About signs and symptoms: can semiotics expand the view of clinical medicine?

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Nessa, J

1996-12-01

Semiotics, the theory of sign and meaning, may help physicians complement the project of interpreting signs and symptoms into diagnoses. A sign stands for something. We communicate indirectly through signs, and make sense of our world by interpreting signs into meaning. Thus, through association and inference, we transform flowers into love, Othello into jealousy, and chest pain into heart attack. Medical semiotics is part of general semiotics, which means the study of life of signs within society. With special reference to a case story, elements from general semiotics, together with two theoreticians of equal importance, the Swiss linguist Ferdinand de Saussure and the American logician Charles Sanders Peirce, are presented. Two different modes of understanding clinical medicine are contrasted to illustrate the external link between what we believe or suggest, on the one hand, and the external reality on the other hand.

Clinical relevance of routinely measured vital signs in hospitalized patients: a systematic review

NARCIS (Netherlands)

Storm-Versloot, Marja N.; Verweij, Lotte; Lucas, Cees; Ludikhuize, Jeroen; Goslings, J. Carel; Legemate, Dink A.; Vermeulen, Hester

2014-01-01

Conflicting evidence exists on the effectiveness of routinely measured vital signs on the early detection of increased probability of adverse events. To assess the clinical relevance of routinely measured vital signs in medically and surgically hospitalized patients through a systematic review.

Radiation stress relieving of polymer articles

International Nuclear Information System (INIS)

Frisch, D.C.; Weber, W.

1982-01-01

A method of rapidly relieving stress in an extruded or molded polymer article is disclosed. The method can be used in the preparation of printed circuit boards. An article comprised of the polymer is exposed to electromagnetic radiation, for a time period sufficient to absorb enough energy to stress relieve the polymer against stress cracking therein. Exposure occurs at one or more ranges of frequencies which are capable of being absorbed by the polymer and which are effective for stress relieving without or substantially without causing heat induced softening or flowing of the polymer. The electromagnetic radiation is selected from the ranges of infrared, microwave or ultraviolet radiation

Inversion Therapy: Can It Relieve Back Pain?

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Inversion therapy: Can it relieve back pain? Does inversion therapy relieve back pain? Is it safe? Answers from Edward R. Laskowski, M.D. Inversion therapy doesn't provide lasting relief from back ...

Clinical Signs, Staphylococcus and Atopic Eczema-Related Seromarkers

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Kam Lun Hon

2017-02-01

Full Text Available Childhood eczema or atopic dermatitis (AD is a distressing disease associated with pruritus, sleep disturbance, impaired quality of life and Staphylococcus aureus isolation. The pathophysiology of AD is complex and various seromarkers of immunity are involved. We investigated if anti-staphylococcal enterotoxin IgE (anti-SE, selected seromarkers of T regulatory (Treg, T helper (Th and antigen-presenting cells (APC are associated with clinical signs of disease severity and quality of life. Disease severity was assessed with the Scoring Atopic Dermatitis (SCORAD index, and quality of life with the Children’s Dermatology Life Quality Index (CDLQI in AD patients ≤18 years old. Concentrations of anti-staphylococcus enterotoxin A and B immunoglobulin E (anti-SEA and anti-SEB, selected Treg/Th/APC chemokines, skin hydration and transepidermal water loss (TEWL were measured in these patients. Forty patients with AD [median (interquartile range age of 13.1 (7.9 years were recruited. Backward stepwise linear regression (controlling for age, personal allergic rhinitis and asthma, and other blood markers showed the serum anti-SEB level was positively associated with S. aureus and S. epidermidis isolations, objective SCORAD, clinical signs and CDLQI. TNF-α (a Th1 cytokine was positively associated with objective SCORAD (B = 4.935, p = 0.010, TGF-β (a Treg cytokine negatively with disease extent (B = −0.015, p = 0.001, IL-18 (an APC cytokine positively with disease extent (B = 0.438, p = 0.001 and with TEWL (B = 0.040, p = 0.010, and IL-23 (an APC cytokine negatively with disease extent (B = −2.812, p = 0.006 and positively with pruritus (B = 0.387, p = 0.007. Conclusions: Blood levels of anti-SEB, Th1, Treg and APC cytokines are correlated with various clinical signs of AD. AD is a systemic immunologic disease involving Staphylococcus aureus, cellular, humoral, cytokine and chemokine pathophysiology.

The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials.

Science.gov (United States)

Schmitt, Jochen; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric; Furue, Masutaka; Deckert, Stefanie; Dohil, Magdalene; Apfelbacher, Christian; Singh, Jasvinder A; Chalmers, Joanne; Williams, Hywel C

2014-10-01

The lack of core outcome sets for atopic eczema (AE) is a major obstacle for advancing evidence-based treatment. The global Harmonising Outcome Measures for Eczema (HOME) initiative has already defined clinical signs, symptoms, quality of life, and long-term control of flares as core outcome domains for AE trials. This article deals with the standardization of measurement instruments to assess clinical signs of AE. To resolve the current lack of standardization of the assessment of clinical signs of AE, we followed a structured process of systematic reviews and international consensus sessions to identify 1 core outcome measurement instrument for assessment of clinical signs in all future AE trials. Systematic reviews indicated that from 16 different instruments identified to assess clinical signs of AE, only the Eczema Area and Severity Index (EASI) and the objective Scoring Atopic Dermatitis (SCORAD) index were identified as extensively validated. The EASI has adequate validity, responsiveness, internal consistency, and intraobserver reliability. The objective SCORAD index has adequate validity, responsiveness, and interobserver reliability but unclear intraobserver reliability to measure clinical signs of AE. In an international consensus study, patients, physicians, nurses, methodologists, and pharmaceutical industry representatives agreed that the EASI is the preferred core instrument to measure clinical signs in all future AE trials. All stakeholders involved in designing, reporting, and using clinical trials on AE are asked to comply with this consensus to enable better evidence-based decision making, clearer scientific communication, and improved patient care. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Clinical and forensic signs related to opioids abuse.

Science.gov (United States)

Dinis-Oliveira, Ricardo Jorge; Carvalho, Felix; Moreira, Roxana; Duarte, Jose Alberto; Proenca, Jorge Brandao; Santos, Agostinho; Magalhaes, Teresa

2012-12-01

For a good performance in Clinical and Forensic Toxicology it is important to be aware of the biological and non-biological signs and symptoms related to xenobiotic exposure. This manuscript highlights and analyzes clinical and forensic imaging related to opioids abuse critically. Particularly, respiratory depression, track marks and hemorrhages, skin "popping", practices of phlebotomy, tissue necrosis and ulceration, dermatitis, tongue hyperpigmentation, "coma blisters", intra-arterial administration, candidiasis, wounds associated with anthrax or clostridium contaminated heroin, desomorphine related lesions and characteristic non-biological evidences are some commonly reported findings in opioids abuse, which will be discussed. For this purpose, clinical and forensic cases from our database (National Institute of Legal Medicine and Forensic Sciences, North Branch, Portugal), in addition to literature data, are reviewed.

Clinical validation study of the SignCare Vital Signs Monitor of Fundación Cardiovascular de Colombia

Directory of Open Access Journals (Sweden)

Leonardo Andrés Rodríguez-Salazar

2016-07-01

Conclusions: The SignCare device is as reliable as the commercial monitor in the qualitative detection of morphologic alterations of electrocardiogram records, as well as in breathing, temperature, oxygen saturation and blood pressure parameters, which makes it recommendable for clinical use in adult population.

[Development of cough-relieving herbal teas].

Science.gov (United States)

Puodziūniene, Gene; Janulis, Valdimaras; Milasius, Arvydas; Budnikas, Vytautas

2005-01-01

Cough-relieving medicinal herbs in tea are used from ancient times. Mucilage present in them or secretion produced under the influence of the active substances covers the oral and throat mucosa soothing its irritability and relieving dry, tiresome cough. It is known that the mixtures of medicinal herbs (Specias) have a complex influence on the human organism and the rational combination of medicinal herbs can improve their curative action and decrease the undesirable side effects. Having summarized the properties of those medicinal herbs we decided to create two formulations of cough-relieving herbal tea. The first formulation consists of marshmallow roots, liquorice roots and lime flowers, the second -- of marshmallow roots, Iceland moss and lime flowers. The methods for identification and assay of the active substances in the compounds were applied. The purity of the mixtures was regulated by limitation of the loss on drying, total ash, microbial contamination, contamination with radionuclides, heavy metals, pesticides and foreign matter. The expiry date of both cough-relieving herbal teas was approved to be 2 years.

Precipitating and relieving factors of migraine versus tension type headache

Directory of Open Access Journals (Sweden)

Haque Badrul

2012-08-01

Full Text Available Abstract Background To determine the differences of precipitating and relieving factors between migraine and tension type headache. Methods This is a cross sectional study. We retrospectively reviewed the records of 250 migraine patients and 250 patients diagnosed as tension type headache from the specialized headache clinic in Dept. of Neurology, Dhaka Medical College Hospital. Data were collected through a predesigned questionnaire containing information on age, sex, social status and a predetermined list of precipitating and relieving factors. Results In this study, the female patients predominated (67%. Most of the patients were within 21–30 years age group (58.6%. About 58% of them belonged to middle class families. The common precipitating factors like stress, anxiety, activity, journey, reading, cold and warm were well distributed among both the migraine and tension type headache (TTH patients. But significant difference was demonstrated for fatigue (p  Conclusion The most frequent precipitating factors for headache appear to be identical for both migraine and TTH patients. Even though some factors like fatigue, sleep deprivation, sunlight and food significantly precipitate migraine and drug, massage are effective maneuver for relieving pain among migrianeurs.

Clinical signs and outcome of dogs treated medically for degenerative lumbosacral stenosis: 98 cases (2004-2012).

Science.gov (United States)

De Decker, Steven; Wawrzenski, Lauren A; Volk, Holger A

2014-08-15

To compare clinical signs of dogs treated medically or surgically for degenerative lumbosacral stenosis (DLSS) and assess outcome after medical treatment. Retrospective case series. Client-owned dogs treated medically (n = 49) or surgically (49) for DLSS. Medical records from 2004 to 2012 were reviewed. Dogs were included if they had clinical signs, clinical examination findings, and MRI abnormalities consistent with DLSS. Several variables were compared between surgically and medically treated dogs: age, sex, duration of clinical signs, presence or absence of neurologic deficits, urinary and fecal incontinence, concurrent medical conditions, and medical treatment before referral. Medical treatment after obtaining a final diagnosis of DLSS consisted of restricted exercise in combination with anti-inflammatory and analgesic drugs. Surgical treatment consisted of dorsal lumbosacral laminectomy. Outcome for medically treated dogs was obtained via a standardized questionnaire. Neurologic deficits were observed significantly more often in surgically treated dogs. Surgically treated dogs had unsuccessful medical treatment before referral significantly more often than did medically treated dogs. Thirty-one of 49 (63.3%) medically treated dogs were available for follow-up evaluation. Of these 31 dogs, 17 (55%) were managed successfully, 10 (32.3%) were managed unsuccessfully and underwent surgical treatment, 3 (9.7%) were euthanized because of progression of clinical signs, and 1 (3.2%) was alive but had an increase in severity of clinical signs after medical management. Clinical signs differed in dogs treated medically or surgically for DLSS. Medical treatment for dogs with DLSS was associated with a fair prognosis.

A correlative study of the clinical and radiographic signs of periodontal disease in dogs

International Nuclear Information System (INIS)

Smith, M.M.; Zontine, W.J.; Willits, N.H.

1985-01-01

Twenty-four dogs admitted for routine teeth cleaning were selected arbitrarily to undergo a periodontal examination and a dental radiographic examination before the dental procedure. Data pertaining to the physical and radiographic manifestations of periodontal disease of 783 teeth were collected. All dogs had lesions consistent with periodontal disease, ranging from mild gingivitis and minimal plaque accumulation to severely inflamed gingiva, exuberant calculus formation, and root exposure. Of the 783 teeth examined, 153 (20%) had a pocket depth greater than or equal to 4 mm and less than or equal to 9 mm. Data regarding these teeth were subjected to statistical analysis. The clinical signs of plaque, calculus, mobility, pocket depth, and furcation were positively associated with radiographic signs of periodonta disease. The association between grossly evident gingivitis and radiographic signs of periodontal disease was not significant. Conditional probability analysis was applied to determine confidence intervals for the probability of a radiographic sign of periodontal disease occurring given that a clinical sign of periodontal disease occurs. (author)

Nasal flaring as a clinical sign of respiratory acidosis in patients with dyspnea.

Science.gov (United States)

Zorrilla-Riveiro, José Gregorio; Arnau-Bartés, Anna; Rafat-Sellarés, Ramón; García-Pérez, Dolors; Mas-Serra, Arantxa; Fernández-Fernández, Rafael

2017-04-01

To determine whether the presence of nasal flaring is a clinical sign of respiratory acidosis in patients attending emergency departments for acute dyspnea. Single-center, prospective, observational study of patients aged over 15 requiring urgent attention for dyspnea, classified as level II or III according to the Andorran Triage Program and who underwent arterial blood gas test on arrival at the emergency department. The presence of nasal flaring was evaluated by two observers. Demographic and clinical variables, signs of respiratory difficulty, vital signs, arterial blood gases and clinical outcome (hospitalization and mortality) were recorded. Bivariate and multivariate analyses were performed using logistic regression models. The sample comprised 212 patients, mean age 78years (SD=12.8), of whom 49.5% were women. Acidosis was recorded in 21.2%. Factors significantly associated with the presence of acidosis in the bivariate analysis were the need for pre-hospital medical care, triage level II, signs of respiratory distress, presence of nasal flaring, poor oxygenation, hypercapnia, low bicarbonates and greater need for noninvasive ventilation. Nasal flaring had a positive likelihood ratio for acidosis of 4.6 (95% CI 2.9-7.4). In the multivariate analysis, triage level II (aOR 5.16; 95% CI: 1.91 to 13.98), the need for oxygen therapy (aOR 2.60; 95% CI: 1.13-5.96) and presence of nasal flaring (aOR 6.32; 95% CI: 2.78-14.41) were maintained as factors independently associated with acidosis. Nasal flaring is a clinical sign of severity in patients requiring urgent care for acute dyspnea, which has a strong association with acidosis and hypercapnia. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinical Significance of the Champagne Bottle Neck Sign in the Extracranial Carotid Arteries of Patients with Moyamoya Disease.

Science.gov (United States)

Yasuda, C; Arakawa, S; Shimogawa, T; Kanazawa, Y; Sayama, T; Haga, S; Morioka, T

2016-05-26

The champagne bottle neck sign represents a rapid reduction in the extracranial ICA diameters and is a characteristic feature of Moyamoya disease. However, the clinical significance of the champagne bottle neck sign is unclear. We investigated the relationship between the champagne bottle neck sign and the clinical and hemodynamic stages of Moyamoya disease. We analyzed 14 patients with Moyamoya disease before revascularization (5 men, 9 women; age, 43.2 ± 19.3 years). The ratio of the extracranial ICA and common carotid artery diameters was determined using carotid ultrasonography or cerebral angiography; a ratio of champagne bottle neck sign-positive. The clinical disease stage was determined using the Suzuki angiographic grading system. CBF and cerebral vasoreactivity also were measured. The ICA/common carotid artery ratio (expressed as median [interquartile range]) decreased as the clinical stage advanced (stages I-II, 0.71 [0.60-0.77]; stages III-IV, 0.49 [0.45-0.57]; stages V-VI, 0.38 [0.34-0.47]; P champagne bottle neck sign-positive arteries were classified as Suzuki stage ≥III, 73% were symptomatic, and 89% exhibited reduced cerebral vasoreactivity. In contrast, all champagne bottle neck sign-negative arteries were Suzuki stage ≤III, 67% were asymptomatic, and all showed preserved cerebral vasoreactivity. The champagne bottle neck sign was related to advanced clinical stage, clinical symptoms, and impaired cerebral vasoreactivity. Thus, detection of the champagne bottle neck sign might be useful in determining the clinical and hemodynamic stages of Moyamoya disease. © 2016 American Society of Neuroradiology.

Performance of clinical signs in the diagnosis of dehydration in children with acute gastroenteritis.

Science.gov (United States)

Hoxha, Teuta; Xhelili, Luan; Azemi, Mehmedali; Avdiu, Muharrem; Ismaili-Jaha, Vlora; Efendija-Beqa, Urata; Grajcevci-Uka, Violeta

2015-02-01

Acute evaluation and treatment of children presenting with dehydration represent one of the most common situation in the pediatric emergency department. To identify dehydration in infants and children before treatment, a number of symptoms and clinical signs have been evaluated. The aim of the study was to describe the performance of clinical signs in detecting dehydration in children. Two hundred children aged 1 month to 5 year were involved in our prospective study. The clinical assessment consisted of the ten clinical signs of dehydration, including those recommended by WHO (World Health Organization), heart rate, and capillary refill time. Two hundred patients with diarrhea were enrolled in the study. The mean age was 15.62±9.03 months and 57.5% were male. Of these 121 had a fluid deficit of dehydration were found to have the following respective gains in percent weight at the end of illness: 2.44±0.3, 6.05± 1.01 and, 10.66± 0.28, respectively. All clinical signs were found more frequently with increasing amounts of dehydration(pdehydration (deficit dehydration (deficit 5% to 9%) was 6.5 and among those with severe dehydration (deficit >10%) the median was 9 (p<0.0001, Kruskal-Wallis test). Using stepwise linear regression and a p value of <0.05 for entry into the model, a four-variable model including sunken eyes, skin elasticity, week radial pulse, and general appearance was derived. None of the 10 findings studied, is sufficiently accurate to be used in isolation. When considered together, sunken eyes, decreased skin turgor, weak pulse and general appearance provide the best explanatory power of the physical signs considered.

Serotonergic mechanism of the relieving effect of bee venom acupuncture on oxaliplatin-induced neuropathic cold allodynia in rats.

Science.gov (United States)

Lee, Ji-Hye; Li, Dong Xing; Yoon, Heera; Go, Donghyun; Quan, Fu Shi; Min, Byung-Il; Kim, Sun Kwang

2014-12-06

Oxaliplatin, an important chemotherapy drug for advanced colorectal cancer, often induces peripheral neuropathy, especially cold allodynia. Our previous study showed that bee venom acupuncture (BVA), which has been traditionally used in Korea to treat various pain symptoms, potently relieves oxaliplatin-induced cold allodynia in rats. However, the mechanism for this anti-allodynic effect of BVA remains poorly understood. We investigated whether and how the central serotonergic system, a well-known pathway for acupuncture analgesia, mediates the relieving effect of BVA on cold allodynia in oxaliplatin-injected rats. The behavioral signs of cold allodynia in Sprague-Dawley (SD) rats were induced by a single injection of oxaliplatin (6 mg/kg, i.p.). Before and after BVA treatment, the cold allodynia signs were evaluated by immersing the rat's tail into cold water (4°C) and measuring the withdrawal latency. For BVA treatment, a diluted BV (0.25 mg/kg) was subcutaneously administered into Yaoyangguan (GV3) acupoint, which is located between the spinous processes of the fourth and the fifth lumbar vertebra. Serotonin was depleted by a daily injection of DL-p-chlorophenylalanine (PCPA, 150 mg/kg, i.p.) for 3 days. The amount of serotonin in the spinal cord was measured by ELISA. Serotonergic receptor antagonists were administered intraperitoneally or intrathecally before BVA treatment. The serotonin levels in the spinal cord were significantly increased by BVA treatment and such increase was significantly reduced by PCPA. This PCPA pretreatment abolished the relieving effect of BVA on oxaliplatin-induced cold allodynia. Either of methysergide (mixed 5-HT1/5-HT2 receptor antagonist, 1 mg/kg, i.p.) or MDL-72222 (5-HT3 receptor antagonist, 1 mg/kg, i.p) blocked the anti-allodynic effect of BVA. Further, an intrathecal injection of MDL-72222 (12 μg) completely blocked the BVA-induced anti-allodynic action, whereas NAN-190 (5-HT1A receptor antagonist, 15 μg, i.t.) or

How Do Pain Relievers Work? (For Kids)

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... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Español How Do Pain Relievers Work? KidsHealth / For Kids / How Do Pain Relievers Work? Print en español ¿ ...

Performance of Clinical Signs in the Diagnosis of Dehydration in Children with Acute Gastroenteritis

OpenAIRE

Hoxha, Teuta; Xhelili, Luan; Azemi, Mehmedali; Avdiu, Muharrem; Ismaili-Jaha, Vlora; Efendija-Beqa, Urata; Grajcevci-Uka, Violeta

2015-01-01

Background: Acute evaluation and treatment of children presenting with dehydration represent one of the most common situation in the pediatric emergency department. To identify dehydration in infants and children before treatment, a number of symptoms and clinical signs have been evaluated. The aim of the study was to describe the performance of clinical signs in detecting dehydration in children. Methods: Two hundred children aged 1 month to 5 year were involved in our prospective study. The...

Performance of Clinical Signs in the Diagnosis of Dehydration in Children with Acute Gastroenteritis

Science.gov (United States)

Hoxha, Teuta; Xhelili, Luan; Azemi, Mehmedali; Avdiu, Muharrem; Ismaili-Jaha, Vlora; Efendija-Beqa, Urata; Grajcevci-Uka, Violeta

2015-01-01

Background: Acute evaluation and treatment of children presenting with dehydration represent one of the most common situation in the pediatric emergency department. To identify dehydration in infants and children before treatment, a number of symptoms and clinical signs have been evaluated. The aim of the study was to describe the performance of clinical signs in detecting dehydration in children. Methods: Two hundred children aged 1 month to 5 year were involved in our prospective study. The clinical assessment consisted of the ten clinical signs of dehydration, including those recommended by WHO (World Health Organization), heart rate, and capillary refill time. Results: Two hundred patients with diarrhea were enrolled in the study. The mean age was 15.62±9.03 months and 57.5% were male. Of these 121 had a fluid deficit of 10%) the median was 9 (p<0.0001, Kruskal-Wallis test). Using stepwise linear regression and a p value of <0.05 for entry into the model, a four-variable model including sunken eyes, skin elasticity, week radial pulse, and general appearance was derived. Conclusion: None of the 10 findings studied, is sufficiently accurate to be used in isolation. When considered together, sunken eyes, decreased skin turgor, weak pulse and general appearance provide the best explanatory power of the physical signs considered. PMID:25870468

Occult inflammatory breast cancer: review of clinical, mammographic, US and pathologic signs

International Nuclear Information System (INIS)

Cumo, Francesca; Gaioni, Maria Berenice; Bonetti, Franco; Manfrin, Erminia; Remo, Andrea; Pattaro, Christian; Policlinico G.B. Rossi, Verona

2005-01-01

Purpose: To examine the clinical, radiologic and pathologic findings of occult inflammatory breast cancer (OIBC) in order to identify features useful for diagnosis. Materials and methods: We retrospectively reviewed the records of 19 women with OIBC observed at our Department between 1992 and 2001. We analysed the clinical history, mammographic, ultrasonographic, and pathologic findings and investigated overall survival (OS), prognostic variables and radio-pathologic correlations. Results: The most common mammographic findings were: diffusely density (52.63%), trabecular thickening (42.1%), mass (36.84%). The most common US findings were axillary lymphadenopathy (68,75%), skin thickening (43.75%) and mass (56.25%). At least one inflammatory sign was found in 14 women (74%) at mammography (subcutaneous thickening, trabecular thickening, diffuse increase of density) or at US (subcutaneous thickening, diffuse increase in echogenicity due to oedema, lymph vessel dilatation). Estrogen receptors (ER) were present in 63.2% and Progesterone receptors (PgR) in 36.8%. Significant prognostic variables were ER and Ki 67. Conclusions: The typical radiological pattern of clinical inflammatory breast carcinoma is less frequently present in OIBC; nevertheless the radiologist must pay attention because frequently OIBC presents just one radiological sign and this should be enough for a diagnostic suspicion. Moreover, the absence of clinical and radiological inflammatory signs does not exclude inflammatory breasts cancer because OIBC can manifest at imaging as a mass or isolated calcification. ER and PgR are positive in a high percentage of patients and confirm that OIBC has a better prognosis that clinical inflammatory breast cancer [it

Two years follow-up study of the pain-relieving effect of gold bead implantation in dogs with hip-joint arthritis

Directory of Open Access Journals (Sweden)

Søli Nils

2007-03-01

Full Text Available Abstract Seventy-eight dogs with pain from hip dysplasia participated in a six-month placebo-controlled, double-blinded clinical trial of gold bead implantation. In the present, non-blinded study, 73 of these dogs were followed for an additional 18 months to evaluate the long-term pain-relieving effect of gold bead implantation. The recently-published results of the six month period revealed that 30 of the 36 dogs (83% in the gold implantation group showed significant improvement (p = 0.02, included improved mobility and reduction in the signs of pain, compared to the placebo group (60% improvement. In the long-term two-year follow-up study, 66 of the 73 dogs had gold implantation and seven dogs continued as a control group. The 32 dogs in the original placebo group had gold beads implanted and were followed for a further 18 months. A certified veterinary acupuncturist used the same procedure to insert the gold beads as in the blinded study, and the owners completed the same type of detailed questionnaires. As in the blinded study, one investigator was responsible for all the assessments of each dog. The present study revealed that the pain-relieving effect of gold bead implantation observed in the blinded study continued throughout the two-year follow-up period.

Clinical signs of dysphagia in infants with acute viral bronchiolitis☆

Science.gov (United States)

Barbosa, Lisiane De Rosa; Gomes, Erissandra; Fischer, Gilberto Bueno

2014-01-01

Objective: To determine the occurrence of clinical signs of dysphagia in infants with acute viral bronchiolitis, to compare the respiratory parameters during deglutition, and to ensure the intra- and inter- examiners agreement, as well as to accomplish intra and interexaminators concordance of the clinical evaluation of the deglutition. Methods: This was a cross-sectional study of 42 infants aged 0-12 months. The clinical evaluation was accompanied by measurements of respiratory rate and pulse oximetry. A score of swallowing disorders was designed to establish associations with other studied variables and to ensure the intra- and interrater agreement of clinical feeding assessments. Caregivers also completed a questionnaire about feeding difficulties. Significance was set at pdysphagia. PMID:25479843

[Brain lateralization and seizure semiology: ictal clinical lateralizing signs].

Science.gov (United States)

Horváth, Réka; Kalmár, Zsuzsanna; Fehér, Nóra; Fogarasi, András; Gyimesi, Csilla; Janszky, József

2008-07-30

Clinical lateralizing signs are the phenomena which can unequivocally refer to the hemispheric onset of epileptic seizures. They can improve the localization of epileptogenic zone during presurgical evaluation, moreover, their presence can predict a success of surgical treatment. Primary sensory phenomena such as visual aura in one half of the field of vision or unilateral ictal somatosensory sensation always appear on the contralateral to the focus. Periictal unilateral headache, although it is an infrequent symptom, is usually an ipsilateral sign. Primary motor phenomena like epileptic clonic, tonic movements, the version of head ubiquitously appear contralateral to the epileptogenic zone. Very useful lateralization sign is the ictal hand-dystonia which lateralizes to the contralateral hemisphere in nearly 100%. The last clonus of the secondarily generalized tonic-clonic seizure lateralizes to the ipsilateral hemisphere in 85%. The fast component of ictal nystagmus appears in nearly 100% on the contralateral side of the epileptic focus. Vegetative symptoms during seizures arising from temporal lobe such as spitting, nausea, vomiting, urinary urge are typical for seizures originating from non-dominant (right) hemisphere. Ictal pallor and cold shivers are dominant hemispheric lateralization signs. Postictal unilateral nose wiping refers to the ipsilateral hemispheric focus compared to the wiping hand. Ictal or postictal aphasia refers to seizure arising from dominant hemisphere. Intelligable speech during complex partial seizures appears in non-dominant seizures. Automatism with preserved consciousness refers to the seizures of non-dominant temporal lobe.

Significance of mammographic signs in clinically occult disease

Energy Technology Data Exchange (ETDEWEB)

Waal, J.C. de; Steil, B.; Baltzer, J.; Vaillant, W.; Zander, J.

1987-10-01

The significance of various radiographic signs in 183 patients with clinically occult breast disease is described. 30.6% hat a carcinoma of the breast or a carcinoma in situ. The radiological features have varying predictive values and there is variation in the incidence of lymph node metastases. It is considered useful to classify the radiological appearances under the headings of round foci, star-shaped opacities, diffuse opacities, opacities with calcification and groups of micro-calcification. Despite the early diagnosis, 24% of patients already had lymph node metastases.

Precipitating and relieving factors of migraine versus tension type headache

OpenAIRE

Haque, Badrul; Rahman, Kazi Mohibur; Hoque, Azharul; Hasan, ATM Hasibul; Chowdhury, Rajib Nayan; Khan, Sharif Uddin; Alam, Mondal Badrul; Habib, Mansur; Mohammad, Quazi Deen

2012-01-01

Abstract Background To determine the differences of precipitating and relieving factors between migraine and tension type headache. Methods This is a cross sectional study. We retrospectively reviewed the records of 250 migraine patients and 250 patients diagnosed as tension type headache from the specialized headache clinic in Dept. of Neurology, Dhaka Medical College Hospital. Data were collected through a predesigned questionnaire containing information on age, sex, social status and a pre...

Thermal stress relieving of dilute uranium alloys

International Nuclear Information System (INIS)

Eckelmeyer, K.H.

1981-01-01

The kinetics of thermal stress relieving of uranium - 2.3 wt % niobium, uranium - 2.0 wt % molybdenum, and uranium - 0.75 wt % titanium are reported and discussed. Two temperature regimes of stress relieving are observed. In the low temperature regime (T 0 C) the process appears to be controlled by an athermal microplasticity mechanism which can be completely suppressed by prior age hardening. In the high temperature regime (300 0 C 0 C) the process appears to be controlled by a classical diffusional creep mechanism which is strongly dependent on temperature and time. Stress relieving is accelerated in cases where it occurs simultaneously with age hardening. The potential danger of residual stress induced stress corrosion cracking of uranium alloys is discussed

Acute effects of massage or active exercise in relieving muscle soreness

DEFF Research Database (Denmark)

Andersen, Lars L; Jay, Kenneth; Andersen, Christoffer H

2013-01-01

Massage is commonly believed to be the best modality for relieving muscle soreness. However, actively warming up the muscles with exercise may be an effective alternative. The purpose of this study was to compare the acute effect of massage with active exercise for relieving muscle soreness. Twenty...... healthy female volunteers (mean age 32 years) participated in this examiner-blind randomized controlled trial (ClinicalTrials.gov NCT01478451). The participants performed eccentric contractions for the upper trapezius muscle on a Biodex dynamometer. Delayed onset muscle soreness (DOMS) presented 48 hours...... later, at which the participants (a) received 10 minutes of massage of the trapezius muscle or (b) performed 10 minutes of active exercise (shoulder shrugs 10 × 10 reps) with increasing elastic resistance (Thera-Band). First, 1 treatment was randomly applied to 1 shoulder while the contralateral...

The interrelationships between clinical signs and their effect on involuntary culling among pregnant sows in group-housing systems

DEFF Research Database (Denmark)

Jensen, Tina Birk; Bonde, Marianne Kjær; Kongsted, Anne Grete

2010-01-01

Sows suffering from clinical signs of disease (e.g. lameness, wounds and shoulder ulcers) are often involuntarily culled, affecting the farmer's economy and the welfare of the animals. In order to investigate the interrelationships between clinical signs of individual pregnant group-housed sows, we...

Hip Dysplasia: Clinical Signs and Physical Examination Findings.

Science.gov (United States)

Syrcle, Jason

2017-07-01

Hip dysplasia is a common developmental disorder of the dog, consisting of varying degrees of hip laxity, progressive remodeling of the structures of the hip, and subsequent development of osteoarthritis. It is a juvenile-onset condition, with clinical signs often first evident at 4 to 12 months of age. A tentative diagnosis of hip dysplasia can be made based on signalment, history, and physical examination findings. The Ortolani test is a valuable tool for identifying juvenile dogs affected with this condition. Further diagnostics can then be prioritized, contributing to prompt diagnosis and appropriate treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical profile and warning sign finding in children with severe dengue and non-severe dengue

Science.gov (United States)

Adam, A. S.; Pasaribu, S.; Wijaya, H.; Pasaribu, A. P.

2018-03-01

Dengue fever is one of the most important emerging vector-borne viral diseases. Approximately 500,000 out of 100 million cases develop to severe dengue infection. Patient with severe dengue (SD) can be predicted by clinical profile, laboratory and warning sign which could be saved by early interventions.This was a retrospective descriptive-analytic study to investigate clinical manifestations, laboratory and warning signs ofchildren with dengue infection in Haji Adam Malik hospital during January 2014–May 2016. Through medical records, we had selected 140 cases which fulfilled research criteria.Cases were classified as SD (n=28) and NSD (n=112). Most common clinical manifestations for NSD were abdominal pain (39.3%), myalgia (39.3%), headache (37.1%), mucosal bleeding (36.4%) while for SD were shock (15.7%), mucosal bleeding (15.7%), clinical fluid accumulation (15%), shortness of breath (14.3%). SGPT >1000IU/L (5 cases), SGOT >1000IU/L (9 cases), PT (10 cases) and aPTT (16 cases) were abnormal in SD. Severe dengue was frequently found in the range of white cell count 1000-4000/L and platelet count 20,000-50,000mm/uL. Clinical manifestations, warning sign, and laboratoryfinding, were different between SD and NSD.

Precipitating and Relieving Factors of Migraine Headache in 200 Iraqi Kurdish Patients

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Ehsan K. Al-Shimmery

2010-07-01

Full Text Available Objectives: To study the precipitating and relieving factors of migraine headache in a group of Iraqi Kurdish patients including the effect of fasting in Ramadan, and to estimate the percentage of family history of migraine. Methods: A series of 200 migraine cases from different parts of the Kurdistan region in the North of Iraq attending the out-patient Neurology clinic at Rizgary Teaching Hospital and a private Neurology clinic at Erbil City was carried out between October 2007 and May 2008 were reviewed. The precipitating factors and relieving factors for migraine headache were registered and tabulated to be compared with others. Case definition of migraine was based on the International Headache Society (IHS criteria.Results: 33% of the patients were aged between 30-39 years, while 40.5% of patients experienced their first attack aged between 20-29 years. Stress or psychological upset was the commonest triggering factor (80%, followed by increasing physical activity (68%, change in weather (65.5%, and in relation to fasting (65%. Fasting in Ramadan was a triggering factor for headaches in 65% of patients. However, there was no significant association between the triggering factors with regards to sex difference. Relief of migraine in the studied sample was achieved using NSAIDs in 50% of patients, and sleep (45.5%. Hence, 61% of the study population had positive family history of migraine, 32.5% of them reported maternal history of migraine. Conclusion: Psychological upset, stress and excessive physical activity were the commonest triggering factors of migraine headache, while NSAID was the commonest relieving factor of migraine in this population. Family history was present in 61% of migraine patients based mainly from maternal root.

Detection of canine distemper virus nucleoprotein gene by RT-PCR in urine of dogs with distemper clinical signs

International Nuclear Information System (INIS)

Gebara, C.M.S.; Wosiachi, S.R.; Negrao, F.J.; Oliveira, D.B. de; Beloni, S.N.E.; Alfieri, A.A.; Alfieri, A.F.

2004-01-01

The urine of 87 dogs with clinical signs suggestive of canine distemper was analyzed by RT-PCR for detection of canine distemper virus (CDV) nucleoprotein gene. The samples were allotted to the following groups: group A- with 41 dogs with systemic symptoms, group B- with 37 dogs with neurological signs, and group C- with 9 dogs with simultaneous systemic and neurological clinical signs. Group D (control) included 20 assymptomatic dogs. A c2 was used to test RT-PCR results according to clinical form and hematological characteristics. The RT-PCR was positive for CDV in 47% (41/87) of the urine samples from dogs with clinical signs. All samples from assymptomatic dogs were RT-PCR negatives. Positive samples were found in all groups of dogs with distemper symptoms according to the following propositions: 51.2% (21/41), 29% (11/37) and 100% (9/9) for groups A, B and C, respectively. In all clinical forms (groups A, B and C) leucocytosis was the most frequent observed hematological alteration. No relationship between RT-PCR results and hematological changes was observed. The results showed that independently of the clinical stage of the illness the RT-PCR based on urine sample can be applied for ante mortem diagnosis of CDV

Ivy Sign on Fluid-Attenuated Inversion Recovery Images in Moyamoya Disease: Correlation with Clinical Severity and Old Brain Lesions

OpenAIRE

Seo, Kwon-Duk; Suh, Sang Hyun; Kim, Yong Bae; Kim, Ji Hwa; Ahn, Sung Jun; Kim, Dong-Seok; Lee, Kyung-Yul

2015-01-01

Purpose Leptomeningeal collateral, in moyamoya disease (MMD), appears as an ivy sign on fluid-attenuated inversion-recovery (FLAIR) images. There has been little investigation into the relationship between presentation of ivy signs and old brain lesions. We aimed to evaluate clinical significance of ivy signs and whether they correlate with old brain lesions and the severity of clinical symptoms in patients with MMD. Materials and Methods FLAIR images of 83 patients were reviewed. Each cerebr...

Validity and reliability of haemoglobin colour scale and its comparison with clinical signs in diagnosing anaemia in pregnancy in Ahmedabad, India.

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Bala, D V; Vyas, S; Shukla, A; Tiwari, H; Bhatt, G; Gupta, K

2012-07-01

This study compared the validity of the haemoglobin colour scale (HCS) and clinical signs in diagnosing anaemia against Sahli's haemoglobinometer method as the gold standard, and assessed the reliability of HCS. The sample comprised 129 pregnant women recruited from 6 urban health centres in Ahmedabad. The prevalence of anaemia was 69.8% by Sahli's method, 78.3% by HCS and 89.9% by clinical signs; there was no statistically significant difference between Sahli's method and HCS whereas there was between Sahlis method and clinical signs. The mean haemoglobin level by Sahli's method and HCS differed significantly. The sensitivity, specificity, positive predictive value and negative predictive value of HCS was 83.3%, 33.3%, 74.3% and 46.4% respectively and that of clinical signs was 91.1%, 12.8%, 70.7% and 38.5% respectively. Interobserver agreement for HCS was moderate (K = 0.43). Clinical signs are better than HCS for diagnosing anaemia. HCS can be used in the field provided assessors are adequately trained.

Clinical and forensic signs related to cocaine abuse.

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Dinis-Oliveira, Ricardo Jorge; Carvalho, Félix; Duarte, José Alberto; Proença, Jorge Brandão; Santos, Agostinho; Magalhães, Teresa

2012-03-01

Good laboratory practice in toxicological analysis requires pre-analytical steps for collection of detailed information related to the suspected poisoning episodes, including biological and non-biological circumstantial evidences, which should be carefully scrutinized. This procedure provides great help to unveil the suspected cause of poisoning, to select the appropriate and correct samples to be analyzed and can facilitate the decision about the analytical techniques to perform. This implies a good knowledge of the signs related to acute and chronic intoxications by drugs of abuse. In this manuscript we highlight and discuss clinical and forensic imaging related to cocaine abuse, namely the midline destructive lesion, dental health, pseudoscleradermatous triad and crack hands, necrosis and gangrene of extremities and several other skin manifestations, reticular purpura, intracerebral and peripheral hemorrhages, angioneurotic edema, rhabdomyolysis, and crack lung. For this purpose, the state of the art on this topic is discussed, using clinical and forensic cases from our professional database in complement to images and mechanistic data from literature.

Risk relievers and customer brand preference in the purchase of cars

African Journals Online (AJOL)

Seventeen risk-relievers were found to be suitable in purchase of cars. The study purported to find out the more influencing risk reducers among the chosen seventeen risk relievers in purchase of cars. Secondly the study tries to find out the impact of risk relievers based on brand choice. Seven brands namely Maruti, Tata, ...

Clinical and neurophysiological investigation of a large family with dominant Charcot-Marie-Tooth type 2 disease with pyramidal signs

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Eduardo Luis de Aquino Neves

2011-06-01

Full Text Available Charcot-Marie-Tooth (CMT disease is a hereditary neuropathy of motor and sensory impairment with distal predominance. Atrophy and weakness of lower limbs are the first signs of the disease. It can be classified, with the aid of electromyography and nerve conduction studies, as demyelinating (CMT1 or axonal (CMT2. OBJECTIVE: Clinical and neurophysiological investigation of a large multigenerational family with CMT2 with autosomal dominant mode of transmission. METHOD: Fifty individuals were evaluated and neurophysiological studies performed in 22 patients. RESULTS: Thirty individuals had clinical signs of motor-sensory neuropathy. Babinski sign was present in 14 individuals. Neurophysiological study showed motor-sensory axonal polyneuropathy. CONCLUSION: The clinical and neurophysiological characteristics of this family does not differ from those observed with other forms of CMT, except for the high prevalence of Babinski sign.

Medical Device Integrated Vital Signs Monitoring Application with Real-Time Clinical Decision Support.

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Moqeem, Aasia; Baig, Mirza; Gholamhosseini, Hamid; Mirza, Farhaan; Lindén, Maria

2018-01-01

This research involves the design and development of a novel Android smartphone application for real-time vital signs monitoring and decision support. The proposed application integrates market available, wireless and Bluetooth connected medical devices for collecting vital signs. The medical device data collected by the app includes heart rate, oxygen saturation and electrocardiograph (ECG). The collated data is streamed/displayed on the smartphone in real-time. This application was designed by adopting six screens approach (6S) mobile development framework and focused on user-centered approach and considered clinicians-as-a-user. The clinical engagement, consultations, feedback and usability of the application in the everyday practices were considered critical from the initial phase of the design and development. Furthermore, the proposed application is capable to deliver rich clinical decision support in real-time using the integrated medical device data.

Peening as a stress relieving method for welded joints

International Nuclear Information System (INIS)

Ferreira, M.L.R.

1984-01-01

The efficacy of the process of stress relieving by hammer-peening, in heavy plates of low carbon steel is analysed. The effects of peening in the mechanical properties of welded metal deposited by shield metal arc welding, using the electrodes E-6010, E-7018 and E-8018C-2, and the weld metal deposited by submerged arc welding, using the filler metals ENil and EA3, are also analysed. X-ray diffraction was used in order to verify the efficacy of peening as a stress-relieving process. The obtained results and the literature reviewed show that, peening is effective in stress relieving. (author) [pt

Scoring clinical signs can help diagnose canine visceral leishmaniasis in a highly endemic area in Brazil.

Science.gov (United States)

Silva, Kleverton Ribeiro da; Mendonça, Vitor Rosa Ramos de; Silva, Kellen Matuzzy; Nascimento, Leopoldo Fabrício Marçal do; Mendes-Sousa, Antonio Ferreira; Pinho, Flaviane Alves de; Barral-Netto, Manoel; Barral, Aldina Maria Prado; Cruz, Maria do Socorro Pires E

2017-01-01

Canine visceral leishmaniasis (CVL) diagnosis is still a challenge in endemic areas with limited diagnostic resources. This study proposes a score with the potential to distinguish positive CVL cases from negative ones. We studied 265 dogs that tested positive for CVL on ELISA and parasitological tests. A score ranging between 0 and 19 was recorded on the basis of clinical signs. Dogs with CVL had an overall higher positivity of the majority of clinical signs than did dogs without CVL or with ehrlichiosis. Clinical signs such as enlarged lymph nodes (83.93%), muzzle/ear lesions (55.36%), nutritional status (51.79%), bristle condition (57.14%), pale mucosal colour (48.21%), onychogryphosis (58.93%), skin lesion (39.28%), bleeding (12.50%), muzzle depigmentation (41.07%), alopecia (39.29%), blepharitis (21.43%), and keratoconjunctivitis (42.86%) were more frequent in dogs with CVL than in dogs with ehrlichiosis or without CVL. Moreover, the clinical score increased according to the positivity of all diagnostic tests (ELISA, p muzzle depigmentation (OR: 4.651; 95% CI: 2.218-9.750; p dogs with CVL in endemic areas with limited diagnostic resources.

Thermal stress relieving of dilute uranium alloys

International Nuclear Information System (INIS)

Eckelmeyer, K.H.

1980-01-01

The kinetics of thermal stress relieving of uranium - 2.3 wt. % niobium, uranium - 2.0 wt. % molybdenum, and uranium - 0.75 wt. % titanium are reported and discussed. Two temperature regimes of stress relieving are observed. In the low temperature regime (T 0 C) the process appears to be controlled by an athermal microplasticity mechanism which can be completely suppressed by prior age hardening. In the high temperature regime (300 0 C 0 C) the process appears to be controlled by a classical diffusional creep mechanism which is strongly dependent on temperature and time. Stress relieving is accelerated in cases where it occurs simultaneously with age hardening. The potential danger of residual stress induced stress corrosion cracking of uranium alloys is discussed. It is shown that the residual stress relief which accompanies age hardening of uranium - 0.75% titanium more than compensates for the reduction in K/sub ISCC/ caused by aging. As a result, age hardening actually decreases the susceptibility of this alloy to residual stress induced stress corrosion cracking

RELIEVE: A FORTRAN 77 program for numerical and graphical processing of digital topographic maps; RELIEVE: Un programa FORTRAN para procesamiento numerico y grafico de mapas topograficos digitalizados

Energy Technology Data Exchange (ETDEWEB)

Sanchez, J.J.; Gorostiza, C.

1995-07-01

The RELIEVE program was developed in order to its integration with the expert system SIRENAS, in the frame of the Industrial Risks Programme, within the CIEMAT center. For accomplishing this mentioned system, arose the necessity of an additional component enabled for analyzing the topography (relieve) of the territory in which the focused site is located. That is just the mission of the RELIEVE program. Basically RELIEVE analyses the digitalized data points of a determinate topographic area, around a location of interest. The program allows us estimation by numerical techniques, using IMSL library, of the deep width, and other geometrical characteristics of the valley that is involved in. Optionally RELIEVE produces also graphical outputs concerning 3D representation of topographical map, level curves, sections of interest considered in the valley, etc., by means of the DISSPLA II library, running in the IBM system of the CIEMAT. (Author) 5 refs.

RELIEVE: A FORTRAN 77 program for numerical and graphical processing of digital topographic maps; RELIEVE: Un programa FORTRAN para procesamiento numerico y grafico de mapas topograficos digitalizados

Energy Technology Data Exchange (ETDEWEB)

Sanchez, J.J.; Gorostiza, C.

1995-12-01

The RELIEVE program was developed in order to its integration with the expert system SIRENAS, in the frame of the Industrial Risks Programme, within the CIEMAT center. For accomplishing this mentioned system, arose the necessity of an additional component unable for analyzing the topography (relieve) of the territory in which the focused site is located. That one is just the mission of the RELIEVE program. Basically RELIEVE analyses the digitalized data points of a determined topographic area, around a location of interest. The program allows us estimation by numerical techniques, using IMSL library, of the deep width, and other geometrical characteristics of the valley that are involved in. Optionally RELIEVE produces also graphical outputs concerning 3D representation of topographical map, level curves, sections of interest considered in the valley, etc., by means of the DISSPLA II library, running in the IBM system of the CIEMAT. (Author)

Scoring clinical signs can help diagnose canine visceral leishmaniasis in a highly endemic area in Brazil

Directory of Open Access Journals (Sweden)

Kleverton Ribeiro da Silva

Full Text Available Canine visceral leishmaniasis (CVL diagnosis is still a challenge in endemic areas with limited diagnostic resources. This study proposes a score with the potential to distinguish positive CVL cases from negative ones. We studied 265 dogs that tested positive for CVL on ELISA and parasitological tests. A score ranging between 0 and 19 was recorded on the basis of clinical signs. Dogs with CVL had an overall higher positivity of the majority of clinical signs than did dogs without CVL or with ehrlichiosis. Clinical signs such as enlarged lymph nodes (83.93%, muzzle/ear lesions (55.36%, nutritional status (51.79%, bristle condition (57.14%, pale mucosal colour (48.21%, onychogryphosis (58.93%, skin lesion (39.28%, bleeding (12.50%, muzzle depigmentation (41.07%, alopecia (39.29%, blepharitis (21.43%, and keratoconjunctivitis (42.86% were more frequent in dogs with CVL than in dogs with ehrlichiosis or without CVL. Moreover, the clinical score increased according to the positivity of all diagnostic tests (ELISA, p < 0.001; parasite culture, p = 0.0021; and smear, p = 0.0003. Onychogryphosis (long nails [odds ratio (OR: 3.529; 95% confidence interval (CI: 1.832-6.796; p < 0.001], muzzle depigmentation (OR: 4.651; 95% CI: 2.218-9.750; p < 0.001, and keratoconjunctivitis (OR: 5.400; 95% CI: 2.549-11.441; p < 0.001 were highly associated with CVL. Interestingly, a score cut-off value ≥ 6 had an area under the curve of 0.717 (p < 0.0001, sensitivity of 60.71%, and specificity of 73.64% for CVL diagnosis. The clinical sign-based score for CVL diagnosis suggested herein can help veterinarians reliably identify dogs with CVL in endemic areas with limited diagnostic resources.

Topical Pain Relievers May Cause Burns

Science.gov (United States)

... joint pain relievers containing the active ingredients menthol, methyl salicylate and capsaicin. These cases were uncovered by FDA ... people who purchase these products, Tan notes. Menthol, methyl salicylate and capsaicin create sensations of local warmth or ...

Mineral trioxide aggregate pulpotomy for permanent molars with clinical signs indicative of irreversible pulpitis: a preliminary study.

Science.gov (United States)

Qudeimat, M A; Alyahya, A; Hasan, A A

2017-02-01

To prospectively investigate the clinical and radiographic success rates of pulpotomy in permanent molars with clinical signs and symptoms suggestive of irreversible pulpitis using mineral trioxide aggregate (MTA) as a pulp dressing agent. Sixteen patients with 23 restorable permanent molars exhibiting signs and symptoms indicative of irreversible pulpitis were enrolled. A standardized operative procedure was followed for all participants. All teeth were isolated with a dental dam and caries was removed, and then, pulpotomy performed with a sterile round and/or flame shape diamond burs. Haemostasis was achieved with 5% sodium hypochlorite (NaOCl). A mixture of MTA was placed against the wound, and a moistened cotton pellet was placed over the MTA. Teeth were temporized with a glass-ionomer restoration. Three to ten days later, the interim restoration was removed and setting of MTA was evaluated. Teeth were restored with stainless steel crowns. Follow-up evaluations were scheduled at 3, 6, 12 months and annually thereafter. Descriptive statistics were used to assess outcomes. The age of patients at time of pulpotomy ranged between 7.6 and 13.6 years (mean = 10.7± 1.7 yrs). The majority of teeth (91%) had clinical signs and symptoms consistent with a diagnosis of symptomatic irreversible pulpitis and symptomatic apical periodontitis (78%). The follow-up examination period ranged from 18.9 to 73.6 months. Clinically and radiographically, all pulpotomies were considered successful at the end of the follow-up period. Radiographically, a hard tissue barrier was noticed in 13 (57%) teeth. In children, MTA was associated with high clinical and radiographic success as a pulpotomy agent in permanent teeth with clinical signs and symptoms suggestive of irreversible pulpitis. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Using psychodrama to relieve social barriers in an autistic child: A case study and literature review

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Jing Li

2015-12-01

Conclusions: It was possible for autistic children to relieve social barriers by implementing psychodrama training, then to improve the social cognitive ability and enhance the social function of the autistic children. These results provided basic Clinical implications for exploring a new intervention technique to reduce autistic symptom severity.

Intramuscular leukemic relapse: clinical signs and imaging findings. A multicentric analysis

Energy Technology Data Exchange (ETDEWEB)

Surov, Alexey [Martin Luther University Halle-Wittenberg, Department of Radiology, Halle (Germany); University of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Kiratli, Hayyam [Hacettepe University School of Medicine, Department of Ophthalmology, Ankara (Turkey); Im, Soo Ah [Seoul St. Mary' s Hospital, Department of Radiology, Seoul (Korea, Republic of); Manabe, Yasuhiro [National Hospital Organization Okayama Medical Center, Department of Neurology, Okayama (Japan); O' Neill, Alibhe; Shinagare, Atul B. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Spielmann, Rolf Peter [Martin Luther University Halle-Wittenberg, Department of Radiology, Halle (Germany)

2014-09-26

Leukemia is a group of malignant diseases involving peripheral blood and bone marrow. Extramedullary tumor manifestation in leukemia can also occur. They more often involve lymph nodes, skin, and bones. Intramuscular leukemic relapse (ILR) is very unusual. The aim of this analysis was to summarize the reported data regarding clinical signs and radiological features of ILR. The PubMed database was searched for publications related to ILR. After an analysis of all identified articles, 20 publications matched the inclusion criteria. The authors of the 20 publications were contacted and provided imaging of their cases for review. The following were recorded: age, gender, primary diagnosis, clinical signs, pattern, localization and size of the intramuscular leukemic relapse. Images of 16 patients were provided [8 computer tomographic (CT) images and 15 magnetic resonance images, MRI]. Furthermore, one patient with ILR was identified in our institutional database. Therefore, images of 17 patients were available for further analysis. Overall, 32 cases with ILR were included in the analysis. In most cases acute myeloid leukemia was diagnosed. Most ILRs were localized in the extremities (44 %) and in the extraocular muscles (44 %). Clinically, ILR manifested as local pain, swelling and muscle weakness. Radiologically, ILR presented most frequently with diffuse muscle infiltration. On postcontrast CT/MRI, most lesions demonstrated homogeneous enhancement. ILRs were hypo-/isointense on T1w and hyperintense on T2w images. ILR manifests commonly as focal pain, swelling and muscle weakness. ILR predominantly involved the extraocular musculature and the extremities. Radiologically, diffuse muscle infiltration was the most common imaging finding. (orig.)

Acute neurological signs as the predominant clinical manifestation in four dogs with Angiostrongylus vasorum infections in Denmark

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Pors Susanne E

2011-06-01

Full Text Available Abstract Four dogs with acute neurological signs caused by haemorrhages in the central nervous system were diagnosed with Angiostrongylus vasorum infection as the underlying aetiology. Two dogs presented with brain lesions, one dog with spinal cord lesions and one with lesions in both the brain and spinal cord. Only one dog presented with concurrent signs of classical pulmonary angiostrongylosis (respiratory distress, cough, and only two dogs displayed overt clinical signs of haemorrhages. Results of coagulation assays were inconsistent. Neurological signs reflected the site of pathology and included seizures, various cranial nerve deficits, vestibular signs, proprioceptive deficits, ataxia and paraplegia. One dog died and three were euthanised due to lack of improvement despite medical treatment. This emphasises canine angiostrongylosis as a potential cause of fatal lesions of the central nervous system and the importance of including A. vasorum as a differential diagnosis in young dogs with acute neurological signs in Denmark.

Clinical signs in the foot that are predictors of ligamentous laxity in the adult population.

Science.gov (United States)

Benhamú-Benhamú, Salomón; Domínguez-Maldonado, Gabriel; García-De-La-Peña, Raquel; Jiménez-Cristino, María Dolores; Gijon-Nogueron, Gabriel

2015-11-01

This study evaluates the influence of ligamentous laxity on the foot from observation of clinical signs and quantification of certain joint ranges. The sample consisted of 400 subjects - 200 in the non-lax control group (ages 32.49 ± 11.06 years) and 200 in the lax group (ages 29.82 ± 9.41 years). The Beighton criteria were applied to each subject to diagnose laxity or non-laxity after noting their gender, age, and 2 joint ranges and 2 clinical signs for both feet. This was an observational analytical study of cases and controls, in which a multivariate binary logistic regression model was applied. Extension of the first metatarsophalangeal joint (MTPJ) ≥95°, extension of the 1st toe's interphalangeal joint (IPJ) ≥14°, and the signs 1st "in the plantar footprint, marked and narrowly confined support under metatarsal heads" and 2nd "in the plantar footprint, continuity of the 1st toe to the 1st metatarsal" presented significant differences between the lax and the non-lax groups. These are usable as parameters with which to detect laxity. The Beighton criteria were confirmed as being the most appropriate for diagnosis. We propose the use of 2 clinical signs that can be evaluated in plantar footprints ("1st" and "2nd") and 2 exploratory manoeuvres (extension of the first MTPJ ≥95° and extension of the 1st toe's IPJ ≥14°) as factors present in the foot which allow the detection of ligamentous laxity in the adult population, for subsequent confirmation by applying the Beighton criteria. Copyright © 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

A novel clinical sign in intraocular tuberculosis: Active chorioretinitis within chorioretinal atrophy

OpenAIRE

Avinash Pathengay; Bhavik Panchal; Himadri Choudhury; Soumyava Basu; Nidhi Relhan; Harry W. Flynn, Jr.

2017-01-01

Purpose: To report a novel clinical sign in patients with intraocular tuberculosis. The current study is an observational consecutive case series of patients diagnosed with intraocular tuberculosis managed at a tertiary eye care centre from June 1, 2012 to December 31, 2015. Observations: The diagnosis of intraocular tuberculosis was made in 6 patients based on ocular features suggestive of tuberculosis along with a positive tuberculin skin testing and chest X-ray consistent with tuberculo...

Clinical signs of pneumonia in children: association with and prediction of diagnosis by fuzzy sets theory

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Pereira J.C.R.

2004-01-01

Full Text Available The present study compares the performance of stochastic and fuzzy models for the analysis of the relationship between clinical signs and diagnosis. Data obtained for 153 children concerning diagnosis (pneumonia, other non-pneumonia diseases, absence of disease and seven clinical signs were divided into two samples, one for analysis and other for validation. The former was used to derive relations by multi-discriminant analysis (MDA and by fuzzy max-min compositions (fuzzy, and the latter was used to assess the predictions drawn from each type of relation. MDA and fuzzy were closely similar in terms of prediction, with correct allocation of 75.7 to 78.3% of patients in the validation sample, and displaying only a single instance of disagreement: a patient with low level of toxemia was mistaken as not diseased by MDA and correctly taken as somehow ill by fuzzy. Concerning relations, each method provided different information, each revealing different aspects of the relations between clinical signs and diagnoses. Both methods agreed on pointing X-ray, dyspnea, and auscultation as better related with pneumonia, but only fuzzy was able to detect relations of heart rate, body temperature, toxemia and respiratory rate with pneumonia. Moreover, only fuzzy was able to detect a relationship between heart rate and absence of disease, which allowed the detection of six malnourished children whose diagnoses as healthy are, indeed, disputable. The conclusion is that even though fuzzy sets theory might not improve prediction, it certainly does enhance clinical knowledge since it detects relationships not visible to stochastic models.

Clinical signs and clinicopathologic abnormalities in dogs with clinical spirocercosis: 39 cases (1996-2004).

Science.gov (United States)

Mylonakis, Mathios E; Rallis, Tim; Koutinas, Alexander F; Leontides, Leonidas S; Patsikas, Michail; Florou, Marianna; Papadopoulos, Elias; Fytianou, Anna

2006-04-01

To determine clinical signs and clinicopathologic abnormalities in dogs with naturally occurring clinical spirocercosis. Retrospective case series. 39 dogs with spirocercosis. Medical records were reviewed, and information on signalment, residence (rural vs urban), owner complaints, physical examination findings, clinicopathologic abnormalities, radiographic and endoscopic findings, and concurrent systemic diseases was recorded. Hellenic hounds and mixed-breed dogs were overrepresented, compared with a group of 117 control dogs without spirocercosis that were examined because of gastrointestinal tract disease, and mean body weight of dogs with spirocercosis was significantly higher than mean body weight of control dogs. Odynophagia (34 [87%]), regurgitation (24 [62%]), and excessive salivation (14 [36%]) were the most common clinical findings. The most common radiographic abnormalities were a mass in the caudodorsal aspect of the mediastinum (15/35 [43%]) and spondylitis of the caudal thoracic vertebrae (10 [29%]). Parasitic nodules were seen during esophagoscopy in all 39 dogs. Normocytic, normochromic, nonregenerative anemia; neutrophilic leukocytosis; hyperproteinemia; and high alkaline phosphatase activity were significantly more common in dogs with spirocercosis than in a control group of 56 healthy dogs. Concurrent systemic diseases, mainly leishmaniosis, dirofilariosis, and monocytic ehrlichiosis, were documented in 14 (36%) dogs. Results suggest that clinical spirocercosis occurs more often in young-adult, large-breed dogs. Nonregenerative anemia, neutrophilic leukocytosis, hyperproteinemia, and high alkaline phosphatase activity may be useful clinicopathologic indicators of this disease.

Cerebellar Ataxia with Bilateral Vestibulopathy: Description of a Syndrome and Its Characteristic Clinical Sign

Science.gov (United States)

Migliaccio, Americo A.; Halmagyi, G. Michael; McGarvie, Leigh A.; Cremer, Phillip D.

2004-01-01

We report four patients with the syndrome of cerebellar ataxia with bilateral vestibulopathy (CABV) and, using search coil oculography, we validate its characteristic clinical sign, namely impairment of the visually enhanced vestibulo-ocular reflex (VVOR) or doll's head reflex. In our four patients, CABV began in the sixth decade of life; they are…

Informed consent in clinical research; Do patients understand what they have signed?

Directory of Open Access Journals (Sweden)

Elena Villamañán

2016-05-01

Full Text Available Informed consent is an essential element of research, and signing this document is required to conduct most clinical trials. Its aim is to inform patients what their participation in the study will involve. However, increasingly, their complexity and length are making them difficult to understand, which might lead patients to give their authorization without having read them previously or without having understood what is stated. In this sense, the Ethics Committees for Clinical Research, and Pharmacists specialized in Hospital Pharmacy and Primary Care in their capacity as members of said committees, play an important and difficult role in defending the rights of patients. These Committees will review thoroughly these documents to guarantee that all legal requirements have been met and, at the same time, that they are easy to understand by the potential participants in a clinical trial

The value of 'positive' clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review.

