CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management

International Nuclear Information System (INIS)

Macari, M.; Faust, M.; Liang, H.; Pachter, H.L.

2007-01-01

Aim: To describe the imaging findings of jejunal diverticulitis as depicted at contrast-enhanced computed tomography (CT) and review the differential diagnosis and clinical management. Materials and Methods: CT and pathology databases were searched for the diagnosis of jejunal diverticulitis. Three cases were identified and the imaging and clinical findings correlated. Results: Jejunal diverticulitis presents as a focal inflammatory mass involving the proximal small bowel. A trial of medical management with antibiotics may be attempted. Surgical resection may be required if medical management is unsuccessful. Conclusion: The imaging findings at MDCT may allow a specific diagnosis of jejunal diverticulitis to be considered and may affect the clinical management of the patient

No antibiotics in acute uncomplicated diverticulitis: does it work?

Science.gov (United States)

Isacson, Daniel; Andreasson, Kalle; Nikberg, Maziar; Smedh, Kenneth; Chabok, Abbas

2014-12-01

The first randomized multicenter study evaluating the need for antibiotic treatment in patients with acute uncomplicated diverticulitis (AUD) could not demonstrate any benefit gained from antibiotic use. The aim of this study was to review the application of the no antibiotic policy and its consequences in regard to complications and recurrence. This retrospective population-based cohort study included all patients diagnosed with all types of colonic diverticulitis during the year 2011 at Västmanland Hospital Västerås, Sweden. All medical records were carefully reviewed. Primary outcomes were the types of treatment adopted for diverticulitis, complications and recurrence. In total, 246 patients with computer tomography-verified diverticulitis were identified, 195 with primary AUD and 51 with acute complicated diverticulitis. Age, sex, and temperature at admission were similar between the groups but there was a significant difference in white blood cell count, C-reactive protein, and length of hospital stay. In the AUD group, 178 (91.3%) patients were not treated with antibiotics. In this group, there were six (3.4%) readmissions but only two developed an abscess. Of the remaining 17 patients (8.7%) who were treated with antibiotics in the AUD group, one developed an abscess. Twenty-five (12.8%) patients in the AUD group presented with a recurrence within 1 year. The no-antibiotic policy for AUD is safe and applicable in clinical practice. The previous results of a low complication and recurrence rate in AUD are confirmed. There is no need for antibiotic treatment for AUD. What does this paper add to the literature? Despite published papers with excellent results, there are still doubts about patient safety against the policy to not use antibiotics in acute uncomplicated diverticulitis. This is the first paper, in actual clinical practice, to confirm that the no antibiotic policy for acute uncomplicated diverticulitis is applicable and safe.

International, Expert-Based, Consensus Statement Regarding the Management of Acute Diverticulitis.

Science.gov (United States)

O'Leary, D Peter; Lynch, Noel; Clancy, Cillian; Winter, Desmond C; Myers, Eddie

2015-09-01

This Delphi study provides consensus related to many aspects of acute diverticulitis and identifies other areas in need of research. To generate an international, expert-based, consensus statement to address controversies in the management of acute diverticulitis. This study was conducted using the Delphi technique from April 3 through October 21, 2014. A survey website was used and a panel of acute diverticulitis experts was formed via the snowball method. The top 5 acute diverticulitis experts in 5 international geographic regions were identified based on their number of publications related to acute diverticulitis. The Delphi study used 3 rounds of questions, after which the consensus statement was collated. A consensus statement related to the management of acute diverticulitis. Twenty items were selected for inclusion in the consensus statement following 3 rounds of questioning. A clear definition of uncomplicated and complicated diverticulitis is provided. In uncomplicated diverticulitis, consensus was reached regarding appropriate laboratory and radiological evaluation of patients as well as nonsurgical, surgical, and follow-up strategies. A number of important topics, including antibiotic treatment, failed to reach consensus. In addition, consensus was reached regarding many nonsurgical and surgical treatment strategies in complicated diverticulitis. Controversy continues internationally regarding the management of acute diverticulitis. This study demonstrates that there is more nonconsensus among experts than consensus regarding most issues, even in the same region. It also provides insight into the status quo regarding the treatment of acute diverticulitis and provides important direction for future research.

Reduced-dose abdominopelvic CT using hybrid iterative reconstruction in suspected left-sided colonic diverticulitis

Energy Technology Data Exchange (ETDEWEB)

Laqmani, Azien; Dulz, Simon; Behzadi, Cyrus; Schmidt-Holtz, Jakob; Wassenberg, Felicia; Adam, Gerhard; Regier, Marc [University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Veldhoen, Simon [University Medical Center Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Derlin, Thorsten [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Sehner, Susanne [University Medical Center Hamburg-Eppendorf, Department of Medical Biometry and Epidemiology, Hamburg (Germany); Nagel, Hans-Dieter [Scientific and Application-oriented Studies and Consulting in Radiology (SASCRAD), Buchholz (Germany)

2016-01-15

To assess the effect of hybrid iterative reconstruction (HIR) and filtered back projection (FBP) on abdominopelvic CT with reduced-dose (RD-APCT) in the evaluation of acute left-sided colonic diverticulitis (ALCD). Twenty-five consecutive patients with suspected ALCD who underwent RD-APCT (mean CTDIvol 11.2 ± 4.2 mGy) were enrolled in this study. Raw data were reconstructed using FBP and two increasing HIR levels, L4 and L6. Two radiologists assessed image quality, image noise and reviewer confidence in interpreting findings of ALCD, including wall thickening, pericolic fat inflammation, pericolic abscess, and contained or free extraluminal air. Objective image noise (OIN) was measured. OIN was reduced up to 54 % with HIR compared to FBP. Subjective image quality of HIR images was superior to FBP; subjective image noise was reduced. The detection rate of extraluminal air was higher with HIR L6. Reviewer confidence in interpreting CT findings of ALCD significantly improved with application of HIR. RD-APCT with HIR offers superior image quality and lower image noise compared to FBP, allowing a high level of reviewer confidence in interpreting CT findings in ALCD. HIR facilitates detection of ALCD findings that may be missed with the FBP algorithm. (orig.)

Logical hypothesis: Low FODMAP diet to prevent diverticulitis

Science.gov (United States)

Uno, Yoshiharu; van Velkinburgh, Jennifer C

2016-01-01

Despite little evidence for the therapeutic benefits of a high-fiber diet for diverticulitis, it is commonly recommended as part of the clinical management. The ongoing uncertainty of the cause(s) of diverticulitis confounds attempts to determine the validity of this therapy. However, the features of a high-fiber diet represent a logical contradiction for colon diverticulitis. Considering that Bernoulli’s principle, by which enlarged diameter of the lumen leads to increased pressure and decreased fluid velocity, might contribute to development of the diverticulum. Thus, theoretically, prevention of high pressure in the colon would be important and adoption of a low FODMAP diet (consisting of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) may help prevent recurrence of diverticulitis. PMID:27867683

CT findings of early right colonic diverticulitis

International Nuclear Information System (INIS)

Lee, Jong Hwa; Ham, Su Yeon; Whang, Kang Ik

1998-01-01

The purpose of this study is to investigate the CT findings of acute right colonic diverticulitis, and to determine the difference between these and published reports describing left colonic, especially sigmoid, diverticulitis. Inflamed diverticula were visible in all cases, and were solitary. Nine cases occurred in the ascending colon and four in the cecum; in particular, eleven occurred around the ileocecal valve. In three cases, the inflamed diverticulum was less than 1 cm in diameter; in five cases, 1-2 cm; in three, 2-3 cm, and in two, 3-4 cm. These were able to be classified into two major forms. In three cases it was nodular with hyperattenuation and some inhomogeneity, and ten shows the target form with thick walls and a central cavity. In five of these target lesions, the wall pattern was partially or completely inhomogeneous, or multilayered. The material filling the central cavity were gas in five cases, fecalith in two, and fluid in three. Abnormal pericoloic fat infiltrations were seen in twelve cases (92%), segmental colonic wall thickening in eleven (85%), other not-inflamed diverticula in five (38%), mesenteric lymph node enlargement in three (23%), free pericecal fluid collection in three (23%), and perirenal fascial thickening in two (15%). The complications such as remote abscess cavity, colonic obstruction, fistula or perforation were not found. On barium colon study, diverticulitis was in all cases confirmed by the presence of barium in the deformed diversiculum. Among CT findings for acute right colonic diverticulitis, the most important and pathognomonic is inflamed diverticula; the forms of these vary, and include gangrenous diverticulitis. The CT findings of early right colonic diverticulitis in Koreans might not, however, reveal the complications which sigmoid diverticulitis frequently involves; in patients with right lower quadrant pain imaging studies are performed promptly, and for the mesentery, the anatomical base between right and

Meat intake and risk of diverticulitis among men.

Science.gov (United States)

Cao, Yin; Strate, Lisa L; Keeley, Brieze R; Tam, Idy; Wu, Kana; Giovannucci, Edward L; Chan, Andrew T

2018-03-01

Diverticulitis is a common disease with a substantial clinical and economic burden. Besides dietary fibre, the role of other foods in the prevention of diverticulitis is underexplored. We prospectively examined the association between consumption of meat (total red meat, red unprocessed meat, red processed meat, poultry and fish) with risk of incident diverticulitis among 46 461 men enrolled in the Health Professionals Follow-Up Study (1986-2012). Cox proportional hazards models were used to compute relative risks (RRs) and 95% CIs. During 651 970 person-years of follow-up, we documented 764 cases of incident diverticulitis. Compared with men in the lowest quintile (Q1) of total red meat consumption, men in the highest quintile (Q5) had a multivariable RR of 1.58 (95% CI 1.19 to 2.11; p for trend=0.01). The increase in risk was non-linear, plateauing after six servings per week (p for non-linearity=0.002). The association was stronger for unprocessed red meat (RR for Q5 vs Q1: 1.51; 95% CI 1.12 to 2.03; p for trend=0.03) than for processed red meat (RR for Q5 vs Q1: 1.03; 95% CI 0.78 to 1.35; p for trend=0.26). Higher consumption of poultry or fish was not associated with risk of diverticulitis. However, the substitution of poultry or fish for one serving of unprocessed red meat per day was associated with a decrease in risk of diverticulitis (multivariable RR 0.80; 95% CI 0.63 to 0.99). Red meat intake, particularly unprocessed red meat, was associated with an increased risk of diverticulitis. The findings provide practical dietary guidance for patients at risk of diverticulitis. 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/.

Treatment strategies in recurrent and ongoing diverticulitis

NARCIS (Netherlands)

Gorter-Stam, Marguerite Annelie Willemijn

2016-01-01

Each year approximately 22,000 patients in the Netherlands are seen in the emergency department with suspected diverticulitis. This leads to an estimated 18,000 admissions a year with total estimated costs of 40 to 80 million euro per year. Diverticulitis is thus one of the most common and costly

What radiologists should know about tomographic evaluation of acute diverticulitis of the colon

Energy Technology Data Exchange (ETDEWEB)

Naves, Aline de Araujo; D' Ippolito, Giuseppe; Souza, Luis Ronan Marquez Ferreira; Borges, Silvia Portela; Fernandes, Glenio Moraes, E-mail: luisronan@gmail.com [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas; Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil); Universidade Federal do Triangulo Mineiro (UFTM), Uberaba, MG, (Brazil)

2017-03-15

Acute diverticulitis of the colon is a common indication for computed tomography, and its diagnosis and complications are essential to determining the proper treatment and establishing the prognosis. The adaptation of the surgical classification for computed tomography has allowed the extent of intestinal inflammation to be established, the computed tomography findings correlating with the indication for treatment. In addition, computed tomography has proven able to distinguish among the main differential diagnoses of diverticulitis. This pictorial essay aims to present the computed tomography technique, main radiological signs, major complications, and differential diagnoses, as well as to review the classification of acute diverticulitis. (author)

Acute diverticulitis of the sigmoid colon: value of ultrasound as an initial diagnostic test; Diverticulitis aguad de sigma: valor de la ecografia como test diagnostico inicial

Energy Technology Data Exchange (ETDEWEB)

Garcia-Aguayo, F J; Gil, P M [Hospital de Sagunto. Valencia (Spain)

2002-07-01

To assess the value of ultrasound as an initial diagnostic method in cases of acute diverticulitis. Ultrasound was carried out in 76 patients with a clinical diagnosis of acute sigmoid diverticulitis. The final diagnosis was based on the clinical course in every case, as well as on computed tomography (CT; n=46), histopathological examination (n=10), colonoscopy (n=4) and barium enema (n=2). The diagnostic criteria established for ultrasound was a thickening of the sigmoid colon wall of >4 mm and the presence of a least one of the following features: diverticular, phlegmon or abscess. The CT diagnosis was based on two indispensable findings: thickening of the sigmoid colon of>4 mm and inflammation of pericolonic fat. The final diagnosis was acute diverticulitis in 52 patients, some other disease in 18 and undetermined in 6. The sensitivities of ultrasound and CT were 81% and 94%, respectively, and their specificities were 79% and 83%, respectively. Of the 10 false negatives on ultrasound, seven corresponded to cases of simple diverticulitis and three to cases of complicated diverticulitis (two in patients with abscess and one in a patient with pneumoperitoneum). CT provided the correct diagnosis in eight of these cases, and resulted in false negatives in two cases of mild diverticulitis. Ultrasound is a valid test in the initial diagnosis of acute diverticulitis of the sigmoid colon. CT should be performed when ultrasound fails to provide a diagnosis or in cases of negative results when there is a strong clinical suspicion of diverticulitis, as well as when the possibility of complicated diverticulitis exists. (Author) 14 refs.

Computed tomography in the imaging of colonic diverticulitis

International Nuclear Information System (INIS)

Buckley, O.; Geoghegan, T.; O'Riordain, D.S.; Lyburn, I.D.; Torreggiani, W.C.

2004-01-01

Colonic diverticulitis occurs when diverticula within the colon become infected or inflamed. It is becoming an increasingly common cause for hospital admission, particularly in western society, where it is linked to a low fibre diet. Symptoms of diverticulitis include abdominal pain, diarrhoea and pyrexia, however, symptoms are often non-specific and the clinical diagnosis may be difficult. In addition, elderly patients and those taking corticosteroids may have limited findings on physical examination, even in the presence of severe diverticulitis. A high index of suspicion is required in such patients in order to avoid a significant delay in arriving at the correct diagnosis. Imaging plays an important role in establishing an early and correct diagnosis. In the past, contrast enema studies were the principal imaging test used to make the diagnosis. However, such studies lack sensitivity and have limited success in identifying abscesses that may require drainage. Conversely computed tomography (CT) is both sensitive and specific in making a diagnosis of diverticulitis. In addition, it is the imaging technique of choice in depicting complications such as perforation, abscess formation and fistulae. CT-guided drainage of diverticular abscesses helps to reduce sepsis and to permit a one-stage, rather than two-stage, surgical operation. The purpose of this review article is to discuss the role of CT in the imaging of diverticulitis, describe the CT imaging features and complications of this disease, as well as review the impact and rationale of CT imaging and intervention in the overall management of patients with diverticulitis

Understanding Diverticulosis and Diverticulitis | NIH MedlinePlus the Magazine

Science.gov (United States)

... the amount of high-fiber foods in the diet. Severe cases of diverticulitis, with acute pain and complications, will likely require a hospital stay. Most cases of severe diverticulitis are treated ...

Diverticulitis exclusiva de ciego Unique diverticulitis of the cecum

Directory of Open Access Journals (Sweden)

Jorge Eduardo Frías Espinosa

2012-12-01

Full Text Available La diverticulitis cecal es una rara entidad de difícil diagnóstico que con frecuencia se confunde con un proceso apendicular agudo. Los divertículos primarios o de origen congénito, generalmente son únicos, suelen presentarse en una edad más temprana que la enfermedad diverticular cólica (divertículos secundarios.La presencia de estos en el colon derecho se reporta con menor frecuencia, su diagnóstico es en muchas ocasiones indistinguible de la apendicitis aguda y se realiza en la mayoría de los casos durante la laparotomía, el tratamiento es variable, según la literatura abarca desde la resección del divertículo hasta la hemicolectomía derecha. El objetivo de esta presentación es referir la dificultad diagnostica y la alta frecuencia de error diagnóstico que presenta esta entidad.The cecal diverticulitis is a strange disease, difficult to be diagnosed, frequently confused with acute appendicular process. The primary diverticula or those of congenital origin are generally unique; they usually appear at younger age than the colic diverticular disease (secondary diverticula. Their presence in the right colon is less frequently reported, the diagnosis is often confused with that of acute appendicitis and most of cases undergo laparatomy. According to the scientific literature, the treatment is variable, ranging from diverticular resection to right hemi-cholectomy. The objective of this paper was to present the difficulties and the high frequency of errors in diagnosing this disease.

Appendiceal Diverticulitis Clinically Masquerading as an Appendiceal Carcinoma

Directory of Open Access Journals (Sweden)

Tadashi Terada

2014-01-01

Full Text Available Appendiceal diverticulosis is a rare condition. Herein reported is a case of appendiceal diverticulosis and diverticulitis clinically masquerading as appendiceal carcinoma. A 62-year-old woman presented with abdominal pain. US and CT showed a tumor measuring 5 × 4 × 4 cm in vermiform appendix. Colon endoscopy showed mucosal elevation and irregularity in the orifice of vermiform appendix. A biopsy of the appendiceal mucosa showed no significant changes. Clinical diagnosis was appendiceal carcinoma and wide excision of terminal ileum, appendix, cecum, and ascending colon was performed. Grossly, the appendix showed a tumor measuring 5 × 3 × 4 cm. The appendiceal lumen was opened, and the appendiceal mucosa was elevated and irregular. The periappendiceal tissue showed thickening. Microscopically, the lesion was multiple appendiceal diverticula. The diverticula were penetrating the muscle layer. The mucosa showed erosions in places. Much fibrosis, abscess formations, and lymphocytic infiltration were seen in the subserosa. Abscesses were also seen in the diverticular lumens. Some diverticula penetrated into the subserosa. The pathologic diagnosis was appendiceal diverticulitis. When they encounter an appendiceal mass, clinicians should consider appendiceal diverticulitis as a differential diagnosis.

Acute Diverticulitis in the Young: The Same Disease in a Different Patient

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Adolfo Pisanu

2013-01-01

Full Text Available Background. Natural history and risk factors for diverticulitis in young patients are still debatable. This study aimed to assess whether difference exists in patients aged 50 and younger when compared to older patients and to identify risk factors for acute diverticulitis in the young. Patients and Methods. From January 2006 to December 2011, 80 patients were admitted to our department for acute diverticulitis. We carried out a cross-sectional study in 23 patients (28.7% aged 50 and younger and 57 older patients (71.3%. Results. Acute diverticulitis in the young was not more aggressive than in the older patient. Diverticulitis at patient’s admission was similar with respect to Hinchey’s stage and prior history of diverticulitis. No significant difference was found for both medical and surgical treatment. The rate of recurrent diverticulitis in nonoperated patients was similar. Male gender, body mass index ≥25, and assumption of alcohol were independent risk factors for the occurrence of an acute diverticulitis in the young. Conclusions. The same disease seems to be affecting young patients such as overweight or obese male individual. Current policies to prevent diverticular disease and its related complications must include obesity control together with high-fiber diet and regular exercise.

Meckel's Diverticulitis as a Cause of an Acute Abdomen in the Second Trimester of Pregnancy: Laparoscopic Management.

Science.gov (United States)

Pandeva, Ivilina; Kumar, Sumit; Alvi, Atif; Nosib, Hema

2015-01-01

Introduction. Meckel's diverticulitis is an extremely rare cause of an acute abdomen in pregnancy. Its clinical presentation tends to be rather unusual and therefore commonly delaying diagnosis. The surgical method of exploration can be either by laparoscopy or through an open incision. Case Report. We report a case of a 34-year-old, P1 with previous Caesarean section, who presented at 20 weeks with worsening right-sided abdominal pain, distention, and peritonism. Ultrasound scan showed an area of a possibly thickened loop of bowel inconsistent with an appendicitis. The findings at laparoscopy were purulent fluid in the pelvis, a congested appendix, and inflamed Meckel's diverticulum. An appendectomy and excision of the diverticulum was performed using stapler technique. Discussion. Meckel's diverticulitis in pregnancy can have nonspecific presentation and poses difficulties for preoperative diagnosis. Delay in diagnosis and management poses significant maternal and fetal risks. The use of laparoscopy if the gestational age and uterine size permit its use allows a thorough exploration of the abdominal cavity and management of rarer and unexpected pathology. Laparoscopic management of acute abdomen in the midtrimester of pregnancy has been found to be safe and effective.

Jejunal diverticulitis in a healthy 91-year-old man.

Science.gov (United States)

Kagolanu, Deepthi Chaitanya; Subhani, Miral; Novick, Daniel; Rizvon, Kaleem

2018-05-30

A 91-year-old African American man was admitted with sudden onset diffuse abdominal pain which radiated to the right flank. CT of the abdomen with contrast showed diverticula in the jejunum with adjacent inflammation and microperforation that was contained. Conservative therapy similar to colonic diverticulitis was effective. Although rare, our case highlights the importance of having an early and high suspicion for jejunal diverticulitis when patients present with non-specific abdominal symptoms in order to avoid perforation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Laparoscopic lavage for perforated diverticulitis with purulent peritonitis

DEFF Research Database (Denmark)

Thornell, Anders; Angenete, Eva; Bisgaard, Thue

2016-01-01

Background: Perforated diverticulitis with purulent peritonitis has traditionally been treated with open colon resection and stoma formation with risk for reoperations, morbidity, and mortality. Laparoscopic lavage alone has been suggested as definitive treatment. Objective: To compare laparoscopic...... lavage with open colon resection and colostomy (Hartmann procedure) for perforated diverticulitis with purulent peritonitis. Design: Randomized, controlled, multicenter, open-label trial. (ISRCTN registry number: ISRCTN82208287) Setting: 9 hospitals in Sweden and Denmark. Patients: Patients who have...... confirmed Hinchey grade III perforated diverticulitis with purulent peritonitis at diagnostic laparoscopy. Intervention: Randomization between laparoscopic lavage and the Hartmann procedure. Measurements: Primary outcome was the percentage of patients having 1 or more reoperations within 12 months. Key...

Fecal microbiome analysis as a diagnostic test for diverticulitis

NARCIS (Netherlands)

Daniels, L.; Budding, A. E.; de Korte, N.; Eck, A.; Bogaards, J. A.; Stockmann, H. B.; Consten, E. C.; Savelkoul, P. H.; Boermeester, M. A.

2014-01-01

Disease-specific variations in intestinal microbiome composition have been found for a number of intestinal disorders, but little is known about diverticulitis. The purpose of this study was to compare the fecal microbiota of diverticulitis patients with control subjects from a general

New trends in the management of diverticulitis and colonic diverticular disease

Directory of Open Access Journals (Sweden)

Francisco Javier Medina-Fernández

2015-03-01

Full Text Available Colonic diverticular disease is a chronic disorder presenting with a variety of abdominal symptoms and recurrent episodes of acute diverticulitis. It is close linked to age so its prevalence has risen notably during the last decades in western countries, increasing costs related to medical attention. Recently, several works have provided evidence to a series of measures that could improve the outcomes as well as reduce expenses associated to this process. The aim of the present review is to expose a view of the new trends in the management of diverticulitis and colonic diverticular disease, based on the highest clinical evidence available.

Meckel’s Diverticulitis as a Cause of an Acute Abdomen in the Second Trimester of Pregnancy: Laparoscopic Management

Directory of Open Access Journals (Sweden)

Ivilina Pandeva

2015-01-01

Full Text Available Introduction. Meckel’s diverticulitis is an extremely rare cause of an acute abdomen in pregnancy. Its clinical presentation tends to be rather unusual and therefore commonly delaying diagnosis. The surgical method of exploration can be either by laparoscopy or through an open incision. Case Report. We report a case of a 34-year-old, P1 with previous Caesarean section, who presented at 20 weeks with worsening right-sided abdominal pain, distention, and peritonism. Ultrasound scan showed an area of a possibly thickened loop of bowel inconsistent with an appendicitis. The findings at laparoscopy were purulent fluid in the pelvis, a congested appendix, and inflamed Meckel’s diverticulum. An appendectomy and excision of the diverticulum was performed using stapler technique. Discussion. Meckel’s diverticulitis in pregnancy can have nonspecific presentation and poses difficulties for preoperative diagnosis. Delay in diagnosis and management poses significant maternal and fetal risks. The use of laparoscopy if the gestational age and uterine size permit its use allows a thorough exploration of the abdominal cavity and management of rarer and unexpected pathology. Laparoscopic management of acute abdomen in the midtrimester of pregnancy has been found to be safe and effective.

Contemporary Review of Risk-Stratified Management in Acute Uncomplicated and Complicated Diverticulitis.

Science.gov (United States)

Boermeester, Marja A; Humes, David J; Velmahos, George C; Søreide, Kjetil

2016-10-01

Acute colonic diverticulitis is a common clinical condition. Severity of the disease is based on clinical, laboratory, and radiological investigations and dictates the need for medical or surgical intervention. Recent clinical trials have improved the understanding of the natural history of the disease resulting in new approaches to and better evidence for the management of acute diverticulitis. We searched the Cochrane Library (years 2004-2015), MEDLINE (years 2004-2015), and EMBASE (years 2004-2015) databases. We used the search terms "diverticulitis, colonic" or "acute diverticulitis" or "divertic*" in combination with the terms "management," "antibiotics," "non-operative," or "surgery." Registers for clinical trials (such as the WHO registry and the https://clinicaltrials.gov/ ) were searched for ongoing, recruiting, or closed trials not yet published. Antibiotic treatment can be avoided in simple, non-complicated diverticulitis and outpatient management is safe. The management of complicated disease, ranging from a localized abscess to perforation with diffuse peritonitis, has changed towards either percutaneous or minimally invasive approaches in selected cases. The role of laparoscopic lavage without resection in perforated non-fecal diverticulitis is still debated; however, recent evidence from two randomised controlled trials has found a higher re-intervention in this group of patients. A shift in management has occurred towards conservative management in acute uncomplicated disease. Those with uncomplicated acute diverticulitis may be treated without antibiotics. For complicated diverticulitis with purulent peritonitis, the use of peritoneal lavage appears to be non-superior to resection.

Increased risk for irritable bowel syndrome after acute diverticulitis.

Science.gov (United States)

Cohen, Erica; Fuller, Garth; Bolus, Roger; Modi, Rusha; Vu, Michelle; Shahedi, Kamyar; Shah, Rena; Atia, Mary; Kurzbard, Nicole; Sheen, Victoria; Agarwal, Nikhil; Kaneshiro, Marc; Yen, Linnette; Hodgkins, Paul; Erder, M Haim; Spiegel, Brennan

2013-12-01

Individuals with diverticulosis frequently also have irritable bowel syndrome (IBS), but there are no longitudinal data to associate acute diverticulitis with subsequent IBS, functional bowel disorders, or related emotional distress. In patients with postinfectious IBS, gastrointestinal disorders cause long-term symptoms, so we investigated whether diverticulitis might lead to IBS. We compared the incidence of IBS and functional bowel and related affective disorders among patients with diverticulitis. We performed a retrospective study of patients followed up for an average of 6.3 years at a Veteran's Administration medical center. Patients with diverticulitis were identified based on International Classification of Diseases, 9th revision codes, selected for the analysis based on chart review (cases, n = 1102), and matched with patients without diverticulosis (controls, n = 1102). We excluded patients with prior IBS, functional bowel, or mood disorders. We then identified patients who were diagnosed with IBS or functional bowel disorders after the diverticulitis attack, and controls who developed these disorders during the study period. We also collected information on mood disorders, analyzed survival times, and calculated adjusted hazard ratios. Cases were 4.7-fold more likely to be diagnosed later with IBS (95% confidence interval [CI], 1.6-14.0; P = .006), 2.4-fold more likely to be diagnosed later with a functional bowel disorder (95% CI, 1.6-3.6; P mood disorder (CI, 1.4-3.5; P IBS and functional bowel disorders. We propose calling this disorder postdiverticulitis IBS. Diverticulitis appears to predispose patients to long-term gastrointestinal and emotional symptoms after resolution of inflammation; in this way, postdiverticulitis IBS is similar to postinfectious IBS. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

Perforated Meckel's diverticulitis complicating active Crohn's ileitis: a case report.

Science.gov (United States)

Schwenter, Frank; Gervaz, Pascal; de Saussure, Philippe; McKee, Thomas; Morel, Philippe

2009-01-13

In Crohn's disease, the extension of active terminal ileitis into a Meckel's diverticulum is possible, but usually has no impact on clinical decision-making. We describe an original surgical approach in a young woman presenting with a combination of perforated Meckel's diverticulitis and active Crohn's ileitis. We report the case of a 22-year-old woman with Crohn's disease, who was admitted for abdominal pain, fever and diarrhoea. CT scan demonstrated active inflammation of the terminal ileum, as well as a fluid collection in the right iliac fossa, suggesting intestinal perforation. Laparoscopy was performed and revealed, in addition to extensive ileitis, a 3 x 3 cm abscess in connection with perforated Meckel's diverticulitis. It was therefore possible to avoid ileocaecal resection by only performing Meckel's diverticulectomy; pathological examination of the surgical specimen revealed the presence of transmural inflammation with granulomas and perforation of the diverticulum at its extremity. Crohn's disease of the ileum may be responsible for Meckel's diverticulitis and cause perforation which, in this case, proved to be a blessing in disguise and spared the patient an extensive small bowel resection.

Heart rate variability is reduced during acute uncomplicated diverticulitis

DEFF Research Database (Denmark)

Huang, Chenxi; Alamili, Mahdi; Rosenberg, Jacob

2016-01-01

BACKGROUND: The aim of the present study was to report the trajectory of heart rate variability (HRV) indices during a low-grade acute inflammation and their associations to biomarkers for infection. METHODS: Twelve patients with uncomplicated acute diverticulitis completed this observational study...

Cancer and diverticulitis of the sigmoid colon. Differentiation with computed tomography versus magnetic resonance imaging - Preliminary experiences

Energy Technology Data Exchange (ETDEWEB)

Oeistaemoe, Emma; Hjern, Fredrik; Abraham-Nordling, Mirna [Dept. of Clinical Sciences, Div. of Surgery, Danderyd Hospital, Karolinska Institutet, Stockholm (Sweden)], e-mail: mirna.abraham.nordling@ki.se; Blomqvist, Lennart [Dept. of Diagnostic Radiology, Dept. of Molecular Medicine and Surgery Karolinska Univ. Hospital Solna and Karolinska Institutet, Stockholm (Sweden); Von Heijne, Anders [Dept. of Clinical Sciences, Div. of Radiology, Danderyd Hospital, Karolinska Institutet, Stockholm (Sweden)

2013-04-15

Background: Both colon cancer and diverticular disease are common in the Western world. A challenge when patients present with clinical findings is that both diseases can present with symptoms that may mimic the other. Purpose: To determine whether magnetic resonance imaging (MRI) could be helpful to differentiate between diverticulitis and cancer of the sigmoid colon compared to the differentiation offered by evaluation of multidetector computed tomography (CT) in a clinical situation. Material and Methods: Thirty patients were consecutively included. Fifteen patients were under work-up for a recently diagnosed sigmoid cancer and 15 patients had recently been treated in hospital due to first-time acute sigmoid diverticulitis. All patients underwent CT, T2- weighted MRI and diffusion-weighted MRI. Anonymized examinations were retrospectively presented in random order to one experienced radiologist. Results: With contrast-enhanced CT, the sensitivity and specificity for diagnosis of cancer and diverticulitis were 66.7% (10/15) and 93.3% (14/15), respectively. Using T2-weighted and diffusion-weighted MR images, the sensitivity and specificity for diagnosis of cancer and diverticulitis were 100% (14/14) and 100% (14/14), respectively. Conclusion: MRI provides information that may contribute to improve the differentiation between sigmoid cancer and diverticulitis that is offered by CT. These encouraging results need to be confirmed in a larger study.

Cancer and diverticulitis of the sigmoid colon. Differentiation with computed tomography versus magnetic resonance imaging - Preliminary experiences

International Nuclear Information System (INIS)

Oeistaemoe, Emma; Hjern, Fredrik; Abraham-Nordling, Mirna; Blomqvist, Lennart; Von Heijne, Anders

2013-01-01

Background: Both colon cancer and diverticular disease are common in the Western world. A challenge when patients present with clinical findings is that both diseases can present with symptoms that may mimic the other. Purpose: To determine whether magnetic resonance imaging (MRI) could be helpful to differentiate between diverticulitis and cancer of the sigmoid colon compared to the differentiation offered by evaluation of multidetector computed tomography (CT) in a clinical situation. Material and Methods: Thirty patients were consecutively included. Fifteen patients were under work-up for a recently diagnosed sigmoid cancer and 15 patients had recently been treated in hospital due to first-time acute sigmoid diverticulitis. All patients underwent CT, T2- weighted MRI and diffusion-weighted MRI. Anonymized examinations were retrospectively presented in random order to one experienced radiologist. Results: With contrast-enhanced CT, the sensitivity and specificity for diagnosis of cancer and diverticulitis were 66.7% (10/15) and 93.3% (14/15), respectively. Using T2-weighted and diffusion-weighted MR images, the sensitivity and specificity for diagnosis of cancer and diverticulitis were 100% (14/14) and 100% (14/14), respectively. Conclusion: MRI provides information that may contribute to improve the differentiation between sigmoid cancer and diverticulitis that is offered by CT. These encouraging results need to be confirmed in a larger study

End-colostomy diverticulitis with parastomal phlegmon

Science.gov (United States)

Muradbegovic, Mirza; St-Amour, Pénélope; Martin, David; Petermann, David; Benabidallah, Samir; Di Mare, Luca

2017-01-01

Abstract Rationale: Acute colonic diverticulitis is a well-known surgical emergency, which occurs in about 10 percent of patients known for diverticulosis. Patient concerns: The case of a 77-year-old woman is reported, with past history of abdominoperineal resection with end-colostomy for low rectal adenocarcinoma, and who developed an acute colonic diverticulitis in a subcutaneous portion of colostomy with parastomal phlegmon. Diagnoses: Initial computed tomography imaging demonstrated a significant submucosal parietal edema with local fat tissues infiltration in regard of 3 diverticula. Interventions: A two-step treatment was decided: first a nonoperative treatment was initiated with 2 weeks antibiotics administration, followed by, 6 weeks after, a segmental resection of the terminal portion of the colon with redo of a new colostomy by direct open approach. Outcomes: Patient was discharged on the second postoperative day without complications. Follow-up at 2 weeks revealed centimetric dehiscence of the stoma, which was managed conservatively until sixth postoperative week by stomatherapists. Lessons subsections: Treatment of acute diverticulitis with parastomal phlegmon in a patient with end-colostomy could primary be nonoperative. Delayed surgical treatment with segmental colonic resection was proposed to avoid recurrence and potential associated complications. PMID:29069019

Routine colonic endoscopic evaluation following resolution of acute diverticulitis: Is it necessary?

Science.gov (United States)

Agarwal, Amit K; Karanjawala, Burzeen E; Maykel, Justin A; Johnson, Eric K; Steele, Scott R

2014-01-01

Diverticular disease incidence is increasing up to 65% by age 85 in industrialized nations, low fiber diets, and in younger and obese patients. Twenty-five percent of patients with diverticulosis will develop acute diverticulitis. This imposes a significant burden on healthcare systems, resulting in greater than 300000 admissions per year with an estimated annual cost of $3 billion USD. Abdominal computed tomography (CT) is the diagnostic study of choice, with a sensitivity and specificity greater than 95%. Unfortunately, similar CT findings can be present in colonic neoplasia, especially when perforated or inflamed. This prompted professional societies such as the American Society of Colon Rectal Surgeons to recommend patients undergo routine colonoscopy after an episode of acute diverticulitis to rule out malignancy. Yet, the data supporting routine colonoscopy after acute diverticulitis is sparse and based small cohort studies utilizing outdated technology. While any patient with an indication for a colonoscopy should undergo appropriate endoscopic evaluation, in the era of widespread use of high-resolution computed tomography, routine colonic endoscopic evaluation following resolution of acute uncomplicated diverticulitis poses additional costs, comes with inherent risks, and may require further study. In this manuscript, we review the current data related to this recommendation. PMID:25253951

Ileal Diverticulitis as a Cause of Right Lower Quadrant Pain: A Case Report and Review of the Literature

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P. Kothadia

2015-12-01

Full Text Available Introduction Small bowel diverticulitis is a rare clinical disease of the small bowel. The incidence of small bowel diverticulitis varies from 0.3 to 2.3 % in the general population. Complications of this rare clinical entity are often confused with other causes of acute abdomen such as acute appendicitis, perforated peptic ulcer, inflammatory bowel disease or ischemic bowel disease. Case Presentation We describe a 65-year-old male with a history of ileal diverticulosis who presented with acute abdomen and was subsequently found to have perforated ileal diverticulitis with abscess formation. Conclusions The case, differential diagnosis, imaging studies, complications and management of this rare clinical disease are discussed.

Trends in Hospital Admission and Surgical Procedures Following ED visits for Diverticulitis

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Margaret B. Greenwood-Ericksen

2016-06-01

Full Text Available Introduction: Diverticulitis is a common diagnosis in the emergency department (ED. Outpatient management of diverticulitis is safe in selected patients, yet the rates of admission and surgical procedures following ED visits for diverticulitis are unknown, as are the predictive patient characteristics. Our goal is to describe trends in admission and surgical procedures following ED visits for diverticulitis, and to determine which patient characteristics predict admission. Methods: We performed a cross-sectional descriptive analysis using data on ED visits from 2006-2011 to determine change in admission and surgical patterns over time. The Nationwide Emergency Department Sample database, a nationally representative administrative claims dataset, was used to analyze ED visits for diverticulitis. We included patients with a principal diagnosis of diverticulitis (ICD-9 codes 562.11, 562.13. We analyzed the rate of admission and surgery in all admitted patients and in low-risk patients, defined as age <50 with no comorbidities (Elixhauser. We used hierarchical multivariate logistic regression to identify patient characteristics associated with admission for diverticulitis. Results: From 2006 to 2011 ED visits for diverticulitis increased by 21.3% from 238,248 to 302,612, while the admission rate decreased from 55.7% to 48.5% (-7.2%, 95% CI [–7.78 to -6.62]; p<0.001 for trend. The admission rate among low-risk patients decreased from 35.2% in 2006 to 26.8% in 2011 (-8.4%, 95% CI [–9.6 to –7.2]; p<0.001 for trend. Admission for diverticulitis was independently associated with male gender, comorbid illnesses, higher income and commercial health insurance. The surgical rate decreased from 6.5% in 2006 to 4.7% in 2011 (-1.8%, 95% CI [–2.1 to –1.5]; p<0.001 for trend, and among low-risk patients decreased from 4.0% to 2.2% (- 1.8%, 95% CI [–4.5 to –1.7]; p<0.001 for trend. Conclusion: From 2006 to 2011 ED visits for diverticulitis increased

CT in acute perforated sigmoid diverticulitis

International Nuclear Information System (INIS)

Lohrmann, Christian; Ghanem, Nadir; Pache, Gregor; Makowiec, Frank; Kotter, Elmar; Langer, Mathias

2005-01-01

Background: To assess the value of computed tomography (CT) in patients with acute perforated sigmoid diverticulitis in correlation with the Hinchey classification of perforated diverticular disease. Methods: Thirty patients with acute perforated sigmoid diverticulitis underwent computed tomography prior to surgery. Computed tomography scans were compared with the surgical and histopathological reports, utilizing the Hinchey classification. Results: In 28 of the 30 (93%) patients examined, the Hinchey stage was correctly determined by means of computed tomography. One patient with Hinchey stage IV was falsely classified as Hinchey stage III, and one patient with Hinchey stage III as Hinchey stage II. Computed tomography revealed 12 out of 14 (86%) patients with perforation sites and 3 out of 3 (100%) patients with contained perforation. In one of 17 (6%) patients with surgically or histopathologically proven perforation or contained perforation, a bowel wall discontinuity was revealed by computed tomography. In 6 of the 17 (35%) patients with surgical or histopathological perforation or contained perforation, extraluminal contrast material was detected by computed tomography. Conclusions: Computed tomography is a valuable imaging tool for determining the degree of acute perforated sigmoid diverticulitis, by means of which patients can be stratified according to the severity of the disease; furthermore, this tool is of assistance in surgical planning

CT findings in acute small bowel diverticulitis; Computertomographie bei akuter Duenndarmdivertikulitis

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Ferstl, F.J.; Obert, R. [Radiologisch-Nuklearmedizinisches Zentrum (RNZ) am St. Theresienkrankenhaus Nuernberg (Germany)

2004-02-01

Small bowel diverticulitis is a rare cause of an acute abdomen. Originating from acquired diverticula of the jejunum, less often of the ileum, or Meckel diverticulum, the symptoms are non-specific, simulating other acute inflammatory disorders, such as appendicitis, cholecystitis or colonic diverticulitis. The diagnosis of small bowel diverticulitis is solely based on radiologic findings, with computed tomography (CT) regarded as the method of choice. In recent years, a number of case reports have described the spectrum of the CT features in acute small bowel diverticulitis and its dependence on the severity of the inflammatory process. Typical findings are an inflamed diverticulum, inflammatory mesenteric infiltration, extraluminal gas collection and mural edema of adjacent small bowel loops with resultant separation of bowel loops. An enterolith is rarely found in an inflamed diverticulum. Complications include abscesses, fistulae, small bowel obstruction and free perforation with peritonitis. Small bowel diverticulitis can be a diagnostic problem if it involves the terminal ileum or Meckel's diverticulum. For preoperative confirmation of the presumed diagnosis of small bowel diverticulitis on CT, an enteroclysis for acquired diverticula or a technetium scan for Meckel's diverticulum should be performed. We present the CT findings in three patients of acute small bowel diverticulitis, two affecting the jejunum and one a Meckel's diverticulum. (orig.) [German] Die akute Duenndarmdivertikulitis ist eine seltene Ursache eines akuten Abdomens. Ausgehend von den erworbenen Divertikeln des Jejunums, seltener des Ileums, oder von einem Meckel-Divertikel, manifestiert sich die Divertikulitis klinisch durch eine unspezifische Symptomatik, die zuerst an die haeufigeren, akutentzuendlichen Erkrankungen des Abdomens wie z. B. Appendizitis, Cholezystitis oder Kolondivertikulitis denken laesst. Die Duenndarmdivertikulitis kann praeoperativ nur durch

Acute diverticulitis of the sigmoid colon: value of ultrasound as an initial diagnostic test

International Nuclear Information System (INIS)

Garcia-Aguayo, F. J.; Gil, P. M.

2002-01-01

To assess the value of ultrasound as an initial diagnostic method in cases of acute diverticulitis. Ultrasound was carried out in 76 patients with a clinical diagnosis of acute sigmoid diverticulitis. The final diagnosis was based on the clinical course in every case, as well as on computed tomography (CT; n=46), histopathological examination (n=10), colonoscopy (n=4) and barium enema (n=2). The diagnostic criteria established for ultrasound was a thickening of the sigmoid colon wall of >4 mm and the presence of a least one of the following features: diverticular, phlegmon or abscess. The CT diagnosis was based on two indispensable findings: thickening of the sigmoid colon of>4 mm and inflammation of pericolonic fat. The final diagnosis was acute diverticulitis in 52 patients, some other disease in 18 and undetermined in 6. The sensitivities of ultrasound and CT were 81% and 94%, respectively, and their specificities were 79% and 83%, respectively. Of the 10 false negatives on ultrasound, seven corresponded to cases of simple diverticulitis and three to cases of complicated diverticulitis (two in patients with abscess and one in a patient with pneumoperitoneum). CT provided the correct diagnosis in eight of these cases, and resulted in false negatives in two cases of mild diverticulitis. Ultrasound is a valid test in the initial diagnosis of acute diverticulitis of the sigmoid colon. CT should be performed when ultrasound fails to provide a diagnosis or in cases of negative results when there is a strong clinical suspicion of diverticulitis, as well as when the possibility of complicated diverticulitis exists. (Author) 14 refs

Israeli Arabs develop diverticulitis at a younger age and are more likely to require surgery than Jews.

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Itai, Ghersin; Slijper, Nadav; Sroka, Gideon; Matter, Ibrahim

2015-01-01

Only few studies have examined the impact of racial differences on the age of onset, course and outcomes of diverticulitis. To provide data about the epidemiology of diverticulitis in northern Israel, and to determine whether ethnicity is a predictor of age of onset, complications, and need for surgery. Was conducted a retrospective review of the charts of all patients diagnosed with a first episode of diverticulitis in our hospital between 2005 and 2012. Were found 638 patients with a first episode of acute diverticulitis in the eight year interval. Israeli Arabs developed a first episode of diverticulitis at a younger age compared to Jews (51.2 vs 63.8 years, p<0.01). Arabs living in rural areas developed diverticulitis at a younger age than Arabs living in urban centers (49.4 vs 54.5 years, P=0.03). Jewish and Arabic men developed diverticulitis at younger age compared to their female counterparts (59.9 vs 66.09, p<0.01, and 47.31 vs 56.93, p<0.01, respectively). Arabs were more likely [odds ratio (OR)=1.81 ,95% confidence interval (CI)1.12-2.90, p=0.017] than Jews to require surgical treatment (urgent or elective) for diverticulitis. Israeli Arabs tend to develop diverticulitis at a younger age and are more likely to require surgical treatment for diverticulitis compared to Jews. Arabs living in rural areas develop diverticulitis at a younger age than Arabs living in urban centers. These findings highlight a need to address the root cause for ethnic differences in onset, course and outcome of acute diverticulitis.

Diverticulitis of the sigmoid colon. A comparison of CT, colonic enema and laparoscopy

International Nuclear Information System (INIS)

Stefansson, T.; Univ. Hospital, Uppsala; Nyman, R.; Nilsson, S.; Ekbom, A.; Univ. Hospital, Uppsala; Paahlman, L.

1997-01-01

Purpose: To evaluate the use of laparoscopy, CT, colonic enema (CE), and laboratory tests (white blood cell count (WBC), sedimentation rate (SR), and C-reactive protein (CRP)) in diagnosing diverticulitis of the sigmoid colon. Material and Methods: The diagnostic methods were prospectively evaluated in 88 patients, 30 of whom were referred for laparoscopy. Results: Fity-two patients were found to have sigmoid diverticulitis: 20 patients by lanparoscopy, 21 by CT, and 11 by CE combined with one positive laboratory test. Laparoscopy proved to be superior to the other diagnostic methods in diagnosing diverticulitis of the sigmoid colon. CT had a high specificity (1.0; 95% CI: 0.92-1.0) but low sensitivity (0.69; 95% CI: 0.56-0.79) in detecting diverticulitis. CE had a higher sensitivity (0.82; 95% CI: 0.71-0.90) but a lower specificity (0.81; 95% CI: 0.67-0.91) than CT. Conclusion: CT was the best method for diagnosing abdominal pathology outside the colon. CT can be recommended as the first examination in seriously ill patients where abscesses and other causes of the symptoms than diverticulitis must first be rule out. Laparoscopy is probably the most accurate method in diagnosing diverticulitis. (orig.)

Pictorial review: magnetic resonance imaging of colonic diverticulitis

International Nuclear Information System (INIS)

Buckley, Orla; Geoghegan, Tony; McAuley, Grainne; Persaud, Thara; Khosa, Faisal; Torreggiani, William C.

2007-01-01

Magnetic resonance imaging (MRI) is rapidly emerging as a useful imaging modality for the evaluation of the gastrointestinal tract. Increasingly rapid sequences and improving hardware have significantly improved the visualisation of diseases of the colon. MRI has a major advantage over CT in that there is no ionising radiation. In our institution, MRI has increasingly been used as a complimentary imaging modality to CT in the diagnosis and evaluation of diverticulitis and its complications. In this review article, we illustrate the emerging role of MRI in the diagnosis and evaluation of colonic diverticulitis. (orig.)

Patients with computed tomography-proven acute diverticulitis require follow-up to exclude colorectal cancer

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Shafquat Zaman

2017-04-01

Full Text Available Background/Aims: Traditionally, patients with acute diverticulitis undergo follow-up endoscopy to exclude colorectal cancer (CRC. However, its usefulness has been debated in this era of high-resolution computed tomography (CT diagnosis. We assessed the frequency and outcome of endoscopic follow-up for patients with CT-proven acute diverticulitis, according to the confidence in the CT diagnosis.Methods: Records of patients with CT-proven acute diverticulitis between October 2007 and March 2014 at Sandwell & West Birmingham Hospitals NHS Trust were retrieved. The National Cancer Registry confirmed the cases of CRC. Endoscopy quality indicators were compared between these patients and other patients undergoing the same endoscopic examination over the same period.Results: We identified 235 patients with CT-proven acute diverticulitis, of which, 187 were managed conservatively. The CT report was confident of the diagnosis of acute diverticulitis in 75% cases. Five of the 235 patients were subsequently diagnosed with CRC (2.1%. Three cases of CRC were detected in the 187 patients managed conservatively (1.6%. Forty-eight percent of the conservatively managed patients underwent follow-up endoscopy; one case of CRC was identified. Endoscopies were often incomplete and caused more discomfort for patients with diverticulitis compared with controls.Conclusions: CRC was diagnosed in patients with CT-proven diverticulitis at a higher rate than in screened asymptomatic populations, necessitating follow-up. CT reports contained statements regarding diagnostic uncertainty in 25% cases, associated with an increased risk of CRC. Follow-up endoscopy in patients with CT-proven diverticulitis is associated with increased discomfort and high rates of incompletion. The use of other follow-up modalities should be considered.

Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

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Jeong, Jewon; Hong, Seong Sook; Hwang, Ji Young; Kim, Hyun Joo; Chang, Yun Woo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

2015-01-15

We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

International Nuclear Information System (INIS)

Ajaj, Waleed; Lauenstein, Thomas; Goehde, Susanne; Kuehle, Christiane; Herborn, Christoph U.; Ruehm, Stefan G.; Langhorst, Jost; Zoepf, Thomas; Gerken, Guido; Goyen, Mathias

2005-01-01

To assess dark-lumen magnetic resonance colonography (MRC) for the evaluation of patients with suspected sigmoid diverticulitis. Forty patients with suspected sigmoid diverticulitis underwent MRC within 72 h prior to conventional colonoscopy (CC). A three-dimensional T1-weighted volumetric interpolated breath-hold examination sequence was acquired after an aqueous enema and intravenous administration of gadolinium-based contrast agents. All MRC data were evaluated by two radiologists. Based on wall thickness and focal uptake of contrast material and pericolic reaction including mesenteric infiltration on T1-weighted sequence the sigmoid colon was assessed for the presence of diverticulitis. MRC classified 17 of the 40 patients as normal with regard to sigmoid diverticulitis. However, CC confirmed the presence of light inflammatory signs in four patients which were missed in MRC. MRC correctly identified wall thickness and contrast uptake of the sigmoid colon in the other 23 patients. In three of these patients false-positive findings were observed, and MRC classified the inflammation of the sigmoid colon as diverticulitis whereas CC and histopathology confirmed invasive carcinoma. MRC detected additionally relevant pathologies of the entire colon and could be performed in cases where CC was incomplete. MRC may be considered a promising alternative to CC for the detection of sigmoid diverticulitis. (orig.)

Minimally invasive and surgical management strategies tailored to the severity of acute diverticulitis.

LENUS (Irish Health Repository)

McDermott, F D

2014-01-01

The severity of acute diverticulitis ranges from mild, simple inflammation to pericolic abscesses, or perforation with faeculent peritonitis. Treatment of diverticulitis has evolved towards more conservative and minimally invasive strategies. The aim of this review is to highlight recent concepts and advances in management.

Outpatient treatment for acute uncomplicated diverticulitis

NARCIS (Netherlands)

Ünlü, Çagdas; Gunadi, Patrick M.; Gerhards, Michael F.; Boermeester, Marja A.; Vrouenraets, Bart C.

2013-01-01

Traditionally, treatment of acute diverticulitis has mostly been based on inpatient care. The question arises whether these patients can be treated on an outpatient basis as the admissions for diverticular disease have been shown to be increasing every year. We studied whether outpatient treatment

Prototheca zopfii associated diverticulitis in an immunosuppressed host, a case presentation and literature review

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Kyle W. Meinke

2017-11-01

Full Text Available Clinical infection with Prototheca species can present in many ways including cutaneous, bursal, or disseminated forms. Of these clinical forms, protothecal intestinal infections are a very rare occurrence, and there have only been a few documented cases within the medical literature. We present a case of a 67 year old African American male who presented to our veterans hospital with bowel obstruction. The patient has a pertinent medical history of prolonged immunosuppressive therapy for cadaveric renal transplant, Clostridium difficile infection, herpetic perirectal ulcer, and diverticulosis. The patient presented with symptoms of weight loss, left lower quadrant pain, and pencil thin stool. Colonoscopic and barium studies confirmed a complete obstruction at the level of the distal descending colon. Carcinoembryonic levels were within normal limits. The patient underwent a left hemicolectomy, and gross examination of the specimen revealed a markedly thickened bowel wall with multiple diverticula. Histologic examination revealed diverticular disease with associated transmural inflammation and numerous associated dark round structures. The basophilic round structures appeared to contain cell walls and stained positively for fungal stains. Overall, the diagnosis of Prototheca zopfii was made based on the characteristic histopathologic features and the results of the fungal staining pattern. To our knowledge, this is the first reported case of a colonic diverticulitis with involvement by Prototheca zopfii. We present an overview of the biology, epidemiology, histopathologic features, clinical manifestations, and treatment options of Prototheca as it relates to our patient.

Western Dietary Pattern Increases, and Prudent Dietary Pattern Decreases, Risk of Incident Diverticulitis in a Prospective Cohort Study.

Science.gov (United States)

Strate, Lisa L; Keeley, Brieze R; Cao, Yin; Wu, Kana; Giovannucci, Edward L; Chan, Andrew T

2017-04-01

Dietary fiber is implicated as a risk factor for diverticulitis. Analyses of dietary patterns may provide information on risk beyond those of individual foods or nutrients. We examined whether major dietary patterns are associated with risk of incident diverticulitis. We performed a prospective cohort study of 46,295 men who were free of diverticulitis and known diverticulosis in 1986 (baseline) using data from the Health Professionals Follow-Up Study. Each study participant completed a detailed medical and dietary questionnaire at baseline. We sent supplemental questionnaires to men reporting incident diverticulitis on biennial follow-up questionnaires. We assessed diet every 4 years using a validated food frequency questionnaire. Western (high in red meat, refined grains, and high-fat dairy) and prudent (high in fruits, vegetables, and whole grains) dietary patterns were identified using principal component analysis. Follow-up time accrued from the date of return of the baseline questionnaire in 1986 until a diagnosis of diverticulitis, diverticulosis or diverticular bleeding; death; or December 31, 2012. The primary end point was incident diverticulitis. During 894,468 person years of follow-up, we identified 1063 incident cases of diverticulitis. After adjustment for other risk factors, men in the highest quintile of Western dietary pattern score had a multivariate hazard ratio of 1.55 (95% CI, 1.20-1.99) for diverticulitis compared to men in the lowest quintile. High vs low prudent scores were associated with decreased risk of diverticulitis (multivariate hazard ratio, 0.74; 95% CI, 0.60-0.91). The association between dietary patterns and diverticulitis was predominantly attributable to intake of fiber and red meat. In a prospective cohort study of 46,295 men, a Western dietary pattern was associated with increased risk of diverticulitis, and a prudent pattern was associated with decreased risk. These data can guide dietary interventions for the prevention of

End-colostomy diverticulitis with parastomal phlegmon: A case report.

Science.gov (United States)

Muradbegovic, Mirza; St-Amour, Pénélope; Martin, David; Petermann, David; Benabidallah, Samir; Di Mare, Luca

2017-10-01

Acute colonic diverticulitis is a well-known surgical emergency, which occurs in about 10 percent of patients known for diverticulosis. The case of a 77-year-old woman is reported, with past history of abdominoperineal resection with end-colostomy for low rectal adenocarcinoma, and who developed an acute colonic diverticulitis in a subcutaneous portion of colostomy with parastomal phlegmon. Initial computed tomography imaging demonstrated a significant submucosal parietal edema with local fat tissues infiltration in regard of 3 diverticula. A two-step treatment was decided: first a nonoperative treatment was initiated with 2 weeks antibiotics administration, followed by, 6 weeks after, a segmental resection of the terminal portion of the colon with redo of a new colostomy by direct open approach. Patient was discharged on the second postoperative day without complications. Follow-up at 2 weeks revealed centimetric dehiscence of the stoma, which was managed conservatively until sixth postoperative week by stomatherapists. Treatment of acute diverticulitis with parastomal phlegmon in a patient with end-colostomy could primary be nonoperative. Delayed surgical treatment with segmental colonic resection was proposed to avoid recurrence and potential associated complications.

Laparoscopic Lavage Is Feasible and Safe for the Treatment of Perforated Diverticulitis With Purulent Peritonitis

DEFF Research Database (Denmark)

Angenete, Eva; Thornell, Anders; Burcharth, Jakob

2016-01-01

OBJECTIVE: To evaluate short-term outcomes of a new treatment for perforated diverticulitis with purulent peritonitis in a randomized controlled trial. BACKGROUND: Perforated diverticulitis with purulent peritonitis (Hinchey III) has traditionally been treated with surgery including colon resection...

An Unusual Cause of Right Lower Quadrant Pain: The Caecum Diverticulitis

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Murat Yildar

2012-01-01

Full Text Available Purpose. In the study presented, preoperative examinations and surgical methods were discussed along with literature, regarding two cases who were operated with the prediagnosis of acute appendicitis and for whom caecum diverticulitis was determined. Case 1. 21 years old male patient who had applied to hospital with complaint of abdominal pain, underwent an operation with a prediagnosis of acute appendicitis. Right hemicolectomy was performed with mass perioperatively determined in caecum. Histopathological examination revealed necrosis and inflammation in diverticulum wall. Case 2. 36 years old female patient applied to emergency department with abdominal pain and underwent an operation with a prediagnosis of acute appendicitis. Appendectomy and diverticulectomy were performed for whom inflame diverticula in caecum was determined perioperatively. Histopathological examination was revealed acute inflammation in diverticulum wall. Conclusion. Although solitary caecum diverticulitis is a rarely encountered disease, it must be considered in the differential diagnosis of right lower abdomen pain.

