All fractures healed without any complication. The radiological, subjective (DASH score) and objective results for both groups were good and showed no differences. Unidirectional palmar locking plates are equally suited for the therapy of C1 and C2 fractures as multidirectional palmar locking plates but multidirectional plates require a longer fluoroscopy time.

  8. [Reconstruction of combined skin and bilateral artey defects at palmar side of fingers by free posterior interrosseous artery flap in a bridge fashion].

    Science.gov (United States)

    Xu, Bao-cheng; Liang, Gang; Chen, Fu-sheng

    2012-05-01

    To investigate the feasibility and therapeutic effect of free posterior interrosseous artery flap in a bridge fashion for combined skin and bilateral artery defects at palmar side of fingers. 6 cases with combined skin and bilateral artery defects at palmar side of fingers were treated with long-pedicled free posterior interrosseous artery flap in a bridge fashion. The flap size ranged from 3.5 cm x 2.0 cm to 6.5 em x 3.0 cm. The wounds at donor sites were closed directly. All the 6 flaps survived completely without any complication, and the wounds healed primarily. The blood supply and vein drainage in all the 6 fingers were normal. 4 cases were followed up for 1-12 months (average, 7 months). Satisfactory cosmetic and functional results were achieved. The flaps looked a little bit thicker than the surrounding tissue. The long-pedicled free posterior interrosseous artery flap in a bridge fashion is a good option for reconstruction of the combined skin and bilateral artery defects at palmar side of fingers in one stage.

  9. Arcuate ligament of the wrist: normal MR appearance and its relationship to palmar midcarpal instability: a cadaveric study

    International Nuclear Information System (INIS)

    Chang, Weiling; Peduto, Anthony J.; Aguiar, Rodrigo O.C.; Trudell, Debra J.; Resnick, Donald L.

    2007-01-01

    To describe the magnetic resonance (MR) imaging and gross anatomic appearance of the scaphocapitate (SC) ligament and triquetrohamocapitate (THC) ligament, which are the radial and ulnar limbs of the composite arcuate ligament, a critical volar midcarpal stabilizing ligament. T1 spin-echo and 3D gradient-echo MR imaging in the standard, coronal oblique, and axial oblique planes were performed both before and following midcarpal arthrography in seven cadaveric wrists. The seven specimens were then sectioned in selected planes to optimally visualize the SC and THC ligaments. These specimens were analyzed and correlated with their corresponding MR images. The SC and THC ligaments can be visualized in MR images as structures of low signal intensity that form an inverted ''V'' joining the proximal and distal carpal rows. The entire ligamentous complex is best visualized with coronal and axial oblique MR imaging but can also be seen in standard imaging planes. SC and THC ligaments together form the arcuate ligament of the wrist. Their function is crucial to the normal functioning of the wrist. Palmar midcarpal instability (PMCI) is a resulting condition when abnormalities of these ligaments occur. Dedicated MR imaging in the coronal and axial imaging planes can be performed in patients suspected of having PCMI. (orig.)

  10. Arcuate ligament of the wrist: normal MR appearance and its relationship to palmar midcarpal instability: a cadaveric study

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Weiling [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Sharp-Grossmont Hospital, Department of Radiology, La Mesa, CA (United States); Peduto, Anthony J. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Westmead Hospital and Western Clinical School of Sydney University, Department of Radiology, Sydney (Australia); Aguiar, Rodrigo O.C. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States); Universidade Federal do Rio de Janeiro, Rio de Janerio (Brazil); Trudell, Debra J.; Resnick, Donald L. [Veterans Administration Medical Center, Department of Radiology, San Diego, CA (United States)

    2007-07-15

    To describe the magnetic resonance (MR) imaging and gross anatomic appearance of the scaphocapitate (SC) ligament and triquetrohamocapitate (THC) ligament, which are the radial and ulnar limbs of the composite arcuate ligament, a critical volar midcarpal stabilizing ligament. T1 spin-echo and 3D gradient-echo MR imaging in the standard, coronal oblique, and axial oblique planes were performed both before and following midcarpal arthrography in seven cadaveric wrists. The seven specimens were then sectioned in selected planes to optimally visualize the SC and THC ligaments. These specimens were analyzed and correlated with their corresponding MR images. The SC and THC ligaments can be visualized in MR images as structures of low signal intensity that form an inverted ''V'' joining the proximal and distal carpal rows. The entire ligamentous complex is best visualized with coronal and axial oblique MR imaging but can also be seen in standard imaging planes. SC and THC ligaments together form the arcuate ligament of the wrist. Their function is crucial to the normal functioning of the wrist. Palmar midcarpal instability (PMCI) is a resulting condition when abnormalities of these ligaments occur. Dedicated MR imaging in the coronal and axial imaging planes can be performed in patients suspected of having PCMI. (orig.)

  11. Circumscribed palmar or plantar hypokeratosis 10 years after the first description: what is known and the issues under discussion.

    Science.gov (United States)

    Urbina, F; Pérez, A; Requena, L; Rütten, A

    2014-01-01

    This review of the literature on palmoplantar hypokeratosis, a process that was first indentified only 10 years ago, discusses the current state of our understanding, the therapeutic options available, and the debate about etiology. Forty-four publications reporting 69 cases were found. Palmar or plantar hypokeratosis occurs mainly in women (76.8%) and age at the time of a first visit to a physician ranges from 42 to 84 years. Most cases present between the ages of 51 and 70 years. The majority of patients have had solitary lesions usually located on the right palm, particularly in the regions of the thenar (in 44/79 lesions [55.7%]) or hypothenar eminences (in 11/79 lesions [13.9%]). In only 8 cases was there a history of prior trauma at the site. Studies using polymerase chain reaction techniques to identify human papillomavirus involvement were negative in most cases. These hypokeratotic lesions are localized epidermal depressions formed by an abrupt thinning of the stratum corneum, providing a singular histopathologic feature. This condition can currently be considered a localized keratinization disorder affecting zones where there is a thick stratum corneum. The precipitating cause is unknown and a definitive treatment remains to be found. The mechanism would be the localized failure of a clone of keratinocytes during differentiation toward normal palmoplantar hyperkeratinization. Copyright © 2012 Elsevier España, S.L. y AEDV. All rights reserved.

  12. An old woman with chronic palmar dermatosis, rheumatism, and nail changes

    Directory of Open Access Journals (Sweden)

    Vitorino Modesto dos Santos

    2017-02-01

    Full Text Available Psoriasis is a chronic inflammatory condition with variable changes on the skin and nails, sometimes associated with osteoarticular manifestations characterizing the psoriatic arthritis. This arthritis may precede, follow, or be concomitant with the skin lesions of psoriasis. Unsuspected psoriatic arthritis may be misdiagnosed by other seronegative spondyloarthritis, mainly in primary care attention, and ominous outcomes are related to late and inadequate management. Therefore, diagnostic exercises with base on significant clinical and radiological images might contribute to enhance the suspicion index about these challenging conditions.

  13. Experience with botulinum toxin therapy for axillary hyperhidrosis and comparison to modelled data for endoscopic thoracic sympathectomy - A quality of life and cost effectiveness analysis.

    Science.gov (United States)

    Gibbons, John P; Nugent, Emmeline; O'Donohoe, Nollaig; Maher, Barry; Egan, Bridget; Feeley, Martin; Tierney, Sean

    2016-10-01

    To estimate cost-effectiveness of botulinum toxin therapy for axillary hyperhidrosis compared to the standard surgical intervention of endoscopic thoracic sympathectomy (ETS). The validated dermatology life quality index questionnaire was given to patients attending for treatment over a 4 month period, to assess their quality of life (QoL) over the preceding week (n = 44). Follow-up was performed 4-6 weeks later by telephone using the same questionnaire to validate the effectiveness of the treatment. The duration of effect of the botulinum toxin treatment was also recorded and this data was used as the basis for cost effectiveness analysis. Using HIPE data, the baseline cost for single intervention using botulinum toxin and ETS was retrieved. Using figures provided by HIPE and expert opinion of the costs of complications, a stochastic model for 10,000 patients was used to evaluate the total costs for ETS including the complications. The results from the QoL analysis show that botulinum toxin therapy is a successful therapy for improvement of symptoms. It was revealed that the mean interval before recurrence of original symptoms after botulinum toxin therapy was 5.6 months. The baseline cost for both treatments are €389 for botulinum toxin and €9389 for uncomplicated ETS. The stochastic model yields a mean cost of €11,390 for ETS including complications. Treatments reached cost equivalence after 13.3 years. However, given the efficacy of the botulinum toxin therapy and the low risk we propose that botulinum toxin therapy for hyperhidrosis should be considered the gold standard. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  14. "Pollical palmar interosseous muscle" (musculus adductor pollicis accessorius): attachments, innervation, variations, phylogeny, and implications for human evolution and medicine.

    Science.gov (United States)

    Bello-Hellegouarch, Gaelle; Aziz, M Ashraf; Ferrero, Eva M; Kern, Michael; Francis, Nadia; Diogo, Rui

    2013-03-01

    Most atlases and textbooks dealing with human anatomy do not refer to the "pollical palmar interosseous" (PPI) muscle of Henle. In order to undertake a fresh and detailed study of this muscle and to thus better understand human comparative anatomy and evolution, we: 1) analyze the frequency of the PPI in a large sample of human hands; 2) describe the attachments, innervation and varieties of the PPI in these hands; 3) compare the data obtained with the information available in the literature; and 4) discuss the phylogenetic origin of the PPI and the implications of our observations and comparisons for medicine and for the understanding of human evolutionary history. Within the 72 hands dissected by us, the PPI is present in 67 hands (93%), commonly having a single muscular branch, originating from the medial side of the base of metacarpal I only, inserting onto the medial side of the base of the pollical proximal phalanx and/or surrounding structures (e.g., ulnar sesamoid bone, wing tendon of extensor apparatus), and passing at least partially, and usually mainly, medial to the princeps pollicis artery. A careful study of the human PPI, as well as a detailed comparison with other mammals, strongly suggest that the muscle is evolutionarily derived from the adductor pollicis, and namely from its oblique head. Therefore, we propose that PPI should be designated by the name musculus adductor pollicis accessorius, which indicates that the muscle is most likely a de novo structure derived from the adductor pollicis. Copyright © 2012 Wiley Periodicals, Inc.

  15. Racing performance in Standardbred trotting horses with proximal palmar/plantar first phalangeal fragments relative to the timing of surgery.

    Science.gov (United States)

    Carmalt, J L; Borg, H; Näslund, H; Waldner, C

    2015-07-01

    Proximal palmar/plantar osteochondral fragmentation of the first phalanx is a frequent radiographic finding in Standardbred horses. These lesions are routinely removed prior to the onset of a racing career with no evidence to support the timing of this surgical intervention. To determine whether horses racing before surgery slowed as they approached surgery date and whether they speeded up after surgery. To investigate the factors affecting whether a horse raced after surgery and compare the performance of horses that did and did not race before surgery. A retrospective study using 193 Swedish Standardbred trotters. Medical records and radiographs of each horse were examined. Racing data were retrieved from official online records. Generalising estimating equations were used to examine presurgery racing performance and determine whether this differed between horses that raced before surgery and those that had not. Multivariable regression was used to examine career earnings and number of career races. Horses racing before surgery neither slowed as they approached surgery, nor speeded up after surgery. Race speed of horses raced before surgery was not different from those that only raced after surgery. Racing before surgery was not associated with whether horses raced following surgery. Only horses with 3 affected legs had slower race speeds than other horses. No other horse level variables affected race speed, number of career races, career earnings or top speed. There was no significant difference in race speed between horses that raced before surgery and those that did not. Horses did not slow down prior to surgery. Horses with 3 affected legs ran slower than those with only a single or 2 affected limbs. There was no association between timing of surgery and race speed or career longevity. The potential benefits of surgical intervention should be critically examined. © 2014 EVJ Ltd.

  16. Avaliação da força de preensão palmar frente à terapia com mobilização neural

    Directory of Open Access Journals (Sweden)

    Bruna Formentão Araujo

    2012-08-01

    Full Text Available INTRODUÇÃO: A mobilização neural é uma técnica que visa a restauração do movimento e da elasticidade do sistema nervoso; contudo, ainda são poucos os estudos que avaliam sua eficácia sobre variáveis clínicas. OBJETIVO: Avaliar a força de preensão palmar em indivíduos submetidos à intervenção com mobilização neural. Metodologia: Estudo cruzado em que compuseram a amostra 20 sujeitos, com média de idade de 19,5 ± 0,92 anos, divididos em dois grupos (G1 e G2 que receberam, a cada semana, uma sessão única de intervenção de forma que o G1 recebeu mobilização neural e o G2 alongamentos convencionais para o supraespinal na primeira semana; o inverso aconteceu na segunda semana, em que o G1 recebeu alongamentos convencionais para o supraespinal e o G2 a mobilização neural. Os alongamentos para o supraespinal serviram apenas como placebo e não impuseram tensão aos nervos em estudo. As mobilizações neurais foram aplicadas nos nervos radial, mediano e ulnar. A força de preensão palmar foi avaliada por meio de um dinamômetro de preensão palmar em vários momentos: antes e imediatamente, 20 minutos e uma hora após cada intervenção. RESULTADOS: Não houve resultados significativos para a mobilização neural, nem para o alongamento. CONCLUSÃO: A mobilização neural não foi eficaz para produzir o aumento da força de preensão palmar em indivíduos saudáveis.

  17. The Brahea edulis palm forest in Guadalupe Island: A North American fog oasis? El palmar de Brahea edulis de Isla Guadalupe: ¿Un oasis de niebla en Norteamérica?

    Directory of Open Access Journals (Sweden)

    PEDRO P GARCILLÁN

    2012-03-01

    Full Text Available Fog is a factor that affects deeply the structure of vegetation of coastal deserts. Guadalupe is an oceanic island located 260 km off the coast of Baja California, and is one of the few places of the Sonoran Desert coasts with scarped coastal topography and frequent fog. With the aim to identify the effect of fog on the community of the palm forest (palmar of Brahea edulis located in the northern tip of the island: (1 we analyzed the richness and composition of vascular plants in the palmar compared to the remainder of the island, and (2 we analyzed the altitudinal variation of the abundance of palms, herbs and mosses to identify if there is altitudinal variation of the vegetation. Although species composition was not different between palmar and the rest of island, species richness and vascular plant cover were greater in the palmar. On the other hand, we found a clear altitudinal zonation of the vegetation in the palmar that is similar to that found in South American fog-driven plant communities such as the lomas. Thus, the palmar community of Guadalupe Island may be considered as a fog oasis, one of the very few that occur in North America.La niebla es un factor que afecta profundamente la estructura de la vegetación de los desiertos costeros. Guadalupe es una isla oceánica a 260 km de la costa de Baja California y constituye uno de los pocos lugares de la costa del Desierto Sonorense donde se reúnen una topografía escarpada próxima a la costa y una alta frecuencia de nieblas. Con el objeto de identificar el efecto de la niebla sobre la comunidad del palmar de Brahea edulis presente en la ladera norte de la isla: (1 analizamos la diferencia de la riqueza y la composición de plantas vasculares del palmar respecto del resto de la isla, y (2 analizamos la variación altitudinal de la abundancia de palmas, plantas acompañantes y musgo para determinar si existe variación altitudinal de la vegetación. Encontramos que, aunque la composici

  18. Sweaty Feet (Hyperhidrosis)

    Science.gov (United States)

    ... RAC) Information OIG Opioid and Chronic Pain Management OSHA Off-Label Use Physician Payment Sunshine Act (Open ... prescription medications, often anticholinergics, can be used. Severe cases of sweaty feet may be treated with a ...

  19. Study of palmar dermatoglyphics in patients with essential hypertension between the age group of 20-50 years

    Directory of Open Access Journals (Sweden)

    Rudragouda S Bulagouda, Purnima J Patil, Gavishiddppa A Hadimani, Balappa M Bannur, Patil BG, Nagaraj S. Mallashetty, Ishwar B Bagoji

    2013-10-01

    Full Text Available Background: In present study, we tried to determine significant palmar dermatoglyphic parameters in case of essential hypertensive’s in age group between 20-50 years and whether the parameters can be used for screening purpose i.e., early detection of hypertension. Method: With the use of modified Purvis Smith method, Black duplicating ink (Kores, Bombay was smeared on both hands one by one and prints will be taken by rolling the hands from wrist creases to finger tips on the roller covered with bond paper. While crystal bond paper, applied firmly over a wooden pad, was used for recording the inked epidermal ridge patterns. Rolled finger prints were recorded after applying uniform pressure on white bond paper from ulnar to radial side. Complete palm impression, including the hollow or the palm was obtained over paper. Thus one set of finger prints and palm prints was obtained. The prints obtained were immediately examined with hand-lens. Result: Right hand and left hand of the both male and female study group showed more number of arches than controls. Right hand and left hand of the both male and female study group showed more number of Radial loops than controls. The right hand and left hand of both male and female control group showed more number of ulnar loops than study group. The right hand and left hand of the male control group showed more number of Whorls than study, while in females, the right hand study group showed more number of whorls than control group and the left hand study group showed less number of Whorls as compared to control group. Conclusion: The present study indicates that there are some genetic factors which are involved in the causation of essential hypertension and it is possible to certain extent to predict from dermatoglyphics individual’s chance of acquiring essential hypertension. Like clinical history, examination and investigations, the dermatoglyphics will play an important role revealing the genetic

  20. Racing performance of Swedish Standardbred trotting horses with proximal palmar/plantar first phalangeal (Birkeland) fragments compared to fragment free controls.

    Science.gov (United States)

    Carmalt, James L; Borg, Hanna; Näslund, Hans; Waldner, Cheryl

    2014-10-01

    The aim of this study was to determine whether horses with a proximal palmar/plantar first phalangeal osteochondral fragment (POF) had comparable racing careers (prior to and following surgery) to horses without this fracture. A retrospective cohort study included 174 Swedish Standardbred trotters with osteochondral fragmentation in the palmar/plantar fetlock joint and 613 radiographically negative control horses presented for prepurchase examinations. Medical records and radiographs were examined for each horse. Racing data were retrieved from online Swedish Standardbred harness racing records. The effect of having a POF on race speed compared to radiographically negative control horses was examined using generalised estimating equations. Multivariable regression was used to examine differences in money earned and career longevity. The horses raced a total of 16,448 races. Horses gained speed as a function of race number. There was no difference in racing speed between horses with POF fractures that raced before surgery and control horses. Horses did not slow before, nor speed up after, surgery. There was no difference in the number of days between the last race prior to, or the first race after, the hospital visit between POF and control horses. Career earnings and lifetime starts were not significantly different between groups. The results of this study suggest the need to reevaluate the previously reported benefits of surgical intervention for POF. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. AVALIAÇÃO DA IMAGEM TURÍSTICA DE SANTA VITÓRIA DO PALMAR (RS, BRASIL, NA PERSPECTIVA DOS RESIDENTES

    Directory of Open Access Journals (Sweden)

    Melise de Lima Pereira

    2017-06-01

    Full Text Available O presente artigo busca identificar os fatores que compõem a imagem turística do destino Santa Vitória do Palmar (RS, Brasil, na perspectiva dos residentes, como medida de manifestação da identidade. A pesquisa possui caráter exploratório, descritivo, empírico e com abordagem predominantemente quantitativa. Foi utilizada uma amostra, não probabilística por conveniência, composta por 93 respondentes, colhida diretamente no município, durante outubro de 2015. Através de Análise Fatorial Exploratória foram identificados os componentes da imagem turística de Santa Vitória do Palmar, que são: Lugares históricos e serviços ofertados, opções de entretenimento, atrativos turísticos, hotelaria e transmissão da cultura local, higiene e comércio e fama do município.

  2. ANÁLISIS FITOLÍTICOS EN SUELOS FORMADOS SOBRE ANTIGUAS TERRAZAS DEL RÍO URUGUAY (COLÓN, ENTRE RÍOS: PRIMERA EVIDENCIA DE RETRACCIÓN DE LOS PALMARES DE BUTIA YATAY (MART.. BECC.

    Directory of Open Access Journals (Sweden)

    Patterer, Noelia I.

    2017-06-01

    Full Text Available Los palmares de Butia yatay (Mart. Becc. en el Parque Nacional El Palmar (Colón, Entre Ríos, son comunidades relictuales que se desarrollan sobre los suelos arenosos que pertenecen al orden de los Entisoles. Estos suelos constituyen las terrazas antiguas del río Uruguay. La serie de suelos Puerto Yeruá son suelos arenosos pardos formados sobre terrazas y poseen un mayor desarrollo pedológico. Se ha estudiado la composición fitolítica de la secuencia pedológica de esta serie de suelos con la finalidad de contribuir al conocimiento de la flora que acompañó el desarrollo de los mismos. Las asociaciones fitolíticas observadas reflejan el cambio de dos ciclos pedológicos, que dividen al perfil analizado en dos zonas demarcadas por la presencia de diferentes paleocomunidades: una de palmares asociados a un estrato herbáceo pobre y una superior de pastizales meso-megatérmicos con escasa presencia de microrestos afines a elementos arbóreos. El registro fitolítico descripto en el presente trabajo es el primer antecedente que muestra el posible punto de cambio en la fisonomía del paisaje y la retracción de los palmares de yatay en el área de estudio.

  3. Prevalência da anemia em crianças avaliada pela palidez palmar e exame laboratorial: implicações para enfermagem Sentimientos de mujeres-madres delante de la cirugía neonatal en las malformaciones congénitas Prevalence of anemia in children assessed by clinical method known as "palmar pallor" and the laboratory exam: implications for nursing

    Directory of Open Access Journals (Sweden)

    Ethel Bastos da Silva

    2011-09-01

    Full Text Available Buscou-se analisar a prevalência de anemia ferropriva em crianças e comparar os dados obtidos pelo método clínico "palidez palmar" e exame laboratorial em uma Estratégia de Saúde da Família no município de Panambi/RS. Pesquisa exploratória/descritiva, quantitativa, realizada de março a junho de 2009. Foram sujeitos 41 crianças de 2 meses a 5 anos. Os dados foram analisados pela estatística descritiva. Das crianças, 51,2% eram do sexo masculino; 41,46% estavam na faixa etária de 0 a 12 meses; 53,6% das famílias situavam-se no nível social D e 43,9% dos chefes de família tinham o Ensino Fundamental completo ou o Ensino Médio incompleto. Pela palidez palmar, a prevalência de anemia foi de 51,2% e pelo exame laboratorial, de 58,53%. O estudo mostra que a palidez palmar e o exame laboratorial, quando usados juntos, fornecem um diagnóstico mais preciso da anemia ferropriva, podendo ser inseridos na prática assistencial da enfermagem na ESF.Se intenta analizar la prevalencia de anemia por deficiencia de fierro en niños y comparar el método clínico "palidez palmar" y el examen de laboratorio en una Estrategia de Salud de la Familia en la municipalidad de Panambi-RS. La pesquisa exploratoria, descriptiva y cuantitativa fue realizada de marzo hasta junio de 2009. Los sujetos fueron 41 niños de 2 meses a 5 años de edad. Los datos fueron analizados por la estadística descriptiva. Del total de niños, 51,2% eran del sexo masculino; 41,46% estaban en la franja etaria de 0 a 12 meses; 53,6% de las familias se sitúan en el nivel social D y 43,9% de los jefes de familia tienen la Enseñanza Fundamental Completa o la Enseñanza Media Incompleta. Por la palidez palmar, la prevalencia de anemia fue de 51,2% y por el examen de laboratorio, de 58,53%. El estudio muestra que la palidez palmar y el examen de laboratorio, cuando usados juntos, proveen un diagnóstico más preciso de la anemia por deficiencia de fierro, pudiendo ser inserido

  4. Frecuencia del alelo causante de la enfermedad de Charcot-Marie-Tooth (tipo axonal con herencia autosómica recesiva en Palmares, Costa Rica

    Directory of Open Access Journals (Sweden)

    Melissa Rojas-Araya

    2009-11-01

    Full Text Available La enfermedad de Charcot-Marie-Tooth constituye elgrupo de neuropatías periféricas hereditarias más común a nivel mundial. Una familia con 18 afectados del cantón de Palmares (Alajuela, Costa Rica con una neuropatía de tipo axonal y herencia autosómica recesiva, permitió localizar el gen responsable en la región 19q13.33. Posteriormente se identificó la mutación causante en el gen MED25. El presente estudio determinó la frecuencia del alelo mutante, así como la distribución geográfica de este alelo. En una muestra al azar de 103 individuos se encontraron seis individuos heteroigotas para la mutación, distribuidos por todo el cantón. No se encontró ninguna persona en estado homocigota para este alelo. No hallamos algunacaracterística clínica que difiera significativamente entre los individuos homocigotos silvestres y los heterocigotos para la mutación. El 5.83% de la población es heterocigota y la frecuencia del alelo Ala335Val es de 0.029, seis veces mayor que en una muestra de toda la población costarricense. Por esta razón se recomienda un análisis molecular de portadores con el fin de alertar sobre la posibilidad de aparición de más casos en el cantón.Frecuency of the allele causing the axonal form of autosomal recessive Charcot-Marie-Tooth in Palmares, Costa Rica. The Charcot-Marie-Tooth disease constitutes is among the most frequent hereditary peripheral neuropathies world-wide. We identified a family from Palmares (Alajuela, Costa Rica with 18 affected members. Their neuropathy is axonal, with an autosomal recessive pattern of inheritance; the responsible gene is at the 19q13.33 chromosomal region. Later the mutation was identified in gene MED25. We studied the frequency and geographic distribution of the mutant allele. In a random sample of 103 individuals, six were heterozygote and were widely distributed in Palmares. There was no person in homozigote state for the mutant allele. Clinical characteristics do

  5. Múltiplos cornos cutâneos em coxins palmares e plantares de um gato persa Multiple cutaneous horns on the footpads of a persian cat

    Directory of Open Access Journals (Sweden)

    Heloisa Justen Moreira de Souza

    2010-03-01

    Full Text Available Cornos cutâneos são infrequentes em gatos, principalmente em felinos jovens. Neste trabalho, é relatado um caso de um felino da raça Persa, macho, com oito meses de idade e apresentando histórico de espirros. Ao exame clínico, identificaram-se projeções corniformes originadas nos coxins palmares e plantares. A avaliação histológica de biópsia excisional demonstrou hiperqueratose densa, com numerosos queratinócitos sobre epiderme hiperplásica, não sendo identificado nenhum grau de malignidade. Não foi constatada a associação das lesões com a infecção pelo vírus da leucemia felina. O tratamento instituído incluiu excisão parcial mensal dos cornos cutâneos e acompanhamento clínico do animal.Cutaneous horns are seldom seen in cats, especially in young ones. A case of a Persian cat, male, eight months old, with a history of sneezes is described. During physical examination, multiple horns on the all footpads were noticed. The histopathological diagnosis of excisional biopsy was dense hyperkeratosis, with numerous keratinocytes above hyperplastic epidermis and no evidence of malignity. There was no association between the lesions and infection with leukemia virus. The treatment was mensal trimming off the cutaneous horns and clinical follow up of the animal.

  6. ATIVIDADES RECREATIVAS E LÚDICAS: um estudo nas escolas estaduais da cidade de Santa Vitória do Palmar, RS – Brasil

    Directory of Open Access Journals (Sweden)

    Alex Borges Dias

    2017-11-01

    Full Text Available Os processos educativos são fundamentais para a formação de cidadãos mais conscientes de seu papel na construção de uma sociedade mais justa e igualitária. Em um mundo onde as atividades humanas são constantemente aceleradas pelas práticas capitalistas, se torna cada vez mais necessário pensar o papel da educação na formação de novos cidadãos conscientes de sua importância na sociedade. Desse modo, este trabalho teve por objetivo identificar as atividades recreativas e lúdicas que contribuem nos processos educativos dos alunos do 1º ano das escolas estaduais em Santa Vitória do Palmar, RS - Brasil. Na metodologia foi feita uma pesquisa bibliográfica. Para a coleta de dados foram feitas entrevistas com os professores responsáveis pelas turmas do primeiro ano de cada escola e foi utilizado o método de observação não-participante, além do levantamento fotográfico. Identificou-se que todas as escolas estaduais da cidade possuem atividades recreativas e lúdicas que contribuem para os processos educativos dos alunos matriculados.

  7. REESTRUTURAÇÃO NO PROJETO EDUCAÇÃO PATRIMONIAL EM ESCOLAS MUNICIPAIS DE SANTA VITÓRIA DO PALMAR, RS – BRASIL

    Directory of Open Access Journals (Sweden)

    Viviane Rocha Teixeira

    2016-12-01

    Full Text Available O presente trabalho surgiu de uma nova análise que foi feita através de observação participante dos membros do grupo PET (Programa de Educação Tutorial Turismo. Identificou-se a necessidade de uma reestruturação no projeto Educação Patrimonial para adequar-se melhor ao perfil das crianças. Assim, como principais resultados, diminuiu-se o número de encontros visando otimizar o tempo e foi realizada algumas modificações como o aumento do tempo de realização de atividades que favorecem a interação entre estudantes. O objetivo deste trabalho é descrever como se efetuou a reestruturação no projeto Educação Patrimonial em escolas municipais de Santa Vitória do Palmar, RS – Brasil. O projeto, que tem como sujeitos crianças do 5º ano, propõem-se a sensibilizá-las e que essas multipliquem os conhecimentos construídos com os adultos (familiares, vizinhos, amigos, entre outros. Acredita-se que pode contribuir, também, em relação ao incremento do turismo histórico-cultural e de lazer na cidade. Para a coleta de dados foi utilizado o método de observação participante e uma pesquisa bibliográfica em trabalhos do próprio Grupo PET. Na análise dos resultados encontra-se a descrição detalhada da reestrputuração do projeto e a justificativa da modificação da estrutura. Palavras-chave: Patrimônio.  Turismo.  Reestruturação.

  8. Frecuencia del alelo causante de la enfermedad de Charcot-Marie-Tooth (tipo axonal con herencia autosómica recesiva en Palmares, Costa Rica

    Directory of Open Access Journals (Sweden)

    Melissa Rojas-Araya

    2009-11-01

    Full Text Available La enfermedad de Charcot-Marie-Tooth constituye elgrupo de neuropatías periféricas hereditarias más común a nivel mundial. Una familia con 18 afectados del cantón de Palmares (Alajuela, Costa Rica con una neuropatía de tipo axonal y herencia autosómica recesiva, permitió localizar el gen responsable en la región 19q13.33. Posteriormente se identificó la mutación causante en el gen MED25. El presente estudio determinó la frecuencia del alelo mutante, así como la distribución geográfica de este alelo. En una muestra al azar de 103 individuos se encontraron seis individuos heteroigotas para la mutación, distribuidos por todo el cantón. No se encontró ninguna persona en estado homocigota para este alelo. No hallamos algunacaracterística clínica que difiera significativamente entre los individuos homocigotos silvestres y los heterocigotos para la mutación. El 5.83% de la población es heterocigota y la frecuencia del alelo Ala335Val es de 0.029, seis veces mayor que en una muestra de toda la población costarricense. Por esta razón se recomienda un análisis molecular de portadores con el fin de alertar sobre la posibilidad de aparición de más casos en el cantón.

  9. Factores bióticos y abióticos que determinan la seroprevalencia de anticuerpos contra Trypanosoma Cruzi en el municipio de Palmar de Bravo, Puebla, México Biotic and abiotic determinants of seroprevalence of antibodies against Trypanosoma cruzi in Palmar de Bravo, Puebla, Mexico

    Directory of Open Access Journals (Sweden)

    Francisca Sosa-Jurado

    2004-02-01

    Full Text Available OBJETIVO: Determinar la prevalencia de anticuerpos contra Trypanosoma cruzi y su relación con los factores bióticos y abióticos en Palmar de Bravo, Puebla, México. MATERIAL Y MÉTODOS: Estudio transversal efectuado en agosto de 2000 a septiembre de 2001, con una muestra aleatoria simple de 390 voluntarios residentes en Palmar de Bravo, Puebla, México. Se hizo determinación de anticuerpos contra T cruzi con técnicas serológicas validadas, búsqueda del vector y de reservorios domésticos, así como determinación de asociación entre caso positivo y factores de riesgo bióticos y abióticos. El análisis estadístico consistió en índice Kappa para las pruebas diagnósticas, empleando tabla de contingencia de 2 x 2; ji cuadrada corregida de Yates, exacta de Fisher y la razón de posibilidad para estimar la significancia de la asociación de factores bióticos y abióticos. RESULTADOS: La seroprevalencia fue de 4% en la población humana estudiada y de los reservorios (equinos, porcinos y caninos, sólo 10% de los caninos resultaron reactivos. Los vectores identificados fueron T barberi y T pallidipennis, con índice de dispersión e índice de colonización de 55 y 40%, respectivamente. Los factores de riesgo más importantes fueron la altitud (>2 150 y OBJECTIVE: To establish the relationship between seroprevalence for antibodies against Trypanosoma cruzi and its relationship with biotic and abiotic factors. MATERIAL AND METHODS: A cross-sectional study was conducted between August 2000 and September 2001. The study population consisted of a simple random sample of 390 volunteers residing in Palmar de Bravo, Puebla, Mexico. Sample and data collection procedures included assaying antibodies against T cruzi with validated assays, and searching for domestic reservoirs and triatomine bugs. The relationship between biotic and abiotic factors with seropositivity was assessed. Statistical analysis was conducted using Kappa values for

  10. PRÁTICAS AMBIENTALMENTE CORRETAS EM MEIOS DE HOSPEDAGEM: um estudo sobre a percepção ambiental e perfil dos gestores hoteleiros de Santa Vitória do Palmar/RS

    Directory of Open Access Journals (Sweden)

    Siuza Monteiro Guedes

    2017-09-01

    Full Text Available Este estudo foi realizado no município de Santa Vitória do Palmar, RS, teve por objetivo analisar a percepção das práticas ambientalmente corretas de gestão ambiental e de economia de recursos naturais entre os gestores do setor de hospedagem do Município de Santa Vitória do Palmar. Trata-se de um estudo qualiquantitavo de caráter exploratório, representativo e participante, com aplicação de instrumento de coleta de dados, realizado no período de novembro de 2016 a março de 2017 em empreendimentos do setor de hoteleiro e extra-hoteleiro, na cidade sede do Município e em três dos balneários marítimos do mesmo. Como principal resultado pode ser destacado a falta de planos de gestão ambiental dos empreendimentos pesquisados. O estudo se justifica uma vez que não foram encontrados estudos similares.

  11. Resultados clínico-radiológicos en pacientes jóvenes con fractura articular completa de radio distal tratados con placa palmar bloqueada. [Clinical and radiological results in young patients with complete articular distal radius fractures treated with volar locked plate.

    Directory of Open Access Journals (Sweden)

    Pablo De Carli

    2016-02-01

    Conclusión: El tratamiento de las fracturas de radio distal tipo C en pacientes jóvenes con placa palmar bloqueada muestra resultados clínicos y radiológicos favorables con corrección de la mayoría de los escalones articulares.

  12. PARQUES DE PRODUÇÃO DE ENERGIA EÓLICA E TRANSFORMAÇÕES NA PAISAGEM – ESTUDO DE CASO EM SANTA VITÓRIA DO PALMAR/RS

    Directory of Open Access Journals (Sweden)

    Anelize Milano Cardoso

    2015-07-01

    Full Text Available Numa região das mais isoladas do Estado, no extremo sul do país, logo no início da BR-471, rodovia que liga o município do Chuí ao município de Santa Vitória do Palmar, já estão instalados os primeiros aerogeradores do Complexo Eólico Campos Neutrais, que reúne três grandes parques: Geribatu, Chuí e Hermenegildo. As dez plantas, cada uma com mais de dez aerogeradores do Parque Eólico Geribatu já estão finalizados e em funcionamento, causando uma alteração drástica na fisionomia da paisagem. O objetivo deste trabalho foi compreender, a partir da literatura referente, o crescimento da produção de energia eólica, as características das áreas em que se implantaram parques ou complexos eólicos e os impactos dos objetos técnicos relacionados a esta produção na paisagem. Foi realizado, primeiramente, um levantamento de material bibliográfico sobre os métodos relativos ao estudo da paisagem, destacando-se a abordagem da percepção. Atualmente observa-se que as alterações sentidas na dinâmica do município, devido à instalação do Parque Eólico, não se limitam apenas ao impacto visual, tais como o aumento do fluxo do trânsito e a maior circulação de pessoas. Santa Vitória do Palmar, com a implementação do Parque, vive uma atmosfera de otimismo, ganhando uma nova identidade, alterando assim de forma positiva, a própria relação da comunidade local com o contexto que a circunda. Santa Vitória do Palmar, no imaginário local, passou a contextualizar-se no mundo globalizado através de um símbolo que representa a ideia de desenvolvimento limpo e responsável.

  13. Amenorrhea - primary

    Science.gov (United States)

    ... of periods - primary Images Primary amenorrhea Normal uterine anatomy (cut section) Absence of menstruation (amenorrhea) References Bulun SE. The physiology and pathology of the female reproductive axis. In: ...