Science.gov (United States)

Daum, Corinna; Hubschmid, Monica; Aybek, Selma

2014-02-01

Experts in the field of conversion disorder have suggested for the upcoming DSM-V edition to put less weight on the associated psychological factors and to emphasise the role of clinical findings. Indeed, a critical step in reaching a diagnosis of conversion disorder is careful bedside neurological examination, aimed at excluding organic signs and identifying 'positive' signs suggestive of a functional disorder. These positive signs are well known to all trained neurologists but their validity is still not established. The aim of this study is to provide current evidence regarding their sensitivity and specificity. We conducted a systematic search on motor, sensory and gait functional signs in Embase, Medline, PsycINfo from 1965 to June 2012. Studies in English, German or French reporting objective data on more than 10 participants in a controlled design were included in a systematic review. Other relevant signs are discussed in a narrative review. Eleven controlled studies (out of 147 eligible articles) describing 14 signs (7 motor, 5 sensory, 2 gait) reported low sensitivity of 8-100% but high specificity of 92-100%. Studies were evidence class III, only two had a blinded design and none reported on inter-rater reliability of the signs. Clinical signs for functional neurological symptoms are numerous but only 14 have been validated; overall they have low sensitivity but high specificity and their use should thus be recommended, especially with the introduction of the new DSM-V criteria.

Lethal dose and clinical signs of Aeromonas hydrophila in Arapaima gigas (Arapaimidae), the giant fish from Amazon.

Science.gov (United States)

Dias, Marcia K R; Sampaio, Luciana S; Proietti-Junior, Aldo A; Yoshioka, Eliane T O; Rodrigues, Dália P; Rodriguez, Anselmo F R; Ribeiro, Ricardo A; Faria, Fernando S E D V; Ozório, Rodrigo O A; Tavares-Dias, Marcos

2016-05-30

Aeromonas hydrophila is causing substantial economic losses in world aquaculture. This study determined the tolerance limit (LD50-96h) of A. hydrophila in Arapaima gigas, and also investigated the clinical signs after intradermal inoculation. Arapaima gigas fingerlings were inoculated intraperitoneally with 0 (control), 1.0×10(5), 1.0×10(6), 1.0×10(7), 1.0×10(9) and 1.0×10(10)CFU/mL of A. hydrophila for the determination of LD50-96h, which was 1.8×10(8)CFU/mL. In another trial with intradermal inoculation of 1.8×10(8)CFU/mL A. hydrophila, there was a 91.6% of mortality between 8 and 23h, and several clinical signs were found. As follows: depigmentation in the tegument, lesions in the tail and fins, loss of balance, reduction of respiratory movements, hemorrhagic foci, necrotic hemorrhages in the kidney, liver and swim bladder, splenomegaly, ascites in the abdominal cavity and hyperemia, enlargement of the gall bladder, among other clinical signs observed. The results showed that A. gigas has a relative tolerance to A. hydrophila when compared to other Neotropical fish species. Copyright © 2016 Elsevier B.V. All rights reserved.

The reliability and validity of video analysis for the assessment of the clinical signs of concussion in Australian football.

Science.gov (United States)

Makdissi, Michael; Davis, Gavin

2016-10-01

The objective of this study was to determine the reliability and validity of identifying clinical signs of concussion using video analysis in Australian football. Prospective cohort study. All impacts and collisions potentially resulting in a concussion were identified during 2012 and 2013 Australian Football League seasons. Consensus definitions were developed for clinical signs associated with concussion. For intra- and inter-rater reliability analysis, two experienced clinicians independently assessed 102 randomly selected videos on two occasions. Sensitivity, specificity, positive and negative predictive values were calculated based on the diagnosis provided by team medical staff. 212 incidents resulting in possible concussion were identified in 414 Australian Football League games. The intra-rater reliability of the video-based identification of signs associated with concussion was good to excellent. Inter-rater reliability was good to excellent for impact seizure, slow to get up, motor incoordination, ragdoll appearance (2 of 4 analyses), clutching at head and facial injury. Inter-rater reliability for loss of responsiveness and blank and vacant look was only fair and did not reach statistical significance. The feature with the highest sensitivity was slow to get up (87%), but this sign had a low specificity (19%). Other video signs had a high specificity but low sensitivity. Blank and vacant look (100%) and motor incoordination (81%) had the highest positive predictive value. Video analysis may be a useful adjunct to the side-line assessment of a possible concussion. Video analysis however should not replace the need for a thorough multimodal clinical assessment. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Does Foot Massage Relieve Acute Postoperative Pain? A Literature Review

Directory of Open Access Journals (Sweden)

Chanif Chanif

2013-01-01

Full Text Available Purpose: This study aimed to examine the current state of knowledge regarding foot massageto determine if foot massage has an effect on relieving acute postoperative pain.Method: The following questions were used to guide this review: How does pain occur?What is the pain management modalities used in relieving acute postoperative pain? Does footmassage relieve acute postoperative pain? A comprehensive systematic search of publishedliterature and journal articles from Science Direct, CINAHL, PubMed, ProQuest and fromrelevant textbooks was conducted. The universal case entry website, Google-scholar was usedas well. The following keywords were used: foot massage, pain management, andpostoperative pain. Eight studies on foot massage and more than thirty related articles werereviewed.Result: Postoperative pain is caused by tissue damage that induces release of chemicalmediators from the surgical wound. The four processes of pain are transduction, transmission,perception and modulation. Pain medication is the goal standard for acute postoperative painrelief. In addition, foot massage is a modality that can be used in relieving acute postoperativepain. Massage stimulates large nerve fibers and dermatome layers which contain tactile andpressure receptors. The receptors subsequently transmit the nerve impulse to the centralnervous system. The gate control system in the dorsal horn is activated through the inhibitoryinterneuron, thus closing the gate. Subsequently, the brain does not receive the pain message.Eight reviewed studies demonstrated that foot massage relieves acute postoperative pain.However, there were some methodological limitations of these studies.Conclusion: It is recommended to examine the effect of foot massage on acute postoperativepain with high homogenous samples using various duration of massage and range of time forpain measurement at different settings.Key words: foot massage, pain management and postoperative pain.

RELIEVE: A FORTRAN 77 program for numerical and graphical processing of digital topographic maps

International Nuclear Information System (INIS)

Sanchez, J.J.; Gorostiza, C.

1995-01-01

The RELIEVE program was developed in order to its integration with the expert system SIRENAS, in the frame of the Industrial Risks Programme, within the CIEMAT center. For accomplishing this mentioned system, arose the necessity of an additional component enabled for analyzing the topography (relieve) of the territory in which the focused site is located. That is just the mission of the RELIEVE program. Basically RELIEVE analyses the digitalized data points of a determinate topographic area, around a location of interest. The program allows us estimation by numerical techniques, using IMSL library, of the deep width, and other geometrical characteristics of the valley that is involved in. Optionally RELIEVE produces also graphical outputs concerning 3D representation of topographical map, level curves, sections of interest considered in the valley, etc., by means of the DISSPLA II library, running in the IBM system of the CIEMAT. (Author) 5 refs

Signs in neuroradiology - part 1

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Goncalves, Fabricio Guimaraes, E-mail: goncalves.neuroradio@gmail.co [McGill University Health Centre (MUHC), Montreal, Quebec (Canada). Montreal General Hospital; Barra, Filipe Ramos; Jovem, Cassio Lemos [Hospital Universitario de Brasilia, DF (Brazil). Dept. of Radiology and Imaging Diagnosis; Matos, Valter de Lima [Hospital Santa Luzia, Brasilia, DF (Brazil); Amaral, Lazaro Luis Faria do [MedImagem - Hospital da Beneficencia Portuguesa de Sao Paulo, SP (Brazil). Dept. of Neuroradiology; Carpio-O' Donovan, Raquel del [McGill University Health Centre (MUHC), Montreal, Quebec (Canada)

2011-03-15

The use of signs or analogies for interpretation and description of medical images is an old and common practice among radiologists. Comparison of findings with animals, food or objects is not unprecedented and routinely performed. Many signs are quite specific and, in some cases, pathognomonic. Indeed, notwithstanding their degree of specificity, signs may help in the characterization of certain diseases. Several neuroradiological signs have been already described. The authors will present 15 neuroradiology signs in the present essay, approaching their main characteristics, the significance of their role in the clinical practice, as well as their respective imaging findings. (author)

Signs in neuroradiology - part 1

International Nuclear Information System (INIS)

Goncalves, Fabricio Guimaraes; Amaral, Lazaro Luis Faria do

2011-01-01

The use of signs or analogies for interpretation and description of medical images is an old and common practice among radiologists. Comparison of findings with animals, food or objects is not unprecedented and routinely performed. Many signs are quite specific and, in some cases, pathognomonic. Indeed, notwithstanding their degree of specificity, signs may help in the characterization of certain diseases. Several neuroradiological signs have been already described. The authors will present 15 neuroradiology signs in the present essay, approaching their main characteristics, the significance of their role in the clinical practice, as well as their respective imaging findings. (author)

A Longitudinal Evaluation of the Effects of Orthodontic Treatment on Clinical Signs and Symptoms of Temporomandibular Disorders.

Science.gov (United States)

1992-05-01

factors in the development of TMD have increased in number (Reynders, 1990). The consequence of these " case studies" and " clinical viewpoints" was a well...0.3, were found between morphological malocclusions and the presence of frequent headaches, bruxism , symptoms or clinical signs of TMD (Egermark...differ significantly enough to allow distinguishing clinical cases from controls, they found lateral excursions, anterior and posterior occlusion, extent

MRI in movement disorder patients: 'hot cross bun' sign

International Nuclear Information System (INIS)

Koh, Seong Beom; Kim, Byung Jo; Park, Min Kyu; Park, Kun Woo; Lee, Nam Joon; Lee, Dae Hie

2003-01-01

Clinically, multiple system atrophy is difficult to differentiate from other basal ganglia disorders such as idiopathic Parkinson's disease or other types of cerebellar ataxia. The 'hot cross bun' sign is a radiological sign which, it has been claimed, is highly specific for multiple system atrophy, and we describe four cases in which this sign occurred. In one patient, multiple system atrophy was clinically diagnosed, but in the other three, the respective clinical diagnosis was spinocerebellar ataxia type 1, type 2 (genetically), and old cerebellar hemorrhage. We therefore suggest that the hot cross bun sign reflects degeneration of transverse pontocerebellar fibers and is not a pathognomic sign of multiple system atrophy

Ultrasonographic, endoscopic and histological appearances of the caecum in cats presenting with chronic clinical signs of caecocolic disease.

Science.gov (United States)

Hahn, Harriet; Pey, Pascaline; Baril, Aurélie; Charpentier, Julie; Desquilbet, Loic; Le Poder, Sophie; Château-Joubert, Sophie; Laloy, Eve; Freiche, Valerie

2017-02-01

Objectives This study aimed to describe the ultrasonographic, endoscopic and histological characteristics of the caecum and ileocaecocolic junction in cats suffering from chronic clinical signs compatible with caecocolic disease. Methods Cats presenting with clinical signs suggestive of a caecocolic disease were prospectively recruited. All cats underwent an ultrasonographic examination of the caecum, ileum, colon, ileocolic lymph nodes and local mesenteric fat, in addition to comprehensive abdominal ultrasonography. This was followed by a colonoscopy with a macroscopic assessment of the caecocolic mucosa; caecocolic tissue samples were systematically collected for histologic analysis. Results Eighteen cats were included. Eleven of 18 cats had ultrasonographic abnormalities adjacent to the ileocaecocolic junction (lymphadenopathy, local steatitis) and 13/18 cats had abnormalities directly related to the junction (wall thickening, loss of wall layering). Seventeen of 18 cats had at least one ultrasonographic abnormality. Endoscopically, hyperaemia, oedema, discoloration and/or erosions were found in all cats. Each cat was classified as having mild or moderate-to-severe lesions according to endoscopic results; no classification could be established statistically for ultrasonographic results. The accentuation of the dimpled pattern tended to be inversely related to the severity of endoscopic lesion scoring. Histologically, a large proportion of cats showed typhlitis (13/16), one had lymphoma and two were normal. All cats with typhlitis also had colitis. There was only slight agreement between endoscopic and histological caecal results regarding the severity of lesions. Loss of caecal wall layering on ultrasound was found in 7/18 cats and, surprisingly, did not appear as a reliable predictor of the severity of inflammation or of malignancy; neither did local steatitis nor lymph node size. Conclusions and relevance Ultrasonography and endoscopy should not be used as the

sign-by-sign'' correlation

International Nuclear Information System (INIS)

Schmidt, Sabine; Lepori, Domenico; Meuwly, Jean-Yves; Duvoisin, Bertrand; Meuli, Reto; Schnyder, Pierre; Denys, Alban; Michetti, Pierre; Felley, Christian; Melle, Guy van

2003-01-01

Our objective was a prospective comparison of MR enteroclysis (MRE) with multidetector spiral-CT enteroclysis (MSCTE). Fifty patients with various suspected small bowel diseases were investigated by MSCTE and MRE. The MSCTE was performed using slices of 2.5 mm, immediately followed by MRE, obtaining T1- and T2-weighted sequences, including gadolinium-enhanced acquisition with fat saturation. Three radiologists independently evaluated MSCTE and MRE searching for 12 pathological signs. Interobserver agreement was calculated. Sensitivities and specificities resulted from comparison with pathological results (n=29) and patient's clinical evolution (n=21). Most pathological signs, such as bowel wall thickening (BWT), bowel wall enhancement (BWE) and lymphadenopathy (ADP), showed better interobserver agreement on MSCTE than on MRE (BWT: 0.65 vs 0.48; BWE: 0.51 vs 0.37; ADP: 0.52 vs 0.15). Sensitivity of MSCTE was higher than that of MRE in detecting BWT (88.9 vs 60%), BWE (78.6 vs 55.5%) and ADP (63.8 vs 14.3%). Wilcoxon signed-rank test revealed significantly better sensitivity of MSCTE than that of MRE for each observer (p=0.028, p=0.046, p=0.028, respectively). Taking the given study design into account, MSCTE provides better sensitivity in detecting lesions of the small bowel than MRE, with higher interobserver agreement. (orig.)

Warning Signs for Suicide: Theory, Research, and Clinical Applications

Science.gov (United States)

Rudd, M. David; Berman, Alan L.; Joiner, Thomas E., Jr.; Nock, Matthew K.; Silverman, Morton M.; Mandrusiak, Michael; Van Orden, Kimberly; Witte, Tracy

2006-01-01

The current article addresses the issue of warning signs for suicide, attempting to differentiate the construct from risk factors. In accordance with the characteristic features discussed, a consensus set of warning signs identified by the American Association of Suicidology working group are presented, along with a discussion of relevant clinical…

31 CFR 585.521 - Donations of food to relieve human suffering authorized.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Donations of food to relieve human... Donations of food to relieve human suffering authorized. (a) Specific licenses may be issued on a case-by.... (b) In general, specific licenses will only be granted for donations of food to be provided through...

Blunt bowel and mesenteric trauma: role of clinical signs along with CT findings in patients' management.

Science.gov (United States)

Firetto, Maria Cristina; Sala, Francesco; Petrini, Marcello; Lemos, Alessandro A; Canini, Tiberio; Magnone, Stefano; Fornoni, Gianluca; Cortinovis, Ivan; Sironi, Sandro; Biondetti, Pietro R

2018-04-27

Bowel and/or mesentery injuries represent the third most common injury among patients with blunt abdominal trauma. Delayed diagnosis increases morbidity and mortality. The aim of our study was to evaluate the role of clinical signs along with CT findings as predictors of early surgical repair. Between March 2014 and February 2017, charts and CT scans of consecutive patients treated for blunt abdominal trauma in two different trauma centers were reread by two experienced radiologists. We included all adult patients who underwent contrast-enhanced CT of the abdomen and pelvis with CT findings of blunt bowel and/or mesenteric injury (BBMI). We divided CT findings into two groups: the first included three highly specific CT signs and the second included six less specific CT signs indicated as "minor CT findings." The presence of abdominal guarding and/or abdominal pain was considered as "clinical signs." Reference standards included surgically proven BBMI and clinical follow-up. Association was evaluated by the chi-square test. A logistic regression model was used to estimate odds ratio (OR) and confidence intervals (CI). Thirty-four (4.1%) out of 831 patients who sustained blunt abdominal trauma had BBMI at CT. Twenty-one out of thirty-four patients (61.8%) underwent surgical repair; the remaining 13 were treated conservatively. Free fluid had a significant statistical association with surgery (p = 0.0044). The presence of three or more minor CT findings was statistically associated with surgery (OR = 8.1; 95% CI, 1.2-53.7). Abdominal guarding along with bowel wall discontinuity and extraluminal air had the highest positive predictive value (100 and 83.3%, respectively). In patients without solid organ injury (SOI), the presence of free fluid along with abdominal guarding and three or more "minor CT findings" is a significant predictor of early surgical repair. The association of bowel wall discontinuity with extraluminal air warrants exploratory laparotomy.

Relieving idiopathic dental pain without drugs

Directory of Open Access Journals (Sweden)

Haryono Utomo

2011-06-01

Full Text Available Background: Teeth are commonly obvious source of orofacial pain. Sometimes the pain source is undetectable, thus called as idiopathic dental pain. Since dentist wants to alleviate or eliminate the pains with every effort in their mind, a lot of drugs could be prescribed. Moreover, it is make sense that endodontic treatment or even tooth extraction will be done. Unfortunately, endodontic treatment may also initiate neuropathic tooth pain that is caused by nerve extirpation, thus worsen the pain. Therefore, another cause of dental pain such as referred pain, periodontal disease, or stress which related to psychoneuroimmunology should be considered. In order to prevent from unnecessary drugs or invasive treatment such as root canal treatment and extraction, correct diagnosis and preliminary non-invasive therapies should be done. Purpose: This review elucidates several therapies that could be done by dentists for relieving idiopathic dental pain which includes massage, the “assisted drainage” therapy, modulation of psychoneuroimmunologic status and dietary omega-3. Reviews: Understanding the basic pathogenesis of pain may help in elucidating the effects of non-drug pain therapy such as muscle massage, the “assisted drainage” therapy, omega-3 and psychological stress relieving. These measures are accounted for eliminating referred pain, reducing proinflammatory mediators and relieving unwanted stress reactions consecutively. Psychological stress increases proinflammatory cytokines and thus lowered pain threshold. Conclusion: As an individual treatment, this non-drug therapy is useful in relieving idiopathic dental pain; nevertheless, if they work together the result could be more superior.Latar belakang: Gigi adalah suatu penyebab umum dari nyeri orofasial. Kadang kala penyebab nyeri tidak dapat ditemukan, sehingga disebut sebagai nyeri gigi idiopatik. Karena dokter gigi berupaya untuk mengurangi atau menghilangkan nyeri dengan segala cara

Clinical impact and value of workstation single sign-on.

Science.gov (United States)

Gellert, George A; Crouch, John F; Gibson, Lynn A; Conklin, George S; Webster, S Luke; Gillean, John A

2017-05-01

CHRISTUS Health began implementation of computer workstation single sign-on (SSO) in 2015. SSO technology utilizes a badge reader placed at each workstation where clinicians swipe or "tap" their identification badges. To assess the impact of SSO implementation in reducing clinician time logging in to various clinical software programs, and in financial savings from migrating to a thin client that enabled replacement of traditional hard drive computer workstations. Following implementation of SSO, a total of 65,202 logins were sampled systematically during a 7day period among 2256 active clinical end users for time saved in 6 facilities when compared to pre-implementation. Dollar values were assigned to the time saved by 3 groups of clinical end users: physicians, nurses and ancillary service providers. The reduction of total clinician login time over the 7day period showed a net gain of 168.3h per week of clinician time - 28.1h (2.3 shifts) per facility per week. Annualized, 1461.2h of mixed physician and nursing time is liberated per facility per annum (121.8 shifts of 12h per year). The annual dollar cost savings of this reduction of time expended logging in is $92,146 per hospital per annum and $1,658,745 per annum in the first phase implementation of 18 hospitals. Computer hardware equipment savings due to desktop virtualization increases annual savings to $2,333,745. Qualitative value contributions to clinician satisfaction, reduction in staff turnover, facilitation of adoption of EHR applications, and other benefits of SSO are discussed. SSO had a positive impact on clinician efficiency and productivity in the 6 hospitals evaluated, and is an effective and cost-effective method to liberate clinician time from repetitive and time consuming logins to clinical software applications. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

How Can I Relieve My Pregnancy Leg Cramps?

Science.gov (United States)

... Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español How Can I Relieve My Pregnancy Leg Cramps? KidsHealth / For Parents / How Can I ...

Increase of resistance to cracking on stress relieving of hardened steel

International Nuclear Information System (INIS)

Velichko, V.V.; Zabil'skij, V.V.; Mikheev, G.M.

1995-01-01

Regularities of increase of resistance to cracking during stress relieving of hardened low-alloyed steels were studied, using complex of methods. Effect of carbon, stress concentrator radius, duration and temperature of stress relieving was studies in particular. Results of investigating kinetics of change of physicomechanical properties, hydrogen desorption from hardened specimens showed, that increase of resistance to cracking was caused by desorption from grain boundaries of diffusion-mobile hydrogen, formed during hardening. 18 refs., 8 figs

Significance of Clinical Signs in Diagnosing Each Variant of Periapical Pathology: A Random Population Study in 1000 Patients

Directory of Open Access Journals (Sweden)

Rakesh Kumar Manne

2011-01-01

Conclusion: Our results suggested high prevalence rate of periapical pathology. This study also elaborated all the clinical signs of periapical pathology and their statistical significance in diagnosing each variant of periapical pathology.

Tissue factor activated thromboelastography correlates to clinical signs of bleeding in dogs

DEFF Research Database (Denmark)

Wiinberg, Bo; Jensen, Asger Lundorff; Rozanski, Elizabeth

2009-01-01

The ability of a laboratory assay to correlate to clinical phenotype is crucial for the accurate diagnosis and monitoring of haemostasis and is therefore challenging with currently used routine haemostasis assays. Thromboelastography (TEG) is increasingly used to evaluate haemostasis in humans...... and may well be of value in the workup of dogs suspected of having a haemostatic disorder. This study was undertaken to evaluate prospectively how tissue factor (TF) activated TEG correlated to clinical signs of bleeding in dogs, compared to a routine coagulation profile. A prospective case-control study...... was performed over a 2 year period from 2004-2006. Eligible dogs were those where the primary clinician requested a coagulation profile to evaluate haemostasis. The dogs were simultaneously evaluated with a TF-activated TEG assay. Twenty-seven dogs, characterised as hypo-coagulable based on the TEG parameter G...

Signs Indicating Imminent Death in Escherichia coli-Infected Broilers.

Science.gov (United States)

Matthijs, M G R; Nieuwenhuis, J F; Dwars, R M

2017-09-01

Broilers were observed during 9 days for clinical signs after intratracheal inoculation at 8 days of age with 10 7 E. coli 506. It was determined if these signs were predictive for imminent death. Hourly observations were made daily from a distance of 1-2 m and nightly by camera observation, with respect to the following parameters: level of attention, locomotory activity, posture and appearance, interaction, and impairment of respiration. For deviations of the normal state for these five parameters (i.e., typical clinical signs of disease), scores were defined in up to four classes. The periods of time elapsing from attaining a score for the first time to death were registered per bird for each score for each parameter. Of 114 birds, 85 did not present typical signs of illness as described, and 29 presented the following clinical history: 25 died after presenting signs of illness, 2 died without previous signs, 1 fell ill but survived, and 1 fell ill and recovered. Extended clinical examination was performed in birds presenting clinical signs; temperature, heart rate, respiratory rate, and subcutaneous capillary refill time were measured. The level of attention, and posture and appearance were affected most often in ill birds; 25% of these birds died within 5 and 4 hr, respectively; 50% died within 12 hr; and 75% died within 20 and 19 hr, respectively. Any of these typical signs of illness visible from 1-2 m indicated imminent death, with 75% of the birds dying within 20 hr. Measurements resulting from extended clinical examination proved of lesser predictive value. From these observations, a protocol for intervention to prevent animal suffering may be designed.

Ivy Sign on Fluid-Attenuated Inversion Recovery Images in Moyamoya Disease: Correlation with Clinical Severity and Old Brain Lesions.

Science.gov (United States)

Seo, Kwon-Duk; Suh, Sang Hyun; Kim, Yong Bae; Kim, Ji Hwa; Ahn, Sung Jun; Kim, Dong-Seok; Lee, Kyung-Yul

2015-09-01

Leptomeningeal collateral, in moyamoya disease (MMD), appears as an ivy sign on fluid-attenuated inversion-recovery (FLAIR) images. There has been little investigation into the relationship between presentation of ivy signs and old brain lesions. We aimed to evaluate clinical significance of ivy signs and whether they correlate with old brain lesions and the severity of clinical symptoms in patients with MMD. FLAIR images of 83 patients were reviewed. Each cerebral hemisphere was divided into 4 regions and each region was scored based on the prominence of the ivy sign. Total ivy score (TIS) was defined as the sum of the scores from the eight regions and dominant hemispheric ivy sign (DHI) was determined by comparing the ivy scores from each hemisphere. According to the degree of ischemic symptoms, patients were classified into four subgroups: 1) nonspecific symptoms without motor weakness, 2) single transient ischemic attack (TIA), 3) recurrent TIA, or 4) complete stroke. TIS was significantly different as follows: 4.86±2.55 in patients with nonspecific symptoms, 5.89±3.10 in patients with single TIA, 9.60±3.98 in patients with recurrent TIA and 8.37±3.39 in patients with complete stroke (p=0.003). TIS associated with old lesions was significantly higher than those not associated with old lesions (9.35±4.22 vs. 7.49±3.37, p=0.032). We found a significant correlation between DHI and motor symptoms (p=0.001). Because TIS has a strong tendency with severity of ischemic motor symptom and the presence of old lesions, the ivy sign may be useful in predicting severity of disease progression.

[Clinical signs of dysphagia in infants with acute viral bronchiolitis].

Science.gov (United States)

Barbosa, Lisiane De Rosa; Gomes, Erissandra; Fischer, Gilberto Bueno

2014-09-01

To determine the occurrence of clinical signs of dysphagia in infants with acute viral bronchiolitis, to compare the respiratory parameters during deglutition, and to ensure the intra- and inter- examiners agreement, as well as to accomplish intra and interexaminators concordance of the clinical evaluation of the deglutition. This was a cross-sectional study of 42 infants aged 0-12 months. The clinical evaluation was accompanied by measurements of respiratory rate and pulse oximetry. A score of swallowing disorders was designed to establish associations with other studied variables and to ensure the intra- and interrater agreement of clinical feeding assessments. Caregivers also completed a questionnaire about feeding difficulties. Significance was set at p<0.05. Changes in the oral phase (prolonged pauses) and pharyngeal phase (wheezing, coughing and gagging) of swallowing were found. A significant increase in respiratory rate between pre- and post-feeding times was found, and it was determined that almost half of the infants had tachypnea. An association was observed between the swallowing disorder scores and a decrease in oxygen saturation. Infants whose caregivers reported feeding difficulties during hospitalization stated a significantly greater number of changes in the swallowing evaluation. The intra-rater agreement was considered to be very good. Infants with acute viral bronchiolitis displayed swallowing disorders in addition to changes in respiratory rate and measures of oxygen saturation. It is suggested, therefore, that infants displaying these risk factors have a higher probability of dysphagia. Copyright © 2014 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Association of clinical signs after acute Schmallenberg virus infection with milk production and fertility in Swiss dairy cows.

Science.gov (United States)

Lechner, Isabel; Wüthrich, Marianne; Meylan, Mireille; van den Borne, Bart H P; Schüpbach-Regula, Gertraud

2017-10-01

Since its first occurrence in August 2011 in Germany and the Netherlands, the Schmallenberg virus (SBV) spread rapidly across Europe, where it caused production losses and abortions in ruminants as well as congenital malformations in the offspring of affected animals. Several studies have investigated the impact of SBV on fertility and production parameters in dairy cows at herd level. However, the impact of clinical disease at the animal level remained undetermined. This study aimed at estimating the impact of clinical disease during and after an infection with SBV on production and fertility parameters in individual Swiss dairy cows. Sixty-seven case and twenty-four control herds were selected according to whether cows had been showing clinical signs indicative of SBV during the epidemic from July to December 2012 in Switzerland. Of these 91 farms, production and fertility data from 388 cows with clinical signs from case herds were collected over a time period of four years, and compared to data from 932 cows without clinical signs originating from case or control herds. Milk yield, somatic cell count, number of inseminations and non-return at day 56 were analysed by means of hierarchical multivariable regression analysis. A significant drop in milk yield was observed in all groups during the SBV epidemic compared to the time before the infection, which amounted to 1.9kg per test day for clinical animals, 1.1kg for non-clinical animals from case herds and 0.6kg for non-clinical animals from control herds. A prolonged effect on milk yield was observed in clinical cows for about one year, suggesting that animals with clinical disease might not return to their previous milk production level in the current lactation after an acute infection with SBV. Clinical animals showed a significantly higher somatic cell count during the epidemic compared to the time before the infection. The number of inseminations per cow and production cycle was higher for clinical animals

Clinical signs, diagnosis, and case reports of Vaccinia virus infections

Directory of Open Access Journals (Sweden)

Daniela Carla Medeiros Silva

Full Text Available Vaccinia virus is responsible for a zoonosis that usually affects cattle and human beings in Brazil. The initial clinical signs of the infection are focal red skin areas, fever, and general symptoms similar to those of a cold. Then, pustules and ulcerated lesions surrounded by edema and erythema follow, as well as local lymphadenopathy that can last for weeks. Cure and healing of the lesions occur over several weeks, leaving a typical scar in the skin of people and animals affected. The infection definitive diagnosis is made through morphological characterization of the virus by use of electron microscopy, followed by PCR for specific viral genes. Since 1963, circulating orthopoxviruses in infectious outbreaks in several regions of Brazil have been reported. Later, the etiological agent of those infections was characterized as samples of Vaccinia virus. In addition, the widespread use of those viruses in research laboratories and mass vaccination of militaries have contributed to increase the cases of those infections worldwide. Thus, several epidemiological and clinical studies are required, as well as studies of viral immunology, public health, and economic impact, because little is known about those Vaccinia virus outbreaks in Brazil.

Comparison between dot-immunoblotting assay and clinical sign determination method for quantifying avian infectious bronchitis virus vaccine by titration in embryonated eggs.

Science.gov (United States)

Yuk, Seong-Su; Kwon, Jung-Hoon; Noh, Jin-Yong; Hong, Woo-Tack; Gwon, Gyeong-Bin; Jeong, Jei-Hyun; Jeong, Sol; Youn, Ha-Na; Heo, Yong-Hwan; Lee, Joong-Bok; Park, Seung-Yong; Choi, In-Soo; Song, Chang-Seon

2016-04-01

A sensitive and specific method for measuring the vaccine titer of infectious bronchitis virus (IBV) is important to commercial manufacturers for improving vaccine quality. Typically, IBV is titrated in embryonated chicken eggs, and the infectivity of the virus dilutions is determined by assessing clinical signs in the embryos as evidence of viral propagation. In this study, we used a dot-immunoblotting assay (DIA) to measure the titers of IBV vaccines that originated from different pathogenic strains or attenuation methods in embryonated eggs, and we compared this assay to the currently used method, clinical sign evaluation. To compare the two methods, we used real-time reverse transcription-PCR, which had the lowest limit of detection for propagated IBV. As a clinical sign of infection, dwarfism of the embryo was quantified using the embryo: egg (EE) index. The DIA showed 9.41% higher sensitivity and 15.5% higher specificity than the clinical sign determination method. The DIA was particularly useful for measuring the titer of IBV vaccine that did not cause apparent stunting but propagated in embryonated chicken eggs such as a heat-adapted vaccine strain. The results of this study indicate that the DIA is a rapid, sensitive, reliable method for determining IBV vaccine titer in embryonated eggs at a relatively low cost. Copyright © 2016 Elsevier B.V. All rights reserved.

Neurological soft signs in the clinical course of schizophrenia

Directory of Open Access Journals (Sweden)

Silke eBachmann

2014-12-01

Full Text Available Neurological soft signs (NSS comprise subtle deficits in sensory integration, motor coordination, and sequencing of complex motor acts which are typically observed in the majority of schizophrenia patients, including chronic cases and neuroleptic-naïve first-episode patients. However, recent studies clearly demonstrate that NSS are not a static feature of schizophrenia but vary in the clinical course of the disorder. This effect was investigated in a meta-analysis based on 17 longitudinal studies published between 1992 and 2012. Studies included between 10 and 93 patients with schizophrenia spectrum disorders (total number 787 with follow-up periods between 2 and 208 weeks. Beside the Neurological Examination Scale, the Cambridge Neurological Inventory and the Heidelberg NSS Scale were used to assess NSS. All but three studies found NSS to decrease in parallel with remission of psychopathological symptoms. This effect was more pronounced in patients with a remitting compared to a non-remitting, chronic course (Cohen´s d 0.81 vs. 0.15 and was significantly correlated with length of the follow-up period (r=-0.64 but not with age (r=0.28. NSS scores did not decrease to the level typically observed in healthy controls. From a clinical perspective, NSS may therefore be used to identify subjects at risk to develop schizophrenia and to monitor disease progression.

New definitions of 6 clinical signs of perceptual disorder in children with cerebral palsy: an observational study through reliability measures.

Science.gov (United States)

Ferrari, A; Sghedoni, A; Alboresi, S; Pedroni, E; Lombardi, F

2014-12-01

Recently authors have begun to emphasize the non-motor aspects of Cerebral Palsy and their influence on motor control and recovery prognosis. Much has been written about single clinical signs (i.e., startle reaction) but so far no definitions of the six perceptual signs presented in this study have appeared in literature. This study defines 6 signs (startle reaction, upper limbs in startle position, frequent eye blinking, posture freezing, averted eye gaze, grimacing) suggestive of perceptual disorders in children with cerebral palsy and measures agreement on sign recognition among independent observers and consistency of opinions over time. Observational study with both cross-sectional and prospective components. Fifty-six videos presented to observers in random order. Videos were taken from 19 children with a bilateral form of cerebral palsy referred to the Children Rehabilitation Unit in Reggio Emilia. Thirty-five rehabilitation professionals from all over Italy: 9 doctors and 26 physiotherapists. Measure of agreement among 35 independent observers was compiled from a sample of 56 videos. Interobserver reliability was determined using the K index of Fleiss and reliability intra-observer was calculated by the Spearman correlation index between ranks (rho - ρ). Percentage of agreement between observers and Gold Standard was used as criterion validity. Interobserver reliability was moderate for startle reaction, upper limb in startle position, adverted eye gaze and eye-blinking and fair for posture freezing and grimacing. Intraobserver reliability remained consistent over time. Criterion validity revealed very high agreement between independent observer evaluation and gold standard. Semiotics of perceptual disorders can be used as a specific and sensitive instrument in order to identify a new class of patients within existing heterogeneous clinical types of bilateral cerebral palsy forms and could help clinicians in identifying functional prognosis. To provide

The administration of a single dose of a multivalent (DHPPiL4R vaccine prevents clinical signs and mortality following virulent challenge with canine distemper virus, canine adenovirus or canine parvovirus

Directory of Open Access Journals (Sweden)

Stephen Wilson

2014-01-01

In conclusion, we demonstrated that a single administration of a minimum titre, multivalent vaccine to dogs of six weeks of age is efficacious and prevents clinical signs and mortality caused by CAV-1 and CDV; prevents clinical signs and significantly reduces virus shedding caused by CAV-2; and prevents clinical signs, leucopoenia and viral excretion caused by CPV.

The range and prevalence of clinical signs and conformation associated with lameness in working draught donkeys in Pakistan.

Science.gov (United States)

Reix, C E; Burn, C C; Pritchard, J C; Barr, A R S; Whay, H R

2014-11-01

Lameness is prevalent in working donkeys and has major welfare implications; however, a detailed study of the associated clinical signs is lacking. To describe the range and prevalence of clinical signs and conformation associated with lameness in working draught donkeys. Prospective, cross-sectional, observational study. Data were collected from 102 working draught donkeys in Pakistan. A lameness assessment adapted for working donkeys was used to record clinical signs of lameness, gait, limb conformation and pain responses in the feet, limbs and spine using observation, palpation and manipulation. Lameness at the walk was scored from 0 to 10 (sound to nonweightbearing). Every donkey examined had gait abnormalities, with 5% having a nonweightbearing limb. Lameness was significantly more severe with older age, lower body condition score and forward-at-the-knee conformation. More severe lameness was also associated with pain responses in the hoof walls, palpation of limb joints and spinal flexion. Joint, tendon and foot pathology was highly prevalent, as well as pain responses to joint flexion and spinal manipulation. Conformational abnormalities showed lateral asymmetries. Over 98% of the world's 42.2 million donkeys are in low-income countries, most being used for work. The high prevalence of lameness, pain and multiple limb and spinal abnormalities in working donkeys is of great welfare concern and highlights the complexity of addressing this problem. This standardised lameness assessment can be used when implementing and monitoring interventions to reduce lameness prevalence in working donkeys. © 2014 EVJ Ltd.

Usher syndrome clinical types I and II: could ocular symptoms and signs differentiate between the two types?

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Tsilou, Ekaterini T; Rubin, Benjamin I; Caruso, Rafael C; Reed, George F; Pikus, Anita; Hejtmancik, James F; Iwata, Fumino; Redman, Joy B; Kaiser-Kupfer, Muriel I

2002-04-01

Usher syndrome types I and II are clinical syndromes with substantial genetic and clinical heterogeneity. We undertook the current study in order to identify ocular symptoms and signs that could differentiate between the two types. Sixty-seven patients with Usher syndrome were evaluated. Based on audiologic and vestibular findings, patients were classified as either Usher type I or II. The severity of the ocular signs and symptoms present in each type were compared. Visual acuity, visual field area, electroretinographic amplitude, incidence of cataract and macular lesions were not significantly different between Usher types I and II. However, the ages when night blindness was perceived and retinitis pigmentosa was diagnosed differed significantly between the two types. There seems to be some overlap between types I and II of Usher syndrome in regard to the ophthalmologic findings. However, night blindness appears earlier in Usher type I (although the difference in age of appearance appears to be less dramatic than previously assumed). Molecular elucidation of Usher syndrome may serve as a key to understanding these differences and, perhaps, provide a better tool for use in clinical diagnosis, prognosis and genetic counseling.

Clinical and microscopic signs of cervicitis and urethritis: correlation with Chlamydia trachomatis infection in female STI patients.

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Berntsson, Matilda; Tunbäck, Petra

2013-03-27

Chlamydia trachomatis is among the most prevalent genital infections and is an important cause of tubal factor infertility. The majority of infected females are asymptomatic. Evidence on the reliability of signs of inflammation used to predict chlamydia in female patients is inconsistent. This study examined associations between criteria routinely used in many Scandinavian sexually transmitted infection (STI) clinics and a positive chlamydia test in a high-prevalence population. Clinical and microscopic signs of cervicitis and urethritis were recorded in 99 women attending due to chlamydia infection in a sexual partner. Mucopurulent cervical discharge, easily induced bleeding from the cervix, and more polymorpho-nuclear cells than epithelial cells in vaginal wet smear all correlated significantly with a positive Chlamydia trachomatis test (odds ratios: 3.4, 4.0 and 4.8, respectively). Increased numbers of polymorphonuclear leucocytes (>30 and ≥ 5 respectively) in stained cervical and urethral smears were not significantly correlated with chlamydia infection. Hence, routine collection of cervical and urethral smears in female STI patients is questionable.

Intensive Blood Pressure Reduction and Spot Sign in Intracerebral Hemorrhage: A Secondary Analysis of a Randomized Clinical Trial.

Science.gov (United States)

Morotti, Andrea; Brouwers, H Bart; Romero, Javier M; Jessel, Michael J; Vashkevich, Anastasia; Schwab, Kristin; Afzal, Mohammad Rauf; Cassarly, Christy; Greenberg, Steven M; Martin, Renee Hebert; Qureshi, Adnan I; Rosand, Jonathan; Goldstein, Joshua N

2017-08-01

The computed tomographic angiography (CTA) spot sign is associated with intracerebral hemorrhage (ICH) expansion and may mark those patients most likely to benefit from intensive blood pressure (BP) reduction. To investigate whether the spot sign is associated with ICH expansion across a wide range of centers and whether intensive BP reduction decreases hematoma expansion and improves outcome in patients with ICH and a spot sign. SCORE-IT (Spot Sign Score in Restricting ICH Growth) is a preplanned prospective observational study nested in the Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-II) randomized clinical trial. Participants included consecutive patients with primary ICH who underwent a CTA within 8 hours from onset at 59 sites from May 15, 2011, through December 19, 2015. Data were analyzed for the present study from July 1 to August 31, 2016. Patients in ATACH-II were randomized to intensive (systolic BP target, spot sign, and 24 of 123 without missing data (19.5%) experienced ICH expansion. The spot sign was associated with expansion with sensitivity of 0.54 (95% CI, 0.34-0.74) and specificity of 0.63 (95% CI, 0.53-0.72). After adjustment for potential confounders, intensive BP treatment was not associated with a significant reduction of ICH expansion (relative risk, 0.83; 95% CI, 0.27-2.51; P = .74) or improved outcome (relative risk of 90-day modified Rankin Scale score ≥4, 1.24; 95% CI, 0.53-2.91; P = .62) in spot sign-positive patients. The predictive performance of the spot sign for ICH expansion was lower than in prior reports from single-center studies. No evidence suggested that patients with ICH and a spot sign specifically benefit from intensive BP reduction. clinicaltrials.gov Identifier: NCT01176565.

Overcoming the problem of diagnostic heterogeneity in applying measurement-based care in clinical practice: the concept of psychiatric vital signs.

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Zimmerman, Mark; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy; Galione, Janine N

2012-02-01

Measurement-based care refers to the use of standardized scales to measure the outcome of psychiatric treatment. Diagnostic heterogeneity poses a challenge toward the adoption of a measurement-based care approach toward outcome evaluation in clinical practice. In the present article, we propose adopting the concept of psychiatric vital signs to facilitate measurement-based care. Medical vital signs are measures of basic physiologic functions that are routinely determined in medical settings. Vital signs are often a primary outcome measure, and they are also often adjunctive measurements. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we examined the frequency of depression and anxiety in a diagnostically heterogeneous group of psychiatric outpatients to determine the appropriateness of considering their measurement as psychiatric vital signs. Three thousand psychiatric outpatients were interviewed with the Structured Clinical Interview for DSM-IV supplemented with items from the Schedule for Affective Disorders and Schizophrenia. We determined the frequency of depression and anxiety evaluated according to the Schedule for Affective Disorders and Schizophrenia items. In the entire sample of 3000 patients, 79.3% (n = 2378) reported clinically significant depression of at least mild severity, 64.4% (n = 1932) reported anxiety of at least mild severity, and 87.4% (n = 2621) reported either anxiety or depression. In all 10 diagnostic categories examined, most patients had clinically significant anxiety or depression of at least mild severity. These findings support the routine assessment of anxiety and depression in clinical practice because almost all patients will have these problems as part of their initial presentation. Even for those patients without depression or anxiety, the case could be made that the measurement of depression and anxiety is relevant and analogous to measuring certain physiologic

Boomerang sign: Clinical significance of transient lesion in splenium of corpus callosum.

Science.gov (United States)

Malhotra, Hardeep Singh; Garg, Ravindra Kumar; Vidhate, Mukund R; Sharma, Pawan Kumar

2012-04-01

Transient signal abnormality in the splenium of corpus callosum on magnetic resonance imaging (MRI) is occasionally encountered in clinical practice. It has been reported in various clinical conditions apart from patients with epilepsy. We describe 4 patients with different etiologies presenting with signal changes in the splenium of corpus callosum. They were diagnosed as having progressive myoclonic epilepsy (case 1), localization-related epilepsy (case 2), hemicrania continua (case 3), and postinfectious parkinsonism (case 4). While three patients had complete involvement of the splenium on diffusion-weighted image ("boomerang sign"), the patient having hemicrania continua showed semilunar involvement ("mini-boomerang") on T2-weighted and FLAIR image. All the cases had noncontiguous involvement of the splenium. We herein, discuss these cases with transient splenial involvement and stress that such patients do not need aggressive diagnostic and therapeutic interventions. An attempt has been made to review the literature regarding the pathophysiology, etiology, and outcome of such lesions.

Boomerang sign: Clinical significance of transient lesion in splenium of corpus callosum

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Hardeep Singh Malhotra

2012-01-01

Full Text Available Transient signal abnormality in the splenium of corpus callosum on magnetic resonance imaging (MRI is occasionally encountered in clinical practice. It has been reported in various clinical conditions apart from patients with epilepsy. We describe 4 patients with different etiologies presenting with signal changes in the splenium of corpus callosum. They were diagnosed as having progressive myoclonic epilepsy (case 1, localization-related epilepsy (case 2, hemicrania continua (case 3, and postinfectious parkinsonism (case 4. While three patients had complete involvement of the splenium on diffusion-weighted image ("boomerang sign", the patient having hemicrania continua showed semilunar involvement ("mini-boomerang" on T2-weighted and FLAIR image. All the cases had noncontiguous involvement of the splenium. We herein, discuss these cases with transient splenial involvement and stress that such patients do not need aggressive diagnostic and therapeutic interventions. An attempt has been made to review the literature regarding the pathophysiology, etiology, and outcome of such lesions.

Clinical and laboratory signs associated to serious dengue disease in hospitalized children

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Sheila Moura Pone

Full Text Available Abstract Objective: To evaluate the validity of clinical and laboratory signs to serious dengue disease in hospitalized children. Methods: Retrospective cohort of children (19 and negative likelihood ratio <0.6. Pleural effusion and abdominal distension had higher sensitivity (82.6%. History of bleeding (epistaxis, gingival or gastrointestinal bleeding and severe hemorrhage (pulmonary or gastrointestinal bleeding in physical examination were more frequent in serious dengue disease (p < 0.01, but with poor accuracy (positive likelihood ratio = 1.89 and 3.89; negative likelihood ratio = 0.53 and 0.60, respectively. Serum albumin was lower in serious dengue forms (p < 0.01. Despite statistical significance (p < 0.05, both groups presented thrombocytopenia. Platelets count, hematocrit, and hemoglobin parameters had area under the curve <0.5. Conclusions: Lethargy, abdominal distension, pleural effusion, and hypoalbuminemia were the best clinical and laboratorial markers of serious dengue disease in hospitalized children, while bleeding, severe hemorrhage, hemoconcentration and thrombocytopenia did not reach adequate diagnostic accuracy. In pediatric referral hospitals, the absence of hemoconcentration does not imply absence of plasma leakage, particularly in children with previous fluid replacement. These findings may contribute to the clinical management of dengue in children at referral hospitals.

Adverse food reactions: Pathogenesis, clinical signs, diagnosis and alternatives to elimination diets.

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Mueller, R S; Unterer, S

2018-06-01

This review summarises available information about adverse food reactions in dogs and cats. Much of the published information on the pathogenesis of adverse food reactions in these species is transferred from what is known in mice and human beings. Clinical signs affect mostly the integument and gastrointestinal system. Pruritus of the distal limbs, face, ears and ventrum is the most common cutaneous presentation in dogs, although urticaria has also been reported. In cats, all so-called 'cutaneous reaction patterns' may be due to adverse food reactions. The most common gastrointestinal signs in both species are diarrhoea and vomiting. An elimination diet over several weeks using a protein source and a carbohydrate source previously not fed is still the diagnostic tool of choice. Improvement on such a diet, deterioration on re-challenge with the old food and improvement again on the elimination diet confirms the diagnosis of adverse food reaction, whereas alternative tests of blood, serum, saliva and hair have been found to be unsatisfactory. Patch testing with food antigens has been recommended as an aid to choose the elimination diet ingredients, since it has a reasonable negative predictability and likelihood ratio, but is laborious and costly. Copyright © 2018 Elsevier Ltd. All rights reserved.

[About the signs of malignant pheochromocytoma].

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Simonenko, V B; Makanin, M A; Dulin, P A; Vasilchenko, M I; Lesovik, V S

2012-01-01

Morphological criteria for malignant pheochromocytoma remain to be developed According to the WHO recommendations, the sole absolute criteria is the presence of metastases in the organs normally containing no chromaffin tissue. Such signs as cellular and nuclear polymorphism, mytotic activity, vascular invasion, capsular ingrowth are not sufficient to describe a pheochromocytoma as malignant. It is equally dfficult to differentiate between malignant and benign tumours based on histological data since histologically mature neoplasms can produce metastases. Based on the results of original studies, the authors believe that such histological features as vascular and capsular invasion do not necessarily suggest unfavourable prognosis. Therefore, the conclusion of malignancy based on such features can not be regarded as absolute. Probably such neoplasms should be called "pheochromocytomas with morphological signs of malignant growths". They should be referred to the tumours with uncertain malignancy potential based on the known discrepancy between morphological structure and biological activity of neoplasms. Comparative studies of clinical and morphological features of pheochromocytomas showed that their histological type (alveolar; solid, dyscomplexed, trabecular) and morphological signs of malignant growth influence both the clinical picture and arterial hypertension. There are no significant relationship between the above morphological signs, timour mass and clinical manifestations of pheochromocytomas.

Radiographic and tomographic aspects of meningeal hemangiosarcoma in a German Shepherd dog with clinical signs of cauda equina sindrome

International Nuclear Information System (INIS)

Pinto, A.C.B. de C.F.; Ferrigno, C.R.A.; Matera, J.M.; Torres, L.N.; Sinhorini, I.L.; Cortopassi, S.R.G.; Hage, M.C.F.N.S.

2007-01-01

Hemangiosarcoma is a highly malignant neoplasia derived from the endothelial cell line and, therefore, can arise in any tissue with blood vessels. A case of a rare meningeal site of hemangiosarcoma in an eight-year old German Shepherd dog with clinical signs of cauda equina sindrome is described. The diagnosis was made based on clinical, radiographic, tomographic and histopathological findings [pt

Lhermitte's sign and vitamin B12 deficiency: case report

OpenAIRE

Teive, Hélio Afonso Ghizoni; Haratz, Salo; Zavala, Jorge; Munhoz, Renato Puppi; Scola, Rosana Hermínia; Werneck, Lineu César

2009-01-01

CONTEXT AND OBJECTIVE: Lhermitte's sign, a classical neurological sign, is a rare manifestation of vitamin B12 deficiency. The aim here was to report on a case of an elderly patient with vitamin B12 deficiency whose first clinical manifestation was the presence of Lhermitte's sign. CASE REPORT: We describe an elderly patient with vitamin B12 deficiency who presented cognitive dysfunction, peripheral polyneuropathy and sensory ataxia, and whose first clinical manifestation was the presence of ...

TBscore: Signs and symptoms from tuberculosis patients in a low-resource setting have predictive value and may be used to assess clinical course

DEFF Research Database (Denmark)

Wejse, Christian; Gustafson, Per; Nielsen, Jens

2008-01-01

We developed a clinical score to monitor tuberculosis patients in treatment and to assess clinical outcome. We used the WHO clinical manual to choose signs and symptoms, including cough, haemoptysis, dyspnoea, chest pain, night sweating, anaemia, tachycardia, lung-auscultation finding, fever, low...

Clinical signs of radiologic pneumonia in under-five hypokalemic diarrheal children admitted to an urban hospital in bangladesh.

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Mohammod Jobayer Chisti

Full Text Available BACKGROUND: Clinical signs of pneumonia are often veiled in under-five diarrheal children presenting with hypokalemia, making clinical diagnosis of pneumonia very difficult in such population. However, there is no published report that describes the influences of hypokalemia on the clinical signs of pneumonia in diarrheal children. Our objective was to assess the influences of hypokalemia, and their outcome in such children. METHODS: We prospectively enrolled all under-five diarrheal children (n = 180 admitted to the Special Care Ward of the Dhaka Hospital of icddr,b from September-December 2007 with radiological pneumonia who also had their serum potassium estimated. We compared the clinical features and outcome of the diarrheal children having pneumonia with (cases = 55 and without hypokalemia (controls = 125. RESULTS: The case-fatality among the cases was 2 times higher compared to the controls, but the difference was not statistically significant (p = 0.202. In logistic regression analysis, after adjusting for potential confounders such as age of the patient, clinical dehydration, severe wasting, abnormally sleepy, lower chest wall in-drawing, nasal flaring and inability to drink on admission, under-five diarrheal children with pneumonia who presented with nutritional edema had 3 times more risk to have hypokalemia compared to those without nutritional edema (OR = 2.76, 95% CI = 1.01-7.51 and these hypokalemic children were 64% less likely to present with fast breathing (OR = 0.36, 95% CI = 0.17-0.74. CONCLUSION AND SIGNIFICANCE: The results of our analysis are simple but may have great public health implications and underscore the importance of diligent assessment for pneumonia in under-five diarrheal children having risk of hypokalemia as in children with nutritional edema even in absence of fast breathing, a useful sign of pneumonia. This may help for early initiation of first dose of parental antibiotics

Clinical Signs of Radiologic Pneumonia in Under-Five Hypokalemic Diarrheal Children Admitted to an Urban Hospital in Bangladesh

Science.gov (United States)

Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Ashraf, Hasan; Faruque, Abu S. G.; Bardhan, Pradip Kumar; Das, Sumon Kumar; Shahunja, K. M.; Shahid, Abu S. M. S. B.; Ahmed, Tahmeed

2013-01-01

Background Clinical signs of pneumonia are often veiled in under-five diarrheal children presenting with hypokalemia, making clinical diagnosis of pneumonia very difficult in such population. However, there is no published report that describes the influences of hypokalemia on the clinical signs of pneumonia in diarrheal children. Our objective was to assess the influences of hypokalemia, and their outcome in such children. Methods We prospectively enrolled all under-five diarrheal children (n = 180) admitted to the Special Care Ward of the Dhaka Hospital of icddr,b from September-December 2007 with radiological pneumonia who also had their serum potassium estimated. We compared the clinical features and outcome of the diarrheal children having pneumonia with (cases = 55) and without hypokalemia (controls = 125). Results The case-fatality among the cases was 2 times higher compared to the controls, but the difference was not statistically significant (p = 0.202). In logistic regression analysis, after adjusting for potential confounders such as age of the patient, clinical dehydration, severe wasting, abnormally sleepy, lower chest wall in-drawing, nasal flaring and inability to drink on admission, under-five diarrheal children with pneumonia who presented with nutritional edema had 3 times more risk to have hypokalemia compared to those without nutritional edema (OR = 2.76, 95% CI = 1.01–7.51) and these hypokalemic children were 64% less likely to present with fast breathing (OR = 0.36, 95% CI = 0.17–0.74). Conclusion and significance The results of our analysis are simple but may have great public health implications and underscore the importance of diligent assessment for pneumonia in under-five diarrheal children having risk of hypokalemia as in children with nutritional edema even in absence of fast breathing, a useful sign of pneumonia. This may help for early initiation of first dose of parental antibiotics along with

Influence of vestibulovaginal stenosis, pelvic bladder, and recessed vulva on response to treatment for clinical signs of lower urinary tract disease in dogs: 38 cases (1990-1999).

Science.gov (United States)

Crawford, Jason T; Adams, William M

2002-10-01

To determine influence of vestibulovaginal stenosis, pelvic bladder, and recessed vulva on response to treatment for clinical signs of lower urinary tract disease in dogs. Retrospective study. 38 spayed female dogs. Medical records and client follow-up were reviewed for dogs evaluated via excretory urography because of clinical signs of lower urinary tract disease. Clinical signs, results of radiography, and response to surgical or medical treatment were analyzed. Clinical signs included urinary tract infection (n = 24), urinary incontinence (20), vaginitis (11), pollakiuria or stranguria (10), and perivulvar dermatitis (4). Vaginocystourethrographic findings included vestibulovaginal stenosis (n = 28), pelvic bladder (17), and ureteritis or pyelonephritis (4). Ten dogs had a vestibulovaginal ratio of stenosis), 9 dogs had a ratio of 0.20 to 0.25 (moderate stenosis), 9 dogs had a ratio of 0.26 to 0.35 (mild stenosis), and 10 dogs had a ratio of > 0.35 (anatomically normal). Lower urinary tract infection, incontinence, and pelvic bladder were not associated with response to treatment for recessed vulva. Vestibulovaginal stenosis with a ratio Dogs without severe vestibulovaginal stenosis that received vulvoplasty for a recessed vulva responded well to treatment. Vestibulovaginal stenosis is likely an important factor in dogs with vestibulovaginal ratio dogs with severe vestibulovaginal stenosis and signs of lower urinary tract disease.

Effect of Inhalation of Lavender Essential Oil on Vital Signs in Open Heart Surgery ICU.

Science.gov (United States)

Salamati, Armaiti; Mashouf, Soheyla; Mojab, Faraz

2017-01-01

This study evaluated the effects of inhalation of Lavender essential oil on vital signs in open heart surgery ICU. The main complaint of patients after open-heart surgery is dysrhythmia, tachycardia, and hypertension due to stress and pain. Due to the side effects of chemical drugs, such as opioids, use of non-invasive methods such as aromatherapy for relieving stress and pain parallel to chemical agents could be an important way to decrease the dose and side effects of analgesics. In a multicenter, single-blind trial, 40 patients who had open-heart surgery were recruited. Inclusion criteria were full consciousness, lack of hemorrhage, heart rate >60 beats/min, systolic blood pressure > 100 mmHg, and diastolic blood pressure > 60 mmHg, not using beta blockers in the operating room or ICU, no history of addiction to opioids or use of analgesics in regular, spontaneous breathing ability and not receiving synthetic opioids within 2 h before extubation. Ten minutes after extubation, the patients› vital signs [including BP, HR, Central Venous Pressure (CVP), SPO2, and RR] were measured. Then, a cotton swab, which was impregnated with 2 drops of Lavender essential oil 2%, was placed in patients' oxygen mask and patients breathed for 10 min. Thirty minutes after aromatherapy, the vital signs were measured again. Main objective of this study was the change in vital sign before and after aromatherapy. Statistical significance was accepted for P 0.001), diastolic blood pressure (p = 0.001), and heart rate (p = 0.03) before and after the intervention using paired t-test. Although, the results did not show any significant difference in respiratory rate (p = 0.1), SpO2 (p = 0.5) and CVP (p = 0.2) before and after inhaling Lavender essential oil. Therefore, the aromatherapy could effectively reduce blood pressure and heart rate in patients admitted to the open heart surgery ICU and can be used as an independent nursing intervention in stabilizing mentioned vital signs. The

Multidisciplinary Modelling of Symptoms and Signs with Archetypes and SNOMED-CT for Clinical Decision Support.

Science.gov (United States)

Marco-Ruiz, Luis; Maldonado, J Alberto; Karlsen, Randi; Bellika, Johan G

2015-01-01

Clinical Decision Support Systems (CDSS) help to improve health care and reduce costs. However, the lack of knowledge management and modelling hampers their maintenance and reuse. Current EHR standards and terminologies can allow the semantic representation of the data and knowledge of CDSS systems boosting their interoperability, reuse and maintenance. This paper presents the modelling process of respiratory conditions' symptoms and signs by a multidisciplinary team of clinicians and information architects with the help of openEHR, SNOMED and clinical information modelling tools for a CDSS. The information model of the CDSS was defined by means of an archetype and the knowledge model was implemented by means of an SNOMED-CT based ontology.

The effect of the quality of vital sign recording on clinical decision making in a regional acute care trauma ward.

Science.gov (United States)

Keene, Claire M; Kong, Victor Y; Clarke, Damian L; Brysiewicz, Petra

2017-10-01

Recording vital signs is important in the hospital setting and the quality of this documentation influences clinical decision making. The Modified Early Warning Score (MEWS) uses vital signs to categorise the severity of a patient's physiological derangement and illustrates the clinical impact of vital signs in detecting patient deterioration and making management decisions. This descriptive study measured the quality of vital sign recordings in an acute care trauma setting, and used the MEWS to determine the impact the documentation quality had on the detection of physiological derangements and thus, clinical decision making. Vital signs recorded by the nursing staff of all trauma patients in the acute care trauma wards at a regional hospital in South Africa were collected from January 2013 to February 2013. Investigator-measured values taken within 2 hours of the routine observations and baseline patient information were also recorded. A MEWS for each patient was calculated from the routine and investigator-measured observations. Basic descriptive statistics were performed using EXCEL. The details of 181 newly admitted patients were collected. Completion of recordings was 81% for heart rate, 88% for respiratory rate, 98% for blood pressure, 92% for temperature and 41% for GCS. The recorded heart rate was positively correlated with the investigator's measurement (Pearson's correlation coefficient of 0.76); while the respiratory rate did not correlate (Pearson's correlation coefficient of 0.02). In 59% of patients the recorded respiratory rate (RR) was exactly 20 breaths per minute and 27% had a recorded RR of exactly 15. Seven percent of patients had aberrant Glasgow Coma Scale readings above the maximum value of 15. The average MEWS was 2 for both the recorded (MEWS(R)) and investigator (MEWS(I)) vitals, with the range of MEWS(R) 0-7 and MEWS(I) 0-9. Analysis showed 59% of the MEWS(R) underestimated the physiological derangement (scores were lower than the MEWS

Name signs in Danish Sign Language

DEFF Research Database (Denmark)

Bakken Jepsen, Julie

2018-01-01

in spoken languages, where a person working as a blacksmith by his friends might be referred to as ‘The Blacksmith’ (‘Here comes the Blacksmith!’) instead of using the person’s first name. Name signs are found not only in Danish Sign Language (DSL) but in most, if not all, sign languages studied to date....... This article provides examples of the creativity of the users of Danish Sign Language, including some of the processes in the use of metaphors, visual motivation and influence from Danish when name signs are created.......A name sign is a personal sign assigned to deaf, hearing impaired and hearing persons who enter the deaf community. The mouth action accompanying the sign reproduces all or part of the formal first name that the person has received by baptism or naming. Name signs can be compared to nicknames...