Elderly patient with acute, left lower abdominal pain: perforated jejunal diverticulitis (2010:7b)

International Nuclear Information System (INIS)

Franca, Manuela; Certo, Manuela; Varzim, Pedro; Silva, Donzilia; Peixoto, Carlos

2010-01-01

An elderly patient with acute, left, lower abdominal pain is described, for whom the diagnosis of perforated jejunal diverticulitis was established by computed tomography (CT). The presence of a jejunal segmental inflammatory process, with or without abscess or perforation, in the setting of jejunal diverticulosis, is very suggestive of jejunal diverticulitis. (orig.)

An assessment of the quality and content of information on diverticulitis on the internet.

Science.gov (United States)

Connelly, Tara M; Khan, Mohammad Shoaib; Victory, Liana; Mehmood, Abeera; Cooke, Fiachra

2018-05-21

Although commonly the first port of call for medical information, the internet provides unregulated information of variable quality. We aimed to evaluate commonly accessed web-based patient information on diverticulitis using validated and novel scoring systems. The top internet search engines (Google/Bing/Yahoo) were queried using the keyword 'diverticulitis.' The first 20 websites from each were graded using the DISCERN and Journal of the American Medical Association (JAMA) benchmark criteria. A novel diverticulitis-specific score was devised and applied. Thirty-six unique websites were identified. The mean total DISCERN score for all websites was 39.92 ± 12.44 (range = 18-62). No website achieved the maximum DISCERN score of 75. The mean JAMA and diverticulitis scores were 2.5 ± 1.08 (maximum possible score = 4) and 11.08 ± 4.17 (19 points possible) respectively. Fourteen (35.9%) and 20 (51.2%) did not provide the date of last update and authorship respectively. Thirty-three (84.6%) mentioned surgery as a treatment option; however, the majority (69.7%) did not describe the surgery or the possibility of a stoma. All except two described disease symptoms. Only ten (25.64%) provided information on when to seek further medical advice or help. Web-based information on diverticulitis is of variable content and quality. The majority of top websites describe disease symptoms and aetiology; however, information to prompt seeking medical attention if required, descriptions of surgical procedures and the possibility of stoma creation are poorly described in the majority of websites. These findings should be highlighted to patients utilising the internet to obtain information on diverticulitis. Copyright © 2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

The Best Choice of Treatment for Acute Colonic Diverticulitis with Purulent Peritonitis Is Uncertain

DEFF Research Database (Denmark)

Hupfeld, Line; Burcharth, Jakob; Pommergaard, Hans-Christian

2014-01-01

Severe stages of acute, colonic diverticulitis can progress into intestinal perforations with peritonitis. In such cases, urgent treatment is needed, and Hartmann's procedure is the standard treatment for cases with fecal peritonitis. Peritoneal lavage may be an alternative to resection for acute...... diverticulitis with purulent peritonitis, but ongoing randomized trials are awaited to clarify this....

A Delayed Recrudescent Case of Sigmoidocutaneous Fistula due to Diverticulitis

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Takaaki Fujii

2007-10-01

Full Text Available Colocutaneous fistula caused by diverticulitis is relatively rare, and a delayed recrudescent case of colocutaneous fistula is very uncommon. We herein report a rare case of a Japanese 56-year-old male with delayed recrudescent sigmoidocutaneous fistula due to diverticulitis. A colocutaneous fistula was formed after a drainage operation against a perforation of the sigmoid colon diverticulum. After 5 years from treatment, he was admitted to our hospital because of lower abdominal pain. We diagnosed the recrudescent sigmoidocutaneous fistula by abdominal computed tomography and gastrografin enema, and managed the patient with total parenteral nutrition and antibiotics. As the fistula formation did not improve, a low anterior resection with fistulectomy was performed. The postoperative course was uneventful and the patient was discharged. It has been reported that, in fistulas of the skin caused by diverticular disease, complete closure of the fistula by conservative therapy may not be possible. This case also implies the possibility of a recurrence of the fistula even if the conservative treatment was effective. In cases of colocutaneous fistulas due to diverticulitis, radical surgery is considered necessary because of possibility of recurrence of the fistula.

Treatment of diverticular disease of the colon and prevention of acute diverticulitis: a systematic review.

Science.gov (United States)

Maconi, Giovanni; Barbara, Giovanni; Bosetti, Cristina; Cuomo, Rosario; Annibale, Bruno

2011-10-01

Diverticular disease of the colon is a common disorder, characterized by recurrent symptoms and complications such as diverticulitis, requiring hospital admissions and surgery. This study aimed to systematically review the evidence for medical therapy of diverticular disease in reducing symptoms and preventing acute diverticulitis. MEDLINE and Embase databases (1966 to February 2010). The studies selected were prospective clinical trials on uncomplicated diverticular disease of the colon. Four investigators independently reviewed articles, extracted data, and assessed study quality according to standardized criteria. The main outcomes measured were improvement in symptoms, complete remission of symptoms, and prevention of acute diverticulitis. We identified 31 studies, including 6 placebo-controlled trials. The methodological quality of these studies was suboptimal. Only 10 trials provided a detailed description of the patient history, 8 assessed symptoms by the use of a validated questionnaire, and 14 appropriately defined inclusion and exclusion criteria. Only one long-term double-blind placebo-controlled study was identified. This reported a significant improvement in symptoms and greater prevalence of symptom-free patients at 1 year with fiber plus rifaximin in comparison with fiber alone. The efficacy of treatment in preventing acute diverticulitis was evaluated in 11 randomized trials. Four trials compared rifaximin plus fiber vs fiber alone and failed to show a significant difference between treatments. However, cumulative data from these trials revealed a significant benefit following rifaximin and fiber (1-year rate of acute diverticulitis: 11/970 (1.1%) vs 20/690 (2.9%); P = .012), but with a number needed to treat of 57, to prevent an attack of acute diverticulitis. : Heterogeneity of the study design, patients' characteristics, regimens and combination of studied treatment, and outcome reporting precluded the pooling of results and limited

Laparoscopic lavage for perforated diverticulitis: a population analysis.

LENUS (Irish Health Repository)

Rogers, Ailín C

2012-09-01

Laparoscopic lavage has shown promising results in nonfeculent perforated diverticulitis. It is an appealing strategy; it avoids the complications associated with resection. However, there has been some reluctance to widespread uptake because of the scarcity of large-scale studies.

New trends in the management of diverticulitis and colonic diverticular disease

OpenAIRE

Medina-Fernández, Francisco Javier; Díaz-Jiménez, Nélida; Gallardo-Herrera, Ana Belén; Gómez-Luque, Irene; Garcilazo-Arsimendi, Dimas Javier; Gómez-Barbadillo, José

2015-01-01

Colonic diverticular disease is a chronic disorder presenting with a variety of abdominal symptoms and recurrent episodes of acute diverticulitis. It is close linked to age so its prevalence has risen notably during the last decades in western countries, increasing costs related to medical attention. Recently, several works have provided evidence to a series of measures that could improve the outcomes as well as reduce expenses associated to this process. The aim of the present review is to e...

Two-year results of the randomized clinical trial DILALA comparing laparoscopic lavage with resection as treatment for perforated diverticulitis

DEFF Research Database (Denmark)

Kohl, A; Rosenberg, J; Bock, D

2018-01-01

BACKGROUND: Traditionally, perforated diverticulitis with purulent peritonitis was treated with resection and colostomy (Hartmann's procedure), with inherent complications and risk of a permanent stoma. The DILALA (DIverticulitis - LAparoscopic LAvage versus resection (Hartmann's procedure...... in the Hartmann's group had a colostomy at 24 months. CONCLUSION: Laparoscopic lavage is a better option for perforated diverticulitis with purulent peritonitis than open resection and colostomy....

Recent advances in the treatment of colonic diverticular disease and prevention of acute diverticulitis

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Elisei, Walter; Tursi, Antonio

2016-01-01

The incidence of diverticulosis and diverticular disease of the colon is increasing worldwide. Although the majority of patients remains asymptomatic long-life, the prevalence of diverticular disease of the colon, including acute diverticulitis, is substantial and is becoming a significant burden on National Health Systems in terms of direct and indirect costs. Focus is now being drawn on identifying the correct therapeutic approach by testing various treatments. Fiber, non-absorbable antibiotics and probiotics seem to be effective in treating symptomatic and uncomplicated patients, and 5-aminosalicylic acid might help prevent acute diverticulitis. Unfortunately, robust evidence on the effectiveness of a medical strategy to prevent acute diverticulitis recurrence is still lacking. We herein provide a concise review on the effectiveness and future perspectives of these treatments. PMID:26752946

Laparoscopic versus open resection for sigmoid diverticulitis.

Science.gov (United States)

Abraha, Iosief; Binda, Gian A; Montedori, Alessandro; Arezzo, Alberto; Cirocchi, Roberto

2017-11-25

Diverticular disease is a common condition in Western industrialised countries. Most individuals remain asymptomatic throughout life; however, 25% experience acute diverticulitis. The standard treatment for acute diverticulitis is open surgery. Laparoscopic surgery - a minimal-access procedure - offers an alternative approach to open surgery, as it is characterised by reduced operative stress that may translate into shorter hospitalisation and more rapid recovery, as well as improved quality of life. To evaluate the effectiveness of laparoscopic surgical resection compared with open surgical resection for individuals with acute sigmoid diverticulitis. We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 2) in the Cochrane Library; Ovid MEDLINE (1946 to 23 February 2017); Ovid Embase (1974 to 23 February 2017); clinicaltrials.gov (February 2017); and the World Health Organization (WHO) International Clinical Trials Registry (February 2017). We reviewed the bibliographies of identified trials to search for additional studies. We included randomised controlled trials comparing elective or emergency laparoscopic sigmoid resection versus open surgical resection for acute sigmoid diverticulitis. Two review authors independently selected studies, assessed the domains of risk of bias from each included trial, and extracted data. For dichotomous outcomes, we calculated risk ratios (RRs) with 95% confidence intervals (CIs). For continuous outcomes, we planned to calculate mean differences (MDs) with 95% CIs for outcomes such as hospital stay, and standardised mean differences (SMDs) with 95% CIs for quality of life and global rating scales, if researchers used different scales. Three trials with 392 participants met the inclusion criteria. Studies were conducted in three European countries (Switzerland, Netherlands, and Germany). The median age of participants ranged from 62 to 66 years; 53% to 64% were

A rare manifestation of perforated diverticulitis: parastomal subcutaneous abscess.

NARCIS (Netherlands)

Peters, J.H.; Bleichrodt, R.P.; Goor, H. van

2003-01-01

Perforation is a serious complication of diverticular disease. The sigmoid is the main affected anatomic site of perforated diverticulitis and sigmoid resection followed either by Hartmann procedure or primary anastomosis are the standard surgical approaches. Surgery, however, does not cure

Experience of managing complicated diverticulitis of colon: a retrospective case series from south asian country

International Nuclear Information System (INIS)

Gala, T.; Alvi, A.R.; Sheikh, G.M.; Habib, H.Y.; Ghafoor, Z.

2014-01-01

To assess the morbidity and mortality associated with complicated diverticulitis in Pakistan. Methods: The retrospective case series was conducted at an urban tertiary care university hospital of Karachi, Pakistan, comprising data from December 1989 to November 2010. International Classification of Diseases codes for diverticular disease and diverticulitis with abscess, fistula, stricture, bowel obstruction and perforation were obtained from the medical record department. SPSS 19 was used for statistical analysis. Results: A total of 60 (1.9%) cases with complicated diverticulitis were located from among 3170 records reviewed. Mean age was 62.7+-13 years with male-to-female ratio being 36:24. In 37 (62%) patients, the diagnosis was established on computed tomography scan of the abdomen, followed by barium enema in 12 (20%) and colonoscopy in 11 (18%). Post-operative morbidity was observed in 24 (40%) and 7 (16%) expired within 28 days of surgery. Post-operative intra-abdominal sepsis, wound dehiscence and incisional hernia were significantly associated with generalised peritonitis (p <0.05), while admission to intensive care unit was associated with age over 60 years and faecal peritonitis. Post-operative mortality was significantly associated with high American Society of Anaesthesiologists-score III and IV and age above 60 years. Conclusion: Complicated diverticulitis carries significant morbidity and mortality in Pakistani population. Since the trend is on the rise, therefore we propose a prospective multi-centre cohort study to understand the spectrum of disease, management and identification of risk factors to achieve the best possible outcomes in patients with complicated diverticulitis. (author)

Sigmoid stenosis caused by diverticulitis vs. carcinoma: usefulness of sonographic features for their differentiation in the emergency setting.

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Ripollés, Tomás; Martínez-Pérez, María Jesús; Gómez Valencia, Diana Patricia; Vizuete, José; Martín, Gregorio

2015-10-01

To retrospectively evaluate the accuracy of ultrasound as a diagnostic method for differentiating acute diverticulitis from colon cancer in patients with sigmoid colon stenosis. Ultrasound examinations of 91 consecutive patients with sigmoid stenosis (50 diverticulitis and 41 colon cancers) were reviewed by two trained radiologists. Sixty-five (71%) patients presented with acute abdominal symptoms. Thirteen sonographic criteria retrieved from the literature were evaluated to differentiate benign from malignant strictures. A score including all parameters which showed significant differences between benign vs. malignant was built. Sensitivity, specificity, accuracy, and positive or negative predictive values of each sonographic sign, the overall diagnosis, and sonographic score were calculated. Loss of the bowel wall stratification was the most reliable criteria for the diagnosis of malignancy (92% and 94% of sensitivity and specificity, respectively), and the best inter-radiologist agreement (κ = 0.848). Adjacent lymph nodes were the most specific feature (98%) for colon cancer, but its sensitivity was low. Global assessment could differentiate both diseases with high sensitivity (92-94.9%) and specificity (98-100%). Sonographic score >3 enabled differentiation of carcinoma from diverticulitis with 95% sensitivity and 92-94% specificity, with an area under the ROC curve of 0.98-0.987. There were no significant differences in the results between patients with acute and nonacute abdominal symptoms. The combination of several morphological sonographic findings using a score can differentiate most cases of diverticulitis from colon carcinoma in sigmoid strictures.

Meckel’s diverticulitis causing small bowel obstruction by a novel mechanism

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Vishalkumar G. Shelat

2011-07-01

Full Text Available Meckel’s diverticulum occurs in 2% of the general population and majority of patients remain asymptomatic. Gastrointestinal bleeding is the most common presentation in the paediatric population. While asymptomatic and incidentally found Meckel’s diverticulum may be left alone, surgery is essential for treating a symptomatic patient. Despite advances in imaging and technology, pre-operative diagnosis is often difficult. We present a first report of an unusual mechanism of small bowel obstruction due to Meckel’s diverticulitis in a paediatric patient. The diagnosis was only apparent at laparotomy.

Short-term mortality, readmission, and recurrence in treatment of acute diverticulitis with abscess formation

DEFF Research Database (Denmark)

Gregersen, Rasmus; Andresen, Kristoffer; Burcharth, Jakob

2016-01-01

PURPOSE: The aim of the study was to investigate short-term mortality, readmission, and recurrence in a national cohort of patients with Hinchey Ib-II diverticulitis. METHODS: The retrospective cohort-investigation was conducted using a database consisting of the entire Danish population (n = 6......, secondary outcomes were mortality, readmission, and recurrence within 30 days post-discharge. The study was reported using RECORD guidelines. RESULTS: A total of 3148 eligible patients were identified. The cohort had a mean age of 65.1 year, 25.6 % had previously been admitted with diverticulitis, and 48...... was associated with mortality with odds-ratio 1.49 (1.23-1.81) and readmission with odds-ratio 2.91 (1.24-6.80). CONCLUSION: Acute diverticulitis with abscess formation is a severe and life-threatening condition. Direct comparisons of treatment groups were not possible due to possible confounding by indication....

Perforated Solitary Diverticulitis of the Ascending Colon

Science.gov (United States)

2005-06-01

postoperative day 6. DISCUSSION Diverticuli of the right colon exist in approximately 1% to 5% of patients with diverticular disease .1-3 They are...ORIGINAL REPORTS Perforated Solitary Diverticulitis of the Ascending Colon CPT David S. Kauvar, MC, USA, MAJ, Jayson Aydelotte, MC, USA, and MAJ...Michael Harnisch, MC, USA Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas KEY WORDS: solitary colon diverticulum

Clinical diagnostic accuracy of acute colonic diverticulitis in patients admitted with acute abdominal pain, a receiver operating characteristic curve analysis.

Science.gov (United States)

Jamal Talabani, A; Endreseth, B H; Lydersen, S; Edna, T-H

2017-01-01

The study investigated the capability of clinical findings, temperature, C-reactive protein (CRP), and white blood cell (WBC) count to discern patients with acute colonic diverticulitis from all other patients admitted with acute abdominal pain. The probability of acute diverticulitis was assessed by the examining doctor, using a scale from 0 (zero probability) to 10 (100 % probability). Receiver operating characteristic (ROC) curves were used to assess the clinical diagnostic accuracy of acute colonic diverticulitis in patients admitted with acute abdominal pain. Of 833 patients admitted with acute abdominal pain, 95 had acute colonic diverticulitis. ROC curve analysis gave an area under the ROC curve (AUC) of 0.95 (CI 0.92 to 0.97) for ages patients. Separate analysis showed an AUC = 0.83 (CI 0.80 to 0.86) of CRP alone. White blood cell count and temperature were almost useless to discriminate acute colonic diverticulitis from other types of acute abdominal pain, AUC = 0.59 (CI 0.53 to 0.65) for white blood cell count and AUC = 0.57 (0.50 to 0.63) for temperature, respectively. This prospective study demonstrates that standard clinical evaluation by non-specialist doctors based on history, physical examination, and initial blood tests on admission provides a high degree of diagnostic precision in patients with acute colonic diverticulitis.

Laparoscopic Lavage vs Primary Resection for Acute Perforated Diverticulitis: The SCANDIV Randomized Clinical Trial.

Science.gov (United States)

Schultz, Johannes Kurt; Yaqub, Sheraz; Wallon, Conny; Blecic, Ljiljana; Forsmo, Håvard Mjørud; Folkesson, Joakim; Buchwald, Pamela; Körner, Hartwig; Dahl, Fredrik A; Øresland, Tom

2015-10-06

Perforated colonic diverticulitis usually requires surgical resection, which is associated with significant morbidity. Cohort studies have suggested that laparoscopic lavage may treat perforated diverticulitis with less morbidity than resection procedures. To compare the outcomes from laparoscopic lavage with those for colon resection for perforated diverticulitis. Multicenter, randomized clinical superiority trial recruiting participants from 21 centers in Sweden and Norway from February 2010 to June 2014. The last patient follow-up was in December 2014 and final review and verification of the medical records was assessed in March 2015. Patients with suspected perforated diverticulitis, a clinical indication for emergency surgery, and free air on an abdominal computed tomography scan were eligible. Of 509 patients screened, 415 were eligible and 199 were enrolled. Patients were assigned to undergo laparoscopic peritoneal lavage (n = 101) or colon resection (n = 98) based on a computer-generated, center-stratified block randomization. All patients with fecal peritonitis (15 patients in the laparoscopic peritoneal lavage group vs 13 in the colon resection group) underwent colon resection. Patients with a pathology requiring treatment beyond that necessary for perforated diverticulitis (12 in the laparoscopic lavage group vs 13 in the colon resection group) were also excluded from the protocol operations and treated as required for the pathology encountered. The primary outcome was severe postoperative complications (Clavien-Dindo score >IIIa) within 90 days. Secondary outcomes included other postoperative complications, reoperations, length of operating time, length of postoperative hospital stay, and quality of life. The primary outcome was observed in 31 of 101 patients (30.7%) in the laparoscopic lavage group and 25 of 96 patients (26.0%) in the colon resection group (difference, 4.7% [95% CI, -7.9% to 17.0%]; P = .53). Mortality at 90 days did not

Long-term use of steroids protects from the development of symptomatic diverticulitis requiring hospitalization in the Asian population.

Science.gov (United States)

Chang, Shen-Shong; Hu, Hsiao-Yun

2015-01-01

The pathophysiology of diverticulitis is poorly understood. Factors such as physical inactivity, constipation, obesity, smoking, and the use of nonsteroidal antiinflammatory drugs (NSAIDs) have been associated with an increased risk of diverticular disease. To evaluate whether patients exhibiting long-term steroid use are at increased risk of colonic diverticulitis. We conducted a population-based, nested case-control study. Data were retrospectively collected from the National Health Insurance Research Database. The study cohort comprised patients diagnosed with diverticulitis, identified using inpatient discharge records using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes (562.11 and 562.13), and those who were administered one or more prescriptions for corticosteroids for systemic use. Control patients were matched to cases by age, sex, NSAID use, laxative drug use, and index date. We enrolled 690 patients with colonic diverticulitis and 2760 in the control group. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression. Compared with steroid nonusers, the adjusted ORs were 0.60 (95% CI = 0.35-1.06) and 0.80 (95% CI = 0.64-1.008) in current steroid users and previous steroid users, respectively. In addition, the adjusted ORs were 0.55 (95% CI = 0.31-0.98), 0.57 (95% CI = 0.31-0.98), and 0.44 (95% CI = 0.22-0.86) for steroid use duration more than half time by an exposure period of 90 days, 180 days, and 365 days before the claim date of colonic diverticulitis, respectively. The results indicated that long-term steroid use within one year is associated with lower risk of colonic diverticulitis.

Long-term use of steroids protects from the development of symptomatic diverticulitis requiring hospitalization in the Asian population.

Directory of Open Access Journals (Sweden)

Shen-Shong Chang

Full Text Available The pathophysiology of diverticulitis is poorly understood. Factors such as physical inactivity, constipation, obesity, smoking, and the use of nonsteroidal antiinflammatory drugs (NSAIDs have been associated with an increased risk of diverticular disease. To evaluate whether patients exhibiting long-term steroid use are at increased risk of colonic diverticulitis.We conducted a population-based, nested case-control study. Data were retrospectively collected from the National Health Insurance Research Database. The study cohort comprised patients diagnosed with diverticulitis, identified using inpatient discharge records using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM codes (562.11 and 562.13, and those who were administered one or more prescriptions for corticosteroids for systemic use. Control patients were matched to cases by age, sex, NSAID use, laxative drug use, and index date. We enrolled 690 patients with colonic diverticulitis and 2760 in the control group. The adjusted odds ratios (ORs and 95% confidence intervals (CIs were estimated using conditional logistic regression.Compared with steroid nonusers, the adjusted ORs were 0.60 (95% CI = 0.35-1.06 and 0.80 (95% CI = 0.64-1.008 in current steroid users and previous steroid users, respectively. In addition, the adjusted ORs were 0.55 (95% CI = 0.31-0.98, 0.57 (95% CI = 0.31-0.98, and 0.44 (95% CI = 0.22-0.86 for steroid use duration more than half time by an exposure period of 90 days, 180 days, and 365 days before the claim date of colonic diverticulitis, respectively.The results indicated that long-term steroid use within one year is associated with lower risk of colonic diverticulitis.

The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitisA and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitisB in perforated diverticulitis (NTR2037

Directory of Open Access Journals (Sweden)

Bruin Sjoerd C

2010-10-01

Full Text Available Abstract Background Recently, excellent results are reported on laparoscopic lavage in patients with purulent perforated diverticulitis as an alternative for sigmoidectomy and ostomy. The objective of this study is to determine whether LaparOscopic LAvage and drainage is a safe and effective treatment for patients with purulent peritonitis (LOLA-arm and to determine the optimal resectional strategy in patients with a purulent or faecal peritonitis (DIVA-arm: perforated DIVerticulitis: sigmoidresection with or without Anastomosis. Methods/Design In this multicentre randomised trial all patients with perforated diverticulitis are included. Upon laparoscopy, patients with purulent peritonitis are treated with laparoscopic lavage and drainage, Hartmann's procedure or sigmoidectomy with primary anastomosis in a ratio of 2:1:1 (LOLA-arm. Patients with faecal peritonitis will be randomised 1:1 between Hartmann's procedure and resection with primary anastomosis (DIVA-arm. The primary combined endpoint of the LOLA-arm is major morbidity and mortality. A sample size of 132:66:66 patients will be able to detect a difference in the primary endpoint from 25% in resectional groups compared to 10% in the laparoscopic lavage group (two sided alpha = 5%, power = 90%. Endpoint of the DIVA-arm is stoma free survival one year after initial surgery. In this arm 212 patients are needed to significantly demonstrate a difference of 30% (log rank test two sided alpha = 5% and power = 90% in favour of the patients with resection with primary anastomosis. Secondary endpoints for both arms are the number of days alive and outside the hospital, health related quality of life, health care utilisation and associated costs. Discussion The Ladies trial is a nationwide multicentre randomised trial on perforated diverticulitis that will provide evidence on the merits of laparoscopic lavage and drainage for purulent generalised peritonitis and on the optimal resectional strategy

Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a systematic review

NARCIS (Netherlands)

Toorenvliet, Boudewijn R.; Swank, Hilko; Schoones, Jan W.; Hamming, Jaap F.; Bemelman, Willem A.

2010-01-01

Aim This systematic review aimed to evaluate the efficacy, morbidity and mortality of laparoscopic peritoneal lavage for patients with perforated diverticulitis. Method We searched PubMed, EMBASE, Web of Science, the Cochrane Library and CINAHL databases, Google Scholar and five major publisher

Perforated Sigmoid Diverticulitis in the Presence of Toxic Epidermal Necrolysis

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P. Heye

2014-02-01

Full Text Available Even though the incidence of toxic epidermal necrolysis (TEN is low, it is also associated with a high mortality rate. The condition predominantly affects the skin, but may also affect the gastrointestinal tract, dramatically increasing mortality. We present a case of perforated sigmoid diverticulitis in the presence of TEN. The patient was taking medication, known to be a risk factor, and presented an affected total body surface area and temporal development similar to previously reported cases of TEN. Characteristic abdominal symptoms, however, were missing. Gastrointestinal involvement in TEN appears to be a poor prognostic factor; medical staff must therefore be alert to patients with TEN who complain of abdominal discomfort. The exact pathogenesis, however, remains unclear.

Acute complicated diverticulitis managed by laparoscopic lavage

DEFF Research Database (Denmark)

Alamili, Mahdi; Gögenur, Ismail; Rosenberg, Jacob

2009-01-01

with antibiotics and laparoscopic lavage. Conversion to laparotomy was made in six (3%) patients and the mean hospital stay was nine days. Ten percent of the patients had complications. During the mean follow-up of 38 months, 38% of the patients underwent elective sigmoid resection with primary anastomosis....... CONCLUSION: Primary laparoscopic lavage for complicated diverticulitis may be a promising alternative to more radical surgery in selected patients. Larger studies have to be made before clinical recommendations can be given....

Qualitative and quantitative analyses of the bifidobacterial microbiota in the colonic mucosa of patients with colorectal cancer, diverticulitis and inflammatory bowel disease

Institute of Scientific and Technical Information of China (English)

无

2007-01-01

AIM: To characterize the bifidobacterial microbiota of the colonic mucosa in patients with colon cancer,inflammatory bowel disease or diverticulitis.METHODS: A sample of the distal colonic mucosa was taken during surgery from a total of 34 patients,twenty-one with diagnosed colorectal cancer, nine with diverticulitis and four with inflammatory bowel disease, requiring surgery for their condition. Bacterial DNA was extracted from the resected mucosal samples and bifidobacterial mucosa-associated microbiota was qualitatively and quantitatively determined by means of qualitative and quantitative PCR.RESULTS: Bifidobacteria were found in 100% of the samples from patients with diverticulitis or IBD and a 76% of those suffering colon cancer. The species B. longum and B. bifidum were the most widely found, followed by B. animalis, B. catenulatum and B.adolescentis. B. breve, B. dentium and B. angulatum were not detected in any sample. A significantly higher occurrence of B. longum was observed in patients with diverticulitis than in those with colon cancer or IBD (100%, 62% and 75%, respectively, P ＜ 0.05).Similar results were obtained for B. animalis (56%, 0%and 25%, P ＜ 0.05), while B. adolescentis was only found in the mucosa from patients with colon cancer (5 out of 21, 24%). At the quantitative level, patients with colon cancer or IBD showed lower counts of total Bifidobacterium (4.94 and 5.91 vs 6.96 log Cells/sample,respectively, P ＜ 0.05) and of the species B.longum (4.05 and 4.79 vs 6.76, P ＜ 0.05) than those with diverticulitis.CONCLUSION: Aberrancies in mucosa associated microbiota are present in different intestinal diseases.This may indicate a role of the microbiota in the pathogenesis of these diseases.

Descending colon endometriosis misdiagnosis as diverticulitis: A case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Ji Hyun; Kim, Min Jeong; Ha, Hong Il; Lee, Kwan Seop; Min, Soo Kee [Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of)

2016-09-15

Endometriosis is defined as the presence of ectopic endometrial tissue outside the uterus. It is a common disease in menstruating females and intestinal involvement is not uncommon. Intestinal endometriosis most commonly involves the sigmoid colon, rectum, ileum, appendix, and cecum. However, the descending colon is a rare site of intestinal endometriosis. Although computed tomography (CT) findings of bowel endometriosis have been presented in several articles, there has been no report describing the CT findings of descending colon endometriosis above the pelvic cavity. Here, we report a rare case of descending colon endometriosis located in the retroperitoneal space, in which the initial impression was acute colonic diverticulitis with a small abscess on preoperative multidetector CT.

Descending colon endometriosis misdiagnosis as diverticulitis: A case report

International Nuclear Information System (INIS)

Kim, Ji Hyun; Kim, Min Jeong; Ha, Hong Il; Lee, Kwan Seop; Min, Soo Kee

2016-01-01

Endometriosis is defined as the presence of ectopic endometrial tissue outside the uterus. It is a common disease in menstruating females and intestinal involvement is not uncommon. Intestinal endometriosis most commonly involves the sigmoid colon, rectum, ileum, appendix, and cecum. However, the descending colon is a rare site of intestinal endometriosis. Although computed tomography (CT) findings of bowel endometriosis have been presented in several articles, there has been no report describing the CT findings of descending colon endometriosis above the pelvic cavity. Here, we report a rare case of descending colon endometriosis located in the retroperitoneal space, in which the initial impression was acute colonic diverticulitis with a small abscess on preoperative multidetector CT

Anaphylaxis to Polyethylene Glycol (Colyte®) in a Patient with Diverticulitis.

Science.gov (United States)

Lee, So Hee; Hwang, Sun Hyuk; Park, Jin Soo; Park, Hae Sim; Shin, Yoo Seob

2016-10-01

Polyethylene glycols (PEGs) are believed to be chemically inert agents, but larger PEG polymers could have immunogenicity. A 39-year-old man was referred to emergency room for loss of consciousness and dyspnea after taking of PEG-3350 (Colyte®). In laboratory findings, the initial serum tryptase level was increased to 91.9 mg/L (normal range: 0.00-11.40 mg/L) without any other laboratory abnormalities. The intradermal test with 10 mg/mL Colyte® showed a 5 × 5 mm wheal, but basophil activation and histamine releasability tests were negative. PEG-3350 is widely used as an osmotic laxative due to its lack of absorption from the gastrointestinal tract. However, the loss of mucosal integrity at gastrointestinal membrane such as diverticulitis may be a predisposing factor for anaphylaxis to Colyte®. We report a case of anaphylaxis induced by the ingestion of PEG-3350 in a patient with diverticulitis which might be a risk factor of anaphylaxis.

Mild colonic diverticulitis can be treated without antibiotics. a case-control study

NARCIS (Netherlands)

de Korte, N.; Kuyvenhoven, J.P.; van der Peet, D.L.; Felt-Bersma, R.J.F.; Cuesta, M.A.; Stockmann, H.B.A.C.

2012-01-01

Aim Conservative treatment of mild colonic diverticulitis usually consists of observation, restriction of oral intake, intravenous fluids and antibiotics. The beneficiary effect of antibiotics remains unclear. The aim of this study is to evaluate the need for antibiotics in mild colonic

A study of the usefulness of CT in diagnosis of diverticulitis of the right colon and acute appendicitis

International Nuclear Information System (INIS)

Watanabe, Jota; Watanabe, Hideo; Tohyama, Taiji; Kushihata, Fumiki; Kobayashi, Nobuaki

2003-01-01

It is difficult to differentiate between diverticulitis of the right colon and acute appendicitis based on pathological and hematological findings. This study was designed to investigate the usefulness of CT in differentiation between the both diseases and indications of operation. Eight cases of right colon diverticulitis and 39 cases of acute appendicitis undergone abdominal plain CT scan before surgery were enrolled in the study. As for diverticulitis cases, diverticulum was visualized on abdominal CT scan in seven (87.5%) out of the eight cases. Of 39 cases of acute appendicitis, the appendix vermiformis was able to be visualized on abdominal CT scan in 26 (66.7%) cases. Some correlations between CT findings and postoperative pathological diagnosis of appendicitis were observed. A comparison was made on acute appendicitis cases by dividing them into two groups; namely, the non-surgery group comprising of cases pathologically diagnosed as non-inflammatory and catarrhal' and the surgery group comprising of cases diagnosed as 'phlegmonous and gangrenous' after surgery. Statistically significant difference was noted between both groups in two factors, whole-circumferential thickening of the appendiceal wall and fading panniculus adiposus around the appendix. It is concluded that abdominal CT scan is useful for differential diagnosis between right colon diverticulitis and acute appendicitis, and further that CT diagnosis of acute appendicitis well reflects the severity of the disease and contribute to decide indication of operation. (author)

Generalized peritonitis due to perforated diverticulitis: Hartmann's procedure or primary anastomosis?

Science.gov (United States)

Trenti, Loris; Biondo, Sebastiano; Golda, Thomas; Monica, Millan; Kreisler, Esther; Fraccalvieri, Domenico; Frago, Ricardo; Jaurrieta, Eduardo

2011-03-01

Hartmann's procedure (HP) still remains the most frequently performed procedure for diffuse peritonitis due to perforated diverticulitis. The aims of this study were to assess the feasibility and safety of resection with primary anastomosis (RPA) in patients with purulent or fecal diverticular peritonitis and review morbidity and mortality after single stage procedure and Hartmann in our experience. From January 1995 through December 2008, patients operated for generalized diverticular peritonitis were studied. Patients were classified into two main groups: RPA and HP. A total of 87 patients underwent emergency surgery for diverticulitis complicated with purulent or diffuse fecal peritonitis. Sixty (69%) had undergone HP while RPA was performed in 27 patients (31%). At the multivariate analysis, RPA was associated with less post-operative complications (P clinical anastomotic leakage and needed re-operation. RPA can be safely performed without adding morbidity and mortality in cases of diffuse diverticular peritonitis. HP should be reserved only for hemodynamically unstable or high-risk patients. Specialization in colorectal surgery improves mortality and raises the percentage of one-stage procedures.

Successful Management of Perforated Duodenal Diverticulitis With Intra-abdominal Drainage and Feeding Jejunostomy: A Case Report and Literature Review

Directory of Open Access Journals (Sweden)

Chin-Fan Chen

2008-08-01

Full Text Available We report the clinical experience of one patient with perforated duodenal diverticulitis who was successfully treated by intra-abdominal drainage and feeding jejunostomy. A 53-year-old male patient visited our hospital due to acute onset of abdominal pain and distension. Physical examination revealed tenderness over the epigastric area and right-lower quadrant of the abdomen without obvious rebound tenderness or muscle guarding. Duodenal diverticulitis with a retroperitoneal abscess was identified by abdominal computed tomography scan. Surgical intervention was performed after the failure of conservative treatment. The operative findings were compatible with perforated duodenal diverticulitis, and intra-abdominal drainage of retroperitoneal abscess with simultaneous feeding jejunostomy was undertaken. The patient was doing well at the 4-month postoperative follow-up visit. We suggest the use of a conservative operative method, as opposed to conventional diverticulectomy and duodenorrhaphy, as an alternative approach for the management of this disorder, especially when conservative treatment has failed.

Timing of prophylactic surgery in prevention of diverticulitis recurrence: a cost-effectiveness analysis.

Science.gov (United States)

Richards, Robert J; Hammitt, James K

2002-09-01

Although surgery is recommended after two or more attacks of uncomplicated diverticulitis, the optimal timing for surgery in terms of cost-effectiveness is unknown. A Markov model was used to compare the costs and outcomes of performing surgery after one, two, or three uncomplicated attacks in 60-year-old hypothetical cohorts. Transition state probabilities were assigned values using published data and expert opinion. Costs were estimated from Medicare reimbursement rates. Surgery after the third attack is cost saving, yielding more years of life and quality adjusted life years at a lower cost than the other two strategies. The results were not sensitive to many of the variables tested in the model or to changes made in the discount rate (0-5%). In conclusion, performing prophylactic resection after the third attack of diverticulitis is cost saving in comparison to resection performed after the first or second attacks and remains cost-effective during sensitivity analysis.

[Follow-up and dietary advice after sigmoid diverticulitis].

Science.gov (United States)

Barret, Maximilien; Abbes, Leila; Zinzindohoué, Franck

2013-06-01

Currently published data do not demonstrate the benefit of any medical treatment in the prevention of the onset or the recurrence of colonic diverticular disease. No specific diet can be recommended to patients with colonic diverticula for the prevention of diverticular disease. Non steroidal anti-inflammatory drugs as well as corticosteroids should be used cautiously in patients with diverticular disease since they induce a higher rate of complications, especially diverticular haemorrhage and severe sigmoid diverticulitis. In patients over 50 years old, or if a sigmoidectomy is needed, physicians should perform a colonoscopy in order to rule out colonic polyps or neoplasm.

Changes in outcome and management of perforated diverticulitis over a 10 year period.

LENUS (Irish Health Repository)

O'Leary, D P

2013-03-04

Aggressive non-operative intervention and evolving surgical strategies have altered the treatment of perforated diverticulitis in the acute setting. These strategies have predominantly been implemented over the last decade. The aim of this study was to assess the impact of this on patient outcome during their index admission and subsequently.

Mesalazine for the Treatment of Symptomatic Uncomplicated Diverticular Disease of the Colon and for Primary Prevention of Diverticulitis: A Systematic Review of Randomized Clinical Trials.

Science.gov (United States)

Picchio, Marcello; Elisei, Walter; Brandimarte, Giovanni; Di Mario, Francesco; Malfertheiner, Peter; Scarpignato, Carmelo; Tursi, Antonio

2016-10-01

Symptomatic uncomplicated diverticular disease (SUDD) is a common gastrointestinal disease, because it affects about one fourth of the patient harboring colonic diverticula. To assess the effectiveness of mesalazine in improving symptoms (namely abdominal pain) and in preventing diverticulitis occurrence in patients with SUDD. Only randomized clinical trials (irrespective of language, blinding, or publication status) that compared mesalazine with placebo or any other therapy in SUDD were evaluated. The selected endpoints were symptom relief and diverticulitis occurrence at maximal follow-up. Absolute risk reduction (ARR, with 95% confidence interval) and the number needed to treat were used as measures of the therapeutic effect. Six randomized clinical trials enrolled 1021 patients: 526 patients were treated with mesalazine and 495 with placebo or other therapies. Symptom relief with mesalazine was always larger than that with placebo and other therapies. However, absolute risk reduction was significant only when mesalazine was compared with placebo, a high-fiber diet, and low-dose rifaximin. The incidence of diverticulitis with mesalazine was lower than that observed with placebo and other treatments, being significant only when compared with placebo. Mesalazine is effective in achieving symptom relief and primary prevention of diverticulitis in patients with SUDD.

Health economic analysis of laparoscopic lavage versus Hartmann's procedure for diverticulitis in the randomized DILALA trial

DEFF Research Database (Denmark)

Gehrman, J.; Angenete, E; Björholt, I.

2016-01-01

Background: Open surgery with resection and colostomy (Hartmann's procedure) has been the standard treatment for perforated diverticulitis with purulent peritonitis. In recent years laparoscopic lavage has emerged as an alternative, with potential benefits for patients with purulent peritonitis...

The impact of surgeon volume on colostomy reversal outcomes after Hartmann's procedure for diverticulitis.

Science.gov (United States)

Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Hensley, Bradley J; Iannuzzi, James C; Noyes, Katia; Monson, John R T; Fleming, Fergal J

2016-11-01

Colostomy reversal after Hartmann's procedure for diverticulitis is a morbid procedure, and studies investigating factors associated with outcomes are lacking. This study identifies patient, surgeon, and hospital-level factors associated with perioperative outcomes after stoma reversal. The Statewide Planning and Research Cooperative System was queried for urgent/emergency Hartmann's procedures for diverticulitis between 2000-2012 in New York State and subsequent colostomy reversal within 1 year of the procedure. Surgeon and hospital volume were categorized into tertiles based on the annual number of colorectal resections performed each year. Bivariate and mixed-effects analyses were used to assess the association between patient, surgeon, and hospital-level factors and perioperative outcomes after colostomy reversal, including a laparoscopic approach; duration of stay; intensive care unit admission; complications; mortality; and 30-day, unscheduled readmission. Among 10,487 patients who underwent Hartmann's procedure and survived to discharge, 63% had the colostomy reversed within 1 year. After controlling for patient, surgeon, and hospital-level factors, high-volume surgeons (≥40 colorectal resections/yr) were independently associated with higher odds of a laparoscopic approach (unadjusted rates: 14% vs 7.6%; adjusted odds ratio = 1.84, 95% confidence interval = 1.12, 3.00), shorter duration of stay (median: 6 versus 7 days; adjusted incidence rate ratio = 0.87, 95% confidence interval = 0.81, 0.95), and lower odds of 90-day mortality (unadjusted rates: 0.4% vs 1.0%; adjusted odds ratio = 0.30, 95% confidence interval = 0.10, 0.88) compared with low-volume surgeons (1-15 colorectal resections/yr). High-volume surgeons are associated with better perioperative outcomes and lower health care utilization after Hartmann's reversal for diverticulitis. These findings support referral to high-volume surgeons for colostomy reversal. Copyright © 2016

Randomized controlled trial of oral vs intravenous therapy for the clinically diagnosed acute uncomplicated diverticulitis.

LENUS (Irish Health Repository)

Ridgway, P F

2009-11-01

Despite the high prevalence of hospitalization for left iliac fossa tenderness, there is a striking lack of randomized data available to guide therapy. The authors hypothesize that an oral antibiotic and fluids are not inferior to intravenous (IV) antibiotics and \\'bowel rest\\' in clinically diagnosed acute uncomplicated diverticulitis.

Surgery for diverticulitis in renal failure.

Science.gov (United States)

Starnes, H F; Lazarus, J M; Vineyard, G

1985-11-01

Twenty-five patients were operated on at the Brigham and Women's Hospital for colonic diverticulitis complicating treated renal failure during the period 1951 to 1983. Twelve patients had functioning renal allografts (eight cadaver, four living-related); 13 were on dialysis therapy. Six patients had polycystic kidney disease. The majority of patients had acute abdominal pain. Four had histories of chronic abdominal pain; nondiagnostic exploratory laparotomies were performed on two of these patients, who developed localized tenderness. The overall mortality in this series was 28 percent, with sepsis being the most common cause of death. Six of seven patients who died had free colonic perforations at surgery. Mortality correlated with age, with six of 14 patients (43 percent) over age 50 dying, as compared with one of 11 patients (9 percent) under age 50. There was no correlation between survival rate and type of surgery performed, dose of prednisone or azathioprine used, or type of treatment received for renal failure.

Surgical management of colonic diverticular disease: discrepancy between right- and left-sided diseases.

Science.gov (United States)

Oh, Heung-Kwon; Han, Eon Chul; Ha, Heon-Kyun; Choe, Eun Kyung; Moon, Sang Hui; Ryoo, Seung-Bum; Jeong, Seung-Yong; Park, Kyu Joo

2014-08-07

To compare the outcome of the surgical management of left-sided and right-sided diverticular disease. The medical records of 77 patients who were surgically treated for diverticular disease between 1999 and 2010 in a tertiary referral hospital were retrospectively reviewed. The study population was limited to cases wherein the surgical specimen was confirmed as diverticulosis by pathology. Right-sided diverticula were classified as those arising from the cecum, ascending colon, and transverse colon, and those from the descending colon, sigmoid colon, and rectum were classified as left-sided diverticulosis. To assess the changing trend of occurrence of diverticulosis, data were compared with two previous studies of 51 patients. The proportion of left-sided disease cases was significantly increased compared to the results of our previous studies in 1994 and 2001, (27.5% vs 48.1%, P disease. However, patients with right-sided disease were significantly younger (50.9 year vs 64.0 year, P disease was significantly associated with a higher incidence of complicated diverticulitis (89.2% vs 57.5%, P diverticular disease, the incidence of left-sided disease in Korea has increased since 2001 and is associated with worse surgical outcomes.

An unusual presentation of Fournier's gangrene.

LENUS (Irish Health Repository)

Kearney, D E

2011-06-01

INTRODUCTION: Fournier\\'s gangrene is a rare severe necrotising fasciitis of the genitalia. CASE: A case of Fournier\\'s gangrene caused by perforated sigmoid diverticulitis in a patient with systemic lupus erythematosus is presented along with a review of the relevant literature.

Evidence for Dietary Fibre Modification in the Recovery and Prevention of Reoccurrence of Acute, Uncomplicated Diverticulitis: A Systematic Literature Review

Science.gov (United States)

Dahl, Camilla; Crichton, Megan; Jenkins, Julie; Nucera, Romina; Mahoney, Sophie; Marx, Wolfgang

2018-01-01

In practice, nutrition recommendations vary widely for inpatient and discharge management of acute, uncomplicated diverticulitis. This systematic review aims to review the evidence and develop recommendations for dietary fibre modifications, either alone or alongside probiotics or antibiotics, versus any comparator in adults in any setting with or recently recovered from acute, uncomplicated diverticulitis. Intervention and observational studies in any language were located using four databases until March 2017. The Cochrane Risk of Bias tool and GRADE were used to evaluate the overall quality of the evidence and to develop recommendations. Eight studies were included. There was “very low” quality evidence for comparing a liberalised and restricted fibre diet for inpatient management to improve hospital length of stay, recovery, gastrointestinal symptoms and reoccurrence. There was “very low” quality of evidence for using a high dietary fibre diet as opposed to a standard or low dietary fibre diet following resolution of an acute episode, to improve reoccurrence and gastrointestinal symptoms. The results of this systematic review and GRADE assessment conditionally recommend the use of liberalised diets as opposed to dietary restrictions for adults with acute, uncomplicated diverticulitis. It also strongly recommends a high dietary fibre diet aligning with dietary guidelines, with or without dietary fibre supplementation, after the acute episode has resolved. PMID:29382074

[Laparoscopic "fast-track" sigmoidectomy for diverticulitis disease in Germany. Results of a prospective quality assurance program].

Science.gov (United States)

Tsilimparis, N; Haase, O; Wendling, P; Kipfmüller, K; Schmid, M; Engemann, R; Schwenk, W

2010-09-01

The natural course of sigmoid colon diverticulitis during conservative therapy and the assessment of the perioperative morbidity after sigmoid colon resection are differently evaluated by surgeons and gastroenterologists. The "fast-track" rehabilitation accelerates the reconvalescence and reduces the rate of postoperative general complications after colorectal surgery. The results of the laparoscopic "Fast-track" sigmoidectomy should be examined within a quality assurance program to better evaluate the perioperative risks following surgical management of diverticulitis. A prospective data collection within the voluntary quality assurance program "fast-track" Kolon II was performed. All participating clinics agreed on a multimodal, evidence-based standard perioperative treatment in terms of a "fast-track" rehabilitation for elective operations for sigmoid diverticulitis. Data from 846 patients undergoing laparoscopic "fast-track" sigmoid colon resection in 23 surgical departments in Germany were collected and evaluated. The mean age of the patients was 63 years (range 23 - 91). 203 patients (24 %) had severe co-morbidities (ASA classification III - IV). A conversion to conventional open surgery was necessary in 51 cases (6 %). Complications occurred in 93 patients (11 %). 76 patients suffered a surgical complication (8.9 %) and 32 patients (3.8 %) a general complication. Two patients died postoperatively due to multi-organ failure following anastomotic leaks. The patients took solid food in median on day 1 after surgery (range, 0 - 5) and passed stool on day 2 (range, 0 - 22). Predefined discharge criteria (free of pain on oral medication, normal oral feeding, stool) were met on day 4 (range, 1 - 58) and the patients were discharged on day 7 (range, 3 - 72). The 30-day re-admission rate was 3.9 %. Patients undergoing laparoscopic "fast-track" sigmoidectomy had a low rate of general complications and had a rapid reconvalescence with a short postoperative in

Damage control strategy for the treatment of perforated diverticulitis with generalized peritonitis.

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Sohn, M; Agha, A; Heitland, W; Gundling, F; Steiner, P; Iesalnieks, I

2016-08-01

The best surgical strategy for the management of perforated diverticulitis with generalized peritonitis of the sigmoid colon is not clearly defined. The aim of this retrospective cohort study was to evaluate the value of a damage control strategy. All patients who underwent emergency laparotomy for perforated diverticular disease of the sigmoid colon with generalized peritonitis between 2010 and 2015 were included. The damage control strategy (study group), included a two- stage procedure: limited resection of the diseased colonic segment, closure of proximal colon and distal stump, and application of an abdominal vacuum at the initial surgery followed by second-look laparotomy 24-48 h later At this point a choice was made between anastomosis and Hartmann's procedure. The control group consisted of patients receiving definitive reconstruction (anastomosis or Hartmann's procedure) at the initial operation. Thirty-seven patients were included in the study. Damage control strategy was applied in 19 patients and the control group consisted of 18 patients. Both groups were comparable in terms of demographics, severity of peritonitis, and comorbidities. The overall postoperative mortality was 11 % (n = 4). There were no statistically significant differences between both groups regarding postoperative morbidity and mortality; however, a significantly higher proportion of patients in the control group had a stoma after the initial hospital stay (83 vs. 47 %, p = 0.038). This difference was still significant after adjustment for sex, age, Mannheim Peritonitis Index, American Society of Anesthesiologists class and presence of septic shock at presentation. At the end of the follow-up period, 15 of 17 survivors in the study group and 13 of 16 survivors in the control group had their intestinal continuity restored (p = 0.66). Damage control strategy in patients with generalized peritonitis due to perforated diverticulitis leads to a significantly reduced stoma rate

Missed opportunities for primary repair in complicated acute diverticulitis.

Science.gov (United States)

Tabbara, Malek; Velmahos, George C; Butt, Muhammad U; Chang, Yuchiao; Spaniolas, Konstantinos; Demoya, Marc; King, David R; Alam, Hasan B

2010-11-01

Complicated acute diverticulitis (CAD) requiring an urgent operation is usually managed by fecal diversion (FD) despite reports suggesting that primary repair (PR) is safe. We aim to identify patient characteristics predicting successful PR and explore if patients are managed by FD despite the presence of such characteristics. We reviewed the medical records of 194 patients with CAD, requiring colectomy within 48 hr of admission from January 1996 to January 2006. Exclusion criteria included: admission for elective repair, treatment with antibiotics and/or percutaneous abscess drainage prior to operation (semi-elective), concurrent inflammatory disease, cancer, and inadequate documentation. Univariate and multivariate analysis identified independent predictors of PR. Patients who despite having these independent predictors underwent FD, were compared with the PR group. Eighteen patients (9%) received PR. They were younger than FD patients, had a lower incidence of left-sided disease, were less frequently operated on within 4 hr of hospital arrival, and had less severe disease (Hinchey I or II). They also had shorter postoperative hospital stays (6.2 ± 2.3 vs 14.6 ±16.1; P = .002) and a trend towards a lower mortality (0% vs 6.8%; P = .38). The independent predictors of performing PR included: age less than 55 years, interval between admission and operation longer than 4 hr, and a Hinchey score I or II. There were 71 patients who had 2 (64) or all 3 (7) independent predictors of PR but still received FD. These patients were not different in any characteristic from the PR patients but had worse outcomes. FD remains the prevailing operative method of choice of CAD. Despite the presence of factors favoring PR, many patients still receive FD and have worse outcomes. PR can be used more liberally in CAD. Copyright © 2010 Mosby, Inc. All rights reserved.

Safety of Nonoperative Management After Acute Diverticulitis

Science.gov (United States)

Amoza Pais, Sonia; Batlle Marin, Xavi; Oronoz Martinez, Begoña; Balen Ribera, Enrique; Yarnoz Irazabal, Concepción

2014-01-01

Purpose The role of surgery in the management of diverticular disease after an episode of acute diverticulitis (AD) managed in a conservative form is evolving. Age, number of episodes of AD, type of episode, and symptoms after the episodes are factors related to the need for elective surgery. The aim of this study is to evaluate the safety of conservative management and the risk factors for emergency surgery after a first episode of AD managed without surgery. Methods We retrospectively evaluated 405 patients diagnosed as having had a first episode of AD. Sixty-nine patients underwent emergency surgery on the first admission, and 69 patients had an elective operation in the follow-up (group A). The remaining 267 patients were managed initially without surgery (group B). Thirteen of these 267 patients needed a further urgent surgical procedure. Factors involved in the decision of elective surgery and the probability of emergency surgery after the first episode of AD managed without surgery were evaluated in relation to demographic factors, risk factors, presence of recurrences, and type of the first episode. Results Patients, mean age was 62.7 years, 71 were aged less than 51, and 151 were males. The mean follow-up for patients with nonoperative management was 91.2 months. An elective operation was performed in 69 patients. Compared to patients in group B, those in group A more frequently had a first episode of complicated acute diverticulitis (CAD) (37.1% vs. 16.4%; P = 0.000) and were more likely to be smokers (46.3% vs. 19.3%; P = 0.000) and to suffer more than one episode of AD (42% vs. 26.9%; P = 0.027). Nonoperative management was chosen for 267 patients, but 13 patients needed an emergency operation later. In the multivariate analysis, we found a significant relation between the presence of CAD in the first episode and the need for emergency surgery. There were no differences in surgical mortality between the patients in the two groups, but patients treated

Midgut malrotation presenting with left-sided acute appendicitis and CT inversion sign

Science.gov (United States)

Çağlar, Emrah; Arıbaş, Bilgin; Tiken, Ramazan; Keskin, Suat

2014-01-01

In patients presenting with abdominal pain, appendicitis is the most common surgical disorder. Appendicitis causing pain in the left lower quadrant is extremely rare and can occur with congenital abnormalities that include true left-sided appendix or as an atypical presentation of right-sided long appendix, which projects into the left lower quadrant. We report a case of a 69-year-old man showing midgut malrotation with acute appendicitis presenting as left lower quadrant abdominal pain. PMID:24682135

Tratamiento quirúrgico de la diverticulitis aguda en la Comunidad Valenciana. Estudio multicéntrico.

OpenAIRE

Salvador Martínez, Antonio

2015-01-01

Diverticulitis aguda. Estado actual y controversias Este término representa un espectro de los cambios inflamatorios que van desde una inflamación local subclínica hasta la peritonitis generalizada con perforación libre. Su mecanismo de aparición gira alrededor de una perforación de un divertículo. El antiguo concepto de obstrucción luminal probablemente represente un hecho raro. El aumento de la presión intraluminal o las partículas espesadas de alimentos pueden erosionar la pared d...

Reversal of Hartmann's procedure following acute diverticulitis: is timing everything?

LENUS (Irish Health Repository)

Fleming, Fergal J

2012-02-01

BACKGROUND: Patients who undergo a Hartmann\\'s procedure may not be offered a reversal due to concerns over the morbidity of the second procedure. The aims of this study were to examine the morbidity post reversal of Hartmann\\'s procedure. METHODS: Patients who underwent a Hartmann\\'s procedure for acute diverticulitis (Hinchey 3 or 4) between 1995 and 2006 were studied. Clinical factors including patient comorbidities were analysed to elucidate what preoperative factors were associated with complications following reversal of Hartmann\\'s procedure. RESULTS: One hundred and ten patients were included. Median age was 70 years and 56% of the cohort were male (n = 61). The mortality and morbidity rate for the acute presentation was 7.3% (n = 8) and 34% (n = 37) respectively. Seventy six patients (69%) underwent a reversal at a median of 7 months (range 3-22 months) post-Hartmann\\'s procedure. The complication rate in the reversal group was 25% (n = 18). A history of current smoking (p = 0.004), increasing time to reversal (p = 0.04) and low preoperative albumin (p = 0.003) were all associated with complications following reversal. CONCLUSIONS: Reversal of Hartmann\\'s procedure can be offered to appropriately selected patients though with a significant (25%) morbidity rate. The identification of potential modifiable factors such as current smoking, prolonged time to reversal and low preoperative albumin may allow optimisation of such patients preoperatively.

Management of Complications Following Emergency and Elective Surgery for Diverticulitis.

Science.gov (United States)

Holmer, Christoph; Kreis, Martin E

2015-04-01

The clinical spectrum of sigmoid diverticulitis (SD) varies from asymptomatic diverticulosis to symptomatic disease with potentially fatal complications. Sigmoid colectomy with restoration of continuity has been the prevailing modality for treating acute and recurrent SD, and is often performed as a laparoscopy-assisted procedure. For elective sigmoid colectomy, the postoperative morbidity rate is 15-20% whereas morbidity rates reach up to 30% in patients who undergo emergency surgery for perforated SD. Some of the more common and serious surgical complications after sigmoid colectomy are anastomotic leaks and peritonitis, wound infections, small bowel obstruction, postoperative bleeding, and injuries to the urinary tract structures. Regarding the management of complications, it makes no difference whether the complication is a result of an emergency or an elective procedure. The present work gives an overview of the management of complications in the surgical treatment of SD based on the current literature. To achieve successful management, early diagnosis is mandatory in cases of deviation from the normal postoperative course. If diagnostic procedures fail to deliver a correlate for the clinical situation of the patient, re-laparotomy or re-laparoscopy still remain among the most important diagnostic and/or therapeutic principles in visceral surgery when a patient's clinical status deteriorates. The ability to recognize and successfully manage complications is a crucial part of the surgical treatment of diverticular disease and should be mastered by any surgeon qualified in this field.

Pushing the envelope: laparoscopy and primary anastomosis are technically feasible in stable patients with Hinchey IV perforated acute diverticulitis and gross faeculent peritonitis.