  14. Força de preensão palmar em idosos com demência: estudo da confiabilidade Handgrip strength in elderly with dementia: study of reliability

    Directory of Open Access Journals (Sweden)

    Mariana A. Alencar

    2012-01-01

    Full Text Available CONTEXTUALIZAÇÃO: Instrumentos de medida devem ser analisados quanto a sua utilidade clínica e científica em diferentes populações. Apesar de o teste da força de preensão palmar (FPP ser amplamente utilizado, pouco foi investigado quanto a sua confiabilidade ao ser utilizado em idosos com demência e em qual grau de demência seria inviabilizado o seu uso. OBJETIVO: Avaliar a confiabilidade teste-reteste da FPP em idosos com diferentes graus de demência. MÉTODO: Realizou-se uma avaliação dos aspectos cognitivos de 76 idosos com demência e uma entrevista com o cuidador, permitindo a classificação do idoso segundo os critérios da Escala Clínica de Demência (Clinical dementia rating - CDR. Para essas avaliações, foram utilizados o Miniexame do Estado Mental e os questionários Pfeffer, Lawton e Katz. Vinte idosos foram classificados como grau questionável (83,4±5,8 anos; 19, como leve (82,4±6,8 anos; 19, como moderado (85,8±5,6 anos e 18, como grave (84,0±5,1 anos. Os idosos tiveram a FPP avaliada por meio de um dinamômetro hidráulico JAMAR e, após uma semana, foram reavaliados. A confiabilidade foi estimada pelo Coeficiente de Correlação Intraclasse (ICC. O nível de significância foi α=0,05. RESULTADOS: A confiabilidade teste-reteste foi excelente para os grupos que apresentaram o CDR questionável (ICC=0,975; p=0,001, leve (ICC=0,968; p=0,002 e moderado (ICC=0,964; p=0,001. A análise do grupo com CDR grave mostrou não haver uma significância estatística e um ICC baixo (ICC=0,415; p=0,376. CONCLUSÃO: O teste de FPP apresenta excelente confiabilidade ao ser utilizado em idosos com demências questionável, leve e moderada, viabilizando seu uso em pesquisas. Já em idosos classificados como graves, seu uso não é recomendado visto que a confiabilidade da medida é baixa e, portanto, sem relevância clínica para uso na prática.BACKGROUND: Measuring instruments should have their scientific and clinical value

  15. Força de preensão palmar em idosos com demência: estudo da confiabilidade Handgrip strength in elderly with dementia: study of reliability

    Directory of Open Access Journals (Sweden)

    Mariana A. Alencar

    2012-12-01

    Full Text Available CONTEXTUALIZAÇÃO: Instrumentos de medida devem ser analisados quanto a sua utilidade clínica e científica em diferentes populações. Apesar de o teste da força de preensão palmar (FPP ser amplamente utilizado, pouco foi investigado quanto a sua confiabilidade ao ser utilizado em idosos com demência e em qual grau de demência seria inviabilizado o seu uso. OBJETIVO: Avaliar a confiabilidade teste-reteste da FPP em idosos com diferentes graus de demência. MÉTODO: Realizou-se uma avaliação dos aspectos cognitivos de 76 idosos com demência e uma entrevista com o cuidador, permitindo a classificação do idoso segundo os critérios da Escala Clínica de Demência (Clinical dementia rating - CDR. Para essas avaliações, foram utilizados o Miniexame do Estado Mental e os questionários Pfeffer, Lawton e Katz. Vinte idosos foram classificados como grau questionável (83,4±5,8 anos; 19, como leve (82,4±6,8 anos; 19, como moderado (85,8±5,6 anos e 18, como grave (84,0±5,1 anos. Os idosos tiveram a FPP avaliada por meio de um dinamômetro hidráulico JAMAR e, após uma semana, foram reavaliados. A confiabilidade foi estimada pelo Coeficiente de Correlação Intraclasse (ICC. O nível de significância foi α=0,05. RESULTADOS: A confiabilidade teste-reteste foi excelente para os grupos que apresentaram o CDR questionável (ICC=0,975; p=0,001, leve (ICC=0,968; p=0,002 e moderado (ICC=0,964; p=0,001. A análise do grupo com CDR grave mostrou não haver uma significância estatística e um ICC baixo (ICC=0,415; p=0,376. CONCLUSÃO: O teste de FPP apresenta excelente confiabilidade ao ser utilizado em idosos com demências questionável, leve e moderada, viabilizando seu uso em pesquisas. Já em idosos classificados como graves, seu uso não é recomendado visto que a confiabilidade da medida é baixa e, portanto, sem relevância clínica para uso na prática.BACKGROUND: Measuring instruments should have their scientific and clinical value

  16. Development of a Free-Electron Laser Center and Research in Medicine, Biology and Materials Science,

    Science.gov (United States)

    1992-05-14

    the reduced electron- larons cause localized distortions in an ionic lattice lattice coupling strength leads to molecule emission, which are... syndrome . Health Science Center at San Antonio and the University Buerger’s disease, palmar hyperhidrosis, frostbite and of Mi.imi School of Medicine, Miami

  17. Zumbi e a Construção da Identidade Negra: uma Análise sobre a História em Quadrinhos “Zumbi – A Saga de Palmares” * Zumbi and Formation of Black Identity: an Analysis on the Comics "Zumbi - The Saga of Palmares"

    Directory of Open Access Journals (Sweden)

    VINÍCIUS FINGER

    2013-04-01

    Full Text Available Resumo: O objetivo deste artigo é realizar uma análise do personagem de Zumbi encontrado no álbum em quadrinhos “Zumbi - A Saga de Palmares” e sua relação com os princípios, ideologias e políticas que embasaram os movimentos antirracistas ao longo do século XX. Analisa também os modos de construção da figura de Zumbi, através das narrativas propostas pelo Movimento Negro Unificado. Apresentando uma síntese dos movimentos antirracismo mais representativos no Brasil durante o século XX.Palavras-chaves: Zumbi – Palmares – MNU. Abstract: The aim of this article is to analyze Zumbi’s character found in the comic book "Zumbi - The Saga of Palmares" and its relationship with the principles, ideologies and policies which based anti-racist movements throughout the twentieth century. It also analyzes the forms of formation of the figure of Zumbi through the narratives proposed by the Unified Black Movement (Movimento Negro Unificado. It presents a summary of the most significant anti-racism movements in Brazil during the twentieth century.Keywords: Zumbi – Palmares – MNU.

  18. Estudo comparativo experimental da injeção perineural do álcool benzílico 0,75% e do álcool etílico absoluto nos nervos palmares de eqüinos

    Directory of Open Access Journals (Sweden)

    José Luiz de Mello Nicoletti

    2007-12-01

    Full Text Available The clinical and histopathological effects of two alcoholic neurolytics were studied in horses. Normal horses were shod with a designed shoe adaptted with 5 screws to produce solar pain. After gait and lameness score analysis, the palmar nerve of 5 horses was injected with 5 ml of 0,75% benzyl alcohol (Group A and 5 horses were injected with 5 ml of absolute ethyl alcohol (Group B. The animals were submitted to regular lameness evaluation and solar sensibility tests during next six months. The solar sensitivity returned 5 months latter in the group injected with benzyl alcohol 0,75%, while in the group injected with absolute ethyl alcohol, the sole was still desensitized 6 months latter. The histopathological findings showed that the nerve injected with benzyl alcohol 0,75%, resulted in axonotmesis, characterized by axonal nerve degeneration, with possibilities for the nerve conduction recovery. The perineural injection of ethyl alcohol absolute, resulted in neurotmesis with difficult nerve regeneration. It was concluded that chemical neurolysis with alcohol is an option for temporary or permanent nerve blocks in horses.

  19. TURISMO CEMITERIAL: proposta de roteirização a partir das potencialidades turísticas impressas no cemitério civil de Santa Vitória do Palmar, RS, Brasil

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    Cláudia Brandão Schwab

    2017-09-01

    Full Text Available Este trabalho apresenta projeto elaborado durante estágio curricular obrigatório, no qual se analisaram as possibilidades de transformação do Cemitério Civil de Santa Vitória do Palmar em um atrativo turístico, a partir da realização de trilhas interpretativas em um processo de roteirização, com vistas à preservação de seu patrimônio. A metodologia utilizada foi análise SWOT partindo da inventariação turística. As incursões exploratórias foram desenvolvidas por meio de pesquisa bibliográfica e em periódicos. A pesquisa de campo realizada fez levantamento da infraestrutura, acessibilidade, segurança do espaço e elementos tumulares visando à elaboração do plano final de roteirização.

  20. Primary explosives

    Energy Technology Data Exchange (ETDEWEB)

    Matyas, Robert; Pachman, Jiri [Pardubice Univ. (Czech Republic). Faculty of Chemical Technology

    2013-06-01

    The first chapter provides background such as the basics of initiation and differences between requirements on primary explosives used in detonators and igniters. The authors then clarify the influence of physical characteristics on explosive properties, focusing on those properties required for primary explosives. Furthermore, the issue of sensitivity is discussed. All the chapters on particular groups of primary explosives are structured in the same way, including introduction, physical and chemical properties, explosive properties, preparation and documented use.

  1. Primary fibromyalgia

    DEFF Research Database (Denmark)

    Jacobsen, S; Jensen, L T; Foldager, M

    1990-01-01

    Serum concentrations of procollagen type III aminoterminal peptide have previously been reported to be low in some patients with primary fibromyalgia and the aim of this study was to determine if such patients differ clinically from primary fibromyalgia patients with normal levels of procollagen...... type III aminoterminal peptide. Subjective symptoms, tender points and dynamic muscle strength in 45 women with primary fibromyalgia were related to serum concentrations of procollagen type III aminoterminal peptide. Patients with low serum concentrations of procollagen type III aminoterminal peptide...... concentrations of procollagen type III aminoterminal peptide of primary fibromyalgia patients are connected to the disease impact....

  2. Primary productivity

    Digital Repository Service at National Institute of Oceanography (India)

    Verlecar, X.N.; Parulekar, A.H.

    Photosynthetic production in the oceans in relation to light, nutrients and mixing processes is discussed. Primary productivity in the estuarine region is reported to be high in comparison to coastal and oceanic waters. Upwelling phenomenon...

  3. Primary Hyperparathyroidism

    Science.gov (United States)

    ... Neoplasia Type 1 Thyroid Disease & Pregnancy Primary Hyperparathyroidism Prolactinoma National Hormone and Pituitary Program (NHPP): Information for ... qualified health care provider nearby. Eating, Diet, and Nutrition Eating, diet, and nutrition have not been shown ...

  4. Primary Myelofibrosis

    Science.gov (United States)

    ... attack is higher. Patients also have an increased risk of acute myeloid leukemia or primary myelofibrosis . Symptoms of polycythemia vera include headaches and a feeling of fullness below the ribs on the left ...

  5. Avaliação do questionário de Boston aplicado no pós-operatório tardio da síndrome do tunel do carpo operados pela técnica de retinaculótomo de paine por via palmar Evaluation of Boston questionnaire applied at late pos-operative period of carpal tunnel syndrome operated with the paine retinaculatome through palmar port

    Directory of Open Access Journals (Sweden)

    Lia Miyamoto Meirelles

    2006-01-01

    Full Text Available Entre os anos de 1995 e 1998, foram realizadas 112 cirurgias para tratamento da Síndrome do Túnel do Carpo (STC pela técnica de incisão palmar e utilização do retináculo de Paine. Com o objetivo de avaliar os resultados em longo prazo, os pacientes foram convocados. Houve o retorno de 44 pacientes. Deste total, três pacientes, por terem doenças associadas, foram excluídos, resultando, um total de 53 mãos analisadas. Apresentaremos os resultados da avaliação subjetiva, obtidos através da aplicação de um teste de auto-avaliação chamado de questionário de Boston. Este questionário consiste em perguntas que avaliam a gravidade dos sintomas e o estado funcional no momento da aplicação do mesmo. Através da aplicação do referido questionário encontramos um escore de 1,41 ± 0,57 para gravidade dos sintomas e 1,59 ± 0,93 para o estado funcional. Como este questionário não foi aplicado no pré-operatório deste grupo de pacientes analisados, comparou-se a pontuação obtida com as encontradas na literatura pertinente. Os resultados obtidos demonstraram que as pontuações pós-operatórias são similares àquelas existentes na literatura, mesmo sendo referidas a tempos diferentes de seguimento pós-operatórios, concluindo que havendo uma melhora dos sintomas, o questionário de Boston é sensível a esta mudança clínica.Between the years of 1995 and 1998, 112 surgeries were performed for treating Carpal Tunnel Syndrome (CTS using the technique of palmar incision employing the Paine retinaculum. With the objective of analyzing results in the long-term, the patients were called for review. Forty four patients returned. From these, three patients were excluded due to associated diseases, thus resulting in a total of 53 hands assessed. Here we present the results of the subjective evaluation achieved by applying a self-assessment test called Boston questionnaire. This questionnaire consists of questions evaluating symptoms

  6. Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome Influência do resfriamento nos parâmetros de condução nervosa mista do mediano e ulnar na síndrome do túnel do carpo

    Directory of Open Access Journals (Sweden)

    Rogério Gayer Machado de Araújo

    2007-09-01

    Full Text Available Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU in electrodiagnosis of carpal tunnel syndrome (CTS. Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands. Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands. PMU was obtained at the usual temperature, >32°C, and after wrist/hand cooling to Temperatura é uma variável comum e importante que modifica os parâmetros de condução nervosa na prática eletrodiagnóstica. Neste trabalho nós estudamos o efeito do esfriamento na diferença de latências palmares entre o nervo mediano e ulnar (PMU, segmento palma-pulso, utilizada rotineiramente para o eletrodiagnóstico da síndrome do túnel do carpo (STC. Foram estudados 22 controles (19 mulheres, média de idade 42,1 anos, 44 mãos e 25 pacientes (25 mulheres, média de idade 46,6 anos, 34 mãos com diagnóstico de STC leve. PMU foi obtida em temperatura usual (>32°C, e após resfriamento de mão/pulso em água com gelo (<27°C. Após o resfriamento houve aumento significativo na PMU e na latência mista palmar do nervo ulnar nos pacientes quando comparados aos controles. Nós concluímos que o resfriamento modifica significativamente a PMU e propomos que as latências obtidas em nervos submetidos à compressão reagem de maneira mais acentuada ao frio e isso poderia ser uma arma útil para o eletrodiagnóstico da STC incipiente. Da mesma forma, houve reação mais acentuada ao frio no estudo da latência mista palmar do nervo ulnar nos pacientes mas não nos controles, que poderia levantar a hipótese de compressão subclínica do nervo ulnar.

  7. Utilização do tendão do músculo palmar longo em procedimentos cirúrgicos: estudo em cadáveres Use of the tendon of the palmaris longus muscle in surgical procedures: study on cadavers

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Angelini Júnior

    2012-01-01

    Full Text Available OBJETIVO: Demonstrar que o tendão do músculo palmar longo pode ser estimado em relação ao seu comprimento e largura antes de usá-lo como enxerto em procedimento cirúrgico. MÉTODOS: Foram examinados 60 antebraços de 30 cadáveres de etnia negra; mensurou-se o comprimento e a largura do tendão do músculo palmar longo e comparou-se com o comprimento do antebraço. RESULTADOS: Foi constatada a ausência unilateral direita em dois cadáveres do sexo feminino. As médias do comprimento e da largura foram respectivamente 11,9 mais ou menos 15,2mm e 4,1 + 1,5mm. A média total do comprimento do antebraço foi de 275.4mm mais ou menos 17,9mm. CONCLUSÃO: Há uma relação significativa entre o comprimento do tendão e o comprimento do antebraço; assim poder-se-á avaliar o tamanho do tendão do músculo palmar longo quando for necessário usá-lo para enxertos. Nível de Evidências IV, Série de casos.OBJECTIVE: Demonstrate that the tendon of palmar long can be estimated in relation to its length and width before using it as a graft in surgical procedure. METHODS: There were examined 60 forearms of 30 corpses of black ethnicity; measure the length and width of the tendon of the palmaris longus muscle and compared the length of the forearm. RESULTS: There are notes their absence unilateral right in two female corpses. The medium length and width were more or less respectively 11.9, 15.2 mm and 4.1 + 1.5 mm. The total average forearm length of 275.4 was more or less 17.9 mm. CONCLUSION: There is a significant relationship between the length of the tendon and the length of the forearm; so we can evaluate the size of the tendon of the palmaris longus muscle when it is necessary to use it for grafts. Levels of Evidence IV, Case series.

  8. [Hypertension: once primary, always primary?

    NARCIS (Netherlands)

    Braam, R.L.; Pieters, G.F.F.M.; Thien, Th.

    2002-01-01

    Three patients diagnosed with primary hypertension suddenly developed hard-to-treat blood pressure after several years of stable blood pressure. One patient, a man aged 48 years, had developed a renal artery stenosis, which had not been present five years earlier. The other two patients, a man aged

  9. Hyperthyroidism (primary)

    OpenAIRE

    Nygaard, Birte

    2010-01-01

    Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone (TSH). Thyrotoxicosis is the clinical effect of high levels of thyroid hormones, whether or not the thyroid gland is the primary source.The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma.About 20 times more women than men have hyperthyroidism.

  10. The Austrian prize list; Le palmares autrichien

    Energy Technology Data Exchange (ETDEWEB)

    Jonas, A.; Gortler, F. [LK Oberosterreich (Austria)

    1999-06-01

    The Austria took stock on the wood furnaces from 1983 to 1997. Many tables present the annual power of automatic installations and networks, the installations number and their localization. Facing the fossil energies competition, the development of this energy needs a government financial assistance to keep its increase. (A.L.B.)

  11. Palmar Dermatoglyphs of South Mrican Indians

    African Journals Online (AJOL)

    1974-03-09

    Mar 9, 1974 ... Interracial Comparisons. Indian males had a significantly higher (O,OOS>P>. 0,001) number of thenar features than had Black males, although, taken separately, the right and left hands were not significantly different. There was no such discrepancy between Indian and Coloured males, and there were no.

  12. Toxina botulínica tipo A tópica con iontoforesis para el tratamiento de la hiperhidrosis axilar: Efecto y persistencia Topic type A botulinum toxin with iontophoresis in the treatment of armpit hyperhidrosis: effect and persistency

    Directory of Open Access Journals (Sweden)

    J.F. Silva-Gavarrete

    2011-09-01

    exocrine glands is termed Hyperhidrosis (HH and frequently become a dermatologic and social problem for humans. Nowadays, we have multiple treatments that controls the armpit HH. Botulinum toxin type A (TXB-A is known to be the best treatment to eliminate this problem but the needing of multiple injections in the armpit limits patients´ acceptance. Clinical iontophoresis method uses galvanic current to introduce many transdermal medications. We perform a simple blind clinical assay over 10 patients with armpit HH in who we apply an inert gel blended with Botulinum toxin type A (TXB-A Dysport® using one session of iontopheresis in one armpit; in the same moment the other armpit was injected with the toxin in the conventional way. The results where evaluated and compare by Minor Test (starch-iodine test in each patient at day 10th, 2 months and 5 months after the application. The same number of units and dilution of TXB-A where used in the topic and injected administration way. Results shows a diminished armpit HH in both sides over the whole study, been higher percentage of the effect in the injected way. In general a 74.67% decrease of armpit sweat for the topical way with iontopheresis and 90.33% of decrease of armpit sweat for the injected way. In the 5 months control of the persistency of the effect, both ways of administration of TXB-A reports with statistical significant results. Therefore in the present study we conclude that TXB-A apply topically with iontopheresis improves the armpit HH and shows a persistency of the effect at least for 5 months period.

  13. Primary Progressive Aphasia

    Science.gov (United States)

    ... which cause different symptoms. Semantic variant primary progressive aphasia Symptoms include these difficulties: Comprehending spoken or written ... word meanings Naming objects Logopenic variant primary progressive aphasia Symptoms include: Having difficulty retrieving words Frequently pausing ...

  14. Brain tumor - primary - adults

    Science.gov (United States)

    ... Vestibular schwannoma (acoustic neuroma) - adults; Meningioma - adults; Cancer - brain tumor (adults) ... Primary brain tumors include any tumor that starts in the brain. Primary brain tumors can start from brain cells, ...

  15. Primary ovarian malignant melanoma

    Directory of Open Access Journals (Sweden)

    Kostov Miloš

    2010-01-01

    Full Text Available Background. Primary ovarian malignant melanoma is extremely rare. It usually appears in the wall of a dermoid cyst or is associated with another teratomatous component. Metastatic primary malignant melanoma to ovary from a primary melanoma elsewhere is well known and has been often reported especially in autopsy studies. Case report. We presented a case of primary ovarian malignant melanoma in a 45- year old woman, with no evidence of extraovarian primary melanoma nor teratomatous component. The tumor was unilateral, macroscopically on section presented as solid mass, dark brown to black color. Microscopically, tumor cells showed positive immunohistochemical reaction for HMB-45, melan-A and S-100 protein, and negative immunoreactivity for estrogen and progesteron receptors. Conclusion. Differentiate metastatic melanoma from rare primary ovarian malignant melanoma, in some of cases may be a histopathological diagnostic problem. Histopathological diagnosis of primary ovarian malignant melanoma should be confirmed by immunohistochemical analyses and detailed clinical search for an occult primary tumor.

  16. Investigating Primary Source Literacy

    Science.gov (United States)

    Archer, Joanne; Hanlon, Ann M.; Levine, Jennie A.

    2009-01-01

    Primary source research requires students to acquire specialized research skills. This paper presents results from a user study testing the effectiveness of a Web guide designed to convey the concepts behind "primary source literacy". The study also evaluated students' strengths and weaknesses when conducting primary source research. (Contains 3…

  17. Primary Hyperparathyroidism: An Overview

    Directory of Open Access Journals (Sweden)

    Jessica MacKenzie-Feder

    2011-01-01

    Full Text Available Primary hyperparathyroidism is a common condition that affects 0.3% of the general population. Primary and tertiary care specialists can encounter patients with primary hyperparathyroidism, and prompt recognition and treatment can greatly reduce morbidity and mortality from this disease. In this paper we will review the basic physiology of calcium homeostasis and then consider genetic associations as well as common etiologies and presentations of primary hyperparathyroidism. We will consider emerging trends in detection and measurement of parathyroid hormone as well as available imaging modalities for the parathyroid glands. Surgical indications and approach will be reviewed as well as medical management of primary hyperparathyroidism with bisphosphonates and calcimimetics.

  18. Normocalcemic Primary Hyperparathyroidism

    Science.gov (United States)

    Cusano, Natalie E.; Silverberg, Shonni J.; Bilezikian, John P.

    2013-01-01

    Primary hyperparathyroidism, a common endocrine disorder, is traditionally defined by hypercalcemia and elevated levels of parathyroid hormone (PTH). A newer presentation of primary hyperparathyroidism has been described over the past decade, in which PTH is elevated but serum calcium is consistently normal, in the absence of secondary causes of hyperparathyroidism, such as renal disease or vitamin D deficiency. Recognition of this phenotype of primary hyperparathyroidism, normocalcemic primary hyperparathyroidism, supports a biphasic chronological time course in some individuals in which PTH levels are first elevated but serum calcium is normal, followed by the development of frank hypercalcemia. This review focuses on the available literature regarding this newly described phenotype of primary hyperparathyroidism. PMID:23374739

  19. Multiple primary cancer

    International Nuclear Information System (INIS)

    Jung, Gyu Sik; Lee, Ouk; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duck

    1989-01-01

    It is rare for one human being to be afflicted with more than one cancer. However with further advances in therapeutic regimens, histopathologic observation, diagnostic modalities, and increased curiosity, there are increasing number of case reports of multiple primary cancer. The present study evaluates 25 histologically confirmed cases of multiple primary cancer from 1974 to 1988 at Kosin Medical Center. The most frequent site of the first primary cancer in male was stomach and in female, uterine cervix. The first primary cancer in female occurred in endocrine-related organs (breast, uterus and thyroid) in 63.6 percent. Synchronous cancers are diagnosed simultaneously or within an interval of about six months and synchronous cancers were 16 out of 25 cases. Metachronous cancers are diagnosed at interval of more than six months. There were 9 metachronous cancers and average interval between the first and second primary cancer was 22.8 months. The incidence of multiple primary cancer was 0.11 percent. The average age was 51.9 years at the time of the first primary cancer (53.1 years in male and 50.3 years in female). CT scan was most helpful in early detection of multiple primary cancers facilitating biopsy and surgery. Multiple primary cancers are beyond the medical curiosity. Early diagnosis of the disease and careful follow-up study, based on an awareness of the possibility of second cancers, will substantially increase the survival of these patients

  20. Avaliação da função manual e da força de preensão palmar máxima em indivíduos com diabetes mellitus Hand function and power grip strength assessment in individuals with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kauê Carvalho de Almeida Lima

    2012-12-01

    Full Text Available O sucesso na realização de atividades manipulativas é crucial para um estilo independente. Como os diabéticos podem apresentar alterações sensoriais nas mãos, podem demonstrar alterações funcionais em tarefas manipulativas. Assim, o objetivo deste estudo foi comparar o desempenho de indivíduos diabéticos não neuropatas com o de não diabéticos em tarefas manipulativas e na capacidade de geração de força de preensão palmar máxima. Treze diabéticos sem diagnóstico de neuropatia (48,6±11,51 anos; 79,9±10,88 kg; 1,68 ±0,09 m e 13 controles pareados por sexo e idade (48,5±10,09 anos; 76,44±11,79 kg; 1,69±0,1 m participaram do estudo. A sensibilidade das mãos foi avaliada por meio do kit de monofilamentos Semmes-Weinstein e, em seguida, foram aplicados três testes comumente utilizados para avaliação da função manual na seguinte ordem: teste de função manual Jebsen Taylor (TFMJT, teste dos nove pinos nos buracos (9-PnB e teste de força de preensão palmar máxima (FPmax. Os resultados do teste de sensibilidade cutânea indicaram que oito diabéticos apresentaram sensibilidade cutânea normal e cinco, alguma alteração sensorial detectável pelo monofilamento, a qual, no entanto, não os caracterizavam como neuropatas. Com relação aos testes funcionais, os resultados não indicaram qualquer diferença entre os grupos para os desempenhos nos três testes realizados (diabéticos e controles - TFMJT: 26,15±3,06 e 25,78±1,29 s; 9-PnB: 15,33±1,35 e 15,48±2,39 s; FPmax: 41,15±10,59 e 43,69±12,59 kgf. Assim, podemos concluir que indivíduos diabéticos sem neuropatia diabética periférica não apresentam qualquer alteração funcional nos membros superiores e na capacidade de gerar força de preensão palmar máxima.A successful object manipulation is crucial for living an independent life. As diabetic individuals could present sensory deficits in their hands, they could decrease functional performance in tasks

  1. Simultaneous acoustic stimulation of human primary and secondary somatosensory cortices using transcranial focused ultrasound.

    Science.gov (United States)

    Lee, Wonhye; Chung, Yong An; Jung, Yujin; Song, In-Uk; Yoo, Seung-Schik

    2016-10-26

    Transcranial focused ultrasound (FUS) is gaining momentum as a novel non-invasive brain stimulation method, with promising potential for superior spatial resolution and depth penetration compared to transcranial magnetic stimulation or transcranial direct current stimulation. We examined the presence of tactile sensations elicited by FUS stimulation of two separate brain regions in humans-the primary (SI) and secondary (SII) somatosensory areas of the hand, as guided by individual-specific functional magnetic resonance imaging data. Under image-guidance, acoustic stimulations were delivered to the SI and SII areas either separately or simultaneously. The SII areas were divided into sub-regions that are activated by four types of external tactile sensations to the palmar side of the right hand-vibrotactile, pressure, warmth, and coolness. Across the stimulation conditions (SI only, SII only, SI and SII simultaneously), participants reported various types of tactile sensations that arose from the hand contralateral to the stimulation, such as the palm/back of the hand or as single/neighboring fingers. The type of tactile sensations did not match the sensations that are associated with specific sub-regions in the SII. The neuro-stimulatory effects of FUS were transient and reversible, and the procedure did not cause any adverse changes or discomforts in the subject's mental/physical status. The use of multiple FUS transducers allowed for simultaneous stimulation of the SI/SII in the same hemisphere and elicited various tactile sensations in the absence of any external sensory stimuli. Stimulation of the SII area alone could also induce perception of tactile sensations. The ability to stimulate multiple brain areas in a spatially restricted fashion can be used to study causal relationships between regional brain activities and their cognitive/behavioral outcomes.

  2. Using Primary Source Documents.

    Science.gov (United States)

    Mintz, Steven

    2003-01-01

    Explores the use of primary sources when teaching about U.S. slavery. Includes primary sources from the Gilder Lehrman Documents Collection (New York Historical Society) to teach about the role of slaves in the Revolutionary War, such as a proclamation from Lord Dunmore offering freedom to slaves who joined his army. (CMK)

  3. Medics in Primary School

    Science.gov (United States)

    Press, Colin

    2003-01-01

    Some time ago a flyer on "Medics in Primary School" came the author's way. It described a programme for making placements in primary schools available to medical students. The benefits of the program to medical students and participating schools were highlighted, including opportunities to develop communication skills and demystify…

  4. Primary Sclerosing Cholangitis (PSC)

    Science.gov (United States)

    ... Legacy Society Make Gifts of Stock Donate Your Car Personal Fundraising Partnership & Support Share Your Story Spread the Word Give While You Shop Contact Us Donate Now Primary Sclerosing Cholangitis Back ...

  5. Primary cultures of astrocytes

    DEFF Research Database (Denmark)

    Lange, Sofie C; Bak, Lasse Kristoffer; Waagepetersen, Helle S

    2012-01-01

    During the past few decades of astrocyte research it has become increasingly clear that astrocytes have taken a central position in all central nervous system activities. Much of our new understanding of astrocytes has been derived from studies conducted with primary cultures of astrocytes...... subsequently found in vivo. Nevertheless, primary cultures of astrocytes are an in vitro model that does not fully mimic the complex events occurring in vivo. Here we present an overview of the numerous contributions generated by the use of primary astrocyte cultures to uncover the diverse functions...... of astrocytes. Many of these discoveries would not have been possible to achieve without the use of astrocyte cultures. Additionally, we address and discuss the concerns that have been raised regarding the use of primary cultures of astrocytes as an experimental model system....

  6. Primary Meningeal Rhabdomyosarcoma

    Science.gov (United States)

    Palta, Manisha; Riedel, Richard F.; Vredenburgh, James J.; Cummings, Thomas J.; Green, Scott; Chang, Zheng; Kirkpatrick, John P.

    2011-01-01

    Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imaging (MRI) demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13). Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC) systemic therapy. PMID:21772793

  7. Primary Meningeal Rhabdomyosarcoma

    Directory of Open Access Journals (Sweden)

    Manisha Palta

    2011-01-01

    Full Text Available Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imaging (MRI demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13. Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC systemic therapy.

  8. Primary meningeal rhabdomyosarcoma.

    Science.gov (United States)

    Palta, Manisha; Riedel, Richard F; Vredenburgh, James J; Cummings, Thomas J; Green, Scott; Chang, Zheng; Kirkpatrick, John P

    2011-01-01

    Primary meningeal rhabdomyosarcoma is a rare primary brain malignancy, with scant case reports. While most reports of primary intracranial rhabdomyosarcoma occur in pediatric patients, a handful of cases in adult patients have been reported in the medical literature. We report the case of a 44-year-old male who developed primary meningeal rhabdomyosarcoma. After developing episodes of right lower extremity weakness, word finding difficulty, and headaches, a brain magnetic resonance imaging (MRI) demonstrated a vertex lesion with radiographic appearance of a meningeal-derived tumor. Subtotal surgical resection was performed due to sagittal sinus invasion and initial pathology was interpreted as an anaplastic meningioma. Re-review of pathology demonstrated rhabdomyosarcoma negative for alveolar translocation t(2;13). Staging studies revealed no evidence of disseminated disease. He was treated with stereotactic radiotherapy with concurrent temozolamide to be followed by vincristine, actinomycin-D, and cyclophosphamide (VAC) systemic therapy.

  9. Primary Nurse - Role Evolution

    Science.gov (United States)

    Mundinger, Mary O'Neil

    1973-01-01

    Primary nursing means that each patient has an individual nurse who is responsible for assessing his nursing needs and planning and evaluating his nursing care. The article describes the advantages and problems connected with this approach to patient care. (AG)

  10. Multiple Primary Tumors

    African Journals Online (AJOL)

    2017-12-05

    Dec 5, 2017 ... Multiple primary tumors occur in clinical practice causing diagnostic dilemma. It is not very .... was estrogen receptor negative, progesterone receptor negative, and ... cervical, ovarian, and urinary bladder cancers. Multiple.

  11. Primary infertility (image)

    Science.gov (United States)

    Primary infertility is a term used to describe a couple that has never been able to conceive a pregnancy ... to do so through unprotected intercourse. Causes of infertility include a wide range of physical as well ...

  12. Primary Intraorbital Ectopic Meningioma

    Science.gov (United States)

    Yokoyama, Tetsuo; Nishizawa, Shigeru; Sugiyama, Kenji; Yokota, Noki; Ohta, Seiji; Uemura, Kenichi; Hinokuma, Kaoru; Inenaga, Chikanori

    1999-01-01

    We report a case of intraorbital meningioma. Operative findings and histopathological examination revealed the tumoc to be meningothelial meningloma and to be located entirely outside the optic dura. This case demonstrates the occurrence of primary intraorbital ectopic meningioma, and the tumor was removed through a modified Dolenc approach. The primary intraorbital ectopic meningioma is discussed and the surgical approach to the orbital apex region is reviewed. ImagesFigure 1Figure 2Figure 4Figure 5 PMID:17171081

  13. Primary leiomyosarcoma of epididymis

    Directory of Open Access Journals (Sweden)

    Dillip Kumar Muduly

    2012-01-01

    Full Text Available Primary leiomyosarcomas rarely arise from epididymis. But they are the most common histopathological types of sarcoma arising from the epididymis. Primary epididymal leiomyosarcoma occurs usually in older patients. We report a young patient of 35 years presenting with leiomyosarcoma of left epididymis. He did not have any metastasis and underwent left high inguinal orchiectomy. He is on regular follow-up and disease free for last two years.

  14. Primary care ... where?

    Science.gov (United States)

    Adcock, G B

    1999-07-01

    Corporate-based nurse managed centers are not the national norm. More prevalent is the use of an occupational health or physician-directed medical model of care. The author describes how a 14-year-old primary care center at a North Carolina computer software company is just "business as usual" when viewed in the context of the company's philosophy, goals, and culture. Included are considerations for nurse practitioners interested in the successful transplantation of this primary care model to other settings.

  15. Other primary headaches

    Directory of Open Access Journals (Sweden)

    Anish Bahra

    2012-01-01

    Full Text Available The ′Other Primary Headaches′ include eight recognised benign headache disorders. Primary stabbing headache is a generally benign disorder which often co-exists with other primary headache disorders such as migraine and cluster headache. Primary cough headache is headache precipitated by valsalva; secondary cough has been reported particularly in association with posterior fossa pathology. Primary exertional headache can occur with sudden or gradual onset during, or immediately after, exercise. Similarly headache associated with sexual activity can occur with gradual evolution or sudden onset. Secondary headache is more likely with both exertional and sexual headache of sudden onset. Sudden onset headache, with maximum intensity reached within a minute, is termed thunderclap headache. A benign form of thunderclap headache exists. However, isolated primary and secondary thunderclap headache cannot be clinically differentiated. Therefore all headache of thunderclap onset should be investigated. The primary forms of the aforementioned paroxysmal headaches appear to be Indomethacin sensitive disorders. Hypnic headache is a rare disorder which is termed ′alarm clock headache′, exclusively waking patients from sleep. The disorder can be Indomethacin responsive, but can also respond to Lithium and caffeine. New daily persistent headache is a rare and often intractable headache which starts one day and persists daily thereafter for at least 3 months. The clinical syndrome more often has migrainous features or is otherwise has a chronic tension-type headache phenotype. Management is that of the clinical syndrome. Hemicrania continua straddles the disorders of migraine and the trigeminal autonomic cephalalgias and is not dealt with in this review.

  16. Primary Ectopic Ethmoidal Craniopharyngioma.

    Science.gov (United States)

    Preti, Andrea; Karligkiotis, Apostolos; Facco, Carla; Ottini, Giorgia; Volpi, Luca; Castelnuovo, Paolo

    2017-06-01

    Craniopharyngiomas are benign but aggressive epithelial tumors usually originating in the anterior lobe of the pituitary gland from squamous remnants of an incompletely involuted craniopharingeal duct developing from the Rathke pouch. To the authors' knowledge only 1 patient of a primary isolated ethmoidal craniopharyngioma has been reported in the literature.The authors report the case of a 17-year-old boy with a primary extracranial ethmoidal craniopharyngioma. An endoscopic endonasal approach was employed to resect the tumor. After 2 years of clinical and radiological follow-up no recurrence of disease was observed.Primary ethmoidal craniopharyngiomas are rare entities and biopsy is necessary for diagnosis. However, a preoperative assessment by means of nasal endoscopy, computed tomography scan, and enhanced magnetic resonance imaging is mandatory to better evaluate the extension and characteristics of the tumor. The endoscopic endonasal technique is a safe and effective approach for the treatment of these lesions.

  17. Primary renal synovial sarcoma

    Directory of Open Access Journals (Sweden)

    Girish D. Bakhshi

    2012-03-01

    Full Text Available Primary Renal Sarcoma is rare tumor comprising only 1% of all renal tumours. Synovial sarcomas are generally deep-seated tumors arising in the proximity of large joints of adolescents and young adults and account for 5-10% of all soft tissue tumours. Primary synovial sarcoma of kidney is rare and has poor prognosis. It can only be diagnosed by immunohistochemistry. It should be considered as a differential in sarcomatoid and spindle cell tumours. We present a case of 33-year-old female, who underwent left sided radical nephrectomy for renal tumour. Histopathology and genetic analysis diagnosed it to be primary renal synovial sarcoma. Patient underwent radiation therapy and 2 years follow up is uneventful. A brief case report with review of literature is presented.

  18. Primary headaches in children

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Pan

    2015-01-01

    Full Text Available Headache is a widespread clinical problem; the prevalence is high in all age groups, from which children and teenagers are not spared. It has been reported that, as many as 75% of school-age children may experience headache infrequently, among them 10% have recurrent headaches. [1],[2] The vast majority of headaches are primary and classified as migraine, tension-type headache (TTH, cluster headache, and other trigeminal autonomic cephalgias. The type of primary headaches could usually be diagnosed by a thorough and careful history taking, and physical examination. Once the diagnosis of migraine is established and appropriate reassurance provided, a balanced and individually tailored treatment plan can be instituted. The goal of treatment includes abortive or acute pain treatment, preventive long-term treatment, and biobehavioral therapy. Knowledge of precise impact of primary headaches on child′s quality of life helps to design a proper comprehensive treatment plan.

  19. Normocalcemic primary hyperparathyroidism

    Science.gov (United States)

    Bilezikian, John P.; Silverberg, Shonni J.

    2011-01-01

    SUMMARY Primary hyperparathyroidism is a common disorder of mineral metabolism characterized by incompletely regulated, excessive secretion of parathyroid hormone from one or more of the parathyroid glands. The historical view of this disease describes two distinct entities marked by two eras. When primary hyperparathyroidism was first discovered about 80 years ago, it was always symptomatic with kidney stones, bone disease and marked hypercalcemia. With the advent of the multichannel autoanalyzer about 40 years ago, the clinical phenotype changed to a disorder characterized by mild hypercalcemia and the absence of classical other features of the disease. We may now be entering a 3rd era in the history of this disease in which patients are being discovered with normal total and ionized serum calcium concentrations but with parathyroid hormone levels that are consistently elevated. In this article, we describe this new entity, normocalcemic primary hyperparathyroidism, a forme fruste of the disease. PMID:20485897

  20. [Primary care in Ireland].

    Science.gov (United States)

    Sánchez-Sagrado, T

    Spanish doctors are still leaving the country to look for quality work. Ireland is not a country with many Spanish professionals but it is interesting to know its particular Health care system. Ireland is one of the countries with a national health care system, although it has a mixture of private health care insurance schemes. People have a right to health care if they have been living in Ireland at least for a year. Access to the primary care health system depends on age and income: free of charge for Category 1 and co-payments for the rest. This division generates great inequalities among the population. Primary Care doctors are self-employed, and they work independently. However, since 2001 they have tended to work in multidisciplinary teams in order to strengthen the Primary Care practice. Salary is gained from a combination of public and private incomes which are not differentiated. The role of the General Practitioner consists in the treatment of acute and chronic diseases, minor surgery, child care, etc. There is no coordination between Primary and Secondary care. Access to specialised medicine is regulated by the price of consultation. Primary Care doctors are not gatekeepers. To be able to work here, doctors must have three years of training after medical school. After that, Continuing Medical Education is compulsory, and the college of general practitioners monitors it annually. The Irish health care system does not fit into the European model. Lack of a clear separation between public and private health care generates great inequalities. The non-existence of coordination between primary and specialised care leads to inefficiencies, which Ireland cannot allow itself after a decade of economic crisis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Thoughts on primary care.

    Science.gov (United States)

    Raskin, Lynne

    2010-01-01

    The uptake of family health teams in Ontario has been tremendous. And the creation of group practices in primary care has taken root in other provinces as well. For many people, being involved with something new is exciting. At the same time, once they are committed, they discover the challenges that can be simultaneously exhilarating and frustrating. This issue of Healthcare Quarterly offers two articles that provide interesting reflections on what has been learned so far from the perspectives of both team leadership and the team members themselves within a transforming primary care system.

  2. Studies on topical antiperspirant control of axillary hyperhidrosis.

    Science.gov (United States)

    Shelley, W B; Hurley, H J

    1975-01-01

    Axillary hyperhidrotics is reviewed from the standpoint of anatomical factors, physiological mechanisms and the history of methods of control. Anhydrous aluminum chloride and anhydrous zirconium tetrachloride are shown to be superior topical agents for partial control of axillary sweating when applied as a powder or in anhydrous nonreactive vehicles. Complete anhidrosis as demonstrated by sustained garment armpit dryness could be achieved in hyperhidrotics within 48 hours by the following trinary antiperspirant system: (1) a saturated solution of aluminum chloride hexahydrate or zirconyl chloride in absolute ethanol or isopropyl alcohol, (2) application to the dry axilla at times of sleep or other prolonged non-sweating period, (3) water vapor occlusion of area for 6 to 8 hours by means of Saran wrap. The hypothesis is presented that metallic antiperspirants act by reflux entrance into the terminal intraepidermal eccrine duct, slowly combining with the intraductal keratin, to produce a fibrillar contraction (super contraction) of keratin and hence functional closure, not histologically evident. This altered keratin is shed weeks later, with the consequent return of ductal patency and sweating.

  3. Primary lymphoma of the brain

    Science.gov (United States)

    Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain ... The cause of primary brain lymphoma is not known. People with a weakened immune system are at high risk for primary lymphoma of the brain. ...