Basilar artery occlusion: Prognostic signs of severity on computed tomography

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Poletti, Pierre-Alexandre, E-mail: pierre-alexandre.poletti@hcuge.ch [Service of Radiology, University Hospital of Geneva (Switzerland); Pereira, Vitor Mendes [Service of Neuroradiology, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva (Switzerland); Department of Medical Imaging, University of Toronto (Canada); Department of Surgery, University of Toronto (Canada); Lovblad, Karl-Olof [Service of Neuroradiology, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva (Switzerland); Canel, Lucie [Service of Radiology, University Hospital of Geneva (Switzerland); Sztajzel, Roman [Service of Neurology, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva (Switzerland); Becker, Minerva [Service of Radiology, University Hospital of Geneva (Switzerland); Perneger, Thomas [Division of Clinical Epidemiology, University Hospital of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva (Switzerland); Platon, Alexandra [Service of Radiology, University Hospital of Geneva (Switzerland)

2015-07-15

Highlights: • The main CT signs associated with basilar artery occlusion were analyzed. • CT sign of acute ischemic lesion is significantly associated with a bad outcome. • The site of the basilar artery occlusion is not associated to the patients’ outcome. - Abstract: Purpose: To determine the computed tomography (CT) signs that are predictive of the clinical outcome of basilar artery occlusion (BAO). Materials and methods: The study population consisted in 37 patients (14 women, 23 men, mean age: 63 years), admitted with onset of neurological deficit, starting 1–72 h prior to admission, who were diagnosed with BAO on the basis of a CT examination with intravenous contrast agent. The following signs were collected on CT scans performed on admission: clot density on noncontrast images, clot length, and clot location, as well as the presence of acute ischemic lesions. The results were compared against the modified Rankin Scale (mRS) score of patients at 3 months, favorable clinical outcome being defined as a mRS score ≤3. Results: The clinical outcome was favorable in 13 (35%) of the 37 patients and unfavorable in 24 (65%). Signs of acute ischemia were visible in 13 of the 24 patients with unfavorable outcome but in none of the 13 patients with favorable outcome (p < 0.001). None of the other CT signs analyzed were significantly correlated with clinical prognosis. Conclusion: Of all the CT signs analyzed, only the presence of signs of acute ischemia on the admission CT of patients with BAO was associated with poor prognosis.

Sepsis and meningitis in hospitalized children: performance of clinical signs and their prediction rules in a case-control study.

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Verbakel, Jan Y; MacFaul, Roderick; Aertgeerts, Bert; Buntinx, Frank; Thompson, Matthew

2014-06-01

Feverish illness is a common presentation to acute pediatric services. Clinical staff faces the challenge of differentiating the few children with meningitis or sepsis from the majority with self-limiting illness. We aimed to determine the diagnostic value of clinical features and their prediction rules (CPR) for identifying children with sepsis or meningitis among those children admitted to a District General Hospital with acute febrile illness. Acutely ill children admitted to a District General Hospital in England were included in this case-control study between 2000 and 2005. We examined the diagnostic accuracy of individual clinical signs and 6 CPRs, including the National Institute for Clinical Excellence "traffic light" system, to determine clinical utility in identifying children with a diagnosis of sepsis or meningitis. Loss of consciousness, prolonged capillary refill, decreased alertness, respiratory effort, and the physician's illness assessment had high positive likelihood ratios (9-114), although with wide confidence intervals, to rule in sepsis or meningitis. The National Institute for Clinical Excellence traffic light system, the modified Yale Observation Scale, and the Pediatric Advanced Warning Score performed poorly with positive likelihood ratios ranging from 1 to 3. The pediatrician's overall illness assessment was the most useful feature to rule in sepsis or meningitis in these hospitalized children. Clinical prediction rules did not effectively rule in sepsis or meningitis. The modified Yale Observation Scale should be used with caution. Single clinical signs could complement these scores to rule in sepsis or meningitis. Further research is needed to validate these CPRs.

Radiological signs of the syndrome of the trephined

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Vasung, Lana [Service du Developpement et de la Croissance, Departement de l' Enfant et de l' Adolescent, Geneve (Switzerland); Geneva University Hospitals, Division of Neuroradiology, Geneva (Switzerland); Hamard, Marion [Geneva University Hospitals, Division of Radiology, Geneva (Switzerland); Alcaraz Soto, Maria Carmen; Sommaruga, Samuel; Vargas, Maria Isabel [Geneva University Hospitals, Division of Neuroradiology, Geneva (Switzerland); Sveikata, Lukas [Geneva University Hospitals, Division of Neurosurgery, Geneva (Switzerland); Leemann, Beatrice [Geneva University Hospitals, Division of Neurorehabilitation, Geneva (Switzerland)

2016-06-15

Syndrome of the trephined (ST) is a post-craniectomy complication. It is characterized by the appearance of new neurological symptoms following the craniectomy, which are relieved after cranioplasty. The purpose of our work was to identify radiological signs and imaging biomarkers of the ST. CT images of 32 patients were retrospectively analyzed (ST = 13, controls = 19). While the shapes of craniectomy flap were qualitatively assessed, deviation of the midline structures, relative intracranial cerebrospinal fluid (CSF) volume, and the 3rd ventricle's volume were quantitatively measured. We did not find between-group differences in the mean age or number of post-craniectomy days. ST was diagnosed during the second post-craniectomy month. The occurrence of a sunken skin flap sign was similar in both groups (69.23 % in ST group, 57.89 % in control group). Occurrence of paradoxical herniation and deviation of the midline structures were not significantly different between groups. Mean relative intracranial CSF volume was significantly smaller in ST patients (ST = 5.59 %, controls = 8.12 %, p = 0.01). ST patients, compared to controls, had also significantly smaller mean 3rd ventricle volumes (ST = 1748 mm{sup 3}, controls = 2772.97 mm{sup 3}, p = 0.03). ST is an infrequent and delayed post-craniectomy complication. The most common radiological findings (paradoxical herniation, deviation of the midline structures, and sunken skin flap sign) might not be specific for ST. Significantly lower 3rd ventricle, and relative intracranial CSF volumes, suggest that altered biophysical CSF properties underlie ST pathophysiology. Therefore, volume measurements of 3rd ventricle could be useful for identification of patients who have higher probability of developing the ST. (orig.)

Effects of herbal medicine Sijunzi decoction on rabbits after relieving intestinal obstruction

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L. Li

2017-09-01

Full Text Available Intestinal obstruction leads to blockage of the movement of intestinal contents. After relieving the obstruction, patients might still suffer with compromised immune function and nutritional deficiency. This study aimed to evaluate the effects of Sijunzi decoction on restoring the immune function and nutritional status after relieving the obstruction. Experimental rabbits (2.5±0.2 kg were randomly divided into normal control group, 2-day intestinal obstruction group, 2-day natural recovery group, 4-day natural recovery group, 2-day treated group, and 4-day treated group. Sijunzi decoction was given twice a day to the treated groups. The concentration of markers was analyzed to evaluate the immune function and nutritional status. The concentration of interleukin-2, immunoglobulins and complement components of the treated groups were significantly higher than the natural recovery group (P<0.05. The levels of CD4+ and CD4+/CD8+ increased then decreased in the treated groups. The levels of tumor necrosis factor-α and CD8+ were significantly lower than the natural recovery group. The level of total protein in the treated groups also increased then decreased after relieving the obstruction. The levels of albumin, prealbumin and insulin-like growth factor-1 were significantly higher in the treated groups than in the natural recovery group (P<0.05. Transferrin level in the treated groups was significantly higher than the obstruction group (P<0.05. Sijunzi decoction can lessen the inflammatory response and improve the nutrition absorption after relieving the obstruction.

Are there clinical signs and symptoms of infection to indicate the presence of multidrug-resistant bacteria in venous ulcers?

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Dos Santos, Silvana de Lima Vieira; Martins, Marlene Andrade; do Prado, Marinésia Aparecida; Soriano, José Verdú; Bachion, Maria Márcia

2017-12-01

The selection of topical and systemic therapies for the treatment of venous ulcers with signs of infection is challenging and should be accompanied by specific precautionary measures to protect against cross-contamination in the presence of multidrug-resistant microorganisms. However, there are still no clinical indicators for this situation, and confirmation of resistant strains occurs through culture and sensitivity, which can take up to 14 days. During this period, protective measures may no longer be taken, contributing to the spread of these pathogens. This study aimed to analyze the relationship between clinical signs and symptoms of infection in venous ulcers and the presence of antimicrobial-resistant Staphylococcus aureus and/or Pseudomonas spp. A cross-sectional study was developed including 69 patients with 98 venous ulcers. Clinical observation protocol was applied to detect infection indicators established by the European Wound Management Association and microbiological analysis of samples of the lesions. Fisher's exact test and χ 2 were used for analyses (P 70%): discoloration of the opaque type and/or dark brick red and increased exudate volume; 31 (31.6%) ulcer samples showed positive culture for the bacteria studied. There was no relationship between signs and symptoms of infection and the presence of multidrug-resistant microorganisms. Taking into account the percentage of lesions with resistant strains, for safe care, contact precautionary measures should be implemented in the treatment rooms, in addition to standard precautions. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

On the System of Person-Denoting Signs in Estonian Sign Language: Estonian Name Signs

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Paales, Liina

2010-01-01

This article discusses Estonian personal name signs. According to study there are four personal name sign categories in Estonian Sign Language: (1) arbitrary name signs; (2) descriptive name signs; (3) initialized-descriptive name signs; (4) loan/borrowed name signs. Mostly there are represented descriptive and borrowed personal name signs among…

A clinical decision-making mechanism for context-aware and patient-specific remote monitoring systems using the correlations of multiple vital signs.

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Forkan, Abdur Rahim Mohammad; Khalil, Ibrahim

2017-02-01

In home-based context-aware monitoring patient's real-time data of multiple vital signs (e.g. heart rate, blood pressure) are continuously generated from wearable sensors. The changes in such vital parameters are highly correlated. They are also patient-centric and can be either recurrent or can fluctuate. The objective of this study is to develop an intelligent method for personalized monitoring and clinical decision support through early estimation of patient-specific vital sign values, and prediction of anomalies using the interrelation among multiple vital signs. In this paper, multi-label classification algorithms are applied in classifier design to forecast these values and related abnormalities. We proposed a completely new approach of patient-specific vital sign prediction system using their correlations. The developed technique can guide healthcare professionals to make accurate clinical decisions. Moreover, our model can support many patients with various clinical conditions concurrently by utilizing the power of cloud computing technology. The developed method also reduces the rate of false predictions in remote monitoring centres. In the experimental settings, the statistical features and correlations of six vital signs are formulated as multi-label classification problem. Eight multi-label classification algorithms along with three fundamental machine learning algorithms are used and tested on a public dataset of 85 patients. Different multi-label classification evaluation measures such as Hamming score, F1-micro average, and accuracy are used for interpreting the prediction performance of patient-specific situation classifications. We achieved 90-95% Hamming score values across 24 classifier combinations for 85 different patients used in our experiment. The results are compared with single-label classifiers and without considering the correlations among the vitals. The comparisons show that multi-label method is the best technique for this problem

[Deficient identification of signs and symptoms in Streptoccoci amigdalitis].

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Carranza-Martínez, Martha Imelda; Valdés-Croda, Oscar; Jaspersen-Gastelum, Víctor; Chavolla-Magaña, Rogelio; Villaseñor-Sierra, Alberto

2006-01-01

To evaluate the degree of identification of main signs and symptoms of streptococcal pharyngitis by resident doctors, general practitioners, family physicians and pediatricians. A prospective, cross-sectional and comparative study was done. A validated questionnaire was applied including the following topics: social demographic, main signs and symptoms, clinical cases; and clinical pictures. We interviewed resident doctors (n = 40), general physicians (n = 21), family physicians (n = 35) and pediatricians (n = 19) from different institutions (SSa, ISSSTE, IMSS) in Guadalajara, Mexico, from March to August 2005. Scores were interpreted as very good, good, regular and poor, and these scores were related with the specialty and clinical years of experience. chi2, student t test and linear regression. This study included 115 physicians between 22 to 60 years old (mean = 39) and with 0 to 31 (mean = 10) clinical years of experience. Regarding the conceptual identification of main signs and symptoms, tonsil exudates were recognized by 33 to 61% of physicians, and a clinical case of streptococcal tonsillitis was recognized by 50 to 70%. A clinical picture of tonsil caseum was misinterpreted as streptococcal tonsillitis by 13 to 35% of the physicians. There was no association between years of clinical experience and the scores obtained in clinical cases (r = 0.20) or clinical pictures (r = 0.09). The clinical identification of streptococcal tonsillitis was regular to poor among all the interviewed physicians, and there had no correlation with the years of clinical experience. The reinforcement in teaching to recognize the key signs and symptoms of streptococcal tonsillitis at medical school would result in better recognition, more rational use of antimicrobials and reduction in health institutions costs.

The onset of virus shedding and clinical signs in chickens infected with high-pathogenicity and low-pathogenicity avian influenza viruses.

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Spickler, Anna R; Trampel, Darrell W; Roth, James A

2008-12-01

Some avian influenza viruses may be transmissible to mammals by ingestion. Cats and dogs have been infected by H5N1 avian influenza viruses when they ate raw poultry, and two human H5N1 infections were linked to the ingestion of uncooked duck blood. The possibility of zoonotic influenza from exposure to raw poultry products raises concerns about flocks with unrecognized infections. The present review examines the onset of virus shedding and the development of clinical signs for a variety of avian influenza viruses in chickens. In experimentally infected birds, some high-pathogenicity avian influenza (HPAI) and low-pathogenicity avian influenza (LPAI) viruses can occur in faeces and respiratory secretions as early as 1 to 2 days after inoculation. Some HPAI viruses have also been found in meat 1 day after inoculation and in eggs after 3 days. There is no evidence that LPAI viruses can be found in meat, and the risk of their occurrence in eggs is poorly understood. Studies in experimentally infected birds suggest that clinical signs usually develop within a few days of virus shedding; however, some models and outbreak descriptions suggest that clinical signs may not become evident for a week or more in some H5 or H7 HPAI-infected flocks. During this time, avian influenza viruses might be found in poultry products. LPAI viruses can be shed in asymptomatically infected or minimally affected flocks, but these viruses are unlikely to cause significant human disease.

Grey matter volume loss is associated with specific clinical motor signs in Huntington's disease.

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Coppen, Emma M; Jacobs, Milou; van den Berg-Huysmans, Annette A; van der Grond, Jeroen; Roos, Raymund A C

2018-01-01

Motor disturbances are clinical hallmarks of Huntington's disease (HD) and involve chorea, dystonia, hypokinesia and visuomotor dysfunction. Investigating the association between specific motor signs and different regional volumes is important to understand the heterogeneity of HD. To investigate the motor phenotype of HD and associations with subcortical and cortical grey matter volume loss. Structural T1-weighted MRI scans of 79 HD patients and 30 healthy controls were used to calculate volumes of seven subcortical structures including the nucleus accumbens, hippocampus, thalamus, caudate nucleus, putamen, pallidum and amygdala. Multiple linear regression analyses, corrected for age, gender, CAG, MRI scan protocol and normalized brain volume, were performed to assess the relationship between subcortical volumes and different motor subdomains (i.e. eye movements, chorea, dystonia, hypokinesia/rigidity and gait/balance). Voxel-based morphometry analysis was used to investigate the relationship between cortical volume changes and motor signs. Subcortical volume loss of the accumbens nucleus, caudate nucleus, putamen, and pallidum were associated with higher chorea scores. No other subcortical region was significantly associated with motor symptoms after correction for multiple comparisons. Voxel-based cortical grey matter volume reductions in occipital regions were related with an increase in eye movement scores. In HD, chorea is mainly associated with subcortical volume loss, while eye movements are more related to cortical volume loss. Both subcortical and cortical degeneration has an impact on motor impairment in HD. This implies that there is a widespread contribution of different brain regions resulting in the clinical motor presentation seen in HD patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Budesonide/formoterol maintenance and reliever therapy versus conventional best practice

DEFF Research Database (Denmark)

Demoly, Pascal; Louis, Renaud; Søes-Petersen, Ulrik

2009-01-01

Budesonide/formoterol maintenance and reliever therapy (Symbicort SMART) reduces asthma exacerbations and symptoms versus fixed-dose regimens plus short-acting beta(2)-agonists (SABA) in double-blind trials. Information is lacking regarding its effectiveness versus conventional best practice (CBP...

Induced Neurocysticercosis in Rhesus Monkeys (Macaca mulatta Produces Clinical Signs and Lesions Similar to Natural Disease in Man

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N. Chowdhury

2014-01-01

Full Text Available Neurocysticercosis is a serious endemic zoonosis resulting in increased cases of seizure and epilepsy in humans. The genesis of clinical manifestations of the disease through experimental animal models is poorly exploited. The monkeys may prove useful for the purpose due to their behavior and cognitive responses mimicking man. In this study, neurocysticercosis was induced in two rhesus monkeys each with 12,000 and 6,000 eggs, whereas three monkeys were given placebo. The monkeys given higher dose developed hyperexcitability, epileptic seizures, muscular tremors, digital cramps at 10 DPI, and finally paralysis of limbs, followed by death on 67 DPI, whereas the monkeys given lower dose showed delayed and milder clinical signs. On necropsy, all the infected monkeys showed numerous cysticerci in the brain. Histopathologically, heavily infected monkeys revealed liquefactive necrosis and formation of irregular cystic cavities lined by atrophied parenchymal septa with remnants of neuropil of the cerebrum. In contrast, the monkeys infected with lower dose showed formation of typical foreign body granulomas characterized by central liquefaction surrounded by chronic inflammatory response. It was concluded that the inflammatory and immune response exerted by the host against cysticerci, in turn, led to histopathological lesions and the resultant clinical signs thereof.

Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases

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Darkovska-Serafimovska M

2018-04-01

Full Text Available Marija Darkovska-Serafimovska,1 Tijana Serafimovska,2 Zorica Arsova-Sarafinovska,1 Sasho Stefanoski,3 Zlatko Keskovski,3 Trajan Balkanov4 1Department of Pharmacology, Faculty of Medical Sciences, Goce Delcev University, Stip, Republic of Macedonia; 2Faculty of Pharmacy, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia; 3NYSK Holdings, Skopje, Republic of Macedonia; 4Department of Pharmacology and Toxicology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia Purpose: The aim of this review was to assess the efficacy of cannabis preparations for relieving pain in patients with malignant diseases, through a systematic review of randomized controlled trials (RCTs, which were predominantly double-blind trials that compared cannabis preparation to a placebo.Methods: An electronic search of all literature published until June 2017 was made in MEDLINE/PubMed, Embase, The Cochrane Controlled Trials Register and specific web pages devoted to cannabis.Results: Fifteen of the 18 trials demonstrated a significant analgesic effect of cannabinoids as compared to placebo. The most commonly reported adverse effects were generally well tolerated, mild to moderate. The main side effects were drowsiness, nausea, vomiting and dry mouth. There is evidence that cannabinoids are safe and modestly effective in neuropathic pain and also for relieving pain in patients with malignant diseases. The proportion of “responders” (patients who at the end of 2 weeks of treatment reported ≥30% reduction in pain intensity on a scale of 0–10, which is considered to be clinically important was 43% in comparison with placebo (21%. Conclusion: The target dose for relieving pain in patients with malignant diseases is most likely about 10 actuations per day, which is about 27 mg tetrahydrocannabinol (THC and 25 mg cannabidiol (CBD, and the highest approved recommended dose is 12 actuations per day (32 mg THC

Gorlin syndrome: Importance of clinical signs and danger of delayed diagnosis - A case report with eight years follow-up

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Erica Dorigatti de-Avila

2015-02-01

Full Text Available Nevoid basal cell carcinoma (NBCCS or Gorlin-Goltz syndrome (GS is a multidisciplinary problem, the early diagnosis of which allows secondary prophylaxis that follows an appropriate regimen to delay progression of the syndrome. The aim of this study was to present a case of delayed diagnosis of GS in a young patient who received multidisciplinary treatment 5 years after onset. The patient presented for evaluation with painless swelling of the left maxilla. Histological examination confirmed the diagnosis of a keratocyst odontogenic tumor (KOT that was enucleated. On presentation, the patient's symptoms and clinical signs were not related to complications of GS, and the possibility of GS was initially rejected, as he did not have a family history of the syndrome. Four years after the first surgery to remove the lesion, the patient came to our clinic with a brown, pigmented lesion. Computed tomography revealed ectopic lamellar calcification of the falx cerebri, which was the conclusive factor for the diagnosis of GS. It is important that clinicians recognize the clinical signs of GS, which mainly manifests itself as multiple basal cell carcinomas in the skin. [Arch Clin Exp Surg 2015; 4(1.000: 49-53

Clinical course and signs in patients with uveitis associated with ankylosing spondylitis

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Refik Oltulu

2013-09-01

Full Text Available Aim: To evaluate clinical course and signs in patients withuveitis associated ankylosing spondylitis (AS.Methods: In this retrospective study we evaluated thepatients who were diagnosed as uveitis related to AS andfollowed up at the Ophthalmology Department of NecmettinErbakan University Hospital between May 2009 andJune 2012. Demographical features and clinical courseswere assessed.Results: Seventeen eyes of 13 patients were includedin the study. Nine patients (69.2% were male and four(30.8% were female. The mean age at presentation was38.54±9.61 years (range 28-63. Bilateral involvementwas observed in four (30.8% patients. The mean followuptime was 17.46±11.86 months (range 3-36. The meannumber of attacks was 1.15±0.37 (range 1-2. Posteriorsegment manifestation accompanied anterior uveitis inthree eyes (17.6%. Posterior synechia developed in one(7.7% and cataract in one patient (7.7%, cystoid macularedema in two patients (15.4%, and epiretinal membranein one patient (%7.7. The mean final visual acuitywas 0.975±0.07 (range 0.2-1.0.Conclusion: The prognosis of anterior uveitis associatedwith AS is good if the treatment is administered at theappropriate time. However, the posterior segment complicationsmay develop in these patients, treatment andfollow-up should be done in co-operation with the departmentof rheumatology.Key words: Ankylosing spondylitis, uveitis, rheumatology,clinical course

The ''hot patella'' sign: is it of any clinical significance. Concise communication

International Nuclear Information System (INIS)

Fogelman, I.; McKillop, J.H.; Gray, H.W.

1983-01-01

The presence of the ''hot patella'' sign was evaluated in a prospective study of 200 consecutive bone scans, and in a review of scans from 148 patients with various metabolic bone disorders and 61 patients with lung carcinoma. The incidence was found to be 31%, 26% and 31% respectively. This sign is an extremely common scan finding and may be seen in association with a wide variety of disorders. It is concluded that this sign cannot be considered to be of diagnostic value

Reverse-namaskar: A new sign in Ehlers-Danlos syndrome: A family pedigree study of four generations

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Premalatha S

2010-01-01

Full Text Available Ehlers-Danlos Syndrome (EDS is a rare group of inheritable connective tissue disorder of defective collagen. Skin, joints and blood vessels are most commonly affected. Clinical signs such as Gorlin sign and Metenier sign have been described in this syndrome. We report another new clinical sign called ′Reverse-Namaskar′ sign as an important clinical finding in EDS, based on the family pedigree study of the proband.

Association of clinical signs and symptoms of Ebola viral disease with case fatality: a systematic review and meta-analysis

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Harsha Moole

2015-09-01

Full Text Available Background: Ebola virus disease (EVD is a public health emergency of international concern. There is limited laboratory and clinical data available on patients with EVD. This is a meta-analysis to assess the utility of clinical signs, symptoms, and laboratory data in predicting mortality in EVD. Aim: To assess the utility of clinical signs, symptoms, and laboratory data in predicting mortality in EVD. Method: Study selection criterion: EVD articles with more than 35 EVD cases that described the clinical features were included. Data collection and extraction: Articles were searched in Medline, PubMed, Ovid journals, and CDC and WHO official websites. Statistical methods: Pooled proportions were calculated using DerSimonian Laird method (random effects model. Results: Initial search identified 634 reference articles, of which 67 were selected and reviewed. Data were extracted from 10 articles (N=5,792 of EVD which met the inclusion criteria. Bleeding events (64.5% vs. 25.1%, abdominal pain (58.3% vs. 37.5%, vomiting (60.8% vs. 31.7%, diarrhea (69.9% vs. 37.8%, cough (31.6% vs. 22.3%, sore throat (47.7% vs. 19.8%, and conjunctivitis (39.3% vs. 20.3% were more often present in pooled proportion of fatal cases as compared to EVD survivors. Conclusions: Clinical features of EVD that may be associated with higher mortality include bleeding events, vomiting, diarrhea, abdominal pain, cough, sore throat, and conjunctivitis. These patients should be identified promptly, and appropriate management should be instituted immediately.

Relieving Pain using Dose-Extending Placebos: A Scoping Review

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Colloca, Luana; Enck, Paul; DeGrazia, David

2017-01-01

Placebos are often used by clinicians, usually deceptively and with little rationale or evidence of benefit, making their use ethically problematic. In contrast with their typical current use, a provocative line of research suggests that placebos can be intentionally exploited to extend analgesic therapeutic effects. Is it possible to extend the effects of drug treatments by interspersing placebos? We reviewed a database of placebo studies, searching for studies that indicate that placebos given after repeated administration of active treatments acquire medication-like effects. We found a total of 22studies in both animals and humans hinting of evidence that placebos may work as a sort of dose extender of active painkillers. Wherever effective in relieving clinical pain, such placebo use would offer several advantages. First, extending the effects of a painkiller through the use of placebos may reduce total drug intake and side effects. Second, dose-extending placebos may decrease patient dependence. Third, using placebos along with active medication, for part of the course of treatment, should limit dose escalation and lower costs. Importantly, provided that nondisclosure is pre-authorized in the informed consent process and that robust evidence indicates therapeutic benefit comparable to that of standard full-dose therapeutic regimens, introducing dose-extending placebos into the clinical arsenal should be considered. This novel prospect of placebo use has the potential to change our general thinking about painkiller treatments, the typical regimens of painkiller applications, and the ways in which treatments are evaluated. PMID:27023425

The saw-tooth sign as a clinical clue for intrathoracic central airway obstruction

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Nakajima Akira

2012-07-01

Full Text Available Abstract Background The saw-tooth sign was first described by Sanders et al in patients with obstructive sleep apnea syndrome as one cause of extrathoracic central airway obstruction. The mechanism of the saw-tooth sign has not been conclusively clarified. The sign has also been described in various extrathoracic central airway diseases, such as in burn victims with thermal injury to the upper airways, Parkinson’s disease, tracheobronchomalacia, laryngeal dyskinesia, and pedunculated tumors of the upper airway. Case presentation A 61-year-old man was referred to our hospital with a two-month history of persistent dry cough and dyspnea. He was diagnosed with lung cancer located in an intrathoracic central airway, which was accompanied by the saw-tooth sign on flow-volume loops. This peculiar sign repeatedly improved and deteriorated, in accordance with the waxing and waning of central airway stenosis by anti-cancer treatments. Conclusion This report suggests that the so-called saw-tooth sign may be found even in intrathoracic central airway obstruction due to lung cancer.

Exophthalmos: A Forgotten Clinical Sign of Cushing's Syndrome

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Aldo Schenone Giugni

2013-01-01

Full Text Available Exophthalmos is typically associated with Graves' ophthalmopathy. Although originally described by Harvey Cushing, exophthalmos is an underappreciated sign of Cushing's syndrome. We present a case of a 38-year-old female who presented with severe bilateral proptosis and was subsequently diagnosed with Cushings disease. We discuss the possible mechanisms causing exophthalmos in patients with either endogenous or exogenous hypercortisolemia.

Can corneal pannus with trachomatous inflammation--follicular be used in combination as an improved specific clinical sign for current ocular Chlamydia trachomatis infection?

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Derrick, Tamsyn; Holland, Martin J; Cassama, Eunice; Markham-David, Rod; Nabicassa, Meno; Marks, Michael; Bailey, Robin L; Last, Anna R

2016-01-27

Trachoma is a blinding disease caused by conjunctival infection with Chlamydia trachomatis (Ct). Mass drug administration (MDA) for trachoma control is administered based on the population prevalence of the clinical sign of trachomatis inflammation - follicular (TF). However, the prevalence of TF is often much higher than the prevalence of Ct infection. The addition of a clinical sign specific for current ocular Ct infection to TF could save resources by preventing unnecessary additional rounds of MDA. Study participants were aged between 1-9 years and resided on 7 islands of the Bijagos Archipelago, Guinea Bissau. Clinical grades for trachoma and corneal pannus and ocular swab samples were taken from 80 children with TF and from 81 matched controls without clinical evidence of trachoma. Ct infection testing was performed using droplet digital PCR. New pannus was significantly associated with Ct infection after adjustment for TF (P = 0.009, OR = 3.65 (1.4-9.8)). Amongst individuals with TF, individuals with new pannus had significantly more Ct infection than individuals with none or old pannus (75.0% vs 45.5%, Chi(2) P = 0.01). TF and new pannus together provide a highly specific (91.7%), but a poorly sensitive (51.9%) clinical diagnostic test for Ct infection. As we move towards trachoma elimination it may be desirable to use a combined clinical sign (new pannus in addition to TF) that is highly specific for current ocular Ct infection. This would allow national health systems to obtain a more accurate estimate of Ct population prevalence to inform further need for MDA without the expense of Ct molecular diagnostics, which are currently unaffordable in programmatic contexts.

Acupoint Massage in Relieving Pain after Ureteroscopic Holmium Laser Lithotripsy

Institute of Scientific and Technical Information of China (English)

Xia Wei-qin

2014-01-01

Objective: To observe the effect of acupoint massage in relieving pain after ureteroscopic holmium laser lithotripsy. Methods: Ninety-two patients undergone ureteroscopic holmium laser lithotripsy were enrolled and randomized into a treatment group and a control group, 46 in each group. Patients in the control group were given regular nursing care, while patients in the treatment group were intervened by acupoint massage in addition to the regular nursing care. The pain was evaluated by visual analogue scale (VAS) at 6 h, 12 h, and 24 h after operation, and compared between the two groups. Results:There was no significant difference in comparing the VAS score at 6 h after operation between the two groups (P>0.05). The VAS scores in the treatment group at 12 h and 24 h after operation were significantly lower than those in the control group (both P Conclusion: Acupoint massage can effectively relieve the pain after ureteroscopic holmium laser lithotripsy, reduce the use of analgesics, and promote the recovery.

Nanostructured transdermal hormone replacement therapy for relieving menopausal symptoms: a confocal Raman spectroscopy study

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Marco Antonio Botelho

2014-02-01

Full Text Available OBJECTIVE: To determine the safety and efficacy of a transdermal nanostructured formulation of progesterone (10% combined with estriol (0.1% + estradiol (0.25% for relieving postmenopausal symptoms. METHODS: A total of 66 postmenopausal Brazilian women with climacteric symptoms of natural menopause received transdermal nanostructured formulations of progesterone and estrogens in the forearm daily for 60 months to mimic the normal ovarian secretory pattern. Confocal Raman spectroscopy of hormones in skin layers was performed. Clinical parameters, serum concentrations of estradiol and follicle-stimulating hormone, blood pressure, BI-RADS classification from bilateral mammography, and symptomatic relief were compared between baseline and 60 months post-treatment. Clinicaltrials.gov: NCT02033512. RESULTS: An improvement in climacteric symptoms was reported in 92.5% of women evaluated before and after 60 months of treatment. The serum concentrations of estradiol and follicle-stimulating hormone changed significantly (p<0.05 after treatment; the values of serum follicle-stimulating hormone decreased after 60 months from 82.04±4.9 to 57.12±4.1 IU/mL. A bilateral mammography assessment of the breasts revealed normal results in all women. No adverse health-related events were attributed to this hormone replacement therapy protocol. CONCLUSION: The nanostructured formulation is safe and effective in re-establishing optimal serum levels of estradiol and follicle-stimulating hormone and relieving the symptoms of menopause. This transdermal hormone replacement therapy may alleviate climacteric symptoms in postmenopausal women.

Nanostructured transdermal hormone replacement therapy for relieving menopausal symptoms: a confocal Raman spectroscopy study

International Nuclear Information System (INIS)

Botelho, Marco Antonio; Queiroz, Dinalva Brito; Barros, Gisele; Guerreiro, Stela; Umbelino, Sonia; Lyra, Arao; Borges, Boniek; Freitas, Allan; Almeida, Jackson Guedes; Quintans Junior, Lucindo

2014-01-01

Objective:to determine the safety and efficacy of a transdermal nanostructured formulation of progesterone (10%) combined with estriol (0.1%) + estradiol (0.25%) for relieving postmenopausal symptoms. Methods: a total of 66 postmenopausal Brazilian women with climacteric symptoms of natural menopause received transdermal nanostructured formulations of progesterone and estrogens in the forearm daily for 60 months to mimic the normal ovarian secretory pattern. Confocal Raman spectroscopy of hormones in skin layers was performed. Clinical parameters, serum concentrations of estradiol and follicle-stimulating hormone, blood pressure, BI-RADS classification from bilateral mammography, and symptomatic relief were compared between baseline and 60 months post-treatment. Clinicaltrials.gov: NCT02033512. Results: an improvement in climacteric symptoms was reported in 92.5% of women evaluated before and after 60 months of treatment. The serum concentrations of estradiol and follicle-stimulating hormone changed significantly (p<0.05) after treatment; the values of serum follicle-stimulating hormone decreased after 60 months from 82.04 ± 4.9 to 57.12 ± 4.1 IU/mL. A bilateral mammography assessment of the breasts revealed normal results in all women. No adverse health-related events were attributed to this hormone replacement therapy protocol. Conclusion: the nanostructured formulation is safe and effective in re-establishing optimal serum levels of estradiol and follicle-stimulating hormone and relieving the symptoms of menopause. This transdermal hormone replacement therapy may alleviate climacteric symptoms in postmenopausal women. (author)

Nanostructured transdermal hormone replacement therapy for relieving menopausal symptoms: a confocal Raman spectroscopy study

Energy Technology Data Exchange (ETDEWEB)

Botelho, Marco Antonio; Queiroz, Dinalva Brito; Barros, Gisele; Guerreiro, Stela; Umbelino, Sonia; Lyra, Arao; Borges, Boniek; Freitas, Allan, E-mail: marcobotelho@pq.cnpq.br [Universidade Potiguar, Natal, RN (Brazil). Lab. de Nanotecnologia; Fechine, Pierre [Universidade Federal do Ceara (GQMAT/UFCE), Fortaleza, CE (Brazil). Dept. de Quimica Analitica. Grupo Avancado de Biomateriais em Quimica; Queiroz, Danilo Caldas de [Instituto Federal de Ciencia e Tecnologia (IFCT), Fortaleza, CE (Brazil). Lab. de Biotecnologia; Ruela, Ronaldo [Instituto de Biotecnologia Aplicada (INBIOS), Fortaleza, CE (Brazil); Almeida, Jackson Guedes [Universidade Federal do Vale de Sao Francisco (UNIVALE), Petrolina, PE (Brazil). Fac. de Ciencias Farmaceuticas; Quintans Junior, Lucindo [Universidade Federal de Sergipe (UFSE), Sao Cristovao, SE (Brazil). Dept. de Fisiologia

2014-06-01

Objective:to determine the safety and efficacy of a transdermal nanostructured formulation of progesterone (10%) combined with estriol (0.1%) + estradiol (0.25%) for relieving postmenopausal symptoms. Methods: a total of 66 postmenopausal Brazilian women with climacteric symptoms of natural menopause received transdermal nanostructured formulations of progesterone and estrogens in the forearm daily for 60 months to mimic the normal ovarian secretory pattern. Confocal Raman spectroscopy of hormones in skin layers was performed. Clinical parameters, serum concentrations of estradiol and follicle-stimulating hormone, blood pressure, BI-RADS classification from bilateral mammography, and symptomatic relief were compared between baseline and 60 months post-treatment. Clinicaltrials.gov: NCT02033512. Results: an improvement in climacteric symptoms was reported in 92.5% of women evaluated before and after 60 months of treatment. The serum concentrations of estradiol and follicle-stimulating hormone changed significantly (p<0.05) after treatment; the values of serum follicle-stimulating hormone decreased after 60 months from 82.04 ± 4.9 to 57.12 ± 4.1 IU/mL. A bilateral mammography assessment of the breasts revealed normal results in all women. No adverse health-related events were attributed to this hormone replacement therapy protocol. Conclusion: the nanostructured formulation is safe and effective in re-establishing optimal serum levels of estradiol and follicle-stimulating hormone and relieving the symptoms of menopause. This transdermal hormone replacement therapy may alleviate climacteric symptoms in postmenopausal women. (author)

[Cortical Release Signs in Patients with Schizophrenia, Depressive Disorders, and Bipolar Affective Disorder].

Science.gov (United States)

de la Espriella, Ricardo Andrés; Hernández, José Fernando; Espejo, Lina María

2013-12-01

Determining the presence of cortical release signs associated with white matter damage, is a clinically easy method to perform. The objective of this study is to determine the presence of cortical release signs in patients with mental illnesses and cerebrovascular disease, as well as its clinical usefulness, given that it indicates cortical damage. A review was made of cortical release signs in patients hospitalized in clinical psychiatry and general hospitals with bipolar affective disorder (40), depression (37), schizophrenia (33), cardiovascular disease (33) and dementia (37). The signs of cortical release do not have the same importance as cortical damage. For example, the glabellar reflex was found in all the groups, that of paratonia, particularly in the group with schizophrenia, and others signs in the group of patients with dementia. It is suggested that these signs imply subcortical white matter damage. The appearance of these signs shows the need for a follow up of patients diagnosed with bipolar affective disorder, depression and schizophrenia. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

The perioperative nursing care of patients with malignant obstructive jaundice treated with interventional therapy: clinical experience in 71 cases

International Nuclear Information System (INIS)

Zhang Huaping; Tao Ran; Zhang Liqin; Zheng Wenping; Jiang Lei

2011-01-01

Objective: To summarize the clinical experience of perioperative nursing for patients with malignant obstructive jaundice who were treated with percutaneous transhepatic biliary drainage. Methods: Sufficient preoperative preparation,careful psychological nursing, serious postoperative observation of vital signs, enhancement of the nutritional support,care of the puncture site and drainage tube, maintenance of the electrolyte balance, correct evaluation of the jaundice, etc. were strictly carried out in all 71 patients with malignant obstructive jaundice who received percutaneous transhepatic biliary drainage. Results: Because the sufficient preoperative preparation and postoperative nursing work were seriously carried out,the obstructive jaundice was well relieved in all patients, the liver function and the living quality were markedly improved and the survival time was prolonged. Conclusion: It is of great clinical significance to intensify the perioperative nursing care for patients with malignant obstructive jaundice who are receiving interventional therapy. (authors)

State and Substate Estimates of Nonmedical Use of Prescription Pain Relievers

Science.gov (United States)

... with other local area data to enhance statistical power and analytic capability. 10 Delete Template National, Regional, and State Estimates In this section, estimates of past year nonmedical use of prescription pain relievers among people aged 12 or older are ...

Distribution of cow-calf producers' beliefs about reporting cattle with clinical signs of foot-and-mouth disease to a veterinarian before or during a hypothetical outbreak.

Science.gov (United States)

Delgado, Amy H; Norby, Bo; Scott, H Morgan; Dean, Wesley; McIntosh, W Alex; Bush, Eric

2014-12-01

Understanding the prevalence of cattle producers' beliefs regarding disease reporting can help officials improve surveillance programs with passive data collection. A cross-sectional survey was conducted in Texas in 2008 and 2009 to determine beliefs about reporting cattle with clinical signs consistent with foot-and-mouth disease (FMD) either prior to (scenario 1) or during an on-going outbreak of FMD (scenario 2). Two questionnaires were developed and distributed to Texas cow-calf producers in order to evaluate their behavioral, control, and normative beliefs related to disease reporting. The context for each behavior was provided through the use of scenarios, and belief strength was measured using a 7-point Likert-like scale. Beliefs were compared across scenarios and demographic categories, and the effect of scenario on belief examined using ordinal logistic regression. Respondents agreed that reporting clinically suspect cases would have positive economic and emotional consequences; however, when an outbreak was known to be present, producers were less likely to agree with many of the positive outcomes of reporting. Important barriers to disease reporting indicated by producers included a lack of knowledge related to clinical signs of highly contagious cattle diseases and which cattle are at risk of contracting FMD. In general, beliefs about barriers to reporting did not differ based on scenario. Veterinarians and regulatory authorities were the groups perceived to most strongly expect disease reporting, regardless of the scenario. Risk education for producers related to clinical signs of reportable livestock diseases, post-reporting procedures, and an understanding of FMD introduction and spread may improve the reporting of cattle with clinical signs consistent with FMD. Published by Elsevier B.V.

Quantifying risk of adverse clinical events with one set of vital signs among primary care patients with hypertension.

Science.gov (United States)

Tierney, William M; Brunt, Margaret; Kesterson, Joseph; Zhou, Xiao-Hua; L'Italien, Gil; Lapuerta, Pablo

2004-01-01

Hypertension is often uncontrolled. One reason might be physicians' reticence to modify therapy in response to single office measurements of vital signs. Using electronic records from an inner-city primary care practice, we extracted information about vital signs, diagnoses, test results, and drug therapy available on the first primary care visit in 1993 for patients with hypertension. We then identified multivariable predictors of subsequent vascular complications in the ensuing 5 years. Of 5,825 patients (mean age 57 years) previously treated for hypertension for 5.6 years, 7% developed myocardial infarctions, 17% had strokes, 24% developed ischemic heart disease, 22% had heart failure, 12% developed renal insufficiency, and 13% died in 5 years. Controlling for other clinical data, a 10-mmHg increase in systolic blood pressure was associated with 13% increased risk (95% confidence interval [CI], 6%-21%) of renal insufficiency, 9% (95% CI, 3%-15%) increased risk of ischemic heart disease, 7% (95% CI, 3%-11%) increased risk of stroke, and 6% (95% CI, 2%-9%) increased risk of first stroke or myocardial infarction. A 10-mmHg elevation in mean blood pressure predicted a 12% (95% CI, 5%-20%) increased risk of heart failure. An increase in heart rate of 10 beats per minute predicted a 16% (95% CI, 2%-5%) increased risk of death. Diastolic blood pressure predicted only a 13% (95% CI, 4%-23%) increased risk of first stroke. Vital signs-especially systolic blood pressure-recorded routinely during a single primary care visit had significant prognostic value for multiple adverse clinical events among patients treated for hypertension and should not be ignored by clinicians.

An outbreak of tuberculosis in Lleyn sheep in the UK associated with clinical signs.

Science.gov (United States)

van der Burgt, G M; Drummond, F; Crawshaw, T; Morris, S

2013-01-19

This case report describes an outbreak of Mycobacterium bovis infection a Lleyn sheep flock associated with clinical signs of illthrift. There was no known direct contact with tuberculous cattle although bovine tuberculosis (bTB) is endemic in the area. The spoligotype isolated from the diseased sheep was the local spoligotype. The repeated use of the comparative intradermal tuberculin test, and the subsequent removal of reactor animals, resulted in apparent elimination of bTB from the flock. Lesions caused by M bovis in sheep may contain very few acid-fast bacilli, and gross lesions may resemble those found in cases of Caseous Lymphadenitis. Routine meat inspection may, therefore, not always easily detect this notifiable disease.

Budesonide/formoterol maintenance plus reliever therapy

DEFF Research Database (Denmark)

Bisgaard, Hans; Le Roux, Pascal; Bjåmer, Ditlef

2006-01-01

on ICS investigated whether a novel regimen using budesonide/formoterol for maintenance and reliever therapy (Symbicort maintenance and relief therapy [SMART]) [Symbicort; AstraZeneca R&D, Lund, Sweden] could reduce exacerbations. METHODS: Patients received SMART (budesonide/formoterol 80/4.5 microg qd...... maintenance plus additional inhalations for symptom relief), budesonide/formoterol 80/4.5 microg qd for maintenance (fixed combination), or higher-dose budesonide 320 microg qd (fixed-dose budesonide). Blinded as-needed medication (terbutaline 0.4 microg) was provided in both fixed-dose groups. RESULTS: SMART...... prolonged the time to first exacerbation vs fixed-dose budesonide (p = 0.02) and fixed-dose combination (p SMART vs fixed-dose budesonide and fixed-dose combination (0.08/patient vs 0.28/patient and 0.40/patient...

Korean Emotional Laborers' Job Stressors and Relievers: Focus on Work Conditions and Emotional Labor Properties.

Science.gov (United States)

Lee, Garam

2015-12-01

The present study aims to investigate job stressors and stress relievers for Korean emotional laborers, specifically focusing on the effects of work conditions and emotional labor properties. Emotional laborers are asked to hide or distort their real emotions in their interaction with clients. They are exposed to high levels of stress in the emotional labor process, which leads to serious mental health risks including burnout, depression, and even suicide impulse. Exploring job stressors and relieving factors would be the first step in seeking alternatives to protect emotional laborers from those mental health risks. Using the third wave data of Korean Working Conditions Survey, logistic regression analysis was conducted for two purposes: to examine the relations of emotional labor and stress, and to find out job stressors and relievers for emotional laborers. The chances of stress arousal are 3.5 times higher for emotional laborers; emotional laborers experience double risk-burden for stress arousal. In addition to general job stressors, emotional laborers need to bear burdens related to emotional labor properties. The effect of social support at the workplace is not significant for stress relief, unlike common assumptions, whereas subjective satisfaction (wage satisfaction and work-life balance) is proven to have relieving effects on emotional laborers' job stress. From the results, the importance of a balanced understanding of emotional labor for establishing effective policies for emotional laborer protection is stressed.

The relieving effects of shelter modes on physiological stress of traffic police in summer

Science.gov (United States)

Zheng, G. Z.; Wang, Y. J.; Bu, W. T.; Lu, Y. Z.; Li, Ke; Li, Z. H.

2018-03-01

In summer, high temperature and strong sun radiation last for a long time. However, traffic police still stick to their positions to ensure normal traffic order. Therefore, the health and safety of traffic police are challenged by the high temperature weather. To protect the safety of the traffic police in the outdoor high temperature environment, some shelter modes, such as sun hat and sun umbrella are selected for duty traffic police. The relieving effects on the physiological stress of the shelter modes are analyzed by comparison of the physiological parameters in these shelter modes. The results show that sun umbrella has a good effect on relieving physiological stress. And sun hat has no effect on relieving physiological stress, although it avoids the direct sunlight on the face. However, it causes the increase of the thermal sensation. This study can provide important methods for health protecting of traffic police in the outdoor high temperature environment. It also provides a theoretical support for the revision of the outdoor high temperature labour protection standard.

Efficacy and safety of topical Trikatu preparation in, relieving mosquito bite reactions: a randomized controlled trial.

Science.gov (United States)

Maenthaisong, Ratree; Chaiyakunapruk, Nathorn; Tiyaboonchai, Waree; Tawatsin, Apiwat; Rojanawiwat, Archawin; Thavara, Usavadee

2014-02-01

Trikatu is composed of dried fruits of Piper nigrum L and Piper retrofractum Vahl, and dried rhizomes of Zingiber officinale R. Although this preparation has been used to relieve pruritis, pain, and inflammation for a long time, there is no clinical evidence to confirm its efficacy and safety. Therefore, we performed a double-blind, within person-randomized controlled study of 30 healthy volunteers to determine efficacy and safety of topical Trikatu on mosquito bite reactions. All subjects were bitten by Aedes aegypti laboratory mosquitoes on their forearms and they were randomly assigned arms to apply either Trikatu or reference product on the mosquito bite papule. The main outcome was the difference of papule size reduction at 30 min, measured by a caliper, between the Trikatu and reference arms. Pruritis, redness, pain, and patient satisfaction were assessed at 15, 30, 60, 180, and 360 min as secondary outcomes. There were no significant differences between treatment and reference arms on any outcome at any time of measurement. Trikatu did not show additional effects for relieving mosquito bite reaction as compared with the reference product containing camphor, menthol, and eucalyptus. For further study, it is very important to consider a proper selection of subjects, comparator product, and concentration of extract when Trikatu preparation is investigated. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Novel Scheme to Relieve Parking Pressure at Tourist Attractions on Holidays

Directory of Open Access Journals (Sweden)

Juan Li

2016-02-01

Full Text Available Parking is a key component of urban transportation managements and has become a severe problem at many tourist attractions during holidays in China. This paper presents a novel scheme to relieve the holiday parking pressure. Based on the perspectives of the activity-based travel characteristics, we propose an effort to develop parking alternatives by utilizing existing traffic facilities. A conceptual model is employed to explore the influence of additional leisure activity of parking and various options of transportation modes. The results indicate that compared to commuters, the scenery is the major factor affecting tourists’ parking preference, besides parking time and cost. Based on the finding, a tourist-centered strategy is designed to satisfy the peak hours parking demands in order to relieve the parking pressure at tourist attractions during holidays.

Comparison of smartphone application-based vital sign monitors without external hardware versus those used in clinical practice: a prospective trial.

Science.gov (United States)

Alexander, John C; Minhajuddin, Abu; Joshi, Girish P

2017-08-01

Use of healthcare-related smartphone applications is common. However, there is concern that inaccurate information from these applications may lead patients to make erroneous healthcare decisions. The objective of this study is to study smartphone applications purporting to measure vital sign data using only onboard technology compared with monitors used routinely in clinical practice. This is a prospective trial comparing correlation between a clinically utilized vital sign monitor (Propaq CS, WelchAllyn, Skaneateles Falls, NY, USA) and four smartphone application-based monitors Instant Blood Pressure, Instant Blood Pressure Pro, Pulse Oximeter, and Pulse Oximeter Pro. We performed measurements of heart rate (HR), systolic blood pressures (SBP), diastolic blood pressure (DBP), and oxygen saturation (SpO 2 ) using standard monitor and four smartphone applications. Analysis of variance was used to compare measurements from the applications to the routine monitor. The study was completed on 100 healthy volunteers. Comparison of routine monitor with the smartphone applications shows significant differences in terms of HR, SpO 2 and DBP. The SBP values from the applications were not significantly different from those from the routine monitor, but had wide limits of agreement signifying a large degree of variation in the compared values. The degree of correlation between monitors routinely used in clinical practice and the smartphone-based applications studied is insufficient to recommend clinical utilization. This lack of correlation suggests that the applications evaluated do not provide clinically meaningful data. The inaccurate data provided by these applications can potentially contribute to patient harm.

In Cats Infected With Feline Herpesvirus Type-1 (FHV-1 Does Treatment With Famciclovir Result in a Reduction of Respiratory and Ocular Clinical Signs?

Directory of Open Access Journals (Sweden)

Jacqueline Cole

2017-07-01

Full Text Available Clinical bottom lineBased on the current available evidence, famciclovir may have a positive effect on reducing respiratory and ocular clinical signs of feline herpesvirus type-1 (FHV-1 disease, however further research is needed before famciclovir can be routinely recommended as part of a treatment protocol for this disease.

Sign Lowering and Phonetic Reduction in American Sign Language.

Science.gov (United States)

Tyrone, Martha E; Mauk, Claude E

2010-04-01

This study examines sign lowering as a form of phonetic reduction in American Sign Language. Phonetic reduction occurs in the course of normal language production, when instead of producing a carefully articulated form of a word, the language user produces a less clearly articulated form. When signs are produced in context by native signers, they often differ from the citation forms of signs. In some cases, phonetic reduction is manifested as a sign being produced at a lower location than in the citation form. Sign lowering has been documented previously, but this is the first study to examine it in phonetic detail. The data presented here are tokens of the sign WONDER, as produced by six native signers, in two phonetic contexts and at three signing rates, which were captured by optoelectronic motion capture. The results indicate that sign lowering occurred for all signers, according to the factors we manipulated. Sign production was affected by several phonetic factors that also influence speech production, namely, production rate, phonetic context, and position within an utterance. In addition, we have discovered interesting variations in sign production, which could underlie distinctions in signing style, analogous to accent or voice quality in speech.

Stress relieving procedure and facility by shot-peening the inside surface of NPP steam generators tubes

International Nuclear Information System (INIS)

Banica, I.; Maioru, H.

1994-01-01

Residual stress relieving of the transition zones between the deformed part and the non deformed part of the heat exchanger tubes expanded in tube sheets of the NPP equipment, is a technological problem attacked on international level as well as on national level through the continuing programme initiated by ICEMENERG. The most recent statistical data point out that over 75% of tube failures are taking place in the tube-to-tubesheet connection zone, a great number of them being produced in this area by intergranular attack and stress corrosion cracking. The increased occurrence of these incidents is explained first by the existence of residual stresses inside tube surfaces, induced by expanding the tubes. Relieving these residual stresses is the purpose of the outlined procedure and it is achieved by overlapping effects (compression stresses added over tensile stresses). In this paper aspects of the procedure are presented and also a facility is described for stress relieving by introducing compressive stresses from uniform and generalized collisions of the inside surface with micro balls of great kinetic energy carried by a pressurized gas. The stress relieving facility can be acted by remote control, the whole process being completely automatic. The procedure aims to the operation maintenance of the NPP steam generators. (Author)

Neurological Soft Signs in Obsessive Compulsive Disorder: Standardised Assessment and Comparison with Schizophrenia

Directory of Open Access Journals (Sweden)

D. Bolton

1999-01-01

Full Text Available While several studies have detected raised levels of neurological soft signs in patients with obsessive compulsive disorder (OCD, the specificity of these abnormalities remains uncertain. This study used a new standardised measure, the Cambridge Neurological Inventory (CNI, to assess soft signs in 51 subjects with OCD. Comparison was made with data on patients with schizophrenia and a non-clinical control group from a previously reported study. Individuals with OCD showed raised levels of soft signs compared with non-clinical controls in many categories of the CNI: Motor Coordination, Sensory Integration, Primitive Reflexes, Extrapyramidal Signs, and Failure of Suppression. Compared with patients with schizophrenia, the OCD group had lower levels of neurological signs in some CNI categories: Hard Signs, Motor Co-ordination, Tardive Dyskinesia, Catatonic Signs, and Extrapyramidal Signs. However, levels of soft signs in the OCD group did not significantly differ from those in the schizophrenia group in other CNI categories: Sensory Integration, Primitive Reflexes and Failure of Suppression. The significance of these patterns of findings is discussed.

Neutron irradiation damage of a stress relieved TZM alloy

International Nuclear Information System (INIS)

Abe, K.; Masuyama, T.; Satou, M.; Hamilton, M.L.

1992-01-01

The objective of this work is to study defect microstructures and irradiation hardening in a stress relieved TZM alloy after irradiation in the Fast Flux Test Facility (FFTF) using the Materials Open Test Assembly (MOTA). Disk specimens of the molybdenum alloy TZM that had been stress relieved at 1199 K (929 C) for 0.9 ks (15 min.) were irradiated in the FFTF/MOTA 1F at 679, 793 and 873 K (406, 520, and 600 C) to a fast fluence of ∼9.6 x 10 22 n/cm 2 . Microstructures were observed in a transmission electron microscope (TEM). Dislocation structures consisted of isolated loops, aggregated loops (rafts) and elongated dislocations. The size of the loops increased with the irradiation temperature. Void swelling was about 1 and 2% at 793 and 873 K (520 and 600 C), respectively. A void lattice was developed in the body centered cubic (bcc) structure with a spacing of 26 - 28 nm. The fine grain size (0.5 - 2 μm) was retained following high temperature irradiation, indicating that the stress relief heat treatment may extend the material's resistance to radiation damage up to high fluence levels. Microhardness measurements indicated that irradiation hardening increased with irradiation temperature. The relationship between the microstructure and the observed hardening was determined

Effect of 0.5g/L cyclosporine A for symptom and sign scores in patients with moderate to severe dry eye

Directory of Open Access Journals (Sweden)

Su-Ying Yu

2016-05-01

Full Text Available AIM:To investigate the effect of 0.5g/L cyclosporine A for symptom and sign scores in patients with moderate to severe dry eye.METHODS:Eighty patients(160 eyeswith moderate to severe dry eye were divided into two groups by double-blind and random principles:40 patients(80 eyesin observation group were treated with 10g/L sodium carboxymethyl cellulose and 0.5g/L cyclosporine A eye drops, 40 patients(80 eyesin the control group were treated with 10g/L sodium carboxymethyl cellulose eye drops. The changes of ocular sign and symptom scores were compared between the two groups.RESULTS:The total effective rate of observation group was 95.0%, which was significantly higher than that of control group(85.0%, PPPP>0.05. After treatment, the four parameters of observation group were improved significantly(PPPCONCLUSION:The 0.5g/L cyclosporine A eye drops can effectively relieve the symptoms and signs of moderate to severe dry eye, promote tear secretion, and improve ocular surface environment. The treatment effect is good.

Hepatic dimple sign on CT

International Nuclear Information System (INIS)

Matsumoto, Kunihiko; Nakajima, Teiichi; Ishikawa, Nobuyoshi; Ebihara, Reiko; Saida, Yukihisa

1983-01-01

The ''Dimple sign'' has been coined by Baltaxe et al. in 1974 and was said to be useful angiographic sign of avascular tumor. Similar dimple can be seen in the margin of the liver on CT examination of the hepatic tumors. We called this hepatic dimple sign and its clinical usefulness on CT examination was studied with 133 cases of hepatic tumors. Among 133 cases, there were 68 cases of hepatocellular carcinoma, 57 cases of metastatic liver tumor, 5 cases of hemangioma of the liver and 3 cases of hepatoblastoma. Hepatic dimple sign was recognized on 2 cases of metastatic liver tumor, 1 case of hemangioma, and 1 case of carcinoma of the gallbladder with hepatic infiltration. Cases experienced in the affiliated hospitals were also studied. A case of hepatocellular carcinoma and a case of metastatic liver tumor were evaluated. These tumors were relativly large measuring over 5cm in the greatest diameter and low density areas were apparent on plain CT. Therefore, dimples in the hepatic margin seen in CT scan did not contribute to the diagnostic accuracy of the liver tumor in these cases. (author)

Hepatic dimple sign on CT

Energy Technology Data Exchange (ETDEWEB)

Matsumoto, Kunihiko; Nakajima, Teiichi; Ishikawa, Nobuyoshi; Ebihara, Reiko; Saida, Yukihisa

1983-06-01

The ''Dimple sign'' has been coined by Baltaxe et al. in 1974 and was said to be useful angiographic sign of avascular tumor. Similar dimple can be seen in the margin of the liver on CT examination of the hepatic tumors. We called this hepatic dimple sign and its clinical usefulness on CT examination was studied with 133 cases of hepatic tumors. Among 133 cases, there were 68 cases of hepatocellular carcinoma, 57 cases of metastatic liver tumor, 5 cases of hemangioma of the liver and 3 cases of hepatoblastoma. Hepatic dimple sign was recognized on 2 cases of metastatic liver tumor, 1 case of hemangioma, and 1 case of carcinoma of the gallbladder with hepatic infiltration. Cases experienced in the affiliated hospitals were also studied. A case of hepatocellular carcinoma and a case of metastatic liver tumor were evaluated. These tumors were relativly large measuring over 5cm in the greatest diameter and low density areas were apparent on plain CT. Therefore, dimples in the hepatic margin seen in CT scan did not contribute to the diagnostic accuracy of the liver tumor in these cases. (author).

Clinical signs of hypoxia with high-Dk soft lens extended wear: is the cornea convinced?

Science.gov (United States)

Sweeney, Deborah F

2003-01-01

To assess the effectiveness of high-Dk soft contact lenses with oxygen transmissibility (Dk/L) beyond the critical level required to avoid corneal edema during overnight wear. The most up-to-date data available on clinical signs of hypoxia with high-Dk contact lenses is reviewed. Chronic corneal edema associated with hypoxia is responsible for the development of large numbers of microcysts, limbal hyperemia, neovascularization, and small increases in myopia. Silicone hydrogel lenses worn continuously for up to 30 nights prevent corneal edema during overnight wear and do not induce a microcyst response. Long-term clinical trials indicate the mean level of limbal redness for patients wearing high-Dk lenses during continuous wear are equivalent to nonlens wearers. No changes in refractive error are associated with continuous wear of high-Dk lenses. High-Dk silicone hydrogel lenses can be worn for up to 3 years with virtual elimination of the hypoxic consequences observed with low-Dk lenses made from conventional lens materials.

Evaluation of kDNA PCR hybridization and ITS1 nPCR methods in different clinical samples for visceral leishmaniasis diagnosis in dogs with and without clinical signs

International Nuclear Information System (INIS)

Ferreira, Aline Leandra C.; Carregal, Virginia M.; Leite, Rodrigo S.; Ferreira, Sidney A.; Andrade, Antero Silva R.; Melo, Maria N.