Science.gov (United States)

Di Saverio, Salomone; Vennix, Sandra; Birindelli, Arianna; Weber, Dieter; Lombardi, Raffaele; Mandrioli, Matteo; Tarasconi, Antonio; Bemelman, Willem A

2016-12-01

Modern management of severe acute complicated diverticulitis continues to evolve towards more conservative and minimally invasive strategies. Although open sigmoid colectomy with end colostomy remains the most commonly used procedure for the treatment of perforated diverticulitis with purulent/faeculent peritonitis, recent major advances challenged this traditional approach, including the increasing attitude towards primary anastomosis as an alternative to end colostomy and use of laparoscopic approach for urgent colectomy. Provided an accurate patients selection, having the necessary haemodynamic stability, pneumoperitoneum is established with open Hasson technique and diagnostic laparoscopy is performed. If faeculent peritonitis (Hinchey IV perforated diverticulitis) is found, laparoscopy can be continued and a further three working ports are placed using bladeless trocars, as in traditional laparoscopic sigmoidectomy, with the addition of fourth trocar in left flank. The feacal matter is aspirated either with large-size suction devices or, in case of free solid stools, these can be removed with novel application of tight sealing endobags, which can be used for scooping the feacal content out and for its protected retrieval. After decontamination, a sigmoid colectomy is performed in the traditional laparoscopic fashion. The sigmoid is fully mobilised from the retroperitoneum, and mesocolon is divided up to the origin of left colic vessels. Whenever mesentery has extremely inflamed and thickened oedematous tissues, an endostapler with vascular load can be used to avoid vascular selective ligatures. Splenic flexure should be appropriately mobilised. The specimen is extracted through mini-Pfannenstiel incision with muscle splitting technique. Transanal colo-rectal anastomosis is fashioned. Air-leak test must be performed and drains placed where appropriate. The video shows operative technique for a single-stage, entirely laparoscopic, washout and sigmoid colectomy

The Ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitis and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitis in perforated diverticulitis (NTR2037)

NARCIS (Netherlands)

Swank, Hilko A.; Vermeulen, Jefrey; Lange, Johan F.; Mulder, Irene M.; van der Hoeven, Joost A. B.; Stassen, Laurents P. S.; Crolla, Rogier M. P. H.; Sosef, Meindert N.; Nienhuijs, Simon W.; Bosker, Robbert J. I.; Boom, Maarten J.; Kruyt, Philip M.; Swank, Dingeman J.; Steup, Willem H.; de Graaf, Eelco Jr; Weidema, Wibo F.; Pierik, Robert E. G. J. M.; Prins, Hubert A.; Stockmann, Henricus B. A. C.; Tollenaar, Rob A. E. M.; van Wagensveld, Bart A.; Coene, Peter-Paul L. O.; Slooter, Gerrit D.; Consten, Esther C. J.; van Duyn, Eino B.; Gerhards, Michael F.; Hoofwijk, Anton G. M.; Karsten, Thomas M.; Neijenhuis, Peter A.; Blanken-Peeters, Charlotte F. J. M.; Cense, Huib A.; Mannaerts, Guido H. H.; Bruin, Sjoerd C.; Eijsbouts, Quirijn A. J.; Wiezer, Marinus J.; Hazebroek, Eric J.; van Geloven, Anna A. W.; Maring, John K.; D'Hoore, Andre; Kartheuser, Alex; Remue, Christophe; van Grevenstein, Wilhelmina M. U.; Konsten, Joop L. M.; van der Peet, Donald L.; Govaert, Marc J. P. M.; Engel, Alexander F.; Reitsma, Johannes B.; Bemelman, Willem A.; 3d, The Dutch Diverticular Disease Collaborative Study Group

2010-01-01

ABSTRACT: BACKGROUND: Recently, excellent results are reported on laparoscopic lavage in patients with purulent perforated diverticulitis as an alternative for sigmoidectomy and ostomy. The objective of this study is to determine whether LaparOscopic LAvage and drainage is a safe and effective

Morphologic Basis for Developing Diverticular Disease, Diverticulitis, and Diverticular Bleeding.

Science.gov (United States)

Wedel, Thilo; Barrenschee, Martina; Lange, Christina; Cossais, François; Böttner, Martina

2015-04-01

Diverticula of the colon are pseudodiverticula defined by multiple outpouchings of the mucosal and submucosal layers penetrating through weak spots of the muscle coat along intramural blood vessels. A complete prolapse consists of a diverticular opening, a narrowed neck, and a thinned diverticular dome underneath the serosal covering. The susceptibility of diverticula to inflammation is explained by local ischemia, translocation of pathogens due to retained stool, stercoral trauma by fecaliths, and microperforations. Local inflammation may lead to phlegmonous diverticulitis, paracolic/mesocolic abscess, bowel perforation, peritonitis, fistula formation, and stenotic strictures. Diverticular bleeding is due to an asymmetric rupture of distended vasa recta at the diverticular dome and not primarily linked to inflammation. Structural and functional changes of the bowel wall in diverticular disease comprise: i) Altered amount, composition, and metabolism of connective tissue; ii) Enteric myopathy with muscular thickening, deranged architecture, and altered myofilament composition; iii) Enteric neuropathy with hypoganglionosis, neurotransmitter imbalance, deficiency of neurotrophic factors and nerve fiber remodeling; and iv) Disturbed intestinal motility both in vivo (increased intraluminal pressure, motility index, high-amplitude propagated contractions) and in vitro (altered spontaneous and pharmacologically triggered contractility). Besides established etiologic factors, recent studies suggest that novel pathophysiologic concepts should be considered in the pathogenesis of diverticular disease.

The ladies trial: Laparoscopic peritoneal lavage or resection for purulent peritonitisA and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitisB in perforated diverticulitis (NTR2037)

NARCIS (Netherlands)

D.J. Swank (Dingeman); J. Vermeulen (Jefrey); J.F. Lange (Johan); I.M. Mulder (Irene); J.A.B. van der Hoeven (Joost); L.P. Stassen (Laurents); R.M.P.H. Crolla (Rogier); M.N. Sosef (Meindert); S.W. Nienhuijs (Simon); R.J.I. Bosker (Robbert); M.J. Boom (Maarten); Ph.M. Kruyt (Philip); W.H. Steup (Willem Hans); E.J.R. de Graaf (Eelco); W.F. Weidema (Wibo); R.E.G.J.M. Pierik (Robert); H.A. Prins (Hubert); H.B.A.C. Stockmann; R.A.E.M. Tollenaar (Rob); B.A. van Wagensveld (Bart); P-P. Coene (Peter Paul); G.D. Slooter (Gerrit); E.C. Consten (Esther); E.B. van Duijn (Eino); M.F. Gerhards (Michael); A.G.M. Hoofwijk; T.M. Karsten (Thomas); P.A. Neijenhuis (Peter); C.F.J.M. Blanken-Peeters (Charlotte); H.A. Cense (Huib); G.H.H. Mannaerts (Guido); S.C. Bruin (Sjoerd); Q.A. Eijsbouts (Quirijn); M.J. Wiezer (Marinus); E.J. Hazebroek (Eric Jasper); A.A. van Geloven (Anna); J.K. Maring (John); A. D'Hoore (André); A. Kartheuser (Alex); C. Remue (Christophe); H.M.U. van Grevenstein (Helma); J.L.M. Konsten (Joop); D.L. van der Peet (Donald); M.J.P.M. Govaert (Marc); A.F. Engel (Alexander); J.B. Reitsma (Johannes); W.A. Bemelman (Willem)

2010-01-01

textabstractBackground: Recently, excellent results are reported on laparoscopic lavage in patients with purulent perforated diverticulitis as an alternative for sigmoidectomy and ostomy. The objective of this study is to determine whether LaparOscopic LAvage and drainage is a safe and effective

Exploring consumer opinions on the presentation of side-effects information in Australian Consumer Medicine Information leaflets.

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Tong, Vivien; Raynor, David K; Blalock, Susan J; Aslani, Parisa

2016-06-01

Consumer Medicine Information (CMI) is a brand-specific and standardized source of written medicine information available in Australia for all prescription medicines. Side-effect information is poorly presented in CMI and may not adequately address consumer information needs. To explore consumer opinions on (i) the presentation of side-effect information in existing Australian CMI leaflets and alternative study-designed CMIs and (ii) side-effect risk information and its impact on treatment decision making. Fuzzy trace, affect heuristic, frequency hypothesis and cognitive-experiential theories were applied when revising existing CMI side-effects sections. Together with good information design, functional linguistics and medicine information expertise, alternative ramipril and clopidogrel CMI versions were proposed. Focus groups were then conducted to address the study objectives. Three focus groups (n = 18) were conducted in Sydney, Australia. Mean consumer age was 58 years (range 50-65 years), with equal number of males and females. All consumers preferred the alternative CMIs developed as part of the study, with unequivocal preference for the side-effects presented in a simple tabular format, as it allowed quick and easy access to information. Consumer misunderstandings reflected literacy and numeracy issues inherent in consumer risk appraisal. Many preferred no numerical information and a large proportion preferred natural frequencies. One single method of risk presentation in CMI is unable to cater for all consumers. Consumer misunderstandings are indicative of possible health literacy and numeracy factors that influence consumer risk appraisal, which should be explored further. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Impact of Operative Delay on Sepsis and Mortality in Patients with Acute Diverticulitis

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Robin F. Irons

2017-03-01

Full Text Available Background Ideal operative timing for non-emergent, acute diverticulitis (AD remains unclear. Medical management is initially attempted to convert a high risk urgent surgery to a less morbid elective surgery, or to avoid surgery altogether. A large proportion of patients will fail medical treatment and require colectomy. Objectives To evaluate the effect of operative delay on sepsis and mortality in patients with AD. Methods Patients from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP database who underwent colectomy with a primary diagnosis of diverticulitis between 2005 and 2014 were included. Multiple patient variables were analyzed to see their combined effect on death and sepsis. Patients undergoing surgical intervention on hospital day 0, emergent cases and those with preoperative sepsis were excluded. The impact of operative delay on mortality and sepsis was evaluated using day from admission as the predictor of the primary outcomes. Secondary outcomes included urinary tract infection (UTI, pneumonia (PNA, need for blood transfusion, septic shock, return to the operating room, length of stay (LOS, readmission, wound dehiscence, and surgical site infections (SSI. Frequency of patient variables was recorded and a multiple variable logistic regression analysis was performed to control for possible confounders. Odds ratios (OR with 95% confidence intervals (CI were calculated for primary and secondary outcomes. Results 32,399 patients underwent colectomy for AD on hospital day 1 - 20. Adjusted for other factors, days to operation was found to be a significant predictor for death (OR = 1.038, 95% CI 1.020 - 1.057; P < 0.0001 and sepsis (OR = 1.051, 95% CI, 1.035 - 1.067; P < 0.0001. Each day in which surgical intervention was delayed was associated with a 3.8% increased risk of mortality and 5.1% increased risk of sepsis. Delay of surgery was also associated with an increased risk of blood transfusion

Support Vector Machine Diagnosis of Acute Abdominal Pain

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Björnsdotter, Malin; Nalin, Kajsa; Hansson, Lars-Erik; Malmgren, Helge

This study explores the feasibility of a decision-support system for patients seeking care for acute abdominal pain, and, specifically the diagnosis of acute diverticulitis. We used a linear support vector machine (SVM) to separate diverticulitis from all other reported cases of abdominal pain and from the important differential diagnosis non-specific abdominal pain (NSAP). On a database containing 3337 patients, the SVM obtained results comparable to those of the doctors in separating diverticulitis or NSAP from the remaining diseases. The distinction between diverticulitis and NSAP was, however, substantially improved by the SVM. For this patient group, the doctors achieved a sensitivity of 0.714 and a specificity of 0.963. When adjusted to the physicians' results, the SVM sensitivity/specificity was higher at 0.714/0.985 and 0.786/0.963 respectively. Age was found as the most important discriminative variable, closely followed by C-reactive protein level and lower left side pain.

Primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a prematurely terminated randomized controlled trial.

Science.gov (United States)

Binda, G A; Karas, J R; Serventi, A; Sokmen, S; Amato, A; Hydo, L; Bergamaschi, R

2012-11-01

This randomized controlled trial (RCT) was performed to test the hypothesis that adverse event rates following primary anastomosis (PRA) are not inferior to those following nonrestorative colon resection for perforated diverticulitis with peritonitis. Patients admitted for perforated diverticulitis with peritonitis were randomly assigned to PRA (left colon resection with PRA and loop ileostomy) or nonrestorative colon resection (left colon resection with end colostomy). The endpoint was adverse events defined as mortality and morbidity following PRA or nonrestorative colon resection and stoma reversal. The estimated sample size was 300 patients in each study arm (alpha 0.10; 90% power). During a 9-year period, 90 patients were randomly assigned to undergo PRA or nonrestorative colon resection in 14 centres in eight countries. Thirty-four PRA patients were comparable to 56 nonrestorative colon resection patients for age (P = 0.481), gender (P = 0.190), APACHE III (P = 0.281), Hinchey stage III vs IV (P = 0.394) and Mannheim Peritonitis Index (P = 0.145). There were no differences in operating time (P = 0.231), surgeries performed at night (P = 0.083), open vs laparoscopic approach (P = 0.419) and litres of peritoneal irrigation (P = 0.096). There was no significant difference in mortality (2.9 vs 10.7%; P = 0.247) and morbidity (35.3 vs 46.4%; P = 0.38) following PRA or nonrestorative colon resection. After a similar lag time (P = 0.43), 64.7% of PRA patients and 60% of nonrestorative colon resection patients underwent stoma reversal (P = 0.659). Adverse event rates following stoma reversal differed significantly after PRA and reversal of nonrestorative resection (4.5 vs 23.5%; P = 0.0589). No conclusions may be drawn on preference of one treatment over another from this RCT because it was prematurely terminated following accrual of 15% of its sample size. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

Sigmoid resection with primary anastomosis and ileostomy versus laparoscopic lavage in purulent peritonitis from perforated diverticulitis: outcome analysis in a prospective cohort of 40 consecutive patients.

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Catry, Jonathan; Brouquet, Antoine; Peschaud, Frédérique; Vychnevskaia, Karina; Abdalla, Solafah; Malafosse, Robert; Lambert, Benoit; Costaglioli, Bruno; Benoist, Stéphane; Penna, Christophe

2016-10-01

This prospective study aimed to compare outcomes after laparoscopic peritoneal lavage (LPL) and sigmoid resection with primary colorectal anastomosis (RPA). From June 2010 to June 2015, 40 patients presenting with Hinchey III peritonitis from perforated diverticulitis underwent LPL or RPA. Patients with Hinchey II or IV peritonitis and patients who underwent an upfront Hartmann procedure were excluded. Primary endpoint was overall 30-day or in-hospital postoperative morbidity after surgical treatment of peritonitis. Twenty-five patients underwent RPA and 15 LPL. Overall postoperative morbidity and mortality rates were not significantly different after RPA and LPL (40 vs 67 %, p = 0.19; 4 vs 6.7 %, p = 1, respectively). Intra-abdominal morbidity and reoperation rates were significantly higher after LPL compared to RPA (53 vs 12 %, p < 0.01; 40 vs 4 %, p = 0.02, respectively). Multivariate analysis showed that LPL (p = 0.028, HR = 18.936, CI 95 % = 1.369-261.886) was associated with an increased risk of postoperative intra-abdominal septic morbidity. Among 6 patients who underwent reoperation after LPL, 4 had a Hartmann procedure. All surviving patients who had a procedure requiring stoma creation underwent stoma reversal after a median delay of 92 days after LPL and 72 days after RPA (p = 0.07). LPL for perforated diverticulitis is associated with a high risk of inadequate intra-abdominal sepsis control requiring a Hartmann procedure in up to 25 % of patients. RPA appears to be safer and more effective. It may represent the best option in this context.

Hartmann's Procedure or Primary Anastomosis for Generalized Peritonitis due to Perforated Diverticulitis: A Prospective Multicenter Randomized Trial (DIVERTI).

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Bridoux, Valerie; Regimbeau, Jean Marc; Ouaissi, Mehdi; Mathonnet, Muriel; Mauvais, Francois; Houivet, Estelle; Schwarz, Lilian; Mege, Diane; Sielezneff, Igor; Sabbagh, Charles; Tuech, Jean-Jacques

2017-12-01

About 25% of patients with acute diverticulitis require emergency intervention. Currently, most patients with diverticular peritonitis undergo a Hartmann's procedure. Our objective was to assess whether primary anastomosis (PA) with a diverting stoma results in lower mortality rates than Hartmann's procedure (HP) in patients with diverticular peritonitis. We conducted a multicenter randomized controlled trial conducted between June 2008 and May 2012: the DIVERTI (Primary vs Secondary Anastomosis for Hinchey Stage III-IV Diverticulitis) trial. Follow-up duration was up to 18 months. A random sample of 102 eligible participants with purulent or fecal diverticular peritonitis from tertiary care referral centers and associated centers in France were equally randomized to either a PA arm or to an HP arm. Data were analyzed on an intention-to-treat basis. The primary end point was mortality rate at 18 months. Secondary outcomes were postoperative complications, operative time, length of hospital stay, rate of definitive stoma, and morbidity. All 102 patients enrolled were comparable for age (p = 0.4453), sex (p = 0.2347), Hinchey stage III vs IV (p = 0.2347), and Mannheim Peritonitis Index (p = 0.0606). Overall mortality did not differ significantly between HP (7.7%) and PA (4%) (p = 0.4233). Morbidity for both resection and stoma reversal operations were comparable (39% in the HP arm vs 44% in the PA arm; p = 0.4233). At 18 months, 96% of PA patients and 65% of HP patients had a stoma reversal (p = 0.0001). Although mortality was similar in both arms, the rate of stoma reversal was significantly higher in the PA arm. This trial provides additional evidence in favor of PA with diverting ileostomy over HP in patients with diverticular peritonitis. ClinicalTrials.gov Identifier: NCT 00692393. Copyright © 2017. Published by Elsevier Inc.

Long-term quality of life after conservative treatment versus surgery for different stages of acute sigmoid diverticulitis.

Science.gov (United States)

Brandlhuber, Martina; Genzinger, Christian; Brandlhuber, Bernhard; Sommer, Wieland H; Müller, Mario H; Kreis, Martin E

2018-03-01

It is controversial whether patients fare better with conservative or surgical treatment in certain stages of acute diverticulitis (AD), in particular when phlegmonous inflammation or covered micro- or macro-perforation are present. The aim of this study was to determine long-term quality of life (QoL) for AD patients who received either surgery or conservative treatment in different stages. We included patients treated for AD at the University Hospital Grosshadern, Munich, Germany, between January 1, 2000, and December 31, 2010. Patients were classified by the Hansen and Stock (HS) classification, the modified Hinchey classification, and the German classification of diverticular disease (CDD). Pre-therapeutic staging was based on multidetector computed tomography. Long-term QoL was assessed by the Cleveland Global Quality of Life (CGQL) questionnaire, the Short Form 36 (SF-36), and the Gastrointestinal Quality of Life Index (GIQLI). Data are mean ± SEM. Patients with phlegmonous AD (HS type 2a, Hinchey Ia and CDD 1b, respectively) had a better long-term QoL on the GIQLI when they were operated (78.5 ± 2.5 vs. 70.7 ± 2.1; p life, patients fare better after elective sigmoid colectomy when abscess size exceeds 1 cm.

Atualização no tratamento da diverticulite aguda do cólon Recent evidences in the management of acute diverticulitis

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André Roncon Dias

2009-09-01

Full Text Available Nas últimas décadas a incidência da moléstia diverticular do cólon e de suas complicações tem aumentado. Durante esse período o número de publicações a respeito do tema se expandiu, bem como as opções terapêuticas. Apesar disso, muitas dúvidas persistem e as decisões terapêuticas continuam relativamente imutadas, baseadas muitas vezes em dados antigos e de baixo poder estatístico. Nesta revisão apresentamos as evidências científicas atuais acerca da terapêutica desta complexa patologia.During the past decades the incidence of diverticular disease of the colon and its complications has increased as well as the therapeutic options have expanded. However, there are still remaining doubts about the timing of surgery indication, the access (open vs laparoscopic and the best approach to complicated diverticulitis. The current decisions are mostly based in old data of poor statistic strength. This review shows the present-day evidence about the treatment of diverticular disease.

Secondary Pulmonary Hypertension and Right-Sided Heart Failure at Presentation in Grave's Disease

OpenAIRE

Ganeshpure, Swapnil Panjabrao; Vaidya, Gaurang Nandkishor; Gattani, Vipul

2012-01-01

A young female presented with evidence of right-sided heart failure and was subsequently found to have significant pulmonary artery hypertension (PAH). Because of her normal left ventricular function and pulmonary capillary wedge pressure, the most probable site of etiology seemed to be the pulmonary vasculature. All the common possible secondary causes of PAH were ruled out, but during the investigations, she was found to have elevated thyroid function tests compatible with the diagnosis of...

Dissecting aneurysm of arch and descending thoracic aorta presenting as a left sided hemorrhagic pleural effusion

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Shamim Shelley

2010-01-01

Full Text Available The most common cause of massive hemorrhagic effusion is malignancy. Herein we present a case of dissecting aneurysm of descending thoracic aorta presenting initially with shortness of breath due to left sided massive pleural effusion. Effusion was hemorrhagic in nature with high hematocrit value. CT scan of thorax with CT angiogram was done and that revealed the diagnosis.

Resection with primary anastomosis vs. nonrestorative resection for perforated diverticulitis with peritonitis: A systematic review and meta-analysis.

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Gachabayov, M; Oberkofler, C E; Tuech, J J; Hahnloser, D; Bergamaschi, R

2018-04-25

It is still controversial whether the optimal operation for perforated diverticulitis with peritonitis is primary anastomosis (PRA) or nonrestorative resection (NRR). The aim of this systematic review and meta-analysis was to evaluate mortality and morbidity rates following emergency resection for perforated diverticulitis with peritonitis and ostomy reversal, as well as ostomy non-reversal rates. The Pubmed, EMBASE, Cochrane Library, MEDLINE via Ovid, CINAHL, and Web of Science databases were systematically searched. Mortality was the primary endpoint. A subgroup meta-analysis of randomized controlled trials was performed in addition to a meta-analysis of all eligible studies. Odds ratios (OR) and mean difference (MD) were calculated for dichotomous and continuous outcomes, respectively. 17 studies, including 3 randomized controlled trials (RCT), involving 1016 patients (392 PRA vs. 624 NRR) were included. Overall, mortality was significantly lower in patients with PRA as compared to patients with NRR [OR(95%CI)=0.38(0.24, 0.60); p<0.0001]. Organ/space surgical site infection (SSI) [OR(95%CI)=0.25(0.10, 0.63); p=0.003], reoperation [OR(95%CI)=0.48(0.25, 0.91); p=0.02], and ostomy non-reversal rates [OR(95%CI)=0.27(0.09, 0.84); p=0.02] were significantly decreased in PRA. In RCTs, mortality rate did not differ [OR(95%CI)=0.46(0.15, 1.38); p=0.17]. The mean operating time for PRA was significantly longer [MD(95%CI)=19.96(7.40, 32.52); p=0.002]. Organ/space SSI [OR(95%CI)=0.28(0.09, 0.82); p=0.02] was lower after PRA. Ostomy non-reversal rates were lower after PRA. The difference was not statistically significant [OR(95%CI)=0.26(0.06, 1.11); p=0.07]. However, it was clinically significant [NNT(95%CI)=5(3.1, 8.9)]. This meta-analysis found that organ/space SSI rates as well as ostomy non-reversal rates were decreased in PRA at the cost of prolonged operating time. This article is protected by copyright. All rights reserved. This article is protected by copyright. All

Divertículo do apêndice vermiforme

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Fernando Costa Nunes

Full Text Available The authors present three cases report of appendicular diverticulum with associated diverticulitis, one of them asymptomatic. The clinical distinction between acute apendicitis and apendical diverticulitis is very difficult, the later usually with earlier suppuration. The are no consensus regarding preventive surgery for apendical diverticulitis. It is possible that incidence of apendicular diverticulum depends on careful anatomopathological exams.

Secondary Pulmonary Hypertension and Right-Sided Heart Failure at Presentation in Grave's Disease.

Science.gov (United States)

Ganeshpure, Swapnil Panjabrao; Vaidya, Gaurang Nandkishor; Gattani, Vipul

2012-01-01

A young female presented with evidence of right-sided heart failure and was subsequently found to have significant pulmonary artery hypertension (PAH). Because of her normal left ventricular function and pulmonary capillary wedge pressure, the most probable site of etiology seemed to be the pulmonary vasculature. All the common possible secondary causes of PAH were ruled out, but during the investigations, she was found to have elevated thyroid function tests compatible with the diagnosis of Grave's disease. The treatment of Grave's disease, initially by medications and subsequently by radioiodine therapy, was associated with a significant reduction in the pulmonary artery systolic pressure. The purpose of this case report is to highlight one of the unusual and underdiagnosed presentations of Grave's disease.

CT colonography versus colonoscopy in the follow-up of patients after diverticulitis - A prospective, comparative study

International Nuclear Information System (INIS)

Hjern, F.; Jonas, E.; Holmstroem, B.; Josephson, T.; Mellgren, A.; Johansson, C.

2007-01-01

Aim: To assess whether computed tomography colonography (CTC) is a viable alternative to colonoscopy or double contrast barium enema in the follow-up of patients after diverticulitis. Material and methods: Fifty patients underwent CTC followed immediately by colonoscopy. Results were blinded to the examiners. Findings of diverticular disease and patient acceptance were evaluated. Results: Bowel preparation and distension were good in the majority of CTC and colonoscopy examinations. Diverticular disease was found in 96% of patients at CTC and in 90% at colonoscopy. The rate of agreement between CTC and colonoscopy for diverticular findings in the sigmoid colon was good (κ = 0.64). No complications were seen. Patients found colonoscopy more uncomfortable (p < 0.03), more painful (p < 0.001), and more difficult (p < 0.01) than CTC. Of the patients favouring one examination, 74% preferred CTC. Conclusion: CTC appears to have a better diagnostic potential for imaging of diverticular disease-specific findings, when compared with colonoscopy. Also, CTC was less uncomfortable and was preferred by a majority of patients. CTC seems to be a reasonable alternative in follow-up of patients with symptomatic diverticular disease

Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: Meta-analysis of test accuracy

International Nuclear Information System (INIS)

Lameris, Wytze; Randen, Adrienne van; Bipat, Shandra; Stoker, Jaap; Bossuyt, Patrick M.M.; Boermeester, Marja A.

2008-01-01

The purpose was to investigate the diagnostic accuracy of graded compression ultrasonography (US) and computed tomography (CT) in diagnosing acute colonic diverticulitis (ACD) in suspected patients. We performed a systematic review and meta-analysis of the accuracy of CT and US in diagnosing ACD. Study quality was assessed with the QUADAS tool. Summary estimates of sensitivity and specificity were calculated using a bivariate random effects model. Six US studies evaluated 630 patients, and eight CT studies evaluated 684 patients. Overall, their quality was moderate. We did not identify meaningful sources of heterogeneity in the study results. Summary sensitivity estimates were 92% (95% CI: 80%-97%) for US versus 94% (95%CI: 87%-97%) for CT (p = 0.65). Summary specificity estimates were 90% (95%CI: 82%-95%) for US versus 99% (95%CI: 90%-100%) for CT (p = 0.07). For the identification of alternative diseases sensitivity ranged between 33% and 78% for US and between 50% and 100% for CT. The currently best available evidence shows no statistically significant difference in accuracy of US and CT in diagnosing ACD. Therefore, both US and CT can be used as initial diagnostic tool until new evidence is brought forward. However, CT is more likely to identify alternative diseases. (orig.)

A Study of Clinicopathological Differences Between Right-sided and Left-sided Colon Cancers

OpenAIRE

芳賀, 駿介; 遠藤, 俊吾; 加藤, 博之; 高橋, 直樹; 吉松, 和彦; 橋本, 雅彦; 石橋, 敬一郎; 梅原, 有弘; 横溝, 肇; 梶原, 哲郎; Shunsuke, HAGA; Shungo, ENDO; Hiroyuki, KATO; Naoki, TAKAHASHI; Kazuhiko, YOSHIMATSU

1996-01-01

The present study was aimed to determine the clinicopathological features of cancers of the right-sided colon (cecum, ascending colon, transverse colon) and left-sided colon (descending colon, sigmoid colon) in order to help improve the efficacy of their treatment. Excluding multiple cancer cases, 364 patients with primary colon cancer underwent surgey at our department between 1974 and 1994; they comprised 171 individuals with right-sided colon cancer and 193 with left-sided colon cancer. A ...

A case study presentation: The MAG3 captopril renal scan, which side are you on ?

International Nuclear Information System (INIS)

Richards, A.

1998-01-01

Full text: A 68-year-old woman with widespread vascular disease presented to the Nuclear Medicine Department with severe hypertension, (a blood pressure of 200/160 supine), a known small right kidney, and a large abdominal aortic aneurysm. A baseline renal scan was performed with IV administration of 300 MBq of 99m Tc-labelled MAG3. A normal left kidney was demonstrated, with a Grade 0 renogram pattern. The right kidney was non visualised and non functioning. The patient was then administered orally with 25 mg of A.C.E. inhibitor captopril and her blood pressure fell by greater than 100 mm Hg. A second MAG3 Renal Scan was performed. The finding conflicted with results of a Renal Artery Angiogram and Renal Artery Doppler Ultrasound, both demonstrating a normal left renal artery. A repeat MAG3 Renal scan with captopril challenge was performed. Differential diagnosis included: 1.Left sided microvascular disease; 2. A functioning though very ischaemic right kidney that was producing renin, suggested by contrast opacification of the right renal cortex on CT; or 3. A false negative renal artery angiogram, with non-visualisation of an arterial stenosis caused by thrombus or compression of the left renal artery by the abdominal aortic aneurysm. Subsequent Renal Vein Renin Sampling measured left renal vein renin activity at 4.50,μg/L/h, (compared with 4.80μg/L/h in the IVC). Right renal vein renin activity was 13.20μg/L/h. This lateralization of renin secretion to the right side with suppression of left sided secretion suggested that the renovascular hypertension was caused by the right kidney. This was a very unusual result, as the MAG3 captopril renal scan had incorrectly and strongly suggested a left sided origin to the renovascular hypertension. In addition, the right kidney not seen to accumulate MAG3 was in fact functioning sufficiently to produce renin. It is hypothesized that the left kidney had adjusted to allow normal function only at very high circulating

S2k guidelines for diverticular disease and diverticulitis. Diagnosis, classification, and therapy for the radiologist; S2k-Leitlinie Divertikelkrankheit und Divertikulitis. Diagnostik, Klassifikation und Therapie fuer die Radiologie

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Schreyer, A.G. [University Hospital Regensburg (Germany). Inst. of Radiology; Layer, G. [Ludwigshafen Hospital (Germany). Central Inst. for Diagnostic and Interventional Radiology

2015-08-15

Diverticular disease and diverticulitis represent an increasingly common disease especially in patients with advanced age. The German Society of Digestive and Metabolic Diseases (DGVS) as well as the German Society of General and Visceral Surgery (DGAV) in collaboration with the German Radiology Society (DRG) created and published S2k guidelines regarding this topic. Knowledge of the diagnosis and therapy of this common disease is extremely important for the radiologist for the daily clinical routine. In this article we review and discuss the most important clinical situations and algorithms of this disease focusing on radiological topics. Additionally, we introduce the new CCD (classification of diverticular disease) system regarding radiology.

Interdisciplinary documentation of treatment side effects in oncology. Present status and perspectives

International Nuclear Information System (INIS)

Seegenschmiedt, M.H.

1998-01-01

Background: The documentation of acute and chronic treatment sequelae is a decisive precondition for the appropriate evaluation of the treatment quality of any cancer therapy. Methods and results: Interdisciplinary (inter)national efforts have resulted in a new consensus for recording of treatment sequelae in oncology. While the acute treatment side effects (day 1 to 90 after treatment) are recommended to be documented and evaluated using the Common Toxicity Criteria (CTC), for the chronic treatment side effects (day 91 and thereafter) the Late Effect Normal Tissue (LENT) criteria are to be implemented. The latter classification system allows to differentiate between the Subjective, Objective, Management and Analytic (SOMA) toxicity aspects. Both classification systems can be implemented not only for clinical applications using radiotherapy or chemotherapy alone but also for combinations with each other or with other treatment modalities. This allows for an effective interdisciplinary comparison between different treatment concepts not only within each institution but also in multicenter trials. Conclusions: Prospective documentation and evaluation of treatment toxicity in oncology should be intensified and systematically included in future mono- and multi-institutional clinical trials. (orig.) [de

Flow and wall shear stress in end-to-side and side-to-side anastomosis of venous coronary artery bypass grafts

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Poulikakos Dimos

2007-09-01

Full Text Available Abstract Purpose Coronary artery bypass graft (CABG surgery represents the standard treatment of advanced coronary artery disease. Two major types of anastomosis exist to connect the graft to the coronary artery, i.e., by using an end-to-side or a side-to-side anastomosis. There is still controversy because of the differences in the patency rates of the two types of anastomosis. The purpose of this paper is to non-invasively quantify hemodynamic parameters, such as mass flow and wall shear stress (WSS, in end-to-side and side-to-side anastomoses of patients with CABG using computational fluid dynamics (CFD. Methods One patient with saphenous CABG and end-to-side anastomosis and one patient with saphenous CABG and side-to-side anastomosis underwent 16-detector row computed tomography (CT. Geometric models of coronary arteries and bypasses were reconstructed for CFD analysis. Blood flow was considered pulsatile, laminar, incompressible and Newtonian. Peri-anastomotic mass flow and WSS were quantified and flow patterns visualized. Results CFD analysis based on in-vivo CT coronary angiography data was feasible in both patients. For both types of CABG, flow patterns were characterized by a retrograde flow into the native coronary artery. WSS variations were found in both anastomoses types, with highest WSS values at the heel and lowest WSS values at the floor of the end-to-side anastomosis. In contrast, the highest WSS values of the side-to-side anastomosis configuration were found in stenotic vessel segments and not in the close vicinity of the anastomosis. Flow stagnation zones were found in end-to-side but not in side-to-side anastomosis, the latter also demonstrating a smoother stream division throughout the cardiac cycle. Conclusion CFD analysis of venous CABG based on in-vivo CT datasets in patients was feasible producing qualitative and quantitative information on mass flow and WSS. Differences were found between the two types of anastomosis

Combination of same-side with opposite-side flavour tagging

CERN Document Server

Calvo, M; Musy, M

2010-01-01

A considerable number of CP violation measurements require the most possible accurate knowledge of the flavour at production of the reconstructed $B$ meson. The performance of different flavour tagging methods will be measured from control channels. One of the possible tagging methods that can be used is the one known as $Same Side kaon$. In this note we present how to calibrate the response of the tagging algorithms using the data and combine the result with the so called $Opposite Side tagging$. Also trigger and selection effects are briefly discussed.

Diverticular Disease of the Colon: News From Imaging.

Science.gov (United States)

Flor, Nicola; Soldi, Simone; Zanchetta, Edoardo; Sbaraini, Sara; Pesapane, Filippo

2016-10-01

Different scenarios embrace computed tomography imaging and diverticula, including asymptomatic (diverticulosis) and symptomatic patients (acute diverticulitis, follow-up of acute diverticulitis, chronic diverticulitis). If the role of computed tomography is validated and widely supported by evidence in case of acute diverticulitis, this is not the case of patients in their follow-up for acute diverticulitis or with symptoms related to diverticula, but without acute inflammation. In these settings, computed tomography colonography is gaining consensus as the preferred radiologic test.

Left-Sided Patent Ductus Arteriosus in a Right-Sided Aortic Arch

Directory of Open Access Journals (Sweden)

Ming-Yen Ng

2014-01-01

Full Text Available We present a 31-year-old female with repaired tetralogy of Fallot (TOF and right-sided aortic arch (RAA with left-sided patent ductus arteriosus (PDA originating from the left brachiocephalic artery. This is a rare finding but most common site for a PDA in TOF and a RAA. To the best of our knowledge, this is the first demonstration of this rare finding on MRI in the literature.

Dietary pattern and colonic diverticulosis.

Science.gov (United States)

Tursi, Antonio

2017-09-01

To assess the role of dietary pattern on the occurrence of colonic diverticulosis, diverticular disease and acute diverticulitis. High-fiber diet does not prevent diverticulosis occurrence, and results about prevention/treatment of diverticular disease and acute diverticulitis are still conflicting.No association was seen between nut, corn or popcorn consumption and occurrence of diverticulosis, diverticular disease and acute diverticulitis.It seems to be a mild association between high alcohol intake and diverticulosis occurrence, whereas alcohol dependence seems to show lower risk of in-hospital mortality due to acute diverticulitis.Higher red-meat consumption shows mild increased risk of acute diverticulitis, especially when consumed as unprocessed red meat (defined as consumption of 'beef or lamb as main dish', 'pork as main dish', 'hamburger' and 'beef, pork or lamb as a sandwich or mixed dish'); higher consumption of poultry (viz. white meat) was not associated with risk of acute diverticulitis.Finally, higher fish intake was associated with reduced risk of diverticulitis in age-adjusted model, but not after further adjustment for other potential confounders. Current literature data about the role of dietary pattern on the occurrence of colonic diverticulosis, diverticular disease and acute diverticulitis are still too conflicting.

Quantitative flow characteristics for side-by-side square cylinders via PIV

Directory of Open Access Journals (Sweden)

Dogan Sercan

2012-04-01

Full Text Available In this study, instantaneous and time-averaged flow structures downstream of the sharp-edged single and two and three side-by-side square cylinders (SCs immersed in a uniform open channel water flow were studied by a technique of particle image velocimetry (PIV. Experimental results of wake flow structures were presented for gap ratios (G/D in the range of 1.0”G/D”3.0 for Reynolds number values of 1050, 2450 and 3400. Flow structures depending on the square cylinder (SC configurations and Reynolds number were discussed. It has been found that the development of the vortex shedding as well as the flow structure were substantially altered for side-by-side SCs comparing to the single SC. Asymmetrical and biased wake structures were observed because of the jetlike flow between the SCs for two SCs cases for the gap ratio less than 2.0. Depending on the gap spacing between the SCs, the interaction results of time2 averaged vorticity, velocity vector field, Reynolds stress correlations and streamline patterns in the wake region form a distinguished flow structure. Strouhal numbers for the single square cylinder for 1050≤Re≤3400 are found in the range of 0.12-0.13. The present results have supported the previous works by providing detailed quantitative experimental information with PIV in the wake region of the SC and might be helpful for validation of numerical studies and designers.

Delayed Migration and Perforation of the Jugular Vein by a Peripherally Inserted Central Catheter

Directory of Open Access Journals (Sweden)

Joshua J. Oliver

2017-10-01

Full Text Available We report a case of peripherally inserted central catheter (PICC migration and perforation of the left internal jugular vein in a home health setting in an 80-year-old female. A left sided PICC was placed for treatment of diverticulitis following hospital discharge. She complained of sudden onset left sided neck pain immediately after starting an infusion of vancomycin. In the emergency department the injury was identified by portable chest radiograph and computed tomography of her neck. Following removal of the line, she had an uneventful course. Emergency physicians should be aware of this possible PICC line complication.

GC Side Event: Africa's Energy Needs and the Potential Role of Nuclear Power. Presentations

International Nuclear Information System (INIS)

2015-01-01

Energy is central to development, and energy availability, accessibility and affordability are central challenges for most African countries. Due to rapidly growing energy demand, the need for socioeconomic development, persistent concerns over climate change and environmental impacts and dependence on imported supplies of fossil fuels, African Member States are looking into possible options to secure sustainable energy supplies, including nuclear energy. The IAEA assists those countries in assessing the nuclear power option and building the necessary infrastructure for a safe, secure and sustainable nuclear power programme. This year, the IAEA is conducting Integrated Nuclear Infrastructure Review (INIR) missions to three African countries (Nigeria, Kenya and Morocco) considering introducing nuclear power. The side event presents recent updates from Africa on the potential role of nuclear power, including the IAEA Third Regional Conference on Energy and Nuclear Power in Africa, held in Mombasa, Kenya, in April 2015, an initiative to launch a new African network for enhancing nuclear power programme development, and others. The event reports on recent developments in several African Member States considering, embarking on, or expanding national nuclear power programmes.

Primary epiploic appendagitis: US and CT findings

International Nuclear Information System (INIS)

Molla, E.; Ripolles, T.; Martinez, M.J.; Morote, V.; Rosello-Sastre, E.

1998-01-01

A retrospective review is presented of seven cases of epiploic appendagitis, with surgical confirmation in one case. The main clinico-analytical data and the US and CT findings are described, as well as the histopathologic features in the sole case that underwent surgical resection. We also calculated the frequency of this entity in patients undergoing emergency abdominal US on clinical suspicion of diverticulitis. In all seven cases the clinico-analytical evidence was nonspecific (localized acute abdominal pain and slight leukocytosis), mimicking in six cases the clinical presentation of sigmoid diverticulitis and in one case that of acute appendicitis. US imaging findings were characteristic: a hyperechoic mass localized under the point of maximum pain, adjacent to the anterior peritoneal wall and fixed during deep breathing. In none of the cases did color Doppler US show flow. CT findings were also typical and showed a mass with a peripheral hyperattenuated rim surrounding an area of fatty attenuation. Overall 7.1 % of patients investigated to exclude sigmoid diverticulitis finally showed findings of primary epiploic appendagitis. Primary epiploic appendagitis thus shows characteristic US and CT findings that allow its diagnosis and follow-up. This entity is much more frequent than previously reported, especially in patients referred for US to exclude sigmoid diverticulitis. (orig.)

Pathogenesis of diverticulosis and diverticular disease.

Science.gov (United States)

Walker, Marjorie M; Harris, Angela K

2017-06-01

Diverticulosis is defined by the presence of diverticula due to herniation of mucosa and muscularis mucosa through the muscularis propria at sites of vascular penetration in the colon and is asymptomatic in the vast majority affected. There are global differences of distribution, in Western industrialized societies, the most common site is in the left colon, but in Asia right sided diverticulosis predominates. Whilst present in 17.5% of a general population and 42% of all comers at endoscopy it is seen in 71% of those aged ≥80 years. Diverticular disease is defined as clinically significant and symptomatic diverticulosis, which may have an absence of macroscopically overt colitis and in true diverticulitis there is macroscopic inflammation of diverticula with related acute or chronic complications. Whilst overall, diverticulitis affects only 4% of those with diverticulosis, in younger patients (aged 40-49 years) this peaks at 11%. Diverticulosis is one of the most common chronic diseases, yet research in this field on pathogenesis has lagged behind other common conditions such as diabetes mellitus. However, in the last decade there have been major advances in taxonomy that can be used to relate to patients' outcome and treatment in both medicine and surgery. It has been shown there is an association with age, diet, drugs and smoking. Genetic studies have shown a familial association and a specific gene, TNFSF 15 may predict severity of disease. The role of the microbiome has been explored and microbial and metabolomic signatures are also important in predicting disease severity. That diverticulosis is a chronic disease is shown by mucosal pathology with subtle chronic inflammation present in those with asymptomatic diverticulosis and inflammation may lead to muscular hypertrophy, enteric nerve remodeling with disordered motility. The diverticulitis quality of life instrument shows that this condition impacts markedly on patients' well-being and prevention and

The far-side solar magnetic index

International Nuclear Information System (INIS)

Hernandez, Irene Gonzalez; Jain, Kiran; Hill, Frank; Tobiska, W Kent

2011-01-01

Several magnetic indices are used to model the solar irradiance and ultimately to forecast it. However, the observation of such indices are generally limited to the Earth-facing hemisphere of the Sun. Seismic maps of the far side of the Sun have proven their capability to locate and track medium-large active regions at the non-visible hemisphere. We present here the possibility of using the average signal from these seismic far-side maps as a proxy to the non-visible solar activity which can complement the current front-side solar activity indices.

Physiological and skill demands of 'on-side' and 'off-side' games.

Science.gov (United States)

Gabbett, Tim J; Jenkins, David G; Abernethy, Bruce

2010-11-01

This study investigated the physiological and skill demands of 'on-side' and 'off-side' games in elite rugby league players. Sixteen male rugby league players participated in 'on-side' and 'off-side' games. Both small-sided games were played in a 40- × 40-m playing area. The 'off-side' game permitted players to have 3 'plays' while in possession of the ball. Players were permitted to pass backward or forward (to an 'off-side' player). The 'on-side' game also permitted players to have 3 'plays' while in possession of the ball. However, players were only permitted to pass backward to players in an 'on-side' position. Heart rate and movement patterns (via global positioning system) were recorded continuously throughout both games. Data were collected on the distance covered, number of high-acceleration and velocity efforts, and recovery between efforts. Video footage was also taken to track the performance of the players. Post hoc inspection of the footage was undertaken to count the number of possessions and the number and quality of disposals. In comparison to 'on-side' games, 'off-side' games had a greater number of involvements ("touches"), passes, and effective passes. However, the cognitive demands of 'on-side' games were greater than 'off-side' games. 'Off-side' games resulted in a greater total distance covered, greater distance covered in mild and moderate accelerations, and greater distance covered in low, moderate, and high-velocity efforts. There were also a greater number of short duration recovery periods between efforts in 'off-side' games. The results of this study demonstrate that 'off-side' games provide greater physiological and skill demands than 'on-side' games. 'Off-side' games may provide a practical alternative to 'on-side' games for the development of skill and fitness in elite rugby league players.

Side Effects

Science.gov (United States)

Side effects are problems that occur when cancer treatment affects healthy tissues or organs. Learn about side effects caused by cancer treatment. Know what signs and symptoms to call your doctor about. Learn about treatments for side effects.

A survey of gas-side fouling in industrial heat-transfer equipment

Science.gov (United States)

Marner, W. J.; Suitor, J. W.

1983-11-01

Gas-side fouling and corrosion problems occur in all of the energy intensive industries including the chemical, petroleum, primary metals, pulp and paper, glass, cement, foodstuffs, and textile industries. Topics of major interest include: (1) heat exchanger design procedures for gas-side fouling service; (2) gas-side fouling factors which are presently available; (3) startup and shutdown procedures used to minimize the effects of gas-side fouling; (4) gas-side fouling prevention, mitigation, and accommodation techniques; (5) economic impact of gas-side fouling on capital costs, maintenance costs, loss of production, and energy losses; and (6) miscellaneous considerations related to gas-side fouling. The present state-of-the-art for industrial gas-side fouling is summarized by a list of recommendations for further work in this area.

Dual-sided reading versus single-sided reading: comparison of image quality and radiation dose between the two computed radiography system

International Nuclear Information System (INIS)

Song Shaojuan; Qi Hengtao; Zhao Yongxia; Jiao Fanglian

2007-01-01

Objective: To assess and compare the difference in image quality and exposure dose between single-sided reading image plate (IP) and dual-sided reading IP. Methods: A contrast-detail phantom CDRAD 2.0 was exposed by single-sided and dual-sided reading IP with different mAs sets. The entrance surface doses were recorded for all images. Images were then presented to two radiologists on a high resolution monitor of diagnosis workstation. The image quality figure (IQF) was measured for each image. Statistical analysis was performed using Spearman's correlation test and Wilcoxon signed-rank test to compare the difference in image quality and exposure dose between single-sided IP and dual-sided reading IP. Results: With different tube current dosage of 5.6, 12.0, 20.0, 25.0, and 40.0 mAs, IQF values of single-sided reading IP were 47.95, 37.68, 34.31, 28.61, and 24.65, respectively, while those of dual- sided reading IP were 38.83, 29.81, 29.65, 25.16, and 21.43, respectively. The IQF difference between them showed statistical significance (P<0.05). Conclusion: Image quality of dual-sided reading IP has been proved to be far superior to that of single-sided reading IP, in particular for low contrast detail. The image quality of single-sided reading IP is similar to that of dual-sided reading IP only at high dose levels. The clinical application of dual-sided reading IP will reduce the exposure dose by about 25% compared with single-sided reading IP. (authors)

Running away from side effects

DEFF Research Database (Denmark)

Casla, S; Hojman, P; Márquez-Rodas, I

2015-01-01

The number of breast cancer survivors increases every year, thanks to the development of new treatments and screening techniques. However, patients present with numerous side effects that may affect their quality of life. Exercise has been demonstrated to reduce some of these side effects...... be an integrative complementary intervention to improve physiological, physical and psychological factors that affect survival and quality of life of these patients. For that reason, the main objective of this review is to provide a general overview of exercise benefits in breast cancer patients and recommendations...

Influence of the side-by-side arrangement on the performance of a small Savonius wind turbine

Directory of Open Access Journals (Sweden)

Jang Choon-Man

2016-01-01

Full Text Available Scaled-down Savonius turbine rotors arrayed side-by-side are introduced to analyze the effects of design parameters on the performance between turbine rotors. Unsteady flow simulation and experimental measurement have been performed to compare turbine performance and validate the numerical simulation of the turbine rotor. Commercial code, SC/Tetra, which uses an unstructured grid system, has been used to solve the three-dimensional unsteady Reynolds-averaged Navier–Stokes equations. Single turbine rotors and two turbine rotors arrayed side-by-side were numerically analyzed. The distance between rotor tips is 0.5 times the rotor diameter. Throughout the numerical simulation, the power coefficient obtained by the time-averaged result of unsteady flow simulation was found to be in good agreement with the experimental result. A discussion on the design parameters using both a single and arrayed turbine rotors is presented based on the results of the unsteady flow simulation, including the flow field, power coefficient, velocity and vorticity contours.

Research Needs: Glass Solar Reflectance and Vinyl Siding

Energy Technology Data Exchange (ETDEWEB)

Hart, Robert; Curcija, Charlie; Arasteh, Dariush; Goudey, Howdy; Kohler, Christian; Selkowitz, Stephen

2011-07-07

The subject of glass solar reflectance and its contribution to permanent vinyl siding distortion has not been extensively studied, and some phenomena are not yet well understood. This white paper presents what is known regarding the issue and identifies where more research is needed. Three primary topics are discussed: environmental factors that control the transfer of heat to and from the siding surface; vinyl siding properties that may affect heat build-up and permanent distortion; and factors that determine the properties of reflected solar radiation from glass surfaces, including insulating window glass. Further research is needed to fully characterize the conditions associated with siding distortion, the scope of the problem, physical properties of vinyl siding, insulating window glass reflection characteristics, and possible mitigation or prevention strategies.

Laparoscopic side-to-side pancreaticojejunostomy for chronic pancreatitis in children

Directory of Open Access Journals (Sweden)

Kyoichi Deie

2016-01-01

Full Text Available Surgical pancreatic duct (PD drainage for chronic pancreatitis in children is relatively rare. It is indicated in cases of recurrent pancreatitis and PD dilatation that have not responded to medical therapy and therapeutic endoscopy. We performed laparoscopic side-to-side pancreaticojejunostomy for two paediatric patients with chronic pancreatitis. The main PD was opened easily by electrocautery after locating the dilated PD by intraoperative ultrasonography. The dilated PD was split longitudinally from the pancreatic tail to the pancreatic head by laparoscopic coagulation shears or electrocautery after pancreatography. A laparoscopic side-to-side pancreaticojejunostomy was performed by a one-layered technique using continuous 4-0 polydioxanone (PDS sutures from the pancreatic tail to the pancreatic head. There were no intraoperative or postoperative complications or recurrences. This procedure has cosmetic advantages compared with open surgery for chronic pancreatitis. Laparoscopic side-to-side pancreaticojejunostomy in children is feasible and effective for the treatment of chronic pancreatitis.

Target Essentiality and Centrality Characterize Drug Side Effects

OpenAIRE

Wang, Xiujuan; Thijssen, Bram; Yu, Haiyuan

2013-01-01

Author Summary The ultimate goal of medical research is to develop effective treatments for disease with minimal side effects. Currently, about 20% of drug candidates failed at clinical trial phases II and III due to safety issues. Therefore, understanding the determining factors of drug side effects is of paramount importance to human health and the pharmaceutical industry. Here, we present the first systematic study to uncover key factors leading to drug side effects within the framework of...

U.S. electric utility demand-side management 1995

International Nuclear Information System (INIS)

1997-01-01

The US Electric Utility Demand-Side Management report is prepared by the Coal and Electric Data and Renewables Division; Office of Coal, Nuclear, Electric and Alternative Fuels; Energy Information Administration (EIA); US Department of Energy. The report presents comprehensive information on electric power industry demand-side management (DSM) activities in the US at the national, regional, and utility levels. The objective of the publication is to provide industry decision makers, government policy makers, analysts, and the general public with historical data that may be used in understanding DSM as it relates to the US electric power industry. The first chapter, ''Profile: US Electric Utility Demand-Side Management'', presents a general discussion of DSM, its history, current issues, and a review of key statistics for the year. Subsequent chapters present discussions and more detailed data on energy savings, peak load reductions and costs attributable to DSM. 9 figs., 24 tabs

Diverticular Disease: Reconsidering Conventional Wisdom

Science.gov (United States)

Peery, Anne F.; Sandler, Robert S.

2013-01-01

Colonic diverticula are common in developed countries and complications of colonic diverticulosis are responsible for a significant burden of disease. Several recent publications have called into question long held beliefs about diverticular disease. Contrary to conventional wisdom, studies have not shown that a high fiber diet protects against asymptomatic diverticulosis. The risk of developing diverticulitis among individuals with diverticulosis is lower than the 10–25% commonly quoted, and may be as low as 1% over 11 years. Nuts and seeds do not increase the risk of diverticulitis or diverticular bleeding. It is unclear whether diverticulosis, absent diverticulitis or overt colitis, is responsible for chronic gastrointestinal symptoms or worse quality of life. The role of antibiotics in acute diverticulitis has been challenged by a large randomized trial that showed no benefit in selected patients. The decision to perform elective surgery should be made on a case-by-case basis and not routinely after a second episode of diverticulitis, when there has been a complication, or in young people. A colonoscopy should be performed to exclude colon cancer after an attack of acute diverticulitis but may not alter outcomes among individuals who have had a colonoscopy prior to the attack. Given these surprising findings, it is time to reconsider conventional wisdom about diverticular disease. PMID:23669306

Review article: the pathophysiology and medical management of diverticulosis and diverticular disease of the colon.

Science.gov (United States)

Tursi, A; Papa, A; Danese, S

2015-09-01

The incidence of diverticulosis and diverticular disease of the colon, including diverticulitis, is increasing worldwide, and becoming a significant burden on national health systems. Treatment of patients with diverticulosis and DD is generally based on high-fibre diet and antibiotics, respectively. However, new pathophysiological knowledge suggests that further treatment may be useful. To review the current treatment of diverticulosis and diverticular disease. A search of PubMed and Medline databases was performed to identify articles relevant to the management of diverticulosis and diverticular disease. Major international conferences were also reviewed. Two randomised controlled trials (RCT) found the role of antibiotics in managing acute diverticulitis to be questionable, particularly in patients with no complicating comorbidities. One RCT found mesalazine to be effective in preventing acute diverticulitis in patients with symptomatic uncomplicated diverticular disease. The role of rifaximin or mesalazine in preventing diverticulitis recurrence, based on the results of 1 and 4 RCTs, respectively, remains unclear. RCTs found rifaximin and mesalazine to be effective in treating symptomatic uncomplicated diverticular disease. The use of probiotics in diverticular disease and in preventing acute diverticulitis occurrence/recurrence appears promising but unconclusive. Finally, the role of fibre in treating diverticulosis remains unclear. Available evidence suggests that antibiotics have a role only in the treatment of complicated diverticulitis. It appears to be some evidence for a role for rifaximin and mesalazine in treating symptomatic uncomplicated diverticular disease. Finally, there is not currently adequate evidence to recommend any medical treatment for the prevention of diverticulitis recurrence. © 2015 John Wiley & Sons Ltd.

The DarkSide Program

Directory of Open Access Journals (Sweden)

Rossi B.

2016-01-01

Full Text Available DarkSide-50 at Gran Sasso underground laboratory (LNGS, Italy, is a direct dark matter search experiment based on a liquid argon TPC. DS-50 has completed its first dark matter run using atmospheric argon as target. The detector performances and the results of the first physics run are presented in this proceeding.

Modeling occupants in far-side impacts.

Science.gov (United States)

Douglas, Clay; Fildes, Brian; Gibson, Tom

2011-10-01

Far-side impacts are not part of any regulated NCAP, FMVSS, or similar test regime despite accounting for 43 percent of the seriously injured persons and 30 percent of the harm in U.S. side impact crashes. Furthermore, injuries to the head and thorax account for over half of the serious injuries sustained by occupants in far-side crashes. Despite this, there is no regulated or well-accepted anthropomorphic test device (ATD) or computer model available to investigate far-side impacts. As such, this presents an opportunity to assess a computer model that can be used to measure the effect of varying restraint parameters on occupant biomechanics in far-side impacts. This study sets out to demonstrate the modified TASS human facet model's (MOTHMO) capabilities in modeling whole-body response in far-side impacts. MOTHMO's dynamic response was compared to that of postmortem human subjects (PMHS), WorldSID, and Thor-NT in a series of far-side sled tests. The advantages, disadvantages, and differences of using MOTHMO compared to ATDs were highlighted and described in terms of model design and instrumentation. Potential applications and improvements for MOTHMO were also recommended. The results showed that MOTHMO is capable of replicating the seat belt-to-shoulder complex interaction, pelvis impacts, head displacement, neck and shoulder belt loading from inboard mounted belts, and impacts from multiple directions. Overall, the model performed better than Thor-NT and at least as well as WorldSID when compared to PMHS results. Though WorldSID and Thor-NT ATDs were capable of reproducing many of these impact loads, measuring the seat belt-to-shoulder complex interaction and thoracic deflection at multiple sites and directions was less accurately handled. This study demonstrated that MOTHMO is capable of modeling whole-body response in far-side impacts. Furthermore, MOTHMO can be used as a virtual design tool to explore the effect of varying restraint parameters on occupant

Laparoscopic management of acute appendicitis in situs inversus

Directory of Open Access Journals (Sweden)

Golash Vishwanath

2006-01-01

Full Text Available Situs inversus is often detected incidentally in adults during imaging for a acute surgical emergency. We present a case of acute appendicitis in an adult who was previously unaware about his situs anomaly. A laparoscopic approach is helpful to deal with this condition. A 40 year old man was admitted with history of acute left lower abdominal pain, with uncontrolled diabetic keto-acidosis. Clinically, he was diagnosed as acute diverticulitis with localized peritonitis. Subsequent imaging studies and laparoscopy confirmed the diagnosis of situs inversus and acute left- sided appendicitis. He successfully underwent laparoscopic appendectomy. His postoperative recovery was uneventful. Although technically more challenging because of the reverse laparoscopic view of the anatomy, the laparoscopic diagnosis and management of acute appendicitis is indicated in situs inversus.

