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Sample records for single pharyngeal aspiration

  1. The detection of pharyngeal incoordination and aspiration by radiosalivagram in cerebral palsy

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    Baikie, G.; Reddihough, D.; Olinsky, A.; South, M.J.; Bowe, J.; Cook, D.J. [Royal Children`s Hospital, Parkville, VIC, (Australia)

    1997-09-01

    Full text: Children with cerebral palsy (CP) may have abnormal respiratory function because of aspiration pneumonitis, chest deformity, upper airways obstruction or central respiratory control abnormalities. The diagnosis of aspiration has long confounded clinicians and is often made indirectly after exclusion of other causes of respiratory disease in susceptible individuals. The radiosalivagram is a technique which permits the demonstration of aspiration of pharyngeal contents in individuals with pharyngeal incoordination. It is a simple procedure which provides both qualitative and quantitative evidence of aspiration. Over an hour and while supine, 20 mL of {sup 99m}Tc-sulphur colloid is instilled into the pharynx via a thin plastic tube using a syringe pump. The neck, thorax and upper abdomen are imaged continuously In normal individuals, radioactivity is demonstrated in the pharynx, oesophagus and stomach; in the presence of pharyngeal incoordination, radioactivity is seen within one or both main bronchi and adjacent lung fields. The rate of clearance from the lungs varies and can be quantified. We have studied 31 children with severe non-ambulant CR The time to first aspiration, maximum quantity aspirated, and retention of aspirated material at 2h have been determined. These data have been compared with measurements of respiratory function. Preliminary results of this ongoing study reveal a broad range of outcomes. Seventeen children (17/31) had aspiration, in 15/17 aspiration was unilateral and in 14/17 there was spontaneous early clearance. The investigation was well tolerated by patients. The radiosalivagram is a simple, quantifiable investigation for demonstrating or excluding pharyngeal incoordination and aspiration in children with unexplained respiratory disease.

  2. Pharyngeal Residue and Aspiration and the Relationship with Clinical/Nutritional Status of Patients with Oropharyngeal Dysphagia Submitted to Videofluoroscopy.

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    Oliveira, D L; Moreira, E A M; de Freitas, M B; Gonçalves, J de A; Furkim, A M; Clavé, P

    2017-01-01

    The aim of this study was to investigate the association between the videofluoroscopic (VFS) signs of impaired efficacy (pharyngeal residue) and safety (aspiration) swallowing and the clinical/nutritional status of patients with suspect of dysphagia. A cross-sectional study was conducted with patients submitted to videofluoroscopy. Data of 76 patients were analyzed between March 2011 and December 2014. The clinical history and VFS exams of patients ≥ 38 years were retrospectively analyzed. 88% patients presented Oropharyngeal Dysphagia (OD), 44.7% presented laryngeal penetration and 32% presented aspiration. 78% patients presented pharyngeal residue. Aspiration was associated with Head Neck Cancer (HNC) [Prevalence Ratio (PR): 2.27, p = 0.028] and cardiovascular disease (PR 1.96, p = 0.027). Underweight [Body Mass Index Underweight patients with OD had a higher prevalence rate of pharyngeal residue than those normally nourished (100% vs. 78%) (PR 1.34, p = 0.011). Pharyngeal residue was associated with male sex (PR 1.32, p = 0.040), neurodegenerative disease (PR 1.57, p = 0.021), stroke (PR 1.62, p = 0.009), cerebral palsy (PR 1.76, p = 0.006) and HNC (PR 1.73, p = 0.002). In the present study, neurologic diseases, HNC, male sex and underweight were associated to impaired swallowing efficacy. Underweight, independently of the other variables, was not associated with impaired swallowing safety.

  3. Feasibility of Tomotherapy-based image-guided radiotherapy to reduce aspiration risk in patients with non-laryngeal and non-pharyngeal head and neck cancer.

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    Nam P Nguyen

    Full Text Available PURPOSE: The study aims to assess the feasibility of Tomotherapy-based image-guided radiotherapy (IGRT to reduce the aspiration risk in patients with non-laryngeal and non-hypopharyngeal cancer. A retrospective review of 48 patients undergoing radiation for non-laryngeal and non-hypopharyngeal head and neck cancers was conducted. All patients had a modified barium swallow (MBS prior to treatment, which was repeated one month following radiotherapy. Mean middle and inferior pharyngeal dose was recorded and correlated with the MBS results to determine aspiration risk. RESULTS: Mean pharyngeal dose was 23.2 Gy for the whole group. Two patients (4.2% developed trace aspiration following radiotherapy which resolved with swallowing therapy. At a median follow-up of 19 months (1-48 months, all patients were able to resume normal oral feeding without aspiration. CONCLUSION AND CLINICAL RELEVANCE: IGRT may reduce the aspiration risk by decreasing the mean pharyngeal dose in the presence of large cervical lymph nodes. Further prospective studies with IGRT should be performed in patients with non-laryngeal and non-hypopharyngeal head and neck cancers to verify this hypothesis.

  4. Fibrous nanocellulose, crystalline nanocellulose, carbon nanotubes, and crocidolite asbestos elicit disparate immune responses upon pharyngeal aspiration in mice.

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    Park, Eun-Jung; Khaliullin, Timur O; Shurin, Michael R; Kisin, Elena R; Yanamala, Naveena; Fadeel, Bengt; Chang, Jaerak; Shvedova, Anna A

    2018-12-01

    With the rapid development of synthetic alternatives to mineral fibers, their possible effects on the environment and human health have become recognized as important issues worldwide. This study investigated effects of four fibrous materials, i.e. nanofibrillar/nanocrystalline celluloses (NCF and CNC), single-walled carbon nanotubes (CNTs), and crocidolite asbestos (ASB), on pulmonary inflammation and immune responses found in the lungs, as well as the effects on spleen and peripheral blood immune cell subsets. BALB/c mice were given NCF, CNC, CNT, and ASB on Day 1 by oropharyngeal aspiration. At 14 days post-exposure, the animals were evaluated. Total cell number, mononuclear phagocytes, polymorphonuclear leukocytes, lymphocytes, and LDH levels were significantly increased in ASB and CNT-exposed mice. Expression of cytokines and chemokines in bronchoalveolar lavage (BAL) was quite different in mice exposed to four particle types, as well as expression of antigen presentation-related surface proteins on BAL cells. The results revealed that pulmonary exposure to fibrous materials led to discrete local immune cell polarization patterns with a T H 2-like response caused by ASB and T H 1-like immune reaction to NCF, while CNT and CNC caused non-classical or non-uniform responses. These alterations in immune response following pulmonary exposure should be taken into account when testing the applicability of new nanosized materials with fibrous morphology.

  5. Importance of Fine Needle Aspiration in Evaluation of Single ...

    African Journals Online (AJOL)

    Background: Improvements in the sensitivity and specificity of biochemical thyroid tests, as well as the development of fine needle aspiration biopsy (FNA) and improved cytological techniques, have dramatically impacted clinical strategies for detecting and treating thyroid disorders. Fine needle aspiration is a safe and ...

  6. Pharyngitis - viral

    Science.gov (United States)

    ... Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Pharyngitis - viral URL of this page: //medlineplus.gov/ency/article/ ...

  7. Single Center Experience with the AngioVac Aspiration System

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    Salsamendi, Jason, E-mail: jsalsamendi@med.miami.edu; Doshi, Mehul, E-mail: mdoshi@med.miami.edu; Bhatia, Shivank, E-mail: sbhatia1@med.miami.edu [University of Miami Miller School of Medicine/Jackson Memorial Hospital, Department of Vascular and Interventional Radiology (United States); Bordegaray, Matthew, E-mail: matthewbordegaray@gmail.com [University of Miami Miller School of Medicine/Jackson Memorial Hospital, Department Radiology (United States); Arya, Rahul, E-mail: rahul.arya@jhsmiami.org [University of Miami Miller School of Medicine/Jackson Memorial Hospital, Department of Vascular and Interventional Radiology (United States); Morton, Connor, E-mail: cmorton@med.miami.edu [University of Miami Miller School of Medicine (United States); Narayanan, Govindarajan, E-mail: gnarayanan@med.miami.edu [University of Miami Miller School of Medicine/Jackson Memorial Hospital, Department of Vascular and Interventional Radiology (United States)

    2015-08-15

    PurposeThe AngioVac catheter system is a mechanical suction device designed for removal of intravascular material using extracorporeal veno-venous bypass circuit. The purpose of this study is to present the outcomes in patients treated with the AngioVac aspiration system and to discuss its efficacy in different vascular beds.Materials and MethodsA retrospectively review was performed of seven patients treated with AngioVac between October 2013 and December 2014. In 6/7 cases, the AngioVac cannula was inserted percutaneously and the patient was placed on veno-venous bypass. In one of the cases, the cannula was inserted directly into the Fontan circuit after sternotomy and the patient was maintained on cardiopulmonary bypass. Thrombus location included iliocaval (2), SVC (1), pulmonary arteries (1), Fontan circuit and Glenn shunt with pulmonary artery extension (1), right atrium (1), and IVC with renal vein extension (1).ResultsThe majority of thrombus (50–95 %) was removed in 5/7 cases, and partial thrombus removal (<50 %) was confirmed in 2/7 cases. Mean follow-up was 205 days (range 64–403 days). All patients were alive at latest follow-up. Minor complications included three neck hematomas in two total patients. No major complications occurred.ConclusionAngioVac is a useful tool for acute thrombus removal in the large vessels. The setup and substantial cost may limit its application in straightforward cases. More studies are needed to establish the utility of AngioVac in treatment of intravascular and intracardiac material.

  8. Pharyngeal Swallowing Mechanics Secondary to Hemispheric Stroke.

    Science.gov (United States)

    May, Nelson H; Pisegna, Jessica M; Marchina, Sarah; Langmore, Susan E; Kumar, Sandeep; Pearson, William G

    2017-05-01

    Computational analysis of swallowing mechanics (CASM) is a method that utilizes multivariate shape change analysis to uncover covariant elements of pharyngeal swallowing mechanics associated with impairment using videofluoroscopic swallowing studies. The goals of this preliminary study were to (1) characterize swallowing mechanics underlying stroke-related dysphagia, (2) decipher the impact of left and right hemispheric strokes on pharyngeal swallowing mechanics, and (3) determine pharyngeal swallowing mechanics associated with penetration-aspiration status. Videofluoroscopic swallowing studies of 18 dysphagic patients with hemispheric infarcts and age- and gender-matched controls were selected from well-controlled data sets. Patient data including laterality and penetration-aspiration status were collected. Coordinates mapping muscle group action during swallowing were collected from videos. Multivariate morphometric analyses of coordinates associated with stroke, affected hemisphere, and penetration-aspiration status were performed. Pharyngeal swallowing mechanics differed significantly in the following comparisons: stroke versus controls (D = 2.19, P mechanics associated with each comparison were visualized using eigenvectors. Whereas current literature focuses on timing changes in stroke-related dysphagia, these data suggest that mechanical changes are also functionally important. Pharyngeal swallowing mechanics differed by the affected hemisphere and the penetration-aspiration status. CASM can be used to identify patient-specific swallowing impairment associated with stroke injury that could help guide rehabilitation strategies to improve swallowing outcomes. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. Doulas' Perceptions on Single Mothers' Risk and Protective Factors, and Aspirations Relative to Child-Birth

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    Arat, Gizem

    2013-01-01

    This study the author aims to explore the perceptions of doulas on single mothers' risk and protective factors, and aspirations relative to child-birth in the postpartum care. The current study was conducted by semi-structured questions, case file reviews, field notes, and twelve home visits via utilizing Grounded Theory. These mothers receive…

  10. A finite element study of micropipette aspiration of single cells: effect of compressibility.

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    Bidhendi, Amirhossein Jafari; Korhonen, Rami K

    2012-01-01

    Micropipette aspiration (MA) technique has been widely used to measure the viscoelastic properties of different cell types. Cells experience nonlinear large deformations during the aspiration procedure. Neo-Hookean viscohyperelastic (NHVH) incompressible and compressible models were used to simulate the creep behavior of cells in MA, particularly accounting for the effect of compressibility, bulk relaxation, and hardening phenomena under large strain. In order to find optimal material parameters, the models were fitted to the experimental data available for mesenchymal stem cells. Finally, through Neo-Hookean porohyperelastic (NHPH) material model for the cell, the influence of fluid flow on the aspiration length of the cell was studied. Based on the results, we suggest that the compressibility and bulk relaxation/fluid flow play a significant role in the deformation behavior of single cells and should be taken into account in the analysis of the mechanics of cells.

  11. Effects of single parenthood on educational aspiration and student disengagement in Korea

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    Hyunjoon Park

    2008-05-01

    Full Text Available The recent rapid increase in divorce, along with its distinctive cultural and welfare environments for single-parent families, makes Korea an interesting case for examining effects of single parenthood on children's education. Using data from Korean 9th and 12th graders, I compare the levels of educational aspiration and student disengagement between students with two parents and those with a single parent, distinguishing divorced single fathers, widowed single fathers, divorced single mothers, and widowed single mothers. Logistic regression analyses show that students with a divorced single parent, regardless of gender of the parent, are much less likely to aspire to four-year university education and more likely to be disengaged than their counterparts with two parents. The effects of widowhood disappear once control variables are held constant. Lower household income among single-parent families explains in part the poorer educational outcomes of their children. Parent-child interaction is another important mediating factor for the effect of single fatherhood but not for single motherhood. The relevance of the extended family system and distinctive features of post-divorce living arrangements in Korea is discussed to understand the effects of single parenthood.

  12. Single blastocyst transfer after ICSI from ejaculate spermatozoa, percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE)

    OpenAIRE

    Nilsson, Staffan; Waldenström, Urban; Engström, Ann-Britt; Hellberg, Dan

    2007-01-01

    Purpose: To investigate the outcome of IVF following intracytoplasmic sperm injection (ICSI) from ejaculate, percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE), with subsequent blastocyst culture and single blastocyst transfer.

  13. Severe Transient Pharyngeal Paralysis Following C2 Fracture Repair.

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    Cumpston, Evan C; Bock, Jonathan M

    2015-08-01

    We report a case of isolated pharyngeal plexus injury following posterior plating of a C2 fracture in an 84-year-old white male. Methods include a case report with literature review. The patient presented with dense pharyngeal paralysis and inability to initiate swallowing but maintained true vocal cord movement. The patient required gastrostomy tube feeding for 3 months but eventually recovered his swallowing function. Prior literature on acute pharyngeal paralysis following upper cervical spine fracture repairs is reviewed with recommendations for care of this unique patient population. Traumatic C2 fracture repair can lead to isolated dense pharyngeal paralysis due to pharyngeal plexus injury with subsequent severe dysphagia. Observation may be appropriate in this population, with consideration of tracheotomy for recurrent aspiration. © The Author(s) 2015.

  14. Bile Gastritis Following Laparoscopic Single Anastomosis Gastric Bypass: Pilot Study to Assess Significance of Bilirubin Level in Gastric Aspirate.

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    Shenouda, Michael M; Harb, Shady ElGhazaly; Mikhail, Sameh A A; Mokhtar, Sherif M; Osman, Ayman M A; Wassef, Arsany T S; Rizkallah, Nayer N H; Milad, Nader M; Anis, Shady E; Nabil, Tamer Mohamed; Zaki, Nader Sh; Halepian, Antoine

    2018-02-01

    Laparoscopic single anastomosis gastric bypass (SAGB) is increasingly performed for morbidly obese patients. This pilot study aims primarily at evaluating the incidence of bile gastritis after SAGB. The occurrence of reflux oesophagitis and reflux symptoms were also assessed. This study included 20 patients having no reflux symptoms. All patients underwent a SAGB as a primary bariatric procedure by a single surgeon. Patients included consented to have an upper GI endoscopy done at 6 months postoperatively. Gastric aspirate was sent for bilirubin level assessment. Gastric and esophageal biopsies were submitted for histopathology and campylobacter-like organism (CLO) test. In our study, the rate of bile gastritis was 30%. In 18 patients, the level of bilirubin in gastric aspirate seems to be related to the degree of mucosal inflammation. The remaining two patients had microscopic moderate to severe gastritis with normal aspirate bilirubin level. Two patients with bilirubin level in aspirate more than 20 mg/dl had severe oesophagitis, gastritis with erosions, and metaplasia. Relationship between bilirubin level and histopathological findings of gastric biopsy examination was statistically significant with a P value of 0.001. The incidence of bile gastritis in this cohort is higher than reported in the literature, and this may be worrying. The correlation between endoscopic findings and patients' symptoms is poor. Bilirubin level and pH in aspirate might be useful tools to confirm alkaline reflux. Its level might help to choose candidates for revision surgery after SAGB. This needs further validation with larger sample size.

  15. The Effects of Single Parenthood on Educational Aspiration: A Comparative Study of Children in the United Kingdom and Hong Kong

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    Wang, Miao; Ngai, Steven Sek-Yum

    2011-01-01

    Using data collected by the Organization for Economic Co-operation and Development's Program for International Student Assessment in 2003, this study examines the gap in the educational aspirations of children from single-parent families and two-parent families in the United Kingdom (UK) and Hong Kong. Consistent with previous research on the…

  16. Altered pharyngeal muscles in Parkinson disease.

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    Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming; Su, Hungxi; Sanders, Ira; Adler, Charles H; Shill, Holly A; Caviness, John N; Samanta, Johan E; Beach, Thomas G

    2012-06-01

    Dysphagia (impaired swallowing) is common in patients with Parkinson disease (PD) and is related to aspiration pneumonia, the primary cause of death in PD. Therapies that ameliorate the limb motor symptoms of PD are ineffective for dysphagia. This suggests that the pathophysiology of PD dysphagia may differ from that affecting limb muscles, but little is known about potential neuromuscular abnormalities in the swallowing muscles in PD. This study examined the fiber histochemistry of pharyngeal constrictor and cricopharyngeal sphincter muscles in postmortem specimens from 8 subjects with PD and 4 age-matched control subjects. Pharyngeal muscles in subjects with PD exhibited many atrophic fibers, fiber type grouping, and fast-to-slow myosin heavy chain transformation. These alterations indicate that the pharyngeal muscles experienced neural degeneration and regeneration over the course of PD. Notably, subjects with PD with dysphagia had a higher percentage of atrophic myofibers versus with those without dysphagia and controls. The fast-to-slow fiber-type transition is consistent with abnormalities in swallowing, slow movement of food, and increased tone in the cricopharyngeal sphincter in subjects with PD. The alterations in the pharyngeal muscles may play a pathogenic role in the development of dysphagia in subjects with PD.

  17. Transrectal ultrasound-guided aspiration in the management of prostatic abscess: A single-center experience

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    Jigish B Vyas

    2013-01-01

    Full Text Available Objectives: The safety and efficacy of transrectal ultrasound (TRUS guided aspiration of prostatic abscess (PA is known. The objective of this study is to describe a treatment algorithm for management of PA with TRUS-guided aspiration, emphasizing on indications and factors predicting the treatment outcome. Materials and Methods: After the institutional review board approval was obtained, a retrospective study was done of all patients suspected with PA on digital rectal examination (DRE and confirmed on TRUS. An 18-gauge two-part needle was used for aspiration. The real-time TRUS-guided aspiration of PA was done in the longitudinal axis. The aspiration of pus and the sequential collapse of cavity was seen "real time." A suprapubic catheter was placed, if the patient had urinary retention, persistent dysuria, and/or severe lower urinary tract symptoms (LUTS. Success was defined as complete resolution of the abscess and/or symptoms. Results: Forty-eight patients were studied with PA, with a mean age of 54.6 ± 14.6 (range 26-79 years. The DRE diagnosed PA in 22 (45.83% patients, while abdominal sonography diagnosed PA in 13 (27.08% patients. TRUS revealed a hypoechoic area with internal echoes in all 48 (100% patients. The diagnosis was confirmed in all 48 cases with aspiration. The mean size of the lesion was 3.2 ± 1.2 (range 1.5-8 cm. Mean volume aspirated was 10.2 ml (range 2.5-30 ml. Complete resolution after first aspiration was observed in 20 (41.66% patients. An average of 4.1 (range 1-7 aspirations was required for complete resolution which was seen in 41 patients (85.42%. Seven (14.58% patients required transurethral resection (deroofing of the abscess cavity. We formulated a treatment algorithm based on the above findings. Conclusion: The proposed algorithm based on our experience suggests that patients with PA larger than 2 cm with severe LUTS and/or leukocytosis benefit from TRUS-guided aspiration. In addition, these patients are

  18. Transrectal ultrasound-guided aspiration in the management of prostatic abscess: A single-center experience.

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    Vyas, Jigish B; Ganpule, Sanika A; Ganpule, Arvind P; Sabnis, Ravindra B; Desai, Mahesh R

    2013-07-01

    The safety and efficacy of transrectal ultrasound (TRUS) guided aspiration of prostatic abscess (PA) is known. The objective of this study is to describe a treatment algorithm for management of PA with TRUS-guided aspiration, emphasizing on indications and factors predicting the treatment outcome. After the institutional review board approval was obtained, a retrospective study was done of all patients suspected with PA on digital rectal examination (DRE) and confirmed on TRUS. An 18-gauge two-part needle was used for aspiration. The real-time TRUS-guided aspiration of PA was done in the longitudinal axis. The aspiration of pus and the sequential collapse of cavity was seen "real time." A suprapubic catheter was placed, if the patient had urinary retention, persistent dysuria, and/or severe lower urinary tract symptoms (LUTS). Success was defined as complete resolution of the abscess and/or symptoms. Forty-eight patients were studied with PA, with a mean age of 54.6 ± 14.6 (range 26-79) years. The DRE diagnosed PA in 22 (45.83%) patients, while abdominal sonography diagnosed PA in 13 (27.08%) patients. TRUS revealed a hypoechoic area with internal echoes in all 48 (100%) patients. The diagnosis was confirmed in all 48 cases with aspiration. The mean size of the lesion was 3.2 ± 1.2 (range 1.5-8) cm. Mean volume aspirated was 10.2 ml (range 2.5-30 ml). Complete resolution after first aspiration was observed in 20 (41.66%) patients. An average of 4.1 (range 1-7) aspirations was required for complete resolution which was seen in 41 patients (85.42%). Seven (14.58%) patients required transurethral resection (deroofing) of the abscess cavity. We formulated a treatment algorithm based on the above findings. The proposed algorithm based on our experience suggests that patients with PA larger than 2 cm with severe LUTS and/or leukocytosis benefit from TRUS-guided aspiration. In addition, these patients are benefitted from urinary drainage (either perurethral or

  19. Pharyngitis - sore throat

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    ... in some cases: Strep throat is caused by group A streptococcus. Less commonly, bacterial diseases such as gonorrhea and chlamydia can cause sore throat. Most cases of pharyngitis occur ... illness often spreads among family members and close contacts.

  20. Clinical Features and Genetic Background of the Periodic Fever Syndrome with Aphthous Stomatitis, Pharyngitis, and Adenitis: A Single Center Longitudinal Study of 81 Patients

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    Daša Perko

    2015-01-01

    Full Text Available PFAPA syndrome is the most common autoinflammatory disorder in childhood with unknown etiology. The aim of our study was clinical evaluation of PFAPA patients from a single tertiary care center and to determine whether variations of AIM2, MEFV, NLRP3, and MVK genes are involved in PFAPA pathogenesis. Clinical and laboratory data of consecutive patients with PFAPA syndrome followed up at the University Children’s Hospital, Ljubljana, were collected from 2008 to 2014. All four genes were PCR amplified and directly sequenced. Eighty-one patients fulfilled criteria for PFAPA syndrome, 50 (63% boys and 31 (37% girls, with mean age at disease onset of 2.1 ± 1.5 years. Adenitis, pharyngitis, and aphthae were present in 94%, 98%, and 56%, respectively. Family history of recurrent fevers in childhood was positive in 78%. Nineteen variants were found in 17/62 (27% patients, 4 different variants in NLRP3 gene in 13 patients, and 6 different variants in MEFV gene in 5 patients, and 2 patients had 2 different variants. No variants of clinical significance were found in MVK and AIM2 genes. Our data suggest that PFAPA could be the result of multiple low-penetrant variants in different genes in combination with epigenetic and environmental factors leading to uniform clinical picture.

  1. Streptococcal acute pharyngitis

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    Lais Martins Moreira Anjos

    2014-07-01

    Full Text Available Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine.

  2. Double Centrifugation Versus Single Centrifugation of Bone Marrow Aspirate Concentrate in Sinus Floor Elevation: A Pilot Study.

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    de Oliveira, Thiago Altro; Aloise, Antonio Carlos; Orosz, José Eduardo; de Mello E Oliveira, Rafael; de Carvalho, Paulo; Pelegrine, André Antonio

    2016-01-01

    To evaluate the regenerative results of the addition of bone marrow aspirate concentrate, using a single or double centrifugation protocol, to a xenogeneic bone graft in sinus floor elevation. Using a randomized, controlled pilot study design in 15 consecutive patients, sinus floor elevation procedures were performed with a xenogenous bone graft alone (control group, CG) or associated with bone marrow aspirate concentrate obtained by single centrifugation (single centrifugation group, SCG) or double centrifugation (double centrifugation group, DCG). In the patients in the single and double centrifugation groups, bone marrow was harvested from the iliac bone. Six months after the grafting procedures, bone biopsy specimens were obtained during implant placement and were analyzed by histomorphometry. Histomorphometric analysis revealed a great amount of vital mineralized tissue in SCG followed by DCG when compared with the CG (38.44 ± 12.34%, 34.63 ± 9.84%, and 27.30 ± 5.55%, respectively). SCG and DCG presented smaller amounts of nonvital mineralized tissue when compared with the CG (13.70 ± 7.50%, 19.63 ± 8.35%, and 22.79 ± 9.60%, respectively), thus presenting higher levels of resorption. Although these differences were not statistically significant (P > .05), a tendency toward bone gain in the experimental groups (SCG and DCG) was found. All groups (SCG, DCG, and CG) showed similar levels of nonmineralized tissue (47.87 ± 6.31%, 45.73 ± 7.33%, and 49.90 ± 7.64%, respectively). This pilot study indicates that the clinical use of bone marrow aspirate concentrate, obtained by either a single or double centrifugation process, combined with a xenograft for maxillary sinus elevation seems to result in more adequate bone repair. However, clinical trials with a larger number of patients are required.

  3. Aspiration pneumonia

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    Anaerobic pneumonia; Aspiration of vomitus; Necrotizing pneumonia; Aspiration pneumonitis ... The type of bacteria that caused the pneumonia depends on: Your ... facility, for example) Whether you were recently hospitalized ...

  4. PHARYNGITIS IN CHILDREN

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    T.A. Polunina

    2011-01-01

    Full Text Available Inflammatory disease of the throat — is a widespread pathology in childhood. The complex treatment of pharyngitis often includes solutions for gargling, sprays, tablets for sucking, hard candy or lozenges containing a variety of anti-inflammatory components. Their use reduces the severity of pain and the time treatment, but does not preclude the use of anti-inflammatory drugs for systemic effects. Key words: pharyhgitis, sore throat, treatment, children (Pediatric Pharmacology. — 2011; 8 (5: 106–108.

  5. Bone marrow aspiration

    Science.gov (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  6. Strategic Aspirations

    DEFF Research Database (Denmark)

    Christensen, Lars Thøger; Morsing, Mette; Thyssen, Ole

    2016-01-01

    aspirations, in other words, have exploratory and inspirational potential—two features that are highly essential in complex areas such as sustainability and CSR. This entry takes a communicative focus on strategic aspirations, highlighting the value of aspirational talk, understood as ideals and intentions...

  7. Lateral Pharyngeal Diverticulum presenting with Dysphagia ...

    African Journals Online (AJOL)

    Lateral pharyngeal diverticulum (Pharyngocele) is the protrusion of pharyngeal mucosa through the pharyngeal wall, usually through either of two weak areas in the pharyngeal wall as an acquired or congenital case. Lateral diverticula are very rare and not to be mistaken for the rather more frequent and abundantly ...

  8. Aspiration in head and neck cancer patients: a single centre experience of clinical profile, bacterial isolates and antibiotic sensitivity pattern.

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    Lakshmaiah, K C; Sirsath, Nagesh T; Subramanyam, Jayshree R; Govind, Babu K; Lokanatha, D; Shenoy, Ashok M

    2013-07-01

    Most patients with head and neck cancer have dysphagia and are at increased risk of having aspiration and subsequent pneumonia. It can cause prolonged hospitalization, treatment delay and/or interruption and mortality in cancer patients. The treatment of these infections often relies on empirical antibiotics based on local microbiology and antibiotic sensitivity patterns. The aim of present study is to analyse respiratory tract pathogens isolated by sputum culture in head and neck cancer patients undergoing treatment at a tertiary cancer centre in South India who presented with features of aspiration. The study is carried out to establish empirical antibiotic policy for head and neck cancer patients who present with features of aspiration. This was a retrospective study. The study included sputum samples sent for culture and sensitivity from January 2011 to December 2012. Analysis of microbiologic species isolated in sputum specimen and the antibiotic sensitivity pattern of the bacterial isolates was performed. A detailed study of case files of all patients was done to find out which is the most common site prone for producing aspiration. There were 47 (31.54 %) gram positive isolates and 102 (68.45 %) gram negative isolates. The most common bacterial isolates were Klebsiella pneumoniae (25.50 %), Pseudomonas aeruginosa (16.77 %) and Haemophilus influenzae (15.43 %). Levofloxacin was the most effective antibiotic with excellent activity against both gram positive and gram negative isolates. Most patients with aspiration had laryngeal cancer (34.89 %). Aspiration pneumonia was present in 14 (9.39 %) patients. Gram negative bacteria are common etiologic agents in head and neck cancer patients presenting with features of aspiration. Levofloxacin should be started as empirical antibiotic in these patients while awaiting sputum culture sensitivity report. As aspiration in head and neck cancer is an underreported event such institutional antibiotic sensitivity

  9. Videofluoroscopic Predictors of Penetration-Aspiration in Parkinson's Disease Patients.

    Science.gov (United States)

    Argolo, Natalie; Sampaio, Marília; Pinho, Patrícia; Melo, Ailton; Nóbrega, Ana Caline

    2015-12-01

    Parkinson's disease (PD) patients show a high prevalence of swallowing disorders and tracheal aspiration of food. The videofluoroscopic study of swallowing (VFSS) allows clinicians to visualize the visuoperceptual and temporal parameters associated with swallowing disorders in an attempt to predict aspiration risk. However, this subject remains understudied in PD populations. Our aim was to identify the predictors of penetration-aspiration in PD patients using the VFSS. Consecutive patients were evaluated using VFSS with different consistencies and volumes of food. A speech-language pathologist measured the type of intra-oral bolus organization, loss of bolus control, bolus location at the initiation of the pharyngeal swallow, the presence of multiple swallows, piecemeal deglutition, bolus residue in the pharyngeal recesses and temporal measures. Scores ≥3 on the penetration-aspiration scale (PAS) indicated the occurrence of penetration-aspiration. Using logistic marginal regression, we found that residue in the vallecula, residue in the upper esophageal sphincter and piecemeal deglutition were associated with penetration-aspiration (odds ratio (OR) = 4.09, 2.87 and 3.83; P = 0.0040, 0.0071 and 0.0009, respectively). Penetration/aspiration occurred only with fluids (both of thin and thick consistency), and no significant differences were observed between fluid types or food volumes. The mechanisms underlying dysphagia and penetration/aspiration in PD patients and indications for further studies are discussed.

  10. Correlation of gastroesophageal reflex with aspiration pneumonia after surgery

    International Nuclear Information System (INIS)

    Hirashima, Tokuji; Hashimoto, Hajime; Noro, Toshio; Takahashi, Tadao; Hino, Yasunori; Kuroiwa, Kouzirou

    1996-01-01

    In order to elucidate the correlation of gastroesophageal reflex (GER) with aspiration pneumonia after surgery, 48 patients (mean, 75.6 years) with gastric cancer treated at the hospital from March, 1994 to December, 1994 were subjected to this prospective study. The pharyngeal stimulation test, nutritional assessment, radionuclide esophageal scintigraphy (34 cases) were performed before surgery and relationship between those results and aspiration pneumonia were studied. Aspiration pneumonia occurred in 3 cases, and all of them were in, significantly, poor nutritional status, compared with other. A significant increase in the frequency of GER was observed when a naso-gastric tube (NGT) was placed, but surprisingly, all the patients with aspiration pneumonia were 3 out of 4 patients who had continuous GER without NGT. It is noteworthy, continuous GER without NGT was significantly (p<0.001) affected postoperative aspiration pneumonia and impaired phalyngeal reflex was frequently correlated with development of aspiration pneumonia, when malnutritional status existed. (author)

  11. Aspiration in Head and Neck Cancer Patients: A Single Centre Experience of Clinical Profile, Bacterial Isolates and Antibiotic Sensitivity Pattern

    OpenAIRE

    Lakshmaiah, K. C.; Sirsath, Nagesh T.; Subramanyam, Jayshree R.; Govind, Babu K.; Lokanatha, D.; Shenoy, Ashok M.

    2013-01-01

    Most patients with head and neck cancer have dysphagia and are at increased risk of having aspiration and subsequent pneumonia. It can cause prolonged hospitalization, treatment delay and/or interruption and mortality in cancer patients. The treatment of these infections often relies on empirical antibiotics based on local microbiology and antibiotic sensitivity patterns. The aim of present study is to analyse respiratory tract pathogens isolated by sputum culture in head and neck cancer pati...

  12. Streptococcal Pharyngitis and Appendicitis in Children.

    Science.gov (United States)

    Nielsen, Jason W; Abel, Stuart A; Kenney, Brian

    2018-01-01

    Several pathologies, including pharyngitis, are associated with abdominal pain that can mimic appendicitis. We sought to further understand the link between appendicitis-like symptoms and streptococcal (strep) pharyngitis. All patients undergoing ultrasound imaging for appendicitis in our emergency department during 2013 were reviewed (n = 1572). A total of 207 patients were identified who underwent both ultrasound for appendicitis and testing for strep pharyngitis. Demographic and outcomes data between rule out appendicitis patients who underwent strep testing and those who did not were compared. Strep testing was more common in younger patients (mean age = 8.26 vs 10.26 years P appendicitis and 35 (16.9%) patients tested positive for strep pharyngitis. No cases of concurrent strep pharyngitis and appendicitis were identified. The negative appendectomy rate in the strep pharyngitis tested group was 38.5% (5/13), compared with 7.7% (23/296) ( P = .003) in the nontested group. The appendicitis rate among the strep tested group was 3.8% (8/207) compared with 20% (273/1365) in the nontested group ( P appendicitis, and had a higher rate of negative appendectomy. A diagnosis of concurrent appendicitis and strep pharyngitis is rare. In cases of patients with sufficient symptoms to warrant testing for strep pharyngitis a diagnosis of appendicitis is less likely and surgical intervention leads to higher negative appendectomy rates.

  13. Tympanic ossicles and pharyngeal arches.

    Science.gov (United States)

    Whyte, J; Cisneros, A; Yus, C; Fraile, J; Obón, J; Vera, A

    2009-02-01

    We have performed a study on 11 human embryos regarding the development of the tympanic ossicles and their relationship with the first pharyngeal arch. After performing measurements to date the embryos and foetuses chronologically, we performed a meticulous dissection of the temporal bones. Subsequently, they were fixed in 10% formol, decalcified with 2% nitric acid, embedded in Paraplast, sectioned in 7-mm sequences and stained with Martin's trichrome technique. In the 21- and 24-mm cranium-raquis (CR) length human embryos, we have observed the head of the malleus and the body of the incus close to Meckel's cartilage, in addition to the handle of the malleus, the long limb of the incus and the stapes. Between them there was a mesenchymal band inside the primordium of the tympanic cavity. In the 27-mm CR embryo, the various components of the malleus and incus were fusing, and in the 30-mm CR embryo the union was complete. From our observations, we can conclude that the malleus and the incus are derived from the first and second pharyngeal arches.

  14. Computed tomography-guided needle aspiration and biopsy of pulmonary lesions - A single-center experience in 1000 patients

    Energy Technology Data Exchange (ETDEWEB)

    Poulou, Loukia S.; Tsagouli, Paraskevi; Thanos, Loukas [Dept. of Medical Imaging and Interventional Radiology, General Hospital of Chest Diseases ' Sotiria' , Athens (Greece)], e-mail: ploukia@hotmail.com; Ziakas, Panayiotis D. [Program of Outcomes Research, Div. of Infectious Diseases, Warren Alpert Medical School, Brown Univ., RI, and Div. of Infectious Diseases, Rhode Island Hospital, Rhode Island (United States); Politi, Dimitra [Dept. of Cythopathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece); Trigidou, Rodoula [Dept. of Pathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece)

    2013-07-15

    Background: Computed tomography (CT)-guided fine needle aspiration (FNA) and biopsies are well-established, minimally invasive diagnostic tools for pulmonary lesions. Purpose: To analyze retrospectively the results of 1000 consecutive lung CT-guided FNA and/or core needle biopsies (CNB), the main outcome measures being diagnostic yield, and complication rates. Material and Methods: Patients considered eligible were those referred to our department for lung lesions. The choice of FNA, CNB, or both was based upon the radiologist's judgment. Diagnostic yield was defined as the probability of having a definite result by cytology/histology. Results: The study included 733 male patients and 267 female patients, with a mean (SD) age of 66.4 (11.4) years. The mean (SD) lesion size was 3.7 (2.4) cm in maximal diameter. Six hundred and forty-one (64%) patients underwent an FNA procedure, 245 (25%) a CNB, and 114 (11%) had been subjected to both. The diagnostic yield was 960/994 (96.6%); this decreased significantly with the use of CNB only (odds ratio [OR] 0.32; 95% CI 0.12 - 0.88; P = 0.03), while it increased with lesion size (OR 1.35; 95% CI 1.03 - 1.79; P = 0.03 per cm increase). In 506 patients (52.7%), a malignant process was diagnosed by cytopathology/histology. The complication rate reached 97/1000 (9.7%); complications included: hemorrhage, 62 (6.2%); pneumothorax, 28 (2.8%); hemorrhage and pneumothorax, 5 (0.5%); and hemoptysis, 2 (0.2%). It was not significantly affected by the type of procedure or localization of the lesion. The overall risk for complications was three times higher for lesions <4 cm (OR 3.26; 95% CI 1.96 - 5.42; P < 0.001). Conclusion: CT-guided lung biopsy has a high diagnostic yield using FNA, CNB, or both. The CNB procedure alone will not suffice. Complication rates were acceptable and correlated inversely with lesion size, not localization or type of procedure.

  15. Pakistan prevalence survey in acute pharyngitis

    International Nuclear Information System (INIS)

    Rathi, S. K.

    2014-01-01

    Objective: To study the prevalence of Group A beta haemolytic Streptococcus in patients with acute pharyngitis and correlation of Modified Centor Score and Rapid Antigen Detection Test. Methods: The multi-centre, prospective, cross-sectional study was conducted in 8 major cities of Pakistan between June 2012 and February 2013, and comprised patients presenting with acute pharyngitis. The subjects were above 3 years of age presenting to primary care physician with sore throat, temperature over 100.4 (degree) F, tonsillar exudates and/or cervical adenopathy (duration of symptoms 4. Conclusion: The prevalence of Group A beta haemolytic Streptococcus as a cause of acute pharyngitis was 25.3%. Modified Centor Score had a strong positive correlation with Rapid Antigen Detection Test in identifying Group A beta haemolytic Streptococcus as a cause of acute pharyngitis. (author)

  16. COMPUTED TOMOGRAPHIC EVALUATION OF CANINE PHARYNGEAL NEOPLASIA

    OpenAIRE

    Carozzi, Gregorio

    2016-01-01

    Computed tomography (CT) is commonly used to investigate head tumours in dogs, and is a fundamental part of the diagnostic work-up, for diagnosis, staging and planning therapy in neoplastic disease. Nasal diseases, either neoplastic or non-neoplastic diseases, oral neoplasia, brain disease, thyroid or carotid body neoplasia have been extensively studied. However little information are available for lesions of the pharyngeal area. In this thesis, cases of dogs affected by pharyngeal neoplas...

  17. First experience with single-source dual-energy computed tomography in six patients with acute arthralgia: a feasibility experiment using joint aspiration as a reference

    Energy Technology Data Exchange (ETDEWEB)

    Diekhoff, Torsten; Kiefer, Tobias; Hamm, Bernd; Hermann, Kay-Geert A. [Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Freie Universitaet Berlin, Department of Radiology, Berlin (Germany); Ziegeler, Katharina; Feist, Eugen [Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Freie Universitaet Berlin, Department of Rheumatology and Clinical Immunology, Berlin (Germany); Mews, Juergen [Toshiba Medical Systems Europe, BV, Zoetermeer (Netherlands)

    2015-11-15

    Dual-energy computed tomography (DECT) is an emerging imaging technique for examining patients with suspected gout. Single-source dual-energy CT (S-DECT) is a new way of obtaining DECT information on conventional CT scanners rather than using special dual-source CT systems. We tested the feasibility of S-DECT (320-row CT; Aquilion ONE, Toshiba Medical Systems, Otawara, Japan) in 6 patients (5 men, 1 woman; mean age 61.3, range 48 to 69 years) with acute arthralgia and suspected gout, and compared the S-DECT findings with the results of joint aspiration. Three patients had a diagnosis of gouty arthritis with negatively birefringent crystals in synovial fluid, in addition to gouty tophi in S-DECT. Three patients had no detectable crystals by polarization microscopy and no tophi on DECT. Their final diagnoses were rheumatoid arthritis, activated osteoarthritis, and septic arthritis in one case each. This initial experience suggests that S-DECT might be a valuable alternative to dual-source CT. Hence, more patients may benefit from its additional diagnostic abilities in the future. (orig.)

  18. Beryllium concentration in pharyngeal tonsils in children

    Directory of Open Access Journals (Sweden)

    Ewa Nogaj

    2014-06-01

    Full Text Available Power plant dust is believed to be the main source of the increased presence of the element beryllium in the environment which has been detected in the atmospheric air, surface waters, groundwater, soil, food, and cigarette smoke. In humans, beryllium absorption occurs mainly via the respiratory system. The pharyngeal tonsils are located on the roof of the nasopharynx and are in direct contact with dust particles in inhaled air. As a result, the concentration levels of beryllium in the pharyngeal tonsils are likely to be a good indicator of concentration levels in the air. The presented study had two primary aims: to investigate the beryllium concentration in pharyngeal tonsils in children living in southern Poland, and the appropriate reference range for this element in children’s pharyngeal tonsils. Pharyngeal tonsils were extracted from a total of 379 children (age 2–17 years, mean 6.2 ± 2.7 years living in southern Poland. Tonsil samples were mineralized in a closed cycle in a pressure mineralizer PDS 6, using 65% spectrally pure nitric acid. Beryllium concentration was determined using the ICP-AES method with a Perkin Elmer Optima 5300DVTM. The software Statistica v. 9 was used for the statistical analysis. It was found that girls had a significantly greater beryllium concentration in their pharyngeal tonsils than boys. Beryllium concentration varies greatly, mostly according to the place of residence. Based on the study results, the reference value for beryllium in pharyngeal tonsils of children is recommended to be determined at 0.02–0.04 µg/g.

  19. The oesophagus and cough: laryngo-pharyngeal reflux, microaspiration and vagal reflexes

    Science.gov (United States)

    2013-01-01

    Gastro-oesophageal reflux disease is generally considered to be one of the commonest causes of chronic cough, however randomised controlled trials of proton pump inhibitors have often failed to support this notion. This article reviews the most recent studies investigating the mechanisms thought to link reflux and cough, namely laryngo-pharyngeal reflux, micro-aspiration and neuronal cross-organ sensitisation. How recent evidence might shed light on the failure of acid suppressing therapies and suggest new approaches to treating reflux related cough are also discussed. PMID:23590893

  20. Joint Aspiration (Arthrocentesis)

    Science.gov (United States)

    ... aspiration is diagnostic but it also can be therapeutic, helping to relieve pain and swelling caused by ... syringe. Sometimes, imaging with an X-ray or ultrasound is required to guide the aspiration needle to ...

  1. Meconium aspiration syndrome

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001596.htm Meconium aspiration syndrome To use the sharing features on this page, please enable JavaScript. Meconium aspiration syndrome (MAS) refers to breathing problems that a newborn ...

  2. Poverty and aspirations failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    We develop a theoretical framework to study the psychology of poverty and ‘aspirations failure’, defined as the failure to aspire to one’s own potential. In our framework, rich and the poor persons share the same preferences and same behavioral bias in setting aspirations. We show that poverty can

  3. Pharyngeal airway changes following mandibular setback surgery

    Directory of Open Access Journals (Sweden)

    Babu Ramesh

    2005-01-01

    Full Text Available Treatment of dentofacial deformities with jaw osteotomies has an effect on airway anatomy and therefore mandibular setback surgery has the potential to diminish airway size. The purpose of this study was to evaluate the effect of mandibular setback surgery on airway size. 8 consecutive patients were examined prospectively. All patients underwent mandibular setback surgery. Cephalometric analysis was performed preoperatively and 3 months post operatively with particular attention to pharyngeal airway changes. Pharyngeal airway size decreased considerably in all, patients thus predisposing to development of obstructive sleep apnea. Therefore, large anteroposterior discrepancies should be corrected by combined maxillary and mandibular osteotomies.

  4. Pharyngitis and sore throat: A review

    African Journals Online (AJOL)

    Jane

    2011-07-06

    Jul 6, 2011 ... and can bring out acute symptoms and give a lot of dis- comfort to the individual, a good example is strep ... symptoms such as severe pain in the throat and other uncomfortable physical symptoms such as ..... as mouth breathing, nausea, vomiting, abdominal pain and diarrhea. BACTERIAL PHARYNGITIS.

  5. Effects of mandibular setback with or without maxillary advancement osteotomies on pharyngeal airways: An overview of systematic reviews.

    Directory of Open Access Journals (Sweden)

    Su Keng Tan

    Full Text Available Mandibular setback osteotomies potentially lead to narrowing of the pharyngeal airways, subsequently resulting in post-surgical obstructive sleep apnea (OSA.To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies.PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date. Systematic reviews studying changes in pharyngeal airway dimensions and respiratory parameters after mandibular setback with or without concomitant upper jaw osteotomies have been identified, screened for eligibility, included and analyzed in this study.Six systematic reviews have been included. While isolated mandibular setback osteotomies result in reduced oropharyngeal airway dimensions, the reduction is lesser in cases with concomitant upper jaw osteotomies. Only scarce evidence exists currently to what happens to naso- and hypo-pharyngeal airways. There is no evidence for post-surgical OSA, even though some studies reported reduced respiratory parameters after single-jaw mandibular setback with or without concomitant upper jaw osteotomies.Although mandibular setback osteotomies reduce pharyngeal airway dimensions, evidence confirming post-surgical OSA was not found. Nevertheless, potential post-surgical OSA should be taken into serious consideration during the treatment planning of particular orthognathic cases. As moderate evidence exists that double-jaw surgeries lead to less compromised post-surgical pharyngeal airways, they should be considered as the method of choice especially in cases with severe dentoskeletal Class III deformity.PROSPERO (registration number: CRD42016046484.

  6. Pharyngeal video fluoroscopy: Selected unusual cases

    International Nuclear Information System (INIS)

    Conoley, P.M.; Fox, D.R.

    1987-01-01

    The videotape in this exhibit presents cases illustrative of the use of pharyngeal video fluoroscopy in diagnostic evaluations and therapeutic decision-making in a variety of speech and swallowing disorders of adults and children. Clinical problems addressed include an interesting compensatory speech mechanism in a cleft-palate patient, a preoperative candidate for a Lefort procedure, uncontrolled nasality in a singer, and dysphagia in an antimony worker

  7. Pulmonary Renal Syndrome After Streptococcal Pharyngitis

    Directory of Open Access Journals (Sweden)

    Gopi Mara-Koosham PhD

    2016-04-01

    Full Text Available Pulmonary renal syndrome is a class of small vessel vasculitides that are characterized by the dual presentation of diffuse alveolar hemorrhage (DAH and glomerulonephritis. Pulmonary renal syndrome has multiple etiologies, but its development has been rarely reported following infection with group A streptococcus. We present the case of a 36-year-old Native American male who was transferred to our facility due to refractory hypoxic respiratory failure. He had been diagnosed with streptococcal pharyngitis 2 weeks prior to admission. Given the presence of hemoptysis, bronchoscopy was performed and was consistent with DAH. Urinalysis demonstrated hematuria and proteinuria, in the setting of elevated creatinine and blood urea nitrogen. Additionally, antistreptolysin O titer was positive. Given the constellation of laboratory findings and history of streptococcal pharyngitis, the patient was diagnosed with PRS secondary to streptococcal infection. High-dose methylprednisolone was initiated with concomitant plasmapheresis. He was extubated successfully after his respiratory status improved and was eventually discharged home after making a full recovery within 2 weeks after admission. This case illustrates the importance of clinically relevant sequelae of streptococcal infection as well as the appropriate treatment of PRS secondary to streptococcal pharyngitis with plasmapheresis and intravenous corticosteroids.

  8. Aspiration and leadership

    NARCIS (Netherlands)

    Jagersma, P.K.

    2007-01-01

    Purpose - Management needs an aspiration as to how the company will work in the future. It needs a guide for corporate priorities. Any company - local or global - must be driven by an aspiration that energizes and motivates the company from top to bottom. Yet very few managers and executives know

  9. Aspiration and leadership

    NARCIS (Netherlands)

    Jagersma, P.K.

    2007-01-01

    Management needs an aspiration as to how the company will work in the future. It needs a guide for corporate priorities. Any company - local or global - must be driven by an aspiration that energizes and motivates the company from top to bottom. Yet very few managers and executives know how a

  10. Poverty and Aspirations Failure

    NARCIS (Netherlands)

    Dalton, P.S.; Ghosal, S.; Mani, A.

    2011-01-01

    We develop a theoretical framework to study the psychology of poverty and 'aspirations failure'. In our framework, the rich and the poor share the same preferences - and also a behavioral bias in setting aspirations. Greater downside risks imposed by poverty exacerbates the effects of this

  11. Comparing performance of amoxicillin and intramuscular benzathine penicillin in relieving manifestations of streptococcal pharyngitis in children.

    Science.gov (United States)

    Eslami, S T; Nassirian, A; Nassirian, H; Hatami, E; Sobhani, E; Najibpour, R

    2014-12-01

    To compare clinical and bacteriologic responses to intramuscular benzathine penicillin G (BPG) and single dose of amoxicillin in Group A streptococcal (GAS) pharyngitis. This study included 571 children from 6 to 15 years old age, with pharyngitis, who were admitted to 45 elementary and guidance schools from 7 regions of Education Organization in North-East of Iran, Mashhad. They were screened for enrollment and if he/she presented pharyngitis with clinical criteria of sore throat, erythema, exudate and tender or enlarged anterior cervical lymph nodes. Exclusion criteria included reports of antibiotic use, negative throat culture for GAS and history of allergy to the drugs. Clinical and bacteriologic responses to BPG and once daily orally amoxicillin were considered and compared. In the amoxicillin group, treatment failure was more than the penicillin group (18.9% vs. 6.4%, respectively) but the difference was not statistically significant (p amoxicillin. Our study was in line with studies comparing the two drugs. The results show that once-daily therapy with amoxicillin is as effective as intramuscular benzathine penicillin G for the treatment of GAS pharyngitis, but penicillin was significantly more effective in reducing exudate and concurrent signs vs. amoxicillin.

  12. The use of single dose of sodium citrate as a prophylaxis against acid aspiration syndrome in obstetric patients undergoing caesarean section.

    Science.gov (United States)

    Lim, S K; Elegbe, E O

    1991-12-01

    The effectiveness of sodium citrate as a prophylaxis against acid aspiration syndrome was studied in 3 groups of obstetric patients. Group I was the control group which consisted of 20 patients in established labour who were not likely to require caesarean section. No antacid had been given to these patients. Group II consisted of 20 patients who underwent elective caesarean section, while Group III consisted of another 20 patients who underwent emergency caesarean section. Group II and III were given 30ml of 0.3M sodium citrate as soon as they arrived in the operation theatre. The gastric content was aspirated after the induction of anaesthesia and at the end of surgery just before extubation. The volume was measured and a sample sent for pH analysis. Sodium citrate was found to increase the gastric pH significantly in both Group II and III patients when compared with Group I patients who underwent emergency caesarean section. We conclude that 30ml of 0.3M sodium citrate is effective in increasing gastric pH though it tends to be associated with an increase in gastric volume.

  13. Aspiration of a cockroach

    Directory of Open Access Journals (Sweden)

    Albert Bousso

    2008-12-01

    Full Text Available It is described a five-month-old infant admitted to our pediatricintensive care unit who aspirated a cockroach. The cockroach wasremoved through bronchoscopy. The child arrived at the emergencyroom in cardiopulmonary arrest and despite full respiratory andcardiovascular support was discharged with evidence of severeneurological sequelae. It is known that this is the first case of acockroach aspiration in a five-month-old infant and reinforces thataspiration of an insect must be considered a possibility in patientswith an unidentified organic foreign body aspiration.

  14. Pharyngeal Electrical Stimulation for Treatment of Dysphagia in Subacute Stroke

    Science.gov (United States)

    Scutt, Polly; Love, Jo; Clavé, Pere; Cohen, David; Dziewas, Rainer; Iversen, Helle K.; Ledl, Christian; Ragab, Suzanne; Soda, Hassan; Warusevitane, Anushka; Woisard, Virginie; Hamdy, Shaheen

    2016-01-01

    Background and Purpose— Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in 3 pilot randomized controlled trials. Methods— We randomly assigned 162 patients with a recent ischemic or hemorrhagic stroke and dysphagia, defined as a penetration aspiration score (PAS) of ≥3 on video fluoroscopy, to PES or sham treatment given on 3 consecutive days. The primary outcome was swallowing safety, assessed using the PAS, at 2 weeks. Secondary outcomes included dysphagia severity, function, quality of life, and serious adverse events at 6 and 12 weeks. Results— In randomized patients, the mean age was 74 years, male 58%, ischemic stroke 89%, and PAS 4.8. The mean treatment current was 14.8 (7.9) mA and duration 9.9 (1.2) minutes per session. On the basis of previous data, 45 patients (58.4%) randomized to PES seemed to receive suboptimal stimulation. The PAS at 2 weeks, adjusted for baseline, did not differ between the randomized groups: PES 3.7 (2.0) versus sham 3.6 (1.9), P=0.60. Similarly, the secondary outcomes did not differ, including clinical swallowing and functional outcome. No serious adverse device-related events occurred. Conclusions— In patients with subacute stroke and dysphagia, PES was safe but did not improve dysphagia. Undertreatment of patients receiving PES may have contributed to the neutral result. Clinical Trial Registration— URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25681641. PMID:27165955

  15. Kinematic and temporal factors associated with penetration-aspiration in liquid swallowing

    Science.gov (United States)

    Molfenter, Sonja M.; Steele, Catriona M.

    2015-01-01

    In this study, we undertook careful analysis of 13 quantitative physiological variables related to oropharyngeal swallowing from a sample of 42 subacute patients referred for dysphagia assessment. Each patient underwent videofluoroscopic swallowing examination in which they swallowed up to 5 boluses of 22% w/v ultra-thin liquid barium suspension administered by teaspoon. Our goal was to determine whether scores on thirteen kinematic or temporal parameters of interest were independently associated with the presence of penetration-aspiration in the final compiled dataset of 178 swallows. Participants were classified as aspirators, based on the presence of at least one swallow demonstrating a penetration-aspiration scale score ≥ 3. The parameters of interest included: six kinematic parameters for capturing hyoid position; three swallow durations (laryngeal closure duration; hyoid movement duration; upper esophageal sphincter (UES) opening duration); and four swallow intervals (laryngeal closure to UES opening; bolus dwell time in the pharynx prior to laryngeal closure; stage transition duration; and pharyngeal transit time). Mixed model repeated measures ANOVAs were conducted to determine the association between each parameter and aspiration status. Only one of the 13 parameters tested distinguished aspirators from non-aspirators: aspirators demonstrated significantly shorter UES opening duration. Additionally, a trend towards reduced maximum superior position of the hyoid was seen in aspirators. Limitations and future considerations are discussed. PMID:24445381

  16. The value of oropharyngoesophageal scintigraphy in the management of aspiration into the tracheobronchial tree in neurological patients.

    Science.gov (United States)

    Grosso, M; Fattori, B; Volterrani, D; Chondrogiannis, S; Boni, G; Nacci, A; Marzola, M C; Rubello, D

    2015-01-01

    Dysphagia and bolus aspiration are two of the most frequent and invalidating symptoms of various neurological diseases. Swallowing disorders often lead to tracheobronchial aspiration with consequent pneumonia episodes. Aspiration pneumonia per se constitutes the most frequent cause of death in these patients, with mortality rate ranging from 20% to 62%. Oropharyngoesophageal scintigraphy (OPES) permits functional quantitative assessment of the different stages of swallowing, together with the detection and quantitative measurement of bolus aspiration. In this work, we analyzed the role of OPES in patients with different neurological conditions to evaluate swallowing and to detect and quantify bolus aspiration. We enrolled 43 neurological patients (25 women and 18 men, mean age 67.3±12.4 yr) complaining of dysphagia with suspected inhalation. All patients underwent OPES with (99m)Tc-nanocolloid using a liquid bolus first, followed by a semi-solid bolus. We evaluated the following parameters: Oral, Pharyngeal and Esophageal Transit Time, Oro-Pharyngeal Retention Index, Esophageal Emptying Rate, and Aspiration Rate (% AR). OPES detected some airway aspiration in 26/43 patients. 19 patients had tracheal aspiration (with a mean 18.1% AR) and the remaining 7 patients had bilateral broncho-pulmonary aspiration (mean 44.9% AR). OPES is a feasible, repeatable and noninvasive method that allows quantitative assessment of bolus aspiration into the tracheobronchial tract, thus representing a useful and accurate tool to guide the most appropriate treatment and to monitor response to therapy in neurological patients with dysphagia. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  17. Comparison of differently viscous iodinated and bariumcontaining contrast agents in the detection of pharyngeal perforation

    International Nuclear Information System (INIS)

    Keberle, M.; Wittenberg, G.; Trusen, A.; Hahn, D.; Baumgartner, W.

    2001-01-01

    Purpose: In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this. Methods: Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration. Results: In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous that the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally. Conclusions: Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose. (orig.) [de

  18. Bone marrow aspiration

    Science.gov (United States)

    Bain, B

    2001-01-01

    Bone marrow aspiration biopsies are carried out principally to permit cytological assessment but also for immunophenotypic, cytogenetic, molecular genetic, and other specialised investigations. Often, a trephine biopsy is carried out as part of the same procedure. Bone marrow aspirations should be carried out by trained individuals who are aware of the indications, contraindications, and hazards of the procedure. They should follow a standard operating procedure. The operator should have made an adequate assessment of clinical and haematological features to ensure both that appropriate indications exist and that all relevant tests are performed. For the patient's comfort and safety, the posterior iliac crest is generally the preferred site of aspiration. Films of aspirated marrow and, when appropriate, films of crushed particles should be made and labelled. Once thoroughly dry, films should be fixed and stained. As a minimum, a Romanowsky stain and a Perls' stain are required. A cover slip should be applied. The bone marrow films should be assessed and reported in a systematic manner so that nothing of importance is overlooked, using a low power, then intermediate, then high power objective. A differential count should be performed. An interpretation of the findings, in the light of the clinical and haematological features, should be given. The report should be signed or computer authorised, using a secure password, and issued in a timely manner. Key Words: bone marrow aspirate • haematological diagnosis PMID:11533068

  19. Residue influences quality of life independently of penetration and aspiration in head and neck cancer survivors.

    Science.gov (United States)

    Meyer, Tanya K; Pisegna, Jessica M; Krisciunas, Gintas P; Pauloski, Barbara R; Langmore, Susan E

    2017-07-01

    Dysphagia is one of the most significant side effects of the treatment of head and neck cancer. Residue and aspiration are two indicators of dysphagia, but aspiration is historically the only indicator of interest, because it may impact health outcomes. Clinicians have anecdotally used residue as another marker of swallowing dysfunction, but it is understudied. This project investigated the impact of aspiration versus residue on function and quality of life (QoL) in these patients. Observational study. A total of 168 head and neck cancer survivors with moderate to severe dysphagia were enrolled in a randomized clinical trial comparing two swallow therapy interventions. Data at time of entry were used for the current study. A modified barium swallow study was done to compute Penetration-Aspiration Scale (PAS) scores, percentage oral residue, and percentage pharyngeal residue with three bolus consistencies (5 mL thin, nectar, and pudding). The Performance Status Scale (PSS) and the Head Neck Cancer Inventory (HNCI) questionnaires were administered. Data were analyzed to determine associations between aspiration and residue estimates with function and QoL scores. Worsening aspiration and residue estimates were all correlated with decreased scores on the PSS functional scales (r = -0.190 to -0.324, P ≤ .031). However, only increasing residue estimates were significantly related to decreased patient-perceived QoL on the HNCI (r = -.178 to -.194, P < .046). This effect was more pronounced with oral versus pharyngeal residue. In this group of head and neck cancer survivors, penetration/aspiration and residue show independent effects. PAS affects functional status only, but residue affects both functional status and QoL. This study supports that residue should be considered a primary measurement of swallowing function and be a target for identification, treatment, and evaluation of swallowing. 2c. Laryngoscope, 127:1615-1621, 2017. © 2016 The American Laryngological

  20. [Usefulness and limitation of crico-pharyngeal myotomy and laryngeal suspension after wide resection of the tongue or oropharynx].

    Science.gov (United States)

    Fujimoto, Y; Hasegawa, Y; Nakayama, B; Matsuura, H

    1998-03-01

    To prevent post-surgical dysphagia in oral or oropharyngeal cancer patients, crico-pharyngeal myotomy and laryngeal suspension are recommended; however, its indication has been controversial. When it was though that patients would lose the mechanisms of laryngeal elevation or mechanisms to produce oropharyngeal pressure we opted for crico-pharyngeal myotomy and laryngeal suspension: total or subtotal glossectomy with bilateral resection of suprahyoid muscles, and wide resection of the oropharynx including the tongue base. In this paper, we report the usefulness and limitation of crico-pharyngeal myotomy and laryngeal suspension after wide resection of the tongue or oropharynx. From April 1992 to January 1996, 19 patients received circo-pharyngeal myotomys and laryngeal suspensions along with their initial operation for oral or oropharyngeal cancer. Their ages ranged from 28 to 69 years. Fourteen had tongue cancer and 5 had oropharyngeal cancer. We examined the relationship between the ability to have an oral diet and the extent of mobile tongue resection, extent of tongue base resection, and extent of resection of the lateral wall of the oropharynx, reconstruction method, and age. Fifteen of the 19 patients (68%) could have an oral diet when they were discharged. The extent of tongue base resection (more than 50%) and age (> or = 60) significantly affected post-surgical aspiration. Two patients who had total glossectomy with total tongue base resection could have an oral diet. They were 41 and 51 years old. One 35-year-old patient who had total glossectomy with wide tongue base resection (80%) was able to have the same diet as his family. On the other hand, 4 elderly patients (> or = 60) who had wide resection of the tongue base (> or = 50%) could not have an oral diet at all. A crico-pharyngeal myotomy and a laryngeal suspension can contribute to the prevention of post-surgical dysphagia. However, if an elderly patient (> or = 60) has had wide tongue base

  1. Pharyngolaryngeal paralysis in a patient with pharyngeal tuberculosis.

    Science.gov (United States)

    Ohki, Masafumi; Komiyama, Sakurako; Tayama, Niro

    2015-02-01

    Pharyngeal tuberculosis is a rare disease, and its commonly reported symptoms include sore throat, dysphagia, and throat discomfort. The dysphagia in pharyngeal tuberculosis cases is not due to pharyngolaryngeal paralysis but due to odynophagia. Herein, we describe the first case of dysphagia caused by pharyngolaryngeal paralysis secondary to pharyngeal tuberculosis. An irregular mass at the right nasopharynx was detected in a 57-year-old female patient, along with dysphagia and hoarseness. She had poor right soft palate elevation, inadequate right velopharyngeal closure, poor constrictor pharyngus muscle contraction, and an immobilized right vocal cord, which collectively indicate right pharyngolaryngeal paralysis. Pathological examination and culture testing revealed pharyngeal tuberculosis. She was diagnosed with pharyngolaryngeal paralysis secondary to pharyngeal tuberculosis. The pharyngolaryngeal paralysis resolved after beginning anti-tuberculous treatment. Right pharyngolaryngeal paralysis was attributed to glossopharyngeal and vagus nerve impairment in the parapharyngeal space. Prior reports indicate that peripheral nerve paralysis, including recurrent laryngeal nerve paralysis caused by tuberculous lymphadenitis, often recovers after anti-tuberculous treatment. Pharyngeal tuberculosis rarely causes dysphagia and hoarseness attributable to pharyngolaryngeal paralysis. The neuropathy may recover after anti-tuberculous treatment. Pharyngeal tuberculosis is a new potential differential diagnosis in pharyngolaryngeal paralysis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Diagnostic ability and factors affecting accuracy of endoscopic ultrasound-guided fine needle aspiration for pancreatic solid lesions: Japanese large single center experience.

    Science.gov (United States)

    Haba, Shin; Yamao, Kenji; Bhatia, Vikram; Mizuno, Nobumasa; Hara, Kazuo; Hijioka, Susumu; Imaoka, Hiroshi; Niwa, Yasumasa; Tajika, Masahiro; Kondo, Shinya; Tanaka, Tsutomu; Shimizu, Yasuhiro; Yatabe, Yasushi; Hosoda, Waki; Kawakami, Hiroshi; Sakamoto, Naoya

    2013-08-01

    Several studies have investigated the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for pancreatic lesions, but they have included only limited patient populations. This study aimed to clarify the diagnostic accuracy of EUS-FNA in a large number of pancreatic lesions, and to describe the factors that influence it. From March 1997 to May 2010, 944 consecutive patients who had undergone EUS-FNA for pancreatic solid lesions were evaluated retrospectively. Factors affecting EUS-FNA accuracy were then analyzed. A total of 996 solid pancreatic lesions were sampled by EUS-FNA. The overall sampling adequacy and diagnostic accuracy of these lesions were 99.3 % (989/996) and 91.8 % (918/996), respectively. The sensitivity and specificity for differentiating malignant from benign lesions were 91.5 % (793/867) and 97.7 % (126/129), respectively. The diagnostic performance was significantly higher when both cytological and cell-block examinations were carried out than with only cytological examination. In multivariate analysis, final diagnosis, location of lesion, lesion size, availability of on-site cytopathological evaluation, and experience of EUS-FNA procedure were independent factors affecting the accuracy of EUS-FNA. On-site cytopathological evaluation and lesion size were found to be the most weighted factors affecting diagnostic accuracy. EUS-FNA for pancreatic solid lesions yielded a high accuracy and low complication rate. Both cytological and cell-block preparations and on-site cytopathological evaluation contributed to improve the accuracy. The diagnostic ability of EUS-FNA was less for smaller lesions, and repeated procedures may be needed if malignancy is suspected.

  3. Usefulness of conventional transbronchial needle aspiration in the diagnosis, staging and molecular characterization of pulmonary neoplasias by thin-prep based cytology: experience of a single oncological institute.