2013-01-01

Visceral leishmaniasis (VL) in Brazil is caused by Leishmania infantum and dogs are considered the main domestic reservoirs of this parasite. The VL control program in Brazil emphasizes the use of serological surveys, followed by elimination of seropositive dogs. However, serologic tests have limitations in terms of sensitivity and specificity. Molecular methods such as PCR (Polymerase Chain Reaction) associated with hybridization using 32 P radiolabeled DNA probes (kDNA PCR hybridization) are useful tools in this scenario, since they are more specific and sensitive than conventional methods. A variety of samples can be employed with PCR; however non-invasive procedures are the most adequate. One of main obstacles for implementation of PCR in the canine visceral leishmaniasis (CVL) diagnosis is the lack of standardization. Few studies up to the moment compared the effectiveness of the different PCR methods and clinical samples available. The objective of this study was to compare the kDNA PCR hybridization and the Internal Transcribed Spacer 1 nested PCR (ITS1 nPCR) methods and four types of clinical samples for the diagnosis of CVL in dogs with and without clinical signs of the disease. The methods were compared using samples of conjunctival swab (SC), bone marrow (BM), skin (S) and peripheral blood (PB). A group of 60 mongrel dogs, all positive in serological and parasitological tests, were equally divided in two groups: S (with clinical signs) and A (without clinical signs). The frequencies of positive results for the kDNA PCR hybridization in the S group were: CS 97% (29/30), BM 83 % (25/30), S 63% (19/30) and PB 4 7% (14/30). By the same method the following results were obtained in the A group: CS 70% (21/30), BM 63% (19/30), S 57% (17/30) and PB 17% (5/30). The ITS1 nPCR allowed the following positivities for the S group: CS 83% (25/30), BM 97% (29/30), S 83% (25/30) and PB 70% (21/30). For the A group the following results were obtained: CS and BM 83% (25

Evaluation of kDNA PCR hybridization and ITS1 nPCR methods in different clinical samples for visceral leishmaniasis diagnosis in dogs with and without clinical signs

Energy Technology Data Exchange (ETDEWEB)

Ferreira, Aline Leandra C.; Carregal, Virginia M.; Leite, Rodrigo S.; Ferreira, Sidney A.; Andrade, Antero Silva R., E-mail: alineleandra@hotmail.com, E-mail: streptos@hotmail.com, E-mail: rleite2005@gmail.com, E-mail: vidasnino@yahoo.com.br, E-mail: antero@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Lab. de Radiobiologia; Melo, Maria N., E-mail: melo@icb.ufmg.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Parasitologia

2013-07-01

Visceral leishmaniasis (VL) in Brazil is caused by Leishmania infantum and dogs are considered the main domestic reservoirs of this parasite. The VL control program in Brazil emphasizes the use of serological surveys, followed by elimination of seropositive dogs. However, serologic tests have limitations in terms of sensitivity and specificity. Molecular methods such as PCR (Polymerase Chain Reaction) associated with hybridization using {sup 32}P radiolabeled DNA probes (kDNA PCR hybridization) are useful tools in this scenario, since they are more specific and sensitive than conventional methods. A variety of samples can be employed with PCR; however non-invasive procedures are the most adequate. One of main obstacles for implementation of PCR in the canine visceral leishmaniasis (CVL) diagnosis is the lack of standardization. Few studies up to the moment compared the effectiveness of the different PCR methods and clinical samples available. The objective of this study was to compare the kDNA PCR hybridization and the Internal Transcribed Spacer 1 nested PCR (ITS1 nPCR) methods and four types of clinical samples for the diagnosis of CVL in dogs with and without clinical signs of the disease. The methods were compared using samples of conjunctival swab (SC), bone marrow (BM), skin (S) and peripheral blood (PB). A group of 60 mongrel dogs, all positive in serological and parasitological tests, were equally divided in two groups: S (with clinical signs) and A (without clinical signs). The frequencies of positive results for the kDNA PCR hybridization in the S group were: CS 97% (29/30), BM 83 % (25/30), S 63% (19/30) and PB 4 7% (14/30). By the same method the following results were obtained in the A group: CS 70% (21/30), BM 63% (19/30), S 57% (17/30) and PB 17% (5/30). The ITS1 nPCR allowed the following positivities for the S group: CS 83% (25/30), BM 97% (29/30), S 83% (25/30) and PB 70% (21/30). For the A group the following results were obtained: CS and BM 83

A clinical study on the interventional treatment of acute pulmonary embolism

International Nuclear Information System (INIS)

Yu Xixiang; Zhang Minghua; Ci Xiao; Wang Chunmei; Lin Xiaojie; Si Tongguo; Huang Linfen; Feng Xiaofeng

2004-01-01

Objective: To evaluate the effectiveness of interventional procedures in the treatment of acute pulmonary embolism (PE). Methods: Pulmonary arterial thrombolytic therapy, suction and fragmentation of thromhi, anti-spasm, and balloon dilation were performed in eighteen cases with clinically highly suspected PE confirmed by emergent pulmonary artery angiography beforehand. Wedged pulmonary arterial pressure, pulmonary recanalization rate, the display ratio of distal pulmonary capillary net, blood gas analysis, blood oxygen saturation, and the improvement of clinical symptoms and signs were used for evaluation of the effectiveness. Seventeen of the alive cases with dislodgement of deep vein thrombi of the lower extremities were confirmed for the formation of PE and then thrombolytic treatment of the thrombotic deep vein was performed after the placement of inferior vena cava filter. Results: Pulmanory artery angiographies showed embolism of the pulmonary arterial trunks or more than two of the branches. The post-treatment pulmonary patency reached 80%-90% in three cases, 90%-95% in eleven cases and 100% in five cases. The display ratio of distal pulmonary capillary net was over 90% in all the cases. Wedged pulmonary arterial pressure decreased to below 25 mmHg in thirteen cases, and to 25-30 mmHg in five cases. Blood oxygen saturation rate improved immediately to 90%-95% in ten cases and to 95%-100% in eight cases. Cough, hemoptysis, dyspnea, and chest pain were completely relieved in thirteen cases and significantly relieved in five cases. Digestive track bleeding was complicated in one case. Conclusions: Pulmonary artery angiography is the golden standard for the diagnosis of pulmonary embolism. Interventional therapy is very effective for acute pulmonary embolism, which can significantly reduce the mortality rate. (authors)

Study on Positive and Negative Signs in Chronic Schizophrenic Women

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Sahel Hemmati

2002-10-01

Full Text Available Objective: Schizophrenia has different clinical manifestations, although, it is one disorder patients divided to two groups type 1 and type 2. type 1 who have positive and type 2 who have negative signs. Materials & Methods: They have chronic schizophrenia and treated at least with one antipsychotic drug. With checklist the signs were controlled. Results: In these chronic patients, hallucinations (positive sign are seen with almost all of negative signs. In the other hand, (1 Flat affect (2 A logia & volition (3 Social inattentiveness (4 Inability to feel intimacy are seen more than another signs. Conclusion: For these above  patients new antipsychotic must be examined.

Signs Observed Among Animal Species Infected with Raccoon Rabies Variant Virus, Massachusetts, USA, 1992–2010

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Linda L. Han

2011-11-01

Full Text Available We analyzed signs occurring among domestic and wild terrestrial animal species infected with raccoon rabies variant virus (RRV in Massachusetts, 1992–2010. The clinical sign of aggression was significantly associated with rabid stray cats (odds ratio, OR = 2.3 and RRV affected major wild terrestrial animal species individually, which included raccoons (OR = 2.8, skunks (OR = 8.0, gray foxes (OR = 21.3, red foxes (OR = 10.4, woodchucks (OR = 4.7 and coyotes (OR = 27.6. While aggression is a useful predictor of rabies among wild animals, combinations of other signs such as ataxia, disorientation, and salivation are useful predictors of rabies among domestic animals. Pets reported with multiple clinical signs had significantly higher rabies positive testing result than those reported with single clinical sign (p < 0.001. The result suggested the importance of avoiding aggressive terrestrial wild animals and giving additional attention to pets with multiple clinical signs.

Correlates of Abusing and Misusing Over-the-Counter Pain Relievers Among Adult Population of Wrocław (Poland).

Science.gov (United States)

Wójta-Kempa, Monika; Krzyżanowski, Dominik M

2016-01-01

Almost 90% of households in Poland buy medicines on their own initiative. The most popular OTC medicines bought by Polish consumers are painkillers and non-steroid-anti-inflammatory drugs. The aim of this article was to recognize and describe the most important predictive factors of the abuse and misuse of over-the-counter pain relievers among adults in Wrocław (Poland). The groups of users were selected and described. Some examples of misuse were analyzed. Three hundred eighty six adult inhabitants of Wrocław took part in the survey. The quota sample was representative referring to the most important socio-demographic factors (sex and median age). Almost 91% of participants declare taking OTC pain relievers, and 1.3% of them are their daily users. Only 6.2% of adult inhabitants of Wrocław never take OTC pain relievers. The category of "heavy users" embraces 11% of participants. The most important risk factors of overusing OTC pain relievers are sex (female), age over 55 years and the low health status. Only half of participants read the box label regularly and 25% of users admit they have modified recommended doses. Over 60% shortened recommended intervals between doses and 16% took two or more different pain medications (containing different substances). The non-medical purposes of using OTC pain relievers were: tiredness (7%), stressful situations (5.4%), and discomfort (18.4%). Some users take pain medications to cure hangovers (26%), or instead of the appropriate medicine (7%). About 20% take pain medications without a doctor's advice for longer than the recommended 3 days, and 10% never consult taking such medications with doctors. Pain should be treated aggressively and successfully, especially among chronically ill patients. We should monitor the consumption of OTC pain relievers and limit their current excessively supply and high availability.

Water Breaking: Understand This Sign of Labor

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Healthy Lifestyle Labor and delivery, postpartum care Water breaking worries? Prepare yourself for childbirth by getting the facts about this important sign of labor. By Mayo Clinic Staff If you're ...

Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study

DEFF Research Database (Denmark)

Juul-Kristensen, B; Kadefors, R; Hansen, K

2006-01-01

-reported neck/shoulder trouble have more clinical findings than those not reporting trouble, and that a corresponding pattern holds true for physical function. In total 42 and 61 questionnaire-defined NS cases and NS controls participated and went through a clinical examination of the neck and upper extremities...... and five physical function tests: maximal voluntary contraction (MVC) of shoulder elevation, abduction, and handgrip, as well as endurance at 30% MVC shoulder elevation and a physical performance test. Based on clinical signs and symptoms, trapezius myalgia (38%), tension neck syndrome (17......%) and cervicalgia (17%) were the most frequent diagnoses among NS cases, and were significantly more frequent among NS cases than NS controls. A total of 60% of the subjects with reported trouble had one or several of the diagnoses located in the neck/shoulder. Physical function of the shoulder was lower...

The effect of aromatherapy with the essential oil of orange on pain and vital signs of patients with fractured limbs admitted to the emergency ward: A randomized clinical trial

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Davood Hekmatpou

2017-01-01

Full Text Available Background and Objective: Pain is an emotional and unpleasant experience associated with actual or potential tissue damage. The literature shows no study on the effect of aromatherapy with the essential oil of orange on unpleasant feelings of patients with fractured limbs. In this regard, this paper aims at studying the effect of aromatherapy with the essential oil of orange on patients with fractured limbs admitted to the emergency ward. Methods: Sixty patients admitted to the emergency ward of Vali-e-Asr Hospital were selected by purposive sampling method and then were divided into two groups of control and experiment by block method. This study was done in one shift work (morning or afternoon. Four drops of the orange oil were poured on a pad and were pinned with a plastic pin to the patient's collar, about 20 cm distant from head. The old pad was replaced by the new one every 1 h. The patients' pain and vital signs were checked every 1 h for at last 6 h. The data were analyzed by SPSS Version 21. Results: Forty (66.7% patients were male and twenty (33.3% were female. Their age average was 37.93 ± 18.19 years old. The most fractured cases were in the scapular (11 patients [18.3%]. Friedman test showed that pain in the experiment group (P = 0.0001 decreased significantly rather than the control group (0.339. However, in vital signs, there could be found that no significant change between the two groups was seen. Conclusion: Aromatherapy with orange oil can relieve pain in patients with fractured limbs but has no effect on their vital signs. Therefore, aromatherapy with orange oil can be used as a complementary medicine in these patients.

Cerebral toxoplasmosis: case review and description of a new imaging sign

International Nuclear Information System (INIS)

Masamed, R.; Meleis, A.; Lee, E.W.; Hathout, G.M.

2009-01-01

Toxoplasmosis can have catastrophic consequences in immunocompromised patients if left untreated. Accurate diagnosis is difficult, as there is substantial overlap between the imaging findings and presenting clinical syndromes of cerebral toxoplasmosis and primary central nervous system lymphoma. This paper reviews the previously described and fairly well-known post-contrast computed tomography (CT) and T1-weighted (W) magnetic resonance imaging (MRI) target signs seen in toxoplasmosis. In addition, it offers a new imaging sign, the T2W/FLAIR (fluid attenuated inversion recovery) target sign, which is often seen in clinical practice but not well-published, as an aid to the diagnosis of cerebral toxoplasmosis.

Cerebral toxoplasmosis: case review and description of a new imaging sign

Energy Technology Data Exchange (ETDEWEB)

Masamed, R. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States)], E-mail: rmasamed@mednet.ucla.edu; Meleis, A. [Princeton University, New Jersey, CA (United States); Lee, E.W. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Hathout, G.M. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, Olive View UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, West L.A. VA Medical Center, Los Angeles, CA (United States)

2009-05-15

Toxoplasmosis can have catastrophic consequences in immunocompromised patients if left untreated. Accurate diagnosis is difficult, as there is substantial overlap between the imaging findings and presenting clinical syndromes of cerebral toxoplasmosis and primary central nervous system lymphoma. This paper reviews the previously described and fairly well-known post-contrast computed tomography (CT) and T1-weighted (W) magnetic resonance imaging (MRI) target signs seen in toxoplasmosis. In addition, it offers a new imaging sign, the T2W/FLAIR (fluid attenuated inversion recovery) target sign, which is often seen in clinical practice but not well-published, as an aid to the diagnosis of cerebral toxoplasmosis.

Implementing the PAIN RelieveIt Randomized Controlled Trial in Hospice Care: Mechanisms for Success and Meeting PCORI Methodology Standards.

Science.gov (United States)

Ezenwa, Miriam O; Suarez, Marie L; Carrasco, Jesus D; Hipp, Theresa; Gill, Anayza; Miller, Jacob; Shea, Robert; Shuey, David; Zhao, Zhongsheng; Angulo, Veronica; McCurry, Timothy; Martin, Joanna; Yao, Yingwei; Molokie, Robert E; Wang, Zaijie Jim; Wilkie, Diana J

2017-07-01

This purpose of this article is to describe how we adhere to the Patient-Centered Outcomes Research Institute's (PCORI) methodology standards relevant to the design and implementation of our PCORI-funded study, the PAIN RelieveIt Trial. We present details of the PAIN RelieveIt Trial organized by the PCORI methodology standards and components that are relevant to our study. The PAIN RelieveIt Trial adheres to four PCORI standards and 21 subsumed components. The four standards include standards for formulating research questions, standards associated with patient centeredness, standards for data integrity and rigorous analyses, and standards for preventing and handling missing data. In the past 24 months, we screened 2,837 cancer patients and their caregivers; 874 dyads were eligible; 223.5 dyads consented and provided baseline data. Only 55 patients were lost to follow-up-a 25% attrition rate. The design and implementation of the PAIN RelieveIt Trial adhered to PCORI's methodology standards for research rigor.

Topical azithromycin and oral doxycycline therapy of meibomian gland dysfunction: a comparative clinical and spectroscopic pilot study.

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Foulks, Gary N; Borchman, Douglas; Yappert, Marta; Kakar, Shelley

2013-01-01

Meibomian gland dysfunction (MGD) is a common clinical problem that is often associated with evaporative dry eye disease. Alterations of the lipids of the meibomian glands have been identified in several studies of MGD. This prospective, observational, open-label clinical trial documents the improvement in both clinical signs and symptoms of disease as well as spectroscopic characteristics of the meibomian gland lipids after therapy with topical azithromycin ophthalmic solution and oral doxycycline treatment. Subjects with symptomatic MGD were recruited. Signs of MGD were evaluated with a slit lamp. Symptoms of MGD were measured by the response of subjects to a questionnaire. Meibum lipid-lipid interaction strength, conformation, and phase transition parameters, and meibum protein content were measured using Fourier transform infrared spectroscopy and principal component analysis. Terpenoids, short-chain CH3 moieties, lipid oxidation, wax, cholesterylesters and glycerides were measured with a proton nuclear magnetic resonance (H-NMR) spectrometer. Topical therapy with azithromycin and oral therapy with doxycycline relieved signs and symptoms and restored the lipid properties of the meibomian gland secretion toward normal. Compared with 4 weeks of azithromycin treatment reported in our previous study, oral doxycycline treatment was slightly less effective in improving foreign body sensation and the signs of plugging and secretion. In subjects with clinical evidence of MGD, changes in ordering of the lipids and phase transition temperature were brought closer to normal with azithromycin treatment than doxycycline treatment. Treatment with doxycycline but not azithromycin restored the Fourier transform infrared spectroscopy-principal component analysis scores and relative area of the H-NMR resonance at 1.26 ppm. Both doxycycline and azithromycin treatment restored the levels of the relative areas of the H-NMR resonance at 5.2 and 7.9 ppm to normal levels. The levels

Parkinsonian signs are a risk factor for falls.

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Dahodwala, Nabila; Nwadiogbu, Chinwe; Fitts, Whitney; Partridge, Helen; Karlawish, Jason

2017-06-01

Parkinsonian signs are common, non-specific findings in older adults and associated with increased rates of dementia and mortality. It is important to understand which motor outcomes are associated with parkinsonian signs. To determine the role of parkinsonian signs on fall rates among older adults. We conducted a longitudinal study of primary care patients from the University of Pennsylvania Health System. Adults over 55 years were assessed at baseline through surveys and a neurological examination. We recorded falls over the following 2 years. Parkinsonian signs were defined as the presence of 2 of 4 cardinal signs. Incident falls were compared between subjects with and without parkinsonian signs, and modified Poisson regression used to adjust for potential confounders in the relationship between parkinsonian signs and falls. 982 subjects with a mean age of 68 (s.d. 8.8) years participated. 29% of participants fell and 12% exhibited parkinsonian signs at baseline. The unadjusted RR for falls among individuals with parkinsonian signs was 1.36 (95% CI 1.05-1.76, p=0.02). After adjusting for age, cognitive function, urinary incontinence, depression, diabetes, stroke and arthritis, individuals with parkinsonian signs were still 38% more likely to fall than those without parkinsonian signs (RR 1.38, 95% CI 1.04-1.82; p=0.03). Falls among those with parkinsonian signs were more likely to lead to injury (53% vs 37%; p=0.04). Parkinsonian signs are a significant, independent risk factor for falls. Early detection of this clinical state is important in order to implement fall prevention programs among primary care patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Health technology assessment of magnet therapy for relieving pain.

Science.gov (United States)

Arabloo, Jalal; Hamouzadeh, Pejman; Eftekharizadeh, Fereshteh; Mobinizadeh, Mohammadreza; Olyaeemanesh, Alireza; Nejati, Mina; Doaee, Shila

2017-01-01

Background: Magnet therapy has been used increasingly as a new method to alleviate pain. Magnetic products are marketed with claims of effectiveness for reducing pain of various origins. However, there are inconsistent results from a limited number of randomized controlled trials (RCTs) testing the analgesic efficacy of magnet therapy. This study aimed to evaluate the safety and effectiveness of magnet therapy on reliving various types of pain. Methods: A systematic search of two main medical databases (Cochrane Library and Ovid Medline) was conducted from 1946 to May 2014. Only English systematic reviews that compared magnet therapy with other conventional treatments in patients with local pain in terms of pain relieving measures were included. The results of the included studies were thematically synthesized. Results: Eight studies were included. Magnet therapy could be used to alleviate pain of various origins including pain in various organs, arthritis, myofascial muscle pain, lower limb muscle cramps, carpal tunnel syndrome and pelvic pain. Results showed that the effectiveness of magnetic therapy was only approved in muscle pains, but its effectiveness in other indications and its application as a complementary treatment have not been established. Conclusion: According to the results, it seems that magnet therapy could not be an effective treatment for relieving different types of pain. Our results highlighted the need for further investigations to be done in order to support any recommendations about this technology.

Medical diagnosis through semiotics. Giving meaning to the sign.

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Burnum, J F

1993-11-01

Physicians are engaged in incorporating quantitative methods for making clinical decisions into their practices. An acquaintance with semiotics, the doctrine of signs, may complement this project. A sign stands for something. We communicate indirectly through signs, and by interpreting what signs mean we make sense of our world and diagnose and understand our patients. Thus, through association and inference, we transform flowers into love, Othello into jealousy, and staring eyes into thyrotoxicosis. Characteristically in diagnosis, beginning with an unstable inference, we test and otherwise ask questions likely to produce signs that support (or discredit) our hypothesis. In a literary sense, we join with the author to clarify and rewrite the text; creative interpretation is the key. Diagnosis is concluded through narration, by the meaning that is revealed by telling the story of the patient. Diagnosis will succeed only to the extent that we respect the principles and caveats of sign interpretation. The sign is both the key to the unknown and the master impersonator. The sign and its meaning are usually not the same; meaning has to be inferred. Because interpretations are made subjectively, they are circumscribed by the experience and bias of the clinician. Moreover, the contexts in which the sign appears shape the meaning of the sign and may change it altogether.

Partial Pulpotomy in Mature Permanent Teeth with Clinical Signs Indicative of Irreversible Pulpitis: A Randomized Clinical Trial.

Science.gov (United States)

Taha, Nessrin A; Khazali, Mohammad A

2017-09-01

This study aimed to assess the outcome of partial pulpotomy using mineral trioxide aggregate (MTA) compared with calcium hydroxide (CH) in mature cariously exposed permanent molars. Fifty permanent molar teeth with carious exposures in 50 patients >20 years old were included. Preoperative pulpal and periapical diagnosis was established based on a history of presenting pain, results of cold testing, and radiographic findings. After informed consent, the tooth was anesthetized, isolated via a dental dam, and disinfected with 5% sodium hypochlorite before caries excavation. Partial pulpotomy was performed by amputating 2 mm of the exposed pulp, hemostasis was achieved, and the tooth was randomly assigned for the placement of either white MTA (White ProRoot; Dentsply, Tulsa, OK) or CH (Dycal; Dentsply Caulk, Milford, DE) as the pulpotomy agent. Postoperative periapical radiographs were taken after placement of the permanent restoration. Clinical and radiographic evaluation was completed after 6 months and 1 and 2 years postoperatively. Statistical analysis was performed using the Fisher exact test. Clinical signs and symptoms suggestive of irreversible pulpitis were established in all teeth. Immediate failure occurred in 4 teeth. At 1 year, MTA showed a higher tendency toward success compared with the CH group, and the difference was statistically significant after 2 years (83% vs 55%, P = .052 at 1 year; 85% vs 43%, P = .006 at 2 years). Sex did not have a statistically significant effect on the outcome. MTA partial pulpotomy sustained a good success rate over the 2-year follow-up in mature permanent teeth clinically diagnosed with irreversible pulpitis. More than half of the CH cases failed within 2 years. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Acute abdomen. Diagnostic radiology according to principal signs

International Nuclear Information System (INIS)

Krestin, G.P.

1994-01-01

The acute abdomen is a frequent and very often dangerous syndrome which requires sophisticated diagnostic evaluation. A decisive factor determining the following case history is efficient and exact diagnosis, calling for experienced clinical and diagnostic experts for efficient application of available methods, and correct interpretation of findings. The book offers: 1. Practice-oriented diagnostic strategies, based on 13 principal signs and constellations derived from clinical experience, presented in each chapter as a combination of - suitable differential diagnostic procedures and methods,- exhaustive description of the clinical signs and diagnostic findings specific of the various symptoms,- algorithmic presentations. 2. A special chapter on the pediatric acute abdomen. 3. The most important findings shown in more than 250 original pictures. 4. A graphical design and presentation of the information which permits quick access to the important content. (orig./CB) [de

Clinical signs and histologic findings in dogs with odontogenic cysts: 41 cases (1995-2010).

Science.gov (United States)

Verstraete, Frank J M; Zin, Bliss P; Kass, Philip H; Cox, Darren P; Jordan, Richard C

2011-12-01

To characterize clinical signs and histologic findings in dogs with odontogenic cysts and determine whether histologic findings were associated with clinical features. Retrospective case series. 41 dogs. Medical records were reviewed to obtain clinical data, including breed, age, sex, and lesion location. Microscopic sections and results of diagnostic imaging were reviewed. Odontogenic cysts were identified in 41 dogs between 1995 and 2010. There were 29 dogs with dentigerous cysts, 1 with a radicular cyst, 1 with a lateral periodontal cyst, and 1 with a gingival inclusion cyst. In addition, 9 dogs with odontogenic cysts that had clinical and histologic features suggestive of, but not diagnostic for, odontogenic keratocysts seen in people were identified. In all 9 dogs, these cysts were located in the maxilla and surrounded the roots of normally erupted teeth. Of the 29 dogs with dentigerous cysts, 23 had a single cyst, 5 had 2 cysts, and 1 had 3 cysts. Six cysts were associated with an unerupted canine tooth, and 30 were associated with an unerupted first premolar tooth (1 cyst was associated both with an unerupted canine tooth and with an unerupted first premolar tooth). Dentigerous cysts were identified in a variety of breeds, but several brachycephalic breeds were overrepresented, compared with the hospital population during the study period. Results suggested that a variety of odontogenic cysts can occur in dogs. In addition, cysts that resembled odontogenic keratocysts reported in people were identified. We propose the term canine odontogenic parakeratinized cyst for this condition.

Systematic review of efficacy of nutraceuticals to alleviate clinical signs of osteoarthritis.

Science.gov (United States)

Vandeweerd, J-M; Coisnon, C; Clegg, P; Cambier, C; Pierson, A; Hontoir, F; Saegerman, C; Gustin, P; Buczinski, S

2012-01-01

Various treatments of osteoarthritis (OA) have been described, including use of nutraceuticals. To review systematically the literature about the effects of nutraceuticals on clinical signs of pain or abnormal locomotion in horses, dogs, and cats, and to discuss methodological aspects of trials and systematic reviews. A systematic search of controlled trials evaluating the impact of nutraceuticals on OA in horses, dogs, and cats was performed, using Medline, CAB Abstracts, and Google Scholar. Scientific evidence was evaluated by means of criteria proposed by the Food and Drug Administration (FDA), and a scoring system adapted from both the CONsolidated Standards of Reporting Trials (CONSORT) statement and recommendations for assessing trials by the Center of Evidence Based Medicine of Oxford. Twenty-two papers were selected and reviewed, with 5 studies performed in horses, 16 in dogs, and 1 in cats. The strength of evidence was low for all nutraceuticals except for omega-3 fatty acid in dogs. There were limited numbers of rigorous randomized controlled trials and of participants in clinical trials. The evidence of efficacy of nutraceuticals is poor, with the exception of diets supplemented with omega-3 fatty acids in dogs. Greater access to systematic reviews must be part of the objectives of the veterinary science in the future. Their reporting would be improved by internationally agreed-upon criteria for standards and guidelines. Copyright © 2012 by the American College of Veterinary Internal Medicine.

Magnetic field control of 90 Degree-Sign , 180 Degree-Sign , and 360 Degree-Sign domain wall resistance

Energy Technology Data Exchange (ETDEWEB)

Majidi, Roya, E-mail: royamajidi@gmail.com [Department of Physics, Shahid Rajaee Teacher Training University, Lavizan, 16788-15811 Tehran (Iran, Islamic Republic of)

2012-10-01

In the present work, we have compared the resistance of the 90 Degree-Sign , 180 Degree-Sign , and 360 Degree-Sign domain walls in the presence of external magnetic field. The calculations are based on the Boltzmann transport equation within the relaxation time approximation. One-dimensional Neel-type domain walls between two domains whose magnetization differs by angle of 90 Degree-Sign , 180 Degree-Sign , and 360 Degree-Sign are considered. The results indicate that the resistance of the 360 Degree-Sign DW is more considerable than that of the 90 Degree-Sign and 180 Degree-Sign DWs. It is also found that the domain wall resistance can be controlled by applying transverse magnetic field. Increasing the strength of the external magnetic field enhances the domain wall resistance. In providing spintronic devices based on magnetic nanomaterials, considering and controlling the effect of domain wall on resistivity are essential.

Treatment of diabetic neuropathy in the lower limb: Signs and ...

African Journals Online (AJOL)

Diabetic peripheral neuropathy (DPN) is defined as 'the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after exclusion of other causes: the diagnosis cannot be made without a clinical examination'. In fact, many of these symptoms and signs may precede the onset of diabetes.

Intraperitoneal Dexamethasone As A New Method for Relieving Postoperative Shoulder Pain after Gynecologic Laparoscopy

Directory of Open Access Journals (Sweden)

Zahra Asgari

2012-01-01

Full Text Available Background: In this study, we tried to show the efficacy of Intraperitoneal dexamethasoneon relieving shoulder pain after gynecologic laparoscopy.Materials and Methods: In this double-blind randomized clinical trial, 63 patients who werecandidates for gynecologic laparoscopy were included. At the end of the procedure patientsrandomly received 16 mg dexamethasone (n=31 or placebo (n=32 intraperitoneally. Visualanalogue scale (VAS was used for clinical evaluation of pain severity during 24 hours afterlaparoscopy . A physician, who was not aware whether patients were treated with drug or placebo,evaluated the patients.Results: The severity of pain in the dexamethasone group within 0, 2, 4, 8, 12, 24 hoursafter procedure was significantly less than in the placebo group (p<0.001. The averageconsumption of opioids as analgesic/ sedative in the placebo group was more than thedexamethasone group (p=0.025.Conclusion: Findings of this study show that the prescription of 16 mg of dexamethasone(single dose in the peritoneal cavity may significantly reduce the severity of painafter Laparoscopy in comparison with placebo and may decrease the need for narcoticsas pain relief (Registration Number: IRCT201105306640N1.

Effects of Competing Narratives on Public Perceptions of Opioid Pain Reliever Addiction during Pregnancy.

Science.gov (United States)

Kennedy-Hendricks, Alene; McGinty, Emma E; Barry, Colleen L

2016-10-01

Opioid pain reliever addiction has increased among women of reproductive age over the last fifteen years. News media and public attention have focused on the implications of this trend for infants exposed to opioids prenatally, with state policy responses varying in the extent to which they are punitive or public health oriented. We fielded a six-group randomized experiment among a nationally representative sample of US adults to test the effects of narratives portraying a woman with opioid pain reliever addiction during pregnancy on beliefs about people addicted to opioid pain relievers, perceptions of treatment effectiveness, policy attitudes, and emotional responses. Portraying a high socioeconomic status (SES) woman in the narrative lowered perceptions of individual blame for addiction and reduced public support for punitive policies. Depicting the barriers to treatment faced by a low SES woman lowered support for punitive policies and increased support for expanded insurance coverage for treatment. The extent to which narratives portraying successfully treated addiction affected public attitudes depended on the SES of the woman portrayed. These findings can inform the development of communication strategies to reduce stigma toward this population, reduce support for punitive policies, and increase support for more public health-oriented approaches to addressing this problem. Copyright © 2016 by Duke University Press.

Radiological signs of transient tachypnoea and its differential diagnosis

International Nuclear Information System (INIS)

Ponhold, W.

1981-01-01

The radiological signs of transient tachypnoea are analysed via a study conducted with 9 children suffering from this disturbance of respiratory adaptation. The main signs are reticulonodular structural increases on both sides and extended vessels with unsharp outlines; to a lesser extent, marked small interlobar fissure, signs of an expiratory disturbance of ventilation, and cardiomegaly are seen also. Differentiation against hyaline membranes is easy and delineation against pneumonic and haemorrhagic infiltrations is usually not at all difficult. However, it may be less easy to differentiate between a relatively severe transient tachypnoea and cardiac left decompensation, since the radiological signs resemble each other. Assessment of a chest X-ray film of the newborn should be evaluated in such cases only if the clinical pattern of signs is known, since this is the only way to obtain adequate radiological clarification. (orig.) [de

Diagonal Earlobe Crease (Frank's Sign): A Predictor of Cerebral Vascular Events.

Science.gov (United States)

Nazzal, Saleh; Hijazi, Basem; Khalila, Luai; Blum, Arnon

2017-11-01

Frank's sign was first described in 1973 by an American physician (Sonders T. Frank). It is a diagonal crease in the earlobe that starts from the tragus to the edge of the auricle in an angle of 45° in varying depths. Frank's sign was described as a predictor of future coronary heart disease and peripheral vascular diseases. The aim of the study was to examine the association between Frank's sign and the development of ischemic stroke. This was a prospective study that enrolled consecutive patients admitted with an acute ischemic stroke. Frank's sign was tested in both ears. Clinical data included age, gender, type 2 diabetes mellitus, and hypertension. The study was approved by the institutional review board (the institutional ethics committee). A total of 241 consecutive patients who were hospitalized with an acute stroke and were eligible to take part in the study were recruited. Frank's sign was present in 190 patients (78.8%). Patients were divided according to clinical findings and the findings from brain computed tomography. There were 153 patients with transient ischemic attacks (63.6% of the patients) and 88 with cerebrovascular accidents (36.4% of the patients). A total of 112 patients with transient ischemic attacks had Frank's sign (73.2%), and 78 patients with cerebrovascular accidents had Frank's sign (88.6%), with a statistically significant difference (P <.01). Frank's sign could predict ischemic cerebrovascular events. Patients with classical cardiovascular risk factors had Frank's sign at a higher frequency. Copyright © 2017 Elsevier Inc. All rights reserved.

Mental Illness in Children: Know the Signs

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... how you can help. By Mayo Clinic Staff Mental illness in children can be hard for parents to ... help they need. Understand the warning signs of mental illness in children and how you can help your ...

Predictive Value of CTA Spot Sign on Hematoma Expansion in Intracerebral Hemorrhage Patients

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Wen-Jie Peng

2017-01-01

Full Text Available Hematoma expansion (HE occurs in approximately one-third of patients with intracerebral hemorrhage and leads to high rates of mortality and morbidity. Currently, contrast extravasation within hematoma, termed the spot sign on computed tomography angiography (CTA, has been identified as a strong independent predictor of early hematoma expansion. Past studies indicate that the spot sign is a dynamic entity and is indicative of active hemorrhage. Furthermore, to enhance the spot sign’s accuracy of predicting HE, spot parameters observed on CTA or dynamic CTA were used for its quantification. In addition, spot signs detected on multiphase CTA and dynamic CTA are shown to have higher sensitivity and specificity when compared with simple standardized spot sign detection in recent studies. Based on the spot sign, novel methods such as leakage sign and rate of contrast extravasation were explored to redefine HE prediction in combination with clinical characteristics and spot sign on CTA to assist clinical judgment. The spot sign is an accepted independent predictor of active hemorrhage and is used in both secondary intracerebral hemorrhage and the process of surgical assessment for hemorrhagic risk in patients with ischemic stroke. Spot sign predicts patients at high risk for hematoma expansion.

Prescription Pain Reliever Abuse and Dependence among Adolescents: A Nationally Representative Study

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Wu, Li-Tzy; Ringwalt, Christopher L.; Mannelli, Paolo; Patkar, Ashwin A.

2008-01-01

The study investigates the prevalence, patterns, and correlates of adolescents' abuse, sub-threshold dependence, and dependence on prescription pain relievers (PPRs) in a nationally representative sample. Results show dependence on PPRs can take place without abuse and that sub-threshold dependence could have implications for major diagnostic…

The C sign: more specific for flatfoot deformity than subtalar coalition

International Nuclear Information System (INIS)

Brown, R.R.; Rosenberg, Z.S.; Thornhill, B.A.

2001-01-01

Objective. To assess the sensitivity and specificity of the C sign, a C-shaped line created by the outline of the talar dome and the inferior margin of the sustentaculum tali on lateral ankle radiographs, for patients with both flatfoot deformity and specifically talocalcaneal (TC) coalition.Design and patients. All patients in this retrospective study were under 35 years of age and had a lateral ankle radiograph and follow-up CT scan for a non-traumatic indication. Forty-eight cases over the past 5 years fulfilled these criteria. Two masked musculoskeletal radiologists determined the presence or absence of the C sign for each lateral radiograph by consensus. Each CT study was then assessed by a third musculoskeletal radiologist for the presence of tarsal coalition. Observations were correlated with clinical history regarding presence or absence of flatfoot deformity.Results. Ten cases of TC coalition were diagnosed, four of which demonstrated a C sign (40%). Eight cases with a C sign were encountered, four of which had TC coalition (50%) and four did not. All patients with a positive C sign had a flatfoot clinically (100%), while only eight of 24 flatfooted patients had a C sign (33%).Conclusion. The C sign is specific, but not sensitive, for flatfoot deformity, and is neither sensitive nor specific for subtalar coalition. (orig.)

SynopSIS: integrating physician sign-out with the electronic medical record.

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Sarkar, Urmimala; Carter, Jonathan T; Omachi, Theodore A; Vidyarthi, Arpana R; Cucina, Russell; Bokser, Seth; van Eaton, Erik; Blum, Michael

2007-09-01

Safe delivery of care depends on effective communication among all health care providers, especially during transfers of care. The traditional medical chart does not adequately support such communication. We designed a patient-tracking tool that enhances provider communication and supports clinical decision making. To develop a problem-based patient-tracking tool, called Sign-out, Information Retrieval, and Summary (SynopSIS), in order to support patient tracking, transfers of care (ie, sign-outs), and daily rounds. Tertiary-care, university-based teaching hospital. SynopSIS compiles and organizes information from the electronic medical record to support hospital discharge and disposition decisions, daily provider decisions, and overnight or cross-coverage decisions. It reflects the provider's patient-care and daily work-flow needs. We plan to use Web-based surveys, audits of daily use, and interdisciplinary focus groups to evaluate SynopSIS's impact on communication between providers, quality of sign-out, patient continuity of care, and rounding efficiency. We expect SynopSIS to improve care by facilitating communication between care teams, standardizing sign-out, and automating daily review of clinical and laboratory trends. SynopSIS redesigns the clinical chart to better serve provider and patient needs. (c) 2007 Society of Hospital Medicine.

Perceived stress, pain and work performance among non-patient working personnel with clinical signs of temporomandibular or neck pain.

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Suvinen, T I; Ahlberg, J; Rantala, M; Nissinen, M; Lindholm, H; Könönen, M; Savolainen, A

2004-08-01

The aim of the present study was to assess the associations between different types of perceived stress, pain and work performance among non-patients with clinical signs of muscle pain in the head/neck region. One-fifth (n = 241) of the 1339 media employees who had participated in a previous survey (Ahlberg J. et al., J Psychosom Res 2002; 53: 1077-1081) were randomly selected for standardized clinical examinations. Altogether 49% (n = 118) of these subjects had clinical signs of temporomandibular and/or neck muscle pain and were enrolled in the present study. The mean age of the study sample was 46.9 years (s.d. 6.6) and the female to male distribution 2:1. Of the 118 employees 46.5% reported that the pain problem interfered with their ability to work. Perceived ability to work was not significantly associated with age, gender or work positions. According to logistic regression, reduced work performance was significantly positively associated with continuous pain [odds ratio (OR) 4.38; 95% CI 1.21-15.7], level of perceived pain severity (OR 1.30; 95% CI 1.04-1.63), and health stress (OR 2.08; 95% CI 1.22-3.54). The results of this study indicated an association between specific self-reported stress regarding health and work issues, pain and work performance. From a preventive perspective this indicates a need for increased awareness about these associations on not only individual level but also at the organizational level and in health care. Copyright 2004 Blackwell Publishing Ltd.

Combining macula clinical signs and patient characteristics for age-related macular degeneration diagnosis: a machine learning approach.

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Fraccaro, Paolo; Nicolo, Massimo; Bonetto, Monica; Giacomini, Mauro; Weller, Peter; Traverso, Carlo Enrico; Prosperi, Mattia; OSullivan, Dympna

2015-01-27

To investigate machine learning methods, ranging from simpler interpretable techniques to complex (non-linear) "black-box" approaches, for automated diagnosis of Age-related Macular Degeneration (AMD). Data from healthy subjects and patients diagnosed with AMD or other retinal diseases were collected during routine visits via an Electronic Health Record (EHR) system. Patients' attributes included demographics and, for each eye, presence/absence of major AMD-related clinical signs (soft drusen, retinal pigment epitelium, defects/pigment mottling, depigmentation area, subretinal haemorrhage, subretinal fluid, macula thickness, macular scar, subretinal fibrosis). Interpretable techniques known as white box methods including logistic regression and decision trees as well as less interpreitable techniques known as black box methods, such as support vector machines (SVM), random forests and AdaBoost, were used to develop models (trained and validated on unseen data) to diagnose AMD. The gold standard was confirmed diagnosis of AMD by physicians. Sensitivity, specificity and area under the receiver operating characteristic (AUC) were used to assess performance. Study population included 487 patients (912 eyes). In terms of AUC, random forests, logistic regression and adaboost showed a mean performance of (0.92), followed by SVM and decision trees (0.90). All machine learning models identified soft drusen and age as the most discriminating variables in clinicians' decision pathways to diagnose AMD. Both black-box and white box methods performed well in identifying diagnoses of AMD and their decision pathways. Machine learning models developed through the proposed approach, relying on clinical signs identified by retinal specialists, could be embedded into EHR to provide physicians with real time (interpretable) support.

Neurocognitive and Neuroplastic Mechanisms of Novel Clinical Signs in CRPS

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Anoop eKuttikat

2016-01-01

Full Text Available Complex Regional Pain Syndrome (CRPS is a chronic, debilitating pain condition that usually arises after trauma to a limb, but its precise etiology remains elusive. Novel clinical signs based on body perceptual disturbances have been reported, but their pathophysiological mechanisms remain poorly understood. Investigators have used functional neuroimaging techniques (including MEG, EEG, fMRI and PET to study changes mainly within the somatosensory and motor cortices. Here we provide a focused review of the neuroimaging research findings that have generated insights into the potential neurocognitive and neuroplastic mechanisms underlying perceptual disturbances in CRPS. Neuroimaging findings, particularly with regard to somatosensory processing, have been promising but limited by a number of technique-specific factors (such as the complexity of neuroimaging investigations, poor spatial resolution of EEG/MEG, and use of modelling procedures that do not draw causal inferences and more general factors including small samples sizes and poorly characterized patients. These factors have led to an underappreciation of the potential heterogeneity of pathophysiology that may underlie variable clinical presentation in CRPS. Also, until now, neurological deficits have been predominantly investigated separately from perceptual and cognitive disturbances. Here, we highlight the need to identify neurocognitive phenotypes of patients with CRPS that are underpinned by causal explanations for perceptual disturbances. We suggest that a combination of larger cohorts, patient phenotyping, the use of both high temporal and spatial resolution neuroimaging methods, and the identification of simplified biomarkers is likely to be the most fruitful approach to identifying neurocognitive phenotypes in CRPS. Based on our review, we explain how such phenotypes could be characterized in terms of hierarchical models of perception and corresponding disturbances in recurrent

Neurocognitive and Neuroplastic Mechanisms of Novel Clinical Signs in CRPS.

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Kuttikat, Anoop; Noreika, Valdas; Shenker, Nicholas; Chennu, Srivas; Bekinschtein, Tristan; Brown, Christopher Andrew

2016-01-01

Complex regional pain syndrome (CRPS) is a chronic, debilitating pain condition that usually arises after trauma to a limb, but its precise etiology remains elusive. Novel clinical signs based on body perceptual disturbances have been reported, but their pathophysiological mechanisms remain poorly understood. Investigators have used functional neuroimaging techniques (including MEG, EEG, fMRI, and PET) to study changes mainly within the somatosensory and motor cortices. Here, we provide a focused review of the neuroimaging research findings that have generated insights into the potential neurocognitive and neuroplastic mechanisms underlying perceptual disturbances in CRPS. Neuroimaging findings, particularly with regard to somatosensory processing, have been promising but limited by a number of technique-specific factors (such as the complexity of neuroimaging investigations, poor spatial resolution of EEG/MEG, and use of modeling procedures that do not draw causal inferences) and more general factors including small samples sizes and poorly characterized patients. These factors have led to an underappreciation of the potential heterogeneity of pathophysiology that may underlie variable clinical presentation in CRPS. Also, until now, neurological deficits have been predominantly investigated separately from perceptual and cognitive disturbances. Here, we highlight the need to identify neurocognitive phenotypes of patients with CRPS that are underpinned by causal explanations for perceptual disturbances. We suggest that a combination of larger cohorts, patient phenotyping, the use of both high temporal, and spatial resolution neuroimaging methods, and the identification of simplified biomarkers is likely to be the most fruitful approach to identifying neurocognitive phenotypes in CRPS. Based on our review, we explain how such phenotypes could be characterized in terms of hierarchical models of perception and corresponding disturbances in recurrent processing

The diagnostic value of the Clarke sign in assessing chondromalacia patella.

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Doberstein, Scott T; Romeyn, Richard L; Reineke, David M

2008-01-01

Various techniques have been described for assessing conditions that cause pain at the patellofemoral (PF) joint. The Clarke sign is one such test, but the diagnostic value of this test in assessing chondromalacia patella is unknown. To (1) investigate the diagnostic value of the Clarke sign in assessing the presence of chondromalacia patella using arthroscopic examination of the PF joint as the "gold standard," and (2) provide a historical perspective of the Clarke sign as a clinical diagnostic test. Validation study. All patients of one of the investigators who had knee pain or injuries unrelated to the patellofemoral joint and were scheduled for arthroscopic surgery were recruited for this study. A total of 106 otherwise healthy individuals with no history of patellofemoral pain or dysfunction volunteered. The Clarke sign was performed on the surgical knee by a single investigator in the clinic before surgery. A positive test was indicated by the presence of pain sufficient to prevent the patient from maintaining a quadriceps muscle contraction against manual resistance for longer than 2 seconds. The preoperative result was compared with visual evidence of chondromalacia patella during arthroscopy. Sensitivity was 0.39, specificity was 0.67, likelihood ratio for a positive test was 1.18, likelihood ratio for a negative test was 0.91, positive predictive value was 0.25, and negative predictive value was 0.80. Diagnostic validity values for the use of the Clarke sign in assessing chondromalacia patella were unsatisfactory, supporting suggestions that it has poor diagnostic value as a clinical examination technique. Additionally, an extensive search of the available literature for the Clarke sign reveals multiple problems with the test, causing significant confusion for clinicians. Therefore, the use of the Clarke sign as a routine part of a knee examination is not beneficial, and its use should be discontinued.

Automatic stress-relieving music recommendation system based on photoplethysmography-derived heart rate variability analysis.

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Shin, Il-Hyung; Cha, Jaepyeong; Cheon, Gyeong Woo; Lee, Choonghee; Lee, Seung Yup; Yoon, Hyung-Jin; Kim, Hee Chan

2014-01-01

This paper presents an automatic stress-relieving music recommendation system (ASMRS) for individual music listeners. The ASMRS uses a portable, wireless photoplethysmography module with a finger-type sensor, and a program that translates heartbeat signals from the sensor to the stress index. The sympathovagal balance index (SVI) was calculated from heart rate variability to assess the user's stress levels while listening to music. Twenty-two healthy volunteers participated in the experiment. The results have shown that the participants' SVI values are highly correlated with their prespecified music preferences. The sensitivity and specificity of the favorable music classification also improved as the number of music repetitions increased to 20 times. Based on the SVI values, the system automatically recommends favorable music lists to relieve stress for individuals.

Towards first principle medical diagnostics: on the importance of disease-disease and sign-sign interactions

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Ramezanpour, Abolfazl; Mashaghi, Alireza

2017-07-01

A fundamental problem in medicine and biology is to assign states, e.g. healthy or diseased, to cells, organs or individuals. State assignment or making a diagnosis is often a nontrivial and challenging process and, with the advent of omics technologies, the diagnostic challenge is becoming more and more serious. The challenge lies not only in the increasing number of measured properties and dynamics of the system (e.g. cell or human body) but also in the co-evolution of multiple states and overlapping properties, and degeneracy of states. We develop, from first principles, a generic rational framework for state assignment in cell biology and medicine, and demonstrate its applicability with a few simple theoretical case studies from medical diagnostics. We show how disease-related statistical information can be used to build a comprehensive model that includes the relevant dependencies between clinical and laboratory findings (signs) and diseases. In particular, we include disease-disease and sign-sign interactions and study how one can infer the probability of a disease in a patient with given signs. We perform comparative analysis with simple benchmark models to check the performances of our models. We find that including interactions can significantly change the statistical importance of the signs and diseases. This first principles approach, as we show, facilitates the early diagnosis of disease by taking interactions into accounts, and enables the construction of consensus diagnostic flow charts. Additionally, we envision that our approach will find applications in systems biology, and in particular, in characterizing the phenome via the metabolome, the proteome, the transcriptome, and the genome.

Directing traffic on DNA-How transcription factors relieve or induce transcriptional interference.

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Hao, Nan; Palmer, Adam C; Dodd, Ian B; Shearwin, Keith E

2017-03-15

Transcriptional interference (TI) is increasingly recognized as a widespread mechanism of gene control, particularly given the pervasive nature of transcription, both sense and antisense, across all kingdoms of life. Here, we discuss how transcription factor binding kinetics strongly influence the ability of a transcription factor to relieve or induce TI.

Metacarpal sign

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Barbara Nieradko-Iwanicka

2018-02-01

Full Text Available Background Archibald's sign, or metacarpal sign is defined as shortening of the IV and V metacarpal bones, is a rare phenomenon found in the Turner syndrome, homocystinuria and in Albright's osteodystrophy. Objectives The aim of the article was to show a rare case of metacarpal sign with atypical shortening of the III and IV metacarpal bones not connected with gonadal dysgenesia, genetic disorders nor osteodystrophy. Material and methods Case report of a 60-year-old female patient. Results Artchibald's metacarpal sign in the described case was accompanied by erosive arthritis in the left lower extremity. No features of genetic disorders nor gonadal disgenesia were found in the patient. Undifferentiated seronegative asymmetric erosive arthritis developed in the patient. The level of parathormon was within the normal range. No signs of tumor were seen in bone scintigraphy. Conclusions Archibald's metacarpal sign may be present in patients without genetic disorders.

Ergonomics and design: traffic sign and street name sign.

Science.gov (United States)

Moroni, Janaina Luisa da Silva; Aymone, José Luís Farinatti

2012-01-01

This work proposes a design methodology using ergonomics and anthropometry concepts applied to traffic sign and street name sign projects. Initially, a literature revision on cognitive ergonomics and anthropometry is performed. Several authors and their design methodologies are analyzed and the aspects to be considered in projects of traffic and street name signs are selected and other specific aspects are proposed for the design methodology. A case study of the signs of "Street of Antiques" in Porto Alegre city is presented. To do that, interviews with the population are made to evaluate the current situation of signs. After that, a new sign proposal with virtual prototyping is done using the developed methodology. The results obtained with new interviews about the proposal show the user satisfaction and the importance of cognitive ergonomics to development of this type of urban furniture.

Sign language comprehension: the case of Spanish sign language.

Science.gov (United States)

Rodríguez Ortiz, I R

2008-01-01

This study aims to answer the question, how much of Spanish Sign Language interpreting deaf individuals really understand. Study sampling included 36 deaf people (deafness ranging from severe to profound; variety depending on the age at which they learned sign language) and 36 hearing people who had good knowledge of sign language (most were interpreters). Sign language comprehension was assessed using passages of secondary level. After being exposed to the passages, the participants had to tell what they had understood about them, answer a set of related questions, and offer a title for the passage. Sign language comprehension by deaf participants was quite acceptable but not as good as that by hearing signers who, unlike deaf participants, were not only late learners of sign language as a second language but had also learned it through formal training.

Cost-effectiveness of budesonide/formoterol for maintenance and reliever asthma therapy in Denmark--cost-effectiveness analysis based on five randomised controlled trials

DEFF Research Database (Denmark)

Wickstrøm, Jannie; Dam, Nanna; Malmberg, Irena

2009-01-01

Budesonide/formoterol maintenance and reliever therapy (Symbicort SMART) is an effective asthma-management regime where patients use budesonide/formoterol both as maintenance treatment and as additional doses as needed to improve overall asthma control by reducing symptoms and exacerbations....... The aim of this study was to determine the cost-effectiveness of the Symbicort SMART regime in Denmark vs higher dose inhaled corticosteroid (ICS) plus reliever medication, similar dose inhaled corticosteroid/long-acting beta(2)-agonist (ICS/LABA) combination therapy plus reliever medication or higher...

Headaches - danger signs

Science.gov (United States)

Migraine headache - danger signs; Tension headache - danger signs; Cluster headache - danger signs; Vascular headache - danger signs ... and other head pain. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: ...

The appropriate use of radiography in clinical practice: a report of two cases of biomechanical versus malignant spine pain

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Wyatt Lawrence H

2006-05-01

Full Text Available Abstract Background To describe the evaluation, treatment, management and referral of two patients with back pain with an eventual malignant etiology, who were first thought to have a non-organic biomechanical disorder. Clinical features The study was a retrospective review of the clinical course of two patients seen by a chiropractor in a multi-disciplinary outpatient facility, who presented with what was thought to be non-organic biomechanical spine pain. Clinical examination by both medical and chiropractic physicians did not indicate the need for radiography in the early course of management of either patient. Upon subsequent re-evaluation, it was decided that certain clinical factors required investigation with advanced imaging. In one instance, the patient responded to conservative care of low back pain for nine weeks, after which she developed severe pain in the pelvis. In the second case, the patient presented with signs and symptoms consistent with uncomplicated musculoskeletal pain that failed to respond to a course of conservative care. He was referred for medical therapy which also failed to relieve his pain. In both patients, malignancy was eventually discovered with magnetic resonance imaging and both patients are now deceased, resulting in an inability to obtain informed consent for the publication of this manuscript. Conclusion In these two cases, the prudent use of diagnostic plain film radiography did not significantly alter the appropriate long-term management of patients with neuromusculoskeletal signs and symptoms. The judicious use of magnetic resonance imaging was an effective procedure when investigating recalcitrant neuromusculoskeletal pain in these two patients.

The significance of beaking sign on cystography in stress urinary incontinence

Energy Technology Data Exchange (ETDEWEB)

Kim, Jee Won; Kim, Jeong Kon; Lee, Seung Soo; Kahng, Yu Ri; Choo, Myung Soo; Cho, Kyoung Sik [College of Medicine, Ulsan Univ, Seoul (Korea, Republic of)

2001-10-01

To evaluate the clinical and urodynamic significance of the beaking sign at cystography in patients with stress urinary incontinence (SUI). We retrospectively reviewed the cystograms of 253 patients with SUI, defining the beaking sign as the triangular contrast collection below the bladder base in the resting state without overt leakage. Various clinical parameters including patients age, symptom duration, parity, the one-hour pad test, and urodynamic study data including Valsalva leak point pressure (VLPP) and maximal urethral closing pressure (MUCP) were compared between the beaking-positive and the beaking-negative group. The distribution of Blaivas type in SUI between these two groups was also analysed. The beaking sign was observed in 153 patients (60%). Those who were older and showed greater parity more often belonged to the beaking-positive group than the beaking-negative (p<0.005). Both VLPP and MUCP were significantly lower in the beaking-positive group than in beaking-negative group (p=0.03; p=0.01, respectively). Type-0 or -I SUI was more common in the beaking-negative group, while the frequency of other types was similar between the two groups. The beaking sign has clinical and urodynamic significance, reflecting functional deficiencies of the intrinsic sphincter, and may possibly be regarded as an additional parameter in the planning of treatment.

Outcome and clinical signs of arthroscopically graded patellar chondromalacia with or without lateral release.

Science.gov (United States)

Korkala, O L; Isotalo, T M; Lavonius, M I; Niskanen, R O

1995-01-01

In a follow-up study of 67 patients with an arthroscopically diagnosed patellar chondromalacia, we compared the results of plain conservative treatment with those after an open lateral retinacular release. The mean follow-up was 35 months. In Grade I chondromalacia the lateral release did not affect the result, which was in all cases good or excellent. In Grade II to IV chondromalacia the lateral release appeared beneficial, although the difference did not reach statistical significance. We also examined the validity of three clinical signs in arthroscopically verified patellar chondromalacia. Patellar inhibition and tracking tests were clearly more sensitive than the lateral apprehension test, which often gave a false negative result. If the patellar inhibition test is positive and a Grade II to IV chondromalacia of the patella is found at arthroscopy, lateral release should be considered among other procedures, like patellar shaving or patellar resurfacing.

Sign language typology: The contribution of rural sign languages

NARCIS (Netherlands)

de Vos, C.; Pfau, R.

2015-01-01

Since the 1990s, the field of sign language typology has shown that sign languages exhibit typological variation at all relevant levels of linguistic description. These initial typological comparisons were heavily skewed toward the urban sign languages of developed countries, mostly in the Western

Incidence of contralateral versus ipsilateral neurological signs associated with lateralised Hansen type I disc extrusion

International Nuclear Information System (INIS)

Smith, J.D.; Newell, S.M.; Budsberg, S.C.; Bennett, R.A.

1997-01-01

Asymmetrical neurological signs were noted in 50 dogs presenting with Hansen type I thoracolumbar disc extrusion. Thoracolumbar myelograms and surgical decompression were performed in all cases. Dogs were divided into two groups (acute and chronic) based on the duration of clinical signs prior to presentation to the University of Georgia. Lateralising extradural cord compressive lesions were noted on all myelograms. In the acute group, 35 per cent of the dogs had asymmetrical neurological signs contralateral to the myelographic and surgical lesion, while in the chronic group only 11 per cent had neurological signs contralateral to the lesion. There was found to be no significant difference in frequency of contralateral asymmetrical clinical signs between the two groups (Fischer's exact test; P = 0.095). The high frequency of contralateral signs documents the importance of thoracolumbar myelography for accurate localisation of the disc material before decompressive surgery

Iliac Artery Stent Placement Relieves Claudication in Patients with Iliac and Superficial Femoral Artery Lesions

International Nuclear Information System (INIS)

Ichihashi, Shigeo; Higashiura, Wataru; Itoh, Hirofumi; Sakaguchi, Shoji; Kichikawa, Kimihiko

2013-01-01

Purpose. To evaluate the efficacy of iliac artery stent placement for relief of claudication in patients with both iliac and superficial femoral artery (SFA) lesions. Methods. Stent placement for only iliac artery occlusive disease was performed in 94 limbs (74 patients) with both iliac and SFA occlusive disease on the same limb. All procedures were performed because intermittent claudication did not improve after continuation of antiplatelet medication therapy and home-based exercise for 3 months. Rutherford classification was 2 in 20 limbs and 3 in 74 limbs. Patients with critical limb ischemia were excluded. Median duration of follow-up was 40 months. Primary patency rates of the iliac stent, clinical improvement rates, and risk factors for requiring additional SFA procedures were evaluated. Results. Primary patency rates of the iliac stent at 1, 3, 5, and 7 years were 97, 93, 79, and 79 %, respectively. The initial clinical improvement rate was 87 %. Continued clinical improvement rates at 1, 3, 5, and 7 years were 87, 81, 69, and 66 %, respectively. SFA Trans-Atlantic Inter-Society Consensus (TASC) II C/D lesion was a significant risk factor for requiring additional SFA procedures. Conclusion. Intermittent claudication was relieved by iliac stent placement in most patients with both iliac and SFA lesions. Thus, the indications for treatment of the SFA intended for claudicants should be evaluated after treatment of the iliac lesion.

Oxygen relieves the CO2 and acetate dependency of Lactobacillus johnsonii NCC 533

NARCIS (Netherlands)

Hertzberger, R.Y.; Pridmore, R.D.; Gysler, C.; Kleerebezem, M.; Teixeira de Mattos, M.J.

2013-01-01

Oxygen relieves the CO2 and acetate dependency of Lactobacillus johnsonii NCC 533. The probiotic Lactobacillus johnsonii NCC 533 is relatively sensitive to oxidative stress; the presence of oxygen causes a lower biomass yield due to early growth stagnation. We show however that oxygen can also be

Duplex investigations in children: Are clinical signs in children with venous disorders relevant?

Science.gov (United States)

Birgitte Maessen-Visch, M; Smeets, L; van Vleuten, C

2015-12-01

Ultra sound colored duplex sonography is the preferred method in diagnosing chronic venous disease. Data in children on incidence, indications, and results are lacking. From the total of 9180 duplex investigations performed in our hospital from 2009 to 2012, data on indication and results of the investigation as well as patient characteristics were evaluated retrospectively for the proportion of pediatric patients. Duplex investigations were performed 49 times in 38 children (6-18 years), with an average of 1.3 times (1-6 times) per child. Forty percent showed abnormalities: 17 times deep venous thrombosis was suspected; deep venous thrombosis was objectified in 18%. In the 21 investigations performed for varicosis-related complaints, varicose veins or venous malformations were objectified in 57%. Edema was never a symptom of chronic venous disease. Duplex investigation is not often performed in children. In children with established deep venous thrombosis, a family history with deep venous thrombosis is common. In general, edema was not seen in children with varicose veins and, therefore, does not seem a reliable clinical sign at young age. © The Author(s) 2014.

Home telemonitoring of vital signs--technical challenges and future directions.

Science.gov (United States)

Celler, Branko G; Sparks, Ross S

2015-01-01

The telemonitoring of vital signs from the home is an essential element of telehealth services for the management of patients with chronic conditions, such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, or poorly controlled hypertension. Telehealth is now being deployed widely in both rural and urban settings, and in this paper, we discuss the contribution made by biomedical instrumentation, user interfaces, and automated risk stratification algorithms in developing a clinical diagnostic quality longitudinal health record at home. We identify technical challenges in the acquisition of high-quality biometric signals from unsupervised patients at home, identify new technical solutions and user interfaces, and propose new measurement modalities and signal processing techniques for increasing the quality and value of vital signs monitoring at home. We also discuss use of vital signs data for the automated risk stratification of patients, so that clinical resources can be targeted to those most at risk of unscheduled admission to hospital. New research is also proposed to integrate primary care, hospital, personal genomic, and telehealth electronic health records, and apply predictive analytics and data mining for enhancing clinical decision support.

Risks associated with managing asthma without a preventer: urgent healthcare, poor asthma control and over-the-counter reliever use in a cross-sectional population survey.

Science.gov (United States)

Reddel, Helen K; Ampon, Rosario D; Sawyer, Susan M; Peters, Matthew J

2017-09-25

Overuse of asthma relievers, particularly without anti-inflammatory preventers, increases asthma risks. This study aimed to identify how many reliever-only users have urgent healthcare, explore their attitudes and beliefs about asthma and its treatment, and investigate whether purchasing over-the-counter relievers was associated with worse asthma outcomes than by prescription. Cross-sectional population-based Internet survey in Australia. Of 2686 participants ≥16 years with current asthma randomly drawn from a web-based panel, 1038 (50.7% male) used only reliever medication. Urgent asthma-related healthcare; Asthma Control Test (ACT); patient attitudes about asthma and medications; reliever purchase (with/without prescription). Of 1038 reliever-only participants, 23.3% had required urgent healthcare for asthma in the previous year, and only 36.0% had a non-urgent asthma review. Those needing urgent healthcare were more likely than those without such events to be male (56.5% vs 49.0%, p=0.003) and current smokers (29.4% vs 23.3%, p=0.009). Only 30.6% had well-controlled asthma (ACT ≥20) compared with 71.0% of those with no urgent healthcare (pasthma symptoms (vs 5.5% of those without urgent healthcare). Those with urgent healthcare were more frustrated by their asthma and less happy with how they managed it, and they were less confident about their ability to manage worsening asthma, but just as likely as those without urgent healthcare to manage worsening asthma themselves rather than visit a doctor. Reliever-only users purchasing over-the-counter relievers were no more likely than those purchasing relievers by prescription to have uncontrolled asthma (35.9% vs 40.6%, p=0.23) but were less likely to have had a non-urgent asthma review. One-quarter of the reliever-only population had needed urgent asthma healthcare in the previous year, demonstrating the importance of identifying such patients. Their attitudes and beliefs suggest opportunities for targeting this

Infection by rhinovirus: similarity of clinical signs included in the case definition of influenza IAn/H1N1.