Endomorphisms on half-sided modular inclusions

International Nuclear Information System (INIS)

Svegstrup, Rolf Dyre

2006-01-01

In algebraic quantum field theory we consider nets of von Neumann algebras indexed over regions of the space time. Wiesbrock [''Conformal quantum field theory and half-sided modular inclusions of von Neumann algebras,'' Commun. Math. Phys. 158, 537-543 (1993)] has shown that strongly additive nets of von Neumann algebras on the circle are in correspondence with standard half-sided modular inclusions. We show that a finite index endomorphism on a half-sided modular inclusion extends to a finite index endomorphism on the corresponding net of von Neumann algebras on the circle. Moreover, we present another approach to encoding endomorphisms on nets of von Neumann algebras on the circle into half-sided modular inclusions. There is a natural way to associate a weight to a Moebius covariant endomorphism. The properties of this weight have been studied by Bertozzini et al. [''Covariant sectors with infinite dimension and positivity of the energy,'' Commun. Math. Phys. 193, 471-492 (1998)]. In this paper we show the converse, namely, how to associate a Moebius covariant endomorphism to a given weight under certain assumptions, thus obtaining a correspondence between a class of weights on a half-sided modular inclusion and a subclass of the Moebius covariant endomorphisms on the associated net of von Neumann algebras. This allows us to treat Moebius covariant endomorphisms in terms of weights on half-sided modular inclusions. As our aim is to provide a framework for treating endomorphisms on nets of von Neumann algebras in terms of the apparently simpler objects of weights on half-sided modular inclusions, we lastly give some basic results for manipulations with such weights

A direct method for calculating instrument noise levels in side-by-side seismometer evaluations

Science.gov (United States)

Holcomb, L. Gary

1989-01-01

The subject of determining the inherent system noise levels present in modem broadband closed loop seismic sensors has been an evolving topic ever since closed loop systems became available. Closed loop systems are unique in that the system noise can not be determined via a blocked mass test as in older conventional open loop seismic sensors. Instead, most investigators have resorted to performing measurements on two or more systems operating in close proximity to one another and to analyzing the outputs of these systems with respect to one another to ascertain their relative noise levels.The analysis of side-by-side relative performance is inherently dependent on the accuracy of the mathematical modeling of the test configuration. This report presents a direct approach to extracting the system noise levels of two linear systems with a common coherent input signal. The mathematical solution to the problem is incredibly simple; however the practical application of the method encounters some difficulties. Examples of expected accuracies are presented as derived by simulating real systems performance using computer generated random noise. In addition, examples of the performance of the method when applied to real experimental test data are shown.

Multiresolution 3-D reconstruction from side-scan sonar images.

Science.gov (United States)

Coiras, Enrique; Petillot, Yvan; Lane, David M

2007-02-01

In this paper, a new method for the estimation of seabed elevation maps from side-scan sonar images is presented. The side-scan image formation process is represented by a Lambertian diffuse model, which is then inverted by a multiresolution optimization procedure inspired by expectation-maximization to account for the characteristics of the imaged seafloor region. On convergence of the model, approximations for seabed reflectivity, side-scan beam pattern, and seabed altitude are obtained. The performance of the system is evaluated against a real structure of known dimensions. Reconstruction results for images acquired by different sonar sensors are presented. Applications to augmented reality for the simulation of targets in sonar imagery are also discussed.

Double-sided FoxFET biased microstrip detectors

International Nuclear Information System (INIS)

Allport, P.P.; Carter, J.R.; Dunwoody, U.C.; Gibson, V.; Goodrick, M.J.; Beck, G.A.; Carter, A.A.; Martin, A.J.; Pritchard, T.W.; Bullough, M.A.; Greenwood, N.M.; Lucas, A.D.; Wilburn, C.D.

1994-01-01

The use of the field effect transistor, integrated onto AC-coupled silicon detectors, as a novel technique for biasing the implanted p + strips [P.P. Allport et al., Nucl. Instr. and Meth. A 310 (1991) 155], was first employed for the OPAL microvertex detector. The detector has proved very successful, with ladders of three single-sided detectors showing signal/noise of 22 : 1 with MX5 readout electronics [P.P. Allport et al., Nucl. Instr. and Meth. A 324 (1993) 34; Nucl. Phys. B (Proc. Suppl.) 32 (1993) 208]. This technique has been extended to bias also the n + strips and p strips on the ohmic side of a double-sided detector [P.P. Allport et al., Nucl. Instr. and Meth. A, to be submitted]. Full-size detectors with orthogonal readout have been fabricated by Micron and tested with MX7 readout on both sides. Both the junction and ohmic sides of these detectors have similar signal/noise values to those for single-sided wafers [P.P. Allport et al., Nucl. Instr. and Meth. A, to be submitted]. Test structures have been irradiated with beta particles to study the radiation hardness of the devices, and probe station electrical measurements of the detectors and test structures are presented. ((orig.))

Audiovisual integration increases the intentional step synchronization of side-by-side walkers.

Science.gov (United States)

Noy, Dominic; Mouta, Sandra; Lamas, Joao; Basso, Daniel; Silva, Carlos; Santos, Jorge A

2017-12-01

When people walk side-by-side, they often synchronize their steps. To achieve this, individuals might cross-modally match audiovisual signals from the movements of the partner and kinesthetic, cutaneous, visual and auditory signals from their own movements. Because signals from different sensory systems are processed with noise and asynchronously, the challenge of the CNS is to derive the best estimate based on this conflicting information. This is currently thought to be done by a mechanism operating as a Maximum Likelihood Estimator (MLE). The present work investigated whether audiovisual signals from the partner are integrated according to MLE in order to synchronize steps during walking. Three experiments were conducted in which the sensory cues from a walking partner were virtually simulated. In Experiment 1 seven participants were instructed to synchronize with human-sized Point Light Walkers and/or footstep sounds. Results revealed highest synchronization performance with auditory and audiovisual cues. This was quantified by the time to achieve synchronization and by synchronization variability. However, this auditory dominance effect might have been due to artifacts of the setup. Therefore, in Experiment 2 human-sized virtual mannequins were implemented. Also, audiovisual stimuli were rendered in real-time and thus were synchronous and co-localized. All four participants synchronized best with audiovisual cues. For three of the four participants results point toward their optimal integration consistent with the MLE model. Experiment 3 yielded performance decrements for all three participants when the cues were incongruent. Overall, these findings suggest that individuals might optimally integrate audiovisual cues to synchronize steps during side-by-side walking. Copyright © 2017 Elsevier B.V. All rights reserved.

Heat transfer from two-side heated helical channels

International Nuclear Information System (INIS)

Shimonis, V.; Ragaishis, V.; Poshkas, P.

1995-01-01

Experimental results are presented on the heat transfer from two-side heated helical channels to gas (air) flows. The study covered six configurations and wide ranges of geometrical (D/h=5.5 to 84.2) and performance (Re=10 3 to 2*10 5 ) parameters. Under the influence of Re and of the channel curvature, the heat transfer from both the convex and the concave surfaces for two-side heating (q w1 ≅ q w2 ) is augmented by 20-30% over one-side heating. Improved relations to predict the critical values of Reynolds Re cr1 and Re cr2 are suggested. They enable more exact predictions of the heat transfer from convex surface in transient flows for one-side heating. The relation for annular channels is suggested for the turbulent heat transfer from the convex and concave surfaces of two-side heated helical channels. It can be adapted by introducing earlier expresions for one-side heated helical channels. (author). 6 refs., 2 tabs., 3 figs

Not all side effects associated with tricyclic antidepressant therapy are true side effects.

Science.gov (United States)

Thiwan, Syed; Drossman, Douglas A; Morris, Carolyn B; Dalton, Chris; Toner, Brenda B; Diamant, Nicholas E; Hu, J B; Whitehead, William E; Leserman, Jane; Bangdiwala, Shrikant I

2009-04-01

Patients with functional gastrointestinal disorders treated with tricyclic antidepressants sometimes report nongastrointestinal symptoms; it is unclear whether these are drug side effects or reflect a behavioral tendency to report symptoms. We evaluated whether symptoms reported before treatment with a tricyclic antidepressant (desipramine) increased in number or worsened in severity after 2 weeks of treatment and assessed the baseline factors that predispose patients to report symptoms. Female patients in a multicenter National Institutes of Health trial for functional bowel disorders completed a 15-item symptom questionnaire at baseline (before randomization), 2 weeks after they were given desipramine (n = 81) or placebo (n = 40), and at study completion (12 weeks). Patients were asked about the severity and frequency of 15 symptoms. Results were analyzed from 57 patients given desipramine who completed the questionnaires. Symptoms reported as side effects to have occurred more frequently and also worsened at week 2 in the group given desipramine included dizziness, dry mouth/thirstiness, lightheadedness, jittery feelings/tremors, and flushing. Symptoms that did not change in severity or showed improvement at week 2 in the group given desipramine included morning tiredness, nausea, blurred vision, headaches, appetite reduction, and trouble sleeping. Psychologic distress but not desipramine blood level correlated with symptom reporting. Most symptoms often attributed to side effects of desipramine were present before treatment; only a few, related to anticholinergic effects, worsened 2 weeks after treatment, suggesting that most so-called side effects were not associated specifically with desipramine use. Such symptoms might instead be associated with psychologic distress.

Development of roller type side slip tester; Roller shiki side slip tester no kaihatsu

Energy Technology Data Exchange (ETDEWEB)

Nishiyama, S [Hiroshima City Industrial Technology Institute, Hiroshima (Japan); Harada, S; Harada, K

1997-10-01

This paper presents a new development of roller type side slip tester (RTSSI). The test equipment consists of four parts, which are developed in this research. These are a roller part, a control part, a remote control part and a CRT part. In this study, we especially investigated the mechanism and performance between tire and roller. We analyzed the amount of side slip with various toe angles. The developed tester is examined under the conditions that is considered in industrial applications. We investigated the influences of toe angle, size of tire, pressure of tire, coefficient of friction between tire and roller, pushing force of tire, revolution velocity of roller, axle load and so on. The validity of the developed RTSST is confirmed under these conditions. It was found that the RTSST can be used in practical use. Some measurement results are presented in the form of parametric plots. And we also compared measurements data between the RTSST and that of flat type using several automobiles. 4 refs., 8 figs., 4 tabs.

Ulnar-sided wrist pain. Part I: anatomy and physical examination

International Nuclear Information System (INIS)

Vezeridis, Peter S.; Blazar, Philip; Yoshioka, Hiroshi; Han, Roger

2010-01-01

Ulnar-sided wrist pain is a common complaint, and it presents a diagnostic challenge for hand surgeons and radiologists. The complex anatomy of this region, combined with the small size of structures and subtle imaging findings, compound this problem. A thorough understanding of ulnar-sided wrist anatomy and a systematic clinical examination of this region are essential in arriving at an accurate diagnosis. In part I of this review, ulnar-sided wrist anatomy and clinical examination are discussed for a more comprehensive understanding of ulnar-sided wrist pain. (orig.)

Side-by-side ANFIS as a useful tool for estimating correlated thermophysical properties

Science.gov (United States)

Grieu, Stéphane; Faugeroux, Olivier; Traoré, Adama; Claudet, Bernard; Bodnar, Jean-Luc

2015-12-01

In the present paper, an artificial intelligence-based approach dealing with the estimation of correlated thermophysical properties is designed and evaluated. This new and "intelligent" approach makes use of photothermal responses obtained when homogeneous materials are subjected to a light flux. Commonly, gradient-based algorithms are used as parameter estimation techniques. Unfortunately, such algorithms show instabilities leading to non-convergence in case of correlated properties to be estimated from a rebuilt impulse response. So, the main objective of the present work was to simultaneously estimate both the thermal diffusivity and conductivity of homogeneous materials, from front-face or rear-face photothermal responses to pseudo random binary signals. To this end, we used side-by-side neuro-fuzzy systems (adaptive network-based fuzzy inference systems) trained with a hybrid algorithm. We focused on the impact on generalization of both the examples used during training and the fuzzification process. In addition, computation time was a key point to consider. That is why the developed algorithm is computationally tractable and allows both the thermal diffusivity and conductivity of homogeneous materials to be simultaneously estimated with very good accuracy (the generalization error ranges between 4.6% and 6.2%).

History of a secondary side inspection tooling development

International Nuclear Information System (INIS)

Harris, W.

2012-01-01

This presentation provides a brief history (1980 to present day) of steam generator secondary side tooling requirements, tooling development, tooling available today and how and where this tooling has been implemented for steam generator secondary side inspections. History of Tooling Development discussion covers the relatively short time period from when the SGSS tooling was required and why as well the associated challenges with development through present day; Available Tooling discussion covers the actual tooling available today, locations in the steam generator where the tooling is used and how the tooling works; Implementation discussion covers where in the world this tooling has been deployed as well the benefits the tooling has provided. (author)

Side-to-side sutureless vascular anastomosis with magnets.

Science.gov (United States)

Erdmann, Detlev; Sweis, Ranya; Heitmann, Christoph; Yasui, Koji; Olbrich, Kevin C; Levin, L Scott; Sharkawy, A Adam; Klitzman, Bruce

2004-09-01

vessel wall after several weeks to incorporate the magnets, making the magnetic force unnecessary; and warrants further study in vessels with different sizes, flow rates, and locations. We present a magnet-based device used to perform side-to-side peripheral vascular anastomoses. Its advantages include the ability to anastomose vessels without requiring circumferential surgical exposure. Vascular anastomosis performed with these magnets demonstrated 100% patency in the dog, lacked apparent aneurysm or other potentially catastrophic failure, and demonstrated remodeling of the vessel wall after several weeks, to incorporate the magnets, making indefinite retention of field strength unnecessary. This technique could enable minimally invasive procedures, such as complex reconstructive and revascularizing surgery, and warrants further study in vessels with different sizes, flow rates, and locations.

Massive hepatic cyst presenting as right-sided heart failure.

LENUS (Irish Health Repository)

O'Connor, A

2010-01-30

A 70-year-old woman presented with clinical features of right heart failure. Cardiopulmonary investigations included an echocardiogram, which showed a hepatic cyst compromising venous return and affecting right atrial filling and a CT abdomen showed a 15.5 x 11.5 cm-cystic mass involving the right hepatic lobe and compressing the right atrium. Percutaneous drainage of the cyst was performed. This led to complete resolution of symptoms but these recurred as the fluid re-accumulated. Subsequent definitive treatment with excision of the cyst was undertaken with symptomatic cure. This case is the first report of a hepatic cyst presenting as right heart due to compression of the right atrium.

Medications and Side Effects

Science.gov (United States)

... to fully work. You might feel some side effects of your medication before your feel the benefits – ... as sleepiness, anxiety or headache) is a side effect or a symptom of your illness. Many side ...

[Side Effects of Smoking Cessation].

Science.gov (United States)

Braun, Raffael; Huwiler, Bernhard

2018-06-01

Side Effects of Smoking Cessation Abstract. We present the case of a clozapine intoxication associated with aspiration pneumonia due to smoking cessation. Clozapine is mainly metabolized by CYP1A2. CYP1A2 is induced by cigarette smoking, which may change the plasma level of clozapine, especially if consuming habits change.

Eat fresh vegetables, fruit, and whole grain products | NIH MedlinePlus the Magazine

Science.gov (United States)

... please turn Javascript on. Feature: Diverticulitis "Eat fresh vegetables, fruit, and whole grain products." Past Issues / Winter 2010 ... or the diverticulitis. I once again eat fresh vegetables and fruit and whole grain products. My two episodes of ...

Medline Plus

Full Text Available ... Merriam, KS, 05/04/2012) Colorectal Cancer Laparoscopic Right Colectomy (Shawnee Mission Medical Center, Merriam, KS, 05/04/2012) Diverticulosis and Diverticulitis Hand Assisted Laparoscopic Left Colectomy Performed for Recurrent Diverticulitis (Broward Health Coral ...

Diverticulitis

Science.gov (United States)

Bhuket TP, Stollman NH. Diverticular disease of the colon. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier ...

Side effects of retinoid therapy on the quality of vision

Directory of Open Access Journals (Sweden)

Bergler-Czop Beata

2016-12-01

Full Text Available Retinoids are compounds chemically related to vitamin A, which are frequently used in dermatological practice (1. They are characterized by numerous mechanisms of action leading to normalization of keratinocyte proliferation and maturation. They have anti-seborrhoeic, immunomodulatory and anti-inflammatory effects (1, 2. A number of side effects to retinoid treatment have been recorded; one group of such side effects relates to eyes and vision. Dry eye syndrome and blepharoconjunctivitis are the most common side effects, appearing in 20-50 % of patients treated with retinoids. They often contribute to the occurrence of other side-effects such as eye discomfort and contact lens intolerance. Due to the widespread use in clinical practice, the adverse effects, including ocular side effects, should be studied. To confirm the variety of adverse effects of retinoids, several case reports of rare side-effects are presented.

A Right-sided Aortic Arch with Kommerell's Diverticulum of the Aberrant Left Subclavian Artery Presenting with Syncope

Directory of Open Access Journals (Sweden)

Ming-Hsun Yang

2009-05-01

Full Text Available A right-sided aortic arch with an aneurysm of the aberrant subclavian artery is a rare disease. We report a case of Kommerell's diverticulum of an aberrant left subclavian artery in a patient with a right-sided aortic arch. Fewer than 50 cases have been reported in the literature. A number of operative strategies are described. Right thoracotomy provides good exposure and avoids the morbidity associated with bilateral thoracotomy or sternotomy and thoracotomy. In our patient with symptoms of dysphagia, syncope, and left subclavian steal syndrome, a left thoracotomy was used. The repair was accomplished by division of a left ligamentum arteriosum, obliteration of the Kommerell's aneurysm, and an aorto-subclavian bypass. Postoperative complications included left vocal cord palsy and Horner's syndrome. Hoarseness and left ptosis recovered spontaneously 3 months after surgery, and the patient remained symptom-free at the 1-year follow-up. We believe a left thoracotomy for direct repair of Kommerell's diverticulum is a simple and safe method without the increased morbidity found in other procedures.

The Moon's near side megabasin and far side bulge

CERN Document Server

Byrne, Charles

2013-01-01

Since Luna and Lunar Orbiter photographed the far side of the Moon, the mysterious dichotomy between the face of the Moon as we see it from Earth and the side of the Moon that is hidden has puzzled lunar scientists. As we learned more from the Apollo sample return missions and later robotic satellites, the puzzle literally deepened, showing asymmetry of the crust and mantle, all the way to the core of the Moon. This book summarizes the author’s successful search for an ancient impact feature, the Near Side Megabasin of the Moon and the extensions to impact theory needed to find it. The implications of this ancient event are developed to answer many of the questions about the history of the Moon.

Side Effects (Management)

Science.gov (United States)

... cancer care is relieving side effects, called symptom management, palliative care, or supportive care. It is important ... treat them. To learn about the symptoms and management of the long-term side effects of cancer ...

$xy$ Position Reconstruction in DarkSide-50

Energy Technology Data Exchange (ETDEWEB)

Brodsky, Jason Philip [Princeton Univ., NJ (United States)

2015-01-01

The DarkSide-50 experiment seeks to directly detect dark matter in a liquid argon time projection chamber. In this dissertation, I present an algorithm of my design that determines the position of particle interactions with the liquid argon. This position reconstruction algorithm will be used by DarkSide-50 to reject backgrounds, particularly backgrounds from radioactive elements on the detector surface. The position reconstruction algorithm functions by constructing light response functions (LRFs) that map locations in the detector to the expected distribution of signal in DarkSide-50's 38 photomultiplier tubes. Accurate LRFs cannot be produced by simulations of DarkSide-50's optics because such simulations are known to be awed. Instead, this algorithm constructs LRFs using an iterative process driven by data. Initial, awed LRFs are produced using simulated events but then used to produce new LRFs from data events. Multiple generations of LRFs are created from data with each generation driven to better satisfy a known feature of the detector: the dominant argon-39 background is uniformly distributed. I also discuss a method of discriminating against surface background as an alternative to the common approach of ducialization. This method considers the di erence in goodnessof- t between the best- t reconstructed position and the best- t position at the detector's surface. I conclude by presenting results on the performance and validity of this algorithm, including some discussion of reconstruction errors.

Distribution side of pleural effusion in heart failure

International Nuclear Information System (INIS)

Park, Cheol Kyu; Park, Young Ha; Jung, Se Young; Park, Seog Hee; Bahk, Yong Whee

1988-01-01

The interrelationship between the etiology of pleural effusion and the side of its occurrence has been a subject of clinical interest for many years. It has often been stated that pleural effusion caused by congestive heart failure tends to occur on the right side. However, some authors contended that such a side proclivity is not reliable. In the present study, the authors investigated the laterally of effusion caused by various cardiovascular diseases complicated by heart failure. We reviewed the chest X-ray films and clinical records of 68 patients with proven pleural effusion resulted from heart failure. 1. There were 34 men and 34 women with the age ranging from 10 to 84 years with the mean of 59. 2. The diagnoses were rheumatic heart disease (2 patients), coronary heart disease (10 patients), hypertensive heart disease (8 patients), mitral valvular disease (18 patients), aortic valvular disease (3 patients), and miscellaneous (27 patients). 3. 34 patients had unilateral pleural effusion, 25 and 9, right and left, respectively. Of the 34 patients with bilateral effusion, 13 patients had predominantly right-sided effusion, 5 patients had predominantly left-sided effusion and 16 patients had evenly distributed bilateral effusion. Thus, 55.8% of effusion was right-sided

49 CFR 231.4 - Fixed-end low-side gondola and low-side hopper cars.

Science.gov (United States)

2010-10-01

... cars. 231.4 Section 231.4 Transportation Other Regulations Relating to Transportation (Continued... Fixed-end low-side gondola and low-side hopper cars. (Cars with sides 36 inches or less above the floor are low-side cars.) (a) Hand brakes—(1) Number. Same as specified for “Box and other house cars” (see...

The unusual asymptotics of three-sided prudent polygons

International Nuclear Information System (INIS)

Beaton, Nicholas R; Guttmann, Anthony J; Flajolet, Philippe

2010-01-01

We have studied the area-generating function of prudent polygons on the square lattice. Exact solutions are obtained for the generating function of two-sided and three-sided prudent polygons, and a functional equation is found for four-sided prudent polygons. This is used to generate series coefficients in polynomial time, and these are analysed to determine the asymptotics numerically. A careful asymptotic analysis of the three-sided polygons produces a most surprising result. A transcendental critical exponent is found, and the leading amplitude is not quite a constant, but is a constant plus a small oscillatory component with an amplitude approximately 10 -8 times that of the leading amplitude. This effect cannot be seen by any standard numerical analysis, but it may be present in other models. If so, it changes our whole view of the asymptotic behaviour of lattice models. (fast track communication)

Subdural Empyema: Clinical Presentations and Management ...

African Journals Online (AJOL)

[craniotomy vs. burr hole, aspiration, and drainage. (BAAD)] depends on the ... the dura and the subarachnoid mater within the brain ambient ... presentations. Posterior fossa right-sided SDE was seen ... the left side of the brain, 15 (83.3%).

Diverticular disease of the right colon

Directory of Open Access Journals (Sweden)

Boutross-Tadross Odette

2011-10-01

Full Text Available Abstract Background The incidence of colonic diverticular disease varies with national origin, cultural background and diet. The frequency of this disease increases with advancing age. Right-sided diverticular disease is uncommon and reported to occur in 1-2% of surgical specimens in European and American series. In contrast the disease is more prevalent and reported in 43-50% of specimens in Asian series. Various lines of evidence suggest this variation may represent hereditary differences. The aim of the study is to report all cases of right sided diverticular disease underwent surgical resection or identified during pathological examination of right hemicoloectomy specimens Methods A retrospective review of all surgical specimens with right sided colonic diverticular disease selected from a larger database of all colonic diverticulosis and diverticulitis surgical specimen reported between January 1993 and December 2010 at the Pathology Department McMaster University Medical Centre Canada. The clinical and pathological features of these cases were reviewed Results The review identified 15 cases of right colon diverticulosis. The clinical diagnoses of these cases were appendicitis, diverticulitis or adenocarcinoma. Eight cases of single congenital perforated diverticuli were identified and seven cases were incidental multiple acquired diverticuli found in specimen resected for right side colonic carcinomas/large adenomas. Laparotomy or laparoscopic assisted haemicolectomies were done for all cases. Pathological examination showed caecal wall thickening with inflammation associated with perforated diverticuli. Histology confirmed true solitary diverticuli that exhibited in two cases thick walled vessels in the submucosa and muscular layer indicating vascular malformation/angiodysplasia. Acquired diverticuli tend to be multiple and are mostly seen in specimens resected for neoplastic right colon diseases. Conclusion Single true diverticular

Diverticular disease of the right colon.

Science.gov (United States)

Radhi, Jasim M; Ramsay, Jennifer A; Boutross-Tadross, Odette

2011-10-06

The incidence of colonic diverticular disease varies with national origin, cultural background and diet. The frequency of this disease increases with advancing age. Right-sided diverticular disease is uncommon and reported to occur in 1-2% of surgical specimens in European and American series. In contrast the disease is more prevalent and reported in 43-50% of specimens in Asian series. Various lines of evidence suggest this variation may represent hereditary differences. The aim of the study is to report all cases of right sided diverticular disease underwent surgical resection or identified during pathological examination of right hemicoloectomy specimens A retrospective review of all surgical specimens with right sided colonic diverticular disease selected from a larger database of all colonic diverticulosis and diverticulitis surgical specimen reported between January 1993 and December 2010 at the Pathology Department McMaster University Medical Centre Canada. The clinical and pathological features of these cases were reviewed The review identified 15 cases of right colon diverticulosis. The clinical diagnoses of these cases were appendicitis, diverticulitis or adenocarcinoma. Eight cases of single congenital perforated diverticuli were identified and seven cases were incidental multiple acquired diverticuli found in specimen resected for right side colonic carcinomas/large adenomas. Laparotomy or laparoscopic assisted haemicolectomies were done for all cases. Pathological examination showed caecal wall thickening with inflammation associated with perforated diverticuli. Histology confirmed true solitary diverticuli that exhibited in two cases thick walled vessels in the submucosa and muscular layer indicating vascular malformation/angiodysplasia. Acquired diverticuli tend to be multiple and are mostly seen in specimens resected for neoplastic right colon diseases. Single true diverticular disease of the right colon is usually of congenital type and affects

Detection of Hyperechoic Inflammatory Fatty Tissue during Transabdominal Ultrasonography: Diagnostic Role in Acute Abdomen

International Nuclear Information System (INIS)

Park, Seong Jin; Lee, Hae Kyung; Yi, Bum Ha; Kim, Hyun Cheol

2005-01-01

To assess the incidence and diagnostic role of hyperechoic inflammatory fatty tissue (HIFT) in transabdominal ultrasonography (TAUS) for acute abdomen. With TAUS, we examined 98 consecutive patients (68 women, 30 men: mean age, 32 years: age range, 4-84 years) having acute abdominal pain. We examined the abdomen and pelvis by TAUS to determine the cause of acute abdomen, to check for the presence of HIFT, and to investigate whether it was easier and earlier to find the main cause and HIFT presence. We also prospectively evaluated the shape, distribution, and diagnostic role of HIFT. Final diagnoses consisted of 47 cases of acute appendicitis, 14 of enterocolitis, 13 of PID, 7 of gynecological hemoperitoneum, 5 of colonic diverticulitis, 3 of ovarian torsion, 2 of colon perforation, 2 of only presence of non-specific HIFT, 1 of mesenteric lymphadenitis, and 4 of normal. HIFT were seen in 67 patients (68.4%), including 44/47(93.6%) of acute appendicitis, 2/14(14.3%) of enterocolitis, 11/13(84.6%) of PID, 0/7 of hemoperitoneum, 5/5 of colonic diverticulitis, 0/3 of ovarian torsion, 2/2 of colon perforation, and 1/1 mesenteric lymphadenitis. HIFT were detected earlier than the main cause in 17/44 of acute appendicitis, 6/11 of PID, and 4/5 of colonic diverticulitis. In acute appendicitis, the shape of HIFT appeared as fat thickening along the mesoappendix in 12/44, fat thickening along the mesoappendix and the opposite side in 13/44, fat encircled appendix in 6/44, fatty mass wrapping abscess in 10/44, and diffuse intraperitoneal fat thickening in 3/44. In PID, HIFT appeared as a single fatty mass in the pelvis and lower abdomen in 6/11, wrapping pelvic abscess in 2/11, and multiple fatty masses scattered in abdomen and pelvis in 3/11. In colonic diverticulitis, all 5 cases appeared as hyperechoic hemispheric mass covering the inflamed diverticulum. HIFT are a usual US finding in patients with acute abdomen, particularly on abdominal and pelvic inflammatory conditions

Industrial demand-side management in Canada. In the market for competition

International Nuclear Information System (INIS)

Fleming, A.

1995-01-01

The requirement for demand-side management brought on by increased competitiveness, a consequence of the deregulation of Canadian electric utilities, was discussed. Options for demand-side management were presented. The effect of deregulation on making demand-side management and energy efficiency high priorities in industry was discussed. Coordinated efforts of Power Smart Inc. and utilities in promoting energy efficiency were claimed to be the key to the success of demand-side management in the electric power industry in Canada. Demand-side management programs were expected to enhance productivity of industry by maximizing the value of plant energy use, and by providing industrial customers with a higher level of customer service

Side-View Face Recognition

NARCIS (Netherlands)

Santemiz, P.; Spreeuwers, Lieuwe Jan; Veldhuis, Raymond N.J.

2010-01-01

Side-view face recognition is a challenging problem with many applications. Especially in real-life scenarios where the environment is uncontrolled, coping with pose variations up to side-view positions is an important task for face recognition. In this paper we discuss the use of side view face

Single-sided NMR

CERN Document Server

Casanova, Federico; Blümich, Bernhard

2011-01-01

Single-Sided NMR describes the design of the first functioning single-sided tomograph, the related measurement methods, and a number of applications. One of the key advantages to this method is the speed at which the images are obtained.

A hierarchical anatomical classification schema for prediction of phenotypic side effects.

Science.gov (United States)

Wadhwa, Somin; Gupta, Aishwarya; Dokania, Shubham; Kanji, Rakesh; Bagler, Ganesh

2018-01-01

Prediction of adverse drug reactions is an important problem in drug discovery endeavors which can be addressed with data-driven strategies. SIDER is one of the most reliable and frequently used datasets for identification of key features as well as building machine learning models for side effects prediction. The inherently unbalanced nature of this data presents with a difficult multi-label multi-class problem towards prediction of drug side effects. We highlight the intrinsic issue with SIDER data and methodological flaws in relying on performance measures such as AUC while attempting to predict side effects.We argue for the use of metrics that are robust to class imbalance for evaluation of classifiers. Importantly, we present a 'hierarchical anatomical classification schema' which aggregates side effects into organs, sub-systems, and systems. With the help of a weighted performance measure, using 5-fold cross-validation we show that this strategy facilitates biologically meaningful side effects prediction at different levels of anatomical hierarchy. By implementing various machine learning classifiers we show that Random Forest model yields best classification accuracy at each level of coarse-graining. The manually curated, hierarchical schema for side effects can also serve as the basis of future studies towards prediction of adverse reactions and identification of key features linked to specific organ systems. Our study provides a strategy for hierarchical classification of side effects rooted in the anatomy and can pave the way for calibrated expert systems for multi-level prediction of side effects.

Incidence of Important Hemobilia Following Transhepatic Biliary Drainage: Left-Sided Versus Right-Sided Approaches

International Nuclear Information System (INIS)

Rivera-Sanfeliz, G. M.; Assar, O. S. A.; LaBerge, J. M.; Wilson, M. W.; Gordon, R. L.; Ring, E. J.; Kerlan, R. K. Jr.

2004-01-01

Our purpose here is to describe our experience with important hemobilia following PTBD and to determine whether left-sided percutaneous transhepatic biliary drainage (PTBD) is associated with an increased incidence of important hemobilia compared to right-sided drainages. We reviewed 346 transhepatic biliary drainages over a four-year period and identified eight patients (2.3%) with important hemobilia requiring transcatheter embolization. The charts and radiographic files of these patients were reviewed. The side of the PTBD (left versus right), and the order of the biliary ductal branch entered (first, second, or third) were recorded. Of the 346 PTBDs, 269 were right-sided and 77 were left-sided. Of the eight cases of important hemobilia requiring transcatheter embolization, four followed right-sided and four followed left-sided PTBD, corresponding to a bleeding incidence of 1.5% (4/269) for right PTBD and 5.2% (4/77) for left PTBD. The higher incidence of hemobilia associated with left-sided PTBD approached, but did not reach the threshold of statistical significance (p = 0.077). In six of the eight patients requiring transcatheter embolization, first or second order biliary branches were accessed by catheter for PTBD. All patients with left-sided bleeding had first or proximal second order branches accessed by biliary drainage catheters. In conclusion, a higher incidence of hemobilia followed left- versus right-sided PTBD in this study, but the increased incidence did not reach statistical significance

Detached Eddy Simulation of Flap Side-Edge Flow

Science.gov (United States)

Balakrishnan, Shankar K.; Shariff, Karim R.

2016-01-01

Detached Eddy Simulation (DES) of flap side-edge flow was performed with a wing and half-span flap configuration used in previous experimental and numerical studies. The focus of the study is the unsteady flow features responsible for the production of far-field noise. The simulation was performed at a Reynolds number (based on the main wing chord) of 3.7 million. Reynolds Averaged Navier-Stokes (RANS) simulations were performed as a precursor to the DES. The results of these precursor simulations match previous experimental and RANS results closely. Although the present DES simulations have not reached statistical stationary yet, some unsteady features of the developing flap side-edge flowfield are presented. In the final paper it is expected that statistically stationary results will be presented including comparisons of surface pressure spectra with experimental data.

Energy perspectives 2035 - Volume 4, side-notes

International Nuclear Information System (INIS)

2007-01-01

This comprehensive report published by the Swiss Federal Office of Energy (SFOE) presents a number of side-notes pertaining to the first three volumes of the Energy Perspectives series of reports. Various topics are discussed by the authors of the first three volumes of the perspectives in the meetings held by the Energy Perspectives Working Group. The sixteen side-notes presented here cover the following topics: General conditions, fossil resources, the influence of climate warming, CO 2 emissions trading (Joint Implementation JI and Clean Development Mechanism CDM), definition of potentials, air traffic, imported renewable electricity, hydro power, electricity cost calculation, sensitivity analysis of centralised power production facilities, heat-pumps and their power consumption, cold spells and heat-waves, risk and its perception, the 2000-Watt society and international and national energy perspectives

Radiation Therapy Side Effects

Science.gov (United States)

Radiation therapy has side effects because it not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. Many people who get radiation therapy experience fatigue. Other side effects depend on the part of the body that is being treated. Learn more about possible side effects.

Side Effects of Adjuvant Radiotherapy in Patients With Testicular Seminoma Stage I

International Nuclear Information System (INIS)

Gamulin, M.; Grgic, M.

2011-01-01

In the present study the side effects of adjuvant radiotherapy of testicular seminoma stage I patients were followed up in the period between 13 to 84 months (median 28 months). The most frequent side effects in these patients during radiotherapy were gastrointestinal problems (nausea/vomiting), psychologic and cognitive problems and minor sexual problems. The reported side effects were treated by antimmimetics and anxiolytics. After radiotherapy, the side effects persisted in 6 % of patients but therapy was needed only in few. Healthy children were born to 76 % of patients in the age group 18 - 39 years after radiotherapy. The present study shows that adjuvant irradiation of paraaortal lymph nodes with total a dose of 24 Gy in 16 daily fractions in testicular seminoma patients causes acceptable side effects with acceptable quality of life and fertility, however in conditions of individual approach and family consulting. (author)

Effects and side effects of inspections and accountability in education

NARCIS (Netherlands)

de Wolff, I.; Janssens, F.

2005-01-01

This paper presents an overview of studies into effects and side effects of control mechanisms in education. We focus on effects and side effects of inspection visits and public performance indicators. A first conclusion is that the studies do not provide us with a clear answer to the question of

Cost benefit analysis of the demand side management programs

International Nuclear Information System (INIS)

Schechtman, R.; Baum, M.

1989-01-01

The several cost and benefit components of the demand side management programs for the society groups, including the concessionaire, consumers and society as a whole are studied. The rule evaluations of management programs by demand side, used by North American concessionaire are also discussed. Finally, the numerical examples, that consolidating the concepts and rules evaluation are presented. (C.G.C.). 5 refs, 1 fig, 3 tabs

Demand side management using profile steering

NARCIS (Netherlands)

Gerards, Marco Egbertus Theodorus; Toersche, Hermen; Hoogsteen, Gerwin; van der Klauw, Thijs; Hurink, Johann L.; Smit, Gerardus Johannes Maria

2015-01-01

Many Demand Side Management (DSM) approaches use energy prices as steering signals. This paper shows that such steering signals may result in power quality problems and high losses. As an alternative, this paper proposes to use desired (e.g., flat) power profiles as steering signals and presents an

Selection of Server-Side Technologies for an E-Business Curriculum

Science.gov (United States)

Sandvig, J. Christopher

2007-01-01

The rapid growth of e-business and e-commerce has made server-side programming an increasingly important topic in information systems (IS) and computer science (CS) curricula. This article presents an overview of the major features of several popular server-side programming technologies and discusses the factors that influence the selection of…

Integrated planning in supply chains with buy-side and sell-side

Indian Academy of Sciences (India)

Supply chain management; dynamic pricing; partner selection; supply chain planning; electronic marketplaces. Abstract. In this paper we develop a quadratic programming model for partner selection and planning in integrated supply chain networks embedded with both sell-side and buy-side electronic marketplaces.

Gecko-inspired bidirectional double-sided adhesives.

Science.gov (United States)

Wang, Zhengzhi; Gu, Ping; Wu, Xiaoping

2014-05-14

A new concept of gecko-inspired double-sided adhesives (DSAs) is presented. The DSAs, constructed by dual-angled (i.e. angled base and angled tip) micro-pillars on both sides of the backplane substrate, are fabricated by combinations of angled etching, mould replication, tip modification, and curing bonding. Two types of DSA, symmetric and antisymmetric (i.e. pillars are patterned symmetrically or antisymmetrically relative to the backplane), are fabricated and studied in comparison with the single-sided adhesive (SSA) counterparts through both non-conformal and conformal tests. Results indicate that the DSAs show controllable and bidirectional adhesion. Combination of the two pillar-layers can either amplify (for the antisymmetric DSA, providing a remarkable and durable adhesion capacity of 25.8 ± 2.8 N cm⁻² and a high anisotropy ratio of ∼8) or counteract (for the symmetric DSA, generating almost isotropic adhesion) the adhesion capacity and anisotropic level of one SSA (capacity of 16.2 ± 1.7 N cm⁻² and anisotropy ratio of ∼6). We demonstrate that these two DSAs can be utilized as a facile fastener for two individual objects and a small-scale delivery setup, respectively, complementing the functionality of the commonly studied SSA. As such, the double-sided patterning is believed to be a new branch in the further development of biomimetic dry adhesives.

Anosognosia for hemiparesis after left-sided stroke.

Science.gov (United States)

Baier, Bernhard; Vucurevic, Goran; Müller-Forell, Wibke; Glassl, Oliver; Geber, Christian; Dieterich, Marianne; Karnath, Hans-Otto

2014-12-01

In patients with left-sided lesions, anosognosia for hemiparesis (AHP) seems to be a rare phenomenon. It has been discussed whether this rareness might be due to an inevitable bias due to language dysfunction and whether the left hemisphere's role for our self-awareness of motor actions thus is underestimated. By applying functional magnetic resonance imaging (fMRI) we examined whether patients with AHP following a left hemisphere stroke show a regular, left-sided or a reversed, right-sided lateralization of language functions. Only the former observation would argue for an original role of the left hemisphere in self-awareness about limb function. In a consecutive series of 44 acute left-sided stroke patients, only one patient (=2%) was identified showing AHP. In this case, we could verify by using fMRI that lateralization of AHP and spatial neglect on the one hand and of language functions on the other hand were reversed. The present single case observation thus argues against an original role of the left hemisphere in self-awareness about limb function. We discuss the data in the context of previous observations in the literature. Copyright © 2014 Elsevier Ltd. All rights reserved.

Rapid detection of the positive side reactions in vanadium flow batteries

International Nuclear Information System (INIS)

Liu, Le; Li, Zhaohua; Xi, Jingyu; Zhou, Haipeng; Wu, Zenghua; Qiu, Xinping

2017-01-01

Highlights: • A method for rapid measurement of the positive side reactions in VFB is presented. • The SOC of positive electrolytes can be detected with resolution of 0.002%. • Side reaction ratios at different charge currents, flow rates are obtained. - Abstract: We present an optical detection method for rapid measurement of the positive side reactions in vanadium flow batteries (VFB). By measuring the transmittance of the positive electrolytes in VFB, the states of charge (SOC) of the positive electrolytes can be detected at very high resolution (better than 0.002% in the SOC range from 98% to 100%), due to the nonlinear transmittance spectra caused by the interactions between V(IV) and V(V) ions. The intensity of the positive side reactions of a VFB can be rapidly measured by a few steps, attributing to the fact that the positive side reactions occur only during the high voltage charging process. The ratios of the positive side reactions at different charge currents and different flow rates are obtained while causing no damage to the battery. This optical detection method can rapidly determine the optimal parameters of the VFB system, providing new means for studying the electrochemical reactions in the VFB system and rapid test in industrial production of VFBs.

Better long-term outcomes with hilar ductoplasty and a side-to-side Roux-en-Y hepaticojejunostomy.

Science.gov (United States)

Xia, Hong-Tian; Liu, Yang; Yang, Tao; Liang, Bin; Wang, Jing; Dong, Jia-Hong

2017-07-01

Whether a wide hilar hepaticojejunostomy after bile duct cyst (BDC) excision can prevent the development of postoperative complications remains an unanswered question. We compared our outcomes after a minimum of 2-y follow-up in patients with Todani type Ia choledochal cyst treated with hilar ductoplasty followed by a side-to-side Roux-en-Y hepaticojejunostomy (ductoplasty group) or radical cyst resection with an end-to-side Roux-en-Y hepaticojejunostomy (conventional group). We retrospectively reviewed the records of patients with Todani type Ia choledochal cyst who received radical cyst excision from January 1997 to December 2012, and we compared the groups' postoperative complications and surgical outcomes. The groups' baseline demographics were similar, except for age. The gender distribution and preoperative presenting symptoms were comparable in the ductoplasty (n = 72) and conventional (n = 53) groups (all P > 0.05). Average age was 37.0 y for the ductoplasty group and 41.8 y for the conventional group (P = 0.024). The short-term complication rate of the groups was not significantly different (conventional group, 13.2% [7/53]; ductoplasty group, 8.3% [6/72]; all P > 0.05). A significant between-group difference was found in the long-term complication rate of biliary-enteric anastomotic strictures (9.4% in the conventional group and 0% in the ductoplasty group, P = 0.012). The rates of satisfactory surgical outcomes were 91.1% and 77.1% in the ductoplasty and conventional groups, respectively (P = 0.036). The application of hilar ductoplasty with a side-to-side Roux-en-Y hepaticojejunostomy as the primary surgery for bile duct cyst excision significantly reduced the postoperative complication of biliary-enteric anastomotic stricture and greatly improved our patients' prognosis with regard to biliary function. Copyright © 2017 Elsevier Inc. All rights reserved.

Diverticular Disease: Epidemiology and Management

Directory of Open Access Journals (Sweden)

Adam V Weizman

2011-01-01

Full Text Available Diverticular disease of the colon is among the most prevalent conditions in western society and is among the leading reasons for outpatient visits and causes of hospitalization. While previously considered to be a disease primarily affecting the elderly, there is increasing incidence among individuals younger than 40 years of age. Diverticular disease most frequently presents as uncomplicated diverticulitis, and the cornerstone of management is antibiotic therapy and bowel rest. Segmental colitis associated with diverticula shares common histopathological features with inflammatory bowel disease and may benefit from treatment with 5-aminosalicylates. Surgical management may be required for patients with recurrent diverticulitis or one of its complications including peridiverticular abscess, perforation, fistulizing disease, and strictures and/or obstruction.

Diverticular disease: Epidemiology and management

Science.gov (United States)

Weizman, Adam V; Nguyen, Geoffrey C

2011-01-01

Diverticular disease of the colon is among the most prevalent conditions in western society and is among the leading reasons for outpatient visits and causes of hospitalization. While previously considered to be a disease primarily affecting the elderly, there is increasing incidence among individuals younger than 40 years of age. Diverticular disease most frequently presents as uncomplicated diverticulitis, and the cornerstone of management is antibiotic therapy and bowel rest. Segmental colitis associated with diverticula shares common histopathological features with inflammatory bowel disease and may benefit from treatment with 5-aminosalicylates. Surgical management may be required for patients with recurrent diverticulitis or one of its complications including peridiverticular abscess, perforation, fistulizing disease, and strictures and/or obstruction. PMID:21876861

Fallopian Tube Herniation through Left Sided Abdominal Drain Site.

Science.gov (United States)

Hussain, Khalid; Masood, Jovaria

2016-06-01

Intra-abdominal drains have been used since long to prevent intra-abdominal collection, and detect any anastomotic leaks. We report a case of left sided fallopian tube herniation from a left lower abdominal drain site in a 27-year female who underwent caesarian section for breach presentation. Several complications related to drain usage has been described but left sided fallopian tube prolapse through drain site has not been reported in literature.

Design of a side-band-separating heterodyne mixer for band 9 of ALMA

NARCIS (Netherlands)

Baryshev, AM; Kooi, J; Mena, FR; Lodewijk, CRJ; Wild, W

2005-01-01

A side-band-separating (SBS) heterodyne mixer has been designed for the Atacama Large Millimeter Array (ALMA) 602-720 GHz band, as it will present a great improvement over the current double-side-band configuration under development at the moment. Here we present design details and the results of

Side Effect Perceptions and Their Impact on Treatment Decisions in Women.

Science.gov (United States)

Waters, Erika A; Pachur, Thorsten; Colditz, Graham A

2017-04-01

Side effects prompt some patients to forego otherwise-beneficial therapies. This study explored which characteristics make side effects particularly aversive. We used a psychometric approach, originating from research on risk perception, to identify the factors (or components) underlying side effect perceptions. Women ( N = 149) aged 40 to 74 years were recruited from a patient registry to complete an online experiment. Participants were presented with hypothetical scenarios in which an effective and necessary medication conferred a small risk of a single side effect (e.g., nausea, dizziness). They rated a broad range of side effects on several characteristics (e.g., embarrassing, treatable). In addition, we collected 4 measures of aversiveness for each side effect: choosing to take the medication, willingness to pay to avoid the side effect (WTP), negative affective attitude associated with the side effect, and how each side effect ranks among others in terms of undesirability. A principal components analysis (PCA) was used to identify the components underlying side effect perceptions. Then, for each aversiveness measure separately, regression analyses were used to determine which components predicted differences in aversiveness among the side effects. The PCA revealed 4 components underlying side effect perceptions: affective challenge (e.g., frightening), social challenge (e.g., disfiguring), physical challenge (e.g., painful), and familiarity (e.g., common). Side effects perceived as affectively and physically challenging elicited the highest levels of aversiveness across all 4 measures. Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice.

Challenging a classic myth: pneumoperitoneum associated with acute diverticulitis is not an indication for open or laparoscopic emergency surgery in hemodynamically stable patients. A 10-year experience with a nonoperative treatment.

Science.gov (United States)

Costi, Renato; Cauchy, François; Le Bian, Alban; Honart, Jean-François; Creuze, Nicolas; Smadja, Claude

2012-07-01

In patients presenting with acute diverticulitis (AD) and signs of acute peritonitis, the presence of extradigestive air (EDA) on a computer tomography (CT) scan is often considered to indicate the need for emergency surgery. Although the traditional management of "perforated" AD is open sigmoidectomy, more recently, laparoscopic drainage/lavage (usually followed by delayed elective sigmoidectomy) has been reported. The aim of this retrospective study is to evaluate the results of nonoperative management of emergency patients presenting with AD and EDA. The outcomes of 39 consecutive hemodynamically stable patients (23 men, mean age = 54.7 years) who were admitted with AD and EDA and were managed nonoperatively (antibiotic and supportive treatment) at a tertiary-care university hospital between January 2001 and June 2010 were retrospectively collected and analyzed. These included morbidity (Clavien-Dindo) and treatment failure (need for emergency surgery or death). A univariate analysis of clinical, radiological, and laboratory criteria with respect to treatment failure was performed. Results of delayed elective laparoscopic sigmoidectomy were also analyzed. There was no mortality. Thirty-six of the 39 patients (92.3%) did not need surgery (7 patients required CT-guided abscess drainage). Mean hospital stay was 8.1 days. Duration of symptoms, previous antibiotic administration, severe sepsis, PCR level, WBC concentration, and the presence of abdominal collection were associated with treatment failure, whereas "distant" location of EDA and free abdominal fluid were not. Five patients had recurrence of AD and were treated medically. Seventeen patients (47.2%) underwent elective laparoscopic sigmoidectomy for which mean operative time was 246 min (range = 100-450) and the conversion rate was 11.8%. Mortality was nil and the morbidity rate was 41.2%. Mean postoperative stay was 7.1 days (range = 4-23). Nonoperative management is a viable option in most emergency

Inversion of the radionuclide regurgitant index in right-sided valvular regurgitation

Energy Technology Data Exchange (ETDEWEB)

Novack, H.; Machac, J.; Horowitz, S.F.

1985-11-01

Estimation of left-sided valvular insufficiency has been obtained using the ratio of left- to right-ventricular stroke counts, i.e., the regurgitant index. The present study was designed to evaluate the usefulness of the regurgitant index in identifying patients with isolated right-sided valvular insufficiency. We identified 12 patients with tricuspid or pulmonic regurgitation by at least two of the following criteria: (1) pulsatile liver, (2) positive Carvallo's sign, and (3) pulsatile jugular-venous distension. In 9 of the 12 patients, the right-sided insufficiency was confirmed by catheterization or contrast echocardiography and flow-directed pulsed-echo Doppler. The regurgitant index in patients with right-sided insufficiency was 0.59 +- 0.23. This was significantly different from patients with left-sided insufficiency (3.09 +- 0.8) and from control subjects (1.49 +- 0.32). In 11 of the 12 patients with right-sided regurgitant lesions, the regurgitant index was less than 1.0. The hepatic expansion fraction, a possible correlate of an expansile liver, has previously been found to be both sensitive and specific for the detection of patients with right-sided regurgitation. We calculated the hepatic expansion fraction in 6 patients with tricuspid regurgitation (including 3 with pulsatile livers) and 5 controls using the method of Handler et al.. In the present study, the hepatic expansion fraction in tricuspid-insufficiency patients was 4.3% as compared to 4.1% in normals (P=NS). In summary, this study suggests that the regurgitant index may be a sensitive tool for the diagnosis of right-sided regurgitant lesions, while the hepatic expansion fraction does not appear to be useful for identifying tricuspid insufficiency.

Inversion of the radionuclide regurgitant index in right-sided valvular regurgitation

International Nuclear Information System (INIS)

Novack, H.; Machac, J.; Horowitz, S.F.; Mount Sinai Medical Center, New York

1985-01-01

Estimation of left-sided valvular insufficiency has been obtained using the ratio of left- to right-ventricular stroke counts, i.e., the regurgitant index. The present study was designed to evaluate the usefulness of the regurgitant index in identifying patients with isolated right-sided valvular insufficiency. We identified 12 patients with tricuspid or pulmonic regurgitation by at least two of the following criteria: (1) pulsatile liver, (2) positive Carvallo's sign, and (3) pulsatile jugular-venous distension. In 9 of the 12 patients, the right-sided insufficiency was confirmed by catheterization or contrast echocardiography and flow-directed pulsed-echo Doppler. The regurgitant index in patients with right-sided insufficiency was 0.59+-0.23. This was significantly different from patients with left-sided insufficiency (3.09+-0.8; P<0.001) and from control subjects (1.49+-0.32; P<0.001). In 11 of the 12 patients with right-sided regurgitant lesions, the regurgitant index was less than 1.0. The hepatic expansion fraction, a possible correlate of an expansile liver, has previously been found to be both sensitive and specific for the detection of patients with right-sided regurgitation. We calculated the hepatic expansion fraction in 6 patients with tricuspid regurgitation (including 3 with pulsatile livers) and 5 controls using the method of Handler et al.. In the present study, the hepatic expansion fraction in tricuspid-insufficiency patients was 4.3% as compared to 4.1% in normals (P=NS). In summary, this study suggests that the regurgitant index may be a sensitive tool for the diagnosis of right-sided regurgitant lesions, while the hepatic expansion fraction does not appear to be useful for identifying tricuspid insufficiency. (orig.)

Neglecting the Left Side of a City Square but Not the Left Side of Its Clock: Prevalence and Characteristics of Representational Neglect

Science.gov (United States)

Guariglia, Cecilia; Palermo, Liana; Piccardi, Laura; Iaria, Giuseppe; Incoccia, Chiara

2013-01-01

Representational neglect, which is characterized by the failure to report left-sided details of a mental image from memory, can occur after a right hemisphere lesion. In this study, we set out to verify the hypothesis that two distinct forms of representational neglect exist, one involving object representation and the other environmental representation. As representational neglect is considered rare, we also evaluated the prevalence and frequency of its association with perceptual neglect. We submitted a group of 96 unselected, consecutive, chronic, right brain-damaged patients to an extensive neuropsychological evaluation that included two representational neglect tests: the Familiar Square Description Test and the O'Clock Test. Representational neglect, as well as perceptual neglect, was present in about one-third of the sample. Most patients neglected the left side of imagined familiar squares but not the left side of imagined clocks. The present data show that representational neglect is not a rare disorder and also support the hypothesis that two different types of mental representations (i.e. topological and non-topological images) may be selectively damaged in representational neglect. PMID:23874416

Comparison between the incidence of right and left sided congenital torticollis

International Nuclear Information System (INIS)

Aslam, S.; Bashir, M.S.; Hussain, S.I.

2013-01-01

Congenital torticollis is an intriguing condition of unknown origin, characterized by unilateral shortening and tightness of the sternocleidomastoid muscle. Patients usually present with head tilt, facial asymmetry and plagiocephaly. A sternomastoid mass or tumor may or may not be clinically apparent. Untreated, cervical function and facial cosmesis may be severely compromised. Objective: My study is aimed at establishing a comparison between the incidence of right versus left sided congenital torticollis. Method: This observational study included 30 patients of congenital torticollis that completed the questionnaire. The data was collected from patients coming to the Physiotherapy and Orthopedic departments of Children Hospital, Lahore. Results: Results showed that right side was involved in 19 (63.3%) patients and left side was involved in 11 (36.7%) patients. Out of 30 patients, 14 (46.7%) were male, of which 8 had right sided congenital torticollis and 6 had left sided congenital torticollis, and 16 (53.3%) were female, of which right sided congenital torticollis and 5 had left sided congenital torticollis. Conclusion: Hence it is concluded that incidence of right sided congenital torticollis is more common than left sided congenital torticollis. The incidence of con-genital torticollis is higher in females than in males. (author)

Elementary affine $lambda$-calculus with multithreading and side effects

OpenAIRE

Madet, Antoine; Amadio, Roberto M.

2011-01-01

Linear logic provides a framework to control the complexity of higher-order functional programs. We present an extension of this framework to programs with multithreading and side effects focusing on the case of elementary time. Our main contributions are as follows. First, we provide a new combinatorial proof of termination in elementary time for the functional case. Second, we develop an extension of the approach to a call-by-value $lambda$-calculus with multithreading and side effects. Thi...

Classification of gap flow regimes in two side-by-side circular cylinders

CSIR Research Space (South Africa)

Atkins, M

2014-02-01

Full Text Available The behavior of the flow around two circular cylinders arranged in a side-by-side configuration strongly depends on the transverse center-to-center gap spacing ratio (T/D) where D is the cylinder diameter. Based on the observed wake structure [13...

Management of Diverticular Disease in Scandinavia.

Science.gov (United States)

Schultz, Johannes K; Yaqub, Sheraz; Øresland, Tom

2016-10-01

Throughout the last century, the incidence of diverticular disease of the colon has increased tremendously in industrialized countries; nevertheless, the management of this condition is still controversial. Although several international guidelines for the management of diverticular disease are based on the same evidence, the recommendations differ greatly, emphasizing the lack of high-quality prospective studies. In Scandinavia, official guidelines for the management of diverticular disease exist only in Denmark. However, the treatment policies are quite similar in all Scandinavian countries. Computed tomography is the first choice for imaging of acute diverticulitis and its complications. Furthermore, the use of antibiotics in uncomplicated diverticulitis is nearly abandoned in Scandinavia, whereas several international guidelines still recommend their use. There is a broad consensus that abscesses secondary to acute diverticulitis can safely be managed with percutaneous drainage, which is in line with international recommendations. The surgical management of perforated diverticulitis with peritonitis is still as controversial in Scandinavia as elsewhere. Common surgical options are laparoscopic peritoneal lavage, primary resection with anastomosis, and primary resection with terminal colostomy (Hartmann's procedure). Elective sigmoid resection in patients with diverticular disease seems to be performed less frequently in Scandinavia than in other European countries; the right indications are a current matter of debate. Symptomatic uncomplicated diverticular disease in the absence of diverticulitis has not gained great attention in Scandinavia.

A Smart Grid Framework for Optimally Integrating Supply-Side, Demand-Side and Transmission Line Management Systems

Directory of Open Access Journals (Sweden)

Chukwuka Monyei

2018-04-01

Full Text Available A coordinated centralized energy management system (ConCEMS is presented in this paper that seeks to integrate for optimal grid operation—the supply side energy management system (SSEMS, home energy management system (HEMS and transmission line management system (TLMS. ConCEMS in ensuring the optimal operation of an IEEE 30-bus electricity network harmonizes the individual objective function of SSEMS, HEMS and TLMS to evolve an optimal dispatch of participating demand response (DR loads that does not violate transmission line ampacity limits (TLMS constraint while minimizing consumer cost (HEMS constraint and supply side operations cost (SSEMS constraint. An externally constrained genetic algorithm (ExC-GA that is influenced by feedback from TLMS is also presented that intelligently varies the dispatch time of participating DR loads to meet the individual objective functions. Hypothetical day ahead dynamic pricing schemes (Price1, Price2 and Price3 have also been adopted alongside an existing time of use (Price0 pricing scheme for comparison and discussion while a dynamic thermal line rating (DTLR algorithm has also been incorporated to dynamically compute power limits based on real time associated data.

Structural and electronic properties of free standing one-sided and two-sided hydrogenated silicene: A first principle study

International Nuclear Information System (INIS)

Mohan, Brij; Kumar, Ashok; Ahluwalia, P. K.