    Science.gov (United States)

    Ramieri, Maria Teresa; Marandino, Ferdinando; Visca, Paolo; Salvitti, Tommaso; Gallo, Enzo; Casini, Beatrice; Giordano, Francesca Romana; Frigieri, Claudia; Caterino, Mauro; Carlini, Sandro; Rinaldi, Massimo; Ceribelli, Anna; Pennetti, Annarita; Alò, Pier Luigi; Marino, Mirella; Pescarmona, Edoardo; Filippetti, Massimo

    2016-08-01

    Conventional transbronchial needle aspiration (c-TBNA) contributed to improve the bronchoscopic examination, allowing to sample lesions located even outside the tracheo-bronchial tree and in the hilo-mediastinal district, both for diagnostic and staging purposes. We have evaluated the sensitivity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the c-TBNA performed during the 2005-2015 period for suspicious lung neoplasia and/or hilar and mediastinal lymphadenopathy at the Thoracic endoscopy of the Thoracic Surgery Department of the Regina Elena National Cancer Institute, Rome. Data from 273 consecutive patients (205 males and 68 females) were analyzed. Among 158 (58%) adequate specimens, 112 (41%) were neoplastic or contained atypical cells, 46 (17%) were negative or not diagnostic. We considered in the analysis first the overall period; then we compared the findings of the first [2005-2011] and second period [2012-2015] and, finally, only those of adequate specimens. During the overall period, sensibility and accuracy values were respectively of 53% and 63%, in the first period they reached 41% and 53% respectively; in the second period sensibility and accuracy reached 60% and 68%. Considering only the adequate specimens, sensibility and accuracy during the overall period were respectively of 80% and 82%; the values obtained for the first period were 68% and 72%. Finally, in the second period, sensibility reached 86% and accuracy 89%. Carcinoma-subtyping was possible in 112 cases, adenocarcinomas being diagnosed in 50 cases; further, in 30 cases molecular predictive data could be obtained. The c-TBNA proved to be an efficient method for the diagnosis/staging of lung neoplasms and for the diagnosis of mediastinal lymphadenopathy. Endoscopist's skill and technical development, associated to thin-prep cytology and to a rapid on site examination (ROSE), were able to provide by c-TBNA a high diagnostic yield and molecular predictive

  4. Small intestine aspirate and culture

    Science.gov (United States)

    ... ency/article/003731.htm Small intestine aspirate and culture To use the sharing features on this page, please enable JavaScript. Small intestine aspirate and culture is a lab test to check for infection ...

  5. Rising Aspirations Dampen Satisfaction

    Science.gov (United States)

    Clark, Andrew E.; Kamesaka, Akiko; Tamura, Teruyuki

    2015-01-01

    It is commonly believed that education is a good thing for individuals. Yet, its correlation with subjective well-being is most often only weakly positive, or even negative, despite the many associated better individual-level outcomes. We here square the circle using novel Japanese data on happiness aspirations. If reported happiness comes from a…

  6. Meconium aspiration syndrome

    Directory of Open Access Journals (Sweden)

    I.O. Bushtyreva

    2010-06-01

    Full Text Available Pathophysiological aspects of formation and development of meconium aspiration syndrome, as well as peculiaritues of its development based on data from native and foreign literature are studied. Special emphasis is pointed out to possible diagnostic techniques and prevention of syndrome

  7. Religious orientation and life aspirations.

    Science.gov (United States)

    Steffen, Patrick R; Clayton, Spencer; Swinyard, William

    2015-04-01

    The effects of religiosity on well-being appear to depend on religious orientation, with intrinsic orientation being related to positive outcomes and extrinsic orientation being related to neutral or negative outcomes. It is not clear, however, why intrinsic and extrinsic religiosity has the relationships they do. Self-determination theory may provide a useful framework of intrinsic and extrinsic aspirations that may help to answer this question. The purpose of the present study was to examine whether intrinsic and extrinsic religiosity would be related to intrinsic and extrinsic life aspirations. We hypothesized that intrinsic religiosity would be positively related to intrinsic life aspirations and negatively related with extrinsic life aspirations, and that extrinsic religiosity would be positively related to extrinsic life aspirations and negatively related to intrinsic aspirations, and that life aspirations would partially mediate the relationships between religious orientation and outcome. To study these hypotheses, a random national sample (total number of 425, average age of 52, 59 % female) completed the measures of religious orientation, life aspirations, affect, and life satisfaction. It was found that intrinsic religiosity was positively related to positive affect, life satisfaction, and intrinsic life aspirations and was negatively related to negative affect and extrinsic life aspirations. Extrinsic religiosity was positively related to extrinsic life aspirations and was not related to the intrinsic life aspirations. When both religious orientation and life aspiration variables were included together in the model predicting outcome, both remained significant indicating that religious orientation and life aspirations are independent predictors of outcome. In conclusion, although religious orientation and life aspirations are significantly related to each other and to outcome, life aspirations did not mediate the effects of religious orientation

  8. Prosthetic management of pharyngeal flap-related snoring.

    Science.gov (United States)

    Williams, William N; Turner, Glenn T; Lewis, Kelley; Pegoraro-Krook, Maria Inês; Dutka-Souza, Jeniffer C R

    2007-07-01

    The obturating pharyngeal flap used in correcting velopharyngeal insufficiency has been implicated in creating difficulty in nasal breathing for some patients and/or in causing hyponasal speech, obstructive sleep apnea, and snoring. This is a case report of an individually designed removable prosthesis that positions an acrylic tube through each port lateral to the pharyngeal flap, with the goal of preventing the collapse of the ports during sleep and the consequent snoring. The acrylic tubes maintain an opening through both lateral ports preventing the soft tissues of the lateral walls from vibrating against the pharyngeal flap (causing the snoring sound) and allowing nasal breathing. The acrylic tubes effectively eliminated the patient's problem of snoring. This case study demonstrates that snoring associated with a pharyngeal flap can be controlled prosthetically by maintaining an opening through the two lateral ports, preventing the soft tissues of the walls of the lateral ports from vibrating against the flap.

  9. Sequential voluntary cough and aspiration or aspiration risk in Parkinson's disease.

    Science.gov (United States)

    Hegland, Karen Wheeler; Okun, Michael S; Troche, Michelle S

    2014-08-01

    Disordered swallowing, or dysphagia, is almost always present to some degree in people with Parkinson's disease (PD), either causing aspiration or greatly increasing the risk for aspiration during swallowing. This likely contributes to aspiration pneumonia, a leading cause of death in this patient population. Effective airway protection is dependent upon multiple behaviors, including cough and swallowing. Single voluntary cough function is disordered in people with PD and dysphagia. However, the appropriate response to aspirate material is more than one cough, or sequential cough. The goal of this study was to examine voluntary sequential coughing in people with PD, with and without dysphagia. Forty adults diagnosed with idiopathic PD produced two trials of sequential voluntary cough. The cough airflows were obtained using pneumotachograph and facemask and subsequently digitized and recorded. All participants received a modified barium swallow study as part of their clinical care, and the worst penetration-aspiration score observed was used to determine whether the patient had dysphagia. There were significant differences in the compression phase duration, peak expiratory flow rates, and amount of air expired of the sequential cough produced by participants with and without dysphagia. The presence of dysphagia in people with PD is associated with disordered cough function. Sequential cough, which is important in removing aspirate material from large- and smaller-diameter airways, is also impaired in people with PD and dysphagia compared with those without dysphagia. There may be common neuroanatomical substrates for cough and swallowing impairment in PD leading to the co-occurrence of these dysfunctions.

  10. Clinical signs suggestive of pharyngeal dysphagia in preschool children with cerebral palsy.

    Science.gov (United States)

    Benfer, Katherine A; Weir, Kelly A; Bell, Kristie L; Ware, Robert S; Davies, Peter S W; Boyd, Roslyn N

    2015-03-01

    This study aimed to determine the discriminative validity, reproducibility, and prevalence of clinical signs suggestive of pharyngeal dysphagia according to gross motor function in children with cerebral palsy (CP). It was a cross-sectional population-based study of 130 children diagnosed with CP at 18-36 months (mean=27.4, 81 males) and 40 children with typical development (TD, mean=26.2, 18 males). Sixteen signs suggestive of pharyngeal phase impairment were directly observed in a videoed mealtime by a speech pathologist, and reported by parents on a questionnaire. Gross motor function was classified using the Gross Motor Function Classification System. The study found that 67.7% of children had clinical signs, and this increased with poorer gross motor function (OR=1.7, pDysphagia cut-points were modified to exclude a single cough on fluids, with a modified prevalence estimate proposed as 50.8%. Clinical signs suggestive of pharyngeal dysphagia are common in children with CP, even those with ambulatory CP. Parent-report on 16 specific signs remains a feasible screening method. While coughing was consistently identified by clinicians, it may not reflect children's regular performance, and was not sufficiently discriminative in children aged 18-36 months. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  11. Infectious Mononucleosis: Pharyngitis and Morbilliform Rash

    Directory of Open Access Journals (Sweden)

    Eric McCoy

    2017-04-01

    Full Text Available History of present illness: A 20-year-old female on day nine of amoxicillin for a recent diagnosis of pharyngitis presented to the emergency department with a complaint of rash for two days. The patient’s clinical course started two weeks prior and included fever, tonsillar exudates, and fatigue. Initial vitals were temperature of 37.6oC, blood pressure 122/82, heart rate 135, respiratory rate 18, and oxygen saturation 100% on room air. Significant findings: Her physical exam was significant for bilateral tonsillar exudates, cervical lymphadenopathy, and a morbilliform rash that included the palms (Figure 1-4. Laboratory testing was significant for white blood cell (WBC count of 16.5 thous/mcl with an elevation in absolute lymphocytes of > 10 thous/mcl. The monospot and EBV (Epstein-Barr virus panel were positive. Discussion: Infectious mononucleosis (IM is a clinical syndrome characterized by a triad of fever, tonsillar pharyngitis, and lymphadenopathy, and is most commonly associated with primary Epstein-Barr virus (EBV infection.1,2 The incidence of IM in the United States is 500 cases/100,000 person-years, with the highest incidence between ages 15 to 24 years.1 EBV transmission occurs predominantly through exposure to infected saliva3, with an incubation period of 30 – 50 days.1 The majority of patients with IM recover without apparent sequelae and most clinical and laboratory findings resolve by 1 month after diagnosis. Cervical adenopathy and fatigue may resolve more slowly ( > 6 months for fatigue.4,5 IM may be associated with several acute complications including splenic rupture (0.5 – 1% and airway obstruction (1%.6 A morbilliform rash occurs in up to 95% of patients with IM who are treated with beta-lactam antibiotics for presumed group A streptococcal infection.1 Diagnosis is typically made in the setting of the clinical syndrome combined with laboratory test to detect antibodies to certain EBV-associated antigens.7 Primary EBV

  12. Measurement of pharyngeal sensory cortical processing: technique and physiologic implications

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    Ringelstein E Bernd

    2009-07-01

    Full Text Available Abstract Background Dysphagia is a major complication of different diseases affecting both the central and peripheral nervous system. Pharyngeal sensory impairment is one of the main features of neurogenic dysphagia. Therefore an objective technique to examine the cortical processing of pharyngeal sensory input would be a helpful diagnostic tool in this context. We developed a simple paradigm to perform pneumatic stimulation to both sides of the pharyngeal wall. Whole-head MEG was employed to study changes in cortical activation during this pharyngeal stimulation in nine healthy subjects. Data were analyzed by means of synthetic aperture magnetometry (SAM and the group analysis of individual SAM data was performed using a permutation test. Results Our results revealed bilateral activation of the caudolateral primary somatosensory cortex following sensory pharyngeal stimulation with a slight lateralization to the side of stimulation. Conclusion The method introduced here is simple and easy to perform and might be applicable in the clinical setting. The results are in keeping with previous findings showing bihemispheric involvement in the complex task of sensory pharyngeal processing. They might also explain changes in deglutition after hemispheric strokes. The ipsilaterally lateralized processing is surprising and needs further investigation.

  13. Development of Pyriform Sinus Suctioning Programs for Aspiration Pneumonia Prevention During the Acute Stroke.

    Science.gov (United States)

    Inui, Yuki; Kamakura, Yayoi; Fukada, Junko; Yoneda, Masahiko; Kataoka, Emiko; Usami, Yasuko; Sugiura, Miki; Nagatani, Tetsuya; Seki, Yukio; Hatano, Norikazu; Yasui, Keizo

    2017-12-01

    Aspiration due to dysphagia is a factor associated with pneumonia during acute stroke. In such cases, it is likely that secretions in the pyriform sinuses enter the laryngeal inlet. The present study was based on the idea that it is possible to reduce aspiration pneumonia by periodically suctioning and removing such secretions (pyriform sinus suctioning), a study was conducted in a single facility. The incidence of pneumonia as a dependent variable was compared between before (control) and after (intervention group) intervention with pyriform sinus suctioning as an independent variable. With a view of unifying the quality and frequency of intervention, two programs to: initially confirm the safety of such suctioning; subsequently enhance/evaluate knowledge and skills related to the procedure (educational); and specify conditions for the implementation and criteria for determining its appropriateness (practical), were developed. The study involved 33 (mean age: 74.6 ± 12.4) and 30 (80.0 ± 8.8) control and intervention group members, respectively, 25 (83.3%) of the latter were treated with pyriform sinus suctioning for 5 days after a stroke. Pneumonia developed in 7 (21.2%) and 2 (6.7%) of the former and latter, respectively. As individuals with a Japan Coma Scale (JCS) score of III or a midline shift on head CT tend to develop pharyngeal dysphagia, the patients were also divided into 2 groups to compare the incidence of pneumonia based on the risk level: low: Japan Coma Scale scores of I-II without a midline shift on head CT; and high: scores of II-III with it. In the latter, the incidence after intervention was markedly lower (p = 0.06, φ = 0.326), while the former did not show changes (p = 0.574, φ = 0.066), supporting the effectiveness of pyriform sinus suctioning to prevent aspiration pneumonia among patients with a low risk level.

  14. CSR as Aspirational Talk

    DEFF Research Database (Denmark)

    Christensen, Lars Thøger; Morsing, Mette; Thyssen, Ole

    2013-01-01

    Most writings on corporate social responsibility (CSR) treat lack of consistency between organizational CSR talk and action as a serious problem that needs to be eliminated. In this article, we argue that differences between words and action are not necessarily a bad thing and that such discrepan......Most writings on corporate social responsibility (CSR) treat lack of consistency between organizational CSR talk and action as a serious problem that needs to be eliminated. In this article, we argue that differences between words and action are not necessarily a bad thing...... and that such discrepancies have the potential to stimulate CSR improvements. We draw on a research tradition that regards communication as performative to challenge the conventional assumption that CSR communication is essentially superficial, as opposed to CSR action. In addition, we extend notions of organizational...... hypocrisy to argue that aspirational CSR talk may be an important resource for social change, even when organizations do not fully live up to their aspirations....

  15. Aspiration of Barium Contrast

    Directory of Open Access Journals (Sweden)

    Cristina Fuentes Santos

    2014-01-01

    Full Text Available The aspiration of barium contrast is a rare complication that may occur during studies of the digestive tract. Barium is an inert material that can cause anywhere from an asymptomatic mechanical obstruction to serious symptoms of respiratory distress that can result in patient death. We present the case of a 79-year-old male patient in whom we observed the presence of contrast medium residue in the lung parenchyma as an incidental finding during hospitalization. When the patient’s medical file was reviewed, images were found of a barium swallow study that the patient had undergone months earlier, and we were able to observe the exact moment of the aspiration of the contrast material. The patient had been asymptomatic since the test.

  16. The Ability of the 10-Item Eating Assessment Tool (EAT-10) to Predict Aspiration Risk in Persons With Dysphagia.

    Science.gov (United States)

    Cheney, Diane M; Siddiqui, M Tausif; Litts, Juliana K; Kuhn, Maggie A; Belafsky, Peter C

    2015-05-01

    Dysphagia is common and costly. The ability of patient symptoms to predict objective swallowing dysfunction is uncertain. This study aimed to evaluate the ability of the Eating Assessment Tool (EAT-10) to screen for aspiration risk in patients with dysphagia. Data from individuals with dysphagia undergoing a videofluoroscopic swallow study between January 2012 and July 2013 were abstracted from a clinical database. Data included the EAT-10, Penetration Aspiration Scale (PAS), total pharyngeal transit (TPT) time, and underlying diagnoses. Bivariate linear correlation analysis, sensitivity, specificity, and predictive values were calculated. The mean age of the entire cohort (N=360) was 64.40 (±14.75) years. Forty-six percent were female. The mean EAT-10 was 16.08 (±10.25) for nonaspirators and 23.16 (±10.88) for aspirators (PEAT-10 score and the PAS (r=0.273, PEAT-10>15 in predicting aspiration were 71% and 53%, respectively. Subjective dysphagia symptoms as documented with the EAT-10 can predict aspiration risk. A linear correlation exists between the EAT-10 and aspiration events (PAS) and aspiration risk (TPT time). Persons with an EAT-10>15 are 2.2 times more likely to aspirate (95% confidence interval, 1.3907-3.6245). The sensitivity of an EAT-10>15 is 71%. © The Author(s) 2014.

  17. Aspiration of Barium Contrast

    OpenAIRE

    Fuentes Santos, Cristina; Steen, Bárbara

    2014-01-01

    The aspiration of barium contrast is a rare complication that may occur during studies of the digestive tract. Barium is an inert material that can cause anywhere from an asymptomatic mechanical obstruction to serious symptoms of respiratory distress that can result in patient death. We present the case of a 79-year-old male patient in whom we observed the presence of contrast medium residue in the lung parenchyma as an incidental finding during hospitalization. When the patient’s medical fil...

  18. Pulmonary exposure to single-walled carbon nanotubes does not affect the early immune response against Toxoplasma gondii

    Directory of Open Access Journals (Sweden)

    Swedin Linda

    2012-05-01

    Full Text Available Abstract Background Single-walled carbon nanotubes (SWCNT trigger pronounced inflammation and fibrosis in the lungs of mice following administration via pharyngeal aspiration or inhalation. Human exposure to SWCNT in an occupational setting may occur in conjunction with infections and this could yield enhanced or suppressed responses to the offending agent. Here, we studied whether the sequential exposure to SWCNT via pharyngeal aspiration and infection of mice with the ubiquitous intracellular parasite Toxoplasma gondii would impact on the immune response of the host against the parasite. Methods C57BL/6 mice were pre-exposed by pharyngeal administration of SWCNT (80 + 80 μg/mouse for two consecutive days followed by intravenous injection with either 1x103 or 1x104 green fluorescence protein and luciferase-expressing T. gondii tachyzoites. The dissemination of T. gondii was monitored by in vivo bioluminescence imaging in real time for 7 days and by plaque formation. The inflammatory response was analysed in bronchoalveolar lavage (BAL fluid, and by assessment of morphological changes and immune responses in lung and spleen. Results There were no differences in parasite distribution between mice only inoculated with T. gondii or those mice pre-exposed for 2 days to SWCNT before parasite inoculum. Lung and spleen histology and inflammation markers in BAL fluid reflected the effects of SWCNT exposure and T. gondii injection, respectively. We also noted that CD11c positive dendritic cells but not F4/80 positive macrophages retained SWCNT in the lungs 9 days after pharyngeal aspiration. However, co-localization of T. gondii with CD11c or F4/80 positive cells could not be observed in lungs or spleen. Pre-exposure to SWCNT did not affect the splenocyte response to T. gondii. Conclusions Taken together, our data indicate that pre-exposure to SWCNT does not enhance or suppress the early immune response to T. gondii in mice.

  19. Fine needle aspiration cytology of oral and oropharyngeal lesions with an emphasis on the diagnostic utility and pitfalls

    Directory of Open Access Journals (Sweden)

    Nalini Gupta

    2012-01-01

    Full Text Available Aim: This study was undertaken to evaluate the diagnostic utility and pitfalls of fine needle aspiration cytology (FNAC in oral and oropharyngeal lesions. Materials and Methods: This was a retrospective audit of oral and oropharyngeal lesions diagnosed with FNAC over a period of six years (2005-2010. Results: Oral/oropharyngeal lesions [n=157] comprised 0.35% of the total FNAC load. The age ranged 1-80 years with the male: female ratio being 1.4:1. Aspirates were inadequate in 7% cases. Histopathology was available in 73/157 (46.5% cases. Palate was the most common site of involvement [n=66] followed by tongue [n=35], buccal mucosa [n=18], floor of the mouth [n=17], tonsil [n=10], alveolus [n=5], retromolar trigone [n=3], and posterior pharyngeal wall [n=3]. Cytodiagnoses were categorized into infective/inflammatory lesions and benign cysts, and benign and malignant tumours. Uncommon lesions included ectopic lingual thyroid and adult rhabdomyoma of tongue, and solitary fibrous tumor (SFT, and leiomyosarcoma in buccal mucosa. A single false-positive case was dense inflammation with squamous cells misinterpreted as squamous cell carcinoma (SCC on cytology. There were eight false-negative cases mainly due to sampling error. One false-negative case due to interpretation error was in a salivary gland tumor. The sensitivity of FNAC in diagnosing oral/oropharyngeal lesions was 71.4%; specificity was 97.8% with diagnostic accuracy of 87.7%. Conclusions: Salivary gland tumors and squamous cell carcinoma (SCC are the most common lesions seen in the oral cavity. FNAC proves to be highly effective in diagnosing the spectrum of different lesions in this region. Sampling error is the main cause of false-negative cases in this region.

  20. Comparison Study of the Adequacy and Pain Scale of Ultrasound-Guided Fine-Needle Aspiration of Solid Thyroid Nodules with a 21- or 23-Gauge Needle for Liquid-Based Cytology: a Single-Center Study.

    Science.gov (United States)

    Jung, Soo Jin; Kim, Dong Wook; Baek, Hye Jin

    2018-03-01

    No published study has compared the cytological adequacy between different caliber needles in liquid-based cytology (LBC) after fine-needle aspiration (FNA) of thyroid nodules. This study aimed to compare cytological adequacy, pain scale, and associated complications depending on the use of a 21- and 23-gauge needle in LBC. From January 2017 to April 2017, 88 solid thyroid nodules (STNs) in 88 patients underwent consecutive ultrasonography (US)-guided FNA (US-FNA) by a single radiologist. The selection of the needle size was randomized and changed biweekly. After FNA, the pain scale and other complications related to FNA were immediately evaluated for each patient. In all cases, adequacy and cellularity in cytology were retrospectively investigated by a single cytopathologist. Of the 88 STNs, 10 (11.4%) showed inadequate cytology: 6 for 21-gauge and 4 for 23-gauge needles. The rate of cytological adequacy was higher in the 23-gauge needle group than in the 21-gauge group, but this was not statistically significant (p = 0.318). The mean values of the pain scale in the 21- and 23-gauge needle groups were 1.8 ± 1.3 and 1.4 ± 1.1, respectively, but this difference was not statistically significant (p = 0.567). There were no significant complications associated with US-FNA, except for one case of mild intrathyroidal hemorrhage. In US-FNA of STNs using LBC, the use of a 23-gauge needle may be recommended rather than a 21-gauge needle.

  1. Pharyngeal odontoma in an adult walleye (Sander vitreus).

    Science.gov (United States)

    Coffee, L L; Bogdanovic, L B; Cushing, T L; Bowser, P R

    2013-05-01

    An adult walleye (Sander vitreus) was submitted to Cornell University for evaluation of a hard pale-tan pharyngeal mass attached to the gill arches. Dozens of hard white conical structures radiated from the surface. Microscopically, conical structures were identified as denticles and rested on plates of dysplastic orthodentine, cementum, and acellular bone. A diagnosis of compound odontoma was made based upon the presence of proliferative epithelial and mesenchymal odontogenic tissues that recapitulated tooth structures normally present on gill rakers. Odontomas are classified as hamartomas and typically develop in immature diphyodont mammals. The pharyngeal location and lifelong regeneration of teeth in fish, however, both qualify the present diagnosis in the pharyngeal region of an adult teleost. Ontogenic and morphologic differences between mammalian and piscine dentition and differentials for tooth-bearing tumors in fish are presented within the context of a developmental anomaly.

  2. Should urologists care for the pharyngeal infection of Neisseria gonorrhoeae or Chlamydia trachomatis when we treat male urethritis?

    Science.gov (United States)

    Hamasuna, Ryoichi; Takahashi, Satoshi; Uehara, Shinya; Matsumoto, Tetsuro

    2012-06-01

    Detection of Neisseria gonorrhoeae (NG) or Chlamydia trachomatis (CT) from the pharynx of women or men is not uncommon. However, there is no recommendation how urologists should care for the pharyngeal infection of men with urethritis in Japan. The aim of this study is to clarify the prevalence of NG or CT infection in the pharynx of men and to show a recommendation for urologists. The Japanese reports about the detection of NG or CT from the pharynx or the oral cavity of men in Japan are reviewed in the literature from 1990 to 2011. The prevalence of NG or CT in the pharynx was 4% or 6% in men who attended clinics, and 20% or 6% in men who were positive for NG or CT from genital specimens, respectively. Single 1-g dose ceftriaxone was recommended to treat pharyngeal NG, but no evidence was found for pharyngeal CT. There was not enough evidence for recommendation. However, when men with urethritis only caused by NG or CT are treated through the guideline of the Japanese Society of Sexually Transmitted Infection, we do not think additional tests or treatment for the pharynx are needed when a single 1-g dose ceftriaxone for gonococcal urethritis or a single 1- or 2- g dose azithromycin is prescribed for chlamydial urethritis in Japan.

  3. ASPIRE: Added-value Sensing

    DEFF Research Database (Denmark)

    Anggorojati, Bayu; Cetin, Kamil; Mihovska, Albena D.

    2010-01-01

    FP7 ICT project ASPIRE is one of the coordinated European efforts to further the advancement of this technology, in the areas of enabling technology development for RFID. The focus of ASPIRE is on the design, development and adoption of an innovative, programmable, royalty-free, lightweight...

  4. [Comparison of iodinated and barium-containing contrast media of different viscosity in the detection of pharyngeal perforation].

    Science.gov (United States)

    Keberle, M; Wittenberg, G; Trusen, A; Baumgartner, W; Hahn, D

    2001-08-01

    In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this. Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration. In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous than the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally. Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose.

  5. The Association between Maxillomandibular Sagittal Relationship and Pharyngeal Airway Passage Dimensions

    Directory of Open Access Journals (Sweden)

    Madhurima Nanda

    2012-01-01

    Conclusion : Sagittal skeletal pattern had a close association between the pharyngeal airway passage and the dimensions of the pharyngeal airway passage. The dimensions of pharyngeal airway passage were decreased from Class III to Class I and Class I to Class II subjects.

  6. Workload, Aspiration, and Fun

    DEFF Research Database (Denmark)

    Muhr, Sara Louise; Pedersen, Michael; Alvesson, Mats

    2012-01-01

    Contemporary working life highlights the challenge between exploitation and exploration both on a general and a more individual level. Here, we focus on the latter, and connect the critical debate regarding selfmanagement to March’s exploitation/exploration trade-off, as this forms a useful...... theoretical frame to understand how employees make sense of their self-management efforts. The employee is subjected to an individual responsibility to understand and manage an exploration of the self while handling the norms of self-exploitation that a self-management culture creates. Through an empirical...... study of a large group of management consultants, we explore how they perform and make sense of selfexploitation and self-exploration through three specific discourses: the discourse of workload, the discourse of aspiration, and the discourse of fun. Through these, the consultants try to identify...

  7. High-frequency focal repetitive cerebellar stimulation induces prolonged increases in human pharyngeal motor cortex excitability.

    Science.gov (United States)

    Vasant, Dipesh H; Michou, Emilia; Mistry, Satish; Rothwell, John C; Hamdy, Shaheen

    2015-11-15

    Neurostimulation is a rapidly emerging approach to swallowing rehabilitation, but cerebellar stimulation has not been explored as a treatment. Such proposed therapies for post-stroke dysphagia have required confirmation of physiological effects and optimisation of parameters in healthy humans prior to translational progression into patient groups. There is strong evidence for a role of the cerebellum in swallowing physiology, but this relationship has been under-explored. Recently, single pulses of cerebellar magnetic stimulation have been shown to directly evoke responses from pharyngeal musculature and produce short-term enhancement of cortico-pharyngeal motor evoked potentials, suggesting the feasibility of a cerebellar approach to neurostimulation in the swallowing system. We therefore examined multiple parameters of repetitive cerebellar magnetic stimulation and have described the optimal settings to provoke longer-lasting changes in swallowing neurophysiology. Based on evidence from the post-stroke dysphagia neurostimulation literature, these changes may have a therapeutic potential for swallowing rehabilitation. Brain neurostimulation has been shown to modulate cortical swallowing neurophysiology in post-stroke dysphagia with therapeutic effects which are critically dependent on the stimulation parameters. Cerebellar neurostimulation is, however, a novel, unexplored approach to modulation of swallowing pathways as a prelude to therapy for dysphagia. Here, we randomised healthy human subjects (n = 17) to receive one of five cerebellar repetitive TMS (rTMS) interventions (Sham, 1 Hz, 5 Hz, 10 Hz and 20 Hz) on separate visits to our laboratory. Additionally, a subset of subjects randomly received each of three different durations (50, 250, 500 pulses) of optimal frequency versus sham cerebellar rTMS. Prior to interventions subjects underwent MRI-guided single-pulse transcranial magnetic stimulation (TMS) to co-localise pharyngeal and thenar representation

  8. Hemophagocytosis on Bone Marrow Aspirate Cytology: Single ...

    African Journals Online (AJOL)

    Pancytopenia and erythroid hyperplasis were common hematological presentation. Moderate to severe hemophagocytosis was ... related hematological findings observed in peripheral blood and bone marrow in cases showing .... Hemophagocytosis is although an interesting finding that is observed in the bone marrow but ...

  9. Pharyngitis and sore throat: A review | Somro | African Journal of ...

    African Journals Online (AJOL)

    Pharyngitis is a sore throat caused by inflammation of the back of the throat. It is one of the most common reasons for visits to family physicians. Throat may be scratchy and swallowing can be painful. Usually, a sore throat is the sign of another illness, such as a cold or the flu. In this review article, epidemiology, national ...

  10. Pharyngeal transit time measured by scintigraphic and biomagnetic method

    International Nuclear Information System (INIS)

    Miquelin, C.A.; Braga, F.J.H.N.; Baffa, O.

    1996-01-01

    A comparative evaluation between scintigraphic and biomagnetic method to measure the pharyngeal transit is presented. Three volunteers have been studied. The aliment (yogurt) was labeled with 9 9 m Technetium for the scintigraphic test and with ferrite for the biomagnetic one. The preliminary results indicate a difference between the values obtained, probably due to the biomagnetic detector resolution

  11. An unusual rhino-pharyngeal foreign body | Onakoya | West African ...

    African Journals Online (AJOL)

    Study design: This is a case report of a 20-year-old male magician with impacted rhino-pharyngeal foreign body. ... des patients adultes avec des corps étranger nasals en particulier sont peu courants et quand il y a des corps étranger bien actifs un grand risque du développement des complications sont provoquées.

  12. Bacterial isolates of tonsillitis and pharyngitis in a paediatric casualty ...

    African Journals Online (AJOL)

    BHS and S. aureus showed 100% sensitivity to cefuroxine, azithromycin, ceftazidine and genticin. All the isolates had little or no sensitivity to ampicillin and cotrimoxazole. BHS is a significant cause of pharyngitis and tonsillitis in our environment and therefore poses a potential danger of rheumatic fever and rheumatic heart ...

  13. Pharyngeal Electrical Stimulation for Treatment of Dysphagia in Subacute Stroke

    DEFF Research Database (Denmark)

    Bath, Philip M W; Scutt, Polly; Love, Jo

    2016-01-01

    BACKGROUND AND PURPOSE: Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in 3 pilot randomized controlled trials. METHODS:...

  14. Chronic Pharyngitis And Multiple Soft Palate Peforation In An HIV ...

    African Journals Online (AJOL)

    This report is at advocating the need for repeated investigation and screening for HIV particularly when there is persistent clinical feature strongly suggestive of AIDS. Should we even start to contemplate therapeutic of antiretroviral dugs in some cases? KEY WORDS: Chronic pharyngitis, Soft palate perforation, AIDS, HIV ...

  15. Pharyngeal related non-lexical vowels in Sephardic Modern Hebrew

    NARCIS (Netherlands)

    Pariente, I.

    2010-01-01

    This paper examines non-lexical vowels in Sephardic Modern Hebrew. It is argued that two kinds of vowel, which are triggered by the pharyngeal consonants, should be identified: (a) true epenthetic vowels that emerge on the surface to repair illicit (marked) syllable structures. (b) "Echo-vowels"

  16. Group A Streptococcus pharyngitis among schoolchildren in Mbulu ...

    African Journals Online (AJOL)

    Streptococcal pharyngitis continues to be one of the most common childhood illnesses throughout the world. Recent evidence indicates an increased incidence of group A Streptococcal (GAS) infections, which is a significant cause of mortality and morbidity on the global scale. The objective of this study was to determine ...

  17. Histological study of the pharyngeal pad of the african catfish ...

    African Journals Online (AJOL)

    The pharyngeal pad located dorsally on the oro-pharynx was processed for light microscopy. The epithelium was of stratified mucous type containing taste buds, club cells and teeth. The micromorphology revealed the co-localization of teeth and taste bud. Developing, erupting and erupted teeth were also seen. The thin ...

  18. Diagnosis and management of group A streptococcal pharyngitis and associated complications [digest].

    Science.gov (United States)

    Vazquez, Michelle N; Sanders, Jennifere E; Wilson, Bryan

    2017-12-21

    Although group A Streptococcus (GAS) pharyngitis is the most common cause of bacterial pharyngitis in children and adolescents, many viral and bacterial infections mimic the symptoms of GAS pharyngitis. Emergency clinicians must recognize the symptomatology of GAS pharyngitis and use appropriate means of diagnosis and treatment to promote good antibiotic stewardship. This issue reviews the signs and symptoms of GAS pharyngitis, as well as associated complications, and provides recommendations for appropriate treatment that focuses on reducing the severity and duration of symptoms, reducing the incidence of nonsuppurative complications, and reducing transmission. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  19. A lateral cephalometric study of pharyngeal cavity in Korean adults

    International Nuclear Information System (INIS)

    Lee, Sang Rae

    1976-01-01

    A study was performed to investigate the size of pharyngeal cavity and sexual differences between Korean adult mal e and female by introducing linear analysis of the lateral cephalogram. The radiograms were composed of 46 adult male aged 24.64 and 52 adult female aged 22.74 respectively. In order to study and measure the pharyngeal area, the following skeletal landmarks were selected: S,N,A,Ptm, B,H,H', M ,S-N, FH and CV, and the angle CV-FH was measured to provide a factor for correction of error resulting from improper he ad positioning of subjects, especially in the relative positions of A and H, while radiography. All points to be measured were projected at right angles to the Frankfort plane. For the purpose of measuring the anteroposterior dimensions of pharyngeal cavity the distances were measured in A-Ptm, A-S, S-Ptm and CV-H, and vertical measurements were made in SN-A, SN-PNS, SN-H' and M-H. The obtained results were as follows: 1. The pharyngeal cavity is broader in the vertical than in the anteroposterior diameter in both sex and the maximum sexual differences were showed in the distances between SN and H', and minimal sexual differences in the distances between S and Ptm. 2. In general, the measurements of male were larger than those of female in the anteroposterior dimensions of pharyngea l cavity, but the distances between A and S, between CV and H showed significant sexual differences when evaluated statistically. 3. All of the measurements were larger in male than in female in vertical dimensions of pharyngeal cavity, and there were statistical significances of sexual differences in all variables.

  20. [Pharyngeal ulcer in patients with acquired immune deficiency syndrome].

    Science.gov (United States)

    Fang, Gaoli; Zhang, Luo; Wang, Chengshuo; Xiao, Jiang; Fu, Qian; Zhao, Hongxin

    2014-02-01

    To understand the high incidence of pharyngeal ulcer in patients with acquired immune deficiency syndrome (AIDS). By analyzing the clinical features in AIDS patients with pharyngeal ulcer, this study provided reference for clinicians. Twenty AIDS patients with pharyngeal ulcer were retrospectively analysed to explore its clinical features and mechanism, and to explore the feasible therapeutic methods. The patients generally had severe sore throat and dysphagia for 7 days to 8 months, resulting in significant weight loss. Common therapeutical method does not work. The ulcers developed mainly at vestibule of pharynx (10 cases), tonsil (3 cases), epiglottis (3 cases) and pyriform sinus (2 cases). Ulcer types included major aphthous ulcer (MaAU, 14 cases), fungal ulcer (2 cases), herpes zoster (1 case), ulcer secondary to drug eruption(1 case ), and lymphoma(2 cases). The disease course was long with CD4(+) T lymphocytes decreased significantly. Treatment was given with highly active antiretroviral therapy (HARRT), regulation of immune function, analgesic, anti-inflammatory and anti fungal. Treatment lasted from 2 weeks to 3 months, ulcer healed in 13 cases; 1 patient lost to follow-up, 6 patients dead. The manifestation of pharyngeal ulcer in AIDS patients has its particularity. It is often associated with a variety of opportunistic infection and tumors. Local treatment is preferred. HAART therapy and systemic comprehensive treatment play more important and effective role. Pharyngeal ulcer persists for a long time, complicated with fever, diarrhea and other symptoms. The history of blood transfusion, injection drug use or unsafe sexual behavior may predict HIV infection.

  1. [Cine-MRI contribution to assess swallowing mechanism and oro-pharyngeal dysphagia].

    Science.gov (United States)

    Fauvet, F; Charpiot, A; Schultz, P; Riehm, S; Vetter, D; Veillon, F; Hémar, P; Debry, C

    2008-01-01

    This study aimed at evaluating the performance of Cine-MRI to assess swallowing in patients previously treated for head and neck cancer. 10 healthy control subjects and a cohort of 10 patients with 8 partial glossectomies, 1 total laryngectomy and 1 glossolaryngectomy underwent imaging from October 2005 to February 2007. The MRI examinations were performed on a 1.5 Tesla system (Siemens Avanto), with True-Fisp sequences (TR = 170 ms, TE = 1 ms, slice thickness = 10 mm) at a rate of 8 pictures per second, during dry swallowing. Results are relevant for real-time spatial resolution from lips to larynx and dynamic motions analyses of tongue, velum, posterior pharyngeal wall and larynx during dry swallowing. Oro-pharyngo-laryngeal occlusion deficiency induces aspiration in case of partial glossectomy. Total laryngectomy modifies tongue, velum and pharynx landmarks. Cine-MRI i) provides functional insight from the oral cavity to the larynx, ii) gives accurate informations about impairments due to the pathology and its treatment, iii) completes others investigations like fiberoptic endoscopy or transit time, iiii) allows a precise analysis of the muscular movements involved in the deficient swallowing mechanism, in order to optimize rehabilitative strategies and results.

  2. A Randomized Controlled Trial to Investigate the Effectiveness of the Prevention of Aspiration Pneumonia Using Recommendations for Swallowing Care Guided by Ultrasound Examination.

    Science.gov (United States)

    Miura, Yuka; Nakagami, Gojiro; Yabunaka, Koichi; Tohara, Haruka; Noguchi, Hiroshi; Mori, Taketoshi; Sanada, Hiromi

    2018-02-12

    Prevention for aspiration pneumonia requires assessment of aspiration and adequate swallowing care. This randomized controlled trial aimed to investigate the effectiveness of ultrasound examination and recommendations for swallowing care for the reduction of aspiration and pharyngeal post-swallow residue as compared with standard swallowing care. Twenty-three participants were randomized to the intervention group and 23 to the control group. The intervention consisted of four ultrasound examinations during mealtimes and recommendations for swallowing care every 2 weeks during an 8 week period. No recommendations concerning swallowing care based on ultrasound examinations were provided to the control group. The frequency of aspiration or residue was defined as x/y × 100% when aspiration or residue were detected x times from y times concerning the total ultrasound measurements. The proportion of the residents with reduced frequency of aspiration which was detected by ultrasonography at eight weeks were 4.3% in the intervention group and 0% in the control group. The median reduction in the frequency of aspiration and residue in the intervention group was 31%, and that in the control group was 11%. In conclusion, swallowing care guided by frequent ultrasound examinations during mealtimes had a trend of reducing the frequency of aspiration and residue during an 8-week period in individuals relative to standard swallowing care alone.

  3. The social contagion of aspirations

    DEFF Research Database (Denmark)

    Folmann, Birgitte

    2017-01-01

    succeed, making some progress along this path seems important and fuels their ongoing aspiration for the good life. Having a ‘life style’ means being able to choose and consume, and getting a ‘life style’ reflects an aspiration for social mobility. Taking the emic approach helps to explain how social......Discussions of health-related behaviors and lifestyle often become theoretical and morally laden owing to their individualistic view on risk factors and life choices. This article uses the analytical concepts of contagion and configuration to explore the spread of aspirations for the good life...... among young men in Northern Uganda. The potential social contagion of aspirations is unfolded to provide a deeper understanding of social processes not only as dynamics between people but also as processes between people and their surroundings in a society which is subject to rapid change...

  4. Habits, aspirations and endogenous fertility

    OpenAIRE

    Luciano Fanti

    2012-01-01

    Motivated by the increasing literature on endogenous preferences as well as on endogenous fertility, this paper investigates the implications of the interaction of the endogenous determination of the number of children with habit and aspiration formation in an OLG model. In contrast with the previous literature, we show that greater aspirations may lead to higher savings, and more interestingly, always increase the neoclassical economic growth.

  5. Risk Factors for Aspiration Pneumonia After Endoscopic Hemostasis.

    Science.gov (United States)

    Kawanishi, Koki; Kato, Jun; Toda, Nobuo; Yamagami, Mari; Yamada, Tomoharu; Kojima, Kentaro; Ohki, Takamasa; Seki, Michiharu; Tagawa, Kazumi

    2016-03-01

    Although all types of endoscopic procedures harbor risk of aspiration, little is understood about risk factors for aspiration pneumonia developing after endoscopic hemostasis. The present study aimed to identify risk factors for aspiration pneumonia after endoscopic hemostasis. Charts from consecutive patients with upper gastrointestinal bleeding that had been treated by endoscopic hemostasis at a single center between January 2004 and January 2015 were retrospectively reviewed. Patient information and clinical characteristics including cause of hemorrhage, established prognostic scales, laboratory data, comorbidities, medications, duration of endoscopic hemostasis, vital signs, sedative use, and the main operator during the procedure were compared between patients who developed aspiration pneumonia and those who did not. Aspiration pneumonia developed in 24 (4.8%) of 504 patients after endoscopic hemostasis. Endotracheal intubation was required for three of them, and one died of the complication. Multivariate analysis revealed that age >75 years (odds ratio (OR) 4.4; 95% confidence interval (CI) 1.5-13.6; p = 0.0073), procedural duration >30 min (OR 5.6; 95% CI 1.9-18.2; p = 0.0023), hemodialysis (OR 3.6; 95% CI 1.2-11; p = 0.024), and a history of stroke (OR 3.8; 95% CI 1-14; p = 0.041) were independent risk factors for developing aspiration pneumonia. Specific risk factors for aspiration pneumonia after endoscopic hemostasis were identified. Endoscopists should carefully consider aspiration pneumonia when managing older patients who are on hemodialysis, have a history of stroke, and undergo a longer procedure.

  6. Supersymmetry: aspirations and prospects

    International Nuclear Information System (INIS)

    Tata, Xerxes

    2015-01-01

    The realization in the early 1980s that weak scale supersymmetry stabilizes the Higgs sector of the spectacularly successful Standard Model (SM) led several authors to explore whether low energy supersymmetry could play a role in particle physics. Among these were Richard Arnowitt, Ali Chamseddine and Pran Nath who constructed a viable locally supersymmetric grand unified theory (GUT), laying down the foundation for supergravity GUT models of particle physics. Supergravity models continue to be explored as one of the most promising extensions of the SM. After a quick overview of some of the issues and aspirations of early researchers working to bring supersymmetry into the mainstream of particle physics, we re-examine early arguments that seemed to imply that superpartners would be revealed in experiments at LEP2 or at the Tevatron. Our purpose is to assess whether the absence of any superpartners in searches at LHC8 presents a crisis for supersymmetry. Toward this end, we re-evaluate fine-tuning arguments that lead to upper bounds on (some) superpartner masses. We conclude that phenomenologically viable superpartner spectra that could arise within a high scale model tuned no worse than a few percent are perfectly possible. While no viable underlying model of particle physics that leads to such spectra has yet emerged, we show that the (supergravity-based) radiatively driven natural supersymmetry framework serves as a surrogate for a phenomenological analysis of an underlying theory with modest fine-tuning. We outline the phenomenological implications of this framework, with emphasis on those LHC and electron–positron collider signatures that might point to the underlying natural origin of gauge and Higgs boson masses. We conclude that the supergravity GUT paradigm laid down in 1982 by Arnowitt, Chamseddine and Nath, and others, remains a vibrant possibility. (invited comment)

  7. Coordination of cough and swallow: a meta-behavioral response to aspiration.

    Science.gov (United States)

    Pitts, Teresa; Rose, Melanie J; Mortensen, Ashley N; Poliacek, Ivan; Sapienza, Christine M; Lindsey, Bruce G; Morris, Kendall F; Davenport, Paul W; Bolser, Donald C

    2013-12-01

    Airway protections is the prevention and/or removal of material by behaviors such as cough and swallow. We hypothesized these behaviors are coordinated to respond to aspiration. Anesthetized animals were challenged with simulated aspiration that induced both coughing and swallowing. Electromyograms of upper airway and respiratory muscles together with esophageal pressure were recorded to identify and evaluate cough and swallow. During simulated aspiration, both cough and swallow intensity increased and swallow duration decreased consistent with rapid pharyngeal clearance. Phase restriction between cough and swallow was observed; swallow was restricted to the E2 phase of cough. These results support three main conclusions: 1) the cough and swallow pattern generators are tightly coordinated so as to generate a protective meta-behavior; 2) the trachea provides feedback on swallow quality, informing the brainstem about aspiration incidences; and 3) the larynx and upper esophageal sphincter act as two separate valves controlling the direction of positive and negative pressures from the upper airway into the thorax. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. The Influence of Monoamine Oxidase Variants on the Risk of Betel Quid-Associated Oral and Pharyngeal Cancer

    Directory of Open Access Journals (Sweden)

    Ping-Ho Chen

    2014-01-01

    Full Text Available Betel quid (BQ and areca nut (AN (major BQ ingredient are group I human carcinogens illustrated by International Agency for Research on Cancer and are closely associated with an elevated risk of oral potentially malignant disorders (OPMDs and cancers of the oral cavity and pharynx. The primary alkaloid of AN, arecoline, can be metabolized via the monoamine oxidase (MAO gene by inducing reactive oxygen species (ROS. The aim of this study was to investigate whether the variants of the susceptible candidate MAO genes are associated with OPMDs and oral and pharyngeal cancer. A significant trend of MAO-A mRNA expression was found in in vitro studies. Using paired human tissues, we confirmed the significantly decreased expression of MAO-A and MAO-B in cancerous tissues when compared with adjacent noncancerous tissues. Moreover, we determined that MAO-A single nucleotide polymorphism variants are significantly linked with oral and pharyngeal cancer patients in comparison to OPMDs patients [rs5953210 risk G-allele, odds ratio = 1.76; 95% confidence interval = 1.02-3.01]. In conclusion, we suggested that susceptible MAO family variants associated with oral and pharyngeal cancer may be implicated in the modulation of MAO gene activity associated with ROS.

  9. The influence of monoamine oxidase variants on the risk of betel quid-associated oral and pharyngeal cancer.

    Science.gov (United States)

    Chen, Ping-Ho; Huang, Bin; Shieh, Tien-Yu; Wang, Yan-Hsiung; Chen, Yuk-Kwan; Wu, Ju-Hui; Huang, Jhen-Hao; Chen, Chun-Chia; Lee, Ka-Wo

    2014-01-01

    Betel quid (BQ) and areca nut (AN) (major BQ ingredient) are group I human carcinogens illustrated by International Agency for Research on Cancer and are closely associated with an elevated risk of oral potentially malignant disorders (OPMDs) and cancers of the oral cavity and pharynx. The primary alkaloid of AN, arecoline, can be metabolized via the monoamine oxidase (MAO) gene by inducing reactive oxygen species (ROS). The aim of this study was to investigate whether the variants of the susceptible candidate MAO genes are associated with OPMDs and oral and pharyngeal cancer. A significant trend of MAO-A mRNA expression was found in in vitro studies. Using paired human tissues, we confirmed the significantly decreased expression of MAO-A and MAO-B in cancerous tissues when compared with adjacent noncancerous tissues. Moreover, we determined that MAO-A single nucleotide polymorphism variants are significantly linked with oral and pharyngeal cancer patients in comparison to OPMDs patients [rs5953210 risk G-allele, odds ratio = 1.76; 95% confidence interval = 1.02-3.01]. In conclusion, we suggested that susceptible MAO family variants associated with oral and pharyngeal cancer may be implicated in the modulation of MAO gene activity associated with ROS.

  10. Diagnostic Value of Processing Cytologic Aspirates of Renal Tumors in Agar Cell (Tissue) Blocks

    DEFF Research Database (Denmark)

    Smedts, F.; Schrik, M.; Horn, T.

    2010-01-01

    Objective To adapt a method enabling utilization of most of the harvest from a fine needle aspirate in an effort to improve diagnostic accuracy in the assessment of a renal tumor in a single histologic slide. Study Design In a series of 43 renal tumors, 2 fine needle aspirations were performed, 4...... smears were prepared after each aspiration for conventional cytology and the remaining aspirate was processed for the improved agar microbiopsy (AM) method. Conventional cytology slides, AM slides and surgical specimens were diagnosed separately, after which the diagnoses were compared...

  11. Laryngeal sensation and pharyngeal delay time after (chemo)radiotherapy.

    Science.gov (United States)

    Maruo, Takashi; Fujimoto, Yasushi; Ozawa, Kikuko; Hiramatsu, Mariko; Suzuki, Atsushi; Nishio, Naoki; Nakashima, Tsutomu

    2014-08-01

    The objective of the study was to evaluate the association between changes in laryngeal sensation and initiation of swallowing reflex or swallowing function before and after (chemo)radiotherapy. A prospective study was conducted in a tertiary referral university hospital. Thirteen patients who received (chemo)radiotherapy for treatment of laryngeal or hypopharyngeal cancer were included. Laryngeal sensation was evaluated at the tip of the epiglottis before and 1, 3 months, and 1 year after (chemo)radiotherapy. Videofluoroscopy was performed at the same time. Quantitative determinations included changes in laryngeal sensation, computed analysis of pharyngeal delay time, the distance and velocity of hyoid bone movement during the phase of hyoid excursion, and pharyngeal residue rate (the proportion of the bolus that was left as residue in the pharynx at the first swallow). Laryngeal sensation significantly deteriorated 1 month after (chemo)radiotherapy, but there was a tendency to return to pretreatment levels 1 year after treatment. Neither pharyngeal delay time nor displacement of the hyoid bone changed significantly before and after (chemo)radiotherapy. In addition, there was no significant difference in the mean velocity of hyoid bone movement and the amount of stasis in the pharynx at the first swallow before and after (chemo)radiotherapy. After (chemo)radiotherapy, laryngeal sensation deteriorated. But, in this study, videofluoroscopy showed that swallowing reflex and function were maintained.

  12. Cytologic features of solid pseudopapillary neoplasms of the pancreas: a single institutional experience based on evaluation of diagnostic utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA).

    Science.gov (United States)

    Gilani, S M; Tashjian, R; Barawi, M; Al-Khafaji, B

    2014-06-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an important modality for diagnosing solid and cystic pancreatic lesions. The objectives of this retrospective study are to review the cytologic criteria used to diagnose pancreatic solid pseudopapillary neoplasms (SPNs) and to evaluate the utility of EUS-FNA by correlating cytologic and histologic samples. Of the 924 pancreatic FNAs performed at our institution from January 2002 through February 2013, four histologically confirmed cases of SPN were identified; three had an initial cytologic diagnosis of SPN. All four cases lacked on-site evaluation. Cytologic smears were assessed by two reviewers for the presence of a cellular aspirate, fibrovascular stalks lined by neoplastic cells with pale to finely granular cytoplasm, and monotonous, oval nuclei containing delicate chromatin, inconspicuous nucleoli, and grooves and inclusions. Three cases were diagnosed as SPN on cytologic examination and confirmed histologically. The remaining case was deemed a pancreatic endocrine neoplasm on cytology, but SPN on final histology. The most consistent cytologic feature we encountered was the presence of a cellular aspirate containing fibrovascular stalks lined by monotonous neoplastic cells with oval nuclei and nuclear grooves. We conclude that EUS-FNA is an effective diagnostic tool in the diagnosis of pancreatic SPNs.

  13. Control of the Pharyngeal Musculature During Wakefulness and Sleep: Implications in Normal Controls and Sleep Apnea

    OpenAIRE

    Edwards, Bradley A.; White, David P

    2011-01-01

    Respiration involves the complex coordination of several pump and upper airway/pharyngeal muscles. From a respiratory perspective, the major function of the pharyngeal muscles is to keep the airway patent allowing for airflow in and out of the lung with minimal work by the respiratory pump muscles. The activity of each of the pharyngeal muscles varies depending on its function, but many reduce their activity during sleep. In healthy individuals, these muscles can respond to respiratory stimul...

  14. Retro-pharyngeal lymphadenopathy in patients with nasopharyngeal carcinoma. A computed tomography-based study

    Energy Technology Data Exchange (ETDEWEB)

    Chua, D.; Sham, J.; Kwong, D.; Au, G.; Choy, D. [Hong Kong Univ. (Hong Kong)

    1998-02-01

    The purpose of this study was to investigate the incidence and the prognostic value of retro-pharyngeal lymphadenopathy in nasopharyngeal carcinoma patients using contrast enhanced computed tomography (CT). In conclusion, using CT imaging, the presence of retro-pharyngeal lymphadenopathy in patients with nasopharyngeal carcinoma does not appear to affect the prognosis. In patients with clinical NO disease, the identification of retro-pharyngeal lymphadenopathy based only on CT imaging is not sufficient evidence for an N1 classification. (N.C.)

  15. Clinical Scoring Value for Diagnosis of Streptococcal Pharyngitis

    Directory of Open Access Journals (Sweden)

    N.M. Noori

    2011-07-01

    Full Text Available Introduction & Objective: β- hemolytic group A streptococcus is the most common cause of acute bacterial pharyngitis in children.Due to the high incidence of this disease and it's difficult diagnosis , we decided to compare clinical scoring and throat cultures for diagnosis of streptococcal pharyngitis. Materials & Methods: This cross-sectional analytic study was done on 3-16 year old patients reffered to pediatric clinic with complaint of sore throat. After taking history and physical examination, scoring was done based on clinical findings.The patients with chronic disease or those who received antibiotics or other drugs were eliminated from the study. Analysis was performed using SPSS. Score for each patient was calculated and compared with the result of throat cultures. Sensitivity, specificity, positive and negative predictive values for each clinical finding were determined. Results: 315 patients out of 350 patients with complaint of sore throat referred to the clinic had fever of whom 51.1% had positive throat culture with 51.1% sensitivity and 77% specifity (p<0.01. 127 patients had pharyngeal petechia of whom 67% had positive throat culture with 66.9% sensitivity and 73.5% specifity (p<0.002. 105 children had pharyngeal exudates of whom 65.7% had positive throat culture with 65.7% sensitivity and 58.3% specifity (p<0.001. Anterior cervical lymphadenopathy was detected in 293 patients of whom 53.24% had positive throat culture with 53.2% sensitivity and 73.8% specifity (p<0.002. 182 patients had no signs of upper respiratory infection, among them 65.9% had positive throat culture with 65.9% sensitivity and 70.4% specifity (p<0.001. 130 patients had sore throat, 66.3% of them had positive throat culture with 62.3% sensitivity and 59% specifity (p<0.001. 310 patients had pharyngeal erythema of which 51.6% had positive throat culture with 57.5% sensitivity and 22.7% specifity (p<0.02. 99 children had gastrointestinal signs, 66.14% had

  16. Pharyngeal Electrical Stimulation for Treatment of Dysphagia in Subacute Stroke: A Randomized Controlled Trial.

    Science.gov (United States)

    Bath, Philip M; Scutt, Polly; Love, Jo; Clavé, Pere; Cohen, David; Dziewas, Rainer; Iversen, Helle K; Ledl, Christian; Ragab, Suzanne; Soda, Hassan; Warusevitane, Anushka; Woisard, Virginie; Hamdy, Shaheen

    2016-06-01

    Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in 3 pilot randomized controlled trials. We randomly assigned 162 patients with a recent ischemic or hemorrhagic stroke and dysphagia, defined as a penetration aspiration score (PAS) of ≥3 on video fluoroscopy, to PES or sham treatment given on 3 consecutive days. The primary outcome was swallowing safety, assessed using the PAS, at 2 weeks. Secondary outcomes included dysphagia severity, function, quality of life, and serious adverse events at 6 and 12 weeks. In randomized patients, the mean age was 74 years, male 58%, ischemic stroke 89%, and PAS 4.8. The mean treatment current was 14.8 (7.9) mA and duration 9.9 (1.2) minutes per session. On the basis of previous data, 45 patients (58.4%) randomized to PES seemed to receive suboptimal stimulation. The PAS at 2 weeks, adjusted for baseline, did not differ between the randomized groups: PES 3.7 (2.0) versus sham 3.6 (1.9), P=0.60. Similarly, the secondary outcomes did not differ, including clinical swallowing and functional outcome. No serious adverse device-related events occurred. In patients with subacute stroke and dysphagia, PES was safe but did not improve dysphagia. Undertreatment of patients receiving PES may have contributed to the neutral result. URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25681641. © 2016 The Authors.

  17. Lifelong Learning: Capabilities and Aspirations

    Science.gov (United States)

    Ilieva-Trichkova, Petya

    2016-01-01

    The present paper discusses the potential of the capability approach in conceptualizing and understanding lifelong learning as an agency process, and explores its capacity to guide empirical studies on lifelong learning. It uses data for 20 countries from the Adult Education Survey (2007; 2011) and focuses on aspirations for lifelong learning. The…

  18. Meconium aspiration in South Africa

    African Journals Online (AJOL)

    This retrospective study of 569 cases of meconium aspiration from 11 institutions in South Africa reveals a high incidence varying from 4 to 11/1 000 and a mortality rate of. 12%. Mortality was significantly related to the degree of asphyxia at birth. Twenty-five per cent of the babies. (136/569) required intensive care and 36% ...

  19. Streptococcal pharyngitis and rheumatic heart disease: the superantigen hypothesis revisited.

    Science.gov (United States)

    Hurst, Jacklyn R; Kasper, Katherine J; Sule, Akshay N; McCormick, John K

    2018-03-09

    Streptococcus pyogenes is a human-specific and globally prominent bacterial pathogen that despite causing numerous human infections, this bacterium is normally found in an asymptomatic carrier state. This review provides an overview of both bacterial and human factors that likely play an important role in nasopharyngeal colonization and pharyngitis, as well as the development of acute rheumatic fever and rheumatic heart disease. Here we highlight a recently described role for bacterial superantigens in promoting acute nasopharyngeal infection, and discuss how these immune system activating toxins could be crucial to initiate the autoimmune process in rheumatic heart disease. Copyright © 2018. Published by Elsevier B.V.

  20. Pharyngitis – fatal infectious disease or medical error?

    Directory of Open Access Journals (Sweden)

    Marta Rorat

    2015-08-01

    Full Text Available Reporting on adverse events is essential to create a culture of safety, which focuses on protecting doctors and patients from medical errors. We present a fatal case of Streptococcus C pharyngitis in a 56-year-old man. The clinical course and the results of additional diagnostics and autopsy showed that sepsis followed by multiple organ failure was the ultimate cause of death. The clinical course appeared fatal due to a chain of adverse events, including errors made by the physicians caring for the patient for 10 days.

  1. Neonatal aspiration syndrome due to vernix caseosa

    International Nuclear Information System (INIS)

    Ohlsson, A.; Najjar, H.; Cumming, W.A.

    1985-01-01

    Fetal aspiration of meconium in amniotic fluid is a well-known cause of respiratory distress in newborn infants. It causes an irregular, coarse, nodular pattern on chest radiographs. Less known is that aspiration of vernix caseoasa causes a similar syncrome. We present a post-mature infant in whom aspiration of vernix caseosa caused respiratory distress, ventilatory difficulty, and radiographic changes essentially the same as aspiration of meconium. (orig.)

  2. Neonatal aspiration syndrome due to vernix caseosa

    Energy Technology Data Exchange (ETDEWEB)

    Ohlsson, A.; Najjar, H.; Cumming, W.A.

    1985-02-01

    Fetal aspiration of meconium in amniotic fluid is a well-known cause of respiratory distress in newborn infants. It causes an irregular, coarse, nodular pattern on chest radiographs. Less known is that aspiration of vernix caseoasa causes a similar syncrome. We present a post-mature infant in whom aspiration of vernix caseosa caused respiratory distress, ventilatory difficulty, and radiographic changes essentially the same as aspiration of meconium.

  3. Aspirations of Latina Adolescent Suicide Attempters

    Science.gov (United States)

    Hausmann-Stabile, Carolina; Gulbas, Lauren; Zayas, Luis H.

    2013-01-01

    Parents' aspirations and expectations are communicated to their offspring. Children internalize their parents' aspirations and accept some of the expectations while rejecting others, all part of the developmental process and identity-consolidation. When the aspirations and expectations of youth and parents are incongruent, the outcomes…

  4. Aspiration pneumonia: a review of modern trends.

    Science.gov (United States)

    DiBardino, David M; Wunderink, Richard G

    2015-02-01

    The purpose was to describe aspiration pneumonia in the context of other lung infections and aspiration syndromes and to distinguish between the main scenarios commonly implied when the terms aspiration or aspiration pneumonia are used. Finally, we aim to summarize current evidence surrounding the diagnosis, microbiology, treatment, risks, and prevention of aspiration pneumonia. Medline was searched from inception to November 2013. All descriptive or experimental studies that added to the understanding of aspiration pneumonia were reviewed. All studies that provided insight into the clinical aspiration syndromes, historical context, diagnosis, microbiology, risk factors, prevention, and treatment were summarized within the text. Despite the original teaching, aspiration pneumonia is difficult to distinguish from other pneumonia syndromes. The microbiology of pneumonia after a macroaspiration has changed over the last 60 years from an anaerobic infection to one of aerobic and nosocomial bacteria. Successful antibiotic therapy has been achieved with several antibiotics. Various risks for aspiration have been described leading to several proposed preventative measures. Aspiration pneumonia is a disease with a distinct pathophysiology. In the modern era, aspiration pneumonia is rarely solely an anaerobic infection. Antibiotic treatment is largely dependent on the clinical scenario. Several measures may help prevent aspiration pneumonia. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Viscosity is not a parameter of postdeglutitive pharyngeal residue: quantification and analysis with scintigraphy

    NARCIS (Netherlands)

    Bogaardt, H. C. A.; Burger, J. J.; Fokkens, W. J.; Bennink, R. J.

    2007-01-01

    The aim of this study was to explore the influence of viscosity on pharyngeal residue in normal healthy volunteers. Scintigraphy was used to measure pharyngeal residue in 11 healthy volunteers after swallowing three different substances (age = 20.2-48.3 years). The first substance was a 10-ml

  6. Colds, flu and coughing: Over-the-counter products for pharyngitis ...

    African Journals Online (AJOL)

    Pharyngotonsillitis is an inflammatory condition of the pharyngeal wall. Respiratory viruses are the major causes of pharyngitis, while bacteria account for 5-30% of cases. Once treatment of the underlying aetiology is considered and addressed, management of pharyngotonsillitis focuses on providing symptomatic relief.

  7. Need for a clinical decision rule for the management of pharyngitis ...

    African Journals Online (AJOL)

    Pharyngitis is a common reason for presentation in the hospital by children. Although viral aetiology is the commonest, Group A Streptococcus is the most important cause of and reason for antibiotic treatment of pharyngitis. The fact that GAS causes the non suppurative sequalae of rheumatic fever and acute ...

  8. Poststreptococcal keratouveitis associated with group C streptococcus pharyngitis

    Directory of Open Access Journals (Sweden)

    Nataneli N

    2011-09-01

    Full Text Available Nathaniel Nataneli1, Zenia P Aguilera1, Pearl S Rosenbaum1, Tamar Goldstein1,2, Martin Mayers11Department of Ophthalmology, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY, USA; 2Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelPurpose: To report the first case of poststreptococcal syndrome uveitis (PSU in association with group C streptococcus (GCS.Patients and methods: Chart review of a 24-year-old man who presented with bilateral ocular redness, pain, and photophobia for 5 days and "white rings" around his eyes for a duration of 3 days. The patient further reported fever and sore throat in the preceding week. Slit-lamp examination showed bilateral keratouveitis. A thorough uveitis workup, antistreptolysin O (ASLO titer, and throat culture were obtained. The patient was treated with frequent topical steroids and systemic doxycycline. The uveitis and keratitis subsided over the next few weeks, leaving extensive peripheral keratolysis.Results: The results of laboratory diagnostic testing revealed an elevated ASLO, C-reactive protein, as well as HLA-B27 positivity. Throat cultures grew beta-hemolytic GCS; group A streptococcus was culture negative.Conclusion: GCS pharyngitis may be a causative organism of PSU.Keywords: pharyngitis, keratolysis, keratouveitis

  9. Observation the swallowing mechanism in elderly patients with pharyngeal dysphagia

    Directory of Open Access Journals (Sweden)

    Claudia Ximena Campo-Cañar

    2010-09-01

    Full Text Available Observation of the swallowing dynamics is an issue that demands close attention by the health professionals involved in the diagnosis and management of patients with dysphagia. This article is a review of the literature aimed to enhance the knowledge regarding the speech therapy assessment of pharyngeal dysphagia in elder adults. The disorder of the swallowing is called dysphagia and it is defined as difficulty swallowing. The dysphagia is often caused by affectation of mechanical or neuromuscular components of the swallowing mechanism. This type of disorder is likely to impact the the oral, pharyngeal and esophageal phases of the swallowing. The speech therapist should take into account assessing aspects such as level of consciousness, vital signs, whether or not the patient is ventilator dependent, means of feeding, if intubated what type of cannula, whether or not the patient uses a speaking valve (if a trach tube is present, nutritional status, the patient’s expressive and receptive language, the anatomical and physiological state of the oral motor structures. When assessing swallowing clinicians should also make sure to develop an adequate beside clinical, voice assessment and videofluoroscopy.

  10. Hallucigenia's head and the pharyngeal armature of early ecdysozoans.

    Science.gov (United States)

    Smith, Martin R; Caron, Jean-Bernard

    2015-07-02

    The molecularly defined clade Ecdysozoa comprises the panarthropods (Euarthropoda, Onychophora and Tardigrada) and the cycloneuralian worms (Nematoda, Nematomorpha, Priapulida, Loricifera and Kinorhyncha). These disparate phyla are united by their means of moulting, but otherwise share few morphological characters--none of which has a meaningful fossilization potential. As such, the early evolutionary history of the group as a whole is largely uncharted. Here we redescribe the 508-million-year-old stem-group onychophoran Hallucigenia sparsa from the mid-Cambrian Burgess Shale. We document an elongate head with a pair of simple eyes, a terminal buccal chamber containing a radial array of sclerotized elements, and a differentiated foregut that is lined with acicular teeth. The radial elements and pharyngeal teeth resemble the sclerotized circumoral elements and pharyngeal teeth expressed in tardigrades, stem-group euarthropods and cycloneuralian worms. Phylogenetic results indicate that equivalent structures characterized the ancestral panarthropod and, seemingly, the ancestral ecdysozoan, demonstrating the deep homology of panarthropod and cycloneuralian mouthparts, and providing an anatomical synapomorphy for the ecdysozoan supergroup.