  4. Surgery of Primary Melanomas

    Directory of Open Access Journals (Sweden)

    Piotr Rutkowski

    2010-05-01

    Full Text Available Surgery remains the mainstay of melanoma therapy, regardless of the tumor site. Only the early diagnosis combined with proper surgical therapy currently gives patients affected by this malignancy the chance for a full cure. The main goal of surgical therapy is to provide the local control of the disease and to secure long-term survival of the patient without reasonable functional and esthetic impairment. The recommended method of biopsy—excisional biopsy, as an initial diagnostic and, to some extent, therapeutic procedure—is performed under local anesthesia as an elliptical incision with visual clear margins of 1–3 mm and with some mm of subcutaneous tissue. The extent of radical excision of the primary tumor (or scar after excisional biopsy is based on the histopathologic characteristics of the primary tumor and usually consists of 1–2 cm margins with primary closure. The philosophy behind conducted randomized clinical trials has been to find the most conservative surgical approach that is able to guarantee the same results as more demolitive treatment. This has been the background of the trials designed to define the correct margins of excision around a primary cutaneous melanoma. Much less definition can be dedicated to the surgical management of patients with non-cutaneous melanomas.

  5. Surgery of Primary Melanomas

    Energy Technology Data Exchange (ETDEWEB)

    Rutkowski, Piotr, E-mail: rutkowskip@coi.waw.pl; Zdzienicki, Marcin; Nowecki, Zbigniew I. [Soft Tissue/Bone Sarcoma and Melanoma Department, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland); Akkooi, Alexander C. J. van [Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2010-05-11

    Surgery remains the mainstay of melanoma therapy, regardless of the tumor site. Only the early diagnosis combined with proper surgical therapy currently gives patients affected by this malignancy the chance for a full cure. The main goal of surgical therapy is to provide the local control of the disease and to secure long-term survival of the patient without reasonable functional and esthetic impairment. The recommended method of biopsy—excisional biopsy, as an initial diagnostic and, to some extent, therapeutic procedure—is performed under local anesthesia as an elliptical incision with visual clear margins of 1–3 mm and with some mm of subcutaneous tissue. The extent of radical excision of the primary tumor (or scar after excisional biopsy) is based on the histopathologic characteristics of the primary tumor and usually consists of 1–2 cm margins with primary closure. The philosophy behind conducted randomized clinical trials has been to find the most conservative surgical approach that is able to guarantee the same results as more demolitive treatment. This has been the background of the trials designed to define the correct margins of excision around a primary cutaneous melanoma. Much less definition can be dedicated to the surgical management of patients with non-cutaneous melanomas.

  6. Surgery of Primary Melanomas

    International Nuclear Information System (INIS)

    Rutkowski, Piotr; Zdzienicki, Marcin; Nowecki, Zbigniew I.; Akkooi, Alexander C. J. van

    2010-01-01

    Surgery remains the mainstay of melanoma therapy, regardless of the tumor site. Only the early diagnosis combined with proper surgical therapy currently gives patients affected by this malignancy the chance for a full cure. The main goal of surgical therapy is to provide the local control of the disease and to secure long-term survival of the patient without reasonable functional and esthetic impairment. The recommended method of biopsy—excisional biopsy, as an initial diagnostic and, to some extent, therapeutic procedure—is performed under local anesthesia as an elliptical incision with visual clear margins of 1–3 mm and with some mm of subcutaneous tissue. The extent of radical excision of the primary tumor (or scar after excisional biopsy) is based on the histopathologic characteristics of the primary tumor and usually consists of 1–2 cm margins with primary closure. The philosophy behind conducted randomized clinical trials has been to find the most conservative surgical approach that is able to guarantee the same results as more demolitive treatment. This has been the background of the trials designed to define the correct margins of excision around a primary cutaneous melanoma. Much less definition can be dedicated to the surgical management of patients with non-cutaneous melanomas

  7. Primary intestinal lymphangiectasia.

    Science.gov (United States)

    Suresh, N; Ganesh, R; Sankar, Janani; Sathiyasekaran, Malathi

    2009-10-01

    Primary intestinal lymphangiectasia (PIL) is a rare disease of intestinal lymphatics presenting with hypoproteinemia, bilateral lower limb edema, ascites, and protein losing enteropathy. We report a series of 4 children from Chennai, India presenting with anasarca, recurrent diarrhea, hypoproteinemia and confirmatory features of PIL on endoscopy and histopathology.

  8. Healthcare is primary

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2015-01-01

    Full Text Available India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2 nd National Conference on Family Medicine and Primary Care 2015 (FMPC brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care, the unfinished agenda of National Health Policy 2002, remains a priority area of implementation.

  9. Multiple Primary Tumors

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... breast and ascending colon. KEYWORDS: Carcinoid, colorectal cancer, metachronous, synchronous. Multiple Primary Tumors. MA Adeyanju, AA Ilori. Address for correspondence: Dr. MA Adeyanju,. Department of Surgery, Federal Medical Centre, Ebute Metta,. Lagos, Nigeria. E-mail: mbadeyanju@yahoo.

  10. Primary malignant intramedullary lymphoma

    International Nuclear Information System (INIS)

    Orrego P, E.; Heinicke Y, H.; Arbaiza A, D.; Yepez R, V.

    1999-01-01

    A case of primary malignant intramedullary lymphoma, localized in the dorsal part of the spinal cord is presented. The clinical symptoms were associated with motor and sensitive deficit. Clinical investigations excluded the presence of lymphoma in other locations in the central nervous system and the extra neural organs. Postoperative radiotherapy and chemotherapy improved relict neurological symptoms. (authors)

  11. Primary black holes

    International Nuclear Information System (INIS)

    Novikov, I.; Polnarev, A.

    1981-01-01

    Proves are searched for of the formation of the so-called primary black holes at the very origin of the universe. The black holes would weigh less than 10 13 kg. The formation of a primary black hole is conditional on strong fluctuations of the gravitational field corresponding roughly to a half of the fluctuation maximally permissible by the general relativity theory. Only big fluctuations of the gravitational field can overcome the forces of the hot gas pressure and compress the originally expanding matter into a black hole. Low-mass black holes have a temperature exceeding that of the black holes formed from stars. A quantum process of particle formation, the so-called evaporation takes place in the strong gravitational field of a black hole. The lower the mass of the black hole, the shorter the evaporation time. The analyses of processes taking place during the evaporation of low-mass primary black holes show that only a very small proportion of the total mass of the matter in the universe could turn into primary black holes. (M.D.)

  12. Familial primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Iqbal, P.; Javed, R.

    2007-01-01

    A case of primary hyperparathyroidism in a 17 years old female is described. Patient presented with severe abdominal and pelvic pains associate with discomfort. Diagnostic testing revealed multiple upper and lower limb fractures and renal stones. Case was self limiting. Patient's condition resolved on parathyroidectomy for adenoma and partial thyroidectomy. Follow-up showed familial links. (author)

  13. Multiple Primary Cancer Monograph

    Science.gov (United States)

    To identify groups of cancer survivors that are at increased risk for multiple primary cancers, investigators led an effort to provide the first comprehensive population-based analysis of the risk of subsequent cancer in the U.S., resulting in a monograph.

  14. Primary cosmic ray flux

    Energy Technology Data Exchange (ETDEWEB)

    Stanev, Todor

    2001-05-01

    We discuss the primary cosmic ray flux from the point of view of particle interactions and production of atmospheric neutrinos. The overall normalization of the cosmic ray flux and its time variations and site dependence are major ingredients of the atmospheric neutrino predictions and the basis for the derivation of the neutrino oscillation parameters.

  15. in primary care

    African Journals Online (AJOL)

    Claire van Deventer

    Keywords: child HIV, doctor involvement, primary health care, quality improvement ... expertise increased, PHC facilities are now expected to be able to .... organised patient documentation were revisited. .... Review: what can we learn from quality ... South Pacific: Review of evidence and lessons from an innovative.

  16. [Primary and secondary encopresis].

    Science.gov (United States)

    Lang-Langer, Ellen

    2007-01-01

    While the difficulty of the child to part with its faeces in primary encopresis is linked to the incapability to experience the object as separated and independent from himself, secondary encopresis is a progressed psychical state of development. In this case we have to deal with regression caused by conflict. Two case-studies show clearly the differences.

  17. Compound palmar ganglion causing compressive neuropathy of the median nerve

    Directory of Open Access Journals (Sweden)

    Tribhuwan Narayan Singh Gaur

    2017-01-01

    Full Text Available Tuberculosis (TB of synovial sheath of tendon is uncommon, it is a severe form of extrapulmonary TB, diagnosis is obvious on clinical grounds in later stages, but is always confirmed by histopathology. Here, we are presenting a case of a 50-year-old female, who presented to us with gradual increasing swelling in her left hand and wrist and numbness over left thenar eminence. The patient was successfully treated with debulking operation and anti-tubercular drugs. Tubercular tenosynovitis of wrist and hand is a severe form of extrapulmonary TB. Intraoperatively, the presence of rice body or melon seed bodies is pathognomonic for confirming the diagnosis. Early diagnosis and intervention give good prognosis.

  18. Palmar, Patellar, and Pedal Human Remains from Pavlov

    Czech Academy of Sciences Publication Activity Database

    Trinkaus, E.; Wojtal, P.; Wilczyński, J.; Sázelová, Sandra; Svoboda, Jiří

    2017-01-01

    Roč. 2017, June (2017), s. 73-101 ISSN 1545-0031 Institutional support: RVO:68081758 Keywords : Gravettian * human remains * isolated bones * anatomically modern humans * Upper Paleolithic Subject RIV: AC - Archeology, Anthropology, Ethnology OBOR OECD: Archaeology http://paleoanthro.org/media/journal/content/PA20170073.pdf

  19. Spirometry in primary care

    Science.gov (United States)

    Coates, Allan L; Graham, Brian L; McFadden, Robin G; McParland, Colm; Moosa, Dilshad; Provencher, Steeve; Road, Jeremy

    2013-01-01

    Canadian Thoracic Society (CTS) clinical guidelines for asthma and chronic obstructive pulmonary disease (COPD) specify that spirometry should be used to diagnose these diseases. Given the burden of asthma and COPD, most people with these diseases will be diagnosed in the primary care setting. The present CTS position statement was developed to provide guidance on key factors affecting the quality of spirometry testing in the primary care setting. The present statement may also be used to inform and guide the accreditation process for spirometry in each province. Although many of the principles discussed are equally applicable to pulmonary function laboratories and interpretation of tests by respirologists, they are held to a higher standard and are outside the scope of the present statement. PMID:23457669

  20. Cancer of unknown primary

    DEFF Research Database (Denmark)

    Dyrvig, Anne-Kirstine; Yderstræde, Knud Bonnet; Gerke, Oke

    2017-01-01

    210 (38.7%) had a CUP diagnosis confirmed. Within the cohort, 347 patients (64.0%) had a registration in CR matching with the NPR registration. Exposure to diagnostic procedures included biopsy (n = 439, 81.0%) and image modalities (n = 532, 98.2%). Survival was poor with 67 (12.4%) individuals alive...... after 4 years.The validity of a CUP diagnosis in NPR was low when using data from CR as reference. More than half the suspected CUP patients had a previous cancer diagnosis with CUP being the most frequent. Patients were diagnosed in compliance with guidelines indicating high external validity, but less...... than 1 quarter had their primary identified and the 1-year survival was approximately 20%. Research is needed to develop efficacious methods for primary detection....

  1. Primary omental pregnancy

    International Nuclear Information System (INIS)

    Yildizhan, R.; Kurdoglu, M.; Kolusari, A.; Erten, R.

    2008-01-01

    Omental pregnancy is a rare form of ectopic pregnancy and can be seen primarily or secondary to a tubal pregnancy. A 25-yeal-old woman presented with abdominal distention with pain and anemia without vaginal bleeding. After a provisional diagnosis of ruptured ectopic pregnancy, laparotomy was performed. On surgical exploration, the bilateral tubes and ovaries were intact, however, an omental pregnancy was detected as the cause of hemoperitoneum. Partial omentectomy was performed. Although most cases are secondary, presented here is an additional case of primary omental pregnancy at 12 weeks according to Studdiford's criteria. Histological evidence of neovascularization into the supporting tissue confirmed our diagnosis. A primary omental pregnancy should always be considered as a possible explanation for severe hemoperitoneum in ectopic pregnancies presenting with acute abdomen and with intact adnexes on surgical exploration. (author)

  2. Basics of primary immunodeficiencies

    Directory of Open Access Journals (Sweden)

    Claudia Hernández-Martínez

    2016-05-01

    Full Text Available Primary immunodeficiencies (PID are a heterogeneous group of inherited disorders, the etiology are the defects in the development or function of the immune system. The principal PID manifestations are the infections in early age, malignancy and diseases of immune dysregulation as autoimmunity and allergy. PIDs are genetics disorders and most of them are inherited as autosomal recessive, also this group of diseases is more prevalent in males and in childhood. The antibody immunodeficiency is the PID more common in adults. The more frequent disorders are the infections in the respiratory tract, abscesses, candidiasis, diarrhea, BCGosis etc. Initial approach included a complete blood count and quantification of immunoglobulins. The delay in diagnosis could be explained due to a perception that the recurrent infections are normal process or think that they are exclusively of childhood. The early diagnosis of PID by primary care physicians is important to opportune treatment and better prognosis.

  3. [Primary care in France].

    Science.gov (United States)

    Sánchez-Sagrado, T

    2016-01-01

    The poor planning of health care professionals in Spain has led to an exodus of doctors leaving the country. France is one of the chosen countries for Spanish doctors to develop their professional career. The French health care system belongs to the Bismarck model. In this model, health care system is financed jointly by workers and employers through payroll deduction. The right to health care is linked to the job, and provision of services is done by sickness-funds controlled by the Government. Primary care in France is quite different from Spanish primary care. General practitioners are independent workers who have the right to set up a practice anywhere in France. This lack of regulation has generated a great problem of "medical desertification" with problems of health care access and inequalities in health. French doctors do not want to work in rural areas or outside cities because "they are not value for money". Medical salary is linked to professional activity. The role of doctors is to give punctual care. Team work team does not exist, and coordination between primary and secondary care is lacking. Access to diagnostic tests, hospitals and specialists is unlimited. Duplicity of services, adverse events and inefficiencies are the norm. Patients can freely choose their doctor, and they have a co-payment for visits and hospital care settings. Two years training is required to become a general practitioner. After that, continuing medical education is compulsory, but it is not regulated. Although the French medical Health System was named by the WHO in 2000 as the best health care system in the world, is it not that good. While primary care in Spain has room for improvement, there is a long way for France to be like Spain. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. [Primary care in Italy].

    Science.gov (United States)

    Sánchez-Sagrado, T

    Italy is not a country where Spanish doctors emigrate, as there is an over-supply of health care professionals. The Italian Servizio Sanitario Nazionale has some differences compared to the Spanish National Health System. The Servizio Sanitario Nazionale is financed by national and regional taxes and co-payments. There are taxes earmarked for health, and Primary Care receives 50% of the total funds. Italian citizens and residents in Italy have the right to free health cover. However, there are co-payments for laboratory and imaging tests, pharmaceuticals, specialist ambulatory services, and emergencies. Co-payments vary in the different regions. The provision of services is regional, and thus fragmentation and major inequities are the norm. Doctors in Primary Care are self-employed and from 2000 onwards, there are incentives to work in multidisciplinary teams. Salary is regulated by a national contract and it is the sum of per-capita payments and extra resources for specific activities. Responsibilities are similar to those of Spanish professionals. However, medical care is more personal. Relationships between Primary Care and specialised care depend on the doctors' relationships. Primary Care doctors are gatekeepers for specialised care, except for gynaecology, obstetrics and paediatrics. Specialised training is compulsory in order to work as general practitioner. The Italian Health Care System is a national health system like the Spanish one. However, health care professionals are self-employed, and there are co-payments. In spite of co-payments, Italians have one of the highest average life expectancy, and they support a universal and publicly funded health-care system. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Primary Tunnel Junction Thermometry

    International Nuclear Information System (INIS)

    Pekola, Jukka P.; Holmqvist, Tommy; Meschke, Matthias

    2008-01-01

    We describe the concept and experimental demonstration of primary thermometry based on a four-probe measurement of a single tunnel junction embedded within four arrays of junctions. We show that in this configuration random sample specific and environment-related errors can be avoided. This method relates temperature directly to Boltzmann constant, which will form the basis of the definition of temperature and realization of official temperature scales in the future

  6. Primary stabbing headache.

    Science.gov (United States)

    Pareja, Juan A; Sjaastad, Ottar

    2010-01-01

    Primary stabbing headache is characterized by transient, cephalic ultrashort stabs of pain. It is a frequent complaint with a prevalence of 35.2%, a female preponderance, and a mean age of onset of 28 years (Vågå study). Attacks are generally characterized by moderate to severe, jabbing or stabbing pain, lasting from a fraction of a second to 3s. Attack frequency is generally low, with one or a few attacks per day. The paroxysms generally occur spontaneously, during daytime. Most patients exhibit a sporadic pattern, with an erratic, unpredictable alternation between symptomatic and non-symptomatic periods. Paroxysms are almost invariably unilateral. Temporal and fronto-ocular areas are most frequently affected. Attacks tend to move from one area to another, in either the same or the opposite hemicranium. Jabs may be accompanied by a shock-like feeling and even by head movement - "jolts" -or vocalization. On rare occasions, conjunctival hemorrhage and monocular vision loss have been described as associated features. Primary stabbing headache may concur, synchronously or independently, with other primary headaches. In contrast to what is the case in adults, in childhood it is not usually associated with other headaches. Treatment is rarely necessary. Indomethacin, 75-150 mg daily, may seem to be of some avail. Celecoxib, nifedipine, melatonin, and gabapentin have been reported to be effective in isolated cases and small series of patients. The drug studies need corroboration. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. [Primary headache and depression].

    Science.gov (United States)

    Gesztelyi, Gyöngyi

    2004-11-28

    Primary headaches--mainly tension-type headache and migraine--affect a significant portion of the population. Depression is also highly prevalent. The co-existence of a primary headache and depression in the same patient therefore might be a coincidence due to the high prevalence of these conditions, but there might be a causal relationship between them, or headaches and depression might have a common background. This review of the literature summarizes the features of the relationship between primary headaches and depression. Depression is more prevalent in headache patients than in the headache-free population. Prospective epidemiological studies suggest a common genetic, biochemical or environmental background behind primary headaches and depression. This theory is supported by the role of the same neurotransmitter systems (mostly serotonin and dopamine) in headaches as well as in depression. Comorbid depression is associated with female gender, higher age, and higher frequency of headaches. Most depression inventories--questionnaires used to screen for the severity of depressive symptoms--contain transdiagnostic items, therefore their use in their original form is limited in organic diseases: due to the somatic items they might overestimate the severity of depression. When examining a headache patient special attention should be paid to the recognition of comorbid depression. The diagnosis of suspected mood disorder could be supported by using simple screening methods, such as the original or the abbreviated versions of standard depression inventories, but the final diagnosis of major depression needs psychiatric evaluation. Quality of life of the headache patient is affected not only by the characteristics of pain (frequency, duration, severity) but also by the disability caused by headache and the associating mood disorder. Recognizing coexisting mood disorder and disability helps to make the best treatment choice for the acute and preventive treatment of

  8. Localization of primary aldosteronism

    International Nuclear Information System (INIS)

    Pagny, J.Y.; Chatellier, G.; Raynaud, A.; Plouin, P.F.; Corvol, P.

    1988-01-01

    After diagnosis of primary aldosteronism on the basis of biochemical evidence, the detection of the tumour is of crucial importance in the management of the disease. The efficacy of CT-Scan, Iodo-Cholesterol Scintigraphy, digitalized phlebography, adrenal vein sampling for steroid measurements (AVS), and Nuclear Magnetic Resonance (NMR) in 160 hypertensive patients with primary aldosteronism was reviewed. Diagnosis of Conn's adenoma (n=96) or Adrenal Hyperplasia (n=40) was confirmed by surgery or at least two concordant tumour localization tests. Scintigraphy gave a correct diagnosis in 53% of the 51 exams, CT-Scan in 82% of the 85 exams, and phlebography in 79% of 61 exams. Plasma Aldosterone/ Cortisol ratio was 5 times higher on the side of adenoma in 55% of the 47 cases but this ratio was also present in 23% of 22 patients with adrenal hyperplasia. Each procedure exhibited few false positive and false negative cases. NMR performed in 15 patients with Conn's adenoma identified all the cases. But tumours displayed a signal close to the liver signal and identical to the normal adrenal. These results and the risk of invasive procedure (failure of catheterization of the right adrenal vein (n=6) and adrenal haematoma (n=2) lead to propose a schema of exploration of patients with primary aldosteronism. The CT-Scan could be performed at the first step once the biological diagnosis confirmed. Phlebography and AVS will be performed only if tumour was less than 1 cm at the CT-Scan despite important biological abnormalities. This schema requires to be validated by a prospective evaluation [fr

  9. Força de preensão palmar e pinça digital em diferentes grupos de pilotos da Academia da Força Aérea brasileira Grip and pinch strength among different groups of Brazilian Air Force pilots

    Directory of Open Access Journals (Sweden)

    Gláucia Helena Gonçalves

    2010-06-01

    Full Text Available Pilotos da Academia de Força Aérea (AFA brasileira, durante vôos, realizam movimentos com grande solicitação da musculatura da mão que comanda o manche, o que pode modificar a força muscular. Este estudo teve por objetivo analisar as forças musculares isométricas de preensão palmar e pinças polpa-a-polpa, trípode e lateral de três grupos de pilotos da AFA. Foram avaliados 15 pilotos da Esquadrilha da Fumaça (EDA, 16 instrutores de vôo (PI e 6 pilotos em treinamento (PT, todos do sexo masculino. Para a avaliação, o posicionamento corporal dos pilotos seguiu a padronização da Sociedade Americana de Terapeutas da Mão e a ordem dos movimentos analisados foi predefinida, evitando fadiga muscular. A força muscular isométrica máxima foi coletada em uma contração sustentada por 6 segundos. Os resultados mostram diferenças significativas na preensão, com superioridade das mãos dominantes em relação às não-dominantes em todos os grupos, tendo ainda o grupo EDA obtido valores significativamente superiores em relação aos demais. Nas medidas da pinça trípode, o grupo EDA apresentou significativos valores superiores aos do grupo PT, sendo encontrados valores das mãos dominantes superiores aos das não-dominantes nos grupos EDA e PI. Conclui-se que o treino específico da musculatura da mão durante o vôo, a especificidade e o período de treinamento interferem na força muscular isométrica da mão.Pilots from Brazilian Air Force Academy (AFA perform strentgth- and accuracy-demanding hand movements, which may modify muscle strength. The aim of this study was to analyse hand isometric strength of grip and pulp-to-pulp, tripode and lateral pinch in three groups of male AFA pilots: ADS (Air Demonstration Squadron, n=15; IP (instructor pilots, n=16; and TP (training pilots, n=6. Pilots body positioning during tests followed the standards of the American Society of Hand Therapists; the sequence of assessed movements was

  10. Teacher of primary English

    CERN Multimedia

    2003-01-01

    Part-time teacher of primary English needed for September 2003 to teach English National Curriculum (KS2) and NLS to mother tongue or good second language English-speakers aged 7-10. 4 hours contact time per week, team planning, marking and meetings. Candidates should be English mother tongue qualified teachers, confident, flexible classroom practitioners and team players. For further details and how to apply see http://enpferney.org/staff_vacancies.htm English National Programme, Lycée International, Ferney-Voltaire (http://enpferney.org/)

  11. Primary isolated hepatic tuberculosis

    International Nuclear Information System (INIS)

    Sheikh, A.S.F.; Qureshi, I.H.; Saba, K.; Bukhari, M.H.

    2013-01-01

    Isolated hepatic tuberculosis without pulmonary or bowel involvement is a diagnostic challenge and can cause considerable morbidity. A young lady from Lahore presented with fever, pain in right hypochondria, nausea and weight loss. CT scan of abdomen showed multiple small hypodense non-enhancing lesions and a heterogeneous texture of liver. Biopsy confirmed the diagnosis of hepatic tuberculosis. It was concluded a case of isolated hepatic tuberculosis without evidence of other primary sites involvement. It is important to consider tuberculosis in the differential diagnosis when suspecting lymphoproliferative or metastatic diseases in a patient with vague symptoms and abnormal hepatic texture on CT. (author)

  12. PRIMARY CARIES: AN OVERVIEW

    Directory of Open Access Journals (Sweden)

    Gaurav Solanki

    2012-01-01

    Full Text Available Primary caries is an initial lesions produced by direct extension from an external surface. Dental caries is called as tooth decay or a cavity is a disease in which bacterial processes changes carbohydrate to acid which than dematerializes the hard tooth structure like enamel, dentin and cementum. Streptococcus mutans and Lactobacillus are the bacteria responsible for the dental caries by acid production. This article throws light on the dental caries disease, its sign and symptoms, treatment and prevention of it. A review of some patents on dental caries is also provided that summarizes the recent technical advancements taken place in this area.

  13. Primary cutaneous lymphoma

    International Nuclear Information System (INIS)

    Nguyen, M. Connie; Cleary, Sean F.; Hoppe, Richard T.

    1995-01-01

    Purpose: A retrospective review analyzed the survival and freedom from relapse of patients with stage IE or IIE primary cutaneous lymphoma (non mycosis fungoides) after treatments with radiation therapy alone (XRT), chemotherapy alone (RX) or combined modality therapy (CMT). Methods and Materials: Fifty two patients with stage IE-IIE cutaneous lymphoma treated at Stanford University Hospital were reviewed. The median age was 57, with a range of 26 to 94 and a male to female ratio of 1.21:1. Patients were staged according to the Ann Arbor System. Pathology was classified according to the Working Formulation. Treatment outcomes were compared using Kaplan-Meier survival curves with a Gehan p-value test. Results: The follow up range was 6 months to 22 years (median 7 years.) Twenty one percent of patients had low grade, 63% had intermediate grade and 15% had high grade lymphoma. The most common histologic subtype was diffuse large cell lymphoma Thirty two patients received radiation alone as initial treatment and sixteen patients received combined modality as initial treatment. Four patients received chemotherapy alone. The only significant prognostic factor for survival was the stage at diagnosis. Patients with stage IE disease had a longer actuarial survival (5-yr=79%, 10-yr=71%), as compared to those with stage IIE (5-yr=49%, 10-yr=33%), (p=0.029). The only significant prognostic factor for freedom from relapse was the initial treatment. Initial combined modality treatment lead to a longer freedom from relapse compared to patients treated with radiation alone (p=0.002), (median 5 years vs. 1.2 years). Despite this, the actuarial overall survival in the combined modality group and the radiation alone group are similar (median survival 7.7 and 8 years). The efficacy of either radiation or chemotherapy as salvage treatment after radiation failure was equivalent and both salvage treatments lead to equally long survival and freedom from second relapse. Conclusion

  14. Bellefonte primary containment structure

    International Nuclear Information System (INIS)

    Olyniec, J.H.

    1981-01-01

    Construction of the reactor building primary containment structure at the Bellefonte Nuclear Plant involved several specialized construction techniques. This two unit plant is one of the nine nuclear units at six different sites now under construction by the Tennessee Valley Authority (TVA). The post-Tensioned, cast-in-place interior steel lined containment structure is unique within TVA. Problems during construction were identified at weekly planning meetings, and options were discussed. Close coordination between craft supervisors and on-site engineering personnel drew together ''hands-on''experience and technical background. Details of the construction techniques, problems, and solutions are presented

  15. Primary Carnitine Deficiency

    DEFF Research Database (Denmark)

    Rasmussen, Jan; Hougaard, David M; Sandhu, Noreen

    2017-01-01

    Primary carnitine deficiency (PCD) causes low levels of carnitine in patients potentially leading to metabolic and cardiac symptoms. Newborn screening for PCD is now routine in many countries by measuring carnitine levels in infants. In this study we report Apgar scores, length and weight...... scores, length and weight compared to controls. Newborns with PCD and newborns born to mothers with PCD had significantly lower levels of free carnitine (fC0) than controls. Screening algorithms focusing only on fC0 had a high rate of detection of newborns with PCD. Sample collection 4-9 days after birth...

  16. Aspirin for Primary Prevention.

    Science.gov (United States)

    Richman, Ilana B; Owens, Douglas K

    2017-07-01

    Aspirin reduces the risk of nonfatal myocardial infarction and stroke, and the risk of colorectal cancer. Aspirin increases the risk of gastrointestinal and intracranial bleeding. The best available evidence supports initiating aspirin in select populations. In 2016, the US Preventive Services Task Force recommended initiating aspirin for the primary prevention of both cardiovascular disease and colorectal cancer among adults ages 50 to 59 who are at increased risk for cardiovascular disease. Adults 60 to 69 who are at increased cardiovascular disease risk may also benefit. There remains considerable uncertainty about whether younger and older patients may benefit. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Primary cutaneous lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, M Connie; Cleary, Sean F; Hoppe, Richard T

    1995-07-01

    Purpose: A retrospective review analyzed the survival and freedom from relapse of patients with stage IE or IIE primary cutaneous lymphoma (non mycosis fungoides) after treatments with radiation therapy alone (XRT), chemotherapy alone (RX) or combined modality therapy (CMT). Methods and Materials: Fifty two patients with stage IE-IIE cutaneous lymphoma treated at Stanford University Hospital were reviewed. The median age was 57, with a range of 26 to 94 and a male to female ratio of 1.21:1. Patients were staged according to the Ann Arbor System. Pathology was classified according to the Working Formulation. Treatment outcomes were compared using Kaplan-Meier survival curves with a Gehan p-value test. Results: The follow up range was 6 months to 22 years (median 7 years.) Twenty one percent of patients had low grade, 63% had intermediate grade and 15% had high grade lymphoma. The most common histologic subtype was diffuse large cell lymphoma Thirty two patients received radiation alone as initial treatment and sixteen patients received combined modality as initial treatment. Four patients received chemotherapy alone. The only significant prognostic factor for survival was the stage at diagnosis. Patients with stage IE disease had a longer actuarial survival (5-yr=79%, 10-yr=71%), as compared to those with stage IIE (5-yr=49%, 10-yr=33%), (p=0.029). The only significant prognostic factor for freedom from relapse was the initial treatment. Initial combined modality treatment lead to a longer freedom from relapse compared to patients treated with radiation alone (p=0.002), (median 5 years vs. 1.2 years). Despite this, the actuarial overall survival in the combined modality group and the radiation alone group are similar (median survival 7.7 and 8 years). The efficacy of either radiation or chemotherapy as salvage treatment after radiation failure was equivalent and both salvage treatments lead to equally long survival and freedom from second relapse. Conclusion

  18. PRIMARY SCHOOL TEACHER

    CERN Multimedia

    Madeleine Dittus

    2002-01-01

    For January 2003, the A.P.E.G. has an opening for a primary school teacher in the German national language program. The position requires one afternoon of teaching (13:30 till 16:30) every Tuesday at the Collège in Prévessin. The candidate should be a native speaker of German and have some knowledge of French. If you are interested, please send your CV, a copy of your diploma, and a short letter of motivation, until December 9th, to the following address. Madeleine Dittus Présidente A.P.E.G. 5, La vie Destraz 01630 St. Genis-Pouilly (France)

  19. Pattern of Primary Nocturnal Enuresis in Primary School Children ...

    African Journals Online (AJOL)

    Pattern of Primary Nocturnal Enuresis in Primary School Children (First Grade) in ... The control group consisting of 100 age-matched non-enuretic children ... was insignificantly associated with a positive family history, family size or birth rank.

  20. Primary iris leiomyoma.

    Science.gov (United States)

    Yeaney, Gabrielle A; Platt, Sean; Singh, Arun D

    Intraocular leiomyomas are uncommon and usually occur in the ciliary body. Primary leiomyoma of the iris is both rare and a difficult diagnosis to make, given melanocytic tumors are more common and may be amelanotic. The somewhat controversial diagnosis of iris leiomyoma requires further confirmation by immunohistochemistry and electron microscopy. Herein, we describe a 58-year-old man with a 2-mm round translucent pink lesion of the iris. The tumor was excised by sector iridectomy. Immunohistochemistry showed positivity for both smooth muscle actin and desmin and negativity for S-100, HMB45, SOX10, MelanA, CD31, CD34, and h-caldesmon. Epstein-Barr virus-associated smooth muscle tumor was excluded by chromogenic in situ hybridization-Epstein-Barr virus-encoded RNA. Ultrastructural analysis showed cytoplasmic myofilaments with focal fusiform densities and micropinocytotic vesicles. Our review of previous literature confirmed the unusual nature of this tumor. Primary iris leiomyoma should be considered in the differential of an amelanotic S-100-immunonegative iris tumor. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Imaging in primary osteosarcomas

    International Nuclear Information System (INIS)

    Davies, A.M.

    1998-01-01

    Osteosarcoma is the most common primary malignant bone tumour with the exception of myeloma. The majority of osteosarcoma cases arise within bone and are called conventional osteosarcoma. Intraosseous variants include telangiectatic, small-cell, low-grade intraosseous and cortical osteosarcoma. Less than 10% of osteosarcomas arise on the surface of bone and are subdivided into periosteal, high-grade surface and parosteal varieties. The imaging features of these subtypes of osteosarcoma are described and the impact on diagnosis highlighted. Using material from over 750 osteosarcomas treated at the author's centre, this article reviews the role of imaging in the management of this condition. Detection still relies principally on the conventional radiograph with bone scintigraphy and MR imaging useful in occult tumours. Establishing the radiological diagnosis depends on careful analysis of the radiographs, with particular attention paid to the nature and extent of bone destruction, periosteal new bone formation and matrix mineralization. The prudent radiologist will be wary of those bone conditions, such as stress fractures and osteomyelitis, which are frequently mistaken for osteosarcoma. Appropriate surgical staging requires MR imaging of the primary tumour to show the bony and soft tissue extent of the lesion and to confirm/exclude skip metastases and local lymph-node involvement. Staging should also include bone scintigraphy to confirm/exclude multiple lesions and chest CT to confirm/exclude pulmonary metastases. Following definitive surgery, imaging is used in the follow-up to monitor potential local recurrence and the development of pulmonary or osseous metastases. (orig.) [de

  2. [Normocalcemic primary hyperparathyroidism].

    Science.gov (United States)

    Spivacow, Francisco R; Sapag Durán, Ana; Zanchetta, María B

    2014-01-01

    This report shows our conclusions on the clinical, biochemical and densitometry characteristics of 35 normocalcemic primary hyperparathyroidism (PHPT) patients. This condition is defined by a high level of intact parathyroid hormone (iPTHI) with persistently normal serum and ionized calcium in the absence of secondary hyperparathyroidism. Our selection consisted of 30 women (90%) and 5 men (10%). The control group of 55 hypercalcemic patients with primary hyperparathyroidism included 51 women (93%) and 4 men (7%). The average age at diagnosis of normocalcemic PHPT was 61.4 ± 11.7 years and 56.4 ± 11.3 years in hypercalcemic PHPT. Besides the expected differences in serum calcium, ionized calcium, phosphorus and 24 h urinary calcium, we found no significant changes in other biochemical variables, and no differences in densitometry evaluations such as the presence of osteopenia or osteoporosis and the number of fractures in the two types of PHPT. But there was a significant difference in the presence of renal lithiasis between normocalcemic PHPT (11.4%) and clasic PHPT (49.1%) p < 0.0005, to some extent associated to the presence of hypercalciuria in classic PHPT. Two of the 35 patients with normocalcemic PHPT became classic hypercalcemic PHPT over a 4 year follow-up period. Our findings support the hypothesis that the normocalcemic PHPT could be an early stage of the classic PHPT, both having similar clinical effects to metabolic renal and bone levels.

  3. Asymptomatic Primary Hyperparathyroidism

    Science.gov (United States)

    Silverberg, Shonni J.; Walker, Marcella D.; Bilezikian, John P.

    2014-01-01

    The clinical profile of primary hyperparathyroidism (PHPT) as it is seen in the United States and most Western countries has evolved significantly over the past half century. The introduction of the multichannel serum autoanalyzer in the 1970s led to the recognition of a cohort of individuals with asymptomatic hypercalcemia, in whom evaluation led to the diagnosis of PHPT. The term “asymptomatic primary hyperparathyroidism” was introduced to describe patients who lack obvious signs and symptoms referable to either excess calcium or parathyroid hormone. Although it was expected that asymptomatic patients would eventually develop classical symptoms of PHPT, observational data suggest that most patients do not evolve over time to become overtly symptomatic. In most parts of the world, the asymptomatic phenotype of PHPT has replaced classical PHPT. This report is a selective review of data on asymptomatic PHPT: its demographic features, presentation and natural history, as well as biochemical, skeletal, neuromuscular, psychological, and cardiovascular manifestations. In addition, we will summarize available information on treatment indications and options for those with asymptomatic disease. PMID:23374736

  4. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State. ... weak management and poor adherence to the basic infrastructure e.g. primary, secondary and tertiary.

  5. Bezafibrate for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N

    2012-01-01

    Treatment of primary biliary cirrhosis is complicated. There are studies suggesting that bezafibrate, alone or in combination with ursodeoxycholic acid (UDCA), is effective in the treatment of primary biliary cirrhosis, but no systematic review has summarised the evidence yet....

  6. BR-5 primary circuit decontamination

    International Nuclear Information System (INIS)

    Efimov, I.A.; Nikulin, M.P.; Smirnov-Averin, A.P.; Tymosh, B.S.; Shereshkov, V.S.

    1976-01-01

    Results and methodology of steam-water and acid decontamination of the primary coolant circuit SBR-5 reactor in 1971 are discussed. Regeneration process in a cold trap of the primary coolant circuit is discussed

  7. Primary Prevention With Statins

    DEFF Research Database (Denmark)

    Mortensen, Martin B; Afzal, Shoaib; Nordestgaard, Børge G

    2015-01-01

    BACKGROUND: Guidelines recommend initiating primary prevention for atherosclerotic cardiovascular disease (ASCVD) with statins based on absolute ASCVD risk assessment. Recently, alternative trial-based and hybrid approaches were suggested for statin treatment eligibility. OBJECTIVES: This study...... the population studied, 42% were eligible for statin therapy according to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) risk assessment and cholesterol treatment guidelines approach, versus 56% with the trial-based approach and 21% with the hybrid approach. Among these statin......-eligible subjects, the ASCVD event rate per 1,000 person-years was 9.8, 6.8, and 11.2, respectively. The ACC/AHA-recommended absolute risk score was well calibrated around the 7.5% 10-year ASCVD risk treatment threshold and discriminated better than the trial-based or hybrid approaches. Compared with the ACC...

  8. Primary care guidelines

    DEFF Research Database (Denmark)

    Ijäs, Jarja; Alanen, Seija; Kaila, Minna

    2009-01-01

    OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...... Guideline. RESULTS: Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p ...: Hypertension Guideline recommendations that require joint agreements between professionals are less often adopted than simple, precise recommendations. More emphasis on effective multidisciplinary collaboration is needed....

  9. Adrenal incidentalomas. Primary hyperaldosteronism

    International Nuclear Information System (INIS)

    Murat, A.; Dupas, B.; Zenatti, M.; Aupetit-Faisant, B.; Tenenbaum, F.; Tabarin, A.; Barrat, J.L.; Gosse, P.; Olivier-Puel, F.; Leprat, F.; Trouette, H.; Laurent, F.; Roger, P.