2014-01-01

We performed first-principle study of the structural and electronic properties of two-dimensional hydrogenated silicene for two configurations; one is hydrogenation along one side of silicene sheet and second is hydrogenation in both sides of silicene sheet. The one-side hydrogenated silicene is found stable at planar geometry while increased buckling of 0.725 Å is found for both-side hydrogenated silicene. The result shows that the hydrogenation occupy the extended π-bonding network of silicene, and thus it exhibits semi-conducting behaviour with a band gap of 1.77 eV and 2.19 eV for one-side hydrogenated silicene and both-side hydrogenated silicene respectively. However, both-side hydrogenated silicene of binding energy 4.56 eV is more stable than one-side hydrogenated silicene of binding energy 4.30 eV, but experimentally silicene is synthesized on substrates which interacts one side of silicene layer and only other side is available for H-atoms. Therefore, practically one-side hydrogenation is also important

The past, present, and future of U.S. utility demand-side management programs

International Nuclear Information System (INIS)

Eto, J.

1996-12-01

Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers' energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests

The past, present, and future of U.S. utility demand-side management programs

Energy Technology Data Exchange (ETDEWEB)

Eto, J. [Lawrence Berkeley National Lab., CA (United States). Environmental Energy Technologies Div.

1996-12-01

Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers` energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests.

Right-sided aortic arch with Kommerell′s aneurysm

Directory of Open Access Journals (Sweden)

Sanjay Orathi Patangi

2014-01-01

Full Text Available We present a case report of a 55-year-old lady who presented with progressive dysphagia and was diagnosed with a Kommerell′s aneurysm and a right-sided aortic arch. This case report outlines our management strategy and the challenges encountered during the perioperative period in a patient with this rare anomaly.

Stabilization of Gob-Side Entry with an Artificial Side for Sustaining Mining Work

Directory of Open Access Journals (Sweden)

Hong-sheng Wang

2016-07-01

Full Text Available A concrete artificial side (AS is introduced to stabilize a gob-side entry (GSE. To evaluate the stability of the AS, a uniaxial compression failure experiment was conducted with large and small-scale specimens. The distribution characteristics of the shear stress were obtained from a numerical simulation. Based on the failure characteristics and the variation of the shear stress, a failure criterion was determined and implemented in the strengthening method for the artificial side. In an experimental test, the distribution pattern of the maximum shear stress showed an X shape, which contributed to the failure shape of the specimen. The shear stress distribution and failure shape are induced by a combination of two sets of shear stresses, which implies that failure of the AS follows the twin shear strength theory. The use of anchor bolts, bolts, and anchor bars enhances the shear strength of the artificial side. When this side is stable, the components can constrain the lateral deformation as well as improve the internal friction angle and cohesion. When the AS is damaged, the components prevent the sliding of broken blocks along the shear failure plane and improve the residual strength of the artificial side. When reinforced with an anchor bar, the AS is still stable even after mining operations for three years.

Quasi-resonant converter with divided resonant capacitor on primary and secondary side

OpenAIRE

Shiroyama, Hironobu; Matsuo, Hirofumi; Ishizuka, Yoichi

2009-01-01

This paper presents a quasi-resonant converter with divided resonant capacitor on primary and secondary side of the isolation transformer. A conventional quasi-resonant converter using flyback topology can realize soft switching with simple circuit. However, relatively large surge voltage is generated in the switching device. To suppress such surge voltage, resonant capacitor is divided on primary side and secondary side in the proposed converter. In case of prototype 95W converter, the volta...

A rare cause of acute abdomen: jejunal diverticulosis with perforation.

Science.gov (United States)

Aydin, Ibrahim; Pergel, Ahmet; Yucel, Ahmet Fikret; Sahin, Dursun Ali

2013-01-01

Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

Integrated double-sided silicon microstrip detectors

Directory of Open Access Journals (Sweden)

Perevertailo V. L.

2011-11-01

Full Text Available The problems of design, technology and manufacturing double-sided silicon microstrip detectors using standard equipment production line in mass production of silicon integrated circuits are considered. The design of prototype high-energy particles detector for experiment ALICE (CERN is presented. The parameters of fabricated detectors are comparable with those of similar foreign detectors, but they are distinguished by lesser cost.

Side effects of sugammadex use in pediatric patients

Directory of Open Access Journals (Sweden)

Sinem Sarı

2013-09-01

Full Text Available Objective: It is accepted that sugammadex show its effectsmore rapidly than the other neuromuscular block antagonistsin many studies, however especially in pediatriccases, it is seen that about its reliability and side effectsare limited in some studies. In our retrospective study,we aimed to present our experiences on sugammadexin terms of its side effects in the pediatric cases in ourhospital for a 1-year period.Methods: The patient files and intraoperative anesthesiarecords, postoperative 24th hour and after postoperative24th hour of the cases that underwent the application ofsugammadex under general anesthesia in pediatric surgeryoperating room in a 1-year period were analyzed.Results: Totally 46 patients received sugammadex; infants(28 days-23 months (n=24, children (2 years-11years (n=16 and adolescent (11-17 years (n=6. Noneof the patients showed hypersensitivity and statisticallysignificant side effects correlated to sugammadex.Conclusion: We think that sugammadex may open newdoors in pediatric patient group with its features. However,more documentation is needed about the safety inpediatric patient group, particularly in infants. J Clin ExpInvest 2013; 4 (3: 265-268Key words: Sugammadex, pediatric patient, side effect

Lift on side by side intruders of various geometries within a granular flow

Science.gov (United States)

Acevedo-Escalante, M. F.; Caballero-Robledo, G. A.

2017-06-01

Obstacles within fluids have been widely used in engineering and in physics to study hydrodynamic interactions. In granular matter, objects within a granular flow have helped to understand fundamental features of drag and lift forces. In our group, we have studied numerically the flow mediated interaction between two static disks within a vertical granular flow in a two-dimensional container where the flow velocity and the distance between obstacles were varied. Attractive and repulsive forces were found depending on flow velocity and separation between intruders. The simulations evidenced a relationship between the average flow velocity in a specific section ahead of the obstacles and the attractive-repulsive lift. On the other hand, it was showed that the lift force on an object dragged within a granular medium depends on the shape of the intruder. Here we present experimental results of the interaction between two side-by-side intruders of different shapes within a vertical granular flow. We built a quasi-two-dimensional container in which we placed the intruders and using load cells we measured lift and drag forces during the discharge process for different flow velocities.

Mean size estimation yields left-side bias: Role of attention on perceptual averaging.

Science.gov (United States)

Li, Kuei-An; Yeh, Su-Ling

2017-11-01

The human visual system can estimate mean size of a set of items effectively; however, little is known about whether information on each visual field contributes equally to the mean size estimation. In this study, we examined whether a left-side bias (LSB)-perceptual judgment tends to depend more heavily on left visual field's inputs-affects mean size estimation. Participants were instructed to estimate the mean size of 16 spots. In half of the trials, the mean size of the spots on the left side was larger than that on the right side (the left-larger condition) and vice versa (the right-larger condition). Our results illustrated an LSB: A larger estimated mean size was found in the left-larger condition than in the right-larger condition (Experiment 1), and the LSB vanished when participants' attention was effectively cued to the right side (Experiment 2b). Furthermore, the magnitude of LSB increased with stimulus-onset asynchrony (SOA), when spots on the left side were presented earlier than the right side. In contrast, the LSB vanished and then induced a reversed effect with SOA when spots on the right side were presented earlier (Experiment 3). This study offers the first piece of evidence suggesting that LSB does have a significant influence on mean size estimation of a group of items, which is induced by a leftward attentional bias that enhances the prior entry effect on the left side.

Assessment of utility side financial benefits of demand side management considering environmental impacts

Science.gov (United States)

Abeygunawardane, Saranga Kumudu

2018-02-01

Any electrical utility prefers to implement demand side management and change the shape of the demand curve in a beneficial manner. This paper aims to assess the financial gains (or losses) to the generating sector through the implementation of demand side management programs. An optimization algorithm is developed to find the optimal generation mix that minimizes the daily total generating cost. This daily total generating cost includes the daily generating cost as well as the environmental damage cost. The proposed optimization algorithm is used to find the daily total generating cost for the base case and for several demand side management programs using the data obtained from the Sri Lankan power system. Results obtained for DSM programs are compared with the results obtained for the base case to assess the financial benefits of demand side management to the generating sector.

Side effects of cancer therapies. International classification and documentation systems

International Nuclear Information System (INIS)

Seegenschmiedt, M.H.

1998-01-01

The publication presents and explains verified, international classification and documentation systems for side effects induced by cancer treatments, applicable in general and clinical practice and clinical research, and covers in a clearly arranged manner the whole range of treatments, including acute and chronic side effects of chemotherapy and radiotherapy, surgery, or combined therapies. The book fills a long-felt need in tumor documentation and is a major contribution to quality assurance in clinical oncology in German-speaking countries. As most parts of the book are bilingual, presenting German and English texts and terminology, it satisfies the principles of interdisciplinarity and internationality. The tabulated form chosen for presentation of classification systems and criteria facilitate the user's approach as well as application in daily work. (orig./CB) [de

49 CFR 229.69 - Side bearings.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Side bearings. 229.69 Section 229.69....69 Side bearings. (a) Friction side bearings with springs designed to carry weight may not have more than 25 percent of the springs in any one nest broken. (b) Friction side bearings may not be run in...

Modeling and experimental studies of a side band power re-injection locked magnetron

Science.gov (United States)

Ye, Wen-Jun; Zhang, Yi; Yuan, Ping; Zhu, Hua-Cheng; Huang, Ka-Ma; Yang, Yang

2016-12-01

A side band power re-injection locked (SBPRIL) magnetron is presented in this paper. A tuning stub is placed between the external injection locked (EIL) magnetron and the circulator. Side band power of the EIL magnetron is reflected back to the magnetron. The reflected side band power is reused and pulled back to the central frequency. A phase-locking model is developed from circuit theory to explain the process of reuse of side band power in SBPRIL magnetron. Theoretical analysis proves that the side band power is pulled back to the central frequency of the SBPRIL magnetron, then the amplitude of the RF voltage increases and the phase noise performance is improved. Particle-in-cell (PIC) simulation of a 10-vane continuous wave (CW) magnetron model is presented. Computer simulation predicts that the frequency spectrum’s peak of the SBPRIL magnetron has an increase of 3.25 dB compared with the free running magnetron. The phase noise performance at the side band offset reduces 12.05 dB for the SBPRIL magnetron. Besides, the SBPRIL magnetron experiment is presented. Experimental results show that the spectrum peak rises by 14.29% for SBPRIL magnetron compared with the free running magnetron. The phase noise reduces more than 25 dB at 45-kHz offset compared with the free running magnetron. Project supported by the National Basic Research Program of China (Grant No. 2013CB328902) and the National Natural Science Foundation of China (Grant No. 61501311).

A rare localization in right-sided endocarditis diagnosed by echocardiography: A case report

Directory of Open Access Journals (Sweden)

Beaufils Philippe

2003-08-01

Full Text Available Abstract Background Right-sided endocarditis occurs predominantly in intravenous drug users, patients with pacemakers or central venous lines and with congenital heart diseases. The vast majority of cases involve the tricuspid valve. Case presentation A case of a 31-year-old woman with intravenous drug abuse who had a right-sided vegetation attached to the muscular bundle of the right ventricle is presented. Transthoracic echocardiography revealed a vegetation in the right ventricular outflow tract. Transesophageal echocardiography clearly showed that the 1.8 cm vegetation was not adherent to the pulmonary valve but attached to a muscular bundle. Conclusions Our case points to an unusual location of right-sided endocarditis in intravenous drug users. It confirms that TTE remains an easy and highly sensitive first-line examination for the diagnosis of right-sided endocarditis.

Gastric diverticulosis and ulcerations in bitches | Abidoye | Sokoto ...

African Journals Online (AJOL)

Two bitches were presented to the Small Animal Clinic Unit of the Ahmadu Bello University Veterinary Teaching Hospital Zaria, Nigeria with clinical manifestation suggestive of gastric diverticulous and ulcer. The cases were confirmed through contrast radiography (using barium meal), hemogram, and ultrasonography.

A Rare Cause of Acute Abdomen: Jejunal Diverticulosis with Perforation

Directory of Open Access Journals (Sweden)

Ibrahim Aydin

2013-01-01

Full Text Available Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

Preservation of bursal-sided tendon in partial-thickness articular-sided rotator cuff tears: a novel arthroscopic transtendon anatomic repair technique.

Science.gov (United States)

Shin, Sang-Jin; Jeong, Jae-Hoon; Jeon, Yoon Sang; Kim, Rag Gyu

2016-12-01

The purpose of this study was to introduce a novel arthroscopic transtendon anatomic repair technique that spares the intact bursal-sided tendon in articular-sided partial-thickness rotator cuff tears (PTRCT) and to present shoulder functional outcomes in patients with symptomatic articular-sided PCRCT that involves more than 50 % of its thickness after arthroscopic repair using a novel technique. Eighteen patients with symptomatic articular-sided PCRCT involving more than 50 % of the tendon's thickness underwent arthroscopic repair using a devised technique. The devised technique restores only the torn articular portion of the rotator cuff at the anatomical footprint using a suture anchor, and preserves the integrity of the corresponding bursal-sided tendon by tying knots at the most lateral bursal side on the subacromial space. Clinical and functional outcome using ASES and Constant scores were evaluated. The structural integrity of the rotator cuff was evaluated by MRI at 6 months postoperatively. Pain relief and shoulder functional outcomes were encouraging during the recovery phase after operation. ASES (preoperative 54.0 ± 10.3 to postoperative 92.6 ± 8.0), Constant score (61.2 ± 8.5-88.0 ± 5.3), VAS for pain (4.9 ± 2.6-0.6 ± 0.7) improved significantly after arthroscopic transtendon anatomic repair (p rotator cuff retears on 6-month MRI. No complications related to surgical procedures had occurred. The devised technique of arthroscopic transtendon repair provided satisfactory functional outcomes without postoperative discomforts. This technique minimizes over-tightening of the articular layer and reduces tension mismatches between the articular and bursal layers, which are considered as important factors for improvement of postoperative shoulder motion.

Surgical complications of Meckel\\'s diverticulae: a review of seven ...

African Journals Online (AJOL)

Out of the seven cases of Meckel\\'s diverticulae, six presented as surgical emergencies. There were three cases of diverticulitis, two of intestinal obstruction due to bands, and one case formed the apex of an intussusception, which presented as an appendix mass. There were no cases of gastro-intestinal bleeding, fistulae, ...

A disappearing left-sided neck mass.

Science.gov (United States)

Lutwak, Nancy; Dill, Curt

2012-07-04

The patient was a 48-year-old man who presented to the emergency department with complaints of a left-sided painful neck mass, which changed in size relative to ingestion of meals. He denied voice change, fever, chills, weight loss, dysphagia and hoarseness. Physical examination was unremarkable. CT scan demonstrated a 3.9 mm calculus of the submandibular gland duct. Therapeutic sialendocopy was successfully performed.

Side core lifter

Energy Technology Data Exchange (ETDEWEB)

Edelman, Ya A

1982-01-01

A side core lifter is proposed which contains a housing with guide slits and a removable core lifter with side projections on the support section connected to the core receiver. In order to preserve the structure of the rock in the core sample by means of guaranteeing rectilinear movement of the core lifter in the rock, the support and core receiver sections are hinged. The device is equipped with a spring for angular shift in the core-reception part.

[Morphological features of utilization intraperitoneal double-sided prostheses in inguinoplasty in dogs].

Science.gov (United States)

de Andrade, Luiz Carlos; Ceneviva, Reginaldo; Coutinho-Netto, Joaquim; Silva Júnior, Orlando de Castro e; dos Santos, José Sebastião; Sukeda, Daniel Hirochi

2009-10-01

To asses the morphological features of the behavior of a double-sided prostheses using inguinoplasty laparotomy in dogs with latex side turned to the visceras. Twenty dogs were divided into two groups of 10 and submitted into infraumbilical laparotomy with double-sided prostheses fixed in an inguinal area and in the other side area a control prostheses of polipropilene (PPL). Macroscopics itens were studied on the 14th and 28th day post-operatory, and they were related to obstruction and intestinal fistulas, encystation, fusion and especially sticker. The microscopic analysis covered the inflammatory process in its acute, chronic and restored phase Infectious process, obstruction or intestinal fistula did not happen. The prostheses presented good accommodation and incorporation. The stickers happened with more prevalent and intensity with the PPL (p0,05). The double-sided prostheses in its parietal side adds the advantages of the incorporation's potential to the noticed material with PPL to the biocompatibility from the latex in its visceral side. The little distance between the PPL disc and the edge of the double-sided prostheses (2 cm) allied to its sticking with just five staples is not enough to avoid gaps, through which the epíploon migrated towards to the inflammatory process provoked by PPL in the parietal side.

The evaluation-mediation hypothesis: does the specification of potential side effects influence the perceived risk of medication?

International Nuclear Information System (INIS)

Reimer, T.

1998-01-01

Full text of publication follows: starting from the assumptions of support theory, this project analyzed the extent to which the specification of potential side effects influences the perceived risk associated, with a particular medication. Respondents were presented with an instruction leaflet for a medication which indicated (a) the overall probability that a side effect will occur or (b) the probability of occurrence of several specific side effects. Support theory predicts that the cognitive availability of potential side effects and therefore the perceived risk increases as a function of the specificity with which the side effects are presented. In contrast the evaluation-mediation hypothesis predicts that a more detailed presentation of potential side effects enhances the perceived quality of the information leaflet and thereby leads to a reduction of perceived risk. Support for the evaluation-mediation hypothesis was found in a series of studies which included the editing hypothesis and the elaboration likelihood model as additional explanations: the more detailed the information about potential side effects, the lower the estimated risk of suffering a side effect on taking the medication. As predicted, the influence of presentation specificity on perceived risk was mediated almost exclusively by the perceived quality of the information leaflet. A current series of studies seeks to support the evaluation-mediation hypothesis in a completely different domain, the perceived risk of environmental pollution by motor vehicles. (author)

Theoretical predictions for side-chain liquid-crystal polymers and comparison to experiment

International Nuclear Information System (INIS)

Dowell, F.

1988-01-01

This paper presents results from a new unique microscopic molecular theory for side-chain liquid-crystalline polymers (LCPs) in the nematic (N) and multiple smectic-A (SA) LC phases and the isotropic (I) liquid phase. There are no ad hoc or arbitrarily adjustable parameters in this theory. The agreement between the theoretical and experimental values for various properties (including transition temperatures and quadratic characteristic radii) is very good (relative deviations between 0% and less than 6.2%). The theoretical results also show--for the first time--that the N and I phases for these LCPs involve the packing of plate-like sections of backbones and side chains and that the local bilayer SA phase involves packing of side-chains within a plate-like section. This type of packing is predicted to be typical for side-chain LCPs. This theory can predict--for the first time--whether the side chains of a molecule pack on the same or alternating opposite sides of the backbone and whether side chains on different molecules interdigitate (overlap) with each other. 13 refs., 1 fig., 4 tabs

[Psychoanalysis and Side Effect].

Science.gov (United States)

Shirahase, Joichiro

2015-01-01

A study of psychoanalysis from the perspective of side effects reveals that its history was a succession of measures to deal with its own side effects. This, however, does not merely suggest that, as a treatment method, psychoanalysis is incomplete and weak: rather, its history is a record of the growth and development of psychoanalysis that discovered therapeutic significance from phenomena that were initially regarded as side effects, made use of these discoveries, and elaborated them as a treatment method. The approach of research seen during the course of these developments is linked to the basic therapeutic approach of psychoanalysis. A therapist therefore does not draw conclusions about a patient's words and behaviors from a single aspect, but continues to make efforts to actively discover a variety of meanings and values from them, and to make the patient's life richer and more productive. This therapeutic approach is undoubtedly one of the unique aspects of psychoanalysis. I discuss the issue of psychoanalysis and side effects with the aim of clarifying this unique characteristic of psychoanalysis. The phenomenon called resistance inevitably emerges during the process of psychoanalytic treatment. Resistance can not only obstruct the progress of therapy; it also carries the risk of causing a variety of disadvantages to the patient. It can therefore be seen as an adverse effect. However, if we re-examine this phenomenon from the perspective of transference, we find that resistance is in fact a crucial tool in psychoanalysis, and included in its main effect, rather than a side effect. From the perspective of minimizing the character of resistance as a side effect and maximizing its character as a main effect, I have reviewed logical organization, dynamic evaluation, the structuring of treatment, the therapist's attitudes, and the training of therapists. I conclude by stating that psychoanalysis has aspects that do not match the perspective known as a side

The study of CD side to side error in line/space pattern caused by post-exposure bake effect

Science.gov (United States)

Huang, Jin; Guo, Eric; Ge, Haiming; Lu, Max; Wu, Yijun; Tian, Mingjing; Yan, Shichuan; Wang, Ran

2016-10-01

In semiconductor manufacturing, as the design rule has decreased, the ITRS roadmap requires crucial tighter critical dimension (CD) control. CD uniformity is one of the necessary parameters to assure good performance and reliable functionality of any integrated circuit (IC) [1] [2], and towards the advanced technology nodes, it is a challenge to control CD uniformity well. The study of corresponding CD Uniformity by tuning Post-Exposure bake (PEB) and develop process has some significant progress[3], but CD side to side error happening to some line/space pattern are still found in practical application, and the error has approached to over the uniformity tolerance. After details analysis, even though use several developer types, the CD side to side error has not been found significant relationship to the developing. In addition, it is impossible to correct the CD side to side error by electron beam correction as such error does not appear in all Line/Space pattern masks. In this paper the root cause of CD side to side error is analyzed and the PEB module process are optimized as a main factor for improvement of CD side to side error.

An Evaluation of One-Sided and Two-Sided Communication Paradigms on Relaxed-Ordering Interconnect

Energy Technology Data Exchange (ETDEWEB)

Ibrahim, Khaled Z. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hargrove, Paul H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Iancu, Costin [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Yelick, Katherine [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2014-08-14

The Cray Gemini interconnect hardware provides multiple transfer mechanisms and out-of-order message delivery to improve communication throughput. In this paper we quantify the performance of one-sided and two-sided communication paradigms with respect to: 1) the optimal available hardware transfer mechanism, 2) message ordering constraints, 3) per node and per core message concurrency. In addition to using Cray native communication APIs, we use UPC and MPI micro-benchmarks to capture one- and two-sided semantics respectively. Our results indicate that relaxing the message delivery order can improve performance up to 4.6x when compared with strict ordering. When hardware allows it, high-level one-sided programming models can already take advantage of message reordering. Enforcing the ordering semantics of two-sided communication comes with a performance penalty. Furthermore, we argue that exposing out-of-order delivery at the application level is required for the next-generation programming models. Any ordering constraints in the language specifications reduce communication performance for small messages and increase the number of active cores required for peak throughput.

Number and location of drainage catheter side holes: in vitro evaluation.

Science.gov (United States)

Ballard, D H; Alexander, J S; Weisman, J A; Orchard, M A; Williams, J T; D'Agostino, H B

2015-09-01

To evaluate the influence of number and location of catheter shaft side holes regarding drainage efficiency in an in vitro model. Three different drainage catheter models were constructed: open-ended model with no side holes (one catheter), unilateral side hole model (six catheters with one to six unilateral side holes), and bilateral side hole model (six catheters with one to six bilateral side holes). Catheters were inserted into a drainage output-measuring device with a constant-pressure reservoir of water. The volume of water evacuated by each of the catheters at 10-second intervals was measured. A total of five trials were performed for each catheter. Data were analysed using one-way analysis of variance. The open-ended catheter had a mean drainage volume comparable to the unilateral model catheters with three, four, and five side holes. Unilateral model catheters had significant drainage volume increases up to three side holes; unilateral model catheters with more than three side holes had no significant improvement in drainage volume. All bilateral model catheters had significantly higher mean drainage volumes than their unilateral counterparts. There was no significant difference between the mean drainage volume with one, two, or three pairs of bilateral side holes. Further, there was no drainage improvement by adding additional bilateral side holes. The present in vitro study suggests that beyond a critical side hole number threshold, adding more distal side holes does not improve catheter drainage efficiency. These results may be used to enhance catheter design towards improving their drainage efficiency. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Metabolic Side Effects of Lithium

Directory of Open Access Journals (Sweden)

M. Cagdas Eker

2010-04-01

Full Text Available Lithium is an alkaline ion being used since 19th century. After its widespread use in psychiatric disorders, observed side effects caused skepticism about its therapeutic efficacy. Despite several disadvantages, lithium is one of the indispensible drugs used in affective disorders, especially in bipolar disorder. It became a necessity for physicians to recognize its side effects since lithium is still accepted as a gold standard in the treatment of bipolar disorder. Adverse effects of chronic administration of lithium on several organ systems are widely known. In this article metabolic effects of lithium on thyroid and parathyroid glands, body mass index and kidneys will be discussed along with their mechanisms, clinical findings, possible risk factors and treatment. One of the most common side effect of lithium is hypothyroidism. It has the same clinical and biochemical properties as primary hypothyroidism and observed as subclinical hypothyroidism in the first place. Hypothyroidism, even its subclinical form, may be associated with non-response or inadequate response and is indicated as a risk factor for development of rapid cycling bipolar disorder. Therefore, hypothyroidism should be screened no matter how severe it is and should be treated with thyroid hormone in the presence of clinical hypothyroidism. Weight gain due to lithium administration disturbs the compliance to treatment and negatively affects the course of the illness. Increased risk for diabetes, hypertension, ischemic heart disease and stroke because of weight gain constitute other centers of problem. Indeed, it is of importance to determine the risk factors before treatment, to follow up the weight, to re-organize nutritional habits and to schedule exercises. Another frequent problematic side effect of lithium treatment is renal dysfunction which clinically present as nephrogenic diabetes insipidus with the common symptoms of polyuria and polydipsia. Nephrogenic diabetes

The electric energy demand-side planning: necessity and possibilities of execution

International Nuclear Information System (INIS)

Sposito, E.S.

1991-05-01

Aiming at reducing the level of investments, is presented a demand-side planning approach, divided into two parts. The first part is an analysis on the actual need of our demand-side approaching. In view of this, is showed a set of data and comments both on economic and technological aspects concerning the electric network and sector, as well as evaluation of the social, ecological and financial aspects which could act against the full expansion of the electric system. In the second part, a demand-side planning methodology is introduced, as well as its main concepts, its variables and its instruments of affecting the demand: energy conservation, replacement of sources, reduction of losses and electric power decentralized generation. Each of them is fully detailed in a set of planning policies and actions. Concluding is presented the basic elements of a National Electric Energy Substitution and Conservation Plan - PLANSCON. (author)

Client-side Skype forensics: an overview

Science.gov (United States)

Meißner, Tina; Kröger, Knut; Creutzburg, Reiner

2013-03-01

IT security and computer forensics are important components in the information technology. In the present study, a client-side Skype forensics is performed. It is designed to explain which kind of user data are stored on a computer and which tools allow the extraction of those data for a forensic investigation. There are described both methods - a manual analysis and an analysis with (mainly) open source tools, respectively.

Side-emitting fiber optic position sensor

Science.gov (United States)

Weiss, Jonathan D [Albuquerque, NM

2008-02-12

A side-emitting fiber optic position sensor and method of determining an unknown position of an object by using the sensor. In one embodiment, a concentrated beam of light source illuminates the side of a side-emitting fiber optic at an unknown axial position along the fiber's length. Some of this side-illuminated light is in-scattered into the fiber and captured. As the captured light is guided down the fiber, its intensity decreases due to loss from side-emission away from the fiber and from bulk absorption within the fiber. By measuring the intensity of light emitted from one (or both) ends of the fiber with a photodetector(s), the axial position of the light source is determined by comparing the photodetector's signal to a calibrated response curve, look-up table, or by using a mathematical model. Alternatively, the side-emitting fiber is illuminated at one end, while a photodetector measures the intensity of light emitted from the side of the fiber, at an unknown position. As the photodetector moves further away from the illuminated end, the detector's signal strength decreases due to loss from side-emission and/or bulk absorption. As before, the detector's signal is correlated to a unique position along the fiber.

Truck side guard specifications : recommended standard

Science.gov (United States)

2016-09-01

This document is intended to be used by (1) public or private medium/heavy-duty truck fleets considering adding side guards; (2) jurisdictions or customers that require side guards through policy or procurement; (3) manufacturers of side guards; and ...

Warfarin Side Effects: Watch for Interactions

Science.gov (United States)

Warfarin side effects: Watch for interactions Although commonly used to treat blood clots, warfarin (Coumadin, Jantoven) can have dangerous side effects or ... bleeding. Here are precautions to take to avoid warfarin side effects. By Mayo Clinic Staff If you' ...

Flapping modes of three filaments placed side by side in a free stream

Science.gov (United States)

Tian, Fang-Bao; Luo, Haoxiang; Zhu, Luoding; Lu, Xi-Yun

2010-11-01

Flexible filaments flapping in a surrounding flow are useful models for understanding the flow-induced vibration and mimicking the schooling behavior of fish. In the present work, the coupled modes of three identical filaments in a side-by- side arrangement are studied using the linear stability analysis and also an immersed boundary--lattice Boltzmann method for low Reynolds numbers (Re on order of 100). The numerical simulations show that the system dynamics exhibits several patterns that depend on the spacing between the filaments. Among these patterns, three can be predicted by the linear analysis and have been reported before. These modes are: (1) the three filaments all flap in phase; (2) the two outer filaments are out of phase while the middle one is stable; (3) the two outer filaments are in phase while the middle one is out of phase. The simulations also identified two additional modes: (1) the outer two filaments are out of phase while the middle one flaps at a frequency reduced by half; (2) the outer two filaments are out of phase while the middle one flaps at a slightly different frequency. In addition to the vibratory modes, the drag force and the flapping amplitude are also computed, and the implication of the result will be discussed.

Factors effecting paint performance on wood siding

Science.gov (United States)

Christopher G. Hunt; R. Sam Williams; Mark Knaebe; Peter Sotos; Steven Lacher

2009-01-01

Several different studies are compared to assess the effectiveness of commercial water repellent preservatives (WRP’s) in the late 1990’s on vertical and horizontal siding. Besides WRP, variables included wood species, exposure location (Wisconsin or Mississippi), and solid color stain vs. primer + paint. Data on substrate checking and paint flaking are presented....

Side insertable spacer

International Nuclear Information System (INIS)

Patterson, J.F.; Ewing, R.H.

1992-01-01

This patent describes a spacer for restraining the fuel rods of a nuclear fuel assembly, the assembly being formed of a plurality of parallel, elongated fuel rods so arranged that the assembly is bounded by a polygon having an even number of sides, the rods being so arranged as to lie in a plurality of sets of parallel rows, the rows of each set being perpendicular to one of the sides of the polygon. It comprises a number of spacer combs equal to at least half the number of the sides of the polygon, the spacer combs being superposed on each other, each of the spacer combs comprising: a single base strip having a length equal to that of one of the sides of the polygon and grid strips equal in number to the spaces between rows in one of the sets, and at least a majority of the grid strips being of a length sufficient to extend substantially the full length of the rows; the grid strips being provided with spring members positioned to engage each of the rods; the grid strips being provided with spring members positioned to engage each of the rods; the grid strips being secured to and extending at right angles to the base strip; the grid strips of different combs being positioned at angles to each other, so as to occupy the spaces between rows in different sets

Simultaneous Primary Hodgkin's Lymphoma of the Sigmoid Colon and Papillary Thyroid Carcinoma in an HIV-Positive Patient.

Science.gov (United States)

Liszewski, Walter; Sittig, Mark; Kandil, Emad; Van Sickels, Nicholas; Safah, Hana

2015-01-01

Primary Hodgkin's lymphoma of the colon is a rare phenomenon previously only reported in patients with chronic diverticulitis or inflammatory bowel disease. Herein we report a case of primary Hodgkin's lymphoma of the sigmoid colon in an HIV-positive patient without a history of inflammatory bowel disease or chronic diverticulitis that was later complicated by the discovery of concurrent papillary thyroid carcinoma.

Functionally Graded Ceramics Fabricated with Side-by-Side Tape Casting for Use in Magnetic Refrigeration

DEFF Research Database (Denmark)

Bulatova, Regina; Bahl, Christian; Andersen, Kjeld Bøhm

2015-01-01

Functionally graded ceramic tapes have been fabricated by a side-by-side tape casting technique. This study shows the possibility and describes the main principles of adjacent coflow of slurries resulting in formation of thin plates of graded ceramic material. Results showed that the small...... variations of solvent and binder system concentrations have a substantial effect on slurry viscosity. Varying these parameters showed that side-by-side tape casting with a well-defined interface area is possible for slurries with viscosities above 3500 mPa s at a casting shear rate of 3.3 s -1...... of developing this graded ceramic tape casting was applications of these specific magnetocaloric properties within the magnetic refrigeration technology....

Numerical study of two side-by-side cylinders with unequal diameters at low Reynolds number

International Nuclear Information System (INIS)

Gao, Y Y; Wang, X K; Tan, S K

2012-01-01

Two-dimensional laminar flow about two side-by-side unequal cylinders with different diameter ratios d/D and centre-to-centre spacing ratios T/D at Re=300 (based on the larger cylinder diameter) was simulated using a CFD software. Comparisons of experimental and numerical results were made to elucidate the degree of interference due to d/D and T/D and their effects on the flow patterns and vortex shedding frequencies. The findings showed that the flow patterns behind two unequal cylinders were distinctly different from that behind two equal side-by-side cylinders, with distinct in-phase and anti-phase vortex shedding, and random switching of modes of vortex shedding.

Percutaneous drainage of diverticular abscess: Adjunct to resection

International Nuclear Information System (INIS)

Mueller, P.R.; Saini, S.; Butch, R.J.; Simeone, J.F.; Rodkey, G.V.; Bousquet, J.C.; Ottinger, L.W.; Wittenberg, J.; Ferrucci, J.T. Jr.

1986-01-01

Traditional surgical management of acute diverticulitis with abscess may require a one-, two-, or three-stage procedure. Because of recent interest in CT diagnosis of diverticulitis, and novel access routes for interventional drainage of deep pelvic abscesses, the authors investigated the potential for converting complex two- and three-stage surgical procedures to simpler, safer one-stage colon resections by percutaneous drainage of the associated abscess. Of 23 patients with acute perforated diverticulitis who were referred for catheter drainage under radiologic guidance, successful catheter drainage and subsequent single-stage colon resection were carried out in 15. In three patients catheter drainage was unsuccessful and a multistage procedure was required. In three patients only percutaneous drainage was performed and operative intervention was omitted entirely

Supply-side and demand-side policies for biosimilars: an overview in 10 European member states.

Science.gov (United States)

Rémuzat, Cécile; Kapuśniak, Anna; Caban, Aleksandra; Ionescu, Dan; Radière, Guerric; Mendoza, Cyril; Toumi, Mondher

2017-01-01

This study aimed to provide an overview of biosimilar policies in 10 EU MSs. Methods : Ten EU MS pharmaceutical markets (Belgium, France, Germany, Greece, Hungary, Italy, Poland, Spain, Sweden, and the UK) were selected. A comprehensive literature review was performed to identify supply-side and demand-side policies in place in the selected countries. Results : Supply-side policies for biosimilars commonly include price linkage, price re-evaluation, and tendering; the use of internal or external reference pricing varies between countries; health technology assessment is conducted in six countries. Regarding demand-side policies, pharmaceutical prescription budgets or quotas and monitoring of prescriptions (with potential financial incentives or penalties) are in place in eight and in seven countries respectively. Switching is generally allowed, but is solely the physician's responsibility. Automatic substitution is not recommended, or even forbidden, in most EU MSs. Prescription conditions or guidelines that apply to biosimilars are established in nearly all surveyed EU MSs. Conclusions : Important heterogeneity in policies on biosimilars was seen between (and even within) selected countries, which may partly explain variations in biosimilar uptake. Supply-side policies targeting price have been reported to limit biosimilar penetration in the long term, despite short-term savings, while demand-side policies are considered to positively impact uptake.

Small Angle Neutron Scattering (sans) Studies on "SIDE-END FIXED" and "SIDE-ON FIXED" Liquid Crystal Polymers

Science.gov (United States)

Hardouin, F.; Noirez, L.; Keller, P.; Leroux, N.; Cotton, J. P.

The following sections are included: * Introduction * Experimental * Results and discussion * Determination of the backbone conformation in the nematic and smectic A phases of "side-end fixed" L.C. polymethacrylates (PMA) or polyacrylates (PA) * Determination of the global and backbone conformation in the nematic and smectic A phases of "side-end fixed" L.C. polysiloxanes (PMS) * Determination of the backbone conformation in the unique nematic phase (without smectic A phase) or in the reentrant nematic phase (below smectic A phase) of "side-end fixed" L.C. polyacrylates (PA) * Determination of the global conformation in the nematic phase of "side-on fixed" L.C. polysiloxanes (PMS) * Determination of the global conformation in the nematic phase of "diluted side-on fixed" L.C. copolysiloxanes * Determination of the backbone conformation in the nematic phase of "side-on fixed" L.C. polyacrylates * Conclusions * References

Gastrointestinal stromal tumor of Meckel's diverticulum: a rare cause of intestinal volvulus.

Science.gov (United States)

Cengız, Fevzi; Sun, Mehmet Ali; Esen, Özgür Sipahi; Erkan, Nazif

2012-08-01

Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. Most cases are asymptomatic; however, when symptomatic, it is often misdiagnosed at presentation. Common complications presenting in adults include bleeding, obstruction, diverticulitis, and perforation. Tumors within a Meckel's diverticulum are rare. Herein, we present a gastrointestinal stromal tumor arising from the Meckel's diverticulum that led to intestinal obstruction by volvulus.

Balancing islanded residential microgrids using demand side management

NARCIS (Netherlands)

Hoogsteen, Gerwin; van der Klauw, Thijs; Molderink, Albert; Hurink, Johann L.; Smit, Gerardus Johannes Maria; Feng, Xianyong; Hebner, Robert E.

2016-01-01

Now that the internet of things is emerging, control of domestic assets within the smart micro grids is also gaining interest. Furthermore, these micro grids may operate in islanded mode for short periods. Various demand side management approaches are presented in literature to control these assets.

Demand side integration aspects in active distribution planning

DEFF Research Database (Denmark)

Silvestro, Federico; Baitch, Alex; Pilo, Fabrizio

2013-01-01

will be implemented in practice? How will regulatory frameworks and connection agreements evolve to support ADSs? The present work provides some information about the closer and closer integration between network planning and Demand Side Integration that is foreseen in the future and shows the necessity to develop...

Diverticulitis Diet

Science.gov (United States)

... Examples of items allowed on a clear liquid diet include: Broth Fruit juices without pulp, such as apple juice Ice chips ... and poultry Refined white bread Fruit and vegetable juice with no ... two or three days of starting the diet and antibiotics. If you haven't started feeling ...

An Unusual Presentation of Right-Sided Sciatica with Foot Drop.

Science.gov (United States)

McCabe, Fergus J; McCabe, John P

2016-01-01

Rarely, sciatica is of extraspinal aetiology. By compressing the sciatic nerve, swelling of the short external rotators of the hip can cause sciatica. Uncommon anatomical relationships between the sciatic nerve and local muscles may potentiate this compressive effect. In this report, we describe the presentation of right sciatica and foot drop resulting from both extreme local constriction and unusual anatomical variation of the right sciatic nerve.

Prediction of methyl-side Chain Dynamics in Proteins

International Nuclear Information System (INIS)

Ming Dengming; Brueschweiler, Rafael

2004-01-01

A simple analytical model is presented for the prediction of methyl-side chain dynamics in comparison with S 2 order parameters obtained by NMR relaxation spectroscopy. The model, which is an extension of the local contact model for backbone order parameter prediction, uses a static 3D protein structure as input. It expresses the methyl-group S 2 order parameters as a function of local contacts of the methyl carbon with respect to the neighboring atoms in combination with the number of consecutive mobile dihedral angles between the methyl group and the protein backbone. For six out of seven proteins the prediction results are good when compared with experimentally determined methyl-group S 2 values with an average correlation coefficient r-bar=0.65±0.14. For the unusually rigid cytochrome c 2 no significant correlation between prediction and experiment is found. The presented model provides independent support for the reliability of current side-chain relaxation methods along with their interpretation by the model-free formalism

Supply-side and demand-side policies for biosimilars: an overview in 10 European member states

OpenAIRE

R?muzat, C?cile; Kapu?niak, Anna; Caban, Aleksandra; Ionescu, Dan; Radi?re, Guerric; Mendoza, Cyril; Toumi, Mondher

2017-01-01

ABSTRACT Objective: This study aimed to provide an overview of biosimilar?policies in 10 EU MSs. Methods: Ten EU MS pharmaceutical markets (Belgium, France, Germany, Greece, Hungary, Italy, Poland, Spain, Sweden, and the UK) were selected. A comprehensive literature review?was performed to identify supply-side and demand-side policies in place in the selected countries. Results: Supply-side policies for biosimilars commonly include price linkage, price re-evaluation, and tendering; the use of...

Biomechanics of side impact: Injury criteria, aging occupants, and airbag technology

OpenAIRE

Yoganandan, Narayan; Pintar, Frank A.; Stemper, Brian D.; Gennarelli, Thomas A.; Weigelt, John A.

2006-01-01

This paper presents a survey of side impact trauma-related biomedical investigations with specific reference to certain aspects of epidemiology relating to the growing elderly population, improvements in technology such as side airbags geared toward occupant safety, and development of injury criteria. The first part is devoted to the involvement of the elderly by identifying variables contributing to injury including impact severity, human factors, and national and international field data. T...

49 CFR 238.217 - Side structure.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Side structure. 238.217 Section 238.217 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Equipment § 238.217 Side structure. Each passenger car shall comply with the following: (a) Side posts and...

Study of side-feeding time for light mass nuclei

International Nuclear Information System (INIS)

Ray, Sudatta; Bisoi, A.; Kshetri, R.; Goswami, A.; Saha Sarkar, M.; Pramanik, D.; Sarkar, S.; Nag, S.; Selva Kumar, K.; Singh, P.; Saha, S.; Sethi, J.; Trivedi, T.; Naidu, B.S.; Donthi, R.; Nanal, V.; Palit, R.

2011-01-01

Precise determination of level lifetime is of utmost importance in nuclear γ-spectroscopy. Doppler Shift Attenuation (DSA) method suitable for measuring sub-pico second lifetimes, involves inclusion of proper correction for side-feeding which is synonymous to unknown feeding of the level under consideration. It is possible to avoid a sidefeeding contribution by gating on Doppler shifted gamma lines above (GTA) the level being studied in the cascade. In the present work, an empirical approach has been adopted to find the dependence of side-feeding times in nuclei in A ≅ 40 region as function of level energies

Vortex interactions in a two side-by-side cylinder near-wake

International Nuclear Information System (INIS)

Wang, Z.J.; Zhou, Y.

2005-01-01

The flow behind two side-by-side circular cylinders is experimentally investigated based on laser-illuminated flow-visualization, particle image velocimetry and hot-wire measurements. The flow is classified as three regimes: single street (the cylinder center-to-center spacing T/d 2.0). Special attention is given to the regime of 1.2 2.0, the flow structure change from the anti-phase to in-phase mode starts with a phase shift between gap vortices. The dynamical role of gap bleeding between cylinders for L/d < 1.2 is also examined

HIV Medicines and Side Effects

Science.gov (United States)

... medicines, talk to your health care provider about possible side effects. Tell your health care provider about your lifestyle and point out any possible side effects that would be especially hard for you to ...

Oral antibiotic treatment of left-sided infectious endocarditis verified by 16S-PCR

DEFF Research Database (Denmark)

Bruun, Louise E; Tønder, Niels; Hansen, Thomas Fritz

2011-01-01

Treatment of infectious endocarditis (IE) comprises intravenously administered antibiotic medications given at high doses for 4-6 weeks--sometimes even longer. Approximately 50% of patients referred to tertiary care centres require additional surgical intervention. At present there are few papers...... describing the effects of oral antibiotic treatment in IE, and only in patients with right-sided endocarditis. In this case report we present a patient with left-sided Streptococcus endocarditis successfully treated with oral antibiotic drugs....

Computer-mediated communication as a channel for social resistance : The strategic side of SIDE

NARCIS (Netherlands)

Spears, R; Lea, M; Corneliussen, RA; Postmes, T; Ter Haar, W

2002-01-01

In two studies, the authors tested predictions derived from the social identity model of deindividuation effects (SIDE) concerning the potential of computer-mediated communication (CMC) to serve as a means to resist powerful out-groups. Earlier research using the SIDE model indicates that the

Probiotics: Safety and Side Effects

Science.gov (United States)

... of this page please turn JavaScript on. Feature: Probiotics Safety and Side Effects Past Issues / Winter 2016 ... Says About the Safety and Side Effects of Probiotics Whether probiotics are likely to be safe for ...

Supply-side and demand-side policies for biosimilars: an overview in 10 European member states

Science.gov (United States)

Rémuzat, Cécile; Kapuśniak, Anna; Caban, Aleksandra; Ionescu, Dan; Radière, Guerric; Mendoza, Cyril; Toumi, Mondher

2017-01-01

ABSTRACT Objective: This study aimed to provide an overview of biosimilar policies in 10 EU MSs. Methods: Ten EU MS pharmaceutical markets (Belgium, France, Germany, Greece, Hungary, Italy, Poland, Spain, Sweden, and the UK) were selected. A comprehensive literature review was performed to identify supply-side and demand-side policies in place in the selected countries. Results: Supply-side policies for biosimilars commonly include price linkage, price re-evaluation, and tendering; the use of internal or external reference pricing varies between countries; health technology assessment is conducted in six countries. Regarding demand-side policies, pharmaceutical prescription budgets or quotas and monitoring of prescriptions (with potential financial incentives or penalties) are in place in eight and in seven countries respectively. Switching is generally allowed, but is solely the physician’s responsibility. Automatic substitution is not recommended, or even forbidden, in most EU MSs. Prescription conditions or guidelines that apply to biosimilars are established in nearly all surveyed EU MSs. Conclusions: Important heterogeneity in policies on biosimilars was seen between (and even within) selected countries, which may partly explain variations in biosimilar uptake. Supply-side policies targeting price have been reported to limit biosimilar penetration in the long term, despite short-term savings, while demand-side policies are considered to positively impact uptake. PMID:28740617

The effect of cyclic rifaximin therapy on symptoms of diverticular disease from the perspective of the gastroenterology outpatient clinic: a "real-life" study.

Science.gov (United States)

Moniuszko, Andrzej; Rydzewska, Grażyna

2017-01-01

Symptomatic uncomplicated diverticular disease of the colon (SUDD) is one of the most common diseases with which patients present to a gastroenterologist. Mild forms of diverticulitis can also be treated using rifaximin. Although numerous randomised controlled trials have already demonstrated the efficacy of rifaximin therapy, there is still a lack of data from daily medical practice. To assess the effect of rifaximin on the symptoms of diverticular disease (SUDD and mild diverticulitis) in patients undergoing routine treatment in gastroenterology outpatient clinics in Poland. The retrospective study included 142 patients with a diagnosis of SUDD and mild diverticulitis, with a mean age of 60-69 years (41%), of whom 65% were women. Patients underwent three cycles of rifaximin therapy at a dose of 2 × 400 mg daily for 7 days over 3 consecutive months. Survey data were collected during monthly clinic appointments using a questionnaire completed by 48 gastroenterologists, and in selected cases standard inflammatory parameters were also determined. After just one cycle of therapy a significant reduction in disease symptoms was observed (abdominal pain, abdominal tenderness, bloating, disturbances in bowel habit), defined over a scale of 0-3 points. The mean intensity of symptoms decreased from 1.7 ±0.7 to 0.8 ±0.3 points (with a maximum symptom intensity of 3.0 points). After three cycles, the severity of symptoms decreased markedly to an average of 0.3 ±0.1, and as many as 75% of patients reported no abdominal pain (previously the percentage was only 4%). These differences were statistically significant, p diverticular disease of the large bowel, and it is also effective in the treatment of mild forms of diverticulitis. Although the effects were already visible after the first cycle of therapy, the highest efficacy was obtained after three cycles of therapy. Rifaximin can be successfully used in routine medical practice.

An Appreciative View of the Brighter Side of Terror Management Processes

OpenAIRE

Kenneth E. Vail, III; Jacob Juhl

2015-01-01

Physical death is an inevitable part of life. From the perspective of terror management theory (TMT), people’s efforts to manage the awareness of death can sometimes have harmful social consequences. However, those negative consequences are merely one side of the existential coin. In considering the other side of the coin, the present article highlights the more beneficial trajectories of the terror management process. For example, the awareness of mortality can motivate people to prioritize ...

Side-by-side comparisons of evacuated compound parabolic concentrator and flat plate solar collector systems at temperatures of 90 to 100C

Science.gov (United States)

Allen, J. W.; Schertz, W. W.; Wantroba, A. S.

1987-03-01

This collector system study is an extension of a previous system study in which Argonne National Laboratory (ANL) compared the performance of three solar energy systems operated side by side for over a year. In the present system study, four solar energy systems were operated side by side for part of a year. Two of the collector systems used commercially available compound parabolic concentrator (CPC) collectors, one used a commercially available flat plate collector, and one used an experimental CPC collector built by The University of Chicago. The collectors were mounted in fixed positions; they did not track the Sun, and their tilt angles were not seasonally adjusted. All of the collector arrays faced south and were tilted at 42 deg with respect to the horizon (to match the 42 deg N latitude at ANL). All four collector systems started each day with their storage temperatures at 90 C. During the day, each system was operated by its own solar controller. At the end of the day, the tanks were mixed and the temperature changes in the tanks were measured. The change in storage energy was calculated from the temperature change, the heat capacity of the storage system, and the pump energy.

Supply-Side Interventions and Student Learning in Guatemala

Science.gov (United States)

Vasquez, William F.

2012-01-01

This paper presents estimates of production functions of reading and mathematics test scores to assess the effects of supply-side interventions, such as the provision of a community-based school management programme, bilingual education and multigrade teaching, on student learning in Guatemala. The efficiency and consistency of the estimates is…

Wrist and Hand Ultrasound: Reliability of Side-to-Side Comparisons of Very Small (Structures.

Science.gov (United States)

Rossi, Federica; Romano, Nicola; Muda, Alessandro; Martinoli, Carlo; Tagliafico, Alberto

2018-04-24

In ultrasound (US) examinations of clinically relevant very small structures of the wrist and hand, the healthy contralateral side can be used as a reference to identify subtle abnormalities. Intraindividual side-to-side variability must be minimal. The aim of this study was to assess the reliability of side-to-side US evaluations of very small structures of the wrist and hand. Forty-one healthy volunteers were prospectively studied. Small structures of the wrist and hand were evaluated bilaterally by 2 musculoskeletal radiologists in separate sessions. The first annular pulleys of the second finger and the thumb, sagittal band of the third finger, extensor and flexor retinacula, ulnar collateral ligament of the thumb, radial collateral ligament of the second finger, and palmar cutaneous branches of the median and ulnar nerves were considered. To assess intra- and inter-reader agreement, 10 of 41 (24%) examinations were repeated. Nonparametric statistics were used. Data were not normally distributed (P > .001). Intra-reader agreement was κ = 0.674 (95% confidence interval [CI], 0.57-0.78), and inter-reader agreement was κ = 0.935 (95% CI, 0.92-0.95). The mean value ± SD for all of the structures was 0.78 ± 0.44 mm. The overall coefficient of variation was 9.8% ± 0.07%. The intraclass correlation coefficient was 0.97 (95% CI, 0.96-0.98). In clinical practice, the healthy contralateral side can be used as a reference during a real-time musculoskeletal US evaluation of small (structures. © 2018 by the American Institute of Ultrasound in Medicine.

Emergency surgery for obstructing colonic cancer: a comparison between right-sided and left-sided lesions.

Science.gov (United States)

Faucheron, J-L; Paquette, B; Trilling, B; Heyd, B; Koch, S; Mantion, G

2018-02-01

Few studies compare management and outcomes of obstructive colonic cancer, depending on the tumor site. We aim to evaluate the differences in patient characteristics, tumor characteristics, and outcomes of emergency surgery for obstructive right-sided versus left-sided colonic cancers. Between 2000 and 2009, 71 consecutive patients had an emergency colectomy following strict and clear definition of obstruction in a single institution. We retrospectively analyzed pre, per, and postoperative data that were prospectively collected. There were 31 and 40 patients in the right and left group, respectively. Patients aged over 80 were more frequent in the right group (p = 0.03). At operation, ileocecal valve was less often competent in the right group (p = 0.03). The one-stage strategy was more frequent in the right group (p = 0.008). Patients in the right group had a higher rate of nodes invasion (p = 0.04). One- and two-year mortality rate in the right group had a tendency to be higher. Patients presenting with a right obstructive colonic cancer are older, have a more advanced locoregional disease, and are more often treated in a one-stage strategy than patients with a left obstructive tumor.

A unified frame of predicting side effects of drugs by using linear neighborhood similarity.

Science.gov (United States)

Zhang, Wen; Yue, Xiang; Liu, Feng; Chen, Yanlin; Tu, Shikui; Zhang, Xining

2017-12-14

Drug side effects are one of main concerns in the drug discovery, which gains wide attentions. Investigating drug side effects is of great importance, and the computational prediction can help to guide wet experiments. As far as we known, a great number of computational methods have been proposed for the side effect predictions. The assumption that similar drugs may induce same side effects is usually employed for modeling, and how to calculate the drug-drug similarity is critical in the side effect predictions. In this paper, we present a novel measure of drug-drug similarity named "linear neighborhood similarity", which is calculated in a drug feature space by exploring linear neighborhood relationship. Then, we transfer the similarity from the feature space into the side effect space, and predict drug side effects by propagating known side effect information through a similarity-based graph. Under a unified frame based on the linear neighborhood similarity, we propose method "LNSM" and its extension "LNSM-SMI" to predict side effects of new drugs, and propose the method "LNSM-MSE" to predict unobserved side effect of approved drugs. We evaluate the performances of LNSM and LNSM-SMI in predicting side effects of new drugs, and evaluate the performances of LNSM-MSE in predicting missing side effects of approved drugs. The results demonstrate that the linear neighborhood similarity can improve the performances of side effect prediction, and the linear neighborhood similarity-based methods can outperform existing side effect prediction methods. More importantly, the proposed methods can predict side effects of new drugs as well as unobserved side effects of approved drugs under a unified frame.

Numerical simulation of side heating for controlling angular ...

Indian Academy of Sciences (India)

In the present study, a 3-D coupled transient thermal analysis model with auxiliary side heating (parallel heating) is developed to control angular distortion. During analysis, parallel heating flames are placed at several locations from weld line in cross direction. A user defined subroutine is used to apply transient heat source ...

Distributed video coding with multiple side information

DEFF Research Database (Denmark)

Huang, Xin; Brites, C.; Ascenso, J.

2009-01-01

Distributed Video Coding (DVC) is a new video coding paradigm which mainly exploits the source statistics at the decoder based on the availability of some decoder side information. The quality of the side information has a major impact on the DVC rate-distortion (RD) performance in the same way...... the quality of the predictions had a major impact in predictive video coding. In this paper, a DVC solution exploiting multiple side information is proposed; the multiple side information is generated by frame interpolation and frame extrapolation targeting to improve the side information of a single...

Children Presenting at the Emergency Department With Right Lower Quadrant Pain

Directory of Open Access Journals (Sweden)

Chien-Heng Lin

2009-01-01

Full Text Available Right lower quadrant (RLQ pain is a common complaint in children presenting at emergency departments. This study analyzed the etiologies of RLQ pain, and compared the clinical presentations, laboratory test results and imaging findings in patients with appendicitis with those in other groups of patients. We also investigated if active observation resulted in delayed diagnosis, to the detriment of patients. Medical records for the period January 2006 to July 2006 were reviewed for children (age < 18 years who presented to the emergency department of one medical center, complaining of RLQ pain. Out of a total of 100 patients (age range: 2–17 years; mean: 11 years, 46 patients presented with only one symptom of RLQ pain, while 32 patients had ≥ 2 associated signs or symptoms, including fever, nausea/vomiting, diarrhea, or rebound tenderness. Imaging studies, including abdominal sonography and/or computed tomography, were performed in 73 patients; 44 underwent surgery for presumed appendicitis and one received surgery for a right paraduodenal hernia. Eleven patients underwent surgery because of peritoneal signs, and eight because of persistent or aggravated RLQ pain. Postoperative pathologic examinations revealed 53 cases of appendicitis, six normal appendices, and other morbidities (1 perforated peptic ulcer, 1 pelvic inflammatory disease, 1 ovarian cyst, 1 diverticulitis, and 1 right paraduodenal hernia. Thirty-three patients were discharged after several hours of observation (range: 0.5–18 hours; mean: 4 hours, and three patients were admitted for further observations. All were discharged without operation. There were significant differences in the incidences of fever (p = 0.004 and rebound tenderness (p = 0.019, and in white cell counts (p < 0.001, neutrophil percentages (p < 0.001, and C-reactive protein levels (p < 0.001 between patients with appendicitis and patients with other causes of RLQ pain. Clinical signs and symptoms, laboratory

Neck injury tolerance under inertial loads in side impacts.

Science.gov (United States)

McIntosh, Andrew S; Kallieris, Dimitrios; Frechede, Bertrand

2007-03-01

Neck injury remains a major issue in road safety. Current side impact dummies and side impact crashworthiness assessments do not assess the risk of neck injury. These assessments are limited by biofidelity and knowledge regarding neck injury criteria and tolerance levels in side impacts. Side impact tests with PMHS were performed at the Heidelberg University in the 1980s and 1990s to improve primarily the understanding of trunk dynamics, injury mechanisms and criteria. In order to contribute to the definition of human tolerances at neck level, this study presents an analysis of the head/neck biomechanical parameters that were measured in these tests and their relationship to neck injury severity. Data from 15 impact tests were analysed. Head accelerations, and neck forces and moments were calculated from 9-accelerometer array head data, X-rays and anthropometric data. Statistically significant relationships were observed between resultant head acceleration and neck force and neck injury severity. The average resultant head acceleration for AIS 2 neck injuries was 112 g, while resultant neck force was 4925 N and moment 241 Nm. The data compared well to other test data on cadavers and volunteers. It is hoped that the paper will assist in the understanding of neck injuries and the development of tolerance criteria.