  11. Pharyngeal mesoderm regulatory network controls cardiac and head muscle morphogenesis.

    Science.gov (United States)

    Harel, Itamar; Maezawa, Yoshiro; Avraham, Roi; Rinon, Ariel; Ma, Hsiao-Yen; Cross, Joe W; Leviatan, Noam; Hegesh, Julius; Roy, Achira; Jacob-Hirsch, Jasmine; Rechavi, Gideon; Carvajal, Jaime; Tole, Shubha; Kioussi, Chrissa; Quaggin, Susan; Tzahor, Eldad

    2012-11-13

    The search for developmental mechanisms driving vertebrate organogenesis has paved the way toward a deeper understanding of birth defects. During embryogenesis, parts of the heart and craniofacial muscles arise from pharyngeal mesoderm (PM) progenitors. Here, we reveal a hierarchical regulatory network of a set of transcription factors expressed in the PM that initiates heart and craniofacial organogenesis. Genetic perturbation of this network in mice resulted in heart and craniofacial muscle defects, revealing robust cross-regulation between its members. We identified Lhx2 as a previously undescribed player during cardiac and pharyngeal muscle development. Lhx2 and Tcf21 genetically interact with Tbx1, the major determinant in the etiology of DiGeorge/velo-cardio-facial/22q11.2 deletion syndrome. Furthermore, knockout of these genes in the mouse recapitulates specific cardiac features of this syndrome. We suggest that PM-derived cardiogenesis and myogenesis are network properties rather than properties specific to individual PM members. These findings shed new light on the developmental underpinnings of congenital defects.

  12. [Foreign body aspiration in children].

    Science.gov (United States)

    Ibarz, J A Esteban; Samitier, A Sáinz; Alvira, R Delgado; Prades, P Burgués; Martínez-Pardo, N González; Pollina, J Elías

    2007-01-01

    The aim to this study is evaluate the history, symptoms, radiographic and endoscopic findings in 420 children who were admitted for suspected foreign body aspiration in our hospital between 1972 and 2005. In 13 children we didn't find foreign body and in 16 children the foreign bodies were lodged in larynx. The mean age was 33 months. The medical history, phisical exploration, auscultation and radiological findings were positive in 91,4%, 78,3%, 91,6% and 81%. The frecuency or foreign body aspiration is undervaluate and sometimes is excluded as diagnosis. Only 218 (51,9%) patients went to the hospital in the first 24 hours, although 87,8% of patients presented symptoms and 75,4% presented severe symptoms. Moreover the removed foreign bodies and suspected foreign bodies are the same in 82,95%. We think that bronchoscopy should by performed in all children who have had a choking episode.

  13. Tuberculose faringolaríngea Laryngo-pharyngeal Tuberculosis

    Directory of Open Access Journals (Sweden)

    Leonardo Conrado Barbosa de Sá

    2007-12-01

    Full Text Available A apresentação faringolaríngea da tuberculose como forma isolada da doença é rara, entretanto, nos últimos anos, com o aumento progressivo do número de casos de tuberculose em geral, a possibilidade dessas localizações aumentou. OBJETIVO: Descrever caso de tuberculose faringolaríngea primária em paciente grávida e imunocompetente. RELATORIO DE CASO: Paciente do sexo feminino, 30 anos, com história de odinofagia há 10 meses, sem qualquer sintoma sistêmico ou outras queixas referentes às vias aéreas superiores. Apresentava lesão granulomatosa em orofaringe e laringe, e o resultado da biópsia revelou bacilos álcool-ácido resistentes. Exames clínico e radiológico do aparelho respiratório sem alterações. Realizado tratamento anti-tuberculose por nove meses com resolução completa do quadro. CONCLUSÃO: Autores realçam a importância epidemiológica da tuberculose e a necessidade de um alto grau de suspeição de lesões das vias aéreas superiores para o diagnóstico precoce da doença.Tuberculosis of the Larynx and pharynx only is rare. However, in the last few years, the number of tuberculosis cases in general have had a dramatic increase, thus increasing the possibility of isolated laryngo-pharyngeal lesions. AIM: To report a case of isolated laryngo-pharyngeal tuberculosis in a pregnant, immunocompetent host. CASE REPORT: A 30- year-old pregnant female had complained of odynophagia for the last ten months. There were no other respiratory or systemic symptoms. An oro-pharyngeal granulomatous lesion was found, and the biopsy revealed acid-fast bacilli. There were no clinical or radiologic pulmonary findings. She was submitted successfully to an tuberculosis treatment protocol for nine months. CONCLUSIONS: The authors point out the epidemiological importance of tuberculosis and the need for a higher degree of suspicion when dealing with uncommon upper airway lesions to make an early diagnosis.

  14. Correlation between nasopharyngoscopy and cephalometry in the diagnosis of hyperplasia of the pharyngeal tonsils.

    Science.gov (United States)

    Ritzel, Rodrigo Agne; Berwig, Luana Cristina; da Silva, Ana Maria Toniolo; Corrêa, Eliane Castilhos Rodrigues; Serpa, Eliane Oliveira

    2012-04-01

     Hyperplasia of the pharyngeal tonsil is one of the main causes of mouth breathing, and accurate diagnosis of this alteration is important for proper therapeutic planning. Therefore, studies have been conducted in order to provide information regarding the procedures that can be used for the diagnosis of pharyngeal obstruction.  To verify the correlation between nasopharyngoscopy and cephalometric examinations in the diagnosis of pharyngeal tonsil hyperplasia.  This was a cross-sectional, clinical, experimental, and quantitative study. Fifty-five children took part in this study, 30 girls and 25 boys, aged between 7 and 11 years. The children underwent nasofibropharyngoscopic and cephalometric evaluation to determine the grade of nasopharyngeal obstruction. The Spearman's rank correlation coefficient at the 5% significance level was used to verify the correlation between these exams.  In the nasopharyngoscopy evaluation, most children showed grade 2 and 3 hyperplasia of the pharyngeal tonsil, which was followed by grade 1. In the cephalometry assessment, most children showed grade 1 hyperplasia of the pharyngeal tonsil, which was followed by grade 2. A statistically significant regular positive correlation was observed between the exams.  It was concluded that the evaluation of the pharyngeal tonsil hyperplasia could be carried out by fiber optic nasopharyngoscopy and cephalometry, as these examinations were regularly correlated. However, it was found that cephalometry tended to underestimate the size of the pharyngeal tonsil relative to nasopharyngoscopy.

  15. Telomerase Expression in Medaka ( Oryzias melastigma) Pharyngeal Teeth.

    Science.gov (United States)

    Tan, W H; Witten, P E; Winkler, C; Au, D W T; Huysseune, A

    2017-06-01

    Nonmammalian vertebrates have the capacity of lifelong tooth replacement. In all vertebrates, tooth formation requires contact and interaction between the oral or pharyngeal epithelium and the underlying mesenchyme. To secure lifelong replacement, the presence of odontogenic stem cells has been postulated, particularly in the epithelial compartment. This study uses an advanced teleost fish species, the marine medaka Oryzias melastigma, a close relative to Oryzias latipes, to examine the expression and distribution of telomerase reverse transcriptase (Tert), the catalytic unit of telomerase, in developing pharyngeal teeth and to relate these data to the proliferative activity of the cells. The data are complemented by expression analysis of the pluripotency marker oct4 and bona fide stem cell marker lgr5. Tert distribution and tert expression in developing tooth germs show a dynamic spatiotemporal pattern. Tert is present first in the mesenchyme but is downregulated as the odontoblasts differentiate. In contrast, in the epithelial enamel organ, Tert is absent during early stages of tooth formation and upregulated first in ameloblasts. Later, Tert is expressed and immunolocalized throughout the entire inner enamel epithelium. The pattern of Tert distribution is largely mutually exclusive with that of proliferating cell nuclear antigen (PCNA) immunoreactivity: highly proliferative cells, as revealed by PCNA staining, are negative for Tert; conversely, PCNA-negative cells are Tert-positive. Only the early condensed mesenchyme is both Tert- and PCNA-positive. The absence of tert-positive cells in the epithelial compartment of early tooth germs is underscored by the absence of oct4- and lgr5-positive cells, suggesting ways other than stem cell involvement to secure continuous renewal.

  16. Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

    Directory of Open Access Journals (Sweden)

    Ataman Köse

    2014-01-01

    Full Text Available It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.

  17. Streptococcus pyogenes emm types and subtypes of isolates from paediatric asymptomatic carriers and children with pharyngitis.

    Science.gov (United States)

    Blandino, Giovanna; Puglisi, Salvatore; Speciale, Annamaria; Musumeci, Rosario

    2011-01-01

    This study determined emm subtypes of Streptococcus pyogenes strains isolated from asymptomatic carriers and children with pharyngitis. All strains were previously investigated for fibronectin-binding genes (prtF1 and prtF2) and antimicrobial susceptibility. The most significant differences between the two groups, which share only 5 of the 14 detected emmsubtypes, concern the presence of the two more common emmsubtypes, 12.0 (50.0% vs. 3.1%, for asymptomatic carriers and children with pharyngitis, respectively) and 1.0 (28.1% vs. 0%, for children with pharyngitis and asymptomatic carriers, respectively).

  18. Short-term outcomes of tonsillectomy in adult patients with recurrent pharyngitis: a randomized controlled trial.

    Science.gov (United States)

    Koskenkorva, Timo; Koivunen, Petri; Koskela, Markku; Niemela, Onni; Kristo, Aila; Alho, Olli-Pekka

    2013-05-14

    Limited evidence exists as to the benefit of tonsillectomy in adult patients. We sought to determine the short-term efficacy of tonsillectomy for recurrent pharyngitis in adults. We conducted a randomized, controlled, parallel-group trial at a tertiary care ear, throat and nose centre in Oulu, Finland, between October 2007 and December 2010. Adult patients with recurrent pharyngitis were randomly assigned to the control group (watchful waiting) or the tonsillectomy group. Our primary outcome was the difference in the proportion of patients with severe pharyngitis (severe symptoms and C-reactive protein level > 40 mg/L) within 5 months. Our secondary outcomes included differences between groups in proportions of patients who had episodes of pharyngitis with or without medical consultation, rates of pharyngitis and numbers of days with symptoms. Of 260 patients referred for tonsillectomy because of recurrent pharyngitis, we recruited 86 participants for our study. Of these, 40 patients were randomly allocated to the control group, and 46 were randomly allocated to the tonsillectomy group. One patient in the control group and no patients in the tonsillectomy group had a severe episode of pharyngitis (difference 3%, 95% confidence interval [CI] -2% to 7%). Seventeen patients in the control group (43%) and 2 patients in the tonsillectomy group (4%) consulted a physician for pharyngitis (difference 38%, 95% CI 22% to 55%). Overall, 32 patients in the control group (80%) and 18 patients in the tonsillectomy group (39%) had an episode of pharyngitis during the 5-month follow-up (difference 41%, 95% CI 22% to 60%). The rate of pharyngitis and number of symptomatic days were significantly lower in the tonsillectomy group than in the control group. There was no significant difference in the number of episodes of severe pharyngitis between the control and treatment groups, and episodes were rare. However, tonsillectomy resulted in fewer symptoms of pharyngitis, consequently

  19. Meconium aspiration syndrome: historical aspects.

    Science.gov (United States)

    Fanaroff, A A

    2008-12-01

    The meconium aspiration syndrome (MAS) is a common problem that continues to concern perinatologists and neonatologists. MAS is defined as respiratory distress in an infant born through meconium-stained amniotic fluid (MSAF) whose symptoms cannot be otherwise explained. This disorder may be life threatening, complicated by respiratory failure, pulmonary air leaks and persistent pulmonary hypertension. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. This report details the management of babies delivered with associated MSAF before the accumulation of evidence for best practice through appropriately powered, prospective randomized controlled trials.

  20. Meconium Aspiration Syndrome: An Insight.

    Science.gov (United States)

    Raju, U; Sondhi, V; Patnaik, S K

    2010-04-01

    Meconium aspiration syndrome (MAS) is respiratory distress in a newborn baby caused by the presence of meconium in the tracheobronchial airways. The aspiration of meconium stained amniotic fluid by the fetus can happen during antepartum or intrapartum periods and can result in airway obstruction, interference with alveolar gas exchange, chemical pneumonitis as well as surfactant dysfunction. These pulmonary effects cause gross ventilation-perfusion mismatching. To complicate matters further, many infants with MAS have primary or secondary persistent pulmonary hypertension of the newborn as a result of chronic in utero stress and thickening of the pulmonary vessels. Although meconium is sterile, its presence in the air passages can predispose the infant to pulmonary infection. MAS is essentially a clinical diagnosis and should always be suspected in a child with respiratory distress and meconium-stained amniotic fluid at delivery. Though a known entity for a long time, its management still remains contentious. Intubation and direct tracheal suction is performed when meconium is observed in the amniotic fluid and the infant is not vigorous. Subsequent management involves ventilation, surfactant instillation and lavage, inhaled nitric oxide and high frequency ventilation. The role of steroids continues to be controversial.

  1. Housing aspiration in an informal urban settlement: A case study

    Directory of Open Access Journals (Sweden)

    Akunnaya P. OPOKO

    2015-11-01

    Full Text Available Housing aspiration is an important aspect of housing market analysis. However, there is a paucity of empirical research on housing aspiration among residents in informal settlements in developing countries. This study therefore investigated housing aspiration among the residents of Ayobo, Lagos, Nigeria. A cross-sectional survey of 1,151 households in Ayobo was conducted using a structured questionnaire as the data-collection instrument. The data were analysed using descriptive statistical and categorical regression analyses. The results show that a majority of the respondents were low-income earners living in rented and rooming-house types of accommodation. Around 73% of them expressed an intention to move to another residence, and 56% of this category of respondents intend to move into self-contained flats. The reasons for the planned relocation include poor condition of their present dwellings, changes in tenure status and household size, and the desire for exclusive use of facilities in their homes. In addition to these reasons, the waste-disposal method, sharing facilities, employment, and age and marital status of the residents emerged as the strongest predictors of housing aspiration among the respondents in the survey. This implies that, in order to meet the housing preferences and aspirations of residents in informal urban settlements in Nigeria, housing developers need to give adequate attention to the marital, age, employment and tenure status of the residents and place emphasis on developing affordable single-family houses and block of flats, as well as strategies for improving access to basic social amenities and services.

  2. Oral Cavity, Pharyngeal, and Laryngeal Cancer Prevention (PDQ®)—Health Professional Version

    Science.gov (United States)

    Expert-reviewed information summary about factors that may influence the risk of developing oral cavity, pharyngeal, and laryngeal cancers and about approaches that may help in the prevention of these diseases.

  3. Arterial baroreflex and peripheral chemoreflex function after radiotherapy for laryngeal or pharyngeal cancer

    NARCIS (Netherlands)

    Timmers, Henri J. L. M.; Karemaker, John M.; Wieling, Wouter; Kaanders, Johannes H. A. M.; Folgering, Hans Th M.; Marres, Henri A. M.; Lenders, Jacques W. M.

    2002-01-01

    Purpose: Denervation of the carotid sinus causes baroreflex and chemoreflex failure, resulting in labile hypertension and loss of hypoxic responsiveness. We investigated whether radiation therapy for laryngeal or pharyngeal cancer affects baroreflex and chemoreflex function. Methods and Materials:

  4. Influence of x-irradiation on pharyngeal induction in the Planarian, Dugesia japonica japonica

    International Nuclear Information System (INIS)

    Asai, Etsuo

    1980-01-01

    Pharyngeal formation was examined in cases where normal or X-irradiated head pieces were transplanted into the postpharyngeal region of normal or irradiated worms. Transplantation experiments were carried out in four different combinations of hosts and grafts: (1) normal host and graft (control), (2) normal host and irradiated graft, (3) irradiated host and normal graft, (4) irradiated host and graft. In the first experiment, well developed pharynges were formed in the areas both anterior and posterior to the graft on the 14th day after transplantation. In the second experiment, formation of new pharynges was delayed compared with that in the first group. In the third experiment, only one pharynx developed in the area posterior to each graft in most cases. In the last experiment, no new pharynx appeared at all. From these results, the influence of X-rays on factors participating in pharyngeal induction was discussed. (author)

  5. Four-bar linkage modelling in teleost pharyngeal jaws: computer simulations of bite kinetics

    Science.gov (United States)

    Grubich, Justin R; Westneat, Mark W

    2006-01-01

    The pharyngeal arches of the red drum (Sciaenops ocellatus) possess large toothplates and a complex musculoskeletal design for biting and crushing hard prey. The morphology of the pharyngeal apparatus is described from dissections of six specimens, with a focus on the geometric conformation of contractile and rotational elements. Four major muscles operate the rotational 4th epibranchial (EB4) and 3rd pharyngobranchial (PB3) elements to create pharyngeal bite force, including the levator posterior (LP), levator externus 3/4 (LE), obliquus posterior (OP) and 3rd obliquus dorsalis (OD). A biomechanical model of upper pharyngeal jaw biting is developed using lever mechanics and four-bar linkage theory from mechanical engineering. A pharyngeal four-bar linkage is proposed that involves the posterior skull as the fixed link, the LP muscle as input link, the epibranchial bone as coupler link and the toothed pharyngobranchial as output link. We used a computer model to simulate contraction of the four major muscles, with the LP as the dominant muscle, the length of which determined the position of the linkage. When modelling lever mechanics, we found that the effective mechanical advantages of the pharyngeal elements were low, resulting in little resultant bite force. By contrast, the force advantage of the four-bar linkage was relatively high, transmitting approximately 50% of the total muscle force to the bite between the toothplates. Pharyngeal linkage modelling enables quantitative functional morphometry of a key component of the fish feeding system, and the model is now available for ontogenetic and comparative analyses of fishes with pharyngeal linkage mechanisms. PMID:16822272

  6. Pharyngeal myopathy of loaded upper airway in dogs with sleep apnea.

    Science.gov (United States)

    Petrof, B J; Pack, A I; Kelly, A M; Eby, J; Hendricks, J C

    1994-04-01

    Recent work indicates that upper airway dilator muscles of individuals with obstructive sleep apnea syndrome (OSAS) demonstrate an increased level of activity during wakefulness compared with normal subjects. In addition, massive bursts of pharyngeal dilator activity are associated with the termination of upper airway occlusive events during sleep. This complex pattern of altered pharyngeal dilator activation is also observed in the English bulldog, an animal model of OSAS. In the present study, it was hypothesized that such alterations in activity level might lead to changes in the structure of pharyngeal muscles in the bulldog. Full-thickness biopsies were obtained from two pharyngeal dilator muscles, the sternohyoid (SH) and geniohyoid, as well as a limb muscle, the anterior tibialis, in bulldogs (n = 5) and control dogs (n = 7). Immunohistochemical analysis of myosin heavy chain expression revealed an increased contribution of fast type II myosin heavy-chain fibers to SH in bulldogs. The bulldog SH also demonstrated increased connective tissue content compared with control dogs, consistent with the presence of fibrosis. Both pharyngeal dilators in the bulldog exhibited an elevated proportion of morphologically abnormal fibers indicative of ongoing or prior injury. No differences in any of the above parameters were seen between bulldogs and control dogs in the anterior tibialis limb muscle. We conclude that the chronic load and altered pattern of usage imposed on the upper airway dilators in OSAS lead to myopathic changes that may ultimately impair the ability of these muscles to maintain pharyngeal patency.

  7. Improved diagnostic accuracy of group A streptococcal pharyngitis with use of real-time biosurveillance.

    Science.gov (United States)

    Fine, Andrew M; Nizet, Victor; Mandl, Kenneth D

    2011-09-20

    Clinical prediction rules do not incorporate real-time incidence data to adjust estimates of disease risk in symptomatic patients. To measure the value of integrating local incidence data into a clinical decision rule for diagnosing group A streptococcal (GAS) pharyngitis in patients aged 15 years or older. Retrospective analysis of clinical and biosurveillance predictors of GAS pharyngitis. Large U.S.-based retail health chain. 82 062 patient visits for pharyngitis. Accuracy of the Centor score was compared with that of a biosurveillance-responsive score, which was essentially an adjusted Centor score based on real-time GAS pharyngitis information from the 14 days before a patient's visit: the recent local proportion positive (RLPP). Increased RLPP correlated with the likelihood of GAS pharyngitis (r(2) = 0.79; P biosurveillance data into clinical guidelines for GAS pharyngitis and other communicable diseases should be considered for reducing missed cases when the contemporaneous incidence is elevated and for sparing unnecessary antibiotics when the contemporaneous incidence is low. Delivering epidemiologic data to the point of care will enable the use of real-time pretest probabilities in medical decision making.

  8. Choosing VET: Aspirations, Intentions and Choice

    Science.gov (United States)

    Hargreaves, Jo; Osborne, Kristen

    2017-01-01

    This summary brings together the findings from two research projects: "Choosing VET: Investigating the VET Aspirations of School Students" and "In Their Words: Student Choice in Training Markets--Victorian Examples." The research investigated school students' post-school aspirations for vocational education and training (VET),…

  9. Endometrial aspiration cytology in gynecological disorders

    Directory of Open Access Journals (Sweden)

    Meenal V Jadhav

    2016-01-01

    Full Text Available Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histology. Endometrial aspiration was performed by infant feeding tube in 10 cases and intra cath cannula in 45 cases. The slides were stained with rapid Papanicolaou (PAP stain and Leishman stain. Results: Endometrial aspiration cytology showed 90% and 94.6% sampling adequacy with infant feeding tube and intra cath cannula, respectively. Intra cath cannula was very convenient to handle and superior to infant feeding tube in aspirating the endometrium. Of the two stains used, rapid PAP stain was less time-consuming and superior to Leishman stain in studying the nuclear details. Leishman stain was helpful in detecting cytoplasmic vacuoles of secretory endometrium. Overall diagnostic accuracy of endometrial cytology was 90.4% while that for morphological hormonal evaluation was 97.6%. It enjoyed a sensitivity of 91.66%, a specificity of 88.23%, positive predictive value of 94.28%, and negative predictive value of 83.33%. Conclusion: Intra cath cannula emerged as an inexpensive, effective, and convenient device for endometrial aspiration. Endometrial aspiration proved to be a fairly effective, simple, and informative diagnostic modality.

  10. Aspiration Curettage and its Outpatient Usage

    African Journals Online (AJOL)

    Aspiration Curettage and its Outpatient Usage. D. A. G. BARFORD, M, NOTELOVITZ. SUMMARY ... its use on a number of outpatients without anaesthesia is discussed. S. Afr. Med. l., 48, 22 (1974). In order to ... plastic aspiration chamber and suction is applied centrally at the base of the chamber, a cylindrical filter within the.

  11. Entrepreneurial aspirations, motivations, and their drivers

    NARCIS (Netherlands)

    S.J.A. Hessels (Jolanda); A.M. van Gelderen (Marco); A.R. Thurik (Roy)

    2008-01-01

    textabstractSeveral drivers of entrepreneurial aspirations and entrepreneurial motivations are investigated using country-level data from the Global Entrepreneurship Monitor (GEM) for the years 2005 and 2006. We estimate a two-equation model explaining aspirations using motivations and socioeconomic

  12. Entrepreneurial aspirations, motivations, and their drivers

    NARCIS (Netherlands)

    Hessels, J.; van Gelderen, M.W.; Thurik, A.R.

    2008-01-01

    Several drivers of entrepreneurial aspirations and entrepreneurial motivations are investigated using country-level data from the Global Entrepreneurship Monitor (GEM) for the years 2005 and 2006. We estimate a two-equation model explaining aspirations using motivations and socioeconomic variables,

  13. Shareholders’ expectations, aspiration levels, and mergers

    NARCIS (Netherlands)

    Diecidue, E.; van de Ven, J.; Weitzel, U.

    This paper offers a new explanation of value-reducing mergers and stock market driven takeovers by introducing recent research on aspiration levels and individual decision making under risk. If market valuation constitutes an aspiration level for managers, we show that managers may be tempted to

  14. An Aspirational Community Theory of the Firm

    DEFF Research Database (Denmark)

    Li, Xin

    contractual labor and aspirational labor, the former being defined as services provided by a laborer in fulfillment of a contract while the latter as services provided by a laborer in pursuit of an aspiration; and argue that firms exist because while the market may be effective and efficient for allocating...

  15. Epidemiology of Anaemia Necesitating Bone Marrow Aspiration ...

    African Journals Online (AJOL)

    Objective: The study aims at investigating, identifying and classifying the various causes of anaemia necessitating bone marrow aspiration cytology in our environment. Methodology: A retrospective review of all bone marrow aspiration cytology reports of patients referred to Haematology and Blood Transfusion department ...

  16. Increasing faculty diversity: How institutions matter to the PhD aspirations of undergraduate students

    Science.gov (United States)

    Deangelo, Linda Teresa

    This study used a Hierarchical Generalized Linear Model (HGLM) to investigate how the experiences a student has in college and the college they attend affects the likelihood that they will aspire to the PhD at the completion of college. This study was particularly interested in ascertaining in what ways postsecondary institutions support or thwart the PhD aspirations of underrepresented racial minority students, and how institutions might improve PhD aspiration outcomes for underrepresented racial minority students, thereby increasing faculty diversity. A three-pronged theoretical lens was used. Status attainment was used to examine how students background characteristics and significant others such as faculty influence PhD aspirations. Relative deprivation and anticipatory socialization were used to explore how institutional characteristics affect PhD aspirations. The longitudinal data came from the Higher Education Research Institute's (HERI) 1994 freshmen and 1998 follow-up survey. Five sample groups -- All Students, underrepresented racial minority students, Caucasian students, initial PhD aspirants, and other initial degree aspirants -- were derived from this dataset. Frequent faculty encouragement for graduate study was the single most important determinant of who aspires to the PhD for all of the student groups, but was particularly important to underrepresented racial minority students and students who begin college as PhD aspirants. Underrepresented racial minority students are more likely to be encouraged frequently at low selectivity institutions, and the encouragement for graduate study they receive at low selectivity institutions is a sort of equalizer that makes up for effects of attending this institutional type. The mean level of initial degree aspirations was the strongest factor at the institutional level for all of the student groups, and the magnitude of the effect was largest for underrepresented racial minority students. Attending a high

  17. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ... Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During ...

  18. Evidence of a true pharyngeal tonsil in birds: a novel lymphoid organ in Dromaius novaehollandiae and Struthio camelus (Palaeognathae

    Directory of Open Access Journals (Sweden)

    Crole Martina R

    2012-08-01

    Full Text Available Abstract Background Tonsils are secondary lymphoid organs located in the naso- and oropharynx of most mammalian species. Most tonsils are characterised by crypts surrounded by dense lymphoid tissue. However, tonsils without crypts have also been recognised. Gut-associated lymphoid tissue (GALT, although not well-organised and lacking tonsillar crypts, is abundant in the avian oropharynx and has been referred to as the “pharyngeal tonsil”. In this context the pharyngeal folds present in the oropharynx of ratites have erroneously been named the pharyngeal tonsils. This study distinguishes between the different types and arrangements of lymphoid tissue in the pharyngeal region of D. novaehollandiae and S. camelus and demonstrates that both species possess a true pharyngeal tonsil which fits the classical definition of tonsils in mammals. Results The pharyngeal tonsil (Tonsilla pharyngea of D. novaehollandiae was located on the dorsal free surface of the pharyngeal folds and covered by a small caudo-lateral extension of the folds whereas in S. camelus the tonsil was similarly located on the dorsal surface of the pharyngeal folds but was positioned retropharyngeally and encapsulated by loose connective tissue. The pharyngeal tonsil in both species was composed of lymph nodules, inter-nodular lymphoid tissue, mucus glands, crypts and intervening connective tissue septa. In S. camelus a shallow tonsillar sinus was present. Aggregated lymph nodules and inter-nodular lymphoid tissue was associated with the mucus glands on the ventral surface of the pharyngeal folds in both species and represented the Lymphonoduli pharyngeales. Similar lymphoid tissue, but more densely packed and situated directly below the epithelium, was present on the dorsal, free surface of the pharyngeal folds and represented a small, non-follicular tonsil. Conclusions The follicular pharyngeal tonsils in D. novaehollandiae and S. camelus are distinct from the pharyngeal folds in

  19. Biopsy needle advancement during bone marrow aspiration increases mesenchymal stem cell concentration

    Directory of Open Access Journals (Sweden)

    Anne E Peters

    2016-03-01

    Full Text Available Point-of-care kits to concentrate bone marrow (BM derived mesenchymal stem cells (MSCs are used clinically in horses. A maximal number of MSCs per ml of marrow aspirated might be desired prior to use of a point-of-care system to concentrate MSCs. Our objective was to test a method to increase the number of MSCs per ml of marrow collected. We collected 2 BM aspirates using 2 different collection techniques from 12 horses. The first collection technique was to aspirate BM from a single site without advancement of the biopsy needle. The second collection technique was to aspirate marrow from multiple sites within the same sternal puncture by advancing the needle 5 mm 3 times for BM aspiration from 4 sites. Numbers of MSCs in collected BM were assessed by total nucleated cell count (TNCC of BM after aspiration, total Colony-Forming-Unit-fibroblast (CFU-F assay, and total MSC number at each culture passage. The BM aspiration technique of 4 needle advancements during BM aspiration resulted in higher initial nucleated cell counts, more CFU-Fs, and more MSCs at the first passage. There were no differences in the number of MSCs at later passages. Multiple advancements of the BM needle during BM aspiration resulted in increased MSC concentration at the time of BM collection. If a point-of-care kit is used to concentrate MSCs, multiple advancements may result in higher MSC numbers in the BM concentrate after preparation by the point-of-care kit. For culture expanded MSCs beyond the first cell passage, the difference is of questionable clinical relevance.

  20. Aspirated Compressors for High Altitude Engines, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Aurora Flight Sciences proposes to incorporate aspirated compressor technology into a high altitude, long endurance (HALE) concept engine. Aspiration has been proven...

  1. Aspiration pneumonia in patients with cleft palate

    International Nuclear Information System (INIS)

    Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il

    2003-01-01

    To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group

  2. Aspiration pneumonia in patients with cleft palate

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hun; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Uhm, Ki Il [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2003-03-01

    To assess the incidence of aspiration pneumonia in infants with cleft palate and to compare the incidence between complete and incomplete types of cleft palate. A review of medical records revealed 100 infants who had undergone initial surgery to repair cleft palate in our hospital during a recent three-year period. Aspiration pneumonia was defined as the coexistence of pneumonia at chest radiography with a history of frequent choking during feeding. The anatomic distribution of aspiration pneumonia was analyzed, and the incidences of aspiration pneumonia in infants with complete and incomplete cleft palate were compared. Among 100 children, aspiration pneumonia was found in 35 (35%). Those with complete and incomplete cleft palate showed similar incidences of the condition (27 of 70 [39%] vs 8 of 30 [27%], p=0.36). Pneumonia was most commonly seen in the left lower lobe (11 of 35), followed by the right upper and lower lobes. Aspiration pneumonia is frequently associated with infants with cleft palate. There is no statistical difference in the incidence of aspiration pneumonia between the complete and the incomplete cleft palate group.

  3. Does evolutionary innovation in pharyngeal jaws lead to rapid lineage diversification in labrid fishes?

    Directory of Open Access Journals (Sweden)

    Wainwright Peter C

    2009-10-01

    Full Text Available Abstract Background Major modifications to the pharyngeal jaw apparatus are widely regarded as a recurring evolutionary key innovation that has enabled adaptive radiation in many species-rich clades of percomorph fishes. However one of the central predictions of this hypothesis, that the acquisition of a modified pharyngeal jaw apparatus will be positively correlated with explosive lineage diversification, has never been tested. We applied comparative methods to a new time-calibrated phylogeny of labrid fishes to test whether diversification rates shifted at two scales where major pharyngeal jaw innovations have evolved: across all of Labridae and within the subclade of parrotfishes. Results Diversification patterns within early labrids did not reflect rapid initial radiation. Much of modern labrid diversity stems from two recent rapid diversification events; one within julidine fishes and the other with the origin of the most species-rich clade of reef-associated parrotfishes. A secondary pharyngeal jaw innovation was correlated with rapid diversification within the parrotfishes. However diversification rate shifts within parrotfishes are more strongly correlated with the evolution of extreme dichromatism than with pharyngeal jaw modifications. Conclusion The temporal lag between pharyngeal jaw modifications and changes in diversification rates casts doubt on the key innovation hypothesis as a simple explanation for much of the richness seen in labrids and scarines. Although the possession of a secondarily modified PJA was correlated with increased diversification rates, this pattern is better explained by the evolution of extreme dichromatism (and other social and behavioral characters relating to sexual selection within Scarus and Chlorurus. The PJA-innovation hypothesis also fails to explain the most dominant aspect of labrid lineage diversification, the radiation of the julidines. We suggest that pharyngeal jaws might have played a more

  4. Posterior pharyngeal candidiasis in the absence of clinically overt oral involvement: a cross-sectional study.

    Science.gov (United States)

    Glavey, Siobhan V; Keane, Niamh; Power, Maria; O'Regan, Anthony W

    2013-12-01

    Although oropharyngeal candidiasis is associated with inhaled corticosteroid (ICS) usage, there is sparse data on the prevalence of posterior pharyngeal candidiasis in those without any detectable oral candidiasis on clinical examination. We systematically investigated the relationship between oral candidiasis on clinical examination and the presence of posterior pharyngeal candidiasis at bronchoscopy. We conducted a cross-sectional study on a convenience sample of 100 patients undergoing bronchoscopy at our institution. Patients were assessed for symptoms of and risk factors for candida infection and had an examination of their oropharynx for evidence of candidiasis before bronchoscopy. They subsequently had a detailed assessment for posterior candidiasis at bronchoscopy. We performed a posteriori subgroup analysis, which focused solely on those patients on ICS maintenance therapy. Median age was 54.7 (27-84) years, and 55 patients were male; 47 % of patients were on ICS, and 20 % of this cohort received recent oral corticosteroids. Twenty-eight percent of this convenience sample had posterior pharyngeal candidiasis; however, only 10.7 % (3/28) of these patients had clinically detectable oral candidiasis on clinical examination before bronchoscopy. Factors that were independently associated with the presence of pharyngeal candidiasis at bronchoscopy were OR (95 % CI) ICS usage 6.9 (2.5-19.2), particularly fluticasone usage 6.8 (2.62-17.9) and the presence of dysphonia 3.2 (1.3-8.0). In the subgroup analysis of ICS usage, posterior pharyngeal candidiasis was correlated with the presence of dysphonia but was not independently associated with fluticasone or budesonide dosage. This study demonstrates that posterior pharyngeal candidiasis in the absence of clinically overt oral candidiasis is frequent amongst ICS users. A history of ICS use, particularly fluticasone usage, as well as the presence of dysphonia are associated with posterior pharyngeal candidiasis at

  5. Improved Diagnostic Accuracy of Group A Streptococcal Pharyngitis Using Real-Time Biosurveillance

    Science.gov (United States)

    Fine, Andrew M.; Nizet, Victor; Mandl, Kenneth D.

    2013-01-01

    Background Clinical prediction rules do not incorporate real time incidence data to adjust estimates of disease risk in symptomatic patients. Objective To measure the value of integrating local incidence data into a clinical decision rule for diagnosing group A streptococcal (GAS) pharyngitis in patients age 15 years and older. Design Retrospective analysis of clinical and biosurveillance predictors of GAS pharyngitis. Setting Large U.S.-based retail-health chain. Patients 82,062 patient visits for pharyngitis. Measurements Accuracy of the Centor score, was compared with that of a biosurveillance-responsive score, essentially an adjusted Centor score based on real-time GAS pharyngitis information from the 14 days prior to a patient’s visit – the recent local proportion positive (RLPP). Results Increased RLPP correlated with likelihood of GAS pharyngitis (r2 =0.79, p0.30, managing patients with Centor scores of 1 as if scores were 2 would identify 62,537 previously missed patients annually while misclassifying 18,446 patients without GAS pharyngitis. Decreasing the score of patients with Centor values of 3 by one point for RLPP biosurveillance data into clinical guidelines for GAS pharyngitis and other communicable diseases should be considered to reduce missed cases when the contemporaneous incidence is elevated and spare unnecessary antibiotics when the contemporaneous incidence is low. Delivering epidemiologic data to the point of care will enable the use of real-time pre-test probabilities in medical decision-making. Primary Funding Source The Mentored Public Health Research Scientist Development Award K01 HK000055 from the Centers for Disease Control and Prevention and R01 LM007677 from the National Library of Medicine, National Institutes of Health. PMID:21930851

  6. The role of group C and group G streptococci in acute pharyngitis in children.

    Science.gov (United States)

    Zaoutis, T; Attia, M; Gross, R; Klein, J

    2004-01-01

    Group C streptococci (GCS) and group G beta-haemolytic streptococci (GGS) have caused well-documented epidemics of acute pharyngitis in children, but the importance of these organisms in causing endemic or sporadic pharyngitis is uncertain. The heterogeneity of GCS and GGS may obscure the role of certain subtypes, such as the large-colony-forming strains of group C (Streptococcus dysgalactiae subsp. equisimilis) or group G, in endemic pharyngitis. For a 1-year period, children (aged 6 months to 18 years) (n = 2085) who presented with pharyngitis to the children's hospital emergency department and two outpatient offices were enrolled in a cross-sectional study to ascertain the role of large-colony-forming GCS and GGS in acute pharyngitis. Control patients (n = 194) were children who presented to the same locations during the same time period with non-respiratory tract symptoms or to the orthopaedic cast clinic. Throat cultures were obtained by a standard reference method, and swabs were plated on Strep-Selective Agar. Lancefield grouping and species identification was performed on all beta-haemolytic isolates. In total, 65 (3%) large-colony-forming GCS and GGS strains were obtained from pharyngitis patients, and three (1.5%) were obtained from the control group (odds ratio 2.0; 95% confidence interval 0.6-6.1). The low isolation rate of large-colony-forming strains of GCS and GGS indicates that even if these organisms are associated with acute, sporadic pharyngitis in paediatric patients, they represent an unusual pathogen.

  7. Aspirant candidate behaviour and progressive political ambition

    Directory of Open Access Journals (Sweden)

    Peter Allen

    2017-02-01

    Full Text Available In this paper we take account of the role of aspirant candidate behaviour in progressive political ambition, specifically how some individuals signal their political ambition to political actors by approaching them to discuss running for office. We examine how the effect of this behaviour compares to the more prominently studied effect of elite recruitment. We conclude that signalling behaviour by an aspirant candidate has a substantial effect, particularly with regard to actually acting on initial considerations of whether to stand, and that elite recruitment makes a difference but only in conjunction with the aspirant candidate themselves signalling their ambition to political actors.

  8. Clinical profile of children with kerosene aspiration.

    Science.gov (United States)

    Venkatesh, C; Sriram, P; Adhisivam, B; Mahadevan, S

    2011-07-01

    Accidental aspiration of kerosene is a common problem among children in developing countries. This descriptive study involved the retrospective analysis of children admitted with kerosene aspiration in a tertiary care hospital in South India for a year. Kerosene aspiration contributed to 60.4% of poisoning cases. Boys aged less than three years and from a rural background formed a significant proportion. Tachypnoea, cough and crepitations were the predominant clinical findings. Male gender and malnutrition (weight for age <80%) were significantly associated with prolonged hospital stay.

  9. Three-dimensional analysis of pharyngeal high-resolution manometry data.

    Science.gov (United States)

    Geng, Zhixian; Hoffman, Matthew R; Jones, Corinne A; McCulloch, Timothy M; Jiang, Jack J

    2013-07-01

    High-resolution manometry (HRM) represents a critical advance in the quantification of swallow-related pressure events in the pharynx. Previous analyses of the pressures measured by HRM, though, have been largely two-dimensional, focusing on a single sensor in a given region. We present a three-dimensional approach that combines information from adjacent sensors in a region. Two- and three-dimensional methods were compared for their ability to classify data correctly as normal or disordered. Case series evaluating new method of data analysis. A total of 1,324 swallows from 16 normal subjects and 61 subjects with dysphagia were included. Two-dimensional single sensor integrals of the area under the curves created by rises in pressure in the velopharynx, tongue base, and upper esophageal sphincter (UES) were calculated. Three-dimensional multi-sensor integrals of the volume under all curves corresponding to the same regions were also computed. The two sets of measurements were compared for their ability to classify data correctly as normal or disordered using an artificial neural network (ANN). Three-dimensional parameters yielded a maximal classification accuracy of 86.71% ± 1.47%, while two-dimensional parameters achieved a maximum accuracy of 83.36% ± 1.42%. Combining two- and three-dimensional parameters with all other variables, including three-dimensional parameters, yielded a classification accuracy of 96.99% ± 0.51%. Including two-dimensional parameters yielded a classification accuracy of 96.32% ± 1.05%. Three-dimensional analysis led to improved classification of swallows based on pharyngeal HRM. Artificial neural network performance with both two-dimensional and three-dimensional analyses was effective, classifying a large percentage of swallows correctly, thus demonstrating its potential clinical utility. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  10. INFLUENCE OF PASSIVE SMOKING ON CONTENT OF NICKEL IN CHILDREN PHARYNGEAL TONSILS

    Directory of Open Access Journals (Sweden)

    Jerzy Kwapuliński

    2010-09-01

    Full Text Available Subject of this study was pharyngeal tonsils which his anatomic location is interesing tissue. They are first tissue which has contact content in air inhalation substances in selective way. Pharyngeal tonsils came from children who lived in Silesia province. Some of these children have been expose to passive smoking. Contains nickel in pharyngeal tonsils was marked by the method of Inductively Coupled Plasma. Geometrical mean of contents of nickel in pharyngeal tonsils from exposed to tobacco smoke girls was 0,75 µg/g, in unexposed girls was 0,67 µg/g, in exposed to tobacco smoke boys was 0,55 µg/g and unexposed boys 0,6 µg/g was observed. The results have verified that sex, living place and exposure to tobacco smoke matter in accumulation nickel in pharyngeal tonsils. The cross-corelation analysis between content of Ni and other metals, found out positive corelation between Ni and Al, Cd, Cu, Pb, Zn, Ca, Mg.

  11. Computational Analysis of Pharyngeal Swallowing Mechanics in Patients with Motor Neuron Disease: A Pilot Investigation.

    Science.gov (United States)

    Garand, K L; Schwertner, Ryan; Chen, Amy; Pearson, William G

    2018-04-01

    Swallowing impairment (dysphagia) is a common sequela in patients with motor neuron disease (MND). The purpose of this retrospective, observational pilot investigation was to characterize how pharyngeal swallowing mechanics are impacted in patients with MND using a comparison with healthy, non-dysphagic control group. Computational analysis of swallowing mechanics (CASM) was used to determine covariate biomechanics of pharyngeal swallowing from videofluoroscopic assessment in 15 patients with MND and 15 age- and sex-matched healthy controls. Canonical variant analysis with post hoc discriminate function analysis (DFA) was performed on coordinate data mapping functional muscle groups underlying pharyngeal swallowing. Differences in swallowing mechanics associated with group (MND; control), motor neuron predominance (upper; lower), onset (bulbar; spinal), and swallow task (thin, pudding) were evaluated and visualized. Pharyngeal swallowing mechanics differed significantly in patients with MND compared with healthy controls (D = 2.01, p mechanics by motor neuron predominance (D = 5.03, p mechanics of patients with MND differ from and are more heterogeneous than healthy controls. These findings suggest patients with MND may compensate reductions in pharyngeal shortening and tongue base retraction by extending the head and neck and increasing hyolaryngeal excursion. This work and further CASM investigations will lead to further insights into development and evaluation of targeted clinical treatments designed to prolong safe and efficient swallowing function in patients with MND.

  12. Introducing a Virtual Lesion Model of Dysphagia Resulting from Pharyngeal Sensory Impairment

    Directory of Open Access Journals (Sweden)

    Paul Muhle

    2018-01-01

    Full Text Available Background/Aims: Performing neurophysiological and functional imaging studies in severely affected patients to investigate novel neurostimulation techniques for the treatment of neurogenic dysphagia is difficult. Therefore, basic research needs to be conducted in healthy subjects. Swallowing is a motor function highly dependent on sensory afferent input. Here we propose a virtual peripheral sensory lesion model to mimic pharyngeal sensory impairment, which is known as a major contributor to dysphagia in neurological disease. Methods: In this randomized crossover study on 11 healthy volunteers, cortical activation during pneumatic pharyngeal stimulation was measured applying magnetoencephalography in two separate sessions, with and without pharyngeal surface anesthesia. Results: Stimulation evoked bilateral event-related desynchronization (ERD mainly in the caudolateral pericentral cortex. In comparison to the no-anesthesia condition, topical anesthesia led to a reduction of ERD in beta (13-30 Hz and low gamma (30-60 Hz frequency ranges (p<0.05 in sensory but also motor cortical areas. Conclusions: Withdrawal of sensory afferent information by topical anesthesia leads to reduced response to pneumatic pharyngeal stimulation in a distributed cortical sensorimotor network in healthy subjects. The proposed paradigm may serve to investigate the effect of neuromodulatory treatments specifically on pharyngeal sensory impairment as relevant cause of neurogenic dysphagia.

  13. Effects of meteorologic factors and schooling on the seasonality of group A streptococcal pharyngitis

    Science.gov (United States)

    Hervás, Daniel; Hervás-Masip, Juan; Ferrés, Laia; Ramírez, Antonio; Pérez, José L.; Hervás, Juan A.

    2016-05-01

    The objective of this study was to determine the seasonal pattern of group A streptococcal pharyngitis in children attended at a hospital emergency department in the Mediterranean island of Mallorca (Spain), and its association with meteorologic factors and schooling. We conducted a retrospective review of the medical records of children aged 1-15 years with a diagnosis of Streptococcus pyogenes pharyngitis between January 2006 and December 2011. The number of S. pyogenes pharyngitis was correlated to temperature, humidity, rainfall, atmospheric pressure, wind speed, solar radiation, and schooling, using regression and time series techniques. A total of 906 patients (median, 4 years old) with S. pyogenes pharyngitis, confirmed by throat culture, were attended during the study period. A seasonal pattern was observed with a peak activity in June and a minimum in September. Mean temperature, solar radiation, and school holidays were the best predicting variables ( R 2 = 0.68; p a clear seasonality predominating in springtime, and an association with mean temperature, solar radiation, and schooling was observed. The resulting model predicted 68 % of S. pyogenes pharyngitis.

  14. [Pharyngeal bacteria and professional oral health care in elderly people].

    Science.gov (United States)

    Hirota, K; Yoneyama, T; Ota, M; Hashimoto, K; Miyake, Y

    1997-02-01

    In 15 elderly residents of an old-age home, we measured the total number of bacteria and the numbers of streptococci and staphylococci in the pharynx over 5 months. Seven residents received professional oral health care from dentists and dental hygienists and eight practiced oral care by themselves or together with a helper. During the 5 months, the total number of bacteria and the numbers of streptococci and staphylococci decreased (p professional care. In contrast, the total number of bacteria and the numbers of streptococci and staphylococci neither did not change or increased in those who did not receive professional care. These findings show that professional oral health care by dentists and dental hygienists can decrease the total number of bacteria and the numbers of streptococci and staphylococci in the pharynx of elderly people, which might prevent aspiration pneumonia.

  15. Combined assessment (aspiration cytology and mammography) of ...

    African Journals Online (AJOL)

    Combined assessment (aspiration cytology and mammography) of clinically suspicious breast masses. W.F. van Wyk, D Dent, E Anne Hacking, Genevieve Learmonth, R.E. Kottler, C Anne Gudgeon, A Tiltman ...

  16. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    2011-06-15

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various ...

  17. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

  18. MECONIUM ASPIRATION SYNDROME : A CLINICAL STUDY

    OpenAIRE

    BEHERA, MK; KULKARNI, SD; GUPTA, RK

    1998-01-01

    Forty two babies with Meconium aspiration syndrome managed in neonatal intensive care unit of a service hospital were analysed. Incidence was 1.7 per cent. Twelve babies were delivered by caserean section and 30 babies by vaginal route. Seventeen deliveries were conducted by team of gynaecologists, pediatrician and nursing staff whereas 25 deliveries were conducted by nursing staff alone. Out of total babies with meconium aspiration syndrome, thin meconium detected in 9 and thick meconium det...

  19. Meconium aspiration syndrome: challenges and solutions

    OpenAIRE

    Goel,Ankita; Nangia,Sushma

    2017-01-01

    Ankita Goel, Sushma Nangia Department of Neonatology, Lady Hardinge Medical College and Kalawati Saran Children Hospital, Shaheed Bhagat Singh Marg, New Delhi, India Abstract: Meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among term newborns. A result of antepartum or postpartum aspiration of meconium stained amniotic fluid (MSAF), MAS causes respiratory distress of varying severity, often complicated by air leaks or persistent pulmonary...

  20. Teaching the pharyngeal flap and sphincter pharyngoplasty: The sticky note method.

    Science.gov (United States)

    Lee, Jake J; Jabbour, Noel

    2015-11-01

    To demonstrate a cost-effective, quick, and easily reproducible three-dimensional sticky note model to enhance the understanding and conceptualization of the geometry and steps of the pharyngeal flap and sphincter pharyngoplasty. The method involves making specified incisions and rearrangements of readily available components, including disposable clear plastic cups, yellow and pink sticky notes, and white paper. Once assembly is complete, further incisions and remodeling are performed to simulate a pharyngeal flap or sphincter pharyngoplasty. The cost of the materials to make one model was $0.94. Average construction time was less than 10 min. This three-dimensional model is an efficient, interactive, and simple visual aid to teach surgical trainees the geometry and steps of the pharyngeal flap and sphincter pharyngoplasty. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Molecular epidemiology of group A streptococcus from pharyngeal isolates in Auckland, New Zealand, 2013.

    Science.gov (United States)

    Williamson, Deborah A; Moreland, Nicole J; Carter, Philip; Upton, Arlo; Morgan, Julie; Proft, Thomas; Lennon, Diana; Baker, Michael G; Dunbar, Rod; Fraser, John D

    2014-01-24

    To describe the molecular epidemiology of emm types associated with circulating pharyngeal group A streptococcus (GAS) isolates in Auckland, New Zealand. GAS isolates were collected over a 10-day period from a community pathology provider in Auckland. PCR analysis and sequencing of the emm gene was performed at the Institute of Environmental Science and Research. A total of 52 emm types were identified from 278 GAS isolates. The three most common emm types were emm1, emm89 and emm12. Overall, the experimental 30-valent GAS M protein vaccine covered 19 / 52 (37%) of emm types in our study. Our study provides baseline data on the circulating pharyngeal GAS emm types in Auckland. Future clinical and molecular surveillance of GAS pharyngitis is essential in the context of ongoing GAS vaccine development.

  2. Spontaneous pharyngeal Chlamydia trachomatis RNA clearance. A cross-sectional study followed by a cohort study of untreated STI clinic patients in Amsterdam, The Netherlands

    NARCIS (Netherlands)

    van Rooijen, Martijn S.; van der Loeff, Maarten F. Schim; Morré, Servaas A.; van Dam, Alje P.; Speksnijder, Arjen G. C. L.; de Vries, Henry J. C.

    2015-01-01

    Objectives Pharyngeal Chlamydia trachomatis (chlamydia) might contribute to ongoing chlamydia transmission, yet data on spontaneous clearance duration are rare. We examined the prevalence, spontaneous clearance, chlamydial DNA concentration and genotypes of pharyngeal chlamydia among clinic patients

  3. Persistence after treatment of pharyngeal gonococcal infections in patients of the STI clinic, Amsterdam, the Netherlands, 2012-2015: a retrospective cohort study

    NARCIS (Netherlands)

    Hananta, I. Putu Yuda; de Vries, Henry John Christiaan; van Dam, Alje P.; van Rooijen, Martijn Sebastiaan; Soebono, Hardyanto; Schim van der Loeff, Maarten Franciscus

    2017-01-01

    Infection of Neisseria gonorrhoeae in the pharynx (pharyngeal Ng) is associated with gonococcal transmission and development of antimicrobial resistance. We assessed proportion of and determinants for persistence after treatment of pharyngeal Ng. At the STI clinic of Amsterdam, the Netherlands,

  4. Is aspiration as detected on pretreatment video fluorography, a harbinger of poor quality of life and early mortality in cancers of the upper aerodigestive tract treated with radiotherapy?

    Directory of Open Access Journals (Sweden)

    Punita Lal

    2014-01-01

    Full Text Available Background: Patients with cancers of the upper aerodigestive tract (head and neck cancer (HNC tend to aspirate, either due to disease or treatment. The association of aspiration (documented on video fluorography (VFG with quality of life (QOL and unexpected mortality was studied prospectively in patients treated with simultaneous integrated boost technique of intensity-modulated radiotherapy (SIB-IMRT. Materials and Methods: Moderately advanced (stage III/IV HNC were treated by SIB-IMRT delivering 66 Gy/30 fr, 60 Gy/30 fr, and 54 Gy/30 fr to high, intermediate, and low risk volumes, respectively. They underwent serial VFG and QOL assessments (Quality of Life Questionnaire-Core 30 ( QLQ-C30 and head and neck-35 (HN35 European Organisation for Research and Treatment of Cancer (EORTC tools at 0, 3, and 6 months. Pharyngeal musculature (PM was additionally delineated on planning computed tomography (CT scans as potential organs at risk (OARs. Results: Between November 2009 and May 2011, 20 HNC were treated as per protocol. All patients were fit (Karnofsky performance status (KPS ≥ 80. Based on VFG findings, seven patients (4/9 oropharynx and 3/11 laryngopharynx were grouped as aspirators (A and remaining 13 as non-aspirators (NA. The QOL study showed that pretreatment coughing and swallowing difficulties were greater in group A versus NA and remained persistently higher. In group A, deaths attributable to aspiration were seen in 3/7 patients, while none occurred in the NA group (Fisher′s exact P = 0.03. The mean PM dose was 60 Gy in both the groups and mean V60 was similar at 69 and 67% in A and NA groups, respectively. Conclusions: VFG helps identify patients who aspirate and are at risk of premature death due to its complications, alerting caregivers to direct attention appropriately.

  5. Aspiring and Aspiration Shaming: Primary Schooling, English, and Enduring Inequalities in Liberalizing Kerala (India)

    Science.gov (United States)

    Mathew, Leya

    2018-01-01

    This paper analyzes narratives about the radical socio-economic changes accompanying liberalization in India to consider how English-medium schooling is becoming an aspirational resource for non-elite parents. I suggest that aspiring is a practice of ethics that marginalized mothers mobilize to negotiate memories of deprivation and yearnings for…

  6. Dysphagia and aspiration after chemoradiotherapy for head-and-neck cancer: which anatomic structures are affected and can they be spared by IMRT?

    Science.gov (United States)

    Eisbruch, Avraham; Schwartz, Marco; Rasch, Coen; Vineberg, Karen; Damen, Eugene; Van As, Corina J; Marsh, Robin; Pameijer, Frank A; Balm, Alfons J M

    2004-12-01

    To identify the anatomic structures whose damage or malfunction cause late dysphagia and aspiration after intensive chemotherapy and radiotherapy (RT) for head-and-neck cancer, and to explore whether they can be spared by intensity-modulated RT (IMRT) without compromising target RT. A total of 26 patients receiving RT concurrent with gemcitabine, a regimen associated with a high rate of late dysphagia and aspiration, underwent prospective evaluation of swallowing with videofluoroscopy (VF), direct endoscopy, and CT. To assess whether the VF abnormalities were regimen specific, they were compared with the VF findings of 6 patients presenting with dysphagia after RT concurrent with high-dose intra-arterial cisplatin. The anatomic structures whose malfunction was likely to cause each of the VF abnormalities common to both regimens were determined by literature review. Pre- and posttherapy CT scans were reviewed for evidence of posttherapy damage to each of these structures, and those demonstrating posttherapy changes were deemed dysphagia/aspiration-related structures (DARS). Standard three-dimensional (3D) RT, standard IMRT (stIMRT), and dysphagia-optimized IMRT (doIMRT) plans in which sparing of the DARS was included in the optimization cost function, were produced for each of 20 consecutive patients with advanced head-and-neck cancer. The posttherapy VF abnormalities common to both regimens included weakness of the posterior motion of the base of tongue, prolonged pharyngeal transit time, lack of coordination between the swallowing phases, reduced elevation of the larynx, and reduced laryngeal closure and epiglottic inversion, contributing to a high rate of aspiration. The anatomic structures whose malfunction was the likely cause of each of these abnormalities, and that also demonstrated anatomic changes after RT concurrent with gemcitabine doses associated with dysphagia and aspiration, were the pharyngeal constrictor muscles (median thickness near midline 2.5 mm

  7. Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head-and-neck cancer.

    Science.gov (United States)

    Eisbruch, Avraham; Lyden, Teresa; Bradford, Carol R; Dawson, Laura A; Haxer, Marc J; Miller, Amy E; Teknos, Theodoros N; Chepeha, Douglas B; Hogikyan, Norman D; Terrell, Jeffrey E; Wolf, Gregory T

    2002-05-01

    To objectively assess swallowing function after an intensive chemoradiation regimen for locally advanced head-and-neck cancer and to assess the clinical implications of swallowing dysfunction. Twenty-nine patients with nonresectable Stage IV head-and-neck cancer participated in a Phase I study of radiation, 70 Gy/7 weeks, concurrent with weekly gemcitabine. Because of a high rate of mucosal toxicity, reduced drug doses were delivered to subsequent patient groups: 300, 150, 50, and 10 mg/m(2)/week. Twenty-six of these patients underwent prospective evaluation of swallowing function with videofluoroscopy and esophagogram. Studies were performed pretherapy, early post-therapy (1-3 months), and late post-therapy (6-12 months). Complete tests were performed pretherapy in 22 patients, early post-therapy in 20, and late post-therapy in 13. Twenty-five patients had at least one post-therapy study. Post-therapy dysfunction was characterized by reduced inversion of the epiglottis, delayed swallow initiation and uncoordinated timing of the propulsion of the bolus, opening of the cricopharyngeal muscle, and closure of the larynx, all of which promoted aspiration during and after the swallow. In addition, reduced base-of-tongue retraction with reduced contact to the posterior pharyngeal wall and incomplete cricopharyngeal relaxation resulted in pooling in the pyriform sinuses and vallecula of residue, which was frequently aspirated after the swallow. Post-therapy aspirations were typically "silent," eliciting no cough reflex, or the cough was delayed and noneffective in expelling the residue. Aspiration was observed in 3 patients (14%) in the pretherapy studies, in 13 (65%) in the early post-therapy studies, and in 8 (62%) in the late post-therapy studies (aspiration rates post-therapy vs. pretherapy: p = 0.0002). Six patients had pneumonia requiring hospitalization 1-14 months after therapy (median: 2.5 months), being the likely cause of death in 2 patients. Five cases of

  8. Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head-and-neck cancer

    International Nuclear Information System (INIS)

    Eisbruch, Avraham; Lyden, Teresa; Bradford, Carol R.; Dawson, Laura A.; Haxer, Marc J.; Miller, Amy E.; Teknos, Theodoros N.; Chepeha, Douglas B.; Hogikyan, Norman D.; Terrell, Jeffrey E.; Wolf, Gregory T.

    2002-01-01

    Purpose:To objectively assess swallowing function after an intensive chemoradiation regimen for locally advanced head-and-neck cancer and to assess the clinical implications of swallowing dysfunction. Patients and Methods:Twenty-nine patients with nonresectable Stage IV head-and-neck cancer participated in a Phase I study of radiation, 70 Gy/7 weeks, concurrent with weekly gemcitabine. Because of a high rate of mucosal toxicity, reduced drug doses were delivered to subsequent patient groups: 300, 150, 50, and 10 mg/m 2 /week. Twenty-six of these patients underwent prospective evaluation of swallowing function with videofluoroscopy and esophagogram. Studies were performed pretherapy, early post-therapy (1-3 months), and late post-therapy (6-12 months). Results:Complete tests were performed pretherapy in 22 patients, early post-therapy in 20, and late post-therapy in 13. Twenty-five patients had at least one post-therapy study. Post-therapy dysfunction was characterized by reduced inversion of the epiglottis, delayed swallow initiation and uncoordinated timing of the propulsion of the bolus, opening of the cricopharyngeal muscle, and closure of the larynx, all of which promoted aspiration during and after the swallow. In addition, reduced base-of-tongue retraction with reduced contact to the posterior pharyngeal wall and incomplete cricopharyngeal relaxation resulted in pooling in the pyriform sinuses and vallecula of residue, which was frequently aspirated after the swallow. Post-therapy aspirations were typically ''silent,'' eliciting no cough reflex, or the cough was delayed and noneffective in expelling the residue. Aspiration was observed in 3 patients (14%) in the pretherapy studies, in 13 (65%) in the early post-therapy studies, and in 8 (62%) in the late post-therapy studies (aspiration rates post-therapy vs. pretherapy: p=0.0002). Six patients had pneumonia requiring hospitalization 1-14 months after therapy (median: 2.5 months), being the likely cause of

  9. Revisional surgery following the superiorly based posterior pharyngeal wall flap. Historical perspectives and current considerations.

    NARCIS (Netherlands)

    Keuning, K.H.; Meijer, G.J.; Bilt, A. van der; Koole, R.A.

    2009-01-01

    The aim of this study was to describe the surgical and functional complications following superiorly based posterior pharyngeal wall (SBPP) flap surgery. Records of 130 patients with velopharyngeal insufficiency (VPI) who had undergone SBPP flap surgery as a secondary procedure to reduce nasal

  10. [Childhood pharyngitis in Sfax (Tunisia): epidemiology and utility of a rapid streptococcal test].

    Science.gov (United States)

    Mezghani Maalej, S; Rekik, M; Boudaouara, M; Jardak, N; Turki, S; Arous, R; Chouchane, S; Marrekchi, F; Kassis, M; Hammami, A

    2010-04-01

    The authors studied the epidemiology of pharyngitis in children and evaluated the contribution of a rapid streptococcal test. This prospective study was conducted from June 2007 to May 2008 in a primary health care institution (Policlinique de la Caisse Nationale de Sécurité Sociale) in Tunisia. Clinical findings were recorded; throat swabs were performed, and a rapid streptococcal test was made. Five hundred and four children were included in this study. The mean age was 5 years and 8 months. Culture was positive for group A streptococcus in 166 cases (32.9 %). Group A streptococcus was more frequently isolated in children aged 5 to 8 years. There was no difference in clinical features between groups of streptococcal and non-streptococcal pharyngitis. The sensitivity and specificity of the rapid test were respectively 93.2 and 95.3 %. Pharyngitis was of bacterial origin in one third of cases; among these, group A streptococcus was the most frequent bacterium. The rapid test is a quick and reliable tool for the diagnosis of pharyngitis and hence an appropriate treatment. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  11. Pharyngeal and peritonsillar abscess due to Leclercia adecarboxylata in an immunocompetant patient.

    Science.gov (United States)

    Bali, Rishi; Sharma, Parveen; Gupta, Komal; Nagrath, Saurabh

    2013-01-15

    Leclercia adecarboxylata was isolated in pure culture from a peritonsillar and lateral pharyngeal abscess in an immunocompetent host. To our knowledge, this is the first case of infection caused by this microorganism being found in an odontogenic area of the head and neck.

  12. Recurrence in oral and pharyngeal cancer is associated with quantitative MGMT promoter methylation

    International Nuclear Information System (INIS)

    Taioli, Emanuela; Ragin, Camille; Wang, Xiao-hong; Chen, Jiangying; Langevin, Scott M; Brown, Ashley R; Gollin, Susanne M; Garte, Seymour; Sobol, Robert W

    2009-01-01

    Biomarkers that predict clinical response, tumor recurrence or patient survival are severely lacking for most cancers, particularly for oral and pharyngeal cancer. This study examines whether gene-promoter methylation of tumor DNA correlates with survival and recurrence rates in a population of patients with oral or pharyngeal cancer. The promoter methylation status of the DNA repair gene MGMT and the tumor suppressor genes CDKN2A and RASSF1 were evaluated by methylation-specific PCR in 88 primary oral and pharyngeal tumors and correlated with survival and tumor recurrence. Quantitative MGMT methylation was also assessed. 29.6% of the tumors presented with MGMT methylation, 11.5% with CDKN2A methylation and 12.1% with RASSF1 methylation. MGMT promoter methylation was significantly associated with poorer overall and disease-free survival. No differences in methylation status of MGMT and RASSF1 with HPV infection, smoking or drinking habits were observed. A significant inverse trend with the amount of MGMT methylation and overall and disease-free survival was observed (p trend = 0.002 and 0.001 respectively). These results implicate MGMT promoter methylation as a possible biomarker for oral and pharyngeal cancer prognosis. The critical role of MGMT in DNA repair suggests that defective DNA repair may be correlative in the observed association between MGMT promoter methylation and tumor recurrence. Follow-up studies should include further quantitative MSP-PCR measurement, global methylation profiling and detailed analysis of downstream DNA repair genes regulated by promoter methylation

  13. Clinical features of acute respiratory viral infections in children in conjunction with pathology of pharyngeal tonsil

    Directory of Open Access Journals (Sweden)

    Олександр Іванович Сміян

    2015-09-01

    Full Text Available Aim: to study clinical features of the clinical course of an acute respiratory viral infection in conjunction with pathology of pharyngeal tonsil in children of preschool age. Methods: generally clinical;Laboratory and instrumental;Statistical.Separation of viral infection was done using the methods of lumicroscopy and polymerase chain reaction from nasopharynx lavage.Statistical processing of received results was carried out with the help of standard statistical computer system «MicrosoftExcel» (2007 adapted for medical and biological studies. Result:In the clinical presentation of respiratory viral infection prevailed rhinorrhea, short cough, subfibrilitet with usual duration near 3 days. On the contrary in children with acute respiratory viral infections with pathology of the pharyngeal tonsil prevailed stuffiness in nose, productive cough, snore and decrease of hearing, ear ache, polyadenopathy. Fever had fibril and hectic character with duration more than 3 days. . Dyspeptic syndrome was demonstrated more intensively in children with acute respiratory viral infections with pathology of the pharyngeal tonsil and characterized with thickening on tongue, periodic ache in stomach, meteorism, constipation, stool instability. Conclusions: The main syndromes in the clinical presentation of an acute respiratory viral infection were: intoxicational, catarrhal and dyspeptic. In children with pathology of the pharyngeal tonsil the clinical course of ARVI was more evident with long course and increase of the frequency of complications of ARVI

  14. Cervical osteomyelitis after carbon dioxide laser excision of recurrent carcinoma of the posterior pharyngeal wall

    NARCIS (Netherlands)

    Timmermans, A. Jacqueline; Brandsma, Dieta; Smeele, Ludi E.; Rosingh, Andert W.; van den Brekel, Michiel W. M.; Lohuis, Peter J. F. M.

    2013-01-01

    Two patients with recurrent carcinoma of the posterior pharyngeal wall, previously treated with carbon dioxide (CO2) laser excision and (chemo)radiotherapy, presented with neck pain due to cervical osteomyelitis. In one patient this led to cervical spine instability, for which a haloframe was

  15. On the roles and regulation of chondroitin sulfate and heparan sulfate in zebrafish pharyngeal cartilage morphogenesis

    DEFF Research Database (Denmark)

    Holmborn, Katarina; Habicher, Judith; Kasza, Zsolt

    2012-01-01

    The present study addresses the roles of heparan sulfate (HS) proteoglycans and chondroitin sulfate (CS) proteoglycans in the development of zebrafish pharyngeal cartilage structures. uxs1 and b3gat3 mutants, predicted to have impaired biosynthesis of both HS and CS because of defective formation...