    1993-01-01

    Adrenal incidentalomas are masses incidentally discovered at X rays, ultrasound or MRI examination of the abdomen. In 100 CT scans, one can expect to find two incidentalomas on average. The article by Murat and Dupas is dealing with the strategy of biological, morphological and scintigraphic examinations to be performed in such patients, to assess whether the tumor is of a benign or a malignant nature. Zenatti et al propose a detailed exploration of the aldosterone pathways, since adrenal carcinoma may be responsible for a specific profile of the serum concentrations of mineralo-steroids, compatible with a blockade of the last step of the aldosterone synthesis. The exploration of primary hyperaldosteronism requires biological and imaging techniques. Tabarin et al summarize the main biological parameters and tests available for the diagnosis of this condition and delineate the indications of imaging techniques, associated to hormonal tests to distinguish between adenoma and bilateral adrenal hyperplasia. (author). 104 refs

  10. Primary Anorectal Melanoma

    Directory of Open Access Journals (Sweden)

    Maliha Khan

    2014-03-01

    Full Text Available Primary malignant melanoma of the anus and rectum is a rare and aggressive neoplasm that tends to invade locally and metastasize early in the course of the disease. It is often misdiagnosed as hemorrhoids or as one of the other benign anorectal conditions and is thus linked to an overall poor prognosis and a 5-year survival rate of less than 20%. Optimal treatment is still controversial, and current evidence does not show any preferential survival benefit from abdominoperineal resection over wide local excision. Chemotherapy or radiotherapy may be used for advanced disease. We report a 71-year-old female presenting with painful bowel movements and blood in stools. She was eventually found to have a mass arising from the anorectal junction with regional lymph node involvement. The patient underwent an abdominoperineal resection and is currently scheduled for chemotherapy.

  11. Primary conjunctival amyloidosis

    Directory of Open Access Journals (Sweden)

    Chandana Chakraborti

    2014-01-01

    Full Text Available A 19-year-old previously healthy male presented with a 4 year history of painless drooping of right upper eyelid.On eversion of the right upper eyelid, a yellowish pink mass was seen in the tarsal region. Rest of the ocular examination was normal in both the eyes. Initial biopsy showed chronic inflammation. Subsequently, the entire mass was excised and histopathological examination showed the presence of amyloid in the subconjunctival stroma. At 3 months follow-up, similar lesion was detected in the right lower, left upper, and lower lid, which were treated with cryotherapy, with partial resolution. Patient has been followed up for more than 2 years without any complaints. To our knowledge, this is the first case report of an isolated primary conjunctival amyloidosis with involvement of both the upper and lower palpebral conjunctiva of either eye. It was treated successfully by excision and cryotherapy.

  12. Prostaglandins and primary dysmenorrhea

    International Nuclear Information System (INIS)

    Seifert, B.; Liedtke, M.P.; Kempf, H.J.; Richter, H.; Alexander, H.; Herter, U.

    1978-01-01

    In 100 patients a total of 171 PG determinations in the menstrual blood was performed under standardized conditions. The primary PGE 1 and PGFsub(2α) were determined by RIA. The evaluation of the analysis of the sexual hormones resulted in a group with a biphasic cycle without dysmenorrhea and a group with a biphasic cycle with dysmenorrhea. Highly significant differences (p < 0.01) were found in the PGFsub(2α) concentration in menstrual blood between a group of healthy women and one of patients with dysmenorrhea. In dysmenorrhea the ratio of the PGs investigated is shifted in favor of PGFsub(2α). Indomethacin can decrease the PGFsub(2α) levels in dysmenorrhea up to 15% (p < 0.01). All treated patients reported that their conditions had improved. Five out of seven women were completely without any complaints. (author)

  13. PRIMARY SCHOOL TEACHER

    CERN Multimedia

    Madeleine Dittus

    2002-01-01

    For the beginning of the school year 2002/2003, the A.P.E.G. has an opening for a primary school teacher in the German national language program. The position requires one afternoon of teaching (13:30 till 16:30) every Tuesday at the Collège in Prévessin. The candidate should be a native speaker of German and have some knowledge of French. If you are interested, please send your CV, a copy of your diploma, and a short letter of motivation, until March 10th, to the following address. Madeleine Dittus - Présidente A.P.E.G. 5, La vie Destraz 01630 St. Genis-Pouilly - France

  14. Primary Fallopian Tube Carcinoma

    Directory of Open Access Journals (Sweden)

    Prasad K Shetty

    2011-01-01

    Full Text Available Primary Fallopian Tube Carcinoma (PFTC is rare and accounts for about 0.3% of all gynecologic cancers. Less than 1500 cases have been reported in the literature. It arises in postmenopausal women and typically presents with abdominal pelvic pain, vaginal bleeding and watery discharge. However, a correct diagnosis is rarely achieved preoperative, and in many cases, the diagnosis is made after incidental surgery for unrelated conditions commonly being ovarian carcinoma . Compared with ovarian carcinoma, PFTC more often presents at early stages, but it has a worse prognosis. PFTC is usually managed in the same manner as ovarian cancer. We report a case of Left PFTC that presented as Left ovarian mass, and we briefly review the literature.

  15. Primary aldosteronism. Clinical management

    International Nuclear Information System (INIS)

    Grant, C.S.; Carpenter, P.; van Heerden, J.A.; Hamberger, B.

    1984-01-01

    We retrospectively reviewed the clinical features, methods of diagnosis and localization, and results of treatment in 105 patients with primary aldosteronism seen between 1969 and 1981. Coincident with the use of computed tomography (CT), 131 I-6-beta-iodomethyl norcholesterol scans (NP-59), and postural response studies, the study group was temporally divided into pre-1976 and post-1976 groups, and subdivided into groups with aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) due to bilateral adrenal hyperplasia. Our results indicate that aldosterone postural response studies and CT differentiate and localize APA and IHA reliably. Adrenalectomy is a safe and effective treatment for APA, whereas medical treatment alone is preferable for IHA

  16. Primary Identity in Literature

    DEFF Research Database (Denmark)

    Graham, Brian Russell

    In our times, literary criticism, as well as larger political and cultural developments, is characterized by identity politics, meaning that our discourses are structured around the notion of different socially identifiable populations in society. In relation to literature, this results in our...... viewing the characters in literature in terms of these political identities. Literature is consequently discussed in relation to political causes. Literary criticism is animated by the same causes, and is viewed as having a direct intervention in society in relation to them. In this paper, I will discuss......, in relation to Frye’s works, the idea that the primary identities of characters in literature were and, to a considerable extent, continue to be those of family-member identities. As such, literature should not be appropriated to a political context too readily. Whereas viewing characters in terms of...

  17. [Primary care in Belgium].

    Science.gov (United States)

    Sánchez-Sagrado, T

    2017-09-01

    Belgium is an attractive country to work in, not just for doctors but for all Spanish workers, due to it having the headquarters of European Union. The health job allure is double; on the one hand, the opportunity to find a decent job, and on the other, because it is possible to develop their professional abilities with patients of the same nationality in a health system with a different way of working. The Belgium health care system is based on security social models. Health care is financed by the government, social security contributions, and voluntary private health insurance. Primary care in Belgium is very different to that in Spain. Citizens may freely choose their doctor (general practitioner or specialist) increasing the lack of coordination between primary and specialized care. This leads to serious patient safety problems and loss of efficiency within the system. Belgium is a European country with room to improve preventive coverage. General practitioners are self-employed professionals with free choice of setting, and their salary is linked to their professional activity. Ambulatory care is subjected to co-payment, and this fact leads to great inequities on access to care. The statistics say that there is universal coverage but, in 2010, 14% of the population did not seek medical contact due to economic problems. It takes 3 years to become a General Practitioner and continuing medical education is compulsory to be revalidated. In general, Belgian and Spaniards living and working in Belgium are happy with the functioning of the health care system. However, as doctors, we should be aware that it is a health care system in which access is constrained for some people, and preventive coverage could be improved. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Primary Teacher Education in Malaysia

    Science.gov (United States)

    Ching, Chin Phoi; Yee, Chin Peng

    2012-01-01

    In Malaysia the training of primary school teachers is solely carried out by teacher training institutes which offer the Bachelor of Teaching with Honors (Primary education) program and was first launched in 2007. This program prepares primary school teachers specializing in various subjects or major and is carried out in 27 teacher training…

  19. Bilateral supernumerary primary maxillary canines

    Directory of Open Access Journals (Sweden)

    Santanu Mukhopadhyay

    2018-01-01

    Full Text Available Supernumerary teeth are more common in the permanent than in primary dentition. In the primary dentition, the anomaly is most frequently observed in the maxillary lateral incisor region, followed by the maxillary midline where they are termed as mesiodens. Supernumerary teeth in the primary canine region are rare. This paper describes a rare case of nonsyndromic supernumerary primary maxillary canine distributed bilaterally in a 4-year-old boy. Both the supernumeraries resembled size and shape of normal primary canine. The right supplemental canine is high labially placed, whereas the left one is seen normally aligned in the dental arch distal to lateral incisor. One of the most significant sequelae of primary supernumerary teeth is their duplication in the permanent series. Radiographic examination of supernumerary primary canine did not indicate any such anomaly in the permanent dentition. The patient was kept under observation.

  20. Comparison between Primary Teacher Educators' and Primary School Teachers' Beliefs of Primary Geography Education Quality

    Science.gov (United States)

    Bent, Gert Jan; Bakx, Anouke; den Brok, Perry

    2016-01-01

    In this study teacher educators' beliefs concerning primary geography education have been investigated and compared with primary school teachers' beliefs. In this study 45 teacher educators and 489 primary school teachers completed a questionnaire, and nine teacher educators have been interviewed as well. It has been found that teacher educators…

  1. Primary hepatic pheochromocytoma

    International Nuclear Information System (INIS)

    Rimmelin, A.; Hartheiser, M.; Gangi, A.; Welsch, M.; Jeung, M.Y.; Jaeck, D.; Tongio, J.; Dietemann, J.L.

    1996-01-01

    Pheochromocytomas are uncommon tumors that represent a potentially curable cause of hypertension. They are usually located in the adrenal glands, but 10% arise from extra-adrenal sites, located along the paravertebral sympathetic chains. We report a case of primary hepatic pheochromocytoma responsible for a severe hypertension in a 24-year-old man. Echotomography showed a lightly heterogeneous mass located in the segment 8 of the liver. Iodine 131 -metaiodobenzylguanidine scintigraphy showed a large hepatic concentration of the tracer and no other localization. This tumor appeared highly vascularized on enhanced CT scan and on aortic angiography. Magnetic resonance imaging revealed a hepatic tumor with a high signal intensity on T2-weighted images and with a signal isointense to the liver on T1-weighted images. The hepatic venous sampling contained the highest catecholamine level, whereas the adrenal venous samping was normal. After surgical resection of the hepatic tumor, the tension level and catecholamines plasmatic level normalized. No recurrent symptoms appeared during a 3-year follow-up. (orig.)

  2. Primary intestinal lymphangiectasia: Minireview

    Science.gov (United States)

    Ingle, Sachin B; Hinge (Ingle), Chitra R

    2014-01-01

    Primary idiopathic intestinal lymphangiectasia is an unusual disease featured by the presence of dilated lymphatic channels which are located in the mucosa, submucosa or subserosa leading to protein loosing enteropathy.Most often affected were children and generally diagnosed before third year of life but may be rarely seen in adults too. Bilateral pitting oedema of lower limb is the main clinical manifestation mimicking the systemic disease and posing a real diagnostic dilemma to the clinicians to differentiate it from other common systemic diseases like Congestive cardiac failure, Nephrotic Syndrome, Protein Energy Malnutrition, etc. Diagnosis can be made on capsule endoscopy which can localise the lesion but unable to take biopsy samples. Thus, recently double-balloon enteroscopy and biopsy in combination can be used as an effective diagnostic tool to hit the correct diagnosis. Patients respond dramatically to diet constituting low long chain triglycerides and high protein content with supplements of medium chain triglyceride. So early diagnosis is important to prevent untoward complications related to disease or treatment for the sake of accurate pathological diagnosis. PMID:25325063

  3. Primary hyperoxaluria in infants

    Directory of Open Access Journals (Sweden)

    Manel Jellouli

    2016-01-01

    Full Text Available The infantile form of primary hyperoxaluria type-1 (PH-1 is characterized by a rapid progression to the end-stage renal disease (ESRD due to both increased oxalate load and reduced glomerular filtration rate. In the literature, data on this form are limited. The purpose of this study is to analyze retrospectively the clinical, biological, and radiological features of children who were diagnosed with PH-1 during the 1styear of life. We reviewed the records of all children with PH-1 diagnosed and followed-up at our department between January 1995 and December 2013. Among them, only infants younger than 12 months of age were retrospectively enrolled in the study. Fourteen infants with the median age of two months were enrolled in the study. At diagnosis, 11 patients had ESRD. All patients had nephrocalcinosis and two of them had calculi. The diagnosis was established in nine patients on the basis of the positive family history of PH-1, bilateral nephrocalcinosis, and quantitative crystalluria. In four patients, the diagnosis was made with molecular analysis of DNA. Kidney biopsy contributed to the diagnosis in one patient. During follow-up, two patients were pyridoxine sensitive and preserved renal function. Seven among 11 patients who had ESRD died, four patients are currently undergoing peritoneal dialysis. Children with infantile PH and ESRD are at high risk of early death. Peritoneal dialysis is not a treatment of choice. Combined liver-kidney transplantation is mandatory.

  4. Primary hyperparathyroidism: recent advances.

    Science.gov (United States)

    Walker, Marcella D; Bilezikian, John P

    2018-07-01

    The purpose of this review is to describe recent advances and changes in the evaluation and management of primary hyperparathyroidism (PHPT). Although it has long been recognized that asymptomatic PHPT is associated with bone loss, particularly at cortical skeletal sites when evaluated with dual-energy X-ray absorptiometry, new imaging techniques suggest that trabecular skeletal deterioration as well as clinically silent vertebral fractures and nephrolithiasis are common. Nonclassical targets of asymptomatic PHPT as well as the effect of vitamin D deficiency and treatment upon PHPT presentation have been the subject of recent intense investigation. Randomized clinical trials are now available regarding the effect of parathyroidectomy (PTX) upon both classical and nonclassical target organs. They have confirmed results from observational studies with regard to the skeletal benefits of PTX but have not consistently shown improvements in nonclassical symptoms. These findings have led to recommendations for more extensive renal and skeletal evaluation and broader criteria for PTX in PHPT. In addition to dual-energy X-ray absorptiometry, vertebral and renal imaging is recommended. When available, trabecular imaging techniques may be helpful. PTX criteria now include subclinical kidney stones, vertebral fractures and hypercalciuria, in addition to those based on age, serum calcium, bone densitometry and renal function.

  5. Primary sclerosing cholangitis

    Directory of Open Access Journals (Sweden)

    Marina G Silveira

    2008-01-01

    Full Text Available Primary sclerosing cholangitis (PSC is a chronic cholestatic liver disease characterized by inflammation and fibrosis of the bile ducts, resulting in end-stage liver disease and reduced life expectancy. PSC primarily affects young and middle-aged men, often in association with underlying inflammatory bowel disease. The etiology of PSC includes immune-mediated components and elements of undefined nature. A cholestatic picture of liver biochemistries with elevations in serum alkaline phosphatase, nonspecific autoantibodies such as perinuclear antineutrophilic antibody, antinuclear antibodies and smooth muscle antibodies, and diffuse multifocal biliary strictures, resulting in a ‘beaded’ appearance on radiographic studies, are the hallmarks of the disease. No effective medical therapy is currently available, although clinical studies are in progress. Ursodeoxycholic acid at high doses (28 mg/kg/day to 30 mg/kg/day is the most promising agent but is unproven so far. Liver transplantation is currently the only life-extending therapy for patients with end-stage disease, although recurrent disease can be observed in the transplanted liver. The multiple complications of PSC include pruritus, fatigue, vitamin deficiencies, metabolic bone disease, peristomal varices, bacterial cholangitis, dominant biliary strictures, gallbladder stones and polyps, and malignancy, particularly cholangiocarcinoma, which is the most lethal complication of PSC.

  6. Primary sclerosing cholangitis

    Directory of Open Access Journals (Sweden)

    Chapman Roger

    2006-10-01

    Full Text Available Abstract Primary sclerosing cholangitis (PSC is a chronic cholestatic liver disease of unknown aetiology characterised by inflammation and fibrosis of the biliary tree. The mean age at diagnosis is 40 years and men are affected twice as often as women. There is a reported annual incidence of PSC of 0.9–1.31/100,000 and point prevalence of 8.5–13.6/100,000. The onset of PSC is usually insidious and many patients are asymptomatic at diagnosis or have mild symptoms only such as fatigue, abdominal discomfort and pruritus In late stages, splenomegaly and jaundice may be a feature. In most, the disease progresses to cirrhosis and liver failure. Cholangiocarcinoma develops in 8–30% of patients. PSC is thought to be immune mediated and is often associated with inflammatory bowel disease, especially ulcerative colitis. The disease is diagnosed on typical cholangiographic and histological findings and after exclusion of secondary sclerosing cholangitis. Median survival has been estimated to be 12 years from diagnosis in symptomatic patients. Patients who are asymptomatic at diagnosis, the majority of whom will develop progressive disease, have a survival rate greater than 70% at 16 years after diagnosis. Liver transplantation remains the only effective therapeutic option for patients with end-stage liver disease from PSC, although high dose ursodeoxycholic acid may have a beneficial effect.

  7. Consanguinity and primary immunodeficiencies.

    Science.gov (United States)

    Al-Herz, Waleed; Aldhekri, Hasan; Barbouche, Mohamed-Ridha; Rezaei, Nima

    2014-01-01

    Primary immunodeficiencies (PIDs) are a heterogeneous group of genetic disorders caused by defects in the immune system that predispose patients to infections, autoimmune diseases, lymphoproliferation and malignancies. Most PIDs are inherited in an autosomal recessive pattern; therefore, they are more common in areas with high rates of consanguineous marriage. Reports about PIDs from these areas have demonstrated a peculiar prevalence of more severe forms of diseases compared to other regions, and patients born to consanguineous parents have increased rates of morbidity and mortality compared to other patients. Individuals at high risk of having a child with a PID who wish to have a healthy child have limited options, these include prenatal diagnosis and pre-implantation genetic diagnosis. However, these options require a collaborative team of specialists and may not always be implemented due to geographic, religious, financial or social factors. The recent introduction of newborn-screening programs for a number of T and B lymphocyte deficiencies will facilitate early diagnosis and therapeutic interventions, which may include hematopoietic stem cell transplantation and intravenous immunoglobulin treatment. There is a need for the implementation of strategies to increase public awareness of the health risks associated with consanguineous marriage. It should be stressed that genetic counseling should be an important component of the care of patients with PIDs as well as their families. © 2014 S. Karger AG, Basel.

  8. Idiopathic (primary achalasia

    Directory of Open Access Journals (Sweden)

    Vaezi Michael F

    2007-09-01

    Full Text Available Abstract Idiopathic achalasia is a primary esophageal motor disorder characterized by esophageal aperistalsis and abnormal lower esophageal sphincter (LES relaxation in response to deglutition. It is a rare disease with an annual incidence of approximately 1/100,000 and a prevalence rate of 1/10,000. The disease can occur at any age, with a similar rate in men and women, but is usually diagnosed between 25 and 60 years. It is characterized predominantly by dysphagia to solids and liquids, bland regurgitation, and chest pain. Weight loss (usually between 5 to 10 kg is present in most but not in all patients. Heartburn occurs in 27%–42% of achalasia patients. Etiology is unknown. Some familial cases have been reported, but the rarity of familial occurrence does not support the hypothesis that genetic inheritance is a significant etiologic factor. Association of achalasia with viral infections and auto-antibodies against myenteric plexus has been reported, but the causal relationship remains unclear. The diagnosis is based on history of the disease, radiography (barium esophagogram, and esophageal motility testing (esophageal manometry. Endoscopic examination is important to rule out malignancy as the cause of achalasia. Treatment is strictly palliative. Current medical and surgical therapeutic options (pneumatic dilation, surgical myotomy, and pharmacologic agents aimed at reducing the LES pressure and facilitating esophageal emptying by gravity and hydrostatic pressure of retained food and liquids. Although it cannot be permanently cured, excellent palliation is available in over 90% of patients.

  9. Idiopathic (primary) achalasia

    Science.gov (United States)

    Farrokhi, Farnoosh; Vaezi, Michael F

    2007-01-01

    Idiopathic achalasia is a primary esophageal motor disorder characterized by esophageal aperistalsis and abnormal lower esophageal sphincter (LES) relaxation in response to deglutition. It is a rare disease with an annual incidence of approximately 1/100,000 and a prevalence rate of 1/10,000. The disease can occur at any age, with a similar rate in men and women, but is usually diagnosed between 25 and 60 years. It is characterized predominantly by dysphagia to solids and liquids, bland regurgitation, and chest pain. Weight loss (usually between 5 to 10 kg) is present in most but not in all patients. Heartburn occurs in 27%–42% of achalasia patients. Etiology is unknown. Some familial cases have been reported, but the rarity of familial occurrence does not support the hypothesis that genetic inheritance is a significant etiologic factor. Association of achalasia with viral infections and auto-antibodies against myenteric plexus has been reported, but the causal relationship remains unclear. The diagnosis is based on history of the disease, radiography (barium esophagogram), and esophageal motility testing (esophageal manometry). Endoscopic examination is important to rule out malignancy as the cause of achalasia. Treatment is strictly palliative. Current medical and surgical therapeutic options (pneumatic dilation, surgical myotomy, and pharmacologic agents) aimed at reducing the LES pressure and facilitating esophageal emptying by gravity and hydrostatic pressure of retained food and liquids. Although it cannot be permanently cured, excellent palliation is available in over 90% of patients. PMID:17894899

  10. Achieving Value in Primary Care: The Primary Care Value Model.

    Science.gov (United States)

    Rollow, William; Cucchiara, Peter

    2016-03-01

    The patient-centered medical home (PCMH) model provides a compelling vision for primary care transformation, but studies of its impact have used insufficiently patient-centered metrics with inconsistent results. We propose a framework for defining patient-centered value and a new model for value-based primary care transformation: the primary care value model (PCVM). We advocate for use of patient-centered value when measuring the impact of primary care transformation, recognition, and performance-based payment; for financial support and research and development to better define primary care value-creating activities and their implementation; and for use of the model to support primary care organizations in transformation. © 2016 Annals of Family Medicine, Inc.

  11. Primary intracranial malignant lymphoma

    International Nuclear Information System (INIS)

    Matsumoto, Mikiro; Ohtsuka, Takatsugu; Kuroki, Takao; Shibata, Iekado; Terao, Hideo; Kudo, Motoshige

    1988-01-01

    Nine cases of primary intracranial malignant lymphoma, which accounts for 3.3 % of all intracranial tumors seen in the authors' institution, were studied in terms of diagnostic computed tomographic (CT) features, the tumors' histologic appearance, treatment, post-treatment blood immunologic and cerebrospinal fluid (CSF) characteristics, and outcome. The patients were seven males and two females aged 42 to 67 years. Their chief signs and symptoms on admission were intracranial hypertension, focal signs, and disturbance of consciousness. CT, which proved the most useful preoperative diagnostic technique, demonstrated multiple lesions in seven cases and, in all cases, regions of isodensity or slight high density that were enhanced by contrast medium. According to the patterns of enhancement, the tumors were classed as diffuse (three cases) or nodular (six cases). The former is considered typical of malignant lymphoma, whereas the latter type was sometimes indistinguishable from metastatic tumor and meningioma. At surgery, one patient underwent radical tumor excision, two partial removal, and six biopsy only. Histologic examination revealed one tumor to be of the diffuse small cell type, three of the medium cell type, and five of the large cell type (Lymphoma Study Group classification). Of seven tumors in which lymphocytes were examined by peroxidase-antiperoxidase staining, four were of the B cell type. Postoperatively, whole brain irradiation with 29 to 46 Gy was followed by local irradiation with 15 to 50 Gy. If the tumor persisted, one of three chemotherapies was administered. In one case, methotrexate was given intrathecally. Seven patients were divided into two groups: long remission (three) and recurrence (four). These two groups were compared in terms of serum immunoglobulin levels, T and B cell ratios, CSF characteristics, CT features, tumor cell type, and treatment. No clear differences were found. (author)

  12. Primary cosmic radiation

    International Nuclear Information System (INIS)

    Anderson, H.R.

    1972-01-01

    The term cosmic radiation means the charged particle flux that reaches the earth from outside its magnetosphere with energies above the solar wind energy of a few keV. There are two sources of flux. Sporadically the sun produces such particles, generally within the energy range 1--200 MeV, and these solar cosmic rays arrive at the earth for a period ranging from hours to days. There may be a small, rather constant flux from the sun also, but the bulk of the steady flux originates outside the earth's orbit. Although some have conjectured that part of this latter flux may be accelerated in the outer portions of the solar system where the outward flowing interplanetary medium meets the interstellar medium, it is generally thought that most or all of it arises in unique systems such as supernovae, and is distributed throughout the galaxy. These galactic particles range in energy from a few MeV to at least 10 13 MeV and consist primarily of protons with significant numbers of heavier nuclei, positrons and electrons. They are supposed to fill our galaxy, or at least the disc, more or less uniformly. However, the flux with energies below a few GeV that reaches earth's orbit is modulated by the interplanetary medium so that the number at earth varies inversely with solar activity and is always somewhat below the interstellar flux. A discussion is presented of primary galactic radiation at earth, its modulation by solar activity, and its interaction with the geomagnetic field. (U.S.)

  13. [Primary care in Portugal].

    Science.gov (United States)

    Sánchez-Sagrado, T

    2018-04-01

    The economic crisis and deterioration of the Portuguese National Health service has forced professionals to leave the country. The Portuguese National Health System was introduced in 1976, but it has been unable to provide citizens with the social and health advantages of an equality of access and free national health system. The Portuguese National Health System is financed by taxes. However, a 35% of its incomes are from private sources. The health minister decides the budget, and it is based on an historical financing plus a per capita system. Portuguese citizens and immigrants are entitled to free health care, but there is a co-payment for care, diagnostic, pharmacy, and emergency care. Health care provision is a mixture of public and private health care at a regional level. It leads to fragmentation of services and greater inequalities. Doctors are civil servants. Salary is regulated and it depends on seniority and on-call shifts. Primary care activities are similar to those of their Spanish counterparts. General practitioners have gatekeeper function, but the system is imperfect, and patients with private insurance get direct access to the specialist. Specialist training is similar to the training system in Spain. Continuing education is not regulated. The Portuguese Health System has been trying to become a national health system since 1979. Political instability, fragmentation of services, lack of clarity between public and private and co-payments are important constraints. Inequalities are an important problem to reconsider while discussing a national health system. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. African Primary Care Research: qualitative interviewing in primary care.

    Science.gov (United States)

    Reid, Steve; Mash, Bob

    2014-06-05

    This article is part of a series on African Primary Care Research and focuses on the topic of qualitative interviewing in primary care. In particular it looks at issues of study design, sample size, sampling and interviewing in relation to individual and focus group interviews.There is a particular focus on helping postgraduate students at a Masters level to write their research proposals.

  15. Primary nocturnal enuresis as a risk factor for sleep disorders: an observational questionnaire-based multicenter study

    Directory of Open Access Journals (Sweden)

    Esposito M

    2013-03-01

    Full Text Available Maria Esposito,1 Beatrice Gallai,2 Lucia Parisi,3 Michele Roccella,3 Rosa Marotta,4 Serena Marianna Lavano,4 Giovanni Mazzotta,5 Marco Carotenuto11Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy; 2Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy; 3Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy; 4Department of Psychiatry, “Magna Graecia” University of Catanzaro, Catanzaro, Italy; 5Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, ItalyIntroduction: Primary nocturnal enuresis (PNE is a common problem in developmental age with an estimated overall prevalence ranging from 1.6% to 15%, and possible persistence during adolescence. There is a growing interest in the sleep habits of children affected by PNE, which is derived from the contradictory data present in clinical literature. The aim of the present study was to evaluate the presence of sleep disturbances in a population of children affected by PNE, and to identify whether PNE could be considered as a risk factor for sleep disturbances among children.Materials and methods: A total of 190 PNE children (97 males, 93 females aged 7–15 years, (mean 9.64 ± 1.35 years, and 766 typically developing children matched for age (P = 0.131 and gender (P = 0.963 were enrolled. To evaluate the presence of sleep habits and disturbances, all of the subjects’ mothers filled out the Sleep Disturbances Scale for Children (SDSC, a questionnaire consisting of six subscales: Disorders in Initiating and Maintaining Sleep (DIMS, Sleep Breathing Disorders (SBD, Disorders of Arousal (DA, Sleep–Wake Transition Disorders (SWTD, Disorders of Excessive Somnolence (DOES, and Nocturnal Hyperhidrosis (SHY. The results were divided into “pathological” and “normal” scores using a cut

  16. Primary epiploic appendagitis

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Real Martinez

    2013-07-01

    Full Text Available Primary epiploic appendagitis (PEA is a seldom reported disease caused by spontaneous torsion of one or more epiploic appendices. The aim of this study is to describe two cases of PEA reviewing the main aspects of the diagnosis and treatment of disease. Case report: Case 1 Male patient, 55 years old, obese, with abdominal right iliac fossa (RIF pain for two days. Abdominal examination showed pain on palpation in the RIF with rebound tenderness. Abdominal computed tomography identified lobulated lesion in the cecum, measuring 4.5 cm in diameter, which was suggestive of PEA or early neoplasm of the colon wall. The lapa- roscopic assessment confirmed the diagnosis of PEA and the appendix was removed. The pa- tient had a satisfactory outcome, being discharged on the second postoperative day. Case 2 Female patient, obese, 47 years old, with abdominal pain for six days, with sudden RIF onset. She had pain at palpation with rebound tenderness. Acute diverticulitis was suspected and patient underwent abdominal CT that identified PEA in the sigmoid colon. After expectant management, the patient showed progressive improvement resuming her activities in seven days. PEA is a rarely recalled condition during the investigation of inflammatory acute abdo- men which can be easily recognized by modern imaging methods of assessment. Resumo: Apendagite epiplóica primária (AEP é uma enfermidade raramente descrita, ocasionada pela torção espontânea de um ou mais apêndices epiplóicos. O objetivo deste estudo é descrever dois casos de AEP revisando os principais aspectos do diagnóstico e tratamento da doença. Relato dos Casos: 1° Homem, 55 anos, obeso com dor abdominal em FID há dois dias. No exame do abdômen apresentava dor à palpação na FID e descompressão brusca presente. A tomografia computadorizada do abdômen identificou lesão expansiva no ceco, lobulada, medindo 4,5 cm de diâmetro, suspeitando-se de AEP ou neoplasia primitiva da parede c

  17. Primary ectopic frontotemporal extradural craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Reza Pourkhalili

    2016-01-01

    Full Text Available We present a case of primary ectopic frontotemporal extradural craniopharyngioma. Primary ectopic craniopharyngiomas are very rare and have been reported involving the fourth ventricle, infrasellar region, lateral ventricle, temporal area, cerebellopontine angle, clivus, corpus callosum, and prepontine cistern. There was just 1 case of craniopharyngioma previously presented in the literature, with nearly same location as the presenting case.

  18. Methotrexate for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Giljaca, Vanja; Poropat, Goran; Stimac, Davor

    2010-01-01

    Methotrexate has been used to treat patients with primary biliary cirrhosis as it possesses immunosuppressive properties. The previously prepared version of this review from 2005 showed that methotrexate seemed to significantly increase mortality in patients with primary biliary cirrhosis. Since...... that last review version, follow-up data of the included trials have been published....

  19. Primary Science Interview: Science Sparks

    Science.gov (United States)

    Bianchi, Lynne

    2016-01-01

    In this "Primary Science" interview, Lynne Bianchi talks with Emma Vanstone about "Science Sparks," which is a website full of creative, fun, and exciting science activity ideas for children of primary-school age. "Science Sparks" started with the aim of inspiring more parents to do science at home with their…

  20. Cardiovascular Risk in Primary Hyperaldosteronism

    NARCIS (Netherlands)

    Prejbisz, A.; Warchol-Celinska, E.; Lenders, J.W.M.; Januszewicz, A.

    2015-01-01

    After the first cases of primary aldosteronism were described and characterized by Conn, a substantial body of experimental and clinical evidence about the long-term effects of excess aldosterone on the cardiovascular system was gathered over the last 5 decades. The prevalence of primary

  1. Primary care research in Denmark

    DEFF Research Database (Denmark)

    Vedsted, Peter; Kallestrup, Per

    2016-01-01

    International Perspectives on Primary Care Research examines how the evidence base from primary care research can strengthen health care services and delivery, tackle the growing burden of disease, improve quality and safety, and increase a person-centred focus to health care. Demonstrating...... the inter-professional nature of the discipline, the book also features a section on cross-nation organisations and primary care networks supporting research. National perspectives are offered from researchers in 20 countries that form part of the World Organization of Family Doctors, providing case...... histories from research-rich to resource-poor nations that illustrate the range of research development and capacity building. This book argues the importance of primary care research, especially to policy makers, decision makers and funders in informing best practice, training primary health care providers...

  2. The Coming Primary Care Revolution.

    Science.gov (United States)

    Ellner, Andrew L; Phillips, Russell S

    2017-04-01

    The United States has the most expensive, technologically advanced, and sub-specialized healthcare system in the world, yet it has worse population health status than any other high-income country. Rising healthcare costs, high rates of waste, the continued trend towards chronic non-communicable disease, and the growth of new market entrants that compete with primary care services have set the stage for fundamental change in all of healthcare, driven by a revolution in primary care. We believe that the coming primary care revolution ought to be guided by the following design principles: 1) Payment must adequately support primary care and reward value, including non-visit-based care. 2) Relationships will serve as the bedrock of value in primary care, and will increasingly be fostered by teams, improved clinical operations, and technology, with patients and non-physicians assuming an ever-increasing role in most aspects of healthcare. 3) Generalist physicians will increasingly focus on high-acuity and high-complexity presentations, and primary care teams will increasingly manage conditions that specialists managed in the past. 4) Primary care will refocus on whole-person care, and address health behaviors as well as vision, hearing, dental, and social services. Design based on these principles should lead to higher-value healthcare, but will require new approaches to workforce training.

  3. Primary amenorrhea: diagnosis and management.

    Science.gov (United States)

    Marsh, Courtney A; Grimstad, Frances W

    2014-10-01

    Puberty is a defining time of many adolescents' lives. It is a series of events that includes thelarche, pubarche, and menarche. Primary amenorrhea is the absence of menarche. There are numerous etiologies including outflow tract obstructions, gonadal dysgenesis, and anomalies of the hypothalamic axis. This review's aims are to define primary amenorrhea and describe the various causes, their workups, associated comorbidities, and treatment options. At the end, a generalist should be able to perform an assessment of an adolescent who presents with primary amenorrhea and, if warranted, begin initial treatment.

  4. Primary vertebral tumours in children

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Beluffi, G.; Masel, J.; Diard, F.; Ferrari-Ciboldi, F.; Le Dosseur, P.; Labatut, J.

    1984-03-01

    20 cases of primary benign and malignant bone tumours in children were reported. The most common tumours were Ewing's sarcoma, aneurismal bone cyst, benign osteoblastoma and osteoid osteoma. Some rare primary bone tumours in children (osteochondroma, chondroblastoma 6F, primary lymphoma of bone and neurofibromatosis with unusual cervical spinal changes) were also reported. The authors believe that radiographic findings together with clinical history and clinical examination may yield a high percentage of accurate diagnoses. Although microscopy is essential in the final diagnosis, the microscopic report should be also accepted with caution.

  5. Primary Productivity (PP_Master)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set included primary production for each subregion in the study (Georges Bank, Gulf of Maine, Southern New England, Middle Atlantic Bight) . The data came...

  6. Problems of Primary Education Today

    Science.gov (United States)

    Dubova, M. V.

    2014-01-01

    Primary education in Russia has failed to adapt to the needs of post-Soviet society, and is still based on rote learning and memorization instead of learning through discovery and learning to use and apply what is learned.

  7. Primary sclerosing cholangitis and pregnancy

    Directory of Open Access Journals (Sweden)

    Casper Q. Kammeijer

    2011-08-01

    Full Text Available Primary sclerosing cholangitis is a progressive disease, and coincidentally in pregnancy it is rare. It is characterized by progressive inflammation and destruction of bile ducts finally resulting in liver failure. A rare case of primary sclerosing cholangitis in pregnancy is presented. The course of the pregnancy was marked by threatened preterm delivery and exacerbation of cholestasis. She was successfully treated with ursodeoxycholic acid (UDCA. Although, primary sclerosing cholangitis has both maternal and fetal effects on pregnancy, the overall outcome is favorable. Only few cases have been reported using high dose ursodeoxycholic acid for primary sclerosing cholangitis in pregnancy, it often improves pruritus but has no protection against stillbirth. Data on the safety to the fetus or neonate and long-term outcome are scarce.

  8. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Quarry industry has become a major means of livelihood in Ebonyi state, but insufficient data exists on their operations ... of Dust Mask among Crushers of Selected Quarry (Crushed ... Journal of Community Medicine and Primary Health Care.

  9. Primary intracerebral lymphoma: Case report

    Directory of Open Access Journals (Sweden)

    Olcay Eser

    2012-09-01

    Full Text Available We describe a case of primary central nervous lymphoma (PCNSL that may be confused with magnetic resonance imaging (MRI findings of high grade glioma. Primary central nervous lymphoma is a rare tumour and it account for 0.3-3% of intracranial tumours. A 61 year’s old woman was admitted to our clinic with a severe headache, vomiting, left hemiparesia and transient loss of consciousness. Primary central nervous lymphoma may show various biological and radiological characteristics. We herein emphasized being confused with MRI findings of PCNSL and high grade glioma. J Clin Exp Invest 2012; 3 (3: 409-411Key words: Primary central nervous lymphoma, high grade glioma, B-cell, diagnosis

  10. Structures in the primary spectrum

    International Nuclear Information System (INIS)

    Kempa, J.; Knurenko, S.P.; Malecki, R.

    2009-01-01

    Structures in the energy spectrum of primary cosmic rays at the 'knee' region and for energies higher than 1 EeV are obtained through studying extensive air showers (EAS). The main problem of the research is the fact that we work in the ranges of highly fluctuating parameters used to obtain the primary energy spectrum. In this paper the log-normal distribution for the error function has been used in convolution with the power spectrum to explain the Yakutsk experimental data. Similar results have been obtained for the gamma distribution as the error function. Using the power law primary spectrum in the energy region around 10 19 eV we will argue that the primary Yakutsk spectrum is overestimated. In the best case this overestimation is not less than 42%.

  11. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    3Department of Community and Primary Health Care, College of Medicine, University of Lagos, Idiaraba, ... Some of the participants (45.3%) carry out physical exercises such as walking ..... hypertension, continuous effective management of.

  12. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    2Primary Health Care Department, Ikpoba Okha Local Government Area, Benin City, ... selected from each of the ten wards in the LGA using multistage sampling technique. ..... Knowledge of HIV/AIDS Insurance Companies in Lagos State.

  13. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Client Satisfaction with Antenatal Care Services in Primary Health Care. Centres in Sabon ... important information about how well clinicians and the population of women within child bearing. 8 ..... model. Health and Quality of Life outcomes.

  14. Primary optic nerve sheath meningioma

    Energy Technology Data Exchange (ETDEWEB)

    Jeremic, Branislav [International Atomic Energy Agency, Vienna (Austria); Pitz, Susanne (eds.) [University Eye Hospital, Mainz (Germany)

    2008-07-01

    Optic nerve sheath meningioma (ONSM) is a rare tumour. Cases are usually separated into primary ONSM, which arises either intraorbitally or, less commonly, intracanalicularly, and secondary ONSM, which arises intracranially and subsequently invades the optic canal and orbit. This is the first book to cover all important aspects of the diagnosis and treatment of primary ONSM. After a general introduction, individual chapters discuss the clinical presentation, clinical examination and diagnosis, imaging, and histology. Treatment options are then addressed in detail, with special emphasis on external beam radiation therapy, and in particular stereotactic fractionated radiation therapy. The latter has recently produced consistently good results and is now considered the emerging treatment of choice for the vast majority of patients with primary ONSM. This well-illustrated book will prove invaluable to all practitioners who encounter primary ONSM in their clinical work. (orig.)

  15. Allegheny County Primary Care Access

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The data on health care facilities includes the name and location of all the hospitals and primary care facilities in Allegheny County. The current listing of...

  16. & PRIMARY HEALTH CARE COMMUNITY MEDICINE

    African Journals Online (AJOL)

    Family planning is an important preventive measure against maternal and child ... users of the services, desire for more children, fear of side effects and partner's ... It is an essential component of primary development across the regions .