Social identity performance : Extending the strategic side of SIDE

NARCIS (Netherlands)

Klein, Olivier; Spears, Russell; Reicher, Stephen

This article extends the social identity model of deindividuation effects (SIDE) by considering the various ways in which relations of visibility to an audience can affect the public expression of identity-relevant norms (identity performance). It is suggested that social identity performance can

Sediment sorting at a side channel bifurcation

Science.gov (United States)

van Denderen, Pepijn; Schielen, Ralph; Hulscher, Suzanne

2017-04-01

Side channels have been constructed to reduce the flood risk and to increase the ecological value of the river. In various Dutch side channels large aggradation in these channels occurred after construction. Measurements show that the grain size of the deposited sediment in the side channel is smaller than the grain size found on the bed of the main channel. This suggest that sorting occurs at the bifurcation of the side channel. The objective is to reproduce with a 2D morphological model the fining of the bed in the side channel and to study the effect of the sediment sorting on morphodynamic development of the side channel. We use a 2D Delft3D model with two sediment fractions. The first fraction corresponds with the grain size that can be found on the bed of the main channel and the second fraction corresponds with the grain size found in the side channel. With the numerical model we compute several side channel configurations in which we vary the length and the width of the side channel, and the curvature of the upstream channel. From these computations we can derive the equilibrium state and the time scale of the morphodynamic development of the side channel. Preliminary results show that even when a simple sediment transport relation is used, like Engelund & Hansen, more fine sediment enters the side channel than coarse sediment. This is as expected, and is probably related to the bed slope effects which are a function of the Shields parameter. It is expected that by adding a sill at the entrance of the side channel the slope effect increases. This might reduce the amount of coarse sediment which enters the side channel even more. It is unclear whether the model used is able to reproduce the effect of such a sill correctly as modelling a sill and reproducing the correct hydrodynamic and morphodynamic behaviour is not straightforward in a 2D model. Acknowledgements: This research is funded by STW, part of the Dutch Organization for Scientific Research under

Comparing Demand Side Management approaches

NARCIS (Netherlands)

Molderink, Albert; Bakker, Vincent; Hurink, Johann L.; Smit, Gerardus Johannes Maria

2012-01-01

Due to increasing energy prices and the greenhouse effect, a more efficient energy supply is desirable, preferably based on renewable sources. To cope with the decrease of flexibility due to the introduction of renewables in production side of the supply chain, a more flexible consumer side is

Wake structures of two side by side spheres in a tripped boundary layer flow

Directory of Open Access Journals (Sweden)

Canli Eyüb

2014-03-01

Full Text Available Two independent spheres were placed in a side by side arrangement and flow structure in the wake region of the spheres was investigated with a Particle Image Velocimetry (PIV system when the spheres were in a boundary layer over a flat plate as a special case. Reynolds number was 5000 based on the sphere diameter which was 42.5 mm. Boundary layer was tripped 8mm away from the leading edge of the flat plate with a 5 mm trip wire. The thickness of the hydrodynamically developed boundary layer was determined as 63mm which was larger than the sphere diameter of D=42.5mm. Wake region of the spheres was examined from point of flow physics for the different sphere locations in the ranges of 0≤G/D ≤1.5 and 0≤S/D ≤1.5 where G and S were the distance between the spheres and the distance between the bottom point of the spheres and the flat plate surface, respectively. Depending on the different sphere locations, instantaneous and time averaged vorticity data, scalar values of time-averaged velocity components and their root mean square (rms values and time averaged vorticity data are presented in the study for the evaluation of wake region of the spheres. It is demonstrated that the gap between the two spheres and the interaction between the gap and the boundary layer greatly affects flow pattern, especially when spheres are located near to the flat plate surface, i.e. S/D=0.1 for 0≤G/D ≤1.5. Different distances between the spheres resulted in various flow patterns as the spheres were approached to the flat plate. The distance S/D=0.1 for all gap values has the strongest effect on the wake structures. Beyond G/D=1.0, the sphere wakes tend to be similar to single sphere case. The instantaneous vorticity fields of the side by side arrangements comprised wavy structures in higher level comparing to an individual sphere case. The gap flow intensifies the occurrence of small scale eddies in the wake region. The submersion rate of the spheres

Comparing outcomes between side-to-side anastomosis and other anastomotic configurations after intestinal resection for patients with Crohn's disease: a meta-analysis.

Science.gov (United States)

Guo, Zhen; Li, Yi; Zhu, Weiming; Gong, Jianfeng; Li, Ning; Li, Jieshou

2013-04-01

Anastomotic configurations may be a predictor of postoperative recurrence for Crohn's disease. One previous meta-analysis showed side-to-side anastomosis was associated with fewer anastomotic leaks but did not reduce postoperative recurrence rates. After 2007, more articles that found distinct results were published. We aimed to update the meta-analysis comparing outcomes between side-to-side anastomosis and other anastomotic configurations after intestinal resection for patients with Crohn's disease. A literature search that included PubMed, EMBASE, the Science Citation Index, and the Cochrane Library was conducted to identify studies up to May 2012. Trials comparing side-to-side anastomosis with other anastomotic configurations for Crohn's disease were analyzed. Sensitivity analysis and heterogeneity assessment were also performed. Eleven trials compared side-to-side with other anastomotic configurations were included. Overall, results showed a significant reduction in the overall postoperative complications [n = 777; odds ratio (OR) = 0.60; P = 0.01], but side-to-side anastomosis did not reduce the anastomotic leak rate (n = 879; OR = 0.48; P = 0.07), complications other than anastomotic leak (n = 777; OR = 0.72; P = 0.13), endoscopic recurrence rates [hazard ratio (HR) = 0.73; P = 0.07], symptomatic recurrence rates (HR = 0.74; P = 0.20), and reoperation rates for recurrence (HR = 0.37; P = 0.06). Sensitivity analysis including two randomized controlled trials found no significant differences in short-term complications between the two groups. Sensitivity analysis including nine trials comparing only stapled side-to-side anastomosis with other anastomotic configurations showed stapled side-to-side anastomosis could reduce reoperation rates (HR = 0.38; P = 0.01). Side-to-side anastomosis did not reduce short-term complications and postoperative recurrence for Crohn's disease. Stapled side-to-side anastomosis may lead to fewer reoperations needed for recurrence

Algebraic Side-Channel Attack on Twofish

Directory of Open Access Journals (Sweden)

Chujiao Ma

2017-05-01

Full Text Available While algebraic side-channel attack (ASCA has been successful in breaking simple cryptographic algorithms, it has never been done on larger or more complex algorithms such as Twofish. Compared to other algorithms that ASCA has been used on, Twofish is more difficult to attack due to the key-dependent S-boxes as well as the complex key scheduling. In this paper, we propose the first algebraic side-channel attack on Twofish, and examine the importance of side-channel information in getting past the key-dependent S-boxes and the complex key scheduling. The cryptographic algorithm and side-channel information are both expressed as boolean equations and a SAT solver is used to recover the key. While algebraic attack by itself is not sufficient to break the algorithm, with the help of side-channel information such as Hamming weights, we are able to correctly solve for 96 bits of the 128 bits key in under 2 hours with known plaintext/ciphertext.

Hardware Trojan Side-Channels based on Physical Unclonable Functions

NARCIS (Netherlands)

Gong, Z.; Makkes, M.X.; Ardagna, C.A.; Zhou, J.

2011-01-01

The separation design and fabrication process in the semiconductor industry leads to potential threats such as trojan side-channels (TSCs). In this paper we design a new family of TSCs from physical unclonable functions (PUFs). In particular, a dedicated attack on the PRESENT block cipher is

The DarkSide experiment

International Nuclear Information System (INIS)

Bottino, B.; Aalseth, C.E.; Acconcia, G.

2017-01-01

DarkSide is a dark matter direct search experiment at Laboratori Nazionali del Gran Sasso (LNGS). DarkSide is based on the detection of rare nuclear recoils possibly induced by hypothetical dark matter particles, which are supposed to be neutral, massive (m > 10 GeV) and weakly interactive (Wimp). The dark matter detector is a two-phase time projection chamber (TPC) filled with ultra-pure liquid argon. The TPC is placed inside a muon and a neutron active vetoes to suppress the background. Using argon as active target has many advantages, the key features are the strong discriminant power between nuclear and electron recoils, the spatial reconstruction and easy scalability to multi-tons size. At the moment DarkSide-50 is filled with ultra-pure argon, extracted from underground sources, and from April 2015 it is taking data in its final configuration. When combined with the preceding search with an atmospheric argon target, it is possible to set a 90% CL upper limit on the WIMP-nucleon spin-independent cross section of 2.0×10"−"44 cm"2 for a WIMP mass of 100 GeV/c"2. The next phase of the experiment, DarkSide-20k, will be the construction of a new detector with an active mass of ∼ 20 tons.

Quality of life differences in patients with right- versus left-sided facial paralysis: Universal preference of right-sided human face recognition.

Science.gov (United States)

Ryu, Nam Gyu; Lim, Byung Woo; Cho, Jae Keun; Kim, Jin

2016-09-01

We investigated whether experiencing right- or left-sided facial paralysis would affect an individual's ability to recognize one side of the human face using hybrid hemi-facial photos by preliminary study. Further investigation looked at the relationship between facial recognition ability, stress, and quality of life. To investigate predominance of one side of the human face for face recognition, 100 normal participants (right-handed: n = 97, left-handed: n = 3, right brain dominance: n = 56, left brain dominance: n = 44) answered a questionnaire that included hybrid hemi-facial photos developed to determine decide superiority of one side for human face recognition. To determine differences of stress level and quality of life between individuals experiencing right- and left-sided facial paralysis, 100 patients (right side:50, left side:50, not including traumatic facial nerve paralysis) answered a questionnaire about facial disability index test and quality of life (SF-36 Korean version). Regardless of handedness or hemispheric dominance, the proportion of predominance of the right side in human face recognition was larger than the left side (71% versus 12%, neutral: 17%). Facial distress index of the patients with right-sided facial paralysis was lower than that of left-sided patients (68.8 ± 9.42 versus 76.4 ± 8.28), and the SF-36 scores of right-sided patients were lower than left-sided patients (119.07 ± 15.24 versus 123.25 ± 16.48, total score: 166). Universal preference for the right side in human face recognition showed worse psychological mood and social interaction in patients with right-side facial paralysis than left-sided paralysis. This information is helpful to clinicians in that psychological and social factors should be considered when treating patients with facial-paralysis. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

A comparison of short-term outcome after laparoscopic, transverse, and midline right-sided colectomy

NARCIS (Netherlands)

Tanis, E.; van Geloven, A. A. W.; Bemelman, W. A.; Wind, J.

2012-01-01

The aim of the present study was to compare the laparoscopy, transverse, and midline laparotomy in right-sided colectomies with respect to short- and long-term outcome. The short- and long-term results of all patients who had an elective right-sided hemicolectomy, from January 2006 to April 2009 for

Association between diverticular disease and Ehlers-Danlos syndrome: a 13-year nationwide population-based cohort study.

Science.gov (United States)

Leganger, Julie; Søborg, Marie-Louise Kulas; Mortensen, Laura Quitzau; Gregersen, Rasmus; Rosenberg, Jacob; Burcharth, Jakob

2016-12-01

The aim of this study was to examine occurrence and consequences of diverticular disease in patients with Ehlers-Danlos syndrome (EDS) compared with a matched cohort. This nationwide population-based cohort study was conducted using data from medical registers in Denmark from year 2000 to 2012. The EDS cohort was identified using the specific diagnosis code for EDS and was randomly matched in a ratio of 1:20 by sex and date of birth (±1 year) with persons from the Danish general population. The occurrence of diverticular disease and the clinical characteristics of the initial diverticular event were compared between the EDS cohort and the comparison cohort. The first admission with diverticulitis was identified, and severity of diverticulitis, treatment, colonoscopies, length of stay, and 30-day mortality were investigated. We identified 1336 patients with EDS and matched a control cohort of 26,720 patients. The occurrence of diverticular disease in the EDS cohort (2.0 %) and the comparison cohort (0.68 %) differed significantly (p < 0.001). At the first diverticular event, the majority of patients were women (85 % for EDS and 87 % for the comparison cohort). Mean age, localization, and type of contact did not differ significantly. Admission with diverticulitis (1.0 % for EDS and 0.34 % for the comparison cohort) differed significantly (p < 0.001). We found no significant difference in severity of diverticulitis, treatment, length of stay, or 30-day mortality between the EDS and the comparison cohorts. Patients with EDS had an increased occurrence of overall diverticular events and admissions with diverticulitis compared with the general population.

GC Side Event: Nuclear Energy Innovation and the Paris Agreement. Presentations

International Nuclear Information System (INIS)

2017-01-01

This event presented roadmaps for nuclear energy innovation linked to nationally determined contributions (NDCs) to the global response to climate change. It covered enabling conditions for research and development, the regulatory framework and infrastructure to support Member States’ NDC updates from 2020 to 2050

[New knowledge on the diverticular disease of colon].

Science.gov (United States)

Dolejsí, Mojmír

2011-01-01

The article is a summary paper aimed at new knowledge, concerning the classification, diagnostics, medication and endoscopic treatment of diverticular disease of colon. Briefly mentioned are the issues of functional disorder in the field of diverticulosis--symptomatic uncomplicated diverticular disease of colon. Diverticular bleeding is explained in terms of its pathogenesis and diagnostics. The problem with estimation the ration of diverticular bleedings in the total number of bleedings into the lower digestive tract is caused by diverse criteria for selecting patients and two levels of diagnostic of diverticular bleeding (definite and presumptive). Attention is paid also to diverticular colitis. Synonyms, endoscopic and histological classification are listed. The main endoscopic findings represent areas of erythema, which are visible on the mucosa between diverticula. Diverticulitis is seen as the most significant complication and the diagnostics of diverticulitis is discussed in detail. The first recommended step in the diagnosis is an urgent abdominal ultrasound; the gold standard is a CT examination of the abdomen, in special situations, some other imaging methods should be used: MRI, colonoscopy. The article ends with an overview of modern therapeutic options in the treatment of diverticular colitis and diverticulitis, particularly the use of antibiotics, probiotics, mesalasine and antispasmodics. Negative effect of NSAIDs on the course of diverticulitis and induction diverticular bleeding is listed.

Dual-sided microstructured semiconductor neutron detectors (DSMSNDs)

International Nuclear Information System (INIS)

Fronk, Ryan G.; Bellinger, Steven L.; Henson, Luke C.; Ochs, Taylor R.; Smith, Colten T.; Kenneth Shultis, J.; McGregor, Douglas S.

2015-01-01

Microstructured semiconductor neutron detectors (MSNDs) have in recent years received much interest as high-efficiency replacements for thin-film-coated thermal neutron detectors. The basic device structure of the MSND involves micro-sized trenches that are etched into a vertically-oriented pvn-junction diode that are backfilled with a neutron converting material. Neutrons absorbed within the converting material induce fission of the parent nucleus, producing a pair of energetic charged-particle reaction products that can be counted by the diode. The MSND deep-etched microstructures produce good neutron-absorption and reaction-product counting efficiencies, offering a 10× improvement in intrinsic thermal neutron detection efficiency over thin-film-coated devices. Performance of present-day MSNDs are nearing theoretical limits; streaming paths between the conversion-material backfilled trenches, allow a considerable fraction of neutrons to pass undetected through the device. Dual-sided microstructured semiconductor neutron detectors (DSMSNDs) have been developed that utilize a complementary second set of trenches on the back-side of the device to count streaming neutrons. DSMSND devices are theoretically capable of greater than 80% intrinsic thermal neutron detection efficiency for a 1-mm thick device. The first such prototype DSMSNDs, presented here, have achieved 29.48±0.29% nearly 2× better than MSNDs with similar microstructure dimensions.

Compressed Sensing mm-Wave SAR for Non-Destructive Testing Applications Using Multiple Weighted Side Information

Directory of Open Access Journals (Sweden)

Mathias Becquaert

2018-05-01

Full Text Available This work explores an innovative strategy for increasing the efficiency of compressed sensing applied on mm-wave SAR sensing using multiple weighted side information. The approach is tested on synthetic and on real non-destructive testing measurements performed on a 3D-printed object with defects while taking advantage of multiple previous SAR images of the object with different degrees of similarity. The tested algorithm attributes autonomously weights to the side information at two levels: (1 between the components inside the side information and (2 between the different side information. The reconstruction is thereby almost immune to poor quality side information while exploiting the relevant components hidden inside the added side information. The presented results prove that, in contrast to common compressed sensing, good SAR image reconstruction is achieved at subsampling rates far below the Nyquist rate. Moreover, the algorithm is shown to be much more robust for low quality side information compared to coherent background subtraction.

End-to-side neurorrhaphy with and without perineurium

Directory of Open Access Journals (Sweden)

Fausto Viterbo

Full Text Available OBJECTIVE: We compared end-to-side neurorraphy with and without the perineural sheath. METHOD: Twenty rats were used. The peroneal nerve was sectioned and the distal end was sutured to the lateral face of the tibial nerve. We removed the perineural sheath only on the right side, but not on the left side. The proximal end of the peroneal nerve was curved back approximately at a 100° angle and implanted into the adductor muscle. Six months later, the 14 surviving animals were submitted to electrophysiological tests, sacrificed, and the nerves and muscles were taken for histological exams. RESULTS: On the right side, the muscles that had positive response needed an average of 258.89 mV (±92.31 of electric stimulus and on the left side 298.34 mV (±139.32. The average weight of the tibial cranial muscles of the right side was 0.47 g (0.18 and for the left side 0.45 g (0.15. The distal end of the peroneal nerve showed averages of 310.29 (±191.34 nerve fibers on the right side and 287.71 (±183.60 on the left side. The tibial nerve above the neurorraphy showed averages of 939.46 (±223.51 nerve fibers on the right side and 959.46 (±327.48 on the left side. The tibial nerve below the neurorraphy showed averages of 935.17 (±298.65 nerve fibers on the right side and 755.31 (±323.26 on the left side. The average areas of the right tibial cranial muscles were 0.0162 m2 (±0.008, after 230 magnification, and 0.0152 m2 (0.0064 for the left tibial cranial muscles. The histological features of the tibial cranial muscles, taking normal as 100%, were 78.21 (±20.75 on the right side and 82.14 (±15.89 on the left side. The statistical analysis (Student's t test did not reveal any difference (p>0.05 among right and left sides for all variables. CONCLUSION: The authors concluded that the two neurorraphies (with and without perineurium did not show any difference regarding morphological and electrophysiological features studied.

End-to-side neurorrhaphy with and without perineurium.

Science.gov (United States)

Viterbo, F; Teixeira, E; Hoshino, K; Padovani, C R

1998-01-01

We compared end-to-side neurorraphy with and without the perineural sheath. Twenty rats were used. The peroneal nerve was sectioned and the distal end was sutured to the lateral face of the tibial nerve. We removed the perineural sheath only on the right side, but not on the left side. The proximal end of the peroneal nerve was curved back approximately at a 100 degrees angle and implanted into the adductor muscle. Six months later, the 14 surviving animals were submitted to electrophysiological tests, sacrificed, and the nerves and muscles were taken for histological exams. On the right side, the muscles that had positive response needed an average of 258.89 mV (+/- 92.31) of electric stimulus and on the left side 298.34 mV (+/- 139.32). The average weight of the tibial cranial muscles of the right side was 0.47 g (0.18) and for the left side 0.45 g (0.15). The distal end of the peroneal nerve showed averages of 310.29 (+/- 191.34) nerve fibers on the right side and 287.71 (+/- 183.60) on the left side. The tibial nerve above the neurorraphy showed averages of 939.46 (+/- 223.51) nerve fibers on the right side and 959.46 (+/- 327.48) on the left side. The tibial nerve below the neurorraphy showed averages of 935.17 (+/- 298.65) nerve fibers on the right side and 755.31 (+/- 323.26) on the left side. The average areas of the right tibial cranial muscles were 0.0162 m2 (+/- 0.008), after 230 magnification, and 0.0152 m2 (0.0064) for the left tibial cranial muscles. The histological features of the tibial cranial muscles, taking normal as 100%, were 78.21 (+/- 20.75) on the right side and 82.14 (+/- 15.89) on the left side. The statistical analysis (Student's t test) did not reveal any difference (p > 0.05) among right and left sides for all variables. The authors concluded that the two neurorraphies (with and without perineurium) did not show any difference regarding morphological and electrophysiological features studied.

Vocal cord palsy: An uncommon presenting feature of myasthenia gravis

Directory of Open Access Journals (Sweden)

Sethi Prahlad

2011-01-01

Full Text Available Vocal cord palsy can have myriad causes. Unilateral vocal cord palsy is common and frequently asymptomatic. Trauma, head, neck and mediastinal tumors as well as cerebrovascular accidents have been implicated in causing unilateral vocal cord palsy. Viral neuronitis accounts for most idiopathic cases. Bilateral vocal cord palsy, on the other hand, is much less common and is a potentially life-threatening condition. Myasthenia gravis, an autoimmune disorder caused by antibodies targeting the post-synaptic acetylcholine receptor, has been infrequently implicated in its causation. We report here a case of bilateral vocal cord palsy developing in a 68-year-old man with no prior history of myasthenia gravis 2 months after he was operated on for diverticulitis of the large intestine. Delay in considering the diagnosis led to endotracheal intubation and prolonged mechanical ventilation with attendant complications. Our case adds to the existing literature implicating myasthenia gravis as an infrequent cause of bilateral vocal cord palsy. Our case is unusual as, in our patient, acute-onset respiratory distress and stridor due to bilateral vocal cord palsy was the first manifestation of a myasthenic syndrome.

VGB primary and secondary side water chemistry guidelines for PWR plants

International Nuclear Information System (INIS)

Neder, H.; Wolter, D.; Staudt, U.

2007-01-01

The recent revision of the VGB Water Chemistry Guidelines was issued in 2005 and published in the second half of 2006. These guidelines are based on the primary and secondary side operating chemistry experience with all Siemens designed pressurized water reactors gained since the beginning of the 1980s. These guidelines cover For the primary side chemistry Modified lithium boron chemistry, Zinc chemistry for dose rate reduction, Enriched boric acid (EBA) chemistry for high duty core design For the secondary side chemistry High all-volatile treatment (AVT) chemistry (high pH operation) Oxygen injection in the secondary side Especially for the secondary side chemistry, compared with the water chemistry guidelines of other organizations worldwide, these Guidelines are less stringent, providing more operational flexibility to the plant operation, and can be applied for all new designs of steam generators with egg-crates or broached hole tube supports and with I 690TT or I 800 tubing materials. This paper gives an overview of the 2006 revision of the VGB Water Chemistry Guidelines for PWR plants and describes the fundamental goals of water chemistry operation strategies. In addition, the reasons for the selected control parameters and action levels, to achieve an adequate plant performance, are presented based on the operating experience. (orig.)

Combined atresia of one left-sided and one right-sided cardiac valve in a premature newborn.

Science.gov (United States)

Roberts, William C; Sing, Alan C; Guileyardo, Joseph M

2017-10-01

Described herein is the heart of a 2-day-old newborn, the product of a 25-week gestation, with atresia of two cardiac valves, one on the right side and one on the left side, apparently a previously undescribed entity.

Flapping propulsion with side-by-side pitching foils

Science.gov (United States)

Huera-Huarte, Francisco

2016-11-01

Fish schools are one of the most common types of collective behaviour observed in nature. One of the reasons why fish swim in groups, is to reduce the cost of transport of the school. In this work we explore the propulsive performance of two foils flapping in a symmetric configuration, i.e. with an out-of-phase flapping motion. Direct thrust measurements and Particle Image Velocimetry (PIV) allowed a detailed examination of the forces and the wake generated by the system, for different kinematics (swept angles and frequencies) and shaft separations. For certain specific cases, volumetric PIV shows major differences on how the different structures in the wake of the system evolve, depending on the imposed kinematics and the side-by-side separation between the foils. Results obtained will be compared against data produced with isolated flapping foils with similar imposed kinematics, with the aim to better understand the interactions between both and the performance of the system as a whole. The author would like to acknowledge the financial support provided by the Spanish Ministerio de Economia y competitividad (MINECO) through Grant DPI2015-71645-P.

Stochastic rocket dynamics under random nozzle side loads: Ornstein-Uhlenbeck boundary layer separation and its coarse grained connection to side loading and rocket response

Energy Technology Data Exchange (ETDEWEB)

Keanini, R.G.; Srivastava, N.; Tkacik, P.T. [Department of Mechanical Engineering, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28078 (United States); Weggel, D.C. [Department of Civil and Environmental Engineering, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28078 (United States); Knight, P.D. [Mitchell Aerospace and Engineering, Statesville, North Carolina 28677 (United States)

2011-06-15

A long-standing, though ill-understood problem in rocket dynamics, rocket response to random, altitude-dependent nozzle side-loads, is investigated. Side loads arise during low altitude flight due to random, asymmetric, shock-induced separation of in-nozzle boundary layers. In this paper, stochastic evolution of the in-nozzle boundary layer separation line, an essential feature underlying side load generation, is connected to random, altitude-dependent rotational and translational rocket response via a set of simple analytical models. Separation line motion, extant on a fast boundary layer time scale, is modeled as an Ornstein-Uhlenbeck process. Pitch and yaw responses, taking place on a long, rocket dynamics time scale, are shown to likewise evolve as OU processes. Stochastic, altitude-dependent rocket translational motion follows from linear, asymptotic versions of the full nonlinear equations of motion; the model is valid in the practical limit where random pitch, yaw, and roll rates all remain small. Computed altitude-dependent rotational and translational velocity and displacement statistics are compared against those obtained using recently reported high fidelity simulations [Srivastava, Tkacik, and Keanini, J. Appl. Phys. 108, 044911 (2010)]; in every case, reasonable agreement is observed. As an important prelude, evidence indicating the physical consistency of the model introduced in the above article is first presented: it is shown that the study's separation line model allows direct derivation of experimentally observed side load amplitude and direction densities. Finally, it is found that the analytical models proposed in this paper allow straightforward identification of practical approaches for: (i) reducing pitch/yaw response to side loads, and (ii) enhancing pitch/yaw damping once side loads cease. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

The DarkSide Program at LNGS

OpenAIRE

Wright, Alex; Collaboration, for the DarkSide

2011-01-01

DarkSide is a direct detection dark matter program based on two phase time projection chambers with depleted argon targets. The DarkSide detectors are designed, using novel low background techniques and active shielding, to be capable of demonstrating in situ a very low level of residual background. This means that each detector in the DarkSide program should have the ability to make a convincing claim of dark matter detection based on the observation of a few nuclear recoil events. The colla...

An Elementary affine λ-calculus with multithreading and side effects (extended version)

OpenAIRE

Madet, Antoine; Amadio, Roberto M.

2011-01-01

Linear logic provides a framework to control the complexity of higher-order functional programs. We present an extension of this framework to programs with multithreading and side effects focusing on the case of elementary time. Our main contributions are as follows. First, we provide a new combinatorial proof of termination in elementary time for the functional case. Second, we develop an extension of the approach to a call-by-value $lambda$-calculus with multithreading and side effects. Thi...

Cutaneous side-effects during therapy of melanoma by vemurafenib

Directory of Open Access Journals (Sweden)

Anna Ankudowicz

2015-06-01

Full Text Available Introduction. Vemurafenib is a selective inhibitor of serine-threonine kinase BRAF used in the treatment of advanced melanoma with BRAF mutation. Effectiveness of this drug was confirmed in a large clinical trial, which led to the increase of its usage. During treatment with vemurafenib, particular attention should be paid to the numerous side effects, including those concerning the skin. Vemurafenib is highly toxic to the skin. Skin lesions occurring during the treatment of melanoma with this medicament can be divided into: early (observed 3 to 6 weeks after beginning treatment, late (observed 6 weeks after beginning treatment and hypersensitivity reactions to vemurafenib. Objective. Presentation of vemurafenib toxic effects on the skin and side effects that can be caused by this drug. Case report. We present a 58-year-old woman with metastatic melanoma who was treated with vemurafenib. During the course of therapy, numerous adverse reactions, including inflammatory tumors, emergence of a number of melanocytic naevi, skin horns, alopecia, hyperkeratosis of the palms and soles, and palmar erythrodysesthesia were observed. She was treated with anti-inflammatory drugs, an antibiotic, circulation-improving preparations and local moisturizing and keratolytic treatment. The patient remains under the care of oncologists and dermatologists. Conclusions. The new generation anti-cancer drugs bring hope for a cure or prolongation of life, but can also significantly reduce the quality of life by inducing both general and local adverse side effects. Oncological patients should also be taken care of by dermatologists.

Secondary-side feed-and-bleed effectiveness in pressurized water reactors

International Nuclear Information System (INIS)

Annunziato, A.

1994-01-01

An analysis is presented of physical phenomena occurring during secondary-side feed-and-bleed, which is being considered as an accident management procedure for pressurized water reactors. Problem areas related to the reliability of this procedure are identified and discussed. Secondary-side feed-and-bleed, as examined in the LOBI (which is the Light Water Reactor Off-Normal Behavior Investigation) integral system test facility, was not successful because of a delay in the secondary-side heat removal caused by the release of stored heat from the steam generator downcomer wall. Countercurrent flow limiting in the hot leg was another major phenomenon that can influence the effectiveness of this procedure. The discussion of the experimental results is complemented by relevant calculations by RELAP5/MOD3. In general, it was found that the effectiveness of the feed-and-bleed procedure is maximized if the number of steam generators used to implement it is reduced

Side Effects: Fatigue

Science.gov (United States)

Fatigue is a common side effect of many cancer treatments such as chemotherapy, radiation therapy, immunotherapy, and surgery. Anemia and pain can also cause fatigue. Learn about symptoms and way to manage fatigue.

Sexual side effects induced by psychotropic drugs

DEFF Research Database (Denmark)

Kristensen, Ellids

2002-01-01

The majority of psychotropic drugs entail sexual side effects. The sexual side effects may reduce quality of life and may give rise to non-compliance. For example, 30-60 per cent of patients treated with antidepressants are known to develop a sexual dysfunction. However, some psychotropic drugs...... with no or very few sexual side effects have begun to emerge. The treatment of sexual side effects induced by psychotropic drugs may consist of: modified sexual habits, reduction in dosage, switching to another medication, possibly in combination with different psychotropic agents, other varieties...

Individual-motivational factors in the acceptability of demand-side and supply-side measures to reduce carbon emissions

International Nuclear Information System (INIS)

Poortinga, Wouter; Spence, Alexa; Demski, Christina; Pidgeon, Nick F.

2012-01-01

As more than a third of all carbon dioxide emissions in the UK are generated by the domestic sector, individuals need to make drastic changes to their current lifestyle in order to play their part in climate change mitigation. Not only do they need to change their personal behaviour, they also have to accept new low-carbon technologies in order to decarbonise the energy they are using. This study uses an adapted version of the Value–Belief-Norm (VBN) model () to examine individual-motivational factors in the acceptability of demand-side and supply-side strategies to reduce carbon emissions. The study found that environmental identity, climate change concern, and personal norms are all significantly associated with the acceptability of both demand-side measures and supply-side technologies. While personal values were also important, their associations were mediated by more specific factors. Overall, the adapted VBN model was better able to explain the acceptability of low-carbon behaviours than of low-carbon energy-supply technologies. Concern about energy security appeared to be of limited importance. It was negatively associated with the willingness to engage in low-carbon behaviours, suggesting that a shift in focus towards energy security issues may not necessarily help a transition to a low-carbon society. - Highlights: ► An adapted VBN model is proposed to study environmentally significant behaviour.► Environmental identity is important for both demand-side and supply-side measures.► Energy security concern is of limited importance to support for supply-side measures.► Energy security concern reduces the willingness to engage in low-carbon behaviours.

PARTICIPATION OF MINI-BASKETBALL PLAYERS DURING SMALL-SIDED COMPETITIONS

Directory of Open Access Journals (Sweden)

M\\u00AA Isabel Pi\\u00F1ar

2009-01-01

Full Text Available This study presents the differences of competition between mini-basketball with the traditional rules (5-a-side and minibasket with rule modifications (3-a-side such as: reduced number of players on court, compulsory participation in 2 of the match's 4 periods, reduced court size, placing the free throw line at 3m from the basket, and including a three-point line. The sample that was selected included 47 mini-basketball players, and the study was carried out using a quasi-experimental design without a control group. The aim was to determine the effect of rule modifications on the participation of the player with the ball. It was demonstrated that the degree of individual participation is greater in mini-basketball with modified rules.

Maternal Mortality in Ghana: the Other Side | Senah | Research ...

African Journals Online (AJOL)

... perspective. However, the determinants of maternal mortality are a complex web of biology and culture. This paper presents the 'other side' of the story: a wider overview of the casual pathways by which simple interventions may produce the desired effect. (Institute of African Studies Research Review: 2003 19(1): 47-56) ...

Side Chain Engineering in Solution-Processable Conjugated Polymers

KAUST Repository

Mei, Jianguo

2014-01-14

Side chains in conjugated polymers have been primarily utilized as solubilizing groups. However, these side chains have roles that are far beyond. We advocate using side chain engineering to tune a polymer\\'s physical properties, including absorption, emission, energy level, molecular packing, and charge transport. To date, numerous flexible substituents suitable for constructing side chains have been reported. In this Perspective article, we advocate that the side chain engineering approach can advance better designs for next-generation conjugated polymers. © 2013 American Chemical Society.

A nationwide Danish cohort study challenging the categorisation into right-sided and left-sided colon cancer

DEFF Research Database (Denmark)

Jess, Per; Hansen, Iben Onsberg; Gamborg, Michael

2013-01-01

The categorisation of colon cancer (CC) into right-sided (RCC) and left-sided (LCC) disease may not capture more subtle variances in aetiology and prognosis. In a nationwide study, we investigated differences in clinical characteristics and survival of RCC versus LCC and of the complete range of CC...

Side Effects: Diarrhea

Science.gov (United States)

Diarrhea, a side effect of cancer treatment, may cause symptoms such as loose, watery stools. Diarrhea can lead to dehydration and malnutrition in cancer patients. Learn about ways to treat and manage diarrhea during cancer treatment.

Side Effects: Pain

Science.gov (United States)

Controlling pain is an important part of your cancer treatment plan. Learn how to track levels of pain. Find out how pain, a side effect of cancer treatment, is treated using acupuncture, biofeedback, and physical therapy.

Effects and side effects of inspections and accountability in education: an overview of empirical studies

NARCIS (Netherlands)

de Wolf, Inge F.; Janssens, F.J.G.

This paper presents an overview of studies into effects and side effects of control mechanisms in education. We focus on effects and side effects of inspection visits and public performance indicators. A first conclusion is that the studies do not provide us with a clear answer to the question of

Working the Dark Side

DEFF Research Database (Denmark)

Bjering, Jens Christian Borrebye

A few days after the terror attacks of 9/11, then Vice President Dick Cheney appeared on television with a call for “working the dark side.” While still unclear what this expression entailed at the time, Cheney's comment appears in retrospect to almost have been prophetic for the years to come....... By analyzing official reports and testimonies from soldiers partaking in the War On Terror, the dissertation's second part—dark arts—focuses on the transformation of the dark side into a productive space in which “information” and the hunt for said information overshadowed all legal, ethical, or political...

Side Effects: Anemia

Science.gov (United States)

Anemia is a side effect of cancer treatments, including chemotherapy and radiation therapy. It can make women and men feel fatigued, dizzy, and short of breath. Learn how to manage fatigue caused by anemia during cancer treatment.

Emerging technologies for demand side management. Demand side management jitsugen no tame no saishin gijutsu

Energy Technology Data Exchange (ETDEWEB)

Suzuki, H; Iyoda, I [Mitsubishi Electric Corp., Tokyo (Japan)

1993-11-05

This paper explains the latest situation in hardware technologies to realize the demand side management, divided into the following technologies: communications technology, measurement technology, client information system technology, load controlling technology, home automation technology, and energy storing and saving technologies. Speaking of the communications technology, information exchange between the supply side and the demand side is important in the demand side management, whereas a technology intended of automatic power distribution and automatic meter-reading is advancing in development. The technology covers transmissions using from power lines and telephone lines to optical cables and wireless communications. Power line communications using power transmission lines as communication lines are simple and economical, but weak against noise, and not suitable for long-distance communications. Wireless communications have been drawing attentions along with the development of mobile communication device technologies. These technologies will give benefits to electric power companies in the initial stage of their use, such as for load investigation and general automation in power distribution. They would shift to benefiting users in about 2010 covering from security information such as about power interruption to publicity information and educations. 8 refs., 8 figs., 1 tab.

[Influences of balancing-side interference on jaw function].

Science.gov (United States)

Baba, K

1991-03-01

The influences of experimental balancing-side interference on the jaw function were investigated on 6 subjects. A specially designed onlay was fabricated for the lower second molar, which acted as an artificial balancing-side interference in the lateral mandibular position. The subjects were asked to do maximum clenching, lateral gliding and gum chewing with and without the device. Electromyographic activity of the masseter and the anterior and posterior temporal muscles were measured and the related mandibular movement was simultaneously recorded during these tasks. Introduction of the experimental interference caused alteration in the muscle activity as follows: 1. When the subjects exerted maximum clenching efforts in the lateral mandibular position, the ratio of the temporal muscle activity on the working-side to the balancing-side decreased, while that of the masseter muscle remained unchanged. 2. There was a tendency for the activity in the working-side posterior temporal muscle to increase during gliding from intercuspation. The ratio of the temporal muscle activity on the working-side to the balancing-side decreased during gliding into intercuspation. 3. Prolongation of the occlusal phase associated with the increase of the muscle activity was observed during gum chewing on the side opposite to the interference. It was suggested that the balancing-side interference might provoke a specific muscle activity in the temporal muscles during parafunctional clenching or grinding.

Rarity of invasiveness in right-sided infective endocarditis.

Science.gov (United States)

Hussain, Syed T; Shrestha, Nabin K; Witten, James; Gordon, Steven M; Houghtaling, Penny L; Tingleff, Jens; Navia, José L; Blackstone, Eugene H; Pettersson, Gösta B

2018-01-01

The rarity of invasiveness of right-sided infective endocarditis (IE) compared with left-sided has not been well recognized and evaluated. Thus, we compared invasiveness of right- versus left-sided IE in surgically treated patients. From January 2002 to January 2015, 1292 patients underwent surgery for active IE, 138 right-sided and 1224 left-sided. Among patients with right-sided IE, 131 had tricuspid and 7 pulmonary valve IE; 12% had prosthetic valve endocarditis. Endocarditis-related invasiveness was based on echocardiographic and operative findings. Invasive disease was rare on the right side, occurring in 1 patient (0.72%; 95% confidence interval 0.02%-4.0%); rather, it was limited to valve cusps/leaflets or was superficial. In contrast, IE was invasive in 408 of 633 patients with aortic valve (AV) IE (65%), 113 of 369 with mitral valve (MV) IE (31%), and 148 of 222 with AV and MV IE (67%). Staphylococcus aureus was a more predominant organism in right-sided than left-sided IE (right 40%, AV 19%, MV 29%), yet invasion was observed almost exclusively on the left side of the heart, which was more common and more severe with AV than MV IE and more common with prosthetic valve endocarditis than native valve IE. Rarity of right-sided invasion even when caused by S aureus suggests that invasion and development of cavities/"abscesses" in patients with IE may be driven more by chamber pressure than organism, along with other reported host-microbial interactions. The lesser invasiveness of MV compared with AV IE suggests a similar mechanism: decompression of MV annulus invasion site(s) toward the left atrium. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

RARE PRESENTATION OF SYMPTOMATIC BILATERAL PROXIMAL POPLITEAL ARTERY ANEURYSM

Directory of Open Access Journals (Sweden)

Thulasikumar Ganapathy

2016-07-01

Full Text Available True Popliteal artery aneurysm is the most common of all the peripheral artery aneurysms. We present a case of proximal popliteal artery aneurysm involvement both lower limb presented with gangrene in one lower limb and incapacitating claudication pain on the other lower limb. We have successfully repaired both sides aneurysm in the same sitting with Poly Tetra Fluro Ethylene (PTFE graft, as the patient also had multiple venous perforators’ involvement on both sides, which left us only with synthetic graft repair option rather than venous graft repair.

An Atypical Presentation Of Pancreatic Carcinoma With Malignant ...

African Journals Online (AJOL)

Background: Pleural effusion secondary to pancreatic tumour is a relatively rare clinical presentation. Aim of study: To present a case of a patient that had pancreatic tumour who presented with features of left sided pleural effusion with a view to highlighting the clinical features of the presentation. Method of study: The case ...

Central nervous system tuberculomata presenting as internuclear ...

African Journals Online (AJOL)

Central nervous system (CNS) tuberculoma can have variable presentation depending upon the site and number of tuberculomata. We are reporting a rare case of a 15 years old girl who presented to our hospital with binocular diplopia on right gaze. Clinical examination revealed left sided internuclear ophthalmoplegia ...

Scintigraphic diagnosis of silent aspiration following double-sided lung transplantation

International Nuclear Information System (INIS)

Toenshoff, G.; Stock, U.; Bohuslavizki, K.H.; Brenner, W.; Costard-Jaeckle, A.; Cremer, J.; Clausen, M.

1996-01-01

We present a case of a 25 year old patient who underwent double-sided lung transplantation and suffered from recurrent pneumonia. Silent aspiration was suspected clinically. Aspiration was proved by scintigraphy enabling to discriminate between direct oro-pulmonal aspiration and aspiration after gastro-esophageal reflux. (orig.) [de

Single side Emitting Transparent OLED lamp

NARCIS (Netherlands)

Lifka, H.; Verschuren, C.A.; Bruls, D.M.; Tanase, C.

2011-01-01

Transparent OLEDs offer great potential for novel applications. Preferably, the light should be emitted from one side only. This can bedone to some extent by modifying electrode thicknesses, but at the cost of reduced transparency. Here, we demonstrate a new approach tomake single side emissive

Side Chain Engineering in Solution-Processable Conjugated Polymers

KAUST Repository

Mei, Jianguo; Bao, Zhenan

2014-01-01

Side chains in conjugated polymers have been primarily utilized as solubilizing groups. However, these side chains have roles that are far beyond. We advocate using side chain engineering to tune a polymer's physical properties, including absorption

49 CFR 231.8 - Tank cars without side sills and tank cars with short side sills and end platforms.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Tank cars without side sills and tank cars with... APPLIANCE STANDARDS § 231.8 Tank cars without side sills and tank cars with short side sills and end platforms. (a) Hand brakes—(1) Number. Same as specified for “Box and other house cars” (see § 231.1(a)(1...

Adenocarcinoma of the lung presenting as retinal detachment

Directory of Open Access Journals (Sweden)

Kaushik Saha

2014-01-01

Full Text Available Retinal detachment is a rare presentation of lung cancer. A young female presented with blurring of vision in her right eye for the last 10 days without any history of trauma. On indirect ophthalmoscopy, there was a presence of right sided retinal detachment which was treated with oral prednisolone (60 mg/day. After 1 month of continuous treatment, she came back with dry cough left sided chest pain and deterioration of her eye symptoms. Chest X-ray showed left lung mass. Computed tomography guided fine needle aspiration cytology and with immunohistochemistry confirmed adenocarcinoma of the lung. She was treated with 6 cycles of chemotherapy with paclitaxel and gemcitabine.

Census study of real-life near-side crashes with modern side airbag-equipped vehicles in the United States.

Science.gov (United States)

Sunnevång, Cecilia; Sui, Bo; Lindkvist, Mats; Krafft, Maria

2015-01-01

This study aimed to investigate the crash characteristics, injury distribution, and injury mechanisms for Maximum Abbreviated Injury Score (MAIS) 2+ injured belted, near-side occupants in airbag-equipped modern vehicles. Furthermore, differences in injury distribution for senior occupants compared to non-senior occupants was investigated, as well as whether the near-side occupant injury risk to the head and thorax increases or decreases with a neighboring occupant. National Automotive Sampling System's Crashworthiness Data System (NASS-CDS) data from 2000 to 2012 were searched for all side impacts (GAD L&R, all principal direction of force) for belted occupants in modern vehicles (model year > 1999). Rollovers were excluded, and only front seat occupants over the age of 10 were included. Twelve thousand three hundred fifty-four MAIS 2+ injured occupants seated adjacent to the intruding structure (near-side) and protected by at least one deployed side airbag were studied. To evaluate the injury risk influenced by the neighboring occupant, odds ratio with an induced exposure approach was used. The most typical crash occurred either at an intersection or in a left turn where the striking vehicle impacted the target vehicle at a 60 to 70° angle, resulting in a moderate change of velocity (delta-V) and intrusion at the B-pillar. The head, thorax, and pelvis were the most frequent body regions with rib fracture the most frequent specific injury. A majority of the head injuries included brain injuries without skull fracture, and non-senior rather than senior occupants had a higher frequency of head injuries on the whole. In approximately 50% of the cases there was a neighboring occupant influencing injury outcome. Compared to non-senior occupants, the senior occupants sustained a considerably higher rate of thoracic and pelvis injuries, which should be addressed by improved thorax side airbag protection. The influence on near-side occupant injury risk by the neighboring

Forskningens personlige side

DEFF Research Database (Denmark)

Hansen, Finn Thorbjørn

2008-01-01

Artiklen omhandler den ontologiske vending inden for universitetspædagogisk forskning, og redegør for hvorfor en mere personlig og eksistentiel side ved forskningen må medtænkes i universitetspædagogikken og -vejledningen. Udgivelsesdato: 24.11.08...

Modelling antibody side chain conformations using heuristic database search.

Science.gov (United States)

Ritchie, D W; Kemp, G J

1997-01-01

We have developed a knowledge-based system which models the side chain conformations of residues in the variable domains of antibody Fv fragments. The system is written in Prolog and uses an object-oriented database of aligned antibody structures in conjunction with a side chain rotamer library. The antibody database provides 3-dimensional clusters of side chain conformations which can be copied en masse into the model structure. The object-oriented database architecture facilitates a navigational style of database access, necessary to assemble side chains clusters. Around 60% of the model is built using side chain clusters and this eliminates much of the combinatorial complexity associated with many other side chain placement algorithms. Construction and placement of side chain clusters is guided by a heuristic cost function based on a simple model of side chain packing interactions. Even with a simple model, we find that a large proportion of side chain conformations are modelled accurately. We expect our approach could be used with other homologous protein families, in addition to antibodies, both to improve the quality of model structures and to give a "smart start" to the side chain placement problem.

The Meteoroid Fluence at Mars Due to Comet Siding Spring

Science.gov (United States)

Moorhead, Althea V.

2014-01-01

Long-period comet C/2013 A1 (Siding Spring) is headed for a close encounter with Mars on 2014 Oct 19. A collision between the comet and the planet has been ruled out, but the comets coma may envelop Mars and its man-made satellites. We present an analytic model of the dust component of cometary comae that describes the spatial distribution of cometary dust and meteoroids and their size distribution. If the coma reaches Mars, we estimate a total incident particle fluence on the planet and its satellites of 0.01 particles per square meter. We compare our model with numerical simulations, data from past comet missions, and recent Siding Spring observations.

MATHEMATICAL SIMULATION OF CONCURRENT TWO-SIDED LENS PROCESSING

Directory of Open Access Journals (Sweden)

A. S. Kozeruk

2015-01-01

Full Text Available The purpose of the paper is to modernize technology for obtaining high-accuracy lenses with fine centre. Presently their operating surfaces are fixed  to an accessory with the help of adhesive substance that leads to elastic deformation in glass and causes local errors in lens parts.A mathematical model for concurrent two-sided processing of high-accuracy optical parts with spherical surfaces has been developed in the paper. The paper presents analytical expressions that permit to calculate sliding speed at any point on the processed spherical surface depending on type and value of technological equipment settings. Calculation of parameter Q = Pv in a diametric section of the convexo-concave lens has been carried out while using these expressions together with functional dependence of pressure on contact zone еarea of tool and part bedding surfaces.Theoretical and experimental investigations have been carried out with the purpose to study changes in Q parameter according to the processed lens surface for various setting parameters of the technological equipment and their optimum values ensuring preferential stock removal in the central or boundary part zone or uniform distribution of the removal along the whole processed surface have been determined in the paper.The paper proposes a machine tool scheme for concurrent two-sided grinding and polishing of lenses while fixing their side (cylindrical surface. Machine tool kinematics makes it possible flexibly and within wide limits to change its setting parameters  that significantly facilitates the control of form-building process of parts with highly-precise spherical surfaces.Methodology for investigations presupposes the following: mathematical simulation of highly-precise spherical surface form-building process under conditions of forced closing, execution of numerical and experimental studies.  

Muscle-related side-effects of statins: from mechanisms to evidence-based solutions.

Science.gov (United States)

Taylor, Beth A; Thompson, Paul D

2015-06-01

This article highlights the recent findings regarding statin-associated muscle side effects, including mechanisms and treatment as well as the need for more comprehensive clinical trials in statin myalgia. Statin myalgia is difficult to diagnose and treat, as major clinical trials have not routinely assessed muscle side-effects, there are few clinically relevant biomarkers and assessment tools for the symptoms, many apparent statin-related muscle symptoms may be nonspecific and related to other drugs or health conditions, and prevalence estimates vary widely. Data thus suggest that only 30-50% of patients with self-reported statin myalgia actually experience muscle pain on statins during blinded, placebo-controlled trials. In addition, evidence to date involving mechanisms underlying statin myalgia and its range of symptoms and presentations supports the hypothesis that there are multiple, interactive and potentially additive mechanisms underlying statin-associated muscle side-effects. There are likely multiple and interactive mechanisms underlying statin myalgia, and recent studies have produced equivocal data regarding prevalence of statin-associated muscle side-effects, contributing factors and effectiveness of common interventions. Therefore, more clinical trials on statin myalgia are critical to the field, as are systematic resources for quantifying, predicting and reporting statin-associated muscle side-effects.

Protection of children restrained in child safety seats in side impact crashes.

Science.gov (United States)

Arbogast, Kristy B; Locey, Caitlin M; Zonfrillo, Mark R; Maltese, Matthew R

2010-10-01

The performance of child restraint systems (CRS) in side impact motor vehicle crashes has been under study due to the injury and fatality burden of these events. Although previous research has quantified injury risk or described injured body regions, safety advances require an understanding of injury causation. Therefore, the objective was to delineate injury causation scenarios for CRS-restrained children in side impacts and document probable contact points in the vehicle interior. Two in-depth crash investigation databases, the Crash Injury Research and Engineering Network and the Partners for Child Passenger Safety Study, were queried for rear-seated, CRS-restrained children in side impact crashes who sustained Abbreviated Injury Scale 2+ injury. These cases were reviewed by a multidisciplinary team of physicians and engineers to describe injury patterns, injury causation, and vehicle components that contributed to the injuries. Forty-one occupants (average age, 2.6 years) met the inclusion criteria. Twenty-four were near side to the crash, 7 were far side, and 10 were center seated. The most common injuries were to the skull and brain with an increasing proportion of skull fracture as age increased. Head and spine injuries without evidence of head contact were rare but present. All thoracic injuries were lung contusions and no rib fractures occurred. Near-side head and face contacts points were along the rear vertical plane of the window and the horizontal plane of the window sill. Head and face contact points for center- and far-side occupants were along the edges of the front seat back and front seat head restraint. Head injuries are the target for injury prevention for children in CRS in side impact crashes. Most of these injuries are due to the contact; for near-side occupants, contact with the CRS structure and the door interior, for far- or center-seated occupants, contact with the front seat back. These data are useful in developing both educational and

Price discrimination in two-sided markets

Directory of Open Access Journals (Sweden)

Kai Zhang

2016-03-01

Full Text Available The use of a price discrimination strategy is an important tool in competition. It can hurt firms and benefit consumers in a one-sided market. However, in two-sided markets, its primary goal is to attract more agents or increase profits. Here, the performance of a second-degree price discrimination strategy in the context of duopoly two-sided platforms is analysed. Two exogenous variables, which include the discount rate and the price discrimination threshold, are used in order to examine whether the price discrimination strategy could help two-sided platforms achieve their objective, which is to maximise their market value. Three cases are considered, and we demonstrate that the price discrimination strategy cannot attract more agents and at the same time increase the profits; a lower price discrimination threshold cannot ensure larger markets shares; a higher discount rate is detrimental to the profit of a platform. However, this is good for its market shares. Moreover, discriminative pricing increases the competition.

SIDES - Segment Interconnect Diagnostic Expert System

International Nuclear Information System (INIS)

Booth, A.W.; Forster, R.; Gustafsson, L.; Ho, N.

1989-01-01

It is well known that the FASTBUS Segment Interconnect (SI) provides a communication path between two otherwise independent, asynchronous bus segments. The SI is probably the most important module in any FASTBUS data acquisition network since it's failure to function can cause whole segments of the network to be inaccessible and sometimes inoperable. This paper describes SIDES, an intelligent program designed to diagnose SI's both in situ as they operate in a data acquisition network, and in the laboratory in an acceptance/repair environment. The paper discusses important issues such as knowledge acquisition; extracting knowledge from human experts and other knowledge sources. SIDES can benefit high energy physics experiments, where SI problems can be diagnosed and solved more quickly. Equipment pool technicians can also benefit from SIDES, first by decreasing the number of SI's erroneously turned in for repair, and secondly as SIDES acts as an intelligent assistant to the technician in the diagnosis and repair process

Chewing side, bite force symmetry, and occlusal contact area of subjects with different facial vertical patterns

Directory of Open Access Journals (Sweden)

Simone Guimarães Farias Gomes

2011-10-01

Full Text Available Craniofacial dimensions influence oral functions; however, it is not known whether they are associated with function asymmetry. The objective of this study was to evaluate chewing side preference and lateral asymmetry of occlusal contact area and bite force of individuals with different craniofacial patterns. Seventy-eight dentate subjects were divided into 3 groups according to the VERT index as follows: (1 mesofacial, (2 brachyfacial and (3 dolichofacial. Chewing side preference was evaluated using jaw tracking equipment, occlusal contact area was measured by silicon registration of posterior teeth, and bite force was measured unilaterally on molar regions using 2.25 mm-thick sensors. Statistical analysis was performed using ANOVA on Ranks, Student's t-test, and Mann-Whitney tests at a 5% significance level. Mesofacial, brachyfacial, and dolichofacial subjects presented more occlusal contact area on the left side. Only dolichofacial subjects showed lateral asymmetry for bite force, presenting higher force on the left side. No statistically significant differences were found for chewing side preference among all groups. Within the limitations of this study, it can be concluded that craniofacial dimensions play a role in asymmetry of bite force. ClinicalTrials.gov ID: NCT01286363.

Lymphadenitis as a Rare Side Effect of H1N1 Vaccine in a Child

Directory of Open Access Journals (Sweden)

Zuhal Gundogdu

2010-01-01

Full Text Available We present a 5-year-old boy who had the complaint of swelling and pain on the right vaccine shot and right axillary areas. The right axillary area was diagnosed as reactive lymphadenitis, which we believe is a rare local side effect of the swine flu vaccine. The key message to take away from this case is that the patient had lymphadenitis as a local side effect of the swine flu vaccine. Lymphadenitis should be reported as a possible local side effect of the swine flu vaccine.

Lymphadenitis as a Rare Side Effect of H1N1 Vaccine in a Child

Science.gov (United States)

Gundogdu, Zuhal; Seyhogullari, Mualla

2010-01-01

We present a 5-year-old boy who had the complaint of swelling and pain on the right vaccine shot and right axillary areas. The right axillary area was diagnosed as reactive lymphadenitis, which we believe is a rare local side effect of the swine flu vaccine. The key message to take away from this case is that the patient had lymphadenitis as a local side effect of the swine flu vaccine. Lymphadenitis should be reported as a possible local side effect of the swine flu vaccine. PMID:21209734

Managing the side effects of multiple sclerosis therapy: pharmacotherapy options for patients.

Science.gov (United States)

Rommer, Paulus S; Zettl, Uwe K

2018-04-01

Multiple sclerosis (MS) is an immune-mediated and neurodegenerative disease with an unpredictable outcome. Immune-modulatory treatment aims at decreasing long-term disability. With the increasing number of treatment options, it is essential to fully digest the possible side effects of the available therapeutics and to monitor patients is essential. Areas covered: All approved disease-modifying drugs (DMD) for MS are discussed in this review. Mode of action, adverse effects, reported risks for infections and malignancies, and pregnancy related issues are discussed in the review. The authors also provide suggestions for monitoring therapy. For all approved DMDs the pivotal studies have been included for possible side effects, as well as reports by health authorities. For this manuscript, PubMed was checked for reports on side effects for various drugs. Expert opinion: Treatment options in MS are manifold, each carrying different risks. The safety-risk profile for approved agents is favorable. Knowing and monitoring these possible side effects is essential to minimize risks associated with treatment. Presently, the long-term experience for some of these therapies is missing and this must be addressed.

Convergent and divergent functional connectivity patterns in patients with long-term left-sided and right-sided deafness.

Science.gov (United States)

Zhang, Yanyang; Mao, Zhiqi; Feng, Shiyu; Wang, Wenxin; Zhang, Jun; Yu, Xinguang

2018-02-05

Cortical reorganization may be induced in long-term single-sided deafness (SD); however, the influence of the deafness side on the functional changes remains poorly understood. Here, we investigated whole-brain functional connectivity patterns in long-term SD patients. The normalized voxel-based functional connectivity strength (FCS) was determined using resting-state fMRI (rs-fMRI) in 17 left-sided deafness (LD) patients, 21 right-sided deafness (RD) patients and 21 healthy controls (HCs). Relative to the HCs, both the LD and RD patients exhibited a reduction in the FCS in the ipsilateral visual cortex. However, compared to that in the HCs, a significantly higher FCS was observed in some regions in the salience and default-mode networks in the RD patients, but this FCS alternation pattern was not observed in the LD patients. A direct comparison of the two patient groups revealed a significantly increased FCS in the supplemental motor area in the LD group. Altogether, the long-term SD groups with LD and RD exhibited convergent and divergent functional connectivity patterns in whole-brain networks, providing promising evidence that the functional changes in long-term SD are highly deafness-side-dependent. Copyright © 2017 Elsevier B.V. All rights reserved.

ODEs with Preisach operator under the derivative and with discontinuous in time right-hand side

International Nuclear Information System (INIS)

Zhezherun, A; Flynn, D

2006-01-01

We consider ordinary Differential equations with a Preisach operator under the derivative. A special case when the right-hand side has discontinuities in time is studied. We present theorems about the existence and uniqueness of solutions. We also prove a theorem which describes the behavior of a solution at the points of discontinuity of the right-hand side

What side effects are problematic for patients prescribed antipsychotic medication? The Maudsley Side Effects (MSE) measure for antipsychotic medication.

Science.gov (United States)

Wykes, T; Evans, J; Paton, C; Barnes, T R E; Taylor, D; Bentall, R; Dalton, B; Ruffell, T; Rose, D; Vitoratou, S

2017-10-01

Capturing service users' perspectives can highlight additional and different concerns to those of clinicians, but there are no up to date, self-report psychometrically sound measures of side effects of antipsychotic medications. Aim To develop a psychometrically sound measure to identify antipsychotic side effects important to service users, the Maudsley Side Effects (MSE) measure. An initial item bank was subjected to a Delphi exercise (n = 9) with psychiatrists and pharmacists, followed by service user focus groups and expert panels (n = 15) to determine item relevance and language. Feasibility and comprehensive psychometric properties were established in two samples (N43 and N50). We investigated whether we could predict the three most important side effects for individuals from their frequency, severity and life impact. MSE is a 53-item measure with good reliability and validity. Poorer mental and physical health, but not psychotic symptoms, was related to side-effect burden. Seventy-nine percent of items were chosen as one of the three most important effects. Severity, impact and distress only predicted 'putting on weight' which was more distressing, more severe and had more life impact in those for whom it was most important. MSE is a self-report questionnaire that identifies reliably the side-effect burden as experienced by patients. Identifying key side effects important to patients can act as a starting point for joint decision making on the type and the dose of medication.