  16. A 10-year review of perioperative complications in pharyngeal flap surgery

    NARCIS (Netherlands)

    Hofer, SOP; Dhar, BK; Robinson, PH; Goorhuis-Brouwer, SM; Nicolai, JPA

    2002-01-01

    A 10-year retrospective study was undertaken to investigate perioperative complications in pharyngeal flap surgery in one institution using inferiorly and superiorly based flaps. In this fashion the current practice of surgical technique based on local findings and perioperative care, through

  17. Oral and pharyngeal cancer : Analysis of patient delay at different tumor stages

    NARCIS (Netherlands)

    Brouha, XDR; Tromp, DM; Hordijk, GJ; Winnubst, JAM; de Leeuw, JRJ

    2005-01-01

    Background. The aim of this study was to examine which factors are related to patient delay in a cohort of consecutive patients with pharyngeal cancer and oral cancer and to determine whether the different stages of patient delay (ie, appraisal, illness, behavioral, and scheduling) were related to

  18. Different miRNA signatures of oral and pharyngeal squamous cell carcinomas: a prospective translational study

    DEFF Research Database (Denmark)

    Lajer, C B; Nielsen, F C; Friis-Hansen, L

    2011-01-01

    MicroRNAs (miRNAs) are small non-coding RNAs, which regulate mRNA translation/decay, and may serve as biomarkers. We characterised the expression of miRNAs in clinically sampled oral and pharyngeal squamous cell carcinoma (OSCC and PSCC) and described the influence of human papilloma virus (HPV)....

  19. Revisiting acoustic correlates of pharyngealization in Jordanian and Moroccan Arabic: Implications for formal representations

    Directory of Open Access Journals (Sweden)

    Jalal Al-Tamimi

    2017-11-01

    Full Text Available This exploratory study of Jordanian and Moroccan Arabic (JA and MA aims to evaluate whether pharyngealization is associated with an epilaryngeal constriction which causes ‘retraction’ and tense voice quality in surrounding vowels, following the Laryngeal Articulator Model (LAM (Esling, 2005. Twenty male speakers (10 per dialect produced vowels preceded by /d or dˤ/. Thirteen acoustic correlates obtained at the onset and midpoint were used to assess this type of constriction. A predictive modeling approach was used; starting with Bayesian Generalized Linear Mixed Effects modeling followed by Conditional Random Forest for classification. Vowels in the pharyngealized context were more open (higher F1, Z1-Z0, more back (lower F2, higher Z3-Z2, more compact (lower Z2-Z1, and showed spectral divergence (higher Z3-Z2. Voice quality results showed these vowels to be produced with a tense voice. High classification rates of 93.5% for JA and 91.1% for MA were obtained and variable importance score showed formant-based measures outperform voice quality ones. This suggests pharyngealization has ‘retraction,’ with a 'back and down 'gesture, as a primary correlate followed by [+CONSTRICTED GLOTTIS]. The implications of these results provide strong support for LAM, the feature [+CET], and the use of the epilarynx to describe pharyngealization.

  20. Detection of invasive protein profile of Streptococcus pyogenes M1 isolates from pharyngitis patients.

    Science.gov (United States)

    Hasegawa, Tadao; Okamoto, Akira; Kamimura, Takuya; Tatsuno, Ichiro; Hashikawa, Shin-Nosuke; Yabutani, Mitsutaka; Matsumoto, Masakado; Yamada, Keiko; Isaka, Masanori; Minami, Masaaki; Ohta, Michio

    2010-03-01

    Streptococcal toxic shock syndrome (STSS) is a re-emerging infectious disease in Japan and many other developed countries. Epidemiological studies have revealed that the M1 serotype of Streptococcus pyogenes is the most dominant causative isolate of STSS. Recent characterization of M1 isolates revealed that the mutation of covS, one of the two-component regulatory systems, plays an important role in STSS by altering protein expression. We analyzed the M1 S. pyogenes clinical isolates before or after 1990 in Japan, using two-dimensional gel electrophoresis (2-DE) and pulsed-field gel electrophoresis (PFGE). PFGE profiles were different between the isolates before and after 1990. Markedly different profiles among isolates after 1990 from STSS and pharyngitis patients were detected. Sequence analysis of two-component regulatory systems showed that covS mutations were detected not only in STSS but also in three pharyngitis isolates, in which proteins from the culture supernatant displayed the invasive type. The mutated CovS detected in the pharyngitis isolates had impaired function on the production of streptococcal pyrogenic exotoxin B (SpeB) analyzed by 2-DE. These results suggest that several covS mutations that lead to the malfunction of the CovS protein occurred even in pharyngeal infection.

  1. Anatomy of the bucco-pharyngeal cavity of Salminus brasiliensis (Cuvier, 1817 (Pisces, Characidae, Salmininae

    Directory of Open Access Journals (Sweden)

    Eliane Menin

    2006-03-01

    Full Text Available The bucco-pharyngeal cavity of Salminus brasiliensis, an ichthyophagous species of fresh water, is anatomically adapted to predation. The wide buccal rift, the oral-aboral enlargement of the buccal cavity and the reduced thickness of the pharyngeal mastigatory apparatus favor the capture and deglutition of larger prey. In function of the oral and pharyngeal dentition type, pre-digestive food preparation does not occur. The pointed and curved teeth, together with the tongue which is relatively mobile, prevent the prey’s escape from the buccopharyngeal cavity. The passage of the food is facilitated by the absence of pronounced folds in the mucous membrane of this cavity and by the disposition of the oral and pharyngeal teeth. The characteristics of flat and thin lips, developed oral dentition, relatively mobile tongue, mucous membrane without folds, pharynx with denticules disposed in dentigerous areas and plates, and short and sharp gill-rackers are anatomical adaptations which are shared by S. brasiliensis and other ichthyophagous Characiformes species such as Salminus maxillosus, Salminus hilarii, Hoplias malabaricus, Hoplias lacerdae, Acestrorhynchus lacustris and Acestrorhynchus britskii. However, different to the mentioned species, except other Salmininae, S. brasiliensis possesses oral teeth of an unique type, present only in the jawbones and distributed in two series.

  2. Aspiration Deaths Among Adults in Istanbul

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    Haşim Asil

    2014-06-01

    Full Text Available Massive aspiration of food is rare, but most common in people under the influence of alcohol or a drug and comatose patients who have impaired functioning of the central nervous system. The finding of small amounts of food material in the airway at autopsy does not indicate the true vital aspiration because of agonal or even early post-mortem overspills. Occlusion of the small airways, mainly the membranous and respiratory bronchioles, partial or total filling of bronchiolar lumen and the alveolar spaces with food or gastric content were typical morphologic findings. In our 10 year retrospective study we presented the data of 21 male and 4 female cases with a final diagnosis of fatal aspiration in age from 23 to 78 years (45.43±14.61 from the records of Morgue Specialization Department of the Council of Forensic Medicine. 13 cases found death at the scene without an eyewitness. All deaths were accidental in manner except one homicide. Toxicological analysis revealed blood alcohol concentration levels between 161 and 339 mg/dL in 7 cases. Morphine metabolites, benzodiazepine and barbituric acid derivatives, toluene and acetone were detected in 5 subjects. Aspirated materials were food in 14 cases, chewing gum in 3 cases, gastric content in 7 cases and a fabric gag in one case. The history, other evidence of external vomit on the clothing or immediate surroundings and toxicological analysis are by no means as significant as autopsy findings especially in cases of aspiration. Key words : adult; aspiration; death; autopsy

  3. Effects of Breathing Pattern on Oxygen Delivery Via a Nasal or Pharyngeal Cannula.

    Science.gov (United States)

    Yamamoto, Natsuhiro; Miyashita, Tetsuya; Takaki, Shunsuke; Goto, Takahisa

    2015-12-01

    During sedation for upper gastrointestinal endoscopy, oxygen delivery via a nasal cannula is often necessary. However, the influences of the oxygen delivery route and breathing pattern on the F(IO2) have not been thoroughly investigated. The aim of this simulation study was to investigate the difference in the F(IO2) with a pharyngeal cannula versus nasal cannula during high- or low-tidal volume (V(T)) ventilation and open- or closed-mouth breathing. Six healthy volunteers were asked to breathe using 2 patterns of ventilation (high or low V(T)) via a sealed face mask connected to an endotracheal tube that was retrogradely inserted into the trachea of a mannequin. The mannequin also had a pharyngeal or nasal cannula inserted into the pharynx or attached to the nose, through which oxygen (2 or 5 L/min) was delivered. The mouth of the mannequin was kept open or closed by packing. We measured the F(IO2) of every breath for 1 min at each setting. During low- and high-V(T) ventilation, the F(IO2) was highest at a flow of 5 L/min with a pharyngeal cannula. Oxygen delivery was higher with the pharyngeal cannula compared with the nasal cannula at all settings. Differences in flow did not result in significant differences in the F(IO2) with high- and low-V(T) ventilation. At a flow of 5 L/min via a pharyngeal cannula, open-mouth breathing resulted in a significantly higher F(IO2) compared with closed-mouth breathing. A pharyngeal cannula provided a higher F(IO2) compared with a nasal cannula at the same oxygen flow. Open-mouth breathing resulted in a higher F(IO2) compared with closed-mouth breathing when 5 L/min oxygen was delivered via a pharyngeal cannula. The breathing pattern did not affect the F(IO2) in this study. Copyright © 2015 by Daedalus Enterprises.

  4. Management of acute pharyngitis in children: summary of the Italian National Institute of Health guidelines.

    Science.gov (United States)

    Chiappini, Elena; Principi, Nicola; Mansi, Nicola; Serra, Agostino; De Masi, Salvatore; Camaioni, Angelo; Esposito, Susanna; Felisati, Giovanni; Galli, Luisa; Landi, Massimo; Speciale, Anna Maria; Bonsignori, Francesca; Marchisio, Paola; de Martino, Maurizio

    2012-06-01

    Discrepancies in the management of pharyngitis in children have been reported in Europe and the United States, and recommendations concerning the use of clinical scores, rapid antigen diagnostic tests (RADTs) or throat cultures, and the indications for antibiotic treatment largely differ. This article summarizes the Italian guidelines on the management of pharyngitis in children issued by the National Institute of Health. A multidisciplinary panel of experts (the Guidelines Development Group) developed and used a set of key questions to conduct a systematic review of the literature. Relevant publications in English were identified through a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through April 30, 2011. Final recommendations were scaled according to the Italian National Guidelines Program grading. Eighteen clinical questions were defined, and 44 recommendations were issued. None of the available scoring systems is sufficiently accurate to identify group A β-hemolytic streptococci (GABHS) pharyngitis in settings with low prevalence for rheumatic disease. RADT should be performed by trained personnel in every child with a history and signs/symptoms suggestive of GABHS pharyngitis. RADT is not recommended in children with a McIsaac score of 0 or 1 with ≥2 signs/symptoms suggestive of viral infection. Backup culture in children with negative RADT result is not recommended. Culture test with antibiotic susceptibility assay should be performed exclusively for epidemiologic purposes. Streptococcal antibody titers are of no value in diagnosing acute pharyngitis. Antibiotic therapy is recommended in microbiologically documented GABHS pharyngitis. Because penicillin V is not available in Italy, amoxicillin (50 mg/kg/d in 2-3 doses orally) for 10 days is the first choice of treatment. In noncompliant cases, benzathine penicillin may be administered. Although not routinely recommended due to the high cost and wide

  5. The sweet lung: Chewing gummi bear aspiration.

    Science.gov (United States)

    Tavladaki, Theonimfi; Fitrolaki, Michaela-Diana; Spanaki, Anna-Maria; Ilia, Staurula; Geromarkaki, Elissabet; Briassoulis, George

    2012-07-01

    Inhalation of foreign bodies, a leading cause of accidental death, is most common in preschool children. In this article we report our experience with a 5-year-old Greek girl who presented with a 24-hour history of sore throat, chest pain, and shortness of breath. Emergency bronchoscopy was performed and multiple small chewing gummi bear (HARIBO) particles impacted in the orifices of the right main bronchus and right lobar and segmentalinic bronchi were successfully removed and aspirated. Aspiration of gummi bears, which is for the first time reported, may cause a silent choking episode leading to life-threatening bronchi obstruction at multiple sites, even in children older than 4 years.

  6. Prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan

    International Nuclear Information System (INIS)

    Chen, Ping-Ho; Tu, Hung-Pin; Ko, Ying-Chin; Shieh, Tien-Yu; Ho, Pei-Shan; Tsai, Chi-Cheng; Yang, Yi-Hsin; Lin, Ying-Chu; Ko, Min-Shan; Tsai, Pei-Chien; Chiang, Shang-Lun

    2007-01-01

    In Taiwan, a distinct ethnic group variation in incidence and mortality rates has been suggested for most carcinomas. Our aim is to identify the role of prognostic factors associated with the survival of oral and pharyngeal carcinoma in Taiwan. Taiwan Cancer Registry records of 9039 subjects diagnosed with oral and pharyngeal carcinoma were analyzed. The population was divided into three ethnic groups by residence, which were Taiwanese aborigines, Hakka and Hokkien communities. Five-year survival rates were estimated by Kaplan-Meier methods. Ethnic curves differed significantly by log-rank test; therefore separate models for Taiwanese aborigines, Hakka and Hokkien were carried out. The Cox multivariate proportional hazards model was used to examine the role of prognostic factors on ethnic survival. The five-year survival rates of oral and pharyngeal carcinoma were significantly poorer for Hokkien community (53.9%) and Taiwanese aborigines community (58.1%) compared with Hakka community (60.5%). The adjusted hazard ratio of Taiwanese aborigines versus Hakka was 1.07 (95%CI, 0.86–1.33) for oral and pharyngeal carcinoma mortality, and 1.16 (95%CI, 1.01–1.33) for Hokkien versus Hakka. Males had significantly poor prognosis than females. Subjects with tongue and/or mouth carcinoma presented the worst prognosis, whereas lip carcinoma had the best prognosis. Subjects with verrucous carcinoma had better survival than squamous cell carcinoma. Prognosis was the worst in elderly subjects, and subjects who underwent surgery had the highest survival rate. Our study presented that predictive variables in oral and pharyngeal carcinoma survival have been: ethnic groups, period of diagnosis, gender, diagnostic age, anatomic site, morphologic type, and therapy

  7. Pharyngeal microflora disruption by antibiotics promotes airway hyperresponsiveness after respiratory syncytial virus infection.

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    Ke Ni

    Full Text Available BACKGROUND: Regulatory T cells (Treg cells, which are essential for regulation of immune response to respiratory syncytial virus (RSV infection, are promoted by pharyngeal commensal pneumococcus. The effects of pharyngeal microflora disruption by antibiotics on airway responsiveness and relative immune responses after RSV infection have not been clarified. METHODS: Female BALB/c mice (aged 3 weeks were infected with RSV and then treated with either oral antibiotics or oral double distilled water (ddH(2O from 1 d post infection (pi. Changes in pharyngeal microflora were analyzed after antibiotic treatment for 7 d and 14 d. At 8 d pi and 15 d pi, the inflammatory cells in bronchoalveolar lavage fluid (BALF were investigated in combination with tests of pulmonary histopathology, airway hyperresponsiveness (AHR, pulmonary and splenic Treg cells responses. Pulmonary Foxp3 mRNA expression, IL-10 and TGF-β1 in BALF and lung homogenate were investigated at 15 d pi. Ovalbumin (OVA challenge was used to induce AHR after RSV infection. RESULTS: The predominant pharyngeal commensal, Streptococcus, was cleared by antibiotic treatment for 7 d. Same change also existed after antibiotic treatment for 14 d. After RSV infection, AHR was promoted by antibiotic treatment at 15 d pi. Synchronous decreases of pulmonary Treg cells, Foxp3 mRNA and TGF-β1 were detected. Similar results were observed under OVA challenge. CONCLUSIONS: After RSV infection, antibiotic treatment cleared pharyngeal commensal bacteria such as Streptococcus, which consequently, might induce AHR and decrease pulmonary Treg cells.

  8. Factors affecting adherence to evidence-based guidelines in the treatment of URI, sinusitis, and pharyngitis

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    Andrew Crocker

    2013-07-01

    Full Text Available Introduction: Sinus infections, sore throats, and upper respiratory tract infections (URI are common reasons patients seek medical care. Well-established treatment guidelines exist for prescribing antibiotics in these clinical scenarios, but are not often followed. Objective: The objective of this study is to determine practice patterns related to prescribing antibiotics for sinusitis, URI, and pharyngitis. The main hypothesis is that attending physicians improve their adherence to antibiotic guidelines with a learner present. Methods: A retrospective cohort study was performed on patients treated for URI, sinusitis, and pharyngitis at an ambulatory faculty practice. The use of relevant ICD-9 codes from January 1, 2008 to January 30, 2012 resulted in 1,548 patient encounters which were reviewed for guideline adherence. Univariate analysis and multivariate logistic regression was performed for each outcome variable to determine if they influence antibiotic adherence. Variables studied were physician, presence of a learner, BMI, age, gender, day of the week, month, diabetes, immunosuppression, and COPD. Results: Multivariate analysis showed the statistically significant variables were age (p=0.038 for pharyngitis and provider (p=0.013 for URI. There were no significant findings for sinusitis. Guideline adherence was 24% in patients with pharyngitis, 42% in acute sinusitis, 79% in URI, and 57% overall. Conclusion: Guideline adherence varies depending on the treating physician and decreases when treating younger patients with pharyngitis. The presence of a learner did not improve prescribing habits. The reason for these findings remain unclear, but considerations for improvement could include following antibiotic adherence as a quality measure, giving patients handouts educating them about the impact of overprescribing antibiotics, and further education amongst faculty and residents about adhering to nationally recognized guidelines.

  9. STUDIES ON DETERMINATION OF ENVIRONMENTAL AND PHYSIOLOGICAL LEVELS OF ZINC IONS IN THE PHARYNGEAL TONSILS

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    Ewa Nogaj

    2010-03-01

    Full Text Available The zinc is one of the most important microelements. Element this conditions has corrected the functioning the nervous system of, immunological, sense of taste and smell. It the weakness of activity was manifested was the shortage of zinc and children’s motive development. The aim of this study was samples of pharyngeal tonsils from children living on Malopolska Region, Silesia and village (made up the area of reference of Southern Poland. We investigated population 95 children, in this 40 girls (42% and 55 boys (58% in age from 2 till 15 years (average 6,8 years. The content of zinc was determined by ICP – AES method. Average the content of zinc in pharyngeal tonsils in whole studied children’s population carried out 74,51 µg/g. The statistical differences were not affirmed among average (the average geometrical content of ions of zinc in studied come from girls – 73,15 µg/g and the boys – 75,49 µg/g. The differences between sex appear, in case of ranges of changes, at boys range this it is clearly larger (55,86–97,59 µg/g in comparison to girls (58,34–88,68 µg/g how also near comparison of content answering 95 percentylowi (the incidental resulting with large environmental exposition contents it in the pharyngeal boys’ tonsils is larger – (87,73 µg/g in comparison to young girls (81,98 µg/g. It was established, on basis of report of changes quotient content zinc in pharyngeal tonsils in function of changes of content zinc in air dust, the physiological quantities of zinc in pharyngeal tonsil on level 42 µg/g.

  10. Current aspects of treatment and rehabilitation of patients with pharyngeal cancer

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    A. L. Kozhanov

    2016-01-01

    Full Text Available Annually in Russia primary diagnosis of new-onset pharyngeal cancer is made in approximately 6–7 thousand people. To modern methods of diagnosing pharyngeal cancer belong: direct and indirect laryngoscopy, microlaryngoscopy, stroboscopy, fibrolaryngoscopy, X-ray study examination, computed tomography, multispiral computed tomography, magnetic resonance tomography, ultrasonographic examination of the throat and organs of the neck, acoustic analysis of voice and morphological studies.Recent years witnessed the development of novel methods of both conservative and surgical management of patient with pharyngeal cancer. Treatment of patients with stage T1–2 and in some patients with stage T3 includes the following methods: radiotherapy, chemoradiotherapy, endolaryngeal surgery with laser, photodynamic therapy, open functionally sparing operations. According to the data of the authors, today currently there is no common algorithm for treatment of stage T1–3 pharyngeal malignant neoplasms.Locally disseminated tumors of the throat and laryngopharynx, corresponding to stages T3–4N0–2M0 as a rule are treated by combined management with pre- or postoperative irradiation. Such approach results in leads to impairment of all functions of the organ and invalidity disablement of patients. The most important task after combined treatment is rehabilitation of the voice function, which may be restored by means of logopedic methods, voice-forming devices and reconstructive plastic operations.Hence novel approaches to treatment of pharyngeal cancer – both conservative and surgical have recently been worked out. However the problem concerning regarding therapeutic decision-making followed by rehabilitation of patients remains disputable.

  11. Coffee is protective against oral and pharyngeal cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Miranda, J; Monteiro, L; Albuquerque, R; Pacheco, J-J; Khan, Z; Lopez-Lopez, J; Warnakulasuryia, S

    2017-09-01

    Coffee is one of the most popular and consumable drinks worldwide. However, there are conflicting results on the influence of this drink in oral and pharyngeal cancer risk. To clarify this, we aimed to systemically review and carry out a meta-analysis of the relevant literature on the association between coffee and oral and pharyngeal cancer. We carried out an electronic search of publications up to August 2016 from PubMed, National Library of Medicines Medline, Embase, Science Direct and the Cochrane Central Register. The Newcastle-Ottawa scale was used to address the quality of the studies a meta-analysis was carried out using random-effects models. From the 22,515 entries identified in the search, 13 case-control and 4 cohort studies were selected. With regards to quality on the Newcastle-Ottawa scale, an overall value of 6.06 was obtained. The analysis for oral and pharyngeal cancer grouped together indicated a pooled OR of .69 (95% CI of .57-.84; pcancers we observed a pooled OR of 0.82; 95% CI =.58-1.16; p=.257) and for pharyngeal cancers a pooled OR of .72 (95% CI of 0.54-.95; p=.019). There was no significant publication bias. The results show an inverse association between high coffee consumption and the risk of oral and pharyngeal cancers, which indicates that coffee may have a protective role against these cancers. Further larger prospective observational cohort studies are needed to address any effect of other possible co-factors.

  12. Aspirations and everyday life of single migrant women in Ghana

    NARCIS (Netherlands)

    Tufuor, T.

    2015-01-01

    Female labour migrants in West Africa including Ghana have been widely perceived as followers of male relatives. Since the late 1990s, the increasing movement of young women to cities in the region has drawn attention to this phenomenon and this study discovered females as actors in the migration

  13. Aspirations and everyday life of single migrant women in Ghana

    NARCIS (Netherlands)

    Tufuor, T.

    2015-01-01

    Female labour migrants in West Africa including Ghana have been widely perceived as followers of male relatives. Since the late 1990s, the increasing movement of young women to cities in the region has drawn attention to this phenomenon and this study discovered females as actors in the migration

  14. Ranitidine and sodium citrate as prophylaxis against acid aspiration syndrome in obstetric patients undergoing caesarean section.

    Science.gov (United States)

    Lim, S K; Elegbe, E O

    1992-12-01

    The efficacy of a single oral dose of 0.3M of sodium citrate alone as a prophylaxis against acid aspiration syndrome in obstetric patients undergoing LSCS (elective and emergency) was compared with that of intravenous ranitidine. One group of patients was given 30 ml of 0.3M sodium citrate orally just before the induction of anaesthesia while the other group was given 50mg of ranitidine intravenously together with the 30ml of 0.3M sodium citrate. This was done for both the elective and the emergency groups of patients. There was no significant difference in the mean pH of the gastric aspirate obtained from those given sodium citrate alone and those given sodium citrate and ranitidine in either the elective or the emergency group. However, in the emergency group, those who were given sodium citrate alone tend to have a larger volume of gastric aspiration when compared with those given ranitidine together with the sodium citrate. There were significantly more patients with gastric aspirates of more than 25ml in the emergency group to which sodium citrate alone was given. It would appear that supplementing an intravenous dose of ranitidine with the oral dose of sodium citrate is useful in emergency LSCS as a prophylaxis against acid aspiration syndrome.

  15. STUDY OF INCIDENCE & MANAGEMENT OF PARA PHARYNGEAL TUMORS

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    Aruna Kumari

    2015-11-01

    Full Text Available INTRODUCTION: Parapharyngeal tumors are rare, comprising approximately 0.5% of all head and neck tumours. Most of them are benign. These tumors present with difficulties in diagnosis - complementary MRI and CT scanning are necessary for diagnosis, and Fine Needle Aspiration Cytology (FNAC is very specific in the histological diagnosis of these tumours. Open biopsy is not advisable due to bleeding, breaching of the capsule and seeding of the tumor. These tumors presents a challenge to the surgeon due to its anatomical complexities. This study deals with the incidence and management of various parapharyngeal tumors. OBJECTIVE OF THE STUDY: This study deals with the incidence of various tumors in the parapharyngeal space in different age and sex groups, role of sophisticated diagnostic modalities like CT, MRI, MR Angio. Colour Doppler along with FNAC and various surgical approaches to this space. This study also deals with intra-operative and post operative complications. In this series, a total of 25 cases has been studied retrospectively in a time period of 2 years from 2012 to 2014, presenting in our ENT and Head and Neck Dept., Gandhi hospital. RESULTS: According to this study, there is male preponderance (52% and highest incidence is seen in 3rd and 5th decade (24% each. Most common presenting symptoms are difficulty in swallowing (36% and swelling either intraoral or in the neck (28%. Least common symptoms being cranial nerve palsy (4%, difficulty in breathing/noisy breathing (4%, nasal regurgitation (4% and hard of hearing (8%. FNAC was done in 21 cases, in which 13 were correlating with the biopsy report. CT scan was required in all cases. MR Angiography was done in 4 cases and colour Doppler in 2 cases. Surgery is the mainstay of the treatment. Most common tumor in PPS is neurogenic (schwannoma/neurofibroma.i.e 44%. Next commonly occurring tumor in our study is of salivary origin-pleomorphic adenoma (24%, paragangliomas (12%. Other less

  16. Aspirations and occupational achievements of Dutch fathers and mothers

    NARCIS (Netherlands)

    van der Horst, Mariska; van der Lippe, Tanja; Kluwer, Esther

    2014-01-01

    Purpose - To investigate how work and family aspirations relate to occupational achievements and gender differences herein. Design/methodology/approach - Using data from 2009 we examined the relationship between career and childrearing aspirations and occupational achievements of Dutch parents.

  17. Combined assessment (aspiration cytology and mammography) of ...

    African Journals Online (AJOL)

    We examined the safety and utility of the combined assessment of aspiration cytology and mammography in. 705 women who had clinically suspicious or malignant palpable breast masses. Histological assessment confirmed 176 benign and 529 malignant lesions. There were no incorrect (false positive) diagnoses made ...

  18. Identity talk of aspirational ethical leaders

    NARCIS (Netherlands)

    Koning, J.B.M.; Waistell, J.

    2012-01-01

    This study investigates how business leaders dynamically narrate their aspirational ethical leadership identities. In doing so, it furthers understanding of ethical leadership as a process situated in time and place. The analysis focuses on the discursive strategies used to narrate identity and

  19. Gender Differences, Career Aspirations and Career Development ...

    African Journals Online (AJOL)

    The purpose of this study therefore is to explore gender differences in adolescents' career aspirations and career development barriers among secondary school students in Kisumu municipality, Kenya. The study was conducted on 348 form four secondary school students. The major findings of this study show that there ...

  20. Educational Aspirations, What Matters? A Literature Review.

    Science.gov (United States)

    Deosaran, Ramesh

    The literature review attempted to identify: 1) what we know and don't know about post-secondary aspirations, expectations, and access; and 2) where and how it is possible for us to embark on solutions or further investigation. The research in this area has been heavily sociological. Socio-economic background, family size, community origins,…

  1. EDUCATIONAL ASPIRATIONS OF FARM BOYS AND GIRLS.

    Science.gov (United States)

    SLOCUM, WALTER L.

    THE EDUCATIONAL AND OCCUPATIONAL ASPIRATIONS OF RURAL HIGH SCHOOL STUDENTS WERE STUDIED IN RELATION TO SOCIAL, CULTURAL, AND ECONOMIC FACTORS. QUESTIONNAIRES WERE ADMINISTERED TO AND COMPLETED BY 3,535 RURAL HIGH SCHOOL STUDENTS. SUPPLEMENTAL INFORMATION WAS GATHERED BY PERSONAL INTERVIEWS WITH 992 STUDENTS. COUNSELORS, ADMINISTRATORS, AND…

  2. Income Aspirations and Cooperation : Experimental Evidence

    NARCIS (Netherlands)

    Dalton, P.S.

    2010-01-01

    This article is the first attempt to study the empirical link between income aspirations and cooperation in a one shot public good game. By combining experimental with survey data, we find evidence that the more frustrated people are with their income, the lower is their propensity to cooperate with

  3. Educational Aspirations: Individual Freedom or Social Injustice?

    Science.gov (United States)

    Deosaran, Ramesh A.

    1977-01-01

    The author examines the concepts of aspiration level (what a student would like to do) and expectation level (more "realistic" choices of action or goal) and the gap that exists between them, a gap primarily due to social class and gender. (MJB)

  4. Extrapulmonary tuberculosis: Fine needle aspiration cytology ...

    African Journals Online (AJOL)

    Background: The increasing prevalence of extrapulmonary manifestation of tuberculosis with the HIV scourge is a cause for concern. Objective: To determine the role of fine needle aspiration cytology (FNAC) in the diagnosis of extrapulmonary tuberculosis. Patients and Methods: This is a consecutive 9-year analysis of ...

  5. FOREIGN BODY ASPIRATION: A CASE REPORT

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    Nafia Ozlem Kazanci

    2013-03-01

    Full Text Available Foreign body aspiration (FBA is common under 3 years of age. FBA can cause sudden respiratory failure. Furthermore, it leads to many respiratory system complications. Therefore, FBA is an important cause of mortality and morbidity for this age group. FBA cases are usually followed by diagnoses like pneumonia, bronchitis or bronchial asthma in the late period that history, clinical and laboratory findings suggesting foreign body aspiration can not be detected. We reported a 2-year-old male patient with pneumonia, who were administered various treatments. In thorax CT of this case, an image compatible with foreign body was seen in the right middle lobe-upper lobe separation area. Granulation tissue was detected in the entrance of the right main bronchus by rigid bronchoscopy and marked improvement occured in lung aeration after bronchoscopy. This case was reported to emphasize the importance of early diagnosis of foreign body aspiration because of high mortality and morbidity and the necessity of considering the foreign body aspiration in children with recurrent pulmonary infections. [J Contemp Med 2013; 3(1.000: 58-61

  6. Dysphagia, dystussia, and aspiration pneumonia in elderly people

    OpenAIRE

    Ebihara, Satoru; Sekiya, Hideki; Miyagi, Midori; Ebihara, Takae; Okazaki, Tatsuma

    2016-01-01

    Despite the development and wide distribution of guidelines for pneumonia, death from pneumonia is increasing due to population aging. Conventionally, aspiration pneumonia was mainly thought to be one of the infectious diseases. However, we have proven that chronic repeated aspiration of a small amount of sterile material can cause the usual type of aspiration pneumonia in mouse lung. Moreover, chronic repeated aspiration of small amounts induced chronic inflammation in both frail elderly peo...

  7. Gender and Leadership Aspiration : The Impact of the Organizational Environment

    NARCIS (Netherlands)

    C. Fritz (Claudia)

    2016-01-01

    markdownabstractSummary The aim of this dissertation is to examine gender differences in leadership aspiration. Although some important work regarding gender-specific aspiration has been done already, conditions fostering leadership aspiration – particularly among women – are not completely

  8. Risk of aspiration in care home residents and associated factors

    NARCIS (Netherlands)

    Maarel-Wierink, C.D. van der; Putten, G.J. van der; Visschere, L.M. De; Bronkhorst, E.M.; Baat, C. de; Schols, J.M.

    2015-01-01

    Pneumonia is a prevalent cause of death in care home residents. Dysphagia is a significant risk factor of aspiration pneumonia. The purpose of the current study was to screen for risk of aspiration in care home residents in the Netherlands and assess potential risk factors of aspiration. Five

  9. Autoaspiration versus manual aspiration in transbronchial needle aspiration in diagnosis of intrathoracic lymphadenopathy.

    Science.gov (United States)

    Boonsarngsuk, Viboon; Pongtippan, Atcharaporn; Juthakarn, Sabaitip; Boonsarngsuk, Wison; Kurimoto, Noriaki

    2009-10-01

    Traditionally, aspiration with high negative pressure is recommended to obtain a specimen in transbronchial needle aspiration (TBNA). Undeniably, however, the assistant experiences difficulty in the generation of the negative pressure and precise control of the syringe while performing the procedure. To evaluate the effectiveness of the autoaspiration method created by our plunger lock in comparison with the conventional manual aspiration in the diagnosis of intrathoracic lymphadenopathy by TBNA. A prospective study was conducted on all patients referred for diagnostic TBNA of enlarged intrathoracic lymph nodes. Both automatic and manual aspiration techniques were performed after the needle had been completely inserted into the nodes. The diagnostic yield and the numbers of diagnostic cells or benign lymphoid cells obtained by each technique were compared in the same node. A total of 31 intrathoracic lymph nodes in 24 patients were prospectively studied. Twenty-four nodes (77.4%) were malignancies whereas 7 nodes (22.6%) were benign disease. Adequate lymph node samples were obtained in 30 targets (96.8%), and TBNA revealed definite diagnosis for 25 nodes (80.6%). Both aspiration techniques showed exactly the same diagnostic yield. However, the autoaspiration technique provided significantly more adequate samples than manual aspiration techniques did (P=0.003). The autoaspiration method using our plunger lock was superior to the manual method in obtaining the numbers of adequate samples in TBNA procedures.

  10. Adaptive phenotypic plasticity in the Midas cichlid fish pharyngeal jaw and its relevance in adaptive radiation

    Directory of Open Access Journals (Sweden)

    Salzburger Walter

    2011-04-01

    Full Text Available Abstract Background Phenotypic evolution and its role in the diversification of organisms is a central topic in evolutionary biology. A neglected factor during the modern evolutionary synthesis, adaptive phenotypic plasticity, more recently attracted the attention of many evolutionary biologists and is now recognized as an important ingredient in both population persistence and diversification. The traits and directions in which an ancestral source population displays phenotypic plasticity might partly determine the trajectories in morphospace, which are accessible for an adaptive radiation, starting from the colonization of a novel environment. In the case of repeated colonizations of similar environments from the same source population this "flexible stem" hypothesis predicts similar phenotypes to arise in repeated subsequent radiations. The Midas Cichlid (Amphilophus spp. in Nicaragua has radiated in parallel in several crater-lakes seeded by populations originating from the Nicaraguan Great Lakes. Here, we tested phenotypic plasticity in the pharyngeal jaw of Midas Cichlids. The pharyngeal jaw apparatus of cichlids, a second set of jaws functionally decoupled from the oral ones, is known to mediate ecological specialization and often differs strongly between sister-species. Results We performed a common garden experiment raising three groups of Midas cichlids on food differing in hardness and calcium content. Analyzing the lower pharyngeal jaw-bones we find significant differences between diet groups qualitatively resembling the differences found between specialized species. Observed differences in pharyngeal jaw expression between groups were attributable to the diet's mechanical resistance, whereas surplus calcium in the diet was not found to be of importance. Conclusions The pharyngeal jaw apparatus of Midas Cichlids can be expressed plastically if stimulated mechanically during feeding. Since this trait is commonly differentiated - among

  11. Meconium aspiration syndrome: possible pathophysiological mechanisms and future potential therapies.

    Science.gov (United States)

    Lindenskov, Paal Helge Haakonsen; Castellheim, Albert; Saugstad, Ola Didrik; Mollnes, Tom Eirik

    2015-01-01

    Does meconium cause meconium aspiration syndrome (MAS) or is meconium discharge only a marker of fetal hypoxia? This dispute has lasted for centuries, but since the 1960s, detrimental effects of meconium itself on the lungs have been demonstrated in animal experiments. In clinical MAS, persistent pulmonary hypertension of the newborn is the leading cause of death in MAS. Regarding the complex chemical composition of meconium, it is difficult to identify a single agent responsible for the pathophysiology. However, considering that meconium is stored in the intestines, partly unexposed to the immune system, aspirated meconium could be recognized as ‘danger', representing damaged self. The common denominator in the pathophysiology could therefore be activation of innate immunity. Thus, a bulk of evidence implies that meconium is a potent activator of inflammatory mediators, including cytokines, complement, prostaglandins and reactive oxygen species. We hypothesize that the two main recognition systems of innate immunity, the Toll-like receptors and the complement system, recognize meconium as ‘danger', which leads not only to lung dysfunction but also to a systemic inflammatory response. This might have therapeutic implications in the future.

  12. A radial basis classifier for the automatic detection of aspiration in children with dysphagia

    Science.gov (United States)

    Lee, Joon; Blain, Stefanie; Casas, Mike; Kenny, Dave; Berall, Glenn; Chau, Tom

    2006-01-01

    Background Silent aspiration or the inhalation of foodstuffs without overt physiological signs presents a serious health issue for children with dysphagia. To date, there are no reliable means of detecting aspiration in the home or community. An assistive technology that performs in these environments could inform caregivers of adverse events and potentially reduce the morbidity and anxiety of the feeding experience for the child and caregiver, respectively. This paper proposes a classifier for automatic classification of aspiration and swallow vibration signals non-invasively recorded on the neck of children with dysphagia. Methods Vibration signals associated with safe swallows and aspirations, both identified via videofluoroscopy, were collected from over 100 children with neurologically-based dysphagia using a single-axis accelerometer. Five potentially discriminatory mathematical features were extracted from the accelerometry signals. All possible combinations of the five features were investigated in the design of radial basis function classifiers. Performance of different classifiers was compared and the best feature sets were identified. Results Optimal feature combinations for two, three and four features resulted in statistically comparable adjusted accuracies with a radial basis classifier. In particular, the feature pairing of dispersion ratio and normality achieved an adjusted accuracy of 79.8 ± 7.3%, a sensitivity of 79.4 ± 11.7% and specificity of 80.3 ± 12.8% for aspiration detection. Addition of a third feature, namely energy, increased adjusted accuracy to 81.3 ± 8.5% but the change was not statistically significant. A closer look at normality and dispersion ratio features suggest leptokurticity and the frequency and magnitude of atypical values as distinguishing characteristics between swallows and aspirations. The achieved accuracies are 30% higher than those reported for bedside cervical auscultation. Conclusion The proposed aspiration

  13. A radial basis classifier for the automatic detection of aspiration in children with dysphagia

    Directory of Open Access Journals (Sweden)

    Blain Stefanie

    2006-07-01

    Full Text Available Abstract Background Silent aspiration or the inhalation of foodstuffs without overt physiological signs presents a serious health issue for children with dysphagia. To date, there are no reliable means of detecting aspiration in the home or community. An assistive technology that performs in these environments could inform caregivers of adverse events and potentially reduce the morbidity and anxiety of the feeding experience for the child and caregiver, respectively. This paper proposes a classifier for automatic classification of aspiration and swallow vibration signals non-invasively recorded on the neck of children with dysphagia. Methods Vibration signals associated with safe swallows and aspirations, both identified via videofluoroscopy, were collected from over 100 children with neurologically-based dysphagia using a single-axis accelerometer. Five potentially discriminatory mathematical features were extracted from the accelerometry signals. All possible combinations of the five features were investigated in the design of radial basis function classifiers. Performance of different classifiers was compared and the best feature sets were identified. Results Optimal feature combinations for two, three and four features resulted in statistically comparable adjusted accuracies with a radial basis classifier. In particular, the feature pairing of dispersion ratio and normality achieved an adjusted accuracy of 79.8 ± 7.3%, a sensitivity of 79.4 ± 11.7% and specificity of 80.3 ± 12.8% for aspiration detection. Addition of a third feature, namely energy, increased adjusted accuracy to 81.3 ± 8.5% but the change was not statistically significant. A closer look at normality and dispersion ratio features suggest leptokurticity and the frequency and magnitude of atypical values as distinguishing characteristics between swallows and aspirations. The achieved accuracies are 30% higher than those reported for bedside cervical auscultation. Conclusion

  14. The road less traveled: transarterial embolization of dural arteriovenous fistulas via the ascending pharyngeal artery.

    Science.gov (United States)

    Gross, Bradley A; Albuquerque, Felipe C; Moon, Karam; McDougall, Cameron G

    2017-01-01

    With the introduction of Onyx, transarterial embolization has become the most common endovascular approach to treating dural arteriovenous fistulas (dAVFs), often via the middle meningeal or occipital arteries. The ascending pharyngeal artery (APA) is a less frequently explored transarterial route because of its small caliber, potential anastomoses to the internal carotid and vertebral arteries, and vital supply to lower cranial nerves. To review our institutional experience and highlight the prevalence of APA supply to dAVFs and cases where it is a safe and effective pedicle for embolization. We reviewed our endovascular database (January 1, 1996 to March 1, 2016) for cranial dAVFs, evaluating dAVF characteristics and embolization results for those treated transarterially via the APA. Of 267 endovascularly treated dAVFs, 68 had APA supply (25%). Of these 68 dAVFs, embolization was carried out via this pedicle in 8 (12%) and 7 were ultimately occluded. No complications, including post-treatment cranial neuropathies or radiographic evidence of non-target embolization, were found. For 5 dAVFs, the APA was selected as the initial pedicle for embolization (two marginal sinus, one distal sigmoid, one cavernous, one tentorial). In four of these five cases, dAVF occlusion was achieved via the initial APA feeding artery pedicle. In one case, near-complete, stagnant occlusion was achieved after APA embolization; complete occlusion was achieved after adjunctive embolization of a single additional middle meningeal artery pedicle. In three other cases of complex transverse/sigmoid dAVFs, the APA was used after multiple attempts via middle meningeal and occipital artery pedicles. Occlusion was not achieved transarterially; two of these three dAVFs were ultimately occluded transvenously. In rare, select cases, the APA is an excellent route for transarterial embolization of cranial dAVFs. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  15. Three-dimensional evaluation of pharyngeal airway in individuals with varying growth patterns using cone beam computed tomography

    OpenAIRE

    Rohan Diwakar; Maninder Singh Sidhu; Mona Prabhakar; Seema Grover; Ritu Phogat

    2015-01-01

    Introduction: The purpose of this study was to evaluate the pharyngeal airway volume in individuals with different vertical growth patterns. Methods: Cone beam computed tomography scans were evaluated of 40 subjects with the age range from 14 to 25 years and were divided into three groups. Horizontal growers consisted of 13 subjects, normal growers consisted of 14 subjects, and the vertical growers consisted of 13 subjects. The pharyngeal airway volume was measured using In Vivo Dental 5.1 so...

  16. Dicer activity in neural crest cells is essential for craniofacial organogenesis and pharyngeal arch artery morphogenesis

    Science.gov (United States)

    Nie, Xuguang; Wang, Qin; Jiao, Kai

    2014-01-01

    MicroRNAs (miRNAs) play important roles in regulating gene expression during numerous biological/pathological processes. Dicer encodes an RNase III endonuclease that is essential for generating most, if not all, functional miRNAs. In this work, we applied a conditional gene inactivation approach to examine the function of Dicer during neural crest cell (NCC) development. Mice with NCC-specific inactivation of Dicer died perinatally. Cranial and cardiac NCC migration into target tissues was not affected by Dicer disruption, but their subsequent development was disturbed. NCC derivatives and their associated mesoderm-derived cells displayed massive apoptosis, leading to severe abnormalities during craniofacial morphogenesis and organogenesis. In addition, the 4th pharyngeal arch artery (PAA) remodeling was affected, resulting in interrupted aortic arch artery type B (IAA-B) in mutant animals. Taken together, our results show that Dicer activity in NCCs is essential for craniofacial development and pharyngeal arch artery morphogenesis. PMID:21256960

  17. Simultaneous videoradiography and solid state intraluminal pharyngeal manometry during barium swallow; videomanometry

    International Nuclear Information System (INIS)

    Olsson, Rolf.

    1995-08-01

    The technique was used in nondysphagic volunteers and in dysphagic patients. Our normal values in nondysphagic volunteers are in accordance with normal values in the literature. Regarding catheter movement we found the a previously not described sensor movement where the sensor in the upper esophageal sphincter followed the laryngeal elevation with no response to soft palate elevation. We found a longitudinal asymmetry in the pharynx with higher contraction pressures at lower levels. In the experimental model we found that intrabolus pressure was dependent on bolus volume, lumen narrowing, sensor position, flow rate, and bolus viscosity. In patients with a cricopharyngeal indentation we found weak pharyngeal constrictors with outpouching of the lumen above and below. Finally, in dysphagic patients with a normal radiologic investigation, videomanometry displayed abnormalities in 74% of the patients. We conclude that barium swallow and manometry are complementary and we suggest the addition of pharyngeal solid state manometry, preferably with simultaneous videoradiography, in dysphagic patients. 128 refs, 4 figs

  18. Simultaneous videoradiography and solid state intraluminal pharyngeal manometry during barium swallow; videomanometry

    Energy Technology Data Exchange (ETDEWEB)

    Olsson, Rolf

    1995-08-01

    The technique was used in nondysphagic volunteers and in dysphagic patients. Our normal values in nondysphagic volunteers are in accordance with normal values in the literature. Regarding catheter movement we found the a previously not described sensor movement where the sensor in the upper esophageal sphincter followed the laryngeal elevation with no response to soft palate elevation. We found a longitudinal asymmetry in the pharynx with higher contraction pressures at lower levels. In the experimental model we found that intrabolus pressure was dependent on bolus volume, lumen narrowing, sensor position, flow rate, and bolus viscosity. In patients with a cricopharyngeal indentation we found weak pharyngeal constrictors with outpouching of the lumen above and below. Finally, in dysphagic patients with a normal radiologic investigation, videomanometry displayed abnormalities in 74% of the patients. We conclude that barium swallow and manometry are complementary and we suggest the addition of pharyngeal solid state manometry, preferably with simultaneous videoradiography, in dysphagic patients. 128 refs, 4 figs.

  19. Carrying pharyngeal of Streptococcus pyogenes and sensitivity profiles in schoolchild from Cartagena

    Directory of Open Access Journals (Sweden)

    Lucy Margarita Villafañe-Ferrer

    2015-07-01

    Full Text Available To determine the frequency of carrying pharyngeal of Streptococcus pyogenes and their sensitivity profiles in schoolchildren from Cartagena. Analytical cross-sectional study, the sample was composed by 131 children. Strains of Streptococcus pyogenes were identified using conventional methods. Antibiotic sensitivity was determined the Kirby-Bauer methods. A questionnaire was applied in order to identify risk factors associated.19,8% of children were carriers of bacterium. 26 isolates of Streptococcus pyogenes were obtained. To evaluate the sensitivity were found strains sensible to ceftriaxone and erytrhomycin (84,6% each one. 23,1% (6/26 0f isolates were resistant to ampicillin. It not was found association between carrying pharyngeal of Streptococcus pyogenes and risk factors (p>0,05. It were found resistant strains to antibiotics considered of first election for therapy of infectious diseases produced by this bacterium.

  20. Sparc (Osteonectin) functions in morphogenesis of the pharyngeal skeleton and inner ear.

    Science.gov (United States)

    Rotllant, Josep; Liu, Dong; Yan, Yin-Lin; Postlethwait, John H; Westerfield, Monte; Du, Shao-Jun

    2008-07-01

    Sparc (Osteonectin), a matricellular glycoprotein expressed by many differentiated cells, is a major non-collagenous constituent of vertebrate bones. Recent studies indicate that Sparc expression appears early in development, although its function and regulation during embryogenesis are largely unknown. We cloned zebrafish sparc and investigated its role during development, using a mo rpholino antisense oligonucleotide-based knockdown approach. Consistent with its strong expression in the otic vesicle and developing pharyngeal cartilages, knockdown of Sparc function resulted in specific inner ear and cartilage defects that are highlighted by changes in gene expression, morphology and behavior. We rescued the knockdown phenotypes by co-injecting sparc mRNA, providing evidence that the knockdown phenotype is due specifically to impairment of Sparc function. A comparison of the phenotypes of Sparc knockdown and known zebrafish mutants with similar defects places Sparc downstream of sox9 in the genetic network that regulates development of the pharyngeal skeleton and inner ear of vertebrates.

  1. Burr hole aspiration of brain abscess in children with cyanotic heart disease

    International Nuclear Information System (INIS)

    Ashraf, M.; Ahmed, S; Hussain, M.

    2017-01-01

    To determine the efficacy of burr hole aspiration of brain abscess in children with cyanotic heart disease in terms of number of aspirations and residual abscess. Study Design: Experimental study. Place and Duration of Study: Department of Pediatric Neurosurgery at The Children's Hospital and The Institute of Child Health, Multan, from July 2010 to June 2014. Methodology: Pediatric patients of cyanotic heart disease with brain abscess were admitted. After taking history, clinical examination and necessary investigation, spiration of abscess through a burr hole was performed. Data was collected through pre-designed proforma. Analysis of results was performed and comparison was made through statistical package for social sciences (SPSS-20). Results: Total number of patients were 50 with 31 (62%) male and 19 (38%) female children. Patients' age ranged from 5-10 years with mean age of 7.44 +-1.11 years. Single abscess in supra tentorial was commonly found in 44 (88%) patients. Multiple abscesses were present in 4 (8%) patients. Cerebellum was involved in 2 (4%) patients. Abscess was completely aspirated in single attempt in 37 (74%) patients, two attempts in 9 (18%) patients, and three attempts in 4 (8%) patients. No bacterial growth on culture was reported in 32 (64%) patients. Culture was positive in 18 (36%) patients. Postoperative hematoma developed in 2 (4%) patients. No mortality was reported in early postoperative period. Conclusion: Aspiration of brain abscess in children with cyanotic heart disease through a burr hole is safe and successful. (author)

  2. Does hardness of food affect the development of pharyngeal teeth of the black carp, Mylopharyngodon piceus (Pisces: Cyprinidae)?

    DEFF Research Database (Denmark)

    Hung, Nguyen Manh; Ryan, Timothy M.; Stauffer, Jay R.

    2015-01-01

    We investigated whether food type influences development of the pharyngeal crushing apparatus of black carp (Mylopharyngodon piceus, Cyprinidae). Fish fed a hard diet had average standard lengths and weights larger than those fed a soft diet; these observations in part could be related to differe......We investigated whether food type influences development of the pharyngeal crushing apparatus of black carp (Mylopharyngodon piceus, Cyprinidae). Fish fed a hard diet had average standard lengths and weights larger than those fed a soft diet; these observations in part could be related...... to differences in nutritional value of the two food types. The lower pharyngeal bones, which bear molariform teeth were examined using three dimensional computed tomography (CT) scans. After adjusting for differences in the standard length of the fish, the total volume and exterior surface areas...... of the pharyngeal teeth were greater in fish fed hard diets than in those fed soft diets. Total weights of the pharyngeal arches were less in the fish fed a soft diet than in those fed a hard diet. These results indicated that food type affects development of the pharyngeal crushing mill of black carp and therefore...

  3. Participatory medicine: A home score for streptococcal pharyngitis enabled by real-time biosurveillance: a cohort study.

    Science.gov (United States)

    Fine, Andrew M; Nizet, Victor; Mandl, Kenneth D

    2013-11-05

    Consensus guidelines recommend against testing or treating adults at low risk for group A streptococcal (GAS) pharyngitis. To help patients decide when to visit a clinician for the evaluation of sore throat. Retrospective cohort study. A national chain of retail health clinics. 71 776 patients aged 15 years or older with pharyngitis who visited a clinic from September 2006 to December 2008. The authors created a score using information from patient-reported clinical variables plus the incidence of local disease and compared it with the Centor score and other traditional scores that require clinician-elicited signs. If patients aged 15 years or older with sore throat did not visit a clinician when the new score estimated the likelihood of GAS pharyngitis to be less than 10% instead of having clinicians manage their symptoms following guidelines that use the Centor score, 230 000 visits would be avoided in the United States each year and 8500 patients with GAS pharyngitis who would have received antibiotics would not be treated with them. Real-time information about the local incidence of GAS pharyngitis, which is necessary to calculate the new score, is not currently available. A patient-driven approach to pharyngitis diagnosis that uses this new score could save hundreds of thousands of visits annually by identifying patients at home who are unlikely to require testing or treatment. Centers for Disease Control and Prevention and the National Library of Medicine, National Institutes of Health.

  4. Aural-pharyngeal polyps associated with Cryptosporidium infection in three iguanas (Iguana iguana).

    Science.gov (United States)

    Uhl, E W; Jacobson, E; Bartick, T E; Micinilio, J; Schimdt, R

    2001-03-01

    Cryptosporidium spp. infection was associated with aural-pharyngeal polyps in three iguanas (Iguana iguana). All iguanas were presented for masses protruding from the ear canal, and the disease was characterized by a chronic clinical course. The masses consisted of nests of cystic glands surrounded by abundant fibrous connective tissue and lined by hyperplastic cuboidal to pseudostratified columnar epithelium that was moderately to heavily colonized by cryptosporidial organisms. Electron microscopy revealed that the majority of organisms were trophozoites.

  5. Trend of oral and pharyngeal cancer mortality in Brazil in the period of 2002 to 2013

    Directory of Open Access Journals (Sweden)

    Lillia Magali Estrada Perea

    2018-02-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the trend of oral and pharyngeal cancer mortality rates in the period of 2002 to 2013 in Brazil according to sex, anatomical site, and macroregion of the country. METHODS The mortality data were obtained from the Mortality Information System and the population data were obtained from the Brazilian Institute of Geography and Statistics. The trend of the rates standardized by sex and age was calculated using the Prais-Winsten estimation, and we obtained the annual percentage change and the respective 95% confidence intervals, analyzed according to sex, macroregion, and anatomical site. RESULTS The average coefficient of oral cancer mortality was 1.87 per 100,000 inhabitants and it remained stable during the study period. The coefficient of pharyngeal cancer mortality was 2.04 per 100,000 inhabitants and it presented an annual percentage change of -2.6%. Approximately eight in every 10 deaths occurred among men. There was an increase in the rates of oral cancer in the Northeast region (annual percentage change of 6.9% and a decrease in the Southeast region (annual percentage change of -2.9%. Pharyngeal cancer mortality decreased in the Southeast and South regions with annual percentage change of -4.8% and -5.1% respectively. Cancer mortality for tonsil, other major salivary glands, hypopharynx, and other and unspecified parts of mouth and pharynx showed a decreasing trend while the other sites presented stability. CONCLUSIONS Pharyngeal cancer mortality decreased in the period of 2002 to 2013. Oral cancer increased only in the Northeast region. Mortality for tonsil cancer, other major salivary glands, hypopharynx, and other and ill-defined sites in the lip, oral cavity, and pharynx decreased.

  6. Characterization and mechanisms of the pharyngeal swallow activated by stimulation of the esophagus.

    Science.gov (United States)

    Lang, Ivan M; Medda, Bidyut K; Jadcherla, Sudarshan R; Shaker, Reza

    2016-11-01

    Stimulation of the esophagus activates the pharyngeal swallow response (EPSR) in human infants and animals. The aims of this study were to characterize the stimulus and response of the EPSR and to determine the function and mechanisms generating the EPSR. Studies were conducted in 46 decerebrate cats in which pharyngeal, laryngeal, and esophageal motility was monitored using EMG, strain gauges, or manometry. The esophagus was stimulated by balloon distension or luminal fluid infusion. We found that esophageal distension increased the chance of occurrence of the EPSR, but the delay was variable. The chance of occurrence of the EPSR was related to the position, magnitude, and length of the stimulus in the esophagus. The most effective stimulus was long, strong, and situated in the cervical esophagus. Acidification of the esophagus activated pharyngeal swallows and sensitized the receptors that activate the EPSR. The EPSR was blocked by local anesthesia applied to the esophageal lumen, and electrical stimulation of the recurrent laryngeal nerve caudal to the cricoid cartilage (RLNc) activated the pharyngeal swallow response. We conclude that the EPSR is activated in a probabilistic manner. The receptors mediating the EPSR are probably mucosal slowly adapting tension receptors. The sensory neural pathway includes the RLNc and superior laryngeal nerve. We hypothesize that, because the EPSR is observed in human infants and animals, but not human adults, activation of EPSR is related to the elevated position of the larynx. In this situation, the EPSR occurs rather than secondary peristalsis to prevent supraesophageal reflux when the esophageal bolus is in the proximal esophagus. Copyright © 2016 the American Physiological Society.

  7. In vivo polarization dependant Second and Third harmonic generation imaging of Caenorhabditis elegans pharyngeal muscles

    Science.gov (United States)

    Filippidis, G.; Troulinaki, K.; Fotakis, C.; Tavernarakis, N.

    2009-07-01

    In this study Second and Third harmonic generation (SHG-THG) imaging measurements were performed to the pharyngeal muscles of the nematode Caenorhabditis elegans, in vivo with linearly polarized laser beam. Complementary information about the anatomy of the pharynx and the morphology of the anterior part of the worm were extracted. THG signals proved to have no dependence on incident light polarization, while SHG images are highly sensitive to the changes of the incident linearly polarized light.

  8. Isolation of Streptococcus pyogenes from children with pharyngitis and emm type analysis

    Directory of Open Access Journals (Sweden)

    Azar D. Khosravi

    2016-05-01

    Conclusion: The result of the present study showed that penicillin and erythromycin are still the most effective antibiotics against the organism. The emm typing revealed that emm type-3 was detected in most of the isolates from patients with purulent pharyngitis. On the basis of the findings of this study, we may conclude that emm typing provides new insights on the genetic diversity of the M proteins, and is of demonstrable value for molecular studies of GAS.

  9. Dysphagia, dystussia, and aspiration pneumonia in elderly people.

    Science.gov (United States)

    Ebihara, Satoru; Sekiya, Hideki; Miyagi, Midori; Ebihara, Takae; Okazaki, Tatsuma

    2016-03-01

    Despite the development and wide distribution of guidelines for pneumonia, death from pneumonia is increasing due to population aging. Conventionally, aspiration pneumonia was mainly thought to be one of the infectious diseases. However, we have proven that chronic repeated aspiration of a small amount of sterile material can cause the usual type of aspiration pneumonia in mouse lung. Moreover, chronic repeated aspiration of small amounts induced chronic inflammation in both frail elderly people and mouse lung. These observations suggest the need for a paradigm shift of the treatment for pneumonia in the elderly. Since aspiration pneumonia is fundamentally based on dysphagia, we should shift the therapy for aspiration pneumonia from pathogen-oriented therapy to function-oriented therapy. Function-oriented therapy in aspiration pneumonia means therapy focusing on slowing or reversing the functional decline that occurs as part of the aging process, such as "dementia → dysphagia → dystussia → atussia → silent aspiration". Atussia is ultimate dysfunction of cough physiology, and aspiration with atussia is called silent aspiration, which leads to the development of life-threatening aspiration pneumonia. Research pursuing effective strategies to restore function in the elderly is warranted in order to decrease pneumonia deaths in elderly people.

  10. Liver CT-guided aspirative biopsies

    International Nuclear Information System (INIS)

    Santos, Gilda da Cunha; Carvalho, Leda Viegas de; Chojniak, Rubens; Morini, Sandra Regina

    1996-01-01

    Sixty-eight CT-guided aspirative biopsies of hepatic nodules were performed at A.C. Camargo Hospital, Sao Paulo, Brazil, from 1992 to 1995. The cases were distributed as follow: 44(64.7%) with a positive diagnosis for neoplastic cells, 6(8.8%) with a negative diagnosis, and 14 (20.5%) with insufficient material. Of the positive cases (primary neoplasias and metastases), the cytological diagnosis was achieved in 39 cases. There were 36 cases of carcinoma (7 hepato carcinomas, 18 adenocarcinomas, 1 small cell carcinoma and 10 cases of unspecified differentiation), 2 cases of melanoma and 1 case of melanoma and 1 case of sarcoma. The correlation with histopathological exams showed no false positive cases and concordance between cytological and histopathological diagnosis. The results demonstrate that CT-guided aspirative biopsy of hepatic nodules permits a rapid diagnosis of neoplastic lesions, especially for the evaluation of metastases. (author)

  11. Air Bag Momentum Force Including Aspiration

    Directory of Open Access Journals (Sweden)

    Guy Nusholtz

    1995-01-01

    Full Text Available A gas-jet momentum force drives the air bag into position during a crash. The magnitude of this force can change as a result of aspiration. To determine the potential magnitude of the effect on the momentum force and mass flow rate in an aspirated system, a series of experiments and simulations of those experiments was conducted. The simulation consists of a two-dimensional unsteady isentropic CFD model with special “infinite boundaries”. One of the difficulties in simulating the gas-jet behavior is determining the mass flow rate. To improve the reliability of the mass flow rate input to the simulation, a sampling procedure involving multiple tests was used, and an average of the tests was adopted.

  12. Effects of pharyngeal lubrication on the opening of obstructed upper airway.

    Science.gov (United States)

    Miki, H; Hida, W; Kikuchi, Y; Chonan, T; Satoh, M; Iwase, N; Takishima, T

    1992-06-01

    We examined the effect of electrical stimulation of the hypoglossal nerve and pharyngeal lubrication with artificial surfactant (Surfactant T-A) on the opening of obstructed upper airway in nine anesthetized supine dogs. The upper airway was isolated from the lower airway by transecting the cervical trachea. Upper airway obstruction was induced by applying constant negative pressures (5, 10, 20, and 30 cmH2O) on the rostral cut end of the trachea. Peripheral cut ends of the hypoglossal nerves were electrically stimulated by square-wave pulses at various frequencies from 10 to 30 Hz (0.2-ms duration, 5-7 V), and the critical stimulating frequency necessary for opening the obstructed upper airway was measured at each driving pressure before and after pharyngeal lubrication with artificial surfactant. The critical stimulation frequency for upper airway opening significantly increased as upper airway pressure became more negative and significantly decreased with lubrication of the upper airway. These findings suggest that greater muscle tone of the genioglossus is needed to open the occluded upper airway with larger negative intraluminal pressure and that lubrication of the pharyngeal mucosa with artificial surfactant facilitates reopening of the upper airway.

  13. Does velopharyngeal closure pattern affect the success of pharyngeal flap pharyngoplasty?

    Science.gov (United States)

    Armour, Alexis; Fischbach, Simone; Klaiman, Paula; Fisher, David M

    2005-01-01

    Historically at The Hospital for Sick Children in Toronto, pharyngeal flap pharyngoplasty has been the treatment of choice for treatment of velopharyngeal insufficiency, regardless of velopharyngeal closure pattern. The authors hypothesize that pharyngeal flap pharyngoplasty is more effective in treating velopharyngeal insufficiency in patients with circular or sagittal velopharyngeal closure and less effective in treating the coronal closure pattern. Ninety-three patients who underwent superiorly based pharyngeal flap surgery for velopharyngeal insufficiency were evaluated in a retrospective chart review. Closure pattern was determined preoperatively by nasopharyngoscopy or multiview videofluoroscopy. Nasalance was assessed preoperatively and at 6 weeks and 1 year postoperatively. Nasalance during nonnasal speech was decreased on average, for all closure patterns, postoperatively. However, a significantly higher percentage of patients were corrected to normal nasalance scores in thenoncoronal group than in the coronal group (57 percent versus 35 percent, respectively) at 1 year postoperatively (p approach to the management of velopharyngeal insufficiency and are more inclined to treat coronal pattern velopharyngeal insufficiency with sphincter pharyngoplasty.

  14. Morphometry of the Palate and Pharyngeal Airway- A Computed Tomographic Study

    Directory of Open Access Journals (Sweden)

    Arvind Kumar Pandey

    2017-10-01

    Full Text Available Background: The morphometry of the palate and pharyngeal airway has a crucial role in the development of disorders like apnea. Therefore the present study aims to explore the shape and dimensions of the palate and the pharyngeal airway. Materials and Methods: The study was carried out on normal sagittal and axial sections of head and neck in 100 CT images. Results: The average length of the hard and soft palates measured 4.49±0.38 and 3.44±0.61cm respectively. The anteroposterior dimension of the soft palate was 0.90±0.33 cm. The velopalatine angle measured 130.23±9.98º. The luminal areas were 4.59±1.81, 2.058±1.09 and 2.99±1.08 cm in naso, oro and laryngo pharynx respectively. The soft palate showed varied shapes which were classified as a straight line, leaf-like, rat-tail, distorted S, crooked and butt like. Conclusion: The present study attempts to provide a normal database to understand the anatomy of the soft palate and pharyngeal airways.

  15. Usefulness of Leukocyte Esterase Test Versus Rapid Strep Test for Diagnosis of Acute Strep Pharyngitis

    Directory of Open Access Journals (Sweden)

    Kumara V. Nibhanipudi MD

    2015-08-01

    Full Text Available Objective: A study to compare the usage of throat swab testing for leukocyte esterase on a test strip(urine dip stick-multi stick to rapid strep test for rapid diagnosis of Group A Beta hemolytic streptococci in cases of acute pharyngitis in children. Hypothesis: The testing of throat swab for leukocyte esterase on test strip currently used for urine testing may be used to detect throat infection and might be as useful as rapid strep. Methods: All patients who come with a complaint of sore throat and fever were examined clinically for erythema of pharynx, tonsils and also for any exudates. Informed consent was obtained from the parents and assent from the subjects. 3 swabs were taken from pharyngo-tonsillar region, testing for culture, rapid strep & Leukocyte Esterase. Results: Total number is 100. Cultures 9(+; for rapid strep== 84(- and16 (+; For LE== 80(- and 20(+ Statistics: From data configuration Rapid Strep versus LE test don’t seem to be a random (independent assignment but extremely aligned. The Statistical results show rapid and LE show very agreeable results. Calculated Value of Chi Squared Exceeds Tabulated under 1 Degree Of Freedom (P<.0.0001 reject Null Hypothesis and Conclude Alternative Conclusions: Leukocyte esterase on throat swab is as useful as rapid strep test for rapid diagnosis of strep pharyngitis on test strip currently used for urine dip stick causing acute pharyngitis in children.

  16. Association between use of rapid antigen detection tests and adherence to antibiotics in suspected streptococcal pharyngitis.

    Science.gov (United States)

    Llor, Carl; Hernández, Silvia; Sierra, Nuria; Moragas, Ana; Hernández, Marta; Bayona, Carolina

    2010-03-01

    Few studies have analysed adherence to antibiotic treatment in pharyngitis. The aim of this study was to evaluate the association of rapid antigen detection tests (RADT) and treatment adherence among patients 18 years of age or over with pharyngitis treated with different antibiotic regimens. Prospective study from 2003 to 2008. Office-based physician practices. Intervention. The adherence of patients prior to the use of RADTs - no test was available until mid-2006 - was compared with the adherence associated with the use of RADTs. Patients with suspected streptococcal pharyngitis. Patient adherence was assessed by electronic monitoring. The adherence outcomes considered were antibiotic-taking adherence, correct dosing, and good timing adherence during at least 80% of the antibiotic course. A total of 196 patients were recruited. The percentage of container openings was 77.9%+/-17.7%, being significantly higher for patients in whom the RADTs were performed compared with those in whom this test was not undertaken (80.1% vs. 70.8% for thrice-daily antibiotic regimens and 88.1% vs. 76.5% for twice-daily regimens; p pills (71.3% vs. 42.2%; p dosing was always greater when the patient had undergone an RADT. Adherence to antibiotic treatment is higher when an RADT is carried out at the consultation prior to administration of antibiotic treatment.

  17. [Usefulness of cephalometry and pharyngeal findings in the primary diagnosis of obstructive sleep apnea syndrome].