  17. Characteristics of Sissi primary beam

    International Nuclear Information System (INIS)

    Nghiem, P.; Payet, J.; Tkatchenko, A.

    1994-01-01

    This study concerns the definition of the Sissi primary beam characteristics. The calculations have been carried out in two steps : -a study of primary and secondary order with the help of BETA matrix code -a study of superior orders with the help of ZGOUBI code which is able to take into consideration the measured fields and in which the movement equations are integrated numerically. (O.L.). 9 figs., 3 tabs

  18. Insomnia (primary) in older people

    OpenAIRE

    Alessi, Cathy; Vitiello, Michael V

    2011-01-01

    Up to 40% of older adults have insomnia, with difficulty getting to sleep, early waking, or feeling unrefreshed on waking. The prevalence of insomnia increases with age. Other risk factors include medical and psychiatric illnesses, psychological factors, stress, daytime napping, and hyperarousal.Primary insomnia is a chronic and relapsing condition that may increase the risks of accidents.Primary insomnia is chronic insomnia without specific underlying medical, psychiatric, or other sleep ...

  19. Hyperuricemia in Childhood Primary Hypertension

    OpenAIRE

    Feig, Daniel I.; Johnson, Richard J.

    2003-01-01

    Experimental animal models suggest that uric acid might have a pathogenic role in the early development of primary hypertension. We hypothesized that serum uric acid is correlated with blood pressure in children with new-onset, untreated, primary hypertension. We evaluated 125 consecutive children referred to the Baylor Pediatric Renal Program for evaluation of hypertension. None of the subjects had previously been evaluated or treated for hypertension. The children ranged in age from 6 to 18...

  20. Glucocorticosteroids for primary sclerosing cholangitis

    DEFF Research Database (Denmark)

    Giljaca, Vanja; Poropat, Goran; Stimac, Davor

    2010-01-01

    Primary sclerosing cholangitis is a chronic cholestatic disease of intrahepatic and extrahepatic biliary ducts, characterised by chronic periductal inflammation and sclerosis of the ducts, which results in segmental stenoses of bile ducts, cholestasis, fibrosis, and ultimately, liver cirrhosis...... sclerosing cholangitis, like ursodeoxycholic acid, glucocorticosteroids, and immunomodulatory agents, but none has been successful in reversing the process of the disease. To date, liver transplantation is the only definite therapeutic solution for patients with advanced primary sclerosing cholangitis...

  1. Primary system boron dilution analysis

    International Nuclear Information System (INIS)

    Crump, R.J.; Naretto, C.J.; Borgen, R.A.; Rockhold, H.C.

    1978-01-01

    The results are presented for an analysis conducted to determine the potential paths through which nonborated water or water with insufficient boron concentration might enter the LOFT primary coolant piping system or reactor vessel to cause dilution of the borated primary coolant water. No attempt was made in the course of this analysis to identify possible design modifications nor to suggest changes in administrative procedures or controls

  2. Gender equality in primary immunisation

    Directory of Open Access Journals (Sweden)

    Deepak S Khismatrao

    2015-01-01

    Full Text Available Context: Immunization, a well-known and effective method of preventing childhood illnesses is basic service under primary health care. Most surveys in India measure primary immunization coverage and quality, but no "Gender Equality." Aims: Assess "Gender Equality" in primary immunization with reference to coverage, quality, and place of immunization. Settings and Design: Cross-sectional survey in a primary health center, Pune, Maharashtra using World Health Organization 30-cluster sampling method with 14 beneficiaries (7 girls and 7 boys to be selected from each cluster. Instead of 420 children, data collected for 345 children, as requisite numbers of children were not available in low population villages and also children whose mothers were not present during survey were excluded. Materials and Methods: Vaccination data collected from either records and/or history by mother. Children born on or between 13-09-2009 and 13-09-2010, were included. Statistical Analysis Used: SPSS 14.01 version with Chi-square as test of significance. Results: Of the study population, 171 (49.6% were females and 174 (50.4% males. A total of 64.1% children had immunization records with female proportion 69.0% and males 59.2%. Primary immunization coverage was 80.0%, with female proportion 82.5% and males 77.6%. One male child was completely unimmunized and remaining partially immunized, with unaware of schedule and illness of child being major reasons for partial immunization. There was no gender wise statistically significant difference observed in Primary Immunization with reference to coverage, quality, and place of immunization. Conclusions: Immunization coverage is nearing 85% benchmark with major contribution from Universal Immunization Program. Gender Equality observed in primary immunization. Preservation of immunization records by community and timely vaccinations are areas for improvement.

  3. Cardiovascular Risk in Primary Hyperaldosteronism.

    Science.gov (United States)

    Prejbisz, A; Warchoł-Celińska, E; Lenders, J W M; Januszewicz, A

    2015-12-01

    After the first cases of primary aldosteronism were described and characterized by Conn, a substantial body of experimental and clinical evidence about the long-term effects of excess aldosterone on the cardiovascular system was gathered over the last 5 decades. The prevalence of primary aldosteronism varies considerably between different studies among hypertensive patients, depending on patient selection, the used diagnostic methods, and the severity of hypertension. Prevalence rates vary from 4.6 to 16.6% in those studies in which confirmatory tests to diagnose primary aldosteronism were used. There is also growing evidence indicating that prolonged exposure to elevated aldosterone concentrations is associated with target organ damage in the heart, kidney, and arterial wall, and high cardiovascular risk in patients with primary aldosteronism. Therefore, the aim of treatment should not be confined to BP normalization and hypokalemia correction, but rather should focus on restoring the deleterious effects of excess aldosterone on the cardiovascular system. Current evidence convincingly demonstrates that both surgical and medical treatment strategies beneficially affect cardiovascular outcomes and mortality in the long term. Further studies can be expected to provide better insight into the relationship between cardiovascular risk and complications and the genetic background of primary aldosteronism. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Primary malignant small bowel tumor

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Kyung Seung; Suh, Ho Jong; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duk [Kosin College, Pusan (Korea, Republic of)

    1990-07-15

    Small bowel tumors are rarely detected unless there is intestinal obstruction or bleeding. In the seven years 1982-1988, at Kosin Medical Center, 25 primary malignant small bowel tumors were studied radiographically with barium and / or computed tomography (CT). CT revealed gastrointestinal abnormalities in 20 patients. In ten, lesion were identified by upper G-I series, in 15 by small bowel series, and in addition, in 3 by colon enema. The most common malignant small bowel tumor was adenocarcinoma (N=15) and was next common lymphoma (N=7). On barium study, primary adenocarcinoma appeared as an irregular stricture (66.7%) and polypoid mass with intussusception was most prominent finding in lymphoma. Leiomyosarcoma appeared as an exophytic mass with excavation or ulceration. CT was found to be accurate in detecting wall thickening, complications and other associated findings. In conclusion, barium study was useful in the diagnosis of primary malignant small bowel tumor and CT was more accurate in detecting secondary findings.

  5. Primary malignant small bowel tumor

    International Nuclear Information System (INIS)

    Oh, Kyung Seung; Suh, Ho Jong; Kim, So Sun; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duk

    1990-01-01

    Small bowel tumors are rarely detected unless there is intestinal obstruction or bleeding. In the seven years 1982-1988, at Kosin Medical Center, 25 primary malignant small bowel tumors were studied radiographically with barium and / or computed tomography (CT). CT revealed gastrointestinal abnormalities in 20 patients. In ten, lesion were identified by upper G-I series, in 15 by small bowel series, and in addition, in 3 by colon enema. The most common malignant small bowel tumor was adenocarcinoma (N=15) and was next common lymphoma (N=7). On barium study, primary adenocarcinoma appeared as an irregular stricture (66.7%) and polypoid mass with intussusception was most prominent finding in lymphoma. Leiomyosarcoma appeared as an exophytic mass with excavation or ulceration. CT was found to be accurate in detecting wall thickening, complications and other associated findings. In conclusion, barium study was useful in the diagnosis of primary malignant small bowel tumor and CT was more accurate in detecting secondary findings

  6. Primary thyroid lymphoma: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyo-Cheol; Han, Moon Hee E-mail: hanmh@radcom.snu.ac.kr; Kim, Keon Ha; Jae, Hwan Jun; Lee, Sang Hyun; Kim, Sam Soo; Kim, Kwang Hyun; Chang, Kee-Hyun

    2003-06-01

    Introduction: To evaluate the computed tomographic (CT) findings of primary thyroid lymphoma. Methods and material: The clinicopathological data and CT images of nine patients with primary thyroid lymphoma were retrospectively reviewed. The CT appearances were classified into three types: type 1, a solitary nodule surrounded by normal thyroid tissue; type 2, multiple nodules in the thyroid, and type 3, a homogeneously enlarged both thyroid glands with a reduced attenuation with or without peripheral thin hyperattenuating thyroid tissue. Results: All patients had a rapidly enlarging thyroid mass and coexistent Hashimoto's thyroiditis. One patient showed type 1 pattern, three type 2, and five type 3. Six patients had homogeneous tumor isoattenuating to surrounding muscles. The tumors had a strong tendency to compress normal remnant thyroid and the surrounding structure without invasion. Conclusion: Primary thyroid lymphoma should be included in the differential diagnosis when old female had a homogeneous thyroidal mass isoattenuating to muscles, which does not invade surrounding structures.

  7. Recurrent Primary Spinal Hydatid Cyst

    Directory of Open Access Journals (Sweden)

    Okan Turk

    2015-03-01

    Full Text Available Primary hydatid disease of spine is rare and spinal hydatitosis constitute only 1% of all hydatitosis. We report a case of recurrent primary intraspinal extradural hydatid cyst of the thoracic region causing progressive paraparesis. The patient was operated 16 years ago for primary spinal hydatid disease involvement and was instrumented dorsally for stabilization. The magnetic resonance imaging (MRI of thoracic spine showed a cystic lesion at T11-12 level and compressed spinal cord posterolaterally. Intraspinal cyst was excised through T11-12 laminectomy which made formerly. The early postoperative period showed a progressive improvement of his neurological deficit and he was discharged with antihelmintic treatment consisting of albendazole and amoxicillin-sulbactam combination. [Cukurova Med J 2015; 40(Suppl 1: 84-89

  8. Primary prevention of chronic obstructive pulmonary disease in primary care.

    Science.gov (United States)

    van der Molen, Thys; Schokker, Siebrig

    2009-12-01

    Chronic obstructive pulmonary disease (COPD) is a prevalent disease, with cigarette smoking being the main risk factor. Prevention is crucial in the fight against COPD. Whereas primary prevention is targeted on whole populations, patient populations are the focus of primary care; therefore, prevention in this setting is mainly aimed at preventing further deterioration of the disease in patients who present with the first signs of disease (secondary prevention). Prevention of COPD in primary care requires detection of COPD at an early stage. An accurate definition of COPD is crucial in this identification process. The benefits of detecting new patients with COPD should be determined before recommending screening and case-finding programs in primary care. No evidence is available that screening by spirometry results in significant health gains. Effective treatment options in patients with mild disease are lacking. Smoking cessation is the cornerstone of COPD prevention. Because cigarette smoking is not only a major cause of COPD but is also a major cause of many other diseases, a decline in tobacco smoking would result in substantial health benefits.

  9. Summarizing primary and secondary effects

    DEFF Research Database (Denmark)

    Karlson, Kristian Bernt

    2013-01-01

    Current methods for decomposing class differentials in educational decisions into primary and secondary effects produce many parameters, rendering them ill-equipped for parsimonious comparisons across countries or birth cohorts. This paper develops a parametric method that provides an optimal...... summary of primary and secondary effects across discrete class origins. Under the testable assumption that the pattern of effects of class origins on academic ability is proportional to the pattern of effects of class origins on educational choice net of academic ability, the method returns a single...

  10. Primary orbital squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Ana L. Campos Arbulú

    2017-02-01

    Full Text Available Primary orbital squamous cell carcinoma is a rare entity. There is little published literature. We report a case of primary squamous cell carcinoma of the orbital soft tissues. Surgical resection offered the best treatment for the patient. Complete resection of the lesion was achieved. The patient received adjuvant radiotherapy due to the proximity of the lesion to the surgical margins. Surgical treatment is feasible and should be considered as part of the surgeon's arsenal. However, therapeutic decisions must be made on a case-by-case basis

  11. Primary carcinoma of the duodenum

    International Nuclear Information System (INIS)

    Steidle, B.; Huetter, B.; Ziegler, F.

    1984-01-01

    Primary carcinoma of the duodenum represents about 0.35% of all gastrointestinal carcinomas and is thus a rare disease. The radiological diagnosis of a duodenal origin is made more difficult by the close proximity of the pancreas, biliary system, right kidney and transverse colon. Histologically, duodenal malignant tumours are usually adenocarcinomas. Between 1973 and 1983, eight patients with primary duodenal carcinomas were diagnosed at the University of Tuebingen. Average age of the patients was 67 years. There was no sex difference. Average survival was 3.3 years. (orig.) [de

  12. Primary Posterior Mediastinum Hydatid Cyst

    International Nuclear Information System (INIS)

    Ahmed, M.; Eid, A. F.; Sheikh, M. Y.; Yiannakou, N.

    2014-01-01

    Primary posterior mediastinal hydatid cyst is a serious health problem for the Mediterranean countries. We diagnosed a case of a 46-year-old female with a primary posterior mediastinum hydatid cyst on CT and MRI. It was provisionally identified as either a hydatid cyst or bronchogenic cyst or neuroenteric cyst. CT guided aspiration with 18 gauge needle confirmed as hydatid sand. This is very rare in this population but it should be kept in mind when one is looking at any cyst in the posterior mediastinum. (author)

  13. Shoulder arthropathy in primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Nussbaum, A.J.; Doppman, J.L.

    1982-01-01

    An erosive arthropathy of the hands and wrists has been recognized in patients with primary and secondary hyperparathyroidism. Recently, intra-articular erosions of the humeral head were described in six patients who had been on chronic long-term hemodialysis with secondary hyperparathyroidism. We would like to present the finding of shoulder erosions in four patients with primary hyperparathyroidism and one patient with renal osteodystrophy and suggest that the humeral erosion can occur in both an intra-articular and peri-articular location. (orig.)

  14. Genetics Home Reference: primary spontaneous pneumothorax

    Science.gov (United States)

    ... Home Health Conditions Primary spontaneous pneumothorax Primary spontaneous pneumothorax Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Primary spontaneous pneumothorax is an abnormal accumulation of air in the ...

  15. Primary pachydermoperiostosis: a case report.

    Science.gov (United States)

    Thappa, D M; Sethuraman, G; Kumar, G R; Elangovan, S

    2000-02-01

    Pachydermoperiostosis (PDP), a rare genodermatosis, occurred in a 38-year-old Indian male. He presented with progressive thickening of the skin on the face and scalp of 15 years duration. Widening of his wrists and ankles and broadening of the fingers and toes had also developed since then. He was born of a consanguineous marriage and had no family history of a similar disorder. He had the typical findings of complete form of PDP including cutis verticis gyrata, coarse facial features, clubbing of the digits in the skin, and periostosis and cortical thickening at the distal ends of long bones of the extremities and small bones of the hands and feet. PDP has two different forms--primary and secondary. These two entities are differentiated by family history and presence or absence of a primary lesion, usually in the lungs. Clinically, in secondary PDP, the cutaneous findings (pachydermia, seborrhoea, oiliness) are less severe than primary PDP; osteoarthropathy is more severe and painful in secondary PDP, especially with congenital heart disease. The present case was suffering from primary PDP that had expressed itself in its complete form.

  16. Primary syphilis of the fingers

    OpenAIRE

    Starzycki, Z

    1983-01-01

    Six patients were seen with primary syphilitic chancres on their fingers between 1965 and 1980. Of these, two had bipolar chancres on their fingers and genitals resulting from sexual foreplay. Because syphilis is rarely suspected in such cases diagnostic errors are common.

  17. Primary acalvaria: a case report

    International Nuclear Information System (INIS)

    Rios, Livia Teresa Moreira; Martins, Marilia da Gloria; Simoes, Vanda Maria Ferreira; Nunes, Marynea do Vale; Marques, Patricia Franco; Godoy, Silvia Helena Cavalcante de Souza

    2010-01-01

    Acalvaria is a rare congenital malformation of unknown pathogenesis characterized by the absence of the flat bones of the cranial vault, dura mater and associated muscles, while the central nervous system is usually preserved. The most accepted physiopathogenic theory suggests the presence of a post neurulation defect with normal placement the embryonic ectoderm. The present report describes neonatal imaging findings of primary acalvaria. (author)

  18. The Primary Dental Care Workforce.

    Science.gov (United States)

    Neenan, M. Elaine; And Others

    1993-01-01

    A study describes the characteristics of the current primary dental care workforce (dentists, hygienists, assistants), its distribution, and its delivery system in private and public sectors. Graduate dental school enrollments, trends in patient visits, employment patterns, state dental activities, and workforce issues related to health care…

  19. Primary Teachers Opinion about Homework

    Science.gov (United States)

    Matei, Stefania; Ciasca, Liliana

    2015-01-01

    Homework assignments trigger various perceptions and attitudes in students, parents or teachers: some overestimate them, others reject them, some do it with pleasure and to others they cause tears. Literature indicates both benefits and disadvantages of homework. In Romania, at primary level, homework is a systematic practice. The explanation is…

  20. Hypertrichosis due to primary hypothyroidism.

    OpenAIRE

    Stern, S R; Kelnar, C J

    1985-01-01

    A 10 year old girl with hypertrichosis associated with primary hypothyroidism that resolved after 6 months' replacement treatment with thyroxine is reported. It is important to consider the diagnosis of hypothyroidism in children with abnormal hairiness or distribution of body hair.

  1. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    2Department of Community Medicine & Primary Care, Faculty of Clinical Sciences, ... It may result from road traffic accident, near saving basic principles in emergency care that even drowning, electric ... (4.3%) at place of work, 8 (11.4%) at.

  2. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Journal of Community Medicine and Primary Health Care. 26 (1) 12-20 .... large proportions of the population work in the poor people use health care services far less than. 19 ... hypertension, cancers and road traffic accidents) below 1 dollar ...

  3. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    VPDs, this represents 17% of global total. 1 ... Knowledge, Attitude and Practice of Childhood Immunization ... Department of Community Health & Primary Care, College of Medicine, University of Lagos, Idi-Araba, P.M.B. 12003, ... include access to services, parental (maternal) ... Calmette Guerin (BCG) vaccine Oral Polio.

  4. Primary Boys and Hegemonic Masculinities.

    Science.gov (United States)

    Skelton, Christine

    1997-01-01

    Explores the relationships between primary-aged boys, hegemonic masculinities, and sexualized/violent behaviors in the school setting. Shows that hegemonic masculinities vary from school to school and that boys draw upon, negotiate, and reject aspects of the hegemonic masculinity of the school in the process of constructing their masculine…

  5. Primary Prevention of Eating Disorders.

    Science.gov (United States)

    Shisslak, Catherine M.; And Others

    1987-01-01

    Summarizes current understanding of anorexia nervosa and bulimia (clinical symptoms and outcome, prevalence and risk factors), offering suggestions for the primary prevention of these disorders at the individual, family, and community levels, and emphasizing prevention in the schools. (Author/KS)

  6. The Relevance of Primary Education

    Science.gov (United States)

    Coe, John

    2018-01-01

    This article sketches a vision of how primary education needs to be re-shaped to let schools focus more sharply on the development of children as individuals. Rapid social change requires a fundamental re-thinking of formal education and assessment. High-stakes testing must end. Greater weight must be given to the application of knowledge and…

  7. Primary Schooling in West Bengal

    Science.gov (United States)

    Sen, Amartya

    2010-01-01

    With his Nobel Prize award money, Amartya Sen set up the Pratichi Trust which carries out research, advocacy and experimental projects in basic education, primary health care, and women's development in West Bengal and Bangladesh. Professor Sen himself took active interest in this work--helping set the agenda, looking at the evidence from…

  8. Patient evaluations of primary care.

    NARCIS (Netherlands)

    Schäfer, W.L.A.; Boerma, W.G.W.; Schellevis, F.G.; Groenewegen, P.P.

    2012-01-01

    Background: So far, studies about people’s appreciation of primary care services has shown that patient satisfaction seems to be lower in health care systems with regulated access to specialist services by gate keeping. Nevertheless, international comparative research about patients’ expectations

  9. Primary Sources and Inquiry Learning

    Science.gov (United States)

    Pappas, Marjorie L.

    2006-01-01

    In this article, the author discusses inquiry learning and primary sources. Inquiry learning puts students in the active role of investigators. Questioning, authentic and active learning, and interactivity are a few of the characteristics of inquiry learning that put the teacher and library media specialist in the role of coaches while students…

  10. Lead-free primary explosives

    Science.gov (United States)

    Huynh, My Hang V.

    2010-06-22

    Lead-free primary explosives of the formula (cat).sub.Y[M.sup.II(T).sub.X(H.sub.2O).sub.6-X].sub.Z, where T is 5-nitrotetrazolate, and syntheses thereof are described. Substantially stoichiometric equivalents of the reactants lead to high yields of pure compositions thereby avoiding dangerous purification steps.

  11. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Background: The well-being of women and children is one of the major determinants ... The Sample for the study were women recruited from 11 primary health care ... respondents educational level and knowledge of preconception care (X =24.76, ... single adult or married couple) are in an optimal state .... The major site for.

  12. Primary Science Education in China

    Science.gov (United States)

    Pook, Gayle

    2013-01-01

    Consider the extent to which primary science teaching has evolved since it became a core subject in England with the introduction of the National Curriculum in 1988, and the pace at which theory-driven classroom practice has advanced. It is no wonder that, given the recent economic restructuring and boom in technological development in China,…

  13. Civil Engineering in Primary Schools

    Science.gov (United States)

    Brown, Martin; Strong, Alan

    2010-01-01

    For many children of primary school age, an engineer is the man who comes to service the central heating system or who fixes the family car when it breaks down. Most have never met a "real" professional engineer, and have no idea of what is involved in the exciting world of engineering. Most assume that engineers are men. To try to…

  14. Assessing primary care data quality.

    Science.gov (United States)

    Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

    2018-04-16

    Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

  15. Primary processes during water radiolysis

    International Nuclear Information System (INIS)

    Pikaev, A.K.

    1980-01-01

    Briefly reviewed are investigations of primary process mechanism taking place during radiolysis of water and similar systems, executed by direct and indirect methods. A conclusion is made on the important role of the water structure during radiolysis of aqueous solutions of some substances. A necessity to take account of this factor during consideration of radiolysis theoretical models is pointed out

  16. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Result: Majority of the mothers (89.2%) had primary/secondary education and 69.4% were traders. Most ... regards immunization, 22.7% of the children were not fully immunized. A total of 69 ..... Nigeria: Perception and Attitudes of the. 17.

  17. Primary acalvaria: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Rios, Livia Teresa Moreira, E-mail: ltlrios@terra.com.b [Universidade Federal do Maranhao (UFMA), Sao Luis, MA (Brazil). Hospital Universitario. Unidade de Diagnostico por Imagem; Martins, Marilia da Gloria [Universidade Federal do Maranhao (UFMA), Sao Luis, MA (Brazil). Hospital Universitario. Servico de Ginecologia e Obstetricia; Simoes, Vanda Maria Ferreira; Nunes, Marynea do Vale; Marques, Patricia Franco; Godoy, Silvia Helena Cavalcante de Souza [Universidade Federal do Maranhao (UFMA), Sao Luis, MA (Brazil). Hospital Universitario. Servico de Neonatologia

    2010-07-15

    Acalvaria is a rare congenital malformation of unknown pathogenesis characterized by the absence of the flat bones of the cranial vault, dura mater and associated muscles, while the central nervous system is usually preserved. The most accepted physiopathogenic theory suggests the presence of a post neurulation defect with normal placement the embryonic ectoderm. The present report describes neonatal imaging findings of primary acalvaria. (author)

  18. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    ... Experience in a primary health care facility in Rivers State, South-South Nigeria. ... health center increased by 3.09% (p-value > 0.05); the patients that had their babies in the facility were ... 100, 000 live births, based on historical studies and.

  19. Phytotherapy in primary health care

    Science.gov (United States)

    Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio

    2014-01-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

  20. Primary pigmented nodular adrenocortical disease

    Directory of Open Access Journals (Sweden)

    Marie T Manipadam

    2011-01-01

    Full Text Available Primary pigmented nodular adrenocortical disease (PPNAD is a rare cause of ACTH-independent Cushing′s syndrome and has characteristic gross and microscopic pathologic findings. We report a case of PPNAD in a 15-year-old boy, which was not associated with Carney′s complex. Bilateral adrenalectomy is the treatment of choice.

  1. Scenarios cancer in primary care.

    NARCIS (Netherlands)

    Velden, L.F.J. van der; Schellevis, F.G.

    2011-01-01

    Introduction: Previous studies predicted an increase in both the incidence and prevalence of cancer in the Netherlands. Other studies showed that cancer patients use primary care more frequently than non-cancer patients. Finally, during the “chronic phase” of the disease, task substitution from

  2. Second Languages in Primary Education.

    Science.gov (United States)

    Donoghue, Mildred R.; Kunkle, John F.

    A book on second languages in primary education, designed to assist both classroom teachers and language specialists, is presented. The following topics are addressed: (1) reasons for studying a second language; (2) reasons for children to learn a second language; (3) language choices; (4) qualifications of teachers; (5) FLES, bilingual education,…

  3. Primary Medical Care in Chile

    DEFF Research Database (Denmark)

    Scarpaci, Joseph L.

    Primary medical care in Chile: accessibility under military rule [Front Cover] [Front Matter] [Title Page] Contents Tables Figures Preface Chapter 1: Introduction Chapter 2: The Restructuring of Medical Care Financing in Chile Chapter 3: Inflation and Medical Care Accessibility Chapter 4: Help......-Seeking Behavior of the Urban Poor Chapter 5: Spatial Organization and Medical Care Accessibility Chapter 6: Conclusion...

  4. Primary Intradural Extraosseous Ewing's Sarcoma

    OpenAIRE

    Kim, Seok Won; Shin, Ho

    2009-01-01

    Ewing's sarcoma usually arises from skeletal bone, but rarely may have an extraskeletal origin. However, Ewing's sarcoma that originates around the spinal column, especially, the intradural extramedullary type is extremely rare. We report a rare case of primary intraspinal extraskeletal Ewing's sarcoma.

  5. Primary extracranial vertebral artery aneurysms.

    Science.gov (United States)

    Morasch, Mark D; Phade, Sachin V; Naughton, Peter; Garcia-Toca, Manuel; Escobar, Guillermo; Berguer, Ramon

    2013-05-01

    Extracranial vertebral artery aneurysms are uncommon and are usually associated with trauma or dissection. Primary cervical vertebral aneurysms are even rarer and are not well described. The presentation and natural history are unknown and operative management can be difficult. Accessing aneurysms at the skull base can be difficult and, because the frail arteries are often afflicted with connective tissue abnormalities, direct repair can be particularly challenging. We describe the presentation and surgical management of patients with primary extracranial vertebral artery aneurysms. In this study we performed a retrospective, multi-institutional review of patients with primary aneurysms within the extracranial vertebral artery. Between January 2000 and January 2011, 7 patients, aged 12-56 years, were noted to have 9 primary extracranial vertebral artery aneurysms. All had underlying connective tissue or another hereditary disorder, including Ehler-Danlos syndrome (n=3), Marfan's disease (n=2), neurofibromatosis (n=1), and an unspecified connective tissue abnormality (n=1). Eight of 9 aneurysms were managed operatively, including an attempted bypass that ultimately required vertebral ligation; the contralateral aneurysm on this patient has not been treated. Open interventions included vertebral bypass with vein, external carotid autograft, and vertebral transposition to the internal carotid artery. Special techniques were used for handling the anastomoses in patients with Ehler-Danlos syndrome. Although endovascular exclusion was not performed in isolation, 2 hybrid procedures were performed. There were no instances of perioperative stroke or death. Primary extracranial vertebral artery aneurysms are rare and occur in patients with hereditary disorders. Operative intervention is warranted in symptomatic patients. Exclusion and reconstruction may be performed with open and hybrid techniques with low morbidity and mortality. Copyright © 2013 Elsevier Inc. All rights

  6. Primary closure in colon trauma.

    Science.gov (United States)

    Salinas-Aragón, Luis Enrique; Guevara-Torres, Lorenzo; Vaca-Pérez, Enrique; Belmares-Taboada, Jaime Arístides; Ortiz-Castillo, Fátima de Guadalupe; Sánchez-Aguilar, Martín

    2009-01-01

    Primary repair of colon injuries is an accepted therapeutic option; however, controversy persists regarding its safety. Our objective was to report the evolution and presence of complications in patients with colon injury who underwent primary closure and to determine if the time interval (>6 h), degree of injury, contamination, anatomic site injured, PATI (Penetrating Abdominal Trauma Index) >25, and the presence of other injuries in colon trauma are associated with increased morbidity and mortality. This was a prospective, observational, longitudinal and descriptive study conducted at the Central Hospital "Dr. Ignacio Morones Prieto," San Luis Potosí, Mexico, from January 1, 2003 to December 31, 2007. We included patients with abdominal trauma with colon injury subjected to surgical treatment. chi(2) was used for basic statistical analysis. There were 481 patients with abdominal trauma who underwent surgery; 77(16.1%) had colon injury. Ninety percent (n = 69) were treated in the first 6 h; 91% (n = 70) were due to penetrating injuries, and gunshot wound accounted for 48% (n = 37). Transverse colon was the most frequently injured (38%) (n = 29). Grade I and II injuries accounted for 75.3% (n = 58). Procedures included primary repair (76.66 %) (n = 46); resection with anastomosis (8.3%) (n = 5); and colostomy (15%) (n = 9). Associated injuries were present in 76.6% (n = 59). There was some degree of contamination in 85.7% (n = 66); 82.8% (58) had PATI colon injury. Primary repair is a safe procedure for treatment of colon injuries. Patients with primary repair had lower morbidity (p <0.009). Surgery during the first 6 h (p <0.006) and in hemodynamically stable patients (p <0.014) had a lower risk of complications.

  7. Primary prevention of adolescent pregnancy.

    Science.gov (United States)

    Schinke, S P; Blythe, B J; Gilchrist, L D; Burt, G A

    1981-01-01

    Teenage pregnancy is associated with many health, emotional and socioeconomic problems including higher rates of anemia, labor complications, mortality, legal and social struggles and hhigher divorce rates. Professional social workers need strategies to help teenagers avoid early, unwanted pregnancy. This paper offers promising experential and research backing for a primary prevention group work strategy for all adolescents. Social and health programs overlook educational, cognitive anc interpersonal factors biasing youths' ability to comprehend and regulate contraception. Primary prevention to assist adolescents in thinking analytically about their sexual behavior must stress problem solving and decision-making as well as facts about human reproduction and birth control. To implement decisions, youths also need interpersonal communication skills. Small groups are ideal for delivering cognitive-behavioral primary prevention. This approach is based on the premise that youths become pregnant not because of a lack of relevant information, but because they lack cognitive and behavioral skills necessary to use information. Group work involving role-playing helps develop communication skills. Results from 2 field studies describe short-term and longitudinal benefits of the prevention strategy. Professionals can reach significant numbers of youth in this way. By treating sexual issues and the risk of pregnancy as normal in adolescence, social workers can introduce information and pertinent skills to all teenagers. No one is singled out as deviant and the group format enables young people to discuss taboo topics, discovering what the norms are and gradually learning how to deal with peers, family members, techers and others. Adolescents in primary prevention groups gained knowledge, cognitive skills and communication acumen. Improved attitudes toward family planning, increased regular contraception and less unsafe sex resulted from this cognitive-behavioral approach

  8. Introducing Cooperative Learning to Primary 1 and Primary 2 Pupils

    Science.gov (United States)

    Fong, Salim; Ho, Linda; Chew, Lay See; Wong, Kok Wah; Wee, Sheila; Jacobs, George M.

    2000-01-01

    It was scary at first. Just getting P1 and 2 students to follow basic instructions is hard enough; trying to get them to work together in groups seemed like asking for extra trouble. But, a dash or two of trouble adds a bit of spice to a veteran teacher's life; so the four of us teachers at Mayflower Primary School--a neighbourhood school in Ang…

  9. [Addison's disease : Primary adrenal insufficiency].

    Science.gov (United States)

    Pulzer, A; Burger-Stritt, S; Hahner, S

    2016-05-01

    Adrenal insufficiency, a rare disorder which is characterized by the inadequate production or absence of adrenal hormones, may be classified as primary adrenal insufficiency in case of direct affection of the adrenal glands or secondary adrenal insufficiency, which is mostly due to pituitary or hypothalamic disease. Primary adrenal insufficiency affects 11 of 100,000 individuals. Clinical symptoms are mainly nonspecific and include fatigue, weight loss, and hypotension. The diagnostic test of choice is dynamic testing with synthetic ACTH. Patients suffering from chronic adrenal insufficiency require lifelong hormone supplementation. Education in dose adaption during physical and mental stress or emergency situations is essential to prevent life-threatening adrenal crises. Patients with adrenal insufficiency should carry an emergency card and emergency kit with them.

  10. Primary ovarian insufficiency: an update

    Directory of Open Access Journals (Sweden)

    Cox L

    2014-02-01

    Full Text Available Leticia Cox, James H LiuUH Case Medical Center, MacDonald Women's Hospital, Department of Obstetrics and Gynecology, Case Western Reserve University School of Medicine, Department of Reproductive Biology, Cleveland, OH, USAAbstract: Primary ovarian insufficiency is a condition that represents impaired ovarian function on a continuum with intermittent ovulation. This condition commonly leads to premature menopause, defined as cessation of ovulation prior to the age of 40 years. Because there are potential immediate and long-term consequences of hypoestrogenism, a timely diagnosis is invaluable. This comprehensive review will discuss identifiable causes for primary ovarian insufficiency, including genetic disorders and metabolic abnormalities, as well as review current strategies for diagnosis, evaluation, and management of women with this condition.Keywords: premature ovarian failure, premature menopause, ovarian dysfunction

  11. Turner syndrome with primary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Jungmee Park

    2013-06-01

    Full Text Available Turner syndrome has multiple comorbidities such as osteoporosis, obesity, diabetes, hypothyroidism, and hypertension. As they are treatable conditions in Turner syndrome, early recognition and proper treatment should be needed. We report on a 23-year-old woman with Turner syndrome who presented with severe osteoporosis and hypercalcemia. Laboratory tests showed elevated levels of serum calcium and parathyroid hormone. Dual-energy X-ray absorptiometry showed severe osteopo-rosis (z score, -3.5. Ultrasound and 99mTc scintigraphy of parathyroid glands showed an adenoma in the right inferior gland. She was diagnosed with primary hyperparathyroidism due to an adenoma of the parathyroid gland. After excision of the adenoma, the patient's serum calcium and parathyroid hormone levels returned to normal. Although only a few cases of Turners syndrome with primary hyperparathyroidism have been reported, hyperparathyroidism should be considered in cases of Turner syndrome with severe osteoporosis and hypercalcemia.

  12. Decontamination of primary cooling system

    International Nuclear Information System (INIS)

    Morikawa, Yoshitake.

    1985-01-01

    Purpose: To effectively eliminate radioactivity accumulated in pipeways, equipments, etc in primary coolant circuits of BWR type power plants by utilizing ion displacement reactions. Method: The reactor pressure vessel is connected with a feedwater pipeway, steam pipeway and a recycling pipeway. The recycling pipeway is disposed with a recycling pump. A recycling by-pass line is branched from the recycling pipeway and disposed with a recycling system heat exchanger and chemical injection point. Water is filled in the primary coolant and heated 280 0 C. Then, while maintaining water at that temperature, non-radioactive cobalt ions are injected and circulated within the system, by which radioactivity accumulated in pipeways, equipments or the likes can effectively be removed. (Horiuchi, T.)

  13. Cinema Sessions in Primary Care

    Directory of Open Access Journals (Sweden)

    Francisco Ignacio MORETA-VELAYOS

    2016-04-01

    Full Text Available For a long time films have been used in teaching and at various levels of professional training  and more specifically in the medical area. In this case, through the description of a project developed in a Primary Care Health Center, we intend to justify the use of movies as a tool that could ease, the sometimes difficult task of continued education among Primary Care professionals. We propose different aspects of everyday practice in which cinema can be potentially useful, as well as the way to include it in the Plan of Continued Education of the Centre and its accreditation.Films and issues discussed in each session, and the project evaluation, are detailed.

  14. Primary shield displacement and bowing

    International Nuclear Information System (INIS)

    Scott, K.V.

    1978-01-01

    The reactor primary shield is constructed of high density concrete and surrounds the reactor core. The inlet, outlet and side primary shields were constructed in-place using 2.54 cm (1 in) thick steel plates as the forms. The plates remained as an integral part of the shields. The elongation of the pressure tubes due to thermal expansion and pressurization is not moving through the inlet nozzle hardware as designed but is accommodated by outward displacement and bowing of the inlet and outlet shields. Excessive distortion of the shields may result in gas seal failures, intolerable helium gas leaks, increased argon-41 emissions, and shield cooling tube failures. The shield surveillance and testing results are presented

  15. Comparative study between endoscopic technique by a proximal port and mini palmary incision in the surgical treatment of carpal tunnel syndrome Estudo comparativo entre a técnica endoscópica pelo portal proximal e a técnica de mini-incisão palmar no tratamento cirúrgico da síndrome do túnel do carpo

    Directory of Open Access Journals (Sweden)

    Eduardo A.R. Pereira

    2003-01-01

    Full Text Available The authors present a prospective study comparing two surgical techniques for carpal tunnel release. A minimal - incision open decompression(3 is compared with an endoscopic release(2, that utilizes only a single proximal portal. There were operated on, 28 wrists in 28 patients, with clinical signs and EMG changes consistent on idiopathic carpal tunnel syndrome, that failed under previous conservative treatment. They were randomized into two groups , undertaken surgical treatment, either by endoscopic release or by open decompression. Grip strength (measured by dynamometric, sensitivity (measured by Semmes-Weinstein monofilaments, presence of pain and paresthesia, date of return to activities of daily living and complications were evaluated pre-operative and at 1, 2, 4, 6, 12 weeks after surgery. After 12 months average follow up, the results indicated that this proximal portal endoscopic technique can be safely performed, showing advantages over open conventional method, in terms of sooner return of grip strength, date of return to activities of daily living, and less incidence of pillar pain. No differences in paresthesia resolution, sensibility improvement or complications incidence were found.Os autores apresentam estudo prospectivo onde comparam duas técnicas cirúrgicas empregadas no tratamento de pacientes acometidos pela síndrome do túnel do carpo. A técnica de descompressão por via aberta, através de mini-incisão palmar(3, é analisada em relação à técnica por via endoscópica, descrita por Agee et al.(2, que utiliza apenas um único portal proximal. Foram operados, de forma randomizada, 28 punhos em 28 pacientes com o diagnóstico clínico e eletromiográfico de síndrome do túnel do carpo idiopático, e que não obtiveram melhora com o tratamento conservador prévio. Os seguintes parâmetros, foram analisados no pré-operatório e na primeira, segunda, quarta, sexta e décima segunda semanas de pós-operatório: força de

  16. Encephalitis in primary HIV infection

    DEFF Research Database (Denmark)

    Helleberg, M; Kirk, O

    2013-01-01

    We report a case of primary HIV encephalitis, which initially presented as acute psychosis. Magnetic resonance imaging of the brain was suggestive of vasculitis and multiple infarctions, whereas a brain biopsy after six weeks of symptoms showed HIV encephalitis with microglial nodules, but no signs...... of vasculitis. We review previous reported cases and radiological findings in HIV encephalitis and discuss the role of antiretroviral therapy and steroids in its management....

  17. Primary biliary cirrhosis: natural history.

    Science.gov (United States)

    Tornay, A S

    1980-03-01

    All patients seen with primary biliary cirrhosis during this decade were reviewed. Sixty per cent were diagnosed during the earliest asymptomatic stage of this illness and only 20% progressed symptomatically during a mean follow-up period of 52 months. Those patients presenting with persistent jaundice followed a classic downhill course. These data establish the previously predicted trend toward earlier diagnosis and raise questions about the concept of universal progression of this disease and its time course.