R and D options for demand side management in Japanese electric utilities

International Nuclear Information System (INIS)

Yamamoto, T.

1995-01-01

Japanese electric utilities are facing several problems: increasing construction cost of power facilities, siting constraints and the environmental issue of greenhouse gas emissions. To overcome these problems, electric utilities have been promoting demand-side-management (DSM) activities as well as supplier-side measures, with some presently being carried out through promoting energy conservation technologies and introducing tariff options for residential/commercial and industrial consumers. R and D works have been carried out on various fields such as energy storage and heat storage which contribute to the improvement of the load factor. 5 figs., 2 tabs

The side-to-side fashion for individual distal coronary anastomosis using venous conduit.

Science.gov (United States)

Kato, Takayoshi; Tsunekawa, Tomohiro; Motoji, Yusuke; Hirakawa, Akihiro; Okawa, Yasuhide; Tomita, Shinji

2017-04-01

Regarding to coronary artery bypass grafting (CABG), the end-to-side anastomosis (ESA) has been performed as a gold standard. Recently, the effectiveness of the distal side-to-side anastomosis (SSA) in CABG using internal mammary artery has been reported. The benefit of SSA comparing to ESA also has been disclosed by computing simulation. However, use of SSA by venous conduit for individual CABG has not been reported. In this study, we investigated feasibility of SSA. From January 2013 to October 2014, we conducted 114 CABGs. There were 92 venous distal anastomoses without sequential anastomotic site (61 SSA and 31 ESA). The anastomosis was evaluated before discharge and at 1 year after the procedure by angiography or multi-detector row computed tomographic coronary angiography. The median values for time to anastomosis were 13 min in the two group (p = 0.89). There was no revision of anastomosis in both groups. Additional stitches for hemostasis were required significantly less in SSA than ESA (18.0 vs 45.2 %, respectively, p fashion is easy to perform and maybe beneficial in blood flow pattern.

Side effects of antiviral therapy in hepatitis C virus infection-sarcoidosis - case report.

Science.gov (United States)

Teodor, D; Teodor, Andra; Grigore, Lucia; Jugănariu, Gabriela; Dorobăţ, Carmen Mihaela; Miftode, Egidia; Azoicăi, Doina

2012-01-01

Standard therapy in chronic hepatitis C virus infection is still a combination of peginterferon alfa2a/2b and ribavirin for 48 weeks. As of side effects, there are organic side effects, such as hematologic disorders, and functional side effects, reflected in the quality of life of hepatitis C patients. Up to 30% of the patients develop specific side effects such as headache, fever, fatigue. Sarcoidosis, known as a granulomatous disease of uncertain cause, is an uncommon finding in this category of patients. This cause-effect relation is accounted for by the convergent action of peginterferon and ribavirin of stimulating type 1 T helper cells and reducing type 2 helper T cells activation. We present the case of male patient known with chronic hepatitis C who developed pulmonary sarcoidosis following antiviral therapy. The first manifestation of the disease was unexplained fever accompanied by pulmonary tract disease. The diagnosis was established by immunophenotyping in bronchial aspirate

Rarity of invasiveness in right-sided infective endocarditis

DEFF Research Database (Denmark)

Hussain, Syed T; Shrestha, Nabin K; Witten, James

2018-01-01

OBJECTIVE: The rarity of invasiveness of right-sided infective endocarditis (IE) compared with left-sided has not been well recognized and evaluated. Thus, we compared invasiveness of right- versus left-sided IE in surgically treated patients. PATIENTS AND METHODS: From January 2002 to January 20...

A protein-dependent side-chain rotamer library.

KAUST Repository

Bhuyan, M.S.; Gao, Xin

2011-01-01

Protein side-chain packing problem has remained one of the key open problems in bioinformatics. The three main components of protein side-chain prediction methods are a rotamer library, an energy function and a search algorithm. Rotamer libraries summarize the existing knowledge of the experimentally determined structures quantitatively. Depending on how much contextual information is encoded, there are backbone-independent rotamer libraries and backbone-dependent rotamer libraries. Backbone-independent libraries only encode sequential information, whereas backbone-dependent libraries encode both sequential and locally structural information. However, side-chain conformations are determined by spatially local information, rather than sequentially local information. Since in the side-chain prediction problem, the backbone structure is given, spatially local information should ideally be encoded into the rotamer libraries. In this paper, we propose a new type of backbone-dependent rotamer library, which encodes structural information of all the spatially neighboring residues. We call it protein-dependent rotamer libraries. Given any rotamer library and a protein backbone structure, we first model the protein structure as a Markov random field. Then the marginal distributions are estimated by the inference algorithms, without doing global optimization or search. The rotamers from the given library are then re-ranked and associated with the updated probabilities. Experimental results demonstrate that the proposed protein-dependent libraries significantly outperform the widely used backbone-dependent libraries in terms of the side-chain prediction accuracy and the rotamer ranking ability. Furthermore, without global optimization/search, the side-chain prediction power of the protein-dependent library is still comparable to the global-search-based side-chain prediction methods.

A protein-dependent side-chain rotamer library.

KAUST Repository

Bhuyan, M.S.

2011-12-14

Protein side-chain packing problem has remained one of the key open problems in bioinformatics. The three main components of protein side-chain prediction methods are a rotamer library, an energy function and a search algorithm. Rotamer libraries summarize the existing knowledge of the experimentally determined structures quantitatively. Depending on how much contextual information is encoded, there are backbone-independent rotamer libraries and backbone-dependent rotamer libraries. Backbone-independent libraries only encode sequential information, whereas backbone-dependent libraries encode both sequential and locally structural information. However, side-chain conformations are determined by spatially local information, rather than sequentially local information. Since in the side-chain prediction problem, the backbone structure is given, spatially local information should ideally be encoded into the rotamer libraries. In this paper, we propose a new type of backbone-dependent rotamer library, which encodes structural information of all the spatially neighboring residues. We call it protein-dependent rotamer libraries. Given any rotamer library and a protein backbone structure, we first model the protein structure as a Markov random field. Then the marginal distributions are estimated by the inference algorithms, without doing global optimization or search. The rotamers from the given library are then re-ranked and associated with the updated probabilities. Experimental results demonstrate that the proposed protein-dependent libraries significantly outperform the widely used backbone-dependent libraries in terms of the side-chain prediction accuracy and the rotamer ranking ability. Furthermore, without global optimization/search, the side-chain prediction power of the protein-dependent library is still comparable to the global-search-based side-chain prediction methods.

Fluid-mediated stability and speed-increase for heaving hydrofoils swimming side-by-side

Science.gov (United States)

Newbolt, Joel; Zhang, Jun; Ristroph, Leif

2017-11-01

As an example of collective motion in active swimmers we study the fluid-mediated interaction between two heaving hydrofoils that swim with a fixed transverse separation (between the heaving mid-heights) but are free to independently choose their forward swimming speeds and positions. Experiments reveal that out-of-phase foils are attracted to a side-by-side configuration which also increases the swimming speed of the pair (up to 59% faster for our parameters), while in-phase foils are repelled from this configuration. Because this type of swimming is qualitatively similar to that of fish and birds this interaction could be important to schooling and flocking.

Lamb wave band gaps in one-dimensional radial phononic crystal plates with periodic double-sided corrugations

Energy Technology Data Exchange (ETDEWEB)

Li, Yinggang [School of Mechanical Engineering and State Key Laboratory for Strength and Vibration of Mechanical Structures, Xi’an Jiaotong University, Xi’an, 710049 (China); School of Transportation, Wuhan University of Technology, Wuhan 430070 (China); Chen, Tianning [School of Mechanical Engineering and State Key Laboratory for Strength and Vibration of Mechanical Structures, Xi’an Jiaotong University, Xi’an, 710049 (China); Wang, Xiaopeng, E-mail: xpwang@mail.xjtu.edu.cn [School of Mechanical Engineering and State Key Laboratory for Strength and Vibration of Mechanical Structures, Xi’an Jiaotong University, Xi’an, 710049 (China); Li, Suobin [School of Mechanical Engineering and State Key Laboratory for Strength and Vibration of Mechanical Structures, Xi’an Jiaotong University, Xi’an, 710049 (China)

2015-11-01

In this paper, we present the theoretical investigation of Lamb wave propagation in one-dimensional radial phononic crystal (RPC) plates with periodic double-sided corrugations. The dispersion relations, the power transmission spectra, and the displacement fields of the eigenmodes are studied by using the finite element method based on two-dimensional axial symmetry models in cylindrical coordinates. Numerical results show that the proposed RPC plates with periodic double-sided corrugations can yield several band gaps with a variable bandwidth for Lamb waves. The formation mechanism of band gaps in the double-sided RPC plates is attributed to the coupling between the Lamb modes and the in-phase and out-phases resonant eigenmodes of the double-sided corrugations. We investigate the evolution of band gaps in the double-sided RPC plates with the corrugation heights on both sides arranged from an asymmetrical distribution to a symmetrical distribution gradually. Significantly, with the introduction of symmetric double-sided corrugations, the antisymmetric Lamb mode is suppressed by the in-phase resonant eigenmodes of the double-sided corrugations, resulting in the disappearance of the lowest band gap. Furthermore, the effects of the geometrical parameters on the band gaps are further explored numerically.

GC Side Event: Future of Nuclear Energy: Engaging the Young Generation. Presentations

International Nuclear Information System (INIS)

2017-01-01

This event presented the IAEA’s programmes for the education and training of a new generation of nuclear professionals. It also featured the annual European Master of Science in Nuclear Engineering (EMSNE) award ceremony

New technique of skin embedded wire double-sided laser beam welding

Science.gov (United States)

Han, Bing; Tao, Wang; Chen, Yanbin

2017-06-01

In the aircraft industry, double-sided laser beam welding is an approved method for producing skin-stringer T-joints on aircraft fuselage panels. As for the welding of new generation aluminum-lithium alloys, however, this technique is limited because of high hot cracking susceptibility and strengthening elements' uneven distributions within weld. In the present study, a new technique of skin embedded wire double-sided laser beam welding (LBW) has been developed to fabricate T-joints consisting of 2.0 mm thick 2060-T8/2099-T83 aluminum-lithium alloys using eutectic alloy AA4047 filler wire. Necessary dimension parameters of the novel groove were reasonably designed for achieving crack-free welds. Comparisons were made between the new technique welded T-joint and conventional T-joint mainly on microstructure, hot crack, elements distribution features and mechanical properties within weld. Excellent crack-free microstructure, uniform distribution of silicon and superior tensile properties within weld were found in the new skin embedded wire double-sided LBW T-joints.

Server-side Statistics Scripting in PHP

Directory of Open Access Journals (Sweden)

Jan de Leeuw

1997-06-01

Full Text Available On the UCLA Statistics WWW server there are a large number of demos and calculators that can be used in statistics teaching and research. Some of these demos require substantial amounts of computation, others mainly use graphics. These calculators and demos are implemented in various different ways, reflecting developments in WWW based computing. As usual, one of the main choices is between doing the work on the client-side (i.e. in the browser or on the server-side (i.e. on our WWW server. Obviously, client-side computation puts fewer demands on the server. On the other hand, it requires that the client downloads Java applets, or installs plugins and/or helpers. If JavaScript is used, client-side computations will generally be slow. We also have to assume that the client is installed properly, and has the required capabilities. Requiring too much on the client-side has caused browsing machines such as Netscape Communicator to grow beyond all reasonable bounds, both in size and RAM requirements. Moreover requiring Java and JavaScript rules out such excellent browsers as Lynx or Emacs W3. For server-side computing, we can configure the server and its resources ourselves, and we need not worry about browser capabilities and configuration. Nothing needs to be downloaded, except the usual HTML pages and graphics. In the same way as on the client side, there is a scripting solution, where code is interpreted, or a ob ject-code solution using compiled code. For the server-side scripting, we use embedded languages, such as PHP/FI. The scripts in the HTML pages are interpreted by a CGI program, and the output of the CGI program is send to the clients. Of course the CGI program is compiled, but the statistics procedures will usually be interpreted, because PHP/FI does not have the appropriate functions in its scripting language. This will tend to be slow, because embedded languages do not deal efficiently with loops and similar constructs. Thus a first

Towards demand-side solutions for mitigating climate change

Science.gov (United States)

Creutzig, Felix; Roy, Joyashree; Lamb, William F.; Azevedo, Inês M. L.; Bruine de Bruin, Wändi; Dalkmann, Holger; Edelenbosch, Oreane Y.; Geels, Frank W.; Grubler, Arnulf; Hepburn, Cameron; Hertwich, Edgar G.; Khosla, Radhika; Mattauch, Linus; Minx, Jan C.; Ramakrishnan, Anjali; Rao, Narasimha D.; Steinberger, Julia K.; Tavoni, Massimo; Ürge-Vorsatz, Diana; Weber, Elke U.

2018-04-01

Research on climate change mitigation tends to focus on supply-side technology solutions. A better understanding of demand-side solutions is missing. We propose a transdisciplinary approach to identify demand-side climate solutions, investigate their mitigation potential, detail policy measures and assess their implications for well-being.

EFFECTS OF SMALL-SIDED GAMES ON PHYSICAL CONDITIONING AND PERFORMANCE IN YOUNG SOCCER PLAYERS

Directory of Open Access Journals (Sweden)

Athanasios Katis

2009-09-01

Full Text Available The purpose of this study was to examine, first, the movement actions performed during two different small-sided games and, second, their effects on a series of field endurance and technical tests. Thirty-four young soccer players (age: 13 ± 0.9 yrs; body mass: 62.3 ± 15.1 kg; height: 1.65 ± 0.06 m participated in the study. Small-sided games included three-a-side (3 versus 3 players and six-a-side (6 versus 6 players games consisting of 10 bouts of 4 min duration with 3 min active recovery between bouts. Soccer player performance was evaluated using five field tests: a 30m sprint, b throw-in for distance, c Illinois Agility Test, d dribbling the ball and e horizontal jump before, in the middle and after the implementation of both game situations. Heart rate was monitored during the entire testing session. Each game was also filmed to measure soccer movements within the game. The ANOVA analysis indicated that the three-a- side games displayed significantly higher heart rate values compared with the six-a-side games (p < 0.05. The number of short passes, kicks, tackles, dribbles and scoring goals were significantly higher during the three-a-side compared with the six-a-side game condition (p < 0. 05 while players performed more long passes and headed the ball more often during the six-a-side (p < 0.05. After the three-a-side games, there was a significant decline in sprint and agility performance (p < 0.05, while after both game conditions significant alterations in the throw-in and the horizontal jump performance were observed (p < 0.05. The results of the present study indicated that three-a-side games provide higher stimulus for physical conditioning and technical improvement than six-a-side games and their use for training young soccer players is recommended

A Diffusion Model for Two-sided Service Systems

Science.gov (United States)

Homma, Koichi; Yano, Koujin; Funabashi, Motohisa

A diffusion model is proposed for two-sided service systems. ‘Two-sided’ refers to the existence of an economic network effect between two different and interrelated groups, e.g., card holders and merchants in an electronic money service. The service benefit for a member of one side depends on the number and quality of the members on the other side. A mathematical model by J. H. Rohlfs explains the network (or bandwagon) effect of communications services. In Rohlfs' model, only the users' group exists and the model is one-sided. This paper extends Rohlfs' model to a two-sided model. We propose, first, a micro model that explains individual behavior in regard to service subscription of both sides and a computational method that drives the proposed model. Second, we develop macro models with two diffusion-rate variables by simplifying the micro model. As a case study, we apply the models to an electronic money service and discuss the simulation results and actual statistics.

RIGHT-SIDED AORTIC ARCH WITH ABERRANT LEFT SUBCLAVIAN ARTERY AND DUPLICATION OF SUPERIOR VENA CAVA

Directory of Open Access Journals (Sweden)

Parikhita Hazarika

2017-08-01

Full Text Available Right-sided aortic arch is a rare anatomical variant present in about 0.1% of the adult population.1,2 Half of the cases are associated with an aberrant left subclavian artery (0.05%-0.1%. Right-sided aortic arch with aberrant left subclavian artery is less common than left-sided aortic arch with aberrant right subclavian artery (0.5-2.0%.3,4 A rightsided aortic arch is an anatomic variant resulting from persistence of the right fourth aortic arch and involution of the left. It can be associated with an aberrant left subclavian artery arises from Kommerell’s diverticulum. It is usually asymptomatic and diagnosed incidentally during adult age. A 40-year-old male presented with cough and a hump in the back. The patient was evaluated for scoliosis and plain CT thorax was done.

Client-side Web Mining for Community Formation in Peer-to-Peer Environments

Data.gov (United States)

National Aeronautics and Space Administration — In this paper we present a framework for forming interests-based Peer-to-Peer communities using client-side web browsing history. At the heart of this framework is...

Demand side resource operation on the Irish power system with high wind power penetration

International Nuclear Information System (INIS)

Keane, A.; Tuohy, A.; Meibom, P.; Denny, E.; Flynn, D.; Mullane, A.; O'Malley, M.

2011-01-01

The utilisation of demand side resources is set to increase over the coming years with the advent of advanced metering infrastructure, home area networks and the promotion of increased energy efficiency. Demand side resources are proposed as an energy resource that, through aggregation, can form part of the power system plant mix and contribute to the flexible operation of a power system. A model for demand side resources is proposed here that captures its key characteristics for commitment and dispatch calculations. The model is tested on the all island Irish power system, and the operation of the model is simulated over one year in both a stochastic and deterministic mode, to illustrate the impact of wind and load uncertainty. The results illustrate that demand side resources can contribute to the efficient, flexible operation of systems with high penetrations of wind by replacing some of the functions of conventional peaking plant. Demand side resources are also shown to be capable of improving the reliability of the system, with reserve capability identified as a key requirement in this respect. - Highlights: → Demand side resource model presented for use in unit commitment and dispatch calculations. → Benefits of demand side aggregation demonstrated specifically as a peaking unit and provider of reserve. → Potential to displace or defer construction of conventional peaking units.

Measurement system analysis for one-sided tolerance

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Szemik Kamil

2017-01-01

Full Text Available Measurement system analysis is carried out in order to determine if a capability to perform measurements in terms of product and process control is sufficient, indicating that the type I and the type II appraisal errors probability are acceptable. Statistical analyses for measurement system evaluation presented in the literature and the industrial manuals are not applicable for all complex and unusual applications. Therefore, the purpose of this study was to develop a robust statistical analysis method for measurement system variability analysis, in terms of product control scenario applied to one-sided tolerance. In the hereby presented study, the authors presented the theoretical principles of statistical techniques for measurement variations evaluation. Subsequently, the formula of gauge repeatability and reproducibility in terms of lower specification limit was proposed. The research hypothesis was tested using the statistical analysis.

Magnetic field sensor based on double-sided polished fibre-Bragg gratings

International Nuclear Information System (INIS)

Tien, Chuen-Lin; Hwang, Chang-Chou; Liu, Wen-Feng; Chen, Hong-Wei

2009-01-01

A new magnetic field sensor based on double-sided polished fibre-Bragg gratings (FBGs) coated with an iron thin film for measuring magnetic flux density was experimentally demonstrated with the sensitivity of 25.6 nm T −1 . The sensing mechanism is based on the Bragg wavelength shift as the magnetic field is measured by the proposed sensing head. Results of this study present the intensity of the reflected optical signal as a function of the applied strain on the FBG. This paper shows that an improved method for sensing the wavelength shift with changes in external magnetic field is developed by use of the double-sided polished FBGs

A GCM Solution for Leveraging Server-side JMS Functionality to Android-based Trading Application

Directory of Open Access Journals (Sweden)

Claudiu VINTE

2013-01-01

Full Text Available The paper presents our solution for a message oriented communication mechanism, employing Google Cloud Messaging (GCM on the client-side, and Java Message Service (JMS on the server-side, in order to leverage JMS functionality to Android-based trading application. Our ongoing research has been focused upon conceiving a way to expose the trading services offered by our academic trading system ASETS to a mobile trading application based on Android platform. ASETS trading platform is a distributed SOA implementation, with an original API based on JMS. In order to design and implement an Android based client, able to inter-communicate with the server-side components of ASETS, in a manner consistent with publisher/subscriber JMS communication model, there was particularly necessary to have object embedded messages, produced by various ASETS services, pushed to the client application. While point-to-point communication model could be resolved on the client-side by employing synchronous HTTP socket connections over TCP/IP, the asynchronously generated messages from the server-side had to reach the client application in a push manner.

Isolated left-sided pulmonary artery agenesis with left lung hypoplasia: A report of two cases

Directory of Open Access Journals (Sweden)

V Govindaraj

2017-01-01

Full Text Available Unilateral absence of pulmonary artery or pulmonary artery agenesis (UAPA is a rare congenital malformation that can present as an isolated lesion or in association with other cardiac anomalies. Though congenital, presentation in adults are also reported. Most common presentation in adults is of exercise intolerance. The developing lung on the affected side is hypoplastic. Diagnosis of UAPA is established by imaging methods like CT and MRI . There is no specific treatment for this condition. Treatment depends on patients symptomatology, presence of pulmonary hypertension and collateral circulation. Presence of pulmonary hypertension carries a bad prognosis. We present two adult patients with isolated left sided unilateral pulmonary artery agenesis with ipsilateral lung hypoplasia. The diagnosis was confirmed by CT chest and perfusion scan.

Terrorism, civil war, one-sided violence and global burden of disease.

Science.gov (United States)

Kerridge, Bradley T; Khan, Maria R; Sapkota, Amir

2012-01-01

Armed conflict and related violence, including terrorism and one-sided violence, has profound effects on people's health and lives. The purpose of this study was to determine the relationship between deaths due to terrorism, civil war and one-sided violence from 1994-2000 and disability-adjusted life years (DALYs) occurring in 2002 attributable to all causes and specific communicable and noncommunicable diseases. Deaths resulting from terrorism, war and one-sided violence were positively associated with all cause as well as a number of communicable and noncommunicable disease-specific DALYs across the majority of sex and age subgroups of the populace, controlling for an array of economic factors empirically shown to affect public health. Overall, a 1.0% increase in deaths due to terrorism, civil war and one-sided violence from 1994-2000 was associated with a 0.16% increase in DALYs lost to all causes in 2002 in the total world population. There was little variation in the magnitude of these associations between males and females and between communicable and noncommunicable diseases. The results of the present study can begin to guide post-conflict recovery by focusing on interventions targeting both noncommunicable as well as communicable diseases, thereby highlighting the full health costs of war and ultimately providing a strong rationale for promoting peace.

Side-band-separating heterodyne mixer for band 9 of ALMA.

NARCIS (Netherlands)

Mena, F. P.; Baryshev, A. M.; Kooi, J.; Lodewijk, C. F. J.; Gerlofsma, G.; Hesper, R.; Wild, W.; Shen, XC; Lu, W; Zhang, J; Dou, WB

2006-01-01

Here we present the realization of a side-band-separating (2SB) heterodyne mixer for the frequency range from 602 to 720 GHz (corresponding to ALMA band 9). The mixer, in brief, consists of a quadrature hybrid, two LO injectors, two SIS junctions, and three dumping loads. All the parts were modeled

Hypoglossal-facial nerve "side"-to-side neurorrhaphy for facial paralysis resulting from closed temporal bone fractures.

Science.gov (United States)

Su, Diya; Li, Dezhi; Wang, Shiwei; Qiao, Hui; Li, Ping; Wang, Binbin; Wan, Hong; Schumacher, Michael; Liu, Song

2018-06-06

Closed temporal bone fractures due to cranial trauma often result in facial nerve injury, frequently inducing incomplete facial paralysis. Conventional hypoglossal-facial nerve end-to-end neurorrhaphy may not be suitable for these injuries because sacrifice of the lesioned facial nerve for neurorrhaphy destroys the remnant axons and/or potential spontaneous innervation. we modified the classical method by hypoglossal-facial nerve "side"-to-side neurorrhaphy using an interpositional predegenerated nerve graft to treat these injuries. Five patients who experienced facial paralysis resulting from closed temporal bone fractures due to cranial trauma were treated with the "side"-to-side neurorrhaphy. An additional 4 patients did not receive the neurorrhaphy and served as controls. Before treatment, all patients had suffered House-Brackmann (H-B) grade V or VI facial paralysis for a mean of 5 months. During the 12-30 months of follow-up period, no further detectable deficits were observed, but an improvement in facial nerve function was evidenced over time in the 5 neurorrhaphy-treated patients. At the end of follow-up, the improved facial function reached H-B grade II in 3, grade III in 1 and grade IV in 1 of the 5 patients, consistent with the electrophysiological examinations. In the control group, two patients showed slightly spontaneous innervation with facial function improved from H-B grade VI to V, and the other patients remained unchanged at H-B grade V or VI. We concluded that the hypoglossal-facial nerve "side"-to-side neurorrhaphy can preserve the injured facial nerve and is suitable for treating significant incomplete facial paralysis resulting from closed temporal bone fractures, providing an evident beneficial effect. Moreover, this treatment may be performed earlier after the onset of facial paralysis in order to reduce the unfavorable changes to the injured facial nerve and atrophy of its target muscles due to long-term denervation and allow axonal

The Influence of Side-Chain Position on the Optoelectronic Properties of a Red-Emitting Conjugated Polymer

NARCIS (Netherlands)

Lu, Li Ping; Finlayson, Chris E.; Kabra, Dinesh; Albert-Seifried, Sebastian; Song, Myoung Hoon; Havenith, Remco W. A.; Tu, Guoli; Huck, Wilhelm T. S.; Friend, Richard H.

2013-01-01

A study of the organic semiconductor F8TBT is presented, directly comparing a conventional form (F8TBT-out) with a form with varied alkyl side-chain position (F8TBT-in), in terms of optical properties and device performance in light-emitting-diodes (LEDs). Computational simulations of the side-chain

Diverticulosis and Diverticulitis

Science.gov (United States)

... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ...

Sparse networks of directly coupled, polymorphic, and functional side chains in allosteric proteins.

Science.gov (United States)

Soltan Ghoraie, Laleh; Burkowski, Forbes; Zhu, Mu

2015-03-01

Recent studies have highlighted the role of coupled side-chain fluctuations alone in the allosteric behavior of proteins. Moreover, examination of X-ray crystallography data has recently revealed new information about the prevalence of alternate side-chain conformations (conformational polymorphism), and attempts have been made to uncover the hidden alternate conformations from X-ray data. Hence, new computational approaches are required that consider the polymorphic nature of the side chains, and incorporate the effects of this phenomenon in the study of information transmission and functional interactions of residues in a molecule. These studies can provide a more accurate understanding of the allosteric behavior. In this article, we first present a novel approach to generate an ensemble of conformations and an efficient computational method to extract direct couplings of side chains in allosteric proteins, and provide sparse network representations of the couplings. We take the side-chain conformational polymorphism into account, and show that by studying the intrinsic dynamics of an inactive structure, we are able to construct a network of functionally crucial residues. Second, we show that the proposed method is capable of providing a magnified view of the coupled and conformationally polymorphic residues. This model reveals couplings between the alternate conformations of a coupled residue pair. To the best of our knowledge, this is the first computational method for extracting networks of side chains' alternate conformations. Such networks help in providing a detailed image of side-chain dynamics in functionally important and conformationally polymorphic sites, such as binding and/or allosteric sites. © 2014 Wiley Periodicals, Inc.

Determining optimum levels of DSM [demand-side management] as a supply-side resource

International Nuclear Information System (INIS)

Giles, S.H.; Mitchell, E.D.

1990-01-01

San Diego Gas and Electric Company (SDGE) recommends the evaluation of demand-side management as a supply-side resource. The advantages of concurrent economic analysis of DSM options with other traditional sources represents a significant improvement over analysis either before or after the development of a resource plan. The evaluation of utility-sponsored DSM programs that provide system benefits that include deferment of capacity additions and improvements in more efficient system operation should be evaluated side-by-side with traditional resources that provide similar benefits. The utility decision to either provide capital costs to construct a power plant or make demand payments for a power purchase is directly analogous to the decision to provide funding for a DSM program that would defer these same investments. Both types of decision represent utility control over investment decisions that allow the utility to provide reliable, low-cost power to its customers. SDGE has also had experience with using generation expansion scenarios to test different levels of pre-selected packages of DSM programs, attempting to evaluate the total costs of system expansion for each of the different packages. This method was fraught with problems, and the best information that could be gained was if the selection of DSM packages happened to bracket a lower cost scenario, when it could reasonably be assumed that both smaller and larger levels of DSM were not as cost effective as the intermediate level. However, in many cases the selection of DSM programs did not produce this result and the important question of whether individual DSM programs were worthwhile when evaluated individually, or whether the lowest cost scenario would be improved with more or less DSM, could not be answered

[A right sided colon volvulus with necrosis in a young patient. A case reported].

Science.gov (United States)

Márquez-Díaz, Adrián; Ramírez-Ortega, Miguel Angel

2010-01-01

Colon volvulus (CV) is the twisting or rotation of an intestinal segment over the mesenterium, which causes occlusion and vascular compromise. It is a frequent disease in individuals over 65 years-old. We report a young patient with right CV and necrosis. A 17 year-old male with clinical findings of acute abdomen presented in the emergency room. During the surgical procedure, a right sided was found, CV with ileocecal valve and caecum ischemia and right colon necrosis with mesenteric vessels thrombosis. The case presented begun with sudden abdominal pain, with intestinal occlusion data, and widespread peritoneal rebound tenderles which suggested an intestinal occlusion. A simple abdomen Rx showed prominent right side colon distention with air levels in small bowel and a "coffee bean" image, suggestive of CVA hemicolectomy with termino-lateral ileocolic anastomosis was performed. Right-sided CV is considered as congenital in origin. They corresponded to 21% of cases in Mexico, with an average age of presentation at 62 years. The CV represents 10% of the causes of large bowel obstruction in Mexico. This is the first case in young people reported in Mexican literature.

Improved side information generation for distributed video coding

DEFF Research Database (Denmark)

Huang, Xin; Forchhammer, Søren

2008-01-01

As a new coding paradigm, distributed video coding (DVC) deals with lossy source coding using side information to exploit the statistics at the decoder to reduce computational demands at the encoder. The performance of DVC highly depends on the quality of side information. With a better side...... information generation method, fewer bits will be requested from the encoder and more reliable decoded frames will be obtained. In this paper, a side information generation method is introduced to further improve the rate-distortion (RD) performance of transform domain distributed video coding. This algorithm...

PIV measurements of acoustic flow-induced vibration in a rectangular channel with co-axial side branches

International Nuclear Information System (INIS)

Li, Yanrong; Someya, Satoshi; Okamoto, Koji

2010-01-01

Systems with closed side-branches are liable to an excitation of sound, as called cavity tone. In this study, flow-induced acoustic resonances of piping systems containing closed side-branches were investigated experimentally. The present investigation on the coaxial closed side-branches is the first rudimentary study to measure the pressure at the downstream side opening of the cavity by microphone and to visualize the fluid flow in the cross-section by using PIV. High-time-resolved PIV has a possibility to analyze the velocity field and the relation between sound propagation and flow field. The fluid flows at different points in the cavity interact with some phase differences and the relation can be clarified. (author)

Development of double-sided silicon strip detectors (DSSD) for a Compton telescope

International Nuclear Information System (INIS)

Takeda, Shin'ichiro; Watanabe, Shin; Tanaka, Takaaki; Nakazawa, Kazuhiro; Takahashi, Tadayuki; Fukazawa, Yasushi; Yasuda, Hajimu; Tajima, Hiroyasu; Kuroda, Yoshikatsu; Onishi, Mitsunobu; Genba, Kei

2007-01-01

The low noise double-sided silicon strip detector (DSSD) technology is used to construct a next generation Compton telescope which is required to have both high-energy resolution and high-Compton reconstruction efficiency. In this paper, we present the result of a newly designed stacked DSSD module with high-energy resolution in highly packed mechanical structure. The system is designed to obtain good P-side and N-side noise performance by means of DC-coupled read-out. Since there are no decoupling capacitors in front-end electronics before the read-out ASICs, a high density stacked module with a pitch of 2 mm can be constructed. By using a prototype with four-layer of DSSDs with an area of 2.56cmx2.56cm, we have succeeded to operate the system. The energy resolution at 59.5 keV is measured to be 1.6 keV (FWHM) for the P-side and 2.8 keV (FWHM) for the N-side, respectively. In addition to the DSSD used in the prototype, a 4 cm wide DSSD with a thickness of 300μm is also developed. With this device, an energy resolution of 1.5 keV (FWHM) was obtained. A method to model the detector energy response to properly handle split events is also discussed

Experimental research on end-to-side anastomosis of peripheral nerves and effect of FK506 on end-to-side anastomosis.

Science.gov (United States)

Yang, L M; Wu, Y X; Zhang, X P; Li, X H

2014-01-01

To study the effects of end-to-side anastomosis of initially-denatured nerves at different times. 60 male Wistar albino rats were used to fabricate animal models for the experiment on end-to-side anastomosis of peripheral nerves and 50 female Wistar albino rats were used to fabricate animal models for the experiment on the effect of FK506 on end-to-side anastomosis. Bilateral common peroneal nerve, tibialis anterior muscle electrophysiological and histological examinations, tibialis anterior muscle wet muscle weight determination, and motor end plate examination were performed 3 months after operation. All recovery rates of action potential, single muscle contraction force and tetanic contraction force of the FK506 experimental group are significantly higher than those of the control group and the sectional area of muscle fiber is also higher than that of the control group of normal saline. The best time for end-to-side anastomosis of nerves should be controlled within 2 weeks and the effect of end-to-side anastomosis of nerves will gradually become unsatisfactory. FK506 plays a role in promoting functional rehabilitation following nerve end-to-side anastomosis (Tab. 7, Fig. 4, Ref. 31).

Detection of Left-Sided and Right-Sided Hearing Loss via Fractional Fourier Transform

Directory of Open Access Journals (Sweden)

Shuihua Wang

2016-05-01

Full Text Available In order to detect hearing loss more efficiently and accurately, this study proposed a new method based on fractional Fourier transform (FRFT. Three-dimensional volumetric magnetic resonance images were obtained from 15 patients with left-sided hearing loss (LHL, 20 healthy controls (HC, and 14 patients with right-sided hearing loss (RHL. Twenty-five FRFT spectrums were reduced by principal component analysis with thresholds of 90%, 95%, and 98%, respectively. The classifier is the single-hidden-layer feed-forward neural network (SFN trained by the Levenberg–Marquardt algorithm. The results showed that the accuracies of all three classes are higher than 95%. In all, our method is promising and may raise interest from other researchers.

Lichen planus pigmentosus: two atypical presentation

Directory of Open Access Journals (Sweden)

Falguni Nag

2013-01-01

Full Text Available Lichen planus pigmentosus (LPP is a chronic pigmentary disorder with variable pattern of presentation. We here by present two cases of LPP one with parallel band like pigmentation over abdomen sparing the abdominal skin creases and other with parallel band like pattern following the Blaschko’s lines over left side of the abdomen. Our cases are unique not only for its presentation but also for the pattern of distribution and LPP should be the differential diagnosis in any pigmentary disorders.

Measuring side effects after radiotherapy for pharynx cancer

DEFF Research Database (Denmark)

Jensen, Kenneth

2007-01-01

Data on side effects after radiotherapy is needed to establish the benefits and drawbacks of new treatments, but side effects are not quantified as easily as survival or local control. Side effects may be quantified using physical measures. Unfortunately, only few endpoints exist where a physical...... measure is obtainable, and the case of a patient-relevant measure is even rarer. Radiotherapy is often followed by complex symptoms not easily quantifiable by the observer. Quantitative patient reported side effects can be retrieved using validated questionnaires, but this kind of data is often difficult...... to interpret and the correlation with clinically observable or measurable changes not straightforward. The exploitation of the possibilities of highly conformal radiotherapy and multimodality treatment depends on a better understanding of the correlation between dose, volume, modifying factors, and side...

Side Effects of Leukotriene Receptor Antagonists in Asthmatic Children.

Science.gov (United States)

Erdem, Semiha Bahceci; Nacaroglu, Hikmet Tekin; Unsal Karkiner, Canan Sule; Gunay, Ilker; Can, Demet

2015-10-01

Leukotriene receptor antagonists (LTRAs) are drugs which have been widely used more than ten years. As the use of LTRAs increases, our knowledge with respect to their side effects increases as well. The objective of our study was to evaluat the observed side effects of LTRAs used in patients with astma. 1024 patients treated only with LTRAs owing to asthma or early wheezing were included in the study for a five-year period. The observed side effects of LTRAs in these patients were retrospectively investigated. The side effects were divided into two parts as psychiatric and non-psychiatric. Among the 1024 cases included in the study, 67.5% of the patients out of 41 with side effects were male, 32.5% were female and the average age was 6.5 years. The rate of patients with asthma was 63.41% and 36.58% of the patients had early wheezing. It was determined that sex, age and diagnosis (early wheezing or asthma) of the patients were ineffective in the emergence of side effects. The average period for the emergence of side effects was the first month. It was observed that hyperactivity was the most frequently observed psychiatric side effect and that abdominal pain was the non-psychiatric side effect. The side effects of LTRAs were common in children. Therefore, patients must be informed at the beginning of the treatment and they must be evaluated at certain intervals.

Side Flow Effect on Surface Generation in Nano Cutting.

Science.gov (United States)

Xu, Feifei; Fang, Fengzhou; Zhang, Xiaodong

2017-12-01

The side flow of material in nano cutting is one of the most important factors that deteriorate the machined surface quality. The effects of the crystallographic orientation, feed, and the cutting tool geometry, including tool edge radius, rake angle and inclination angle, on the side flow are investigated employing molecular dynamics simulation. The results show that the stagnation region is formed in front of tool edge and it is characterized by the stagnation radius R s and stagnation height h s . The side flow is formed because the material at or under the stagnation region is extruded by the tool edge to flow to the side of the tool edge. Higher stagnation height would increase the size of the side flow. The anisotropic nature of the material which partly determines the stagnation region also influences the side flow due to the different deformation mechanism under the action of the tool edge. At different cutting directions, the size of the side flow has a great difference which would finally affect the machined surface quality. The cutting directions of {100} , {110} , and {110}  are beneficial to obtain a better surface quality with small side flow. Besides that, the side flow could be suppressed by reducing the feed and optimizing the cutting tool geometry. Cutting tool with small edge radius, large positive rake angle, and inclination angle would decrease the side flow and consequently improve the machined surface quality.

Fracture Mechanics Analyses of the Slip-Side Joggle Regions of Wing-Leading-Edge Panels

Science.gov (United States)

Raju, Ivatury S.; Knight, Norman F., Jr.; Song, Kyongchan; Phillips, Dawn R.

2011-01-01

The Space Shuttle wing-leading edge consists of panels that are made of reinforced carbon-carbon. Coating spallation was observed near the slip-side region of the panels that experience extreme heating. To understand this phenomenon, a root-cause investigation was conducted. As part of that investigation, fracture mechanics analyses of the slip-side joggle regions of the hot panels were conducted. This paper presents an overview of the fracture mechanics analyses.

Detection of leakage magnetic flux from near-side and far-side defects in carbon steel plates using a giant magneto-resistive sensor

International Nuclear Information System (INIS)

Singh, W Sharatchandra; Rao, B P C; Vaidyanathan, S; Jayakumar, T; Raj, Baldev

2008-01-01

Giant magneto-resistive (GMR) sensors are attractive for magnetic flux leakage measurements, especially for the detection of shallow near-side cracks and deeply located defects. An optimized measurement system with magnetic yoke, GMR sensor and selective amplifier has been devised to detect the tangential component of leakage flux from various near-side notches and far-side notches (widths 0.5 mm and 1.0 mm, respectively) in 12 mm thick carbon steel plates. Far-side notches located at nearly 11 mm below the measurement surface have been detected with a good signal-to-noise ratio. The performance of the GMR sensor with lift off has also been studied for possible non-contact examination of hot surfaces and a lift off of 2 mm is expected to ensure the saturation-free detection of near-side as well as far-side notches

The Road Side Unit for the A270 Test Site

NARCIS (Netherlands)

Passchier, I.; Driessen, B.J.F.; Heijligers, B.M.R.; Netten, B.D.; Schackmann, P.P.M.

2011-01-01

The design and implementation of the Road Side Unit for the A270 Test Site is presented. It consists of a sensor platform and V2I communication platform with full coverage of the test site. A service platform enables applications to make use of these facilities. The RSU will be used both for the

Advection within side-by-side liquid micro-cylinders in a cross-flow

Science.gov (United States)

Dong, Qingming; Sau, Amalendu

2017-11-01

The gaseous SO2 entrainment from outer air stream and dispersion in binary and ternary liquid micro-cylinders appearing side-by-side are examined hereby. The separation/attachment regulated non-uniform interfacial momentum exchange creates main stream driven "primary" and shear reversed "secondary" vortices in the liquid cylinders. At separation points, the sense of rotation of the generated "primary-secondary" vortex pair remains inward directed. We define such a vortex pair as the "inflow" type. However, at stagnation or attachment points, the sense of rotation of a "primary-primary" or "secondary-secondary" vortex pair remains outward directed, and such a vortex pair is defined as the "outflow" type. For the coupled water cylinders facing an oncoming stream contaminated by gaseous SO2, its absorption and internal transport are effectively controlled by dominant "inflow" and "outflow" natured dynamics of the said vortex pairs, besides by diffusion. The evolving "inflow" natured "primary-secondary" vortex pairs at separation points actively entrain the outer SO2, whereas the "outflow" natured vortex-pairs oppose SO2 entry through the stagnation regions. Moreover, the blockage induced steady-symmetric, steady-deflected, and flip-flopping air-jets through gaps, for varied gap-ratio (1 ≤ G/R ≤ 4) and Reynolds number (30 ≤ Re ≤ 160), create distinctive impact both on quantitative SO2 absorption (mso2 ') and convective nature of the SO2 transport in upper, lower, and middle cylinders, by virtue of modified strength and size of the inflow and outflow paired vortices. The present study shows that the tiny "secondary vortices" play important roles in SO2 entrainment and in effectively controlling the local absorption rate Rs o2. The sudden acceleration and upward/downward deflection of gap-flows enhanced near-neck advective SO2 entrainment by suitably strengthening the "inflow" natured local vortex dynamics. Conversely, for the reduced size of secondary vortices

Calculation model for 16N transit time in the secondary side of steam generators

International Nuclear Information System (INIS)

Liu Songyu; Xu Jijun; Xu Ming

1998-01-01

The 16 N transit time is essential to determine the leak-rate of steam generator tubes leaks with 16 N monitoring system, which is a new technique. A model was developed for calculation 16 N transit time in the secondary side of steam generators. According to the flow characters of secondary side fluid, the transit times divide into four sectors from tube sheet to the sensor on steam line. The model assumes that 16 N is moving as vapor phase in the secondary-side. So the model for vapor velocity distribution in tube bundle is presented in detail. The 16 N transit time calculation results of this model compare with these of EDF on steam generator of Qinshan NPP

Exploring Tradeoffs in Demand-Side and Supply-Side Management of Urban Water Resources Using Agent-Based Modeling and Evolutionary Computation

Directory of Open Access Journals (Sweden)

Lufthansa Kanta

2015-11-01

Full Text Available Urban water supply systems may be managed through supply-side and demand-side strategies, which focus on water source expansion and demand reductions, respectively. Supply-side strategies bear infrastructure and energy costs, while demand-side strategies bear costs of implementation and inconvenience to consumers. To evaluate the performance of demand-side strategies, the participation and water use adaptations of consumers should be simulated. In this study, a Complex Adaptive Systems (CAS framework is developed to simulate consumer agents that change their consumption to affect the withdrawal from the water supply system, which, in turn influences operational policies and long-term resource planning. Agent-based models are encoded to represent consumers and a policy maker agent and are coupled with water resources system simulation models. The CAS framework is coupled with an evolutionary computation-based multi-objective methodology to explore tradeoffs in cost, inconvenience to consumers, and environmental impacts for both supply-side and demand-side strategies. Decisions are identified to specify storage levels in a reservoir that trigger: (1 increases in the volume of water pumped through inter-basin transfers from an external reservoir; and (2 drought stages, which restrict the volume of water that is allowed for residential outdoor uses. The proposed methodology is demonstrated for Arlington, Texas, water supply system to identify non-dominated strategies for an historic drought decade. Results demonstrate that pumping costs associated with maximizing environmental reliability exceed pumping costs associated with minimizing restrictions on consumer water use.

Health and Physiological Adaptations of Small-Sided Ball Games in Untrained Older Adults Aged 65-93 Years

DEFF Research Database (Denmark)

Vorup Petersen, Jacob

function, and 3) the feasibility, motivation and injury rate of regular small-sided ball games in untrained elderly. Purpose. The overall aims of the present thesis were to examine physiological adaptations important for health after a period of small-sided ball game training and protein ingestion...... adults, 16 weeks of small-sided soccer was shown to improve physical function and exercise capacity, whereas muscle mass was unaffected by the training despite a high intake of daily protein. However, a number of questions still need to be answered regarding small-sided ball game training in untrained...... elderly: 1) The effect of other small-sided ball games, e.g. floorball training and cone ball, on physiological adaptations important for health as well as the effect of combined protein intake, 2) the effect of regular small-sided ball games in older adults with a more advanced age and low physical...

“Side effects affected my daily activities a lot”: a qualitative exploration of the impact of contraceptive side effects in Bangladesh

Directory of Open Access Journals (Sweden)

Jain A

2017-07-01

Full Text Available Aparna Jain,1 Laura Reichenbach,1 Iqbal Ehsan,2 Ubaidur Rob2 1Evidence Project, Population Council, Washington, DC, USA; 2Evidence Project, Population Council, Dhaka, Bangladesh Purpose: In a country like Bangladesh that has made great progress in contraceptive use with one of the lowest levels of fertility and highest levels of contraceptive use, understanding what factors influence women’s decisions to discontinue a contraceptive method and not switch to a new method is critical in designing interventions and programs that will help enable Bangladesh to reach its FP2020 goals. Research on side effects has focused on physical manifestations like headaches, moodiness, abdominal pain, and menstrual irregularities. While physical effects alone may stop women from continuing a contraceptive method, less is known about how side effects influence women’s daily activities and lives. The purpose of this study is to understand the ways that side effects affect Bangladeshi women’s participation in different social settings.Methods: Thirty-five in-depth interviews with married women who recently discontinued or switched to a different contraceptive method were conducted in Sylhet and Khulna Divisions. Interviews explored reasons for discontinuation including experience of side effects and impact of side effects on women’s lives.Results: Key themes emerged including that side effects are not only experienced physically but are barriers to women’s participation in many aspects of their lives. The spheres of life that most commonly appeared to be influenced by side effects include religion, household, and sexual intimacy irrespective of method used or residence.Conclusion: Family planning providers need to be aware of these additional consequences associated with contraceptive side effects to provide tailored counseling that recognizes these issues and helps women to mitigate them. For Bangladesh to achieve its FP2020 goals, understanding the

The Need of Slanted Side Holes for Venous Cannulae

Directory of Open Access Journals (Sweden)

Joong Yull Park

2012-01-01

Full Text Available Well-designed cannulae must allow good flow rate and minimize nonphysiologic load. Venous cannulae generally have side holes to prevent the rupture of blood vessel during perfusion. Optimizing side hole angle will yield more efficient and safe venous cannulae. A numerical modeling was used to study the effect of the angle (0°–45° and number (0–12 of side holes on the performance of cannulae. By only slanting the side holes, it increases the flow rate up to 6% (in our models. In addition, it was found that increasing the number of side holes reduces the shear rate up to 12% (in our models. A new parameter called “penetration depth” was introduced to describe the interfering effect of stream jets from side holes, and the result showed that the 45°-slanted side holes caused minimum interfering for the flow in cannula. Our quantitative hemodynamic analysis study provides important guidelines for venous cannulae design.

Temporomandibular Disorders: The Habitual Chewing Side Syndrome

Science.gov (United States)

Santana-Mora, Urbano; López-Cedrún, José; Mora, María J.; Otero, Xosé L.; Santana-Penín, Urbano

2013-01-01

Background Temporomandibular disorders are the most common cause of chronic orofacial pain, but, except where they occur subsequent to trauma, their cause remains unknown. This cross-sectional study assessed chewing function (habitual chewing side) and the differences of the chewing side and condylar path and lateral anterior guidance angles in participants with chronic unilateral temporomandibular disorder. This is the preliminary report of a randomized trial that aimed to test the effect of a new occlusal adjustment therapy. Methods The masticatory function of 21 randomly selected completely dentate participants with chronic temporomandibular disorders (all but one with unilateral symptoms) was assessed by observing them eat almonds, inspecting the lateral horizontal movement of the jaw, with kinesiography, and by means of interview. The condylar path in the sagittal plane and the lateral anterior guidance angles with respect to the Frankfort horizontal plane in the frontal plane were measured on both sides in each individual. Results Sixteen of 20 participants with unilateral symptoms chewed on the affected side; the concordance (Fisher’s exact test, P = .003) and the concordance-symmetry level (Kappa coefficient κ = 0.689; 95% confidence interval [CI], 0.38 to 0.99; P = .002) were significant. The mean condylar path angle was steeper (53.47(10.88) degrees versus 46.16(7.25) degrees; P = .001), and the mean lateral anterior guidance angle was flatter (41.63(13.35) degrees versus 48.32(9.53) degrees P = .036) on the symptomatic side. Discussion The results of this study support the use of a new term based on etiology, “habitual chewing side syndrome”, instead of the nonspecific symptom-based “temporomandibular joint disorders”; this denomination is characterized in adults by a steeper condylar path, flatter lateral anterior guidance, and habitual chewing on the symptomatic side. PMID:23593156

Temporomandibular disorders: the habitual chewing side syndrome.

Directory of Open Access Journals (Sweden)

Urbano Santana-Mora

Full Text Available BACKGROUND: Temporomandibular disorders are the most common cause of chronic orofacial pain, but, except where they occur subsequent to trauma, their cause remains unknown. This cross-sectional study assessed chewing function (habitual chewing side and the differences of the chewing side and condylar path and lateral anterior guidance angles in participants with chronic unilateral temporomandibular disorder. This is the preliminary report of a randomized trial that aimed to test the effect of a new occlusal adjustment therapy. METHODS: The masticatory function of 21 randomly selected completely dentate participants with chronic temporomandibular disorders (all but one with unilateral symptoms was assessed by observing them eat almonds, inspecting the lateral horizontal movement of the jaw, with kinesiography, and by means of interview. The condylar path in the sagittal plane and the lateral anterior guidance angles with respect to the Frankfort horizontal plane in the frontal plane were measured on both sides in each individual. RESULTS: Sixteen of 20 participants with unilateral symptoms chewed on the affected side; the concordance (Fisher's exact test, P = .003 and the concordance-symmetry level (Kappa coefficient κ = 0.689; 95% confidence interval [CI], 0.38 to 0.99; P = .002 were significant. The mean condylar path angle was steeper (53.47(10.88 degrees versus 46.16(7.25 degrees; P = .001, and the mean lateral anterior guidance angle was flatter (41.63(13.35 degrees versus 48.32(9.53 degrees P = .036 on the symptomatic side. DISCUSSION: The results of this study support the use of a new term based on etiology, "habitual chewing side syndrome", instead of the nonspecific symptom-based "temporomandibular joint disorders"; this denomination is characterized in adults by a steeper condylar path, flatter lateral anterior guidance, and habitual chewing on the symptomatic side.

Side-by-side determination of workers' exposure to wood dust with IOM and open-faced samplers.

Science.gov (United States)

Cavlović, Anka Ozana; Beljo Lučić, Ružica; Jug, Matija; Radmanović, Kristijan; Bešlić, Ivan

2013-09-01

Woodworkers' exposure to airborne particles is measured with different sampling techniques throughout the world. Due to a great number of exposure data obtained with different samplers, European countries have aimed over the last ten years to find a conversion factor for mass concentrations that would render these measurements comparable. Following the accepted EU standards and regulations, we replaced a 25 mm open-faced (OF) filter holder with an IOM head to determine woodworkers' exposure to inhalable dust and establish an IOM/OF sampler ratio that might serve as a reliable factor for converting the existing OF data to IOM dust mass concentration in the industrial environment. For this side-by-side sampling we used personal 25 mm OF (N=29) and IOM (N=29) sampling heads over eight working hours. The obtained IOM/OF ratios ranged between 0.7 and 2.3. However, mass concentrations obtained by IOM and OF samplers did not significantly differ. Our findings suggest that there is no need for conversion of the existing OF data for workers exposed to wood dust, provided that dust mass concentrations in the working environment range between 1 mg m-3 and 7 mg m-3. Future side-by-side measurements should also involve environments with low wood dust mass concentrations.

Co-optimization of Energy and Demand-Side Reserves in Day-Ahead Electricity Markets

Science.gov (United States)

Surender Reddy, S.; Abhyankar, A. R.; Bijwe, P. R.

2015-04-01

This paper presents a new multi-objective day-ahead market clearing (DAMC) mechanism with demand-side reserves/demand response (DR) offers, considering realistic voltage-dependent load modeling. The paper proposes objectives such as social welfare maximization (SWM) including demand-side reserves, and load served error (LSE) minimization. In this paper, energy and demand-side reserves are cleared simultaneously through co-optimization process. The paper clearly brings out the unsuitability of conventional SWM for DAMC in the presence of voltage-dependent loads, due to reduction of load served (LS). Under such circumstances multi-objective DAMC with DR offers is essential. Multi-objective Strength Pareto Evolutionary Algorithm 2+ (SPEA 2+) has been used to solve the optimization problem. The effectiveness of the proposed scheme is confirmed with results obtained from IEEE 30 bus system.

The "Double" Tessier 7 Cleft: An Unusual Presentation of a Transverse Facial Cleft.

Science.gov (United States)

Raveendran, Janani A; Chao, Jerry W; Rogers, Gary F; Boyajian, Michael J

2018-07-01

Congenital macrostomia, or Tessier number 7 cleft, is a rare craniofacial anomaly. We present a unique patient with bilateral macrostomia that consisted of a "double" transverse cleft on the left side and a single transverse cleft on the right side. A staged reconstructive approach was used to repair the "double" left-sided clefts. This staged technique produced a satisfactory aesthetic and functional outcome.

End-to-side nerve neurorrhaphy: critical appraisal of experimental and clinical data.

Science.gov (United States)

Fernandez, E; Lauretti, L; Tufo, T; D'Ercole, M; Ciampini, A; Doglietto, F

2007-01-01

End-to-side neurorrhaphy (ESN) or terminolateral neurorraphy consists of connecting the distal stump of a transected nerve, named the recipient nerve, to the side of an intact adjacent nerve, named the donor nerve, "in which only an epineurial window is performed". This procedure was reintroduced in 1994 by Viterbo, who presented a report on an experimental study in rats. Several experimental and clinical studies followed this report with various and sometimes conflicting results. In this paper we present a review of the pertinent literature. Our personal experience using a sort of end-to-side nerve anastomosis, in which the donor nerve is partially transected, is also presented and compared with ESN as defined above. When the proximal nerve stump of a transected nerve is not available, ESN, which is claimed to permit anatomic and functional preservation of the donor nerve, seems an attractive technique, though yet not proven to be effective. Deliberate axotomy of the donor nerve yields results that are proportional to the entity of axotomy, but such technique, though resembling ESN, is an end-to-end neurorrhaphy. Neither experimental or clinical evidence support liberalizing the clinical use of ESN, a procedure with only an epineurial window in the donor nerve and without deliberate axotomy. Much more experimental investigation needs to be done to explain the ability of normal, intact nerves to sprout laterally. Such procedure appears justified only in an investigational setting.

Are there differences in outcome after elective sigmoidectomy for diverticular disease and for cancer? A national inpatient study.

Science.gov (United States)

Ilyas, M I M; Zangbar, B; Nfonsam, V N; Maegawa, F A; Joseph, B A; Patel, J A; Wexner, S D

2017-03-01

The postoperative outcome after elective sigmoidectomy for diverticulitis has not been compared to that for cancer. The study aimed to evaluate the differences in the postoperative outcome after sigmoidectomy for diverticular disease and cancer. The National Inpatient Sample Database was used to identify patients who underwent elective sigmoid resection for diverticular disease or cancer between 2004 and 2011. After excluding patients with metastatic cancer and preoperative weight loss, sigmoid cancer and diverticulitis patients were matched using propensity score, controlling for age, gender, race, type of operation (open vs laparoscopic) and comorbidities. The end-points of interest were infective complications, reoperation, anastomotic leakage, rebleeding, length of hospital stay and in-hospital mortality. After propensity score matching (diverticulitis 11 192 patients, sigmoid cancer 11 192 patients), the mean age was 65 ± 12.5 years, 53.8% were male and 61.5% were Caucasian. Only 18.0% of the operations were done by laparoscopy. The overall complication rate was 17.7% and the in-hospital mortality rate was 0.9%. The diverticulitis group had a higher rate of surgical site infection (3.2% vs 2.6%, P = 0.004), intra-abdominal abscess formation (1.2% vs 0.4%, P diverticular disease has a higher risk of infective complications, elective sigmoidectomy for cancer has a higher risk of anastomotic leakage. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

Side Effects: Sleep Problems

Science.gov (United States)

Sleep problems are a common side effect during cancer treatment. Learn how a polysomnogram can assess sleep problems. Learn about the benefits of managing sleep disorders in men and women with cancer.

SCit: web tools for protein side chain conformation analysis.

Science.gov (United States)

Gautier, R; Camproux, A-C; Tufféry, P

2004-07-01

SCit is a web server providing services for protein side chain conformation analysis and side chain positioning. Specific services use the dependence of the side chain conformations on the local backbone conformation, which is described using a structural alphabet that describes the conformation of fragments of four-residue length in a limited library of structural prototypes. Based on this concept, SCit uses sets of rotameric conformations dependent on the local backbone conformation of each protein for side chain positioning and the identification of side chains with unlikely conformations. The SCit web server is accessible at http://bioserv.rpbs.jussieu.fr/SCit.

Cancer treatment: fertility and sexual side effects in women

Science.gov (United States)

... Cancer treatment: fertility and sexual side effects in women To use the sharing features on this page, ... Bladder cancer Types of Sexual Side Effects For women, the most common sexual side effects include: Loss ...