    Science.gov (United States)

    Kitamura, Takuro; Sakabe, Akiko; Ueda, Narihisa; Shiomori, Teruo; Udaka, Tsuyoshi; Ohbuchi, Toyoaki; Suzuki, Hideaki

    2008-11-01

    We studied the usefulness of cephalometry and pharyngeal findings in determining efficient primary diagnosis of obstructive sleep apnea syndrome (OSAS). Subjects were 171 adult men with sleep-disordered breathing, who underwent cephalometry and polysomnography (PSG) and had pharyngeal findings evaluated by modified Mallampati grade (MMP) and palatine tonsil size. An apnea-hypopnea index (AHI) of > or = 15 in PSG was considered to indicate OSAS. We analyzed the correlation between AHI and other parameters and conducted stepwise multiple regression analysis to predict AHI, and studied the screening performance of prediction equations using a receiver operating characteristic (ROC) curve. Of the 8 cephalometric parameters examined, the length of the soft palate (PNS-P; p = 0.011) and the distance from the mandibular plane to the hyoid bone (MP-H; p (a) > (b). Sensitivity and of equation (c) with a cutoff of 15 were 0.95 and specificity 0.25. These results indicate that both cephalometric parameters and pharyngeal indices should be included in conducting an efficient primary diagnosis for OSAS.

  18. Assessment of Upper and Lower Pharyngeal Airway Width in Skeletal Class I, II and III Malocclusions

    Directory of Open Access Journals (Sweden)

    Shalu Jain

    2014-01-01

    Full Text Available Introduction: There is a close relationship between the dimensions of airway and the sagittal skeletal malocclusion which makes it reasonable to expect that width of airway is a reflection of determining patency of airway in different skeletal malocclusion groups. So, aim of this study was to assess the upper and lower pharyngeal airway width in skeletal Class I, II and III malocclusion groups and also to evaluate sexual dimorphism in western Uttar Pradesh population. Materials and methods: A sample of 150 subjects in the age group of 18 to 25 years, from Western Uttar Pradesh adult population was selected on the basis of skeletal Class I, II and III malocclusion. Digital lateral cephalograms were taken in natural head position. Nine variables were selected which included four upper and five lower pharyngeal airway variables. Results: Upper and lower pharynx showed statistical significant difference among the skeletal Class I, II and III malocclusion and also between males and females. Conclusion: Wider upper and lower pharyngeal airway width was seen in males than in females in both skeletal Class I as well as Class III malocclusion groups respectively. Skeletal Class III malocclusion subjects had the widest airway width as compared to skeletal Class I malocclusion group. Skeletal Class II malocclusion, airway width was found to be narrowest.

  19. Modeling the pharyngeal anatomical effects on breathing resistance and aerodynamically generated sound.

    Science.gov (United States)

    Xi, Jinxiang; Si, Xiuhua; Kim, JongWon; Su, Guoguang; Dong, Haibo

    2014-07-01

    The objective of this study was to systematically assess the effects of pharyngeal anatomical details on breathing resistance and acoustic characteristics by means of computational modeling. A physiologically realistic nose-throat airway was reconstructed from medical images. Individual airway anatomy such as the uvula, pharynx, and larynx was then isolated for examination by gradually simplifying this image-based model geometry. Large eddy simulations with the FW-H acoustics model were used to simulate airflows and acoustic sound generation with constant flow inhalations in rigid-walled airway geometries. Results showed that pharyngeal anatomical details exerted a significant impact on breathing resistance and energy distribution of acoustic sound. The uvula constriction induced considerably increased levels of pressure drop and acoustic power in the pharynx, which could start and worsen snoring symptoms. Each source anatomy was observed to generate a unique spectrum with signature peak frequencies and energy distribution. Moreover, severe pharyngeal airway narrowing led to an upward shift of sound energy in the high-frequency range. Results indicated that computational aeroacoustic modeling appeared to be a practical tool to study breathing-related disorders. Specifically, high-frequency acoustic signals might disclose additional clues to the mechanism of apneic snoring and should be included in future acoustic studies.

  20. Human Pharyngeal Microbiome May Play A Protective Role in Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Zhancheng Gao

    2014-06-01

    Full Text Available The human pharyngeal microbiome, which resides at the juncture of digestive and respiratory tracts, may have an active role in the prevention of respiratory tract infections, similar to the actions of the intestinal microbiome against enteric infections. Recent studies have demonstrated that the pharyngeal microbiome comprises an abundance of bacterial species that interacts with the local epithelial and immune cells, and together, they form a unique micro-ecological system. Most of the microbial species in microbiomes are obligate symbionts constantly adapting to their unique surroundings. Indigenous commensal species are capable of both maintaining dominance and evoking host immune responses to eliminate invading species. Temporary damage to the pharyngeal microbiome due to the impaired local epithelia is also considered an important predisposing risk factor for infections. Therefore, reinforcement of microbiome homeostasis to prevent invasion of infection-prone species would provide a novel treatment strategy in addition to antibiotic treatment and vaccination. Hence continued research efforts on evaluating probiotic treatment and developing appropriate procedures are necessary to both prevent and treat respiratory infections.

  1. The Caenorhabditis elegans paxillin orthologue, PXL-1, is required for pharyngeal muscle contraction and for viability.

    Science.gov (United States)

    Warner, Adam; Qadota, Hiroshi; Benian, Guy M; Vogl, A Wayne; Moerman, Donald G

    2011-07-15

    We have identified the gene C28H8.6 (pxl-1) as the Caenorhabditis elegans orthologue of vertebrate paxillin. PXL-1 contains the four C-terminal LIM domains conserved in paxillin across all species and three of the five LD motifs found in the N-terminal half of most paxillins. In body wall muscle, PXL-1 antibodies and a full-length green fluorescent protein translational fusion localize to adhesion sites in the sarcomere, the functional repeat unit in muscle responsible for contraction. PXL-1 also localizes to ring-shaped structures near the sarcolemma in pharyngeal muscle corresponding to podosome-like sites of actin attachment. Our analysis of a loss-of-function allele of pxl-1, ok1483, shows that loss of paxillin leads to early larval arrested animals with paralyzed pharyngeal muscles and eventual lethality, presumably due to an inability to feed. We rescued the mutant phenotype by expressing paxillin solely in the pharynx and found that these animals survived and are essentially wild type in movement and body wall muscle structure. This indicates a differential requirement for paxillin in these two types of muscle. In pharyngeal muscle it is essential for contraction, whereas in body wall muscle it is dispensable for filament assembly, sarcomere stability, and ultimately movement.

  2. The Caenorhabditis elegans paxillin orthologue, PXL-1, is required for pharyngeal muscle contraction and for viability

    Science.gov (United States)

    Warner, Adam; Qadota, Hiroshi; Benian, Guy M.; Vogl, A. Wayne; Moerman, Donald G.

    2011-01-01

    We have identified the gene C28H8.6 (pxl-1) as the Caenorhabditis elegans orthologue of vertebrate paxillin. PXL-1 contains the four C-terminal LIM domains conserved in paxillin across all species and three of the five LD motifs found in the N-terminal half of most paxillins. In body wall muscle, PXL-1 antibodies and a full-length green fluorescent protein translational fusion localize to adhesion sites in the sarcomere, the functional repeat unit in muscle responsible for contraction. PXL-1 also localizes to ring-shaped structures near the sarcolemma in pharyngeal muscle corresponding to podosome-like sites of actin attachment. Our analysis of a loss-of-function allele of pxl-1, ok1483, shows that loss of paxillin leads to early larval arrested animals with paralyzed pharyngeal muscles and eventual lethality, presumably due to an inability to feed. We rescued the mutant phenotype by expressing paxillin solely in the pharynx and found that these animals survived and are essentially wild type in movement and body wall muscle structure. This indicates a differential requirement for paxillin in these two types of muscle. In pharyngeal muscle it is essential for contraction, whereas in body wall muscle it is dispensable for filament assembly, sarcomere stability, and ultimately movement. PMID:21633109

  3. Laryngospasm With Apparent Aspiration During Sedation With Nitrous Oxide.

    Science.gov (United States)

    Babl, Franz E; Grindlay, Joanne; Barrett, Michael Joseph

    2015-11-01

    Nitrous oxide and oxygen mixture has become increasingly popular for the procedural sedation and analgesia of children in the emergency department. In general, nitrous oxide is regarded as a very safe agent according to large case series. We report a case of single-agent nitrous oxide sedation of a child, complicated by laryngospasm and radiographically confirmed bilateral upper lobe pulmonary opacities. Although rarely reported with parenteral sedative agents, laryngospasm and apparent aspiration has not been previously reported in isolated nitrous oxide sedation. This case highlights that, similar to other sedative agents, nitrous oxide administration also needs to be conducted by staff and in settings in which airway emergencies can be appropriately managed. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  4. Meconium aspiration syndrome: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Goel A

    2017-08-01

    Full Text Available Ankita Goel, Sushma Nangia Department of Neonatology, Lady Hardinge Medical College and Kalawati Saran Children Hospital, Shaheed Bhagat Singh Marg, New Delhi, India Abstract: Meconium aspiration syndrome (MAS is an important cause of morbidity and mortality among term newborns. A result of antepartum or postpartum aspiration of meconium stained amniotic fluid (MSAF, MAS causes respiratory distress of varying severity, often complicated by air leaks or persistent pulmonary hypertension (PPHN. There has been a tremendous change in the concepts of pathophysiology and management of MAS over the last few decades. Routine endotracheal suctioning is no longer recommended in both vigorous and nonvigorous neonates with MSAF. Supportive management, along with newer therapies such as surfactant, inhaled nitric oxide, and high-frequency ventilation, has resulted in marked improvement in the overall outcome of MAS. The present review highlights the challenges in understanding the complex pathophysiology and optimal management approach to MAS. Potential future therapies and drugs in trial are also discussed briefly. Keywords: meconium aspiration syndrome, endotracheal suction, surfactant, inhaled nitric oxide, high-frequency ventilation, persistent pulmonary hypertension

  5. ASPIRE: Active Societal Participation in Research and Education

    Science.gov (United States)

    Garza, C.; Parrish, J.; Harris, L.; Posselt, J.; Hatch, M.

    2017-12-01

    Active Societal Participation In Research and Education (ASPIRE) aims to cultivate a generation of geoscientists with the leadership knowledge and skills, scholarship, and material support to reframe and rebrand the geosciences as socially relevant and, thereby, to broaden participation in these fields. This generation of geoscientists will do so by bridging longstanding divides that impede access to and inclusion in the geosciences: between basic and applied science, between scholars in the academy and members of historically marginalized communities, and between the places where science is needed and the places where it is typically conducted. To bring about these types of change, we draw upon, refine, and institutionalize the working group model as the Mobile Working Group (MWG), directly referencing the need to move outside of the "ivory tower" and into the community. Led by a geoscientist with one foot in the academy and the other in the community - the Boundary Spanner - each MWG will focus on a single issue linked to a single community. ASPIRE supports multiple MWGs working across the geographic, ethnographic and "in practice" community space, as well as across the body of geoscience research and application. We hypothesize that in institutionalizing a new mode of geoscience research (MWG), learning from Boundary Spanners experiences with MWG, and refining a leadership development program from our findings, that we will have a scalable leadership tool and organizational structure that will rebrand the geosciences as socially relevant and inclusive of geoscientists from diverse backgrounds even as the "science space" of geoscience expands to incorporate in-community work.

  6. Clinical analysis of pharyngeal musculature and genioglossus exercising to treat obstructive sleep apnea and hypopnea syndrome.

    Science.gov (United States)

    Tang, Shi-xiong; Qing, Jing; Wang, Yao-wen; Chai, Liang; Zhang, Wei-min; Ye, Xian-wang; Zhang, Jie; Huang, Yi-qin; Cheng, Peng

    2015-11-01

    To evaluate the effect of pharyngeal musculature and genioglossus exercising on obstructive sleep apnea and hypopnea syndrome (OSAHS). We conducted a non-randomized retrospective clinical trial of 75 patients with OSAHS. Fifty-four patients were managed by exercising of the pharyngeal musculature and genioglossus (exercising group). Twenty-one patients, who refused to undertake any treatment, were defined as the control group. We took the Epworth Sleepiness Scale (ESS), checked patients' polysomnography, and took 320-detector computed tomography (CT) before treatment. Six and twelve months later, we made records of apnea hypopnea index (AHI), lowest arterial oxygen saturation (LSaO2), body mass index (BMI), the shortest sagittal diameter, and transverse diameter, and the effective rates of exercising were calculated and compared with the 21 patients without any treatment (control group) at the same time. SPSS 10.0 was used to analyze the data. Before treatment, the ESS value was 7.67; 6 and 12 months later, the values were 3.54 and 3.25, respectively in the exercising group. AHI was decreased to 15.36 after 6 months and 13.79 after 12 months from 22.84 at the beginning. LSaO2 values were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. There were significant differences in ESS scores, AHI, and LSaO2 between pre-treatment and post-treatment in the exercising group (P0.05). At 12 months of exercising, the compliance of the anteroposterior pharyngeal wall of the retropalatal area was lower (P<0.01) than that before treatment. There was no significant change of BMI in either group. Exercising pharyngeal musculature and genioglossus is a kind of non-invasive and cost-effective method to treat some OSAHS patients, especially those who are old, without surgical complications, and especially mild and moderate OSAHS patients who do not want to take surgery and continuous positive airway pressure (CPAP) treatment. In addition, exercising

  7. CT demonstration of pharyngeal narrowing in adult obstructive sleep apnea

    Energy Technology Data Exchange (ETDEWEB)

    Bohlman, M.E. (Johns Hopkins Univ. School of Medicine, Baltimore, MD); Haponik, E.F.; Smith, P.L.; Allen, R.P.; Bleecker, E.R.; Goldman, S.M.

    1983-03-01

    Sleep apnea is a major cause of daytime hypersomnolence. Among the proposed etiologies, focal obstruction of the airways at the level of the pharynx has been suggested but not proven. Using computed tomography, the cross-sectional area of the airway can be readily assessed. Thirty-three adults with clinically proven sleep apnea and 12 normal adults underwent systematic computed tomography of the neck. Significant airway narrowing was demonstrated in all the patients with obstructive sleep apnea, whereas no such narrowing was seen in the controls. In 11, the narrowing was at a single level, whereas in 22 patients two or more levels were affected. This study has shown that a structurally abnormal airway may serve as an anatomic substrate for the development of sleep apnea. On the basis of this evidence, uvulopalatopharyngoplasty has been performed in two patients with relief of symptoms in one.

  8. CT demonstration of pharyngeal narrowing in adult obstructive sleep apnea

    International Nuclear Information System (INIS)

    Bohlman, M.E.; Haponik, E.F.; Smith, P.L.; Allen, R.P.; Bleecker, E.R.; Goldman, S.M.

    1983-01-01

    Sleep apnea is a major cause of daytime hypersomnolence. Among the proposed etiologies, focal obstruction of the airways at the level of the pharynx has been suggested but not proven. Using computed tomography, the cross-sectional area of the airway can be readily assessed. Thirty-three adults with clinically proven sleep apnea and 12 normal adults underwent systematic computed tomography of the neck. Significant airway narrowing was demonstrated in all the patients with obstructive sleep apnea, whereas no such narrowing was seen in the controls. In 11, the narrowing was at a single level, whereas in 22 patients two or more levels were affected. This study has shown that a structurally abnormal airway may serve as an anatomic substrate for the development of sleep apnea. On the basis of this evidence, uvulopalatopharyngoplasty has been performed in two patients with relief of symptoms in one

  9. Toward improving fine needle aspiration cytology by applying Raman microspectroscopy

    Science.gov (United States)

    Becker-Putsche, Melanie; Bocklitz, Thomas; Clement, Joachim; Rösch, Petra; Popp, Jürgen

    2013-04-01

    Medical diagnosis of biopsies performed by fine needle aspiration has to be very reliable. Therefore, pathologists/cytologists need additional biochemical information on single cancer cells for an accurate diagnosis. Accordingly, we applied three different classification models for discriminating various features of six breast cancer cell lines by analyzing Raman microspectroscopic data. The statistical evaluations are implemented by linear discriminant analysis (LDA) and support vector machines (SVM). For the first model, a total of 61,580 Raman spectra from 110 single cells are discriminated at the cell-line level with an accuracy of 99.52% using an SVM. The LDA classification based on Raman data achieved an accuracy of 94.04% by discriminating cell lines by their origin (solid tumor versus pleural effusion). In the third model, Raman cell spectra are classified by their cancer subtypes. LDA results show an accuracy of 97.45% and specificities of 97.78%, 99.11%, and 98.97% for the subtypes basal-like, HER2+/ER-, and luminal, respectively. These subtypes are confirmed by gene expression patterns, which are important prognostic features in diagnosis. This work shows the applicability of Raman spectroscopy and statistical data handling in analyzing cancer-relevant biochemical information for advanced medical diagnosis on the single-cell level.

  10. CT guided puncture aspiration and sclerosing treatment of ovary cyst

    International Nuclear Information System (INIS)

    Peng Yongjun; Du Xiumei; Yuan Jinrong; Chen Chanqing

    2007-01-01

    Objective: To analyze the method and the curative effect with CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst. Method: 22 ovary cysts in 22 patients were treated with percutaneous puncture aspiration and underwent repeated sclerotherapy with 99.7% ethanol injection. Among the 22 patients, 18 patients had solitary ovary cyst and was aspirated with an 18-22G gauge aspiration needle. The amount of aspirated fluid varied from 30ml-500ml and 25%-30% cyst volume was replaced by appropriate ethanol Post treatment follow-up were achieved every 3 months. Results All the Punctures were successfully completed. During the 3 months to one year follow-up, 16 ovary cyst disappeared, 6 cysts were small over 50%, without main complication. Conclusion CT guided percutaneous puncture aspiration and sclerosing treatment of ovary cyst is a treatment of choice because of its safety, low complication, and high curative effect. (authors)

  11. When Aspirations Exceed Expectations: Quixotic Hope Increases Depression among Students.

    Directory of Open Access Journals (Sweden)

    Katharine H Greenaway

    Full Text Available A paradox exists in modern schooling: students are simultaneously more positive about the future and more depressed than ever. We suggest that these two phenomena may be linked. Two studies demonstrated that students are more likely to be depressed when educational aspirations exceed expectations. In Study 1 (N = 85 aspiring to a thesis grade higher than one expected predicted greater depression at the beginning and end of the academic year. In Study 2 (N = 2820 aspiring to a level of education (e.g., attending college higher than one expected to achieve predicted greater depression cross-sectionally and five years later. In both cases the negative effects of aspiring high while expecting low persisted even after controlling for whether or not students achieved their educational aspirations. These findings highlight the danger of teaching students to aspire higher without also investing time and money to ensure that students can reasonably expect to achieve their educational goals.

  12. When Aspirations Exceed Expectations: Quixotic Hope Increases Depression among Students.

    Science.gov (United States)

    Greenaway, Katharine H; Frye, Margaret; Cruwys, Tegan

    2015-01-01

    A paradox exists in modern schooling: students are simultaneously more positive about the future and more depressed than ever. We suggest that these two phenomena may be linked. Two studies demonstrated that students are more likely to be depressed when educational aspirations exceed expectations. In Study 1 (N = 85) aspiring to a thesis grade higher than one expected predicted greater depression at the beginning and end of the academic year. In Study 2 (N = 2820) aspiring to a level of education (e.g., attending college) higher than one expected to achieve predicted greater depression cross-sectionally and five years later. In both cases the negative effects of aspiring high while expecting low persisted even after controlling for whether or not students achieved their educational aspirations. These findings highlight the danger of teaching students to aspire higher without also investing time and money to ensure that students can reasonably expect to achieve their educational goals.

  13. Aspirating and Nonaspirating Swallow Sounds in Children: A Pilot Study.

    Science.gov (United States)

    Frakking, Thuy; Chang, Anne; O'Grady, Kerry; David, Michael; Weir, Kelly

    2016-12-01

    Cervical auscultation (CA) may be used to complement feeding/swallowing evaluations when assessing for aspiration. There are no published pediatric studies that compare the properties of sounds between aspirating and nonaspirating swallows. To establish acoustic and perceptual profiles of aspirating and nonaspirating swallow sounds and determine if a difference exists between these 2 swallowing types. Aspiration sound clips were obtained from recordings using CA simultaneously undertaken with videofluoroscopic swallow study. Aspiration was determined using the Penetration-Aspiration Scale. The presence of perceptual swallow/breath parameters was rated by 2 speech pathologists who were blinded to the type of swallow. Acoustic data between groups were compared using Mann Whitney U-tests, while perceptual differences were determined by a test of 2 proportions. Combinations of perceptual parameters of 50 swallows (27 aspiration, 23 no aspiration) from 47 children (57% male) were statistically analyzed using area under a receiver operating characteristic (aROC), sensitivity, specificity, and positive and negative predictive values to determine predictors of aspirating swallows. The combination of post-swallow presence of wet breathing and wheeze and absence of GRS and normal breathing was the best predictor of aspiration (aROC = 0.82, 95% CI, 0.70-0.94). There were no significant differences between these 2 swallow types for peak frequency, duration, and peak amplitude. Our pilot study has shown that certain characteristics of swallow obtained using CA may be useful in the prediction of aspiration. However, further research comparing the acoustic swallowing sound profiles of normal children to children with dysphagia (who are aspirating) on a larger scale is required. © The Author(s) 2016.

  14. Gender and Leadership Aspiration: The Impact of the Organizational Environment

    OpenAIRE

    Fritz, Claudia

    2016-01-01

    markdownabstractSummary The aim of this dissertation is to examine gender differences in leadership aspiration. Although some important work regarding gender-specific aspiration has been done already, conditions fostering leadership aspiration – particularly among women – are not completely understood. Therefore, the focus of this dissertation is on assessing the potential impact of the organizational environment, including formal and informal elements, as well as relevant actors and their re...

  15. Risk Factors for Aspiration Pneumonia in Older Adults

    OpenAIRE

    Manabe, Toshie; Teramoto, Shinji; Tamiya, Nanako; Okochi, Jiro; Hizawa, Nobuyuki

    2015-01-01

    Backgrounds Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly. Methodology and Principal Findings We conducted an observational study using data from a nationwide survey of g...

  16. Three-dimensional evaluation of pharyngeal airway in individuals with varying growth patterns using cone beam computed tomography

    Directory of Open Access Journals (Sweden)

    Rohan Diwakar

    2015-01-01

    Full Text Available Introduction: The purpose of this study was to evaluate the pharyngeal airway volume in individuals with different vertical growth patterns. Methods: Cone beam computed tomography scans were evaluated of 40 subjects with the age range from 14 to 25 years and were divided into three groups. Horizontal growers consisted of 13 subjects, normal growers consisted of 14 subjects, and the vertical growers consisted of 13 subjects. The pharyngeal airway volume was measured using In Vivo Dental 5.1 software (Anatomage, Anatomy Imaging Software, San Jose, CA, USA. Results: The results obtained were analyzed statistically. The statistical test used for the analysis of the result was Student′s t-test. The independent t-test was done to compare the mean of the pharyngeal airway between the normal growers and horizontal growers and between the normal growers and the vertical growers. No statistically significant difference between the three groups was found in the volumetric measurements of the various sections of airway. Conclusions: Pharyngeal airway volume does not differ significantly in different vertical jaw relationships. It was possible to evaluate the pharyngeal airway volume three dimensionally.

  17. The effect of rapid maxillary expansion on pharyngeal airway pressure during inspiration evaluated using computational fluid dynamics.

    Science.gov (United States)

    Iwasaki, Tomonori; Takemoto, Yoshihiko; Inada, Emi; Sato, Hideo; Suga, Hokuto; Saitoh, Issei; Kakuno, Eriko; Kanomi, Ryuzo; Yamasaki, Youichi

    2014-08-01

    Recent evidence suggests that rapid maxillary expansion (RME) is an effective treatment of obstructive sleep apnea syndrome (OSAS) in children with maxillary constriction. Nonetheless, the effect of RME on pharyngeal airway pressure during inspiration is not clear. The purpose of this retrospective study was to evaluate changes induced by the RME in ventilation conditions using computational fluid dynamics. Twenty-five subjects (14 boys, 11 girls; mean age 9.7 years) who required RME had cone-beam computed tomography (CBCT) images taken before and after the RME. The CBCT data were used to reconstruct 3-dimensional shapes of nasal and pharyngeal airways. Measurement of airflow pressure was simulated using computational fluid dynamics for calculating nasal resistance during exhalation. This value was used to assess maximal negative pressure in the pharyngeal airway during inspiration. Nasal resistance after RME, 0.137 Pa/(cm(3)/s), was significantly lower than that before RME, 0.496 Pa/(cm(3)/s), and the maximal negative pressure in the pharyngeal airway during inspiration was smaller after RME (-48.66 Pa) than before (-124.96 Pa). Pharyngeal airway pressure during inspiration is decreased with the reduction of nasal resistance by the RME. This mechanism may contribute to the alleviation of OSAS in children. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Volumetric, planar, and linear analyses of pharyngeal airway change on computed tomography and cephalometry after mandibular setback surgery.

    Science.gov (United States)

    Park, Jae-Woo; Kim, Nam-Kug; Kim, Jong-Wan; Kim, Myung-Jin; Chang, Young-Il

    2010-09-01

    The purpose of this study was to use lateral cephalometry and computed tomography (CT) to examine the volumetric, planar, and linear changes in the pharyngeal airway after mandibular setback surgery. The pharyngeal airways of 12 subjects who underwent mandibular setback surgery at Seoul National University Dental Hospital were assessed linearly and volumetrically on lateral cephalometric radiographs and CT before surgery and 6 months after surgery. The pharynx, nasopharynx, and oropharynx were evaluated by volumetric analysis. Pharyngeal depth, airway space, pharyngeal soft-tissue thickness, and hyoid bone position were measured by linear analysis. The axial section area of the airway was measured by area analysis. From the linear analysis, a significant decrease in pharyngeal depth and a significant posterior movement of the hyoid bone (P 0.05). Although the structures around the mandible inevitably moved backward after mandibular setback surgery on linear analysis, physiologic deformation could occur to preserve the airway capacity after sagittal compression. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  19. Histone deacetylase 1 and 2 are essential for murine neural crest proliferation, pharyngeal arch development, and craniofacial morphogenesis.

    Science.gov (United States)

    Milstone, Zachary J; Lawson, Grace; Trivedi, Chinmay M

    2017-12-01

    Craniofacial anomalies involve defective pharyngeal arch development and neural crest function. Copy number variation at 1p35, containing histone deacetylase 1 (Hdac1), or 6q21-22, containing Hdac2, are implicated in patients with craniofacial defects, suggesting an important role in guiding neural crest development. However, the roles of Hdac1 and Hdac2 within neural crest cells remain unknown. The neural crest and its derivatives express both Hdac1 and Hdac2 during early murine development. Ablation of Hdac1 and Hdac2 within murine neural crest progenitor cells cause severe hemorrhage, atrophic pharyngeal arches, defective head morphogenesis, and complete embryonic lethality. Embryos lacking Hdac1 and Hdac2 in the neural crest exhibit decreased proliferation and increased apoptosis in both the neural tube and the first pharyngeal arch. Mechanistically, loss of Hdac1 and Hdac2 upregulates cyclin-dependent kinase inhibitors Cdkn1a, Cdkn1b, Cdkn1c, Cdkn2b, Cdkn2c, and Tp53 within the first pharyngeal arch. Our results show that Hdac1 and Hdac2 function redundantly within the neural crest to regulate proliferation and the development of the pharyngeal arches by means of repression of cyclin-dependent kinase inhibitors. Developmental Dynamics 246:1015-1026, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  20. Silent aspiration: results of 2,000 video fluoroscopic evaluations.

    Science.gov (United States)

    Garon, Bernard R; Sierzant, Tess; Ormiston, Charles

    2009-08-01

    The purpose of this retrospective study of aspiration and the lack of a protective cough reflex at the vocal folds (silent aspiration) was to increase the awareness of nursing staffs of the diagnostic pathology groups associated with silent aspiration. Of the 2,000 patients evaluated in this study, 51% aspirated on the video fluoroscopic evaluation. Of the patients who aspirated, 55% had no protective cough reflex (silent aspiration). The diagnostic pathology groups with the highest rates of silent aspiration were brain cancer, brainstem stroke, head-neck cancer, pneumonia, dementia/Alzheimer, chronic obstructive lung disease, seizures, myocardial infarcts, neurodegenerative pathologies, right hemisphere stroke, closed head injury, and left hemisphere stroke. It is of high concern that the diagnostic groups identified in this research as having the highest risk of silent aspiration be viewed as "red-flag" patients by the nursing staff caring for them. Early nursing dysphagia screens, with close attention to the clinical symptoms associated with silent aspiration, and early referral for formal dysphagia evaluation are stressed.

  1. Leukocytes Mediate Acid Aspiration Induced Multi-Organ Injury

    National Research Council Canada - National Science Library

    Goldman, Gideon

    1991-01-01

    .... This study investigates whether localized acid aspiration triggers both local and remote PMN sequestration and whether these cells are responsible for pulmonary edema and systemic organ injury...

  2. [Advantages and problems of traditional Chinese medicine in treatment of acute pharyngitis].

    Science.gov (United States)

    Zhang, Xia; Xie, Yan-Ming; Li, Guang-Xi; Gao, Yang; Zhao, Yuan-Chen; Tang, Jing-Jing; Yao, Xiao-Yan; Li, Meng

    2017-10-01

    This paper systematically studies relevant literatures at home and abroad in recent years. China National Knowledge Internet (CNKI) was used to collect the literatures for acute pharyngitis treated with traditional Chinese medicine from January 1, 2006, to December 31, 2016, and the bibliometric method was employed for statistical analysis. A total of 493 papers were preliminarily selected. According to the inclusion criteria and exclusion criteria, 182 eligible articles were selected. According to the evaluation and analysis of the literatures, the Guidelines for Clinical Research of New Drugs is currently used as the common standards for the diagnosis and treatment of acute pharyngitis; Chinese patent medicines are the main traditional Chinese medicine for treating this disease; Decoctions for treatment of this disease include Lonicerae Japonicae Flos, Scutellariae Radix, Platycodonis Radix, Forsythiae Fructus, Glycyrrhizae Radix et Rhizoma, Scrophdlariae Radix, Isatidis Radix, and Ophiopogonis Radix; The bloodletting puncture is the common external therapy. Traditional Chinese medicine and Western medicine have their own characteristics in the treatment of this disease. Western medicine for the treatment of acute pharyngitis are mainly antiviral, antibiotic and glucocorticoid drugs, whose disadvantages are toxicity, side effects, drug resistance and double infections. Traditional Chinese medicine doctors have rich experiences in the treatment of the disease, which is characterized by treatment determination based on syndrome differentiation, safe and reliable medication, significant curative effect, low drug resistance, and wide varieties of traditional Chinese medicine forms, convenient portability and taking, low price, and low toxic and side effects. It is an arduous and significant task to explore traditional Chinese medicine, and study and develop new-type effective drugs. Copyright© by the Chinese Pharmaceutical Association.

  3. Multilevel treatment of moderate and severe obstructive sleep apnea with bone-anchored pharyngeal suspension sutures.

    Science.gov (United States)

    Berg, Eric E; Bunge, Frederick; Delgaudio, John M

    2013-08-01

    Success rates for the surgical treatment of obstructive sleep apnea (OSA) vary, with phase I surgical success ranging from 40 to 75%. Pharyngeal suspension suture procedures are minimally invasive techniques with a reported efficacy of 20 to 78%. We conducted a study to evaluate the effectiveness of pharyngeal suspension suture procedures in conjunction with uvulopalatopharyngoplasty (UPPP) as a multilevel treatment for OSA. We retrospectively reviewed the charts of 30 adults-22 men and 8 women, with a mean age of 49 years and a mean BMI of 30.6-who were treated at a tertiary care academic medical center and a private otolaryngology practice. All patients had moderate or severe OSA, and all had failed continuous positive airway pressure therapy. Of this group, 20 patients underwent tongue base and hyoid suspension (TBHS) and 10 underwent tongue base suspension (TBS) alone; 23 patients had undergone concurrent or previous UPPP, 13 in the TBHS group and all 10 in the TBS group. Polysomnography was performed an average of 3.9 months postoperatively. Surgical success was defined as a reduction in respiratory distress index (RDI) of more than 50% and a postoperative RDI of 20 or less. The overall surgical success rate was 63% (19/30). In the surgical success group, the mean RDI fell from 44.6 to 9.4 (p breaks, and 1 dislodged screw. We conclude that pharyngeal suspension suture procedures as part of the multilevel treatment of moderate and severe OSA yields better outcomes than conventional surgical treatments with the added benefit of being minimally invasive.

  4. Molecular characterization of macrolide resistant Streptococcus pyogenes isolates from pharyngitis patients in Serbia.

    Science.gov (United States)

    Opavski, Natasa; Gajic, Ina; Borek, Anna L; Obszańska, Katarzyna; Stanojevic, Maja; Lazarevic, Ivana; Ranin, Lazar; Sitkiewicz, Izabela; Mijac, Vera

    2015-07-01

    A steady increase in macrolide resistance in Streptococcus pyogenes, group A streptococci (GAS) was reported in Serbia during 2004-2009 (9.9%). However, there are no data on the molecular epidemiology of pharyngeal macrolide resistance GAS (MRGAS) isolates. Therefore, the aims of this first nationwide study were to examine the prevalence of macrolide resistance in Serbian GAS and to determine their resistance phenotypes, genotypes and clonal relationships. Overall 3893 non-duplicate pharyngeal S. pyogenes isolates from outpatients with GAS infection were collected throughout country during 2008 and 2009. Among 486 macrolide resistant pharyngeal isolates collected, 103 were further characterized. Macrolide resistance phenotypes and genotypes were determined by double-disk diffusion test and PCR, respectively. Strain relatedness was determined by emm typing, multilocus sequence typing (MLST), multilocus variable tandem repeat analysis (MLVA), phage profiling (PP) and virulence factor profiling (VFP). Overall, macrolide resistance among GAS isolates in Serbia was 12.5%. M phenotype was the most common (71.8%), followed by iMLS (18.4%) and cMLS (9.7%). Three clonal complexes--emm75/mefA/ST49, emm12/mefA/ST36 and emm77/ermA/tetO/ST63 comprised over 90% of the tested strains. Although MLVA, PP and VFP distinguished 10, 20 and 12 different patterns, respectively, cluster analysis disclosed only small differences between strains which belonged to the same emm/ST type. Our data indicate dominance of three major internationally widely disseminated macrolide resistant clones and a high genetic homogeneity among the Serbian MRGAS population. Continued surveillance of macrolide resistance and clonal composition in MRGAS in Serbia in future is necessary to determine stability of MRGAS clones and to guide therapy strategies. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (pfapa) syndrome in children.

    Science.gov (United States)

    Semianchuk, Vira B

    Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome refers to a group of primary immunodeficiencies, namely autoinflammatory diseases. Most pediatricians and otolaryngologists do not suspect PFAPA syndrome when treating recurrent pharyngitis (according to Ukrainian classification - tonsillitis) and stomatitis. Therefore, patients with a given syndrome receive unnecessary treatment (antibiotic therapy or antiviral drugs) and the diagnosis is made late. The aim of the research was to provide pediatricians, family physicians and otolaryngologists with information on the importance of early diagnosis of PFAPA syndrome. The analysis of the prevalence and diagnosis of PFAPA syndrome in Ukraine and worldwide has been made as well as a late diagnosis of PFAPA syndrome in a child living in Ivano-Frankivsk, Ukraine has been described (case report). The Сase report 7-year-old boy, who grows and develops normally. The symptoms of pharyngitis including high body temperature (>40 º С), sore throat and white spots on the tonsils appeared for the first time at the age of two years. The boy received antibacterial drugs about 10 times a year. During a four-year period of recurrent episodes of the disease antimicrobial susceptibility testing to determine susceptibility of the oropharyngeal flora to the antibiotics were continuously performed, different blood tests for herpes viruses, Epstein-Barr virus infection and cytomegalovirus in particular were made using the enzyme immunoassay (EIA) and polymerase chain reaction (PCR) in addition to long-term treatment. An example of late diagnosing PFAPA syndrome (four years after the onset of first symptoms) resulting in regular examinations, medical manoeuvres, outpatient and inpatient treatment, use of antibiotic therapy including intravenous injections on a monthly basis has been studied.

  6. Management of Esophageal and Pharyngeal Perforation as Complications of Anterior Cervical Spine Surgery.

    Science.gov (United States)

    Kang, Moo Sung; Kim, Kyung Hyun; Park, Jeong Yoon; Kuh, Sung Uk; Chin, Dong Kyu; Jin, Byung Ho; Kim, Keun Su; Cho, Yong Eun

    2017-06-01

    To describe our experience in treating esophageal and pharyngeal perforation after anterior cervical spine surgery. Six patients with esophageal injury and one patient with pharyngeal injury after anterior cervical spinal surgery, managed at our department between 2000 and 2015, were analyzed retrospectively. During the study period, 7 patients (6 male and 1 female; mean age, 45 years) presented with esophageal perforation. The original anterior cervical spinal surgery was performed due to trauma in 2 patients and because of a degenerative cervical disorder in 5. Early esophageal perforation was diagnosed in 2 patients, and delayed esophageal injury due to chronic irritation with the cervical implants was noted in 5. Three of the five delayed perforation cases were related to cervical instrument displacement. Two patients showed no definite signs of infection, whereas 5 patients had various symptoms, including fever, neck pain, odynophagia, neck swelling, and upper extremity weakness. Two patients with a large defect underwent surgical repair and three with minimal perforation due to chronic irritation from the implants underwent instrument removal without direct repair of defect. Two asymptomatic patients received no intervention. Six patients with infection completely recovered from esophageal injury after treatment for a mean duration of 5.2 weeks (range, 4-8 weeks). One patient died because of postoperative pneumonia and sepsis after implant removal. Esophageal and pharyngeal injury after cervical spinal surgery may occur either directly due to spinal trauma and vigorous intraoperative retraction or due to chronic irritation with cervical implants. In cases of perforation associated with infection, various surgical modalities, including primary closure and reinforcement with a flap, could be considered depending on factors such as esophageal defect size, infection severity, and timing of recognition of injury. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Probiotic capsules and xylitol chewing gum to manage symptoms of pharyngitis: a randomized controlled factorial trial.

    Science.gov (United States)

    Little, Paul; Stuart, Beth; Wingrove, Zoe; Mullee, Mark; Thomas, Tammy; Johnson, Sophie; Leydon, Gerry; Richards-Hall, Samantha; Williamson, Ian; Yao, Lily; Zhu, Shihua; Moore, Michael

    2017-12-18

    Reducing the use of antibiotics for upper respiratory tract infections is needed to limit the global threat of antibiotic resistance. We estimated the effectiveness of probiotics and xylitol for the management of pharyngitis. In this parallel-group factorial randomized controlled trial, participants in primary care (aged 3 years or older) with pharyngitis underwent randomization by nurses who provided sequential intervention packs. Pack contents for 3 kinds of material and advice were previously determined by computer-generated random numbers: no chewing gum, xylitol-based chewing gum (15% xylitol; 5 pieces daily) and sorbitol gum (5 pieces daily). Half of each group were also randomly assigned to receive either probiotic capsules (containing 24 × 10 9 colony-forming units of lactobacilli and bifidobacteria) or placebo. The primary outcome was mean self-reported severity of sore throat and difficulty swallowing (scale 0-6) in the first 3 days. We used multiple imputation to avoid the assumption that data were missing completely at random. A total of 1009 individuals consented, 934 completed the baseline assessment, and 689 provided complete data for the primary outcome. Probiotics were not effective in reducing the severity of symptoms: mean severity scores 2.75 with no probiotic and 2.78 with probiotic (adjusted difference -0.001, 95% confidence interval [CI] -0.24 to 0.24). Chewing gum was also ineffective: mean severity scores 2.73 without gum, 2.72 with sorbitol gum (adjusted difference 0.07, 95% CI -0.23 to 0.37) and 2.73 with xylitol gum (adjusted difference 0.01, 95% CI -0.29 to 0.30). None of the secondary outcomes differed significantly between groups, and no harms were reported. Neither probiotics nor advice to chew xylitol-based chewing gum was effective for managing pharyngitis. Trial registration: ISRCTN, no. ISRCTN51472596. © 2017 Joule Inc. or its licensors.

  8. A Lateral Cephalometric Study of the Pharyngeal Growth in Korean Children

    International Nuclear Information System (INIS)

    Choi, Ki Chae; Lee, Sang Rae; Lee, Man Sup

    1990-01-01

    The aim of this study has been to investigate the growth of the pharynx and sexual differences in the lateral cephalograms of Korean children. The material includes 173 cepalograms from two groups composed of 51 males aged 12.0 years and 39 females aged 12.2 years in group 2, and 45 males aged 7.4 years and 39 females aged 7.5 year in group 1, respectively. In order to study and measure the pharyngeal area the following skeletal landmarks were selected: S, N, A, Ptm, B, H, H', M, S-N, FH and CV, and the angle CV-FH was measured to provide a factor for correction of error resulting from improper head positioning of subjects, especially in relative positions of A and H, while radiography. For each variable the statistically treated data have been presented in the table II, III, IV. The main results are presented as follows: 1. In general, the measurements of male were larger than those of female in antero-posterior dimension of pharyngeal cavity, but all variables did not show significant sexual differences in both groups when evaluated statistically. 2. All of the measurements were larger in male than in female in vertical dimensions of pharyngeal cavity in group 2, and there were statistical significances of sexual differences in the variables except M-H', but all variables did not show significant sexual differences in group 1 when evaluated statistically. 3. The dimensional increase of the pharynx by the growth in the vertical dimensions was shown to be greater than in the antero-posterior dimensions in the both sexes.

  9. Arterial baroreflex and peripheral chemoreflex function after radiotherapy for laryngeal or pharyngeal cancer

    International Nuclear Information System (INIS)

    Timmers, Henri J.L.M.; Karemaker, John M.; Wieling, Wouter; Kaanders, Johannes H.A.M.; Folgering, Hans Th.M.; Marres, Henri A.M.; Lenders, Jacques W.M.

    2002-01-01

    Purpose: Denervation of the carotid sinus causes baroreflex and chemoreflex failure, resulting in labile hypertension and loss of hypoxic responsiveness. We investigated whether radiation therapy for laryngeal or pharyngeal cancer affects baroreflex and chemoreflex function. Methods and Materials: Twelve patients were studied after radiation therapy for locally advanced laryngeal or pharyngeal cancer (11 male, 1 female, age: 56.0 ± 7.9 years), 3.3 years (median; range 1.0-4.7) after radiotherapy and 15 healthy controls (11 male, 4 female, 53.4 ± 9.2 years). We measured baroreflex sensitivity (phenylephrine), blood pressure level and variability (24-h Spacelabs and 5-h Portapres recordings), responses to cardiovascular reflex tests, and the ventilatory responses to normocapnic and hypercapnic hypoxia. Results: Baroreflex sensitivity was lower in patients (9.7 ± 7.8 ms/mm Hg) than in controls (17.5 ± 10.3 ms/mm Hg, p=0.011). Mean office blood pressure was significantly higher in patients (141.5 ± 27.8/89.2 ± 10.6 mm Hg, 63.3 ± 12.3 bpm) than in controls (117.3 ± 10.1/75.1 ± 6.8 mm Hg, 61.8 ± 10.8 bpm). Blood pressure variability was not different between groups, nor were the responses to reflex tests. The normo/hypercapnic ventilatory response to hypoxia was similar in patients (0.21 ± 0.10/1.37 ± 0.60 L/min/%) and controls (0.22 ± 0.16/1.19 ± 0.78 L/min/%). Conclusions: Radiation therapy for laryngeal or pharyngeal carcinoma does not affect chemoreflex function, but results in an attenuated baroreflex sensitivity. Clinically relevant blood pressure lability is absent however

  10. Antiseptic mouthwash against pharyngeal Neisseria gonorrhoeae: a randomised controlled trial and an in vitro study.

    Science.gov (United States)

    Chow, Eric Pf; Howden, Benjamin P; Walker, Sandra; Lee, David; Bradshaw, Catriona S; Chen, Marcus Y; Snow, Anthony; Cook, Stuart; Fehler, Glenda; Fairley, Christopher K

    2017-03-01

    Gonorrhoea is increasing among men who have sex with men (MSM). We aimed to determine whether Listerine, a commercial mouthwash product, has an inhibitory effect against Neisseria gonorrhoeae in a randomised controlled trial (RCT) and an in vitro study, and therefore may be a potentially useful agent for gonorrhoea control. In vitro: a suspension of ∼10 8 colony forming units per mL (CFU/mL) of N. gonorrhoeae was added to a serial of dilutions (up to 1:32) of alcohol-containing Listerine mouthwashes (Cool Mint and Total Care) for 1 min. A 10 µL aliquot was spread over the surface of a gonococcal agar plate and the number of N. gonorrhoeae colonies present at each dilution was calculated. The phosphate buffered saline (PBS) was used as a control. RCT: we recruited MSM with pharyngeal gonorrhoea who returned for treatment at the Melbourne Sexual Health Centre between May 2015 and February 2016. Untreated men were randomised to rinse and gargle either Listerine Cool Mint or saline for 1 min. Pharyngeal swabs were taken before and after rinsing and gargling for culture of N. gonorrhoeae . The analysis included only men who were culture positive for N. gonorrhoeae before using the allocated solution on the day of recruitment. In vitro: Listerine mouthwashes at dilutions of up to 1:4 for 1 min resulted in significant reduction of total N. gonorrhoeae counts but PBS has no inhibitory effect against N. gonorrhoeae . RCT: a total of 196 MSM were recruited, 58 (30%) were culture positive before using the solution. After gargling the allocated solution, men in the Listerine group were significantly less likely to be culture positive on the pharyngeal surface (52%) compared with men in the saline group (84%) (p=0.013). This data suggest Listerine, significantly reduces the amount of N. gonorrhoeae on the pharyngeal surface. With daily use it may increase gonococcal clearance and have important implications for prevention strategies. ACTRN12615000716561. Published by

  11. Total body irradiation for pediatric patients of hematological malignancies. Fraction and oral-pharyngeal mucosal reaction

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Tomoki; Kashiwado, Kozo; Ueno, Toshihiro; Nakashige, Aya; Toda, Hiroyuki; Mori, Masaki; Hamamoto, Kazuko [Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital (Japan)

    2001-03-01

    Twenty one pediatric patients of hematological malignancies received bone marrow transplantation (BMT) using total body irradiation (TBI). We discussed its acute toxicity. Especially in children, reduction of acute toxicity is important to keep the quality of treatment. Our routine TBI schedule was 12 Gy/4 frac.. But in one patient who recently treated by 13.6 Gy/8 frac., oral-pharyngeal mucosal reaction was apparently mild. So we changed the routine treatment schedule of TBI from 12 Gy/4 frac. to 12.6 Gy/6 frac.. (author)

  12. T-shaped Pectoralis Major Musculocutaneous Flap for Reconstruction of an Extensive Circumferential Pharyngeal Defect

    Directory of Open Access Journals (Sweden)

    Shimpei Miyamoto, MD

    2014-04-01

    Full Text Available Summary: In the era of free-flap transfer, the pectoralis major musculocutaneous flap still plays a unique role in head and neck reconstruction. We report on a patient with a recurrent hypopharyngeal carcinoma after total pharyngolaryngectomy and adjuvant chemoradiotherapy in whom defects included a circumferential defect of the oropharynx and the entire tongue. The defects were successfully reconstructed with a T-shaped pectoralis major musculocutaneous flap whose skin island included multiple intercostal perforators from the internal mammary vessels. This flap design is effective for reconstructing circumferential pharyngeal defects in vessel-depleted neck.

  13. Treatment of Streptococcal Pharyngitis. II. In vitro studies of antibacterial activity.

    Science.gov (United States)

    Marks, M I; Rabinovitch, M; MacKenzie, R; Brazeau, M

    1973-05-19

    One hundred and forty isolates of beta-hemolytic streptococcus cultured from patients with clinical pharyngitis were studied by disc diffusion for antibiotic sensitivity to lincomycin, erythromycin, cephalexin and penicillin and by agar dilution to cephalexin and penicillin. All isolates were sensitive to group A betahemolytic streptococcus was resistant to erythromycin by disc diffusion. When compared to Lancefield grouping 18% of strains were incorrectly identified as group A by the bacitracin-disc test. Cephalexin was uniformly effective in vitro in inhibiting beta-hemolytic streptococci and the 30 mug. cephalexin disc was reliable in predicting these sensitivities.

  14. Two cases of atopic cough successfully treated by oral cleansing with amphotericin B: Relationship with Basidiomycetes detected from pharyngeal swab

    Directory of Open Access Journals (Sweden)

    Haruhiko Ogawa

    2004-01-01

    Full Text Available We report herein two cases of atopic cough in which Basidiomycetes was detected from pharyngeal swabs and in which gargling with amphotericin B was efficacious. One case is a 38-year-old woman and the other is a 54-year-old woman. Both patients visited Ishikawa ken Saiseikai Kanazawa Hospital for the diagnosis and treatment of isolated severe non-productive cough. They did not have bronchial hyperresponsiveness to methacholine or heightened bronchomotor tone. Bronchodilator therapy was not effective for their coughing. Basidiomycetes was isolated from pharyngeal swabs in both cases. Oral cleansing with amphotericin B at 300 mg/day for approximately 2 weeks was effective in treating the severe coughs. This is the first report concerning the effectiveness of oral cleansing with amphotericin B for atopic cough, in which Basidiomycetes was detected from pharyngeal swabs.

  15. Access to Rehabilitation at Six Months Post Stroke: A Profile from the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) Study.

    Science.gov (United States)

    Hall, Patricia; Williams, David; Hickey, Anne; Brewer, Linda; Mellon, Lisa; Dolan, Eamon; Kelly, Peter J; Shelley, Emer; Horgan, N Frances

    2016-01-01

    Stroke is the third leading cause of death and disability. Few studies have assessed the profile and adequacy of access to rehabilitation services after ischaemic stroke both in the inpatient and community setting. The objectives of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) study were to assess the disability and rehabilitation profile, adherence with rehabilitation recommendations and needs of patients 6 months following hospital admission for stroke. A rehabilitation prescription was completed before hospital discharge for each participant, and adherence to this prescription was assessed at 6 months to determine whether patients received their recommended rehabilitation needs. Two hundred and fifty six patients were recruited to ASPIRE-S. The average age was 69 (SD 12.8). A majority (n = 221, 86%) were referred to the hospital multidisciplinary team, 59% (n = 132) were referred to all services (physiotherapy (PT), occupational therapy (OT), speech and language therapy (SLT)). Fifty-four percent (n = 119) of patients (seen by the multidisciplinary team) were referred for further rehabilitation in the community on discharge. Of these 119 patients, 112 (95%) recalled receiving community rehabilitation services. However, while most (68%) patients were referred for several disciplines (PT, OT, SLT), the most commonly recalled therapy (55%) was from a single discipline. The most commonly recommended frequency of therapy required was on a weekly basis. Sixty-one patients (51%) reported a delay in services, with some still awaiting services at 6 months. Results from this prospective study revealed that a significant number of patients (57%) did not receive the therapy recommended on discharge. Future initiatives should include the development of policies, which support more effective, equitable multidisciplinary rehabilitation for stroke patients in the community. © 2016 S. Karger AG, Basel.

  16. Inflammatory potential of diet and risk of oral and pharyngeal cancer in a large case-control study from Italy.

    Science.gov (United States)

    Shivappa, Nitin; Hébert, James R; Rosato, Valentina; Garavello, Werner; Serraino, Diego; La Vecchia, Carlo

    2017-08-01

    Diet and inflammation have been suggested to be important risk factors for oral and pharyngeal cancer. We examined the association between dietary inflammatory index (DII™) and oral and pharyngeal cancer in a large case-control study conducted between 1992 and 2009 in Italy. This study included 946 cases with incident, histologically confirmed oral and pharyngeal cancer, and 2,492 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a valid 78-item food frequency questionnaire and was adjusted for nonalcohol energy intake using the residual approach (E-DII™). Logistic regression models were used to estimate odds ratios (ORs), and 95% confidence intervals (CIs), adjusted for age, sex, non-alcohol energy intake, study center, year of interview, education, body mass index, tobacco smoking, and alcohol drinking. Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of oral and pharyngeal cancer, the OR being 1.80 (95% CI 1.36-2.38) for the highest versus the lowest DII quartile and 1.17 (95% CI 1.10-1.25) for a one-unit increase (8% of the DII range). When stratified by selected covariates, a stronger association was observed among women (OR quartile4 v.1 3.30, 95% CI 1.95-5.57). We also observed a stronger association for oral cancers and a strong combined effect of higher DII score and tobacco smoking or alcohol consumption on oral and pharyngeal cancer. These results indicate that the pro-inflammatory potential of the diet, as shown by higher DII scores, is associated with higher odds of oral and pharyngeal cancer. © 2017 UICC.

  17. The Effect of Pharyngeal Packing during Nasal Surgery on the Incidence of Post Operative Nausea, Vomiting, and Sore Throat

    Directory of Open Access Journals (Sweden)

    Ali Karbasfrushan

    2014-10-01

    Full Text Available Introduction: Nausea and vomiting after ear, nose and throat (ENT surgery is one of the most common and notable problems facing anesthesiologists in this area. This study was conducted to determine the effect of a pharyngeal pack on the severity of nausea, vomiting, and sore throat among patients after ear, pharynx, and throat surgeries.   Materials and Methods: This randomized clinical study was performed in 140 patients (61 men and 79 women; age range, 20–40 years who had undergone nasal surgery in 2010. Patients were divided into two groups: the first group were treated using a pharyngeal pack (case group and the second group were managed without a pharyngeal pack (control group. Statistical analysis was performed using the Chi-square test and the Mann-Whitney U test. SPSS software was used for data analysis.   Results: The mean severity of nausea and vomiting in the two groups was 2.057, 1.371 and 1.100, respectively, with no significant differences between groups. However, the mean severity of sore throat was 1.714 in the group with the pharyngeal pack and 1.385 in the group without pharyngeal pack (P=0.010.   Conclusion:  Not only does a pharyngeal pack in ENT surgery not reduce the extent and severity of nausea and vomiting, but it also increases the severity of sore throat in patients when leaving the recovery room and discharging hospital.

  18. Effect of palatal augmentation prosthesis on pharyngeal manometric pressure in a patient with functional dysphagia: A case report.

    Science.gov (United States)

    Ohno, Tomohisa; Ohno, Ryo; Fujishima, Ichiro

    2017-10-01

    A 53-year-old institutionalized male patient with a history of postoperative bilateral hypoglossal nerve injury was admitted for treatment of dysphagia. He experienced dysphagia involving oral cavity-to-pharynx bolus transportation because of restricted tongue movement and was treated with a palatal augmentation prosthesis (PAP), which resulted in improved bolus transportation, pharyngeal swallowing pressure, and clearance of oral and pharyngeal residue. The mean pharyngeal swallowing pressure at tongue base with the PAP (145.5±7.5mmHg) was significantly greater than that observed immediately after removal of the PAP (118.3±10.1mmHg; pDysphagia rehabilitation with the PAP was continued. Approximately 1 month after PAP application, the patient could orally consume three meals, with the exception of foods particularly difficult to swallow. The supporting contact between the tongue and palate enabled by the PAP resulted in improvement of bolus transportation, which is the most important effect of a PAP. The increase in pharyngeal swallowing pressure at the tongue base because of PAP-enabled tongue-palate contact might play an important role in this improvement. Since a PAP augments the volume of the palate, it enables easy contact between the tongue and palate, resulting in the formation of an anchor point for tongue movement during swallowing. Thus, application of a PAP increases the tongue force, especially that of the basal tongue. A palatal augmentation prosthesis helps improve pharyngeal swallowing pressure at the basal tongue region and might contribute to the decrease of oral as well as pharyngeal residue. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  19. Increase of Substance P Concentration in Saliva after Pharyngeal Electrical Stimulation in Severely Dysphagic Stroke Patients – an Indicator of Decannulation Success?

    Directory of Open Access Journals (Sweden)

    Paul Muhle

    2017-10-01

    Full Text Available Background/Aims: Substance P (SP is a neuropeptide, likely acting as a neurotransmitter in the pharyngeal mucosa enhancing the swallow and cough reflex. Pharyngeal Electrical Stimulation (PES induces a temporary increase of salivary SP levels in healthy adults. Previous evidence suggests that post-stroke dysphagia is related to reduced SP levels. Here, we investigated the effects of PES on SP levels in severely dysphagic stroke patients and a possible link between increase of SP and treatment success. Methods: 23 tracheotomized stroke patients who could not be decannulated due to severe and persisting dysphagia according to endoscopic evaluation received PES for 10 minutes a day over three consecutive days in this prospective single-center study. If initial treatment failed, repetitive stimulation cycles were provided. Saliva samples were collected before and directly after each PES. Results: 61% of participants were decannulated after the first treatment cycle. Increase of SP levels post-stimulation was closely related to treatment success, i.e. decannulation with 79% of successfully treated patients showing increase of SP, whereas 89% of unsuccessfully treated patients had stable or decreased SP levels. Applying logistic regression analysis, increase of SP level remained the only independent predictor of decannulation after PES. All 3 repetitively treated patients showed increased SP levels when progressing from the 1st to the 2nd cycle, two of whom were decannulated hereafter. Conclusions: The physiological mechanism of PES may consist in restoration of sensory feedback, which is known to be crucial for the execution of a safe swallow. SP possibly acts as a biomarker for indicating response to PES.

  20. The Effect of Rapid Antigen Detection Test on Antibiotic Prescription Decision of Clinicians and Reducing Antibiotic Costs in Children with Acute Pharyngitis.

    Science.gov (United States)

    Kose, Engin; Sirin Kose, Seda; Akca, Deniz; Yildiz, Kerem; Elmas, Cengizhan; Baris, Mustafa; Anil, Murat

    2016-08-01

    We aimed to investigate the effect of rapid antigen detection test (RADT) in the diagnosis of streptococcal pharyngitis, its impact on antibiotic prescription decision of pediatricians and influence on reduction of antibiotic treatment costs in children with pharyngitis. The study group consisted of 223 patients who were diagnosed with pharyngitis by pediatricians. The sensitivity and specificity of RADT were 92.1% (95% Cl: 78.6-98.3%) and 97.3% (95% Cl: 93.8-99.1%), respectively. In the first assessment, before performing RADT, pediatricians decided to prescribe antibiotics for 178 (79.8%) patients with pharyngitis. After learning RADT results, pediatricians finally decided to prescribe antibiotics for 83 (37.2%) patients with pharyngitis, and antibiotic prescription decreased by 42.6%. Antibiotic costs in non-Group A streptococcus pharyngitis, Group A streptococcus pharyngitis and all subjects groups decreased by 80.8%, 48%, and 76.4%, respectively. Performing RADT in children with pharyngitis has an important impact on treatment decision of clinicians, reduction of unnecessary antibiotic prescriptions and antibiotic costs. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Study of Educational Aspirations of Preparatory School Students in Yemen.

    Science.gov (United States)

    Edington, Everett D.

    To identify causes for low enrollment in secondary agricultural schools in Yemen, the United States Agency for International Development and the Yemen Ministry of Education surveyed 990 preparatory (junior high) students, examining their educational aspirations, differences between rural and urban youth, major influences on student aspirations,…

  2. Aspirations and occupational achievements of Dutch fathers and mothers

    NARCIS (Netherlands)

    Horst, M.F.J. van der; Lippe, A.G. van der; Kluwer, E.S.

    2014-01-01

    Purpose: The purpose of this paper is to investigate how work and family aspirations relate to occupational achievements and gender differences herein. Design/methodology/approach: Using data from 2009 the authors examined the relationship between career and childrearing aspirations and occupational

  3. Relationships of Teenage Smoking to Educational Aspirations and Parents' Education.

    Science.gov (United States)

    Waldron, Ingrid; Lye, Diane

    Past research has shown that teenagers with less educated parents and teenagers with lower academic aspirations are more likely than their peers to smoke. This study was conducted to provide additional descriptive data concerning the relationships of smoking to parents' education and students' educational aspirations and to provide preliminary…

  4. Total bilirubin in nasogastric aspirates: A potential new indicator of ...

    African Journals Online (AJOL)

    Background: The aim of our study was to investigate if total bilirubin (T-bil), amylase (Amy), and sodium (Na) in nasogastric (NG) aspirates can refl ect gastrointestinal motility reliably. Materials and Methods: NG aspirates from all laparotomies lasting more than 150 min in children less than 12 months old were studied for 3 ...

  5. Diagnosis Of Thyroid Enlargement: Use Of Fine Needle Aspiration ...

    African Journals Online (AJOL)

    One hundred and ten Fine Needle Aspiration Biopsies (FNAC) obtained from 87 patients with thyroid enlargement or nodules were retrospectively reviewed. Aspiration biopsy was accomplished using 21-gauge needle attached with 20-ml plastic syringe. There were 14 males and 73 females involved in the study. Sixty- four ...

  6. Rural Aspirations, Rural Futures: From "Problem" to Possibility

    Science.gov (United States)

    Tieken, Mara Casey; San Antonio, Donna M.

    2016-01-01

    Young people aspire, make choices, and develop within a particular place and historical context. Recently, federal and state governments, policy and research institutes, and advocacy organizations have shown a growing interest in the aspirations and transitions of rural youth--and, in particular, the role that schools play in shaping and…

  7. The role of information and aspiration in bargaining behaviour ...

    African Journals Online (AJOL)

    The dependent variable was bargaining behavior and was considered as aspiration, opening bids and bargaining outcomes. Data obtained revealed that participants with incomplete information had higher aspiration level and higher opening bid than those with complete information. Those with complete information and ...

  8. 21 CFR 886.4150 - Vitreous aspiration and cutting instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vitreous aspiration and cutting instrument. 886.4150 Section 886.4150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... cutting instrument. (a) Identification. A vitreous aspiration and cutting instrument is an electrically...

  9. Cold Antimatter Plasmas, and Aspirations for Cold Antihydrogen

    Science.gov (United States)

    2002-06-24

    UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADP012494 TITLE: Cold Antimatter Plasmas, and Aspirations for Cold...part numbers comprise the compilation report: ADP012489 thru ADP012577 UNCLASSIFIED Cold Antimatter Plasmas, and Aspirations for Cold Antihydrogen G...and positrons. The antiprotons come initially from the new Antiproton Decel- erator facility at CERN. Good control of such cold antimatter plasmas is

  10. Discordance Rate between Thyroid Fine Needle Aspiration Cytology ...

    African Journals Online (AJOL)

    Discordance Rate between Thyroid Fine Needle Aspiration Cytology and Histopathologic Diagnosis. Wondwossen Ergete, Daniel Abebe. Abstract. Fine Needle Aspiration (FNA) of the thyroid is a low cost procedure, which can give an accurate diagnosis promptly. The objective of this study was to assess the diagnostic ...

  11. Aspiration Pneumonia in Acute Stroke | SALAMI | Sahel Medical ...

    African Journals Online (AJOL)

    Abstract. This was a prospective study that was conducted between July 2000 and September 2001. It was designed to determine the incidence and the risk factor(s) of aspiration pneumonia in patients with acute cerebrovascular accident. Aspiration pneumonia was recorded in 23.5% of the 68 patients that were recruited.

  12. Aspirations and occupational achievements of Dutch fathers and mothers

    NARCIS (Netherlands)

    van der Horst, Mariska; van der Lippe, Tanja; Kluwer, Esther

    2014-01-01

    Purpose – The purpose of this paper is to investigate how work and family aspirations relate to occupational achievements and gender differences herein. Design/methodology/approach – Using data from 2009 the authors examined the relationship between career and childrearing aspirations and

  13. TABU SEARCH WITH ASPIRATION CRITERION FOR THE TIMETABLING PROBLEM

    Directory of Open Access Journals (Sweden)

    Oscar Chávez-Bosquez

    2015-01-01

    Full Text Available The aspiration criterion is an imperative element in the Tabu Search, with aspiration-by-default and the aspiration-by-objective the mainly used criteria in the literature. In this paper a new aspiration criterion is proposed in order to implement a probabilistic function when evaluating an element classified as tabu which improves the current solution, the proposal is called Tabu Search with Probabilistic Aspiration Criterion (BT- CAP. The test case used to evaluate the performance of the Probabilistic Aspiration Criterion proposed consists on the 20 instances of the problem described in the First International Timetabling Competition. The results are compared with 2 additional variants of the Tabu Search Algorithm: Tabu Search with Default Aspiration Criterion (BT-CAD and Tabu Search with Objective Aspiration Criterion (BT-CAO. Wilcoxon test was applied to the generated results, and it was proved with 99 % confidence that BT-CAP algorithm gets better solutions than the two other variants of the Tabu Search algorithm.

  14. Pharyngeal fibromatosis presenting as adenoid hypertrophy: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Segun Segun-Busari

    2013-01-01

    Full Text Available A 10-year-old girl presented with a noisy breathing noticed from birth and failure to thrive. Examination revealed a huge lobulated firm mass in the oropharynx (toward the left side. Plain radiography of the neck showed a huge circumscribed pharyngeal mass extending from the base of the tongue to the level of the fourth cervical vertebrae. The mass measuring 6 cm Χ 5 cm was excised through a left lateral pharyngotomy. Histological examination showed sections of highly cellular interlacing bundles of fibroblast with moderate hyalinization extending to the surrounding fibro-fatty tissue. The cells have spindle nuclei with tapering ends. Occasional mitosis and in some areas myxoid degeneration were seen. A diagnosis of pharyngeal fibroma was made. Patient had an uneventful post-operative recovery with complete resolution of symptoms for the past 6 years. This rare benign tumor has not previously been reported at this site and may thus give rise to difficulty in diagnosis or to a misdiagnosis.

  15. Counseling a Patient with the Antenatal Diagnosis of a Cerebellar Abnormality and a Pharyngeal Cyst

    Directory of Open Access Journals (Sweden)

    Lissa Francois

    2014-11-01

    Full Text Available Introduction - Prenatal counseling with regards to the prognosis of a cerebellar abnormality is hindered not only by the diverse clinical presentations but also by the presence of subtle findings. We present a case of a distinct combination of asymmetric cerebellar hypoplasia secondary to an anterior meningoencephalocele through a clival defect that caused a severe airway obstruction in the newborn. Case Description - A 21-year-old gravida 4 para 0 mother with a dichorionic–diamniotic twin pregnancy was referred for a second trimester sonographic survey. An asymmetric cerebellar hypoplasia, mega cisterna magna, and a pharyngeal cystic mass were noted on twin A. Magnetic resonance imaging report confirmed posterior fossa abnormalities and shed no light on the differential diagnosis of the cystic mass. The pregnancy ended by Cesarean delivery at 32 weeksʼ gestation after a preterm premature rupture of the membranes. Twin A had a severe airway obstruction. Postnatal evaluation confirmed a midline anterior meningoencephalocele through a defect in the clivus. The microarray chromosomal analysis demonstrated a 5q15 variant with uncertain clinical significance. Conclusion - Antenatal recognition of the unique combination of a cerebellar hypoplasia with a pharyngeal cyst can impact the prenatal counseling as well as neonatal management.