Science.gov (United States)

de Oña Navarro, Maria; Melón García, Santiago; Alvarez-Argüelles, Marta; Fernández-Verdugo, Ana; Boga Riveiro, Jose Antonio

2012-08-01

Although new influenza virus (IAn/H1N1) infections are mild and indistinguishable from any other seasonal influenza virus infections, there are few data on comparisons of the clinical features of infection with (IAn/H1N1) and with other respiratory viruses. The incidence, clinical aspects and temporal distribution of those respiratory viruses circulating during flu pandemic period were studied. Respiratory samples from patients with acute influenza-like symptoms were collected from May 2009 to December 2009. Respiratory viruses were detected by conventional culture methods and genome amplification techniques. Although IAn/H1N1 was the virus most frequently detected, several other respiratory viruses co-circulated with IAn/H1N1 during the pandemic period, especially rhinovirus. The similarity between clinical signs included in the clinical case definition for influenza and those caused by other respiratory viruses, particularly rhinovirus, suggest that a high percentage of viral infections were clinically diagnosed as case of influenza. Our study offers useful information to face future pandemics caused by influenza virus, indicating that differential diagnoses are required in order to not overestimate the importance of the pandemic. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Upper midbrain profile sign and cingulate sulcus sign. MRI findings on sagittal images in idiopathic normal-pressure hydrocephalus, Alzheimer's disease, and progressive supranuclear palsy

International Nuclear Information System (INIS)

Adachi, Michito; Ohshima, Fumi; Kawanami, Toru; Kato, Takeo

2006-01-01

On magnetic resonance imaging (MRI) sagittal sections, we sometimes encounter abnormal aspects of the superior profile of the midbrain and the cingulate sulcus in patients with dementia. In this preliminary study, we refer to these findings as the ''upper midbrain profile sign'' and the cingulate sulcus sign.'' We prospectively evaluated the usefulness of these signs for the diagnosis of idiopathic normal-pressure hydrocephalus (iNPH), Alzheimer's disease (AD) and progressive supranuclear palsy (PSP). We evaluated the upper midbrain profile sign and the cingulate sulcus sign on MRI sagittal images obtained from 21 people with headaches but no neurological deficit (controls), 10 iNPH patients, 11 AD patients, and 5 PSP patients. The upper midbrain profile sign indicated a concave shape to the superior profile of the midbrain on mid-sagittal images, and the cingulate sulcus sign indicated a narrow, tight aspect of the posterior part of the cingulate sulcus on paramedian-sagittal images. These signs were never seen in any images from the controls. The upper midbrain profile sign was seen in 7 of 10 patients with iNPH, 5 of 11 with AD, and 3 of 5 with PSP. The cingulate sulcus sign was seen in all 10 patients with iNPH but was never seen in any patient with AD or PSP. The upper midbrain profile sign could support a diagnosis of PSP but cannot discriminate among iNPH, AD, and PSP. In contrast, the cingulate sulcus sign has a very high sensitivity for iNPH and should facilitate the distinction of iNPH from other dementias. In the clinical setting, it is momentous to evaluate these signs easily by one simple MRI sequence. (author)

A new multivalent (DHPPi/L4R) canine combination vaccine prevents infection, shedding and clinical signs following experimental challenge with four Leptospira serovars.

Science.gov (United States)

Wilson, Stephen; Stirling, Catrina; Thomas, Anne; King, Vickie; Plevová, Edita; Chromá, Ludmila; Siedek, Elisabeth; Illambas, Joanna; Salt, Jeremy; Sture, Gordon

2013-06-28

Although effective vaccines have been developed against the common Leptospira serovars, they are still reported in clinical cases, while others are increasingly prevalent. The results from four challenge studies following vaccination of dogs with a new combination vaccine (DHPPi/L4R) containing inactivated L. serovars, L. canicola, L. icterohaemorrhagiae, L. bratislava and L. grippotyphosa conducted to satisfy the requirements of the European Pharmacopoeia monograph (01/2008:0447), are reported. Six week old dogs received two vaccinations, three weeks apart, and were challenged 25 days later with different isolates of the L. serovars. Clinical observations were recorded, and blood, urine and tissue samples were collected for analysis. Following challenge, non-vaccinated dogs demonstrated various clinical signs, while no vaccinated dogs were affected; significant differences in mean clinical scores were observed. Measurable antibody titres to each Leptospira antigen were seen in vaccinated dogs 21 days following the first vaccination, with further increases in antibody titres observed following challenge with the respective Leptospira strain. Non-vaccinated dogs remained seronegative until challenge. Leptospira were re-isolated from the blood, urine, kidney and liver of all non-vaccinated dogs following challenge. In contrast no vaccinated dogs had Leptospira re-isolated from the same tissues. Significant differences were seen in number of days with positive isolation (blood and urine) and in number of dogs with positive samples (kidney and liver). In conclusion, vaccination of dogs with the new vaccine induces protective immunity 25 days after second vaccination with protection against infection, renal infection and clinical signs following challenge. Copyright © 2013 Elsevier Ltd. All rights reserved.

Malaysian sign language dataset for automatic sign language ...

African Journals Online (AJOL)

Journal of Fundamental and Applied Sciences. Journal Home · ABOUT ... SL recognition system based on the Malaysian Sign Language (MSL). Implementation results are described. Keywords: sign language; pattern classification; database.

Images in pediatrics: the thymic sail sign and thymic wave sign.

Science.gov (United States)

Alves, Nuno D; Sousa, Marta

2013-01-01

The authors present a radiographic image portraying the "thymic sail sign" and the "thymic wave sign," both normal findings in infant radiographs and present a short description of these signs. These are distinguished from pathologic findings such as the "spinnaker-sail sign" in pneumomediastinum.

Relieving existential suffering through palliative sedation: discussion of an uneasy practice.

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Bruce, Anne; Boston, Patricia

2011-12-01

This article presents a discussion of the use of palliative sedation in response to intractable (not responsive to treatment) existential suffering. Patients suffering from a terminal illness are often faced with severe symptoms at the end of life. Although palliative sedation is sometimes used when no other options are effective in relieving unbearable pain or suffering, its use in response to intractable existential suffering in terminal illness remains controversial. A literature search was conducted for published articles addressing the use of palliative sedation between 1996 and 2009 using established databases. Palliative sedation remains an uneasy practice. The debates have centred on ethical issues surrounding decisions to use sedation and on separating the intent of palliative sedation (relief of intolerable symptoms) from the intent of euthanasia (hastening death). There is lack of consensus in defining existential suffering. Consequently, there is limited understanding of how decisions are being made when using palliative sedation to treat intractable existential suffering. Given the confusion and uncertainty about ethical and clinical justifications for palliative sedation in treating existential suffering, we argue that a better understanding of the controversies and decision-making process is needed. Greater understanding is required to prevent palliative sedation from becoming a substitute for intensive treatment of this kind of suffering. © 2011 Blackwell Publishing Ltd.

Sign language in dental education-A new nexus.

Science.gov (United States)

Jones, T; Cumberbatch, K

2017-08-14

The introduction of the landmark mandatory teaching of sign language to undergraduate dental students at the University of the West Indies (UWI), Mona Campus in Kingston, Jamaica, to bridge the communication gap between dentists and their patients is reviewed. A review of over 90 Doctor of Dental Surgery and Doctor of Dental Medicine curricula in North America, the United Kingdom, parts of Europe and Australia showed no inclusion of sign language in those curricula as a mandatory component. In Jamaica, the government's training school for dental auxiliaries served as the forerunner to the UWI's introduction of formal training of sign language in 2012. Outside of the UWI, a couple of dental schools have sign language courses, but none have a mandatory programme as the one at the UWI. Dentists the world over have had to rely on interpreters to sign with their deaf patients. The deaf in Jamaica have not appreciated the fact that dentists cannot sign and they have felt insulted and only go to the dentist in emergency situations. The mandatory inclusion of sign language in the Undergraduate Dental Programme curriculum at The University of the West Indies, Mona Campus, sought to establish a direct communication channel to formally bridge this gap. The programme of two sign language courses and a direct clinical competency requirement was developed during the second year of the first cohort of the newly introduced undergraduate dental programme through a collaborating partnership between two faculties on the Mona Campus. The programme was introduced in 2012 in the third year of the 5-year undergraduate dental programme. To date, two cohorts have completed the programme, and the preliminary findings from an ongoing clinical study have shown a positive impact on dental care access and dental treatment for deaf patients at the UWI Mona Dental Polyclinic. The development of a direct communication channel between dental students and the deaf that has led to increased dental

Performance of clinical signs in poultry for the detection of outbreaks during the avian influenza A (H7N7) epidemic in The Netherlands in 2003.

Science.gov (United States)

Elbers, Armin R W; Koch, Guus; Bouma, Annemarie

2005-06-01

The aim of this study was to make an inventory of the clinical signs of high-pathogenicity avian influenza (HPAI), to facilitate the development of an operational syndrome-reporting system (SRS) in The Netherlands as an early warning system for HPAI outbreaks. A total of 537 poultry flocks (240 infected and 297 non-infected) with a clinical suspicion of an infection with HPAI virus were investigated with respect to the clinical signs observed. Standardized reports were analysed with respect to observed clinical signs in the flocks. Various poultry types were distinguished. In infected commercial flocks with egg-producing chickens, the presence of increased mortality, apathy, coughing, reduction in normal vocalization, or pale eggs appeared to be overall the most sensitive indicators to detect a HPAI outbreak, matching a sensitivity of 99% with a specificity of 23%. In infected turkey flocks, the presence of apathy, decreased growth performance, reduction of normal vocalization, swollen sinuses, yawning, huddling, mucosal production from the beak, or lying down with an extended neck appeared to be overall the most sensitive indicators to detect a HPAI outbreak, matching a sensitivity of 100% with a specificity of 79%. In infected backyard/hobby flocks, increased mortality or swollen head appeared to be overall the most sensitive indicators of a HPAI outbreak, matching a sensitivity of 100% with a specificity of 26%. These results indicate that there is a solid basis for the choice of using increased mortality in the operational SRS in The Netherlands as an early warning system for HPAI outbreaks. The presence of apathy, specifically for turkeys, should be added to the SRS as an indicator.

Egophony: is this classic semeiological sign still helpful?

Directory of Open Access Journals (Sweden)

Domenico Viviani

2013-04-01

Full Text Available BACKGROUND Egophony, also known as “E to A change”, is a classical, clinical sign detected by chest auscultation, consisting into a change in timbre, but not pitch or volume, produced by solid interposed between the resonator and the stethoscope head. Egophony was first described in 1916 by R.T.H. Laënnec, but today it is almost unknown. Yet it is a powerful tool to detect pleural effusion as well as other pathological conditions associated with lung compression or consolidation, such as hemothorax or atelectasis of the lung. AIM OF THE STUDY The aim of this paper is to remember the value of this frequently neglected clinical sign and to stress the importance of physical examination, that should always precede – and could often replace – instrumental tests, which are quite expensive and sometimes unnecessary.

On the System of Place Name Signs in Estonian Sign Language

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Liina Paales

2011-05-01

Full Text Available A place name sign is a linguistic-cultural marker that includes both memory and landscape. The author regards toponymic signs in Estonian Sign Language as representations of images held by the Estonian Deaf community: they reflect the geographical place, the period, the relationships of the Deaf community with hearing community, and the common and distinguishing features of the two cultures perceived by community's members. Name signs represent an element of signlore, which includes various types of creative linguistic play. There are stories hidden behind the place name signs that reveal the etymological origin of place name signs and reflect the community's memory. The purpose of this article is twofold. Firstly, it aims to introduce Estonian place name signs as Deaf signlore forms, analyse their structure and specify the main formation methods. Secondly, it interprets place-denoting signs in the light of understanding the foundations of Estonian Sign Language, Estonian Deaf education and education history, the traditions of local Deaf communities, and also of the cultural and local traditions of the dominant hearing communities. Both perspectives - linguistic and folkloristic - are represented in the current article.

Common signs and symptoms in hypothyroidism in central part of iran

International Nuclear Information System (INIS)

Jabbari, A.; Besharat, S.; Razavianzadeh, N.; Moetabar, M.

2008-01-01

This study was designed to evaluate the common signs and symptoms of hypothyroidism in persons with clinical diagnosis of hypothyroidism that was confirmed with laboratory tests. This descriptive cross-sectional study was done during 13 months in medical centers of Shahrood city, in central part of Iran. All cases with probable diagnosis of hypothyroidism based on the signs and symptoms, referred to health care services were included in the study. Radioimmunoassay tests and thyroid hormones evaluation were done. Demographic data and signs were recorded through interview. Data were entered in the computer and analyzed by SPSS software. Patients who completed questionnaires (n=50) were interviewed three times during this period. Female/male ratio was 6/1. The most common signs were cold intolerance (95%), weight gain and menorrhagia. The most common symptoms were edema (80%) and pallor (60%). The severe disease was seen in 4%. Mild type was the most common presentation of hypothyroidism (60%). The most common signs and symptoms of hypothyroidism in the central part of Iran (Shahrood city), that is one of the iodine deficient areas in Iran; were different from other studies. Socio-demographic and nutritional status, illiteracy level and personal self-care are among the probable causes. Unfortunately, concomitance of some of the signs and symptoms are not diagnostic for hypothyroidism. It seems that strong clinical suspicious and laboratory confirmation are the only reliable methods for hypothyroidism diagnosis. (author)

Added value of delayed computed tomography angiography in primary intracranial hemorrhage and hematoma size for predicting spot sign.

Science.gov (United States)

Wu, Te Chang; Chen, Tai Yuan; Shiue, Yow Ling; Chen, Jeon Hor; Hsieh, Tsyh-Jyi; Ko, Ching Chung; Lin, Ching Po

2018-04-01

Background The computed tomography angiography (CTA) spot sign represents active contrast extravasation within acute primary intracerebral hemorrhage (ICH) and is an independent predictor of hematoma expansion (HE) and poor clinical outcomes. The spot sign could be detected on first-pass CTA (fpCTA) or delayed CTA (dCTA). Purpose To investigate the additional benefits of dCTA spot sign in primary ICH and hematoma size for predicting spot sign. Material and Methods This is a retrospective study of 100 patients who underwent non-contrast CT (NCCT) and CTA within 24 h of onset of primary ICH. The presence of spot sign on fpCTA or dCTA, and hematoma size on NCCT were recorded. The spot sign on fpCTA or dCTA for predicting significant HE, in-hospital mortality, and poor clinical outcomes (mRS ≥ 4) are calculated. The hematoma size for prediction of CTA spot sign was also analyzed. Results Only the spot sign on dCTA could predict high risk of significant HE and poor clinical outcomes as on fpCTA ( P spot sign on fpCTA or dCTA in the absence of intraventricular and subarachnoid hemorrhage. Conclusion This study clarifies that dCTA imaging could improve predictive performance of CTA in primary ICH. Furthermore, the XY value is the best predictor for CTA spot sign.

Clinical effectiveness of DSA-guided foam sclerotherapy for varicose veins of lower limbs

International Nuclear Information System (INIS)

Fu Jianhua; He Xu; Chen Guoping; Gu Jianping; Wang Yafei

2011-01-01

Objective: To investigate the clinical effect of DSA-guided foam sclerotherapy for varicose veins of lower limbs. Methods: A total of 25 diseased limbs in 20 patients with varicose veins were treated with foam sclerotherapy. The patients were followed up for six months. Sodium morrhuate, used as the sclerosant, was foamed with air by using Tessari's method, with liquid-gas ratio of 1 : 4. The clinical effectiveness was estimated by CEAP, clinical signs and symptoms. Results: A total of 25 limbs in 20 patients with varicose veins were successfully treated with foam sclerotherapy. The technical success rate was 100%. No serious complications such as pulmonary embolism occurred. Phlebitis was observed in two cases at 2 days 4 days after foam sclerotherapy respectively which was relieved after anti-inflammatory medication for 3 days. At the time of discharge, excellent result was seen in 12 (48%) limbs, good effect in 13 (52%) limbs. The total effective rate was 100%. Six months after the treatment, excellent effect was obtained in 15 (60%) limbs and good effect was seen in 10 (40%) limbs. The total effective rate was 100%. Conclusion: DSA-guided foam sclerotherapy is a safe, effective and micro-invasive treatment for varicose veins of lower limbs with high technical success rate, although the long-term clinical effect needs to be further evaluated. (authors)

The rope sign: a case of interstitial granulomatous dermatitis with arthritis.

Science.gov (United States)

Savoia, Francesco; Stinchi, Caterina; Gaddoni, Giuseppe; Patrizi, Annalisa; Odorici, Giulia; Tengattini, Vera; Cataleta, Pierluigi; Zago, Silvia

2016-02-01

Interstitial granulomatous dermatitis with arthritis (IGDA), also known as Ackerman's syndrome, is a rare cutaneous disease classically characterized by the triad of cutaneous cords, a typical histologic infiltrate mainly constituted by histiocytes and arthritis/connective tissue disease. Here we report the case of IGDA with the typical clinical and histological features in a patient affected by lupus erythematosus. In this article we underline that IGDA may have a variety of different clinical and histological features. The rope sign is typical but infrequent, while histology is usually characteristic and shows a dermal inflammatory infiltrate, with a predominance of histiocytes, localized interstitially and in a palisaded array between collagen fibres, that show signs of degeneration. Clinical and histological differential diagnoses are discussed.

Extravasation of contrast (Spot Sign) predicts in-hospital mortality in ruptured arteriovenous malformation.

Science.gov (United States)

Ye, Zengpanpan; Ai, Xiaolin; Zheng, Jun; Hu, Xin; You, Chao; Andrew M, Faramand; Fang, Fang

2017-10-09

The spot sign is a highly specific and sensitive predictor of hematoma expansion in following primary intracerebral hemorrhage (ICH). Rare cases of the spot sign have been documented in patients with intracranial hemorrhage secondary to arteriovenous malformation (AVM). The purpose of this retrospective study is to assess the accuracy of spot sign in predicting clinical outcomes in patients with ruptured AVM. A retrospective analysis of a prospectively maintained database was performed for patients who presented to West China Hospital with ICH secondary to AVM in the period between January 2009 and September 2016. Two radiologists blinded to the clinical data independently assessed the imaging data, including the presence of spot sign. Statistical analysis using univariate testing, multivariate logistic regression testing, and receiver operating characteristic curve (AUC) analysis was performed. A total of 116 patients were included. Overall, 18.9% (22/116) of subjects had at least 1 spot sign detected by CT angiography, 7% (8/116) died in hospital, and 27% (31/116) of the patients had a poor outcome after 90 days. The spot sign had a sensitivity of 62.5% and specificity of 84.3% for predicting in-hospital mortality (p = .02, AUC 0.734). No correlation detected between the spot sign and 90-day outcomes under multiple logistic regression (p = .19). The spot sign is an independent predictor for in-hospital mortality. The presence of spot sign did not correlate with the 90 day outcomes in this patient cohort. The results of this report suggest that patients with ruptured AVM with demonstrated the spot sign on imaging must receive aggressive treatment early on due to the high risk of mortality.

Use of Warning Signs for Dengue by Pediatric Health Care Staff in Brazil.

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Luana Sicuro Correa

Full Text Available The aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system.Cross-sectional study (2012 with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test and in the ranking assigned to each of them (Kruskal-Wallis were assessed according to health care occupation and level of care (p<0.05.The final sample comprised 474 participants (97%, mean age of 37 years (standard deviation = 10.3, mainly females (83.8%, physicians (40.1% and from tertiary care (75.1%. The majority (91% reported using warning signs for dengue in pediatrics clinical practice. The most widely used and highly valued signs were major hemorrhages (gastrointestinal, urinary, abdominal pain, and increase in hematocrit concurrent or not with rapid decrease in platelet count. Persistent vomiting as well as other signs of plasma leakage such as respiratory distress and lethargy/restlessness were not identified as having the same degree of importance, especially by nurse technicians and in primary or secondary care.Although most health care staff reported using dengue warning signs, it would be useful to extend the training for identifying easily recognizable signs of plasma leakage that occur regardless of bleeding.

LSE-Sign: A lexical database for Spanish Sign Language.

Science.gov (United States)

Gutierrez-Sigut, Eva; Costello, Brendan; Baus, Cristina; Carreiras, Manuel

2016-03-01

The LSE-Sign database is a free online tool for selecting Spanish Sign Language stimulus materials to be used in experiments. It contains 2,400 individual signs taken from a recent standardized LSE dictionary, and a further 2,700 related nonsigns. Each entry is coded for a wide range of grammatical, phonological, and articulatory information, including handshape, location, movement, and non-manual elements. The database is accessible via a graphically based search facility which is highly flexible both in terms of the search options available and the way the results are displayed. LSE-Sign is available at the following website: http://www.bcbl.eu/databases/lse/.

Sign language perception research for improving automatic sign language recognition

NARCIS (Netherlands)

Ten Holt, G.A.; Arendsen, J.; De Ridder, H.; Van Doorn, A.J.; Reinders, M.J.T.; Hendriks, E.A.

2009-01-01

Current automatic sign language recognition (ASLR) seldom uses perceptual knowledge about the recognition of sign language. Using such knowledge can improve ASLR because it can give an indication which elements or phases of a sign are important for its meaning. Also, the current generation of

The Research on the Impact of Green Beans Sports Drinks on Relieving Fatigue in Sports Training.

Science.gov (United States)

Qi, Li; Ying, Liu

2015-01-01

For researching the function of relieving fatigue of green beans sports drinks, this paper selected 60 mice as subjects. They were randomly divided into four groups (low dose group, middle dose group, high dose group and physiological saline group). Each time they were respectively feed 10g 20g/L, 40g/L, 80 g/L green beans sports drinks and 15ml/(kg.d) physiological saline. The experiment lasted for a month. We recorded weight of mice, swimming time and blood urea nitrogen indicators. The results show that green beans sports drinks can significantly prolong swimming time of mice (p beans sports drinks have a certain function of relieving physical fatigue.

Clothing-related eponyms and signs

Directory of Open Access Journals (Sweden)

Valencia Long

2016-01-01

Full Text Available The world of dermatology is pieced together by clinical conditions unique in their colors, morphology, and configuration. Dermatological signs and terms are influenced by etymology, language, and history. Eponyms also make dermatology a fascinating but linguistically challenging subject. This article reviews dermatological conditions described in relation to fashion, and what we wear in everyday life from top to toe, demonstrating that dermatology can be inspired even in the most common things.

Pain-relieving properties of topically applied morphine on arterial leg ulcers: a pilot study.

NARCIS (Netherlands)

Jansen, M.M.; Horst, J.C. van der; Valk, P.G.M. van der; Kuks, P.F.M.; Zylicz, Z.; Sorge, A.A. van

2009-01-01

OBJECTIVE: To assess whether topical morphine is pharmacologically effective in relieving pain from ulcers caused by arterial insufficiency and identify whether this effect is centrally or peripherally mediated. METHOD: The analgesic effect of a topically applied hydrogel containing 0.5% of morphine

A comparative study of the blend sign and the black hole sign on CT as a predictor of hematoma expansion in spontaneous intracerebral hemorrhage.

Science.gov (United States)

Li, Ruili; Yang, Mingfei

2017-01-01

Hematoma expansion (HE) is a major determinant of a poor outcome in patients with a spontaneous intracerebral hemorrhage (sICH). The blend sign and the black hole sign are distinguished from non-contrast CT (NCCT) in patients with sICH, and both are independent neuroimaging predictors of HE. The purpose of the current study was to compare the value of the two signs in the prediction of HE. We retrospectively analyzed clinical and neuroimaging data from 228 patients with sICH who were treated at our hospital between August 2015 and September 2017. NCCT of the brain was performed upon admission (within 6 h of the onset of symptoms) to identify the blend sign and the black hole sign. HE was determined based on CT during a follow-up 24 h later. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with which the blend sign and the black hole sign predicted HE were calculated. Receiver operating characteristic (ROC) curve analysis was performed in order to compare the accuracy of the two signs in predicting HE. The blend sign was identified in 46 patients (20.2%) and the black hole sign was identified in 38 (16.7%) based on NCCT of the brain upon admission. Of the 65 patients with HE, the blend sign was noted in 28 and the black hole sign was noted in 22. The blend sign had a sensitivity of predicting HE of 43.1%, a specificity of 89.0%, a PPV of 60.9%, and an NPV of 79.7%. In contrast, the black hole sign had a sensitivity of predicting HE of 33.9%, a specificity of 90.2%, a PPV of 57.9%, and an NPV of 77.4%. The area under the ROC curve was 0.660 for the blend sign and 0.620 for the black hole sign (p = 0.516). In conclusion, the blend sign and the black hole sign on CT are both good predictors of HE in patients with sICH, though the blend sign seems to have a higher level of accuracy.

Deformaciones neotectónicas en el relieve fluvial de la Llanura Sur de Pinar del Río, Cuba

OpenAIRE

Estévez Cruz, Elmidio; Ordaz Hernández, Alexis; Hernández Santana, José Ramón

2017-01-01

Resumen: Las investigaciones neotectónicas se enfocan a la determinación de los movimientos tectónicos más recientes de la corteza terrestre y poseen un gran significado en el análisis geomorfológico de la estructura del relieve moderno. En las regiones relativamente llanas no siempre resulta fácil el reconocimiento de evidencias de las deformaciones neotectónicas en el relieve fluvial. Desde el punto de vista metodológico, quedó demostrada la eficiencia del empleo de los métodos geológicos, ...

Relieving stress. A short-term support group for home attendants.

Science.gov (United States)

Blaine, M

2000-01-01

Home attendants (HAs) work in relative isolation, burdened by conflicting demands. This article details an eight-session support group for HAs, designed to explore its effects on their work life. Meeting for hour-and-a-half sessions with no fixed agenda, the group offered members an opportunity to communicate with others in similar situations. Participants reported that the group experience helped relieve stress and made them feel less alone. Other benefits included gaining strategies for coping with difficult situations and learning to set boundaries. Further investigation into the effectiveness of similar groups is suggested.

[The relationship between chronic hip pain and femoroacetabular impingement: an evaluation with clinical signs and radiography].

Science.gov (United States)

Sahin, Namik; Atici, Teoman; Oztürk, Alpaslan; Ozkaya, Güven; Avcu, Bülent; Ozkan, Yüksel

2011-12-01

In this study, we investigated the rate of the clinical and radiographic findings of femoroacetabular impingement (FAI) in patients with chronic hip pain and compared the findings with those of a control group. The clinical and radiographic findings of FAI in 38 patients (group 1) having hip pain for more than three months were analyzed and compared with 42 controls (group 2). Internal rotation degrees were measured while the hips were at 90° flexion and impingement test was performed by rotating the hips internally at 90° flexion and adduction. The FAI findings were investigated on anteroposterior pelvis radiographs and cross-table lateral radiographs of the hip joint in both groups. The collum-diaphyseal angle, alpha angle and anterior offset ratio on the femoral side and the center-edge angle, acetabular index, extrusion index and crossover sign on the acetabular side were evaluated. The internal rotation degree of the painful hips were less than 20 degree in 18 (47.4%) patients in group 1 and in one (2.4%) patient in group 2 (pcam type FAI was 76.3% (n=29) in group 1 and 42.9% (n=18) in group 2 (p=0.002). Femoroacetabular impingement is one of the causes of chronic hip pain and if evaluated with suitable clinical and radiographic parameters, the rates of diagnosis may increase.

Umbilical Cord-Derived Mesenchymal Stem Cells Relieve Hindlimb Ischemia through Enhancing Angiogenesis in Tree Shrews

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Cunping Yin

2016-01-01

Full Text Available Hindlimb ischemia is still a clinical problem with high morbidity and mortality. Patients suffer from consequent rest pain, ulcers, cool limbs, and even amputation. Angiogenesis is a promising target for the treatment of ischemic limbs, providing extra blood for the ischemic region. In the present study, we investigated the role of umbilical cord-derived mesenchymal stem cells (UC-MSCs in regulating angiogenesis and relieving hindlimb ischemia. UC-MSCs were isolated from the umbilical cord of tree shrews. Angiography results showed that UC-MSCs injection significantly promoted angiogenesis in tree shrews. Moreover, the ankle brachial index, transcutaneous oxygen pressure, blood perfusion, and capillary/muscle fiber ratio were all markedly increased by the application of UC-MSCs. In addition, the conditioned culture of human umbilical vein endothelial cells using medium collected from UC-MSCs showed higher expression of angiogenic markers and improved migration ability. In short, the isolated UC-MSCs notably contributed to restoring blood supply and alleviating the symptoms of limb ischemia through enhancing angiogenesis.

Spot Sign in Acute Intracerebral Hemorrhage in Dynamic T1-Weighted Magnetic Resonance Imaging.

Science.gov (United States)

Schindlbeck, Katharina A; Santaella, Anna; Galinovic, Ivana; Krause, Thomas; Rocco, Andrea; Nolte, Christian H; Villringer, Kersten; Fiebach, Jochen B

2016-02-01

In computed tomographic imaging of acute intracerebral hemorrhage spot sign on computed tomographic angiography has been established as a marker for hematoma expansion and poor clinical outcome. Although, magnetic resonance imaging (MRI) can accurately visualize acute intracerebral hemorrhage, a corresponding MRI marker is lacking to date. We prospectively examined 50 consecutive patients with acute intracerebral hemorrhage within 24 hours of symptom onset. The MRI protocol consisted of a standard stroke protocol and dynamic contrast-enhanced T1-weighted imaging with a time resolution of 7.07 s/batch. Stroke scores were assessed at admission and at time of discharge. Volume measurements of hematoma size and spot sign were performed with MRIcron. Contrast extravasation within sites of the hemorrhage (MRI spot sign) was seen in 46% of the patients. Patients with an MRI spot sign had a significantly shorter time to imaging than those without (Pspot sign compared with those without (P≤0.001). Hematoma expansion was observed in the spot sign group compared with the nonspot sign group, although the differences were not significant. Spot sign can be detected using MRI on postcontrast T1-weighted and dynamic T1-weighted images. It is associated with worse clinical outcome. The time course of contrast extravasation in dynamic T1 images indicates that these spots represent ongoing bleeding. © 2015 American Heart Association, Inc.

Learning Disorders: Know the Signs, How to Help

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Healthy Lifestyle Children's health Learning disorders can make it hard for a child to read, write or do simple math. Understand the signs and what ... By Mayo Clinic Staff Many children who have learning disorders, also known as learning disabilities, struggle for ...

Professional Quality of Life and Clinical Competencies among Korean Nurses

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Kyunghee Kim, PhD

2015-09-01

Conclusions: This study demonstrated that it is possible to directly examine the relationship between professional quality of life level and clinical competence among nurses. Thus, interventions to increase nurses' compassion satisfaction and relieve compassion fatigue are needed, as professional quality of life may affect clinical competence.

Pimpinella anisum in the treatment of functional dyspepsia: A double-blind, randomized clinical trial

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S Ashraffodin Ghoshegir

2015-01-01

Full Text Available Background: We aimed to evaluate the effects of Pimpinella anisum (anise from Apiaceae family on relieving the symptoms of postprandial distress syndrome (PDS in this double-blind randomized clinical trial. Materials and Methods: Totally, 107 patients attending the gastroenterology clinic, aged 18-65 years, diagnosed with PDS according to ROME III criteria and signed a written consent form were enrolled. They were randomized to receive either anise or placebo, blindly, for 4 weeks. Anise group included 47 patients and received anise powders, 3 g after each meal (3 times/day. Control group involved 60 patients and received placebo powders (corn starch, 3 gafter each meal (3 times/day. The severity of Functional dyspepsia (FD symptoms was assessed by FD severity scale. Assessments were done at baseline and by the end of weeks 2, 4 and 12. Mean scores of severity of FD symptoms and the frequency distribution of patients across the study period were compared. Results: The age, sex, body mass index, smoking history, and coffee drinking pattern of the intervention and control groups were not significantly different. Mean (standard deviation total scores of FD severity scale before intervention in the anise and control groups were 10.6 (4.1 and 10.96 (4.1, respectively (P = 0.6. They were 7.04 (4.1 and 12.30 (4.3 by week 2, respectively (P = 0.0001, 2.44 (4.2 and 13.05 (5.2 by week 4, respectively (P = 0.0001, and 1.08 (3.8 and 13.30 (6.2 by week 12, respectively (P = 0.0001. Conclusion: This study showed the effectiveness of anise in relieving the symptoms of postpartum depression. The findings were consistent across the study period at weeks 2, 4 and 12.

Post Traumatic Tension Pneumocephalus: The Mount Fuji Sign

LENUS (Irish Health Repository)

Ryan, J

2017-04-01

Pneumocephalus is defined as the presence of intracranial air. This is most commonly secondary to a traumatic head injury. Tension pneumocephalus presents radiologically with compression of the frontal lobes and widening of the interhemispheric space between the frontal lobes. It is often termed the Mount Fuji sign due to a perceived similarity with an iconic mountain peak in Japan. We present the case of a 52-year-old gentleman who presented to the emergency department shortly before 8am on a Saturday morning following an assault. He was alert and ambulatory with no clinical evidence of raised intracranial pressure. A plain radiograph of the facial bones showed significant pneumocephalus. A later CT was consistent with a tension pneumocephalus which usually necessitates urgent decompression.The patient showed no clinical signs or symptoms of raised intracranial pressure and was managed conservatively. He was discharged home 16 days later with no neurological deficit

Extracts from Hericium erinaceus relieve inflammatory bowel disease by regulating immunity and gut microbiota.

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Diling, Chen; Xin, Yang; Chaoqun, Zheng; Jian, Yang; Xiaocui, Tang; Jun, Chen; Ou, Shuai; Yizhen, Xie

2017-10-17

Hericium erinaceus (HE), a traditional edible mushroom, is known as a medicine food homology to ameliorate gastrointestinal diseases. To investigate whether HE is clinically effective in alleviating inflammatory bowel disease (IBD), HE extracts (polysaccharide, alcoholic extracts and whole extracts were prepared using solvent extraction methods) were administrated for 2 weeks in rats with IBD induced by trinitro-benzene-sulfonic acid (TNBS) enema (150 mg/kg). Significant clinical and histological changes in IBD rats were identified, including damage activity, common morphous and tissue damage index scores in colonic mucosa and myeloperoxidase (MPO) activity. The damage activity, common morphous and tissue damage index scores in colonic mucosa ( P <0.05) were improved, MPO activities were decreased. Inflammatory factors were also differentially expressed in colonic mucosa in IBD rats, including serum cytokines, Foxp3 and interleukin (IL)-10 were increased while NF-κB p65 and tumor necrosis factor (TNF)-α were decreased ( P <0.05), and T cells were activated ( P <0.05), especially in the alcohol extracts-treated group. We also found that the structure of gut microbiota of the H. erinaceus extracts-treated groups changed significantly by compared with the model group. Further studies revealed that the polysaccharides in HE extracts may play a prebiotic role, whereas the alcoholic extracts show bactericidin-like and immunomodulatory effects. Taken together, we demonstrated that H. erinaceus extracts could promote the growth of beneficial gut bacteria and improve the host immunity in vivo IBD model, which shows clinical potential in relieving IBD by regulating gut microbiota and immune system.

Verification of dimensional stability on ITER blanket shield block after stress relieving

Energy Technology Data Exchange (ETDEWEB)

Kim, Sa-Woong, E-mail: swkim12@nfri.re.kr; Jung, Hun-Chea; Ha, Min-Su; Shim, Hee-Jin

2016-11-01

Highlights: • The SB#08 FSP were manufactured by using conventional manufacturing processes such as cutting, milling, drilling and welding. • Especially, a strong back system was adopted in order to prevent welding deformation during cover plate welding process. • Post-Welding Heat Treatment (PWHT) for stress relieving and Hot He Leak Test (HHLT) were waived from the lake of huge test facility in the pre-qualification program. • The PWHT combined with the HHLT, however, were implemented to remove the residual stress and to confirm the soundness of welded parts as an internal R&D activities after the pre-qualification program. • Three dimensional inspection also carried out after the PWHT to check the dimensional stabilization. - Abstract: The tight tolerance requirement is one of key issue to manufacture the ITER blanket shield blocks (SBs) which have many interfaces with the First Wall (FW) and Vacuum Vessel (VV). Manufactured SB shall be satisfied with general tolerances (Class “C” of ISO 2768-1 and “L” of ISO 2768-2) and specific tolerance in 2D general assembly drawings. In order to fulfill the tight tolerance requirements in the final stage of SB, stress relieving after welding operations in the manufacturing process shall be performed. Hot helium leak test, Post Welding Heat Treatment (PWHT) and three-dimensional inspection before and after heat treatment were implemented by using the Full Scale Prototype (FSP) of SB in the framework of domestic R&D activities. The hot He leak test was performed at 250 °C for 30 min, and the result was satisfied the requirements. PWHT was carried out at 400 °C for 24 h by brazing furnace with test chamber. The deformation value before and after was measured by contact type coordinate measuring machine. The objective of this study is to verify dimensional stability of SB after stress relieving. The results will support to determine the machining allowance prior to welding process.

'Felson Signs' revisited

International Nuclear Information System (INIS)

George, Phiji P.; Irodi, Aparna; Keshava, Shyamkumar N.; Lamont, Anthony C.

2014-01-01

In this article we revisit, with the help of images, those classic signs in chest radiography described by Dr Benjamin Felson himself, or other illustrious radiologists of his time, cited and discussed in 'Chest Roentgenology'. We briefly describe the causes of the signs, their utility and the differential diagnosis to be considered when each sign is seen. Wherever possible, we use CT images to illustrate the basis of some of these classic radiographic signs.

Relationship between striatal [123I]β-CIT binding and four major clinical signs in Parkinson's disease

International Nuclear Information System (INIS)

Shinotoh, Hitoshi; Uchida, Yoshitaka; Ito, Hisao; Hattori, Takamichi

2000-01-01

We investigated the correlation between clinical severity and striatal [ 123 I]β-CIT binding in 12 patients with Parkinson's Disease (PD: 6 men and 6 women, age: 65±7 years, Hoehn-Yahr stage: 1 to 3). The clinical severity of PD patients was measured with the Unified Parkinson's Disease Rating Scale (UPDRS) after withdrawal of antiparkinsonian medication at least 12 hours before assessment. [ 123 I]β-CIT binding in the caudate and putamen was measured at 3 hours [V'' 3 (day 1)], and at 24 hours [V'' 3 (day 2)] after tracer injection with small square ROIs. The specific striatal uptake index (day 2) was calculated with large square ROIs that encompassed the whole striatum. The best correlation (r=-0.82, p 3 (day 2) and the motor UPDRS scores. When the motor UPDRS scores were divided into four subscales, bradykinesia was the only sign that correlated significantly with putamenal V'' 3 (day 2) (r=-0.81, p 123 I]β-CIT SPECT is a useful marker of disease severity in PD with potential utility in the serial monitoring of disease progression. (author)

The prevalence of secondary dentinal lesions in cheek teeth from horses with clinical signs of pulpitis compared to controls.

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Casey, M B; Tremaine, W H

2010-01-01

With the advent of detailed oral examination in horses using dental mirrors and rigid endoscopy, secondary dentinal lesions are observed more frequently. More information regarding the association of secondary dentinal defects with apical dental disease would improve the sensitivity of oral examination as a diagnostic aid for pulpitis. To assess prevalence and severity of secondary dentinal defects observed on examination of occlusal surfaces of cheek teeth (CT) from horses showing clinical signs of pulpitis compared to asymptomatic controls. Records from all cases of equine CT exodontia at the University of Bristol over a 4 year period were examined. Case selection criteria included the presence of clinical signs of pulpitis, an intact extracted tooth and availability of a complete history and follow up. Cases where coronal fracture or periodontal pocketing featured were excluded. CT from cadavers with no history of dental disease served as normal controls. Triadan positions and eruption ages of control teeth were matched with those of teeth extracted from cases. CT from selected cases and control teeth were examined occlusally. Secondary dentinal defects were identified and graded. Prevalence of occlusal lesions in CT with pulpitis and controls was compared. From the records of 120 horses where exodontia was performed, 40 cases matched selection criteria. Twenty-three mandibular and 21 maxillary CT were extracted from cases. The controls consisted of 60 mandibular and 60 maxillary CT from 7 cadaver skulls. Secondary dentinal defects were significantly over-represented in CT extracted from cases of pulpitis (P pulpitis in equine CT.

Pearl necklace sign in diabetic macular edema: Evaluation and significance

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Kshirasagar Ajay

2016-01-01

Full Text Available Purpose: (1 The purpose of this study was to describe significance and prevalence of the newly reported pearl necklace spectral domain optical coherence tomography (SDOCT sign, in diabetic macular edema (DMO, (2 to track the course of this sign over a period of at least 10 months. Materials and Methods: The pearl necklace SDOCT sign refers to hyperreflective dots in a contiguous ring around the inner wall of cystoid spaces in the retina, recently described for the first time in 21 eyes with chronic exudative maculopathy. A retrospective analysis was performed of SDOCT images of all patients presenting to the DMO referral clinic of a tertiary eye care center, over a period of 24 months. Images of patients displaying this sign were sequentially analyzed for at least 10 months to track the course of the sign. Results: Thirty-five eyes of 267 patients (13.1% were found to display the pearl necklace sign. Twenty-eight eyes responded to intravitreal ranibizumab treatment with resolution of edema. In 21 eyes, the dots coalesced to form a clump, visible in the infrared fundus photograph as hard exudates; in seven eyes, dots disappeared without leaving visible exudates. In three eyes, the sign was seen in subfoveal cystoid spaces, with subsequent development of hard exudates, and drop in visual acuity of 20 letters or more. Conclusion: Pearl necklace SDOCT sign is not infrequent in DMO. This sign is a precursor to hard exudates in the majority of cases. If this sign is seen subfoveally, drop in visual acuity can be expected, despite treatment.

Shoulder impingement syndrome: diagnostic accuracy of magnetic resonance imaging and radiographic signs

International Nuclear Information System (INIS)

Williamson, M.P.; Chandnani, V.P.; Baird, D.E.; Deberardino, T.M.; Swenson, G.W.; Hansen, M.F.

1994-01-01

Shoulder impingement syndrome is commonly encountered in orthopaedics. In a blinded retrospective study, magnetic resonance imaging and roentgenographic signs in 41 patients with clinical signs of impingement syndrome were compared with 40 control patients. Statistically significant differences between the groups included the absence of subacromial fat, as well as the presence of a supraspinatus tear, subacromial osteophytes, and a decreased coracohumeral distance. Other signs reported to occur in patients with impingement syndrome did not vary significantly in the population studied. 20 refs., 12 figs

Identifying patterns in signs and symptoms preceding the clinical diagnosis of Alzheimer's disease: Retrospective medical record review study and a nested case -control design.

Science.gov (United States)

Bature, Fidelia; Pang, Dong; Robinson, Anthea; Polson, Norma; Pappas, Yannis; Guinn, Barbara

2018-04-04

Evidence suggests that individuals with Alzheimer's disease (AD) are often diagnosed in the later stages of their disease with a poor prognosis. This study aimed to identify patterns in signs and symptoms preceding the clinical diagnosis of AD to suggest a predictive model for earlier diagnosis of the disease in the primary care. A retrospective medical record review; nested case control design. Participants included one hundred and nine patients from three general practice (GP) surgeries in Milton Keynes and Luton Clinical Commissioning groups (CCG) (37 cases with AD and 72 controls without AD). A retrospective analysis using the logistic regression of the presence of signs and symptoms before the diagnosis of AD was attained. Identification of the timing and sequence of appearance of these presentations as first reported before the clinical diagnosis was measured. Episodic memory with an odds ratio of 1.85 was the most frequent presentation, documented in 1.38% of the controls and 75.6% in cases. Auditory disturbance with an odds ratio of 3.03, which has not previously been noted except in the form of auditory hallucination, could have a diagnostic value. Auditory disturbance, which occurred mostly in the Caucasian females, could discriminate individuals with AD from those without. The symptom, which presented up to 14.5 (mean time) years prior to clinical diagnosis, was identified in Caucasians and mixed race individuals only. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The Effect of Plastic Cover on Regulation of Vital Signs in Preterm Infants: A Randomized Cross-over Clinical Trial

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Leila Valizadeh

2017-06-01

Full Text Available Background: Considering the susceptibility of preterm infants to disturbances of vital signs, this study was conducted to investigate the effects of using plastic covers on regulation of vital signs in preterm neonates.Methods: This randomized, cross-over, clinical trial was carried out on 80 preterm infants admitted to neonatal intensive care unit (NICU of Taleghani Hospital, Tabriz, Iran. The study was conducted in two days (on the second and third days of the infants’ life. In group 1, plastic cover was used during the first day followed by the use of blanket on the second day, while the order was reversed in group 2. Digital thermometer was used to measure the infants’ axillary temperature. Heart rate and oxygen saturation were measured through monitoring. To analyze the data, descriptive (Mean and SE, 95%CI and inferential statistics (repeated measurement and ANCOVA tests were used in SPSS version 13 and MiniTab software.Results: Fourteen infants who were covered with blanket were found to suffer from hypothermia, while no infant with a plastic cover encountered this problem. The percentage of arterial blood oxygen saturation in the group with plastic covers was higher, and as a result, the infants received less oxygen supplements. However, no statistically significant differences were observed in heart rate between the groups.Conclusion: Use of plastic cover during NICU stay prevented hypothermia in premature infants, with the arterial blood oxygen saturation being within the normal limits. Yet, it did not seem to have a significant effect on other vital signs.

Neurological Soft Signs in Indian Children with Specific Developmental Disorders of Scholastic Skills

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Sadhu, Raja; Mehta, Manju; Kalra, Veena; Sagar, Rajesh; Mongia, Monica

2008-01-01

Aim: To compare the occurrence of neurological soft signs (NSS) in children with specific developmental disorders of scholastic skills (SDDSS) and normal children. Methods: 36 cases of SDDSS were compared with 30 control children regarding sociodemographic and clinical variables and neurological soft signs. Results: Children with SDDSS had…

Depression signs, Teasing and Low Self-esteem in Female Obese Adolescents: a clinical evaluation

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Emanuele Maria Merlo

2018-04-01

Full Text Available Objective: the study identifies the presence of the signs of depression, teasing and self-esteem in obese female adolescents compared to a control group. Methods: the studied group consisted of female subjects (N= 106 obese adolescents and 106 control group aged from 12 to 18. In the study, the subjects were administered measures of body image, Montgomery Asberg depression rating scale (MADRS, Scale of perceived Teasing, Self-Liking (SL and Self-competence (SC to appraise self-esteem. Results: the comparative assessment highlighted that obese adolescents are significantly depressed. Regarding the teasing, the adolescents were affected from a physical viewpoint. A significant difference also emerged in relation to self-esteem. Conclusion: the emotional consequences should be carefully weighed  in consideration of the possible psychopathologies that may arise, i.e. mood signs. In relation to the signs, the prevention  with psychological interventions is important for eating disorders and  improve psychosocial health.

[Lymphogranuloma venereum: new serovariant L2b and old "groove sign"].

Science.gov (United States)

de Lavaissière, M; Nougué, J

2013-08-01

An ongoing lymphogranuloma venereum (LGV) outbreak has been reported in several European countries since 2003, related to a new variant L2b. This serovar appears to affect men who have sex with men (MSM), most of them being co-infected with the Human Immunodeficiency Virus (HIV). The secondary stage of LGV may involve lymph nodes and the inguinal form has sometimes been described on each side of the inguinal ligament thus named the "groove sign". We report the case of LGV serovariant L2b acquired by an heterosexual intercourse in an HIV seronegative patient who presented with an inguinal lymph node and a "groove sign". This is an uncommon but suggestive sign of LGV and we suggest that the clinical presentation of L2b LGV might not be so different than other variants and than the 20th century authors' description. Such a new Chlamydia trachomatis variant may circulate in other populations than MSM in Europe and clinical awareness must prevail.

Skin puckering an uncommon sign of underlying humeral neck fracture: a case report.

LENUS (Irish Health Repository)

Davarinos, N

2012-01-31

Skin puckering is a sign that is well associated with certain fractures such as supracondylar humeral fractures in children. To our knowledge, there has been only one clinical report of skin puckering associated with fractured neck of humerus of an adult. This is a second such case of fractured proximal humerus in an adult presenting with skin puckering and the first from the Republic of Ireland. Skin puckering is suggestive of soft tissue interposition and may be an important clinical sign indicating the need for internal fixation.

Computed tomography signs of pulmonary hypertension: old and new observations

Energy Technology Data Exchange (ETDEWEB)

Devaraj, A. [Department of Radiology, Royal Brompton Hospital, London (United Kingdom); Hansell, D.M. [Department of Radiology, Royal Brompton Hospital, London (United Kingdom)], E-mail: davidhansell@rbht.nhs.uk

2009-08-15

Pulmonary hypertension (PH) has a poor prognosis. It may be idiopathic or develop secondary to various cardiac and respiratory disorders. The diagnosis of PH is challenging because its signs and symptoms are non-specific and there is no completely reliable non-invasive test for its detection. Most patients with suspected PH or with the non-specific symptoms of PH will undergo computed tomography (CT) as part of their diagnostic work-up and, therefore, it is important for radiologists to be aware of the CT signs that may suggest the diagnosis. This article will review the numerous CT signs of PH describing their individual strengths and weaknesses, and discuss how they may be applied in clinical practice.

Computed tomography signs of pulmonary hypertension: old and new observations

International Nuclear Information System (INIS)

Devaraj, A.; Hansell, D.M.

2009-01-01

Pulmonary hypertension (PH) has a poor prognosis. It may be idiopathic or develop secondary to various cardiac and respiratory disorders. The diagnosis of PH is challenging because its signs and symptoms are non-specific and there is no completely reliable non-invasive test for its detection. Most patients with suspected PH or with the non-specific symptoms of PH will undergo computed tomography (CT) as part of their diagnostic work-up and, therefore, it is important for radiologists to be aware of the CT signs that may suggest the diagnosis. This article will review the numerous CT signs of PH describing their individual strengths and weaknesses, and discuss how they may be applied in clinical practice.

Effectiveness of Variable Message Signs on Driving Behavior Based on a Driving Simulation Experiment

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Xuedong Yan

2014-01-01

Full Text Available Variable message signs (VMSs, as one of the important ITS devices, provide real-time traffic information of road network to drivers in order to improve route choice and relieve the traffic congestion. In this study, the effectiveness of VMS on driving behavior was tested based on a driving simulation experiment. A road network with three levels of VMS location to route-diverging intersection and three types of VMS information format was designed in a high fidelity driving simulator platform. Fifty-two subjects who were classified by driver age, gender, and vocation successfully completed this experiment. The experimental results showed that driver characteristics, VMS location, and information format profoundly influence driving behaviors. Based on the research findings, it is suggested that VMS would be positioned between 150 m and 200 m upstream of the diverging point to balance the VMS effects on traffic safety and operation and the graphic information VMS format is better than the format with text massage only.

Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI).

Science.gov (United States)

Øhre, Beate; Saltnes, Hege; von Tetzchner, Stephen; Falkum, Erik

2014-05-22

There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI). The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnostic interview by clinical experts and with the MINI. Inter-rater reliability was assessed with Cohen's kappa and "observed agreement". There was 65% agreement between MINI diagnoses and clinical expert diagnoses. Kappa values indicated fair to moderate agreement, and observed agreement was above 76% for all diagnoses. The MINI diagnosed more co-morbid conditions than did the clinical expert interview (mean diagnoses: 1.9 versus 1.2). Kappa values indicated moderate to substantial agreement, and "observed agreement" was above 88%. The NSL version performs similarly to other MINI versions and demonstrates adequate reliability and validity as a diagnostic instrument for assessing mental disorders in persons who have sign language as their primary and preferred language.

Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI)

Science.gov (United States)

2014-01-01

Background There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI). Methods The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnostic interview by clinical experts and with the MINI. Inter-rater reliability was assessed with Cohen’s kappa and “observed agreement”. Results There was 65% agreement between MINI diagnoses and clinical expert diagnoses. Kappa values indicated fair to moderate agreement, and observed agreement was above 76% for all diagnoses. The MINI diagnosed more co-morbid conditions than did the clinical expert interview (mean diagnoses: 1.9 versus 1.2). Kappa values indicated moderate to substantial agreement, and “observed agreement” was above 88%. Conclusion The NSL version performs similarly to other MINI versions and demonstrates adequate reliability and validity as a diagnostic instrument for assessing mental disorders in persons who have sign language as their primary and preferred language. PMID:24886297

CDC Vital Signs: Prescription Painkiller Overdoses (Methadone)

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... Relievers The White House – Office of National Drug Control Policy SAMSHA – Substance Abuse and Mental Health Services Administration Drug Enforcement Administration – Office of Diversion Control National ...

Toward First Principle Medical Diagnostics: On the Importance of Disease-Disease and Sign-Sign Interactions

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Abolfazl Ramezanpour

2017-07-01

Full Text Available A fundamental problem in medicine and biology is to assign states, e.g., healthy or diseased, to cells, organs or individuals. State assignment or making a diagnosis is often a nontrivial and challenging process and, with the advent of omics technologies, the diagnostic challenge is becoming more and more serious. The challenge lies not only in the increasing number of measured properties and dynamics of the system (e.g., cell or human body but also in the co-evolution of multiple states and overlapping properties, and degeneracy of states. We develop, from first principles, a generic rational framework for state assignment in cell biology and medicine, and demonstrate its applicability with a few simple theoretical case studies from medical diagnostics. We show how disease–related statistical information can be used to build a comprehensive model that includes the relevant dependencies between clinical and laboratory findings (signs and diseases. In particular, we include disease-disease and sign–sign interactions and study how one can infer the probability of a disease in a patient with given signs. We perform comparative analysis with simple benchmark models to check the performances of our models. We find that including interactions can significantly change the statistical importance of the signs and diseases. This first principles approach, as we show, facilitates the early diagnosis of disease by taking interactions into accounts, and enables the construction of consensus diagnostic flow charts. Additionally, we envision that our approach will find applications in systems biology, and in particular, in characterizing the phenome via the metabolome, the proteome, the transcriptome, and the genome.

The reversed halo sign: update and differential diagnosis

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Godoy, M C B; Viswanathan, C; Marchiori, E; Truong, M T; Benveniste, M F; Rossi, S; Marom, E M

2012-01-01

The reversed halo sign is characterised by a central ground-glass opacity surrounded by denser air–space consolidation in the shape of a crescent or a ring. It was first described on high-resolution CT as being specific for cryptogenic organising pneumonia. Since then, the reversed halo sign has been reported in association with a wide range of pulmonary diseases, including invasive pulmonary fungal infections, paracoccidioidomycosis, pneumocystis pneumonia, tuberculosis, community-acquired pneumonia, lymphomatoid granulomatosis, Wegener granulomatosis, lipoid pneumonia and sarcoidosis. It is also seen in pulmonary neoplasms and infarction, and following radiation therapy and radiofrequency ablation of pulmonary malignancies. In this article, we present the spectrum of neoplastic and non-neoplastic diseases that may show the reversed halo sign and offer helpful clues for assisting in the differential diagnosis. By integrating the patient's clinical history with the presence of the reversed halo sign and other accompanying radiological findings, the radiologist should be able to narrow the differential diagnosis substantially, and may be able to provide a presumptive final diagnosis, which may obviate the need for biopsy in selected cases, especially in the immunosuppressed population. PMID:22553298

Spa therapy (balneotherapy) relieves mental stress, sleep disorder, and general health problems in sub-healthy people

Science.gov (United States)

Yang, Bei; Qin, Qi-zhong; Han, Ling-li; Lin, Jing; Chen, Yu

2018-02-01

To investigate the relieving effects of hot spring balneotherapy on mental stress, sleep disorder, general health problems, and women's health problems in sub-healthy people, we recruited 500 volunteers in sub-health in Chongqing, and 362 volunteers completed the project, including 223 in the intervention group and 139 in the control group. The intervention group underwent hot spring balneotherapy for 5 months, while the control group did not. The two groups took questionnaire investigation (general data, mental stress, emotional status, sleep quality, general health problems, as well as some women's health problems) and physical examination (height, weight, waist circumference, blood pressure, blood lipid, blood sugar) 5 months before and after the intervention, respectively. After intervention, sleep disorder (difficulty in falling asleep ( P = 0.017); dreaminess, nightmare suffering, and restless sleep ( P = 0.013); easy awakening ( P = 0.003) and difficulty in falling into sleep again after awakening( P = 0.016); and mental stress ( P = 0.031) and problems of general health (head pain ( P = 0.026), joint pain( P = 0.009), leg or foot cramps ( P = 0.001), blurred vision ( P = 0.009)) were relieved significantly in the intervention group, as compared with the control group. While other indicators (fatigue, eye tiredness, limb numbness, constipation, skin allergy) and women's health problems (breast distending pain; dysmenorrhea, irregular menstruation) were relieved significantly in the self-comparison of the intervention group before and after intervention ( P 0.05). All indications (except bad mood, low mood, and worry or irritability) in the intervention group significantly improved, with effect size from 0.096 to 1.302. Multiple logistic regression analysis showed that the frequency, length, and location of balneotherapy in the intervention group were the factors influencing emotion, sleep, and health condition ( P Physical examination found that waist

The Clinical Usefulness of Simultaneous Placement of Double Endoscopic Nasobiliary Biliary Drainage

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Hong Jun Kim

2015-11-01

Full Text Available Background/Aims: To evaluate the technical feasibility and clinical efficacy of double endoscopic nasobiliary drainage (ENBD as a new method of draining multiple bile duct obstructions. Methods: A total of 38 patients who underwent double ENBD between January 2004 and February 2010 at the Asan Medical Center were retrospectively analyzed. We evaluated indications, laboratory results, and the clinical course. Results: Of the 38 patients who underwent double ENBD, 20 (52.6% had Klatskin tumors, 12 (31.6% had hepatocellular carcinoma, 3 (7.9% had strictures at the anastomotic site following liver transplantation, and 3 (7.9% had acute cholecystitis combined with cholangitis. Double ENBD was performed to relieve multiple biliary obstruction in 21 patients (55.1%, drain contrast agent filled during endoscopic retrograde cholangiopancreatography in 4 (10.5%, obtain cholangiography in 4 (10.5%, drain hemobilia in 3 (7.9%, relieve Mirizzi syndrome with cholangitis in 3 (7.9%, and relieve jaundice in 3 (7.9%. Conclusions: Double ENBD may be useful in patients with multiple biliary obstructions.

Psychological stress-relieving effects of chewing - Relationship between masticatory function-related factors and stress-relieving effects.

Science.gov (United States)

Tasaka, Akinori; Kikuchi, Manaki; Nakanishi, Kousuke; Ueda, Takayuki; Yamashita, Shuichiro; Sakurai, Kaoru

2018-01-01

The objective of the present study was to investigate the relationship between masticatory function-related factors (masticatory performance, occlusal contact area, maximum bite force, number of chewing strokes, and muscle activity) and the stress-relieving effects of chewing. A total of 28 healthy male subjects were instructed to rest or chew for 10min after 30min of stress loading with arithmetic calculations. Their stress state was assessed by measuring salivary cortisol levels. Saliva was collected at three time points: before stress loading, immediately after stress loading, and 10min after stress loading. Compared to resting, chewing produced a significantly greater reduction in the rate of change in salivary cortisol levels 10min after stress loading. A negative correlation was observed between the rate of decrease in salivary cortisol levels and the number of chewing strokes. No significant correlation was observed between the rate of decrease in salivary cortisol levels and other measurement items. In healthy dentulous people, the number of chewing strokes has been shown to be a masticatory function-related factor that affects stress relief from chewing, suggesting the possibility that more appropriate chewing would produce a greater effect psychological stress relief. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Sign Inference for Dynamic Signed Networks via Dictionary Learning

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Yi Cen

2013-01-01

Full Text Available Mobile online social network (mOSN is a burgeoning research area. However, most existing works referring to mOSNs deal with static network structures and simply encode whether relationships among entities exist or not. In contrast, relationships in signed mOSNs can be positive or negative and may be changed with time and locations. Applying certain global characteristics of social balance, in this paper, we aim to infer the unknown relationships in dynamic signed mOSNs and formulate this sign inference problem as a low-rank matrix estimation problem. Specifically, motivated by the Singular Value Thresholding (SVT algorithm, a compact dictionary is selected from the observed dataset. Based on this compact dictionary, the relationships in the dynamic signed mOSNs are estimated via solving the formulated problem. Furthermore, the estimation accuracy is improved by employing a dictionary self-updating mechanism.

Awareness of Deaf Sign Language and Gang Signs.

Science.gov (United States)

Smith, Cynthia; Morgan, Robert L.

There have been increasing incidents of innocent people who use American Sign Language (ASL) or another form of sign language being victimized by gang violence due to misinterpretation of ASL hand formations. ASL is familiar to learners with a variety of disabilities, particularly those in the deaf community. The problem is that gang members have…

Performance of clinical signs in poultry for the detection of outbreaks during the avian influenza A (H7N7) epidemic in the Netherlands in 2003

NARCIS (Netherlands)

Elbers, A.R.W.; Koch, G.; Bouma, A.

2005-01-01

The aim of this study was to make an inventory of the clinical signs of high-pathogenicity avian influenza (HPAI), to facilitate the development of an operational syndrome-reporting system (SRS) in The Netherlands as an early warning system for HPAI outbreaks. A total of 537 poultry flocks (240

A novel selective prostaglandin E2 synthesis inhibitor relieves pyrexia and arthritis in Guinea pigs inflammatory models

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Ryusuke Sugita

2016-02-01

Full Text Available Prostaglandin E2 (PGE2, one of the terminal products in the cyclooxygenase pathway, plays an important role in various inflammatory responses. To determine whether selective inhibition of PGE2 may relieve these inflammatory symptoms, we synthesized a selective PGE2 synthesis inhibitor, compound A [1-(6-fluoro-5,7-dimethyl-1,3-benzothiazol-2-yl-N-[(1S,2R-2-(hydroxymethylcyclohexyl]piperidine-4-carboxamide], then investigated the effects on pyrexia, arthritis and inflammatory pain in guinea pigs. In LPS-stimulated guinea pig macrophages, compound A selectively inhibited inducible PGE2 biosynthesis in a dose-dependent manner whereas enhanced the formation of thromboxane B2 (TXB2. Compound A suppressed yeast-evoked PGE2 production selectively and enhanced the production of TXB2 and 6-keto PGF1α in vivo. In addition, compound A relieved yeast-induced pyrexia and also suppressed paw swelling in an adjuvant-induced arthritis model. The effect on gastrointestinal (GI ulcer formation was also evaluated and compound A showed a lower GI adverse effect than indomethacin. However, compound A failed to relieve yeast-induced thermal hyperalgesia. These results suggest that selective inhibition of PGE2 synthesis may have anti-pyretic and anti-inflammatory properties without GI side effect, but lack the analgesic efficacy.