The Variation of Interface Formation with Slurry Viscosity Change in Side-By-Side Tape Casting

DEFF Research Database (Denmark)

Bulatova, Regina; Jabbari, Masoud; Andersen, Kjeld Bøhm

Homogenous and flexible adjacently graded tapes were produced by casting the organic-based slurries simultaneously. To develop side-by-side tape casing (SBSTC), the material optimization, modernization of the doctor blade design, and parameters control of such processes as casting, drying, de......-bindering and sintering were studied. Solvent and binder concentrations were varied in order to optimize co-casting flow, as well as the drying and sintering shrinkage. Tapes were evaluated in terms of rheological behavior of the slurries, the green and sintered tape microstructure, the quality of the interface area...

[Excimer laser therapy of alopecia areata--side-by-side evaluation of a representative area].

Science.gov (United States)

Raulin, Christian; Gündogan, Cüneyt; Greve, Bärbel; Gebert, Susanne

2005-07-01

We report for the first time on hair regrowth in alopecia areata of the scalp achieved with the 308-nm xenon-chloride excimer laser in a prospective side-by-side trial. The alopecia areata had shown progression over a period of three years, and various treatments had not been effective. Out of a number of affected areas, one representative lesion was chosen; one half of it was treated, the other half remained untreated. After 27 sessions (200 - 4000 mJ/cm2, cumulative dose 52.6 J/cm2) over 3 months, only the treated area showed hair growth; which suggests that this was most probably not a spontaneous remission.

Research on Battery Energy Storage System Based on User Side

Science.gov (United States)

Wang, Qian; Zhang, Yichi; Yun, Zejian; Wang, Xuguang; Zhang, Dong; Bian, Di

2018-01-01

This paper introduces the effect of user side energy storage on the user side and the network side, a battery energy storage system for the user side is designed. The main circuit topology of the battery energy storage system based on the user side is given, the structure is mainly composed of two parts: DC-DC two-way half bridge converter and DC-AC two-way converter, a control strategy combining battery charging and discharging characteristics is proposed to decouple the grid side and the energy storage side, and the block diagram of the charging and discharging control of the energy storage system is given. The simulation results show that the battery energy storage system of the user side can not only realize reactive power compensation of low-voltage distribution network, but also improve the power quality of the users.

What matters when judging intentionality-moral content or normative status? Testing the rational scientist model of the side-effect.

Science.gov (United States)

Papadopoulos, C; Hayes, B K

2018-06-01

Previous work has demonstrated a "side-effect effect," such that intentionality is more likely to be attributed to agents who bring about negatively valenced as opposed to positively valenced side effects. The rational-scientist model explains this by suggesting that norm-violating side effects are more informative for inferring intentionality than norm-conforming side effects. In the present study we reexamined this account, addressing limitations of previous empirical tests (e.g., Uttich & Lombrozo, Cognition 116: 87-100, 2010). Side-effect valence and norm status were manipulated factorially, enabling an examination of the impact of norm status on intentionality judgments in both positively and negatively valenced side effects. Additionally, the impact of side-effect norm status on the perceived valences of side effects and agents was examined. Effects of norm status were found for both positive and negative side effects. Violation of an ostensibly neutral norm led to negative perceptions of the side effect. However, a norm status effect on intentionality judgments persisted when these effects were controlled. These results support the view that the side-effect effect is the result of the rational use of social-cognitive evidence.

Role of three side support ankle–foot orthosis in improving the ...

African Journals Online (AJOL)

Cerebral palsy (CP) is a heterogeneous group of permanent, non-progressive motor disorders of movement and posture. Ankle–foot orthoses (AFOs) are frequently prescribed to correct skeletal misalignments in spastic CP. The present study aims to evaluate the effect of the three side support ankle–foot orthosis on ...

DarkSide search for dark matter

Energy Technology Data Exchange (ETDEWEB)

Alexander, T.; Alton, D.; Arisaka, K.; Back, H. O.; Beltrame, P.; Benziger, J.; Bonfini, G.; Brigatti, A.; Brodsky, J.; Bussino, S.; Cadonati, L.; Calaprice, F.; Candela, A.; Cao, H.; Cavalcante, P.; Chepurnov, A.; Chidzik, S.; Cocco, A. G.; Condon, C.; D' Angelo, D.; Davini, S.; Vincenzi, M. De; Haas, E. De; Derbin, A.; Pietro, G. Di; Dratchnev, I.; Durben, D.; Empl, A.; Etenko, A.; Fan, A.; Fiorillo, G.; Franco, D.; Fomenko, K.; Forster, G.; Gabriele, F.; Galbiati, C.; Gazzana, S.; Ghiano, C.; Goretti, A.; Grandi, L.; Gromov, M.; Guan, M.; Guo, C.; Guray, G.; Hungerford, E. V.; Ianni, Al; Ianni, An; Joliet, C.; Kayunov, A.; Keeter, K.; Kendziora, C.; Kidner, S.; Klemmer, R.; Kobychev, V.; Koh, G.; Komor, M.; Korablev, D.; Korga, G.; Li, P.; Loer, B.; Lombardi, P.; Love, C.; Ludhova, L.; Luitz, S.; Lukyanchenko, L.; Lund, A.; Lung, K.; Ma, Y.; Machulin, I.; Mari, S.; Maricic, J.; Martoff, C. J.; Meregaglia, A.; Meroni, E.; Meyers, P.; Mohayai, T.; Montanari, D.; Montuschi, M.; Monzani, M. E.; Mosteiro, P.; Mount, B.; Muratova, V.; Nelson, A.; Nemtzow, A.; Nurakhov, N.; Orsini, M.; Ortica, F.; Pallavicini, M.; Pantic, E.; Parmeggiano, S.; Parsells, R.; Pelliccia, N.; Perasso, L.; Perasso, S.; Perfetto, F.; Pinsky, L.; Pocar, A.; Pordes, S.; Randle, K.; Ranucci, G.; Razeto, A.; Romani, A.; Rossi, B.; Rossi, N.; Rountree, S. D.; Saggese, P.; Saldanha, R.; Salvo, C.; Sands, W.; Seigar, M.; Semenov, D.; Shields, E.; Skorokhvatov, M.; Smirnov, O.; Sotnikov, A.; Sukhotin, S.; Suvarov, Y.; Tartaglia, R.; Tatarowicz, J.; Testera, G.; Thompson, J.; Tonazzo, A.; Unzhakov, E.; Vogelaar, R. B.; Wang, H.; Westerdale, S.; Wojcik, M.; Wright, A.; Xu, J.; Yang, C.; Zavatarelli, S.; Zehfus, M.; Zhong, W.; Zuzel, G.

2013-11-22

The DarkSide staged program utilizes a two-phase time projection chamber (TPC) with liquid argon as the target material for the scattering of dark matter particles. Efficient background reduction is achieved using low radioactivity underground argon as well as several experimental handles such as pulse shape, ratio of ionization over scintillation signal, 3D event reconstruction, and active neutron and muon vetos. The DarkSide-10 prototype detector has proven high scintillation light yield, which is a particularly important parameter as it sets the energy threshold for the pulse shape discrimination technique. The DarkSide-50 detector system, currently in commissioning phase at the Gran Sasso Underground Laboratory, will reach a sensitivity to dark matter spin-independent scattering cross section of 10^-45 cm² within 3 years of operation.

INFLUENCE OF ELECTROACUPUNCTURE ON ARTIFICIAL ABORTION-INDUCED SIDE EFFECTS

Institute of Scientific and Technical Information of China (English)

田丽颖

2001-01-01

In the present study, the effect of electroecupuncture (EA) of acupoints of Ren, Spleen and Stomach Meridians on artificial abortion-induced side effects was observed in 100 artificial abortion women. In comparison with 45 artificial abortion women in the control group (who had not accepted EA treatment), EA possessed significant effects in relieving abdominal pain, reducing vaginal bleeding duration, lowering infection rate and infertility rate after artificial abortion operation.

Right-sided infective endocarditis: recent epidemiologic changes

Science.gov (United States)

Yuan, Shi-Min

2014-01-01

Background: Infective endocarditis (IE) has been increasingly reported, however, little is available regarding recent development of right-sided IE. Methods: Right-sided IE was comprehensively analyzed based on recent 5⅓-year literature. Results: Portal of entry, implanted foreign material, and repaired congenital heart defects were the main predisposing risk factors. Vegetation size on the right-sided valves was much smaller than those beyond the valves. Multiple logistic regression analysis revealed that predisposing risk factors, and vegetation size and locations were independent predictive risks of patients’ survival. Conclusions: Changes of right-sided IE in the past 5⅓ years included younger patient age, and increased vegetation size, but still prominent Staphylococcus aureus infections. Complication spectrum has changed into more valve insufficiency, more embolic events, reduced abscess formation, and considerably decreased valve perforations. With effective antibiotic regimens, prognoses of the patients seemed to be better than before. PMID:24482708

Handedness and dominant side of symptoms in Parkinson's disease.

Science.gov (United States)

Shi, Jie; Liu, Jie; Qu, Qiumin

2014-02-20

To investigate the association between handedness and the side of symptom dominance in Parkinson's disease (PD). One hundred and forty-six PD patients with symmetric symptoms (92 males and 54 females), aged 64.3 ± 9.1 years old, from a series of 247 PD patients were assessed for handedness and clinical features. The severity of PD was scored by unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr staging on the "ON" state. Of 134 right-handed patients (91.8%), 83 (61.7%) had an initial onset on the right side (P=0.008), while of 12 left-handed patients (8.2%), 9 (75.0%) had an initial onset on the left side (P=0.013). Out of right-handed patients, 103 (76.9%) had the right-side dominance of PD symptoms (P<0.001). Among the left-handed subjects, 7 patients (58.3%) had left-sided and 5 patients (41.7%) had right-sided symptom dominance (P=0.564). In general, dominant side of symptoms was in accordance with handedness (P=0.008). In right-handed patients, rest tremor was the most common initial symptom (P<0.001), while rest tremor and rigidity-bradykinesia were initial symptoms in left-handed patients (P=0.366). PD symptoms emerge more often on the dominant hand-side, and the dominant side of symptoms is in accordance with handedness. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Residue-Specific Side-Chain Polymorphisms via Particle Belief Propagation.

Science.gov (United States)

Ghoraie, Laleh Soltan; Burkowski, Forbes; Li, Shuai Cheng; Zhu, Mu

2014-01-01

Protein side chains populate diverse conformational ensembles in crystals. Despite much evidence that there is widespread conformational polymorphism in protein side chains, most of the X-ray crystallography data are modeled by single conformations in the Protein Data Bank. The ability to extract or to predict these conformational polymorphisms is of crucial importance, as it facilitates deeper understanding of protein dynamics and functionality. In this paper, we describe a computational strategy capable of predicting side-chain polymorphisms. Our approach extends a particular class of algorithms for side-chain prediction by modeling the side-chain dihedral angles more appropriately as continuous rather than discrete variables. Employing a new inferential technique known as particle belief propagation, we predict residue-specific distributions that encode information about side-chain polymorphisms. Our predicted polymorphisms are in relatively close agreement with results from a state-of-the-art approach based on X-ray crystallography data, which characterizes the conformational polymorphisms of side chains using electron density information, and has successfully discovered previously unmodeled conformations.

Cochlear implantation for single-sided deafness and tinnitus suppression.

Science.gov (United States)

Holder, Jourdan T; O'Connell, Brendan; Hedley-Williams, Andrea; Wanna, George

To quantify the potential effectiveness of cochlear implantation for tinnitus suppression in patients with single-sided deafness using the Tinnitus Handicap Inventory. The study included 12 patients with unilateral tinnitus who were undergoing cochlear implantation for single-sided deafness. The Tinnitus Handicap Inventory was administered at the patient's cochlear implant candidacy evaluation appointment prior to implantation and every cochlear implant follow-up appointment, except activation, following implantation. Patient demographics and speech recognition scores were also retrospectively recorded using the electronic medical record. A significant reduction was found when comparing Tinnitus Handicap Inventory score preoperatively (61.2±27.5) to the Tinnitus Handicap Inventory score after three months of cochlear implant use (24.6±28.2, p=0.004) and the Tinnitus Handicap Inventory score beyond 6months of CI use (13.3±18.9, p=0.008). Further, 45% of patients reported total tinnitus suppression. Mean CNC word recognition score improved from 2.9% (SD 9.4) pre-operatively to 40.8% (SD 31.7) by 6months post-activation, which was significantly improved from pre-operative scores (p=0.008). The present data is in agreement with previously published studies that have shown an improvement in tinnitus following cochlear implantation for the large majority of patients with single-sided deafness. Copyright © 2017 Elsevier Inc. All rights reserved.

Inverting adherent cells for visualizing ECM interactions at the basal cell side

Energy Technology Data Exchange (ETDEWEB)

Gudzenko, Tetyana [DFG-Center for Functional Nanostructures, Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Strasse 1a, 76131 Karlsruhe (Germany); Franz, Clemens M., E-mail: clemens.franz@kit.edu [DFG-Center for Functional Nanostructures, Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Strasse 1a, 76131 Karlsruhe (Germany)

2013-05-15

Interactions with the extracellular matrix (ECM) govern a wide range of cellular functions, including survival, migration and invasion. However, in adherent cells these interactions occur primarily on the basal cell side, making them inaccessible to high-resolution, surface-scanning imaging techniques such as atomic force microscopy (AFM) or scanning electron microscopy (SEM). Here we describe a fast and reliable method for inverting adherent cells, exposing the basal cell membrane for direct analysis by AFM or SEM in combination with fluorescence microscopy. Cells including their matrix adhesion sites remain intact during the inversion process and are transferred together with the complete array of basally associated ECM proteins. Molecular features of ECM proteins, such as the characteristic 67 nm collagen D-periodicity, are well preserved after inversion. To demonstrate the versatility of the method, we compared basal interactions of fibroblasts with fibrillar collagen I and fibronectin matrices. While fibroblasts remodel the fibronectin layer exclusively from above, they actively invade even thin collagen layers by contacting individual collagen nanofibrils both basally and apically through a network of cellular extensions. Cell–matrix entanglement coincides with enhanced cell spreading and flattening, indicating that nanoscale ECM interactions govern macroscopic changes in cell morphology. The presented cell inversion technique can thus provide novel insight into nanoscale cell–matrix interactions at the basal cell side. - Highlights: ► We present a novel method for inverting adherent cells to expose the basal cell side. ► Basal cell sides can be imaged at high resolution by AFM and SEM. ► Cells can be inverted together with the underlying extracellular matrix. ► AFM images of inverted cells provide a nanoscale look at basal cell–ECM interactions.

MESOTHELIOMA PRESENTING WITH PNEUMOTHORAX AND INTERLOBAR TUMOR

NARCIS (Netherlands)

MANNES, GPM; GOUW, ASH; BERENDSEN, HH; VERHOEFF, AJ; POSTMUS, PE

A patient presented with a pneumothorax, a parahilar mass and a pleural effusion on the left side. Histology proved that this was caused by a malignant mesothelioma, epithelial type. The pneumothorax persisted, even after chest drainage and pleurodesis with talc powder and tetracycline.

9 m side drop test of scale model

International Nuclear Information System (INIS)

Ku, Jeong-Hoe; Chung, Seong-Hwan; Lee, Ju-Chan; Seo, Ki-Seog

1993-01-01

A type B(U) shipping cask had been developed in KAERI for transporting PWR spent fuel. Since the cask is to transport spent PWR fuel, it must be designed to meet all of the structural requirements specified in domestic packaging regulations and IAEA safety series No.6. This paper describes the side drop testing of a one - third scale model cask. The crush and deformations of the shock absorbing covers directly control the deceleration experiences of the cask during the 9 m side drop impact. The shock absorbing covers greatly mitigated the inertia forces of the cask body due to the side drop impact. Compared with the side drop test and finite element analysis, it was verified that the 1/3 scale model cask maintain its structural integrity of the model cask under the side drop impact. The test and analysis results could be used as the basic data to evaluate the structural integrity of the real cask. (J.P.N.)

Metabolic and Endocrine Side Effects of Atypical Antipsychotic Drugs in Children and Adolescents

Directory of Open Access Journals (Sweden)

Aysegul Tahiroglu

2011-03-01

Full Text Available omorbid psychiatric disorders, frequent hospitalization, multiple outpatient treatment, prior history of hypertension, obesity and lipid dysregulation are associated with higher risk of metabolic syndrome in children. Side effects of antipsychotic drugs and their management have recently become a major subject of research due to enhanced antipsychotic drug usage in child and adolescents. Prevention strategies are usually preferred to secondary or tertiary strategies in the management of metabolic syndrome associated with antipsychotic drugs. Clinicians should present multidisciplinary approach to endocrine and metabolic side effects due to antipsychotic use in pediatric patient groups and avoid multiple drug use in such patients. In this paper, we briefly reviewed metabolic side effects of second generation antipsychotic drugs in child and adolescent population, possible mechanisms of susceptibility to metabolic syndrome and pharmacological and non pharmacological treatment approach to prevention of weight gain.

Endogenous preemption on both sides of a market

OpenAIRE

Güth, W.; Müller, W.; Potters, J.J.M.

2006-01-01

We study a market in which both buyers and sellers can decide to preempt and set their quantities before market clearing.Will this lead to preemption on both sides of the market, only one side of the market, or to no preemption at all?We find that preemption tends to be asymmetric in the sense that it is restricted to only one side of the market (buyers or sellers).

New type side weir discharge coefficient simulation using three novel hybrid adaptive neuro-fuzzy inference systems

Science.gov (United States)

Bonakdari, Hossein; Zaji, Amir Hossein

2018-03-01

In many hydraulic structures, side weirs have a critical role. Accurately predicting the discharge coefficient is one of the most important stages in the side weir design process. In the present paper, a new high efficient side weir is investigated. To simulate the discharge coefficient of these side weirs, three novel soft computing methods are used. The process includes modeling the discharge coefficient with the hybrid Adaptive Neuro-Fuzzy Interface System (ANFIS) and three optimization algorithms, namely Differential Evaluation (ANFIS-DE), Genetic Algorithm (ANFIS-GA) and Particle Swarm Optimization (ANFIS-PSO). In addition, sensitivity analysis is done to find the most efficient input variables for modeling the discharge coefficient of these types of side weirs. According to the results, the ANFIS method has higher performance when using simpler input variables. In addition, the ANFIS-DE with RMSE of 0.077 has higher performance than the ANFIS-GA and ANFIS-PSO methods with RMSE of 0.079 and 0.096, respectively.

A double-sided linear primary permanent magnet vernier machine.

Science.gov (United States)

Du, Yi; Zou, Chunhua; Liu, Xianxing

2015-01-01

The purpose of this paper is to present a new double-sided linear primary permanent magnet (PM) vernier (DSLPPMV) machine, which can offer high thrust force, low detent force, and improved power factor. Both PMs and windings of the proposed machine are on the short translator, while the long stator is designed as a double-sided simple iron core with salient teeth so that it is very robust to transmit high thrust force. The key of this new machine is the introduction of double stator and the elimination of translator yoke, so that the inductance and the volume of the machine can be reduced. Hence, the proposed machine offers improved power factor and thrust force density. The electromagnetic performances of the proposed machine are analyzed including flux, no-load EMF, thrust force density, and inductance. Based on using the finite element analysis, the characteristics and performances of the proposed machine are assessed.

Side Effects: Appetite Loss

Science.gov (United States)

Cancer treatments may lower your appetite. Side effects such as nausea, fatigue, or mouth sores can also making eating difficult. Learn how to eat well to avoid losing weight or becoming dehydrated, so you stay strong during treatment.

Design and fabrication of a double-sided piezoelectric transducer for harvesting vibration power

Energy Technology Data Exchange (ETDEWEB)

Chang, Wei-Tsai; Chen, Ying-Chung [Department of Electrical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC (China); Kao, Kuo-Sheng [Department of Computer and Communication, Shu-Te University, Kaohsiung, Taiwan, ROC (China); Chu, Yu-Hsien [Department of Electrical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC (China); Cheng, Chien-Chuan, E-mail: chengccc@dlit.edu.tw [Department of Electronic Engineering, De Lin Institute of Technology, Taipei, Taiwan, ROC (China)

2013-02-01

This investigation examines a means of integrating high-performance ZnO piezoelectric thin films with a flexible stainless steel substrate (SUS304) to fabricate a double-sided piezoelectric transducer for vibration-energy harvesting applications. The double-sided piezoelectric transducer is constructed by depositing ZnO piezoelectric thin films on both the front and the back sides of the SUS304 substrate. The titanium and platinum layers were deposited using a dual-gun DC sputtering system between the ZnO piezoelectric thin film and the back side of the SUS304 substrate. The scanning electron microscopy and X-ray diffraction of ZnO piezoelectric films reveal a rigid surface structure and a highly c-axis-preferring orientation. To fabricate a transducer with a low resonant frequency, a tip-mass of 0.5 g and a vibration-area of 1 cm{sup 2} are designed, based on the cantilever vibration theory. The maximum open circuit voltage of the power transducer is approximately 18 V. After rectification and filtering through a 33 nF capacitor, a specific power output of 1.31 μW/cm{sup 2} is obtained from the transducers with a load resistance of 6 MΩ. The variation of the power output of ± 0.001% is obtained after 24-hour continuous test. - Highlights: ► A double-sided piezoelectric transducer is fabricated with the ZnO thin films. ► Vibrated frequency of a double-sided transducer is designed and presented. ► A maximum output power of 3.23 μW/cm{sup 2} is obtained under turbulent vibration.

The Dark Side of Friendship: Questions about Negative Interactions between Friends.

Science.gov (United States)

Berndt, Thomas J.

Alluding to the difficulty in explaining the two opposing powers, the "dark side" and the Force, in the Star Wars movies, this paper focuses on the complex combination of negative and positive interactions among children who are best friends. Presented in question-answer format, the paper discusses research findings and needs related to…

Lateral side impact against kerbstones and its influence on side airbag sensing

Energy Technology Data Exchange (ETDEWEB)

Olders, S. [RWTH Aachen (Germany). Inst. fuer Kraftfahrwesen

2001-07-01

High level requirements are made to the control units and sensors of side airbag systems with regard to the reaction time until activation, because there is only a short deformation zone within the lateral zone of a vehicle. For further development of these systems and in order to minimise the possibility of erroneous activation, these airbag systems are tested in many impact configurations relevant to airbag activation and in so-called misuse tests. One of these non-deployment requirements is the kerbstone impact. Since the load on the occupants is only minimal in this impact configuration, activation of the side airbags is not necessary. Kerbstone impacts can be simulated realistically at the Institute for Automotive Engineering Aachen (Institut fuer Kraftfahrwesen Aachen (ika)) - by means of sled tests. By varying the boundary test conditions, additional information can be gathered regarding the positioning of sensors and the signal curves for adjustment of airbag electronics. (orig.)

Calculation methods for single-sided natural ventilation - simplified or detailed?

DEFF Research Database (Denmark)

Larsen, Tine Steen; Plesner, Christoffer; Leprince, Valérie

2016-01-01

A great energy saving potential lies within increased use of natural ventilation, not only during summer and midseason periods, where it is mainly used today, but also during winter periods, where the outdoor air holds a great cooling potential for ventilative cooling if draft problems can...... be handled. This paper presents a newly developed simplified calculation method for single-sided natural ventilation, which is proposed for the revised standard FprEN 16798-7 (earlier EN 15242:2007) for design of ventilative cooling. The aim for predicting ventilative cooling is to find the most suitable......, while maintaining an acceptable correlation with measurements on average and the authors consider the simplified calculation method well suited for the use in standards such as FprEN 16798-7 for the ventilative cooling effects from single-sided natural ventilation The comparison of different design...

Dynamics of energy-related CO2 emissions in China during 1980-2002: the relative importance of energy supply-side and demand-side effects

International Nuclear Information System (INIS)

Libo Wu; Kaneko, Shinji; Matsuoka, Shunji

2006-01-01

Based on a newly developed model that integrates energy production, transformation and consumption processes, this paper compares the relative importance of some traditionally recognized factors operating on the energy demand side with a body of newly defined factors on the supply side, in terms of their contribution to trends in China's CO 2 emissions related to the total primary energy supply (C-TPES). Before 1996, changes in China's C-TPES were mainly driven by changes on the energy demand side. Factors operating on the energy supply side played trivial roles. During the period 1996-2000, however, increasing demand-side effects declined dramatically and at the same time decreasing effects from supply side expanded significantly. Such changes resulted directly in a decline in the C-TPES. The decreasing effects from international trade as well as statistical imbalances between supply and demand reinforced the declining trend. The shrinkage of demand side effects mainly arose from the slowdown of economic growth and speed of decrease in energy intensity. The expansion of supply-side effects was principally attributed to the speed of decrease in gross unit consumption in transformation sectors, especially in electricity sector. Therefore, the acceleration of efficiency improvements in end-use and transformation sectors accounted for the decline in the C-TPES over the period 1996-2000. (author)

Rational Design of Coordination Polymers with Flexible Oxyethylene Side Chains

International Nuclear Information System (INIS)

Choi, Eun Young; Gao, Chunji; Lee, Suck Hyun; Kwon, O Pil

2012-01-01

We rationally designed and synthesized metallopolymers with organic 1,4-benzenedicarboxylic acid (BDC) linkers with different lengths of oxyethylene side chains in order to examine the influence of side chains on the coordination characteristics. While in a previous report the BDC linkers with alkyl side chains were found to form three-dimensional (3D) isoreticular metal-organic framework (IRMOF) structures or one-dimensional (1D) coordination polymeric structures with short -O(CH 2 ) 6 CH 3 or long -O(CH 2 ) 9 CH 3 side chains, respectively, new BDC linkers with oxyethylene side chains of the same lengths, -(OCH 2 CH 2 ) 2 CH 3 and -(OCH 2 CH 2 ) 3 CH 3 , form only 3D IRMOF structures. This result is attributed to the higher flexibility and smaller volume of oxyethylene side chains compared to alkyl side chains

Dark Side of the Universe

CERN Document Server

2016-01-01

The Dark Side of the Universe (DSU) workshops bring together a wide range of theorists and experimentalists to discuss current ideas on models of the dark side, and relate them to current and future experiments. This year's DSU will take place in the colorful Norwegian city of Bergen. Topics include dark matter, dark energy, cosmology, and physics beyond the standard model. One of the goals of the workshop is to expose in particular students and young researchers to the fascinating topics of dark matter and dark energy, and to provide them with the opportunity to meet some of the best researchers in these areas .

A gastrocnemius heterotopical transplant model with end-to-side neurorraphy.

Science.gov (United States)

Jaeger, Marcos Ricardo de Oliveira; Silva, Jefferson Luis Braga; Bain, James; Ely, Pedro Bins; Pires, Jefferson André; Ferreira, Lydia Masako

2014-01-01

To present an animal model to assess the effects of end-to-side innervation in the heterotopically transplanted model with reduced chances of neural contamination. The medial portion of the gastrocnemius muscle in wistar male rats was isolated and its pedicle dissected and performed a flap in the abdominal portion. To prevent neural contamination in the abdominal region, the muscle was wrapped with a Goretex(r) sheet. The specimens were divided into 2 groups (G). In G1 was performed an end-to-end suture between tibial nerve of the gastrocnemius and femoral motor nerve and between the saphenous sensory nerve and the motor nerve. In G2 was performed a end-to-side suture between the tibial nerve and the motor femoral and between the tibial nerve and saphenous motor nerve. The specimens were evaluated 60 days later to check the structure of the neurorraphy. Sections were obtained proximal and distal to the coaptation site. The medial gastrocnemius muscle had the advantage of maintaining visible mass after 60 days. No disruption of the coaptation site was found. No major injury to the donor nerve was seen in group 2. The proposed model is simple, reproduciple and prevent the neural contamination in the flap in end-to-side suture.

Laparoscopic management of terminal ileal volvulus caused by Meckel's diverticulum.

Science.gov (United States)

Xanthis, A; Hakeem, A; Safranek, P

2015-04-01

Complications from a Meckel's diverticulum include diverticulitis, bleeding, intussusception, bowel obstruction, a volvulus, a vesicodiverticular fistula, perforation or very rarely as a tumour. We report a case where a Meckel's diverticulum presented with a terminal ileal volvulus in a 32-year-old man without the presence of a typical vitelline band or axial torsion of the diverticulum causing the volvulus. It was successfully managed laparoscopically.

Side Effects of Chemotherapy and Radiation (For Parents)

Science.gov (United States)

... Safe Videos for Educators Search English Español Side Effects of Chemotherapy and Radiation KidsHealth / For Parents / Side Effects of Chemotherapy and Radiation What's in this article? What to ...

Side Stream Filtration for Cooling Towers

Energy Technology Data Exchange (ETDEWEB)

None

2012-10-20

This technology evaluation assesses side stream filtration options for cooling towers, with an objective to assess key attributes that optimize energy and water savings along with providing information on specific technology and implementation options. This information can be used to assist Federal sites to determine which options may be most appropriate for their applications. This evaluation provides an overview of the characterization of side stream filtration technology, describes typical applications, and details specific types of filtration technology.

Communication technologies for demand side management

Energy Technology Data Exchange (ETDEWEB)

Uuspaeae, P [VTT Energy, Espoo (Finland)

1998-08-01

The scope of this research is data communications for electric utilities, specifically for the purposes of Demand Side Management (DSM). Demand Side Management has the objective to change the customer`s end use of energy in a manner that benefits both the customer and the utility. For example, peak demand may be reduced, and the peak demand may be relocated to off peak periods. Thus additional investments in generation and network may be avoided. A number of Demand Side Management functions can be implemented if a communication system is available between the Electric Utility and the Customer. The total communication capacity that is needed, will depend on several factors, such as the functions that are chosen for DSM, and on the number and type of customers. Some functions may be handled with one-way communications, while some other functions need to have two-way communication

The Social Side Effects of Acetaminophen

Science.gov (United States)

Mischkowski, Dominik

About 23% of all adults in the US take acetaminophen during an average week (Kaufman, Kelly, Rosenberg, Anderson, & Mitchell, 2002) because acetaminophen is an effective physical painkiller and easily accessible over the counter. The physiological side effects of acetaminophen are well documented and generally mild when acetaminophen is consumed in the appropriate dosage. In contrast, the psychological and social side effects of acetaminophen are largely unknown. Recent functional neuroimaging research suggests that the experience of physical pain is fundamentally related to the experience of empathy for the pain of other people, indicating that pharmacologically reducing responsiveness to physical pain also reduces cognitive, affective, and behavioral responsiveness to the pain of others. I tested this hypothesis across three double-blind between-subjects drug intervention studies. Two experiments showed that acetaminophen had moderate effects on empathic affect, specifically personal distress and empathic concern, and a small effect on empathic cognition, specifically perceived pain, when facing physical and social pain of others. The same two experiments and a third experiment also showed that acetaminophen can increase the willingness to inflict pain on other people, i.e., actual aggressive behavior. This effect was especially pronounced among people low in dispositional empathic concern. Together, these findings suggest that the physical pain system is more involved in the regulation of social cognition, affect, and behavior than previously assumed and that the experience of physical pain and responsiveness to the pain of others share a common neurochemical basis. Furthermore, these findings suggest that acetaminophen has unappreciated but serious social side effects, and that these side effects may depend on psychological characteristics of the drug consumer. This idea is consistent with recent theory and research on the context-dependency of neurochemical

High efficiency double sided solar cells

International Nuclear Information System (INIS)

Seddik, M.M.

1990-06-01

Silicon technology state of the art for single crystalline was given to be limited to less than 20% efficiency. A proposed new form of photovoltaic solar cell of high current high efficiency with double sided structures has been given. The new forms could be n ++ pn ++ or p ++ np ++ double side junctions. The idea of double sided devices could be understood as two solar cells connected back-to-back in parallel electrical connection, in which the current is doubled if the cell is illuminated from both sides by a V-shaped reflector. The cell is mounted to the reflector such that each face is inclined at an angle of 45 deg. C to each side of the reflector. The advantages of the new structure are: a) High power devices. b) Easy to fabricate. c) The cells are used vertically instead of horizontal use of regular solar cell which require large area to install. This is very important in power stations and especially for satellite installation. If the proposal is made real and proved to be experimentally feasible, it would be a new era for photovoltaic solar cells since the proposal has already been extended to even higher currents. The suggested structures could be stated as: n ++ pn ++ Vp ++ np ++ ;n ++ pn ++ Vn ++ pn ++ ORp ++ np ++ Vp ++ np ++ . These types of structures are formed in wedged shape to employ indirect illumination by either parabolic; conic or V-shaped reflectors. The advantages of these new forms are low cost; high power; less in size and space; self concentrating; ... etc. These proposals if it happens to find their ways to be achieved experimentally, I think they will offer a short path to commercial market and would have an incredible impact on solar cell technology and applications. (author). 12 refs, 5 figs

The scapular glenopolar angle: standard values and side differences

Energy Technology Data Exchange (ETDEWEB)

Tucek, Michal; Bartonicek, Jan [Charles University and Military University Hospital Prague, Department of Orthopaedic Trauma, 1st Faculty of Medicine, Prague 6 (Czech Republic); Nanka, Ondrej [Charles University, Institute of Anatomy, 1st Faculty of Medicine, Prague 2 (Czech Republic); Malik, Jozef [Military University Hospital Prague, Department of Radiology, Prague 6 (Czech Republic)

2014-11-15

The aim of this study is to determine normal glenopolar angle (GPA) values on bone specimens of the scapula and compare them with various radiological views and CT examination. GPA values were measured on 100 mature, dry, non-paired scapulae, 20 pairs of dry scapulae, 50 AP radiographs of the shoulder, 50 Neer I views, 50 AP chest radiographs and 20 3D CT reconstructions of the scapula. Measurements made on bone specimens of the scapula showed an average GPA value of 42.3 ; the mean absolute side-to-side difference was on average 1.6 . The average GPA measured on 50 AP shoulder radiographs was 35.9 , on Neer I views 40.6 and AP chest radiographs 37.1 , with the mean absolute side-to-side difference on average 4.9 ; on 3D CT the average GPA was 43.0 and the mean absolute side-to-side difference on average 1.4 . GPA values depend on the method of measurement used. Measurements made on 3D CT reconstructions and Neer I views showed almost the same values as those measured on bone specimens. The values measured on AP shoulder views and AP chest radiographs were statistically significantly lower. Side-to-side variability (right and left) measured on 3D CT reconstructions was insignificant, and the obtained values corresponded to the values from bone specimens. Therefore, the best method to measure the GPA is a 3D CT reconstruction and an exact Neer I projection. (orig.)

Obstacle circumvention and eye coordination during walking to least and most affected side in people with Parkinson's disease.

Science.gov (United States)

Barbieri, Fabio Augusto; Polastri, Paula Favaro; Gobbi, Lilian Teresa Bucken; Simieli, Lucas; Pereira, Vinicius Ignácio Alota; Baptista, André Macari; Moretto, Gabriel Felipe; Fiorelli, Carolina Menezes; Imaizumi, Luis Felipe Itikawa; Rodrigues, Sérgio Tosi

2018-07-02

The mechanisms that contribute to gait asymmetry in people with Parkinson's disease (PD) are unclear, mainly during gait with greater environmental demand, such as when an obstacle is circumvented while walking. The aim of this study was to investigate the effects of obstacle circumvention of the least and most affected side on motor and gaze behavior in people with PD under/without the effects of dopaminergic medication. Fifteen people with PD and 15 matched-control individuals were instructed to walk along a pathway, at a self-selected velocity, and to circumvent an obstacle, avoiding contact with it. Each participant performed five trials for each side. Kinematic parameters, mediolateral and horizontal body clearance to the obstacle, strategy to circumvent the obstacle, and gaze behavior were calculated. Parameters were grouped according to the side that the obstacle was circumvented and compared by three-way ANOVAs. Both people with PD and the control group presented asymmetry to circumvent an obstacle during walking, however this was exacerbated in people with PD. Individuals with PD presented safe strategies (largest mediolateral and horizontal body clearance to the obstacle, "lead-out" strategy, and higher number and time of fixations on the obstacle) during obstacle circumvention for the least affected side compared to the most affected side. In addition, positive effects of dopaminergic medication on body clearance, spatial-temporal parameters, and gaze behavior were evidenced only when the obstacle was circumvented to the least affected side. The obstacle circumvention to the most affected side is risky for people with PD. Copyright © 2017 Elsevier B.V. All rights reserved.

Time course of late rectal- and urinary bladder side effects after MRI-guided adaptive brachytherapy for cervical cancer

Energy Technology Data Exchange (ETDEWEB)

Georg, P.; Georg, D.; Poetter, R.; Doerr, W. [Medical University Vienna/ AKH Wien (Austria). Dept. of Radiooncology; Medical University Vienna (Austria). Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology; Medical University Vienna/ AKH Wien (Austria). Comprehensive Cancer Centre; Boni, A.; Ghabuous, A. [Medical University Vienna/ AKH Wien (Austria). Dept. of Radiooncology; Goldner, G.; Schmid, M.P. [Medical University Vienna/ AKH Wien (Austria). Dept. of Radiooncology; Medical University Vienna/ AKH Wien (Austria). Comprehensive Cancer Centre

2013-07-15

Background and purpose: To analyze the time course of late rectal- and urinary bladder complications after brachytherapy for cervical cancer and to compare the incidence- and prevalence rates thereof. Patients and methods: A total of 225 patients were treated with external-beam radiotherapy (EBRT) and magnetic resonance imaging (MRI)-guided brachytherapy with or without chemotherapy. Late side effects were assessed prospectively using the Late Effects in Normal Tissue - Subjective, Objective, Management and Analytic (LENT/SOMA) scale. The parameters analyzed were time to onset, duration, actuarial incidence- (occurrence of new side effects during a defined time period) and prevalence rates (side effects existing at a defined time point). Results: Median follow-up was 44 months. Side effects (grade 1-4) in rectum and bladder were present in 31 and 49 patients, 14 and 27 months (mean time to onset) after treatment, respectively. All rectal and 76 % of bladder side effects occurred within 3 years after radiotherapy. Mean duration of rectal events was 19 months; 81 % resolved within 3 years of their initial diagnosis. Mean duration of bladder side effects was 20 months; 61 % resolved within 3 years. The 3- and 5-year actuarial complication rates were 16 and 19 % in rectum and 18 and 28 % in bladder, respectively. The corresponding prevalence rates were 9 and 2 % (rectum) and 18 and 21 % (bladder), respectively. Conclusion: Late side effects after cervical cancer radiotherapy are partially reversible, but their time course is organ-dependent. The combined presentation of incidence- and prevalence rates provides the most comprehensive information. (orig.)

Time course of late rectal- and urinary bladder side effects after MRI-guided adaptive brachytherapy for cervical cancer

International Nuclear Information System (INIS)

Georg, P.; Georg, D.; Poetter, R.; Doerr, W.; Medical University Vienna; Medical University Vienna/ AKH Wien; Boni, A.; Ghabuous, A.; Goldner, G.; Schmid, M.P.; Medical University Vienna/ AKH Wien

2013-01-01

Background and purpose: To analyze the time course of late rectal- and urinary bladder complications after brachytherapy for cervical cancer and to compare the incidence- and prevalence rates thereof. Patients and methods: A total of 225 patients were treated with external-beam radiotherapy (EBRT) and magnetic resonance imaging (MRI)-guided brachytherapy with or without chemotherapy. Late side effects were assessed prospectively using the Late Effects in Normal Tissue - Subjective, Objective, Management and Analytic (LENT/SOMA) scale. The parameters analyzed were time to onset, duration, actuarial incidence- (occurrence of new side effects during a defined time period) and prevalence rates (side effects existing at a defined time point). Results: Median follow-up was 44 months. Side effects (grade 1-4) in rectum and bladder were present in 31 and 49 patients, 14 and 27 months (mean time to onset) after treatment, respectively. All rectal and 76 % of bladder side effects occurred within 3 years after radiotherapy. Mean duration of rectal events was 19 months; 81 % resolved within 3 years of their initial diagnosis. Mean duration of bladder side effects was 20 months; 61 % resolved within 3 years. The 3- and 5-year actuarial complication rates were 16 and 19 % in rectum and 18 and 28 % in bladder, respectively. The corresponding prevalence rates were 9 and 2 % (rectum) and 18 and 21 % (bladder), respectively. Conclusion: Late side effects after cervical cancer radiotherapy are partially reversible, but their time course is organ-dependent. The combined presentation of incidence- and prevalence rates provides the most comprehensive information. (orig.)

Flow Features of Three Side-by-side Circular Cylinders at Low Reynolds Number

Directory of Open Access Journals (Sweden)

Liu Junkao

2016-01-01

Full Text Available In order to study the fluctuation of kinetic parameter of cylinder matrix in incompressible stationary flow, the flow fluid around three side-by-side circular cylinders are simulated using Immersed Boundary–Lattice Boltzmann method (IB-LBM. Drag and lift force of the three cylinders are investigated as the interval between each cylinder varied from zero to five times of the cylinder diameter. Five flow patterns are defined according to the vortices structure in the downstream of the cylinders. Power spectrum analysis of lift force is developed to explain the vortex patterns. Through the research, we find the strength and phase of the gap flow play an important role in the vortex formatting process. The vortices shedding from different cylinders neutralize and combine in the near wake, contributing a lot to the variation of forces.

18FDG-PET in 733 consecutive patients with or without side-by-side CT evaluation. Analysis of 921 lesions

International Nuclear Information System (INIS)

Buell, U.; Wieres, F.J.; Schneider, W.; Reinartz, P.

2004-01-01

Side-by-side analysis of CT and conventional 18 FDG-PET in oncological imaging is well established. Aim of this study was to find out which patients or diagnostic groups may benefit the most from the newly introduced integrated PET/CT scanners. Patients, methods: 407 consecutively admitted oncological patients with accompanying CT (groups A-D) and 326 patients without CT (groups E-G) were examined by conventional ring PET. Two nuclear medicine physicians and two radiologists assessed each patient's PET and CT scans for pathological lesions with regard to localisation and infiltration of adjacent anatomical structures. Patients without pathological PET findings were assigned to groups A (with CT) or E (without CT). If the localisation and/or extent of a pathological PET focus could only be assessed by taking into account the CT scan, the patient was assigned to group C (with CT) or G (without CT). If PET alone was sufficient for both questions the patient was assigned to groups B (with CT) or F (without CT). If neither method allowed for a precise lesion characterisation, the patient was assigned to group D. Results: 38.6% (A, E) of all patients were PET-negative. PET alone sufficed in 20.6% (B, F). Side-by-side reading of PET and CT was needed for 43.5% (C) of patients referred to PET with a current CT. Side-by-side reading of CT and PET did not suffice for 7.3% (D) of patients in that cohort. A total of 28.2% (G) of the cases without CT would have profited from it. The most frequent oncological diagnoses in group D (PET and conventional CT not sufficient) were bronchial carcinoma with abdominal lesions, while in group G (without CT but CT required) head/neck cancer with thoracic lesions was predominant. Conclusions: Side-by-side reading of PET and already existing conventional CT failed to yield conclusive data with regard to lesion characterisation in only 7.4% of patients so that PET/CT might have been helpful in these cases. 28.2% of the patients without

Analytical and numerical study concerning the behaviour of single-sided bonded patch repairs

Directory of Open Access Journals (Sweden)

Gheorghi OPATCHI

2011-06-01

Full Text Available Adhesive bonded joints are used in the assembling of structural parts, especially of those which are made from dissimilar materials. Lightweight fibre reinforced polymer composites and other adhesive bonded components represent a major proportion of a modern aircraft. Bonded patch repair technology has been widely used to repair cracked thin-walled structures to extend their service life, because a correctly executed repair significantly enhances the structural performance.In practice, the single-sided bonded patch repair is the most used because a good solution like the double-sided repair may not be an option if the access to the structure is only available from one side.This paper presents a relatively simple and effective design procedure for the single strapped bonded joints. Also, the influence of various geometrical parameters of the joint is evaluated. The analytical development is validated based on nonlinear finite element analyses.

Comparison of side effects in myelography with iopamidol and metrizamide

International Nuclear Information System (INIS)

Lee, Yong; Kang, Heung Sik; Chang, Kee Hyun; Han, Seoul Heui; Kwon, Oh Sung; Myung, Ho Gin

1986-01-01

The study was conducted to compare the side effects in myelography of the two non-ionic water-soluble contrast medias, lopamidol (Niopam) and Metrizamide (Amipaque). A total of 111 patients were examined, 64 with lopamidol and 47 with Metrizamide. Side effects consisted of headache, nausea, vomiting, dizziness, urinary difficulty, muscular pain, seizure, neurobehavioral disturbance, neurological sign change, vital sign change and etc. The common side effects were headache, nausea, vomiting and dizziness in order of frequency. Most of the side effects were subsided within 24 hours following myelography. lopamidol myelography caused fewer and milder side effects than Metrizamide study. The side effects were more commonly observed in cervical, thoracic or total myelography than in lumbar myelography with either lopamidol or Metrizamide. There was no significant correlation between incidence of the side effects and premedication with phenobarbital or valium injection before myelography and CSF sampling during the procedure.

Comparison of side effects in myelography with iopamidol and metrizamide

Energy Technology Data Exchange (ETDEWEB)

Lee, Yong; Kang, Heung Sik; Chang, Kee Hyun; Han, Seoul Heui; Kwon, Oh Sung; Myung, Ho Gin [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1986-12-15

The study was conducted to compare the side effects in myelography of the two non-ionic water-soluble contrast medias, lopamidol (Niopam) and Metrizamide (Amipaque). A total of 111 patients were examined, 64 with lopamidol and 47 with Metrizamide. Side effects consisted of headache, nausea, vomiting, dizziness, urinary difficulty, muscular pain, seizure, neurobehavioral disturbance, neurological sign change, vital sign change and etc. The common side effects were headache, nausea, vomiting and dizziness in order of frequency. Most of the side effects were subsided within 24 hours following myelography. lopamidol myelography caused fewer and milder side effects than Metrizamide study. The side effects were more commonly observed in cervical, thoracic or total myelography than in lumbar myelography with either lopamidol or Metrizamide. There was no significant correlation between incidence of the side effects and premedication with phenobarbital or valium injection before myelography and CSF sampling during the procedure.

Effects of side lying on lung function in older individuals.

Science.gov (United States)

Manning, F; Dean, E; Ross, J; Abboud, R T

1999-05-01

Body positioning exerts a strong effect on pulmonary function, but its effect on other components of the oxygen transport pathway are less well understood, especially the effects of side-lying positions. This study investigated the interrelationships between side-lying positions and indexes of lung function such as spirometry, alveolar diffusing capacity, and inhomogeneity of ventilation in older individuals. Nineteen nonsmoking subjects (mean age=62.8 years, SD=6.8, range=50-74) with no history of cardiac or pulmonary disease were tested over 2 sessions. The test positions were sitting and left side lying in one session and sitting and right side lying in the other session. In each of the positions, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), single-breath pulmonary diffusing capacity (DLCO/VA), and the slope of phase III (DN2%/L) of the single-breath nitrogen washout test to determine inhomogeneity of ventilation were measured. Compared with measurements obtained in the sitting position, FVC and FEV1 were decreased equally in the side-lying positions, but no change was observed in DLCO/VA or DN2%/L. Side-lying positions resulted in decreases in FVC and FEV1, which is consistent with the well-documented effects of the supine position. These findings further support the need for prescriptive rather than routine body positioning of patients with risks of cardiopulmonary compromise and the need to use upright positions in which lung volumes and capacities are maximized.

Environmental Assessment for Enhanced Use Leasing West Side Development, Phase I South, Hill AFB, Utah

National Research Council Canada - National Science Library

Winn, Kay

2006-01-01

This document presents potential environmental and socioeconomic consequences associated with the proposed project called the West Side Development, Phase 1 South, developing approximately 44 acres...

Side loading filter apparatus

International Nuclear Information System (INIS)

Reynolds, K.E.

1981-01-01

A side loading filter chamber for use with radioactive gases is described. The equipment incorporates an inexpensive, manually operated, mechanism for aligning filter units with a number of laterally spaced wall openings and for removing the units from the chamber. (U.K.)

Teaching Spatial Awareness In Small-Sided Games

Science.gov (United States)

Phillips, David; Hannon, James C.; Molina, Sergio

2015-01-01

This article supports the use of strategy and tactics at games stage three (how to teach basic offensive and defensive strategy using small-sided games) as a best practices in physical education. Potential learning through game stages three and four (full-sided games) is only possible when teachers have advanced content knowledge to teach the…

Ewing’s Sarcoma Presenting as Pleural Effusion

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Nuzhat Husain

2011-09-01

Full Text Available  A 20-year-old female presented to the Pulmonary Medicine Department with complaints of fever, left sided chest pain and progressive dyspnoea of four months duration. Radiological examination revealed a mass lesion with massive pleural effusion and rib erosion. Histopathology showed neoplastic cells with scanty cytoplasm, hyperchromatic nuclei and rosette formation suggestive of Ewing sarcoma. The rarity of this tumor and its unusual presentation prompted this report.

An Appreciative View of the Brighter Side of Terror Management Processes

Directory of Open Access Journals (Sweden)

Kenneth E. Vail, III

2015-10-01

Full Text Available Physical death is an inevitable part of life. From the perspective of terror management theory (TMT, people’s efforts to manage the awareness of death can sometimes have harmful social consequences. However, those negative consequences are merely one side of the existential coin. In considering the other side of the coin, the present article highlights the more beneficial trajectories of the terror management process. For example, the awareness of mortality can motivate people to prioritize their physical health; uphold prosocial values; build loving relationships and peaceful, charitable communities; and foster open-mindedness. Further, the article explores the possible balance between defense and growth motivations, including the motivations toward integrative self-expansion, creativity, and well-being. And finally, we tentatively consider the potential positive impacts of direct confrontations with mortality on terror management processes. In sum, the present analysis suggests that although death awareness can sometimes produce some harmful outcomes, at least under certain conditions it can also motivate attitudes and behaviors that have positive personal and social consequences.

Hydrodynamics of magnetizable suspensions in a traveling magnetic field of a single-sided inductor

International Nuclear Information System (INIS)

Maiorov, M.M.; Tsebers, A.O.

1979-01-01

A few qualitative tests are described which validate the basic concepts about the behavior of magnetic fluids in a traveling field of a single-sided inductor. In the experiment small droplets of a magnetic fluid were deposited on both sides of a transparent plate. With the traveling field turned on, one could observe the motion of these droplets in opposite directions: the droplets on the inductor side of the plate moving in the direction of the traveling field. This pattern of motion can be explained by the action of antisymmetric stresses due to rotation of ferromagnetic particles, in the traveling field, on the surface of a droplet. On the basis of present results, it is concluded that accounting for the antisymmetric stresses in the selection of an adequate model of magnetic relaxation makes it possible to correctly describe the motion of a magnetic fluid in a traveling field of a single-sided inductor. An adequate model for describing the motion of a colloidal suspension of cobalt ferrite is magnetic relaxation of rigid dipoles. 10 refs

Central nervous system side effects associated with zolpidem treatment.

Science.gov (United States)

Toner, L C; Tsambiras, B M; Catalano, G; Catalano, M C; Cooper, D S

2000-01-01

Zolpidem is one of the newer medications developed for the treatment of insomnia. It is an imidazopyridine agent that is an alternative to the typical sedative-hypnotic agents. Zolpidem use is gaining favor because of its efficacy and its side effect profile, which is milder and less problematic than that of the benzodiazepines and barbiturates used to treat insomnia. Still, side effects are not uncommon with zolpidem use. We report a series of cases in which the patients developed delirium, nightmares and hallucinations during treatment with zolpidem. We will review its pharmacology, discuss previous reports of central nervous system side effects, examine the impact of drug interactions with concurrent use of antidepressants, examine gender differences in susceptibility to side effects, and explore the significance of protein binding in producing side effects.

Development and performance of double sided silicon strip detectors

International Nuclear Information System (INIS)

Batignani, G.; Forti, F.; Moneta, L.; Triggiani, G.; Bosisio, L.; Focardi, E.; Giorgi, M.A.; Parrini, G.; Tonelli, G.

1991-01-01

Microstrip silicon detectors with orthogonal readout on opposite sides have been designed and fabricated. The active area of each device is 25 cm 2 and the strip pitch is 25 μm on the junction side and 50 μm on the opposite ohmic side. A space resolution of 15 μm on the junction side (100 μm readout pitch) and 24 μm on the ohmic side (200 μm readout pitch) has been measured. We also report on AC-coupling chips, designed and fabricated in order to allow AC connection of the strips to the amplifiers. These chips are 6.4x5.0 mm 2 and have 100 μm pitch. Both AC-couplers and detectors have been installed as part of the ALEPH minivertex. (orig.)

Systematic identification of proteins that elicit drug side effects

DEFF Research Database (Denmark)

Kuhn, Michael; Al Banchaabouchi, Mumna; Campillos, Monica

2013-01-01

Side effect similarities of drugs have recently been employed to predict new drug targets, and networks of side effects and targets have been used to better understand the mechanism of action of drugs. Here, we report a large-scale analysis to systematically predict and characterize proteins...... that cause drug side effects. We integrated phenotypic data obtained during clinical trials with known drug-target relations to identify overrepresented protein-side effect combinations. Using independent data, we confirm that most of these overrepresentations point to proteins which, when perturbed, cause......) is responsible for hyperesthesia in mice, which, in turn, can be prevented by a drug that selectively inhibits HTR7. Taken together, we show that a large fraction of complex drug side effects are mediated by individual proteins and create a reference for such relations....

Extensional Structures on the Po Valley Side of the Northern Apennines

Science.gov (United States)

Bettelli, G.; Vannucchi, P.; Capitani, M.

2001-12-01

The present-day tectonics of the Northern Apennines is characterized by extension in the inner Tyrrhenian side and compression in the outer Po Valley-Adriatic side. The boundary separating the two domains, extensional and compressional, is still largely undetermined and mainly based on geophysical data (focal mechanisms of earthquakes). Map-scale extensional structures have been studied only along the Tyrrhenian side of the Northern Apennines (Tuscany), while along the Po Valley-Adriatic area the field studies concentrated on compressional features. A new, detailed field mapping of the Po Valley side of the Northern Apennines carried out in the last ten years within the Emilia Romagna Geological Mapping Program has shown the presence of a large extensional fault crossing the high Bologna-Modena-Reggio Emilia provinces, from the Sillaro to the Val Secchia valleys. This Sillaro-Val Secchia Normal Fault (SVSNF) is NW-SE trending, NE dipping and about 80 km long. The age, based on the younger displaced deposits, is post-Miocene. The SVSNF is a primary regional structure separating the Tuscan foredeep units from the Ligurian Units in the south-east sector of the Northern Apennines, and it is responsible for the exhumation of the Tuscan foredeep units along the Apennine water divide. The sub-vertical, SW-NE trending faults, formerly interpreted as strike slip, are transfer faults associated to the extensional structure. A geological cross-section across the SVSNF testifies a former thickness reduction and lamination of the Ligurian Units, as documented in the field, in the innermost areas of the Bologna-Modena-Reggio Emilia hills, implying the occurrence of a former extensional fault. These data indicate that the NE side of the water divide has already gone under extension reducing the compressional domain to the Po Valley foothills and plain. They can also help in interpreting the complex Apennines kinematics.

Side-Scan-Sonar Points for Hudson River, NY

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Side Scan Point Files. These points correspond to individual pings which produced hte side-scan-sonar backscatter imagery. Sonar data were collected November 6 to...

A randomized side-by-side study comparing alexandrite laser at different pulse durations for port wine stains

DEFF Research Database (Denmark)

Carlsen, Berit C; Wenande, Emily; Erlendsson, Andres M

2017-01-01

hypertrophic (n = 7) PWS were included. Four side-by-side test areas were marked within each lesion. Three test areas were randomized to Alex laser at pulse durations of 3, 5, or 10 ms (8 mm spot, DCD 60/40), while the fourth was untreated. The lowest effective fluence to create purpura within the entire test...... spot was titrated and applied to intervention areas. Standardized clinical photographs were taken prior to, immediately after laser exposure and at 6-8 weeks follow up. Clinical PWS clearance and laser-related side effects were assessed using clinical photos. RESULTS: Alex laser at 3, 5, and 10 ms......BACKGROUND AND OBJECTIVES: Pulsed dye laser (PDL) represents the gold-standard treatment for port wine stains (PWS). However, approximately 20% of patients are poor responders and yield unsatisfactory end-results. The Alexandrite (Alex) laser may be a therapeutic alternative for selected PWS...

Side-chain liquid crystalline polyesters for optical information storage

DEFF Research Database (Denmark)

Ramanujam, P.S.; Holme, Christian; Hvilsted, Søren

1996-01-01

and holographic storage in one particular polyester are described in detail and polarized Fourier transform infrared spectroscopic data complementing the optical data are presented. Optical and atomic force microscope investigations point to a laser-induced aggregation as responsible for permanent optical storage.......Azobenzene side-chain liquid crystalline polyester structures suitable for permanent optical storage are described. The synthesis and characterization of the polyesters together with differential scanning calorimetry and X-ray investigations are discussed. Optical anisotropic investigations...

Chemotherapy Side Effects: A Cause of Heart Disease?

Science.gov (United States)

... Can chemotherapy side effects increase the risk of heart disease? Answers from Timothy J. Moynihan, M.D. Chemotherapy side effects may increase the risk of heart disease, including weakening of the heart muscle (cardiomyopathy) and ...

Displacement and resonance behaviors of a piezoelectric diaphragm driven by a double-sided spiral electrode

KAUST Repository

Shen, Zhiyuan

2012-04-03

This paper presents the design of a lead zirconate titanate (PZT) diaphragm actuated by double-sided patterned electrodes. Au/Cr electrodes were deposited on bulk PZT wafers by sputtering while patterned by a lift-off process. SU-8 thick film was used to form the structural layer. Double-spiral electrode induced in-plane poling and piezoelectric elongation are converted to an out-of-plane displacement due to the confined boundary condition. The influence of different drive configurations and electrode parameters on deflection has been calculated by finite element methods (FEM) using a uniform field model. Impedance and quasi-static displacement spectra of the diaphragm were measured after poling. Adouble-sided patterned electrode diaphragm can be actuated by more drive configurations than a single-sided one. Compared with a single-sided electrode drive, a double-sided out-of-phase drive configuration increases the coupling coefficient of the fundamental resonance from 7.6% to 11.8%. The displacement response of the diaphragm increases from 2.6 to 8.6nmV 1. Configurations including the electric field component perpendicular to the poling direction can stimulate shear modes of the diaphragm. © 2012 IOP Publishing Ltd.

The effect of cyclic rifaximin therapy on symptoms of diverticular disease from the perspective of the gastroenterology outpatient clinic: a “real-life” study