  16. Pharyngeal electrical stimulation device for the treatment of neurogenic dysphagia: technology update

    Directory of Open Access Journals (Sweden)

    Restivo DA

    2018-01-01

    Full Text Available Domenico A Restivo,1 Shaheen Hamdy2 1Neurological Unit, Garibaldi Hospital, Catania, Italy; 2School of Translational Medicine—Inflammation Sciences, Faculty of Medical and Human Sciences, University of Manchester, Salford Royal Hospital, Salford, UK Abstract: Neurogenic dysphagia (ND can occur in patients with nervous system diseases of varying etiologies. Moreover, recovery from ND is not guaranteed. The therapeutic approaches for oropharyngeal ND have drastically changed over the last decade, mainly due to a better knowledge of the neurophysiology of swallowing along with the progress of neuroimaging and neurophysiological studies. For this reason, it is a priority to develop a treatment that is repeatable, safe, and can be carried out at the bedside as well as for outpatients. Pharyngeal electrical stimulation (PES is a novel rehabilitation treatment for ND. PES is carried out via location-specific intraluminal catheters that are introduced transnasally and enable clinicians to stimulate the pharynx directly. This technique has demonstrated increasingly promising evidence in improving swallowing performance in patients with ND associated with stroke and multiple sclerosis, probably by increasing the corticobulbar excitability and inducing cortical reorganization of swallowing motor cortex. In this article, we update the reader as to both the physiologic background and past and current studies of PES in an effort to highlight the clinical progress of this important technique. Keywords: pharyngeal electrical stimulation, swallowing, neurogenic dysphagia, swallowing motor cortex, pharynx, catheter

  17. Characterization of corticobulbar pharyngeal neurophysiology in dysphagic patients with Parkinson's disease.

    Science.gov (United States)

    Michou, Emilia; Hamdy, Shaheen; Harris, Mary; Vania, Adil; Dick, Jeremy; Kellett, Mark; Rothwell, John

    2014-12-01

    Dysphagia in patients with Parkinson's disease, persisting despite dopaminergic treatment, affects intake of nutrients and medication, and reduces quality of life (QOL). We investigated the neurophysiologic mechanisms that contribute to dysphagia in these patients, on and off L-3,4-dihydroxyphenylalanine (levodopa), using transcranial magnetic stimulation. We studied 26 patients with Parkinson's disease (age, 65 ± 9 y; 10 men). Dysphagia and QOL were first assessed with qualitative questionnaires. Twelve hours after patients were taken off levodopa, they underwent cortical transcranial magnetic stimulation mapping of the pharyngeal musculature and trigeminal (bulbar) transcranial magnetic stimulation, as well as videofluoroscopy to examine swallowing. The analyses were repeated after administration of levodopa. Eleven patients initially reported dysphagia and reduced QOL scores. Videofluoroscopy identified 10 patients with swallowing impairments on and off levodopa, and 6 patients with swallowing impairments only on levodopa; the remaining 10 subjects showed no swallowing impairments, on or off the drug. While patients were on levodopa, those with swallowing impairments had bilateral increases in pharyngeal cortical excitability compared with those with no swallowing impairment (P Parkinson's disease, dopaminergic medications such as levodopa can negatively affect swallowing. The increased cortical excitability observed in dysphagic patients after they begin taking levodopa likely results from compensatory mechanisms, perhaps secondary to subcortical disease, because we observed associated inhibition of brainstem reflexes in patients with affected swallowing on medication. UK clinical trials registration no., 9882. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. Thyroid fine needle aspiration biopsy: Do we really need an on-site cytopathologist?

    Energy Technology Data Exchange (ETDEWEB)

    Cengic, Ismet, E-mail: ismetcengic@yahoo.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Tureli, Derya, E-mail: deryatureli@yahoo.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Ahiskali, Rengin, E-mail: renginiara@gmail.com [Department of Pathology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Bugdayci, Onur, E-mail: onurbug@hotmail.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Aydin, Hilal, E-mail: hilalaltasaydin@gmail.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Aribal, Erkin, E-mail: earibal@gmail.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey)

    2014-04-15

    Purpose: The aim of this single center study is to evaluate the effectiveness of performing ultrasound-guided thyroid fine-needle aspiration biopsies (FNAB) performed by the radiologist alone without an on-site cytopathologist. Materials and methods: In this prospective randomized study, 203 patients with single nodules measuring 10 mm or more underwent ultrasound-guided FNAB: 102 patients underwent FNAB performed by the radiologist accompanied by a cytopathologist (control group); 101 patients underwent FNAB by the radiologist alone (study group). In both groups biopsy time, specimen adequacy ratio, total aspiration number, cytopathologist's cytological diagnosis time (t1), cytopathologist's total time consumption (t2) were evaluated. Results: Mean total biopsy time was 8.74 ± 2.31 min in the study group and was significantly shorter than the control group's 11.97 ± 6.75 min (p = 0.004). The average number of aspirations per patient in the study group was 4.00 ± 0; compared to the control group's 3.56 ± 1.23 this was significantly higher (p = 0.001). t1 of the study group was 307.48 ± 226.32 s; compared to 350.14 ± 247.64 s in the control group, there was no statistically significant difference (p = 0.137). t2 of the study group was 672.93 ± 270.45 s; compared to the control group (707.03 ± 258.78 s) there was no statistically significant difference (p = 0.360). Diagnostic adequacy of aspirated specimens was reassessed in the pathology laboratory. In the study group, 84 out of 101 aspirations and in the control group 89 out of 102 aspirations was determined as adequate with no statistically significant difference (p = 0.302). Conclusions: We believe that in centers where a cytopathologist is not available, ultrasound-guided thyroid FNAB can be adequately performed by an experienced radiologist who was effectively trained in smear preparation.

  19. Recurrent Aspiration Pneumonia due to Anterior Cervical Osteophyte

    Directory of Open Access Journals (Sweden)

    Jae Jun Lee

    2017-02-01

    Full Text Available A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.

  20. Aspiration lung disorders in bovines: A case report and review

    Directory of Open Access Journals (Sweden)

    Anthony S. Shakespeare

    2012-04-01

    Full Text Available Lung aspiration disorders in bovines are invariably diagnosed as infectious aspiration pneumonias. There is a distinct differentiation between aspiration pneumonia and aspiration pneumonitis in humans that can be applied to bovines. The nature and quantity of the aspirate can result in differing pathogeneses which can require differing therapeutic approaches. Whilst blood gases were important in detecting and prognosticating lung problems, changes in barometric pressure with altitude have to be considered when interpreting partial pressures of oxygen. Anatomical differences in the lungs of bovines can explain why this species is more prone to certain pneumonic problems. Pulmonary physiotherapy is important in treating lung disorders in humans and should be considered as an adjunct therapy in bovine respiratory conditions. A case work-up was used to highlight some of the points discussed in this article.

  1. The Astrophysics Project Integrating Research and Education (ASPIRE)

    Science.gov (United States)

    Callahan, J.

    The Astrophysics Science Project Integrating Research and Education (ASPIRE) is funded by the National Science Foundation as the public education and outreach (EPO) component the High Resolution Fly's Eye Cosmic Ray Research Group. Since 1997, ASPIRE has been creating some of the most engaging and interactive science lessons and lab activities on the World Wide Web. In this poster, we will present an overview of the ASPIRE project, and report on the the most recent usage statistics. In addition to creating and maintaining lessons and the website, ASPIRE provides direct outreach to local teachers and students. These contacts include, in particular, local groups that are under-represented in the scientific and technical fields. Continuing as the EPO arm of the new Telescope Array (TA/TALE) project, ASPIRE will also be conducting summer workshops for students and teachers in Millard County, where the new experiment is under construction.

  2. The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke

    Directory of Open Access Journals (Sweden)

    Paula Cristina Cola

    2010-03-01

    Full Text Available CONTEXT: The effect of sour taste and food temperature variations in dysphagic patients has not been entirely clarified. OBJECTIVE: To determine the effect of sour and cold food in the pharyngeal transit times of patients with stroke. METHODS: Patients participating in this study were 30 right-handed adults, 16 of which were male and 14 were female, aged 41 to 88 (average age 62.3 years with ictus varying from 1 to 30 days (median of 6 days. To analyze the pharyngeal transit time a videofluoroscopy swallow test was performed. Each patient was observed during swallow of a 5 mL paste bolus given by spoon, totaling four different stimuli (natural, cold, sour and cold sour, one at a time, room temperature (22ºC and cold (8ºC were used. Later, the tests were analyzed using specific software to measure bolus transit time during the pharyngeal phase. RESULTS: The results showed that the pharyngeal transit time was significantly shorter during swallow of cold sour bolus when compared with other stimuli. Conclusion - Sour taste stimuli associated to cold temperature cause significant change in swallowing patterns, by shortening the pharyngeal transit time, which may lead to positive effects in patients with oropharyngeal dysphagia.CONTEXTO: O efeito do sabor azedo e as variações da temperatura dos alimentos em indivíduos disfágicos, ainda não foi totalmente esclarecidos. OBJETIVO: Verificar o efeito do sabor azedo e da temperatura fria no tempo de trânsito faríngeo da deglutição em indivíduos após acidente vascular encefálico hemisférico isquêmico. MÉTODOS: Participaram deste estudo 30 indivíduos adultos, sendo 16 do gênero masculino e 14 do feminino, destros, com faixa etária variando de 41 a 88 anos (média de 62,3 anos e ictus que variou de 1 a 30 dias (mediana de 6 dias. Para analisar o tempo de trânsito faríngeo da deglutição foi realizado o exame de videofluoroscopia da deglutição. Cada indivíduo foi observado durante a

  3. The Potential Scientist’s Dilemma: How the Masculine Framing of Science Shapes Friendships and Science Job Aspirations

    Directory of Open Access Journals (Sweden)

    G. Robin Gauthier

    2017-02-01

    Full Text Available In the United States, girls and boys have similar science achievement, yet fewer girls aspire to science careers than boys. This paradox emerges in middle school, when peers begin to play a stronger role in shaping adolescent identities. We use complete network data from a single middle school and theories of gender, identity, and social distance to explore how friendship patterns might influence this gender and science paradox. Three patterns highlight the social dimensions of gendered science persistence: (1 boys and girls do not differ in self-perceived science potential and science career aspirations; (2 consistent with gender-based norms, both middle school boys and girls report that the majority of their female friends are not science kinds of people; and (3 youth with gender-inconsistent science aspirations are more likely to be friends with each other than youth with gender normative science aspirations. Together, this evidence suggests that friendship dynamics contribute to gendered patterns in science career aspirations.

  4. Destroyed lung due to aspiration of phenolphthalein.

    Science.gov (United States)

    De Wulf, M; Ceuppens, H; Gheysens, B; Inderadjaja, N

    2005-01-01

    A 76-year-old female, presented with a recurrent cough and haemoptysis after an aspiration of a 'grain de Valls'. Chest radiography and computed tomography demonstrated an atelectasis of the medial segment of the right middle pulmonary lobe. Bronchoscopy was negative for any malignancy but the onco-PET-scan showed a pathologic hypermetabolic lesion in the right middle lobe. A lobectomy was performed and pathology revealed a 'destroyed lung' with images of foreign body reactions and microabscesses without any sign of malignancy. Postoperatively, clinical improvement with complete resolution of the symptoms was observed. With this case report we demonstrate the irritative and clastogenic characteristics of phenolphtalein, the main active ingredient of the 'grain de Valls'. This case also illustrates an example of a false positive PET-scan.

  5. Transbronchial needle aspiration "by the books"

    Directory of Open Access Journals (Sweden)

    Kupeli Elif

    2011-01-01

    Full Text Available Background : Training for advanced bronchoscopic procedures is acquired during the interventional pulmonology (IP Fellowship. Unfortunately a number of such programs are small, limiting dissemination of formal training. Objective : We studied success of conventional transbronchial needle aspiration (C-TBNA in the hands of physicians without formal IP training. Methods : A technique of C-TBNA was learned solely from the literature, videos and practicing on inanimate models at "Hands-On" courses. Conventional TBNA with 21 and/or 19 gauge Smooth Shot Needles (Olympus® , Japan was performed on consecutive patients with undiagnosed mediastinal lymphadenopathy. Results : Thirty-four patients (male 23, mean age 54.9 ± 11.8 years underwent C-TBNA. Twenty-two patients had nodes larger than 20 mms. Suspected diagnoses were malignancy in 20 and nonmalignant conditions in 14. Final diagnoses were malignancy 17, sarcoidosis 4, reactive lymph nodes 12, and tuberculosis 1. Final diagnosis was established by C-TBNA in 14 (11 malignancy, 3 sarcoidosis; yield 41.1%, mediastinoscopy in 14, transthoracic needle aspiration in 3, peripheral lymph node biopsies in 2 and by endobronchial biopsy in 1. Nodal size had an impact on outcome (P = 0.000 while location did not (P = 0.33. C-TBNA was positive in 11/20 when malignancy was suspected (yield 55%, while 3/14 when benign diagnosis was suspected (yield 21.4% (P = 0.05. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 66.6%, 100%, 100%, 65%, and 79.4%, respectively. There were no complications or scope damage. Conclusion : Conventional-TBNA can be learned by the books and by practicing on inanimate models without formal training and results similar to those published in the literature could be achieved.

  6. Aspiration Risk and Respiratory Complications in Patients with Esophageal Atresia.

    Science.gov (United States)

    Kovesi, Thomas

    2017-01-01

    Chronic, long-term respiratory morbidity (CRM) is common in patients with a history of repaired congenital esophageal atresia, typically associated with tracheoesophageal fistula (EA/TEF). EA/TEF patients are at high risk of having aspiration, and retrospective studies have associated CRM with both recurrent aspiration and atopy. However, studies evaluating the association between CRM in this population and either aspiration or atopy have reported conflicting results. Furthermore, CRM in this population may be due to other related conditions as well, such as tracheomalacia and/or recurrent infections. Aspiration is difficult to confirm, short of lung biopsy. Moreover, even within the largest evidence base assessing the association between CRM and aspiration, which has evaluated the potential relationship between gastroesophageal reflux and asthma, findings are contradictory. Studies attempting to relate CRM to prior aspiration events may inadequately estimate the frequency and severity of previous aspiration episodes. There is convincing evidence documenting that chronic, massive aspiration in patients with repaired EA/TEF is associated with the development of bronchiectasis. While chronic aspiration is likely associated with other CRM in patients with repaired EA/TEF, this does not appear to have been confirmed by the data currently available. Prospective studies that systematically evaluate aspiration risk and allergic disease in patients with repaired EA/TEF and document subsequent CRM will be needed to clarify the causes of CRM in this population. Given the prevalence of CRM, patients with repaired EA/TEF should ideally receive regular follow-up by multidisciplinary teams with expertise in this condition, throughout both childhood and adulthood.

  7. Risk Factors for Aspiration Pneumonia in Older Adults.

    Science.gov (United States)

    Manabe, Toshie; Teramoto, Shinji; Tamiya, Nanako; Okochi, Jiro; Hizawa, Nobuyuki

    2015-01-01

    Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly. We conducted an observational study using data from a nationwide survey of geriatric medical and nursing center in Japan. The study subjects included 9930 patients (median age: 86 years, women: 76%) who were divided into two groups: those who had experienced an episode of aspiration pneumonia in the previous 3 months and those who had not. Data on demographics, clinical status, activities of daily living (ADL), and major illnesses were compared between subjects with and without aspiration pneumonia. Two hundred and fifty-nine subjects (2.6% of the total sample) were in the aspiration pneumonia group. In the univariate analysis, older age was not found to be a risk factor for aspiration pneumonia, but the following were: sputum suctioning (odds ratio [OR] = 17.25, 95% confidence interval [CI]: 13.16-22.62, p risk factors associated with aspiration pneumonia after propensity-adjustment (258 subjects each) were sputum suctioning (OR = 3.276, 95% CI: 1.910-5.619), deterioration of swallowing function in the past 3 months (OR = 3.584, 95% CI: 1.948-6.952), dehydration (OR = 8.019, 95% CI: 2.720-23.643), and dementia (OR = 1.618, 95% CI: 1.031-2.539). The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia. These results could help improve clinical management for preventing repetitive aspiration pneumonia.

  8. Pre-hospital aspiration is associated with increased pulmonary complications.

    Science.gov (United States)

    Fawcett, Vanessa J; Warner, Keir J; Cuschieri, Joseph; Copass, Michael; Grabinsky, Andreas; Kwok, Heemun; Rea, Thomas; Evans, Heather L

    2015-04-01

    Rates of ventilator-associated pneumonia (VAP) are highest among patients intubated on an emergency basis following trauma. We reported previously a retrospective analysis demonstrating an association between subjective aspiration and VAP after pre-hospital intubation. We hypothesize that by directing paramedics to note features of aspiration at intubation, we will confirm prospectively the association between pre-hospital aspiration and subsequent pneumonia in trauma patients. Paramedics collected data regarding aspiration at the time of intubation. All intubated patients admitted to a level 1 trauma center intensive care unit (ICU) were included. Data comprised a clinical impression of pre-hospital aspiration, as well as the presence and timing of blood and emesis in the airway. Injury severity, co-morbidities, and outcomes were collected from the trauma registry. Healthcare-associated pneumonia (HAP) was identified by medical record review of both bronchoalveolar lavage culture results and discharge diagnosis. Descriptive statistics and univariate analysis of outcomes by aspiration status, as well as covariable adjustment using propensity scores, were performed. Of the 228 patients, 89 (39%) were determined by paramedics to have aspirated. The majority of those who aspirated (84 [94%]) did so prior to intubation. Patients who aspirated had higher Injury Severity Scores than those who did not aspirate (25.0 ± 1.7 vs. 21.9 ± 1.5 points; p=0.04) and lower preintubation Glasgow Coma Scale scores (8.2 ± 0.50 vs. 9.6 ± 0.40; p=0.02). Of the 89 patients who aspirated around the time of intubation, 14 (16%) developed HAP vs. five (3.6%) of those who did not aspirate (paspiration (deaths: 21 [23.6%] vs. 23 [16.6%]; p=0.19; ICU LOS: 5.3 ± 0.9 vs. 4.1 ± 0.5 days; p=0.13; duration of mechanical ventilation: 5.3 ± 1.2 vs. 3.2 ± 0.5 days; p=0.10). Aspiration prior to intubation was reported commonly by paramedics and was associated with a higher risk of HAP.

  9. STATUS OF THE IMMUNITY OF PATIENTS WITH CHRONIC STAPHYLOCOCCUS’S PHARYNGITIS

    Directory of Open Access Journals (Sweden)

    Ognivenko E.V.

    2015-12-01

    Full Text Available Immunomodulatory and immunostimulatory drugs present the greatest interest in treating such patients and the rehabilitation of their immune system. Today, a wide clinical application has Polioksidonium (Petrovax Pharm, which has a wide range of influence on the immune system. There are studies proving the effectiveness of Polioksidonium treatment of inflammatory diseases of the nasal cavity and paranasal sinuses, chronic inflammatory process in pharyngeal plexus. Material and methods. We observed 62 patients on chronic staphylococcus’s pharyngitis in age from 21 to 45 years, who were treated in the communal health institution "Kharkiv city hospital № 6". The first group (basic group amounted to 32 patients, together with anti-inflammatory therapy (topical Decatilen 1 tablet 3 times daily for 7 days, physiotherapy for 5 days, was obtained Polioksidonium (12 mg every 24 hours per os for 10 days. The second group (control group consisted of 30 patients who received similar therapy without Polioksidonium. Clinical, microbiological, immunological studies were performed before the treatment, at 7 and 30 days after the end of the therapy. As indicators of standards the results of 30 healthy individuals were used. Immunological studies included the determination of the phagocytic activity of neutrophils, their biocidity, opsonizing properties serum titers of antibodies to the causative infectious agents, concentrations of the major classes of immunoglobulins in saliva and serum. Results and discussion. Before the treatment the patients showed complaints to pain and irritation in a throat, feeling of a foreign matter in a throat, dry cough and low-grade fever. Microbiological examination of oropharyngeal secretions ChFh patients revealed a 34 % S. pneumonia, at 24 % - S.aureus. Microbial associations were sown in 45 % of the cases. Immunological studies have shown that patients with chronic staphylococcus’s pharyngitis of increasing concentrations

  10. X-ray cinematographic determination of standard values of pharyngeal motility as a basis for diagnostic evaluation of pathologic changes

    International Nuclear Information System (INIS)

    Hannig, C.; Hess, U.

    1998-01-01

    The study was intended to reveal a normal bolus, yield standard values of the pharyngeal motility, define reference data and use them for verification with patient groups with known pathologic changes. Furthermore, the dependence of standard values on the physiological ageing process and various bolus volumina was tested. (orig./CB) [de

  11. Evaluation of two commercial, rapid, ELISA kits testing or scrapie in retro-pharyngeal lymph nodes in sheep

    NARCIS (Netherlands)

    Kittelberger, R.; McIntuyre, L.; Watts, S.; MacDiarmid, S.; Hannah, M.J.; Jenner, J.; Bueno, R.; Swainsbury, R.; Langeveld, J.P.M.; Keulen, van L.J.M.; Zijderveld, van F.G.; Wemheuer, W.M.; Richt, J.A.; Sorenson, S.J.; Pigott, C.J.; O'Keefe, J.S.

    2014-01-01

    AIMS: To estimate the number of cases of scrapie that would occur in sheep of different prion protein (PrP) genotypes if scrapie was to become established in New Zealand, and to compare the performance of two commercially available, rapid ELISA kits using ovine retro-pharyngeal lymph nodes (RLN)

  12. Superficial fine needle aspiration by clinicians: a survey of utilization.

    Science.gov (United States)

    Fitzpatrick, B T; Bibbo, M

    1996-09-01

    Quality assurance is as much concerned with cost, turnaround time, and use of resources as with test reliability and outcome. The cytopathologist needs to be aware of the knowledge base and expectations of clinicians who perform fine needle aspiration (FNA) biopsies of superficial lesions without technical assistance. To this end, a single correct answer multiple choice questionnaire was sent to 82 procedure-oriented clinical faculty members. Completed answer sheets from 35 faculty members were analyzed. The score for fee and turnaround time was 63.2 per cent and for knowledge of technique 70.6 per cent. The overall score for use of FNA was 64.7 per cent and for specimen handling was 45.6 per cent. Of those 65 per cent of participants who made comments, 30 per cent stressed importance of shorter turnaround time and 27 per cent emphasized the need for training in this area of endeavor. It is concluded that the quality of diagnosis can be improved by placing greater emphasis on training and education, the provision of written material, courses or tutorials in technique, written and verbal feedback regarding specimen adequacy, and by making more extensive use of electronic transmission of results.

  13. Predictors of mortality in neonates with meconium aspiration syndrome.

    Science.gov (United States)

    Louis, Deepak; Sundaram, Venkataseshan; Mukhopadhyay, Kanya; Dutta, Sourabh; Kumar, Praveen

    2014-08-01

    To identify risk factors for mortality in neonates with meconium aspiration syndrome. All neonates (2004-2010) with meconium aspiration syndrome, irrespective of gestation were included. Risk factors were compared between those who died and survived. Out of 172 included neonates, 44 (26%) died. Mean (SD) gestation and birth weight were 37.9 (2.3) weeks and 2545 (646g), respectively. Myocardial dysfunction [aOR 28.4; 95% CI (8.0-101); PMeconium aspiration syndrome is associated with significant mortality. Myocardial dysfunction, birth weight, and initial oxygen requirement are independent predictors of mortality.

  14. Pharyngeal Flap Is Effective Treatment for Post Maxillary Advancement Velopharyngeal Insufficiency in Patients With Repaired Cleft Lip and Palate.

    Science.gov (United States)

    Dentino, Kelley M; Marrinan, Eileen M; Brustowicz, Katherine; Mulliken, John B; Padwa, Bonnie L

    2016-06-01

    Patients with repaired cleft lip and cleft palate (CL/P) can develop velopharyngeal insufficiency (VPI) after Le Fort I maxillary advancement. The aim of this study was to evaluate speech outcomes in patients who required a pharyngeal flap after Le Fort I maxillary advancement. This retrospective cohort study included all patients with repaired CL/P who underwent a Le Fort I osteotomy and subsequently required a pharyngeal flap to correct VPI. Patients were included if they had outcome measurements documented at 3 time points: 1) before Le Fort I (baseline), 2) after Le Fort I, and 3) after pharyngeal flap. Outcome measurements, including speech characteristics (resonance, nasal emission, and intraoral pressure) and velopharyngeal function, were evaluated on perceptual assessment by a speech pathologist specializing in cleft care. Velopharyngeal closure was assessed with multi-view videofluoroscopy or nasopharyngoscopy. Patient characteristics and descriptive statistics were summarized and continuous data were expressed as mean ± standard deviation. Repeated-measures analysis of variance and paired samples t test were used to measure changes in speech outcome variables between time points. All P values were 2-tailed and considered significant for values less than .05. There were 23 patients for analysis (13 girls [56.5%] and 10 boys [43.5%]). Two patients (9%) had cleft palate only, 9 (39%) had unilateral cleft lip and palate (CLP), and 12 (52%) had bilateral CLP. Follow-up evaluations performed on average 12 months postoperatively showed statistically meaningful improvement for all variables, including decreased hypernasality, reduced nasal emission, and increased intraoral pressure for consonant production. Patients with repaired CL/P who had VPI after Le Fort I maxillary advancement showed significant improvement in all outcome measurements after pharyngeal flap (P < .001). The superiorly based pharyngeal flap is highly successful in correcting VPI after Le

  15. Bupivacaine Lozenge Compared with Lidocaine Spray as Topical Pharyngeal Anesthetic before Unsedated Upper Gastrointestinal Endoscopy

    DEFF Research Database (Denmark)

    Salale, Nesrin; Treldal, Charlotte; Mogensen, Stine

    2014-01-01

    Unsedated upper gastrointestinal endoscopy (UGE) can induce patient discomfort, mainly due to a strong gag reflex. The aim was to assess the effect of a bupivacaine lozenge as topical pharyngeal anesthetic compared with standard treatment with a lidocaine spray before UGE. Ninety-nine adult...... outpatients undergoing unsedated diagnostic UGE were randomized to receive either a bupivacaine lozenge (L-group, n = 51) or lidocaine spray (S-group, n = 42). Primary objective was assessment of patient discomfort including acceptance of the gag reflex during UGE. The L-group assessed the discomfort...... significantly lower on a visual analog scale compared with the S-group (P = 0.02). There was also a significant difference in the four-point scale assessment of the gag reflex (P = 0.03). It was evaluated as acceptable by 49% in the L-group compared with 31% in the S-group. A bupivacaine lozenge compared...

  16. Molecular detection of cancer cells in saliva from oral and pharyngeal cancer patients.

    Science.gov (United States)

    Okami, Kenji; Imate, Yuji; Hashimoto, Yoko; Kamada, Tomomi; Takahashi, Masahiro

    2002-09-01

    A key to improve the prognosis of head and neck cancers is an early diagnosis of the disease. No screening method to detect these cancers has been developed yet. Molecular techniques using polymerase chain reaction are a sensitive method to detect a small population of cancer cells among normal cells. We conducted a series of microsatellite analysis to detect cancer cells in saliva from 23 oral and pharyngeal cancer patients. Eight microsatellite markers were selected to test for microsatellite instability (MSI) in the tumor and saliva samples. Of 23 samples, 5 (22%) had MSI in the tumor samples. In 4 of 5 (80%) MSI positive samples, we detected the identical MSI in saliva. The possibility of the molecular screening and molecular follow-up is discussed.

  17. Facial diplegia, pharyngeal paralysis, and ophthalmoplegia after a timber rattlesnake envenomation.

    Science.gov (United States)

    Madey, Jason J; Price, Amanda B; Dobson, Joseph V; Stickler, David E; McSwain, S David

    2013-11-01

    The timber rattlesnake, also known as Crotalus horridus, is well known to cause significant injury from toxins stored within its venom. During envenomation, toxic systemic effects immediately begin to cause damage to many organ systems including cardiovascular, hematologic, musculoskeletal, respiratory, and neurologic. One defining characteristic of the timber rattlesnake is a specific neurotoxin called crotoxin, or the "canebrake toxin," which is a potent β-neurotoxin affecting presynaptic nerves that can cause paralysis by inhibiting appropriate neuromuscular transmission. We present an unusual case of an 8-year-old boy bitten twice on his calf by a timber rattlesnake, who presented with a life-threatening envenomation and suffered multisystem organ failure as well as a prominent presynaptic neurotoxicity resulting in facial diplegia, pharyngeal paralysis, and ophthalmoplegia.

  18. Genome Analysis of Streptococcus pyogenes Associated with Pharyngitis and Skin Infections

    Science.gov (United States)

    Ibrahim, Joe; Eisen, Jonathan A.; Jospin, Guillaume; Coil, David A.; Khazen, Georges

    2016-01-01

    Streptococcus pyogenes is a very important human pathogen, commonly associated with skin or throat infections but can also cause life-threatening situations including sepsis, streptococcal toxic shock syndrome, and necrotizing fasciitis. Various studies involving typing and molecular characterization of S. pyogenes have been published to date; however next-generation sequencing (NGS) studies provide a comprehensive collection of an organism’s genetic variation. In this study, the genomes of nine S. pyogenes isolates associated with pharyngitis and skin infection were sequenced and studied for the presence of virulence genes, resistance elements, prophages, genomic recombination, and other genomic features. Additionally, a comparative phylogenetic analysis of the isolates with global clones highlighted their possible evolutionary lineage and their site of infection. The genomes were found to also house a multitude of features including gene regulation systems, virulence factors and antimicrobial resistance mechanisms. PMID:27977735

  19. The influence of the lateral pharyngeal wall anatomy on snoring and sleep apnoea.

    Science.gov (United States)

    Korhan, Ibrahim; Gode, Sercan; Midilli, Rasit; Basoglu, Ozen Kacmaz

    2015-02-01

    To elucidate the variations of the lateral pharyngeal wall anatomy on physical examination and to assess the clinical importance of the examination of the lateral pharyngeal wall on the presence and severity of obstructive sleep apnoea syndrome. The cross-sectional study was conducted at Ege University Medical School, Izmir, Turkey, between May 2010 and April 2011. The patients were divided into four equal groups: Group 1--snoring without apnoea (age 20-40); Group 2--snoring without apnoea (age 40-60); Group 3--apnoea-hypopnoea index 30/hr. Calibrated oropharynx pictures were taken. Distance between palatoglossal and palatopharyngeal arches, height of palatoglossal and palatopharyngeal arches, uvula width, uvula length and distance between tonsils were measured. SPSS 17 was used for statistical analysis. Of the 80 patients in the study, 44 (55%) were men. Mean distance between palatopharyngeal and palatoglossal arches were 1.55 ± 0.34 cm and 2.70 ± 0.43 cm respectively. Mean height of palatopharyngeal and palatoglossal arches were 0.60 ± 0.21 cm and 1.37 ± 0.36 cm respectively (p > 0.05). Mean uvula width and uvula length were 0.80 ± 0.12cm and 1.25 ± 0.27 cm respectively (p > 0.05). Mean distance between tonsils was 2.24 ± 0.56 cm (p > 0.05). Distance between palatopharyngeal arches was significantly different between groups 3 and 4 (p < 0.05). Palatopharyngeal arch anatomy was found to be significantly associated with obstructive sleep apnoea syndrome severity, especially in patients with normal or small tonsil size. Patients with the palatopharyngeal arches, which narrow the oropharyngeal inlet more than the tonsils, should further be investigated with polysomnography.

  20. Reliability of upper pharyngeal airway assessment using dental CBCT: a systematic review.

    Science.gov (United States)

    Zimmerman, Jason N; Lee, Janson; Pliska, Benjamin T

    2017-10-01

    Upper airway analysis is an often-cited use of cone beam computed tomography (CBCT) imaging in orthodontics. However, the reliability of this process in a clinical setting is largely unknown. Our objective was to systematically review the literature to evaluate the reliability of upper pharyngeal airway assessment using dental CBCT. MEDLINE, EMBASE, Web of Science, and Google Scholar were searched through June 2015. Human studies that measured reliability of upper airway assessment in patients using CBCT as part of the study protocol were considered. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was followed. Data were collected on overall study characteristics and measurements, CBCT unit and machine settings used, and examination characteristics of the included studies. Methodological quality of the included studies was evaluated. Forty-two studies were evaluated, representing the CBCT scans of 956 patients. Studies included a wide variety of patients and CBCT machines with various scan settings. Only five studies were deemed high quality. The available evidence indicates that under specific restricted conditions there is moderate to excellent intra- and inter-examiner reliability. Airway volume demonstrated greater intra- and inter-examiner reliability than did minimum cross-sectional area. However, significant methodological limitations of the current literature, most importantly a lack of manual orientation of the images and selection of threshold sensitivity in study protocols, suggest that reliability has not been adequately established. The current literature reports moderate to excellent reliability, with airway volume having higher reliability than minimum cross-sectional area. However, only limited aspects of the process of airway analysis have been evaluated, indicating that further research is required to adequately establish the reliability of upper pharyngeal airway assessment of patients using dental CBCT. None.

  1. Pharyngeal Airway Space Changes After Condylar Replacement and Mandibular Advancement Surgery.

    Science.gov (United States)

    Yuen, Holly; Rossouw, P Emile; Wolford, Larry M; Wang, Hongyue

    2018-01-03

    The aim of this study was to examine the total volume and cross-sectional areas of the pharyngeal airway after bilateral condylar replacement and mandibular advancement surgery. A total of 137 patients (126 women and 11 men) underwent bilateral temporomandibular joint total joint replacement performed by 1 surgeon. A subsample of 30 patients who underwent condylar replacement and only mandibular advancement were evaluated for impact on the airway. Measurements were taken preoperatively, postoperatively, and at a follow-up 1 year after surgery on cone beam computed tomography scans. InVivoDental 3-dimensional imaging (Anatomage, San Jose, CA) was used to measure airway space regarding total volume (in cubic centimeters); minimum cross-sectional area (in square millimeters); minimum cross sections of the first, second, and third cervical vertebrae; and whether the patient had mandibular retrognathia before surgery. A second operator was used to test for interoperator error. Descriptive and bivariate statistics were computed, and the P value was set at .05. There was a significant increase in all measurements at the follow-up visit compared with the preoperative visit. There were no significant differences between groups based on simultaneous Le Fort I surgery, mandibular retrognathia, and gender. However, there were statistically significant differences in cross sections 1 and 2, as well as minimum cross-sectional area, regarding age. Condylar replacement and mandibular advancement have a significant association with an increase in airway space. The intraclass correlation coefficient showed excellent agreement between interoperator measurements. Patients undergoing bilateral temporomandibular joint replacement and mandibular advancement surgery showed an increase in pharyngeal airway space at a 1-year follow-up. In this study, age was significantly associated with the cross-sectional areas of the airway, with older patients having smaller values. Copyright © 2018

  2. Association of naso-Oro-pharyngeal structures with the sleep architecture in suspected obstructive sleep apnea.

    Science.gov (United States)

    Singhal, Pawan; Gupta, Ravi; Sharma, Rajanish; Mishra, Prakash

    2014-01-01

    The study was conducted to find out the association of various naso-oro-pharyngeal structures with sleep macro-architecture in suspected obstructive sleep apnea subjects. Study included 51 subjects with suspected obstructive sleep apnea. Subjects with possible central apnea and those consuming any substance that can affect sleep architecture were excluded. Level I polysomnography was performed after thorough physical examination. Overnight study was scored in 30 s epochs to find out the polysomnographic variables. Surgical treatment was offered wherever indicated. Subjects with moderate to severe obstructive sleep apnea were manually titrated on CPAP with the polysomnogram. SPSS v 17.0 was used for statistical analysis. We did not find any difference in the sleep architecture between genders. Sleep Efficiency was better in subjects with dental overjet, dental attrition, high tongue base, macroglossia, lesser oral cavity volume, edematous uvula, increased submental fat, hypertrophied facial muscles and Mallampatti grade III-IV. Shorter Sleep Latency was seen in subjects with tender TMJ and Mallampatti Gr III-IV. REM latency was shorter in subjects with high tongue base, macroglossia and hypertrophied muscles of mastication. Increased REM was observed in subjects with high tongue base, edematous uvula and tender TMJ. Enlarged tonsils had reversed effect with poor sleep efficiency, increased REM latency and decreased REM. CPAP therapy (N = 20) lessened awake time, decreased N2 and increased REM. Oro-pharyngeal structures affect the sleep architecture in suspected OSA subjects. Nasal structures do not affect the sleep architecture in these subjects and enlarged tonsils have opposite effect. Sleep architecture changes on the titration night with CPAP.

  3. Isolation of Streptococcus pyogenes from children with pharyngitis and emm type analysis.

    Science.gov (United States)

    Khosravi, Azar D; Ebrahimifard, Nasim; Shamsizadeh, Ahmad; Shoja, Saeed

    2016-05-01

    The group A streptococcus (GAS) M protein, encoded by the emm gene, acts as a major virulence factor. Emm-typing is the GAS gold standard molecular typing and is based on the DNA sequence of the nucleotides of the emm gene. The aim of the present study was to isolate GAS from patients and to detect the emm types of the isolates using emm typing. A total of 1000 throat samples were collected from patients with pharyngitis referred to Aboozar Children's Hospital in Ahvaz, Iran. We performed antimicrobial susceptibility testing on all isolates using the Kirby-Bauer disk diffusion method. Additionally, amplification of the emm gene was performed using polymerase chain reaction using the standard primers and described protocol. From all throat samples screened, 25 isolates (2.5%) were identified as GAS. Antibiotic susceptibility testing revealed that all the GAS isolates were susceptible to penicillin and erythromycin, but 44% showed resistance to vancomycin. Based on polymerase chain reaction for the emm gene, the obtained emm types were: emm-3, observed in 20 isolates (80%); emm-1 observed in four isolates (16%); and emm-75 observed in one isolate (4%). The result of the present study showed that penicillin and erythromycin are still the most effective antibiotics against the organism. The emm typing revealed that emm type-3 was detected in most of the isolates from patients with purulent pharyngitis. On the basis of the findings of this study, we may conclude that emm typing provides new insights on the genetic diversity of the M proteins, and is of demonstrable value for molecular studies of GAS. Copyright © 2016. Published by Elsevier Taiwan LLC.

  4. Placental Lesions in Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Binnari Kim

    2017-09-01

    Full Text Available Background Meconium aspiration syndrome (MAS is defined by respiratory distress requiring supplemental oxygen in a meconium-stained neonate. MAS is clinically subclassified as mild, moderate, and severe according to the oxygen requirement. The aims of this study were to compare the histological findings in the placentas of MAS neonates with those of meconium-stained but non-MAS neonates and to analyze the correlation between the severity of MAS and the grade of its histological parameters. Methods We collected 160 singleton term placentas from neonates with meconium staining at birth from a tertiary medical center, Seoul, Republic of Korea. We reviewed hematoxylin and eosin sections of tissue samples (full-thickness placental disc, chorioamniotic membranes, and umbilical cord. Results Funisitis was present more frequently in MAS than in non-MAS (p < .01, of which the stage was correlated with the severity of MAS (p < .001. The histological findings consistent with maternal underperfusion and chronic deciduitis were more frequent in MAS than in non-MAS (p < .05. There was a correlation between the degree of chorionic vascular muscle necrosis and the severity of MAS (p < .05. Conclusions Our results suggest that fetal inflammatory response evidenced by funisitis occurs prenatally in MAS and that the stage of funisitis and of chorionic vascular muscle necrosis may be a predictive marker of the severity of MAS.

  5. Placental Lesions in Meconium Aspiration Syndrome.

    Science.gov (United States)

    Kim, Binnari; Oh, Soo-Young; Kim, Jung-Sun

    2017-09-01

    Meconium aspiration syndrome (MAS) is defined by respiratory distress requiring supplemental oxygen in a meconium-stained neonate. MAS is clinically subclassified as mild, moderate, and severe according to the oxygen requirement. The aims of this study were to compare the histological findings in the placentas of MAS neonates with those of meconium-stained but non-MAS neonates and to analyze the correlation between the severity of MAS and the grade of its histological parameters. We collected 160 singleton term placentas from neonates with meconium staining at birth from a tertiary medical center, Seoul, Republic of Korea. We reviewed hematoxylin and eosin sections of tissue samples (full-thickness placental disc, chorioamniotic membranes, and umbilical cord). Funisitis was present more frequently in MAS than in non-MAS (p < .01), of which the stage was correlated with the severity of MAS (p < .001). The histological findings consistent with maternal underperfusion and chronic deciduitis were more frequent in MAS than in non-MAS (p < .05). There was a correlation between the degree of chorionic vascular muscle necrosis and the severity of MAS (p < .05). Our results suggest that fetal inflammatory response evidenced by funisitis occurs prenatally in MAS and that the stage of funisitis and of chorionic vascular muscle necrosis may be a predictive marker of the severity of MAS.

  6. Lung ultrasound findings in meconium aspiration syndrome.

    Science.gov (United States)

    Piastra, Marco; Yousef, Nadya; Brat, Roselyne; Manzoni, Paolo; Mokhtari, Mostafa; De Luca, Daniele

    2014-09-01

    Meconium aspiration syndrome (MAS) is a rare and life-threatening neonatal lung injury induced by meconium in the lung and airways. Lung ultrasound (LUS) is a quick, easy and cheap imaging technique that is increasingly being used in critical care settings, also for newborns. In this paper we describe ultrasound findings in MAS. Six patients with MAS of variable severity were examined by LUS during the first hours of life. Chest X-rays were used as reference. The following dynamic LUS signs were seen in all patients: (1) B-pattern (interstitial) coalescent or sparse; (2) consolidations; (3) atelectasis; (4) bronchograms. No pattern was observed for the distribution of signs in lung areas, although the signs varied with time, probably due to the changing localisation of meconium in the lungs. LUS images corresponded well with X-ray findings. In conclusion, we provide the first formal description of LUS findings in neonates with MAS. LUS is a useful and promising tool in the diagnosis and management of MAS, providing real-time bedside imaging, with the additional potential benefit of limiting radiation exposure in sick neonates. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Career Aspirations and Emotional Adjustment of Chinese International Graduate Students

    Directory of Open Access Journals (Sweden)

    Deanna L. Cozart

    2015-12-01

    Full Text Available There are more Chinese student-scholars than any other group of international students studying in the United States. Despite this, there are relatively few studies that have focused on specific educational needs and required career support services for Chinese international students. This exploratory study was conducted to determine the relationship between career aspirations and emotional adjustment of Chinese international students. Results from Chinese students were compared with those of students from the United States. Relationships between the career aspirations and emotional adjustment of Chinese and U.S. students did not reveal statistically significant differences. However, regression analysis indicated that social stress was a statistically significant predictor of career aspirations for U.S. students. Chinese and U.S. students were more alike than different on career aspirations and emotional adjustment, and observed educational similarities appeared to outweigh any cultural differences that existed when determining these outcomes.

  8. Micronuclei in breast aspirates. Is scoring them helpful?

    Directory of Open Access Journals (Sweden)

    A Hemalatha

    2014-01-01

    Conclusion: An increase in micronuclei values was seen from fibroadenoma to infiltrating ductal carcinoma. Micronuclei scoring can be used as a biomarker on fine needle aspiration cytology smears of breast carcinoma.

  9. An analysis of students' aspirations, expectations and gains in ...

    African Journals Online (AJOL)

    Assessment Questionnaire that examined students' expectations, aspirations, perceived and envisaged needs or gains using Eisner's (1985) five orientations, namely: the development of cognitive processes; academic rationalism; personal relevance; social adaptation or reconstruction; and curriculum as technology,

  10. Aspirations of young people living in disadvantaged areas in Denmark

    DEFF Research Database (Denmark)

    Frørup, Anna Kathrine; Jensen, Niels Rosendal

    2017-01-01

    how young people's (living in a socially disadvantaged area) possibilities, aspirations and demands are raised, strengthened, transformed or put aside and in what way they feel participating within different local programmes....

  11. Measurement of membrane elasticity by micro-pipette aspiration

    DEFF Research Database (Denmark)

    Henriksen, Jonas Rosager; Ipsen, John H.

    2004-01-01

    The classical micro-pipette aspiration technique, applied for measuring the membrane bending elasticity, is in the present work reviewed and extended to span the range of pipette aspiration pressures going through the °accid (low pressures) to tense (high pressures) membrane regime. The quality...... of the conventional methods for analysing data is evaluated using numerically generated data and a new method for data analysis, based on thermodynamic analysis and detailed statistical mechanical modelling, is introduced. The analysis of the classical method, where the membrane bending modulus is obtained from micro......-pipette aspiration data acquired in the low-pressure regime, reveals a signi¯cant correction from membrane stretching elasticity. The new description, which includes the full vesicle geometry and both the membrane bending and stretching elasticity, is used for the interpretation of micro-pipette aspiration...

  12. Comparison of manual vacuum aspiration and misoprostol in the ...

    African Journals Online (AJOL)

    Comparison of manual vacuum aspiration and misoprostol in the management of inc omplete abortion. Gabkika Bray Madoue, Dangar Daniel, Adoum Tchari, Mahamat Chene, Khadidja Mahayedine Salah, Zakaria Brahim, Constant Naîm, Ndilbe Steve ...

  13. Farm practical training and job aspiration of undergraduates of ...

    African Journals Online (AJOL)

    Farm practical training and job aspiration of undergraduates of agriculture in universities in Kwara State, Nigeria. Olayinka Jelili Yusuf, Ibrahim Folorunsho Ayanda, Felicia Motunrayo Olooto, Latifat Ololade Salawu, Stephen Kayode Subair ...

  14. Current Concepts in the Management of Meconium Aspiration Syndrome.

    Science.gov (United States)

    Chettri, Subhash; Bhat, B Vishnu; Adhisivam, B

    2016-10-01

    In developing countries, meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among neonates. The concepts of pathophysiology and management of meconium stained amniotic fluid (MSAF) and meconium aspiration syndrome have undergone tremendous change in recent years. Routine intranatal and postnatal endotracheal suctioning of meconium in vigorous infants is no longer recommended. Recent studies have challenged its role even in non-vigorous infants. Supportive therapy like oxygen supplementation, mechanical ventilation and intravenous fluids are the cornerstone in the management of meconium aspiration syndrome. Availability of surfactant, inhaled nitric oxide, high frequency ventilators and extracorporeal membrane oxygenation has made it possible to salvage more infants with meconium aspiration syndrome. In this review the authors have discussed the current concepts in the pathophysiology and management of MAS. Drugs in trials and future therapeutic targets are also discussed briefly.

  15. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

    Directory of Open Access Journals (Sweden)

    P. J. Corsi

    1999-01-01

    Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.

  16. Cryoextraction: A novel approach to remove aspirated chewing gum

    Directory of Open Access Journals (Sweden)

    Edmundo Rubio

    2013-01-01

    Full Text Available The extraction of aspirated foreign bodies can prove challenging at times, requiring even rigid bronchoscopy. Cryotherapy probes have been reported to help with extraction of foreign bodies. We present a case where successful "cryoextraction" was performed on an aspirated chewing gum. The case highlights the fact that this technique is useful to extract all materials that have water content. This technique can be performed through flexible bronchoscopy and can save patients from more aggressive approaches.

  17. A Case of Bipolar Affective Disorder and Aspiration Pneumonia

    Directory of Open Access Journals (Sweden)

    Alessandro Gerada

    2013-01-01

    Full Text Available Adults with mental illness are at a higher risk of aspiration pneumonia than the general population. We describe the case of a patient with bipolar affective disorder and two separate episodes of aspiration pneumonia associated with acute mania. We propose that he had multiple predisposing factors, including hyperverbosity, sedative medications, polydipsia (psychogenic and secondary to a comorbidity of diabetes insipidus, and neuroleptic side effects.

  18. Aspiration dynamics of multi-player games in finite populations

    Science.gov (United States)

    Du, Jinming; Wu, Bin; Altrock, Philipp M.; Wang, Long

    2014-01-01

    On studying strategy update rules in the framework of evolutionary game theory, one can differentiate between imitation processes and aspiration-driven dynamics. In the former case, individuals imitate the strategy of a more successful peer. In the latter case, individuals adjust their strategies based on a comparison of their pay-offs from the evolutionary game to a value they aspire, called the level of aspiration. Unlike imitation processes of pairwise comparison, aspiration-driven updates do not require additional information about the strategic environment and can thus be interpreted as being more spontaneous. Recent work has mainly focused on understanding how aspiration dynamics alter the evolutionary outcome in structured populations. However, the baseline case for understanding strategy selection is the well-mixed population case, which is still lacking sufficient understanding. We explore how aspiration-driven strategy-update dynamics under imperfect rationality influence the average abundance of a strategy in multi-player evolutionary games with two strategies. We analytically derive a condition under which a strategy is more abundant than the other in the weak selection limiting case. This approach has a long-standing history in evolutionary games and is mostly applied for its mathematical approachability. Hence, we also explore strong selection numerically, which shows that our weak selection condition is a robust predictor of the average abundance of a strategy. The condition turns out to differ from that of a wide class of imitation dynamics, as long as the game is not dyadic. Therefore, a strategy favoured under imitation dynamics can be disfavoured under aspiration dynamics. This does not require any population structure, and thus highlights the intrinsic difference between imitation and aspiration dynamics. PMID:24598208

  19. Advances in the Management of Meconium Aspiration Syndrome

    OpenAIRE

    Swarnam, Kamala; Soraisham, Amuchou S.; Sivanandan, Sindhu

    2011-01-01

    Meconium aspiration syndrome (MAS) is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hype...

  20. The impact of homelessness on children's level of aspiration.

    Science.gov (United States)

    Donahue, P J; Tuber, S B

    1995-01-01

    In a sample of 39 school-age homeless children, their length of stay in shelters for the homeless was significantly correlated with an index of their level of aspiration. This correlation remained significant even when the effects of the children's intelligence and their performance on a related cognitive task were partialed out. Stories given in response to two Thematic Apperception Test cards by a small sample of these children illustrate the potentially traumatic consequences of homelessness on children's hopes and aspirations.

  1. [Gastric aspiration therapy is a possible alternative to treatment of obesity

    DEFF Research Database (Denmark)

    Christensen, Marie Møller; Jorsal, Tina; Naver, Lars Peter Skat

    2017-01-01

    Aspiration therapy with AspireAssist is a novel endoscopic obesity treatment. Patients aspirate approximately 30% of an ingested meal through a draining system connected to a percutanous endoscopic gastrostomy tube. AspireAssist was recently approved by the US Food and Drug Administration...

  2. Microbiological profile of anterior chamber aspirates following uncomplicated cataract surgery

    Directory of Open Access Journals (Sweden)

    Prajna N

    1998-01-01

    Full Text Available Anterior chamber aspirate cultures were done for 66 patients who underwent either an uncomplicated intracapsular cataract extraction, extracapsular cataract extraction with posterior-chamber intraocular lens implantation, or phacoemulsification with posterior-chamber intraocular lens implantation. The aspirate was obtained at the time of wound closure. The aspirates were immediately transferred to the microbiology laboratory where one drop of the aspirate was placed on a glass slide for gram stain, and the remainder was unequally divided and inoculated into blood agar, chocolate agar and thioglycolate broth. The cultures were incubated at 37° C with 5% CO2 and held for 5 days. Of 66 patients 4 (6%, had smear-positive anterior chamber aspirates. None of the aspirates showed any growth on any of the 3 culture media used. None of the eyes in the study developed endophthalmitis. This study concludes that there is no contamination of the anterior chamber by viable bacteria after cataract surgery, irrespective of the mode of intervention.

  3. Quality of canine spermatozoa retrieved by percutaneous epididymal sperm aspiration.

    Science.gov (United States)

    Varesi, S; Vernocchi, V; Faustini, M; Luvoni, G C

    2013-02-01

    To investigate the feasibility of percutaneous epididymal sperm aspiration in dogs and whether it might provide a population of epididymal spermatozoa similar to the population that can be obtained by processing isolated epididymis caudae. Concentration and total sperm number, motility, morphology and acrosomal integrity of spermatozoa retrieved by percutaneous epididymal sperm aspiration, in vitro aspiration and mincing of the cauda of the epididymis were compared. Percutaneous epididymal sperm aspiration is a feasible procedure to retrieve a population of spermatozoa in dogs. Quality is similar to that of spermatozoa collected in vitro, although a wide variation amongst animals was observed. In case of ejaculation failure due to pathological conditions in dogs, the collection of spermatozoa from the cauda of the epididymis could be an option for providing gametes for assisted reproductive technologies. Percutaneous epididymal sperm aspiration can be used in dogs with compromised reproductive performance, in which orchiectomy cannot be performed for medical or owner reasons. Further studies aimed to investigate whether the percutaneous epididymal sperm aspiration technique might be feasible for repeated semen collection and to accurately evaluate side effects are required. © 2013 British Small Animal Veterinary Association.

  4. Blood lactate level and meconium aspiration syndrome.

    Science.gov (United States)

    Karabayir, Nalan; Demirel, Ali; Bayramoglu, Elvan

    2015-04-01

    Approximately 5% of infants born with a meconium-stained amniotic fluid (MSAF) develop meconium aspiration syndrome (MAS). Early recognition of infants at highest risk for the development of MAS and the prediction of disease severity are important for optimizing the clinical strategies for prevention and treatment. The aim of the present study was to identify the risk factors for MAS and to investigate the effect of blood lactate level on the development of MAS. Between January 2011 and January 2012, data were recorded with regard to gender, mode of delivery, gestational week, birth weight, 5-min Apgar score, and need for resuscitation of the meconium-stained depressed infants who underwent tracheal aspiration. Moreover, the number of cases developing MAS, blood pH value, and lactate level in capillary blood gases obtained during the first hour after delivery, duration of oxygen supplementation, the number of cases receiving mechanical ventilation and surfactant therapy, duration of hospital stay, and outcomes of the infants were recorded. The number of live births during the study period was 17,202, and of them, 1,341 (7.8%) infants were born through MSAF. Of 195 infants who were meconium-stained depressed, 90 were girls and 105 were boys. Their mean gestational week was 39.37 ± 0.89 weeks and mean birth weight was 3,426 ± 634 g. Eighty-four of them were born through cesarean section (C/S), and 111 were born via normal spontaneous labor. For 40 infants, Apgar score at fifth minute was less than 6. In total, resuscitation was performed on 43 (22.9%) infants. Of the infants, 141 did not develop MAS and 54 developed MAS. While there were no significant differences between infants with and without MAS with regard to gender, delivery route, gestational week, and birth weight, a significant difference was observed regarding the Apgar score (p = 0.0001). The blood pH value in capillary blood gas analysis was less than 7.25 in 18 (28.5%) cases with MAS and four (3

  5. Meconium aspiration syndrome: do we know?

    Science.gov (United States)

    Yurdakök, Murat

    2011-01-01

    Meconium is a common finding in amniotic fluid and placental specimens, particularly in the term or post-term pregnancy. The most important consequence of meconium-stained amniotic fluid (MSAF) is meconium aspiration syndrome (MAS), and at least 5% of infants born through MSAF develop MAS. MAS continues to be a threat to many newborns throughout the world, with a case fatality rate of 5% (as much as 40%), in addition to short- and long-term pulmonary and neurodevelopmental sequelae. The exact pathophysiology of meconium passage into the amniotic fluid and consequences of meconium aspiration are unknown. There are three prevailing and possibly compatible theories for mechanisms of meconium release. Firstly, meconium passage is probably related with the maturation of the gastrointestinal tract, because meconium passage in the preterm third trimester fetus has been reported to be a rare event, as typically it occurs near or post-term. Secondly, an alternate hypothesis for in utero meconium passage is that pathologic processes, such as stress via hypoxia or infection, can trigger meconium passage. However, the predictive values of MSAF for fetal distress and acidosis at birth are poor and controversial. Thirdly, an alternative route for the presence of MSAF in the presence of fetal hypoxia is reduced clearance of defecated meconium due to impaired fetal swallowing or unidentified placental dysfunction in addition to or instead of an increase in its passage. The pathophysiology of MAS is multifactorial and extremely complex. Meconium causes mechanical obstruction and pulmonary air leak, induces surfactant inactivation, causes pulmonary inflammation, and induces apoptosis. Preventing prolonged pregnancy by labor induction might reduce the risk of MSAF. Labor induction with prostaglandins appears to be associated with the occurrence of MSAF. Amnioinfusion for suspected umbilical cord compression has no clear effect on the occurrence of MSAF. Intrapartum suctioning of the

  6. Inflammatory indices in meconium aspiration syndrome.

    Science.gov (United States)

    Hofer, Nora; Jank, Katharina; Strenger, Volker; Pansy, Jasmin; Resch, Bernhard

    2016-06-01

    Meconium aspiration syndrome (MAS) is linked to inflammation, but data on the patterns of hematological indices and C-reactive protein (CRP) in MAS are lacking. The aim of the study was to evaluate CRP, white blood cell count (WBC), absolute neutrophil count (ANC), and immature-to-total neutrophil ratio (IT-ratio) in MAS and to assess their association with disease severity. Retrospective cross-sectional study including 239 consecutively admitted neonates with MAS to a level III NICU. Neonates with early onset sepsis were excluded. Results Neonates with severe MAS (invasive mechanical ventilation for <7 days) and very severe MAS (invasive mechanical ventilation for ≥7 days or high frequency ventilation or ECMO) had higher CRP and IT-ratio compared to neonates with non-severe MAS (no invasive mechanical ventilation) during the first 2 days of life (CRP: 13.0 and 40.9 vs. 9.5 mg/L, P = 0.039 and <0.001, respectively) and neonates with very severe MAS had lower WBC and ANC. All four inflammatory indices correlated significantly with duration of invasive mechanical ventilation, duration of respiratory support and with length of hospital stay, arterial hypotension, and persistent pulmonary hypertension. Neonates with all four inflammatory indices beyond the normal range had a more than 20-fold increase in risk for very severe MAS. High CRP and IT-ratio and low WBC and ANC values were closely linked to a more severe course of MAS during the early phases of the disease. These findings reflect the role of inflammation in the pathogenesis of MAS. Pediatr Pulmonol. 2016;51:601-606. 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  7. Neurosurgical sapphire handheld probe for intraoperative optical diagnostics, laser coagulation and aspiration of malignant brain tissue

    Science.gov (United States)

    Shikunova, Irina A.; Zaytsev, Kirill I.; Stryukov, Dmitrii O.; Dubyanskaya, Evgenia N.; Kurlov, Vladimir N.

    2017-07-01

    In this paper, a handheld contact probe based on sapphire shaped crystal was developed for the intraoperative optical diagnosis and aspiration of malignant brain tissue combined with the laser hemostasis. Such a favorable combination of several functions in a single instrument significantly increases its clinical relevance. It makes possible highly-accurate real-time detection and removal of either large-scale malignancies or even separate invasive cancer cells. The proposed neuroprobe was integrated into the clinical neurosurgical workflow for the intraoperative fluorescence identification and removal of malignant tissues of the brain.

  8. Risk Factors for Aspiration Pneumonia in Older Adults.

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    Toshie Manabe

    Full Text Available Aspiration pneumonia is a dominant form of community-acquired and healthcare-associated pneumonia, and a leading cause of death among ageing populations. However, the risk factors for developing aspiration pneumonia in older adults have not been fully evaluated. The purpose of the present study was to determine the risk factors for aspiration pneumonia among the elderly.We conducted an observational study using data from a nationwide survey of geriatric medical and nursing center in Japan. The study subjects included 9930 patients (median age: 86 years, women: 76% who were divided into two groups: those who had experienced an episode of aspiration pneumonia in the previous 3 months and those who had not. Data on demographics, clinical status, activities of daily living (ADL, and major illnesses were compared between subjects with and without aspiration pneumonia. Two hundred and fifty-nine subjects (2.6% of the total sample were in the aspiration pneumonia group. In the univariate analysis, older age was not found to be a risk factor for aspiration pneumonia, but the following were: sputum suctioning (odds ratio [OR] = 17.25, 95% confidence interval [CI]: 13.16-22.62, p < 0.001, daily oxygen therapy (OR = 8.29, 95% CI: 4.39-15.65, feeding support dependency (OR = 8.10, 95% CI: 6.27-10.48, p < 0.001, and urinary catheterization (OR = 4.08, 95% CI: 2.81-5.91, p < 0.001. In the multiple logistic regression analysis, the risk factors associated with aspiration pneumonia after propensity-adjustment (258 subjects each were sputum suctioning (OR = 3.276, 95% CI: 1.910-5.619, deterioration of swallowing function in the past 3 months (OR = 3.584, 95% CI: 1.948-6.952, dehydration (OR = 8.019, 95% CI: 2.720-23.643, and dementia (OR = 1.618, 95% CI: 1.031-2.539.The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia. These results could help improve clinical management for preventing

  9. Peripheral blood aspirates overexpressing IGF-I via rAAV gene transfer undergo enhanced chondrogenic differentiation processes.

    Science.gov (United States)

    Frisch, Janina; Orth, Patrick; Rey-Rico, Ana; Venkatesan, Jagadeesh Kumar; Schmitt, Gertrud; Madry, Henning; Kohn, Dieter; Cucchiarini, Magali

    2017-11-01

    Implantation of peripheral blood aspirates induced towards chondrogenic differentiation upon genetic modification in sites of articular cartilage injury may represent a powerful strategy to enhance cartilage repair. Such a single-step approach may be less invasive than procedures based on the use of isolated or concentrated MSCs, simplifying translational protocols in patients. In this study, we provide evidence showing the feasibility of overexpressing the mitogenic and pro-anabolic insulin-like growth factor I (IGF-I) in human peripheral blood aspirates via rAAV-mediated gene transfer, leading to enhanced proliferative and chondrogenic differentiation (proteoglycans, type-II collagen, SOX9) activities in the samples relative to control (reporter rAAV-lacZ) treatment over extended periods of time (at least 21 days, the longest time-point evaluated). Interestingly, IGF-I gene transfer also triggered hypertrophic, osteo- and adipogenic differentiation processes in the aspirates, suggesting that careful regulation of IGF-I expression may be necessary to contain these events in vivo. Still, the current results demonstrate the potential of targeting human peripheral blood aspirates via therapeutic rAAV transduction as a novel, convenient tool to treat articular cartilage injuries. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  10. Epidemiology of group A streptococcal pharyngitis & impetigo: a cross-sectional & follow up study in a rural community of northern India.

    Science.gov (United States)

    Kumar, R; Vohra, H; Chakraborty, A; Sharma, Y P; Bandhopadhya, S; Dhanda, V; Sagar, V; Sharma, M; Shah, B; Ganguly, N K

    2009-12-01

    Group A streptococcus (GAS) causes a wide array of human diseases. Epidemiological picture of streptococcal infection in India is not complete. Hence, disease burden due to GAS in 5-15 yr old school children in northern India was studied and emm typing of GAS isolates was carried out to help in designing prevention strategies. A cross-sectional survey was carried out among 4249 school children (5-15 yr) from Raipur Rani Block of Panchkula district in Haryana during 2000-2002; 334 children were followed up fortnightly for one year. Standard clinical and microbiological procedures were used for collection of swabs from throat and skin and confirmation of GAS and its emm types. Of the 4249 children studied, 658 (15.5%) had pharyngitis; 579 of them could be swabbed, of which 2.8 per cent had GAS. From 3591 children without pharyngitis, 3385 who could be swabbed, GAS was found in 1.3 per cent of them. Impetigo was rare (0.7%), but 7.1 per cent (2/28) children had GAS. In the followup study, 17.4 per cent (776/4447 child-contacts) had pharyngitis, 761 could be swabbed and 2.4 per cent had GAS; among those without pharyngitis, 2016 swabs could be taken and GAS was found in 1.3 per cent; whereas only 2.6 per cent (2/75) of skin sores had GAS. Three children had GAS pharyngitis twice during follow up. Fourteen different GAS emm types were found. emm 71, 77 and 81 constituted 69 per cent of the pharyngeal isolates. GAS pharyngitis and impetigo were more common in winters and summers respectively. In north India, pharyngitis was more common than impetigo. Most prevalent emm types of GAS in this region differ from those included in M protein-based vaccines.

  11. Pharyngeal-cervical-brachial variant of pediatric Guillain-Barré syndrome with antecedent acute hepatitis A virus infection.

    Science.gov (United States)

    Thapa, Rajoo; Biswas, Biawajit; Mallick, Debkrishna; Mukherjee, Swapan

    2009-07-01

    Pharyngeal-cervical-brachial weakness is considered a variant of Guillain-Barré syndrome with limited oropharyngeal, neck, and upper limb muscle involvement. The authors report on a 7-year-old boy, who developed pharyngeal-cervical-brachial type of Guillain-Barré syndrome following an antecedent episode of acute hepatitis A virus infection, 2 weeks prior to admission. The presentation was characterized by acute onset dysphagia, loss of head control, and bilateral arm weakness. The diagnosis was confirmed by acute motor axonal changes in the arm and albuminocytologic dissociation of the cerebrospinal fluid. The child was treated with intravenous immunoglobulin, which resulted in gradual improvement over 3 weeks. Documented instances of this form of Guillain-Barré syndrome remain rare in the pediatric age group, with none existing following antecedent hepatitis A virus infection. The authors emphasize that acute hepatitis A virus infection be included in the triggers responsible for Guillain-Barré syndrome in children.

  12. NAD(P-DEPENDENT DEHYDROGENASE ACTIVITY IN PERIPHERAL BLOOD LYMPHOCYTES OF INFANTS WITH ENLARGEMENT OF PHARYNGEAL TONSILS

    Directory of Open Access Journals (Sweden)

    L. M. Kurtasova

    2014-01-01

    Full Text Available We have observed and examined 57 children 1 to 3 years old diagnosed with enlargement of pharyngeal tonsils. A control group was presented by 35 healthy children. Bioluminescence technique was applied for studying NAD(P-dependent dehydrogenase activity in peripheral blood lymphocytes. Activation of aerobic respiration and increasing activity of pentose phosphate cycle-dependent plastic processes were registered in blood lymphocytes of children with hypertrophic pharyngeal tonsils; along with decreased function of malate-aspartate shunt in energy metabolism of the cells, diminished anaerobic reaction of NADHdependent LDH, lower interaction between Krebs cycle and reactions of amino acid metabolism, and reduced activity of glutathione reductase.

  13. Influence of anteflexion of head position on the shape of pharyngeal space by magnetic resonance imaging

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    Inoko, Yoshimi; Takahashi, Fumi; Ohnuma, Tomoyuki; Morita, Osami; Sasaki, Yoshihiko; Tsuchimochi, Makoto [Nippon Dental Univ. (Japan). School of Dentistry at Niigata

    2002-02-01

    There are reports on the efficacy of an oral appliance when used for dental treatment of obstructive sleep apnea syndrome. However, the influence of wearing it during evaluation of its therapeutic effects, on the soft tissue of the middle pharynx, has not been fully studied by magnetic resonance imaging. In this study, effects of anteflexion of the head position during the imaging were investigated, as to the shape of the pharyngeal space. Sixteen healthy adults who did not snore were studied. Magnetic resonance imaging (MRI) was taken at four different positions of the head (H{sub 2}, H{sub 4}, H{sub 6}, H{sub 8}) with 2, 4, 6, or 8 intervening acrylic plates, 1 cm in thickness inserting under the occipital region. For the control position (H{sub 0}), imaging was conducted without inserting the intervening plate. To determine the shape of the pharyngeal cavity from the sagittal view, the antero-posteior length, and the areas of posterior nasal spine, the posterior uvula palatina, and the posterior lingual radix, were measured on MRI images, and ratios of the respective measurements at the positions H{sub 2}, H{sub 4}, H{sub 6}, and H{sub 8}, to that of the control position H{sub 0}, were calculated, for comparison among the positions of the head. Statistical analysis was made by repeated-measures ANOVA for the factor of head position. From the sagittal view using MRI, the differences in each antero-posterior length of the posterior nasal spine and the posterior uvula palatina were not significant among the head positions, whereas the length of the posterior lingual radix was significantly different among head positions. The lengths of the posterior lingual radix for H{sub 6} and H{sub 8} were significantly shorter than those for H{sub 2} and H{sub 4}. The present results indicate that the position of the head should be restricted in MRI for morphological assessments of the pharynx from mid-sagittal views. (author)

  14. Pharyngeal cancer prevention: evidence from a case--control study involving 232 consecutive patients.

    Science.gov (United States)

    Escribano Uzcudun, Ana; Rabanal Retolaza, Ignacio; García Grande, Antonio; Miralles Olivar, Lara; García García, Alfredo; González Barón, Manuel; Gavilán Bouzas, Javier

    2002-07-01

    The aim of this study was to determine risk factors for pharyngeal cancer and to propose 10 result-based preventive measures. It was a case-control study conducted in Madrid, Spain, with 232 consecutive patients diagnosed between January 1 1990 and December 31, 1995, sex- and age-matched with 232 control individuals with no oncological disease or history. By means of an interviewer-administered questionnaire, seven different epidemiological areas were surveyed, namely: (1) sociodemographic variables, (2) familial all-site cancer history, (3) medical history, (4) lifestyle (habits), (5) diet, (6) occupational exposure, and (7) non-occupational exposure. Of the great number of factors within each epidemiological area, the following were found to be risk factors after adjustment for tobacco smoking and alcoholic beverage drinking: (1) tobacco smoking, (2) alcoholic beverage drinking, (3) low and low-middle socioeconomic background, (4) low educational level, (5) rural milieu, (6) working, or having worked, as a manual worker in agriculture, (7) working, or having worked as a manual worker in building industry, (8) having an upper aerodigestive tract cancer familial history, (9) having a medical history of alcholism, low weight/malnutrition, gastroesophageal reflux or chronic obstructive bronchopneumonia, (10) low dietary intake of fruit, fruit juice, uncooked vegetables, dietary fibre-containing foods, fish and milk and dairy products, (11) high dietary intake of meat and fried foods, (12) deficient oral and dental hygiene, (13) abuse of black coffee, (14) abuse of 'carajillo' (a typical Spanish drink composed of black coffee and flambéed brandy), (15) occupational exposure to pesticides, solvents and dust of different origins. On the basis of our results and those reported by other authors, we put forward 10 measures for the prevention of pharyngeal cancer. However, due to the small size of the nasopharyngeal cancer subsample (n = 35, 15.08 per cent), our results as

  15. Management of adults with acute streptococcal pharyngitis: minimal value for backup strep testing and overuse of antibiotics.