Algorithmic tools for interpreting vital signs.

Science.gov (United States)

Rathbun, Melina C; Ruth-Sahd, Lisa A

2009-07-01

Today's complex world of nursing practice challenges nurse educators to develop teaching methods that promote critical thinking skills and foster quick problem solving in the novice nurse. Traditional pedagogies previously used in the classroom and clinical setting are no longer adequate to prepare nursing students for entry into practice. In addition, educators have expressed frustration when encouraging students to apply newly learned theoretical content to direct the care of assigned patients in the clinical setting. This article presents algorithms as an innovative teaching strategy to guide novice student nurses in the interpretation and decision making related to vital sign assessment in an acute care setting.

A Randomized Controlled Trial to Compare the Safety and Efficacy of Tadalafil and Tamsulosin in Relieving Double J Stent Related Symptoms

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Satinder Pal Aggarwal

2015-01-01

Full Text Available Objectives. To evaluate the safety and efficacy of Tadalafil and Tamsulosin in treating Double J stent related symptoms. Methods. In a prospective study, 161 patients with DJ related symptoms were randomized into 3 groups: Group A patients (54, Group B patients (53, and Group C patients (54. They were given Tadalafil, Tamsulosin, and placebo, respectively, at 1st week till removal of DJ stent at 3rd week. All patients completed Ureteral Stent Symptom Questionnaire (USSQ at 1st week and at 3rd week. The statistical significant difference among groups was determined by the t-test, Kruskal-Wallis test and multivariate analysis were used to assess association of the variables within the three groups, and the level of significance was set at P<0.05. Results. Tadalafil and Tamsulosin were comparable in relieving urinary symptoms, general health, and work performance (OR = 0.65, 1.8, and 0.92. But Tadalafil was more effective in relieving body pain, sexual problems, and additional problems than Tamsulosin (OR = 5.95, 19.25, and 2.69 and was statistically significant as P<0.05. Conclusion. Tadalafil was as effective as Tamsulosin in relieving urinary symptom but more effective in relieving sexual symptoms and body pain.

Signs for early diagnosis of heart failure in primary health care

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Devroey D

2011-09-01

Full Text Available Dirk Devroey1,2, Viviane Van Casteren11Scientific Institute of Public Health, Unit of Epidemiology, Brussels, Belgium; 2Vrije Universiteit Brussel (VUB, Department of Family Medicine, Brussels, BelgiumObjective: The current guidelines for the diagnosis of heart failure (HF are based on studies of hospital-based patients. The aim of this study is to describe the symptoms, clinical signs, and diagnostic procedures confirming the diagnosis of HF in primary health care.Materials/subjects and methods: Data were prospectively collected during a 2-year period by a nationwide network of sentinel practices. All adult patients without known HF, for which the diagnosis of HF was clinically suspected for the first time, were registered. When diagnosed, HF was confirmed after 1 month.Results: 754 patients with a suspicion of HF were recorded. The diagnosis of HF was confirmed for 74% of the patients. The average age of the patients with confirmed HF was 77.7 years, and for those without HF 75.6 years (P = 0.018. From a logistic regression, breathlessness on exercise (P < 0.001, limitations of physical activity (P = 0.003, and orthopnea (P = 0.040 were the symptoms most associated with HF. The clinical signs most associated with HF, were pulmonary rales (P < 0.001, peripheral edema (P < 0.001, and raised jugular venous pressure (P = 0.039. An electrocardiogram was performed in 75% of the cases, blood analyses in 68%, echocardiogram in 63%, chest X-ray in 61%, and determination of natriuretic peptides in 11% of the cases.Conclusion: Many clinical signs may occur in patients with HF. However, the occurrence of peripheral edema, breathlessness on exercise, or pulmonary rales, are highly suggestive for HF when diagnosed in primary health care, as is the case in hospital-admitted patients. The diagnosis of HF was often left unconfirmed by an echocardiogram and/or an electrocardiogram.Keywords: heart failure, primary health care, diagnostic clinical signs

Automatic sign language recognition inspired by human sign perception

NARCIS (Netherlands)

Ten Holt, G.A.

2010-01-01

Automatic sign language recognition is a relatively new field of research (since ca. 1990). Its objectives are to automatically analyze sign language utterances. There are several issues within the research area that merit investigation: how to capture the utterances (cameras, magnetic sensors,

Inuit Sign Language: a contribution to sign language typology

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Schuit, J.; Baker, A.; Pfau, R.

2011-01-01

Sign language typology is a fairly new research field and typological classifications have yet to be established. For spoken languages, these classifications are generally based on typological parameters; it would thus be desirable to establish these for sign languages. In this paper, different

Painful rib hump: a new clinical sign for detecting intraspinal rib displacement in scoliosis due to neurofibromatosis

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Katsalouli Marina

2006-06-01

Full Text Available Abstract Background Spinal cord compression and associate neurological impairment is rare in patients with scoliosis and neurofibromatosis. Common reasons are vertebral subluxation, dislocation, angulation and tumorous lesions around the spinal canal. Only twelve cases of intraspinal rib dislocation have been reported in the literature. The aim of this report is to present a case of rib penetration through neural foramen at the apex of a scoliotic curve in neurofibromatosis and to introduce a new clinical sign for its detection. Methods A 13-year-old girl was evaluated for progressive left thoracic kyphoscoliotic curve due to a type I neurofibromatosis. Clinical examination revealed multiple large thoracic and abdominal "cafe-au-lait" spots, neurological impairment of the lower limbs and the presence of a thoracic gibbous that was painful to pressure at the level of the left eighth rib (Painful Rib Hump. CT-scan showed detachment and translocation of the cephalic end of the left eighth rib into the adjacent enlarged neural foramen. The M.R.I. examination of the spine showed neither cord abnormality nor neurogenic tumor. Results The patient underwent resection of the intraspinal mobile eighth rib head and posterior spinal instrumentation and was neurologically fully recovered six months postoperatively. Conclusion Spine surgeons should be aware of intraspinal rib displacement in scoliotic curves in neurofibromatosis. Painful rib hump is a valuable diagnostic tool for this rare clinical entity.

Major clinical events, signs and severity assessment scores related to actual survival in patients who died from primary biliary cirrhosis. A long-term historical cohort study

NARCIS (Netherlands)

van Dam, GM; Gips, CH; Reisman, Y; Maas, KW; Purmer, IM; Huizenga, [No Value; Verbaan, BW

1999-01-01

BACKGROUND/AIMS: One of the prognostic methods for survival in primary biliary cirrhosis (PBC) is the Mayo model, with a time-scale limited to 7 years. The aim of our study was to assess how major clinical events, signs, several severity assessment methods and Mayo survival probabilities fit in with

Clinical application of percutaneous lumbar puncture to treat sciatica caused by lumbar disc herniation under CT guidance

International Nuclear Information System (INIS)

Wang Linyou; Li Yuan; Shao Yangtong

2004-01-01

Objective: To evaluate the effect of the percutaneous lumbar puncture to treat sciatica caused by lumbar disc herniation. Methods: 75 cases of lumbar disc herniation with significant clinical signs were confirmed by CT scan. The technique of the percutaneous lumbar puncture led the needle to approach nerve root and injected medicine diffusing into extraduramater, and then relieved the symptom of sciatica. Results: The rate of success of percutaneous lumbar puncture guided by CT reached to 100%. After two weeks of follow-up, the symptom of pain was obviously improved and disappeared in 63.3% cases. There were 23.0% cases needed a second procedure, and no change was obsesved in 9.3% cases. Conclusions: The percutaneous lumbar puncture guided by CT to treat sciatica resulted from lumbar disc herniation is one of the safe, reliable, effective new methods with no complication. The long term effectiveness is still in need of investigation. (authors)

Toward the Ideal Signing Avatar

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Nicoletta Adamo-Villani

2016-06-01

Full Text Available The paper discusses ongoing research on the effects of a signing avatar's modeling/rendering features on the perception of sign language animation. It reports a recent study that aimed to determine whether a character's visual style has an effect on how signing animated characters are perceived by viewers. The stimuli of the study were two polygonal characters presenting two different visual styles: stylized and realistic. Each character signed four sentences. Forty-seven participants with experience in American Sign Language (ASL viewed the animated signing clips in random order via web survey. They (1 identified the signed sentences (if recognizable, (2 rated their legibility, and (3 rated the appeal of the signing avatar. Findings show that while character's visual style does not have an effect on subjects' perceived legibility of the signs and sign recognition, it has an effect on subjects' interest in the character. The stylized signing avatar was perceived as more appealing than the realistic one.

Significance of satellite sign and spot sign in predicting hematoma expansion in spontaneous intracerebral hemorrhage.

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Yu, Zhiyuan; Zheng, Jun; Ali, Hasan; Guo, Rui; Li, Mou; Wang, Xiaoze; Ma, Lu; Li, Hao; You, Chao

2017-11-01

Hematoma expansion is related to poor outcome in spontaneous intracerebral hemorrhage (ICH). Recently, a non-enhanced computed tomography (CT) based finding, termed the 'satellite sign', was reported to be a novel predictor for poor outcome in spontaneous ICH. However, it is still unclear whether the presence of the satellite sign is related to hematoma expansion. Initial computed tomography angiography (CTA) was conducted within 6h after ictus. Satellite sign on non-enhanced CT and spot sign on CTA were detected by two independent reviewers. The sensitivity and specificity of both satellite sign and spot sign were calculated. Receiver-operator analysis was conducted to evaluate their predictive accuracy for hematoma expansion. This study included 153 patients. Satellite sign was detected in 58 (37.91%) patients and spot sign was detected in 38 (24.84%) patients. Among 37 patients with hematoma expansion, 22 (59.46%) had satellite sign and 23 (62.16%) had spot sign. The sensitivity and specificity of satellite sign for prediction of hematoma expansion were 59.46% and 68.97%, respectively. The sensitivity and specificity of spot sign were 62.16% and 87.07%, respectively. The area under the curve (AUC) of satellite sign was 0.642 and the AUC of spot sign was 0.746. (P=0.157) CONCLUSION: Our results suggest that the satellite sign is an independent predictor for hematoma expansion in spontaneous ICH. Although spot sign has the higher predictive accuracy, satellite sign is still an acceptable predictor for hematoma expansion when CTA is unavailable. Copyright © 2017 Elsevier B.V. All rights reserved.

Computational triadic algebras of signs

Energy Technology Data Exchange (ETDEWEB)

Zadrozny, W. [T.J. Watson Research Center, Yorktown Heights, NY (United States)

1996-12-31

We present a finite model of Peirce`s ten classes of signs. We briefly describe Peirce`s taxonomy of signs; we prove that any finite collection of signs can be extended to a finite algebra of signs in which all interpretants are themselves being interpreted; and we argue that Peirce`s ten classes of signs can be defined using constraints on algebras of signs. The paper opens the possibility of defining multimodal cognitive agents using Peirce`s classes of signs, and is a first step towards building a computational logic of signs based on Peirce`s taxonomies.

Transcriptomic profiling of peripheral blood nucleated cells in dogs with and without clinical signs of chronic mitral valve disease

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Garncarz Magdalena

2014-03-01

Full Text Available The aim of the study was to demonstrate differences in the gene expression of signalling pathways between healthy dogs and dogs with chronic mitral valve disease in different heart failure groups. Blood samples were collected from 49 dogs of various breeds between 1.4 and 15.2 years of age. Isolated RNA samples were analysed for quality and integrity and the gene expression profile was determined. The study demonstrated that nucleated cells from peripheral blood can be used to assess the status of heart failure in dogs. Furthermore, significant differences in the expression of the genes were noticed between healthy dogs and dogs with clinical signs of chronic mitral valve disease. This is a preliminary non-invasive study showing the feasibility of genetic testing from peripheral blood nucleated cells, which at the same time has made it possible to set the future directions of genetic studies in clinical cases of canine chronic mitral valve disease.

How effective are the 6 European Society of Immunodeficiency warning signs for primary immunodeficiency disease?

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Arslan, Sevket; Ucar, Ramazan; Caliskaner, Ahmet Zafer; Reisli, Ismail; Guner, Sukru Nail; Sayar, Esra Hazar; Baloglu, Ismail

2016-02-01

The European Society of Immunodeficiency (ESID) developed 6 warning signs to promote the awareness of adult primary immunodeficiency disease (PID). To screen adult patients for the presence of PID using these 6 warning signs to determine the effectiveness of this protocol. Questions related to the ESID warning signs for adult PID were added to the standard outpatient clinic file system and asked of 3,510 patients who were admitted to our clinic for any reason. Patients with signs and/or suspicion of PID based on their medical history underwent immunologic investigation. In total, 24 patients were diagnosed as having a PID. The most common reason that patients with PID were admitted was frequent infection (n=18 [75%]), and the most common PID subgroup was common variable immunodeficiency (n=12 [50%]). Twenty patients with PID had at least one positive finding according to the ESID warning signs. Two patients with gastrointestinal concerns and 2 with dermatologic symptoms were also diagnosed as having a PID, although they did not have any of the ESID warning signs. The ESID warning signs do not specify the need for symptoms to diagnose a PIDs and do not include a comprehensive list of all signs and symptoms of PIDs. As a result, more than infection-centric questions are needed to identify adult patients with immunodeficiencies. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Influence of gravity upon some facial signs.

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Flament, F; Bazin, R; Piot, B

2015-06-01

Facial clinical signs and their integration are the basis of perception than others could have from ourselves, noticeably the age they imagine we are. Facial modifications in motion and their objective measurements before and after application of skin regimen are essential to go further in evaluation capacities to describe efficacy in facial dynamics. Quantification of facial modifications vis à vis gravity will allow us to answer about 'control' of facial shape in daily activities. Standardized photographs of the faces of 30 Caucasian female subjects of various ages (24-73 year) were successively taken at upright and supine positions within a short time interval. All these pictures were therefore reframed - any bias due to facial features was avoided when evaluating one single sign - for clinical quotation by trained experts of several facial signs regarding published standardized photographic scales. For all subjects, the supine position increased facial width but not height, giving a more fuller appearance to the face. More importantly, the supine position changed the severity of facial ageing features (e.g. wrinkles) compared to an upright position and whether these features were attenuated or exacerbated depended on their facial location. Supine station mostly modifies signs of the lower half of the face whereas those of the upper half appear unchanged or slightly accentuated. These changes appear much more marked in the older groups, where some deep labial folds almost vanish. These alterations decreased the perceived ages of the subjects by an average of 3.8 years. Although preliminary, this study suggests that a 90° rotation of the facial skin vis à vis gravity induces rapid rearrangements among which changes in tensional forces within and across the face, motility of interstitial free water among underlying skin tissue and/or alterations of facial Langer lines, likely play a significant role. © 2015 Society of Cosmetic Scientists and the Société Fran

Evaluation of the Cerebral State Index in Cats under Isoflurane Anaesthesia: Dose-Effect Relationship and Prediction of Clinical Signs

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Joana R. Sousa

2014-01-01

Full Text Available The performance of the cerebral state index (CSI in reflecting different levels of isoflurane anaesthesia was evaluated in ten cats subjected to four end-tidal isoflurane concentrations (EtIso, each maintained for 15 minutes (0.8%, 1.2%, 1.6%, or 2.0% EtIso. The CSI, hemodynamic data, ocular reflexes, and eye position were recorded for each EtIso concentration. Pharmacodynamic analysis of CSI with EtIso was performed, as well as prediction probability analysis with a clinical scale based on the eye reflexes. The CSI values showed great variability. Between all parameters, burst suppression ratio showed the better fitting with the sigmoidal concentration-effect model (R2=0.93 followed by CSI (R2=0.82 and electromyographic activity (R2=0.79. EtIso was the variable with better prediction of the clinical scale of anaesthesia (prediction probability value of 0.94. Although the CSI values decrease with increasing isoflurane concentrations, the huge variability in CSI values may be a strong limitation for its use in cats and it seems to be no better than EtIso as a predictor of clinical signs.

Gesture, sign, and language: The coming of age of sign language and gesture studies.

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Goldin-Meadow, Susan; Brentari, Diane

2017-01-01

How does sign language compare with gesture, on the one hand, and spoken language on the other? Sign was once viewed as nothing more than a system of pictorial gestures without linguistic structure. More recently, researchers have argued that sign is no different from spoken language, with all of the same linguistic structures. The pendulum is currently swinging back toward the view that sign is gestural, or at least has gestural components. The goal of this review is to elucidate the relationships among sign language, gesture, and spoken language. We do so by taking a close look not only at how sign has been studied over the past 50 years, but also at how the spontaneous gestures that accompany speech have been studied. We conclude that signers gesture just as speakers do. Both produce imagistic gestures along with more categorical signs or words. Because at present it is difficult to tell where sign stops and gesture begins, we suggest that sign should not be compared with speech alone but should be compared with speech-plus-gesture. Although it might be easier (and, in some cases, preferable) to blur the distinction between sign and gesture, we argue that distinguishing between sign (or speech) and gesture is essential to predict certain types of learning and allows us to understand the conditions under which gesture takes on properties of sign, and speech takes on properties of gesture. We end by calling for new technology that may help us better calibrate the borders between sign and gesture.

Creep properties of annealed Zr-Nb-O and stress-relieved Zr-Nb-Sn-Fe cladding tubes and their performance comparison

International Nuclear Information System (INIS)

Ko, S.; Hong, S.I.; Kim, K.T.

2010-01-01

Creep properties of annealed Zr-Nb-O and stress-relieved Zr-Nb-Sn-Fe cladding tubes were studied and compared. The creep rates of the annealed Zr-Nb-O alloy were found to be greater than those of the stress-relieved Zr-Nb-Sn-Fe alloy. Zr-Nb-O alloy was found to have stress exponents of 5-7 independent of stress level whereas Zr-Nb-Sn-Fe alloy exhibited the transition of the stress exponent from 6.5 to 7.5 in the lower stress region to ∼4.2 in the higher stress region. The reduction of stress exponent at high stresses in Zr-Nb-Sn-Fe can be explained in terms of the dynamic solute-dislocation effect caused by Sn atoms. The constancy of stress exponent without the transition was observed in Zr-Nb-O alloy, supporting that the decrease of the stress exponent with increasing stress in Zr-Nb-Sn-Fe is associated with Sn atoms. The difference of creep life between annealed Zr-Nb-O and stress-relieved Zr-Nb-Sn-Fe is not large considering the large difference of strength level between annealed Zr-Nb-O and annealed stress-relieved Zr-Nb-Sn-Fe. The better-than-expected creep life of annealed Zr-Nb-O alloy can be attributable to the combined effects of creep ductility enhancement associated with softening and the decreased contribution of grain boundary diffusion due to the increased grain size.

Aspartame Attenuates 2, 4-Dinitrofluorobenzene-Induced Atopic Dermatitis-Like Clinical Symptoms in NC/Nga Mice.

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Kim, Gun-Dong; Park, Yong Seek; Ahn, Hyun-Jong; Cho, Jeong-Je; Park, Cheung-Seog

2015-11-01

Atopic dermatitis (AD) is a common multifactorial chronic skin disease that has a multiple and complex pathogenesis. AD is gradually increasing in prevalence globally. In NC/Nga mice, repetitive applications of 2, 4-dinitrofluorobenzene (DNFB) evoke AD-like clinical symptoms similar to human AD. Aspartame (N-L-α-aspartyl-L-phenylalanine 1-methyl ester) is a methyl ester of a dipeptide, which is used as an artificial non-nutritive sweetener. Aspartame has analgesic and anti-inflammatory functions that are similar to the function of nonsteroidal anti-inflammatory drugs such as aspirin. We investigated whether aspartame can relieve AD-like clinical symptoms induced by DNFB treatment in NC/Nga mice. Sucrose did not relieve AD-like symptoms, whereas aspartame at doses of 0.5 μg kg(-1) and 0.5 mg kg(-1) inhibited ear swelling and relieved AD-like clinical symptoms. Aspartame inhibited infiltration of inflammatory cells including eosinophils, mast cells, and CD4(+) T cells, and suppressed the expression of cytokines including IL-4 and IFN-γ, and total serum IgE levels. Aspartame may have therapeutic value in the treatment of AD.

SIGNS The sandwich sign

African Journals Online (AJOL)

The sandwich sign is demonstrated on cross-sectional imaging, commonly on CT or ultrasound. It refers to homogeneous soft- tissue masses representing mesenteric lymphadenopathy as the two halves of a sandwich bun, encasing the mesenteric fat and tubular mesenteric vessels that constitute the 'sandwich filling' (Figs ...

Clinical management of dietary induced urolithiasis associated with balanoposthitis in a Boer goat

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Y. Abba

2015-04-01

Full Text Available A Boer-Kajang cross male goat was presented to the Veterinary Hospital, University Malaysia Kelantan with a history of dysuria, hematuria and restlessness. The goat was intensively managed (confined to the pen and fed with only palm kernel cake for the last three months. Physical examination revealed that the goat was dull, depressed, having an inflamed penis and prepuce with blood stained urine dripping from the penis. The differential diagnoses were obstructive urolithiasis, urinary tract infection and balanoposthitis. Based on the history, clinical signs, physical examination, urinalysis, ultrasonagraphy and feed analysis, the goat was diagnosed with obstructive urolithiasis and balanoposthitis. Treatment was instituted by amputation of the urethral process and retrograde urohydropulsion to relieve the blockade. Sulfadiazine-trimethoprim (Norodine®24 15mg/kg, I.M; flunixin meglumine 2.2mg/kg, I.M; vitamin B complex 1ml/10kg, I.M and ammonium chloride 300mg/kg orally were administered. The goat responded well to treatment and was recovering well during a follow up visit.

Features of clinical signs of nervous and psychosomatic disorders in the Chernobyl' NPP personnel and human populations of affected regions at different stages of accident and its response

International Nuclear Information System (INIS)

Aleksandrovskij, Yu.A.; Tabachnikov, S.I.; Bebeshko, V.G.; Shchukin, B.P.; Rumyantseva, G.M.; Roslyakov, V.S.; Mel'nik, V.V.; Cherenkov, V.N.; Bero, M.P.; Mukhamadieva, R.A.

1989-01-01

Clinical signs of nervous and psychosomatic disorders in the Chernobyl' NPP personnel and persons taking part in the emergency response were analysed. Main stress factors for the personnel side by side with radiation hazard were the following ones: house loss, family separation, future uncertainties, etc. Singularity of labour under conditions of remaining threat for life and health, absence of information on the environmental radioactivity, unsatisfactory life conditions were in the first place for arrived persons. Analysis of determined psychopathological signs testifies to the prevalence of wide range of nervous disorders peculiar to natural calamities and disasters

Refuting the lipstick sign.

Science.gov (United States)

Grassbaugh, Jason A; Bean, Betsey R; Greenhouse, Alyssa R; Yu, Henry H; Arrington, Edward D; Friedman, Richard J; Eichinger, Josef K

2017-08-01

Arthroscopic examination of the tendon has been described as the "gold standard" for diagnosis of tendinitis of the long head of the biceps (LHB). An arthroscopic finding of an inflamed and hyperemic LHB within the bicipital groove has been described as the "lipstick sign." Studies evaluating direct visualization in diagnosis of LHB tendinitis are lacking. During a 1-year period, 363 arthroscopic shoulder procedures were performed, with 16 and 39 patients prospectively selected as positive cases and negative controls, respectively. All positive controls had groove tenderness, positive Speed maneuver, and diagnostic ultrasound-guided bicipital injection. Negative controls had none of these findings. Six surgeons reviewed randomized deidentified arthroscopic pictures of enrolled patients The surgeons were asked whether the images demonstrated LHB tendinitis and if the lipstick sign was present. Overall sensitivity and specificity were 49% and 66%, respectively, for detecting LHB tendinitis and 64% and 31%, respectively, for erythema. The nonweighted κ score for interobserver reliability ranged from 0.042 to 0.419 (mean, 0.215 ± 0.116) for tendinitis and from 0.486 to 0.835 (mean, 0.680 ± 0.102) for erythema. The nonweighted κ score for intraobserver reliability ranged from 0.264 to 0.854 (mean, 0.615) for tendinitis and from 0.641 to 0.951 (mean, 0.783) for erythema. The presence of the lipstick sign performed only moderately well in a rigorously designed level III study to evaluate its sensitivity and specificity. There is only fair agreement among participating surgeons in diagnosing LHB tendinitis arthroscopically. Consequently, LHB tendinitis requiring tenodesis remains a clinical diagnosis that should be made before arthroscopic examination. Published by Elsevier Inc.

Chest radiographic findings in neurotuberculosis without pulmonary signs and symptoms

International Nuclear Information System (INIS)

Aurangzeb, S.; Badshah, M.; Khan, B.R.S.

2008-01-01

To determine the chest radiographic findings in patients of adult neurotuberculosis, with no pulmonary signs and symptoms. A total of 100 patients fulfilling pre-defined criteria of neurotuberculosis were included. Chest radiographic (CXR) evidence of pulmonary TB was looked for in those patients and its frequency, pattern and association with the clinical grades at presentation was determined by using Chi-square test. Out of the 100 patients of neurotuberculosis, with no clinical evidence of pulmonary TB, radiographic evidence of pulmonary TB was seen in only 30% patients. The predominant patterns on CXR were apical infiltration (26.6%), military mottling (20%) and hilar enlargement (16.6%). Positive CXR was found in 16.7% patients in clinical grade I and 40% and 43.3% in patients in grade II and III respectively. There was a strong association of grade II and grade III with positive chest radiographic findings (p= 0.03). Patients of neurotuberculosis may have chest radiographic evidence of pulmonary TB even in the absence of pulmonary signs and symptoms at presentation. There is a strong association of clinical grade II and grade III with positive chest radiographic findings. (author)

Persistence of external signs in Pacific herring Clupea pallasii Valenciennes with ichthyophoniasis

Science.gov (United States)

Hart, Lucas M.; Conway, Carla M.; Elliott, Diane G.; Hershberger, Paul K.

2016-01-01

The progression of external signs of Ichthyophonus infection in Pacific herring Clupea pallasii Valenciennes was highly variable and asynchronous after intraperitoneal injection with pure parasite preparations; however, external signs generally persisted through the end of the study (429 days post-exposure). Observed signs included papules, erosions and ulcers. The prevalence of external signs plateaued 35 days post-exposure and persisted in 73–79% of exposed individuals through the end of the first experiment (147 days post-exposure). Among a second group of infected herring, external signs completely resolved in only 10% of the fish after 429 days. The onset of mortality preceded the appearance of external signs. Histological examination of infected skin and skeletal muscle tissues indicated an apparent affinity of the parasite for host red muscle. Host responses consisted primarily of granulomatous inflammation, fibrosis and necrosis in the skeletal muscle and other tissues. The persistence and asynchrony of external signs and host response indicated that they were neither a precursor to host mortality nor did they provide reliable metrics for hindcasting on the date of exposure. However, the long-term persistence of clinical signs in Pacific herring may be useful in ascertaining the population-level impacts of ichthyophoniasis in regularly observed populations.

Clinical application of permanent implantation of iodine 125 seeds for osseous metastases

International Nuclear Information System (INIS)

Li Jinxin; Zhang Qizhou; Li Guoliang

2010-01-01

Objective: To evaluate the clinical efficacy of permanent implantation of iodine 125 seeds in the treatment of osseous metastases. Methods: Radioactive iodine 125 seeds were implanted permanently in 32 lesions of 25 patients with osseous metastases of different origins. The ostalgia-relieving degree and the imaging alterations of the osseous metastasis lesions were observed. Results: The effective pain-relieving rate was 92% caused by permanent implantation of iodine 125 seeds. Of al 1 the patients, 15 patients achieved complete response, 8 patients obtained partial response (PR), and 2 patients had no change. The pain grade was decreased significantly after the treatment (P 125 I seeds has a definite effect on tumor metastasis and caused minimal damage and few complications. It is worthy of popularization in clinic. (authors)

Signed Language Working Memory Capacity of Signed Language Interpreters and Deaf Signers

Science.gov (United States)

Wang, Jihong; Napier, Jemina

2013-01-01

This study investigated the effects of hearing status and age of signed language acquisition on signed language working memory capacity. Professional Auslan (Australian sign language)/English interpreters (hearing native signers and hearing nonnative signers) and deaf Auslan signers (deaf native signers and deaf nonnative signers) completed an…

Information structure in Russian Sign Language and Sign Language of the Netherlands

NARCIS (Netherlands)

Kimmelman, V.

2014-01-01

This dissertation explores Information Structure in two sign languages: Sign Language of the Netherlands and Russian Sign Language. Based on corpus data and elicitation tasks we show how topic and focus are expressed in these languages. In particular, we show that topics can be marked syntactically

Warning Signs of Bullying

Science.gov (United States)

... of Aggressive Behavior Print Share Warning Signs for Bullying There are many warning signs that may indicate ... Get help right away . Signs a Child is Bullying Others Kids may be bullying others if they: ...

The effect of reflexotherapy and massage therapy on vital signs and stress before coronary angiography: An open-label clinical trial.

Science.gov (United States)

Khaledifar, Ali; Nasiri, Marzeih; Khaledifar, Borzoo; Khaledifar, Arsalan; Mokhtari, Ali

2017-03-01

Complementary medicine interventions are now successfully used to reduce stress as well as to stabilize hemodynamic indices within different procedures. The present study aimed to examine the effect of massage therapy and reflexotherapy on reducing stress in patients before coronary angiography. In this open-label clinical trial, 75 consecutive patients who were candidate for coronary angiography were randomly assigned to receive reflexotherapy (n = 25), or massage therapy (n = 25), or routine care (n = 25) before angiography. The Spielberger State-Trait Anxiety Inventory was used to determine the stress level of patients before and after interventions and vital signs were also measured. Improvement in diastolic blood pressure, heart rate, and respiratory rate was shown in the reflexotherapy group, and similar effects were observed following other interventions including massage therapy and routine resting program. In subjects who received reflexotherapy the level of stress decreased slightly compared with the other two groups. However, following interventions the level of stress in reflexotherapy group was shown to be lower than other study groups. Reflexotherapy before coronary angiography can help to stabilize vital sign as well as reduce the level of stress. The effect of massage therapy was limited to reducing stress.

Effects of Moderate Exercise on Relieving Mental Load of Elementary School Teachers

Directory of Open Access Journals (Sweden)

Shing-Hong Liu

2015-01-01

Full Text Available Long-term endurance exercise could increase activity of parasympathetic nervous and decrease activity of sympathetic nervous at rest. However, previous studies all focused on the effect of endurance training on heart rate variability (HRV for athletes or sedentary subjects. In Taiwan, elementary school teachers teaching and processing the children’s and administrative problems always stand and walk. They will sit down only when they review and correct the students’ home work. Thus, the goal of this study was to elucidate the beneficial effect of moderate intensity exercise on relieving mental load of elementary school teachers. There were 20 participants in the exercise group and another 20 participants in the nonexercise group. The exercising teachers performed 12 weeks of moderate intensity exercise training for an average of 30 minutes per day, 3 times per week. HRV was measured before and after the 4th, 6th, and 12th weeks. The time and frequency domain parameters of HRV all had significant increases between the beginning and after 12 weeks of training. However, the time and frequency domain parameters of HRV in the nonexercise group had significant decreases between the beginning and after 12 weeks of training. The long-term moderate exercises can relieve mental load of elementary school teachers. Moreover, age was the considerable factor affecting HRV in this study.

The Danish Sign Language Dictionary

DEFF Research Database (Denmark)

Kristoffersen, Jette Hedegaard; Troelsgård, Thomas

2010-01-01

The entries of the The Danish Sign Language Dictionary have four sections:  Entry header: In this section the sign headword is shown as a photo and a gloss. The first occurring location and handshape of the sign are shown as icons.  Video window: By default the base form of the sign headword...... forms of the sign (only for classifier entries). In addition to this, frequent co-occurrences with the sign are shown in this section. The signs in the The Danish Sign Language Dictionary can be looked up through:  Handshape: Particular handshapes for the active and the passive hand can be specified...... to find signs that are not themselves lemmas in the dictionary, but appear in example sentences.  Topic: Topics can be chosen as search criteria from a list of 70 topics....

Feasibility of local stress relieving close to main shell of a large vessel

International Nuclear Information System (INIS)

Hancinsky, O.A.

1978-01-01

This work determines the feasibility of local stress relieving for a circumferential pipe-to-nozzle field weld positioned close to the main shell of a large pressure vessel. This is applicable to nuclear as well as conventional vessels. ANSYS computer program is utilized to perform thermal and thermal stress analysis and ASME Pressure Vessels Code is adhered to. Conclusions and recommendations are made with a view on their applicability in practice

The prevalence and clinical significance of maxillary sinus mucous retention cysts in a general clinic population.

Science.gov (United States)

Rhodus, N L

1990-02-01

Previous studies have documented the occurrence and potential clinical significance of MSMR cysts. Studies also have alluded to a relationship between the MSMR cyst and certain signs or symptoms of disease. We determined the prevalence of MSMR cysts in a general clinic population and identified some important correlations with clinical signs and symptoms.

Modelo digital del relieve original del yacimiento Punta Gorda

Directory of Open Access Journals (Sweden)

Luis F. Mena-Matos

2003-03-01

Full Text Available Se obtiene un MDT del relieve original del yacimiento de níquel Punta Gorda, transformado por veinte años de explotación minera. Se parte de tres fuentes de información: la red de exploración espaciada a 33,33 m, precisa pero poco densa; la red de explotación espaciada a 16,67 m, densa pero imprecisa, y la tercera es la carta topográfica a escala 1: 5 000, digitalizada con vectorización semiautomática sobre las imágenes rectificadas con polinomios de 2do y 3do órdenes; ésta es poco precisa, pero representativa de la variabilidad espacial del terreno. Se compararon las fuentes de información tomando como referencia la carta topográfica y en función de estas diferencias se planificó un levantamiento de campo para el control de errores. Se compararon los puntos de control con las fuentes de información y algunas de sus combinaciones, convertidas en grids espaciados a 2 m de distancia, estos grids fueron estimados mediante interpolación lineal con triangulación de Delaunay, Kriging Ordinario (KO y Kriging con Drift Externo (KDE. Se empleó también la técnica de Jackknife, y se tomaron como destino los puntos de comprobación. Los mejores resultados se obtuvieron con KDE tomando como variable la cota de la red de explotación y como drift la carta topográfica 1: 5 000, a ésta se agregó la red de explotación para densificar la información del drift. Se eliminaron los datos no robustos y se obtuvo un MDT usando la precisión de la red de exploración y la información del comportamiento espacial del relieve brindados por la red de explotación y la carta topográfica 1: 5 000.

Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders.

Science.gov (United States)

Marklund, Susanna; Wänman, Anders

2010-09-01

To analyze whether gender, self-reported bruxism, and variations in dental occlusion predicted incidence and persistence of temporomandibular disorder (TMD) during a 2-year period. The study population comprised 280 dental students at Umeå University in Sweden. The study design was that of a case-control study within a 2-year prospective cohort. The investigation comprised a questionnaire and a clinical examination at enrolment and at 12 and 24 months. Cases (incidence) and controls (no incidence) were identified among those without signs and symptoms of TMD at the start of the study. Cases with 2-year persistence of signs and symptoms of TMD were those with such signs and symptoms at all three examinations. Clinical registrations of baseline variables were used as independent variables. Odds ratio estimates and 95% confidence intervals of the relative risks of being a case or control in relation to baseline registrations were calculated using logistic regression analyses. The analyses revealed that self-reported bruxism and crossbite, respectively increased the risk of the 2-year cumulative incidence and duration of temporomandibular joint (TMJ) signs or symptoms. Female gender was related to an increased risk of developing and maintaining myofascial pain. Signs of mandibular instability increased the risk of maintained TMD signs and symptoms during the observation period. This 2-year prospective observational study indicated that self-reported bruxism and variations in dental occlusion were linked to the incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.

The Phonetics of Head and Body Movement in the Realization of American Sign Language Signs.

Science.gov (United States)

Tyrone, Martha E; Mauk, Claude E

2016-01-01

Because the primary articulators for sign languages are the hands, sign phonology and phonetics have focused mainly on them and treated other articulators as passive targets. However, there is abundant research on the role of nonmanual articulators in sign language grammar and prosody. The current study examines how hand and head/body movements are coordinated to realize phonetic targets. Kinematic data were collected from 5 deaf American Sign Language (ASL) signers to allow the analysis of movements of the hands, head and body during signing. In particular, we examine how the chin, forehead and torso move during the production of ASL signs at those three phonological locations. Our findings suggest that for signs with a lexical movement toward the head, the forehead and chin move to facilitate convergence with the hand. By comparison, the torso does not move to facilitate convergence with the hand for signs located at the torso. These results imply that the nonmanual articulators serve a phonetic as well as a grammatical or prosodic role in sign languages. Future models of sign phonetics and phonology should take into consideration the movements of the nonmanual articulators in the realization of signs. © 2016 S. Karger AG, Basel.

Shifting the IGF-axis: An age-related decline in human tear IGF-1 correlates with clinical signs of dry eye.

Science.gov (United States)

Patel, Roshni; Zhu, Meifang; Robertson, Danielle M

2018-02-06

The human corneal epithelium expresses both the insulin-like growth factor type 1 receptor (IGF-1R) and the IGF-1R/insulin receptor (INSR) hybrid. Despite the previous identification of IGF-1 in human tear fluid, little is known regarding the regulation of IGF-1 in tear fluid and its role in corneal epithelial homeostasis. In the present study, we investigated the impact of biological parameters on the concentration of human tear levels of IGF-1. Tear levels of IGF-1 were measured in 41 healthy, human volunteers without any reported symptoms of dry eye. All volunteers underwent standard biomicroscopic examination of the cornea and tear film. In a subgroup of volunteers, corneal staining with sodium fluorescein, tear film break up time and tear production using a Schirmer's test strip were measured to assess clinical signs of dry eye. Tears were collected from the inferior tear meniscus using glass microcapillary tubes and IGF-1 levels were measured using a solid phase sandwich ELISA. Tear levels of IGF-1 were highest in young adults and significantly decreased in older adults (P = 0.003). There were no differences in tear IGF-1 between males and females (P = 0.628). Tear IGF-1 levels were correlated with tear film break up time (R = 0.738) and tear production (R = 0.826). These data indicate that there is a progressive decline in tear IGF-1 due to aging that is associated with clinical signs of dry eye. This effect is likely due to age-related changes in the lacrimal gland. Copyright © 2018 Elsevier Ltd. All rights reserved.

Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome.

Science.gov (United States)

Forootan, Mojgan; Shekarchizadeh, Masood; Farmanara, Hamedreza; Esfahani, Ahmad Reza Shekarchizadeh; Esfahani, Mansooreh Shekarchizadeh

2018-01-12

Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9 ± 45.74 months in non-responder group (P=0.22). There were more ulcers in non-responder group than responder group (1.50 ±0.71 versus 1.33±- 0.71 before and 1.30 ± 0.95 versus 0.67 ±0.50 after biofeedback), although the difference was not significant (P=0.604, 0.10 respectively). The most prevalent symptoms were constipation (79%), rectal bleeding (68%) and anorectal pain (53%). The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome

Directory of Open Access Journals (Sweden)

Mojgan Forootan

2018-03-01

Full Text Available Solitary rectal ulcer syndrome (SRUS is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9±45.74 months in non-responder group (P=0.22. There were more ulcers in non-responder group than responder group (1.50±0.71 versus 1.33±-0.71 before and 1.30 ± 0.95 versus 0.67±0.50 after biofeedback, although the difference was not significant (P=0.604, 0.10 respectively. The most prevalent symptoms were constipation (79%, rectal bleeding (68% and anorectal pain (53%. The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

New radiation warning sign

International Nuclear Information System (INIS)

Mac Kenzie, C.; Mason, C.

2006-01-01

Full text: Radiation accidents involving orphan radioactive sources have happened as a result of people not recognizing the radiation trefoil symbol or from being illiterate and not understanding a warning statement on the radiation source. The trefoil symbol has no inherent meaning to people that have not been instructed in its use. A new radiation warning sign, to supplement the existing trefoil symbol, has been developed to address these issues. Human Factors experts, United Nations member states, and members of the international community of radiation protection professionals were consulted for input on the design of a new radiation warning sign that would clearly convey the message of 'Danger- Run Away- Stay Away' when in close proximity to a dangerous source of radiation. Cultural differences of perception on various warning symbols were taken into consideration and arrays of possible signs were developed. The signs were initially tested in international children for identification with the desired message and response. Based on these test results and further input from radiation protection professionals, five warning signs were identified as the most successful in conveying the desired message and response. These five signs were tested internationally in eleven countries by a professional survey company to determine the best sign for this purpose. The conclusion of the international testing is presented. The new radiation warning sign is currently a draft ISO standard under committee review. The design of the propose d radiation warning sign and the proposed implementation strategy outlined in the draft ISO standard is presented. (authors)

Lupus and Depression: Know the Signs and How to Get Help

Science.gov (United States)

... Donate Share on Twitter Facebook Pinterest Email Print Lupus and depression: Know the signs and how to ... free of lupus. Facts about clinical depression and lupus Between 15 and 60 percent of people with ...

Green's Theorem for Sign Data

OpenAIRE

Houston, Louis M.

2012-01-01

Sign data are the signs of signal added to noise. It is well known that a constant signal can be recovered from sign data. In this paper, we show that an integral over variant signal can be recovered from an integral over sign data based on the variant signal. We refer to this as a generalized sign data average. We use this result to derive a Green's theorem for sign data. Green's theorem is important to various seismic processing methods, including seismic migration. Results in this paper ge...

A phenomenological study into the impact of the sign-off mentor in the acute hospital setting.

Science.gov (United States)

Hutchison, Trudy; Cochrane, Jill

2014-06-01

Mentoring provides an essential quality assurance mechanism within undergraduate support and assessment of nurses. Recent changes to the standards for supporting pre-registration learners in clinical practice have provided additional structure to this process. Existing evidence suggests there are numerous challenges such as balancing clinical and mentoring priorities and making appropriate decisions; evidence about the sign-off mentor role in particular is currently lacking. This study explores the impact of the sign-off mentor role within the acute setting utilising a phenomenological approach. A purposive sample of 6 sign-off mentors contributed to data collection via the use of semi-structured interviews. Data were collected using a digital tape recorder and transcribed verbatim. Analysis of findings allowed for the development of 3 main themes which are accountability, time and commitment. A key finding of this study is the change in focus for sign-off mentors to one of assessment of clinical competence and professional regulation as opposed to mentors who have concentrated on the teaching and pastoral aspects of this role. However, sustainability requires further investment in this new role from a managerial and educational perspective. Recommendations include further attempts to embed protected time into organisational processes, the consideration of limiting students to sign-off mentors when mentoring a final placement student and negotiating maximum number of exposures to this role within a set time frame. © 2013.

Signed languages and globalization

NARCIS (Netherlands)

Hiddinga, A.; Crasborn, O.

2011-01-01

Deaf people who form part of a Deaf community communicate using a shared sign language. When meeting people from another language community, they can fall back on a flexible and highly context-dependent form of communication called international sign, in which shared elements from their own sign

Dermatology Eponyms – sign –Lexicon (O

Directory of Open Access Journals (Sweden)

Piotr Brzeziński

2015-01-01

Full Text Available Eponyms are used almost daily in the clinical practice of dermatology. And yet, information about the person behind the eponyms is difficult to find. Indeed, who is? What is this person’s nationality? Is this person alive or dead? How can one find the paper in which this person first described the disease? Eponyms are used to describe not only disease, but also clinical signs, surgical procedures, staining techniques, pharmacological formulations, and even pieces of equipment. In this article we present the symptoms starting with (O and other. The symptoms and their synonyms, and those who have described this symptom or phenomenon.

Tranexamic acid for acute intracerebral hemorrhage growth predicted by spot sign trial: Rationale and design.

Science.gov (United States)

Liu, Liping; Wang, Yilong; Meng, Xia; Li, Na; Tan, Ying; Nie, Ximing; Liu, Dacheng; Zhao, Xingquan

2017-04-01

Rationale Acute intracerebral hemorrhage inflicts a high-economic and -health burden. Computed tomography angiography spot sign is a predictor of hematoma expansion, is associated with poor clinical outcome and is an important stratifying variable for patients treated with haemostatic therapy. Aims We aim to compare the effect of treatment with tranexamic acid to placebo for the prevention of hemorrhage growth in patients with high-risk acute intracerebral hemorrhage with a positive spot sign. Design The tranexamic acid for acute intracerebral hemorrhage growth predicted by spot sign (TRAIGE) is a prospective, multicenter, placebo-controlled, double-blind, investigator-led, randomized clinical trial that will include an estimated 240 participants. Patients with intracerebral hemorrhage demonstrating symptom onset within 8 h and with the spot sign as a biomarker for ongoing hemorrhage, and no contraindications for antifibrinolytic therapy, will be enrolled to receive either tranexamic acid or placebo. The primary outcome measure is the presence of hemorrhage growth defined as an increase in intracerebral hemorrhage volume >33% or >6 ml from baseline to 24 ± 2 h. The secondary outcomes include safety and clinical outcomes. Conclusion The TRAIGE trial evaluates the efficacy of haemostatic therapy with tranexamic acid in the prevention of hemorrhage growth among high-risk patients with acute intracerebral hemorrhage.

Extending role by Japanese pharmacists after training for performing vital signs monitoring

Directory of Open Access Journals (Sweden)

Hasegawa F

2014-09-01

Full Text Available Background: In Japan, the circumstances in which pharmacists work are changing. Pharmacists are expected to assess conditions of patients subject to medication to ensure proper use of pharmaceutical products. To ensure fulfilment of these roles, there have already been pharmacists’ efforts in performing vital signs monitoring. Objective: To clarify the necessity and related issues, by investigating the state of vital sign monitoring in clinical field by pharmacists who have been trained in vital sign monitoring. Method: A web survey was conducted from 4th October to 3rd December 2012, subjecting 1,026 pharmacists who completed the vital signs training hosted by The Japanese Association of Home Care Pharmacies (JAHCP. Survey items were 1 basic information of a respondent, 2 situation of homecare conducted by pharmacists, 3 seminar attendance status, and 4 vital signs monitoring status after the seminar. Results: The number of valid respondents was 430 and the response rate was 41.9%. As a result of the present research, it was revealed that 168 pharmacists (41.4%, had the opportunity to perform vital signs monitoring. By conducting vital sign monitoring, effects such as 1 improved motivation of pharmacists and better communication with patients, 2 proper use of medication, and 3 cost reduction were confirmed. Conclusion: Judging from the results of the survey, pharmacists can improve medication therapy for patients by attaining vital sign skills and conduct vital sign monitoring. Pharmacists who perform vital sign monitoring should share cases where they experienced positive patient outcomes.

Crossed Leg Sign Is Associated With Severity of Unilateral Spatial Neglect After Stroke

Directory of Open Access Journals (Sweden)

Gustavo José Luvizutto

2018-04-01

Full Text Available BackgroundThe crossed leg sign in patients with right hemisphere stroke is thought to be associated with perceptual disorders, such as unilateral spatial neglect (USN. The aim of this study was to compare the crossed leg sign with the severity of USN during the acute phase of stroke.Experimental proceduresThis was an observational and prospective clinical study of individuals with a diagnosis of right parietal stroke, as confirmed by neuroimaging. The occurrence of the crossed leg sign, the time at which this occurred after the stroke, and a clinical diagnosis of USN were measured and recorded. The patients’ age, sex, and lesion severity, as determined by the National Institutes of Health Stroke Scale and Glasgow coma scale, were included in the analyses as confounding variables. The outcome of interest was the degree of USN, as measured by the cancellation and bisection tests. Binary logistic regression was used to analyze the effect of crossed leg syndrome on the severity of USN. In the adjusted multiple regression model, a p-value of <0.05 was considered statistically significant.ResultsOverall, 60 patients were included in this study. There were no associations between patient demographics and the presence of the crossed leg sign. There was, however, an association between the crossed leg sign and the absolute value of the deviation in the line bisection test (B = −0.234; p = 0.039. The crossed leg sign was not associated with other measures of USN.ConclusionBased on the results of our study, we can conclude that a crossed leg sign in the acute phase of stroke is associated with USN severity, specifically the misinterpretation of the midline.

On the temporal dynamics of sign production: An ERP study in Catalan Sign Language (LSC).

Science.gov (United States)

Baus, Cristina; Costa, Albert

2015-06-03

This study investigates the temporal dynamics of sign production and how particular aspects of the signed modality influence the early stages of lexical access. To that end, we explored the electrophysiological correlates associated to sign frequency and iconicity in a picture signing task in a group of bimodal bilinguals. Moreover, a subset of the same participants was tested in the same task but naming the pictures instead. Our results revealed that both frequency and iconicity influenced lexical access in sign production. At the ERP level, iconicity effects originated very early in the course of signing (while absent in the spoken modality), suggesting a stronger activation of the semantic properties for iconic signs. Moreover, frequency effects were modulated by iconicity, suggesting that lexical access in signed language is determined by the iconic properties of the signs. These results support the idea that lexical access is sensitive to the same phenomena in word and sign production, but its time-course is modulated by particular aspects of the modality in which a lexical item will be finally articulated. Copyright © 2015 Elsevier B.V. All rights reserved.

Gender-related differences in clinical presentation, electrocardiography signs, laboratory markers and outcome in patients with acute pulmonary embolism.

Science.gov (United States)

Obradović, Slobodan; Džudović, Boris; Rusović, Siniša; Subota, Vesna; Obradović, Dragana

2016-09-01

Acute pulmonary embolism (PE) is a potentially life threating event, but there are scarce data about genderrelated differences in this condition. The aim of this study was to identify gender-specific differences in clinical presentation, the diagnosis and outcome between male and female patients with PE. We analysed the data of 144 consecutive patients with PE (50% women) and compared female and male patients regarding clinical presentation, electrocardiography (ECG) signs, basic laboratory markers and six-month outcome. All the patients confirmed PE by visualized thrombus on the multidetector computed tomography with pulmonary angiography (MDCTPA), ECG and echocardiographic examination at admission. Compared to the men, the women were older and a larger proportion of them was in the third tertile of age (66.0% vs 34.0%, p = 0.008). In univariate analysis the men more often had hemoptysis [OR (95% CI) 3.75 (1.16-12.11)], chest pain [OR (95% CI) 3.31 (1.57-7.00)] febrile state [OR (95% CI) 2.41 (1.12-5.22)] and pneumonia at PE presentation [OR (95% CI) 3.40 (1.25-9.22)] and less likely had heart decompensation early in the course of the disease [OR (95%CI) 0.48 (0.24-0.97)]. In the multivariate analysis a significant difference in the rate of pneumonia and acute heart failure between genders disappeared due to strong influence of age. There was no significant difference in the occurrence of typical ECG signs for PE between the genders. Women had higher level of admission glycaemia [7.7 mmol/L (5.5-8.2 mmol/L) vs 6.9 mmol/L (6.3-9.6 mmol/L), p = 0.006] and total number of leukocytes [10.5 x 109/L (8.8-12.7 x 109/L vs 8.7 x 109/L (7.0-11.6 x 109/L)), p = 0.007]. There was a trend toward higher plasma level of brain natriuretic peptide in women compared to men 127.1 pg/mL (55.0-484.0 pg/mL), p = 0.092] vs [90.3 pg/mL (39.2-308.5 pg/mL). The main 6-month outcomes, death and major bleeding, had similar frequencies in both sexes. There are several important differences

Autocorrelation descriptor improvements for QSAR: 2DA_Sign and 3DA_Sign

Science.gov (United States)

Sliwoski, Gregory; Mendenhall, Jeffrey; Meiler, Jens

2016-03-01

Quantitative structure-activity relationship (QSAR) is a branch of computer aided drug discovery that relates chemical structures to biological activity. Two well established and related QSAR descriptors are two- and three-dimensional autocorrelation (2DA and 3DA). These descriptors encode the relative position of atoms or atom properties by calculating the separation between atom pairs in terms of number of bonds (2DA) or Euclidean distance (3DA). The sums of all values computed for a given small molecule are collected in a histogram. Atom properties can be added with a coefficient that is the product of atom properties for each pair. This procedure can lead to information loss when signed atom properties are considered such as partial charge. For example, the product of two positive charges is indistinguishable from the product of two equivalent negative charges. In this paper, we present variations of 2DA and 3DA called 2DA_Sign and 3DA_Sign that avoid information loss by splitting unique sign pairs into individual histograms. We evaluate these variations with models trained on nine datasets spanning a range of drug target classes. Both 2DA_Sign and 3DA_Sign significantly increase model performance across all datasets when compared with traditional 2DA and 3DA. Lastly, we find that limiting 3DA_Sign to maximum atom pair distances of 6 Å instead of 12 Å further increases model performance, suggesting that conformational flexibility may hinder performance with longer 3DA descriptors. Consistent with this finding, limiting the number of bonds in 2DA_Sign from 11 to 5 fails to improve performance.

Black Hole Sign Predicts Poor Outcome in Patients with Intracerebral Hemorrhage.

Science.gov (United States)

Li, Qi; Yang, Wen-Song; Chen, Sheng-Li; Lv, Fu-Rong; Lv, Fa-Jin; Hu, Xi; Zhu, Dan; Cao, Du; Wang, Xing-Chen; Li, Rui; Yuan, Liang; Qin, Xin-Yue; Xie, Peng

2018-01-01

In spontaneous intracerebral hemorrhage (ICH), black hole sign has been proposed as a promising imaging marker that predicts hematoma expansion in patients with ICH. The aim of our study was to investigate whether admission CT black hole sign predicts hematoma growth in patients with ICH. From July 2011 till February 2016, patients with spontaneous ICH who underwent baseline CT scan within 6 h of symptoms onset and follow-up CT scan were recruited into the study. The presence of black hole sign on admission non-enhanced CT was independently assessed by 2 readers. The functional outcome was assessed using the modified Rankin Scale (mRS) at 90 days. Univariate and multivariable logistic regression analyses were performed to assess the association between the presence of the black hole sign and functional outcome. A total of 225 patients (67.6% male, mean age 60.3 years) were included in our study. Black hole sign was identified in 32 of 225 (14.2%) patients on admission CT scan. The multivariate logistic regression analysis demonstrated that age, intraventricular hemorrhage, baseline ICH volume, admission Glasgow Coma Scale score, and presence of black hole sign on baseline CT independently predict poor functional outcome at 90 days. There are significantly more patients with a poor functional outcome (defined as mRS ≥4) among patients with black hole sign than those without (84.4 vs. 32.1%, p black hole sign independently predicts poor outcome in patients with ICH. Early identification of black hole sign is useful in prognostic stratification and may serve as a potential therapeutic target for anti-expansion clinical trials. © 2018 S. Karger AG, Basel.

Clarifying Delirium Management: Practical, Evidenced-Based, Expert Recommendations for Clinical Practice

Science.gov (United States)

Pirrello, Rosene D.; Hirst, Jeremy M.; Buckholz, Gary T.; Ferris, Frank D.

2013-01-01

Abstract Delirium is highly prevalent in those with serious or advanced medical illnesses. It is associated with many adverse consequences, including significant patient, family, and health care provider distress. This article suggests a novel approach to delirium assessment and management and provides useful, practical guidance for clinicians based on a complete review of the existing literature and the expert clinical opinion of the authors and their colleagues, derived from over a decade of collective bedside experience. Comprehensive assessment includes careful description of observed symptoms, signs, and behaviors; and an understanding of the patient's situation, including primary diagnosis, associated comorbidities, functional status, and prognosis. The importance of incorporating goals of care for the patient and family is discussed. The concepts of potential reversibility versus irreversible delirium and delirium subtype are proffered, with a description of how diagnostic and management strategies follow from these concepts. Pharmacological interventions that provide rapid, effective, and safe relief are presented. Employing both pharmacological and nonpharmacological interventions, including patient and family education, improves symptoms and relieves patient and family distress, whether the delirium is reversible or irreversible, hyperactive or hypoactive. All interventions can be provided in any setting of care, including patients' homes. PMID:23480299

Chinese Medicinal Formula (MHGWT for Relieving Diabetic Neuropathic Pain: A Randomized, Double-Blind, Placebo-Controlled Trial

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Chia-I Tsai

2013-01-01

Full Text Available Objective. To investigate the effects of modified Hungqi Guizhi Wuwu Tang (MHGWT, a formula that comprises Chinese medicinal herbs, in relieving neuropathic pain in diabetics. Method. Between March 2008 and April 2009, 112 participants were randomly assigned to either the MHGWT group, whose members received MHGWT (n=56, or the control group, whose members received a placebo (n=56. Diabetic neuropathic pain (DNP was rated using the 15-item Short-Form Brief Pain Inventory (SF-BPI, the 17-item Short-Form McGill Pain Questionnaire (SF-MPQ, the 13-item Modified Michigan Neuropathy Screening Instrument (MMNSI, and the 36-item “SF-36.” Nerve conduction studies (NCSs were performed before and after treatment. Results. After 12 weeks of treatment, the SF-MPQ and SF-BPI scores of the MHGWT group were significantly (P0.05 reduced, and no significant difference in NCS level was observed between the groups (P>0.05. Conclusions. MHGWT shows promise in relieving DNP and deserves further investigation.

British Sign Name Customs

Science.gov (United States)

Day, Linda; Sutton-Spence, Rachel

2010-01-01

Research presented here describes the sign names and the customs of name allocation within the British Deaf community. While some aspects of British Sign Language sign names and British Deaf naming customs differ from those in most Western societies, there are many similarities. There are also similarities with other societies outside the more…

Negation switching invariant signed graphs

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Deepa Sinha

2014-04-01

Full Text Available A signed graph (or, $sigraph$ in short is a graph G in which each edge x carries a value $\\sigma(x \\in \\{-, +\\}$ called its sign. Given a sigraph S, the negation $\\eta(S$ of the sigraph S is a sigraph obtained from S by reversing the sign of every edge of S. Two sigraphs $S_{1}$ and $S_{2}$ on the same underlying graph are switching equivalent if it is possible to assign signs `+' (`plus' or `-' (`minus' to vertices of $S_{1}$ such that by reversing the sign of each of its edges that has received opposite signs at its ends, one obtains $S_{2}$. In this paper, we characterize sigraphs which are negation switching invariant and also see for what sigraphs, S and $\\eta (S$ are signed isomorphic.

Clinical Signs, Causes, and Risk Factors of Pediatric Chronic Kidney Diseases: a Hospital-based Case-control Study

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Parsa Yousefichaijan

2016-06-01

Full Text Available Background This retrospective study aimed to determine the epidemiologic characteristics and risk factors of chronic kidney diseases (CKD in patients < 18 years old at a single referral center. Materials and Methods In a hospital-based case control study, 66 CKD patients less than 18 years old were compared to 81 control patients (also under 18 without CKD. A patient was defined as a CKD case with renal injury and/or had a glomerular filtration rate (GFR of Results Fever, chills, and urinary tract infections were the most common clinical signs in the referred patients. Urinary tract infection (39.5% and growth failure (12.9% were the most important causes in referred pediatric CKD. After controlling the effect of confounding variables, household income, using packed water for drinking, percentile of body mass index (BMI, and gestational age were the significant predictors of pediatric CKD (P

The Shepherd's Crook Sign: A New Neuroimaging Pareidolia in Joubert Syndrome.

Science.gov (United States)

Manley, Andrew T; Maertens, Paul M

2015-01-01

By pareidolically recognizing specific patterns indicative of particular diseases, neuroimagers reinforce their mnemonic strategies and improve their neuroimaging diagnostic skills. Joubert Syndrome (JS) is an autosomal recessive disorder characterized clinically by mental retardation, episodes of abnormal deep and rapid breathing, abnormal eye movements, and ataxia. Many neuroimaging signs characteristic of JS have been reported. In retrospective case study, two consanguineous neonates diagnosed with JS were evaluated with brain magnetic resonance imaging (MRI), computed tomography (CT), and neurosonography. Both cranial ultrasound and MRI of the brain showed the characteristic molar tooth sign. There was a shepherd's crook in the sagittal views of the posterior fossa where the shaft of the crook is made by the brainstem and the pons. The arc of the crook is made by the abnormal superior cerebellar peduncle and cerebellar hemisphere. By ultrasound, the shepherd's crook sign was seen through the posterior fontanelle only. CT imaging also showed the shepherd's crook sign. Neuroimaging diagnosis of JS, which already involves the pareidolical recognition of specific patterns indicative of the disease, can be improved by recognition of the shepherd's crook sign on MRI, CT, and cranial ultrasound. Copyright © 2014 by the American Society of Neuroimaging.