  18. Primary cerebral lymphoma: radiological findings

    International Nuclear Information System (INIS)

    Ruiz, J.C.; Grandse, D.; Equidazu, J.; Elizagaray, E.; Grande, J.; Carrandi, J.

    1990-01-01

    We present four cases of primary cerebral lymphoma in non-immunodepressed adult patients. All cases were dsemonstrated with pathological study. CAT study showed solitary or multiple isodense lesions, which incorporated avidly and homoneneously the contrast. Arteriography performed in three patients and magnetic resonance, performed in one did not help for diagnosis. We also review the radiological findings obtained with different imaging methods, and suggest the criteria which could be useful for early diagnosis (Author)

  19. Primary bone tumours in infants

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Beluffi, G.; Cohen, D.H.; Padovani, J.; Tamaela, L.; Azouz, M.; Bale, P.; Martin, H.C.; Nayanar, V.V.; Arico, M.

    1985-09-01

    Ten cases of primary bone tumours in infants (1 osteosarcoma, 3 Ewing's sarcoma, 1 chondroblastoma and 5 angiomastosis) are reported. All cases of angiomatosis showed characteristic radiographic findings. In all the other tumours the X-ray appearances were different from those usually seen in older children and adolescents. In the auhtors' opinion the precise diagnosis of malignant bone tumours in infancy is very difficult as no characteristic X-ray features are present in this age period.

  20. Clinical presentation of primary hypothyroidism

    International Nuclear Information System (INIS)

    Ahmed, B.; Hussain, T.; Memon, A. R.; Solangi, G. A.

    2001-01-01

    Objective: To determine the clinical preparation of primary hypothyroidism at the time of diagnosis. Design: It was an observational and prospective study. Place and Duration of Study: Civil Hospital, Karachi from 1st January 1997 to 31st December 1997. Subjects and Methods: Forty-eight consecutive cases of primary hypothyroidism were included. A detailed history with special emphasis on symptoms and signs was conducted and the findings observed were noted in previously made proforma. Results: Primary hypothyroidism was found to be 5 times more common in female patients, with male to female ratio 1:5, majority of cases (33.33%) were between 41 to 50 years of age. The common symptoms at the time of presentation were tiredness (95.8%), weakness (91.6%), weight gain (85.4%), hoarseness of voice (83.3%), cold intolerance (77.0%) and constipation (75.0%) in patients. Physical signs observed were delayed relaxation of ankle jerk (93.7%), periorbital edema (83.3%), thick tongue (62.5%), goiter (50.0%), dry and coarse skin (47.9%) in patients. Serum, TSH, T4 and T3 were performed in all cases through immunoradiometric technique. Serum TSH was markedly elevated, with normal to reduced T4 and T3 levels in all cases. Conclusion: Primary hypothyroidism was found more common in female than male of the age group 41-50 years. Weakness, tiredness, hoarseness of voice and constipation were the common symptoms noted. The diagnosis is almost certain on clinical grounds if the patient happens to have delayed relaxation of ankle jerks and periorbital puffiness. (author)

  1. Primary hypothyroidism masquerading pituitary macroadenoma

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2014-03-01

    Full Text Available Diffuse and reactive pituitary gland enlargement secondary to primary hypothyroidism is an uncommon occurrence and that can masquerade many pituitary disorders. In present article, we report a case of 19 year female severe hypothyroidism presenting with diffuse enlargement of pituitary gland and hyperprolactinemia and review the clinical importance of this entity. Knowledge of this entity is very important to avoid unnecessary surgery and irreversible complications in this sub-group of patients.

  2. Primary hypothyroidism masquerading pituitary macroadenoma

    OpenAIRE

    Agrawal Amit; Reddy Amareesh P.; Malleswara Rao G.; Reddy V. Umamaheswara

    2014-01-01

    Diffuse and reactive pituitary gland enlargement secondary to primary hypothyroidism is an uncommon occurrence and that can masquerade many pituitary disorders. In present article, we report a case of 19 year female severe hypothyroidism presenting with diffuse enlargement of pituitary gland and hyperprolactinemia and review the clinical importance of this entity. Knowledge of this entity is very important to avoid unnecessary surgery and irreversible complications in this sub-group of patients.

  3. Renal manifestations of primary hyperparathyroidism

    OpenAIRE

    Lila, Anurag Ranjan; Sarathi, Vijaya; Jagtap, Varsha; Bandgar, Tushar; Menon, Padma S.; Shah, Nalini Samir

    2012-01-01

    Primary hyperparathyroidism (PHPT) is associated with nephrolithiasis and nephrocalcinosis. Hypercalciuria is one of the multiple factors that is implicated in the complex pathophysiology of stone formation. The presence of a renal stone (symptomatic or asymptomatic) categorizes PHPT as symptomatic and is an indication for parathyroid adenomectomy. Progression of nephrocalcinosis is largely reversible after successful surgery, but the residual risk persists. PHPT is also associated with decli...

  4. Managing obesity in primary care.

    Science.gov (United States)

    Goldie, Christine; Brown, Jenny

    Obesity is a complex problem and often difficult to tackle in primary care. A year-long pilot of a practice nurse-led scheme that used a holistic approach towards self-care in obesity management was set up to reduce the cardiovascular risk of patients who were obese and improve their quality of life. This person-centred approach may offer an important tool in the management of these patients in the GP surgery.

  5. Primary prevention of colorectal cancer.

    Science.gov (United States)

    Chan, Andrew T; Giovannucci, Edward L

    2010-06-01

    Colorectal cancer has been strongly associated with a Western lifestyle. In the past several decades, much has been learned about the dietary, lifestyle, and medication risk factors for this malignancy. Although there is controversy about the role of specific nutritional factors, consideration of dietary pattern as a whole appears useful for formulating recommendations. For example, several studies have shown that high intake of red and processed meats, highly refined grains and starches, and sugars is related to increased risk of colorectal cancer. Replacing these factors with poultry, fish, and plant sources as the primary source of protein; unsaturated fats as the primary source of fat; and unrefined grains, legumes and fruits as the primary source of carbohydrates is likely to lower risk of colorectal cancer. Although a role for supplements, including vitamin D, folate, and vitamin B6, remains uncertain, calcium supplementation is likely to be at least modestly beneficial. With respect to lifestyle, compelling evidence indicates that avoidance of smoking and heavy alcohol use, prevention of weight gain, and maintenance of a reasonable level of physical activity are associated with markedly lower risks of colorectal cancer. Medications such as aspirin and nonsteroidal anti-inflammatory drugs and postmenopausal hormones for women are associated with substantial reductions in colorectal cancer risk, though their utility is affected by associated risks. Taken together, modifications in diet and lifestyle should substantially reduce the risk of colorectal cancer and could complement screening in reducing colorectal cancer incidence.

  6. Multiple primary cancers: An enigma

    Directory of Open Access Journals (Sweden)

    Amitabh Jena

    2016-01-01

    Full Text Available Background: Incidence of multiple primary cancers though uncommon, is being frequently reported now-a-days owing to better diagnostic techniques, the prolonged life span and the increased incidence of long-term survival of cancer patients. Materials and Methods: This is a retrospective study. Cases of multiple malignancies diagnosed histopathologically were retrieved from the archives of department of surgical oncology. Clinical data were obtained from the medical records. They were categorized as synchronous malignancies if the interval between them was less or equal to 6 months and metachronous, if the interval was more than 6 months. Results: A total of 13 cases were encountered in the 5 year study period. Out of them two were in the metachronous category and the rest were synchronous as the 2nd malignancy was detected mostly during clinical evaluation of the patients for the primary malignancy. There was female predominance with age range being 43-68 years. Majority of the cases were in the 7th decade. The most common organ involved was breast, followed by cervix. Apart from bilateral breast malignancies, there were combinations like breast with uterine endometrial carcinoma, cervical carcinoma and even papillary thyroid carcinoma. Conclusion: Detection of multiple primary malignancies is becoming increasingly common in day-to-day practice. Greater awareness of this is required among both cancer patients and their treating clinicians.

  7. Radiotherapy in primary cerebral lymphoma

    International Nuclear Information System (INIS)

    Legros, L.; Benezery, K.; Lagrange, J.L.

    1999-01-01

    Primary cerebral lymphoma is a rare disease with an unfavorable prognosis. Whole brain radiotherapy has been the standard treatment, but neither the optimal radiation fields nor optimal dose level of the regimen are as yet firmly establisheD. From this review of the literature, it seems that the whole brain must be treated, and a boost to the area of the primary site must be discussed. With regard to dose, the radiation dose-response relationship is not clearly proven. Yet, a minimum dose of 40 Gy is necessary, and the maximum dose is set at 50 Gy because of late neurological sequelae. Because of the poor prognosis of this disease and the risk of late sequelae, other avenues have been explored. Chemotherapy has been studied, seem to have a survival advantage and combinations of radiotherapy and chemotherapy, especially with high-dose methotrexate. Because primary cerebral lymphoma is an uncommon disease, randomized clinical trials that compare radiotherapy alone to chemotherapy plus radiotherapy may not be feasible. Finally, even if chemotherapy seems to have a survival advantage, the regimen of chemotherapy is still a matter of debate. (authors)

  8. Lymphocytes B and primary immunodeficiencies

    Directory of Open Access Journals (Sweden)

    Gabriela López-Herrera

    2016-03-01

    Full Text Available Primary antibody deficiencies represent the most frequent genetic diseases of the immune system and the first to be recognized along immunology history. The antibodies were recognized as part of the humoral immune system long ago, and after immunoglobulin discovery, the first antibody immunodeficiency were recognized and named as “agammaglobulinemia”, followed by the common variable immunodeficiency and the hyper-IgM syndrome. The following discoveries in immunology history made possible the understanding of these pathologies, for example: the discoveries of B cells, pre-B cells, the signaling pathway directed by the antigen receptor and many other cellular and molecular mechanisms. Primary antibody deficiencies have been studied for a long time and the discoveries of new syndromes have been helpful in the understanding of immunological mechanisms that take place in our organism. Then, this manuscript pretends to review the relevant findings in the history of immunology, focused on the B cells and the connection with the description of representative clinical entities of primary antibody deficiencies. The aim of this manuscript is to show to the reader that the generation of scientific knowledge has a direct application in the understanding of the molecular mechanisms that are affected in these diseases.

  9. Common primary headaches in pregnancy

    Directory of Open Access Journals (Sweden)

    Anuradha Mitra

    2015-01-01

    Full Text Available Headache is a very common problem in pregnancy. Evaluation of a complaint of headache requires categorizing it as primary or secondary. Migrainous headaches are known to be influenced by fluctuation of estrogen levels with high levels improving it and low levels deteriorating the symptoms. Tension-type Headaches (TTHs are the most common and usually less severe types of headache with female to male ratio 3:1. Women known to have primary headache before conception who present with a headache that is different from their usual headache, or women not known to have primary headache before conception who present with new-onset of headache during pregnancy need neurologic assessments for potential secondary cause for their headache. In addition to proper history and physical examination, both non-contrast computed tomography (CT and Magnetic Resonance Imaging (MRI are considered safe to be performed in pregnant women when indicated. Treatment of abortive and prophylactic therapy should include non-pharmacologic tools, judicious use of drugs which are safe for mother and fetus.

  10. Technological Innovation in Primary Education

    Directory of Open Access Journals (Sweden)

    Luisana Sleny López Alvarado

    2018-05-01

    Full Text Available The purpose of this essay is to reflect on technological innovation in Primary Education. In this idea, information processing was used to support the analysis of the theoretical approaches related to the relevance of education that is based on a significant pedagogical practice capable of developing the capacities and interests, so that they can appropriate the global and local content in the vision of access to information, considering social opportunities. The restructuring to which education has been subjected has been influenced by advances in science, technology and the demands of a complex, dynamic and uncertain society in the processes of educational innovation, which involves the introduction of something new in education. the educational system, modifying its teaching-learning structures through the incorporation of Information and Communication Technologies (ICT in the curricular design of primary education in its intention to train for incursion into science and technology from use of a wide range of didactic resources that lead to pedagogical innovation. It was concluded that technological innovation in the educational praxis of primary education, requires in addition to the vocation of service, to study the new didactic paradigms to display their reflective capacity and assume the commitment to acquire digital literacy to assume the requirements of a knowledge society which is increasingly globalized.

  11. The primary protection system software

    International Nuclear Information System (INIS)

    Tooley, P.A.

    1992-01-01

    This paper continues the detailed description of the Primary Protection System for Sizewell-B by providing an overview of design and implementation of the software, including the features of the design process which ensure that quality is delivered by the contractor. The Nuclear Electric software assessment activities are also described. The argument for the excellence of the software is made on the basis of a quality product delivered by the equipment supplier's design process, and the confirmation of this provided by the Nuclear Electric assessment process, which is as searching and complete an examination as is reasonably practicable to achieve. (author)

  12. Extra osseous primary Ewing's sarcoma.

    Science.gov (United States)

    Ali, Syed Asad; Muhammad, Agha Taj; Soomro, Abdul Ghani; Siddiqui, Akmal Jamal

    2010-01-01

    The case of 20 years old boy with an extra osseous Ewing's sarcoma is described. He was initially diagnosed as a case of infiltrative malignant tumour of left suprarenal gland on the basis of preoperative workup but postoperative biopsy of surgically excised specimen confirmed Extra-osseous Ewing's Sarcoma (EES) suprarenal gland with no evidence of malignancy on skeletal scintiscan, bone marrow aspirate and histopathology Suprarenal location of primary EES is unknown and probably has not been reported in literature. We report a unique case of EES.

  13. Diuretics in primary hypertension - Reloaded.

    Science.gov (United States)

    Mishra, Sundeep

    Diuretics have long been cherished as drugs of choice for uncomplicated primary hypertension. Robust mortality and morbidity data is available for diuretics to back this strategy. Off-late the interest for diuretics has waned off perhaps due to availability of more effective drugs but more likely due to perceived lack of tolerance and side-effect profile of high-dose of diuretics required for mortality benefit. Low-dose diuretics particularly thiazide diuretics are safer but lack the mortality benefit shown by high-dose. However, indapamide and low dose chlorthalidone have fewer side-effects but continue to provide mortality benefit. Copyright © 2016. Published by Elsevier B.V.

  14. Traumatic primary brain stem haemorrhage

    International Nuclear Information System (INIS)

    Andrioli, G.C.; Zuccarello, M.; Trincia, G.; Fiore, D.L.; De Caro, R.

    1983-01-01

    We report 36 cases of post-traumatic 'primary brain stem haemorrhage' visualized by the CT scan and confirmed at autopsy. Clinical experience shows that many technical factors influence the inability to visualize brain stem haemorrhages. Experimental injection of fresh blood into the pons and midbrain of cadavers shows that lesions as small as 0.25 ml in volume may be visualized. The volume and the anatomical configuration of traumatic lesions of the brain stem extended over a rostro-caudal direction, and their proximity to bony structures at the base of the skull are obstacles to the visualization of brain stem haemorrhages. (Author)

  15. [Mental disorders in primary care].

    Science.gov (United States)

    Herzig, Lilli; Mühlemann, Nicole; Bischoff, Thomas

    2010-05-19

    Mental disorders (depression, anxiety and somatization) are frequent in Primary care and are often associated to physical complaints and to psychosocial stressors. Mental disorders have in this way a specific presentation and in addition patients may present different associations of them. Sometimes it is difficult to recognize them, but it is important to do so and to take rapidly care of these patients. Specific screening questions exist and have been used in a research of the Institute of General Medicine and the Department of Ambulatory Care and Community Medicine (PMU), University of Lausanne, Switzerland.

  16. Primary Anorectal Melanoma: An Update

    Directory of Open Access Journals (Sweden)

    P Carcoforo, M.T Raiji, G.M Palini, M Pedriali, U Maestroni, G Soliani, A Detroia, M.V Zanzi, A.L Manna, J.G Crompton, R.C Langan, A Stojadinovic, I Avital

    2012-01-01

    Full Text Available The anorectum is a rare anatomic location for primary melanoma. Mucosal melanoma is a distinct biological and clinical entity from the more common cutaneous melanoma. It portrays worse prognosis than cutaneous melanoma, with distant metastases being the overwhelming cause of morbidity and mortality. Surgery is the treatment of choice, but significant controversy exists over the extent of surgical resection. We present an update on the state of the art of anorectal mucosal melanoma. To illustrate the multimodality approach to anorectal melanoma, we present a typical patient.

  17. Oncology in primary health care

    International Nuclear Information System (INIS)

    Mendoza del Pino, Mario Valentín

    2009-01-01

    The book O ncology in the primary health care , constitutes an important contribution to the prevention and treatment of cancer, from a very comprehensive assessment. It's a disease that is the second leading cause of death in our country, to much pain and suffering is for the patient and their family. The book has a very useful for basic health equipment approach, since it emphasizes that cancer can be prevented if achieved in the population changes in lifestyle. The book is valued not correct food as responsible for one third of all cancers. Currently important research being developed in relation to psiconeuroinmuno-Endocrinology, who is studying the association between psychological factors and the development of cancer valuing that kept stress and depression reduces the antitumor activity of the immune system; that made programs with encouraging results where the treatment of cancer has joined elements of psychotherapy, immunotherapy and the use of the biotherapy. The focus of the book fills an important place in the primary health care and is an indispensable guide for professionals at this level of care (author)

  18. Stages of Adult Primary Liver Cancer

    Science.gov (United States)

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Adult Primary Liver Cancer Treatment (PDQ®)–Patient Version Treatment ... are different types of treatment for patients with adult primary liver cancer. Different types of treatments are ...

  19. The skin in primary immunodeficiency disorders

    NARCIS (Netherlands)

    Sillevis Smitt, J. Henk; Wulffraat, Nico M.; Kuijpers, Taco W.

    2005-01-01

    Primary immunodeficiency disorders comprise serious and rare diseases, predominantly in children. The skin may be involved in a primary immunodeficiency and the cutaneous alterations such as infections, eczematous dermatitis, erythroderma, autoimmune dermatoses and vasculitis may be the basis for

  20. Bile acids for primary sclerosing cholangitis

    DEFF Research Database (Denmark)

    Chen, Weikeng; Gluud, C

    2003-01-01

    Bile acids have been used for treating primary sclerosing cholangitis, but their beneficial and harmful effects remain unclear.......Bile acids have been used for treating primary sclerosing cholangitis, but their beneficial and harmful effects remain unclear....

  1. Genetics Home Reference: primary ciliary dyskinesia

    Science.gov (United States)

    ... primary ciliary dyskinesia also have year-round nasal congestion and a chronic cough. Chronic respiratory tract infections ... likely due to abnormal cilia in the fallopian tubes. Another feature of primary ciliary dyskinesia is recurrent ...

  2. Multiple neoplasms, single primaries, and patient survival

    International Nuclear Information System (INIS)

    Amer, Magid H

    2014-01-01

    Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined. This was a retrospective review of clinical data for all consecutive patients with histologically confirmed cancer, with emphasis on single versus multiple primary neoplasms. Second primaries discovered at the workup of the index (first) primary were termed simultaneous, if discovered within 6 months of the index primary were called synchronous, and if discovered after 6 months were termed metachronous. Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies; these included two primaries (n=284), and three or more primaries (n=38). Forty-seven patients had synchronous primaries and 275 had metachronous primaries. Patients with multiple primaries were predominantly of Caucasian ancestry (91.0%), with a tendency to develop thrombosis (20.2%), had a strong family history of similar cancer (22.3%), and usually presented with earlier stage 0 through stage II disease (78.9%). When compared with 1,551 patients with a single primary, these figures were 8.9%, 15.6%, 18.3%, and 50.9%, respectively (P≤0.001). Five-year survival rates were higher for metachronous cancers (95%) than for synchronous primaries (59%) and single primaries (59%). The worst survival rate was for simultaneous concomitant multiple primaries, being a median of 1.9 years. The best survival was for patients with three or more primaries (median 10.9 years) and was similar to the expected survival for the age-matched and sex-matched general population (P=0.06991). Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent clinical behavior with longer survival rates, possibly related to genetic predisposition

  3. Depressive Disorders in Primary Health Care

    OpenAIRE

    Vuorilehto, Maria

    2008-01-01

    The Vantaa Primary Care Depression Study (PC-VDS) is a naturalistic and prospective cohort study concerning primary care patients with depressive disorders. It forms a collaborative research project between the Department of Mental and Alcohol Research of the National Public Health Institute, and the Primary Health Care Organization of the City of Vantaa. The aim is to obtain a comprehensive view on clinically significant depression in primary care, and to compare depressive patients in prima...

  4. Primary Leiomyosarcoma of the Kidney

    Directory of Open Access Journals (Sweden)

    Kusuma Venkatesh

    2010-01-01

    Full Text Available Primary leiomyosarcoma of the kidney is a rare tumor with an aggressive behaviour. A 55-year-old woman presented with a left sided abdominal mass in our outpatient department. Radiologic investigations revealed the mass to be renal in origin with colonic adhesions for which radical nephrectomy and hemicolectomy were done. The tumor completely appeared to replace the left kidney and had a whorled character focally on cut section. Microscopically, spindle cells having malignant features with cigar shaped nuclei were seen. The smooth muscle origin of the cells was confirmed by immunohistochemical positivity for smooth muscle actin. Sarcomatoid variant of the renal cell carcinoma was ruled out as the tumor was negative for cytokeratin. Tumors with spindle cell morphology in the kidney should not always be taken for a sarcomatoid variant of renal cell carcinoma and should be investigated thoroughly.

  5. Imaging in primary progressive aphasia

    International Nuclear Information System (INIS)

    Abe, K.; Ukita, H.; Yanagihara, T.

    1997-01-01

    Primary progressive aphasia (PPA) presents with aphasia, with or without other minor cognitive dysfunction. We report five patients with PPA to show the correlation between their clinical signs and imaging findings. The patients can be divided into those with nonfluent (group 1) and those with fluent (group 2) aphasia. The characteristic speech impairment was bradylalia in group 1 and word amnesia in group 2. Impairment of comprehension was common but mild in both groups. On MRI, patients in group 1 showed predominantly left frontal and perisylvian atrophy with reduced uptake in the same region on single photon emission computed tomography (SPECT) using technetium-99m hexamethyl propyleneamine oxime ( 99m Tc HMPAO). Patients in group 2 showed left temporal atrophy involving the superior, middle and inferior temporal gyri, hippocampus and parahippocampal gyrus on MRI and reduced uptake in the same region on SPECT. These findings correlated well with the functional anatomy of speech impairment. (orig.). With 4 figs., 1 tab

  6. Imaging in primary progressive aphasia

    Energy Technology Data Exchange (ETDEWEB)

    Abe, K. [Department of Neurology, Osaka University Medical School, 2-2 Yamadaoka, Suita, Osaka 565 (Japan); Ukita, H. [Rehabilitation Service, Osaka University Hospital, Osaka (Japan); Yanagihara, T. [Department of Neurology, Osaka University Medical School, 2-2 Yamadaoka, Suita, Osaka 565 (Japan)

    1997-08-01

    Primary progressive aphasia (PPA) presents with aphasia, with or without other minor cognitive dysfunction. We report five patients with PPA to show the correlation between their clinical signs and imaging findings. The patients can be divided into those with nonfluent (group 1) and those with fluent (group 2) aphasia. The characteristic speech impairment was bradylalia in group 1 and word amnesia in group 2. Impairment of comprehension was common but mild in both groups. On MRI, patients in group 1 showed predominantly left frontal and perisylvian atrophy with reduced uptake in the same region on single photon emission computed tomography (SPECT) using technetium-99m hexamethyl propyleneamine oxime ({sup 99m}Tc HMPAO). Patients in group 2 showed left temporal atrophy involving the superior, middle and inferior temporal gyri, hippocampus and parahippocampal gyrus on MRI and reduced uptake in the same region on SPECT. These findings correlated well with the functional anatomy of speech impairment. (orig.). With 4 figs., 1 tab.

  7. Primary hypoparathyroidism in a dog

    Directory of Open Access Journals (Sweden)

    Mateus do Amaral Freitas

    2014-02-01

    Full Text Available The hypoparathyroidism is a rare endocrinopathy reported in dogs, caused by a deficiency in the synthesis of parathyroid hormone (PTH. The lack of PTH causes hypocalcemia and hyperphosphatemia, resulting in a series of neurological and neuromuscular disorders. Unlike most endocrinopathies, hypoparathyroidism is a disease in which the exogenous hormone replacement is not being viable, becoming the treatment a challenge. The present report aims to describe a case of primary hypoparathyroidism in a Schnauzer dog with seizures and neuromuscular disorders, and successful treatment employed, this being the first case, according to the literature, of hypoparathyroidism diagnosed in Brazil. The hypoparathyroidism should be considered as a differential diagnosis in cases of seizure. A complete neurological evaluation and determination of serum ionized calcium and parathyroid hormone are essential for the diagnosis of this disease. Early diagnosis may improve the quality of life of affected animals, since after the initiation of therapy, there is complete remission of clinical signs.

  8. Primary Hepatic Lymphoma Mimicking Cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Foroogh Forghani1,

    2017-07-01

    Full Text Available Primary hepatic lymphoma (PHL presenting with obstructive jaundice is rare and can mimic a preoperative diagnosis of cholangiocarcinoma. We should consider PHL in patients with radiological hepatic disease with normal serum alpha-fetoprotein and carcinoembryonic antigen levels, and elevated lactate dehydrogenase. We present the case of a 67-year-old male with no significant medical history presented with abdominal pain, jaundice, fever, and abnormal liver function tests. Abdominal sonography and computed tomography scan suggested a diagnosis of obstructive jaundice and cholangitis due to cholangiocarcinoma (Klatskin tumor. A subsequent liver biopsy diagnosed PHL, and the patient was treated with combination chemotherapy, including rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP. PHL should be considered in patients presenting with biliary obstruction.

  9. Primary Prevention of Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Danny J. Eapen, MD

    2016-09-01

    Full Text Available Cardiovascular disease (CVD is the leading cause of death worldwide. This article focuses on current guidelines for the primary prevention of CVD and addresses management of key risk factors. Dietary modification, weight loss, exercise, and tobacco use cessation are specific areas where focused efforts can successfully reduce CVD risk on both an individual and a societal level. Specific areas requiring management include dyslipidemia, hypertension, physical activity, diabetes, aspirin use, and alcohol intake. These preventive efforts have major public health implications. As the global population continues to grow, health care expenditures will also rise, with the potential to eventually overwhelm the health care system. Therefore it is imperative to apply our collective efforts on CVD prevention to improve the cardiovascular health of individuals, communities, and nations.

  10. A case of primary hypersomnia

    Directory of Open Access Journals (Sweden)

    John Dinesh

    2007-01-01

    Full Text Available Primary hypersomnia (PH is a disorder of presumed central nervous system etiology that is associated with a normal or prolonged major sleep episode and excessive sleepiness consisting of prolonged (one or two hour episodes of non-rapid eye movement sleep. It has a similar presentation to narcolepsy, but is not generally associated with cataplexy or sleep-onset rapid eye movement. Although PH is a chronic disorder, fluctuations and spontaneous remissions are known to occur. Treatment with stimulants is beneficial in most patients. We present the case of a 32-year-old Caucasian woman with the classical features of PH. Her condition has progressed over the years and she sleeps for days on end or until aroused. She has been treated with multiple stimulants, with limited success. This case highlights the clinical presentation, diagnostic criteria and treatment modalities of this rare condition.

  11. Europeanizing Danish Primary School Students

    DEFF Research Database (Denmark)

    Ratner, Helene Gad

    , the primary school’s annual national test was changed to better align with PISA’s scale of assessment. With the new test, PISA becomes more than a means for comparison between different (EU) countries as the ‘Danish’ data links up to PISA data. The paper explores how ‘Europeanised’ national test data......EU uses the OECD’s Programme for International Student Assessment (PISA) to assemble and govern the different member states’ student populations (Nóvoa and Lord, 2002; Grek, 2009). This paper explores how ‘Europe-building’ occurs through PISA-affected Danish governmental data practices. In 2015...... inwards, tracking a temporal movement within each individual. This resonates a shift in EU policy from ‘education’ to ‘learning’ (Ozga et al, 2011). The conception of the population has also changed. A big data analysis concluded that students’ national test results can predict their PISA performance...

  12. Cutaneous manifestations of primary immunodeficiency

    Directory of Open Access Journals (Sweden)

    Safa Abdelhakim

    2017-01-01

    Full Text Available Primary immunodeficiency diseases (PIDs are a group of rare, chronic disorders with deficient or malfunctioning immune system. It commonly affects the hematopoietic system, with skin the second most affected organ. Skin involvement is observed in half of pediatric PID cases and often precedes the final diagnosis. Skin infections and eczemas are the two most common manifestations in PID.[1] Skin manifestations associated with PIDs can be of infectious and noninfectious causes. Common noninfectious causes are eczema, erythroderma, cutaneous granulomas, dysplasia, vasculitis, and telangiectasia. It is important to be aware of skin manifestations in pediatric patients as early detection of PID may aid in the management of serious immunologic conditions and prevent associated morbidity and mortality.

  13. Primary unilateral cleft lip repair.

    Science.gov (United States)

    Adenwalla, H S; Narayanan, P V

    2009-10-01

    The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web.

  14. Primary unilateral cleft lip repair

    Directory of Open Access Journals (Sweden)

    Adenwalla H

    2009-10-01

    Full Text Available The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web.

  15. Bilateral persistent hyperplastic primary vitreous

    Directory of Open Access Journals (Sweden)

    Jain Tarun

    2009-01-01

    Full Text Available A case of bilateral persistent hyperplastic primary vitreous (PHPV in a 3-month-old male infant, who had bilateral leukokoria, is presented. The child was referred for imaging with a clinical suspicion of retinoblastoma. Gray-scale ultrasound evaluation revealed an echogenic band in the posterior segment of both globes, extending from the posterior surface of the lens capsule to the optic disc. Doppler examination revealed the presence of arterial flow in the band in both globes. Associated echogenic hemorrhage was also seen, which was confirmed by computed tomography. Most cases of PHPV are sporadic and unilateral, and bilateral PHPV is rare. The imaging features in this case suggest the diagnosis of bilateral PHPV and differentiate it from retinoblastoma. This entity, although infrequent, should be considered in the differential diagnosis while evaluating bilateral leukokoria.

  16. Primary neural leprosy: systematic review

    Directory of Open Access Journals (Sweden)

    Jose Antonio Garbino

    2013-06-01

    Full Text Available The authors proposed a systematic review on the current concepts of primary neural leprosy by consulting the following online databases: MEDLINE, Lilacs/SciELO, and Embase. Selected studies were classified based on the degree of recommendation and levels of scientific evidence according to the “Oxford Centre for Evidence-based Medicine”. The following aspects were reviewed: cutaneous clinical and laboratorial investigations, i.e. skin clinical exam, smears, and biopsy, and Mitsuda's reaction; neurological investigation (anamnesis, electromyography and nerve biopsy; serological investigation and molecular testing, i.e. serological testing for the detection of the phenolic glycolipid 1 (PGL-I and the polymerase chain reaction (PCR; and treatment (classification criteria for the definition of specific treatment, steroid treatment, and cure criteria.

  17. Primary encopresis: evaluation and treatment.

    Science.gov (United States)

    O'Brien, S; Ross, L V; Christophersen, E R

    1986-01-01

    Cathartic and behavioral treatment procedures for eliminating diurnal and nocturnal primary encopresis were investigated using a multiple-baseline design across four children. The dependent and independent variables measured were appropriate bowel movements, soiling accidents, independent toiletings, and cathartic use. Over 177 reliability observations (home visits) were conducted. For two of the children, treatment with cathartics and child-time remedied their soiling accidents and increased their independent toiletings in 8 to 11 weeks. While the cathartics and child-time increased the rate of appropriate bowel movements, they did not eliminate the soiling accidents with the other two children. Independent toiletings for these two children were achieved after 32 to 39 weeks of treatment when punishment procedures (positive practice, time-out, and hourly toilet sits) were incorporated and the suppositories were faded systematically. PMID:3733585

  18. Renal manifestations of primary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Anurag Ranjan Lila

    2012-01-01

    Full Text Available Primary hyperparathyroidism (PHPT is associated with nephrolithiasis and nephrocalcinosis. Hypercalciuria is one of the multiple factors that is implicated in the complex pathophysiology of stone formation. The presence of a renal stone (symptomatic or asymptomatic categorizes PHPT as symptomatic and is an indication for parathyroid adenomectomy. Progression of nephrocalcinosis is largely reversible after successful surgery, but the residual risk persists. PHPT is also associated with declining renal function. In case of asymptomatic mild PHPT, annual renal functional assessment is advised. Guidelines suggest that an estimated glomerular filtration rate (eGFR < 60 ml / minute / 1.73 m 2 is an indication for parathyroid adenomectomy. This article discusses how to monitor and manage renal stones and other related renal parameters in case of PHPT.

  19. Optimizing the Primary Prevention of Type-2 Diabetes in Primary Health Care

    Science.gov (United States)

    2017-08-18

    Interprofessional Relations; Primary Health Care/Organization & Administration; Diabetes Mellitus, Type 2/Prevention & Control; Primary Prevention/Methods; Risk Reduction Behavior; Randomized Controlled Trial; Life Style

  20. Childhood Leukemia and Primary Prevention

    Science.gov (United States)

    Whitehead, Todd P.; Metayer, Catherine; Wiemels, Joseph L.; Singer, Amanda W.; Miller, Mark D.

    2016-01-01

    Leukemia is the most common pediatric cancer, affecting 3,800 children per year in the United States. Its annual incidence has increased over the last decades, especially among Latinos. Although most children diagnosed with leukemia are now cured, many suffer long-term complications, and primary prevention efforts are urgently needed. The early onset of leukemia – usually before age five – and the presence at birth of “pre-leukemic” genetic signatures indicate that pre- and postnatal events are critical to the development of the disease. In contrast to most pediatric cancers, there is a growing body of literature – in the United States and internationally – that has implicated several environmental, infectious, and dietary risk factors in the etiology of childhood leukemia, mainly for acute lymphoblastic leukemia, the most common subtype. For example, exposures to pesticides, tobacco smoke, solvents, and traffic emissions have consistently demonstrated positive associations with the risk of developing childhood leukemia. In contrast, intake of vitamins and folate supplementation during the pre-conception period or pregnancy, breastfeeding, and exposure to routine childhood infections have been shown to reduce the risk of childhood leukemia. Some children may be especially vulnerable to these risk factors, as demonstrated by a disproportionate burden of childhood leukemia in the Latino population of California. The evidence supporting the associations between childhood leukemia and its risk factors – including pooled analyses from around the world and systematic reviews – is strong; however, the dissemination of this knowledge to clinicians has been limited. To protect children’s health, it is prudent to initiate programs designed to alter exposure to well-established leukemia risk factors rather than to suspend judgement until no uncertainty remains. Primary prevention programs for childhood leukemia would also result in the significant co

  1. Primary care performance in Dominica

    Directory of Open Access Journals (Sweden)

    James Macinko

    2015-02-01

    Full Text Available Objective. To document the structure and functions of primary care (PC in the country of Dominica using the Primary Care Assessment Tools (PCAT, a set of questionnaires that evaluate PC functions. Methods. This cross-sectional study combined data from two surveys. The systems PCAT (S-PCAT survey gathered national-level data from key informants about health system characteristics and PC performance. The provider version (P-PCAT survey collected data on PC performance from health providers (nurses and physicians at all PC facilities in the country. Provider-level data were aggregated to obtain national and district-level results for PC domains scored from 0.00 (worst to 1.00 (best. Results. From the systems perspective, results showed several knowledge gaps in PC policy, financing, and structure. Key informants gave “Good” (adequate ratings for “first-contact” care (0.74, continuity of care (0.77, comprehensive care (0.70, and coordinated care (0.78; middling scores for family-centered care and community-oriented care (0.65; and low scores for access to care (0.57. PC providers assessed access to care (which included “first-contact” care, in the P-PCAT surveys (0.84, continuity of care (0.86, information systems (0.84, family-centered care (0.92, and community-oriented care (0.85 as “Very Good”; comprehensive care as “Good” (0.79; and coordinated care as “Reasonable” (0.68. Overall, the scores for the country's health districts were good, although the ratings varied by specific PC domain. Conclusions. The assessments described here were carried out with relatively little expense and have provided important inputs into strategic planning, strategies for improving PC, and identification of priority areas for further investigation. This two-staged approach could be adapted and used in other countries.

  2. Conceptualising primary labour relationship quality

    Directory of Open Access Journals (Sweden)

    Lukas I. Ehlers

    2017-05-01

    Full Text Available Background: A typology of desirable social conditions in supervisory relationships suggested that such conditions may also be desirable in other forms of labour relationships. A literature review confirmed that trust, compliance, fairness and good faith can be confidently regarded as universally desirable social conditions in all forms of individual or collective labour relationships between employers and employees. Aim: The purpose of this study was to determine if primary labour relationship quality (PLQ can be confidently conceptualised as a social construct that strongly relates to the perceived levels of compliance, fairness and good faith in supervisory or primary labour relationships. Setting: A combination of random and convenience sampling approaches was implemented to collect PLQ related data from 454 voluntary respondents, who were subordinate employees in the Tshwane region. Methods: A quantitative research methodology was adopted. This included conceptual definition of the PLQ construct, objective measurement of PLQ levels of voluntary respondents in an adequately sized sample, factor analysis and testing for relationships and differences in means between variables. Results: Data analysis results confirmed that it can be confidently concluded that the conceptual definition of PLQ was valid, and that positive PLQ perceptions of subordinate employees were significantly related to at least two other forms of desirable organisational outcomes. Conclusion: PLQ perceptions can be confidently defined as a distinct subjective quality estimate that is assimilated from unique expectations and perceptions of the levels of compliance, fairness, good faith and trust that a supervisor displays in a labour relationship with an immediate subordinate.

  3. Primary School Teachers' Knowledge, Attitude and Perceived ...

    African Journals Online (AJOL)

    This study endeavored to investigate primary school teachers' knowledge, attitudes, and perceived practices of continuous assessment (CA). Ninety-five primary school teachers from three primary schools in West Gojjam, Ethiopia, were randomly selected for the study. Questionnaire, interviews and content analyses were ...

  4. Screening and Identification in Pediatric Primary Care

    Science.gov (United States)

    Simonian, Susan J.

    2006-01-01

    This article reviews issues related to behavioral screening in pediatric primary care settings. Structural-organizational issues affecting the use of pediatric primary care screening are discussed. This study also reviewed selected screening instruments that have utility for use in the primary care setting. Clinical and research issues related to…

  5. Primary care workforce development in Europe.

    NARCIS (Netherlands)

    Groenewegen, P.; Heinemann, S.; Gress, S.; Schäfer, W.

    2014-01-01

    Background: There is a large variation in the organization of primary care in Europe. In some health care systems, primary care is the gatekeeper to more specialized care, whilst in others patients have the choice between a wide range of providers. Primary care has increasingly become teamwork.

  6. PRIMARY MALIGNANT MELANOMA OF ARYEPIGLOTTIC FOLD

    African Journals Online (AJOL)

    2015-12-01

    Dec 1, 2015 ... commonly in larynx, tongue, and tonsil.2 Primary mel- anoma of the larynx and trachea are very rare among the group of non-cutaneous melanomas. In primary melanoma of the larynx, the least common site is the subglottic mucosa.3 Here we present a case of primary malignant melanoma of aryepiglottic ...

  7. 45 CFR 96.47 - Primary care.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Primary care. 96.47 Section 96.47 Public Welfare... and Tribal Organizations § 96.47 Primary care. Applications for direct funding of Indian tribes and tribal organizations under the primary care block grant must comply with 42 CFR Part 51c (Grants for...

  8. the relationship between primary school teachers extrinsic

    African Journals Online (AJOL)

    PROF EKWUEME

    Primary School Teachers Motivation Questionnaire (PSTMQ) and objective test items in English Language, Mathematics and Primary Science to measure students' performance. ... Mathematics and Primary Science. ... teachers as those who mediate pupils learning and act as facilitators ..... Students' perception of teacher- ...