    Science.gov (United States)

    Nakhoul, Georges N; Hickner, John

    2013-06-01

    Rapid antigen detection tests (RADT) are commonly used to guide appropriate antibiotic treatment of group A beta-hemolytic streptococcal (GABHS) pharyngitis. In adults, there is controversy about the need for routine backup testing of negative RADT. Estimate the costs and benefits in adults of routine backup testing by DNA Gen-probe of negative RADT (Acceava). Observational follow-up study. All patients aged 18 years and older visiting a Cleveland Clinic generalist physician in 2009 and 2010 with a visit diagnosis of acute pharyngitis (ICD codes 462, 034.0). The patients were identified using the Cleveland Clinic Epic Clarity database. We determined the proportion of false negative RADT, antibiotic prescription patterns and rate of serious suppurative complications within 30 days of the office visit. Of 25,130 patients with acute pharyngitis, 19% had no testing and 81% were tested. Of the 15,555 patients that had a negative RADT and follow-up DNA probe, 6% had a positive DNA probe. Of the 953 patients who had a negative RADT and a positive DNA strep probe, 48% received an antibiotic prescription at the time of the visit and 51% received an antibiotic prescription after an average of 2.3 days. Only one patient with a negative RADT and no follow-up DNA probe developed a peritonsillar abscess. Overall, of the 15,555 DNA probes performed, management was altered in only 3% of the patients at a total cost of $1,757,715. Fifty-six percent received an antibiotic while only 19.5% had a confirmed strep throat diagnosis. The false negative rate of Acceava RADT for the diagnosis of GABHS pharyngitis was 6%. We question the benefit of routine DNA probe backup testing in adults because of its substantial cost, an average delay in antibiotic prescribing of over 2 days, and because suppurative complications are very uncommon. We found a high rate of inappropriate antibiotic prescribing.

  16. Oral cavity, pharyngeal and salivary gland cancer: disparities in ethnicity-specific incidence among the London population.

    Science.gov (United States)

    Donaldson, Chris D; Jack, Ruth H; Møller, Henrik; Lüchtenborg, Margreet

    2012-09-01

    We examined the association between ethnicity and the incidence of oral and pharyngeal cancers in the London population. Data on London residents diagnosed with oral and pharyngeal cancer (ICD-10 codes C00-C14) between 1998 and 2007 were retrieved from the Thames Cancer Registry. Age-standardised incidence rate ratios (IRR) for cancers of the nasopharynx (C11), oropharynx (C09-C10), hypopharynx (C12-C13), oral cavity (C00.3-C06), salivary glands (C07-C08) and Waldeyer's ring (C02.4, C09, C11.1, C14.2) were calculated for different ethnic groups using White males and females as the baseline groups. Records on 5833 individuals were examined, and ethnicity information was available for 4679 (80%) of these patients. The incidence rate of oral and pharyngeal cancer combined was 9.0 and 3.9 per 100,000 for males and females, respectively. Compared with their White counterparts, the highest incidence rate ratios of nasopharyngeal cancer were seen in Chinese males (IRR: 23, 95% confidence interval (CI): 7-73) and females (IRR: 16, 95% CI: 2-107). Waldeyer's ring cancers were most common in Bangladeshi and White groups. Analysis of the oropharynx and oral cavity cancers gave rise to variable but less obvious patterns among the different ethnic groups, whereas less variation was observed between ethnic groups for cancers of the hypopharynx and salivary glands. The incidence rates of individual oral and pharyngeal cancer types are low, but seem to vary by ethnic group. The variation in incidence appears to be unique to the different cancer subtypes and may therefore reflect specific ethnicity-related risk factors. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. The duration of stage transition during pharyngeal swallowing among young-elderly, and mid-elderly individuals

    OpenAIRE

    Byeon, Haewon; Koh, Hyeung Woo

    2016-01-01

    [Purpose] Understanding the normal movements of the pharyngeal stage is important in the assessment of dysphagia. This study classified an elderly population into young-elderly and mid-elderly individuals and investigated the difference in stage transition duration between the two groups to provide basic material for assessment of dysphagia in old age. [Subjects and Methods] The subjects of the study were 12 middle-aged individuals (40?49 years), young-elderly individuals (65?74 years), and 9...

  18. Evaluation of the natural history of patients who aspirate.

    Science.gov (United States)

    Bock, Jonathan M; Varadarajan, Varun; Brawley, Mary C; Blumin, Joel H

    2017-12-01

    The natural clinical progression of aspiration to eventual pulmonary compromise is not well understood. We hypothesized that dietary modification recommendations, Penetration-Aspiration Scale (PAS) score, and dysphagia etiology would be associated with changes in time to first pulmonary event and overall survival for patients with documented aspiration on radiologic testing. This study identified a cohort of patients with detectable unsensed penetration or aspiration on videofluoroscopic swallowing study (VFSS), and followed this cohort over time for development of pulmonary events and death. We then evaluated the association of aspiration severity and dietary modification recommendations on incidence of these endpoints. Retrospective chart review. A total of 2,616 VFSS exam reports were reviewed from our institution performed between January 1, 2009 and December 31, 2010. Aspiration or unsensed penetration (PAS of 5 or greater) was detected in 564 (21.5%) of these patients, who were then included in the study cohort. Medical records were reviewed retrospectively for development of pulmonary events (pneumonia, pneumonitis, or other life-threatening pulmonary illness) and all-cause mortality for up to 54 months after initial VFSS. Univariate Kaplan-Meier analysis and multivariate Cox regression were performed for time to first pulmonary event and survival predicted by recommended diet, PAS score, and dysphagia etiology. Dysphagia etiology was highly associated with increased development of pulmonary events for some patients, especially those with generalized nonspecific dysphagia due to deconditioning or frailty (hazard ratio [HZ] vs. stroke 2.95, 95% confidence interval [CI]: 1.53-5.69, P = .001) and esophageal dysphagia (HZ: 2.66, 95% CI: 1.17-6.02, P = .019). Dysphagia etiology was also associated with increased mortality for patients with generalized nonspecific dysphagia due to deconditioning or frailty (HZ: 3.32, 95% CI: 2.0-5.52, P penetration or aspiration

  19. New insights into the role of the pharyngeal jaw apparatus in the sound-producing mechanism of Haemulon flavolineatum (Haemulidae).

    Science.gov (United States)

    Bertucci, Frédéric; Ruppé, Laëtitia; Van Wassenbergh, Sam; Compère, Philippe; Parmentier, Eric

    2014-11-01

    Grunts are fish that are well known to vocalize, but how they produce their grunting sounds has not been clearly identified. In addition to characterizing acoustic signals and hearing in the French grunt Haemulon flavolineatum, the present study investigates the sound-production mechanism of this species by means of high-speed X-ray videos and scanning electron microscopy of the pharyngeal jaw apparatus. Vocalizations consist of a series of stridulatory sounds: grunts lasting ~47 ms with a mean period of 155 ms and a dominant frequency of ~700 Hz. Auditory capacity was determined to range from 100 to 600 Hz, with greatest sensitivity at 300 Hz (105.0±11.8 dB re. 1 μPa). This suggests that hearing is not tuned exclusively to detect the sounds of conspecifics. High-speed X-ray videos revealed how pharyngeal jaws move during sound production. Traces of erosion on teeth in the fourth ceratobranchial arch suggest that they are also involved in sound production. The similarity of motor patterns of the upper and lower pharyngeal jaws between food processing and sound production indicates that calling is an exaptation of the food-processing mechanism. © 2014. Published by The Company of Biologists Ltd.

  20. Inactivation of Bmp4 from the Tbx1 Expression Domain Causes Abnormal Pharyngeal Arch Artery and Cardiac Outflow Tract Remodeling

    Science.gov (United States)

    Nie, Xuguang; Brown, Christopher B.; Wang, Qin; Jiao, Kai

    2011-01-01

    Maldevelopment of outflow tract and aortic arch arteries is among the most common forms of human congenital heart diseases. Both Bmp4 and Tbx1 are known to play critical roles during cardiovascular development. Expression of these two genes partially overlaps in pharyngeal arch areas in mouse embryos. In this study, we applied a conditional gene inactivation approach to test the hypothesis that Bmp4 expressed from the Tbx1 expression domain plays a critical role for normal development of outflow tract and pharyngeal arch arteries. We showed that inactivation of Bmp4 from Tbx1-expressing cells leads to the spectrum of deformities resembling the cardiovascular defects observed in human DiGeorge syndrome patients. Inactivation of Bmp4 from the Tbx1 expression domain did not cause patterning defects, but affected remodeling of outflow tract and pharyngeal arch arteries. Our further examination revealed that Bmp4 is required for normal recruitment/differentiation of smooth muscle cells surrounding the PAA4 and survival of outflow tract cushion mesenchymal cells. PMID:21123999

  1. Consecutive regression of MALT lymphomas coexisting in the pharyngeal and gastric tissue after the eradication of Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Giuseppe Ivan Potente

    2012-09-01

    Full Text Available The stomach is one of the most common organs in which mucosa-associated lymphoid tissue (MALT lymphoma develops. It is well established that Helicobacter pylori (Hp infection plays a major role in the development of gastric MALT lymphoma and that the presence of Hp in the gastric mucosa is connected with mucosa-associated lymphatic tissue (MALT.The same tissue is located in the oral cavity and pharynx in Waldayer’s circuit. Recently, the oral cavity was proposed as an extragastric reservoir of Hp infection. We report the case of a 79-year-old female patient with concomitant pharyngeal (MALT lymphoma and Hp-related gastric MALT lymphoma. Gastric MALT lymphoma was detected both through endoscopic examination as well as in biopsies. Pharyngeal MALT lymphoma was also detected in biopsies. Hp has been recognized in the gastric mucosa by positive serum H. pylori antibody and urease tests. Treatment of the Hp infection in our patient using antibiotics led to the regression of both lesions. This is the first case report on the regression of a pharyngeal MALT lymphoma after Hp eradication.

  2. Computational fluid dynamics study of the pharyngeal airway space before and after mandibular setback surgery in patients with mandibular prognathism.

    Science.gov (United States)

    Yajima, Y; Oshima, M; Iwai, T; Kitajima, H; Omura, S; Tohnai, I

    2017-07-01

    The purpose of this study was to investigate the relationship between the pressure drop in the pharyngeal airway space (ΔP PAS ) and the minimum cross-sectional area (minCSA) of the pharyngeal airway before and after mandibular setback surgery using computational fluid dynamics, in order to prevent iatrogenic obstructive sleep apnoea. Eleven patients with mandibular prognathism underwent bilateral sagittal split osteotomy for mandibular setback. Three-dimensional models of the upper airway were reconstructed from preoperative and postoperative computed tomography images, and simulations were performed using computational fluid dynamics. ΔP PAS and the minCSA of the pharyngeal airway were calculated, and the relationship between them was evaluated by non-linear regression analysis. In all cases, the minCSA was found at the level of the velopharynx. After surgery, ΔP PAS increased significantly and the minCSA decreased significantly. The non-linear regression equation expressing the relationship between these variables was ΔP PAS =3.73×minCSA -2.06 . When the minCSA was <1cm 2 , ΔP PAS increased greatly. The results of this study suggest that surgeons should consider bimaxillary orthognathic surgery rather than mandibular setback surgery to prevent the development of iatrogenic obstructive sleep apnoea when correcting a skeletal class III malocclusion. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Effect of occlusal plane control procedure on hyoid bone position and pharyngeal airway of hyperdivergent skeletal Class II patients.

    Science.gov (United States)

    Li, Xiaolong; Zhao, Qing; Zhao, Rui; Gao, Meiya; Gao, Xiaolei; Lai, Wenli

    2017-03-01

    To evaluate the effect of occlusal plane control on the hyoid bone position and pharyngeal airway of hyperdivergent skeletal Class II patients during orthodontic treatment. Cephalograms of 47 hyperdivergent skeletal Class II subjects with occlusal plane control (OPC), and another 50 subjects without occlusal plane control (NOPC) were selected to compare the effects of the occlusal plane control procedure. Lateral cephalograms before treatment (T1), immediately after treatment (T2), and an average of 12 months after treatment (T3) were obtained, and 17 measurements were analyzed in each group and compared between groups. With respect to the T2-T1 changes, the sagittal discrepancies in both groups were alleviated. In the OPC group, both the occlusal and mandibular plane angles decreased, accompanied by anterior and superior movement and counterclockwise rotation of the hyoid bone. The overall changes from T3 to T1 in each group exhibited trends similar to that induced by treatment. As for pharyngeal airway space alterations, no significant difference in OPC group was presented throughout treatment or retention periods. The customized occlusal plane control procedure was effective for hyperdivergent skeletal Class II patients: The occlusal plane rotated counterclockwise, followed by a counterclockwise rotation of the mandibular plane. The hyoid bone moved anteriorly and superiorly, accompanied by its counterclockwise rotation. However, this procedure did not induce significant alteration of the pharyngeal airway space.

  4. The association between RCAS1 expression in laryngeal and pharyngeal cancer and its healthy stroma with cancer relapse

    International Nuclear Information System (INIS)

    Dutsch-Wicherek, Magdalena; Tomaszewska, Romana; Lazar, Agata; Wicherek, Lukasz; Skladzien, Jacek

    2009-01-01

    The purpose of this study has been to establish the level of RCAS1 – a membrane protein expressed in various cancer cells and able to induce apoptosis of CTLs and NK cells in pharyngeal and laryngeal cancer and its clear surgical margin – with respect to clinicopathological features and to patient's follow up and evaluate its possible role in cancer relapse. A total of 122 tissue samples were obtained: 51 samples from laryngeal and pharyngeal squamous cell carcinoma, 51 samples from the clear surgical margins of these tumors, and 20 tissue samples derived from the healthy mucous membranes of the upper respiratory tract mucosa of patients without cancerous tumors. Patients were observed for a total of 4 years following surgical treatment. The level of RCAS1 expression was assessed by immunohistochemistry and Western blot. RCAS1 was identified in all laryngeal and pharyngeal carcinomas and in almost all the clear surgical margin samples. The level of RCAS1 expression was significantly higher in the cancerous samples than in the clear surgical margins and was determined to be related to the grade of the cancer and the presence of lymph node metastases. In cases of cancer relapse, significantly higher levels of RCAS1 expression were observed in the clear surgical margins. Selective cytotoxic immune cell suppression concomitant with tumor growth and associated with RCAS1 expression seems to be an important event connected with cancer relapse

  5. [Pulmonary function in children after neonatal meconium aspiration syndrome].

    Science.gov (United States)

    Djemal, N; Ben Ammar, H; Masmoudi, K; Rguaieg, R; Trigui, L; Ben Hmad, A; Kannou, M; Hmida, N; Gargouri, A; Zouari, N; Rekik, A

    2008-02-01

    Meconium aspiration syndrome is a disease of the newborn mature or post mature. The acute pulmonary consequences can be extremely severe. In the few studies of the long-term pulmonary sequelae, it seems that certain children surviving meconium aspiration syndrome keep an obstructive syndrome. The aim of our study was to assess long term respiratory residual damage from meconium aspiration syndrome. During a seven-year period going from 1994 to 2000, we reviewed the files of children hospitalized in neonatology department of Sfax for meconium aspiration syndrome. The children who were convoked (group M: n=27), underwent spirometry, followed by an exercise stress. An age matched control group (group C: n=23) of healthy children was investigated in the same way. The group M comprised 15 boys and 12 girls aged four to 11, an average of 7+/-1.9 years. With the study of the respiratory function, we did not find an obstructive syndrome. Spirometry revealed a total pulmonary capacity in an average of 133+/-55.65% of theoretical (group M) versus 105.5+/-27.96% of theoretical (group C) (Pmeconium aspiration syndrome tend to develop alveolar hyperinflation and airway hyperreactivity to exercise.

  6. [Comparison of two forms of nasal and pharyngeal topical anestesia for performing esophageal manometry].

    Science.gov (United States)

    Carmona-Sánchez, Ramón; Esmer-Sánchez, David; Tostado-Fernández, Fernando Alvarez

    2007-01-01

    The esophageal manometry (EM) is an invasive procedure that causes nasal pain, pharyngeal pain, and nausea. A topical anesthetic may improve tolerance of the examination. To compare the effectiveness of 10% lidocaine with 20% benzocaine as topical anesthetics in order to reduce discomfort during an EM. 251 patients who had been prescribed an EM received either lidocaine or benzocaine in the nose and pharynx before inserting the catheter An EM was carried out using the usual pull-trough technique and an observer registered the insertion time of the catheter. Patients assessed the intensity of nasal pain and nausea by means of a visual analog scale. Finally, patients were asked whether, if necessary, they would repeat the study. 127 patients were studied in the lidocaine group and 124 in the benzocaine group. The EM was carried out on all patients without complications. Although benzocaine tended to be the preferred anesthetic, no significant differences were found between the groups in relation to nasal pain, nausea, and insertion time. The percentage of patients with moderate or intense discomfort was significantly less in the benzocaine group (nasal pain 10 vs. 33%, p < 0.001; and nausea 24 vs. 36%, p = 0.05). A similar percentage of patients said they would not agree to having another EM (p = NS). Both lidocaine and benzocaine are topical anesthetics that can reduce discomfort during an EM. Benzocaine seems to achieve a better effect among more patients submitted to this procedure.

  7. TGF-β Signaling Is Necessary and Sufficient for Pharyngeal Arch Artery Angioblast Formation

    Directory of Open Access Journals (Sweden)

    Maryline Abrial

    2017-07-01

    Full Text Available The pharyngeal arch arteries (PAAs are transient embryonic blood vessels that mature into critical segments of the aortic arch and its branches. Although defects in PAA development cause life-threating congenital cardiovascular defects, the molecular mechanisms that orchestrate PAA morphogenesis remain unclear. Through small-molecule screening in zebrafish, we identified TGF-β signaling as indispensable for PAA development. Specifically, chemical inhibition of the TGF-β type I receptor ALK5 impairs PAA development because nkx2.5+ PAA progenitor cells fail to differentiate into tie1+ angioblasts. Consistent with this observation, we documented a burst of ALK5-mediated Smad3 phosphorylation within PAA progenitors that foreshadows angioblast emergence. Remarkably, premature induction of TGF-β receptor activity stimulates precocious angioblast differentiation, thereby demonstrating the sufficiency of this pathway for initiating the PAA progenitor to angioblast transition. More broadly, these data uncover TGF-β as a rare signaling pathway that is necessary and sufficient for angioblast lineage commitment.

  8. Risk factors for laryngeal and pharyngeal cancer in patients treated at Liaquat University Hospital, Jamshoro, Pakistan

    International Nuclear Information System (INIS)

    Amur, S.A.; Channa, N.A.; Mugheri, M.H.; Khuhro, Q.

    2017-01-01

    To assess the environmental as well as dietary risk factors for the laryngeal and pharyngeal cancer (LPC) in patients treated at Liaquat University Hospital, Jamshoro. Methodology: Total 395 LPC patients and 550 healthy persons were interviewed through a standard questionnaire specially designed to study the risk factors for LPC disease. Significance level (p<0.05) was assessed with chi-squared test (95% confidence interval) and odds ratios were measured for associations of factors with LPC by logistic regression analysis. Results: The age range was 37.6 to 56.6 years with majority of males as compared to females. Majority of LPC patients were married, underweight and labor workers. Use of non-branded oil, smoking and illiteracy and sun exposure 1 hour were significantly positively associated with LPC. Mainpuri was observed at highest significant positive risk factor for LPC. Less vegetables, less fruit and less meat consumption as well as, deep fried/fried foods and more tea intake were found significantly positively associated with LPC disease. Conclusion: Labor work, Illiteracy, smoking, use of non-branded cooking oil, sun exposure 1 hour, manipuri, consumption of less vegetables, less fruit and less meat, deep fried/fried foods and more tea intake were found significantly positively associated risk factors of LPC. (author)

  9. Is pepsin detected in the saliva of patients who experience pharyngeal reflux?

    Science.gov (United States)

    Printza, A; Speletas, M; Triaridis, S; Wilson, J

    2007-07-01

    To investigate if pepsin is detected, with an activity assay, in the saliva of patients with a clinical diagnosis of laryngopharyngeal reflux (LPR) and can therefore be used as a diagnostic marker of laryngopharyngeal reflux. Pilot, prospective study. Adult participants with a clinical diagnosis of LPR collected whole saliva samples on regular intervals for a day, and upon experiencing symptoms attributed to LPR. Patients were selected on the basis of presence of severe symptoms and laryngoscopic findings of laryngopharyngeal reflux and symptoms of gastroesopharyngeal reflux. They reported voice disorders, dysphagia, throat clearing, excessive secretions, breathing difficulties, cough, globus sensation and throat pain. Control participants reported the absence of pharyngeal and laryngeal symptoms and of symptoms of gastroesophageal reflux. Saliva samples were assayed with fibrinogen on an agarose gel plate. The detection of pepsin was based on the presence of peptic activity which was qualitatively evaluated. The control participants had negative assays. No saliva samples from the LPR patients, collected at regular sampling, tested positive for pepsin. All the samples collected at the presence of symptoms and following regurgitation episodes tested negative for pepsin. Saliva samples pH ranged from 7 to 8. Pepsin was not detected, with an activity assay, in the saliva of patients with a clinical diagnosis of LPR. A concentration method might be more sensitive although saliva and swallowing physiology renders the detection of pepsin in the saliva difficult.

  10. Dynamic radiological study by videorecording of normal oral-pharyngeal deglutition

    International Nuclear Information System (INIS)

    Montesi, A.; Pesaresi, A.; Antico, E.; Piloni, V.

    1988-01-01

    The upsurge of interest in dynamic radiology of the oral pharyngeal phases of deglutition can be explained by: (a) the increased survival-rate in neuromuscular diseases; (b) the improved results in head and neck surgery and radiotherapy; (c) the awareness of the existence of a ''silent'' form of dysphagia. This paper is aimed at divulgating the radiological dynamic investigation of deglutition by videorecording, and at assessing the findings of a study on 119 consecutive non-dysphagic patients (55 males and 64 females; mean age 54 years) as a control group for future studies on dysphagic patients. Seventy-nine out of 119 subjects (66.4%) were found to be normal. Various abnormalities were observed in the remaining 40 (33.6%), such as barium penetration in the subepiglottic or supraglottic space (20 cases), dysmotility of the epiglottis (14 cases), transient and mild circopharyngeal muscle dysfunction (17 cases), diverticula (6 cases). Further studies are needed to evaluate the true significance and implication of these findings in asymptomatic patients. Finally, a more widespread use of this method is hoped for, in order to establish its diagnostic and clinical efficacy

  11. Tissue tropisms in group A Streptococcus: what virulence factors distinguish pharyngitis from impetigo strains?

    Science.gov (United States)

    Bessen, Debra E

    2016-06-01

    Group A streptococci (GAS) are a common cause of pharyngitis and impetigo, and distinct throat strains and skin strains have been long recognized. This review aims to describe recent advances in molecular differences between throat and skin strains, and the pathogenic mechanisms used by virulence factors that may distinguish between these two groups. Recent findings include a new typing scheme for GAS strains based on sequence clusters of genes encoding the entire surface-exposed portion of M protein; correlations between emm-based typing schemes, clinical disease and surface adhesins; covalent bond formation mediated by GAS pili and other adhesins in binding to host ligands; a key role for superantigens in oropharyngeal infection via binding major histocompatibility complex class II antigen; and migration of GAS-specific Th17 cells from the upper respiratory tract to the brain, which may be relevant to autoimmune sequelae. The gap between molecular markers of disease (correlation) and virulence mechanisms (causation) in the establishment of tissue tropisms for GAS infection currently remains wide, but the gap also continues to narrow. Whole genome sequencing combined with mutant construction and improvements in animal models for oropharyngeal infection by GAS may help pave the way for new discoveries.

  12. Atypical Pharyngeal Pouch Arising Bilaterally between the Hyoid Bone and Thyroid Cartilage

    Directory of Open Access Journals (Sweden)

    Lawrence J. Oh

    2017-01-01

    Full Text Available Introduction. Pharyngoesophageal diverticuli are a common cause of dysphagia; they are associated with various morbidities and a decreased quality of life. There are several different types of the diverticuli, and they are divided based on the anatomical location of origin relative to the cricopharyngeal muscle; these include Zenker’s, Killian-Jamieson’s, and Laimer’s diverticula. The authors present a unique case of pharyngoesophageal diverticulum that has not been previously described. Case Presentation. A 65-year-old male presented with a 12-month history of dysphagia and odynophagia for solids. Barium swallow revealed bilateral moderately sized diverticuli that altered in size during the different phases of swallow. CT scan of the neck with oral contrast further identified the anatomy of the diverticuli, arising between the hyoid bone and thyroid cartilage. Discussion. An external transcervical approach was utilised to successfully repair the diverticuli. Subsequent cricopharyngeal spasm was treated with botulinum toxin, and the patient recovered with no ongoing symptoms. The barium swallow study is a commonly utilised initial investigation as it is easy to perform and safe and has good diagnostic value. Definitive management usually involves either endoscopic or open surgery. This case depicts a unique case of a pharyngeal diverticulum arising between the hyoid bone and thyroid cartilage.

  13. Herbst appliance effects on pharyngeal airway ventilation evaluated using computational fluid dynamics.

    Science.gov (United States)

    Iwasaki, Tomonori; Sato, Hideo; Suga, Hokuto; Minami, Ayaka; Yamamoto, Yuushi; Takemoto, Yoshihiko; Inada, Emi; Saitoh, Issei; Kakuno, Eriko; Kanomi, Ryuzo; Yamasaki, Youichi

    2017-05-01

    To evaluate the effect of a Herbst appliance on ventilation of the pharyngeal airway (PA) using computational fluid dynamics (CFD). Twenty-one Class II patients (10 boys; mean age, 11.7 years) who required Herbst therapy with edgewise treatment underwent cone-beam computed tomography (CBCT) before and after treatment. Nineteen Class I control patients (8 boys; mean age, 11.9 years) received edgewise treatment alone. The pressure and velocity of the PA were compared between the groups using CFD based on three-dimensional CBCT images of the PA. The change in oropharyngeal airway velocity in the Herbst group (1.95 m/s) was significantly larger than that in the control group (0.67 m/s). Similarly, the decrease in laryngopharyngeal airway velocity in the Herbst group (1.37 m/s) was significantly larger than that in the control group (0.57 m/s). The Herbst appliance improves ventilation of the oropharyngeal and laryngopharyngeal airways. These results may provide a useful assessment of obstructive sleep apnea treatment during growth.

  14. Atrophy, fibrosis, and increased PAX7-positive cells in pharyngeal muscles of oculopharyngeal muscular dystrophy patients.

    Science.gov (United States)

    Gidaro, Teresa; Negroni, Elisa; Perié, Sophie; Mirabella, Massimiliano; Lainé, Jeanne; Lacau St Guily, Jean; Butler-Browne, Gillian; Mouly, Vincent; Trollet, Capucine

    2013-03-01

    Oculopharyngeal muscular dystrophy (OPMD) is a late-onset autosomal dominant inherited dystrophy caused by an abnormal trinucleotide repeat expansion in the poly(A)-binding-protein-nuclear 1 (PABPN1) gene. Primary muscular targets of OPMD are the eyelid elevator and pharyngeal muscles, including the cricopharyngeal muscle (CPM), the progressive involution of which leads to ptosis and dysphagia, respectively. To understand the consequences of PABPN1 polyalanine expansion in OPMD, we studied muscle biopsies from 14 OPMD patients, 3 inclusion body myositis patients, and 9 healthy controls. In OPMD patient CPM (n = 6), there were typical dystrophic features with extensive endomysial fibrosis and marked atrophy of myosin heavy-chain IIa fibers. There were more PAX7-positive cells in all CPM versus other muscles (n = 5, control; n = 3, inclusion body myositis), and they were more numerous in OPMD CPM versus control normal CPM without any sign of muscle regeneration. Intranuclear inclusions were present in all OPMD muscles but unaffected OPMD patient muscles (i.e. sternocleidomastoid, quadriceps, or deltoid; n = 14) did not show evidence of fibrosis, atrophy, or increased PAX7-positive cell numbers. These results suggest that the specific involvement of CPM in OPMD might be caused by failure of the regenerative response with dysfunction of PAX7-positive cells and exacerbated fibrosis that does not correlate with the presence of PABPN1 inclusions.

  15. Sequential Coordination between Lingual and Pharyngeal Pressures Produced during Dry Swallowing

    Directory of Open Access Journals (Sweden)

    Jitsuro Yano

    2014-01-01

    Full Text Available The aim of this study was to investigate oropharyngeal pressure flow dynamics during dry swallowing in ten healthy subjects. Tongue pressure (TP was measured using a sensor sheet system with five measuring points on the hard palate, and pharyngeal pressure (PP was measured using a manometric catheter with four measuring points. The order and correlations of sequential events, such as onset, peak, and offset times of pressure production, at each pressure measuring point were analyzed on the synchronized waveforms. Onset of TP was earlier than that of PP. The peak of TP did not show significant differences with the onset of PP, and it was earlier than that of PP. There was no significant difference between the offset of TP and PP. The onset of PP was temporally time-locked to the peak of TP, and there was an especially strong correlation between the onset of PP and TP at the posterior-median part on the hard palate. The offset of PP was temporally time-locked to that of TP. These results could be interpreted as providing an explanation for the generation of oropharyngeal pressure flow to ensure efficient bolus transport and safe swallowing.

  16. Clinical features of pharyngeal intraepithelial neoplasias and outcomes of treatment by endoscopic submucosal dissection.

    Science.gov (United States)

    Kuwabara, Takayasu; Hiyama, Toru; Oka, Shiro; Urabe, Yuji; Tanaka, Shinji; Yoshihara, Masaharu; Arihiro, Koji; Shimamoto, Fumio; Chayama, Kazuaki

    2012-12-01

    Endoscopic detection of superficial squamous epithelial lesions of the pharynx has increased. To clarify the association between macroscopic and histologic characteristics of intraepithelial pharyngeal neoplasias, and to evaluate the effectiveness of endoscopic submucosal dissection (ESD) for their treatment. Retrospective analysis of the features of high-grade dysplasia or carcinoma in situ (HGD/CIS) versus low-grade dysplasia (LGD) and of ESD-based outcomes. Endoscopy department at a university hospital. Fifty-one patients with 66 lesions treated by ESD from November 2007 to March 2011. Primary hypopharyngeal lesions were significantly more frequent in HGD/CIS than in LGD (54.1% vs 20.7%, P = .011), and oropharyngeal lesions were significantly less frequent in HGD/CIS (45.9% vs 79.3%, P = .011). HGD/CIS lesions were significantly larger than LGD lesions (median 8 mm vs 4 mm, P neoplasias. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  17. Longitudinal analysis of the group A Streptococcus transcriptome in experimental pharyngitis in cynomolgus macaques.

    Science.gov (United States)

    Virtaneva, Kimmo; Porcella, Stephen F; Graham, Morag R; Ireland, Robin M; Johnson, Claire A; Ricklefs, Stacy M; Babar, Imran; Parkins, Larye D; Romero, Romina A; Corn, G Judson; Gardner, Don J; Bailey, John R; Parnell, Michael J; Musser, James M

    2005-06-21

    Identification of the genetic events that contribute to host-pathogen interactions is important for understanding the natural history of infectious diseases and developing therapeutics. Transcriptome studies conducted on pathogens have been central to this goal in recent years. However, most of these investigations have focused on specific end points or disease phases, rather than analysis of the entire time course of infection. To gain a more complete understanding of how bacterial gene expression changes over time in a primate host, the transcriptome of group A Streptococcus (GAS) was analyzed during an 86-day infection protocol in 20 cynomolgus macaques with experimental pharyngitis. The study used 260 custom Affymetrix (Santa Clara, CA) chips, and data were confirmed by TaqMan analysis. Colonization, acute, and asymptomatic phases of disease were identified. Successful colonization and severe inflammation were significantly correlated with an early onset of superantigen gene expression. The differential expression of two-component regulators covR and spy0680 (M1_spy0874) was significantly associated with GAS colony-forming units, inflammation, and phases of disease. Prophage virulence gene expression and prophage induction occurred predominantly during high pathogen cell densities and acute inflammation. We discovered that temporal changes in the GAS transcriptome were integrally linked to the phase of clinical disease and host-defense response. Knowledge of the gene expression patterns characterizing each phase of pathogen-host interaction provides avenues for targeted investigation of proven and putative virulence factors and genes of unknown function and will assist vaccine research.

  18. Light and hydrogen peroxide inhibit C. elegans feeding through gustatory receptor orthologs and pharyngeal neurons

    Science.gov (United States)

    Bhatla, Nikhil; Horvitz, H. Robert

    2015-01-01

    SUMMARY While gustatory sensing of the five primary flavors (sweet, salty, sour, bitter, and savory) has been extensively studied, pathways that detect non-canonical taste stimuli remain relatively unexplored. In particular, while reactive oxygen species cause generalized damage to biological systems, no gustatory mechanism to prevent ingestion of such material has been identified in any organism. We observed that light inhibits C. elegans feeding and used light as a tool to uncover molecular and neural mechanisms for gustation. Light can generate hydrogen peroxide, and we discovered that hydrogen peroxide similarly inhibits feeding. The gustatory receptor family members LITE-1 and GUR-3 are required for the inhibition of feeding by light and hydrogen peroxide. The I2 pharyngeal neurons increase calcium in response to light and hydrogen peroxide, and these responses require GUR-3 and a conserved antioxidant enzyme peroxiredoxin PRDX-2. Our results demonstrate a gustatory mechanism that mediates the detection and blocks ingestion of a non-canonical taste stimulus, hydrogen peroxide. PMID:25640076

  19. Two-miRNA classifiers differentiate mutation-negative follicular thyroid carcinomas and follicular thyroid adenomas in fine needle aspirations with high specificity

    DEFF Research Database (Denmark)

    Stokowy, Tomasz; Wojtas, Bartosz; Jarzab, Barbara

    2016-01-01

    , since no single miRNA had satisfactory predictive power, classifiers comprising two differentially expressed miRNAs were designed with the aim to improve the classification. Six two-miRNA classifiers were established and quantitative polymerase chain reaction validated in fine needle aspiration samples...

  20. Aspiration biopsy of testis: another method for histologic examination

    International Nuclear Information System (INIS)

    Nseyo, U.O.; Englander, L.S.; Huben, R.P.; Pontes, J.E.

    1984-01-01

    The most important method for evaluating the pathogenesis of male infertility is open testicular biopsy. Herein the authors describe a method of aspiration biopsy of testis for histologic examination. Sexually mature dogs and rats treated with chemotherapeutic agents and ionizing radiation were followed with periodic testicular aspiration biopsy during and after treatment. The histologic findings from the aspiration biopsy compare with the results of routine histologic examination in assessing spermatogenetic activity and delineating pathologic changes. The puncture in the experimental animals was performed under general anesthesia. In human patients testicular biopsy could be done under local anesthesia in an outpatient clinic. The procedure would be less painful, minimally invasive, and more cost-effective

  1. Squalene aspiration pneumonia : thin-section CT and histopathologic findings

    International Nuclear Information System (INIS)

    Lee, Jin Seong; Gong, Gyung Yub; Lim, Tae Hwan

    1998-01-01

    The purpose of this study was to describe the thin-section computed tomography (CT) findings and histopathologic findings of squalene aspiration pneumonia. Thin-section CT scans were obtained from nine patients with proven exogenous lipoid pneumonia resulting from aspiration of squalene (derived from shark liver oil). The condition was diagnosed by biopsy (n=3), bronchoalveolar lavage(n=4), or sputum cytology and clinical history (n=2) of squalene use was confirmed in all patients. Specimens of transbronchial lung biopsy were also reviewed and compared with thin-section CT findings. On the basis of these results, we concluded that squalene aspiration pneumonia can be reliably diagnosed by thin-section CT findings particularly when the appropriate history is known. (author). 19 refs., 3 figs

  2. [Recommendations for the prevention of foreign body aspiration].

    Science.gov (United States)

    Lluna, Javier; Olabarri, Mikel; Domènech, Anna; Rubio, Bárbara; Yagüe, Francisca; Benítez, María T; Esparza, María J; Mintegi, Santiago

    2017-01-01

    The aspiration of a foreign body remains a common paediatric problem, with serious consequences that can produce both acute and chronic disease. Aspiration usually causes a medical emergency that requires a prompt diagnosis and an urgent therapeutic approach as it may result in the death of the child or severe brain injury. It typically involves organic foreign bodies (mainly food or nuts) aspirated by children under 5 years old, and usually at home. In this statement, the Committee on Safety and Prevention of Non-Intentional Injury in Childhood of the Spanish Paediatrics Association provides a series of recommendations, both educational (while eating and playing), as well as legal, to prevent such episodes. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Regional and individual determinants of entrepreneurial growth aspirations

    Directory of Open Access Journals (Sweden)

    Joan-Lluís Capelleras

    2018-01-01

    Full Text Available This paper investigates the unique and joint effects of population density and early-stage entrepreneurs’ human capital endowments (higher education, entrepreneurship training and owner-manager experience on entrepreneurial growth aspirations. We test a number of hypotheses using data that combine individual and province level information in Spain over the period 2008-2010. We argue that growth aspirations of early-stage entrepreneurs are higher in more densely populated regions, but that such environmental influence is stronger for individuals with greater human capital. This is because they will be more aware that denser regions offer more favorable conditions for new businesses and also requires greater firm growth to compensate for a higher risk of business failure. Consistent with our view, we find that the growth aspirations of entrepreneurs with higher education are higher in densely populated provinces.

  4. Aspiration pneumonia of mineral oil: a case report

    International Nuclear Information System (INIS)

    Malheiros, Noemia Reis; Costa Praxedes, Marcia da; Machado, Dianne Mello; Marchiori, Edson

    1995-01-01

    The authors report a case of 14 month-old boy with clinical features of dyspnea, cough and acrocyanosis following aspiration of mineral oil used in the treatment of partial small bowel obstruction by Ascaris lumbricoides. A chest roentgenogram was reported as extensive bilateral confluent consolidation that showed progressive improvement and the presence of a bilateral infiltration. The diagnosis of aspiration pneumonia of mineral oil was confirmed by lung biopsy. Radiological and anatomo pathological aspects are presented as well as a review of the medical literature about the case. (author). 6 refs., 3 figs

  5. Migration and Social Aspirations: Chinese Cosmopolitanism in Wenzhou Region (China

    Directory of Open Access Journals (Sweden)

    Irene Rodrigues

    2018-04-01

    Full Text Available This article explores what motivates the movements of Chinese migrants from China to Portugal. It presents an ethnographic account of social aspirations in Wenzhou, a port city located in South Zhejiang (Southeast China, where post-Mao economic prosperity, allied to the existence of networks of trade and migration, resulted in social and economic inequalities and great social pressure to become rich and successful. Based on ethnographic fieldwork conducted in Wenzhou and in Lisbon (Portugal between 2008 and 2010, this paper argues that Wenzhou migratory projects are a result of modernity aspirations and desires for material modernization articulated with core Chinese values such as filial piety.

  6. AstroBiology Explorer Mission Concepts (ABE/ASPIRE)

    Science.gov (United States)

    Sandford, Scott; Ennico, Kimberly A.

    2006-01-01

    The AstroBiology Explorer (ABE) and the Astrobiology Space InfraRed Explorer (ASPIRE) Mission Concepts are two missions designed to address the questions (1) Where do we come from? and (2) Are we alone? as outlined in NASA s Origins Program using infrared spectroscopy to explore the identity, abundance, and distribution of molecules of astrobiological importance throughout the Universe. The ABE mission s observational program is focused on six tasks to: (1) Investigate the evolution of ice and organics in dense clouds and star formation regions, and the young stellar/planetary systems that form in them; (2) Measure the evolution of complex organic molecules in stellar outflows; (3) Study the organic composition of a wide variety of solar system objects including asteroids, comets, and the planets and their satellites; (4) Identify organic compounds in the diffuse interstellar medium and determine their distribution , abundance, and change with environment; (5) Detect and identify organic compounds in other galaxies and determine their dependence on galactic type; and (6) Measure deuterium enrichments in interstellar organics and use them as tracers of chemical processes. The ASPIRE mission s observational program expands upon ABE's core mission and adds tasks that (7) Address the role of silicates in interstellar organic chemistry; and (8) Use different resolution spectra to assess the relative roles and abundances of gas- and solid-state materials. ABE (ASPIRE) achieves these goals using a highly sensitive, cryogenically-cooled telescope in an Earth drift-away heliocentric orbit, armed with a suite of infrared spectrometers that cover the 2.5-20(40) micron spectral region at moderate spectral resolution (R>2000). ASPIRE's spectrometer complement also includes a high-resolution (R>25,000) module over the 4-8 micron spectral region. Both missions target lists are chosen to observe a statistically significant sample of a large number of objects of varied types in

  7. The Influence of Laterality of Pharyngeal Bolus Passage on Dysphagia in Hemiplegic Stroke Patients

    Science.gov (United States)

    Kim, Min Seok; Lee, Seong Jae; Seo, Dong Hyuk; Hyun, Jung Keun; Kim, Jae Il

    2012-01-01

    Objective To investigate swallowing laterality in hemiplegic patients with stroke and recovery of dysphagia according to the laterality. Method The sample was comprised of 46 dysphagic patients with hemiplegia after their first stroke. The sample's videofluoroscopic swallowing study (VFSS) was reviewed. Swallowing laterality was determined by the anterior-posterior view of VFSS. We measured width difference of barium sulfate liquid flow in the pharyngoesophageal segment. If there was double or more the width of that from the opposite width in the pharyngoesophageal segment more than twice on three trials of swallowing, then it was judged as having laterality. Subjects were assigned to no laterality (NL), laterality that is ipsilateral to hemiplegic side (LI), and laterality that is contralateral to hemiplegic side (LC) groups. We measured the following: prevalence of aspiration, the 8-point penetration-aspiration scale, and the functional dysphagia scale of the subjects at baseline and follow up. Results Laterality was observed in 45.7% of all patients. Among them, 52.4% were in the hemiplegic direction. There was no significant difference between groups at baseline in all measurements. When we compared the changes in all measurements on follow-up study, there were no significant differences between groups. Conclusion Through this study, we found that there was no significant relation between swallowing laterality and the severity or prognosis of swallowing difficulty. More studies for swallowing laterality on stroke patients will be needed. PMID:23185735

  8. A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis.

    Science.gov (United States)

    Kim, Joon Yub; Chung, Seok Won; Kim, Joo Hak; Jung, Jae Hong; Sung, Gwang Young; Oh, Kyung-Soo; Lee, Jong Soo

    2016-03-01

    Olecranon bursitis might be a minor problem in the outpatient clinic but relatively be common to occur. However, there are few well-designed studies comparing approaches to treatment. (1) Which treatment (compression bandaging with nonsteroidal antiinflammatory drugs [NSAIDs], aspiration, or aspiration with steroid injections) is associated with the highest likelihood of resolution of nonseptic olecranon bursitis? (2) Which treatment is associated with earliest resolution of symptoms? (3) What factors are associated with treatment failure by 4 weeks? We enrolled 133 patients from two centers; after applying prespecified exclusions (septic bursitis or concomitant inflammatory arthritis, intraarticular elbow pathology, recent aspiration or steroid injection done elsewhere, and refusal to participate), 90 patients were randomly allocated to receive compression bandaging with NSAIDs (C), aspiration (A), or aspiration with steroid injection (AS) groups (30 patients in each). The groups were similar at baseline in terms of age and gender. Seven patients (four from Group A and three from Group AS) were lost to followup. All patients were followed up weekly for 4 weeks, and the same treatment procedure was repeated if the bursitis recurred with any substantial fluid collection. At 4 weeks, the state of resolution and pain visual analog scale (VAS) were evaluated. Failed resolution was defined as presence of persistent olecranon bursal fluid collection at Week 4 after the initiation of the treatment; on the contrary, if bursal fluid collection was clinically reduced or completely disappeared by the end of Week 4, the treatment was considered successful. We compared the proportion of resolution by Week 4 and the median times to resolution among the treatment groups. In addition, we evaluated whether the resolution affected pain VAS and what factors were associated with the resolution. There were no differences in the proportion of patients whose bursitis resolved by Week 4

  9. Effect of Clark's twin-block appliance (CTB and non-extraction fixed mechano-therapy on the pharyngeal dimensions of growing children

    Directory of Open Access Journals (Sweden)

    Batool Ali

    2015-12-01

    Full Text Available Abstract Introduction: Narrow airway dimensions due to mandibular deficiency can predispose an individual to severe respiratory distress. Hence, treatment with mandibular advancement devices at an early age might help improving the pharyngeal passage and reduce the risk of respiratory difficulties. Therefore, the aim of the current study was to evaluate the mean changes in the pharyngeal dimensions of children with mandibular deficiency treated with Clark's twin-block appliance (CTB followed by fixed orthodontic treatment. Methods: Orthodontic records of 42 children with mandibular deficiency were selected. Records comprised three lateral cephalograms taken at the start of CTB treatment, after CTB removal and at the end of fixed appliance treatment, and were compared with 32 controls from the Bolton-Brush study. Friedman test was used to compare pre-treatment, mid-treatment and post-treatment pharyngeal dimensions. Wilcoxon signed rank test was used to compare the airway between pre-treatment and post follow-up controls. Mann-Whitney U test was applied to compare the mean changes in pharyngeal dimensions between treatment group and controls from T2 to T0. Post-hoc Dunnet T3 test was used for multiple comparisons of treatment outcomes after CTB and fixed appliances, taking a p-value of ≤ 0.05 as statistically significant. Results: Superior pharyngeal space (p < 0.001 and upper airway thickness (p = 0.035 were significantly increased after CTB, and the change in superior pharyngeal space remained stable after fixed mechano-therapy. Conclusion: CTB can have a positive effect in improving pharyngeal space and the resultant increase in airway remains stable on an average of two and a half years.

  10. Trends in oral cavity, pharyngeal, oesophageal and gastric cancer mortality rates in Spain, 1952-2006: an age-period-cohort analysis.

    Science.gov (United States)

    Seoane-Mato, Daniel; Aragonés, Nuria; Ferreras, Eva; García-Pérez, Javier; Cervantes-Amat, Marta; Fernández-Navarro, Pablo; Pastor-Barriuso, Roberto; López-Abente, Gonzalo

    2014-04-11

    Although oral cavity, pharyngeal, oesophageal and gastric cancers share some risk factors, no comparative analysis of mortality rate trends in these illnesses has been undertaken in Spain. This study aimed to evaluate the independent effects of age, death period and birth cohort on the mortality rates of these tumours. Specific and age-adjusted mortality rates by tumour and sex were analysed. Age-period-cohort log-linear models were fitted separately for each tumour and sex, and segmented regression models were used to detect changes in period- and cohort-effect curvatures. Among men, the period-effect curvatures for oral cavity/pharyngeal and oesophageal cancers displayed a mortality trend that rose until 1995 and then declined. Among women, oral cavity/pharyngeal cancer mortality increased throughout the study period whereas oesophageal cancer mortality decreased after 1970. Stomach cancer mortality decreased in both sexes from 1965 onwards. Lastly, the cohort-effect curvature showed a certain degree of similarity for all three tumours in both sexes, which was greater among oral cavity, pharyngeal and oesophageal cancers, with a change point in evidence, after which risk of death increased in cohorts born from the 1910-1920s onwards and decreased among the 1950-1960 cohorts and successive generations. This latter feature was likewise observed for stomach cancer. While the similarities of the cohort effects in oral cavity/pharyngeal, oesophageal and gastric tumours support the implication of shared risk factors, the more marked changes in cohort-effect curvature for oral cavity/pharyngeal and oesophageal cancer could be due to the greater influence of some risk factors in their aetiology, such as smoking and alcohol consumption. The increase in oral cavity/pharyngeal cancer mortality in women deserves further study.

  11. Electrically-activated dilator muscles reduce pharyngeal resistance in anaesthetized dogs with upper airway obstruction.

    Science.gov (United States)

    Bishara, H; Odeh, M; Schnall, R P; Gavriely, N; Oliven, A

    1995-09-01

    There is current controversy as to whether electrical stimulation of upper airway musculature can be used us a beneficial treatment modality in patients with obstructive sleep apnoea syndrome. Increased upper airway (UAW) muscle activity decreases UAW resistance (Ruaw) in isolated UAW of dogs. In the present study, we evaluated the effect of UAW muscle contraction on UAW patency in anaesthetized dogs in vivo breathing spontaneously through partially and completely obstructed UAW. Airflow and supraglottic pressure were measured to obtain Ruaw. Ruaw could be regulated by inhalation of a rubber balloon implanted transcutaneously in the pharyngeal submucosa to produce partial or complete obstruction. Wire electrodes were implanted bilaterally into the genioglossus (GG), geniohyoid (GH), sternothyroid (ST), and sternohyoid (SH) muscles for electrical stimulation (ES), and into the alae nasi for electromyographic (EMG) recording. Three levels of electrical stimulation were delivered to each muscle before and during partial or complete UAW obstruction. Genioglossus and geniohyoid stimulation both resulted in a significant reduction in Ruaw, which was most pronounced during partial obstruction, reducing Ruaw from 54 +/- 11 to 14 +/- 3 and from 74 +/- 12 to 31 +/- 5 cmH2O.L-1.s, respectively. At low voltage, stimulation of the genioglossus was more effective than stimulation of the geniohyoid in reducing Ruaw. Furthermore, electrical stimulation of the genioglossus but not of the geniohyoid released total obstruction. In contrast, electrical stimulation of the sternohyoid and sternothyroid produced no significant change in Ruaw. These findings demonstrate that selective UAW dilatory muscle contraction in spontaneously breathing anaesthetized dogs reduces Ruaw in the presence of UAW obstruction and releases UAW occlusion, with the genioglossus being the most effective muscle. This favours further attempts to investigate the benefits of electrical stimulation of selected

  12. Oculo-auriculo-vertebral spectrum: going beyond the first and second pharyngeal arch involvement.

    Science.gov (United States)

    Davide, Brotto; Renzo, Manara; Sara, Ghiselli; Elisa, Lovo; Rodica, Mardari; Irene, Toldo; Alessandro, Castiglione; Giovanni, Schifano; Valentina, Stritoni; Roberto, Bovo; Patrizia, Trevisi; Alessandro, Martini

    2017-03-01

    Intracranial vascular, bone, and brain abnormalities might be observed in oculo-auriculo-vertebral spectrum (OAVS) patients even though these structures do not derive embryologically from the first and second pharyngeal arches. This neuroimaging study investigated their type, frequency and phenotype correlations among OAVS patients. Thirty-five OAVS patients (mean-age 4.8 ± 6.0 years; age range 0.3-30, 14 females) underwent head CT (all patients) and brain MRI (32 patients); 19 patients had a more severe phenotype (Goldenhar syndrome). Internal carotid artery hypoplasia/agenesia and abnormal course, brain abnormalities, internal acoustic canal stenosis/aplasia, cochlear-vestibular malformations, facial nerve bony canal anomalies, and oval window atresia were recorded. Nine of 35 (26%) OAVS patients showed internal carotid artery anomalies; 18/32 (56%) had protean brain MRI abnormalities, ranging from tegmental cap anomaly to mild ventriculomegaly, which were associated with Goldenhar syndrome (p < 0.001) and concomitant cranial nerve abnormalities (p = 0.004); 11/35 (31%) disclosed cochlear-vestibular abnormalities including Michel deformity, common cavity, cochlear hypoplasia, and incomplete partition type-1 that were associated with Goldenhar syndrome (p = 0.01) and ipsilateral VIII cranial nerve abnormalities (p < 0.001); 16/35 (46%, 23 sides) presented facial nerve bony canal abnormalities that were associated with Goldenhar syndrome (p < 0.001) and ipsilateral VII cranial nerve (p < 0.001) and cochlear-vestibular (p < 0.001) abnormalities; and 23/31 (74%, 31 sides) showed oval window atresia, always with concomitant ossicular chain dysplasia. Intracranial vascular, bone, and brain abnormalities in OAVS patients are strikingly common and heterogeneous. As their detection might impact significantly on clinical and surgical management of affected patients, accurate neuroimaging investigations should be included in the diagnostic work-up of OAVS.

  13. Interactome analysis of longitudinal pharyngeal infection of cynomolgus macaques by group A Streptococcus.

    Science.gov (United States)

    Shea, Patrick R; Virtaneva, Kimmo; Kupko, John J; Porcella, Stephen F; Barry, William T; Wright, Fred A; Kobayashi, Scott D; Carmody, Aaron; Ireland, Robin M; Sturdevant, Daniel E; Ricklefs, Stacy M; Babar, Imran; Johnson, Claire A; Graham, Morag R; Gardner, Donald J; Bailey, John R; Parnell, Michael J; Deleo, Frank R; Musser, James M

    2010-03-09

    Relatively little is understood about the dynamics of global host-pathogen transcriptome changes that occur during bacterial infection of mucosal surfaces. To test the hypothesis that group A Streptococcus (GAS) infection of the oropharynx provokes a distinct host transcriptome response, we performed genome-wide transcriptome analysis using a nonhuman primate model of experimental pharyngitis. We also identified host and pathogen biological processes and individual host and pathogen gene pairs with correlated patterns of expression, suggesting interaction. For this study, 509 host genes and seven biological pathways were differentially expressed throughout the entire 32-day infection cycle. GAS infection produced an initial widespread significant decrease in expression of many host genes, including those involved in cytokine production, vesicle formation, metabolism, and signal transduction. This repression lasted until day 4, at which time a large increase in expression of host genes was observed, including those involved in protein translation, antigen presentation, and GTP-mediated signaling. The interactome analysis identified 73 host and pathogen gene pairs with correlated expression levels. We discovered significant correlations between transcripts of GAS genes involved in hyaluronic capsule production and host endocytic vesicle formation, GAS GTPases and host fibrinolytic genes, and GAS response to interaction with neutrophils. We also identified a strong signal, suggesting interaction between host gammadelta T cells and genes in the GAS mevalonic acid synthesis pathway responsible for production of isopentenyl-pyrophosphate, a short-chain phospholipid that stimulates these T cells. Taken together, our results are unique in providing a comprehensive understanding of the host-pathogen interactome during mucosal infection by a bacterial pathogen.

  14. The Effect of Maternal Employment on Schoolchildren's Educational Aspirations in Korea.

    Science.gov (United States)

    Ju, Dong-Beom; Chung, Il-Hwan

    2000-01-01

    Examined the relationships between maternal employment and schoolchildren's educational aspirations in Korea. Found that children whose mothers were working full-time had lower educational aspirations, although maternal involvement and parents' educational expectations mitigated these effects. (JPB)

  15. Clinical audit of ultrasound guided fine needle aspiration in a general cytopathology service

    Directory of Open Access Journals (Sweden)

    Gunjan Mangla

    2015-01-01

    Conclusions: Reporting practices varied and did not conform to a uniform structure. The inadequacy rates of breast and thyroid aspirates were comparable to the rates in the literature. Comparable studies were not available for intra-abdominal aspirates.

  16. Clinical audit of repeat fine needle aspiration in a general cytopathology service

    Directory of Open Access Journals (Sweden)

    Rachna Goyal

    2014-01-01

    Conclusions: Inadequate aspirates, non-diagnostic descriptive reports, and FNAC/FNAB from thyroid, lymph nodes, and breast contribute to repeats. We suggest steps to reduce the number of repeat aspirates to eliminate extra work.

  17. Understanding Graduate School Aspirations: The Effect of Good Teaching Practices

    Science.gov (United States)

    Hanson, Jana M.; Paulsen, Michael B.; Pascarella, Ernest T.

    2016-01-01

    This study examined the effects of good teaching practices on post-baccalaureate degree aspirations using logistic regression techniques on a multi-institutional, longitudinal sample of students at 4-year colleges and universities in the USA. We examined whether eight good teaching practices (non-classroom interactions with faculty, prompt…

  18. The Hierarchical Personality Structure of Aspiring Creative Writers

    Science.gov (United States)

    Maslej, Marta M.; Rain, Marina; Fong, Katrina; Oatley, Keith; Mar, Raymond A.

    2014-01-01

    Empirical studies of personality traits in creative writers have demonstrated mixed findings, perhaps due to issues of sampling, measurement, and the reporting of statistical information. The goal of this study is to quantify the personality structure of aspiring creative writers according to a modern hierarchal model of trait personality. A…

  19. Weblogs as learning tools for aspirant reflective practitioners

    NARCIS (Netherlands)

    Wopereis, Iwan; Sloep, Peter

    2013-01-01

    Wopereis, I., & Sloep, P. B. (2013, January-February). Weblogs as learning tools for aspirant reflective practitioners. Position paper presented at the Workshop on Technology support for reflecting on experiences and sharing them across learning contexts at the Alpine Rendez-Vous 2013,

  20. Counseling Implications of Black Women's Market Position, Aspirations and Expectancies.

    Science.gov (United States)

    Gurin, Patricia; Pruitt, Anne

    The major premise of this paper is that career and educational counseling for women, and particularly for black women, needs to be based on an understanding of their market position. Data on black women's options and choices in a discriminatory market, on their occupational and educational aspirations, and on the role of expectations in their work…

  1. Performance of Naturally Aspirating IC Engines Operating at High ...

    African Journals Online (AJOL)

    The loss of power and the increase of fuel consumption of naturally aspirating IC engines operating with low atmospheric pressure at high altitude as well as changes in the mixture quality with non adapting mixture formation systems are principally known. Other effects like the additional advance of ignition timing in petrol ...

  2. Diagnostic accuracy of fine needle aspiration cytology in patients ...

    African Journals Online (AJOL)

    thyroid carcinoma being the most predominant type and colloid goiter was the most predominant benign thyroid disease. The sensitivity was 61.5% and specificity 89.5% . Conclusion: This study revealed high specificity and low sensitivity of Fine Needle Aspiration Cytology (FNAC) at detecting malignancy in thyroid nodules.

  3. Who Wants a Job in Biology? Student Aspirations and Perceptions

    Science.gov (United States)

    Henderson, Danielle; Stanisstreet, Martin; Boyes, Edward

    2007-01-01

    This paper describes the results of a questionnaire survey of UK Year 3 biology undergraduates' career aspirations, and their perceptions of employment in teaching, research and conservation. Although most students sought material benefits in their potential careers, even more wished to gain job satisfaction. None of the careers in biology was…

  4. Microfilaria in thyroid gland fine needle aspiration cytology - an ...

    African Journals Online (AJOL)

    Involvement of thyroid gland by filariasis is an unusual finding. We report a case in which microfilaria was found in thyroid aspirate smear. Patient did not have any symptoms or signs suggestive of filariasis. The patient was treated with diethylcarbamazine and a later hemithyroidectomy was performed. We reviewed the ...

  5. Fine Needle Aspiration: A simple and convenient alternative for ...

    African Journals Online (AJOL)

    Nine patients followed up to hospital for other medical problems unrelated to ganglion cysts and only one patient had to undergo surgical excision due to the large size of the cyst. No patient returned with a recurrence. Conclusion: Fine needle aspiration is a simple, non traumatic, inexpensive and low risk alternative method ...

  6. Educational and Occupational Aspirations and Expectations of Rural Youth.

    Science.gov (United States)

    Slocum, Walter L.; Garrett, Gerald R.

    Some of the more significant responses to a questionnaire on educational and occupational aspirations and expectations which was administered to a statewide sample of sophomores, juniors, and seniors in 30 rural high schools by the Department of Rural Sociology at Washington State University were presented in this report. A principal objective of…

  7. Experience With Manual Vacuum Aspiration in Jos, Nigeria | Mutihir ...

    African Journals Online (AJOL)

    Incomplete abortion was the indication for manual vacuum aspiration in 85.3% of the cases, missed abortion in 7.8%, and the evacuation of molar pregnancies in 6.2%. Sedation ... It has eliminated the admissions of the patients to the ward for more than 24 hours, thereby drastically reducing costs from hospital bed charges.

  8. Manual Vacuum Aspiration In The Management Of Post Abortal ...

    African Journals Online (AJOL)

    Eleven (11) patients with tetanus were managed by uterine evacuation using the manual vacuum aspiration at the University of Port Harcourt Teaching Hospital, Nigeria over a period of ten years. Eight (8) of the patients had uterine evacuation while in coma, while three (3) were conscious but had spasm and features of ...

  9. Uncertain aspirations for continuing in education: antecedents and associated outcomes.

    Science.gov (United States)

    Gutman, Leslie Morrison; Schoon, Ingrid; Sabates, Ricardo

    2012-11-01

    Relatively little is known about adolescents who hold uncertain aspirations, that is, those who do not know what they would like to do in the future regarding their educational or occupational plans. Drawing upon the Longitudinal Study of Young People in England born in 1989-1990, the authors tested a pathway model to investigate the antecedents of uncertain aspirations for continuing in education past compulsory schooling age (i.e., 16 years) and associated later educational outcomes. Gender differences in the pathways are also tested. Findings indicate that the relationship linking socioeconomic status to uncertain aspirations is mediated through parents' educational expectations and the relationship linking academic performance at age 11 to uncertain aspirations is mediated through parents' educational expectations and adolescents' self-perceived ability, which, in turn, predict academic performance at age 16 and educational enrollment at age 18. Gender differences in these processes are also evident: young males not only hold greater uncertainty about continuing in education, the consequences of uncertainty regarding later academic performance are worse for males than females.

  10. The impact of the manual vacuum aspiration (MVA) technique on ...

    African Journals Online (AJOL)

    Objectives. To assess the impact of the manual vacuum aspiration (MVA) technique on health care services and its acceptability to patients and staff. Design. Prospective descriptive survey. Setting. The university teaching hospital, Blantyre, Malawi. Participants. All 456 patients who had MVA for treatment or investigation ...

  11. Parents' occupation as correlate of students' career aspiration in ...

    African Journals Online (AJOL)

    This study investigated the relationship between parents' occupation and students' career aspiration in public secondary schools in Esan West Local Government Area of Edo State. The correlational research design was adopted for the study. A sample of 320 students was drawn for by simple random sampling technique ...

  12. Fine Needle Aspiration Cytology In Tumour Diagnosis | Obaseki ...

    African Journals Online (AJOL)

    Fine needle aspiration cytology (FNAC), a technique for obtaining cellular material for cytological examination and diagnosis using a 21- gauge or smaller needle, is performed using a 5, 10, or 20ml syringe either freehand or using special syringe holders. It allows a minimally invasive, rapid diagnosis of tissue samples but

  13. Working Memory: The Influence of Culture on Aspirations.

    Science.gov (United States)

    Lawrence, Barbara Kent

    1998-01-01

    Describes an ethnographic dissertation that portrays how patterns of culture and history in a rural community in Maine negatively influence many rural students' academic aspirations. Consolidated schools exacerbate the effect by separating students from their parents and communities and alienating them in school. (TD)

  14. Experience with manual vacuum aspiration at the Imo State ...

    African Journals Online (AJOL)

    Background: Criminal or illegal abortions and it's attendant complications contribute significantly to maternal morbidity and mortality in developing countries. Manual vacuum aspiration provides a cheap, safe and effective means of reducing this morbidity and mortality. Aim: To evaluate the usefulness of manual vacuum ...

  15. Fine Needle Aspiration Cytology [FNAC] Technique As A Diagnostic ...

    African Journals Online (AJOL)

    Background: The Fine needle aspiration technique is frequently done in the University of Maiduguri Teaching Hospital for swellings from any anatomical site of the body. Objective: This paper is aimed at highlighting the importance of the technique in the diagnosis of tumours in any health care institution. Methods: A ...

  16. Diagnostic accuracy of fine needle aspiration cytology in patients ...

    African Journals Online (AJOL)

    Background: Thyroid disease affects about 5% of the World's population. Fine Needle Aspiration Cytology (FNAC) helps in planning extent of surgery. In some studies, FNAC has been found to have a low accuracy for malignancy. Objective: To estimate the sensitivity and specificity of FNAC in detecting malignancy for ...

  17. Fine needle aspiration cytology of breast lumps with histopathologic ...

    African Journals Online (AJOL)

    Objective: To determine the histopathologic correlation of fine needle aspiration cytology FNAC of breast masses seen in the department of histopathology of the Federal Medical Center Owo, Southwestern Nigeria. Design: This is a 5-year retrospective study of breast lumps seen at Department of Histopathology, Federal ...

  18. The impact of the manual vacuum aspiration (MVA) technique on ...

    African Journals Online (AJOL)

    Objectives. To assess the impact of the manual vacuum aspiration (MVA) technique on health care services and its acceptability to patients and staff. Design. Prospective descriptive survey. Setting. The university teaching hospital, Blantyre,. Malawi. Participants. All 456 patients who had MVA for treatment or investigation ...

  19. The cost-effectiveness of introducing manual vacuum aspiration ...

    African Journals Online (AJOL)

    Background. Despite the proven efficacy of manual vacuum aspiration (MVA) for incomplete miscarriages its use is low in Swaziland, including Raleigh Fitkin Memorial (RFM) Hospital, Manzini. Uncertainty about the cost implications of introducing MVA to replace dilatation and curettage (D&C) is probably the major obstacle ...

  20. The Challenges facing Women aspiring for School Leadership ...

    African Journals Online (AJOL)

    ... a manager's position.The study shows that although the professional profile of women in management posts differs from that of their male counterparts in schools, women can also effectively lead and manage schools. Key words: aspirations to principalship; female principals; gender discrimination; school management ...