Pathology, clinical signs, and tissue distribution of Toxoplasma gondii in experimentally infected reindeer (Rangifer tarandus

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Émilie Bouchard

2017-12-01

Full Text Available Toxoplasma gondii is a zoonotic parasite found in vertebrates worldwide for which felids serve as definitive hosts. Despite low densities of felids in northern Canada, Inuit people in some regions show unexpectedly high levels of exposure, possibly through handling and consumption of Arctic wildlife. Free-ranging caribou (Rangifer tarandus are widely harvested for food across the Canadian North, show evidence of seroexposure to T. gondii, and are currently declining in numbers throughout the Arctic. We experimentally infected three captive reindeer (conspecific with caribou with 1000, 5000 or 10,000 oocysts of T. gondii via stomach intubation to assess clinical signs of infection, pathology, and tissue distribution. An unexposed reindeer served as a negative control. Signs of stress, aggression, and depression were noted for the first two weeks following infection. By 4 weeks post infection, all infected reindeer were positive on a modified agglutination test at the highest titer tested (1:200 for antibodies to T. gondii. At 20 weeks post infection, no gross abnormalities were observed on necropsy. Following histopathology and immunohistochemistry, tissue cysts were visualized in the reindeer given the highest and lowest dose of oocysts. Focal pleuritis and alveolitis were associated with respiratory problems in reindeer given the middle dose. DNA of T. gondii was detected following traditional DNA extraction and conventional PCR on 25 mg samples from 17/33 muscles and organs, and by magnetic capture DNA extraction from 100 g samples from all 26 tissues examined. This research demonstrated that reindeer/caribou can serve as intermediate hosts for T. gondii, and that the parasite may be associated with health effects in wildlife. The presence of T. gondii in all tissues tested, many of which are commonly consumed raw, smoked, or dried in northern communities, suggests that caribou may serve as a source of human exposure to T

The effect of reflexotherapy and massage therapy on vital signs and stress before coronary angiography: An open-label clinical trial

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Ali Khaledifar

2017-05-01

Full Text Available BACKGROUND: Complementary medicine interventions are now successfully used to reduce stress as well as to stabilize hemodynamic indices within different procedures. The present study aimed to examine the effect of massage therapy and reflexotherapy on reducing stress in patients before coronary angiography. METHODS: In this open-label clinical trial, 75 consecutive patients who were candidate for coronary angiography were randomly assigned to receive reflexotherapy (n = 25, or massage therapy (n = 25, or routine care (n = 25 before angiography. The Spielberger State-Trait Anxiety Inventory was used to determine the stress level of patients before and after interventions and vital signs were also measured. RESULTS: Improvement in diastolic blood pressure, heart rate, and respiratory rate was shown in the reflexotherapy group, and similar effects were observed following other interventions including massage therapy and routine resting program. In subjects who received reflexotherapy the level of stress decreased slightly compared with the other two groups. However, following interventions the level of stress in reflexotherapy group was shown to be lower than other study groups. CONCLUSION: Reflexotherapy before coronary angiography can help to stabilize vital sign as well as reduce the level of stress. The effect of massage therapy was limited to reducing stress.   

Signs of political economy

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Bernard Lamizet

2015-12-01

Full Text Available Like any political system, economy is a system of signs and representations. The Semiotics of economy elaborates its analytical methods to interpret such signs, which give meaning to the economy by representing its performances in public debate and in the media. Four major features distinguish the Semiotics of political economy from other semiotic forms or other systems of information and political representation. First of all, the relationship between the signification of the economy and the real or the imaginary phenomena to which they refer always pertains to the order of values. The second characteristic of economic signs is the significance of the state of lack they express. The third characteristic of signs of the economy is the form of sign production, which can be designated by the concept of emission of signs and their diffusion. Finally, as all signs, the economic sign is arbitrary. In the field of Economics, such arbitrariness does not imply that the Subject is free to superimpose whatever value to the signs themselves, but refers to the rupture between the world and its possible transformation. The very meaning of the word economy is here at stake. Oikos, in Greek (the term from which the word economy is derived refers to a known, familiar space. Economy transforms the real, natural world into a symbolic social world, into a world of relations with others whom we recognise and whose actions are relatively predictable. It might be useful to consider the contemporary issue of debt, its implications and its multiple meanings, which includes both the ethical and moral dimension of the condemnation of debt as well as the imaginary political dimension based on the expression of an idea of independence.

Planning Sign Languages: Promoting Hearing Hegemony? Conceptualizing Sign Language Standardization

Science.gov (United States)

Eichmann, Hanna

2009-01-01

In light of the absence of a codified standard variety in British Sign Language and German Sign Language ("Deutsche Gebardensprache") there have been repeated calls for the standardization of both languages primarily from outside the Deaf community. The paper is based on a recent grounded theory study which explored perspectives on sign…

Signs of the arctic: Typological aspects of Inuit Sign Language

NARCIS (Netherlands)

Schuit, J.M.

2014-01-01

In this thesis, the native sign language used by deaf Inuit people is described. Inuit Sign Language (IUR) is used by less than 40 people as their sole means of communication, and is therefore highly endangered. Apart from the description of IUR as such, an additional goal is to contribute to the

Clinical prognosis of patients with diagnosed chronic solvent intoxication

Energy Technology Data Exchange (ETDEWEB)

Juntunen, J; Antti-Poika, M; Tola, S; Partanen, T

1982-05-01

The clinical symptoms and signs of 80 patients with chronic organic solvent intoxication were evaluated after 3-9 years (mean 5.8 years) of follow-up. Thirty-one of the patients had slight clinical neurological signs at the time of diagnosis while the rest of the patients had only neurophysiological or psychological disturbances. The most common subjective symptoms were headache, tiredness and memory disturbances. Of the clinical signs, disturbances occurred frequently in cerebellar functions, gait and station and fine motorics. In addition, psycho-organic alteration and neurasthenic signs were often found. After the follow-up clinical signs of impairment in the nervous system were present in 42 cases. At the group level, the subjective symptoms decreased during the follow-up but the objective clinical signs increased and worsened. Only the prognosis of disturbances in gait and station correlated with the duration and intensity of exposure. The present results emphasize the great difficulties arising in occupational neurology regarding chronic organic solvent intoxications. No clear-cut clinical picture exists and reliable estimation of prognosis in general cannot be made on the basis of the present knowledge.

Ranks of dense alternating sign matrices and their sign patterns

Czech Academy of Sciences Publication Activity Database

Fiedler, Miroslav; Gao, W.; Hall, F.J.; Jing, G.; Li, Z.; Stroev, M.

2015-01-01

Roč. 471, April (2015), s. 109-121 ISSN 0024-3795 R&D Projects: GA ČR(CZ) GA14-07880S Institutional support: RVO:67985840 Keywords : alternating sign matrix * dense matrix * sign pattern matrix Subject RIV: BA - General Mathematics Impact factor: 0.965, year: 2015 http://www.sciencedirect.com/science/article/pii/S0024379515000257

Dermatology eponyms – phenomen / sign – Lexicon (F

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Piotr Brzezinski

2012-01-01

Full Text Available Eponyms are used almost daily in the clinical practice of dermatology. And yet, information about the person behind the eponyms is difficult to find. Indeed, who is? What is this person's nationality? Is this person alive or dead? How can one find the paper in which this person first described the disease? Eponyms are used to describe not only disease, but also clinical signs, surgical procedures, staining techniques, pharmacological formulations, and even pieces of equipment. In this article we present the symptoms starting with (F. The symptoms and their synonyms, and those who have described this symptom or phenomenon.

Sociolinguistic Variation and Change in British Sign Language Number Signs: Evidence of Leveling?

Science.gov (United States)

Stamp, Rose; Schembri, Adam; Fenlon, Jordan; Rentelis, Ramas

2015-01-01

This article presents findings from the first major study to investigate lexical variation and change in British Sign Language (BSL) number signs. As part of the BSL Corpus Project, number sign variants were elicited from 249 deaf signers from eight sites throughout the UK. Age, school location, and language background were found to be significant…

Mediastinal involvement in lymphangiomatosis: a previously unreported MRI sign

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Shah, Vikas; Shah, Sachit; Barnacle, Alex; McHugh, Kieran [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); Sebire, Neil J. [Great Ormond Street Hospital for Children, Department of Histopathology, London (United Kingdom); Brock, Penelope [Great Ormond Street Hospital for Children, Department of Oncology, London (United Kingdom); Harper, John I. [Great Ormond Street Hospital for Children, Department of Dermatology, London (United Kingdom)

2011-08-15

Multifocal lymphangiomatosis is a rare systemic disorder affecting children. Due to its rarity and wide spectrum of clinical, histological and imaging features, establishing the diagnosis of multifocal lymphangiomatosis can be challenging. The purpose of this study was to describe a new imaging sign in this disorder: paraspinal soft tissue and signal abnormality at MRI. We retrospectively reviewed the imaging, clinical and histopathological findings in a cohort of eight children with thoracic involvement from this condition. Evidence of paraspinal chest disease was identified at MRI and CT in all eight of these children. The changes comprise heterogeneous intermediate-to-high signal parallel to the thoracic vertebrae on T2-weighted sequences at MRI, with abnormal paraspinal soft tissue at CT and plain radiography. Multifocal lymphangiomatosis is a rare disorder with a broad range of clinicopathological and imaging features. MRI allows complete evaluation of disease extent without the use of ionising radiation and has allowed us to describe a previously unreported imaging sign in this disorder, namely, heterogeneous hyperintense signal in abnormal paraspinal tissue on T2-weighted images. (orig.)

Kinetic mechanism of an aldehyde reductase of Saccharomyces cerevisiae that relieves toxicity of furfural and 5-hydroxymethylfurfural

Science.gov (United States)

An effective means of relieving the toxicity of furan aldehydes, furfural (FFA) and 5-hydroxymethylfurfural (HMF), on fermenting organisms is essential for achieving efficient fermentation of lignocellulosic biomass to ethanol and other products. Ari1p, an aldehyde reductase from Saccharomyces cerev...

Experiences of health science students during clinical placements at ...

African Journals Online (AJOL)

Inadequate supervision and inappropriate behaviours by supervisors were some of the challenges faced. Almost 89% used stress-relieving strategies such as focusing on why they were doing the clinical placement and the importance of successful completion. Ninety-one per cent had never used cannabis/mbanje but 41% ...

Adolf Kussmaul and Kussmaul's sign

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Navreet Singh

2015-01-01

Full Text Available Kussmaul's has provided us with three important signs: Pulses paradoxus, Kussmaul's sign and Kussmaul Breathing. This article discusses Kussmaul's sign, its discovery, first description, pathophyiology and exceptions.

Avaliação clínica de sinais e sintomas da disfunção temporomandibular em crianças Clinical evaluation of signs and symptoms of children’s temporomandibular dysfunction

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Eduardo César Almada Santos

2006-04-01

Full Text Available OBJETIVO: avaliar a freqüência dos sinais e sintomas, dos hábitos parafuncionais e das características oclusais de 80 crianças, pacientes da clínica de Ortodontia Preventiva da Faculdade de Odontologia de Araçatuba - UNESP. METODOLOGIA: o exame clínico constituiu-se de avaliação das características oclusais do paciente e observação da presença de hábitos parafuncionais. As crianças foram submetidas a uma entrevista, supervisionadas pelos pais, cujas perguntas relacionavam-se com os sinais e sintomas da disfunção. RESULTADOS E CONCLUSÕES: concluiu-se que os sinais e sintomas mais freqüentes foram o hábito de ranger os dentes, dores de cabeça e ruídos na ATM. A onicofagia e o bruxismo foram os hábitos parafuncionais mais prevalentes. A freqüência de sinais e sintomas da disfunção temporomandibular pode ser verificada em crianças por meio da entrevista e exame clínico minucioso.AIM: to assess the frequency of signs and symptoms of the parafunctional habits and of the occlusal characteristics of 80 children, patients of the Preventive Orthodontics Clinic at Araçatuba’s Faculty of Dentistry - UNESP. METHODS: the clinical test comprised evaluation of the patient’s occlusal characteristics and observation of the presence of parafunctional habits. The children were submitted to a parent-supervised interview, whose questions were related to the signs and symptoms of the dysfunction. RESULTS AND CONCLUSION: we concluded that the most frequent signs and symptoms were teeth-grinding, headache and ATM noises. The most prevalent parafunctional habits were onicophagy and bruxism. The frequency of signs and symptoms of temporomandibular dysfunction can be noticed in children through interview and a detailed clinical test.

DIFFERENCES BETWEEN AMERICAN SIGN LANGUAGE (ASL AND BRITISH SIGN LANGUAGE (BSL

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Zora JACHOVA

2008-06-01

Full Text Available In the communication of deaf people between them­selves and hearing people there are three ba­sic as­pects of interaction: gesture, finger signs and writing. The gesture is a conditionally agreed manner of communication with the help of the hands followed by face and body mimic. The ges­ture and the move­ments pre-exist the speech and they had the purpose to mark something, and later to emphasize the speech expression.Stokoe was the first linguist that realised that the signs are not a whole that can not be analysed. He analysed signs in insignificant parts that he called “chemeres”, and many linguists today call them pho­nemes. He created three main phoneme catego­ries: hand position, location and movement.Sign languages as spoken languages have back­ground from the distant past. They developed par­allel with the development of spoken language and undertook many historical changes. Therefore, to­day they do not represent a replacement of the spoken language, but are languages themselves in the real sense of the word.Although the structures of the English language used in USA and in Great Britain is the same, still their sign languages-ASL and BSL are different.

Accuracy of clinical signs, SEP, and EEG in predicting outcome of hypoxic coma: a meta-analysis.

Science.gov (United States)

Lee, Y C; Phan, T G; Jolley, D J; Castley, H C; Ingram, D A; Reutens, D C

2010-02-16

Accurate prediction of neurologic outcome after hypoxic coma is important. Previous systematic reviews have not used summary statistics to summarize and formally compare the accuracy of different prognostic tests. We therefore used summary receiver operating characteristic curve (SROC) and cluster regression methods to compare motor and pupillary responses with sensory evoked potential (SEP) and EEG in predicting outcome after hypoxic coma. We searched PubMed, MEDLINE, and Embase (1966-2007) for reports in English, German, and French and identified 25 suitable studies. An SROC was constructed for each marker (SEP, EEG, M1 and M SEP was larger than those for M1, M SEP (AUC 0.891) and that for M1 (AUC 0.786) was small (0.105, 95% confidence interval 0.023-0.187), only reaching significance on day 1 after coma onset. The use of M SEP) is marginally better than M1 at predicting outcome after hypoxic coma. However, the superiority of SEP diminishes after day 1 and when M SEP is a better marker than clinical signs.

Phantom-based standardization of CT angiography images for spot sign detection

International Nuclear Information System (INIS)

Morotti, Andrea; Rosand, Jonathan; Romero, Javier M.; Jessel, Michael J.; Vashkevich, Anastasia; Schwab, Kristin; Greenberg, Steven M.; Hernandez, Andrew M.; Boone, John M.; Burns, Joseph D.; Shah, Qaisar A.; Bergman, Thomas A.; Suri, M.F.K.; Ezzeddine, Mustapha; Kirmani, Jawad F.; Agarwal, Sachin; Hays Shapshak, Angela; Messe, Steven R.; Venkatasubramanian, Chitra; Palmieri, Katherine; Lewandowski, Christopher; Chang, Tiffany R.; Chang, Ira; Rose, David Z.; Smith, Wade; Hsu, Chung Y.; Liu, Chun-Lin; Lien, Li-Ming; Hsiao, Chen-Yu; Iwama, Toru; Afzal, Mohammad Rauf; Qureshi, Adnan I.; Cassarly, Christy; Hebert Martin, Renee; Goldstein, Joshua N.

2017-01-01

The CT angiography (CTA) spot sign is a strong predictor of hematoma expansion in intracerebral hemorrhage (ICH). However, CTA parameters vary widely across centers and may negatively impact spot sign accuracy in predicting ICH expansion. We developed a CT iodine calibration phantom that was scanned at different institutions in a large multicenter ICH clinical trial to determine the effect of image standardization on spot sign detection and performance. A custom phantom containing known concentrations of iodine was designed and scanned using the stroke CT protocol at each institution. Custom software was developed to read the CT volume datasets and calculate the Hounsfield unit as a function of iodine concentration for each phantom scan. CTA images obtained within 8 h from symptom onset were analyzed by two trained readers comparing the calibrated vs. uncalibrated density cutoffs for spot sign identification. ICH expansion was defined as hematoma volume growth >33%. A total of 90 subjects qualified for the study, of whom 17/83 (20.5%) experienced ICH expansion. The number of spot sign positive scans was higher in the calibrated analysis (67.8 vs 38.9% p < 0.001). All spot signs identified in the non-calibrated analysis remained positive after calibration. Calibrated CTA images had higher sensitivity for ICH expansion (76 vs 52%) but inferior specificity (35 vs 63%) compared with uncalibrated images. Normalization of CTA images using phantom data is a feasible strategy to obtain consistent image quantification for spot sign analysis across different sites and may improve sensitivity for identification of ICH expansion. (orig.)

Phantom-based standardization of CT angiography images for spot sign detection.

Science.gov (United States)

Morotti, Andrea; Romero, Javier M; Jessel, Michael J; Hernandez, Andrew M; Vashkevich, Anastasia; Schwab, Kristin; Burns, Joseph D; Shah, Qaisar A; Bergman, Thomas A; Suri, M Fareed K; Ezzeddine, Mustapha; Kirmani, Jawad F; Agarwal, Sachin; Shapshak, Angela Hays; Messe, Steven R; Venkatasubramanian, Chitra; Palmieri, Katherine; Lewandowski, Christopher; Chang, Tiffany R; Chang, Ira; Rose, David Z; Smith, Wade; Hsu, Chung Y; Liu, Chun-Lin; Lien, Li-Ming; Hsiao, Chen-Yu; Iwama, Toru; Afzal, Mohammad Rauf; Cassarly, Christy; Greenberg, Steven M; Martin, Renee' Hebert; Qureshi, Adnan I; Rosand, Jonathan; Boone, John M; Goldstein, Joshua N

2017-09-01

The CT angiography (CTA) spot sign is a strong predictor of hematoma expansion in intracerebral hemorrhage (ICH). However, CTA parameters vary widely across centers and may negatively impact spot sign accuracy in predicting ICH expansion. We developed a CT iodine calibration phantom that was scanned at different institutions in a large multicenter ICH clinical trial to determine the effect of image standardization on spot sign detection and performance. A custom phantom containing known concentrations of iodine was designed and scanned using the stroke CT protocol at each institution. Custom software was developed to read the CT volume datasets and calculate the Hounsfield unit as a function of iodine concentration for each phantom scan. CTA images obtained within 8 h from symptom onset were analyzed by two trained readers comparing the calibrated vs. uncalibrated density cutoffs for spot sign identification. ICH expansion was defined as hematoma volume growth >33%. A total of 90 subjects qualified for the study, of whom 17/83 (20.5%) experienced ICH expansion. The number of spot sign positive scans was higher in the calibrated analysis (67.8 vs 38.9% p spot signs identified in the non-calibrated analysis remained positive after calibration. Calibrated CTA images had higher sensitivity for ICH expansion (76 vs 52%) but inferior specificity (35 vs 63%) compared with uncalibrated images. Normalization of CTA images using phantom data is a feasible strategy to obtain consistent image quantification for spot sign analysis across different sites and may improve sensitivity for identification of ICH expansion.

Phantom-based standardization of CT angiography images for spot sign detection

Energy Technology Data Exchange (ETDEWEB)

Morotti, Andrea; Rosand, Jonathan [Harvard Medical School, Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA (United States); Romero, Javier M. [Harvard Medical School, Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, Neuroradiology Service, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Jessel, Michael J.; Vashkevich, Anastasia; Schwab, Kristin; Greenberg, Steven M. [Harvard Medical School, J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA (United States); Hernandez, Andrew M.; Boone, John M. [University of California Davis, Department of Radiology, Sacramento, CA (United States); Burns, Joseph D. [Lahey Hospital and Medical Center, Department of Neurology, Burlington, MA (United States); Shah, Qaisar A. [Abington Memorial Hospital, Abington, PA (United States); Bergman, Thomas A. [Hennepin County Medical Center, Minneapolis, MN (United States); Suri, M.F.K. [St. Cloud Hospital, St. Cloud, MN (United States); Ezzeddine, Mustapha [University of Minnesota, Minneapolis, MN (United States); Kirmani, Jawad F. [JFK Medical Center, Stroke and Neurovascular Center, Edison, NJ (United States); Agarwal, Sachin [Columbia University Medical Center, New York, NY (United States); Hays Shapshak, Angela [University of Alabama at Birmingham, Birmingham, AL (United States); Messe, Steven R. [University of Pennsylvania, Philadelphia, PA (United States); Venkatasubramanian, Chitra [Stanford University, Stanford, CA (United States); Palmieri, Katherine [The University of Kansas Health System, Kansas City, KS (United States); Lewandowski, Christopher [Henry Ford Hospital, Detroit, MI (United States); Chang, Tiffany R. [University of Texas Medical School, Houston, TX (United States); Chang, Ira [Colorado Neurological Institute, Swedish Medical Center, Englewood, CO (United States); Rose, David Z. [Tampa General Hospital, University of South Florida College of Medicine, Tampa, FL (United States); Smith, Wade [UCSF Medical Center, San Francisco, CA (United States); Hsu, Chung Y.; Liu, Chun-Lin [China Medical University Hospital, Taichung (China); Lien, Li-Ming; Hsiao, Chen-Yu [Shin Kong Wu Ho-Su Memorial Hospital, Taipei (China); Iwama, Toru [Gifu University Hospital, Gifu (Japan); Afzal, Mohammad Rauf; Qureshi, Adnan I. [University of Minnesota, Zeenat Qureshi Stroke Research Center, Minneapolis, MN (United States); Cassarly, Christy; Hebert Martin, Renee [Medical University of South Carolina, Department of Public Health Sciences, Charleston, SC (United States); Goldstein, Joshua N. [Harvard Medical School, Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (United States); Collaboration: ATACH-II and NETT Investigators

2017-09-15

The CT angiography (CTA) spot sign is a strong predictor of hematoma expansion in intracerebral hemorrhage (ICH). However, CTA parameters vary widely across centers and may negatively impact spot sign accuracy in predicting ICH expansion. We developed a CT iodine calibration phantom that was scanned at different institutions in a large multicenter ICH clinical trial to determine the effect of image standardization on spot sign detection and performance. A custom phantom containing known concentrations of iodine was designed and scanned using the stroke CT protocol at each institution. Custom software was developed to read the CT volume datasets and calculate the Hounsfield unit as a function of iodine concentration for each phantom scan. CTA images obtained within 8 h from symptom onset were analyzed by two trained readers comparing the calibrated vs. uncalibrated density cutoffs for spot sign identification. ICH expansion was defined as hematoma volume growth >33%. A total of 90 subjects qualified for the study, of whom 17/83 (20.5%) experienced ICH expansion. The number of spot sign positive scans was higher in the calibrated analysis (67.8 vs 38.9% p < 0.001). All spot signs identified in the non-calibrated analysis remained positive after calibration. Calibrated CTA images had higher sensitivity for ICH expansion (76 vs 52%) but inferior specificity (35 vs 63%) compared with uncalibrated images. Normalization of CTA images using phantom data is a feasible strategy to obtain consistent image quantification for spot sign analysis across different sites and may improve sensitivity for identification of ICH expansion. (orig.)

Ankle fracture spur sign is pathognomonic for a variant ankle fracture.

Science.gov (United States)

Hinds, Richard M; Garner, Matthew R; Lazaro, Lionel E; Warner, Stephen J; Loftus, Michael L; Birnbaum, Jacqueline F; Burket, Jayme C; Lorich, Dean G

2015-02-01

The hyperplantarflexion variant ankle fracture is composed of a posterior tibial lip fracture with posterolateral and posteromedial fracture fragments separated by a vertical fracture line. This infrequently reported injury pattern often includes an associated "spur sign" or double cortical density at the inferomedial tibial metaphysis. The objective of this study was to quantitatively establish the association of the ankle fracture spur sign with the hyperplantarflexion variant ankle fracture. Our clinical database of operative ankle fractures was retrospectively reviewed for the incidence of hyperplantarflexion variant and nonvariant ankle fractures as determined by assessment of injury radiographs, preoperative advanced imaging, and intraoperative observation. Injury radiographs were then evaluated for the presence of the spur sign, and association between the spur sign and variant fractures was analyzed. The incidence of the hyperplantarflexion variant fracture among all ankle fractures was 6.7% (43/640). The spur sign was present in 79% (34/43) of variant fractures and absent in all nonvariant fractures, conferring a specificity of 100% in identifying variant fractures. Positive predictive value and negative predictive value were 100% and 99%, respectively. The ankle fracture spur sign was pathognomonic for the hyperplantarflexion variant ankle fracture. It is important to identify variant fractures preoperatively as patient positioning, operative approach, and fixation construct of variant fractures often differ from those employed for osteosynthesis of nonvariant fractures. Identification of the spur sign should prompt acquisition of advanced imaging to formulate an appropriate operative plan to address the variant fracture pattern. Level III, retrospective comparative study. © The Author(s) 2014.

'Twisted tape sign': Its significance in recurrent sigmoid volvulus

International Nuclear Information System (INIS)

Gopal, K.; Lim, Y.; Banerjee, B.

2005-01-01

Aim: Sigmoid volvulus is a common cause of intestinal obstruction in the elderly. Mild attacks of sigmoid volvulus may be more difficult to diagnose due to the lack of severity of symptoms which may resolve spontaneously only to recur after an interval. This study was a review of patients to assess the incidence of the 'twisted tape sign' and to evaluate the significance of its presence in cases of recurrent sigmoid volvulus. Methods and materials: A retrospective study over eight years revealed six cases of surgically confirmed recurrent sigmoid volvulus. Case records and barium enemas of all patients were reviewed. Results: Six patients were identified, including four men and two women, with a median age of 56 years. Diagnostic difficulties were encountered in four (67%) patients with a delay ranging between 10 and 37 months with a mean 17.3 months. Twisted tape sign was confirmed on all barium examinations retrospectively. Conclusion: Recognition of twisted tape sign on barium enema examination along with an appropriate clinical history would suggest a diagnosis of recurrent sigmoid volvulus

Use of symptom-relieving drugs before and after surgery for urinary incontinence in women: a cohort study

DEFF Research Database (Denmark)

Sørensen, Guldberg; Brostrøm, Søren; Kesmodel, Ulrik Schiøler

2013-01-01

To describe the use of symptom-relieving drugs (antimuscarinic drugs or duloxetine) before and after surgery for urinary incontinence (UI); and for those with use of antimuscarinic drugs or duloxetine before surgery, to estimate the risk of being a postoperative user, relative to those without use...

CT angiography spot sign in intracerebral hemorrhage predicts active bleeding during surgery.

Science.gov (United States)

Brouwers, H Bart; Raffeld, Miriam R; van Nieuwenhuizen, Koen M; Falcone, Guido J; Ayres, Alison M; McNamara, Kristen A; Schwab, Kristin; Romero, Javier M; Velthuis, Birgitta K; Viswanathan, Anand; Greenberg, Steven M; Ogilvy, Christopher S; van der Zwan, Albert; Rinkel, Gabriel J E; Goldstein, Joshua N; Klijn, Catharina J M; Rosand, Jonathan

2014-09-02

To determine whether the CT angiography (CTA) spot sign marks bleeding complications during and after surgery for spontaneous intracerebral hemorrhage (ICH). In a 2-center study of consecutive spontaneous ICH patients who underwent CTA followed by surgical hematoma evacuation, 2 experienced readers (blinded to clinical and surgical data) reviewed CTAs for spot sign presence. Blinded raters assessed active intraoperative and postoperative bleeding. The association between spot sign and active intraoperative bleeding, postoperative rebleeding, and residual ICH volumes was evaluated using univariable and multivariable logistic regression. A total of 95 patients met inclusion criteria: 44 lobar, 17 deep, 33 cerebellar, and 1 brainstem ICH; ≥1 spot sign was identified in 32 patients (34%). The spot sign was the only independent marker of active bleeding during surgery (odds ratio [OR] 3.4; 95% confidence interval [CI] 1.3-9.0). Spot sign (OR 4.1; 95% CI 1.1-17), female sex (OR 6.9; 95% CI 1.7-37), and antiplatelet use (OR 4.6; 95% CI 1.2-21) were predictive of postoperative rebleeding. Larger residual hematomas and postoperative rebleeding were associated with higher discharge case fatality (OR 3.4; 95% CI 1.1-11) and a trend toward increased case fatality at 3 months (OR 2.9; 95% CI 0.9-8.8). The CTA spot sign is associated with more intraoperative bleeding, more postoperative rebleeding, and larger residual ICH volumes in patients undergoing hematoma evacuation for spontaneous ICH. The spot sign may therefore be useful to select patients for future surgical trials. © 2014 American Academy of Neurology.

Workplace clinics: a sign of growing employer interest in wellness.

Science.gov (United States)

Tu, Ha T; Boukus, Ellyn R; Cohen, Genna R

2010-12-01

Interest in workplace clinics has intensified in recent years, with employers moving well beyond traditional niches of occupational health and minor acute care to offering clinics that provide a full range of wellness and primary care services. Employers view workplace clinics as a tool to contain medical costs, boost productivity and enhance companies' reputations as employers of choice. The potential for clinics to transform primary care delivery through the trusted clinician model holds promise, according to experts interviewed for a new qualitative research study from the Center for Studying Health System Change (HSC). Achieving that model is dependent on gaining employee trust in the clinic, as well as the ability to recruit and retain clinicians with the right qualities--a particular challenge in communities with provider shortages. Even when clinic operations are outsourced to vendors, initial employer involvement--including the identification of the appropriate scope and scale of clinic services--and sustained employer attention over time are critical to clinic success. Measuring the impact of clinics is difficult, and credible evidence on return on investment (ROI) varies widely, with very high ROI claims made by some vendors lacking credibility. While well-designed, well-implemented workplace clinics are likely to achieve positive returns over the long term, expecting clinics to be a game changer in bending the overall health care cost curve may be unrealistic.

Improvement in clinical signs and cellular immunity of dogs with visceral leishmaniasis using the immunomodulator P-MAPA.

Science.gov (United States)

Santiago, Maria Emília B; Neto, Luiz Silveira; Alexandre, Eduardo Costa; Munari, Danísio Prado; Andrade, Mariana Macedo C; Somenzari, Marcos Arruda; Ciarlini, Paulo César; de Lima, V M F

2013-09-01

This study investigated the immunotherapeutic potential of the protein aggregate magnesium-ammonium phospholinoleate-palmitoleate anhydride immuno-modulator (P-MAPA) on canine visceral leishmaniasis. Twenty mongrel dogs presenting clinical symptoms compatible with leishmaniasis and diagnosis confirmed by the detection of anti-leishmania antibodies were studied. Ten dogs received 15 doses of the immunomodulator (2.0 mg/kg) intramuscularly, and 10 received saline as a placebo. Skin and peripheral blood samples were collected following administration of the immunomodulator. The groups were followed to observe for clinical signals of remission; parasite load in the skin biopsies using real-time PCR, the cytokines IL-2, IL-10 and IFN-γ in the supernatant of peripheral blood mononuclear cells stimulated in vitro with either total promastigote antigen or phytohemagglutinin measured by capture ELISA, and changes in CD4⁺ and CD8⁺ T cell subpopulations evaluated by flow cytometry. Comparison between the groups showed that treatment with the immunomodulator promoted improvement in clinical signs and a significant reduction in parasite load in the skin. In peripheral blood mononuclear cell cultures, supernatants showed a decrease in IL-10 levels and an increase in IL-2 and IFN-γ. An increase in CD8⁺ T cells was observed in peripheral blood. In addition, the in vitro leishmanicidal action of P-MAPA was investigated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and no leishmanicidal activity was detected. These findings suggest that P-MAPA has potential as an immunotherapeutic drug in canine visceral leishmaniasis, since it assists in reestablishing partial immunocompetence of infected dogs. Copyright © 2013 Elsevier B.V. All rights reserved.

Nystagmus-based approach to vertebrobasilar stroke presenting as vertigo without initial neurologic signs.

Science.gov (United States)

Kim, Min-Beom; Boo, Sung Hyun; Ban, Jae Ho

2013-01-01

We aimed to investigate the clinical courses and common nystagmus of isolated vertigo patients with vertebrobasilar stroke. The patients who presented with isolated acute spontaneous vertigo with spontaneous nystagmus (acute vestibular syndrome) at the Emergency Department were retrospectively analyzed. They were referred to the Otolaryngology Department due to the absence of neurologic signs or even of imaging abnormalities after the initial examination at the Emergency Department. Various clinical features, including presenting symptoms, delayed neurologic signs, the site of infarction, and videonystagmographic (VNG) findings were analyzed. Of the 468 cases of acute vestibular syndrome, 23 (4.9%) cases of radiologically proven vertebrobasilar stroke were identified. Of the 23 patients, 17 (74%) showed aggravation of vertigo or delayed neurologic signs during the admission. In the analysis of VNG, 11 (48%) cases of direction-changing gaze-evoked nystagmus, 7 (30%) cases of fixation failure in the caloric test, 6 (27%) cases of periodic alternating nystagmus, and 4 (17%) cases of atypical head-shaking nystagmus were presented. Stroke occurred in the cerebellum (n=18, 78%), medulla (n=4, 17%), and pons (n=1, 4%). In the early stage of vertebrobasilar stroke, an accurate diagnosis was difficult in the Emergency Department even though a radiologic study was performed, but various VNG abnormalities and delayed neurologic signs could help to diagnose whether the origin is central or not. Copyright © 2013 S. Karger AG, Basel.

Testing multiple statistical hypotheses resulted in spurious associations: a study of astrological signs and health.

Science.gov (United States)

Austin, Peter C; Mamdani, Muhammad M; Juurlink, David N; Hux, Janet E

2006-09-01

To illustrate how multiple hypotheses testing can produce associations with no clinical plausibility. We conducted a study of all 10,674,945 residents of Ontario aged between 18 and 100 years in 2000. Residents were randomly assigned to equally sized derivation and validation cohorts and classified according to their astrological sign. Using the derivation cohort, we searched through 223 of the most common diagnoses for hospitalization until we identified two for which subjects born under one astrological sign had a significantly higher probability of hospitalization compared to subjects born under the remaining signs combined (P<0.05). We tested these 24 associations in the independent validation cohort. Residents born under Leo had a higher probability of gastrointestinal hemorrhage (P=0.0447), while Sagittarians had a higher probability of humerus fracture (P=0.0123) compared to all other signs combined. After adjusting the significance level to account for multiple comparisons, none of the identified associations remained significant in either the derivation or validation cohort. Our analyses illustrate how the testing of multiple, non-prespecified hypotheses increases the likelihood of detecting implausible associations. Our findings have important implications for the analysis and interpretation of clinical studies.

Modeling online social signed networks

Science.gov (United States)

Li, Le; Gu, Ke; Zeng, An; Fan, Ying; Di, Zengru

2018-04-01

People's online rating behavior can be modeled by user-object bipartite networks directly. However, few works have been devoted to reveal the hidden relations between users, especially from the perspective of signed networks. We analyze the signed monopartite networks projected by the signed user-object bipartite networks, finding that the networks are highly clustered with obvious community structure. Interestingly, the positive clustering coefficient is remarkably higher than the negative clustering coefficient. Then, a Signed Growing Network model (SGN) based on local preferential attachment is proposed to generate a user's signed network that has community structure and high positive clustering coefficient. Other structural properties of the modeled networks are also found to be similar to the empirical networks.

Sign language: an international handbook

NARCIS (Netherlands)

Pfau, R.; Steinbach, M.; Woll, B.

2012-01-01

Sign language linguists show here that all the questions relevant to the linguistic investigation of spoken languages can be asked about sign languages. Conversely, questions that sign language linguists consider - even if spoken language researchers have not asked them yet - should also be asked of

MR imaging of displaced meniscal tears of the knee. Importance of a 'disproportional posterior horn sign'

International Nuclear Information System (INIS)

Chen, H.C.; Hsu, C.Y.; Shih, T.T.F.; Huang, K.M.; Li, Y.W.

2001-01-01

Purpose: Meniscal tears associated with displaced fragments are clinically significant. We propose the 'disproportional posterior horn sign' as a supportive criterion to identify a posterocentrally displaced meniscal fragment on MR imaging studies. If the meniscal posterior horn in the central portion appears larger than that in the peripheral section, it is considered positive for 'disproportional posterior horn sign'. Material and Methods: MR images obtained in 42 patients with 43 lesions, confirmed to have displaced meniscal tears, were included in this study. The MR images were retrospectively evaluated for the presence of the 'disproportional posterior horn sign', as well as the other known signs. Results: The 'disproportional posterior horn sign' was seen in 9 (20.9%) of 43 lesions, including 1 lateral discoid meniscal tear, 5 lateral meniscal tears and 3 medial meniscal tears. Five of them also had other signs of a displaced meniscal fragment. However, the remaining 4 cases only exhibited the 'disproportional posterior horn sign'. For the other MR signs, the 'absent bow tie sign' was detected in 40 (93%) of 43 lesions, the 'flipped meniscus sign' in 27 (62.8%) of 43 lesions, the 'double posterior cruciate ligament sign' in 17 (39.5%) of 43 lesions and the 'notch fragment sign' in 22 (51.2%) of 43 lesions. Conclusion: The 'disproportional posterior horn sign' is helpful in demonstrating a posterocentrally displaced meniscal fragment, especially when other characteristic signs are unremarkable or absent

Traffic sign detection and analysis

DEFF Research Database (Denmark)

Møgelmose, Andreas; Trivedi, Mohan M.; Moeslund, Thomas B.

2012-01-01

Traffic sign recognition (TSR) is a research field that has seen much activity in the recent decade. This paper introduces the problem and presents 4 recent papers on traffic sign detection and 4 recent papers on traffic sign classification. It attempts to extract recent trends in the field...

Natural Arctium lappa fruit extract improves the clinical signs of aging skin.

Science.gov (United States)

Knott, Anja; Reuschlein, Katja; Mielke, Heiko; Wensorra, Ursula; Mummert, Christopher; Koop, Urte; Kausch, Martina; Kolbe, Ludger; Peters, Nils; Stäb, Franz; Wenck, Horst; Gallinat, Stefan

2008-12-01

Subclinical, chronic tissue inflammation involving the generation of cytokines (e.g., interleukin-6 and tumor necrosis factor-alpha) might contribute to the cutaneous aging process. This study aims to screen for an active ingredient with anti-inflammatory (i.e., reduction of interleukin-6 and tumor necrosis factor-alpha) and matrix-stimulating efficacy which improves the clinical signs of skin aging in vivo. In vitro studies with pure Arctiin were performed investigating the inhibition of cytokine induction and stimulation of collagen neo-synthesis. In vivo home-in-use studies using an Arctium lappa fruit extract-containing formulation were carried out to determine procollagen and hyaluronan synthesis, hyaluronan synthase-2 gene expression, and reduction of wrinkle volume after treatment. In vitro studies on human dermal fibroblasts and monocyte-derived dendritic cells supplemented with pure Arctiin showed relative to untreated control cells a stimulation of collagen synthesis and a decrease in interleukin-6 and tumor necrosis factor-alpha concentration, respectively. In addition, topical in vivo application of an A. lappa fruit extract-containing formulation for 12 weeks significantly stimulated procollagen synthesis and increased hyaluronan synthase-2 expression as well as hyaluronan levels compared to vehicle-treated control areas. Similarly, after a 4-week treatment with an A. lappa fruit extract-containing formulation, wrinkle volume in the crow's feet area was significantly reduced as compared to treatment with the vehicle. Our data show that topical treatment with a natural A. lappa fruit extract significantly improves the metabolism of the dermal extracellular matrix and leads to a visible wrinkle reduction in vivo. In conclusion, A. lappa fruit extract represents a targeted means to regenerate dermal structures and, thus, offers an effective treatment option for mature skin.

The Forbidden Signs

DEFF Research Database (Denmark)

Kilstrup, Mogens

2016-01-01

While the field of semiotics has been active since it was started by Peirce, it appears like the last decade has been especially productive with a number of important new concepts being developed within the biosemiotics community. The novel concept of the Semiotic scaffold by Hoffmeyer is an impo......While the field of semiotics has been active since it was started by Peirce, it appears like the last decade has been especially productive with a number of important new concepts being developed within the biosemiotics community. The novel concept of the Semiotic scaffold by Hoffmeyer...... is an important addition that offers insight into the hardware requirements for bio-semiosis. As any type of semiosis must be dependent upon Semiotic scaffolds, I recently argued that the process of semiosis has to be divided into two separate processes of sign establishment and sign interpretation....... I also show that biological semiosis offers examples of forbidden signs, where the faulty interpretation of signs may lead to decimation of whole evolutionary lines of organisms. A new concept of Evolutionary memory which is applicable to both human and biological semiosis is explained...

Acupuncture and Auricular Acupressure in Relieving Menopausal Hot Flashes of Bilaterally Ovariectomized Chinese Women: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Jue Zhou

2011-01-01

Full Text Available The objective of this study is to explore the effects of acupuncture and auricular acupressure in relieving menopausal hot flashes of bilaterally ovariectomized Chinese women. Between May 2006 and March 2008, 46 bilaterally ovariectomized Chinese women were randomized into an acupuncture and auricular acupressure group (n = 21 and a hormone replacement therapy (HRT group (Tibolone, n = 25. Each patient was given a standard daily log and was required to record the frequency and severity of hot flashes and side effects of the treatment felt daily, from 1 week before the treatment started to the fourth week after the treatment ended. The serum levels of follicle stimulating hormone (FSH, LH and E2 were detected before and after the treatment. After the treatment and the follow-up, both the severity and frequency of hot flashes in the two groups were relieved significantly when compared with pre-treatment (P   .05, while after the follow-up, the severity of hot flashes in the HRT group was alleviated more. After the treatment and the follow-up, the frequency of menopausal hot flashes in the HRT group was reduced more (P <  .05. After treatment, the levels of FSH decreased significantly and the levels of E2 increased significantly in both groups (P <  .05, and they changed more in the HRT group (P <  .05. Acupuncture and auricular acupressure can be used as alternative treatments to relieve menopausal hot flashes for those bilaterally ovariectomized women who are unable or unwilling to receive HRT.

EDAR-induced hypohidrotic ectodermal dysplasia: a clinical study on signs and symptoms in individuals with a heterozygous c.1072C > T mutation

Science.gov (United States)

2014-01-01

Background Mutations in the EDAR-gene cause hypohidrotic ectodermal dysplasia, however, the oral phenotype has been described in a limited number of cases. The aim of the present study was to clinically describe individuals with the c.1072C > T mutation (p. Arg358X) in the EDAR gene with respect to dental signs and saliva secretion, symptoms from other ectodermal structures and to assess orofacial function. Methods Individuals in three families living in Sweden, where some members had a known c.1072C > T mutation in the EDAR gene with an autosomal dominant inheritance (AD), were included in a clinical investigation on oral signs and symptoms and self-reported symptoms from other ectodermal structures (n = 37). Confirmation of the c.1072C > T mutation in the EDAR gene were performed by genomic sequencing. Orofacial function was evaluated with NOT-S. Results The mutation was identified in 17 of 37 family members. The mean number of missing teeth due to agenesis was 10.3 ± 4.1, (range 4–17) in the mutation group and 0.1 ± 0.3, (range 0–1) in the non-mutation group (p  T mutation in the EDAR-gene displayed a typical pattern of congenitally missing teeth in the frontal area with functional consequences. They therefore have a need for special attention in dental care, both with reference to tooth agenesis and low salivary secretion with an increased risk for caries. Sweating problems were the most frequently reported symptom from other ectodermal structures. PMID:24884697

Radiofrequency Procedures to Relieve Chronic Knee Pain: An Evidence-Based Narrative Review.

Science.gov (United States)

Bhatia, Anuj; Peng, Philip; Cohen, Steven P

2016-01-01

Chronic knee pain from osteoarthritis or following arthroplasty is a common problem. A number of publications have reported analgesic success of radiofrequency (RF) procedures on nerves innervating the knee, but interpretation is hampered by lack of clarity regarding indications, clinical protocols, targets, and longevity of benefit from RF procedures. We reviewed the following medical literature databases for publications on RF procedures on the knee joint for chronic pain: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar up to August 9, 2015. Data on scores for pain, validated scores for measuring physical disability, and adverse effects measured at any timepoint after 1 month following the interventions were collected, analyzed, and reported in this narrative review. Thirteen publications on ablative or pulsed RF treatments of innervation of the knee joint were identified. A high success rate of these procedures in relieving chronic pain of the knee joint was reported at 1 to 12 months after the procedures, but only 2 of the publications were randomized controlled trials. There was evidence for improvement in function and a lack of serious adverse events of RF treatments. Radiofrequency treatments on the knee joint (major or periarticular nerve supply or intra-articular branches) have the potential to reduce pain from osteoarthritis or persistent postarthroplasty pain. Ongoing concerns regarding the quality, procedural aspects, and monitoring of outcomes in publications on this topic remain. Randomized controlled trials of high methodological quality are required to further elaborate role of these interventions in this population.

Numeral Incorporation in Japanese Sign Language

Science.gov (United States)

Ktejik, Mish

2013-01-01

This article explores the morphological process of numeral incorporation in Japanese Sign Language. Numeral incorporation is defined and the available research on numeral incorporation in signed language is discussed. The numeral signs in Japanese Sign Language are then introduced and followed by an explanation of the numeral morphemes which are…

Canadian Economic Evaluation of Budesonide-Formoterol as Maintenance and Reliever Treatment in Patients with Moderate to Severe Asthma

Directory of Open Access Journals (Sweden)

Elizabeth Miller

2007-01-01

Full Text Available OBJECTIVES: To compare the cost-effectiveness of budesonide-formoterol in a single inhaler used as both maintenance and reliever medication versus clinician-directed titration of salmeterol-fluticasone as maintenance medication, plus salbutamol taken as needed, in controlling asthma in adults and adolescents.

Budesonide/formoterol maintenance and reliever therapy in primary care asthma management : effects on bronchial hyperresponsiveness and asthma control

NARCIS (Netherlands)

Riemersma, Roland A.; Postma, Dirkje; van der Molen, Thys

Background: The management of asthma has changed since the introduction of budesonide/formoterol (Symbicort (R)) as both maintenance and reliever therapy (SMART). SMART and its effects on bronchial hyperresponsiveness (BHR) have not been studied in primary care. Aims: To compare the effects of SMART

13 CFR 305.12 - Project sign.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Project sign. 305.12 Section 305... WORKS AND ECONOMIC DEVELOPMENT INVESTMENTS Requirements for Approved Projects § 305.12 Project sign. The... the construction period of a sign or signs at a conspicuous place at the Project site indicating that...

Relieving dyspnoea by non-invasive ventilation decreases pain thresholds in amyotrophic lateral sclerosis.

Science.gov (United States)

Dangers, Laurence; Laviolette, Louis; Georges, Marjolaine; Gonzalez-Bermejo, Jésus; Rivals, Isabelle; Similowski, Thomas; Morelot-Panzini, Capucine

2017-03-01

Dyspnoea is a threatening sensation of respiratory discomfort that presents many similarities with pain. Experimental dyspnoea in healthy subjects induces analgesia. This 'dyspnoea-pain counter-irritation' could, in reverse, imply that relieving dyspnoea in patients with chronic respiratory diseases would lower their pain thresholds. We first determined pressure pain thresholds in 25 healthy volunteers (22-31 years; 13 men; handheld algometer), during unloaded breathing (BASELINE) and during inspiratory threshold loading (ITL). Two levels of loading were used, adjusted to induce dyspnoea self-rated at 60% or 80% of a 10 cm visual analogue scale (ITL6 and ITL8). 18 patients with chronic respiratory failure due to amyotrophic lateral sclerosis (ALS) were then studied during unassisted breathing and after 30 and 60 min of non-invasive ventilation-NIV30 and NIV60-(same dyspnoea evaluation). In healthy volunteers, pressure pain thresholds increased significantly in the deltoid during ITL6 (pNIV30 and NIV60 (pNIV in patients with ALS having respiratory failure is associated with decreased pressure pain thresholds. Clinical implications have yet to be determined, but this observation suggests that patients with ALS could become more susceptible to pain after the institution of NIV, hence the need for reinforced attention towards potentially painful diagnostic and therapeutic interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats

OpenAIRE

Lascelles, B Duncan X; Dong, Yaa-Hui; Marcellin-Little, Denis J; Thomson, Andrea; Wheeler, Simon; Correa, Maria

2012-01-01

Abstract Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to...

Nursing assessment of continuous vital sign surveillance to improve patient safety on the medical/surgical unit.

Science.gov (United States)

Watkins, Terri; Whisman, Lynn; Booker, Pamela

2016-01-01

Evaluate continuous vital sign surveillance as a tool to improve patient safety in the medical/surgical unit. Failure-to-rescue is an important measure of hospital quality. Patient deterioration is often preceded by changes in vital signs. However, continuous multi-parameter vital sign monitoring may decrease patient safety with an abundance of unnecessary alarms. Prospective observational study at two geographically disperse hospitals in a single hospital system. A multi-parameter vital sign monitoring system was installed in a medical/surgical unit in Utah and one in Alabama providing continuous display of SpO2, heart rate, blood pressure and respiration rate on a central station. Alarm thresholds and time to alert annunciations were set based on prior analysis of the distribution of each vital sign. At the end of 4 weeks, nurses completed a survey on their experience. An average alert per patient, per day was determined retrospectively from the saved vital signs data and knowledge of the alarm settings. Ninety-two per cent of the nurses agreed that the number of alarms and alerts were appropriate; 54% strongly agreed. On average, both units experienced 10·8 alarms per patient, per day. One hundred per cent agreed the monitor provided valuable patient data that increased patient safety; 79% strongly agreed. Continuous, multi-parameter patient monitoring could be performed on medical/surgical units with a small and appropriate level of alarms. Continuous vital sign assessment may have initiated nursing interventions that prevented failure-to-rescue events. Nurses surveyed unanimously agreed that continuous vital sign surveillance will help enhance patient safety. Nursing response to abnormal vital signs is one of the most important levers in patient safety, by providing timely recognition of early clinical deterioration. This occurs through diligent nursing surveillance, involving assessment, interpretation of data, recognition of a problem and meaningful

"Hearing" the signs:influence of sign language in an inclusive classroom

OpenAIRE

Monney, M. (Mariette)

2017-01-01

Abstract Finding new methods to achieve the goals of Education For All is a constant worry for primary school teachers. Multisensory methods have been proved to be efficient in the past decades. Sign Language, being a visual and kinesthetic language, could become a future educational tool to fulfill the needs of a growing diversity of learners. This ethnographic study describes how Sign Language exposure in inclusive classr...

Kinship in Mongolian Sign Language

Science.gov (United States)

Geer, Leah

2011-01-01

Information and research on Mongolian Sign Language is scant. To date, only one dictionary is available in the United States (Badnaa and Boll 1995), and even that dictionary presents only a subset of the signs employed in Mongolia. The present study describes the kinship system used in Mongolian Sign Language (MSL) based on data elicited from…

Eye Gaze in Creative Sign Language

Science.gov (United States)

Kaneko, Michiko; Mesch, Johanna

2013-01-01

This article discusses the role of eye gaze in creative sign language. Because eye gaze conveys various types of linguistic and poetic information, it is an intrinsic part of sign language linguistics in general and of creative signing in particular. We discuss various functions of eye gaze in poetic signing and propose a classification of gaze…

Evaluation of neurological complications using who warning signs for dengue disease severity

International Nuclear Information System (INIS)

Akmal, A.; Tauseef, A.; Akram, T.

2015-01-01

In 2009 a new classification of dengue was proposed by WHO Tropical Disease Research, which classifies dengue into dengue (D), dengue with warning signs (DW) and severe dengue (SD). This classification highlights the warning signs of dengue disease severity. Neurological complications are one of the most serious complications of dengue disease. This study was carried out to see association of neurological complications of dengue patients with WHO warning signs for dengue disease severity, and their outcome. Methods: It was a cross-sectional analytical study and included 180 diagnosed and registered cases of dengue hemorrhagic fever. The participants were subjected to a detailed clinical evaluation, laboratory assessment including blood counts, hematocrit, serology for dengue fever and sonography at 24 hours and 48 hours of their admission. Results: Twenty-six percent patients were suffering from neurological complications due to dengue. The warning signs for dengue disease severity like altered sensorium (85.5%, p=0.001), raised hematocrit (n=47, p=0.029), gall bladder wall thickening, pleural effusion and ascites on sonographic report (n=47, p=0.024), were strongly associated with the neurological complications. Conclusion: Our study reveals significant association of WHO warning signs for dengue disease severity with neurological complications of dengue disease. (author)

Electronic traffic signs: Reflecting upon its transition

Energy Technology Data Exchange (ETDEWEB)

Arbaiza Martin, A.E.; Alba, A.L.; Hernando Mazon, A.; Blanch Mico, M.T.

2016-07-01

In our days we face a fundamental issue concerning road signs. We may display contents in vertical and horizontal format (static signs, variable message signs, road markings), either on a post, a gantry or a dashboard. And we foresee a coming age where the excellent matrix resolution of painted signs will be truly approached by the resolution of full matrix displays. But we also risk a babel context threatening the universal approach encouraged by international catalogues as the 1968 Convention (ECE/TRANS/196, 2007). And the fundamental risk comes from our decisions regarding how the transition from the contents and formats displayed on static message signs to the ones displayed on electronic signs (in gantries or dashboards) should be. Our work explores this issue specifically, considering the transition from Advance Direction Signs (static message signs, class G, 1 in the 1968 Convention) to what could be termed Advance Location Signs (signs concerning the location of variable events with regards to certain landmarks) developed as an adaptation of the G, 1 class to electronic traffic signs.(Author)

Acetyl aspartic acid, a novel active ingredient, demonstrates potential to improve signs of skin ageing: from consumer need to clinical proof.

Science.gov (United States)

Mavon, A

2015-10-01

The megatrend of population ageing is leading to a growing demand for "anti-ageing" treatments, especially to prevent or treat skin ageing. Facing an increasing offer, consumers are choosing more and more skin care products supported by a scientific rationale, active ingredients and clinical proof of efficacy. Considering consumer expectations, this research led to the discovery of acetyl aspartic acid (A-A-A), a novel active ingredient to improve sagging skin and loss of skin firmness. This supplement is featuring seven manuscripts aiming at presenting the research and investigations from consumer insights, discovery of A-A-A, its in vitro activity confirmation, safety assessment, formulation and its dermal absorption to the clinical proof of efficacy, investigated through two pilots' double bind randomized and placebo controlled studies on photo-aged skin. This extensive research enabled us to discover A-A-A, as an active ingredient with potential to repair sign of skin ageing and supported by clinical proof of efficacy. This active ingredient will be soon launched in a commercial innovative skin care range, delivering desirable anti-wrinkle and skin lifting benefits. © 2015 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Road Signs for UV-Completion

CERN Document Server

Dvali, Gia; Gomez, Cesar

2012-01-01

We confront the concepts of Wilsonian UV-completion versus self-completion by Classicalization in theories with derivatively-coupled scalars. We observe that the information about the UV-completion road is encoded in the sign of the derivative terms. We note that the sign of the derivative couplings for which there is no consistent Wilsonian UV-completion is the one that allows for consistent classicalons. This is an indication that for such a sign the vertex must be treated as fundamental and the theory self-protects against potential inconsistencies, such as superluminality, via self-completion by classicalization. Applying this reasoning to the UV-completion of the Standard Model, we see that the information about the Higgs versus classicalization is encoded in the sign of the scattering amplitude of longitudinal W-bosons. Negative sign excludes Higgs or any other weakly-coupled Wilsonian physics.

The Use of Sign Language Pronouns by Native-Signing Children with Autism

Science.gov (United States)

Shield, Aaron; Meier, Richard P.; Tager-Flusberg, Helen

2015-01-01

We report the first study on pronoun use by an under-studied research population, children with autism spectrum disorder (ASD) exposed to American Sign Language from birth by their deaf parents. Personal pronouns cause difficulties for hearing children with ASD, who sometimes reverse or avoid them. Unlike speech pronouns, sign pronouns are…

Korean Emotional Laborers' Job Stressors and Relievers: Focus on Work Conditions and Emotional Labor Properties

OpenAIRE

Garam Lee

2015-01-01

Background: The present study aims to investigate job stressors and stress relievers for Korean emotional laborers, specifically focusing on the effects of work conditions and emotional labor properties. Emotional laborers are asked to hide or distort their real emotions in their interaction with clients. They are exposed to high levels of stress in the emotional labor process, which leads to serious mental health risks including burnout, depression, and even suicide impulse. Exploring job st...

Novel Signs and Their Clinical Utility in Diagnosing Complex Regional Pain Syndrome (CRPS): A Prospective Observational Cohort Study.

Science.gov (United States)

Kuttikat, Anoop; Shaikh, Maliha; Oomatia, Amin; Parker, Richard; Shenker, Nicholas

2017-06-01

Delays in diagnosis occur with complex regional pain syndrome (CRPS). We define and prospectively demonstrate that novel bedside tests measuring body perception disruption can identify patients with CRPS postfracture. The objectives of our study were to define and validate 4 bedside tests, to identify the prevalence of positive tests in patients with CRPS and other chronic pain conditions, and to assess the clinical utility (sensitivity, specificity, positive predictive value, negative predictive value) for identifying CRPS within a Fracture cohort. This was a single UK teaching hospital prospective cohort study with 313 recruits from pain-free volunteers and patients with chronic pain conditions.Four novel tests were Finger Perception (FP), Hand Laterality identification (HL), Astereognosis (AS), and Body Scheme (BS) report. Five questionnaires (Brief Pain Inventory, Upper Extremity Functional Index, Lower Extremity Functional Index, Neglect-like Symptom Questionnaire, Hospital Anxiety and Depression Score) assessed the multidimensional pain experience. FP and BS were the best performing tests. Prospective monitoring of fracture patients showed that out of 7 fracture patients (total n=47) who had both finger misperception and abnormal BS report at initial testing, 3 developed persistent pain with 1 having a formal diagnosis of CRPS. Novel signs are reliable, easy to perform, and present in chronic pain patients. FP and BS have significant clinical utility in predicting persistent pain in a fracture group thereby allowing targeted early intervention.

Clinical evaluation of guidelines and two-test approach for lyme disease

NARCIS (Netherlands)

Blaauw, A. A.; van Loon, A. M.; Schellekens, J. F.; Bijlsma, J. W.

1999-01-01

The diagnosis of Lyme disease should be based on objective clinical signs and symptoms. In a clinical study, we have evaluated whether the recommended two-step approach for serodiagnosis of Lyme disease is useful in daily clinical practice and can influence clinical decision making. The signs and

Misleading signs in acute vertigo.

Science.gov (United States)

Lance, Sean; Mossman, Stuart Scott

2018-04-01

The acute vestibular syndrome is common and usually has a benign cause. Sometimes, however, even experienced neurologists can find it difficult to determine the cause clinically. Furthermore, neuroimaging is known to be insensitive.We describe two cases of acute vestibular syndrome where conflicting clinical findings contributed to a delay in making the correct diagnosis. The first patient with symptomatic vertigo had signs consistent with horizontal benign paroxysmal positional vertigo but also had an abnormal horizontal head impulse test, superficially suggesting acute vestibular neuritis but later accounted for by the finding of a vestibular schwannoma (acoustic neuroma). The second patient also had an abnormal horizontal head impulse test, with skew deviation suggesting stroke as the cause. However, later assessment identified that a long-standing fourth nerve palsy was the true cause for her apparent skew. We discuss potential errors that can arise when assessing such patients and highlight ways to avoid them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Dry eye signs and symptoms in night-time workers

OpenAIRE

Ali Makateb; Hamed Torabifard

2017-01-01

Purpose: To determine the effect of night-time working on dry eye signs and symptoms. Methods: A total of 50 healthy subjects completed a dry eye questionnaire and underwent clinical examinations including basic Schirmer's test and tear breakup time (TBUT) test on two consecutive days, before and after the night shift (12-hrs night-shift). Results: All dry eye symptoms were aggravated significantly after the night shift (P 

Grey Turner's and Cullen's signs induced by spontaneous hemorrhage of the abdominal wall after coughing.

Science.gov (United States)

Fan, Zhe; Zhang, Yingyi

2017-08-01

Grey Turner's and Cullen's signs are rare clinical signs, which most appear in patients with severe acute pancreatitis. The present patient complained of abdominal pain after coughing. However, contrast-enhanced CT revealed a hemorrhage of the abdominal wall. Therefore, spontaneous hemorrhage of the abdominal wall was diagnosed. The patient recovered through immobilization and hemostasis therapy. This case report and literature review aims to remind clinicians of manifestations and treatment of spontaneous hemorrhage.

Are there clinically useful predictors and early warning signs for pending relapse?

Science.gov (United States)

Gaebel, Wolfgang; Riesbeck, Mathias

2014-02-01

Despite the availability of effective long-term treatment strategies in schizophrenia, relapse is still common. Relapse prevention is one of the major treatment objectives, because relapse represents burden and costs for patients, their environment, and society and seems to increase illness progression at the biological level. Valid predictors for relapse are urgently needed to enable more individualized recommendations and treatment decisions to be made. Mainly recent evidence regarding predictors and early warning signs of relapse in schizophrenia was reviewed. In addition, data from the first-episode (long-term) study (FES; Gaebel et al., 2007, 2011) performed within the German Research Network on Schizophrenia were analyzed. On the basis of FES data, premorbid adjustment, residual symptoms and some side effects are significant predictors. Although a broad spectrum of potential parameters has been investigated in several other studies, only a few and rather general valid predictors were identified consistently. Data of the FES also indicated that predictive power could be enhanced by considering interacting conjunctions, as suggested by the Vulnerability-Stress-Coping model. Prospective studies, however, are rare. In addition, prodromal symptoms as course-related characteristics likewise investigated in the FES add substantially to early recognition of relapse and may serve as early warning signs, but prognosis nevertheless remains a challenge. Comprehensive and well-designed studies are needed to identify and confirm valid predictors for relapse in schizophrenia. In this respect, broadly accepted and specifically defined criteria for relapse would greatly facilitate comparison of results across studies. © 2013 Elsevier B.V. All rights reserved.

The predictive accuracy of the black hole sign and the spot sign for hematoma expansion in patients with spontaneous intracerebral hemorrhage.

Science.gov (United States)

Yu, Zhiyuan; Zheng, Jun; Ma, Lu; Guo, Rui; Li, Mou; Wang, Xiaoze; Lin, Sen; Li, Hao; You, Chao

2017-09-01

In patients with spontaneous intracerebral hemorrhage (sICH), hematoma expansion (HE) is associated with poor outcome. Spot sign and black hole sign are neuroimaging predictors for HE. This study was aimed to compare the predictive value of two signs for HE. Within 6 h after onset of sICH, patients were screened for the computed tomography angiography spot sign and the non-contrast computed tomography black hole sign. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of two signs for HE prediction were calculated. The accuracy of two signs in predicting HE was analyzed by receiver-operator analysis. A total of 129 patients were included in this study. Spot sign was identified in 30 (23.3%) patients and black hole sign in 29 (22.5%) patients, respectively. Of 32 patients with HE, spot sign was observed in 19 (59.4%) and black hole sign was found in 14 (43.8%). The occurrence of black hole sign was significantly associated with spot sign (P black hole sign for predicting HE were 43.75, 84.54, 48.28, and 82.00%, respectively. The area under the curve was 0.740 for spot sign and 0.641 for black hole sign. (P = 0.228) Both spot sign and black hole sign appeared to have good predictive value for HE, and spot sign seemed to be a better predictor.