  9. Reactor primary pumps dynamic balancing test

    International Nuclear Information System (INIS)

    Lu Qunxian

    2002-01-01

    Reactor primary Pump is the important equipment in the primary circuit, its working quality would directly influence the safety and operation of nuclear power plant. The author describes that the primary pump vibration status, vibration fault diagnosis and dynamic balancing process on site have been performed since commercial operation of DA YA BAY Nuclear Power plant

  10. 30 CFR 817.151 - Primary roads.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Primary roads. 817.151 Section 817.151 Mineral... roads. Primary roads shall meet the requirements of § 817.150 and the additional requirements of this section. (a) Certification. The construction or reconstruction of primary roads shall be certified in a...

  11. 30 CFR 816.151 - Primary roads.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Primary roads. 816.151 Section 816.151 Mineral... roads. Primary roads shall meet the requirements of section 816.150 and the additional requirements of this section. (a) Certification. The construction or reconstruction of primary roads shall be certified...

  12. Multiple primary cancers: Simultaneously occurring prostate cancer ...

    African Journals Online (AJOL)

    We also reviewed the existing literatures for possible biologic links between prostatic carcinoma and other primary tumors. ... The primary tumors co-existing with prostate cancer were colonic adenocarcinoma, rectal adenocarcinoma, urinary bladder transitional cell carcinoma, primary liver cell carcinoma, and thyroid ...

  13. Sensitivity to friction for primary explosives.

    Science.gov (United States)

    Matyáš, Robert; Šelešovský, Jakub; Musil, Tomáš

    2012-04-30

    The sensitivity to friction for a selection of primary explosives has been studied using a small BAM friction apparatus. The probit analysis was used for the construction of a sensitivity curve for each primary explosive tested. Two groups of primary explosives were chosen for measurement (a) the most commonly used industrially produced primary explosives (e.g. lead azide, tetrazene, dinol, lead styphnate) and (b) the most produced improvised primary explosives (e.g. triacetone triperoxide, hexamethylenetriperoxide diamine, mercury fulminate, acetylides of heavy metals). A knowledge of friction sensitivity is very important for determining manipulation safety for primary explosives. All the primary explosives tested were carefully characterised (synthesis procedure, shape and size of crystals). The sensitivity curves obtained represent a unique set of data, which cannot be found anywhere else in the available literature. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. [Primary intestinal lymphangiectasia (Waldmann's disease)].

    Science.gov (United States)

    Vignes, S; Bellanger, J

    2017-08-31

    Primary intestinal lymphangiectasia (PIL), Waldmann's disease, is a rare disorder of unknown etiology characterized by dilated intestinal lacteals leading to lymph leakage into the small-bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. PIL is generally diagnosed before 3 years of age but may be diagnosed in older patients. The main symptom is bilateral lower limb edema. Edema may be moderate to severe including pleural effusion, pericarditis or ascites. Protein-losing enteropathy is confirmed by the elevated 24-h stool α1-antitrypsin clearance and diagnosis by endoscopic observation of intestinal lymphangiectasia with the corresponding histology of biopsies. Videocapsule endoscopy may be useful when endoscopic findings are not contributive. Several B-cell lymphomas of the gastrointestinal tract or with extra-intestinal localizations were reported in PIL patients. A long-term strictly low-fat diet associated with medium-chain triglyceride and liposoluble vitamin supplementation is the cornerstone of PIL medical management. Octreotide, a somatostatin analog, have been proposed with an inconsistent efficacy in association with diet. Surgical small-bowel resection is useful in the rare cases with segmental and localized intestinal lymphangiectasia. A prolonged clinical and biological follow-up is recommended. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  15. Primary Prevention of Food Allergy.

    Science.gov (United States)

    Greenhawt, Matthew J; Fleischer, David M

    2017-04-01

    Food allergy is estimated to affect approximately 8% of children in the USA. This is a disease without any known treatment or cure and, for some, a disease that can be quite severe, even life-threatening. While recent advances in potential treatment have made remarkable strides, with two food-targeted immunotherapy products now in phase III trials, perhaps the biggest gains in the field have come in the advent of potential preventative strategies to avoid the development of food allergy in high-risk individuals. There have been multiple, randomized, controlled trials (RCTs) performed in the past 5 years that have demonstrated significant risk reduction from early allergen introduction. These include two trials for early peanut introduction and five trials for early egg introduction in the first year of life. The results indicate that primary prevention of food allergy through early allergen introduction may represent a strategy that could potentially avert tens of thousands of children from becoming food allergic. In support of the data for peanut, the National Institute of Allergy and Infectious Diseases recently sponsored an addendum to the 2010 food allergy guidelines, specifically recommending peanut be introduced in both high- and standard-risk infants to reduce the risk of developing peanut allergy. To date, no formal recommendations have been made for egg, however. This review will focus on the latest evidence supporting early introduction as a strategy to prevent food allergy, as well as on practical aspects for its successful implementation.

  16. Rare primary headaches: clinical insights.

    Science.gov (United States)

    Casucci, G; d'Onofrio, F; Torelli, P

    2004-10-01

    So-called "rare" headaches, whose prevalence rate is lower than 1% or is not known at all and have been reported in only a few dozen cases to date, constitute a very heterogeneous group. Those that are best characterised from the clinical point of view can be classified into forms with prominent autonomic features and forms with sparse or no autonomic features. Among the former are trigeminal autonomic cephalalgias (TACs) and hemicrania continua, while the latter comprise classical trigeminal neuralgia, hypnic headache, primary thunderclap headache, and exploding head syndrome. The major clinical discriminating factor for the differential diagnosis of TACs is the relationship between duration and frequency of attacks: the forms in which pain is shorter lived are those with the higher frequency of daily attacks. Other aspects to be considered are the time pattern of symptoms, intensity and timing of attacks, the patient's behaviour during the attacks, the presence of any triggering factors and of the refractory period after an induced attack, and response to therapy, especially with indomethacin. Often these are little known clinical entities, which are not easily detected in clinical practice. For some of them, e. g., thunderclap headache, it is always necessary to perform instrumental tests to exclude the presence of underlying organic diseases.

  17. [Teenager counselling in primary care].

    Science.gov (United States)

    Millán, Teresa; Morera, Iván; Vargas, Nelson A

    2007-04-01

    Teenager counseling to recognize risks and reinforce strengths is carried out in a primary care outpatient clinic since 2003. To describe the epidemiology and causes for consultation in this teenage counseling program. Retrospective review of the records of 116 teenagers (median age 13 years, 67% females) that received teenager counseling. Seventy percent of women and 50% of men came from nuclear families. More than two thirds were primogenital. Most adolescents were accompanied by their mother, that were the main adult raw model. Fifty percent had dysfunctional families. All were attending school regularly and 21% of women and 29% of men had repeated a school level. Sixty eight percent of women and 62% of men declared to have a life project. Twenty percent were worried about their physical appearance. Seventy seven percent of women and 62% of men considered themselves as happy. Thirty six percent of women and 14% of men smoked. The figures for alcohol consumption were 21% and 14%, respectively. The causes for consultation were obesity, overweight, unspecific symptoms, behavioral problems, bad school achievement, communication problems or pregnancy. Reasons for counseling were family dysfunction, low self esteem, bad school achievement and information about sexuality. The information obtained could help to improve the interdisciplinary work and to coordinate counseling with the family and schools.

  18. ITER primary cryopump test facility

    International Nuclear Information System (INIS)

    Petersohn, N.; Mack, A.; Boissin, J.C.; Murdoc, D.

    1998-01-01

    A cryopump as ITER primary vacuum pump is being developed at FZK under the European fusion technology programme. The ITER vacuum system comprises of 16 cryopumps operating in a cyclic mode which fulfills the vacuum requirements in all ITER operation modes. Prior to the construction of a prototype cryopump, the concept is tested on a reduced scale model pump. To test the model pump, the TIMO facility is being built at FZK in which the model pump operation under ITER environmental conditions, except for tritium exposure, neutron irradiation and magnetic fields, can be simulated. The TIMO facility mainly consists of a test vessel for ITER divertor duct simulation, a 600 W refrigerator system supplying helium in the 5 K stage and a 30 kW helium supply system for the 80 K stage. The model pump test programme will be performed with regard to the pumping performance and cryogenic operation of the pump. The results of the model pump testing will lead to the design of the full scale ITER cryopump. (orig.)

  19. Bone disease in primary hyperparathyroidism

    Science.gov (United States)

    Bandeira, Francisco; Cusano, Natalie E.; Silva, Barbara C.; Cassibba, Sara; Almeida, Clarissa Beatriz; Machado, Vanessa Caroline Costa; Bilezikian, John P.

    2015-01-01

    Bone disease in severe primary hyperparathyroidism (PHPT) is described classically as osteitis fibrosa cystica (OFC). Bone pain, skeletal deformities and pathological fractures are features of OFC. Bone mineral density is usually extremely low in OFC, but it is reversible after surgical cure. The signs and symptoms of severe bone disease include bone pain, pathologic fractures, proximal muscle weakness with hyperreflexia. Bone involvement is typically characterized as salt-and-pepper appearance in the skull, bone erosions and bone resorption of the phalanges, brown tumors and cysts. In the radiography, diffuse demineralization is observed, along with pathological fractures, particularly in the long bones of the extremities. In severe, symptomatic PHPT, marked elevation of the serum calcium and PTH concentrations are seen and renal involvement is manifested by nephrolithiasis and nephrocalcinosis. A new technology, recently approved for clinical use in the United States and Europe, is likely to become more widely available because it is an adaptation of the lumbar spine DXA image. Trabecular bone score (TBS) is a gray-level textural analysis that provides an indirect index of trabecular microarchitecture. Newer technologies, such as high-resolution peripheral quantitative computed tomography (HR-pQCT), have provided further understanding of the microstructural skeletal features in PHPT. PMID:25166047

  20. Ocular changes in primary hypothyroidism.

    Science.gov (United States)

    Ozturk, Banu T; Kerimoglu, Hurkan; Dikbas, Oguz; Pekel, Hamiyet; Gonen, Mustafa S

    2009-12-29

    To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT), anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus) and cup to disc ratio (C/D), mean retinal thickness and mean retinal nerve fiber layer (RNFL) thickness measurements with optical coherence tomography (OCT) in addition to ophthalmological examination preceeding the replacement therapy and at the 1(st), 3(rd )and 6(th )months of treatment. The mean age of the patients included in the study were 40.58 +/- 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP) revealed no significant change. The mean CCT was 538.05 +/- 3.85 mu initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 +/- 0.03 and the mean retinal thickness was 255.83 +/- 19.49 mu initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.

  1. Ocular changes in primary hypothyroidism

    Directory of Open Access Journals (Sweden)

    Pekel Hamiyet

    2009-12-01

    Full Text Available Abstract Background To determine the ocular changes related to hypothyrodism in newly diagnosed patients without orbitopathy. Findings Thirty-three patients diagnosed to have primary overt hypothyroidism were enrolled in the study. All subjects were assigned to underwent central corneal thickness (CCT, anterior chamber volume, depth and angle measurements with the Scheimpflug camera (Pentacam, Oculus and cup to disc ratio (C/D, mean retinal thickness and mean retinal nerve fiber layer (RNFL thickness measurements with optical coherence tomography (OCT in addition to ophthalmological examination preceeding the replacement therapy and at the 1st, 3rd and 6th months of treatment. The mean age of the patients included in the study were 40.58 ± 1.32 years. The thyroid hormone levels return to normal levels in all patients during the follow-up period, however the mean intraocular pressure (IOP revealed no significant change. The mean CCT was 538.05 ± 3.85 μ initially and demonstrated no statistically significant change as the anterior chamber volume, depth and angle measurements did. The mean C/D ratio was 0.29 ± 0.03 and the mean retinal thickness was 255.83 ± 19.49 μ initially and the treatment did not give rise to any significant change. The mean RNFL thickness was also stable during the control visits, so no statistically significant change was encountered. Conclusions Neither hypothyroidism, nor its replacement therapy gave rise to any change of IOP, CCT, anterior chamber parameters, RNFL, retinal thickness and C/D ratio.

  2. Update on Primary Biliary Cirrhosis

    Directory of Open Access Journals (Sweden)

    Jenny Heathcote

    2000-01-01

    Full Text Available The diagnosis of primary biliary cirrhosis (PBC is most often made in the asymptomatic phase, sometimes before the development of abnormal liver biochemistry. The antimitochondrial antibody remains the predominant hallmark, although not all patients test positive, even when the most sensitive techniques are used. The etiology of PBC remains elusive; studies suggest that the interlobular bile duct destruction is immune based, and associated autoimmune diseases are common. There are no surrogate markers that predict outcome in asymptomatic patients, whose chance of survival is less than that of age- and sex-matched populations but much better than the median survival of eight years in patients with symptomatic PBC. Symptoms common in this disease are fatigue, pruritus and xanthelasma, as well as complications of portal hypertension and osteoporosis. Treatment includes symptomatic and preventive measures, as well as specific therapeutic measures. Immunosuppressive therapy has yielded disappointing results in the long term management of PBC, and the only therapy shown to improve survival is the hydrophobic dihydroxy bile acid ursodeoxycholic acid. Treatment at a dose of 13 to 15 mg/kg/day is optimal, given in separate doses or as a single dose at least 4 h from giving the oral anion exchange resin cholestyramine, which may be used to control pruritus. However, liver transplantation remains the only cure for this disease, and the best postoperative survival is seen in patients whose serum bilirubin does not exceed 180 µmol/L at the time of liver transplantation. Recurrence takes place but is rarely symptomatic and does not deter from the benefits of transplantation.

  3. Primary hyperparathyroidism in North India

    International Nuclear Information System (INIS)

    Bhansali, Anil; Masoodi, Shariq Rashid; Reddy, K.S.S.; Dash, Jiban Radharaman; Behera, Aruanshu; Katariya, Rabinder Nath; Mittal, Bhagwant Rai

    2005-01-01

    Primary hyperparathyroidism (PHPT) has a variable clinical expression. Symptomatic PHPT is still predominant form of the disease in many parts of the world, especially developing countries. Because the clinical profile of the disease has changed from that described in the past we sought to improve our understanding of the disease in patients in North India. We summarized the clinical presentation, biochemical and radiological features, and operative findings from the case records from the last 13 years of 52 patients at a tertiary care center in North India who had documented PHPT. The male: female was 1:3.3 with ages ranging from 6 to 60 years (mean+-SD, 36.38+-12.73). Bone disease (46%), recurrent renal stones (21%) and body aches and pains (21%) were the most common modes of the presentation. The lag time varied ranged from 1 month to 16 years. Common clinical manifestations included bone pain (67%), weakness/fatigue (56%), fracture of long bones (48%), abdominal pain (39%), polyuria (37%) and psychiatric manifestations (23.1%). Hypertension was observed in 42% and a palpable nodule in the neck in 19%. Biochemical features included hypercalcemia (86.5%), hypophosphatemia (65.4%) and hyperphosphatasia (67.3%). Mean intact PTH (+-SD)was 809.0+-696.3 ng/L with levels significantly lower in patients who had only kidney stone diseases compared with those with bone disease (P=0.017). A single parathyroid was localized in 50(98%) patients. Hungry bone disease was seen in 59% patients. (author)

  4. Scintigraphic Evaluation in Primary Hyperparathyroidism

    International Nuclear Information System (INIS)

    Ghita, S.; Mazilu, C.; Marinescu, G.; Mititelu, R.; Rambu, A.; Murgoci, P.; Codorean, I.

    2006-01-01

    Full text: Primary hyperparathyroidism typically presents as an asymptomatic disorder. Classical findings of 'stones, bones, abdominal groans and psychic moans' are quite rare. Even in advanced cases symptoms may be seldom and unspecific, diagnosis being sometimes difficult to make. Case report. 35 year-old man, admitted in our hospital with left femoral neck fracture. The patient had a previous surgical intervention on the same femoral neck 10 months ago, for a benign tumor. Histopathology: 'Tissue rich in giant cells of osteoclastic type and blood vessels, areas of lysis and bony formation. Aneurismal bone cyst'. Radiographic exam of left hip at admission: 'Pathologic fracture of the left femoral neck. Sclerotic lesions in the proximal half of left femur with cortical thinning and internal septa'. Lab tests: ALP 803.94 IU/l (N: 38 - 126), Hb 9.7 g/dl, ESR 30/1h. Bone scan: Superscan with diffuse high uptake in both axial and appendicular skeleton. Extremely high uptake in the skull. Some focal uptakes in the left femur (proximal extremity neck, trochanteric region, and distal 1/3 of diaphysis), both patellae and right humerus. Conclusions: Super scan aspect suggesting the presence of changes in bone metabolism (hyperparathyroidism?). Focal changes which in such context may reflect the presence of osteitis fibrosa cystica / brown tumours. Further investigations: Rx confirms generalized demineralization. Serum calcium: 13.28 mg/dl indicating the probability of a primary hyper para-thyroidism. 99m Tc Tetrofosmin scan ('wash-out'): focal uptake in the left lower region of the neck, distal to the left thyroid lobe, visible on the early images, with almost complete normalization on late images (rapid wash-out). Probable diagnosis: adenoma of the left inferior parathyroid gland. Whole body acquisition performed immediately after the early acquisitions for parathyroid adenoma work-up revealed diffuse uptake in the skeleton reflecting a high metabolic rate; focal uptakes

  5. Multiple neoplasms, single primaries, and patient survival

    Directory of Open Access Journals (Sweden)

    Amer MH

    2014-03-01

    Full Text Available Magid H Amer Department of Medicine, St Rita's Medical Center, Lima, OH, USA Background: Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined. Methods: This was a retrospective review of clinical data for all consecutive patients with histologically confirmed cancer, with emphasis on single versus multiple primary neoplasms. Second primaries discovered at the workup of the index (first primary were termed simultaneous, if discovered within 6 months of the index primary were called synchronous, and if discovered after 6 months were termed metachronous. Results: Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies; these included two primaries (n=284, and three or more primaries (n=38. Forty-seven patients had synchronous primaries and 275 had metachronous primaries. Patients with multiple primaries were predominantly of Caucasian ancestry (91.0%, with a tendency to develop thrombosis (20.2%, had a strong family history of similar cancer (22.3%, and usually presented with earlier stage 0 through stage II disease (78.9%. When compared with 1,551 patients with a single primary, these figures were 8.9%, 15.6%, 18.3%, and 50.9%, respectively (P≤0.001. Five-year survival rates were higher for metachronous cancers (95% than for synchronous primaries (59% and single primaries (59%. The worst survival rate was for simultaneous concomitant multiple primaries, being a median of 1.9 years. The best survival was for patients with three or more primaries (median 10.9 years and was similar to the expected survival for the age-matched and sex-matched general population (P=0.06991. Conclusion: Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent

  6. Primary progressive aphasia and apraxia of speech.

    Science.gov (United States)

    Jung, Youngsin; Duffy, Joseph R; Josephs, Keith A

    2013-09-01

    Primary progressive aphasia is a neurodegenerative syndrome characterized by progressive language dysfunction. The majority of primary progressive aphasia cases can be classified into three subtypes: nonfluent/agrammatic, semantic, and logopenic variants. Each variant presents with unique clinical features, and is associated with distinctive underlying pathology and neuroimaging findings. Unlike primary progressive aphasia, apraxia of speech is a disorder that involves inaccurate production of sounds secondary to impaired planning or programming of speech movements. Primary progressive apraxia of speech is a neurodegenerative form of apraxia of speech, and it should be distinguished from primary progressive aphasia given its discrete clinicopathological presentation. Recently, there have been substantial advances in our understanding of these speech and language disorders. The clinical, neuroimaging, and histopathological features of primary progressive aphasia and apraxia of speech are reviewed in this article. The distinctions among these disorders for accurate diagnosis are increasingly important from a prognostic and therapeutic standpoint. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Ursodeoxycholic acid for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Gong, Y.; Huang, Z.B.; Christensen, Erik

    2008-01-01

    , and the references of identified studies. The last search was performed in January 2007. SELECTION CRITERIA: Randomised clinical trials evaluating UDCA versus placebo or no intervention in patients with primary biliary cirrhosis. DATA COLLECTION AND ANALYSIS: The primary outcomes were mortality and mortality......, trial duration, and patient's severity of primary biliary cirrhosis. We also used Bayesian meta-analytic approach to estimate the UDCA effect as sensitivity analysis. MAIN RESULTS: Sixteen randomised clinical trials evaluating UDCA against placebo or no intervention were identified. Data from three......BACKGROUND: Primary biliary cirrhosis is an uncommon autoimmune liver disease with unknown aetiology. Ursodeoxycholic acid (UDCA) has been used for primary biliary cirrhosis, but the effects remain controversial. OBJECTIVES: To evaluate the benefits and harms of UDCA on patients with primary...

  8. Primary uterine inertia in four labrador bitches.

    Science.gov (United States)

    Davidson, Autumn P

    2011-01-01

    Uterine inertia is a common cause of dystocia in the bitch and is designated as primary (i.e., uterine contractions fail to ever be initiated) or secondary (i.e., uterine contractions cease after a period of time but before labor is completed). The etiology of primary uterine inertia is not well understood. The accurate diagnosis of primary uterine inertia requires the use of tocodynamometry (uterine monitoring). Primary uterine inertia has been postulated to result from a failure of luteolysis resulting in persistently elevated progesterone concentrations. In this study, primary uterine inertia was diagnosed in a series of four bitches in which luteolysis was documented suggesting some other etiopathogenesis for primary uterine inertia.

  9. Primary leiomyosarcoma of the innominate vein.

    Science.gov (United States)

    Illuminati, Giulio; Miraldi, Fabio; Mazzesi, Giuseppe; D'urso, Antonio; Ceccanei, Gianluca; Bezzi, Marcello

    2007-01-01

    Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread.

  10. Primary Oral Tuberculosis - A Case Report

    Directory of Open Access Journals (Sweden)

    B N Praveen

    2007-01-01

    Full Text Available Tuberculosis is most common disease in developing countries because of lack of public health awareness, poverty, nutritional deficiencies, absence of medical facilities. Primary oral lesions in tuberculosis are still exceedingly rare. Oral involvement may be primary or secondary to systemic involvement. Involvement of oral cavity is rare accounting for 0.2-1.5% of cases. A rare case report of primary oral tuberculosis is presented.

  11. Primary multifocal osseous lymphoma in a child

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Takashi S.P. [University of Iowa, Carver College of Medicine, Iowa City, IA (United States); Ferguson, Polly J. [University of Iowa, Department of Pediatrics, Iowa City, IA (United States); Khanna, Geetika [Washington University, Mallinckrodt Institute of Radiology, St Louis, MO (United States)

    2008-12-15

    We report a case of primary multifocal osseous lymphoma in a 6-year-old girl presenting with multifocal osteolytic lesions without systemic symptoms or identifiable non-osseous primary tumor. The differential diagnoses for such a presentation include histiocytosis X, chronic recurrent multifocal osteomyelitis, acute lymphoblastic leukemia, metastatic disease, and primary bone lymphoma. Although non-Hodgkin lymphoma is common in the pediatric population, its presentation as a primary bone tumor, especially with multifocal disease, is extremely rare and is frequently misdiagnosed. We hope that awareness of this entity will help radiologists achieve timely diagnosis and intervention. (orig.)

  12. Blueprint for an Undergraduate Primary Care Curriculum.

    Science.gov (United States)

    Fazio, Sara B; Demasi, Monica; Farren, Erin; Frankl, Susan; Gottlieb, Barbara; Hoy, Jessica; Johnson, Amanda; Kasper, Jill; Lee, Patrick; McCarthy, Claire; Miller, Kathe; Morris, Juliana; O'Hare, Kitty; Rosales, Rachael; Simmons, Leigh; Smith, Benjamin; Treadway, Katherine; Goodell, Kristen; Ogur, Barbara

    2016-12-01

    In light of the increasing demand for primary care services and the changing scope of health care, it is important to consider how the principles of primary care are taught in medical school. While the majority of schools have increased students' exposure to primary care, they have not developed a standardized primary care curriculum for undergraduate medical education. In 2013, the authors convened a group of educators from primary care internal medicine, pediatrics, family medicine, and medicine-pediatrics, as well as five medical students to create a blueprint for a primary care curriculum that could be integrated into a longitudinal primary care experience spanning undergraduate medical education and delivered to all students regardless of their eventual career choice.The authors organized this blueprint into three domains: care management, specific areas of content expertise, and understanding the role of primary care in the health care system. Within each domain, they described specific curriculum content, including longitudinality, generalism, central responsibility for managing care, therapeutic alliance/communication, approach to acute and chronic care, wellness and prevention, mental and behavioral health, systems improvement, interprofessional training, and population health, as well as competencies that all medical students should attain by graduation.The proposed curriculum incorporates important core features of doctoring, which are often affirmed by all disciplines but owned by none. The authors argue that primary care educators are natural stewards of this curriculum content and can ensure that it complements and strengthens all aspects of undergraduate medical education.

  13. Ion transport by the amphibian primary ureter

    DEFF Research Database (Denmark)

    Møbjerg, Nadja

    2008-01-01

    putative ion transport mechanisms in the primary ureter of the freshwater amphibian Ambystoma mexicanum (axolotl). Primary ureters isolated from axolotl larvae were perfused in vitro and single cells were impaled across the basal cell membrane with glass microelectrodes. In 42 cells the membrane potential......+] steps from 3 to 20 mmol/l and a hyperpolarization of Vm upon lowering [Na+] from 102 to 2 mmol/l, indicating the presence of luminal K+ and Na+ conductances. This study provides the first functional data on the vertebrate primary ureter. The data show that the primary ureter of axolotl larvae...

  14. Primary data collection in health technology assessment.

    Science.gov (United States)

    McIsaac, Michelle L; Goeree, Ron; Brophy, James M

    2007-01-01

    This study discusses the value of primary data collection as part of health technology assessment (HTA). Primary data collection can help reduce uncertainty in HTA and better inform evidence-based decision making. However, methodological issues such as choosing appropriate study design and practical concerns such as the value of collecting additional information need to be addressed. The authors emphasize the conditions required for successful primary data collection in HTA: experienced researchers, sufficient funding, and coordination among stakeholders, government, and researchers. The authors conclude that, under specific conditions, primary data collection is a worthwhile endeavor in the HTA process.

  15. Primary intestinal lymphangiectasia (Waldmann's disease).

    Science.gov (United States)

    Vignes, Stéphane; Bellanger, Jérôme

    2008-02-22

    Primary intestinal lymphangiectasia (PIL) is a rare disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. PIL is generally diagnosed before 3 years of age but may be diagnosed in older patients. Prevalence is unknown. The main symptom is predominantly bilateral lower limb edema. Edema may be moderate to severe with anasarca and includes pleural effusion, pericarditis or chylous ascites. Fatigue, abdominal pain, weight loss, inability to gain weight, moderate diarrhea or fat-soluble vitamin deficiencies due to malabsorption may also be present. In some patients, limb lymphedema is associated with PIL and is difficult to distinguish lymphedema from edema. Exsudative enteropathy is confirmed by the elevated 24-h stool alpha1-antitrypsin clearance. Etiology remains unknown. Very rare familial cases of PIL have been reported. Diagnosis is confirmed by endoscopic observation of intestinal lymphangiectasia with the corresponding histology of intestinal biopsy specimens. Videocapsule endoscopy may be useful when endoscopic findings are not contributive. Differential diagnosis includes constrictive pericarditis, intestinal lymphoma, Whipple's disease, Crohn's disease, intestinal tuberculosis, sarcoidosis or systemic sclerosis. Several B-cell lymphomas confined to the gastrointestinal tract (stomach, jejunum, midgut, ileum) or with extra-intestinal localizations were reported in PIL patients. A low-fat diet associated with medium-chain triglyceride supplementation is the cornerstone of PIL medical management. The absence of fat in the diet prevents chyle engorgement of the intestinal lymphatic vessels thereby preventing their rupture with its ensuing lymph loss. Medium-chain triglycerides are absorbed directly into the portal venous circulation and avoid lacteal overloading. Other inconsistently effective

  16. Primary intestinal lymphangiectasia (Waldmann's disease

    Directory of Open Access Journals (Sweden)

    Bellanger Jérôme

    2008-02-01

    Full Text Available Abstract Primary intestinal lymphangiectasia (PIL is a rare disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. PIL is generally diagnosed before 3 years of age but may be diagnosed in older patients. Prevalence is unknown. The main symptom is predominantly bilateral lower limb edema. Edema may be moderate to severe with anasarca and includes pleural effusion, pericarditis or chylous ascites. Fatigue, abdominal pain, weight loss, inability to gain weight, moderate diarrhea or fat-soluble vitamin deficiencies due to malabsorption may also be present. In some patients, limb lymphedema is associated with PIL and is difficult to distinguish lymphedema from edema. Exsudative enteropathy is confirmed by the elevated 24-h stool α1-antitrypsin clearance. Etiology remains unknown. Very rare familial cases of PIL have been reported. Diagnosis is confirmed by endoscopic observation of intestinal lymphangiectasia with the corresponding histology of intestinal biopsy specimens. Videocapsule endoscopy may be useful when endoscopic findings are not contributive. Differential diagnosis includes constrictive pericarditis, intestinal lymphoma, Whipple's disease, Crohn's disease, intestinal tuberculosis, sarcoidosis or systemic sclerosis. Several B-cell lymphomas confined to the gastrointestinal tract (stomach, jejunum, midgut, ileum or with extra-intestinal localizations were reported in PIL patients. A low-fat diet associated with medium-chain triglyceride supplementation is the cornerstone of PIL medical management. The absence of fat in the diet prevents chyle engorgement of the intestinal lymphatic vessels thereby preventing their rupture with its ensuing lymph loss. Medium-chain triglycerides are absorbed directly into the portal venous circulation and avoid lacteal overloading. Other

  17. Primary health care in India.

    Science.gov (United States)

    Deodhar, N S

    1982-03-01

    relative neglect of development of health manpower for nursing, environmental engineering, and other technical and paramedical personnel. Community involvement and participation were at a minimum if they existed at all. The basic concern about primary health care for all continued unabated however. To realize the goal of health care for all, 3 programs will have to be pursued simultaneously during the next 2 decades: integrated overall development including family planning; improvement in nutrition, environment, and health education; and the provision of adequate health care services for all, particularly the poor and underprivileged. It is necessary to redefine the roles of the central and state governments in view of the large power powers delegated to local bodies at the district level and below. Voluntary agencies will have to function within the overall plan/aid down by the state.

  18. Primary School Teachers' Perceptions of Adequacy and Quality of Physical Facilities in Public Primary Schools under Free Primary Education

    Science.gov (United States)

    Muthima, Ndirangu Wahome; Udoto, Maurice O.; Anditi, Zephania O.

    2016-01-01

    The Free Primary Education (FPE) programme was commissioned in Kenya in January 2003 to provide basic education to all children of school going age and to ease the burden of cost sharing from the parents. However, even though the public primary school class teachers were to shoulder the greatest responsibility in the implementation of this…

  19. The primary care amplification model: taking the best of primary care forward

    Directory of Open Access Journals (Sweden)

    Nicholson Caroline

    2008-12-01

    Full Text Available Abstract Background Primary care internationally is approaching a new paradigm. The change agenda implicit in this threatens to de-stabilise and challenge established general practice and primary care. Discussion The Primary Care Amplification Model offers a means to harness the change agenda by 'amplifying' the strengths of established general practices around a 'beacon' practice. Conclusion Such 'beacon' practices can provide a mustering point for an expanded scope of practice for primary care, integrated primary/secondary service delivery, interprofessional learning, relevant local clinical research, and a focus on local service innovation, enhancing rather than fragmenting the collective capacity of existing primary care.

  20. Primary care in Switzerland gains strength.

    Science.gov (United States)

    Djalali, Sima; Meier, Tatjana; Hasler, Susann; Rosemann, Thomas; Tandjung, Ryan

    2015-06-01

    Although there is widespread agreement on health- and cost-related benefits of strong primary care in health systems, little is known about the development of the primary care status over time in specific countries, especially in countries with a traditionally weak primary care sector such as Switzerland. The aim of our study was to assess the current strength of primary care in the Swiss health care system and to compare it with published results of earlier primary care assessments in Switzerland and other countries. A survey of experts and stakeholders with insights into the Swiss health care system was carried out between February and March 2014. The study was designed as mixed-modes survey with a self-administered questionnaire based on a set of 15 indicators for the assessment of primary care strength. Forty representatives of Swiss primary and secondary care, patient associations, funders, health care authority, policy makers and experts in health services research were addressed. Concordance between the indicators of a strong primary care system and the real situation in Swiss primary care was rated with 0-2 points (low-high concordance). A response rate of 62.5% was achieved. Participants rated concordance with five indicators as 0 (low), with seven indicators as 1 (medium) and with three indicators as 2 (high). In sum, Switzerland achieved 13 of 30 possible points. Low scores were assigned because of the following characteristics of Swiss primary care: inequitable local distribution of medical resources, relatively low earnings of primary care practitioners compared to specialists, low priority of primary care in medical education and training, lack of formal guidelines for information transfer between primary care practitioners and specialists and disregard of clinical routine data in the context of medical service planning. Compared to results of an earlier assessment in Switzerland, an improvement of seven indicators could be stated since 1995. As a

  1. Primary extradural meningioma arising from the calvarium

    Directory of Open Access Journals (Sweden)

    N Ravi

    2013-06-01

    Full Text Available Meningiomas are the most common intracranial tumours. Meningiomas arising at other locations are termed primary extradural meningiomas (EDM and are rare. Here we report a case of EDM arising from the calvarium – a primary calvarial meningioma (PCM.

  2. [Primary childhood vasculitis new classification criteria

    DEFF Research Database (Denmark)

    Herlin, T.; Nielsen, Susan

    2008-01-01

    Primary vasculitis is seen in both adults and children, but some of the diseases like Kawasaki disease occur primarily in children. The Chapel Hill Classification Criteria for primary vasculitis refers to the size of vessels but has not been validated in children. Recently, new criteria...

  3. Oxidative stress in primary glomerular diseases

    DEFF Research Database (Denmark)

    Markan, Suchita; Kohli, Harbir Singh; Sud, Kamal

    2008-01-01

    To evaluate the status of oxidative stress in patients with different primary glomerular diseases (PGD) which have differential predisposition to renal failure.......To evaluate the status of oxidative stress in patients with different primary glomerular diseases (PGD) which have differential predisposition to renal failure....

  4. A Conceptual Framework for Primary Source Practices

    Science.gov (United States)

    Ensminger, David C.; Fry, Michelle L.

    2012-01-01

    This article introduces a descriptive conceptual framework to provide teachers with a means of recognizing and describing instructional activities that use primary sources. The framework provides structure for professional development programs that have been established to train teachers to access and integrate primary sources into lessons. The…

  5. Diversity of primary care systems analysed.

    NARCIS (Netherlands)

    Kringos, D.; Boerma, W.; Bourgueil, Y.; Cartier, T.; Dedeu, T.; Hasvold, T.; Hutchinson, A.; Lember, M.; Oleszczyk, M.; Pavlick, D.R.

    2015-01-01

    This chapter analyses differences between countries and explains why countries differ regarding the structure and process of primary care. The components of primary care strength that are used in the analyses are health policy-making, workforce development and in the care process itself (see Fig.

  6. Second primary tumours in oral cancer

    NARCIS (Netherlands)

    van der Waal, I.; de Bree, R.

    2010-01-01

    Second primary tumours in patients treated for oral cancer occur at a rate of 3% to 7% per year. The majority of these tumours show up at least six months after the detection of the primary and are often located in the upper aerodigestive tract. Cessation of smoking habits may reduce the risk of the

  7. Humor Climate of the Primary Schools

    Science.gov (United States)

    Sahin, Ahmet

    2018-01-01

    The aim of this study is to determine the opinions primary school administrators and teachers on humor climates in primary schools. The study was modeled as a convergent parallel design, one of the mixed methods. The data gathered from 253 administrator questionnaires, and 651 teacher questionnaires was evaluated for the quantitative part of the…

  8. An Introduction to Primary Physical Education

    Science.gov (United States)

    Griggs, Gerald, Ed.

    2012-01-01

    Physical Education is a core component of the primary school curriculum. The primary years are perhaps the most significant period for motor development in children, a time during which basic movement competencies are developed and which offers the first opportunity for embedding physical activity as part of a healthy lifestyle. This is the first…

  9. Standardization of Primary Education in Great Britain

    Science.gov (United States)

    Yarovaya, Yelena B.

    2015-01-01

    The article examines the standardization of primary education as one of the development trends of the British school at the present moment in the context of improving its efficiency and quality. It analyses the positive results of the standard-based reforms (modernization of primary education content, improvement of younger students' outcomes,…

  10. Primary School Principals' Self-Monitoring Skills

    Science.gov (United States)

    Konan, Necdet

    2015-01-01

    The aim of the present study is to identify primary school principals' self-monitoring skills. The study adopted the general survey model and its population comprised primary school principals serving in the city of Diyarbakir, Turkey, while 292 of these constituted the sample. Self-Monitoring Scale was used as the data collection instrument. In…

  11. Primary School Teachers' Perceptions of Mathematical Reasoning

    Science.gov (United States)

    Loong, Esther Yook-Kin; Vale, Colleen; Bragg, Leicha A.; Herbert, Sandra

    2013-01-01

    Little is known about how Australian teachers interpret, enact and assess reasoning. This paper reports on primary teachers' perceptions of reasoning prior to observation and subsequent trialling of demonstration lessons in a primary school. The findings indicate that while some teachers were able to articulate what reasoning means, others were…

  12. Melinda: De Facto Primary School Music Teacher

    Science.gov (United States)

    de Vries, Peter

    2013-01-01

    A series of reviews dating back to the 1960s and a body of research literature points to the inadequate delivery of music education by generalist primary school teachers in Australian schools. Despite recommendations for specialist music teachers to teach music in all Australian primary schools to counter this ongoing trend, such an approach has…

  13. Primary Immune Deficiency Treatment Consortium (PIDTC) report

    NARCIS (Netherlands)

    L.M. Griffith (Linda); M. Cowan (Morton); L.D. Notarangelo (Luigi Daniele); R. Kohn (Robert); J. Puck (Jennifer); S.-Y. Pai (Sung-Yun); B. Ballard (Barbara); S.C. Bauer (Sarah); J. Bleesing (Jack); M. Boyle (Marcia); R.W. Brower (Ronald); R.H. Buckley (Rebecca); M. van der Burg (Mirjam); L.M. Burroughs (Lauri); F. Candotti (Fabio); A. Cant (Andrew); T. Chatila (Talal); C. Cunningham-Rundles (Charlotte); M.C. Dinauer (Mary); J. Dvorak (Jennie); A. Filipovich (Alexandra); L.A. Fleisher (Lee); H.B. Gaspar (Bobby); T. Gungor (Tayfun); E. Haddad (Elie); E. Hovermale (Emily); F. Huang (Faith); A. Hurley (Alan); M. Hurley (Mary); S.K. Iyengar (Sudha); E.M. Kang (Elizabeth); B.R. Logan (Brent); J.R. Long-Boyle (Janel); H. Malech (Harry); S.A. McGhee (Sean); S. Modell (Sieglinde); S. Modell (Sieglinde); H.D. Ochs (Hans); R.J. O'Reilly (Richard); R. Parkman (Robertson); D. Rawlings (D.); J.M. Routes (John); P. Shearer (P.); T.N. Small (Trudy); H. Smith (H.); K.E. Sullivan (Kathleen); P. Szabolcs (Paul); A.J. Thrasher (Adrian); D. Torgerson; P. Veys (Paul); K. Weinberg (Kenneth); J.C. Zuniga-Pflucker (Juan Carlos)

    2014-01-01

    textabstractThe Primary Immune Deficiency Treatment Consortium (PIDTC) is a network of 33 centers in North America that study the treatment of rare and severe primary immunodeficiency diseases. Current protocols address the natural history of patients treated for severe combined immunodeficiency

  14. Teaching Primary Science with Almost Nothing

    Science.gov (United States)

    Kelly, Lois; Schofield, Kathy

    2012-01-01

    In the summer of 2010 the authors spent two weeks helping teachers in a primary school near Kampala to develop their science curriculum. In common with many primary schools in Uganda science was taught as "facts to be learnt." This was partly because the teachers had had little or no first-hand experience of practical science or science…

  15. Teaching Primary Science: How Research Helps

    Science.gov (United States)

    Harlen, Wynne

    2010-01-01

    The very first edition of "Primary Science Review" included an article entitled "Teaching primary science--how research can help" (Harlen, 1986), which announced that a section of the journal would be for reports of research and particularly for teachers reporting their classroom research. The intervening 24 years have seen…

  16. Sensitivity to friction for primary explosives

    International Nuclear Information System (INIS)

    Matyáš, Robert; Šelešovský, Jakub; Musil, Tomáš

    2012-01-01

    Highlights: ► The friction sensitivity of 14 samples of primary explosives was determined. ► The same apparatus (small scale BAM) and the same method (probit analysis) was used. ► The crystal shapes and sizes were documented with microscopy. ► Almost all samples are less sensitive than lead azide, which is commercially used. ► The organic peroxides (TATP, DADP, HMTD) are not as sensitive as often reported. - Abstract: The sensitivity to friction for a selection of primary explosives has been studied using a small BAM friction apparatus. The probit analysis was used for the construction of a sensitivity curve for each primary explosive tested. Two groups of primary explosives were chosen for measurement (a) the most commonly used industrially produced primary explosives (e.g. lead azide, tetrazene, dinol, lead styphnate) and (b) the most produced improvised primary explosives (e.g. triacetone triperoxide, hexamethylenetriperoxide diamine, mercury fulminate, acetylides of heavy metals). A knowledge of friction sensitivity is very important for determining manipulation safety for primary explosives. All the primary explosives tested were carefully characterised (synthesis procedure, shape and size of crystals). The sensitivity curves obtained represent a unique set of data, which cannot be found anywhere else in the available literature.