  1. Determinants of career aspirations of medical students in southern China.

    Science.gov (United States)

    She, LingBing; Wu, BingLi; Xu, LiYan; Wu, JianYi; Zhang, PiXian; Li, EnMin

    2008-12-11

    With recent changes in both the Chinese medical system and compensation of medical doctors, the career aspirations of Chinese medical students have become more diverse. Shantou University Medical College has conducted evaluations and instituted programs to enhance student preparedness to enter a variety of medical careers. A survey was conducted with 85 students to evaluate medical career aspirations and their association with family background, personal skills, English language proficiency, and interest in biomedical research, which were considered as possible factors affecting their career interest. Chinese students aspire to traditional as well as nontraditional medical careers. A significant minority of students are now interested in nontraditional careers such as medical teaching or research. However, poor proficiency in the English language and lack of computer skills may limit their academic and career opportunities. Career aspirations have changed among medical undergraduates. Although many wish to pursue a traditional clinical doctor career, many are interested in research and teaching careers. Factors such as family background, personal characteristics, school mentoring, and extracurricular support may play a role.

  2. Determinants of career aspirations of medical students in southern China

    Directory of Open Access Journals (Sweden)

    Zhang PiXian

    2008-12-01

    Full Text Available Abstract Background With recent changes in both the Chinese medical system and compensation of medical doctors, the career aspirations of Chinese medical students have become more diverse. Shantou University Medical College has conducted evaluations and instituted programs to enhance student preparedness to enter a variety of medical careers. Methods A survey was conducted with 85 students to evaluate medical career aspirations and their association with family background, personal skills, English language proficiency, and interest in biomedical research, which were considered as possible factors affecting their career interest. Results Chinese students aspire to traditional as well as nontraditional medical careers. A significant minority of students are now interested in nontraditional careers such as medical teaching or research. However, poor proficiency in the English language and lack of computer skills may limit their academic and career opportunities. Conclusion Career aspirations have changed among medical undergraduates. Although many wish to pursue a traditional clinical doctor career, many are interested in research and teaching careers. Factors such as family background, personal characteristics, school mentoring, and extracurricular support may play a role.

  3. Analysis Of Career Aspirations Of Agricultural Science Graduates ...

    African Journals Online (AJOL)

    The objective of this study was to identify the career aspirations of agricultural science graduates from Nigerian Universities of Agriculture. A random sample of 215 graduating students of agriculture was selected using stratified random sampling method. Data were collected with the aid of a structured questionnaire and the ...

  4. Desired Mobility or Satisfied Immobility? Migratory Aspirations among Knowledge Workers

    Science.gov (United States)

    Ferro, Anna

    2006-01-01

    Among the aspects discussed within the globalisation process, the international mobility of professional workers assumes considerable relevance. This paper focuses on migratory aspirations among knowledge workers within the context of economic globalisation and market restructuring in Romania. Due to a lack of literature dealing with these issues,…

  5. Aspiration of a perforated pen cap: complete tracheal obstruction ...

    African Journals Online (AJOL)

    Foreign body aspiration is a common but underestimated event in children with potentially fatal outcome. Because of unreliable histories and inconsistent clinical and radiologic findings, diagnosis and treatment can represent a challenge. Inhaled pen caps predispose for complete airway obstruction and are difficult to ...

  6. A Cross Section Study to Correlate Fine Needle Aspiration Cytology ...

    African Journals Online (AJOL)

    ADMIN

    Background: Needle Aspiration Cytology (FNAC) is cheap, simple, quick, minimally invasive procedure that is widely used for preoperative diagnosis of Parotid tumours. Methods: Twenty five patients were prospectively studied over a two-year period at four major hospitals in Zambia. FNAC was done using a 10cc syringe ...

  7. An Assessment Of The Level Of Entrepreneurial Aspiration Of Ogun ...

    African Journals Online (AJOL)

    ... as giving interest free loan, free consultancy services, establishment of centre for enterprises development in tertiary institutions, so as to assist students to realize their entrepreneurial aspirations and launch them into the business world. African Journal of Cross-Cultural Psychology and Sport Facilitation Vol. 10 2008: pp.

  8. Fine needle aspiration cytology of breast lumps with histopathologic ...

    African Journals Online (AJOL)

    E-mail: tunjiomotayo@yahoo.co.uk. Conflict of interest: None declared. SUMMARY. Objective: To determine the histopathologic correlation of fine needle aspiration cytology FNAC of breast masses seen in the department of histopathology of the Federal Medical Center Owo, Southwestern Nigeria. Design: This is a 5-year ...

  9. Tumour reduction with a Cavitron Ultrasonic Surgical Aspirator ® in ...

    African Journals Online (AJOL)

    A 54-year-old woman developed a fungating locally invasive anaplastic thyroid cancer with distant metastases, and was treated with aggressive tumour reduction, using a Cavitron® Ultrasonic Surgical Aspirator. This mode of treatment, applied for the first time in this context, proved to be effective, safe and improved her ...

  10. Efficacy of Fine Needle Aspiration Cytology in the Diagnosis of ...

    African Journals Online (AJOL)

    Background: Fine needle aspiration cytology (FNAC) is a safe, easy to perform, cost effective and an accurate procedure used in the diagnosis of thyroid lesions. Objective: In this study we aimed to demonstrate the effectiveness of FNAC in the diagnosis of thyroid swellings in Red Sea State, Sudan. Methods: FNAC from ...

  11. Comparision of Fine Needle Aspiration Cytology and Fine Needle ...

    African Journals Online (AJOL)

    Background: Open biopsy of the breast used to be the main traditional method of diagnosis of breast lumps. Fine Needle Aspiration Cytology (FNAC) was later introduced which depends on suction and thus yields hemorrhagic material for cytological study.This study was undertaken to find out if there is a difference in ...

  12. Bio rapid prototyping by extruding/aspirating/refilling thermoreversible hydrogel

    Energy Technology Data Exchange (ETDEWEB)

    Iwami, K; Noda, T; Ishida, K; Umeda, N [Department of Mechanical Systems and Engineering, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo 184-8588 (Japan); Morishima, K [Department of Bio-Applications and Systems Engineering, Tokyo University of Agriculture and Technology, 2-24-16 Nakacho, Koganei, Tokyo 184-8588 (Japan); Nakamura, M, E-mail: k_iwami@cc.tuat.ac.j [Department of Life Sciences and Bioengineering, University of Toyama, 3190 Gofuku, Toyama, 930-8555 (Japan)

    2010-03-15

    This paper reports a method for rapid prototyping of cell tissues, which is based on a system that extrudes, aspirates and refills a mixture of cells and thermoreversible hydrogel as a scaffold. In the extruding mode, a cell-mixed scaffold solution in the sol state is extruded from a cooled micronozzle into a temperature-controlled substrate, which keeps the scaffold in the gel state. In the aspiration mode, the opposite process is performed by Bernoulli suction. In the refilling mode, the solution is extruded into a groove created in the aspiration mode. The minimum width of extruded hydrogel pattern is 114 +- 15 mum by employing a nozzle of diameter 100 mum, and that of aspirated groove was 355 +- 10 mum using a 500 mum-diameter nozzle. Gum arabic is mixed with the scaffold solution to avoid peeling-off of the gel pattern from the substrate. Patterning of Sf-9 cell tissue is demonstrated, and the stability of the patterned cell is investigated. This system offers a procedure for rapid prototyping and local modification of cell scaffolds for tissue engineering.

  13. Auditing Inequity: Teaching Aspiring Administrators to Be Social Justice Leaders

    Science.gov (United States)

    Hernandez, Frank; Marshall, Joanne

    2017-01-01

    While much has been written about preparing educational leaders to lead for social justice, much less has been written about how to do so. This study is one of the first to analyze the reflections and written assignments of aspiring administrators to determine what they are currently thinking about poverty, race/ethnicity, and social justice…

  14. Fournier's gangrene - a rare complication of hydrocele aspiration

    International Nuclear Information System (INIS)

    Ali, M.Z.

    2004-01-01

    A case of Fournier's gangrene of scrotum with systemic inflammatory response syndrome resulting from hydrocele aspiration in young male patient is presented. He was treated with antibiotics, wide local debridement of scrotal skin with evacuation of pus and gas; followed by serial debridements and dressings. Secondary suturing of scrotal defect was done after 02 weeks. (author)

  15. Aspirations for a Master's-Level Teaching Profession in England

    Science.gov (United States)

    Thomas, Lorraine

    2016-01-01

    This research investigates aspirations for a master's-level teaching profession in England, providing key stakeholder perceptions in one densely populated region within a multiple case study. Although this intended move to a master's-level profession represented a major shift in teachers' professional development in England, only limited…

  16. Comparison of the CDC Backpack aspirator and the Prokopack aspirator for sampling indoor- and outdoor-resting mosquitoes in southern Tanzania

    Directory of Open Access Journals (Sweden)

    Mgando Joseph

    2011-06-01

    Full Text Available Abstract Background Resting mosquitoes can easily be collected using an aspirating device. The most commonly used mechanical aspirator is the CDC Backpack aspirator. Recently, a simple, and low-cost aspirator called the Prokopack has been devised and proved to have comparable performance. The following study evaluates the Prokopack aspirator compared to the CDC backpack aspirator when sampling resting mosquitoes in rural Tanzania. Methods Mosquitoes were sampled in- and outdoors of 48 typical rural African households using both aspirators. The aspirators were rotated between collectors and households in a randomized, Latin Square design. Outdoor collections were performed using artificial resting places (large barrel and car tyre, underneath the outdoor kitchen (kibanda roof and from a drop-net. Data were analysed with generalized linear models. Results The number of mosquitoes collected using the CDC Backpack and the Prokopack aspirator were not significantly different both in- and outdoors (indoors p = 0.735; large barrel p = 0.867; car tyre p = 0.418; kibanda p = 0.519. The Prokopack was superior for sampling of drop-nets due to its smaller size. The number mosquitoes collected per technician was more consistent when using the Prokopack aspirator. The Prokopack was more user-friendly: technicians preferred using the it over the CDC backpack aspirator as it weighs considerably less, retains its charge for longer and is easier to manoeuvre. Conclusions The Prokopack proved in the field to be more advantageous than the CDC Backpack aspirator. It can be self assembled using simple, low-cost and easily attainable materials. This device is a useful tool for researchers or vector-control surveillance programs operating in rural Africa, as it is far simpler and quicker than traditional means of sampling resting mosquitoes. Further longitudinal evaluations of the Prokopack aspirator versus the gold standard pyrethrum spray catch for indoor resting

  17. Interfacing an aspiration ion mobility spectrometer to a triple quadrupole mass spectrometer

    International Nuclear Information System (INIS)

    Adamov, Alexey; Viidanoja, Jyrki; Kaerpaenoja, Esko; Paakkanen, Heikki; Ketola, Raimo A.; Kostiainen, Risto; Sysoev, Alexey; Kotiaho, Tapio

    2007-01-01

    This article presents the combination of an aspiration-type ion mobility spectrometer with a mass spectrometer. The interface between the aspiration ion mobility spectrometer and the mass spectrometer was designed to allow for quick mounting of the aspiration ion mobility spectrometer onto a Sciex API-300 triple quadrupole mass spectrometer. The developed instrumentation is used for gathering fundamental information on aspiration ion mobility spectrometry. Performance of the instrument is demonstrated using 2,6-di-tert-butyl pyridine and dimethyl methylphosphonate

  18. THREE-DIMENSIONAL ASSESSMENT OF THE PHARYNGEAL AIRWAY AND MAXILLARY SINUS VOLUMES IN INDIVIDUALS WITH NON-SYNDROMIC CLEFT LIP AND PALATE

    Directory of Open Access Journals (Sweden)

    Ana NEMȚOI

    2015-09-01

    Full Text Available Introduction: Children with cleft lip and palate (CLP are known to have airway problems. Introduction of ConeBeam CT (CBCT and imaging software has facilitated generation of 3D images for assessing the volume of maxillary sinuses and pharyngeal airway. Consequently, the present study aimed at evaluating and comparing the maxillary sinus and pharyngeal airway volume of patients with cleft lip and palate in healthy patients, using cone beam computed tomography (CBCT images. Materials and method: The sample group included 27 individuals (15 with cleft lip and palate subjects and 12 healthy subjects. The pharyngeal airway and each maxillary sinus were three-dimensionally assessed, segmented and their volume was calculated. A comparison between the right and left sinus was performed by Student t-test, and the differences between the control and cleft groups were calculated using ANOVA. Results: No statistically significant differences were found when the maxillary sinuses volumes from each side were compared (p >0.05. The unilateral CLP patients presented the lowest sinus volume. Individuals with CLP did not exhibit a total airway volume smaller than the nonCLP controls. Conclusions: 3D imaging using CBCT and Romexis software is reliable for assessing maxillary sinus and pharyngeal airway volume. The present study showed that the pharyngeal airway is not compromised in CLP individuals. The unilateral CLP individuals present maxillary sinuses with smaller volumes, no differences being recorded between the cleft and non-cleft side.

  19. Treatment of bacterial brain abscess by repeated aspiration. Follow up by serial computed tomography

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    Yamamoto, Masaaki; Fukushima, Takeo; Hirakawa, Katsuyuki; Kimura, Hideo; Tomonaga, Masamichi [Fukuoka Univ. (Japan). School of Medicine

    2000-02-01

    Bacterial brain abscess often requires repeated aspiration before the abscess finally resolves. However, there are no guidelines for treatment by aspiration; for example, when should the abscess be tapped again, or when can an abscess be treated by antibiotics alone without further aspiration. Eleven patients with bacterial brain abscess treated by aspiration were evaluated to establish treatment guidelines for brain abscess, in particular the abscess size on serial computed tomography (CT) after aspiration. CT was performed about 24 hours after aspiration to evaluate the size of the abscess, and almost weekly during follow up. The diameter of the brain abscess before and after the initial and last aspirations were reviewed. In eight of the 11 patients, abscesses were aspirated repeatedly: two to three times in most patients. The diameter of the abscesses was 2.5-4.5 cm (mean 3.5 cm) before the last aspiration, and 1.4-3.4 cm (mean 2.3 cm) after the last aspiration, or when continuous drainage was discontinued. Perifocal edema was moderately decreased within 3 weeks after the last aspiration by medical treatment alone, with a concomitant decrease in the volume of the abscess. There were no deaths, and most patients had a favorable outcome. These results suggest that after the diameter of the abscess becomes less than 2 to 3 cm and does not increase anymore on serial CT, medical treatment alone can be anticipated to give satisfactory results without further aspiration. (author)

  20. Treatment of bacterial brain abscess by repeated aspiration. Follow up by serial computed tomography

    International Nuclear Information System (INIS)

    Yamamoto, Masaaki; Fukushima, Takeo; Hirakawa, Katsuyuki; Kimura, Hideo; Tomonaga, Masamichi

    2000-01-01

    Bacterial brain abscess often requires repeated aspiration before the abscess finally resolves. However, there are no guidelines for treatment by aspiration; for example, when should the abscess be tapped again, or when can an abscess be treated by antibiotics alone without further aspiration. Eleven patients with bacterial brain abscess treated by aspiration were evaluated to establish treatment guidelines for brain abscess, in particular the abscess size on serial computed tomography (CT) after aspiration. CT was performed about 24 hours after aspiration to evaluate the size of the abscess, and almost weekly during follow up. The diameter of the brain abscess before and after the initial and last aspirations were reviewed. In eight of the 11 patients, abscesses were aspirated repeatedly: two to three times in most patients. The diameter of the abscesses was 2.5-4.5 cm (mean 3.5 cm) before the last aspiration, and 1.4-3.4 cm (mean 2.3 cm) after the last aspiration, or when continuous drainage was discontinued. Perifocal edema was moderately decreased within 3 weeks after the last aspiration by medical treatment alone, with a concomitant decrease in the volume of the abscess. There were no deaths, and most patients had a favorable outcome. These results suggest that after the diameter of the abscess becomes less than 2 to 3 cm and does not increase anymore on serial CT, medical treatment alone can be anticipated to give satisfactory results without further aspiration. (author)

  1. The Role of Aspirations in Young Children's Emotional and Behavioural Problems

    Science.gov (United States)

    Moulton, Vanessa; Flouri, Eirini; Joshi, Heather; Sullivan, Alice

    2015-01-01

    Using data from a large UK cohort (n = 11,656), we investigated the determinants of 7-year-old children's aspirations, and the role of these aspirations in emotional and behavioural problems, as reported by both parents and teachers. Aspirations were classified to reflect their occupational status, masculinity/femininity and intrinsic/extrinsic…

  2. Serum cytokine and chemokine profiles in neonates with meconium aspiration syndrome.

    Science.gov (United States)

    Okazaki, Kaoru; Kondo, Masatoshi; Kato, Masahiko; Kakinuma, Ryota; Nishida, Akira; Noda, Masahiro; Taniguchi, Kiyosu; Kimura, Hirokazu

    2008-04-01

    Various inflammatory cytokines and chemokines are thought to be associated with the pathophysiology of meconium aspiration syndrome. To clarify any such association, we compared various serum cytokine and chemokine profiles in patients with and without meconium aspiration syndrome. Using a highly sensitive fluorescence microsphere method, 17 types of cytokines and chemokines in sera were measured in 11 neonatal patients with meconium aspiration syndrome, 16 neonatal patients without meconium aspiration syndrome, and 9 healthy children. The concentrations of 8 types of proinflammatory cytokines and chemokines were significantly higher in the meconium aspiration syndrome group than in healthy controls: interleukin-1beta, interleukin-6, interleukin-8, granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, interferon-gamma, macrophage inflammatory protein-1beta, and tumor necrosis factor-alpha. Six types of proinflammatory cytokines and chemokines were significantly higher in the meconium aspiration syndrome group than in the nonmeconium aspiration syndrome group: interleukin-6, interleukin-8, granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, interferon-gamma, and tumor necrosis factor-alpha. Serum concentrations of interleukin-10 (anti-inflammatory cytokine) in the meconium aspiration syndrome group were higher than those in both the nonmeconium aspiration syndrome group and healthy children group (P = .007 and 0.001, respectively). Most types of proinflammatory cytokines and chemokines in sera of neonates with meconium aspiration syndrome were higher than those without meconium aspiration syndrome, giving support to the suggestion that elevated levels are associated with the pathogenesis of meconium aspiration syndrome.

  3. Human papillomavirus DNA in pharyngeal scrapes as a marker of HPV-related squamous cell cancer of the oropharynx.

    Science.gov (United States)

    Snietura, Miroslaw; Rutkowski, Tomasz; Piglowski, Wojciech; Hajduk, Agata; Wygoda, Andrzej; Skladowski, Krzysztof; Lange, Dariusz

    2015-10-01

    Recent studies have indicated that human papillomavirus is an etiologic agent for a subset of head and neck cancers associated with better prognosis, therefore, prompt confirmation of such etiology seems to be crucial for choosing the optimal therapeutic option. Standard HPV diagnosis is currently based on histopathological material. In the present study, the novel diagnostic method based on pharyngeal brush biopsy is proposed. The aim of this study was to evaluate the usefulness of the Real-Time PCR-based (RT-PCR) test in detecting HPV-related cancer of the oropharynx using superficial scraps taken from the oropharyngeal region. Ninety patients with head and neck squamous cell cancer were enrolled in the study. The presence of HPV DNA in pharyngeal superficial scrapes assessed by RT-PCR was compared to the HPV status in the tumor tissue samples determined by a combined RT-PCR/P16(INK4A) expression algorithm. Analytical sensitivity and specificity were calculated and the clinical outcome was analyzed in correlation to the HPV status. HR-HPV DNA in pharyngeal swabs was revealed in 25 cases (28.4%) and simultaneously confirmed in all corresponding tissue samples. Sensitivity and specificity of the viral status assessment in the brush biopsies in respect to the RT-PCR/P16(INK4A) 20 were 100% and 96.2%, respectively. HR-HPV positive status was associated with an excellent clinical outcome and reduced hazard ratio of recurrence and disease-related death. The proposed novel method of HPV status assessment using RT-PCR and superficial scraps appeared to be highly sensitive, specific, and useful in predicting the clinical outcome. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Three dimensional assessment of the pharyngeal airway in individuals with non-syndromic cleft lip and palate.

    Directory of Open Access Journals (Sweden)

    Tracy Cheung

    Full Text Available INTRODUCTION: Children with cleft lip and palate (CLP are known to have airway problems. Previous studies have shown that individuals with CLP have a 30% reduction in nasal airway size compared to non-cleft controls. No reports have been found on cross-sectional area and volume of the pharyngeal airway in clefts. Introduction of Cone-Beam CT (CBCT and imaging software has facilitated generation of 3D images for assessment of the cross-sectional area and volume of the airway. OBJECTIVE: To assess the pharyngeal airway in individuals with CLP using CBCT by measuring volume and smallest cross-sectional areas and compare with 19 age- and sex-matched non-cleft controls. METHODS: Retrospective study of CBCT data of pre-adolescent individuals (N = 19, Mean age = 10.6, 7 females, 12 males, UCLP = 6, BCLP = 3 from the Center for Craniofacial Anomalies. Volumetric analysis was performed using image segmentation features in CB Works 3.0. Volume and smallest cross-sectional were studied in both groups. Seven measurements were repeated to verify reliability using Pearson correlation coefficient. Volume and cross-sectional area differences were analyzed using paired t-tests. RESULTS: The method was found to be reliable. Individuals with CLP did not exhibit smaller total airway volume and cross sectional area than non-CLP controls. CONCLUSION: 3D imaging using CBCT and CB Works is reliable for assessing airway volume. Previous studies have shown that the nasal airway is restricted in individuals with CLP. In our study, we found that the pharyngeal airway is not compromised in these individuals.

  5. CC10 reduces inflammation in meconium aspiration syndrome in newborn piglets.

    Science.gov (United States)

    Angert, Robert M; Pilon, Aprile L; Chester, Darrin; Davis, Jonathan M

    2007-12-01

    Complications from meconium aspiration syndrome (MAS) remain significant despite a variety of therapeutic interventions. Clara cell protein (CC10) is a novel anti-inflammatory agent that can also inhibit phospholipase A2 (PLA2) (an important component of meconium). The present study examined whether administration of recombinant human CC10 (rhCC10) would reduce inflammation and improve lung function in a piglet model of MAS. Following meconium instillation, piglets exhibited significant physiologic dysfunction that improved significantly after surfactant administration. Analysis of tracheal aspirates revealed significant increases in both tumor necrosis factor (TNF) alpha and interleukin (IL)-8 after meconium instillation. rhCC10-treated animals had significantly lower TNF-alpha levels at 24 h (561 +/- 321 versus 1357 +/- 675 pg/mL, p < 0.05) compared with saline controls. There were no differences between rhCC10-treated and untreated groups with respect to other measured physiologic variables or inflammatory markers, including secretory PLA2 activity. Histologic analyses revealed marked inflammatory infiltrates and thickened alveolar walls, but no significant differences among rhCC10 and control animals. Newborn piglets with MAS have significant physiologic dysfunction, marked inflammatory changes and histologic abnormalities, which was partially counteracted by a single dose of exogenous surfactant and rhCC10.

  6. Effectiveness of percutaneous aspiration thrombectomy for acute or subacute thromboembolism in infrainguinal arteries

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Jung Guen; Kim, Chan Sun; Kim, Young Hwan; Kim, See Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2017-06-15

    To report the feasibility and long-term clinical outcome of percutaneous aspiration thrombectomy for treating acute or subacute arterial thromboembolism in the infrainguinal arteries. Thirty limbs of 29 patients were enrolled in this retrospective study between January 2004 and March 2014. Nine limbs underwent overnight catheter-directed thrombolysis followed by percutaneous aspiration thrombectomy (PAT). Eighteen limbs underwent PAT with adjunctive selective intra-arterial thrombolysis in a single session. The remaining three limbs underwent PAT alone. Balloon angioplasty (n = 16) or stent placement (n = 3) was performed as required. In-hospital mortality and complications were estimated. The primary patency rate and the rate of freedom from reintervention were calculated using the Kaplan-Meier method. Technical success was achieved in 28 limbs. Clinical success was achieved in 27 limbs. The mean ankle-brachial index increased from 0.17 ± 0.26 to 0.98 ± 0.19 after the procedure. Three in-hospital deaths and no major amputations were recorded. Distal embolization of crural arteries occurred as a minor complication in five limbs, but no major complications occurred. The primary patency rate and the rate of freedom from reintervention were 74.9% and 90.9% at 1 year, respectively, and 66.6% and 80.8% at 2 years, respectively. PAT is a rapid and effective method to remove a thrombus from occluded infrainguinal arteries.

  7. Incidencia de faringitis por Streptococcus pyogenes en Bariloche: Argentina Incidence of Streptococcus pyogenes pharyngitis in Bariloche: Argentina

    Directory of Open Access Journals (Sweden)

    G. Rubinstein

    2005-06-01

    Full Text Available Fueron evaluadas la incidencia y estacionalidad de faringitis por Streptococcus pyogenes en Bariloche, una ciudad donde las bajas temperaturas favorecen las condiciones de hacinamiento durante gran parte del año. Se analizaron 5.276 hisopados de fauces durante el período 2000-2003. Las muestras fueron sembradas en agar sangre ovina (5% e incubadas 24-48 h a 35 °C. Las colonias beta-hemolíticas fueron identificadas utilizando los métodos convencionales. Se calcularon las medias mensuales de hisopados de fauces totales, de aislamientos de S. pyogenes y de los porcentajes de faringitis por S. pyogenes. La incidencia de faringitis por este microorganismo fue superior al 24% en todos los meses del período abril-diciembre, con un máximo en noviembre (33%. El mes de menor incidencia fue febrero (13%. Se observó una tendencia creciente desde marzo a noviembre, con un leve valle en julio y un marcado descenso que se inició en diciembre y mostró valores mínimos en enero y febrero, los meses más cálidos. Este patrón estacional difiere del observado en climas templados. La incidencia fue alta durante gran parte del año, abarcando desde mediados del otoño hasta principios del verano.The incidence and seasonality of pharyngitis by S. pyogenes in Bariloche, a city were long periods of low temperatures result in extended indoor activities were studied. A total of 5276 throat swab specimens collected during 2000-2003 in the clinical microbiology laboratories of the three main medical institutions of the city, were analyzed. Samples were cultured on blood-agar media containing 5% defibrinated sheep blood, and incubated for 24-48 h at 35 °C. Strains were identified using standard procedures. Monthly means for throat swabs, S. pyogenes isolates, and percent of S. pyogenes pharyngitis, were estimated. The incidence of pharyngitis by this microorganism was greater than 24% for every month within the April-December period, reaching a maximum in

  8. Acute radiation reactions in oral and pharyngeal mucosa: tolerable levels in altered fractionation schedules

    International Nuclear Information System (INIS)

    Fowler, Jack F.; Harari, Paul M.; Leborgne, Felix; Leborgne, Jose H.

    2003-01-01

    Purpose:To investigate whether a predictive estimate can be obtained for a 'tolerance level' of acute oral and pharyngeal mucosal reactions in patients receiving head and neck radiotherapy, using an objective set of dose and time data. Materials and methods:Several dozen radiotherapy schedules for treating head and neck cancer have been reviewed, together with published estimates of whether they were tolerated or (in a number of schedules) not. Those closest to the borderline were given detailed analysis. Total doses and biologically effective doses (BED or ERD) were calculated for a range of starting times of cellular repopulation and rates of daily proliferation. Starting times of proliferation from 5 to 10 days and daily cellular doubling rates of 1-3 days were considered. The standard published form of BED with its linear overall time factor was used: BED=nd1+((d)/(α/β))-((Ln2T-T k )/(αT p )) (see text for parameters). Results: A clear progression from acceptable to intolerable mucosal reactions was found, which correlated with total biologically effective dose (BED in our published modeling), for all the head and neck cancer radiotherapy schedules available for study, when ranked into categories of 'intolerable' or 'tolerable'. A review of published mechanisms for mucosal reactions suggested that practical schedules used for treatment caused stimulated compensatory proliferation to start at about 7 days. The starting time of compensatory proliferation had little predictive value in our listing, so we chose the starting time of 7 days. Very short and very long daily doubling rates also had little reliability, so we suggest choosing a doubling time of 2.5 days as a datum. With these parameters a 'tolerance zone of uncertainty' could be identified which predicted acute-reaction acceptability or not of a schedule within a range of about 2-10 Gy in total BED. If concurrent chemoradiotherapy is used, our provisional suggestion is that this zone should be reduced

  9. Evaluation of pharyngeal volume and compliance of OSAHS patients using 3D CT and volume measurement

    International Nuclear Information System (INIS)

    Lan, Zhijie

    2004-01-01

    The intrinsic properties such as baseline caliber and compliance of the upper airway are thought to be important in the pathogenesis of obstructive sleep apnea hypopnea syndrome (OSAHS).The author attempted using imaging methods to evaluate both baseline caliber and compliance in normal individuals and OSAHS patients, and to localize the obstructive sites in OSAHS patients. Critical closing pressure (P crit ) and minimally effective therapeutical pressure (P eff ) were measured and computed tomography (CT) scan of pharynx was performed during wakefulness and drug-induced sleep with P crit , 0 cm H 2 O and P eff being given through a nose mask system. 7 normal individuals (age, 32.2±6.5 y's and body mass index, 23.6±5.4 kg/m 2 ) and 13 OSAHS patients (age, 33.3±6.4 y's and body mass index, 25.9±6.0 kg/m 2 ) were studied. 3D images of pharyngeal airway were reconstructed, and volume of each subdivision of pharynx was measured. Volume, average area and compliance of each subdivision were compared between the two groups. On an air-mode view of 3D image, the outline of pharynx was shown as transparent tubal structure, on which the narrowing collapse of airway at any level or any direction can be easily identified. Anatomy of pharynx could be easily understood on the virtual endoscopic mode. During wakefulness, the average area of the upper (1.20±0.26 cm 2 vs. 1.57±0.17 cm 2 , P 2 vs. 2.58±0.27 cm 2 , P 2 vs. 1.45±0.18 cm 2 , P 2 vs. 2.44±0.26 cm 2 ). The compliance of the middle part (0.28±0.15/cmH 2 O vs. 0.13±0.07/cmH 2 O, P<0.05) of pharynx was significantly higher in OSAHS patients than in normal individuals. The data suggested that OSAHS patients have a narrower and more collapsible pharynx compared to the normal subjects. The method of the present study is valid to evaluate both morphology and function of the upper airway. (author)

  10. Crohn's disease-associated silent aspiration in the outpatient setting: Anesthesiologists beware.

    Science.gov (United States)

    Snell, Christopher; Coleman, Scott; Van Hal, Michele; Rashidian, Farshad; Okum, Gary; Green, Michael Stuart

    2018-01-01

    Every anesthesia provider fears aspiration of gastric contents during an anesthetic, and it may occur even in the absence of overt signs such as coughing or choking. Whether the aspiration is frank or silent, catastrophic and deleterious consequences may ensue. Therefore, familiarity with risk factors for silent aspiration is essential. Crohn's disease reportedly delays gastric emptying making these patients more susceptible to silent aspiration during surgery. Anesthesia providers must be cognizant of this risk and vigilant in the recognition to formulate a specific treatment plan preoperatively. We present a case of an ambulatory surgical patient with suspected silent aspiration undiagnosed by the anesthesia care team before induction of anesthesia.

  11. High Resolution Computed Tomography Appearences of late sequelae of Barium Aspiration in an asymptomatic young child

    International Nuclear Information System (INIS)

    Venkatraman, Bhat; Rahman, Hatim A.; Abdul-Wahab, Atiqa

    2005-01-01

    Barium aspiration is a well-known complication of upper gastro-intestinal studies. Consequences of aspiration are generally insignificant and leave no permanent changes in the lung parenchyma. However, large quantities of high density barium, if aspirated, lead to silent interstitial changes and fibrosis. High-resolution computed tomography HRCT appearances of lung changes have been demonstrated in adults; few such reports are available in the pediatric literature. We report a case of a child who aspirated barium 3 months before this presentation. The HRCT appearances of barium aspiration are presented with a review of the literature. (author)

  12. Pharyngeal Gonorrhoea: The Willingness of Australian Men Who Have Sex with Men to Change Current Sexual Practices to Reduce Their Risk of Transmission-A Qualitative Study.

    Science.gov (United States)

    Walker, Sandra; Bellhouse, Clare; Fairley, Christopher K; Bilardi, Jade E; Chow, Eric P F

    2016-01-01

    The pharynx is a common site of gonorrhoea among men who have sex with men (MSM) and may serve as a reservoir for infection, with saliva implicated in transmission possibly through oral sex, kissing, and rimming. Reducing sexual activities involving saliva may reduce pharyngeal gonorrhoea. This study aimed to explore MSM's views and knowledge of pharyngeal gonorrhoea and their willingness to change saliva transmitting sexual practices. MSM were also asked their views on using alcohol-containing mouthwash to potentially reduce transmission. Using a qualitative descriptive approach, 30 MSM who were part of a larger study (GONE) conducted at the Melbourne Sexual Health Centre agreed to take part in semi-structured interviews between 14th May and 8th September 2015. The 10 interviews conducted face to face and 20 by telephone, lasted between 20-45 minutes. Data were analysed using qualitative content analysis. Most men considered pharyngeal gonorrhoea to be a non-serious sexually transmitted infection and attributed transmission primarily to oral sex. Almost all men reported they would not stop kissing, oral sex, or consider using condoms for oral sex to reduce their risk of pharyngeal gonorrhoea. Kissing and oral sex were commonly practised and considered enjoyable low risk sexual activities. Men were more likely to consider stopping sexual activities they did not enjoy or practice often, in particular insertive rimming. If proven effective, the majority of men reported they would use alcohol-containing mouthwash to reduce or prevent their risk of pharyngeal gonorrhoea. Findings from this study suggest MSM are unlikely to stop saliva transmitting sexual practices they enjoy and consider low risk. Men would, however, consider using alcohol-containing mouthwash if found to be effective, highlighting the importance of exploring innovative strategies to reduce pharyngeal gonorrhoea.

  13. Willingness to change behaviours to reduce the risk of pharyngeal gonorrhoea transmission and acquisition in men who have sex with men: a cross-sectional survey.

    Science.gov (United States)

    Chow, Eric Pf; Walker, Sandra; Phillips, Tiffany; Fairley, Christopher K

    2017-11-01

    The aim of this study was to examine the willingness of men who have sex with men (MSM) to change their behaviours to potentially reduce the risk of pharyngeal gonorrhoea transmission and acquisition. A cross-sectional questionnaire-based study was conducted among MSM attending the Melbourne Sexual Health Centre, Australia, between March and September 2015. Participants were asked how likely they would change their behaviours to reduce the risk of pharyngeal gonorrhoea. Six different potential preventive interventions were asked: (1) stop tongue kissing; (2) stop having receptive oral sex; (3) stop performing rimming; (4) stop using saliva as a lubricant during anal sex; (5) use of condoms during oral sex; and (6) use of alcohol-containing mouthwash daily. Of the 926 MSM who completed the questionnaire, 65.4% (95% CI 62.3% to 68.5%) expressed they were likely to use mouthwash daily to reduce the risk of pharyngeal gonorrhoea, 63.0% (95% CI 59.8% to 66.1%) would stop using saliva as a lubricant, and 49.5% (95% CI 46.2% to 52.7%) would stop rimming. In contrast, 77.6% (95% CI 74.8% to 80.3%) of MSM expressed they were unlikely to stop tongue kissing. MSM who were younger and had less male partners expressed they were unlikely to use mouthwash daily as an intervention to reduce risk of pharyngeal gonorrhoea acquisition. The practices MSM are willing to change to reduce the risk of pharyngeal gonorrhoea transmission and acquisition vary greatly; however, the majority of men are likely to use mouthwash daily to reduce the risk of pharyngeal gonorrhoea. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. A Rare Form of Guillan Barre Syndrome: A Child Diagnosed with Anti-GD1a and Anti-GD1b Positive Pharyngeal-Cervical-Brachial Variant

    OpenAIRE

    Metin Uysalol; Burak Tatlı; Erhan Aygün; Semra Kayaoğlu; Nedret Uzel; Agop Çıtak

    2013-01-01

    Background: Pharyngeal-cervical-brachial (PCB) variant is a rare form of Guillan-Barre Syndrome (GBS). Antibodies against other membrane proteins like GM1b and GD1a have been found only in a small number of patients with Guillan Barre syndrome variant. Case Report: Here, we report a 5.5 year-old boy diagnosed early with positive GD1a and GD1b gangliosides of Guillan-Barre syndrome pharyngeal cervical-Brachial variant, who improved and recovered fully in a short period. This is in contrast...

  15. A Rare Form of Guillan Barre Syndrome: A Child Diagnosed with Anti-GD1a and Anti-GD1b Positive Pharyngeal-Cervical-Brachial Variant

    OpenAIRE

    Uysalol, Metin; Tatlı, Burak; Uzel, Nedret; Çıtak, Agop; Aygün, Erhan; Kayaoğlu, Semra

    2014-01-01

    Background: Pharyngeal-cervical-brachial (PCB) variant is a rare form of Guillan-Barre Syndrome (GBS). Antibodies against other membrane proteins like GM1b and GD1a have been found only in a small number of patients with Guillan Barre syndrome variant. Case Report: Here, we report a 5.5 year-old boy diagnosed early with positive GD1a and GD1b gangliosides of Guillan-Barre syndrome pharyngeal cervical-Brachial variant, who improved and recovered fully in a short period. This is in cont...

  16. The occurrence of calcium in pharyngeal tonsils of children dependent on gender, living place and influence of passive smoking

    Directory of Open Access Journals (Sweden)

    Ewa Nogaj

    2011-03-01

    Full Text Available The characteristic of occurrence calcium content in pharyngeal tonsils from 60 girls and 90 boys living in 9 region of Upper Silesia is presented in this article. Analysis of content of Ca in pharyngheal tonsils was observed in four groups of children: girls and boys exposed to tobacco smoke and unexposed to tabacco smoke, influence parameters environments on contents Ca in tissue tonsil and the cross-correlation analysis between content of ion Ca and other metals Al, Cd, Cu, Ni, Pb, Zn, Mg, Ba, showed repeating co-dependences between Ca in girls from Cd, Al., Zn, Ni, Pb. In case of boys colective dependence was been dependence Ca in Mg, Cd, Zn. Arithmetic mean of calcium in pharyngeal tonsils from exposed girls was 1345.00 µg/g, in comparison to unexposed girls 1292.88 µg/g, in exposed to tobacco smoke boys- 1832.63 µg/g and unexposed boys 565.05 µg/g. It turned out that gender perform important part in absorbed calcium and here noticeable was been big ability to concentrate toxic metals in girls

  17. Pharyngeal swallowing pressures in the base-of-tongue and hypopharynx regions identified with three-dimensional manometry.

    Science.gov (United States)

    Rosen, Sarah P; Jones, Corinne A; McCulloch, Timothy M

    2017-09-01

    This study aims to use three-dimensional (3D) high-resolution manometry to identify circumferential pressure patterns generated within the asymmetrical base-of-tongue and hypopharynx regions of the pharynx during deglutition. Case series. Radial pressures in the regions of interest were evaluated during swallowing events in 12 healthy subjects using 3D high-resolution manometry. Repeated measures analysis of variance revealed asymmetrical pharyngeal clearance pressures in the base-of-tongue and hypopharynx regions during swallowing. A significant main effect of direction on pressure was found at the time point of average maximum pressure (P tongue region, an anteroposterior dominant pressure pattern was observed in the hypopharynx. Pressure waveform complexity in the hypopharynx also is likely attributed to activity in the anterior and posterior directions. Symmetrical pressure generation was observed during intrabolus flow within the hypopharynx. This study shows that pressure is asymmetrically generated in the base-of-tongue and hypopharynx regions during swallowing of a 10-mL bolus, reflecting the complex anatomy within the pharynx. Understanding of these complex pressure patterns aids in the interpretation of high-resolution manometry and can help guide further study in the clinical assessment and treatment of pharyngeal pathology. 4. Laryngoscope, 127:1989-1995, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Foxc2 in pharyngeal arch mesenchyme is important for aortic arch artery remodelling and ventricular septum formation.

    Science.gov (United States)

    Uddin, Mohammad Khaja Mafij; Kimura, Wataru; Ishikura, Tomoyuki; Koseki, Haruhiko; Yoshida, Nobuaki; Islam, Mohammad Johirul; Amin, Mohammed Badrul; Nakamura, Kasumi; Wu, Yi-Xin; Sato, Eiji; Aoto, Kazushi; Miura, Naoyuki

    2015-01-01

    The forkhead box C2 (Foxc2) protein is a member of the forkhead/winged helix transcription factor family and plays an essential role in cardiovascular development. Previous studies showed that Foxc2 null mouse embryos die during midgestation or just after birth with severe cardiovascular defects, including interruption, coarctation of the aortic arch and ventricular septal defects. These are also seen in human congenital heart disease. However, the tissue specific role of Foxc2 in aortic arch remodelling is not yet fully understood. Here we show that Foxc2 is expressed in a restricted pattern in several cell populations, including the mesenchyme and endothelium of pharyngeal arch arteries, which are important for cardiovascular development. In this study, we use a conditional knockout approach to examine the tissue specific role of Foxc2 in aortic arch remodelling. We demonstrate that mouse embryos lacking Foxc2 in Nkx2.5-expressing mesenchyme and endothelium of pharyngeal arch arteries display aortic arch interruption type B and ventricular septal defects. In contrast, conditional deletion of Foxc2 in Tie2-expressing endothelial cells does not result in aortic arch or ventricular septal defects, but does result in embryonic lethality due to peripheral oedema. Our data therefore provide for a detailed understanding of the role of mesenchymal Foxc2 in aortic arch remodelling and in the development of ventricular septum.

  19. X-ray cone beam microtomography for quantitative assessment of tracheal and pharyngeal volumes of Rhodnius prolixus

    International Nuclear Information System (INIS)

    Souza, Izabella Soares de

    2017-01-01

    In the past decade microcomputerized tomography imaging using synchrotron radiation has become a powerful technique to generate high resolution images of Rhodinus prolixus. Images of soft tissues (protocerebrum and muscles) and dense structures (pharynx, trachea and esophagus) of R. prolixus head have been obtained using synchrotron radiation microtomography in mono and polychromatic configuration, respectively. Advancements in conventional microtomography have increased the achievable resolution and contrast, making this relatively inexpensive and widely available technology potentially useful for studies of insect internal morphology. The main goal of this work was to provide a new set of high quality microtomographic images of R. prolixus achieved by means of a desktop X-ray microtomograph. It allows the three-dimensional visualization of important chitinized structures: pharynx and tracheae. Pharyngeal and tracheal volumes were quantitatively evaluated at different days (1, 4, 10, 15 and 20) after feeding. The results suggest that variation of average volumes could be attributed to insect hormone 20-hydroxy-ecdysone (20-OH-Ec) pulse at 11 days after feeding. Pharyngeal volumes decrease 3.80 times. On the other hand, tracheal volumes increase 1.78 times. Head total volume showed similar trends than trachea. (author)

  20. Changes in oro-pharyngeal airway dimension after treatment with function appliance in class II skeletal pattern

    International Nuclear Information System (INIS)

    Ali, B.; Shaikh, A.; Fida, M.

    2015-01-01

    Background: Functional appliances have been used since many decades for the correction of mandibular retrognathism. Similar oral appliances are a treatment modality for patients with Obstructive sleep apnea. Hence, interception at the right age with these growth modification appliances might benefit a child from developing long term respiratory insufficiency. Therefore, the purpose of our study was to assess the short term effects of Twin block appliance (CTB) on pharyngeal airway size in subjects with skeletal Class II pattern in a sample of Pakistani population. Methods: A retrospective study was conducted from orthodontic records of 62 children (31 males, 31 females) with retrognathic mandibles using lateral cephalograms obtained at initial visit and after CTB treatment. Paired t-test was used to compare the pre-functional and post-functional treatment airway size. Independent sample t-test was used for comparison between the genders and statistical significance was kept at =0.05. Results: The upper airway width (p<0.001), nasopharyngeal depth (p=0.03) and upper airway thickness (p=0.008) was substantially improved after CTB treatment. Males showed a greater increase in upper airway width (p= 0.03) and nasopharyngeal depth (p=0.01) in comparison to the females. Conclusion: Functional appliance therapy can improve the narrow pharyngeal airway of growing children presenting with deficient mandibles having Class II skeletal pattern. (author)

  1. Utilization of influenza and streptococcal pharyngitis point-of-care testing in the community pharmacy practice setting.

    Science.gov (United States)

    Klepser, Donald G; Klepser, Michael E; Smith, Jaclyn K; Dering-Anderson, Allison M; Nelson, Maggie; Pohren, Lauren E

    2018-04-01

    One way to reduce the complications and costs of influenza like illness and pharyngitis is to improve access to testing and treatment in early stages of infection. Pharmacy-based screening and treatment of group A streptococcus (GAS) infection and influenza has the potential to improve patient care and population health. To improve patient care and population health, the objective of this retrospective study was to assess if a previously validated service model could be implemented by pharmacy chains without mandated standardization. Researchers utilized a certificate program to provide initial training to pharmacists and shared templates from previous validated models. Pharmacy companies were responsible for navigation of all implementation within their company. Researchers analyzed the de-identified data from patients seeking point-of-care testing from the participating pharmacies. Participating pharmacies reported 661 visits for adult (age 18 and over) patients tested for influenza for GAS pharyngitis. For the GAS patients, 91 (16.9%) tested positive. For the Influenza patients, 22.9% tested positive and 64 (77.1%) testing negative. Access to care was improved as patients presented to the visit outside normal clinic hours for 38% of the pharmacy visits, and 53.7% did not have a primary care provider. A collaborative care model for managing patients with symptoms consistent with influenza or group A streptococcus can be successfully implemented, and improve access to care outside of normal clinic hours and for those without a regular primary care provider. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Localised inhibition of FGF signalling in the third pharyngeal pouch is required for normal thymus and parathyroid organogenesis

    Science.gov (United States)

    Gardiner, Jennifer R.; Jackson, Abigail L.; Gordon, Julie; Lickert, Heiko; Manley, Nancy R.; Basson, M. Albert

    2012-01-01

    The thymus and parathyroid glands are derived from the third pharyngeal pouch endoderm. The mechanisms that establish distinct molecular domains in the third pouch and control the subsequent separation of these organ primordia from the pharynx are poorly understood. Here, we report that mouse embryos that lack two FGF feedback antagonists, Spry1 and Spry2, display parathyroid and thymus hypoplasia and a failure of these organ primordia to completely separate from the pharynx. We show that FGF ligands and downstream reporter genes are expressed in highly regionalised patterns in the third pouch and that sprouty gene deletion results in upregulated FGF signalling throughout the pouch endoderm. As a consequence, the initiation of markers of parathyroid and thymus fate is altered. In addition, a normal apoptotic programme that is associated with the separation of the primordia from the pharynx is disrupted, resulting in the maintenance of a thymus-pharynx attachment and a subsequent inability of the thymus to migrate to its appropriate position above the heart. We demonstrate that the sprouty genes function in the pharyngeal endoderm itself to control these processes and that the defects in sprouty-deficient mutants are, at least in part, due to hyper-responsiveness to Fgf8. Finally, we provide evidence to suggest that parathyroid hypoplasia in these mutants is due to early gene expression defects in the third pouch, whereas thymus hypoplasia is caused by reduced proliferation of thymic epithelial cells in the thymus primordium. PMID:22912418

  3. Comparing the efficacy and safety of laryngeal mask airway, streamlined liner of the pharyngeal airway and I-gel following tracheal extubation

    Directory of Open Access Journals (Sweden)

    Hesameddin Modir

    2017-01-01

    Full Text Available Adverse events following surgical operations are common complications due to removal of tracheal tube in contrast to the tracheal intubation. Awareness about the new methods and strategies for tracheal tube extubation is necessary for a safe and successful extubation. Therefore, we aimed to assess the safety and efficacy of laryngeal mask airway (LMA, streamlined liner of the pharyngeal airway (SLIPA and I-gel in extubation time of tracheal tube. A one-single randomized clinical trial was conducted in 105 eligible patients in three groups including LMA, SLIPA and I-gel. The patients were under surgery after general anesthesia with propofol (2–3 mg/kg and fentanyl (1–2 μg/kg. Hemodynamic responses and extubation consequences including coughing rate, laryngospasm, airway obstruction, apnea, breath holding and straining of patients, vomiting, and need for re-intubation were recorded every 5 minutes since inserting of supraglottic airway devices (SADs until patients restore consciousness. Analysis of data was conducted in SPSS software by analysis of variance (ANOVA and ANOVA for repeated measurements tests. The overall successful insertion was 100% for LMA and I-Gel and this rate was 97.1% for SLIPA method. A significant decrease was observed in trend of hemodynamic responses in all three groups. Nevertheless, the MBP was lower in LMA group and lower HR was observed in I-Gel and higher HR occurred in SLIPA (P 0.05. However, the incidence rate of apnea, and laryngospasm, as well as re-intubation need in SLIPA group was 2.9%, respectively. LMA, I-GEL and SLIPA could be considered as useful and safe devices for ventilation control after tracheal tube removal at the end of operation. Three devices were same regarding to sore throat, vomiting, coughing, and breath holding. However, LMA showed lower side effects while SLIPA was related to more occurrences of apnea, laryngospasm, and re-intubation need.

  4. ASPIRE: Teachers and researchers working together to enhance student learning

    Directory of Open Access Journals (Sweden)

    Lollie Garay

    2014-11-01

    Full Text Available Abstract Science, Technology, Engineering, and Math (STEM disciplines have become key focus areas in the education community of the United States. Newly adopted across the nation, Next Generation Science Standards require that educators embrace innovative approaches to teaching. Transforming classrooms to actively engage students through a combination of knowledge and practice develops conceptual understanding and application skills. The partnerships between researchers and educators during the Amundsen Sea Polynya International Research Expedition (ASPIRE offer an example of how academic research can enhance K-12 student learning. In this commentary, we illustrate how ASPIRE teacher–scientist partnerships helped engage students with actual and virtual authentic scientific investigations. Crosscutting concepts of research in polar marine science can serve as intellectual tools to connect important ideas about ocean and climate science for the public good.

  5. Art in Science Promoting Interest in Research and Exploration (ASPIRE)

    Science.gov (United States)

    Fillingim, M.; Zevin, D.; Thrall, L.; Croft, S.; Raftery, C.; Shackelford, R.

    2015-11-01

    Led by U.C. Berkeley's Center for Science Education at the Space Sciences Laboratory in partnership with U.C. Berkeley Astronomy, the Lawrence Hall of Science, and the YMCA of the Central Bay Area, Art in Science Promoting Interest in Research and Exploration (ASPIRE) is a NASA EPOESS-funded program mainly for high school students that explores NASA science through art and highlights the need for and uses of art and visualizations in science. ASPIRE's aim is to motivate more diverse young people (especially African Americans) to learn about Science, Technology, Engineering, and Mathematics (STEM) topics and careers, via 1) Intensive summer workshops; 2) Drop-in after school workshops; 3) Astronomy visualization-focused outreach programming at public venues including a series of free star parties where the students help run the events; and 5) A website and a number of social networking strategies that highlight our youth's artwork.

  6. Suicidal ideation and migration aspirations among youth in central Mexico.

    Science.gov (United States)

    Hoffman, Steven

    2013-10-16

    Over the past 100 years the state of Guanajuato has consistently been one of the highest migrant sending states in Mexico. Youth living in high migratory states such as Guanajuato are heavily influenced by the expectation that they will travel to the US, and research has shown that those who do not migrate may be looked down upon by members of their community. This secondary analysis looks at the connection between suicidal ideation and migration aspirations among a group of adolescents living in Guanajuato, Mexico. Data were originally collected in 2007 as part of a comprehensive health survey of youth attending an alternative high schooling program. Regression analyses show that suicidal ideation predicts intentions to migrate among both males and females, while other factors differentially influence the adolescents by gender. The results indicate that suicidal ideation may be associated with migration aspirations among Mexican youth living in high migratory communities. Study limitations and implications are discussed.

  7. Fine-needle aspiration of the thyroid: an overview

    Directory of Open Access Journals (Sweden)

    Nguyen Gia-Khanh

    2005-06-01

    Full Text Available Abstract Thyroid nodules (TN are a common clinical problem. Fine needle aspiration (FNA of the thyroid now is practiced worldwide and proves to be the most economical and reliable diagnostic procedure to identify TNs that need surgical excision and TNs that can be managed conservatively. The key for the success of thyroid FNA consists of an adequate or representative cell sample and the expertise in thyroid cytology. The FNA cytologic manifestations of TNs may be classified into seven working cytodiagnostic groups consisting of a few heterogenous lesions each to facilitate the differential diagnosis. Recent application of diagnostic molecular techniques to aspirated thyroid cells proved to be useful in separating benign from malignant TNs in several cases of indeterminate lesions.

  8. ENGLISH TEACHERS’ MASTERY OF THE ENGLISH ASPIRATION AND STRESS RULES

    Directory of Open Access Journals (Sweden)

    Arina Isti'anah

    2014-01-01

    Full Text Available This  paper  tries  to  observe  the  English  teachers’  awareness  and representation  of  the  English  aspiration  and  stress  rules.  The research purposes to find out whether or not the teachers are aware of the English aspiration and stress rules,  and to find out how the teachers represent the English aspiration and stress rules. Based on the analysis, it can be concluded that the teachers’ awareness of the English aspiration and stress rules is very low. It is indicated with the percentage which equals to 44% and 48% for English aspiration and  stress  rules.  In  representing  the  English  aspiration  and  stress rules, the teachers face the problems in producing aspiration in the pronunciation,  placing  the  right  stress  and  pronouncing  three  and four  X  in  the  coda  position.  There  are  two  reasons  affecting  the teachers’  awareness  of  the  English  aspiration  and  stress  rules namely exposure and L1 influence. Artikel  ini  bertujuan  untuk  meneliti  kesadaran  dan  representasi aturan aspirasi dan tekanan oleh guru bahasa Inggris. Penelitian ini bertujuan  untuk  menjelaskan  apakah  guru  bahasa  Inggris mempunyai  kesadaran  atas  aturan  aspirasi  dan  tekanan  dalam bahasa  Inggris,  dan    untuk  menunjukkan  bagaimana  guru  Bahasa Inggris  mewujudkan  aturan  aspirasi  dan  tekanan  dalam  pelafalan mereka.  Berdasarkan  analisis  yang  dilakukan,  dapat  disimpulkan bahwa  kesadaran  guru  Bahasa  Inggris  atas  aturan  aspirasi  dan tekanan  dalam  Bahasa  Inggris  masih  sangat  rendah.  Hal  tersebut ditunjukkan  oleh  rendahnya  prosentase  dalam  perwujudan  aturan aspirasi  dan  tekanan:  44%  dan  48%.  Dalam  mewujudkan  aturan aspirasi dan tekanan, guru Bahasa Inggris menemui masalah dalam menghasilkan  aspirasi  dalam  pelafalan,  meletakkan  tekanan  pada

  9. Ultrasound guided aspiration cytology of neck mass except thyroid mass

    International Nuclear Information System (INIS)

    Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik; Suh, Jung Ho; Park, Cheong Soo; Lee, Gwang Gil

    1988-01-01

    Results of ultrasound guided aspiration cytology of extrathyroidal neck masses of 73 patients were reviewed. Included cases were 23 malignant lesions; 16 metastatic tumors, 4 lymphomas, 3 salivary gland tumors and 50 benign lesions: 24 tuberculous lymphadenites, 15 abscess, 3 benign lymph node hyperplasias, etc. There were one case of false negative and none of false positive result for malignancy. In two cases of malignancy, insufficient cellular material was obtained. In one case of lymphoma, and a benign lymph node hyperplasia, it was difficult to distinguish between benignancy and malignancy on cytologic smear. For the malignant lesions, sensitivity was 83%, specificity was 98%, and overall accuracy was 93%. There were none who had suffered adverse effect from the procedure. Ultrasound guided aspiration cytology seems to be simple, accurate and safe diagnostic modality for neck masses especially in condition that malignancy can not be excluded

  10. Advances in the Management of Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Kamala Swarnam

    2012-01-01

    Full Text Available Meconium aspiration syndrome (MAS is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN. This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO use. In this paper, we review the current understanding of the pathophysiology and management of MAS.

  11. Advances in the Management of Meconium Aspiration Syndrome

    Science.gov (United States)

    Swarnam, Kamala; Soraisham, Amuchou S.; Sivanandan, Sindhu

    2012-01-01

    Meconium aspiration syndrome (MAS) is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN). This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO) has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO) use. In this paper, we review the current understanding of the pathophysiology and management of MAS. PMID:22164183

  12. Bile acid aspiration in suspected ventilator-associated pneumonia.

    Science.gov (United States)

    Wu, Yu-Chung; Hsu, Po-Kuei; Su, Kang-Cheng; Liu, Lung-Yu; Tsai, Cheng-Chien; Tsai, Shu-Ho; Hsu, Wen-Hu; Lee, Yu-Chin; Perng, Diahn-Warng

    2009-07-01

    The aims of this study were to measure the levels of bile acids in patients with suspected ventilator-associated pneumonia (VAP) and provide a possible pathway for neutrophilic inflammation to explain its proinflammatory effect on the airway. Bile acid levels were measured by spectrophotometric enzymatic assay, and liquid chromatography mass spectrometry was used to quantify the major bile acids. Alveolar cells were grown on modified air-liquid interface culture inserts, and bile acids were then employed to stimulate the cells. Reverse transcriptase polymerase chain reaction and Western blots were used to determine the involved gene expression and protein levels. The mean (+/- SE) concentration of total bile acids in tracheal aspirates was 6.2 +/- 2.1 and 1.1 +/- 0.4 mumol/L/g sputum, respectively, for patients with and without VAP (p VAP group (p aspiration may reduce the intensity of neutrophilic inflammation in intubated and mechanically ventilated patients in the ICU.

  13. Recurrent aspiration pneumonia associated with giant aortic aneurysm

    OpenAIRE

    Hoff, Leonardo Santos; Schestatsky, Pedro

    2014-01-01

    A 83-year-old woman presented to the emergency department with fever, productive cough and dyspnea. She was previously diagnosed with dementia and systemic hypertension, and was heavy smoker for nearly 50 years. Her relatives reported that in the past four months she was admitted two times for aspiration pneumonia. Chest radiography showed right lower lobe consolidation and a large mediastinal mass (Panel A). A computed tomography angiography revealed a 10,2 cm descending aortic aneurysm comp...

  14. ROLE OF BONE MARROW ASPIRATION IN DIAGNOSIS OF HAEMATOLOGICAL DISORDER

    Directory of Open Access Journals (Sweden)

    Poonam Nanwani

    2017-03-01

    Full Text Available BACKGROUND The bone marrow examination is an essential investigation for the diagnosis of disorders of the blood and bone marrow. This simple and relatively safe procedure is important, particularly in resource poor centres since access to adjuvant diagnostic techniques are often lacking or absent. MATERIALS AND METHODS 189 patients of all age groups were studied for haematological and non-haematological disorders by bone marrow aspiration in the Department of Pathology, MGM Medical College during the period of 2014 to 2016. RESULTS Majority of the patients who had bone marrow aspiration were aged 0-15 years. The male-to-female ratio was 1:1.03. Most (97% of the marrow aspirate examined had definitive pathologic features, while 14 (7% were normal marrow elements. Out of 189 cases of bone marrow aspiration, acute leukaemia was the most common haematological disease diagnosed using this procedure. Acute lymphoblastic leukaemia was more common than acute myeloid leukaemia. Aplastic anaemia was seen in 16% cases. Megaloblastic anaemia occurred more commonly than other anaemias. Megaloblastic anaemia was seen in 13 cases (7% and microcytic anaemia was seen in 5 cases (3%. There were 10 cases (5% of Idiopathic Thrombocypenic Purpura. Myelodysplastic syndrome and multiple myeloma was seen in 7% and 2% cases respectively. Storage disorder was seen in 3 cases (2%, out of this 02 cases were Gaucher’s disease and one case was Niemann-Pick’s disease. CONCLUSION Bone marrow examination is an important step to arrive at the confirmatory diagnosis of many haematological disorders. This procedure remains a veritable tool in the diagnosis and management of a wide range of haematological diseases, especially in a resource poor centre.

  15. Aspiration for acute pilonidal abscess-a cohort study.

    Science.gov (United States)

    Lasithiotakis, Konstantinos; Aghahoseini, Assad; Volanaki, Dimitra; Peter, Mark; Alexander, David

    2018-03-01

    The traditional open incision and drainage of a pilonidal abscess is associated with slow healing and delayed return to normal daily activities. The aim of this study is to assess safety, effectiveness, and patient satisfaction of aspiration followed by antibiotics for a pilonidal abscess. All patients presenting with an acute pilonidal abscess during the period December 2010 and December 2014 in York Hospital, UK, were treated with bedside aspiration under local anesthetic, followed by oral cefalexin and metronidazole for 7 days. Patients with immunosuppression, diabetes, overlying skin necrosis, and perforation were excluded. Complications of the procedure were prospectively recorded. Long-term outcomes and overall patients' satisfaction were assessed with the use of mailed questionnaires and Visual Analogue Scales (VAS) (0 = not satisfied at all, 10 = very satisfied). One hundred sixty-nine patients presented with an acute pilonidal abscess and a total of 100 patients were treated with aspiration and antibiotics. There were 50 women (50%) and the median (interquartile range [IQR]) age of the cohort was 24 (14) years. Eleven patients had a history of a previous pilonidal procedure. Seven patients were treated successfully with a reaspiration. Overall, 10 patients required incision and drainage after a median (IQR) follow-up time of 29 (47) months. Fifty-six patients returned completed questionnaires. The median (IQR) of the VAS for the overall satisfaction of the procedure was 9 (5). Aspiration of a pilonidal abscess in selected patients is effective in 83%, and it is associated with high overall satisfaction rates. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Fine Needle Aspiration Biopsy in a Rural Family Practice

    African Journals Online (AJOL)

    ultrasound scan. A 21-gauge 1½-inch or 23-gauge 1¼-inch needle, attached to a 10-mL disposable plastic syringe, was used for FNAB of superficial masses. For percutaneous FNAB of deep-seated organs and masses, a 23 gauge 1¼-inch needle or 3½-inch spinal needle was used. The aspirate was spread on slides and ...

  17. Migration aspirations in Ukraine: Human rights violations as migration drivers

    OpenAIRE

    Borshchevska, Yuliya

    2014-01-01

    Ukraine is ranked highly among emigration countries and in particular among countries supplying labor migrants to the EU and Russia. The slumping economy and deteriorating political situation with an increasing number of authoritarian traits logically evoke the question of how non-economic motivation factors impact migration aspirations in Ukraine. The worsening human rights situation in the country is, in a way, seen as a separate matter and is not always associated with migration. This arti...

  18. Nurses' leadership self-efficacy, motivation, and career aspirations.

    Science.gov (United States)

    Cziraki, Karen; Read, Emily; Spence Laschinger, Heather K; Wong, Carol

    2018-02-05

    Purpose This paper aims to test a model examining precursors and outcomes of nurses' leadership self-efficacy, and their aspirations to management positions. Design/methodology/approach A cross-sectional survey of 727 registered nurses across Canada was conducted. Structural equation modelling using Mplus was used to analyse the data. Findings Results supported the hypothesized model: χ 2 (312) = 949.393; CFI = 0.927; TLI = 0.919; RMSEA = 0.053 (0.049-0.057); SRMR 0.044. Skill development opportunities ( ß = 0.20), temporary management roles ( ß = 0.12) and informal mentoring ( ß = 0.11) were significantly related to nurses' leadership self-efficacy, which significantly influenced motivation to lead ( ß = 0.77) and leadership career aspirations ( ß = 0.23). Motivation to lead was significantly related to leadership career aspirations ( ß = 0.50). Practical implications Nurses' leadership self-efficacy is an important determinant of their motivation and intention to pursue a leadership career. Results suggest that nurses' leadership self-efficacy can be influenced by providing opportunities for leadership mastery experiences and mentorship support. Leadership succession planning should include strategies to enhance nurses' leadership self-efficacy and increase front-line nurses' interest in leadership roles. Originality value With an aging nurse leader workforce, it is important to understand factors influencing nurses' leadership aspirations to develop and sustain nursing leadership capacity. This research study makes an important contribution to the nursing literature by showing that nurses' leadership self-efficacy appears to be an important determinant of their motivation to lead and desire to pursue a career as a nurse leader.

  19. The effect of hyperbaric oxygen treatment on aspiration pneumonia.

    Science.gov (United States)

    Sahin, Sevtap Hekimoglu; Kanter, Mehmet; Ayvaz, Suleyman; Colak, Alkin; Aksu, Burhan; Guzel, Ahmet; Basaran, Umit Nusret; Erboga, Mustafa; Ozcan, Ali

    2011-08-01

    We have studied whether hyperbaric oxygen (HBO) prevents different pulmonary aspiration materials-induced lung injury in rats. The experiments were designed in 60 Sprague-Dawley rats, ranging in weight from 250 to 300 g, randomly allotted into one of six groups (n = 10): saline control, Biosorb Energy Plus (BIO), hydrochloric acid (HCl), saline + HBO treated, BIO + HBO treated, and HCl + HBO treated. Saline, BIO, HCl were injected into the lungs in a volume of 2 ml/kg. A total of seven HBO sessions were performed at 2,4 atm 100% oxygen for 90 min at 6-h intervals. Seven days later, rats were sacrificed, and both lungs in all groups were examined biochemically and histopathologically. Our findings show that HBO inhibits the inflammatory response reducing significantly (P edema, alveolar exudate, alveolar histiocytes, interstitial fibrosis, granuloma, and necrosis formation in different pulmonary aspiration models. Pulmonar aspiration significantly increased the tissue HP content, malondialdehyde (MDA) levels and decreased (P < 0.05) the antioxidant enzyme (SOD, GSH-Px) activities. HBO treatment significantly (P < 0.05) decreased the elevated tissue HP content, and MDA levels and prevented inhibition of SOD, and GSH-Px (P < 0.05) enzymes in the tissues. Furthermore, there is a significant reduction in the activity of inducible nitric oxide synthase, TUNEL and arise in the expression of surfactant protein D in lung tissue of different pulmonary aspiration models with HBO therapy. It was concluded that HBO treatment might be beneficial in lung injury, therefore, shows potential for clinical use.

  20. Assessment of difficult laryngoscopy by electronically measured maxillo-pharyngeal angle on lateral cervical radiograph: A prospective study

    Directory of Open Access Journals (Sweden)

    Gupta Kumkum

    2010-01-01

    Full Text Available Background: Difficult airway continued to be a major cause of anesthesia-related morbidity and mortality. Successful airway management depends on direct laryngoscopy and tracheal intubation. Difficult laryngoscopy is a resultant of incomplete structural arrangements during the process of head positioning. Through clinical history,examination of the patients along with craniofacial indices alerts the anesthetist for difficult laryngoscopy. But it does not predict all causes of difficult laryngoscopy during pre-anesthetic evaluation. The maxillo-pharyngeal angle, an upper airway anatomical balance, was proposed for better understanding the pathophysiology of difficult laryngoscopy. In our study we have assess difficult laryngoscopy by electronically measuring maxillo-pharyngeal angles on a lateral cervical radiograph. This angle is normally greater than 100 o . Less than 90 o angle suggests either impossible or difficult direct laryngoscopy when all known craniofacial indices were within the normal range. Cervical radiographic assessment is a simple, economical, and non-invasive predictive method for difficult laryngoscopy. It should be used routinely along with other indices as pre-anesthetic airway assessment criteria to predict the difficult laryngoscopy. Context: Difficulties with airway management continue to be a major cause of anesthesia-related morbidity, mortality, and litigation. Pre-operative assessment of difficult laryngoscopy by the simple and non-invasive radiological method can help to prevent them. Aims: To assess the difficult laryngoscopy pre operatively by a simple and non invasive radiological method by electronically measuring maxillo-pharyngeal angle on a lateral cervical radiograph and it′s correlation with Cormack and Lehane grading. Settings and Design: This is a controlled, nonrandomized, prospective, cohort observation study. Patients and Methods: The 157 adult consented patients of ASA grade I to III of either sex