Gross, computed tomographic and histological findings in mandibular cheek teeth extracted from horses with clinical signs of pulpitis due to apical infection.

Science.gov (United States)

Casey, M B; Pearson, G R; Perkins, J D; Tremaine, W H

2015-09-01

The most prevalent type of equine dental pulpitis due to apical infection is not associated with coronal fractures or periodontal disease. The pathogenesis of this type of pulpitis is not fully understood. Computed tomography (CT) is increasingly used to investigate equine dental disorders. However, gross, tomographic and histopathological changes in equine dental pulpitis have not been compared previously. To compare gross, CT and histological appearances of sectioned mandibular cheek teeth extracted from horses with clinical signs of pulpitis without coronal fractures or periodontal disease. To contribute to understanding the pathogenesis of equine dental pulpitis. Descriptive study using diseased and healthy teeth. Mandibular cheek teeth extracted from horses with clinical signs of pulpitis (cases), and from cadavers with no history of dental disease (controls), were compared using CT in the transverse plane at 1 mm intervals. Teeth were then sectioned transversely, photographed and processed for histopathological examination. Tomographs were compared with corresponding gross and histological sections. Cement, dentine and bone had similar ranges of attenuation (550-2000 Hounsfield Units, HU) in tomographs but could be differentiated from pulp (-400 to 500 HU) and enamel (> 2500 HU). Twelve discrete dental lesions were identified grossly, 10 of which were characterised histologically. Reactive and reparative dentinogenesis and extensive pulpar mineralisation, previously undescribed, were identified. Pulpar oedema, neutrophilic inflammation, cement and enamel defects, and reactive cemental deposition were also observed. The CT and pathological findings corresponded well where there was mineralised tissue deposited, defects in mineralised tissue, or food material in the pulpar area. Pulpar and dentinal necrosis and cement destruction, evident grossly and histologically, did not correspond to CT changes. Computed tomography is useful for identifying deposition and

Seizure ending signs in patients with dyscognitive focal seizures.

Science.gov (United States)

Gavvala, Jay R; Gerard, Elizabeth E; Macken, Mícheál; Schuele, Stephan U

2015-09-01

Signs indicating the end of a focal seizure with loss of awareness and/or responsiveness but without progression to focal or generalized motor symptoms are poorly defined and can be difficult to determine. Not recognizing the transition from ictal to postictal behaviour can affect seizure reporting accuracy by family members and may lead to delayed or a lack of examination during EEG monitoring, erroneous seizure localization and inadequate medical intervention for prolonged seizure duration. Our epilepsy monitoring unit database was searched for focal seizures without secondary generalization for the period from 2007 to 2011. The first focal seizure in a patient with loss of awareness and/or responsiveness and/or behavioural arrest, with or without automatisms, was included. Seizures without objective symptoms or inadequate video-EEG quality were excluded. A total of 67 patients were included, with an average age of 41.7 years. Thirty-six of the patients had seizures from the left hemisphere and 29 from the right. All patients showed an abrupt change in motor activity and resumed contact with the environment as a sign of clinical seizure ending. Specific ending signs (nose wiping, coughing, sighing, throat clearing, or laughter) were seen in 23 of 47 of temporal lobe seizures and 7 of 20 extra-temporal seizures. Seizure ending signs are often subtle and the most common finding is a sudden change in motor activity and resumption of contact with the environment. More distinct signs, such as nose wiping, coughing or throat clearing, are not specific to temporal lobe onset. A higher proportion of seizures during sleep went unexamined, compared to those during wakefulness. This demonstrates that seizure semiology can be very subtle and arousals from sleep during monitoring should alert staff. Patient accounts of seizure frequency appear to be unreliable and witness reports need to be taken into account. [Published with video sequences].

Dermatology eponyms – sign – Lexicon (R: Part 2

Directory of Open Access Journals (Sweden)

Piotr Brzeziński

2017-01-01

Full Text Available Eponyms are used almost daily in the clinical practice of dermatology. And yet, information about the person behind the eponyms is difficult to find. Indeed, who is? What is this person’s nationality? Is this person alive or dead? How can one find the paper in which this person first described the disease? Eponyms are used to describe not only disease, but also clinical signs, surgical procedures, staining techniques, pharmacological formulations, and even pieces of equipment. In this article we present the symptoms starting with (R and other. The symptoms and their synonyms, and those who have described this symptom or phenomenon.

Sociolinguistic Typology and Sign Languages.

Science.gov (United States)

Schembri, Adam; Fenlon, Jordan; Cormier, Kearsy; Johnston, Trevor

2018-01-01

This paper examines the possible relationship between proposed social determinants of morphological 'complexity' and how this contributes to linguistic diversity, specifically via the typological nature of the sign languages of deaf communities. We sketch how the notion of morphological complexity, as defined by Trudgill (2011), applies to sign languages. Using these criteria, sign languages appear to be languages with low to moderate levels of morphological complexity. This may partly reflect the influence of key social characteristics of communities on the typological nature of languages. Although many deaf communities are relatively small and may involve dense social networks (both social characteristics that Trudgill claimed may lend themselves to morphological 'complexification'), the picture is complicated by the highly variable nature of the sign language acquisition for most deaf people, and the ongoing contact between native signers, hearing non-native signers, and those deaf individuals who only acquire sign languages in later childhood and early adulthood. These are all factors that may work against the emergence of morphological complexification. The relationship between linguistic typology and these key social factors may lead to a better understanding of the nature of sign language grammar. This perspective stands in contrast to other work where sign languages are sometimes presented as having complex morphology despite being young languages (e.g., Aronoff et al., 2005); in some descriptions, the social determinants of morphological complexity have not received much attention, nor has the notion of complexity itself been specifically explored.

Sociolinguistic Typology and Sign Languages

Science.gov (United States)

Schembri, Adam; Fenlon, Jordan; Cormier, Kearsy; Johnston, Trevor

2018-01-01

This paper examines the possible relationship between proposed social determinants of morphological ‘complexity’ and how this contributes to linguistic diversity, specifically via the typological nature of the sign languages of deaf communities. We sketch how the notion of morphological complexity, as defined by Trudgill (2011), applies to sign languages. Using these criteria, sign languages appear to be languages with low to moderate levels of morphological complexity. This may partly reflect the influence of key social characteristics of communities on the typological nature of languages. Although many deaf communities are relatively small and may involve dense social networks (both social characteristics that Trudgill claimed may lend themselves to morphological ‘complexification’), the picture is complicated by the highly variable nature of the sign language acquisition for most deaf people, and the ongoing contact between native signers, hearing non-native signers, and those deaf individuals who only acquire sign languages in later childhood and early adulthood. These are all factors that may work against the emergence of morphological complexification. The relationship between linguistic typology and these key social factors may lead to a better understanding of the nature of sign language grammar. This perspective stands in contrast to other work where sign languages are sometimes presented as having complex morphology despite being young languages (e.g., Aronoff et al., 2005); in some descriptions, the social determinants of morphological complexity have not received much attention, nor has the notion of complexity itself been specifically explored. PMID:29515506

Sociolinguistic Typology and Sign Languages

Directory of Open Access Journals (Sweden)

Adam Schembri

2018-02-01

Full Text Available This paper examines the possible relationship between proposed social determinants of morphological ‘complexity’ and how this contributes to linguistic diversity, specifically via the typological nature of the sign languages of deaf communities. We sketch how the notion of morphological complexity, as defined by Trudgill (2011, applies to sign languages. Using these criteria, sign languages appear to be languages with low to moderate levels of morphological complexity. This may partly reflect the influence of key social characteristics of communities on the typological nature of languages. Although many deaf communities are relatively small and may involve dense social networks (both social characteristics that Trudgill claimed may lend themselves to morphological ‘complexification’, the picture is complicated by the highly variable nature of the sign language acquisition for most deaf people, and the ongoing contact between native signers, hearing non-native signers, and those deaf individuals who only acquire sign languages in later childhood and early adulthood. These are all factors that may work against the emergence of morphological complexification. The relationship between linguistic typology and these key social factors may lead to a better understanding of the nature of sign language grammar. This perspective stands in contrast to other work where sign languages are sometimes presented as having complex morphology despite being young languages (e.g., Aronoff et al., 2005; in some descriptions, the social determinants of morphological complexity have not received much attention, nor has the notion of complexity itself been specifically explored.

The Role of Porta Hepatis Irradiation in Relieving Malignant Obstructive Jaundice

International Nuclear Information System (INIS)

Yang, Kwang Mo; Suh, Hyun Suk

1990-01-01

We have analysed 13 patients with malignant obstructive jaundice due to metastasis who were treated with local radiation therapy to the area of porta hepatis at the Radiation Therapy Department of Paik hospital attached to the Inje University between 1984 and 1988. A good response was observed in 6 out of 7 evaluable patients receiving a total radiation dose ranging from 2600 to 5480 cGy in 2.6 to 6 weeks. A complete response was noted in 5 patients, a partial response in 1 patient, and no response in 1 patient. The overall median survival for 13 patients was 3 months. But two patients lived more than a year without recurrence of jaundice. Moderate dose, localized field radiation therapy appears to the beneficial in relieving obstructive jaundice and gives a good symptomatic relief

Adapting tests of sign language assessment for other sign languages--a review of linguistic, cultural, and psychometric problems.

Science.gov (United States)

Haug, Tobias; Mann, Wolfgang

2008-01-01

Given the current lack of appropriate assessment tools for measuring deaf children's sign language skills, many test developers have used existing tests of other sign languages as templates to measure the sign language used by deaf people in their country. This article discusses factors that may influence the adaptation of assessment tests from one natural sign language to another. Two tests which have been adapted for several other sign languages are focused upon: the Test for American Sign Language and the British Sign Language Receptive Skills Test. A brief description is given of each test as well as insights from ongoing adaptations of these tests for other sign languages. The problems reported in these adaptations were found to be grounded in linguistic and cultural differences, which need to be considered for future test adaptations. Other reported shortcomings of test adaptation are related to the question of how well psychometric measures transfer from one instrument to another.

Sociolinguistic Typology and Sign Languages

OpenAIRE

Adam Schembri; Jordan Fenlon; Kearsy Cormier; Trevor Johnston

2018-01-01

This paper examines the possible relationship between proposed social determinants of morphological ‘complexity’ and how this contributes to linguistic diversity, specifically via the typological nature of the sign languages of deaf communities. We sketch how the notion of morphological complexity, as defined by Trudgill (2011), applies to sign languages. Using these criteria, sign languages appear to be languages with low to moderate levels of morphological complexity. This may partly reflec...

Phonological Development in Hearing Learners of a Sign Language: The Influence of Phonological Parameters, Sign Complexity, and Iconicity

Science.gov (United States)

Ortega, Gerardo; Morgan, Gary

2015-01-01

The present study implemented a sign-repetition task at two points in time to hearing adult learners of British Sign Language and explored how each phonological parameter, sign complexity, and iconicity affected sign production over an 11-week (22-hour) instructional period. The results show that training improves articulation accuracy and that…

Association between patterns of jaw motor activity during sleep and clinical signs and symptoms of sleep bruxism.

Science.gov (United States)

Yoshida, Yuya; Suganuma, Takeshi; Takaba, Masayuki; Ono, Yasuhiro; Abe, Yuka; Yoshizawa, Shuichiro; Sakai, Takuro; Yoshizawa, Ayako; Nakamura, Hirotaka; Kawana, Fusae; Baba, Kazuyoshi

2017-08-01

The aim of this study was to investigate the association between patterns of jaw motor activity during sleep and clinical signs and symptoms of sleep bruxism. A total of 35 university students and staff members participated in this study after providing informed consent. All participants were divided into either a sleep bruxism group (n = 21) or a control group (n = 14), based on the following clinical diagnostic criteria: (1) reports of tooth-grinding sounds for at least two nights a week during the preceding 6 months by their sleep partner; (2) presence of tooth attrition with exposed dentin; (3) reports of morning masticatory muscle fatigue or tenderness; and (4) presence of masseter muscle hypertrophy. Video-polysomnography was performed in the sleep laboratory for two nights. Sleep bruxism episodes were measured using masseter electromyography, visually inspected and then categorized into phasic or tonic episodes. Phasic episodes were categorized further into episodes with or without grinding sounds as evaluated by audio signals. Sleep bruxism subjects with reported grinding sounds had a significantly higher total number of phasic episodes with grinding sounds than subjects without reported grinding sounds or controls (Kruskal-Wallis/Steel-Dwass tests; P bruxism subjects with tooth attrition exhibited significantly longer phasic burst durations than those without or controls (Kruskal-Wallis/Steel-Dwass tests; P bruxism subjects with morning masticatory muscle fatigue or tenderness exhibited significantly longer tonic burst durations than those without or controls (Kruskal-Wallis/Steel-Dwass tests; P bruxism represents different aspects of jaw motor activity during sleep. © 2016 European Sleep Research Society.

Standardization of Sign Languages

Science.gov (United States)

Adam, Robert

2015-01-01

Over the years attempts have been made to standardize sign languages. This form of language planning has been tackled by a variety of agents, most notably teachers of Deaf students, social workers, government agencies, and occasionally groups of Deaf people themselves. Their efforts have most often involved the development of sign language books…

Enzooty of non-Hodgkin's malignant lymphoma of Papio hamadryas in Sukhumi monkey colony. Clinical and morphological signs of pre-lymphoma.

Science.gov (United States)

Yakovleva, Lelita A; Lapin, Boris A; Agumava, Aslan A

2018-04-01

Inoculation of hamadryas baboons with blood of leukemia ill people-induced malignant non-Hodgkin's lymphoma in experimental animals for a very considerable latency period. At close contact of inoculated baboons with healthy non-inoculated animals, the lymphoma spread between them. The epidemiological analysis, postmortem examination, histological analysis, tissue culturing, and PCR were used for the diagnostics of lymphoma and pre-lymphoma, purification, identification of STLV-1, and HVP viruses. Characteristic clinical and morphological signs designated by us as pre-lymphoma often precede the lymphoma development. In some cases, pre-lymphoma does not develop in lymphoma because animals die from various diseases and do not reach the point of the lymphoma development. The horizontal transmission of lymphoma arising with the participation of T-lymphotropic retrovirus STLV-1 is shown. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Multicenter comparison of the efficacy on prevention of pressure ulcer in postoperative patients between two types of pressure-relieving mattresses in China

Science.gov (United States)

Jiang, Qixia; Li, Xiaohua; Zhang, Aiqin; Guo, Yanxia; Liu, Yahong; Liu, Haiying; Qu, Xiaolong; Zhu, Yajun; Guo, Xiujun; Liu, Li; Zhang, Liyan; Bo, Suping; Jia, Jing; Chen, Yuejuan; Zhang, Rui; Wang, Jiandong

2014-01-01

Objective: Present study is designed to evaluate the effects of preventing pressure ulcer in surgical patients with two types of pressure-relieving mattresses. Methods: 1074 surgical patients from 12 hospitals in China were divided into A group (static air mattress with repositioning every 2 hours, n = 562) and B group (power pressure air mattress with repositioning every 2 hours, n = 512). The patient was subjected to a pressure-relieving mattress and observed from 0-5 days after surgery. Indications include the Braden scores, hospital-acquired pressure ulcers (HAPU) incidence and stage. Results: The Braden scores between two groups in five days after surgery were no significant (P > 0.05). The incidence of HAPU between two groups in same days also was no significant (1.07% vs. 0.98%, P > 0.05). The incidence of Stage I and stage II pressure ulcers in group A and B were 1.07% (6/562) and 0.98% (5/512), respectively (χ2 = 0.148, P = 0.882). Conclusion: The effects of preventing pressure ulcer in surgical patients with two types of pressure-relieving mattresses are similar, but the protocol by static air mattress with repositioning every 2 hours is benefit when no power. PMID:25356144

The relationship between observed signs of impairment and THC concentration in oral fluid.

Science.gov (United States)

Fierro, Inmaculada; González-Luque, Juan Carlos; Alvarez, F Javier

2014-11-01

Studies have shown that cannabis intake increases the risk of traffic accidents. Controlled experiments support these findings and have shown a positive dose-effect relationship. In this retrospective cross-sectional study of data from a roadside survey, we investigated whether a police officer's judgment regarding signs of impairment is related to the concentration of delta-9-tetrahydrocannabinol (THC) in the oral fluid (OF). We investigated 2,632 cases from a representative sample of 3,302 Spanish drivers: 253 drivers positive for THC only, 32 positive for THC and ethanol, 201 with only ethanol detected in their breath, and 2,146 drivers who tested negative for ethanol in breath and drugs in OF. Recorded data comprised breath alcohol concentrations, THC concentrations in the OF, and the 31 observed signs of impairment. Subject groups were compared using the chi-square test, and logistic regression was used to examine the risk of being categorized as exhibiting signs of impairment. A relationship was found between the OF THC concentration and some observed signs of impairment. Eye signs were noticeable from a THC concentration >3.0 ng/ml in OF, and >25 ng/ml was related to behavior, facial expression, and speech signs. Alcohol and THC contribute to impairment independently and, when taken simultaneously, the effects are comparable to the sum of the effects when consumed separately. The observation of signs of impairment due to cannabis occurs in an OF concentration-related manner but, as a clinical test, OF has low sensitivity and specificity in a random roadside survey. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Relieving pre-exam anxiety syndrome with wrist-ankle acupuncture: a randomized controlled trial].

Science.gov (United States)

Shu, Shi; Li, Tong-ming; Fang, Fan-fu; He, Hou-luo; Zhou, Qing-hui; Gu, Wei; Zhou, Shuang

2011-06-01

Pre-exam anxiety syndrome is a common condition occurring in pre-exam students and directly affects their examination performance and physical state. Wrist-ankle acupuncture has significant therapeutic effects in treating mental disorders and may also relieve the symptoms of pre-exam anxiety syndrome. To assess the therapeutic effect of wrist-ankle acupuncture on pre-exam anxiety syndrome. A total of 60 students who met the inclusion criteria of pre-exam anxiety syndrome were enrolled from a university in Shanghai and they were randomly divided into treatment group and control group. There were 30 cases in each group, and no case failed to follow-up. In the treatment group, wrist-ankle acupuncture was adopted to point upper 1 bilaterally (impression between flexor carpi ulnaris tendon and ulnar margin), and there was no requirement for Deqi (arrival of qi). In the control group, sham acupuncture was adopted. The treatment was applied 3 times totally in both groups one week before the exam, once every other day, each time with the needles retained for 30 min. The therapeutic effects were compared between two groups. Before and after 3 treatments, Sarason Test Anxiety Scale (TAS) and Expectation and Treatment Credibility Scale (ETCS) were measured and evaluated. The therapeutic effect experienced by the treatment group was better than that of the control group (PETCS before treatment between the two groups. The scores of TAS after treatment in two groups were higher than those before treatment (PETCS than those in the control group (P<0.05, P<0.01). No adverse reaction was reported. Wrist-ankle acupuncture can relieve the symptoms of pre-exam anxiety syndrome significantly, and this therapy is highly safe.

Phonological Similarity in American Sign Language.

Science.gov (United States)

Hildebrandt, Ursula; Corina, David

2002-01-01

Investigates deaf and hearing subjects' ratings of American Sign Language (ASL) signs to assess whether linguistic experience shapes judgments of sign similarity. Findings are consistent with linguistic theories that posit movement and location as core structural elements of syllable structure in ASL. (Author/VWL)

[Use of stairs in a hospital increased by a sign near the stairs or the elevator].

Science.gov (United States)

Houweling, S T; Stoopendaal, J; Kleefstra, N; Meyboom-de Jong, B; Bilo, H J G

2005-12-24

To investigate whether signs encouraging taking the stairs or discouraging taking the elevator lead to an increasing number of patients taking the stairs instead of the elevator in a hospital. Interventional study. During a period of 6 weeks in the period October-December 2004, an investigator recorded how many patients took the stairs and how many took the elevator on the first floor of a hospital close to a diabetes outpatient clinic. A baseline measurement was done over a period of 2 weeks and 4 weeks were used for evaluating the effect of 2 different interventions, each lasting 2 weeks. During the first intervention, a sign was hung up near the elevator, which read: 'Exercise is healthy, take the stairs'. During the second intervention the sign read: 'Use of this elevator is exclusively for personnel and persons with restricted mobility'. Staff members and disabled patients were excluded from the study. A total of 2674 movements were counted. Use of the stairs increased statistically significantly during both interventions: from 54.6% to 63.4% during the first intervention and to 70.4% during the second intervention. Signs in a diabetes outpatient clinic that either encouraged the use of the stairs or discouraged the use of the elevator increased the patients' use of the stairs.

Can we improve the clinical utility of respiratory rate as a monitored vital sign?

Science.gov (United States)

Chen, Liangyou; Reisner, Andrew T; Gribok, Andrei; McKenna, Thomas M; Reifman, Jaques

2009-06-01

Respiratory rate (RR) is a basic vital sign, measured and monitored throughout a wide spectrum of health care settings, although RR is historically difficult to measure in a reliable fashion. We explore an automated method that computes RR only during intervals of clean, regular, and consistent respiration and investigate its diagnostic use in a retrospective analysis of prehospital trauma casualties. At least 5 s of basic vital signs, including heart rate, RR, and systolic, diastolic, and mean arterial blood pressures, were continuously collected from 326 spontaneously breathing trauma casualties during helicopter transport to a level I trauma center. "Reliable" RR data were identified retrospectively using automated algorithms. The diagnostic performances of reliable versus standard RR were evaluated by calculation of the receiver operating characteristic curves using the maximum-likelihood method and comparison of the summary areas under the receiver operating characteristic curves (AUCs). Respiratory rate shows significant data-reliability differences. For identifying prehospital casualties who subsequently receive a respiratory intervention (hospital intubation or tube thoracotomy), standard RR yields an AUC of 0.59 (95% confidence interval, 0.48-0.69), whereas reliable RR yields an AUC of 0.67 (0.57-0.77), P support algorithms.

The importance of plain radiographic signs for emergency aortography in blunt chest trauma

International Nuclear Information System (INIS)

Schumacher, K.A.; Trost, K.; Bargon, G.

1983-01-01

A retrospective study of plain radiographic findings in 11 patients with traumatic rupture of the aorta was conducted, and the results compared with the incidence of numerous chest x-rays signs previously described in 294 cases of angiographically proven thoracic aorta dissection. It is concluded that positive plain radiographic signs obtained from patients with blunt chest trauma reveal high sensitivity and may thus be used as an indication for emergency aortography. However, since this procedure lacks 100% specificity even those patients with normal x-ray findings but clinically and/or anamnestically adequate thoracic trauma should be submitted to aortography. (orig.) [de

The halo sign and peripancreatic fluid: useful CT signs of hypovolaemic shock complex in adults

International Nuclear Information System (INIS)

Ryan, M.F.; Hamilton, P.A.; Sarrazin, J.; Chu, P.; Benjaminov, O.; Lam, K.

2005-01-01

AIM: To report two new, useful computed tomography (CT) signs of the hypovolaemic shock complex (HSC) in adults admitted after blunt abdominal trauma: the halo sign (ring of fluid around a collapsed intra-hepatic inferior vena cava (IVC)), and peripancreatic retroperitoneal fluid. MATERIALS AND METHODS: CT images of 498 consecutive patients admitted after blunt abdominal trauma were reviewed, of which 27 had CT signs of the HSC. The CT images of these 27 patients were analysed. A control group of 101 patients examined using CT for suspected blunt abdominal trauma who did not have the HSC were chosen for comparison. RESULTS: The most common features involved the vascular compartment: diminished IVC diameter (n=27), a positive halo sign (n=21); diminished anteroposterior diameter of the aorta (n=13); and abnormal vascular enhancement (n=10). Peripancreatic retroperitoneal fluid in the absence of pancreatic injury, pancreatitis or pancreatic disease was observed in eight patients. Hollow visceral abnormalities included: diffuse increased mucosal enhancement of both the small and large bowel (n=19); diffuse thickening of the small bowel wall (n=11); and small bowel dilatation (n=7). Solid visceral abnormalities included both decreased and or increased enhancement. Several concomitant intra- and extra-abdominal injuries were also identified. CONCLUSION: In the setting of blunt abdominal trauma, early abdominal CT can show diffuse abnormalities due to the HSC, which occasionally may alert clinicians of unsuspected shock. Recognition of these signs as distinguished from injured viscera is important in order to avoid unnecessary laparotomy. Two new signs are described: the halo sign and peripancreatic retroperitoneal fluid

The halo sign and peripancreatic fluid: useful CT signs of hypovolaemic shock complex in adults

Energy Technology Data Exchange (ETDEWEB)

Ryan, M.F.; Hamilton, P.A.; Sarrazin, J.; Chu, P.; Benjaminov, O.; Lam, K

2005-05-01

AIM: To report two new, useful computed tomography (CT) signs of the hypovolaemic shock complex (HSC) in adults admitted after blunt abdominal trauma: the halo sign (ring of fluid around a collapsed intra-hepatic inferior vena cava (IVC)), and peripancreatic retroperitoneal fluid. MATERIALS AND METHODS: CT images of 498 consecutive patients admitted after blunt abdominal trauma were reviewed, of which 27 had CT signs of the HSC. The CT images of these 27 patients were analysed. A control group of 101 patients examined using CT for suspected blunt abdominal trauma who did not have the HSC were chosen for comparison. RESULTS: The most common features involved the vascular compartment: diminished IVC diameter (n=27), a positive halo sign (n=21); diminished anteroposterior diameter of the aorta (n=13); and abnormal vascular enhancement (n=10). Peripancreatic retroperitoneal fluid in the absence of pancreatic injury, pancreatitis or pancreatic disease was observed in eight patients. Hollow visceral abnormalities included: diffuse increased mucosal enhancement of both the small and large bowel (n=19); diffuse thickening of the small bowel wall (n=11); and small bowel dilatation (n=7). Solid visceral abnormalities included both decreased and or increased enhancement. Several concomitant intra- and extra-abdominal injuries were also identified. CONCLUSION: In the setting of blunt abdominal trauma, early abdominal CT can show diffuse abnormalities due to the HSC, which occasionally may alert clinicians of unsuspected shock. Recognition of these signs as distinguished from injured viscera is important in order to avoid unnecessary laparotomy. Two new signs are described: the halo sign and peripancreatic retroperitoneal fluid.

Generating potentially nilpotent full sign patterns

NARCIS (Netherlands)

Kim, I.J.; Olesky, D.D.; Shader, B.L.; Driessche, van den P.; Holst, van der H.; Vander Meulen, K.N.

2009-01-01

A sign pattern is a matrix with entries in {+,-, 0}. A full sign pattern has no zero entries. The refined inertia of a matrix pattern is defined and techniques are developed for constructing potentially nilpotent full sign patterns. Such patterns are spectrally arbitrary. These techniques can also

LHCb: Wrong-Sign to Right-Sign Yield in Flavor Tagged $D^0 \\to K\\pi$ Data at LHCb

CERN Multimedia

Bessner, M

2011-01-01

Initial results on wrong-sign $D^0 \\rightarrow K^+ \\pi^-$ decays based on the 2010 dataset are presented: the selection criteria, the yield, the time-integrated ratio of wrong-sign to right-sign ($D^0 \\rightarrow K^- \\pi^+$) decays, and a decay time acceptance corrected ratio. The corrected ratio is measured to be $R_{acc \\, cor} = (0.409 \\pm 0.031 (stat.) \\pm 0.039 (sys.)) \\%$. This analysis is the first step towards the measurement of the time-dependent wrong-sign/right-sign ratio from which $D^0$ mixing parameters may be extracted.

Kinematic parameters of signed verbs.

Science.gov (United States)

Malaia, Evie; Wilbur, Ronnie B; Milkovic, Marina

2013-10-01

Sign language users recruit physical properties of visual motion to convey linguistic information. Research on American Sign Language (ASL) indicates that signers systematically use kinematic features (e.g., velocity, deceleration) of dominant hand motion for distinguishing specific semantic properties of verb classes in production ( Malaia & Wilbur, 2012a) and process these distinctions as part of the phonological structure of these verb classes in comprehension ( Malaia, Ranaweera, Wilbur, & Talavage, 2012). These studies are driven by the event visibility hypothesis by Wilbur (2003), who proposed that such use of kinematic features should be universal to sign language (SL) by the grammaticalization of physics and geometry for linguistic purposes. In a prior motion capture study, Malaia and Wilbur (2012a) lent support for the event visibility hypothesis in ASL, but there has not been quantitative data from other SLs to test the generalization to other languages. The authors investigated the kinematic parameters of predicates in Croatian Sign Language ( Hrvatskom Znakovnom Jeziku [HZJ]). Kinematic features of verb signs were affected both by event structure of the predicate (semantics) and phrase position within the sentence (prosody). The data demonstrate that kinematic features of motion in HZJ verb signs are recruited to convey morphological and prosodic information. This is the first crosslinguistic motion capture confirmation that specific kinematic properties of articulator motion are grammaticalized in other SLs to express linguistic features.

Associations of endodontic symptoms and signs with particular combinations of specific bacteria.

Science.gov (United States)

Gomes, B P; Lilley, J D; Drucker, D B

1996-03-01

Significant associations have been reported between (a) specific bacterial species isolated from root canals and (b) between individual bacterial species and endodontic symptoms and signs. The prime objective of this study was to determine whether particular combinations of specific bacteria are associated with individual endodontic symptoms and signs. Seventy root canals were investigated microbiologically taking care to maintain the viability of obligate anaerobes, which accounted for 64% of the total species isolated, including Peptostreptococcus micros, Prevotella melaninogenica, Prevotella oralis, Eubacterium aerofaciens, Eubacterium lentum, Fusobacterium nucleatum, Prevotella buccae and Prevotella intermedia. Significant associations were found between individual clinical features and the following pairs of species: (a) pain (37 cases) and Peptostreptococcus spp./Prevotella spp., Peptostreptococcus spp./Prevotella melaninogenica, Pstr. micros/Prev. melaninogenica (all P spp. (P spp./Eubacterium spp. (P spp./Eubacterium spp. (P < 0.05). Thus data from this investigation suggests that statistically significant associations exist between individual endodontic symptoms and signs and particular combinations of specific bacteria.

A comparison between the use of intravenous bags and the Heelift suspension boot to prevent pressure ulcers in orthopedic patients.

Science.gov (United States)

Bales, Isabel

2012-03-01

The heel is the second most common area where patients develop pressure ulcers (PrUs). Some of the interventions commonly used today to prevent PrUs have not been empirically tested, whereas other interventions have been studied and shown to prevent heel PrUs. Currently, there are no specific studies comparing a pressure-relieving suspension boot with the use of intravenous bags. This quasi-experimental study compared the use of these interventions to determine which intervention was more effective for heel-pressure relief. The target population consisted of a convenience sample of 30 patients admitted to the hospital for hip or knee surgery. Subjects were randomized to intravenous bags or pressure-relieving suspension boots. Daily pressure assessment of heels and the Achilles area was completed using validated pressure scales. Data were analyzed using the SPSS statistical program and were then used to determine the extent to which signs and symptoms of pressure were associated with each intervention. The results demonstrated a significant difference between the pressure-relieving suspension boot and the intravenous bag as heel-pressure-relief methods. Based on the statistical results of this study, the pressure-relieving suspension boot (Heelift; DM Systems Inc, Evanston, Illinois) was the better clinical intervention for patients with decreased mobility.

Adaptation of a Vocabulary Test from British Sign Language to American Sign Language

Science.gov (United States)

Mann, Wolfgang; Roy, Penny; Morgan, Gary

2016-01-01

This study describes the adaptation process of a vocabulary knowledge test for British Sign Language (BSL) into American Sign Language (ASL) and presents results from the first round of pilot testing with 20 deaf native ASL signers. The web-based test assesses the strength of deaf children's vocabulary knowledge by means of different mappings of…

Budesonide/formoterol maintenance and reliever therapy in adolescent patients with asthma

DEFF Research Database (Denmark)

Jorup, Carin; Lythgoe, Dan; Bisgaard, Hans

2018-01-01

Asthma control is often suboptimal in adolescents, but few studies have evaluated asthma treatments in this population.This post hoc analysis assessed the efficacy and safety of budesonide/formoterol (BUD/FORM) maintenance and reliever therapy (MART) for treatment of persistent asthma in adolescent...... (age 12-17 years) subgroups within six randomised, double-blind trials. The primary end-point was time to first severe exacerbation. Secondary end-points included number of severe exacerbations, asthma-related symptoms, night-time awakenings, morning peak expiratory flow, forced expiratory volume in 1...... s, as-needed medication use and five-item asthma control questionnaire scores.In adolescents (n=1847), BUD/FORM MART was similar to or more effective than comparators across each of the studies in reducing the risk of a first severe exacerbation (hazard ratios (HR) BUD/FORM MART versus comparators 0...

'Twisted tape sign': Its significance in recurrent sigmoid volvulus

Energy Technology Data Exchange (ETDEWEB)

Gopal, K. [Tameside and Glossop Acute Services NHS Trust, Fountain Street, Ashton-under-Lyne OL6 9RW (United Kingdom)]. E-mail: karthikgopal73@yahoo.co.uk; Lim, Y. [Tameside and Glossop Acute Services NHS Trust, Fountain Street, Ashton-under-Lyne OL6 9RW (United Kingdom); Banerjee, B. [Tameside and Glossop Acute Services NHS Trust, Fountain Street, Ashton-under-Lyne OL6 9RW (United Kingdom)

2005-11-01

Aim: Sigmoid volvulus is a common cause of intestinal obstruction in the elderly. Mild attacks of sigmoid volvulus may be more difficult to diagnose due to the lack of severity of symptoms which may resolve spontaneously only to recur after an interval. This study was a review of patients to assess the incidence of the 'twisted tape sign' and to evaluate the significance of its presence in cases of recurrent sigmoid volvulus. Methods and materials: A retrospective study over eight years revealed six cases of surgically confirmed recurrent sigmoid volvulus. Case records and barium enemas of all patients were reviewed. Results: Six patients were identified, including four men and two women, with a median age of 56 years. Diagnostic difficulties were encountered in four (67%) patients with a delay ranging between 10 and 37 months with a mean 17.3 months. Twisted tape sign was confirmed on all barium examinations retrospectively. Conclusion: Recognition of twisted tape sign on barium enema examination along with an appropriate clinical history would suggest a diagnosis of recurrent sigmoid volvulus.

Chinese herbal medicine for chronic neck pain due to cervical degenerative disc disease.

Science.gov (United States)

Trinh, Kien; Cui, Xuejun; Wang, Yong-Jun

2010-11-15

Systematic review. To assess the efficacy of Chinese herbal medicines in treating chronic neck pain with radicular signs or symptoms. Chronic neck pain with radicular signs or symptoms is a common condition. Many patients use complementary and alternative medicine, including traditional Chinese medicine, to address their symptoms. We electronically searched CENTRAL, MEDLINE, EMBASE, CINAHL, and AMED (up to 2009), the Chinese Biomedical Database and related herbal medicine databases in Japan and South Korea (up to 2007). We also contacted content experts and hand searched a number of journals published in China.We included randomized controlled trials with adults with a clinical diagnosis of cervical degenerative disc disease, cervical radiculopathy, or myelopathy supported by appropriate radiologic findings. The interventions were Chinese herbal medicines. The primary outcome was pain relief, measured with a visual analogue scale, numerical scale, or other validated tool. All 4 included studies were in Chinese; 2 of which were unpublished. Effect sizes were not clinically relevant and there was low quality evidence for all outcomes due to study limitations and sparse data (single studies). Two trials (680 participants) found that Compound Qishe Tablets relieved pain better in the short-term than either placebo or Jingfukang; one trial (60 participants) found than an oral herbal formula of Huangqi relieved pain better than Mobicox or Methycobal, and another trial (360 participants) showed that a topical herbal medicine, Compound Extractum Nucis Vomicae, relieved pain better than Diclofenac Diethylamine Emulgel. There is low quality evidence that an oral herbal medication, Compound Qishe Tablet, reduced pain more than placebo or Jingfukang and a topical herbal medicine, Compound Extractum Nucis Vomicae, reduced pain more than Diclofenac Diethylamine Emulgel. Further research is very likely to change both the effect size and our confidence in the results.

The Legal Recognition of Sign Languages

Science.gov (United States)

De Meulder, Maartje

2015-01-01

This article provides an analytical overview of the different types of explicit legal recognition of sign languages. Five categories are distinguished: constitutional recognition, recognition by means of general language legislation, recognition by means of a sign language law or act, recognition by means of a sign language law or act including…

Visual cortex entrains to sign language.

Science.gov (United States)

Brookshire, Geoffrey; Lu, Jenny; Nusbaum, Howard C; Goldin-Meadow, Susan; Casasanto, Daniel

2017-06-13

Despite immense variability across languages, people can learn to understand any human language, spoken or signed. What neural mechanisms allow people to comprehend language across sensory modalities? When people listen to speech, electrophysiological oscillations in auditory cortex entrain to slow ([Formula: see text]8 Hz) fluctuations in the acoustic envelope. Entrainment to the speech envelope may reflect mechanisms specialized for auditory perception. Alternatively, flexible entrainment may be a general-purpose cortical mechanism that optimizes sensitivity to rhythmic information regardless of modality. Here, we test these proposals by examining cortical coherence to visual information in sign language. First, we develop a metric to quantify visual change over time. We find quasiperiodic fluctuations in sign language, characterized by lower frequencies than fluctuations in speech. Next, we test for entrainment of neural oscillations to visual change in sign language, using electroencephalography (EEG) in fluent speakers of American Sign Language (ASL) as they watch videos in ASL. We find significant cortical entrainment to visual oscillations in sign language sign is strongest over occipital and parietal cortex, in contrast to speech, where coherence is strongest over the auditory cortex. Nonsigners also show coherence to sign language, but entrainment at frontal sites is reduced relative to fluent signers. These results demonstrate that flexible cortical entrainment to language does not depend on neural processes that are specific to auditory speech perception. Low-frequency oscillatory entrainment may reflect a general cortical mechanism that maximizes sensitivity to informational peaks in time-varying signals.

Spot sign as a predictor of rebleeding after endoscopic surgery for intracerebral hemorrhage.

Science.gov (United States)

Miki, Koichi; Yagi, Kenji; Nonaka, Masani; Iwaasa, Mitsutoshi; Abe, Hiroshi; Morishita, Takashi; Arima, Hisatomi; Inoue, Tooru

2018-05-25

OBJECTIVE In patients with spontaneous intracerebral hemorrhage (sICH), postoperative recurrent hemorrhage (PRH) is one of the most severe complications after endoscopic evacuation of hematoma (EEH). However, no predictors of this complication have been identified. In the present study, the authors retrospectively investigated whether PRH can be preoperatively predicted by the presence of the spot sign on CT scans. METHODS In total, 143 patients with sICH were treated by EEH between June 2009 and March 2017, and 127 patients who underwent preoperative CT angiography were included in this study. Significant correlations of PRH with the patients' baseline, clinical, and radiographic characteristics, including the spot sign, were evaluated using multivariable logistic regression models. RESULTS The incidence of and risk factors for PRH were assessed in 127 patients with available data. PRH occurred in 9 (7.1%) patients. Five (21.7%) cases of PRH were observed among 23 patients with the spot sign, whereas only 4 (3.8%) cases of PRH occurred among 104 patients without the spot sign. The spot sign was the only independent predictor of PRH (OR 5.81, 95% CI 1.26-26.88; p = 0.02). The following factors were not independently associated with PRH: age, hypertension, poor consciousness, antihemostatic factors (thrombocytopenia, coagulopathy, and use of antithrombotic drugs), the location and size of the sICH, other radiographic findings (black hole sign and blend sign), surgical duration and procedures, and early surgery. CONCLUSIONS The spot sign is likely to be a strong predictor of PRH after EEH among patients with sICH. Complete and careful control of bleeding in the operative field should be ensured when surgically treating such patients. New surgical strategies and procedures might be needed to improve these patients' outcomes.

Analysis of factors temporarily impacting traffic sign readability

Directory of Open Access Journals (Sweden)

Majid Khalilikhah

2016-10-01

Full Text Available Traffic sign readability can be affected by the existence of dirt on traffic sign faces. However, among damaged signs, dirty traffic signs are unique since their damage is not permanent and they just can be cleaned instead of replaced. This study aimed to identify the most important factors contributing to traffic sign dirt. To do so, a large number of traffic signs in Utah were measured by deploying a vehicle instrumented with mobile LiDAR imaging and digital photolog technologies. Each individual daytime digital image was inspected for dirt. Location and climate observations obtained from official sources were compiled using ArcGIS throughout the process. To identify contributing factors to traffic sign dirt, the chi-square test was employed. To analyze the data and rank all of the factors based on their importance to the sign dirt, Random forests statistical model was utilized. After analyzing the data, it can be concluded that ground elevation, sign mount height, and air pollution had the highest effect on making traffic signs dirty. The findings of this investigation assist transportation agencies in determining traffic signs with a higher likelihood of sign dirt. In this way, agencies would schedule to clean such traffic signs more frequently.

Useful radiologic sign in diagnosis of peripheral lung cancer: Nucleohalo sign and its pathologic basis

International Nuclear Information System (INIS)

Wang, H.; Shi, D.

1994-01-01

The authors investigated the x-ray findings of 117 patients with peripheral lung cancer proved by operation and pathology, of them 35(29.9%) cases were found to have the 'nucleohalo sign', 6(13.6%) in 44 cases of solitary metastatic lung cancers, but none in 167 cases of benign lung nodular lesions and 4 cases of primary lung sarcoma and lymphoma. Radiologic and pathologic correlative study of the nucleohalo sign with surgical specimens of 14 lung cancers suggested that the cancerous parenchymas in nuclear areas were more than the interstitices in 12 cases and the other 2 were equal in both parenchymas and interstitices. Instead, the cancerous parenchymas in halo areas were less than cancerous interstitices in all cases. Dynamic observation of the 'nucleohalo sign' showed that this sign was an appearance of a stage in cancer growth. It is considered a very important sign in x-ray diagnosis of peripheral lung cancer, especially in the early diagnosis of lung cancer under or equal to 3 cm in diameter

Is synovitis detected on non-contrast-enhanced magnetic resonance imaging associated with serum biomarkers and clinical signs of effusion? Data from the Osteoarthritis Initiative.

Science.gov (United States)

Deveza, L A; Kraus, V B; Collins, J E; Guermazi, A; Roemer, F W; Nevitt, M C; Hunter, D J

2017-09-20

To determine the relationship between synovitis detected on non-contrast-enhanced (non-CE) magnetic resonance imaging (MRI), biochemical markers of inflammation, and clinical assessment of effusion in people with knee osteoarthritis (OA). We examined data from the OA Biomarkers Consortium within the Osteoarthritis Initiative (n = 600). Non-CE MRIs were semi-quantitatively scored (grades 0-3) for severity of Hoffa synovitis and effusion synovitis. Serum (s) matrix metalloproteinase-3 (sMMP-3), hyaluronic acid (sHA), and nitrated epitope of the α-helical region of type II collagen (sColl2-1NO2) were quantified. The bulge and patellar tap clinical tests were performed at baseline and performance characteristics were assessed for the detection of effusion synovitis on MRI. Multinomial logistic regression adjusted for covariates was used to assess the association between biochemical and imaging markers at baseline and over 12 and 24 months. At baseline, sHA and sMMP-3 were associated with moderate to large (score ≥ 2, n = 117) effusion synovitis, with odds ratio = 1.35 and 1.30 per 1 standard deviation in biochemical markers (95% confidence intervals 1.07, 1.71 and 1.00, 1.69), c-statistics 0.640 and 0.626, respectively. The c-statistics for the presence of Hoffa synovitis (score ≥ 2) were 0.693, 0.694, and 0.694 for sHA, sMMP-3, and sColl2-1NO2, respectively. There was no significant association between biochemical markers (baseline and 12 and 24 month time-integrated concentrations) and changes in MRI markers. The bulge and patellar tap signs were 22.0% and 4.3% sensitive and 88.8% and 94.8% specific, respectively, for detecting effusion synovitis (score ≥ 1) on MRI. sHA and sMMP-3 were modestly associated with effusion synovitis at baseline. Clinical signs of effusion are insensitive but highly specific for the presence of any effusion synovitis on non-CE MRI.

The lambda sign: a new radiographic indicator of latent syndesmosis instability.

Science.gov (United States)

Ryan, Ltc Paul; Hills, Maj Chad; Chang, James; Wilson, Cpt David

2014-09-01

Latent syndesmotic instability is a common cause of chronic ankle pain. The diagnosis is not readily apparent on static imaging as the fibula remains reduced. The hypothesis of this study was that a previously undescribed novel finding on coronal MRI (lambda sign) is an independent indicator of latent syndesmosis instability. We also report on the utility of classic radiographic and physical exam findings. A total of 23 patients with latent syndesmotic instability diagnosed via arthroscopy (group I) were compared to a cohort of 40 patients who were found to have a stable syndesmosis during arthroscopy for unrelated conditions (group II). A retrospective chart review was performed evaluating their clinical history, preoperative physical examination, and radiologic findings. The lambda sign is a high intensity signal seen on coronal MR imaging that resembles the Greek letter lambda. All of the physical exam findings tested were statistically significant. Pain at the syndesmosis had the highest sensitivity (83%), while pain reproduced with the proximal squeeze test resulted in the highest specificity (89%). The external rotation stress test had the highest positive predictive value (75%). Of the radiographic examinations performed, only the lambda sign was found to have statistical significance with a sensitivity of 75% and a specificity of 63%. The presence of a lambda sign on the MRI of patients with physical exam findings suggestive of syndesmotic pain was highly sensitive (75%) and specific (85%). The lambda sign noted on the coronal MRI was both sensitive and specific for injuries involving greater than 2 mm of diastasis on arthroscopic stress examination of the syndesmosis. While neither the lambda sign nor any other finding on physical or radiographic examination represented an independent predictor of syndesmotic instability, the presence of a lambda sign in concert with positive physical exam findings might help health care providers determine which patients

Study on road sign recognition in LabVIEW

Science.gov (United States)

Panoiu, M.; Rat, C. L.; Panoiu, C.

2016-02-01

Road and traffic sign identification is a field of study that can be used to aid the development of in-car advisory systems. It uses computer vision and artificial intelligence to extract the road signs from outdoor images acquired by a camera in uncontrolled lighting conditions where they may be occluded by other objects, or may suffer from problems such as color fading, disorientation, variations in shape and size, etc. An automatic means of identifying traffic signs, in these conditions, can make a significant contribution to develop an Intelligent Transport Systems (ITS) that continuously monitors the driver, the vehicle, and the road. Road and traffic signs are characterized by a number of features which make them recognizable from the environment. Road signs are located in standard positions and have standard shapes, standard colors, and known pictograms. These characteristics make them suitable for image identification. Traffic sign identification covers two problems: traffic sign detection and traffic sign recognition. Traffic sign detection is meant for the accurate localization of traffic signs in the image space, while traffic sign recognition handles the labeling of such detections into specific traffic sign types or subcategories [1].

Mechanisms-based classifications of musculoskeletal pain: part 3 of 3: symptoms and signs of nociceptive pain in patients with low back (± leg) pain.

LENUS (Irish Health Repository)

Smart, Keith M

2012-08-01

As a mechanisms-based classification of pain \\'nociceptive pain\\' (NP) refers to pain attributable to the activation of the peripheral receptive terminals of primary afferent neurones in response to noxious chemical, mechanical or thermal stimuli. The symptoms and signs associated with clinical classifications of NP have not been extensively studied. The purpose of this study was to identify symptoms and signs associated with a clinical classification of NP in patients with low back (± leg) pain. Using a cross-sectional, between-subjects design; four hundred and sixty-four patients with low back (± leg) pain were assessed using a standardised assessment protocol after which their pain was assigned a mechanisms-based classification based on experienced clinical judgement. Clinicians then completed a clinical criteria checklist indicating the presence\\/absence of various symptoms and signs. A regression analysis identified a cluster of seven clinical criteria predictive of NP, including: \\'Pain localised to the area of injury\\/dysfunction\\

The sign language skills classroom observation: a process for describing sign language proficiency in classroom settings.

Science.gov (United States)

Reeves, J B; Newell, W; Holcomb, B R; Stinson, M

2000-10-01

In collaboration with teachers and students at the National Technical Institute for the Deaf (NTID), the Sign Language Skills Classroom Observation (SLSCO) was designed to provide feedback to teachers on their sign language communication skills in the classroom. In the present article, the impetus and rationale for development of the SLSCO is discussed. Previous studies related to classroom signing and observation methodology are reviewed. The procedure for developing the SLSCO is then described. This procedure included (a) interviews with faculty and students at NTID, (b) identification of linguistic features of sign language important for conveying content to deaf students, (c) development of forms for recording observations of classroom signing, (d) analysis of use of the forms, (e) development of a protocol for conducting the SLSCO, and (f) piloting of the SLSCO in classrooms. The results of use of the SLSCO with NTID faculty during a trial year are summarized.

Repetitions in French Belgian Sign Language (LSFB) and Flemish Sign Language (VGT) narratives and conversations

OpenAIRE

Notarrigo, Ingrid; Meurant, Laurence; Van Herreweghe, Mieke; Vermeerbergen, Myriam

2016-01-01

Repetition was described in the nineties by a limited number of sign linguists: Vermeerbergen & De Vriendt (1994) looked at a small corpus of VGT data, Fisher & Janis (1990) analysed “verb sandwiches” in ASL and Pinsonneault (1994) “verb echos” in Quebec Sign Language. More recently the same phenomenon has been the focus of research in a growing number of signed languages, including American (Nunes and de Quadros 2008), Hong Kong (Sze 2008), Russian (Shamaro 2008), Polish (Flilipczak and Most...

A Study of Soft Neurological Signs and Its Correlates in Drug-Naive Patients with First Episode Psychosis.

Science.gov (United States)

Gunasekaran, Vanishree; Venkatesh, V Mathan Kumar; Asokan, T V

2016-01-01

Soft neurological signs are minor, non localizing, objective abnormalities, thought to reflect damage in cortical and sub-cortical connections or connections within different cortical regions. Regional structural grey matter anomalies have already been observed and correlated with the presence of cognitive deficits and presence of soft neurological signs in schizophrenic patients. Drug naive patients presenting with first episode of psychosis (FEP)were clinically evaluated for soft neurological signs using the Cambridge Neurological Inventory. The soft neurological signs scores were compared with scores in healthy volunteers. In the patient group, this score was also correlated with demographic and disorder variables. Of the 30 patients with FEP, 60% were women. The average age of the participant was 36.2 years. The average duration of illness was 1.55 years. More than 50% of the patients had schizophrenia. 93.3% of patients with FEP had atleast one soft neurological sign compared to 16.6% of controls. The average score on BPRS was 25.86 and on PANSS was 39.29, and BPRS, PANSS scores had a significant correlation with total soft neurological signs score. There is a significantly higher incidence of soft neurological signs in patients with FEP, particularly schizophrenia. The presence of soft signs correlated with the severity of psychosis.

Signs and symptoms of developmental abnormalities of the genitourinary tract

Directory of Open Access Journals (Sweden)

Paulo Cesar Koch Nogueira

2016-06-01

Full Text Available Abstract Objective: The abnormalities of the genitourinary tract development are the leading cause of chronic kidney disease (CKD in children. The diagnosis of this disease in Brazil is late and incomplete, which results in increased morbidity and mortality in this age group. Early diagnosis of this condition is the prerogative of generalist pediatricians, and the aim of this study was to review the clinical signs and symptoms associated with developmental abnormalities of the genitourinary tract. Data sources: Based on the description of a symbolic clinical case, the authors conducted a non-systematic review of medical literature. Data synthesis: The results suggest that the following data should be used as a warning for early diagnosis of affected children: (a combined urinary tract abnormalities (chromosomal abnormalities; sequence of malformations [VACTERLand Prune-Belly]; and musculoskeletal, digestive tract, heart, and nervous system malformations; (b previous history (congenital anomalies of the kidney and urinary tract [CAKUT] in the family, low birth weight, and oligoamnios; (c clinical signs (polyuria/nocturia, urinary tract infection, systemic arterial hypertension, failure to thrive, weak urinary stream, difficulty to start urination, distended bladder, non-monosymptomatic enuresis, urinary/urge incontinence, and bowel and bladder dysfunction; and (d pre- and postnatal ultrasonographic alterations (increased anteroposterior diameter of the renal pelvis, mainly in the third trimester of pregnancy; single kidney; hydronephrosis associated with other abnormalities; and hydronephrosis with parenchymal involvement in the post-neonatal assessment. Conclusion: The suggestions shown here can help the pediatrician to establish clinical hypotheses for the early diagnosis of developmental abnormalities of the genitourinary tract without resorting to expensive and invasive procedures.

Does Courvoisier's sign stand the test of time?

International Nuclear Information System (INIS)

Murphy, K.; McLaughlin, P.; O'Connor, B.R.; Breen, M.; O'Súilleabháin, C.; MacEneaney, P.; Maher, M.M.

2012-01-01

Aim: To investigate the validity of Courvoisier's sign, in the age of cross-sectional imaging and image analysis software by objectively measuring gallbladder volumes at magnetic resonance cholangiopancreatography (MRCP) in patients with and without biliary obstruction and to assess whether gallbladder volume is more significantly increased in patients with gallstone-related rather than non-gallstone-related biliary obstruction. Materials and methods: All MCRP investigations that were performed at a tertiary hepatobiliary centre over a 2-year period were analysed. The information recorded included the presence or absence of gallbladder stones as well as the presence and type of common bile duct (CBD) disease. Gallbladder volume was calculated from MRCP studies using image analysis software. Results: Three hundred and ninety-four of 645 examined MRCPs (61.1%) were eligible for analysis. A statistically significant difference in mean gallbladder volume existed between the summated obstructive and non-obstructive groups (p < 0.001). In addition, a significant difference existed in mean gallbladder volume between those with CBD stones and non-gallstone CBD obstruction (p = 0.03). Conclusion: A significant difference was observed in gallbladder volumes in the group with biliary obstruction from choledocholithiasis compared with the group with biliary obstruction from other causes. Thus, objective measurement of gallbladder volume from modern cross-sectional imaging studies appears to validate Courvoisier's sign as a valuable clinical sign, which could be applied to modern imaging studies in distinguishing different causes of biliary obstruction in the jaundiced patient.

Comparison of the clinical efficacy of craniotomy and craniopuncture therapy for the early stage of moderate volume spontaneous intracerebral haemorrhage in basal ganglia: Using the CTA spot sign as an entry criterion.

Science.gov (United States)

Ge, Chunyan; Zhao, Wangmiao; Guo, Hong; Sun, Zhaosheng; Zhang, Wanzeng; Li, Xiaowei; Yang, Xuehui; Zhang, Jinrong; Wang, Dongxin; Xiang, Yi; Mao, Jianhui; Zhang, Wenchao; Guo, Hao; Zhang, Yazhao; Chen, Jianchao

2018-06-01

Surgical treatment is widely used for haematoma removal in spontaneous intracerebral haemorrhage (ICH) patients, but there is controversy about the selection of surgical methods. The CT angiography (CTA) spot sign has been proven to be a promising factor predicting haematoma expansion and is recommended as an entry criterion for haemostatic therapy in patients with ICH. This trial was designed to evaluate the clinical efficacy of two surgical methods (haematoma removal by craniotomy and craniopuncture combined with urokinase infusion) for patients in the early stage (≤6h from symptom onset) of spontaneous ICH with a moderate haematoma volume (30 ml - 60 ml). From January 2012 to July 2017, 196 eligible patients treated in our institution were enrolled according to the inclusion criteria. The patients were divided into the CTA spot sign positive type and CTA spot sign negative type according to the presence or absence of the CTA spot sign. For each type, the patients were randomly assigned to two groups, i.e., the craniotomy group, in which patients underwent craniotomy with haematoma removal, and the craniopuncture group, in which patients underwent minimally invasive craniopuncture combined with urokinase infusion therapy. Neurological function was evaluated with the Scandinavian Stroke Scale (SSS) at day 14. The disability level and the activities of daily living were assessed using a modified Rankin Scale (mRS) and Barthel Index (BI) at day 90. Case fatalities were recorded at day 14 and 90. Complications were recorded during hospitalization. For the CTA spot sign positive type, the craniotomy group had a higher SSS than that in the craniopuncture group (P spot sign negative type, there were no significant differences in the SSS, mRS, BI, fatality rate and complication rate between the two groups. ICH can be divided into the CTA spot sign positive and negative type according to the presence or absence of the CTA spot sign. For the CTA spot sign

Clinical signs, diagnosis and treatment of three dogs with angiostrongylosis in ireland

Directory of Open Access Journals (Sweden)

Brennan Sheila F

2004-02-01

Full Text Available Infection with Angiostrongylus vasorum was diagnosed at necropsy on a dog that died from acute pulmonary haemorrhage, and on recovery of L1 larvae by Baermann examination of faeces from two dogs, one of which had abdominal pain and retroperitoneal haemorrhage, while the other had right-sided heart failure due to cor pulmonale. The presenting signs included syncope (one dog, exercise intolerance (two dogs, cough (two dogs, abdominal pain (one dog and depression (one dog. One-stage prothrombin time and activated partial thromboplastin time were prolonged in two dogs, buccal mucosal bleeding time was prolonged in one dog and globulin was elevated in all three dogs. Two dogs were treated with fenbendazole and recovered.

Electronic structure of C28, Pa at sign C28, and U at sign C28

International Nuclear Information System (INIS)

Zhao, K.; Pitzer, R.M.

1996-01-01

Electronic structure calculations, including relativistic core potentials and the spin-orbit interaction, have been carried out on the C 28 , Pa at sign C 28 , and U at sign C 28 species. Excitation energies, spin-orbit splittings, the electron affinity, and the ionization potential are computed for C 28 . The ground state of C 28 is described well by the Hartree-Fock wave functions, but other states are not. The computed electron affinity and ionization potential are similar to those of C 60 . Strong metal-cage binding is found for Pa at sign C 28 and U at sign C 28 , similar to that in U(C 8 H 8 ) 2 . The ground electronic states depend on the order of the lowest-energy cage π * and metal 5f orbitals, with (π * ) 1 and (π * ) 1 (5f) 1 found to be the ground electronic configurations for the two complexes. U at sign C 28 is found to be diamagnetic. 30 refs., 1 fig., 13 tabs

Epidemiology of discordance between symptoms and signs of dry eye.

Science.gov (United States)

Ong, Erin S; Felix, Elizabeth R; Levitt, Roy C; Feuer, William J; Sarantopoulos, Constantine D; Galor, Anat

2018-05-01

The frequent lack of association between dry eye (DE) symptoms and signs leads to challenges in diagnosing and assessing the disease. Participants underwent ocular surface examinations to evaluate signs of disease and completed questionnaires to assess ocular symptoms, psychological status and medication use. To assess nociceptive system integrity, quantitative sensory testing (QST), including vibratory and thermal threshold measures and temporal summation of pain were obtained at the forearm and forehead. Correlations between DE discordance score (degree of discrepancy between symptom severity and DE signs) and patient characteristics were determined. Higher discordance scores indicated more symptoms than signs. 326 patients participated (mean age: 62 years; SD: 10 years; 92% men). Age was negatively correlated with DE discordance score (Pearson r=-0.30, p<0.0005), while mental health indices were positively correlated. Chronic pain elsewhere in the body (ie, non-ocular pain conditions) and intensity ratings of prolonged aftersensations of pain evoked by noxious hot and cold stimuli were also significantly correlated with DE discordance score. Multiple linear regression demonstrated that post-traumatic stress disorder and non-ocular pain intensity were important predictors of DE discordance score, Dry Eye Questionnaire-5 and Ocular Surface Disease Index and that DE discordance was also sensitive to QST as well. The present study provides evidence that the degree of discordance between DE symptom report and measurable signs of ocular surface disease is associated with comorbidities related to clinical pain and to hyperalgesia as demonstrated with QST. Understanding the epidemiology of DE discordance can aid in interpreting the DE exam and individualising treatment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Blurring of the vessels of the interhemispheric fissure in multislice CT angiography: a sign of meningeal carcinomatosis

International Nuclear Information System (INIS)

Ertl-Wagner, Birgit B.; Hoffmann, Ralf-Thorsten; Herrmann, Karin; Reiser, Maximilian F.; Bruening, Roland; Dichgans, Martin

2004-01-01

Meningeal carcinomatosis remains a challenging diagnosis to make, with both cerebrospinal fluid (CSF) analysis and radiological methods having a limited sensitivity. We aimed at describing a possible diagnostic sign of multislice CT angiography (MS-CTA) in the diagnosis of meningeal carcinomatosis. Upon retrospective analysis of MSCT angiographies of the brain, a conspicuous sign of the vessels of the interhemispheric fissure was noted in five patients. Cranial MSCT angiographies were performed with a standardized protocol (120 kV, 200 mA s, collimation of 4 x 1 mm, table feed per rotation 4 mm). We injected 120 ml of nonionic contrast medium as a bolus, and data acquisition was started after a fixed delay of 35 s. In order to elucidate the finding, correlation with clinical follow-up and/or CSF findings was performed for all patients. In five patients there was a blurring, an increased number, and a pathologic configuration of the vessels of the interhemispheric fissure. All five patients with this sign had clinical signs and symptoms of meningeal carcinomatosis. Three patients had positive CSF cytology, one further patient had follow-up spinal MRI 6 weeks later demonstrating meningeal carcinomatosis. One patient declined lumbar puncture. MS-CTA has the capacity to demonstrate a pathologic configuration of the vessels of the interhemispheric fissure in patients with meningeal carcinomatosis. This sign may serve as an indicator of meningeal carcinomatosis and should raise the suspicion of this disease entity. (orig.)