  17. Sensitivity to friction for primary explosives

    Energy Technology Data Exchange (ETDEWEB)

    Matyas, Robert, E-mail: robert.matyas@upce.cz [Institute of Energetic Materials, Faculty of Chemical Technology, University of Pardubice, Pardubice 532 10 (Czech Republic); Selesovsky, Jakub; Musil, Tomas [Institute of Energetic Materials, Faculty of Chemical Technology, University of Pardubice, Pardubice 532 10 (Czech Republic)

    2012-04-30

    Highlights: Black-Right-Pointing-Pointer The friction sensitivity of 14 samples of primary explosives was determined. Black-Right-Pointing-Pointer The same apparatus (small scale BAM) and the same method (probit analysis) was used. Black-Right-Pointing-Pointer The crystal shapes and sizes were documented with microscopy. Black-Right-Pointing-Pointer Almost all samples are less sensitive than lead azide, which is commercially used. Black-Right-Pointing-Pointer The organic peroxides (TATP, DADP, HMTD) are not as sensitive as often reported. - Abstract: The sensitivity to friction for a selection of primary explosives has been studied using a small BAM friction apparatus. The probit analysis was used for the construction of a sensitivity curve for each primary explosive tested. Two groups of primary explosives were chosen for measurement (a) the most commonly used industrially produced primary explosives (e.g. lead azide, tetrazene, dinol, lead styphnate) and (b) the most produced improvised primary explosives (e.g. triacetone triperoxide, hexamethylenetriperoxide diamine, mercury fulminate, acetylides of heavy metals). A knowledge of friction sensitivity is very important for determining manipulation safety for primary explosives. All the primary explosives tested were carefully characterised (synthesis procedure, shape and size of crystals). The sensitivity curves obtained represent a unique set of data, which cannot be found anywhere else in the available literature.

  18. The relationship between primary school teachers extrinsic ...

    African Journals Online (AJOL)

    The study investigated the relationship between primary school teacher's extrinsic motivation and pupils' academic performance in Cross river State, Nigeria. Ex Post Facto research design was adopted for the study. The population of the study consisted of 17,221 teachers and 68,201 Primary Six Pupils in the three ...

  19. Problem Solving Strategies among Primary School Teachers

    Science.gov (United States)

    Yew, Wun Thiam; Lian, Lim Hooi; Meng, Chew Cheng

    2017-01-01

    The purpose of this article was to examine problem solving strategies among primary school teachers. The researchers employed survey research design to examine their problem solving strategies. The participants of this study consisted of 120 primary school teachers from a public university in Peninsula Malaysia who enrolled in a 4-year Graduating…

  20. Bile acids for primary sclerosing cholangitis

    DEFF Research Database (Denmark)

    Poropat, Goran; Giljaca, Vanja; Stimac, Davor

    2011-01-01

    Primary sclerosing cholangitis is a progressive chronic cholestatic liver disease that usually leads to the development of cirrhosis. Studies evaluating bile acids in the treatment of primary sclerosing cholangitis have shown a potential benefit of their use. However, no influence on patients...

  1. Primary Education and Dropout in Nepal

    Science.gov (United States)

    Devkota, Shree Prasad; Bagale, Shiba

    2015-01-01

    This article tries to highlight the dropout rate of primary education of Nepal. The main essence of the article is to explore the situation of dropout of primary education. There are several programs and policies to reduce the dropout, out of the school children and so on but still there are several issues that are left behind. Educational budget…

  2. Leading Change in the Primary Science Curriculum

    Science.gov (United States)

    Waller, Nicky; Baker, Chris

    2014-01-01

    Nicky Waller and Chris Baker believe that change can be a good thing and explain how their training has helped others to adjust to the new science curriculum. In September 2013, teachers across England received the definitive version of the new primary curriculum "Leading Change in the Primary Science Curriculum." This course aimed to…

  3. Distribution of nutrients, chlorophyll and phytoplankton primary ...

    African Journals Online (AJOL)

    Distribution of nutrients, chlorophyll and phytoplankton primary production in ... Two cruises were undertaken in the vicinity of the Cape Frio upwelling cell ... and concentrations of nitrate, phosphate, silicate, oxygen and chlorophyll a. ... Estimates of the annual primary production for each of the water bodies were calculated.

  4. Primary School Leadership Today and Tomorrow

    Science.gov (United States)

    Southworth, Geoff

    2008-01-01

    The article provides a retrospective and prospective view of primary school leadership. It begins with an analytic description of primary school leadership in the recent past. The second part looks at school leadership today, identifies contemporary issues and examines role continuities and changes. The third part looks at what the future might…

  5. Method for the production of primary amines

    NARCIS (Netherlands)

    Baldenius, Kai-Uwe; Ditrich, Klaus; Breurer, Michael; Navickas, Vaidotas; Janssen, Dick; Crismaru, Ciprian; Bartsch, Sebastian

    2014-01-01

    The present invention relates to a novel enzymatically catalyzed method for the production of aliphatic primary amines, which method comprises the enzymatic oxidation of a primary aliphatic alcohol catalyzed by an alcohol dehydrogenase, amination of the resulting oxocompound catalyzed by a

  6. Primary Science Quality Mark--2016 Update

    Science.gov (United States)

    Turner, Jane

    2016-01-01

    Back in May 2011, an article in "Primary Science" described how the idea for a quality mark for primary science was developed from an initial conversation at an Association for Science Education annual conference (Turner, Marshall and Elsmore, 2011). Its intention then, as now, was to support and champion good practice and raise the…

  7. Gender Preference in Primary School Enrolment among ...

    African Journals Online (AJOL)

    2017-05-01

    May 1, 2017 ... The benefits of equal enrolment and retention in primary schools cannot be underestimated for ... Gender Preference in Primary School Enrolment among Households in Northern Region, Ghana decisions ... is a major decision maker in issues of education (Akaguri, 2011; Al-Samarrai & Peasgood,. 1998).

  8. Information communication technology policy and public primary ...

    African Journals Online (AJOL)

    The main objective of this study was to correlate Information Communication Technology with public primary schools' efficiency in Rwanda. The study employed the descriptive survey and descriptive co-relational design. One hundred and forty-four primary teachers participated in the study. The level of ICT was poor (M ...

  9. 16 CFR 316.3 - Primary purpose.

    Science.gov (United States)

    2010-01-01

    ....3 Primary purpose. (a) In applying the term “commercial electronic mail message” defined in the CAN-SPAM Act, 15 U.S.C. 7702(2), the “primary purpose” of an electronic mail message shall be deemed to be... does not intend for these criteria to treat as a “commercial electronic mail message” anything that is...

  10. Suicidal ideation in German primary care

    NARCIS (Netherlands)

    Wiborg, J.F.; Gieseler, D.; Lowe, B.

    2013-01-01

    OBJECTIVE: To examine suicidal ideation in a sample of German primary care patients. METHODS: We conducted a cross-sectional study and included 1455 primary care patients who visited 1 of 41 general practitioners (GPs) working at 19 different sites. Suicidal ideation and psychopathology were

  11. Photodynamic therapy for multiple primary lung cancer

    International Nuclear Information System (INIS)

    Konaka, C.; Okunaka, T.; Sakai, H.; Furukawa, K.; Hayata, Y.; Kato, H.

    1992-01-01

    In recent years, multiple primary lung cancers have been reported with greater frequency. As for the treatment of multiple primary lung cancer, operative excision is usually difficult for all lesions due to problems of pulmonary function. PDT is a good therapeutic modality in the treatment of multiple primary lung cancer, especially central type lung cancer, for preservation of lung function. Since 1980, 50 patients of endoscopically-evaluated early stage lung cancers have been treated with PDT at Tokyo Medical College. Within this group, 16 patients were classified as having multiple primary lung cancers. This paper evaluates the effectiveness of PDT in the treatment of these patients with multiple primary bronchogenic carcinoma. (author). 6 refs., 2 tabs

  12. Bilateral primary adrenocortical carcinoma complicated by Addisonian crisis: case report

    International Nuclear Information System (INIS)

    Foster, M.; Nolan, R.L.; Hong, H.H.

    2001-01-01

    Primary adrenal carcinoma is a rare malignancy. Primary adrenal insufficiency (i.e. Addison's disease) is a rare complication of bilateral infiltration. We report a case of primary bilateral adrenal carcinoma complicated by an episode of primary adrenal insufficiency. (author)

  13. VHA Support Service Center Primary Care Management Module (PCMM)

    Data.gov (United States)

    Department of Veterans Affairs — The Primary Care Management Module (PCMM) was developed to assist VA facilities in implementing Primary Care. PCMM supports both Primary Care and non-Primary Care...

  14. HANPP Collection: Human Appropriation of Net Primary Productivity as a Percentage of Net Primary Productivity

    Data.gov (United States)

    National Aeronautics and Space Administration — The Human Appropriation of Net Primary Productivity (HANPP) as a Percentage of Net Primary Product (NPP) portion of the HANPP Collection represents a map identifying...

  15. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies

    2009-10-01

    Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  16. Integrated primary health care in Australia.

    Science.gov (United States)

    Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna

    2009-10-14

    To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  17. Interprofessional Competencies in Integrative Primary Healthcare

    Science.gov (United States)

    Brooks, Audrey J.; Maizes, Victoria; Goldblatt, Elizabeth; Klatt, Maryanna; Koithan, Mary S.; Kreitzer, Mary Jo; Lee, Jeannie K.; Lopez, Ana Marie; McClafferty, Hilary; Rhode, Robert; Sandvold, Irene; Saper, Robert; Taren, Douglas; Wells, Eden; Lebensohn, Patricia

    2015-01-01

    In October 2014, the National Center for Integrative Primary Healthcare (NCIPH) was launched as a collaboration between the University of Arizona Center for Integrative Medicine and the Academic Consortium for Integrative Health and Medicine and supported by a grant from the Health Resources and Services Administration. A primary goal of the NCIPH is to develop a core set of integrative healthcare (IH) competencies and educational programs that will span the interprofessional primary care training and practice spectra and ultimately become a required part of primary care education. This article reports on the first phase of the NCIPH effort, which focused on the development of a shared set of competencies in IH for primary care disciplines. The process of development, refinement, and adoption of 10 “meta-competencies” through a collaborative process involving a diverse interprofessional team is described. Team members represent nursing, the primary care medicine professions, pharmacy, public health, acupuncture, naturopathy, chiropractic, nutrition, and behavioral medicine. Examples of the discipline-specific sub-competencies being developed within each of the participating professions are provided, along with initial results of an assessment of potential barriers and facilitators of adoption within each discipline. The competencies presented here will form the basis of a 45-hour online curriculum produced by the NCIPH for use in primary care training programs that will be piloted in a wide range of programs in early 2016 and then revised for wider use over the following year. PMID:26421232

  18. Third sector primary care for vulnerable populations.

    Science.gov (United States)

    Crampton, P; Dowell, A; Woodward, A

    2001-12-01

    This paper aims to describe and explain the development of third sector primary care organisations in New Zealand. The third sector is the non-government, non-profit sector. International literature suggests that this sector fulfils an important role in democratic societies with market-based economies, providing services otherwise neglected by the government and private for-profit sectors. Third sector organisations provided a range of social services throughout New Zealand's colonial history. However, it was not until the 1980s that third sector organisations providing comprehensive primary medical and related services started having a significant presence in New Zealand. In 1994 a range of union health centres, tribally based Mäori health providers, and community-based primary care providers established a formal network -- Health Care Aotearoa. While not representing all third sector primary care providers in New Zealand, Health Care Aotearoa was the best-developed example of a grouping of third sector primary care organisations. Member organisations served populations that were largely non-European and lived in deprived areas, and tended to adopt population approaches to funding and provision of services. The development of Health Care Aotearoa has been consistent with international experience of third sector involvement -- there were perceived "failures" in government policies for funding primary care and private sector responses to these policies, resulting in lack of universal funding and provision of primary care and continuing patient co-payments. The principal policy implication concerns the role of the third sector in providing primary care services for vulnerable populations as a partial alternative to universal funding and provision of primary care. Such an alternative may be convenient for proponents of reduced state involvement in funding and provision of health care, but may not be desirable from the point of view of equity and social cohesion

  19. Primary lymphocytic lymphoma of lacrimal gland.

    Science.gov (United States)

    Romero-Caballero, M D; Lozano-García, I; Gómez-Molina, C; Gil-Liñán, A I; Arcas, I

    2017-02-01

    We report a case of primary small-cell lymphocytic lacrimal gland lymphoma in a male diagnosed with primary antiphospholipid syndrome. These rare lymphomas are usually presented in the clinic as disseminations secondary to chronic lymphocytic leukaemia, and the primary site is rare in the orbit. Non-Hodgkin lymphomas are a heterogeneous group of tumours. Although treatment in the IE stage is usually radiotherapy, due to its association with antiphospholipid syndrome, systemic treatment with rituximab was administered. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Aging mourning doves by outer primary wear

    Science.gov (United States)

    Wight, H.M.; Blankenship, L.H.; Tomlinson, R.E.

    1967-01-01

    Many immature mourning doves (Zenaidura macroura) cannot be aged by the conventional white-tipped primary covert method if molt has proceeded beyond the 7th primary. A new method of aging doves in this group is based on the presence (immature) or absence (adult) of a buff-colored fringe on the tips of the 9th and 10th primaries. Experienced biologists were nearly 100 percent accurate in aging wings of 100 known-age doves from eastern and midwestern states. The technique is not as reliable for doves from southwestern United States because of added feather wear, apparently from harsh vegetative and soil conditions.

  1. Renal involvement in primary antiphospholipid syndrome.

    Science.gov (United States)

    Marcantoni, Carmelita; Emmanuele, Carmela; Scolari, Francesco

    2016-08-01

    Antiphospholipid syndrome is an autoimmune disorder characterized by recurrent venous or arterial thrombosis and/or pregnancy-related problems associated with persistently elevated levels of antiphospholipid antibodies. The kidney is a major target organ in both primary and secondary antiphospholipid syndrome. This review describes several aspects of the renal involvement in the primary form of the syndrome, in particular the histological pattern of the so-called antiphospholipid syndrome nephropathy (APSN). APSN is a vascular nephropathy characterized by small vessel vaso-occlusive lesions associated with fibrous intimal hyperplasia of interlobular arteries, recanalizing thrombi in arteries and arterioles, and focal atrophy, a constellation of morphological lesions suggestive of primary antiphospholipid syndrome.

  2. Etiological evaluation of primary congenital hypothyroidism cases.

    Science.gov (United States)

    Bezen, Diğdem; Dilek, Emine; Torun, Neşe; Tütüncüler, Filiz

    2017-06-01

    Primary congenital hypothyroidism is frequently seen endocrine disorder and one of the preventable cause of mental retardation. Aim of study was to evaluate the frequency of permanent/transient hypothyrodism, and to detect underlying reason to identfy any marker which carries potential to discriminate permanent/transient form. Forty eight cases older than 3 years of age, diagnosed as primary congenital hypothyroidism and started thyroxin therapy in newborn-period, and followed up between January 2007-June 2013 were included in the study. Thyroid hormon levels were evaluated and thyroid ultrasonography was performed in cases who are at the end of their 3 years of age, after 6 weeks of thyroxine free period. Thyroid sintigraphy was performed if serum thyroid-stimulating hormone was high (≥ 5 mIU/mL) and perchlorate discharge test was performed if uptake was normal or increased on sintigraphy. Cases with thyroid-stimulating hormone levels ≥ 5 mIU/mL were defined as permanent primary congenital hypothyroidism group and as transient primary congenital hypothyroidism group with normal thyroid hormones during 6 months. The mean age was 3.8±0.7 years. Mean diagnosis age was 16.6±6.5 days and 14 cases (29.2%) were diagnosed by screening program of Ministry of Health. There were 23 cases (14F, 9M) in permanent primary congenital hypothyroidism group and 12 (52.2%) of them were dysgenesis (8 hypoplasia, 4 ectopia), and 11 (47.8%) dyshormonogenesis. In transient primary congenital hypothyroidism group, there were 25 cases (17M, 8F). The mean thyroid-stimulating hormone levels at diagnosis were similar in two groups. The mean thyroxin dose in permanent primary congenital hypothyroidism group was significantly higher than transient group at the time of thyroxin cessation (2.1±0.7, 1.5±0.5 mg/kg/d, respectively, p=0.004). Thyroxin dose ≥1.6 mcg/kg/d was 72% sensitive and 69.6% specific for predicting permenant primary congenital hypothyroidism. Transient primary

  3. Primary Mural Endocarditis Without Valvular Involvement.

    Science.gov (United States)

    Tahara, Mai; Nagai, Tomoo; Takase, Yoshiyuki; Takiguchi, Shunichi; Tanaka, Yoshiaki; Kunihara, Takashi; Arakawa, Junko; Nakaya, Kazuhiro; Hamabe, Akira; Gatate, Youdou; Kujiraoka, Takehiko; Tabata, Hirotsugu; Katsushika, Shuichi

    2017-03-01

    Primary mural endocarditis is an extremely rare infection in which nonvalvular endocardial involvement is seen without any cardiac structural abnormalities such as ventricular septal defects. The rapid and precise diagnosis of this disease remains challenging. We present 2 cases (67- and 47-year-old male patients) of pathologically confirmed primary mural endocarditis that could have been detected by initial transthoracic echocardiography in the emergency department. Transthoracic echocardiography and transesophageal echocardiography play critical roles in the early recognition and confirmation of primary mural endocarditis. © 2017 by the American Institute of Ultrasound in Medicine.

  4. Brown tumor of mandible with primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Ali, S.K.; Khan, F.A.; Siddiq, A.; Hanif, M.S.

    2011-01-01

    Parathyroid hormone (PTH) is secreted and released by the parathyroid glands, the activity of which is controlled by the ionized serum calcium level. Increased PTH secretion results in hyperparathyroidism. Hyperparathyroidism is classified as primary, secondary and tertiary types. Primary hyperparathyroidism is characterized by increased parathyroid hormone secretion occurring as a result of abnormality in one or more of the parathyroid glands. Brown tumors are non-neoplastic lesions as a result of abnormal bone metabolism in cases of hyperparathyroidism, creating a local destructive phenomenon. A rare case of a young female patient with brown tumors in her mandible associated with primary hyperparathyroidism, is reported. (author)

  5. Single stage bilateral uniportal videothoracoscopic sympathicotomy for hyperhidrosis: can it be managed as an outpatient procedure?

    Directory of Open Access Journals (Sweden)

    Ahmet Demirkaya

    2016-05-01

    Full Text Available Introduction : The videothoracoscopic approach is minimally invasive with benefits that include less postoperative pain and shorter hospital stay. It is also a safe procedure which can be performed on an outpatient basis. Aim: To determine whether videothoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure. Material and methods: Between July 2005 and October 2015, a total of 92 patients underwent bilateral and single port thoracoscopic sympathicotomy in our department on an outpatient basis. The level of sympathicotomy was T2 in 2 (2.2% patients, T2 to T3 in 31 (33% patients, T2 to T4 in 46 (50% patients and T3 to T4 in 12 (13% patients. Demographic data, length of postoperative stay, substitution index (SI, admission rate (AR and readmission rate (RR, complications and patient satisfaction were reviewed retrospectively. Results: Two (2.2% patients suffered from chest pain, while 4 (4.3% patients complained about pain at the port site. Mean discharge time after surgery was 5.1 h (range: 4–6 h, mean duration of hospital stay was 0.15 days (0–3 days postoperatively and the mean operation time was 43.6 min (15–130 min. In 8 (8.6% patients, pneumothorax was detected on postoperative chest X-ray, while 5 (5.4% patients required chest tube drainage. Mild or moderate compensatory sweating developed in 32 (34.7% patients. No recurrence was observed, and the satisfaction rate was 96.7%. Substitution index and admission rate were 91.3% and 11% respectively, while RR was 0%. Conclusions : Bilateral video-assisted thoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure.

  6. Inferior limbal conjunctival autografting in primary pterygium

    Directory of Open Access Journals (Sweden)

    Farouk M Othman

    2015-01-01

    In patients with primary pterygium, conjunctival limbal autografting from the lower bulbar conjunctiva is an effective technique with a low recurrence rate. It can be a suitable treatment for glaucomatous patients with pterygium to leave the upper bulbar conjunctiva untouched.

  7. Primary xanthoma of calcaneus bone: Case report

    Directory of Open Access Journals (Sweden)

    Ghalib Ahmed

    2014-01-01

    CONCLUSION: We present this case to raise the suspicion of this lesion that is rarely described in the literatures. This is the first case of primary xanthoma of calcaneus bone that has been reported in Qatar.

  8. Factors influencing the prevalence of primary dysmenorrhoea ...

    African Journals Online (AJOL)

    ... of primary dysmenorrhoea amongst Abia State university medical students, South ... its impact on school and social activities and the students' management strategies. ... is high, and not consistently associated with demographic risk factors.

  9. Political Broadcast Advertising and Primary Election Voting

    Science.gov (United States)

    Wanat, John

    1974-01-01

    Results of a research project which hypothisized that: Other things being equal, the heavier a candidate's usage of broadcast advertising in a primary election campaign, the greater will be his share of the votes in the election. (Author/HB)

  10. primary prevention of mental, neurological and psychosocial

    African Journals Online (AJOL)

    92-4-. 154516X. This well written book addresses the primary prevention of ... a broad, public health perspective. ... suicide include gun control, gas detoxification and responsible ... It will be most useful for policy makers, and professionals and.

  11. Primary effluent filtration for coastal discharges

    Energy Technology Data Exchange (ETDEWEB)

    Cooper-Smith, G.D. [Yorkshire Water Services, Huddersfield (United Kingdom); Rundle, H. [The Capital Controls Group, Nottingham (United Kingdom)

    1998-12-31

    The use of a Tetra Deep Bed filter demonstration unit to treat primary effluent (Primary Effluent Filtration, PEF) was investigated. PEF proved capable of achieving the UWWTD primary standard, even when the primary stage performs poorly, but is not a cost-effective alternative to chemically assisted settlement. Results demonstrated that using a 1.5 to 2.2 mm grade medium, a filtration rate of 5 m/h, three backwashes a day and dosing 40 mg/l of PAXXL60 (a polyaluminium silicte) an average effluent quality of 20 mg/l BOD and 15 mgl/l total solid could be achieved. UV disinfection produced an effluent which complied with the Bathing Water Directive imperative requirement. A high enterovirus kill was also achieved. However, considerable additional work would be required before PEF could be considered suitable for full-scale applications. (orig.)

  12. Six elements of integrated primary healthcare.

    Science.gov (United States)

    Brown, Lynsey J; Oliver-Baxter, Jodie

    2016-03-01

    Integrated care has the potential to deliver efficiencies and improvements in patient experiences and health outcomes. Efforts towards integrated care, especially at the primary and community health levels, have increasingly been under focus, both nationally and internationally. In Australia, regional integration is a priority, and integration of care is a task for meso-level organisations such as Primary Health Networks (PHNs). This paper seeks to provide a list of elements and questions for consideration by organisations working across primary healthcare settings, looking to enact and improve the delivery of integrated care. Six elements that consistently emerged during the development of a series of rapid reviews on integrated primary healthcare in Australia are presented in this paper. The elements identified are context, governance and leadership, infrastructure, financing, engagement, and communication. They offer a starting point for reflection in the planning and practices of organisations in their drive for continuous improvements in integrated care.

  13. Rotary endodontics in primary teeth - A review.

    Science.gov (United States)

    George, Sageena; Anandaraj, S; Issac, Jyoti S; John, Sheen A; Harris, Anoop

    2016-01-01

    Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the "gold-standard" over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel-titanium (Ni-Ti) rotary files have been developed for use in pediatric endodontics. Using rotary instruments for primary tooth pulpectomies is cost effective and results in fills that are consistently uniform and predictable. This article reviews the use of nickel-titanium rotary files as root canal instrumentation in primary teeth. The pulpectomy technique is described here according to different authors and the advantages and disadvantages of using rotary files are discussed.

  14. Multiple Primary Cancers: Simultaneously Occurring Prostate ...

    African Journals Online (AJOL)

    2016-05-20

    May 20, 2016 ... occurring prostate cancer and other primary tumors-our experience and literature ..... thyroid cancers, pancreatic tumors, renal cancers, and melanoma. ... Hsing AW, Yeboah E, Biritwum R, Tettey Y, De Marzo AM,. Adjei A, et ...

  15. Attention Deficit Disorder (ADHD): Primary school teachers ...

    African Journals Online (AJOL)

    Hennie

    The participants were 200 South African primary school teachers (178 female, 22 male; mean age = 43 years) of children enrolled in ... education reforms would be the training of teachers in classroom management. ..... Assistive technology.

  16. EJSCREEN Version 1, Primary EJ Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — The primary EJ index measures how much a particular place contributes to overall nationwide differences in environmental indicator values between demographic groups....

  17. Primary renal osteosarcoma: A case report

    African Journals Online (AJOL)

    C. Ahomadégbé

    Primitive renal osteosarcoma is a rare sarcoma of the kidney with only 27 cases reported in the literature. Its histogenesis .... low-grade extraskeletal osteosarcoma. Skeletal ... et al. Primary Ewing's sarcoma/primitive neuroectodermal tumor of.

  18. Primary ventral or groin hernia in pregnancy

    DEFF Research Database (Denmark)

    Oma, E; Bay-Nielsen, M; Jensen, K K

    2017-01-01

    BACKGROUND: Prevalence, management, and risk of emergency operation for primary ventral or groin hernia in pregnancy are unknown. The objective of this study was to estimate the prevalences of primary ventral or groin hernia in pregnancy and the potential risks for elective and emergency repair...... was conducted to identify patients registered with a primary ventral or groin hernia in pregnancy. Follow-up was conducted by review of medical record notes within the Capital Region of Denmark supplemented with structured telephone interviews on indication. RESULTS: In total, 20,714 pregnant women were...... included in the study cohort. Seventeen (0.08%) and 25 (0.12%) women were registered with a primary ventral and groin hernia, respectively. None underwent elective or emergency repair in pregnancy, and all had uncomplicated childbirth. In 10 women, the groin bulge disappeared spontaneously after delivery...

  19. Bisphosphonates for osteoporosis in primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena; Giljaca, Vanja; Krstic, Miodrag N

    2011-01-01

    Bisphosphonates are widely used for treatment of postmenopausal osteoporosis. Patients with primary biliary cirrhosis often have osteoporosis - either postmenopausal or secondary to the liver disease. No systematic review or meta-analysis has assessed the effects of bisphosphonates for osteoporosis...

  20. Primary Sjogren's syndrome associated with inappropriate ...

    African Journals Online (AJOL)

    A patient in whom primary Sjogren's syndrome and inappropriate antiduretic hormone secretion were associated is reported. This is the first report of such an association. The possible pathophysiological mechanisms are discussed and vasculitis proposed as the underlying pathogenetic mechanism.

  1. Strengthening primary healthcare through community involvement in ...

    African Journals Online (AJOL)

    Strengthening primary healthcare through community involvement in Cross River State, Nigeria: a descriptive study. Hilary Adie, Thomas Igbang, Akaninyene Otu, Ekanem Braide, Okpok Okon, Edet Ikpi, Charles Joseph, Alexander Desousa, Johannes Sommerfeld ...

  2. Neurostimulation therapies for primary headache disorders

    DEFF Research Database (Denmark)

    Magis, Delphine; Jensen, Rigmor; Schoenen, Jean

    2012-01-01

    Most pharmacological treatments of primary headache disorders are partially effective and have cumbersome side effects. Therapies with better efficacy and tolerance are needed. Neurostimulation techniques may have this potential. This is an attempt to summarize the latest clinical trial results...

  3. Dentin Permeability of Carious Primary Teeth

    African Journals Online (AJOL)

    primary dental pulp make it difficult to determine which modality offers the best ... The most common pathology of the dentine is dental caries. ... to evaluate dentine permeability is to calculate its hydraulic conductance (Lp) using fluid filtration ...

  4. Primary small bowel anastomosis in generalised peritonitis

    NARCIS (Netherlands)

    deGraaf, JS; van Goor, Harry; Bleichrodt, RP

    Objective: To find out if primary small bowel anastomosis of the bowel is safe in patients with generalised peritonitis who are treated by planned relaparotomies. Design: Retrospective study. Setting: University hospital, The Netherlands. Subjects. 10 Patients with generalised purulent peritonitis

  5. Primary Cilia, Signaling Networks and Cell Migration

    DEFF Research Database (Denmark)

    Veland, Iben Rønn

    Primary cilia are microtubule-based, sensory organelles that emerge from the centrosomal mother centriole to project from the surface of most quiescent cells in the human body. Ciliary entry is a tightly controlled process, involving diffusion barriers and gating complexes that maintain a unique...... this controls directional cell migration as a physiological response. The ciliary pocket is a membrane invagination with elevated activity of clathrin-dependent endocytosis (CDE). In paper I, we show that the primary cilium regulates TGF-β signaling and the ciliary pocket is a compartment for CDE...... on formation of the primary cilium and CDE at the pocket region. The ciliary protein Inversin functions as a molecular switch between canonical and non-canonical Wnt signaling. In paper II, we show that Inversin and the primary cilium control Wnt signaling and are required for polarization and cell migration...

  6. Primary coolant circuits in FBR type reactors

    International Nuclear Information System (INIS)

    Kutani, Masushiro.

    1985-01-01

    Purpose: To eliminate the requirement of a pump for the forcive circulation of primary coolants and avoid the manufacturing difficulty of equipments. Constitution: In primary coolant circuits of an LMFBR type reactor having a recycling path forming a closed loop between a reactor core and a heat exchanger, coolants recycled through the recycling path are made of a magnetic fluid comprising liquid sodium incorporated with fine magnetic powder, and an electromagnet is disposed to the downstream of the heat exchanger. In the above-mentioned structure, since the magnetic fluid as the primary coolants losses its magnetic property when heated in the reactor core but recovers the property at a lower temperature after the completion of the heat exchange, the magnetic fluid can forcively be flown through the recycling path under the effect of the electromagnet disposed to the down stream of the heat exchanger to thereby forcively recycle the primary coolants. (Kawakami, Y.)

  7. Primary photosynthetic processes: from supercomplex to leaf

    NARCIS (Netherlands)

    Broess, K.

    2009-01-01

    This thesis describes fluorescence spectroscopy experiments on photosynthetic complexes that cover the primary photosynthetic processes, from the absorption of light by photosynthetic pigments to a charge separation (CS) in the reaction center (RC). Fluorescence spectroscopy is a useful tool in

  8. FFTBM and primary pressure acceptance criterion

    International Nuclear Information System (INIS)

    Prosek, A.

    2004-01-01

    When thermalhydraulic computer codes are used for simulation in the area of nuclear engineering the question is how to conduct an objective comparison between the code calculation and measured data. To answer this the fast Fourier transform based method (FFTBM) was developed. When the FFTBM method was developed the acceptance criteria for primary pressure and total accuracy were set. In the recent study the FFTBM method was used for accuracy quantification of RD-14M large LOCA test B9401 calculations. The blind accuracy analysis indicated good total accuracy while the primary pressure criterion was not fulfilled. The objective of the study was therefore to investigate the reasons for not fulfilling the primary pressure acceptance criterion and the applicability of the criterion to experimental facilities simulating heavy water reactor. The results of the open quantitative analysis showed that sensitivity analysis for influence parameters provide sufficient information to judge in which calculation the accuracy of primary pressure is acceptable. (author)

  9. Gender Preference in Primary School Enrolment among ...

    African Journals Online (AJOL)

    Gender Preference in Primary School Enrolment among Households in Northern ... Narrowing and eliminating enrolment gaps between male and female ... that income level of the household head, number of male and female children of ...

  10. Temperature sensing by primary roots of maize

    Science.gov (United States)

    Poff, K. L.

    1990-01-01

    Zea mays L. seedlings, grown on agar plates at 26 degrees C, reoriented the original vertical direction of their primary root when exposed to a thermal gradient applied perpendicular to the gravity vector. The magnitude and direction of curvature can not be explained simply by either a temperature or a humidity effect on root elongation. It is concluded that primary roots of maize sense temperature gradients in addition to sensing the gravitational force.

  11. Primary urachal adenocarcinoma: A case report

    Directory of Open Access Journals (Sweden)

    I. Ziouziou

    2014-06-01

    Full Text Available Primary urachal adenocarcinoma is an aggressive rare cancer that often presents at advanced stages with poor prognosis. We report this case of a 52-year-old patient with a stage-I (Mayo Clinic primary urachal adenocarcinoma with good outcomes after surgery in a 2-year follow-up period. We analyze epidemiological, clinical and therapeutic features of this disease in the literature review.

  12. Primary vertex reconstruction with the ATLAS detector

    International Nuclear Information System (INIS)

    Meloni, F.

    2016-01-01

    Efficient and precise reconstruction of the primary vertex in a LHC collision is essential for determining the full kinematic properties of a hard-scatter event and of soft interactions as a measure of the amount of pile-up. The reconstruction of primary vertices in the busy, high pile-up environment of Run-2 of the LHC is a challenging task. The algorithms developed by the ATLAS experiments to reconstruct multiple vertices with small spatial separation are presented.

  13. Primary hemangiopericytoma of the lung: Case report

    International Nuclear Information System (INIS)

    Seong, Hyun Lim; Yang, Jae Beom; Park, Chan Sup; Park, Yang Hee; Lee, Sang Seun

    1990-01-01

    Hemangiopericytoma may occur at any age and can arise in almost any part of the body, but seldom in the lung. Since the first report by Stout, around fifty cases of primary hemangiopericytoma of the lung have been reported in English literature journal up to 1987. We report a case of primary pulmonary hemangiopericytoma in a 19 year old man which manifest as a solitary nodule

  14. Modes of failures: primary and secondary stresses

    International Nuclear Information System (INIS)

    Roche, R.L.

    1987-07-01

    The paper begins with a reminder that the purpose of stress classification is to ensure suitable margins with respect to failure modes. The distinction between primary stresses and secondary stresses is then examined and a method is given for assessing the degree of elastic follow up in the elastic plastic field. The importance of elastic follow up is then highlighted by an examination of the effect of primary and secondary stresses on crack behavior

  15. Primary periosteal lymphoma - rare and unusual

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, Ibrahim F. [Coney Island Hospital, Department of Radiology, New York, NY (United States); Hoch, Benjamin [Mount Sinai School of Medicine, CUNY, Department of Pathology, New York, NY (United States); Hermann, George [Mount Sinai School of Medicine, CUNY, Department of Radiology, New York, NY (United States); Bianchi, Stefano [Clinique et Fondation des Grangettes, Geneva (Switzerland); Klein, Michael J. [UAB School of Medicine, Department of Pathology, Birmingham, AL (United States); Springfield, Dempsey S. [Mount Sinai School of Medicine, CUNY, Department of Orthopedics, New York, NY (United States)

    2007-04-15

    We describe a primary periosteal lymphoma that involved only the periosteum without affecting the adjacent medulla or the regional lymph nodes. No other lymphomatous foci were found in either the distant lymph nodes or viscera. This unusual presentation simulates the imaging appearance of surface lesions of bone, namely benign and malignant tumors, and departs from the typical appearance of primary lymphoma of bone. Therefore, this rare type of lymphoma should be considered in the differential diagnosis of surface bone lesions. (orig.)

  16. Primary clear cell sarcoma of bone

    International Nuclear Information System (INIS)

    Choi, J.H.; Gu, M.J.; Kim, M.J.; Bae, Y.K.; Choi, W.H.; Shin, D.S.; Cho, K.H.

    2003-01-01

    Clear cell sarcoma is a rare soft tissue sarcoma of young adults with melanocytic differentiation. It occurs predominantly in the soft tissue of extremities, typically involving tendons and aponeuroses. Primary clear cell sarcoma of bone is extremely rare. We report a case of primary clear cell sarcoma of the right first metatarsal in a 48-year-old woman and provide a literature review of the entity. (orig.)

  17. Percutaneous drainage treatment of primary liver abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Berger, H.; Pratschke, E.; Berr, F.; Fink, U.

    1989-02-01

    28 primary liver abscesses, including 9 amoebic abscesses, in 24 patients were drained percutaneously. Indication for drainage in amoebic abscesses was imminent rupture and clinical symptoms as pleural effusion, lung atelectasis and pain. 95% of the primary abscesses were cured by percutaneous drainage and systemic antibiotic treatment. There was one recurrence of abscess, which was managed surgically. Reasons for drainage failure were: tumour necrosis and tumour perforation with secondary liver abscess.

  18. Percutaneous drainage treatment of primary liver abscesses

    International Nuclear Information System (INIS)

    Berger, H.; Pratschke, E.; Berr, F.; Fink, U.; Klinikum Grosshadern, Muenchen; Klinikum Grosshadern, Muenchen

    1989-01-01

    28 primary liver abscesses, including 9 amoebic abscesses, in 24 patients were drained percutaneously. Indication for drainage in amoebic abscesses was imminent rupture and clinical symptoms as pleural effusion, lung atelectasis and pain. 95% of the primary abscesses were cured by percutaneous drainage and systemic antibiotic treatment. There was one recurrence of abscess, which was managed surgically. Reasons for drainage failure were: tumour necrosis and tumour perforation with secondary liver abscess. (orig.) [de

  19. Do school inspections improve primary school performance?

    OpenAIRE

    Dinand Webbink; Rob Luginbuhl; I. de Wolf

    2007-01-01

    Inspectors from the Dutch Inspectorate of Education inspect primary schools, write inspection reports on each inspected school, and make recommendations as to how each school can improve. We test whether these inspections result in better school performance. Using a fixed-effects model, we find evidence that school inspections do lead to measurably better school performance. Our assessment of school performance is based on the Cito test scores of pupils in their final year of primary school. ...

  20. Dsm-iv hypochondriasis in primary care

    OpenAIRE

    Escobar, JI; Gara, M; Waitzkin, H; Silver, RC; Holman, A; Compton, W

    1998-01-01

    The object of this study was to assess the prevalence and correlates of the DSM-IV diagnosis of hypochondriasis in a primary care setting. A large sample (N = 1456) of primary care users was given a structured interview to make diagnoses of mood, anxiety, and somatoform disorders and estimate levels of disability. The prevalence of hypochondriasis (DSM-IV) was about 3%. Patients with this disorder had higher levels of medically unexplained symptoms (abridged somatization) and were more impair...